Support assembly for ophthalmic visualization system

Abstract

The present disclosure relates to a visualization system for surgery, and more particularly to an imaging and display support system for an ophthalmic visualization system. The optical systems described herein provide improved ergonomics for surgeons because such systems incorporate optical heads and corresponding displays on a single support arm to enable surgeons to directly and unobstructively view corresponding display screens placed in ergonomically advantageous locations for ophthalmic surgery. Even if the optical head of the system is moved or rotated during an ophthalmic procedure, such a system maintains the corresponding display screen in the aforementioned ergonomically advantageous position without the need for further adjustments by a surgeon or operator.

Description

[0001] background

[0002] Vitreoretinal surgery and cataract surgery are the most commonly performed ophthalmic surgeries. As the name implies, vitreoretinal surgery is performed in the gelatinous vitreous located in a relatively small ocular space and on the light-sensitive retinal surface. Common conditions that require vitreoretinal surgery include epiretinal membrane, vitreomacular schisis, vitreomacular traction syndrome, diabetic traction retinal detachment, proliferative vitreoretinopathy (PVR), retinal detachment, macular holes, and various other conditions that require microinjection surgery for gene therapy and cell therapy. On the other hand, cataract surgery involves removing the cloudy natural lens of the eye and replacing it with a new artificial lens. There are generally two types of cataract surgery: phacoemulsification, in which the cloudy lens is removed after it is broken up by applying ultrasound; and extracapsular extraction, in which the cloudy core of the lens is removed in one piece.

[0003] Traditionally, surgeons performing vitreoretinal and / or cataract surgery have utilized surgical microscope eyepieces to provide magnified, illuminated images of ophthalmic structures within the eye. However, recent advances in imaging technology have led to the use of heads-up digital surgical visualization systems. Such visualization systems rely on high-resolution stereo cameras and / or microscopes to transmit images from the patient's eye to a heads-up display for the surgeon to view, and offer advantages over conventional microscopes in that they provide better ergonomics for the surgeon, reduced phototoxicity, peripheral visualization, and increased magnification.

[0004] Despite the many benefits of using a heads-up digital surgical visualization system, such systems still have many constraints. A major drawback of some systems is that the surgeon has an obstructed line of sight with the corresponding heads-up display showing the microscopic image captured by the system camera. For example, in a purely digital system using only a camera and a display, problems may arise because the camera needs to be 150-200mm (working distance) above the patient's eyes. The combination of the necessary working distance and the relative height of the camera may present an obstacle that hinders the ideal line of sight between the surgeon and the display. Similarly, in systems utilizing a digital microscope or a microscope integrated with a digital camera, the corresponding display is typically placed next to the microscope, requiring the surgeon to adopt a less than ideal ergonomic position to view the display while performing surgery.

[0005] In addition, microscopes / cameras and heads-up displays for many digital surgical visualization systems are typically supported by separate support devices, which may cause unnecessary difficulties when adjusting such components between surgical operations. For example, for ophthalmic surgery, the surgeon can take three main positions relative to the patient's head: left temporal, right temporal, and upper. For each position, the display and related equipment must be moved to a specific position to ensure that the surgeon has a clear line of sight to the center of the display. In terms of ergonomics, the system should also be arranged so that the surgeon's head remains flush and does not need to be turned when viewing the display. Further, in order to provide the surgeon with an immersive 3D effect, the surgeon's display also needs to be positioned at a specific distance from the surgeon. Therefore, the display and related equipment of the digital surgical visualization system and other equipment in the operating room must be set before the surgical operation based on the position that the surgeon will take during the surgical operation.

[0006] If the position that the surgeon is to assume in a subsequent procedure in the operating room is different from the previous procedure performed in that operating room, the display and other related equipment of the digital surgical visualization system may need to be moved and / or adjusted to correspond to the new position. Therefore, maintaining good ergonomics for the surgeon during consecutive surgical procedures may be particularly challenging if different components of the digital surgical visualization system are supported by separate devices, which may each require separate adjustment to support the surgeon's different positions during the surgical procedure. This repositioning of equipment can be very laborious and time-consuming for the surgical staff, so that surgical procedures are ultimately scheduled based on the position that the surgeon is to assume in order to reduce the number of repositionings of equipment during a day. However, in surgical emergencies, such scheduling coordination may not always be feasible.

[0007] Thus, the combination of camera and / or microscope geometry, and the mounting of the camera and corresponding display on separate support structures may result in a poor ergonomic setup for the surgeon during ophthalmic surgery, which may affect the procedure and outcome. Accordingly, there is a need in the art for an improved support device for a surgical visualization system. Summary of the invention

[0008] Embodiments of the present disclosure relate to visualization systems for surgical procedures, and more particularly to an imaging and display support system for an ophthalmic visualization system.

[0009] In certain embodiments, a support system for an ophthalmic visualization system is provided, the support system comprising: a base column; a first arm connected to the base column, wherein the first arm is configured to rotate and translate along a first horizontal plane around a first rotational joint at the base column; an optical head connected to the first arm; and a first display connected to a top surface of the first arm.

[0010] In another embodiment, a support system for an ophthalmic visualization system is provided, the support system comprising: a base column; a base arm, the base arm comprising a proximal end and a distal end, wherein the proximal end of the base arm is connected to the base column via a first rotational joint, and the distal end of the base arm is connected to the support column extending between the base arm and the proximal end of the first arm; an optical head, the optical head is connected to the distal end of the first arm; a first display, the first display is connected to the top surface of the first arm; and wherein translation of the base arm around the first rotational joint along a second horizontal plane parallel to the first horizontal plane simultaneously causes translation of the first arm along the first horizontal plane. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] In order to be able to understand in detail the manner in which the above-mentioned features of the present disclosure are achieved, the present disclosure briefly summarized above may be described in more detail by reference to embodiments, some of which are shown in the accompanying drawings. However, it should be noted that the drawings show only exemplary embodiments and are therefore not to be considered limiting of their scope and may allow for other equally effective embodiments.

[0012] Figure 1 A perspective view of an exemplary visualization system arm assembly for use during an ophthalmic surgical procedure is shown in accordance with certain embodiments of the present disclosure.

[0013] Figure 2 Some embodiments of the present disclosure are shown Figure 1 Another perspective view of the visualization system arm assembly.

[0014] Figure 3 A secondary horizontal support arm connected to a secondary heads-up display is shown according to certain embodiments of the present disclosure. Figure 1 A top view of an exemplary configuration of a portion of a visualization system arm assembly.

[0015] Figure 4 Some embodiments of the present disclosure are shown Figure 3 A top view of a portion of a visualization system arm assembly with a secondary head-up display moving from a first position to a second position.

[0016] FIG. 5A to FIG. 5B Some embodiments according to the present disclosure are shown respectively. Figure 1Side and perspective views of another exemplary configuration of a portion of a visualization system arm assembly with the horizontal support arm in an extended position. Figure 5C Some embodiments of the present disclosure are shown FIG. 5A to FIG. 5B Side view of a portion of the visualization system arm assembly.

[0017] FIG. 6A to FIG. 6B A side view of another exemplary visualization system arm assembly configured with secondary optics, according to certain embodiments of the present disclosure, is shown.

[0018] FIG. 7A to FIG. 7C Some embodiments of the present disclosure are shown Figure 1 Stereoscopic views of the visualization system arm assembly positioned at the right temporal, left temporal, and superior positions of the patient, respectively.

[0019] To facilitate understanding, identical reference numerals have been used, where possible, to designate identical elements that are common to the figures. It is contemplated that elements and features of one embodiment may be beneficially incorporated in other embodiments without further recitation. DETAILED DESCRIPTION

[0020] In the following description, details are set forth by way of example to facilitate understanding of the disclosed subject matter. However, it is clear to those of ordinary skill in the art that the disclosed embodiments are exemplary and are not exhaustive of all possible embodiments. Therefore, it should be understood that the reference to the described examples is not intended to limit the scope of the present disclosure. Those skilled in the art in the technical field involved in the present disclosure are generally fully able to envision any changes and further modifications to the described devices, instruments, methods, and any further applications of the principles of the present disclosure. In particular, it is fully envisioned that the features, components, and / or steps described for one embodiment can be combined with the features, components, and / or steps described for other embodiments of the present disclosure.

[0021] It should be noted that as described herein, the distal end, distal segment, or distal portion of a component refers to the end, segment, or portion that is closer to the patient's target tissue during its use. On the other hand, the proximal end, proximal segment, or proximal portion of a component refers to the end, segment, or portion that is farther from the patient's target tissue.

[0022] As used herein, the term "about" may refer to a + / - 10% variation from the nominal value. It should be understood that such variations may be included in any value provided herein.

[0023] The present disclosure relates to visualization systems for surgical procedures, and more specifically to support systems for heads-up digital visualization systems that can be used during ophthalmic surgical procedures. As discussed above, conventional heads-up digital surgical visualization systems may not be ergonomically optimized for ophthalmic surgical procedures. For example, such digital surgical visualization systems may have displays that are mounted to the side of a microscope and / or camera, requiring the surgeon to adopt a less than ideal ergonomic position to view the display while performing the surgical procedure. Further, in systems where the imaging device and the corresponding display are mounted to separate support assemblies, the position of the imaging device and / or display must be individually readjusted and changed each time the surgeon assumes a different position for subsequent surgery, which may be challenging for the surgical staff and may unnecessarily delay the surgery and increase transition time. The support assembly described herein addresses the deficiencies of certain existing designs by providing a single robotic arm assembly that supports both an optical head and an associated heads-up display for use with a digital surgical visualization system. Such support assemblies described herein further provide the surgeon and / or associated surgical team with unobstructed visual access to a heads-up display showing the target surgical site, thereby facilitating improved ergonomics for the surgeon and / or surgical team during ophthalmic surgery. The support assemblies described herein may also be repositioned by the surgeon as needed during surgery while maintaining the improved ergonomics described above during repositioning.

[0024] Figure 1 An exemplary arm assembly for use with a heads-up digital surgical visualization system during ophthalmic surgery is shown in accordance with certain embodiments described herein. Figure 1In an example of the present invention, a visualization system arm assembly ("arm assembly") 100 is coupled to and supported by a horizontal base arm 160 that extends from a vertical base column 162. The vertical base column 162 may extend downwardly and perpendicularly to an operating room floor from a base structure (not shown), such as a boom arm assembly, an operating room ceiling, a robotic arm on a cart, etc. The vertical base column 162 may be movably connected to the base structure so that the vertical base column 162 may be moved relative to the operating room to roughly move and position the arm assembly 100. The horizontal base arm 160 includes a first end 164, a second end 166, and is rotatably coupled to the vertical base column 162 at the first end 164 via a base rotation joint 168, and is coupled to the arm assembly 100 at the second end 166. The horizontal base arm 160 can be configured to rotate about a vertical axis A extending through the base rotation joint 168 and the vertical base column 162, thereby allowing horizontal movement of the horizontal base arm 160 along an XY horizontal plane parallel to the floor relative to the vertical base column 162. In some embodiments, the base rotation joint 168 is configured to slide up and down along the vertical base column 162 to allow the horizontal base arm 160 to translate vertically along the vertical axis A while maintaining the horizontal base arm 160 in a horizontal and / or diagonal orientation.

[0025] The arm assembly 100 includes a horizontal support arm 102 extending from a vertical column 104 connected to a second end 166 of a horizontal base arm 160. The arm assembly 100 also includes an optical head 110 movably coupled to a distal end 109 of the horizontal support arm 102 opposite the vertical column 104. The vertical column 104 extends downwardly from the horizontal support arm 102 and perpendicular to the operating room floor. The vertical column 104 supports the horizontal support arm 102, thereby allowing a surgeon to move the horizontal support arm 102 and the optical head 110 relative to a patient to align and properly orient the optical head 110 over the patient for surgery.

[0026] exist Figure 1 , the optical head 110 includes a single low profile optical head to facilitate providing a direct unobstructed view of the primary heads-up display 108A to a surgeon standing opposite the distal end 109 of the horizontal support 102. In general, the optical head 110 may include one or more of the following optical devices: a microscope, a digital microscope, a compound microscope, a digital compound microscope, a digital auxiliary microscope, a digital microscope camera, a digital camera, an ophthalmic 3D stereo microscope camera, etc. Such a device may include any suitable optical and / or digital mechanism for high resolution imaging of ocular structures in an eye of a patient undergoing surgery.

[0027] In some embodiments, the optical head 110 is rotatably connected to the distal end 109 of the horizontal support arm 102 via a yoke 107. The yoke 107 can be operable to achieve fine and precise "roll" and "pitch" movements of the optical head 110 (respectively indicated by arrows and θ indicated) to provide a surgeon with a dynamic view of the patient's eye when the optical head 110 is in use. Such "roll" and "pitch" motions are orthogonal to the optical axis "E" of the optical head 110. The yoke 107 includes a yoke base 107A and a pair of yoke arms 107B, 107C extending from opposite ends of the yoke base 107A. The pair of yoke arms 107B, 107C may extend from the yoke base 107A in the same direction and parallel to each other, so that the yoke 107 is formed into a generally "U" shape, wherein the optical head 110 is positioned between the yoke arms 107B, 107C, within the "U". The yoke 107 is rotatably connected to the horizontal support arm 102 at the yoke base 107A by a revolute joint 170, such that the yoke 107 is configured to rotate about the longitudinal axis B of the horizontal support 102 to enable the yoke 107, and therefore the optical head 110 (when the optical head 110 is connected to the yoke 107), to perform a "tumble" motion. As shown, the optical head 110 can be connected to each yoke arm 107B, 107C by a revolute joint 172, 174, such that the optical head 110 is configured to rotate about a lateral axis C that is perpendicular to the longitudinal axis B. The rotation of the optical head 110 about the lateral axis C between the yoke arms 107B, 107C allows the optical head 110 to perform fine "pitch" motions.

[0028] In some embodiments, the optical head 110 may also include one or more handles 113 for manually moving the optical head 110 and / or the connected horizontal support arm 102 around the vertical column 104. The one or more handles 113 may also be used to manually adjust the above-mentioned "pitch" and "roll" movements of the optical head 110. In other embodiments, the assembly 100 may include one or more actuators, motors and / or controllers so that the control and movement of the "pitch" and "roll" movements of the optical head 110, as well as any horizontal translation of the horizontal support arm 102 and / or the horizontal base arm 160, can be motorized. In such examples, the movement of the assembly 100 can be controlled by the surgeon via a console, such as a surgical console (not shown).

[0029] like Figure 1As further shown, the arm assembly 100 also includes one or more primary heads-up displays 108A and / or secondary heads-up displays 108B (collectively referred to as heads-up displays 108) for viewing images of the target surgical site relayed by the optical head 110 and / or other image sources. For example, during an ophthalmic surgical procedure such as vitreoretinal surgery or cataract surgery, a camera within the optical head 110 can relay a magnified illuminated image of the ocular structures in the patient's eye to the heads-up display 108 for viewing by the surgeon and any of his or her surgical staff. Thus, the surgeon (and surgical staff) can view such images without having to look into the eyepiece of the microscope, thereby achieving the advantages of providing the surgeon (and surgical staff) with better visual optics and ergonomics.

[0030] exist Figure 1 In the example shown, the primary heads-up display 108A is fixed adjacent to the top surface of the horizontal support arm 102. When the arm assembly 100 is in use, the surgeon can stand opposite the distal end 109 of the horizontal support arm 102 so that the optical head 110 is positioned between the surgeon and the primary heads-up display 108A. In this position, the horizontal support arm 102 extends in the direction the surgeon is facing, and the viewing portion of the primary heads-up display 108 is set directly in front of the surgeon (e.g., in front of the surgeon). Therefore, when the arm assembly 100 is used in combination with a 3D visualization system during a surgical procedure, the angle of the surgeon's line of sight relative to the primary heads-up display 108A can be set within the necessary limitations of the 3D visualization system to produce the best 3D effect. In addition, in order to provide the surgeon with the most favorable ergonomics during surgery, the arm assembly 100 further helps to position the primary heads-up display 108A so that the surgeon's head is flush with the center of the primary heads-up display 108A. Still further, the arrangement and orientation of the arm assembly 100 and the size of the primary heads-up display 108A enable the surgeon to have an unobstructed view of any portion of the primary heads-up display 108A.

[0031] During an ophthalmic surgical procedure, due to the surgeon's position relative to the primary heads-up display 108A, the view of the primary heads-up display 108A by one or more surgical personnel (other than the surgeon) may be obstructed or angled such that the surgical personnel may not be able to obtain the 3D visual effects provided by the display. Therefore, in order to provide the surgical personnel with a view of the same or similar quality as that seen by the surgeon, in some embodiments, the arm assembly 100 may include an optional secondary heads-up display 108B. Figure 1 and Figure 2In the example shown, the secondary heads-up display 108B is secured to an articulated secondary horizontal support arm 112 that is coupled to the vertical column 104. In general, the secondary heads-up display 108B may be used to display the same or different images than those displayed by the primary heads-up display 108A, thereby facilitating a direct, unobstructed view of the target surgical site by the surgical staff and improving the ergonomics of the procedure for the entire surgical team.

[0032] In some embodiments, to accommodate different positions of the surgeon during different types of surgical procedures, the horizontal base arm 160, the vertical column 104, and the horizontal support arm 102 are arranged and coupled so that the entire assembly 100 can be rotated by translating / rotating the horizontal base arm 160 about the vertical axis A of the base column 162. In some embodiments, the second end 166 of the horizontal base arm 160 can be rigidly coupled to the vertical column 104, and the vertical column 104 can be rigidly coupled to the horizontal support arm 102 so that the horizontal support arm 102 extends parallel to the horizontal base arm 160. In such embodiments, when the optical head 110 is oriented with its optical axis E perpendicular to, for example, an operating room floor, the optical axis E can coincide with and align with the vertical axis A of the vertical base column 162, thereby forming a single vertical axis. Thus, rotational translation of the horizontal base arm 160 about the vertical base column 162 will facilitate rotation of the optical head 110 with little XY translation of the optical head 110 that would otherwise require realignment of the optical head 110 after rotation of the assembly 100 to accommodate the surgeon's position during surgery. Accordingly, axial alignment of the optical head 110 can be maintained during rotation of the assembly 100 between these different positions.

[0033] like Figure 1 As shown, since the axis of rotation of the assembly 100 about the XY plane occurs at the vertical base column 162, any rotation of the optical head 110 will include simultaneous rotation of the horizontal base arm 160 and the vertical column 104 along with any heads-up display 108 attached thereto. This allows the entire assembly 100 (including any heads-up display 108 attached to the horizontal support arm 102 or the vertical column 104) to be rotated with a single translational movement of the assembly 100 about the vertical base column 162. This effectively ensures that ergonomics for the surgeon are maintained when the assembly 100 is moved to a new position.

[0034] Figure 2 Some embodiments of the present disclosure are shown Figure 1 Another perspective view of the arm assembly 100. As shown, the horizontal support arm 102 of the arm assembly 100 is connected to the vertical column 104 at the first joint 106. Figure 1In the example shown, the horizontal support arm 102 extends horizontally at an angle of approximately 90 degrees relative to the vertical axis D of the vertical column 104. In general, the horizontal support arm 102 can extend from the vertical column 104 horizontally and / or diagonally (eg, at a non-zero angle relative to the horizontal and vertical planes).

[0035] In some embodiments, the horizontal support arm 102 can be configured to rotate or pivot about the vertical column 104 and the vertical axis D (e.g., by having the vertical column 104 act as an axle, pin, or cylinder). In such embodiments, the first joint 106 can include a revolute joint that can include a needle bearing or other similar bearings and / or devices to facilitate smooth rotational movement of the horizontal support arm 102 about the vertical column 104. In other embodiments, the horizontal support arm 102 can be non-rotatably coupled to the vertical column 104. In further embodiments, the first joint 106 is configured to slide up and down along the vertical column 104 to allow the horizontal support arm 102 to translate vertically along the vertical axis D while maintaining the horizontal and / or diagonal orientation of the horizontal support arm 102. In such embodiments, the first joint 106 includes a sliding joint.

[0036] In some embodiments, the horizontal support arm 102 has a length determined according to the display size (e.g., corner-to-corner diagonal length) of the primary heads-up display 108A, so that when the arm assembly 100 is used during a surgical procedure, the horizontal arm 102 helps the surgeon achieve the best ergonomic and immersive 3D experience / effect when viewing the 3D image of the patient's eye. This allocation of the horizontal arm support 102 is referred to herein as the "ergonomic display distance".

[0037] In a particular embodiment, the primary heads-up display 108A may include a 32 inch display such that the ergonomic display distance for the surgeon is approximately 750 mm from the surgeon's eyes. Thus, the horizontal support arm 102 is sized such that when the surgeon is positioned adjacent to the optical head 110 and opposite and facing the primary heads-up display 108A while the surgeon is performing an ophthalmic surgery using the arm assembly 100, the horizontal support arm 102 maintains an ergonomic distance of 750 mm between the surgeon and the primary heads-up display 108A.

[0038] In some embodiments, the arm assembly 100 maintains the ergonomic display distance regardless of any movement or rotation of the optical head 110 required by the surgeon with respect to changes in the position of the patient's head. For example, in some embodiments, since both the optical head 110 and the primary heads-up display 108A are fixed to the horizontal support arm 102, the primary heads-up display 108A always rotates and / or moves (e.g., translates) correspondingly with any movement or rotation of the optical head 110 by the surgeon. However, in some other embodiments, the arm assembly 100 must be manually set to the ergonomic display distance by physically adjusting the position of the primary display 108A.

[0039] like Figure 2 As shown, in some embodiments, the primary head-up display 108A is fixed to the horizontal support arm 102 by a first bracket 114, which is adjacent to the proximal end 111 of the horizontal support arm 102 near the first joint 106. The first bracket 114 can be configured to mount the primary head-up display 108A in a fixed position on the horizontal support arm 102, with the back side of the display 108A adjacent to the vertical column 104 and against the vertical column, and the viewing side of the display 108A facing the optical head 110 and the distal end 109 of the horizontal support arm 102. In some embodiments, the first bracket 114 can be configured to have one or more additional hinges or joints to allow the primary head-up display 108A to tilt and move, thereby providing dynamic adjustment for the primary head-up display 108A.

[0040] Meanwhile, as described above, the secondary head-up display 108B may be secured to the vertical column 104 via an articulated secondary horizontal support arm 112 that is movably coupled to the vertical column 104. The articulated secondary horizontal support arm 112 may be configured to enable the secondary head-up display 108B to be independently movable relative to the horizontal support arm 102 and / or the primary head-up display 108A.

[0041] Figure 3 Some embodiments of the present disclosure are shown Figure 1 1 is a top view of an exemplary configuration of a portion of the arm assembly 100. Figure 3 The parts shown include those set in Figure 1 Components below section line AA in . As shown, the articulated secondary horizontal support arm 112 includes two segments: a first proximal segment 116 and a second distal segment 118. The proximal end 115 of the proximal segment 116 is rotatably connected to the vertical column 104 via a second rotational joint 120, and the proximal segment 116 extends horizontally or obliquely from the second rotational joint. The second rotational joint 120 is configured to rotate the proximal segment 116 about a vertical axis D extending through the vertical column 104, thereby providing the proximal segment 116 with horizontal movement relative to the vertical column 103 along an XY horizontal plane parallel to the floor. Figure 2 and Figure 3 In the example shown, the second revolute joint 120 is positioned above (e.g., on top of) the first joint 106, but other arrangements are also contemplated. The second revolute joint 120 can also be configured to enable the proximal segment 116 to slide up and down along the vertical column 104 to adjust the vertical positioning of the secondary horizontal support arm 112 relative to the vertical column 104 along the XZ vertical plane.

[0042] The distal end 117 of the proximal segment 116 is rotatably connected to the proximal end 119 of the distal segment 118 at the third revolute joint 122, and the distal segment 118 extends horizontally or obliquely from the third revolute joint. The third revolute joint 122 is arranged so that its axis of rotation is parallel to the axis of rotation of the second revolute joint 120, and is therefore perpendicular to the operating room floor and parallel to the vertical axis D. Accordingly, the third revolute joint 122 facilitates XY movement of the distal segment 118 relative to the proximal segment 116.

[0043] The distal end 121 of the distal segment 118 is further rotatably connected to an optional secondary head-up display 108B at a fourth rotation joint 124. The secondary head-up display 108B may further include an adjustable mounting bracket 126 for fixing the secondary head-up display 108B to the fourth rotation joint 124. The fourth rotation joint 124 is configured and oriented so that its rotation axis is parallel to the vertical axis and is therefore perpendicular to the operating room floor. Accordingly, the fourth rotation joint 124 facilitates the secondary head-up display 108B to rotate horizontally around the distal end 121 of the distal segment 118 along the XY plane.

[0044] In general, the proximal and distal segments 116, 118 and the revolute joints 120, 122, and 124 of the articulated secondary horizontal support arm 112 facilitate horizontal translation and movement of the secondary head-up display 108B parallel to the operating room floor. More specifically, the XY motion achieved by the proximal and distal segments 116, 118 and the revolute joints 120, 122, and 124 enables the secondary head-up display 108B to have a horizontal range of motion from one side of the primary head-up display 108A to the other side around the vertical column 104, which enables surgical personnel located around the surgeon during eye surgery to view the secondary head-up display 108B. In addition, because the revolute joints 120, 122, and 124 are oriented parallel to each other, these axes of rotation do not oppose gravity, thereby providing a greater payload for the secondary horizontal support arm 112. In certain embodiments, the revolute joints 120 , 122 , and 124 may include needle bearings or similar devices to facilitate smooth rotational movement of the secondary heads-up display 108B about the vertical column 104 .

[0045] Figure 4Demonstrating the ability to move according to certain embodiments of the present disclosure Figure 3 108B. As discussed above, the proximal segment 116 and the distal segment 118 of the secondary horizontal support arm 112 provide the secondary head-up display 108B with horizontal translation and movement about the vertical column 104. Figure 4 In the example shown, the secondary heads-up display 108B moves from a first secondary heads-up display position 125, where the secondary heads-up display 108B is located to the right of the primary heads-up display 108A when viewed from the viewing side of the primary heads-up display 108A, to a second secondary display position 127, where the secondary heads-up display 108B is located to the left of the primary heads-up display 108A when viewed from the viewing side of the primary heads-up display 108A. These positions of the secondary heads-up display 108B may be utilized depending on the position of the surgeon relative to the patient's head during surgery and the position of the surgical staff in the operating room. The secondary heads-up display 108B may be positioned to provide the surgical staff with a direct, unobstructed view of the target surgical site being operated on by the surgeon to further improve the ergonomics of the surgery for the surgical team.

[0046] To change the secondary heads-up display 108B between the positions 125 and 127, the proximal segment 116, the distal segment 118, and the secondary heads-up display 108 may each be individually rotated approximately 180 degrees about the second, third, and fourth revolute joints 122, 124, and 126, respectively, to swing the secondary heads-up display 108B about the vertical column 104 between the first position 125 and the second position 127. In certain embodiments, the arm assembly 100 may be capable of locking in any given position between and including the first and second positions 125 and 127.

[0047] In certain aspects of the present disclosure, the arm assembly 100 may include more than one secondary heads-up display 108B connected to the vertical column 104, wherein similar to Figure 4 In the example shown, each display is mounted to a corresponding horizontal support arm. In some embodiments, more than one secondary head-up display 108B may be connected to the same secondary horizontal support arm 112. In other embodiments, one or more secondary head-up displays 108B may also be connected to the horizontal support arm 102. Alternatively, the assembly 100 may not include any secondary head-up displays 108B, but may be limited to the primary head-up display 108A.

[0048] Now back to Figure 3In some embodiments, the horizontal support arm 102, the first bracket 114, and the vertical column 104 may also be movably coupled together so that the horizontal support arm 102 (and the optical head 110 connected thereto) may be moved relative to the vertical column 104 to provide X and Y motions for the optical head 110 without moving the rest of the arm assembly 100 (e.g., the vertical column 104, the horizontal base 160, and the vertical base column 162). In some embodiments, the horizontal support arm 102 may be movably coupled to the first bracket 114 along a plurality of sliding tracks (not shown) extending along the Y axis on the horizontal support arm 102 so that the horizontal support arm 102 can be moved relative to the first bracket 114 and the vertical column 104 along the Y axis. In some embodiments, the first bracket 114 may be movably coupled to the vertical column 104 along a plurality of sliding tracks (not shown) extending along the X axis so that the first bracket 114 (and the horizontal support arm 102 and the optical head 110 connected thereto) may be moved relative to the vertical column 104 along the X axis. Thus, movement of the first bracket 114 along the X-axis (with the horizontal support arm 102 fixed in position on the first bracket 114) enables the optical head 110 to move along the X-axis relative to the vertical column 104 without moving the remainder of the arm assembly 100 (e.g., the vertical column 104, the horizontal base 160, and the vertical base column 162).

[0049] In certain embodiments, the movement of the horizontal support arm 102 relative to the first bracket 114 in the Y direction (1) and the movement of the first bracket 114 relative to the vertical column 104 in the X direction (2) can be motorized and controlled by the surgeon via one or more actuators, motors, and / or controllers connected between the horizontal support arm 102, the first bracket 114, and the vertical column 104 and implemented with the assembly 100. When motorized, the assembly provides the surgeon with additional fine X and Y motion of the horizontal support arm 102 / optical head 110 without further changing the settings of the assembly 100.

[0050] FIG. 5A to FIG. 5C A schematic diagram of an optical head 110 having an extension mechanism according to certain embodiments of the present disclosure is shown. Figure 1 A side view and a perspective view of another exemplary configuration of a portion of an arm assembly of. Likewise, FIG. 5A to FIG. 5C The parts shown in the figure include those set in Figure 1 As shown, the horizontal support arm 102 may include an internal extension mechanism 135 configured to separate and extend the optical head 110 from the distal end 109 of the horizontal support arm 102 so that the optical head 110 can translate vertically and longitudinally relative to the horizontal support arm 102.

[0051] As discussed above, during ophthalmic surgery, one of the three primary positions that the surgeon can assume relative to the patient's head is the above-the-patient position (eg, Figure 7C As shown, relative to the patient 200), the surgeon is now located on top of the patient's head. In this case, the arm assembly 100 is positioned so that the proximal end 111 of the horizontal support arm 102 is disposed above the mid-portion of the patient and extends from the patient's chest to their head. Due to the positioning of the horizontal support arm 102, in some cases, the patient's chest may contact the bottom of the horizontal support arm 102 before the optical head 110 is brought within working distance from the patient's 200 eyes. In order to accommodate the patient's chest, the horizontal support 102 can be adjusted along the vertical column 104 to raise it above the patient's chest. The extension mechanism 135 of the optical head 110 can then be used to extend and lower the optical head 110 toward the patient's head to properly align the optical head 110 with the target surgical site on the patient's head and position any imaging device within its appropriate working distance from the optical head 110.

[0052] exist Figure 5C , a portion of the horizontal support arm 102 (e.g., its housing) is depicted in cross-section to illustrate its internal extension mechanism, which facilitates a combination of longitudinal ("Y" movement) and vertical ("Z" movement) separation and translation of the optical head 110 from the distal end 109 of the horizontal support arm 102. Specifically, the internal translation mechanism shown can enable the optical head 110 to move relative to the horizontal support 102 between a "starting" position and an "extended" position, wherein in the "starting" position, the optical head 110 is adjacent to the distal end 109 of the horizontal support arm 102, as shown in FIG. Figure 1 In contrast, when the optical head 110 is in the "extended" position, the optical head 110 is separated from the distal end 109 of the horizontal support arm 102, as shown in FIG. FIG. 5A to FIG. 5C shown.

[0053] In some embodiments, such as FIG. 5A to FIG. 5CIn the example shown in , the horizontal support arm 102 includes a four-bar parallelogram mechanism 128, which is fixed between a head base 134 rotatably connected to the proximal end 136 of the yoke 107 and a carriage 138 slidably connected to a plurality of rails 140 formed in a cavity 144 of the horizontal support arm 102. The four-bar parallelogram mechanism 128 enables passive, lockable vertical movement of the optical head 110. The four-bar parallelogram mechanism 128 is formed by at least four rods 130, which are movably connected by four horizontal rotation joints 132, facilitating vertical movement of the optical head 110 relative to the carriage 138 in the cavity 144 and the distal end 109 of the horizontal support arm 102. Compared to the revolute joints 120, 122, and 124, the revolute joint 132 is arranged so that each of its rotation axes is parallel to the operating room floor (i.e., parallel to the XY horizontal plane) and perpendicular to the vertical axis D or vertical column 104. Such an arrangement enables the optical head 110 to move vertically perpendicular to the plane of the operating room floor, such as Figure 5C As shown, the parallel orientation of the revolute joints 120, 122, and 124 is maintained simultaneously. In certain embodiments, the four-bar parallelogram mechanism 128 may be spring-balanced and may include one or more springs disposed between the revolute joints 132 thereof.

[0054] To achieve longitudinal movement of the optical head 110, the horizontal support arm 102 includes a plurality of guide rails 140 and a carriage 138 located within a cavity 144 of the horizontal support arm 102. In certain embodiments, the plurality of guide rails 140 are formed inside the horizontal support arm 102 along the inner surface of the cavity 144 and may extend from an opening 146 located at a distal end of the horizontal support arm 102 toward a proximal end 111 of the horizontal support arm 102. The carriage 138 and the plurality of guide rails 140 may be slidably connected and configured as a dovetail sliding mechanism such that the carriage 138 may slide between the proximal end 111 and the opening 146 along the horizontal support 102 and the plurality of guide rails 140 within the cavity 144. Thus, movement of the carriage 138 along the longitudinal axis of the horizontal support arm 102 and parallel to the floor of the operating room facilitates longitudinal movement of the optical head 110 relative to the horizontal support arm 102.

[0055] When the optical head 110 is in the "starting position", the carriage 138 is positioned adjacent to the proximal end 111 of the horizontal support arm 102, and the entire four-bar parallelogram mechanism 128 is disposed within the chamber 144 of the horizontal support arm 102. The head base 134 can then be assembled over the opening 146, so that the optical head 110 is connected to the horizontal support arm 102 and is therefore in the "starting" position. The carriage 138 slides away from the proximal end 111 toward the opening 146 to facilitate the extension of the horizontal support arm 102 and the longitudinal movement of the optical head 110 away from the opening 146 to the "extended" position.

[0056] When the optical head 110 is in the “extended” position, the yoke 107 can still provide “pitch” and “roll” motion of the optical head 110. For example, when the optical head 110 is extended, the yoke 107 can still rotate about the optical head base 134, thereby facilitating the “roll” motion of the optical head 110 about the longitudinal axis B. When the optical head 110 is extended, the attachment points between the optical head 110 and the pair of yoke arms 107B, 107C facilitate the “pitch” motion of the optical head 110 about the lateral axis C. In some embodiments, in the extended position, the optical head 110 can be configured so that control of the “pitch” and “roll” motion of the optical head 110 can be manually performed by the surgeon. Alternatively, the movement of the optical head 110 can be motorized and controlled by the surgeon via one or more actuators, motors, and / or controllers connected to the optical head 110 and implemented with the assembly 100. When motorized, the X, Y, and Z motion of the optical head 110 can allow for spherical motion of the optical head 110 about its optical focus. Accordingly, the support system described herein provides several benefits over conventional systems.

[0057] FIG. 6A to FIG. 6B Side views of an arm assembly 100 configured with additional optics are shown in a "home" position and a "deployed" position, respectively, according to certain embodiments of the present disclosure.

[0058] In the example shown, in some embodiments, the horizontal support arm 102 can include a secondary optical device 148 fixed along the bottom surface of the horizontal support arm 102. In some embodiments, the secondary optical device 148 can include a diagnostic device, such as an aberrometer, a corneal topographer, an autorefractor, etc. The secondary optical device 148 can be slidably connected to the horizontal support arm 102 using, for example, a dovetail slide 150 that is configured to enable the secondary optical device 148 to move along the bottom surface of the horizontal support arm 102. The dovetail slide 150 can facilitate longitudinal movement or "Y" movement of the secondary optical device 148 along an XY plane parallel to the operating room floor. Fig. 6A The secondary optics 148 is shown in a "starting" position below the horizontal support arm 102. To use the secondary optics 148, the secondary optics can be moved to a position such as Figure 6B The "deployed" position shown allows the secondary optical device 148 to be moved toward the optical head 110 to be aligned with and positioned over the target surgical site of the optical head 110. When the secondary optical device 148 is positioned over the target surgical site, the optical axis E of the optical head 110 and the secondary optical device 148 can be coaxially aligned so that the secondary optical device 148 is positioned over the same target site previously observed by the optical head 110.

[0059] FIG. 7A to FIG. 7CSome embodiments of the present disclosure are shown Figure 1 The arm assemblies are positioned at the left temporal position, the right temporal position and the upper position of the patient 200, respectively.

[0060] As discussed above, during ophthalmic surgery, there are three primary positions that the surgeon assumes relative to the patient's head for different procedures - left temporal, right temporal, and superior. Fig. 7A The assembly 100 is shown oriented for a left temporal position, with the surgeon standing facing the left side of the patient's head. Figure 7B The assembly 100 is shown oriented for a right temporal position, with the surgeon standing facing the right side of the patient's head. Figure 7C The assembly 100 is shown oriented for an upper position, with the surgeon standing facing the top of the patient's head.

[0061] To adjust the assembly 100 between the three positions described above, the horizontal base arm 160 can be rotated about the base rotation joint 168, thereby rotating the orientation of the optical head 110 and the primary head-up display 108b about an XY horizontal plane parallel to the operating room floor. Figure 7B The right temporal position shown changes to Figure 7C 108A. In the upper position shown, the base arm 160 can be rotated counterclockwise 90 degrees about the vertical base column 162. As the base arm 160 rotates, the optical head 110, the support arm 102, the vertical column 104, and the primary heads-up display 108A also rotate. The simultaneous corresponding rotation of the primary heads-up display 108a and the horizontal support arm 102 maintains the ideal ergonomic distance between the surgeon and the primary display 108A, which helps maintain the ideal ergonomics for the surgeon when the system is adjusted between positions without requiring the surgeon or the surgical team to further adjust the primary display 108A. In this way, when it is necessary to move the optical head 110 and the corresponding surgical vision system to accommodate different surgical positions of the surgeon, the assembly 100 discussed herein is extremely efficient in maintaining ergonomics.

[0062] In summary, embodiments of the present disclosure include imaging and display support arms for ophthalmic visualization systems that provide improved ergonomics for both surgeons and their surgical staff. For example, the arrangement of both the primary head-up display and the optical head on the horizontal support arm provides the surgeon with a direct, unobstructed line of sight to the primary head-up display at all times, thereby providing the surgeon with the most favorable ergonomics possible during surgery. In addition, the use of a movable secondary horizontal support arm facilitates other surgical staff to directly and unobstructedly view the surgical target site on the secondary head-up display, thereby further improving the ergonomics of the surgery for the entire surgical team. Further, the extension of the optical head driven by a combined four-bar parallelogram mechanism and a dovetail sliding mechanism facilitates the utilization of a digital surgical visualization system while avoiding interference or obstruction caused by the horizontal support arm contacting the patient's chest, and further enables the visualization display screen to be positioned and maintained directly in front of the surgeon. Accordingly, the support system described herein provides several benefits over conventional systems.

[0063] Although cataract surgery and vitreoretinal surgery are discussed as examples of surgical procedures that may benefit from the described embodiments, the advantages of the surgical devices and systems described herein may also be beneficial in other surgical procedures.

[0064] While the foregoing is directed to embodiments of the present disclosure, other and further embodiments of the present disclosure may be envisaged without departing from the basic scope of the present disclosure, and the scope of the present disclosure is determined by the claims that follow.

[0065] As used herein, a phrase referring to "at least one of" a list of items refers to any combination of those items, including single members. For example, "at least one of a, b, or c" is intended to cover any combination of a, b, c, ab, ac, bc, and abc, as well as multiples of the same element (e.g., aa, aaa, aab, aac, abb, acc, bb, bbb, bbc, cc, and ccc or any other order of a, b, and c).

[0066] The foregoing description is provided to enable any person skilled in the art to practice the various embodiments described herein. Various modifications to these embodiments will be apparent to those skilled in the art, and the general principles defined herein may be applied to other embodiments. Therefore, the claims are not intended to be limited to the embodiments shown herein, but are to be given the full scope consistent with the language of the claims.

[0067] In the claims, unless otherwise specified, reference to a singular element is not intended to mean "one and only one", but "one or more". Unless otherwise specifically stated, the term "some" refers to one or more. All structural and functional equivalents of the elements of the various aspects described throughout the present disclosure that are known or will be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be covered by the claims. In addition, regardless of whether such disclosure is explicitly recited in the claims, the content disclosed herein is not intended to be committed to the public. According to 35 U.S.C. §112 (f), the elements of any claim will not be interpreted unless the phrase "device for..." is used to expressly recite these elements, or in the case of a method claim, the phrase "step for..." is used to recite these elements. The word "exemplary" is used herein to mean "used as an example, instance, or illustration". Any aspect described as "exemplary" herein is not necessarily interpreted as preferred or advantageous over other aspects.

Claims

1. A support system for an ophthalmic visualization system, the support system comprising: base column; a first arm connected to the base column, wherein the first arm is configured to rotate and translate along a first horizontal plane about a first revolute joint at the base column; an optical head coupled to a distal end of the first arm; and A first display is coupled to a top surface of the first arm.

2. The support system of claim 1, further comprising: A base arm comprising a proximal end and a distal end, wherein connecting the first arm to the base column comprises coupling the proximal end of the base arm to the base column via the first rotational joint, connecting the distal end of the base arm to a support column extending between the base arm and the proximal end of the first arm, and wherein rotational translation of the base arm along a second horizontal plane around the first rotational joint simultaneously causes rotational translation of the first arm along the first horizontal plane.

3. The support system of claim 2, wherein: The rotational translation of the base arm around the base column simultaneously causes the optical head, the first arm, the support column, and the first display coupled to the first arm to rotationally translate around the base column.

4. The support system of claim 2, wherein: Rotational translation of the base arm about the base column rotates the optical head about a longitudinal base axis aligned with the optical axis of the optical head.

5. The support system of claim 2, further comprising an articulated second arm connected to the support column, the articulated second arm comprising: a first segment, the first segment including a proximal end and a distal end, the first segment being configured to rotationally translate along a third horizontal plane about a second revolute joint at a proximal end of the articulated second arm, the first segment being coupled to the support column via the second revolute joint; a second segment, the second segment comprising a proximal end and a distal end, the second segment being configured to rotationally translate along the third horizontal plane about a third revolute joint at the proximal end thereof, the second segment being coupled to the first segment via the third revolute joint; as well as A second display is coupled to a distal end of the second segment and is configured to rotationally translate along the third horizontal plane via a fourth revolute joint, the second display being coupled to the second segment via the fourth revolute joint.

6. The support system of claim 4, wherein: The first revolute joint, the second revolute joint, the third revolute joint, and the fourth revolute joint are arranged parallel to each other.

7. The support system of claim 1, wherein: The optical head includes one or more of the following devices: a microscope, a digital microscope, a compound microscope, a digital compound microscope, a digital auxiliary microscope, a digital microscope camera, a digital camera, and an ophthalmic 3D stereo microscope camera.

8. The support system of claim 1, further comprising: A yoke connecting the proximal end of the optical head to the distal end of the first arm, wherein the yoke is configured to rotationally translate about a longitudinal axis extending through the first arm via a second rotational joint at the distal end of the first arm, and wherein the optical head is configured to rotationally translate about a lateral axis extending perpendicular to the longitudinal axis via one or more yoke rotational joints connecting the optical head to the yoke.

9. The support system of claim 8, wherein: Rotational translation of the yoke about the longitudinal axis provides a "tumbling" motion of the optical head relative to the first arm.

10. The support system of claim 8, wherein: Rotational translation of the optical head about the lateral axis at the one or more yoke revolute joints on the yoke provides a "pitch" motion of the optical head relative to the yoke.

11. The support system of claim 1, wherein: The first arm further includes a dovetail slide mechanism extending between the optical head and the first arm to facilitate extension of the optical head away from the first arm along a longitudinal axis of the first arm.

12. The support system of claim 11, wherein: The first arm further includes a four-bar parallelogram mechanism extending between the optical head and the dovetail slide mechanism to facilitate vertical translation of the optical head from the first arm.

13. The support system of claim 11, further comprising an opening at the distal end of the first arm and a chamber extending from the opening toward the proximal end of the first arm, wherein: The dovetail slide mechanism includes a carriage slidably connected to the first arm within the cavity.

14. The support system of claim 12, wherein: The dovetail sliding mechanism and the four-bar parallelogram mechanism facilitate separation and extension of the optical head from the first arm.

15. The support system of claim 2, wherein: The first revolute joint is configured to slide along the support column to facilitate vertical movement of the first arm thereof.

16. The support system of claim 5, wherein: The second revolute joint is configured to slide along the support column to facilitate vertical movement of its articulated second arm.

17. The support system of claim 12, wherein: The four-bar parallelogram mechanism further includes one or more springs to help configure the four-bar parallelogram mechanism as a spring balance.

18. The support system of claim 1, further comprising a secondary optic coupled along a bottom surface of the first arm.

19. The support system of claim 5, wherein: The articulated second arm facilitates translation of the second display along the third horizontal plane to move between a first position on a first side of the first display and a second position on a second side of the first display.

20. The support system of claim 1, wherein: The first arm maintains a desired ergonomic distance between a vertical plane at a distal end of the optical head and the first display when the first arm is adjusted relative to the base column.

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