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Publication Number
US-10376208-B2
Publication Date
2019-08-13
Expiration Date
Abstract
A nerve mapping system includes a plurality of electrodes, a sensor, and a processor in communication with each of the plurality of electrodes and the sensor. Each electrode is disposed on the distal end portion of one or more elongate medical devices configured to extend within an intracorporeal treatment area of a subject. The sensor is in communication with a muscle of a subject, and is configured to provide an output signal corresponding to a monitored response of the muscle. The processor receives an indication of the location of each electrode and an indication of a magnitude of the monitored muscular response. Using these parameters, the processor determines a distance to the nerve from the location of each of the plurality of electrodes, and constructs a virtual model of the nerve using the determined distance to the nerve at each of the plurality of locations.
Core Innovation
The described invention relates to a nerve mapping system that uses an elongate medical device configured to explore an intracorporeal treatment area of a subject. The device includes a distal end portion tapering to a tip, a central axis intersecting the tip and extending through the device, a first electrode disposed at the tip on the central axis, and at least one second electrode spaced apart from the first electrode and radially offset from the central axis in a second location. The system also includes a non-invasive mechanical sensor configured to provide a mechanomyography output signal corresponding to a monitored mechanical response of a muscle innervated by a nerve.
While the elongate medical device explores the intracorporeal treatment area, the processor receives an indication of the first location and the second location within the intracorporeal treatment area and provides an electrical stimulus to the first electrode and the at least one second electrode so that the electrical stimulus may be transmitted to intracorporeal tissue at the first location and the second location. The processor receives an indication of the magnitude of the monitored mechanical response of the muscle from the mechanomyography output signal, wherein the monitored mechanical response is induced by the electrical stimulus.
The processor determines a distance to a nerve from the first location and the second location using the magnitude of the electrical stimulus and the monitored mechanical response, without using an electromyography signal corresponding to an electrical potential of the muscle and skin. Using the determined distance(s), the processor constructs a virtual three-dimensional model of the nerve and thereby guides the elongate medical device within the intracorporeal treatment area without contacting the nerve. The disclosed model can represent a nerve portion and a second portion representative of space within the intracorporeal treatment area that does not contain the nerve.
Claims Coverage
The provided relevant claims contain two independent claims, each describing an elongate medical-device-based nerve mapping system using mechanomyography and constructing a virtual three-dimensional model without using electromyography. Across the independent claims, at least two inventive feature groups are emphasized: distance/nerve modeling based on mechanomyography response and electrode locations without electromyography, and representing nerve and non-nerve space in a virtual three-dimensional model to enable precise device guidance.
Mechanomyography-based nerve distance determination without electromyography
Provide an electrical stimulus to a first electrode and at least one second electrode such that the electrical stimulus may be transmitted to intracorporeal tissue at first and second locations, receive a mechanomyography output signal indicating a monitored mechanical response of a muscle innervated by a nerve induced by the electrical stimulus, and determine a distance to a nerve from the first location and the second location using the magnitude of the electrical stimulus and the monitored mechanical response, without using an electromyography signal corresponding to an electrical potential of the muscle and skin.
Virtual three-dimensional nerve model for guiding the elongate medical device without contacting the nerve
Construct a virtual three-dimensional model of the nerve using the determined distance(s) to thereby precisely guide the elongate medical device within the intracorporeal treatment area without contacting the nerve.
Virtual three-dimensional model including nerve portion and non-nerve space portion
Construct a virtual three-dimensional model of the intracorporeal treatment area from the current magnitude of the electrical stimulus at the first and second locations and from the mechanomyography output signal without using an electromyography signal, wherein the virtual three-dimensional model includes a first portion representative of the nerve and a second portion representative of a space within the intracorporeal treatment area that does not contain the nerve.
The independent claims require an elongate medical device with multiple spaced electrodes and a non-invasive mechanomyography sensor, use mechanomyography response and electrode-location information to determine nerve distances without electromyography, and construct a virtual three-dimensional model that guides the device without contacting the nerve. One independent claim further specifies the virtual model to include both nerve and non-nerve space portions.
Stated Advantages
Determining distance to a nerve without using electromyography.
Precisely guiding the elongate medical device within the intracorporeal treatment area without contacting the nerve.
A virtual three-dimensional model includes a portion representative of space that does not contain the nerve, enabling guidance based on nerve and non-nerve space.
Documented Applications
Guiding an elongate medical device within an intracorporeal treatment area without contacting a nerve using a virtual three-dimensional nerve model constructed from determined distance(s).
Constructing a virtual three-dimensional model of an intracorporeal treatment area including a nerve portion and a non-nerve space portion for precisely guiding the device without contacting the nerve.
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