Sequential Dilation System with Offset Bores and Integrated Electrodes
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Solution Overview
Problem
Current lateral surgical access methods, such as those using concentric dilators, are limited in their ability to continuously monitor nerve proximity and create a desired surgical access site shape while minimizing tissue damage, particularly when accessing the spine to avoid neural elements.
Innovation Solution
The development of a dilation system comprising sequential dilators with offset bores and integrated electrodes allows for continuous nerve monitoring and controlled tissue dilation, enabling the creation of a surgical access site that can be assembled in concentric or eccentric configurations to avoid nerve tissue, using a stimulating probe and electrodes to determine nerve location and facilitate safe tissue separation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Volume of moving object
If concentric dilators are used to create surgical access, then the surgical access site can be enlarged, but neural elements or nerves located outside the safe zone may be impinged upon
Solution Approach 1:
The dilation system is divided into multiple sequential dilators (first dilator, second dilator, third dilator) that are inserted in sequence. Each dilator creates a controlled expansion step, allowing the surgical access site to be enlarged gradually while maintaining control over the dilation direction and avoiding neural structures.
Solution Approach 2:
The dilators are designed with non-uniform geometries (e.g., the first dilator has a first diameter, the second dilator has a second diameter, and they may have different shapes) to create directional dilation. This allows selective expansion in specific directions away from neural elements while maintaining access to the target site.
2Object-affected harmful factors
If directional dilators are used to avoid neural elements, then nerve proximity can be controlled, but the ability to continuously monitor nerve proximity and create a desired surgical access site shape is limited
Solution Approach 1:
Electrodes are integrated into the dilators, merging the dilation function with the nerve monitoring function. The electrodes can detect neural elements in real-time during the dilation process, providing continuous feedback on nerve proximity while the dilators create the surgical access site.
Solution Approach 2:
The electrodes provide real-time feedback on neural element detection during the dilation process. This feedback mechanism allows the surgeon to adjust the dilation direction and speed based on continuous nerve proximity information, ensuring safe creation of the surgical access site.
3Stability of the object's composition
If concentric dilators are used to enlarge the surgical access site, then uniform tissue dilation occurs, but tissue damage increases and the desired surgical access site shape cannot be precisely controlled
Solution Approach 1:
The dilators are designed with asymmetric geometries where the first dilator has a first diameter and the second dilator has a second diameter that may differ. This asymmetric design enables precise control over the final shape of the surgical access site while still providing uniform dilation in the intended direction, avoiding unnecessary tissue damage.
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 enhances the precision and safety of surgical access by allowing for real-time nerve monitoring and controlled tissue expansion, reducing the risk of neural damage and improving the shape and size of the surgical access site.
Implementation Method 1
The neural elements or nerves of the psoas muscle may be mapped using a stimulating probe. In this manner, the most posterior neural or nerve free area of the psoas muscle may be located and identified.
Data Source
AI summary
A dilation system for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a wedge assembly and an actuating mechanism. The wedge assembly comprises includes a base and a plurality of blades extending from the base so that the distal end of the blades extend away from the base. The mechanism is operably associated with the blades so as to cause the distal end of the blades to move from a closed condition to an expanded condition.