Transoral Retractor Dynamics for Surgical Access
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Solution Overview
Problem
Traditional transoral robotic surgery (TORS) techniques face challenges in visualization and access due to compression of the tongue, larynx, and hypopharynx, limiting effective exposure and practicality, especially in supine positions.
Innovation Solution
The development of oral retractor devices with adjustable mechanisms that increase and decrease separation distance between maxillary and mandibular troughs, allowing for positional adjustment and improved access by moving the mandible forward, along with articulating surgical tools that accommodate curved anatomy and individual patient anatomy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If traditional oral retractors push on the tongue to enable straight line-of-sight visualization, then visualization of the upper aerodigestive tract is improved, but compression of the base of tongue, larynx, and hypopharynx occurs making access difficult
Solution Approach 1:
The oral retractor device employs a dynamic scissors mechanism with movable arms that can adjust the separation distance between maxillary and mandibular troughs. This dynamic adjustment allows the device to adapt to different patient anatomies and surgical requirements, resolving the contradiction between maintaining visualization and providing access by enabling the operator to optimize the retraction force and separation distance in real-time
2Device complexity
If the mouth is retracted in an open position with fixed separation between maxillary and mandibular troughs, then structural simplicity is maintained, but transoral access to target operative areas is limited
Solution Approach 1:
The device incorporates a scissors mechanism that provides dynamic adjustment capability while maintaining relative structural simplicity. The mechanism includes movable arms with pivot joints that allow separation distance adjustment, and an adjust mechanism that enables positional adjustment of the mandibular trough, achieving both accessibility and operational ease without excessive complexity
Solution Approach 2:
The oral retractor device is divided into separate functional components including maxillary and mandibular troughs, movable arms, pivot joints, and adjustment mechanisms. This segmentation allows each component to perform its specific function independently while contributing to the overall goal of improved transoral access
3Device complexity
If standard surgical instruments are used with straight line-of-sight approach, then device simplicity is maintained, but effective exposure and practicality are limited due to anatomical compression
Solution Approach 1:
The articulating surgical tool incorporates a dynamic articulating mechanism with a pivot joint that enables the end effector to move relative to the longitudinal axis of the tool. This articulation capability allows the tool to navigate curved anatomical pathways and provide effective exposure and access to target operative areas while maintaining reasonable device simplicity
Solution Approach 2:
The articulating surgical tool adds a rotational dimension to the standard straight-line instrument by incorporating an articulating mechanism that allows the end effector to pivot and articulate. This dimensional addition enables the tool to access curved anatomical structures and improve effective exposure without significantly increasing overall device complexity
Data Source
AI summary
Devices and methods can be used for performing transoral surgery. For example, this document provides oral retractor devices and articulating surgical tools that are well-suited for transoral surgery uses. The devices and methods provided herein may be used to treat conditions such as, but not limited to, mouth cancer, throat cancer, tongue cancer, larynx cancer, tonsil cancer, obstructive sleep disorders, and pharyngeal diverticulum, to provide some examples.