# US 11,298,190 B2 · Robotically-assisted constraint mechanism

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- Number: US 11,298,190 B2
- Document ID: US11298190B2
- Status: Granted
- Kind: B2
- Application number: 16/911,982
- Filed: 2020-06-25
- Published: 2020-10-15
- Granted: 2022-04-12
- Earliest claimed: 2002-03-06
- Assignees: MAKO Surgical Corp.
- Applicants: MAKO Surgical Corp.
- Inventors: Arthur E. Quaid, III
- Web page: https://patentgrep.com/patent/US11298190B2

## CPC

- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 17/1703: {using imaging means, e.g. by X-rays}
- A61B 17/3403: {Needle locating or guiding means}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/25: {User interfaces for surgical systems}
- A61B 34/30: Surgical robots
- A61B 34/32: operating autonomously
- A61B 34/35: for telesurgery
- A61B 34/37: Leader-follower robots (A61B34/35 takes precedence)
- A61B 34/70: {Manipulators specially adapted for use in surgery}
- A61B 34/74: {Manipulators with manual electric input means}
- A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback}
- A61B 34/77: {Manipulators with motion or force scaling}
- A61B 90/03: {Automatic limiting or abutting means, e.g. for safety}
- A61B 90/06: {Measuring instruments not otherwise provided for}
- A61B 90/36: {Image-producing devices or illumination devices not otherwise provided for}
- A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers}
- B25J 9/0081: {with leader teach-in means}
- B25J 13/025: {comprising haptic means}
- A61B 17/1757: {for the spine}
- A61B 17/1767: {for the patella}
- A61B 2017/00022: {Sensing or detecting at the treatment site}
- A61B 2017/00119: {alarm; indicating an abnormal situation}
- A61B 2017/00128: {related to intensity or progress of surgical action}
- A61B 2017/00199: {with a console, e.g. a control panel with a display}
- A61B 2017/00212: {using remote controls}
- A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids}
- A61B 2017/3405: {using mechanical guide means}
- 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 2034/105: {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 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- A61B 2034/2072: {Reference field transducer attached to an instrument or patient}
- A61B 2034/252: {indicating steps of a surgical procedure}
- A61B 2034/254: {being adapted depending on the stage of the surgical procedure}
- A61B 2090/031: {torque limiting}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/3945: {Active visible markers, e.g. light emitting diodes}
- 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})

## Abstract

A computer-assisted surgery system for performing a surgical procedure on a patient's anatomy includes a robotic device, a guide coupled to the robotic device, and a computer in communication with the robotic device. The computer is configured to command the robotic device to selectively operate in one of a first mode in which the guide is manually moved by a user or a second mode in which the robotic device autonomously moves the guide. In the first mode, the robotic device is controlled by the computer to constrain motion of the guide to a predefined plane while allowing the guide to be manually moved along the pre-defined plane.

## Claims

### Claim 1

A computer-assisted surgery system for performing a surgical procedure on a patient's anatomy, the computer-assisted surgery system comprising:
a foot pedal;
a touch screen;
a robotic device;
a guide coupled to the robotic device; and
a computer in communication with the robotic device and configured to command the robotic device to operate, at different times:
in a first mode in which the guide is manually moved by a user;
in a second mode in which the robotic device autonomously moves the guide; and
in a third mode in which the robotic device locks the guide in a pose;
wherein, in the first mode, the robotic device is controlled by the computer to constrain motion of the guide to a predefined plane while allowing the guide to be manually moved along the predefined plane;
wherein the computer is configured to control the robotic device to enter the third mode to lock the guide in the pose in response to the guide moving to the pose via constrained motion in the first mode and occurrence of both a first user interaction with the touchscreen and a second user interaction with the foot pedal.

### Claim 2 (depends on 1)

The computer-assisted surgery system of claim 1, wherein the guide is configured for insertion of a cutting tool into the guide.

### Claim 3 (depends on 1)

The computer-assisted surgery system of claim 1, wherein the computer is further configured to receive a preoperative image dataset of the patient's anatomy.

### Claim 4 (depends on 3)

The computer-assisted surgery system of claim 3, wherein the preoperative image dataset comprises x-ray images.

### Claim 5 (depends on 3)

The computer-assisted surgery system of claim 3, further comprising a trackable probe, wherein the computer is further configured to register the preoperative image dataset to the patient's anatomy based on data indicative of positions of the trackable probe.

### Claim 6 (depends on 1)

The computer-assisted surgery system of claim 1, further comprising a display for displaying images of the patient's anatomy.

### Claim 7 (depends on 1)

The computer-assisted surgery system of claim 1, further comprising a camera and a first array of trackable markers attachable to the patient's anatomy.

### Claim 8 (depends on 7)

The computer-assisted surgery system of claim 7, wherein the trackable markers are passive reflective markers.

### Claim 9 (depends on 1)

The computer-assisted surgery system of claim 1, wherein the robotic device comprises a robotic arm configured to move the guide in at least four degrees of freedom.

### Claim 10

Storage media storing instructions that, when executed by a processor, cause the processor to perform operations comprising:
determining a position of a guide relative to a plane, wherein the guide is coupled to a robotic device;
commanding the robotic device to operate in a first mode and a second mode at different times, wherein the guide is manually manipulated by a user in the first mode and the robotic device operates autonomously in the second mode; and
commanding the robotic device in the first mode to constrain movement of the guide to the plane, with the guide moveable along the plane to reach a target area of a patient's anatomy;
commanding the robotic device in a third mode to lock the guide in a pose relative to the target area of the patient's anatomy such that a surgical procedure can be performed once the guide is locked in the pose; and
switching into the third mode to lock the guide in the pose in response to movement of the guide to the pose and occurrence of both a first user input to a touchscreen and second user input to a foot pedal.

### Claim 11 (depends on 10)

The storage media of claim 10, wherein the operations further comprise receiving a preoperative image dataset taken of the patient's anatomy using an imaging modality.

### Claim 12 (depends on 11)

The storage media of claim 11, wherein the imaging modality comprises x-ray imaging.

### Claim 13 (depends on 11)

The storage media of claim 11, further comprising registering the preoperative image dataset to the patient's anatomy.

### Claim 14 (depends on 10)

The storage media of claim 10, wherein the operations further comprise controlling a display device to display images of the patient's anatomy on a display.

### Claim 15 (depends on 10)

The storage media of claim 10, wherein the operations further comprise controlling the display device to further display a virtual representation of the plane.

### Claim 16 (depends on 10)

The storage media of claim 10, wherein the operations further comprise determining a position of the guide relative to the plane based on tracking data from a camera configured to locate an array of trackable markers attached to the patient's anatomy.

### Claim 17

A method of operating a robotically-assisted surgical device, comprising:
planning a bone resection to obtain a virtual plane defined relative to an anatomical feature;
providing a robotic device and a guide coupled to the robotic device;
operating the robotic device in a first mode in which the guide is manually moved by a user and, at different times, in a second mode in which the robotic device autonomously moves the guide; and
operating the robotic device in a third mode in which the robotic device locks the guide in a position;
wherein operating the robotic device in the first mode comprises causing the robotic device to constrain motion of the guide to the virtual plane while allowing the guide to be manually moved along the virtual plane;
wherein operating the robotic device in the third mode is initiated in response to the guide moving to the position via constrained motion in the first mode and occurrence of both a first user interaction with a touchscreen and a second user interaction with a foot pedal.

### Claim 18 (depends on 17)

The method of claim 17, wherein the method further comprises controlling a display device to display an image of the anatomical feature and a virtual representation of the virtual plane.

### Claim 19 (depends on 17)

The method of claim 17, wherein planning the bone resection comprises obtaining a preoperative image dataset comprising x-ray images of the anatomical feature.

### Claim 20 (depends on 17)

The method of claim 17, wherein the method further comprises coupling an array of reflective markers to the anatomical feature.