CN107072673A - 用于在骨组织中制备孔的防滑手术器械 - Google Patents

用于在骨组织中制备孔的防滑手术器械 Download PDF

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CN107072673A
CN107072673A CN201580043738.9A CN201580043738A CN107072673A CN 107072673 A CN107072673 A CN 107072673A CN 201580043738 A CN201580043738 A CN 201580043738A CN 107072673 A CN107072673 A CN 107072673A
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S·科斯切夫斯基
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/162—Chucks or tool parts which are to be held in a chuck
    • A—HUMAN NECESSITIES
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
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    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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Abstract

本文描述一种用于在骨组织中制备孔的防滑手术器械。所揭示的手术器械提供在手术(例如，脊柱手术及椎弓根螺钉放置、髓内螺钉放置)期间在骨组织中制备精确孔的能力。无论钻轴与所述骨组织的表面之间的角度是否垂直，所揭示的手术器械均实现精确孔放置。所揭示的技术包含平坦的钻孔表面，其垂直于所述手术器械的主体的表面。这减小所述手术器械在所述骨组织的所述表面上打滑的可能性且由此增加所述孔的精确性。

Description

用于在骨组织中制备孔的防滑手术器械
优先权申请案
本申请案主张2014年7月14日申请的标题为“用于在骨组织中制备孔的防滑手术器械(Anti-Skid Surgical Instrument for use in Preparing Holes in BoneTissue)”的第62/024,402号美国临时专利申请案的优先权及权益，所述美国临时专利申请案以全文引用的方式并入本文中。
技术领域
本发明涉及用于在手术期间在骨组织中制备孔的防滑手术器械。
背景技术
脊柱手术通常需要在骨组织中进行精确钻孔及放置螺钉或其它器具。归因于脊髓及动脉的接近性，在脊柱手术期间灾难性损坏或死亡可起因于对身体的不当钻孔或操纵。此外，准确的放置对成功的结果来说通常是必要的。举例来说，脊柱融合通常通过使用固定装置(例如，金属螺钉、杆及板)使脊椎稳定以促进骨融合来增强。在脊柱融合以及其它手术中，螺钉放置于骨中的准确性对过程的结果具有直接影响。试图治愈的两个骨之间存在的运动越小，骨将成功融合的变化越高。固定装置的使用极大地增加了脊柱融合过程的成功率。
此类过程主要依赖于外科医生的专业技能，且在不同的外科医生之间成功率存在显著变化。已开发出若干导航及验证方法。然而，螺钉的错误放置在此类手术过程中仍是常见的问题。螺钉可归因于在***螺钉之前钻出的不准确的孔而未对准。钻的尖端的角可致使钻头在所述尖端接触骨组织时打滑，由此致使沿着不正确的轨迹钻孔。通常，除非骨钻相对于骨表面以90度被驱动，否则存在钻头在骨表面上方打滑的趋势，由此不适当地放置孔。因此，需要一种用于手术器械，其用于在患者的骨中制备孔同时最小化所述器械在所述手术器械与骨接触之后打滑的风险。
发明内容
本文描述一种用于在骨组织中制备孔的防滑手术器械。所揭示的手术器械提供在手术(例如，脊柱手术及椎弓根螺钉放置、髓内螺钉放置)期间在骨组织中制备精确孔的能力。无论钻轴与骨组织的表面之间的角度是否垂直，所揭示的手术器械均实现精确孔放置。所揭示的技术包含平坦的钻孔表面，其垂直于所述手术器械的主体的表面。这减小所述手术器械在所述骨组织的表面上打滑的可能性且由此增加所述孔的精确性。
一方面，所揭示的技术包含一种用于在手术期间在患者的骨组织中制备孔的防滑手术器械。在某些实施例中，所述防滑手术器械具有细长结构，其包含：处于所述细长结构的端处的铣削头，其用于在所述防滑手术器械与所述骨组织接触之后所述手术器械的打滑(例如，所述手术器械的非故意横向移动)减小的情况下移除骨组织，其中所述铣削头具有大体上垂直于所述细长结构的纵轴的平坦端以及围绕所述细长结构的所述纵轴的用于切入到骨组织中的一或多个侧切槽；用于连接到钻的柄；及所述铣削头与所述柄之间的轴件，所述轴件具有用于排出移除的骨组织的一或多个钻槽(例如，非切槽)。
在某些实施例中，所述铣削头的所述平坦端具有用于轴向切入到所述骨组织中的一或多个端切槽。
在某些实施例中，所述一或多个钻槽不同于所述一或多个侧切槽。
在某些实施例中，所述一或多个钻槽包含两个、三个、四个、六个、八个、十个或二十个槽。
在某些实施例中，一或多个侧切槽包含两个、三个、四个、六个、八个、十个或二十个槽。
在某些实施例中，所述轴件的纵长大于所述铣削头的纵长。
在某些实施例中，所述轴件的纵长大于所述柄的纵长。
在某些实施例中，所述一或多个钻槽具有高于所述一或多个侧切槽的扭转速率(即，较大槽角)。
在某些实施例中，所述一或多个钻槽具有低于所述一或多个侧切槽的扭转速率(即，较小槽角)。
在某些实施例中，所述一或多个钻槽具有不同于所述一或多个侧切槽的扭转速率(即，不同槽角)。
在某些实施例中，所述手术是脊柱手术、矫形手术、牙科手术、耳科手术、鼻部手术或喉部手术。
在某些实施例中，所述防滑手术器械可***到手术器械引导件中，使得所述手术器械由所述手术器械引导件约束。
在某些实施例中，所述手术器械引导件包含刚性中空管状结构，其具有第一开口端及第二开口端，所述结构界定所述管状结构的轴，沿着所述轴限制手术器械滑动通过所述结构的移动，其中所述管状结构具有内表面，其经塑形及设定大小以容纳滑动通过所述引导件的所述防滑手术器械，使得所述防滑手术器械(例如，其配有工具支架)的移动在除沿着由所述引导件界定的所述轴外的全部方向上受约束。
在某些实施例中，所述防滑手术器械配有工具支架，所述工具支架经塑形及设定大小以沿着由所述引导件所界定的所述轴滑动通过所述手术器械引导件。
在某些实施例中，所述防滑手术器械是钻头，且所述手术器械引导件是钻头引导件。
在某些实施例中，所述防滑手术器械经配置以由包括机器人臂的机器人手术***引导。
在某些实施例中，所述机器人臂具有端效应器，其包括被附接到其的手术器械引导件，所述手术器械引导件经配置以固持及/或限制手术器械通过其的移动。
在某些实施例中，导航标记由导航摄像机使用以跟踪所述防滑手术器械。
在某些实施例中，所述手术器械引导件经配置以用于引导螺钉植入物及组织保护器。
在某些实施例中，操纵器被附接到所述机器人臂。
在某些实施例中，所述操纵器被模制到所述机器人臂中。
在某些实施例中，所述手术器械引导件的所述轴可经由所述操纵器与关于所述患者情形所期望的轨迹对准。
另一方面，所揭示的技术包含一种使用防滑手术器械在患者的骨组织中制备孔来执行手术的方法。在某些实施例中，所述方法包含：操纵所述防滑手术器械以在所述患者的所述骨组织中制备所述孔，其中所述防滑手术器械具有细长结构，其包含：处于所述细长结构的所述端处的铣削头，其用于在所述防滑手术器械与所述骨组织接触之后所述手术器械的打滑(例如，所述手术器械的非故意横向移动)减小的情况下移除骨组织，其中所述铣削头具有大体上垂直于所述细长结构的纵轴的平坦端以及围绕所述细长结构的所述纵轴的用于切入到骨组织中的一或多个侧切槽；用于连接到钻的柄；以及所述铣削头与所述柄之间的轴件，所述轴件具有用于排出被移除的骨组织的一或多个钻槽(例如，非切槽)。
在某些实施例中，操纵所述防滑手术器械包含：将所述手术器械***到手术器械引导件中，使得所述手术器械由所述手术器械引导件约束。
在某些实施例中，所述手术器械引导件包括刚性中空管状结构，其具有第一开口端及第二开口端，所述结构界定所述管状结构的轴，沿着所述轴限制手术器械滑动通过所述结构的移动，其中所述管状结构具有内表面，其经塑形及设定大小以容纳滑动通过所述引导件的所述防滑手术器械，使得所述防滑手术器械(例如，其配有工具支架)的移动在除沿着由所述引导件界定的所述轴外的全部方向上受约束。
在某些实施例中，所述防滑手术器械配有工具支架，其经塑形及设定大小以沿着由所述引导件界定的所述轴滑动通过所述手术器械引导件。
在某些实施例中，所述防滑手术器械是钻头，且所述手术器械引导件是钻头引导件。
在某些实施例中，所述防滑手术器械用于脊柱手术、矫形手术、牙科手术、耳科手术、鼻部手术及喉部手术中的至少一者。
在某些实施例中，所述防滑手术器械由包含机器人臂的机器人手术***引导。
在某些实施例中，所述机器人臂具有端效应器，其包含被附接到其的手术器械引导件，所述手术器械引导件经配置以固持及/或限制手术器械通过其的移动。
在某些实施例中，所述方法包含固定所述机器人臂的所述位置(且，因此，固定所述手术器械引导件的位置)。
在某些实施例中，导航标记由导航摄像机使用以跟踪所述防滑手术器械。
在某些实施例中，所述方法包含：获得或存取患者情形的CT扫描、3D CT扫描、荧光镜检查、3D荧光镜检查或基于自然标记点的图像。
在某些实施例中，操纵器被附接到所述机器人臂。
在某些实施例中，所述操纵器被模制到所述机器人臂中。
在某些实施例中，所述轴可经由所述操纵器与关于所述患者情形所期望的轨迹对准。
在某些实施例中，所述铣削头的所述平坦端具有用于轴向切入到所述骨组织中的一或多个端切槽。
在某些实施例中，所述一或多个钻槽不同于所述一或多个侧切槽。
在某些实施例中，所述一或多个钻槽包含两个、三个、四个、六个、八个、十个或二十个槽。
在某些实施例中，一或多个侧切槽包含两个、三个、四个、六个、八个、十个或二十个槽。
在某些实施例中，所述轴件的纵长大于所述铣削头的纵长。
在某些实施例中，所述轴件的纵长大于所述柄的纵长。
在某些实施例中，所述一或多个钻槽具有高于所述一或多个侧切槽的扭转速率(即，较大槽角)。
在某些实施例中，所述一或多个钻槽具有低于所述一或多个侧切槽的扭转速率(即，较小槽角)。
在某些实施例中，所述一或多个钻槽具有不同于所述一或多个侧切槽的扭转速率(即，不同槽角)。
附图说明
通过参考结合附图进行的以下描述，将更加明白且更好地理解本发明的前述及其它目标、方面、特征及优点，其中：
图1是用于在骨组织中制备孔的实例钻头的说明；以及
图2是用于在骨组织中制备孔的实例手术器械的说明。
当结合图式时，从下文陈述的详细描述将更加明白本发明的特征及优点，其中相似的参考字符识别全文的对应元件。在图示中，相似的参考数字大体上指示相同、功能类似及/或结构类似的元件。
具体实施方式
本文描述一种用于在骨组织中制备孔的防滑手术器械。在某些类型的手术(例如，脊柱手术及椎弓根螺钉放置、髓内螺钉放置)中，有必要在骨组织中制备精确孔；然而，在许多实例中，人体解剖学不能良好地适用于在这些区域中钻孔，这是因为钻轴与骨的表面之间的角度不垂直。所揭示的技术提供通过最小化手术器械在接触骨组织时打滑的可能性来在骨组织中精确地制备孔。
如本文中使用，短语“在骨组织中制备孔”涵盖对骨组织及/或骨状组织进行铣削、钻孔、研磨及/或切割。“孔”涵盖任何空腔、凹痕或凹陷。
图1是实例现有技术钻头102及104及实例手术器械引导件106的说明。通常，手术器械包含变窄成为点116的锥形端114。点116用于引导钻头。标准手术器械，尤其是钻头可能会在骨组织的表面上打滑，这显著降低孔的精确性。打滑可能与钻角α有关，钻角α不能很好地适于相对于骨组织表面成某一角度(其不同于直角)进行钻孔。考虑到多数骨的表面并非完全平坦，所以标准钻头通常导致骨中的不精确孔。举例来说，如果钻的侧(例如，钻的锥形尖端114的侧)在钻头的尖端116已进入组织并提供引导之前触碰骨组织，那么更可能发生钻打滑。
图2是接触骨组织208的表面的三个钻头的比较。如图2中所展示，钻头202很可能打滑，这是因为钻头202的尖端216a将不会首先接触骨组织208的表面。相反，锥形尖端的侧214a将在尖端216a之前接触骨组织208。相比之下，钻头204的尖端216a较不可能打滑，这是因为钻头204的尖端216b首先接触骨组织208。然而，难以预测钻头在手术期间是否将打滑及何时将打滑的原因中的一者是难以确定钻头的尖端是否将首先接触骨组织208。如图2中所展示的防滑手术器械206减小钻头打滑的风险，这是因为“尖端”是垂直于手术器械的主体的表面的平坦的铣削表面218。防滑手术器械206的铣削头210适于在进入骨组织208时进行铣削(例如，而非钻孔)。在一些实施方案中，头210后面的器械主体212的部分适于进行钻孔(例如，其含有排出孔、螺线、螺旋线等等)。
在一些实施方案中，防滑手术器械206具有处于细长结构的端处的用于在所述防滑手术器械与所述骨组织208接触之后所述手术器械的打滑(例如，所述手术器械的非故意横向移动)减小的情况下移除骨组织的铣削头210。铣削头210具有大体上垂直于细长结构的纵轴的平坦的端218。在一些实施方案中，铣削头210具有围绕所述细长结构的纵轴的用于切入到骨组织中的一或多个侧切槽220(例如，经尖锐化的)。一或多个侧切槽220可包含两个、三个、四个、六个、八个、十个或二十个槽。
在一些实施方案中，防滑手术器械206具有用于连接到钻的柄(未展示)。在一些实施方案中，防滑手术器械206在铣削头210与所述柄之间具有轴件212，轴件212具有用于排出被移除的骨组织的一或多个钻槽224(例如，非切槽；比如，未经尖锐化的槽)。在一些实施方案中，一或多个钻槽224包含两个、三个、四个、六个、八个、十个或二十个槽。一或多个钻槽224不同于一或多个侧切槽220。举例来说，钻槽224可具有不同于(例如，大于或小于)侧切槽220的扭转速率(例如，槽角)。
在一些实施方案中，铣削头210的平坦的端218具有用于轴向地切入到骨组织中的一或多个端切槽(未展示)。在一些实施方案中，一或多个端切槽是切削齿。另外，在一些实施方案中，轴件的纵长大于铣削头的纵长。在一些实施方案中，轴件的纵长小于铣削头的纵长。
如图2中所展示，防滑手术器械206具有细长结构，所述细长结构包括具有铣削表面218的铣削头210、具有钻表面的轴件212。在一些实施方案中，器械206包含与第一端210相对的第二端，其具有经配置以由钻抓握的柄。防滑手术器械206的铣削头210是平坦的，且大体上垂直于细长结构的表面，由此减小手术器械206在铣削表面218与骨组织208接触之后的打滑(例如，手术器械206的非故意横向移动)。
在一些实施方案中，铣削端210利用旋切机来移除材料。铣削端210可采用若干形状及大小的形式。举例来说，铣削端210可为端铣刀、平板铣刀或其它类型的铣削装置。
在一些实施方案中，铣削头210的槽是在刀具上延伸的深螺旋形凹槽，而沿着槽220的边缘的尖锐刀片被称为齿。所述齿切割材料，且此材料的碎屑通过刀具的旋转朝槽220被向上提拉。在一些实施方案中，每个槽存在一个齿。在一些实施方案中，每个槽存在两个或两个以上齿。举例来说，每一槽220的刀具可具有2、3、4、5或5个以上齿(例如，1到4、5到10或10到20个齿)。通常，刀具具有的齿越多，其可移除材料的速度就越快。因此，通常，4齿刀具可以2齿刀具的两倍速率移除材料。铣削头210可为在铣削端210的一个端(即，平坦的端218)及侧220上具有切割齿的端铣刀。举例来说，平坦的端218可为平坦的底部刀具。
在一些实施方案中，手术器械206被刚性引导(例如，由机器人手术***进行引导)。手术器械206可在进入骨组织208时引起更高的径向力，因此，刚性引导件保证孔将被准确地放置。在一些实施方案中，结合手术器械206使用的钻足够刚性以避免钻本身的偏转。高旋转速度钻(例如，电钻)可用于减小径向力。
在一些实施方案中，手术器械206与机器人手术***(例如，2014年4月30日申请且标题为用于手术工具的精确引导的设备、***及方法(Apparatus,Systems,and Methodsfor Precise Guidance of Surgical Tools)的第14/266,769号美国专利申请案中描述的机器人手术***，所述美国专利申请案特此以全文引用的方式并入)组合使用。在一些实施方案中，手术器械206结合无源臂或提供对手术器械206的刚性固定的任何装置使用。手术器械206可***到手术器械引导件中，使得手术器械206由手术器械引导件约束。手术器械引导件可包含刚性中空管状结构，其具有第一开口端及第二开口端。引导件的结构可界定轴，沿着所述轴限制手术器械滑动通过所述结构的移动。管状结构可具有内表面，其经塑形及设定大小以容纳滑动通过引导件的防滑手术器械206，使得手术器械206(例如，其配有工具支架)的移动在除沿着由引导件界定的轴外的全部方向上受约束。手术器械206可配有或具有集成工具支架，使得工具支架啮合引导件以提供对手术器械206的准确引导。举例来说，防滑手术器械206可被配有工具支架，所述工具支架经塑形及设定大小以沿着由引导件界定的轴滑动通过手术器械引导件。
在其中手术器械206由机器人手术***进行引导的实例中，机器人手术***可包含机器人臂。在一些实施方案中，机器人臂具有端效应器，其包含附接到其的手术器械引导件，所述手术器械引导件经配置以固持及/或限制手术器械通过其的移动。导航标记可用于跟踪手术器械206。手术器械引导件的轴可经由操纵器与关于患者情形所期望的轨迹对准。
在一些实施方案中，鉴于本文描述的***及方法的所述结构、功能及设备，提供一种用于结合机器人手术***执行手术的***及方法。已描述用于支撑机器人手术***的方法及设备的某些实施方案，所属领域的技术人员现将明白，可使用并入本发明的概念的其它实施方案。因此，本发明不应限于某些实施方案，而仅应由所附权利要求书的精神及范围限制。
贯穿所述描述，在设备及***被描述为具有、包含或包括特定组件的情况下或在过程及方法被描述为具有、包含或包括特定步骤的情况下，应预期，另外存在基本上由或由所述组件组成的所揭示的技术的设备及***，且存在根据所揭示的技术的基本上由或由所述处理步骤组成的过程及方法。
应理解，步骤的顺序或用于执行某些动作的顺序是不重要的，只要所揭示的技术维持可操作。此外，可同时进行两个或两个以上步骤或动作。
所除非技术上不兼容，否则所描述的本发明的各种实施例可结合其它实施例中的一或多者使用。
本文描述一种用于在骨组织中制备孔的防滑手术器械。所揭示的手术器械提供在手术(例如，脊柱手术及椎弓根螺钉放置、髓内螺钉放置)期间在骨组织中制备精确孔的能力。无论钻轴与所述骨组织的表面之间的角度是否垂直，所揭示的手术器械均实现精确孔放置。所揭示的技术包含平坦的钻孔表面，其垂直于所述手术器械的主体的所述表面。这减小所述手术器械在所述骨组织的所述表面上打滑的可能性且由此增加所述孔的精确性。

Claims (45)

1.一种用于在手术期间在患者的骨组织中制备孔的防滑手术器械，所述防滑手术器械具有细长结构，其包括：
处于所述细长结构的端处的铣削头，其用于在所述防滑手术器械与所述骨组织接触之后所述手术器械的打滑(例如，所述手术器械的非故意横向移动)减小的情况下移除骨组织，其中所述铣削头具有大体上垂直于所述细长结构的纵轴的平坦端以及围绕所述细长结构的所述纵轴的用于切入到骨组织中的一或多个侧切槽；
用于连接到钻的柄；以及
所述铣削头与所述柄之间的轴件，所述轴件具有用于排出被移除的骨组织的一或多个钻槽(例如，非切槽)。
2.根据权利要求1所述的防滑手术器械，其中所述铣削头的所述平坦端具有用于轴向切入到所述骨组织中的一或多个端切槽。
3.根据权利要求1或2所述的防滑手术器械，其中所述一或多个钻槽不同于所述一或多个侧切槽。
4.根据权利要求1到3中任一权利要求所述的防滑手术器械，其中所述一或多个钻槽包括两个、三个、四个、六个、八个、十个或二十个槽。
5.根据权利要求1到4中任一权利要求所述的防滑手术器械，其中一或多个侧切槽包括两个、三个、四个、六个、八个、十个或二十个槽。
6.根据权利要求1到5中任一权利要求所述的防滑手术器械，其中所述轴件的纵长大于所述铣削头的纵长。
7.根据权利要求1到6中任一权利要求所述的防滑手术器械，其中所述轴件的纵长大于所述柄的纵长。
8.根据权利要求1到7中任一权利要求所述的防滑手术器械，其中所述一或多个钻槽具有高于所述一或多个侧切槽的扭转速率(即，较大槽角)。
9.根据权利要求1到7中任一权利要求所述的防滑手术器械，其中所述一或多个钻槽具有低于所述一或多个侧切槽的扭转速率(即，较小槽角)。
10.根据权利要求1到9中任一权利要求所述的防滑手术器械，其中所述一或多个钻槽具有不同于所述一或多个侧切槽的扭转速率(即，不同槽角)。
11.根据权利要求1到10中任一权利要求所述的防滑手术器械，其中所述手术是脊柱手术、矫形手术、牙科手术、耳科手术、鼻部手术或喉部手术。
12.根据权利要求1到11中任一权利要求所述的防滑手术器械，其中所述防滑手术器械可***到手术器械引导件中，使得所述手术器械由所述手术器械引导件约束。
13.根据权利要求12所述的防滑手术器械，其中所述手术器械引导件包括刚性中空管状结构，其具有第一开口端及第二开口端，所述结构界定所述管状结构的轴，沿着所述轴限制手术器械滑动通过所述结构的移动，其中所述管状结构具有内表面，其经塑形及设定大小以容纳滑动通过所述引导件的所述防滑手术器械，使得所述防滑手术器械(例如，其配有工具支架)的移动在除沿着由所述引导件界定的所述轴外的全部方向上受约束。
14.根据权利要求13所述的防滑手术器械，其中所述防滑手术器械配有工具支架，所述工具支架经塑形及设定大小以沿着由所述引导件所界定的所述轴滑动通过所述手术器械引导件。
15.根据权利要求12到14中任一权利要求所述的防滑手术器械，其中所述防滑手术器械是钻头，且所述手术器械引导件是钻头引导件。
16.根据权利要求12到15中任一权利要求所述的防滑手术器械，其中所述防滑手术器械经配置以由包括机器人臂的机器人手术***引导。
17.根据权利要求16所述的防滑手术器械，其中所述机器人臂具有端效应器，其包括被附接到其的手术器械引导件，所述手术器械引导件经配置以固持及/或限制手术器械通过其的移动。
18.根据权利要求16到17中任一权利要求所述的防滑手术器械，其中导航标记由导航摄像机使用以跟踪所述防滑手术器械。
19.根据权利要求16到18中任一权利要求所述的防滑所述器械，其中所述手术器械引导件经配置以用于引导螺钉植入物及组织保护器。
20.根据权利要求16到19中任一权利要求所述的防滑手术器械，其中操纵器被附接到所述机器人臂。
21.根据权利要求16到20中任一权利要求所述的防滑手术器械，其中所述操纵器被模制到所述机器人臂中。
22.根据权利要求12到21中任一权利要求所述的防滑手术器械，其中所述手术器械引导件的所述轴可经由所述操纵器与关于所述患者情形所期望的轨迹对准。
23.一种使用防滑手术器械在患者的骨组织中制备孔来执行手术的方法，所述方法包括：
操纵所述防滑手术器械以在所述患者的所述骨组织中制备所述孔，其中所述防滑手术器械具有细长结构，其包括：
处于所述细长结构的端处的铣削头，其用于在所述防滑手术器械与所述骨组织接触之后所述手术器械的打滑(例如，所述手术器械的非故意横向移动)减小的情况下移除骨组织，其中所述铣削头具有大体上垂直于所述细长结构的纵轴的平坦端以及围绕所述细长结构的所述纵轴的用于切入到骨组织中的一或多个侧切槽；
用于连接到钻的柄；以及
所述铣削头与所述柄之间的轴件，所述轴件具有用于排出被移除的骨组织的一或多个钻槽(例如，非切槽)。
24.根据权利要求23所述的方法，其中操纵所述防滑手术器械包括：将所述手术器械***到手术器械引导件中，使得所述手术器械由所述手术器械引导件约束。
25.根据权利要求24所述的方法，其中所述手术器械引导件包括刚性中空管状结构，其具有第一开口端及第二开口端，所述结构界定所述管状结构的轴，沿着所述轴限制手术器械滑动通过所述结构的移动，其中所述管状结构具有内表面，其经塑形及设定大小以容纳滑动通过所述引导件的所述防滑手术器械，使得所述防滑手术器械(例如，其配有工具支架)的移动在除沿着由所述引导件界定的所述轴外的全部方向上受约束。
26.根据权利要求25所述的方法，其中所述防滑手术器械配有工具支架，其经塑形及设定大小以沿着由所述引导件界定的所述轴滑动通过所述手术器械引导件。
27.根据权利要求24到26中任一权利要求所述的方法，其中所述防滑手术器械是钻头，且所述手术器械引导件是钻头引导件。
28.根据权利要求23到27中任一权利要求所述的方法，其中所述防滑手术器械用于脊柱手术、矫形手术、牙科手术、耳科手术、鼻部手术及喉部手术中的至少一者。
29.根据权利要求23到28中任一权利要求所述的方法，其中所述防滑手术器械由包括机器人臂的机器人手术***引导。
30.根据权利要求29所述的方法，其中所述机器人臂具有端效应器，其包括被附接到其的手术器械引导件，所述手术器械引导件经配置以固持及/或限制手术器械通过其的移动。
31.根据权利要求29或30所述的方法，其包括：
固定所述机器人臂的位置(且，因此，固定所述手术器械引导件的位置)。
32.根据权利要求29到31中任一权利要求所述的方法，其中导航标记由导航摄像机使用以跟踪所述防滑手术器械。
33.根据权利要求29到32中任一权利要求所述的方法，其包括：获得或存取患者情形的CT扫描、3D CT扫描、荧光镜检查、3D荧光镜检查或基于自然标记点的图像。
34.根据权利要求29到33中任一权利要求所述的方法，其中操纵器被附接到所述机器人臂。
35.根据权利要求29到34中任一权利要求所述的方法，其中所述操纵器被模制到所述机器人臂中。
36.根据权利要求29到35中任一权利要求所述的方法，其中所述轴可经由所述操纵器与关于所述患者情形所期望的轨迹对准。
37.根据权利要求23到36中任一权利要求所述的方法，其中所述铣削头的所述平坦端具有用于轴向切入到所述骨组织中的一或多个端切槽。
38.根据权利要求23到37中任一权利要求所述的方法，其中所述一或多个钻槽具有不同于所述一或多个侧切槽的扭转速率(即，不同槽角)。
39.根据权利要求23到38中任一权利要求所述的方法，其中所述一或多个钻槽不同于所述一或多个侧切槽。
40.根据权利要求23到39中任一权利要求所述的方法，其中所述一或多个钻槽包括两个、三个、四个、六个、八个、十个或二十个槽。
41.根据权利要求23到40中任一权利要求所述的方法，其中一或多个侧切槽包括两个、三个、四个、六个、八个、十个或二十个槽。
42.根据权利要求23到41中任一权利要求所述的方法，其中所述轴件的纵长大于所述铣削头的纵长。
43.根据权利要求23到42中任一权利要求所述的方法，其中所述轴件的纵长大于所述柄的纵长。
44.根据权利要求23到43中任一权利要求所述的方法，其中所述一或多个钻槽具有高于所述一或多个侧切槽的扭转速率(即，较大槽角)。
45.根据权利要求23到43中任一权利要求所述的方法，其中所述一或多个钻槽具有低于所述一或多个侧切槽的扭转速率(即，较小槽角)。
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