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| United States Patent | 5299288 |
| Link to this page | http://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) |
| Abstract | A 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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Title Information  |
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Drawing from US Patent 5299288 |
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Image-directed robotic system for precise robotic surgery including
redundant consistency checking |
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| 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) |
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| Publication Date |
March 29, 1994 |
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| Filing Date |
September 18, 1991 |
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| 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 . |
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Title Information  |
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References  |
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U.S. References |
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| | Reference | Relevancy | Comments | Reference | Relevancy | Comments | 5097839 Allen
Mar,1992 |      Your vote accepted [0 after 0 votes] | | 4991579 Allen
Feb,1991 |      Your vote accepted [0 after 0 votes] | | 4979949 Matsen, III et al.
Dec,1990 |      Your vote accepted [0 after 0 votes] | | 4945914 Allen
Aug,1990 |      Your vote accepted [0 after 0 votes] | | 4858149 Quarendon
Aug,1989 |      Your vote accepted [0 after 0 votes] | | 4791934 Brunnett
Dec,1988 |      Your vote accepted [0 after 0 votes] | | 4750487 Zanetti
Jun,1988 |      Your vote accepted [0 after 0 votes] | | 4704686 Aldinger
Nov,1987 |      Your vote accepted [0 after 0 votes] | | 4691694 Boyd et al.
Sep,1987 |      Your vote accepted [0 after 0 votes] | | 4618978 Cosman
Oct,1986 |      Your vote accepted [0 after 0 votes] | | 4485453 Taylor
Nov,1984 |      Your vote accepted [0 after 0 votes] | | 4150326 Engelberger et al.
Apr,1979 |      Your vote accepted [0 after 0 votes] | | |
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Foreign References |
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Other References |
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| | Reference | Relevancy | Comments | "Robotic Total Hip Replacement Surgery in Dogs", R. Taylor et al., IEEE Engineering in Medicine & Biology Society, 11th Annual International
Conf., Nov. 9-12, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "A Robotic System for Cementless Total Hip Replacement Surgery in Dogs", by R. Taylor et al., Proc. 2nd IARP Workshop on Medical & Healthcare Robotics, OK, Sep. 5-7, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "An Articulated Neurosurgical Navigation System Using MRI and CT Images", by R. Kosugi et al., IEEE Transactions on Biomedical Engineering, vol. 35, No. 2, Feb. 1988.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "A Robot with Improved Absolute Positioning Accuracy for CT Guided Stereotactic Brain Surgery", by Y. Kwoh et al., IEEE Trans. on Biomedical Engin., vol. 35, No. 2, Feb. 1988.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "A New System for Computer Assisted Neurosurgery", by S. Lallee, Adv. Topics in Birobotics, 0926--IEEE Engineering in Medicine & Biology Society, 11th Annual International Conf., Nov. 9-12, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "S.M.O.S.: Stereotaxical Microtelemanipulator for Ocular Surgery", A. Guerrouad et al., Medical Applications of Robotics, IEEE Engineering in Medicine & Biology Society, 11th Annual Int'l. Conf., Nov. 9-12, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "The United Kingdom Advanced Medical Robotics Initiative", P. Finlay, Medical Applications of Robotics, IEEE Engineering in Medicine & Biology Society, 11th Annual International Conf., Nov. 9-12, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "Computer Assisted Medical Interventions", by P. Cinquin et al., Proc. 2nd IARP Workshop on Medical & Healthcare Robotics, OK, Sep. 5-7, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "Use of Puma 560 Robot in Biopsies", by M. Thorn et al., Use of Robots as an Aid to Deskilling the Taking of Biopsies, Dept. of Electrical & Electronic Engineering Huddersfield Polytechnic, Sep. 5-7, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "A Surgeon Robot for Prostatectomies", by B. Davies et al., Proc. 2nd IARP Workshop on Medical & Healthcare Robotics, OK, Sep. 5-7, 1989.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | School of Medicine, University of California UC Davis Medical Background, Feb. 11, 1988.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | IBM, University of California "Developing Robot-Assisted Surgical Procedure", Feb. 11, 1988.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "IBM Robotics Technology Background", Feb. 11, 1988.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "Robotic Instrumentation in Total Knee Arthroplasty", by J. L. Garbini et al., 33rd Annual Meeting, Orthopaedic Research Society, Jan. 1987, Calif., p. 413.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "Watchdog Safety Computer Design and Implementation", by R. D. Kilmer et al., presented at the RI/SME Robots 8 Conference, Jun. 1984, pp. 101-117.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "Bilateral Control for Manipulators with Different Configurations", to Arai et al.
. Apr,2007 |      Your vote accepted [0 after 0 votes] | | "Computer Assisted Surgery", IEEE Computer Graphics and Applications, vol. 1, No. 3, May 1990, (IEEE), pp. 43-51.. Apr,2007 |      Your vote accepted [0 after 0 votes] | | |
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Claims  |
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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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Claims  |
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Description  |
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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 | | |