Device for facilitating surgical procedures

Abstract

A device (100, 1800) for use with a microsurgical instrument (206, 1964) comprises a rotation coordinator (101, 1901) and a translation coordinator (208, 1900). The rotation coordinator comprises an input subassembly (102, 1902), an output subassembly (155, 1904), and a linkage (600, 1908). The input subassembly comprises a handle (152, 1926), an actuator (153, 1927), and an input gimbal (103, 1903). The output subassembly comprises a holder (207, 1963) that holds the instrument, an effector (202, 1972) to manipulate the instrument, and an output gimbal (156, 1905). The linkage operatively couples the input gimbal to the output gimbal. The translation coordinator mechanically connects the input assembly to the output subassembly, so as to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly. Other embodiments are also described.

Description

DEVICE FOR FACILITATING SURGICAL PROCEDURESCROSS-REFERENCES TO RELATED APPLICATIONS

[0001] This application claims priority to Provisional US Application 63 / 605,738 to Shvalb et al., titled "A six DOF mechanical device applicable for microsurgery," filed 4 December 2023, which is incorporated herein by reference in its entirety.FIELD OF THE INVENTION

[0002] Some applications of the present invention relate in general to medical procedures and devices therefor. More specifically, some applications of the present invention relate to microsurgery and devices therefor.BACKGROUND

[0003] Microsurgery typically includes anastomosis of blood vessels and / or coaptation of nerves. Microsurgery typically includes the use of optical magnification, such as through an operating microscope or loupe. This is due to the fact that the blood vessels and / or nerves are too small to work on with the naked eye.

[0004] Conventionally surgeons perform the surgery by hand or through the use of a robot. Performing the surgery by hand is extremely difficult because the blood vessels and / or nerves are so small. It could take years for a surgeon to develop the proper techniques and the execution of those techniques to perform a successful microsurgery. While robots can alleviate some of the expertise required to perform the microsurgery, these robots are typically too expensive for mid-size and smaller hospitals and / or clinics. Furthermore, the robots are typically large and can occupy or obstruct most or all of the surgical site. The large robots can obstruct the surgeon and / or others from viewing the surgical site and / or performing necessary surgical interventions should an emergency arise.

[0005] It would therefore be desirable to provide an apparatus for microsurgery which is simplistic to use and requires minimal training. It would further be desirable to provide an apparatus which is relatively inexpensive. It would further be desirable to provide an apparatus which does not physically and / or visually obstruct the surgical site.SUMMARY OF THE INVENTION

[0006] This summary is meant to provide some examples and is not intended to be limiting of the scope of the invention in any way. For example, any feature included in an example of this summary is not required by the claims, unless the claims explicitly recite the features. Also, the features, components, steps, concepts, etc. described in examples in this summary and elsewhere in this disclosure can be combined in a variety of ways. Various features and steps as described elsewhere in this disclosure may be included in the examples summarized here.

[0007] Any of the techniques, methods, operations, steps, etc. described or suggested herein can be performed on a living animal (e.g., human, other mammal, etc.) or on a non-living simulation such as a cadaver, a cadaver heart, an anthropomorphic ghost, and / or a simulator device (which may include computerized and / or physical representations of body parts, tissue, etc.).

[0008] In accordance with some implementations, apparatus is provided that is configured to transmit and downscale translational (e.g. up-down, left-right, forward-backward) movements performed by a surgeon to a surgical instrument at a distal part of the apparatus. The apparatus may additionally or alternatively transmit angular / rotational movements of the surgeon to the surgical instrument without downscaling. Thus, the apparatus may facilitate performance of microsurgery by enabling the surgeon to perform a microsurgical procedure by making macroscopic translational and angular / rotational movements - e.g. of a handle of the apparatus.

[0009] There is therefore provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device including a rotation coordinator, and / or a translation coordinator.

[0010] The rotation coordinator includes an input subassembly, an output subassembly, and / or a linkage.

[0011] The input subassembly includes a handle, an actuator, and / or an input gimbal on which the handle and the actuator are mounted.

[0012] The output subassembly includes a holder configured to hold the instrument, an effector, operable via actuation of the actuator to manipulate the instrument held by the holder, and / or an output gimbal on which the holder and the effector are mounted.

[0013] The linkage operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle.

[0014] The translation coordinator has the input subassembly and the output subassembly mounted thereon. The translation coordinator: (i) includes an armature that mechanically connects the input subassembly to the output subassembly; and / or (ii) is configured to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly.

[0015] In some implementations, the translation coordinator is configured to transmit and downscale translational movement of the input subassembly along a first vector to become downscaled translational movement of the output subassembly along a second vector that is parallel with, and shorter than, the first vector.

[0016] In some implementations, the translation coordinator is configured to transmit and downscale translational movement of the input subassembly along a first three-dimensional path to become downscaled translational movement of the output subassembly along a second three-dimensional path, the second three-dimensional path being identically- shaped but smaller-sized than the first three-dimensional path.

[0017] In some implementations, the rotation coordinator is configured such that rotational movement of the holder mimics rotational movement of the handle.

[0018] In some implementations, the rotation coordinator is configured to synchronize rotational movement between the holder and the handle.

[0019] In some implementations, transmitting rotational movement of the holder to the handle via the linkage maintains the orientation of the holder relative to the handle.

[0020] In some implementations, the handle defines a handle-pointing direction, the holder defines an instrument-pointing direction, and the rotation coordinator is configured to maintain the instrument-pointing direction parallel with the handle-pointing direction.

[0021] In some implementations, the linkage is an electronic or electromechanical linkage.

[0022] In some implementations, the effector is mechanically operable via actuation of the actuator.

[0023] In some implementations, the effector is electronically operable via actuation of the actuator.

[0024] In some implementations, the system further includes the instrument.

[0025] In some implementations, the instrument includes forceps.

[0026] In some implementations, the instrument is selected from the group consisting of: scalpel, forceps, scissors, clamp, needle, suture, clips, and blade.

[0027] In some implementations, the linkage is a mechanical linkage.

[0028] In some implementations, the linkage includes one or more Bowden devices.

[0029] In some implementations, the handle is elongate along a handle axis, the instrument is elongate along an instrument axis, and the rotation coordinator is configured to maintain the instrument axis parallel with the handle axis during operation of the device.

[0030] In some implementations, the rotation coordinator is configured to synchronize a rotation of the handle about the handle axis with a rotation of the instrument about the instrument axis.

[0031] In some implementations, the device includes a bracket for hingedly mounting the device.

[0032] In some implementations, the apparatus further includes a bearing on which the bracket is hingedly mountable.

[0033] In some implementations: (i) the input gimbal includes at least one input wheel; (ii) the output gimbal includes at least one output wheel; and / or (iii) the rotation coordinator transmits rotational movement from the at least one input wheel to the at least one output wheel.

[0034] In some implementations: (i) the at least one input wheel consists of three input wheels; (ii) the at least one output wheel consists of three output wheels; and / or (iii) the rotation coordinator transmits the rotational movement from the three input wheels to a corresponding one of the three output wheels.

[0035] In some implementations: (i) each of the input wheels include a central axis; and / or (ii) the rotational movement includes rotation of the input wheels about the central axes of each respective input wheel.

[0036] In some implementations, the three input wheels are concatenated and the three output wheels are concatenated.

[0037] In some implementations: (i) the three input wheels include a first input wheel, a second input wheel and a handle input wheel; (ii) the three output wheels include a first output wheel, a second output wheel, and a holder output wheel; (iii) each of the three input wheels and three output wheels include a housing surrounding the respective wheel; (iv) the housing of the second input wheel is connected to the first input wheel such that the housing of the second input wheel and the first input wheel rotate in tandem; (v) the housing of the handle input wheel is connected to the second input wheel such that the housing of the handle input wheel and the second input wheel rotate in tandem; (vi) the housing of the second output wheel is connected to the first output wheel such that the housing of the second output wheel and the first output wheel rotate in tandem; and / or (vii) the housing of the holder output wheel is connected to the second output wheel such that the housing of the holder output wheel and the second output wheel rotate in tandem.

[0038] In some implementations, the holder output wheel holds the instrument such that a tip of the instrument remains at a substantially fixed point during the rotational movement.

[0039] In some implementations: (i) each of the three input wheels rotate, at a respective fixed radius, about a control point along a first curved virtual surface; (ii) each of the three output wheels rotate, at the fixed radii corresponding to the three input wheels, about an operation point along a second curved virtual surface; and / or (iii) the first and second curved virtual surfaces are hemispherical and congruent.

[0040] In some implementations, rotating one of the three input wheels to a location on the first curved virtual surface, rotates a corresponding one of the three output wheels to a location on the second virtual curved surface which corresponds to the location on the first curved virtual surface.

[0041] In some implementations: (i) one of the three output wheels holds the instrument such that a tip of the instrument is located at an operation point; and / or (ii) the tip is coincident with the operation point during rotation of any of the three output wheels.

[0042] In some implementations: (i) the at least one input wheel is connected to the armature via a first arm; and / or (ii) the at least one output wheel is connected to the armature via a second arm.

[0043] There is further provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device includes a rotation coordinator and / or a translation coordinator.

[0044] The rotation coordinator includes an input subassembly, an output subassembly, and / or a linkage.

[0045] The input subassembly includes (i) a handle; (ii) an actuator; and / or (iii) an input gimbal on which the handle and the actuator are mounted.

[0046] The output subassembly includes (i) a holder configured to hold the instrument; (ii) an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and / or (iii) an output gimbal on which the holder and the effector are mounted.

[0047] The linkage operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0048] The translation coordinator has the input subassembly and the output subassembly mounted thereon, the translation coordinator being configured to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly.

[0049] There is further provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device includes a translation coordinator and / or a rotation coordinator.

[0050] The translation coordinator includes (i) an input end; (ii) an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; (iii) a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end, and / or (iv) a bracket for hingedly mounting the translation coordinator for tilting of the translation plane.

[0051] The rotation coordinator includes (i) an input subassembly that is mounted on the input end, and includes: (a) a handle; (b) an actuator; and / or (c) an input gimbal on which the handle and the actuator are mounted; (ii) an output subassembly, mounted on the output end, and including: (a) a holder configured to hold the instrument; (b) an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and / or (c) an output gimbal on which the holder and the effector are mounted; and / or (iii) a linkage that operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle.

[0052] In some implementations, the pantograph accounts for translational movement along two axes.

[0053] In some implementations, the pantograph includes a parallelogram.

[0054] In some implementations, the pantograph includes two parallelograms.

[0055] In some implementations, the system further includes a stand on which the bracket is mountable.

[0056] In some implementations, the bracket is rotatable about a central axis of a bearing of the stand.

[0057] In some implementations, the bracket is rotatable about a bearing of the stand along two axes.

[0058] There is further provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device including a translation coordinator, and / or a rotation coordinator.

[0059] The translation coordinator includes (i) an input end; (ii) an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; (iii) a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end; and / or (iv) a bracket for: (a) hingedly mounting the translation coordinator; and / or (b) tilting of the translation plane.

[0060] The rotation coordinator includes (i) an input subassembly, mounted on the input end, and including: (a) a handle, (b) an actuator and / or (c) an input gimbal on which the handle and the actuator are mounted; (ii) an output subassembly, mounted on the output end, and including: (a) a holder configured to hold the instrument, (b) an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and / or (c) an output gimbal on which the holder and the effector are mounted; and / or (iii) a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0061] There is further provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device includes a translation coordinator, and / or a rotation coordinator.

[0062] The translation coordinator includes (i) an input end; (ii) an output end; (iii) a hinge; (iv) an armature, coupled to the hinge and mechanically connecting the input end to the output end in a manner that: (a) defines an origin of the device; and / or (b) transmits and downscales translational movement of the input end with respect to the origin to become downscaled translational movement of the output end with respect to the origin.

[0063] The rotation coordinator includes (i) an input subassembly, mounted at the input end, and including: (a) a handle; (b) an actuator; and / or (c) an input gimbal on which the handle and the actuator are mounted; (ii) an output subassembly, mounted at the output end, and including: (a) a holder configured to hold the instrument; (b) an effector, operable via actuation of the actuator to manipulate the microsurgical instrument held by the holder; and / or (c) an output gimbal on which the holder and the effector are mounted; and / or (iii) a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0064] In some implementations, the translational movement of the device is confined to a spherical coordinate system.

[0065] In some implementations, the origin is located at a center of the spherical coordinate system.

[0066] There is further provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device including a translation coordinator, and / or a rotation coordinator.

[0067] The rotation coordinator includes (i) an input subassembly, including: (a) a handle; and / or (b) an input gimbal on which the handle is mounted; (ii) an output subassembly, including: (a) a holder configured to hold the instrument; and / or (b) an output gimbal on which the holder is mounted; and / or (iii) a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0068] The translation coordinator includes (i) a hinge; and / or (ii) an armature, coupled to the hinge and mechanically connecting the input subassembly to the output subassembly in a manner that: (a) defines an origin of the device; and / or (b) transmits and downscales translational movement of the input subassembly with respect to the origin to become downscaled translational movement of the output subassembly with respect to the origin.

[0069] In some implementations, the device further includes: (i) an actuator; and / or (ii) an effector, at the output subassembly, the effector being operable via actuation of the actuator to manipulate the instrument held by the holder.

[0070] There is further provided, in accordance with some implementations, apparatus for facilitation of microsurgery, the apparatus including a device for use with a microsurgical instrument, the device including a translation coordinator, and / or a rotation coordinator.

[0071] The translation coordinator includes (i) an input end; (ii) an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; (iii) a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end; and / or (iv) a bracket for hingedly mounting the pantograph for tilting of the translation plane.

[0072] The rotation coordinator includes (i) an input subassembly, (ii) an output subassembly, and / or (iii) an actuator.

[0073] The input subassembly is mounted on the input end, and includes a first input-rotator, a second input-rotator, and a third input-rotator, each including a house and a wheel that is rotationally mounted to the respective house to define a rotation axis of the respective wheel, the first input-rotator, the second input-rotator, and the third input-rotator being connected in series such that: (I) the house of the first input-rotator is attached to the wheel of the second input-rotator such that: (A) the first input-rotator is revolvable about the rotation axis of the second input-rotator; and / or (B) the rotation axis of the wheel of the second input-rotator is angularly offset from the rotation axis of the wheel of the first input-rotator; (II) the house of the second input-rotator is attached to the wheel of the third input-rotator such that: (A) the second input-rotator is revolvable about the rotation axis of the third input-rotator; and / or (B) the rotation axis of the wheel of the third input-rotator is angularly offset from the rotation axis of the wheel of the second input-rotator. The input subassembly also includes a handle, connected to the wheel of the first input-rotator.

[0074] The output subassembly is mounted on the output end, and includes a first outputrotator, a second output-rotator, and a third output-rotator, each including a house and a wheel that is rotationally mounted to the respective house to define a respective rotation axis of the wheel, the first output-rotator, the second output-rotator, and the third output-rotator being connected in series such that: (A) the wheel of the first output-rotator is attached tothe house of the second output-rotator, and is operably coupled to the third input-rotator, such that: (I) rotation of the wheel of the third input-rotator rotates the wheel of the first output-rotator, which revolves the second output-rotator about the rotation axis of the first output-rotator; and / or (II) the rotation axis of the wheel of the second output-rotator is angularly offset from the rotation axis of the wheel of the first output-rotator; (B) the wheel of the second output-rotator is attached to the house of the third output-rotator, and is operably coupled to the second input-rotator such that: (I) rotation of the wheel of the second input-rotator rotates the wheel of the second output-rotator, which revolves the third outputrotator about the rotation axis of the second output-rotator; and / or (II) the rotation axis of the wheel of the third output-rotator is angularly offset from the rotation axis of the wheel of the second output-rotator; and / or (C) the wheel of the third output-rotator is operably coupled to the first input-rotator such that rotation of the wheel of the first input-rotator rotates the wheel of the third output-rotator.

[0075] The output subassembly also includes (i) a holder, connected to the wheel of the third output-rotator, and configured to hold the instrument; and / or (ii) an effector, operable via actuation of the actuator to manipulate the instrument held by the holder.

[0076] In some implementations, the holder is configured to hold the instrument along an instrument axis that is coincident with the rotation axis of the wheel of the third outputrotator.

[0077] In some implementations, the handle is elongate and defines a handle axis that is coincident with the rotation axis of the wheel of the first input-rotator.

[0078] In some implementations, the input and output ends are translationally movable along two axes within the translation plane.

[0079] In some implementations, the rotation axis of the wheel of the third input-rotator is perpendicular to the translation plane.

[0080] In some implementations, the device includes a rod for hingedly mounting the device.

[0081] In some implementations, rotating the device about the rod translates the output subassembly along a Z axis at a fixed downscaling ratio in relation to a translation of the input subassembly along the Z axis.

[0082] In some implementations, the device further includes a pantograph mechanism for downscaling translational movements.

[0083] In some implementations, the pantograph mechanism moves along a mathematical plane that is perpendicular to the Z axis.

[0084] The present invention will be more fully understood from the following detailed description of applications thereof, taken together with the drawings, in which:BRIEF DESCRIPTION OF THE DRAWINGS

[0085] Fig. 1 shows illustrative apparatus in accordance with principles of the invention.

[0086] Fig. 2 shows illustrative apparatus in accordance with principles of the invention.

[0087] Fig. 3 shows illustrative apparatus in accordance with principles of the invention.

[0088] Fig. 4 shows illustrative apparatus in accordance with principles of the invention.

[0089] Fig. 5 shows illustrative apparatus in accordance with principles of the invention.

[0090] Fig. 6 shows illustrative apparatus in accordance with principles of the invention.

[0091] Fig. 7 shows illustrative apparatus in accordance with principles of the invention.

[0092] Fig. 8 shows illustrative apparatus in accordance with principles of the invention.

[0093] Fig. 9 shows illustrative apparatus in accordance with principles of the invention.

[0094] Fig. 10 shows illustrative apparatus in accordance with principles of the invention.

[0095] Fig. 11 shows illustrative apparatus in accordance with principles of the invention.

[0096] Fig. 12 shows illustrative apparatus in accordance with principles of the invention.

[0097] Fig. 13 shows a partial schematic of illustrative apparatus in accordance with principles of the invention.

[0098] Fig. 14 shows a partial schematic of illustrative apparatus in accordance with principles of the invention.

[0099] Fig. 15 shows illustrative apparatus in accordance with principles of the invention.

[0100] Fig. 16 shows illustrative apparatus in accordance with principles of the invention.

[0101] Fig. 17 shows a cross-section of illustrative apparatus in accordance with principles of the invention.

[0102] Fig. 18 shows illustrative apparatus in accordance with principles of the invention.

[0103] Fig. 19 shows illustrative apparatus in accordance with principles of the invention.

[0104] Fig. 20 shows illustrative apparatus in accordance with principles of the invention.

[0105] Fig. 21 shows illustrative apparatus in accordance with principles of the invention.

[0106] Fig. 22 shows illustrative apparatus in accordance with principles of the invention.

[0107] Fig. 23 shows a translation of illustrative apparatus in accordance with principles of the invention.

[0108] Fig. 24 shows a rotation of illustrative apparatus in accordance with principles of the invention.

[0109] Fig. 25 shows a translation of illustrative apparatus in accordance with principles of the invention.

[0110] Fig. 26 shows a rotation of illustrative apparatus in accordance with principles of the invention.

[0111] Fig. 27 shows a rotation of illustrative apparatus in accordance with principles of the invention.

[0112] Fig. 28 shows illustrative apparatus in accordance with principles of the invention.DETAILED DESCRIPTION OF EMBODIMENTS

[0113] The present disclosure includes different variants of some elements. Variants of a given element typically have the same structure and / or function as each other except for any differences described. For any given element for which different variants are disclosed, the identical name is used for each variant, in order to denote that they are, in fact, variants of the same given element. Unless stated otherwise, applications of the devices, systems, and techniques described herein may include any arrangement in which one variant of an element is substituted with another identically-named variant of that element. Furthermore, throughout the figures, suffixes may be used to denote different variants of the same element. Unless stated otherwise, such variants may be substituted with each other, mutatis mutandis. That is, unless stated otherwise, any element having a given reference numeral may be substituted with any other element (i.e. any other variant of the element) having the same reference numeral, independent of any suffix.

[0114] In order to avoid undue clutter from having too many reference numbers and lead lines on a particular drawing, some elements are introduced via one or more drawings and not explicitly identified in every other drawing that contains that element.

[0115] Apparatus and methods for facilitating a microsurgical procedure such as, but not limited to, a microvascular anastomosis are provided. The apparatus may downscale the surgeon’s translational movements of an input subassembly to an output subassembly at the surgical site according to a downscaling ratio. The apparatus may synchronize the surgeon’s rotational movements of the input subassembly to the output subassembly at the surgical site. The synchronization may include rotating the output subassembly such that each degree of rotation of the input subassembly is matched at the output subassembly.

[0116] The downscaling ratio may be a predetermined ratio. The downscaling ratio may be adjustable. The downscaling ratio may correspond to a magnification provided by the microscope.

[0117] The translational movements may include movement along three dimensions (e.g. X, Y and Z axes). The rotational movements may include angular movement in three dimensions (e.g. pitch, yaw and roll).

[0118] The apparatus may include one or more of a device and a stand. The device may include a rotation coordinator and a translation coordinator.

[0119] The rotation coordinator may include the input subassembly, the output subassembly and a linkage. The linkage may connect the input subassembly to the output subassembly. The rotation coordinator may effectuate the transfer of rotational motion from the input subassembly to the output subassembly.

[0120] The input subassembly may include one or more of a handle, an actuator and / or an input gimbal. The surgeon may maneuver the handle to effectuate the translational and rotational movements of the input subassembly. The one or more input gimbals may transfer the rotational movement via the linkage. The actuator may actuate an effector of the output subassembly via the linkage. The input subassembly may be mounted on the translation coordinator.

[0121] The output subassembly may include a holder, the effector, and one or more output gimbals. The holder may hold an instrument. The rotational movements of the handle may be duplicated on the holder. The rotation coordinator may transfer the rotational movement, imparted to the one or more input gimbals, to the one or more output gimbals via the linkage.The one or more output gimbals may duplicate the rotational movement of the handle to the holder. The output subassembly may be mounted on the translation coordinator.

[0122] The effector may manipulate the instrument when actuated by the actuator. The linkage may connect the actuator to the effector. The actuator may include a portion of the handle, a button, and / or a switch. Squeezing and / or releasing the handle, pressing the button, or flipping the switch may cause the linkage to engage the effector. The linkage engaging the effector may duplicate the manipulation on the instrument. The manipulation may include squeezing and / or releasing the instrument.

[0123] The holder may hold or include tweezers, scissors, forceps or any other suitable surgical instrument that may be manipulated.

[0124] The holder may hold or include a scalpel, blade, needle or other suitable surgical instrument that does not require manipulation. When the surgical instrument does not require manipulation (squeezing or moving internal parts of the instrument) the input subassembly may exclude the actuator, the output subassembly may exclude the effector, and the linkage between the handle and the effector may be excluded as well.

[0125] The linkage may include one or more Bowden mechanisms. The linkage may include any other suitable device for transferring rotational motions. There may be one or more Bowden mechanisms connecting the input subassembly to the output subassembly. There may be one or more Bowden mechanisms connecting the handle to the effector.

[0126] The rotation coordinator may transmit the rotational movement from the handle to the holder. The rotation coordinator may synchronize rotational movement between the handle and the holder.

[0127] The rotation coordinator may be entirely mechanical. The rotation coordinator may be devoid of electrical components, such as motors, sensors, circuit boards, etc. The rotation coordinator may include electrical components. The electrical components may include motors, sensors, circuit boards, power cables, communication cables and any other suitable electrical components.

[0128] The device may include a translation coordinator. The translation coordinator may include an input end, an output and a downscaling device. The translation coordinator may transmit the translational movement from the handle to the holder.

[0129] Operation of the translation coordinator may be independent from operation of the rotation coordinator. The translation coordinator may include parts independent of the rotation coordinator. The translation coordinator may include overlapping parts with the rotation coordinator.

[0130] The input end may be connected to the input subassembly. The input end may include portions or all of the input subassembly. The output end may be connected to the output subassembly. The output end may include portions or all of the output subassembly. The input end may be connected to the output end via the downscaling device.

[0131] The downscaling device may include one or more pantograph mechanisms. The downscaling device may include, or be defined by, an armature. The downscaling device may include a bracket or hinge.

[0132] The bracket or hinge may be mounted on the stand. The downscaling device may be mounted on the stand via the bracket or hinge. The device may be mounted on the stand via the downscaling device. The device may be manufactured separately from the stand. The stand may be suitable to mount different devices. The stand may be reusable. The device may be consumable. The device may be sterilized before use with the stand. The stand may be sterilized after each use.

[0133] The downscaling ratio in the X, Y, or Z directions may be defined by a first ratio between a first distance between the input end to a pivoting axis and a second distance between the output end and the pivoting axis.

[0134] The downscaling ratio in the X, Y, or Z directions may be defined by a second ratio between a first length of the input end to a second length of the output end.

[0135] The input end may impart the translational movement to the downscaling device. The translational movement may include a direction and a distance travelled. The downscaling device may duplicate the direction of the translational movement. The downscaling device may downscale the distance travelled of the translational movement. The downscaling device may impart a downscaled translational movement to the output end. The downscaled translational movement may include the direction and the downscaled distance travelled.

[0136] The translational movement may be imparted to the input end via the handle and input subassembly. The downscaling device may convert the translational movement to the downscaled translational movement. The output end may impart the downscaled translational movement to the output subassembly and holder.

[0137] The downscaling device may convert and impart the translational movements in the X, Y and Z directions. The downscaling device may convert and impart the translational movements in the X and Y directions. The downscaling device may convert and impart the translational movements in the X direction only.

[0138] The stand may include an anchored base, a standing arm and a leveling arm. The anchored base may suspend the standing arm. The standing arm may suspend the leveling arm. The leveling arm may suspend the armature. The leveling arm may suspend the bracket or hinge. The downscaling device may suspend the input and output subassemblies.

[0139] The leveling arm may not be rotatable. The leveling arm may not be tiltable. The leveling arm may be rotatable. The leveling arm may be tiltable. The leveling arm may be connected to the anchored base via a non-movable joint. The leveling arm may be connected to the anchored base via a spherical bearing. The spherical bearing may allow the leveling arm to rotate and tilt relative to the anchored base.

[0140] The leveling arm may be inserted into a bracket of the armature. The bracket may include a balance mechanism. The balance mechanism may include a torsion spring, a counterweight, a pneumatic mechanism and / or any other suitable counterbalancing device.

[0141] One end of the torsion spring may be connected to the bracket. An opposite end of the torsion spring may be connected to the leveling arm. The torsion spring may maintain the armature generally parallel to the ground when no translational movement is imparted onto the device. The torsion spring may include a torque. The torque may correlate to a weight of the device.

[0142] One end of the leveling arm may include a counterweight. The counterweight may be equal to the weight of the device such that the counterweight maintains the armature generally parallel to the ground when no translational movement is imparted onto the device. The counterweight may be greater than the weight of the device such that the counterweight lifts the device away from the surgical site.

[0143] The leveling arm may include a central axis. The bracket may rotate about the central axis of the leveling arm. The rotation about the central axis may effectuate the downscaling in the Z direction. The tilting about the spherical bearing may effectuate the downscaling in the Y and Z directions. The tilting about the spherical bearing may effectuate the rotational movement of the handle.

[0144] The movements of the translation coordinator may be confined within a spherical coordinate system. The center of the spherical coordinate system may be defined as an origin of the coordinate system. All the translational movements may be relative to the origin. The device may be constructed such that the origin is oriented as close to the surgical site as possible.

[0145] The translation coordinator may be entirely mechanical. The translation coordinator may be devoid of electrical components, such as motors, sensors, circuit boards, etc. The translation coordinator may include electrical components. The electrical components may include motors, sensors, circuit boards, power cables, communication cables and any other suitable electrical components.

[0146] The device may synchronize a direction of movement and the rotational movements of the handle and holder, while downscaling the distance moved. Maintaining the direction of movement may allow the surgeon to more easily visualize the direction the holder is moving to direct the holder during microsurgery. Maintaining the rotational movements may allow the surgeon to more easily sew together the blood vessels. Downscaling the distance moved may allow the surgeon more precise control over the small distances the holder may need to travel during microsurgery. The device may be able to accomplish the above in a relatively inexpensive manner, without occupying a large footprint.

[0147] The footprint of the device may allow two or more devices to be suspended over the surgical site. The second device may be controlled by a second surgeon. The second device may be controlled by the surgeon using a different hand.

[0148] Fig. 1 shows apparatus 10 being used by a surgeon 2 to perform microsurgery on a patient 1. In the example shown, device 100 is shown being used to manipulate a needle 5 and suture 6 to repair (e.g. by stitching) a blood vessel 7 - e.g. to perform an anastomosis. Surgeon 2 may use a microscope 8 during the microsurgery. Microscope 8 may provide a magnification of a surgical site 4.

[0149] A portion of device 100 may be suspended, via an anchored base 3, over surgical site 4. While one device 100 and one surgeon 2 are shown, it is contemplated that a given surgeon 2 may operate two devices 100 - e.g. with the output assemblies of the devices (described hereinbelow) converging at site 4. For example, the surgeon may operate one device 100 with one hand, and another device 100 with the other hand. Furthermore, two surgeons mayeach operate one or more devices 100 - e.g. standing on opposite sides of patient 1, with the output assemblies of the devices converging at site 4.

[0150] Fig. 2 shows apparatus 10 in more detail. Apparatus 10 may include device 100 and stand 277. Device 100 may include a rotation coordinator 101 and a translation coordinator 208. Rotation coordinator 101 and translation coordinator 208 may include one or more of input subassembly 102, output subassembly 155, armature 209 and linkage 600.

[0151] Input subassembly 102 may include handle 152, actuator 153, and / or an input gimbal 103. Handle 152 and / or actuator 153 may be mounted on input gimbal 103.

[0152] Input gimbal 103 may include one or more input rotators. The one or more input rotators may include a first input rotator 302, a second input rotator 308 and a handle rotator 318. The first input rotator 302 may include one or more of support arm 104, bore 106, halfhousing 108, threaded protrusions 110 and 112, through-hole 114, wheel 116, hex bore 118, oblique shaft 120, locking shaft 122 and central axis axi l. The second input rotator 308 may include one or more of support arm 124, threaded protrusions 126 and 128, through-hole 130 and central axis axl2. The handle rotator 318 may include one or more of support arm 132, half-housing 134, threaded protrusions 136 and 138, through-hole 140, recess 142, linkage inlet 144, handle wheel 146, hinges 148, through-hole 150, and central axis axl3.

[0153] Handle 152 may be fastened or connected to input gimbal 103. Handle 152 may include holes 154.

[0154] Actuator 153 may be included on an end of handle 152. Actuator 153 may be separate and distinct from handle 152.

[0155] Input subassembly 102 may be translated in the X, Y or Z direction. Translating input subassembly 102 in the X, Y or Z direction may cause output subassembly to be translated in the same X, Y or Z direction by a downscaled distance. That is, translation of input subassembly 102 along a vector having a direction and an input distance may cause translation of output subassembly 155 along a vector having the same direction (i.e. parallel with the first vector) but having a shorter distance.

[0156] Output subassembly 155 may include a holder 207, an effector 202, and / or an output gimbal 156. Holder 207 and / or effector 202 may be mounted on output gimbal 156. Holder 207 is configured to hold instrument 206. In the example shown, instrument 206 is forceps. However, other instruments may be used, such as a scalpel, scissors, needle etc. Holder 207 may comprise an aperture, a clip, a clamp, or any other component configured to holdinstrument 206. Holder 207 may be configured to facilitate interchange (e.g. hot-swapping) between different types of instruments. In some implementations, holder 207 (and device 100 as a whole) is configured to accept an off-the-shelf instrument 206. In some implementations, specialized instruments 206 may be provided specifically for use with device 100. In some implementations, instrument 206 is actually a component of device 100 - e.g. the apparatus is provided with the instrument already held at output subassembly 155.

[0157] Output gimbal 156 may comprise one or more output rotators. The one or more output rotators may include a first output rotator 157, a second output rotator 179, and a holder rotator 185. First output rotator 157 may include one or more of support arm 158, bore 160, half-housing 162, threaded protrusions 164 and 166, through-hole 168, recess 170, wheel 172, hex-bore 174, oblique shaft 176 and locking shaft 178. Second output rotator 179 may include support arm 180, threaded protrusion 182 and through-hole 184. Holder rotator 185 may include one or more of support arm 186, half-housing 188, threaded protrusions 190 and 192, recess 194, linkage inlet 196, instrument wheel 198, hinges 200, effector 202, through-hole 204 and instrument 206.

[0158] Armature 209 may include one or more of end cap 210, shaft 212, double hinged end cap 214, clips 216, through-holes 218, double hinge 220, hinged end cap 222, single hinge 224, joint 226, clip 228, through-holes 230, shaft 232, elongated end cap 234, elongated hinge 236, joint 238, anchor joint 240, bellcrank 242, hinged end cap 244, shaft 246, hinged end cap 248, joint 250, output hinge 252, joint 254, cylindrical extension 256, bracket 258, anchoring end 260, joint 262, bar 264, cutout 266, joint 268, ring 270, clip 272, through-hole 274, and leveling bore 276.

[0159] Some or all of bracket 258, anchoring end 260, joint 262, bar 264, cutout 266, joint 268, ring 270, clip 272, through-hole 274, and leveling bore 276 may be separate from armature 209.

[0160] Stand 277 may include one or more of leveling arm 278 and standing arm 280. Leveling arm 278 may define a bearing for bracket 258.

[0161] Some or all of leveling arm 278 and standing arm 280 may be included in armature 209. Some or all of leveling arm 278 and standing arm 280 may be included with bracket 258.

[0162] Rotation coordinator 101 may include input subassembly 102, output subassembly 155 and linkage 600.

[0163] Translation coordinator 208 may include an input end an output end and a downscaling device. The input end may include one or more of input subassembly 102, handle 152 and / or end cap 210. The output end may include one or more of output subassembly 155, instrument 206 and / or output hinge 252. The downscaling device may include one or more of armature 209, bracket 258 and stand 277.

[0164] Armature 209 and / or stand 277 may include a balancing mechanism. The balancing mechanism may include a torsion spring, a counterweight, a pneumatic mechanism and / or any other suitable counterbalancing device. The balancing mechanism may allow surgeon 2 to manipulate device 100 as if it was weightless. The balancing mechanism may prevent device 100 from falling into patient 1 when device 100 is released by surgeon 2. The balancing mechanism may include a hard stop. The hard stop may prevent device 100 from moving too far in one direction, for example into the patient.

[0165] Device 100 may include damping mechanisms. The damping mechanisms may ensure the translational movements of device 100 do not exceed a threshold velocity. The damping mechanisms may slow device 100. Slowing device 100 may prevent sudden movements that may occur when device 100 is accidentally mishandled. The balancing mechanism may include at least one damping mechanism.

[0166] Fig. 3 shows a view of input subassembly 102. Input subassembly 102 may include input gimbal 103, handle 152 and actuator 153. Input gimbal 103 may include one or more of first input rotator 302, second input rotator 308 and handle rotator 318. First input rotator 302, second input rotator 308 and handle rotator 318 may be concatenated.

[0167] First input rotator 302, second input rotator 308 and handle rotator 318 may receive rotational movements via handle 152. First input rotator 302 may receive angular rotations about axis ax 11. Second input rotator 308 may receive angular rotations about axis axl2. Handle rotator 318 may receive angular rotations about axis as 13.

[0168] Second input rotator 308 may include all of the features of first input rotator 302. Second input rotator 308 may include the same manufactured parts as first input rotator 302, mutatis mutandis.

[0169] Support arm 104 may suspend input subassembly 102 from armature 209. Support arm 104 may include bore 106. Bore 106 may receive a set screw to secure support arm 104 to armature 209. Support arm 104 may include half of a housing for first input rotator 302. Half-housing 108 may correspond to the missing housing of support arm 104. Support arm104 and half-housing 108 may be secured together to form a housing. Support arm 104 may include threaded protrusion 110. Half-housing 108 may include threaded protrusion 112. Threaded protrusions 110 and 112 may include through-hole 114. A screw or other suitable fastener may be inserted into through-hole 114 to secure threaded protrusions 110 and 112 together. There may be threaded protrusions 110 and 112 on either side of support arm 104 and half-housing 108 respectively. Support arm 104 and half-housing 108 may include recesses 306 on a side of threaded protrusions 110 and 112 to allow for the diameter of a head of the screw.

[0170] Wheel 116 may be disposed within support arm 104 and half-housing 108. Rotation of wheel 116 may cause an inner wire of first Bowden device 602 to synchronously rotate wheel 172 of output subassembly 155.

[0171] The inner wire of first Bowden device 602 may be secured to wheel 116 at one end and to wheel 172 at another end, such that rotation of wheel 116 may cause the inner wire to rotate about wheel 116. Rotation of the inner wire about wheel 116 may pull on wheel 172. Pulling on wheel 172 may rotate wheel 172. The inner wire may enter and exit support arm 104 via linkage inlets 304. There may be one linkage inlet 304 on either side of support arm 104. The inner wire may enter the housing of first input rotator 302 and wrap around wheel 116.

[0172] Wheel 116 may be secured to support arm 124. A nut may be inserted into hex bore 118 to receive a screw or bolt inserted through bore in support arm 124 to secure support arm 124 to wheel 116. Wheel 116 may rotate via support arm 124. Rotating handle 152 in a motion about axis axi l may rotate support arm 124.

[0173] Support arm 124 may suspend second input rotator 308 from first input rotator 302. Support arm 124 may include half of a housing for second input rotator 308. Half-housing 310 may correspond to the missing housing of support arm 124. Support arm 124 and halfhousing 310 may be secured together to form a housing. Support arm 124 may include threaded protrusion 126. Half-housing 310 may include threaded protrusion 128. Threaded protrusions 126 and 128 may include through-hole 130. A screw or other suitable fastener may be inserted into through-hole 130 to secure threaded protrusions 126 and 128 together. There may be threaded protrusions 126 and 128 on either side of support arm 124 and halfhousing 310 respectively. Support arm 124 and half-housing 310 may include recesses 314 on a side of threaded protrusions 126 and 128 to allow for the diameter of a large screw.

[0174] Wheel 312 may be disposed within support arm 124 and half-housing 310. Rotation of wheel 312 may cause an inner wire of second Bowden device 604 to synchronously rotate second output rotator 179.

[0175] The inner wire of second Bowden device 604 may be secured to wheel 312 at one end and secured to second output rotator 179 at another end, such that rotation of wheel 312 may cause the inner wire to rotate about wheel 312. Rotation of the inner wire about wheel 312 may pull second output rotator 179. Pulling second output rotator 179 may rotate second output rotator 179. The inner wire may enter and exit support arm 124 via linkage inlets 316. There may be one linkage inlet 316 on either side of support arm 124. The inner wire may enter the housing of second input rotator 308 and wrap around wheel 312.

[0176] Wheel 312 may be secured to support arm 132. A nut may be inserted into the hex bore to receive a screw or bolt inserted through bore 320 in support arm 132 to secure support arm 132 to wheel 312. Wheel 312 may rotate via support arm 132. Rotating handle 152 in a motion about axis axl2 may rotate support arm 132.

[0177] Support arm 132 may suspend handle rotator 318 from second input rotator 308. Support arm 132 may include half of a housing for handle rotator 318. Half-housing 134 may correspond to the missing housing of support arm 132. Support arm 132 and halfhousing 134 may be secured together to form a housing. Support arm 132 may include threaded protrusion 136. Half-housing 134 may include threaded protrusion 138. Threaded protrusions 136 and 138 may include through-hole 140. A screw or other suitable fastener may be inserted into through-hole 140 to secure threaded protrusions 136 and 138 together. There may be threaded protrusions 136 and 138 on either side of support arm 132 and halfhousing 134 respectively. Support arm 132 and half-housing 134 may include recesses 142 on a side of threaded protrusions 136 and 138 to allow for the diameter of a large screw.

[0178] Handle wheel 146 may be disposed within support arm 132 and half-housing 134. Handle wheel 146 may include the same diameter as wheel 116 and wheel 312. Handle wheel 146 may include a larger or smaller diameter as wheel 116 and wheel 312. Handle wheel 146 may include a larger height than wheel 116 and wheel 312. Handle wheel 146 may include the same height as wheel 116 and wheel 312.

[0179] Rotating handle 152 in a motion about axis axl3 may rotate handle wheel 146. Rotation of handle wheel 146 may cause an inner wire of third Bowden device 606 to synchronously rotate instrument wheel 198 of output subassembly 155. Instrument wheel198 may be substantially similar to handle wheel 146. Instrument wheel 198 may be positioned such that it faces a parallel but opposite direction as handle wheel 146.

[0180] The inner wire of third Bowden device 606 may be secured to handle wheel 146 at one end and secured to instrument wheel 198 at another end, such that rotation of handle wheel 146 may cause the inner wire to rotate about handle wheel 146. Rotation of the inner wire about handle wheel 146 may pull instrument wheel 198. Pulling instrument wheel 198 may rotate instrument wheel 198. The inner wire may enter and exit support arm 132 via linkage inlets 144. There may be one linkage inlet 144 on either side of support arm 132. The inner wire may enter the housing of handle rotator 318 and wrap around handle wheel 146.

[0181] Handle wheel 146 may include hinges 148. Hinges 148 may include through-hole 150. Handle 152 may be inserted between hinges 148. Handle 152 may include a through- hole that aligns with through -hole 150. A nut, linkage or fastener may be inserted through through-hole 150 to secure handle 152 to hinges 148.

[0182] Handle 152 may include actuator 153. Manipulating handle 152 may cause actuator 153 to actuate effector 202. Actuating effector 202 may manipulate instrument 206 in a similar manner. Squeezing handle 152 may cause actuator 153 to pull on an inner wire of fourth Bowden device 620. The inner wire may be secured to actuator 153 via holes 154. The inner wire may pull on effector 202 to squeeze instrument 206 in a similar manner (as shown with reference to Fig. 28), mutatis mutandis.

[0183] Actuator 153 may be distinct and separate from handle 152. Actuator 153 may be disposed on other areas of device 100, for example on first input rotator 302, second input rotator 308, handle rotator 318, armature 209 or a separate device. Actuator 153 may be embodied as a button, a switch, a lever, or any other suitable devices for actuation. Surgeon 2 may actuate actuator 153 manually or electronically.

[0184] Axes axi l, axl2 and axl3 may converge to a control point, represented in Fig. 3 by a dot. The control point may be indicative of an operating point on which instrument 206 performs the operation. Rotational and translational movements may be made with respect to the control point. The motion of input subassembly 102 which is imparted to output subassembly 155 may be motion with respect to the control point.

[0185] Input gimbal 103 may define or act as a virtual spherical joint - e.g. such that handle 152 can deflect (e.g. orbit) about the control point while axis ax 13 remains pointing at thecontrol point. In some implementations, handle 152 can deflect in this manner throughout at least 2TI steradians (e.g. at least about 6 steradians), such as a hemisphere. As shown, this virtual spherical joint may be implemented by first input rotator 302, second input rotator 308 and handle rotator 318 collectively defining a curved virtual surface (e.g. orbital plane) via the rotational movement of support arms 124 and 132. The curved virtual surface (e.g. its size, curvature, and / or distance from the control point) may be defined at least in part by the angles between axes axi l, axl2 and axl3. The curved virtual surface may be hemispherical, e.g. with the control point being a center of a base of the hemisphere. Each of second input rotator 308 and handle rotator 318 may revolve (e.g. orbit) about the control point at a respective fixed radius (e.g. orbital plane). First input rotator 302, second input rotator 308 and handle rotator 318 may be concatenated such that handle rotator 318 may be directed to nearly any location on the virtual curved surface.

[0186] Device 100 may include a spherical coordinate system. The spherical coordinate system may be defined by a sphere created when the control point is moved to its furthest location from the operating point along each of the X, Y, and Z directions. The spherical coordinate system may include a center. The center of the coordinate system may define an origin. The origin may be the point in which the control point would coincide with the operating point - e.g. in the absence of mechanical constraints. Translational movement imparted to input subassembly 102 may be relative to the origin. Downscaled translational movement imparted to output subassembly 155 may be relative to the origin. Increasing or decreasing the dimensions of armature 209 may respectively increase or decrease the spherical coordinate system. Placement of axis ax31 may affect the location of the origin.

[0187] In illustrated Fig. 3 downscaling in the X and Y directions is accomplished via armature 209. Downscaling in the Z direction is accomplished via one or more of armature 209, bracket 258 and leveling arm 278.

[0188] Fig. 4 shows another view of input subassembly 102.

[0189] Wheel 116 may include hex bore 118, oblique shaft 120 and locking shaft 122. Oblique shaft 120 may extend through wheel 116 to a center of wheel 116. The inner wire of first Bowden device 602 may be inserted into wheel 116 via oblique shaft 120 opening at the center of wheel 116. The inner wire of first Bowden device 602 may extend through wheel 116 via oblique shaft 120.

[0190] The inner wire of first Bowden device 602 may be secured to wheel 116 via locking shaft 122. The inner wire may be wrapped around a screw or bolt inserted into locking shaft 122 and secured to a threaded nut inserted into a bottom end of wheel 116. In this manner first Bowden device 602 may be secured to wheel 116 such that the inner wire of first Bowden device 602 will rotate when wheel 116 is rotated.

[0191] Wheel 312 may include hex bore 402, oblique shaft 404 and locking shaft 406. Hex bore 402 may be aligned with bore 320. Hex bore 402 may receive a nut. A screw or bolt may be inserted through bore 320 and lock onto the nut to secure support arm 132 to wheel 312.

[0192] Oblique shaft 404 may extend through wheel 312 to a center of wheel 312. The inner wire of second Bowden device 604 may be inserted into wheel 312 via oblique shaft 404 opening at the center of wheel 312. The inner wire of second Bowden device 604 may extend through wheel 312 via oblique shaft 404.

[0193] The inner wire of second Bowden device 604 may be secured to wheel 312 via locking shaft 406. The inner wire may be wrapped around a screw or bolt inserted into locking shaft 406 and secured to a threaded nut inserted into a bottom end of wheel 312. In this manner second Bowden device 604 may be secured to wheel 312 such that the inner wire of second Bowden device 604 will rotate when wheel 312 is rotated.

[0194] Handle 152 may include recess 408. Recess 408 may allow the inner wire of fourth Bowden device 620 to pass underneath handle 152, such that when actuator 153 is squeezed the inner wire will not obstruct the motion of handle 152. The inner wire may be passed through handle wheel 146 via through-hole 410. The inner wire may pass through recess 408 to the outside of actuator 153. The inner wire may pass through the bottom hole 154 to the inside of actuator 153 and pass back through the top hole 154 to the outside of actuator 153. The inner wire may be secured to actuator 153 via a screw through the top hole 154. The top hole 154 may be threaded to receive the screw.

[0195] The inner wire may include a ball (not shown) or other object attached thereon at the intersection between recess 408 and through-hole 410 when actuator 153 is at rest. The ball may be larger in diameter than both recess 408 and through-hole 410. Squeezing actuator 153 inwardly may push the ball inwardly and thereby pull the inner wire upwardly. Pulling inner wire upwardly may exert a pulling force on effector 202. Once pulled, effector 202 may effectuate a similar squeezing motion on instrument 206. Squeezing actuator 153 mayincrease a tension in the inner wire. The increased tension in the inner wire may cause effector 202 to release instrument 206 when actuator 153 is released.

[0196] Handle wheel 146 may include hex bore 412. Hex bore 412 may receive a nut. The nut may correspond to a screw or bolt inserted through a locking shaft on the opposite end of handle wheel 146. The locking shaft may secure the inner wire of third Bowden device 606 to handle wheel 146.

[0197] Fig. 5 shows another view of input subassembly 102.

[0198] Support arm 124 may include bore 502. Support arm 124 may be secured to wheel 116 via fastening a screw or bolt through bore 502 and into a nut in hex bore 118.

[0199] Handle wheel 146 may include instrument aperture 504, oblique shaft 506 and locking shaft 508. Instrument aperture 504 may receive a portion of handle 152. Oblique shaft 506 may receive the inner wire of third Bowden device 606 in a similar manner to oblique shaft 120 and the inner wire of first Bowden device 602. Locking shaft 508 may secure the inner wire of third Bowden device 606 to handle wheel 146 in a similar manner to locking shaft 122 of wheel 116.

[0200] Hole 154 may include top hole 510. Top hole 510 may include a larger diameter opening on an outer portion of handle 152. The larger diameter opening may receive a screw to secure the inner wire of fourth Bowden device 620 as described above.

[0201] Support arms 104, 124 and 132 and half-housings 108, 310 and 134 may each include inner shelf 512. Inner shelf 512 may surround a groove in wheels 116, 312 and handle wheel 146 (see Fig. 11, described below). The inner wires may be disposed around the groove. Inner shelf 512 may surround the groove to protect the inner wires.

[0202] Figure 6 shows a view of linkage 600. Linkage 600 may include first Bowden device 602, second Bowden device 604, third Bowden device 606 and fourth Bowden device 620.

[0203] First Bowden device 602 may include an outer sheath, inner sheath 608 and inner wire 614. Second Bowden device 604 may include an outer sheath, inner sheath 610 and inner wire 616. Third Bowden device 606 may include an outer sheath, inner sheath 612 and inner wire 618. Fourth Bowden device 620 may include an outer sheath, inner sheath 622 and inner wire 624. Inner wires 614, 616 and 618 may be looped. Inner wires 614, 616 and 618 may each include two distinct wires. Inner wires 614, 616 and 618 may each include one distinct wire. Inner sheaths 608, 610 and 612 may prevent respective inner wires fromrubbing against each other during operation. Inner wire 624 may include one distinct wire. Inner wire 624 may include two distinct wires or a looped wire.

[0204] One looped end of inner wire 614 may be secured to wheel 116. The other looped end of inner wire 614 may be secured to wheel 172. One looped end of inner wire 616 may be secured to wheel 312. The other looped end of inner wire 616 may be secured to wheel 706 (see Fig. 7). One looped end of inner wire 618 may be secured to handle wheel 146. The other looped end of inner wire 618 may be secured to instrument wheel 198. One end of inner wire 624 may be secured to actuator 153. The other end of inner wire 624 may be secured to effector 202.

[0205] Inner sheaths 608, 610, 612 and 622 may move relative to their respective outer sheaths. Inner wires 614, 616, 618 and 624 may move relative to their respective inner sheaths 608, 610, 612 and 622.

[0206] Fig. 7 shows a view of output subassembly 155. Output subassembly 155 may include one or more features similar with input subassembly 102. Like named parts function in a similar manner and therefore any part of output subassembly 155 with a name described in input subassembly 102 will not be described again.

[0207] First output rotator 157, second output rotator 179 and holder rotator 185 may be concatenated.

[0208] First output rotator 157 may include support arm 158, half-housing 162 and wheel 172. Support arm 158 may include threaded protrusions 164, linkage input 702 and recess 170. Half-housing 162 may include threaded protrusions 166 and recess 170. Wheel 172 may rotate about axis ax21.

[0209] Wheel 172 may be secured to support arm 180. Linkage 600 may rotate wheel 172 about axis ax21 as described above. Wheel 172 may rotate support arm 180. Support arm 180 may rotate instrument 206 about axis ax21. As such, rotating handle 152 about axis axi l may rotate wheel 116. Rotating wheel 116 may cause linkage 600 to rotate wheel 172. Rotating wheel 172 may cause instrument 206 to rotate about axis ax21. Accordingly, a rotational movement of handle 152 about axis axi l may synchronously cause the same rotational movement of instrument 206 about axis ax21.

[0210] Second output rotator 179 may include support arm 180, a half-housing and wheel 706. Support arm 180 may include threaded protrusions, linkage inlets 704 and recesses. Thehalf-housing may include threaded protrusions and recesses. Wheel 706 may rotate about axis ax22.

[0211] Wheel 706 may be secured to support arm 186. Linkage 600 may rotate wheel 706 about axis ax22 as described above. Wheel 706 may rotate support arm 186. Support arm 186 may rotate instrument 206 about axis ax22. As such, rotating handle 152 about axis axl2 may rotate wheel 312. Rotating wheel 312 may cause linkage 600 to rotate wheel 706. Rotating wheel 706 may cause instrument 206 to rotate about axis ax22. Accordingly, a rotational movement of handle 152 about axis axl2 may synchronously cause the same rotational movement of instrument 206 about axis ax22.

[0212] Holder rotator 185 may include support arm 186, half-housing 188, instrument wheel 198 and effector 202. Support arm 186 may include threaded protrusions, linkage inlets and recesses. Half-housing 188 may include threaded protrusions and recesses.

[0213] Instrument wheel 198 may include holder 207. Holder 207 may include instrument aperture 504 and tracks 1208 (see Fig. 12). Holder 207 may be separate from instrument wheel 198. Holder 207 may be embodied as a clip, mount, recess, or any other suitable device for holding instrument 206.

[0214] Instrument wheel 198 may be secured to instrument 206. Linkage 600 may rotate instrument wheel 198 about axis ax23 as described above. Instrument wheel 198 may rotate instrument 206 about axis ax23. As such, rotating handle 152 about axis ax 13 may rotate handle wheel 146. Rotating handle wheel 146 may cause linkage 600 to rotate instrument wheel 198. Rotating instrument wheel 198 may cause instrument 206 to rotate about axis ax23. Accordingly, a rotational movement of handle 152 about axis ax 13 may synchronously cause the same rotational movement of instrument 206 about axis ax23.

[0215] Handle 152 may be oriented in the same direction as instrument 206. Handle 152 may be oriented in a different direction as instrument 206. Regardless of the orientation differences between handle 152 and instrument 206, translational movements of handle 152 may be downsized to instrument 206 and rotational movements of handle 152 may be maintained by instrument 206.

[0216] Axes ax21, ax22 and ax23 may converge onto the operating point. The operating point may be offset from the control point in the X, Y and / or Z axes. Axes axi l, axl2 and ax 13 may be parallel to axes ax21, ax22 and ax23 respectively. Alternatively, axes axi l, axl2 and axl3 may be angularly offset from axes ax21, ax22 and ax23 respectively - e.g.for physical and / or visual access, and / or to correspond with an orientation of the microscopic imaging of the procedure.

[0217] Output gimbal 156 may define or act as a virtual spherical joint - e.g. such that instrument 206 can deflect (e.g. orbit) about the operating point while axis ax23 remains pointing at the operating point. In some implementations, instrument 206 can deflect in this manner throughout at least 2K steradians (e.g. at least about 6 steradians), such as a hemisphere. As shown, this virtual spherical joint may be implemented by first output rotator 157, second output rotator 179 and holder rotator 185 collectively defining a curved virtual surface (e.g. orbital plane) via the rotational movement of support arms 180 and 186. The curved virtual surface (e.g. its size, curvature, and / or distance from the operation point) may be defined at least in part by the angles between axes ax21, ax22 and ax23. The curved virtual surface may be hemispherical, e.g. with the operating point being a center of a base of the hemisphere. Each of second output rotator 179 and holder rotator 185 may revolve (e.g. orbit) about the operating point at a respective fixed radius (e.g. orbital plane). First output rotator 157, second input rotator 179 and holder rotator 185 may be concatenated such that holder rotator 185 may be directed to nearly any location on the curved virtual surface.

[0218] A first curved (e.g. hemispherical) virtual surface may be created by first input rotator 302, second input rotator 308 and handle rotator 318. A second curved (e.g. hemispherical) virtual surface may be created by first output rotator 157, second output rotator 179 and holder rotator 185. The first curved virtual surface may be substantially congruent with the second curved virtual surface. Moving handle rotator 318 to a location on the first curved virtual surface may cause holder rotator 185 to move to a corresponding location on the second curved virtual surface.

[0219] Instrument wheel 198 may include tightening bore 708. Tightening bore 708 may lock instrument 206 to instrument wheel 198. Tightening bore 708 may be internally threaded. A screw or bolt may be inserted into tightening bore 708 to secure instrument 206 to instrument wheel 198.

[0220] Effector 202 may be secured to instrument wheel 198 via hinges 200 in a similar manner as handle 152 is secured to handle wheel 146 via hinges 148. Effector 202 may be rotatably secured to instrument wheel 198 via a rod. Inner wire 624 may be secured to the rod. Pulling on inner wire 624 may rotate effector 202 towards instrument wheel 198. When rotated, a portion of effector 202 may push against instrument 206 to squeeze instrument206 closed. Removing the pulling force on inner wire 624 may release tension on instrument 206 and allow it to return to its equilibrium state.

[0221] Support arm 158 may be secured to armature 209. Support arm 158 may be secured to cylindrical extension 256. Cylindrical extension 256 may extend from output hinge 252. Output hinge 252 may be secured to hinged end cap 248 and inner arm 710 at distinct respective joints. Hinged end cap 248 may cover an end of shaft 246. Shaft 246 may be hollow. Bowden devices 602, 604, 606 and 620 may be strung through the hollow of shafts 246, 232 and 212 to reach input subassembly 102.

[0222] Fig. 8 shows a view of illustrative apparatus.

[0223] Wheel 172 may include hex bore 174, oblique shaft 176 and locking shaft 178. Output hinge 252 may be secured to hinged end cap 248 via joint 250. Output hinge 252 may be secured to inner arm 710 via joint 254.

[0224] Fig. 9 shows a view of holder rotator 185.

[0225] Effector 202 may be rotatably connected to holder rotator 185. Effector 202 may include through-hole 204 and rod 902. Rod 902 may be inserted into through-hole 204. An end of inner wire 624 may be secured to rod 902. Squeezing actuator 153 may pull another end of inner wire 624, which may pull rod 902 in a direction towards holder rotator 185. Pulling rod 902 may rotate effector 202 about the rod within hinges 200. Rotating effector 202 may push a portion of effector 202 into instrument 206 thus effectuating a squeezing of instrument 206 a similar distance to the squeezing of actuator 153.

[0226] Instrument wheel 198 may include through hole 904 and locking shaft 906. Inner wire 624 may traverse through-hole 904. Locking shaft 906 may extend entirely through instrument wheel 198. Locking shaft 906 may include a hexagonal shape at a first end of instrument wheel 198. The hexagonal shape may receive a nut which may correspond to a screw inserted into the entrance of locking shaft 906 on the other end of instrument wheel 198. The screw may secure inner wire 618 to instrument wheel 198.

[0227] Fig. 10 shows another view of holder rotator 185.

[0228] Effector 202 may include push bar 1002. Push bar 1002 may push against instrument 206 when inner wire 624 is pulled by actuator 153.

[0229] Fig. 11 shows a view of wheel 116.

[0230] Wheel 116 may include hex bore 118, oblique shaft 120, locking shaft 122, groove 1102, ridge 1104 and locking bore 1106.

[0231] Groove 1102 may surround wheel 116. Groove 1102 may receive one looped end of inner wire 614. Ridge 1104 may maintain inner wire 614 within groove 1102.

[0232] The looped end of inner wire 614 may include two distinct wires overlapping around groove 1102. An end of one of the distinct wires may be secured to wheel 116 via locking bore 1106 and a screw. An end of the other distinct wire may be threaded through oblique shaft 404 and secured to wheel 116 via locking shaft 406 and a screw. The overlap around wheel 116 may allow the distinct wires to move concurrent with wheel 116 when wheel 116 is rotated. The amount of overlap may determine a maximum angular rotation of wheel 116. An overlap of 300 degrees may allow for a maximum of 300 degrees of rotation of wheel 116. An overlap of 660 degrees may allows for a maximum of 660 degrees of rotation of wheel 116.

[0233] Inner shelf 512 may have a height that is larger than a distance between a top of upper ridge 1104 and a bottom of lower ridge 1104.

[0234] Wheel 116 may be rotatable with respect to support arm 104 and half-housing 108.

[0235] Wheels 312, 172 and 706 may include all the features of wheel 116. Wheels 312, 172 and 706 may be substantially the same as wheel 116. Wheels 312, 172 and 706 may include the same, larger or smaller diameters as wheel 116. Wheels 312, 172 and 706 may include the same, larger or smaller heights as wheel 116.

[0236] Fig. 12 shows a view of handle wheel 146.

[0237] Handle wheel 146 may include through-hole 410, instrument aperture 504, oblique shaft 506, locking shaft 508, tightening bore 708, groove 1202, ridge 1204, locking bore 1206, tracks 1208, hinges 148, through-hole 150 and rod 1210.

[0238] Handle wheel 146 may include one or more features similar with wheel 116. Like named parts function in a similar manner and therefore any part of handle wheel 146 with a name described in wheel 116 will not be described again.

[0239] Instrument wheel 198 may include all the features of handle wheel 146. Instrument wheel 198 may be substantially the same as handle wheel 146. Instrument wheel 198 may include the same, larger or smaller diameters as handle wheel 146. Instrument wheel 198 may include the same, larger or smaller heights as handle wheel 146.

[0240] Tracks 1208 may guide instrument 206 within and through instrument aperture 504. Tracks 1208 may be sized to separate instrument 206 into two halves. Tightening bore 708 was described above and will not be described again.

[0241] Fig. 13 shows a partial schematic view of armature 209.

[0242] Fig. 13 may show a motion of armature 209 in the X direction. A plane in which armature 209 is shown moving within in Fig. 13 may define a translation plane. A translational movement in the X direction from the input end of the translation coordinator may cause the motion shown in Fig. 13. The motion shown in Fig. 13 may schematically show the translational movement from the input end downscaled at the output end.

[0243] The distance in the Y direction between shaft 212 and anchoring joint 240 may be designated as “A”. “A” may define the input end. The distance in the Y direction between shaft 246 and anchoring joint 240 may be 1 / 5 the distance in the Y direction between shaft 212 and anchoring joint 240. The distance between shaft 246 and anchoring joint 240 may thus be designated as “A / 5”. “A / 5” may define the output end. In this schematic, the ratio 1 / 5 may be the downscaling ratio. Changing the distance of shaft 246 with respect to anchoring joint 240 and shaft 212 may change the downscaling ratio. The downscaling ratio of 1 / 5 is merely an example illustrated in Fig. 13. The downscaling ratio may be 1 / 2, 1 / 3, 1 / 4, 1 / 5, 1 / 7, 1 / 10 or any other suitable ratio. The downscaling ratio may correspond to the magnification of microscope 8.

[0244] With respect to motion in the X direction, shafts 212, 232 and 246 may move together as unit 1300. Unit 1300 may rotate about anchoring joint 240 when a force in the X direction is placed on unit 1300. The force may move handle 152 a distance B in the X direction. The resultant motion of unit 1300 may cause instrument 206 to move a distance B / 5 in the X direction. The ratio of B / 5 may be due to the downscaling ratio.

[0245] Shaft 232 moves along angle a, due to the longer moment arm shaft 212 moves a longer distance than shaft 246. Because shaft 212 is 5 times farther away from anchoring joint 240 than shaft 246, handle 152 will move 5 times farther away in the X direction than instrument 206.

[0246] Unit 1300 may move together with respect to motion in the Z direction as well. However, instead of rotating about anchoring joint 240, unit 1300 may rotate about axis ax31 (seen in Fig. 2) via bracket 258. Because shaft 212 is 5 times farther away from axis ax31than shaft 246, any translational movement in the Z direction will move handle 152 a distance 5 times greater in the Z direction than instrument 206.

[0247] Components of unit 1300 may define portions of one or more pantograph mechanisms.

[0248] Fig. 14 shows another partial schematic view of armature 209.

[0249] Fig. 14 may show a motion of armature 209 in the Y direction. Unit 1400 may define the parts shown in Fig. 14. A plane in which Unit 1400 is shown moving within in Fig. 14 may define a translation plane. A translational movement in the Y direction from the input end of the translation coordinator may cause the motion shown in Fig. 14. The motion shown in Fig. 14 may schematically show the translational movement from the input end downscaled at the output end.

[0250] The length of shaft 212 may be designated as “A”. The length of a portion of output hinge 252 parallel to shaft 212 may be 1 / 5 the length of shaft 212. The length of the portion may thus be designated as “A / 5”. In this schematic, the ratio 1 / 5 may be the downscaling ratio. Changing the length of shaft 212 with respect to the length of the portion may change the downscaling ratio. The downscaling ratio of 1 / 5 is merely an example illustrated in Fig. 14. The downscaling ration may be 1 / 2, 1 / 3, 1 / 4, 1 / 5, 1 / 7, 1 / 10 or any other suitable ratio.

[0251] In order to effectuate a downscaled movement in instrument 206 in the Y direction a principle is used similar to that as described above. Rotating shaft 212 about joint 226 at angle a may cause handle 152 to move a distance of “B” in the Y direction. This may cause output hinge 252 to be rotated about joint 250 at angle a. Because the moment arm of shaft 212 is 5 times longer than the moment arm of the portion of output hinge 252, instrument 206 may move a distance 1 / 5 of “B”. This distance may thus be designated “B / 5”.

[0252] In order to rotate output hinge 252 at the same angle as shaft 212, a series of parallelograms are used to preserve the angle. When two adjacent corners of a parallelogram are fixed, movement of one of the free corners will cause the other free corner to move through the same angle.

[0253] With respect to motion in the Y direction, shafts 232 and 246, elongated hinge 236, bracket 258 and bar 264 act as fixed objects. Shaft 232 may be integral with elongated hinge 236. Elongated hinge 236 may include joint 238.

[0254] Therefore, rotating shaft 212 about joint 226 at angle a will cause inner arm 1402 to push bellcrank 242. Pushing bellcrank 242 will cause bellcrank 242 to rotate about joint 238 at angle a. Rotating bell crank 242 about joint 238 at angle a will push inner 710. Pushing inner arm 710 will cause output hinge 252 to rotate about joint 250 at angle a. Thus, moving handle 152 a distance “B” in the Y direction will move instrument 206 a distance “B / 5” in the Y direction.

[0255] Components of unit 1400 may define portions of one or more pantograph mechanisms.

[0256] Fig. 15 shows a view of armature 209.

[0257] End cap 210 may be secured to input subassembly 102. End cap 210 may fit into an end of shaft 212. Shaft 212 may be hollow. Portions of linkage 600 may pass through the hollow of shaft 212. Double hinged end cap 214 may fit over another end of shaft 212. Double hinged end cap 214 may include clips 216, through-hole 218, double hinge 220 and joint 226. Clips 216 may receive a screw or bolt through through-hole 218 to tighten double hinged end cap 214 to shaft 212. Joint 226 may rotatably connect double hinged end cap 214 to single hinge 224 of hinged end cap 222. Double hinge 220 may include a joint between double hinged end cap 214 and inner arm 1402.

[0258] Hinged end cap 222 may fit over an end of shaft 232. Hinged end cap 222 may include single hinge 224, clips 228 and through hole 230. Clips 228 may receive a screw or bolt through through-hole 230 to tighten hinged end cap 222 to shaft 232. Shaft 232 may be hollow. Portions of linkage 600 may pass through the hollow of shaft 212. Inner arm 1402 may traverse the hollow of shaft 212.

[0259] Elongated hinge 236 may fit over another end of shaft 232. Elongated hinge 236 may include joint 238 and anchoring joint 240. Joint 238 may rotatably connect elongated hinge 236 to bellcrank 242. Anchoring joint 240 may rotatably connect elongated hinge 236 to bracket 258.

[0260] Bellcrank 242 may be rotatably connected to inner arm 1402 at a joint. Bellcrank 242 may be further connected to inner arm 710 at another joint. Bellcrank 242 may transfer motion from inner arm 1402 in a first direction to inner arm 710 in a second direction perpendicular to the first direction. The first direction may be angularly offset from the second direction.

[0261] Inner arm 710 may traverse a hollow of shaft 246. Linkage 600 may pass through the hollow of shaft 246. Hinged end cap 248 may fit over an end of shaft 246. Hinged end cap 248 may include joint 250. Joint 250 may rotatably connect hinged end cap 248 to output hinge 252. Output hinge 252 may include joint 254. Joint 254 may rotatably connect inner arm 710 to output hinge 252. Output hinge 252 may include cylindrical extension 256. Cylindrical extension 256 may connect to output subassembly 155.

[0262] Leveling bore 276 may be disposed on bracket 258. Bracket 258 may be supported by inserting leveling arm 278 into leveling bore 276. Leveling arm 278 may act as a hinge for bracket 258. Hinge and bracket may also be defined as an array of articulating joints. Alternatively, leveling bore 276 may be disposed on standing arm 280, leveling arm 278 may be integral with bracket 258, and bracket 258 may be supported by inserting leveling arm 278 into leveling bore 276. Bracket 258 may support armature 209 via joint 240 and bar 264. Bar 264 may rotatably connect to ring 270. Ring 270 may surround shaft 246. Ring 270 may include clips 272 and through-hole 274. Clips 272 may receive a screw or bolt through through-hole 274 to tighten ring 270 to shaft 246. Moving shaft 212 in an X direction (see Fig. 13) may cause shaft 246 to move in an X direction. Joints 262 and 268 may allow shaft 246 to move relative to bracket 258 while connected to ring 270 and bar 264.

[0263] A translational movement may move input subassembly 102 along a first three- dimensional path. Armature 209 may transfer and downscale the translational movement to output subassembly 155 such that output subassembly 155 moves along a second three- dimensional path. The second three-dimensional path may be identically-shaped but proportionately smaller.

[0264] Fig. 16 shows an exploded view of armature 209.

[0265] Elongated hinge 236 may rotatable connect to hinged end cap 244 via joint 238. Hinged end cap 244 may fit over an end of shaft 246.

[0266] Inner arm 710 may include two or more sub-arms 1602 and 1612. Sub-arm 1602 may include offset arm 1604, slot 1606 and joint 1608. Sub-arm 1612 may include offset arm 1610, joint 1614 and slot 1616. Sub-arm 1602 may be substantially the same as sub-arm 1612. Sub-arm 1602 may connect to sub-arm 1612. A screw or bolt may be inserted through slot 1606 and connect to joint 1614. A screw or bolt may be inserted through slot 1616 and connect to joint 1608. Moving sub-arm 1602 relative to sub-arm 1612 may adjust a length of inner arm 710. Inner arm 710 may be adjusted to fit within shaft 246. Shaft 246 may bereplaced with longer or shorter shafts in order to lengthen or shorten the distance between bracket 258 and surgical site 4.

[0267] Inner arm 1402 may similarly include two or more sub-arms. In this manner a length of inner arm 1402 may be adjustable as well.

[0268] Bracket 258 may include balance mechanism 1600. In illustrated Fig. 16 balance mechanism 1600 includes torsion spring 1618 and spring holder 1620. Balance mechanism 1600 may include other mechanisms for counterbalancing device 100.

[0269] Fig. 17 shows a cross section of armature 209.

[0270] Joint 1702 may rotatably connect double hinged end cap 214 to inner arm 1402. Joint 1704 may rotatably connect inner arm 1402 to elongated hinge 236. Joint 1706 may rotatably connect bellcrank 242 to inner arm 710. Bore 1708 may receive a screw or bolt through through-hole 114 to connect output subassembly 155 to cylindrical extension 256.

[0271] In illustrated Fig. 17 balance mechanism 1600 includes torsion spring 1618. Torsion spring 1618 may be disposed inside leveling bore 276. One end of torsion spring 1618 may be connected to leveling bore 276 and bracket 258. The other end of torsion spring 1618 may be connected to leveling arm 278 via a screw. The screw may be inserted through hole 1710 and screw into torsion spring 1618 and leveling arm 278 to connect torsion spring 1618 to leveling arm 278. Torsion spring 1618 may be able to provide a force that at least partly counters the amount of torque applied by the weight of device 100. The force may allow torsion spring 1618 to suspend device 100 in a rest position - e.g. such that surgeon 2 can release device 100 without it falling onto the patient. For example, this rest position may be substantially parallel to the ground.

[0272] Any other suitable means for suspending the device generally parallel to the ground when at rest may be used.

[0273] Fig. 18 shows apparatus 1810 being used by a surgeon 2 to perform microsurgery on a patient 1. In the example shown, device 1800 is shown being used to manipulate a needle 5 and suture 6 to repair (e.g. by stitching) a blood vessel 7 - e.g. to perform an anastomosis. A portion of device 1800 may be suspended, via anchored base 1802, over surgical site 4.

[0274] While one device 1800 and one surgeon 2 are shown, it is contemplated that a given surgeon 2 may operate two devices 1800 - e.g. with the output assemblies of the devices (described hereinbelow) converging at site 4. For example, the surgeon may operate onedevice 1800 with one hand, and another device 1800 with the other hand. Furthermore, two surgeons may each operate one or more devices 1800 - e.g. standing on opposite sides of patient 1, with the output assemblies of the devices converging at site 4.

[0275] Device 1800 may include a balance mechanism 1820.

[0276] Fig. 19 shows apparatus 1810 in more detail. Apparatus 1810 may include device 1800 and stand 1801. Device 1800 may include rotation coordinator 1901 and translation coordinator 1900. Rotation coordinator 1901 and translation coordinator 1900 may include one or more of input subassembly 1902, output subassembly 1904, armature 1906 and linkage 1908. Stand 1801 may include anchored base 1802.

[0277] Input subassembly 1902 may include one or more of handle 1926, actuator 1927 and / or input gimbal 1903. Handle 1926 and / or actuator 1927 may be mounted on input gimbal 1903.

[0278] Input gimbal 1903 may include one or more of support arm 1910, half-housing 1912, threaded protrusions 1914 and 1916, through-hole 1918, handle wheel 1920, hinges 1922, through-holes 1924, locking shaft 1930, linkage inlet 1932, wheel base 1934, through-holes 1936, and wheel 1938.

[0279] Handle 1926 may include holes 1928.

[0280] Actuator 1927 may be integrated into handle 1926. Actuator 1927 may be distinct and separate from handle 1926 as discussed above regarding handle 152 and actuator 153.

[0281] Output subassembly 1904 may include one or more of holder 1963, effector 1972 and output gimbal 1905.

[0282] Output gimbal 1905 may include one or more of support arm 1952, half-housing 1954, threaded protrusion 1956, threaded protrusions 1958, through-hole 1960, instrument wheel 1962, oblique shafts 1966, locking shafts 1968, through-hole 1970, through-holes 1978, wheel base 1980, wheel 1982, track 1984 and oblique shaft 1986.

[0283] Holder 1963 may support instrument 1964.

[0284] Effector 1972 may include through-hole 1974, and rod 1976,

[0285] Armature 1906 may include one or more of angled bracket 1940, bearing 1942, shaft 1944, lower pinion gear 1946, upper pinion gear 1947, bearing 1948, sliding block 1950,angled bracket 1988, through-hole 1990, shaft 1992, linkage inlet 1994, sliding block 1996, through-hole 1998, output rack 2000, teeth 2002, input rack 2004 and teeth 2006.

[0286] One or more of leveling arm 2008, standing arm 2010 and spherical bearing 2012 may be include in device 1800. One or more of leveling arm 2008, standing arm 2010 and spherical bearing 2012 may be include in stand 1801. A connection between device 1800 and stand 1801 may be between armature 1906 and leveling arm 2008, leveling arm 2008 and standing arm 2010, standing arm 2010 and spherical bearing 2012, and spherical bearing 2012 and anchored base 1802. Anchored base 1802 may define a hinge at a top portion thereof for spherical bearing 2012.

[0287] Linkage 1908 may include one or more of first Bowden device 2014, inner sheath 2016, second Bowden device 2018, inner sheath 2020, third Bowden device 2022, inner sheath 2024 and inner wire 2026.

[0288] Input subassembly 1902 may be substantially similar with handle rotator 318 and like parts will not be explained.

[0289] Support arm 1910 may be secured to wheel base 1934. Wheel base 1934 may include through-holes 1936. Support arm 1910 may include through-holes which correspond with through-holes 1936. Screws, bolts or any other suitable fasteners may be inserted into through-holes 1936 to secure support arm 1910 to wheel base 1934.

[0290] Wheel base 1934 may include wheel 1938. Wheel 1938 may be connected to wheel 1982 via second Bowden device 2018. Second Bowden device 2018 may be connected at one end to wheel 1938 and at an opposite end to wheel 1982. The connection between second Bowden device 2018 and wheel 1934 and 1982 may be substantially the same as the connection between second Bowden device 604 and wheels 312 and 706 discussed above (e.g. via oblique shaft 1986).

[0291] Wheel base 1934 and wheel 1938 may include a through-hole through a central axis of wheel 1938. A screw, bolt or other suitable fastener may be inserted into the through-hole to secure wheel base 1934 and wheel 1938 to angled bracket 1940.

[0292] Angled bracket 1940 may include linkage inlets for inner sheath 2020. Angled bracket 1940 may include cutouts sized and shaped to accommodate bearings 1942 and 1948 respectively. Bearings 1942 and 1948 and shaft 1944 may support a compound gear. The compound gear may include lower pinion gear 1946 and upper pinion gear 1947. Bearings1942 and 1948 and shaft 1944 may allow the compound gear to rotate relative to angled bracket 1940.

[0293] Sliding plate 1950 may be secured to an inner portion of angled bracket 1940. Sliding plate 1950 may facilitate sliding between angled bracket 1940 and armature 1906.

[0294] Output subassembly 1904 may be substantially similar with holder rotator 185 and like parts will not be explained.

[0295] Support arm 1952 may be secured to wheel base 1980. Support arm 1952 may include through-holes 1978. Wheel base 1980 may include through-holes which correspond with through-holes 1978. Screws, bolts or any other suitable fasteners may be inserted into through-holes 1978 to secure support arm 1952 to wheel base 1980. Wheel base 1980 may include wheel 1982.

[0296] Instrument wheels 1920 and 1962 may include one or two oblique shafts 1966 and one or two locking shafts 1930 and 1968 respectively. As discussed above inner wire of first Bowden device 2014 may be locked to instrument wheels 1920 and 1962 in two locations. One location may correspond with one oblique shaft 1966 and one locking shaft 1968. The other location may correspond to a second of oblique shaft 1966 and a second of locking shaft 1968.

[0297] Wheel base 1980 and wheel 1982 may include a through-hole through a central axis of wheel 1982. A screw, bolt or other suitable fastener may be inserted into the through-hole to secure wheel base 1980 and wheel 1982 to angled bracket 1988.

[0298] Angled bracket 1988 may include linkage inlets 1994 for inner sheath 2020. Angled bracket 1940 may include through-hole 1990. Shaft 1992 may be inserted into through-hole 1990 and through output rack 2000. Translational movement of output rack 2000 may translate output subassembly 1904 via shaft 1992.

[0299] Sliding block 1996 may be secured to an inner portion of angled bracket 1940 via through-hole 1998 and a screw or bolt. Sliding block 1996 may facilitate sliding between angled bracket 1988 and armature 1906.

[0300] Input rack 2004 may be secured to leveling arm 2008. Input rack 2004 may be stationary with respect to handle 1926, when handle 1926 is moved in the X direction. Output rack 2000 may be non- stationary with respect to handle 1926, when handle 1926 is movedin the X direction. Lower pinion gear 1946 may engage teeth 2006. Upper pinion gear 1947 may engage teeth 2002.

[0301] Instrument 1964 may move the same distance in the X direction as output rack 2000. Instrument 1964 may be coupled to output rack 2000 via instrument wheel 1962, support arm 1952, wheel base 1980, angled bracket 1988 and shaft 1992.

[0302] Moving handle 1926 a first distance in the +X direction may cause upper pinion gear 1947 to move the first distance in the +X direction as well. Moving upper pinion gear 1947 the first distance may cause output rack 2000 to move the first distance in the +X direction due to its engagement with upper pinion gear 1947 via teeth 2002. Moving handle 1926 in the +X direction may cause lower pinion gear 1946 to rotate counterclockwise about shaft 1944 due to its engagement with teeth 2006. Rotating lower pinion gear 1946 may cause upper pinion gear 1947 to rotate counterclockwise due to being part of the compound gear. Rotating lower pinion gear 1947 counterclockwise may move output rack 2000 in the -X direction a second distance due to its engagement with counterclockwise rotating lower pinion gear 1947 via teeth 2002. Moving output rack 2000 may move instrument 1964.

[0303] Therefore, moving handle 1926 the first distance in the +X direction may move instrument 1964 the first distance in the +X direction plus the second distance in the -X direction. The ratio of the second distance to the first distance may depend on the sizing of lower and upper pinion gears 1946 and 1947. In the illustrated apparatus 1800 the ratio of teeth between upper pinion gear 1947 and lower pinion gear 1946 is 4:5. Therefore, the total distance instrument 1964 moves is 1 (the first distance) minus 4 / 5 (the second distance) or 1 / 5 the movement of handle 1926.

[0304] The ratio may coincide with the downscaling ratio. The downscaling ratio may be 1 / 2, 1 / 3, 1 / 4, 1 / 5, 1 / 7, 1 / 10 or any other suitable ratio. The downscaling ratio may be adjustable by replacing the compound gear with a different compound gear containing a different ratio of teeth between the lower pinion gear and the upper pinion gear.

[0305] In illustrated device 1800 the downscaling in the X direction is accomplished via rack and pinion gears. It is also contemplated to achieve the downscaling in the X direction via a hydraulic mechanism. For example, a handle may push on a piston at one end of hydraulic mechanism a first distance and hydraulic mechanism pushes a second piston out at a second end of hydraulic mechanism a second distance, the second distance being asmaller ratio than the first distance. The second piston may push the tool the second distance. Any other suitable electrical or mechanical downscaling mechanisms are contemplated.

[0306] In illustrated device 1800 the downscaling in the Y and Z directions is accomplished via spherical bearing 2012.

[0307] Device 1800 may duplicate rotational movements of handle 1926 to instrument 1964 in angular directions. The angular directions may include one or more of pitch, yaw, and roll directions. Device 1800 may downsize translation movements of handle 1926 to instrument 1964 in the X, Y and Z directions.

[0308] Device 1800 may include a spherical coordinate system. The spherical coordinate system may be defined similar to the spherical coordinate system of device 100 discussed above. The spherical coordinate system may include a center. The center of the coordinate system may define an origin. The origin may be the point in which the control point completely coincides with the operating point. In illustrated device 1800 the origin may be a center of spherical bearing 2012.

[0309] In illustrated Fig. 19 spherical bearing is used for two dimensions of translational motion about the origin. Other devices and / or mechanisms may similarly be used to effectuate translational motion about the origin. The other devices and / or mechanism may be chosen and adjusted such that the location of the origin may be in a specific location. The specific location may be oriented such that it is adjacent to or close to the surgical site.

[0310] Fig. 20 shows another view of device 1800. Angled bracket 1940 and 1988 may include through-holes 2050 and 1998 respectively. Screws or bolts may be inserted into through-holes 2050 and 1998 to secure angled brackets 1940 and 1988 to sliding blocks 1950 and 1996 respectively.

[0311] Angled bracket 1940 may include linkage inlets 2052.

[0312] Fig. 21 shows an exploded view of apparatus 1810. Instrument wheel 1962 may include holder 1963. Holder 1963 may include instrument aperture 2102. Instrument aperture 2102 may be sized to receive instrument 1964.

[0313] First Bowden device 2014 may include inner wire 2104. Second Bowden device 2018 may include inner wire 2106.

[0314] Sliding blocks 1950 and 1996 may include through-holes 2108 and 2110 respectively. Screws or bolts may be inserted into through-holes 2050, 1998, 2108 and 2110 to secure angled brackets 1940 and 1988 to sliding blocks 1950 and 1996 respectively.

[0315] Balance mechanism 1820 may include counterweight 2112. Counterweight 2112 may be able to provide a force that at least partly counters the weight of device 1800. The force may allow counterweight 2112 to suspend device 1800 in a rest position - e.g. such that surgeon 2 can release device 1800 without it falling onto the patient. For example, this rest position may be substantially parallel to the ground. Alternatively, counterweight 2112 may weigh more than device 1800 such that when surgeon 2 releases device 1800, device 1800 is lifted up and away from patient 1.

[0316] Counterweight 2112 may include a handle such that when the handle is cranked counterweight 2112 may be moved along a rod in the X direction. Moving counterweight 2112 along the rod in the X direction may adjust a torque applied to device 1800. In this manner the balancing of device 1800 may be selectable by surgeon 2.

[0317] Any other suitable means for suspending the device generally parallel to the ground when at rest may be used.

[0318] Fig. 22 shows another view of apparatus 1810. 2202 may indicate motion of handle 1926 in the +X direction. 2204 may indicate motion of handle 1926 in the -X direction. 2206 may indicate motion of handle 1926 in the +Y direction. 2208 may indicate motion of handle 1926 in the -Y direction. 2210 may indicate motion of handle 1926 in the +Z direction. 2212 may indicate motion of handle in the -Z direction. 2214 may indicate motion of instrument 1964 in the +X direction. 2216 may indicate motion of instrument 1964 in the -X direction. 2218 may indicate motion of instrument 1964 in the +Y direction. 2220 may indicate motion of instrument 1964 in the -Y direction. 2222 may indicate motion of instrument 1964 in the +Z direction. 2224 may indicate motion of instrument 1964 in the -Z direction. The motion of instrument 1964 may be a ratio of the motion of handle 1926. The ratio may be the downscaling ratio.

[0319] Fig. 23 shows portions of device 1800 being moved in the +X direction.

[0320] Fig. 24 shows device 1800 rotated about a central axis of spherical bearing 2012 parallel with the X-axis. This rotation may be considered a roll rotation. Because handle 1926 and instrument 1964 are oriented in the same direction with respect to leveling arm2008, rotating handle 1926, and thereby leveling arm 2008, in a roll rotation about spherical bearing 2012 will impart a synchronous roll rotation to instrument 1964.

[0321] Fig. 25 shows device 1800 translated in a +Z direction. As described above with reference to Fig. 13, the longer moment arm of handle 1926 moves handle 1926 further in the +Z direction with respect to instrument 1964. The ratio between moment arms may define the ratio of distance moved between handle 1926 and instrument 1964. The ratio may be the downscaling ratio. The ratio may change as handle 1926 is moved along the X axis, however due to the small size of the surgical site, the ratio may change minimally and have little practical effect on surgeon 2.

[0322] Translating handle 1926 in the Y-direction may cause instrument 1964 to move the Y-direction in a similar manner as described above with regards to translational movement in the Z-direction.

[0323] Fig. 26 shows device 1800 with handle 1926 rotated about a central axis of wheel 1938 parallel with the Z-direction. This rotation may be considered a yaw rotation. Rotating handle 1926 in this manner may cause wheel base 1934 and wheel 1938 to rotate. Rotating wheel 1938 may cause inner wire 2106 to rotate wheel 1982. Rotating wheel 1982 may cause output subassembly 1904 to rotate as shown. As such rotational synchroneity through a yaw rotation may be maintained.

[0324] Fig. 27 shows device 1800 with handle 1926 rotated about a central axis of handle wheel 1920. This rotation may be considered a pitch rotation. Rotating handle 1926 in this manner may cause handle wheel 1920 to rotate. Rotating handle wheel 1920 may cause inner wire 2104 to rotate instrument wheel 1962. Rotating wheel 1962 may cause instrument 1964 to rotate as shown. As such rotational synchroneity through a pitch rotation may be maintained.

[0325] Fig. 28 shows a manipulation of handle 1926. The resulting manipulation of handle 1926 may cause a similar manipulation of instrument 1964. Squeezing handle 1926 may pull on inner wire 2026 to squeeze instrument 1964 in a similar manner as discussed above with reference to Figs. 3, 4 and 9.

[0326] Reference is again made to Figs. 1-28. There is therefore provided, in accordance with some implementations, apparatus comprising a device (e.g. device 100 and / or 1800) for use with a microsurgical instrument (e.g. instrument 206 and / or 1964), the device comprising a rotation coordinator - e.g. rotation coordinator 101 and / or 1901), and atranslation coordinator (e.g. translation coordinator 208 and / or 1900). The rotation coordinator may comprise an input subassembly (e.g. input subassembly 102 and / or 1902); an output subassembly (e.g. output subassembly 155 and / or 1904; and / or a linkage (e.g. linkage 600 and / or 1908) therebetween. The input subassembly is mounted on the translation coordinator, and may comprise a handle (e.g. handle 152 and / or 1926); an actuator (e.g. actuator 153 and / or 1927); and an input gimbal (e.g. input gimbal 103 and / or 1903) on which the handle and the actuator are mounted. The output subassembly is mounted on the translation coordinator, and may comprise a holder (e.g. holder 207 and / or 1963) configured to hold the instrument; an effector (e.g. effector 202 and / or 1972) operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal (e.g. output gimbal 156 and / or 1905) on which the holder and the effector are mounted. The linkage operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle, and / or provides a rotation synchronization between the handle and the holder. The translation coordinator, which may comprise an armature (e.g. armature 209 and / or 1906) that mechanically connects the input subassembly to the output subassembly, is configured to transmit and downscale translational movement of the input subassembly into translational movement of the output subassembly.

[0327] Reference is again made to Figs. 1-28. There is therefore provided, in accordance with some implementations, apparatus comprising a device (e.g. device 100 and / or 1800) for use with a microsurgical instrument (e.g. instrument 206 and / or 1964), the device comprising a translation coordinator (e.g. translation coordinator 208 and / or 1900); and a rotation coordinator (e.g. rotation coordinator 101 and / or 1901). The translation coordinator may comprise an input end (e.g. end cap 210 and / or angled bracket 1940), an output end (e.g. cylindrical extension 256 and / or angled bracket 1988), a pantograph (e.g. armature 209 and / or 1906), and a bracket (e.g. bracket 258 and / or leveling arm 2008). The output end may be movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable. The pantograph may be configured to transmit and downscale in-plane translational movement of the input end into in-plane translational movement of the output end. The bracket may hingedly mount the translation coordinator for tilting of the translation plane. The rotation coordinator may comprise an input subassembly (e.g. input subassembly 102 and / or 1902); an output subassembly (e.g. output subassembly 155 and / or 1904); and / or a linkage (e.g. linkage 600 and / or 1908) therebetween. The input subassembly is mounted on the input end,and may comprise a handle (e.g. handle 152 and / or 1926); an actuator (e.g. actuator 153 and / or 1927); and an input gimbal (e.g. input gimbal 103 and / or 1903) on which the handle and the actuator are mounted. The output subassembly is mounted on the output end, and may comprise a holder (e.g. holder 207 and / or 1963) configured to hold the instrument; an effector (e.g. effector 202 and / or 1972) operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal (e.g. output gimbal 156 and / or 1905) on which the holder and the effector are mounted. The linkage operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle. The linkage may provide a rotation synchronization between the handle and the holder.

[0328] Reference is again made to Figs. 1-28. There is therefore provided, in accordance with some implementations, apparatus comprising a device (e.g. device 100 and / or 1800) for use with a microsurgical instrument (e.g. instrument 206 and / or 1964), the device comprising a translation coordinator (e.g. translation coordinator 208 and / or 1900) and a rotation coordinator (e.g. rotation coordinator 101 and / or 1901). The translation coordinator may comprise an input end (e.g. end cap 210 and / or angled bracket 1940), an output end (e.g. cylindrical extension 256 and / or angled bracket 1988), an armature (e.g. armature 209 and / or 1906), and a hinge (e.g. leveling arm 278 and / or anchored base 1802). The armature may couple to the hinge. The armature may mechanically connect the input end to the output end in a manner that defines an origin of the device, and transmits and downscales translational movement of the input end with respect to the origin into translational movement of the out end with respect to the origin. The rotation coordinator may comprise an input subassembly (e.g. input subassembly 102 and / or 1902); an output subassembly (e.g. output subassembly 155 and / or 1904); and / or a linkage (e.g. linkage 600 and / or 1908) therebetween. The input subassembly is mounted on the input end, and may comprise a handle (e.g. handle 152 and / or 1926); an actuator (e.g. actuator 153 and / or 1927); and an input gimbal (e.g. input gimbal 103 and / or 1903) on which the handle and the actuator are mounted. The output subassembly is mounted on the output end, and may comprise a holder (e.g. holder 207 and / or 1963) configured to hold the instrument; an effector (e.g. effector 202 and / or 1972) operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal (e.g. output gimbal 156 and / or 1905) on which the holder and the effector are mounted. The linkage operatively couples the input gimbal to the outputgimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0329] Reference is again made to Figs. 1-28. There is therefore provided, in accordance with some implementations, apparatus comprising a device (e.g. device 100 and / or 1800) for use with a microsurgical instrument (e.g. instrument 206 and / or 1964), the device comprising a rotation coordinator (e.g. rotation coordinator 101 and / or 1901) and a translation coordinator (e.g. translation coordinator 208 and / or 1900). The rotation coordinator may comprise an input subassembly (e.g. input subassembly 102 and / or 1902); an output subassembly (e.g. output subassembly 155 and / or 1904); and / or a linkage (e.g. linkage 600 and / or 1908) therebetween. The input subassembly is mounted on the input end, and may comprise a handle (e.g. handle 152 and / or 1926); and an input gimbal (e.g. input gimbal 103 and / or 1903) on which the handle is mounted. The output subassembly may comprise a holder (e.g. holder 207 and / or 1963) configured to hold the instrument; and an output gimbal (e.g. output gimbal 156 and / or 1905) on which the holder is mounted. The linkage operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder. The translation coordinator may comprise an armature (e.g. armature 209 and / or 1906), and a hinge (e.g. leveling arm 278 and / or anchored base 1802). The armature may couple to the hinge. The armature may mechanically connect the input end to the output end in a manner that defines an origin of the device, and transmits and downscales translational movement of the input end with respect to the origin into translational movement of the out end with respect to the origin.

[0330] The described elements may be made from plastic, stainless steel, iron alloys, metals, carbon fibers or any other suitable material or combination of materials.

[0331] All through-holes and threaded protrusions may be internally threaded to receive screws, bolts or any other suitable fastener. Other means of fastening parts are contemplated such as by welding, using adhesives, riveting, by brazing or any other suitable fasteners.

[0332] The described systems, apparatuses, devices, methods, etc. should not be construed as limiting in any way. Instead, the present disclosure is directed toward all novel and nonobvious features and aspects of the various disclosed implementations and applications, alone and in various combinations and sub-combinations with one another. The disclosed systems, apparatuses, devices, methods, etc. are not limited to any specific aspect, feature, or combination thereof, nor do the disclosed systems, apparatuses, devices, methods, etc. require that any one or more specific advantages be present or problems be solved.

[0333] Although the operations of some of the disclosed methods are described in a particular, sequential order for convenient presentation, it should be understood that this manner of description encompasses rearrangement, unless a particular ordering is required by specific language set forth herein. For example, operations described sequentially can in some cases be rearranged or performed concurrently. Moreover, for the sake of simplicity, the attached figures may not show the various ways in which the disclosed systems, apparatuses, devices, methods, etc. can be used in conjunction with other systems, apparatuses, devices, methods, etc.

[0334] Example Implementations (some non-limiting examples of the concepts herein are recited below):

[0335] Example 1. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a rotation coordinator, comprising: an input subassembly, comprising: a handle; an actuator; and / or an input gimbal on which the handle and the actuator are mounted; an output subassembly, comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and / or an output gimbal on which the holder and the effector are mounted; and / or a linkage that operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle; and / or a translation coordinator on which the input subassembly and the output subassembly are mounted, the translation coordinator: comprising an armature that mechanically connects the input subassembly to the output subassembly; and / or being configured to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly.

[0336] Example 2. The apparatus according to example 1, wherein the translation coordinator is configured to transmit and downscale translational movement of the input subassembly along a first vector to become downscaled translational movement of the output subassembly along a second vector that is parallel with, and shorter than, the first vector.

[0337] Example 3. The apparatus according to any one of examples 1-2, wherein the translation coordinator is configured to transmit and downscale translational movement of the input subassembly along a first three-dimensional path to become downscaled translational movement of the output subassembly along a second three-dimensional path, the second three-dimensional path being identically-shaped but smaller-sized than the first three-dimensional path.

[0338] Example 4. The apparatus according to any one of examples 1-3, wherein the rotation coordinator is configured such that rotational movement of the holder mimics rotational movement of the handle.

[0339] Example 5. The apparatus according to any one of examples 1-4, wherein the rotation coordinator is configured to synchronize rotational movement between the holder and the handle.

[0340] Example 6. The apparatus according to any one of examples 1-5, wherein transmitting rotational movement of the holder to the handle via the linkage maintains the orientation of the holder relative to the handle.

[0341] Example 7. The apparatus according to any one of examples 1-6, wherein the handle defines a handle-pointing direction, the holder defines an instrument-pointing direction, and the rotation coordinator is configured to maintain the instrument-pointing direction parallel with the handle -pointing direction.

[0342] Example 8. The apparatus according to any one of examples 1-7, wherein the linkage is an electronic or electromechanical linkage.

[0343] Example 9. The apparatus according to any one of examples 1-8, wherein the effector is mechanically operable via actuation of the actuator.

[0344] Example 10. The apparatus according to any one of examples 1-9, wherein the effector is electronically operable via actuation of the actuator.

[0345] Example 11. The apparatus according to any one of examples 1-10, further comprising the instrument.

[0346] Example 12. The apparatus according to example 11, wherein the instrument comprises forceps.

[0347] Example 13. The apparatus according to example 11, wherein the instrument is selected from the group consisting of: scalpel, forceps, scissors, clamp, needle, suture, clips, and blade.

[0348] Example 14. The apparatus according to any one of examples 1-13, wherein the linkage is a mechanical linkage.

[0349] Example 15. The apparatus according to example 14, wherein the linkage comprises one or more Bowden devices.

[0350] Example 16. The apparatus according to any one of examples 1-15, wherein the handle is elongate along a handle axis, the instrument is elongate along an instrument axis, and the rotation coordinator is configured to maintain the instrument axis parallel with the handle axis during operation of the device.

[0351] Example 17. The apparatus according to example 16, wherein the rotation coordinator is configured to synchronize a rotation of the handle about the handle axis with a rotation of the instrument about the instrument axis.

[0352] Example 18. The apparatus according to any one of examples 1-17, wherein the device comprises a bracket for hingedly mounting the device.

[0353] Example 19. The apparatus according to example 18, further comprising a bearing on which the bracket is hingedly mountable.

[0354] Example 20. The apparatus according to any one of examples 1-19, wherein: the input gimbal includes at least one input wheel; the output gimbal includes at least one output wheel; and / or the rotation coordinator transmits rotational movement from the at least one input wheel to the at least one output wheel.

[0355] Example 21. The apparatus according to example 20, wherein: the at least one input wheel consists of three input wheels; the at least one output wheel consists of three output wheels; and / or the rotation coordinator transmits the rotational movement from the three input wheels to a corresponding one of the three output wheels.

[0356] Example 22. The apparatus according to example 21, wherein:each of the input wheels include a central axis; and / or the rotational movement includes rotation of the input wheels about the central axes of each respective input wheel.

[0357] Example 23. The apparatus according to example 21, wherein the three input wheels are concatenated and the three output wheels are concatenated.

[0358] Example 24. The apparatus according to example 21, wherein: the three input wheels comprise a first input wheel, a second input wheel and a handle input wheel; the three output wheels comprise a first output wheel, a second output wheel, and a holder output wheel; each of the three input wheels and three output wheels include a housing surrounding the respective wheel; the housing of the second input wheel is connected to the first input wheel such that the housing of the second input wheel and the first input wheel rotate in tandem; the housing of the handle input wheel is connected to the second input wheel such that the housing of the handle input wheel and the second input wheel rotate in tandem; the housing of the second output wheel is connected to the first output wheel such that the housing of the second output wheel and the first output wheel rotate in tandem; and / or the housing of the holder output wheel is connected to the second output wheel such that the housing of the holder output wheel and the second output wheel rotate in tandem.

[0359] Example 25. The apparatus according to example 24, wherein the holder output wheel holds the instrument such that a tip of the instrument remains at a substantially fixed point during the rotational movement.

[0360] Example 26. The apparatus according to example 21, wherein: each of the three input wheels rotate, at a respective fixed radius, about a control point along a first curved virtual surface; each of the three output wheels rotate, at the fixed radii corresponding to the three input wheels, about an operation point along a second curved virtual surface; and / or the first and second curved virtual surfaces are hemispherical and congruent.

[0361] Example 27. The apparatus according to example 26, wherein rotating one of the three input wheels to a location on the first curved virtual surface, rotates a corresponding one of the three output wheels to a location on the second virtual curved surface which corresponds to the location on the first curved virtual surface.

[0362] Example 28. The apparatus according to example 20, wherein: one of the three output wheels holds the instrument such that a tip of the instrument is located at an operation point; and / or the tip is coincident with the operation point during rotation of any of the three output wheels.

[0363] Example 29. The apparatus according to example 20, wherein: the at least one input wheel is connected to the armature via a first arm; and / or the at least one output wheel is connected to the armature via a second arm.

[0364] Example 30. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a rotation coordinator, comprising: an input subassembly, comprising: a handle; an actuator; and / or an input gimbal on which the handle and the actuator are mounted; an output subassembly, comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and / or an output gimbal on which the holder and the effector are mounted; and / or a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder; and / or a translation coordinator on which the input subassembly and the output subassembly are mounted, the translation coordinator being configured to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly.

[0365] Example 31. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end; an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end, and / or a bracket for hingedly mounting the translation coordinator for tilting of the translation plane; and / or a rotation coordinator, comprising: an input subassembly, mounted on the input end, and comprising: a handle; an actuator; and / or an input gimbal on which the handle and the actuator are mounted; an output subassembly, mounted on the output end, and comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; an output gimbal on which the holder and the effector are mounted; and / or a linkage that operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle.

[0366] Example 32. The apparatus according to example 31, wherein the pantograph accounts for translational movement along two axes.

[0367] Example 33. The apparatus according to any one of examples 31-32, wherein the pantograph includes a parallelogram.

[0368] Example 34. The apparatus according to any one of examples 31-33, wherein the pantograph includes two parallelograms.

[0369] Example 35. The apparatus according to any one of examples 31-34, further comprising a stand on which the bracket is mountable.

[0370] Example 36. The apparatus according to example 35, wherein the bracket is rotatable about a central axis of a bearing of the stand.

[0371] Example 37. The apparatus according to example 35, wherein the bracket is rotatable about a bearing of the stand along two axes.

[0372] Example 38. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end; an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end; and / or a bracket for: hingedly mounting the translation coordinator; and / or tilting of the translation plane; and / or a rotation coordinator, comprising: an input subassembly, mounted on the input end, and comprising: a handle, an actuator and an input gimbal on which the handle and the actuator are mounted; an output subassembly, mounted on the output end, and comprising: a holder configured to hold the instrument, an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; an output gimbal on which the holder and the effector are mounted; and / or a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0373] Example 39. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising:a translation coordinator, comprising: an input end; an output end; a hinge; an armature, coupled to the hinge and mechanically connecting the input end to the output end in a manner that: defines an origin of the device; and / or transmits and downscales translational movement of the input end with respect to the origin to become downscaled translational movement of the output end with respect to the origin; and / or a rotation coordinator, comprising: an input subassembly, mounted at the input end, and comprising: a handle; an actuator; and / or an input gimbal on which the handle and the actuator are mounted; an output subassembly, mounted at the output end, and comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the microsurgical instrument held by the holder; an output gimbal on which the holder and the effector are mounted; and / or a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

[0374] Example 40. The apparatus according to example 39, wherein the translational movement of the device is confined to a spherical coordinate system.

[0375] Example 41. The apparatus according to example 40, wherein the origin is located at a center of the spherical coordinate system.

[0376] Example 42. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a rotation coordinator, comprising: an input subassembly, comprising: a handle; and / oran input gimbal on which the handle is mounted; an output subassembly, comprising: a holder configured to hold the instrument; and / or an output gimbal on which the holder is mounted; and / or a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder; and / or a translation coordinator, comprising: a hinge; and / or an armature, coupled to the hinge and mechanically connecting the input subassembly to the output subassembly in a manner that: defines an origin of the device; and / or transmits and downscales translational movement of the input subassembly with respect to the origin to become downscaled translational movement of the output subassembly with respect to the origin.

[0377] Example 43. The apparatus according to example 42, wherein the device further comprises: an actuator; and / or an effector, at the output subassembly, the effector being operable via actuation of the actuator to manipulate the instrument held by the holder.

[0378] Example 44. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end; an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end; and / or a bracket for hingedly mounting the pantograph for tilting of the translation plane; and / or a rotation coordinator, comprising:an input subassembly, mounted on the input end, and comprising: a first input-rotator, a second input-rotator, and a third input-rotator, each comprising a house and a wheel that is rotationally mounted to the respective house to define a rotation axis of the respective wheel, the first input-rotator, the second input-rotator, and the third input-rotator being connected in series such that: the house of the first input-rotator is attached to the wheel of the second input-rotator such that: the first input-rotator is revolvable about the rotation axis of the second input-rotator; and / or the rotation axis of the wheel of the second inputrotator is angularly offset from the rotation axis of the wheel of the first input-rotator; the house of the second input-rotator is attached to the wheel of the third input-rotator such that: the second input-rotator is revolvable about the rotation axis of the third input-rotator; and / or the rotation axis of the wheel of the third inputrotator is angularly offset from the rotation axis of the wheel of the second input-rotator; a handle, connected to the wheel of the first input-rotator; and / or an actuator; and / or an output subassembly, mounted on the output end, and comprising: a first output-rotator, a second output-rotator, and a third outputrotator, each comprising a house and a wheel that is rotationally mounted to the respective house to define a respective rotation axis of the wheel, the first output-rotator, the second output-rotator, and the third output-rotator being connected in series such that: the wheel of the first output-rotator is attached to the house of the second output-rotator, and is operably coupled to the third input-rotator, such that: rotation of the wheel of the third input-rotator rotates the wheel of the first output-rotator, which revolves thesecond output-rotator about the rotation axis of the first output-rotator; and / or the rotation axis of the wheel of the second outputrotator is angularly offset from the rotation axis of the wheel of the first output-rotator; the wheel of the second output-rotator is attached to the house of the third output-rotator, and is operably coupled to the second input-rotator such that: rotation of the wheel of the second input-rotator rotates the wheel of the second output-rotator, which revolves the third output-rotator about the rotation axis of the second output-rotator; and / or the rotation axis of the wheel of the third outputrotator is angularly offset from the rotation axis of the wheel of the second output-rotator; and / or the wheel of the third output-rotator is operably coupled to the first input-rotator such that rotation of the wheel of the first input-rotator rotates the wheel of the third output-rotator; a holder, connected to the wheel of the third output-rotator, and configured to hold the instrument; and / or an effector, operable via actuation of the actuator to manipulate the instrument held by the holder.

[0379] Example 45. The apparatus according to example 44, wherein the holder is configured to hold the instrument along an instrument axis that is coincident with the rotation axis of the wheel of the third output-rotator.

[0380] Example 46. The apparatus according to any one of examples 44-45, wherein the handle is elongate and defines a handle axis that is coincident with the rotation axis of the wheel of the first input-rotator.

[0381] Example 47. The apparatus according to any one of examples 44-46, wherein the input and output ends are translationally movable along two axes within the translation plane.

[0382] Example 48. The apparatus according to any one of examples 44-47, wherein the rotation axis of the wheel of the third input-rotator is perpendicular to the translation plane.

[0383] Example 49. The apparatus according to any one of examples 44-48, wherein the device comprises a rod for hingedly mounting the device.

[0384] Example 50. The apparatus according to example 49, wherein rotating the device about the rod translates the output subassembly along a Z axis at a fixed downscaling ratio in relation to a translation of the input subassembly along the Z axis.

[0385] Example 51. The apparatus according to example 50, wherein the device further comprises a pantograph mechanism for downscaling translational movements.

[0386] Example 52. The apparatus according to example 51, wherein the pantograph mechanism moves along a mathematical plane that is perpendicular to the Z axis.

[0387] The present invention is not limited to the examples that have been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description.

Claims

CLAIMS1. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a rotation coordinator, comprising: an input subassembly, comprising: a handle; an actuator; and an input gimbal on which the handle and the actuator are mounted; an output subassembly, comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal on which the holder and the effector are mounted; and a linkage that operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle; and a translation coordinator on which the input subassembly and the output subassembly are mounted, the translation coordinator: comprising an armature that mechanically connects the input subassembly to the output subassembly; and being configured to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly.

2. The apparatus according to claim 1, wherein the translation coordinator is configured to transmit and downscale translational movement of the input subassembly along a first vector to become downscaled translational movement of the output subassembly along a second vector that is parallel with, and shorter than, the first vector.

3. The apparatus according to any one of claims 1-2, wherein the translation coordinator is configured to transmit and downscale translational movement of the input subassembly along a first three-dimensional path to become downscaled translational movement of the output subassembly along a second three-dimensional path, the second three-dimensional path being identically-shaped but smaller-sized than the first three- dimensional path.

4. The apparatus according to any one of claims 1-3, wherein the rotation coordinator is configured such that rotational movement of the holder mimics rotational movement of the handle.

5. The apparatus according to any one of claims 1-4, wherein the rotation coordinator is configured to synchronize rotational movement between the holder and the handle.

6. The apparatus according to any one of claims 1-5, wherein transmitting rotational movement of the holder to the handle via the linkage maintains the orientation of the holder relative to the handle.

7. The apparatus according to any one of claims 1-6, wherein the handle defines a handle-pointing direction, the holder defines an instrument-pointing direction, and the rotation coordinator is configured to maintain the instrument-pointing direction parallel with the handle-pointing direction.

8. The apparatus according to any one of claims 1-7, wherein the linkage is an electronic or electromechanical linkage.

9. The apparatus according to any one of claims 1-8, wherein the effector is mechanically operable via actuation of the actuator.

10. The apparatus according to any one of claims 1-9, wherein the effector is electronically operable via actuation of the actuator.

11. The apparatus according to any one of claims 1-10, further comprising the instrument.

12. The apparatus according to claim 11, wherein the instrument comprises forceps.

13. The apparatus according to claim 11, wherein the instrument is selected from the group consisting of: scalpel, forceps, scissors, clamp, needle, suture, clips, and blade.

14. The apparatus according to any one of claims 1-13, wherein the linkage is a mechanical linkage.

15. The apparatus according to claim 14, wherein the linkage comprises one or more Bowden devices.

16. The apparatus according to any one of claims 1-15, wherein the handle is elongate along a handle axis, the instrument is elongate along an instrument axis, and the rotationcoordinator is configured to maintain the instrument axis parallel with the handle axis during operation of the device.

17. The apparatus according to claim 16, wherein the rotation coordinator is configured to synchronize a rotation of the handle about the handle axis with a rotation of the instrument about the instrument axis.

18. The apparatus according to any one of claims 1-17, wherein the device comprises a bracket for hingedly mounting the device.

19. The apparatus according to claim 18, further comprising a bearing on which the bracket is hingedly mountable.

20. The apparatus according to any one of claims 1-19, wherein: the input gimbal includes at least one input wheel; the output gimbal includes at least one output wheel; and the rotation coordinator transmits rotational movement from the at least one input wheel to the at least one output wheel.

21. The apparatus according to claim 20, wherein: the at least one input wheel consists of three input wheels; the at least one output wheel consists of three output wheels; and the rotation coordinator transmits the rotational movement from the three input wheels to a corresponding one of the three output wheels.

22. The apparatus according to claim 21, wherein: each of the input wheels include a central axis; and the rotational movement includes rotation of the input wheels about the central axes of each respective input wheel.

23. The apparatus according to claim 21, wherein the three input wheels are concatenated and the three output wheels are concatenated.

24. The apparatus according to claim 21, wherein: the three input wheels comprise a first input wheel, a second input wheel and a handle input wheel; the three output wheels comprise a first output wheel, a second output wheel, and a holder output wheel;each of the three input wheels and three output wheels include a housing surrounding the respective wheel; the housing of the second input wheel is connected to the first input wheel such that the housing of the second input wheel and the first input wheel rotate in tandem; the housing of the handle input wheel is connected to the second input wheel such that the housing of the handle input wheel and the second input wheel rotate in tandem; the housing of the second output wheel is connected to the first output wheel such that the housing of the second output wheel and the first output wheel rotate in tandem; and the housing of the holder output wheel is connected to the second output wheel such that the housing of the holder output wheel and the second output wheel rotate in tandem.

25. The apparatus according to claim 24, wherein the holder output wheel holds the instrument such that a tip of the instrument remains at a substantially fixed point during the rotational movement.

26. The apparatus according to claim 21, wherein: each of the three input wheels rotate, at a respective fixed radius, about a control point along a first curved virtual surface; each of the three output wheels rotate, at the fixed radii corresponding to the three input wheels, about an operation point along a second curved virtual surface; and the first and second curved virtual surfaces are hemispherical and congruent.

27. The apparatus according to claim 26, wherein rotating one of the three input wheels to a location on the first curved virtual surface, rotates a corresponding one of the three output wheels to a location on the second virtual curved surface which corresponds to the location on the first curved virtual surface.

28. The apparatus according to claim 20, wherein: one of the three output wheels holds the instrument such that a tip of the instrument is located at an operation point; and the tip is coincident with the operation point during rotation of any of the three output wheels.

29. The apparatus according to claim 20, wherein: the at least one input wheel is connected to the armature via a first arm; andthe at least one output wheel is connected to the armature via a second arm.

30. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a rotation coordinator, comprising: an input subassembly, comprising: a handle; an actuator; and an input gimbal on which the handle and the actuator are mounted; an output subassembly, comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal on which the holder and the effector are mounted; and a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder; and a translation coordinator on which the input subassembly and the output subassembly are mounted, the translation coordinator being configured to transmit and downscale translational movement of the input subassembly to become downscaled translational movement of the output subassembly.

31. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end; an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end, anda bracket for hingedly mounting the translation coordinator for tilting of the translation plane; and a rotation coordinator, comprising: an input subassembly, mounted on the input end, and comprising: a handle; an actuator; and an input gimbal on which the handle and the actuator are mounted; an output subassembly, mounted on the output end, and comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal on which the holder and the effector are mounted; and a linkage that operatively couples the input gimbal to the output gimbal in a manner that maintains an orientation of the holder relative to the handle.

32. The apparatus according to claim 31, wherein the pantograph accounts for translational movement along two axes.

33. The apparatus according to any one of claims 31-32, wherein the pantograph includes a parallelogram.

34. The apparatus according to any one of claims 31-33, wherein the pantograph includes two parallelograms.

35. The apparatus according to any one of claims 31-34, further comprising a stand on which the bracket is mountable.

36. The apparatus according to claim 35, wherein the bracket is rotatable about a central axis of a bearing of the stand.

37. The apparatus according to claim 35, wherein the bracket is rotatable about a bearing of the stand along two axes.

38. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end;an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end; and a bracket for: hingedly mounting the translation coordinator; and tilting of the translation plane; and a rotation coordinator, comprising: an input subassembly, mounted on the input end, and comprising: a handle, an actuator and an input gimbal on which the handle and the actuator are mounted; an output subassembly, mounted on the output end, and comprising: a holder configured to hold the instrument, an effector, operable via actuation of the actuator to manipulate the instrument held by the holder; and an output gimbal on which the holder and the effector are mounted; and a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

39. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end; an output end; a hinge; an armature, coupled to the hinge and mechanically connecting the input end to the output end in a manner that: defines an origin of the device; andtransmits and downscales translational movement of the input end with respect to the origin to become downscaled translational movement of the output end with respect to the origin; and a rotation coordinator, comprising: an input subassembly, mounted at the input end, and comprising: a handle; an actuator; and an input gimbal on which the handle and the actuator are mounted; an output subassembly, mounted at the output end, and comprising: a holder configured to hold the instrument; an effector, operable via actuation of the actuator to manipulate the microsurgical instrument held by the holder; an output gimbal on which the holder and the effector are mounted; and a linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder.

40. The apparatus according to claim 39, wherein the translational movement of the device is confined to a spherical coordinate system.

41. The apparatus according to claim 40, wherein the origin is located at a center of the spherical coordinate system.

42. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a rotation coordinator, comprising: an input subassembly, comprising: a handle; and an input gimbal on which the handle is mounted; an output subassembly, comprising: a holder configured to hold the instrument; and an output gimbal on which the holder is mounted; anda linkage that operatively couples the input gimbal to the output gimbal in a manner that provides a rotation synchronization between the handle and the holder; and a translation coordinator, comprising: a hinge; and an armature, coupled to the hinge and mechanically connecting the input subassembly to the output subassembly in a manner that: defines an origin of the device; and transmits and downscales translational movement of the input subassembly with respect to the origin to become downscaled translational movement of the output subassembly with respect to the origin.

43. The apparatus according to claim 42, wherein the device further comprises: an actuator; and an effector, at the output subassembly, the effector being operable via actuation of the actuator to manipulate the instrument held by the holder.

44. Apparatus for facilitation of microsurgery, the apparatus comprising a device for use with a microsurgical instrument, the device comprising: a translation coordinator, comprising: an input end; an output end movably coupled to the input end such that the translation coordinator defines a translation plane in which the input end and the output end are translationally movable; a pantograph, configured to transmit and downscale in-plane translational movement of the input end to become downscaled in-plane translational movement of the output end; and a bracket for hingedly mounting the pantograph for tilting of the translation plane; and a rotation coordinator, comprising: an input subassembly, mounted on the input end, and comprising: a first input-rotator, a second input-rotator, and a third input-rotator, each comprising a house and a wheel that is rotationally mounted to the respective house to define a rotation axis of the respective wheel, the firstinput-rotator, the second input-rotator, and the third input-rotator being connected in series such that: the house of the first input-rotator is attached to the wheel of the second input-rotator such that: the first input-rotator is revolvable about the rotation axis of the second input-rotator; and the rotation axis of the wheel of the second inputrotator is angularly offset from the rotation axis of the wheel of the first input-rotator; the house of the second input-rotator is attached to the wheel of the third input-rotator such that: the second input-rotator is revolvable about the rotation axis of the third input-rotator; and the rotation axis of the wheel of the third inputrotator is angularly offset from the rotation axis of the wheel of the second input-rotator; a handle, connected to the wheel of the first input-rotator; and an actuator; and an output subassembly, mounted on the output end, and comprising: a first output-rotator, a second output-rotator, and a third outputrotator, each comprising a house and a wheel that is rotationally mounted to the respective house to define a respective rotation axis of the wheel, the first output-rotator, the second output-rotator, and the third output-rotator being connected in series such that: the wheel of the first output-rotator is attached to the house of the second output-rotator, and is operably coupled to the third input-rotator, such that: rotation of the wheel of the third input-rotator rotates the wheel of the first output-rotator, which revolves the second output-rotator about the rotation axis of the first output-rotator; and the rotation axis of the wheel of the second outputrotator is angularly offset from the rotation axis of the wheel of the first output-rotator;the wheel of the second output-rotator is attached to the house of the third output-rotator, and is operably coupled to the second input-rotator such that: rotation of the wheel of the second input-rotator rotates the wheel of the second output-rotator, which revolves the third output-rotator about the rotation axis of the second output-rotator; and the rotation axis of the wheel of the third outputrotator is angularly offset from the rotation axis of the wheel of the second output-rotator; and the wheel of the third output-rotator is operably coupled to the first input-rotator such that rotation of the wheel of the first input-rotator rotates the wheel of the third output-rotator; a holder, connected to the wheel of the third output-rotator, and configured to hold the instrument; and an effector, operable via actuation of the actuator to manipulate the instrument held by the holder.

45. The apparatus according to claim 44, wherein the holder is configured to hold the instrument along an instrument axis that is coincident with the rotation axis of the wheel of the third output-rotator.

46. The apparatus according to any one of claims 44-45, wherein the handle is elongate and defines a handle axis that is coincident with the rotation axis of the wheel of the first input-rotator.

47. The apparatus according to any one of claims 44-46, wherein the input and output ends are translationally movable along two axes within the translation plane.

48. The apparatus according to any one of claims 44-47, wherein the rotation axis of the wheel of the third input-rotator is perpendicular to the translation plane.

49. The apparatus according to any one of claims 44-48, wherein the device comprises a rod for hingedly mounting the device.

50. The apparatus according to claim 49, wherein rotating the device about the rod translates the output subassembly along a Z axis at a fixed downscaling ratio in relation to a translation of the input subassembly along the Z axis.

51. The apparatus according to claim 50, wherein the device further comprises a pantograph mechanism for downscaling translational movements.

52. The apparatus according to claim 51, wherein the pantograph mechanism moves along a mathematical plane that is perpendicular to the Z axis.

Images