Methods and apparatus for planning and/or carrying out a total knee replacement surgical procedure on a knee of a leg of a patient are described. Anatomical data for the leg of the patient is obtained, which allows the femoral mechanical axis, the tibial mechanical axis and the joint line of the knee to be determined. A planned proximal tibial cut angle and a planned distal femoral cut angle are determined. A total knee replacement procedure is carried out on the knee of the patient, wherein a distal femoral cut is made using the planned distal femoral cut angle and a proximal tibial cut is made using the planned proximal tibial cut angle.

Methods and system for characterizing ligament properties using elastography are disclosed. An ultrasound system capable of performing shear wave elasticity imaging and/or supersonic shear imaging may retrieve one or more images from a proposed surgical site. The one or more images may be provided to a surgical planning system that identifies one or more properties of ligaments proximate to the surgical site. Musculoskeletal simulations may be performed using the identified properties to preoperatively identify a surgical plan. Preoperative identification of a surgical plan may enable a surgeon to select from more fine-tuning options for a joint replacement than conventional systems.

A surgical device controllable by a surgical robotic system is provided. The surgical device includes a housing capable of being coupled to the surgical robotic system; a drive system at least partially mounted in the housing; and a shaft rotatably coupled to the drive system at a first end of the shaft. The surgical device further includes a tissue-removal assembly coupled to the second end of the shaft. The tissue-removal assembly includes a first cutting member having a plurality of rotatable blades. The first cutting member is coupled to a second end of the shaft. The tissue-removal assembly further includes a second cutting member, one or more support elements slidably or fixedly coupled to the second cutting member, and one or more extendable elements slidably or fixedly coupled to the second cutting member.

A drill guide fixture may be configured to prepare a skull for attachment of a cranial insertion fixture. The drill guide fixture may include a central drill guide and a bone anchor guide at a base of the drill guide fixture. The central drill guide may define a central drill guide hole therethrough, wherein the central drill guide hole has a first opening at a base of the drill guide fixture and a second opening spaced apart from the base of the drill guide fixture. The bone anchor drill guide may define a bone anchor drill guide hole therethrough, and the bone anchor drill guide hole may be offset from the central drill guide hole in a direction that is perpendicular with respect to a direction of the central drill guide hole. Related cranial insertion fixtures, robotic systems, and methods are also discussed.

A surgical instrument connectable to a surgical energy module that is configured to provide a first drive signal at a first frequency range for driving a first energy modality and a second drive signal at a second frequency range for driving a second energy modality is provided. The surgical instrument can comprise a surgical instrument component configured to receive power from a direct current (DC) power source, an end effector, and a circuit. The circuit can be configured to convert the first electrical signal to a DC voltage, apply the DC voltage to the surgical instrument component, and deliver the second energy modality to the end effector according to the second drive signal. Alternatively, the circuit can be disposed within a cable assembly configured to connect the surgical instrument to the surgical energy module.

( robotic surgical system with user engagement monitoring includes a surgeon console having a hand detection system and a tracking device including an image capture device configured to capture an image of a user position reference point, wherein information from the hand detection system and the tracking device are combined to control operation of the robotic surgical system.

A method performed by a computing system comprises receiving a fluoroscopic image of a patient anatomy while a portion of a medical instrument is positioned within the patient anatomy. The fluoroscopic image has a fluoroscopic frame of reference. The portion has a sensed position in an anatomic model frame of reference. The method further comprises identifying the portion in the fluoroscopic image and identifying an extracted position of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image. The method further comprises registering the fluoroscopic frame of reference to the anatomic model frame of reference based on the sensed position of the portion and the extracted position of the portion.

A medical manipulator system includes: an endoscope; a first manipulator equipped with a first treatment tool at a distal end thereof; a second manipulator equipped with a second treatment tool at a distal end thereof; a display for a user to view; and a controller configured to generate an image to be displayed on the display. The controller is configured to: acquire a first image taken by the endoscope, the first image contains the first treatment tool; and in response to determining that the second treatment tool does not exist in the first image: calculate a relative distance and a relative direction between the first treatment tool and the second treatment tool; generate a second image showing the relative distance and the relative direction between the first treatment tool and the second treatment tool; and send the first image and the second image to the display.

Orthopedic implants, systems, instruments, and methods. A bi-portal lumbar interbody fusion system may include an expandable interbody implant and minimally invasive pedicle-based intradiscal fixation implants. The interbody and intradiscal implants may be installed with intelligent instrumentation capable of repeatably providing precision placement of the implants. The bi-portal system may be robotically-enabled to guide the instruments and implants along desired access trajectories to the surgical area.

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.