Multi-arm robotic system for spine surgery with imaging guidance
Systems and methods for monitoring a surgical procedure are provided. A coordinate system of a first robotic arm and a second robotic arm may be co-registered or correlated to each other. One or more poses of an imaging device may be determined to provide real-time intraoperative imaging of a region of interest during a surgical procedure. Anatomical elements may be identified in the real-time images of the region of interest from which a surgical tool should maintain a predetermined distance. The surgical tool may be prevented from approaching the identified anatomical elements by less than a predetermined distance using the co-registration of the coordinate systems.
1. A robotic system, comprising:
a first robotic arm configured to orient an imaging device;
a second robotic arm configured to orient at least one surgical tool;
at least one processor; and
at least one memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to:
correlate coordinate systems of the first robotic arm and the second robotic arm;
analyze intraoperative images obtained from the imaging device to identify a first anatomical element for the at least one surgical tool to avoid and to identify and obtain a pose of the at least one surgical tool;
annotate the intraoperative images to label the identified first anatomical element;
prevent the at least one surgical tool from approaching the identified first anatomical element based on the labelled identified first anatomical element;
calculate a volume of a second anatomical element based on the intraoperative images;
remove an amount of material from the second anatomical element;
recalculate the volume of the second anatomical element to determine the amount of material removed; and
generate a notification when the determined amount of material removed equals a known volume to be removed.
2. The system of claim 1 , wherein identifying the first anatomical element is accomplished through image processing.
3. The system of claim 1 , wherein identifying the first anatomical element is accomplished through machine learning recognition of images of anatomic elements from a database.
4. The system of claim 1 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
cause the second robotic arm to perform a surgical procedure using the at least one surgical tool.
5. The system of claim 1 , wherein the imaging device is configured to acquire three-dimensional images by use of at least two imaging positions of the imaging device.
6. The system of claim 5 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
cause the first robotic arm to position the imaging device at each of the at least two imaging positions according to a surgical plan.
7. The system of claim 4 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
calculate a volume of an anatomical feature during the surgical procedure.
8. The system of claim 7 , wherein the second anatomical element undergoing the surgical procedure is an intervertebral disc.
9. The system of claim 4 , wherein the surgical procedure comprises one of a vertebral discectomy, a laminectomy, a foraminotomy, or a laminotomy, the surgical procedure being carried out either transcutaneously or by open surgery.
10. The system of claim 1 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
cause the first robotic arm to reposition the imaging device if a region in which the at least one surgical tool is operating becomes situated outside a field of view of the imaging device.
11. The system of claim 1 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
cause the first robotic arm to reposition the imaging device if the identified first anatomical element becomes situated outside a field of view of the imaging device.
12. The system of claim 1 , wherein the identified first anatomical element is one of a spinal nerve, a nerve root, a dorsal root ganglion, an intervertebral disc, a spinal meninges, a spinal cord, a vertebral foramen, or an intervertebral foramen.
13. The system of claim 1 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
provide instructions to position and operate the at least one surgical tool.
14. The system of claim 13 , wherein the instructions comprise a plan for a surgical procedure based on one of a set of three-dimensional preoperative images or an intraoperative plan designed by a surgeon.
15. The system of claim 14 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
modify the intraoperative plan to optimize the pose of the at least one surgical tool based on images received from the imaging device.
16. A robotic system, comprising:
a first robotic arm configured to orient an imaging device;
a second robotic arm configured to orient at least one surgical tool;
at least one processor; and
at least one memory storing instructions for execution by the at least one processor that, when executed, cause the at least one processor to:
execute movements of the first robotic arm and the second robotic arm in a single coordinate system;
cause the first robotic arm to position the imaging device in a location to image a region to be operated on by the at least one surgical tool;
receive a plurality of images from the imaging device and identify in the plurality of images of the region, a first anatomical feature with which the at least one surgical tool should avoid contact;
annotate the plurality of images to label the first identified anatomical feature;
determine, based on the plurality of images, a position of the imaging device and a pose of the at least one surgical tool;
cause the second robotic arm to guide the at least one surgical tool away from the first anatomical feature based on the labelled first identified anatomical feature with which the at least one surgical tool should avoid contact;
calculate a volume of a second anatomical feature based on the plurality of images;
remove an amount of material from the second anatomical feature;
recalculate the volume of the second anatomical feature to determine the amount of material removed; and
generate a notification when the determined amount of material removed equals a known volume to be removed.
17. The system of claim 16 , wherein causing the first robotic arm to position the imaging device is based on a surgical plan.
18. The system of claim 16 , wherein at least two predetermined positions for the imaging device are provided, and wherein the imaging device is adapted to acquire three-dimensional images in real-time.
19. The system of claim 18 , wherein at least one position for the imaging device is one of: facing an intervertebral disc undergoing discectomy, within a vertebral foramen, or facing a lamina of a vertebra undergoing laminectomy or laminotomy.
20. The system of claim 16 , wherein the memory stores additional instructions for execution by the at least one processor that, when executed, further cause the at least one processor to:
cause the first robotic arm to move the imaging device in incremental steps such that sequential two-dimensional images are generated; and
reconstruct three-dimensional images from the sequential two-dimensional images.
21. A method for monitoring a surgical procedure, the method comprising:
co-registering a coordinate system of a first robotic arm and a second robotic arm;
determining a pose of an imaging device to provide real-time intraoperative imaging of a region of interest during the surgical procedure;
identifying in the real-time intraoperative images of the region of interest, a first anatomical element from which a surgical tool should maintain a predetermined distance;
annotating the real-time intraoperative images to label the first identified anatomical element;
identifying, in the real-time intraoperative images of the region of interest, a pose of the surgical tool;
causing the second robotic arm to prevent the surgical tool from approaching the first anatomical element based on the labelled first identified anatomical element by less than the predetermined distance using the co-registration of the coordinate system of the first and second robotic arms;
calculating a volume of a second anatomical element based on the intraoperative images;
removing an amount of material from the second anatomical element;
recalculating the volume of the second anatomical element to determine the amount of material removed; and
generating a notification when the determined amount of material removed equals a known volume to be removed.