Abstract: A three-pin skull clamp [10] includes a C-shaped frame [12] which partially encircles the head [15] of the patient, with a spring-loaded single skull pin assembly [22] located at one end of the frame [12] and adapted to engage the head [15] of the patient with a desired engagement force, and two spaced skull pins [30] mounted to a rocker arm [44] located at an opposite end of the frame [12]. Each of the rocker arm skull pins [30] resides in operative contact with an indicator cap [66] held by a spring-loaded pin carrier assembly [50], the indicator cap [66] being movable relative to the rest of the pin carrier assembly [50] in response to the engagement force applied to the corresponding skull pin [30] by the head [15] of the patient.

Abstract: A three-pin skull clamp includes a C-shaped frame which partially encircles the head of the patient, with a spring-loaded single skull pin assembly located at one end of the frame and adapted to engage the head of the patient with a desired engagement force, and two spaced skull pins mounted to a rocker arm located at an opposite end of the frame. Each of the rocker arm skull pins resides in operative contact with an indicator cap held by a spring-loaded pin carrier assembly, the indicator cap being movable relative to the rest of the pin carrier assembly in response to the engagement force applied to the corresponding skull pin by the head of the patient. By visibly comparing the positions of the indicator caps relative to their respective pin carrier assemblies, one can readily determine whether the engagement forces are equally distributed between the two rocker arm skull pins.

Abstract: A radiolucent surgical table extension assembly for use in combination with a scanning machine having an enclosed scanning zone. A radiolucent support member has a proximal end adapted to be removably attached to one end of a table in a cantilever fashion. The radiolucent support member has a rigidity sufficient to support an upper torso and head of a patient. The table and the radiolucent support member are movable relative to the scanning machine to locate the radiolucent support member and the head of the patient within the scanning zone. A radiolucent mounting structure is connected to the radiolucent support member, and a radiolucent head support is attached to the radiolucent mounting structure for supporting the head of the patient. The radiolucent head support has an opening extending therethrough. The opening receives a locking clamp for attaching the radiolucent head support to the radiolucent mounting structure.

Abstract: An advantageous interoperative system includes a scanner [20] with an enclosed scanning zone, an image guided system [24] operatively connected to the scanner [20], a surgical table [22] having a radiolucent member [228] attached to one end thereof with a radiolucent support [264] held near an outboard end [236] of the radiolucent member [228] by a radiolucent adaptor assembly [210], the radiolucent adaptor assembly [210] being hingedly connected to both the radiolucent member [228] and the radiolucent support [264]. The table [22] and the radiolucent member [228] attached thereto are movable relative to the scanner [20] to locate the radiolucent member [228] and the head of a patient supported thereon within the scanning zone, to facilitate interoperative scans.

Abstract: An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient's skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient's brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path.

Abstract: An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient's skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient's brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path.

Abstract: A surgical instrument support is provided having an articulated arm with first structure on a proximal end of the arm. A lockable target ball is rotatably mounted on a distal end of the articulated arm, and the lockable ball has a diametric hole therein for receiving and supporting a surgical instrument. A mount has second structure that receives and secures the proximal end of the articulated arm. The first structure on the articulated arm cooperates with the second structure on the mount to automatically align the proximal end of the articulated arm with the mount in a repeatable relationship. The mount is adapted to be releasably attached to a fixed structure. Thus, after establishing a desired alignment of the lockable ball to a patient, the articulated arm can be removed from the fixed structure and then subsequently remounted therein without losing the desired alignment of the lockable ball with the patient.

Abstract: An articulated surgical table configured to alternatively receive an orthopedic attachment and a scanning table attachment. The orthopedic attachment is provided with a frame having a plurality of mounting points for mounting two detachable spar members. Either or both of the spar members may be mounted to the frame to provide the desired level of patient support and operator access. In addition, a pelvic support plate is supported on top of the frame and is formed with an asymmetrical construction. The pelvic support plate includes a cutout area on a front corner thereof for permitting additional access to the affected or broken leg of a patient. The plate may be flipped over to position the cutout area on the opposite side of the patient, depending on the location of the affected leg.

Abstract: An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient's skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient's brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path.

Abstract: A target socket for frameless stereotactic surgery has a ring with an arcuate band that captures a target ball therein. The ring defines a pair of spaced apart channels which provide the ring with a degree of flexibility. The ring defines a radially oriented gap extending throughout the ring's entire thickness, the gap being spanned by a tightening member which allows a user to easily manually tighten the ring upon a target ball held within the arcuate band. The target socket is also provided with an attachment element for attaching the target socket to a surgical tooling structure. The attachment element has at least three links to provide the target socket with at least six degree of freedom.

Abstract: An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient's skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient's brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path.

Abstract: A noninvasive apparatus for supporting tools associated with a stereotactic apparatus and procedures to guide tools along any selected path. In one embodiment of the invention, the tool support system is mounted to a skull clamp holding a patient's head. In another embodiment, the tool holder and an articulated arm and probe are mounted to the tool support system which in turn, is mounted to the side rails of a table supporting a patient. With the second embodiment, stereotactic procedures can be practiced with respect to any part of the patient's body.

Abstract: A surgical endoscope support device for supporting a surgical endoscope at an end of a support arm over, and proximate to, a surgical site of a patient, the endoscope support device comprising a support and pivot body including a socket housing and a pivot ball, the socket housing having a centrally positioned inner bore in open communication between upper and lower surfaces, the inner bore having a spherical surface, and the pivot ball, positionable within the inner bore of the socket housing, in pivotable contact with the spherical surface of the inner bore, the pivot ball including a cylindrical bore through the center of the pivot ball, the cylindrical bore having a substantially uniform inner diameter along a long axis of the cylindrical bore, and an endoscope adapter having a substantially cylindrical outer wall and a substantially cylindrical central bore, the outer wall having an outer dimension substantially equivalent to the inner diameter of the cylindrical bore of the pivot ball for a sufficiently

Abstract: An apparatus and method are disclosed for displaying a path between a selected target and selected points on a patient's skull and for guiding surgical instruments along any selected path. The system is comprised of an image display system, an articulated arm and probe, and a stereotactic system. The sub-systems are coupled to one another so that the articulated probe may be used to select patient fiducial points that correspond to selected image fiducial points. Using these points, the image display system coregisters the external locations to the displayed images so that the probe condition may be displayed with the displayed images. The system further permits the identification of a selected target within a patient's brain and to project a path from the external position to the target prior to the performance of a craniotomy. After evaluation of the path, a surgeon may lock the stereotactic system in place to preserve a selected surgical path and to guide instruments along that path.

Abstract: A medical retractor having a support shaft on which is threaded a retractor arm drive that supports a retractor arm. The retractor arm drive includes a worm with threads that engage peripheral gear teeth of a worm gear; and the worm gear is threaded onto the support shaft. Rotating the worm, turns the worm gear and moves the retractor arm drive and retractor arm longitudinally along the support shaft. A stop prevents the support shaft from rotating with the worm gear in response to rotation of the worm.

Abstract: A base unit for mounting a head support to a medical table wherein a generally U-shaped frame of the base member is mounted with respect to the table. A transitional member has a first end adapted to support the head support and a shaft extending from a second end. A base clamp is mounted on the generally U-shaped frame and has a bore sized and shaped to receive the shaft of a transitional member. The shaft of the transitional member and the bore of the base clamp include a pivot joint comprised of a spring biased plunger that is located in an annular groove that together function to maintain the shaft of the transitional member at a desired axial position with respect to the bore of the base clamp.

Abstract: A radiolucent head clamp having a C-shaped frame with a fixed head-engaging pin on one side and a pair of head-engaging pins on the opposite side. The opposite side of the clamp has a radiolucent rotation mechanism for adjusting the angular position of the pair of head-engaging pins and a radiolucent translation mechanism for linearly moving the pair of head-engaging pins with respect to the fixed head-engaging pin.

Abstract: A halo style surgical retractor having fixed and movable curvilinear members each of which has an outwardly directed retractor channel extending over the full length of the member. A support arm is attached to the fixed member to hold the fixed member in a desired fixed, but adjustable position. The ends of fixed and movable members are coupled together so that, first, when the members are brought into a generally coplanar relationship, there is an uninterrupted and continuous retractor holder path around the combined length of the fixed and movable members. Second, the couplings permit the movable member to pivot to a position directly above and overlaying with the fixed retractor member, that is, a position in which the movable retractor member is in a plane directly above and generally parallel to the plane of the fixed retractor member.