Surgical robotic system and control of a surgical robotic system

Abstract

A surgical robotic system for use in an intraocular procedure is provided, the surgical robotic system comprising: a surgical arm comprising a movable arm portion comprising an end effector for holding a surgical instrument; an OCT probe configured to be attached to or integrated into an intraocular portion of the surgical instrument; and an actuator subsystem configured to actuate the movable arm portion. During the intraocular procedure, the presence of a feature of interest can be monitored via repeatedly acquiring sensor data via the OCT probe at respective positions of the surgical instrument, analyzing reflectivity depth curves to determine a property of the feature of interest in the reflectivity depth curves, and if the property meets a predetermined property indicator, completing a feedback action. Thereby, a human operator can not need to manually determine the property of the feature of interest anymore, and the feedback action can help to perform a (semi-) autonomous operation.

Description

Technical Field

[0001] This invention relates to a surgical robot system for use in intraocular procedures, and to a computer program comprising instructions that, when executed by a processor subsystem of the surgical robot system, cause the processor subsystem to control the surgical robot system during intraocular procedures. Background Technology

[0002] Intraocular procedures are increasingly involving the use of surgical robotic systems. These systems are not expected to operate entirely autonomously, but rather are anticipated to remain at least partially under the control of a human operator for the foreseeable future. For example, the human operator can directly or indirectly control the movement of surgical instruments mounted on the surgical arms of the robotic system. However, future surgical robotic systems are expected to be more autonomous and require less or even no human operator involvement.

[0003] A surgical robotic system designed for intraocular procedures may be provided with a surgical arm comprising a movable arm portion, wherein the movable arm portion includes an end effector for holding a surgical instrument. Accordingly, the surgical instrument can be positioned by the surgical arm. An actuator subsystem may be provided for actuating the movable arm portion to perform movement of the surgical instrument. Movement of the surgical instrument can be in a lateral direction, such as relative to the retinal surface, and in a longitudinal direction, such as along the longitudinal axis of the surgical instrument. This longitudinal movement allows the surgical instrument to move toward and away from a surgical target within the eye. Accordingly, the surgical instrument can be used to trim (biological) tissue near the surgical target, deliver medication to the surgical target, etc. Examples of surgical instruments include, but are not limited to, forceps, mechanical cutters, coagulation cutters, scissors, injection needles, sealing devices, etc.

[0004] Surgical robot systems of the aforementioned type are known in themselves. For example, WO 2016 / 030336 A1 describes a surgical robot system for use in a surgical procedure, the surgical robot system including a surgical arm, the surgical arm including a movable arm portion including an instrument connector for mounting surgical instruments, the surgical instruments having a longitudinal axis, the movable arm portion having at least one degree of freedom such that the surgical instruments can move longitudinally toward a surgical target along the longitudinal axis of the surgical instruments. The surgical robot system further includes: a human-machine interface for receiving positioning commands from a human operator to control the longitudinal movement of the surgical instruments; an actuator configured to actuate the movable arm portion to perform the longitudinal movement of the surgical instruments; and a processor configured to control the actuator according to the positioning commands. Summary of the Invention

[0005] During intraocular procedures, the characteristics and properties of the area near the surgical instruments may be of particular interest. For example, in membrane peeling surgery, the presence and / or thickness of the epiretinal membrane near the surgical instruments may be of interest.

[0006] It would be advantageous if surgical robotic systems could assist in determining the properties of such features of interest.

[0007] In a first aspect of the invention, a surgical robot system is provided for use in surgical procedures, such as intraocular procedures. The surgical robot system includes:

[0008] - A surgical arm, the surgical arm including a movable arm portion, the movable arm portion including an end effector for holding surgical instruments;

[0009] - Optical coherence tomography (OCT) probe, wherein the OCT probe is configured to attach to or be integrated into an insertable portion of the surgical instrument (e.g., an intraocular portion) for insertion into the patient’s interior, such as into the eye;

[0010] - An actuator subsystem configured to actuate the movable arm portion;

[0011] - A processor subsystem configured to control the actuator subsystem to control the position of a surgical instrument during a surgical procedure, wherein the processor subsystem is further configured to monitor features of interest by repeatedly performing the following operations at the corresponding position of the surgical instrument:

[0012] - Sensor data is acquired via the OCT probe, wherein the sensor data indicates the reflectivity depth profile of the structure originating from the beam within the OCT probe;

[0013] - Analyze the reflectance-depth curve to determine the properties of the feature of interest within the reflectance-depth curve; and

[0014] - If the attribute meets the predefined attribute criteria, then complete the feedback action.

[0015] In another aspect of the invention, a computer program including instructions is provided that, when executed by a processor subsystem of a surgical robot system, cause the processor subsystem to control the surgical robot system during a surgical procedure, such as an intraocular procedure. The surgical robot system includes:

[0016] - A surgical arm, the surgical arm including a movable arm portion, the movable arm portion including an end effector for holding surgical instruments;

[0017] - Optical coherence tomography (OCT) probe, wherein the OCT probe is configured to attach to or be integrated into an insertable portion of the surgical instrument (e.g., an intraocular portion) for insertion into the patient’s interior, such as into the eye;

[0018] - An actuator subsystem configured to actuate the movable arm portion;

[0019] - This processor subsystem;

[0020] The computer program includes instructions for causing the processor subsystem to perform the following operations:

[0021] - Control the actuator subsystem to control the position of the surgical instrument during the surgical procedure; and

[0022] - The feature of interest is monitored simultaneously with or alternately in time by repeatedly performing the following operations at the corresponding location of the surgical instrument:

[0023] - Sensor data is acquired via the OCT probe, wherein the sensor data indicates the reflectivity depth profile of the structure originating from the beam within the OCT probe;

[0024] - Analyze the reflectance-depth curve to determine the properties of the feature of interest within the reflectance-depth curve; and

[0025] - If the attribute meets the predefined attribute criteria, then complete the feedback action.

[0026] In another aspect of the invention, a transient or non-transitory computer-readable medium is provided, the computer-readable medium comprising data representing a computer program.

[0027] The above aspects of the present invention provide a surgical robot system including a surgical arm. The surgical arm may include a movable arm portion, and the movable arm portion may include an end effector for holding a surgical instrument. For example, the end effector may include an instrument connector for, for example, removably mounting the surgical instrument. The surgical instrument may typically have a longitudinal axis that typically passes through the end of the surgical instrument. The movable arm portion may have at least one degree of freedom (DoF) to allow the end of the surgical instrument to move laterally, for example, relative to an anatomical surface (such as the surface of the retina or the surface of another structure inside or on the eye). The movable arm portion may typically have three or more DoFs, for example, to enable the surgical instrument to move longitudinally along the longitudinal axis, for example, advancing toward and / or retracting away from the surgical target, and to enable the end of the surgical instrument to move laterally along a plane perpendicular to the longitudinal axis. It should be noted that surgical arms having the functions described in this paragraph are known per se from the field of medical robotics and are also referred to as instrument manipulators, robotic arms, surgical robot end devices, etc.

[0028] An actuator subsystem can be provided to actuate the movable arm portion to achieve lateral movement of the tip of the surgical instrument, and typically also to achieve its longitudinal movement. Another term for the actuator subsystem is the drive mechanism.

[0029] A processor subsystem can be provided for controlling the actuator subsystem to control the position of surgical instruments during a surgical procedure, such as the position relative to the intraocular surface during an intraocular procedure. In some embodiments, the processor subsystem can be configured to receive positioning instructions from a human operator, for example, via a user input interface, and control the actuator subsystem according to the positioning instructions. This type of control can also be referred to as master-slave control. In some embodiments, the processor subsystem can be configured to enable the human operator to exclusively control the position of the surgical instruments. In other embodiments, the processor subsystem can be configured to semi-autonomously or even fully autonomously control the position of the surgical instruments for at least a portion of the surgical procedure. In such embodiments, the human operator may be able to exercise super-autonomous control.

[0030] The processor subsystem can be further configured to monitor features of interest during the surgical procedure. For example, in an intraocular procedure, the feature of interest could be an intraocular feature, such as a feature on or below the surface of the retina, or a feature within the vitreous cavity, such as vitreous floaters. Typically, the feature of interest can be an anatomical feature, such as an anatomical structure; tissue type, organ, etc., or in some cases, a foreign body. To monitor the feature of interest, the processor subsystem can utilize sensor data acquired by an optical coherence tomography (OCT) probe, which may be attached to or integrated into an insertable portion of a surgical instrument. Here, the term 'insertable portion' can refer to a portion of the surgical instrument configured for insertion into the patient. For example, in the case of an intraocular procedure, this portion may be intended for insertion into the eye. The OCT probe may be, for example, an optical fiber connected to an OCT sensor, wherein the OCT sensor is located more proximally, for example, outside the eye. The OCT probe can be forward-facing, as it can face forward of the tip of the surgical instrument along its longitudinal axis. In some embodiments, the OCT probe may additionally or alternatively face sideways. For example, an OCT probe can be a multi-directional probe with axial and lateral viewing capabilities, so as to be able to determine the properties of the feature of interest in the lateral direction at the tip of a surgical instrument.

[0031] By using an OCT probe, the processor subsystem can acquire sensor data indicating a reflectance depth profile of a structure originating from the radiation beam within the OCT probe. By analyzing the sensor data, for example using template matching or machine learning-based techniques, attributes of the feature of interest can be determined within the reflectance depth profile. Therefore, the attributes of a feature can be determined by applying feature detection techniques to the sensor data. Attributes can be, for example, the presence state of the feature of interest and / or one or more characteristics of the feature of interest. Determining attributes can include confirming the value of the attribute, such as the presence or absence of the presence state, or the size or dimension. n mm', etc. In this way, determining the attribute of the feature of interest can refer to confirming the value of the attribute.

[0032] The steps of acquiring sensor data, analyzing sensor data, and determining the attributes of the feature of interest can be repeated at different locations on the tip of the surgical instrument to establish monitoring of the attributes of the feature of interest. The processor subsystem can be further configured to perform a feedback action depending on whether the attribute of the feature of interest satisfies a predetermined criterion. For example, if the attribute is the presence state of the feature of interest, and if a predetermined attribute criterion requires the presence state to be equal to 'present', then the processor subsystem can perform a feedback action if the attribute is determined to exist. In another example, if the predetermined attribute criterion requires the presence state to be equal to 'not present', then the processor subsystem can perform a feedback action if the attribute is determined to not exist. In yet another example, if the attribute is the thickness of the feature of interest, and if a predetermined attribute criterion requires the thickness of the feature of interest to be equal to or greater than 10 micrometers, then the processor subsystem can perform a feedback action if the thickness is indeed determined to be equal to or greater than 10 micrometers.

[0033] Typically, a predefined attribute metric can define or indicate reference values ​​and operators. For example, if the attribute is the presence state of a feature of interest, such as 'exist' or 'non-existent' as mentioned above, the predefined attribute metric might require the attribute value to be equal to one of the possible values ​​of that attribute, such as 'exist'. An attribute can also be a characteristic of a feature of interest, in which case the predefined attribute metric can define the attribute value as well as the numerical value of the metric or other quantifiable references, such as 'equal to', 'greater than', 'less than', etc. This characteristic could be, for example, the distance, size, dimensions (e.g., length, width, height, etc.), orientation, etc., of the feature of interest. In some examples, the processor subsystem can monitor multiple attributes of a feature of interest simultaneously, for example, by monitoring the presence state of the feature of interest and one or more characteristics, or by monitoring multiple characteristics of the feature of interest.

[0034] The aforementioned measures can have the following effects: during surgical procedures, such as intraocular procedures, enabling the surgical robot system to monitor the properties of features of interest and take feedback actions based on their property values. This can be advantageous because in many intraoperative procedures, there may be features relevant to the procedure that previously required monitoring of their properties by a human operator (such as a surgeon). For example, in epiretinal membrane peeling surgery, the surgeon may be responsible for determining the presence of an epiretinal membrane beneath the tip of the surgical instrument. This can require significant effort from the surgeon, potentially distracting their attention from controlling the surgical instruments and the surgical steps to be taken. By automatically monitoring the properties of features of interest and taking corresponding feedback actions through the surgical robot system, this mental task for the human operator can be alleviated at least to some extent. Moreover, in the case of semi-autonomous or autonomous operation, feedback actions can facilitate the execution of semi-autonomous or autonomous operations. For example, the surgical instruments can be controlled differently based on whether the properties of the features of interest meet or not predetermined property indices.

[0035] It should be noted that the feature of interest can be a specific feature. For example, the feature of interest can be selected by the user, or it can be automatically selected by the processor subsystem, for example, based on the type of surgical procedure or procedure steps. It should be understood that in some embodiments, the processor subsystem can monitor the attributes of multiple features of interest. In other words, the processor subsystem can attempt to detect multiple features of interest in the sensor data and take appropriate feedback actions in response to detection.

[0036] Advantageously, surgical robotic systems can be used in a variety of surgical procedures. For example, they can be used in intraocular procedures such as retinal membrane peeling, phacoemulsification, cortical removal and / or polishing during cataract surgery, and stent placement during glaucoma surgery. Another example or use case could be using a surgical robotic system during minimally invasive glaucoma surgery (MIGS) to locate the opening of the scleral venous sinus. Therefore, the feature of interest could be the scleral venous sinus, and predetermined attribute indicators could be defined as requiring the scleral venous sinus to be open. Yet another example or use case could be using a surgical robotic system during retinal photocoagulation to detect the presence of blood vessels, for example, to prevent the delivery of laser power to such vessels. Yet another example or use case could be detecting the absence of tumor tissue or critical structures (e.g., nerves, blood vessels) during transoral laser microsurgery.

[0037] The following optional aspects are described with reference to the surgical robot system, but are equally applicable to the corresponding computer program.

[0038] Optionally, the processor subsystem is configured to perform the feedback action in the following manner:

[0039] - Generate and output sensor-perceptible feedback signals, such as auditory signals, tactile signals and / or visual signals;

[0040] - Adjust the control of the actuator subsystem, for example, to slow down or stop the movement of surgical instruments; and / or

[0041] - Control of surgical instruments or other surgical instruments held by the surgical robot system.

[0042] Feedback actions can be used for one or more of the purposes described above. For example, a feedback action can be used to alert a human operator to the presence and / or absence of a feature of interest via a sensorily perceptible feedback signal. In other examples, the feedback action can be an internal action, for example, taken internally within control logic implemented by a processor subsystem. In this way, one or more autonomous operations of the surgical robot system can be adjusted based on the presence and / or absence of the feature of interest. For example, a feedback action can be one or more operating parameters of a surgical instrument or other surgical instrument, such as the suction rate and / or position and / or orientation, such as the axial orientation, of a microvacuum pickup.

[0043] Optionally, the processor subsystem is configured to periodically or continuously perform feedback actions whenever the attribute meets predetermined attribute criteria. Human operators may be fully engaged in controlling surgical instruments and / or procedural steps. Frequent and isolated feedback actions can be distracting. Such feedback actions can be frequent and isolated if triggered individually at each location of the surgical instrument. It has been found that less disruptive feedback can be provided by periodically (e.g., at regular time intervals) or continuously, as long as the attribute meets predetermined attribute criteria. Thus, the feedback can, in principle, be location-independent as long as the attribute does not change. Therefore, a relatively constant form of feedback can be provided as long as the feature of interest is detected or remains absent. For example, a continuous audio signal can be provided in response to an attribute meeting predetermined attribute criteria, and the audio signal can only be stopped when the attribute changes in a way that does not meet the predetermined attribute criteria. This allows human operators to focus more on changes in attribute values ​​rather than being repeatedly alerted to the same attribute value through isolated feedback actions.

[0044] Optionally, the processor subsystem is configured to determine the attributes of the feature of interest in the reflectance depth curve, further based on one or more previous reflectance depth curves obtained at one or more previous locations of the surgical instrument. By considering not only the current reflectance depth curve but also the reflectance depth curves obtained at one or more previous locations of the surgical instrument, the reliability of feature detection can be improved. For example, the previous locations may be near the current location, and sensor data obtained at those previous locations can further indicate the attribute values ​​at the current location. For example, if the feature of interest is found to exist in surrounding locations, this can increase the expectation that the feature of interest is present at the current location, which can then be used to influence or guide feature detection.

[0045] Optionally, the processor subsystem is configured to use template matching or machine learning-based techniques to analyze the reflectivity depth profile.

[0046] Optionally, the feature of interest is an intraocular feature, such as one or a combination of the following:

[0047] - Fluids in the vitreous cavity, such as blood.

[0048] - Floating objects in the vitreous cavity, such as vitreous floaters or partially detached retina.

[0049] - Foreign fluids in the vitreous cavity, such as dyes or silicone oils.

[0050] - Retinal membranes, such as the anterior retinal membrane or internal limiting membrane.

[0051] - The retinal layer, and

[0052] - Subretinal structures, such as blood vessels or tissue defects.

[0053] Optionally, the feature of interest is tissue type, such as tumor tissue.

[0054] Optionally, the processor subsystem is configured to build a map of attributes indicating features of interest in the following manner:

[0055] - Control the actuator subsystem to move the surgical instruments along the trajectory;

[0056] - Sensor data is acquired at the corresponding locations along the trajectory via an OCT probe;

[0057] - Analyze the sensor data to obtain multiple values ​​of the attribute of the feature of interest along the trajectory;

[0058] - The map is generated based on the multiple values ​​of this attribute and their corresponding locations; and

[0059] - Output the atlas for use during or after the surgical procedure.

[0060] Surgical instruments can move laterally and / or longitudinally (e.g., axially). By integrating individual detection results from different locations into an atlas (such as a one-dimensional, two-dimensional, or three-dimensional atlas), a spatial overview of the attribute values ​​of features of interest in a given region can be obtained. For example, an atlas that extends spatially in the lateral and / or longitudinal directions can be generated. This spatial overview can aid in interactive procedures, such as planning trajectories, further procedural steps, etc. In a specific example, the atlas could be a three-dimensional atlas covering the volume within the eye.

[0061] Optionally, the surgical robot system includes a user input interface for receiving positioning commands from the user, wherein a processor subsystem is configured to control the actuator subsystem based on these positioning commands, enabling the user to determine the trajectory of the surgical instruments. Atlases can be built while the human operator controls the position of the surgical instruments. Thus, atlases can be automatically generated during the intraoperative procedure due to the movement of the surgical instruments. Such functionality also allows the user to purposefully control the position of the surgical instruments to extend the atlas to previously uncovered directions. Advantageously, the above measures establish a non-intrusive mechanism for atlas generation without requiring a separate atlas generation stage, which could otherwise interfere with the surgical procedure.

[0062] Optionally, the processor subsystem is configured to provide feedback to the user regarding how to cover the area or volume inside the patient (e.g., inside the eye) with a trajectory. It may be desirable to limit the movement of surgical instruments inside the patient (e.g., inside the eye), as any type of movement may carry the risk of injury, such as due to impact or forces applied at the point of entry into the eye. Simultaneously, it may be desirable to establish a map of features of interest via the movement of the surgical instruments. To support the generation of the map using minimal or at least relatively little movement, the processor subsystem can determine a trajectory to efficiently cover the area or volume inside the patient and provide the trajectory for navigation guidance to the human operator, for example, in the form of visual, auditory, or tactile feedback. Such trajectory planning may itself be known in more distant domains (e.g., monitoring), but their underlying technologies can be used and modified for the aforementioned purposes.

[0063] Optionally, the processor subsystem is configured to incrementally build the atlas during the surgical procedure by adding, updating, or deleting relevant portions of the atlas in response to changes in the position of surgical instruments.

[0064] Optionally, changes in the position of surgical instruments may be caused by changes in eye pose, such as due to anticipated eye reorientation, to increase the reach of the surgical robotic system. The surgical robotic system may include one or more sensors for determining changes in eye pose, such as sensors for providing pupil tracking, sensors for tracking the pose of the surgical arm, or sensors for tracking the cannula used as the entry point for the surgical instrument. In response to such changes in eye pose, the processor subsystem may determine the properties of the features of interest at the changed position of the surgical instrument and, if applicable, perform feedback actions and / or update the atlas.

[0065] Alternatively, the processor subsystem is configured to use color coding in the atlas to indicate the presence of features of interest, for example, by using colors associated with staining the retinal membrane (such as trypan blue, brilliant blue G (BBG), or indocyanine green (ICG)). Human operators specializing in intraocular procedures are likely very familiar with such dyes, and therefore can easily interpret the atlas.

[0066] Optionally, the processor subsystem is configured to analyze the atlas to determine the position of the surgical instruments when performing the maneuver. After generating the atlas of the feature of interest, the maneuver can be planned based on the atlas. For example, the maneuver may be a grasping action or a peeling action, and the processor subsystem can use the atlas to determine, for example, at which lateral position and from which direction the feature of interest is best grasped and / or peeled. In a specific example, the atlas of the epiretinal membrane can be used to determine where it is best to grasp and begin peeling the epiretinal membrane.

[0067] Optionally, the surgical robot system can be configured for microsurgery. The surgical instrument can therefore be a microsurgical instrument.

[0068] Optionally, the surgical robot system can be configured for minimally invasive surgery. Therefore, the surgical instrument can be a surgical instrument for such minimally invasive surgery.

[0069] Optionally, the surgical robot system can be configured for intraocular surgery. Therefore, the surgical instrument can be an intraocular surgical instrument.

[0070] Those skilled in the art will understand that two or more of the above embodiments, implementations and / or aspects of the present invention can be combined in any manner deemed useful.

[0071] Those skilled in the art can make modifications and changes to the computer programs and / or computer-readable media corresponding to the modifications, variations, and optional aspects described in this specification of the surgical robot system. Attached Figure Description

[0072] These and other aspects of the invention are apparent from the embodiments described below and will be illustrated with reference to these embodiments. In the accompanying drawings:

[0073] Figure 1 A schematic representation of a surgical robot system is shown;

[0074] Figure 2 A surgical instrument with four degrees of freedom (DoF) is shown for passing through a cannula during minimally invasive surgery.

[0075] Figure 3An articulation diagram showing the kinematics of a movable arm portion of a surgical arm used in minimally invasive surgery is presented.

[0076] Figure 4 Joint diagrams illustrating the kinematics of the motion controller are shown;

[0077] Figure 5 A surgical instrument for the eye according to an embodiment of the present invention is shown;

[0078] Figure 6A and Figure 6B The detection of attributes of the features of interest is shown;

[0079] Figure 7 A map showing the presence of features of interest is presented;

[0080] Figure 8 A method for controlling a surgical robot system during a surgical procedure is schematically illustrated; and

[0081] Figure 9 A non-transitory computer-readable medium is shown;

[0082] It should be noted that items with the same reference numerals in different figures have the same structural features and the same function, or the same signal. If the function and / or structure of such an item have already been explained, it is unnecessary to repeat the explanation in the detailed description.

[0083] List of reference numerals

[0084] The following list of reference numerals and abbreviations is provided to facilitate the interpretation of the drawings and should not be construed as limiting the claims or terms.

[0085] 20 User Interface Subsystem

[0086] 22 User Input

[0087] 30 sensors

[0088] 32 Sensor Data

[0089] 40 Processor Subsystem

[0090] 42 Actuation Command

[0091] 60 Actuator Subsystem

[0092] 62. Actuation of the surgical arm

[0093] 80 surgical arms

[0094] 82 Movable arm section

[0095] 100 Surgical Robot System

[0096] 104 The coordinate system axis fixed to the end of the instrument is orthogonal to the longitudinal axis of the instrument.

[0097] 105 The coordinate system axis fixed to the end of the instrument is orthogonal to the longitudinal axis of the instrument.

[0098] 106 The axes of the Cartesian coordinate system are aligned with the longitudinal axis of the instrument.

[0099] 107 The rotation of the surgical instrument causes its tip to shift laterally.

[0100] 108 ψ The rotation of the surgical instrument causes its tip to shift laterally.

[0101] 109 z The longitudinal (along its longitudinal axis) translation of the surgical instrument, or the direction of penetration or advancement.

[0102] 110 θ, the rotation of the surgical instrument about its longitudinal axis

[0103] 111 Rotational DoF of the movable arm section

[0104] 112 ψ Rotational DoF of the movable arm section

[0105] 113 z Translational DoF of the movable arm section

[0106] 114 θ Rotational DoF of the movable arm section

[0107] 115 Rotational DoF of the motion controller

[0108] 116 ψ m Rotational DoF of the motion controller

[0109] 117 z m Translation DoF of motion controller

[0110] 118 θ m Rotational DoF of the motion controller

[0111] 119 Surgical Instruments

[0112] 121 Sensor or sensor component

[0113] 122 Surgical instrument tip

[0114] 123 Surgical Goals

[0115] 124 cannula

[0116] 125 Remote Sports Center (RCM)

[0117] 126 Buttons on the motion controller holder

[0118] 127 beams

[0119] 200 eyes

[0120] 210 Retina

[0121] 220 First-level organization

[0122] 230 Second-level organization

[0123] 240 Features of Interest

[0124] 250 audio signal

[0125] 252 Audio signal muted

[0126] 300 Atlas

[0127] 310 Features of interest exist

[0128] 400 Methods for controlling surgical robot systems

[0129] 410 Control Actuator Subsystem

[0130] 420 Monitor the attributes of features of interest

[0131] 430 Acquiring Sensor Data

[0132] 440 Analysis of reflectivity depth curve

[0133] 450 Determine if attribute values ​​match predefined criteria

[0134] 460 Complete feedback action

[0135] 500 Non-transitory computer-readable media

[0136] 510 represents the data of a computer program. Detailed Implementation

[0137] The following embodiments relate to a surgical robot system for use in surgical procedures. During a surgical procedure, the surgical robot system can monitor the properties of a feature of interest using an OCT probe that is attached to or integrated into an insertable portion of a surgical instrument for insertion into the patient's interior. The following description refers to a specific surgical robot system (i.e., one configured for intraocular surgery and particularly referenced to) Figures 1 to 4 Such monitoring is described within the context of the described surgical robot system. Nevertheless, the embodiments described in this patent specification are not limited to this type of surgical robot system, nor are they limited to the field of intraocular surgery. Rather, these embodiments can be adapted and applied to other types of surgical robot systems used in intraocular procedures, as well as to other types of surgical robot systems used in other types of surgical procedures (such as microsurgical procedures, minimally invasive procedures, intracavitary procedures, etc.). Therefore, any references to intraocular surgery and intraocular structures should be understood to also apply to other types of surgical procedures and corresponding types of anatomical structures.

[0138] Figure 1 A surgical robot system 100 for use in intraocular surgical procedures is schematically illustrated. The surgical robot system 100 may include a surgical arm 80. The surgical arm 80 may include a movable arm portion 82, which may include an end effector for holding surgical instruments 119. Figure 1 (Not explicitly shown). For example, surgical instrument 119 may be an irrigation / aspiration instrument for irrigating or aspirating fluid at a desired target location, a photocoagulation instrument for applying light energy at a desired distance from the target, a vitrectomy instrument for cutting and aspirating vitreous fluid or other fluids at a desired distance from the target, a tissue manipulation instrument that may need to be placed at a tissue interface, etc. To hold surgical instrument 119, the end effector may include an instrument connector to which surgical instrument 119 may be mounted. The movable arm portion 82 may have at least three degrees of freedom (DoF) to allow the surgical instrument to move longitudinally toward the surgical target within the eye and to move laterally in a plane perpendicular to the longitudinal movement. Here, longitudinal movement may refer to the surgical instrument 119 along its longitudinal axis (…). Figure 1 (Not shown separately) movement. In some embodiments, the surgical robot system 100 may be configured to enable lateral movement within a curved plane. The curvature of the curved plane may, for example, follow the curvature inside the eye. This type of lateral movement along the curved plane can be achieved by the surgical robot system adjusting the longitudinal position of the surgical instrument 119 during lateral movement. The shape of the curved plane may be determined, for example, based on a model of the eye or intraocular structures (e.g., the retina).

[0139] In some embodiments, the surgical robot system 100 may further include a user interface subsystem 20 for receiving user input 22 from a user. Therefore, the user interface subsystem 20 can at least serve as a user interface. enter The interface, and in some embodiments, as well as elsewhere, is additionally or alternatively used as a user interface. Output Interface. User input 22 may include, for example, positioning instructions from a human operator (e.g., a surgeon) to enable the human operator to determine the trajectory of the surgical instrument. In some embodiments, the positioning instructions may be positioning commands for directly controlling the movement of the surgical instrument. In other embodiments, the positioning instructions may be provided as input during the planning process of planning the trajectory of the surgical instrument. Other types of user input may include, for example, confirmation input indicating instructions to continue the procedure or procedure steps, and / or input information such as indicating operating parameters, and / or indication of the surgical target location, etc. Examples of user input interfaces for receiving user input from a user include, but are not limited to, keyboards, mice, touch-sensitive surfaces, joysticks, foot pedals, microphones, gesture recognition systems, etc. The user input interface may employ any suitable input modality, such as touch, pressing actions, voice commands, eye movements, gesture recognition, etc.

[0140] The surgical robot system 100 may further include an actuator subsystem 60 configured and arranged to actuate a movable arm portion to perform longitudinal and lateral movement of a surgical instrument. The actuator subsystem 60 may include any suitable actuator(s) from, for example, the field of surgical robots or from the more general field of actuators. In particular, the actuator subsystem 60 may include multiple actuators that together provide actuation of the movable arm portion 60 along three or more DoFs. Accordingly, it should be understood that any reference to a particular configuration of the actuator subsystem 60 is to be construed as referring to a (joint) configuration of such multiple actuators.

[0141] Figure 1 The actuation of the surgical arm 80 is schematically shown, i.e., indicated by dashed line 62. It should be noted that although shown separately from the surgical arm 80, the actuator subsystem 60 may be integrated into or mounted on the surgical arm 80.

[0142] The surgical robot system 100 may further include a sensor 30. The sensor 30 may be or include an optical coherence tomography (OCT) probe. The OCT probe may be, for example, an optical fiber attached to the surgical instrument 119 or integrated into the surgical instrument, wherein the optical fiber is connected to a remotely positioned OCT sensor. In other examples, the OCT probe may include an OCT sensor directly attached to or integrated into the surgical instrument. Sensor data 32 provided by the OCT probe may include: A scans, which may include line measurements and are defined as intensity varying with distance; B scans, which form a 2D image; C scans, such as from multiple B scans, etc. It should be noted that although the sensor 30 is in Figure 1 The sensor is shown as separate from surgical instrument 119, but the sensor or a portion thereof may also be attached to or integrated into surgical instrument 119. In other examples, attached to or replacing the OCT probe, sensor 30 may include a stereo camera arranged for capturing images through a microscope, an optical interferometer integrated into or attached to surgical instrument 119, a time-of-flight sensor integrated into or attached to surgical instrument, and an ultrasonic sensor integrated into or attached to surgical instrument, etc. In some embodiments, surgical robot system 100 may include a microscope communicatively coupled to surgical robot system 100.

[0143] The surgical robot system 100 may further include a processor subsystem 40 configured to control the actuator subsystem 60 to control the position of the surgical instrument 119 during intraocular procedures. For the purpose of controlling the actuator subsystem 60, the processor subsystem 40 may provide actuation commands 42 to the actuator subsystem. For example, through such control, the surgical instrument 119 may be positioned relative to an intraocular surface, which may be a surface associated with the surgical procedure. In a specific example, in an epiretinal membrane peeling procedure, the surgical instrument 119 may be positioned relative to a surface of the retina to grasp and peel the epiretinal membrane starting from its edge. Another example is that during cataract surgery, the surgical instrument 119 may be positioned relative to a surface of the lens or capsular bag. Yet another example is that during glaucoma surgery, the surgical instrument 119 may be positioned relative to a surface of the trabecular meshwork. The following continues to relate to the lateral positioning of the surgical instrument 119 relative to an intraocular surface. However, it should be understood that surgical instruments can also be moved in any other manner (e.g., relative to another reference object) or in a non-lateral (e.g., longitudinal) manner. Therefore, any example or embodiment involving lateral positioning relative to the intraocular surface can be equally applied to any other positioning of surgical instruments, such as the aforementioned longitudinal positioning.

[0144] As discussed elsewhere, processor subsystem 40 can operate in operator-controlled mode, autonomous control mode, or a combination of operator-controlled and autonomous control modes in a semi-autonomous control mode. In operator-controlled mode, processor subsystem 40 directly executes positioning commands received from a human operator. In autonomous control mode, processor subsystem 40 autonomously controls the position of surgical instruments, for example, based on a pre-planned trajectory and sensor data. During intraocular procedures, and therefore during or intermittently with the control of actuator subsystem 60, processor subsystem 40 can monitor the properties of features of interest on or below the intraocular surface by repeatedly acquiring sensor data 32 via an OCT probe at the corresponding location of the surgical instruments. The sensor data can indicate a reflectance-depth profile of a structure derived from the radiation beam within the OCT probe. Processor subsystem 40 can analyze the reflectance-depth profile, for example, using template matching or machine learning-based techniques, to determine the properties of the features of interest within the reflectance-depth profile. Processor subsystem 40 can determine whether the property satisfies a predetermined property criterion, for example, whether the property in the form of a state of presence is equal to 'present', and if so, perform a feedback action. Thus, determining the attribute can include identifying whether a feature of interest exists in the depth curve, where, in this example, the attribute is the presence or presence status of the feature of interest.

[0145] Feedback actions can include, for example, adjusting the control of the actuator subsystem, such as slowing down or stopping the movement of surgical instruments. Another example of a feedback action could be the control of additional surgical instruments held by a surgical robot system. Yet another example of a feedback action could be generating sensory-perceptible feedback signals and outputting them to the user. Sensory-perceptible feedback signals can be, for example, auditory signals, tactile signals, and / or visual signals. For example, processor subsystem 40 can be configured to output sensory-perceptible feedback signals via user interface subsystem 20. In such an example, user interface subsystem 20 can therefore serve at least as an output interface. For example, sensory-perceptible feedback signals can be visually rendered, for example, superimposed on an image of the surgical area; as audio output, for example, via a speaker of user interface subsystem 20; and / or as visual numerical output, for example, on a display of user interface subsystem 20. Another example is that tactile signals can be provided via a user input interface, for example, by providing tactile signals via a motion controller. In some examples, sensory-perceptible feedback signals can be provided periodically or continuously as long as the attributes meet predetermined attribute indicators. For example, sensory feedback signals can be provided as long as the feature of interest is detected below the tip of the surgical instrument.

[0146] Figure 2A surgical instrument 119 is shown that passes through a cannula 124 during minimally invasive surgery. For example, in the case of vitreoretinal surgery, the cannula 124 can be placed in the sclera. Rotation and translation around the cannula through the cannula can be performed within four DoFs (e.g., rotation). 107. ψ 108. θ 110 and translation z It is possible to approach or penetrate the surgical target 123 from point 109. The tip 122 of the surgical instrument 119 and the three axes 104-106 of the coordinate system fixed to the instrument tip 122 are further shown, wherein... Align 106 with the longitudinal axis of surgical instrument 119. Rotate. 107 and ψ 108 can cause the instrument tip 122 to move in the direction of... 105 and direction Lateral displacement on 104. Translation. z 109 can cause longitudinal movement of the surgical instrument tip 122.

[0147] The surgical robot system 100 can be used in intraocular surgical procedures, such as the minimally invasive surgical procedures described above.

[0148] Figure 3 An articulation diagram illustrating the kinematics of a movable arm portion of a surgical arm used in intraocular surgical procedures, particularly in minimally invasive surgery, is shown. Figure 3 In the example, the surgical robot system includes a surgical arm, wherein the surgical arm includes a movable arm portion having a DoF (DoF) Φ 111、 Ψ 112. Z 113 and Θ 114, thus allowing as previously in Figure 2 The instruments shown are moved 107 to 110, thereby causing movement of the surgical instrument tip 122. The DoFs can be arranged such that there is a point on the surgical instrument 122 that does not move in space, referred to as the remote center of motion (RCM) 125. By moving the base of the surgical arm, the movable arm portion can be positioned such that the remote center of motion 125 of the surgical instrument is positioned at the cannula. Appropriate actuators can be arranged to perform movement on all four DoFs 111 to 114.

[0149] As previously referenced Figure 1The surgical robot system discussed may include a user input interface for receiving user input, such as positioning commands, from a human operator (e.g., a surgeon or healthcare provider). In some embodiments, the user interface may include or be composed of a motion controller (e.g., a joystick). In some embodiments, the motion controller may be an external device to which the user interface or processor subsystem 40 is configured to interface. In some embodiments, the motion controller may be included as an additional component in the surgical robot system, for example, configured to interface with processor subsystem 40 and / or user interface subsystem 20. Figure 4 Joint diagrams illustrating the kinematics of this motion controller are shown. Here, the motion controller is shown as having DoF. Φ m 115. Ψ m 116. Z m 117 and Θ m 118. The user can provide user input, such as positioning commands, to directly control the movement of the movable arm portion, for example by holding the motion controller at the gripper portion, pressing button 126, and moving the gripper portion of the motion controller in space.

[0150] Figure 5 A surgical instrument 119 in the eye 200 is shown. The tip 122 of the surgical instrument 119 is also shown enlarged. The tip 122 of the surgical instrument 119 can be an operational tip, as it can be operatively involved in intraocular procedures. Figure 5 As shown on the left side, surgical instrument 119 is shown inserted into eye 200. Surgical instrument 119 may be close to retina 210, as shown in the figure, but this is merely exemplary and the invention is not limited thereto. In some embodiments, surgical instrument 119 may be close to another area, structure, or tissue layer of the eye, such as a pocket or part of the eye drainage system. The tip 122 of surgical instrument 119 is... Figure 5The right side is shown magnified. In this example, the surgical target 123 is located in the retina. The surgical instrument 119 may be, for example, an irrigation / aspiration instrument for irrigating or aspirating fluid at a desired target location, a photocoagulation instrument for applying light energy at a desired distance from the target, a vitrectomy instrument for cutting and aspirating vitreous fluid or other fluids at a desired distance from the target, a tissue manipulation instrument that may require more or less precise placement at a first interface of the tissue, and so on. The tip 122 of the surgical instrument 119 may be, for example, an injection lumen. A sensor or sensor component 121 (such as an optical fiber) may be integrated into or attached to the surgical instrument 119. In some embodiments, the sensor 30 may include an optical fiber (as shown) coupled to an OCT sensor and configured to emit a beam 127 to capture cross-sectional images of the retina 210 and other structures within the eye. The optical fiber 121 may be recessed from the tip 122 of the surgical instrument 119, which may allow sensor data to be captured while the tip 122 of the surgical instrument 119 may puncture or penetrate tissue layers.

[0151] By using an OCT probe, a surgical robotic system can acquire sensor data indicating reflectance depth profiles of structures originating from or beneath the inner surface of the eye. As discussed elsewhere, a processor subsystem can analyze the reflectance depth profile to determine the properties of a feature of interest (ROI) within it. ROIs can be, for example, retinal membranes, such as the anterior or internal limiting membrane; retinal layers; and subretinal structures, such as vascular or tissue defects (e.g., pathological changes such as retinal detachment or subretinal fluid, or retinal tears, interlaminar spaces, or membrane detachment). Because the OCT probe can be longitudinally anterior, the sensor data can indicate the presence of a ROI laterally anterior to the tip of the surgical instrument, which can be considered 'below' the tip of the instrument. It should be noted that when operating surgical instruments in the periphery of the eye or near the posterior aspect of the lens during vitrectomy, the ROI can be positioned more laterally than longitudinally anteriorly. To account for this lateral positioning, the OCT probe can be a multi-directional probe with axial and lateral viewing capabilities to detect ROIs also laterally anterior to the tip of the surgical instrument.

[0152] Figure 6A A surgical instrument 119 is shown in a given first lateral position relative to the retina 210 (the retina is in...). Figure 6A and Figure 6B The diagram shows the inclusion of retinal layers 220 and 230. In the first lateral position, the properties of the feature of interest can be determined, for example, using an OCT probe coupled to or attached to surgical instrument 119 or integrated into the surgical instrument. Figure 5As shown. Preferably, sensor measurements are performed when the surgical instrument 119 is stationary. In this example, the feature of interest may be a retinal membrane, particularly an epiretinal membrane 240, that may have formed on a portion of the surface of the retina 210. Through the above analysis of the reflectance depth profile, the processor subsystem can determine whether the epiretinal membrane 240 is present at or near the current lateral position of the surgical instrument. Figure 6A This is illustrated as an example where the attribute can be 'existent'. The processor subsystem can then take a feedback action, such as emitting an audio signal 250 (in...). Figure 6A and Figure 6B (The speaker symbol is used to illustrate this schematically). Figure 6B The surgical instrument 119 is shown having been laterally moved to a second position within the eye 200, where the epiretinal membrane 240 is no longer present. Lateral movement of the tip 122 of the surgical instrument 122 can be achieved via the RCM surrounding the surgical instrument (…). Figure 6B (Not shown in the image) is obtained by rotation. Since the preretinal membrane 240 is no longer present at or near the second lateral position, the processor subsystem may not take a feedback action, and if the feedback action was originally performed continuously or periodically in response to the properties of the feature of interest, the feedback action is stopped. Figure 6B The latter case is illustrated by showing that audio signal 252 is muted.

[0153] It should be understood that, although Figure 6A and Figure 6B The example demonstrates a feedback action taken in response to the presence of a feature of interest; however, alternatively, a feedback action could be taken in response to the absence of a feature of interest.

[0154] Figure 7A map 300 is shown, illustrating attributes of a feature of interest, which in this specific example are presence states in binary representation (e.g., yes, no) of the presence 310 of the feature of interest. Such a map 300 can be created by a processor subsystem by determining the attributes of the feature of interest at corresponding lateral positions to obtain multiple values ​​of the attributes, and generating the map based on these multiple values ​​and the corresponding lateral positions. For example, different lateral positions can be located along the trajectory followed by the surgical instrument as it moves autonomously, semi-autonomously, or under the direct control of a human operator. The map 300 can be output by a map generation function and can be used internally by the processor subsystem, for example, for further decision-making by the processor subsystem, and / or externally, for example, by displaying or otherwise rendering the map for perception by a human operator. As noted elsewhere in this specification, the map can additionally or alternatively extend in the longitudinal direction based on the longitudinal movement of the surgical instrument. Thus, the map can be a map having at least one longitudinal dimension, which can also be referred to as a 'depth' or 'axial' dimension. A specific example of a map having at least one longitudinal dimension is a map that covers the volume within the vitreous cavity, such as indicating the presence and / or one or more characteristics of bodily fluids, foreign fluids, and / or floating objects.

[0155] In some embodiments, the processor subsystem may incrementally build atlas 300 during operation of the surgical robot system, such as when a human operator manipulates surgical instruments along a specific trajectory, or when the trajectory is executed (semi-)autonomously. In some embodiments, the processor subsystem may determine how to optimally or at least adequately cover the intraocular area or volume with the trajectory and may provide feedback to the human operator instructing on the trajectory. The atlas may be updated during operation of the surgical robot system. For example, when the surgical instruments are positioned in a new location, a corresponding portion of the atlas may be added to reflect the attribute values ​​of the feature of interest at the new location. Another example is that when the surgical instruments are repositioned in a previously visited location, a corresponding portion of the atlas may be updated to reflect the latest attribute values ​​of the feature of interest. Yet another example is that when new sensor data invalidates a previous determination of the attributes of the feature of interest, a portion of the atlas may be deleted. For example, if it is determined that the feature of interest does not exist at the current location, it can be concluded that the previous determination that the feature of interest existed at the previous location was incorrect. Therefore, the portion of the atlas related to the previous location may be deleted, or its attribute values ​​may be corrected.

[0156] While various types of visualization of the atlas are conceivable, in some embodiments, the processor subsystem may be configured to specifically use color coding of the atlas 300 to indicate the presence of a feature of interest, for example, by using a color associated with staining the retinal membrane (such as trypan blue, brilliant blue G (BBG), or indocyanine green (ICG)). In some embodiments, the processor subsystem may be configured to analyze the atlas 300 to determine the position of a surgical instrument when performing an action (such as a grasping or peeling action that can be performed with respect to a feature of interest). For example, if the feature of interest is the epiretinal membrane, the processor subsystem may analyze the atlas 300 to determine a lateral position where the surgical instrument can grasp the edge of the epiretinal membrane to peel or further peel it.

[0157] Examples of using surgical robotic systems outside of intraocular surgery include situations where the system is configured for selective tumor removal, such as in the vocal cord region of the throat during transoral laser microsurgery. In such examples, the surgical robotic system may be equipped with surgical instruments that combine an OCT probe with an optical system for delivering laser radiation to the tissue. Sensor data from the OCT probe can be used to distinguish between healthy and tumor tissue. Furthermore, key structures such as blood vessels or nerves can be identified within the sensor data. Based on the presence of the feature of interest, 'tumor tissue,' and the absence of 'key structures (e.g., nerves, blood vessels),' a feedback action can be triggered that activates or prevents laser activation in a lateral position. Additionally or alternatively, the processor subsystem can be configured to generate an atlas of the tissue region to be treated based on a scan of the relevant tissue region. This scan can be obtained by laterally scanning the tip of the OCT probe in both directions while recording an axial OCT distance scan (OCT-A scan). Based on the generated atlas of the region to be treated, an automated treatment plan can be generated and executed for automated tumor removal.

[0158] Another example is that surgical robotic systems can use fluorescence imaging to differentiate between scar tissue and recurrent cancer outside the line of sight of an optical precision microscope (OPMI). For this purpose, the surgical robotic system can detect features of interest, such as tortuous and dilated new blood vessels in areas where cancer has been previously removed.

[0159] Typically, the processor subsystem described in this patent specification may include one or more (micro)processors executing appropriate software. The software implementing the functions of the processor subsystem may have been downloaded and / or stored in one or more corresponding memories, for example, in volatile memory (such as RAM) or in non-volatile memory (such as flash memory). Alternatively, the processor subsystem may be implemented as programmable logic, for example, as a field-programmable gate array (FPGA). Any input and / or output interfaces may be implemented by corresponding hardware and / or software interfaces. Typically, the processor subsystem, input interfaces, and / or output interfaces may each be implemented as circuits or circuit systems. The processor subsystem may also be implemented in a distributed manner, for example, involving different devices or apparatuses.

[0160] Figure 8 A method 400 for controlling a surgical robot system during a surgical procedure is illustrated. Method 400 may include: controlling 410 an actuator subsystem to control the position of a surgical instrument during the surgical procedure; and simultaneously or alternately over time monitoring 420 an attribute of a feature of interest, wherein monitoring is performed by: repeatedly acquiring 430 sensor data at a corresponding location on the surgical instrument via an OCT probe; analyzing 440 a reflectivity-depth profile to determine the attribute of the feature of interest within the reflectivity-depth profile; determining 450 whether the attribute satisfies a predetermined attribute criterion; and if satisfied, performing 460 a feedback action.

[0161] It should be noted that any method described in this patent specification (e.g., in any of the claims or clauses) can be implemented on a computer as a computer-implemented method, dedicated hardware, or a combination of both. Instructions for a computer (e.g., executable code) can be stored, for example... Figure 9 On the computer-readable medium 500 shown, for example, in the form of a series of machine-readable physical marks 510 and / or as a series of elements with different electrical (e.g., magnetic or optical) properties or values. Executable code may be stored in a transient or non-transient manner. Examples of computer-readable media include memory devices, optical storage devices, integrated circuits, servers, online software, etc. Figure 9 The memory card 500 is illustrated by way of example.

[0162] The following are a series of independently claimable aspects of the invention, which may be expressed by the corresponding claims.

[0163] Clause 1. A computer-implemented method for controlling a surgical robot system during an intraocular procedure, wherein the surgical robot system comprises:

[0164] - A surgical arm, the surgical arm including a movable arm portion, the movable arm portion including an end effector for holding surgical instruments;

[0165] - Optical coherence tomography (OCT) probe, wherein the OCT probe is configured to be attached to or integrated into the intraocular portion of the surgical instrument for insertion into the interior of the eye;

[0166] - An actuator subsystem configured to actuate the movable arm portion;

[0167] The method includes:

[0168] - Control the actuator subsystem to control the position of the surgical instrument during the intraocular procedure; and

[0169] - The presence of the feature of interest is monitored simultaneously with or alternately in time by repeatedly performing the following operations at the corresponding location of the surgical instrument:

[0170] - Sensor data is acquired via the OCT probe, wherein the sensor data indicates the reflectivity depth profile of a structure originating from within the beam of the OCT probe;

[0171] - Analyze the reflectance-depth curve to determine the properties of the feature of interest within the reflectance-depth curve; and

[0172] - If the attribute meets the predefined attribute criteria, then complete the feedback action.

[0173] Clause 2. A transient or non-transitory computer-readable medium comprising data representing a computer program including instructions for causing a processor system to perform the methods described in accordance with Clause 1.

[0174] It should be noted that the above embodiments illustrate the invention but are not intended to limit it, and those skilled in the art will be able to devise many alternative embodiments without departing from the scope of the appended claims or terms.

[0175] In a claim or clause, any reference numerals enclosed in parentheses shall not be construed as limiting the claim or clause. The use of the verb "comprising" and variations thereof does not exclude the presence of elements or stages other than those recited in the claim or clause. The article "a / an" preceding an element does not exclude the presence of a plurality of such elements. When preceding a series or group of elements, expressions such as "at least one of" indicate the selection of all elements or any subset from that series or group. For example, the expression "at least one of A, B, and C" should be understood to include only A, only B, only C, both A and B, both A and C, both B and C, or all of A, B, and C. The invention can be embodied by hardware comprising several different elements and by a suitably programmed computer. In an apparatus claim or clause enumerating several means, several of these means may be embodied by the same hardware. The simple fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used advantageously.

Claims

1. A surgical robot system (100) for use in intraocular procedures, the surgical robot system comprising: - A surgical arm (80) including a movable arm portion (82) including an end effector for holding a surgical instrument (119); - Optical coherence tomography (OCT) probe (30, 121), wherein the OCT probe (30, 121) is configured to be attached to or integrated into the intraocular portion of the surgical instrument (119) for insertion into the interior of the eye; - Actuator subsystem (60) configured to actuate the movable arm portion (82); - A processor subsystem (40) configured to control the actuator subsystem (60) to control the position of the surgical instrument (119) during the intraocular procedure, wherein the processor subsystem (40) is further configured to monitor features of interest (240) by repeatedly performing the following operations at the corresponding positions of the surgical instrument (119): - Sensor data (32) is acquired via the OCT probe (30, 121), wherein the sensor data (32) indicates the reflectivity depth profile of the structure originating from the beam within the OCT probe; - Analyze the reflectance depth profile to determine the properties of the feature of interest (240) within the reflectance depth profile; and - If the attribute meets the predefined attribute criteria, then complete the feedback action (250).

2. The surgical robot system (100) according to claim 1, wherein, The processor subsystem (40) is configured to perform the feedback action in the following manner: - Generate and output sensor-perceptible feedback signals, such as auditory signals (250), tactile signals and / or visual signals; - Adjust the control of the actuator subsystem (60), for example, to slow down or stop the movement of the surgical instrument (119); and / or - Control the surgical instrument (119) or another surgical instrument held by the surgical robot system.

3. The surgical robot system (100) according to claim 1 or 2, wherein, The processor subsystem (40) is configured to perform the feedback action (250) periodically or continuously as long as the attribute meets the predetermined attribute index.

4. The surgical robot system (100) according to any one of claims 1 to 3, wherein, The processor subsystem (40) is configured to further determine the properties of the feature of interest (240) in the reflectivity depth curve based on one or more previous reflectivity depth curves obtained at one or more previous locations of the surgical instrument (119).

5. The surgical robot system (100) according to any one of claims 1 to 4, wherein, The processor subsystem (40) is configured to analyze the reflectivity depth curve using template matching or machine learning-based techniques.

6. The surgical robot system (100) according to any one of claims 1 to 5, wherein, The feature of interest (240) is an in-eye feature, such as one or a combination of the following: - Fluid in the vitreous cavity, for example, due to bleeding, - Floating objects in the vitreous cavity, such as vitreous floaters or partially detached retina. - Foreign fluids in the vitreous cavity, such as dyes or silicone oils. - Retinal membranes, such as the anterior retinal membrane or internal limiting membrane. - The retinal layer, and - Subretinal structures, such as blood vessels or tissue defects.

7. The surgical robot system (100) according to any one of claims 1 to 6, wherein, The processor subsystem (40) is configured to build a map of attributes indicating the feature of interest in the following manner: - Control the actuator subsystem (60) to move the surgical instrument (119) along the trajectory; - Sensor data (32) is acquired at the corresponding location along the trajectory via the OCT probe (30, 121). - Analyze the sensor data (32) to obtain multiple values ​​of the property of the feature of interest along the trajectory; - Generate the map (300) based on the multiple values ​​of this attribute and their corresponding locations; and - Output the map for use in or after the intraocular procedure.

8. The surgical robot system (100) according to claim 7, further comprising a user input interface (20) for receiving positioning commands from a user, wherein, The processor subsystem (40) is configured to control the actuator subsystem (60) based on the positioning command so that the user can determine the trajectory of the surgical instrument (119).

9. The surgical robot system (100) according to claim 8, wherein, The processor subsystem (40) is configured to generate feedback to the user about how to cover the area or volume inside the eye with the trajectory.

10. The surgical robot system (100) according to any one of claims 7 to 9, wherein, The processor subsystem (40) is configured to incrementally build the atlas (300) by adding, updating or deleting corresponding portions of the atlas (300) in response to changes in the position of the surgical instrument (119) during the intraocular procedure.

11. The surgical robot system (100) according to any one of claims 7 to 10, wherein, The processor subsystem (40) is configured to use the color coding in the map (300) to indicate the presence of the feature of interest (240), for example by using a color associated with staining the retinal membrane, such as trypan blue, brilliant blue G (BBG) or indocyanine green (ICG).

12. The surgical robot system (100) according to any one of claims 7 to 11, wherein, The processor subsystem (40) is configured to analyze the map (300) to determine the position of the surgical instrument (119) when an operation is to be performed.

13. The surgical robot system (100) according to claim 12, wherein, The action is either a grasping or peeling action.

14. A computer program comprising instructions that, when executed by a processor subsystem of a surgical robot system, cause the processor subsystem to control the surgical robot system during an intraocular procedure, wherein, The surgical robot system includes: - A surgical arm, the surgical arm including a movable arm portion, the movable arm portion including an end effector for holding surgical instruments; - Optical coherence tomography (OCT) probe, wherein the OCT probe is configured to be attached to or integrated into the intraocular portion of the surgical instrument for insertion into the interior of the eye; - An actuator subsystem configured to actuate the movable arm portion; - This processor subsystem; The computer program includes instructions for causing the processor subsystem to perform the following operations: - Control (410) the actuator subsystem to control the position of the surgical instrument during the intraocular procedure; and - The presence of the feature of interest is monitored (420) by repeatedly performing the following operation at the corresponding location of the surgical instrument, either simultaneously with or alternately in time with the control: - Sensor data (430) is acquired via the OCT probe, wherein the sensor data indicates the reflectivity depth curve of the structure originating from the beam within the OCT probe; - Analyze (440) the reflectance-depth curve to determine the properties of the feature of interest within the reflectance-depth curve; and - If the attribute meets the predefined attribute criteria, then complete the (460) feedback action.

15. A non-transitory computer-readable medium (500) comprising data (510) representing a computer program according to claim 14.

Images