2369results about "Instruments for stereotaxic surgery" patented technology

A medical instrument that includes an instrument shaft having proximal and distal ends; a tool for performing a medical procedure; a control handle; a distal motion member for coupling the distal end of the instrument shaft to the tool; a proximal motion member for coupling the proximal end of the instrument shaft to the control handle; actuation means extending between the distal and proximal motion members for coupling motion of the proximal motion member to the distal motion member for controlling the positioning of the tool; a control tube through which the instrument shaft and tool extend; the control tube including, along the length thereof, a curved section; the curved section of the control tube, upon rotation thereof, providing an additional degree of freedom by displacing the tool out of a plane defined by the curved section of the control tube.

An advancer system is described for moving an elongate medical device within a body. The system includes a drive unit having a motor. The drive unit is configured to translate movement of the motor to the device so as to alternately advance and retract the device relative to the body. The advancer system also includes a user-operable control system configured to control the drive unit. The control system can interface with a magnetic navigation system. The above-described system allows an operating physician to control catheter advancement and retraction while remaining outside an x-ray imaging field. Thus the physician is freed from repeated x-ray exposure.

The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place. The inner surfaces of the shells are relatively smooth, and adapted to slide easily across a portion of the outer surface of a central body disposed between the shells. The central body has a shape that cooperates with the shape of the inner surface of the shell so as to provide a range of motion similar to that provided by a healthy joint. A flexible sheath extends between edges of the opposing shells. The inner surface of this sheath, together with the inner surfaces of the rigid shells, defines a cavity encasing the central body. At least a portion of this cavity is filled with a fluid lubricant, further decreasing the frictional force between inner surfaces of the shell and the surface of the central body.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies. Access and occluding devices may be used to facilitate insertion of working devices such asendoscopes, wires, probes, needles, catheters, balloon catheters, dilation catheters, dilators, balloons, tissue cutting or remodeling devices, suction or irrigation devices, imaging devices, sizing devices, biopsy devices, image-guided devices containing sensors or transmitters, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting or delivering devices and implants, etc.

The distal end of a surgical instrument is movable in all six Cartesian degrees of freedom independently of other components of a telemanipulated surgical system. The surgical instrument extends trough a guide tube. The distal end is moved by actuators that are telemanipulatively controlled.

A display and navigation system for use in guiding a medical device to a target in a patient includes a tracking sensor, a tracking device and display. The tracking sensor is associated with the medical device and is used to track the medical device. The tracking device tracks the medical device with the tracking sensor. The display includes indicia illustrating at least five degree of freedom information and indicia of the medical device in relation to the five degree of freedom information.

The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place. The inner surfaces of the shells are relatively smooth, and adapted to slide easily across a portion of the outer surface of a central body disposed between the shells. The central body has a shape that cooperates with the shape of the inner surface of the shell so as to provide a range of motion similar to that provided by a healthy joint. A flexible sheath extends between edges of the opposing shells. The inner surface of this sheath, together with the inner surfaces of the rigid shells, defines a cavity encasing the central body. At least a portion of this cavity is filled with a fluid lubricant, further decreasing the frictional force between inner surfaces of the shell and the surface of the central body.

Apparatus and methods for treating a target tissue by delivering a fluid at a defined temperature to a patient's body. An apparatus of the invention includes a fluid delivery unit for delivering fluid in at least close proximity to the target tissue, an aspiration unit for withdrawing the fluid, and a fluid source unit for providing the fluid at the defined temperature. A method of the invention includes forming a void in at least close proximity to the target tissue, and circulating a preheated fluid through the void, wherein the target tissue undergoes adjustment from body temperature to a treatment temperature due to heat exchange between the fluid and the target tissue.

Articulating mechanisms, link systems, and components thereof, useful for a variety of purposes including, but not limited to, the remote manipulation of instruments such as surgical or diagnostic instruments or tools are provided. The link systems include links wherein at least two adjacent links are pivotable relative to one another around two distinct pivot points. Mechanisms for locking the links are also provided.

Systems and methods for joint replacement are provided. The systems and methods include a surgical orientation device, a reference sensor device, and at least one orthopedic fixture. The surgical orientation device, reference sensor device, and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of a cutting plane or planes along a bony surface, or otherwise to assist in an orthopedic procedure(s).

Methods and apparatus for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. In a method of the invention high frequency (RF) electrical energy is applied to one or more active electrodes on an electrosurgical probe in the presence of an electrically conductive fluid to remove, contract or otherwise modify the structure of tissue targeted for treatment. In one aspect, a dura mater and spinal cord are insulated from the electrical energy by an insulator positioned on a non-active side of the probe. In another aspect, a plasma is aggressively formed in the electrically conductive fluid by delivering a conductive fluid to a distal end portion of the probe and aspirating the fluid from a location proximal of the return electrode. In another aspect, a distal end of an electrosurgical probe having at least one electrode on a biased, curved, bent, or steerable shaft is guided or steered to a target site within an intervertebral disc having a disc defect for treatment of tissue to be treated at the target site by the selective application of electrical energy thereto.

Apparatus and methods for advancing and retracting a medical instrument within an introducer device, wherein the instrument includes a distal tip, a distal linear portion, a first distal curve, a substantially linear inter-curve portion, and a second proximal curve. The length of the distal linear portion and the angle of the first curve determine the position of the distal tip within a lumen of the introducer device, such that the distal tip occupies a substantially central transverse location within the lumen and the distal tip avoids contact with the introducer device. The length of the inter-curve portion and the angle of the second curve determine deflection of the distal tip from a longitudinal axis of the shaft when the second curve is extended distally beyond a distal end of the introducer device. Also, methods and apparatus for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

This invention discloses a method and apparatus to deliver medical devices to targeted locations within human tissues using imaging data. The method enables the target location to be obtained from one imaging system, followed by the use of a second imaging system to verify the final position of the device. In particular, the invention discloses a method based on the initial identification of tissue targets using MR imaging, followed by the use of ultrasound imaging to verify and monitor accurate needle positioning. The invention can be used for acquiring biopsy samples to determine the grade and stage of cancer in various tissues including the brain, breast, abdomen, spine, liver, and kidney. The method is also useful for delivery of markers to a specific site to facilitate surgical removal of diseased tissue, or for the targeted delivery of applicators that destroy diseased tissues in-situ.

A system for use during a medical or surgical procedure on a body. The system generates a display representing the position of two or more body elements during the procedure based on a reference image data set generated by a scanner. The system produces a reference image of a body elements, discriminates the body elements in the images and creates an image data set representing the images of the body elements. The system produces a density image of the body element. The system modifies the image data set according to the density image of the body element during the procedure, generates a displaced image data set representing the position and geometry of the body element during the procedure, and compares the density image of the body element during the procedure to the reference image of the body element. The system also includes a display utilizing the displaced image data set generated by the processor to illustrate the position and geometry of the body element during the procedure. Methods relating to the system are also disclosed.

An acetabular instrument alignment guide for aligning at least one orthopaedic instrument relative to an acetabulum in a pelvis. The acetabular instrument alignment guide includes an interchangeable head configured for positioning within the acetabulum where the interchangeable head has a primary axis. A drill guide is releasably connected to the interchangeable head. The drill guide includes a drill bore offset from the primary axis, and the drill bore is configured for aligning a drill relative to the pelvis. The acetabular instrument alignment guide further includes at least one reference pin and an instrument guide connected to the at least one reference pin, the instrument guide being both rotatable and translatable relative to the at least one reference pin. The reference pin is configured for placement in at least one hole in the pelvis produced by the drill.

An obturator as part of a biopsy system enhances use with Magnetic Resonance Imaging (MRI) by indicating location of a side aperture in an encompassing cannula. The cannula (e.g., detached probe, sleeve sized to receive a core biopsy probe) includes a side aperture for taking a tissue sample. When the obturator is inserted in lieu of the biopsy device into the cannula, a notch formed in a shaft of the obturator corresponds to the side aperture. A dugout trough into the notch may further accept aqueous material to further accentuate the side aperture. In addition, a series of dimensionally varied apertures (e.g., wells, slats) that communicate through a lateral surface of the shaft and that are proximal to the side aperture receive an aqueous material to accentuate visibility in an MRI image, even in a skewed MRI slice through the cannula/obturator.

Apparatus and methods are provided to penetrate a bone and associated bone marrow using a powered driver. The powered driver may include a housing having a gear assembly, a motor and a power supply disposed therein. A penetrator assembly may be releasably engaged with one end of a drive shaft extending from the housing. The powered driver may include a light operable to illuminate an insertion site for the penetrator assembly. An indicator may be provided to show status of an associated power supply. An indicator may also be provided to show status of penetrating bone and/or associated bone marrow using a penetrator assembly. The apparatus may include an enable switch to prevent undesired operation of the powered driver.

A robotic system for overlapping radiofrequency ablation (RFA) in tumor treatment is disclosed. The robot assisted navigation system is formed of a robotic manipulator and a control system designed to execute preoperatively planned needle trajectories. Preoperative imaging and planning is followed by interoperative robot execution of the ablation treatment plan. The navigation system combines mechanical linkage sensory units with an optical registration system. There is no requirement for bulky hardware installation or computationally demanding software modules. Final position of the first needle placement is confirmed for validity with the plan and then is used as a reference for the subsequent needle insertions and ablations.

An instrument for the penetration of tissue, including a backstop assembly having a shaft and a backstop; and a penetration member slidingly engaged with the backstop shaft, and configured for penetrating tissue. The backstop assembly and the penetration member are configured such that the backstop may be positioned adjacent tissue to be penetrated, such that as the penetration member is urged through the tissue along the backstop shaft, the backstop will limit the depth of penetration of the penetration member through the tissue. A method of using this instrument is also provided.

A system for indicating a position within an object such as a head of a body of a patient. The position of a tip of a probe relative to a reference is determined. The position of reference points of the object relative to the reference is measured. The determined position is translated into an image coordinate system and an image of the object is displayed.

MRI-Surgical systems include: (a) at least one MRI-compatible surgical tool; (b) a circuit adapted to communicate with an MRI scanner; and (c) at least one display in communication with the circuit. The circuit electronically recognizes predefined physical characteristics of the at least one tool to automatically segment MR image data provided by the MRI scanner whereby the at least one tool constitutes a point of interface with the system. The circuit is configured to provide a User Interface that defines workflow progression for an MRI-guided surgical procedure and allows a user to select steps in the workflow, and wherein the circuit is configured to generate multi-dimensional visualizations using the predefined data of the at least one tool and data from MRI images of the patient in substantially real time during the surgical procedure.

There is provided a guide apparatus for orienting a medical tool relative to and through a remote fulcrum or remote center of motion. The guide apparatus may comprise: at least one crank arm comprising at least a portion of a first hinged coupling for hinged coupling to a stabilizer; at least one link arm comprising at least a portion of a second hinged coupling for hinged coupling to the crank arm at a location spaced from the first hinged coupling; a tool holder for supporting a medical tool on the link arm at a location spaced from the first hinged coupling; wherein the rotational axes of the first and second hinged couplings intersect to define a remote fulcrum. The guide apparatus may be configured to be an open-loop spherical chain or a closed-loop spherical chain.

Apparatus and methods for treating an inter-vertebral disc by ablation, coagulation, shrinking, stiffening, or other treatment of disc tissue. A method of the invention includes positioning at least one active electrode within the inter-vertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. An apparatus of the invention includes an electrosurgical probe, an introducer needle adapted for passing the distal end of the probe therethrough, and a positioning unit for monitoring a position of the probe in relation to the introducer needle.

A minimally invasive surgical instrument includes a U-turn mechanism that transmits actuating forces around a U-turn. The U-turn mechanism is coupled between segments of the instrument and has a bend radius that is smaller than flexible arms having a similar cross section diameter. The actuating forces transmitted by the U-turn mechanism are used to move distal components of the instrument, such as an end effector and a wrist mechanism.

A surgical instrument extends through a guide tube in a minimally invasive surgical system. The instrument may be an operative instrument or a camera instrument. One or more illumination devices, such as LEDs, are place on a side of the instrument. A cooling channel in the instrument cools the illumination device(s).

An apparatus and method for penetrating the bone marrow is provided. The apparatus includes a housing, a penetrator assembly, operable to penetrate the bone marrow, a connector operable to releasably attach the penetrator assembly to a drill shaft, the drill shaft operable to connect the penetrator assembly to a gear assembly, a gear assembly operable to engage and rotate the drill shaft, a motor operable to engage the reduction gear assembly and drive the penetrator into the bone marrow by rotation of the drill shaft, and a power supply and associated circuitry operable to power the motor. The apparatus and method may be adapted to insert a probe through the skull and into the brain.

A method of monitoring a position of a medical instrument with respect to a patient's body, including positioning a patient reference unit on a portion of the patient's body; positioning a remote unit with respect to the medical instrument; associating at least one field sensor with at least one of the patient reference unit and the remote unit; generating an electromagnetic position characteristic field; producing position data responsive to a sensor output signal that is responsive to the presence of the electromagnetic position characteristic field such that the sensor output signal is representative of a position of the remote unit with respect to the patient reference unit; determining image data representing a plurality of images of the patient's body; and displaying an image of the patient's body based on the image data and responsive to position image data that varies for different position data.

A number of improvements are provided relating to computer aided surgery. The improvement relates to both the methods used during computer aided surgery and the devices used during such procedures. Some of the improvement relate to controlling the selection of which data to display during a procedure and/or how the data is displayed to aid the surgeon. Other improvements relate to the structure of the tools used during a procedure and how the tools can be controlled automatically to improve the efficiency of the procedure. Still other improvements relate to methods of providing feedback during a procedure to improve either the efficiency or quality, or both, for a procedure.

A method of resecting distal and anterior portions of a distal portion of a femur for a bicompartmental prosthesis is provided. The method includes generating a geometric representation of the distal portion of the femur. A virtual anterior resection plane is calculated at a predetermined depth and is oriented at a predetermined angle relative to the femur. The method identifies a distal-most point of a lateral portion of the virtual anterior resection plane and an AP line. A varus/valgus angle and an anterior-posterior distance are calculated. Anterior and distal resection guides are navigated according to the parameters calculated from the method.