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Nov. 6, 11962
n. A. KEATING
3,062,213
MECHANICAL LESION GENERATOR
Filed March 1, 1960
3 Sheets-Sheet 1
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INVENTOR.
DONALD A. KzA'rimi
Nov. 6, 1962
D. A. KEATING
3,062,213
MECHANICAL LESION GENERATOR
Filed March 1. 1960
s Sheets-Sheet 2
INVENTOR.
DONALD Fl. KEATI'NG
BY
Nov. 6, 1962
D. A. KEATING
’
3,062,213
MECHANICAL LESION GENERATOR
Filed March 1, 1960
3 Sheets-Sheet 3
Ila.
—\ \\\\\\\\‘
INVENTOR.
DONALD A. KEATING
BY
M FIZZ?“
ATTORNEYS
United States Patent 0 M1C6
1
3,062,213
Patented Nov. 6, .1962
2
because of the necessity for multiple needlings and in
3,062,213
Donald A. Keating, 3235 White Oak Drive, Apt. 10,
Dayton, Ohio
creased likelihood of chance damage to blood vessels en
route. Even if this does not occur, a larger axis of inter
MECHANICAL LESION GENERATOR
vening brain is damaged by multiple insertions. A second
technique utilized is chemical in accordance with which
the area of destruction about a needle point will be rough-7
ly proportionate to the volume of absolute alcohol injected
Filed Mar. 1, 1960, Ser. No. 12,236
8 Claims. (Cl. 128—303)
This invention relates to a mechanical lesion generator
for the neurosurgical alleviation of certain diseases hav
(chemopallidectomy). However, the distribution of the
injected material is capricious, being governed by chance
ing their origin or a means of control thereof, in the hu
man brain; and more particularly a mechanical lesion
tissue planes, so that destruction is often produced at a
remote and undesirable point beyond the limits of the
proposed sphere. There is a further possibility of chem
ical necrosis of small blood vessels which will lead to
generator especially adapted for the neurosurgical alle
viation of Parkinsonism.
This application is a continuation-in-part of my co
bleeding or thrombosis hours later, with far more destruc
tion than was planned, and undesirable physiologic altera
tion.
A uniform needle incorporating at its point a plastic bal
loon capable of expansion so as to produce the desired
sphere of destruction by gentle pressure has been previ
pending application Serial No. 776,057 ?led November
24, 195 8, now abandoned.
Parkinson’s disease is one of the most ba?ling ailments
of the 20th century, affecting more than 1,500,000’
Americans. At the onset, the victim may feel a stiffness
in his muscles.
Normal walking and talking become
ously attempted. However, these have the disadvantage
increasingly difficult. He may sometimes shake uncon
trollably. His movements become slow and unsure. He
cannot form facial expression and ?nds it dif?cult to hold
of expanding eccentrically and unpredictably in relation to
the volume of ?uid injected. Quite frequently the plastic
balloons break during the operation.
It is a principal object of this invention, therefore, to
himself erect. As time progresses, so does the disease.
The victim can no longer tie his shoelaces or button his
provide an instrument capable of yielding a controlled
sphere of destruction. It has been found that such a con
coat, and the day comes when he must give up working.
Eventually, the victim can no longer feed himself.
trolled sphere of destruction may be accomplished by
means of an instrument which expands a metallic band
It has now been found that normal function can be
restored or substantially improved in certain chronic
diseases, particularly Parkinson’s disease, by destroying
normal brain tissue in certain speci?c areas. When in
jury to certain pathways in the brain has produced an
unremitting disturbance in a patient’s control over move
ment, as in the tremor and rigidity of palsy or Parkin
sonism, the writhing movements of athetosis, or the jerk
ings of choreic states, further destruction of what is
termed the extra-pyramidal motor system in a con?ned
anatomical area, the creation of lesions in the globus
pallidus has been found to abolish dramatically the ab
normal tone of certain muscles or the involuntary, jerky
30
from its point with radii of controlled extent.
Other objects of the invention will appear as the de
scription proceeds.
To the accomplishment of the foregoing and related
ends, said invention, then, consists of the means herein
after fully described and particularly pointed out in the
appended claims, the following description and annexed
drawing setting forth in detail certain illustrative embodi
v
impulses to them, with great improvement in voluntary
movement.
ments of the invention, such disclosed ‘means constituting,
however, but a few of the various forms in which the prin
ciple of this invention may be employed.
Broadly stated, this invention is in the provision of a
mechanical lesion generator for neurosurgical use com
prising an outer tube and an inner tube telescopically as
In certain states of intractable pain, resulting from in
sembled for relative movement, expansible band means
jury or incurable cancer, the transmission of pain to con~
anchored at one end of the inner tube to form a resilient
scious levels can be blocked by afferent pathways through 45 loop portion projecting outwardly from the corresponding
end of the outer tube, means for maintaining a predeter
small areas of destruction in the spinal cord or brain
mined axial dimension of the projecting portion of the
stem.
loop, and means for ‘moving the inner tube in either direc
Accurate stereotaxic placement of a needle or ?ne
plastic catheter so that its end will lie in a desired nucleus
of the brain with no more than 2 mm. error in any co 50
ordinate is already entirely feasible. Properly projected
X-ray studies of the head, after certain landmarks in the
brain have been outlined with radio-opaque material in
jected into its arteries or its ventricles, allow calculation
tion relative to the outer tube to selectively expand or con
tract the projecting portion of the loop.
In the annexed drawings:
FIG. 1 is a plan view of a mechanical lesion generator
with accordance with this invention.
FIG. 2 is a fragmentary cross-sectional view of a means
of the exact angle and depth to ‘Which a needle must be 55 for advancing and retracting the inner tube to control the
expansion and contraction of the expansible band.
inserted from its support on a calibrated frame a?xed
FIG. 3 is a modi?cation of the means shown in FIG. 2,
to the skull. The approach and arrival of the needle
additionally providing means for independent adjustment
point at the proposed target is veri?ed by additional se
of the outer tube.
rial X-rays. A route of approach can ordinarily be se
lected such that no tissue of important function is dis 60 FIG. 4 is a fragmentary cross-sectional view of the ex
pansible band end of the instrument.
turbed along the injection path. Reference may be had
FIG. 5 is an enlarged view of the end of the probe
to Cooper, Irving 8.: “The Neurosurgical Alleviation of
shown in FIG. 4.
Parkinsonism” for the details of the operation for insert
FIG. 6 is a cross-sectional view taken on the line 6—6
ing a cannula into the brain and locating the globus pal
lidus by means of a pallidectomy guide
65 of FIG. 4.
‘FIG. 7 is a fragmentary perspective view of the end of
The technical problem of producing a localized sphere
of brain destruction about the end of an inserted instru
the outer tube.
,
FIG. 8 is a ‘fragmentary perspective view of the end of
the inner tube.
to be only one or two mm. in diameter. If the sphere must 70
FIG. 9 is a fragmentary perspective view of the end of
be 10 to 15 mm. in diameter to produce the desired physi
the probe tube.
ologic effect, the electrolytic technique becomes unwieldy
FIG. 10 is a fragmentary side illustration of the distal
ment has not been satisfactorily solved. Electrolytic
lesions are satisfactory where the sphere of destruction is
3,062,218
4
3
instrument and does not appear in FIG. 4. The band end
of the probe provides an outer tube 1, an inner tube 10
telescopically assembled for relative movement within
FIG. 11 is an illustration of a different means for an
outer tube 1, and a probe tube 11. Probe tube 11 may be
choring the bands to the probe tube.
hollow and thus adapted to receive an electrode probe 4
' FIG. 12 is a fragmentary cross-sectional view of an
as shown in FIG. 1 and FIGS. 5 and 6, or it may be solid.
assembled distal end of an instrument in accordance with
With
the hollow tube, when the electrode 4 is withdrawn
this invention.
therefrom, the hollow tube may also be used for the pur
FIGS. 2 through 12 ‘are shown in very much enlarged
pose of injecting ?uids. Also shown in FIG. 4 is the ex
pansion band 2, which is ai?xed to the outermost end of
' Referring more particularly to 'FIG. 1, there is here
the probe tube 11 by suitable means at a point interme
shown a full view of a mechanical lesion generator in ac
diate its ends. The free ends of the band 2 are then folded
cordance with this invention. Generally speaking, the.
back on the probe tube 11 and a?ixed to the telescopi
instrument is composed of an outer tube -1 having an
cally movable inner tube 10. The probe tube 11 extends
expansible band 2 protruding from one end thereof and
having its other end attached to control means 3 for ex 15 beyond the ends of both the outer tube 1 and the inner
tube 10, and provides one means for maintaining a pre
panding and contracting the band 2. Piercing the entire
determined axial dimension of the projecting portion of
instrument is a removable electrode probe 4. Manual con
the loop of band 2. The distance between the outer ex~
trol means 5, for example the knurled handled screw
tremity of the probe tube 11 and the outer extremity of
shank coacting with the housing 3, enables the surgeon
to control the degree of expansion of the expansion 20 the outer tube 1 is set at a predetermined ‘axial displace
ment. As shown in FIG. 3, adjusting means may be pro
band 2.
vided to vary the distance between the outer end of the
FIGS. 2 and 3 show in much enlarged detail a fragmen
probe tube 11 and the outer extremity of the outer tube 1.
tary cross-sectional view of a control means 3 suitable for
It will be observed that as the inner tube 10 is telescopi
use in accordance with this invention. FIGS. 2 and 3 also
illustrate the additional function of the control means 3 25 cally moved with respect to the outer tube 1 and the probe
tube 11, the band 2 expands or contracts forming loops in
for retaining the several tubular members. There is thus
a direction radial with respect to the probe tube 11.
provided a housing 6 internally threaded as shown at 7,
FIG. 5 is an end view of the outer end of the probe
and ?tted with a cover plate 8 at its one end. The cover
shown in FIG. 4 with the exception that the electrode 4
plate 8 provides means for retaining the outer tube 1. As
shown in FIG. 2, the outer tube 1 is soldered or otherwise 30 is shown in place. The endv of probe tube 11 may be
notched as shown in FIG. 9 to receive the band 2 at a
rigidly a?ixed to the cover plate 8. In FIG. 3, the outer
point intermediate its ends and hold the same ?rmly in
tube 1 is movable with respect to the cover plate 8 as by a
place as by soldering. As shown in FIG. 5, the band 2
rack and pinion system 9 for advancing and retracting the
may be provided‘ with an aperture 19 to permit the passage
outer tube 1 independently of the inner tube 14}. Disposed
within the inner tube 10 is a probe tube 11 which extends 35 of the electrode 4 therethrough. Alternately, the band 2
may be soldered to the side of probe tube 11 and the
entirely through the, control means 3, the surgeon’s con
notches 20' omitted, thereby avoiding the necessity of
trol 5 and emerges at, the end of the instrument opposite
piercing the band 2.
the band end. Any suitable means 12 (FIG. 1) may be
In FIG. 6 there is shown in cross-section a view taken
provided for securing the probe tube 11 to prevent axial
displacement thereof. As shown in FIG. 1, this retaining 40 on the line 6-6 of FIG. 4. In this view the electrode‘
4 has been placed in position within the probe tube 11.
means 12 is a pair of wire brackets, one end of which is
FIG. 6 also shows the manner of attaching‘ the free ends
soldered to the housing 6, and the other end of each of’
of‘ the band 2 in the notched end of inner tube 10. Any
which is soldered to the probe tube 11.
suitable means for a?ixing the ends of the band 2 in the
As indicated above, the inner tube 10 is telescopically
notches 21 may be used such as imbedding in plastic,
assembled for relative movement with respect to both the
probe tube 11 and the outer tube 1. The surgeon’s control 45 soldering, welding, etc.
' FIGS. 7, 8 and 9 are fragmentary prospective views of
5" advances and retracts within the housing 6 as the
the outer ends of outer tube 1, inner tube 10 and probe
surgeon may desire by rotating threaded surgeon’s control
- tube 11, respectively, and show convenient notching of
5' in the desired, direction. When thread means are em.
the ends of these tubes to adapt them toreceive and guide
ployed for advancing and retracting the inner tube 10,v
means must also be provided to prevent rotation of the 50 the expansible band 2.
end of inner tube 10 having a split vband attached thereto
composed of halves 2a.
scale.
__
V
"
inner tube 10 as the threaded control '5 revolves. Accord‘
' It becomes convenient at this point to describe a speci?c
ingly, in the embodiment shown in FIGS. 2 and 3, the
threaded control 5 is provided with a cylindrical recess 13
and preferred embodiment of the present invention which
control 5 is rotated. The tube 10 is affixed by suitable
Variations therein may be made by those skilled in the
is useful in the alleviation of Parkinsonism. When used
for thispurpose, sizes of parts, especially the tubular parts
and a cover plate 14 having a bore 15 therethrough so
sized as to permit relative rotation of the cover plate 14 55 and the expansion band, become extremely important and
reference to actual sizes will be made, it being under
with respect to the inner tube 10. Mounted within the
stood, however, that this speci?c example represents only
recess_13 is adisc 16, so. sized as to permit relative rota-t
tion of the disc 16‘ within the recess 13 as the surgeon’s , one preferred embodiment of the- present invention.
means such as silver-soldering to the disc 16. The means 60 art without departing fromthe spirit of the invention.
_ The surgeon’s control 5, shown in FIGS. 1, 2 and 3,
for converting the rotatory and axial displacement of the
1s the component part which the surgeon uses to control
threaded shank 5 to axial displacement only also includes
or govern the expansion of the “lesion generating” bands
a key 17 suitably a?ixed to the inner tube 10 as by solder
inside the brain. This part consists in the preferred form
ing, which key is adapted to traverse the slot 18 in the
housing 6. Any other means for telescopically moving the 65 of a round shank, one end of which is ‘a raised knurled
portion for the surgeon’s touch control. For convenience,
inner tube 10 with respect to the outer tube 1 and the
the shank portion has been identi?ed in FIG. 1 as 22
probe tube 11 without rotation of the inner tube 10 may,
and the raised knurled portion as 23. The other end of
of course, be provided.
the surgeon’s control 5 is conveniently threaded such that
In FIG. 3, there is also shown means 9 for- adjusting
the position of the outer end of the outer tube- 1 with 70 the piston can screw'into the- screw housing 6. A drilled
respect to the probe tube 11.
'
Referring more particularly to FIG. 4, this is a frag
mentary cross-sectional view in enlarged size of’ the outer
hole is provided throughout the. entire length of the sur
ge'on’s. control 5 to allow for passage of the‘ probe tube
or band end of the structure shown in FIG. 1. The elec
therethrough to provide an entrance for the introduction
of liquids such‘ as'procaine or alcohol therethrough, or
trode. member 4 of FIG. 1 has, been withdrawnfrom the
for the introductionofanelectrode 4 therethrough. This.
r.
3,062,213
6
E}
part is desirably made of brass to insure .a ?rm threaded
portion. However, lighter materials such as aluminum
may be used with advantage to reduce the moment force
due to increased moment arm when this part is at its
furthest extension out of the instrument. The total length
of the screw travel in a preferred embodiment of this
inside and outside surfaces so that the device can be easily
sterilized. The outer tube 1 is the “guiding tube” for
the inner tube 10. The outer tube 1 is ?xed at one end
to the cover plate 8. The other end is notched as shown
in FIG. 7 so as to guide the band 2 in its expansion.
The outer tube 1 and the probe end including the band 2
are in immediate contact with the brain. The opposite
The internally threaded housing 6 is a cylindrical part
end of the tube near the surgeon’s control 5 will be
with internal threads to receive the surgeon’s control 5
clamped by a “head cannula holder” (not shown) so
and a keyway or slot 18 to guide the key 17. Only one 10 as to ?x the instrument’s location in the brain according
end of the cylinder 6 is covered, in a preferred embodi
to procedures now well known to those skilled in the
ment, and this is the end intermediate the extremities of
art.
the instrument and nearest the expansion band. The
The inner tube 10 desirably has the same metallurgical
invention need not be more than 0.5 inch.
cover plate 8 is soldered to the end of the cylindrical
housing 6 and provides the point of attachment of the
outer tube 1.
Brass is a preferred material for construc
tion of the housing 6 because of its machineability and
ability to be soldered. The cover plate 8 is desirably of
the same material as the screw housing 6 (brass) so as
to enable it to be easily soldered to the housing 6.
In a preferred embodiment of this invention, there is
provided a part identi?ed in FIGS. 2 and 3 as 16, which
may, for convenience, be called the inner tube plate 16.
The inner tube plate 16 is conveniently made of copper
and has ?rmly affixed thereto, as by silver-soldering, the
inner tube 10. The primary function of the inner tube
plate 16, with the aid of the key 17, is to change combined
properties as the outer tube 1. One end of the tube 10
is ?xed to the inner tube plate 16, and the outer end is
desirably notched as shown in FIG. 8 and secured to the
ends of the expansible band 2. The key 17 is also ?xed
to this tube 10 to insure only longitudinal motion. This
tube 10 can be considered to be a link between the sur
geon’s control 5 and the band 2.
The probe tube 11 desirably has the same metallurgical
properties as the outer tube 1 and the inner tube 10. The
band end of the tube 11 is notched as shown in FIG. 9
and secured to the band 2 so as to ?x its location.
The
probe tube 11 is the longest tube in the instrument and
in the preferred embodiment extends the entire length so
that its extremity opposite to the band end may be secured
rotary and axial motion of the surgeon’s control 5 into
as by retaining arms 12 (FIG. 1) to prevent axial dis
longitudinal, or axial motion only. The parts as shown
placement thereof with respect to the outer tube 1. In
in FIGS. 3 and 4 perform this function since the sur 30 a preferred embodiment of this invention, the distance
geon’s control 5 is free to rotate upon the inner tube
between the ends of the outer tube 1 and the probe tube
plate 16 which is held captive within the recess 13 by
11 is 5 mm. As shown in FIG. 3, the distance between
the cover plate 1-4.. Accordingly, there is imparted to
the ends of the outer tube 1 and the probe tube 11 may
the inner tube 10 only longitudinal motion.
be made adjustable so that a range of axial displacement
The key 17 is conveniently made of brass and has pass
of the relative ends of outer tube 1 and probe tube 11
ing through it the inner tube 10 which is conveniently
may vary from about 4 to about 15 mm. Alternatively,
soldered to the key. The key 17 slides in the key way
the outer tube 1 may be ?xed as in FIG. 2 and the probe
or slot 18 in the screw housing 5 which de?nitely insures
tube 11 made adjustable as by a set screw in the wire
longitudinal motion without any rotational motion derived
bracket 12, not shown. The probe tube 11 itself extends
from the surgeon’s control 5.
40 back through the instrument so as to be a guide for the
The plate 14 is also of brass with a drilled hole
electrode probe 4 and when the electrode probe 4 is with
through it to allow complete freedom of its rotary motion
drawn from the instrument to serve as a channel for the
upon the inner tube 10. It is soldered to the end of the
introduction of liquid medicaments.
surgeon’s control 5 and its sole function is to enclose and
As indicated above, the size of these tubes is somewhat
retain the inner tube plate 16 within the bore or recess 13,
critical. The following internal and external diameters
the bore therethrough being so sized as to fail to impart
of tubes suitable for use in accordance with this inven
any rotary motion to the inner tube 10‘.
tion are dictated by commercially available tube sizes
The physical dimensions of the portions of the instru
and are offered as a guide to the magnitude of tubes
ment thus far described as comprising a preferred embodi
which may be used for neurosurgical operation purposes.
ment of the invention are not critical and need only be 50 Variations from these sizes are, of course, possible but
designed to accommodate the needs of the surgeon, hear
should be designed within the limits dictated by- the
ing in mind the weight of the instrument, moment forces,
physiological effect of such tube on the membrane or
etc. Thus the housing 6 may be 1.5” long by 0.5"
organ wherein it is to be used.
diameter. The key-way 18 may be 0.75" long by 0.125”
The outer tube, therefore, in a preferred embodiment
wide. The surgeou’s control 5 is 2.75" long with a
threaded portion 0.75” long, 40 threads per inch, and
0.3125" pitch diameter. The recess 13 is 0.1875" diam
eter by 0.09375" deep. The shank portion is 0.25" diam
eter and the knurled portion 0.5" long by 0.625" diam
has an OD. of 0.072 inch and an ID. of 0.054 inch.
The inner tube has an 0.1). of 0.049 inch and an ID. of
0.033 inch. The probe tube has an CD. of 0.032 inch
and an ID. of 0.020 inch. The dimensions of the notch
ing in each of the tubes is conveniently as follows: On
eter. The control 5' has an axial bore 0.032" in diameter. 60
the outer tube the notch is conveniently 0.025 inch wide
The cover plate 14 is 0.25” diameter by 0.0625" thick
and has an axial bore 0.054" diameter. The inner tube
plate 16 is 0.15625” diameter by 0.0625” thick with an
axial bore 0.049” diameter. The key 17 is a brass ‘block
0.125" x 0.125" x 0.310" with a bore 0.049" diameter
on a central axis 0.0625" from base.
With the tubular portions of the preferred embodiment,
more critical attention must be paid to the size of the
tubes. The instrument, in one of its intended uses, is to
be designed for insertion in the brain.
In the preferred embodiment, the outer tube 1 is de
sirably of standard AISZ Type 304 Austenitic chromium
nickel stainless steel hypodermic needle tubing. The
tubing should be of hard-drawn temper which insures
maximum hardness, and have a clean bright ?nish on both 75
and 0.010 inch deep (axial). On the inner tube, the
notch is conveniently 0.015 inch wide and 0.1875 inch
long.
On the probe tube, the notch is conveniently 0.015
inch wide and 0.010 inch deep. Where an electrode tube
is used, it may have an 0.1). of 0.018 and an ID. of
0.010 inch.
The length of the respective tubes will, of course, be
determined by convenience in design. In the device not
providing for adjustable distance between the ends of the
outer tube 1 and the probe tube 11, a convenient distance
(?xed) between such ends is 5 mm. In such a ?xed
device, the outer tube may conveniently have a length
of 5.06 inch, the inner tube a length of 5.50 inches and
the probe tube a length of 9.0 inches.
The expansion band is perhaps the most important part
3,062,213
7
of the instrument as its purpose is to generate the desired.
lesion by gentle pressure upon that portion of the brain
to be- damaged. The expansion band 2 is a continuous
band of ?at “Invar-alloy” clock spring strip 0.008 inch
thick, 0.020 inch in width, and 1.50 inches long. The
ends of this band are silver-soldered to the inner tube
10>and at a point intermediate its ends to the probe tube
end. The band 2 is expanded by longitudinal motion
of the inner tube 10,- thus buckling or expanding the band.
8
distal extremity of probe tube 11a. Axle pins spanning
the slots 25 might also be used for anchoring means or
hinges for the divided band sections 2a.
FIG. 12 is a fragmentary cross-sectional view of an
assembled distal end of an instrument in accordance with
this invention embodying the structure utilizing a divided
band 2, and illustrating a preferred means for anchoring
sections 2a.
The outer tube 1 is partially shown with
inner tube 10 telescopically moveably retained therein.
At full expansion, the path of lesion will be elliptical in 10 Band portions 2a, 2a are ?xedly attached to inner tube
20 as by silver soldering. Probe tube 11a is shown in
shape,,being 5 mm. at the minor axis and about 10 mm.
place having the sleeve 22 ?tted over its extremity. The
at the major axis. A very thin coating of polyethylene
loops 24 encircle the ring 23 and are restrained from
may be applied to the band. The coating is inert and will
lateral movement by portions of the loops 24 resting in
produce no chemical reaction in. the brain. Further the
slots 25, respectively. Probe tube 11a is modi?ed to
coating acts as a safety feature if the metal band should
eliminate notches 20 in probe tube 11 (FIG. 9) and adapt
fracture. The expansion can then be contracted without
it to receive and retain sleeve 22.
rupture of the coating by the metal band which would
In making the soldered joints, consideration should be
induce laceration of brain tissue. The coating also
given to sterilization temperatures. Silver-soldering is
serves to round the sharp corners of the rectangular spring
satisfactory for either autoclaving or chemical steriliza
strip and will insure against laceration of brain tissue
tion techniques. To maintain the metallurgical proper
and vessels. Polyethylene can be coated on the metal
ties of the band, gas or cold sterilization is preferred.
by dipping or ?ame spraying. The best material which
In the surgical operation, the instrument is placed in
has been found for making the expansible band 2 is
a cannula guide ‘and enters the brain only a short distance.
material expanding to a loop having its base 5 mm. long, 25 The electrode probe 4 is then advanced farther into the
Invar-clock spring alloy. :It has been found that this.
can withstand a maximum de?ection radially of about
0.438 inch before the band will “?op over.” and form
a closed loop.
This is more than su?icient for the pur
poses of the present invention since the maximum radial
expanion on a base 5 mm. in length will be no more than
about 10 mm. Stainless spring steel maybe used since
it satis?es the requirement of a maximum de?ection
(ymax) greater than 2.5 mm., the material is relatively
inert and is currently used in surgery. It is capable of
being easily soldered to the inner tube. However, stain
less steel spring wire thinner than 0.005 inch in diameter
is seldom made. Linear polyethylene also satis?es the
(ymx) requirement of 2.5 mm. or greater. However,
at expansion it is extremely ?exible and giveslittle resist
brain. With proper recording and measuring equipment
in use, the electrode is advanced until the lesion site is
located. The electrode probe is now clamped in position
by an extension of the cannula holder. The instrument
itself is‘ now advanced until it is at the site of future de->
struction within 2 mm. error. The location is checked.
by X-ray. Once the instrument is at the lesion site, itv is
clamped into a ?xed location by the cannula holder. Thev
electrode-probe is then withdrawn. Now approximately
0.25 cubic centimeter of procaine is injected into the
brain through the probe tube 11. If localization has been
accurate, this injection of procaine will result in an im
mediate marked lessening or abolition of contra-lateral.
tremor and rigidity. If it does not, the needle is ad
ance to any applied pressure. It is also dif?cult to secure 40 vanced to a greater depth and injection is repeated. If.
neither of these localizations produce alleviation of
a- polyethylene. band to the inner tube’ 10. While poly
tremor and rigidity, one must replace the needle in a
ethylene is not a preferred material for use in designingv
more anterior or a more posterior plane, depending to a
the band, it is very useful as a band covering. Clock.
large extent on past surgical experience.
spring steel, S.A.E. 1095 is not recommended since its
Once procaine injection has resulted in alleviation of
(ymax) is not that of 2.5 mm. or greater. The theoretical 4.5
contralateral tremor and rigidity, one can then proceed‘
calculation was checked by experiment which demon
with the production of a destructive lesion. The lesion
strated fracture of the band at 2.5 mm. expansion. The
is generated by simply turning the surgeon’s control 5
Invar-alloy is an’ alloy of nickel and exhibits the proper
which displaces the inner tube 10 longitudinally, thus
ties of high strength, low modulus of elasticity and re
sistance to many chemicals and corrosion. The maxi— 50 expanding the band 2 in one plane. Throughoilt the
period of expansion, one tests the contralateral extrem
mum de?ection at expansion can be made greater than
ities as well as speech and mental functions, the patient
51mm” at’ which the band oifers considerable resistance
being under only local anesthesia during the operation.
to applied pressure at its surface. The band can be
If any untowards signs or symptoms develop during ex
silver-soldered to the inner tube 10 and the end of probe
tube 11 without any bonding problems. The band can 55 pansion, one can terminate the procedure without en
be expanded Without any fatigue problems if (ymax) is
larging the lesion. The expansion is continued until the
desired results are obtained, or until the limit of the in
strument is reached. The surgeon can then collapse the
band and ‘rotate the instrument in another plane, thus
tained, and can be coated with polyethylene. This ma 60 generating the lesions in more than one plane, if he so
wishes or deems it more bene?cial. The operation can
terial is a preferred material for the expansion band.
then be completed by simply collapsing the band 2 and
Any suitable means of attaching the band, or halves
withdrawing the instrument from the brain.
thereof, to the probe tube and the inner tube may be
never greater than 5 mm., such that the band is not in
the plastic range undergoing cold working. This ma
terial possesses all of the requirements and is easily ob
employed.
Further in accordance with this invention, I have pro
Other modes of applying the principle of this invention
may be employed instead of those speci?cally set forth
above, changes being made as regards the details herein
disclosed, provided the elements set forth in any of the
following claims, or the equivalent of such be employed.
vided the structure shown in FIGS. l0, l1 and 12 as a
means for anchoring a divided band 2. to the distal end
of the instrument.
It is, therefore, particularly pointed out and distinctly
FIG. 10 shows a fragmentary side illustration of the
distal end of the inner tube 10 having a split band 2 com 70 claimed as the invention:
posed of halves 2a and 2a.v The free ends of the bands
2a are conveniently provided with loops 24 adapted to
loosely encircle'an axle member 23 (FIG. 11). The axle
1. A mechanical lesion generator for neurosurgical use
comprising an outer tube and an inner tube telescopically
assembled for relative movement, and a probe member
disposed within said inner tube, said probe member ex.
member 23 is illustrated in FIG. 11 as a metallic ring 23
a?ixed to a. slotted sleeve 22 which tightly ?ts over the 75 tending beyond the extremity of said inner tube, expan
9
3,062,213
10
sible band means anchored at one end of the inner tube
and to the outer end of said probe member to form a
pansible band secured at a point intermediate its ends
to the outer extremity of said probe member, and said
resilient loop portion projecting outwardly from the cor
band having its extremities secured to the end of said
responding end of said outer tube, means for maintain
inner tube adjacent said outer extremity of said probe
ing a predetermined ?xed axial dimension of the pro
member, and means for telescopically moving the said
jecting portion of the loop between the distal end of said
end of said inner tube in either direction in the annular
probe member and the distal end of said outer tube, and
space between said probe member and said outer tube to
means for moving the inner tube in either direction rela
expand and contract said band.
tive to the outer tube to selectively expand or contract
7. A mechanical lesion generator for neurosurgical use
the projecting portion of the loop.
10 comprising an outer tube, an inner tube concentrically
2. A mechanical lesion generator for neurosurgical use
disposed Within said outer tube, and a tubular probe
comprising an outer tube, an inner tube concentrically
member concentrically disposed Within said inner tube
disposed within said outer tube, and a probe member
and extending beyond the extremities of said outer tube
disposed within said inner tube, said probe member ex
and means for ?xing the axial relationship of said inner
tending beyond the extremity of said inner tube, an ex
tube, said outer tube and said probe member, an ex
pansible band secured at a point intermediate its ends
pansible band secured at a point intermediate its ends
to the outer end of said probe member, and said band
to the outer extremity of said probe member, and said
having its extremities secured to the end of said inner
band having its extremities secured to the end of said
tube adjacent said outer end of said probe member, means
inner tube adjacent said outer extremity of said probe
for maintaining a predetermined ?xed axial dimension
member, and means for telescopically moving the said
of the projecting portion of the loop between the distal
end of said inner tube in either direction in the annular
end of said probe tube ‘and the distal end of said outer
space between said probe member and said outer tube
tube, and means for telescopically moving said inner tube
to expand and contract said band, a housing provided
relative to said probe member and said outer tube to ex
at one end with an apertured plate for passing said inner
pand and contract said band.
tube and said probe member therethrough, said plate
3. A mechanical lesion generator for neurosurgical use
?xedly retaining said outer tube, a piston within said hous
comprising an outer tube and an inner tube telescopically
ing mounted for axial movement in either direction within
assembled for relative movement, and a probe member
said housing and having said inner tube attached thereto,
disposed within said inner tube, said probe member ex
means for moving said piston in either direction inde
tending beyond the extremity of said inner tube, ex 30 pendently of said probe member, means coacting with
pansible band means including a pair of ?exible bands
said inner tube to prevent rotation thereof about its axis,
disposed on opposite sides of said probe member each
and means for anchoring said probe member to said
of said bands being anchored at one end of said inner
housing.
tube, and the other end hinged to the outer end of said
8. A mechanical lesion generator for neurosurgical use
probe member to form a pair of resilient loops projecting
comprising an outer tube, an inner tube concentrically
outwardly from the corresponding end of the outer tube,
disposed within said outer tube, and a tubular probe
means for maintaining a predetermined ?xed axial dimen
member concentrically disposed within said inner tube
sion of the projecting portions of the loops between the
and extending beyond the extremities of said outer tube
distal end of said probe tube and the distal end of said
‘and said inner tube, said outer tube and said probe mem
inner tube, and means for moving the inner tube in either
ber being in ?xed axial relationship, ‘an expansible band
direction relative to the outer tube to selectively expand
secured at ‘a point intermediate its ends to the outer
or contract the projecting portion of the loops.
extremity of said probe member, and said band having
4. The mechanical lesion generator of claim 3 wherein
its extremities secured to the end of said inner tube ad
the probe member is tubular.
jacent said outer extremity of said probe member, and
5. A mechanical lesion generator for neurosurgical 45 means for telescopically moving the said end of said
use comprising an outer tube, an inner tube concen
inner tube in either direction in the annular space between
trically disposed within said outer tube, and a probe
said probe member and said outer tube to expand and
member disposed Within said inner tube, said probe
contract said band, an internally threaded cylinder pro
member extending beyond the outer extremities of said
vided at its innermost end with an apertured plate for
inner tube and said outer tube, means for adjusting and 50 passing said inner tube and said probe therethrough,
?xing the distance between the outer extremity of said
said plate ?xedly retaining said outer tube, a threaded
probe member and the outer extremity of said outer tube,
piston within said cylinder mounted for axial movement
an expansible band secured at a point intermediate its
in either direction within said cylinder, means for con
ends to the outer extremity of said probe member and
verting the rotatory and axial displacements of said
said band having its extremities secured to the outer ex 55 threaded piston to axial {displacement only and trans
tremity of said inner tube, and means for telescopically
mitting said axial displacement to said inner tube, said
moving said inner tube independently of said probe mem
threaded piston having a bore for passing said probe
ber and said outer tube to expand said band to form
member therethrough, and means for anchoring said
substantially U-shaped loops of said band projecting
probe member to said cylinder to restrain axial movement
laterally from said probe member and to contract said 60 thereof.
band inwardly toward said probe member.
6. A mechanical lesion generator for neurosurgical use
comprising an outer tube, an inner tube concentrically
disposed within said outer tube, and a tubular probe
member concentrically disposed within said inner tube 65
‘and extending beyond the extremities of said outer tube
and means for ?xing the axial relationship of said inner
tube, said outer tube and said probe member, an ex
References Cited in the ?le of this patent
UNITED STATES PATENTS
618,521
654,763
687,112
1,677,209
Palmer ______________ __ Jan. 31,
Russell ______________ __ July 31,
Bowker ______________ __ Nov. 19,
Rose _______________ __ July 17,
1899
1900
1901
1928
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