Apparatus for surgical stereotactic procedures

• US 5,891,157 A
• Filed: 04/26/1996
• Issued: 04/06/1999
• Est. Priority Date: 09/30/1994
• Status: Expired due to Fees

• Current Assignee: Schaerer Medical USA Incorporated
• Original Assignee: Ohio Medical Instrument Co., Inc.
• Inventors: Mowlai-Ashtiani, Ali, Day, James L.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US08/638,616
• Time in Patent Office: 1,075 Days
• Field of Search: 606/1, 606/130, 600/417, 600/429
• US Class Current: 606/130
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based 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: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

A noninvasive apparatus for supporting tools associated with a stereotactic apparatus and procedures to guide tools along any selected path. In one embodiment of the invention, the tool support system is mounted to a skull clamp holding a patient'"'"'s head. In another embodiment, the tool holder and an articulated arm and probe are mounted to the tool support system which in turn, is mounted to the side rails of a table supporting a patient. With the second embodiment, stereotactic procedures can be practiced with respect to any part of the patient'"'"'s body.

Claims

1. A tooling support apparatus for use with a stereotactic apparatus being used to perform a procedure on a patient supported by a patient support comprising:

a support apparatus providing a path of motion in a plane;

a rod having a lower end adapted to be connected to the patient support and having an upper end connected to the support apparatus, the rod holding the support apparatus at a desired elevation above the patient support; and

a tool holder including

a support element mounted to the support apparatus and movable along the path of motion to selected positions with respect to the support apparatus and the patient,

a first alignment element rotatably mounted on the support element and adapted to receive a tool, the first alignment element being selectively rotatable to change the orientation of the first alignment element without changing its position with respect to the patient, thereby defining a surgical path between the tool and a target point within the patient, and

a first clamp operably mounted with respect to the first alignment element for selectively locking the first alignment element at a desired orientation.

2. The tooling support apparatus of claim 1 wherein the upper end of the rod is pivotally connected to the support apparatus.

3. The tooling support apparatus of claim 1 wherein the rod is adapted to be connected with respect to the patient support at selectable points along a length of the rod.

4. The tooling support apparatus of claim 1 wherein the patient support includes a skull clamp and the rod is adapted to be mounted to the skull clamp.

5. The tooling support apparatus of claim 4 wherein the rod is adapted to be connected to the skull clamp at selectable points along a length of the rod.

6. The tooling support apparatus of claim 1 wherein the patient support includes a table and the rod is adapted to be mounted with respect to the table.

7. The tooling support apparatus of claim 6 wherein the table includes a side rail and the rod is adapted to be mounted with respect to the side rail.

8. The tooling support apparatus of claim 1 further comprising a bracket having one end mounted with respect to the support apparatus and an opposite end adapted to receive a probe tip on one end of an articulated arm.

9. The tooling support apparatus of claim 8 wherein the path of the support apparatus is a dovetail path and the one end of the bracket has a dovetail sized to slide in the dovetail path of the support apparatus.

10. The tooling support apparatus of claim 9 wherein the opposite end of the bracket has a connecting element adapted to receive a connecting element of a support base connected to one end of the articulated arm.

11. The tooling support apparatus of claim 1 wherein the support element of the tool holder further comprises:

a first shaft having one end adjustably coupled to the support apparatus; and

a second shaft having one end rotatably connected and selectively lockable to an opposite end of the first shaft to permit the second shaft to be oriented at an angle with respect to the first shaft, whereby the tool holder is selectively moved to a desired position by adjusting the positions of the first and second shafts.

12. The tooling support apparatus of claim 11 wherein the support element further comprises a member mounted to the support apparatus and having a bore for rotationally receiving the one end of the first shaft to permit a selected length of the first shaft to extend through the clamp at a selectable angle.

13. The tooling support apparatus of claim 1 further comprising a second rod connected at an upper end to the support apparatus and a lower end of the second rod is adapted to be connected to the patient support, the rods holding the support apparatus at the desired elevation above the patient support.

14. The tooling support apparatus of claim 13 wherein the patient support includes a table having a side rail extending longitudinally along each side of the table and one of the support rods is adapted to be mounted to one of the side rails.

15. The tooling support apparatus of claim 14 wherein one of the rods is adapted to be selectively movable to different locations along the side rails.

16. The tooling support apparatus of claim 13 wherein the tool holder further comprises:

a bracket having one end mating with and connectable to the curvilinear member, the bracket extending from the curvilinear member to a location inside the circumference of the curvilinear member and being movable and lockable with respect to the curvilinear member at a selected position with respect to the patient.

17. The tooling support apparatus of claim 16 wherein the support apparatus has a dovetail path and the one end of the bracket has a dovetail sized to slide in the dovetail path of the support apparatus.

18. The tooling support apparatus of claim 16 wherein the tool holder further comprises:

a second alignment element rotatably mounted on the support element and adapted to receive a tool; and

a second clamp disposed with respect to the second alignment element for locking the second alignment element in a selected orientation.

19. The tooling support apparatus of claim 18 wherein the first and second clamps include respective first and second paths for receiving the first and second alignment elements, respectively, thereby permitting each of the alignment elements to change position with respect to each other.

20. The tooling support apparatus of claim 19 wherein the first and second alignment elements are generally spherical in shape and have a bore extending diametrically therethrough.

21. The tooling support apparatus of claim 20 wherein the first and second alignment elements rotate within their respective first and second paths.

22. The tooling support apparatus of claim 1 wherein the support apparatus is a curvilinear member and the path of motion extends around a circumference of the curvilinear member.

23. The tooling support apparatus of claim 22 wherein the path of motion is a a circular path.

24. The tooling support apparatus of claim 23 wherein the circular path is a dovetail channel.

25. The tooling support apparatus of claim 1 wherein the first alignment element is generally spherical in shape with a bore extending diametrically therethrough.

26. A tooling support apparatus for use with a stereotactic apparatus being used to perform a procedure on a patient supported by a patient support comprising:

a support apparatus adapted to be connected with respect to the patient support; and

a tool holder including

a support element mounted to the support apparatus and movable to selected positions with respect to the patient,

first and second alignment elements rotatably mounted on the support element and adapted to simultaneously receive tools, each of the first and second alignment elements being independently movable to selectively change position and orientation of its respective tool with respect to the patient, thereby defining two surgical paths extending into the patient from the two tools.

27. A tooling support apparatus of claim 26 wherein the support element of the tool holder further comprises:

a first shaft having one end adjustably coupled to the support apparatus; and

a second shaft having one end rotatably connected and selectively lockable to an opposite end of the first shaft to permit the second shaft to be oriented at an angle with respect to the first shaft, the first and second alignment elements being rotatably mounted with respect to the second shaft, whereby the first and second alignment elements are selectively moved to respective desired positions by adjusting the positions of the first and second shafts.

28. The tooling support apparatus of claim 26 wherein the tool holder further comprises a clamp mounted with respect to the alignment elements for locking the alignment elements in selected orientations.

29. The tooling support apparatus of claim 28 wherein the tool holder comprises first and second clamps disposed with respect to the first and second alignment elements, respectively, for locking the alignment elements in selected positions.

30. The tooling support apparatus of claim 29 wherein the first and second clamps include respective first and second paths for receiving the first and second alignment elements, respectively, thereby permitting each of the alignment elements to change position with respect to each other.

31. The tooling support apparatus of claim 30 wherein the first and second alignment elements are generally spherical in shape and have a bore extending diametrically therethrough.

32. The tooling support apparatus of claim 31 wherein the first and second alignment elements rotate within their respective first and second paths.

33. A tooling support apparatus of claim 30 wherein the support element of the tool holder further comprises:

a first shaft having one end adjustably coupled to the support apparatus; and

a second shaft having one end rotatably connected and selectively lockable to an opposite end of the first shaft to permit the second shaft to be oriented at an angle with respect to the first shaft, the first and second alignment elements being rotatably mounted with respect to the second shaft, whereby the first and second alignment elements are selectively moved to respective desired positions by adjusting the positions of the first and second shafts.

34. A tooling support apparatus of claim 33 wherein the second shaft pivots with respect to the first shaft about an axis of rotation substantially perpendicular to a length of the first shaft, and the first and second alignment elements move in the respective first and second paths in a direction substantially parallel to the axis of rotation.

35. A tooling support for use with a stereotactic system being used to perform a procedure on a patient supported by a patient support comprising:

a support apparatus;

a rod having a lower end adapted to be connected to the patient support and having an upper end connected to the support apparatus, the rod holding the support apparatus above the patient support; and

a tool holder including

a support element mounted on the support apparatus and being movable to and lockable at selected positions relative to the support apparatus above the patient support,

a generally spherical alignment element rotatably mounted on the support element and adapted to receive a tool, the alignment element being pivotable with respect to the tool holder to selectively change the orientation of the alignment element without changing its position with respect to the patient, thereby defining a surgical path between the tool and a target point within the patient, and

a clamp operably mounted with respect to the alignment element for selectively locking the alignment element at a desired orientation.

36. A tooling support for use with a stereotactic system being used to perform a procedure on a patient supported by a patient support comprising:

a support apparatus providing a path of motion in a plane;

a rod having a lower end adapted to be connected to the patient support and having an upper end connected to the support apparatus, the rod holding the support apparatus such that the plane of motion is at a desired elevation above the patient support; and

a tool holder mounted on the support apparatus and adapted to receive a tool, the tool holder including

a first shaft having one end adjustably coupled to the support apparatus,

a second shaft having one end rotatably connected and selectively lockable to an opposite end of the first shaft to permit the second shaft to be oriented at an angle with respect to the first shaft,

an alignment element rotatably mounted at an opposite end of the second shaft and adapted to receive a tool at the desired position with respect to the patient, the alignment element being selectively adjustable to change the position and orientation of the tool to define a path between a target point within the patient, and

a clamp operably mounted with respect to the alignment element for selectively locking the alignment element.

37. The tooling support of claim 36 wherein the tool holder further comprises a member mounted to the support apparatus and having a bore for rotationally receiving the one end of the first shaft to permit a selected length of the first shaft to extend through the clamp at a selectable angle.

38. The tooling support of claim 37 wherein the support apparatus includes a curvilinear member having a path extending around a circumference of the curvilinear member.

39. A tooling support for use with a stereotactic system being used to perform a procedure on a patient supported by a patient support comprising:

a support apparatus providing a path of motion in a plane;

a rod having a lower end adapted to be connected to the patient support and having an upper end connected to the support apparatus, the rod holding the support apparatus such that the plane of the path of motion is substantially nonperpendicular to and above the patient support; and

a tool holder including

a support element mounted on the support apparatus and being movable to and lockable at selected positions along the path of motion relative to the support apparatus,

a generally spherical alignment element rotatably mounted on the support element and adapted to receive a tool, the alignment element being selectively pivotable with respect to the patient to define a surgical path between the tool and a target point within the patient, and

a clamp operably connected to the alignment element for selectively locking the alignment element with respect to the support element.