Endoscopic Guide Tool Knife Stop and Channel Design
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Solution Overview
Problem
Current endoscopic carpal tunnel release procedures face challenges such as accidental cutting of anatomy due to the knife's tendency to rise out of the channel, interference between the endoscope and knife, and confusion in guide orientation, particularly in distinguishing between left and right hand guides.
Innovation Solution
The system includes a retrograde knife with a guide tool featuring a knife stop, self-dilating tip, and pivot pin and groove system to prevent the knife from inadvertently rising, separate channels for the endoscope and knife to prevent interference, and indicators for proper orientation and hand specificity.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the knife is inserted alongside the endoscope to cut the transverse carpal ligament, then the carpal tunnel can be released, but the knife may inadvertently rise out of the channel and accidentally cut anatomy
Solution Approach 1:
A guide tool with a defined channel is introduced as an intermediary between the surgeon's control and the knife blade. The channel physically constrains the knife's movement path, preventing it from rising out of control and accidentally cutting anatomy. The guide tool mediates the interaction between the surgeon's manual manipulation and the cutting action, ensuring the knife remains confined to the safe cutting zone.
Solution Approach 2:
The guide tool is inserted and positioned in the carpal tunnel before the knife is introduced. This preliminary positioning establishes the safe cutting zone and constraining channel in advance, so that when the knife is subsequently inserted and manipulated, the safety constraints are already in place to prevent accidental cutting of surrounding anatomy.
2Device complexity
If a single channel is used for both endoscope and knife, then device complexity is reduced, but interference between the endoscope and knife occurs
Solution Approach 1:
The single channel is segmented into two separate channels within the guide tool - one channel for the endoscope and another channel for the knife. This segmentation physically separates the two instruments, eliminating interference between them while allowing both to function simultaneously within the same surgical field. The guide tool's structure is divided into distinct pathways for each instrument.
3Ease of manufacture
If the guide tool lacks orientation indicators, then manufacturing is simpler, but confusion arises in distinguishing between left and right hand guides
Solution Approach 1:
Orientation indicators such as colored markers, arrows, or symbolic markings are added to the guide tool's exterior surface. These visual indicators provide immediate orientation information to help surgeons correctly identify and select the appropriate guide for left or right hand procedures. The indicators use color or graphical changes to convey directional and hand-specific information without complicating the fundamental manufacturing process.
Data Source
AI summary
A method, apparatus, and system for cutting anatomic members, such as ligaments, in surgical procedures such as carpal tunnel release, plantar fasciotomy, gastroc release, and cubital and tarsal tunnel release. The apparatus includes a guide tool for guiding a knife and a scope during surgery which may be employed with a translating knife. Relevant features include a knife stop for preventing the knife from inadvertently raising out of the knife channel, indicia viewable to show the proper orientation for the guide tool, a self dilating tip and channel design on the guide tool, a cover piece and/or pivotable panel system for preventing ligaments and other anatomy from getting caught in the guide tool, a pivot pin and groove system for stabilizing the knife and also assuring that the knife blade is not inadvertently raised out of the channel, and a use indicator employable to prevent re-use of the device.