# US 11,896,317 B2 · Triangulation of item in patient body > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,896,317 B2 - Document ID: US11896317B2 - Status: Granted - Kind: B2 - Application number: 16/984,514 - Filed: 2020-08-04 - Published: 2022-02-10 - Granted: 2024-02-13 - Earliest claimed: 2020-08-04 - Assignees: Mazor Robotics Ltd. - Applicants: Mazor Robotics Ltd. - Inventors: Nir Ofer; Ziv Seemann; Dor Kopito; Yair Schwartz; Ofir Dahan; Gal Eshed; Dvir Kadshai; Amir Keret; Maor Sviri; Adi Talmor; Ron Visbrot; Arie Shneiderman; Aviv Ellman; Gal Barazani - Web page: https://patentgrep.com/patent/US11896317B2 ## CPC - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations - A61B 34/25: {User interfaces for surgical systems} - A61B 34/30: Surgical robots - G01S 5/01: {Determining conditions which influence positioning, e.g. radio environment, state of motion or energy consumption} - G01S 5/30: Determining absolute distances from a plurality of spaced points of known location - A61B 2034/102: {Modelling of surgical devices, implants or prosthesis} - A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones} - A61B 2034/2048: {using an accelerometer or inertia sensor} - A61B 2034/2055: {Optical tracking systems} - A61B 2034/2059: {Mechanical position encoders} - A61B 2034/2063: {Acoustic tracking systems, e.g. using ultrasound} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G01S: RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES ## Abstract A surgical positioning system includes an emitter secured to a medical implant; at least three microphones; at least one processor; and a memory. The emitter has a speaker and a power source. The memory stores instructions for execution by the processor that, when executed, cause the processor to receive, from each of the at least three microphones, information about a detected sound; and calculate, based on position information corresponding to each of the at least three microphones and the received information, a position of the implant. ## Claims ### Claim 1 A surgical positioning system, comprising: an emitter secured to a medical implant, comprising: a speaker; and a power source; at least three microphones; at least one processor; and a memory storing instructions for execution by the processor that, when executed, cause the processor to: receive, from each of the at least three microphones, information about a detected sound; receive a model of a portion of a patient's anatomy, the model being generated from one or more preoperative images that include the portion of the patient's anatomy; calculate, based on the model, a predicted speed of sound through at least a segment of the portion of the patient's anatomy by: determining, using the model, which materials lie along the segment; measuring, within the model, a thickness of each material that lies along the segment; determining a speed of sound through each material that lies along the segment; and calculating the predicted speed of sound based on the thickness of each material and the speed of sound of each material that lies along the segment; and calculate, based on position information corresponding to each of the at least three microphones, the predicted speed of sound, and the received information, a position of the implant. ### Claim 2 (depends on 1) The surgical positioning system of claim 1, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: determine the speed of sound through each material that lies along the segment by retrieving the speed of sound of each material from a database. ### Claim 3 (depends on 1) The surgical positioning system of claim 1, wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: update the predicted speed of sound based on calibration data corresponding to a calibration sound generated by the emitter and detected by each of the at least three microphones. ### Claim 4 (depends on 3) The surgical positioning system of claim 3, wherein the calculating the position of the implant is further based on the updated predicted speed of sound. ### Claim 5 (depends on 2) The surgical positioning system of claim 2, wherein each of the at least three microphones is mounted in a fixed position relative to any others of the at least three microphones. ### Claim 6 (depends on 1) The surgical positioning system of claim 1, wherein the detected sound has a frequency less than 20 kHz. ### Claim 7 (depends on 1) The surgical positioning system of claim 1, wherein the detected sound has a frequency less than 20 Hz. ### Claim 8 (depends on 1) The surgical positioning system of claim 1, wherein at least one of the at least three microphones is mounted to a movable arm, and the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: receive arm position data corresponding to a position of the movable arm; and calculate, based at least in part on the arm position data, a location of each of the at least three microphones. ### Claim 9 (depends on 1) The surgical positioning system of claim 1, wherein the position information for each of the at least three microphones comprises data about a position of each of the at least three microphones relative to the others of the at least three microphones, and the calculated emitter position is relative to the positions of the at least three microphones. ### Claim 10 (depends on 1) The surgical positioning system of claim 1, wherein the position information for each of the at least three microphones is relative to a common coordinate system. ### Claim 11 (depends on 1) The surgical positioning system of claim 1, wherein the emitter comprises a plurality of speakers, each speaker is configured to emit sound at a different frequency than the other speakers in the plurality of speakers, the received information comprises information about a detected sound generated by each of the plurality of speakers, respectively, and the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: determine an orientation of the implant based at least in part on the received information. ### Claim 12 A method of locating an object during a surgery, comprising: receiving a model of a portion of a patient's anatomy; receiving a surgical plan comprising information about a planned position of an implant within the portion of the patient's anatomy; calculating, based on the planned position of the implant and the model, a predicted speed of sound along at least one path that extends at least partially through the portion of the patient's anatomy, the predicted speed of sound being calculated by: determining, using the model, which materials lie along the at least one path; measuring, within the model, a thickness of each material that lies along the at least one path; determining a speed of sound through each material that lies along the at least one path; and calculating the predicted speed of sound based on the thickness of each material and the speed of sound of each material that lies along the at least one path; receiving, from at least three microphones, detection information about a detected sound generated by a speaker secured to the implant; and determining, based on the predicted speed of sound and the detection information, a position of the implant. ### Claim 13 (depends on 12) The method of claim 12, wherein the detection information comprises first detection information about a first detected sound generated by the speaker at a first time, the method further comprising: receiving, from the at least three microphones, second detection information about a second detected sound generated by the speaker, the second detected sound generated at a second time after the first time; and determining, based on first detection information and the second detection information, a movement of the implant. ### Claim 14 (depends on 12) The method of claim 12, wherein the detection information corresponds to detected sounds generated by a plurality of speakers secured to the implant, the method further comprising: determining, based on the predicted speed of sound and the detection information, an orientation of the implant. ### Claim 15 (depends on 14) The method of claim 14, wherein each of the detected sounds has a unique frequency relative to any others of the detected sounds. ### Claim 16 (depends on 12) The method of claim 12, wherein the determining is further based on location information corresponding to a location of each of the at least three microphones. ### Claim 17 (depends on 12) The method of claim 12, wherein the detection information comprises first detection information about a first detected sound generated by the speaker at a first time, the method further comprising: receiving, from the at least three microphones, second detection information about a second detected sound generated by a second speaker affixed to an anatomical element of the patient; and determining, based on first detection information and the second detection information, a position of the implant relative to the anatomical element. ### Claim 18 A surgical triangulation system comprising: a plurality of microphones configured to be installed in fixed locations about an operating room; an emitter configured to be secured to an internal anatomical feature of a patient or an implant, the emitter comprising: a speaker; and a power source; at least one processor; and a memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to: receive a surgical plan comprising information about a portion of the patient's anatomy; receive a model of the portion of the patient's anatomy, the model being generated from one or more preoperative images that include the portion of the patient's anatomy; calculate, based on the model, a predicted speed of sound through at least a segment of the portion of the patient's anatomy by: determining, using the model, which materials lie along the segment; measuring, within the model, a thickness of each material that lies along the segment; determining a speed of sound through each material that lies along the segment; and calculating the predicted speed of sound based on the thickness of each material and the speed of sound of each material that lies along the segment; receive, from the plurality of microphones, sound information about a sound detected by the plurality of microphones and generated by the speaker; and calculate, based on the surgical plan, the predicted speed of sound, the sound information, and information about the fixed locations of the plurality of microphones, a position of the emitter. ### Claim 19 (depends on 18) The surgical triangulation system of claim 18, wherein the emitter is biocompatible. ### Claim 20 (depends on 18) The surgical triangulation system of claim 18, wherein emitter comprises a second speaker, and the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to: receive, from the plurality of microphones, second sound information about a second sound detected by the plurality of microphones and generated by the second speaker; and calculate, based on the surgical plan, the second sound information, and the information about the fixed locations of the plurality of microphones, an orientation of the emitter.