Patent Description:
Where considered appropriate, reference numerals may be repeated among the drawings to indicate corresponding or analogous elements. Moreover, some of the blocks depicted in the drawings may be combined into a single function.

In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of embodiments of the invention. However, it will be understood by those of ordinary skill in the art that the embodiments of the present invention may be practiced without these specific details. In other instances, well-known methods, procedures, components, and circuits have not been described in detail so as not to obscure the present invention.

The inventors have developed a system that allows a surgeon to operate on a variety of locations on a patient, including left and right thoracic cavity; left and right abdominal cavity; left, right, and center of the brain; and areas of the neck. The system includes a gantry including a CT, a platform supporting the gantry, and a robotic arm assembly attached to the platform or the gantry via a pivot arm.

Depending on the bore diameter of the gantry, various embodiments have been made to allow the robotic arm to access different parts of the body.

Reference is now made to <FIG>, which shows a system <NUM> for performing robotic surgery, according to an embodiment of the present invention. System <NUM> includes gantry <NUM>, which contains within it a CT scanning and imaging device, platform <NUM> that supports gantry <NUM>, and robotic arm assembly <NUM>. Gantry <NUM> may move along direction <NUM> via carriage <NUM> in order to engage and disengage the CT with patient <NUM>, who is disposed on bed <NUM>. Patient <NUM> may be human or may be an animal, in the event that the CT device is used for veterinary purposes. Gantry <NUM> may have a bore diameter of <NUM> or more to allow patient <NUM> to have full body access to the CT device. Bed <NUM> may be a poly-articulated operating bed, e.g., the TruSystem® <NUM> Hybrid Operating Room Table manufactured by Trumpf Medical, of Germany, a subsidiary of Hill-Rom Holdings, Inc. Other operating beds may also be used, including those that are not fixed in place (e.g., those with wheels that lock). An example of a radiological bed has been described in <CIT>. Platform <NUM> may have wheels in order to move the whole system if needed, for example to allow for more space for surgical staff to perform surgery. Robotic arm assembly <NUM> is attached via pivot arm <NUM> to a second carriage <NUM>, which is attached to platform <NUM> and may move along direction <NUM>.

Pivot arm <NUM> is substantially parallel to the upper surface of platform <NUM>. Pivot arm <NUM> allows robotic arm assembly <NUM> to be placed in multiple positions to allow better access to patient <NUM>. As shown in <FIG>, pivot arm <NUM> is attached to second carriage <NUM> via pivot <NUM>, which may be pivoted by a surgeon. As shown in <FIG>, pivot <NUM> may be replaced by motor shaft <NUM> attached to motor <NUM>, which may be a stepper motor, which may allow for more precise positioning and control of robotic arm assembly <NUM> around the pivot point, including to lock pivot arm <NUM> in place. The pivot/motor assembly may also include optical encoder <NUM> and multiple solenoids (not shown), brushless torque actuators (BTA), or other alternative means, such as ratcheting devices, or gear arrangements, to enhance the precision, control, and locking abilities. The motion of second carriage <NUM> along direction <NUM> may be "sensorized" (i.e., have sensors) in order to know its position with respect one of the ends of platform <NUM>. Second carriage <NUM> could also be motorized in order to be positioned electronically along direction <NUM>. In this case there will be two positioning axes (the translation along direction <NUM> and the rotation about pivot <NUM>) plus six axes for the robot for a total of eight axes.

Robotic arm assembly <NUM>, which may be a six-axis robot, may perform the surgical procedure itself. The robotic arm assembly may include a sensorized guide, which may be used as a surgical instrument holder that is placed automatically in the right locations using the proper orientation. The surgical instrument may be inserted directly into the patient or into a cannula attached to the robotic arm assembly or sensorized guide at a single access point. The surgical procedure may be monitored using CT or fluoroscopy. Examples of robotic arm assemblies have been described in the following documents that are subject to an assignment to the applicant of this application or to an affiliate of the applicant: (<NUM>) <CIT>; (<NUM>) <CIT>; (<NUM>) <CIT>; (<NUM>) <CIT>, and (<NUM>) <CIT>.

<FIG> is a top view of system <NUM>, showing four possible locations for robotic arm assembly <NUM> - 40a, 40b, 40c, 40d. Locations 40a, 40d may be realized with second carriage <NUM> in the position shown in <FIG>; locations 40b, 40c may be realized with second carriage <NUM> in a second position, translated towards gantry <NUM> in direction <NUM>. Location 40a may allow easier access to the patient's lower left side during surgery; location 40b may allow easier access to the patient's upper left side during surgery; location 40c may allow easier access to the patient's upper right side during surgery; and location 40d may allow easier access to the patient's lower right side during surgery.

The operation of system <NUM>, and other systems described in this specification, are generally consistent with the operation of systems described in the following documents that are subject to an assignment to the applicant of this application or to an affiliate of the applicant: (<NUM>) <CIT>; (<NUM>) <CIT>; (<NUM>) <CIT>; (<NUM>) <CIT>; and (<NUM>) <CIT>. The entireties of <CIT>, <CIT>, and <CIT>, <CIT>, and <CIT>.

<FIG> and <FIG> show uses of system <NUM> during abdominal cavity operations, according to embodiments of the invention. In <FIG>, gantry <NUM> may move forward on platform <NUM> in order to perform a scan or a fluoroscopy, either prior to or during surgery. In <FIG>, after the scan, gantry <NUM> may move back, and robotic arm assembly <NUM> may move via movement of second carriage <NUM> and pivot arm <NUM> so that the robot may perform (or assist in) surgery.

<FIG> show uses of system <NUM> during thoracic operations (on the patient's spine). In <FIG>, gantry <NUM> may move forward on platform <NUM> in order to perform a scan or a fluoroscopy, either prior to or during surgery. In <FIG>, after the scan, gantry <NUM> may move back, and robotic arm assembly <NUM> may move via movement of second carriage <NUM> and pivot arm <NUM> so that the robot may perform (or assist in) surgery. <FIG> shows a top view of <FIG> in which robotic arm assembly <NUM> has pivoted to the other side of bed <NUM> to perform an operation from the right side of the patient.

<FIG> show uses of a system <NUM> during brain operations. System <NUM> is a modified version of system <NUM>, in which gantry <NUM> includes x-ray source <NUM> and x-ray detector <NUM>, which are movable toward and away from each other. Having the source and detector movable increases the scan resolution, which is important for brain surgery. In <FIG>, patient <NUM> and bed <NUM> approach system <NUM> from the opposite direction illustrated in previous figures.

In <FIG>, gantry <NUM> may move forward on platform <NUM> in order to perform a scan or a fluoroscopy, either prior to or during surgery. In <FIG>, after the scan, gantry <NUM> may move back, x-ray source <NUM> and x-ray detector <NUM> may retract, and robotic arm assembly <NUM> may move via movement of second carriage <NUM> and pivot arm <NUM> so that the robot may perform (or assist in) surgery. <FIG> shows that robotic arm assembly <NUM>, via movement of second carriage <NUM> and pivot arm <NUM>, may move out of the operating area if desired.

<FIG> shows a system <NUM> for performing robotic surgery, not forming part of the present invention. System <NUM> varies from systems <NUM> and <NUM> in a few ways. First, the bore diameter of gantry <NUM> is generally smaller than that of gantries <NUM> and <NUM> - on the order of <NUM> rather than <NUM> or more. Such gantries are more suited for brain operations, and possibly for pediatric and veterinary operations. Gantry <NUM> also contains within it a CT scanning and imaging device, is supported by platform <NUM>, and may move via carriage <NUM> in order to engage and disengage the CT with patient <NUM> disposed on bed <NUM>. Platform <NUM> may have wheels as did platform <NUM>. An example of a CT device to be used within system <NUM> is Epica International's Vimago™ CT scanner.

Second, system <NUM> includes robotic arm assembly <NUM>, which may be attached via pivot arm <NUM> to pivot <NUM> at the top center of gantry <NUM>. Pivot <NUM> and pivot arm <NUM> may operate in the same manner as pivot <NUM> and pivot arm <NUM> in system <NUM>. Pivot <NUM> may also be replaced by a motor shaft and a motor and control system as described with respect to system <NUM>. In these ways, robotic arm assembly <NUM> may operate on either side of gantry <NUM>, and may operate on the right or left side of the patient's body.

<FIG> shows a system <NUM> for performing robotic surgery. System <NUM> varies from system <NUM> in that robotic arm assembly <NUM> is attached via pivot arm <NUM> at the bottom center of gantry <NUM>. Except for the placement of the pivot, robotic arm assembly <NUM> operates in the same manner as robotic arm assembly <NUM>. In addition, any of the drawings that follow that show the robotic arm assembly being attached at the top of the gantry may be modified by having the robotic arm assembly attached to the bottom of the gantry, as shown in <FIG>.

<FIG> show uses of system <NUM> (and <NUM>) during operations with robotic arm assembly <NUM> and pivot arm <NUM> disposed on the front side of gantry <NUM>. The patient's area of interest (e.g., brain) may be within the CT analysis zone of gantry <NUM>. <FIG> shows robotic arm assembly <NUM> and pivot arm <NUM> in the front center position, and <FIG> shows robotic arm assembly <NUM> and pivot arm <NUM> in the front right position. <FIG> shows a side view of an operation with robotic arm assembly <NUM> and pivot arm <NUM> on the front side of gantry <NUM>. <FIG> shows a top view of three different positions for robotic arm assembly <NUM> and pivot arm <NUM> - location 244a, front left; location 244b, front center; and location 244c, front right. There may be more than three positions on the front side of gantry <NUM> into which robotic arm assembly <NUM> may be placed, the mechanics of which were described with respect to <FIG>.

<FIG> show uses of system <NUM> (and <NUM>) during operations with robotic arm assembly <NUM> and pivot arm <NUM> disposed on the back side of gantry <NUM>. In those examples, gantry <NUM> may move forward on platform <NUM> out of the way of the patient. <FIG> shows robotic arm assembly <NUM> and pivot arm <NUM> in the back left position, and <FIG> shows robotic arm assembly <NUM> and pivot arm <NUM> in the back right position. <FIG> shows a side view of an operation with robotic arm assembly <NUM> and pivot arm <NUM> on the back side of gantry <NUM>. Robotic arm assembly <NUM> may be placed in more than these positions on the back side of gantry <NUM>, the mechanics of which were described with respect to <FIG>.

<FIG> show uses of system <NUM> (and <NUM>) during operations with robotic arm assembly <NUM> and pivot arm <NUM> again disposed on the front side of gantry <NUM>. The patient and table are located on the front side of gantry <NUM> rather than on the back side, as was shown in <FIG>. In <FIG> (perspective view) and 8B (side view), the patient's area of interest (e.g., brain) may be within the CT analysis zone of gantry <NUM> during the operation. In <FIG> (perspective view) and 8D (side view), platform <NUM> and gantry <NUM> have been moved so that the patient is no longer within the CT analysis zone of gantry <NUM> during the operation.

<FIG> show a system <NUM> for performing robotic surgery, not forming part of the present invention. System <NUM> varies from systems <NUM> and <NUM> in that platform <NUM> is smaller, and there is no carriage separate from the platform that can move gantry <NUM>. Instead, platform <NUM> itself can be moved if desired. System <NUM> may be locked in the chosen position using four pins that can shunt the four wheels when the CT is in position. The four pins can be moved by hand or hydraulically. The bore diameter of gantry <NUM> is comparable to that of gantry <NUM> - on the order of <NUM> - and thus used for brain, pediatric, and veterinary operations. <FIG> shows the patient not yet within the CT analysis zone of gantry <NUM>. <FIG> shows that bed <NUM> can extend the patient into the CT analysis zone of gantry <NUM>. In <FIG> (perspective view) and 9D (top view), the patient's area of interest (e.g., brain) may be within the CT analysis zone of gantry <NUM> during the operation, with robotic arm assembly <NUM> and pivot arm <NUM> in the front left position. In <FIG> (perspective view) and 9F (top view), the patient's area of interest (e.g., brain) may be within the CT analysis zone of gantry <NUM> during the operation, with robotic arm assembly <NUM> and pivot arm <NUM> in the front right position. An example of a CT device to be used within system <NUM> is Epica International's Pico™ CT scanner.

<FIG> show uses of system <NUM> during operations with robotic arm assembly <NUM> and pivot arm <NUM> again disposed on the front side of gantry <NUM>. The patient and table are located on the front side of gantry <NUM> rather than on the back side, as was shown in <FIG>. In <FIG> (perspective view), 10B (side view), and 10C (top view), the patient's area of interest (e.g., neck and/or brain) may be within the CT analysis zone of gantry <NUM> during the operation. Robotic arm assembly <NUM> and pivot arm <NUM> can reach either side of the patient's body.

Accordingly, systems for performing robotic surgery have been described that provide increased access to surgical areas on a patient who is subject to CT scanning and/or imaging. The systems incorporate a CT gantry, a platform supporting the gantry, and a robotic arm assembly attached to the platform or gantry via a pivot arm. The pivot arm increases the surgical angles for the robotic arm. The pivot arm and associated motors may also help lock the robotic arm into position for more precise surgery.

Claim 1:
A system (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>) for performing robotic surgery on a patient (<NUM>) disposed on a bed (<NUM>), comprising:
- a gantry (<NUM>, <NUM>, <NUM>, <NUM>) comprising a computed tomography (CT) diagnostic device;
- a platform (<NUM>, <NUM>, <NUM>) supporting the gantry (<NUM>, <NUM>, <NUM>, <NUM>), the platform (<NUM>, <NUM>, <NUM>) having an upper surface, wherein the gantry (<NUM>, <NUM>, <NUM>, <NUM>) is configured to slide along the platform (<NUM>, <NUM>, <NUM>) via a first carriage (<NUM>) to allow entry of at least part of the patient (<NUM>) into the bore of the CT device; and
- a robotic arm assembly (<NUM>, <NUM>, <NUM>, <NUM>) attached to the platform (<NUM>, <NUM>, <NUM>) via a pivot arm (<NUM>,<NUM>,<NUM>,<NUM>) and a second carriage (<NUM>) to allow the robotic arm assembly (<NUM>, <NUM><NUM>, <NUM>) to slide along the platform (<NUM>, <NUM>, <NUM>) to enable surgery to be performed on the patient (<NUM>);
and characterized by that
- the robotic arm assembly (<NUM>, <NUM>, <NUM>, <NUM>) is attached to the platform (<NUM>, <NUM>, <NUM>) via the pivot arm (<NUM>, <NUM>, <NUM>, <NUM>) to a single pivot (<NUM>, <NUM>),
- the pivot arm (<NUM>, <NUM>, <NUM>, <NUM>) is substantially parallel to the upper surface of the platform (<NUM>, <NUM>, <NUM>) and
- the pivot (<NUM>, <NUM>) defines a rotation axis substantially perpendicular to the upper surface of the platform (<NUM>, <NUM>, <NUM>).