Surgical Access System with Neural Detection Electrodes

Solution Overview

Problem

Existing surgical access systems face challenges in creating and maintaining an operative corridor, especially when accessing sites with neural structures, leading to potential neural impairment and limited access options due to the risk of contacting sensitive tissues.

Innovation Solution

A novel access system equipped with a tissue distraction and retraction assembly, featuring electrodes for neural structure detection, allowing for safe traversal of tissues with neural structures by distracting and retracting tissues while monitoring neural presence and direction.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If an expandable portion is deployed at the distal end of a cannula to create a region of increased cross-sectional area, then instrument manipulation is improved, but sensitive neural and vasculature tissues adjacent to the surgical target site may be compressed or impinged causing neural and/or vasculature compromise, damage and/or pain

Engineering Contradiction:

Improveinstrument manipulationVSAvoidneural and vasculature compromise

Core Design Contradiction:

Ease of operationVSObject-affected harmful factors

Solution Approach 1:

The system performs preliminary detection of neural structures using electrodes and nerve surveillance before and during the creation of the operative corridor. This advance detection allows the surgeon to plan the surgical path to avoid neural structures, preventing the harmful effect of neural impingement while still achieving the goal of improved instrument manipulation through expandable cannula portions.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The nerve surveillance system provides real-time feedback during the surgical procedure by monitoring for neural responses when instruments approach or contact neural structures. This feedback mechanism allows the surgeon to adjust the surgical approach immediately, preventing neural damage while maintaining the ability to manipulate instruments effectively within the operative corridor.

Inventive Principle:

Principle #23Feedback

2Adaptability or versatility

If instruments are advanced directly through strong tissue such as the psoas muscle to create an operative corridor, then access to the surgical target site is achieved, but tissue stress and tearing may occur leading to unwanted effects

Engineering Contradiction:

Improveaccess to surgical target siteVSAvoidtissue stress and tearing

Core Design Contradiction:

Adaptability or versatilityVSObject-generated harmful factors

Solution Approach 1:

The system performs preliminary detection of neural structures using electrodes and nerve surveillance before and during the creation of the operative corridor. This advance detection allows the surgeon to plan the surgical path to avoid neural structures, preventing the harmful effect of neural impingement while still achieving the goal of improved instrument manipulation through expandable cannula portions.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The nerve surveillance system provides real-time feedback during the surgical procedure by monitoring for neural responses when instruments approach or contact neural structures. This feedback mechanism allows the surgeon to adjust the surgical approach immediately, preventing neural damage while maintaining the ability to manipulate instruments effectively within the operative corridor.

Inventive Principle:

Principle #23Feedback

3Length of moving object

If the operative corridor is established through tissue having major neural structures, then access to deep surgical target sites is achieved, but neural impairment may result if neural structures are contacted or impinged

Engineering Contradiction:

Improvedepth of accessVSAvoidneural structure safety

Core Design Contradiction:

Length of moving objectVSReliability

Solution Approach 1:

The system performs preliminary detection of neural structures using electrodes and nerve surveillance before and during the creation of the operative corridor. This advance detection allows the surgeon to plan the surgical path to avoid neural structures, preventing the harmful effect of neural impingement while still achieving the goal of improved instrument manipulation through expandable cannula portions.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The nerve surveillance system provides real-time feedback during the surgical procedure by monitoring for neural responses when instruments approach or contact neural structures. This feedback mechanism allows the surgeon to adjust the surgical approach immediately, preventing neural damage while maintaining the ability to manipulate instruments effectively within the operative corridor.

Inventive Principle:

Principle #23Feedback

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

Enables broader access to surgical sites by minimizing neural impairment risks, allowing for less invasive procedures and reducing the need for extensive tissue manipulation or bony structure modification.

Implementation Method 1

capable of monitoring for the presence, direction and/or distance to neural structures

Methodology Applied

Scientific EffectElectromyography (EMG):

Data Source

PatentUS7819801B2Surgical access system and related methods

Publication Date: 2010.10.26 NUVASIVE INC

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.