# US 11,298,191 B2 · Robotically-assisted surgical guide

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- Number: US 11,298,191 B2
- Document ID: US11298191B2
- Status: Granted
- Kind: B2
- Application number: 17/373,960
- Filed: 2021-07-13
- Published: 2021-11-04
- 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/US11298191B2

## 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 at a target area on a patient's anatomy. Said computer-assisted surgery system includes a robotic device having a plurality of joints and a plurality of actuators and a guide mechanically coupled to said robotic device. Said robotic device is configured to constrain said guide according to a pre-defined virtual geometry with said guide being movable along said pre-defined virtual geometry toward the target area on the patient's anatomy. The computer-assisted surgery system also includes a computer in communication with said robotic device and configured to command said robotic device to operate in one of a first mode in which said guide is manually manipulated by a user or a second mode in which said robotic device operates autonomously.

## Claims

### Claim 1

A computer-assisted surgery system for performing a surgical procedure at a target area on a patient's anatomy, said computer-assisted surgery system comprising:
a robotic device having a plurality of joints and a plurality of actuators;
a guide mechanically coupled to said robotic device, wherein said robotic device is configured to constrain said guide according to a pre-defined virtual geometry with said guide being movable along said pre-defined virtual geometry toward the target area on the patient's anatomy; and
a computer in communication with said robotic device and configured to command said robotic device to operate in one of a first mode in which said guide is manually manipulated by a user or a second mode in which said robotic device operates autonomously;
wherein said robotic device is configured to be controlled by said computer to generate force feedback in said first mode in response to said guide being manually manipulated by the user in said first mode in order to constrain said guide with said pre-defined virtual geometry;
wherein said robotic device is further controlled to lock the guide in a desired pose in response to the guide moving to the desired pose via manual manipulation in the first mode and occurrence of a combination of inputs to a foot pedal and a touchscreen.

### Claim 2 (depends on 1)

The computer-assisted surgery system of claim 1, wherein said computer is further configured to:
receive a preoperative image dataset of the patient's anatomy taken with an imaging modality; and
register the preoperative image dataset to the patient's anatomy.

### Claim 3 (depends on 2)

The computer-assisted surgery system of claim 2, wherein said computer is further configured to receive a second preoperative image dataset of the patient's anatomy taken with a second imaging modality different than the imaging modality and register the preoperative image dataset and the second preoperative image dataset to the patient's anatomy, wherein the preoperative image dataset is different than the second preoperative image dataset.

### Claim 4 (depends on 1)

The computer-assisted surgery system of claim 1, wherein said computer is further configured to define the target area relative to a virtual representation of the patient's anatomy and register the virtual representation of the patient's anatomy to the patient's anatomy.

### Claim 5 (depends on 1)

The computer-assisted surgery system of claim 1, wherein the guide is a drill guide.

### 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 an imaging modality for generating an image dataset of the target area of the patient's anatomy.

### Claim 8 (depends on 1)

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

### Claim 9 (depends on 8)

The computer-assisted surgery system of claim 8, wherein said trackable markers comprise passive reflective markers.

### Claim 10 (depends on 1)

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

### Claim 11 (depends on 10)

The computer-assisted surgery system of claim 10, wherein the predefined virtual geometry is a line, a plane, or a surface.

### Claim 12

A method for performing a surgical procedure at a target area using a computer-assisted surgery system comprising a computer and a robotic device in communication with the computer, the robotic device having a plurality of joints and a plurality of actuators, said method comprising:
determining, with the computer-assisted surgery system, a position of a guide relative to a pre-defined virtual geometry with the guide being mechanically coupled to the robotic device;
commanding, by the computer-assisted surgery system, the robotic device to operate in one of a first mode or a second mode, wherein the guide is manually manipulated by a user in the first mode and the robotic device operates autonomously in the second mode; and
generating, with the robotic device, force feedback in response to the guide being manually manipulated by the user in the first mode to constrain the guide to the pre-defined virtual geometry with the guide moveable along the pre-defined virtual geometry to provide access to the target area; and
locking, by the robotic device, the guide in a desired pose in response to the guide moving to the desired pose via manual manipulation along the pre-defined virtual geometry in the first mode and occurrence of a combination of inputs to a foot pedal and a touchscreen.

### Claim 13 (depends on 12)

The method of claim 12, further comprising:
receiving, at the computer-assisted surgery system, a preoperative image dataset taken of a patient's anatomy using an imaging modality; and
registering the preoperative image dataset to the patient's anatomy.

### Claim 14 (depends on 13)

The method of claim 13, further comprising receiving, at the computer-assisted surgery system, a second preoperative image dataset taken of the patient's anatomy using a second imaging modality different than the imaging modality, and registering, with the computer-assisted surgery system, the preoperative image dataset and the second preoperative image dataset to the patient's anatomy, wherein the second preoperative image data set is different than the preoperative image dataset.

### Claim 15 (depends on 12)

The method of claim 12, wherein the target area is defined relative to a virtual representation of a patient's anatomy and the method further comprises registering the virtual representation with the patient's anatomy.

### Claim 16 (depends on 12)

The method of claim 12, wherein the guide is a drill guide.

### Claim 17 (depends on 12)

The method of claim 12, further comprising displaying a virtual representation of a patient's anatomy on a display.

### Claim 18 (depends on 12)

The method of claim 12, further comprising displaying a virtual representation of the pre-defined virtual geometry on a display.

### Claim 19 (depends on 12)

The method of claim 12, wherein the predefined virtual geometry is a line, a plane, or a surface.

### Claim 20 (depends on 12)

The method of claim 12, wherein determining, with the computer-assisted surgery system, the position of the guide relative to the pre-defined virtual geometry comprises tracking a patient's anatomy with a camera and an array of trackable markers attached to the patient's anatomy.