# US 11,298,197 B2 · Methods and systems for robotic-assisted insertion of medical fasteners

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- Number: US 11,298,197 B2
- Document ID: US11298197B2
- Status: Granted
- Kind: B2
- Application number: 17/433,775
- Filed: 2021-02-12
- Published: 2022-02-10
- Granted: 2022-04-12
- Earliest claimed: 2020-02-13
- Assignees: Smith & Nephew, Inc.; Smith & Nephew Orthopaedics AG; Smith & Nephew Asia Pacific Pte. Limited
- Applicants: Smith & Nephew, Inc.; Smith & Nephew Asia Pacific Pte. Limited; Smith & Nephew Orthopaedics AG
- Inventors: Samuel C. Dumpe; Brett J. Bell; Constantinos Nikou; Gene Edward Austin
- Web page: https://patentgrep.com/patent/US11298197B2

## CPC

- A61B 34/30: Surgical robots
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/162: {Chucks or tool parts which are to be held in a chuck}
- A61B 17/1624: {Drive mechanisms therefor}
- A61B 17/1628: {Motors; Power supplies}
- A61B 17/1633: {Sleeves, i.e. non-rotating parts surrounding the bit shaft, e.g. the sleeve forming a single unit with the bit shaft (A61B17/1644 takes precedence)}
- A61B 17/848: {Kirschner wires, i.e. thin, long nails}
- A61B 17/865: {Packages or dispensers for bone screws or threaded wires}
- A61B 17/8875: {Screwdrivers, spanners or wrenches}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- G16H 10/20: for electronic clinical trials or questionnaires
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G16H 20/40: relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
- G16H 30/40: for processing medical images, e.g. editing
- G16H 40/63: for local operation
- G16H 40/67: for remote operation
- G16H 50/30: for calculating health indices; for individual health risk assessment
- G16H 50/50: for simulation or modelling of medical disorders
- A61B 17/1626: {Control means; Display units}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/25: {User interfaces for surgical systems}
- A61B 34/32: operating autonomously
- A61B 34/37: Leader-follower robots (A61B34/35 takes precedence)
- A61B 90/96: using barcodes
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2063: {Acoustic tracking systems, e.g. using ultrasound}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/066: {for measuring torque}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/372: {Details of monitor hardware}
- A61B 2090/3937: {Visible markers}
- A61B 2090/3979: {infrared}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61B 2090/502: {Headgear, e.g. helmet, spectacles}
- G06N 3/044: Recurrent networks, e.g. Hopfield networks
- G06N 3/045: Combinations of networks
- G06N 3/08: Learning methods
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- Y02A 90/10: Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G06N: COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
- Y02A: TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE

## Abstract

Methods and systems of placing a medical fastener at a predetermined depth in a bone are described. A surgical tool can include an attachment assembly configured to interchangeably engage a medical fastener and a cutting element or bone removal tool and a drive assembly coupled to the attachment assembly. The attachment assembly can be configured to automatically release the medical fastener in response to the drive assembly reaching its end or distal-most position to place the medical fastener at a predetermined depth within the bone.

## Claims

### Claim 1

A surgical tool comprising:
an attachment assembly comprising:
a collet configured to interchangeably receive a medical fastener or a bone removal tool therein,
a sleeve slidable relative to the collet between a first configuration and a second configuration, the sleeve comprising a sleeve recess,
a biasing member configured to bias the sleeve towards the first configuration, and
a detent residing within the sleeve recess, wherein insertion of the medical fastener or the bone removal tool into the collet causes the detent to move into and at least partially occupy a corresponding recess of the medical fastener or the bone removal tool, wherein in the first configuration the sleeve bears against the detent, thereby causing the detent to maintain its position within the corresponding recess of the medical fastener or the bone removal tool and constraining axial movement of the medical fastener or the bone removal tool;
a rotational actuator configured to rotationally drive the attachment assembly;
a stop; and
an axial actuator configured to axially drive the attachment assembly between a first position and a second position, wherein as the attachment assembly approaches the second position as driven by the axial actuator, the sleeve contacts the stop, thereby causing the sleeve to slide relative to the collet to the second configuration, thereby causing the detent to move radially into the sleeve recess and vacate the corresponding recess of the medical fastener, thereby releasing the medical fastener at a predetermined depth corresponding to the second position.

### Claim 2 (depends on 1)

The surgical tool of claim 1, wherein the detent comprises a ball bearing.

### Claim 3 (depends on 1)

The surgical tool of claim 1, further comprising:
a barrel; and
a magazine well that is configured to engage with a medical fastener magazine, the medical fastener magazine configured to reload one of a plurality of medical fasteners into the barrel upon the medical fastener being released from the surgical tool when the attachment assembly is in the second configuration.

### Claim 4 (depends on 1)

The surgical tool of claim 1, wherein the bone removal tool comprises a burr.

### Claim 5 (depends on 1)

The surgical tool of claim 1, wherein the axial actuator is selected from the group consisting of a motor, a hydraulic actuator, a screw-type actuator, a rack and pinion assembly, and a piezoelectric actuator.

### Claim 6 (depends on 1)

The surgical tool of claim 1, wherein the biasing member comprises a spring.

### Claim 7 (depends on 1)

The surgical tool of claim 1, wherein the medical fastener is selected from the group consisting of a pin, a Kirschner wire, and a Schanz screw.

### Claim 8 (depends on 1)

The surgical tool of claim 1, wherein the corresponding recess of the medical fastener comprises a groove extending about the medical fastener.

### Claim 9 (depends on 1)

The surgical tool of claim 1, wherein the sleeve recess comprises a groove extending about an interior surface of the sleeve.

### Claim 10

A surgical system comprising:
a surgical navigation system; and
a surgical tool comprising:
a tracking array configured to be detected by the surgical navigation system,
an attachment assembly comprising:
a collet configured to interchangeably engage a medical fastener or a bone removal tool,
a sleeve slidable relative to the collet between a first configuration and a second configuration, the sleeve comprising a sleeve recess,
a biasing member configured to bias the sleeve towards the first configuration, and
a detent residing within the sleeve recess, wherein insertion of the medical fastener or the bone removal tool into the collet causes the detent to move into and at least partially occupy a corresponding recess of the medical fastener or the bone removal tool, wherein in the first configuration the sleeve bears against the detent, thereby causing the detent to maintain its position within the corresponding recess of the medical fastener or the bone removal tool and constraining axial movement of the medical fastener or the bone removal tool,
a rotational actuator configured to rotationally drive the attachment assembly;
a stop; and
an axial actuator configured to axially drive the attachment assembly between a first position and a second position, wherein as the attachment assembly approaches the second position as driven by the axial actuator, the sleeve contacts the stop, thereby causing the sleeve to slide relative to the collet to the second configuration, there causing the detent to move radially into the sleeve recess and vacate the corresponding recess of the medical fastener, thereby releasing the medical fastener at a predetermined depth corresponding to the second position.

### Claim 11 (depends on 10)

The surgical system of claim 10, wherein the detent comprises a ball bearing.

### Claim 12 (depends on 10)

The surgical system of claim 10, wherein the surgical tool further comprises:
a barrel; and
a magazine well that is configured to engage with a medical fastener magazine, the medical fastener magazine configured to reload one of a plurality of medical fasteners into the barrel upon the medical fastener being released from the surgical tool when the attachment assembly is in the second configuration.

### Claim 13 (depends on 10)

The surgical system of claim 10, wherein the bone removal tool comprises a burr.

### Claim 14 (depends on 10)

The surgical system of claim 10, wherein the axial actuator is selected from the group consisting of a motor, a hydraulic actuator, a screw-type actuator, a rack and pinion assembly, and a piezoelectric actuator.

### Claim 15 (depends on 10)

The surgical system of claim 10, further comprising:
a medical fastener caddy comprising:
a plurality of medical fasteners, and
one or more trackers configured to be detected by the surgical navigation system.

### Claim 16 (depends on 15)

The surgical system of claim 15, further comprising:
a robotic arm configured to manipulate the surgical tool, wherein the robotic arm is configured to be controlled to cause the surgical tool to be selectively engaged with one of the plurality of medical fasteners in the medical fastener caddy.

### Claim 17 (depends on 16)

The surgical system of claim 16, wherein the robotic arm comprises a passive robotic arm.

### Claim 18 (depends on 10)

The surgical system of claim 10, wherein the medical fastener is selected from the group consisting of a pin, a Kirschner wire, and a Schanz screw.

### Claim 19 (depends on 10)

The surgical system of claim 10, wherein the corresponding recess of the medical fastener comprises a groove extending about the medical fastener.

### Claim 20 (depends on 10)

The surgical system of claim 10, wherein the sleeve recess comprises a groove extending about an interior surface of the sleeve.