Low profile instrument immobilizer

• US 20050192594A1
• Filed: 12/06/2004
• Published: 09/01/2005
• Est. Priority Date: 09/17/2002
• Status: Active Grant

• Current Assignee: Image Guided Neurologics, Inc. (Medtronic Plc)
• Original Assignee: Image Guided Neurologics, Inc. (Medtronic Plc)
• Inventors: Skakoon, James G., Solar, Matthew S., Miller, Thomas I., Freas, Mark Stephen, Helmer, Patrick R.
• Granted Patent: US 7,704,260 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• 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 apparatus comprising:

a base hoop, sized and shaped to be disposed about a burr hole, the base hoop includes an upper surface and a lower surface, the base hoop defines an access passage extending between the upper surface and the lower surface of the base, the base hoop includes at least one slot opening on a side of the base hoop, and at least one hole sized and shaped to receive a fastener therethrough to secure the base hoop; and

at least one cover piece, sized and shaped to be inserted through the at least one slot opening to substantially cover the access passage in a closed position, and in the closed position the at least one cover piece is operable to retain at least one instrument.

2. The apparatus of claim 1, in which the at least one cover piece includes a beveled edge which defines a lateral groove when the at least one cover piece is in the closed position, the lateral groove is sized and shaped to retain a portion of the least one instrument.

3. The apparatus of claim 2, in which the base hoop includes at least one lateral exit groove aligned to the lateral groove.

4. The apparatus of claim 1, further comprising:

a second slot opening on an opposed side of the base hoop;

a second cover piece sized and shaped to be inserted through the second slot opening to substantially cover, in the closed position, the access passage together with the at least one cover piece, and in the closed position, the first cover piece and the second cover piece are operable to retain the at least one instrument.

5. The apparatus of claim 4, in which the at least one cover piece and the second cover piece include respective beveled edges together providing a lateral groove when the at least one cover piece and the second cover piece are in the closed position, the lateral groove is sized and shaped to retain a portion of the at least one instrument.

6. The apparatus of claim 1, in which the at least one cover piece includes a catch to secure the at least one cover piece in the closed position.

7. An apparatus comprising:

a base, sized and shaped to be disposed above a burr hole, the base includes a slot, a first portion of the slot extends between an upper surface and a lower surface of the base, and the base includes at least one hole sized and shaped to receive a fastener therethrough to secure the base; and

a latch, rotatably eccentrically coupled to the base above the slot, the latch movable between an open position allowing access to the first portion of the slot and a closed position wherein the latch is operable to retain at least one instrument within the first portion of the slot between the base and the latch.

8. The apparatus of claim 7, in which the base includes a tab at least partially overlying the slot for securing a portion of the at least one instrument within the slot.

9. The apparatus of claim 7, in which the latch is retained in the closed position by a detent extending from a lower surface of the latch and engaging the base.

10. An apparatus comprising:

a base, sized and shaped to be cantilevered over at least a portion of a burr hole, the base includes at least one hole sized and shaped to receive a fastener therethrough to secure a portion of the base, a second portion of the base includes a clasp moveably coupled to the base, the clasp is sized and shaped to operably retain at least one instrument extending into the burr hole; and

a lateral groove in the base, the lateral groove is aligned with the clasp to seat a portion of the at least one instrument retained by the clasp.

11. The apparatus of claim 12, further including at least one retaining member extending from the base, the at least one retaining member is cantilevered over the groove to retain the at least one instrument within the groove.

12. The apparatus of claim 10, in which the clasp includes a substantially semi-circular geometry between a first end and a second end, wherein the first end of the clasp is movably coupled to the base, and the second end of the clasp includes a snap-fitting sized and shaped to operably couple the second end to the base.

13. The apparatus of claim 12, further including a hinge coupling the clasp.

14. An apparatus comprising:

a first base piece and a second base piece, the first base piece and second base piece each include first and second ends, the first end of the first base piece and the first end of the second base piece include respective holes sized and shaped for receiving a fastener therethough for rotatable motion thereabout, the second end of the first base piece includes at least one coupler sized and shaped to engage an at least one corresponding coupler disposed on the second base piece, the first base piece is sized and shaped to be disposed along a first side of a burr hole and the second base piece is sized and shaped to be disposed along a second side of the burr hole such that the at least one coupler of the first base piece is operable to engage at least one coupler of the second base piece to retain at least one instrument extending between the first and second base pieces into the burr hole.

15. The apparatus of claim 14, in which at least one of the first and second base pieces includes a lateral exit groove sized and shaped to retain a portion of the at least one instrument within the groove.

16. The apparatus of claim 14, in which the first base piece and the second base piece rotate about parallel axes.

17. The apparatus of claim 14, in which the first base piece and second base piece rotate within substantially the same plane.

18. The apparatus of claim 14, in which the hole in the first end of the first base piece is disposed on an opposing side of the burr hole from the hole in the first end of the second base piece.

19. An apparatus comprising:

a base hoop, sized and shaped to be disposed about a burr hole, the base hoop including an upper surface and a lower surface, the base hoop defining an access passage between the upper surface and lower surface of the base, the base hoop including at least one hole sized and shaped for receiving a fastener therethrough to secure the hoop base; and

an insert, sized and shaped to be positioned within and to engage a surface defining the access passage of the base hoop, the insert includes a first retaining member slidably coupled to the insert and a second retaining member slidably coupled to the insert, and when in a closed position the first retaining member and second retaining member engage each other and are operable to retain at least one instrument therebetween.

20. The apparatus of claim 19, in which the first retaining member includes a beveled edge and the second retaining remember includes a beveled edge, the beveled edges together defining a lateral groove when the first retaining member and second retaining member are in the closed position, the lateral groove is sized and shaped to retain a portion of the instrument therein.

21. The apparatus of claim 20, in which the base hoop includes at least one lateral exit groove aligned to the lateral groove.

22. An apparatus comprising:

a base hoop, sized and shaped to be disposed about a burr hole, the base hoop including an upper surface and a lower surface, the base hoop includes an access passage, the access passage extends between the upper surface and lower surface of the base, the base hoop includes at least one hole sized and shaped for receiving a fastener therethrough to secure the base hoop; and

a lid coupled to the base hoop, the lid includes at least one slot, the slot extends through the lid and includes at least one socket, the socket is sized and shaped to retain at least one instrument.

23. The apparatus of claim 22, in which the socket extends substantially through the center of the lid.

24. The apparatus of claim 23, in which the slot extends from an outer edge of the lid and tapers inward toward the socket.

25. The apparatus of claim 22, in which the lid includes a lateral groove extending from the socket to an outer edge of the lid, the lateral groove is sized and shaped to retain a portion of the at least one instrument disposed therein.

26. The apparatus of claim 22, in which the lid further includes a second slot, the second slot extends through the lid and includes a second socket, the second socket is sized and shaped to retain another at least one instrument.

27. A method of immobilizing an instrument, comprising:

disposing an instrument within a passage of an instrument immobilizer base;

advancing a first cover piece and a second cover piece toward the instrument; and

engaging the first cover piece and the second cover piece against the instrument to immobilize the instrument therebetween.

28. The method of claim 27, further comprising:

sliding the first cover piece through a slot in the instrument immobilizer base; and

sliding the second cover piece through another slot in the instrument immobilizer base.

29. The method of claim 28, further including retaining a portion of the instrument within a groove defined by the first cover piece and the second cover piece.

30. A method for immobilizing an instrument, comprising:

disposing an instrument within a passage of an instrument immobilizer base;

rotating a latch including a notch toward the instrument; and

engaging the instrument against the latch to immobilize the instrument;

wherein the surface defining the notch engages the instrument.

31. The method of claim 30, further including retaining the latch against the instrument by engaging a portion of the latch to a mating portion of the instrument immobilizer base.

32. The method of claim 30, further including positioning a portion of the instrument laterally against the instrument immobilizer base, and tucking the portion of the instrument under an overlying retaining member that holds the portion of the instrument against the instrument immobilizer base.

33. A method for immobilizing an instrument, comprising:

cantilevering an instrument immobilizer base above a burr hole;

disposing an instrument near a side of the instrument immobilizer base;

advancing a clasp around the instrument by rotating the clasp about a first end of the clasp; and

engaging another end of the clasp with the instrument immobilizer base to immobilize the instrument.

34. The method of claim 33, further comprising:

positioning a portion of the instrument laterally against the instrument immobilizer base; and

tucking the instrument under a retaining member overlying the instrument and a groove.

35. The method of claim 33, in which the engaging another end of the clasp includes snap-fitting the clasp to the instrument immobilizer base.

36. A method for immobilizing an instrument within a lumen extending through a surface, comprising:

positioning an instrument between a first base piece and a second base piece;

rotatably advancing the first base piece toward the instrument, wherein the first base piece is rotatably coupled with the surface; and

engaging the first base piece and the second base piece against the instrument to immobilize the instrument therebetween.

37. The method of claim 36, further comprising rotatably advancing the second base piece toward the instrument, wherein the second base piece is rotatably coupled with the surface.

38. The method of claim 36, further comprising snapping the first base piece together with the second base piece.

39. The method of claim 36, further including positioning a portion of the instrument within a groove defined by one of the first base piece or second base piece.

40. A method of immobilizing an instrument, comprising:

disposing an instrument within a passage of an instrument immobilizer base;

advancing a first retaining member and a second retaining member toward the instrument; and

engaging the first retaining member and second retaining member against the instrument to immobilize the instrument.

41. The method of claim 40, further comprising coupling an insert with an instrument immobilizer base.

42. The method of claim 40, further including receiving a portion of the instrument within along edges of the first retaining member and the second retaining member.

43. A method of immobilizing an instrument, comprising:

disposing an instrument within a tapered slot of an instrument immobilizer base; and

moving the instrument along the tapered slot until the instrument is grasped by the tapered slot and immobilized.

44. The method of claim 43, further comprising:

disposing a second instrument within a second tapered slot of the instrument immobilizer base; and

moving the second instrument along the second tapered slot until the second instrument is grasped by the second tapered slot and immobilized.

45. The method of claim 43, further including receiving a portion of the instrument laterally along the instrument immobilizer base.

46. An apparatus comprising:

a seat, sized and shaped to be disposed within a burr hole, wherein at least a portion of the seat is deformable and operable to be press fit into the burr hole;

at least one bridge extending from the seat; and

a collar coupled to the bridge and at least partially disposed within a space defined by an inner surface of the seat, wherein the collar defines a socket sized and shaped to retain an instrument immobilizer.

47. The apparatus of claim 46, wherein an outer perimeter of the seat is substantially circular.

48. The apparatus of claim 47, wherein the collar is a substantially circular ring.

49. The apparatus of claim 47, wherein the bridge spans the distance between the inner surface of the seat and an outer perimeter of the collar.

50. The apparatus of claim 46, wherein the collar is disposed below the seat.

51. An apparatus comprising:

a seat, sized and shaped to be disposed within a burr hole, wherein an inner surface of the seat defines an access lumen;

a collar coupled to the seat, wherein the collar extends radially inward from the inner surface of the seat into the access lumen; and

an instrument immobilizer coupled to the collar, wherein the instrument immobilizer substantially covers the access lumen.

52. The apparatus of claim 51, wherein the instrument immobilizer is flush with an upper surface around the burr hole or below the upper surface.

53. The apparatus of claim 51, wherein a flange extends radially from the seat, and the flange is substantially adjacent to an end surface of the seat.

54. The apparatus of claim 53, wherein the flange extends around the seat.

55. The apparatus of claim 51, wherein the seat includes at least one snap fitting, and the instrument immobilizer is coupled to the collar with the at least one snap fitting.

56. The apparatus of claim 51, wherein the seat includes threading along an outer perimeter of the seat, and the threading is self tapping.

57. An apparatus comprising:

a seat, dimensioned and configured to be disposed within a burr hole, wherein at least a portion of the seat defines an access lumen;

an instrument immobilizer coupled to the seat; and

wherein at least one of the seat or instrument immobilizer includes at least one socket, and the other of the instrument immobilizer or seat includes at least one projection, and the socket is dimensioned and configured to snugly receive the at least one projection and engage the instrument immobilizer to the seat.

58. The apparatus of claim 57, wherein the at least one projection includes a snap fitting, and the snap fitting releasably couples the instrument immobilizer to the seat.

59. The apparatus of claim 57, wherein at least one face of the instrument immobilizer is engaged to an end surface of the seat.

60. The apparatus of claim 59, wherein the end surface of the seat has an outer perimeter substantially corresponding to the outer perimeter of the instrument immobilizer.

61. The apparatus of claim 57, wherein the seat includes threading along an outer perimeter of the seat, and the threading is self tapping.

62. A method of positioning an instrument immobilizer comprising:

coupling an instrument immobilizer to a collar of a seat, wherein an inner perimeter of the seat defines an access lumen and the collar extends radially inward into the access lumen, and the instrument immobilizer substantially covers the access lumen; and

disposing the seat within a burr hole, wherein the instrument immobilizer is flush with an upper surface around the burr hole or below the upper surface.

63. The method of claim 62, wherein coupling the instrument immobilizer to the collar of the seat includes snap fitting the instrument immobilizer to the collar.

64. The method of claim 62, wherein disposing the seat within a burr hole includes screwing the seat into the burr hole, and the outer perimeter of the seat includes threading.

65. The method of claim 62, wherein coupling the instrument immobilizer to the collar of the seat is performed after disposing the seat within the burr hole.

66. The method of claim 62, further comprising engaging a flange with an upper surface around the burr hole, wherein the flange extends radially from an outer perimeter of the seat.

67. A method of positioning an instrument immobilizer comprising:

coupling an instrument immobilizer to a seat, wherein the seat defines an access lumen;

disposing the seat within a burr hole, wherein the seat and the instrument immobilizer are flush with an upper surface around the burr hole or below the upper surface.

68. The method of claim 67, wherein coupling the instrument immobilizer to the seat includes snap fitting the instrument immobilizer to an end surface of the seat.

69. The method of claim 68, wherein coupling the instrument immobilizer to the seat includes disposing a post having a snap fitting within a socket dimensioned and configured to receive the snap fitting.

70. The method of claim 67, wherein disposing the seat within a burr hole includes screwing the seat into the burr hole, and the outer perimeter of the seat includes threading.

71. The method of claim 67, wherein coupling the instrument immobilizer to the seat is performed after disposing the seat within the burr hole.

72. The method of claim 67, wherein disposing the seat within the burr hole includes deforming the seat to fit within the burr hole and releasing the seat to expand and engage against a surface defining the burr hole.

73. The method of claim 72, wherein deforming the seat is performed without deforming the collar.

74. The method of claim 67, wherein disposing the seat within the burr hole includes coupling the seat to the surface defining the countersink.

75. The method of claim 67, wherein disposing the seat within the burr hole is performed prior to coupling the instrument immobilizer to the seat.

76. A method of positioning an instrument immobilizer comprising:

disposing the instrument immobilizer within a collar coupled to a seat by a bridge; and

coupling the seat to a surface defining a countersink.

77. The method of positioning the instrument immobilizer of claim 76, further comprising disposing an instrument within a passage of the instrument immobilizer

78. The method of positioning the instrument immobilizer of claim 77, further comprising:

advancing a first cover piece and a second cover piece toward the instrument; and

engaging the first cover piece and the second cover piece against the instrument to immobilize the instrument therebetween.

79. The method of positioning the instrument immobilizer of claim 76, wherein coupling the seat to the surface defining the countersink is performed prior to disposing the instrument immobilizer within the collar.

80. The method of positioning the instrument immobilizer of claim 76, further comprising cutting a countersink around the burr hole.