System for determining proximity of a surgical tool to key anatomical features

A method of facial nerve proximity detection comprising:

• providing a facial nerve proximity detection system comprising:
• a surgical robot comprising at least one surgical tool operably connected to the surgical robot, the robot being configured to operate near the facial nerve;
• an electromyography system comprising a pulse generator and a stimulation probe connected to the pulse generator functioning to emit pulses from the pulse generator into tissue, and a monitoring unit configured to receive pulse responses from nerves;
• a tissue impedance measurement system comprising a measurement probe and a processing unit to measure tissue impedance near the measurement probe;
• a first pose measurement system comprising a stereotactic surgical tracking system configured to track the surgical robot, the at least one surgical tool, the stimulation probe and the measurement probe relative to a patient;
• a second pose measurement system operating independently of the first pose measurement system configured to track the pose of the at least one surgical tool relative to the patient through non-stereotactic means;
• and
• a control unit comprising a graphical user interface, configured to acquire inputs from the electromyography and tissue impedance system, the first pose measurement system and the second pose measurement system and produce a weighted facial nerve proximity score based on the inputs from the electromyography system, the tissue impedance measurement system, the first pose measurement system and the second pose measurement system, and configured to provide command inputs to a control system of the surgical robot and to track the robot, the at least one surgical tool, the stimulation probe and the measurement probe relative to the patient;
• receiving the outputs from the electromyography and tissue impedance systems, the first pose measurement system and the second pose measurement system;
• producing the weighted facial nerve proximity score;
• tracking the robot, the at least one surgical tool, the stimulation probe and the measurement probe to obtain tracking information pertaining to the robot, the at least one surgical tool and the measurement probe and the stimulation probe;
• and
• providing the command inputs to the control system of the surgical robot according to the weighted facial nerve proximity score and the tracking information so as to avoid the facial nerve.