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Publication numberUS3508552 A
Publication typeGrant
Publication dateApr 28, 1970
Filing dateOct 23, 1965
Priority dateOct 27, 1961
Publication numberUS 3508552 A, US 3508552A, US-A-3508552, US3508552 A, US3508552A
InventorsMarcel Hainault
Original AssigneeAlexandre & Cie
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Apparatus for stereotaxic neurosurgery
US 3508552 A
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Description  (OCR text may contain errors)

April 1970 M. HAINAULT 3,508,552

APPARATUS FOR STEREOTAXIC NEUROSURGERY Filed Oct. 25, 1965 3 Sheets-Sheet 1 April 28, 1970 M. HAINAULT APPARATUS FOR STEREOTAXIC NEUROSURGERY 3 Sheets-Sheet 3 Filed Oct. 25; 1965 April 28, 1970 M. HAINAULT APPARATUS FOR STEREOTAXIC NEUROSURGERY Filed Oct. 25, 1965 5 Sheets-Sheet 5 United States Patent 3,508,552 APPARATUS FOR STEREOTAXIC NEUROSURGERY Marcel Hainault, Paris, France, assignor to Alexandre & Cie, Romainville, Seine, France, a socit anonyme Continuation-impart of application Ser. No. 222,897,

Sept. 11, 1962. This application Oct. 23, 1965, Ser.

No. 503,678 Claims priority, application France, Oct. 27, 1961,

Int. Cl. Alm 19/00 US. Cl. 128303 3 Claims ABSTRACT OF THE DISCLOSURE This apparatus comprises a rectangular frame provided with means for fastening same to the patients skull and three double grids each formed with parallel rectilinear passages therethrough, said passages forming a regul r square pattern. Two of these double grids acting as double locating grids are secured to two adjacent sides of said frame whereby an X-ray handling performed after having positioned the apparatus on the patients skull makes it possible to determine, in each locating grid, the specific rectilinear passage leading to the point to be operated. The third grid acting as a guide grid for the operating spindle is mounted adjustable about an axis parallel to one of the frame sides. By using simple means and of the space reserved for the patients skull it is possible to deterinine which is the rectilinear passage of the guide double grid which is to receive the operating drift, as well as the depth of penetration of this drift which is necessary for bringing its end at the intersection of two rectilinear passages located in the two location double grids.

This is a continuation-in-part of the U.S. Patent application Ser. No. 222,897, now abandoned.

Apparatus designed for stereotaxic neurosurgery are already known which comprise a frame adapted to be rigidly secured to the head of the patient and at least one reference grid adapted to be mounted on one side of the frame in front of an X-ray receiving plate for obtaining a picture showing simultaneously the image of the interior of the patients brain and said reference grid, the latter acting in this case as a positioning grid. This picture, on which the point of the patients brain which is to be operated is designated by the end of a surgical drift, permits of locating in the grid a rectilinear passage leading to this point to be operated. By repeating this operation with the same grid or a similar grid mounted on another side of the frame at right angles to the preceding grid, it will be possible to determine another passage leading to the point to be operated and the intersection of these two passages will locate this point geometrically within the brain. To operate, it is then only sufficient, after removing the X- ray apparatus, to engage the surgical drift in that one of the passages in said grid (becoming then the guide grid) which leads to the point to be operated and to drive this surgical drift to a depth easily measured on the X-ray picture corresponding to the other position of said grid. However, these apparatus, while constituting a substantial improvement over the previous state of the art, are objectionable in that the only choice with which the surgeon is confronted for directing the surgical drift is to utilize, as a guide grid, the grid disposed in one or the other of said two locating positions. Thus, one or the other of the two corresponding directions of the surgical drift is therefore a direction parallel to the general plane of said frame, although the surgeon might deem more desirable to drive the surgical drift in a direction either parallel, or more or less inclined, to the perpendicular to the general plane of said frame.

It is a first object of this invention to provide a stereotaxic neurosurgery apparatus of the general type set forth hereinabove, wherein the surgeon disposes for guiding the surgical drift of a latitude such that he can select a penetration direction in a plane lying at right angles to the general plane of said frame.

It is another object of this invention to provide a stereotaxic neurosurgery apparatus of the general type set forth hereinabove, wherein the conventional grid or grids serve only positioning or locating purposes, and this apparatus comprises in addition at least one guide grid pivotally mounted with an adjustable inclination about a fixed pivot axis underlying the aforesaid frame and parallel to the general plane of said frame.

It is a further object of this invention to provide a stereotaxic neurosurgery apparatus comprising means for determining in a simple yet reliable manner the passage to be selected in the double guide grid for engaging the surgical drift in the direction of the point to be operated as geometrically determined by the passages located in the two positions of said guide double grid, and setting on this drift a stop member adapted to engage said guide double grid to limit the penetration of said surgical drift to the depth corresponding to the position in which its operative end attains the point to be operated in the patients brain.

It is a complementary object of this invention to provide a stereotaxic neurosurgery apparatus comprising several guide double grids having all their axes of oscillation either parallel to the same two opposite sides of the frame, or parallel the ones to a pair of opposite sides of said frame and the others to the other pair of opposite sides of said frame.

The features and advantages characterizing this invention will appear more completely from the following description given hereinafter by way of example with reference to the accompanying drawing, in which:

FIGURE 1 illustrates the apparatus positioned on the patients head shown diagrammatically by the contour of the skull, this apparatus being equipped on one side of the frame with a double positioning grid and withan X- ray receiving plate;

FIGURE 2 shows the same apparatus after the positioning in the guide double grid of the passage leading to the point of the brain which is to be operated and after the positioning and securing of the guide double grid above the frame in the operative position of said grid which is desired by the surgeon;

FIGURE 3 is a fragmentary View showing the same apparatus after the mounting of the guide double grid on an adjacent side of the frame, upon completion of the X-ray determination of the passage, in this new position of the guide double grid, leading to the point of the patients brain which is to be operated;

FIGURE 4 is a fragmentary view showing the same apparatus during the use of auxiliary equipment for 10- cating the passage to be selected in the guide double grid for engaging the operating drift, and also for fitting on this drift a stop member adapted to engage said guide double grid when the operative end of the drift has attained the point to be operated;

FIGURES 5 to 8 are plan views from above showing the apparatus equipped with four guide grids according to four different mounting procedures.

The apparatus comprises a rectangular frame 10 secured to the operation table with an adjustable setting by means of adequate connecting means 11, this frame carrying at its four corners four support means 12 in which adjustable bone clamping rods 13 are mounted, these rods 13 being adapted to secure the patients skull a to said frame 10. Each one of the four sides of said frame 10 has formed therethrough perforations 14 for detachably securing a positioning double grid 15 as shown in FIGURE 1. This double grid 15 comprises two parallel flat walls in which circular holes are formed to constitute a regular chequer-work with the same relative spacing, on the two Walls, to constitute pairs of aligned holes having parallel axes. An X-ray equipment is provided for forming on a receiving plate 16, by means of rays adjusted in the direction of said pairs of holes in said double grid 15, a first X-ray picture showing the interior of the skull and the grid. After removing the grid, another picture will show the interior of the skull without the grid, and the point of the skull which is to be operated. Besides, the order in which these two X-ray pictures are taken may be reversed. A simple comparison between the two pictures will permit of determining which one of the rectilinear passages through the grid leads to the point of the patients brain which is to be operated, as will clearly appear from the passage of the following description which deals with FIGURES 3 and 4 of the drawing.

This apparatus, as shown in FIGURE 2, comprises a guide double grid 17 identical with the positioning or cating grid and provided with an arm 18 on which it is pivotally mounted about an axis parallel to one of the two series of rows of holes of the grid. This arm carries a clamping knob 19 for locking the guide double grid 17 in the desired angular position in relation to the arm 18. The upper ends of said support means 12 are formed with coupling means corresponding to reverse means formed on the relevant end of the arm 18 of said double grid 17, or of another grid which may be either the same or symmetrical thereto, with the knob 19 directed to the outside of frame 10 and the axis of rotation of the double grid 17 extending parallel to one of the sides of said frame. This axis is parallel to the side of frame 10 on which the locating double grid 15 is mounted. The axes of the pairs of coaxial holes of the guide double grid 17 are disposed at spaced intervals along rows extending in parallel, equally spaced planes disposed at right angles to the pivot axis of said double grid 17, and the guide double grid 17 and positioning double grid 15 are so mounted on the frame 10 that these parallel planes are coincident with the planes containing the axes of the pairs of holes of the corresponding rows of said guide double grid 15. The positioning effected by means of the pair of passage holes in the positioning double grid 15 will thus automatically determine the specific row containing the pair of passage holes in the guide double grid 17. The element 20 of arm 18 is a spring-loaded bolt tending to lock the guide double grid 17 in a particularly conventional position, namely in a position parallel to the plane of frame 10.

Then another locating grid 15a identical with grid 15 is mounted on another side of frame 10 adjacent to the first side, as shown in FIGURE 3, and the same procedure as that described hereinabove with reference to FIGURE 1 may be followed. A proper adjustment then permits of taking radiographic pictures in the direction of the rectilinear passages formed through the grid 15a. A first picture will show the interior of the brain and the grid. After removing the grid, a further X-ray picture will show the interior of the patients brain without the grid and the specific point of the brain which is to be operated. However, the order in which these X-ray pictures are taken may be reversed. A subsequent comparison between the two X-ray pictures will permit of determining which is the rectilinear passage formed through the grid which leads to the brain point to be operated. The grid 15a is subsequently restored as shown in FIGURE 3, or replaced by another one, if desired, for example an identical grid but having thicker walls which can act as a guide grid.

Under these conditions it is possible, as already known, to perform the operation by using said double grid 15a as a guide grid for the surgical drift by inserting this drift to the depth known from the radiographic picture taken facing the double locating grid 15, as already described with reference to FIGURE 1. There is shown by way of example in the drawing a small electromotor 21 of which the rectilinear drill engaging the pair of holes located in the double 15a performs the drilling operation necessary for inserting a surgical drift for example an electrode.

To adhere to the procedure of this invention by engaging the surgical drift through the double guide grid 17,

it is necessary to complete the selection of the pair of guide holes to be used for, so far, only the row containing this pair of holes (which was determined from the data obtained by means of the double locating grid 15) is known, as already described with reference to FIGURE 2. To this end, the perpendicular row is determined by using, as shown in FIGURE 4, very simple means comprising a positioning bracket 23 and a gauging stick 22. The positioning bracket 23 has a fiat under face bounded by a rectilinear edge 27 and is provided with two studs (not shown in the drawing) whereby said bracket can be secured with its fiat under face bearing against the upper face of the guide double grid 17 and with the rectilinear edge of said flat under face along one of the rows of holes of said guide double grid parallel to its axis of oscillation. This positioning bracket 23 extends beyond the side of the frame 10, in an arm 28 having a small flat upper face 29 coplanar with the under flat face of the bracket 23. Said arm 28 is bored to have rectilinear guiding holes 30 having a same axis and crossing perpendicularly the flat upper face 29 of arm 28 and meeting the alignment of the rectilinear edge 27 of the fiat underface of the positioning bracket 23. The gauging stick 22 is to be engaged through said rectilinear passage of the double grid 15a that meets the point of the patients brain to be operated with a part projecting outwardly under the arm 28 of positioning bracket 23. The surgical drift 24 provided with an adjustable stop member 25 is engaged from above through the holes 30 of arm 23 till the lower end of said surgical drift halts at a level beneath the outward projecting part of the gauging stick 22. The surgical drift 24 is left in such a position by adjustable setting of its adjustable stop member 25 hearing on the small upper face 29. The bracket 23 is moved on the upper face of the guide double grid 17, by releasing and re-engaging its knobs, to its use position wherein the lower end to the surgical drift 24 contacts the outward propecting part of the gauging stick 22. The surgical drift 24 is then pulled upwards till its lower end abuts, as shown in FIGURE 4, the outward projecting part of the gauging stick 22 and gauge in said position by setting its adjustable stop member 25 on the small upper face 29. The rectilinear edge of the positioning bracket 23 will thus register with the row of holes parallel to the pivotal axis along which the pair of holes to be used for guiding the drift are positioned. This pair of holes is thus definitely located and it is only necessary to operate by engaging therein the surgical drift 24 provided with the thus adjusted stop member 25 which will automatically stop the movement of translation of the drift when its end has attained the point to be operated.

Of course, the handling of this apparatus may be further facilitiated by providing two double locating grids mounted for example on the frame before the operation respectively in the two selected positions where they can be left until the operation is completed and the assembly removed from the apparatus.

Several double guide grids of the type set forth hereinabove may advantageously be used, if desired. More particularly four guide grids comprising a first pair of identical grids and a second pair of grids symmetrical to those of said first pair, may be provided, these grids being mounted separately on the four supports 12. With this set of guide grids comprising two guide grids 17 identical with the guide grid 17 of FIGURES 2 to 4, and two guide grids 117 having symmetrical structure and disposal, it is possible to devise different mountings of the apparatus for example as shown in FIGURES to 8. In the mounting shown in FIGURE 5 all the grids permit of inclining the operating drift in a plane at right angles to the major axis of said frame 10. In the mounting of FIGURE 6, all the double guide grids permit of inclining the operating drift in a plane at right angles to the minor axis of said frame. In the mountings shown in FIGURES 7 and 8, which are symmetrical to each other, the planes of said double guide grids permit of inclining the operating drift in a plane perpendicular to the minor axis of the frame, and the other pair of double guide grids permit of inclining this drift in a plane perpendicular to the major axis of the frame.

Although the present invention has been described in conjunction with preferred embodiments, it is to be understood that modifications and variations may be resorted to without departing from the spirit and scope of the invention, as those skilled in the art will readily understand. Such modifications and variations are considered to be within the purview and scope of the invention and appended claims.

What I claim is:

1. An apparatus for treating at least one point of the brain by means of the end of at least one surgical drift, which comprises a rectangular frame, supports carried by said frame at each corner, bone clamping rods extending from each support for securing the frame to the patients skull, first and second locating double grids each comprising two opposite parallel surfaces formed with circular openings defining parallel rectilinear passages disposed in a regular square pattern, said first and second locating double grids being removably secured respectively to a first side and to a second side perpendicular to said first side, with the rectilinear passages of each double grid extending at right angles to the relevant frame side and disposed to form two series of aligned passages lying in planes parallel to the frame plane, a selected passage of each one of said two locating grids leading to a point of the brain which is to be operated upon, which has previously been located by as X-ray method, an arm mounted on one of said supports extending over the frame, a guide double grid of the same construction as said locating double grids, means pivotally mounting said guide double grid on said arm for rotation about an axis parallel to said frame, and means for'loclging said guide double grid in a desired position of angular adjustment.

2. The structure of claim 1 wherein a plurality of arms are mounted on a plurality of supports and a pivotally mounted guide double grid is carried by each arm.

3, The structure of claim 1 wherein adjustable stop means are provided cooperating with said guide double grid for limiting the insertion of a surgical drift.

References Cited UNITED STATES PATENTS 581,540 4/1897 Dennis 12892 1,129,333 2/1915 Clarke 128-2 3,061,936 11/1962 Dobbeleer 33-174 3,223,087 12/1965 Vladyka et al 128-303 X FOREIGN PATENTS 1,282,623 12/1961 France.

DALTON L. TRULUCK, Primary Examiner

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US581540 *Jan 16, 1897Apr 27, 1897 dennis
US1129333 *Jun 27, 1914Feb 23, 1915Robert Henry ClarkeStereotaxic apparatus.
US3061936 *Jul 8, 1959Nov 6, 1962Univ LouvainStereotaxical methods and apparatus
US3223087 *Jun 15, 1961Dec 14, 1965Chirana Praha NpStereotaxic device
FR1282623A * Title not available
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US4228799 *Sep 22, 1978Oct 21, 1980Anichkov Andrei DMethod of guiding a stereotaxic instrument at an intracerebral space target point
US4341220 *Apr 13, 1979Jul 27, 1982Pfizer Inc.Stereotactic surgery apparatus and method
US4350159 *Feb 29, 1980Sep 21, 1982Gouda Kasim IFrame for stereotactic surgery
US4475550 *Mar 30, 1982Oct 9, 1984Bremer Orthopedics, Inc.Halo for stereotaxic applications
US4580561 *May 4, 1984Apr 8, 1986Williamson Theodore JInterstitial implant system
US4608977 *Dec 20, 1982Sep 2, 1986Brown Russell ASystem using computed tomography as for selective body treatment
US4617925 *Sep 28, 1984Oct 21, 1986Laitinen Lauri VAdapter for definition of the position of brain structures
US4653509 *Jul 3, 1985Mar 31, 1987The United States Of America As Represented By The Secretary Of The Air ForceGuided trephine samples for skeletal bone studies
US4686997 *Nov 13, 1986Aug 18, 1987The United States Of America As Represented By The Secretary Of The Air ForceSkeletal bone remodeling studies using guided trephine sample
US4834089 *Dec 1, 1986May 30, 1989Koivukangas John PAdapter for brain surgery
US4961422 *May 2, 1988Oct 9, 1990Marchosky J AlexanderMethod and apparatus for volumetric interstitial conductive hyperthermia
US4998912 *Mar 2, 1989Mar 12, 1991Board Of Regents, The University Of Texas SystemDiverging gynecological template
US5056523 *Nov 22, 1989Oct 15, 1991Board Of Regents, The University Of Texas SystemPrecision breast lesion localizer
US5176689 *Jul 11, 1990Jan 5, 1993Medical Instrumentation And Diagnostics CorporationThree-dimensional beam localization apparatus for stereotactic diagnoses or surgery
US5197466 *Jan 7, 1992Mar 30, 1993Med Institute Inc.Method and apparatus for volumetric interstitial conductive hyperthermia
US5306272 *Nov 2, 1992Apr 26, 1994Neuro Navigational CorporationAdvancer for surgical instrument
US5339812 *Dec 14, 1992Aug 23, 1994Medical Instrumentation And Diagnostic CorporationThree-dimensional computer graphics simulation and computerized numerical optimization for dose delivery and treatment planning
US5354314 *Aug 28, 1992Oct 11, 1994Medical Instrumentation And Diagnostics CorporationThree-dimensional beam localization apparatus and microscope for stereotactic diagnoses or surgery mounted on robotic type arm
US5398684 *Mar 31, 1992Mar 21, 1995Hardy; Tyrone L.Method and apparatus for video presentation from scanner imaging sources
US5423832 *Sep 30, 1993Jun 13, 1995Gildenberg; Philip L.Method and apparatus for interrelating the positions of a stereotactic Headring and stereoadapter apparatus
US5634929 *Oct 26, 1994Jun 3, 1997Oregon Neuro-Medical Technology, Inc.Upon a target within a skull
US5640496 *Feb 4, 1991Jun 17, 1997Medical Instrumentation And Diagnostics Corp. (Midco)Method and apparatus for management of image data by linked lists of pixel values
US5855582 *Dec 19, 1995Jan 5, 1999Gildenberg; Philip L.Noninvasive stereotactic apparatus and method for relating data between medical devices
US5984931 *Mar 18, 1997Nov 16, 1999Greenfield; Bruce G.Diagnostic measurement transfer apparatus
US6036632 *May 28, 1998Mar 14, 2000Barzell-Whitmore Maroon Bells, Inc.Sterile disposable template grid system
US6071288 *Dec 6, 1997Jun 6, 2000Ohio Medical Instrument Company, Inc.Apparatus and method for surgical stereotactic procedures
US6240308Mar 22, 1996May 29, 2001Tyrone L. HardyMethod and apparatus for archiving and displaying anatomico-physiological data in a normalized whole brain mapping and imaging system
US6261300Apr 20, 2000Jul 17, 2001Ohio Medical Instrument Company, Inc.Apparatus and method for surgical stereotactic procedures
US6423077Jul 13, 2001Jul 23, 2002Ohio Medical Instrument Company, Inc.Apparatus and method for surgical stereotactic procedures
US6752812Nov 21, 2000Jun 22, 2004Regent Of The University Of MinnesotaRemote actuation of trajectory guide
US6782288Feb 23, 2001Aug 24, 2004Regents Of The University Of MinnesotaMethod and apparatus for positioning a device in a body
US6846315Jun 3, 2002Jan 25, 2005Barzell-Whitmore Maroon Bells, Inc.Template grid
US6902569Aug 17, 2001Jun 7, 2005Image-Guided Neurologics, Inc.Trajectory guide with instrument immobilizer
US7204840Apr 6, 2001Apr 17, 2007Image-Guided Neurologics, Inc.Deep organ access device and method
US7235084Jun 20, 2002Jun 26, 2007Image-Guided Neurologics, Inc.Deep organ access device and method
US7366561Apr 4, 2001Apr 29, 2008Medtronic, Inc.Robotic trajectory guide
US7497863Dec 4, 2004Mar 3, 2009Medtronic, Inc.Instrument guiding stage apparatus and method for using same
US7559935Feb 20, 2003Jul 14, 2009Medtronic, Inc.Target depth locators for trajectory guide for introducing an instrument
US7636596Dec 20, 2002Dec 22, 2009Medtronic, Inc.Organ access device and method
US7637915Jul 20, 2004Dec 29, 2009Medtronic, Inc.Trajectory guide with instrument immobilizer
US7658879May 4, 2006Feb 9, 2010Medtronic, Inc.Trajectory guide with angled or patterned guide lumens or height adjustment
US7660621Apr 5, 2001Feb 9, 2010Medtronic, Inc.Medical device introducer
US7699854May 4, 2006Apr 20, 2010Medtronic, Inc.Trajectory guide with angled or patterned guide lumens or height adjustment
US7704260Dec 6, 2004Apr 27, 2010Medtronic, Inc.Low profile instrument immobilizer
US7744606Dec 4, 2004Jun 29, 2010Medtronic, Inc.Multi-lumen instrument guide
US7803163Oct 28, 2005Sep 28, 2010Medtronic, Inc.Multiple instrument retaining assembly and methods therefor
US7815651Jun 25, 2007Oct 19, 2010Medtronic, Inc.Device for immobilizing a primary instrument and method therefor
US7828809Jun 26, 2007Nov 9, 2010Medtronic, Inc.Device for immobilizing a primary instrument and method therefor
US7833231Jun 25, 2007Nov 16, 2010Medtronic, Inc.Device for immobilizing a primary instrument and method therefor
US7857820Jun 26, 2007Dec 28, 2010Medtronic, Inc.Sheath assembly for an access device and method therefor
US7867242Jan 7, 2009Jan 11, 2011Medtronic, Inc.Instrument for guiding stage apparatus and method for using same
US7896889Feb 20, 2003Mar 1, 2011Medtronic, Inc.Trajectory guide with angled or patterned lumens or height adjustment
US7981120Apr 23, 2007Jul 19, 2011University Of South FloridaTrajectory guide with angled or patterned guide lumens or height adjustment
US8083753Oct 16, 2007Dec 27, 2011Medtronic, Inc.Robotic trajectory guide
US8116850Nov 9, 2009Feb 14, 2012Medtronic, Inc.Organ access device and method
US8192445Nov 17, 2009Jun 5, 2012Medtronic, Inc.Trajectory guide with instrument immobilizer
US8221435 *May 6, 2003Jul 17, 2012Elekta Ab (Publ)Device comprising a pin support member and insulation means for fixation to a patients skull during neurological diagnosis, and a method for assembling said device
US20120245645 *Feb 22, 2012Sep 27, 2012Knee Creations, LlcNavigation and positioning systems and guide instruments for joint repair
WO1989003665A1 *Oct 20, 1988May 5, 1989Neal E FearnotSystem for volumetric interstitial conductive hyperthermia
WO2009007574A2 *Jun 19, 2008Jan 15, 2009AlcisStereotaxy rigid frame
Classifications
U.S. Classification606/130, 378/162, 33/512
International ClassificationA61B6/02, A61B19/00, A61B6/00
Cooperative ClassificationA61B19/201, A61B6/022, A61B6/501
European ClassificationA61B6/50B, A61B19/20B, A61B6/02B