Method and apparatus for controlled insertion and withdrawal of electrodes

• US 8,734,466 B2
• Filed: 04/25/2007
• Issued: 05/27/2014
• Est. Priority Date: 04/25/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Appenrodt, Peter, Gielen, Frans L. H.
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): EASTWOOD, DAVID C
• Application Number:
  US11/739,791
• Publication Number:
  US 20080269777A1
• Time in Patent Office: 2,589 Days
• Field of Search: 606/129, 606/130, 606/108, 604/506, 604/508, 604/510, 604/512, 607/6, 607/7, 607/115, 607/116, 607/117, 607/148, 607/45, 600/373, 600/377, 600/378
• US Class Current: 606/129
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• 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 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• 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 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: A61N 1/0529 Electrodes for brain stimulation

Abstract

A system for a controlled insertion and withdrawal of at least one electrode in the anatomy. The system can include a guide device and at least one electrode located within the guide device to at least one of record or stimulate an anatomy. The system can also include an indicator coupled to the electrode to indicate a position of a distal end of an electrode relative to the guide device.

Claims

1. A system for controlled insertion and withdrawal of at least one electrode in an anatomy comprising:

at least one insertion cannula that defines a first through passage and a distal end;

a macroelectrode moveably disposed in the first through passage, the macroelectrode having a proximal end and a distal end, the distal end selectively extendable to a first extended position outside and beyond the distal end of the at least one insertion cannula to engage the anatomy, the distal end also selectively extendable to a second extended position outside and beyond the distal end of the at least one insertion cannula, the distal end of the macroelectrode being extended further away from the distal end of the at least one insertion cannula in the first extended position as compared to the second extended position, the macroelectrode defining a second through passage;

an insulating member that covers a portion of the macroelectrode and that electrically insulates the macroelectrode from the at least one insertion cannula;

a microelectrode moveably disposed in the second through passage, the microelectrode having a proximal end and a distal end, the distal end selectively extendable beyond the distal end of the macroelectrode to engage the anatomy; and

an indicator having a visible marking on the insulating member, the visible marking being a color contrasted from other portions of the insulating member, the visible marking having a length that is substantially equal to a difference in distance between the first extended position and the second extended position, the visible marking being fully blocked by the at least one insertion cannula when the macroelectrode is in the first extended position and the visible marking being fully revealed from the at least one insertion cannula and fully visible when the macroelectrode is in the second extended position such that the indicator indicates only that the macroelectrode is in the first extended position or alternatively in the second extended position.

2. The system of claim 1, comprises a plurality of insertion cannulas and each of the plurality of insertion cannulas include a respective macroelectrode and a respective microelectrode.

3. The system of claim 1, further comprising:

a drive system coupled to the insertion cannula to move the insertion cannula, the macroelectrode and the microelectrode relative to the anatomy; and

a frame coupled to the anatomy and the drive system.

4. The system of claim 3, further comprising:

at least one tracking device coupled to at least one of the frame and the drive system; and

a navigation system that tracks the at least one tracking device relative to the anatomy during a surgical procedure.

5. The system of claim 4, wherein in the first extended position, the insertion cannula includes the microelectrode extended beyond the distal end of the macroelectrode and the macroelectrode extended beyond the distal end of the insertion cannula such that the microelectrode enters into the anatomy when the drive system moves the insertion cannula.

6. The system of claim 5, wherein in the second extended position, the insertion cannula includes the macroelectrode extended beyond the distal end of the insertion cannula a first distance, and the microelectrode is retracted within the macroelectrode.

7. The system of claim 1, wherein the distal end of the macroelectrode is tapered.

8. The system of claim 1, further comprising a stop that is fixed to the macroelectrode, the stop having a width greater than a diameter of the first through passage to limit movement of the macroelectrode relative to the insertion cannula.

9. A system for controlled insertion and withdrawal of at least one electrode in an anatomy comprising:

at least one insertion cannula that defines a distal end, a proximal end, and a first through passage that extends through the cannula;

an electrically conductive macroelectrode slideably disposed in the first through passage, the macroelectrode having a proximal end and a distal end, the distal end selectively extendable to a first extended position outside and beyond the distal end of the at least one insertion cannula to electrically communicate with the anatomy, the distal end selectively extendable to a second extended position outside and beyond the distal end of the at least one insertion cannula to substantially occlude the first through passage for gradually engaging the anatomy as the macroelectrode and insertion cannula are advanced relative to the anatomy, the distal end of the macroelectrode being extended further away from the distal end of the at least one insertion cannula in the first extended position as compared to the second extended position, the macroelectrode defining a second through passage that extends through the macroelectrode;

an insulating member that covers a portion of the macroelectrode and that electrically insulates the macroelectrode from the at least one insertion cannula;

an electrically conductive microelectrode slideably disposed in the second through passage, the microelectrode having a proximal end and a distal end, the distal end selectively extendable outside and beyond the distal end of the macroelectrode to electrically communicate with the anatomy; and

at least one indicator having a visible marking on the insulating member, the visible marking being color contrasted from other portions of the insulating member, the visible marking having a length that is substantially equal to a difference in distance between the first extended position and the second extended position, the visible marking being fully blocked by the at least one insertion cannula when the macroelectrode is in the first extended position and the visible marking being fully revealed from the at least one insertion cannula and fully visible when the macroelectrode is in the second extended position such that the indicator indicates only that the macroelectrode is in the first extended position or alternatively in the second extended position.

10. The system of claim 9, comprising a plurality of insertion cannulas each including a respective one of the macroelectrode and a respective one of the microelectrode.

11. The system of claim 10, further comprising:

a drive system coupled to the plurality of insertion cannulas to move the insertion cannulas, the macroelectrodes, and the microelectrodes relative to the anatomy; and

a frame coupled to the anatomy and the drive system.

12. The system of claim 11, further comprising:

at least one tracking device operably coupled to at least one of the frame and the drive system; and

a navigation system that tracks the at least one tracking device relative to the anatomy during a surgical procedure.

13. The system of claim 10, wherein a selected one of the plurality of insertion cannulas in the respective second extended position includes the respective macroelectrode extended beyond the respective insertion cannula a first distance, the respective microelectrode is retracted within the respective macroelectrode for each of the insertion cannulas, and the distal end of the macroelectrode of the selected one extends a second distance beyond each of the insertion cannulas other than the selected one.

14. The system of claim 13, wherein the at least one indicator indicates if the respective macroelectrode of the insertion cannulas other than the selected one are in the second extended position.

15. The system of claim 9, wherein the distal end of the macroelectrode is tapered.

16. The system of claim 9, further comprising a stop that is fixed to the macroelectrode, the stop having a width greater than a diameter of the first through passage to limit movement of the macroelectrode relative to the insertion cannula.

17. A system for controlled insertion and withdrawal of at least one electrode in an anatomy comprising:

at least one insertion cannula that defines a terminal distal end, a terminal proximal end, and a first through passage that extends continuously through the cannula from the terminal proximal end to the terminal distal end;

an electrically conductive macroelectrode slideably disposed in the first through passage, the macroelectrode having a terminal proximal end and a terminal distal end, the terminal distal end being tapered, the terminal distal end selectively extendable beyond the terminal distal end of the at least one insertion cannula to electrically communicate with the anatomy, the macroelectrode defining a second through passage that extends continuously through the macroelectrode from the terminal proximal end to the terminal distal end;

an insulating member that covers a portion of the macroelectrode and that electrically insulates the macroelectrode from the at least one insertion cannula;

an electrically conductive microelectrode slideably disposed in the second through passage, the microelectrode having a terminal proximal end and a terminal distal end, the terminal distal end selectively extendable beyond the distal end of the macroelectrode to electrically communicate with the anatomy;

at least one visible marking on a portion of the insulating member, the visible marking being a color contrasted from other portions of the insulating member to indicate the position of the distal end of the macroelectrode relative to the distal end of the insertion cannula, the at least one visible marking indicating that the distal end of the macroelectrode is in a first extended position extending outside and beyond the distal end of the at least one insertion cannula to electrically communicate with the anatomy, the at least one visible marking indicating that the distal end of the macroelectrode is in a second extended position extending outside and beyond the distal end of the at least one insertion cannula to substantially occlude the first through passage for gradually engaging the anatomy as the macroelectrode and insertion cannula are advanced relative to the anatomy, wherein the distal end of the macroelectrode is extended further away from the distal end of the at least one insertion cannula in the first extended position as compared to the second extended position, the visible marking having a length that is substantially equal to a difference in distance between the first extended position and the second extended position, the visible marking being fully blocked by the at least one insertion cannula when the macroelectrode is in the first extended position and being fully revealed from the at least one insertion cannula and fully visible when the macroelectrode is in the second extended position such that the visible marking indicates only that the macroelectrode is in the first extended position or alternatively in the second extended position;

a stop that is fixed to the macroelectrode, the stop having a width greater than a diameter of the first through passage to limit movement of the macroelectrode relative to the insertion cannula;

a drive system coupled to the at least one insertion cannula to move the at least one insertion cannula, the macroelectrode, and the microelectrode relative to the anatomy;

a frame coupled to the anatomy and the drive system;

at least one tracking device coupled to at least one of the frame and the drive system; and

a navigation system that tracks the at least one tracking device relative to the anatomy during a surgical procedure.