Tubular Retractor with Multi-Planar Navigation Markers for Spinal Decompression
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Solution Overview
Problem
Current microendoscopic spine surgery techniques face limitations in visualizing regional anatomy and effectively decompressing spinal structures due to limited field of view and lack of direct visualization, leading to potential destabilization of spinal segments and increased risk of further surgery.
Innovation Solution
A novel system incorporating a tubular retractor with integrated multi-planar navigation markers, irrigation, and suction systems, along with a camera and navigated instruments like burrs and osteotomes, allows for real-time multi-planar imaging and improved visualization during microendoscopic decompression surgery, enabling precise instrument placement and navigation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional open spinal surgery is performed with direct visualization, then the surgeon can clearly see anatomical structures and perform precise decompression, but this requires extensive tissue dissection and muscle disruption leading to spinal destabilization
Solution Approach 1:
The surgical approach is segmented into two independent components: (1) a tubular retractor system that provides minimally invasive access through small incisions without extensive muscle disruption, and (2) an integrated navigation system with multi-planar imaging and augmented reality that provides enhanced visualization of anatomical structures. This segmentation allows achieving clear visualization without the harmful tissue disruption of traditional open surgery.
Solution Approach 2:
The patent introduces an intermediary navigation system that acts as a mediator between the surgeon and the anatomical structures. The system uses registered preoperative imaging data, intraoperative multi-planar imaging, and augmented reality overlays to provide virtual visualization of anatomical structures, replacing the need for direct visual exposure through extensive dissection. This intermediary system enables precise decompression while maintaining spinal stability.
2Object-affected harmful factors
If small tubular retractors are used for minimally invasive access, then muscle and ligament disruption is reduced, but the field of view is limited to the area immediately around the tube
Solution Approach 1:
The patent extends the field of view from the limited two-dimensional area around the tube to a three-dimensional multi-planar perspective. The navigation system integrates axial, coronal, and sagittal views, allowing the surgeon to visualize anatomical structures in multiple dimensions simultaneously. This dimensional expansion provides comprehensive visualization of the surgical field and surrounding anatomy without requiring physical exposure.
Solution Approach 2:
The patent replaces the mechanical approach to expanding field of view (physical retraction and dissection of tissues) with an optical and computational system. The integrated imaging system captures images from multiple angles and planes, and the augmented reality display synthesizes these into a comprehensive virtual view, substituting mechanical tissue manipulation with information-based visualization.
3Area of stationary object
If a camera is placed into the tubular retractor to improve visualization, then the field of view increases beyond the tube area, but the ability to differentiate regional anatomy is reduced due to indirect visualization
Solution Approach 1:
The patent merges multiple visualization modalities into a unified navigation system: direct camera views from within the retractor, preoperative CT or MRI images, intraoperative multi-planar imaging, and augmented reality overlays. These separate sources of visual information are integrated and displayed together, providing both the expanded field of view from indirect visualization and the precise anatomical differentiation from multiple imaging modalities.
Solution Approach 2:
The system creates accurate virtual copies of the anatomical structures through registered preoperative imaging data and intraoperative image guidance. These digital copies preserve all anatomical details and relationships, allowing the surgeon to study and differentiate regional anatomy with the same precision as direct visualization, even though the physical view is indirect. The augmented reality overlay projects these virtual copies onto the actual surgical field.
4Measurement precision
If navigation technology is coupled to microendoscopic instrumentation, then the ability to define regional anatomy and guide instrument placement is improved, but the system complexity increases
Solution Approach 1:
The patent designs the navigation system as a universal platform that performs multiple functions: preoperative image registration, intraoperative multi-planar imaging, real-time tracking of instruments and retractors, augmented reality display, and guidance for decompression surgery. This multi-functional system consolidates what would otherwise require separate devices and procedures, managing complexity through integration rather than proliferation of separate systems.
Solution Approach 2:
The navigation system employs a nested structure where multiple levels of functionality are integrated: the tubular retractor contains the camera and irrigation/suction channels; the navigation system contains the imaging, tracking, and display components; and the entire system is coordinated through a central control platform. This nesting organizes complexity hierarchically, with each level managing specific functions while contributing to the overall surgical goal.
Data Source
AI summary
Instrumentation for microendoscopic surgery comprises a retractor system including a navigated initial probe, nested retractors and a navigated final tubular retractor defining an interior passage extending between a proximal end and a distal working end. A multi-planar navigation marker including a plurality of spaced-apart, radiopaque marker bodies can be mounted to the tubular retractor at a predetermined multi-planar spatial and rotational relation to the distal working end. The retractor can optionally include systems for fluid irrigation and suction with differential activation allows for the option of maintaining a dry surgical field or a submerged surgical field depending on the surgeon's preference during various portions of the procedure. The instrumentation can also include a camera for direct viewing and navigated burrs and/or navigated osteotomes, which allow the surgeon to use direct visualization and/or information from instrument localization on multi-planar images depending on surgeon facility resources.