Percutaneous Breast Reconstruction Tools for Tissue Suspension
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Solution Overview
Problem
Existing breast reconstruction methods, such as the TRAM flap, are invasive, have high complication rates, and require major incisions, while less invasive alternatives like the RAFT procedure offer a more patient-friendly and less complication-prone method for transferring abdominal tissue to the chest.
Innovation Solution
A kit comprising components for mobilizing abdominal tissue, inserting a suspension suture, securing it to the clavicle, percutaneously dividing restrictive fibers, and filling with fat to create a breast mound without major incisions, using tools like grommets, needles, and a tissue mesher to achieve tissue advancement and shaping.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional TRAM flap breast reconstruction is performed, then breast reconstruction can be achieved, but the procedure becomes highly invasive with major incisions and high complication rates
Solution Approach 1:
The surgical procedure is divided into multiple percutaneous steps: (1) tumescent fluid injection to loosen tissue, (2) liposuction to deflate the apron, (3) percutaneous dissection to create interface, (4) purse string suture insertion through small punctures, (5) suspension suture placement, and (6) tissue mesher expansion. This segmentation eliminates the need for a single major incision while achieving the same reconstructive goal.
Solution Approach 2:
A purse string suture acts as an intermediary mechanism to suspend the abdominal apron to the clavicle without requiring major incisions. The suture is threaded through the dermis/subdermal tissue layers and suspended to the clavicle, serving as a minimally invasive bridge between the tissue to be advanced and the anchoring structure.
2Ease of operation
If minimally invasive RAFT procedure is used, then patient friendliness and reduced complications are achieved, but tissue advancement and suspension require specialized tools and techniques
Solution Approach 1:
The surgical kit integrates multiple specialized tools for the minimally invasive procedure: a tissue mesher with multiple needles for percutaneous expansion, a purse string suture inserter for threading sutures through small punctures, a suspension suture system with bone anchors for clavicle attachment, and a fat grafting system. These multi-functional tools enable the complete RAFT procedure through percutaneous access points.
Solution Approach 2:
The tissue mesher creates a mesh pattern of small punctures that copies the expansion effect of a large incision. By creating multiple small access points arranged in a mesh pattern, the procedure achieves tissue expansion and relaxation similar to open surgery but with the benefits of minimally invasive access.
3Device complexity
If abdominal apron is advanced to breast without loosening, then procedure is simpler, but tissue tension restricts advancement and causes pain
Solution Approach 1:
Before advancing the abdominal apron, several preliminary actions are performed: (1) Tumescent fluid is injected to loosen the tissue, (2) Liposuction is performed to deflate the apron and create space, (3) Percutaneous dissection creates an interface to ensure long-term maintenance. These preliminary actions reduce tissue tension before the main advancement step, making the procedure feasible and comfortable.
Solution Approach 2:
The tissue properties are changed through tumescent fluid injection, which alters the physical state of the tissue by introducing fluid that loosens the tissue structure. This parameter change (from tight to loosened) enables subsequent advancement without excessive tension. The liposuction further changes the volume parameter by removing fat, creating more space for advancement.
4Volume of moving object
If percutaneous meshing is performed to expand abdominal apron, then tissue advancement is improved, but more puncture sites and procedural steps are required
Solution Approach 1:
The tissue mesher device nests multiple needles within a single handle, allowing multiple puncture sites to be created through one integrated tool. The needles are arranged in a specific pattern within the mesher device, enabling systematic creation of mesh expansion points without requiring separate instruments for each puncture.
Data Source
AI summary
Surgical tools and kits for performing methods include a grommet with cylindrical shaft, cutting tip, annular flange with suture retaining anchoring fixture; a grommet jig for extending between adjacent grommets and guiding a needle therebetween; a family of needles with single and double pointed ends, reinforced eyelets, stops to limit inadvertent exiting, double shaft construction with a longitudinal gap and sharpened, slicing ends, including a “J” shape embodiment; a bone anchor with ring to secure sutures about a patient's clavicle; a tissue dissector having radially extending cones to nick taut connecting tissues; a tissue rasp having a series of crisscrossing grooves along an end; a tissue mesher comprising one or more blocks having a matrix of holes for damping a plurality of needles and a supporting framework; and a kit device and a method of surgically inserting an internal mesh brassiere under the breast skin.