System for guiding instruments having different sizes

• US 7,879,045 B2
• Filed: 04/10/2007
• Issued: 02/01/2011
• Est. Priority Date: 04/10/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gielen, Frans L. H., Appenrodt, Peter, Duysens, Victor, Van Venrooij, Paulus Cornelis
• Primary Examiner(s): Manahan; Todd E
• Assistant Examiner(s): Hollm; Jonathan A
• Application Number:
  US11/733,362
• Publication Number:
  US 20080255544A1
• Time in Patent Office: 1,393 Days
• Field of Search: 606/129, 600/201, 600/206, 600/207, 600/429, 604/164.11
• US Class Current: 606/130
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• 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 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

A system and procedure for using the system are disclosed for guiding instruments of varying sizes. The instruments can be guided into various portions of the anatomy for performing a procedure, providing a treatment, measuring a physiological response, or the like. Two or more instruments of varying sizes can be driven or guided relative to one another with the same system.

Claims

1. A system for guiding an instrument during a surgical procedure relative to an anatomy, comprising:

a guide section defining a first guide passage extending along a first axis through the guide section and a plurality of independently adjustable movement members each extending radially outward through an outer peripheral wall of the guide section;

a plurality of guide members each including a first member defining only a portion of a second guide passage extending along a second axis, and a second member extending substantially perpendicular to the first member and beyond the outer peripheral wall of the guide section, the second member including a movement bore extending therethrough and configured to receive a corresponding movement member therein;

a plurality of slide members extending radially outward from the outer peripheral wall of the guide section, the second member of each guide member including a slide bore configured to receive one of the plurality of slide members;

wherein the first guide axis and the second guide axis are substantially parallel;

wherein each guide member is operable to translate relative to the guide section about a corresponding movement member and a corresponding slide member along a radial axis.

2. The system of claim 1, wherein each movement member extends perpendicular to the first axis and each guide member is operable to translate about a corresponding movement member along a radial axis perpendicular to the first axis.

3. The system of claim 1, wherein the first guide passage defines a dimension greater than a dimension of the second guide passage.

4. The system of claim 3, wherein the dimensions of the first and second guide passages include at least one of a diameter, a perimeter, a length, or combinations thereof.

5. The system of claim 1,

wherein at least a sub-plurality of the plurality of guide members are operable to move with a respective one of the plurality of movement members to define a complete second guide passage.

6. The system of claim 1, further comprising:

a first instrument operable to be guided only with the first guide passage; and

a second instrument operable to be guided only with the second guide passage.

7. The system of claim 6, further comprising:

a surgical navigation system including a tracking system and a display device;

wherein the tracking system includes a tracking sensor;

wherein the tracking sensor is associated with at least one of the first instrument or the second instrument to be tracked with the tracking system;

wherein the surgical navigation system is operable to form an icon on the display device based upon the tracked location of the tracking device.

8. The system of claim 5,

wherein each movement bore includes an internal thread and each movement member includes an external thread configured to threadably engage the internal thread such that rotation of each movement member translates a corresponding guide member of the plurality of guide members along a corresponding slide member between the first and second positions.

9. A system for guiding an instrument during a surgical procedure relative to an anatomy, comprising:

a guide fixture extending between a first end and a second end and also defining a height between a top edge and a bottom edge;

a plurality of guide members associated with the guide fixture, the plurality of guide members each defining a first movement portion and a guide portion, the guide portion of each of the plurality of guide members including a plurality of guide depressions formed in a peripheral wall thereof;

a movement section associated with the guide fixture, the movement section associated with the first movement portion of each of the plurality of guide members and adapted to allow movement of each guide member between a first position and a second position relative to the guide fixture, the plurality of guide depressions of each of the plurality of guide members configured to cooperate with a sub-plurality of the plurality of guide depressions of at least another two of the plurality of guide members in the first position to define a plurality of first guide areas; and

a plurality of second guide areas defined by the guide fixture and substantially aligned with the plurality of first guide areas;

wherein when the plurality of guide members are in the second position, the plurality of guide members are located to allow the instrument unrestricted access to the plurality of second guide areas.

10. The system of claim 9, wherein at least two of the plurality of guide members in the first position allow at least one of the guide depressions from each of the at least two guide members to define one of the plurality of first guide areas;

and

wherein each of the plurality of guide members in the first position allows another one of the guide depressions from each of the plurality of guide members to define another one of the plurality of first guide areas spaced apart from the defined one of the plurality of first guide areas.

11. The system of claim 9, wherein the plurality of first guide areas include a first dimension different from a second dimension of the plurality of second guide areas.

12. The system of claim 11, wherein the movement section further comprises:

a plurality of guide tracks each including a slide section extending from the guide fixture;

wherein each of the guide members are operable to move relative to one another along a respective guide track;

wherein the plurality of guide members are operable to slide along the respective slide section to allow the association and disassociation of the guide portions defined by each of the plurality of guide members with each other.

13. The system of claim 9, wherein the movement section includes a plurality of movement members extending from the guide fixture;

wherein the first movement portion of each of the guide members defines a bore operable to be associated with one of the movement members extending from the guide fixture;

wherein each guide member is operable to move along a respective movement member.

14. The system of claim 13, wherein the guide fixture defines a radial axis;

and

wherein each of the guide members move between the first position and the second position along one of the movement members and about the radial axis.

15. The system of claim 9, wherein the plurality of first guide areas each include a dimension that is smaller than a dimension defined by each of the plurality of second guide areas.

16. The system of claim 15, further comprising:

a first instrument having a first dimension and a second instrument having a second dimension;

wherein at least one of the plurality of first guide areas is operable to guide the first instrument and at least one of the plurality of second guide areas is operable to guide the second instrument.

17. The system of claim 16, wherein the at least one first guide area includes a dimension that is operable only to guide the first instrument.

18. The system of claim 9, further comprising:

a drive system;

an instrument;

wherein the drive system is operable to drive the instrument through at least one of the plurality of first guide areas, at least one of the plurality of second guide areas, or combinations thereof.

19. The system of claim 18, further comprising:

a positioning system.

20. The system of claim 19, wherein the positioning system includes at least one of a stereotactic head frame, a small-scale head frame, a robotic system, or combinations thereof.

21. The system of claim 16, further comprising:

a surgical navigation system including a tracking system operable to determine a position of at least one of the first instrument, the second instrument, the guide fixture, the guide member, one of the plurality of first guide areas, one of the plurality of second guide areas, or combinations thereof to determine the position of the instruments being guided by the one of the first guide areas or the one of the second guide areas.

22. The system of claim 9, further comprising:

an imaging system including at least one of a magnetic resonance imaging system, a PET imaging system, a SPECT imaging system, an x-ray imaging system, a computer aided tomography imaging system, or combinations thereof.

23. A system for guiding an instrument during a surgical procedure relative to an anatomy, comprising:

a drive system adapted to be positioned relative to the anatomy, the drive system including;

a drive section operable to drive an instrument into the anatomy from a drive area;

a guide fixture positioned relative to the drive section and having a guide section substantially aligned with the drive area of the drive section;

a plurality of guide members each defining a plurality of first guide portions in outer walls thereof and moveably connected to the guide fixture, wherein each guide member is operable to move relative to the guide fixture from a first position to a second position, each of the plurality of first guide portions of each of the plurality of guide members being aligned with the drive section when each of the guide members are in the first position, wherein the plurality of first guide portions of each of the plurality of guide members are configured to cooperate with a sub-plurality of the plurality of first guide portions of at least another two of the plurality of guide members in the first position to define a plurality of first guide areas; and

a second guide portion defined by the guide section of the guide fixture substantially permanently aligned with the drive section, the second guide portion defining a plurality of second guide areas;

wherein the plurality of first guide areas are operable to be aligned with the plurality of second guide areas when the plurality of guide members are in the first position.

24. The system of claim 23, further comprising:

a support system adapted to be associated with the anatomy;

wherein the support system includes at least one of a stereotactic head frame, a small-scale head frame, a robotic support system, a rigid support system, a manipulable support system;

or combinations thereof.

25. The system of claim 24, further comprising:

a surgical navigation system;

wherein the surgical navigation system is operable to navigate at least one of the support system, the drive section, or combinations thereof relative to the anatomy.

26. The system of claim 25, wherein the surgical navigation system includes at least one of a tracking system, an imaging system, a navigation processor, or combinations thereof.

27. The system of claim 23, further comprising:

a plurality of movement members each including a rod extending radially from the guide section of the guide fixture;

wherein each of the plurality of guide members define a movement bore extending therethrough;

wherein each guide member is operable to slide along one of the movement members along a radial axis of the guide fixture.

28. The system of claim 27, wherein the sub-plurality of the plurality of first guide portions is operable to define one of the plurality of first guide areas aligned with the drive section when at least a first sub-plurality of the plurality of guide members is in the first position.

29. The system of claim 27, further comprising:

an instrument operable to be driven by the drive section;

wherein the instrument is operable to pass through one of the plurality of first guide areas and one of the plurality of second guide areas.

30. The system of claim 29, further comprising:

a second instrument operable to be driven with the drive section wherein the second instrument passes substantially only through one of the plurality of second guide areas.

31. The system of claim 29, wherein the instrument is at least one of a micro-electrode , a deep brain stimulation probe or electrode, a biopsy needle, a cannula, a catheter, a delivery device, or combinations thereof.

32. The system of claim 29, further comprising:

a guide cannula positioned through the one of the plurality of first guide areas and the one of the plurality of second guide areas and through which the first instrument is operable to pass.

33. The system of claim 23, wherein each of the plurality of first guide areas defines a first dimension and each of the plurality of second guide areas defines a second dimension;

wherein the first dimension and the second dimension are different.

34. The system of claim 33, wherein the second dimension is larger than the first dimension;

wherein an instrument is operable to be guided with only one of the first guide areas or one of the second guide areas.