1. Field of the Invention
This invention relates generally to a method and apparatus for use in surgical procedures and, more particularly, to a method and apparatus for re-attachment of a cranial flap using a cranial clamp.
2. Discussion of the Related Art
During various types of surgical procedures, it is often necessary to remove and re-attach a portion of bone. In certain neuro-surgical procedures, this portion of bone may include a portion of a human skull. For example, when performing surgery on the brain, it is often necessary to perform a craniotomy to provide access to the brain. To perform a craniotomy, one or more holes are drilled through the skull. These holes are generally known as burr holes which may be located, for example, at the corners of a triangular region of bone that is to be temporarily removed. After the burr holes have been drilled, osteonomies are made by a saw, (i.e., a craniotome) which connect the burr holes. This type of saw will typically include a guide nose that serves to avoid injuries to the dura matter. The resulting bone cover or cranial flap is subsequently lifted or removed from the underlying dura to expose and provide access to the brain.
Once the surgical procedure on the brain is completed, the bone flap or cover must be reattached to the skull at its original position. One procedure for reattaching a bone flap involves the use of sutures to retain the bone flap relative to the skull. However, this technique may not provide a desired rigid connection between the bone flap and the skull. Other techniques employed may use mechanical clamps which engage both an inner and outer surface of the bone flap and skull to retain one relative to the other. However, some of the commercially available mechanical clamps may not provide enough holding strength to assure rigid fixation of the bone flap relative to the skull, while others are difficult to implant. For example, some techniques require the use of many individual instruments which are difficult to handle and maneuver during the surgical procedure. Some of these instruments are also designed specifically for only right or left hand use and require an excess amount of arm or grip strength to operate. Others tend to create sharp surfaces which may cause patient discomfort, while others are also difficult to assemble/disassemble for cleaning and sterilization purposes.
What is needed then is a method and apparatus for reattachment of a cranial flap using a cranial clamp which does not suffer from the above-mentioned disadvantages. This will, in turn, provide a more rigid securement of the cranial flap relative to the skull, reduce the number of surgical instruments required to implant the cranial clamp, reduce or eliminate any sharp edges created on the cranial clamp, provide a set of instruments that may be used by right or left handed users, provide instruments that may be easily assembled/disassembled for cleaning and sterilization, and provide contoured mating surfaces between the cranial clamp and an applier instrument to reduce grip strength required to implant the cranial clamp. It is, therefore, an object of the present invention to provide such a method and apparatus for reattachment of a cranial flap using a cranial clamp.
In accordance with the teachings of the present invention, a method and apparatus for reattachment of a cranial flap using a cranial clamp having a base, a cap and a stem is disclosed. This reattachment method employs a set of surgical instruments that quickly and efficiently implants the cranial clamp to retain the cranial flap. This set of surgical instruments includes an applier instrument, a stem holder instrument, a stem cutter instrument, and a removal forceps instruments. Each of these instruments has a distinct use during the implantation procedure.
In one preferred embodiment, a set of surgical instruments for use in reattachment of a cranial flap using a cranial clamp having a base, a cap, and a stem includes an applier instrument and a stem cutter instrument. The applier instrument slidably receives a portion of the stem and moves the cap relative to the base. The applier instrument includes a handle, a trigger and a barrel configured as a gun-style instrument. The stem cutter instrument removes a portion of the stem from the cranial clamp, such that each of these instruments is used to implant the cranial clamp to reattach the cranial flap.
In another preferred embodiment, a set of surgical instruments for use in reattachment of a cranial flap using a cranial clamp having a base, a cap, and a stem includes an applier instrument and a stem cutter instrument. The applier instrument slidably receives a portion of the stem and moves the cap relative to the base. The applier instrument includes an engagement mechanism having a textured engagement surface that matingly engages a textured engagement surface on a portion of the stem. The stem cutter instrument removes a portion of the stem from the cranial clamp, such that each of these instruments is used to implant the cranial clamp to reattach the cranial flap.
In yet another preferred embodiment, a set of surgical instruments for use in reattachment of a cranial flap using a cranial clamp having a base, a cap and a stem includes an applier instrument, a stem holder instrument and a stem cutter instrument. The applier instrument slidably receives a portion of the stem and moves the cap relative to the base. The stem holder instrument engages and holds a portion of the stem and includes a pair of handles and a lock mechanism that may be locked upon squeezing the pair of handles once and opened upon squeezing the pair of handles once again. The stem cutter instrument removes a portion of the stem from the cranial clamp, such that each of these instruments is used to implant the cranial clamp to reattach the cranial flap.
In yet another preferred embodiment, a set of surgical instruments for use in reattachment of a cranial flap using a cranial clamp having a base, a cap, and a stem includes an applier instrument and a stem cutter instrument. The applier instrument slidably receives a portion of the stem and moves the cap relative to the base. The stem cutter instrument removes a portion of the stem from the cranial clamp and includes a capture mechanism that retains a sheared portion of the stem, such that each of these instruments is used to implant the cranial clamp to reattach the cranial flap.
In another preferred embodiment, a method of reattachment of the cranial flap using a cranial clamp having a base, a cap and a stem is set forth. This method includes engaging a textured engagement surface on a portion of the stem with an applier instrument having a mating textured engagement surface, moving the cap relative to the base as the applier instrument matingly engages the textured engagement surface on the portion of the stem, and removing a portion of the stem from the cranial clamp with a stem cutter instrument.
Use of the present invention provides a method and apparatus for reattachment of a cranial flap using a cranial clamp. As a result, the aforementioned disadvantages associated with the currently available reattachment devices, instruments and procedures have been substantially reduced or eliminated.