Retractor systems with closed loop control

• US 9,636,096 B1
• Filed: 02/04/2009
• Issued: 05/02/2017
• Est. Priority Date: 02/04/2009
• Status: Active Grant

• Current Assignee: ViOptix, Inc.
• Original Assignee: ViOptix, Inc.
• Inventors: Keller, Alex, Lash, Robert E., Mao, Jimmy Jian-min, Heaton, II, Larry C.
• Primary Examiner(s): Rodriguez, Cris L
• Assistant Examiner(s): APONTE, MIRAYDA ARLENE
• Application Number:
  US12/365,716
• Time in Patent Office: 3,009 Days
• Field of Search: 600201-246
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/0262 with a provision for protecting nerves
• CPC Class Codes: A61B 2090/032 pressure limiting, e.g. hydrostatic
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor

Abstract

A retractor system with a closed loop control includes a retractor having one or more sensors, which measure parameters associated with a retracted tissue. The system further includes a positioning mechanism connected to the retractor and a controller which receives feedback signals from the sensors. Based on the feedback signals from the sensors, the retractor is actuated by the positioning mechanism so that the tissue can be retracted while maintaining the parameters associated with the retracted tissue above a threshold level or within a desired range. Another retractor system includes a retractor with a force sensor and at least one additional sensor, which can be used without a closed loop control arrangement.

Claims

1. A system comprising:

a retractor for retracting a tissue, comprising a tissue oximeter sensor, wherein the tissue oximeter sensor can make oxygen saturation measurements of the tissue when there is no pulse;

a positioning mechanism coupled to the retractor; and

a controller coupled to the tissue oximeter sensor and the positioning mechanism, wherein the controller electronically controls the positioning mechanism to adjust a mechanical positioning of the nerve retractor based on an oxygen saturation reading from the tissue oximeter sensor,

the retractor comprises a shaft having a proximal end coupled to the linkage element and a distal end comprising a tip, wherein the tip comprises the tissue oximeter sensor and a retractor portion, and

the tissue oximeter sensor comprises a first sensor emitter opening, a second sensor emitter opening, a first sensor detector opening, and a second sensor detector opening, wherein any of the three openings are positioned in a linear arrangement on a bottom side of the tip.

2. The system of claim 1 wherein the controller is configured to generate a control signal to control movement of the positioning mechanism based on an oxygen saturation value of the tissue measured by the tissue oximeter sensor.

3. The system of claim 2 wherein the control signal actuates the retractor to decrease a retraction distance, through movement of the positioning mechanism, if the oxygen saturation value is not above a first value.

4. The system of claim 3 wherein the control signal actuates the retractor to increase a retraction distance, through movement of the positioning mechanism, if the oxygen saturation value is not below a second value, wherein the second value is greater than the first value.

5. The system of claim 1 wherein the controller comprises a monitor which is configured to display the oxygen saturation value of the tissue.

6. The system of claim 1 further comprising a force sensor coupled to the retractor and the positioning mechanism.

7. The system of claim 1 wherein the positioning mechanism comprises an actuator coupled to a linkage element, wherein the linkage element is coupled to the retractor and transfers movement produced by the actuator to the retractor.

8. The system of claim 7 further comprising a force sensor which is coupled between the linkage element and the retractor for measuring force applied to the retractor via the linkage element through movement of the actuator.

9. The system of claim 1 wherein the second sensor emitter opening is between the first sensor emitter opening and the first sensor detector opening, and the first sensor detector opening is between the second sensor emitter opening and the second sensor detector opening, and wherein the first sensor detector opening is spaced away from the second sensor detector by about 5/3 millimeters or less, and the first sensor detector openings is spaced away from the second sensor emitter opening by about 5/3 millimeters or less.

10. The system of claim 1 wherein the tissue is a nerve, and the retractor is a nerve retractor.

11. The system of claim 1 wherein the tissue is at least one of a liver, kidney, lung, brain, muscle, stomach, intestine, uterus, ovary, or bladder.

12. The system of claim 1 wherein the tissue to be retracted comprises a flap that has been separated from a body.

13. The system of claim 1 wherein the tissue does not have pulsing arterial blood passing through it.

14. The system of claim 1 comprising:

a force sensor coupled to the retractor.

15. A system comprising:

a nerve retractor comprising a tissue oximeter sensor;

a force sensor coupled to the nerve retractor comprising tissue oximeter sensor;

a positioning mechanism coupled to the nerve retractor; and

a controller coupled to the tissue oximeter sensor and the positioning mechanism, wherein the controller controls the positioning mechanism to adjust a positioning of the nerve retractor based on an oxygen saturation reading from the tissue oximeter sensor,

a first signal is from the controller, and a second signal is from the tissue oximeter sensor, and

the first signal actuates the retractor, through movement of the positioning mechanism, if the second signal produced by the sensor is not above a first value.

16. The system of claim 15 wherein the controller generates the first signal to control movement of the positioning mechanism based on the second signal from the tissue oximeter sensor.

17. The system of claim 15 wherein the tissue oximeter sensor comprises at least one source structure to emit electromagnetic radiation and at least one detector structure to receive an attenuated version of the emitted electromagnetic radiation.

18. The system of claim 17 wherein the at least one source structure comprises a first fiber optic cable and the at least one detector structure comprises a second fiber optic cable.

19. The system of claim 18 wherein the nerve retractor has a shaft with an internal channel and wherein the first fiber optic cable and the second fiber optic cable pass through the channel and are coupled to the controller.

20. The system of claim 15 wherein the first signal actuates the retractor, through movement of the positioning mechanism, if the second signal produced by the tissue oximeter sensor is not below a second value, wherein the second value is greater than the first value.

21. The system of claim 15 wherein the nerve retractor comprises a shaft having a proximal end coupled to a handle and a distal end comprising a tip, wherein the positioning mechanism is coupled to the handle and the sensor is located at the tip.

22. The system of claim 15 wherein the tissue to be retracted comprises a flap that has been separated from a body.

23. The system of claim 15 wherein the tissue does not have pulsing arterial blood passing through it.

24. The system of claim 15 wherein the tissue oximeter sensor comprises an emitter structure, a first detector structure, and a second detector structure.

25. A system comprising:

a retractor for retracting a tissue, comprising a tissue oximeter sensor, wherein the tissue oximeter sensor can make oxygen saturation measurements of the tissue when there is no pulse;

a positioning mechanism coupled to the retractor; and

a controller coupled to the tissue oximeter sensor and the positioning mechanism, wherein the controller electronically controls the positioning mechanism to adjust a mechanical positioning of the nerve retractor based on an oxygen saturation reading from the tissue oximeter sensor, and

the tissue oximeter sensor comprises at least a first fiber optic cable coupled to a fiber combiner, which is coupled to at least a second fiber optic cable and a third fiber optic cable.

26. The system of claim 25 wherein in the fiber combiner, there is a separating bar between at least a portion of the second and third fiber optic cables.

27. A system comprising:

a nerve retractor comprising a tissue oximeter sensor;

a force sensor coupled to the nerve retractor comprising tissue oximeter sensor;

a positioning mechanism coupled to the nerve retractor; and

a controller coupled to the tissue oximeter sensor and the positioning mechanism, wherein the controller controls the positioning mechanism to adjust a positioning of the nerve retractor based on an oxygen saturation reading from the tissue oximeter sensor,

the tissue oximeter sensor comprises at least a first fiber optic cable coupled to a fiber combiner, which is coupled to at least a second fiber optic cable and a third fiber optic cable, and

in the fiber combiner, there is a separating bar between at least a portion of the second and third fiber optic cables.