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Publication Number
US-10449002-B2
Publication Date
2019-10-22
Expiration Date
Abstract
A method of modeling a nerve disposed within an intracorporeal treatment area of a patient includes locating an electrode at a plurality of locations within a virtual workspace and providing an electrical stimulus from the electrode to the intracorporeal treatment area. The response of a muscle to the electrical stimulus is monitored and used to determine a distance to the nerve from each of the plurality of locations. A virtual model of the nerve is then constructed within the virtual workspace using the determined distance to the nerve from each of the different positions, and the plurality of locations within the virtual workspace.
Core Innovation
Exploring an intracorporeal treatment area with a stimulator shaped as an elongated cylinder includes providing an electrical stimulus to intracorporeal tissue at a plurality of different positions. The stimulator includes a distal end portion tapering to a tip, a central axis extending through the elongated cylinder, a first electrode disposed at the tip on the central axis, and at least one second electrode spaced apart and radially offset.
A mechanical response of a muscle innervated by the nerve is monitored to each electrical stimulus using a non-invasive mechanical sensor. A distance to the nerve from each of the plurality of different positions is determined from a magnitude of the electrical stimulus and the monitored mechanical response of the muscle.
A virtual model of the nerve is constructed within the virtual workspace using the determined distance to thereby guide the stimulator within the intracorporeal treatment area without contacting the nerve. The virtual model is merged with anatomical imagery representative of the intracorporeal treatment area and can be used to guide robotic control by providing a shortest path that avoids the nerve and obstructing structures, or to constrain motion of an end effector within the intracorporeal treatment area.
Claims Coverage
The relevant independent claims are clm-00001, clm-00014, and clm-00019. Across these independent claims, the inventive coverage centers on three inventive features: an elongated-cylinder multi-electrode stimulator registered in a virtual workspace, non-invasive mechanical sensing to determine nerve distance from stimulus magnitude and muscle response, and construction of a virtual nerve or treatment-area model for guidance and robotic controller use.
Multi-electrode elongated-cylinder stimulator registered in a virtual workspace
Registering the first location and the second location at a plurality of locations within a virtual workspace, where each location corresponds to a respective position within the intracorporeal treatment area, and where the stimulator is shaped as an elongated cylinder including a distal end portion tapering to a tip, a central axis intersecting the tip, a first electrode at the tip on the central axis, and at least one second electrode spaced apart and radially offset from the central axis.
Non-invasive mechanical sensing for nerve distance determination
Monitoring a mechanical response of a muscle innervated by the nerve to each of the provided electrical stimuli using a non-invasive mechanical sensor, and determining a distance to the nerve from each of the plurality of different positions using a magnitude of the electrical stimulus and the monitored mechanical response of the muscle.
Virtual nerve model construction for guiding without nerve contact
Constructing a virtual model of the nerve within the virtual workspace using the determined distance to the nerve from each of the plurality of different positions to thereby precisely guide the stimulator within the intracorporeal treatment area without contacting the nerve.
Stimulator location monitoring and nerve presence virtual modeling
Monitoring a location of a stimulator within the intracorporeal treatment area and providing electrical stimuli via the first electrode and the at least one second electrode at respective different locations, monitoring a muscle innervated by the nerve for a mechanical response using a non-invasive mechanical sensor, determining a distance between the nerve and at least one of the plurality of different locations, and constructing a virtual model of the intracorporeal treatment area that includes a first portion representative of the nerve and a second portion representative of space that does not contain the nerve.
Current-magnitude-based nerve distance and virtual nerve model construction
Providing electrical stimuli having a current magnitude at respective ones of a plurality of different locations within the intracorporeal treatment area, monitoring a mechanical response of a muscle using a non-invasive mechanical sensor, determining a distance between the nerve and each location using the current magnitude and the mechanical response, and constructing a virtual model of the nerve within a virtual workspace using the determined distance.
Across the independent claims, the core inventive approach is to register and use a specified elongated-cylinder stimulator with multiple electrodes to deliver stimuli at different intracorporeal positions, monitor a non-invasive muscle mechanical response, determine nerve-to-location distance from stimulus magnitude and the mechanical response, and construct a virtual model that represents nerve at determined distance and space that does not contain the nerve, including guidance and robotic controller use.
Stated Advantages
Precisely guide the stimulator within the intracorporeal treatment area without contacting the nerve.
Construct a virtual model that includes a nerve-representative portion and a non-nerve-representative space portion to model nerve presence in the intracorporeal treatment area.
Enable providing a shortest path that avoids the nerve and obstructing structures for display or a robotic controller.
Constrain motion of an end effector within an intracorporeal treatment area using the virtual model.
Documented Applications
Precisely guide the stimulator within an intracorporeal treatment area without contacting the nerve.
Model an intracorporeal treatment area for the presence of a nerve and represent space that does not contain the nerve.
Provide a shortest path for navigating around the nerve portion and obstructing structures to a display or a robotic controller.
Control and constrain an end effector’s motion within an intracorporeal treatment area using the virtual model.
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