Vanderbilt University

Other

University of Rochester

Johnson & Johnson Professional, Inc.

George S. Allen

J Michael Fitzpatrick

Robert F Labadie

Jennifer J McCrory

Calvin R Maurer, Jr

Jason E Mitchell

Peter E Konrad

Matthew Y Wang

Robert J Maciunas

Changquing C Kao

George S Allen

Robert J Webster, Iii

Benoit M Dawant

Thomas J Withrow

Hsuan Chang

Gregoire S Blachon

Rory Randall

Jenna Toennies

Robert Maciunas

M Robert Willcott

A method and apparatus of percutaneous cochlear implantation (PCI). In one embodiment, the method includes the steps of (a) implanting a plurality of anchor members in a skull of a patient surrounding an ear of the patient, (b) attaching a docking frame to the plurality of anchor members, wherein the docking frame has a docking platform and a plurality of fiducial members, (c) acquiring a computed-tomography (CT) image of an area of the patient's head including the ear and the plurality of fiducial members, (d) determining a centroid of each of the plurality of fiducial members and a trajectory for a PCI according to the CT image, (e) configuring a parallel robot by a computer processor according to the CT image such that a top platform of the parallel robot is aligned with the trajectory with respect to the centroids of the plurality of fiducial members, (f) attaching the configured parallel robot to the docking frame, and (g) performing the PCI using one or more surgical tools received by the top platform of the parallel robot.

Apparatus and methods for percutaneous cochlear implantation

The present invention, in another aspect, relates to a microstereotactic table. In one embodiment, the microstereotactic table includes a plate member having a first surface, an opposite, second surface, a body portion defined therebetween, a plurality of leg members, each of them removably engaged with the plate member, respectively, and a passage is formed between the first surface and the opposite, second surface of the body portion of the plate member and along a longitudinal axis, wherein a step is formed within the passage, and wherein the step is formed such that the distance from the step to one of the first surface and the opposite, second surface along the longitudinal axis is a predetermined length.

Microstereotactic table

In one aspect, an apparatus for supporting an adjustable surgical platform is disclosed. In one embodiment, the apparatus includes a supporting platform portion with a body portion that defines bore along a central axis. Arm portions with engaging means extend radially from the supporting platform portion. The apparatus also includes a shaft portion extending from the supporting platform portion in a first direction, with a shaft body portion that defines a bore along a longitudinal axis B. The bore of the shaft body portion is in communication with the bore of the supporting platform portion. The apparatus further includes a base portion connected to the shaft portion, and that defines a bore in communication with the bore of the shaft portion and the bore of the supporting platform portion. Mounting means are configured to secure the base portion to a region of interest of a living subject.

Apparatus for supporting an adjustable surgical platform

A system and methods for providing an access to a cochlea of a living subject. In one embodiment of the present invention, a method comprises the steps of operating a surgical instrument towards a region of interest of the living subject for opening an access to the cochlea of the living subject from the lateral edge of the skull of the living subject to the cochlea of the living subject, and intra-operatively monitoring at least a part of the surgical instrument so that the surgical instrument is operated substantially along a predetermined path.

System and methods of using image-guidance for providing an access to a cochlear of a living subject

A surgical instrument for securing an anchor in a target area of the skull of a patient, wherein the anchor has a shaped surface, a top and a base. In one embodiment, the surgical instrument includes a driver having a first end, an opposite, second end, and a body portion defined therebetween forming a bore therein along a longitudinal axis, where the bore is configured to allow the anchor to be received therein, a first inner surface formed inside the bore proximate to the first end, wherein the first inner surface is formed with a shape that is complimentary to the shaped surface of the anchor, and a second inner surface formed inside the bore and between the first inner surface and the second end, wherein the second inner surface is formed with a shape that is different from that of the first inner surface.

Anchor driver with assured seating

In one aspect, the present invention relates to a surgical instrument for providing an access to a target of interest of a living subject. In one embodiment, the surgical instrument has a bearing member, a shaft member and a probe. The bearing member has a first end portion, an opposite, second end portion, a body portion defined therebetween having a longitudinal axis, and a shoulder portion extending from the second end portion. The body portion defines a bore therein along the longitudinal axis. The shoulder portion defines a passage substantially coaxial with and in communication with the bore. The shaft member has an first end portion and an opposite, second end portion, and is slidably received in the bore of the bearing member. The shaft member defines a space extending from the first end portion to the second end portion. The probe has a working end portion and is received in the space of the shaft member such that the working end portion is extendable through the passage of the shoulder portion of the bearing member to reach a target of interest of a living subject so as to provide an access thereto.

Adjustable surgical platform and surgical instrument using same

A system for selectively disabling a surgical instrument operating in a surgical site of a region of interest of a living subject. In one embodiment, the system includes means for noninvasively placing a number of fiducial markers in an anatomic space of the region of interest of the living subject, means for pre-operatively measuring a location of each fiducial marker in the anatomic space, an imaging acquisition device for pre-operatively acquiring an image volume from the region of interest of the living subject, a probe for intra-operatively monitoring a location of the surgical instrument in the anatomic space, and a controller configured to perform the steps of identifying a centroid of each fiducial marker in the image volume, registering the identified centroid of each fiducial marker in the image volume to the measured location of the corresponding fiducial marker in the anatomic space to determine a registration transformation, mapping the monitored location of the surgical instrument in the anatomic space onto a corresponding location in the image volume by an inverse of the registration transformation, and generating a signal to disable the surgical instrument when the mapped location of the surgical instrument is substantially close to a boundary of the surgical site of the region of interest in the image volume.

System and method for surgical instrument disablement via image-guided position feedback

A surgical platform usable for performing a surgical procedure. In one embodiment, the surgical platform comprises a base portion configured to receive at least one probe; a plurality of adjustable legs configured to support the base portion, each adjustable legs having a first end portion and an opposite, second end potion defining a length therebetween; and at least one movable portion configured to adjust the length of at least one adjustable leg.

Adjustable universal surgical platform

A method for determining an orientation of a base () to which a fiducial marker () is detachably mounted. The method includes the steps of determining the axis of symmetry for the fiducial marker and choosing the determined axis of symmetry of the fiducial marker () as the axis of symmetry of the base ().

Apparatus and methods of determining marker orientation in fiducial registration

A method of optimal placement of a deep brain stimulator in a targeted region of a brain of a living subject for optimal deep brain stimulation. In one embodiment, the method includes the steps of nonmanually selecting an initial optimal position from, refining the nonmanually selected initial optimal position to determine a final position, and placing the deep brain stimulator at the final position in the targeted region of the brain of the living subject.

Apparatus and methods of optimal placement of deep brain stimulator

An image of a patient taken through X-ray computed tomography or the like is registered to physical measurements taken on the patient's body. Different parts of the patient's body are given different numerical weights; for example, if bone measurements are deemed to be more accurate than skin measurements, the bones can be given a higher weight than the skin. The weights are used in an iterative registration process to determine a rigid body transformation function. The transformation function is used in robot-assisted surgical procedures, stereotactic procedures or the like.

Apparatus and method for registration of images to physical space using a weighted combination of points and surfaces

An implantable fiducial marker having a sealed cavity for the introduction of an imaging agent that provides imaging capability in several modes, including Computed Tomographic imaging (CT) and Magnetic Resonance Imaging (MRI) is disclosed. The marker may be permanent, or it may be temporary and readily detachable from its anchor site. Combinations or agents imageable under CT scanning are combined with agents imageable under MRI scanning.

Fiducial marker

A detachable cap for use in determining the location of the center of the imageable portion of a fiducial marker is disclosed. The lower portion of the cap has three arms and a boss for providing a detachable connection with an implanted base portion to which an imaging marker can be attached. The upper portion of the cap includes a divot-like depression that is configured to mate with a ball whose center can be determined. The ball, marker, and divot are configured so that the center of the ball, when mated to the divot, is coincident with the center of the marker when it is attached to the base in place of the cap. Knowledge of the location of the center of the ball when it is brought into engagement with the divot of the cap can be used to determine the location of the center of the marker when it is attached to the base.

Method for determining the location in physical space of a point of

An automatic computer implemented technique which may be used for identifying markers and determining the centroids of fiducial markers (e.g., cylindrical fiducial markers) attached to the head in magnetic resonance (MR) and X-ray computed tomography (CT) volume images is disclosed. This technique may be referred to as image space localization. A first portion of the technique identifies many candidate voxel points included in a bright area of the image which may correspond to candidate markers. A second portion of the technique selects from the identified candidate voxels a predetermined number of candidate points of the image volume that are most likely to lie within an actual fiducial marker. The centroid for each of these markers is then determined. The method finds markers whose images are of a higher intensity than their surroundings and which have a given shape and size.

Automatic technique for localizing externally attached fiducial markers

A surgeon can select an entry point and a target point in a preoperative image volume of the patient. The target point and entry point form a trajectory line along which the surgeon wishes to perform a surgical procedure such as a biopsy and line up a surgical instrument. Once a surgical platform is moved along a guide arm arc close to a point on the trajectory line, the surgical platform is locked to the guiding arm. A pivot point position at the center of a ball joint in the middle of a metal plate is then arranged to be exactly at a point on the trajectory line. The metal plate is locked down and the ball joint is rotated to ensure that the surgical sleeve extends exactly along the trajectory line. This allows a decoupling between the position and orientation movements required to line the surgical sleeve up with the trajectory line to perform a surgical procedure. An interoperative localization device (ILD) is used to track the position of the surgical guide relative to the image space.

Growing community of inventors

Nashville, TN, United States of America

J Michael Fitzpatrick