Rotatable Electrode Dilator for Intraoperative Nerve Direction Sensing
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Solution Overview
Problem
Existing intraoperative monitoring systems for surgeries involving neural structures, such as spine surgery, lack an efficient method to detect the presence and direction of nerves during the creation of an operative corridor, particularly when traversing through tissues like the psoas muscle, which may contain nerve roots.
Innovation Solution
A stationary directional dilator with a rotatable electrode at its distal end, maintained in a static position, is used in conjunction with an intraoperative monitoring system to detect nerve proximity and direction by rotating the electrode while advancing through tissue, utilizing electrical stimulation to identify nerve locations.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If a sequential dilator system with rotatable dilators is used for intraoperative monitoring, then nerve detection capability is improved, but device complexity and ease of operation deteriorate due to the need to rotate and manage multiple dilators
Solution Approach 1:
The invention separates the rotation function from the dilator body by using a独立的旋转电极组件。The electrode can rotate independently within the dilator shaft, allowing nerve detection in multiple directions without needing to rotate the entire dilator or use multiple dilators. This segmentation simplifies the overall system while maintaining the ability to detect nerves from different orientations.
Solution Approach 2:
The rotatable electrode within a single dilator performs the function of multiple directional electrodes. By rotating the electrode to different angular positions, a single dilator can detect nerves in multiple directions, replacing the need for multiple specialized dilators and simplifying the device set required for comprehensive nerve monitoring.
2Loss of information
If sequential dilators with electrodes are rotated during stimulation to determine nerve direction, then nerve direction information is improved, but ease of operation and time efficiency worsen due to the manual rotation process
Solution Approach 1:
The electrode is pre-configured to be rotatable within the dilator shaft, allowing the surgeon to quickly adjust its angular position without removing or changing dilators. This preliminary design of the rotatable mechanism saves time during the surgical procedure by enabling rapid repositioning of the electrode to detect nerves in different directions.
3Length of moving object
If multiple sequential dilators are used to establish an operative corridor, then the ability to traverse tissue is improved, but the risk of nerve contact and neurological deficit increases
Solution Approach 1:
The electrode provides real-time feedback by detecting electrical signals from nearby nerves during the dilation process. When the electrode detects a nerve signal, it alerts the surgeon to adjust the dilator's position or angle, preventing direct contact with the nerve. This continuous feedback mechanism reduces the risk of neurological damage while establishing the operative corridor.
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 precise detection of nerve presence and direction, allowing surgeons to safely and reproducibly establish an operative corridor by navigating around or past nerves, reducing the risk of neurological deficits.
Implementation Method 1
Each sequential dilator has an electrode at the distal end which, when coupled to the intraoperative monitoring system, provides the ability to send a stimulation signal into the surrounding tissue to help determine the presence of nerves.
Data Source
AI summary
A stationary dilator has one or more electrodes in the distal region that are rotatable around the longitudinal axis of the dilator. The one or more electrodes are operable to deliver electrical stimulation signals to tissue through which the dilator is passed. The stimulation signals can be used for determining nerve directionality and optionally nerve proximity during surgical procedures involving the presence of neural structures.