# US 2019/0167362 A1 · Surgical robot platform

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- Number: US 2019/0167362 A1
- Document ID: US20190167362A1
- Status: Published application
- Kind: A1
- Application number: 16/267,833
- Filed: 2019-02-05
- Published: 2019-06-06
- Earliest claimed: 2006-02-16
- Assignees: Globus Medical, Inc.
- Applicants: Globus Medical, Inc.
- Inventors: Neil R. Crawford; Nicholas Theodore; Mitchell A. Foster
- Web page: https://patentgrep.com/patent/US20190167362A1

## CPC

- A61B 34/30: Surgical robots
- A61B 5/061: {Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body (A61B1/00158 takes precedence)}
- A61B 5/062: {using magnetic field}
- A61B 5/066: {Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging}
- A61B 6/12: Arrangements for detecting or locating foreign bodies
- A61B 10/02: Instruments for taking cell samples or for biopsy {(A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48)}
- A61B 10/0233: {Pointed or sharp biopsy instruments}
- A61B 10/0275: {with sample notch, e.g. on the side of inner stylet}
- A61B 17/025: {Joint distractors}
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1671: {for the spine}
- A61B 17/1703: {using imaging means, e.g. by X-rays}
- A61B 17/1757: {for the spine}
- A61B 17/7082: {for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws}
- A61B 17/8866: {for gripping or pushing bones, e.g. approximators (joint distractors A61B17/025)}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/25: {User interfaces for surgical systems}
- A61B 34/32: operating autonomously
- A61B 34/70: {Manipulators specially adapted for use in surgery}
- A61B 34/74: {Manipulators with manual electric input means}
- A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback}
- A61B 46/20: specially adapted for patients
- A61B 50/13: Trolleys{, e.g. carts}
- A61B 90/14: Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers}
- A61B 90/96: using barcodes
- A61B 90/98: using electromagnetic means, e.g. transponders
- A61F 2/46: Special tools for implanting artificial joints
- A61M 5/172: electrical or electronic
- A61N 1/0529: {Electrodes for brain stimulation}
- B25J 9/1065: {with parallelograms}
- A61B 5/064: {using markers (A61B5/062 takes precedence)}
- A61B 6/4435: {the source unit and the detector unit being coupled by a rigid structure}
- A61B 6/547: {involving tracking of position of the device or parts of the device}
- A61B 17/17: Guides {or aligning means} for drills {, mills, pins or wires}
- A61B 90/11: with guides for needles or instruments, e.g. arcuate slides or ball joints
- A61B 90/36: {Image-producing devices or illumination devices not otherwise provided for}
- A61B 2010/0208: {Biopsy devices with actuators, e.g. with triggered spring mechanisms}
- A61B 2017/00119: {alarm; indicating an abnormal situation}
- A61B 2017/00203: {with speech control or speech recognition}
- A61B 2017/00207: {with hand gesture control or hand gesture recognition}
- A61B 2017/00876: {magnetic}
- A61B 2017/0256: {for the spine}
- A61B 2034/102: {Modelling of surgical devices, implants or prosthesis}
- 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 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2059: {Mechanical position encoders}
- A61B 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- A61B 2034/2072: {Reference field transducer attached to an instrument or patient}
- A61B 2034/2074: {Interface software}
- A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes}
- A61B 2034/741: {Glove like input devices, e.g. "data gloves"}
- A61B 2034/742: {Joysticks}
- A61B 2034/743: {Keyboards}
- A61B 2034/744: {Mouse}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/374: {NMR or MRI}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3762: {using computed tomography systems [CT]}
- A61B 2090/3764: {with a rotating C-arm having a cone beam emitting source}
- A61B 2090/378: {using ultrasound}
- A61B 2090/3937: {Visible markers}
- A61B 2090/3941: {Photoluminescent markers}
- A61B 2090/3945: {Active visible markers, e.g. light emitting diodes}
- A61B 2090/395: {with marking agent for marking skin or other tissue}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61B 2090/3975: {active}
- A61B 2090/3979: {infrared}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61F 2002/4632: {using computer-controlled surgery, e.g. robotic surgery}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- B25J: MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES ({manipulators specially adapted for use in surgery A61B34/70; manipulators used in cleaning hollow articles B08B9/04}; manipulators associated with rolling mills B21B39/20; manipulators associated with forging machines B21J13/10; {manipulators associated with picking-up and placing mechanisms B23P19/007}; means for holding wheels or parts thereof B60B30/00; {vehicles with ground-engaging propulsion means, e.g. walking members B62D57/02, B62D57/032; devices for picking-up and depositing articles or materials between conveyors B65G47/90, B65G47/91; manipulators with gripping or holding means for transferring packages B65H67/065}; cranes B66C; {manipulators used in the protection or supervision of pipe-line installations F17D5/00; walking equipment adapted for nuclear steam-generators F22B37/006}; manipulators specially adapted for, or associated with, nuclear reactors G21C; {apparatus used for handling wafers during manufacture or treatment of semiconductor H10P72/50})

## Abstract

A medical robot system, including a robot coupled to an effectuator element with the robot configured for controlled movement and positioning. The system may include a transmitter configured to emit one or more signals, and the transmitter is coupled to an instrument coupled to the effectuator element. The system may further include a motor assembly coupled to the robot and a plurality of receivers configured to receive the one or more signals emitted by the transmitter. A control unit is coupled to the motor assembly and the plurality of receivers, and the control unit is configured to supply one or more instruction signals to the motor assembly. The instruction signals can be configured to cause the motor assembly to selectively move the effectuator element.

## Claims

### Claim 1

A method for calibrating to a medical image for use with a medical robot system, the medical robot system comprising a targeting fixture comprising a plurality of radio-opaque markers, a display, a robot arm, an end-effector coupled to the robot arm and controlled by at least one motor, and a computer, said method comprising:
receiving, via the computer of the medical robot system, data associated with the medical image representative of the plurality of radio-opaque markers in an imaging coordinate system, wherein the display is configured to show the imaging coordinate system;
determining, via the computer, a geometrical center, in the imaging coordinate system, associated with each of the radio-opaque markers;
mapping, via the computer, each geometrical center to the associated radio-opaque marker; and
retaining in the computer, a center coordinate for each geometrical center in the imaging coordinate system,
wherein calibration of the targeting fixture to the imaging coordinate system occurs based upon the center coordinate for each geometrical center and wherein the center coordinate for each geometrical center is determined by analyzing pixels that reach a predetermined value, and
wherein a trajectory of the medical robot system relative to a patient is controlled based upon the calibration of the targeting fixture.

### Claim 2 (depends on 1)

The method of claim 1, wherein determining the geometrical center further comprises using image thresholding to define one or more edges of each radio-opaque marker and each geometrical center.

### Claim 3 (depends on 2)

The method of claim 2, wherein image thresholding includes displaying pixels that satisfy a thresholding criterion at an intensity encountered at the edge of a radio-opaque marker to indicate a circular outline of each radio-opaque marker on the medical image.

### Claim 4 (depends on 3)

The method of claim 3, wherein determining a geometrical center includes determining a mean x threshold position of each geometrical center and determining a mean y threshold position of each geometrical center.

### Claim 5 (depends on 3)

The method of claim 3, wherein determining a geometrical center includes determining a two-dimensional (2D) center for each geometrical center by examining a slice for each of two orthogonal view for the associated radio-opaque marker.

### Claim 6 (depends on 1)

The method of claim 1, further comprising:
using a threshold setting for determining the geometrical center for each radio-opaque marker;
adjusting the threshold setting upon a determination that one or more geometrical centers cannot be identified.

### Claim 7 (depends on 1)

The method of claim 1, wherein the plurality of radio-opaque markers are disposed on a calibration fixture.

### Claim 8 (depends on 7)

The method of claim 7, wherein mapping comprises implementing a sorting process to establish each geometric center with the associated radio-opaque marker, wherein the sorting process is configured to distinguish between the plurality of radio-opaque markers to establish each geometric center.

### Claim 9 (depends on 8)

The method of claim 8, wherein the sorting process includes distinguishing a particular one of the radio-opaque markers from other radio-opaque markers by measuring inter-marker distances from mean positions of the plurality of radio-opaque markers in the imaging coordinate system and comparing with retained pre-measured inter-marker distances of each of the plurality of radio-opaque markers based on the calibration fixture.

### Claim 10 (depends on 1)

The method of claim 1, wherein the targeting fixture and each center coordinate is used to track the position of the robot in the imaging coordinate system.

### Claim 11

A method for calibrating a targeting fixture containing a plurality of radio-opaque markers to a medical image for use with a surgical robot, said method comprising:
receiving data associated with the medical image representative of the plurality of radio-opaque markers in an imaging coordinate system;
determining a geometrical center, in the imaging coordinate system, associated with each of the radio-opaque markers;
mapping each geometrical center to the associated radio-opaque marker; and
retaining in a computer of the surgical robot, a center coordinate for each geometrical center in the imaging coordinate system,
wherein the surgical robot comprises:
the targeting fixture containing the plurality of radio-opaque markers;
the computer;
a display; and
a housing, wherein the housing further comprises a robot arm and an end-effectuator,
wherein calibration of the targeting fixture to the imaging coordinate system occurs based upon the center coordinate for each geometrical center and wherein the center coordinate for each geometrical center is determined by analyzing pixels that reach a predetermined value, and
wherein a trajectory of the robot arm and end-effectuator relative to a patient is controlled based upon the calibration of the targeting fixture.

### Claim 12 (depends on 11)

The method of claim 11, wherein determining the geometrical center further comprises using image thresholding to define one or more edges of each radio-opaque marker and each geometrical center.

### Claim 13 (depends on 12)

The method of claim 12, wherein image thresholding includes displaying pixels that satisfy a thresholding criterion at an intensity encountered at the edge of a radio-opaque marker to indicate a circular outline of each radio-opaque marker on the medical image.

### Claim 14 (depends on 13)

The method of claim 13, wherein determining a geometrical center includes determining a mean x threshold position of each geometrical center and determining a mean y threshold position of each geometrical center.

### Claim 15 (depends on 13)

The method of claim 13, wherein determining a geometrical center includes determining a two-dimensional (2D) center for each geometrical center by examining a slice for each of two orthogonal view for the associated radio-opaque marker.

### Claim 16 (depends on 11)

The method of claim 11, further comprising:
using a threshold setting for determining the geometrical center for each radio-opaque marker;
adjusting the threshold setting upon a determination that one or more geometrical centers cannot be identified.

### Claim 17 (depends on 11)

The method of claim 11, wherein the plurality of radio-opaque markers are disposed on a calibration fixture.

### Claim 18 (depends on 17)

The method of claim 17, wherein mapping comprises implementing a sorting process to establish each geometric center with the associated radio-opaque marker, wherein the sorting process is configured to distinguish between the plurality of radio-opaque markers to establish each geometric center.

### Claim 19 (depends on 18)

The method of claim 18, wherein the sorting process includes distinguishing a particular one of the radio-opaque markers from other radio-opaque markers by measuring inter-marker distances from mean positions of the plurality of radio-opaque markers in the imaging coordinate system and comparing with retained pre-measured inter-marker distances of each of the plurality of radio-opaque markers based on the calibration fixture.

### Claim 20 (depends on 11)

The method of claim 11, wherein each center coordinate is used to track the position of the surgical robot in the imaging coordinate system.