Surgery – Instruments – Stereotaxic device
Reexamination Certificate
2000-02-22
2002-04-09
Truong, Kevin (Department: 3731)
Surgery
Instruments
Stereotaxic device
C600S429000
Reexamination Certificate
active
06368330
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to an apparatus and to instruments for frameless stereotactic surgery and computer aided surgery.
BACKGROUND OF THE INVENTION
Various type of apparatuses are known for precisely positioning and for orientating a surgical instrument with relation to a patient's skull. The instrument may be inserted into the brain down to a precise location for taking a biopsy or for recording an epileptic site by an electrode of for other similar surgical procedures.
In an article published in the Journal of Applied Neuro-Physiology, Volume 46, pages 272 to 275, (1983) and entitled “A new headclamp for stereotactic and intracranial procedures”, André Olivier, M.D. one of the present co-inventors and Gilles Bertrand, M.D. describe a semi-circular headclamp to be fixed to the patient'head for stereotactic and intracranial procedures. This headclamp, which is a part of the apparatus in accordance with the present invention, was then used in combination with the previously known Leksell stereotactic frame.
An advertising leaflet published in 1965 and entitled “Accessories for neurosurgery”, describes a headclamp made of two pivoted parts with three spring loaded pins to engage the patient's skull and secure the headclamp in position on the skull. This headclamp, made by American Sterilizer is designed for use with three basic neuro attachments more particularly illustrated in the document.
U.S. Pat. No. 4,465,069 dated Aug. 14, 1984, entitled “Cranial insertion of surgical needle utilizing computer-assisted tomography”, inventors: Jean-Yves Barbier and Christopher J. Moran describes a ring secured to the patient's head by rubber cushions and secured to the operating table by a ring mount. An instrument guide is adjustably supported by the ring.
U.S. Pat. No. 4,805,615 dated Feb. 21, 1989, entitled “Method and apparatus for performing stereotactic surgery”, inventor: Mark P. Carol, describes and illustrates a positioning fixture which is designed to be secured to the patient's skull by means of self-tapping screws. The positioning fixture carries a ball collet which can be secured in any selected orientated position by a set screw. The ball collet has a through bore for slidable insertion of a surgical instrument, such as a pin.
U.S. Pat. No. 4,955,891 dated Sep. 11, 1990, entitled “Method and apparatus for performing stereotactic surgery”, inventor: Mark P. Carol shows basically the same positioning device as in the previously noted U.S. Pat. No. 4,805,615.
U.S. Pat. No. 5,443,464 dated Aug. 22, 1995, entitled “External fixator apparatus”, co-inventors: Thomas A. Russell and Harry E. Lee Jr., describes an apparatus for stabilizing bone fractures which includes a double chuck with ball collets and retaining nuts, to receive two retaining pins. Each ball collet has slits and both the axial position and the orientation of a pin is locked by a single retaining nut.
U.S. Pat. No. 5,618,288 dated Apr. 8, 1997, entitled “Stereotactic system for surgical procedures”, inventor: Antonio M. Calvo, describes a frame which is secured to the patient's head by a plurality of fixing screws and which supports an arc-shaped member on which a slider is mounted to guide and hold a surgical instrument.
U.S. Pat. No. 5,649,936 dated Jul. 22, 1997, entitled “Stereotactic guide apparatus for use with neurosurgical headframe”, inventor: Douglas D. Real, describes another type of apparatus for guiding a surgical instrument with precision within the patient's skull.
U.S. Pat. No. 5,695,501 dated Dec. 9, 1997, entitled “Apparatus for neurosurgical stereotactic procedures”, co-inventors: Mark Carol, James L. Day, Erik G. Miller and Robert J. Riker, describes an apparatus for guiding a surgical instrument to a selected target within a patient's skull and along any selected path. The apparatus includes a positioning device similar to the one described in previous noted U.S. Pat. Nos. 4,805,615 and 4,955,891, and a headclamp to secure the patient's head with respect to the operating table or chair. An articulated arm is secured to the headframe and supports at its distal end a probe holder which has a ball and socket mechanism and an adjustment ball; probe holder may be maneuvered about a patient's head and selectively locked into position for path evaluation, surgical instrument guidance or attachment of the hemispheric system. However, this arrangement does not provide a positioning device which may position with great precision a surgical instrument with its tip at a desired target within the patient's brain.
OBJECTS OF THE INVENTION
The general object of the present invention is to provide a frameless stereotactic guiding system which has maximum accessibility to all the surface of the patient's skull.
Another object of the present invention is to provide a guiding apparatus of the character described which provides for skull penetration at two or more locations at the same time and with great precision, thanks to a computer assisting assembly.
Another object of the present invention is to provide an apparatus of the character described which is very easy to manipulate.
Another object of the present invention is to provide a chuck to hold a surgical instrument in a precise spatial position.
Another object of the present invention is to provide a chuck which is used as a guide for precise and safe skull penetration by a surgical instrument.
Another object of the present invention is to provide a double chuck which uses one chuck for holding a stabilizing pin while a surgical instrument is guided through the other chuck.
Another object of the present invention is to provide a chuck in which an instrument orientation is set by a first locking device and an instrument axial position is set by a second, independently actuated, locking device.
Another object of the present invention is to provide a double chuck to which a stabilizing stop pin can be secured in one chuck while guiding a drill through the other chuck.
SUMMARY OF THE INVENTION
The frameless stereotactic apparatus of the present invention comprises a rigid half circular headclamp, at least three fixation pins carried by said headclamp spaced from one another and extending inwardly thereof toward the center of the latter, said fixation pins for application to a patient's skull to secure said clamp on said skull in outwardly spaced position therefrom, a connector carried by one end of said clamp to firmly secure said clamp to a patient support surface, an articulated arm having a proximal end and a distal end, an attachment device carried by sad proximal end and securing said articulated arm to said headclamp, a double chuck device secured to the distal end of said articulated arm, said articulated arm including arm sections and clampable joints to secure said chuck in any spatial position close to said patient skull, said chuck including a body, a ball collet in said body, said ball collet capable of axially guiding an elongated surgical instrument, a first locking device to releasably lock said ball collet in a selected orientation and a second locking device to releasably lock said elongated instrument in a selected axial position, said first and second locking devices actuated independently of each other.
Preferably, said clamp has a plurality of spaced inwardly threaded through bores extending radially toward the center of said headclamp, said attachment device capable of being secured into any one of said through bores.
Preferably, said fixation pins have an externally threaded cylindrical body capable of being secured into any one of said through bores.
Preferably, said fixation pins include a spring loaded ratchet device to limit the pressure exerted by said pins on the patient's skull.
Preferably, said connector is a starburst connector.
The present invention is also directed to a stereotactic guide apparatus for use with a neurosurgical headclamp and comprising an articulated arm having a proximal and a distal end, an attachment device car
Hynes Brian
Olivier Andre
Hybex Surgical Specialties Inc.
Orange John R. S.
Orange & Chari
Truong Kevin
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