TRAJECTORY GUIDE WITH ANGLED OR PATTERNED GUIDE LUMENS OR HEIGHT ADJUSTMENT

• US 20070191867A1
• Filed: 04/23/2007
• Published: 08/16/2007
• Est. Priority Date: 02/20/2003
• Status: Active Grant

• Current Assignee: University of South Florida (State University System of Florida)
• Original Assignee: Image Guided Neurologics, Inc. (Medtronic Plc)
• Inventors: Solar, Matthew, Freeman, Thomas, Mazzocchi, Rudy
• Granted Patent: US 7,981,120 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• 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 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

This document discusses trajectory guides that include an instrument guide with at least one lumen angled with respect to an orthogonal or other through-axis. In one example, patterned lumens on the instrument guide provide a mirror image pattern of trajectory axes intersecting a target plane. In another example, height adjustment of the instrument guide extends these or other targeting techniques to a three-dimensional volume. This document also describes a method of manufacturing such an instrument guide, which is also applicable to manufacturing an instrument guide providing parallel lumens.

Claims

1. An apparatus comprising:

a base, sized and shaped to be secured in or about a pre-existing entry portal in a human or animal subject that includes a target within the subject beyond the entry portal, the entry portal defining an entry plane, and the target defining a target plane that is substantially parallel to the entry plane; and

an instrument guide, coupled to the base and configured to be oriented with respect to the base to define a first axis extending through the instrument guide and the entry portal toward the target, the instrument guide including a lumen extending through the instrument guide to define a second axis nonparallel to the first axis, the second axis extending through the same entry portal as the first axis.

2. The apparatus of claim 1, wherein the lumen is a second lumen and the instrument guide includes a first lumen extending through the instrument guide coaxially to the first axis.

3. The apparatus of claim 2, in which the instrument guide includes an outer surface, distal from the entry portal, the first and second lumens extending through the surface, the surface shaped such that a distance along the first lumen between the surface and the target plane is substantially equal to a distance along the second lumen between the surface and the target plane.

4. The apparatus of claim 1, in which the first and second axes define a first plane and the second axis is angled at a first angle, in the first plane, with respect to the first axis, and in which the first and second axes are configured to intersect in the subject at or beyond the entry portal.

5. The apparatus of claim 1, in which a first angle between the first and second axes is selected at a specified value to provide a specified offset distance between intersection points of the first and second axes with a range plane, located beyond the entry portal, that is substantially orthogonal to the first axis.

6. The apparatus of claim 5, in which the apparatus includes an adjustable coupling of the instrument guide and the base, the coupling configured to position the instrument guide at an adjustable height above the entry portal.

7. The apparatus of claim 6, in which the adjustable coupling is configured to position the instrument guide at a height above the entry portal that obtains intersection of at least a portion of the target by the range plane.

8. The apparatus of claim 5, in which the specified offset distance exceeds a radius of the entry portal.

9. The apparatus of claim 1, in which the apparatus includes an adjustable coupling of the instrument guide and the base, the coupling configured to position the instrument guide at an adjustable height above the entry portal.

10. The apparatus of claim 9, in which the adjustable coupling includes a threaded coupling.

11. The apparatus of claim 1, in which the instrument guide includes a plurality of lumens through the instrument guide, the plurality of lumens configured to define corresponding axes passing through the entry portal, at least one of the axes being nonparallel to another of the axes.

12. The apparatus of claim 11, in which the axes corresponding to the plurality of lumens intersect a range plane beyond the entry portal, the range plane being substantially orthogonal to the first axis.

13. The apparatus of claim 12, wherein lumen axis intersection points with the range plane form a scaled mirror image of lumen axis intersection points with a plane through the instrument guide that is orthogonal to the first axis.

14. The apparatus of claim 12, in which the axes corresponding to the plurality of lumens are configured to substantially intersect about a single point in the subject adjacent to the entry portal.

15. The apparatus of claim 12, in which the apparatus includes a visualization portal configured to allow a user to view an instrument being inserted through at least one of the plurality of lumens into the subject.

16. The apparatus of claim 1, in which the base and the instrument guide are integrally formed of a customized fixed size and shape that is tailored to orient the first axis toward the target within the subject.

17. The apparatus of claim 1, in which the base and the instrument guide are adjustably coupled together to adjustably orient the first axis toward the target within the subject.

18. The apparatus of claim 17, including a ball-and-socket adjustable coupling between the base and the instrument guide.

19. The apparatus of claim 17, in which the base and the instrument guide are adjustably coupled using at least one of:

a rotational coupling that allows rotation of the instrument guide about an axis that is substantially orthogonal to the entry portal; and

an angle-adjusting coupling that allows adjustment of an angle between the first axis and the axis that is substantially orthogonal to the entry portal.

20. The apparatus of claim 1, in which the base includes a viewing portal through which the entry portal is visible.

21. An apparatus comprising:

means for securing the apparatus in or about a pre-existing entry portal in a human or animal subject that includes a target within the subject beyond the entry portal, the entry portal defining an entry plane, and the target defining a target plane that is substantially parallel to the entry plane; and

means for guiding an instrument, coupled to the means for securing and configured to be oriented with respect to the means for securing to define a first axis extending through the means for guiding and the entry portal toward the target, the means for guiding including a lumen extending through the means for guiding to define a second axis nonparallel to the first axis, the second axis extending through the same entry portal as the first axis.

22. The apparatus of claim 21, including means for adjusting the apparatus with respect to the entry portal.

23. The apparatus of claim 22, wherein the means for adjusting includes a rotational coupling that allows rotation of the means for guiding about an axis that is substantially orthogonal to the entry portal.

24. The apparatus of claim 22, wherein the means for adjusting includes an angle-adjusting coupling that allows adjustment of an angle between the first axis and an axis that is substantially orthogonal to the entry portal.

25. The apparatus of claim 22, wherein the means for adjusting includes a height adjustable coupling configured to adjust the height of the means for guiding above the entry portal.

26. An apparatus comprising:

a base, sized and shaped to be secured in or about a pre-existing entry portal in a human or animal subject that includes a target within the subject beyond the entry portal, the entry portal defining an entry plane, and the target defining a target plane that is substantially parallel to the entry plane; and

an instrument guide, coupled to and configured to be oriented with respect to the base, the instrument guide including first and second lumens, the first lumen extending through the instrument guide to define a first axis extending through the instrument guide and the entry portal toward the target, the second lumen extending through the instrument guide to define a second axis nonparallel to the first axis, the second axis extending through the same entry portal as the first axis, wherein the instrument guide is adjustably coupled to the base to allow at least one of;

height adjustment of the instrument guide with respect to the entry portal;

rotation of the instrument guide, with respect to the base, about the first axis;

or

angle adjustment of the instrument guide with respect to the base to allow adjustment of an angle between the first axis and an axis that is substantially orthogonal to the entry portal.

27. The apparatus of claim 26, in which the first and second axes define a first plane and the second axis is angled at a first angle, in the first plane, with respect to the first axis, and in which the first and second axes are configured to intersect in the subject at or beyond the entry portal.

28. The apparatus of claim 26, in which a first angle between the first and second axes is selected at a specified value to provide a specified offset distance between intersection points of the first and second axes with a range plane, located beyond the entry portal, that is substantially orthogonal to the first axis.

29. The apparatus of claim 28, in which the specified offset distance exceeds a radius of the entry portal.

30. The apparatus of claim 26, in which the instrument guide includes a plurality of lumens through the instrument guide, the plurality of lumens configured to define corresponding axes passing through the entry portal, at least one of the axes being nonparallel to another of the axes.

31. The apparatus of claim 26, in which the base includes a viewing portal through which the entry portal is visible.

32. The apparatus of claim 26, in which the instrument guide is adjustably coupled to the base to allow height adjustment of the instrument guide with respect to the entry portal.

33. The apparatus of claim 26, in which the instrument guide is adjustably coupled to the base to allow rotation of the instrument guide, with respect to the base, about the first axis.

34. The apparatus of claim 26, in which the instrument guide is adjustably coupled to the base to allow angle adjustment of the instrument guide with respect to the base to allow adjustment of an angle between the first axis and an axis that is substantially orthogonal to the entry portal.

35. The apparatus of claim 26, in which the instrument guide is adjustably coupled to the base to allow any two of:

height adjustment of the instrument guide with respect to the entry portal;

rotation of the instrument guide, with respect to the base, about the first axis;

or

angle adjustment of the instrument guide with respect to the base to allow adjustment of an angle between the first axis and an axis that is substantially orthogonal to the entry portal.