US 10,376,209 B2
Neural locating method
Christopher Wybo, Highland, MI (US)
Assigned to Innovative Surgical Solutions, LLC, Wixom, MI (US)
Filed by Innovative Surgical Solutions, LLC, Wixom, MI (US)
Filed on Oct. 5, 2016, as Appl. No. 15/286,328.
Application 15/286,328 is a continuation in part of application No. 14/032,924, filed on Sep. 20, 2013, granted, now 9,622,684.
Prior Publication US 2017/0020451 A1, Jan. 26, 2017
Int. Cl. A61B 5/00 (2006.01); A61B 5/11 (2006.01)
CPC A61B 5/4893 (2013.01) [A61B 5/1104 (2013.01); A61B 5/1107 (2013.01); A61B 5/4029 (2013.01); A61B 5/6848 (2013.01); A61B 5/6886 (2013.01); A61B 5/746 (2013.01); A61B 2505/05 (2013.01)] 20 Claims
OG exemplary drawing
 
1. A method of locating a nerve within an intracorporeal space, the method comprising:
exploring an intracorporeal space of a subject with a stimulator;
wherein the stimulator is shaped as an elongated cylinder and includes:
a distal end portion that tapers to a tip;
a central axis intersecting the tip and extending through a center of the elongated cylinder;
a first electrode disposed in a first location at the tip and on the central axis; and
at least one second electrode that is spaced apart from the first electrode and radially offset from the central axis in a second location;
periodically applying a first electrical stimulus from the first electrode while the stimulator is exploring the intracorporeal space;
detecting a mechanical response of a muscle innervated by a nerve within the intracorporeal space to the first electrical stimulus with a non-invasive mechanical sensor configured to provide a mechanomyography output signal corresponding to the mechanical response of the muscle;
after detecting the mechanical response, applying a locating electrical stimulus from the at least one second electrode at a plurality of locations within the intracorporeal space;
monitoring a magnitude of the mechanical response of the muscle to the locating electrical stimulus at the second location;
determining a distance between the nerve and the second location from a) the magnitude of the mechanical response of the muscle to the locating electrical stimulus, and from b) a magnitude of the locating electrical stimulus without using an electromyography signal corresponding to an electrical potential of the muscle and skin of the subject; and
determining a location of the nerve by triangulating the location from the determined distance at each of the plurality of locations to thereby precisely guide the stimulator within the intracorporeal space without contacting the nerve.