# US 10,945,801 B2 · Soft tissue cutting instrument and method of use > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,945,801 B2 - Document ID: US10945801B2 - Status: Granted - Kind: B2 - Application number: 13/900,484 - Filed: 2013-05-22 - Published: 2013-11-28 - Granted: 2021-03-16 - Earliest claimed: 2012-05-22 - Assignees: MAKO Surgical Corp. - Applicants: MAKO Surgical Corp. - Inventors: Todd Borus; Carinne Cecile Granchi - Web page: https://patentgrep.com/patent/US10945801B2 ## CPC - A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback} - A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 17/1742: {for the hip} - A61B 18/1402: {Probes for open surgery} - A61B 2017/00123: {and automatic shutdown} - A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones} - A61B 2034/107: {Visualisation of planned trajectories or target regions} - A61B 2034/2055: {Optical tracking systems} - A61B 2090/08021: {of the patient or his organs} - A61B 2090/374: {NMR or MRI} - A61B 2090/3762: {using computed tomography systems [CT]} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A surgical apparatus includes a surgical device and a surgical controller. The surgical device is configured to be manipulated by a user to perform a soft tissue cutting procedure on a patient. The surgical controller is programmed to create a virtual object representing an anatomy of the patient based upon data acquired during a pre-operative scan and associate the virtual object with the anatomy of the patient. The surgical controller is also programmed to identify a plurality of soft tissue attachment points on the virtual object which correspond to a plurality of soft tissue attachment points on the anatomy of the patient. The surgical controller is also programmed to determine the location of the surgical device in relation to the anatomy of the patient and provide real-time visualization on the virtual object of the location of the surgical device in relation to the anatomy of the patient. ## Claims ### Claim 1 A surgical apparatus, comprising: a surgical device configured to be manipulated by a user to perform a soft tissue cutting procedure on a patient; and a surgical controller comprising a processing circuit configured to: create a virtual object comprising a three-dimensional model representing an anatomy of the patient; identify a plurality of soft tissue attachment points on the three-dimensional model; identify a proposed soft tissue release pathway relative to the virtual object and the plurality of soft tissue attachment points such that following the proposed soft tissue release pathway with the surgical device results in release of soft tissue from one or more of the soft tissue attachment points; determine a location of the surgical device in relation to the anatomy of the patient; and control a display device to provide real-time visualization of the location of the surgical device in relation to the proposed soft tissue release pathway based on the location of the surgical device in relation to the anatomy of the patient. ### Claim 2 (depends on 1) The surgical apparatus of claim 1, wherein the virtual object is created based upon data acquired during a pre-operative scan. ### Claim 3 (depends on 1) The surgical apparatus of claim 1, wherein the virtual object is created by acquiring locations of points on a surface of a bone of the patient to create a point cloud that represents the patient's anatomy. ### Claim 4 (depends on 1) The surgical apparatus of claim 1, wherein the processing circuit is configured to control the display device to display a plurality of unique indicia indicating locations of the plurality of soft tissue attachment points on the virtual object. ### Claim 5 (depends on 1) The surgical apparatus of claim 1, wherein the processing circuit is configured to control the display device to show an immediately upcoming tissue release pathway and one or more subsequent tissue release pathways, the immediately upcoming tissue release pathway visually distinguished from the one or more subsequent tissue release pathways. ### Claim 6 (depends on 1) The surgical apparatus of claim 1, wherein the processing circuit is configured to identify tissue release pathways that have been traversed by the surgical device and control the display device to indicate the tissue release pathways that have been traversed by the surgical device. ### Claim 7 (depends on 1) The surgical apparatus of claim 1, further comprising a tracking system having a detection device for determining the location of a tracked object and a trackable element on the tracked object, detectable by the detection device. ### Claim 8 (depends on 7) The surgical apparatus of claim 7, wherein the trackable element is configured to be attached to the surgical device. ### Claim 9 (depends on 7) The surgical apparatus of claim 7, wherein the trackable element is configured to be attached to an anatomy tracker that is attached to the anatomy of the patient. ### Claim 10 (depends on 7) The surgical apparatus of claim 7, wherein the trackable element comprises a reflective sphere. ### Claim 11 (depends on 1) The surgical apparatus of claim 1, wherein the surgical device comprises a cutting tip. ### Claim 12 (depends on 11) The surgical apparatus of claim 11, wherein the cutting tip comprises at least one of a scalpel blade, an electrocautery device, an ultrasonic cutting tool, or a vibratory cutting device adapted and configured to provide hemostasis. ### Claim 13 (depends on 1) The surgical apparatus of claim 1, wherein the processing circuit is further configured to adjust the virtual object in response to movement of the anatomy during a procedure by monitoring detected movement of the anatomy and then adjusting the virtual object in response to the detected movement. ### Claim 14 (depends on 1) The surgical apparatus of claim 1, further comprising the display device. ### Claim 15 (depends on 1) The surgical apparatus of claim 1, wherein the surgical controller is further programmed to cease operation of the surgical device when the surgical device is moved outside a predefined cutting region. ### Claim 16 (depends on 15) The surgical apparatus of claim 15, wherein the predefined cutting region is defined by a predetermined distance from the proposed soft tissue release pathway. ### Claim 17 (depends on 1) The surgical apparatus of claim 1, wherein: the surgical device comprises a feedback mechanism configured to supply feedback to the user manipulating the surgical device; and the processing circuit is configured to control the feedback mechanism to provide haptic guidance to the user based on the location of the surgical device in relsation to the anatomy of the patient. ### Claim 18 A surgical apparatus, comprising: a surgical device configured to be manipulated by a user to perform a soft tissue cutting procedure on a patient; and a surgical controller comprising a processing circuit configured to: create a virtual object representing an anatomy of the patient; define a soft tissue release pathway such that following the proposed soft tissue release pathway with the surgical device releases soft tissue from the anatomy of the patient; cause a display device to display the proposed soft tissue release pathway relative to the virtual object; determine a location of the surgical device in relation to the anatomy of the patient; and provide, via the display device, real-time visualization of the location of the surgical device in relation to the proposed soft tissue release pathway based on the location of the surgical device in relation to the anatomy of the patient. ### Claim 19 (depends on 18) The surgical apparatus of claim 18, wherein the surgical controller is further configured to identify a plurality of soft tissue attachment points on the virtual object which correspond to a plurality of soft tissue attachment points on the anatomy of the patient and provide, via the display device, a visualization of the plurality of soft tissue attachment points on the virtual object. ### Claim 20 (depends on 18) The surgical apparatus of claim 18, further comprising a tracking system having a detection device for determining the location of a tracked object and a trackable element on the tracked object, detectable by the detection device. ### Claim 21 (depends on 20) The surgical apparatus of claim 20, wherein the trackable element is configured to be attached to an anatomy tracker that is attached to the anatomy of the patient. ### Claim 22 (depends on 18) The surgical apparatus of claim 18, wherein the surgical device comprises a cutting tip. ### Claim 23 (depends on 22) The surgical apparatus of claim 22, wherein the cutting tip comprises at least one of a scalpel blade, an electrocautery device, an ultrasonic cutting tool, or a vibratory cutting device adapted and configured to provide hemostasis. ### Claim 24 (depends on 18) The surgical apparatus of claim 18, wherein the surgical controller is further configured to cease operation of the surgical device when the surgical device is moved outside a predefined cutting region. ### Claim 25 (depends on 24) The surgical apparatus of claim 24, wherein the predefined cutting region is defined by a predetermined distance from the proposed soft tissue release pathway. ### Claim 26 (depends on 18) The surgical apparatus of claim 18, wherein the processing circuit is configured to identify a tissue release pathway that has been traversed by the surgical device and control the display device to show the tissue release pathway that has been traversed by the surgical device. ### Claim 27 (depends on 1) The surgical apparatus of claim 1, wherein the surgical controller is further configured to control the display device to represent the soft tissue attachment points on the virtual model by indicia representative of the soft tissue attachment points, and wherein the indicia comprise markings on the virtual object indicating the location of the soft tissue attachment points. ### Claim 28 (depends on 1) The surgical apparatus of claim 1, wherein the processing circuit is configured to control the display device to represent a plurality of soft tissue attachment points on the virtual model by indicia representative of the soft tissue attachment points, and wherein the indicia comprise colored markings on the virtual object indicating the location of the soft tissue attachment points. ### Claim 29 (depends on 28) The surgical apparatus of claim 28, wherein the indicia representative of the soft tissue attachment points comprise a first colored marking indicating the location of a first soft tissue attachment point and a second colored marking indicating the location of a second soft tissue attachment point, wherein the first colored marking is a different color than the second colored marking. ### Claim 30 (depends on 18) The surgical apparatus of claim 18, wherein the processing circuit is further configured to provide, via the display device, a visualization of indicia representative of soft tissue attachment points to be released, wherein the indicia comprise markings on the virtual object indicating the location of the soft tissue attachment points. ### Claim 31 (depends on 30) The surgical apparatus of claim 30, wherein the markings are colored. ### Claim 32 (depends on 31) The surgical apparatus of claim 31, wherein the indicia representative of the soft tissue attachment points to be released comprise a first colored marking indicating the location of a first soft tissue attachment point and a second colored marking indicating the location of a second soft tissue attachment point, the first colored marking having a different color than the second colored marking.