Abstract: Embodiments consistent with the present disclosure allow the ring, arc, and linear offset values for a stereotactic frame to be determined for a cranial procedure without requiring a CT scan to be acquired with the fiducial frame attached. Having the ring, arc, and offset values available for a cranial procedure allows the surgeon to revert to traditional stereotactic ring-arc frame guidance as a fallback strategy in case a robot cannot be used. This disclosure also provides an alternate method for registering a ring-arc system to the medical image volume for facilities having no CT scanner or scanner with limited field of view such that the intended fiducial localizer cannot be used.

Abstract: A system for robotic surgery makes use of an end-effector which has been configured so that a drill connected thereto is guided in its trajectory and limited in its advancement into an associated anatomical feature by a drill guide. The drill guide may be adjusted manually to engage a corresponding surface of the drill after its advancement by a pre-selected amount. The drill guide likewise includes features to guide the drill during trajectories having oblique angles relative to the surface of the anatomical feature associated with the medical procedure.

Abstract: A system of robotic surgery includes components capable of drilling a bore in the cranium of a patient in connection with craniotomy and other cranial surgeries. A perforator associated with such system is controlled by suitable computer-implemented instructions to maintain the perforator tip along a desired trajectory line while moving the perforator bit at locations proximal to such perforator tip in a circular motion, thereby imparting a conical oscillation to the perforator bit relative to the trajectory line. The angle at which the perforator bit is oscillated relative to such trajectory line results in the bore formed in the cranium having a diameter larger than the bit diameter, and the larger diameter and related conical oscillation is selected so as to reduce frictional force opposing withdrawal of the bit from the situs of the bore, thereby reducing the risk of jamming of the bit during its associated operations.

Abstract: A method includes registering a region of interest in 3-D imaging data with an initial ultrasound image so that the region of interest is in an imaging plane of the initial ultrasound image. The method further includes acquiring a subsequent ultrasound image with a transducer array. The method further includes comparing the initial ultrasound image and the subsequent ultrasound image. The method further includes steering at least one of the transducer array or an instrument based on a result of the comparing so that at least one of the region of interest or the instrument is in the imaging plane.

Abstract: A system for robotic surgery makes use of an end-effector which has been configured so that any selected one of a group of surgical tools may be selectively connected to such end-effector. The end-effector makes use of a tool-insert locking mechanism which secures a selected one of the surgical tools at not only a respective, predetermined height and angle of orientation, but also at a rotational position relative to an anatomical feature of the patient. The tool-insert locking mechanism may include interchangeable inserts to interconnect multiple tools to the same end-effector. In this way, different robotic operations may be accomplished with less reconfiguration of the end-effector. The end-effector may also include a tool stop which has a sensor associated with a moveable stop mechanism which may be positioned to selectively inhibit tool insertion or end-effector movement.

Abstract: Embodiments consistent with the present disclosure allow the ring, arc, and linear offset values for a stereotactic frame to be determined for a cranial procedure without requiring a CT scan to be acquired with the fiducial frame attached. Having the ring, arc, and offset values available for a cranial procedure allows the surgeon to revert to traditional stereotactic ring-arc frame guidance as a fallback strategy in case a robot cannot be used. This disclosure also provides an alternate method for registering a ring-arc system to the medical image volume for facilities having no CT scanner or scanner with limited field of view such that the intended fiducial localizer cannot be used.

Abstract: A system of robotic surgery includes components capable of drilling a bore in the cranium of a patient in connection with craniotomy and other cranial surgeries. A perforator associated with such system is controlled by suitable computer-implemented instructions to maintain the perforator tip along a desired trajectory line while moving the perforator bit at locations proximal to such perforator tip in a circular motion, thereby imparting a conical oscillation to the perforator bit relative to the trajectory line. The angle at which the perforator bit is oscillated relative to such trajectory line results in the bore formed in the cranium having a diameter larger than the bit diameter, and the larger diameter and related conical oscillation is selected so as to reduce frictional force opposing withdrawal of the bit from the situs of the bore, thereby reducing the risk of jamming of the bit during its associated operations.

Abstract: A drill guide fixture may be configured to prepare a skull for attachment of a cranial insertion fixture. The drill guide fixture may include a central drill guide and a bone anchor guide at a base of the drill guide fixture. The central drill guide may define a central drill guide hole therethrough, wherein the central drill guide hole has a first opening at a base of the drill guide fixture and a second opening spaced apart from the base of the drill guide fixture. The bone anchor drill guide may define a bone anchor drill guide hole therethrough, and the bone anchor drill guide hole may be offset from the central drill guide hole in a direction that is perpendicular with respect to a direction of the central drill guide hole. Related cranial insertion fixtures, robotic systems, and methods are also discussed.

Abstract: A surgical robot system includes a surgical robot, a robot arm connected to such surgical robot, and an end-effector connected to the robot arm. A registration fixture is used in conjunction with various registration systems in the surgical robot system. Such registration systems likewise include a detachable base in the form of a detachable dynamic reference base, along with an associated mount, the dynamic reference base and mount having certain features which permit the dynamic reference base to be selectively attached, detached, and reattached at different phases of an operation, whether pre-operative or intra-operative, and such successive attachments are done without the dynamic reference base, and tracking markers associated therewith, losing registration. Related methods allow for the more efficient and effective performance of operations by virtue of the dynamic reference base maintaining its registration during attachments and reattachments.

Abstract: A cranial surgery planning system including at least one network interface connectable to obtain radiological patient images generated by a radiological image scanner, a display device, at least one processor, and at least one memory storing program code that is executed by the at least one processor. The operations include obtaining through the at least one network interface a first radiological patient image of cranial structure of a patient along a first plane and obtain a second radiological patient image of the cranial structure of the patient along a second plane that is angularly offset to the first plane. Operations also include merging the first and second radiological patient images to an image coordinate system. Operations also include obtaining a surgical trajectory plan defining an entry point on the patient's skull and a target point in the patient's brain captured in the merged first and second radiological patient images.

Abstract: A drill guide fixture may be configured to prepare a skull for attachment of a cranial insertion fixture. The drill guide fixture may include a central drill guide and a bone anchor guide at a base of the drill guide fixture. The central drill guide may define a central drill guide hole therethrough, wherein the central drill guide hole has a first opening at a base of the drill guide fixture and a second opening spaced apart from the base of the drill guide fixture. The bone anchor drill guide may define a bone anchor drill guide hole therethrough, and the bone anchor drill guide hole may be offset from the central drill guide hole in a direction that is perpendicular with respect to a direction of the central drill guide hole. Related cranial insertion fixtures, robotic systems, and methods are also discussed.

Abstract: A surgical robot system includes a surgical robot, a robot arm connected to such surgical robot, and an end-effector connected to the robot arm. A registration fixture is used in conjunction with various registration systems in the surgical robot system. Such registration systems likewise include a detachable base in the form of a detachable dynamic reference base, along with an associated mount, the dynamic reference base and mount having certain features which permit the dynamic reference base to be selectively attached, detached, and reattached at different phases of an operation, whether pre-operative or intra-operative, and such successive attachments are done without the dynamic reference base, and tracking markers associated therewith, losing registration. Related methods allow for the more efficient and effective performance of operations by virtue of the dynamic reference base maintaining its registration during attachments and reattachments.

Abstract: A system of robotic surgery includes components capable of drilling a bore in the cranium of a patient in connection with craniotomy and other cranial surgeries. A perforator associated with such system is controlled by suitable computer-implemented instructions to maintain the perforator tip along a desired trajectory line while moving the perforator bit at locations proximal to such perforator tip in a circular motion, thereby imparting a conical oscillation to the perforator bit relative to the trajectory line. The angle at which the perforator bit is oscillated relative to such trajectory line results in the bore formed in the cranium having a diameter larger than the bit diameter, and the larger diameter and related conical oscillation is selected so as to reduce frictional force opposing withdrawal of the bit from the situs of the bore, thereby reducing the risk of jamming of the bit during its associated operations.

Abstract: A system for robotic surgery makes use of an end-effector which has been configured so that any selected one of a group of surgical tools may be selectively connected to such end-effector. The end-effector makes use of a tool-insert locking mechanism which secures a selected one of the surgical tools at not only a respective, predetermined height and angle of orientation, but also at a rotational position relative to an anatomical feature of the patient. The tool-insert locking mechanism may include interchangeable inserts to interconnect multiple tools to the same end-effector. In this way, different robotic operations may be accomplished with less reconfiguration of the end-effector. The end-effector may also include a tool stop which has a sensor associated with a moveable stop mechanism which may be positioned to selectively inhibit tool insertion or end-effector movement.

Abstract: A system for robotic surgery makes use of an end-effector which has been configured so that a drill connected thereto is guided in its trajectory and limited in its advancement into an associated anatomical feature by a drill guide. The drill guide may be adjusted manually to engage a corresponding surface of the drill after its advancement by a pre-selected amount. The drill guide likewise includes features to guide the drill during trajectories having oblique angles relative to the surface of the anatomical feature associated with the medical procedure.

Abstract: A system of robotic surgery includes components capable of drilling a bore in the cranium of a patient in connection with craniotomy and other cranial surgeries. A perforator associated with such system is controlled by suitable computer-implemented instructions to maintain the perforator tip along a desired trajectory line while moving the perforator bit at locations proximal to such perforator tip in a circular motion, thereby imparting a conical oscillation to the perforator bit relative to the trajectory line. The angle at which the perforator bit is oscillated relative to such trajectory line results in the bore formed in the cranium having a diameter larger than the bit diameter, and the larger diameter and related conical oscillation is selected so as to reduce frictional force opposing withdrawal of the bit from the situs of the bore, thereby reducing the risk of jamming of the bit during its associated operations.

Abstract: A system for robotic surgery makes use of an end-effector which has been configured so that any selected one of a group of surgical tools may be selectively connected to such end-effector. The end-effector makes use of a tool-insert locking mechanism which secures a selected one of the surgical tools at not only a respective, predetermined height and angle of orientation, but also at a rotational position relative to an anatomical feature of the patient. The tool-insert locking mechanism may include interchangeable inserts to interconnect multiple tools to the same end-effector. In this way, different robotic operations may be accomplished with less reconfiguration of the end-effector. The end-effector may also include a tool stop which has a sensor associated with a moveable stop mechanism which may be positioned to selectively inhibit tool insertion or end-effector movement.

Abstract: A method includes registering a region of interest in 3-D imaging data with an initial ultrasound image so that the region of interest is in an imaging plane of the initial ultrasound image. The method further includes acquiring a subsequent ultrasound image with a transducer array. The method further includes comparing the initial ultrasound image and the subsequent ultrasound image. The method further includes steering at least one of the transducer array or an instrument based on a result of the comparing so that at least one of the region of interest or the instrument is in the imaging plane.

Abstract: A method includes registering a region of interest in 3-D imaging data with an initial ultrasound image so that the region of interest is in an imaging plane of the initial ultrasound image. The method further includes acquiring a subsequent ultrasound image with a transducer array. The method further includes comparing the initial ultrasound image and the subsequent ultrasound image. The method further includes steering at least one of the transducer array or an instrument based on a result of the comparing so that at least one of the region of interest or the instrument is in the imaging plane.

Abstract: A position is determined for each fiducial marker of a plurality of fiducial markers in an image volume. Based on the determined positions, a position and orientation of the registration fixture with respect to the anatomical feature is determined. A position is determined for each tracked marker of a first plurality of tracked markers on the registration fixture and a second plurality of tracked markers on the robot arm in a tracking data frame. Based on the determined positions of tracked markers, a position and orientation of the registration fixture and the robot arm of a surgical robot with respect to the tracking space are determined.