Support assembly for an ophthalmic visualization system

Abstract

The present disclosure relates to visualization systems for surgical procedures, and more particularly to imaging and display support systems for ophthalmic visualization systems. The optical systems described herein provide improved ergonomics for surgeons because such systems incorporate an optical head and corresponding display on a single support arm, providing the surgeon with a direct and unobstructed view of the corresponding display screen positioned in an ergonomically advantageous position relative to the ophthalmic procedure. Such systems also maintain the corresponding display screen in the ergonomically advantageous position, even when the system's optical head is moved or rotated during the ophthalmic procedure, without requiring further adjustments by the surgeon or surgical staff.

Description

[Background technology]

[0001] The most commonly performed ophthalmic procedures are vitreoretinal and cataract surgeries. As the names imply, vitreoretinal surgery is performed within the gel-like vitreous humor and on the light-sensing surface of the retina within the relatively small eye cavity. Common conditions requiring vitreoretinal surgery include epiretinal membranes, vitreomacular separation, vitreomacular traction syndrome, diabetic traction retinal detachment, proliferative vitreoretinopathy (PVR), retinal detachment, macular hole, and various other conditions requiring microinjection surgery for gene and cell therapy. Cataract surgery, on the other hand, involves removing the eye's cloudy lens and replacing it with a new artificial lens. Generally, there are two types of cataract surgery: phacoemulsification, in which the cloudy lens is broken down and then removed using ultrasound, and extracapsular surgery, in which the cloudy core of the lens is removed intact.

[0002] Traditionally, surgeons performing vitreoretinal and / or cataract surgery have utilized surgical microscope eyepieces that provide magnified and illuminated images of ophthalmic structures within the eye. More recently, however, advances in imaging technology have led to the use of heads-up digital surgical visualization systems. Such visualization systems, which rely on high-resolution stereoscopic cameras and / or microscopes to transmit images from the patient's eye to a heads-up display screen for viewing by the surgeon, offer advantages over traditional microscopes, including better ergonomics for the surgeon, reduced phototoxicity, peripheral visualization, and improved magnification.

[0003] While there are many benefits associated with the use of heads-up digital surgical visualization systems, such systems still have many limitations. One major drawback of some systems is the obstructed line of sight between the surgeon and the corresponding heads-up display that shows the microscopic image captured by the system's camera. For example, in purely digital systems in which only a camera and display are used, problems can arise due to the camera's need to be located 150–200 mm (working distance) above the patient's eye. The required working distance, combined with the associated height of the camera, creates an obstruction that can prevent an ideal line of sight between the surgeon and the display. Similarly, in systems utilizing digital microscopes or microscopes integrated with digital cameras, the corresponding display is often located next to the microscope, thereby requiring the surgeon to view the display while performing surgery in an ergonomically less than ideal position.

[0004] In addition, the microscope / camera and head-up display for many digital surgical visualization systems are typically supported by separate support devices, which can create unnecessary difficulties when adjusting such components between surgical procedures. For example, in ophthalmic surgery, there are three main positions a surgeon can assume relative to the patient's head: left temporal position, right temporal position, and upright position. For each position, the display and associated equipment must be moved to a specific position to ensure the surgeon's line of sight to the center of the display is clear. Ergonomically, the system should also be positioned so that the surgeon's head is at the same height and does not rotate when viewing the display. Furthermore, to provide an immersive 3D effect to the surgeon, the surgeon's display must also be positioned a specific distance from the surgeon. Therefore, prior to a surgical procedure, the display and associated equipment of the digital surgical visualization system, as well as other equipment in the operating room, must be set up based on the position the surgeon is expected to assume during the procedure.

[0005] If the position assumed by the surgeon in a subsequent procedure in the operating room differs from the immediately preceding procedure performed in the operating room, the display of the digital surgical visualization system and other associated equipment may need to be moved and / or adjusted to accommodate the new position. Thus, maintaining good ergonomics for the surgeon during successive surgical procedures can be particularly challenging when various components of the digital surgical visualization system are supported by separate devices, each of which may require individual adjustments to support the surgeon's various positions during the procedure. Because such equipment repositioning can be very taxing and time-consuming for surgical staff, to reduce the amount of equipment repositioning throughout the day, surgical procedures are scheduled based on the positions assumed by the surgeon. However, such scheduling accommodations may not always be feasible in emergency situations.

[0006] Thus, the combination of the camera and / or microscope geometry and the mounting of the camera and corresponding monitor on a separate support structure can create a poor ergonomic setup for the surgeon during ophthalmic surgery, which can affect both the procedure and the outcome. Accordingly, there is a need in the art for improved support devices for surgical visualization systems. Summary of the Invention [Means for solving the problem]

[0007] Embodiments of the present disclosure relate to visualization systems for surgical procedures, and more particularly to imaging and display support systems for ophthalmic visualization systems.

[0008] In certain embodiments, a support system for an ophthalmic visualization system is provided, the support system comprising: a base post; a first arm connected to the base post, the first arm configured to move along a first horizontal plane and rotate about a first pivot joint on the base post; an optical head coupled to the first arm; and a first display coupled to an upper surface of the first arm.

[0009] In another embodiment, a support system for an ophthalmic visualization system is provided, the support system comprising: a base post; a base arm including a proximal end and a distal end, wherein the proximal end of the base arm is coupled to the base post via a first pivot joint and the distal end of the base arm is connected to a support column extending between the base arm and the proximal end of the first arm; an optical head coupled to the distal end of the first arm; and a first display coupled to an upper surface of the first arm, wherein movement of the base arm about the first pivot joint along a second horizontal plane parallel to the first horizontal plane simultaneously causes movement of the first arm along the first horizontal plane.

[0010] In order that the features of the present disclosure described above may be understood in detail, the present disclosure, briefly summarized above, may be more particularly described by reference to embodiments, some of which are illustrated in the accompanying drawings. It should be noted, however, that the accompanying drawings illustrate only exemplary embodiments and should not be considered to limit the scope thereof, as other equally effective embodiments may be recognized. [Brief explanation of the drawings]

[0011] [Figure 1] 1 illustrates a perspective view of an exemplary visualization system arm assembly in use during ophthalmic surgery, according to certain embodiments of the present disclosure. [Figure 2] 2 illustrates another perspective view of the visualization system arm assembly of FIG. 1 in accordance with certain embodiments of the present disclosure. [Figure 3]2 illustrates a top view of an exemplary configuration of a portion of the visualization system arm assembly of FIG. 1 having a secondary horizontal support arm connected to a secondary head-up display, according to certain embodiments of the present disclosure. [Figure 4] 4 illustrates a top view of a portion of the visualization system arm assembly of FIG. 3 with the secondary head-up display moved from a first position to a second position, according to certain embodiments of the present disclosure. [Figure 5A-5B] 2A and 2B show side and perspective views, respectively, of another exemplary configuration of a portion of the visualization system arm assembly of FIG. 1 with the horizontal support arm in an extended position, in accordance with certain embodiments of the present disclosure. [Figure 5C] 5A-5B, showing a side view of a portion of the visualization system arm assembly according to a specific embodiment of the present disclosure. [Figures 6A-6B] 10 illustrates a side view of another exemplary visualization system arm assembly configured with a secondary optical device, in accordance with certain embodiments of the present disclosure. [Figure 7A-7C] 2A-2C show perspective views of the visualization system arm assembly of FIG. 1 positioned in a right temporal position, a left temporal position, and a superior position relative to the patient, respectively, in accordance with certain embodiments of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0012] For clarity, where possible, the same reference numerals have been used to denote identical elements common to the figures, and it is contemplated that elements and features of one embodiment may be beneficially incorporated in other embodiments without specific indication.

[0013] In the following description, details are set forth as examples to facilitate understanding of the disclosed subject matter. However, it should be apparent to those skilled in the art that the disclosed implementations are illustrative and do not encompass all possible implementations. Therefore, it should be understood that reference to the described examples is not intended to limit the scope of the present disclosure. Any changes and further modifications to the described devices, apparatuses, and methods, and any further applications of the principles of the present disclosure, are fully contemplated as would normally occur to one skilled in the art to which the present disclosure pertains. In particular, it is fully contemplated that features, components, and / or steps described with respect to one implementation can be combined with features, components, and / or steps described with respect to other implementations of the present disclosure.

[0014] It should be noted that, as described herein, a distal end, segment, or portion of a component refers to the end, segment, or portion that is closer to the target tissue of a patient during use, while a proximal end, segment, or portion of a component refers to the end, segment, or portion that is farther away from the target tissue of a patient.

[0015] As used herein, the term "about" may refer to a + / - 10% variation from the nominal value. It is understood that such a variation may be included in any value provided herein.

[0016] The present disclosure relates to visualization systems for surgical procedures, and more particularly, to a support system for a head-up digital visualization system that may be used during ophthalmic surgery. As discussed above, conventional head-up digital surgical visualization systems may not be ergonomically optimized for ophthalmic surgery. For example, such digital surgical visualization systems may have a display mounted to the side of the microscope and / or camera, thereby requiring the surgeon to assume a less-than-ergonomic position to view the display while performing the surgical procedure. Furthermore, in systems in which the imaging device and corresponding display are mounted on separate support assemblies, having to separately readjust and reposition the imaging device and / or display each time the surgeon assumes a different position for a subsequent procedure can be difficult for surgical staff and can unnecessarily delay the procedure and increase transition time. The support assembly described herein addresses deficiencies in certain existing designs by providing a single mechanical arm assembly that supports both an optical head and an associated head-up display for use with a digital surgical visualization system. Such support assemblies described herein further provide the surgeon and / or associated surgical team with unobstructed visual access to a head-up display showing the surgical target site, thus facilitating improved ergonomics for the surgeon and / or surgical team during ophthalmic surgery. The support assemblies described herein may also be repositioned as needed by the surgeon during surgery, while maintaining the above-mentioned ergonomic improvements during repositioning.

[0017] FIG. 1 illustrates an exemplary arm assembly for use with a heads-up digital surgical visualization system during ophthalmic surgery, according to certain embodiments described herein. In the example of FIG. 1 , a visualization system arm assembly (“arm assembly”) 100 is coupled to and supported by a horizontal base arm 160 extending from a vertical base post 162. The vertical base post 162 may extend downward from a base structure (not shown), such as a boom arm assembly, an operating room ceiling, or a robotic arm on a cart, and vertically to the operating room floor. The vertical base post 162 may be movably connected to the base structure such that the vertical base post 162 may be moved relative to the operating room to provide overall movement and positioning of the arm assembly 100. The horizontal base arm 160 includes a first end 164 and a second end 166, and is rotatably coupled to the vertical base post 162 at the first end 164 via a base pivot joint 168 and to the arm assembly 100 at the second end 166. The horizontal base arm 160 may be configured to rotate about a vertical axis A extending through the base resolute joint 168 and the vertical base column 162, thereby providing horizontal movement of the horizontal base arm 160 relative to the vertical base column 162 along a horizontal XY plane parallel to the floor. In certain embodiments, the base pivot joint 168 is configured to slide up and down along the vertical base column 162, allowing the horizontal base arm 160 to move vertically along the vertical axis A while maintaining the horizontal and / or diagonal orientation of the horizontal base arm 160.

[0018] The arm assembly 100 includes a horizontal support arm 102 extending from a vertical post 104 connected to a second end 166 of the horizontal base arm 160. The arm assembly 100 also includes an optical head 110 movably coupled to a distal end 109 of the horizontal support arm 102 opposite the vertical post 104. The vertical post 104 extends downward from the horizontal support arm 102 and perpendicular to the operating room floor. The vertical post 104 supports the horizontal support arm 102 such that the horizontal support arm 102 and the optical head 110 can be moved relative to the patient by the surgeon to align and properly orient the optical head 110 above the patient for surgery.

[0019] 1 , optical head 110 includes a single, low-profile optical head to facilitate providing a direct and unobstructed view of primary head-up display 108A to a surgeon standing on the opposite side of distal end 109 of horizontal support 102. Generally, optical head 110 may include one or more of the following optical devices: a microscope, a digital microscope, a compound microscope, a digital compound microscope, a digitally assisted microscope, a digital microscope camera, a digital camera, an ophthalmic 3D stereo microscope camera, etc. Such devices may include any suitable optical and / or digital mechanism for high-resolution imaging of ophthalmic structures in a patient's eye during surgery.

[0020] In certain embodiments, the optical head 110 is rotatably connected to the distal end 109 of the horizontal support arm 102 by a yoke 107. The yoke 107 operably provides fine and precise “roll” and “pitch” motion of the optical head 110, as indicated by arrows φ and θ, respectively, to provide the surgeon with a dynamic view of the patient's eye during use of the optical head 110. Such “roll” and “pitch” motion is perpendicular to the optical axis “E” of the optical head 110. The yoke 107 includes a yoke base 107A and a pair of yoke arms 107B and 107C extending from opposite ends of the yoke base 107A. The pair of yoke arms 107B and 107C may extend parallel to each other in the same direction from the yoke base 107A such that the yoke 107 is formed substantially in the shape of a “U” and the optical head 110 is disposed within the “U” between the yoke arms 107B and 107C. The yoke 107 is rotatably connected to the horizontal support arm 102 at the yoke base 107A by a pivot joint 170 such that when the optical head 107 is connected to the yoke 107, the yoke 107 is configured to rotate about the longitudinal axis B of the horizontal support 102, thereby enabling "roll" motion of the yoke 107 and, thereby, the optical head 110. As shown, the optical head 110 can be connected to each of the yoke arms 107B, 107C by pivot joints 172, 174 such that the optical head 110 is configured to rotate about a transverse axis C that is perpendicular to the longitudinal axis B. Rotation of the optical head 110 about the transverse axis C between the yoke arms 107B, 107C provides fine "pitch" motion to the optical head 110.

[0021] In certain embodiments, the optical head 110 may also include one or more handles 113 for manually moving the optical head 110 and / or the connected horizontal support arm 102 about the vertical post 104. The one or more handles 113 may also be used to manually adjust the aforementioned "pitch" and "roll" motion of the optical head 110. In other embodiments, the assembly 100 may include one or more actuators, motors, and / or controllers such that control and actuation of the "pitch" and "roll" motion of the optical head 110, as well as any horizontal movement of the horizontal support arm 102 and / or horizontal base arm 160, may be motorized. In such examples, movement of the assembly 100 may be controlled by a surgeon via a console, such as a surgical console (not shown).

[0022] 1 , arm assembly 100 also includes one or more primary and / or secondary head-up displays 108A, 108B (collectively head-up displays 108) for viewing images of the target surgical site relayed by optical head 110 and / or other image sources. For example, during ophthalmic surgery, such as vitreoretinal or cataract surgery, a camera within optical head 110 may relay magnified and illuminated images of ophthalmic structures in the patient's eye to head-up display 108 for viewing by the surgeon and, if present, surgical staff. Thus, the surgeon (and surgical staff) can view such images without having to look through the eyepieces of a microscope, thereby providing additional visual, optical, and ergonomic benefits for the surgeon (and surgical staff).

[0023] In the example shown in FIG. 1 , the primary head-up display 108A is mounted adjacent to the upper surface of the horizontal support arm 102. When the arm assembly 100 is in use, the surgeon can stand opposite the distal end 109 of the horizontal support arm 102 so that the optical head 110 is positioned between the surgeon and the primary head-up display 108A. In this position, the horizontal support arm 102 extends along the direction the surgeon is facing, and the display portion of the primary head-up display 108 is positioned directly in front of (e.g., forward of) the surgeon. Therefore, when the arm assembly 100 is used in combination with a 3D visualization system during a surgical procedure, the angle of the surgeon's line of sight relative to the primary head-up display 108A can be positioned within the required limits of the 3D visualization system to provide an optimal 3D effect. Additionally, to provide the most ergonomic benefit for the surgeon during surgery, the arm assembly 100 further facilitates positioning the primary head-up display 108A so that the surgeon's head is flush with the center of the primary head-up display 108A. Furthermore, the placement and orientation of the arm assembly 100 and the dimensions of the primary head-up display 108A may allow the surgeon's line of sight to any portion of the primary head-up display 108A to be unobstructed.

[0024] During ophthalmic surgery, the surgeon's position relative to the primary head-up display 108A may obstruct one or more surgical staff members' (non-surgeon) view of the primary head-up display 108A, or the display may be positioned at an angle such that the 3D visual effects provided by the display may be lost for such surgical staff members. Thus, to provide staff with a view of the same or similar quality as that seen by the surgeon, the arm assembly 100 may, in certain embodiments, include an optional secondary head-up display 108B. In the example shown in FIGS. 1 and 2 , the secondary head-up display 108B is mounted on an articulating horizontally supported secondary arm 112 coupled to the vertical column 104. In general, the secondary head-up display 108B may be utilized to display the same or a different image than that displayed by the primary head-up display 108A, thereby facilitating a direct and unobstructed view of the surgical target site for the surgical staff and enhancing the ergonomics of the surgery for the entire surgical team.

[0025] In certain embodiments, to accommodate various surgeon positions in various types of surgical procedures, the horizontal base arm 160, the vertical post 104, and the horizontal support arm 102 are positioned and coupled such that the entire assembly 100 can be rotated by translation / rotation of the horizontal base arm 160 about the vertical axis A of the base post 162. In certain embodiments, the second end 166 of the horizontal base arm 160 can be rigidly coupled to the vertical post 104, which can be rigidly coupled to the horizontal support arm 102 such that the horizontal support arm 102 extends parallel to the horizontal base arm 160. In such embodiments, when the optical head 110 is oriented so that its optical axis E is perpendicular to, for example, the operating room floor, the optical axis E can be aligned coincident with the vertical axis A of the vertical base post 162, thus forming a single vertical axis. As a result, rotational movement of the horizontal base arm 160 about the vertical base post 162 facilitates rotation of the optical head 110 with little to no XY movement of the optical head 110 that would otherwise be required to realign the optical head 110 after rotation of the assembly 100 to accommodate the surgeon's position during surgery. Thus, the axial alignment of the optical head 110 can be maintained by rotating the assembly 100 between these various positions.

[0026] 1, by having the axis of rotation of assembly 100 in the XY plane reside on vertical base post 162, any rotation of optical head 110 involves simultaneous rotation of horizontal base arm 160 and vertical post 104 along with any head-up displays 108 attached thereto. This allows the entire assembly 100, including any head-up displays 108 attached to horizontal support arm 102 or vertical post 104, to be rotated with a single movement of assembly 100 about vertical base post 162. This effectively ensures that ergonomic conditions for the surgeon are maintained as assembly 100 is moved to a new position.

[0027] Figure 2 shows another perspective view of the arm assembly 100 of Figure 1, in accordance with certain embodiments of the present disclosure. As shown, the horizontal support arm 102 of the arm assembly 100 is coupled to a vertical post 104 at a first joint 106. In the example shown in Figure 1, the horizontal support arm 102 extends horizontally at an angle of approximately 90 degrees relative to a vertical axis D of the vertical post 104. In general, the horizontal support arm 102 may extend horizontally and / or obliquely (e.g., at a non-zero angle relative to the horizontal and vertical planes) from the vertical post 104.

[0028] In certain embodiments, the horizontal support arm 102 may be configured to pivot or rotate about the vertical post 104 and the vertical axis D (e.g., by the vertical post 104 functioning as an axle, pin, or cylinder). In such embodiments, the first joint 106 may include a pivot joint, which may include a needle bearing or other similar bearing and / or device to facilitate smooth rotational movement of the horizontal support arm 102 about the vertical post 104. In other embodiments, the horizontal support arm 102 may be non-rotatably coupled to the vertical post 104. In further embodiments, the first joint 106 is configured to slide up and down along the vertical post 104, allowing the horizontal support arm 102 to move vertically along the vertical axis D while maintaining the horizontal and / or diagonal orientation of the horizontal support arm 102. In such embodiments, the first joint 106 includes a sliding joint.

[0029] In certain embodiments, the horizontal support arm 102 has a length sized according to the monitor size (e.g., diagonal corner-to-corner length) of the primary head-up display 108A such that when the arm assembly 100 is used during a surgical procedure, the horizontal arm 102 facilitates an optimal ergonomic and immersive 3D experience / effect for the surgeon when viewing the 3D image of the patient's eye. Such distribution of the horizontal arm support 102 is referred to herein as the "ergonomic display distance."

[0030] In certain embodiments, the primary head-up display 108A may include a 32-inch monitor display so that the ergonomic display distance for the surgeon is approximately 750 mm from the surgeon's eyes. As such, the horizontal support arm 102 is sized such that when the arm assembly 100 is used by the surgeon to perform ophthalmic surgery, the horizontal support arm 102 maintains an ergonomic 750 mm distance between the surgeon and the primary head-up display 108A when the surgeon is positioned adjacent to the optical head 110 and opposite the primary head-up display 108A.

[0031] In certain embodiments, the arm assembly 100 maintains the ergonomic display distance regardless of any movement or rotation of the optical head 110 necessitated by changes in the surgeon's position about the patient's head. For example, in certain embodiments, due to both the optical head 110 and the primary head-up display 108A being mounted on the horizontal support arm 102, the primary head-up display 108A is always correspondingly rotated and / or moved (e.g., translated) with any movement or rotation of the optical head 110 by the surgeon. However, in certain other embodiments, the arm assembly 100 must be manually set to the ergonomic monitor distance by physically adjusting the position of the primary display 108A.

[0032] 2 , in certain embodiments, the primary head-up display 108A is attached to the horizontal support arm 102 by a first bracket 114 adjacent the proximal end 111 of the horizontal support arm 102 near the first joint 106. The first bracket 114 may be configured to mount the primary head-up display 108A in a fixed position on the horizontal support arm 102 with a back surface of the display 108A adjacent to and in contact with the vertical post 104 and a viewing side of the display 108A facing the optical head 110 and the distal end 109 of the horizontal support arm 102. In certain embodiments, the first bracket 114 may be configured with one or more additional hinges or joints to allow the primary head-up display 108A to tilt and move for dynamically adjusting the primary head-up display 108A.

[0033] Alternatively, as described above, the secondary head-up display 108B may be attached to the vertical post 104 by an articulating secondary horizontal support arm 112 that is movably coupled to the vertical post 104. The articulating secondary horizontal support arm 112 may be configured to allow the secondary head-up display 108B to be independently moved relative to the horizontal support arm 102 and / or the primary head-up display 108A.

[0034] FIG. 3 illustrates a top view of an exemplary configuration of a portion of the arm assembly 100 of FIG. 1 , in accordance with certain embodiments of the present disclosure. The portion illustrated in FIG. 3 includes components located below section line AA in FIG. 1 . As illustrated, the articulating secondary horizontal support arm 112 includes two segments: a first proximal segment 116 and a second distal segment 118. A proximal end 115 of the proximal segment 116 is rotatably connected to the vertical post 104 by a second pivot joint 120 along which the proximal segment 116 extends horizontally or diagonally. The second pivot joint 120 is configured to rotate the proximal segment 116 about a vertical axis D extending through the vertical post 104, thereby providing horizontal movement of the proximal segment 116 relative to the vertical post 104 along a horizontal XY plane parallel to the floor. 2 and 3, the second pivot joint 120 is positioned above (e.g., on) the first joint 106, although other arrangements are contemplated. The second pivot joint 120 may also be configured to allow the proximal segment 116 to slide up and down along the vertical post 104 to adjust the vertical positioning of the sub-horizontal support arm 112 along the vertical XZ plane relative to the vertical post 104.

[0035] The distal end 117 of the proximal segment 116 is rotatably connected to the proximal end 119 of the distal segment 118 at a third pivot joint 122 about which the distal segment 118 extends horizontally or diagonally. The third pivot joint 122 is positioned so that its axis of rotation is parallel to the axis of the second pivot joint 120 and therefore perpendicular to the operating room floor and parallel to the vertical axis D. Thus, the third pivot joint 122 facilitates XY movement of the distal segment 118 relative to the proximal segment 116.

[0036] The distal end 121 of the distal segment 118 is further rotatably connected to an optional secondary head-up display 108B at a fourth pivot joint 124. The secondary head-up display 108B may further include an adjustable mounting bracket 126 for mounting the secondary head-up display 108B to the fourth pivot joint 124. The fourth pivot joint 124 is configured and oriented such that its axis of rotation is parallel to the axis of the vertical axis and, therefore, perpendicular to the operating room floor. Thus, the fourth pivot joint 124 facilitates horizontal rotation of the secondary head-up display 108B along the XY plane about the distal end 121 of the distal segment 118.

[0037] Collectively, the proximal and distal segments 116, 118, and pivot joints 120, 122, and 124 of the articulating secondary horizontal support arm 112 facilitate horizontal movement and movement of the secondary head-up display 108B parallel to the operating room floor. More specifically, the XY movement facilitated by the proximal and distal segments 116, 118, and pivot joints 120, 122, and 124 allows a range of horizontal movement of the secondary head-up display 108B from one side of the primary head-up display 108A to the other about the vertical column 104, thereby enabling surgical staff positioned around the surgeon to view the secondary head-up display 108B during ophthalmic surgery. Additionally, because the pivot joints 120, 122, and 124 are oriented parallel to one another, their axes of rotation are not fighting gravity, thereby providing the secondary horizontal support arm 112 with a larger payload. In certain embodiments, the pivot joints 120 , 122 , and 124 may include needle bearings or similar devices that facilitate smooth rotational movement of the secondary head-up display 108 B about the vertical post 104 .

[0038] FIG. 4 illustrates a top view of the secondary head-up display 108B of FIG. 3 being moved, in accordance with certain embodiments of the present disclosure. As described above, the proximal segment 116 and the distal segment 118 of the secondary horizontal support arm 112 provide the secondary head-up display 108B with horizontal movement and motion about the vertical column 104. In the example illustrated in FIG. 4 , the secondary head-up display 108B is moved from a first secondary head-up display position 125, where the secondary head-up display 108B is to the right of the primary head-up display 108A when viewed from the viewing side of the primary head-up display 108A, to a second secondary monitor viewing position 127, where the secondary head-up display 108B is to the left of the primary head-up display 108A when viewed from the viewing side of the primary head-up display 108A. Such positions of the secondary head-up display 108B may be utilized depending on the position of the surgeon relative to the patient's head during surgery and the positions of the surgical staff within the operating room. The secondary head-up display 108B may be positioned to provide the surgical staff with a direct and unobstructed view of the surgical target site being operated on by the surgeon, further enhancing the ergonomics of the surgical team's operation.

[0039] To change the secondary head-up display 108B between position 125 and position 127, the proximal segment 116, the distal segment 118, and the secondary head-up display 108 may be individually rotated approximately 180 degrees about the second, third, and fourth pivot joints 122, 124, and 126, respectively, to cause the secondary head-up display 108B to swing about the vertical post 104 between the first position 125 and the second position 127. In certain embodiments, the arm assembly 100 may be lockable at any predetermined position between the first position 125 and the second position 127.

[0040] In certain aspects of the present disclosure, the arm assembly 100 may include two or more secondary head-up displays 108B connected to the vertical post 104, with each display mounted on a corresponding horizontal support arm similar to the example shown in FIG. 4. In certain embodiments, two or more secondary head-up displays 108B may be connected to the same secondary horizontal support arm 112. In further embodiments, one or more secondary head-up displays 108B may also be connected to the horizontal support arm 102. Alternatively, the assembly 100 may not include any secondary head-up displays 108B and may be limited to the primary head-up display 108A.

[0041] 3 , in certain embodiments, the horizontal support arm 102, the first bracket 114, and the vertical post 104 may also be movably coupled together such that the horizontal support arm 102 (and the optical head 110 connected thereto) may be moved relative to the vertical post 104 to provide X and Y movement to the optical head 110 without moving the remainder of the arm assembly 100 (e.g., the vertical post 104, the horizontal base 160, and the vertical base post 162). In certain embodiments, the horizontal support arm 102 may be movably coupled to the first bracket 114 along a plurality of sliding tracks (not shown) extending along the Y axis on the horizontal support arm 102 to enable movement of the horizontal support arm 102 relative to the first bracket 114 and the vertical post 104 along the Y axis. In certain embodiments, the first bracket 114 may be movably coupled to the vertical post 104 along a plurality of sliding tracks (not shown) extending along the X-axis such that the first bracket 114 (and the horizontal support arm 102 and optical head 110 connected thereto) may be moved along the X-axis relative to the vertical post 104. Thus, movement of the first bracket 114 along the X-axis (with the position of the horizontal support arm 102 on the first bracket 114 remaining fixed) may move the optical head 110 along the X-axis relative to the vertical post 104 without moving the remainder of the arm assembly 100 (e.g., the vertical post 104, the horizontal base 160, and the vertical base post 162).

[0042] In certain embodiments, (1) movement of the horizontal support arm 102 relative to the first bracket 114 in the Y direction and (2) movement of the first bracket 114 relative to the vertical post 104 in the X direction may be subject to motorized movement and control by the surgeon via one or more actuators, motors, and / or controllers connected between the horizontal support arm 102, the first bracket 114, and the vertical post 104 and implemented on the assembly 100. When motorized, the assembly provides the surgeon with additional fine X and Y movement of the horizontal support arm 102 / optical head 110 without further modification to the setup of the assembly 100.

[0043] 5A-5C show side and perspective views of another exemplary configuration of a portion of the arm assembly of FIG. 1 including an extension mechanism for the optical head 110, in accordance with certain embodiments of the present disclosure. Again, the portion shown in FIGS. 5A-5C includes components located below section line AA in FIG. 1. As shown, the horizontal support arm 102 can include an internal extension mechanism 135 configured to separate and extend the optical head 110 from the distal end 109 of the horizontal support arm 102 such that the optical head 110 can be moved vertically and longitudinally relative to the horizontal support arm 102.

[0044] As mentioned above, one of the three main positions a surgeon can assume relative to a patient's head during ophthalmic surgery is a patient-over-head position (with respect to patient 200, shown in FIG. 7C ), in which the surgeon is positioned above the patient's head. In such an example, the arm assembly 100 is positioned such that the proximal end 111 of the horizontal support arm 102 is positioned over the patient's midsection and extends from the patient's chest to their head. Due to the positioning of the horizontal support arm 102, in some cases, the patient's chest may contact the bottom of the horizontal support arm 102 before the optical head 110 is within working distance of the patient's 200's eye. To accommodate the patient's chest, the horizontal support 102 can be adjusted along the vertical column 104 to be elevated above the patient's chest. The extension mechanism 135 of the optical head 110 can then be used to extend and lower the optical head 110 toward the patient's head to properly align the optical head 110 over the target surgical site on the patient's head and position any imaging devices within the appropriate working distance of the optical head 110.

[0045] In FIG. 5C , a portion of the horizontal support arm 102 (e.g., its outer shell) is shown in cross section to illustrate the internal extension mechanism of the horizontal support arm 102 that facilitates longitudinal ("Y" movement) and vertical ("Z" movement) separation and combination of movement of the optical head 110 from the distal end 109 of the horizontal support arm 102. Specifically, the illustrated internal movement mechanism may enable the optical head 110 to be moved relative to the horizontal support 102 between a "home" position and an "extended" position, where in the "home" position the optical head 110 sits adjacent the distal end 109 of the horizontal support arm 102, as shown in FIG. 1 . In contrast, when the optical head 110 is in the "extended" position, the optical head 110 is separated from the distal end 109 of the horizontal support arm 102, as shown in FIGS. 5A-5C .

[0046] 5A-5C , the horizontal support arm 102 includes a parallel four-joint mechanism 128 mounted between a head base 134 rotatably connected to a proximal end 136 of the yoke 107 and a carriage 138 slidably connected to a plurality of rails 140 formed within a chamber 144 of the horizontal support arm 102. The parallel four-joint mechanism 128 enables passive, lockable vertical movement of the optical head 110. The parallel four-joint mechanism 128 is formed by at least four joints 130 movably coupled by four horizontal pivot joints 132 that facilitate vertical movement of the optical head 110 relative to the carriage 138 within the chamber 144 and the distal end 109 of the horizontal support arm 102. The pivot joint 132, in contrast to the pivot joints 120, 122, and 124, is positioned such that each of the pivot joint's rotation axes is parallel to the operating room floor, i.e., parallel to the horizontal XY plane, and perpendicular to the vertical axis D or vertical column 104. This configuration allows vertical movement of the optical head 110 perpendicular to the operating room floor while maintaining the parallel orientation of the pivot joints 120, 122, and 124, as shown in FIG. 5C . In certain embodiments, the parallel four-bar mechanism 128 may be spring balanced and may include one or more springs disposed between its pivot joints 132.

[0047] To facilitate longitudinal movement of the optical head 110, the horizontal support arm 102 includes a plurality of rails 140 and a carriage 138 within a chamber 144 of the horizontal support arm 102. In certain embodiments, the plurality of rails 140 may be formed within the horizontal support arm 102 along the inner surface of the chamber 144 and extend from an opening 146 at the distal end of the horizontal support arm 102 to near the proximal end 111 of the horizontal support arm 102. The carriage 138 and the plurality of rails 140 may be slidably connected and configured as a dovetail slide mechanism such that the carriage 138 may slide within the chamber 144 along the horizontal support arm 102 and the plurality of rails 140 between the proximal end 111 and the opening 146. Thus, movement of the carriage 138 along the longitudinal axis of the horizontal support arm 102 parallel to the operating room floor facilitates longitudinal movement of the optical head 110 relative to the horizontal support arm 102.

[0048] When the optical head 110 is in the "home position," the carriage 138 is positioned adjacent the proximal end 111 of the horizontal support arm 102, with the entire parallel four mechanism 128 located within a chamber 144 of the horizontal support arm 102. The head base 134 can then be mounted over the opening 146 so that the optical head 110 is connected to the horizontal support arm 102 and is therefore in the "home" position. Sliding the carriage 138 away from the proximal end 111 and toward the opening 146 in turn facilitates extension of the horizontal support arm 102 and movement of the optical head 110 longitudinally, away from the opening 146, to the "extended" position.

[0049] When the optical head 110 is in the “extended” position, the yoke 107 can still provide both “pitch” and “roll” movement of the optical head 110. For example, when the optical head 110 is extended, the yoke 107 can still rotate about the head base 134, thus facilitating “roll” movement of the optical head 110 about the longitudinal axis B. When the optical head 110 is extended, the attachment points between the optical head 110 and the pair of yoke arms 107B, 107C facilitate “pitch” movement of the optical head 110 about the transverse axis C. In certain embodiments, in the extended position, the optical head 110 can be configured such that control of the “pitch” and “roll” movement of the optical head 110 can be performed manually by the surgeon. Alternatively, movement of the optical head 110 can be subject to motorized operation and control by the surgeon via one or more actuators, motors, and / or controllers connected to the optical head 110 and implemented in the assembly 100. When motorized, the X, Y, and Z motion of the optical head 110 may allow spherical motion about the focal point of the optics of the optical head 110. Thus, the support system described herein offers several advantages over conventional systems.

[0050] 6A-6B show side views of arm assembly 100 configured in "home" and "deployed" positions, respectively, with an additional optical device, according to certain embodiments of the present disclosure.

[0051] In the illustrated example, in certain embodiments, the horizontal support arm 102 may include a secondary optical device 148 mounted along its underside. In certain embodiments, the secondary optical device 148 may include a diagnostic device such as an aberrometer, a corneal topographer, or an autorefractor. The secondary optical device 148 may be slidably connected to the horizontal support arm 102 using, for example, a dovetail slide 150 configured to allow the secondary optical device 148 to move along the underside of the horizontal support arm 102. The dovetail slide 150 may facilitate longitudinal or "Y" movement of the secondary optical device 148 along an XY plane parallel to the operating room floor. FIG. 6A shows the secondary optical device 148 in a "home" position below the horizontal support arm 102. To use the secondary optical device 148, the secondary optical device may be moved to a "deployed" position such that the secondary optical device 148 can be moved toward and aligned with the optical head 110 and positioned over the target surgical site, as shown in FIG. 6B. When the secondary optical device 148 is positioned over the target surgical site, the optical axis E of the optical head 110 and the secondary optical device 148 can be coaxially aligned so that the secondary optical device 148 is positioned over the same target site previously viewed by the optical head 110.

[0052] 7A-7C show the arm assembly of FIG. 1 positioned in a left temporal position, a right temporal position, and a superior position, respectively, centered on patient 200, in accordance with certain embodiments of the present disclosure.

[0053] As mentioned above, during ophthalmic surgery, there are three main positions that a surgeon may assume relative to a patient's head for various procedures: the left temporal position, the right temporal position, and the superior position. Figure 7A shows the assembly 100 oriented for the left temporal position, where the surgeon stands facing the left side of the patient's head. Figure 7B shows the assembly 100 oriented for the right temporal position, where the surgeon stands facing the right side of the patient's head. Finally, Figure 7C shows the assembly 100 oriented for the superior position, where the surgeon stands facing the top of the patient's head.

[0054] To adjust the assembly 100 between each of the three positions, the horizontal base arm 160 can be rotated about the base pivot joint 168, thereby rotating the orientation of the optical head 110 and primary head-up display 108b about a horizontal XY plane parallel to the operating room floor. For example, to change the assembly 100 from the right-side-up position shown in FIG. 7B to the upright position shown in FIG. 7C, the base arm 160 can be rotated 90 degrees counterclockwise about the vertical base post 162. As the base arm 160 rotates, the optical head 110, support arm 102, vertical post 104, and primary head-up display 108A rotate with it. The simultaneous, corresponding rotation of the primary head-up display 108A and horizontal support arm 102, which maintains an ideal ergonomic distance between the surgeon and the primary display 108A, facilitates maintaining ideal ergonomics for the surgeon as the system is adjusted between positions without requiring further adjustment of the primary display 108A by the surgeon or surgical team. In this manner, the assembly 100 described herein is highly efficient at maintaining ergonomic conditions when the optical head 110 and corresponding surgical vision system need to be moved to accommodate various surgical positions by the surgeon.

[0055] In summary, embodiments of the present disclosure include an imaging and display support arm for an ophthalmic visualization system that provides improved ergonomics for both surgeons and their surgical staff. For example, by placing both the primary head-up display and the optical head on the horizontal support arm, the surgeon always has a direct, unobstructed line of sight to the primary head-up display, thereby providing the surgeon with the most favorable ergonomic position possible during surgery. In addition, utilizing a movable secondary horizontal support arm facilitates a direct, unobstructed view of the surgical target site on the secondary head-up display for other surgical staff, thereby further enhancing the ergonomics of the entire surgical team. Furthermore, the combination of a parallel-four and dovetail slide mechanism that drives the extension of the optical head facilitates use of the digital surgical visualization system while avoiding interference or obstruction caused by the horizontal support arm contacting the patient's chest, and further allows the visualization display screen to be positioned and maintained directly in front of the surgeon. As such, the support system described herein offers several advantages over conventional systems.

[0056] Although cataract surgery and vitreoretinal surgery are discussed as examples of surgeries that may benefit from the described embodiments, other surgeries may benefit from the advantages of the surgical devices and systems described herein as well.

[0057] While the foregoing relates to embodiments of the present disclosure, other and further embodiments of the present disclosure may be devised without departing from the basic scope thereof, which scope is determined by the claims that follow.

[0058] As used herein, a phrase referring to "at least one of" a list of items refers to any combination of those items, including single members. As an example, "at least one of a, b, or c" is intended to cover a, b, c, ab, ac, bc, and abc, as well as any combination with multiples of the same element (e.g., aa, aaa, aab, aac, abb, acc, bb, bbb, bbc, cc, and ccc, or a, b, and c in any other order).

[0059] The above description is provided to enable those skilled in the art to practice the various embodiments described herein. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other embodiments. Accordingly, the claims are not intended to be limited to the embodiments shown herein, but are to be accorded the full scope consistent with the language of the claims.

[0060] Reference to an element in the claims in the singular is intended to mean one or more, not one and only one, unless otherwise specified. The term "some" refers to one or more, unless otherwise specified. All structural and functional equivalents of the elements of the various embodiments described throughout this disclosure that are or later become known to those skilled in the art are expressly incorporated herein by reference and are intended to be encompassed by the claims. Moreover, nothing disclosed herein is intended as a dedication to the public, regardless of whether such disclosure is expressly recited in the claims. No element of a claim shall be construed under the provisions of 35 U.S.C. 112(f) unless the element is expressly recited using the phrase "means for," or, in the case of a method claim, the element is recited using the phrase "step for." The word "exemplary" is used herein to mean "serving as an example, instance, or illustration." Any aspect described herein as "exemplary" is not necessarily to be construed as preferred or advantageous over other aspects.

Claims

1. 1. A support system for an ophthalmic visualization system, the support system comprising: The foundation pillar and a first arm connected to the base post, the first arm configured to move along a first horizontal plane and rotate about a first pivot joint in the base post; an optical head coupled to a distal end of the first arm; a first display coupled to an upper surface of the first arm; A support system comprising:

2. a base arm including a proximal end and a distal end, wherein said first arm being connected to said base post comprises said proximal end of said base arm being coupled to said base post via said first pivot joint and said distal end of said base arm being connected to a strut extending between said base arm and said proximal end of said first arm, wherein rotational movement of said base arm along a second horizontal plane and about said first pivot joint simultaneously causes rotational movement of said first arm along said first horizontal plane. The support system of claim 1 further comprising:

3. 3. The support system of claim 2, wherein rotational movement of the base arm about the base column simultaneously rotates and moves the optical head, the first arm, the support column, and the first display coupled to the first arm about the base column.

4. The support system of claim 2 , wherein rotational movement of the base arm about the base post rotates the optical head about a base longitudinal axis in alignment with an optical axis of the optical head.

5. a second articulated arm connected to the support post, the second articulated arm comprising: a first segment including a proximal end and a distal end, the first segment configured to move along a third horizontal plane and rotate about a second pivot joint at the proximal end of the second articulated arm, the first segment coupled to the strut via the second pivot joint; a second segment including a proximal end and a distal end, the second segment configured to move along the third horizontal plane and rotate about a third pivot joint at the proximal end thereof, the second segment coupled to the first segment via the third pivot joint; a second display coupled to the distal end of the second segment and configured to rotate and move along the third horizontal plane via a fourth pivot joint, the second display coupled to the second segment via the fourth pivot joint; and a second articulated arm comprising: The support system of claim 2 further comprising:

6. The support system of claim 4 , wherein the first, second, third, and fourth pivot joints are disposed parallel to one another.

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

8. a yoke connecting a proximal end of the optical head to a distal end of the first arm, the yoke configured to rotate and move about a longitudinal axis extending through the first arm via a second pivot joint at the distal end of the first arm, and the optical head configured to rotate and move about a transverse axis extending perpendicular to the longitudinal axis via one or more yoke pivot joints connecting the optical head to the yoke. The support system of claim 1 further comprising:

9. The support system of claim 8 , wherein the rotational movement of the yoke about the longitudinal axis provides the optical head with a “roll” motion relative to the first arm.

10. The support system of claim 8 , wherein rotational movement of the optical head about the lateral axis at the one or more yoke pivot joints on the yoke provides a “pitch” motion to the optical head relative to the yoke.

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

12. 12. The support system of claim 11, wherein the first arm further comprises a parallelepiped mechanism extending between the optical head and the dovetail slide mechanism to facilitate vertical movement of the optical head from the first arm.

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

14. The support system of claim 12 , wherein the dovetail slide mechanism and parallel four mechanism facilitate separation and extension of the optical head from the first arm.

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

16. The support system of claim 5 , wherein the second pivot joint is configured to slide along the post to facilitate vertical movement of the second articulated arm thereof.

17. 13. The support system of claim 12, wherein the parallel four-bar mechanism further comprises one or more springs that facilitate configuring the parallel four-bar mechanism as spring balanced.

18. The support system of claim 1 further comprising a secondary optical device coupled along a lower surface of the first arm.

19. 6. The support system of claim 5, wherein the second articulating arm facilitates movement of the second display along the third horizontal plane between a first position on a first side of the first display and a second position on a second side of the first display.

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

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