WO1998017191A1 - Support autobloquant se fixant en un point - Google Patents

Support autobloquant se fixant en un point Download PDF

Info

Publication number
WO1998017191A1
WO1998017191A1 PCT/CH1997/000386 CH9700386W WO9817191A1 WO 1998017191 A1 WO1998017191 A1 WO 1998017191A1 CH 9700386 W CH9700386 W CH 9700386W WO 9817191 A1 WO9817191 A1 WO 9817191A1
Authority
WO
WIPO (PCT)
Prior art keywords
piece
hole
locking
slats
insert
Prior art date
Application number
PCT/CH1997/000386
Other languages
German (de)
English (en)
Inventor
René BERNAYS
Adriano Viganò
Original Assignee
Magnetic Vision Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Magnetic Vision Gmbh filed Critical Magnetic Vision Gmbh
Priority to JP10518768A priority Critical patent/JP2000502279A/ja
Priority to IL12508497A priority patent/IL125084A0/xx
Priority to AU44493/97A priority patent/AU4449397A/en
Priority to EP97942749A priority patent/EP0884980A1/fr
Publication of WO1998017191A1 publication Critical patent/WO1998017191A1/fr
Priority to NO982899A priority patent/NO982899L/no

Links

Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
    • 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
    • A61B2090/103—Cranial plugs for access to brain
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body

Definitions

  • the invention relates to a holder according to the preamble of claim 1. This can be used in a wide variety of fields.
  • biopsies are generally performed as stereotactic interventions.
  • the biopsy path is defined based on the trepanation and target point chosen by the surgeon.
  • stereotaxy rings and target arcs were used (e.g. the Kelly System, Riechert & Mundinger, CRW, BRW; see also: “Neurosurgery”, RH Wilkins and SS Rengachary, 2nd edition 1996, volume m, pages 4067 f ⁇ where a good overview about the current state of the art). These require a multi-point fixation in the tabula externa of the skull cap (outer layer of the skull bone). This stereotaxi ring fixed in this way must be worn by the patient for several hours, which means a considerable burden for the patient. In addition, the surgical radius of action for the surgeon is limited by the stereotaxy system.
  • the invention solves tasks in the field of neurosurgery, for example, which arise from the further development of the magnetic resonance scanner or magnetic resonance device (MRI) to become an interventional magnetic resonance device (IMR).
  • IMR interventional magnetic resonance device
  • the IMR generates high-quality slice images of the body in real time and, as a technological innovation, allows interventions to be carried out on the patient while the image is being generated.
  • individual images generated before the intervention are used as the calculation basis for planning the operation. This method cannot take into account changes between the generation of the slice images and the intervention.
  • the fixed auxiliary reference system created and required by the conventional stereotaxic method is no longer required in the IMR since the patient is in the IMR with the reference system defined by the auxiliary device "Flashpoint System" (FPS) connected to the IMR during the entire procedure.
  • FPS Flashpoint System
  • the FPS is a two- or three-LED guide whose position in three-dimensional space is measured by three cameras.
  • the FPS allows the planning of an intervention by defining an axis, which is included in the image generated by the IMR and displayed on a monitor at the same time.
  • the virtual axis generated by the FPS is brought into line with the biopsy path.
  • the task now is to maintain the found biopsy axis by fixing the FPS in three-dimensional space.
  • the manufacturer of the FPS designed this for fixation on a gooseneck.
  • the goosenecks known to date do not allow reliable fixation.
  • the invention permits perfect fixation in three-dimensional space, since in the selected example it is fixed on the patient's skull. Furthermore, the invention takes up little space and reduces inconvenience and operational stress on the patient to a minimum.
  • FIG. 1-18 show an application example of the invention in the field of medicine.
  • An MR-compatible version for a biopsy in neurosurgery was chosen as an example. It shows: Fig. 1: Exploded view of the bracket.
  • Fig. 2 Assembled and inserted into the skull cap 7 holder with inserted biopsy needle 6.
  • Fig. 3 Explosion plan of the localizer.
  • Fig. 4 Locator assembled; with attached FPS 10.
  • Fig. 5 ram.
  • Fig. 6 Exploded view of the combination tool: Duralos and measuring device.
  • Fig. 7 Combination tool assembled.
  • Fig. 8 Exploded view of the locking sleeve remover.
  • Fig. 9 Locking sleeve remover assembled.
  • Fig. 10 Insert piece 4 and preload wheel 5 screwed together, before insertion in
  • Fig. 11 Insert 4 and preload wheel 5 inserted in skull cap 7.
  • Fig. 12 Locking sleeve 3 is inserted with the aid of the plunger 11.
  • Fig. 13 Fixing wheel 1 and guide sleeve 2 are inserted into the insert 4.
  • Fig. 14 The holder is assembled and ready for use in the skull cap
  • Fig. 15 Locking sleeve remover in a relaxed state before removing the
  • Fig. 16 Locking sleeve remover snapped into locking sleeve 3 but not yet locked.
  • Fig. 17 Locking sleeve remover locked by pressure on the head 15a.
  • 18 Removal of the locking sleeve 3.
  • the invention is based on the idea of inserting a self-locking holder into the borehole necessary for brain surgery.
  • the holder uses the shape of a cylindrical borehole to find a hold without having to rely on third fixing points.
  • the FPS 10 is placed on the target pin 9 of the locator (FIG. 4).
  • the locator is assembled as shown in FIG. 3.
  • the ball joint of the aiming pin 9b is guided through the upper la and lower 8c joint spans contained in the fixing wheel 1 and in the locating stand 8.
  • the swivel radius of the target pin 9 is limited by the conical inner surface of the fixing wheel 1 as the guide sleeve in the fixing wheel 1 is later limited.
  • the localizer is now held against the patient's head with the pedicles 8a and moved around until the target pin 9 or the axis calculated by the FPS point to the location to be operated.
  • the flexible pedicles 8a now make it possible to press the central marker 8b onto the scalp by pressing on the locator and thus to mark the location where drilling is to be carried out.
  • the drill and outer radius of the blades 4b are now selected to be the same size.
  • the meninges are detached from the inside of the skull cap 7 using the duraloser 12 (FIG. 6).
  • the thickness of the skull cap 7 (FIG. 7) can then be measured by means of the measurement scale 12a, which is attached to the duralosolator 12, and the optimum size of the insert 4 can thus be selected.
  • the flexible lamellae 4b are reduced to a smaller radius by the protruding hooks 4c compressed.
  • the flexible blades 4b spring back into their starting position, whereby the hooks 4c are pressed over the edge of the borehole (FIGS.
  • the locking sleeve 3 is then inserted into the insert 4 with the aid of the plunger 11 (FIG. 12). Due to its fit with the inner radius of the flexible slats 4c, the locking sleeve 3 prevents the slats from springing back again.
  • the skull cap 7 is clamped between the hook 4b and the preload wheel 5.
  • the preload wheel 5 allows different wall thicknesses of the cap 7 to be taken into account.
  • the locking sleeve 3 in turn is fixed in position by screwing on the fixing wheel 1.
  • Locking sleeve 3 and screwed on fixing wheel 1 form the upper la and lower 3 a integrated joint spans for the ball joint of the guide sleeve 2b.
  • the guide sleeve 2 can be pivoted through this joint 2b in a selectable radius. Cones are therefore recessed in the axis of the guide sleeve 2 in the fixing wheel 1 and the locking sleeve 3.
  • the guide sleeve 2 can be fixed in its position by turning the fixing wheel 1 (FIGS. 13, 14).
  • the biopsy needle 8 can now be inserted into the guide sleeve 2 and the sample removed (FIG. 14).
  • the fixing wheel 1 is unscrewed.
  • the locking sleeve 3 is then removed with the aid of the locking sleeve remover (FIGS. 8, 9) (FIGS. 15 to 18).
  • the pin of the locking sleeve remover 15 is pressed as far as the upper stop of the locking pin 15b in the pin lock 14c.
  • the locking sleeve remover can be inserted into the locking sleeve 3, since the expansion slats 14b can be pressed together (FIGS. 15, 16).
  • the expansion slats 14b are fixed in their position (FIGS.

Abstract

La partie d'insertion (4) du support selon l'invention présente des lamelles (4b) qui sont disposées, en fonction de la forme d'un trou, de façon telle qu'après introduction dans le trou, elles soient en liaison de forme et que les crochets (4c) viennent s'accrocher sur le bord du trou. La partie de blocage (3), qui est en liaison de force avec le côté intérieur des lamelles (4b), fixe les lamelles (4b) en position. Une sortie intempestive de la partie de blocage (3) est empêchée par la partie de fixation (1). Selon le mode de réalisation, une roue de prétention (5) peut augmenter le maintien et permettre l'adaptation à différentes épaisseurs de parois (7) et une douille de guidage (2) peut permettre un guidage précis d'instruments (6).
PCT/CH1997/000386 1996-10-23 1997-10-13 Support autobloquant se fixant en un point WO1998017191A1 (fr)

Priority Applications (5)

Application Number Priority Date Filing Date Title
JP10518768A JP2000502279A (ja) 1996-10-23 1997-10-13 一点固定式の自動ロック式保持方法
IL12508497A IL125084A0 (en) 1996-10-23 1997-10-13 Self-locking holding device with single-point fixation
AU44493/97A AU4449397A (en) 1996-10-23 1997-10-13 Self-locking holding device with single-point fixation
EP97942749A EP0884980A1 (fr) 1996-10-23 1997-10-13 Support autobloquant se fixant en un point
NO982899A NO982899L (no) 1996-10-23 1998-06-22 SelvlÕsende holdeanordning med enkelpunktsfastgj°ring

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH2587/96 1996-10-23
CH258796 1996-10-23

Publications (1)

Publication Number Publication Date
WO1998017191A1 true WO1998017191A1 (fr) 1998-04-30

Family

ID=4237144

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH1997/000386 WO1998017191A1 (fr) 1996-10-23 1997-10-13 Support autobloquant se fixant en un point

Country Status (7)

Country Link
EP (1) EP0884980A1 (fr)
JP (1) JP2000502279A (fr)
AU (1) AU4449397A (fr)
CA (1) CA2240456A1 (fr)
IL (1) IL125084A0 (fr)
NO (1) NO982899L (fr)
WO (1) WO1998017191A1 (fr)

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5993463A (en) * 1997-05-15 1999-11-30 Regents Of The University Of Minnesota Remote actuation of trajectory guide
EP1029509A1 (fr) 1999-02-19 2000-08-23 Magnetic Vision GmbH Appareil pour couper et aspirer des tissus
EP1326539A2 (fr) * 2000-10-11 2003-07-16 Popcab, LLC Instruments et systemes pour chirurgie de pontage de l'artere coronaire off-pump, a point d'acces
WO2003082071A2 (fr) * 2002-03-30 2003-10-09 Delia Schinkel-Fleitmann Dispositif de fixation d'un trocart, tuyau ou catheter
EP2174602A1 (fr) * 2008-10-07 2010-04-14 Neurendo B.V. Ensemble neurochirurgical minimalement invasif
EP2324790A1 (fr) 2009-11-19 2011-05-25 Neurendo B.V. Connecteur de tige pour l'accès du crâne
WO2012158254A3 (fr) * 2011-05-19 2013-01-10 Synthes Usa, Llc Boulon crânien articulé
ITMI20120663A1 (it) * 2012-04-20 2013-10-21 Promev S R L Dispositivo di supporto e guida di uno strumento chirurgico, in particolare per neurochirurgia
US8845656B2 (en) 2000-04-07 2014-09-30 Medtronic, Inc. Device for immobilizing a primary instrument and method therefor
WO2016178857A1 (fr) * 2015-05-01 2016-11-10 Musc Foundation For Research Development Système et procédé de positionnement et d'ancrage crânien
US9901713B2 (en) 2002-09-17 2018-02-27 Medtronic, Inc. Low profile instrument immobilizer
WO2018175280A1 (fr) * 2017-03-24 2018-09-27 Musc Foundation For Research Development Système d'ancrage et de positionnement crânien
US10086193B2 (en) 2004-02-13 2018-10-02 Medtronic, Inc. Apparatus for securing a therapy delivery device within a burr hole and method for making same

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* Cited by examiner, † Cited by third party
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US8961407B2 (en) * 2004-07-21 2015-02-24 Covidien Lp Surgical port assembly
CA2696791A1 (fr) * 2007-10-26 2009-04-30 Boston Scientific Neuromodulation Corporation Cheville de trou pratique a l'aide d'une fraise
US10631946B2 (en) * 2015-11-30 2020-04-28 Penumbra, Inc. System for endoscopic intracranial procedures
EP3442460B1 (fr) 2016-04-15 2021-05-26 Stryker European Holdings I, LLC Verrou de canule comprenant un frein qui tourne et des ancrages qui se déploient dans l'os contre lequel le verrou de canule est placé

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3017887A (en) * 1960-01-19 1962-01-23 William T Heyer Stereotaxy device
EP0207452A2 (fr) * 1985-07-02 1987-01-07 Mark P. Carol Méthode et appareil pour exécuter la chirurgie stéréotactique
US4809694A (en) * 1987-05-19 1989-03-07 Ferrara Vincent L Biopsy guide
US4998938A (en) * 1988-06-09 1991-03-12 Neurodynamics, Inc. Removable skull mounted work platform and method of assembling same
US5263956A (en) * 1992-03-04 1993-11-23 Neuro Navigational Corporation Ball joint for neurosurgery

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3017887A (en) * 1960-01-19 1962-01-23 William T Heyer Stereotaxy device
EP0207452A2 (fr) * 1985-07-02 1987-01-07 Mark P. Carol Méthode et appareil pour exécuter la chirurgie stéréotactique
US4809694A (en) * 1987-05-19 1989-03-07 Ferrara Vincent L Biopsy guide
US4998938A (en) * 1988-06-09 1991-03-12 Neurodynamics, Inc. Removable skull mounted work platform and method of assembling same
US5263956A (en) * 1992-03-04 1993-11-23 Neuro Navigational Corporation Ball joint for neurosurgery

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
"Das Kelly System", CRW, BRW, article RIECHERT&MUNDINGER
R.H. WILKINS UND S.S. RENGACHARY, NEUROSURGERY, vol. 2, no. III, 1996, pages 4067FF

Cited By (35)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6206890B1 (en) 1997-05-15 2001-03-27 Regents Of The University Of Minnesota Remote actuation of trajectory guide
US6267770B1 (en) 1997-05-15 2001-07-31 Regents Of The University Of Minnesota Remote actuation of trajectory guide
US6368329B1 (en) 1997-05-15 2002-04-09 Regents Of The University Of Minnesota Method of using trajectory guide
US5993463A (en) * 1997-05-15 1999-11-30 Regents Of The University Of Minnesota Remote actuation of trajectory guide
EP1029509A1 (fr) 1999-02-19 2000-08-23 Magnetic Vision GmbH Appareil pour couper et aspirer des tissus
US8845656B2 (en) 2000-04-07 2014-09-30 Medtronic, Inc. Device for immobilizing a primary instrument and method therefor
US10300268B2 (en) 2000-04-07 2019-05-28 Medtronic, Inc. Device for immobilizing a primary instrument and method therefor
US8911452B2 (en) 2000-04-07 2014-12-16 Medtronic, Inc. Device for immobilizing a primary instrument and method therefor
EP1326539A2 (fr) * 2000-10-11 2003-07-16 Popcab, LLC Instruments et systemes pour chirurgie de pontage de l'artere coronaire off-pump, a point d'acces
EP1326539A4 (fr) * 2000-10-11 2007-12-26 Medcanica Llc Instruments et systemes pour chirurgie de pontage de l'artere coronaire off-pump, a point d'acces
WO2003082071A2 (fr) * 2002-03-30 2003-10-09 Delia Schinkel-Fleitmann Dispositif de fixation d'un trocart, tuyau ou catheter
WO2003082071A3 (fr) * 2002-03-30 2004-03-11 Delia Schinkel-Fleitmann Dispositif de fixation d'un trocart, tuyau ou catheter
US10058681B2 (en) 2002-09-17 2018-08-28 Medtronic, Inc. Low profile instrument immobilizer
US9901713B2 (en) 2002-09-17 2018-02-27 Medtronic, Inc. Low profile instrument immobilizer
US10974029B2 (en) 2002-09-17 2021-04-13 Medtronic, Inc. Low profile instrument immobilizer
US11938312B2 (en) 2004-02-13 2024-03-26 Medtronic, Inc. Apparatus for securing a therapy delivery device within a burr hole and method for making same
US10086193B2 (en) 2004-02-13 2018-10-02 Medtronic, Inc. Apparatus for securing a therapy delivery device within a burr hole and method for making same
EP2537478A1 (fr) * 2008-10-07 2012-12-26 Neurendo B.V. Ensemble neurochirurgical minimalement invasif
US8690761B2 (en) * 2008-10-07 2014-04-08 Neurendo B.V. Minimal invasive neurosurgery assembly as well as a method for neurosurgery using such a neurosurgery assembly
US20100145142A1 (en) * 2008-10-07 2010-06-10 Neurendo B.V. Minimal invasive neurosurgery assembly as well as a method for neurosurgery using such a neurosurgery assembly
EP2174602A1 (fr) * 2008-10-07 2010-04-14 Neurendo B.V. Ensemble neurochirurgical minimalement invasif
EP2324790A1 (fr) 2009-11-19 2011-05-25 Neurendo B.V. Connecteur de tige pour l'accès du crâne
US8647331B2 (en) 2009-11-19 2014-02-11 Neurendo B.V Shaft connector
US10610207B2 (en) 2011-05-19 2020-04-07 DePuy Synthes Products, Inc. Articulating cranial bolt
US20140343563A1 (en) * 2011-05-19 2014-11-20 DePuy Synthes Products, LLC Articulating Cranial Bolt
US9226735B2 (en) 2011-05-19 2016-01-05 DePuy Synthes Products, Inc. Articulating cranial bolt
WO2012158254A3 (fr) * 2011-05-19 2013-01-10 Synthes Usa, Llc Boulon crânien articulé
ITMI20120663A1 (it) * 2012-04-20 2013-10-21 Promev S R L Dispositivo di supporto e guida di uno strumento chirurgico, in particolare per neurochirurgia
EP2653130A1 (fr) * 2012-04-20 2013-10-23 Promev S.r.l. Dispositif de support et de guidage pour instrument chirurgical, en particulier pour la neurochirurgie
WO2016178857A1 (fr) * 2015-05-01 2016-11-10 Musc Foundation For Research Development Système et procédé de positionnement et d'ancrage crânien
EP3656337A1 (fr) * 2015-05-01 2020-05-27 Musc Foundation for Research Development Système et procédé de positionnement et d'ancrage crânien
US10265136B2 (en) 2015-05-01 2019-04-23 Musc Foundation For Research Development Cranial anchoring and positioning system and method
US11147646B2 (en) 2015-05-01 2021-10-19 Musc Foundation For Research Development Cranial anchoring and positioning system and method
US11446111B2 (en) 2017-03-24 2022-09-20 Musc Foundation For Research Development Cranial anchoring and positioning system and method
WO2018175280A1 (fr) * 2017-03-24 2018-09-27 Musc Foundation For Research Development Système d'ancrage et de positionnement crânien

Also Published As

Publication number Publication date
AU4449397A (en) 1998-05-15
EP0884980A1 (fr) 1998-12-23
IL125084A0 (en) 1999-01-26
JP2000502279A (ja) 2000-02-29
NO982899D0 (no) 1998-06-22
CA2240456A1 (fr) 1998-04-30
NO982899L (no) 1998-06-23

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