# US 10,441,294 B2 · System for the treatment of a planned volume of a body part

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- Number: US 10,441,294 B2
- Document ID: US10441294B2
- Status: Granted
- Kind: B2
- Application number: 14/896,900
- Filed: 2014-06-11
- Published: 2016-04-28
- Granted: 2019-10-15
- Earliest claimed: 2013-06-11
- Assignees: Depuy Ireland Unlimited Company
- Applicants: DePuy Ireland Unlimited Company
- Inventors: Stephane Lavallee; Matias De La Fuente Klein; Klaus Radermacher; Annegret Niesche; Meiko Muller; Gregory Dez; Herve Collet
- Web page: https://patentgrep.com/patent/US10441294B2

## CPC

- A61B 17/154: {for preparing bone for knee prosthesis}
- A61B 17/15: Guides therefor
- A61B 17/17: Guides {or aligning means} for drills {, mills, pins or wires}
- A61B 17/1764: {for the knee}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/30: Surgical robots
- A61B 34/70: {Manipulators specially adapted for use in surgery}
- B25J 9/0009: {Constructional details, e.g. manipulator supports, bases}
- B25J 15/0019: {End effectors other than grippers}
- A61B 17/1742: {for the hip}
- A61B 34/25: {User interfaces for surgical systems}
- A61B 2034/104: {Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/304: {including a freely orientable platform, e.g. so called 'Stewart platforms'}
- Y10S 901/09: Closed loop, sensor feedback controls arm movement
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- B25J: MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES ({manipulators specially adapted for use in surgery A61B34/70; manipulators used in cleaning hollow articles B08B9/04}; manipulators associated with rolling mills B21B39/20; manipulators associated with forging machines B21J13/10; {manipulators associated with picking-up and placing mechanisms B23P19/007}; means for holding wheels or parts thereof B60B30/00; {vehicles with ground-engaging propulsion means, e.g. walking members B62D57/02, B62D57/032; devices for picking-up and depositing articles or materials between conveyors B65G47/90, B65G47/91; manipulators with gripping or holding means for transferring packages B65H67/065}; cranes B66C; {manipulators used in the protection or supervision of pipe-line installations F17D5/00; walking equipment adapted for nuclear steam-generators F22B37/006}; manipulators specially adapted for, or associated with, nuclear reactors G21C; {apparatus used for handling wafers during manufacture or treatment of semiconductor H10P72/50})
- Y10S: TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS

## Abstract

The invention relates to a surgical system comprising: (i) a handheld device (100) comprising: a base (1), an end-effector (2) for mounting a surgical tool or tool guide, an actuation unit (4) connected to said base (1) and end-effector (2), a support unit (5) designed to make contact with the treated part to be treated or an adjacent region to provide a partial mechanical link between the base (1) or end-effector (2), and the part to be treated, (ii) a tracking unit (200), (iii) a control unit (300) configured to: (a) compute in real time an optimized path of the end-effector, (b) detect whether said computed path of the tool or end-effector can be achieved without changing the pose of the base, and, if not, determine a possible repositioning of the base with respect to the part to be treated, (c) configure the actuation unit so as to move the end-effector according to said computed path, and (d) iterate steps (a) to (c) until the planned volume has been treated, (iv) a user interface (400).

## Claims

### Claim 1

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated, the support unit configured so that reaction forces exerted on the partial mechanical link by the part to be treated or the region of the patient's body adjacent to the part to be treated are directed towards a proximal end of the handheld device;
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated;
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path, and
(d) iterate steps (a) to (c) until the planned volume has been treated; and
(iv) a user interface configured to indicate feedback information from the control unit to the user.

### Claim 2 (depends on 1)

The system of claim 1, wherein a tool guide is mounted on the end-effector and the support unit comprises the tool guide.

### Claim 3 (depends on 1)

The system of claim 1, wherein the support unit comprises at least one sensor for detecting a force exerted by the user on the partial mechanical link and wherein the control unit is configured to check whether said force is greater than a threshold such that the support unit has a minimal damping parameter.

### Claim 4 (depends on 1)

The system of claim 1, wherein the support unit comprises at least one damping element, such that said mechanical link created between the base or end-effector and the part to be treated is able to absorb reaction forces exerted by the treated part onto the tool.

### Claim 5 (depends on 4)

The system of claim 4, wherein the damping characteristics of said at least one damping element are adjustable.

### Claim 6 (depends on 1)

The system of claim 1, wherein the support unit comprises at least one pin having at least one rigid or damped degree of freedom.

### Claim 7 (depends on 1)

The system of claim 1, wherein the support unit comprises at least one pad with a surface configured to adhere to patient soft tissue adjacent to the part to be treated.

### Claim 8 (depends on 1)

The system of claim 1, wherein the support unit comprises a first portion connected to the base or the end-effector and a second portion intended to at least fit or to be fixed to the part to be treated or to a part of the patient adjacent to the part to be treated.

### Claim 9 (depends on 8)

The system of claim 8, wherein the connection between the first and second portions of the support unit includes a hook-and-loop fastener or a magnetic fastener.

### Claim 10 (depends on 1)

The system of claim 1, wherein the support unit comprises a hand grip configured to be held by the other user's hand.

### Claim 11 (depends on 1)

The system of claim 1, wherein the support unit is articulated with respect to the base.

### Claim 12 (depends on 1)

The system of claim 1, wherein the surgical tool is articulated with respect to the end-effector.

### Claim 13 (depends on 1)

The system of claim 1, wherein the control unit is configured to stop at least one of the actuation unit and the tool if said control unit detects that the current pose of the tool is outside of the planned volume.

### Claim 14 (depends on 1)

The system of claim 1, wherein the support unit comprises a holding arm connected to the base of the handheld device and configured to be connected to a mechanical support.

### Claim 15 (depends on 1)

The system of claim 1, further comprising a planning system configured to determine a volume to be treated by the tool.

### Claim 16 (depends on 1)

The system of claim 1, wherein a drill guide or a saw guide is comprised in the end-effector or in the support unit and the tool is a drill or a saw that is intended to be moved within the axis or the plane of said guide.

### Claim 17 (depends on 1)

The system of claim 1, wherein the surgical tool comprises a saw, a drill, a mill, a shaver or a burr.

### Claim 18 (depends on 1)

The system of claim 1, wherein the tracking unit comprises at least one emitter and at least one sensor, said at least one emitter being mounted on the base or on the end-effector and said at least one sensor being adapted to be mounted on the part to be treated.

### Claim 19 (depends on 1)

The system of claim 1, wherein the feedback information provided by the user interface comprises an indication of whether said computed path is achievable without changing the pose of at least one of the base and the support unit with respect to the part to be treated, and, if not, an indication of a possible repositioning of at least one of the base and the support unit determined by the control unit.

### Claim 20 (depends on 1)

The system of claim 1, further comprising a cable extending from a spring pulley, said cable supporting the base of the handheld device.

### Claim 21 (depends on 14)

The system of claim 14, wherein the mechanical support is an operating table.

### Claim 22 (depends on 15)

The system of claim 15, wherein the planning system is further configured to determine at least one processing parameter of the tool.

### Claim 23

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated,
wherein the support unit comprises a first portion connected to the base or the end-effector and a second portion intended to at least fit or to be fixed to the part to be treated or to a part of the patient adjacent to the part to be treated, the connection between the first and second portions of the support unit including a hook-and-loop fastener or a magnetic fastener,
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated,
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path, and
(d) iterate steps (a) to (c) until the planned volume has been treated,
(iv) a user interface configured to indicate feedback information from the control unit to the user.

### Claim 24

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body, the end-effector defining a longitudinal axis extending therethrough,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated,
wherein the element is off-axis fron the longitudinal axis of the end effector;
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated,
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path, and
(d) iterate steps (a) to (c) until the planned volume has been treated,
(iv) a user interface configured to indicate feedback information from the control unit to the user.

### Claim 25

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated, the support unit configured so that the element does not obstruct the path of the end effector;
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated,
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path, and
(d) iterate steps (a) to (c) until the planned volume has been treated,
(iv) a user interface configured to indicate feedback information from the control unit to the user.

### Claim 26 (depends on 25)

The system of claim 25, wherein the support unit comprises at least one resilient damping element.

### Claim 27 (depends on 26)

The system of claim 26, wherein the resilient damping element comprises a spring.

### Claim 28

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated,
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated;
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path, and
(d) iterate steps (a) to (c) until the planned volume has been treated; and
(iv) a user interface configured to indicate feedback information from the control unit to the user;
wherein the support unit comprises at least one sensor for detecting a force exerted by the user on the partial mechanical link and wherein the control unit is configured to check whether said force is greater than a threshold such that the support unit has a minimal damping parameter.

### Claim 29

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated,
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated;
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path, and
(d) iterate steps (a) to (c) until the planned volume has been treated; and
(iv) a user interface configured to indicate feedback information from the control unit to the user;
wherein the support unit comprises at least one pad with a surface configured to adhere to patient soft tissue adjacent to the part to be treated.

### Claim 30

A surgical system comprising:
(i) a handheld device comprising:
a base configured to be held in a user's hand,
an end-effector for mounting a surgical tool or a tool guide for guiding the surgical tool, said surgical tool being configured to treat a planned volume of a part of a patient's body,
an actuation unit connected to said base and said end-effector for moving said surgical tool or tool guide with respect to the base in order to treat said planned volume,
a support unit connected to the base or to the end-effector, comprising at least one element configured to make contact with the part to be treated or a region of the patient's body adjacent to the part to be treated so as to provide a partial mechanical link between the base or the end-effector and the part to be treated,
(ii) a tracking unit configured to determine in real time a measured pose of at least one of the tool, the end-effector and the base with respect to the part to be treated;
(iii) a control unit configured to:
(a) compute in real time an optimized path of the tool or of the end-effector with respect to the base depending on said measured pose as determined by the tracking unit,
(b) detect whether said optimized path of the tool or of the end-effector can be achieved without changing the pose of the base, and, if this is not the case, determine a possible repositioning of the base with respect to the part to be treated,
(c) configure the actuation unit so as to move the end-effector according to said computed path,
(d) iterate steps (a) to (c) until the planned volume has been treated; and
(iv) a user interface configured to indicate feedback information from the control unit to the user; and
(v) a cable extending from a spring pulley, said cable supporting the base of the handheld device.

### Claim 31 (depends on 1)

The system of claim 1, wherein the partial mechanical link is configured to be non-invasive as the end effector is moved along the computed path.

### Claim 32 (depends on 1)

The system of claim 1, wherein the surgical tool extends distally beyond the distal end of the partial mechanical link.