Abstract: An alignment device and method is provided. Higher precision is achieved when fixing an orientation of an insertion axis using alignment devices shown. A symmetric clamping force is provided that reduces or eliminates unwanted displacement after the desired orientation is obtained. Another feature includes increased flexibility to use a variety of primary medical devices. Another feature includes a standoff feature that reduces tissue damage. Another feature includes an orienting fixture for image guided procedures.

Abstract: A system can be used to navigate or guide an instrument or device into an anatomy of a patient. The navigation can occur with the use of image data acquired of the patient. The image data can be registered to the patient space for navigation. One or more tracking devices can be the associated with the patient and with guiding instruments for tracking guiding devices relative to 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, 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.

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 alignment device and method is provided. Higher precision is achieved when fixing an orientation of an insertion axis using alignment devices shown. A symmetric clamping force is provided that reduces or eliminates unwanted displacement after the desired orientation is obtained. Another feature includes increased flexibility to use a variety of primary medical devices. Another feature includes a standoff feature that reduces tissue damage. Another feature includes an orienting fixture for image guided procedures.

Abstract: A system for positioning a guide relative to an anatomy is provided. The system can include a base adapted to be coupled to the anatomy, and a guide that can move relative to the base. The system can include at least one tracking device that can be coupled to the base and the guide, and a tracking system that tracks a position of the tracking device. The system can include a navigation system that determines a position of the base and the guide relative to the anatomy, and whether the position of the base and the guide are in a desired position. The system can include a display, which can display at least one icon superimposed on the image of the anatomy that graphically indicates a manipulation of the guide required to move the guide into the desired position.

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: An insertion guide device guides an instrument toward a target location in a subject. The insertion guide device includes a base portion securable to the subject and an insertion guide portion defining an insertion axis. The insertion guide portion guides the instrument along the insertion axis, and the insertion guide portion is moveably supported by the base portion for movement of the insertion axis about at least two axes. Moreover, the insertion guide device includes a locking device that selectively fixes the insertion guide portion relative to the base portion. The locking device selectively fixes the insertion axis relative to the at least two axes substantially concurrently.

Abstract: An introducer is described that is coupled to a patient, specifically a patient's skull. The introducer may include an advancer that is remote from the patient, the advancer communicating with the introducer by means of a cable system. The introducer may also include a local position sensor that indicates the position of the primary medical device being introduced. The introducer may also include a frameless reference system that locates the primary medical device relative to a table that the patient is fixed to.

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: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined computed tomography (CT) imagable 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) imagable 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: This patent document discusses assemblies and methods for remotely detecting a position of a surgical instrument in the presence of a magnetic field. In varying examples, a position detection system includes an encoder coupled to move in concert with the instrument. The encoder includes an a translucent substrate and light blocking indicia disposed thereon. A light source and a light detector array are effectively disposed outside of the magnetic field. Light from the light source is carried to an encoder first side using an input optical fiber, while the light passing through the encoder is received at an encoder second side by an output optical fiber. The light received by the output optical fiber is transmitted to the light detector array, which converts the received light to position representative electrical signals. Such signals are subsequently transmitted to a control module adapted to formulate and convey a position of the instrument.

Abstract: An insertion guide is shown that includes at least one insertion point adjustment device. A user such as a surgeon is able to adjust a lateral position of an insertion point to more precisely center the insertion point within an opening in a subject, such as a burr hole. Selected insertion guide devices further include a centering guide that easily indicates to a user when the insertion point is substantially centered within the opening in the subject. Selected insertion guide devices include adjustability of multiple degrees of rotational freedom of an insertion axis. Selected insertion guide devices further permit a user to fix multiple degrees of rotational freedom of an insertion axis using a single locking device. Tissue damage due to an attachment procedure of an insertion guide device is reduced using selected configurations described herein.

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: 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: This patent document discusses assemblies and methods for remotely detecting a position of a surgical instrument in the presence of a magnetic field. In varying examples, a position detection system includes an encoder coupled to move in concert with the instrument. The encoder includes an a translucent substrate and light blocking indicia disposed thereon. A light source and a light detector array are effectively disposed outside of the magnetic field. Light from the light source is carried to an encoder first side using an input optical fiber, while the light passing through the encoder is received at an encoder second side by an output optical fiber. The light received by the output optical fiber is transmitted to the light detector array, which converts the received light to position representative electrical signals. Such signals are subsequently transmitted to a control module adapted to formulate and convey a position of the instrument.

Abstract: A device and method of placement of a chronic micro-catheter is shown that allows effective guiding of micro-catheters through a host catheter that is later removable while leaving the micro-catheter implanted in place within the patient. The novel configuration allows the micro-catheter to be completely radially enclosed during insertion, and still allows the host catheter to be removed, leaving the micro-catheter behind. Additionally, the configuration allows several micro-catheters to be placed at any number of depths and orientations while still using a minimally invasive host catheter.

Abstract: An insertion device and method of using and manufacturing an insertion device is shown, wherein the insertion device is capable of distributing a media over a large distribution volume inside a patient while reducing the amount of tissue disturbed by the procedure. Also shown is a computer-readable medium with instructions stored thereon, the instructions when executed operable to cause generation of a set of data for use with an insertion device. An insertion device and methods are shown that allows a series of iterations to be performed within a single insertion procedure that distributes media, such as cells for cell therapy, over a large volume.

Abstract: This document discusses, among other things, examples of a stereotactic apparatus that includes reticles or other imagable locators for confirming placement of an instrument introduced along a desired trajectory. In certain examples, the reticles are re-positionable with respect to the trajectory to permit placement confirmation along different views. In other examples, the reticles are positionable toward or away from a skull.