Rotatable Surgical Table Supports for Positioning and Site Access
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Solution Overview
Problem
Existing spinal surgery techniques face challenges such as the need for prone-to-supine patient repositioning, nerve compression, limited visibility, and instrument slippage during minimally invasive procedures, particularly in lateral access methods like TLIF and XLIF, which complicate implant placement and increase surgical time and risk.
Innovation Solution
A direct visualization retractor system with adjustable modular components that allow for stable, lateral access to the spine while maintaining the patient in a prone position, featuring a retractor body and hood that can be independently manipulated and coupled to form a stable channel for surgical instruments and implants, enhancing tissue sparing and visibility.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If minimally invasive lateral access techniques (TLIF, XLIF) are used to reduce surgical trauma, then patient recovery time is improved, but instrument slippage and limited visibility occur
Solution Approach 1:
The retractor system is divided into multiple independent components: a retractor body with fixation members and a separate retractor hood. This segmentation allows each component to perform its specific function optimally - the body provides stable fixation while the hood provides visualization and instrument guidance, resolving the contradiction between minimally invasive access and instrument stability
Solution Approach 2:
The retractor hood is designed to be received within the retractor body, creating a nested configuration. This nesting arrangement allows the hood to be precisely positioned and secured within the body structure, preventing instrument slippage while maintaining the minimally invasive lateral access pathway
2Adaptability or versatility
If prone-to-supine patient repositioning is performed to access different spinal regions, then comprehensive spinal intervention is achieved, but surgical time and patient risk increase
Solution Approach 1:
The retractor system is designed with adjustable and modular components that can accommodate different spinal levels and surgical approaches while maintaining the patient in a single prone position. The fixation members can be positioned at various locations on the retractor body, and the hood can be adjusted to provide optimal visualization angles for different spinal regions, eliminating the need for patient repositioning
3Ease of operation
If traditional retractors are used in lateral access surgery, then surgical access is achieved, but nerve compression and tissue damage occur
Solution Approach 1:
The retractor hood is designed with specific local features including a defined opening size and shape that can be customized to match the surgical site requirements. The hood's structure provides localized retraction force distribution, concentrating the retraction effect where needed while minimizing compression on adjacent neural structures. The fixation members are positioned to anchor the retractor body without compressing nerves
4Device complexity
If fixed non-modular retractors are used, then device simplicity is maintained, but adaptability to different surgical sites is limited
Solution Approach 1:
The retractor system incorporates dynamic and adjustable features: the fixation members can be repositioned on the retractor body, and the retractor hood can be adjusted in position and orientation. This dynamic adjustability allows the same basic device structure to adapt to different spinal levels, access routes, and patient anatomies without requiring multiple specialized retractors
Data Source
AI summary
An apparatus for positioning a patient during surgery includes a surgical table frame having a longitudinal dimension, two or more longitudinal rails that are laterally spaced from a centerline between the longitudinal rails and defining a generally planar surface of the surgical table frame, and at least one rotatable support mounted on the surgical table frame for supporting a portion of a body of the patient when resting thereon the at least one rotatable support having a support surface that is substantially planar and generally parallel to the generally planar surface of the surgical table frame. The at least one rotatable support enables positional adjustment of the portion of the body of the patient when resting thereon by rotational movement of the at least one rotatable support to displace the supported body position in one of first and second directions of rotation to thereby allow for manipulation of the patient's anatomy to maximize access to a surgical site of interest.