Apparatus and method for locating a nerve
First Claim
1. An apparatus for stimulating and locating a nerve, comprising:
- means for applying a stimulus to a plurality of sites within an area of tissue likely to contain the nerve to be located;
means for detecting a response to said stimulus;
means for automatically modifying the site of stimulation, said means for automatically modifying the site of stimulation including means for interpreting the response provided by said response detecting means; and
means for indicating the location of the nerve to the user;
wherein said modifying means automatically modifies the site of a stimulus applied to the area of tissue likely to contain the nerve based on an interpretation of the detected response by said interpreting means to further stimulate the nerve to determine its location.
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Accused Products
Abstract
An apparatus and method for stimulating and locating a nerve is described. The apparatus is closed-loop in nature in that the device is automated and is independent of the skill of the operator. The apparatus includes a stimulating probe having an array of electrodes, an automatic control means, and a response detecting means. Response feedback is analyzed according to an electrode selecting algorithm (incorporating a response interpreting algorithm) so that ongoing stimulation is restricted to a subset of the array which produces a criterion response with the least magnitude of stimulation. A method of use is also described. The device and method are also intended to permit optimal stimulation of a located nerve for therapeutic purposes.
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Citations
99 Claims
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1. An apparatus for stimulating and locating a nerve, comprising:
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means for applying a stimulus to a plurality of sites within an area of tissue likely to contain the nerve to be located; means for detecting a response to said stimulus; means for automatically modifying the site of stimulation, said means for automatically modifying the site of stimulation including means for interpreting the response provided by said response detecting means; and means for indicating the location of the nerve to the user; wherein said modifying means automatically modifies the site of a stimulus applied to the area of tissue likely to contain the nerve based on an interpretation of the detected response by said interpreting means to further stimulate the nerve to determine its location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. An apparatus for stimulating and locating the cavernosal nerve, comprising:
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a stimulator circuit for generating a stimulus; a probe disposed in connection with said stimulator circuit, said probe having a handle portion and a stimulating tip for applying a stimulus to an area of tissue likely to contain the nerve to be located, said stimulating tip comprising an array of electrodes; a control means for governing activation of said array of electrodes, said control means comprising; memory for storing an electrode selecting algorithm which activates the electrodes of said array based on an evaluation of a change in a tumescence response to successful stimulation of the cavernosal nerve; and means for employing the electrode selecting algorithm; and a response detection means for detecting and measuring a tumescence response, wherein said response detection means provides tumescence response information to said control means for evaluation by said electrode selecting algorithm to further stimulate the nerve to determine its location. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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30. An apparatus for locating and optimally stimulating a nerve, comprising:
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an implant comprising an array of electrodes for delivering a stimulus to a nerve; a control means for governing activation of said electrodes of said array, said array of electrodes being activated in accordance with an electrode selecting algorithm which evaluates a response to successful stimulation of the nerve; and a response detection means for detecting and measuring a response, said response detection means providing response feedback information to said control means for evaluation by said electrode selecting algorithm. - View Dependent Claims (31, 32, 33, 34, 35, 36)
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37. A method for stimulating the cavernosal nerve comprising the step of:
applying a stimulus, said stimulus being capable of initiating sub-maximal tumescence of the penis such that subsequent tumescence responses to subsequently applied stimuli occur with shorter delay from the onset of successful stimulation. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44)
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45. A method for stimulating and locating the cavernosal nerve, comprising the steps of:
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(a) applying a stimulus to a tissue site likely to contain the nerve to be located to evoke a tumescence response, the stimulus having an intensity known to stimulate the nerve when the site of stimulation is within a known distance from the nerve; (b) detecting a tumescence response to stimulation of the nerve; (c) evaluating the tumescence response to stimulation of the nerve; and (d) automatically modifying the site of subsequent stimulation based on the evaluation of the tumescence response to further stimulate the nerve to determine its location. - View Dependent Claims (46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57)
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58. A method for locating a nerve, comprising the steps of:
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(a) applying a stimulus to a tissue site likely to contain the nerve to be located; (b) detecting a response to stimulation of the nerve; (c) evaluating the response to successful stimulation of the nerve; and (d) automatically modifying the site of subsequent stimulation based on the evaluation of the response to further stimulate the nerve to determine its location. - View Dependent Claims (59, 60, 61, 62, 63)
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64. An apparatus for locating a nerve, comprising:
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a source of electricity; a stimulus applying means coupled to said source of electricity for applying a stimulus to an area of tissue likely to contain the nerve to be located, said stimulus applying means including an array of electrodes; means for detecting a response to said stimulus; means for varying activation of the electrodes of said array; and indicating means for indicating location of the nerve to the user, wherein said activation means varies activation of the electrodes of said array based on the detected response to the stimulus applied by said stimulus applying means to further stimulate the nerve to determine its location.
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65. A method for stimulating and locating the cavernosal nerve, comprising the steps of:
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(a) applying a low intensity stimulus to a tissue site likely to contain the nerve to evoke a sub-maximal tumescence response, said stimulus having an intensity known to stimulate the nerve when the site of stimulation is within a minimal distance from the nerve; (b) detecting a tumescence response to stimulation of the nerve; (c) evaluating the differential of the tumescence response to stimulation of the nerve; (d) automatically modifying the site of subsequent stimulation based on the evaluation of the differential of the tumescence response to further stimulate the nerve to determine its location. - View Dependent Claims (66, 67, 68)
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69. An apparatus for stimulating and locating a nerve, comprising:
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means for applying a stimulus to a plurality of sites within an area of tissue likely to contain the nerve to be located; means for detecting and measuring a response to said stimulus; means for automatically modifying the site of stimulation within the area of tissue likely to contain the nerve to be located; means for determining the location of the nerve to be located, wherein said means for determining the location of the nerve evaluates the responses elicited by application of a stimulus to each of said plurality of sites to determine the location of the nerve; and means for indicating the location of the nerve to the operator. - View Dependent Claims (70, 71, 72, 73, 74, 75, 76, 77, 78)
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79. A method for locating a nerve, comprising the steps of:
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(a) applying a stimulus to a site within an area of tissue likely to contain the nerve to be located; (b) detecting a response to stimulation of the nerve; (c) measuring the detected response; and (d) automatically modifying the site of subsequent stimulation in accordance with a predefined site selecting program. - View Dependent Claims (80, 81, 82, 83, 84, 85, 86)
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87. An apparatus for stimulating and locating a nerve, comprising:
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means for applying a stimulus to a plurality of sites within an area of tissue likely to contain the nerve to be located; means for detecting and measuring a response to said stimulus; means for determining the location of the nerve to be located, wherein said means for determining the location of the nerve evaluates the responses elicited by application of a stimulus to each of said plurality of sites within the area of tissue likely to contain the nerve to determine the location of the nerve; and means for indicating the location of the nerve to the user. - View Dependent Claims (88, 89, 90)
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91. A method for locating a nerve, comprising the steps of:
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(a) applying a stimulus to a site within an area of tissue likely to contain the nerve to be located; (b) detecting a response to stimulation of the nerve; (c) measuring the detected response; (d) modifying the site of subsequent stimulation; (e) applying a subsequent stimulus to the modified site of stimulation; and (f) evaluating the detected responses elicited by application of a stimulus to each of the stimulation sites to determine the location of the nerve. - View Dependent Claims (92, 93, 94, 95, 96, 97, 98, 99)
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Specification