Cranial insertion of surgical needle utilizing computer-assisted tomography

• US 4,360,028 A
• Filed: 01/14/1980
• Issued: 11/23/1982
• Est. Priority Date: 01/14/1980
• Status: Expired due to Term

• Current Assignee: Jean Y. Barbier, Moran, Christopher J.
• Original Assignee: Jean Y. Barbier, Moran, Christopher J.
• Inventors: Moran, Christopher J., Barbier, Jean Y.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US06/111,892
• Time in Patent Office: 1,044 Days
• Field of Search: 128/659, 128/303 B, 128/630, 128/653
• US Class Current: 600/436
• CPC Class Codes: A61B 2017/00902 transparent or translucent
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 6/501 for diagnosis of the head, e.g. neuroimaging or craniography
• 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 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

The head of a patient is held in place horizontally on the indexable sliding cradle of an X-ray scanner by a vertical ring encircling the head having radiolucent rests supporting the head behind the ears at the mastoid processes and beneath the eyes at the cheekbone area. Adjustable horizontally-projecting instrument support structure is carriage-mounted on an arcuate track in the ring between the forward rests and has a horizontally-bored instrument guide-holder of such density as to appear on an X-ray scan and positionable adjacent to the head with its horizontal bore in the plane of any indexable scanning section of the X-ray scanner. By scanning the head and adjacent guide holder, the holder may be positioned with its bore in the same plane as and on a line directed to a point of interest in the brain. Thereafter, the holder may be utilized to guide a surgical needle to the point of interest.

Claims

1. A method of performing brain surgical procedures through the skull to a point of procedure by utilizing a computer-assisted tomography scanner of the type which develops indexed parallel planar sectional representations of the head, comprising the steps of

securing a patient'"'"'s head, below the level at which such sectional representations are to be developed, in fixed position relative to the movable, indexable cradle of the scanner,

preliminarily scanning the head and selecting from the sectional representations so developed an indexed plane of interest at which a chosen point of procedure is located,

positioning an instrument holder having a density substantially of the order of that of soft human tissue and having a bore for guiding a surgical instrument with the axis of the bore in the plane of interest,

further positioning the instrument holder angularly in the plane of interest with the axis of its bore along a straight line directed to the point of procedure through a point of entrance into the skull,

scanning at the plane of interest to confirm that the bore of the instrument holder is positioned for guidance of the instrument along the selected line to the point of procedure,

drilling through the skull at the point of entrance guided by the bore of the instrument holder, and

inserting the surgical instrument through the guide-holder bore and the skull point of entrance and guiding same by the instrument holder bore to the point of procedure.

2. The method defined in claim 1, wherein the step of inserting the surgical instrument is accompanied by the step of

scanning at the plane of interest with the surgical instrument so inserted to confirm that the instrument is inserted to the point of procedure.

3. The method defined in claim 1, wherein the step of securing a patient'"'"'s head to the scanner includes

supporting the rear of the head behind the ears at the mastoid processes, and

supporting the front of the head beneath the eyes at the zygomatic arches.

4. The method defined in claim 1, wherein the step of securing a patient'"'"'s head to the scanner includes

supporting the rear of the head beneath the ears at the mastoid processes, and

supporting the front of the head beneath the eyes at the maxilla.