Abstract:
A system and method for the minimally invasive insertion of an intervertebral rod into the vertebrae of a subject, according to a preoperative surgical plan also defining positions for the insertion of rod clamping screws into the vertebrae. The rod shape for connecting the heads of the screws is calculated, and a path planning algorithm used to determine whether the distal end of the rod can be threaded through the screw heads by longitudinal and rotational manipulation of the proximal end of the rod. If so, instructions are provided for forming that rod shape and for the robotic insertion of the screw holes and the rod. If not, either or both of the screw positions and the rod shape are adjusted, to moderate the bends in the rods, until insertion becomes possible. The insertion can be performed robotically, or, if a navigation tracking system is added, manually.
Abstract:
A system for insertion of a surgical tool along a trajectory to a target region in a patient's tissues, under the guidance of ultrasound imaging. The system includes a hand-held robot to whose base the probe of an ultrasound system is rigidly connected. The activated platform of the hand held robot carries a surgical tool guide. The alignment of the tool guide defines the trajectory which the tool takes within the subject's body. The position of the target region seen on the ultrasound display, can be recorded, and the robot coordinate frame of reference registered thereto. The system aligns the pose of the robot such that the surgical tool is aimed directly at the target region, independently of motion of the ultrasound probe and its associated robot. An inertial measurement unit can be incorporated to provide back-up positional information if the image of the lesion is lost.
Abstract:
A system and method for the minimally invasive insertion of an intervertebral rod into the vertebrae of a subject, according to a preoperative surgical plan also defining positions for the insertion of rod clamping screws into the vertebrae. The rod shape for connecting the heads of the screws is calculated, and a path planning algorithm used to determine whether the distal end of the rod can be threaded through the screw heads by longitudinal and rotational manipulation of the proximal end of the rod. If so, instructions are provided for forming that rod shape and for the robotic insertion of the screw holes and the rod. If not, either or both of the screw positions and the rod shape are adjusted, to moderate the bends in the rods, until insertion becomes possible. The insertion can be performed robotically, or, if a navigation tracking system is added, manually.
Abstract:
A robotic surgical system comprising at least two robotic arms having co-ordinate systems known relative to each other, one of the arms carrying an X-ray source, and the other an imaging detector plate. The arms are disposed to enable an image to be generated on the region of interest of a subject. One of the arms can additionally or alternatively carry a surgical tool or tool holder, such that the pose of the tool is known in the same co-ordinate system as that of an image generated by the X-ray source and detector. Consequently, any surgical procedure planned on such an X-ray image can be executed by the tool with high accuracy, since the tool position is known in the image frame of reference. This enables the surgeon to accurately position his tool in a real-time image without the need for an external registration procedure.
Abstract:
A balloon dilator device, comprising an annularly shaped, cylindrical type structure having walls that are expandable from a radially collapsed state to a radially expanded state by inflation of a balloon inserted within the annular structure. Once the walls have been expanded, they remain in the expanded state even if the balloon is deflated, because the radially expanded state is a state of minimum mechanical potential energy, and in order to return to the collapsed state, the structure would have to pass a state of higher potential energy. The device walls require sufficient stiffness in their longitudinal direction to enable the device to be pushed into a minimally invasive incision made in the subject. This device stiffness can be achieved either by its mechanical material properties, or by its substantially closed wall structure, or by use of a stiff protector sheath used to protect the walls during insertion.
Abstract:
A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.
Abstract:
A minimally invasive system using a surgical robot as a three-dimensional printer for fabrication of biological tissues inside the body of a subject. A preoperative plan is used to direct and control both the motion of the robot and the robotic bio-ink extrusion. The robotic motion is coordinated with the ink extrusion to form layers having the desired thickness and dimensions, and use of different types of ink enables composite elements to be laid down. Such systems have a small diameter bio-ink ejecting mechanism, generally in the form of a piston driven cannula, enabling access to regions such as joints, with limited space. The robotic control is programmed such that angular motion takes place around a pivot point at the point of insertion into the subject. The bio-inks can be stored in predetermined layers in the cannula to enable sequential dispensing from one cannula.
Abstract:
A system and method for the minimally invasive insertion of an intervertebral rod into the vertebrae of a subject, according to a preoperative surgical plan also defining positions for the insertion of rod clamping screws into the vertebrae. The rod shape for connecting the heads of the screws is calculated, and a path planning algorithm used to determine whether the distal end of the rod can be threaded through the screw heads by longitudinal and rotational manipulation of the proximal end of the rod. If so, instructions are provided for forming that rod shape and for the robotic insertion of the screw holes and the rod. If not, either or both of the screw positions and the rod shape are adjusted, to moderate the bends in the rods, until insertion becomes possible. The insertion can be performed robotically, or, if a navigation tracking system is added, manually.
Abstract:
Methods and apparatus for detecting or predicting surgical tool-bone skiving are disclosed. In some embodiments, the surgical tool is movably and/or snugly disposed within a guide-sleeve. In some embodiments, a magnitude of a lateral force between the surgical tool and the guide-sleeve is measured (e.g. by a force sensor or strain sensor). The present or future skiving may be detected or predicted according to the magnitude of the lateral force. In some embodiments, an alert signal is generated in response to the detecting or predicting of the skiving.
Abstract:
A method for optimizing orthopedic spinal implant survival using preoperative finite element analysis combined with intraoperative stress analysis. Based on clinically relevant data, finite element analysis, and corrected values of spinal parameters, an acceptable long-term stress score is determined for an appropriate implant, which is selected from a set of potential implants, such that the shape of the implant minimizes predicted stress values. From a preoperative medical image set, values of selected spinal alignment parameters are determined; finite element analysis is performed on potential implants to determine stress values; and a selected implant is digitally positioned in the medical image set to create a virtual bone/implant configuration. After the selected implant is inserted and bent to shape, actual stress values are measured intraoperatively. The process of bending and measuring stress values is repeated until the bone/implant configuration falls within the acceptable long-term stress score range.