# US 9,750,510 B2 · Notched apparatus for guidance of an insertable instrument along an axis during spinal surgery > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,750,510 B2 - Document ID: US9750510B2 - Status: Granted - Kind: B2 - Application number: 14/996,115 - Filed: 2016-01-14 - Published: 2016-05-12 - Granted: 2017-09-05 - Earliest claimed: 2014-01-15 - Assignees: Globus Medical, Inc. - Applicants: KB Medical SA - Inventors: Szymon Kostrzewski; Billy Nussbaumer; Roderik Berthelin; Chetan K. Patel - Web page: https://patentgrep.com/patent/US9750510B2 ## CPC - A61B 17/17: Guides {or aligning means} for drills {, mills, pins or wires} - A61B 17/1703: {using imaging means, e.g. by X-rays} - A61B 17/3417: {Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00)} - A61B 34/30: Surgical robots - A61B 34/37: Leader-follower robots (A61B34/35 takes precedence) - A61B 90/11: with guides for needles or instruments, e.g. arcuate slides or ball joints - A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers} - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 2034/2055: {Optical tracking systems} - A61B 2034/305: {Details of wrist mechanisms at distal ends of robotic arms} - A61B 2090/061: {for measuring dimensions, e.g. length} - A61B 2090/062: {penetration depth} - A61B 2090/065: {for measuring contact or contact pressure} - A61B 2090/066: {for measuring torque} - A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image} - A61B 2090/368: {changing the image on a display according to the operator's position} - A61B 2090/3937: {Visible markers} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Described herein is a surgical instrument guide for use with a robotic surgical system, for example, during spinal surgery. In certain embodiments, the guide is attached to or is part of an end effector of a robotic arm, and provides a rigid structure that allows for precise preparation of patient tissue (e.g., preparation of a pedicle) by drilling, tapping, or other manipulation, as well as precise placement of a screw in a drilled hole or affixation of a prosthetic or implant in a prepared patient situation. ## Claims ### Claim 1 A surgical instrument guide for use with a robotic surgical system, the surgical instrument guide comprising a rigid hollow tubular structure having a first open end and a second open end, said structure defining an axis along which movement of a surgical instrument in the structure is restricted, wherein the tubular structure comprises: an interior surface shaped and sized to accommodate the surgical instrument in the surgical instrument guide such that movement of the surgical instrument is constrained in at least one direction; a longitudinal notch in a side of the rigid hollow tubular structure, wherein the longitudinal notch is sized in relation to a peg to (i) permit a navigation marker attached to the surgical instrument via the peg to be viewable by a navigation camera, and (ii) constrain movement along the axis to a translational range defined by a distance between the lock and the terminal end. ### Claim 2 (depends on 1) The surgical instrument guide of claim 1, wherein the rigid hollow tubular structure is a cylindrical structure. ### Claim 3 (depends on 1) The surgical instrument guide of claim 1, wherein the longitudinal notch is a slot. ### Claim 4 (depends on 1) The surgical instrument guide of claim 1, wherein the navigation marker is used by navigation camera to track the surgical instrument. ### Claim 5 (depends on 1) The surgical instrument guide of claim 1, wherein the notch is sized in relation to a peg to permit the surgical instrument to slide along the axis. ### Claim 6 (depends on 1) The surgical instrument guide of claim 1, wherein the tubular structure comprises a second longitudinal notch extending from the first open end of the rigid hollow tubular structure, the second longitudinal notch having a terminal end that limits insertion of the surgical instrument. ### Claim 7 (depends on 6) The surgical instrument guide of claim 6, wherein the second longitudinal notch is sized in relation to a peg to (i) permit a navigation marker attached to the surgical instrument via the peg to be viewable by a navigation camera, (ii) constrain movement of the marker to along the axis. ### Claim 8 (depends on 1) The surgical instrument guide of claim 1, wherein the lock, when engaged, prevents movement of a surgical instrument within the rigid hollow tubular structure beyond a preset position along the axis defined by the surgical instrument guide. ### Claim 9 (depends on 1) The surgical instrument guide of claim 1, wherein the lock, when engaged, prevents removal of a surgical instrument from the surgical instrument guide. ### Claim 10 (depends on 9) The surgical instrument guide of claim 9, wherein the lock is an end lock. ### Claim 11 (depends on 1) The surgical instrument guide of claim 1, comprising an intermediate lock that, when engaged, prevents movement of a surgical instrument within the rigid hollow tubular structure beyond a preset position along the axis. ### Claim 12 (depends on 1) The surgical instrument guide of claim 1, comprising an instrument position sensor that detects the position of a surgical instrument when the surgical instrument is in and/or attached to the rigid hollow tubular structure. ### Claim 13 (depends on 12) The surgical instrument guide of claim 12, wherein the instrument position sensor detects when the surgical instrument is at the bottom position within the surgical instrument guide. ### Claim 14 (depends on 12) The surgical instrument guide of claim 12, wherein the instrument position sensor detects when the surgical instrument is at the bottom position within the surgical instrument guide such that robot generates movement of the surgical instrument guide along a desired trajectory. ### Claim 15 (depends on 12) The surgical instrument guide of claim 12, wherein the instrument position sensor is selected from the group consisting of: an inductive sensor, a capacitive sensor, a resistive sensor, a mechanical end switch, an optical measuring device, a force sensing device, and a position sensor. ### Claim 16 (depends on 1) The surgical instrument guide of claim 1, comprising: one or more input devices. ### Claim 17 (depends on 1) The surgical instrument guide of claim 1, comprising: an activation switch that detects the presence of a surgeon's hand on the surgical instrument guide. ### Claim 18 (depends on 1) The surgical instrument guide of claim 1, wherein said at least one direction comprises all directions except along the axis defined by the surgical instrument guide. ### Claim 19 (depends on 1) The surgical instrument guide of claim 1, wherein the interior surface of the tubular structure is shaped and sized to accommodate the surgical instrument sliding through the surgical instrument guide. ### Claim 20 (depends on 1) The surgical instrument guide of claim 1, wherein the surgical instrument guide comprises two or more rails that restrict movement of a surgical instrument in the structure along the axis. ### Claim 21 (depends on 1) The surgical instrument guide of claim 1, wherein the tubular structure comprises: an exterior surface comprising at least one flange that is configured for secure coupling of the surgical instrument guide to an end effector of the robotic surgical system. ### Claim 22 (depends on 1) The surgical instrument guide of claim 1, wherein the longitudinal notch prevents rotation of the surgical instrument about the axis when the surgical instrument is inserted. ### Claim 23 (depends on 21) The surgical instrument guide of claim 21, wherein the at least one flange comprises one or more holes for bolting the surgical instrument guide to the end effector.