Robotic Surgical Instrument Positioning System with Remote Cable Control
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Solution Overview
Problem
Traditional spine surgery methods cause significant harm to muscles and ligaments, leading to muscle atrophy, reduced function, and transitional syndrome, necessitating additional surgeries and complications like 'failed back syndrome', due to the disruption of posterior musculature and ligaments during pedicle screw instrumentation. Current image guidance technologies may not provide adequate accuracy for pedicle screw placement.
Innovation Solution
A surgical device positioning system that allows remote positioning of surgical instruments relative to a patient, using a vertically mounted post, clamp, and translational arm with sliding elements for precise rotational, anterior-posterior, and medial-lateral positioning, coupled with electro-physiologic monitoring to prevent nerve root injury, and allows fluoroscopic imaging without exposing the surgeon to radiation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional open procedures are used for pedicle screw instrumentation, then accurate visualization and palpation of bony anatomy is achieved, but significant harm is done to muscles and ligaments causing muscle atrophy and reduced function
Solution Approach 1:
The patent introduces fluoroscopic image guidance as an intermediary technology that allows visualization of bony anatomy through radiation images rather than direct visual inspection. This mediator enables accurate pedicle screw placement while avoiding the need to detach and manipulate soft tissues, thus resolving the contradiction between visualization accuracy and muscle/ligament injury
Solution Approach 2:
The patent replaces the mechanical approach of directly visualizing and palpating bony anatomy through open surgery with a radiological system using fluoroscopy. This substitution eliminates the need for mechanical disruption of soft tissues while achieving the same surgical objective of accurate instrument placement
2Ease of operation
If posterior retraction of multifidus and erector spinae muscles is performed, then access to bony anatomy is improved, but transitional syndrome occurs leading to canal stenosis
Solution Approach 1:
Fluoroscopic image guidance serves as an intermediary that provides sufficient anatomical information without requiring muscle retraction. The radiation images allow the surgeon to visualize pedicle anatomy and plan screw placement while the muscles remain in their natural position, eliminating the harmful transitional syndrome
3Measurement precision
If fluoroscopic images are taken during surgery, then real-time imaging is achieved, but radiation exposure to the surgeon increases
Solution Approach 1:
The patent introduces a lead shield as an intermediary protective barrier between the fluoroscopic radiation source and the surgeon. This shield allows the surgeon to view real-time fluoroscopic images through a lead glass window while blocking direct radiation exposure, thus resolving the contradiction between imaging capability and radiation safety
Solution Approach 2:
The patent extracts the surgeon from the direct radiation field by positioning them behind a lead shield and allowing image viewing through a separate lead glass window. This separation removes the harmful radiation exposure while preserving the ability to view real-time surgical images
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
Enables accurate and safe percutaneous pedicle screw placement while minimizing radiation exposure and reducing the risk of nerve root injury, thereby reducing the incidence of transitional syndrome and improving surgical outcomes by maintaining the natural integrity of the spinal anatomy.
Implementation Method 1
A control unit is mechanically coupled to the instrument positioning assembly at a remote location by cables for controlling the position of the sliding elements
Implementation Method 2
allows fluoroscopic imaging without exposing the surgeon to radiation
Implementation Method 3
Electrodes can be coupled to the system to allow for electro-physiologic monitoring during device placement
Data Source
AI summary
A robotic surgical device positioning system that allows a surgeon to accurately and remotely position a surgical instrument relative to a patient and to provide fluoroscopic images of the instrument without exposing the surgeon to radiation. The system includes a vertical post that is slidebly coupled to an operating table, a clamp mounted to the vertical post and spaced from the table, and a translational arm mounted to the clamp. The system further includes an instrument positioning assembly mounted to the translational arm opposite to the clamp that includes a plurality of sliding elements that are slidebly mounted to the assembly to provide rotational, anterior-posterior and medial-lateral positioning of the surgical instrument. A control unit is mechanically coupled to the instrument positioning assembly at a remote location by flexible cables for controlling the position of the sliding elements.