Described herein are systems, apparatus, and methods for precise placement and guidance of tools during surgery, particularly spinal surgery, using minimally invasive surgical techniques. Several minimally invasive approaches to spinal surgeries were conceived, percutaneous technique being one of them. This procedures looks to establish a skin opening as small as possible by accessing inner organs via needle-puncture of the skin. The percutaneous technique is used in conjunction with a robotic surgical system to further enhance advantages of manual percutaneous techniques by improving precision, usability and/or shortening surgery time by removal of redundant steps.

A device for guiding a medical instrument (2) inserted into a natural duct (101) or an artificial duct of a patient in order to bring at least a distal end (1) of the instrument in proximity to an internal organ (100). The device includes an articulated arm (3) with a plurality of degrees of freedom, for moving a proximal end (4) of the instrument, and a controlled blocking mechanism (7) for blocking the degrees of freedom of the articulated arm. The blocking mechanism is designed in such a way that, for at least one of the degrees of freedom, a blockage imposed on the degree of freedom can be released when an outer stress exerted on the instrument (2) exceeds a predetermined threshold.

The present invention relates to a method, such as a surgical method for assisting a surgeon for placing screws in the spine using a robot attached to a passive structure. The present invention also related to a method, such as a surgical method for assisting a surgeon for removing volumes in the body of a patient using a robot attached to a passive structure and to a device to carry out said methods. The present invention further concerns a device suitable to carry out the methods according to the present invention.

Apparatus and methods are described including designating within an image of blood vessels of a subject, a target portion of the blood vessels. In response to a first input from a user that designates a single point on the image, a first location within the blood vessels in a vicinity of the designated point is designated. In response to second and third inputs from the user, proximal and distal locations within the target portion are designated. The target portion is designated such that the target portion passes from the proximal location of the target portion to the distal location of the target portion, and such that the target portion includes the first location. Quantitative vessel analysis is performed on the target portion of the blood vessels, and an output is generated based upon the quantitative vessel analysis. Other applications are also described.

A pre-shift set of fiducials each including a pre-shift fiducial impedance location and a pre-shift fiducial magnetic location can be determined. The pre-shift fiducial impedance locations and the pre-shift fiducial magnetic location are associated with a medical device. A post-shift set of fiducials each including a post-shift fiducial impedance location and a post-shift fiducial magnetic location can be determined. The post-shift fiducial impedance locations and the post-shift fiducial magnetic locations are associated with the medical device. A pre-shift transformation can be fit to the pre-shift set of fiducials and a post-shift transformation can be fit to the post-shift set of fiducials. A determination can be made whether the pre-shift transformation differs from the post-shift transformation. An indication that an impedance shift has occurred between the pre-shift set of fiducials and the post-shift set of fiducials can be generated based on the difference between the pre-shift transformation and the post-shift transformation.

The present invention relates to a method, such as a surgical method for assisting a surgeon for placing screws in the spine using a robot attached to a passive structure. The present invention also related to a method, such as a surgical method for assisting a surgeon for removing volumes in the body of a patient using a robot attached to a passive structure and to a device to carry out said methods. The present invention further concerns a device suitable to carry out the methods according to the present invention.

A system with coupled control modes includes a first manipulator, a second manipulator, an input device for commanding movement of the first manipulator or the second manipulator, and one or more controllers. The one or more controllers are configured to detect movement of the input device; when movement of the first manipulator is responsive to movement of the input device: determine a commanded movement for the first manipulator from the detected movement of the input device and command the second manipulator to move in response, at least in part, to the commanded movement of the first manipulator; and when movement of the second manipulator is responsive to the movement of the input device: determine a commanded movement for the second manipulator from the detected movement of the input device and command the first manipulator to move in response, at least in part, to the commanded movement of the second manipulator.

In certain embodiments, the systems, apparatus, and methods disclosed herein relate to robotic surgical systems with built-in navigation capability for patient position tracking and surgical instrument guidance during a surgical procedure, without the need for a separate navigation system. Robotic based navigation of surgical instruments during surgical procedures allows for easy registration and operative volume identification and tracking. The systems, apparatus, and methods herein allow re-registration, model updates, and operative volumes to be performed intra-operatively with minimal disruption to the surgical workflow. In certain embodiments, navigational assistance can be provided to a surgeon by displaying a surgical instrument's position relative to a patient's anatomy. Additionally, by revising pre-operatively defined data such as operative volumes, patient-robot orientation relationships, and anatomical models of the patient, a higher degree of precision and lower risk of complications and serious medical error can be achieved.

In one embodiment, a method of repairing a heart valve accesses an interior of a patient's beating heart minimally invasively and inserts one or more sutures into each of a plurality of heart valve leaflets with a suturing instrument. The suture ends of the sutures are divided into suture pairs, with each pair including one suture end from a suture inserted into a first valve leaflet and one suture end from a suture inserted into a second valve leaflet. One or more tourniquet tubes is advanced over the suture pairs to the leaflets to draw the sutures together to coapt the leaflets and then the sutures are secured in that position.

Aspects of the present disclosure relate to systems for performing a surgical procedure using a power tool or power instrument with systems, devices and/or control units for adjusting, regulating, interrupting, and/or restoring electric current to the power tool or instrument during operation, for example, when the power tool or instrument is at a predetermined distance to a boundary of a safe zone or a target volume of operation.