Patent Description:
An operating table can have multiple degrees of freedom and can rotate and/or translate to position a patient at a desired location. Robots may be used in connection with some surgeries, whether to assist a surgeon and/or to complete a surgical procedure autonomously. <CIT> and <CIT> disclose systems and methods of the prior art.

Claims <NUM> and <NUM> define the invention and dependent claims disclose embodiments. No surgical methods are claimed, Example aspects of the present disclosure include:.

An operating table control system according to at least one embodiment of the present disclosure comprises a memory storing instructions; and a processor configured to execute the instructions, the instructions causing the processor to: determine, based on first information about a robotic region of interest of a robot and second information about a patient region of interest, a center of rotation, cause an operating table having multiple degrees of freedom to rotate about the center of rotation from a first position to a second position, and control the robot based on the operating table being in the second position.

Any of the aspects herein, wherein the second information comprises a preoperative plan.

Any of the aspects herein, wherein the second position corresponds to a step of the preoperative plan.

Any of the aspects herein, wherein the operating table is movable independent of the robot.

Any of the aspects herein, wherein the instructions further cause the processor to automatically update a registration between a robotic coordinate space and a patient coordinate space based on the rotation of the operating table from the first position to the second position.

Any of the aspects herein, wherein the patient region of interest is a volume greater than a volume of the robotic region of interest, and the operating table is selectively movable to bring any location in the patient region of interest within the robotic region of interest.

Any of the aspects herein, wherein the center of rotation is a first center of rotation and wherein the instructions further cause the processor to determine a second center of rotation based on the robotic region of interest and the patient region of interest.

Any of the aspects herein, wherein the robotic region of interest includes a plurality of robotic regions of interest, each corresponding to one of a plurality of robots.

Any of the aspects herein, wherein the instructions further cause the processor to determine a combined robotic region of interest based on the plurality of robotic region of interests.

Any of the aspects herein, wherein the center of rotation is further based on the combined robotic region of interest.

Any of the aspects herein, wherein the second information corresponds to at least one of input from a surgeon, sensor data from at least one sensor, or input from a navigation system.

Any of the aspects herein, wherein the patient region of interest is positioned above a surface of the operating table.

Any of the aspects herein, wherein the patient region of interest is smaller than the robotic region of interest, and rotation of the operating table about the center of rotation ensures that the patient region of interest remains within the robotic region of interest.

A method for determining and maintaining a center of rotation according to at least one embodiment of the present disclosure comprises determining, based on first information about a robotic region of interest of a robot and second information about a patient region of interest, a center of rotation; causing an operating table having multiple degrees of freedom to rotate about the center of rotation from a first position to a second position; and causing a control system to control the robot based on the operating table being in the second position.

A method determining and maintaining a plurality of centers of rotation according to at least one embodiment of the present disclosure comprises determining a first center of rotation based on first information about a robotic region of interest and second information about a first patient region of interest; determining a second center of rotation based on the first information and third information about a second patient region of interest; causing an operating table having multiple degrees of freedom to rotate about the first center of rotation from a first position to a second position; causing a control system to control the robot based on the operating table being in the second position; causing the operating table to move to a third position to position the second center of rotation within the robotic region of interest; and causing the control system to control the robot based on the operating table being in the third position.

Any of the aspects herein, wherein the first center of rotation corresponds to a first surgical procedure in the first patient region of interest and the second center of rotation corresponds to a second surgical procedure in the second patient region of interest.

It should also be understood that, depending on the example or embodiment, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, and/or may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the disclosed techniques according to different embodiments of the present disclosure). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of units or modules associated with, for example, a computing device and/or a medical device.

In one or more examples, the described methods, processes, and techniques may be implemented in hardware, software, firmware, or any combination thereof.

Instructions may be executed by one or more processors, such as one or more digital signal processors (DSPs), general purpose microprocessors (e.g., Intel Core i3, i5, i7, or i9 processors; Intel Celeron processors; Intel Xeon processors; Intel Pentium processors; AMD Ryzen processors; AMD Athlon processors; AMD Phenom processors; Apple A10 or 10X Fusion processors; Apple A11, A12, A12X, A12Z, or A13 Bionic processors; or any other general purpose microprocessors), application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry.

When a surgical robot is used in connection with an operating table, movement of the table allows an area of interest where a surgical procedure is being performed to remain within reach of the surgical robot. Movement of the table may enable movement of the patient without compromising the surgical robot's reach of the area of interest. Such movements may occur at the beginning of the procedure or during the procedure.

During surgery on a patient (e.g., a spine surgery), the patient's position may need to be modified. Where the surgery is a robotic surgery with an operating table and a robot that are independently movable, the patient position may need to be adjusted to keep the region of interest of the patient within a robot work volume. A table with at least two positioning degrees of freedom and one rotational degrees of freedom may enable a surgeon to rotate a patient (e.g., by rotating the operating table) around any center of rotation to keep the region of interest within the robot work volume.

Embodiments of the present disclosure comprise or utilize a control system for determining a center of rotation of a table to maintain a patient region of interest ("ROI") within a robotic region of interest. The control system enables a table and a robot to move independently of each other and/or enables the patient to be moved while maintaining the patient ROI within the robotic ROI. The present disclosure enables efficient use of robots that are detached from and independent of an operating table. Thus, surgical procedures utilizing robots independent of an operating table may be streamlined by maintaining a positioning of a patient within a robot's work volume without needing to reposition or move the robot for a particular patient region of interest. Additionally, the present disclosure enables efficient use of larger robots that cannot be moved as easily as an operating table.

As described more fully below, methods and systems for maintaining a patient region of interest within a robotic region of interest according to at least some embodiments of the present disclosure may beneficially comprise determining a center of rotation for an operating table to rotate or otherwise move about, and causing a control system to control the robot based on the operating table rotating about the center of rotation.

Turning first to <FIG>, a block diagram of a system <NUM> according to at least one embodiment of the present disclosure is shown. The system <NUM> may be used to execute a center of rotation algorithm <NUM> and/or carry out other aspects of one or more of the methods disclosed herein. The system <NUM> comprises a computing device <NUM>, an operating table <NUM>, a navigation system <NUM>, one or more robots <NUM>, and/or one or more control systems <NUM>. Systems according to other embodiments of the present disclosure may comprise more or fewer components than the system <NUM>. For example, the system <NUM> may not include the navigation system <NUM>.

The computing device <NUM> comprises a processor <NUM>, a memory <NUM>, a communication interface <NUM>, and a user interface <NUM>. Computing devices according to other embodiments of the present disclosure may comprise more or fewer components than the computing device <NUM>.

The processor <NUM> of the computing device <NUM> may be any processor described herein or any similar processor. The processor <NUM> may be configured to execute instructions stored in the memory <NUM>, which instructions may cause the processor <NUM> to carry out one or more computing steps utilizing or based on data received from the operating table <NUM>, the control system <NUM>, the robot <NUM>, and/or the navigation system <NUM>. The instructions may also cause the processor <NUM> to carry out, and/or to generate one or more commands or signals that cause one or more other components of the system <NUM> to carry out, one or more steps of any method described herein.

The memory <NUM> may be or comprise RAM, DRAM, SDRAM, other solid-state memory, any memory described herein, or any other tangible, non-transitory memory for storing computer-readable data and/or instructions. The memory <NUM> may store information or data useful for completing, for example, any step of the methods <NUM> or <NUM> described herein. The memory <NUM> may store, for example, one or more center of rotation algorithms <NUM>, one or more control system instructions <NUM>, and/or one or more surgical plans <NUM>. the algorithms <NUM> and/or control system instructions <NUM> may, in some embodiments, be organized into one or more applications, modules, packages, layers, or engines. The algorithms may cause the processor <NUM> to manipulate data stored in the memory <NUM>, reflected in a surgical plan <NUM>, and/or received from the operating table <NUM>, the robot <NUM>, the control system <NUM>, and/or the navigation system <NUM>.

The computing device <NUM> may also comprise a communication interface <NUM>. The communication interface <NUM> may be used for receiving information from an external source (such as the operating table <NUM> (e.g., from one or more sensors or other smart elements of the operating table <NUM>), the navigation system <NUM>, the control system <NUM>, and/or the robot <NUM>), and/or for transmitting instructions, images, and/or other information to an external system or device (e.g., another computing device <NUM>, the navigation system <NUM>, the operating table <NUM>, the control system <NUM>, and/or the robot <NUM>). The communication interface <NUM> may comprise one or more wired interfaces (e.g., a USB port, an ethernet port, a Firewire port) and/or one or more wireless interfaces (configured, for example, to transmit information via one or more wireless communication protocols such as <NUM>. 11a/b/g/n, Bluetooth, NFC, ZigBee, and so forth). In some embodiments, the communication interface <NUM> may be useful for enabling the device <NUM> to communicate with one or more other processors <NUM> or computing devices <NUM>, whether to reduce the time needed to accomplish a computing-intensive task or for any other reason.

The computing device <NUM> may also comprise one or more user interfaces <NUM>. The user interface <NUM> may be or comprise a keyboard, mouse, trackball, monitor, television, touchscreen, headset, and/or any other device for receiving information from a user and/or for providing information to a user. In some embodiments, the user interface <NUM> may receive information and/or commands from a user via voice activation. In other embodiments, the user interface <NUM> may incorporate augmented reality or virtual reality. The user interface <NUM> may be used, for example, to receive a user selection or other user input regarding determining a first center of rotation; to receive a user selection or other user input regarding determining a second center of rotation; to receive a user selection or other user input regarding causing an operating table <NUM> to rotate about the first center of rotation from a first position to a second position; to receive a user selection or other user input regarding causing a control system <NUM> to control a robot <NUM> based on the operating table <NUM> being in the second position; to receive a user selection or other user input regarding causing the operating table <NUM> to move to a third position to position the second center of rotation within a robotic region of interest; to receive a user selection or other user input regarding causing the control system <NUM> to control the robot <NUM> based on the operating table <NUM> being in the third position; and/or to display the image data and/or the surgical plan <NUM>. In some embodiments, the user interface <NUM> may be useful to allow a surgeon or other user to modify the plan <NUM>, or other information displayed, though it will be appreciated that each of the preceding inputs may be generated automatically by the system <NUM> (e.g., by the processor <NUM> or another component of the system <NUM>) or received by the system <NUM> from a source external to the system <NUM>. In some embodiments, user input such as that described above may be optional or not needed for operation of the systems, devices, and methods described herein.

Although the user interface <NUM> is shown as part of the computing device <NUM>, in some embodiments, the computing device <NUM> may utilize a user interface <NUM> that is housed separately from one or more remaining components of the computing device <NUM>. In some embodiments, the user interface <NUM> may be located proximate one or more other components of the computing device <NUM>, while in other embodiments, the user interface <NUM> may be located remotely from one or more other components of the computer device <NUM>.

Turning to the operating or surgical table <NUM>, the table <NUM> is operable to maneuver a patient while maintaining a specific anatomy of the patient within a region of interest of the robot <NUM>. In some embodiments, the table <NUM> has two positioning degrees of freedom and one rotational degrees of freedom, which allows positioning of the specific anatomy of the patient anywhere in space (within a volume defined by the limits of movement of the table <NUM>). For example, the table <NUM> can slide forward and backward and from side to side, and can tilt (e.g., around an axis positioned between the head and foot of the table <NUM>, and extending from one side of the table <NUM> to the other) and/or roll (e.g., around an axis positioned between the two sides of the table <NUM>, and extending from the head of the table <NUM> to the foot thereof). In other embodiments, the table <NUM> can bend at one or more areas (which bending may be possible due to, for example, the use of a flexible surface for the table <NUM>, or by physically separating one portion of the table <NUM> from another portion of the table <NUM> and moving the two portions independently). The table <NUM> may be manually moved or manipulated by, for example, a surgeon or other user, or the table <NUM> may comprise one or more motors, actuators, and/or other mechanisms configured to enable movement and/or manipulation of the table <NUM> by the control system <NUM>. The robot <NUM> may be independent of and unattached to the table <NUM> in some embodiments. In other words, the robot <NUM> may be manipulated and moved separately from the table <NUM>. In such embodiments, the robot <NUM> may be secured to one or more of a floor, wall, and/or ceiling of an operating room, or to any structure affixed to any of the foregoing. In other embodiments, the robot <NUM> may be attached to the table <NUM>.

The navigation system <NUM> may provide navigation for a surgeon and/or a surgical robot during an operation. The navigation system <NUM> may be any now-known or future-developed navigation system, including, for example, the Medtronic StealthStation™ S8 surgical navigation system. The navigation system <NUM> may include a camera or other sensor(s) for tracking one or more reference markers, navigated trackers, or other objects within the operating room or other room where a surgery takes place. In various embodiments, the navigation system <NUM> may be used to track a position of a patient (or, more particularly, of a navigated reference marker attached, directly or indirectly, in fixed relation to the patient), the operating table <NUM> (or, more particularly, of a navigated reference marker attached, directly or indirectly, in fixed relation to the table <NUM>), and/or of the robot <NUM> (or, more particularly, of a navigated reference marker attached, directly or indirectly, in fixed relation to the robot <NUM>). The navigation system <NUM> may include a display for displaying one or more images from an external source (e.g., the computing device <NUM> or other source) or a video stream from the camera or other sensor of the navigation system <NUM>.

In some embodiments, the navigation system <NUM> may be used to track movement of the robot <NUM>, the table <NUM>, and/or the patient and may provide feedback regarding, or confirmation of, a position of the robot <NUM>, the table <NUM>, and/or the patient. For example, the navigation system <NUM> may indicate - audibly and/or visually via a display - that the robot <NUM> and/or the table <NUM> needs to be moved, automatically or manually, to a suggested robot or table position based on a center of rotation, the patient region of interest, and/or the robotic region of interest. The navigation system <NUM> can monitor or track the robot <NUM> or the table <NUM> as the robot <NUM> or the table <NUM> is moved toward the suggested robot or table position, or to any other position. The navigation system <NUM> can further indicate to or alert a user when the robot <NUM> or the table <NUM> has reached the suggested robot position or any other predetermined position. In other embodiments, a user may view a display of the navigation system <NUM> while moving the robot <NUM> or the table <NUM> to the suggested robot or table position, so as to ensure that the user moves the robot <NUM> or the table <NUM> to the correct position. In some embodiments, the system <NUM> can operate without the use of navigation system <NUM>.

Reference markers (i.e., navigation markers) may be placed on the robot <NUM>, a robotic arm <NUM> of the robot <NUM>, the table <NUM>, a patient, and/or any other object in the surgical space. The reference markers may be tracked by the navigation system <NUM>, and the results of the tracking may be used by the robot <NUM> and/or by an operator of the system <NUM> or any component thereof. As described above, in some embodiments, the navigation system <NUM> can be used to track other components of the system <NUM> (e.g., operating table <NUM>).

The robot <NUM> may be any surgical robot or surgical robotic system. The robot <NUM> may be or comprise, for example, the Mazor X™ Stealth Edition robotic guidance system. The robot <NUM> may comprise the robotic arm <NUM>. In some embodiments, the robotic arm <NUM> may comprise a plurality of robotic arms, though the robot <NUM> may comprise one robotic arm, two robotic arms, or more than two robotic arms. The robotic arm <NUM> may be used to selectively hold and/or operate one or more surgical tools, an imaging device, one or more reference markers, and/or any other tool or instrument.

In the illustrated embodiment, the system <NUM> includes the control system <NUM>, though in some embodiments the system <NUM> may not include the control system <NUM>. In other embodiments, the control system <NUM> may be integrated into the computing device <NUM>, the robot <NUM>, and/or the operating table <NUM>. The control system <NUM> may include a controller that may be an electronic, a mechanical, or an electro-mechanical controller. The control system <NUM> may comprise or may be any processor described herein. The control system <NUM> may comprise a memory storing instructions for executing any of the functions or methods described herein as being carried out by the control system <NUM>. In some embodiments, the control system <NUM> may be configured to simply convert signals received from the computing device <NUM> (e.g., via a communication interface <NUM>) into commands for operating the operating table <NUM>, the navigation system <NUM>, and/or the robot <NUM>. In other embodiments, the control system <NUM> may be configured to process and/or convert signals received from the operating table <NUM>, the navigation system <NUM>, and/or the robot <NUM>. Further, the control system <NUM> may receive signals from one or more sources (e.g., the operating table <NUM>, the navigation system <NUM>, and/or the robot <NUM>) and may output signals to one or more sources. In some embodiments, the functions of the control system as described herein may be performed by the computing device <NUM>, and the system <NUM> may not comprise a separate control system <NUM>.

Turning to <FIG>, at least a portion of a surgical room <NUM> is illustrated including two robots <NUM> (each of which may be the same as or similar to the robot <NUM> described above) each having a robotic arm <NUM> (which may be the same as or similar to the robotic arm <NUM>), an operating table <NUM> (which may be the same as or similar to the table <NUM> described above), and a patient <NUM> laying prone on the table <NUM>. The table <NUM> is movable from a first position, as shown in <FIG>, to a second position, as shown in <FIG>. In the illustrated example, the movement of the table <NUM> from the first position shown in <FIG> to the second position shown in <FIG> is a tilting movement, though the table <NUM> may move in any direction or orientation. The table <NUM> may be moved as needed during a procedure and/or may be moved based on and/or in preparation for one or more steps of a surgical or preoperative plan <NUM>. As previously described, the table <NUM> may be moved manually by a surgeon or operator or may be moved automatically by the control system <NUM> and one or more motors, actuators, and/or other mechanisms.

The table <NUM> selectively moves about a center of rotation (COR) <NUM>, depicted as a first dashed sphere, which is determined, for example, from first information and second information. The first information corresponds to information about a robotic region of interest (ROI) <NUM>, depicted as a second dashed sphere, and the second information corresponds to information about a patient region of interest (ROI) <NUM>, depicted as a third dashed sphere. It will be understood that the COR, patient ROI, and/or robotic ROI may be any shape or size. Further, the first dashed sphere, the second dashed sphere, and the third dashed sphere are demonstrative and are not visible in practice though it will also be appreciated that such COR, patient ROI, and/or robotic ROI may be displayed in an augmented or virtual reality headset or other display (e.g., a monitor).

The robotic ROI <NUM> correlates to a dimensional reach of the robotic arm <NUM>. In some embodiments, the robotic ROI <NUM> may be or comprise a plurality of robotic ROIs and each robotic ROI may correspond to one of a plurality of robotic arms. In other words, in embodiments where a plurality of robotic arms is used during a procedure, each robotic arm will have its own robotic ROI. The robotic ROIs of each of a plurality of robots may overlap in whole or in part. In such embodiments having a plurality of robotic ROIs, a combined robotic ROI (e.g., an ROI the entirety of which may be reached by each of the plurality of robots) may be calculated or determined and the combined robotic ROI may be used to determine the COR <NUM>.

The patient ROI <NUM> correlates to an area of and/or surrounding a surgical site that the robot <NUM> (or a surgeon) may contact, access, or within which the robot <NUM> (or surgeon) may otherwise move. The patient ROI <NUM> can be positioned above a surface of the table <NUM>. The patient ROI <NUM> may have a volume greater than, less than, or equal to a volume of the robotic ROI <NUM>. Similarly, the patient ROI <NUM> may have the same shape or a different shape than a shape of the robotic ROI <NUM>. In embodiments where the patient ROI <NUM> is smaller than the robotic ROI <NUM>, rotation of the table <NUM> about the COR <NUM> ensures that the patient ROI <NUM> remains within the robotic ROI <NUM>. In embodiments where the patient ROI <NUM> is greater than the robotic ROI <NUM>, the operating table may be selectively moved to bring any location in the patient ROI <NUM> within the robotic ROI <NUM>.

In some embodiments, more than one COR <NUM> may be calculated. For example, in embodiments where the patient ROI <NUM> is greater than the robotic ROI <NUM> and the robotic arm <NUM> cannot reach all areas of the patient ROI <NUM>, first and second CORs <NUM> may be determined. In other examples, a first COR <NUM> may correspond to a first surgical procedure in a first area of the patient <NUM> and a second COR <NUM> may correspond to a second surgical procedure in a second area of the patient <NUM>. In such embodiments, the table <NUM> may selectively move from the first position to the second position about the first COR <NUM>. The table <NUM> may then move to position the second COR <NUM> within the robotic ROI <NUM>. Alternatively, the robot <NUM> may move to position the robotic ROI <NUM> such that the second COR <NUM> is within the robotic ROI <NUM>. When the robotic ROI <NUM> and the second COR <NUM> are aligned or otherwise positioned, the table <NUM> may rotate about the second COR <NUM> to maintain the patient ROI <NUM> within the robotic ROI <NUM>.

Turning now to <FIG>, a method <NUM> for determining and maintaining a center of rotation may be executed in whole or in part, for example, on a computing device such as the computing device <NUM> or similar device, and may utilize one or more other components of the system <NUM> or similar components. One or more aspects of the method <NUM> may be performed by or with a surgical robot, a surgeon, or a combination of both.

The method <NUM> comprises determining, based on first information and second information, a center of rotation such as the center of rotation (COR) <NUM> (step <NUM>). The COR may be determined using a center of rotation algorithm such as the center of rotation algorithm <NUM>, and the algorithm may receive the first information and the second information as inputs.

The first information may correspond to a robotic region of interest (ROI) such as the robotic ROI <NUM> of a robot such as the robot <NUM> or <NUM>. The second information may correspond to a patient ROI such as the patient ROI <NUM>. The first information and/or the second information may be received via a user interface such as the user interface <NUM> and/or via a communication interface such as the communication interface <NUM> of a computing device such as the computing device <NUM>, and may be stored in a memory such as the memory <NUM>. The first information and/or the second information may also be generated by and/or uploaded to any other component of the system. In some embodiments, the first information may be received directly from the robot. The first information may include a dimensional reach of a robotic arm such as the robotic arm <NUM> or <NUM>, dimensions of the robot and/or of the robotic arm, degrees of freedom of the robotic arm, and/or whether the robot is independent of an operating table such as the table <NUM> or <NUM>.

In various embodiments, the second information (pertaining to the patient ROI) corresponds to at least one of input from a surgeon, sensor data from at least one sensor, or input from a navigation system such as the navigation system <NUM>. In other embodiments, the second information may comprise or be extracted or otherwise obtained from a surgical or preoperative plan such as the surgical plan <NUM>. In further embodiments, a marker may be placed within the desired patient ROI and tracked by a navigation system, such as the navigation system <NUM>. In other embodiments, a marker may be placed on the desired patient ROI and imaged by an imaging device, such as an X-ray based imaging device or ultrasound device. In either case, the marker may be secured, for example, either temporarily or permanently to an anatomical element within the patient ROI. In such embodiments, the marker may be used to define (or at least to assist in defining) the patient ROI, which may then be used as at least one input to determine the COR.

The method <NUM> also comprises causing an operating table such as the table <NUM> or <NUM> to rotate about the COR from a first position to a second position (step <NUM>). The table may be moveable independent of the robot. In some embodiments, a registration between a robotic coordinate space and a patient coordinate space may be updated based on rotation or other movement of the operating table from the first position to the second position.

The table may also have multiple degrees of freedom and can rotate or move in any direction. In some embodiments, the table has two positioning degrees of freedom (to allow the table to move forward and backward and side-to-side) and one rotational degrees of freedom (to allow the table to tilt and roll). In other embodiments, the table can bend at one or more locations, in any manner described herein or any other manner that allows the table to continue to support the patient. The table may be manually moved or manipulated by, for example, a surgeon or other user, or the table may be caused to be moved or manipulated by a control system, such as the control system <NUM>.

The method <NUM> also comprises causing a control system (such as the control system <NUM>, for example) to control the robot based on the operating table being in the second position (step <NUM>). The control system may receive control system instructions such as the control system instructions <NUM> from a computing device such as the computing device <NUM>. The control system instructions may cause the control system to control the robot. The control system instructions may be received via the user interface and/or via the communication interface of the computing device and may be stored in the memory. The control system instructions may also be generated by and/or uploaded to any other component of the system <NUM>. In some embodiments, the control system instructions are based on a surgical plan such as the surgical plan <NUM>. For example, each movement of the robot may correlate to a surgical step of the surgical plan.

In some embodiments, the step <NUM> may comprise causing, with a computing device (e.g., the computing device <NUM>), the robot to move based on, for example, a surgical plan, the position of the operating table, and/or an existing registration of a coordinate system of the robot to a coordinate system of the patient and/or to a coordinate system of a navigation system.

The method <NUM> may comprise, in some embodiments, receiving a surgical plan, which may be the same as or similar to the surgical plan <NUM>. The surgical plan may be received via a user interface (e.g., the user interface <NUM>) and/or a communication interface (e.g., the communication interface <NUM>) of a computing device such as the computing device <NUM>, and may be stored in a memory such as the memory <NUM> of the computing device. The surgical plan may include information about one or more planned movements of a tool held by the robotic arm during a surgical procedure. The surgical plan may be used to generate the control system instructions, or may comprise the control system instructions. In some embodiments, the surgical plan includes a planned trajectory of one or more medical devices (e.g., medical tools, medical screws, medical plates, etc.). The information may also include a timeline or schedule of the one or more planned movements. The one or more planned movements may include one or more of timestamps, types of movement (e.g., translational and/or rotational), durations of movement, and/or positional information (e.g., starting, intermediate, and/or ending coordinates and/or orientation).

In some embodiments, the method <NUM> may comprise determining information about one or more needed movements of the tool during a surgical procedure outlined or otherwise described in a surgical plan. In such embodiments, the surgical plan may not include any such information about needed movements of the tool, but a processor (whether of a computing device such as the computing device <NUM>, or of a control system such as the control system <NUM>, or otherwise), executing instructions stored in a memory, may generate such information based on the surgical plan.

The step <NUM> of causing the table to rotate about the COR from a first position to a second position may be further based on the surgical plan. For example, in some embodiments, the method <NUM>, and more specifically the step <NUM>, may comprise causing the operating table to rotate about the COR from a first position to a second position wherein the second position corresponds to a step of the plan. In such embodiments, the plan may include information about a needed movement of the operating table (and/or of the patient) from the first position to the second position, or a determination to move the operating table (and thus the patient) from the first position to the second position may be made based on the surgical plan.

Although described herein in connection with a robot that is not connected to an operating table, the method <NUM> may be used in connection with robots of any kind, including robots that are connected to the table, robots that are supported on a selectively moveable cart, robots supported entirely by a patient's body, and robots that may be selectively connected to a structure other than an operating table. The present disclosure may be particularly useful, however, when the operating table and/or patient is/are movable independently of the robot.

Turning now to <FIG>, a method <NUM> for determining and maintaining a plurality of centers of rotation may be executed in whole or in part, for example, on a computing device such as the computing device <NUM> or similar device, and may utilize one or more other components of the system <NUM> or similar components. One or more aspects of the method <NUM> may be performed by or with a surgical robot, a surgeon, or a combination of both.

The method <NUM> comprises determining, based on first information and second information, a first COR of a plurality of CORs based on first information and second information (step <NUM>) and determining a second COR of the plurality of CORs based on the first information and third information (step <NUM>). The first COR and the second COR may each be determined using a center of rotation algorithm such as the center of rotation algorithm <NUM>. The algorithm may receive the first information, the second information, and/or the third information as inputs. In some embodiments, the first COR may correspond to a first surgical procedure in a first patient ROI and the second COR may correspond to a second surgical procedure in a second patient ROI. For example, if a patient is to undergo a multi-level spinal surgery, the first patient ROI may correspond to a first spinal level at which a portion of the surgery will take place, and the second patient ROI may correspond to a second spinal level at which another portion of the surgery will take place. The first patient ROI and the second patient ROI may be completely separate and spaced from each other, or completely separate but with a common boundary, or may overlap. In at least some embodiments, the first and second patient ROIs are not, however, co-extensive. In other embodiments, the first and second patient ROIs (or other ROIs) may be assembled into a combined ROI and one or more CORs may be determined for the combined ROI.

The first information may correspond to a robotic ROI such as the robotic ROI <NUM> of a robot, such as the robot <NUM> or <NUM>; the second information may correspond to the first patient ROI <NUM>; and the third information may correspond to the second patient ROI. The first information, the second information, and/or the third information may be received via a user interface such as the user interface <NUM> and/or via a communication interface such as the communication interface <NUM> of a computing device such as the computing device <NUM>. The first, second, and/or third information may be stored in a memory such as the memory <NUM>. The first information, the second information, and/or the third information may also be generated by and/or uploaded to any other component of the system. In some embodiments, the first information may be received directly from the robot. The first information may include a dimensional reach of a robotic arm of the robot (which may be, for example, the same as or similar to the robotic arm <NUM> or <NUM>), dimensions of the robot and/or the robotic arm, degrees of freedom of the robotic, and/or whether the robot is independent of an operating table such as the table <NUM> or <NUM>.

In various embodiments, each of the second information and the third information (pertaining to the patient's first ROI and second ROI, respectively) corresponds to at least one of input from a surgeon, sensor data from at least one sensor, or input from a navigation system such as the navigation system <NUM>. In other embodiments, the second information and/or the third information may each be extracted from or otherwise obtained from, or comprise, a surgical or preoperative plan such as the surgical plan <NUM>. In further embodiments, a marker may be placed within the desired patient ROI and tracked by a navigation system, such as the navigation system <NUM>. In other embodiments, a marker may be placed on the desired patient ROI and imaged by an imaging device, such as an X-ray based imaging device or ultrasound device. In either case, the marker may be secured, for example, either temporarily or permanently to an anatomical element within the patient ROI. In such embodiments, the marker may be used to define (or at least to assist in defining) the patient ROI, which may then be used as at least one input to determine the COR.

The method <NUM> also comprises causing an operating table such as the table <NUM> or <NUM> to rotate about the first COR from a first position to a second position (step <NUM>). The table may be moveable independent of the robot. In some embodiments, a registration between a robotic coordinate space and a patient coordinate space (and/or between a navigation coordinate space and a patient coordinate space) may be updated based on rotation of the operating table from the first position to the second position.

The table may also have multiple degrees of freedom, which may enable the table to rotate or move in any direction. In some embodiments, the table has two positioning degrees of freedom.

(to allow the table to move forward and backward and side-to-side) and one rotational degrees of freedom (to allow the table to tilt and/or roll). In other embodiments, the table can bend at one or more locations (e.g., in any manner described herein). The table may be manually moved or manipulated by, for example, a surgeon or other user, or the table may be caused to be moved or manipulated by a control system, such as the control system <NUM>.

The method <NUM> also comprises causing a control system (such as the control system <NUM>, for example) to control the robot based on the operating table being in the second position (step <NUM>). The control system may receive control system instructions such as the control system instructions <NUM> from a computing device such as the computing device <NUM>. The control system instructions may cause the control system to control the robot. The control system instructions may be received via the user interface and/or via the communication interface of the computing device and may be stored in the memory. The control system instructions may also be generated by and/or uploaded to any other component of the system <NUM>. In some embodiments, the control system instructions are based on a surgical plan such as the surgical plan <NUM>.

The method <NUM> also comprises causing the table to move to a third position to position the second COR within the robotic ROI (step <NUM>). The step <NUM> may be carried out in a substantially similar manner to the step <NUM>. In some embodiments, the registration between a robotic coordinate space and a patient coordinate space may be updated based on movement of the table from the second position to the third position.

The method <NUM> also comprises causing the control system to control the robot based on the operating table being in the third position (step <NUM>). The step <NUM> may be carried out in a substantially similar manner to the step <NUM>. The control system may receive control system instructions such as the control system instructions <NUM> from a computing device such as the computing device <NUM>. The control system instructions may be the same instructions as the instructions of step <NUM>, or may be new or updated control system instructions. The control system instructions may be received via the user interface and/or via the communication interface of the computing device, and may be stored in the memory. The control system instructions may also be generated by and/or uploaded to any other component of the system. In some embodiments, the control system instructions are based on the surgical plan. For example, each movement of the robot may correlate to a surgical step of the surgical plan.

The steps <NUM> and <NUM> of causing the table to rotate about the first COR from a first position to a second position and causing the table to move to a third position to position the second COR within the robotic ROI, respectively, may each be further based on the surgical plan. For example, in some embodiments, the method <NUM>, and more specifically the steps <NUM> and <NUM>, may comprise causing the operating table to rotate about the first COR from a first position to a second position and causing the operating table to move to a third position to position the second COR within the robotic ROI, wherein the second position and the third position each corresponds to a step of the plan. In such embodiments, the plan may include information about a needed movement of the operating table (and/or of the patient) from the first position to the second position or from the second position to the third position, or a determination to move the operating table (and thus the patient) from the first position to the second position or from the second position to the third position may be made based on the surgical plan.

The methods and systems described herein provide a control system and method for determining a center of rotation of an operating table to align and maintain a patient region of interest within a robotic region of interest. The methods and systems described herein enables efficient use of robots that are unattached and independent of an operating table, thereby beneficially streamlining an operating procedure by maintaining a positioning of a patient within a robot's work volume without the need to reposition or move the robot.

As may be appreciated based on the foregoing disclosure, the present disclosure encompasses methods with fewer than all of the steps identified in <FIG> and <FIG> (and the corresponding description of the methods <NUM> and <NUM>), as well as methods that include additional steps beyond those identified in <FIG> and <FIG> (and the corresponding description of the methods <NUM> and <NUM>). One or more steps of the methods described herein may be performed in an order other than the order in which they are described herein.

As may also be appreciated based on the foregoing disclosure; embodiments of the present disclosure may include one or more aspects of PCT Patent Application <CIT>.

The foregoing discussion has been presented for purposes of illustration and description. The foregoing is not intended to limit the disclosure to the form or forms disclosed herein. In the foregoing Detailed Description, for example, various features of the disclosure are grouped together in one or more aspects, embodiments, and/or configurations for the purpose of streamlining the disclosure. The features of the aspects, embodiments, and/or configurations of the disclosure may be combined in alternate aspects, embodiments, and/or configurations other than those discussed above.

Claim 1:
An operating table control system (<NUM>) comprising:
a memory (<NUM>) storing instructions; and
a processor (<NUM>) configured to execute the instructions, the instructions causing the processor (<NUM>) to:
determine, based on first information about a robotic region of interest (<NUM>) of a robot (<NUM>, <NUM>) and second information about a patient region of interest (<NUM>), a center of rotation (<NUM>),
cause an operating table (<NUM>, <NUM>) having multiple degrees of freedom to rotate about the center of rotation (<NUM>) from a first position to a second position, and
control the robot (<NUM>, <NUM>) based on the operating table (<NUM>, <NUM>) being in the second position.