Innovative Surgical Solutions, LLC

Stephen Bartol

Christopher Wybo

A method of identifying a change in the health of a nerve during a surgical procedure includes determining a sensitivity of the nerve at a first time, determining a sensitivity of the nerve at a second time, and providing an indication to a user corresponding to a change in the sensitivity of the nerve from the first time to the second time. In each instance, the sensitivity of the nerve is determined by providing an electrical stimulus via an electrode disposed on a distal end portion of an elongate medical instrument, and monitoring a magnitude of a mechanical response of a muscle innervated by the nerve.

System and method for assessing neural health

A neural monitoring device includes a stimulator configured to provide a stimulus, a mechanical sensor configured to generate an output signal corresponding to a sensed event, and a receiver configured to receive an output signal from the mechanical sensor and determine if the output signal corresponds to the stimulus provided by the stimulator.

Minimally invasive nerve monitoring device and method

A method of detecting the presence of a sacral nerve in a human subject includes providing an electrical stimulus within an intracorporeal treatment area of the human subject; detecting a physical response of at least one of an external sphincter of the bladder and an external sphincter of the anus; and providing an indication to a user if the detected physical response corresponds to the provided electrical stimulus.

Method of detecting a sacral nerve

A method of determining a change in nerve function attributable to a surgical procedure includes assessing the nerve function via a first, induced mechanomyographic muscle response prior to the surgical procedure, and reassessing the nerve function via a second, induced mechanomyographic muscle response after the surgical procedure. Each mechanomyographic muscle response may be induced through an electrical stimulus provided directly to the nerve of the subject.

Method of assessing neural function

A neural monitoring system for determining a proximity between a stimulator and a nerve within an intracorporeal treatment area of a human subject includes a stimulator, a mechanical sensor, and a receiver. The stimulator is configured to extend within the intracorporeal treatment area and to provide an electrical stimulus therein. The mechanical sensor is configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle. The receiver is configured to: receive the mechanomyography output signal from the mechanical sensor; receive an indication of a magnitude of the provided intracorporeal stimulus; determine a magnitude of acceleration of the muscle from the received mechanomyography output signal; and determine a proximity between the stimulator and the nerve from the magnitude of the provided intracorporeal stimulus and the magnitude of acceleration of the muscle.

Neural monitoring system

A system for detecting the presence of a nerve within a subject includes a stimulator configured to provide a stimulus to a portion of the subject, a sensing device configured to be placed in communication with a muscle of the subject and to generate an output signal corresponding to a monitored parameter of the muscle, the sensing device including a mechanical sensor configured to monitor a mechanical parameter of the muscle, and a receiver configured to receive the output signal from the sensing device and to determine if the output signal corresponds to the stimulus provided by the stimulator.

A robotic surgical system for performing a surgical procedure within the body of a subject includes an elongate surgical instrument, a robotic controller configured to control the motion of the distal end portion of the surgical instrument, and a mechanomyography feedback system in communication with the robotic controller. The mechanomyography feedback system includes an elongate sphincter contraction sensor configured to monitor a physical response of a sphincter of the subject and to provide a mechanomyography signal corresponding to the monitored response. Additionally, the feedback system includes a processor configured to receive the mechanomyography signal, to determine if the received signal is indicative of an induced sphincter response, and to provide a control signal to the robotic controller if an induced sphincter response is detected.

Robotic surgical system with mechanomyography feedback

A neural monitoring system for detecting an induced response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject includes a mechanical sensor configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle, and a receiver in communication with the mechanical sensor. The receiver is configured to: receive the mechanomyography output signal from the mechanical sensor; compute a time derivative of the sensed muscle movement from the mechanomyography output signal; compare the computed time derivative to a threshold; and indicate that the sensed mechanical movement of the muscle was induced by the provided intracorporeal stimulus if the computed time derivative exceeds the threshold.

A robotic surgical system for performing a surgical procedure within the body of a subject includes an elongate surgical instrument, a robotic controller configured to control the motion of the distal end portion of the surgical instrument, and a mechanomyography feedback system in communication with the robotic controller. The mechanomyography feedback system includes a mechanical sensor configured to monitor a physical motion of a muscle and to provide a mechanomyography signal corresponding to the monitored physical motion. Additionally, the feedback system includes a processor configured to receive the mechanomyography signal, to determine if the received signal is indicative of an induced muscle response, and to provide a control signal to the robotic controller if an induced muscle response is detected.

A neural monitoring system for detecting an induced response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject includes a mechanical sensor configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle, and a receiver in communication with the mechanical sensor. The receiver is configured to: receive the mechanomyography output signal from the mechanical sensor; compute a time derivative of an acceleration of the muscle from the mechanomyography output signal; compare the computed time derivative of acceleration to a jerk threshold; and indicate that the sensed mechanical movement of the muscle was induced by the provided intracorporeal stimulus if the computed time derivative of acceleration exceeds the jerk threshold.

A method of detecting an induced muscle response includes monitoring a mechanical parameter of a muscle; computing an amount of muscle jerk from the monitored parameter; comparing the computed muscle jerk to a jerk threshold; and identifying the occurrence of an induced muscle response if the computed muscle jerk exceeds the threshold.

Neural event detection

A sensing device for detecting a muscle event includes a mechanical sensor, such as an accelerometer, that is configured to provide a signal corresponding to a mechanical movement of a muscle, a plurality of electrodes disposed on the sensing device; and a contact detection device coupled with the plurality of electrodes and configured to detect if the sensing device is in contact with a subject.

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Windsor, CA, United States of America

Stephen Bartol