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公开(公告)号：US20190269342A1
公开(公告)日：2019-09-05
申请号：US16414313
申请日：2019-05-16
发明人： Christopher Wybo
摘要： A nerve mapping system includes an elongate medical device, a non-invasive mechanical sensor, and a processor. The elongate medical device includes a distal end portion configured to explore an intracorporeal treatment area of a subject, and the distal end portion includes an electrode. The non-invasive mechanical sensor is configured to provide a mechanomyography output signal corresponding to a monitored mechanical response of a muscle innervated by the nerve. The processor is in communication with the electrode and the sensor, and is configured to provide a plurality of electrical stimuli to the electrode. Each of the plurality of stimuli is provided when the electrode is located at a different position within the intracorporeal treatment area. The processor determines the likelihood of a nerve existing at a particular point using the magnitudes of each of the stimuli and the detected response of the muscle.
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公开(公告)号：US10376209B2
公开(公告)日：2019-08-13
申请号：US15286328
申请日：2016-10-05
发明人： Christopher Wybo
摘要： A method of locating a nerve within an intracorporeal space includes advancing a distal end portion of a stimulator toward an anatomical target within the intracorporeal space, and periodically applying a first electrical stimulus from a first electrode disposed on a central axis of the stimulator. If a muscular response to the first electrical stimulus is detected, a locating electrical stimulus is then applied from a plurality of locations offset from the central axis of the stimulator, and a magnitude of the response of the muscle is monitored. A distance between the nerve and each of the plurality of locations is determined from the magnitude of the muscular response, and from a magnitude of the locating electrical stimulus provided at each of the plurality of locations. The location of the nerve is then triangulated from the determined distance at each of the plurality of locations.
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公开(公告)号：US10376208B2
公开(公告)日：2019-08-13
申请号：US15286323
申请日：2016-10-05
发明人： Christopher Wybo
摘要： A nerve mapping system includes a plurality of electrodes, a sensor, and a processor in communication with each of the plurality of electrodes and the sensor. Each electrode is disposed on the distal end portion of one or more elongate medical devices configured to extend within an intracorporeal treatment area of a subject. The sensor is in communication with a muscle of a subject, and is configured to provide an output signal corresponding to a monitored response of the muscle. The processor receives an indication of the location of each electrode and an indication of a magnitude of the monitored muscular response. Using these parameters, the processor determines a distance to the nerve from the location of each of the plurality of electrodes, and constructs a virtual model of the nerve using the determined distance to the nerve at each of the plurality of locations.
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公开(公告)号：US09301711B2
公开(公告)日：2016-04-05
申请号：US14077272
申请日：2013-11-12
发明人： Stephen Bartol , Christopher Wybo
CPC分类号： A61B5/11 , A61B5/1104 , A61B5/1107 , A61B5/4029 , A61B5/4041 , A61B5/4519 , A61B5/4893 , A61B5/6828 , A61B2505/05 , A61B2562/0219 , A61N1/0551
摘要： 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.
摘要翻译： 在外科手术过程中识别神经健康变化的方法包括：在第一时间确定神经的灵敏度，在第二时间确定神经的灵敏度，以及向用户提供对应于变化的指示 在神经的敏感性从第一次到第二次。 在每种情况下，通过经由设置在细长医疗器械的远端部分上的电极提供电刺激并监测由神经支配的肌肉的机械反应的大小来确定神经的灵敏度。
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公开(公告)号：US08979767B2
公开(公告)日：2015-03-17
申请号：US13676809
申请日：2012-11-14
发明人： Stephen Bartol , Christopher Wybo
IPC分类号： A61B5/11 , A61B5/0488 , A61B5/00
CPC分类号： A61B5/1106 , A61B5/0488 , A61B5/1104 , A61B5/1107 , A61B5/4029 , A61B5/4519 , A61B5/4893 , A61B5/6828 , A61B5/6843 , A61B5/7217 , A61B5/7239 , A61B2505/05 , A61B2560/0276 , A61B2560/0412 , A61B2562/0219 , G06F19/00
摘要： 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.
摘要翻译： 用于确定刺激器与人体内体内治疗区域内的神经之间的接近度的神经监测系统包括刺激器，机械传感器和接收器。 刺激器构造成在体内治疗区域内延伸并在其中提供电刺激。 机械传感器被配置成与肌肉机械连通并且产生对应于感测到的肌肉机械运动的机械输液输出信号。 接收器被配置为：从机械传感器接收机械手输出信号; 获得提供的体内刺激的大小的指示; 从接收到的肌肉造影输出信号确定肌肉的加速度的大小; 并从所提供的体内刺激的大小和肌肉加速度的大小来确定刺激器和神经之间的接近度。
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公开(公告)号：US20140088612A1
公开(公告)日：2014-03-27
申请号：US13627283
申请日：2012-09-26
发明人： Stephen Bartol , Christopher Wybo
IPC分类号： A61B19/00
CPC分类号： A61B5/486 , A61B5/04882 , A61B5/6852 , A61B34/30 , A61B2018/00839 , A61B2090/065
摘要： 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.
摘要翻译： 用于在受试者的身体内执行外科手术的机器人手术系统包括细长的外科器械，被配置为控制外科器械的远端部分的运动的机器人控制器，以及与机器人控制器 。 机械手术反馈系统包括细长括约肌收缩传感器，其被配置为监测受试者的括约肌的物理反应并提供对应于所监测的反应的机械造影信号。 另外，反馈系统包括处理器，其被配置为接收机械造影信号，以确定接收到的信号是否指示感应括约肌反应，并且如果检测到诱导的括约肌反应，则向机器人控制器提供控制信号。
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公开(公告)号：US20130253533A1
公开(公告)日：2013-09-26
申请号：US13428693
申请日：2012-03-23
申请人： Stephen Bartol , Christopher Wybo
发明人： Stephen Bartol , Christopher Wybo
IPC分类号： A61B19/00
CPC分类号： A61B34/30 , A61B90/03 , A61N1/0551 , A61N1/36017
摘要： 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.
摘要翻译： 用于在受试者的身体内执行外科手术的机器人手术系统包括细长的外科器械，被配置为控制外科器械的远端部分的运动的机器人控制器，以及与机器人控制器 。 机械手术反馈系统包括被配置为监测肌肉的身体运动并提供对应于所监视的身体运动的机械通道信号的机械传感器。 另外，反馈系统包括处理器，其被配置为接收机械通道信号，以确定接收的信号是否指示诱导的肌肉反应，以及如果检测到诱导的肌肉反应，则向机器人控制器提供控制信号。
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公开(公告)号：US20170020611A1
公开(公告)日：2017-01-26
申请号：US15286317
申请日：2016-10-05
发明人： Christopher Wybo
CPC分类号： A61B34/10 , A61B5/1104 , A61B5/1107 , A61B5/4029 , A61B5/4893 , A61B5/6848 , A61B5/746 , A61B2034/105 , A61B2505/05 , G16H50/50
摘要： 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.
摘要翻译： 设置在患者的体内治疗区域内的神经建模的方法包括将电极定位在虚拟工作空间内的多个位置处，并且提供从电极到体内治疗区域的电刺激。 监测肌肉对电刺激的响应并用于确定从多个位置中的每一个到神经的距离。 然后在虚拟工作区内使用从各个不同位置到神经的确定距离以及虚拟工作空间内的多个位置来构建神经的虚拟模型。
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公开(公告)号：US09084550B1
公开(公告)日：2015-07-21
申请号：US12605020
申请日：2009-10-23
申请人： Stephen Bartol , Christopher Wybo
发明人： Stephen Bartol , Christopher Wybo
IPC分类号： A61B5/06 , A61B1/00 , A61B5/0488 , A61B5/00 , A61B5/11
CPC分类号： A61B5/0488 , A61B5/1104 , A61B5/1106 , A61B5/1107 , A61B5/4029 , A61B5/4519 , A61B5/4893 , A61B5/6828 , A61B5/6833 , A61B5/7217 , A61B2505/05 , A61B2560/0412 , A61B2562/0219
摘要： 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.
摘要翻译： 神经监测装置包括被配置为提供刺激的刺激器，被配置为产生对应于感测到的事件的输出信号的机械传感器以及被配置为从机械传感器接收输出信号并确定输出信号是否对应于 刺激提供的刺激。
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公开(公告)号：US20140073986A1
公开(公告)日：2014-03-13
申请号：US14077272
申请日：2013-11-12
发明人： Stephen Bartol , Christopher Wybo
CPC分类号： A61B5/11 , A61B5/1104 , A61B5/1107 , A61B5/4029 , A61B5/4041 , A61B5/4519 , A61B5/4893 , A61B5/6828 , A61B2505/05 , A61B2562/0219 , A61N1/0551
摘要： 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.
摘要翻译： 在外科手术过程中识别神经健康变化的方法包括：在第一时间确定神经的灵敏度，在第二时间确定神经的灵敏度，以及向用户提供对应于变化的指示 在神经的敏感性从第一次到第二次。 在每种情况下，通过经由设置在细长医疗器械的远端部分上的电极提供电刺激并监测由神经支配的肌肉的机械反应的大小来确定神经的灵敏度。
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