Abstract: A surgical alignment device is disclosed that is controlled remotely through the use of an actuator, where the actuator in turn controls at least one local adjustment device. The alignment device is suited for neurosurgery, although it is not exclusively limited to neurosurgery. The alignment device includes an insertion guide that is coupled to the local adjustment device, the insertion guide being used to guide a device such as a catheter into a patient. The alignment device may also be coupled to a control module such as a microcomputer that controls the orientation of the insertion guide in response to inputs from the surgeon as to a location of interest within the patient.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined imagable fiducial locator and divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example is reflective such that it is locatable by a remote detector of an optical positioning system. A generally cylindrical (e.g., faceted cylindrical) columnar locator permits easy application of reflective tape. Other examples discusses a unitary fiducial marker with multiple divots and a swiveling and/or tilted fiducial marker divot, each of which allows manipulation of a positioning wand into a remote camera's field of view. Another example includes at least one reflector that can be aimed. A further example discusses an imagable fiducial marker carrier that is attachable to a single location on a patient's skull to reduce trauma.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined computed tomography (CT) imageable fiducial locator head, an integral bone screw, and an integral divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example includes a fluid/gel-absorbing coating or cover into which a magnetic resonance (MR) imageable fluid is introduced, thereby permitting both CT and MR imaging. Protective caps and collars may be used to protect the fiducial marker from mechanical impact and/or to guide the fiducial marker during affixation. A bull's-eye or other template is used to select a center of a substantially spherical fiducial marker head on an image, such as for use during patient registration.

Abstract: A system to allow registration of a patient to image space is disclosed. The registration can be performed without touching a plurality of fiducial points on the patient or in the image data. The registration process can eliminate manual steps of image to patient registration and image to image registration.

Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: This document discusses trajectory guides that include an instrument guide with at least one lumen angled with respect to an orthogonal or other through-axis. In one example, patterned lumens on the instrument guide provide a mirror image pattern of trajectory axes intersecting a target plane. In another example, height adjustment of the instrument guide extends these or other targeting techniques to a three-dimensional volume. This document also describes a method of manufacturing such an instrument guide, which is also applicable to manufacturing an instrument guide providing parallel lumens.

Abstract: An insertion device with an insertion axis includes an axial actuator with a first portion and a second portion. The first portion is moveable along the insertion axis relative to the second portion. The insertion device further includes a first tube coupled to the first portion of the axial actuator, and the first tube is movable along the insertion axis in response to movement of the first portion relative to the second portion. The device further includes a second tube having a radially biased distal end. The distal end is substantially contained within the first tube in a first state, and the second tube is rotatable with respect to the first tube. Also, the second tube is axially movable to a second state, and a portion of a distal end of the second tube is exposed from a distal end of the first tube in the second state.

Abstract: A device, system and method deliver an agent to a soft mass, such as an area of the body, and more specifically the brain. One aspect includes creation of one or more channels, tunnels or grooves in tissue using a relatively small diameter, minimally-invasive stylet and then removing the stylet prior to infusion. The stylet-created channels become paths of increased hydraulic conductivity, through which the infusate will tend to flow and produce a predictable infusion pattern. Infusate will be carried into these channels with relatively low resistance, and then infuse outward from these channels into the surrounding tissue. By carefully positioning these channels, one can control and modify the preferred paths and duration of distribution.

Abstract: This document discusses trajectory guides that include an instrument guide with at least one lumen angled with respect to an orthogonal or other through-axis. In one example, patterned lumens on the instrument guide provide a mirror image pattern of trajectory axes intersecting a target plane. In another example, height adjustment of the instrument guide extends these or other targeting techniques to a three-dimensional volume. This document also describes a method of manufacturing such an instrument guide, which is also applicable to manufacturing an instrument guide providing parallel lumens.

Abstract: Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Abstract: Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Abstract: This documents describes among other things a normalizing stage apparatus, tools and methods. One example includes a base that defines a trajectory. A first stage is moveably coupled to the base and the first stage moves along the trajectory. A second stage is moveably coupled to the first stage and moves an instrument coupled thereto with respect to the base and the first stage. Before movement of the instrument, the first and second stages are in first positions desired (e.g. predetermined) distances from a target area in the body. Another example includes the first stage and a guide tube stop coupled with the first stage. A guide tube is coupled with the guide tube stop and extends through a guide tube stop lumen. The guide tubes outer perimeter is dimensioned and configured to snugly couple with the surface defining the guide tube stop lumen.

Abstract: Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Abstract: Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Abstract: Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Abstract: Devices and methods provide accurate targeting, placement, and/or stabilization of an electrode or other instrument(s) into the brain or other body organ, such as to treat severe tremor or other neurological disorders. Targeting is performed using any form of image-guidance, including real-time MRI, CT, or frameless surgical navigation systems.

Abstract: This document discusses, among other things, a fiducial marker assembly that includes an internally engagable base. The base is sized and shaped to be mounted flush to or recessed from an outer surface of a patient's skull, thereby reducing or avoiding patient discomfort. The fiducial marker assembly includes an imagable locator and a registration receptacle. A base insertion instrument is engaged to the base to attach the base to the patient's skull. In one example the base includes a faceted head, permitting a socket-like device to screw or unscrew the base into or out of the skull. In another example, the base includes at least one step or slot for engaging an insertion or extraction tool.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined imagable fiducial locator and divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example is reflective such that it is locatable by a remote detector of an optical positioning system. A generally cylindrical (e.g., faceted cylindrical) columnar locator permits easy application of reflective tape. Other examples discusses a unitary fiducial marker with multiple divots and a swiveling and/or tilted fiducial marker divot, each of which allows manipulation of a positioning wand into a remote camera's field of view. Another example includes at least one reflector that can be aimed. A further example discusses an imagable fiducial marker carrier that is attachable to a single location on a patient's skull to reduce trauma.

Abstract: This document discusses, among other things, examples of a low profile instrument immobilizer and means for positioning the same. In one example, the low profile instrument immobilizer grasps, secures, and immobilizes an electrode or other instrument that extends through a burr hole in a skull to a target location in a patient's brain.