The present disclosure relates generally to equipment for facilitating performance of ophthalmic surgery.
Many disorders of the eye are treatable with ophthalmic surgery. Defects of the crystalline lens, such as cataracts, may be corrected by replacement of the crystalline lens with an artificial intraocular lens (IOL). Disorders of the retina may also be corrected through various surgical procedures. The eye is extremely delicate and the anatomy operated upon are extremely small. Therefore, ophthalmic surgery is performed in a highly-controlled environment with sophisticated equipment.
The present disclosure relates generally to operating room equipment for supporting ophthalmic surgery.
Particular embodiments disclosed herein include operating equipment including a base for resting on a floor. A boom extends upwardly from the base and extends outwardly from the base in a forward direction. A gantry is suspended from the boom and has three or more degrees of freedom. A surgical instrument is mounted to the gantry. One or more electrical components are mounted in the base and are configured to support performing ophthalmic surgery.
The following description and the related drawings set forth in detail certain illustrative features of one or more embodiments.
The appended figures depict certain aspects of the one or more embodiments and are therefore not to be considered limiting of the scope of this disclosure.
To facilitate understanding, identical reference numerals have been used, where possible, to designate identical elements that are common to the drawings. It is contemplated that elements and features of one embodiment may be beneficially incorporated in other embodiments without further recitation.
In prior approaches to performing ophthalmic surgery, many pieces of equipment are needed, each with its own power cord, housing, and possibly other features, such as vacuum tubes. As a result, the operating room can become cluttered and present many tripping hazards.
In the operating equipment disclosed herein a boom is mounted to a base housing one or more computing device, vacuum pumps, and possibly other equipment. A gantry is mounted to the boom and surgical equipment may be mounted to the gantry, such as a surgical microscope and one or more displays. A surgical chair is mounted to an arcuate path such that the chair may readily be moved to the left or right of a patient bed or superior to the patient bed. The chair has adjustable arms mounted thereto for holding additional pieces of equipment, such as a holder for a phaco-vit handpiece, a scanner for surgical instruments, and/or an additional display. The patient bed may have a storage device and electrically connect to a computing device in the base in order to transfer and receive patient data for an ophthalmic surgery.
The operating room equipment 100 may include a support frame 104 including a boom 106. The boom 106 extends upwardly in the vertical direction 102c from the floor as well as extending outwardly along the longitudinal direction 102a, i.e. “the forward direction” as used herein. The boom 106 extends upwardly from a central base 108. The central base 108 may have sufficient weight to prevent tipping of the boom 106 including when various items of surgical equipment are suspended therefrom. The central base 108 may therefore include both a structural frame for securing to the boom 106 as well as some form of ballast, such as steel plates, concrete blocks, or other dense material.
In the illustrated embodiment, lateral bases 110a, 110b secure to the central base 108 and extend outwardly in the transverse direction 102b and in the forward direction to provide additional stability. The boom 106, central base 108, and lateral bases 110a, 110b may be formed of an internal frame, such as a steel frame, covered in a shell, such as a shell made of one or more plastic panels.
The lateral bases 110a, 110b may cooperate with the weight of the central base 108 to resist tipping of the boom 106. However, in some implementations, the lateral bases 110a, 110b are either omitted or detachable such that the central base 108 alone is sufficient to prevent tipping. In still other embodiments, the central base 108 or boom 106 may be anchored to the floor, wall, column, or other structure to prevent tipping.
The central base 108 and lateral bases 110a, 110b may be hollow and provide a cavity for housing computing devices, power adapters, power distribution wires, vacuum pumps, and other components (see
The boom 106 may have a control panel 114 mounted thereto and facing in the forward direction. The control panel 114 may have controls (buttons, switches, touch screens, etc.) for controlling a vacuum tool, such as a phaco-vit tool for performing phaco-emulsification and vitrectomy. The control panel 114 may further define connectors for connecting to hoses 116 of the vacuum tool. The control panel 114 may further define physical connectors or a wireless interface for receiving inputs from another device, such as a foot pedal. The control panel 114 may be connected to a vacuum pump housed within the central base 108 and control the vacuum pump according to control inputs received by the control panel 114.
A gantry 118 secures to the boom 106 and extends downwardly from the boom 106 in the vertical direction 102c. The gantry 118 may define one or more degrees of translation along some or all of the longitudinal direction 102a, transverse direction 102b, and vertical direction 102c. The gantry 118 may define one or more degrees of rotational movement, such as rotation about axes parallel to some or all of the longitudinal direction 102a, transverse direction 102b, and vertical direction 102c. For example, the gantry 118 may define, three or more degrees of freedom and may have up to six degrees of freedom including up to three translational degrees of freedom and up to three rotational degrees of freedom.
The gantry 118 may have various items of equipment mounted thereto, such as a surgical microscope 120 and one or more displays 122. The surgical microscope 120 and one or more displays may have computing components housed within themselves or connect to computing components housed within the central base 108. The equipment mounted to the gantry 118 may be readily removed and replaced in a modular manner. Power and data wires and tubing for connecting to equipment mounted to the gantry 118 may be routed up and through the boom 106 in order to reach components mounted within the central base 108.
The operating room equipment 100 may further include an articulated surgical chair 126 and a patient bed 128, both of which are described in greater detail below. Any number of additional displays 130 may also mount to the support frame 104, such as to one or both of the lateral bases 110a, 110b by means of a gantry 132 having one or more articulated joints each with from one to six degrees of freedom. The displays 130 may be connected by wires or wireless connections to computing components housed within the central base 108.
The rotatable member 200 may define a slot 202, such as a slot 202 having a long dimension thereof substantially (e.g., within 5 degrees of) parallel to the longitudinal direction 102a. A plate 204 or other structure may be slidably mounted on or in the slot 202 and be slidable along the slot 202 in the longitudinal direction 102a. In the illustrated embodiment, a floor 206 extends inwardly from the slot 202 in the transverse direction 102b and defines an inner slot 208. The plate 204 may therefore rest on the floor 206 and be slidable along the floor 206.
A collar 210 may be rotatably mounted to the plate 204 and extend into the inner slot 208 and be slidable within the inner slot 208. The collar 210 rotatably, and possibly removably receives, a shaft 212 to which the gantry 218 is mounted. The gantry 218 may be mounted such that an optical axis of the surgical microscope 120 (or other optical instrument) is substantially collinear (e.g., within 10 cm) and parallel (e.g., within 5 degrees) to the axis of rotation of the shaft 212. For example, the shaft 212 may have one or more pins 214 protruding outwardly therefrom and the interior 216 of the collar 210 may define one or slots 218 arranged parallel to the axis of symmetry of the interior 216 (e.g., axis of a cylinder defined by the interior 216, in a helix, or other configuration. The shaft 212 may be inserted through the collar 210 with the one or more pins 214 positioned within the one or more slots 218. The shaft 212 may then be rotated relative to the collar 210 and the pins 214 may be seated within one or more indentations 220 defined by the upper edge of the collar 210. The weight of the shaft 212, gantry 218, and any equipment mounted to the gantry 118 may then resist removal of the pins 214 from the indentations 220.
The collar 210 may be rotatable with respect to the plate 204 thereby defining a rotational degree of freedom for the gantry 118 perpendicular to the rotational degree of freedom provided by the rotatable member 200. The gantry 118 itself may then provide up to six degrees of freedom as well in order to provide fine tuning of the orientation and position of equipment secured to the gantry 218.
The boom 106, rotatable member 200, and shaft 212 are preferably sufficiently rigid to resist vibrations induced by actuators of the gantry 118 and equipment mounted thereto, such as the surgical microscope 112. In this manner, vibrations induced by adjustment of the position and/or orientation of the gantry 118 or zooming in or out with the surgical microscope 112 will be more quickly attenuated.
The combination of the pivoting of the rotatable member 200, the sliding motion of the collar 210, and rotational of the shaft 212, along with the optical axis of the surgical microscope 120 or other optical instrument being aligned with the axis of rotation of the shaft 212 may result in a relatively small lateral motions in the longitudinal and transverse directions 102a, 102b and rotational motion coaxial to the axis of rotation of the shaft 212. This facilitates ergonomically and rapidly achieving the three main surgical positions (left temporal, superior, and right temporal). Current operating room equipment requires a large range of motion to achieve the main surgical positions and often requires the equipment to move to the opposite side of the patient's bed in a slow and cumbersome process. Some operating rooms will have the patient rolled in feet first instead of head first so that equipment doesn't have to change to a different side of the bed, which is difficult so many cords and tubes on the floor.
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A locking mechanism may be activated by a user to lock the sliding base 504 relative to the track 502. An actuator in the base 500 or the sliding base 504 may move the sliding base 504 relative to the track 502 responsive to control inputs from a user. Alternatively, the sliding base 504 may be manually moved around the track 502. In some implementations, one or both of the gantry 118 and arm 302 may be coupled to actuators that are coordinated with the position of the sliding base 504. For example, upon sliding of the sliding base 504 to the right side of the track 502, actuators of the gantry 118 and/or coupled to the arm 302 may also rotate such that the surgical microscope 120, display 122, and/or display 300 are on the left side of the track 502, e.g., having the patient bed 126 between the sliding base 504 and the surgical microscope 120, display 122, and/or display 300.
The sliding base 504 may have structures secured thereto for mounting and positioning accessories. In the illustrated embodiment, these structures include rings 508 encircling the sliding base 504 and that are rotatable relative to the sliding base 504 and may be locked at various points along the range of rotation of the rings 508 about the sliding base 504. Each ring 508 may have one or more arms 510 extending outwardly and upwardly therefrom such that a distal end of each arm 510 is conveniently positioned to a surgeon seated within the seat 506. Each arm 510 may be adjusted to and locked into various positions with respect to one or more degrees of freedom such as extending the length of each arm 510, tilting each arm 510, and/or articulating one or more joints in each arm 510. A distal end of each arm 510 may have an accessory mounted thereto, such as a ring 512 for holding a handpiece of a phaco-vit vacuum pump, a display 514 (e.g., tablet computer), an instrument holder 516, an instrument tray, tube manager, mechanical arm, robotic arm, or other accessories. The instrument holder 516 may include a scanner 518 for scanning instruments removed from and returned to the instrument holder 516.
The sliding base 504 may have one or more foot controls 520 mounted thereto and positioned to be contacted by the surgeon when seated within the seat 506. The foot controls 520 may be fixed to the sliding base 504 and translate therewith. The foot controls 520 may include foot controls for controlling any of the components forming part of the operating room equipment 100. For example, the foot controls 520 may include controls for controlling an actuator positioning the sliding base 504 on the track 502, controlling a phaco-vit vacuum pump, controlling positioning of the gantry 118, controlling positioning of the display 300, controlling information displayed on any of the displays 122, 130, 300, 514, or controlling any other item of equipment included on the operating room equipment 100.
The base 504 may provide a space for routing of tubing and wires between the central base 108 and the sliding base 504 in order to reduce clutter and remove tripping hazards. Tubing and/or wires may then be routed up through the base 504 and arms 510 to components mounted to or resting on the arms 510.
The electronic components 600 may include a control computing device 604. The control computing device 604 may implement control of actuators incorporated into some or all of the gantry 118, coupled to the arm 302, controlling movement of the sliding base 504, or any other actuators incorporated into the operating room equipment. The control computing device 604 may be programmed to perform coordinated movement of components, such as movement of the gantry 118 and/or display 300 responsive to movement of the sliding base.
The electronic components 600 may include an imaging computing device 606 that receives images captured by the surgical microscope 120, or other imaging device, and displays the images on any of the displays 122, 130, 300, 514. The imaging computing device 606 may process the images in order to generate processed images that are output on any of the displays 130, 300, 514. For example, the processed images may have guides superimposed thereon for guiding performance of ophthalmic surgery, such as placement of incisions, alignment of an IOL, and the like.
The electronic components 600 include one or more imaging devices 608, such as the surgical microscope 120 that provide images to the imaging computing device 606. Other imaging devices 608 may include an optical coherence tomography (OCT) scanner.
The electronic components 600 may include positioning actuators 610. The positioning actuators 610 may include actuators for positioning the gantry 118, the arm 302, the sliding base 504, or other components of the operating room equipment 100.
The electronic components 600 may include one or more displays 612, such as some or all of the display 122, display 130, display 300, and display 514. The electronic components 600 may include a phaco-vit vacuum pump 614. The electronic components 600 may also include the control panel 114.
The electronic components 600 may include electronic components 616 of the surgical chair 126. These electronic components 616 may include the scanner 518, the foot controls 520, and possibly actuators 618 for adjusting the position and orientation of the surgical chair 126, e.g., height, forward/backward positioning, tilt, and position and height of arms 510, position of accessories 512, 514, 516, 518, and position of foot controls 520.
The electronic components 600 may include electronic components of the patient bed 128. The patient bed 128 may include one or more actuators 620, such as actuators for raising and lowering of the platform 128a of the patient bed 128 or for changing the angle of portions of the platform. The electronic components of the patient bed 128 may include sensors 622, such as sensors for detecting whether the patient bed 128 is connected to the plug 400, the position of the platform 128a of the patient bed 128, or other attributes of the patient bed 128. The electronic components may further include a storage device 624. As noted above, the storage device 624 may be a storage device alone or may be incorporated into a computing device housed within the patient bed 128.
Various other electronic components 600 may be incorporated. For example, the electronic components 600 may include sensors for monitoring stress of the surgeon and a computing device (which may be the control computing device 604) programmed to receive and process the outputs of these sensors. The electronic components may include sensors for monitoring vitals and stress of a patient and a computing device (which may be the control computing device 604) programmed to receive and process the outputs of these sensors. The outputs from any of these sensors may be used to generate content displayed on any of the displays 122, 130, 300, 514 or output on another output of device, such as emitted by a speaker. The sensors for monitoring vitals and stress of the patient may include a Galvanic skin response wristband, which may include other physiological sensors such as a heart rate sensor.
The method may further include uploading, at step 708, surgeon preferences for positioning the platform 128a of the patient bed 128. Step 708 may include either (a) uploading the preferences to the patient bed 128, such as a computing device incorporated into the patient bed, and the computing device will then implement the preferences by activating the actuators 620 of the patient bed or (b) the control computing device 604 sends control signals to the actuators 620 in order to implement the surgeon preferences. In this manner, a surgeon can ensure that the patient is positioned at a preferred height when performing ophthalmic surgery without needing to manually adjust the height of the platform 128a of the patient bed 128. The actuators 620 may control other components of the patient bed 128, such as headrest position, spinal support positioning, and knee bolster positioning.
In some implementations, the method 700 further includes uploading, at step 710, post-operative data to the storage device 624 of the patient bed 128, thereby ensuring that a copy of the post-operative data is created and is associated with the patient.
The apparatus and methods described above provide the following advantages:
The preceding description is provided to enable any person skilled in the art to practice the various embodiments described herein. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments. For example, changes may be made in the function and arrangement of elements discussed without departing from the scope of the disclosure. Various examples may omit, substitute, or add various procedures or components as appropriate. Also, features described with respect to some examples may be combined in some other examples. For example, an apparatus may be implemented or a method may be practiced using any number of the aspects set forth herein. In addition, the scope of the disclosure is intended to cover such an apparatus or method that is practiced using other structure, functionality, or structure and functionality in addition to, or other than, the various aspects of the disclosure set forth herein. It should be understood that any aspect of the disclosure disclosed herein may be embodied by one or more elements of a claim.
As used herein, a phrase referring to “at least one of” a list of items refers to any combination of those items, including single members. As an example, “at least one of: a, b, or c” is intended to cover a, b, c, a-b, a-c, b-c, and a-b-c, as well as any combination with multiples of the same element (e.g., a-a, a-a-a, a-a-b, a-a-c, a-b-b, a-c-c, b-b, b-b-b, b-b-c, c-c, and c-c-c or any other ordering of a, b, and c).
As used herein, the term “determining” encompasses a wide variety of actions. For example, “determining” may include calculating, computing, processing, deriving, investigating, looking up (e.g., looking up in a table, a database or another data structure), ascertaining and the like. Also, “determining” may include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory) and the like. Also, “determining” may include resolving, selecting, choosing, establishing and the like.
The methods disclosed herein comprise one or more steps or actions for achieving the methods. The method steps and/or actions may be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order of steps or actions is specified, the order and/or use of specific steps and/or actions may be modified without departing from the scope of the claims. Further, the various operations of methods described above may be performed by any suitable means capable of performing the corresponding functions. The means may include various hardware and/or software component(s) and/or module(s), including, but not limited to a circuit, an application specific integrated circuit (ASIC), or processor. Generally, where there are operations illustrated in figures, those operations may have corresponding counterpart means-plus-function components with similar numbering.
The various illustrative logical blocks, modules and circuits described in connection with the present disclosure may be implemented or performed with a general purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device (PLD), discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A general-purpose processor may be a microprocessor, but in the alternative, the processor may be any commercially available processor, controller, microcontroller, or state machine. A processor may also be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration.
A processing system may be implemented with a bus architecture. The bus may include any number of interconnecting buses and bridges depending on the specific application of the processing system and the overall design constraints. The bus may link together various circuits including a processor, machine-readable media, and input/output devices, among others. A user interface (e.g., keypad, display, mouse, joystick, etc.) may also be connected to the bus. The bus may also link various other circuits such as timing sources, peripherals, voltage regulators, power management circuits, and the like, which are well known in the art, and therefore, will not be described any further. The processor may be implemented with one or more general-purpose and/or special-purpose processors. Examples include microprocessors, microcontrollers, DSP processors, and other circuitry that can execute software. Those skilled in the art will recognize how best to implement the described functionality for the processing system depending on the particular application and the overall design constraints imposed on the overall system.
If implemented in software, the functions may be stored or transmitted over as one or more instructions or code on a computer-readable medium. Software shall be construed broadly to mean instructions, data, or any combination thereof, whether referred to as software, firmware, middleware, microcode, hardware description language, or otherwise. Computer-readable media include both computer storage media and communication media, such as any medium that facilitates transfer of a computer program from one place to another. The processor may be responsible for managing the bus and general processing, including the execution of software modules stored on the computer-readable storage media. A computer-readable storage medium may be coupled to a processor such that the processor can read information from, and write information to, the storage medium. In the alternative, the storage medium may be integral to the processor. By way of example, the computer-readable media may include a transmission line, a carrier wave modulated by data, and/or a computer readable storage medium with instructions stored thereon separate from the wireless node, all of which may be accessed by the processor through the bus interface. Alternatively, or in addition, the computer-readable media, or any portion thereof, may be integrated into the processor, such as the case may be with cache and/or general register files. Examples of machine-readable storage media may include, by way of example, RAM (Random Access Memory), flash memory, ROM (Read Only Memory), PROM (Programmable Read-Only Memory), EPROM (Erasable Programmable Read-Only Memory), EEPROM (Electrically Erasable Programmable Read-Only Memory), registers, magnetic disks, optical disks, hard drives, or any other suitable storage medium, or any combination thereof. The machine-readable media may be embodied in a computer-program product.
A software module may comprise a single instruction, or many instructions, and may be distributed over several different code segments, among different programs, and across multiple storage media. The computer-readable media may comprise a number of software modules. The software modules include instructions that, when executed by an apparatus such as a processor, cause the processing system to perform various functions. The software modules may include a transmission module and a receiving module. Each software module may reside in a single storage device or be distributed across multiple storage devices. By way of example, a software module may be loaded into RAM from a hard drive when a triggering event occurs. During execution of the software module, the processor may load some of the instructions into cache to increase access speed. One or more cache lines may then be loaded into a general register file for execution by the processor. When referring to the functionality of a software module, it will be understood that such functionality is implemented by the processor when executing instructions from that software module.
The following claims are not intended to be limited to the embodiments shown herein, but are to be accorded the full scope consistent with the language of the claims. Within a claim, reference to an element in the singular is not intended to mean “one and only one” unless specifically so stated, but rather “one or more.” Unless specifically stated otherwise, the term “some” refers to one or more. No claim element is to be construed under the provisions of 35 U.S.C. § 112(f) unless the element is expressly recited using the phrase “means for” or, in the case of a method claim, the element is recited using the phrase “step for.” All structural and functional equivalents to the elements of the various aspects described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be encompassed by the claims. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the claims.
Number | Date | Country | |
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63399134 | Aug 2022 | US |