Robotic systems for microsurgical procedures.

Abstract

The present invention provides an apparatus and method for performing microsurgical procedures in a robotic manner. [Solution] An apparatus and method are described for performing a procedure on a portion of a patient's body using one or more tools (21). A robotic unit (20) includes a tool mount (30) configured to securely hold one or more tools (21). An articulated arm (32) is disposed on a side of the tool mount (30) and configured to movably support the tool mount (30). A plurality of arm motors (34) associated with at least one articulated arm (32) are configured to move the tool mount (30) with at least five degrees of freedom. One or more mount motors (36) associated with the tool mount (30) are configured to move the tool (21) relative to the tool mount (30) with a sixth degree of freedom. Other applications are also described.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application is U.S. Provisional Patent Application No. 63 / 057,391, filed July 28, 2020, by Glozman et al., entitled “Robotic system for microsurgical procedures”; and This application claims priority to U.S. Provisional Patent Application No. 63 / 087,408 by Glozman et al., entitled "Control component for microsurgical robotic system," filed on October 5, 2020.

[0002] All of the above US provisional applications are incorporated herein by reference.

[0003] Some applications of the present invention relate generally to medical devices and methods, and more particularly, to devices and methods for robotically performing microsurgical procedures. [Background technology]

[0004] Cataract surgery consists of removing the eye's natural lens that has developed opacity (known as a cataract) and replacing it with an intraocular lens. Such surgery usually involves several standard steps that are performed in sequence.

[0005] In the first step, the patient's face around the eye is disinfected (usually with an iodine solution) and the face is covered with a sterile drape to expose only the eye. Once disinfection and draping are complete, the eye is anesthetized using a local anesthetic, usually administered in the form of eye drops. The eye is then exposed using a retractor that holds the upper and lower eyelids open. One or more incisions (usually two or three incisions) are made in the cornea of ​​the eye. The incisions are usually made using a specialized blade called a keratome blade. At this stage, lidocaine is usually injected into the anterior chamber of the eye to further anesthetize the eye. Following this step, a viscoelastic injection is administered through the corneal incision. The viscoelastic injection is administered to stabilize the anterior chamber and to help maintain intraocular pressure for the remainder of the procedure, as well as to expand the lens capsule.

[0006] In a later step known as capsulorhexis, a portion of the anterior lens capsule is removed. Various enhanced techniques have been developed to perform capsulorhexis, including laser-assisted capsulorhexis, zepto-assisted incision (using precise nano-pulse technology), and marker-assisted capsulorhexis (where the cornea is marked using a defined marker to indicate the desired size for the capsule opening).

[0007] It is then common to inject a fluid wave through the corneal incision to slice through the outer layer of the cataract, in a step known as hydrodissection. In a subsequent step known as hydrodelineation, the outer, softer epi-nucleus of the lens is separated from the inner, harder endo-nucleus by injection of a fluid wave. The next step is ultrasonic emulsification of the lens in a process known as phacoemulsification. The nucleus of the lens is first fragmented using a chopper, after which the outer fragments of the lens are broken and removed, usually using an ultrasonic phacoemulsification probe. A separate tool is also usually used to perform aspiration during phacoemulsification. Once phacoemulsification is complete, the remaining cortical (i.e., outer layer of the lens) material is aspirated from the capsule. During phacoemulsification and aspiration, the aspirated fluid is usually supplemented by irrigation with a balanced salt solution to maintain fluid pressure in the anterior chamber. In some cases, the capsule is polished if deemed necessary. An intraocular lens (IOL) is then inserted into the capsule. The IOL is usually foldable and inserted in a folded state, after which it is deployed inside the capsule. At this stage, the viscoelastic material is usually removed using a suction device that was previously used to aspirate the fluid from the capsule. If necessary, the incision is closed by increasing intraocular pressure, forcing the incision closed by pressing the inner tissue against the outer tissue. Summary of the Invention

[0008] According to some applications of the present invention, a robotic system is used for micro-surgical procedures such as intraocular surgery. It is noted that intraocular surgery, particularly cataract surgery, is characterized by the fact that there are relatively few patient-specific variations in ocular anatomy and / or geometry. Cataract surgery also has a relatively standardized procedure flow, with the usual sequence of steps being as described in the background section above. In view of the relatively standard dimensions and sequence of steps associated with cataract surgery, in some applications of the present invention, a robotic system is first trained to perform one or more steps of cataract surgery in an automated manner based on the standard dimensional ranges of each part of the human eye.

[0009] Typically, a robotic system comprises first and second robotic units (configured to hold a tool), as well as an imaging system, a display, and a control component, through which a medical professional can control the robotic units. Typically, a robotic system comprises one or more computer processors, through which the components of the system and a user (e.g., a medical professional) can operably interact with each other.

[0010] In some applications, during the training phase, the movement of the robotic unit (and / or control of other aspects of the robotic system) is at least partially controlled by a user (e.g., a medical professional). For example, the user may receive images of the patient's eye, the robotic unit, and / or tools disposed therein via a display. Typically, such images are acquired by an imaging system. In some applications, the imaging system is a stereoscopic imaging device and the display is a stereoscopic display. Based on the received images, the user typically performs steps of the procedure. In some applications, the user provides commands to the robotic unit via a control component (described in more detail below). Typically, such commands include commands to control the position and / or orientation of tools disposed within the robotic unit and / or commands to control operations performed by the tools. For example, the commands may control a phacoemulsification tool (e.g., an operating mode and / or suction force of the phacoemulsification tool) and / or an injection tool (e.g., which fluid (e.g., a viscoelastic fluid, saline, etc.) should be injected and / or at what flow rate). Alternatively or additionally, a user may input commands to control the imaging system (e.g., magnification, focus, and / or xy positioning of the imaging system). In some applications, the commands include controlling an IOL manipulator tool that manipulates the IOL inside the eye, for example, for precise positioning of the IOL within the eye.

[0011] In some applications, after an initial training phase, the robotic system is used to perform one or more steps of cataract surgery on a given patient's eye in an at least partially automated manner. In some such applications, at least one image of the patient's eye is obtained using the imaging system. For example, the image may be obtained before or during one or more steps of cataract surgery are performed on the patient's eye. Typically, a computer processor analyzes the image to determine precise dimensions of the patient's eye, and the steps of the cataract surgery are planned based on the training and the determined eye dimensions. Typically, such steps include controlling the position and orientation of tools via the robotic unit, as described above, and controlling additional aspects of the procedure (such as controlling the functions of tools and / or the functions and movements of the imaging system). Following this, the computer processor typically causes the robotic unit and / or additional components of the robotic system to perform the planned steps. In some applications, the medical professional may control the movements of the robotic unit and / or other aspects of the robotic system during the procedure. For example, the computer processor may plan the steps of the procedure and indicate the planned steps to the medical professional. The medical professional may then override and / or refine the planned treatment steps, for example via the control component.

[0012] In some applications, any one of the following steps (parts or combinations thereof) of a cataract treatment is performed in an automated or semi-automated manner using the techniques described herein: corneal incision (e.g., a two- or three-plane incision, typically using a keratome blade), viscoelastic injection (including needle insertion through one incision and / or simultaneous injection and retraction of the needle), capsulotomy, hydrodissection, hydrodellineation, phacoemulsification (including nucleus cutting and / or ultrasonic emulsification using a phacoemulsification probe), irrigation, aspiration, implantation of an IOL (e.g., using an IOL injection system), viscoelastic removal, wound healing, and / or any combination thereof.

[0013] In some applications, the steps of imaging the patient's eye, planning procedural steps, and moving the robotic unit and / or controlling other aspects of the robotic system are performed iteratively. Typically, the patient's eye and the robotic unit (and / or tools disposed therein) are continuously imaged in real time throughout the time period during which a given procedural step is being performed. In response to the real-time images, the position and orientation of the tool are updated to correspond with the real-time movement of the patient's eye (as described in more detail below). Typically, the position and orientation of the tool are updated by moving the tool via the robotic unit. Alternatively or additionally, the computer processor is configured to detect when the eye is in a given position and measure the time that a certain function is performed by the robotic unit such that the certain function is performed when the eye is in a given position.

[0014] Typically, the computer processor detects three-dimensional movements of the patient's eye by analyzing images obtained by an imaging system (usually a stereoscopic imaging system, as described above). In some applications, in response to the detected movements of the patient's eye, the computer processor drives the robotic unit to move the tool such that the entry of the tool into the patient's eye remains through the incision point even when the patient's eye undergoes three-dimensional movements. Typically, even when the patient's eye undergoes three-dimensional movements, the computer processor causes the robotic unit to perform at least a portion of a procedure on the patient's eye by desirably moving the tip of the tool relative to the eye to perform a portion of the procedure while maintaining the entry of the tool into the patient's eye fixed at the incision point. In this way, the robotic unit acts to provide a dynamic remote center of motion, which is the center of motion of the tool, located at the incision point. Typically, the remote center of motion moves in conjunction with the movement of the eye. In some applications, the above steps are performed while the patient's eye is held substantially stationary by the tool being placed in the eye. That is, while the eye is held stationary, the computer processor causes the robotic unit to perform at least a portion of a procedure on the patient's eye by maintaining the entry of the tool into the patient's eye fixed at the incision point while moving the tip of the tool as desired relative to the eye to perform a portion of the procedure.

[0015] As described above, in some applications, a user provides commands to the robotic unit via a control component. Typically, a control component arm of the control component is configured to be moved by the user to control the movement of the arm of the robotic unit. Typically, the control component comprises first and second control component arms configured to correspond to each robotic unit of the robotic system. In some applications, the control component arms are configured to hold therein each control component tool (to replicate the arm of the robotic unit). In some applications, each of the control component arms comprises at least three joints and a corresponding rotational encoder coupled to each of the three joints. The rotational encoder is configured to detect the movement of each joint and generate rotational encoder data in response thereto. In some applications, the control component arms further comprise an inertial measurement unit comprising a three-axis accelerometer, a three-axis gyroscope, and / or a three-axis magnetometer. Typically, the inertial measurement unit generates inertial measurement unit data related to a three-dimensional orientation of the control component arm in response to the control component arm being moved. In some applications, a computer processor receives the rotational encoder data and the inertial measurement unit data. Typically, the computer processor determines the XYZ position of the tip of the control component tool based on the rotary encoder data, and determines the orientation (e.g., 3 Euler azimuth angles, and / or another orientation representation) of the tip of the control component tool based on the inertial measurement unit data. Thus, based on a combination of the rotary encoder data and the inertial measurement unit data, the computer processor is configured to determine the XYZ position and orientation of the tip of the control component tool.

[0016] In some applications, the computer processor drives the robotic unit such that the tip of the actual tool being used to perform the procedure tracks the movement of the tip of the control component tool. Typically, by incorporating an inertial measurement unit to detect the three-dimensional orientation of the control component arm, a user can control the movement of the robotic unit using fewer sensors than if rotational encoders were used to detect the movement of all six degrees of freedom of the control component arm. Furthermore, typically, reducing the number of rotational encoders used tends to reduce the overall complexity of the control component, since the introduction of additional rotational encoders requires additional wires to pass through the rotating joints.

[0017] Although some applications of the present invention are described with respect to cataract surgery, the scope of this application includes the application of the devices and methods described herein to other medical procedures, mutatis mutandis. In particular, the devices and methods described herein may be applied to other microsurgical procedures such as general surgery, orthopedic surgery, gynecology, otorhinolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery, podiatric surgery, vascular surgery, and / or pediatric surgery, performed using microsurgical techniques.

[0018] It should be noted that the scope of this application includes the mutatis mutandis application of the devices and methods described herein to intraocular procedures other than cataract surgery, which may include collagen cross-linking, endothelial keratoplasty (e.g., DSEK, DMEK, and / or PDEK), DSO (Descemet's membrane stripping without grafts), laser-assisted corneal transplantation, corneal transplantation, LASIK / PRK, SMILE, pterygium, ocular surface cancer treatment, secondary IOL placement (suture, transconjunctival, etc.), iris repair, IOL repositioning, IOL exchange, corneal epithelial resection, minimally invasive glaucoma surgery (MIGS), limbal stem cell transplantation, astigmatic keratectomy, limbal relaxing incision (LRI), amniotic membrane transplantation (AMT), glaucoma surgery (e.g., trabs, tubes, minimally invasive glaucoma surgery), automated lamellar keratoplasty (ALK), anterior vitrectomy, and / or pars plana anterior vitrectomy.

[0019] Thus, according to some applications of the present invention, there is provided an apparatus for performing a procedure on a part of a patient's body using one or more tools, comprising: a tool mount configured to securely hold one or more tools; at least one articulated arm disposed on a side of the tool mount and configured to movably support the tool mount; a plurality of arm motors associated with the at least one articulated arm and configured to move the tool mount with at least five degrees of freedom; An apparatus is provided that includes a robotic unit having one or more mount motors associated with a tool mount and configured to move a tool relative to the tool mount in a sixth degree of freedom.

[0020] For some applications, the at least one articulated arm is disposed on a single side of the tool mount and includes two or more articulated arms configured to movably support the tool mount.

[0021] For some applications, the multiple arm motors are configured to move the tool mount along x-, y-, and z-axes, as well as through pitch and yaw rotations.

[0022] For some applications, the multiple arm motors are configured to move the tool mount with six or more degrees of freedom. For some applications, the multiple arm motors are configured to move the tool with additional degrees of freedom.

[0023] In some applications, the robotic unit reduces backlash in the articulated arm by further comprising one or more tension cables disposed around multiple joints of at least one articulated arm and a tension cable motor configured to apply tension to the tension cables to generate tension at the joints.

[0024] In some applications, at least one articulated arm includes a vertical link disposed at each joint and pairs of parallel beams extending between adjacent pairs of the vertical links such that the ends of the links of the articulated arm remain parallel to each other as the arm moves.

[0025] For some applications, at least one articulated arm includes a pulley and cable system with a pulley disposed at each joint of the arm, the pulleys positioned such that the pulleys remain oriented in a constant direction as the arm moves.

[0026] For some applications, one or more mount motors associated with the tool mount are configured to move the tool with an additional degree of freedom relative to the tool mount, hi some applications, one or more mount motors associated with the tool mount are configured to move the tool with respect to the tool mount to control injection of a substance into a patient's eye.

[0027] In some applications, the one or more tools include two or more tools each having a different respective circumference from the other, and the tool mount is configured to securely hold each of the two or more tools. In some applications, the tool mount is configured to securely hold a tool having a diameter of 3 mm to 20 mm. In some applications, the two or more tools include a keratome blade and a phacoemulsification probe, and the tool mount is configured to securely hold both the keratome blade and the phacoemulsification probe. In some applications, a first tool of the two or more tools has a diameter of 5 to 8 mm, and a second tool of the two or more tools has a diameter of 10 to 14 mm. In some applications, the tool mount is configured to securely hold the one or more tools while allowing the one or more tools to rotate relative to the tool mount. In some applications, the tool mount is configured to allow the one or more tools to rotate within a range of ±80 degrees from a central position.

[0028] In accordance with some applications of the present invention, there is provided an apparatus for performing a procedure on a part of a patient's body using two or more tools having different circumferences, the apparatus comprising: a tool mount configured to be adjustable between the positions to thereby securely hold a respective one of the tools in each of the positions; at least one arm disposed on a side of the tool mount and configured to movably support the tool mount; An apparatus is further provided that includes a robotic unit having one or more mount motors associated with the tool mount and configured to securely hold the tool within the tool mount while rotating each of two or more tools relative to the tool mount.

[0029] For some applications, the tool mount is configured to securely hold a tool having a diameter of 3 mm to 20 mm. For some applications, the two or more tools include a keratome blade and a phacoemulsification probe, and the tool mount is configured to securely hold both the keratome blade and the phacoemulsification probe. For some applications, a first tool of the two or more tools has a diameter of 5 to 8 mm, and a second tool of the two or more tools has a diameter of 10 to 14 mm. For some applications, the one or more mount motors are configured to rotate each of the two or more tools relative to the tool mount within a range of ±80 degrees from a central position.

[0030] For some applications, one or more mount motors associated with the tool mount are configured to move at least one of the tools with an additional degree of freedom relative to the tool mount, hi some applications, one or more mount motors associated with the tool mount are configured to move at least one of the tools relative to the tool mount to control injection of a substance into a patient's eye.

[0031] According to some applications of the present invention, there is provided a method for use in a robotic system for use in intraocular surgery, comprising the steps of: training a robotic system to perform one or more steps of a cataract surgery in an automated manner based on standard dimensional ranges of portions of a human eye; Performing one or more steps of cataract surgery for a given patient's eye, receiving at least one image of the eye; determining one or more dimensions of the eye from the at least one image; and A method is further provided that includes programming the robotic system to perform by performing one or more steps of a cataract surgery based on the training and the determined eye dimensions.

[0032] In some applications, training the robotic system to perform one or more steps of the cataract surgery in an automated manner includes writing an algorithm that directs one or more computer processors associated with the robotic system to cause components of the robotic system to perform one or more steps of the cataract surgery. In some applications, training the robotic system to perform one or more steps of the cataract surgery in an automated manner includes utilizing machine learning to train the robotic system to perform one or more steps of the cataract surgery in an automated manner.

[0033] In some applications, The method further includes determining an eye position and orientation from the at least one image; Performing one or more steps of the cataract surgery includes performing one or more steps of the cataract surgery based at least in part on the position and orientation of the eye.

[0034] In some applications, Determining the eye position and orientation from the at least one image includes determining a current eye position and orientation from the at least one image; Performing one or more steps of the cataract surgery includes performing one or more steps of the cataract surgery based at least in part on the current position and orientation of the eye.

[0035] In some applications, performing one or more steps of the cataract surgery includes, during the performance of one or more steps of the cataract surgery, receiving a real-time image of at least a portion of the patient's eye and the robotic system; and This includes automatically performing actions in response to the real-time images while taking into account real-time movements of the patient's eye.

[0036] In some applications, automatically performing operations while considering real-time movements of the patient's eye includes automatically moving one or more tools while considering real-time movements of the patient's eye. In some applications, automatically performing operations while considering real-time movements of the patient's eye includes automatically controlling one or more components of an imaging system of a robotic system while considering real-time movements of the patient's eye.

[0037] In some applications, automatically performing an operation while considering the real-time movement of the patient's eye includes automatically controlling a phacoemulsification probe while considering the real-time movement of the patient's eye. In some applications, automatically performing an operation while considering the real-time movement of the patient's eye includes automatically controlling an injection tool while considering the real-time movement of the patient's eye. In some applications, automatically performing an operation while considering the real-time movement of the patient's eye includes detecting when the eye is in a given position and determining a time to perform the operation when the eye is in the given position. In some applications, automatically performing an operation while considering the real-time movement of the patient's eye includes automatically controlling an IOL manipulator tool while considering the real-time movement of the patient's eye. In some applications, automatically controlling an IOL manipulator tool while considering the real-time movement of the patient's eye includes controlling an IOL manipulator tool such that the tool manipulates an IOL inside the patient's eye for precise positioning of the IOL in the patient's eye. In some applications, automatically performing an operation while considering the real-time movement of the patient's eye includes moving a tip of the tool as desired relative to the patient's eye to perform the operation while maintaining the entry of the tool into the patient's eye fixed at the incision point. In some applications, maintaining the entry of a tool into a patient's eye fixed at the incision point while taking into account real-time movement of the patient's eye includes providing a dynamic, remote center of motion located at the incision point, which is the center of motion of the tool and moves in conjunction with eye movement.

[0038] According to some applications of the present invention, a robotic system configured to perform intraocular surgery; During the training phase, receiving programming instructions to perform one or more steps of a cataract surgery in an automated manner based on standard dimensional ranges of portions of a human eye; During the latter stage, one or more steps of cataract surgery for a given patient's eye are receiving at least one image of the eye; determining one or more dimensions of the eye from at least one image; An apparatus is further provided comprising: at least one computer processor configured to cause the robotic system to perform one or more steps of a cataract surgery based on the programming instructions and the determined eye dimensions.

[0039] For some applications, the at least one computer processor comprises: determining an eye position and orientation from at least one image; The device is configured to perform one or more steps of a cataract surgery based at least in part on the position and orientation of the eye.

[0040] For some applications, the at least one computer processor comprises: determining a current position and orientation of the eye from the at least one image; The system is configured to perform one or more steps of a cataract surgery based at least in part on the current position and orientation of the eye.

[0041] In some applications, the at least one computer processor, during performance of one or more steps of the cataract surgery, receiving a real-time image of at least a portion of the patient's eye and the robotic system; By having the robotic system automatically perform actions in response to real-time images and taking into account real-time movements of the patient's eye. The robotic system is configured to perform one or more steps of a cataract surgery procedure on a given patient's eye.

[0042] In some applications, the device is for use with one or more tools, and the at least one computer processor is configured to drive the robotic system to automatically move the one or more tools while taking into account real-time movements of the patient's eye. In some applications, the device is for use with an imaging system, and the at least one computer processor is configured to automatically control one or more components of the imaging system while taking into account real-time movements of the patient's eye. In some applications, the device is for use with a phacoemulsification probe, and the at least one computer processor is configured to cause the robotic system to control the phacoemulsification probe while taking into account real-time movements of the patient's eye.

[0043] In some applications, the device is for use with an injection tool, and the at least one computer processor is configured to cause the robotic system to control the injection tool while considering real-time movements of the patient's eye. In some applications, the at least one computer processor is configured to detect when the eye is in a given position and cause the robotic system to determine the execution time of the operation when the eye is in the given position. In some applications, the device is for use with an IOL manipulator tool, and the at least one computer processor is configured to cause the robotic system to control the IOL manipulator tool while considering real-time movements of the patient's eye. In some applications, the at least one computer processor is configured to cause the robotic system to control the IOL manipulator tool such that the tool manipulates the IOL inside the patient's eye for precise positioning of the IOL in the patient's eye.

[0044] In some applications, the device is for use with a tool, and the at least one computer processor is configured to drive the robotic system to desirably move the tip of the tool relative to the patient's eye to perform the operation while maintaining the insertion of the tool into the patient's eye fixed at the incision point. In some applications, the at least one computer processor is configured to cause the robotic system to provide a dynamic, remote center of motion located at the incision point, which is a center of motion for the tool and moves in coordination with eye movements.

[0045] According to some applications of the present invention, a robotic system configured to perform intraocular surgery; During a training phase, where training is performed via machine learning, performing one or more steps of a cataract surgery in an automated manner based on standard dimensional ranges of parts of a human eye; During the latter stage, one or more steps of cataract surgery for a given patient's eye are receiving at least one image of the eye; determining one or more dimensions of the eye from at least one image; An apparatus is further provided comprising: one or more computer processors configured to cause the robotic system to perform one or more steps of a cataract surgery based on the programming instructions and the determined eye dimensions.

[0046] For some applications, the at least one computer processor comprises: determining an eye position and orientation from at least one image; The device is configured to perform one or more steps of a cataract surgery based at least in part on the position and orientation of the eye.

[0047] For some applications, the at least one computer processor comprises: determining a current position and orientation of the eye from the at least one image; The system is configured to perform one or more steps of a cataract surgery based at least in part on the current position and orientation of the eye.

[0048] In some applications, the at least one computer processor, during performance of one or more steps of the cataract surgery, receiving a real-time image of at least a portion of the patient's eye and the robotic system; By having the robotic system automatically perform actions in response to real-time images and taking into account real-time movements of the patient's eye. The robotic system is configured to perform one or more steps of a cataract surgery procedure on a given patient's eye.

[0049] For some applications, the device is for use with one or more tools, and the at least one computer processor is configured to drive the robotic system to automatically move the one or more tools while taking into account real-time movements of the patient's eye. For some applications, the device is for use with an imaging system, and the at least one computer processor is configured to automatically control one or more components of the imaging system while taking into account real-time movements of the patient's eye.

[0050] In some applications, the device is for use with a phacoemulsification probe, and the at least one computer processor is configured to cause the robotic system to control the phacoemulsification probe while considering real-time movements of the patient's eye. In some applications, the device is for use with an injection tool, and the at least one computer processor is configured to cause the robotic system to control the injection tool while considering real-time movements of the patient's eye. In some applications, the at least one computer processor is configured to detect when the eye is in a given position and cause the robotic system to determine the execution time of the operation when the eye is in the given position. In some applications, the device is for use with an IOL manipulator tool, and the at least one computer processor is configured to cause the robotic system to control the IOL manipulator tool while considering real-time movements of the patient's eye. In some applications, the at least one computer processor is configured to cause the robotic system to control the IOL manipulator tool such that the tool manipulates the IOL inside the patient's eye for precise positioning of the IOL in the patient's eye.

[0051] In some applications, the device is for use with a tool, and the at least one computer processor is configured to drive the robotic system to desirably move the tip of the tool relative to the patient's eye to perform the operation while maintaining the insertion of the tool into the patient's eye fixed at the incision point. In some applications, the at least one computer processor is configured to cause the robotic system to provide a dynamic, remote center of motion located at the incision point, which is a center of motion for the tool and moves in coordination with eye movements.

[0052] In accordance with some applications of the present invention, an apparatus for performing intraocular surgery on a patient's eye using a tool having a tip, the apparatus comprising: a tool mount configured to securely hold the tool and configured to insert the tool into the patient's eye such that entry of the tool into the patient's eye is via the incision point and a tip of the tool is disposed within the patient's eye; one or more articulated arms disposed on a single side of the tool mount and configured to movably support the tool mount; An apparatus is further provided comprising: a computer processor configured to cause the robotic unit to perform at least a portion of a procedure on the patient's eye by maintaining the entry of the tool into the patient's eye fixed at the incision point while desirably moving the tip of the tool relative to the eye to perform a portion of the procedure.

[0053] For some applications, the apparatus further comprises an imaging device configured to acquire an image of the patient's eye, and the computer processor: receiving an image of the patient's eye; By analyzing the images, the 3D movement of the patient's eye is detected. In response to the detected movement of the patient's eye, the robotic unit is configured to drive the tool tip to desirably move relative to the eye to perform a portion of the procedure while maintaining the entry of the tool into the patient's eye fixed at the incision point.

[0054] In some applications, the one or more articulated arms are configured to move the tool mount along the x-axis, y-axis, and z-axis and through pitch and yaw rotations, and the computer processor is configured to drive the one or more articulated arms to move the tool mount along the x-axis, y-axis, and z-axis and through pitch and yaw rotations while keeping the entry of the tool into the patient's eye fixed at the incision point.

[0055] In some applications, the one or more articulated arms are configured to move the tool mount through a yaw angle rotation of ±25 degrees from a central orientation, and the computer processor is configured to drive the one or more articulated arms to move the tool mount through a yaw angle rotation of ±25 degrees from a central orientation while keeping the entry of the tool into the patient's eye fixed at the incision point. In some applications, the one or more articulated arms are configured to move the tool mount through a pitch angle rotation of 60 degrees from a starting pitch, and the computer processor is configured to drive the one or more articulated arms to move the tool mount through a pitch angle rotation of 60 degrees from a starting pitch while keeping the entry of the tool into the patient's eye fixed at the incision point.

[0056] For some applications, the tool mount is configured to allow the tool to rotate relative to the tool mount, and the computer processor is configured to rotate the tool relative to the tool mount while maintaining entry of the tool into the patient's eye fixed at the incision point. For some applications, the tool mount is configured to allow the tool to rotate relative to the tool mount through a roll angle rotation of ±80 degrees from a central position, and the computer processor is configured to rotate the tool relative to the tool mount through a roll angle rotation of ±80 degrees from a central position while maintaining entry of the tool into the patient's eye fixed at the incision point.

[0057] For some applications, the computer processor is configured to cause the robotic unit to provide a dynamic remote center of motion that is a center of motion of the tool located at the incision point. In some applications, the computer processor is configured to cause the robotic unit to provide a dynamic remote center of motion by providing a dynamic remote center of motion that moves in conjunction with eye movements, thereby maintaining the entry of the tool into the patient's eye fixed at the incision point even as the patient's eye experiences three-dimensional movement.

[0058] In accordance with some applications of the present invention, a method of performing intraocular surgery on a patient's eye using a tool having a tip includes the steps of: Fixing the tool within a tool mount of the robot unit; driving the robotic unit to insert the tool into the patient's eye such that the tool enters the patient's eye through the incision point and a tip of the tool is positioned in the patient's eye; and A method is further provided that includes using a computer processor to cause the robotic unit to perform at least a portion of a procedure on the patient's eye by desirably moving the tip of the tool relative to the eye to perform a portion of the procedure while maintaining the entry of the tool into the patient's eye fixed at the incision point.

[0059] In some applications, the method includes using a computer processor to: receiving an image of the patient's eye; Detecting three-dimensional movement of the patient's eye by analyzing the images; and The method further includes, in response to the detected movement of the patient's eye, driving the robotic unit to desirably move the tip of the tool relative to the eye to perform a portion of the procedure while maintaining the insertion of the tool into the patient's eye fixed at the incision point.

[0060] Having the robotic unit perform at least a portion of a procedure on a patient's eye by desirably moving the tip of the tool relative to the eye to perform a portion of the procedure includes driving the robotic unit to move the tool mount along the x-, y-, and z-axes and through pitch and yaw rotations while maintaining the entry of the tool into the patient's eye fixed at the incision point.

[0061] In some applications, driving the robotic unit to move the tool mount along the x-, y-, and z-axes and through pitch and yaw rotations includes driving the robotic unit to move the tool mount through a yaw rotation of ±25 degrees from a central orientation while keeping the entry of the tool into the patient's eye fixed at the incision point. In some applications, driving the robotic unit to move the tool mount along the x-, y-, and z-axes and through pitch and yaw rotations includes driving the robotic unit to move the tool mount through a pitch rotation of 60 degrees from a starting pitch while keeping the entry of the tool into the patient's eye fixed at the incision point.

[0062] For some applications, having the robotic unit perform at least a portion of a procedure on the patient's eye by desirably moving a tip of a tool relative to the eye to perform a portion of the procedure includes rotating the tool relative to the tool mount while maintaining entry of the tool into the patient's eye fixed at the incision point, hi some applications, rotating the tool relative to the tool mount includes rotating the tool through a roll angle rotation of ±80 degrees from a center position while maintaining entry of the tool into the patient's eye fixed at the incision point.

[0063] In some applications, having the robotic unit perform at least a portion of a procedure on a patient's eye by desirably moving the tip of the tool relative to the eye to perform a portion of the procedure while maintaining the entry of the tool into the patient's eye fixed at the incision point includes providing a dynamic remote center of motion located at the incision point and about which the tool moves. In some applications, providing a dynamic remote center of motion includes maintaining the entry of the tool into the patient's eye fixed at the incision point even as the patient's eye experiences three-dimensional movement by providing a dynamic remote center of motion that moves in conjunction with eye movement.

[0064] According to some applications of the present invention, an apparatus for performing a procedure on a part of a patient's body using one or more tools, comprising: a robotic unit configured to move the tool with six degrees of freedom; A control component having at least one control component arm configured to be moved by a user, the control component arm comprising: A control component tool that defines a tip; At least six joints, three rotary encoders, each coupled to a respective one of the joints and configured to detect movement of each joint and, in response thereto, generate rotary encoder data indicative of the XYZ position of the tip of the control component tool; a control component comprising an inertial measurement unit comprising at least one sensor selected from the group consisting of a three-axis accelerometer, a three-axis gyroscope, and a three-axis magnetometer, the inertial measurement unit being configured to generate inertial measurement unit data indicative of an orientation of the tip of the control component tool; receiving rotary encoder data and inertial measurement unit data; determining an XYZ position and orientation of the tip of the control component tool based on a combination of the rotary encoder data and the inertial measurement unit data; and a computer processor configured to move the robotic unit in response thereto.

[0065] For some applications, the control component includes one or more wrist support elements configured to support a user's wrist during movement of the control component arm.

[0066] For some applications, the control component includes a built-in stereoscopic display configured to display a real-time stereoscopic image of the patient's body part and one or more tools to a user.

[0067] In some applications, The apparatus is for use with at least a first and a second tool; the robot unit comprises a first part configured to move a first tool with six degrees of freedom and a second part configured to move a second tool with six degrees of freedom; the at least one control component arm includes two control component arms, a first control component arm configured to be moved by a user's right hand and a second control component arm configured to be moved by a user's left hand; The computer processor is configured to control a first portion of the robotic unit in response to movement of a first one of the control component arms and to control a second portion of the robotic unit in response to movement of a second one of the control component arms.

[0068] For some applications, the first and second control component arms are asymmetric with respect to one another.

[0069] For some applications, the device further comprises a head-mounted display configured to display a real-time image of the patient's body part and the one or more tools to the user.

[0070] For some applications, the head mounted display comprises a stereoscopic head mounted display configured to display a real-time stereoscopic image of the patient's body part and the one or more tools to the user.

[0071] The present invention will be more fully understood from the following detailed description of the embodiments thereof, taken in conjunction with the drawings, in which: [Brief description of the drawings]

[0072] [Figure 1A] FIG. 1 is a schematic diagram of a robotic system configured for use in microsurgical procedures, such as intraocular surgery, in accordance with some applications of the present invention. [Figure 1B]1 is a schematic diagram of first and second robotic units of a robotic system configured for use in intraocular surgery, in accordance with some applications of the present invention. [Diagram 2] FIG. 1C is a schematic diagram of the robotic unit shown in FIG. 1B shown without patient anatomy, in accordance with some applications of the present invention. [Figure 3A] 1 is a schematic diagram of a tool mount of a robotic unit in accordance with some applications of the present invention. [Figure 3B] 1 is a schematic diagram of a tool mount of a robotic unit in accordance with some applications of the present invention. [Figure 3C] 1 is a schematic diagram of a tool mount of a robotic unit in accordance with some applications of the present invention. [Figure 3D] 1 is a schematic diagram of a tool mount of a robotic unit in accordance with some applications of the present invention. [Figure 4] 1 is a schematic diagram of a robotic unit with a tension cable, according to some applications of the present invention. [Figure 5A] FIG. 1 is a schematic diagram illustrating a range of motion of a tool configured to be moved by a robotic unit that corresponds to the normal range of motion of a surgical tool moved by an ophthalmologist during manual intraocular surgery, according to some applications of the present invention. [Figure 5B] FIG. 1 is a schematic diagram illustrating a range of motion of a tool configured to be moved by a robotic unit that corresponds to the normal range of motion of a surgical tool moved by an ophthalmologist during manual intraocular surgery, according to some applications of the present invention. [Figure 5C] FIG. 1 is a schematic diagram illustrating a range of motion of a tool configured to be moved by a robotic unit that corresponds to the normal range of motion of a surgical tool moved by an ophthalmologist during manual intraocular surgery, according to some applications of the present invention. [Figure 6] 1A and 1B are schematic diagrams of a robot unit used in a robot system according to some application examples of the present invention. [Figure 7]1 is a schematic diagram of a control component arm configured to be moved by a user to control the movement of an arm of a robotic unit, according to some applications of the present invention. [Figure 8] FIG. 2 is a schematic diagram of control components according to some applications of the present invention. [Figure 9A] 1A-1C are schematic diagrams of respective views of a control component with a built-in stereoscopic vision system according to some applications of the present invention. [Figure 9B] 1A-1C are schematic diagrams of respective views of a control component with a built-in stereoscopic vision system according to some applications of the present invention. [Figure 10] 1 is a schematic diagram of a control component and a head mounted display used with the control component, according to some applications of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0073] Reference is now made to FIG. 1A, which is a schematic diagram of a robotic system 10 configured for use in a microsurgical procedure, such as intraocular surgery, according to some applications of the present invention. Reference is also made to FIG. 1B, which is a schematic diagram of a first and second robotic unit 20 of the robotic system, according to some applications of the present invention. It should be noted that the example of the robotic unit 20 shown in FIG. 1B is different from that shown in FIG. 1A. Typically, the robotic system 10 includes a first and second robotic unit 20 (configured to hold a tool 21), as well as an imaging system 22, a display 24, and a control component 26, through which a user (e.g., a medical professional) can control the robotic unit 20 via the control component 26. Typically, the robotic system 10 includes one or more computer processors 28, through which the components of the system and a user (e.g., a medical professional) operably interact with each other. In some applications, the first and second robotic units 20 are supported on a support surface 27, as shown in the figure. The scope of the present application includes mounting the first and second robotic units in any of a variety of different positions relative to each other.

[0074] It should be noted that intraocular surgery, and in particular cataract surgery, is characterized by the fact that there are relatively few patient-to-patient variations in ocular anatomy and / or geometry. Cataract surgery also has a relatively standardized procedure flow, with a typical sequence of steps as described in the background section above. In view of the relatively standard dimensions and sequence of steps associated with cataract surgery, in some applications of the present invention, the robotic system 10 is first trained to perform one or more steps of cataract surgery in an automated manner based on standard dimensional ranges of each part of a human eye. Typically during the training phase, the movement of the robotic unit (and / or control of other aspects of the robotic system) is at least partially controlled by a user (e.g., a medical professional). For example, the user may receive images of the patient's eye and the robotic unit and / or tools disposed therein via the display 24. Typically, such images are acquired by the imaging system 22. In some applications, the imaging system 22 is a stereoscopic imaging device and the display 24 is a stereoscopic display. Based on the received images, the user typically performs the steps of the procedure. In some applications, a user provides commands to the robotic unit via control component 26 (described in more detail below). Typically, such commands include commands that control the position and / or orientation of tools disposed within the robotic unit and / or commands that control operations performed by the tools. For example, the commands may control a phacoemulsification tool (e.g., the operating mode and / or suction power of the phacoemulsification tool) and / or an injection tool (e.g., which fluid (e.g., viscoelastic fluid, saline, etc.) to be injected and / or at what flow rate). Alternatively or additionally, a user may input commands to control an imaging system (e.g., magnification, focus, and / or xy positioning of the imaging system). In some applications, the commands include controlling an IOL manipulator tool that manipulates an IOL inside the eye, for example, for precise positioning of the IOL within the eye.

[0075] In some applications, the computer processor 28 of the robotic system 10 analyzes commands provided by a user (e.g., a medical professional) to perform each step of the procedure. Typically, based on the analysis of many such procedures, the computer processor (and / or another computer processor associated with the computer processor) determines how to perform one or more steps of the cataract surgery in an automated manner based on typical dimensional ranges of each part of the human eye. In some applications, the above steps are performed using machine learning algorithms such as linear regression, logistic regression, decision trees, support vector machines, naive Bayes, kNN, K-means, random forests, dimensionality reduction algorithms, and / or gradient boosting algorithms. It should be noted that training is not typically performed using a single robotic system and a single associated computer processor. Rather, many such robotic systems typically provide data that is processed by a centralized computer processor (or a network of computer processors). It should be further noted that after an initial training phase, it is typical for the robotic system to continue to receive additional training data as additional procedures are performed on additional patients.

[0076] In some applications, the computer processor is trained at least in part by one or more human programmers by the human programmers providing the computer processor with programming instructions on how to perform each step (and / or portions thereof and / or combinations thereof). For example, the one or more human programmers may analyze a procedure to be performed on a portion of a human eye having a standard size range. Based on this analysis, the one or more human programmers may analyze the movements undergone by the tools, other functions of the tools, and / or functions of other parts of the robotic system (e.g., functions and / or movements undergone by the imaging system) when each step (and / or portions thereof and / or combinations thereof) of the procedure is performed. The human programmers may then write algorithms that instruct one or more computer processors to cause the robotic unit (and / or other components of the robotic system) to automatically perform the movements and / or functions. In some applications, at least a portion of the algorithms are written by the computer processor analyzing inputs entered into the computer processor via the control component 26.

[0077] In some applications, after an initial training phase, the robotic system 10 is used to perform one or more steps of a cataract surgery on a given patient's eye in an at least partially automated manner. In some such applications, at least one image of the patient's eye is obtained using the imaging system 22. For example, the image may be obtained before or during one or more steps of the cataract surgery are performed on the patient's eye. Typically, the computer processor analyzes the image to determine precise dimensions of the patient's eye, and the steps of the cataract surgery are planned based on the training and the determined eye dimensions. In some applications, the image is further analyzed to determine a position and / or orientation of the eye, and the steps of the cataract surgery are further planned based on the determined position and / or orientation of the eye. Typically, planning the steps of the cataract surgery includes planning to control the position and orientation of tools via the robotic unit, as described above, and to control additional aspects of the surgery (such as controlling the function of the tools and / or controlling the function and / or positioning of the imaging system). After planning is performed, the computer processor typically causes the robotic unit and / or additional components of the robotic system to perform the planned steps. In some applications, a user (e.g., a medical professional) may control the movements of the robotic unit and / or other aspects of the robotic system during a procedure. For example, the computer processor may plan the steps of a procedure and present the planned steps to a user (e.g., via display 24). The user may then override and / or refine the planned steps of the procedure, for example, via control component 26.

[0078] In some applications, any one of the following steps (or portions thereof, and / or combinations thereof) of a cataract procedure is performed in an automated or semi-automated manner using the techniques described herein: corneal incision (e.g., bi- or tri-plane incision, typically using a keratome blade), viscoelastic injection (including needle insertion through one incision and / or simultaneous injection and retraction of the needle), capsulotomy, hydrodissection, hydrodellineation, phacoemulsification (including nucleus cutting and / or ultrasonic emulsification using a phacoemulsification probe), irrigation, aspiration, implantation of an IOL (e.g., using an IOL injection system), viscoelastic removal, wound healing, and / or any combination thereof. In some applications, performing the above steps includes controlling the position and / or orientation of a tool disposed in the robotic unit and / or controlling the motions performed by the tool. For example, controlling a phacoemulsification tool (e.g., the operating mode and / or suction power of the phacoemulsification tool) and / or an injection tool (e.g., which fluid (e.g., viscoelastic fluid, saline, etc.) to inject and / or at what flow rate). Alternatively or additionally, performing the above steps may include controlling an imaging system (e.g., magnification, focus, and / or xy positioning of the imaging system). In some applications, performing the above steps includes controlling an IOL manipulator tool to manipulate the IOL inside the eye, for example, for precise positioning of the IOL within the eye.

[0079] In some applications, the steps of imaging the patient's eye, planning procedural steps, and moving the robotic unit and / or controlling other aspects of the robotic system are performed iteratively. Typically, the patient's eye and the robotic unit (and / or tools disposed therein) are continuously imaged in real time throughout the time period during which a given procedural step is being performed. In response to the real-time images, the position and orientation of the tool are automatically updated to correspond with the real-time movement of the patient's eye (as described in more detail below with reference to FIGS. 5A-5C). Typically, the position and orientation of the tool are updated by moving the tool via the robotic unit. Alternatively or additionally, the computer processor is configured to detect when the eye is in a given position and determine the time for the robotic unit to perform certain functions such that the certain functions are performed when the eye is in a given position.

[0080] Reference is now made to FIG. 2, which is a schematic diagram of the robotic unit 20 shown in FIG. 1B (where the robotic unit is shown without patient anatomy) according to some applications of the present invention. For some applications, each of the robotic units includes a tool mount 30 configured to securely hold a tool and insert the tool into the patient's eye such that entry of the tool into the patient's eye is via an incision point and a tip of the tool is disposed within the patient's eye. For some applications, two articulated arms 32 are disposed on a single side of the tool mount and configured to movably support the tool mount.

[0081] Typically, the computer processor detects three-dimensional movements of the patient's eye by analyzing images acquired by the imaging system 22 (which is typically a stereoscopic imaging system, as described above). In some applications, in response to the detected movements of the patient's eye, the computer processor drives the robotic unit to move the tool such that the entry of the tool into the patient's eye remains through the incision point even when the patient's eye undergoes three-dimensional movements. Typically, even when the patient's eye undergoes three-dimensional movements, the computer processor causes the robotic unit to perform at least a portion of a procedure on the patient's eye by desirably moving the tip of the tool relative to the eye to perform a portion of the procedure while keeping the entry of the tool into the patient's eye fixed at the incision point. In this way, the robotic unit acts to provide a dynamic remote center of motion, which is the center of the tool's movement, located at the incision point. Typically, the remote center of motion moves in conjunction with the movement of the eye. Alternatively or additionally, the computer processor is configured to detect when the eye is at a given position and determine the time at which certain functions are performed by the robotic unit such that certain functions are performed when the eye is at a given position. In some applications, the above steps are performed while the patient's eye is held substantially stationary by the tool being positioned within the eye, i.e., while the eye is held stationary, the computer processor causes the robotic unit to perform at least a portion of the procedure on the patient's eye by maintaining the entry of the tool into the patient's eye fixed at the incision point while desirably moving the tip of the tool relative to the eye to perform a portion of the procedure.

[0082] Typically, multiple arm motors 34 are associated with the two articulated arms 32. The multiple arm motors move the tool mount 30 with five degrees of freedom (e.g., movement along the x-, y-, and z-axes, as well as pitch and yaw). In some applications, the multiple arm motors are configured to move the tool mount (and / or tool) with six or more degrees of freedom. More typically, one or more mount motors 36 (more clearly shown in FIGS. 3A and 3B ) are associated with the tool mount and configured to move the tool with a sixth degree of freedom (e.g., roll) relative to the tool mount. In some applications, one or more mount motors associated with the tool mount are configured to move the tool with additional degrees of freedom relative to the tool mount.

[0083] Reference is now made to Figures 3A, 3B, 3C and 3D, which are schematic diagrams of different views of a tool mount 30 of a robotic unit 20 according to some applications of the present invention. Typically, the tool mount 30 is configured to accommodate a number of tools of various sizes. In some applications, the tool mount comprises first and second roller sets 40, 42 disposed in fixed positions relative to each other, and a third roller 44 movable relative to the first and second roller sets. Typically, the rollers are mounted on a first support element 50 (supporting the first and second roller sets) and a second support element 52 (supporting the third roller), the second support element being pivotally mounted relative to the first support element such that the third roller 44 is movable relative to the first and second roller sets. Thus, as shown, the tool mount is configured to securely hold tools having different perimeters, and the third roller is moved relative to the first and second rollers such that a different combination of the first, second and third rollers surround each perimeter. For example, a tool with a relatively small perimeter may be held between the first roller set and the third roller (as shown in FIGS. 3A and 3C), while a tool with a large perimeter may be held between the second roller set and the third roller (as shown in FIGS. 3B and 3D). The tool mount is typically configured to securely hold tools with different diameters such that each of the tools can rotate while disposed within the tool mount. In some applications, the tool mount is configured to securely hold tools with diameters ranging from 3 mm to 20 mm, e.g., 6 mm to 15 mm. For example, FIGS. 3A and 3C show a tool mount that securely holds a keratome blade 46 (typically 5 to 8 mm in diameter), while FIGS. 3B and 3D show a tool mount that securely holds a phacoemulsification probe 48 (typically 10 to 14 mm in diameter). In some applications, the tool mount is designed in a different manner that allows the tool mount to (a) securely hold tools with different perimeters while (b) allowing each of the tools to rotate while disposed within the tool mount.

[0084] As noted above, one or more mount motors 36 are associated with the tool mount and are configured to move the tool in a sixth degree of freedom (e.g., roll) relative to the tool mount. In some applications, the mount motor rotates the tool by rotating the fourth roller 54 via a gear mechanism 58 (gear mechanism 58 can be seen in FIG. 3C).

[0085] As explained above, the rollers are typically attached to support elements 50 and 52. In some applications, the support surface and rollers are separable from the rest of the robotic unit and configured to be sterilized between uses with different patients and / or configured to be discarded after being used for a single procedure. In some applications, the robotic unit defines a seventh degree of freedom, typically associated with a tool mount, for controlling the movement of a syringe piston (i.e., syringe plunger) and thereby controlling the injection of fluids, saline, viscoelastic substances, etc. Alternatively or additionally, the robotic unit has additional degrees of freedom associated with additional functions of the tool 21.

[0086] Reference is now made to Figure 4, which is a schematic diagram of a robotic unit 20 including one or more tension cables 60, in accordance with some applications of the present invention. It should be noted that the example of the robotic unit 20 shown in Figure 4 is generally similar to that shown in Figure 1A, and differs from that shown in Figures 1B and 2. In the example shown in Figure 4, there are respective articulated arms 62 disposed on each side of the tool mount 30. In general, the features of the robotic unit 20 shown in Figure 4 and the techniques described for use with the robotic unit 20 are applicable to other examples of the robotic unit 20, and vice versa.

[0087] It is common for the movement of the robotic unit to be controlled via motors and gear mechanisms. Typically, such gear mechanisms are allowed some freedom of movement even in the absence of input to the gear mechanism to prevent the gear mechanism from getting stuck. Typically, this can cause backlash in the gear mechanism after it moves, which can lead to less precise positioning of the tools disposed in the robotic unit relative to the patient's eye. Thus, in some applications, one or more tension cables are placed around some of the joints 64 of the articulated arm, which creates tension in the joints. In some applications, a tension cable motor 66 is configured to apply tension to the tension cables. Typically, the tension cable motor 66 applies a constant current and / or torque tension (e.g., by using a constant torque motor as the tension cable motor 66), which creates a constant tension in the tension cables. Typically, this reduces (or eliminates) the backlash of the articulated arm compared to when no tension cable is used. Alternatively or additionally, other techniques are used to reduce (or eliminate) the backlash of the articulated arm. For example, an anti-backlash gear mechanism may be used.

[0088] Reference is now made to Figures 5A, 5B and 5C, which are schematic diagrams showing the range of motion of tools configured to be moved by the robotic unit 20, which corresponds to the normal range of motion of surgical tools during manual intraocular surgery performed by an ophthalmologist, according to some applications of the present invention. With reference to Figure 5A, the diameter D1 of the working space in which cataract surgery is typically performed is typically 10 to 15 mm, e.g., about 12 mm. Typically, during the procedure, this working space will move within a circle with a diameter D2 of 20 to 30 mm, e.g., about 25 mm, since the eye moves within a circle indicated by the dashed circle showing the range of eye movement in each direction. With reference to Figure 5B, the depth of the working space in which cataract surgery is typically performed is typically 10 to 20 mm, e.g., about 15 mm.

[0089] In some applications, the robotic system 10 includes a first and a second robotic unit 20 to replicate standard surgical practice in which an ophthalmologist performs a procedure by holding in his left and right hands tools that are inserted into the eye from different angles. The use of the first and second robotic units in this manner is illustrated in FIG. 1A and FIG. 1B. As explained above, the tool mount of the robotic unit can be moved with at least five degrees of freedom. In some applications, the robotic unit is configured to move the tool mount with five degrees of freedom, which moves the tool along the x-axis, the y-axis, and the z-axis, as well as through pitch and yaw angular motions. Referring to FIG. 5C, typically, the robotic unit is configured to move the tool mount through a yaw angle rotation α of ±25 degrees from a central orientation. In some applications, the robotic unit is configured to move the tool mount through a pitch angle rotation β of 60 degrees. Typically, the pitch angle rotation β of the tool mount is initiated from a starting pitch γ of about 20 degrees (e.g., 15 to 25 degrees) from the xy plane (as shown in FIG. 5C). More typically, the robotic unit is configured to move the tool with a sixth degree of freedom (e.g., roll) relative to the tool mount. For some applications, the robotic unit is configured to rotate the tool relative to the tool mount such that the tool has a range of roll angle rotation θ of ±80 degrees from a center position, as shown in FIG. 5C.

[0090] Typically, the patient's eye and the robotic unit (and / or the tool disposed therein) are continuously imaged in real time throughout the time that a given procedural step is being performed. In response to the real-time images, the position and orientation of the tool are updated to correspond to the real-time movement of the patient's eye (as described in more detail below). Typically, the position and orientation of the tool are updated by moving the tool via the robotic unit. In some applications, during the procedure (or steps thereof), the computer processor detects three-dimensional movement of the patient's eye by analyzing images obtained by the imaging system 22 (which is typically a stereoscopic imaging system, as described above). In some such applications, in response to the detected movement of the patient's eye, the computer processor drives the robotic unit to move the tool such that its entry into the patient's eye remains through the incision point even as the patient's eye undergoes three-dimensional movement. Typically, even when the patient's eye undergoes three-dimensional movement, the computer processor causes the robotic unit to perform at least a portion of a procedure on the patient's eye by desirably moving the tip of the tool relative to the eye to perform a portion of the procedure while maintaining the entry of the tool into the patient's eye fixed at the incision point. Alternatively or additionally, the computer processor is configured to detect when the eye is in a given position and determine a time when certain functions are to be performed by the robotic unit such that the certain functions are performed when the eye is in the given position.

[0091] Reference is now made to Figures 6A and 6B, which are schematic diagrams of alternative examples of the robot unit 20 used in the robot system 10, according to some applications of the present invention. It may be observed in Figures 6A-6B that each bar 80 of at least one articulated arm 32 of the robot system comprises two parallel beams 82 extending between vertical links 84 disposed at each joint. In some applications, this arrangement of parallel beams and vertical links ensures that the ends of each link of a given articulated arm remain parallel to each other as the arm moves (as shown in the transition from Figure 6A to Figure 6B). This in turn prevents the tool mount from rotating relative to the support surface 27. In some applications, each of the articulated arms is configured as described above. Alternatively, only one of the articulated arms is configured as described above.

[0092] Referring again to FIG. 2, which illustrates a robot unit 20 according to some applications of the present invention, in some applications, as an alternative to the configuration illustrated in FIGS. 6A-6B, one or more of the articulated arms are stabilized using a pulley and cable system as illustrated in FIG. 2. Typically, the articulated arm includes a pulley 86 disposed at the end of the arm closest to the support surface 27. The pulley 86 is held in a fixed position that is non-rotatable relative to the support surface 27. An additional pulley 88 is disposed on each additional link 84 (illustrated in FIG. 6) of the articulated arm. Typically, a loop of cable 87 having a fixed length is disposed between each adjacent pair of pulleys (including pulley 86 and additional pulley 88). The additional pulley is free to rotate about its axis. However, because the length of the cable loop is constant and the pulley 86 is held in a fixed position that is non-rotatable relative to the support surface 27, the additional pulley 88 will be oriented in a fixed direction (as indicated by arrow 89) even as the articulated arm moves. For some applications, the above configuration prevents the tool mount from rotating relative to the support surface 27. For some applications, each of the articulated arms is configured as described above. Alternatively, only one of the articulated arms is configured as described above.

[0093] It should be noted that the use of a parallel beam system (as shown in Figures 6A-6B) to prevent rotation relative to the support surface 27 of the tool mount typically limits the range of motion of the articulated arm by the parallel beams colliding with one another. For example, the articulated arm typically cannot be folded beyond the configuration shown in Figure 6B, whereas the arm would not be so limited if it were equipped with a pulley and cable system as shown in Figure 2. Typically, in the configuration shown in Figure 2, adjacent portions of the arm may be folded so that they are approximately parallel to one another (e.g., adjacent portions of the arm are disposed at an angle of less than 10 degrees relative to one another).

[0094] Reference is now made to FIG. 7, which is a schematic illustration of a control component arm 70 of the control component 26 configured to be moved by a user to control the movement of the arm of the robotic unit 20, according to some applications of the present invention. According to the above description of FIGS. 1A-1B, in some applications, the control component 26 is used to control the robotic unit during a training phase in which the robotic system is being trained to perform a procedure (and / or steps thereof). Alternatively or additionally, the control component 26 is used to control the robotic unit when a procedure is to be performed later on a given patient, for example to override and / or refine steps of a procedure that the robotic system is to perform. Still alternatively or additionally, by default, the control component is used to control the movement of the arm of the robotic unit when a procedure is to be performed on a given patient.

[0095] Typically, the control component comprises first and second control component arms 70 configured to correspond to respective robotic units 20 of the robotic system as shown in Figure 1A. In some applications, the control component arms are configured to hold respective control component tools 71 (to replicate the arms of the robotic units), also as shown in Figure 1A. (Only one control component arm is shown in Figure 7, and the control component arm is shown without a control component tool.)

[0096] In some applications, each of the control component arms 70 includes at least three joints 72 and a respective rotary encoder 74 coupled to a respective one of the three joints. The rotary encoder is configured to detect movement of each joint and generate rotary encoder data in response thereto. In some applications, the control component arms further include an inertial measurement unit 76 including a three-axis accelerometer, a three-axis gyroscope, and / or a three-axis magnetometer. The inertial measurement unit typically generates inertial measurement unit data related to a three-dimensional orientation of the control component arm in response to the control component arm being moved. In some applications, the computer processor 28 receives the rotary encoder data and the inertial measurement unit data. Typically, the computer processor determines an XYZ position of the tip of the control component tool 71 based on the rotary encoder data, and determines an orientation (e.g., three Euler azimuth angles, and / or another orientation representation) of the tip of the control component tool 71 based on the inertial measurement unit data. Thus, based on a combination of the rotary encoder data and the inertial measurement unit data, the computer processor is configured to determine an XYZ position and orientation of the tip of the control component tool.

[0097] In some applications, the computer processor drives the robotic unit such that the tip of the actual tool being used to perform the procedure tracks the movement of the tip of the control component tool. Typically, by incorporating an inertial measurement unit to detect the three-dimensional orientation of the control component arm, the user can control the movement of the robotic unit using fewer sensors than if rotational encoders were used to detect the movement of all six degrees of freedom of the control component arm. Furthermore, typically, reducing the number of rotational encoders used tends to reduce the overall complexity of the control component, since the introduction of additional rotational encoders requires additional wires to pass through the rotating joints.

[0098] Reference is now made to FIG. 8, which is a schematic diagram of the control component 26 according to some applications of the present invention. In some applications, the control component comprises one or more ergonomic features. For example, the control component may comprise a wrist support element 90, such as a cushion or gel-filled pad. In some applications, the left and right control component arms 70 are designed asymmetrically, allowing a user to grasp and comfortably move the arms with the left and right hands. As explained above, the control component arm is typically used to control the movement of the arm of the robotic unit 20. For example, based on a combination of the rotary encoder data and the inertial measurement unit data, as described above, the computer processor may be configured to determine the XYZ position and orientation of the tip of the control component tool. In some applications, the control component arm comprises additional control means. For example, the control component arm may comprise a button 92 configured to activate a tool, such as forceps.

[0099] Reference is now made to Figures 9A and 9B, which are schematic diagrams of a control component 26 with a built-in stereo vision system 94 from different perspectives, according to some applications of the present invention. As explained above, in some applications, the imaging system 22 is a stereoscopic imaging device. In some such applications, based on images acquired by the imaging system, real-time stereoscopic images are displayed to the user on the stereoscopic vision system 94 built into the control component. Based on the received images, the user typically performs steps of the procedure by providing commands to the robotic unit via the control arm 70 of the control component 26.

[0100] Reference is now made to Fig. 10, which is a schematic diagram of the control component 26 and a head mounted display 96 used with the control component, according to some applications of the present invention. As explained above, in some applications, real-time images are displayed to a user based on images acquired by the imaging system 22. In some applications, the images are displayed on the head mounted display 96. Typically, the imaging system acquires stereoscopic images, and the head mounted display displays the stereoscopic images to the user. Based on the received images, the user typically performs steps of the procedure by providing commands to the robotic unit via the control arm 70 of the control component 26.

[0101] Although some applications of the present invention are described for cataract surgery, the scope of the present application includes the mutatis mutandis application of the devices and methods described herein to other medical procedures. In particular, the devices and methods described herein may be applied to other microsurgical procedures such as general surgery, orthopedic surgery, gynecology, otorhinolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery, podiatry surgery, vascular surgery, and / or pediatric surgery, performed using microsurgical techniques. In some such applications, the imaging system includes one or more microscopic imaging units.

[0102] It should be noted that the scope of this application includes the mutatis mutandis application of the devices and methods described herein to intraocular procedures other than cataract surgery, which may include collagen cross-linking, endothelial keratoplasty (e.g., DSEK, DMEK, and / or PDEK), DSO (Descemet's membrane stripping without grafts), laser-assisted corneal transplantation, corneal transplantation, LASIK / PRK, SMILE, pterygium, ocular surface cancer treatment, secondary IOL placement (suture, transconjunctival, etc.), iris repair, IOL repositioning, IOL exchange, corneal epithelial resection, minimally invasive glaucoma surgery (MIGS), limbal stem cell transplantation, astigmatic keratectomy, limbal relaxing incision (LRI), amniotic membrane transplantation (AMT), glaucoma surgery (e.g., trabs, tubes, minimally invasive glaucoma surgery), automated lamellar keratoplasty (ALK), anterior vitrectomy, and / or pars plana anterior vitrectomy.

[0103] Applications of the invention described herein may take the form of a computer program product accessible from a computer usable or computer readable medium (e.g., a non-transitory computer readable medium) that provides program code for use by or in connection with a computer or any instruction execution system, such as computer processor 28. For purposes of this description, a computer usable or computer readable medium may be any apparatus that can contain, store, transmit, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device. The medium may be an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system (or apparatus or device) or propagation medium. Typically, the computer usable or computer readable medium is a non-transitory computer usable or computer readable medium.

[0104] Examples of computer-readable media include semiconductor or solid state memory, magnetic tape, removable computer diskettes, random access memory (RAM), read-only memory (ROM), rigid magnetic disks, and optical disks. Current examples of optical disks include compact disk-read only memory (CD-ROM), compact disk-read / write (CD-R / W), DVDs, and USB drives.

[0105] A data processing system suitable for storing and / or executing program code will include at least one processor (e.g., computer processor 28) coupled directly or indirectly to memory elements via a system bus. The memory elements may include local memory used during the actual execution of the program code, bulk storage, and cache memory for temporary storage of at least some of the program code to reduce the number of times the code must be retrieved from bulk storage during execution. The system is capable of reading instructions according to the present invention on a program storage device and performing the method of the present invention according to these instructions.

[0106] Network adapters may be coupled to a processor to enable the processor to be coupled to other processors, remote printers, or storage devices through intervening private or public networks. Modems, cable modems, and Ethernet cards are just a few of the types of network adapters currently available.

[0107] Computer program code for carrying out operations of the present invention may be written in any combination of one or more programming languages, including object-oriented programming languages, such as Java, Smalltalk, C++, and conventional procedural programming languages, such as the C programming language or a similar programming language.

[0108] It will be understood that the algorithms described herein may be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine whereby the instructions executed by the processor of the computer (e.g., computer processor 28) or other programmable data processing apparatus produce means for performing the functions / actions specified in the algorithms described herein. These computer program instructions may also be stored on a computer readable medium (e.g., a non-transitory computer readable medium) and may direct a computer or other programmable data processing apparatus to function in a particular manner, whereby the instructions stored on the computer readable medium produce an article of manufacture including instruction means for performing the functions / actions specified in the algorithms. The computer program instructions may also be loaded into a computer or other programmable data processing apparatus to cause the computer or other programmable apparatus to perform a series of operational steps to produce a computer implemented process whereby the instructions executing on the computer or other programmable apparatus provide a process for performing the functions / actions specified in the algorithms described herein.

[0109] The computer processor 28 is typically a hardware device that is programmed with computer program instructions to create a special purpose computer. For example, when programmed to execute the algorithms described with reference to the figures, the computer processor 28 typically functions as a special purpose robotics system computer processor. Typically, the operations described herein as being performed by the computer processor 28 change the physical state of a memory, which is an actual physical item, resulting in a different magnetic polarity, charge, etc., depending on the memory technology used. In some applications, the operations described as being performed by a computer processor are performed by multiple computer processors that are coupled together.

[0110] It will be understood by those skilled in the art that the present invention is not limited to what has been particularly shown and described above, but rather the scope of the present invention includes both combinations and subcombinations of the various features described in the foregoing specification, as well as variations and modifications thereof that are not in the prior art and that would occur to those skilled in the art upon reading the foregoing description.

Claims

1. 1. An apparatus for performing a procedure on a part of a patient's body using one or more tools, comprising: a robotic unit configured to move the tool in six degrees of freedom; A control component comprising at least one control component arm configured to be moved by a user, the control component arm comprising: a control component tool defining a tip; At least six joints; three rotary encoders, each coupled to a respective one of the joints, configured to detect movement of each of the joints and in response generate rotary encoder data indicative of an XYZ position of the tip of the control component tool; a control component comprising: an inertial measurement unit comprising at least one sensor selected from the group consisting of a three-axis accelerometer, a three-axis gyroscope, and a three-axis magnetometer, the inertial measurement unit being configured to generate inertial measurement unit data indicative of an orientation of the tip of the control component tool; receiving the rotary encoder data and the inertial measurement unit data; determining the XYZ position and the orientation of the tip of the control component tool based on a combination of the rotary encoder data and the inertial measurement unit data; and a computer processor configured to move the robotic unit in response thereto.

2. The device of claim 1 , wherein the control component comprises one or more wrist support elements configured to support the user's wrist during movement of the control component arm.

3. The apparatus of claim 1 , wherein the control component comprises an integrated stereoscopic display configured to display a real-time stereoscopic image of the portion of the patient's body and the one or more tools to the user.

4. the apparatus being for use with at least a first and a second tool; the robot unit comprising a first part configured to move the first tool with six degrees of freedom and a second part configured to move the second tool with six degrees of freedom; the at least one control component arm includes two control component arms, a first one of the control component arms configured to be moved by a right hand of the user and a second one of the control component arms configured to be moved by a left hand of the user; 4. The apparatus of claim 1, wherein the computer processor is configured to control the first portion of the robotic unit in response to movement of the first control component arm of the control component arms and to control the second portion of the robotic unit in response to movement of the second control component arm of the control component arms.

5. The apparatus of claim 4 , wherein the first and second control component arms are asymmetric with respect to each other.

6. 4. The apparatus of claim 1, further comprising a head mounted display configured to display a real time image of the portion of the patient's body and the one or more tools to the user.

7. 7. The apparatus of claim 6, wherein the head mounted display comprises a stereoscopic head mounted display configured to display a real-time stereoscopic image of the portion of the patient's body and the one or more tools to the user.

8. The robot unit comprises: a tool mount configured to securely hold the one or more tools; at least one articulated arm disposed on a side of the tool mount and configured to movably support the tool mount; a plurality of arm motors associated with the at least one articulated arm and configured to move the tool mount with at least five degrees of freedom; 4. The apparatus of claim 1 , further comprising: one or more mount motors associated with the tool mount and configured to move the tool relative to the tool mount in a sixth degree of freedom.

9. The apparatus of claim 8 , wherein the plurality of arm motors are configured to move the tool mount along x-, y-, and z-axes and through pitch and yaw rotations.

10. 9. The apparatus of claim 8, wherein the one or more tools include two or more tools each having a different respective circumference from one another, and the tool mount is configured to securely hold each of the two or more tools.

11. The apparatus of claim 8 , wherein the one or more mount motors associated with the tool mount are configured to move the tool with an additional degree of freedom relative to the tool mount.

12. The apparatus of claim 8 , wherein the tool mount is configured to securely hold the one or more tools while allowing the one or more tools to rotate relative to the tool mount.

13. the robotic unit is configured to perform intraocular surgery on the patient's eye using the one or more tools, the one or more tools having a tip; the robot unit comprising: a tool mount configured to securely hold the one or more tools; and one or more articulated arms disposed on a single side of the tool mount and configured to movably support the tool mount; 4. The apparatus of claim 1, wherein the computer processor is configured to drive the robotic unit to perform at least a portion of the procedure on the patient's eye by moving the tip of the tool in a desired manner relative to the eye to perform at least a portion of the procedure on the patient's eye while maintaining the entry of the tool into the patient's eye fixed at an incision point.

14. 14. The apparatus of claim 13, wherein the one or more articulated arms are configured to move the tool mount along x-, y-, and z-axes and through pitch and yaw rotations, and the computer processor is configured to drive the one or more articulated arms to move the tool mount along x-, y-, and z-axes and through pitch and yaw rotations while keeping entry of the one or more tools into the patient's eye fixed at the incision point.

15. 14. The apparatus of claim 13, wherein the one or more articulated arms are configured to move the tool mount along x-, y-, and z-axes and through pitch and yaw rotations, and the computer processor is configured to rotate the tool relative to the tool mount while maintaining entry of the tool into the patient's eye fixed at the incision point.

Images