Nerve Evoked Potential Monitoring for Surgical Pathway Navigation
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Solution Overview
Problem
Current intra-operative nerve evoked potential monitoring during surgery is limited by the inability to observe real-time physiological responses in unconscious patients, making it challenging to accurately navigate surgical pathways and avoid nerve stimulation or tissue damage.
Innovation Solution
The method involves stimulating a site on the patient's body and recording electrical activity to determine somatosensory nerve evoked potentials, allowing for real-time monitoring of nerve function and tissue dissection by comparing baseline and subsequent nerve evoked potentials, thereby guiding surgical procedures to avoid unwanted nerve stimulation and tissue damage.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If radiologic evidence is used for electrode positioning, then placement accuracy is improved, but real-time physiological feedback is lost because patients are under general anesthesia
Solution Approach 1:
The patent introduces real-time feedback by recording nerve evoked potentials during surgery. The system continuously monitors physiological responses (latency and amplitude measurements) and provides immediate feedback to the surgical team, allowing adjustment of electrode positioning based on actual nerve function rather than relying solely on pre-operative radiologic evidence.
Solution Approach 2:
The patent replaces the mechanical/radiologic positioning method with a physiological monitoring approach. Instead of relying on imaging-based mechanical positioning, the system uses electrical stimulation and recording of nerve evoked potentials to determine accurate electrode placement, substituting a physiological measurement system for a mechanical positioning system.
2Manufacturing precision
If nerve evoked potentials are monitored in real-time, then surgical pathway navigation precision is improved, but the complexity of the monitoring system increases
Solution Approach 1:
The patent employs a multi-functional monitoring system that performs multiple functions: electrical stimulation of nerves, recording of evoked potentials, analysis of latency and amplitude, and provision of surgical guidance. By integrating these functions into a single system, the patent reduces overall complexity compared to using separate devices for each function.
Solution Approach 2:
The monitoring system is designed to be self-contained, with the ability to automatically stimulate nerves, record responses, analyze the data, and provide feedback without requiring separate external equipment for each function. The system serves itself by integrating all necessary components into one unified platform.
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
This approach enables real-time monitoring of nerve function during surgery, allowing for precise navigation of surgical pathways and minimizing tissue damage by providing immediate feedback on nerve stimulation, thus enhancing surgical precision and patient safety.
Implementation Method 1
stimulating a stimulation site of the patient's body... stimulating a stimulation site of the patient's body within stimulation parameters
Implementation Method 2
recording electrical activity from a recording site of the patient's body... recording electrical signals from a recording site of the patient's body in response to the stimulation
Implementation Method 3
nerve evoked potentials in a nerve comprising sensory fibers that propagates in an antidromic direction
Data Source
AI summary
Methods for intra-operatively monitoring nerve evoked potentials such as somatosensory nerve evoked potentials during a surgical procedure. The methods include orthodromic and antidromic monitoring of nerve evoked potentials. Monitoring includes navigating the surgical pathway to avoid insult to anatomical tissue, minimizing activation of sensory nerves that result in undesirable side effects in a patient, and determining the suitable location for placement of an implantable medical device.