CN118574585A

CN118574585A - Force feedback for robotic microsurgery

Info

Publication number: CN118574585A
Application number: CN202280080028.3A
Authority: CN
Inventors: 约阿夫·戈兰; 奥里·本泽埃夫; 塔尔·科尔曼; 丹尼尔·格楼兹曼
Original assignee: Fossett Robotics Co ltd
Current assignee: Fossett Robotics Co ltd
Priority date: 2021-12-02
Filing date: 2022-12-01
Publication date: 2024-08-30

Abstract

Devices and methods for performing surgery on a patient's eye are described. The robot unit inserts the ophthalmic tool (21) into the eye via an incision in the cornea such that a tip of the ophthalmic tool (21) is disposed within the eye and a remote center of motion position of the ophthalmic tool (21) is disposed within the incision. The position and orientation of the tip of the control component tool (32) is determined from data received from one or more position sensors (92, 94), and the tip of the ophthalmic tool (21) is moved within the eye in a manner corresponding to the movement of the control component tool (32). Feedback is provided to the operator indicating the placement of the remote center of motion position of the ophthalmic tool (21) relative to the incision. Other applications are also described.

Description

Force feedback for robotic microsurgery

Cross Reference to Related Applications

The present application claims priority from U.S. provisional patent application No. 63/285,218 entitled "Robotic unit for microsurgical procedures (robotic unit for microsurgery)" filed by Korman at 12, and U.S. provisional patent application No. 63/406,881 entitled "Force feedback for robotic microsurgical procedures (force feedback for robotic microsurgery)" filed by Golan at 15, 2022. The above two U.S. provisional applications are incorporated herein by reference.

Field of embodiments of the invention

Some applications of the present invention relate generally to medical devices and methods. In particular, some applications of the present invention relate to apparatus and methods for robotically performing microsurgery (microsurgical procedure).

Background

Cataract surgery involves removing the natural lens of the eye that has undergone clouding (known as cataract) and replacing it with an intraocular lens. Such procedures typically include a number of standard steps that are performed in sequence.

In an initial step, the face around the patient's eyes is sterilized (typically with iodine solution) and their face is covered with sterile drape (STERILEDRAPE) so that only the eyes are exposed. When disinfection and drape have been completed, the eye is typically anesthetized with a local anesthetic, which is administered in the form of a liquid eye drop. Then, the eyeballs are exposed using an eyelid speculum that keeps the upper and lower eyelids open. One or more incisions (and typically two or three incisions) are made in the cornea of the eye. The incision is typically made using a special blade called a keratome blade. At this stage, lidocaine is typically injected into the anterior chamber of the eye in order to further anesthetize the eye. After this step, a viscoelastic injection is applied through the corneal incision. Viscoelastic injection is performed to stabilize the anterior chamber and help maintain intraocular pressure during the remainder of the procedure, and also to dilate the lens capsule.

In a subsequent stage (called capsulorhexis), a portion of the anterior lens capsule is removed. Various enhancement techniques have been developed for performing capsulorhexis, such as laser-assisted capsulorhexis, zepto-capsulorhexis (zepto-rhexis) (using precision nanopulse techniques), and marker-assisted capsulorhexis (where a pre-defined marker is used to mark the cornea in order to indicate the desired size of the capsular opening).

Fluid waves are then injected, typically through a corneal incision, to dissect the outer cortical layer of the cataract in a step called water separation (hydrodissection). In a subsequent step, called the water stratification, the outer softer outer core (epi-nucleus) of the lens is separated from the inner harder inner core (endo-nucleus) by injecting fluid waves. In the next step, in a process called phacoemulsification, phacoemulsification of the lens is performed. The nucleus of the lens is first broken using a nucleus splitter (chopper), and then the outer fragments of the lens are broken and removed, typically using an ultrasonic phacoemulsification probe. Further, in general, aspiration is performed using a separate tool during phacoemulsification. When phacoemulsification is complete, the remaining lens cortex (i.e., the outer layer of the lens) material is aspirated from the capsule. During phacoemulsification and aspiration, the aspirated fluid is typically replaced with a balanced salt irrigation solution to maintain the fluid pressure in the anterior chamber. In some cases, the bladder is polished if deemed necessary. An intraocular lens (IOL) is then inserted into the capsule. IOLs are typically foldable and are inserted in a folded configuration prior to deployment within the capsule. At this stage, the viscoelastic is typically removed using an aspiration device previously used to aspirate fluid from the balloon. If necessary, the incision is sealed by increasing the pressure inside the eyeball (bulbus oculi), i.e., the eye, so that the internal tissue presses against the external tissue of the incision to force the incision closed.

SUMMARY

According to some applications of the present application, a robotic system is configured for use in microsurgery (e.g., intraocular surgery). Typically, the robotic system includes one or more robotic units (configured to hold a tool) in addition to an imaging system, one or more displays, and a control unit (e.g., a control unit including a pair of control units such as joysticks), by which one or more operators (e.g., healthcare professionals, such as doctors and/or nurses) can control the robotic units. Typically, robotic systems include one or more computer processors by which components of the system and operators operably interact with each other. The scope of the application includes mounting one or more robotic units in any of a variety of different positions relative to each other.

Typically, movement of the robotic unit (and/or control of other aspects of the robotic system) is controlled, at least in part, by one or more operators (e.g., healthcare professionals, such as doctors and/or nurses). For example, an operator may receive images of the patient's eyes and the robotic unit and/or tools disposed therein via a display. The operator typically performs the steps of the procedure based on the received images. For some applications, the operator provides commands to the robotic unit through the control unit. Typically, such commands include commands to control the position and/or orientation of a tool arranged within the robotic unit, and/or commands to control actions performed by the tool. For example, these commands may control the blade, the phacoemulsification tool (e.g., the operating mode and/or suction of the phacoemulsification tool), and/or the syringe tool (e.g., what fluid (e.g., viscoelastic fluid, saline, etc.) should be injected and/or what the flow rate is). Alternatively or additionally, the operator may input commands that control the imaging system (e.g., zoom, focus, and/or x-y positioning of the imaging system). For some applications, the command includes controlling an intraocular lens manipulator tool, e.g., such that the tool manipulates an intraocular lens within the eye to precisely position the intraocular lens within the eye.

Typically, the control component units include one or more control component joysticks configured to correspond to respective robotic units of the robotic system. For example, the system may include a first robotic unit and a second robotic unit, and the control component unit may include a first joystick and a second joystick. Typically, each joystick is a control member arm that includes a plurality of links coupled to one another by joints. (the terms "joystick" and "control member arm" are used interchangeably throughout this disclosure). For some applications, the control component joystick includes a corresponding control component tool therein (to replicate the robotic unit). Typically, the computer processor determines the XYZ position and orientation of the tip of the control component tool and drives the robotic unit such that the tip of the actual tool used to perform the procedure tracks the movement of the tip of the control component tool. In some cases, the actual tool used to perform the procedure is described herein in the specification and claims as an "ophthalmic tool". This term is used to distinguish between tools for performing surgery and control component tools and should not be construed as limiting the types of tools that may be used in any way. The term "ophthalmic tool" should be construed to include any of the tools described herein and/or any other type of tool that would occur to one of ordinary skill in the art upon reading this disclosure.

Typically during cataract surgery, one or more incisions (typically two or three incisions) are made in the cornea of the eye. The incision is typically made using a specialized blade called a keratome blade. Typically, the robotic unit is configured to insert the ophthalmic tool into the patient's eye such that the tool enters the patient's eye through an incision in the cornea, and the tip of the tool is disposed within the patient's eye. Further, typically, the robotic system is configured to move the tip of the tool within the patient's eye such that the entrance of the tool into the patient's eye is constrained to remain within the incision.

To perform non-robotic anterior ophthalmic surgery, a surgeon typically makes one or more incisions in the cornea of a patient, which are then used as access points for various surgical tools. The tool is inserted through the incision and manipulated within the eye to achieve the surgical goal. When such manipulation occurs, it is medically preferred that the tool not be excessively forced against the edge of the incision, lifted up or depressed down. Such movement may cause the edges of the incision to tear, thereby enlarging the incision and possibly negatively affecting the surgical outcome. Ideally, the surgeon will manipulate the tool such that at the point of entry of the tool through the incision, the tool rotates about the center of the incision, rather than moving laterally, wherein such movement of the tool at the incision is described herein as maintaining the center of motion. For robotic surgery, such as those described herein, the above-described motions of the tool are described as maintaining a remote center of motion, as the tool is typically controlled from a remote location (e.g., via a control unit). In non-robotic surgery, it is difficult to manually maintain the center of motion, especially when the surgeon needs to focus on the tip of the tool that is performing the current surgical action. According to some applications of the present invention, feedback is provided to assist an operator in performing a robot-assisted ophthalmic procedure. Feedback (as described in further detail below) typically provided by the control component unit typically assists the operator in maintaining the remote center of motion of the ophthalmic tool by applying a force that resists attempted movement of the joystick and/or control component tool by the operator that may violate the remote center of motion.

As described above, for some applications, the operator provides commands to the robotic unit via the control component unit. Typically, such commands include commands to control the position and/or orientation of a tool arranged within the robotic unit, and/or commands to control actions performed by the tool. For some applications, the robotic unit is configured to allow the tool to enter the patient's eye for movement within the incision, and the computer processor is configured to drive the output unit to provide feedback to the operator indicating the position of the tool into the patient's eye within the incision. For example, the computer processor may generate an output on the display that displays the incision area and the entry location of the tool within the incision area. For some applications, an output, such as a visual or audible alert, is generated when the tool is moved such that the position of the tool into the patient's eye is within a given distance of the edge of the incision.

For some applications, the computer processor is configured to drive the control component unit to provide feedback to the operator indicating the position of the tool within the incision into the patient's eye. For example, as the tool moves such that the position of the tool into the patient's eye is closer to the edge of the incision, the resistance to movement of the control component arm may increase, and/or the control component arm may vibrate, and/or a different output may be produced. Note that according to some such applications of the present invention, the motion of the ophthalmic tool itself is not constrained to maintain a remote center of motion. Instead, the tool is allowed to move freely, but the control member unit provides force feedback (and/or other feedback) to the operator, which assists the operator in moving the joystick and control member tool in a manner that causes the ophthalmic tool to maintain its remote center of motion within the incision or incision tract.

Thus, according to some applications of the present invention, there is provided an apparatus for performing surgery on an eye of a patient using an ophthalmic tool having a tip, the apparatus comprising:

a robotic unit configured to move the ophthalmic tool; and

A control unit, comprising:

A control component tool configured to be moved by an operator and define a tip; and

At least one control component arm coupled to the control component tool and comprising one or more position sensors, and;

A processor of the computer is provided with a processor, the computer processor is configured to:

Driving the robotic unit to insert the ophthalmic tool into the patient's eye via an incision in the cornea of the patient's eye such that a tip of the ophthalmic tool is disposed within the patient's eye and a remote center of motion position of the ophthalmic tool is disposed within the incision;

Determining a position and orientation of a tip of the control component tool based on data received from the one or more position sensors;

Moving a tip of the ophthalmic tool within the patient's eye in a manner corresponding to the movement of the control component tool; and

Feedback is provided to the operator indicating the placement of the remote center of motion position of the ophthalmic tool relative to the incision.

In some applications, the control component arm includes a plurality of links coupled to one another via a rotating arm joint, and the one or more position sensors include:

three rotary encoders, each coupled to a respective one of the rotary arm joints and configured to detect movement of the respective rotary arm joint and, in response to detecting movement of the respective rotary arm joint, generate rotary encoder data indicative of XYZ positions of a tip of the control component tool; and

An inertial measurement unit comprising at least one sensor selected from the group consisting of a tri-axial accelerometer, a tri-axial gyroscope, and a tri-axial magnetometer, the inertial measurement unit configured to generate inertial measurement unit data indicative of an orientation of a tip of the control component tool.

In some applications, the control component arm includes a plurality of links coupled to each other via swivel arm joints, and the control component tool is coupled to the control component arm via three swivel tool joints, and the one or more position sensors include:

two rotary encoders coupled to each of the rotary arm joints and configured to detect movement of the rotary arm joint and, in response to detecting movement of the rotary arm joint, generate rotary encoder data indicative of XYZ position of the tip of the control component tool; and

A rotary encoder coupled to each of the rotary tool joints and configured to detect movement of the rotary tool joint and, in response to detecting movement of the rotary tool joint, generate rotary encoder data indicative of an orientation of a tip of the control component tool;

In some applications, the computer processor is configured to provide feedback to the operator indicating the placement of the remote center of motion position of the ophthalmic tool relative to the incision by generating an alert when the ophthalmic tool is moved such that the remote center of motion position of the ophthalmic tool is within a given distance from the edge of the incision.

In some applications, the computer processor is configured to generate an audio alert.

In some applications, the computer processor is configured to generate a visual alert.

In some applications, the computer processor is configured to provide feedback to the operator indicating the placement of the remote center of motion position of the ophthalmic tool relative to the incision by providing force feedback to the operator via the control component arm.

In some applications, the computer processor is configured to:

determining the identity of an ophthalmic tool that has been inserted into the eye of the patient, and

Based on the identity of the ophthalmic tool, an arrangement of a remote center of motion position of the ophthalmic tool relative to the incision is calculated.

In some applications, the computer processor is configured to provide force feedback to the operator via the control component by:

a speed measurement is performed on the control means tool,

Calculating a force to be applied to the operator based on the speed measurement, an

The control means is driven to apply the calculated force to the operator.

In some applications, the computer processor is configured to provide force feedback to the operator via the control component arm by:

measuring the position of the ophthalmic tool relative to the incision,

Calculating a force to be applied to the operator based on the position measurement, and

The control member arm is driven to apply the calculated force to the operator.

In some applications, the computer processor is configured to calculate the force to be applied to the operator by calculating a force equal to and opposite to the force applied by the operator to the control component tool.

In some applications, the computer processor is configured to calculate a force to be applied to the operator by calculating a force proportional to a distance of an outer edge of the ophthalmic tool from a center of the incision.

In some applications, the computer processor is configured to receive input from the operator indicating the stiffness of the force feedback they wish to receive, and calculate the force to be applied to the operator based at least in part on the input from the operator.

In some applications, the computer processor is configured to constrain movement of the control component tool in a manner corresponding to how movement of the remote center of motion position of the ophthalmic tool relative to the incision should be constrained.

In some applications, the computer processor is configured to constrain movement of the control component tool in a manner that constrains the remote center of motion position of the ophthalmic tool to remain within an incision area that is larger than the incision.

In some applications, the computer processor is configured to constrain movement of the control component tool in a manner that constrains the remote center of motion position of the ophthalmic tool to remain within the incision.

In some applications, the computer processor is configured to calculate the force to be applied to the operator by calculating a force function based on the distance of the outer edge of the ophthalmic tool from the center of the incision in both directions.

In some applications, a first of the two directions is parallel to the incision and tangential to the cornea of the patient's eye at the incision, and a second of the two directions is perpendicular to the first direction and tangential to the cornea of the patient's eye at the incision.

In some applications:

The control component arm includes a plurality of links coupled to each other by rotary arm joints, and one or more motors operably coupled to respective rotary arm joints; and

The computer processor is configured to provide force feedback to the operator by driving the control component arm using the plurality of motors.

In some applications, the control component arm includes exactly three motors operably coupled to respective joints.

In some applications, the control component arm includes a conveyor belt (belt), and at least one of the motors is operatively coupled to a respective one of the rotary arm joints via the conveyor belt such that the at least one of the motors is disposed closer to the base of the control component unit than when the at least one of the motors directly drives the respective one of the rotary arm joints.

In some applications, a majority of the one or more motors directly drive respective ones of the rotary arm joints to which the one or more motors are operatively coupled.

In some applications, the one or more position sensors include:

Three rotary encoders, each coupled to a respective one of the rotary arm joints and configured to detect movement of the respective rotary arm joint and, in response to detecting movement of the respective rotary arm joint, generate rotary encoder data indicative of XYZ position of the tip of the control component tool; and

In some applications, the control component tool is coupled to the control component arm via three rotary tool joints, and wherein the one or more position sensors comprise:

There is also provided, in accordance with some applications of the present invention, an apparatus for performing surgery on an eye of a patient using an ophthalmic tool having a tip, the apparatus comprising:

a robotic unit configured to move the tool;

a control unit, comprising:

A control component arm coupled to the control component tool, the control component arm comprising:

a plurality of links coupled to each other via a rotary arm joint;

one or more position sensors; and

One or more motors operatively coupled to the respective rotary arm joints:

a computer processor configured to:

driving the robotic unit to insert the ophthalmic tool into the patient's eye via an incision in the cornea of the patient's eye such that a tip of the ophthalmic tool is disposed within the patient's eye;

moving the tip of the selected ophthalmic tool within the patient's eye in a manner corresponding to the movement of the control component tool; and

Force feedback is provided to the operator by driving the control member arm using the plurality of motors.

In some applications, the control component includes exactly three motors operatively coupled to respective rotary arm joints.

In some applications, the control component arm includes a conveyor belt, and at least one of the motors is operatively coupled to a respective one of the rotary arm joints via the conveyor belt such that the at least one of the motors is disposed closer to the base of the control component unit than when the at least one of the motors directly drives the respective one of the rotary arm joints.

In some applications, the one or more position sensors include:

In some applications, the computer processor is configured to:

Driving the robotic unit to insert the ophthalmic tool into the patient's eye via an incision in the cornea of the patient's eye such that a tip of the ophthalmic tool is disposed within the patient's eye and a remote center of motion position of the ophthalmic tool is disposed within the incision; and

Force feedback is provided to the operator indicating the placement of the remote center of motion position of the ophthalmic tool relative to the incision.

In some applications, the computer processor is configured to:

a speed measurement is performed on the control means tool,

The control component is driven via the one or more motors to apply the calculated force to the operator.

measuring the position of the ophthalmic tool relative to the incision,

The control means is driven to apply the calculated force to the operator.

In some applications, the computer processor is configured to receive input from the operator indicative of a stiffness of the force feedback that the operator wishes to receive, and calculate a force to be applied to the operator based at least in part on the input from the operator.

There is also provided, in accordance with some applications of the present invention, an apparatus for performing surgery on an eye of a patient using a plurality of ophthalmic tools, each ophthalmic tool having a tip, the apparatus comprising:

a robotic unit configured to move the ophthalmic tool; and

A computer processor configured to:

Driving the robotic unit to insert a selected one of the ophthalmic tools into the patient's eye via an incision in the cornea of the patient's eye such that a tip of the selected ophthalmic tool is disposed within the patient's eye and a remote center of motion position of the ophthalmic tool is disposed within the incision;

Determining an identity of an ophthalmic tool that has been inserted into an eye of the patient;

calculating an arrangement of a remote center of motion position of the ophthalmic tool relative to the incision based on an identity of the selected ophthalmic tool; and

Feedback is provided to the operator indicating the placement of the remote center of motion position of the selected ophthalmic tool relative to the incision.

There is also provided, in accordance with some applications of the present invention, a method of performing surgery on an eye of a patient using an ophthalmic tool having a tip, the method comprising:

Driving a robotic unit to insert the ophthalmic tool into the patient's eye via an incision in the cornea of the patient's eye such that a tip of the ophthalmic tool is disposed within the patient's eye and a remote center of motion position of the ophthalmic tool is disposed within the incision;

Determining a position and orientation of a tip of a control component tool configured to be moved by an operator based on data received from one or more position sensors disposed on a control component arm coupled to the control component tool;

Force feedback is provided to the operator via the control component arm, wherein the control component arm includes a plurality of links coupled to each other via a rotary arm joint and one or more motors operatively coupled to the respective rotary arm joints, and the force feedback is provided to the operator by driving the control component arm using the plurality of motors.

There is also provided, in accordance with some applications of the present invention, a method of performing surgery on an eye of a patient using a plurality of ophthalmic tools, each ophthalmic tool having a tip, the method comprising:

calculating an arrangement of a remote center of motion position of the ophthalmic tool relative to the incision based on the identity of the selected ophthalmic tool; and

There is also provided, in accordance with some applications of the present invention, apparatus for robotic microsurgery of an eye of a patient using one or more tools, the apparatus comprising:

An end effector;

A tool mount coupled to the end effector and configured to securely hold the one or more tools;

One or more robotic arms coupled to the end effector, the one or more robotic arms configured to control yaw and pitch angle rotation of the one or more tools such that a tip of a tool held by the tool mount moves within the patient's eye in a desired manner while a position of the tool into the patient's eye is held within an incision zone that is greater than 150% of a maximum cross-section of the tool through the incision zone;

A control member configured to be moved by an operator to move the tool in a desired manner; and

An output unit configured to provide feedback to the operator indicating the location of the tool into the incision tract of the patient's eye.

In some applications, the output unit includes a display that displays the location of the incision tract and the entrance of the tool within the incision tract.

In some applications, the output unit includes an output unit configured to generate an alarm when the tool is moved such that the position of the tool into the patient's eye is near the edge of the incision tract.

In some applications, the output unit includes a portion of the control component configured to provide haptic feedback to the operator.

In some applications, the control component is configured to increase resistance to movement of the control component as the tool is brought into the patient's eye closer to the edge of the incision tract.

The invention will be more fully understood from the following detailed description of embodiments of the invention, taken in conjunction with the accompanying drawings, in which:

Brief Description of Drawings

FIG. 1 is a schematic view of a robotic system configured for microsurgery, such as intraocular surgery, according to some applications of the present invention;

FIG. 2 is a schematic illustration of an incision in a patient's cornea according to some applications of the present invention;

FIGS. 3A and 3B are schematic illustrations of a tool inserted through a cornea of a patient such that a tip of the tool moves within the patient's eye in a desired manner while a position of the tool into the patient's eye remains within the incision tract, in accordance with some applications of the present invention;

Fig. 4A, 4B, 4C, 4D, 4E, 4F, 4G, 4H and 4I are corresponding applications according to the present invention, graphically illustrating a feedback force applied by the control component unit to an operator, the feedback force varying according to a distance of a portion of the tool from a center of an incision in the cornea of the subject;

FIG. 5 is a flow chart showing steps of a procedure according to some applications of the present invention;

FIGS. 6A, 6B and 6C are schematic illustrations of a joystick and control component tool according to some applications of the present invention; and

FIG. 7 is a schematic illustration of some additional components of a control component joystick according to some applications of the present invention.

Detailed Description

Reference is now made to fig. 1, which is a schematic illustration of a robotic system 10 according to some applications of the present application, the robotic system 10 being configured for microsurgery, such as intraocular surgery. Typically, when used in intraocular surgery, the robotic system 10 includes one or more robotic units 20 (which are configured to hold a tool 21), in addition to an imaging system 22, one or more displays 24, and a control component unit 26 (e.g., a control component unit including a pair of control components such as a joystick 30, as shown in the enlarged portion of fig. 1) by which one or more operators 25 (e.g., healthcare professionals, such as doctors and/or nurses) can control the robotic unit 20. Typically, robotic system 10 includes one or more computer processors 28 by which components of the system and operator 25 operably interact with each other. The scope of the application includes mounting one or more units in any of a variety of different positions relative to one another.

Typically, movement of the robotic unit (and/or control of other aspects of the robotic system) is controlled, at least in part, by one or more operators 25 (e.g., healthcare professionals, such as doctors and/or nurses). For example, an operator may receive images of the patient's eyes and the robotic unit and/or tools disposed therein via the display 24. Typically, such images are acquired by imaging system 22. For some applications, imaging system 22 is a stereoscopic imaging device and display 24 is a stereoscopic display. The operator typically performs the steps of the procedure based on the received images. For some applications, the operator provides commands to the robotic unit via the control unit 26. Typically, such commands include commands to control the position and/or orientation of a tool arranged within the robotic unit, and/or commands to control actions performed by the tool. For example, these commands may control the blade, the phacoemulsification tool (e.g., the operating mode and/or suction of the phacoemulsification tool), and/or the syringe tool (e.g., what fluid (e.g., viscoelastic fluid, saline, etc.) should be injected and/or what the flow rate is). Alternatively or additionally, the operator may input commands that control the imaging system (e.g., zoom, focus, and/or x-y positioning of the imaging system). For some applications, the command includes controlling an intraocular lens manipulator tool, e.g., such that the tool manipulates an intraocular lens within the eye to precisely position the intraocular lens within the eye.

Typically, the control component units include one or more control component joysticks 30 configured to correspond to respective robotic units 20 of the robotic system. For example, as shown, the system may include a first robotic unit and a second robotic unit, and the control component unit may include a first joystick and a second joystick, as shown. Typically, each joystick is a control component arm that includes a plurality of links coupled to each other by joints, as described in further detail below with reference to fig. 6A-7. For some applications, as shown in fig. 1, the control component joystick includes a corresponding control component tool 32 therein (to replicate the robotic unit). Typically, the computer processor determines the XYZ position and orientation of the tip of the control component tool 32 and drives the robotic unit such that the tip of the actual tool 21 for performing the procedure tracks the movement of the tip of the control component tool. In some cases, in the present specification and claims, the tool 21 is described as an "ophthalmic tool". The term is used to distinguish between the tool 21 and the control member tool 32 and should not be construed as limiting in any way the types of tools that may be used as tools 21. The term "ophthalmic tool" should be construed to include any of the tools described herein and/or any other type of tool that would occur to one of ordinary skill in the art upon reading this disclosure.

Reference is now made to fig. 2, which is a schematic illustration of an incision 40 in a cornea 42 of a patient according to some applications of the present invention. As described in the background section above, one or more incisions (typically two or three incisions) are formed in the cornea of the eye, typically during cataract surgery. Incisions are typically made using a specialized blade called a keratome blade. Typically, the robotic unit is configured to insert the tool 21 into the patient's eye such that the tool enters the patient's eye via incision 40 and the tip of the tool is disposed within the patient's eye. Further, typically, the robotic system 10 is configured to move the tip of the tool within the patient's eye such that the entrance of the tool into the patient's eye is constrained to remain within the incision. For some applications, the incision width is equal to the width of the keratome blade. The center point 43 of the incision (labeled in fig. 2) is thus defined as the point on the corneal surface centered over the width of the incision. In fig. 2, an axis has been added, where the x-axis is parallel to the incision and tangential to the cornea at the incision, and the y-axis is perpendicular to the x-axis and tangential to the cornea at the incision. Examples of the present invention will be described below with reference to the x-axis and the y-axis.

To perform non-robotic anterior ophthalmic surgery, a surgeon typically makes one or more incisions in the cornea of a patient, which are then used as access points for various surgical tools. Tools are inserted through the incision and manipulated within the eye to achieve surgical goals. When such manipulation occurs, it is medically preferred that the tool not be pressed too hard against the edge of the incision, lifted up or depressed down. Such movement may cause the edges of the incision to tear, thereby enlarging the incision and possibly negatively affecting the surgical outcome. Ideally, the surgeon will manipulate the tool such that at the point of entry of the tool through the incision, the tool rotates about the center of the incision, rather than moving laterally, wherein such movement of the tool at the incision is described herein as maintaining the center of motion. For robotic surgery, such as those described herein, the above-described movement of the tool 21 is described as maintaining a remote center of motion, as the tool is typically controlled from a remote location (via the control unit 26). In non-robotic surgery, it is difficult to manually maintain the center of motion, especially when the surgeon needs to focus on the tip of the tool that is performing the current surgical action. According to some applications of the present invention, feedback is provided to assist an operator in performing a robot-assisted ophthalmic procedure. Feedback (as described in further detail below) typically provided by the control component unit 26 assists the operator in maintaining the remote center of motion of the tool 21, typically by applying a force that resists attempted movement of the joystick 30 and/or control component tool 32 by the operator that may violate the remote center of motion.

As described above, for some applications, the operator provides commands to the robotic unit via the control unit 26 (shown in fig. 1). Typically, such commands include commands to control the position and/or orientation of a tool arranged within the robotic unit, and/or commands to control actions performed by the tool. For some applications, the robotic unit is configured to allow the tool to enter the patient's eye for movement within the incision, and the computer processor is configured to drive the output unit to provide feedback to the operator indicating the location of the tool entering the entrance of the patient's eye within the incision. For example, the computer processor may generate an output on the display 24 that shows the incision area and the location of the tool entry within the incision area. For some applications, an output, such as a visual or audible alert, is generated when the tool is moved such that the position of the tool into the patient's eye is within a given distance of the edge of the incision. For some applications, the computer processor is configured to drive the control component unit to provide feedback to the operator indicating the position of the tool within the incision into the patient's eye. For example, as the tool moves such that the position of the tool into the patient's eye is closer to the edge of the incision, the resistance to movement of the control component arm may increase, and/or the control component arm may vibrate, and/or a different output may be produced. Note that according to some such applications of the present invention, the movement of the tool 21 itself is not constrained to maintain a remote center of motion. Instead, the tool is allowed to move freely, but the control provides force feedback (and/or other feedback) to the operator to assist the operator in moving the joystick 30 and control tool 32 in a manner that will maintain the tool 21 in its remote center of motion within the incision or incision tract. Some applications of the above feedback will now be described in more detail.

Referring now to fig. 3A and 3B, fig. 3A and 3B are schematic illustrations of a tool 21 inserted through a patient's cornea 42 such that the tip 50 of the tool moves within the patient's eye in a desired manner while the position of the tool into the patient's eye remains within the incision, according to some applications of the present invention. Fig. 3A shows the irrigation suction tool 46 inserted through the incision 40, while fig. 3B shows the syringe 48 being inserted. Typically, robotic system 10 is configured to insert tool 21 into the patient's eye such that the tool enters the patient's eye through incision 40 (i.e., the remote center of motion position of the tool), and tip 50 of the tool is disposed within the patient's eye. Further, typically, the robotic system is configured to assist the operator in moving the tip of the tool within the patient's eye such that the entrance of the tool into the patient's eye (i.e., the remote center of motion position of the tool) remains within the incision. For some applications, the robotic system is configured to assist the operator by constraining movement of the control member tool in a manner corresponding to how movement of the ophthalmic tool should be constrained to prevent movement of the tool out of the incision into the entrance of the patient's eye. For some applications, the computer processor provides feedback to the operator that constrains movement of a portion of the control member tool corresponding to the portion of the tool 21 currently within the incision (i.e., the remote center of motion position of the tool), while allowing the tip of the control member tool (corresponding to the tip of the tool 21) to move in a desired manner. Typically, the control component tool is configured to provide feedback using one or more control component motors, as described in further detail below with reference to fig. 6A-6C.

For some applications, the computer processor identifies the tool currently disposed within the incision (i.e., the type of tool currently disposed within the incision), and calculates an arrangement of the remote center of motion position of the ophthalmic tool relative to the incision based on the tool identified as currently disposed within the incision. For example, the computer processor identifies the tool currently disposed within the incision by analyzing images obtained using the imaging system 22 (e.g., using machine vision algorithms). Alternatively or additionally, each tool may have a tool recognition component (e.g., a marker, barcode, and/or QR code), and the computer processor identifies the tool currently disposed within the incision by identifying the tool recognition component in the image acquired using imaging system 22. For some applications, the computer processor is configured to receive manual input identifying which tool is currently disposed within the incision. As described above, the computer processor typically drives the control component unit to provide force feedback to the operator based on the placement of the remote center of motion position of the ophthalmic tool relative to the incision. Referring to fig. 3B, for some applications, rather than restricting the entrance of the tool into the patient's eye to remain within the incision (which is typically only slightly larger than the maximum cross-sectional dimension of the tool through the incision point), the entrance of the tool into the patient's eye is restricted to remain within an incision tract 41 that is larger than the incision. For some applications, the area of the kerf region is greater than 150% or 200% of the maximum cross-sectional dimension of the tool through the kerf region. For example, the entrance of a tool into the eye of a patient may be constrained to remain within an incision tract having an area of 2mm 2 to 10mm 2. Alternatively, the robotic system is configured to constrain the entrance of the tool into the patient's eye to remain within the incision that is only slightly larger than the largest cross-sectional dimension of the tool passing through the incision, or to remain within the incision that is not larger than the largest cross-sectional dimension of the tool passing through the incision.

As described above, the robotic system is typically configured to assist the operator in moving the tool 21 such that the tip of the tool moves within the patient's eye in a desired manner while the entrance of the tool into the patient's eye remains within the incision. The longitudinal portion of the tool that is within the incision and serves as the remote center of motion is referred to herein as the "remote center of motion position of the tool". Generally speaking, all descriptions of robotic systems that assist an operator in moving the tip of a tool within a patient's eye in a manner that the remote center of motion position of the tool remains within the incision should be understood to mean that the operator is assisted in maintaining the remote center of motion position of the tool either within the incision itself or within a predetermined amount of incision area greater than the incision (e.g., as described in the previous paragraph). For some applications, a force is applied to the operator by the control member unit, which force varies according to the distance of the outer edge of the tool relative to the center of the incision.

For some applications, the control component unit is configured to apply an orientation force calculated based on the placement (i.e., position and orientation) and movement of the control component joystick 30 and/or the control component tool 32. For example, the computer processor may perform a velocity measurement on the movement of the control component tool and may calculate a force to be applied to the control component arm that simulates a physical interaction based on the velocity measurement. Alternatively or additionally, the computer processor may perform a measurement of the position of the ophthalmic tool relative to the incision, and may calculate a force applied to the control component arm that simulates the physical interaction based on the position measurement. For some applications, the control component arm is configured to apply torque to a user. For some applications, the feedback is configured to simulate a wall by applying a force to an operator each time the operator attempts to move a portion of the control component tool 32 through a certain plane. For some such applications, the applied force is configured to be equal and opposite to the force applied by the operator to the control component tool 32, for example, providing a rigid wall feel that the operator cannot pass. Alternatively or additionally, the applied force is configured to be proportional to the distance of the outer edge of the ophthalmic tool 21 from the center of the incision. In general, this creates a resilient, spring-like barrier feel, which is harder to access the more inward.

Referring again to fig. 3A, and purely by way of example, the irrigation suction tool 46 may be inserted through the 2.6mm wide incision 40. The end of the flushing suction tool 46 has a well-defined longitudinal axis 52 passing through its cross section. It is generally desirable to keep the longitudinal axis of the irrigation suction tool 46 as close as possible to the center of the incision 40. Assuming that the longitudinal axis of the flushing suction tool 46 passes through the center of the incision, incision extension may occur if the operator moves the tool along the x-axis more than a given amount. Typically, due to the flexibility of the tissue, it is possible to move the outer edge of the tool beyond the edge of the incision without causing corneal tears. Thus, as described above, for some applications, the entrance of the tool into the patient's eye is constrained to remain within incision tract 41 that is larger than the incision.

For some applications, the computer processor is configured to determine a position and orientation of a remote center of motion position of the tool relative to the incision based on images of the tool and the patient's eye, and predetermined data regarding the size of the tool. For some applications, the computer processor determines the position of the incision based on the position and orientation of the keratome blade (and predetermined data regarding the width of the keratome blade) at the time the incision is made, or by using computer vision, or a combination of both. For some applications, the computer processor determines the position of the longitudinal axis of the tool relative to the incision (e.g., relative to the center of the incision, relative to the edge of the incision, and/or relative to the edge of the incision tract). In the case of some tools, the longitudinal axis is a straight line and the cross section of the tool is symmetrical about its axis. In the case of some tools, the longitudinal axis of the tool is not a straight line, but it differs at different locations along the length of the tool, the longitudinal axis following the centroid of the tool cross section. For some applications, the computer processor determines a distance between an outer edge of the remote center of motion location of the tool relative to the incision (e.g., relative to a center of the incision, relative to an edge of the incision, and/or relative to an edge of the incision tract). Typically, the computer processor determines the magnitude and/or direction of the feedback force provided to the operator based on the above calculations.

For some applications, based on the above calculations, the computer processor calculates a force function that returns a force vector to be provided to the operator by the control component arm. The scope of the present disclosure includes providing any type of force function, some of which are described in detail with reference to fig. 4A-4I. For some applications, the force function is based on movement along the x-axis, along the y-axis, or both, either calculated as two separate functions or as one function with two inputs. For some applications (e.g., where the tool has a longitudinal axis that is straight and of constant cross-section), the force is not applied based on movement along the z-axis (i.e., by retraction or advancement of the incision, the z-axis being perpendicular to the x-and y-axes) because movement along the z-axis does not result in a remote center of motion position of the violation tool being left within the incision or within the incision tract. However, if the cross-section of the tool varies along its length, movement along the z-axis may result in feedback because the position of the outer edge of the tool cross-section varies relative to the kerf or kerf region as a result of movement along the z-axis. Similarly, if the longitudinal axis of the tool is disposed at an angle relative to the z-axis, movement along the z-axis may result in feedback because the position of the outer edge of the tool cross-section changes relative to the kerf or kerf region as a result of movement along the z-axis.

Reference is now made to fig. 4A, 4B, 4C, 4D, 4E, 4F, 4G, 4H and 4I, which are graphs schematically illustrating the force applied to the control member arm as a function of distance from the outer edge of the tool to an incision in the cornea of a subject, according to a corresponding application of the present invention.

Referring to fig. 4A, for some applications, a step function is applied. As described above with reference to fig. 3A, as an example, the irrigation suction tool 46 may be inserted through the 2.6mm wide incision 40. In this example, a step function can be applied in the x-direction with a kerf width of 2.6mm:

F＝0；|x|≤1.3mm

F＝10N；|x|>1.3mm

[ function 1]

In this embodiment, the force function is applied as a function of the distance of the longitudinal axis of the tool from the center of the incision of the tool at the remote center of motion location, although the scope of the present disclosure includes calculating the force function as a function of other variables, such as the distance of the outer edge of the tool from the outer edge of the incision at the remote center of motion location of the tool. Furthermore, the scope of the present disclosure should not be construed by the particular distances and forces provided in the examples above or below. Rather, these examples are provided to demonstrate the types of force functions that may be provided. The scope of the present disclosure includes modifying these examples so that these types of force functions are applied using different distances and forces than provided.

Using function 1, when the operator moves the tool such that the axis of the tool is less than 1.3mm from the center of the cutout in either direction along the x-axis, no force is applied. When the operator moves the tool such that the axis of the tool is more than 1.3mm from the center of the incision in either direction along the x-axis, a force of 10N is applied. In this example, only the magnitude of the force is shown. The direction of the force is generally opposite to the direction of the violation, i.e. opposite to the sign of the distance. The more complete function is:

F＝0；|x|≤1.3mm

F＝-10N；x>1.3mm

F＝+10N；x<1.3mm

[ function 2]

For simplicity, the force is shown as magnitude for all other functions described herein. However, it should be appreciated that the direction of the force is generally opposite the direction of movement and is directed toward the center of the incision.

The step function shown in fig. 4A is used to create the feel of two virtual walls at the edge of the incision. When the tool is within the incision, the operator does not feel the applied force, and when trying to move the axis of the tool beyond 1.3mm from the centre of the incision, a force of 10N (in this example) opposes the operator's movement. Typically, the force is made to the maximum allowed by the device to simulate a rigid wall. For such a force function, if the operator applies a force greater than 10N (in this example), the tool edge of the tool will move out of the incision and the operator will feel a constant opposing force at the control member arm.

Other options for the force function may be applied, for example to create a different feel for the operator. One example is a linear function, as shown in fig. 4B. In this case, the farther the operator moves the tool axis from the center of the incision (or the tool edge from the edge of the incision), the greater the force applied to attempt to draw the tool back into the center of the incision. Such a function typically provides an operator with a "resilient" feel that may more accurately reflect the feel of the tool pushing against the edge of the incision than a step function. In addition, this allows the operator to push the tool past the edge of the incision while providing an indication to the operator of the extent to which the tool is pushed past the edge of the incision.

For some applications, a combination of functions is provided. For example, as shown graphically in fig. 4C, a linear function may be applied within a distance from the center of the incision, whereas when the distance from the center exceeds a certain amount (1 mm in the example shown), a linear function is applied. In this case, the operator typically does not feel resistance in the incision, but applies a force that varies linearly from the center of the incision toward the edge of the incision. This typically provides some indication to the operator that the edge of the incision is being reached or has been reached. As with the function illustrated in fig. 4B, this function allows the operator to push the tool beyond the edge of the incision while providing the operator with a tactile cue of the extent to which the tool is pushed beyond the edge of the incision.

For some applications, the parameters of the force function are configured to produce a given sensation. For example, for a linear force function, the stiffness k can be changed to change the feel of feedback using function 3 as shown below:

F＝k|x|

[ function 3]

Fig. 4D illustrates the appearance of a linear force function using different stiffness values, each line representing a different stiffness value. The lower the stiffness value, the less force is applied a given distance from the center of the incision and vice versa. For some applications, the robotic system allows the operator to select the function of the force they wish to apply and/or the level of stiffness they wish to apply (e.g., by providing input to a computer processor), and calculate the force to be applied to the operator based at least in part on the operator's selection. Some operators may prefer a force function with high stiffness (to receive a clearer indication of tool movement toward or beyond the edge of the incision), while other operators may prefer a force function with low stiffness (such that the operator applies less to the force feedback).

For some applications, different combinations of force functions are used. For example, as shown in fig. 4E, (a) no force is applied when the longitudinal axis of the tool is within a first given distance range from the center of the incision (0-0.5 mm in the illustrated example), (b) a linear force function is applied when the axis of the tool is within a second given distance range from the center of the incision (0.5 mm-1.3mm in the illustrated example), and (c) a step function is applied when the axis of the tool is within a third given distance range from the center of the incision (1.3 mm and greater in the illustrated example). For some applications, this combines the advantages of each type of function in that the operator (a) does not need to apply force feedback when approaching the center of the incision, (b) is provided with a gradual cue that the operator is approaching the edge of the incision, and (c) is provided with a "stiff wall" feel to prevent the operator from pushing the tool out of the edge or incision area of the incision.

For some applications, other types of force functions are applied, such as an exponential force function, as shown in fig. 4F, whose exponents vary as follows:

F＝b·e^a|x|+c

[ function 4]

Where a, b and c are configurable parameters and e is the euler number.

For some applications, this function is configured to give the operator increasing force feedback as they move away from the center, producing a variable stiffness feel. Other functions may also be used, such as functions that include polynomials, logarithms, or powers.

For some applications, additional combinations of functions are used. For example, as shown graphically in fig. 4G, a linear function (closer to the center of the incision) may be combined with an exponential function (further from the center of the incision).

Fig. 4A-4G graphically illustrate functions applied based on displacement along the x-axis. For some applications, a similar function applies to displacement along the y-axis. For some applications, the force applied based on displacement along the y-axis is calculated independently. Alternatively, a 2D force function is used based on displacement along the x-axis and the y-axis.

Purely by way of example, fig. 4H and 4I graphically illustrate alternative representations of examples of 2D exponential force functions applied in accordance with some applications of the invention.

For example, the function 5 given below may be used as a 2D force function:

the force output may be interpreted as a vector or an amplitude. If treated as an amplitude, the direction of the vector is generally toward the center of the notch.

Reference is now made to fig. 5, which is a flow chart illustrating steps of a procedure according to some applications of the present invention. In a first step 60, the tool 21 is inserted into the incision 40 (the tool and incision are shown in fig. 3A-3B). In a second step 62, the force feedback function of the control unit is activated. Depending on the respective application, the force feedback function of the control member unit is activated automatically (in response to detecting that a tool has been inserted into the incision) or manually by an operator. As described above, for some applications, the operator selects the type and/or stiffness of the force function for feedback. Subsequently, the computer processor detects whether the tool is still within the patient's eye (step 64). Assuming the tool is still in the eye, the computer processor calculates the distance between the axis of the tool and the center of the incision at a remote center of motion location along the tool (step 66). (alternatively or additionally, as described above, the computer processor calculates the distance between the edge of the tool and the edge of the incision or the end of the incision tract at a remote center of motion location along the tool.) based on step 66, the computer processor calculates the magnitude and direction of the force to be provided to the operator by the control component unit (step 68). In step 70, the force calculated in step 68 is applied. Assuming that the tool is no longer in the eye as detected in step 64, the force feedback ceases (step 72). The force feedback function of the control member unit is terminated automatically (in response to detecting that the tool has been removed from the incision) or manually by an operator, depending on the respective application.

Reference is now made to fig. 6A, 6B and 6C, which are schematic illustrations of a joystick 30 and a control member tool 32 of the control member unit 26 according to some applications of the present invention. As shown in fig. 6A, 6B, and 6C, for some applications, the joystick 30 is configured as a control component arm that includes two or more links 80A, 80B, 80C connected via swivel arm joints 82A, 82B, 82C. The terms "joystick" and "control member arm" are used interchangeably throughout this disclosure. For some applications, a respective motor 84A, 84B, 84C is configured to control movement of each rotary arm joint to provide feedback to the operator. Typically, the feedback effectively causes the position 86 on the control component tool 32 to feel like the center of motion of the control component tool, such that movement of the position in a given direction will provide a feedback force to the operator. Generally, the strength and direction of the feedback force will be consistent with one of the examples described above. Further, typically, the total vector of forces will consist of forces in the x, y and z directions of the control component tool (as shown in fig. 6A). Note that the x, y, and z directions of the control member tool do not necessarily directly correspond to the x, y, and z directions of the ophthalmic tool 21 (as described above).

Referring to fig. 6B and 6C, note that typically, most motors (e.g., at least two motors (motors 84B and 84C)) apply torque directly to the rotating arm joint without the need for gears or a conveyor belt to transfer force, i.e., they are direct drive motors. For some applications, at least one motor (84A) applies torque to one rotating arm joint (82A) via a conveyor belt 88. Typically, a conveyor belt is used so that the motor can be positioned closer to the base 90 of the control member unit (the base 90 is shown in fig. 7) so as to be placed closer to the rotary arm joint 82A relative to the third motor, reducing the weight and inertia perceived by the operator.

Note that in order to increase the richness of feedback provided by the joystick to the operator reflecting the remote center of motion position of the ophthalmic tool relative to the position of the incision, a greater number of control component motors are preferably used. For example, for some applications, six motors are used such that the control component is configured to apply a 3D force vector and a 3D torque vector. The scope of the present disclosure includes using one to six motors to provide feedback to an operator via a control component. However, the use of more than three motors generally increases the weight and complexity of the joystick design. Furthermore, the inventors have found that the feedback provided using three motors adequately reflects the position of the remote center of motion of the ophthalmic tool relative to the incision, thereby assisting the operator. Thus, as shown in fig. 6A and 6B, each joystick typically includes three motors.

Reference is now made to fig. 7, which is a schematic illustration of some additional components of the control component unit 26 according to some applications of the present invention. Typically, each control component arm includes, in addition to the motor described above, a respective rotary encoder 92 coupled to each of the three rotary arm joints 82A, 82B, 82C (e.g., as described in U.S. patent application 17/818,477, which is a continuation of WO 22-023962 of Glozman, which is incorporated herein by reference). The rotary encoder is configured to detect movement of the respective rotary arm joint and generate rotary encoder data in response thereto. For some applications, the control component arm additionally includes an inertial measurement unit 94, and the inertial measurement unit 76 includes a tri-axial accelerometer, tri-axial gyroscope, and/or tri-axial magnetometer. The rotary encoder and inertial measurement unit are collectively referred to herein as a "position sensor". The inertial measurement unit generally generates inertial measurement unit data related to the three-dimensional orientation of the control component arm in response to the control component arm being moved. For some applications, the computer processor 28 receives rotary encoder data and inertial measurement unit data. Typically, the computer processor determines the XYZ position of the tip of the control component tool 32 based on the rotary encoder data and determines the orientation (e.g., another representation of the 3 euler orientation angles and/or orientations) of the tip of the control component tool 32 based on the inertial measurement unit data or based on a combination of the rotary encoder data and the inertial measurement unit data. Thus, the computer processor is configured to determine the XYZ position and orientation of the tip of the control component tool based on a combination of the rotary encoder data and the inertial measurement unit data.

For some applications, the computer processor drives the robotic unit such that the tip of the ophthalmic tool used to perform the procedure tracks movement of the tip of the control component tool. For some applications, the computer processor drives the robotic unit such that the tip of the ophthalmic tool used to perform the procedure tracks the movement of the tip of the control component tool in six degrees of freedom. Typically, incorporating an inertial measurement unit to detect the three-dimensional orientation of the control member arm allows an operator to control movement of the robotic unit using a reduced number of sensors (relative to the case where rotary encoders are used to detect movement of the control member arm in all six degrees of freedom). Furthermore, in general, reducing the number of rotary encoders used tends to reduce the overall complexity of the control member arm, as introducing additional rotary encoders would require additional cords to pass through the rotary joint.

Despite the complexity associated with having additional rotary encoders, for some applications the control component arm includes more than three rotary encoders and inertial measurement units for redundancy, i.e., so that in the event of failure of some position sensors, the system can use additional position sensors. For some such applications, the control component arm includes an additional rotary encoder at each rotary arm joint for redundancy. Furthermore, for some applications, in addition to the inertial measurement unit, for redundancy, the control component includes rotary encoders to detect roll, pitch and yaw of the tool 32 of the control component tool. For some such applications, the tool 32 is coupled to the control component arm by three rotary tool joints corresponding to roll, pitch, and yaw of the tool 32. Typically, the rotary encoders described above detect movement of a corresponding rotary tool joint through which the control member tool is coupled to the control member arm.

Although some applications of the application are described with reference to cataract surgery, the scope of the application includes application of the devices and methods described herein to other medical procedures with appropriate modifications. In particular, the devices and methods described herein for other medical procedures may be applied to other microsurgery, such as general surgery, orthopedic surgery, gynecological surgery, otorhinolaryngological surgery, neurosurgery, oral maxillofacial surgery, orthopedic surgery, podiatric surgery, vascular surgery, and/or pediatric surgery performed using microsurgical techniques. For some such applications, the imaging system includes one or more microscopic imaging units.

It should be noted that the scope of the present application includes application of the devices and methods described herein, with appropriate modifications, to intraocular procedures other than cataract surgery. Such procedures may include collagen crosslinking, endothelial keratoplasty (e.g., DSEK, DMEK, and/or PDEK), DSO (post-corneal elastic delamination without grafting), laser assisted keratoplasty, LASIK/PRK, SMILE, pterygium, ocular surface cancer treatment, secondary IOL implantation (post-suture secondary IOL implantation, transconjugulated secondary IOL implantation, etc.), iris repair, IOL replacement, superficial keratotomy, minimally Invasive Glaucoma Surgery (MIGS), limbal stem cell transplantation, astigmatic keratotomy, limbal Relief (LRI), amniotic Membrane Transplantation (AMT), glaucoma surgery (e.g., trabeculectomy (trabs), catheterization (tubes), minimally invasive glaucoma surgery), automatic Lamellar Keratoplasty (ALK), anterior vitrectomy, and/or anterior pars vitrectomy.

Applications of the invention described herein may take the form of a computer program product accessible from a computer-usable or computer-readable medium (e.g., non-transitory computer-readable medium) providing program code for use by or in connection with a computer or any instruction execution system (e.g., computer processor 28). For the purposes of this description, a computer-usable or computer readable medium can be any apparatus that can contain, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device. The medium can be an electronic medium, a magnetic medium, an optical medium, an electromagnetic medium, an infrared medium, or a semiconductor system (or apparatus or device) or a propagation medium. Generally, a computer-usable or computer-readable medium is a non-transitory computer-usable or computer-readable medium.

Examples of a computer-readable medium include a semiconductor or solid state memory, magnetic tape, a removable computer diskette, a Random Access Memory (RAM), a read-only memory (ROM), a rigid magnetic disk and an optical disk. Current examples of optical discs include compact disc read only memory (CD-ROM), compact disc read/write (CD-R/W), DVD, and USB drives.

A data processing system suitable for storing and/or executing program code will include at least one processor (e.g., computer processor 28) coupled directly or indirectly to memory elements through a system bus. The memory elements can include local memory employed during actual execution of the program code, bulk storage, and cache memories which provide temporary storage of at least some program code in order to reduce the number of times code must be retrieved from bulk storage during execution. The system may read the inventive instructions on the program storage device and follow those instructions to perform the methods of the embodiments of the present invention.

Network adapters may be coupled to the processor to enable the processor to become coupled to other processors or remote printers or storage devices through intervening private or public networks. Modems, cable modem and Ethernet cards are just a few of the currently available types of network adapters.

Computer program code for carrying out operations of the present invention may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, smalltalk, C + + and the like and conventional procedural programming languages, such as the C programming language or similar programming languages.

It will be appreciated that the algorithms described herein may be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer (e.g., computer processor 28) or other programmable data processing apparatus, create means for implementing the functions/acts specified in the algorithm described in this specification. These computer program instructions may also be stored in a computer-readable medium (e.g., a non-transitory computer-readable medium) that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable medium produce an article of manufacture including instruction means which implement the function/act specified in the algorithm. The computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide processes for implementing the functions/acts specified in the algorithm(s) described in the present application.

The computer processor 28 is typically a hardware device programmed with computer program instructions to produce a special purpose computer. For example, when the computer processor 28 is programmed to execute the algorithms described with reference to the drawings, the computer processor 28 typically acts as a dedicated robotic system computer processor. In general, the operations described herein performed by computer processor 28 transform the physical state of memory (which is a real physical object) into having different magnetic polarities, charges, etc., depending on the memory technology used. For some applications, operations described as being performed by a computer processor are performed by multiple computer processors in combination with one another.

It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and sub-combinations of the various features described hereinabove, as well as variations and modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not in the prior art.

Claims

1. An apparatus for performing a procedure on an eye of a patient using an ophthalmic tool having a tip, the apparatus comprising:

A robotic unit configured to move the ophthalmic tool; and

A control unit, the control unit comprising:

At least one control component arm coupled to the control component tool and including one or more position sensors, and;

2. The apparatus of claim 1, wherein the control component arm comprises a plurality of links coupled to one another via a rotating arm joint, and wherein the one or more position sensors comprise:

3. The apparatus of claim 1, wherein the control component arm comprises a plurality of links coupled to each other via swivel arm joints, and wherein the control component tool is coupled to the control component arm via three swivel tool joints, and wherein the one or more position sensors comprise:

Two rotary encoders coupled to each of the rotary arm joints and configured to detect movement of the rotary arm joints and, in response to detecting movement of the rotary arm joints, generate rotary encoder data indicative of XYZ positions of the tip of the control component tool; and

4. The apparatus of any of claims 1-3, wherein the computer processor is configured to provide feedback to the operator indicating the placement of the remote center of motion position of the ophthalmic tool relative to the incision by generating an alert when the ophthalmic tool is moved such that the remote center of motion position of the ophthalmic tool is within a given distance from the edge of the incision.

5. The apparatus of claim 4, wherein the computer processor is configured to generate an audio alert.

6. The apparatus of claim 4, wherein the computer processor is configured to generate a visual alert.

7. The apparatus of any of claims 1-3, wherein the computer processor is configured to provide feedback to the operator indicating the placement of the remote center of motion position of the ophthalmic tool relative to the incision by providing force feedback to the operator via the control component arm.

8. The apparatus of claim 7, wherein the computer processor is configured to:

9. The apparatus of claim 7, wherein the computer processor is configured to provide force feedback to the operator via the control component by:

a speed measurement is performed on the control means tool,

The control means is driven to apply the calculated force to the operator.

10. The apparatus of claim 7, wherein the computer processor is configured to provide force feedback to the operator via the control component arm by:

measuring the position of the ophthalmic tool relative to the incision,

The control member arm is driven to apply the calculated force to the operator.

11. The apparatus of claim 7, wherein the computer processor is configured to calculate the force to be applied to the operator by calculating a force equal to and opposite to the force applied by the operator to the control component tool.

12. The apparatus of claim 7, wherein the computer processor is configured to calculate a force to be applied to the operator by calculating a force proportional to a distance of an outer edge of the ophthalmic tool from a center of the incision.

13. The apparatus of claim 7, wherein the computer processor is configured to receive an input from the operator indicating a stiffness of the force feedback the operator wishes to receive, and to calculate a force to be applied to the operator based at least in part on the input from the operator.

14. The apparatus of claim 7, wherein the computer processor is configured to constrain movement of the control component tool in a manner corresponding to how movement of the remote center of motion position of the ophthalmic tool relative to the incision should be constrained.

15. The apparatus of claim 14, wherein the computer processor is configured to constrain movement of the control component tool in a manner that constrains the remote center of motion position of the ophthalmic tool to remain within an incision area that is larger than the incision.

16. The apparatus of claim 14, wherein the computer processor is configured to constrain movement of the control component tool in a manner that constrains the remote center of motion position of the ophthalmic tool to remain within the incision.

17. The apparatus of claim 7, wherein the computer processor is configured to calculate the force to be applied to the operator by calculating a force function based on a distance of an outer edge of the ophthalmic tool from a center of the incision in both directions.

18. The apparatus of claim 17, wherein a first of the two directions is parallel to the incision and tangential to the cornea of the patient's eye at the incision, and a second of the two directions is perpendicular to the first direction and tangential to the cornea of the patient's eye at the incision.

19. A device according to any one of claims 1-3, wherein:

the control component arm includes a plurality of links coupled to each other via swivel arm joints, and one or more motors operably coupled to respective swivel arm joints; and

20. The apparatus of claim 19, wherein the control component arm comprises exactly three motors operably coupled to respective joints.

21. The apparatus of claim 19, wherein the control component arm comprises a conveyor belt, and at least one of the motors is operatively coupled to a respective one of the rotary arm joints via the conveyor belt such that the at least one of the motors is disposed closer to the base of the control component unit than if the at least one of the motors directly driven the respective one of the rotary arm joints.

22. The apparatus of claim 19, wherein a majority of the one or more motors directly drive a respective one of the rotary arm joints to which the one or more motors are operatively coupled.

23. The apparatus of claim 19, wherein the one or more position sensors comprise:

24. The apparatus of claim 19, wherein the control component tool is coupled to the control component arm via three rotary tool joints, and wherein the one or more position sensors comprise:

25. An apparatus for performing a procedure on an eye of a patient using an ophthalmic tool having a tip, the apparatus comprising:

a robotic unit configured to move the tool;

a control unit, the control unit comprising:

a plurality of links coupled to each other via a rotary arm joint;

one or more position sensors; and

One or more of the motors may be provided, the one or more motors are operably coupled to respective rotary arm joints:

26. The apparatus of claim 25, wherein the control component comprises exactly three motors operably coupled to respective rotary arm joints.

27. The apparatus of claim 25, wherein the control component arm comprises a conveyor belt, and at least one of the motors is operatively coupled to a respective one of the rotary arm joints via the conveyor belt such that the at least one of the motors is disposed closer to the base of the control component unit than when the at least one of the motors directly drives the respective one of the rotary arm joints.

28. The apparatus of claim 25, wherein a majority of the one or more motors directly drive a respective one of the rotary arm joints to which the one or more motors are operatively coupled.

29. The apparatus of claim 25, wherein the one or more position sensors comprise:

Three rotary encoders, each coupled to a respective one of the rotary arm joints and configured to detect movement of the respective rotary arm joint and, in response to detecting movement of the respective rotary arm joint, generate rotary encoder data indicative of XYZ position of a tip of the control component tool; and

30. The apparatus of claim 25, wherein the control component tool is coupled to the control component arm via three rotary tool joints, and wherein the one or more position sensors comprise:

31. The apparatus of any of claims 25-30, wherein the computer processor is configured to:

32. The apparatus of claim 31, wherein the computer processor is configured to:

33. The apparatus of claim 31, wherein the computer processor is configured to provide force feedback to the operator via the control component by:

a speed measurement is performed on the control means tool,

34. The apparatus of claim 31, wherein the computer processor is configured to provide force feedback to the operator via the control component by:

measuring the position of the ophthalmic tool relative to the incision,

The control means is driven to apply the calculated force to the operator.

35. The apparatus of claim 31, wherein the computer processor is configured to calculate the force to be applied to the operator by calculating a force equal to and opposite to the force applied by the operator to the control component tool.

36. The apparatus of claim 31, wherein the computer processor is configured to calculate the force to be applied to the operator by calculating a force proportional to the distance of the outer edge of the ophthalmic tool from the center of the incision.

37. The apparatus of claim 31, wherein the computer processor is configured to receive an input from the operator indicating a stiffness of the force feedback the operator wishes to receive, and to calculate a force to be applied to the operator based at least in part on the input from the operator.

38. The apparatus of claim 31, wherein the computer processor is configured to constrain movement of the control component tool in a manner corresponding to how movement of the remote center of motion position of the ophthalmic tool relative to the incision should be constrained.

39. The apparatus of claim 38, wherein the computer processor is configured to constrain movement of the control component tool in a manner that constrains the remote center of motion position of the ophthalmic tool to remain within an incision area that is larger than the incision.

40. The apparatus of claim 38, wherein the computer processor is configured to constrain movement of the control component tool in a manner that constrains the remote center of motion position of the ophthalmic tool to remain within the incision.

41. The apparatus of claim 31, wherein the computer processor is configured to calculate the force to be applied to the operator by calculating a force function based on a distance of an outer edge of the ophthalmic tool from a center of the incision in both directions.

42. The apparatus of claim 41, wherein a first of the two directions is parallel to the incision and tangential to a cornea of the patient's eye at the incision, and a second of the two directions is perpendicular to the first direction and tangential to a cornea of the patient's eye at the incision.

43. An apparatus for performing surgery on an eye of a patient using a plurality of ophthalmic tools, each of the plurality of ophthalmic tools having a tip, the apparatus comprising:

A robotic unit configured to move the ophthalmic tool; and

Determining an identity of the ophthalmic tool that has been inserted into the patient's eye;

44. A method of performing surgery on an eye of a patient using an ophthalmic tool having a tip, the method comprising:

45. A method of performing surgery on an eye of a patient using an ophthalmic tool having a tip, the method comprising:

46. A method for performing surgery on an eye of a patient using a plurality of ophthalmic tools, each of the plurality of ophthalmic tools having a tip, the method comprising:

47. An apparatus for robotic microsurgery of an eye of a patient using one or more tools, the apparatus comprising:

An end effector;

48. The device of claim 47, wherein the output unit comprises a display that displays the incision tract and the location of the tool within the incision tract.

49. The apparatus of claim 47, wherein the output unit comprises an output unit configured to generate an alarm when the tool is moved such that a position of the tool into the patient's eye is proximate to an edge of the incision tract.

50. The apparatus of any of claims 47-49, wherein the output unit comprises a portion of the control component configured to provide haptic feedback to the operator.

51. The apparatus of claim 50, wherein the control component is configured to increase resistance to movement of the control component as the tool enters the patient's eye in a position closer to the edge of the incision tract.