Surgical device guide for use with an imaging system

• US 20060089626A1
• Filed: 10/22/2004
• Published: 04/27/2006
• Est. Priority Date: 10/22/2004
• Status: Abandoned Application

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Cilag Gmbh International (Johnson & Johnson)
• Inventors: Gill, Robert Perrin, Vlegele, James W.
• Application Number:
  US10/971,668
• Publication Number:
  US 20060089626A1
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/3494 with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors for the peridural space A61B17/3401
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/397 electromagnetic other than visible, e.g. microwave
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A device and method useful for guiding insertion of a surgical device with image guided surgery. The device includes a base that may be connected to a fixation device to hold the device in place, and a guide for the surgical device. The guide is connected to the base by a semispherical ball joint, which allows the trajectory of the guide to be adjusted. The device includes an adjustable depth stop that controls the distance the surgical device is inserted into the patient. A positional indicator is attached to the depth stop. An insertion indicator signals when the depth stop is set so as to limit the insertion distance to that necessary to treat the target tissue within the patient.

Claims

1. A device for controlling the insertion of a surgical device into the body of a patient comprising:

a base having an aperture therein, the aperture having an annular surface;

a guide for the surgical device having an aperture engaging end, the aperture engaging end being outwardly flared; and

a curved outer surface at the aperture engaging end that is compatible with the annular surface of the aperture.

2. The device of claim 1, wherein the aperture engaging end terminates in a bottom surface and having a center of rotation located approximately on the bottom surface.

3. The device of claim 1, wherein the curved outer surface is semispherical.

4. The device of claim 1, wherein the device further includes a positional lock for fixing the position of the device with respect to the body.

5. The device of claim 4, wherein the device further includes a trajectory lock for fixing the trajectory of the device with respect to the body.

6. The device of claim 1, wherein the device further includes a positional indicator.

7. The device of claim 6, further including:

an adjustable stop for limiting the distance the surgical device can be inserted into the body;

a first fixture for the positional indicator associated with the guide; and

a second fixture for the positional indicator operatively associated with the stop, wherein by determining the position of the positional indicator in the first and second fixtures, the stop can be set so that the surgical instrument can be inserted a limited distance into the body.

8. The device of claim 7, further including an insertion indicator, such that the insertion indicator signals when the adjustable stop is set so as to limit the distance the surgical device can be inserted into the body to a desired distance.

9. The device of claim 8, wherein the insertion indicator displays the limited distance the surgical device may be inserted into the body.

10. The device of claim 1, further including a holder connected to the base.

11. The device of claim 10, wherein the holder includes a sliding disk;

12. The device of claim of 11, further including a disk lock for fixing the position of the sliding disk.

13. The device of claim 10, wherein the base is connected to the holder by a hinge joint.

14. The device of claim 10, wherein the holder includes an adhesive, such that the holder is affixed to a patient.

15. The device of claim 10, wherein the holder includes a guide for an incision making device.

16. The device of claim 13, further including a skin nick guide, the skin nick guide having an arm pivotably mounted on the base, the arm having at least one slot, such that the slot functions as a guide for an incision making device.

17. The device of claim 1, further including an insert which may be seated in the guide and which is adapted to receive a surgical device.

18. The device of claim 6, wherein the positional indicator is a magnetic sensor.

19. The device of claim 6, wherein the positional indicator is an optical sensor.

20. The device of claim 5, wherein the guide includes:

an outer stem having a channel therethrough, an inclined surface thereon, and the aperture engaging end; and

an inner stem located coaxially within the channel of the outer stem having an inner channel and an aperture engaging end adjacent to the aperture engaging end of the outer stem, the inner stem being flared outwardly at the aperture engaging end.

21. The device of claim 20, wherein the trajectory lock includes:

a knob having an inclined surface that cooperates with the inclined surface on the outer stem, the knob being joined to the inner stem wherein by turning the knob in one direction the knob moves along the inclined surface of the outer stem and draws the inner stem into the outer stem, whereupon the flared portion of the inner stem forces the outer stem into engagement with the aperture, to thereby fix the trajectory of the guide.

22. The device of claim 21, further including a shutter pivotably mounted on the outer stem, having a movable arm projecting into the inner channel of the inner stem, such that when the arm is positioned inside the inner channel, the tip of the surgical device rests upon the arm at a known location in the inner channel.

23. The device of claim 1, wherein the curved outer surface at the aperture engaging end of the guide has at least one slot.

24. A device for controlling the insertion of a surgical device into the body of a patient comprising:

a guide for the surgical device;

a positional indicator;

an adjustable stop for limiting the distance the surgical device can be inserted into the body;

a first fixture for the positional indicator associated with the guide; and

a second fixture for the positional indicator operatively associated with the stop, wherein by determining the position of the positional indicator in the first and second fixtures, the stop can-be set so that the surgical instrument can be inserted a limited distance into the body.

25. The device of claim 24, further including:

a base connected to the guide;

a positional lock for fixing the position of the device with respect to the body; and

a trajectory lock for fixing the trajectory of the device with respect to the body.

26. The device of claim 25, further including a holder connected to the base.

27. The device of claim 26, wherein the holder includes an adhesive, such that the holder is affixed to a patient.

28. The device of claim 26, wherein the holder includes a guide for an incision making device.

29. The device of claim 26, wherein the holder includes a sliding disk;

30. The device of claim of 29, further including a disk lock for fixing the position of the sliding disk.

31. A method for guiding a surgical device, the method comprising the steps of:

positioning a surgical device guide in relation to a patient using an image guided surgery system, the surgical device comprising;

a base having an aperture therein, the aperture having an annular surface;

a guide for the surgical device having an aperture engaging end, the aperture engaging end being outwardly flared; and

a curved outer surface at the aperture engaging end that is compatible with the annular surface of the aperture;

a positional indicator;

a positional lock for fixing the position of the device with respect to the body; and

a trajectory lock for fixing the trajectory of the device with respect to the body;

using the image guided surgery system to determine the trajectory of the surgical device guide;

locking the trajectory of the guide; and

inserting a surgical device into the guide.

32. A device for controlling the insertion of a surgical device into the body of a patient comprising:

an adjustable stop for limiting the distance the surgical device can be inserted into the body;

a positional indicator;

a first fixture for the positional indicator associated with the surgical device; and

a second fixture for the positional indicator operatively associated with the stop, wherein by determining the position of the positional indicator in the first and second fixtures, the stop can be set so that the surgical instrument can be inserted a limited distance into the body.

33. The device of claim 32, further including an insertion indicator, such that the insertion indicator signals when the adjustable stop is set so as to limit the distance the surgical device can be inserted into the body to a desired distance.

34. The device of claim 33, wherein the insertion indicator displays the limited distance the surgical device may be inserted into the body.

35. The device of claim 34, wherein the insertion indicator is a numerical readout.

36. The device of claim 32, wherein the adjustable stop includes a clamp such that the adjustable stop may be mounted on the surgical device.

37. The device of claim 32, wherein the positional indicator is a magnetic sensor.

38. The device of claim 32, wherein the positional indicator is a optical sensor.

39. A method for treating tissue in a body volume with a surgical device, the method comprising the steps of:

collecting image data associated with the body volume using an imaging device;

creating an image from the image data;

displaying the image on a display screen;

selecting at least one tissue target in the body volume for treatment;

determining an insertion distance for the surgical device, such that the surgical device may be used to treat the tissue target when inserted the insertion distance into the body volume;

providing an adjustable stop for limiting the distance the surgical device may be inserted in the body volume;

placing a positional indicator at a first fixture associated with the surgical device;

placing the positional indicator at a second fixture associated with the adjustable stop;

determining the position of the positional indicator in the first and second fixtures, such that the adjustable stop can be set so that the surgical device can be inserted the insertion distance;

setting the adjustable stop to limit insertion of the surgical device to the insertion distance;

inserting the surgical device the insertion distance; and

treating the tissue target.