Stereotactic instrument guided placement
First Claim
1. A ventriculostomy procedure for a human patient, utilizing a catheter guide having opposed point members disposed on a common linear axis, comprising the steps of substantially sequentially:
- (a) marking the proposed position of a burr hole on the patient'"'"'s skull;
(b) deciding upon the location of a ventricle, desired to be drained, within the patient'"'"'s skull, to define an intraventricular target point;
(c) effecting coordinate multiplanar tomographic imaging of the patient'"'"'s skull and brain;
(d) utilizing data from step (c), calculating a coordinate line between said burr hole proposed position and said intraventricular target point;
(e) utilizing the calculated coordinate line, determining a fixing point on the patient'"'"'s skull opposite the proposed position of the burr hole, and marking that fixing point on the patient'"'"'s skull;
(f) forming a burr hole in the patient'"'"'s skull at the marked proposed burr hole position;
(g) placing the catheter guide into operative association with the patient'"'"'s skull so that the opposed point members engage the burr hole and the fixing point;
(h) passing a catheter into the burr hole, positively guided by the catheter guide, along the common linear axis of the opposed point members, until the catheter tip reaches the intraventricular target point; and
(i) draining fluid from the area of the patient'"'"'s brain around the intraventricular target point.
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Accused Products
Abstract
A stereotactic neurological instrument placement guide is utilized to facilitate ventriculostomy procedures, or other neurological procedures such as biopsy, radioactive seed placement, and lesion generation. The guide has a pair of point members disposed on a common linear axis. The proposed position of a burr hole in the patient'"'"'s skull is marked, the location of a target point (e.g. ventricle) within the patient'"'"'s skull is decided upon, and the patient is given a CT or MRI scan. Utilizing data from the scan, a coordinate line is calculated between the burr hole proposed position and the target point. Utilizing the calculated coordinate line, a fixing point on the patient'"'"'s skull opposite the proposed position of the burr hole is determined, and the fixing point is marked. The instrument guide is placed into operative association with the patient'"'"'s skull so that the opposed point members engage the burr hole and the fixing point, and then a neurological instrument is passed into the burr hole positively guided by the instrument guide until the instrument reaches the target point at which a neurological procedure is performed. Calculations establishing the coordinate line are obtained by vector parameterization, utilizing a programmable scientific calculator.
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Citations
18 Claims
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1. A ventriculostomy procedure for a human patient, utilizing a catheter guide having opposed point members disposed on a common linear axis, comprising the steps of substantially sequentially:
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(a) marking the proposed position of a burr hole on the patient'"'"'s skull; (b) deciding upon the location of a ventricle, desired to be drained, within the patient'"'"'s skull, to define an intraventricular target point; (c) effecting coordinate multiplanar tomographic imaging of the patient'"'"'s skull and brain; (d) utilizing data from step (c), calculating a coordinate line between said burr hole proposed position and said intraventricular target point; (e) utilizing the calculated coordinate line, determining a fixing point on the patient'"'"'s skull opposite the proposed position of the burr hole, and marking that fixing point on the patient'"'"'s skull; (f) forming a burr hole in the patient'"'"'s skull at the marked proposed burr hole position; (g) placing the catheter guide into operative association with the patient'"'"'s skull so that the opposed point members engage the burr hole and the fixing point; (h) passing a catheter into the burr hole, positively guided by the catheter guide, along the common linear axis of the opposed point members, until the catheter tip reaches the intraventricular target point; and (i) draining fluid from the area of the patient'"'"'s brain around the intraventricular target point. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A neurological instrument placement procedure for a human patient, utilizing an instrument guide having opposed point members disposed on a common linear axis, comprising the steps of substantially sequentially:
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(a) marking the proposed position of a burr hole on the patient'"'"'s skull; (b) deciding upon the location of a target point within the patient'"'"'s skull; (c) effecting coordinate multiplanar tomographic imaging of the patient'"'"'s skull and brain; (d) utilizing data from step (c), calculating a coordinate line between the burr hole proposed position and the target point; (e) utilizing the calculated coordinate line, determining a fixing point on the patient'"'"'s skull opposite the proposed position of the burr hole, and marking that fixing point on the patient'"'"'s skull; (f) forming a burr hole in the patient'"'"'s skull at the marked proposed burr hole position; (g) placing the instrument guide into operative association with the patient'"'"'s skull so that the opposed point members engage the burr hole and the fixing point; (h) passing a neurological instrument into the burr hole, positively guided by the instrument guide, along the common linear axis of the opposed point members, until the instrument reaches the target point; and (i) performing a neurological procedure with the neurological instrument at the target point. - View Dependent Claims (8, 9)
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10. A method of determining the position of a line between two points on or within a human patient'"'"'s body, utilizing data normally determined from a coordinate multiplanar tomographic imaging of the patient'"'"'s body during which there is a non-zero angle of inclination between imaging equipment and the patient and while there is an incremental advance between images, comprising the steps of:
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(a) during coordinate multiplanar tomographic imaging of the patient'"'"'s body, determining the coordinates of a first point on or within the patient'"'"'s body; (b) during coordinate multiplanar tomographic imaging of the patient'"'"'s body, determining the coordinates of a second point on or within the patient'"'"'s body; (c) determining the non-zero angle of inclination of the imaging equipment with respect to the patient and the incremental advance between images; and (d) utilizing the coordinates of the first and second points, the non-zero angle of inclination, and the incremental advance, by vector parameterization calculating the distance between the first and the second points and the loci of points along a line containing the first and second points. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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Specification