METHOD, SYSTEM AND TOOL FOR SURGICAL PROCEDURES

• US 20090299439A1
• Filed: 06/02/2008
• Published: 12/03/2009
• Est. Priority Date: 06/02/2008
• Status: Abandoned Application

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Mire, David, Saladino, Joseph
• Application Number:
  US12/131,592
• Publication Number:
  US 20090299439A1
• Time in Patent Office: Days
• US Class Current: 607/60
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1757 for the spine

Abstract

A surgical tool is disclosed that is capable of communicating wirelessly with either a neural integrity monitoring system or a surgical navigation system. The surgical tool includes electronic circuitry operable to provide a neural stimulation signal to a surgical instrument connected with the tool. If a predetermined response is received by the neural integrity monitoring system, it is capable of automatically stopping rotation of the surgical instrument. Further, if a predetermined safe threshold is breached or about to be breached, the surgical navigation system is operable to automatically stop rotation of the surgical instrument. In addition, the surgical tool is provided with audio and visual feedback of the neurological status of the patient.

Claims

1. A surgical tool, comprising:

a motor disposed within a housing coupled to an output shaft;

a trigger mechanism configured to selectively supply power to said motor to rotate said output shaft; and

a neural signal generation unit configured to generate an expected electric signal that is provided to a surgical instrument connected with said output shaft.

2. The surgical tool of claim 1, wherein said neural signal generation unit comprises a control unit.

3. The surgical tool of claim 1, wherein said neural signal generation unit comprises an electronic circuit.

4. The surgical tool of claim 1, wherein said surgical instrument is selected from a group of surgical instruments consisting of a drill bit, a tap, a probe, a socket, a keyed drive, a screwdriver, a screw and an implant.

5. The surgical tool of claim 1, further comprising a transceiver connected with a control unit configured to conduct wireless communication with a neural integrity monitoring system.

6. The surgical tool of claim 5, wherein said control unit is operable to stop said motor if a signal is received from said neural integrity monitoring system indicative of said neural integrity monitoring system receiving a response above a specified neural threshold.

7. The surgical tool of claim 1, further comprising a transceiver connected with a control unit for communicating with a surgical navigation system.

8. The surgical tool of claim 7, wherein said control unit is operable to stop said motor if a signal is received from said surgical navigation system indicative of said surgical instrument breaching a safe threshold defined on an image of said surgical navigation system.

9. The surgical tool of claim 1, further comprising a neural signal adjustment member connected with said neural signal generation mechanism for adjusting an intensity setting of said expected electric signal.

10. The surgical tool of claim 1, further comprising an optical indicator located on an outside surface of said housing, wherein said optical indicator is operable to generate a visual warning if said surgical instrument or an implant to which said surgical instrument is connected causes a response above a specified threshold to be detected by a neural integrity monitoring system.

11. The surgical tool of claim 1, further comprising an audible indicator connected with a control unit, wherein said audible indicator is configured to generate an audible warning if said surgical instrument or an implant to which said surgical instrument is connected causes a response above a specified threshold to be detected by a neural integrity monitoring system.

12. A system, comprising:

a surgical tool for implanting a device, comprising;

a motor disposed within a housing coupled to an output shaft;

a trigger mechanism for selectively supplying power to drive said motor;

a neural signal generation unit operable to generate an expected electric signal;

means for providing said expected electric signal to a surgical instrument connected with said output shaft;

a receiver for receiving wireless communication signals; and

a neural integrity monitoring system operable to monitor a neurological status of a patient, wherein said neural integrity monitoring system wirelessly is operable to transmit a motor shut down signal to said surgical tool if said neural integrity monitoring system determines that said neurological status of said patient is at risk as a function of a response received to said expected electric signal.

13. The system of claim 12, wherein said surgical tool further comprises an adjustment mechanism connected with said neural signal generation unit configured to allow adjustment of said expected electrical signal.

14. The system of claim 12, wherein said surgical tool further comprises an optical indicator located on an outside surface of said housing configured to generate a visual indication indicative of a neurological status of said patient.

15. The system of claim 12, wherein said surgical tool further comprises an audible indicator configured to generate an audible alarm if said neurological status of said patient is at risk.

16. The system of claim 12, wherein said neurological status of said patient is at risk if said response received by said neural integrity monitoring system is above a specified threshold.

17. The system of claim 16, wherein prior to receiving a respective response above said specified threshold said neural integrity monitoring system is configured to operate in a nerve proximity mode.

18. The system of claim 17, wherein said nerve proximity mode is configured to cause said surgical tool to generate audible responses that increase in intensity as a function of a sensed response of said expected electric signal by said neural integrity monitoring system.

19. A system, comprising:

a surgical tool for implanting a device, comprising;

a motor disposed within a housing coupled to an output shaft;

a trigger mechanism for selectively supplying power to drive said motor;

a neural signal generation circuit operable to generate an expected electric signal;

means for providing said expected electric signal to a surgical instrument connected with said output shaft;

a receiver for receiving wireless communication signals; and

a surgical navigation system operable to allow a user to define a safe threshold on at least one image of a bone structure of a patient that will receive said device, wherein said surgical navigation system is configured to wirelessly transmit a motor shut down signal to said surgical tool if said surgical navigation system determines that said safe threshold is at risk of being breached by said device.

20. The system of claim 19, wherein said motor shut down signal causes said surgical tool to shut down for a predetermined amount of time.

21. The system of claim 19, wherein said surgical tool further comprises at least one optical indicator located on an outside surface of said housing for generating a visible indication of a status of said safe threshold.

22. The system of claim 19, wherein said surgical navigation system is configured to cause an audible indicator on said surgical tool to generate audible sounds as a function of a proximity of said device to said safe threshold.

23. The system of claim 19, wherein said surgical tool further comprises a navigation enabling member connected with said housing for allowing said surgical navigation system to determine a location of said surgical tool in relation to said patient.

24. A method, comprising:

attaching a neural integrity monitoring system to a patient to monitor a neurological status of said patient during a surgical procedure;

providing a surgical tool including a motor connected with a trigger mechanism for selective operation of said motor;

using a surgical instrument connected with an output shaft of said surgical tool during said surgical procedure to assist in implantation of a device in said patient;

generating an electric signal that is electrically transmitted to said surgical instrument at least while said trigger mechanism is depressed to activate said motor; and

stopping said surgical tool from rotating said surgical instrument if a response above a specified threshold is detected by said neurological integrity monitoring system.

25. The method of claim 24, further comprising generating an optical indication on said surgical tool indicating a safe operating condition while said response above said specified threshold is not detected.

26. The method of claim 24, further comprising generating an optical indication on said surgical tool indicative of said response being above said specified threshold.

27. The method of claim 24, further comprising generating an audible indication with said surgical tool indicative of said response being above said specified threshold.

28. The method of claim 24, further comprising resetting said surgical tool for operation after a predetermined period of time.

29. The method of claim 24, further comprising adjusting an intensity setting of said electric signal using a control mechanism located on said surgical tool.

30. The method of claim 24, further comprising adjusting an intensity setting of said electric signal with said neural integrity monitoring system.

31. The method of claim 30, wherein said intensity setting is adjusted by transmitting a wireless signal from said neural integrity monitoring system to said surgical tool.

32. The method of claim 24, further comprising wirelessly transmitting a signal from said neural integrity monitoring system to said surgical tool to stop said surgical tool from rotating.

33. The method of claim 32, further comprising wirelessly transmitting a signal from said neural integrity monitoring system to said surgical tool to reset said surgical tool if said surgical tool is stopped.

34. The method of claim 24, further comprising operating said neural integrity monitoring system in a nerve proximity mode, wherein as said response increases in intensity an audible sound generated by said surgical tool increases in intensity to alert a surgeon.

35. A method, comprising:

generating an anatomical image of a portion of a patient undergoing a surgical procedure with a surgical navigation system;

defining a safe threshold on said anatomical image of said portion of said patient for implantation of a device;

providing a surgical tool including a motor connected with a trigger mechanism for selective operation of said motor;

using a surgical instrument attached to said surgical tool during said surgical procedure to assist in implantation of said device in said patient; and

automatically stopping said surgical tool from rotating said surgical instrument if said safe threshold is about to be breached by said device.

36. The method of claim 35, further comprising generating a visual indication on said surgical tool when said safe threshold is about to be breached.

37. The method of claim 35, further comprising generating an audible indication indicative of said device approaching said safe threshold.

38. The method of claim 35, further comprising resetting said surgical tool for operation after a predetermined period of time after said surgical tool has been stopped.