Microsurgical micromanipulator system

Abstract

Described herein is an implementation of a surgical robot designed for microsurgeries including cataract surgery. For example, there is a drivetrain system for a robotic surgical micromanipulator having: a motor of an insertion joint base configured to couple to and power gears of a surgical instrument holder gearbox; the surgical instrument holder gearbox, in which the gearbox includes a vertical transmission having at least a pair of vertical gears configured to transmit torque to a drive system; the drive system, in which the drive system is configured to power a surgical instrument holder; the surgical instrument holder; and a surgical instrument having a tip, in which the surgical instrument is configured for assembly with the surgical instrument holder. Other examples are described.

Description

MICROSURGICAL MICROMANIPULATOR SYSTEMCLAIM OF PRIORITY

[0001] This application claims priority to U.S. Provisional Application No. 63 / 748,407, titled “MICROSURGICAL MICROMANIPULATOR SYSTEM,” filed January 22, 2025, the contents of which are incorporated herein by reference in their entirety.INCORPORATION BY REFERENCE

[0002] All publications and patent applications mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.FIELD

[0003] The present invention relates to surgical robotic systems and, more specifically, to robotic arm designs for ophthalmic surgical robots.BACKGROUND

[0004] Safety and functionality are paramount to surgical robotics. Specifically in the context of a surgical robot for ophthalmology, the ease at which damage can be caused to a patient from imperfect control suggests that a great emphasis be placed on the hardware design having improved safety in terms of limitations on actuation, sensing, robustness to failures, and surgical instrument motion. Simultaneously, there are high functional demands to complete an ophthalmologic procedure, such as cataract surgery, in terms of ability to utilize many surgical instruments, precision and accuracy, maintaining a sterile field around the operating site, not blocking line of sight of the operating surgeon directly or through an imaging system, and allowing for two or more port operations in a confined space.

[0005] It is common practice in surgical robotics, particularly those designed for laparoscopic or similar procedures, for the robot to enter the patient’s body through a single point held stationary in space. This point, typically aligned with the incision, is generally referred to as a remote center of motion (RCM). Constraining robot motions to pivot about and insert into / out of the body through the RCM, but not translate laterally, helps to minimize stresses placed on the body and resulting tissue trauma. These constraints can be applied in the control systems and software of the robot or can be mechanically incorporated into the kinematics. When mechanically constrained, the resulting suggested kinematic topology is that of a spherical - 1 of 57- SG Docket No.: 14843-711.600mechanism with 4 degrees-of-freedom (DOFs): three to pivot about the RCM and one to insert into / withdraw, though additional DOFs can exist for auxiliary functions or to move a distal portion of a robot that has already been inserted past the incision.

[0006] Though a general kinematic topology is suggested, the exact kinematic relationship between each joint, described by Denavit-Hartenberg (DH) parameters or equivalent, is not a given. Additionally, the positioning of the base of the mechanism and the physical implementation of each joint have many options for implementation. Very different mechanisms, each with a mechanical RCM, can be designed so that each meets the clinical requirements of a particular surgery or surgeries, but do not meet the requirements of others.

[0007] In the case of ophthalmologic surgery, a robot designed with a mechanical RCM must enable sufficient intraocular workspace of any attached surgical instrument. Additionally, throughout this workspace, the mechanism external to the eye must not collide with the patient, operating table, or any other part of the robot. Further, it is desirable that the robot leave an unobstructed view of the eye from above, as the surgeon or imaging system (such as a microscope, digital microscope, and / or optical coherence tomography device [OCT]) must be able to obtain information about the location of the eye and tissues within. Some ophthalmologic surgeries are also performed with either one or two surgical instruments at the same time, and a robot(s) that enables simultaneous use of two surgical instruments must be able to move without causing unwanted / unexpected collisions between the mechanisms holding the instruments. These requirements place strong constraints on a mechanical design, such that a satisfactory solution is non-obvious.

[0008] The precision and accuracy required of ophthalmological surgeries, such as cataract surgery, necessitates additional consideration in the mechanical design. Specifically, the kinematics of the mechanism that is physically implemented must be known accurately after all machining and assembly errors. Though calibration can partially address this to improve accuracy of surgical instrument tip placement, the nature of a mechanical RCM mechanism causes poor accuracy and portions of the desired workspace to become inaccessible if the RCM is not “ideal.” An “ideal” RCM may be one in which all joint axes of the mechanism (at least any rotational joints about the RCM and prismatic joints through the RCM) exactly intersect at a point in space that does not move regardless of motion of those joints. However, this may be physically unrealizable, as machining / assembly errors will cause small misalignments, and loads (including gravitational forces) will generally cause structural deformation of the mechanism as a function of at least the joint angles. The result may be an undesirable “non-ideal / pseudo-RCM”, where the joint axes are neither stationary nor intersecting.- 2 of 57 - SG Docket No.: 14843-711.600

[0009] In many surgical procedures, including in ophthalmology broadly and cataract surgery specifically, more than one surgical instrument may be used. Additionally, surgical instruments must generally be changed entirely between surgeries to newly sterilized ones. Further, a sterile field must be created in the area around the patient including the surgical instrument and contacting parts of a surgical robot. As such, it must be possible to not only accommodate multiple different surgical instruments, but easily, safely, and securely attach and detach them while maintaining the sterile field.

[0010] Design of a robot for surgery, particularly those involving tissues as delicate as the eyes, must also strongly consider safety in normal operation, hazardous situations, and under unexpected failure conditions of the robot. These situations include, but are not limited to, sudden unexpected motions of the patient, failure of a sensor, failure of an actuator, loss of power, loss of reliable controllability, and the mechanism being subjected to fluids.

[0011] Thus there remains the need for a novel implementation of a robotic surgical micromanipulator that aims to address the above problems and requirements for safety, maneuverability and component preservation and maintenance.SUMMARY OF THE DISCLOSURE

[0012] Described herein is a robotic surgical micromanipulator system having: a plurality of serially connected joints intersecting at a remote center of motion (RCM); an end-effector of the micromanipulator system configured to manipulate a plurality of surgical instruments via an associated joint motor and motor driver; a surgical instrument holder system comprising: a surgical instrument holder configured to mount each of the plurality of surgical instruments to the surgical instrument holder, and the plurality of surgical instruments; a surgical instrument holder gearbox and a plurality of surgical instrument holder gearbox motors configured to power the surgical instrument holder system; a carriage block containing an insertion link and having a low friction surface configured to ease motion of the surgical instrument holder system; a printed circuit board (PCB) adjacent to the carriage block, the printed circuit board adapted and configured for electronic operation of the robotic surgical micromanipulator system; a shell covering configured to seal at least one of the plurality of serially-connected joints and the associated joint motor and motor driver of the end-effector; and a wire routing network for a plurality of wires extending through the plurality of serially-connected joints and into the surgical instrument holder system via the insertion link.

[0013] According to certain examples of the surgical micromanipulator system, the plurality of serially-connected joints includes five joints, in which the RCM comprises five degrees of freedom having: two rotational joints configured to pivot about a central longitudinal axis of - 3 of 57 - SG Docket No.: 14843-711.600the plurality of surgical instruments about the RCM, a prismatic joint configured for insertion and retraction of the plurality of surgical instruments in and out of the RCM, a rotary joint configured to spin the plurality of surgical instruments about the surgical instrument’s central longitudinal axis, and an auxiliary joint configured for additional functionality of the plurality of surgical instruments including one or more of: injection of a material, manipulating an instrument tip, and grasping of a forceps.

[0014] According to certain examples of the surgical micromanipulator system, the system further includes a kinematic configuration of the system wherein the base is positioned such that a first joint of the plurality of serially-connected joints is vertical, in which an angle between subsequent joints of the plurality of serially-connected joints is between 45°-75°.

[0015] According to certain examples of the surgical micromanipulator system, the kinematic configuration is configured to maximize an intraocular workspace of the system and to minimize collisions between robotic arms coupled to a plurality of the surgical micromanipulator system and between a robotic arm coupled to a first of the plurality of the surgical micromanipulator system and one or more of: the patient, the imaging system, and a second of the plurality of the surgical micromanipulator system configured to operate on the operative eye in tandem with the first of the plurality of the surgical micromanipulator system.

[0016] According to certain examples of the surgical micromanipulator system, the plurality of serially-connected joints are configured to actuate via a triple pivot mechanism having a range of motion of approximately 160°- 180°.

[0017] According to certain examples of the surgical micromanipulator system, the triple pivot mechanism is enhanced by hardware including fasteners and kinematic coupling configured to allow positioning and adjustment of a rotational axis of at least one of the plurality of serially-connected joints relative to subsequent joints of the plurality of serially-connected joints.

[0018] According to certain examples of the surgical micromanipulator system, the triple pivot mechanism is configured for use on one or more of: (i) the operative eye, wherein the operative eye is a right eye or a left eye of the patient, and (ii) in tandem with a second ophthalmic robotic surgical micromanipulator system, based on the triple pivot mechanism having symmetry about a 0° position of the triple pivot mechanism.

[0019] According to certain examples of the surgical micromanipulator system, the surgical instrument holder of the surgical instrument holder system is one of a universal surgical instrument holder configured to receive a plurality of off-the-shelf surgical instruments.- 4 of 57 - SG Docket No.: 14843-711.600

[0020] According to certain examples of the surgical micromanipulator system, the surgical instrument holder of the surgical instrument holder system is a custom surgical instrument holder configured to receive a custom surgical instrument.

[0021] According to certain examples of the surgical micromanipulator system, the surgical instrument holder of the surgical instrument holder system is configured to mount the plurality of surgical instruments via one of: a threaded collet and sleeve, a clamping collar and collet mechanism and a screw-on clamping collar or wherein the mounted plurality of surgical instruments are configured to receive accessories.

[0022] According to certain examples of the surgical micromanipulator system, a distance from a tip of any of the plurality of surgical instruments mounted to the surgical instrument holder and a front face of the surgical instrument holder has the same length.

[0023] According to certain examples of the surgical micromanipulator system, the surgical instrument holder gearbox is dual-sided with each side providing torque for one of actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder, further in which the surgical instrument holder gearbox motor powers both the actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder.

[0024] According to certain examples of the surgical micromanipulator system, transmission of the torque between the surgical instrument holder gearbox and surgical instrument holder system occurs via a quick-connect torque transmission design comprising a spring-loaded male spindle on the sterile barrier plate configured to engage with a female spindle on both the surgical instrument holder gearbox and the surgical instrument holder, further in which the quick-connect torque transmission design is configured to prevent unintended removal of the surgical instrument holder via preventing upward movement of the sterile barrier plate when coupled to the surgical instrument holder.

[0025] According to certain examples of the surgical micromanipulator system, the female spindle on both the surgical instrument holder gearbox and the surgical instrument holder has a floral pattern configured for engagement with the male spindle at a plurality of orientations configured for flexibility in alignment precision during engagement of the surgical instrument holder with the surgical instrument holder gearbox and sterile barrier plate.

[0026] According to certain examples of the surgical micromanipulator system, the surgical instrument holder system is configured for safe manual removal of each of the plurality of surgical instruments mounted to the surgical instrument holder in a direction away from the operative eye via one or more of: torque transmitted through the surgical instrument holder gearbox and manual removal in a failure mode.- 5 of 57 - SG Docket No.: 14843-711.600

[0027] According to certain examples of the surgical micromanipulator system, the surgical instrument holder gearbox is positioned below the surgical instrument holder system and configured to avoid collision between the surgical instrument holder gearbox motor and the patient.

[0028] According to certain examples of the surgical micromanipulator system, the system further includes a sterile barrier plate adapted and configured as a floor for the surgical instrument holder system and to engage with the surgical instrument holder gearbox to centrally align the sterile barrier plate and surgical instrument holder system relative to other components of the surgical micromanipulator system.

[0029] According to certain examples of the surgical micromanipulator system, the system further includes a drape coupled to the sterile barrier plate sized for positioning beneath the sterile barrier plate and to envelop the micromanipulator system and a robotic arm coupled to the micromanipulator system.

[0030] According to certain examples of the surgical micromanipulator system, the drape is one of attached to or assembled independently of the sterile barrier plate.

[0031] According to certain examples of the surgical micromanipulator system, an insertion axis motor for a third joint of the plurality of serially-connected joints is parallel and coupled to a lead screw via gears for rapid retraction of any of the plurality of surgical instruments mounted to the surgical instrument holder, in which the rapid retraction occurs along a straight line away from the operative eye.

[0032] According to certain examples of the surgical micromanipulator system, the system further includes a plurality of redundant sensors on the plurality of serially-connected joints, in which the plurality of redundant sensors are configured for mitigating sensor failure via monitoring positions of the plurality of serially-connected joints and the associated joint motor.

[0033] According to certain examples of the surgical micromanipulator system, the plurality of serially-connected joints are configured to be immobile under gravity conditions and normal operative loads, further wherein the plurality of serially-connected joints are configured for manual override manipulation during a failure mode of the surgical micromanipulator system.

[0034] According to certain examples of the surgical micromanipulator system, the wire routing network is configured to be maintained by a plurality of the associate motor driver and a plurality of actuators having bores and hollow shafts, in which at least a portion of the bores are hollow.- 6 of 57 - SG Docket No.: 14843-711.600

[0035] According to certain examples of the surgical micromanipulator system, the plurality of wires are routed from a fourth and fifth joint of the plurality of serially-connected joints to the PCB via the surgical instrument holder gearbox, in which the PCB is configured for enabling rigid and sharp turns of wiring through a gap formed by a magnetically loaded spring-steel strip configured to cover the insertion link.

[0036] According to certain examples of the surgical micromanipulator system, the plurality of wires may be further routed to the insertion link via a forked design of the carriage block.

[0037] According to certain examples of the surgical micromanipulator system, the system is configured for ingress-egress protection via one or more of: a magnetically loaded springsteel strip, the PCB, and the shell covering.

[0038] According to certain examples of the surgical micromanipulator system, the shell covering is configured to seal the associated joint motor of at least two of the plurality of serially-connected joints, or the shell covering has an opening configured to receive the PCB, or the shell covering covers a bend of the spring-steel strip.

[0039] Described herein is a robotic surgical micromanipulator system having: an imaging system configured to acquire imaging data of an operative eye of a patient; a base; a plurality of serially-connected joints intersecting at a remote center of motion (RCM); an end-effector of the micromanipulator system configured to manipulate a plurality of surgical instruments via an associated joint motor and motor driver, having: a surgical instrument tool holder system with a surgical instrument tool holder configured to mount each of the plurality of surgical instruments to the surgical instrument holder, and the plurality of surgical instruments; a surgical instrument holder gearbox and a plurality of surgical instrument holder gearbox motors configured to power the surgical instrument holder system; a sterile barrier plate; a carriage block containing an insertion link and having a low friction surface configured to ease motion of the surgical instrument holder; a printed circuit board (PCB) for electronic operation of the surgical micromanipulator system; a shell covering configured to seal at least one of the plurality of serially-connected joints and the associated joint motor and motor driver; and a wire routing network for a plurality of wires extending through the plurality of serially-connected joints and into the surgical instrument holder system via an insertion link.

[0040] According to certain examples of the system, the plurality of serially-connected joints may include five joints and the RCM may have five degrees of freedom including: two rotational joints configured to pivot about a central longitudinal axis of the plurality of surgical instruments about the RCM, a prismatic joint configured for insertion and retraction of the plurality of surgical instruments in and out of the RCM, a rotary joint configured to - 7 of 57 - SG Docket No.: 14843-711.600spin the plurality of surgical instruments about their central longitudinal axis, and an auxiliary joint configured for additional functionality of the plurality of surgical instruments including injection of material and grasping of forceps.

[0041] According to certain examples of the system, there may be a kinematic configuration of the system in which the base is positioned such that a first joint of the plurality of serially-connected joints is vertical. There may be a link twist between subsequent joints of the plurality of joints, the link twist being between 45°-75° between a first and second joint as well as between the second and a third joint of the plurality of serially-connected joints.

[0042] According to certain examples of the system, the kinematic configuration may be configured to maximize an intraocular workspace of the system and to minimize collisions between robotic arms coupled to a plurality of the surgical micromanipulator system and between a robotic arm coupled to a first of the plurality of the surgical micromanipulator system and one or more of: the patient, the imaging system, and a second of the plurality of the surgical micromanipulator system configured to operate on the operative eye in tandem with the first of the plurality of the surgical micromanipulator system.

[0043] According to certain examples of the system, the plurality of serially-connected joints may be configured to actuate via a triple pivot mechanism having a range of motion of approximately 160°- 180°.

[0044] According to certain examples of the system, the triple pivot mechanism may be enhanced by hardware including fasteners and kinematic coupling configured to enable positioning and adjustment of a rotational axis of at least one of the plurality of serially-connected joints relative to subsequent joints of the plurality of serially-connected joints. This may account for one or more of: errors in matching, errors in assembly, and gravity-induced deformation of the plurality of serially-connected joints.

[0045] According to certain examples of the system, the triple pivot mechanism may be configured for use on one or more of: (i) the operative eye, which may be a right eye or left eye of the patient, and (ii) in tandem with a second ophthalmic robotic surgical micromanipulator system, which may be enabled by the triple pivot mechanism having symmetry about a 0° position.

[0046] According to certain examples of the system, the surgical instrument holder of the surgical instrument holder system may be one of a universal surgical instrument holder configured to receive a plurality of off-the-shelf surgical instruments and a custom surgical instrument holder configured to receive a custom surgical instrument; wherein the surgical instrument holder is configured to mount the plurality of surgical instruments via one of: a threaded collet and sleeve, a clamping collar and collet mechanism and a screw-on clamping - 8 of 57 - SG Docket No.: 14843-711.600collar, further wherein the mounted plurality of surgical instruments may be configured to have sufficient clearance for attaching further components or accessories including one or more of: tubing and surgical instrument tips.

[0047] According to certain examples of the system, a distance from a tip of any of the plurality of surgical instruments mounted to the surgical instrument holder and a front face of the surgical instrument holder is consistent in length, in which any of the plurality of surgical instruments extend a same distance from a front face of the surgical instrument holder to the tip of the surgical instrument for a given surgical instrument.

[0048] According to certain examples of the system, the surgical instrument holder gearbox may be dual-sided with each side providing torque for one of actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder, further in which the surgical instrument holder gearbox motor may power both the actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder. The surgical instrument holder gearbox may be associated with a fourth and fifth of the five degrees of freedom. The surgical instrument holder gearbox may also have integrated alignment features including magnets and spindles.

[0049] According to certain examples of the system, transmission of the torque between the surgical instrument holder gearbox and surgical instrument holder system may occur via a quick-connect torque transmission design having a spring-loaded male spindle on the sterile barrier plate configured to engage with a female spindle on both the surgical instrument holder gearbox and the surgical instrument holder. Such a quick-connect torque transmission design may be configured to prevent unintended removal of the surgical instrument holder for the plurality of surgical instruments via preventing upward movement of the sterile barrier plate coupled to the associated surgical instrument holder of the surgical instrument holder system.

[0050] According to certain examples of the system, the female spindle on both the surgical instrument holder gearbox and the surgical instrument hold er may have a floral pattern configured for engagement with the male spindle at a plurality of orientations configured for flexibility in alignment precision during engagement of the surgical instrument holder with the surgical instrument holder gearbox and sterile barrier plate.According to certain examples of the system, the surgical instrument holder system is configured for safe manual removal of each of the plurality of surgical instruments mounted to the associated surgical instrument holder in a direction away from the operative eye via one or more of: torque transmitted through the surgical instrument holder gearbox and manual removal in a failure mode.- 9 of 57 - SG Docket No.: 14843-711.600

[0051] According to certain examples of the system, the surgical instrument holder gearbox may be positioned below the surgical instrument holder system and configured to avoid collision between the plurality of surgical instrument holder gearbox motors and the patient.

[0052] According to certain examples of the system, the sterile barrier plate may be configured to be a floor for the surgical instrument holder system and to engage with the surgical instrument holder gearbox to centrally align the sterile barrier plate and surgical instrument holder system relative to other components of the surgical micromanipulator system.

[0053] According to certain examples of the system, the system may further include a drape configured to be positioned beneath the sterile barrier plate and to envelop the micromanipulator system and a robotic arm coupled to the micromanipulator system. In certain examples, the drape may be attached to or independent of the sterile barrier plate.

[0054] According to certain examples of the system, an insertion axis motor for the third joint may be parallel and coupled to a lead screw via gears for rapid retraction of any of the plurality of surgical instruments mounted to the surgical instrument holder. In such examples, rapid retraction may occur along a straight line away from the operative eye in response to unexpected motions of the patient.

[0055] According to certain examples of the system, the system may have a plurality of redundant sensors on the plurality of serially-connected joints. The plurality of redundant sensors may be configured for mitigating sensor failure via monitoring positions of the plurality of serially-connected joints and the associated joint motor of the plurality of serially-connected joints.

[0056] According to certain examples of the system, a back-drivability of the plurality of joints may be configured to be immobile under gravity conditions and normal operative loads. The back-drivability of the plurality of joints may be configured for manual override manipulation during a failure mode of the surgical micromanipulator system.

[0057] According to certain examples of the system, the wire routing network may be configured to be maintained by a plurality of the associate motor driver and a plurality of actuators and hollow shafts. In certain examples, at least a portion of the actuators may have hollow bores.

[0058] According to certain examples of the system, a plurality of wires from a fourth and fifth joint of the plurality of serially-connected joints may be routed from to the PCB via the surgical instrument holder gearbox. The PCB may be configured for enabling rigid and sharp turns of wiring through a gap formed by a magnetically loaded spring-steel strip configured- 10 of 57 - SG Docket No.: 14843-711.600to cover the insertion link. The plurality of wires may be further routed to the insertion link via a forked design of the carriage block.

[0059] According to certain examples of the system, the system may be configured for ingress-egress protection via one or more of: a magnetically loaded spring-steel strip, the PCB, and the shell covering. The shell covering may be configured to seal the associated joint motor of at least two of the plurality of serially-connected joints. The shell covering may also have an opening configured to receive the PCB. The shell covering may also cover a bend of the spring-steel strip.

[0060] According to certain examples of the system, there is a drivetrain system for a robotic surgical micromanipulator having: a motor of an insertion joint base configured to couple to and power gears of a surgical instrument holder gearbox; the surgical instrument holder gearbox, in which the gearbox includes a vertical transmission having at least a pair of vertical gears configured to transmit torque to a drive system; the drive system, in which the drive system is configured to power a surgical instrument holder; the surgical instrument holder; and a surgical instrument having a tip, in which the surgical instrument is configured for assembly with the surgical instrument holder.

[0061] According to certain examples of the system, the at least one pair of vertical gears of the vertical transmission includes rotation and actuation gears having different torque requirements and gear ratios.

[0062] According to certain examples of the system, the drive system is inverted for direct coupling to the surgical instrument holder and a compact form factor.

[0063] According to certain examples of the system, the vertical transmission includes a quick torque transmission design configured to transmit torque between the surgical instrument holder gearbox and the drive system powering the surgical instrument holder.

[0064] According to certain examples of the system, the insertion joint base has a folded configuration and is coupled to an end-effector of a triple pivot mechanism, in which the triple pivot mechanism is coupled to a robotic arm of a robotic microsurgical system.

[0065] According to certain examples of the system, the surgical instrument tip is configured to be protracted and retracted into a no-fly zone, in which the no-fly zone encompasses one or more of an operative eye of a patient and a remote center of motion for a triple pivot mechanism, in which a path of motion of distal components coupled to the surgical instrument tip are configured to stay out of the no-fly zone, further in which the distal components are configured to avoid collision with the patient, in which the distal components include the surgical tool holder, the surgical tool holder gearbox, the insertion joint base, an end-effector of a triple pivot mechanism, and a robotic arm of a robotic microsurgical system.- 11 of 57 - SG Docket No.: 14843-711.600

[0066] According to certain examples of the system, the no-fly zone is configured for intraoperative imaging of the operative eye including by a multi-modal imaging system including a digital microscope and ocular coherence tomography (OCT).

[0067] According to certain examples of the system, a distance ‘d’ between the tip of the surgical instrument and an anterior surface of the surgical instrument tool holder when the surgical instrument is assembled onto the surgical instrument tool holder is configured to remain constant independent of properties of the surgical instrument and surgical instrument holder, in which the distance ‘d’ is configured to maintain a proper orientation and length of the surgical instrument relative to an operative eye and exclusivity of the tip of the surgical instrument within a no-fly zone encompassing the operative eye.

[0068] According to certain examples of the system, the surgical instrument holder is configured to recognize the surgical instrument assembled onto the surgical instrument holder and execute one or more of a corresponding drive interface and drive control algorithm for the surgical instrument via the drive system.

[0069] According to certain examples of the system, the surgical instrument holder is configured to couple to the surgical instrument holder gearbox via a sterile barrier plate configured to rest on a non-sterile component of the robotic surgical micromanipulator, in which the sterile barrier plate further comprises a rigid plastic drape.

[0070] According to certain examples of the system, the robotic surgical micromanipulator is configured for movement corresponding to at least five joints and at least three degrees of adjustability, further in which the system comprises ingress-egress protection and wire routing features between and insertion link and a fourth and fifth joint of the as lest five joints.

[0071] According to certain examples of the system, the surgical instrument holder gearbox includes a top portion and a bottom portion, in which the top and bottom portion are separated by a sterile barrier plate.

[0072] According to certain examples of the system, the vertical transmission enables manual retraction and removal of one or more of the surgical instrument and surgical instrument holder, in which the manual retraction and removal is configured to retract and remove the tip of the surgical instrument from an operative eye during one or more of a power failure, a mechanical failure or other emergency.

[0073] According to certain examples of the system, the motor of the insertion joint base is one or more of a high power-density motor and an insertion motor placed parallel to and coupled with gears and a lead screw configured to enable mechanical retraction and removal- 12 of 57 - SG Docket No.: 14843-711.600of the surgical instrument in a straight line from an operative eye, in which a velocity of the mechanical retraction is comparable to velocity of manual removal by a surgeon.

[0074] According to certain examples of the system, the system further includes a drape positioned beneath the sterile barrier plate and configured to envelop the micromanipulator and a robotic arm coupled to the micromanipulator.

[0075] According to certain examples of the system, alignment features including a plurality of precision bores configured to engage with the surgical instrument holder gearbox to centrally position one or more of the surgical instrument holder and a sterile barrier plate upon which the surgical instrument holder rests, relative to a robotic system coupled to the surgical robotic micromanipulator.

[0076] According to certain examples of the system, torque generated by the vertical transmission of the surgical instrument holder gearbox is transmitted across a sterile barrier plate to the surgical instrument holder via a plurality of male spindles having a spring-loaded mechanism and configured for vertical displacement and to engage with a plurality of female spindles, in which the plurality of female spindles are on one or more of the surgical instrument holder gearbox and surgical instrument holder, further in which the plurality of male spindles are separated by the plurality of female spindles via the sterile barrier plate.

[0077] According to certain examples of the system, the plurality of female spindles have a floral pattern with a plurality of facets configured to engage with the plurality of male spindles for guided alignment, further in which the plurality of female spindles have a slotted chamfered pattern having an interface area configured to receive the plurality of male spindles, still further in which the interface area comprises non-flat surfaces to prevent jamming between the plurality of male and female spindles.

[0078] According to certain examples of the system, the spring-loaded mechanism is configured to prevent vertical displacement and removal of the sterile barrier plate when the surgical instrument is installed on the surgical instrument holder.

[0079] According to certain examples of the system, the plurality of male spindles may have a chamfered pattern having one or more pins with non-flat surfaces configured to prevent jamming of the plurality of male spindles when misaligned and further configured to bias the plurality of male spindles towards self-alignment and pushing of the surgical instrument holder into the sterile barrier plate.

[0080] According to certain examples of the system, the plurality of male spindles having a spring-loaded mechanism may include two halves with a first half containing a pin and the second half containing a slot, further in which the pin is configured to slide within the lot,- 13 of 57 - SG Docket No.: 14843-711.600still further in which the spring-loaded mechanism is configured to be compressed between the first and second halves to bias the first and second halves outwards.

[0081] According to certain examples of the system, the plurality of male spindles are configured to allow unobstructed movement of the surgical instrument holder to a front face of the sterile barrier plate when one or more of the surgical instrument holder gearbox, sterile plate barrier and surgical instrument holder are misaligned.

[0082] The drivetrain system of claim 21, further in which the surgical instrument holder gearbox is configured to rotate to align the pin of the plurality of male spindles with the plurality of female spindles on the surgical instrument holder gearbox and for a first one of the first and second halves of the plurality of male spindles to push outward to engage with the surgical instrument holder gearbox. The surgical instrument holder gearbox may be configured to continue rotating to match the plurality of male spindles to a pattern of the plurality of female spindles on the surgical instrument holder gearbox. A second one of the first and second halves of the plurality of male spindles may be configured to push outward to connect the surgical instrument holder and a plurality of male spindles on the sterile barrier plate to complete a connection between the surgical instrument holder gearbox, the sterile barrier plate and the surgical instrument holder.

[0083] According to certain examples of the system, a driving spindle in the surgical instrument holder gearbox having a spring mechanism configured to preload the driving spindle towards a mating spindle, in which the mating spindle is a slotted spindle, further in which the spring mechanism is configured to be compressed during misalignment of the driving spindle and mating spindle, still further in which the misaligned driving spindle and mating spindle are configured to be held in an interfering space and aligned for mating pursuant to powering of the surgical instrument holder gearbox.

[0084] According to certain examples of the system, the surgical instrument holder is configured to be axially secured to the micromanipulator via a plurality of steel plates on a front and bottom surface of the surgical instrument holder coupled to a plurality of magnets on the micromanipulator, in which an interface between the surgical instrument holder and the micromanipulator is a common interface.

[0085] According to certain examples, there is a method for powering a drivetrain system for a robotic surgical micromanipulator including: coupling a motor of an insertion joint base to power gears of a surgical instrument holder gearbox; transmitting torque to a drive system via a vertical transmission of the surgical instrument holder gearbox having at least a pair of vertical gears including rotating a rotation gear and actuating and actuation gear; powering a- 14 of 57 - SG Docket No.: 14843-711.600surgical instrument holder via the torque transmitted to the drive system; and actuating at least a tip of a surgical instrument assembled to the surgical instrument holder.

[0086] According to certain examples, the method further includes actuating the tip of the surgical instrument includes protracting and retracting the tip into a no-fly zone encompassing one or more of an operative eye of a patient and a remote center of motion (RCM) for a triple pivot mechanism.

[0087] According to certain examples, the method further includes manually retracting one or more of the surgical instrument and surgical instrument holder via the vertical transmission to retract the tip of the surgical instrument from the operative eye during one or more of a power failure, a mechanical failure or other emergency.

[0088] According to certain examples, the method further includes mechanically retracting and removing the surgical instrument in a straight line from an operative eye via the motor of the insertion joint base being one or more of a high power-density motor and an insertion motor placed parallel to and coupled with gears and a lead screw, in which a velocity of the mechanical retraction is comparable to velocity of manual removal by a surgeon.

[0089] According to certain examples, the method further includes generating torque by the vertical transmission of the surgical instrument holder gearbox; and transmitting the generated torque across a sterile barrier plate to the surgical instrument holder via a plurality of male spindles having a spring-loaded mechanism and configured for vertical displacement and to engage with a plurality of female spindles, in which the plurality of female spindles are on one or more of the surgical instrument holder gearbox and surgical instrument holder, further in which the plurality of male spindles are separated by the plurality of female spindles via the sterile barrier plate.

[0090] According to certain examples, the method further includes engaging the plurality of female spindles with the plurality of male spindles via a floral pattern on the plurality of female spindles having a plurality of facets configured for guided alignment, further in which the plurality of female spindles have a slotted chamfered pattern having an interface area configured to receive the plurality of male spindles, still further in which the interface area comprises non-flat surfaces to prevent jamming between the plurality of male and female spindles.

[0091] According to certain examples, the method further includes obstruction of vertical displacement and removal of the sterile barrier plate via the spring-loaded mechanism pursuant to installation of the surgical instrument on the surgical instrument holder.

[0092] According to certain examples, the method further includes rotating the surgical instrument holder gearbox to align a pin of the plurality of male spindles with the plurality of - 15 of 57 - SG Docket No.: 14843-711.600female spindles on the surgical instrument holder gearbox and pushing outward a first one of a first and second half of the plurality of male spindles and engaging the surgical instrument holder gearbox; further including further rotating surgical instrument holder gearbox and matching the plurality of male spindles to a pattern of the plurality of female spindles on the surgical instrument holder gearbox, further including pushing outward a second one of the first and second halves of the plurality of male spindles and connecting the surgical instrument holder and a plurality of male spindles on the sterile barrier plate, thus completing a connection between the surgical instrument holder gearbox, the sterile barrier plate and the surgical instrument holder.

[0093] According to certain examples, the method further includes preloading a driving spindle in the surgical instrument holder gearbox towards a mating spindle via a spring mechanism, in which the mating spindle is a slotted spindle; further including compressing the spring mechanism during misalignment of the driving spindle and mating spindle; holding the misaligned driving spindle and mating spindle in an interfering space; and aligning the misaligned driving spindle and mating spindle pursuant to powering the surgical instrument holder gearbox.

[0094] According to certain examples, the method further includes axially securing the surgical instrument holder to the micromanipulator via coupling a plurality of steel plates on a front and bottom surface of the surgical instrument holder to a plurality of magnets on the micromanipulator, in which an interface between the surgical instrument holder and the micromanipulator is a common interface.

[0095] According to certain examples, the method further includes executing one or more of a corresponding drive interface and drive control algorithm for the surgical instrument via the drive system pursuant to the surgical instrument holder recognizing the surgical instrument assembled onto the surgical instrument holder.

[0096] According to certain examples, the method further includes moving the robotic surgical micromanipulator via one or more of at least five joints and adjusting the robotic surgical micromanipulator based on one or more of at least three degrees of adjustability.

[0097] According to certain examples, the method further includes centrally positioning, via engaging a plurality of precision bores with the surgical instrument holder gearbox, one or more of the surgical instrument holder and a sterile barrier plate upon which the surgical instrument holder rests, relative to a robotic system coupled to the surgical robotic micromanipulator.

[0098] All and each of the methods and apparatuses described herein, in any combination, are herein contemplated and can be used to achieve the benefits as described herein.- 16 of 57 - SG Docket No.: 14843-711.600BRIEF DESCRIPTION OF THE DRAWINGS

[0099] A better understanding of the features and advantages of the methods and apparatuses described herein will be obtained by reference to the following detailed description that sets forth illustrative embodiments, and the accompanying drawings of which:

[0100] FIG. 1 depicts surgical micromanipulator kinematics and joints of a robotic arm of a surgical robotic system having a micromanipulator.

[0101] FIGS. 2A-2C depict triple pivot mechanism range of motion.

[0102] FIG. 3 A depicts the robotic surgical system operating on an operative eye of a patient.

[0103] FIG. 3B depicts two robotic surgical systems operating on an operative eye of a patient.

[0104] FIGS. 4A-4B depict degrees of adjustability ofjoint axes.

[0105] FIG. 5A is an exemplary threaded collet and sleeve assembly.

[0106] FIG. 5B is an exemplary cross-sectional view of the threaded collet and sleeve assembly mounted to a surgical instrument holder.

[0107] FIG. 5C is an exemplary assembly with a collet and clamping collar.

[0108] FIG. 6A is an exploded view of a surgical instrument holder system with a sterile barrier plate and surgical instrument holder gearbox.

[0109] FIGS. 6B-6D depict various surgical instruments mounted to respective surgical instrument holders with a consistent distance between surgical instrument tips and the surgical instrument holder.

[0110] FIGS. 7A-7B are perspective views of a surgical instrument holder gearbox coupled to the surgical instrument holder system.[oni] FIGS. 8A-8B depict removal of the surgical instrument holder system from a sterile barrier plate and directly away from an operative eye.

[0112] FIG. 9A is a perspective view of a micromanipulator draping feature on the sterile barrier plate.

[0113] FIG. 9B is a perspective view of a micromanipulator alignment feature on a surgical instrument holder gearbox.

[0114] FIGS. 10A-10D depict spindles of the surgical robotic system and spindle interaction.

[0115] FIGS. 10E-10R depict further coupling and spindle designs.

[0116] FIG. 11 depicts a folded insertion joint of the surgical robotic system configured for high-speed surgical instrument retraction.

[0117] FIGS. 12A-12D depict top views of ingress-egress protection and wire routing features between an insertion link and fourth and fifth joints of the surgical robotic system.- 17 of 57 - SG Docket No.: 14843-711.600

[0118] FIGS. 12E-12G depict side views of ingress-egress protection and wire routing features between an insertion link and fourth and fifth joints of the surgical robotic system.

[0119] FIG. 13 depicts internal driver and hollow shaft placement within the surgical robotic system.

[0120] FIG. 14A depicts a front view of a hollow shaft of the surgical robotic system.

[0121] FIG. 14B depicts a top view of a hollow shaft of the surgical robotic system.

[0122] FIG. 15 depicts attachment features between the steel barrier plate and surgical instrument holder.

[0123] FIGS. 16A-16G2 depicts an attachment workflow and interfacing between components of the surgical instrument tool holder system and micromanipulator.DETAILED DESCRIPTION

[0124] The present invention details the hardware implementation of a surgical robot designed for microsurgeries including cataract surgery. A novel combination of features results in a system capable of meeting both the functional and safety demands involved in the surgery.

[0125] For examples of robotic systems that may be used with the systems and methods described herein, see U.S. Application No. 17 / 052,758 entitled SYSTEM AND METHOD FOR AUTOMATED IMAGE-GUIDED ROBOTIC INTRAOCULAR SURGERY filed on November 3, 2020 and International Application No. PCT / US2024 / 038892 entitled ROBOTIC ASSISTED OPHTHALMIC SURGERY SYSTEM filed on July 19, 2024, the entire contents of which are incorporated by reference herein.

[0126] For examples of remote center of motion mechanisms that may be used with the systems and methods described herein, see U.S. Application No. 63 / 639,529 entitled SYSTEM, METHODS AND APPARATUSES FOR TELEMANIPULATION WITH REMOTE CENTER OF MOTION IN OCULAR SURGERY filed on April 26, 2024 and International Application No. PCT / US2024 / 055267 entitled TRIPLE PIVOT REMOTE CENTER OF MOTION JOINT FOR SURGICAL ROBOTIC SYSTEMS filed on November 8, 2024, the entire contents of which are incorporated by reference herein.

[0127] The present invention details the hardware implementation of a surgical robot designed for microsurgeries including cataract surgery. A novel combination of features results in a system capable of meeting both the functional and safety demands involved in the surgery.

[0128] FIG. 1 depicts surgical micromanipulator kinematics and joints of a robotic arm of a surgical robotic system having a micromanipulator.- 18 of 57 - SG Docket No.: 14843-711.600

[0129] The claimed invention features a surgical robotic system 100 including a micromanipulator 101 with a remote center of motion 112 having 5 degrees of freedom (DOFs) including three rotational joints, a prismatic joint, and an auxiliary joint for surgical instrument functionality. The first two joints 102 and 104, respectively, may be rotational, responsible for pivoting the central long axis of a surgical instrument 134 about the RCM 112. The third joint 106, which may be a prismatic joint, may be configured to enable the insertion / retraction of tool tip 114 of surgical instrument 134 directly into / out of the RCM 112. A fourth joint 108 may be a rotary joint that is coincident with the third joint 106 and configured to spin the surgical instrument 134 about its central long axis. The fifth joint 110 may be used to perform additional surgical instrument 134 functionality such as injection of a syringe or intraocular lens and grasping of forceps. When the micromanipulator 101 is positioned such that the RCM 112 is coincident with an incision, all motions of the surgical instrument 134 may be configured to satisfy the mechanical RCM 112 requirement and minimize stresses on and trauma to the ocular and surrounding tissue of operative eye(s) of a patient.

[0130] Enabled by transmission mechanisms such as a vertical transmission and compact form factor withing folded insertion joint 111 / surgical instrument holder gearbox 142, coordination and compliance between arm connection point 100 A of the robotic system 100, triple pivot mechanism 133, end effector connector to folded insertion joint base 199, various joint axis from the first joints 102 and 104 through the fifth joint 110, surgical instrument tool holder 143 and micromanipulator 101 coordinate for smooth end effector / surgical instrument 134 motion (including tool tip 114 of the surgical instrument 134), without needing to move the arm of robotic system 100 which attaches at arm connection point 100 A, for example via use of third joint 106 for direct insertion and retraction of surgical tool tip 114 into the incision 112 within no fly zone 113.

[0131] Offering advantages over axial drive mechanisms, inverted drive mechanisms may be used with vertical transmission may be placed below a drive system, in the general region of surgical instrument holder gearbox 142 and allow for direct docking of surgical instrument tool holder 143 and the motion of joint 106 as well as linear motion that allows for safety considerations including retraction of the surgical tool from the operative eye.

[0132] With separation of gross and fine movement, movement may be controlled to keep motion of robotic system 100, triple pivot mechanism 133, the various joints 102 / 104 / 106 / 108 / 110 as well as components other than the tool tip 114 of surgical instrument 134 out of no fly zone 113 and away from collisions with a patient and patient anatomy. Fine gears may allow for precise control and rotation.- 19 of 57 - SG Docket No.: 14843-711.600

[0133] No fly zone 113 may be configured for safety and continuous, real-time imaging of a patient’s eye, for example via a multi-modal imaging system including digital microscope and ocular coherence tomography (OCT) scanning. In certain examples, no-fly zone 113 may include or be concentric to RCM 112 which may also be a point of the incision. Various clutch and spindle mechanisms may enable proper alignment and engagement of various components described herein such as male and female spindles, gearbox and surgical instrument holder. Drive and placement may be standardized to track tool tip motion and control robotic system 100.

[0134] Given the selected joint types and RCM requirement, the orientation of the first joint 102 as well as the relationship between joints given by DH parameters may not be fully defined. Instead, additional constraints may be imposed from the requirements of cataract surgery. Cataract surgery can be performed with one or more incisions. Commonly, two corneal incisions are made temporally slightly anterior to the limbus, and different surgical instruments are inserted through each across the surgery. The required intraocular workspace, described by the roll, pitch, and yaw angles as well as insertion depth of a surgical instrument about the RCM, is quite large. Required yaw (about an axis parallel with the optical axis of the eye) range of motion can be more than 150°, while desired pitch (angling the surgical instrument tip anteriorly / superiorly with respect to the incision point) range of motion can be well over 100°. Motions of the surgical instrument, and any surgical robot manipulating the surgical instrument, outside of the eye can therefore be quite large. Consequently, collisions of the surgical instrument or robot micromanipulator with the patient (eyebrow, cheek, nose, shoulder, torso), any imaging system, or second micromanipulator can often occur within the desired workspace depending on the DH parameters of the robot and physical implementation of each joint. Although surgeons can amplify their intraocular workspace relative to their hand motions to prevent collisions by using curved surgical instruments and moving the eye during the surgery, the disclosed invention is designed to reach the necessary workspace with the eye held stationary and using straight instruments (those without portions that bend beyond the intended insertion depth). These additional constraints improve safety by enabling single-DOF retraction of any surgical instrument, stabilizing the eye for improved accuracy of sensing (visually by the surgeon or an imaging system) and accuracy of surgical instrument tip within the eye relative to anatomy, and minimizing stress to the tissue at the incisions. However, the constraints maintain the high requirements for robot intraocular workspace. An investigation of possible DH parameter combinations, as well as robot base orientation arrived at an adequate robot kinematic configuration. Relevant intraocular workspace may be maximized while problematic collisions may be minimized when the base - 20 of 57 - SG Docket No.: 14843-711.600of the robot is positioned such that the first joint 102 is configured to be vertical and parallel to the optical axis of the operative eye when the patient is lying on an operating bed with the operative eye of the patient looking vertically upwards, and the link twists (angle between subsequent intersecting j oint axes) between the first and second joints 103, and the second and third joints 105 are each between 45°-75°.

[0135] Vertical orientation of the first joint 102 is problematic for a traditional rotary joint having a physical joint along an axis and links intersecting the axis, as it blocks overhead view of the eye unless the mechanism is very large. A large mechanism may be undesirable, as it may introduce numerous other problems if implemented. Additionally, in the event that two surgical instruments are used, two identical micromanipulators with traditional rotary first joints would overlap given the small distances between incision points. As such, the present invention uses a triple pivot mechanism (TPM).

[0136] FIGS. 2A-2C depicts triple pivot mechanism ranges of motion 200”, 200 and 200’ respectively.

[0137] As shown here, there are corresponding no fly zones for each range of motion, with triple pivot mechanism and tool holder and other components of the robotic system 100 from FIG. 1 configured to remain outside of no fly zones 213”, 213 and 213’ corresponding to ranges of motion 200”, 200 and 200’, respectively. No fly zones 213”, 213 and 213’ may correspond with incision points, patient eye and other anatomy as discussed in FIG. 1.

[0138] For example, in FIG. 2A, tool tip 214” of surgical tool holder 243” may be configured to insert and retract into no fly zone 213” from an inferior-left lateral angle of motion 200”, while surgical tool holder 243”, gearbox 242”, folded insertion joint 211”, end effector connector to folded insertion joint base 299” and triple pivot mechanism 233” may be configured to remain outside of no fly zone 213” and collision-free from patient anatomy.

[0139] For example, in FIG. 2B, tool tip 214 of surgical tool holder 243 may be configured to insert and retract into no fly zone 213 from an superior-left lateral angle 200, while surgical tool holder 243, gearbox 242, folded insertion joint 211, end effector connector to folded insertion joint base 299 and triple pivot mechanism 233 may be configured to remain outside of no fly zone 213” and collision-free from patient anatomy.

[0140] For example, in FIG. 2C, tool tip 214’ of surgical tool holder 243’ may be configured to insert and retract into no fly zone 213’ from an superior -right lateral angle 200’, while surgical tool holder 243’, gearbox 242’, folded insertion joint 211’, end effector connector to folded insertion joint base 299’ and triple pivot mechanism 233’ may be configured to remain outside of no fly zone 213’ and collision-free from patient anatomy.- 21 of 57 - SG Docket No.: 14843-711.600

[0141] A TPM is a joint mechanism that enables nearly 180° rotation 2007200" about an axis in space that the joint does not physically occupy. Additionally, it possesses symmetry about a 0° position 200, making it suitable for use on both left and right eyes, and for surgeries using two surgical instruments as shown in FIGS. 3 A and 3B, respectively. For various surgical instruments and surgical instrument holders that may be used with FIGS. 3A-3B, see FIGS. 6B-6D, 7A-7B and their corresponding descriptions in this Specification.

[0142] FIG. 3A depicts the robotic surgical system 300 operating on an operative eye 330 of a patient. Triple pivot mechanism 333 of robotic surgical system 300 may approach at a superior-left lateral angle while downstream components including from folded insertion joint 311 to surgical tool tip 314 may have independent motion to approach eye 330 within no fly zone 313 at a direct or near-direct left horizontal or other desired angle. Components including triple pivot mechanism 333, end effector connector to folded insertion joint base 399, folded insertion joint 311, gearbox 342, and surgical tool holder 343 may be configured to remain outside of no fly zone 313 and to avoid collision with patient anatomy.

[0143] FIG. 3B depicts two robotic surgical systems 301 / 302 operating on an operative eye 330 of a patient.

[0144] Triple pivot mechanism 333’ of robotic surgical system 301 may approach at an inferior -left lateral angle while downstream components including from folded insertion joint 311’ to surgical tool tip 314’ may have independent motion to approach eye 330 within no fly zone 313 at a direct or near-direct left horizontal or other desired angle. Components including triple pivot mechanism 333’, end effector connector to folded insertion joint base 399’, folded insertion joint 311’, gearbox 342’, and surgical tool holder 343’ may be configured to remain outside of no fly zone 313 and to avoid collision with patient anatomy.

[0145] Triple pivot mechanism 333” of robotic surgical system 302 may approach at an superior-medial angle while downstream components including from folded insertion joint 311” to surgical tool tip 314” may have independent motion to approach eye 330 within no fly zone 313 at a superior-left lateral or other desired angle. Components including triple pivot mechanism 333”, end effector connector to folded insertion joint base 399”, folded insertion joint 311”, gearbox 342”, and surgical tool holder 343” may be configured to remain outside of no fly zone 313 and to avoid collision with patient anatomy.

[0146] Thus, the kinematics structure, base orientation, and triple pivot mechanism together allow for one or two surgical instruments to be used with minimized collisions and unobstructed view from above, as shown in FIGS. 3A and 3B, respectively.

[0147] The use of a TPM for the first joint introduces additional complexity to the manufacturing and assembly of the robotic micromanipulator. Additionally, the structure of - 22 of 57 - SG Docket No.: 14843-711.600the TPM, with a series of effectively cantilevered attachments, is prone to structural deformation due to gravity. As the joint angle moves from the 0° position 200 shown in FIG.2, the stiffness of the mechanism to gravity decreases, and the instantaneous location and orientation of the first joint diverges slightly from that at the 0° position. As such, it is not feasible to reliably machine and assemble the mechanism with an ideal RCM position, and a non-ideal RCM is created. The ideal RCM is a theoretical construct, defined by the axes of the plurality of joints intersecting at a single point that does not move.

[0148] With reference to

[0149] FIGS. 4A-4B depict degrees of adjustability of joint axes.

[0150] Three degrees of adjustability may be added to the micromanipulator and the end effector connector to folded insertion joint base 499 (shown here again connected to triple pivot mechanism 433 with robotic arm connection point 400 A) using a combination of shims, set screws, kinematic coupling, and fasteners. As shown in FIG. 4A, these enable translation of the second joint with respect to the first joint in two perpendicular directions 418 / 420, allowing for translation / adjustment of base of the triple mechanism component 416 forwards and backwards along dashed line 420 with respect to connection between triple pivot mechanism pivots component 414, as well as translation / adjustment of base of end effector connector to folded insertion joint base component 419 along solid line 418 with respect to component 416.

[0151] As shown in FIG. 4B, third and fourth joints may be translated with respect to the second joint in one direction 426 and underside of non-sterile component 422 on micromanipulator may be translated along solid line 426 with respect to underside of folded insertion joint base component 424. Also shown is surgical instrument holder 443, underside of gearbox 442 (see rotation gear 754 and actuation gear 752 of FIG. 7A), precision bore feature 460, and base plate 499’ which may be configured to connect to end effector connector to folded insertion joint base 499 coupled to the triple pivot mechanism shown in FIG. 4A.

[0152] As such, the second joint can be mechanically adjusted in a calibration process with measured kinematic data to nominally intersect the first joint, and the third and fourth joints can be adjusted to intersect the intersection of the first and second joints. This enables the mechanism to be assembled with an RCM that is far closer to ideal than is possible without adjustability, where machining tolerances and nominal kinematics that do not account for joint value-dependent mechanism stiffness to gravity are used.

[0153] Universal Surgical Instrument Holders- 23 of 57 - SG Docket No.: 14843-711.600

[0154] For examples of surgical instruments and surgical instrument holders that may be used with the systems and methods described herein, see International Application No.PCT / US2024 / 010586 entitled SURGICAL TOOL HOLDER FOR INTRAOCULAR ROBOTIC SURGICAL SYSTEMS filed on January 5, 2024, the entire contents of which are incorporated by reference herein.

[0155] The surgical instrument holder may be a sterile component that is capable of interfacing with many different surgical instrument geometries. Each surgical instrument holder may be mounted to a single surgical instrument prior to procedure and may serve to create an interface between surgical instruments and the micromanipulator. Interfacing between a general instrument geometry and the holder may occur through one of two methods:

[0156] 1. Threaded collet and sleeve

[0157] 2. Clamping collar and collet

[0158] FIG. 5A is an exemplary threaded collet and sleeve assembly. The threaded collet and sleeve design functions by utilizing a sleeve 530 with a standard external geometry and an internal geometry that is matched to the surgical instrument. The sleeve 532 may slide into a collet 530 which is constrained within the surgical instrument holder (not shown). A nut 528 may be threaded onto the collet 530, thereby compressing the collet 530 to clamp on the sleeve 532, surgical instrument 534, and holder, creating a friction hold. As a result, this completed assembly can be mounted to the micromanipulator to function during the surgical procedure.

[0159] FIG. 5B is an exemplary cross-sectional view of the threaded collet 530 and sleeve assembly 532 mounted to a surgical instrument holder 536.

[0160] FIG. 5C is an exemplary assembly with a collet and clamping collar.

[0161] An alternative method of clamping is a screw-on clamping collar 538. The collar 538 may be manufactured from a compliant material that is able to bend and clamp onto a surgical instrument 534 as a screw is turned by hand. The collar 538 may function similarly to a one-sided shaft collar. This clamping may secure the surgical instrument 534 to the collet 530 and as a result, to a surgical instrument holder as well, similarly to the “threaded collet and sleeve” design.

[0162] Both of the aforementioned clamping designs may allow a user in the sterile field to secure the surgical instrument to the holders by hand and without the use of additional tooling. The holders may be designed with enough clearance such that a user can attach any necessary components and accessories to the surgical instrument (i.e. tubing, tips, etc.) after the surgical instrument is attached to the surgical instrument holder without obstruction.- 24 of 57 - SG Docket No.: 14843-711.600

[0163] FIG. 6A is an exploded view of a surgical instrument holder system such the system of FIG. 6C with a sterile barrier plate and surgical instrument holder gearbox.

[0164] As shown here, there is a surgical instrument sleeve 632, surgical instrument holder 636, which may be a universal surgical instrument holder configured to hold a variety of off-the-shelf surgical instruments or a custom surgical instrument holder, surgical instrument 634 with surgical instrument tip 648, which may be an off-the-shelf surgical instrument or custom surgical instrument, sterile barrier plate 658, surgical instrument holder gearbox 642 having a central dip portion 642D and may be comprised of a top portion 642A and bottom portion 642B. The sterile barrier plate 658 may be configured to support surgical instrument 634 and rest on drape 640 which may cover at least non-sterile component of the micromanipulator 644. In certain examples, drape 640 may be a sterile drape and be configured to further cover non-sterile components of the robotic surgical system. Sterile barrier plate with assembled surgical instrument holder 636 may also be configured to push against top portion of gearbox 642 A to mate female spindle 636F with corresponding males spindles on top portion of gearbox 642 A to transmit torque to surgical instrument holder 636 and surgical instrument 634, see FIGS. 16E1-16E2. Surgical instrument holder 636 may have a variable diameter and be configured to hold and fix the orientation of surgical instrument 634. Sleeve 632 may be configured to at least partially house a distal portion of surgical instrument 634.

[0165] Thus, in certain examples, the surgical instrument holder may have a common interface configured for any surgical instrument such as a custom surgical instrument or an off-the-shelf surgical instrument, assuming that the surgical instrument is configured to fit into the interface of the surgical instrument tool holder, as well as being adapted and configured for being maneuvered and powered, driven, operated, and coupled to auxiliary systems and components including air, light, water, ultrasound, and any other support systems facilitating full functional use of the surgical instrument.

[0166] FIGS. 6B-6D depict various surgical instruments mounted to respective surgical instrument holders with a consistent distance between surgical instrument tips and the surgical instrument holder.

[0167] As shown here, surgical instrument holders 636A / B / C, which may be a universal surgical instrument holder or a custom surgical instrument holder for a given surgical instrument 634A / B / C, is designed such that when securing any surgical instrument 634A / B / C to the holders 636A / B / C, the surgical instrument tip 648A / B / C is always placed at the same distance relative to the front face 650A / B / C of the respective surgical instrument holder 636A / B / C when the surgical instrument 634A / B / C is assembled into corresponding surgical instrument holder 636A / B / C. This provides a fixed or standardized distance d 646 from “tip - 25 of 57 - SG Docket No.: 14843-711.600from tool holder” or from “tip to transmission” irrespective of different surgical instruments such as 634A / B / C engaged on various surgical instrument tool hoi der / dri vers 636A / B / C, which also standardizing the distalmost location of surgical instrument 634A / B / C regardless of tool type and may also provide a consistent orientation of surgical instrument 634A / B / C. This may offer the benefit of easing control of the surgical robotic system and assists with a consistent robotic workspace for every surgical step, further aided by gross or known placement of the surgical instrument 634A / B / C from kinematics of the arm of the robotic system, the triple pivot mechanism, etc. Furthermore, fixed distance d 646 ensures that only the surgical tool tip such as surgical instrument tip 648A / B / C enters the no fly zone 113 described in FIGS. 1-3B and keeps surgical instrument holder 636A / B / C and transmission components out of the no fly zone. In certain examples, a minimum anterior portion of a shaft of a surgical instrument such as surgical instruments 634A / B / C may also enter the no fly zone. Fixed distance d 646 may also standard drive mechanisms. In certain examples the robotic system or surgical instrument holder may identify a given surgical instrument and execute a corresponding drive interface or drive control algorithm.

[0168] Also shown is gearbox 642, sterile plate barrier 658 and sterile barrier plate 640.

[0169] Universal Surgical Instrument Holder Torque Transmission

[0170] In certain example, there may be required control of the surgical instrument through the surgical instrument holder, which may fall into one of two categories:

[0171] 1. Rotation

[0172] 2. Actuation (injection or grasp)

[0173] FIGS. 7A-7B are perspective views of a surgical instrument holder gearbox coupled to the surgical instrument holder system.

[0174] As shown in FIG. 7A, controls may be powered through a dual-sided gearbox 742 with each side providing torque with differing gear ratios. FIG. 7A depicts a surgical instrument that requires but actuation and rotation. In the event that only actuation is required (FIG. 6C), only the rotation gear transmission may be needed to power rotation and the actuation gear transmission may not run. In the case that only actuation of a surgical instrument is required (FIG. 6D), only the actuation gear transmission may be used to power actuation and the rotation gear transmission may not be powered. With differing gear ratios on both sides of the gearbox 742, the same motor type can be used for both rotation gear 754 and actuation gear transmission 752 despite differing torque requirements. Rotation gear transmission 754 may be coupled to a motor cable 744A connecting to surgical instrument holder gearbox 742 to PCB 1285 from FIG. 12C. Also shown is a housing 711 surrounding or serving as a base to the lower portion of gearbox 742. In certain examples, housing 711 may - 26 of 57 - SG Docket No.: 14843-711.600be a part of folded insertion joint 111 from FIG. 1. The transmission of torque between the gearbox 742 and surgical instrument holder 736 may occur through a quick-connect torque transmission design configured to power and actuate / rotate surgical instrument 734. Also shown are drive shafts 738 which may be configured to protract and retract surgical instrument 734 and coupled via drive shaft connector 738 A. In certain examples, one of drive shafts 738 may drive the other and be configured for controlled driving of the surgical instrument 734 and and / or its tip 714. In certain examples, the drive mechanism may be a vertical drive mechanism configured to transfer power between vertically oriented shafts or components such as surgical instrument-side components and end-effector components such as motors of folded insertion joint 111 from FIG. 1 which may be coupled to surgical instrument holder 736 via gearbox 742, permitting actuation along various axis such as the x and y axis. Also shown is sterile barrier plate 758 which may act as a stopper for surgical instrument holder 736. As shown here, the transmission drive design may be an inverted drive with the transmission / gearbox 742 located below the drive system such as surgical instrument drive shafts 738, and rotation gear 754 placed below actuation gear 752. This inverted and vertical drive design may allow for a compact form factor and more precise mechanical control, including movement of the surgical instrument 734 without needed to move other components such as surgical instrument holder 736, gearbox 742, etc.

[0175] FIG. 7B is an inverted view FIG. 7A, again shown are the aforementioned components including surgical instrument holder 736, surgical instrument 734, surgical instrument drive shafts 738 and connector 738A, gearbox 742 with actuation gear 752 and rotation gear 754 and transmission belt 744A, housing 711, non-sterile component 744 and sterile barrier plate 740.

[0176] Always-Safe Instrument Holder Detachment

[0177] Multiple surgical instruments may generally be required in the duration of an ophthalmic surgical procedure, which creates the necessity for safely switching between surgical instrument holders as each holder may correspond to one surgical instrument. To meet this need, torque may be transmitted through the surgical instrument holder gearbox, and not directly through the motors of the surgical instrument holder gearbox. In certain examples, the use of an inverted surgical instrument holder gearbox allows the motors of the surgical instrument holder gearbox to be positioned below the surgical instrument holder which removes the possibility of collisions between the motors of the surgical instrument holder gearbox and the patient and allows a user to manually remove the surgical instrument in the opposite of direction of the patient’s eye.- 27 of 57 - SG Docket No.: 14843-711.600

[0178] FIGS. 8A-8B depict manual removal 856 of the surgical instrument holder system, including surgical instrument holder 836 and surgical instrument 834, from the sterile barrier plate and away from an operative eye 830 (completed removal is shown in FIG. 8B). This may occur during an emergency situation or power failure and is enabled by the aforementioned inverted surgical instrument holder gearbox design placing the motors of the surgical instrument holder gearbox 842 below the surgical instrument holder 836. Also shown is folded insertion joint 811, which may be configured to serve as a base for gearbox 842. Also shown in FIG. 8B is alignment feature 836AF and corresponding cutout 858C.

[0179] Sterile Barrier and Draping

[0180] FIG. 9A is a perspective view of a micromanipulator draping feature on a sterile barrier plate 958. Also shown as before are surgical instrument holder 936, top portion of gearbox 942A and bottom portion of gearbox 942B (which may be separated by drape 940) and central dip 942D in top portion of gearbox 942A.

[0181] In certain examples, there may be two components to a sterile barrier plate of the surgical robot system, which may be configured to rest upon the gearbox and receive the surgical instrument holder with mounted surgical instrument on top of it.1. The sterile barrier plate may be a rigid plastic drape 958 featuring a precision-engineered mating surface designed to interface with the surgical instrument.2. A flexible drape positioned beneath the sterile barrier plate, designed to envelop the entirety of the micromanipulator and macromanipulator arm (robotic arm).

[0182] Thus, the drape may be independent or attached to the sterile barrier plate. The independence of these two components enables re-sterilization of the high-precision sterile barrier plate separately or their combination allows for a more streamlined sterile barrier plate.

[0183] FIG. 9B is a perspective view of a micromanipulator alignment feature on a surgical instrument holder gearbox.

[0184] The position of the sterile barrier plate and surgical instrument holder is critical to ensuring the robot's accuracy. To achieve precise alignment, the sterile barrier plate may incorporate a precision bore feature 960 that engages with the surgical instrument holder gearbox, centrally positioning the sterile plate and surgical instrument holder relative to the robot. In certain examples precision bore feature may be a single centrally placed feature at the dip 942D of top portion of gearbox 942A. In yet other examples the surfaces of top portion of gearbox 942A may also serve as precision features used for alignment and placement. Also shown as before are surgical instrument holder 935, screws 960, bottom portion of gearbox 642B and sterile barrier plate 940.- 28 of 57 - SG Docket No.: 14843-711.600

[0185] Quick-connect Torque Transmission with Safety Lock

[0186] FIGS. 10A-10D depict spindles of the surgical robotic system and spindle interaction.

[0187] As shown in FIG. 10 A, a top-down view of the sterile barrier plate and the surgical instrument holder, torque generated by the non-sterile portion 1044 of the surgical instrument holder gearbox may be transferred 1065 across the sterile barrier plate 1040 to the surgical instrument holder 1036, which may be sterile, via a spring-loaded male spindle 1062, thus providing a short vertical displacement. The male spindle 1062 is designed to align for engagement 1070 with a corresponding female spindle 1068. Such engagement on both the surgical instrument holder gearbox (non-sterile side 1044) and surgical instrument holder 1036 sides, separated by sterile barrier plate 1040, may be seen in FIG. 16G2.

[0188] FIG. 10C depicts a female spindle with a floral pattern / facets 1068 configured for flexibility regarding the angle and orientation of engagement at which male spindle 1062 engages with female spindle 1068. This may enable flexibility in alignment precision during engagement of the surgical instrument holder 1036 to the surgical instrument holder gearbox (non-sterile portion 1044) and sterile barrier plate 1040. Floral pattern / facets 1068 may be configured to engage completely or in part with male spindle 1062 to prevent misalignment.

[0189] As shown in FIG. 10A, a spring-loaded mechanism may permit vertical displacement 1065 of the sterile barrier plate 1040 in the absence of a surgical instrument, facilitating its removal. However, as shown in FIG. 10B, when a surgical instrument is installed, the spring mechanism prevents upward movement 1066 of the sterile barrier plate 1040, thereby ensuring secure retention and preventing unintended removal.

[0190] FIGS. 10E-10R depict further coupling and spindle designs.

[0191] Further designs may include modifications to or variations of female spindles 1068 integrated into the surgical instrument holder gearbox, male spindles 1070 inside of the sterile plate, and the surgical instrument holder (see surgical instrument holder 1536 from FIG. 15). In certain examples, the further designs may include changes or variations of the interface and mating between these components. Such designs may be configured to improve the alignment process between the surgical instrument holder, the sterile barrier plate, and the surgical instrument holder gearbox. Such improvement may enhance usability and ease for surgical staff to assemble components and provide consistency and reliability of secure attachments.

[0192] FIG. 10E depicts a chamfered female spindle. In certain examples, the female spindle may be a floral pattern as shown in FIG. 10C, further comprising a slotted chamfered pattern 1072. The chamfered female pattern 1072 may be configured such that within the spindle interface area 1078 (shown in FIG. 10H) for a corresponding male spindle such as those - 29 of 57 - SG Docket No.: 14843-711.600shown in FIGS. 10F-10G. In certain examples, pattern 1072 may be configured to contain no flat surfaces that would permit jamming between male and female spindles.

[0193] As shown in FIGS. 10F-10G, male spindles may be configured to engage with the chamfered female pattern as shown in FIG. 10E. Male spindles may consist of a chamfered configuration with one pin 1076 as shown in FIG. 10G or two pins 1074 as shown in FIG.10F. According to certain examples, chamfered pins 1074 / 1076 may not have flat surfaces in their geometry. Male spindles may be configured to avoid jamming on each other if misaligned. Alternatively, the chamfers may bias the spindle towards self-alignment, thus allowing the user to push the surgical instrument holder into the sterile plate with ease.

[0194] The single pin design shown in FIG. 10G may be configured to improve the alignment between the interfaces by decreasing the number of interface surfaces. In certain examples, such a single pin design may be configured to ensure that jamming of the spindles does not occur even if the male and / or female spindles are misaligned, for example due to errors in manufacturing or assembly.

[0195] FIG. 10J depicts a spring-loaded spindle. In certain examples, an alternative spindle may be configured to integrate an internal spring 1084 within the spindle. The spring-loaded spindle may contain two halves with one portion or half containing a pin 1080 and the other portion or half containing a slot 1082. Pin 1080 may be configured to slide within the slot 1082 creating relative motion between one another. Spring 1084 may be compressed between the two halves or portions, biasing the two halves or portions outward.

[0196] FIG. 10K2 depicts an exploded view of the spindle within the gearbox 1086 shown in FIG. 10K1.

[0197] As shown here, the spindle 1062 acts such that in the case that the surgical instrument holder gearbox 1042, sterile plate 1040, and surgical instrument holder 1036 are all misaligned, the user can push the surgical instrument holder 1036 up to the front face of the sterile barrier plate 1040 without jamming. Also shown are pins 1080, slot 1082 and internal spring 1084.

[0198] FIG. 10L depicts another view of the spindle.

[0199] As shown here, once the surgical instrument holder 1036 is placed, the surgical instrument holder gearbox 1042 can rotate until the pins 1080 on the male spindle align 1087 with the pattern 1068 on the surgical instrument holder gearbox 1042. Also shown is internal spring 1084.

[0200] As shown in FIG. 10M, upon alignment, one piece of the spring 1084-loaded spindle 1062 may push outward 1088 and engage with the gearbox 1042.- 30 of 57 - SG Docket No.: 14843-711.600

[0201] With the spindle 1062 engaged to the gearbox 1042, the gearbox 1042 can continue rotating until the male spindle 1062 pattern matches the female pattern 1068 on the surgical instrument holder 1036.

[0202] As shown in FIG. 10N, once the geometries match, the other half of the spring 1084-loaded spindle 1062 pushes outward 1089 and creates a connection between the surgical instrument holder 1036 and the sterile plate spindle 1040S, resulting in a complete connection between the surgical instrument holder gearbox 1042, the sterile plate 1040, and the surgical instrument holder 1036.

[0203] According to certain examples, the design of the spring-loaded spindle may be configured to accommodate various geometry including the floral pattern and the chamfered pin containing one or two pins.

[0204] FIGS. 101 and 100-1 OP represent various examples of pin geometry (two pins 1074 on the sides with top spindle protrusion 1000TS facing right in FIG. 101, two pins 1074 on the sides with top spindle protrusion 1000TS facing center in FIG. 10O and one pin 1076 on the right side with top spindle protrusion facing right in FIG. 10P).

[0205] FIG. 10Q depicts an internal spring with slotted spindle.

[0206] As shown here, another solution to assist spindle alignment may include a spring 1084 on the driving spindle 1084DS located in the gearbox 1042. This solution moves the complexity off the consumable components and onto the robot. It consists of a hollow driveshaft 1084HS that houses spring 1084 which preloads the driving spindle 2084DS towards 1090 its mating spindle / slotted spindle 1092. When misalignment occurs, the spring 1084 is compressed allowing for the misaligned spindles to occupy the interfering space until the gearbox 1042 is powered, clocking the spindles into its appropriate orientation for proper mating between male 1084DS and female 1092 spindles. Similarly to the design referenced in FIGS. 10J-10P, this design may be configured to allow the surgical instrument holder to be pushed all the way to the sterile plate barrier without jamming, improving the consistency of the system and user experience.

[0207] FIG. 10R depicts various geometries for the spindles, including a chamfered 1072 spindle (see FIG. 10E) for a spring -loaded gearbox 1042 shown on the medial side of the top gear 752 A.

[0208] The workflow of the surgical instrument holder placement on the sterile plate and instrument holder gearbox as shown in FIGS. 15-16G may be configured to remain the same independent of pin geometry.

[0209] Ophthalmic surgeries, such as cataract surgery, can be performed with or without general anesthesia. In general, however, there is the possibility for unexpected motions of the - 31 of 57 - SG Docket No.: 14843-711.600patient to occur. At times, these motions can be sudden and fast, such as if a patient sneezes or adjusts their head or body without warning. A surgeon or surgical robot can prevent trauma to the eye in one of two ways: accommodating patient motion by moving with the patient or quickly retracting the surgical instruments from within the eye. As the micromanipulator of the present invention may have a mechanical RCM and rigid structure, it may not be able to accommodate patient motion by moving the RCM. Instead, it may be designed to be able to very rapidly withdraw the surgical instrument when commanded.

[0210] FIG. 11 depicts a folded insertion joint of the surgical robotic system configured for high-speed surgical instrument retraction.

[0211] By using a high power-density motor 1180, which may be an insertion motor, placed parallel to and coupled with gears 1172 to a lead screw 1176, that may be configured to control surgical instrument insertion / retraction, the surgical robotic system can withdraw the surgical instrument in a straight line out of the patient’s eye at velocities comparable to and accuracy exceeding that of a human surgeon while maintaining a compact mechanism or form factor. Also shown are motor drivers 1182, a linear rail 1176 and forked carriage 1174. The top portion may include further end-effector components such as the gearbox 1142 and surgical instrument holder 1143.

[0212] It is always possible for one or more components in a robot to fail, thus attention must be paid to ensuring safety even in the event of failure. Of particular note are failures of actuators and sensors. The surgical micromanipulator addresses possible sensor failure via use of redundant sensors. The first, second and third joints may each possess two rotation sensors on the shafts of their respective motors, as well as an additional position (rotary for the first and second joints, linear for the third joint) on the output link. The fourth and fifth joints, which may couple to the surgical instrument holder, may have two rotary position sensors on each motor. This may allow for redundant monitoring of motor positions and output link positions of safety critical joints such as the first, second and third joints, as any error of a single sensor of any joint or of the transmission between motor and output link of these joints may be detected as a mismatch between sensor readings. Additionally, all joints of the micromanipulator may be designed with transmission of sufficient stiffness, efficiency, and transmission ratios such that they do not move under gravity with expected loads but can be back-driven by a human if power to and / or control of joints are disconnected. As such, the micromanipulator is always in a “safe” state for a stationary patient, as the surgical instrument will not move unless commanded but can be safely removed directly out of the incision through manual intervention.- 32 of 57 - SG Docket No.: 14843-711.600

[0213] FIGS. 12A-12D depict top views of ingress-egress protection and wire routing features between an insertion link and fourth and fifth joints of the surgical robotic system.

[0214] In addition to unexpected patient motions and safe failure states, it may be beneficial to the patient and robotic surgical system for there to be ingress-egress protection as well as internal routing of wires and placement of drivers. Ingress-egress protection may help to prevent bioburden buildup within the robot and leakage of particulates out of the robotic surgical system. The fourth and fifth joint motors may be physically positioned after the prismatic third joint. Although there are methods for sealing cabling in energy drag chains and sealing openings created by linear stages, the need to pass power and signal wires through the linear stage to the final two joints while maintaining ingress-egress protection and a compact form to prevent collisions is a non-trivial design problem. The surgical micromanipulator may feature a combination of magnetically loaded spring-steel strip 1288, custom printed circuit board (PCB) 1285, and the shell covering 1289 the motors 1287 and transmission of the fourth and fifth joints to accomplish this. Magnets may preload the spring-steel strip 1288 to seal around the opening of the linear stage except for where it must extend up over the carriage block 1284, which may have a layer of low-friction material 1286 configured to ease motion and prevent metal-on-metal wear. The carriage block 1284 may have a forked design with opening 1283 on the side. Opening 1283 may be the only access into insertion link 1290, which the custom PCB 1285 may be shaped to enter through. The PCB 1285 may enable rigid and well-defined sharp turns of wiring, and connects the fourth and fifth joint motors to wiring within the insertion link without risk of wires getting caught on the insertion axis transmission or the opening of the linear stage. The shell covering 1289 the fourth and fifth joint motors 1287 may be placed around the PCB 1285, to prevent other objects or materials from also easily entering through the opening that the PCB 1285 is placed through, as well as to hide the bend in spring-steel strip 1288. Also shown are base plate 1298, which is the opposite side of base plate 1299’ which connects the folded insertion joint (third joint 106 from FIG. 1) to the first joint 102 and second joint 104 of the triple pivot mechanism 133 from FIG. 1. Further shown is PCB cover 1297.

[0215] As shown, wires may be routed from the fourth and fifth joint motors 1287 (FIG. 12C) to the PCB 1285 (FIG. 12B), and from the PCB 1285 into the insertion link 1290 (FIG.12G) through the forked carriage 1284 (FIG. 12 A), bypassing the ingress-egress protection provided by the spring steel strip 1288 (FIG. 12D) that slides along the low-friction surface 1286 (FIG. 12B) as the forked carriage 1284 moves the sterile barrier 1258 (FIG. 12G), motors 1287, gearbox 1242 (FIG. 12F), and surgical instrument holder 1236 (FIG. 12F) along the length of the opening 1283 (FIG. 12 A). Magnets inside the insertion link 1290 may seal - 33 of 57 - SG Docket No.: 14843-711.600the spring-steel strip 1288 against the insertion link 1290 except for where it lifts over the low-friction surface 1286. The motor covers 1289 (FIG. 12G) may prevent access into a gap from the side and prevent contact with the electrical components. Also shown is base plate 1299’ (FIGS. 12E-12G) which may be configured to connect to end effector connector to folded insertion joint base 499 coupled to the triple pivot mechanism shown in FIG. 4A, as well as connection point 1242CP for gearbox 1242, which may be a linear guide carriage / carriage block.

[0216] Although specific joints of the plurality of joints are described for wire routing, it should be noted that wire routing may be accomplished across one or more joints and components of the system and provide benefit for wire management ease of manufacturing, as well as protecting the integrity of wires from degradation and damage by protecting them from being pulled, tangled, caught, or encumbering other components of the system during use of the micromanipulator or other components of the system.

[0217] FIG. 13 depicts internal driver and shaft placement within the surgical robotic system.

[0218] Wire routing may be maintained internally throughout the micromanipulator by internal placement of motor drivers 1382, use of actuators with hollow bores, and custom hollow shafts 1392 for the physical joints of the TPM. These hollow bores and shafts 1392 may enable wires to be routed through them, improving range of motion, reducing repeated bending on the wires, and preventing the wires from snagging as joints are actuated. Shown again are surgical instrument holder 1343, gearbox 1342, folded insertion joint 1311, end effector connector to folded insertion joint base 1399, triple pivot mechanism 1333 and arm connection point 1300A. Triple pivot mechanism 1333 may be configured for both gross and fine movement and mated onto the micromanipulator 1301 for further / refined fine movement such as rotation and extension and actuation of the surgical instrument / tip as well as switching and repositioning of surgical instruments. The end effector connector to folded insertion joint base 1399 may be configured to rotate and receive drive signals to drive a connected surgical instrument. This may be contrasted with the robotic system 100 from FIG.1 which is configured for gross movement.

[0219] FIG. 14A depicts a front view of a hollow shaft of the surgical robotic system.

[0220] FIG. 14B depicts a side view of a hollow shaft of the surgical robotic system.

[0221] While various embodiments have been described and / or illustrated herein in the context of fully functional computing systems, one or more of these example embodiments may be distributed as a program product in a variety of forms, regardless of the particular type of computer-readable media used to actually carry out the distribution. The embodiments disclosed herein may also be implemented using software modules that perform - 34 of 57 - SG Docket No.: 14843-711.600certain tasks. These software modules may include script, batch, or other executable files that may be stored on a computer-readable storage medium or in a computing system. In some embodiments, these software modules may configure a computing system to perform one or more of the example embodiments disclosed herein.

[0222] Surgical Instrument Holder, Sterile Plate, Micromanipulator Kinematic Magnetic Coupling

[0223] FIG. 15 depicts attachment features between the steel barrier plate and surgical instrument holder.

[0224] The secure attachment of the surgical instrument holder 1536 and sterile plate 1558 is critical for ensuring safe and efficient surgical procedures. Alignment of the sterile plate 1558 and surgical instrument holder 1536 to datum point 1593 on the micromanipulator may be facilitated by a magnetic system comprising eight magnets 1594 embedded within the carriage plate and corresponding steel plates 1595 integrated into the sterile plate 1558 and surgical instrument holder 1536. This magnetic coupling may reduce mechanical complexity and potential failure points, while providing a simplified and reliable attachment mechanism that eliminates the need for mechanical latches, enhancing ease of use for medical personnel.

[0225] Attachment Workflow and Interfacing:

[0226] FIGS. 16A-16G depicts an attachment workflow and interfacing between components of the surgical instrument tool holder system and micromanipulator. For further examples, see FIGS. 10E-10R described previously. In certain examples, the attachment workflow and the attachment of the surgical instrument holder to the sterile barrier plate described here may be compatible with the various designs and examples in FIGS. 10E-10R.

[0227] Mounting the surgical instrument holder to the micromanipulator end effector may be a multi-step process that maintains sterility while being efficient for a user. The components may all be designed such that the sterile surgical instrument can be easily mated to the non-sterile micromanipulator.

[0228] As shown in FIG. 16 A, the first step of the mounting process may be to attach the sterile barrier plate 1658 to the micromanipulator 1601. As shown in FIG. 16B, a curved mating feature 1696 on the sterile barrier plate 1658 may be configured to mate directly with the surgical instrument holder gearbox 1642, which ensures high-accuracy attachment. To create a rigid constraint, steel plates on the sterile barrier plate 1642 as mentioned above may be coupled to magnets on the micromanipulator 1601, creating a downward and axial coupling to the micromanipulator 1601.

[0229] As shown in FIG. 16C, when the sterile barrier plate 1658 is attached to the micromanipulator, it may not be configured to engage with the motors of the surgical - 35 of 57 - SG Docket No.: 14843-711.600instrument holder gearbox 1642. As shown in FIG. 16D which is a cross-sectional view of FIG. 16C, the spindles of male spindle 1662 on the sterile barrier plate 1658 may be spring-loaded away from the female spindle 1668 on the surgical instrument holder gearbox 1642.

[0230] The next step in the mounting process may be to mount the surgical instrument holder 1636 to the sterile barrier plate 1658 as shown in FIGS. 16E-16F.

[0231] As shown in FIG. 16El,the front face 1697A of the surgical instrument holder 1636 may be configured to push against 1699 the face 1697B of the sterile barrier plate 1658 to align it axially, and a curvature on the surgical instrument holder 1698 A may be configured to mate with a corresponding curvature 1698B on the sterile barrier plate 1658 to fully constrain the surgical instrument holder 1636. Furthermore, an alignment feature 1636AF on a side of surgical instrument may be configured to lock into a cutout 1658C of sterile barrier plate 1658. Also shown is at least one female spindle 1636F on front face of surgical instrument holder 1636, of which there may be a plurality of on front face of surgical instrument holder 1636.

[0232] FIG. 16E2 illustrates surgical instrument holder 1636 fully pushed up against the face 1697B of the sterile barrier plate 1658. Alignment feature 1636AF on surgical instrument holder 1636 is shown locked into cutout 1658C of sterile barrier plate 1658. This securement prepares female spindle(s) 1636F on the front face 1697 A of the surgical instrument holder 1636 for mating with corresponding male spindles on the gearbox. Furthermore, the locking of alignment feature 1636AF on surgical instrument holder 1636 into cutout 1658C of sterile barrier plate 1658 fixes a distance d between the surgical instrument tip and the front face 1697 A of the surgical instrument holder for surgical instrument stability, positioning and standardization across surgical instruments and surgical instrument holders as discussed in FIGS. 6B-6D and corresponding description in paragraphs

[0101] -

[0102] (see fixed distance d 646). For a discussing of mating between male and female spindles and transmission of torque to the surgical instrument holder via the gearbox, see FIGS. 10A-10R and corresponding paragraphs of description. For other examples of alignment features and cutouts, see alignment feature 836AF and cutout 858C in FIG. 8B.

[0233] As shown in FIG. 16G2 (an exploded view of FIG. 16G1), axial securement may be achieved through steel plates on the front face and bottom of the surgical instrument holder 1643, which may be configured to couple to magnets on the micromanipulator as referenced above. As the surgical instrument holder 1643 is pushed toward its axial alignment face, it may be configured to interface with the male spindle 1682 of the sterile barrier plate 1640. Pushing toward the face may be configured to oppose the spring force of the spindle 1682 within the sterile barrier plate 1640, such that when the surgical instrument holder 1643 is at - 36 of 57 - SG Docket No.: 14843-711.600a correct axial alignment, the male spindle 1682 may be configured to engage with the female spindle 1668 on the surgical instrument holder gearbox 1642. The completion of this process, detailed by cross-section 1699, may be configured to guarantee full constraint of the surgical instrument holder 1643 and create transmission between the surgical instrument holder 1643 and the surgical instrument holder gearbox 1642 on the micromanipulator / folded insertion joint 1611.

[0234] Thus, in certain examples, the interface between the surgical instrument holder and the micromanipulator may be a common interface.

[0235] The various exemplary methods described and / or illustrated herein may also omit one or more of the steps described or illustrated herein or comprise additional steps in addition to those disclosed. Further, a step of any method as disclosed herein can be combined with any one or more steps of any other method as disclosed herein.

[0236] When a feature or element is herein referred to as being "on" another feature or element, it can be directly on the other feature or element or intervening features and / or elements may also be present. In contrast, when a feature or element is referred to as being "directly on" another feature or element, there are no intervening features or elements present. It will also be understood that, when a feature or element is referred to as being "connected", "attached" or "coupled" to another feature or element, it can be directly connected, attached or coupled to the other feature or element or intervening features or elements may be present. In contrast, when a feature or element is referred to as being "directly connected", "directly attached" or "directly coupled" to another feature or element, there are no intervening features or elements present. Although described or shown with respect to one embodiment, the features and elements so described or shown can apply to other embodiments. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed "adjacent" another feature may have portions that overlap or underlie the adjacent feature.

[0237] Terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. For example, as used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms "comprises" and / or "comprising," when used in this specification, specify the presence of stated features, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items and may be abbreviated as " / ".- 37 of 57 - SG Docket No.: 14843-711.600

[0238] Spatially relative terms, such as "under", "below", "lower", "over", "upper" and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures is inverted, elements described as "under" or "beneath" other elements or features would then be oriented "over" the other elements or features. Thus, the exemplary term "under" can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms "upwardly", "downwardly", "vertical", "horizontal" and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.

[0239] Although the terms “first” and “second” may be used herein to describe various features / elements (including steps), these features / elements should not be limited by these terms, unless the context indicates otherwise. These terms may be used to distinguish one feature / element from another feature / element. Thus, a first feature / element discussed below could be termed a second feature / element, and similarly, a second feature / element discussed below could be termed a first feature / element without departing from the teachings of the present invention.

[0240] Throughout this specification and the claims which follow, unless the context requires otherwise, the word “comprise”, and variations such as “comprises” and “comprising” means various components can be co-jointly employed in the methods and articles (e.g., compositions and apparatuses including device and methods). For example, the term “comprising” will be understood to imply the inclusion of any stated elements or steps but not the exclusion of any other elements or steps.

[0241] In general, any of the apparatuses and methods described herein should be understood to be inclusive, but all or a sub-set of the components and / or steps may alternatively be exclusive, and may be expressed as “consisting of’ or alternatively “consisting essentially of’ the various components, steps, sub-components or sub-steps.

[0242] As used herein in the specification and claims, including as used in the examples and unless otherwise expressly specified, all numbers may be read as if prefaced by the word "about" or “approximately,” even if the term does not expressly appear. The phrase “about” or “approximately” may be used when describing magnitude and / or position to indicate that the value and / or position described is within a reasonable expected range of values and / or positions. For example, a numeric value may have a value that is + / - 0.1% of the stated value - 38 of 57 - SG Docket No.: 14843-711.600(or range of values), + / - 1% of the stated value (or range of values), + / - 2% of the stated value (or range of values), + / - 5% of the stated value (or range of values), + / - 10% of the stated value (or range of values), etc. Any numerical values given herein should also be understood to include about or approximately that value, unless the context indicates otherwise. For example, if the value "10" is disclosed, then "about 10" is also disclosed. Any numerical range recited herein is intended to include all sub-ranges subsumed therein. It is also understood that when a value is disclosed that "less than or equal to" the value, "greater than or equal to the value" and possible ranges between values are also disclosed, as appropriately understood by the skilled artisan. For example, if the value "X" is disclosed the "less than or equal to X" as well as "greater than or equal to X" (e.g., where X is a numerical value) is also disclosed. It is also understood that the throughout the application, data is provided in a number of different formats, and that this data, represents endpoints and starting points, and ranges for any combination of the data points. For example, if a particular data point “10” and a particular data point “15” are disclosed, it is understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15 are considered disclosed as well as between 10 and 15. It is also understood that each unit between two particular units are also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0243] Although various illustrative embodiments are described above, any of a number of changes may be made to various embodiments without departing from the scope of the invention as described by the claims. For example, the order in which various described method steps are performed may often be changed in alternative embodiments, and in other alternative embodiments one or more method steps may be skipped altogether. Optional features of various device and system embodiments may be included in some embodiments and not in others. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be interpreted to limit the scope of the invention as it is set forth in the claims.

[0244] The examples and illustrations included herein show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. As mentioned, other embodiments may be utilized and derived there from, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term “invention” merely for convenience and without intending to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is, in fact, disclosed. Thus, although specific embodiments have - 39 of 57 - SG Docket No.: 14843-711.600been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. Combinations of the above embodiments, and other embodiments not specifically described herein, will be apparent to those of skill in the art upon reviewing the above description.- 40 of 57 - SG Docket No.: 14843-711.600

Claims

1. CLAIMSWhat is claimed is:

1. A robotic surgical micromanipulator system comprising:a plurality of serially-connected joints intersecting at a remote center of motion (RCM); an end-effector of the micromanipulator system configured to manipulate a plurality of surgical instruments via an associated joint motor and motor driver;a surgical instrument holder system comprising: a surgical instrument holder configured to mount each of the plurality of surgical instruments to the surgical instrument holder, and the plurality of surgical instruments;a surgical instrument holder gearbox and a plurality of surgical instrument holder gearbox motors configured to power the surgical instrument holder system;a carriage block containing an insertion link and having a low friction surface configured to ease motion of the surgical instrument holder system;a printed circuit board (PCB) adjacent to the carriage block, the printed circuit board adapted and configured for electronic operation of the robotic surgical micromanipulator system; a shell covering configured to seal at least one of the plurality of serially-connected joints and the associated joint motor and motor driver of the end-effector; anda wire routing network for a plurality of wires extending through the plurality of serially-connected joints and into the surgical instrument holder system via the insertion link.

2. The surgical micromanipulator system of claim 1, wherein the plurality of serially-connected joints comprise five joints, wherein the RCM comprises five degrees of freedom having:two rotational joints configured to pivot about a central longitudinal axis of the plurality of surgical instruments about the RCM,a prismatic joint configured for insertion and retraction of the plurality of surgical surgical instruments in and out of the RCM,a rotary joint configured to spin the plurality of surgical instruments about the surgical instrument’s central longitudinal axis, andan auxiliary joint configured for additional functionality of the plurality of surgical surgical instruments including one or more of: injection of a material, manipulating an instrument tip, and grasping of a forceps.- 41 of 57 - SG Docket No.: 14843-711.6003. The surgical micromanipulator system of claim 1, further comprising a kinematic configuration of the system wherein the base is positioned such that a first joint of the plurality of serially-connected joints is vertical, wherein an angle between subsequent joints of the plurality of serially-connected joints is between 45°-75°.

4. The surgical micromanipulator system of claim 2, wherein the kinematic configuration is configured to maximize an intraocular workspace of the system and to minimize collisions between robotic arms coupled to a plurality of the surgical micromanipulator system and between a robotic arm coupled to a first of the plurality of the surgical micromanipulator system and one or more of: the patient, the imaging system, and a second of the plurality of the surgical micromanipulator system configured to operate on the operative eye in tandem with the first of the plurality of the surgical micromanipulator system.

5. The surgical micromanipulator system of claim 1, wherein the plurality of serially-connected joints are configured to actuate via a triple pivot mechanism having a range of motion of approximately 160°- 180°.

6. The surgical micromanipulator system of claim 5, wherein the triple pivot mechanism is enhanced by hardware including fasteners and kinematic coupling configured to allow positioning and adjustment of a rotational axis of at least one of the plurality of serially-connected joints relative to subsequent joints of the plurality of serially-connected joints.

7. The surgical micromanipulator system of claim 5, wherein the triple pivot mechanism is configured for use on one or more of: (i) the operative eye, wherein the operative eye is a right eye or a left eye of the patient, and (ii) in tandem with a second ophthalmic robotic surgical micromanipulator system, based on the triple pivot mechanism having symmetry about a 0° position of the triple pivot mechanism.

8. The surgical micromanipulator system of claim 1, wherein the surgical instrument holder of the surgical instrument holder system is one of a universal surgical instrument holder configured to receive a plurality of off-the-shelf surgical instruments.

9. The surgical micromanipulator system of claim 1, wherein the surgical instrument holder of the surgical instrument holder system is a custom surgical instrument holder configured to receive a custom surgical instrument.- 42 of 57 - SG Docket No.: 14843-711.60010. The surgical micromanipulator system of claim 1, wherein the surgical instrument holder of the surgical instrument holder system is configured to mount the plurality of surgical instruments via one of: a threaded collet and sleeve, a clamping collar and collet mechanism and a screw-on clamping collar or wherein the mounted plurality of surgical instruments are configured to receive accessories.

11. The surgical micromanipulator system of any one of claim 1, claim 8, claim 9, or claim 10 wherein a distance from a tip of any of the plurality of surgical instruments mounted to the surgical instrument holder and a front face of the surgical instrument holder has the same length.

12. The surgical micromanipulator system of claim 1, wherein the surgical instrument holder gearbox is dual-sided with each side providing torque for one of actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder, further wherein the surgical instrument holder gearbox motor powers both the actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder.

13. The surgical micromanipulator system of claim 12, wherein transmission of the torque between the surgical instrument holder gearbox and surgical instrument holder system occurs via a quick-connect torque transmission design comprising a spring-loaded male spindle on the sterile barrier plate configured to engage with a female spindle on both the surgical instrument holder gearbox and the surgical instrument holder, further wherein the quickconnect torque transmission design is configured to prevent unintended removal of the surgical instrument holder via preventing upward movement of the sterile barrier plate when coupled to the surgical instrument holder.

14. The surgical micromanipulator system of claim 13, wherein the female spindle on both the surgical instrument holder gearbox and the surgical instrument holder has a floral pattern configured for engagement with the male spindle at a plurality of orientations configured for flexibility in alignment precision during engagement of the surgical instrument holder with the surgical instrument holder gearbox and sterile barrier plate.

14. The surgical micromanipulator system of claim 1, wherein the surgical instrument holder system is configured for safe manual removal of each of the plurality of surgical instruments mounted to the surgical instrument holder in a direction away from the operative eye via one - 43 of 57 - SG Docket No.: 14843-711.600or more of: torque transmitted through the surgical instrument holder gearbox and manual removal in a failure mode.

15. The surgical micromanipulator system of claim 1, wherein the surgical instrument holder gearbox is positioned below the surgical instrument holder system and configured to avoid collision between the surgical instrument holder gearbox motor and the patient.

16. The surgical micromanipulator system of claim 1, further comprising: a sterile barrier plate adapted and configured as a floor for the surgical instrument holder system and to engage with the surgical instrument holder gearbox to centrally align the sterile barrier plate and surgical instrument holder system relative to other components of the surgical micromanipulator system.

17. The surgical micromanipulator system of claim 16, further comprising a drape coupled to the sterile barrier plate sized for positioning beneath the sterile barrier plate and to envelop the micromanipulator system and a robotic arm coupled to the micromanipulator system.

18. The surgical micromanipulator system of claim 17, wherein the drape is one of attached to or assembled independently of the sterile barrier plate.

19. The surgical micromanipulator system of claim 1, an insertion axis motor for a third joint of the plurality of serially-connected joints is parallel and coupled to a lead screw via gears for rapid retraction of any of the plurality of surgical instruments mounted to the surgical instrument holder, wherein the rapid retraction occurs along a straight line away from the operative eye.

20. The surgical micromanipulator system of claim 1, further comprising a plurality of redundant sensors on the plurality of serially-connected joints, wherein the plurality of redundant sensors are configured for mitigating sensor failure via monitoring positions of the plurality of serially-connected joints and the associated joint motor.

21. The surgical micromanipulator system of claim 1, wherein the plurality of serially-connected joints are configured to be immobile under gravity conditions and normal operative loads, further wherein the plurality of serially-connected joints are configured for manual override manipulation during a failure mode of the surgical micromanipulator system.- 44 of 57 - SG Docket No.: 14843-711.60022. The surgical micromanipulator system of claim 1, wherein the wire routing network is configured to be maintained by a plurality of the associate motor driver and a plurality of actuators having bores and hollow shafts, wherein at least a portion of the bores are hollow.

23. The ophthalmic surgical micromanipulator system of claim 1, wherein the plurality of wires are routed from a fourth and fifth joint of the plurality of serially-connected joints to the PCB via the surgical instrument holder gearbox, wherein the PCB is configured for enabling rigid and sharp turns of wiring through a gap formed by a magnetically loaded spring-steel strip configured to cover the insertion link.

24. The ophthalmic surgical micromanipulator system of claim 23 further wherein the plurality of wires may be further routed to the insertion link via a forked design of the carriage block.

25. The surgical micromanipulator system of claim 1, wherein the system is configured for ingress-egress protection via one or more of: a magnetically loaded spring-steel strip, the PCB, and the shell covering.

26. The surgical micromanipulator system of claim 25, wherein the shell covering is configured to seal the associated joint motor of at least two of the plurality of serially-connected joints, or the shell covering has an opening configured to receive the PCB, or the shell covering covers a bend of the spring-steel strip.

27. A robotic surgical micromanipulator system comprising:an imaging system configured to acquire imaging data of an operative eye of a patient; a base;a plurality of serially-connected joints intersecting at a remote center of motion (RCM); an end-effector of the micromanipulator system configured to manipulate a plurality of surgical instruments via an associated joint motor and motor driver, comprising:a surgical instrument holder system comprising:a surgical instrument holder configured to mount each of the plurality of surgical instruments to the surgical instrument holder, and the plurality of surgical instruments;- 45 of 57 - SG Docket No.: 14843-711.600a surgical instrument holder gearbox and a plurality of surgical instrument holder gearbox motors configured to power the surgical instrument holder system;a sterile barrier plate;a carriage block containing an insertion link and having a low friction surface configured to ease motion of the surgical instrument holder system;a printed circuit board (PCB) configured for electronic operation of the roboticsurgical micromanipulator system;a shell covering configured to seal at least one of the plurality of serially-connected joints and the associated joint motor and motor driver of the end-effector; anda wire routing network for a plurality of wires extending through the plurality of serially-connected joints and into the surgical instrument holder system via an insertion link.

28. The surgical micromanipulator system of claim 27, wherein the plurality of serially-connected joints comprise five joints, wherein the RCM comprises five degrees of freedom having:two rotational joints configured to pivot about a central longitudinal axis of the plurality of surgical instruments about the RCM,a prismatic joint configured for insertion and retraction of the plurality of surgical surgical instruments in and out of the RCM,a rotary joint configured to spin the plurality of surgical instruments about the surgical instrument’s central longitudinal axis, andan auxiliary joint configured for additional functionality of the plurality of surgical surgical instruments including one or more of: injection of material and grasping of forceps.

29. The surgical micromanipulator system of claim 27, further comprising a kinematic configuration of the system wherein the base is positioned such that a first joint of the plurality of serially-connected joints is vertical, wherein an angle between subsequent joints of the plurality of serially-connected joints is between 45°-75°.

30. The surgical micromanipulator system of claim 28, wherein the kinematic configuration is configured to maximize an intraocular workspace of the system and to minimize collisions between robotic arms coupled to a plurality of the surgical micromanipulator system and between a robotic arm coupled to a first of the plurality of the surgical micromanipulator system and one or more of: the patient, the imaging system, and a second of the plurality of - 46 of 57 - SG Docket No.: 14843-711.600the surgical micromanipulator system configured to operate on the operative eye in tandem with the first of the plurality of the surgical micromanipulator system.

31. The surgical micromanipulator system of claim 27, wherein the plurality of serially-connected joints are configured to actuate via a triple pivot mechanism having a range of motion of approximately 160°-180°.

32. The surgical micromanipulator system of claim 31, wherein the triple pivot mechanism is enhanced by hardware including fasteners and kinematic coupling configured to allow positioning and adjustment of a rotational axis of at least one of the plurality of serially-connected joints relative to subsequent joints of the plurality of serially-connected joints.

33. The surgical micromanipulator system of claim 31, wherein the triple pivot mechanism is configured for use on one or more of (i) the operative eye, wherein the operative eye is a right eye or a left eye of the patient, and (ii) in tandem with a second ophthalmic robotic surgical micromanipulator system, based on the triple pivot mechanism having symmetry about a 0° position of the triple pivot mechanism.

34. The surgical micromanipulator system of claim 27, wherein the surgical instrument holder of the surgical instrument holder system is one of a universal surgical instrument holder configured to receive a plurality of off-the-shelf surgical instruments and a custom surgical instrument holder configured to receive a custom surgical instrument; wherein the surgical instrument holder is configured to mount the plurality of surgical instruments via one of a threaded collet and sleeve, a clamping collar and collet mechanism and a screw-on clamping collar, further wherein the mounted plurality of surgical instruments are configured to receive accessories.

35. The surgical micromanipulator system of claim 27, wherein a distance from a tip of any of the plurality of surgical instruments mounted to the surgical instrument holder and a front face of the surgical instrument holder has the same length.

36. The surgical micromanipulator system of claim 27, wherein the surgical instrument holder gearbox is dual-sided with each side providing torque for one of actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder, further- 47 of 57 - SG Docket No.: 14843-711.600wherein the surgical instrument holder gearbox motor powers both the actuation and rotation of the plurality of surgical instruments mounted to the surgical instrument holder.

37. The surgical micromanipulator system of claim 36, wherein transmission of the torque between the surgical instrument holder gearbox and surgical instrument holder system occurs via a quick-connect torque transmission design comprising a spring-loaded male spindle on the sterile barrier plate configured to engage with a female spindle on both the surgical instrument holder gearbox and the surgical instrument holder, further wherein the quickconnect torque transmission design is configured to prevent unintended removal of the surgical instrument holder via preventing upward movement of the sterile barrier plate when coupled to the surgical instrument holder.

38. The surgical micromanipulator system of claim 37, wherein the female spindle on both the surgical instrument holder gearbox and the surgical instrument holder has a floral pattern configured for engagement with the male spindle at a plurality of orientations configured for flexibility in alignment precision during engagement of the surgical instrument holder with the surgical instrument holder gearbox and sterile barrier plate.

39. The surgical micromanipulator system of claim 27, wherein the surgical instrument holder system is configured for safe manual removal of each of the plurality of surgical instruments mounted to the surgical instrument holder in a direction away from the operative eye via one or more of: torque transmitted through the surgical instrument holder gearbox and manual removal in a failure mode.

40. The surgical micromanipulator system of claim 27, wherein the surgical instrument holder gearbox is positioned below the surgical instrument holder system and configured to avoid collision between the surgical instrument holder gearbox motor and the patient.

41. The surgical micromanipulator system of claim 27, wherein the sterile barrier plate is configured to be a floor for the surgical instrument holder system and to engage with the surgical instrument holder gearbox to centrally align the sterile barrier plate and surgical instrument holder system relative to other components of the surgical micromanipulator system.- 48 of 57 - SG Docket No.: 14843-711.60042. The surgical micromanipulator system of claim 27, further comprising a drape configured to be positioned beneath the sterile barrier plate and to envelop the micromanipulator system and a robotic arm coupled to the micromanipulator system, wherein the drape is one of attached to or assembled independently of the sterile barrier plate.

43. The surgical micromanipulator system of claim 27, an insertion axis motor for a third joint of the plurality of serially-connected joints is parallel and coupled to a lead screw via gears for rapid retraction of any of the plurality of surgical instruments mounted to the surgical instrument holder, wherein the rapid retraction occurs along a straight line away from the operative eye.

44. The surgical micromanipulator system of claim 27, further comprising a plurality of redundant sensors on the plurality of serially-connected joints, wherein the plurality of redundant sensors are configured for mitigating sensor failure via monitoring positions of the plurality of serially-connected joints and the associated joint motor.

45. The surgical micromanipulator system of claim 27, wherein the plurality of serially-connected joints are configured to be immobile under gravity conditions and normal operative loads, further wherein the plurality of serially-connected joints are configured for manual override manipulation during a failure mode of the surgical micromanipulator system.

46. The surgical micromanipulator system of claim 27, wherein the wire routing network is configured to be maintained by a plurality of the associate motor driver and a plurality of actuators having bores and hollow shafts, wherein at least a portion of the bores are hollow.

47. The ophthalmic surgical micromanipulator system of claim 27, wherein the plurality of wires are routed from a fourth and fifth joint of the plurality of serially-connected joints to the PCB via the surgical instrument holder gearbox, wherein the PCB is configured for enabling rigid and sharp turns of wiring through a gap formed by a magnetically loaded spring-steel strip configured to cover the insertion link, further wherein the plurality of wires may be further routed to the insertion link via a forked design of the carriage block.

48. The surgical micromanipulator system of claim 27, wherein the system is configured for ingress-egress protection via one or more of: a magnetically loaded spring-steel strip, the PCB, and the shell covering, further wherein the shell covering is configured to seal the - 49 of 57 - SG Docket No.: 14843-711.600associated joint motor of at least two of the plurality of serially-connected joints, further wherein the shell covering has an opening configured to receive the PCB, still further wherein the shell covering covers a bend of the spring-steel strip.

49. A drivetrain system for a robotic surgical micromanipulator comprising:a motor of an insertion joint base configured to couple to and power gears of a surgical instrument holder gearbox;the surgical instrument holder gearbox, wherein the gearbox includes a vertical transmission having at least a pair of vertical gears configured to transmit torque to a drive system; the drive system, wherein the drive system is configured to power a surgical instrument holder;the surgical instrument holder; anda surgical instrument having a tip, wherein the surgical instrument is configured for assembly with the surgical instrument holder.

50. The drivetrain system of claim 49, wherein the at least one pair of vertical gears of the vertical transmission includes rotation and actuation gears having different torque requirements and gear ratios.

51. The drivetrain system of claim 49, wherein the drive system is inverted for direct coupling to the surgical instrument holder and a compact form factor.

52. The drivetrain system of claim 49, wherein the vertical transmission includes a quick torque transmission design configured to transmit torque between the surgical instrument holder gearbox and the drive system powering the surgical instrument holder.

53. The drivetrain system of claim 49, wherein the insertion joint base has a folded configuration and is coupled to an end-effector of a triple pivot mechanism, wherein the triple pivot mechanism is coupled to a robotic arm of a robotic microsurgical system.

54. The drivetrain system of claim 49, wherein the surgical instrument tip is configured to be protracted and retracted into a no-fly zone, wherein the no-fly zone encompasses one or more of an operative eye of a patient and a remote center of motion for a triple pivot mechanism, wherein a path of motion of distal components coupled to the surgical instrument tip are configured to stay out of the no-fly zone, further wherein the distal components are - 50 of 57 - SG Docket No.: 14843-711.600configured to avoid collision with the patient, wherein the distal components include the surgical tool holder, the surgical tool holder gearbox, the insertion joint base, an end-effector of a triple pivot mechanism, and a robotic arm of a robotic microsurgical system.

55. The drivetrain system of claim 54, wherein the no-fly zone is configured for intraoperative imaging of the operative eye including by a multi-modal imaging system including a digital microscope and ocular coherence tomography (OCT).

56. The drivetrain system of claim 49, wherein a distance ‘d’ between the tip of the surgical instrument and an anterior surface of the surgical instrument tool holder when the surgical instrument is assembled onto the surgical instrument tool holder is configured to remain constant independent of properties of the surgical instrument and surgical instrument holder, wherein the distance ‘d’ is configured to maintain a proper orientation and length of the surgical instrument relative to an operative eye and exclusivity of the tip of the surgical instrument within a no-fly zone encompassing the operative eye.

57. The drivetrain system of claim 49, wherein the surgical instrument holder is configured to recognize the surgical instrument assembled onto the surgical instrument holder and execute one or more of a corresponding drive interface and drive control algorithm for the surgical instrument via the drive system.

58. The drivetrain system of claim 49, wherein the surgical instrument holder is configured to couple to the surgical instrument holder gearbox via a sterile barrier plate configured to rest on a non-sterile component of the robotic surgical micromanipulator, wherein the sterile barrier plate further comprises a rigid plastic drape.

59. The drivetrain system of claim 49, wherein the robotic surgical micromanipulator is configured for movement corresponding to at least five joints and at least three degrees of adjustability, further wherein the system comprises ingress-egress protection and wire routing features between and insertion link and a fourth and fifth joint of the as lest five joints.

60. The drivetrain system of claim 49, wherein the surgical instrument holder gearbox comprises a top portion and a bottom portion, wherein the top and bottom portion are separated by a sterile barrier plate.- 51 of 57 - SG Docket No.: 14843-711.60061. The drivetrain system of claim 49, wherein the vertical transmission enables manual retraction and removal of one or more of the surgical instrument and surgical instrument holder, wherein the manual retraction and removal is configured to retract and remove the tip of the surgical instrument from an operative eye during one or more of a power failure, a mechanical failure or other emergency.

62. The drivetrain system of claim 49, wherein the motor of the insertion joint base is one or more of a high power-density motor and an insertion motor placed parallel to and coupled with gears and a lead screw configured to enable mechanical retraction and removal of the surgical instrument in a straight line from an operative eye, wherein a velocity of the mechanical retraction is comparable to velocity of manual removal by a surgeon.

63. The drivetrain system of claim 49, further comprising a drape positioned beneath the sterile barrier plate and configured to envelop the micromanipulator and a robotic arm coupled to the micromanipulator.

64. The drivetrain system of claim 49, wherein alignment features including a plurality of precision bores configured to engage with the surgical instrument holder gearbox to centrally position one or more of the surgical instrument holder and a sterile barrier plate upon which the surgical instrument holder rests, relative to a robotic system coupled to the surgical robotic micromanipulator.

65. The drivetrain system of claim 49, wherein torque generated by the vertical transmission of the surgical instrument holder gearbox is transmitted across a sterile barrier plate to the surgical instrument holder via a plurality of male spindles having a spring-loaded mechanism and configured for vertical displacement and to engage with a plurality of female spindles, wherein the plurality of female spindles are on one or more of the surgical instrument holder gearbox and surgical instrument holder, further wherein the plurality of male spindles are separated by the plurality of female spindles via the sterile barrier plate.

66. The drivetrain system of claim 65, wherein the plurality of female spindles have a floral pattern with a plurality of facets configured to engage with the plurality of male spindles for guided alignment, further wherein the plurality of female spindles have a slotted chamfered pattern having an interface area configured to receive the plurality of male- 52 of 57 - SG Docket No.: 14843-711.600spindles, wherein the interface area comprises non-flat surfaces to prevent jamming between the plurality of male and female spindles.

67. The drivetrain system of claim 65, wherein the spring-loaded mechanism is configured to prevent vertical displacement and removal of the sterile barrier plate when the surgical instrument is installed on the surgical instrument holder.

68. The drivetrain system of claim 49, wherein the plurality of male spindles have a chamfered pattern having one or more pins with non-flat surfaces configured to prevent jamming of the plurality of male spindles when misaligned and further configured to bias the plurality of male spindles towards self-alignment and pushing of the surgical instrument holder into the sterile barrier plate.

69. The drivetrain system of claim 49, wherein the plurality of male spindles having a spring-loaded mechanism comprises two halves with a first half containing a pin and the second half containing a slot, further wherein the pin is configured to slide within the lot, wherein the spring-loaded mechanism is configured to be compressed between the first and second halves to bias the first and second halves outwards.

70. The drivetrain system of claim 49, wherein the plurality of male spindles are configured to allow unobstructed movement of the surgical instrument holder to a front face of the sterile barrier plate when one or more of the surgical instrument holder gearbox, sterile plate barrier and surgical instrument holder are misaligned.

71. The drivetrain system of claim 69, further wherein the surgical instrument holder gearbox is configured to rotate to align the pin of the plurality of male spindles with the plurality of female spindles on the surgical instrument holder gearbox and for a first one of the first and second halves of the plurality of male spindles to push outward to engage with the surgical instrument holder gearbox, further wherein the surgical instrument holder gearbox is configured to continue rotating to match the plurality of male spindles to a pattern of the plurality of female spindles on the surgical instrument holder gearbox, further wherein a second one of the first and second halves of the plurality of male spindles is configured to push outward to connect the surgical instrument holder and a plurality of male spindles on the sterile barrier plate to complete a connection between the surgical instrument holder gearbox, the sterile barrier plate and the surgical instrument holder.- 53 of 57 - SG Docket No.: 14843-711.60072. The drivetrain system of claim 49, further comprising a driving spindle in the surgical instrument holder gearbox having a spring mechanism configured to preload the driving spindle towards a mating spindle, wherein the mating spindle is a slotted spindle, wherein the spring mechanism is configured to be compressed during misalignment of the driving spindle and mating spindle, wherein the misaligned driving spindle and mating spindle are configured to be held in an interfering space and aligned for mating pursuant to powering of the surgical instrument holder gearbox.

73. The drivetrain system of claim 49, wherein the surgical instrument holder is configured to be axially secured to the micromanipulator via a plurality of steel plates on a front and bottom surface of the surgical instrument holder coupled to a plurality of magnets on the micromanipulator, wherein an interface between the surgical instrument holder and the micromanipulator is a common interface.

74. A method for powering a drivetrain system for a robotic surgical micromanipulator comprising:coupling a motor of an insertion joint base to power gears of a surgical instrument holder gearbox;transmitting torque to a drive system via a vertical transmission of the surgical instrument holder gearbox having at least a pair of vertical gears including rotating a rotation gear and actuating and actuation gear;powering a surgical instrument holder via the torque transmitted to the drive system; and actuating at least a tip of a surgical instrument assembled to the surgical instrument holder.

75. The method of claim 74, wherein actuating the tip of the surgical instrument including protracting and retracting the tip into a no-fly zone encompassing one or more of an operative eye of a patient and a remote center of motion (RCM) for a triple pivot mechanism.

76. The method of claim 74, further comprising manually retracting one or more of the surgical instrument and surgical instrument holder via the vertical transmission to retract the tip of the surgical instrument from the operative eye during one or more of a power failure, a mechanical failure or other emergency.- 54 of 57 - SG Docket No.: 14843-711.60077. The method of claim 74, further comprising mechanically retracting and removing the surgical instrument in a straight line from an operative eye via the motor of the insertion joint base being one or more of a high power-density motor and an insertion motor placed parallel to and coupled with gears and a lead screw, wherein a velocity of the mechanical retraction is comparable to velocity of manual removal by a surgeon.

78. The method of claim 74, further comprising:generating torque by the vertical transmission of the surgical instrument holder gearbox; and transmitting the generated torque across a sterile barrier plate to the surgical instrument holder via a plurality of male spindles having a spring-loaded mechanism and configured for vertical displacement and to engage with a plurality of female spindles, wherein the plurality of female spindles are on one or more of the surgical instrument holder gearbox and surgical instrument holder, further wherein the plurality of male spindles are separated by the plurality of female spindles via the sterile barrier plate.

79. The method of claim 78, further comprising engaging the plurality of female spindles with the plurality of male spindles via a floral pattern on the plurality of female spindles having a plurality of facets configured for guided alignment, further wherein the plurality of female spindles have a slotted chamfered pattern having an interface area configured to receive the plurality of male spindles, wherein the interface area comprises non-flat surfaces to prevent jamming between the plurality of male and female spindles.

80. The method of claim 78, further comprising obstruction of vertical displacement and removal of the sterile barrier plate via the spring-loaded mechanism pursuant to installation of the surgical instrument on the surgical instrument holder.

81. The method of claim 78, further comprising rotating the surgical instrument holder gearbox to align a pin of the plurality of male spindles with the plurality of female spindles on the surgical instrument holder gearbox and pushing outward a first one of a first and second half of the plurality of male spindles and engaging the surgical instrument holder gearbox; further comprising further rotating surgical instrument holder gearbox and matching the plurality of male spindles to a pattern of the plurality of female spindles on the surgical instrument holder gearbox, further comprising pushing outward a second one of the first and second halves of the plurality of male spindles and connecting the surgical instrument holder and a plurality of male spindles on the sterile barrier plate, thus completing a connection - 55 of 57 - SG Docket No.: 14843-711.600between the surgical instrument holder gearbox, the sterile barrier plate and the surgical instrument holder.

82. The method of claim 78, further comprising preloading a driving spindle in the surgical instrument holder gearbox towards a mating spindle via a spring mechanism, wherein the mating spindle is a slotted spindle; further comprising compressing the spring mechanism during misalignment of the driving spindle and mating spindle; holding the misaligned driving spindle and mating spindle in an interfering space; and aligning the misaligned driving spindle and mating spindle pursuant to powering the surgical instrument holder gearbox.

83. The method of claim 78, further comprising axially securing the surgical instrument holder to the micromanipulator via coupling a plurality of steel plates on a front and bottom surface of the surgical instrument holder to a plurality of magnets on the micromanipulator, wherein an interface between the surgical instrument holder and the micromanipulator is a common interface.

84. The method system of claim 74, further comprising executing one or more of a corresponding drive interface and drive control algorithm for the surgical instrument via the drive system pursuant to the surgical instrument holder recognizing the surgical instrument assembled onto the surgical instrument holder.

85. The method of claim 74, further comprising moving the robotic surgical micromanipulator via one or more of at least five joints and adjusting the robotic surgical micromanipulator based on one or more of at least three degrees of adjustability.

86. The method of claim 74, further comprising centrally positioning, via engaging a plurality of precision bores with the surgical instrument holder gearbox, one or more of the surgical instrument holder and a sterile barrier plate upon which the surgical instrument holder rests, relative to a robotic system coupled to the surgical robotic micromanipulator.- 56 of 57 - SG Docket No.: 14843-711.600

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