WO2024148331A2 - Surgical tool holder for intraocular robotic surgical systems - Google Patents

Abstract

A number of different surgical tool holder assemblies are provided. A number of configurations are suited for use in intraocular robotic surgery. The assembly includes a housing and a kinematic alignment feature on the housing right side and a kinematic alignment feature on the housing left side. There is also a tool sleeve coupled to a surgical instrument and a tool collar coupled to the tool sleeve. There is also a rotary transmission connector on the housing proximal end coupled to a drive shaft and a drive gear, the drive gear engaged to the driven gear. There may also be an alignment plate above the tool holder, the alignment plate having at least one kinematic alignment feature. Several kinematic alignment features are bi-directionally operable.

Description

SURGICAL TOOL HOLDER FOR INTRAOCULAR ROBOTIC SURGICAL SYSTEMS

CLAIM OF PRIORITY

[0001] This application claims priority to U.S. Provisional Application No. 63/478,770, titled “SURGICAL TOOL HOLDER FOR INTRAOCULAR ROBOTIC SURGICAL SYSTEMS,” filed January 6, 2023, the contents of which is incorporated herein by reference in its 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] This disclosure relates generally to a tool exchange mechanism for surgical instruments or tools in intraocular robotic surgical systems. In particular, this disclosure relates to facilitating tool exchange in a precise, repeatable, and rapid manner within a robotic microsurgery setting.

BACKGROUND

[0004] Automated microsurgery using a robotic system will require rapid and precise exchange of surgical tools between surgical procedures. The design of the surgical tool interface is critical not only for the rapid and precise exchange of tools, but also for additional functions embedded in the interface such as tool actuation, fluid exchange, and alignment.

[0005] However, intraocular surgical procedures are multistep processes that involve the use of several tools such as a retinal pick, a vitreous cutter, and an infusion-aspiration probe, among others of various sizes and shapes. In addition, for a given surgical procedure, there are typically (at most) three entry sites into the eye, and surgical instruments or tools for the surgical procedure are constrained to pass through these sites. Therefore, due both to the multistep nature of intraocular microsurgical procedures, as well as a constrained number of entry sites in such procedures, it is desired to provide a mechanism to exchange one surgical instrument for another instrument to perform different functions as well as to hold any of the variety of instruments used and enable the functionality of each one. Furthermore, a mechanism to exchange tools rapidly is desirable for reasons of surgical safety and efficacy. In view of these additional unmet needs there is a continued need for improvement in the field of surgical tools for microsurgery and associated robotic systems.

SUMMARY OF THE DISCLOSURE

[0006] Embodiments of this disclosure are directed to a standardized interface mechanism for rapid, precise, and repeatable removal and replacement of surgical instruments or tools during surgical procedures, such as intraocular surgical procedures. The various surgical tool holder assemblies can be equipped for manual use or in combination with an end effector of a robotic surgical system and/or a tool exchange system. Because of the commonality of the coupling and other interfaces, each surgical tool holder assembly can accommodate arbitrary surgical tool sizes, shapes and functionality while still providing accurate and precise actuation of translational motion and rotational motion of the associated surgical tool.

[0007] In one embodiment, there is provides a surgical tool holder assembly for intraocular robotic surgery that has a housing having a proximal end, a distal end, an upper surface, a lower surface, a left side extending between the proximal end and the distal end and a right side extending from the proximal end to the distal end. There is also a kinematic alignment feature on the housing right side and a kinematic alignment feature on the housing left side. There is also a tool sleeve coupled to a surgical instrument and a tool collar coupled to the tool sleeve. A front support wall and a rear support wall on the housing upper surface, a driven gear between the front support wall and the rear support wall wherein the drive gear, the front support wall and the rear support wall are sized to receive and support the tool collar. There is also a rotary transmission connector on the housing proximal end coupled to a drive shaft and a drive gear, the drive gear engaged to the driven gear. There may also be an alignment plate above the tool holder, the alignment plate having an upper surface, a proximal end, a distal end, a left side extending between the proximal end and the distal end and a right side extending from the proximal end to the distal end and at least one kinematic alignment feature.

[0008] Additionally, there may be at least one kinematic alignment feature positioned along the alignment plate upper surface, the alignment plate right side or the alignment plate left side. In another aspect, there is at least one alignment feature is any of a right distal alignment feature at the right side adjacent to the distal end; a left distal alignment feature at the left side adjacent to the distal end; a right proximal alignment feature at the right side adjacent to the proximal end; a left proximal alignment feature at the left side adjacent to the proximal end. In still other aspects, the kinematic alignment feature on any of the lower surface or the upper surface is one or a combination of a pin, a slot, a magnetic feature, or part of a releasable mechanical coupling or the kinematic alignment feature on any of the left side or the right side of the base or the left side or the right sight of the alignment plate is one or a combination of a pin, a slot, a magnetic feature, or part of a releasable mechanical coupling. There may also be a kinematic alignment feature on the housing right side comprising a right distal alignment feature at the right side adjacent to the distal end and a right proximal alignment feature at the right side adjacent to the proximal end; and further wherein the kinematic alignment feature on the housing left side comprising a left distal alignment feature at the left side adjacent to the distal end and a left proximal alignment feature at the left side adjacent to the proximal end. There may also be provided a kinematic alignment feature on the right side and the kinematic alignment feature on the left side are coupled to a robotic end effector, a driver on the robotic end effector is coupled to the rotary transmission connector. Still further variations include the option where the surgical instrument is a surgical tool adapted and configured for intraocular surgery or, alternatively, where the surgical tool has a distal end comprising a hook, an expressor, a cystotome, a needle, a knife, or a curette. Advantageously, the surgical tool holder assembly may include a low-power wireless communication element, a near field communication element or an RFID element electronic identification positioned on the housing and containing machine readable information about the surgical tool assembly. In another aspect, where a specific orientation or alignment of a surgical instrument is advantageous there may configurations of a tool sleeve that include a plurality of alignment fins along an exterior surface and the tool collar further comprising an arrangement of alignment slots sized and arrangement for engagement with the plurality of alignment fins when the tool sleeve is secured within the tool collar.

[0009] In still other embodiments, there is provided a method of preparing a surgical instrument for use in a surgical tool holder assembly, that begins by inserting the surgical instrument into a tool sleeve sized to fit about a shaft or a handle of the surgical instrument. Next, there is a step of inserting the surgical instrument into a tool collar to position the tool sleeve within the interior of the tool collar. Then, there is a step of securing the tool collar between a front support wall and a rear support wall wherein rotation of a driven gear of the surgical tool holder assembly rotates a distal end of surgical tool in the tool collar. In one aspect, the surgical instrument is a surgical tool adapted and configured for intraocular surgery. In another aspect, the surgical instrument tool distal end comprises a hook, an expressor, a cystotome, a needle, a knife, or a curette.

[0010] In yet another embodiment, there is provided a method of preparing a surgical instrument for use in a surgical tool holder assembly by first inserting the surgical instrument into a tool sleeve sized to fit about a shaft or a handle of the surgical instrument, wherein alignment fins on the tool sleeve provide a preselected orientation of a distal end of the surgical instrument. Then, there is a step of inserting the surgical instrument into a tool collar to position the tool sleeve alignment fins within corresponding alignment slots in the tool sleeve so as to maintain the preselected orientation of the distal end of the instrument. Next, there is a step of securing the tool collar between a front support wall and a rear support wall whereby rotation of a driven gear of the surgical tool holder assembly rotates a surgical tool distal end. In one variation, the surgical instrument is a surgical tool adapted and configured for intraocular surgery. In still other alternatives, the surgical instrument tool distal end comprises a hook, an expressor, a cystotome, a needle, a knife, or a curette.

BRIEF DESCRIPTION OF THE DRAWINGS

[0011] FIG. 1A is a schematic high-level summary of functionality required of the tool holder having tool exchanger and robot end effector interfaces at opposite sides of a surgical tool holder.

[0012] FIG. IB is a schematic high-level summary of functionality required of the tool holder having tool exchanger interfaces on the sides and a robot end effector interface at an end of a surgical tool holder.

[0013] FIG. 2 is an illustration of various components and subassemblies of a surgical tool holder assembly and an end effector interface.

[0014] FIGS. 3A, 3B and 3C are right perspective, left perspective and exploded views respectively of a Version 1 or VI attachment mechanism.

[0015] FIG. 4A is a left perspective view of an assembled surgical tool holder assembly having a Version 2 or a V2 attachment mechanism. The tightening nut is secured to the tool collar and adjacent to the rear support wall.

[0016] FIG. 4B is a left perspective view of the surgical tool holder of FIG. 4A with the tool sleeve removed [0017] FIG. 4C1 is a perspective view of an open tool collar of the surgical tool holder assembly in FIGs. 4A and 4B. FIG. 4C2 is an end view of the tool collar of FIG. 4C1 with arrows indicating the direction of each of the separate segments when the tightening nut of FIG. 4C3 is advanced along the tool collar to the position shown in FIG. 4A.

[0018] FIG. 5 is a perspective view of a surgical tool holder assembly providing a toolspecific functionality for linear motion of the surgical tool tip.

[0019] FIG. 6A is a top view of a surgical tool holder assembly having an upper coupling plate adapted as a mechanical interface with an automated tool exchange system.

[0020] FIG. 6B is a bottom-up view of the surgical tool holder assembly of FIG. 6A showing a lower coupling plate for mechanical interface with robotic and-effector.

[0021] FIGs. 7A and 7B are proximal and distal end views respectively of an exemplary surgical tool holder assembly having a single coupling plate.

[0022] FIGs. 8A and 8B are proximal and distal end views respectively of an exemplary surgical tool holder assembly having an upper coupling plate and a lower coupling plate.

[0023] FIG. 9 is a flow diagram illustrating a method for surgical tool exchange and transmitting tool functionality.

[0024] FIG. 10 is a flow diagram illustrating the different modes of surgical tool manipulation.

DETAILED DESCRIPTION

[0025] Embodiments of the surgical tool holder assembly provide common mechanical and electromechanical interfaces for the range of different surgical tools, in specific implementations the surgical tool holder assemblies are adapted and configured for those tools needed to perform intraocular surgery.

[0026] For example, there is surgical tool exchange system, including: a tool exchanger; a tool holder assembly having an assembly frame, in which the tool holder assembly is configured to attach, align, and transmit functionality to one or more of a plurality of tools at the tool holder assembly; and a robotic end-effector configured to identify and manipulate the one or more of the plurality of tools, in which one or more of the robotic end-effector and tool holder assembly transmit signals to the one or more plurality of tools; in which the tool holder assembly mechanically interfaces with the robotic end-effector and tool exchanger via one or more interfaces. [0027] According to one example of the surgical tool exchange system, the transmission of functionality to the one or more plurality of tools includes one or more of: mechanical, electric, or hydraulic function, wherein the tool holder assembly transmits specific characteristics and function to the one or more plurality of tools including one or more of: a signal to inject fluid through the tool, a signal to produce motion at a tip of the tool, and intraocular lens insertion. [0028] According to another example of the surgical tool exchange system, the one or more interfaces, tool exchanger, and robotic end-effector are oriented at various surfaces of the tool holder assembly. In one aspect, the surgical tool is adapted and configured for intraocular surgery. In still other embodiments, the surgical tool has distal end comprising a hook, an expressor, a cystotome, a needle, a knife, or a curette. In one aspect, depending on the desired orientation and operation of the tool, the tool is placed in the tool holder without regard for the alignment of the tip (i.e., FIGS. 3A-3C) or with regard to alignment of the tip (i.e., FIGS 4A- 4C3). Put another way, the distal end or tip of the instrument may be set into a specific orientation with regard to the tool assembly housing to provide a first level of alignment of the tool tip for use when coupled to the robotic end effector (see FIGS. 1A, IB and 2).

[0029] According to another example of the surgical tool exchange system, the tool holder assembly includes a holder housing configured to receive one or more of the plurality of tools, a tool sleeve, tool collar, and alignment tube configured to adjust aligning of an axis of the tool relative to the holder housing.

[0030] According to another example of the surgical tool exchange system, one or more transmissions of the tool holder assembly are coupled to actuators of the robotic end-effector, including a rotary transmission of the tool holder assembly having a driver gear and a driven gear, further wherein the alignment tube is configured to act as one or more of the transmissions. [0031] According to another example of the surgical tool exchange system, the robotic endeffector includes one or more of: a sterile barrier, carriage, and base plate, further in which the actuators of the robotic end-effector include one or more of: a rotary actuator, a tool actuator, and a linear actuator.

[0032] According to another example of the surgical tool exchange system, the one or more interfaces include: a tool exchanger interface between the tool holder assembly and the tool exchanger, and a robotic end-effector interface between the tool holder assembly and the robotic end-effector. [0033] According to another example of the surgical tool exchange system, the tool holder assembly includes a cover, in which the cover at least partially encompasses one or more of the plurality of tools, tool sleeve, tool collar, alignment tube, and holder housing.

[0034] According to another example of the surgical tool exchange system, one or more of the tool holder assembly, tool exchanger, and robotic end-effector have one or more coupling plates having coupling hardware configured to couple and align the tool holder assembly to one or more of the tool exchanger and robotic end-effector, in which the coupling hardware includes: magnets, pins, cut-outs, and Dowel pins.

[0035] According to another example of the surgical tool exchange system, one or more of the tool holder assembly and tool sleeve accommodate size and motion requirements for the one or more plurality of tools.

[0036] According to another example of the surgical tool exchange system, the tool holder assembly includes connection points to external accessories.

[0037] According to another example of the surgical tool exchange system, the tool holder assembly includes mount hardware for kinematic coupling and alignment, in which the mount hardware is coupled to the assembly frame of the tool holder assembly.

[0038] According to another example of the surgical tool exchange system, the attaching and aligning by the tool holder assembly includes coupling the tool sleeve to the tool collar via one or more of: threaded nuts, support walls, the driver gear and the driven gear, drive shaft, and the rotary transmission, in which the rotary transmission is configured to engage with a rotary actuator of the robotic end-effector.

[0039] According to another example of the surgical tool exchange system, the intraocular lens insertion signal is a rotary signal applied to a tool transmission coupling having a driven gear coupled to an leadscrew and a linear actuator, in which continued rotation produces linear motion of the tool tip towards a surgical site, in which reversing the tool transmission and rotation of the driven gear advances the leadscrew and linear actuator away from the tool holder assembly to produce linear motion of the tool tip away from the surgical site, in which the driven gear and leadscrew are configured to be adapted in size and ratio to provide fine movements of the tool tip.

[0040] As shown in FIGS. 1A and IB, embodiments of a surgical tool holder assembly provide three functional capabilities. First, the surgical tool holder assembly is the point of tool attachment and as well as tool alignment. Second, the surgical tool holder enables the transmission of tool functionality to the surgical site. Examples of this kind of functionality include mechanical, electrical, electromechanical, hydraulic, ultrasonic, optical and the like depending upon the performance characteristics of a specific tool. In some embodiments, a surgical tool holder assembly may also include suitable connection points to external accessories such as a phacoemulsification system, or other systems depending upon the surgery being performed. Third, the surgical tool holder assembly also provides mechanical interfaces for attaching to and detaching from a robotic end-effector. Additionally, the surgical tool holder assembly also provides mechanical interfaces for attaching to and detaching from a tool exchanger.

[0041] Turning now to additional aspects of the interfaces between the surgical tool holder assembly and one or both of (a) a surgical robot end-effector, and (b) an automated tool exchanger.

[0042] FIGS. 1A and IB illustrate the unique location of the functional interfaces between a surgical tool holder assembly and external systems to which it interfaces. FIGs 1A and IB provide exemplary interface orientations to a tool exchanger and a robotic end-effector. In general, a tool exchanger is a container used to store one or more surgical tool holder assemblies in a manner easily adapted to manual or automated loading and unloading operations. In a particular embodiment, both the tool exchanger and the surgical tool assembly employ standardized form factors and design features to simplify the tool exchange process. In still other implementations, the interfaces between a tool exchanger - a surgical tool holder assembly and an end-effector - a surgical tool holder assembly are designed and implemented to minimize robotic actuator movement and enable reliable and rapid exchange of a surgical tool assembly.

[0043] By way of example, FIG. 1A provides a surgical tool holder assembly 100 that interfaces with a tool exchanger system 102 at one side and a robotic end effector 104 at an opposite side. In a horizontal orientation, a tool exchanger interface 106 is positioned on one end and a robotic end-effector interface 108 is on an opposite end. In a vertical orientation, the interface to the tool exchanger 106 may be on the top or an upper surface (see FIG. 6A) while the interface to the robot end effector 108 may be on a bottom or lower surface (see FIG. 6B). In certain examples, various functions of the tool holder 110 may include tool attachment and alignment 110A, transmission of functionality to tool HOB including mechanical, electrical, hydraulic, and other types of functionality, as well as mechanical interfaces 110C to attach and detach tool holder 110 to robotic end-effector 104 and tool exchanger 102. [0044] Optionally, in another illustrative embodiment shown in FIG IB, a surgical tool holder assembly 150 may have an interface to a tool exchanger 106 on the sides while the interface to a robot interface 108 in/on an end between the sides. In the embodiment of FIG. IB a tool exchanger 102 may have a tool holder assembly dock that is adapted and configured to engage with features on the sides of the tool holder assembly 150 (see FIGS. 4A and 5) while the robot end-effector 108 engages with the bottom and end face of the surgical tool assembly 150. A side orientation tool exchanger 102 may provide a series of surgical tool assembly holders in a linear tray arrangement or stacked as in a shelf arrangement. An exemplary end effector motion to disengage from a side tool exchanger 102 would be to lift from beneath the surgical tool holder assembly 150, disengage the side holder and then move clear of the tool holder.

[0045] FIG. 2 is a schematic view of an exemplary robotic end effector and a surgical tool holder assembly 200. The robotic end-effector 204 includes a base plate 204A which supports all the electrical, mechanical or electromechanical drivers to enable the functionality of a specific surgical tool holder assembly 210. Advantageously, the surgical end effector 204 provides a range of different types of actuation from unique locations on the end effector 204. One aspect of the tool assembly - end effector interface 208 is the standardization of actuator locations on the end effector 204 and corresponding interface locations on the tool holder assembly 210. In the illustrated embodiment, the base plate supports a linear actuator 204B which is coupled to a linear stage or carriage 204C. The linear stage 204C supports a rotary actuator 204D and a tool actuator 204E. The boundary between the robotic end effector 204 is a plate 204F which is also a sterile barrier. Turning now to the surgical tool holder assembly interface 202. The end effector rotary actuator 204D is coupled to a rotary transmission 202D on the tool assembly. The end effector tool actuator 204E is coupled to a tool transmission 202E on the surgical tool holder assembly 210. The interface between each transmission 202D-202E used on a specific surgical tool assembly 210 is provided by a tool sleeve 202A and tool collar 202B, or tool sleeve 202A, tool collar 202B and alignment tube 202C combination. In this illustrative embodiment, the surgical tool 202F is positioned within a tool sleeve 202A. The tool sleeve 202A is held in position by a tool collar 202B. An alignment tube 202C may also be included to ensure a tool 202F is properly positioned with respect to the transmission of a particular tool holder assembly 210. Each tool assembly 210 also includes a base that is sized and configured to support the various components of the tool holder assembly 210. Each tool assembly 210 also includes one or more front and rear support walls that are positioned and sized relative to the alignment tube 202C, tube collar 202B and surgical tool 202F and act as bearings to support the rotation of the components of the surgical tool holder assembly 210. Also shown in holder housing 202G and cover 202H of tool holder assembly 210. According to certain examples, holder housing 202G may house at least a part of tool 202F, tool sleeve 202A, tool collar 202B, and alignment tube 202C. Likewise, cover 202H may be placed over at least a part of tool 202F, tool sleeve 202A, tool collar 202B, and alignment tube 202C, as well as holder housing 202G.

Tool attachment + alignment FIGS. 1A-FIGS. IB)

[0046] Prior to surgery, each surgical tool 202F to be used is assembled into a correspondingly designed surgical tool holder assembly 210. Advantageously, the various alternative tool assembly embodiments enable an assembly process that is (a) simple to perform and (b) results in secure and accurate alignment of the surgical tool axis relative to the central axis of rotation and motion. The central axis of the tool holder 210 is delineated structurally by the tool collar 202B. The tool sleeve 202A is the adaptor between the variety of different surgical tool 202F shaft shapes and sizes and tool collar 202B. Accordingly, the tool sleeve 202A has an inner size and shape that conforms to an external size and shape of the surgical tool 202F and an outer size and shape that conforms to the inner size and shape of the tool collar 202B. As there are a plurality of surgical tool 202F sizes and shapes, there are as many a plurality of specifically configured tool sleeves 202A which are custom fitted to adapt each tool shaft to the tool collar 202B. Version 1 or VI and Version 2 or V2 are two exemplary attachment mechanisms for the tool sleeve 202A to the tool collar 202B. Each will now be described in turn.

[0047] FIGS. 3A, 3B and 3C are right perspective, left perspective and exploded views respectively of a Version 1 or VI attachment mechanism. The final form or “ready for use” version of the VI attachment mechanism is best seen in the views of FIGS. 3A and 3B A pair of front 304A and rear 304B threaded nuts secure tool 302, tool sleeve 302A, tool collar 302B and alignment tube 302C between the front support wall 306 and the rear support wall 308. Additionally, a driven gear 310 is positioned about the alignment tube 302C. FIG. 3B shows the position of the rotary transmission connector 302D, the drive shaft 312S, and the driver gear 312, In use, the rotary transmission connector 302D engages with the rotary actuator 204D (from FIG. 2) on the end effector 204 (from FIG. 2) and then in turn rotates the drive shaft 312S and the driver gear 312. The driver gear 312 is coupled to the driven gear 310 which in turn is coupled to the alignment tube 302C. As such, rotation of the rotary transmission connector produces rotation of the assembled tool sleeve 302A, tool collar 302B, alignment tube 302C and associated surgical tool 302. Also visible in the views of FIGs. 3 A and 3B are an exemplary single mount kinematic coupling 320A. In this embodiment, the single coupling 320A is along the sides of the surgical tool assembly frame 320. A pair of pins 302P and a magnet 302M on the left side and the right side of the tool assembly frame 320 provide the kinematic alignment 320A.

[0048] In another example, single mount kinematic coupling 320A on tool assembly base 320 include one or more pins 302P with magnet 302M adjacent to distal most pin 302P on the left side and magnet 302M adjacent to the rear support wall 308 on the right side.

[0049] FIG. 3C provides an exploded view of the components of the VI attachment mechanism. The alignment tube 302C and the rear threaded nut 304B have been removed. The tool sleeve 302A and associated elastomeric ring 302A1 are visible on the surgical tool shaft 302. The tool collar 302B is shown in place with the front threaded nut 304A secured onto the associated threaded end of the tool collar 302B and tool sleeve 302A. Two threaded nuts 304A/304B are used to clamp an angled compliant flange 304A1 against the tool collar 302B from, optionally, only one end or from both ends as in the illustrated embodiment. Once the tool 302, tool sleeve 302B and alignment tube 302C are positioned appropriately between the front support wall 306 and the rear support wall 308, the threaded nut 304A/304B is screwed on. As the nut 304A/304B is advanced, the angled compliant flange 304A1 is pressed radially into the tool sleeve 302A, securing the sleeve 302A with friction. Additionally, one or more features on the tool sleeve 302A axially align the tool sleeve 302A with the tightening nuts 304A/304B.

Similarly, the alignment tube 302C includes features to ensure the proper alignment of the driven gear 310 to the driver gear 312.

[0050] FIG. 4A is a left perspective view of an assembled surgical tool holder assembly having a Version 2 or a V2 attachment mechanism. The tightening nut 404B is secured to the tool collar 402B and adjacent to the rear support wall 408. FIG. 4B is a left perspective view of the surgical tool holder of FIG. 4A with the tool sleeve 402A removed. The tightening nut 404B is now shown spaced apart from the rear support wall 408. In this position, the tool collar 402B is in an open configuration as shown in FIG. 4C 1 . The threads of the tightening nut 404B are visible in the interior view of FIG. 4C3. The tightening nut 404B is threaded to engage with the threads of the tool collar 402B. In an open configuration the alignment slots and adjacent segments of the tool collar 402B are open and spaced apart. To complete the assembly, the tool tip 402F1 is inserted through the opening of the tightening nut (right hand side of FIG. 4B, 404B0) and into the open tool collar (FIG. 4C1). During this stage, the alignment fins 402Z on the proximal end of the surgical tool 402F are positioned to enter into the alignment slots 422 of the tool collar 402B. Rotation of the tightening nut 404B will press the segments of the tool collar 402B down onto the outer surface of the tool sleeve 402A by the motion 422F shown in FIG. 4C2.

[0051] Also visible in FIG. 4A is an exemplary single mount kinematic coupling 420A. In this embodiment, the single coupling 420A is along the sides of the surgical tool assembly frame 420. A pair of pins 402P and a magnet (not shown) on the left side and the right side of the tool assembly frame 420 provide the kinematic alignment 420A.

[0052] Aspects of the attachment mechanisms described herein are to reliability and naturally align the surgical tool axis to the central axis of the tool collar 402B without any subsequent adjustment of the alignment. Additionally or optionally, there may also be provided an additional element that enables fine-adjustment of the alignment of the surgical tool axis relative to the holder housing 402G. In one embodiment, there is an adjustment tube included in the surgical tool holder assembly. In one embodiment, the adjustment tube is a hollow cylinder, surrounding the tool collar 402B, and is coupled to the tool collar 402B to allow for adjustment of the relative orientation of the central axis of the Surgical Tool 402 + Tool Sleeve 402A + Tool Collar 402B subassembly. In cases of misalignment, the central axis of the tool collar 402B must itself be adjusted relative to the holder housing 402G to compensate for misalignment of the surgical tool 402F.

Transmission of functionality to surgical tool (HOB., FIGS. 1A-1B)

[0053] With regard to FIGS. 1A, IB and 2, it is to be appreciated that each of the various surgical tool holder assemblies is adapted and configured for use with a robot end-effector having a standardized interface for common engagement with any of the various different surgical tool assembly embodiments. The robot end-effector will provide several different multimodal signals through the tool holder assembly to the surgical tool. In some embodiments, these signals can include mechanical, electrical, and hydraulic signals. In still other embodiments, there is a specific set of signals transmitted to and by a specific tool holder assembly embodiment based on the specific characteristics and function of the associated surgical tool.

Transmission of rotary actuation (HOC, FIGS. 1A-1B) [0054] In one embodiment of the surgical tool holder assembly, the tool holder assembly transmits a mechanical signal to rotate the tool about the tool collar’s central axis. The signal is supplied by a rotary actuator which is transmitted to the tool through the rotary transmission element 202D (from FIG. 2). In a specific embodiment best seen in FIG. 3B, the rotary transmission element 302D is coupled to the drive shaft 312S that is turn is coupled to the drive gear or pinion 312. A driven gear 310 is coupled to the drive gear 312. The driver gear 312 is the one with a rotation axis coinciding with a drive shaft 312S coupled to an external axis driven by a rotary actuator on an end effector (not shown but in use engages transmission element 302D). The driven gear 310 has an axis of rotation coinciding with the tool collar 302B. Additionally or optionally, in some embodiments an alignment tube 302C acts as the transmission element and supports the driven gear 310 as shown above in FIG. 3 A.

Transmission of tool-specific functionality: Fluid exchange

[0055] In certain embodiments, the set of tool-specific signals includes a signal to inject fluid through the tool.

[0056] In one embodiment, the fluid is held within a reservoir local to the surgical tool holder assembly. In one aspect, the tool-specific signal is a mechanical motion that creates hydraulic pressure within the tool to expel the fluid. In one implementation, the source of this mechanical signal is an actuator located on the robot end-effector via the interface (not shown) and is transmitted to the surgical tool through an appropriately configured tool transmission element of the surgical tool holder assembly, (e.g., FIGS. 7A and 8A).

[0057] In still another fluid exchange embodiment, an external pressure source may be adapted and configured to provide an appropriately configured hydraulic pressure signal to the surgical tool holder assembly in order to expel the fluid.

Tool tip motion (grasping, curving, manipulating and other motions)

[0058] In another alternative configuration of a surgical tool holder assembly embodiment, there is provided a signal to produce motion at the surgical tool’s distal end relative to the body of the surgical tool. In one implementation of this motion, the surgical tool central axis will maintain position while the tip of the surgical tool is actuated. Examples of this type of toolspecific actuations include grasping of two opposing distal ends, a curving motion of the tip which deviates from the tool axis and along with other types of motion adapted for tool specific actuation, engagement or manipulation of tissue at the surgical site.

Intraocular lens (IOL) insertion [0059] In another alternative embodiment, a surgical tool holder assembly includes a signal for IOL injection. In one implementation, a mechanical signal is created by the tool actuator on a robot end-effector through the tool transmission element. FIG. 5 is a right-side perspective view of an embodiment of a surgical tool holder assembly configured, for example, for IOL insertion. The embodiment of FIG. 5 is also of an example of a transmission on a surgical tool assembly adapted to convert rotation into linear movement. FIG. 5 has housing 520H having an open upper surface 520U. According to certain examples, upper surface 520U may have components for upper kinetic coupling 520K such as magnets 520M/620MA and pins 520P/620P (see also FIG. 6A-6B). Side kinematic coupling 520A, which may also be accomplished via magnets 520M and pins 520P, is also shown at the side of tool assembly base 520. In this configuration, the mechanical signal is a rotary signal applied to the tool transmission coupling, for example via tool transmission 502E which when activated may rotate driven gear 510. Driven gear may be to a threaded hub or drive gear 508 engaged to a lead screw 502F. Drive gear 509 may be adjacent to a support wall 506 of housing 520H. Continued rotation will draw the lead screw 502F and according to certain embodiments linear actuator/drive shaft 502L towards the tool assembly base 520 and thereby impart linear motion 530 of the surgical tool tip 502F1 towards the surgical site 532. According to certain examples, drive shaft 502L may be coupled to end effector 204D. Reversing tool transmission 502E and driven gear 510 rotation will advance the lead screw 502F and linear actuator/drive shaft 502L away from the tool assembly and thereby impart linear motion 530 of the surgical tool tip 502F1 away from the surgical site 534. The size and ratio of the leadscrew 502F threads and driven gear 510 may be adapted and configured to provide exact movements of the surgical tip 502F1 as needed for IOL insertion

[0060] In still other embodiments, there are a variety of appropriately configured surgical tool holder assemblies utilizing linear motion, rotating motion, combinations of rotation and translation alone or in any combination with any of a variety of tool-specific functionality or accessories in order to provide specifically configured surgical tool holder assemblies designed to provide both the functionality requirements and accommodate the size and motion requirements of an entire set of relevant surgical tools. In additional aspects, surgical tools having a common functionality requirement may use a similar surgical tool holder assembly with a different tool sleeve adapted and configured for the size and characteristics of that surgical tool. External mechanical interfaces [0061] Referring back to FIGS. 1 A and IB, the various surgical tool assembly embodiments may also be provided with one or a series of external mechanical interfaces to facilitate manual, semi-autonomous or fully autonomous integration with other systems such as a robotic handler and end effector as well as a tool exchanger as discussed above. In a general way, a surgical tool holder assembly may be considered as having a single coupling plate or dual coupling plates. Examples of single coupling plates are provided and discussed above in the various embodiments of FIGS. 3A, 3B, 4A, 4B and 5. It is to be appreciated that the size, shape, orientation of the pins as well as the position of the magnet may be varied in order to meet a wide range of different interface configurations. Additionally or optionally, there are configurations where a bottom surface of a surgical tool holder assembly is adapted and configured to provide an additional coupling plate.

[0062] FIGS. 6A and 6B are top down and bottom up views, respectively of a surgical tool holder assembly having two coupling plates. FIG. 6A is a view of a top coupling plate 602 along an upper surface of the tool assembly housing 602G. The tool assembly housing in this embodiment covers or encloses the components of the tool assembly such as those shown in FIGs. 3A, 3B, 4A, and 4B. The top coupling plate 602 has one or more kinematic features arranged along or within the surface as described herein. For example, the top coupling plate 602 includes three alignment cutouts 620C and three magnets 620M. One alignment cutout 620C is in a middle portion on the left side of the assembly. The other two alignment cutouts 620C are in the front right corner and the left right comer. One magnet 620M is positioned on the middle portion on the right side. Two magnets 620M are positioned on the left front comer and the left rear comer. Also shown in FIG. 6A is a representative coupling plate 620T keyed to be releasably joined to the top coupling plate 602 having pins 620P positioned to engage with the alignment cutouts 620C and magnets or metal targets 620MA in positions opposite the magnets 620M on the top coupling plate. In one embodiment, the coupling plate 620T keyed to join to the top coupling plate 602 may be appropriately positioned on a portion of a tool exchanger adapted and configured to hold one or more surgical tool holder assemblies as described herein. [0063] FIG. 6B is a bottom-up view of the surgical tool holder in FIG. 6A. The tool holder housing has a bottom coupling plate 604 with a configuration similar to those described above. The bottom coupling plate 604 has one or more kinematic features arranged along or within the surface as described herein. A pair of pins 620DP are positioned along the sides of the base adjacent to the front and rear comers. According to certain examples, pins 620DP may be pins smooth walled or shaped with a specific contour surface similar to dowels. Addtionally or optionally, the cross section of pins used as kinematic features may have a circular cross section (as shown in FIG. 6B) or an oval, oblong or polygonal shape in order to provide the desired coupling to the corresponding kinematic feature on an end effector (see FIGS. 1A, IB and 2). Additionally, a magnet 620M is positioned in a middle portion of each of the left and the right sides. In one illustrative embodiment, the pins 620DP may slide perpendicularly into cutouts appropriately sized and positioned in the end effector plate (i.e., at the sterile barrier 204F indicated in FIG. 2) in order to kinematically constrain motion. Referring back to FIG. 2, it is to be appreciated that several differently sized and arranged clearances and chamfers are built into the interface 208 between tool holder assembly housing 202G and the end effector plate 204F to allow for easy placement. Moreover, one or a series of magnets may be installed in the holder housing 202G and plate 204F to not only repeatably and accurately align the holder 210 with respect to the plate 204F but to also provide a unique coupling configuration. In one exemplary coupling operation, the magnets 620M (from FIG. 6B) are arranged to push/pull the tool holder assembly 210 to one side of the end effector plate 204F and pull the tool holder assembly 210 to the back of the plate 204F, securing the above-mentioned pins in the cutouts of the plate 620C (from FIG. 6A).

[0064] Considering the top 602 and bottom 604 coupling plates together, it is to be appreciated that the upper surface of the surgical tool holder 602 contains a series of magnets, pins/extrusions, and/or cutouts/holes that match up to their counterparts on various surfaces (such as 620T) of an appropriately configured tool exchanger. When placed in proximity to the tool exchanger, the magnets 620M/620MA work to pull the tool holder against the exchanger and insert dowel pins 620DP into dowel holes on each part. Advantageously, these pins/holes 620DP/620P/620C and coupling motion of the upper coupling plate 602 are arranged such that they kinematically prevent the motion that is used to connect/disconnect the robot end-effector 204 from FIG. 2 (at the plate 204F from FIG. 2) to the tool holder 210 from FIG. 2 (at the holder housing 202G from FIG. 2) as accomplished by the coupling action of the lower coupling plate 604. As such, embodiments of the surgical tool assembly may use a set of coupling motions for an upper coupling plate and a different and non-conflicting set of coupling motions for a lower coupling plate. In this way, embodiments of the various surgical tool holder assemblies provide a surgeon with a wide array of different tools and functionalities all with a common set of unique coupling exchanges to each of a tool exchanger and a robot end effector. [0065] FIGS. 7A and 7B are proximal and distal end views respectively of an exemplary surgical tool holder assembly having a single coupling plate. In various alternative embodiments, one or more pins 704AC of different size, shape, orientation and position may be positioned along any of the sides or the bottom surface in order to facilitate the desired connectivity 704E to a robotic end effector or tool exchanger. Additionally or optionally, the coupling plate 704F may include electronic identification means or instruction sets in computer readable code positioned appropriately on the coupling plate 704F for interrogation and communication with an end effector, tool exchanger or other accessory. Examples of electronic identification means include, for example and not limitation, low-power wireless communication, near field communication (NFC) or RFID suited for identification or interrogation between the robotic end effector and the surgical tool holder assembly.

[0066] FIGS. 8A and 8B are proximal and distal end views respectively of an exemplary surgical tool holder assembly having dual coupling plates. In various alternative embodiments, one or more pins 804AC of different size, shape, orientation, and position may be positioned along any of the sides or the bottom surface of the lower coupling plate 804F or upper surface of the upper coupling plate 804CP in order to facilitate the desired connectivity 804E to a robotic end effector or tool exchanger. Additionally or optionally, either or both of the upper 804CP and lower 804F coupling plate may include electronic identification means or instruction sets in computer readable code positioned appropriately on the coupling plate for interrogation and communication with an end effector, tool exchanger or other accessory.

[0067] FIG. 9 is a flow diagram illustrating a method for surgical tool exchange and transmitting tool functionality 900.

[0068] Method 900 begins at block 902 with mechanically interfacing a tool holder assembly having an assembly frame with a robotic end-effector and tool exchanger via one or more interfaces.

[0069] Method 900 continues at block 904 with transmitting signals, via one or more of the robotic end-effector and tool holder assembly, to one or more of a plurality of tools at the tool holder assembly.

[0070] Method 900 continues at block 906 with identifying and manipulating the one or more of a plurality of tools via the signals transmitted by the robotic end-effector.

[0071] Finally, at block 908, method 900 involves attaching, aligning, and transmitting functionality to the one or more of the plurality of tools via the tool holder assembly. [0072] According to another example of method 900, the transmission of functionality to the one or more plurality of tools includes one or more of: mechanical, electric, or hydraulic function, wherein the tool holder assembly transmits specific characteristics and function to the one or more plurality of tools including one or more of: a signal to inject fluid through the tool, a signal to produce motion at a tip of the tool, and intraocular lens insertion.

[0073] According to another example of method 900, the one or more interfaces, tool exchanger, and robotic end-effector are oriented at various surfaces of the tool holder assembly. [0074] According to another example of method 900, the tool holder assembly includes a holder housing configured to receive one or more of the plurality of tools, a tool sleeve, tool collar, and alignment tube configured to adjust aligning of an axis of the tool relative to the holder housing.

[0075] According to another example of method 900, one or more transmissions of the tool holder assembly are coupled to actuators of the robotic end-effector, including a rotary transmission of the tool holder assembly having a driver gear and a driven gear, further wherein the alignment tube is configured to act as one or more of the transmissions.

[0076] According to another example of method 900, the robotic end-effector includes one or more of: a sterile barrier, carriage, and base plate, further wherein the actuators of the robotic end-effector include one or more of: a rotary actuator, a tool actuator, and a linear actuator.

[0077] According to another example of method 900, the one or more interfaces include: a tool exchanger interface between the tool holder assembly and the tool exchanger, and a robotic end-effector interface between the tool holder assembly and the robotic end-effector.

[0078] According to another example of method 900, the tool holder assembly includes a cover, wherein the cover at least partially encompasses one or more of the plurality of tools, tool sleeve, tool collar, alignment tube, and holder housing.

[0079] According to another example of method 900, one or more of the tool holder assembly, tool exchanger, and robotic end-effector have one or more coupling plates having coupling hardware configured to couple and align the tool holder assembly to one or more of the tool exchanger and robotic end-effector, wherein the coupling hardware includes: magnets, pins, cut-outs, and Dowel pins.

[0080] According to another example of method 900, one or more of the tool holder assembly and tool sleeve accommodate size and motion requirements for the one or more plurality of tools. [0081] According to another example of method 900, the tool holder assembly includes connection points to external accessories.

[0082] According to another example of method 900, the tool holder assembly includes mount hardware for kinematic coupling and alignment, wherein the mount hardware is coupled to the assembly frame of the tool holder assembly.

[0083] According to another example of method 900, the attaching and aligning by the tool holder assembly includes coupling the tool sleeve to the tool collar via one or more of: threaded nuts, support walls, the driver gear and the driven gear, drive shaft, and the rotary transmission, wherein the rotary transmission is configured to engage with a rotary actuator of the robotic endeffector.

[0084] According to another example of method 900, the intraocular lens insertion signal is a rotary signal applied to a tool transmission coupling having a driven gear coupled to an leadscrew and a linear actuator, wherein continued rotation produces linear motion of the tool tip towards a surgical site, wherein reversing the tool transmission and rotation of the driven gear advances the leadscrew and linear actuator away from the tool holder assembly to produce linear motion of the tool tip away from the surgical site, wherein the driven gear and leadscrew are configured to be adapted in size and ratio to provide fine movements of the tool tip.

[0085] A person of ordinary skill in the art will recognize that any process or method disclosed herein can be modified in many ways. The process parameters and sequence of the steps described and/or illustrated herein are given by way of example only and can be varied as desired. For example, while the steps illustrated and/or described herein may be shown or discussed in a particular order, these steps do not necessarily need to be performed in the order illustrated or discussed.

[0086] Additional aspects of the operation and utilization of the surgical tool holder assembly and a robotic end effector may be appreciated with reference to U.S. Provisional Patent Application No. 63/478,581 titled “Autonomous Tool Exchange System for Automated and Semi-Automated Intraocular Surgical Procedures,” (“the ‘0569 application”) filed on January 5, 2023, and the corresponding Patent Cooperation Treat Application No. PCT/US2024/010569, titled “Autonomous Tool Exchange System for Automated and Semi-Automated Intraocular Surgical Procedures,” and filed on January 5, 2024, with Attorney Docket Number 14843- 704.600, each of which are incorporated herein by reference in their entirety. In one specific example, the various kinematic and bi-directional kinematic couplings described herein may be adapted and configured for use hybrid configurations where each specific tool assembly dock is configured for top-bottom or side-side engagement and release depending on the specific kinematics of a specific tool assembly. As a result, the various configurations of the tool carousel detailed in the “Autonomous Tool Exchange System for Automated and Semi- Automated Intraocular Surgical Procedures” may include all tool assembly docks for top-bottom engagement, all tool assembly docks for side-side engagement or combinations thereof where a mixture of top-bottom and side-side kinematic tool assemblies may be included on the same tool carousel

[0087] 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. Consider for example, the variations in surgical tool manipulation as set forth in FIG. 10.

[0088] FIG. 10 is a flow diagram of an exemplary method 1000 illustrating the different modes of surgical tool manipulation via the robotic end-effector interface. It is to be appreciated that there may be a number of different modes of operation depending on the specific surgical instrument within a tool holder assembly and the surgical step or procedure being performed. First, at step 1002, there is the process of mechanically interfacing a surgical tool holder assembly with a robotic-end effector. This may involve the various techniques of engaging one or more kinematic couplings in order to complete the mechanical interface and fully dock the tool assembly with the end effector. Examples of the engagement between a robotic end-effector and a surgical tool assembly with reference to FIGs. 5A-5D in the ‘0569 application.

[0089] Next, depending on the specific capabilities and requirements for the use of the surgical tool assembly, the robotic end effector may drive the tool assembly to produce axial translation of the surgical tool (step 1004). Additionally or optionally, depending on the specific capabilities and requirements for the use of the surgical tool assembly, the robotic end effector may drive the tool assembly to produce rotational motion of the surgical tool (step 1006). Additionally or optionally, depending on the specific capabilities and requirements for the use of the surgical tool assembly, the robotic end effector may drive the tool assembly to produce blended rotational -translational motion of the surgical tool (step 1008). [0090] The processor as described herein can be configured to perform one or more steps of any method disclosed herein. Alternatively or in combination, the processor can be configured to combine one or more steps of one or more methods as disclosed herein.

[0091] 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.

[0092] 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 "/".

[0093] 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.

[0094] 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.

[0095] 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.

[0096] 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.

[0097] 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 (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.

[0098] 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.

[0099] 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 been 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

Claims

CLAIMS What is claimed is:

1. A surgical tool holder assembly for intraocular robotic surgery, comprising:

A housing having a proximal end, a distal end, an upper surface, a lower surface, a left side extending between the proximal end and the distal end and a right side extending from the proximal end to the distal end;

A kinematic alignment feature on the housing right side;

A kinematic alignment feature on the housing left side;

A tool sleeve coupled to a surgical instrument;

A tool collar coupled to the tool sleeve;

A front support wall and a rear support wall on the housing upper surface, a driven gear between the front support wall and the rear support wall wherein the drive gear, the front support wall and the rear support wall are sized to receive and support the tool collar; and

A rotary transmission connector on the housing proximal end coupled to a drive shaft and a drive gear, the drive gear engaged to the driven gear.

2. The surgical tool holder assembly of claim 1, further comprising an alignment plate above the tool holder, the alignment plate having an upper surface, a proximal end, a distal end, a left side extending between the proximal end and the distal end and a right side extending from the proximal end to the distal end and at least one kinematic alignment feature.

3. The surgical tool holder assembly of claim 2, wherein the at least one kinematic alignment feature is along the alignment plate upper surface, the alignment plate right side or the alignment plate left side.

4. The surgical tool holder assembly of claim 2 or claim 3, wherein the at least one alignment feature is any of a right distal alignment feature at the right side adjacent to the distal end; a left distal alignment feature at the left side adjacent to the distal end; a right proximal alignment feature at the right side adjacent to the proximal end; a left proximal alignment feature at the left side adjacent to the proximal end.

5. The surgical tool holder assembly of any of claims 1-4, wherein the kinematic alignment feature on any of the lower surface or the upper surface is one or a combination of a pin, a slot, a magnetic feature, or part of a releasable mechanical coupling.

6. The surgical tool holder assembly of any of claims 1-4, wherein the kinematic alignment feature on any of the left side or the right side of the base or the left side or the right sight of the alignment plate is one or a combination of a pin, a slot, a magnetic feature, or part of a releasable mechanical coupling.

7. The surgical tool holder assembly of claim 1, wherein the kinematic alignment feature on the housing right side comprising a right distal alignment feature at the right side adjacent to the distal end and a right proximal alignment feature at the right side adjacent to the proximal end; and further wherein the kinematic alignment feature on the housing left side comprising a left distal alignment feature at the left side adj cent to the distal end and a left proximal alignment feature at the left side adjacent to the proximal end.

8. The surgical tool holder assembly of claim 1, wherein when the kinematic alignment feature on the right side and the kinematic alignment feature on the left side are coupled to a robotic end effector, a driver on the robotic end effector is coupled to the rotary transmission connector.

9. The surgical tool holder assembly of any of the above claims wherein the surgical instrument is a surgical tool adapted and configured for intraocular surgery.

10. The surgical tool holder assembly of any of the above claims wherein the surgical tool has a distal end comprising a hook, an expressor, a cystotome, a needle, a knife, or a curette.

11. The surgical tool holder assembly of any of the above claims further comprising: a low- power wireless communication element, a near field communication element or an RFID element electronic identification positioned on the housing and containing machine readable information about the surgical tool assembly.

12. The surgical tool holder assembly of any of the above claims the tool sleeve further comprising a plurality of alignment fins along an exterior surface and the tool collar further comprising an arrangement of alignment slots sized and arrangement for engagement with the plurality of alignment fins when the tool sleeve is secured within the tool collar.

13. A method of preparing a surgical instrument for use in a surgical tool holder assembly, comprising:

Inserting the surgical instrument into a tool sleeve sized to fit about a shaft or a handle of the surgical instrument;

Inserting the surgical instrument into a tool collar to position the tool sleeve within the interior of the tool collar; and

Securing the tool collar between a front support wall and a rear support wall wherein rotation of a driven gear of the surgical tool holder assembly rotates a distal end of surgical tool in the tool collar.

14. The method of claim 13, wherein the surgical instrument is a surgical tool adapted and configured for intraocular surgery.

15. The method of claim 13, wherein the surgical instrument tool distal end comprises a hook, an expressor, a cystotome, a needle, a knife, or a curette.

16. A method of preparing a surgical instrument for use in a surgical tool holder assembly, comprising:

Inserting the surgical instrument into a tool sleeve sized to fit about a shaft or a handle of the surgical instrument, wherein alignment fins on the tool sleeve provide a preselected orientation of a distal end of the surgical instrument;

Inserting the surgical instrument into a tool collar to position the tool sleeve alignment fins within corresponding alignment slots in the tool sleeve so as to maintain the preselected orientation of the distal end of the instrument; and Securing the tool collar between a front support wall and a rear support wall whereby rotation of a driven gear of the surgical tool holder assembly rotates a surgical tool distal end.

17. The method of claim 16, wherein the surgical instrument is a surgical tool adapted and configured for intraocular surgery.

18. The method of claim 16, wherein the surgical instrument tool distal end comprises a hook, an expressor, a cystotome, a needle, a knife, or a curette.

19. A surgical tool exchange system, comprising: a tool exchanger; a tool holder assembly having an assembly frame, wherein the tool holder assembly is configured to attach, align, and transmit functionality to one or more of a plurality of tools at the tool holder assembly; and a robotic end-effector configured to identify and manipulate the one or more of the plurality of tools, wherein one or more of the robotic end-effector and tool holder assembly transmit signals to the one or more plurality of tools; wherein the tool holder assembly mechanically interfaces with the robotic end-effector and tool exchanger via one or more interfaces.

20. The system of claim 19, wherein the transmission of functionality to the one or more plurality of tools includes one or more of: mechanical, electric, or hydraulic function, wherein the tool holder assembly transmits specific characteristics and function to the one or more plurality of tools including one or more of: a signal to inject fluid through the tool, a signal to produce motion at a tip of the tool, and intraocular lens insertion.

21. The system of claim 19, wherein the one or more interfaces, tool exchanger, and robotic end-effector are oriented at various surfaces of the tool holder assembly.

22. The system of claim 19, wherein the tool holder assembly includes a holder housing configured to receive one or more of the plurality of tools, a tool sleeve, tool collar, and alignment tube configured to adjust aligning of an axis of the tool relative to the holder housing.

23. The system of claim 22, wherein one or more transmissions of the tool holder assembly are coupled to actuators of the robotic end-effector, including a rotary transmission of the tool holder assembly having a driver gear and a driven gear, further wherein the alignment tube is configured to act as one or more of the transmissions.

24. The system of claim 19, wherein the robotic end-effector includes one or more of: a sterile barrier, carriage, and base plate, further wherein the actuators of the robotic endeffector include one or more of: a rotary actuator, a tool actuator, and a linear actuator.

25. The system of claim 19, wherein the one or more interfaces include: a tool exchanger interface between the tool holder assembly and the tool exchanger, and a robotic endeffector interface between the tool holder assembly and the robotic end-effector.

26. The system of claim 22, wherein the tool holder assembly includes a cover, wherein the cover at least partially encompasses one or more of the plurality of tools, tool sleeve, tool collar, alignment tube, and holder housing.

27. The system of claim 19, wherein one or more of the tool holder assembly, tool exchanger, and robotic end-effector have one or more coupling plates having coupling hardware configured to couple and align the tool holder assembly to one or more of the tool exchanger and robotic end-effector, wherein the coupling hardware includes: magnets, pins, cut-outs, and Dowel pins.

28. The system of claim 22, wherein one or more of the tool holder assembly and tool sleeve accommodate size and motion requirements for the one or more plurality of tools.

29. The system of claim 19, wherein the tool holder assembly includes connection points to external accessories.

30. The system of claim 19, wherein the tool holder assembly includes mount hardware for kinematic coupling and alignment, wherein the mount hardware is coupled to the assembly frame of the tool holder assembly.

31. The system of claim 23, wherein the attaching and aligning by the tool holder assembly includes coupling the tool sleeve to the tool collar via one or more of: threaded nuts, support walls, the driver gear and the driven gear, drive shaft, and the rotary transmission, wherein the rotary transmission is configured to engage with a rotary actuator of the robotic end-effector.

32. The system of claim 20, wherein the intraocular lens insertion signal is a rotary signal applied to a tool transmission coupling having a driven gear coupled to an leadscrew and a linear actuator, wherein continued rotation produces linear motion of the tool tip towards a surgical site, wherein reversing the tool transmission and rotation of the driven gear advances the leadscrew and linear actuator away from the tool holder assembly to produce linear motion of the tool tip away from the surgical site, wherein the driven gear and leadscrew are configured to be adapted in size and ratio to provide fine movements of the tool tip.

33. A method for surgical tool exchange, comprising: mechanically interfacing a tool holder assembly having an assembly frame with a robotic end-effector and tool exchanger via one or more interfaces; transmitting signals, via one or more of the robotic end-effector and tool holder assembly, to one or more of a plurality of tools at the tool holder assembly; identifying and manipulating the one or more of a plurality of tools via the signals transmitted by the robotic end-effector; and attaching, aligning, and transmitting functionality to the one or more of the plurality of tools via the tool holder assembly.

34. The method of claim 33, wherein the transmission of functionality to the one or more plurality of tools includes one or more of: mechanical, electric, or hydraulic function, wherein the tool holder assembly transmits specific characteristics and function to the one or more plurality of tools including one or more of: a signal to inject fluid through the tool, a signal to produce motion at a tip of the tool, and intraocular lens insertion.

35. The method of claim 33, wherein the one or more interfaces, tool exchanger, and robotic end-effector are oriented at various surfaces of the tool holder assembly.

36. The method of claim 33, wherein the tool holder assembly includes a holder housing configured to receive one or more of the plurality of tools, a tool sleeve, tool collar, and alignment tube configured to adjust aligning of an axis of the tool relative to the holder housing.

37. The method of claim 36, wherein one or more transmissions of the tool holder assembly are coupled to actuators of the robotic end-effector, including a rotary transmission of the tool holder assembly having a driver gear and a driven gear, further wherein the alignment tube is configured to act as one or more of the transmissions.

38. The method of claim 33, wherein the robotic end-effector includes one or more of: a sterile barrier, carriage, and base plate, further wherein the actuators of the robotic endeffector include one or more of: a rotary actuator, a tool actuator, and a linear actuator.

39. The method of claim 33, wherein the one or more interfaces include: a tool exchanger interface between the tool holder assembly and the tool exchanger, and a robotic endeffector interface between the tool holder assembly and the robotic end-effector.

40. The method of claim 36, wherein the tool holder assembly includes a cover, wherein the cover at least partially encompasses one or more of the plurality of tools, tool sleeve, tool collar, alignment tube, and holder housing.

41. The method of claim 33, wherein one or more of the tool holder assembly, tool exchanger, and robotic end-effector have one or more coupling plates having coupling hardware configured to couple and align the tool holder assembly to one or more of the tool exchanger and robotic end-effector, wherein the coupling hardware includes: magnets, pins, cut-outs, and Dowel pins.

42. The method of claim 36, wherein one or more of the tool holder assembly and tool sleeve accommodate size and motion requirements for the one or more plurality of tools.

43. The method of claim 33, wherein the tool holder assembly includes connection points to external accessories.

44. The method of claim 33, wherein the tool holder assembly includes mount hardware for kinematic coupling and alignment, wherein the mount hardware is coupled to the assembly frame of the tool holder assembly.

45. The method of claim 37, wherein the attaching and aligning by the tool holder assembly includes coupling the tool sleeve to the tool collar via one or more of: threaded nuts, support walls, the driver gear and the driven gear, drive shaft, and the rotary transmission, wherein the rotary transmission is configured to engage with a rotary actuator of the robotic end-effector.

46. The method of claim 34, wherein the intraocular lens insertion signal is a rotary signal applied to a tool transmission coupling having a driven gear coupled to an leadscrew and a linear actuator, wherein continued rotation produces linear motion of the tool tip towards a surgical site, wherein reversing the tool transmission and rotation of the driven gear advances the leadscrew and linear actuator away from the tool holder assembly to produce linear motion of the tool tip away from the surgical site, wherein the driven gear and leadscrew are configured to be adapted in size and ratio to provide fine movements of the tool tip.