Lateral Retractor System Minimizing Psoas Muscle Damage

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Solution Overview

Problem

Existing lateral surgical approaches to the spine, such as the lateral retractor system, cause significant muscle and nerve damage due to the compression and trapping of soft tissues, leading to complications like ipsilateral upper thigh pain, hip flexor weakness, and nerve injury, with current systems lacking effective neuromonitoring and ergonomic design.

Innovation Solution

A lateral retractor system featuring a narrow dilator with opposing flat surfaces and a dual-blade assembly that can be rotated to minimize tissue damage, incorporating real-time 360-degree neuromonitoring and built-in LED lighting for improved visualization, allowing for a more precise and minimally invasive surgical pathway.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If sequential circular dilators are used to create a surgical pathway through the psoas muscle, then the surgical access to the spine is achieved, but muscle compression and nerve damage occur leading to thigh pain and hip flexor weakness

Engineering Contradiction:

Improvesurgical accessVSAvoidmuscle compression and nerve damage

Core Design Contradiction:

Ease of operationVSObject-affected harmful factors

Solution Approach 1:

The retractor system is divided into multiple blades (typically four blades) that can be independently positioned and adjusted. Each blade can be separately retracted to create the surgical pathway, allowing for more precise control over tissue separation and reducing unwanted compression on muscle and nerves compared to a single circular dilator approach.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The retractor blades are designed to be dynamically adjustable during surgery. The blades can be retracted to different degrees and positions based on the specific surgical needs, allowing the surgeon to optimize the surgical pathway while minimizing damage to surrounding tissues. This dynamic adjustment capability enables real-time adaptation to protect nerves and muscles.

Inventive Principle:

Principle #15Dynamics

2Ease of operation

If traditional retractors are used to separate psoas muscle, then surgical pathway is created, but soft tissues become crushed and trapped near the distal end causing trappage and requiring additional cautery

Engineering Contradiction:

Improvesurgical pathway creationVSAvoidtissue trappage and crushing

Core Design Contradiction:

Ease of operationVSObject-generated harmful factors

Solution Approach 1:

Instead of forcing tissues into a confined space and then trying to clear them, the retractor blades are designed to separate and hold tissues apart from the outset. The blades create a controlled surgical corridor that prevents tissue trappage by maintaining open spaces for nerve and muscle passage, eliminating the need for subsequent cautery to remove trapped tissues.

Inventive Principle:

Principle #13The other way round (Inversion)

Solution Approach 2:

The retractor blades act as intermediaries between the surgical site and the surrounding tissues. They create a controlled interface that separates the surgical pathway from adjacent muscles and nerves, preventing direct contact and potential damage. The blades serve as protective barriers that guide tissues away from the surgical field rather than allowing them to be crushed against the vertebral bodies.

Inventive Principle:

Principle #24Intermediary (Mediator)

3Area of stationary object

If multiple sequential dilators of increasing diameter are used, then adequate surgical access is obtained, but the dilation process causes significant muscle injury and atrophy

Engineering Contradiction:

Improvesurgical access areaVSAvoidmuscle injury and atrophy

Core Design Contradiction:

Area of stationary objectVSObject-affected harmful factors

Solution Approach 1:

The gradual dilation process is segmented into multiple discrete blade retraction steps rather than forcing sequential circular dilators through the muscle. Each blade can be independently retracted to progressively create the surgical pathway, allowing for more controlled and less traumatic tissue separation that minimizes muscle injury and atrophy while still achieving adequate surgical access.

Inventive Principle:

Principle #1Segmentation

Data Source

PatentUS10856861B2Lateral retractor system for minimizing muscle damage in spinal surgery

Publication Date: 2020.12.08 RUSTAMZADEH EDWARD

AI summary

A lateral retractor system for forming a surgical pathway to a patient's intervertebral disc space includes a single dilator and a retractable dual-tapered-blade assembly. The single dilator may feature a narrow rectangular body for insertion at an insertion orientation parallel to the fibers of the patient's psoas muscle and at an approximate 45-degree angle to the patient's spine. The retractable dual-tapered-blade assembly consists of only two blade subassemblies, each having a blade bordered by adjustable wings, along with built-in lighting and video capabilities. The dual-tapered-blade assembly may be passed over the single dilator at the insertion orientation and rotated approximately 45-50 degrees from the insertion orientation to a final rotated orientation parallel to the intervertebral disc space before the two blade subassemblies are retracted away from one another to create the surgical pathway. Other embodiments are also disclosed.