# US 11,992,271 B2 · Surgical system using a registration device > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,992,271 B2 - Document ID: US11992271B2 - Status: Granted - Kind: B2 - Application number: 16/430,710 - Filed: 2019-06-04 - Published: 2019-10-17 - Granted: 2024-05-28 - Earliest claimed: 2007-11-01 - Assignees: Stephen B. Murphy - Applicants: Stephen B. Murphy - Inventors: Stephen B. Murphy; William S. Murphy - Web page: https://patentgrep.com/patent/US11992271B2 ## 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 34/30: Surgical robots - A61B 34/70: {Manipulators specially adapted for use in surgery} - A61B 2017/00725: {Calibration or performance testing} - A61B 2017/00973: {pedal-operated} - 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 2034/2048: {using an accelerometer or inertia sensor} - A61B 2034/2051: {Electromagnetic tracking systems} - A61B 2034/2055: {Optical tracking systems} - A61B 2034/2063: {Acoustic tracking systems, e.g. using ultrasound} - A61B 2034/207: {Divots for calibration} - A61B 2034/254: {being adapted depending on the stage of the surgical procedure} - A61B 2090/067: {for measuring angles} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A system and method creates a patient-specific surgical plan for use during a surgical procedure. The plan may reference an instrument for registering a portion of a patient during the procedure. The plan may be based on a computer-generated model of a portion of the patient's anatomy. The plan may be provided to a surgeon who uses the registration instrument to register the portion of the patient's anatomy according to the plan. Spatial location data for a plurality of points on the instrument and/or on the patient's anatomy may be obtained, and a patient-based coordinate system may be established using the registration instrument, the captured spatial location data or combinations thereof. The coordinate system may be used to attach one or more prosthetic components to the patient at locations and/or orientations specified in the plan. ## Claims ### Claim 1 A computer-implemented method, comprising: registering a portion of a patient's anatomy, to be operated on, to a patient-specific coordinate system, the registering performed by (1) placing a plurality of different points of a single physical device simultaneously in direct contact with different surface points on a surface of the patient's anatomy and (2) capturing a coordinate system from the single physical device mated to the patient's anatomy; continuously tracking, by a processor, one or more positions of a robotic controlled instrument relative to the patient-specific coordinate system as the robotic controlled instrument moves in relation to the portion of the patient's anatomy; and automatically engaging and disengaging operation of the robotic controlled instrument based on the continuously tracked positions relative to the patient-specific coordinate system. ### Claim 2 (depends on 1) The computer-implemented method of claim 1, wherein the single physical device is a template that is custom-fabricated to fit to the patient's anatomy. ### Claim 3 (depends on 1) The computer-implemented method of claim 1, wherein the portion of the patient's anatomy is a pelvis, and the single physical device is a template that is custom-fabricated to fit to an acetabulum of the patient's pelvis. ### Claim 4 (depends on 1) The computer-implemented method of claim 1, wherein the automatically engaging and disengaging operation of the robotic controlled instrument includes at least one of turning the robotic controlled instrument on and off, controlling power to the robotic controlled instrument, or extending and retracting a protective sheath of the robotic controlled instrument. ### Claim 5 (depends on 1) The computer-implemented method of claim 1, further comprising: defining, preoperatively, at least one of an orientation or a location of an implant at the portion of the patient's anatomy relative to the patient-sprecific coordinate system, wherein the implant is an acetabular cup component. ### Claim 6 (depends on 5) The computer-implemented method of claim 5, wherein the portion of the patient's anatomy includes an acetabulum, the robotic controlled instrument is a reamer, and the reamer is controlled to shape the acetabulum to receive the acetabular cup component. ### Claim 7 (depends on 1) The computer-implemented method of claim 1, wherein the robotic controlled instrument is a reamer, and the one or more positions of a robotic controlled instrument include one or more positions of a drill point of the reamer. ### Claim 8 (depends on 1) The computer-implemented method of claim 1, wherein the robotic controlled instrument is a reamer. ### Claim 9 (depends on 1) The computer-implemented method of claim 1, wherein the single physical device defines a pelvic plane. ### Claim 10 (depends on 1) The computer-implemented method of claim 1, further comprising undocking the single physical device from the patient's anatomy prior to the continuously tracking the one or more positions of the robotic controlled instrument. ### Claim 11 A method, comprising: determining a patient-specific coordinate system for a portion of a patient's anatomy to be operated on; registering the portion of the patient's anatomy to the patient-specific coordinate system, the registering performed using (1) a single physical instrument having a plurality of different physical points that directly contact different surface points of the portion of the patient's anatomy or (2) a single virtual instrument having a plurality of different virtual points that virtually mate directly with the portion of the patient's anatomy; continuously tracking, by a processor, positions of a robotic controlled instrument relative to the patient-specific coordinate system as the robotic controlled instrument moves near the portion of the patient's anatomy; automatically engaging and disengaging operation of the robotic controlled instrument based on the continuously tracked positions relative to the patient-specific coordinate system; and utilizing the patient-specific coordinate system to at least one of orient, or locate an implant at the portion of the patient's anatomy. ### Claim 12 (depends on 11) The method of claim 11, wherein the patient-specific coordinate system defines at least one of an anterior pelvic (AP) plane or an ipsilateral hemipelvic plane. ### Claim 13 (depends on 11) The method of claim 11, wherein the registering is performed using the single physical instrument and the single physical instrument is a template that is custom-fabricated to fit to the patient's anatomy. ### Claim 14 (depends on 11) The method of claim 11, wherein the registering is performed using the single physical instrument and the physical instrument has legs with tips that contact a surface of the patient's anatomy. ### Claim 15 A method, comprising: registering a portion of a patient's anatomy, to be operated on, to a patient-specific coordinate system by docking a physical instrument to the patient's anatomy; continuously tracking, by a processor, one or more positions of a robotic controlled instrument relative to the patient-specific coordinate system as the robotic controlled instrument moves in relation to the portion of the patient's anatomy, wherein the physical instrument is undocked from the patient's anatomy prior to and while the one or more positions of the robotic controlled instrument are continuously tracked relative to the patient-specific coordinate system; and automatically engaging or disengaging operation of the robotic controlled instrument based on the continuously tracked positions relative to the patient-specific coordinate system. ### Claim 16 (depends on 15) The method of claim 15, further comprising: defining, preoperatively, at least one of an orientation, or a location of an implant at the portion of the patient's anatomy relative to the patient-specific coordinate system; and placing the implant at the portion of the patient's anatomy according to the at least one of the orientation, or the location. ### Claim 17 (depends on 16) The method of claim 16, wherein the implant is an acetabular cup component. ### Claim 18 (depends on 16) The method of claim 16, further comprising: creating, preoperatively, a surgical plan, wherein the surgical plan includes the patient-specific coordinate system, and the at least one of the orientation, or the location of the implant. ### Claim 19 (depends on 15) The method of claim 15, wherein the portion of the patient's anatomy includes an acetabulum, the robotic controlled instrument is a reamer, and the reamer is controlled to shape the acetabulum to receive an acetabular cup component. ### Claim 20 (depends on 15) The method of claim 15, wherein the registering further includes: digitizing a plurality of points on the physical instrument. ### Claim 21 (depends on 15) The method of claim 15, further comprising: tracking, by the processor, a surgical instrument that installs an implant; computing, based on the tracking the surgical instrument that installs the implant, at least one of a location or an orientation of the implant relative to the patient-specific coordinate system; and presenting the at least one of the location or the orientation on a user interface. ### Claim 22 (depends on 21) The method of claim 21, wherein the at least one of the location or the orientation is updated in real time on the user interface. ### Claim 23 (depends on 21) The method of claim 21, wherein the at least one of the location or the orientation includes one or more flexion values and one or more abduction values. ### Claim 24 (depends on 15) The method of claim 15, wherein the automatically engaging and disengaging operation of the robotic controlled instrument includes at least one of turning the robotic controlled instrument on and off, controlling power to the robotic controlled instrument, or extending and retracting a protective sheath of the robotic controlled instrument. ### Claim 25 (depends on 15) The method of claim 15, wherein the physical instrument defines at least one of an anterior pelvic (AP) plane or an ipsilateral hemipelvic plane.