Abstract: A seal for sealing against a surgical instrument shaft includes a plurality of seal layers and a plurality of overlapping seal openings formed in the seal layers. The plurality of seal openings together can create an effective seal opening that is smaller than any of the individual overlapping seal openings. The effective seal opening is sized and shaped to seal against an instrument shaft when an instrument shaft is inserted through the effective seal opening.

Abstract: A surgical access port or trocar is provided. The trocar has a trocar seal housing and a trocar cannula with an optical obturator insertable through the trocar seal housing and the trocar cannula. The trocar is configured to access a body cavity, to maintain positive pressure and to prevent loss of surgical insufflation gas used in laparoscopic procedures. The trocar seal housing can be releasably attached to the trocar cannula. The trocar seal housing may also have a shield and/or alignment channel that provide protection or assist in operation of instrument and zero seals housed in the trocar seal housing.

Abstract: An access device configured for inserting an intraosseous catheter into an interior portion of a bone is disclosed. In one embodiment, an intraosseous access device is disclosed, comprising a device body, a trocar needle included with the device body, and an intraosseous catheter removably disposed on the trocar needle. The device body is configured to enable a user of the access device to manually insert a distal tip of the trocar needle through a skin surface of a body of a patient to an external surface of a bone of the patient. An advancement mechanism is also disclosed and is configured to selectively and distally advance the trocar needle and intraosseous catheter a predetermined distance into an internal portion of the bone of the patient after the distal tip of the trocar needle has been inserted to the external surface of the bone.

Abstract: A polyp removal device comprises an outer tubular body; an inner tubular body being movable with respect to the outer tubular body; a handle; an actuation member configured to cause movement of the inner tubular body with respect to the outer tubular body when the actuation member is moved with respect to the handle; a vacuum port for coupling thereto of a vacuum source; and an opening near a distal end of the polyp removal device, the opening configured to allow fluid communication between an environment external to the polyp removal device and the lumen of the inner tubular body, wherein a size of the opening is variable based on the movement of the inner tubular body with respect to the outer tubular body.

Abstract: A spinal construct includes a coupling member including a first mating surface engageable with an existing fastener implant. The existing fastener implant being connected with an existing spinal rod implant. A connector is engageable with the existing fastener implant and has a rod extending therefrom. A locking member is engageable with a second mating surface of the coupling member. Systems, surgical instruments, implants and methods are disclosed.

Abstract: Disclosed herein are a hook with rotating saddle and a rotatable mono axial pedicle screw. In an embodiment, the disclosed hook may include at least one body comprising a hook member and a saddle member. The hook member and saddle member may be rotatably mounted to one another so as to rotate with respect to each other only about a common axis, and the saddle member may be configured for connection to an end of a connecting member. A surgical screw system may include receiver and screw members engagable with one another such that when engaged, only rotation of the receiving member about the longitudinal axis of the screw member and restrain against substantially all other translational or rotational movement.

Abstract: An interspinous implant comprises a first member and a second member. The members define a pathway. A third member is movable along the pathway relative to the first member and the second member. Systems and methods are disclosed.

Abstract: Systems and methods for percutaneously installing a vertebral stabilization system. A first anchor is positionable within a body of a patient through a first percutaneous opening and a second anchor is positionable within a body of a patient through a second percutaneous opening. A stabilization member is positionable within the body of a patient through the first percutaneous opening to engage and connect the first and second anchors.

Abstract: There is disclosed a composition formed by a reaction of at least one component A and at least one component B, wherein component A is selected from among a compound having at least two thiol-groups and a disulfide derivative of a compound having at least two thiol groups, and wherein component B is a compound having at least two vinyl reactive groups, for the manufacture of an implant for the treatment of a bone fracture. Advantages include that the adhesive patch formed by the composition will be solid in body fluid upon curing and will exhibit excellent mechanical strength. Advantages include that the composition is biocompatible, the material can be applied in small and inaccessible areas, the process requires less surgeon training, it solves drawback with open surgery, and it is possible to use cost effective materials and methods in the process.

Abstract: One or more arrays of flexible, disposable, bone plate sizers with corresponding arrays of permanent bone plates, systems using these bone plate sizers and/or templates, and methodologies using these bone plate sizers and/or templates are embodied. Each array of disposable bone plate sizers has a plurality of sizers having differing configurations and sizes, each of the disposable sizers in a given array corresponding to a particular bone screw size. Each of the disposable bone plate sizers in a given array are mounted upon and easily detachable from a frame member. The disposable bone plate sizers may be malleable such that may be manipulated by the surgeon into the desired three-dimensional shape to match the contour of the bone segments to be joined, thereby providing a template to shape the corresponding permanent bone plate.

Abstract: A minimally invasive tissue incision system for creating joint capsulotomies and releasing/incising various tendon and fibrous band structures. The system contains a penetrating needle which is retractable so as to expose a cutting element, and which may be used as a penetrating needle to pierce the skin and other soft tissue structures. The cutting element provided within the penetrating needle may be used to incise subsequent tissue structures after the initial penetration. The system facilitates such procedures by providing the cutting element with the confines of the needle which provides safe introduction of the cutting element directly to the site via the needle.

Abstract: The present disclosure illustrates an osteotome for treating hard tissue. The osteotome embodiments described herein include a shaft with a working end configured to displace hard tissue and a lumen to deliver material through the shaft. The working end may create pathways by selectively transitioning from a linear to a non-linear configuration. The lumen may deliver material through the shaft while the working end is in a linear or a non-linear configuration allowing precise filling of the pathways.

Abstract: A device for handling a bone screw to be connected with a vertebral rod includes an essentially cylindrical and hollow housing and an adjustment tool which axially traverses the housing and which has a section provided with an outer threading and is screwed into an internal threading of the housing, wherein the housing is constructed pliers-like and has a first and a second jaw which relative to the user each have a proximal and a distal end, wherein the distal ends engage at the head of the bone screw, wherein the two jaws are pivotably connected with each other via a pivot axis which is situated between the distal and proximal ends and extends orthogonally in relation to the longitudinal axis of the housing, and wherein the internal threading of the housing is provided on a proximal end of a single one of the jaws.

Abstract: Methods and cryogenic devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation. Some methods include advancing a cryo-ablation catheter into a patient's vasculature and ablating tissue within a carotid septum.

Abstract: The present invention generally relates to improved medical devices, systems, and methods. In many embodiments, devices, systems, and methods for locating and treating a target nerve with cold therapy are provided. For example, a focused cold therapy treatment device may be provided that is adapted to couple with or be fully integrated with a nerve stimulation device such that nerve stimulation and focused cold therapy may be performed concurrently with the cryo-stimulation device. Improvements in nerve localization and targeting may increase treatment accuracy and physician confidence in needle placement during treatment. In turn, such improvements may decrease overall treatment times, the number of repeat treatments, and the re-treatment rate. Further, additional improvements in nerve localization and targeting may reduce the number of applied treatment cycles and may also reduce the number of cartridge changes (when replaceable refrigerant cartridges are used).

Abstract: A method for determining motional branch current in an ultrasonic transducer of an ultrasonic surgical device over multiple frequencies of a transducer drive signal. The method may comprise, at each of a plurality of frequencies of the transducer drive signal, oversampling a current and voltage of the transducer drive signal, receiving, by a processor, the current and voltage samples, and determining, by the processor, the motional branch current based on the current and voltage samples, a static capacitance of the ultrasonic transducer and the frequency of the transducer drive signal.

Abstract: Regions of tissue having reduced electrical propagation are created in a bladder to affect its electrical or mechanical properties. To create these tissue regions, a tubular device is advanced through the urethra leading to the interior of the bladder, a distal expandable structure of the device is expanded to contact the inner wall of the bladder, and electrodes or other active energy delivery elements of the device are activated to deliver ablation energy. The electrodes or other active energy delivery elements are disposed over the expandable structure which is shaped to conform to the interior of the bladder. The inner wall of the organ is ablated in a predetermined pattern. The same or other electrodes disposed over the expandable structure can used to electrically map the bladder. This map of electrical activity can be used to create the predetermined pattern.

Abstract: An electrically energized medical instrument uses one or more drive cables to both actuate mechanical components of a wrist mechanism or an effector and to electrically energize the effector. Electrical isolation can be achieved using an insulating main tube through which drive cables extend from a backend mechanism to the effector, an insulating end cover that leaves only the desired portions of the effector exposed, and one or more seals to prevent electrically conductive liquid from entering the main tube. Component count and cost may be further reduced using a pair of pulleys that are shared by four drive cables.

Abstract: A therapeutic treatment system includes a holding section configured to hold a biological tissue, electrodes provided in the holding section and capable of outputting first high-frequency energy for sealing the biological tissue at a first sealing temperature and second high-frequency energy for dissecting the biological tissue at a first dissection temperature higher than the first sealing temperature, electrodes provided in the holding section and capable of outputting first thermal energy for sealing the biological tissue at a second sealing temperature higher than the first sealing temperature and second thermal energy for dissecting the biological tissue at a second dissection temperature lower than the first dissection temperature and higher than the second sealing temperature, and a control section configured to control temperature of each of the electrodes to output the second thermal energy after the output of the first high-frequency energy.

Abstract: A method for treating an infection using irreversible electroporation is presented. The method includes providing an ablation device that has at least one electrode and inserting the ablation device into a target tissue of a patient. The tissue at least partially surrounds the implanted medical device. The outer surface of the medical device is at least partially covered by infectious cells. The method also involves positioning at least one electrode in or near the implanted medical device and delivering electrical pulses to or near the implanted medical device sufficient to irreversibly electroporate the infectious cells.

Abstract: An electrosurgical device includes a distal end region, a proximal end region and a malleable or curved shaft extending between the distal and proximal end regions. A hand-piece is disposed at the proximal end region and a surgical tip with a rounded and tapered front area is positioned at the distal end region. The device includes a microdebrider. Radio frequency electrodes and bipolar electrodes are positioned at a bottom part of the distal end region spaced from the rounded and tapered front area. A heat-resistant upper surface is disposed at a top area of said surgical tip for separating the radio frequency electrodes and bipolar electrodes from overlying surface tissue.

Abstract: A corrugated radiofrequency ablation catheter having wall-attaching adjustment wires (6, 6A, 6B, 6A?, and 6B?), provided with a strip-shaped connecting catheter, an electrode frame provided at the front extremity of the connecting catheter, and a control handle (20) provided at the rear extremity of the connecting catheter. The electrode frame is a corrugated electrode frame consisting of one or more corrugations, where one or more electrodes (2) respectively are distributed on the corrugations. The rear sections of the wall-attaching adjustment wires (6, 6A, 6B, 6A?, and 6B?) are slidably provided within one lumen of the connecting catheter and are connected at the rear extremities (60) onto a control element (22) provided on the control handle (20) or connected onto a control element (22) provided outside of the control handle (20).

Abstract: Methods for treating polycystic kidney disease with therapeutic renal neuromodulation and associated systems and methods are disclosed herein. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a renal artery of a kidney of a patient. One or more measurable physiological parameter corresponding to the polycystic kidney disease can thereby be reduced. Moreover, central sympathetic drive in the patient can be reduced in a manner that treats the patient for the polycystic kidney disease. Renal sympathetic nerve activity can be modulated along the afferent and/or efferent pathway. The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a neuromodulation assembly, e.g., a neuromodulation assembly configured to cryotherapeutically cool the renal nerve or to deliver an energy field to the renal nerve.

Abstract: A medical device may include an elongate tubular member having a distal portion that is configured to curl in a desired direction. A shape-memory alloy structure may be disposed in a lumen of the elongate tubular member at the distal portion. The shape-memory alloy may have an original, pre-deformed shape that is curved to facilitate the curling of the distal portion in the desired direction.

Abstract: Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient's vessel, e.g.

Abstract: An ablation catheter adapted for use with a guide wire has a 3-D shaped portion that carries ring electrodes for ablating a vessel or tubular region, including the renal artery. The 3-D shaped portion, for example, a helical portion, enables the ring electrodes to contact an inner surface of the vessel at a plurality of locations at different depths along the vessel to form a conduction block without forming a closed conduction loop which would otherwise increase the risk of stenosis of the vessel. In one embodiment, the catheter has a lumen with entry and exit ports to allow the guide wire to pass through the lumen but bypass the 3-D shaped portion. In another embodiment, the catheter has outer bands providing side tunnels through which the guide wire can pass through.

Abstract: Described embodiments include an apparatus for removal of a thrombus from a body of a subject. The apparatus includes a first electrode, made of a first conductive metal, a second electrode, made of a second conductive metal that is different from the first conductive metal, and a voltage source, configured to apply a positive unipolar voltage between the first electrode and the second electrode while the first electrode is in contact with the thrombus, and while the second electrode is inside the body of the subject. Other embodiments are also described.

Abstract: The ablation systems, ablation probes, and corresponding methods according to the present disclosure reduce or eliminate energy radiating from an ablation probe into the environment. Some ablation probes include a retractable sheath that shields at least the radiating portion of the ablation probe. The retractable sheath and/or the ablation probe may include conduits through which a fluid may flow to shield the radiating portion and to drive the retractable sheath to an extended state. Other ablation probes include apertures defined in the probe walls through which the fluid can flow to expand a balloon surrounding the radiating portion. Yet other ablation probes include a thermal indicator to indicate the temperature of the ablation probe to a user. The ablation systems include fluid circuits and associated mechanical controls for varying the contents and/or flow rate of the fluid provided to the radiating portion of the ablation probe.

Abstract: The present application relates to a method for setting a cutting distance (?laser skip opt(z)) between a laser beam (14) and a skin surface (5) in a laser shaving device (1), said laser shaving device having a laser deactivation threshold (?laser_skin_opt(z)), said method comprising: operating an optical system (12) to generate the laser beam; determining a skin variation value (?) indicative of the variation in the distance of the skin surface from a reference point; determining a cutting distance between said laser beam and the skin surface in dependence on at least the laser deactivation threshold and said skin variation value; and adjusting said optical system to locate the laser beam in dependence on said determined cutting distance.

Abstract: The present invention generally relates to the field of laser treatment of tissue, and particularly, to a system and method for creating microablated channels in skin. The present invention is more particularly directed to treating subsurface tissue through the created channels.

Abstract: A light-diverting catheter tip is provided according to embodiments disclosed herein. The light-diverting catheter tip may be coupled with the distal tip of a laser catheter and divert at least a portion of the light exiting the distal tip of the laser catheter such that the spot size of the laser beam on an object after exiting the catheter tip is larger than the spot size of the light entering the catheter without the catheter tip. The catheter tip may be removably coupled with the catheter or constructed as part of the catheter. In other embodiment, the catheter tip may conduct fluid and/or divert fluid at the tip of the laser catheter.

Abstract: Systems and methods are provided for generating a high density (HD) map for identifying a location and/or an orientation of an electromagnetic (EM) sensor within an EM volume in which an EM field is generated by way of an antenna assembly. A measured EM field strength at each gridpoint of a set of gridpoints of the EM volume are received from a measurement device. An EM field strength at each gridpoint of a second set of gridpoints of the EM volume is calculated based on a geometric configuration of an antenna of the antenna assembly. The HD map is generated based on the measured EM field strength at each gridpoint of the first set of gridpoints and the calculated EM field strength at each gridpoint of the second set of gridpoints.

Abstract: Methods and systems for optimizing perivascular neuromodulation therapy using computational fluid dynamics. Digital data regarding three-dimensional imaging of a target blood vessel and corresponding hemodynamic data are inputs to generating a computational fluid dynamics (CFD) model. The CFD model enables identification of one or more regions of the vessel suitable for neuromodulation therapy and/or identifying one or more regions of the vessel to avoid during such therapy. A system of the present technology can include a neuromodulation catheter, a computing device that can generate and analyze the CFD model, and a user interface for displaying the vessel with indicia for target regions and/or avoidance regions.

Abstract: Multi-metric surgery simulator devices, systems, and methods, involving at least one sensor configured to collect surgical training performance data relevant to at least one surgical task, the at least one sensor configured to operate with a surgical navigation system comprising a processor, the processor configurable, by way of a set of executable instructions storable in relation to a non-transitory medium, to perform at least one of analyze collected data, transform the collected data, and provide feedback in relation thereto; and at least one surgery simulator apparatus operatively coupled with the at least one sensor, the at least one surgery simulator apparatus configured to operate with a tracking system, whereby collected data is obtainable and clinical performance in relation to the at least one surgical task is quantitatively evaluable and progressively improvable.

Abstract: The present application relates to systems and methods for performing a computerized cardiac simulation for at least one of diagnosis, risk assessment or treatment planning including: receiving, by a computer, a plurality of three-dimensional cardiac images of a subject's heart such that each three-dimensional cardiac image corresponds to a different phase of a single cardiac cycle of the subject's heart; modeling structure, using the computer, of the left atrium of the subject as a function of time using the plurality of three-dimensional cardiac images of the subject's heart; modeling blood flow, using the computer, within, into and out of the left atrium of the subject as a function of time using computational fluidic dynamics and using structure of said left atrium obtained from at least one of said plurality of three-dimensional cardiac images or said modeling structure of said left atrium; simulating at least one of time dependent structural function or time-dependent blood flow of said left atrium usin

Abstract: The present disclosure relates to a system and method of providing surgical assistance. The method includes obtaining a 3D space including an organ and a lesion located within the organ. Based on a shape of the organ, a grid is overlaid on a surface of the organ. The lesion is projected at a first location on an overlaid grid. A graphical tool disposed in a first orientation is positioned at the first location in the 3D space, and a plurality of parameter values of the lesion corresponding to the first orientation of the graphical tool are displayed in the 3D space. The graphical tool is manipulated to be disposed in a second orientation at a second location on the overlaid grid, and the plurality of parameter values of the lesion corresponding to the second orientation of the graphical tool are displayed in the 3D space.

Abstract: A customized patient-specific combined template and implant for spinal fixation and method for use.

Abstract: Devices and methods for performing a surgical step or surgical procedure with visual guidance using an optical head mounted display are disclosed.

Abstract: A system for calibrating an electromagnetic navigation system is provided. The system includes an antenna assembly having a substrate, multiple pairs of transmit coils, multiple receive coils, multiple input terminals, and multiple output terminals. The substrate includes multiple layers, and each of the transmit coils is deposited on a respective one of the layers and each of the receive coils is deposited on another respective one of the layers. Each of the pairs of transmit coils corresponds to a respective one of the receive coils. Each of the transmit coils is coupled to a respective one of the input terminals, and each of the receive coils is coupled to a respective one of the output terminals.

Abstract: Systems and methods for identifying a location and/or an orientation of an electromagnetic (EM) sensor navigated within an EM volume are provided. Calculated EM field strengths at each gridpoint of a second set of gridpoints of the EM volume are retrieved from a memory. An EM field is generated by way of an antenna assembly. A measured EM field strength is received from the EM sensor. A first gridpoint among a first set of gridpoints of the EM volume is identified based on the measured EM field strength and a high density (HD) map. The location and/or the orientation of the EM sensor is identified based on the HD map, using the first gridpoint as an initial condition, with the second set of gridpoints also including the first set of gridpoints.

Abstract: A system and method for providing image guidance for placement of one or more medical devices at a target location. The system can determine one or more intersections between a medical device and an image region based at least in part on first emplacement data and second emplacement data. Using the determined intersections, the system can cause one or more displays to display perspective views of image guidance cues, including an intersection ghost in a virtual 3D space.

Abstract: A method of real-time 3D flexible needle tracking for image-guided surgery is provided that includes uploading, using a controller, a virtual model of a flexible needle to a calibrated 3D mixed reality headset, where the virtual model, establishing an initial position of a base of a flexible needle relative to a target under test, using the controller and the flexible needle, where the flexible needle includes sensors spanning from the base to along a length of the flexible needle, where the sensors communicate a position, a shape, and an orientation of the flexible needle to the controller, where the controller communicates the sensor positions to the calibrated 3D mixed-reality headset, and using the calibrated 3D mixed-reality headset to display in real-time a position and shape of the flexible needle relative to the target under test.

Abstract: A method for the fluoroscopic registration in real time for placement of pedicle screws or the like during spinal surgery, comprising creating a lateral image in which a pedicle has appropriate anatomic contour and superior endplate, advancing a pin into the pedicle starting in the posterior cortex and moved far enough into the pedicle to anchor the pin, rotating the fluoroscopy to obtain an AP image of the pedicle which is moved to render the pin to be neutral in a cephalad to candad direction, and positioning a pedicle screw in the pedicle following 2D contour mapping generated by manual or automated templating.

Abstract: Example embodiments relate to surgical devices, systems, and methods. The system may include an end-effector assembly. The end-effector assembly may comprise an instrument assembly and a wrist assembly. The instrument assembly may comprise an instrument for performing a surgical action. The instrument assembly may further comprise an instrument driven portion configurable to be driven in such a way as to move the instrument relative to a first axis. The instrument assembly may further comprise an instrument insulative portion providable between the instrument and the instrument driven portion. The instrument insulative portion may be configurable to electrically isolate the instrument from at least the instrument driven portion when the instrument insulative portion is provided between the instrument and the instrument driven portion. The wrist assembly may include a wrist driven portion configurable to be driven in such a way as to move the instrument relative to a second axis.

Abstract: Robotic surgical tools, systems, and methods for preparing for and performing robotic surgery include a memory mounted on the tool. The memory can perform a number of functions when the tool is loaded on the tool manipulator: first, the memory can provide a signal verifying that the tool is compatible with that particular robotic system. Secondly, the tool memory may identify the tool-type to the robotic system so that the robotic system can reconfigure its programming. Thirdly, the memory of the tool may indicate tool-specific information, including measured calibration offsets indicating misalignment of the tool drive system, tool life data, or the like. This information may be stored in a read only memory (ROM), or in a nonvolatile memory which can be written to only a single time. The invention further provides improved engagement structures for coupling robotic surgical tools with manipulator structures.

Abstract: A medical device positioner for use with a remote catheter guidance system (RCGS) is provided, which can address angular, lateral and/or translational misalignment of an elongate medical device between the RCGS and an access point on a patient's body. Such a medical device positioner can include first and second tube sections connected by a joint septum, with at least a portion of the second tube section being adapted to be inserted into a vascular system of a patient at an access point.

Abstract: A tool driver for use in robotic surgery includes a base configured to couple to a distal end of a robotic arm, and a tool carriage slidingly engaged with the base and configured to receive a surgical tool. In one variation, the tool carriage may include a plurality of linear axis drives configured to actuate one or more articulated movements of the surgical tool. In another variation, the tool carriage may include a plurality of rotary axis drives configured to actuate one or more articulated movements of the surgical tool. Various sensors, such as a capacitive load cell for measuring axial load, a position sensor for measuring linear position of the guide based on the rotational positions of gears in a gear transmission, and/or a capacitive torque sensor based on differential capacitance, may be included in the tool driver.

Abstract: A tool driver for use in robotic surgery includes a base configured to couple to a distal end of a robotic arm, and a tool carriage slidingly engaged with the base and configured to receive a surgical tool. In one variation, the tool carriage may include a plurality of linear axis drives configured to actuate one or more articulated movements of the surgical tool. In another variation, the tool carriage may include a plurality of rotary axis drives configured to actuate one or more articulated movements of the surgical tool. Various sensors, such as a capacitive load cell for measuring axial load, a position sensor for measuring linear position of the guide based on the rotational positions of gears in a gear transmission, and/or a capacitive torque sensor based on differential capacitance, may be included in the tool driver.

Abstract: Embodiments of a system and method for surgical tracking and control are generally described herein. A system may include a robotic arm configured to allow interactive movement and controlled autonomous movement of an end effector, a cut guide mounted to the end effector of the robotic arm, the cut guide configured to guide a surgical instrument within a plane, a tracking system to determine a position and an orientation of the cut guide, and a control system to permit or prevent interactive movement or autonomous movement of the end effector.

Abstract: Embodiments of a system and method for surgical tracking and control are generally described herein. A system may include a robotic arm configured to allow interactive movement and controlled autonomous movement of an end effector, a cut guide mounted to the end effector of the robotic arm, the cut guide configured to guide a surgical instrument within a plane, a tracking system to determine a position and an orientation of the cut guide, and a control system to permit or prevent interactive movement or autonomous movement of the end effector.