WO2006069288A2

WO2006069288A2 - Overhead mount for a medical robot for use with medical scanning equipment

Info

Publication number: WO2006069288A2
Application number: PCT/US2005/046719
Authority: WO
Inventors: Gilbert J. Williams; Robert M. Taylor; Jaydeep Roy
Original assignee: Williams Gilbert J; Taylor Robert M; Jaydeep Roy
Priority date: 2004-12-20
Filing date: 2005-12-19
Publication date: 2006-06-29
Also published as: WO2006069288A3

Abstract

An apparatus to support a medical device is disclosed. The apparatus is secured to an overhead mounting. The apparatus may be configured for use with a movable table. The apparatus may include a brace which attaches to the movable table. The brace may be rigid, and maintains the position of a medical device relative to the movable table while the table is moving. Methods of using the apparatus and a robotic surgical system containing the apparatus is also disclosed.

Description

OVERHEAD MOUNT FOR A MEDICAL ROBOT FOR USE WITH MEDICAL SCANNING EQUIPMENT

BACKGROUND

[001] Surgical robots are actively controlled mechanical devices. Surgical robots may be used to conduct surgical procedures. Such surgical robots are typically equipped with one or more medical instruments, e.g. biopsy needles, blades, or lasers. Typically, surgical robots are remotely controlled by a surgeon, for example through a control interface. Surgical robots may be used to perform a procedure on a patient placed on a table. Known surgical robots with six degrees of freedom can be used to orient a device at any entry angle at any given point in space. See, e.g., Stoianovici, D., K. Cleary, A. Patriciu, et al., "TRACKER: A Robotic System for Radiological Interventions", IEEE Transactions on Robotics and Automation. Medical scanning equipment may include an imaging device and a movable table. A patient is placed on the movable table, in proximity to the imaging device. During use, the movable table moves back and forth allowing the imaging device to scan the patient at a range of different positions, so that a three-dimensional scan may be produced, e.g. using computerized tomography. Unfortunately, such movements during the scanning process prevent traditional surgical procedures because the patient is moving. However, it would be beneficial to conduct a surgical procedure on a patient while utilizing the scanning equipment, e.g., while the patient is moving relative to a scanner.

[002] Surgical robots typically need to be mounted on a stable platform. There is also a need to keep the active robotic motion in a fixed frame of reference relative to the patient, even if the table moves. This allows the robot to detect and correct for

SUBSTITUTE SHEET (RULE 26) i deviations in its actual path, in comparison to a commanded path stored on-board. Previously, a surgical robot has been mounted on a movable table for use with medical scanning equipment. Johns Hopkin's Tracker System, Computer Motion's Zeuss system, and Intuitive's Da Vinci systems all mount a surgical robot on a table. For example, a surgical robot may be mounted on a full bridge mount attached to a movable table as depicted in Figure 1, as was demonstrated in Johns Hopkin's Tracker System. Alternatively, a surgical robot may be mounted on a half bridge mount attached to a movable table as depicted in Figure 2. Various mounts are described in Taylor, R. and D. Stoianovici, "Medical Robotics in Computer-Integrated Surgery", IEEE Transactions on Robotics and Automation. [003] Unfortunately, mounting a surgical robot directly on an operating table or a scanner table has several disadvantages. The presence of the bridge in close proximity to the patient obstructs a doctor's access to the patient. The bridge must be removed prior to treating the patient in some instances, for example during patient emergencies such as patient codes. In such an emergency, the removal of the robot increases the elapsed time before proper medical care can be rendered. Finally, complex modifications must be made to the movable table to accommodate the table- mounted surgical robot. The entire static load of the robot must be born by the table, which may preclude the use of a standard table or require expensive modification. [004] In a previous surgical robot embodiment, a support is mounted onto a large cart, the cart being placed near the imaging device table. An example of such a system is Computer Motion's Aesop system. Such an embodiment allows for a surgical robot near the patient, but clutters up the floor space around the table. In addition, such an embodiment shares some of the disadvantages of table-mounted surgical robots discussed above.

SUBSTITUTE SHEET (RULE 26) [005] In non-robotic applications, overhead mounts have been used, e.g., the General Electric Proteus system, available from the GE medical systems division. These mounts allow devices, e.g., dental tools or radiographic equipment, to be rapidly deployed but stored out of the way when not in use without using floor space. These mounting systems may include ceiling mounted tracks and rails, arms with pivot points or other articulated devices, as well as other forms of moving mounts.

BRIEF DESCRIPTION OF THE DRAWINGS

[006] Figure 1 illustrates a perspective view of a first table-mounted robotic system.

[007] Figure 2 illustrates a perspective view of a second table-mounted robotic system.

[008] Figure 3 illustrates a first perspective view of a robotic surgical system, according to an example embodiment of the present invention.

[009] Figure 4 illustrates a second perspective view of the robotic surgical system illustrated in Figure 3, according to an example embodiment of the present invention.

[010] Figure 5 illustrates an example clamp device for attaching the brace to the table, according to an example embodiment of the present invention.

[011] Figure 6 illustrates a first perspective view of a first overhead support system for a medical device, according to an embodiment of the present invention.

[012] Figure 7 illustrates a second perspective view of the first overhead support system for a medical device illustrated in Figure 6, according to an example embodiment of the present invention.

[013] Figure 8 illustrates a profile view of a second overhead support system for a medical device, according to an example embodiment of the present invention.

SUBSTITUTE SHEET (RULE 26) [014] Figure 9 illustrates a profile view of a third overhead support system for a medical device, according to an example embodiment of the present invention. [015] Figure 10 illustrates a profile view of a fourth overhead support system for a medical device, according to an example embodiment of the present invention. [016] Figure 11 illustrates a perspective view of a fifth overhead support system for a medical device, according to an example embodiment of the present invention. [017] Figure 12 illustrates a profile view of a sixth overhead support system for a medical device, according to an example embodiment of the present invention. [018] Figure 13 illustrates a brace attached to a movable table, according to an example embodiment of the present invention.

[019] Figure 14 illustrates an example procedure for performing a medical procedure using a medical instrument, according to an example embodiment of the present invention.

[020] Figure 15 illustrates an example procedure for performing a surgical procedure, according to an example embodiment of the present invention. DETAILED DESCRIPTION OF EXAMPLE EMBODIMENTS [021] It will be appreciated that when the term "operably attached" is used, the attachment may be either direct or indirect. For example, a direct attachment may be achieved by utilizing bolts, clamps, screws, welding, rivets, etc. An indirect attachment may be achieved by utilizing an intervening rod, chain, arm, or other component. "Coupled" is used to denote a linkage between two components that is not necessarily achieved by a physical connection. Two components that are tied together by a control system so that they move in concert without an attachment may be coupled, without being operably attached. This coupling may be achieved by optical tracking, encoded positional data, or other types of control systems.

SUBSTITUTE SHEET (RULE 26) [022] In the discussion below, elements denoted with primes '"" may have similar structures to correspondingly numbered elements (without primes) in the embodiments discussed before them, except where differences are identified. [023] Given that existing surgical robots with six degrees of freedom can be oriented at any point in any direction, there is a need for an environment in which the working space of the robot is fixed relative to the table on which a patient is placed. There is a further need for an environment where the working space is maintained in a fixed position relative to the table, even when the table is moving. There is also a need to avoid table modifications, if possible, and to avoid placing large static loads on the surgical tables.

[024] Some example embodiments of the present invention allow an active robotic arm to be correctly positioned relative to the table and/or patient, while supporting the active load of the robotic arm from overhead rather than the table. Previous systems have supported medical devices from overhead, for example for medical X-ray systems, but these systems have not been used for surgical robots, or for devices that are otherwise maintained in a fixed position relative to a moving table. In embodiments discussed herein, the robotic arm may either be operably attached to the table, for example with a table brace as described in several of the embodiments described below, or may he coupled to the table with an active control system that maintains the relative position of the base of the robot and the patient or table. [025] Some example embodiments of the present invention include medical robotic systems for use with a movable table.

[026] Example medical robotic systems for use with a movable table according to the present invention may include an overhead mounting and a surgical robot

SUBSTITUTE SHEET (RULE 26) operably connected to the overhead mounting, the surgical robot coupled to the movable table so that the robot has a fixation point that is fixed relative to the table.

[027] In some example embodiments of the medical robotic system according to the present invention, the overhead mounting may include a rigid arm that can be locked in place in at least one dimension, while allowing movement in concert with the movable table in at least one other dimension, hi some example embodiments of the medical robotic system, the rigid arm may telescope in a vertical direction.

[028] In some example embodiments of the medical robotic system, the overhead mounting may alternatively include a non-rigid structure which suspends the surgical robot from the overhead mounting.

[029] In some example embodiments of the medical robotic system, the overhead mount may also include a data interface operable to provide a data link with the surgical robot. In some example embodiments of the medical robotic system, the overhead mount may also include power cabling operable to provide electrical power to the surgical robot.

[030] Some example embodiments of the medical robotic system according to the present invention may also include a brace configured to operably attach the surgical robot to a movable table. In some embodiments, the brace may be retractable. In some embodiments, the brace may be configured to maintain a vertical position of the fixation point of the surgical robot when the brace is attached to the table.

[031 ] In some example embodiments of the medical robotic system according to the present invention, the movable table may provide motive power to move the fixation point of the surgical robot when the brace is attached to the table.

[032] Some example embodiments of the medical robotic system according to the present invention may also include a controller in communication with the overhead

SUBSTITUTE SHEET (RULE 26) mount, the controller receiving data input and using the data input to maintain the fixation point of the robotic arm relative to the movable table. In some example embodiments, the data may include positional data output from the table. Some example embodiments of the medical robotic system may also include an optical device configured to measure the position of the table. In some example embodiments, data input may include output data from the optical device.

[033] Example embodiments of the present invention may also include a support for a surgical robot.

[034] Example embodiments of a support for a surgical robot according to the present invention may include an overhead mounting, a surgical robot receiver operably attached to the overhead mounting, the surgical robot receiver configured to receive a surgical robotic arm; and a brace operably attached to the medical equipment receiver, the brace configured to attach to a table.

[035] Some example embodiments of supports for a surgical robot may include a rigid arm operably connecting the overhead mounting and the surgical robot equipment receiver, the overhead mount and rigid arm configured to allow a proximal end of the arm to move in concert with the table when the brace is attached to the table.

[036] Alternative example embodiments of supports for a surgical robot may include a non-rigid structure operably connecting the mounting and the surgical equipment receiver, the non-rigid structure configured to allow the surgical robot receiver to move in concert with the table when the brace is attached to the table.

[037] Example embodiments of supports for a surgical robot may also include a pivot joint operably attaching the brace to at least one of the overhead mounting and the surgical robot receiver.

SUBSTITUTE SHEET (RULE 26) [038] Example embodiments of supports for a surgical robot may also include a locking attachment operably attached to the distal end of the brace, the locking attachment configured to operably attach the brace to the table.

[039] Example embodiments of supports for a surgical robot may also include a connector interface included in the surgical robot receiver, the connector interface providing communications and power to an instrument attached to the surgical robot receiver.

[040] In some example embodiments of supports for a surgical robot, the overhead mounting may be secured to a ceiling.

[041] In some example embodiments of supports for a surgical robot, the overhead mounting further includes a track and roller mechanism.

[042] In some example embodiments of supports for a surgical robot, the overhead mounting may include a rail operably attached to a wall.

[043] In some example embodiments of supports for a surgical robot, the overhead mounting may be operably attached to an imaging device. In some example embodiments, the imaging device may include a scanner gantry to which the overhead mounting is secured.

[044] In some example embodiments of supports for a surgical robot, the overhead mounting may be secured to a movable frame. In some example embodiments, the support may include a roller operably attached to the surgical robot receiver; and a track operably attached to the overhead mounting, the track retaining the roller in a vertical axis while allowing the roller to move freely in at least one other axis. In some example embodiments, the support may also include a brake operably attached to the roller, the brake configured to stop the roller from moving along the track.

SUBSTITUTE SHEET (RULE 26) [045] Some example embodiments of supports for a surgical robot may include a rigid arm operably connected to the overhead mounting; and a rigid member pivotally attached to the rigid arm, the surgical robot receiver operably connected to the rigid member, the surgical robot receiver freely moving along the length of the rigid member so that a surgical robot attached to the surgical robot receiver can move in concert with the table.

[046] Some example embodiments of supports for a surgical robot may also include, a second rigid member operably attached to the rigid arm; and a medical equipment receiver operably attached to the second rigid member, the medical equipment receiver configured to support a medical device. In some embodiments, the medical device may be a control interface for a robot. In some embodiments, the second rigid member moves independently of the first rigid member.

[047] Example embodiments of the present invention may also include a brace for a surgical robotic system.

[048] Example embodiments of a brace for a surgical system according to the present invention may include a rigid member; a first point on the rigid member including a first attachment configured to operably connect the rigid member to a surgical robot; and a second point on the rigid member including a second attachment, the second attachment configure to operably connect the rigid member to a movable table, in a manner which enables the surgical robot to move in concert with the movable table. In some example embodiments of the brace, the rigid member is concave toward the movable table.

[049] Some example embodiments of the brace for a surgical robotic system

SUBSTITUTE SHEET (RULE 26) [050] may include a first branch, the first branch operably connected to the first point; and a second branch, the second branch attached to the first branch and operably connected to the second point.

[051 ] In some embodiments of the brace for a surgical robotic system, the rigid member may be configured to transmit motive power from the movable table to a surgical robot when the rigid member is attached to the movable table.

[052] Some example embodiments of the brace for a surgical robotic system may also include a quick release mechanism in the second attachment.

[053] Example embodiments of the present invention may also include a method for using a surgical robot.

[054] Example methods for using a surgical robot according to the present invention may include placing a patient on a movable table; positioning the surgical robot in proximity to the patient, the surgical robot mounted on an overhead support; operably attaching the surgical robot to the movable table; and maintaining a fixation point of the surgical robot in a fixed position relative to the movable table.

[055] In some example methods for using a surgical robot according to the present invention, the overhead support may be mounted to the ceiling.

[056] Some example methods for using a surgical robot according to the present invention may also include providing motive power from the movable table to move the surgical robot in concert with the movable table.

[057] Example embodiments of the present invention may also include methods of performing a surgical procedure,

[058] Some example methods of performing a surgical procedure according to the present invention may include placing a patient on a movable table; positioning an overhead mount so a surgical robot operably attached to the overhead mount is

SUBSTITUTE SHEET (RULE 26) situated near the patient; positioning the surgical robot in a desired location relative to the patient; maintaining a fixation point of the surgical robot in a fixed position relative to the movable table; and performing a desired surgical procedure using the surgical robot.

[059] In some example methods of performing a surgical procedure according to the present invention the desired surgical procedure maybe performed without compensating for movements of the movable table.

[060] Some example methods of performing a surgical procedure according to the present invention may include operably attaching the surgical robot to the movable table with a brace.

[061 ] Some example methods of performing a surgical procedure according to the present invention may include providing motive power from the table via the brace to maintain the fixation point of the surgical robot in a fixed position relative to the movable table.

[062] Some example methods of performing a surgical procedure according to the present invention may include, after positioning the surgical robot, locking the overhead mount so that some of its degrees of freedom are fixed during the surgical procedure.

[063] Example embodiments of the present invention may include a support for a surgical robot.

[064] Example surgical robots according to the present invention may include a mounting attached to a ceiling; a track attached to the mounting; a roller secured to the track, the roller configured to move freely along the track; a vertical arm attached to the roller, the vertical arm able to extend and retract in length; a surgical robot receiver attached to the arm, the surgical robot receiver configured to receive and

SUBSTITUTE SHEET (RULE 26) support the surgical robot, the surgical robot receiver configured to move in an axis parallel to the track; a rigid brace operably attached to the surgical robot receiver, where the rigid brace is configured to attach to a movable table, the rigid brace is operably attached in a pivotal manner to at least on of the vertical arm and the surgical robot receiver, the rigid brace transmitting motive power from the movable table to the surgical robot receiver when the rigid brace is attached to the movable table; and a connector interface coupled to the surgical robot receiver, the connector interface providing communications and power to the surgical robot. [065] Example embodiments of the present invention may also include a surgical robotic system.

[066] Example surgical robotic systems according to the present invention may include an imaging device; a movable table positioned in proximity to the imaging device; an overhead mounting; a surgical robot operably attached to the overhead mounting; and a brace operably attached to the surgical robot, the brace configured to operably attach the surgical robot to the movable table and enable the robot to move in concert with the movable table.

[067] In some example surgical robotic systems according to the present invention, the robotic arm may further include a fixation point that is provides a fixed frame of reference relative to the movable table when the surgical robot is operably attached to the movable table by the brace.

[068] In some example surgical robotic systems according to the present invention, the overhead mounting telescopes to move the robotic arm vertically with respect the table, and wherein the overhead mounting includes a locking mechanism to lock the vertical movement with respect to the table during a surgical procedure.

SUBSTITUTE SHEET (RULE 26) [069] In some example surgical robotic systems according to the present invention, the movable the table provides motive power to move the surgical robot via the brace. [070] In some example surgical robotic systems according to the present invention, the overhead mount bears substantially all the static load of the surgical robot when the brace is operably attached to the movable table. The overhead mount may be spring balanced so that minimal force needs to be applied to position the surgical robot.

[071] Some example surgical robotic systems according to the present invention may also have a quick release mechanism included in the brace. [072] Figure 3 illustrates a first perspective view of a robotic surgical system, according to an example embodiment of the present invention. The robotic surgical system may include a medical scanning device 170. For example, the medical scanning device 170 may be a CAT scanner, an X-ray scanner, an MRJ scanner, or a PET scanner. It will be appreciated that other types of scanning devices may be used, for example, those utilizing radiation such as angiography or fluoroscopy, ultrasound, etc.

[073] The robotic surgical system may include a movable table 111. The movable table 111 may be a component of the medical scanning device 170. It will be appreciated other types of tables may be used, for example, a stand alone table. The movable table may be positioned in proximity to the medical scanning device 170. [074] The robotic surgical system may include a support system 100. The support system 100 maybe mounted overhead. The support system 100 maybe mounted in proximity to the medical scanning device 170 and the movable table 111. The illustrated example support system 100 is mounted from a ceiling. It will be appreciated that support system 100 may be mounted on surfaces other than the

SUBSTITUTE SHEET (RULE 26) ceiling, for example, the walls. It will be also appreciated that the support system 100 may be mounted on mobile structures, for example, a movable cart or a movable frame. A mobile structure may have a brake mechanism able to stop the mobile structure from moving. The support system 100 may also be mounted directly to the medical scanning device 170, as illustrated in another embodiment discussed below. [075] The support system 100 may be configured to support a medical device, such as a surgical robot 110 or other medical instrument. It will be appreciated that other medical devices, besides surgical robots, may also be supported by support system 100.

[076] hi the example embodiment, the surgical robot provides a minimum of 6 degrees of movement to allow positioning and orientation at any patient point. The support and connecting brace are configured to allow these movements to be maintained in a fixed frame of reference relative to the patent, even if the table has moved or is moving. It will be appreciated that many conventional methods of providing the 6 degrees of freedom may be employed, e.g., X,Y,Z Cartesian stage, a remote center of motion device, and needle driver. It will also be appreciated that more than or less than 6 degrees of freedom may be provided. [077] The robotic surgical system may include a brace 106. The brace 106 may be operably attached to the support system 100 by a movable joint. Although a pivot mount is illustrated connecting the brace 106 and the support system 100, it will be appreciated that the brace 106 may be operably attached to the support system 100 by other types of connections, including attachments that allow removal of the brace. Figure 3 illustrates the robotic surgical system with the brace 106 in a retracted position. The retracted position keeps the brace 106 clear of the patient, facilitating access to the patient.

SUBSTITUTE SHEET (RULE 26) [078] Figure 4 illustrates a second perspective view of the robotic surgical system illustrated in Figure 3, according to an example embodiment of the present invention. In Figure 4, the module table 111 has moved into the scanning device 170. The brace 106, shown in an extended position, is attached to the table 111, operably connecting the support 100 with the table 111. It will be appreciated that the brace may be attached at different points along the table edge, depending on the type of procedure being performed.

[079] Figure 5 illustrates an example attachment mechanism 150 for attaching the brace 106 to a table. The example attachment mechanism 150 does not require any table modifications, and may be attached at any position along the side of the movable table top. It will be appreciated that alternative attachment devices may be used, including separate clamps, screws, snaps, etc. A brace 106 may include an attachment mechanism 150. The attachment mechanism 150 may be located at a distal end of brace 106.

[080] The attachment mechanism 150 may include jaws 502. The jaws 502 may be configured to lock into a receiving unit, e.g., on a movable table. When locked, the jaws 502 may insure the brace 106 remains substantially motionless relative to an object to which it is attached, e.g., a movable table. The jaws are strong enough and stable enough to transmit motive powers from the table to the overhead mounted robot, enabling the robot to move in concert with the table. It will be appreciated that the jaws may be attached to directly to the top surface of the movable table. Advantageously, no modification to the top surface of the movable table, such as a receiver or cooperating mechanism is required. The brace may be attached using the jaws to almost any position along the side of the movable table. This facilitates the

SUBSTITUTE SHEET (RULE 26) placement of the surgical robot close to a desired part of the patient where a procedure is to be performed.

[081 ] The attachment mechanism 150 may also include a release mechanism 152. The release mechanism 152 may be configured to release the jaws 502 from a movable table. The release mechanism 152 may be prominently labeled. [082] Figure 6 illustrates a first perspective view of a first overhead support system for a medical device, according to an embodiment of the present invention. The first overhead support system 100 may include a mounting 102. The mounting 102 may be an overhead mounting operably attached to a ceiling. For example, a conventional active or passive overhead medical device mount like those used for overhead x-ray systems may be modified to accept a robotic arm. It will be appreciated that the mounting may also be attached to a scaffolding, a medical scanning device gantry, a rail, or a movable frame, or other overhead structure that is sufficiently strong and stable for the overhead mounting of a medical robot or other instrument. The mounting 102 may be attached in different ways, for e.g. with bolts, screws, clamps, etc.

[083] The example overhead support system allows the user to select a point in space which is fixed relative to the patient table but that moves relative to the stationary room. This selection of a point fixes the base. The example 6 degrees of freedom in the robotic arm then may move relative to the base and hence relative to the patient table. In this manner, the base of the robotic system may be originally positioned relative to the table in one of many possible positions, but once attached the base remains at that relative position irrespective of the movement of the table. This may be achieved either by actively moving the base in concert with the table, or by passively allow the table to provide motive power to move the base.

SUBSTITUTE SHEET (RULE 26) [084] The example system allows the user to adjust and fix with respect to subsequent table motion the relative position of the robot base longitudinally along the table axis and vertically (e.g., relative to the floor). Thus, the example system provides two degrees of freedom in selection of the fixation point or robot base. These degrees of freedom are separate from the degrees of freedom provided by the robotic arm which is attached to the movable base. It will be appreciated that different attachment or coupling methods may provide more or less degrees of freedom in selection of the fixation point. For example, it will be appreciated that freedom to move across the table, in addition to longitudinally, may be added to the example system. This addition would add a third degree of freedom, which would increase flexibility, but would also increase the complexity of the mounting system. It will be appreciated that additional degrees of freedom may be added while still providing for setting the fixation point from which the robotic system moves relative to a possibly moving table and patient.

[085] It will be appreciated that, once the base or fixation point is set, a mechanism may be provided to move the robotic arm with the table, preferably tracking the tables movement. It will be appreciated that the motive power for the tracking may either be provided by the robotic arm or base through active control, or passively by using the motive power of the table. It will be appreciated that the example system need not move with the table in each degree of freedom in which fixation is allowed. For example, the system may allow a user to adjust an orientation but not allow the modification of that orientation based on table movement.

[086] In the example system described here, a wheeled carriage on rails may be used to provide the degree of fixation and table tracking in the longitudinal direction of the table. Vertical flexibility maybe provided via telescoping tubes supported by cables

SUBSTITUTE SHEET (RULE 26) and pulleys. It may desirable to lock these two axes when the table is not moving to provide additional stability. It will be appreciated that goosenecks, articulated pivots, and other mechanisms may be used to provide the degrees of freedom of fixation and table tracking.

[087] The support system 100 may include an arm 104. The arm 104 may be operably attached to mounting 102. The arm 104 maybe configured to allow movement relative to the mounting 102, e.g., along a longitudinal axis of the mounting. The arm 104 may also be configured to allow it to be locked in place, e.g., when the robot is used not in conjunction with a moving table. The arm 104 may be attached to mounting 102 by, for example, using the example track and- roller system illustrated below. It will be appreciated that other attachments may also be used. It will be appreciated that the arm 104 may be configured to have a telescoping ability so that the distal end of arm 104 may be placed at a desired height above the patient. The telescoping ability may be accomplished by, for example, enclosing an arm member within a sleeve, such that the arm member may slide freely in and out of the sleeve. It will be appreciated that the telescoping mechanism may include a brake to stop the arm from telescoping or lock it in a fixed horizontal position relative to a table or a patient. It will also be appreciated that other mechanisms for providing vertical motion and locking may also be employed.

[088] The support system 100 may include a surgical robot receiver 110. The surgical robot receiver 110 may be attached to a distal end of arm 104. The surgical robot receiver 110 may be attached to arm 104 in different conventional ways. The surgical robot receiver 110 may be configured to receive a medical device, for example, a surgical robot or other medical instrument. The receiver 110 may serve as the fixation point from which controlled robotic movement will be referenced. The

SUBSTITUTE SHEET (RULE 26) surgical robot may be attached to the surgical robot receiver by, a custom designed bracket, locking rings, or other mechanisms such as screws or bolts. The surgical robot receiver 110 may also be configured to provide power and communications to the medical device, e.g., with cables passing through the arm 104 to an interface on the receiver 110.

[089] The support system 100 may include a brace 106. The brace 106 may be operably attached to the surgical robot receiver 110. For example, the brace 106' may be operably attached to the surgical robot receiver 110 by a pivotable joint 109; located at the proximal end of the brace. The pivotable joint may allow the brace 106 to be placed in a retracted or an extended position. A one axis pivot joint may be used, although it will be appreciated that, other attachment mechanisms may be employed, e.g. telescoping slides. The brace 106 may also include a locking mechanism 108 at brace's distal end. The locking mechanism 108 may be configured to stop the brace 106 from moving relative an object to which the locking mechanism 108 is attached, e.g., a table. It will be appreciated the locking mechanism may be a quick connect or snapping mechanism that allows rapid patient access, such as the device previously illustrated, although clamps or other devices 108 maybe employed. [090] Conventional track and roller mechanisms may be used to attach the support system to the ceiling, while allowing longitudinal motion along the access of the table. It will be appreciated that other mechanisms may also be employed, e.g. slides, lead screws, etc.

[091 ] Figure 7 illustrates a second perspective view of the first overhead support system for a medical device illustrated in Figure 6, according to an example embodiment of the present invention.

SUBSTITUTE SHEET (RULE 26) [092] It will be appreciated that Figure 7 illustrates the first overhead support system for a medical device illustrated in Figure 6, but with the brace 106 in an extended position and attached to the movable table 111. In this configuration, moving the table 111 parallel with the mounting 102, may cause the mounting 100, and with the surgical robot 110 to move in concert with the table 111. The entire motive power for this movement may be provided by the table 111.

[093] Figure 8 illustrates a profile view of a second overhead support system for a medical device, according to an example embodiment of the present invention. The second overhead support system includes a support system 200. The support system 200 may include a rail 273. A mounting 102' may be secured to the rail 273. The mounting 202 may be configured to move freely along the rail 273. The mounting 102' may also include a brake, the brake able to stop the support 200 from moving along the rail 273. The brake may be internal inside mounting 102' or external outside mounting 102'. The mounting 102% a torus, may be attached to a cylindrical rod, or may be attached with other mechanisms.

[094] Figure 9 illustrates a profile view of a third overhead support system for a medical device, according to an example embodiment of the present invention, similar to Figure 9, except the third overhead support system includes a support system 300. The support system 300 may include a medical scanning device 170'. A mounting 102' may be attached to the medical scanning device 170'. It will be appreciated that the scanning device entry maybe modified to receive the support system 300. The arm 304 projects out from the medical scanning device 170' over the movable table 111'. It will be appreciated the mounting 102' may be attached in other ways. In this embodiment, active control may be used to make the arm 304 in concert with the table 111 ' keeping the medical device fixed relative to the patient. For example, some

SUBSTITUTE SHEET (RULE 26) degrees of freedom may be used to maintain base reference point fixed relative to the table. The rest of the degrees of freedom may then be used to control the robotic arm. Active control may be provided by several possible approaches. For example, conventional moving scanner tables provided coded data output indicating there present position. This information could be used as input to a robotic control system to keep the robotic arm fixed relative to the table. Alternatively, an optical tracker or other measurement system may be used to track the position of the table, e.g., using a fiducial. This information may then be employed in the control system to keep the overhead mount synchronized with the table.

[095] Figure 10 illustrates a profile view of a fourth overhead support system for a medical device, according to an example embodiment of the present invention. The fourth overhead support system includes a support system 400. The support system 400 may include a movable frame 475. The movable frame 475 may be mounted on wheels 478a and 478b. The wheels 478a and 478b may be configured to freely rotate, allowing the frame to be moved. The movable frame 475 may be moved to a position proximate with a patient. The support 400 may be mounted on the movable frame 475. The wheels 478a and 478b may have brakes configured to stop the movable frame 475 from moving. The support system 400 may include a medical scanning device 170'. The movable frame 475 may enclose the medical scanning device 170' and movable table 111'. The support system may include a mount 102' that allows the support system to travel along a track on the movable frame, which operates like the ceiling mount described above.

[096] Figure 11 illustrates a perspective view of a fifth overhead support system for a medical device, according to an example embodiment of the present invention. A support system 500 for medical devices is depicted. The support system 500 may

SUBSTITUTE SHEET (RULE 26) include a mounting 102'. The mounting 102' may be attached to a ceiling. The mounting 102' may be attached to a ceiling by bolts, brackets, anchors, etc. Alternatively, the mounting 102' maybe attached to, for example, a scaffolding, a scanning device gantry, a rail, medical scanning device, or a movable frame. [097] The support system 500 may include an arm 504. The arm 504 may be attached to the mounting 102'. The arm 504 may be fixedly attached to the mounting. [098] The support system 500 may include a second arm 520. The second arm 520 may be attached to the arm 504. The second arm 520 may be configured to freely rotate about its point of attachment to arm 504, for example, using omni-directional joints. It will be appreciated that other types of attachments allowing movement may be used.

[099] The support system 500 may include a medical equipment receiver 522. The medical equipment receiver 522 may be operably attached to the second arm 520. The medical equipment receiver 522 may be attached to a control interface for a medical device. Alternatively, the medical equipment receiver 522 may be attached to, for example, a medical instrument.

[0100] The support system 500 may include a third arm 512. The third arm 512 may be attached to the arm 504. The third arm 512 may be configured to freely rotate about its point of attachment to arm 504, for example, using omni-directional joints. It will be appreciated that other types of attachments allowing movement may be used. [0101] The arm 512 may include a track 514. The track 514 maybe attached to the third arm 512. The track 514 maybe attached along a portion of the length of the third arm 512. A roller 518 may be secured to track 514. The roller 518 may be secured by, for example, a groove in the track 514. The roller 518 maybe configured

SUBSTITUTE SHEET (RULE 26) to move freely along the track 514. The roller 518 may include a brake, the brake able to stop the roller 518 from moving along the track 514. [0102] The support system 500 may include a joint 519. The joint 519 may be attached to the roller 518. The joint 519 may be, for example, an omni-directional joint. It will be appreciated that other types of attachments allowing movement may be used.

[0103] The support system 500 may include a fourth arm 516. The fourth arm 516 may be attached to the joint 519. The joint 519 may allow the fourth arm 516 to rotate freely.

[0104] The support system 500 may include a surgical robot receiver 110'. The surgical robot receiver 110' may be operably attached to the fourth arm 516. The surgical robot receiver 110' may be attached to the fourth arm 516 through a joint, e.g., with a pin, bolt, or clamp. The surgical robot receiver 110' may be configured to support a surgical robot. The surgical robot receiver 110' may also be configured to supply the surgical robot with power and communications. For example, the surgical robot receiver 110' may have a standard attachment interface capable of receiving and securing a surgical robot with a reciprocal attachment interface. For example, power and communications may be supplied through cables secured to the arm 504. Alternatively, communications may be supplied to the surgical robot wirelessly the surgical robot may self-powered.

[0105] The support system 500 may include a brace 106'. Abrace 106' maybe operably attached to the surgical robot receiver 110'. A first end 109' of the brace 106 may be operably attached to the surgical robot receiver 110'. A second end 108' of the brace 106' may be configured to attach to a moveable table. For example, the attachment mechanism discussed above and depicted in Figure 5 may attach the

SUBSTITUTE SHEET (RULE 26) second end 108' to a movable table. The brace 106' may be configured to be placed in either a retracted or extended position. When extended, the first end 109' may lock to prevent the brace 106' from substantially moving relative to the surgical robot receiver 110'. The second end 108' may then be attached to a movable table. As the brace 106' may be rigid, it may maintain the surgical robot receiver 110' substantially motionless relative to the movable table 111' when the movable table 111 ' is moving. [0106] Figure 12 illustrates a profile view of a sixth overhead support system for a medical device, according to an example embodiment of the present invention. [0107] The sixth overhead support system includes a support system 600. The support system 600 may include a mounting 602. The mounting 602 may be attached to, for example, a ceiling, a scaffolding, a scanning device gantry, a rail, medical scanning device, or a movable frame. The mounting 602 may be attached with, for example, screws, bolts, etc.

[0108] The support system 600 may include a surgical robot receiver 110'. The surgical robot receiver 110' may be attached to a distal end of the support system 600. The surgical robot receiver 110' may be configured to receive a medical device, for example, a surgical robot or a medical instrument. The medical device may be attached to the surgical robot receiver by, for example, screws, bolts, clamps, etc. The surgical robot receiver 110' may be configured to provide power and communications to the medical device.

[0109] The support system 600 may include a brace 106'. The brace 106' may be operably attached to the surgical robot receiver 110'. For example, the brace 106' may be operably attached to the surgical robot receiver 110' by a first end 109'. The brace 106' may be attached to the receiver by a joint, allowing the brace 106' to be placed in a retracted or an extended position. It will be appreciated that, for example,

SUBSTITUTE SHEET (RULE 26) a one-axis pivot joint may be used. The brace 106' may include a locking mechanism proximate to the first end 109' which maybe configured to stop the brace 106' from moving relative to an object to which it is attached. As in the first embodiment, the brace allows the medical device to move in concert with the table, the motive power being supplied by the table.

[0110] When not braced to the table the mount device and medical may be retracted.

The support system 600 may include springs 660a and 660b. The springs 660a and

660b may operably connect the mounting 602 to the surgical robot receiver 110'.

[0111] The support system 600 may also include cables 663 a and 663b. The cables

663 a and 663b may provide power and communications to a medical device.

Alternatively, communications may be provided wirelessly. Alternatively, the medical device may be self-powered.

[0112] It will be appreciated that the cables 660a and 660b may be able to extend and retract in length. Alternatively, the cables 660a and 660b may be spring mounted inside the mounting 602 so they extend and retract as the surgical robot receiver 110' moves back and forth when attached to the movable table 111'.

[0113] Figure 13 illustrates a brace attached to a movable table, according to an example embodiment of the present invention. A brace 106 may connect a surgical robot receiver 110 to a movable table 111. The brace 106 may be concave away from a patient lying on the movable table 111.

[0114] The brace 106 may include a first end 109. The first end 109 may be operably attached to the surgical robot receiver 110. The first end 109 may be attached by, for example, a joint.

[0115] The brace 106 may include a second end 108. The second end 108 may include an attachment mechanism 150. The attachment mechanism 150 is configured

SUBSTITUTE SHEET (RULE 26) to attach to a movable table 111. The attachment mechanism 150 may include a release mechanism 152 which will release the attachment mechanism 150 from the movable table 111.

[0116] Power and control signals may be provided to the surgical robot via the support system. Alternatively, separate cabling may be provided. [0117] The following example illustrates an example use of the embodiment depicted in Figure 6 and Figure 7. A patient may first be placed on the movable table 111. The arm 104 may then be positioned. The brace 106 may then be extended. The distal end of brace 106 may be attached to the movable table 111 using attachment mechanism 108. This locking of the first end 109 may prevent further movement of the brace 106 relative to the surgical robot receiver 110. The surgical robot receiver 110 may then be positioned at a desired location relative to the patient lying on the movable table 111. It will be appreciated that in an alternative system relying on electronic rather than physical coupling between the robotic reference point and the table, a signal or other indication that the base of the robot has been properly positioned may need to be entered by a user into the system.

[0118] The movable table 111 may begin to translate back and forth. An imaging device may be activated. A medical instrument attached to the surgical robot receiver 110 may then be utilized while the movable table 111 is translating and the imaging device is scanning the patient. The medical instrument will remain in substantially the same position relative to the patient as the movable table 111 translates. If the instrument is a robotic surgical device, it may provide additional degrees of freedom to move a needle or other instrument. However, the base of the robot may remain motionless relative to the moving patient.

SUBSTITUTE SHEET (RULE 26) [0119] Figure 14 illustrates an example procedure for performing a medical procedure using a medical instrument, according to an example embodiment of the present invention. The medical instrument may be a surgical robot, or some other type of medical instrument, e.g., a measurement device. In 810 a patient may be placed on a movable table. In 812, the overhead mount may be positioned above the patient. In 814 the overhead mount may be operably attached to the movable table, e.g., using a brace such as the one described previously. In 816, a surgical robot that is operably attached to the overhead mount may be placed close to the patient, e.g., in contact or close proximity with a measurement point or surgical entry point. The table may then be allowed to move, e.g., to allow a three-dimensional imaging procedure to be performed by a medical scanner. In 818, while the table is moving, the base of the robotic arm is maintained in a fixed positioned relative to the movable table. The base of the robotic arm is moved using the motive power of the table, which may be conveyed to the robotic arm through the overhead mount (and possibly through a brace, such as the one described previously.) It will be appreciated that, while the base of the robotic arm remains relatively motionless with respect to the table, the robotic arm may in fact move its operative components, e.g., the working end of a robotic arm in order that the procedure may be performed on the patient. In 820, the instrument may be used to perform a procedure on the patient, such as taking a measurement or conducting a surgery

[0120] Figure 15 illustrates an example procedure for performing a surgical procedure, according to an example embodiment of the present invention. In 910, a patient may be placed on a movable table. In 912 an overhead mount may be placed above the patient. The placement of the overhead mount over the patient may bring a surgical robot operably attached to the overhead mount into the general proximity of

SUBSTITUTE SHEET (RULE 26) the patient, and in particular a part of the patient on which a surgical procedure is to be performed using the surgical robot. In 914, a brace operably attached to the surgical robot may be locked on to the movable table. In 916 the operative end of the surgical robot may be placed in close proximity to the patient, e.g., a needle attached to the surgical robot may be brought close to the desired entry point. If the table is a movable table, the brace operably attaching the surgical robot to the table may keep the robot's base motionless relative to the table as the table moves. In 918 a surgical procedure may be performed using the surgical robot. This method allows a surgical procedure to be performed as the table is moving.

[0121] In the preceding specification, the present invention has been described with reference to specific example embodiments thereof. It will, however, be evident that various modifications and changes may be made thereunto without departing from the broader spirit and scope of the present invention as set forth in the claims that follow. The specification and drawings are accordingly to be regarded in an illustrative rather than restrictive sense.

SUBSTITUTE SHEET (RULE 26)

Claims

What is Claimed is:

1. A medical robotic system for use with a movable table, comprising: an overhead mounting; and a surgical robot operably connected to the overhead mounting, the surgical robot coupled to the movable table so that the surgical robot has a fixation point that is fixed relative to the table.

2. The medical robotic system of claim 1 , wherein the overhead mounting further comprises a rigid arm that can be locked in place in at least one dimension, while allowing movement in concert with the movable table in at least one other dimension.

3. The medical robotic system of claim 2, wherein the rigid arm telescopes in a vertical direction.

4. The medical robotic system of claim 1, wherein the overhead mounting further comprises a non-rigid structure which suspends the surgical robot from the overhead mounting.

5. The medical robotic system of claim 1, wherein the overhead mount further comprises a data interface operable to provide a data link with the surgical robot.

6. The medical robotic system of claim 1, wherein

SUBSTITUTE SHEET (RULE 26) the overhead mount further comprises power cabling operable to provide electrical power to the surgical robot.

7. The medical robotic system of claim 1 , further comprising: a brace configured to operably attach the surgical robot to the movable table.

8. The medical robotic system of claim 7, wherein the brace is retractable.

9. The medical robotic system of claim 8, wherein the brace is configured to maintain a vertical position of the fixation point of the surgical robot when the brace is attached to the movable table.

10. The medical robotic system of claim 9, wherein the movable table provides a motive power to move the fixation point of the surgical robot when the brace is attached to the movable table.

11. The medical robotic system of claim 1 , further comprising: a controller in communication with the overhead mount, the controller receiving data input and using said data input to maintain the fixation point of the surgical robot relative to the movable table.

12. The medical robotic system of claim 11 , wherein the data input includes positional data output from the movable table.

SUBSTITUTE SΗEET (RULE 26)

13. The medical robotic system of claim 11 , farther comprising: an independent device configured to determine the position of the movable table, and wherein the data input includes output data from the independent device.

14. The medical robotic system of claim 13, wherein the independent device optically detects the position of the movable table.

15. The medical robotic system of claim 13, wherein the independent device physically detects the position of the movable table.

16. A support for a surgical robot, comprising: an overhead mounting; a surgical robot receiver operably attached to the overhead mounting, the surgical robot receiver configured to receive a surgical robotic arm; and a brace operably attached to the surgical robot receiver, the brace configured to attach to a table.

17. The support for a surgical robot of claim 16, further comprising: a rigid arm operably connecting the overhead mounting and the surgical robot receiver, the overhead mount and rigid arm configured to allow a proximal end of the arm to move in concert with the table when the brace is attached to the table.

18. The support for a surgical robot of claim 16, further comprising:

SUBSTITUTE SHEET (RULE 26) a non-rigid structure operably connecting the overhead mounting and the surgical robot receiver, the non-rigid structure configured to allow the surgical robot receiver to move in concert with the table when the brace is attached to the table.

19. The support for a surgical robot of claim 16, further comprising: a pivot joint operably attaching the brace to at least one of the overhead mounting and the surgical robot receiver.

20. The support for a surgical robot of claim 16, further comprising: a locking attachment operably attached to a distal end of the brace, the locking attachment configured to operably attach the brace to the table.

21. The support for a surgical robot of claim 16, further comprising: a connector interface included in the surgical robot receiver, the connector interface providing communications and power to an instrument attached to the surgical robot receiver.

22. The support for a surgical robot of claim 16, wherein, the overhead mounting is secured to a ceiling.

23. The support for a surgical robot of claim 22, wherein the overhead mounting further includes a track and roller mechanism.

24. The support for a surgical robot of claim 16, wherein the overhead mounting further includes a rail operably attached to a wall.

SUBSTITUTE SHEET (RULE 26)

25. The support for a surgical robot of claim 16, wherein the overhead mounting is operably attached to an imaging device.

26. The support for a surgical robot of claim 25, wherein the imaging device includes a scanner gantry to which the overhead mounting is secured.

27. The support for a surgical robot of claim 16, wherein the overhead mounting is secured to a movable frame.

28. The support for a surgical robot of claim 16, further comprising: a roller operably attached to the surgical robot receiver; and a track operably attached to the overhead mounting, the track retaining the roller in a vertical axis while allowing the roller to move freely in at least one other axis.

29. The support for a surgical robot of claim 28, further comprising: a brake operably attached to the roller, the brake configured to stop the roller from moving along the track.

SUBSTITUTE SHEET (RULE 26)

30. The support for a surgical robot of claim 16, further comprising: a rigid arm operably connected to the overhead mounting; and a rigid member pivotally attached to the rigid arm, the surgical robot receiver operably connected to the rigid member, the surgical robot receiver freely moving along the length of the rigid member so that a surgical robot attached to the surgical robot receiver can move in concert with the table.

31. The support for a surgical robot of claim 30, further comprising: a second rigid member operably attached to the rigid arm; and a medical equipment receiver operably attached to the second rigid member, the medical equipment receiver configured to support a medical device.

32. The support for a surgical robot of claim 31 , wherein the medical device is a control interface for a robot.

33. The support for a surgical robot of claim 31 , wherein the second rigid member moves independently of the first rigid member.

34. A brace for a surgical robotic system comprising: a rigid member; a first point on the rigid member including a first attachment configured to operably connect the rigid member to a surgical robot; and

SUBSTITUTE SHEET (RULE 26) a second point on the rigid member including a second attachment, the second attachment configure to operably connect the rigid member to a movable table, in a manner which enables the surgical robot to move in concert with the movable table.

35. The brace for a surgical robotic system of claim 34, wherein the rigid member is concave toward the movable table.

36. The brace for a surgical robotic system of claim 34, wherein the rigid member is convex toward the movable table.

37. The brace for a surgical robotic system of claim 34, wherein the rigid member is substantially straight between the first point and the second point.

38. The brace for a surgical robotic system of claim 34, further comprising: a first branch, the first branch operably connected to the first point; and a second branch, the second branch attached to the first branch and operably connected to the second point.

39. A brace for a surgical robotic system of claim 34, wherein the rigid member is configured to transmit motive power from the movable table to the surgical robot when the rigid member is attached to the movable table.

40. A brace for a surgical robotic system of claim 34, further comprising: a quick release mechanism included in the second attachment.

SUBSTITUTE SHEET (RULE 26)

41. A method for using a surgical robot, comprising: placing a patient on a movable table; positioning a surgical robot in proximity to the patient, the surgical robot mounted on an overhead support; operably attaching the surgical robot to the movable table; and maintaining a fixation point of the surgical robot in a fixed position relative to the movable table.

42. The method for positioning a surgical robot of claim 41 , wherein the overhead support is mounted to a ceiling.

43. The method for positioning a surgical robot of claim 41 , further comprising: providing motive power from the movable table to move the surgical robot in concert with the movable table.

44. A method of performing a surgical procedure, comprising: placing a patient on a movable table; positioning an overhead mount so a surgical robot operably attached to the overhead mount is situated near the patient; positioning the surgical robot in a desired location relative to the patient; maintaining a fixation point of the surgical robot in a fixed position relative to the movable table; and performing a desired surgical procedure using the surgical robot.

SUBSTITUTE SHEET (RULE 26)

45. The method of performing a surgical procedure of claim 44, wherein . the desired surgical procedure may be performed without compensating for movements of the movable table.

46. The method of performing a surgical procedure of claim 44, further comprising: operably attaching the surgical robot to the movable table with a brace.

47. The method of performing a surgical procedure of claim 46, further comprising: providing motive power from the table via the brace to maintain the fixation point of the surgical robot in a fixed position relative to the movable table.

48. The method of performing a surgical procedure of claim 44, further comprising: after positioning the surgical robot, locking the overhead mount so that some of its degrees of freedom are fixed during the surgical procedure.

49. A support for a surgical robot, comprising: a mounting attached to a ceiling; a track attached to the mounting; a roller secured to the track, the roller configured to move freely along the track; a vertical arm attached to the roller, the vertical arm able to extend and retract in length;

SUBSTITUTE SHEET (RULE 26) a surgical robot receiver attached to the vertical arm, the surgical robot receiver configured to receive and support the surgical robot, the surgical robot receiver configured to move along an axis parallel to the track; a rigid brace operably attached to the surgical robot receiver, where the rigid brace is configured to attach to a movable table, the rigid brace is operably attached in a pivotal manner to at least one of the vertical arm and the surgical robot receiver, the rigid brace transmitting motive power from the movable table to the surgical robot receiver when the rigid brace is attached to the movable table; and a connector interface coupled to the surgical robot receiver, the connector interface providing communications and power to the surgical robot.

50. A surgical robot system, comprising: an imaging device; a movable table positioned in proximity to the imaging device; an overhead mounting; a surgical robot operably attached to the overhead mounting; and a brace operably attached to the surgical robot, the brace configured to operably attach the surgical robot to the movable table and enable the surgical robot to move in concert with the movable table.

51. The system of claim 50, wherein the surgical robot has a fixation point that provides a fixed frame of reference relative to the movable table when the surgical robot is operably attached to the movable table by the brace.

SUBSTITUTE SHEET (RULE 26)

52. The system of claim 50, wherein the overhead mounting telescopes to move the robotic arm vertically with respect the movable table, and wherein the overhead mounting includes a locking mechanism to lock the vertical movement with respect to the table during a surgical procedure.

53. The surgical robot system of claim 50, wherein the movable table provides motive power to move the surgical robot via the brace.

54. The surgical robot system of claim 50, wherein the overhead mount bears substantially all the static load of the surgical robot when the brace is operably attached to the movable table.

55. The surgical robot system of claim 50, wherein the overhead mount is balanced so that the operator can place the system with minimal force.

56. The surgical robot system of claim 55, wherein the overhead mount is spring balanced.

57 . The surgical robot system of claim 50, further comprising: a quick release mechanism included in the brace.

SUBSTITUTE SHEET (RULE 26)