# US 10,869,728 B2 · Robotic surgery

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- Number: US 10,869,728 B2
- Document ID: US10869728B2
- Status: Granted
- Kind: B2
- Application number: 16/272,650
- Filed: 2019-02-11
- Published: 2019-09-12
- Granted: 2020-12-22
- Earliest claimed: 2002-03-20
- Assignees: P Tech, LLC
- Applicants: P Tech, LLC
- Inventors: Peter M. Bonutti
- Web page: https://patentgrep.com/patent/US10869728B2

## CPC

- A61B 34/30: Surgical robots
- A61B 5/0071: {by measuring fluorescence emission}
- A61B 6/032: {Transmission computed tomography [CT]}
- A61B 17/025: {Joint distractors}
- A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 17/0644: {penetrating the tissue, deformable to closed position}
- A61B 17/14: Surgical saws ({A61B17/1637 takes precedence;} dental saws for teeth A61C3/12)
- A61B 17/1626: {Control means; Display units}
- A61B 17/88: {Osteosynthesis instruments;} Methods or means for implanting or extracting internal {or external} fixation devices {(A61B17/7074 takes precedence)}
- A61B 17/8802: {Equipment for handling bone cement or other fluid fillers}
- A61B 17/8805: {for introducing fluid filler into bone or extracting it (A61B17/7097, A61B17/8833 take precedence)}
- A61B 17/885: {Tools for expanding or compacting bones or discs or cavities therein (A61B17/8805, A61B17/7097 take precedence)}
- A61B 17/8852: {capable of being assembled or enlarged, or changing shape, inside the bone or disc}
- A61B 17/8855: {inflatable, e.g. kyphoplasty balloons}
- A61B 17/8858: {laterally or radially expansible (inflatable A61B17/8855)}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/32: operating autonomously
- A61B 34/77: {Manipulators with motion or force scaling}
- A61B 90/03: {Automatic limiting or abutting means, e.g. for safety}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers}
- A61F 2/0063: {Implantable repair or support meshes, e.g. hernia meshes}
- A61B 17/154: {for preparing bone for knee prosthesis}
- A61B 17/8875: {Screwdrivers, spanners or wrenches}
- A61B 2017/00557: {inflatable (A61B2017/22051 takes precedence)}
- A61B 2017/0256: {for the spine}
- A61B 2017/0648: {threaded, e.g. tacks with a screw thread}
- A61B 2034/303: {specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/065: {for measuring contact or contact pressure}
- A61B 2090/3916: {Bone tissue}
- A61F 2/389: {Tibial components (A61F2/3868 takes precedence)}
- A61F 2002/30133: {kidney-shaped or bean-shaped}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

A method of using a robotic guidance system for performing surgery on a spine is provided. The method includes utilizing a computerized tomographic scan image of a location on a spinal column of a patient, such that the computerized tomographic scan image is connected to a computer and visible on a monitor connected to the computer. The method also includes attaching a coupling component to the spinal column of the patient, coupling a marker to the coupling component, and imaging, with a fluoroscope, the view of the spinal column of the patient, wherein the fluoroscope image is transmitted to the computer and visible on the monitor and the at marker is clearly visible in the fluoroscope image. The method also includes positioning a cannula, with a robotic mechanism, to a first position relative to a vertebra in the spinal column of the patient, drilling a passage through the cannula into bone of the vertebra in the spinal column of the patient, inserting a guidewire through the cannula into the passage in the bone of the vertebra in the spinal column of the patient, and positioning a screw into the bone of the vertebra in the spinal column of the patient.

## Claims

### Claim 1

A surgical robot for facilitating spine surgery, the surgical robot comprising:
a computer configured to receive a computerized image of a spinal column of a patient on whom a spinal surgical procedure is to be performed;
a monitor connected to the computer, wherein the monitor is configured to display, from the computer, the computerized image of the spinal column of the patient on whom the spinal surgical procedure is to be performed;
a robotic arm in communication with the computer; and
a cannula coupled to the robotic arm, wherein the cannula is configured to receive a surgical instrument for performing the spinal surgical procedure,
wherein the computer is configured to control the robotic arm to position the cannula relative to the spinal column of the patient during the spinal surgical procedure,
wherein the robotic arm is coupled to a base configured to be on a floor next to the patient during the spinal surgical procedure.

### Claim 2 (depends on 1)

The surgical robot set forth in claim 1, further comprising the surgical instrument received in the cannula during the spinal surgical procedure.

### Claim 3 (depends on 2)

The surgical robot set forth in claim 2, wherein the surgical instrument is configured to insert an implant into the spinal column of the patient.

### Claim 4 (depends on 2)

The surgical robot set forth in claim 2, wherein the surgical instrument is configured to insert a screw into a vertebra of the spinal column of the patient.

### Claim 5 (depends on 2)

The surgical robot set forth in claim 2, wherein the surgical instrument is configured to insert an implant between adjacent vertebrae of the spinal column of the patient.

### Claim 6 (depends on 2)

The surgical robot set forth in claim 2, wherein the surgical instrument comprises a drill configured to create a passage in a vertebra of the spinal column of the patient.

### Claim 7 (depends on 1)

The surgical robot set forth in claim 1, further comprising:
at least one coupling component configured to couple to the spinal column of the patient; and
at least one marker configured to be coupled to the at least one coupling component, wherein the at least one marker is configured to be visible in a fluoroscope image of the spinal column of the patient during the spinal surgical procedure.

### Claim 8 (depends on 7)

The surgical robot set forth in claim 7, wherein at least one fluoroscope image is transmitted to the computer and visible on the monitor connected to the computer.

### Claim 9 (depends on 1)

The surgical robot set forth in claim 1, further comprising at least one marker configured to be coupled to the spinal column of the patient, wherein the at least one marker is configured to be visible in a fluoroscope image of the spinal column of the patient during the spinal surgical procedure.

### Claim 10 (depends on 9)

The surgical robot set forth in claim 9, wherein at least one fluoroscope image is transmitted to the computer and visible on the monitor connected to the computer.

### Claim 11

A method of performing robotic spine surgery, the method comprising:
displaying a computerized image of a spinal column of a patient on monitor,
wherein the displayed computerized image is received from a computer connected to the monitor;
controlling, via the computer, a robotic arm in communication with the computer to position a cannula coupled to the robotic arm relative to the spinal column of the patient, wherein the robotic arm is coupled to a base configured to be on a floor next to the patient during the spinal surgical procedure, wherein the cannula is configured to receive a surgical instrument for performing the spinal surgical procedure.

### Claim 12 (depends on 11)

The method of performing robotic spine surgery set forth in claim 11, further comprising inserting the surgical instrument into the cannula after said controlling, via the computer, a robotic arm in communication with the computer to position a cannula coupled to the robotic arm relative to the spinal column of the patient.

### Claim 13 (depends on 12)

The method of performing robotic spine surgery set forth in claim 12, further comprising inserting an implant into the spinal column of the patient using the surgical instrument.

### Claim 14 (depends on 12)

The method of performing robotic spine surgery set forth in claim 12, further comprising threading a screw into a vertebra of the spinal column of the patient using the surgical instrument.

### Claim 15 (depends on 12)

The method of performing robotic spine surgery set forth in claim 12, further comprising inserting an implant between adjacent vertebrae of the spinal column of the patient using the surgical instrument.

### Claim 16 (depends on 12)

The method of performing robotic spine surgery set forth in claim 12, further comprising drilling a passage in a vertebra of the spinal column of the patient using the surgical instrument.

### Claim 17 (depends on 11)

The method of performing robotic spine surgery set forth in claim 11, further comprising:
coupling at least one coupling component to the spinal column of the patient; and
coupling at least one marker to the at least one coupling component, wherein the at least one marker is configured to be visible in a fluoroscope image of the spinal column of the patient.

### Claim 18 (depends on 17)

The method of performing robotic spine surgery set forth in claim 17, further comprising:
transmitting at least one fluoroscope image to the computer; and
displaying the at least one fluoroscope image on the monitor.

### Claim 19 (depends on 11)

The method of performing robotic spine surgery set forth in claim 11, further comprising coupling at least one marker to the spinal column of the patient, wherein the at least one marker is configured to be visible in a fluoroscope image of the spinal column of the patient.

### Claim 20 (depends on 11)

The method of performing robotic spine surgery set forth in claim 11, further comprising:
transmitting at least one fluoroscope image to the computer; and
displaying the at least one fluoroscope image on the monitor.