NEUROSURGICAL DEVICES AND ASSOCIATED SYSTEMS AND METHODS

• US 20130158578A1
• Filed: 09/02/2011
• Published: 06/20/2013
• Est. Priority Date: 09/03/2010
• Status: Abandoned Application

• Current Assignee: University of Washington
• Original Assignee: University of Washington
• Inventors: Wilcox, Robert, Ghodke, Basavaraj, Cooke, Daniel
• Application Number:
  US13/820,739
• Publication Number:
  US 20130158578A1
• Time in Patent Office: Days
• US Class Current: 606/170
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/320024 Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/320775 Morcellators, impeller or propeller like means
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 8/0808 for diagnosis of the brain
• CPC Class Codes: A61B 8/485 involving measuring strain or elastic properties
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61M 2039/025 through bones or teeth, e.g. through the skull
• CPC Class Codes: A61M 2039/0261 Means for anchoring port to the body, or ports having a special shape or being made of a specific material to allow easy implantation/integration in the body
• CPC Class Codes: A61M 2039/027 having a particular valve, seal or septum
• CPC Class Codes: A61M 2039/0273 for introducing catheters into the body
• CPC Class Codes: A61M 2039/0279 for introducing medical instruments into the body, e.g. endoscope, surgical tools
• CPC Class Codes: A61M 2039/0288 protectors, caps or covers therefor
• CPC Class Codes: A61M 39/0247 : Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053

Abstract

Neurosurgical devices including or used with cannulas or catheters and associated systems and methods are disclosed herein. The neurosurgical devices can include, for example, a cannula having a main portion and an angle-forming member proximate a distal end of the main portion. The angle-forming member can be configured to transition from a substantially straight configuration while the cannula is advanced through tissue along a substantially straight first portion of a path to an angled configuration when the angle-forming member reaches an end of the substantially straight first portion of the path. The neurosurgical devices also can include, for example, a neurosurgical catheter including a surface disrupter, an elongated macerator, or a lateral opening. Neurosurgical catheterization portals also are disclosed. The neurosurgical catheterization portals can, for example, have an adjustable portal that is movable relative to a body to accommodate different entry angles of a catheterization path.

Claims

1. A neurosurgical catheter, comprising:

a body having a lumen; and

a surface disrupter movable within the lumen along a length of the neurosurgical catheter and extendable from a distal end of the lumen, wherein the surface disrupter includes a distal portion and a proximal portion, wherein the distal portion is substantially blunt, and wherein the proximal portion includes a cutting edge.

2. The neurosurgical catheter of claim 1, wherein the surface disrupter at least partially defines a recess, and wherein the cutting edge is a ring around an opening of the recess.

3. The neurosurgical catheter of claim 1, wherein both the distal portion and the proximal portion of the surface disrupter are extendable beyond the distal end of the lumen.

4. The neurosurgical catheter of claim 1, further comprising a lateral opening extending through a wall of the body and into the lumen at a distal portion of the neurosurgical catheter, wherein the surface disrupter is movable within the lumen such that at least a portion of the surface disrupter slides through the lumen proximate the lateral opening.

5. The neurosurgical catheter of claim 1, wherein the blunt distal end is substantially convex, and wherein the cutting edge is at least partially curved.

6. The neurosurgical catheter of claim 1, further comprising an elongated macerator positioned with the lumen and rotatable around an axis substantially collinear with a length of the body.

7. The neurosurgical catheter of claim 1, wherein the surface disrupter is a first surface disrupter, and wherein the neurosurgical catheter further comprises:

a second surface disrupter extending from the distal end of the lumen, wherein the second surface disrupter is configured to restrict extension of the first surface disrupter from the distal end of the lumen.

8. The neurosurgical catheter of claim 7, wherein the second surface disrupter includes two or more curved elongated members.

9. The neurosurgical catheter of claim 7, wherein the second surface disrupter is fixed to the distal end of the lumen.

10. A neurosurgical catheter, comprising:

a body at least partially defining a lumen;

a surface disrupter extended or extendable from a distal end of the lumen; and

an elongated macerator positioned with the lumen and rotatable around an axis substantially collinear with a length of the body.

11. The neurosurgical catheter of claim 10, wherein the surface disrupter is configured to be in a collapsed configuration within the lumen and expand into an expanded configuration when extended from the distal end of the lumen, and wherein, in the expanded configuration, the surface disrupter has a diameter greater than a diameter of the lumen.

12. The neurosurgical catheter of claim 10, wherein the surface disrupter includes two or more curved elongated members.

13. The neurosurgical catheter of claim 10, wherein the surface disrupter is substantially shaped as a spheroid or a portion of a spheroid.

14. The neurosurgical catheter of claim 10, wherein the surface disrupter includes an abrasive pattern.

15. The neurosurgical catheter of claim 10, further comprising a driver connected to the surface disrupter and extending proximally through the lumen.

16. The neurosurgical catheter of claim 10, wherein the elongated macerator includes a screw conveyor, and wherein the neurosurgical catheter is configured such that rotating the elongated macerator helps to move material within the lumen proximally along the length of the neurosurgical catheter.

17. The neurosurgical catheter of claim 10, wherein the elongated macerator is sufficiently flexible to bend through angles of a catheterization path.

18. The neurosurgical catheter of claim 10, wherein the elongated macerator is moveable along the length of the neurosurgical catheter.

19. The neurosurgical catheter of claim 10, wherein the surface disrupter is a distal portion of the elongated macerator.

20. The neurosurgical catheter of claim 10, wherein the elongated macerator is configured to transfer rotational or axial movement along at least a portion of the length of the neurosurgical catheter to the surface disrupter.

21. The neurosurgical catheter of claim 10, wherein the elongated macerator includes a spiraling elongated member.

22. The neurosurgical catheter of claim 21, wherein the spiraling elongated member is a wire.

23. A neurosurgical catheter, comprising:

a body at least partially defining a lumen;

a lateral opening extending through a wall of the body and into the lumen at a distal portion of the neurosurgical catheter; and

a surface disrupter movable within the lumen along a length of the neurosurgical catheter such that at least a portion of the surface disrupter slides through the lumen proximate the lateral opening.

24. The neurosurgical catheter of claim 23, wherein the lateral opening extends through a curved wall of the body.

25. The neurosurgical catheter of claim 23, wherein the surface disrupter includes a sharpened edge.

26. A neurosurgical catheter, comprising:

a body at least partially defining a lumen with a distal opening; and

a suction conduit within the lumen, the suction conduit having a main portion and a plug, the plug at least partially defining a plug chamber with a distal opening and a proximal opening into the plug chamber,

wherein the plug is rotatable between (a) a first position in which the distal opening of the body and the distal opening into the plug chamber are substantially aligned and the proximal opening into the plug chamber and the distal opening of the main portion of the suction conduit are not substantially aligned and (b) a second position in which the distal opening of the body and the distal opening into the plug chamber are not substantially aligned and the proximal opening into the plug chamber and the distal opening of the main portion of the suction conduit are substantially aligned.

27. The neurosurgical catheter of claim 26, further comprising a flush conduit within the lumen, wherein the plug is rotatable into (c) a third position in which an opening into the plug chamber is substantially aligned with an opening of the flush conduit and the proximal opening into the plug chamber is substantially aligned with the distal opening of the main portion of the suction conduit or a separate distal opening of the main portion of the suction conduit.

28. A neurosurgical catheterization portal, comprising:

a body configured to be mounted to a surface of a neurosurgical catheterization entry site; and

an adjustable portal having a directional portion at least partially defining a lumen, wherein the lumen is elongated and substantially straight, the neurosurgical catheterization portal has a first configuration in which the adjustable portal is movable relative to the body to angle the directional portion or rotate the directional portion and a second configuration in which the adjustable portal is fixed relative to the body.

29. The neurosurgical catheterization portal of claim 28, wherein the directional portion of the adjustable portal is substantially rigid and has a length between about 10 times and about 50 times a diameter of the lumen.

30. The neurosurgical catheterization portal of claim 28, wherein the body further includes a base configured to be mounted to the surface of the neurosurgical catheterization entry site and a cap separable from the base, and wherein a portion of the adjustable portal is captured between the base and the cap when the neurosurgical catheterization portal is in the second configuration.

31. The neurosurgical catheterization portal of claim 30, wherein the portion of the adjustable portal captured between the base and the cap when the neurosurgical catheterization portal is in the second configuration includes a convex surface, and wherein the cap includes a concave surface adjacent to the convex surface of the adjustable portal when the neurosurgical catheterization portal is in the second configuration.

32. The neurosurgical catheterization portal of claim 30, wherein the base and the cap include interlocking threads, thread recesses, or both allowing the cap to be screwed onto the base.

33. The neurosurgical catheterization portal of claim 30, wherein the base includes two or more mounting tabs having screw-receiving holes, and wherein a living hinge connects each of the mounting tabs to another portion of the base.

34. The neurosurgical catheterization portal of claim 30, wherein the base includes a gasket recess, and wherein the neurosurgical catheterization portal further comprises a gasket configured to be positioned between the gasket recess of the base and the surface of the neurosurgical catheterization entry site.

35. The neurosurgical catheterization portal of claim 30, wherein the base at least partially defines a chamber configured to be adjacent to the surface of the neurosurgical catheterization entry site, and wherein the neurosurgical catheterization portal further comprises a conduit extending between an external portion of the neurosurgical catheterization portal and the chamber.

36. The neurosurgical catheterization portal of claim 35, wherein the conduit is a first conduit, and wherein the neurosurgical catheterization portal further comprises:

a second conduit extending between an external portion of the neurosurgical catheterization portal and the chamber; and

a pump configured to move a flushing fluid into the chamber through the first conduit and out of the chamber through the second conduit.

37. A neurosurgical system, comprising:

a cannula; and

an angle-forming member proximate a distal end of the cannula, wherein the cannula is substantially straight and substantially rigid, and wherein the angle-forming member is configured to transition from a substantially straight configuration while the angle-forming member is advanced through tissue along a substantially straight first portion of a path to an angled configuration when the angle-forming member reaches an end of the substantially straight first portion of the path.

38. The neurosurgical system of claim 37, wherein the angle-forming member has a length between about 3 times and about 10 times its diameter.

39. The neurosurgical system of claim 37, wherein the cannula is a first cannula and the angle-forming member is a first angle-forming member, and wherein the neurosurgical system further comprises:

a second cannula positioned coaxially within or around the first cannula, wherein the second cannula is advanceable along a substantially straight second portion of the path, and wherein the angled configuration of the first angle-forming member corresponds to an angle of the substantially straight second portion of the path relative to the substantially straight first portion of the path.

40. The neurosurgical system of claim 39, wherein the second cannula is substantially flexible.

41. The neurosurgical system of claim 39, further comprising a second angle-forming member proximate a distal end of the second cannula, wherein the second angle-forming member is configured to transition from a substantially straight configuration while the second cannula is advanced through tissue along the substantially straight second portion of the path to an angled configuration when the second angle-forming member reaches an end of the substantially straight second portion of the path.

42. The neurosurgical system of claim 39, further comprising a catheter sized to fit within the cannula and advanceable relative to the cannula so as to extend through a lumen of the angle-forming member when the angle-forming member is in the angled configuration.

43. The neurosurgical system of claim 42, wherein the catheter includes an ultrasound transducer.

44. The neurosurgical system of claim 42, wherein the catheter includes a tip ultrasound transducer proximate a tip of a distal portion of the catheter and two or more radial ultrasound transducers proximate a lateral wall of the distal portion of the catheter.

45. The neurosurgical system of claim 42, further comprising a processing system configured to receive A-mode ultrasound data from an ultrasonography system including an ultrasound transducer within a distal portion of the catheter.

46. A neurosurgical method, comprising:

advancing a cannula having a main portion and an angle-forming member through brain tissue along a first portion of a path to a target area, the main portion being substantially straight, the angle-forming member having a first configuration in which the angle-forming member is substantially straight and a second configuration in which a lumen of the angle-forming member is curved, wherein the first portion of the path is substantially straight, and the angle-forming member is in the first configuration while the cannula is advanced along the first portion of the path;

actuating the angle-forming member to cause the angle-forming member to change from the first configuration to the second configuration after advancing the cannula along the first portion of the path; and

advancing a catheter through the cannula after actuating the angle-forming member such that the catheter extends through a curve of the lumen of the angle-forming member in the second configuration.

47. The neurosurgical method of claim 46, further comprising drilling a hole in bone matter before advancing the cannula through the brain tissue, wherein drilling the hole includes aligning a drilling member with an elongated lumen of a directional portion of a neurosurgical catheterization portal attached to the bone matter, the elongated lumen of the directional portion of the neurosurgical catheterization portal is substantially aligned with the first portion of the path, and the first portion of the path is not substantially perpendicular to a surface around the hole.

48. The neurosurgical method of claim 47, further comprising adjusting a position of the directional portion of the neurosurgical catheterization portal relative to a fixed portion of the neurosurgical catheterization portal, and fixing the directional portion of the neurosurgical catheterization portal to the fixed portion of the neurosurgical catheterization portal in an adjusted position.

49. The neurosurgical method of claim 46, further comprising navigating a distal portion of the catheter using ultrasonography, wherein the distal portion of the catheter includes an ultrasound transducer.

50. The neurosurgical method of claim 49, wherein navigating the distal portion of the catheter using ultrasonography includes navigating the distal portion of the catheter using A-mode ultrasonography.

51. The neurosurgical method of claim 49, wherein navigating the distal portion of the catheter using ultrasonography includes using ultrasonography to monitor a distance between the distal portion of the catheter and an interface between brain tissue and a blood clot.

52. The neurosurgical method of claim 51, wherein using ultrasonography to monitor a distance between the distal portion of the catheter and an interface between brain tissue and a blood clot includes monitoring a distance between a tip ultrasound transducer positioned proximate a tip of the distal portion of the catheter and the interface between brain tissue and the blood clot, monitoring a distance between a first radial ultrasound transducer positioned proximate a lateral wall of the distal portion of the catheter and the interface between brain tissue and the blood clot, and monitoring a distance between a second radial ultrasound transducer positioned proximate the lateral wall of the distal portion of the catheter and the interface between brain tissue and the blood clot.