# US 12,178,522 B2 · Versatile tracking arrays for a navigation system and methods of recovering registration using the same

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- Number: US 12,178,522 B2
- Document ID: US12178522B2
- Status: Granted
- Kind: B2
- Application number: 17/453,006
- Filed: 2021-11-01
- Published: 2022-02-17
- Granted: 2024-12-31
- Earliest claimed: 2018-05-25
- Assignees: MAKO Surgical Corp.
- Applicants: MAKO Surgical Corp.
- Inventors: Jonathan Mark Morgan; Jean Gonzalez
- Web page: https://patentgrep.com/patent/US12178522B2

## CPC

- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 17/88: {Osteosynthesis instruments;} Methods or means for implanting or extracting internal {or external} fixation devices {(A61B17/7074 takes precedence)}
- A61B 34/30: Surgical robots
- A61B 17/1764: {for the knee}
- A61B 17/846: {Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface (A61B17/72, A61B17/86 take precedence)}
- A61B 90/96: using barcodes
- A61B 2017/00123: {and automatic shutdown}
- A61B 2017/564: {Methods for bone or joint treatment}
- A61B 2034/2048: {using an accelerometer or inertia sensor}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- A61B 2034/252: {indicating steps of a surgical procedure}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2090/3916: {Bone tissue}
- A61B 2090/3945: {Active visible markers, e.g. light emitting diodes}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61B 2090/3991: {having specific anchoring means to fixate the marker to the tissue, e.g. hooks}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A navigation system includes a first and second tracker supports independently affixed to a rigid object and separated by a distance. A first plurality of trackable elements are secured to the first tracker support and a second plurality of trackable elements are secured to the second tracker support. A localizer tracks the trackable elements and controller(s) define a tracking arrangement to be tracked based on a combination of the first and second plurality of trackable elements. A geometry of the tracking arrangement is registered relative to the rigid object and the controller(s) track the rigid object by detecting the registered geometry. The controller(s) identify a condition wherein at least one trackable element has been displaced relative to the registered geometry, and in response, generate an instruction to a manipulator controller to interrupt operation of a robotic manipulator.

## Claims

### Claim 1

A method for operating a navigation system usable with a robotic manipulator and a manipulator controller configured to control the robotic manipulator, the navigation system comprising a first tracker support affixed to a rigid object and a first plurality of trackable elements secured to the first tracker support, a second tracker support affixed to the rigid object and a second plurality of trackable elements secured to the second tracker support, the first tracker support and the second tracker support adapted to be independently secured to the rigid object and separated by a distance, the navigation system comprising a localizer configured to track the first and second plurality of trackable elements, the method comprising the navigation system:
defining a tracking arrangement to be tracked based on a combination of the first and second plurality of trackable elements;
registering a geometry of the tracking arrangement relative to the rigid object;
tracking the rigid object by detecting the registered geometry of the tracking arrangement;
identifying a condition wherein at least one trackable element has been displaced relative to the registered geometry and the displacement of the at least one trackable element is not a candidate for recovering registration of the registered geometry; and
in response to identifying the condition, generating an instruction to the manipulator controller for interrupting operation of the robotic manipulator.

### Claim 2 (depends on 1)

The method of claim 1, wherein generating the instruction to the manipulator controller further comprises the navigation system generating the instruction for causing the robotic manipulator to stop motion.

### Claim 3 (depends on 1)

The method of claim 1, wherein generating the instruction to the manipulator controller further comprises the navigation system generating the instruction for causing the robotic manipulator to move away from a surgical object.

### Claim 4 (depends on 1)

The method of claim 1, wherein the rigid object is a bone and the robotic manipulator is configured to support and move a surgical tool including an energy applicator to manipulate the bone, and further comprising the navigation system:
tracking the robotic manipulator to determine a relationship between the energy applicator and the bone.

### Claim 5 (depends on 4)

The method of claim 4, further comprising the navigation system:
generating a second instruction to use the robotic manipulator to touch an anatomical landmark of the bone with the energy applicator;
registering a position of the anatomical landmark; and
identifying, based on the registered position of the anatomical landmark, the at least one trackable element that has been displaced relative to the registered geometry.

### Claim 6 (depends on 1)

The method of claim 1, further comprising the navigation system:
evaluating an amount of displacement of the at least one trackable element relative to a predetermined displacement threshold or tolerance to determine whether recovering registration of the registered geometry is possible by manipulating the at least one displaced trackable element to return to the registered geometry of the tracking arrangement;
determining that recovering registration is not possible based on the evaluating the amount of displacement; and
in response, generating a notification indicating that recovering registration is not possible or that a complete re-registration is required.

### Claim 7 (depends on 1)

The method of claim 1, wherein the first plurality of trackable elements comprises two or fewer trackable elements and the second plurality of trackable elements comprises two or fewer trackable elements, and further comprising the navigation system:
defining the tracking arrangement to be tracked based on a combination of the two or fewer trackable elements of the first plurality and the two or fewer trackable elements of the second plurality.

### Claim 8

A method for operating a surgical system comprising navigation system, a robotic manipulator, and a manipulator controller, the navigation system comprising a first tracker support affixed to a rigid object and a first plurality of trackable elements secured to the first tracker support, a second tracker support affixed to the rigid object and a second plurality of trackable elements secured to the second tracker support, the first tracker support and the second tracker support adapted to be independently secured to the rigid object and separated by a distance, the navigation system comprising a localizer configured to track the first and second plurality of trackable elements, the method comprising:
defining, with the navigation system, a tracking arrangement to be tracked based on a combination of the first and second plurality of trackable elements;
registering, with the navigation system, a geometry of the tracking arrangement relative to the rigid object;
tracking, with the navigation system, the rigid object by detecting the registered geometry of the tracking arrangement;
controlling, with the manipulator controller, operation of the robotic manipulator;
identifying, with the navigation system, a condition wherein at least one trackable element has been displaced relative to the registered geometry and the displacement of the at least one trackable element is not a candidate for recovering registration of the of the registered geometry;
in response to identifying the condition, generating, with the navigation system, an instruction and communicating the instruction to the manipulator controller; and
in response to receiving the instruction from the navigation system, interrupting, with the manipulator controller, operation of the robotic manipulator.

### Claim 9 (depends on 8)

The method of claim 8, wherein interrupting, with the manipulator controller, operation of the robotic manipulator further comprises stopping motion of the robotic manipulator.

### Claim 10 (depends on 8)

The method of claim 8, wherein interrupting, with the manipulator controller, operation of the robotic manipulator further comprises controlling the robotic manipulator to move away from a surgical object.

### Claim 11 (depends on 8)

The method of claim 8, wherein the rigid object is a bone and the robotic manipulator is configured to support and move a surgical tool including an energy applicator to manipulate the bone, and further comprising:
tracking, with the navigation system, the robotic manipulator to determine a relationship between the energy applicator and the bone.

### Claim 12 (depends on 11)

The method of claim 11, further comprising:
generating, with the navigation system, a second instruction to use the robotic manipulator to touch an anatomical landmark of the bone with the energy applicator;
controlling, with the manipulator controller, operation of the robotic manipulator to facilitate touching the anatomical landmark of the bone with the energy applicator;
registering, with the navigation system, a position of the anatomical landmark touched by the energy applicator; and
identifying, with the navigation system, and based on the registered position of the anatomical landmark, the at least one trackable element that has been displaced relative to the registered geometry.

### Claim 13 (depends on 11)

The method of claim 11, further comprising the navigation system:
evaluating an amount of displacement of the at least one trackable element relative to a predetermined displacement threshold or tolerance to determine whether recovering registration of the registered geometry is possible by manipulating the at least one displaced trackable element to return to the registered geometry of the tracking arrangement;
determining that recovering registration is not possible based on the evaluating the amount of displacement; and
in response, generating a notification indicating that recovering registration is not possible or that a complete re-registration is required.