Laser-Guided Percutaneous Needle Access Reducing Fluoroscopy Time
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Solution Overview
Problem
Conventional percutaneous surgery techniques require continuous fluoroscopy for needle placement, leading to significant radiation exposure for both patients and surgical teams, increasing the risk of deterministic and stochastic effects such as cancer and genetic damage.
Innovation Solution
A method and device that utilize laser guidance and ultrasound to facilitate precise needle placement with minimal fluoroscopy use, allowing for incremental reduction in radiation exposure by using a flexible ureteroscope and instruments like balloon or basket catheters, which can be visualized under ultrasound, reducing the need for continuous fluoroscopy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If continuous fluoroscopy is used for needle placement, then positioning accuracy is improved, but radiation exposure increases
Solution Approach 1:
The patent introduces an intermediary alignment system consisting of a laser guide and visual markers that mediate between the surgeon and the target anatomy. The laser projects a visible beam along the intended needle trajectory, and markers on the skin and needle provide visual reference points, allowing the surgeon to align the needle accurately without continuous fluoroscopy. This intermediary visual guidance system resolves the contradiction by providing sufficient positioning information through non-radiative means.
Solution Approach 2:
The patent employs preliminary action by pre-marking the skin surface with the projected laser beam to indicate the exact insertion point and trajectory before needle placement. The alignment system is established in advance, allowing the surgeon to plan and execute the needle insertion based on pre-established visual guides rather than relying on continuous real-time fluoroscopy during the actual insertion process.
2Object-affected harmful factors
If fluoroscopy time is reduced, then radiation exposure decreases, but needle placement precision may be compromised
Solution Approach 1:
The patent replaces the mechanical/radiological imaging system (fluoroscopy) with an optical alignment system. Instead of using ionizing radiation to visualize anatomy and guide needle placement, the invention uses a laser-based optical system with visual markers to define the insertion trajectory. This substitution eliminates the need for continuous fluoroscopy while maintaining guidance precision through optical means.
Solution Approach 2:
The patent creates a visual copy or representation of the intended needle trajectory through the projected laser beam and alignment markers. This optical copy serves as a surrogate for the actual needle path, allowing the surgeon to verify alignment and precision without needing to continuously image the actual needle position via fluoroscopy. The visual copy provides sufficient information to ensure accurate placement.
3Ease of operation
If hands are placed inside fluoroscopy beam to grasp needle, then tactile control is improved, but radiation exposure increases
Solution Approach 1:
The patent extracts the surgeon's hands from the fluoroscopy beam by providing visual feedback through the alignment system. The laser projection and markers provide sufficient visual information about needle position and trajectory, eliminating the need for the surgeon to place their hands within the radiation field to obtain tactile or visual confirmation. This extraction resolves the contradiction by providing alternative sensing modalities that do not require radiation exposure.
4Object-affected harmful factors
If needle holder device is used to decrease radiation exposure, then radiation exposure decreases, but tactile control is reduced
Solution Approach 1:
The patent implements a visual feedback system through the laser alignment and markers that compensates for the loss of tactile control when using a needle holder device. The real-time visual information provided by the alignment system allows the surgeon to monitor needle position and trajectory accurately, replacing the tactile feedback that would be available with direct hand manipulation. This feedback mechanism resolves the contradiction by providing alternative sensory information.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Significantly reduces radiation exposure during percutaneous access procedures, minimizing the risk of radiation-induced cancers and other health effects while maintaining accurate needle placement, with the potential to decrease fluoroscopy time from minutes to seconds.
Implementation Method 1
A method and device that utilize laser guidance and ultrasound to facilitate precise needle placement with minimal fluoroscopy use
Implementation Method 2
A method and device that utilize laser guidance and ultrasound to facilitate precise needle placement with minimal fluoroscopy use, allowing for incremental reduction in radiation exposure by using a flexible ureteroscope and instruments like balloon or basket catheters, which can be visualized under ultrasound
Data Source
AI summary
A needle access assembly and method for obtaining percutaneous needle access with little or no fluoroscopy. The method can include selecting a target for percutaneous access, directing a laser guide at a desired needle-insertion angle and in line with the selected target, aligning the needle access assembly with the laser, and inserting the needle into the target.