EP-4452092-B1 - BILATERAL ROBOTIC SPINAL ENDOSCOPY

Inventors

• BAR, YOSSI

Dates

Publication Date

20260513

Application Date

20220922

Claims (7)

1. A system for robotically coordinated spinal endoscopy at a patient's target anatomy in a surgical field, said system comprising: a robotic system comprising at least three robotic arms (104, 105, 106) mounted on a single chassis housing a central control unit; a first robotic arm (104) of the at least three robotic arms holding a device providing a first minimally invasive working channel configured to carry a first thin and rigid wire (113) to the surgical field from a first side of a patient's body; a second robotic arm (105) of the at least three robotic arms holding a device providing a second minimally invasive working channel configured to carry a second thin and rigid wire (112) to the surgical field from a second side of the patient's body; a third robotic arm (105) of the at least three robotic arms holding an imaging device (107) or sensor; and at least one marker element (115, 116) attached to an aspect of the patient's bony anatomy in the surgical field; characterized in that wherein the central control unit is configured to position the first and second minimally invasive working channels to locate the first and second thin and rigid wires (113, 112) carried by the first and second minimally invasive working channels at the target anatomy and to detect contact between the wires to confirm proper placement of the minimally invasive working channels; wherein the first minimally invasive working channel and the second minimally invasive working channel are configured to provide safe access to the surgical field without the need for x-ray radiation and without risking damage to delicate nervous system structures.
2. The system of claim 1, wherein the robotic system is mobile.
3. The system of claim 1, wherein the imaging device (107) or sensor is a surgical navigation camera.
4. The system of claim 1, wherein at least two marker elements (115, 116) are attached to two adjacent aspects of the patient's bony anatomy in the surgical field.
5. The system of any of the preceding claims, wherein the movement of the robotic arms (104, 105, 106) is robotically coordinated by the central control unit relative to a single origin point.
6. The system of claim 3, wherein the first robotic arm (104) and the second robotic arm (105) are positioned by the central control unit in position with respect to the patient's bony anatomy with the assistance of the surgical navigation camera (107).
7. The system of any of the preceding claims, wherein the central control unit is further configured to detect electrical contact between the first thin rigid wire (113) and the second thin rigid wire (112).

Description

FIELD OF THE INVENTION The invention relates to systems and method for robotically controlled and coordinated spinal endoscopy procedures. In particular, the invention relates to robotic systems comprising multiple robotic elements, such as robotic arms, end effectors, surgical instruments, cameras, imaging devices, tracking devices, sensors or other devices useful for robotic spinal endoscopy. The invention also relates to robotic systems wherein the placement and movement of the robotic elements are controlled and coordinated by a single control unit, and wherein all of the robotic elements are based on a single rigid mobile chassis and, thus, are robotically coordinated at a single origin point. Specifically, multiple robotic elements may be attached to, and controlled by, a single control unit and may be used in a coordinated fashion to deploy and/or relate to surgical instruments, trackers, cameras, and other surgical tools as part of a robotic spinal endoscopy procedure. More particularly, in the context of robotic spinal surgery, multiple end effectors may be deployed on multiple robotic arms and controlled by a single control unit and may be used in a centrally coordinated fashion to perform a robotic surgical procedure, with the relative movements of each robotic element being coordinated by the central control unit. Most particularly, in the context of minimally invasive spinal endoscopy procedures, the safety, efficiency and precision of a bilateral approach to the procedure may be enabled by surgical tools, sensors and cameras being deployed on multiple robotic arms that are controlled in a synchronized and coordinated fashion to perform a safe and efficient surgical procedure. BACKGROUND OF THE INVENTION Robotic surgery is well known in the art, as is the application of robotic techniques to spinal surgery procedures. Many robotic surgery systems, such as the da Vinci robotic surgery system from Intuitive Surgical, are teleoperated. Multi-arm robotic surgical systems are available in the field, for example those provided by Cambridge Medical Robotics, but these known systems are often also teleoperated and are all comprised of single arms deployed separately on separate carts or chassis with some level of coordination provided by a remotely-positioned control unit. Systems comprising multiple arms on multiple carts have significant drawbacks regarding integration into surgical workflow, along with an undesirably large footprint in the operating room. Also, the control of teleoperated units by a remotely-positioned control unit does not provide the level of control required for a full range of surgical procedures, particularly in the case of spinal surgery. Accuracy will inevitably be inferior to a system where all robotic arms are fixed to, and coordinated by, a single chassis comprising a single control unit. This is particularly important in the context of spinal endoscopy, which requires an even greater level of precision and control than other spinal surgical procedures due to the need to safely position ports/trocars and keep them in position throughout the duration of the surgical procedure. Performance of a full range of spinal surgery procedures, including spinal endoscopy, requires robotically coordinated navigation which is not available today. A typical procedure may require the maneuvering of one or more end effectors deployed by robotic arms, the deployment of other instruments, placement of multiple passive or active markers on bone and/or on soft tissue or on instruments or robotic arms, and one or more robotically controlled and maneuvered cameras that can be placed at varying distances and angulations from the surgical field, and one or more end effectors deployed by robotic arms. Such a mobile bi-lateral multi-arm/multi-camera system mounted on, and controlled by, one cart, is not available in the current state of the art. There is a strong and long-felt need for such a system as it will enable the performance of safe and precise spinal endoscopy procedures with robotically coordinated control and navigation at a level of accuracy not currently possible. A robotically coordinated bilateral approach to spinal endoscopy is likely even more preferred. The need for a centrally coordinated multi-faceted approach is felt strongly in spinal endoscopy procedures. The endoscopic approach in spinal surgery is the most minimally invasive approach and therefore is attractive to patients, surgeons and hospitals. Spinal endoscopy, despite being attractive, is not performed very often due to the difficulties and risks inherent in the procedure at current state of the art. In most applications, it is very difficult to place and maintain the ports/trocars/working channels in a safe location, with safety being defined as not impacting nervous structures. One current option for enhancing safety is the use of x-rays, but x-rays cannot visualize delicate nerve roots and there is a concern about ex