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Image-directed robotic system for precise robotic surgery including redundant consistency checking    

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United States Patent5299288   
Link to this pagehttp://www.wikipatents.com/5299288.html
Inventor(s)Glassman; Edward (New York, NY), Hanson; William A. (Mountain View, CA), Kazanides; Peter (Davis, CA), Mittelstadt; Brent D. (Placerville, CA), Musits; Bela L. (Hopewell Junction, NY), Paul; Howard A. (Loomis, CA), Taylor; Russell H. (Ossining, NY)
AbstractA robotic surgical system includes a multiple degree of freedom manipulator arm having a surgical tool. The arm is coupled to a controller for controllably positioning the surgical tool within a three dimensional coordinate system. The system further includes a safety monitoring processor for determining the position of the surgical tool in the three dimensional coordinate system relative to a volumetric model. The volumetric model may be represented as a constructive solid geometry (CSG) tree data structure. The system further includes an optical tracking camera system disposed for imaging a region of space that includes at least a portion of the manipulator arm. An output of the camera system is coupled to the processor that processes the volumetric model for determining if the surgical tool is positioned outside of the volumetric model. The system further includes a strain gage for detecting slippage in three dimensions between an immobilized tissue, such as bone, and a reference point. The system also includes multiple and redundant safety features for suspending a motion of the surgical tool to prevent the tool from operating outside of the predetermined volume of space.
   














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Drawing from US Patent 5299288
Image-directed robotic system for precise robotic surgery including
     redundant consistency checking - US Patent 5299288 Drawing
Image-directed robotic system for precise robotic surgery including redundant consistency checking
Inventor     Glassman; Edward (New York, NY) , Hanson; William A. (Mountain View, CA) , Kazanides; Peter (Davis, CA) , Mittelstadt; Brent D. (Placerville, CA) , Musits; Bela L. (Hopewell Junction, NY) , Paul; Howard A. (Loomis, CA) , Taylor; Russell H. (Ossining, NY)
Owner/Assignee     International Business Machines Corporation (Armonk, NY) Regents of the University of California (Armonk, NY)
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Publication Date     March 29, 1994
Application Number     07/761,720
PAIR File History     Application Data   Transaction History
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Litigation
Filing Date     September 18, 1991
US Classification     700/245 606/130 623/908 706/924
Int'l Classification    
Examiner     MacDonald; Allen R.
Assistant Examiner     Davis; George
Attorney/Law Firm     Perman & Green
Address
Parent Case     This is a divisional of copending application(s) of application Ser. No. 07/523,611 filed on May 11, 1990, now U.S. Pat. No. 5,086,401 .
Priority Data    
USPTO Field of Search     364/522 364/468 364/413.19 364/413.13 364/413.02 395/80 395/94 395/95 395/924 606/130 623/16 623/22
Patent Tags     image-directed robotic precise robotic surgery including redundant consistency checking
   
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5097839
Allen

Mar,1992

[0 after 0 votes]
4991579
Allen

Feb,1991

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4979949
Matsen, III et al.

Dec,1990

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4945914
Allen

Aug,1990

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4858149
Quarendon

Aug,1989

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4791934
Brunnett

Dec,1988

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4750487
Zanetti

Jun,1988

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4704686
Aldinger

Nov,1987

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4691694
Boyd et al.

Sep,1987

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4618978
Cosman

Oct,1986

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4485453
Taylor

Nov,1984

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4150326
Engelberger et al.

Apr,1979

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Having thus described our invention, what we claim as new, and desire to secure by Letters Patent is:

1. A method of surgically removing a quantity of tissue from a patient, the tissue being removed from a region having a predetermined three dimensional shape, the method comprising the steps of:

representing the three dimensional shape as a volumetric model or as a portion of a volumetric model;

determining a location of the volumetric model relative to the tissue that is to be removed; and

operating a multiple degree of freedom manipulator arm means having a surgical tool coupled thereto such that the tissue is removed, the step of operating including the steps of:

monitoring an output of a force sensor means that is coupled to the surgical tool;

detecting a position of the manipulator arm means;

determining a position of the surgical tool relative to the detected position of the manipulator arm means in accordance with a predetermined transformation function;

processing the volumetric model for determining if the determined position of the surgical tool is outside of the volumetric model; and

suspending a further movement of the surgical tool if the surgical tool is determined to be positioned outside of the volumetric model or if the step of monitoring the output of the force sensor means indicates that a sensed force has exceeded a first predetermined threshold.

2. A method as set forth in claim 1 wherein the step of operating includes an additional step of monitoring an output of a strain gage means to determine if a movement of the patient has occurred and suspending a further movement of the surgical tool if a movement is detected.

3. A method as set forth in claim 1 wherein the step of monitoring includes an additional step of de-energizing the manipulator arm means if a force is measured that exceeds a second, higher predetermined threshold.

4. A method as set forth in claim 1 wherein the step of operating includes an additional step of periodically monitoring an operational status of the manipulator arm means and suspending a further movement of the surgical tool if the operational status is determined to be less than optimum.

5. A method as set forth in claim 1 wherein the tissue includes bone tissue, wherein the volumetric model has a shape representative of a shape of a prosthetic implant, and wherein the step of representing the three dimensional shape as a volumetric model includes a step of:

selecting a shape of a prosthetic implant from a library of prosthetic implant shapes;

and wherein the step of determining a location of the volumetric model relative to the tissue that is to be removed includes a step of:

interactively determining a position of the selected prosthetic implant shape relative to images of the bone tissue.

6. A method as set forth in claim 5 and including an additional step of storing data for use during the step of processing, the stored data being expressive of the dimensions and shape of the selected prosthetic implant and data expressive of the determined position.

7. A method as set forth in claim 5 wherein the step of operating further includes a step of displaying in succession cross-sectional images of the bone tissue each having a corresponding cross-sectional view of the selected prosthetic implant superimposed thereon, a specific one of the cross-sectional bone tissue images being selected for display as a function of the position of the surgical tool relative to the volumetric model.

8. A method as set forth in claim 1 wherein the tissue includes bone tissue, wherein the volumetric model has a shape representative of a shape of a prosthetic implant, and wherein the step of representing the three dimensional shape as a volumetric model includes a step of:

defining a shape of a prosthetic implant as a function at least of the shape of the bone tissue;

and wherein the step of determining a location of the volumetric model relative to the tissue that is to be removed includes a step of:

interactively determining a position of the defined prosthetic implant shape relative to images of the bone tissue.

9. A method of preparing a cavity within a tissue to receive a prosthetic implant, the method comprising the steps of:

representing the prosthetic implant as a volumetric model or as a portion of a volumetric model;

determining a location of the volumetric model relative to the tissue within which the prosthetic implant is to be implanted; and

operating a multiple degree of freedom manipulator arm means having a surgical tool coupled thereto such that a cavity is prepared within the tissue to receive the prosthetic implant therein, the step of operating including the steps of:

monitoring an output of a force sensor means that is coupled to the surgical tool;

imaging a portion of the manipulator arm means during the operation thereof so as to determine a position of the manipulator arm means within a three-dimensional coordinate system;

determining a position of the surgical tool, relative to the determined position of the manipulator arm means, in accordance with a predetermined transformation function;

processing the volumetric model for determining if the determined position of the surgical tool is outside of the volumetric model; and

suspending a further movement of the surgical tool if the surgical a tool is determined to be positioned outside of the volumetric model or if the step of monitoring the output of the force sensor means indicates that a sensed force has exceeded a first predetermined threshold.

10. A method as set forth in claim 9 wherein the step of operating includes an additional step of monitoring an output of a strain gage means that is coupled to the tissue so as to detect a movement of the tissue; and suspending a further movement of the surgical tool if a movement is detected.

11. A method as set forth in claim 9 wherein the step of monitoring includes an additional step of de-energizing the manipulator arm means if a force is measured that exceeds a second predetermined threshold, the second predetermined threshold being greater than the first predetermined threshold.

12. A method as set forth in claim 9 wherein the tissue includes bone tissue, and wherein the step of monitoring includes a step detecting if a position of the surgical tool transitions between trabecular bone and cortical bone.

13. A method as set forth in claim 9 wherein the tissue includes bone tissue, and wherein the step of representing the prosthetic implant as a volumetric model includes a step of:

selecting a shape of a prosthetic implant from a library of prosthetic implant shapes;

and wherein the step of determining a location of the volumetric model relative to the tissue includes a step of:

interactively determining a desired position of the selected prosthetic implant shape relative to images of the bone tissue.

14. A method as set forth in claim 13 and including an additional step of storing data for use during the step of processing, the stored data being expressive of the dimensions and shape of the selected prosthetic implant and data expressive of the determined position.

15. A method as set forth in claim 13 wherein the step of operating further includes a step of displaying in succession cross-sectional images of the bone tissue each having a corresponding cross-sectional view of the selected prosthetic implant superimposed thereon, a specific one of the cross-sectional bone tissue images being selected for display as a function of a current position of the surgical tool relative to the volumetric model.

16. A method as set forth in claim 9 wherein the tissue includes bone tissue, and wherein the step of representing the prosthetic implant as a volumetric model includes a step of:

defining a shape of a prosthetic implant as a function at least of the shape of the bone tissue;

and wherein the step of determining a location of the volumetric model relative to the tissue includes a step of:

interactively determining a desired position of the defined prosthetic implant shape relative to images of the bone tissue.
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FIELD OF THE INVENTION

This invention relates generally to robotic systems and, in particular, to a robotic system that integrates an interactive Computed Tomagraphy (CT)-based presurgical planning component with a surgical system that includes a multiple-degree of freedom robot and redundant motion monitoring. An illustrative application is presented in the context of a system that prepares a femoral cavity to have a shape precisely determined for receiving a cementless prosthetic hip implant.

BACKGROUND OF THE INVENTION

It has been found that computed tomagraphy (CT) imaging and computer modelling methods provide a precision for pre-surgical planning, simulation, and custom implant design that greatly exceeds the precision of subsequent surgical execution. For example, approximately one half of the 300,000 total hip replacement operations performed each year use cementless implants. Stability of the implant, uniform stress transfer from the implant to the bone, and restoration of the proper biomechanics critically affect efficacy and, in turn, are significantly affected by the proper placement of the implant relative to the bone. An important factor in achieving proper placement of the implant is the accuracy with which the femoral cavity is prepared to match the implant shape.

Recently reported research confirms that gaps between implant and bone significantly affect bone ingrowth. One study of the standard manual broaching method for preparing the femoral cavity found that the gaps between the implant and the bone is commonly in the range of one millimeter to four millimeters and that the overall resulting hole size was 36% larger than the broach used to form the hole. As a result, only 18-20 percent of the implant actually touches bone when it is inserted into such a hole. Furthermore, the placement of the implant cavity in the bone, which affects restoration of biomechanics, is as much a function where the broach "seats" itself as of any active placement decision on the part of the surgeon.

Typically, precise surgical execution has been limited to procedures, such as brain biopsies, for which a suitable stereotactic frame is available. However, the inconvenience and restricted applicability of these devices has led some researchers to explore the use of robots to augment a surgeon's ability to perform geometrically precise tasks planned from CT or other image data.

Safety is an obvious consideration whenever a moving device such as a robot is used in the vicinity of a patient. In some applications, the robot does not need to move during the "in-contact" part of the procedure. In these applications the robot moves a passive tool guide or holder to a desired position and orientation relative to the patient. Brakes are then set and motor power is turned off while a surgeon provides whatever motive force is needed for the surgical instruments. Oth