Three-pivot remote center of motion joint for surgical robotic systems

Abstract

A surgical robotic system is described having an externally mobile remote center of motion that can align with a cylindrical imaging volume of a patient's eye. Additionally, the surgical robotic system can include a three-pivot mechanism configured for use in one or more robotic arms of the surgical robot.

Description

[0001] Priority requirements This application claims priority to U.S. Provisional Patent Application No. 63 / 597,627, filed November 9, 2023, entitled “TRIPLE PIVOT REMOTE CENTER OFMOTION JOINT FOR SURGICAL ROBOTIC SYSTEMS,” the contents of which are incorporated herein by reference in their entirety.

[0002] By incorporating references All publications and patent applications mentioned in this specification are incorporated herein by reference to the same extent that each individual publication or patent application is specifically and individually indicated to be incorporated herein by reference.

[0003] field This invention relates to robot control mechanisms, particularly robot control mechanisms used in the field of surgical robotic systems.

[0004] background Surgical robots typically employ a mechanism that includes a remote center of motion (RCM). The robot's end effector (in this case, the surgical instrument) pivots around this RCM as the robot's joints are actuated. Before inserting the instrument into the patient, the surgical robot's RCM is aligned using a point through the skin incision. This ensures patient safety and minimizes tissue damage at the incision site. This basic configuration is well-suited for laparoscopic surgery, where there is a single point of entry through the skin for the instrument, and the surgical action occurs within the patient at a significant distance from the insertion point. However, this critical constraint remains challenging in ophthalmic surgery. One challenge is that the incision is formed through corneal tissue, and any damage to this tissue can lead to significant complications. Another challenge, unique to ophthalmic surgery, is that controlled surgical actions must occur much closer to the incision point, in many cases at a distance smaller than the diameter of the human eye (approximately 25 mm), and during some steps within just a few millimeters or less than one millimeter of the incision point. Therefore, there is still a need to improve the control of robotic surgical manipulators that operate close to surgical incisions.

[0005] Overview of this disclosure In one aspect, a system for image-guided robotic ophthalmic surgery is described, the system having: a defined imaging volume envelope aligned with the visual axis of the eye, within which image-guided robotic ophthalmic surgery will be performed; and a microsurgical robotic arm adapted and configured for movement about a remote center pivot point via a triple pivot mechanism, the remote center pivot point being adapted and configured to allow the imaging volume envelope and the working envelope of the end effector of the robotic arm to coexist adjacently in a mutually exclusive region.

[0006] In some aspects, the three-pivot mechanism may include: a first four-bar structure having a right offset arm and a left offset arm and configured to connect a proximal linkage of the robot arm having a first pair of proximal pivots to a first pivot point on the base of the robot arm; a second four-bar structure below and parallel to the first four-bar structure, having a right offset arm and a left offset arm and configured to connect a distal linkage of the robot arm having a pair of distal pivots to a second pair of proximal linkages distal to the first pair of proximal linkages and a second pivot point on the base; and a remote center pivot.

[0007] In some aspects, the first four-bar linkage, the first pair of proximal pivots, and the first pivot point on the base form a drive triangle having the pair of proximal pivots as the base of the drive triangle and the first pivot point on the base as the apex of the drive triangle, wherein the drive triangle pivots about the first pivot point, and further wherein a motor is coupled to the first pivot point to actuate the drive triangle.

[0008] In some aspects, the second four-bar structure, the second pair of proximal pivots, and the second pivot point on the base form an idler wheel triangle having the second pair of proximal pivots as the base of the idler wheel triangle and the second pivot point on the base as the apex of the idler wheel triangle; wherein the idler wheel triangle is configured for passive movement and pivoting about the second pivot point.

[0009] In some aspects, the pair of distal pivots and the remote center point form a virtual triangle, the virtual triangle having the pair of distal pivots as the base of the virtual triangle and the remote center point as the vertex of the virtual triangle; wherein the virtual triangle pivots about the remote center point.

[0010] In some aspects, the drive triangle, the idler triangle, and the virtual triangle are longitudinally connected via the right offset arm and the left offset arm of the first four-bar linkage and the second four-bar linkage, wherein the right offset arm and the left offset arm are configured to provide offset between the drive triangle, the idler triangle, and the virtual triangle, and to allow the triangle to rotate about the remote central pivot.

[0011] In some aspects, the system also includes an additional microsurgical robotic arm configured to operate collaboratively with the microsurgical robotic arm and the three-pivot mechanism around the remote central pivot, wherein the additional robotic arm has an end effector whose working envelope is mutually exclusive and cooperative with the working envelope and imaging volume envelope of the end effector of the additional robotic arm.

[0012] In some aspects, the working envelope of the robotic arm and the working envelope of the additional robotic arm correspond to designated mutually exclusive regions of the patient's right and left eyes, wherein the end effector of the robotic arm and the end effector of the additional robotic arm are configured to enter the respective mutually exclusive regions of the right and left eyes via an entry angle and path that does not obstruct the patient's facial anatomy, wherein the respective mutually exclusive regions of the right and left eyes include designated surgical incision points.

[0013] In some respects, the imaging volume envelope is a visualization no-entry zone, and further, the visualization no-entry zone is defined by the system's visualization system.

[0014] In some respects, the end effector of the robotic arm is configured to support the three-pivot mechanism and an additional connection that can be attached to the end effector to pivot around the remote central pivot point.

[0015] In other aspects, there is a method for actuating an end effector of a robotic arm within an operational envelope maintained outside an imaging volume, comprising: defining an imaging volume of a surgical environment; actuating movement of a distal end effector at a distal linkage of a three-pivot mechanism about a remote central pivot point by: actuating pivoting of a connected proximal drive triangle and an idler wheel triangle of the three-pivot mechanism in a first direction to actuate the distal end effector about the remote central pivot point and within the operational envelope outside the imaging volume in a counterclockwise direction; and actuating pivoting of the connected proximal drive triangle and idler wheel triangle of the three-pivot mechanism in a second direction to actuate the distal end effector about the remote central pivot point and within the operational envelope outside the imaging volume in a clockwise direction.

[0016] In some aspects, the method further includes offsetting the distance between the drive triangle and the idler triangle via an offset arm of the three-pivot mechanism, the offset arm connecting the distal end effector to the idler triangle and the drive triangle.

[0017] In some aspects of the method, defining the imaging volume defines a visualization no-entry zone.

[0018] In some aspects of the method, the definition of the imaging volume is performed by a visualization system.

[0019] In some aspects, the method further includes pivoting the centerline aligned with the drive triangle and the idler triangle in a neutral position in a first direction to actuate the distal end effector clockwise about the remote central pivot point via the three-pivot mechanism. The method also includes pivoting the centerline aligned with the drive triangle and the idler triangle in the neutral position in a second direction to actuate the distal end effector counterclockwise about the remote central pivot point via the three-pivot mechanism.

[0020] In one embodiment, there is a three-pivot mechanism for a surgical robot, comprising: The upper three-pivot plate has a first proximal pivot point and a second proximal pivot point; the lower three-pivot plate has a apex pivot point, a first proximal pivot point, and a second proximal pivot point; a left offset arm has a proximal end and a distal end; a first proximal pivot point is located on the proximal end of the left offset arm; a second proximal pivot point is located on the left offset arm distal to the first proximal pivot point; a right offset arm has a proximal end and a distal end; a first proximal pivot point is located on the proximal end of the right offset arm; a second proximal pivot point is located on the right offset arm distal to the first proximal pivot point; and a drive motor is connected to the upper three-pivot plate, wherein the rotation axis of the drive motor is... It is the rotation axis of the three-pivot mechanism; the pivot connection is located between the sleeve adjacent to the distal portion of the upper three-pivot plate and the vertex pivot point of the lower three-pivot plate; the first left proximal pivot point is located between the first proximal pivot point of the left offset arm and the second proximal pivot point of the upper three-pivot plate; the second left proximal pivot point is located between the second proximal pivot point of the left offset arm and the second proximal pivot point of the lower three-pivot plate; the first right proximal pivot point is located between the first proximal pivot point of the right offset arm and the first proximal pivot point of the upper three-pivot plate; and the second right proximal pivot point is located between the second proximal pivot point of the right offset arm and the first proximal pivot point of the lower three-pivot plate. In another aspect, the three-pivot mechanism for a surgical robot also includes an end effector coupled between the distal ends of the right offset arm and the left offset arm. The end effector is further coupled to a pivoting connection between the distal ends of the right and left offset arms. In another aspect, the three-pivot mechanism for a surgical robot includes a motor mount coupled to the distal ends of the right and left offset arms. A second motor mount may also be present, coupled to the pivoting connection between the distal ends of the right and left offset arms. Alternatively, operation of the motors of the three-pivot mechanism produces movement of the distal ends of the right and left offset arms about a virtual axis of rotation parallel to the axis of rotation of the three-pivot mechanism.

[0021] In another embodiment, there is a three-pivot mechanism for a surgical robot, comprising: a left offset arm having a proximal end and a distal end; a right offset arm having a proximal end and a distal end; a first four-bar linkage for driving the three-pivot mechanism, the first four-bar linkage including the distal end of the left offset arm, a first proximal pivot of the left offset arm, a drive plate of the upper three-pivot plate, a first proximal pivot point of the right offset arm, and the distal end of the right offset arm; and a second four-bar linkage adjacent to and driven by the first four-bar linkage, the second four-bar linkage including the distal end of the left offset arm, a second proximal pivot of the left offset arm, a vertex pivot point of the lower three-pivot plate, a first proximal pivot point of the right offset arm, and the distal end of the right offset arm. In one aspect, the first four-bar linkage and the second four-bar linkage each form an M-shape, wherein the base of the legs of the M-shape is located at the distal ends of the right offset arm and the left offset arm. In another aspect, operation of the first four-bar linkage causes the distal ends of the left offset arm and the right offset arm to move around a remote center of motion.

[0022] In yet another alternative embodiment, there is a three-pivot mechanism for a surgical robot, comprising: a first four-bar linkage having a right offset arm and a left offset arm and configured to connect a proximal linkage of the robot arm having a first pair of proximal pivots to a first pivot point on the base of the robot arm; a second four-bar linkage below and parallel to the first four-bar linkage, having a right offset arm and a left offset arm and configured to connect a distal linkage of the robot arm having a pair of distal pivots to a second pair of proximal linkages distal to the first pair of proximal linkages and a second pivot point on the base; and a remote central pivot. In one aspect, the first four-bar linkage, the first pair of proximal pivots, and the first pivot point on the base form a drive triangle, the drive triangle having the pair of proximal pivots as the base of the drive triangle and the first pivot point on the base as the apex of the drive triangle, wherein the drive triangle pivots about the first pivot point, and further wherein a motor is coupled to the first pivot point to actuate the drive triangle. In another aspect, the second four-bar linkage, the second pair of proximal pivots, and the second pivot point on the base form an idler triangle, the idler triangle having the second pair of proximal pivots as the base of the idler triangle and the second pivot point on the base as the apex of the idler triangle; wherein the idler triangle is configured for passive movement and pivoting about the second pivot point. In one aspect, the pair of distal pivots and the remote center point form a virtual triangle, the virtual triangle having the pair of distal pivots as the base of the virtual triangle and the remote center point as the vertex of the virtual triangle; wherein the virtual triangle pivots about the remote center point. In another alternative, the drive triangle, the idler wheel triangle, and the virtual triangle are longitudinally connected via the right offset arm and the left offset arm of the first four-bar linkage and the second four-bar linkage, wherein the right offset arm and the left offset arm are configured to provide offset between the drive triangle, the idler wheel triangle, and the virtual triangle, and to allow the triangle to rotate about the remote center pivot. Additionally or alternatively, an additional microsurgical robotic arm is configured to cooperate with the microsurgical robotic arm and the three-pivot mechanism about the remote center pivot, wherein the additional robotic arm has an end effector whose working envelope is mutually exclusive and cooperates with the working envelope and imaging volume envelope of the end effector of the additional robotic arm.In one aspect, the working envelope of the robotic arm and the working envelope of the additional robotic arm correspond to designated mutually exclusive regions of the patient's right and left eyes, wherein the end effector of the robotic arm and the end effector of the additional robotic arm are configured to enter the respective mutually exclusive regions of the right and left eyes via entry angles and paths that do not obstruct the patient's facial anatomy, wherein the respective mutually exclusive regions of the right and left eyes include designated surgical incision points. In another aspect, the imaging volume envelope is a visualization no-entry zone, further wherein the visualization no-entry zone is defined by the system's visualization system. In yet another aspect, the end effector of the robotic arm is configured to support the three-pivot mechanism and an additional connection capable of being attached to the end effector to pivot about the remote central pivot point.

[0023] In another alternative, there is a method for actuating an end effector of a robotic arm within an operational envelope maintained outside the imaging volume. This method is achieved by: defining an imaging volume of a surgical environment; and actuating the movement of a distal end effector at a distal linkage of a three-pivot mechanism about a remote central pivot point via: actuating the pivoting of the connected proximal drive triangle and idler wheel triangle of the three-pivot mechanism in a first direction to actuate the distal end effector about the remote central pivot point and within the operational envelope outside the imaging volume in a counterclockwise direction; and actuating the pivoting of the connected proximal drive triangle and idler wheel triangle of the three-pivot mechanism in a second direction to actuate the distal end effector about the remote central pivot point and within the operational envelope outside the imaging volume in a clockwise direction. In a variant, there is a step of offsetting the distance between the drive triangle and the idler wheel triangle via an offset arm of the three-pivot mechanism, the offset arm connecting the distal end effector to the idler wheel triangle and the drive triangle. In another alternative, defining the imaging volume defines a visualization no-entry zone. In one aspect, defining the imaging volume is performed by a visualization system. Optionally, the centerline aligned with the drive triangle and the idler triangle is pivoted in a neutral position in a first direction to actuate the distal end effector clockwise about the remote central pivot point via the three-pivot mechanism. The method further includes pivoting the centerline aligned with the drive triangle and the idler triangle in the neutral position in a second direction to actuate the distal end effector counterclockwise about the remote central pivot point via the three-pivot mechanism.

[0024] In another alternative embodiment, there is a system for image-guided robotic ophthalmic surgery comprising: a visualization system defining a cylindrical imaging volume aligned with the patient's visual axis of the eye, within which image-guided robotic ophthalmic surgery will be performed; and a microsurgical robotic arm adapted and configured to move within a region surrounding but not intersecting the cylindrical imaging volume, wherein a first rotational axis of yaw motion is parallel to the patient's visual axis, wherein the mechanism for the rotational yaw axis is a remote central articulation mechanism adapted and configured to allow the envelope of the visualization system and the movement envelope of the rotational axis mechanism to coexist directly adjacently without colliding with the envelope of the visualization system. In one aspect, the first rotational axis of yaw motion includes at least a distal linkage mechanism and a proximal linkage mechanism, wherein in use, the proximal linkage mechanism and the distal linkage mechanism are kept in a parallel orientation, and the distal linkage mechanism is located outside the cylindrical imaging volume. In one variation, at least the distal and proximal linkage mechanisms are part of a three-pivot mechanism. In another option, the mechanical design of the three-pivot mechanism is constrained by the dimensions of the cylindrical image-forming volume. In yet another variation, the first axis of rotation of the yaw motion is adjacent to the patient's visual axis, or the first axis of rotation of the yaw motion is parallel to the patient's visual axis and displaced from the patient's visual axis by less than 1 cm. In yet another alternative, the first axis of rotation of the yaw motion is parallel to the patient's visual axis of the eye and rotates at the surgical incision point of the eye.

[0025] In another embodiment, there is a microsurgical robot for image-guided ophthalmic surgery comprising a set of two identical robotic arms according to any of the above configurations, wherein each of the pair of robotic arms is adapted and configured to maintain a predetermined operational envelope away from the cylindrical image volume and the other robotic arm of the pair. In a variant, the pair of identical surgical robotic arms are a first robotic arm and a second robotic arm, the operational envelope of each of the first and second robotic arms being configured such that: the first robotic arm enters an upper incision point in a first eye, while the second robotic arm is configured to simultaneously enter a lower incision point in the first eye, and wherein the first and second robotic arms are configured to move without collision, such that the first surgical robotic arm enters a lower incision point in a second eye, while the second robotic arm simultaneously enters an upper incision point in the second eye.

[0026] In yet another alternative embodiment, there is a surgical robotic arm for use in microsurgery near a remote center of motion, comprising: a first joint employing a remote central joint mechanism having a rotational axis coaxial with the visualization axis of an image-guided system used during the microsurgery, and the first joint having a range of motion of + / - 90 degrees from a nominal configuration. In another aspect, the robotic arm includes additional degrees of freedom distal to the first remote central mechanism. In a further variation, the additional degrees of freedom are one or a combination of a remote central joint, a non-remote central joint, a linear joint, or a prismatic joint, or the first joint comprises a three-pivot mechanism. In yet another variation, the microsurgery is ophthalmic surgery, and the rotational axis of the first joint is parallel and adjacent to the visual axis of the eye of the patient undergoing the ophthalmic surgery. In another alternative, the microsurgery is an ophthalmic procedure in which the visualization axis of the image-guided system is coaxial with the visual axis of the patient's eye undergoing the ophthalmic procedure, and the rotation axis of the first joint is parallel to the patient's visual axis and displaced from the patient's visual axis by less than 1 cm.

[0027] In another alternative, there is a system for image-guided robotic ophthalmic surgery comprising: a defined imaging volume envelope aligned with the visual axis of the eye, within which image-guided robotic ophthalmic surgery will be performed; and a pair of microsurgical robotic arms as described herein, the pair of microsurgical robotic arms being adapted and configured for movement about a common remote central pivot point via a three-pivot mechanism, the common remote central pivot point being adapted and configured to allow the imaging volume envelope and the working envelope of the end effector of each of the pair of robotic arms to coexist adjacently in a mutually exclusive region. Brief description of the attached diagram The novel features of the invention are particularly set forth in the appended claims. A better understanding of the features and advantages of the invention will be obtained by referring to the following detailed description and accompanying drawings, which illustrate illustrative embodiments utilizing the principles of the invention, in which: Figure 1 It is a top-down view of part of the patient's face, showing the left eye, right eye, and nose.

[0029] Figure 2A This is an exploded diagram of a representative three-pivot mechanism.

[0030] Figure 2B This is a perspective view of a representative three-pivot mechanism of a robotic arm.

[0031] Figure 2C This is a view of an exemplary four-bar structure of a three-pivot mechanism.

[0032] Figure 2D This is a view of the pivot point of an exemplary four-bar linkage of a three-pivot mechanism.

[0033] Figure 2E It is an isometric view of a three-pivot mechanism in a neutral position.

[0034] Figure 2F This is an isometric view of the three-pivot mechanism in the first position.

[0035] Figure 2G This is an isometric view of the three-pivot mechanism in the second position.

[0036] Figure 3 This is a top-down view illustrating three positions of an exemplary second joint (J2) of the three-pivot mechanism moving to the output linkage mechanism relative to an exemplary cutout point in the eye.

[0037] Figure 4 It is a perspective view of a pair of three-pivot mechanisms configured with a left robotic arm and a right robotic arm (or a first robotic arm and a second robotic arm) relative to a pair of surgical entry points relative to the visual restricted area and the patient's right eye.

[0038] Figure 5A This is a top-down view of the three-pivot mechanism in the first position, where the output link is at the 12 o'clock position relative to the axis of the corresponding first joint J1.

[0039] Figure 5B yes Figure 5A A top-down view of the three-pivot mechanism, with the output / remote linkage at the 2 o'clock position.

[0040] Figure 6A This is a top-down view of a pair of three-pivot mechanisms configured as a first robotic arm and a second robotic arm, the first and second robotic arms being positioned to allow each robotic arm to enter as... Figure 1 One of the two incision points in the left eye.

[0041] Figure 6B This is a top-down view of a pair of three-pivot mechanisms configured as a first robotic arm and a second robotic arm, the first and second robotic arms being positioned to allow each robotic arm to enter as... Figure 1 One of the two incision points on the right eye.

[0042] Figure 7 This is a flowchart illustrating a method for locating joints or connectors of a robotic arm around an imaging area in a surgical setting.

[0043] Detailed description Various embodiments of the remote central first joint of a surgical robotic arm for microsurgical applications address many shortcomings of current surgical robotic systems, particularly those where the desired surgical actions will be performed adjacent to, near, or directly adjacent to the surgical incision point. In one aspect, an embodiment of a three-pivot mechanism is provided, adapted and configured for the first joint of a surgical robotic arm. Embodiments of the three-pivot mechanism design enable the surgical robotic system to meet a wide range of requirements for surgical robotic systems operating at, near, or immediately adjacent to the surgical incision point.

[0044] In one aspect, an embodiment of a three-pivot mechanism for ophthalmic robotic surgery provides a base for a robotic arm that does not move during operation. Furthermore, the embodiment provides a workspace for each surgical robotic arm with one or more characteristics or combinations of characteristics, such as (a) rotation of approximately 180 degrees about an optical axis (azimuth angle); and (b) rotation of +30 / -75 degrees about an axis coplanar with the limbal plane (polar angle) of the eye, to extend from front to back within the eye. Additionally, it is believed that +30 degrees is required to reach the anterior portion of the eye. One or more disadvantages have been observed compared to conventional surgical robotic systems that do not possess such workspace characteristics.

[0045] In one aspect, an embodiment of a three-pivot mechanism configured for operation as the first joint or joint 1 of a surgical robot provides a solution that satisfies the aforementioned workspace requirements. The embodiments of the three-pivot mechanism described herein offer a range of advantageous features. A pair of robotic arms includes identical and interchangeable first joints. Therefore, the pair of robotic arms can coordinate operations during surgeries performed on both the left and right eyes. In some examples, there may be an operational envelope defining a workspace corresponding to the rotational axis of motion for each robotic arm. Such an operational envelope can be predetermined, and the operational envelope for one robotic arm can be mutually exclusive with the operational envelope of the other robotic arm to avoid collisions between the robotic arms. Therefore, each robotic arm can be configured to remain outside the operational envelope of the other robotic arm.

[0046] In another aspect, the axis of joint 1 is parallel to the vertical optical axis of the patient and the visualization system. One advantage of this position is improved stability against gravity, as the actuators used for joint 1 typically bear the weight of the entire robotic arm. Additionally, this type of vertical alignment of any axis of rotation prevents the actuators associated with this joint from constantly resisting gravity. This configuration also has the ability to limit posture-related material strain due to gravity. For similar reasons as described above, aligning the axis of joint 1 with gravity improves the stiffness of the robotic arm. This alignment of joint 1 further reduces the complexity of coordinated movements between the robotic arms. Using a vertical axis for the first joint of both arms can be advantageous, as it greatly simplifies calculations to prevent collisions between the arms.

[0047] On the other hand, the configuration of a three-pivot mechanism implemented in a surgical robotic arm as described herein ensures that the working envelope does not collide with the patient or the visualization system. The visualization system occupies space primarily along the optical axis above the eye. As a result, the standard rotary joint for joint 1 in some conventional robotic systems cannot achieve the desired vertical placement because such a position would either a) undesirably obstruct the optical axis of the visualization system or b) increase the size of the robotic system to an undesirable degree. To address this issue, joint 1 must be a remotely centered joint, such as the three-pivot mechanism described herein.

[0048] The three-pivot mechanism described herein offers numerous advantages for telemobile center robotic surgical systems. First, the mechanical design of the three-pivot mechanism, as a telemobile center joint, inherently utilizes a visualization system to avoid collisions. Second, when configured with a vertical first axis, the linkage torsion between the first and second joints physically prevents collisions between the linkage prior to the second joint and the patient. Third, it avoids the limitations of conventional robotic systems on bimanual operation. Some conventional robotic systems are designed such that, in bimanual operation, one arm must be placed temporally and the other nasally. This is necessary to provide sufficient workspace for each arm while preventing collisions between arms during bimanual surgical procedures. Disadvantages of conventional systems include: (i) the need for nasotemporal placement using a difficult-to-use and retractable bending tool in emergencies; (ii) the absence of nasotemporal placement in standard cataract surgery, making it difficult for surgeons to adopt and learn; and (iii) insufficient available workspace for the nasal insertion tool regardless of its geometry, increasing the complexity of operating such surgical robots.

[0049] Figure 1This is a top-down view of a portion of the patient's face, showing the left eye 104, right eye 102, and nose 106. The left eye 104 and right eye 102 include indications of a pair of exemplary temporal incision points 103 / 101 for accessing the internal portion of the eye, respectively. For illustrative purposes, an upper and lower entry point (107 / 108) are shown within the temporal incision points 103 / 101. Alignment of the robotic joints along the axis for entry points 107 / 107' achieves the lower entry point 107 in the right eye 102 and the upper entry point 107' in the left eye 104. Alignment of the robotic joints along the axis for entry points 108 / 108' achieves the lower entry point 108' on the left eye 104 or the upper entry point 108 on the right eye 102. The robotic joint axes aligned with the entry points 107 / 107' / 108 / 108' can be the axis of the first joint (J1) of the first or second robotic arm, or an axis corresponding to the first joint (J1), and are located at, near, or through the temporal incision points 101 and 103. Therefore, each robotic arm can have its own operating envelope for ophthalmic surgery to eliminate collisions or operational conflicts between robotic arms within each other's operating envelopes. The three-pivot mechanism of J1 can achieve a pair of very close axes, where, for example, there is only a few millimeters between the surgical incision points 107 / 108 within incision region 101 and the surgical incision points 107' / 108' within incision region 103. For further description, see [link to documentation]. Figures 6A-6B .

[0050] Figure 2A This is an exploded view of a representative three-pivot mechanism 200.

[0051] The left offset arm 201 and right offset arm 202 are shown here, which may be part of a four-bar structure 204 having 207P2-207A and 207P1-207A. The left arm 201 of the four-bar structure 204 may have a first proximal pivot point 201P1 and a second proximal pivot point 201P2, the first proximal pivot point 201P1 being configured to receive and pivot the upper three-pivot plate 205 via connector 201C1, and the second proximal pivot point 201P2 being configured to receive and pivot the lower three-pivot plate 207 via connector 201C2. The left arm 201 of the four-bar linkage 204 may also have a distal connection / distal pivot point 201P3, which can be configured to be connected to the end effector 219 via a connector 201C3, which is connected to a connection point 219C1 on the end effector 219.

[0052] The right arm 202 of the four-bar linkage 204 may have a first proximal pivot point 202P1 and a second proximal pivot point 202P2. The first proximal pivot point 202P1 is configured to receive and pivot the upper three-pivot plate 205 via connector 202C1, and the second proximal pivot point 202P2 is configured to receive and pivot the lower three-pivot plate 207 via connector 202C2. The right arm 202 of the four-bar linkage 204 may also have a distal connection / distal pivot point 202P3, which may be configured to be coupled to the end effector 219 via connector 202C3, which is coupled to connection point 219C2 on the end effector 219. An axis 219A from the front 219F of the end effector 219 to a remote central pivot point, which may be referred to as point C (RCM), is also shown. In some examples, the axis 219A from the end effector 219 (and the distal end of the three-pivot mechanism 200) to the remote central pivot point is maintained, independent of the direction in which the end effector 219 is driven or rotated.

[0053] The upper three-pivot plate 205 is also shown, which may be a drive plate with a proximal end having proximal base pivots 205P1 and 205P2 and a drive mount 205MP located at the apex 205A or distal end of the upper plate 205. Therefore, the upper three-pivot plate 205 may be a drive triangle having bases 205P1-205P2 and sides 205P1-205A and 203P2-205A.

[0054] The drive mount 205MP can be configured to receive the motor base plate 206BP of the motor 206, which also has a motor sleeve 206S and a motor shaft 206MA, which can be a J1 motor shaft for the first joint.

[0055] A lower three-pivot plate 207 is also shown, which may be an idler plate with a proximal end having proximal base pivots 207P1 and 207P2 and a vertex 207A located at the distal end of the lower plate 207. Therefore, the lower three-pivot plate 207 may be an idler triangle with bases 207P1-207P2 and sides 207P1-207A and 207P2-207A. The vertex 207A of the lower three-pivot plate 207 may be configured to receive a motor sleeve 206S via a connector 206C.

[0056] Figure 2B This is a perspective view of a representative three-pivot mechanism 200 of a robotic arm.

[0057] The proximal linkage mechanism 205P2-205P1 may have two pivots 205P2 and 205P1. The proximal linkage mechanism 205P2-205P1 may be connected to or continuous with the upper plate 205, which may have a connected first motor 206 with a J1 motor axis 206MA. As shown here, the first motor 206 may be mounted on the lower plate 207, which may be connected to the offset arms 201 / 202. The offset arms 201 / 202 may be part of a four-bar linkage mechanism / structure, with their bases extending to the apex side of the upper plate 205 or the apex side of the lower plate 207. In some examples, the upper plate 205 and the lower plate 207, as well as the proximal linkage mechanism 205P2-205P1 and the distal linkage mechanism 201P3-202P3, may be continuous with or part of the offset arm 201 / 202.

[0058] Each of the upper plate 205 and the lower plate 207 can be three-sided (triangular), with two pivots at the base and one pivot at the vertex. The base can be wider than the vertex. The lower plate 207 can be configured to be smaller than the upper plate 205.

[0059] Offset arms 201 / 202 may have a proximal end and a distal end. The proximal end is coupled to the base of the upper plate 206 (which may correspond to the proximal linkage mechanisms 205P2-205P1) and to the base of the lower plate 207 at different points. It is coupled to the apex of both the upper and lower plates 205 at a common pivot point. The distal end is coupled to an end effector or base mount 219 (which may be located at the distal end of the offset arms 201 / 202 as shown). In some examples, the end effector / base mount 219 may be configured to engage or serve as a transition for additional or subsequent linkage mechanisms of the robot arm, such as a second joint (J2) or subsequent joint, a base plate, or an additional actuator. In other examples, the end effector / base mount 219 may be a second joint J2.

[0060] An accessory configured to attach to and actuate a surgical instrument may engage or cooperate with an end effector 219. Additional details of a tool holder configured to receive a surgical instrument and may be attached to an end effector 219 are described in International Patent Application No. PCT / US2024 / 010586, filed January 5, 2024, entitled “SURGICAL TOOL HOLDER FOR INTRAOCULARROBOTIC SURGICAL SYSTEMS,” the contents of which are incorporated herein by reference in their entirety.

[0061] The end effector / base mount 219 can be configured to hold the center of motion along the J2 axis 219A pointing to the remote center pivot point C (RCM), and to maintain drive for the next joint to move with or pivot about the remote center pivot point C (RCM). In some examples, the remote center pivot point C (RCM) may be located in the right eye or left eye 202 / 204.

[0062] This view also includes the visual axis of the visualization system 230, which may be the imaging system axis 251. The view illustrates the existence of a virtual J1 axis 252 parallel to both the J1 motor axis 206MA and the imaging system axis 251. The virtual J1 axis 252 may intersect the pivot point C (RCM) and the J2 axis 219A to align with desired cutout points in the eye 202 / 204, for example... Figure 1 The incision points 107 / 108 / 107' / 108' are described in the text. In some examples, the imaging system axis 251 may be offset from the virtual J1 axis 252 and may not intersect with the remote central pivot point C (RCM). The virtual J1 axis 252 passes through the desired incision points 20 for operating eyes 102, 104, such as 101, 103, or 107 / 108 or 107' / 108', as shown. Figure 1 As shown (see also) Figure 3 The cut 315 corresponds to the J2 axis 319A / 319B / 319C. As a result, the operation of the J1 mechanism produces movement of the end effector / second (J2) joint 219 along its axis 219A and around the remote central pivot point C (RCM), while keeping both J1 and J2 outside the imaging restricted area 350 (see [link]). Figure 3 ). Figure 2C This is a view of an exemplary four-bar structure of a three-pivot mechanism.

[0063] According to some examples, there can be two four-bar linkages: a first four-bar linkage represented by links 203+201C1, 205P2-205A, 205P1-205A, and 202C2+201, and a second four-bar linkage represented by links 203, 207P2-207A, 207P1-207A, and 201. The first four-bar linkage can have a proximal linkage 205P2-205P1, which can be the distance between the main pivot points 205P2 and 205P1, and the main pivot points 205P2 and 205P1 are configured to pivot the first four-bar linkage proximally. The second four-bar linkage can have a proximal linkage mechanism 207P2-207P1, which can be the distance between secondary pivot points 207P2 and 207P1. The secondary pivot points 207P2 and 207P1 are configured to pivot the second four-bar linkage mechanism proximally.

[0064] These two four-bar structures can share a common base with a center 205A, which can be the intersection / vertices of the non-vertical arms 205P2-205A and 205P1-205A of the first four-bar structure. The non-vertical arms 207P2-207A and 207P1-207A of the second four-bar structure can intersect at vertex 207A. One four-bar structure can create a parallelogram configured with offset arms represented by bars 203 / 201 and / or 203+201C1 / 201+202C2 to remain parallel to the base, and point 201P3 / 202P3 delineates a circle with a radius equal to the length of any one of the non-vertical bars 207P2-207A, 205P2-205A, 205P1-205A, and 207P1-207A. Other four-bar structures can be configured similarly. Also shown is a four-bar to four-bar connector 206C, which is configured to connect two four-bar structures together between the vertex 205A of the first four-bar structure and the vertex 207A of the second four-bar structure, so that the two four-bar structures can move together.

[0065] Figure 2D This is a view of the pivot point of an exemplary four-bar linkage of a three-pivot mechanism.

[0066] As shown here, there are three pivot points, including points A and B, which can be physical pivot points, and point C (RCM), which can be a virtual / remote pivot point or a remote center of motion. In some examples, the axes passing through the pivot points including pivot points A / B / C can be parallel.

[0067] The corresponding parallel rod / axis pairs shown here may include: 203' / 201', GF / ED / 201P3'-202P3', GA / EB / 202P3'-C and AF / BD / C-201P3'.

[0068] Triangular members forming the links corresponding to the four-bar linkage include an upper triangular member AF / GF / GA that can pivot about point A and a lower triangular member BD / ED / EB that can pivot about point B. A virtual triangular member can be formed by C-201P3' / 201P3'-202P3' / 202P3'-C configured to pivot about a virtual / remote motion center point C (RCM). Links 203' and 201' can connect the triangular members AF / GF / GA and BD / ED / EB together, for example, at points F / G and D / E at the base of the triangular members AF / GF / GA and BD / ED / EB, respectively. Links 203' and 201' can also create constraints that cause the link / remote link / remote linkage 201P3'-202P3' to pivot about point C (RCM) and determine the distances of point C (RCM) from points A and B.

[0069] In some examples, the motor can be attached between the base and the upper triangular member AF / GF / GA, centered at point A. The upper triangular member AF / GF / GA can be referred to as the drive triangular member driven by the motor. The lower triangular member BD / ED / EB can be referred to as the idler wheel triangular member because it can be configured to be actuated like an idler wheel, and it can rotate freely if it is not constrained to follow the movement of the upper / drive triangular member AF / GF / GA. The levers 203' / 201' can be offset arms configured to create an offset between the upper / drive triangular member AF / GF / GA, the lower / idler wheel triangular member BD / ED / EB, and the virtual triangular member C-201P3' / 201P3'-202P3' / 202P3'-C rotating about point C (RCM).

[0070] In some examples, the dimensions and thickness / volume of the upper / drive triangle AF / GF / GA and the lower / idler triangle AF / GF / GA may differ, but the segment lengths and angles of each of these triangles may remain equal to the other segments and angles of a particular triangle. For example, the upper / drive triangle AF / GF / GA may be wider to accommodate a larger motor or guide wiring passing through it. Similarly, the thickness of the triangles may be increased to accommodate the loads carried by the triangles.

[0071] In some examples, the distance from point A to point B can be 20 mm, and the distance from point B to point C can be 195 mm. In some examples, the upper / drive triangle AF / GF / GA and the lower / idler triangle BD / ED / EB can have a dimension of 100 mm from their base to their vertex (corresponding to the distance between the midpoint of point FG and point A, and the midpoint of point DE and point B), a base width of 70 mm (corresponding to the distance between the midpoint of point FG and point DE), and a Z dimension or thickness of 4.5 mm, and a distance of approximately 106 mm from the side point of the base to the vertex (corresponding to the distance between the midpoint of point GA, point FA, point DB, and point EB).

[0072] Figure 2E This is an isometric view of the three-pivot mechanism in a neutral position. As shown here, there is an upper plate 205 that can correspond to the drive triangle and a lower plate 207 that can correspond to the idler wheel drive. In some examples, the upper plate 205 and the lower plate 207 are aligned along the centerline of the three-pivot mechanism. The end effector / base mount 219 at the distal output linkage of the three-pivot mechanism is also shown in a neutral position, with the front face 219F of the end effector / base mount 219 facing the distal direction and angled downward along the axis 291A from the front face 219F to the distal central pivot point.

[0073] Figure 2F This is an isometric view of the three-pivot mechanism in the first position. The upper plate 205 and lower plate 207, pivoting to the left, and the end effector / base mount 219, rotating counterclockwise, for example, around a remote center pivot point corresponding to an axis 219A from the front face 219F of the end effector / base mount 219 to a remote center pivot point.

[0074] Figure 2G This is an isometric view of the three-pivot mechanism in the second position. Here are shown an upper plate 205 and a lower plate 207 pivoting to the right, and an end effector / base mount 219 rotating clockwise, for example about an axis 219A extending through the front face 219F of the end effector / base mount 219 and a remote central pivot point.

[0075] Figure 3This is a top-down view 300 illustrating an exemplary second joint (J2) of a three-pivot mechanism moved to output linkage / end effector positions 319I / 319II / 319III, pivoting / rotating 315 relative to exemplary cutout points 301 / 303 in eyes 302 / 304 at three positions 301 / 302, 301' / 302', and 301'' / 302''. In some examples, the first joint J1 can operate J2 at the three positions 319I / 319II / 319III shown for the output linkage / end effector. The J2 axes 319A / 319B / 319C can be configured to remain aligned with cutout points 301 / 303, which can be or correspond to the removal of the central pivot point, for example, previously in Figure 2D The C (RCM) described in the diagram. The three-pivot mechanism 300 may include proximal linkages 305P2-305P1, a primary pivot triangle 305, a secondary pivot triangle 307, distal linkages 301P3-302P3, and J2 motor axes 319A / 319B / 319C, which can be configured to actuate J2 and the coupled left offset arm 301 and right offset arm 302 at various positions (as shown by the exemplary second joint (J2) positions 301-302 / 301'-302' / 301''-302'' at the output linkages 301P3-302P3). The view also illustrates that the three-pivot mechanism 300 does not cause any physical overlap with the visualization restricted area 350, which may be defined by or coincide with the field of view of the visualization system 330.

[0076] Exemplary eyes 302 / 304 and incision points 301 / 303 are shown. The dashed circle around the eyes is a visualization no-entry zone 350, ensuring that the operation of the robotic system does not interfere with the surgical visualization system 330. In other words, the dashed circle 350 is the spatial requirement of the visualization system. Operation of the joint 1 motor produces movements 319I / 319II / 319III into all three positions. Each position 319I / 319II / 319IIII indicates that the corresponding J2 rotation axes 319A / 319C / 319B are aligned with the illustrative incision points 301 / 303, respectively. As a result of the three-pivot mechanism design 300, each possible configuration of the three-pivot mechanism 300 will remain away from the visualization no-entry zone 350.

[0077] in addition, Figure 3The illustration shows how the main body of the mechanism is displaced from the axis of rotation to become a remote central joint mechanism. Arc 315 around the intersecting circle / notch point 301 / 303 represents the axis of rotation 315 of the remote central joint. In some embodiments, the axis of rotation of the remote central joint 301 / 303 may be parallel to the line of sight. In other embodiments, the axis of rotation of the remote central joint may be slightly displaced from the line of sight (+ / - 1 cm).

[0078] Figure 4 This is a perspective view of a pair of three-pivot mechanisms 404A / 404B configured as a left and right robotic arm (or a first and second robotic arm) relative to a pair of surgical entry points relative to a visualization no-entry zone 5450 and the patient's right eye. These surgical entry points may correspond to surgical tool axes 407A / 408A for the left and right robotic arms, respectively. A first joint rotation axis 452 is also shown, which may be parallel to the visualization system 430. Each of the left and right robotic arms may have a pair of surgical robotic arms (such as 401A / 402A), a first joint motor axis 406MA / 406MB, and an exemplary second joint at an output linkage mechanism 419A / 419B.

[0079] The first joint of each of the surgical robotic arms is designed as a three-pivot mechanism 404A / 404B. This design ensures that the robotic arm remains as close as possible to the visualization no-entry zone 450 without obstructing the space between the visualization system 430 and the patient's eyes. Figure 4 It also shows how each robotic arm interacts with... Figure 1 One of the two incision points described herein is aligned. Thus, the two robotic arms can advantageously operate in series at a location adjacent to the patient's head, while remaining away from the visual restricted area 450 and entering through a pair of entry incisions in the same eye.

[0080] Figure 5A This is a top-down view of the three-pivot mechanism in the first position 500, with the output link at the 12 o'clock position relative to the corresponding first joint J1 axis 506MA (which may be the motor axis for the first joint J1). The proximal linkages 505P2-505P1, the main pivot triangle / drive triangle 505, the secondary pivot / idler triangle 507, the base 505MP with center 505A, and the offset left arm 501 and offset right arm 502 connected to the proximal linkages 505P2-505P1 and the distal linkages 501P3-502P3 are also shown. The end effector axis 519A, aligning the distal linkages 501P3-502P3 with the remote center pivot point C (RCM), is further shown.

[0081] Figure 5B yes Figure 5A A top-down view of the three-pivot mechanism 500, wherein operation of the articulated motor has caused the output / distal linkage mechanisms 501P3-502P3 to rotate 506MA' relative to the corresponding J1 motor axis 506MA in the first position 500 to the 2 o'clock position 500'. The proximal linkage mechanisms 505P2-505P1' and the center 505A' of the base 505MP', the main pivot triangle / drive triangle 505', the secondary pivot triangle / idler triangle 507', and the distal linkage mechanisms 501P3-502P3' are shown again, rotating about the end effector axis 519A' while maintaining the position of the remote center pivot point C (RCM).

[0082] Let's take a look together. Figure 5A and Figure 5B , Figure 5A and Figure 5B The diagram illustrates the operating principles of the three-pivot mechanism 500 / 500' of the present invention. The illustrative three-pivot mechanism 500 / 500' has proximal links 505P2-505P1 / 505P2-505P1' and distal links 501P3-502P3 / 501P3-502P3'. The proximal links are positioned such that a joint motor (which may be on the base 505MP / 505MP') is located between the proximal links and the cutout portion. The distal links are positioned such that a joint motor (e.g., joint motor 519 / 519') is located between the distal links and the cutout portion. The proximal and distal links remain parallel at all times, thereby allowing the bottom link or distal link to rotate about an axis offset from the body of the mechanism (e.g., the end effector / J2 axis 519A'). The robot's additional distal joints are mounted to distal links or bottom links, causing the remote center of the robot arm (such as the remote center pivot point C (RCM)) to be offset from the main body of the joint mechanism. This configuration advantageously increases the range of motion and provides a more compact design.

[0083] Figure 6A This is a top-down view of a pair of three-pivot mechanisms 600A / 600B configured as a first robotic arm 601A / 602A and a second robotic arm 601B / 602B, wherein the first robotic arm 601A / 602A and the second robotic arm 601B / 602B are positioned to allow each robotic arm to enter as... Figure 1One of a pair of incision points for the left eye. The three-pivot mechanism motors of the first robotic arm 601A / 602A are adjacent to the top of the patient's head, while the three-pivot mechanism motors of the second robotic arm 601B / 602B are adjacent to the patient's mandible. The view also shows how each robotic arm provides the desired alignment for each incision point on the tool axis 607A / 607B while remaining away from the visual no-entry zone 650. In this illustrative embodiment, the first robotic arm 601A / 602A (adjacent to the patient's head) is positioned to enter the upper incision point, while the second robotic arm 601B / 602B (adjacent to the patient's mandible) is positioned to enter the lower incision point.

[0084] Figure 6B This is a top-down view of a pair of three-pivot mechanisms 600A' / 600B' configured as a first robotic arm 601A' / 602A' and a second robotic arm 601B' / 602B', wherein the first robotic arm 601A' / 602A' and the second robotic arm 601B' / 602B' are positioned for allowing each robotic arm to enter as... Figure 1 One of a pair of incision points for the right eye. The three-pivot mechanism motors of the second robotic arm 601B' / 602B' are adjacent to the top of the patient's head, while the three-pivot mechanism motors of the first robotic arm 601A' / 602A' are adjacent to the patient's jaw. The view also shows how each robotic arm provides the desired alignment for each incision point on the tool axis 607A' / 607B' while remaining away from the visual no-entry zone 650'. In this illustrative embodiment, the arms have been moved to approach the right eye. The second robotic arm 601B' / 602B' (now adjacent to the patient's head) is positioned to enter the upper incision point, while the first robotic arm 601A' / 602A' (now adjacent to the patient's jaw) is positioned to enter the lower incision point.

[0085] Therefore, the first and second robotic arms can be configured to operate in separate and non-overlapping surgical fields, with each robotic arm operating within its respective operational envelope to eliminate robotic arm conflicts when cooperating with an imaging system that defines the imaging field / visual exclusion zone. In some examples, the first and second robotic arms can have coordinated motion while sharing a common remote central pivot point. The first and second robotic arms can be configured to optimally approach designated portions of the eye and head anatomy from a convenient angle, while avoiding movement across the face, nose, etc., for example, by moving clockwise between the patient's right and left eyes across the chin and ears. In some examples, the bases of the robotic arms can move in series to reposition the actuators to approach the opposing eye.

[0086] Figure 7This is a flowchart illustrating a method for actuating an end effector of a robotic arm within an operational envelope maintained outside the imaging volume 700.

[0087] Method 700 begins at box 705, where the imaging volume of the surgical environment is defined.

[0088] Method 700 continues at block 710, wherein the movement of the distal end effector at the distal linkage of the actuating three-pivot mechanism about the remote central pivot point is actuated.

[0089] Method 700 actuates the distal end effector around the remote center pivot point (as described in block 715) by actuating the pivoting of the proximal drive triangle and idler wheel triangle of the three-pivot mechanism in a first direction to actuate the distal end effector around the remote center pivot point and within the working envelope outside the imaging volume.

[0090] Method 700 further actuates the distal end effector around the remote center pivot point (as described in block 720) by actuating the pivoting of the proximal drive triangle and idler wheel triangle of the three-pivot mechanism in a first direction to actuate the distal end effector around the remote center pivot point and within the working envelope outside the imaging volume.

[0091] In some examples, method 700 also includes offsetting the distance between the drive triangle and the idler triangle via an offset arm of a three-pivot mechanism that connects the distal end effector to the idler triangle and the drive triangle.

[0092] In some examples of method 700, the defined imaging area defines a visualization no-entry zone.

[0093] In some examples of method 700, the definition of the imaging area is performed by the visualization system.

[0094] In some examples, method 700 further includes pivoting the centerline aligned with the drive triangle and the idler triangle in a neutral position in a first direction to actuate the distal end effector clockwise about a remote central pivot point via a three-pivot mechanism, and method 700 further includes pivoting the centerline aligned with the drive triangle and the idler triangle in a neutral position in a second direction to actuate the distal end effector counterclockwise about a remote central pivot point via a three-pivot mechanism.

[0095] The embodiments of the three-pivot mechanism described herein can be adapted and configured for use in an image-guided robotic microsurgery system, which is described in U.S. Provisional Patent Application No. 63 / 514,777, filed July 20, 2023, entitled “Robotic Assisted Ophthalmic Surgery System” (Attorney General’s File No. 14843-705.100), which is incorporated herein by reference for all purposes.

[0096] When a feature or element is referred to herein as being “on” another feature or element, it may be directly on the other feature or element, or there may be intermediate features or elements present. Conversely, when a feature or element is referred to as being “directly on” another feature or element, no intermediate features or elements are present. It will also be understood that when a feature or element is referred to as being “connected,” “attached,” or “joined” to another feature or element, it may be directly connected, attached, or joined to the other feature or element, or there may be intermediate features or elements present. Conversely, when a feature or element is referred to as being “directly connected,” “directly attached,” or “directly joined” to another feature or element, no intermediate features or elements are present. Although described or illustrated with respect to one embodiment, the features and elements thus described or illustrated may be applied to other embodiments. Those skilled in the art will also recognize that a structure or feature referring to being “adjacent” to another feature may have portions overlapping with or below the adjacent feature.

[0097] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the invention. For example, as used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well, unless the context otherwise clearly indicates otherwise. It should be further understood that the terms “comprises” and / or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term “and / or” includes any and all combinations of one or more of the associated listed items and may be abbreviated as “ / .”

[0098] Spatially related terms such as “under,” “below,” “lower,” “over,” and “upper” are used herein to facilitate description of the relationship of an element or feature as illustrated in the accompanying drawings to other elements or features. It should be understood that spatially related terms are intended to encompass different orientations of the device in use or operation beyond those depicted in the drawings. For example, if the device in the drawings is reversed, an element described as “below” or “under” other elements or features would then be oriented “over” other elements or features. Thus, the exemplary term “below” can include both “over” and “below” orientations. The device may be otherwise oriented (rotated 90 degrees or otherwise), and the spatially related descriptive terms used herein are interpreted accordingly. Similarly, unless otherwise specifically stated, the terms “upwardly,” “downwardly,” “vertical,” and “horizontal” are used herein for illustrative purposes.

[0099] While the terms "first" and "second" may be used herein to describe various features / elements (including steps), these features / elements should not be limited by these terms unless the context otherwise requires. These terms may be used to distinguish one feature / element from another. Therefore, without departing from the teachings of the invention, the first feature / element discussed below may be referred to as the second feature / element, and similarly, the second feature / element discussed below may be referred to as the first feature / element.

[0100] Throughout this specification and the appended claims, unless the context otherwise requires, the term "comprise" and its variations such as "comprises" and "comprising" mean that various components may be used together in methods and articles of manufacture (e.g., compositions and apparatuses, including devices and methods). For example, the term "comprising" will be understood to imply the inclusion of any of the stated elements or steps, but does not exclude any other elements or steps.

[0101] As used herein in the specification and claims, including in the examples, and unless otherwise expressly stated, all figures may be treated as if preceded by the words “about” or “approximately”, even if the term is not explicitly stated. The phrase “about” or “approximately” may be used when describing magnitude and / or location to indicate that the described value and / or location is within a reasonably expected range of value and / or location. For example, numerical values ​​may have values ​​of + / -0.1% of the stated value (or range of values), + / -1% of the stated value (or range of values), + / -2% of the stated value (or range of values), + / -5% of the stated value (or range of values), + / -10% of the stated value (or range of values), etc. Any numerical value given herein should also be understood to include about or approximately that value, unless the context otherwise requires. For example, if the value “10” is disclosed, “about 10” is also disclosed. Any numerical ranges listed herein are intended to include all subranges contained therein. It should also be understood that, as those skilled in the art will appropriately understand, when a value is disclosed, the terms "less than or equal to" that value, "greater than or equal to" that value, and possible ranges between values ​​are also disclosed. For example, if the value "X" is disclosed, then "less than or equal to X" and "greater than or equal to X" (e.g., where X is a numerical value) are also disclosed. It should also be understood that throughout the application, data is provided in a variety of different formats, and this data represents the endpoints and starting points, as well as the range, of any combination of data points. For example, if specific data point "10" and specific data point "15" are disclosed, then it should be understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15, as well as between 10 and 15, are considered disclosed. It should also be understood that each unit between two specific units is also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0102] While various illustrative embodiments have been described above, any of several changes may be made to the various embodiments without departing from the scope of the invention as described in the claims. For example, in alternative embodiments, the order in which the various described method steps are performed may typically be changed, and in other alternative embodiments, one or more method steps may be skipped in total. Optional features of the various apparatus and system embodiments may be included in some embodiments but not in others. Therefore, the foregoing description is provided primarily for illustrative purposes and should not be construed as limiting the scope of the invention as set forth in the claims.

[0103] The examples and illustrations included herein are shown by way of illustration, not limitation, of specific embodiments in which the subject matter can be practiced. As mentioned, other embodiments can be utilized and derived therefrom, allowing for structural and logical substitutions and changes without departing from the scope of this disclosure. For convenience only, such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term "invention," and if more than one is actually disclosed, it is not intended to actively limit the scope of this application to any single invention or inventive concept. Thus, while specific embodiments have been illustrated and described herein, any arrangement believed to achieve the same purpose may replace the specific embodiments shown. This disclosure is intended to cover any and all modifications or variations of the various embodiments. Upon reading the above description, those skilled in the art will understand the combinations of the above embodiments and other embodiments not specifically described herein.

Claims

1. A three-pivot mechanism for a surgical robot, comprising: The upper three-pivot plate has a first proximal pivot point and a second proximal pivot point; The lower three-pivot plate has a vertex pivot point, a first proximal pivot point, and a second proximal pivot point; A left offset arm having a proximal end and a distal end; The first proximal pivot point is located at the proximal end of the left offset arm; The second proximal pivot point is located distal to the first proximal pivot point on the left offset arm; A right offset arm having a proximal end and a distal end; The first proximal pivot point is located at the proximal end of the right offset arm; The second proximal pivot point is located distal to the first proximal pivot point on the right offset arm; A drive motor is connected to the upper three-pivot plate, wherein the rotation axis of the drive motor is the rotation axis of the three-pivot mechanism; A pivoting connection is located between the sleeve adjacent to the distal portion of the upper three-pivot plate and the vertex pivot point of the lower three-pivot plate; The first left proximal pivot point is located between the first proximal pivot point of the left offset arm and the second proximal pivot point of the upper three-pivot plate; The second left proximal pivot point is located between the second proximal pivot point of the left offset arm and the second proximal pivot point of the lower three-pivot plate; The first right proximal pivot point is located between the first proximal pivot point of the right offset arm and the first proximal pivot point of the upper three-pivot plate; and The second right proximal pivot point is located between the second proximal pivot point of the right offset arm and the first proximal pivot point of the lower three-pivot plate.

2. The three-pivot mechanism for a surgical robot according to claim 1, further comprising an end effector coupled between the distal end of the right offset arm and the distal end of the left offset arm.

3. The three-pivot mechanism for a surgical robot according to claim 2, wherein, The end effector is connected to the pivot connection between the distal end of the right offset arm and the distal end of the left offset arm.

4. The three-pivot mechanism for a surgical robot according to claim 1, further comprising a motor mount connected to the distal end of the right offset arm and the distal end of the left offset arm.

5. The three-pivot mechanism for a surgical robot according to claim 4, wherein, The second motor mount is connected to the pivot connection between the distal end of the right offset arm and the distal end of the left offset arm.

6. The three-pivot mechanism for a surgical robot according to claim 1, wherein, The operation of the drive motor produces movement of the distal ends of the right offset arm and the distal ends of the left offset arm about a virtual axis of rotation parallel to the axis of rotation of the three-pivot mechanism.

7. A three-pivot mechanism for a surgical robot, comprising: A left offset arm having a proximal end and a distal end; A right offset arm, the right offset arm having a proximal end and a distal end; The first four-bar linkage is used to drive the three-pivot mechanism. The first four-bar linkage includes the distal end of the left offset arm, the first proximal pivot of the left offset arm, the drive plate of the upper three-pivot plate, the first proximal pivot point of the right offset arm, and the distal end of the right offset arm. and The second four-bar structure is adjacent to and driven by the first four-bar structure. The second four-bar structure includes the distal end of the left offset arm, the second proximal pivot of the left offset arm, the apex pivot point of the lower three-pivot plate, the first proximal pivot point of the right offset arm, and the distal end of the right offset arm.

8. The three-pivot mechanism according to claim 7, wherein, The first four-bar structure and the second four-bar structure each form an M-shape, wherein the base of the legs of the M-shape is located at the distal end of the right offset arm and the distal end of the left offset arm.

9. The three-pivot mechanism according to claim 7, wherein, The operation of the first four-bar linkage causes the distal ends of the left offset arm and the right offset arm to move around a remote center of motion.

10. A three-pivot mechanism for a surgical robot, comprising: A first four-bar linkage having a right offset arm and a left offset arm, and configured to connect a proximal linkage mechanism of the robot arm having a first pair of proximal pivots to a first pivot point on the base of the robot arm; The second four-bar linkage is located below and parallel to the first four-bar linkage. The second four-bar linkage has a right offset arm and a left offset arm and is configured to connect the distal linkage mechanism of the robot arm with a pair of distal pivots to a second pair of proximal linkage mechanisms distal to the first pair of proximal linkage mechanisms and a second pivot point on the base. and Remote central pivot.

11. The system according to claim 10, wherein, The first four-bar linkage, the first pair of proximal pivots, and the first pivot point on the base form a drive triangle, the drive triangle having the pair of proximal pivots as the base of the drive triangle and the first pivot point on the base as the vertex of the drive triangle, wherein the drive triangle pivots about the first pivot point, and further wherein a motor is coupled to the first pivot point to actuate the drive triangle.

12. The system according to claim 11, wherein, The second four-bar structure, the second pair of proximal pivots, and the second pivot point on the base form an idler wheel triangle, the idler wheel triangle having the second pair of proximal pivots as the base of the idler wheel triangle and the second pivot point on the base as the vertex of the idler wheel triangle; wherein the idler wheel triangle is configured for passive movement and pivoting about the second pivot point.

13. The system according to claim 12, wherein, The pair of distal pivots and the remote center point form a virtual triangle, the virtual triangle having the pair of distal pivots as the base of the virtual triangle and the remote center point as the vertex of the virtual triangle; wherein the virtual triangle pivots about the remote center point.

14. The system according to claim 13, further wherein, The drive triangle, the idler triangle, and the virtual triangle are longitudinally connected via the right offset arm and the left offset arm of the first four-bar linkage and the second four-bar linkage, wherein the right offset arm and the left offset arm are configured to provide offset between the drive triangle, the idler triangle, and the virtual triangle, and to allow the triangle to rotate about the remote central pivot.

15. The system of claim 10, further comprising an additional microsurgical robotic arm configured to operate collaboratively with the microsurgical robotic arm and the three-pivot mechanism around the remote central pivot, wherein, The additional robotic arm has an end effector whose working envelope is mutually exclusive with and cooperative with the working envelope of the end effector and the imaging volume envelope of the robotic arm.

16. The system according to claim 15, wherein, The working envelope of the robotic arm and the working envelope of the additional robotic arm correspond to designated mutually exclusive regions of the patient's right and left eyes, wherein the end effector of the robotic arm and the end effector of the additional robotic arm are configured to enter the respective mutually exclusive regions of the right and left eyes via an entry angle and path that does not obstruct the patient's facial anatomy, wherein the respective mutually exclusive regions of the right and left eyes include designated surgical incision points.

17. The system according to claim 10, wherein, The imaging volume envelope is a visualization no-entry zone, further wherein the visualization no-entry zone is defined by the visualization system of the system.

18. The system according to claim 10, wherein, The end effector of the robotic arm is configured to support the three-pivot mechanism and an additional connection that can be attached to the end effector to pivot about a remote central pivot point.

19. A method for actuating an end effector of a robotic arm within an operational envelope maintained outside an imaging volume, comprising: Limit the imaging volume of the surgical environment; The movement of the distal end effector at the distal linkage of the three-pivot mechanism about the remote central pivot point is actuated by the following operation: - Actuate the pivoting of the proximal drive triangle and idler wheel triangle of the three-pivot mechanism in a first direction to actuate the distal end effector to move counterclockwise around the remote central pivot point and within the working envelope outside the imaging volume; and - Actuate the pivoting of the proximal drive triangle and idler wheel triangle of the three-pivot mechanism in the second direction to actuate the clockwise movement of the distal end effector around the remote central pivot point and within the working envelope outside the imaging volume.

20. The method of claim 19, further comprising offsetting the distance between the drive triangle and the idler triangle via an offset arm of the three-pivot mechanism, the offset arm connecting the distal end effector to the idler triangle and the drive triangle.

21. The method according to claim 19, wherein, The defined imaging volume defines the no-visualization zone.

22. The method according to claim 19, wherein, The imaging volume is defined by the visualization system.

23. The method of claim 19, further comprising pivoting the centerline aligned with the drive triangle and the idler triangle in a neutral position in a first direction to actuate the distal end effector clockwise about the remote center pivot point via the three-pivot mechanism, the method further comprising pivoting the centerline aligned with the drive triangle and the idler triangle in the neutral position in a second direction to actuate the distal end effector counterclockwise about the remote center pivot point via the three-pivot mechanism.

24. A system for image-guided robotic ophthalmic surgery, comprising: A visualization system that defines a cylindrical imaging volume aligned with the patient's visual axis of the eye, in which image-guided robotic ophthalmic surgery will be performed; and A microsurgical robotic arm adapted and configured to move within a region surrounding but not intersecting the cylindrical imaging volume, wherein a first axis of rotation for yaw motion is parallel to the patient's visual axis, wherein the mechanism for the yaw axis is a remote central articulation mechanism adapted and configured to allow the envelope of the visualization system and the movement envelope of the rotation axis mechanism to coexist directly adjacently without colliding with the envelope of the visualization system.

25. The system according to claim 24, wherein, The first rotation axis of the yaw motion includes at least a distal linkage mechanism and a proximal linkage mechanism, wherein in use, the proximal linkage mechanism and the distal linkage mechanism are kept in parallel orientation, and the distal linkage mechanism is located outside the cylindrical image-forming volume.

26. The system according to claim 25, wherein, At least the distal linkage mechanism and the proximal linkage mechanism are part of a three-pivot mechanism.

27. The system according to claim 26, wherein, The mechanical design of the three-pivot mechanism is constrained by the dimensions of the cylindrical image-forming volume.

28. The system according to any one of claims 24-27, wherein, The first axis of rotation of the yaw motion is adjacent to the patient's visual axis.

29. The system according to any one of claims 24-27, wherein, The first axis of rotation of the yaw motion is parallel to the patient's visual axis and is displaced from the patient's visual axis by less than 1 cm.

30. The system according to any one of claims 24-27, wherein, The first axis of rotation of the yaw motion is parallel to the patient's visual axis of the eye and rotates at the surgical incision point of the eye.

31. A microsurgical robot for image-guided ophthalmic surgery, comprising a set of two identical robotic arms according to claim 24, wherein, Each of a pair of robotic arms is adapted and configured to remain away from the cylindrical forming image volume and a predetermined operating envelope of the other robotic arm in the pair.

32. The microsurgical robot according to claim 31, wherein, A pair of identical surgical robotic arms are a first robotic arm and a second robotic arm, the working envelope of each of the first and second robotic arms being configured such that: the first robotic arm enters an upper incision point in a first eye, while the second robotic arm is configured to simultaneously enter a lower incision point in the first eye, and wherein the first and second robotic arms are configured to move without collision such that the first surgical robotic arm enters a lower incision point in a second eye, while the second robotic arm simultaneously enters an upper incision point in the second eye.

33. A surgical robotic arm for use in microsurgery near a remote center of motion, comprising: The first joint employs a remote central joint mechanism having a rotation axis coaxial with the visualization axis of the image-guided system used during the microsurgery, and the first joint has a range of motion of + / -90 degrees from the nominal configuration.

34. The surgical robotic arm according to claim 33, wherein, The robotic arm includes additional degrees of freedom on the distal side of the first remote central mechanism.

35. The surgical robotic arm according to claim 34, wherein, The additional degree of freedom is one or a combination of a remote central joint, a non-remote central joint, a linear joint, or a prismatic joint.

36. The surgical robotic arm according to any one of claims 33-35, wherein, The first joint includes a three-pivot mechanism.

37. The surgical robotic arm according to claim 36, wherein, The microsurgical procedure is an ophthalmic procedure, and the axis of rotation of the first joint is parallel to and adjacent to the visual axis of the eye of the patient undergoing the ophthalmic procedure.

38. The surgical robotic arm according to claim 36, wherein, The microsurgical procedure is an ophthalmic procedure in which the visualization axis of the image-guided system is coaxial with the visual axis of the patient's eye undergoing the ophthalmic procedure, and the rotation axis of the first joint is parallel to the patient's visual axis and is displaced from the patient's visual axis by less than 1 cm.

39. A system for image-guided robotic ophthalmic surgery, comprising: A defined imaging volume envelope, which is aligned with the visual axis of the eye, within which image-guided robotic ophthalmic surgery will be performed; and A pair of microsurgical robotic arms according to any one of claims 1, 7, 10, 24, and 33, the pair of microsurgical robotic arms being adapted and configured for movement about a common remote central pivot point via a three-pivot mechanism, the common remote central pivot point being adapted and configured to allow the imaging volume envelope and the working envelope of the end effector of each of the pair of robotic arms to coexist adjacently in a mutually exclusive region.

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