Drill guide fixtures, cranial insertion fixtures, and related methods and robotic systems

1 . A robotically guided method of attaching a temporary guide fixture to a skull of a patient, the temporary guide fixture configured to receive a needle to be inserted into a brain of the patient, the method comprising:

controlling a robot to automatically place an end effector having a tube to a desired location adjacent to the skull along a planned trajectory based on tracking of the skull by the robot;

inserting a drill through the placed end effector tube;

drilling a hole in the skull with the inserted drill through the tube of the end effector while the robot is holding the end effector at the desired location;

drilling a fastener hole for the temporary guide fixture, the fastener hole being laterally spaced from the hole, with assistance from the end effector under the control of the robot such that the robot is holding the end effector at a fixed location while the fastener hole is being drilled;

after drilling the hole and the fastener hole, causing the end effector to move away from the desired location;

inserting, into the drilled hole, a distal end of the temporary guide fixture;

inserting a fastener into the drilled fastener hole to affix the temporary guide fixture to the skull;

inserting the needle using the affixed temporary guide fixture without any assistance from the end effector.

2 . The method of claim 1 , further comprising:

inserting a burr hole drill having a smaller drill diameter than the drill through the inserted temporary guide fixture;

drilling a through hole in the skull with the inserted burr hole drill.

3 . The method of claim 1 , further comprising:

attaching a tracking array to the temporary guide fixture for tracking by the robot;

adjusting the temporary guide fixture with guidance from the robot tracking the tracking array.

4 . The method of claim 1 , wherein the temporary guide fixture comprises:

a base providing a plurality of spaced apart contact areas configured to provide contact with the skull; and

a guide tube coupled with the base, wherein the guide tube includes a contact end and an insertion end, wherein the contact end is configured to contact an opening in the skull, and wherein the insertion end is configured to receive a medical device, the method further comprising attaching the base to the skull.

5 . The method of claim 4 , wherein the temporary guide fixture further comprises:

a moveable coupling between the base and a first portion of the guide tube, wherein the moveable coupling is configured to allow angular movement of the guide tube relative to the base; and

an adjustment member coupled between the base and a second portion of the guide tube, the method further comprising adjusting an angular orientation of the temporary guide fixture with the moveable coupling and the adjustment member.

6 . The method of claim 5 , wherein the moveable coupling comprises a spherical joint allowing angular movement of the guide tube relative to the base.

7 . The method of claim 5 , wherein the adjustment member comprises at least three telescoping adjustment members coupled between the base and the second portion of the guide tube, wherein the telescoping adjustment members are configured to lock the guide tube in different angular orientations relative to the base.

8 . The method of claim 5 , wherein the adjustment member comprises at least three telescoping actuators configured to move the guide tube to different angular orientations relative to the base.

9 . The method of claim 8 , wherein each of the telescoping actuators comprises an electrically and/or hydraulically actuated actuator.

10 . The method of claim 4 , wherein the base further defines a plurality of spaced apart anchor screw holes, and wherein each of the plurality of spaced apart anchor screw holes is provided at a respective one of the spaced apart contact areas.

11 . The method of claim 1 , wherein:

the temporary guide fixture includes a bone anchor drill guide at a base of the temporary guide fixture, wherein the bone anchor drill guide defines a bone anchor drill guide hole therethrough, and wherein the bone anchor drill guide hole is offset from a central drill guide hole in a direction that is perpendicular with respect to a direction of the central drill guide hole.

12 . The method of claim 11 , wherein the temporary guide fixture further comprises a rotational coupling between the central drill guide and the bone anchor drill guide so that the bone anchor drill guide is rotatable relative to the central drill guide.

13 . The method of claim 12 , wherein the bone anchor drill guide hole is a first drill guide hole, and wherein the bone anchor drill guide comprises a second drill guide hole spaced apart from the first drill guide hole.

14 . The method of claim 12 , wherein the central drill guide hole is cylindrical, wherein the bone anchor drill guide hole is cylindrical, wherein an axis of rotation of the bone anchor drill guide is parallel with respect to an axial direction of the central drill guide hole, and wherein a first opening of the bone anchor drill guide hole adjacent the base of the bone anchor drill guide is closer to the central drill guide hole than a second opening of the bone anchor drill guide hole spaced apart from the base of the bone anchor drill guide.

15 . The method of claim 11 , wherein the bone anchor drill guide hole is non-parallel with respect to the central drill guide hole.

16 . A robotically guided method of attaching a temporary guide fixture to a skull of a patient, the temporary guide fixture configured to receive a needle to be inserted into a brain of the patient, the method comprising:

controlling a robot to automatically place an end effector having a tube to a desired location adjacent to the skull along a planned trajectory based on tracking of tracking markers of a dynamic reference base attached to the skull;

inserting a first drill through the placed end effector tube;

drilling a recess in the skull with the inserted drill through the tube of the end effector while the robot is holding the end effector at the desired location;

drilling a fastener hole for the temporary guide fixture, the fastener hole being laterally spaced from the recess, with assistance from the end effector under the control of the robot such that the robot is holding the end effector at a fixed location while the fastener hole is being drilled;

inserting a second drill having a smaller drill diameter than the first drill through the temporary guide fixture;

drilling a through hole in the skull with the inserted second drill through the drilled recess;

after drilling the through hole and the fastener hole, causing the end effector to move away from the desired location;

inserting, into the drilled recess, a distal end of the temporary guide fixture;

inserting a fastener into the drilled fastener hole to affix the temporary guide fixture to the skull;

inserting the needle using the affixed temporary guide fixture without any assistance from the end effector.

17 . The method of claim 16 , wherein drilling a fastener hole includes:

inserting a pilot hole drill through the end effector tube;

drilling a plurality of holes with the inserted pilot hole drill through the tube of the end effector while the robot is holding the pilot hole drill in the end effector tube.

18 . The method of claim 17 , further comprising:

attaching a base of the temporary guide fixture using the drilled plurality of holes.

19 . The method of claim 16 , further comprising:

attaching a tracking array to the temporary guide fixture for tracking by the robot;

adjusting the temporary guide fixture with guidance from the robot tracking the tracking array.