System for assisting injection in intraocular surgery

Abstract

Disclosed herein are system, apparatus, articles of manufacture, methods, computer program product embodiments, and combinations and sub-combinations thereof for assisting an injection in an intraocular procedure, comprising: a robotic arm; a control unit configured to control the robot arm; a targeting instrument mounted on the robotic arm, where the targeting instrument is configured to aim at a target location, where an orientation of the robotic arm in a direction of the target location is saved in a memory of a control unit for access, and where the targeting instrument is further configured to be replaced with an injection instrument; and the injection instrument mounted on the robotic arm, where the injection instrument is configured to be positioned in a preserved orientation of the robotic arm at the target location, and where the injection instrument is further configured to inject into the target location.

Description

Technical Field

[0001] This disclosure generally relates to a surgical instrument mounted on a surgical robotic arm to assist and guide injections for minimally invasive intraocular surgery, and specifically to a system for assisting injections during intraocular surgery. Background Technology

[0002] In recent years, surgical robots have been increasingly used to perform minimally invasive surgeries, including intraocular surgeries. Robot-assisted surgery can enhance the capabilities of surgeons performing procedures. Typically, surgeons use a computer with a controller to control surgical instruments used during surgery, rather than their own hands. This controller allows the surgeon to perform surgery-related movements, but the robotic arm uses various surgical instruments depending on the surgery to make these movements via instructions from the controller. Similarly, a computer-controlled system can control the robotic arm following input from the surgeon.

[0003] This type of robot is typically used to treat retinal abnormalities or diseases through various types of surgery, such as vitrectomy or subretinal injection. Surgery can remove material that prevents light from focusing properly on the retina, or remove wrinkled or torn retinal scar tissue that causes poor vision. Additionally, this surgery can repair retinal detachment or macular holes. Within the eye, the accumulation of clumped protein chains makes lateral movement within the eye difficult with certain surgical instruments. Movement within the eye is challenging because vitreous material is attached to retinal tissue, and such lateral movement within the vitreous material can lead to retinal tears, which is undesirable. To treat different points of interest along the retina and minimize traction on the retina, it is desirable to move the surgical instruments from the cannula along a straight trajectory to the location of interest.

[0004] Typically, subretinal injections require vitrectomy, an ocular surgical procedure that can treat various problems with the retina and vitreous body, and must be performed on the patient before the actual subretinal injection. Vitrectomy involves altering the trajectory of the vitrectomy device or vitreous cutter during approach to the retina. In cases where the vitrectomy device inadvertently collides with the posterior surface of the lens, this can lead to the formation of a cataract in the patient's eye, which then requires further surgery and procedures. Typically, during a vitrectomy, fluid in the eye is removed or aspirated and replaced with water, silicone oil, or saline; however, this carries numerous risks and potential problems afterward.

[0005] Therefore, there is a need for a system for moving surgical instruments linearly or axially within the eye. As described herein, such a system would preemptively prevent vitrectomy. Summary of the Invention

[0006] This document provides examples, combinations, and sub-combinations of systems, devices, methods, and computer programs for surgical instruments mounted on a surgical robotic arm to assist and guide injections for minimally invasive intraocular surgery.

[0007] According to one aspect of this disclosure, a system for assisting injection during intraocular surgery may include: a robotic arm; a control unit configured to control the robotic arm; a targeting device mounted on the robotic arm, wherein the targeting device is configured to aim at a target location, wherein the orientation of the robotic arm in the direction of the target location is stored in a memory for access, and wherein the targeting device is further configured to be replaced with an injection device; and an injection device mounted on the robotic arm, wherein the injection device is configured to be positioned on the robotic arm in the stored orientation at the target location, and wherein the injection device is further configured to inject into the target location.

[0008] In some embodiments, the targeting device is a laser device.

[0009] In some embodiments, the targeting device emits a beam of light in the orange, green, or red wavelength spectrum at the target location.

[0010] In some embodiments, the injection device is a needle or a subretinal injection needle.

[0011] In some embodiments, the target location is a surface point on the retina.

[0012] In some embodiments, the orientation preserved by the robotic arm at the target location includes a representation of the robotic arm's remote center of motion.

[0013] In some embodiments, the robotic arm is configured to move the injection device axially.

[0014] According to one aspect of this disclosure, a method for assisting injection during intraocular surgery may include: mounting a targeting device on a robotic arm; positioning the targeting device at a target location; saving the orientation of the robotic arm at the target location; replacing the targeting device with an injection device on the robotic arm; accessing the saved orientation of the robotic arm; positioning the injection device at the saved location; and administering an injection at the target location via the injection device.

[0015] According to one aspect of this disclosure, a method for assisting injection during intraocular surgery may include: mounting an injection device on a robotic arm; accessing a stored location, wherein the stored location is the orientation of the robotic arm at a target location, the target location being targeted via a targeting device previously mounted on the robotic arm; positioning the injection device at the stored location, wherein the stored location includes a representation of the remote center of motion of the robotic arm; and injecting at the target location via the injection device. Attached Figure Description

[0016] The accompanying drawings are incorporated herein by reference and form part of the specification.

[0017] Figure 1 A robot according to some embodiments is shown, which includes surgical instruments mounted on a robotic arm.

[0018] Figure 2A A procedure for mounting surgical instruments for aiming at a target location is shown according to some embodiments.

[0019] Figure 2B The procedure for a surgical instrument for aiming at a target location is shown according to some embodiments.

[0020] Figure 3A Procedures for mounting surgical instruments for injection at a target site are shown according to some embodiments.

[0021] Figure 3B The procedure for a surgical instrument for injecting at a target site, according to some embodiments, is shown.

[0022] Figure 4 A method is shown for mounting surgical instruments on a surgical robotic arm to assist and guide injections for minimally invasive intraocular surgery, according to some embodiments.

[0023] Figure 5 Example computer systems, according to some embodiments, are shown that can be used to implement various embodiments.

[0024] In the accompanying drawings, similar reference numerals generally indicate the same or similar elements. Additionally, the leftmost numeral of the reference numerals typically indicates the drawing in which that reference numeral first appears. Detailed Implementation

[0025] This document provides examples, combinations, and sub-combinations, of systems, devices, apparatuses, methods, and computer programs for use with surgical instruments mounted on a surgical robotic arm to assist and guide injections for minimally invasive intraocular surgery.

[0026] To provide a procedure for moving surgical instruments linearly or axially, various surgical instruments can be used on the robot. These instruments can include, but are not limited to, targeting instruments, removal instruments, and injection instruments. By moving the injection instrument axially, a more precise injection can be performed at the target location. Axial movement allows the surgical instrument to pass through the vitreous humor without exerting traction on the retina. Furthermore, this precise injection eliminates the need for vitrectomy. Avoiding vitrectomy not only saves time due to fewer procedures but also reduces the cost of such surgery. Subsequently, the surgical instrument can be moved laterally.

[0027] For example, a surgeon performing such an injection manually may experience slight hand movement during the injection. Even small movements in any direction can lead to injection in the wrong location within the eye or cause widening of the retinal aperture. Such problems can lead to reflux and inflammation in the eye. Additionally, movement of the surgeon's hand may cause the injection to be too deep into the eye, which can also lead to complications. By aiming at and maintaining the target location, the precision of injections into the eye can be improved. This precision, due to the use of a robot, prevents further complications of the eye later in the patient's life. While the methods and systems described herein relate to intraocular surgery, using these methods and systems in conjunction with a robot can be applied to other (microsurgical) procedures performed on humans or animals.

[0028] The target location may be known to the surgeon. The surgeon may have already deduced the target location from images created by optical coherence tomography (OCT). OCT is an imaging technique typically used to produce images with micrometer-level depth resolution by using interferometry and light with short coherence lengths. OCT imaging uses a beam of light and lateral scans of light reflected from within the eye. Additionally, the target location may be known because certain gene therapy drugs should be injected at specific points along the retina. Furthermore, the surgeon can use intraoperative optical coherence tomography (iOCT) with a microscope to help identify the target location. The surgeon may also know the target location during surgery, during visual feedback from the microscope.

[0029] Figure 1 A robot 100 according to some embodiments is shown, the robot including surgical instruments 134 mounted on a robotic arm 130. The robot 100 may include surgical instruments 134 all mounted on the robotic arm 130 and a distal end 134b of the surgical instruments. The robotic arm 130 may be connected to a control unit 140. The surgical instruments 134 may be inserted during surgery through a cannula 138 placed in an eye 110 using a cannula port 136 to perform a desired function on the eye 110.

[0030] The robotic arm 130 can move the surgical instrument 134 in the axial direction and orient it. The orientation of the robotic arm 130 can be saved for later access.

[0031] In some embodiments, the surgical instrument 134 may be a targeting instrument, a removal instrument, or an injection instrument, depending on the desired function during the procedure. A cannula 138, typically used in minimally invasive ophthalmic surgery, may include a cannula or seal (not shown). The cannula 138 may assist in the aspiration of fluid from the body (e.g., the eye 110), or it may be used to guide the surgical instrument 134 toward the eye 110. The cannula 138 is the entry point for any surgical instrument 134 into the eye 110. The surgical instrument 134 may be a laser device, microsurgical forceps, a needle, a micropickup device, or a subretinal injection needle, etc. For example, a removal instrument may be a microsurgical forceps that assist in the removal or peeling of a membrane from the retina of the eye 110.

[0032] The robotic arm 130 may include a cannula holder (not shown). The cannula holder can further assist in guiding the surgical instrument 134 toward the eye 110, as it ensures a secure connection from the robotic arm 130 to the eye 110. The cannula port 136 is inserted into the eye, allowing various functions to be performed on the eye 110. The distal end 134b of the surgical instrument is the portion of the surgical instrument 134 that first enters the cannula 138 and then advances toward the interior of the eye 110. The distal end 134b of the surgical instrument can assist or aid in targeting within the eye 110, injecting into the eye 110, dissecting within the eye 110, scraping away debris (such as clumps of protein chains or membranes) within the eye 110, etc.

[0033] The cannula 138 may include a cannula port 136 that is placed on and pierces the surface of the eye 110. The cannula 138 secures the entry point of the surgical instrument 134. Due to this secured entry point, the cannula 138 can act as a remote center of motion (RCM) of the robotic arm 130 via a cannula holder. The RCM can be considered a remote anchor point around which the surgical instrument 134 can rotate, without a physical swivel joint. Tools on the robotic arm 130 (such as the surgical instrument 134) will enter the eye 110 via the cannula 138 and can then move laterally (i.e., rotate) and axially in the direction of the instrument axis, thereby advancing and retracting the surgical instrument 134 as needed.

[0034] Surgeons can perform surgery by controlling the robotic arm 130 via a controller (not shown) that manipulates the robotic arm 130 through a control unit 140. The control unit 140 may be included in... Figure 5In the computer system 500 further described below, a control unit 140 can assist in the control of the robot 100 or the robot arm 130. The control unit 140 can send electronic control signals to the motors (not shown) of the robot arm 130. In response to receiving the control signals, the motors can rotate the robot arm 130 to a certain position. In addition, the motors can move the surgical instrument 134, which is in an axial position, to a certain position.

[0035] In some embodiments, the robotic arm 130 can move a surgical instrument 134 toward the eye 110 via a cannula 138, the surgical instrument 134 performing a desired function requested by the surgeon. Typically, the robotic arm 130 responds to the surgeon's desired movement. The robotic arm 130 has a duty cycle of approximately 1 kHz, thus achieving a latency of up to 1 ms, which is extremely low.

[0036] Figure 2A A procedure 200, according to some embodiments, for mounting a surgical instrument 134 on a robotic arm 130 for aiming at a target location 212 is illustrated. The procedure 200 may include the robotic arm 130, the surgical instrument 134, and a laser beam 242 incident on an eye 110 via a cannula 138 through a cannula port 136. The eye 110 may include a substance 210. The eye 110 may further include a target location 212. The target location 212 may be the location where the surgeon wants to inject the substance. Although only one target location 212 is depicted in Figures 2 and 3, more target locations 212 can be envisioned along the eye 110.

[0037] The substance to be injected can be a fluid. For example, the fluid can be or include a therapeutic agent, which can encompass a wide range of liquid formulations, including solutions, suspensions, emulsions, or colloids. Therapeutic agents can contain active pharmaceutical ingredients, such as drugs, biological agents (including proteins, peptides, nucleic acids, or cells), and excipients or additives (such as stabilizers, preservatives, or buffers). Furthermore, fluids can be designed for various therapeutic purposes, such as analgesia, antibiotic therapy, anti-inflammatory therapy, or chemotherapy.

[0038] Additionally, the target location 212 can be a point within the retina of the eye 110 (such as the subretinal space), a surface point on the retina, a point on the surface of the optic disc, or a point within the optic disc of the eye 110. The target location 212 can also be a vein, artery, or blood vessel.

[0039] The eye 110 may include a substance 210 permeating the eye, such as coagulated protein chains or membranes, through which the surgical instrument 134 has difficulty moving laterally. The substance 210 may be, for example, vitreous humor or vitreous fibers made of collagen. This substance may also be a jelly-like substance within the eye 110, resembling a spaghetti-like structure that fills the eye 110. Typically, when the tip of the surgical instrument 134 is to be moved to the target location 212, it will be necessary to change the orientation of the surgical instrument 134, which may lead to future ocular complications.

[0040] Movement of the surgical instrument 134 through the material 210 may cause tension in the retina and potential damage to the retina or eye 110. However, in this disclosure, the surgical instrument 134 may be a targeting instrument (such as a laser device) and directly aimed at a target location 212. By aiming at the target location 212, the position of the robotic arm 130 aimed at the target location 212 can be saved, and the laser device does not need to enter the eye 110. Once the position of the robotic arm 130 aimed at the target location 212 is saved (via laser point 244), the surgical instrument 134 can be replaced with an injection device for further procedures, as illustrated in Figure 3. The saved position may include the orientation of the robotic arm 130.

[0041] In some embodiments, the surgical instrument 134 may be a targeting instrument (such as a laser device) and may be mounted to the robotic arm 130. The laser device may be introduced into the eye 110 via a cannula 138 using the cannula port 136. The laser device may assist in looking into the posterior segment of the eye 110, but does not necessarily need to enter the eye 110 completely. The posterior segment may include the posterior two-thirds of the eye 110 and may further include vitreous fluid, the retina, the choroid, and the optic nerve.

[0042] The laser device can be inserted through the cannula 138 with minimal insertion, ensuring that the laser beam reaches the target position 212 correctly without beam distortion. In some cases, the laser device can be flush with the end of the cannula 138, but this is not necessary.

[0043] In some embodiments, the laser device may include a laser diode from which a laser beam 242 is emitted and is harmless to the eye 110. The laser beam 242 may be able to visualize the orientation of the robotic arm 130 using the macula or the near-peripheral region surrounding the macula in the retina and the reflection of the laser beam 242 as it is emitted into the vitreous material of the eye 110. This reflection from the laser beam 242 can be used to recreate the orientation of the robotic arm 130 via the cannula 138. This orientation will determine the path in which the injection instrument will pass through the vitreous and enter the injection site on the macula or in the near-peripheral region surrounding the macula in the retina, as described later in Figure 3.

[0044] For example, the surgeon can see the retina and laser point 244 through a microscope (not shown) and can adjust the orientation of the robotic arm 130. The adjustment can continue until the laser point 244 is on the target position 212, which is the desired location on the retina by the surgeon. This target position 212 is later the injection site.

[0045] The laser device does not need to be fully inserted into the cannula 138, as only the position of the generated laser beam 242 is required. The laser device enters the eye 110 with minimal penetration through the cannula 138.

[0046] The orientation of the robotic arm 130 may include rotation about a fixed point caused by the remote center of motion of the robot 100. The motors (not shown) of the robotic arm 130 are aware of this orientation to be maintained when the surgical instrument 134 is correctly positioned. The maintained position specifically includes the orientation of the robotic arm 130. The orientation of the robotic arm 130 may be defined by two rotational degrees of freedom. The RCM, which serves as the entry point for the surgical instrument 134 into the cannula 138, remains constant throughout the procedure. These two rotational degrees of freedom can be changed and maintained, allowing the surgical instrument 134 to re-reach the target position 212.

[0047] Figure 2B A procedure 250 for aiming a surgical instrument 134 at a target location 212, according to some embodiments, is shown. The procedure 250 may include a robotic arm 130, the surgical instrument 134, and a laser beam 242, the laser point 244 of which is targeted within an eye 110 via a cannula 138 using a cannula port 136, which may include a target location 212 near the material 210.

[0048] Once the surgical instrument 134 (in this case, the laser device) has been positioned to aim at the target location 212, the surgical instrument 134 can directly aim the laser beam 242 at the target location 212. The laser beam 242 can be in the orange, green, or red wavelength spectrum, with a wavelength between 500 nm and 750 nm. For example, a low-intensity laser beam 242 can be used, which reduces the chance of injury to the eye 110 during the procedure. Once the laser beam 242 is incident on the target location 212, a laser spot 244 is generated.

[0049] In some embodiments, the surgical instrument 134 can target a target location 212 after receiving instructions from the robotic arm 130. For example, the surgeon may have already seen an optical scan of the patient's eye 110. The surgeon will know where to aim the surgical instrument 134 at the target location 212, based on the scan of the eye 110, and guide the laser device to the correct location, in this case, the target location 212. The surgeon can use an image seen from a microscope (not shown) to move the laser device to the target location 212 via a controller. Additionally, the surgeon will later know how deep the injection should be based on the scan of the eye 110. If the injection is too deep into the retina, the eye 110 may be damaged.

[0050] The coordinates of the laser device incident on the target position 212 can be stored. The target position may include the orientation of the robot arm 130 relative to a remote motion center. The remote motion center relative to the orientation of the robot arm 130 allows the robot arm 130 to be brought back to this accurate orientation and posture.

[0051] Once the orientation of the robotic arm 130 at target position 212 is saved, the targeting instrument (in this case, a laser device) can be retracted from the eye 110. The surgical instrument 134 on the robotic arm 130 can be replaced with a different surgical instrument 134 (e.g., an injection device, which could be a subretinal injection needle). The orientation of the robotic arm 130 positioned at target position 212 can be saved and can be the desired trajectory of the injection device, as illustrated in Figure 3.

[0052] In some embodiments, the surgical instrument may include an integrated optical fiber for aiming at target position 212. If an integrated optical fiber is used, there is no need to replace the instrument, because the injection device and the optical fiber can be integrated together as surgical instrument 134.

[0053] Figure 3A A procedure 300 for mounting a surgical instrument 134 for injection at a target location 212, according to some embodiments, is shown. The procedure 300 may include a robotic arm 130, a surgical instrument 134, and a distal end 134b of the surgical instrument for injection into an eye 110 via a cannula 138 using a cannula port 136, which may include a target location 212 near the substance 210.

[0054] The robotic arm 130 previously moved slightly away from the patient's eye 110 automatically via a controller on the robot 100 or via a processor, but without disconnecting from the eye 110. The robotic arm 130 can be moved away so that the target position 212 can be reached again without lateral movement of the surgical instrument 134. Because the position of the RCM point has been saved, the control system 140 allows the target position 212 to be found again. The robotic arm 130 will not disengage from the eye 110 via the cannula port 136. The connection between the cannula holder (not shown) and the cannula 138 can be maintained.

[0055] In some embodiments, the orientation of the robotic arm 130 can be represented by the movement RCM of the robotic arm 130 connected to the eye 110 via the cannula 138. That is, the RCM is the point at which the surgical instrument 134 can pivot about the cannula 138 without disengaging the robotic arm 130 from the cannula 138. Because the orientation of the robotic arm 130 is preserved by the movement of the surgical instrument 134 about the RCM, the surgical instrument 134 can return to the preserved orientation.

[0056] The surgical instrument 134 (which was previously a laser device for targeting target site 212) can be replaced with an injection device. The injection device can be a needle, a subretinal injection needle, etc. Alternatively, the surgical instrument 134 can be a micropickup device, forceps, etc., to perform other desired functions during the procedure instead of injection.

[0057] The orientation of the robotic arm 130, positioned at target location 212, has been previously saved during procedure 250. In the case where the surgical instrument 134 is a subretinal injection needle, the surgical instrument can be prepared for direct injection into target location 212 on the eye 110 via cannula 138. That is, after changing and replacing the surgical instrument 134, the robotic arm 130 can be restored to its orientation at target location 212, and has an accurate posture based on the saved orientation of the robotic arm. Up to this point, the surgical instrument 134 can be a subretinal injection needle, and it will only need to be moved axially toward the eye 110 via cannula 138; the material 210 (such as coagulated protein chains or membranes) is no longer a problem of the movement of the surgical instrument 134.

[0058] Figure 3B A procedure 350 for injecting a surgical instrument 134 at a target location 212, according to some embodiments, is shown. The procedure 350 may include a robotic arm 130, a surgical instrument 134, and a distal end 134b of the surgical instrument, thereby injecting into the eye 110 via a cannula 138 using a cannula port 136, which may include a target location 212 near the substance 210.

[0059] A surgical instrument 134 (e.g., an injection device, more specifically a subretinal injection cannula) can be inserted into a cannula 138. Before the robotic arm 130 moves again toward the eye 110 via the cannula 138, the robotic arm 130 can be automatically brought to a stored target position 212. Now that the injection device is in the stored orientation of the robotic arm 130 position, the distal end 134b of the surgical instrument can move directly toward the target position 212. The injection device can recall the stored orientation of the robotic arm 130 position at the target position 212, eliminating the need for lateral movement of the injection device. The surgical instrument 134 (here, the injection device) can then be injected into the target position 212 of the eye 110 via the cannula 138 at the distal end 134b of the surgical instrument. Furthermore, when the surgical instrument 134 is inserted in the axial direction, the depth of the surgical instrument 134 at the target position 212 can be adjusted, for example, by the surgeon. Intraoperative optical coherence tomography (iOCT) using a microscope can be used to further control the depth.

[0060] In some embodiments, a subretinal injection needle can, for example, inject gene therapy drugs into the eye 110. Gene therapy in a patient's eye is a known treatment that involves replacing a non-functional gene with a healthy copy of the gene to slow or stop vision loss. Individuals diagnosed with a hereditary eye disease can be candidates for treatment using gene therapy. The injection described herein can provide such treatment.

[0061] In some embodiments, in addition to gene therapy for various eye diseases, proteins such as tissue plasminogen activator (tPA) can be injected to treat subretinal hemorrhage. tPA can also be injected into the retinal vein to dissolve blood clots using the injection method described herein. The injection can be performed at the optic nerve within the eye. The injection can be performed at the desired depth within the optic nerve. The injection described herein is not limited to intraretinal injection.

[0062] In some embodiments, a quick and easy intraocular procedure can be achieved by first aiming the laser beam 242 at the target location 212 and then moving the surgical instrument 134 (such as a subretinal injection needle) only in the axial direction. The patient will experience fewer complications in their eye 110 later in life.

[0063] Figure 4A method 400 is illustrated, according to some embodiments, for mounting a surgical instrument 134 on a surgical robotic arm 130 to assist and guide an injection for minimally invasive intraocular surgery. Method 400 can be executed by processing logic, which may include hardware (e.g., circuitry, dedicated logic, programmable logic, microcode, etc.), software (e.g., instructions executed on a processing device), or a combination thereof. It should be understood that not all steps may be required to perform the disclosure provided herein. Furthermore, as those skilled in the art will understand, some steps may be performed simultaneously or in combination with… Figure 4 The different execution sequences are shown.

[0064] Reference Figure 1 Method 400 is described up to Figure 3. However, method 400 is not limited to this example embodiment.

[0065] In step 402, a targeting device can be mounted on the robotic arm. The targeting device can be a laser device. For example, the targeting device (such as a laser device) can be surgical instrument 134 and can be mounted on the robotic arm 130.

[0066] In step 404, the targeting instrument can be positioned at the target location. The targeting instrument can emit a light beam within the orange, green, or red wavelength spectrum at the target location. The target location can be a surface point on the retina. Here, the surgical instrument 134 can emit a laser beam 242 at the target location 212 on the surface point on the retina of the eye 110, the laser beam being within the orange, green, or red wavelength spectrum.

[0067] In step 406, the orientation of the robot arm at the target location can be saved. The laser point 244 generated by the laser beam 242 indicates the target location 212, wherein the corresponding orientation of the robot arm 130 position can be saved and accessed again later.

[0068] Alternatively, after step 406, in step 407a, the targeting instrument can be positioned at another target location. For example, surgical instrument 134 can be positioned at another target location 212, different from the target location in step 404. The other target location 212 can be a surface point on the retina. Here, surgical instrument 134 can emit a laser beam 242 at the other target location 212 on the surface point on the retina of the eye 110, the laser beam being in the orange, green, or red wavelength spectrum.

[0069] Alternatively, after step 407a, in step 407b, another position of the robot arm's orientation at another target location can be saved. For example, the position of the robot arm's orientation at another target location 212 can be saved, preferably without overwriting the saved data corresponding to the target location 212 obtained in step 406. The laser point 244 generated by the laser beam 242 indicates the other target location 212, wherein the corresponding orientation of the robot arm 130 position can be saved and accessed again later. Steps 407a and 407b can also be repeated multiple times to obtain multiple target locations 212 throughout the eye 110 and save the corresponding position of the robot arm's orientation at the corresponding target location 212.

[0070] In step 408, the targeting device can be replaced with an injection device and can be mounted on the robotic arm. The injection device can be a subretinal injection needle. For example, an injection device such as a subretinal injection needle can be a surgical instrument 134. The surgical instrument 134 can be mounted on the robotic arm 130.

[0071] In step 410, the saved position of the robot arm's orientation can be accessed. The saved position can be the robot arm's orientation at the targeted target location. For example, the saved position can be accessed again such that it is in the direction of the injection device (e.g., surgical instrument 134). The injection device can move forward in the axial direction toward the target location 212.

[0072] In step 412, the injection device can be positioned at a saved location. The saved location may include the orientation of the robotic arm at the target location. Positioning the injection device may further include axial movement of the injection device. For example, the surgical instrument 134 (here, a subretinal injection needle) can be moved to a saved location, which is target location 212. Target location 212 may include the orientation of the robotic arm 130. The robotic arm 130 can move the surgical instrument 134 axially. The surgical instrument 134 can be moved forward in its axial direction until the tip of the surgical instrument (here, a subretinal injection needle) is placed at target location 212.

[0073] In step 414, the target site can be injected via an injection device. For example, surgical instrument 134 (in this case, a subretinal injection needle) can be injected into target site 212. Injection at target site 212 may include gene therapy injection, etc.

[0074] Various embodiments may utilize, for example, one or more well-known computer systems (e.g., Figure 5The computer device 500 shown is used for implementation. For example, the robotic arm 130 can be implemented using a combination or sub-combination of the computer device 500. Moreover, one or more computer devices 500 can be used, for example, to implement any of the embodiments discussed herein, as well as combinations and sub-combinations thereof.

[0075] Figure 5 A computing device 500 for implementing various embodiments according to some embodiments of this disclosure is shown. For example, the computing device 500 may be used as a system of the robotic arm 130 or any(multiple) parts thereof, or multiple computing devices 500 may be used as a system of the robotic arm 130.

[0076] The computing device 500 can be implemented on any electronic device running software applications derived from compiled instructions, including but not limited to personal computers, servers, smartphones, media players, tablet computers, game consoles, email devices, etc. In some embodiments, the computing device 500 may include one or more processors 502, one or more input devices 504, one or more display devices 506, one or more communication interfaces 508, and one or more computer-readable media 510. Each of these components can be connected via a bus 518, and in some embodiments, these components may be distributed across multiple physical locations and connected via a network.

[0077] Control unit 140 can assist in the control of robot 100 or robotic arm 130. Control unit 140 can send electronic control signals to the motors of robotic arm 130. In response to receiving the control signal, the motors rotate robotic arm 130 to a certain position. The surgeon or another user can configure control unit 140 by creating instructions and providing them to computer device 500. For example, instructions can be uploaded to the database of computer device 500, or the surgeon can use input device 504 to control the movement of robotic arm 130.

[0078] Display device 506 can be any known display technology, including but not limited to display devices using liquid crystal display (LCD) or light-emitting diode (LED) technology. Processor 502 can be any known processor technology, including but not limited to graphics processors and multi-core processors. Input device 504 can be any known input device technology, including but not limited to keyboards (including virtual keyboards), mice, controllers, joysticks, trackballs, touchpads, or displays.

[0079] Bus 518 can be any known internal or external bus technology, including but not limited to ISA, EISA, PCI, PCI Express, NuBus, USB, Serial ATA, or FireWire. In some embodiments, some or all of the devices shown connected via bus 518 may be connected to each other not via a physical bus but via, for example, a network connection. Computer-readable medium 510 can be any medium that participates in providing instructions to processor 502 for execution, including but not limited to non-volatile storage media (e.g., optical disc, magnetic disk, flash drive, etc.) or volatile media (e.g., SDRAM, ROM, etc.).

[0080] Computer-readable medium 510 may include various instructions for implementing operating system 512 (e.g., Mac OS, Windows, Linux). Operating system 512 may be multi-user, multi-processor, multi-tasking, multi-threaded, real-time, etc. Operating system 512 can perform basic tasks, including but not limited to: recognizing input from input device 504; sending output to display device 506; tracking files and directories on computer-readable medium 510; controlling peripheral devices (e.g., disk drives, printers, etc.) that can be controlled directly or through an I / O controller; and managing traffic on bus 518. Network communication 514 can establish and maintain network connections (e.g., software for implementing communication protocols such as TCP / IP, HTTP, Ethernet, telephone, etc.).

[0081] Applications and program modules 516 may be applications that use or implement the processes described herein as a result and / or the result of other processes. For example, application 516 may provide for displaying and / or manipulating updated UIs and / or UI elements as described above and recognized by computer device 500. In some embodiments, these various processes may also be implemented in operating system 512.

[0082] The described features can be implemented in one or more computer programs, which can be executable on a programmable system including at least one programmable processor linked to receive and transmit data and instructions from a data storage system, at least one input device, and at least one output device. A computer program is a set of instructions that can be used directly or indirectly in a computer to perform a specific activity or produce a specific result. Computer programs can be written in any form of programming language (e.g., Objective-C, Java), including compiled or interpreted languages, and can be deployed in any form, including as a standalone program or as a module, component, subroutine, or other unit suitable for use in a computing environment.

[0083] For example, a suitable processor 502 for executing instruction programs may include both general-purpose and special-purpose microprocessors, as well as a single processor or one of multiple processors or cores in any type of computer. Typically, processor 502 may receive instructions and data from read-only memory or random access memory, or both. The basic elements of a computer may include processor 502 for executing instructions and one or more memories for storing instructions and data. Typically, a computer may also include one or more mass storage devices for storing data files, or operatively coupled to and communicating with such mass storage devices; such devices include disks, such as internal hard disks and removable disks; magneto-optical disks; and optical disks. Storage devices suitable for tangibly representing computer program instructions and data may include all forms of non-volatile memory, including, for example, semiconductor memory devices, such as EPROM, EEPROM, and flash memory devices; disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks. The processor and memory may be supplemented or incorporated into ASICs (Application-Specific Integrated Circuits).

[0084] To enable interaction with the user, these features can be implemented on a computer that has a display device (such as an LED or LCD monitor) for displaying information to the user and a keyboard and pointing device (such as a mouse or trackball) for the user to provide input to the computer.

[0085] These features can be implemented in computer systems that include back-end components (such as data servers), middleware components (such as application servers or internet servers), or front-end components (such as client computers with graphical user interfaces or internet browsers), or any combination thereof. The components of the system can be connected via digital data communication of any form or medium (such as communication networks). Examples of communication networks include, for instance, telephone networks, LANs, WANs, and computer networks that form the internet.

[0086] Computer systems can include clients and servers. Clients and servers can typically be geographically separated and can interact via a network. The client-server relationship can be established by computer programs running on the respective computers and having a client-server relationship with each other.

[0087] In addition to the features or steps specifically described above as being implemented using APIs and / or SDKs, one or more features or steps of the disclosed embodiments may also be implemented using APIs and / or SDKs. An API may define one or more parameters passed between the calling application and other software code (e.g., operating system, library routines, functions) that provides services, provides data, or performs operations or computations. An SDK may include APIs (or multiple APIs), integrated development environments (IDEs), documentation, libraries, code samples, and other utilities.

[0088] APIs and / or SDKs can be implemented as one or more calls in program code, which send or receive one or more parameters based on the calling conventions defined in the API and / or SDK specification documentation, through parameter lists or other structures. Parameters can be constants, key-value pairs, data structures, objects, object classes, variables, data types, pointers, arrays, lists, or other calls. API and / or SDK calls and parameters can be implemented in any programming language. Programming languages ​​can define the vocabulary and calling conventions that programmers will use to access functions that support the API and / or SDK.

[0089] In some implementations, API and / or SDK calls can report to the application the capabilities of the device running the application, such as input capabilities, output capabilities, processing capabilities, power capabilities, communication capabilities, etc.

[0090] While various embodiments have been described above, it should be understood that they are presented by way of example and not limitation. Those skilled in the art will appreciate that various changes in form and detail can be made therein without departing from the spirit and scope. Indeed, after reading the above description, those skilled in the art will understand how to implement alternative embodiments. For example, other steps may be provided to the described process, or steps may be omitted, and other components may be added to or removed from the described system. Accordingly, other implementations are also within the scope of the following claims.

[0091] Furthermore, it should be understood that any figures highlighting functionality and advantages are presented for illustrative purposes only. The disclosed methods and systems are each flexible and configurable enough that they can be utilized in ways other than those shown. The breadth and scope of this disclosure should not be limited to any of the exemplary embodiments described above, but should be defined solely by the following claims and their equivalents.

Claims

1. A system for assisting injection in intraocular surgery, the system comprising: a robotic arm; a control unit configured to control the robotic arm; a targeting instrument mounted on the robotic arm, wherein the targeting instrument is configured to aim at a target location, wherein an orientation of the robotic arm in a direction of the target location is saved in a memory of the control unit for access, and wherein the targeting instrument is further configured to be exchanged for an injection instrument; and the injection instrument mounted on the robotic arm, wherein the injection instrument is configured to be positioned in the saved orientation of the robotic arm at the target location, and wherein the injection instrument is further configured to inject into the target location.

2. The system of claim 1, wherein, The targeting instrument is a laser device.

3. The system of claims 1-2, wherein, The targeting instrument emits a light beam within an orange, green or red wavelength spectrum at the target location.

4. The system of claims 1 to 3, wherein, The injection instrument is a needle or a subretinal injection needle.

5. The system of claims 1 to 4, wherein, The target location is a surface point on the retina.

6. The system of claims 1 to 5, wherein, The saved orientation of the robotic arm at the target location comprises a representation of a remote center of motion of the robotic arm.

7. The system of claims 1 to 6, wherein, The robotic arm is configured to axially move the injection instrument.

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