Low profile instrument immobilizer

• US 10,058,681 B2
• Filed: 03/14/2013
• Issued: 08/28/2018
• Est. Priority Date: 09/17/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Skakoon, James G., Solar, Matthew S., Miller, Thomas I., Helmer, Patrick R., Freas, Mark S.
• Primary Examiner(s): YABUT, DIANE D
• Application Number:
  US13/828,136
• Publication Number:
  US 20130197472A1
• Time in Patent Office: 1,993 Days
• Field of Search: 606129, 606130, 604174, 604178, 607115, 607116
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/347 Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 5/6864 Burr holes
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61M 2025/024 having a clip or clamp system
• CPC Class Codes: A61M 25/02 Holding devices, e.g. on the body
• CPC Class Codes: A61N 1/0536 Preventing neurodegenerative response or inflammatory reaction
• CPC Class Codes: A61N 1/0539 Anchoring of brain electrode systems, e.g. within burr hole

Abstract

This document discusses, among other things, examples of a low profile instrument immobilizer and means for positioning the same. In one example, the low profile instrument immobilizer grasps, secures, and immobilizes an electrode or other instrument that extends through a burr hole in a skull to a target location in a patient'"'"'s brain.

Claims

1. An instrument immobilizer apparatus for immobilizing an instrument relative to a patient, comprising:

a base having an exterior wall defining a central passage, the base sized and shaped to be disposed about a burr hole of a patient; and

an insert configured to be disposed within the central passage, the insert defining an access opening through the insert and having a first retaining member with a first edge configured to engage the instrument and a second retaining member with a second edge, wherein the first edge and the second edge are configured to engage the instrument;

wherein the first and second retaining members maintain the first edge opposed to the second edge throughout their full range of movement relative to one another;

wherein the first and second retaining members are configured for holding therebetween the instrument extending through the central passage, the access opening, and into the burr hole;

wherein the insert is configured to be rotated when disposed within the central passage of the base;

wherein the first edge is a first beveled edge;

wherein the second edge is a second beveled edge.

2. The apparatus of claim 1, wherein the base defines a lateral exit groove separate and distinct from the insert;

wherein the instrument extends from the insert and through the exit groove that is sized and shaped to retain a portion of the instrument within the exit groove.

3. The apparatus of claim 2, wherein the base defines first and second holes on opposite sides of the central passage for fastening the base around the burr hole.

4. The apparatus of claim 1, wherein the insert is configured to be selectively coupled to the base with a groove and detent combination to prevent unwanted rotation of the insert relative to the base.

5. The apparatus of claim 1, wherein the insert has an insert wall separate from the base that defines the access opening;

wherein the first retaining member and the second retaining member move relative to the wall.

6. The apparatus of claim 5, wherein the first retaining member and the second retaining member are both movable toward and away from one another within the access opening and relative to the wall.

7. The apparatus of claim 6, wherein the access opening includes opposing side slide rails slidably carrying the first retaining member and the second retaining member.

8. The apparatus of claim 7, wherein the first retaining member and the second retaining member include mating couplings configured to hold the first retaining member and the second retaining member in engagement.

9. The apparatus of claim 8, wherein the mating couplings include snap-fit features.

10. The apparatus of claim 7, wherein at least one of the first retaining member and the second retaining member includes an engagement coupling configured to be secured to the insert, wherein the engagement coupling includes a one-way toothed surface substantially disposed on the slide rails.

11. The apparatus of claim 10, wherein the engagement coupling includes tabs disposed on a bottom surface of the at least one of the first retaining member and the second retaining member, the tabs configured to engage the toothed surface and allow sliding motion of the corresponding one of the first and second retaining members.

12. The apparatus of claim 1, wherein the first and second edges include opposed semicircular surfaces configured to engage the instrument.

13. The apparatus of claim 12, wherein the semi-circular surfaces are configured to form a circular opening when the first retaining member and the second retaining member are positioned adjacent to one another.

14. The apparatus of claim 1, further comprising a cap configured to be affixed to the instrument immobilizer.

15. The apparatus of claim 1,

wherein the first beveled edge and the second beveled edge are configured to directly engage the instrument.

16. The apparatus of claim 15, wherein the first beveled edge is configured to be positioned adjacent to the second beveled edge to form a lateral groove.

17. An instrument immobilizer apparatus for immobilizing an instrument relative to a patient, comprising:

a base having a wall defining a central passage, the base being sized and hoop-shaped to be disposed about a burr hole of the patient; and

an insert separate from and configured to be disposed within the central passage of the base, the insert having;

a wall that defines an access opening through the insert;

a first retaining member slidably positioned on the wall and within the access opening of the insert and having a first engagement face; and

a second retaining member slidably positioned on the wall and within the access opening of the insert and having a second engagement face directed toward the first engagement face;

wherein the first and second engagement faces are configured to be moved relative to another and the wall to engage and hold therebetween the instrument extending through the access opening of the insert and the central passage of the base;

wherein the first and second engagement faces have respective first and second beveled edges.

18. The apparatus of claim 17, wherein the first and second engagement faces include opposed semicircular surfaces configured to engage the instrument.

19. The apparatus of claim 17, wherein the insert is configured to rotate relative to the base prior to the insert being selectively engaged to the base with a groove and detent combination to prevent unwanted rotation of the insert relative to the base.

20. The apparatus of claim 17, wherein the base defines a lateral exit groove sized and shaped to retain a portion of the instrument within the groove.

21. The apparatus of claim 20, wherein the base defines first and second holes on opposite sides of the central passage for fastening the base around the burr hole.

22. The apparatus of claim 17, wherein the first and second retaining members are movable toward and away from one another within the access opening while the first and second engagement faces are directed toward one another.

23. The apparatus of claim 17, further comprising a cap configured to be affixed to the instrument immobilizer.

24. The apparatus of claim 17, wherein the insert is configured to be selectively rotatably positioned within the central passage of the base.

25. The apparatus of claim 17, wherein the insert is configured to be inserted into the central passage of the base and the insert has the access opening formed at least by sides within the insert that allow the first retaining member and the second retaining member to slide within the access opening.

26. The apparatus of claim 17, wherein the first and second retaining members are movable toward and away from one another within the access opening while the first and second engagement faces are directed toward one another;

wherein the first and second engagement faces are moveable relative to one another;

wherein a lateral groove is formed when the first and second beveled edges are adjacent one another.

27. An instrument immobilizer apparatus for immobilizing an instrument relative to a patient, comprising:

a hoop-shaped base having a wall defining a central passage and a grooved surface disposed upon an intermediate surface therein, the hoop-shaped base sized and shaped to be disposed about a cranial burr hole of the patient; and

an insert rotatably received within the central passage, the insert having;

a body having an insert wall defining an access opening;

at least one detent disposed about an insert surface and projecting to a side of the body; and

a first retaining member and a second retaining member, the first and second retaining members slidable toward and away from one another within the body defining the access opening and relative to the insert wall, the first retaining member having a first engagement face with a first semicircular surface defined in the first engagement face, the second retaining member having a second engagement face with a second semicircular surface defined in the second engagement face, wherein the first and second engagement faces are configured for holding therebetween at the first and second semicircular surfaces the instrument extending through the central passage into the burr hole;

wherein the at least one detent is configured to engage the grooved surface;

wherein the first and second engagement faces have respective first and second beveled edges.

28. The apparatus of claim 27, wherein the first and second retaining members include mating couplings configured to hold the first and second retaining members in engagement.

29. The apparatus of claim 27, wherein the insert is configured to be selectively engaged to the hoop-shaped base with the at least one detent and the grooved surface combination to prevent unwanted rotation of the insert relative to the hoop-shaped base when rotatably received within the central passage.

30. The apparatus of claim 27, wherein the hoop-shaped base defines a lateral exit groove sized and shaped to retain a portion of the instrument within the groove and defines first and second holes on opposite sides of the central passage for fastening the hoop-shaped base around the burr hole.

31. A method of securing a medical instrument on a patient comprising:

mounting a hoop-shaped base around a cranial burr hole at least by passing a fastener through an outer passage, wherein the hoop-shaped base is configured such that a portion of the medical instrument may extend through a central passage of the hoop-shaped base;

moving an insert having an insert wall separate from the hoop-shaped base toward the central passage, the insert further having a first retaining member with a first engagement face and a second retaining member with a second engagement face, wherein the first engagement face is maintained opposed to the second engagement face throughout movement of the first engagement face and the second engagement face;

mounting the insert within the central passage; and

moving the first retaining member and second retaining member toward one another and relative to the insert wall to secure the medical instrument through an access opening of the insert;

wherein moving the first and second retaining members toward one another includes sliding at least one of the first or second retaining members relative to the insert wall towards the other of the first or second retaining member;

wherein the first and second engagement faces have respective first and second beveled edges.

32. The method of claim 31, wherein moving the first and second retaining members towards one another further includes moving the first engagement face of the first retaining member toward the second engagement face of the second retaining member, where the first and second engagement faces are directed toward one another throughout movement of the first and second retaining members.

33. The method of claim 32, further comprising capturing the medical instrument between at least a pair of opposed semicircular surfaces in the first and second engagement faces.

34. The method of claim 31, wherein moving the first and second retaining members toward one another includes sliding both of the first and second retaining members toward one another along the insert wall.

35. The method of claim 31, wherein prior to mounting the insert within the central passage, selectively rotatably positioning the insert within the central passage of the hoop-shaped base.

36. The method of claim 31, wherein mounting the insert within the central passage includes snapping the insert within the central passage of the hoop-shaped base.

37. The method of claim 31, wherein moving the first and second retaining members toward one another includes forming a lateral groove by moving the first and second retaining members adjacent one another.