Surgical Access System with Neural Detection and Articulating Cannula
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Solution Overview
Problem
Existing surgical access systems face challenges in creating and maintaining an operative corridor, especially when accessing surgical target sites with neural structures, leading to restricted access paths and potential neural impairment.
Innovation Solution
A novel access system equipped with a tissue distraction and retraction assembly, featuring electrodes for detecting neural structures, allowing for safer traversal through tissues with neural structures by distracting and retracting tissues while monitoring nerve proximity and direction.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional open surgical techniques are used to access surgical target sites, then adequate access and exposure are achieved, but large incisions and high tissue displacement are required, leading to increased pain, morbidity, and hospitalization time
Solution Approach 1:
The surgical access system divides the access pathway into discrete components including a guide needle, sequential dilators of increasing size, and a working cannula. This segmentation allows progressive tissue separation rather than single-step large-scale displacement, reducing overall tissue trauma while achieving adequate access
Solution Approach 2:
The system performs preliminary actions by first inserting a thin guide needle to establish the target trajectory, then sequentially dilating tissue planes before introducing the final working cannula. This preliminary preparation creates a pre-defined corridor that minimizes unexpected tissue displacement and reduces surgical site trauma
2Object-affected harmful factors
If sequential dilation systems are used to reduce tissue trauma, then tissue stress is minimized, but the operative corridor remains relatively narrow, limiting instrument manipulation and angulation
Solution Approach 1:
The working cannula incorporates a dynamic articulation mechanism with a pivot joint that allows the distal end to articulate relative to the proximal end. This dynamic capability enables the distal end to be angled up to 30 degrees in multiple planes while the proximal end remains stable, providing versatile instrument manipulation without requiring a larger cannula diameter that would increase tissue stress
Solution Approach 2:
The articulation mechanism adds a rotational dimension to the otherwise linear cannula structure. By introducing this angular degree of freedom, the system achieves enhanced instrument access and manipulation capability in deep surgical sites without compromising the narrow profile that minimizes tissue trauma
3Ease of operation
If operative corridors are established through tissues with major neural structures, then access to certain surgical target sites is achieved, but the risk of neural impairment increases
Solution Approach 1:
The system incorporates neural monitoring capabilities that provide real-time feedback during the access procedure. Electrodes detect neural signals as instruments advance through tissue, alerting the surgeon to the proximity of neural structures. This feedback mechanism allows the surgeon to adjust the trajectory or stop advancement before neural impairment occurs, enabling safe access through or near neural tissues
Solution Approach 2:
The system uses an intermediary neural monitoring system that acts as a mediator between the surgical instruments and neural structures. The monitoring electrodes serve as an intermediary detection layer that provides early warning of approaching instruments, allowing preventive adjustment of the access path before direct neural contact occurs
Data Source
AI summary
A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site. The tissue retraction assembly has a plurality of blades which may be introduced while in a closed configuration, after which point they may be opened to create an operation corridor to the surgical target site, including pivoting at least one blade to expand the operative corridor adjacent to the operative site. The surgical access system further includes pressure sensing technology to measure the pressure being exerted upon body tissues before, during, and/or after retraction and/or distraction.