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US-12616535-B2 - Systems and methods for handheld robotic surgery

US12616535B2US 12616535 B2US12616535 B2US 12616535B2US-12616535-B2

Abstract

A robotic surgery system for cutting a bone of a patient includes a handheld manipulator configured to be manually moved in a global coordinate system relative to the bone. The handheld manipulator includes a cutting tool, a handle, and an actuator coupled between the handle and the cutting tool such that the actuator is configured to move the cutting tool relative to the handle. The system also includes a controller programmed to control the actuator to compensate for both operator tremor and patient movement.

Inventors

  • Hyosig Kang
  • Scott Nortman

Assignees

  • MAKO SURGICAL CORP.

Dates

Publication Date
20260505
Application Date
20240730

Claims (16)

  1. 1 . A robotic surgery system for cutting a bone of a patient, comprising: a handheld manipulator configured to be manually moved relative to the bone, the handheld manipulator comprising: a cutting tool; a handle; and an actuator coupled between the handle and the cutting tool such that the actuator is configured to move the cutting tool relative to the handle; a mechanical tracking arm coupled to the handle and configured to be coupled to the patient so as to extend between the handheld manipulator and the patient; and a controller programmed to control the actuator to compensate for both operator tremor and patient movement.
  2. 2 . The robotic surgery system of claim 1 , wherein the controller is programmed to detect the operator tremor by detecting movements having greater than a threshold frequency.
  3. 3 . The robotic surgery system of claim 1 , wherein the controller is programmed to control the actuator by identifying a portion of the patient as an attractive volume and causing the actuator to move the cutting tool towards the attractive volume in response to the operator tremor or the patient movement.
  4. 4 . The robotic surgery system of claim 1 , further comprising a display screen, wherein the controller is programmed to cause the display screen to display an interaction between the cutting tool and an anatomical structure.
  5. 5 . The robotic surgery system of claim 1 , further comprising an intraoperative imaging system configured to verify positioning of surgical structures.
  6. 6 . The robotic surgery system of claim 1 , wherein the controller is programmed to automatically adjust an oscillating frequency or reciprocating frequency of the cutting tool based on a position of the cutting tool relative to a planned region.
  7. 7 . The robotic surgery system of claim 1 , wherein the actuator is configured to move the cutting to relative to the handle in a plurality of degrees of freedom.
  8. 8 . The robotic surgery system of claim 7 , wherein the plurality of degrees of freedom comprising at least two rotational degrees of freedom and at least one translational degree of freedom.
  9. 9 . A method for a robotic surgery system for cutting a bone of a patient, comprising: tracking, by a mechanical tracking arm coupled to the patient and to a handle of a handheld manipulator so as to extend between the handheld manipulator and the patient, movement of the handheld manipulator relative to the bone, wherein the handheld manipulator is configured to be manually moved relative to the bone; detecting an operator tremor based on the tracking; detecting a patient movement based on the tracking; and automatically controlling, by a controller, an actuator of the handheld manipulator to compensate for the operator tremor and the patient movement, wherein the actuator is coupled between the handle and a cutting tool of the handheld manipulator such that the actuator is configured to move the cutting tool relative to the handle.
  10. 10 . The method of claim 9 , wherein detecting the operator tremor comprising detecting relative movement above a first frequency and detecting the patient movement comprised detecting movement below a second frequency, the second frequency lower than the first frequency.
  11. 11 . The method of claim 9 , wherein automatically controlling the actuator of the handheld manipulator comprises implementing, in a controller, an attractive volume corresponding to an intended region of interaction between the cutting tool and the patient.
  12. 12 . The method of claim 11 , further comprising displaying a representation of the interaction between the cutting tool and the patient on a display screen.
  13. 13 . The method of claim 9 , wherein the cutting tool is a rotary cutting tool, and wherein the method further comprises automatically adjusting a rotational frequency of the rotary cutting tool to different frequencies based on the movement of the handheld manipulator relative to the patient.
  14. 14 . The method of claim 9 , wherein the cutting tool is a reciprocating cutting tool, and wherein the method further comprises automatically adjusting an oscillating frequency of the reciprocating cutting tool to different frequencies based on the movement of the handheld manipulator relative to the patient.
  15. 15 . The method of claim 9 , further comprising: modifying a bone surface of the patient using the cutting tool; placing an implant on the bone surface; and capturing an intraoperative fluoroscopic or ultrasonic image to verify a placement of the implant on the bone surface.
  16. 16 . The method of claim 9 , wherein automatically controlling the actuator comprises causing the actuator to move the cutting tool relative to the handle in a plurality of degrees of freedom.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application is a continuation of U.S. application Ser. No. 17/960,974 filed Oct. 6, 2022, which is a continuation of U.S. application Ser. No. 16/731,640 filed Dec. 31, 2019, which is a continuation of U.S. application Ser. No. 15/804,246, filed Nov. 6, 2017, which is a divisional of U.S. application Ser. No. 15/408,175, filed Jan. 17, 2017, which is a continuation of U.S. application Ser. No. 14/736,792, filed Jun. 11, 2015, which is a divisional of U.S. application Ser. No. 13/276,099, filed Oct. 18, 2011, all of which are hereby incorporated by reference herein in their entireties. FIELD OF THE INVENTION The present invention relates generally to surgical systems, and more specifically to systems and methods for positioning and orienting tools during surgical procedures. BACKGROUND Minimally invasive surgery (MIS) is the performance of surgery through incisions that are considerably smaller than incisions used in traditional surgical approaches. For example, in an orthopedic application such as total knee replacement surgery, an MIS incision length may be in a range of about 4 to 6 inches, whereas an incision length in traditional total knee surgery is typically in a range of about 6 to 12 inches. As a result of the smaller incision length, MIS procedures are generally less invasive than traditional surgical approaches, which minimizes trauma to soft tissue, reduces post-operative pain, promotes earlier mobilization, shortens hospital stays, and speeds rehabilitation. MIS presents several challenges for a surgeon. For example, in minimally invasive orthopedic joint replacement, the small incision size may reduce the surgeon's ability to view and access the anatomy, which may increase the complexity of sculpting bone and assessing proper implant position. As a result, accurate placement of implants may be difficult. Conventional techniques for counteracting these problems include, for example, surgical navigation, positioning the subject patient limb for optimal joint exposure, and employing specially designed, downsized instrumentation and complex surgical techniques. Such techniques, however, typically require a large amount of specialized instrumentation, a lengthy training process, and a high degree of skill. Moreover, operative results for a single surgeon and among various surgeons are not sufficiently predictable, repeatable, and/or accurate. As a result, implant performance and longevity varies among patients. To assist with MIS and conventional surgical techniques, advancements have been made in surgical instrumentation, and in technologies for understanding the spatial and rotational relationships between surgical instruments and tissue structures with which they are intervening during surgery. For example, instruments for calcified tissue intervention that are smaller, lighter, and more maneuverable than conventional instruments have become available, such as handheld instruments configured to be substantially or wholly supported manually as an operator creates one or more holes, contours, etc. in a subject bony tissue structure. In certain surgical scenarios, it is desirable to be able to use such handheld type instrumentation while understanding where the working end of the pertinent tools are relative to the anatomy. In particular, it is desirable to be able to control the intervention such that there are no aberrant aspects, wherein bone or other tissue is removed outside of the surgical plan, as in a situation wherein a surgical operator has a hand tremor that mistakenly takes the cutting instrument off path, or wherein a patient moves unexpectedly, thereby taking the instrument off path relative to subject tissue structure. There is a need for handheld systems that are capable of assisting a surgeon or other operator intraoperatively by compensating for aberrant movements or changes pertinent to the spatial relationship between associated instruments and tissue structures. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1A illustrates a handheld bone cutting tool adjacent various tissue structures of the skeleton. FIG. 1B illustrates a close in view of a handheld bone cutting tool adjacent a femur, both of which reside in a common global coordinate system. FIG. 1C illustrates an embodiment wherein an optical tracking system is utilized to track one or more of a targeted tissue structure and a cutting tool. FIG. 1D illustrates an embodiment wherein an optical tracking system is utilized to track one or more of a targeted tissue structure and a cutting tool, which may be coupled to a robotic arm. FIG. 1E illustrates an embodiment wherein two mechanical tracker linkages are utilized to monitor the spatial positions of a targeted tissue structure and an interventional tool. FIG. 1F illustrates an embodiment wherein a mechanical tracker linkage is utilized to monitor the spatial relationship between a targeted tissue structure and an interventional tool. FIG