Cerebral surgery apparatus

• US 5,154,723 A
• Filed: 01/21/1992
• Issued: 10/13/1992
• Est. Priority Date: 12/02/1987
• Status: Expired due to Term

• Current Assignee: Olympus Optical Company Ltd. (Olympus Corporation)
• Original Assignee: Olympus Optical Company Ltd. (Olympus Corporation)
• Inventors: Ikeda, Yuichi, Karasawa, Hitoshi, Hashiguchi, Toshihiko, Kubota, Tetsumaru
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): Lewis, William W.
• Application Number:
  US07/823,629
• Time in Patent Office: 266 Days
• Field of Search: 606/130, 128/4-6, 128/7-9
• US Class Current: 606/130
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61G 13/12 Rests specially adapted therefor; Arrangements of patient-supporting surfaces rests for the surgeon A61B90/60; restraining devices A61F5/37
• CPC Class Codes: A61G 13/121 Head or neck

Abstract

A cerebral surgery endoscope apparatus comprises a stereotaxic instrument secured to the head of a patient and adapted to effect positioning of an affected part; an adjusted support means whose inserting direction is determined by its orientation to the stereotaxic instrument and which determines the direction in which a treating instrument is inserted into the head of the patient; a viewing device such as an endoscope supported on the support means and having a channel into which a treating instrument can be inserted, the treating instrument being inserted into a channel of the viewing device and then into the head of the patient. A fixing device is connected to the stereotaxic instrument and adapted to secure the support means, the viewing device and/or the treating instrument in a fixed position on with respect to the affected part.

Claims

1. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient to effect positioning of a treating instrument in an affected part;

treating instrument inserting means whose inserting direction is determined by said stereotaxic instrument, for inserting treating instruments into the head of the patient, a rear end of said inserting means extending to and operatively connecting with said stereotaxic instrument, and an overall length of said inserting means being hollow; and

a telescope detachably inserted into said inserting means having a channel into which a treating instrument can be inserted and further having an insertable part to be inserted into said inserting means,

said telescope and channel being removably inserted into said inserting means in a state that the longitudinal axis of the insertable part of said telescope and the longitudinal axis of said inserting means are substantially in parallel, and said treating instrument being removably insertable into said channel, and further

said telescope and channel being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said telescope is removably inserted into said inserting means.

14. A cerebral surgery endoscope apparatus according to any one of claims 1 to 13, wherein said telescope includes an elongated inserting portion which is adapted to be inserted into said inserting means, illumination means for making illumination light emergent from a distal end portion of said inserting portion;

an image-forming optical system provided at said distal end portion of said inserting portion, an eyepiece section provided at a rear end portion of said inserting portion, and an image-transmitting optical system for transmitting an image formed by said image-forming optical system to said eyepiece section.

15. A cerebral surgery endoscope apparatus according to any one of claims 1 to 13, wherein said telescope includes a telescope body and a treating instrument installing section which is detachable from said telescope body.

16. A cerebral surgery endoscope apparatus according to claim 14, further comprising a television camera connected detachably to said eyepiece section and display means for displaying an image picked up by said television camera.

17. A cerebral surgery endoscope apparatus according to any one of claims 1 to 13, wherein said telescope includes an elongated inserting portion which is inserted into said inserting means, illumination means for making illumination light emergent from a distal end portion of said inserting portion, an image-forming optical system provided at a distal end portion of said inserting portion, and image pickup means using a solid-state image sensor for sensing an image formed by said image-forming optical system.

20. A cerebral surgery endoscope apparatus according to any one of claims 1 to 13, wherein said stereotaxic instrument has an inner ring for fixing the head of a patient and an outer ring for fixing said inner ring such as to adjust the position of said inner ring.

2. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient to effect positioning of a treating instrument in an affected part;

treating instrument inserting means whose inserting direction is determined by said stereotaxic instrument, for inserting treating instruments into the head of the patient;

a telescope detachably inserted into said inserting means having a channel into which a treating instrument can be inserted and further having an insertable part to be inserted into said inserting means,

said telescope and channel being removably inserted into said inserting means in a state that the longitudinal axis of the insertable part of said telescope and the longitudinal axis of said inserting means are substantially in parallel, and said treating instrument being removably insertable into said channel, and further

said telescope and channel being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said telescope is removably inserted into said inserting means; and

a fixing device connected to said stereotaxic instrument to support and fix said inserting means and said telescope with respect to said stereotaxic instrument, a rear end of said inserting means extending to and operatively connecting with said fixing device, and an overall length of said inserting means being hollow.

3. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient to effect position of a treating instrument in an affected part;

an inserting means whose inserting direction is determined by said stereotaxic instrument, for inserting treating instruments into the head of the patient, a rear end of said inserting means extending to and operatively connecting with said stereotaxic instrument, and an overall length of said inserting means being hollow; and

a telescope detachably inserted into said inserting means having a channel into which a treating instrument can be inserted and further having an insertable part to be inserted into said inserting means,

said telescope and channel being removably inserted into said inserting means in a state that the longitudinal axis of the insertable part of said telescope and the longitudinal axis of said inserting means are substantially in parallel, and said telescope and channel being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said telescope is removably inserted in said inserting means, and further

said treating instrument being removably insertable into said channel,

said treating instrument being insertable into said channel of said telescope and then into the head of the patient.

4. A cerebral surgery endoscope apparatus according to claim 3, further comprising:

an adapter for detachably connecting said treating instrument and said telescope.

5. A cerebral surgery endoscope apparatus according to claim 4, wherein said treating instrument is an ultrasonic suction instrument having a tubular probe, and said adapter includes a hollow portion into which said probe is inserted and an inlet and an outlet for a refrigerant for cooling said probe inserted into said hollow portion.

6. A cerebral surgery endoscope apparatus according to claim 4, wherein said treating instrument is an ultrasonic suction instrument having a tubular probe, and said adapter includes a cylindrical member into which said probe is inserted and a window allowing presence of said probe inserted in said cylindrical member to be confirmed.

7. A cerebral surgery endoscope apparatus according to claim 4:

wherein

said treating instrument is removably insertable into said channel of said telescope and then into the head of the patient

wherein said adapter includes a telescope-side connecting portion detachably connectable to said telescope, a treating instrument-side connecting portion detachably connectable to said treating instrument, connecting means for connecting said telescope side connecting portion and said treating instrument-side connecting portion such as to allow the same to advance and retract, and fixing means which is capable of fixing positions of said telescope-side connecting portion and said treating instrument-side connecting portion at desired positions, a rear end of said inserting means extending to and operatively connecting with said adapter, and an overall length of said inserting means being hollow.

8. A cerebral surgery endoscope apparatus according to claim 7, further comprising a fixing device connected to said stereotaxic instrument and adapted to support and fix said inserting means, said telescope, said adapter, and said treating instrument.

9. A cerebral surgery endoscope apparatus according to claim 7 or 8, wherein said adapter includes at a front end portion thereof a substantially tubular adapter body having said telescope-side connecting portion and at a rear end portion thereof said treating instrument-side connecting portion, said adapter further including a sliding member fitted slidably at a rear end portion of said adapter body;

a moving device having a cam ring fitted rotatably around the outer peripheral portions of said adapter body and said sliding member, cam grooves provided in said adapter body and said sliding member, and a cam pin which is secured to said cam ring, is engaged into said cam grooves, and is slidable along said cam grooves so as to make said sliding member longitudinally movable relative to said adapter body by the rotation of said cam ring;

a scale indicating the position of said sliding member relative to said adapter body; and

a setscrew capable of fixing said sliding member to said adapter body.

10. A cerebral surgery endoscope apparatus according to claim 7 or 8, wherein said adapter includes at a front end portion thereof a substantially tubular adapter body having said telescope-side connecting portion and at a rear end portion thereof said treating instrument-side connecting portion, said adapter further including a sliding member fitted slidably at a rear end portion of said adapter body, a scale for indicating the position of said sliding member relative to said adapter body, and a fixing member which is capable of fixing said sliding member to said adapter body when the outside diameter of outer periphery-side members of said adapter body and said sliding member is reduced.

11. A cerebral surgery endoscope apparatus according to claim 7 or 8, wherein said adapter includes at a front end portion thereof a substantially tubular adapter body having said telescope-side connecting portion and at a rear end portion thereof said treating instrument-side connecting portion, said adapter further including a sliding member fitted slidably at a rear end portion of said adapter body, a moving device having a rack provided on one of said adapter body and said sliding member and a pinion provided on the other and engaging with said rack, thereby making it possible to move said sliding member longitudinally relative to said adapter body as said pinion is rotated, and a setscrew capable of fixing said sliding member to said adapter body.

18. A cerebral surgery endoscope apparatus according to any one of claims 3 to 13, wherein said treating instrument is an ultrasonic suction instrument.

19. A cerebral surgery endoscope apparatus according to claim 18, wherein said ultrasonic suction instrument includes a vibrator section for generating ultrasonic vibrations, a tubular probe connected to said vibrator section and adapted to transmit the ultrasonic vibrations, and suction means for sucking an object to be sucked through a hollow portion of said probe.

41. A cerebral surgery endoscope apparatus according to claim 4

wherein said adapter detachably connects said treating instrument and said telescope, said adapter including a telescope-side connecting portion detachably connectable to said telescope, a treating instrument-side connecting portion detachable connectable to said treating instrument, connecting means for connecting said telescope-side connecting portion such as to allow the same to advance and retract, and fixing means which is capable of fixing position of said telescope-side connecting portion and said treating instrument-side connecting portion at desired positions.

12. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient to effect positioning of a treating instrument in an affected part;

an inserting means whose inserting direction is determined by said stereotaxic instrument and which is inserted into the head of the patient;

a telescope detachably inserted into said inserting means having a channel into which a treating instrument can be inserted and further having an insertable part to be inserted into said inserting means;

said telescope and channel being removably inserted into said inserting means in a state that the longitudinal axis of the insertable part of said telescope and the longitudinal axis of said insert means are substantially in parallel, and

said telescope and channel being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said telescope is removably inserted in said inserting means, and further

said treating instrument being removably insertable into said channel,

said treating instrument being inserted into said channel of said telescope and then into the head of the patient; and

a fixing device connected to said stereotaxic instrument to support and secure said inserting means, said telescope, and said treating instrument, a rear end of said inserting means extending to and operatively connecting with said fixing device, and an overall length of said inserting means being hollow.

13. A cerebral surgery endoscope apparatus according to claim 12,

wherein said inserting means can insert treating instruments into the head of the patient;

wherein

said treating instrument is removably insertable into said channel of said telescope and then into the head of the patient; and

wherein said apparatus further comprises;

an adapter for detachably connecting said treating instrument and said telescope.

40. A cerebral surgery endoscope apparatus according to claim 12, further comprising:

an adapter for detachably connecting a telescope and said treating instrument inserted into said treating instrument channel to said telescope, said adapter comprising;

a telescope-side connecting portion detachably connectable to said telescope;

a treating instrument-side connecting portion detachably connectable to said treating instrument;

connecting means for connecting said telescope-side connecting portion and said treating instrument-side connecting portion such as to be capable of advancing and retracting the same; and

fixing means capable of fixing the positions of said telescope-side connecting portion and said treating instrument-side connecting portion at desired positions.

21. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient to effect positioning of a treating instrument in an affected part;

an inserting means whose inserting direction is determined by said stereotaxic instrument, for inserting treating instruments into the head of the patient;

a telescope detachably inserted into said inserting means having a channel into which a treating instrument can be inserted and further having an insertable part to be inserted into said inserting means;

said telescope and channel being removably inserted into said inserting means in a state that the longitudinal axis of the insertable part of said telescope and the longitudinal axis of said inserting means are substantially in parallel, and

said telescope and channel being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said telescope is removably inserted in said inserting means, and further

said treating instrument being removably insertable into said channel,

said treating instrument being insertable into said channel of said telescope and then into the head of the patient; and

a fixing device connected to said stereotaxic instrument to support and fix said inserting means, said telescope, and said treating instrument, said fixing device having moving means which is capable of allowing said inserting means, said telescope, and said treating instrument to be advanced and retracted in an inserting direction of said inserting means, a rear end of said inserting means extending to and operatively connecting with said fixing device, and an overall length of said inserting means being hollow.

22. A cerebral surgery endoscope apparatus according to claim 21, wherein said fixing device has means which allows said inserting means, said telescope, and said treating instrument to be rotated.

23. A cerebral surgery endoscope apparatus according to claim 21, further comprising an adapter for detachably connecting said treating instrument and said telescope.

24. A cerebral surgery endoscope apparatus according to claim 23, wherein said fixing device has a support for supporting said sheath, said telescope, and said treating instrument, and said moving means is fixed to at least one of said inserting means, said telescope, said treating instrument, and said adapter and has a slider which is longitudinally slidable relative to said support.

25. A cerebral surgery endoscope apparatus according to claim 24, wherein said slider includes a guide portion connected to said support, a sliding body which is longitudinally slidable along said guide portion, a support member which is secured to at least one of said inserting means, said telescope, said treating instrument, and said adapter and is longitudinally slidable relative to said sliding body, fixing means for fixing said sliding body relative to said guide portion, and fixing means for fixing said support member relative to said sliding body.

26. A cerebral surgery endoscope apparatus according to claim 25, wherein said slider includes a moving device having a rack which is provided one of either said sliding body and said support member and a pinion provided on the other and meshing with said rack, thereby allowing said support member to be longitudinally movable relative to said sliding body as said pinion is rotated.

27. A cerebral surgery endoscope apparatus according to claim 26, wherein a scale indicating the position of said support member relative to said sliding body is provided on one of said sliding body and said support member.

28. A cerebral surgery endoscope apparatus according to claim 26, wherein said support member has a clamping portion for clamping and fixing said adapter.

29. A cerebral surgery endoscope apparatus according to claim 26, wherein said support member has a belt wound around an outer peripheral portion of said adapter and adapted to fix said support member and said adapter.

30. A cerebral surgery endoscope apparatus according to claim 26, wherein said support member has an arm for fixing said support member and said adapter by pressing an outer peripheral portion of said adapter.

31. A cerebral surgery endoscope apparatus according to claim 24, wherein said slider has a guide portion and support member which is secured to at least one of said inserting means, said telescope, said treating instrument, and said adapter and is longitudinally movable along said guide portion.

32. A cerebral surgery endoscope apparatus according to claim 31, wherein said slider further has a rack provided on either one of said guide portion and said support member and a pinion provided on the other and meshing with said rack, thereby allowing said support member to be longitudinally movable relative to said guide portion as said pinion is rotated.

33. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient to effect positioning of a treating instrument in an affected part;

an inserting means whose inserting direction is determined by said stereotaxic instrument, for inserted treating instruments into the head of the patient;

a telescope detachably inserted into said inserting means having a channel into which a treating instrument can be inserted and further having an insertable part to be inserted into said inserting means;

said telescope and channel being removably inserted into said inserting means in a state that the longitudinal axis of the insertable part of said telescope and the longitudinal axis of said inserting means are substantially in parallel, and

said telescope and channel being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said telescope is removably inserted in said inserting means, and further

said treating instrument being removably insertable into said channel,

said treating instrument being insertable into said channel of said telescope and then into the head of the patient; and

a fixing device connected to said stereotaxic instrument to support and fix said treating instrument, said fixing device having adjusting means allowing the position of said treating instrument to be adjusted, a rear end of said inserting means extending to and operatively connecting with said fixing device, and an overall length of said inserting means being hollow.

34. A cerebral surgery endoscope apparatus according to claim 33, further comprising an adapter for detachably connecting said treating instrument and said telescope.

35. A cerebral surgery endoscope apparatus according to claim 33 or 34, wherein said fixing device has a position adjusting mechanism fixed to said stereotaxic instrument, an arm connected to said position adjusting mechanism, and an inserting means holder provided at an end portion of said arm and adapted to hold said inserting means.

36. A cerebral surgery endoscope apparatus according to claim 33 or 34, wherein said fixing device has a support member which is fixed to said stereotaxic instrument and is flexible but rigid enough to support said inserting means, said telescope, and said treating instrument, as well as an inserting means holder connected to said support member and adapted to hold said inserting means.

37. A cerebral surgery endoscope apparatus according to claim 33 or 34, wherein said fixing device has a position adjusting mechanism fixed to said stereotaxic instrument, an inserting means holder for holding said inserting means, and an arm connecting said position adjusting mechanism and said inserting means holder and adapted to support said inserting means holder from below.

38. A cerebral surgery endoscope apparatus according to claim 33 or 34, wherein said fixing device has a position adjusting mechanism fixed to said stereotaxic instrument, an arm opposite end portions of which are respectively connected to said position adjusting mechanism, and an inserting means holder fixed at a desired position on said arm and adapted to hold said inserting means.

39. A cerebral surgery endoscope apparatus according to claim 33 or 34, wherein said stereotaxic instrument and said fixing device are made of material, such as a plastics, which does not produce an artifact for a CT image.

42. A cerebral surgery endoscope apparatus comprising:

a stereotaxic instrument to be secured to the head of a patient, including a support means and means for positionally orienting the support means with respect to an affected part;

treating instrument inserting means supported on the support means for receiving a treating instrument to be inserted into the affected part for treatment thereof, a rear end of said inserting means extending to and operatively connecting with the support means, and an overall length of said inserting means being hollow; and

a viewing instrument supported on the support means and operatively associated with said treating instrument inserting means so as to be insertable therewith into the affected part to provide real time observation of the treatment, and further having an insertable part to be inserted into said inserting means,

said viewing instrument being removably inserted into said treating instrument inserting means in a state such that the longitudinal axis of the insertable part of said viewing instrument and the longitudinal axis of said inserting means are substantially in parallel, and said treating instrument being removably insertable in said inserting in said inserting means with said viewing instrument, and further

said said viewing instrument and treating instrument being removably insertable into said inserting means allowing supplying or draining of liquid through a cavity of said inserting means while said viewing instrument is removably inserted in said inserting means.

43. Endoscope apparatus as recited in claim 42 wherein said viewing instrument is an endoscope.

44. An endoscope apparatus as recited in claim 43 wherein said endoscope includes illumination means, an image forming optical system, and a solid-state image sensing means.

45. An endoscope apparatus as recited in claim 42 further including fixing means for securing the stereotaxic instrument, support means, treating instrument inserting means, and viewing instrument in fixed position with respect to said affected part.