US3053256A - Pallidectomy needle holders - Google Patents

Pallidectomy needle holders Download PDF

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Publication number
US3053256A
US3053256A US575832A US57583256A US3053256A US 3053256 A US3053256 A US 3053256A US 575832 A US575832 A US 575832A US 57583256 A US57583256 A US 57583256A US 3053256 A US3053256 A US 3053256A
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needle
pallidectomy
holder
frame
scalp
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US575832A
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Irving S Cooper
Arnold S J Lee
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HOME FOR INCURABLES
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints

Definitions

  • This invention relates to a pallidectomy needle holder Ifatgrdirecting a needle or cannula to a specific part of the
  • the operation of chemopallidectomy has been found effective in the treatment and cure of Parkinsons disease.
  • the operation consists in the destruction of a small portion of the brain known as the mesial globus pallidus.
  • pneumoencephalography Before the operation is performed, pneumoencephalography, with the use of sufficient air to fill and visualize radiographically the lateral and third ventricles, is used to locate the globus pallidus in the patient under treatment, and a line passing directly through the globus is indicated by marks made on the scalp and face. At the lower mark which lies below one of the temples, an incision is made and a trephine opening is made in the skull. It is then necessary to direct the needle passed through this opening towards the mark which has been made in the opposite side of the scalp and to check this direction radiographically.
  • the specific purpose of the present invention is to provide a device for facilitating t 's.
  • FIG. 1 is a front elevation of the holder applied to a skull and showing the needle partially inserted into the brain;
  • FIG. 2 is a right-hand side elevation of the device shown in FIG. 1 indicating the position of the skull and the trephine opening therein;
  • FIG. 3 is a top view of the device shown in FIGS. 1 and 2;
  • FIG. 4 is an enlarged detail side elevation of the needle guide shown in FIG. 1;
  • FIGS. 5 and 6 are sections on the lines 5-5 and 66 of FIG. 4;
  • FIG. 7 is a perspective view of a modified needle holder
  • FIG. 8 is a vertical section on the plane 8-8 of FIG. 7;
  • FIG. 9 is a top view of a modified adjustable needle guide for use in the needle holder of FIG. 1.
  • the needle holder of FIGS. 1 to 6 has a light open and rigid frame 10 adapted to surround a part of the head and lie at some distance from it.
  • the frame 10 is most desirably made of aluminum.
  • the needle guide 12 Secured to a lower bar 11 of the frame 10 is the needle guide 12.
  • This consists of a metal block secured at a flattened face on the bar 11 by a screw 13, and having in its top a groove or channel 14 for guiding the needle or cannula 15'.
  • a removable T-shaped cover 16 holds the needle 15 in the groove 14.
  • Two pins 17 secured to the cover 16 pass through bores in the block 12 in which they may be locked by a releasable hand screw 18 in conjunction with a plug 19 which is engaged by the end of screw 18 and forced against pins 17.
  • the needle holder In order that the needle holder may be mounted securely on the head, it is provided with at least three inwardly extending scalp-engaging means which are shown as pointed screws '20, 21, 22.
  • the screw 20 serves not only as an attachment means but also as a means for indicating the line passing through the globus. It extends inwardly from the frame 10 directly in line with the groove 14 of the needle guide 12.
  • the screws 21 and 3,053,256 Patented Sept. 11, 1962 22 extend in general oppositely to the direction of the screw 20 and are placed at some distance from the needle guide 12 so as to be well clear of the incision.
  • the holder is placed about the patients head with the point of the screw 20 engaging the mark on the scalp which is made during the pneumoencephalography.
  • the holder is then swung about the point of the screw 20 until the needle in the guide 12 is directed toward the trephine opening.
  • the holder is then secured in this position by screwing the screws 21 and 22 firmly in the scalp.
  • the position of the line between the needle and the screw 20 is checked roentgenographically, and another such check is most desirably made after partial insertion of the cannula.
  • the needle holder of FIGS. 7 and 8 differs from that previously described in that it has two light rigid frames 10a and 10'! which are connected at a hinge pivot 25.
  • this pivot 25 rather than one of the fastening screws, lies on the line on which the needle is guided.
  • the needle guide 12 is mounted so that the needle 15 in its groove 14 is pointed directly at the hinge pivot 25.
  • the frame is placed about the head with the hinge pivot 25 on the mark which had been made on the scalp.
  • the frame 10a is then secured on the head by screwing the four fastening screws 26, 27, 28, 2'9 firmly into the scalp.
  • the frame 10b may be swung about the pivot 25 by means of vertical and horizontal adjusting screws 30, 31 in order to direct the needle in the guide 12 into the trephine opening along the proper line.
  • This device has an advantage over the simpler device of FIG. 1 in that it permits minor adjustment of the needle position without loosening the fasteners from the scalp.
  • the device shown in FIG. 1 may be modified by giving the needle guide 12 a universal mounting on the bar 11 of the frame as shown in FIG. 9. This is readily done by providing bar 11 with ends 35, 35 of reduced diameter that telescope within the hollow frame 10' to permit the bar 11', and its block 12, to be rotated about a horizontal axis.
  • the bar can be held in selected position on its horizontal axis by lock screws 36, 36.
  • the block 12 is supported on the bar 11' for movement about the vertical axis indicated by dotted lines at 37.
  • the universal mounting is graduated as shown so that slight but accurate adjustments may be made in the direction of the needle in accordance with the indications of the roentgenograms taken after the needle holder has been secured on the head.
  • the needle 15 may be freed from the guide 12. After this has been done, the frame may be removed after loosening the holding screws, while leaving the cannula in position. This is important, as in this operation it is sometimes necessary to allow the needle or cannula to remain in the brain for several days after the operation so that additional injections may be made.
  • a pallidectomy needle holder comprising a light rigid frame, scalp-engaging means for securely mounting said frame about the head, a block on said frame containing an elongated needle guiding groove, and an easily detachable cover having a tongue adapted to enter said groove for holding a needle in said groove.
  • a pallidectomy needle holder comprising two light rigid frames, a pivotal connection between said frames, scalp-engaging means for mounting one of said frames about the head, a needle guide on the other of said frames directed towards said pivot, and adjusting screws connected with both of the frames for relative adjustment of said frames about the pivot.
  • a pallidectomy needle holder comprising a light rigid frame, scalp-engaging means for mounting said frame firmly about the head, a block spaced from said scalpengaging means and mounted on said frame for universal adjustment with respect to said frame, and a needle guiding groove in said block.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Description

P 1962 I. s. COOPER ETAL 3,053,255
PALLIDECTOMY NEEDLE HOLDERS Filed April 3, 1956 3 Sheets-Sheet 1 YIIIIIIIIIIIIIIIIIII/I-W INVENTORS hum/4 61 Ibo/=54? 169M010 63 1' 55 P 1962 l. s. COOPER ETAL 3,053,256
PALLIDECTOMY NEEDLE HOLDERS s Sheets-Sheet 2 Filed April 3; 1956 INVENTORs hum 4 6f Coo/=55 BY film 040 .5. I 156 a P 1962 l. s. COOPER ETAL 3,053,256
PALLIDECTOMY NEEDLE HOLDERS 3 Sheets-Sheet 3 Filed April 3, 1956 INVENTORS /?l//VG .51 600/ 51? rfiswaza 6.212515 wz awmm United States Patent G 3,053,256 PALLIDECTOMY NEEDLE HOLDERS Irving S. Cooper, Bronxville, N.Y., and Arnold S. J. Lee, Wall TOWllSl'llP, Monmouth County, N.J., assignors to Home For Incurables, New York, N.Y., a membership corporation of New York Filed Apr. 3, 1956, Ser. No. 575,832 3 Claims. (Cl. 128-303) This invention relates to a pallidectomy needle holder Ifatgrdirecting a needle or cannula to a specific part of the The operation of chemopallidectomy has been found effective in the treatment and cure of Parkinsons disease. The operation consists in the destruction of a small portion of the brain known as the mesial globus pallidus.
Before the operation is performed, pneumoencephalography, with the use of sufficient air to fill and visualize radiographically the lateral and third ventricles, is used to locate the globus pallidus in the patient under treatment, and a line passing directly through the globus is indicated by marks made on the scalp and face. At the lower mark which lies below one of the temples, an incision is made and a trephine opening is made in the skull. It is then necessary to direct the needle passed through this opening towards the mark which has been made in the opposite side of the scalp and to check this direction radiographically. The specific purpose of the present invention is to provide a device for facilitating t 's.
In order that the invention may be clearly understood, We will describe the needle holder shown in the accompanying drawings in which:
FIG. 1 is a front elevation of the holder applied to a skull and showing the needle partially inserted into the brain;
FIG. 2 is a right-hand side elevation of the device shown in FIG. 1 indicating the position of the skull and the trephine opening therein;
FIG. 3 is a top view of the device shown in FIGS. 1 and 2;
FIG. 4 is an enlarged detail side elevation of the needle guide shown in FIG. 1;
FIGS. 5 and 6 are sections on the lines 5-5 and 66 of FIG. 4;
FIG. 7 is a perspective view of a modified needle holder;
FIG. 8 is a vertical section on the plane 8-8 of FIG. 7; and
FIG. 9 is a top view of a modified adjustable needle guide for use in the needle holder of FIG. 1.
The needle holder of FIGS. 1 to 6 has a light open and rigid frame 10 adapted to surround a part of the head and lie at some distance from it. The frame 10 is most desirably made of aluminum.
Secured to a lower bar 11 of the frame 10 is the needle guide 12. This consists of a metal block secured at a flattened face on the bar 11 by a screw 13, and having in its top a groove or channel 14 for guiding the needle or cannula 15'. A removable T-shaped cover 16 holds the needle 15 in the groove 14. Two pins 17 secured to the cover 16 pass through bores in the block 12 in which they may be locked by a releasable hand screw 18 in conjunction with a plug 19 which is engaged by the end of screw 18 and forced against pins 17.
In order that the needle holder may be mounted securely on the head, it is provided with at least three inwardly extending scalp-engaging means which are shown as pointed screws '20, 21, 22. The screw 20 serves not only as an attachment means but also as a means for indicating the line passing through the globus. It extends inwardly from the frame 10 directly in line with the groove 14 of the needle guide 12. The screws 21 and 3,053,256 Patented Sept. 11, 1962 22 extend in general oppositely to the direction of the screw 20 and are placed at some distance from the needle guide 12 so as to be well clear of the incision.
The manner in which the needle holder of FIGS. 1 to 6 is used is as follows:
The holder is placed about the patients head with the point of the screw 20 engaging the mark on the scalp which is made during the pneumoencephalography. The holder is then swung about the point of the screw 20 until the needle in the guide 12 is directed toward the trephine opening. The holder is then secured in this position by screwing the screws 21 and 22 firmly in the scalp. After the holder has been mounted on the head, the position of the line between the needle and the screw 20 is checked roentgenographically, and another such check is most desirably made after partial insertion of the cannula.
If these checks fail to show the line of the needle in correct position with respect to the ventricles shown in the roentgenogr-ams, the attachment of the needle holder to the head is released by loosening the screws and its position is readjusted.
The needle holder of FIGS. 7 and 8 differs from that previously described in that it has two light rigid frames 10a and 10'!) which are connected at a hinge pivot 25. In this form of holder, this pivot 25, rather than one of the fastening screws, lies on the line on which the needle is guided. In this case, the needle guide 12 is mounted so that the needle 15 in its groove 14 is pointed directly at the hinge pivot 25.
In using the holder of FIGS. 7 and 8, the frame is placed about the head with the hinge pivot 25 on the mark which had been made on the scalp. The frame 10a is then secured on the head by screwing the four fastening screws 26, 27, 28, 2'9 firmly into the scalp. After this has been done, the frame 10b may be swung about the pivot 25 by means of vertical and horizontal adjusting screws 30, 31 in order to direct the needle in the guide 12 into the trephine opening along the proper line.
This device has an advantage over the simpler device of FIG. 1 in that it permits minor adjustment of the needle position without loosening the fasteners from the scalp.
The device shown in FIG. 1 may be modified by giving the needle guide 12 a universal mounting on the bar 11 of the frame as shown in FIG. 9. This is readily done by providing bar 11 with ends 35, 35 of reduced diameter that telescope within the hollow frame 10' to permit the bar 11', and its block 12, to be rotated about a horizontal axis. The bar can be held in selected position on its horizontal axis by lock screws 36, 36. The block 12 is supported on the bar 11' for movement about the vertical axis indicated by dotted lines at 37. The universal mounting is graduated as shown so that slight but accurate adjustments may be made in the direction of the needle in accordance with the indications of the roentgenograms taken after the needle holder has been secured on the head.
By loosening the hand screw 18 and removing the cover 16, the needle 15 may be freed from the guide 12. After this has been done, the frame may be removed after loosening the holding screws, while leaving the cannula in position. This is important, as in this operation it is sometimes necessary to allow the needle or cannula to remain in the brain for several days after the operation so that additional injections may be made.
What is claimed is:
l. A pallidectomy needle holder comprising a light rigid frame, scalp-engaging means for securely mounting said frame about the head, a block on said frame containing an elongated needle guiding groove, and an easily detachable cover having a tongue adapted to enter said groove for holding a needle in said groove.
2. A pallidectomy needle holder comprising two light rigid frames, a pivotal connection between said frames, scalp-engaging means for mounting one of said frames about the head, a needle guide on the other of said frames directed towards said pivot, and adjusting screws connected with both of the frames for relative adjustment of said frames about the pivot.
3. A pallidectomy needle holder comprising a light rigid frame, scalp-engaging means for mounting said frame firmly about the head, a block spaced from said scalpengaging means and mounted on said frame for universal adjustment with respect to said frame, and a needle guiding groove in said block.
References Cited in the file of this patent UNITED STATES PATENTS Mylius July 27, Landmeier Dec. 9, Ulett et al. Sept. 2, Pincock Jan. 13, Bloom Jan. 17, Stephens Jan. 2,
FOREIGN PATENTS Germany Mar. 9, Germany Jan. 4,
US575832A 1956-04-03 1956-04-03 Pallidectomy needle holders Expired - Lifetime US3053256A (en)

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Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3135263A (en) * 1960-10-05 1964-06-02 Smiths America Corp Surgical instrument positioning device
US3196875A (en) * 1962-12-10 1965-07-27 Pfeiffer Andrew Manipulating device
US3223087A (en) * 1960-06-18 1965-12-14 Chirana Praha Np Stereotaxic device
US3336922A (en) * 1965-01-14 1967-08-22 Marvin T Taylor Adjustable immobilization device
US3674032A (en) * 1969-04-17 1972-07-04 Ernesto Minganti Device for anchoring new-born babies umbilical cords until atrophy thereof
US3955558A (en) * 1974-11-04 1976-05-11 Medcom, Inc. Instrument for spinal taps
US4815467A (en) * 1987-03-13 1989-03-28 Chestnut William J Acromioplasty guide pins
US4834089A (en) * 1985-02-12 1989-05-30 Koivukangas John P Adapter for brain surgery
US5112340A (en) * 1989-11-10 1992-05-12 Christian Krenkel Fixation device with frame members and pins
US5122132A (en) * 1991-08-01 1992-06-16 Bremer Medical, Inc. Skull pin with enhanced shear resistance
US5300080A (en) * 1991-11-01 1994-04-05 David Clayman Stereotactic instrument guided placement
US5330485A (en) * 1991-11-01 1994-07-19 Clayman David A Cerebral instrument guide frame and procedures utilizing it
US5569267A (en) * 1994-03-04 1996-10-29 University Of Washington Device and methods for parieto-occipital placement of ventricular catheters
US6007549A (en) * 1997-06-13 1999-12-28 The University Of Iowa Research Foundation Posterior burr hole localizer
FR2782631A1 (en) * 1998-08-25 2000-03-03 Patrick Metais Human brain cell sampling point positioner for post mortem diagnosis of Alzheimer's disease has variable-angle positioning and guide rods
US20110077695A1 (en) * 2003-10-03 2011-03-31 Smith & Nephew, Inc. Surgical positioners

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2088481A (en) * 1936-05-21 1937-07-27 Westinghouse Electric & Mfg Co Terminal clamp
US2265911A (en) * 1939-08-18 1941-12-09 Wadsworth Electric Mfg Co Solderless wire connector
US2426958A (en) * 1944-12-27 1947-09-02 Jr George A Ulett Electrode holder for use in electroencephalography
US2434431A (en) * 1944-09-16 1948-01-13 Jack R Pava Surgical pin guide
US2494792A (en) * 1947-03-03 1950-01-17 Frederick A Bloom Skull clamp
US2536963A (en) * 1948-10-14 1951-01-02 Guidoscope Corp Pin guide and securing means for surgical nail and pin directing apparatus
DE869842C (en) * 1951-12-14 1953-03-09 Werner Dr Boehlke Facility for treating localized areas of the brain
DE900743C (en) * 1950-02-17 1954-01-04 Dr Med Friedrich Menken Device for setting up bone fractures

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2088481A (en) * 1936-05-21 1937-07-27 Westinghouse Electric & Mfg Co Terminal clamp
US2265911A (en) * 1939-08-18 1941-12-09 Wadsworth Electric Mfg Co Solderless wire connector
US2434431A (en) * 1944-09-16 1948-01-13 Jack R Pava Surgical pin guide
US2426958A (en) * 1944-12-27 1947-09-02 Jr George A Ulett Electrode holder for use in electroencephalography
US2494792A (en) * 1947-03-03 1950-01-17 Frederick A Bloom Skull clamp
US2536963A (en) * 1948-10-14 1951-01-02 Guidoscope Corp Pin guide and securing means for surgical nail and pin directing apparatus
DE900743C (en) * 1950-02-17 1954-01-04 Dr Med Friedrich Menken Device for setting up bone fractures
DE869842C (en) * 1951-12-14 1953-03-09 Werner Dr Boehlke Facility for treating localized areas of the brain

Cited By (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3223087A (en) * 1960-06-18 1965-12-14 Chirana Praha Np Stereotaxic device
US3135263A (en) * 1960-10-05 1964-06-02 Smiths America Corp Surgical instrument positioning device
US3196875A (en) * 1962-12-10 1965-07-27 Pfeiffer Andrew Manipulating device
US3336922A (en) * 1965-01-14 1967-08-22 Marvin T Taylor Adjustable immobilization device
US3674032A (en) * 1969-04-17 1972-07-04 Ernesto Minganti Device for anchoring new-born babies umbilical cords until atrophy thereof
US3955558A (en) * 1974-11-04 1976-05-11 Medcom, Inc. Instrument for spinal taps
US4834089A (en) * 1985-02-12 1989-05-30 Koivukangas John P Adapter for brain surgery
US4815467A (en) * 1987-03-13 1989-03-28 Chestnut William J Acromioplasty guide pins
US5112340A (en) * 1989-11-10 1992-05-12 Christian Krenkel Fixation device with frame members and pins
US5122132A (en) * 1991-08-01 1992-06-16 Bremer Medical, Inc. Skull pin with enhanced shear resistance
US5300080A (en) * 1991-11-01 1994-04-05 David Clayman Stereotactic instrument guided placement
US5330485A (en) * 1991-11-01 1994-07-19 Clayman David A Cerebral instrument guide frame and procedures utilizing it
US5474564A (en) * 1991-11-01 1995-12-12 Clayman; David A. Method of utilizing a cerebral instrument guide frame
US5569267A (en) * 1994-03-04 1996-10-29 University Of Washington Device and methods for parieto-occipital placement of ventricular catheters
US6007549A (en) * 1997-06-13 1999-12-28 The University Of Iowa Research Foundation Posterior burr hole localizer
FR2782631A1 (en) * 1998-08-25 2000-03-03 Patrick Metais Human brain cell sampling point positioner for post mortem diagnosis of Alzheimer's disease has variable-angle positioning and guide rods
US20110077695A1 (en) * 2003-10-03 2011-03-31 Smith & Nephew, Inc. Surgical positioners
US8491597B2 (en) * 2003-10-03 2013-07-23 Smith & Nephew, Inc. (partial interest) Surgical positioners

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