The present disclosure relates generally to marking of a patient's skin or tissue, during or before a medical procedure.
Some medical procedures can include marking the skin or tissue of a patient. In some examples, a practitioner can mark the skin or tissue so that the practitioner can return to the marked location in a later part of a procedure. In some examples, the practitioner can use the marking to show a proper orientation for a surgical tool or device.
For example, in an ultrasound guided procedure, a practitioner can identify a target location by scanning portions of the patient's anatomy with an ultrasound transducer. The ultrasound transducer can contact the patient's skin through ultrasound gel. When the practitioner has determined the target location, the practitioner can mark a needle entry point on the patient's skin, and the skin can then be sterilized.
Marking the needle entry point is challenging, due to the presence of the ultrasound gel. Using a surgical pen to form the markings is not ideal, because pen ink may not mark clearly through the ultrasound gel, and the ink can further smudge or be removed entirely upon sterilizing the skin. Some practitioners attempt to form an imprint on the skin or tissue using a needle cap or a retracted ball point pen. These imprints can be of poor quality and may be inaccurate.
As a result, these inadequate current marking techniques can lead to poor orientation of a probe, which leads to increased time to orient the ultrasound probe during the sterile portion of the procedure. Further, these inadequate current marking techniques can often require remarking, which can add time and expense to a procedure.
For example, for some procedures, it can be beneficial to mark an orientation of a transducer as well as a needle entry site. For example, in some surgical procedures, a practitioner can rely on a particular pattern marked on the skin, which can show an orientation in addition to a location. Typically, the practitioner draws such a pattern freehand with a surgical pen.
As another example, in a toric intraocular lens implantation procedure, a practitioner can identify a suitable rotational orientation for the implantable lens by marking the patient's cornea. For corneal marking, a practitioner typically applies ink to a metal tool by rubbing the tool with a standard surgical marker, then marks the cornea with the inked tool. The metal tool requires sterilization following each use. In general, marking the cornea in this manner can be cumbersome, due to the use of multiple tools, and expensive.
Accordingly, there exists a need for a device and method that can form improved markings on the patient's skin or tissue.
A marking device can produce visible temporary marks, including at least one of indentations or colorations, in a specified pattern on skin or tissue of a patient. The marking device can include a body, such as a cap, that can removably attach over an end of a surgical marker. The body can include marking features, such as blades, optionally positioned at a longitudinal end of the body. The marking features can be pressed against the skin or tissue of the patient to form the visible temporary marks. The marking features can optionally be inked, optionally by the surgical marker, before the marks are formed. The marking features can optionally be distributed between a first subset, positioned generally along a line, and a second subset, positioned asymmetrically with respect to the line. The subsets may optionally also create markings at the end points of a profile which collectively define the profile. An optional inclinometer can attach to the body to allow alignment to a horizontal direction.
Corresponding reference characters indicate corresponding parts throughout the several views. Elements in the drawings are not necessarily drawn to scale. The configurations shown in the drawings are merely examples, and should not be construed as limiting the scope of the invention in any manner.
An improved surgical marking device and method is discussed herein. The device can form improved markings on the skin or tissue of a patient.
Known devices are discussed in U.S. Pat. No. 6,805,669, United States Patent Application No. 2006/0106312, and United States Patent Application No. 2012/0209280.
The present examples of a device and method can improve over these and other known marking techniques. One improvement can include indicating a direction or orientation, in addition to a location on the skin or tissue. Another improvement can include an increased ability to remain on the skin or tissue after the skin or tissue has been sterilized. Another improvement can include a decreased cost, compared to some typical marking devices. Another improvement can be an inclusion of the marking ink and the marking component (e.g., the part that forms an imprint on the skin or tissue) on the same device.
In some examples, the device discussed herein can be formed as a pen cap, which can couple with a surgical marking pen. In some examples, the pen cap can include a marking face with a profile outlined by one or more marking tines, bevels, blades, or other marking features. In some examples, the pen cap can include a cavity that can removably couple onto an end of a standard surgical marking pen, and thus the pen can serve as a handle for the operator to grasp and use to manipulate the marking device.
The marking device has marking features that produce temporary marks in a specified pattern. The pattern of the temporary marks can provide guidance and information. In some examples, the profile can provide information to the practitioner. For example, a “T” shaped profile can provide the practitioner with information regarding transducer orientation and an axis for needle access in ultrasound-guided procedures. Additionally, the resulting marking points can optionally be equally spaced at a standard distance, providing a measurement reference for the practitioner.
In some examples, the marking caused by the device and method discussed herein can be a temporary skin indentation, optionally coupled with ink to form an inked indentation. There are several techniques to couple the ink to the marking features of the device. In one example, the practitioner can rub a skin marker against the marking features of the device, to transfer ink from the skin marker to the marking features. In other examples, the marking features can be manufactured with ink pre-coated on the marking features or present in channels within the marking features. In still other examples, the device can include an absorbent pad positioned at the base of the cap, with the absorbent pad including ink. In these examples, the absorbent pad can transfer ink to the marking features by contacting the marking features when the cap is placed over the marking features.
In some examples, which can form markings on a cornea for toric intraocular lens implantation procedures, the device can form markings at one or more of the 0°, 90°, 180° or 270° axes of the cornea. These angles are not intended to be limiting and any angle may be marked. In some examples, the marking features can optionally be rotatable relative to an inclinometer, allowing for the practitioner to implant the intraocular lens at a desired angle of marking relative to a horizontal meridian of the eye. Angular marking of the eye is useful in toric intraocular lens procedures for aligning features of the implant with the steep axis of astigmatism of the eye.
In some examples, the pen cap can optionally include a flat face with equally spaced graduations, for use as a ruler in measuring features on the skin or tissue of the patient.
A body section 20 can include a proximal section 21. In some examples, the proximal section 21 can include a standard pen cap geometry for mating with a surgical pen, which can then serve as a handle which allows the operator to grasp and manipulate the marking device. The body section 20 can include a distal section 22. In some examples, the distal section 22 can be continuous with a transition section 11 from the body to the marking face 13. The transition section 11 may be continuous with an angled junction 12, which may be continuous with the marking face 13. Protruding from the marking face 13 are protrusions such as conical marking features 10 which create the mark in skin when depressed into the patient's body without piercing or damaging the tissue. The marking features 10 can optionally form a “T” pattern, which can provide ultrasound transducer orientation and needle axis orientation for ultrasound-guided procedures. The marking features 10 can optionally be partially or entirely composed of radiopaque material for visualization under fluoroscopy.
In some examples, the marking face 13 can optionally include a flat edge 30, which can optionally sit flush against an ultrasound transducer.
In the example of
In some examples, the device cap 80 can include an absorbent pad 90 positioned at a base of a device cap channel. In some examples, the absorbent pad 90 can optionally include a skin marking solution. In some examples, the marking features of the marking device of
In some examples, the marking face 101 can optionally include a partial circle with a gap in the center (or a complete circle) for viewing of the patient's eye. The gap may be a semi-circular shape. In some examples, the marking features can optionally include one or more curved surfaces 100. In some examples, the one or more curved surfaces 100 can optionally have a radius of curvature similar to that of a human eye. In other examples, the marking features can optionally include one or more other surface geometries, such as tines or bevels.
The marking features can optionally include one or more curved surfaces 100 to complement different shaped surfaces to mark. The marking features contact the curved surface with similar amount of pressure.
In the example of
In some examples, the device can include an optional snap fit feature 104, which can removably or fixedly attach to the housing 102 (e.g., the inclinometer). Other coupling mechanisms known in the art may also be used to joint the device and inclinometer together such as fasteners including pins, screws, hook and loop, and others
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The marking device of
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Embodiments described herein provide a marking device to produce visible temporary marks in a specified pattern on skin or tissue of a patient. The marking device can include a body, such as a cap, that can removably attach over an end of a surgical marker. The body can include marking features, such as blades, optionally positioned at a longitudinal end of the body. The marking features can be pressed against the skin or tissue of the patient to form the visible temporary marks. The marking features can optionally be inked, optionally by the surgical marker, before the marks are formed. The marks can be different indentations or colorations.
In some examples, the marking features are generally conical blades having tips that are positioned in a same plane. The conical blades can extend from a generally planar surface. The marking features can be planar if the tissue surface they are marking is close to planar locally (i.e. most parts of the skin). An example pattern in the “T” for ultrasound and the line for the eye.
In some examples, the marking features are generally conical blades having tips that are positioned in different planes. The marking features on different planes can be used for marking distinctly curved surfaces like the eye.
In some examples, the blades have a same depth. In other examples, at least two of the blades have different depths. The varying depths and non-planar features can be for contouring to a curved surface.
In some examples, the marking features can be grouped in different sets to define the boundary of the resulting marks. By grouping into sets there can be fewer marks, but still define the necessary geometry of the mark. For instance, if a mark needs to be a line, there could be grouped sets at each end of the line that define the line
In some examples, the marking features can optionally be distributed between a first subset, positioned generally along a line, and a second subset, positioned asymmetrically with respect to the line. The subsets may optionally also create markings at the end points of a profile which collectively define the profile.
There can be a first subset of the marking features positioned generally along a line, and a second subset of the marking features positioned asymmetrically with respect to the line. In some examples, at least some of the first subset of the marking features are evenly spaced along the line.
In some examples, the first subset of the marking features are distributed between a third subset of the marking features and a fourth subset of the marking features. The third subset and the fourth subset can be separated by a gap sized to accommodate a cornea of a human eye. An optional inclinometer can attach to the body to allow alignment to a horizontal direction.
Filing Document | Filing Date | Country | Kind |
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PCT/CA2020/051039 | 7/29/2020 | WO |
Number | Date | Country | |
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62879985 | Jul 2019 | US |