A serial dilation system includes a plurality of serial dilators that can be advanced over each other so as to dilate anatomical soft tissue along a trajectory toward a target anatomical site. An access cannula can then be introduced over the serial dilators. The serial dilators can be coupled to each other, such that once the access cannula is in place, removal of one of the serial dilators from the access cannula causes all of the serial dilators to be removed from the access cannula.

Systems, methods, and devices are disclosed for surgical instruments, systems, and methods for detecting skiving of a surgical instrument, such as an instrument used during a robotic or robot-assisted surgery. The embodiments disclosed herein may include one or more sensors adjacent to, coupled to, disposed on, or embedded into an instrument in order to measure deflection thereof during use that may indicate skiving of the instrument. A variety of sensors may be utilized, including strain gauges, resistance-based sensors, fiber optic cables, laser distance measurement units, ultrasonic distance measurement units, optical cable measurement units, etc. In some embodiments, multiple such sensors may be included in an instrument in order to measure magnitude and/or direction of deflection.

The present invention is directed to material removal instrument for forming cavities in interior body regions, particularly cavities in intervertebral discs and vertebrae. The instrument includes a cannula and a rotation mechanism disposed at least partially within the cannula. A cutting element extends from the rotation mechanism and impacts and dislocates tissue as the rotation mechanism is rotated within the body. Dislocated tissue with withdrawn from the body via the cannula.

Described herein is an anti-skid surgical instrument for use in preparing holes in bone tissue. The disclosed surgical instrument provides the ability to prepare a precise hole in bone tissue during surgery (e.g., spinal surgeries and pedicle screw placement, intramedullary screw placement). The disclosed surgical instrument accomplishes precise hole placement regardless of whether the angle between the drill axis and surface of the bone tissue is perpendicular. The disclosed technology includes a flat drilling surface which is perpendicular to the surface of the body of the surgical instrument. This reduces the likelihood of the surgical instrument skidding on the surface of the bone tissue and thereby increases the precision of the hole.

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.

In one embodiment, an access instrument for creating a surgical working portal includes a body having a first end and a body length, a first slot having a first slot length running along the length of the body from the first end, and a second slot having a second slot length running along the length of the body from the first end, wherein the first slot length and the second slot length are less than the body length.

A method for performing an efficient and thorough percutaneous discectomy includes making into the patient a percutaneous incision, which is a small stab wound, no more than approximately 10 mm in length. A stimulated combination neuro-monitoring dilating probe is passed through an approximately 10 mm or less skin incision and into a patient's disc space to establish a safe path and trajectory through Kambin's Triangle. Once a neuro-monitoring dilating probe is in the disc space, a second dilator is placed over the neuro-monitoring dilating probe and impacted into the disc space. Neuro-monitoring dilating probe may then be removed. An access portal optionally combined with a force dissipation device may then be placed over the second dilator and into the disc space. The second dilator is removed and then discectomy instruments may be placed through the access portal to perform the discectomy.

A method includes tracking one or more of a plurality of vertebrae of a patient, planning a planned alignment of the plurality of vertebrae, creating an implant placement plan based on the planned alignment, and robotically preparing the plurality of vertebrae to receive an implant in accordance with the implant placement plan.

A surgical instrument includes a housing, an outer shaft, an inner shaft, a trial sizer, a rod, and a head. The outer shaft is operatively coupled with the housing such that rotation of the housing causes axial displacement of the outer shaft. The outer shaft includes a keel cutter configured to form a channel in a vertebral body. The inner shaft disposed within the outer shaft. The trial sizer is configured to be received in intervertebral space. The trial sizer includes a pair of wings transitionable between a retracted position and an extended position in which the pair of wings extends transversely outward. The head is connected to the rod, wherein the head is operatively coupled with the pair of wings such that axial displacement of the rod causes transition of the pair of wings between the retracted and extended positions.