Surgical Access System with Neural Detection Electrodes
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Solution Overview
Problem
Current surgical access systems face challenges in creating and maintaining an operative corridor, especially when accessing surgical target sites beneath or behind strong tissues or near neural structures, leading to tissue trauma, limited access options, and risks of neural impairment.
Innovation Solution
A novel access system equipped with a tissue distraction assembly and a tissue retraction assembly, both featuring electrodes for detecting neural structures, allowing for safer establishment of an operative corridor by distracting and retracting tissues while avoiding neural structures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If an operative corridor is established through strong tissues (such as psoas muscle) using traditional sequential dilation, then access to the surgical target site is achieved, but tissue trauma and stress/tearing occur
Solution Approach 1:
The system performs preliminary detection of neural structures using electrodes on the stylet and dilators before advancing the operative corridor. This preliminary action allows the surgeon to identify neural structures and adjust the approach to avoid them, preventing tissue trauma and neural impairment while still achieving access to the target site
Solution Approach 2:
The stylet with electrodes serves as an intermediary tool that detects neural structures before the main dilators and retractor are advanced. This intermediary detection system provides real-time feedback about neural structure location, allowing the surgeon to navigate around them and create the operative corridor without direct contact or trauma
2Object-affected harmful factors
If a narrow operative corridor is created using traditional working cannula, then tissue displacement is reduced, but instrument manipulation and angulation are restricted
Solution Approach 1:
The retractor assembly is designed with movable retractor blades that can be dynamically adjusted and repositioned within the operative corridor. This dynamic capability allows instruments to be manipulated and angled freely while maintaining a minimally invasive access point, resolving the contradiction between corridor size and instrument flexibility
Solution Approach 2:
The retractor system is segmented into multiple adjustable blades rather than a single fixed structure. This segmentation allows each blade to be independently positioned to create the necessary working space and angles for instrument manipulation while maintaining overall minimal tissue displacement
3Adaptability or versatility
If an operative corridor is established near neural structures using traditional methods, then access to target sites is achieved, but risk of neural impairment increases
Solution Approach 1:
The system incorporates real-time feedback through electrodes on the stylet and dilators that detect neural structures during advancement. This feedback mechanism provides continuous information about neural structure proximity, allowing the surgeon to adjust the approach dynamically and avoid neural impairment while maintaining access options
Solution Approach 2:
Neural structures are detected preliminarily using the electrode-equipped stylet before the main operative corridor is established. This preliminary detection action identifies safe pathways and allows the surgeon to plan the corridor creation to avoid neural structures, reducing impairment risk while preserving access versatility
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.