Sternal Ascender Ribcage Lifting for Minimally Invasive Access
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Solution Overview
Problem
Minimally invasive surgical procedures, such as coronary revascularization and epicardial lead placement, require larger working spaces to accommodate surgical tools and maintain chest wall integrity without cardiopulmonary bypass, while ensuring reliable cardiac repair.
Innovation Solution
A sternal ascender apparatus with an indicator handle, support beam, and actuator drive mechanism that lifts the ribcage to increase operable space during minimally invasive surgeries, allowing for improved visualization and tool maneuverability.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If a minimally invasive surgical approach is used, then patient recovery is improved and cosmetic results are superior, but surgical working space is reduced and visualization is compromised
Solution Approach 1:
The sternal ascender apparatus utilizes the vertical dimension by lifting the sternum upward, creating additional working space in the subxiphoid region without requiring larger incisions. This dimensional approach allows surgeons to gain space in the z-axis while maintaining the minimally invasive nature of the procedure through small subxiphoid ports.
Solution Approach 2:
The sternal ascender acts as an intermediary device between the surgical team and the surgical field. By mechanically elevating the sternum, it creates a stable platform that facilitates the insertion and manipulation of other surgical instruments, endoscopes, and suturing tools through the minimally invasive ports.
2Ease of operation
If larger working space is created by traditional sternotomy, then surgical access is improved, but chest wall integrity is compromised and invasiveness increases
Solution Approach 1:
The sternal ascender apparatus provides dynamic, adjustable sternal elevation that can be modified during the procedure. The mechanical lifting mechanism allows the sternum to be raised to the optimal position for surgical access while maintaining the ability to adjust or release the elevation as needed, unlike the permanent separation caused by sternotomy.
Solution Approach 2:
The apparatus changes the spatial parameter of the sternum by elevating it vertically, thereby creating working space without altering the fundamental integrity of the chest wall. The sternum remains attached and can be returned to its original position, unlike in sternotomy where the bone is permanently divided.
3Device complexity
If manual retraction is used to create surgical space, then device complexity is reduced, but operating time increases and surgical precision decreases
Solution Approach 1:
The sternal ascender apparatus is designed to be self-retaining, using its own mechanical structure to maintain sternal elevation without requiring continuous manual effort from the surgical team. Once positioned and engaged, the device maintains the elevated position autonomously, freeing the surgical team to focus on the surgical procedure itself.
Solution Approach 2:
The apparatus replaces manual mechanical retraction with a structured mechanical lifting system. The sternal ascender uses a engineered mechanism to elevate and hold the sternum, substituting the imprecise and time-consuming manual retraction process with a controlled, reproducible mechanical system that improves surgical precision.
Data Source
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AI summary
A sternal elevator apparatus is disclosed. The sternal elevator may include a panel, a support beam traversing the panel, and a post coupled to a proximal end of the panel. The apparatus may also include an indicator handle coupled to the sternal elevator, an actuator drive pivotably coupled to the indicator handle, and a housing movably coupled to the actuator drive. The sternal elevator apparatus may have an actuator drive incorporating a linear rack. The housing further may include a cylindrical gear where the cylindrical gear is engaged with the linear rack.