Retractable Surgical Device for Ligamentum Flavum Dissection
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Solution Overview
Problem
Current treatments for spinal stenosis, such as open laminectomy, cause significant pain and spinal instability due to muscle and ligament damage, while minimally invasive techniques are limited by the small size of the spinal canal and risk nerve damage during surgery.
Innovation Solution
A surgical system with a retractable device featuring an anchor hook and orbital hook mechanism that allows for precise dissection and evacuation of hypertrophied ligamentum flavum through a minimally invasive approach, reducing the need for open surgery and minimizing nerve damage.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If open laminectomy is performed to remove thickened ligamentum flavum, then complete tissue removal and decompression are achieved, but significant muscle and ligament damage occurs causing post-operative pain and spinal instability
Solution Approach 1:
The procedure is divided into sequential steps: first creating a laminar defect, then using a Kerrison rongeur to remove the ligamentum flavum in segments through the defect. This segmentation allows complete tissue removal while limiting exposure and damage to surrounding muscles and ligaments compared to traditional open laminectomy.
Solution Approach 2:
The surgical approach focuses on creating a localized laminar defect only at the specific level requiring decompression, rather than removing the entire lamina. The Kerrison rongeur is used to precisely remove the ligamentum flavum through this localized defect, minimizing damage to surrounding healthy tissues while achieving adequate decompression.
2Object-affected harmful factors
If minimally invasive techniques are used to reduce muscle damage, then post-operative pain and recovery time are reduced, but the small size of the spinal canal limits the ability to safely dissect and remove tissue
Solution Approach 1:
The Kerrison rongeur serves as an intermediary tool that can be introduced through a minimally invasive laminar defect and used to safely dissect and remove the ligamentum flavum. The rongeur's design allows for controlled tissue removal through the narrow spinal canal space, overcoming the limitations of minimally invasive access while maintaining safety.
Solution Approach 2:
The surgical approach uses dynamic control of the Kerrison rongeur to adapt to the confined space within the spinal canal. The instrument can be maneuvered and repositioned as needed to safely dissection the ligamentum flavum, allowing the surgeon to navigate the limited space while maintaining precision and control.
3Reliability
If traditional open surgery with general anesthesia is performed, then adequate exposure for complete tissue removal is achieved, but patients require extended hospital stay and rehabilitation
Solution Approach 1:
The procedure segments the decompression into a focused removal through a laminar defect rather than extensive open exposure. This allows complete tissue removal to be achieved through a more efficient, targeted approach that reduces surgical time and subsequent recovery requirements.
Solution Approach 2:
The ligamentum flavum is extracted through the pre-created laminar defect using the Kerrison rongeur, eliminating the need for extensive open exposure. This extraction approach achieves complete tissue removal while significantly reducing the surgical footprint and associated recovery time compared to traditional open laminectomy.
Data Source
AI summary
A cutting device for performing a surgical procedure includes a cannula extending between a proximal end and a distal end, a first cutting element, and a second cutting element. The cannula of the cutting device includes an inner surface defining a passageway. The first cutting element extends from the distal end of the elongated shaft so as to contact tissue. The second cutting element also extends from the distal end of the elongated shaft. The second cutting element is configured for retractable extension beyond the distal end of the elongated shaft so as to contact tissue. The cutting device also includes a deployment mechanism disposed with the proximal end of the elongated shaft for actuating movement of the second cutting element.