Classifications

• • G—PHYSICS
  • G05—CONTROLLING; REGULATING
  • G05G—CONTROL DEVICES OR SYSTEMS INSOFAR AS CHARACTERISED BY MECHANICAL FEATURES ONLY
  • G05G1/00—Controlling members, e.g. knobs or handles; Assemblies or arrangements thereof; Indicating position of controlling members
  • G05G1/30—Controlling members actuated by foot
  • G05G1/305—Compound pedal co-operating with two or more controlled members
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  • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
• • A—HUMAN NECESSITIES
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  • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
  • A61F9/007—Methods or devices for eye surgery
  • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
• • A—HUMAN NECESSITIES
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  • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
  • A61F9/007—Methods or devices for eye surgery
  • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
  • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
  • A61F9/007—Methods or devices for eye surgery
  • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
  • A61F9/00763—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments with rotating or reciprocating cutting elements, e.g. concentric cutting needles
• • G—PHYSICS
  • G08—SIGNALLING
  • G08C—TRANSMISSION SYSTEMS FOR MEASURED VALUES, CONTROL OR SIMILAR SIGNALS
  • G08C19/00—Electric signal transmission systems
  • G08C19/16—Electric signal transmission systems in which transmission is by pulses
  • G08C19/28—Electric signal transmission systems in which transmission is by pulses using pulse code
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
  • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
  • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
• • H—ELECTRICITY
  • H02—GENERATION; CONVERSION OR DISTRIBUTION OF ELECTRIC POWER
  • H02H—EMERGENCY PROTECTIVE CIRCUIT ARRANGEMENTS
  • H02H3/00—Emergency protective circuit arrangements for automatic disconnection directly responsive to an undesired change from normal electric working condition with or without subsequent reconnection ; integrated protection
  • H02H3/12—Emergency protective circuit arrangements for automatic disconnection directly responsive to an undesired change from normal electric working condition with or without subsequent reconnection ; integrated protection responsive to underload or no-load
• • A—HUMAN NECESSITIES
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  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/14—Probes or electrodes therefor
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  • A61B2017/0003—Conductivity or impedance, e.g. of tissue of parts of the instruments
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• • A—HUMAN NECESSITIES
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  • A61B2017/0019—Means for setting or varying the pulse width
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• • A—HUMAN NECESSITIES
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  • A61B2017/00429—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping with a roughened portion
  • A61B2017/00433—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping with a roughened portion knurled
• • A—HUMAN NECESSITIES
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  • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
  • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61B2017/00973—Surgical instruments, devices or methods, e.g. tourniquets pedal-operated
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61B2017/00973—Surgical instruments, devices or methods, e.g. tourniquets pedal-operated
  • A61B2017/00977—Surgical instruments, devices or methods, e.g. tourniquets pedal-operated the depression depth determining the power rate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
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• • A—HUMAN NECESSITIES
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• • A—HUMAN NECESSITIES
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  • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
  • A61B90/361—Image-producing devices, e.g. surgical cameras
  • A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre
• • A—HUMAN NECESSITIES
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• • A—HUMAN NECESSITIES
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• • A—HUMAN NECESSITIES
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  • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• • A—HUMAN NECESSITIES
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  • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61G12/00—Accommodation for nursing, e.g. in hospitals, not covered by groups A61G1/00 - A61G11/00, e.g. trolleys for transport of medicaments or food; Prescription lists
  • A61G12/001—Trolleys for transport of medicaments, food, linen, nursing supplies
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  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
• • A—HUMAN NECESSITIES
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  • A61M2205/00—General characteristics of the apparatus
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  • A61M2205/00—General characteristics of the apparatus
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  • A61M2205/6081—Colour codes
• • H—ELECTRICITY
  • H01—ELECTRIC ELEMENTS
  • H01H—ELECTRIC SWITCHES; RELAYS; SELECTORS; EMERGENCY PROTECTIVE DEVICES
  • H01H3/00—Mechanisms for operating contacts
  • H01H2003/008—Mechanisms for operating contacts with a haptic or a tactile feedback controlled by electrical means, e.g. a motor or magnetofriction
• • H—ELECTRICITY
  • H01—ELECTRIC ELEMENTS
  • H01H—ELECTRIC SWITCHES; RELAYS; SELECTORS; EMERGENCY PROTECTIVE DEVICES
  • H01H2300/00—Orthogonal indexing scheme relating to electric switches, relays, selectors or emergency protective devices covered by H01H
  • H01H2300/04—Programmable interface between a set of switches and a set of functions, e.g. for reconfiguration of a control panel

Definitions

• the invention relates to the control of surgical instruments, especially microsurgical and ophthalmic systems, by the use of foot controls, and more particularly, to a surgical foot control, with programmable features and functions for specific use m a modular microsurgical system for anterior and posterior ophthalmic surgery.
• a surgeon conducting surgery or carrying out ophthalmic procedures in the anterior or posterior portions of the eye necessarily will have his or her eyes at a microscopic viewing instrument, and desires to be able to carry out control of the various ophthalmic modules by the use of a foot control of the invention.
• a foot control desirably provides controls not only for the various ophthalmic modules, selecting the surgical mode desired, and controlling the rate of operation produced by handpieces interconnected with the modules, such as aspiration, vitrectomy cutting, phacoe ulsification, scissor cutting, and so forth.
• Ophthalmic microsurgical systems in present day use and as have been proposed and used for a number of years m modern ophthalmic surgical practice, have heretofore been controlled by foot controls, as typically may be used m conjunction with a display console.
• foot controls as heretofore known are not without considerable drawbacks when it is desired to be able to use the same foot control for controlling a variety of possible devices, ophthalmic tools and instruments; or where it is desired that the same foot control be equally as useful with one type of module as for another, while allowing the foot control to select the mode or module desired, while providing also capability for use of the foot control with any of possible future modules as they become available.
• a specific concern in the use of foot controls for ophthalmic surgery systems is that ophthalmic surgeons may have various different preferences and individual practices or customs in the way in which they want or expect the foot control to perform or operate. Thus, a surgeon may be left- footed or right-footed.
• the foot control permit accommodation of various possible differences and preferences in rate, control sensitivity and feedback, as will facilitate surgical preferences in practice in myriad precise and different procedures which may vary from one individual to the next, and there are even differences according to whether a ophthalmic surgeon is performing anterior segment procedures or posterior procedures.
• a foot control for such a system provide the capability of receiving, implementing and reporting various signals for system communication in a digital format used by such system.
• a foot control is itself modular, and that it be a "smart control.” It is further desired that it use only low voltage, low power circuitry as appropriate for operating room environment, but with the circuitry being capable of interfacing with digital circuits, including a central processor and any of various modules and peripherals, of such a modular microsurgical system as the foregoing. It is desired that the "smart control" have the capability for system communication with such circuits by means of appropriate interface network protocols such as the known RS-485 protocol.
• the foot control provide an actuating foot pedal with capability for movement in both pitch and yaw in order to accommodate various possible control actions in accordance with the mode of usage of the system at any given time.
• a surgeon can use the pitch control for one or more distinct modes of operation; and the yaw control for one or more other modes of operation.
• a surgeon in an irrigation mode may then be able to move the foot pedal from zero deflection with increasing deflection causing increasing aspiration; and then with further deflection, the foot pedal can be moved through a second region in which a mode such as phacoe ulsification or vitrectomy cutting occurs with increasing rate as the pedal is still further deflected in the second region.
• a mode such as phacoe ulsification or vitrectomy cutting occurs with increasing rate as the pedal is still further deflected in the second region.
• the foot control and surgical system in which it is used permit the point of transition from the first region to the second region be electronically selected by the operation of controls. This may be carried out by touch screen control, as made possible by the referenced modular microsurgical system.
• the modular microsurgical system is not only diverse and versatile in its configuration, so also should the foot control used in such a system be diverse and versatile in its capabilities and in the degree of its range of operation (as for precise control over cutting rates for example) and its degree of sensitivity when used in any of the various possible modes of the system. Accordingly, among the objects and advantages of the new surgical foot control, namely a peripheral foot control module, as herein described and illustrated, are such a foot control -- which includes programmable features and functions for specific use in a modular microsurgical system for anterior and posterior ophthalmic surgery;
• Fig. 1 is a perspective view of a microsurgical control system for use with ophthalmic microsurgical instruments, and having a plurality of control modules, and utilizing a surgical foot control assembly of the present invention
• Fig. 2 is a top plan of a peripheral foot control of the microsurgical system, referred to in its entirety as a foot control assembly, or simply foot control, in accordance with a preferred embodiment
• Fig. 3 is a bottom plan view of the foot control, illustrating certain circuit and related components
• Fig. 4 is perspective view of the foot control
• Fig. 5 is a circuit schematic block diagram of circuitry of the foot control of the invention
• Figs. 6A-6F together show a detailed circuit schematic diagram of foot control circuitry, in which: Fig.
• FIG. 6A is a detailed circuit schematic diagram of microprocessor features of the circuitry
• Fig. 6B is a detailed circuit schematic diagram of EPLD circuitry used with the circuitry of Fig. 6A
• Fig. ⁇ C is a detailed circuit schematic diagram of certain reset circuitry used with the circuitry of Fig. 6A
• Fig. 6D is a detailed circuit schematic diagram of certain RS-485 circuitry used with the circuitry of Fig. 6A for bus communication with a modular microsurgical system with which the foot control is used
• Fig. 6E is a detailed circuit schematic diagram of a power supply for powering the above circuits
• Fig. 6F is a detailed circuit schematic diagram of certain brake drive circuitry of the foot control, as controlled by the circuitry of Fig. 6A;
• Fig. 7 is a block circuit diagram of the brake drive circuitry; Figs. 8A-8C together illustrate main events m the operation of the foot control;
• Figs. 9A and 9B are graphical representations indicating different detent possibilities for operation of the brake drive circuitry;
• Fig. 10 is a perspective view of certain pedal mechanical features, illustrating brake pedal pitch- responsive components;
• Fig. 11 is a perspective view of certain pedal mechanical features, and illustrating brake pedal yaw- responsive components
• Fig. 12 is an exemplary screen display depicting screen settings and displays appropriate for reconfiguring the operation of the foot control .
• foot control assembly 15 constitutes a peripheral foot control which is interconnected with the modular microsurgical control system 1 by means of a cable 2312 which provides bus protocol connection, namely serial RS-485 bus interfacing, and reset signal lines, interconnecting the system and the foot control, and which also provides power, for example, 24 v.d.c. for the foot control and circuitry thereof.
• bus protocol connection namely serial RS-485 bus interfacing, and reset signal lines
• foot control 15 is functionally equivalent to modules 13 with respect to data communications and provides primary control input for a surgeon to interact with the system during ophthalmic procedures by foot control input permitting controlling of the various modules 13 such as any of the various possible ophthalmic modules 13 which are or can be employed in the modular microsurgical system 1.
• modules 13 such as any of the various possible ophthalmic modules 13 which are or can be employed in the modular microsurgical system 1.
• Examples are air/fluid exchange and scissors/forceps module 327, bipolar coagulation and radio frequency diathermy module 329, illumination module 331, irrigation and scroll aspiration module 323 (which includes vitrectomy cutter capability) ; irrigation, ventu ⁇ aspiration and vitrectomy module 321; and phacoemulsification and phacoefragmentation module 325.
• Foot control 15 includes a housing, or console, generally indicated by reference character 2314, as formed preferably of molded material, so as to define an upper surface 2316 sloping to increasing height from a heel portion 2318 toward left and right upper portions 2320, 2322 which define between them an approximately U-shaped recess
• a center pedal that is, a foot pedal 2326 of foot-accommodating shape.
• the foot pedal is dimensionally narrower than recess 2324 so that, as will become apparent, it may be moved from side-to-side in yaw movement by rotation about an shaft assembly 2328 emerging from the walls of recess 2324 and which shaft assembly presents the foot pedal for movement and operation.
• the foot pedal is flared upwardly, providing slight flanges 2327, at opposite sides of the foot pedal, which may be apertured as illustrated for lightness and texturing effect tending to make contact by the foot still more secure.
• the foot pedal 2326 is movable also in pitch, by rocking movement of the shaft assembly, with increasing user pressure upon the pedal m the manner of a vehicular accelerator pedal.
• a heel rest 2330 m the form of a shallow depression accommodating and resting the heel of the user steadily, i.e., it is a heel recess, whether it be of the left foot or right foot, and permitting precisely controlled movement of the foot pedal in either pitch or yaw modes; and in this regard, establishing a reference point for placing the user's foot upon surface 16 and for relative tactile location of the foot in precise position for operating the foot pedal 2326.
• the foot pedal 2326 be movable through pitch movement of 15° about the pitch axis defined by shaft assembly 2328, with the limits of movement defined mechanically such that the initial elevation is 15° from horizontal; and fully depressed, final elevation is 0° relative to horizontal.
• a suitable spring return as later discussed, is included for return to the initial elevation (home position) if the foot is lifted from the pedal. No mechanical detenting is used; but instead programmable detents are created by circuit operation to be described, to include both forward and rearward detent action.
• the foot pedal 2326 be swmgable in yaw through rotation about a yaw axis defined by shaft assembly 2328 such that 10° of travel is permitted from the nominal center position illustrated, and with spring return to the center position, and center detenting being provided mechanically, with operation such that linear control will be provided by movement of the user m the direction of the instep of the control, relative to center, and movement in the opposite direction may by comparison be binary, as for switching on and off of aspiration.
• the yaw possibilities are illustrated by the legends YAW LEFT and YAW RIGHT, about a centerline 2329.
• Left and right upper portions 2320, 2322 of the housing define corresponding outer narrow projections 2332, 2334 between which extend a handle 2336 preferably formed integrally with the one-piece housing 2314 which can be used for lifting the foot control assembly 15 and for storing the unit on an instrumentation cart 21 of the microsurgical system 1.
• cable 2312 emerges from housing 2314 beneath foot pedal 2326 and handle 2336 and interconnects by appropriate plug arrangement (e.g. connector 157) with the microsurgical system 1. Cable 2312 accordingly provides a power supply and communication bus connection with the microsurgical system 1 so that foot control 15, with its own microprocessor circuitry (e.g., control circuit 105 in Figs.
• the foot control circuitry constitutes nodes on a computer network established by the microsurgical system of Fig. 1.
• the computer network provides power distribution and peer-to-peer data communication between the nodes, including foot control 15.
• Mounted within right upper portion 2322 of the housing surface is a rocker switch 2336 having left and right actuating surfaces 2338, 2338' for momentary actuation upon pressing either actuating surface 2338 or 2338' about the center portion of the rocker switch as denoted by a slight projection 339.
• surfaces 2338 or 2338' will be selectively pressed by the user's foot for purposes presently appearing, and preferably include switch-defining tactile feedback by snap action.
• Rocker switch 2336 is programmable when used with the microsurgical system of Fig. 1 so as to provide up/down, increment/decrement, or on/off controls for all applicable functions of the system. Thus it may be regarded as an alternate position binary switch device, functioning according to which of its surfaces are selectively pressed. To the right of heel rest 2330 is a corresponding, similar shallow depression providing a heel rest 2330' for resting and precisely locating the heel when a surgical user desires to operate rocker switch 2336.
• the heel recesses 2330, 2330' within the upper surface of the housing 2314 define for the user the pedal - operating and rocker switch-operating positions, permitting tactile placement of the foot without visual ascertainment.
• a mode button 2340 mounted within left upper portion 2320 of the housing surface are a mode button 2340, and above it, a bipolar button 2342, both being of momentary actuation type switches with tactile feedback.
• the mode button is used by the surgeon to select a mode of operation, for example, as to selection of a module 13 or to change of operation of module 13 from one mode to another.
• the mode switch selects operation modes by the microsurgical system 1.
• the bipolar button coated m the color blue to contrast with the overall different color, e.g., gray, of the foot control housing, is selectively pressed by the surgeon to cause bipolar coagulation operation by an ophthalmic handpiece .
• housing 2314 is shown from the bottom but without a cover, which normally maintains sealing of components, which is shown removed to illustrate components within the interior, generally designated 2344, of housing 2314.
• Shaft assembly 2328 as extending through interior walls 2344 of the housing includes at its midpoint a gearbox 2346 n which are located components for translating foot pedal yaw into corresponding rotary motion for driving a yaw encoder 2348 interconnected with microprocessor-controlled circuits 2350 on a circuit board 2351.
• Such circuits communicate by cable 2312, using RS-485 serial data bus protocol, with the modular microsurgical system 1.
• a pitch encoder 2352 is also interconnected with circuit board 2350, and this encoder is driven from the other end of shaft assembly 2328 by one end of a rockable pinion-drive arm 2354 which rocks with pitch movement of the foot pedal, and the features and operation of which arm will be explained below.
• the opposite end of arm 2354 is interconnected with a magnetic particle brake 2356 which provides electronically-controlled detenting of the foot pedal in its pitch mode, as more fully later described.
• yaw encoder 2348 Associated with yaw encoder 2348 is a limit switch, i.e., home switch, 2349, which serves to illustrate a similar limit switch, i.e., home switch, 2353 (see Fig. 3) associated with pitch encoder 2352.
• the yaw and pitch limit switches are connected to circuit board 2350 for signalling home positions of the respective encoders for corresponding home positions of the foot pedal, i.e., when centered (0° yaw) and when not depressed in pitch.
• FIG. 5 a block diagram shows the preferred embodiment of control circuitry 2350 of the new foot control, illustrating its key circuit features.
• Cable 2312 provides d.c. power at 24 volts to the foot control and a twisted-pair serial bus connection for transfer of data by RS-485 protocol with the modular surgical system.
• a power input circuit 2355 provides the voltage supply to a power supply 2356 serving as a Vcc generator for logic circuitry, which provides regulated Vcc low voltage, e.g., 5 v.d.c, to other circuits, including an RS-485 communication transceiver 2358 and RS-485 reset transceiver which both communicate with the serial bus connection provided by cable 2312.
• Vcc generator 2356 also serves as the Vcc power source for an integrated circuit ("IC") device, namely a distributed communications and control processor (e.g., processor 225) available from Motorola, Inc. and designated by the registered trademark "Neuron” (of Echelon Corp.), and referred to herein for convenience as the Neuron IC. It is designated 2362, and is interconnected with a memory IC 2364 such as preferably 90ns or faster 64Kx8 flash memory devices commercially available under type designation Atmel AT29C257-90.
• IC integrated circuit
• Vcc generator 2356 also supplies operating voltage to a logic IC 2366, namely electronically programmable logic device (EPLD) , as explained below.
• EPLD electronically programmable logic device
• Vcc generator also supplies certain circuit components of a brake drive circuit 2368 which drives magnetic particle brake 2356 for electronically-controlled detenting of the foot pedal.
• Brake drive circuit 2368 for this purpose is also provided with 24-v. power by power input 2355, thus receiving a voltage adequate for driving brake 2356.
• Logic IC 2366 used for switch logic input/output expansion purposes and control and for encoder decoding.
• IC 2366 provides switch decoding of the respective limit switches as well as the bipolar and mode switches 2340, 2342 and rocker switch 2336, and all of which switches are here simply represented as a group of the various switches 2370 which are decoded by EPLD logic 2366.
• EPLD logic IC 2366 interconnected with EPLD logic IC 2366 are yaw encoder 2348 and pitch encoder 2352 for quadrature decoding/ multiplying .
• EPLD IC 2366 also provides brake strength encoding, selecting brake strength, and for this purpose interconnected as shown with brake drive circuit 2368 which includes circuit features for selectively energizing and controlling magnetic particle brake 2356.
• a detailed circuit schematic of the foot control circuitry shows details in accordance with the preferred embodiment .
• Neuron IC 2362 is provided with a clock crystal input 2372 for its operation and has data and address connections by parallel data transfer with memory IC 2364 in which is stored in resident ROM application program code for Neuron IC 2362.
• a series of gates 2374a, b,c connect IC's 2362 and 2364 and provide signal conditioning for read/write enable control and clocking signals NEUR R/W* and NEUR ECLK, where the asterisk here and elsewhere in the circuitry denotes logic inversion (low true) .
• On-chip RAM internal to Neuron IC 2364 stores data in accordance with the IC 2362 program code.
• the EPLD IC 2366 is preferably chip device available under Lattice part designation ISP1024. It is provided with inputs by various jacks J10,
• a jack J2 shows the main connection of the circuitry by means of cable 2312.
• EPLD IC 2366 is also interconnected with Neuron IC 2362 input/output terminals by the connection labeled NEUR IO ⁇ 10..0> for providing input and output, e.g., the status of the foregoing group, i.e., a matrix, 2370 of switches, and for reporting the yaw and pitch encoder data; and receives the Neuron IC clock signal NEUR ECLK.
• EPLD IC 2364 receives reset signals LOCAL RESET and LOCAL RESET* from a reset circuit shown in Fig. 6C.
• transceiver 2360 is preferably commercial device type 75176, a line- driver/buffer which provides appropriate signal conditioning of reset signals RESET-LO and RESET-HI .
• a group of logic devices 2376a, b,c,d provides conditioning of the signal output of transceiver 2360 to a reset chip 2378, preferably commercial device type MAX705. It is a buffer which receives periodic watchdog timer pulses normally as a signal WDT IN from the Neuron IC 2362.
• reset chip 2378 does not receive such a normal watchdog time pulse within the normal pulse interval, it times out to send a reset signal via gates 2376a, b,c,d for local resetting the foot control circuitry, providing by means of transistors 2380a, 2380b three reset signals, LOCAL RESET, LOCAL RESET* and NEUR RESET*.
• the watchdog timer generates appropriate reset signals within the foot control if a problem occurs within the foot control circuitry, and preferably so resetting at least once every 1.0 sec, the watchdog reset pulse being preferably greater than 50 nsec .
• FIG. 6D shows communication transceiver 2358 (also referred to as transceiver 223) which is preferably commercial device type 75176. It a line-driver/buffer which provides appropriate signal conditioning for communication signals RS485-LO and RS485-HI as an interface with corresponding local signals CP2 , CP1 and CPO which are the communication protocol signals for Neuron IC 2362.
• Diode clamp circuits 2382a, 2382b are provided respectively for the circuitry of Figs. 6C and 6D for controlling line levels appropriately for the reset and RS485 signals.
• Fig. 6E shows power supply circuitry including commercial chip device LM2574, serving thus as Vcc generator 2356 of Fig. 5, and its circuit design will be understood by those skilled in the art and is generally derived from application notes as provided by National Semiconductor, Inc .
• brake drive circuit 2368 (Fig. 5) is shown in specific detail.
• Fig. 7 a block diagram of the brake control circuitry, which shows the input of a brake enable signal BRAKE EN to be received by this circuitry for enabling driving of magnetic particle brake 2356 by which detenting of foot pedal 2326 is achieved.
• the coil 2356W (Fig. 6F) of magnetic particle brake 2356 has a high inductance which slows its response time to engage and disengage.
• the brake control circuitry will provide means for speeding up this response time upon braking by first energizing the brake coil with a voltage significantly higher than its normal operating voltage. Then, once the current in the brake has reached the required operating value, the drive voltage must be reduced to a level to maintain that operating current.
• One conventional method to achieve a faster response is to apply a fixed high voltage to a ballast resistor m series with the brake coil; but the ballast resistor consumes excess energy and produces unwanted heat.
• the present arrangement as shown m Fig. 7 provides for rapid engaging and disengaging of the brake without an excess consumption of power. This is accomplished in part by using a pulse width modulated drive for the brake, the pulse width being feedback voltage-controllable, specifically employing a DC-to-DC switching voltage regulator circuit, namely comprising a switching-type power supply chip device 2384, most preferably a single chip switcher voltage regulator, which operates to provide a constant voltage supply; and specifically provides a constant current through the brake coil, which constitutes a highly inductive element in the switching voltage regulator circuit .
• BRAKE EN is here shown as ON-OFF CONTROL signal provided to an ON*/OFF input of chip device 2384, having a V IN input which receives a suitably high voltage (24 v.d.c), being thus high enough for efficiently driving the coil winding 2356W of magnetic particle brake 2356 which when energized exerts drag on the mechanism of foot pedal 2326, here shown by dotted line connection (connecting foot pedal 2326 and brake 2356) to create a detent feedback by establishing a selectively variable force resistance to further pushing of foot pedal 2325, as well as modulating such force resistance in accordance with the operation of Neuron IC 2362 so that the user may have the feeling of pushing through a detent position, so as to in order readily to perceive the point of transition from one region to the next .
• Chip voltage regulator being a switching-type power supply, provides at a terminal OUTPUT a switched output (e.g., at 52kHz) for constant energization of a circuit including the coil winding 2356W, a quick disengage resistor 2386a and a sense resistor 2386b, which develops a voltage which is proportion to the current in coil winding 2356W.
• These two resistors provide a node 2387 between them for a feedback connection 2388 provided to a FEEDBACK input of chip device 2384, so as to control the duty cycle of device 2384, and so modulating its output voltage to maintain the required operating current in brake coil winding 2356W and resistances 2386a and 2386b.
• a solid state switch 2390 includes an electronic switching element with contacts 2390b are connected to bridge across and short resistor 2386a when enabled by the brake enable signal BRAKE EN which is made available to ON/OFF* .
• resistor 2386a acts as a quick disengage resistor, for it is shorted by operation of contacts 2390b, and resistor 2386b acts as a sensing resistor, as the voltage across it defines the feedback signal provided by feedback connection 2388 for controlling the brake current.
• a flywheel diode 2392 completes the circuit .
• a brake enable signal BRAKE EN appears, the switching power supply chip 2384 is turned on and the solid state switch 2390 operates with speed typical of semiconductor switching devices, bypassing the quick disengage resistor 2386a.
• the sensing resistor 2386b develops a voltage providing pulse width modulation feedback control signal to the switching power supply to control current in the loop including brake coil winding 2356W, and the FET serves as solid state switching means for rapidly increasing loop current for brake actuation by initially providing to the brake coil winding 2356W a brake drive voltage significantly higher than its normal operating voltage, and when the brake current has reached a required operating value for braking action, the brake drive voltage being reduced to a level to maintain an operating current for braking action.
• switching power supply chip 2384 is turned off solid state switch 2390 again deenergizes with speed typical of semiconductor circuits, removing the current bypass the FET provides, and thus with extreme rapidity diverts current flow through quick disengage resistor 2386a, causing the loop current through brake coil 2356W to drop quickly, and this will immediately be sensed by the user as the passage of the detent. In this way the user is tactilely signalled that the foot pedal has pushed through the detent position, and receives a palpable sensation of transitioning from one activation region of the foot pedal to another.
• the circuitry enables more than one detent position, and enables the magnitude of the magnetic particle brake- induced detent to be preset according to predetermined criteria, which may include preference of the surgeon-user, e.g., as for higher resistance or lower resistance detent. It further enables the regions of activation of the foot pedal to be selectively varied in arcuate extent. Referring to Fig. 6F, the preferred circuit actualization of the circuitry of Fig. 7 is illustrated.
• the brake enable signal BRAKE EN is provided through a logic gate 2393 for being sent with inversion (low true) to an inverting input of chip regulator 2384, which receives its 24 v.d.c. power through an inductive-capacitive filter 2394.
• the inverted output of gate 2393 drives the base of a transistor 2396 which, as will be apparent, is connected to control accordingly the state of solid state switch 2390, here seen to be constituted by an FET having an internal reverse polarity transient clamp diode 2391 connected across the drain and source electrodes which effectively provide the contacts 2390b shown in Fig. 235, and across which is connected disengage resistor 2386a.
• Sense resistor 86b is supplemented by a resistor divider pair 2398a, 2398b between which is a node 2399 to which four resistors 2400a,b,c,d are connected at one end and at their opposite ends to corresponding switching outputs 2402a, b,c,d of a solid state switching device 2402 which preferably is commercially available chip device type DG212, which will be understood to selectively connect any one of resistors 2400a,b,c,d to ground dependent upon the presence or absence (high or low) of brake intensity control signals BRAKE-OUT1, BRAKE-OUT2, BRAKE-0UT3 or BRAKE-OUT4 at corresponding inputs of switching device 2402, and which inputs are biased to Vcc by corresponding resistors 2404a,b,c,d.
• a resistor divider pair 2398a, 2398b between which is a node 2399 to which four resistors 2400a,b,c,d are connected at one end and at their opposite ends to
• resistors 2402a, b,c,d together act with resistor 2388b to provide a voltage divider for altering the voltage level at node 2387 in a sense for controlling the feedback 2388 so as to predetermine the extent to which brake winding 2356W will be energized when FET 2390 switches to its conductive state, and dependent upon brake intensity control signals BRAKE-OUTl, BRAKE-OUT2, BRAKE-0UT3 or BRAKE- OUT4 provided by Neuron IC 2362 in accordance with program selection by the modular microsurgical system, so that each of such brake intensity control signals defines a braking detent value from minimum to maximum.
• Figs. 8A, 8B and 8C the operation of the control circuitry of the foot control will now be more clearly understood.
• Neuron IC 2362 software operates in an idle loop until an event occurs. An event would be operating one of the push buttons of group 2370, change in yaw encoder 2348 or change in pitch encoder 2352.
• Fig. 8A illustrates Neuron IC-defined push button sequence.
• Neuron IC 2362 effectively establishes by its software a push button timer interval during which the pressing of any of the footswitches may be detected.
• a first step 2406-1 shows expiration of the push button interval.
• serial data input may be received by Neuron IC 2362 from the microsurgical system.
• a next step 2406-3 checks to see if any of the home switches, i.e., those associated with yaw encoder 2348 or pitch encoder 2352 are engaged, i.e., indicating that the foot pedal is neither depressed nor yawed. If so ("Y" for yes) , the encoder counts are zeroed at step 2406-3A.
• step 2406-4 represents a check to see if new buttons are pressed. If so ("Y"), the condition is reported at step 2406-5 via the network connection cable 2312 to the modular microsurgical system processor. If not ("N" ⁇ , the event cycle is done, shown by step 2406-6; and the idle loop continues similarly until an event occurs.
• a step 2408-1 represents its detection. In step 2408-2 the new position limit is detected. The data is then sent to the system processor at step 2408-3.
• a step 2410-1 shows detection of the change. In step 2410-2 the new position limit is computed.
• Step 2410-3 follows in which detent management is calculated.
• brake winding 2356W is energized appropriately for creating detenting of movement of the foot pedal, which is fully as palpable to the user as if there were mechanical devices.
• the data representing the conditions so measured is sent to the system processor at step 2410-4.
• Figs. 9A and 9B indicate the possibilities. In both, relative braking force is plotted against the percentage of foot pedal deflection in pitch, from 0% through 100%, with detent points being indicated as
• breaking force is applied to provide pedal force F- ⁇ j . (or a lesser chosen value) is quickly applied as a pulse. Passing through the detent thus created, pedal excursion continues until a second point x 2 , e.g., 50%, and again breaking force is applied to create pedal force F max
• hysteresis between brake force on and brake force off is used.
• x- shows the point of first energization
• x : ' shows a lower value of depression provided during retarding the pedal before the user can turn off the detent, so as to prevent the user from being on an edge point in which the detent would be toggling on and off.
• a shaded hysteresis area 2413 of the pulse is indicated.
• a similar hysteresis 2413 is provided also for the next brake pulse initiated at x 2 .
• a second possible method shown in Fig. 9B pedal excursion to the first position x x results in quick application of a braking force to bring pedal force to a value F- .
• Hysteresis may in this method also be used to keep the user from being on a ' foot pedal edge point, as would toggle on and off braking force if the user were to ease the foot pedal back slightly from one of the detent points.
• a shaded hysteresis band area 2413' of the pulse is indicated, wherein once braking force is engaged at x- it will not be disengaged until the pedal retracts over a hysteresis interval down to x : ' .
• a similar hysteresis band 2413' is provided also for the next brake increase at x 2 .
• the detent points x ⁇ and x 2 are shown by positions of foot pedal 2326 illustrated in dashed lines.
• the software permits the detent points x 1 and x 2 to be varied, as a percentage of foot pedal travel .
• the user can be enabled if desired to vary the detent points, as well as the extent of braking force signalling the detent points .
• a shaft extension of shaft assembly to which is affixed for rotation with foot pedal 2326 in pitch an actuating arm 2416 having a first set of teeth 2418 at one end for meshing with a pinion 2420 carried by the shaft of magnetic particle brake 2456 and a second set of teeth 2422 at the other end for meshing with a pinion 2424 carried by the shaft of pitch encoder 2352.
• Home switch 53 which determines the home limit of pitch encoder 2352 is not collocated with it, but is instead proximate brake 2356.
• a yaw shaft extension 2426 carrying a pulley 2428 about which is a belt 2430 extending around a corresponding pulley 2432 carried by the shaft of yaw encoder 2348.
• actuating arm 2416 meshes at its opposite ends with encoder pinion 2424 and brake pinion 2420, being rockable about the axis of a bore 2434 (to which shaft extension 114, here removed for illustration clarity) is secured for rotation about such axis as the foot pedal is moved in pitch.
• a coiled compression spring 2436 seated within a recess 2438 of arm 2416, and bearing at its outer end against suitable structure of housing 2314, urges arm 2416 in a clockwise sense as viewed in Fig. 10, for biasing brakepedal 2326 to home pitch position (i.e., which it will occupy when not pressed by the user) .
• Home switch 2418 is actuated when in the home position by an actuator arm 2418', carried by arm
• gearbox housing 2346 and shaft assembly 2328 are stripped away in Fig. 11 to reveal elements more clearly.
• gearbox housing 2346 is a gear assembly driven by a plate 2442 for securement to foot pedal 2326 by suitable screw affixation through apertures as at 2443.
• a shaft 2444 which carries a helical gear 2446 which meshes with a corresponding gear 2448 affixed to a yaw coupling shaft 2450 which carries at its outer end pulley 2428. It will be evident that yaw of plate 2442 in response to user positioning of foot pedal 2326 in yaw will rotate drive gear 2446 for causing corresponding rotation of shaft 2450 and pulley 2428 affixed thereto, and such rotation will be coupled by belt 2430 to pulley 2432 of yaw encoder 2348, which is affixed to the foot control housing by a suitable bracket 2451.
• Limit switch 2349 which detects the home position (corresponding to 0° yaw) may be of the same optoelectronic type as pitch home switch 118.
• a pedal- centered 0°-yaw position of plate 2442 is maintained by the centering action of a pair of coiled compression springs 2452 affixed centrally to an arm 2454 carried by the lower end of shaft 2444, as the outer the outer ends of springs 2452 bear against appropriate seats within gear housing 2346 (Fig. 3) .
• shaft assembly 2328 provides independent shaft coupling of the separate possible pitch and yaw movements by providing separate shaft outputs at the opposite ends of the shaft assembly, respectively operating the yaw and pitch encoders 2348, 2352 independently and permitting their location relatively remote from shaft assembly 2328, and without requiring them to be difficultly incorporated into the actual foot pedal pivot or mounting mechanism, and thereby providing a more convenient arrangement for assembly and adjustment, as well as achieving an efficient, highly reliable construction capable of withstanding the substantial rigors of surgical use year after year in the operating room environment.
• the new foot control provides hitherto- unavailable flexibility in meeting each user's preferences, as well as ability to change parameters associated with such preferences during use.
• the new foot control provides the primary input for a surgeon to interact with the system, allowing both linear inputs by either left-footed or right-footed actuation of foot pedal 2326 in pitch and yaw, and provides also pushbutton actuated binary control .
• the foot control also affords the surgeon complete control over what function is assigned to what linear control or what button.
• the foot control can be made to work similarly for the right -footed surgeon or the left-footed surgeon.
• the assignment of functions may also change as the setup of the surgical device changes.
• the primary linear control may control linear aspiration in one setting and linear phacoemulsification power in another.
• foot pedal 2326 is utilized in pitch and yaw.
• the pitch and yaw may control two separate linear functions simultaneously, so that the system may be said to be a dual- linear system.
• the aspiration function for example, is preferably always controlled by pitch action of the foot pedal and another linear function, such as phacoemulsification, controlled linearly by yaw action of the foot pedal.
• the yaw movement is also usable to simulate left/right side switching actions that activate functions, e.g., enabling vitrectomy cutter to one side, reflux to an opposite side.
• the detent levels provided by magnetic particle brake 2356 are fully programmable in pitch movement.
• an exemplary screen display of the microsurgical system 1 shows screen settings and displays appropriate for reconfiguring the operation of the foot control.
• the user touches the desired video- displayed "button” or arrow-indicator on touch-responsive screen 255, as appropriate, for effecting a change.
• touch-screen display indicates a touch area for providing foot pedal settings and corresponding display on the screen 255, as here depicted.
• Reference character 2458 indicates a touch-screen display area with display buttons for selection of left-footed or right-footed operation.
• a switch settings panel 2464 includes display button for allowing the programmable function switch (mode switch 2342) to be selected from a software-defined list for use; and here is shown as having its mode sequence enabled.
• the mode switch when pressed will then cycle from one mode to the next.
• tapping the mode switch button 2342 will cycle from a selected one of the bipolar coagulation function, to an aspiration function, to a phaco-emulsification modes, to a selected aspiration mode once more, and then recycle again to the bipolar mode.
• the mode switch can be selected to transition between a present mode and a previous mode, e.g., from a vitrectomy mode, to a scissors mode, to the vitrectomy mode, etc., so that the foot pedal may then be used in its linear and/or binary control capabilities in the selected mode.
• the foot pedal may be moved inward (in the direction of the instep) over a linear region of from zero to 100%, relative to its centered position, and when moved outwardly in the lateral aspect may toggle in binary mode to allow reflux operation (i.e., turning reflux on/off).
• An adjacent screen panel 2466 has display button for selecting the function from a software-defined list to be controlled by rocker switch 2336, here shown as controlling upward and downward movement of the IV pole.
• display areas 2468, 2470, 2472 are provided, for defining activation regions (or what may be termed active regions) of the foot pedal movement in pitch, and for establishing thereby the points at which detents are produced by magnetic particle brake 2356. For example, as here shown, activation region one is set at 0%, activation region two is set at 30%, and activation region three is set at 50%. Display buttons in each of areas 2468, 2470, 2472 are pressed by user touching of the screen to change the degree settings selectively, for bringing about detenting action in accordance with user preference, as hereinabove described with reference to the brake control circuitry.
• a screen display area provides a pictographic display of the brakepedal control activation regions, with detent demarcation, accordingly produced by the latter display button operations.
• bipolar switch 2342 is not programmed, and will be used its intrinsic binary on/off mode, i.e., enabled when pressed.
• foot pedal movement in yaw is not programmable from screen display, but is instead enabled according to whether left foot or right foot operation is selected at panel 2460, and in accordance with programmable function switch selection at panel 2464, e.g., for mode sequence .

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• Accommodation For Nursing Or Treatment Tables (AREA)

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ID=26699814

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• 1997
  • 1997-08-22 CA CA002264663A patent/CA2264663C/en not_active Expired - Lifetime
  • 1997-08-22 WO PCT/US1997/014841 patent/WO1998008479A1/en active IP Right Grant
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  • 1997-08-28 WO PCT/US1997/015197 patent/WO1998008448A1/en active Application Filing
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  • 1997-08-28 AU AU41693/97A patent/AU4169397A/en not_active Abandoned
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  • 1997-08-28 WO PCT/US1997/015196 patent/WO1998008447A1/en not_active Application Discontinuation
  • 1997-08-28 CN CNB971992819A patent/CN1168420C/zh not_active Expired - Fee Related
  • 1997-08-28 BR BR9711274-7A patent/BR9711274A/pt unknown
  • 1997-08-28 AU AU40939/97A patent/AU4093997A/en not_active Abandoned
  • 1997-08-28 BR BR9711288-7A patent/BR9711288A/pt not_active Application Discontinuation
  • 1997-08-28 EP EP97941377A patent/EP1006894A4/de not_active Ceased
  • 1997-08-28 EP EP97940672A patent/EP1006891A1/de not_active Withdrawn
  • 1997-08-28 WO PCT/US1997/015203 patent/WO1998008449A1/en active IP Right Grant
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  • 1997-08-28 WO PCT/US1997/015223 patent/WO1998008450A1/en not_active Application Discontinuation
  • 1997-08-28 WO PCT/US1997/015227 patent/WO1998008453A1/en active Application Filing
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• 2007
  • 2007-05-14 JP JP2007127618A patent/JP4551423B2/ja not_active Expired - Fee Related
• 2009
  • 2009-12-08 JP JP2009278874A patent/JP2010088916A/ja active Pending

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