Method And Apparatus For Controlled Insertion and Withdrawal of Electrodes

• US 20080269777A1
• Filed: 04/25/2007
• Published: 10/30/2008
• Est. Priority Date: 04/25/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Appenrodt, Peter, Gielen, Frans L.H.
• Granted Patent: US 8,734,466 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• 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 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• 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 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61N 1/0529 Electrodes for brain stimulation

Abstract

A system for a controlled insertion and withdrawal of at least one electrode in the anatomy. The system can include a guide device and at least one electrode located within the guide device to at least one of record or stimulate an anatomy. The system can also include an indicator coupled to the electrode to indicate a position of a distal end of an electrode relative to the guide device.

Claims

1. A system for a controlled insertion and withdrawal of at least one electrode in an anatomy comprising:

a guide device;

at least one electrode located within the guide device to at least one of record or stimulate the anatomy; and

an indicator coupled to the electrode to indicate a position of a distal end of the at least one electrode relative to the guide device.

2. The system of claim 1, wherein the guide device comprises at least one of a stereotactic head frame, a small-scale head frame, a navigation system, an insertion cannula, and combinations thereof.

3. The system of claim 2, wherein the guide device comprises a plurality of insertion cannulas, and the at least one electrode comprises a plurality of microelectrodes and a plurality of macroelectrodes that define a first bore, with one of the plurality of microelectrodes retained within the first bore of each of the plurality of macroelectrodes, and each of the plurality of macroelectrodes retained within a second bore defined in each of the plurality of insertion cannulas.

4. The system of claim 3, further comprising:

a drive system coupled to each of the plurality of insertion cannulas, the drive system operable to move each of the plurality of insertion cannulas to a selected position and a second position relative to the anatomy.

5. The system of claim 3, wherein each of the insertion cannulas, macroelectrodes, and microelectrodes define a cannulated electrode system and each are positionable in a first position and a second position, wherein the first position, each of the plurality of macroelectrodes are extended beyond a distal end of each of the plurality of insertion cannulas to a first distance and each of the plurality of microelectrodes are extended beyond a distal end of each of the plurality of macroelectrodes such that each of the plurality of microelectrodes contact the anatomy to record activity within the anatomy

6. The system of claim 5, wherein in the second position, each of the plurality of microelectrodes are retracted within the first bore of each of the plurality of macroelectrodes, and all but a selected one of the plurality of macroelectrodes are retracted to a second distance relative to the distal end of each of the plurality of insertion cannulas.

7. The system of claim 6, wherein the indicator is coupled to each of the plurality of macroelectrodes to indicate if each of the plurality of macroelectrodes are retracted to the second distance relative to the distal end of each of the plurality of insertion cannulas.

8. The system of claim 7, wherein the indicator is a visual indicator formed on an exterior surface of the macroelectrode that extends for a distance equal to the difference between the first distance and the second distance.

9. The system of claim 1, wherein the indicator comprises at least one of a visual indicator, a tactile indicator, an audible indicator or combinations thereof.

10. A system for controlled insertion and withdrawal of at least one electrode in an anatomy comprising:

at least one insertion cannula that defines a first through passage and a distal end;

a macroelectrode slideably coupled in the first through passage, the macroelectrode having a proximal end and a distal end, the distal end selectively extendable beyond the distal end of the at least one insertion cannula to engage the anatomy, the macroelectrode defining a second through passage;

a microelectrode slideably coupled in the second through passage, the microelectrode having a proximal end and a distal end, the distal end selectively extendable beyond the distal end of the macroelectrode to engage the anatomy; and

at least one indicator operable to indicate the position of the distal end of one of the macroelectrode or the microelectrode relative to the distal end of the at least one insertion cannula.

11. The system of claim 10, comprises a plurality of insertion cannulas and each of the plurality of insertion cannulas include the macroelectrode and the microelectrode.

12. The system of claim 11, further comprising:

a drive system coupled to the plurality of insertion cannulas to move the plurality of insertion cannulas, the macroelectrode and the microelectrode relative to the anatomy; and

a frame coupled to the anatomy and the drive system.

13. The system of claim 12, further comprising:

at least one tracking device coupled to at least one of the frame and the drive system; and

a navigation system that tracks the at least one tracking device relative to the anatomy during a surgical procedure.

14. The system of claim 13, wherein in a first position, each of the plurality of insertion cannulas include the microelectrode extended beyond the macroelectrode and the macroelectrode extended beyond the insertion cannula such that the microelectrode of each of the plurality of insertion cannulas enter into the anatomy when the drive system moves the insertion cannulas.

15. The system of claim 14, wherein in a second position, a selected one of the plurality of insertion cannulas includes the macroelectrode extended beyond the insertion cannula a first distance, the microelectrode is retracted within the macroelectrode of each of the plurality of insertion cannulas and the distal end of the macroelectrode extends beyond the insertion cannula a second distance for the remainder of the plurality of insertion cannulas.

16. The system of claim 15, wherein the at least one indicator indicates if the macroelectrode of the remainder of the plurality of the insertion cannulas is in the second position.

17. The system of claim 10, wherein the at least one indicator is selected from the group comprising at least one of a visual indicator, an audible indicator, a tactile indicator and combinations thereof.

18. The system of claim 16, wherein the at least one indicator comprises a marking formed on the macroelectrode of each of the plurality of insertion cannulas.

19. The system of claim 18, wherein the visual indicator extends for a length equal to the difference between the first distance and the second distance such that the visual indicator on the macroelectrode of the remainder of the plurality of insertion cannulas indicates the position of the macroelectrode relative to the insertion cannula for each of the plurality of insertion cannulas.

20. A system for the controlled insertion and withdrawal of at least one electrode comprising:

a cannulated electrode assembly that includes at least one insertion cannula and at least one electrode slideably coupled to a first bore defined in the at least one insertion cannula, the at least one electrode selectively extendable beyond a distal end of the at least one insertion cannula;

a drive system coupled to the at least one insertion cannula to move one of the at least one insertion cannula or the at least one electrode into an anatomy;

a guide system coupled to the anatomy and the drive system to enable a desired orientation of the drive system relative to the anatomy; and

an indicator coupled to the at least one electrode that indicates the position of the at least one electrode with respect to the at least one insertion cannula.

21. The system of claim 20, wherein the guide system is at least one of a navigation system, a stereotactic head frame, a small-scale head frame or combinations thereof.

22. The system of claim 21, wherein the navigation system further comprises:

at least one tracking device coupled to the drive system; and

a tracking system that tracks the at least one tracking device relative to the anatomy during a surgical procedure.

23. The system of claim 20, wherein the at least one insertion cannula comprises a plurality of insertion cannulas and each of the plurality of insertion cannulas include at least one electrode.

24. The system of claim 23, wherein each of the at least one electrode of each of the plurality of insertion cannulas further comprises:

a macroelectrode slideably coupled to the first bore, the macroelectrode having a proximal end and a distal end selectively extendable beyond the distal end of each of the plurality of insertion cannulas to engage the anatomy, the macroelectrode defining a second bore; and

a microelectrode slideably coupled in the second bore, the microelectrode selectively extendable beyond the distal end of the macroelectrode to engage the anatomy.

25. The system of claim 24, wherein in a first position, each of the plurality of insertion cannulas include the microelectrode extended beyond the macroelectrode and the macroelectrode extended beyond the insertion cannula such that the microelectrode of each of the plurality of insertion cannulas contacts the anatomy, and in a second position, a selected one of the plurality of insertion cannulas includes the macroelectrode extended beyond the insertion cannula a first distance and the microelectrode retracted within the macroelectrode of the plurality of insertion cannulas, with the distal end of the macroelectrode extended beyond the insertion cannula a second distance for the remainder of the plurality of insertion cannulas.

26. The system of claim 25, wherein the indicator indicates if each of the remaining macroelectrodes are retracted the second distance within the insertion cannulas in the second position.

27. The system of claim 20, wherein the indicator is selected from the group comprising at least one of a visual indicator, an audible indicator, a tactile indicator and combinations thereof.

28. The system of claim 26, wherein the indicator comprises a visual indicia formed on the outer layer of the macroelectrode.

29. The system of claim 28, wherein the visual indicia extends for a length equal to a difference between the first distance and the second distance.

30. The system of claim 20, further comprising at least one of a deep brain stimulator (DBS) probe, a therapy cannula, an implant and combinations thereof to perform a therapy on the anatomy.

31. A method of controlling the insertion and withdrawal of at least one electrode from an anatomy comprising:

positioning at least one electrode in a guide device;

guiding the at least one electrode to a first position in the anatomy;

guiding the at least one electrode to a second position in the anatomy; and

receiving information from an indicator coupled to the at least one electrode to confirm the at least one electrode is in the second position.

32. The method of claim 31, wherein the electrode comprises a plurality of microelectrodes, and positioning the at least one electrode in a guide device further comprises:

positioning each of the microelectrodes within a first through passage defined in each of a plurality of macroelectrodes; and

positioning each of the plurality of macroelectrodes within a second through passage defined in each of a plurality of insertion cannulas.

33. The method of claim 32, wherein guiding the at least one electrode into the anatomy in a first position further comprises:

coupling each of the plurality of insertion cannulas to a drive system; and

driving each of the plurality of insertion cannulas into the anatomy such that the microelectrodes of each of the insertion cannulas engage the anatomy.

34. The method of claim 33, wherein guiding the at least one electrode into the anatomy in a first position further comprises:

positioning each of the plurality of microelectrodes beyond a distal end of each of the plurality of macroelectrodes; and

positioning each of the plurality of macroelectrodes beyond a distal end of each of the plurality of insertion cannulas such that the plurality of macroelectrodes extend a first distance beyond the distal end of the plurality of insertion cannulas.

35. The method of claim 34, wherein guiding the at least one electrode into the second position further comprises:

retracting each of the plurality of microelectrodes within each of the plurality of macroelectrodes;

retracting all but a selected one of the plurality of macroelectrodes relative to the plurality of insertion cannulas such that each of the retracted plurality of macroelectrodes extend a second distance beyond the distal end of the plurality of insertion cannulas.

36. The method of claim 35, wherein receiving information from the indicator further comprises:

viewing at least one a visual indicia that indicates that the retracted plurality of macroelectrodes extend the second distance beyond the distal end of the plurality of insertion cannulas.

37. The method of claim 36, further comprising:

retracting all of the plurality of macroelectrodes; and

performing at least one therapy in a trajectory defined by the selected one of the plurality of macroelectrodes.

38. The method of claim 37, wherein performing at least one therapy further comprises:

inserting at least one a deep brain stimulation (DBS) probe, therapy cannula, radioactive material, implant or combinations thereof into the trajectory defined by the selected one of the plurality of macroelectrodes.

39. The method of claim 31, wherein positioning at least one electrode in a guide device includes positioning a plurality of electrodes in the guide device in a selected orientation;

providing each of the plurality of electrodes to include a microelectrode positioned through a through passage of a macroelectrode, positioned through a through passage of an insertion cannula;

orienting each of the plurality of electrodes such that a tip of each of the microelectrodes extends a first distance beyond a tip of each of the macroelectrodes, and wherein each of the macroelectrodes extends a distance beyond the tip of the insertion cannula;

wherein guiding at least one electrode to a first position in the anatomy includes guiding each of the electrodes with the microelectrodes and the macroelectrodes extended to the first position in the anatomy;

recording an activity within the anatomy with the microelectrodes;

selecting a region within the anatomy;

withdrawing each of the microelectrodes substantially completely into the through passage of the macroelectrodes;

withdrawing each of the macroelectrodes a selected distance into the insertion cannula, wherein a selected portion of the tip of the macroelectrode occludes an internal opening of the insertion cannula;

wherein at least one of the macroelectrodes remains extended a distance from the insertion cannula tip greater than the a distance of the retracted macroelectrodes;

wherein guiding the at least one electrode to the second position in the anatomy includes guiding each of the electrodes, including the retroactive electrodes and the extended electrodes to the second position in the anatomy;

wherein guiding the plurality of the electrodes to the second position includes position substantially only the extending macroelectrode into the selected region of the anatomy.