Mako Surgical Corporation

Jienan Ding

Hyosig Kang

Peter L Ebbitt

Min Wu

Snehal Kasodekar

Ta-Cheng Chang

Jean Gonzalez

Viktor Krebs

Matt Harrow

David Gene Bowling

Christopher Wayne Jones

Greg McEwan

Lucas Gsellman

Robert A Brindley

Jamil Elbanna

Vijay Subramanian

Michael Prieto

Joseph J Bos

Tim Perez

Saul Najera

Xiaohui Gao

Thomas Trey Miller

Robert Lee Boudreaux

Jeremiah Beers

Spinal surgery systems and methods include a manipulator with a robotic arm and an end effector. A navigation system with a localizer tracks a patient and the manipulator. A control system registers, with the navigation system, a desired trajectory for a vertebra of the patient and detects that the end effector is within a predetermined distance to the desired trajectory. In response to the end effector being within the predetermined distance and detection of a user input, the control system autonomously moves the robotic arm to align the end effector to the desired trajectory. The end effector is constrained to the desired trajectory with a line haptic object and can exit the line haptic object in response to being moved along the line haptic object until the end effector reaches an exit point defined relative to the line haptic object.

Robotic spine surgery system and methods

Surgical systems and methods involve a robotic manipulator with a force sensor and a surgical tool that holds a screw. The screw has a known thread geometry. A navigation system tracks a pose of a target anatomy. Controller(s) store the known thread geometry and control the robotic manipulator to maintain the rotational axis on a planned trajectory with respect to the target anatomy based on the tracked pose of the target anatomy. The controller(s) detect, with the force sensor, a force applied by a user. The controller(s) control a rotational rate of the surgical tool to rotate the screw about a rotational axis and an advancement rate of the surgical tool to linearly advance the screw along the planned trajectory. The rotational rate and the advancement rate are based on the force applied by the user and are proportional to the known thread geometry.

Surgical systems and methods involve manipulation of a bone. A robotic manipulator supports and moves a surgical tool that has a cutting bur rotatable about a cutting axis. Controller(s) control the manipulator to align the cutting axis to a target axis associated with the bone and advance the cutting bur along the target axis towards a cortical region of the bone. The controller(s) control the surgical tool to rotate the cutting bur about the cutting axis and contact the cortical region. The controller(s) detect, from sensor(s), forces applied to the cutting bur by the cortical region and compare the sensed forces to a threshold indicative of skiving of the cutting bur relative the cortical region. In response to the sensed forces exceeding the threshold, the controller(s) adjust control of the manipulator and/or surgical tool to reduce forces applied to the cutting bur by the cortical region.

Robotic surgical systems and methods for mitigating skiving between rotary cutting tool and cortical bone

A method for intraoperatively augmenting a revision implant includes removing a primary implant from a bone, intraoperatively determining a size of a defect of the bone, intraoperatively cutting a bone filler material to the size of the defect, installing the bone filler material at the defect, and installing the revision implant on the bone.

Systems and methods for guiding a revision procedure

A method for intraoperative planning and facilitating a revision arthroplasty procedure includes displaying a virtual model of a bone, capturing positions of a tracked probe as the tracked probe contacts points at a perimeter of a primary implant component coupled to the bone, generating a virtual representation of an interface between the primary implant component and the virtual model of the bone using the positions of the tracked probe, planning a bone resection using the virtual representation of the interface, and guiding execution of the bone resection.

A robotic system and methods for performing spine surgery are disclosed. The system comprises a robotic manipulator with a tool to hold a screw and to rotate the screw about a rotational axis. The screw is self-tapping and has a known thread geometry that is stored by one or more controllers. A navigation system tracks a position of a target anatomy. Movement of the robotic manipulator is controlled to maintain the rotational axis of the surgical tool along a planned trajectory with respect to the target anatomy based on the tracked position of the target anatomy. In autonomous or manual modes of operation, the rotational rate of the screw about the rotational axis and/or an advancement rate of the screw linearly along the planned trajectory is controlled to be proportional to the known thread geometry stored in the memory.

A method of performing a procedure includes preparing a subject, gaining access to a portion of the subject with a first instrument, removing a first portion of the portion of the subject with the first instrument, gaining access to the portion of the subject with a tracked instrument, moving the tracked instrument to a surface revealed by removal of at least the first portion from the portion of the subject, tracking the tracked instrument while moving at least the tracked instrument to the surface, and determining a representation of the surface based on the tracking the tracked instrument.

Systems and methods for a robotic-assisted revision procedure

A fiber optic tracking sensor includes an outer tube, a plurality of optical fibers within the outer tube and including a central optical fiber and a plurality of additional optical fibers, and one or more structural members within the outer tube and configured to provide a spacing between the plurality of optical fibers such that the central optical fiber is positioned along a central longitudinal axis of the outer tube and the plurality of additional optical fibers are spaced apart from one another and from the central optical fiber.

Systems and methods for fiber optic tracking

A method for intraoperatively planning and facilitating a revision arthroplasty procedure. The method includes capturing positions of a tracked probe as the tracked probe contacts an interface area between a bone and a primary implant component implanted on the bone, intraoperatively generating a virtual boundary corresponding to a portion of the interface area to be removed to detach the primary implant component from the bone using the positions of the tracked probe and without use of pre-operative medical imaging, facilitating removal of the primary implant component from the bone by providing a constraint on operation of a cutting tool while the cutting tool removes the portion of the interface area, the constraint based on a relationship between the cutting tool and the virtual boundary.

A fiber optic tracking sensor includes at least three optical fibers, each optical fiber having a plurality of fiber optic sensors along a length of a sensing portion of the sensor. A shape-memory member is coupled to the three optical fibers and provides support to the sensor. The at least three optical fibers are arranged in a spaced apart relationship, each offset from a central longitudinal axis of the sensor.

Disclosed herein are techniques for preparation of a bone structure wherein a robotically controlled cutting bur is utilized for both milling the entry point at the outer cortical region and cannulation of the cancellous bone region for receipt of an implant. A robotic manipulator supports and moves the cutting bur and one or more controllers analyze measurements from sensors and, in response, control the robotic manipulator and/or the cutting bur for purposes such as landmark detection to determine entry point, avoiding tool skiving at entry point, and avoidance of cortical wall breach during cannulation. Also described are techniques for managing feed rate, rotational cutting speed, or mode of operation depending on operational conditions surrounding various stages of cannulation. A control interface is also provided to enable the user to manage or adjust cutting bur operation and feed rate.

Robotic surgical system and methods utilizing a cutting bur for bone penetration and cannulation

A robotic system for performing spine surgery. The robotic system comprises a robotic manipulator and a navigation system to track a surgical tool relative to a patient's spine. The robotic system may be controlled manually and/or autonomously to place implants in the patient's spine.

A robotic system and methods for performing spine surgery are disclosed. The system comprises a robotic manipulator with a tool to hold a screw and to rotate the screw about a rotational axis. The screw is self-tapping and has a known thread geometry that is stored by a controller. A navigation system tracks a position of a target site. Movement of the robotic manipulator is controlled to maintain the rotational axis of the surgical tool along a planned trajectory with respect to the target site based on the tracked position of the target site. In autonomous or manual modes of operation, the rotational rate of the screw about the rotational axis and/or an advancement rate of the screw linearly along the planned trajectory is controlled to be proportional to the known thread geometry stored in the memory.

A method for performing a revision surgery using a robotic-assisted surgery system includes determining information related to an interface area between an implant component and a bone, and generating a planned virtual boundary associated with a portion of the interface area to be removed in a representation of the implant and the bone, based at least in part on the information related to the interface area. The method further includes tracking movement in the physical space of a cutting tool such that movement of the cutting tool is correlated with movement of a virtual tool, and providing a constraint on the cutting tool while the cutting tool removes the portion of the interface area. The constraint is based on a relationship between the virtual tool and the planned virtual boundary. The portion of the interface area is removed to remove the implant component from the bone.

A system for cutting a bone of a patient may include a motor; a rotating shaft drivingly coupled to the motor; a support tube positioned around the rotating shaft and supporting the rotating shaft at a plurality of locations; a plurality of steering wires coupled to the support tube; and a bone cutter at a distal end of the rotating shaft.

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Weston, FL, United States of America

Jienan Ding