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WO2012073240A2 - Boring element for selective boring - Google Patents

Boring element for selective boring Download PDF

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Publication number
WO2012073240A2
WO2012073240A2 PCT/IL2011/000919 IL2011000919W WO2012073240A2 WO 2012073240 A2 WO2012073240 A2 WO 2012073240A2 IL 2011000919 W IL2011000919 W IL 2011000919W WO 2012073240 A2 WO2012073240 A2 WO 2012073240A2
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WO
WIPO (PCT)
Prior art keywords
boring
subject
sensor
boring element
housing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IL2011/000919
Other languages
French (fr)
Other versions
WO2012073240A3 (en
Inventor
Yossi Gross
Moshe Gelber
Noah Amit
Ruth Alon
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2012073240A2 publication Critical patent/WO2012073240A2/en
Publication of WO2012073240A3 publication Critical patent/WO2012073240A3/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1626—Control means; Display units
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C3/00—Dental tools or instruments
    • A61C3/02—Tooth drilling or cutting instruments; Instruments acting like a sandblast machine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00106—Sensing or detecting at the treatment site ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/04—Measuring instruments specially adapted for dentistry

Definitions

  • Some applications of the present invention generally relate to external medical apparatus. Specifically, some applications of the present invention relate to apparatus for selectively boring holes in a subject's body.
  • hematopoietic stem cells are removed from the bone marrow of a healthy patient in order to transplant the cells to a diseased patient.
  • the hematopoietic stem cells are typically removed from the bone marrow of a large bone of the healthy subject, such as the pelvis or the femur.
  • a dental implant is an artificial root that is used to support dental prostheses, such as crowns, bridges, and/or dentures.
  • dental prostheses such as crowns, bridges, and/or dentures.
  • Many implants are root-form endosseous implants, which are placed into a hole that has been bored in the patient's mandible.
  • apparatus and methods are provided for use with a first portion of a subject's body that is adjacent to a second portion of the subject's body, it being desirable to bore a hole through the first portion, but not to bore through the second portion.
  • the first and second portions may be, respectively, bone and bone marrow, or the inferior maxillary bone and the mandibular nerve.
  • a boring element bores a hole through the first portion of the subject's body.
  • a sensor coupled to the boring element senses a parameter (e.g., an electrical parameter) at the distal end of the boring element.
  • a control unit terminates the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is at, or in the vicinity of, the second portion.
  • the boring element is housed in a housing that is shaped to accommodate the first and second portions of the subject's body.
  • apparatus for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus including:
  • a boring element configured to bore a hole through the first portion of the subject's body
  • a housing configured to house the boring element, the housing being shaped to accommodate and at least partially surround the first and second portions of the subject's body;
  • a sensor coupled to the boring element and configured to sense a parameter in a vicinity of the distal end of the boring element
  • control unit configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is in a vicinity of the second portion.
  • the first portion includes an inferior maxillary bone of the subject
  • the second portion includes a mandibular nerve of the subject
  • the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
  • the first portion includes bone tissue of a femur of the subject
  • the second portion includes marrow of the subject's femur
  • the control unit is configured to prevent boring of the marrow by terminating the boring.
  • the senor includes an ultrasound probe.
  • the senor includes a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
  • the boring element is configured to act as an electrode
  • the sensor is configured to sense the electrical parameter via the boring element.
  • each of the boring elements being coupled to the housing at a distance from an adjacent one of the boring elements that is 1-10 mm; a sensor, coupled to each boring element and configured to sense a parameter at the distal end of the boring elements; and
  • control unit configured to terminate the boring of a given one of the boring elements in response to the parameter that is sensed by the sensor indicating that the distal end of the given boring element is in a vicinity of the second portion.
  • each of the boring elements is coupled to the housing at a distance from an adjacent one of the boring elements that is 3-5 mm.
  • the plurality of boring elements are disposed in a triangular configuration.
  • control unit is configured to terminate the boring of all of the boring elements in response to the parameter that is sensed by the sensor indicating that the distal end of any one of the boring elements is in the vicinity of the second portion.
  • the first portion includes an inferior maxillary bone of the subject
  • the second portion includes a mandibular nerve of the subject
  • the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
  • the first portion includes bone tissue of a femur of the subject
  • the second portion includes marrow of the subject's femur
  • the control unit is configured to prevent boring of the marrow by terminating the boring.
  • the senor includes an ultrasound probe.
  • the sensor includes a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
  • the boring element is configured to act as an electrode
  • the sensor is configured to sense the electrical parameter via the boring element.
  • apparatus for use wit a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus including:
  • a boring element configured to bore a hole through the first portion of the subject's body
  • a sensor coupled to the boring element and configured to sense a parameter at the distal end of the boring element
  • control unit configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is at a vicinity of the second portion
  • a mechanism configured to couple the boring element to the housing such that: when the housing is pressed with a pressure that is below a threshold pressure, the boring element is not activated to bore the first portion of the subject's body, and
  • the boring element when the housing is pressed with a pressure that is greater than the threshold pressure, the boring element is applied to the first portion of the subject's body with a constant pressure, irrespective of the extent to which the pressure with which the housing is pressed is greater than the threshold pressure.
  • the first portion includes an inferior maxillary bone of the subject
  • the second portion includes a mandibular nerve of the subject
  • the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
  • the first portion includes bone tissue of a femur of the subject
  • the second portion includes marrow of the subject's femur
  • the control unit is configured to prevent boring of the marrow by terminating the boring.
  • the senor includes an ultrasound probe.
  • the senor includes a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
  • the boring element is configured to act as an electrode
  • the sensor is configured to sense the electrical parameter via the boring element.
  • FIG. 1 is a schematic illustration of a boring element boring through a subject's femur, in order to extract marrow from the femur, in accordance with some applications of the present invention
  • Fig. 2 is a schematic illustration of a boring element configured to bore through the inferior maxillary bone, the boring element being disposed in a housing, in accordance with some applications of the present invention.
  • Fig. 3 is a schematic illustration of a plurality of boring elements disposed in a housing, in accordance with some applications of the present invention.
  • Fig. 1 is a schematic illustration of a boring element 20 boring through a subject's femur 22 (or a different bone, such as the pelvis), in order to allow extraction of marrow 24 from the femur, in accordance with some applications of the present invention.
  • the boring element includes a sensor 25 (for example, at a distal end thereof), the sensor being configured to detect a parameter in the vicinity of the distal end of the boring element.
  • the sensor may be configured to detect an electrical parameter, such as electrical impedance.
  • the sensor may be an ultrasound sensor.
  • the boring element itself acts as an electrical sensor, or the boring element acts as an electrode, which sends an electrical signal to a sensor that is part of a control unit 26 (e.g., a control unit that is disposed in the handle of the boring element).
  • a control unit 26 e.g., a control unit that is disposed in the handle of the boring element.
  • control unit 26 controls the boring of the boring element.
  • the control unit is configured to determine when the boring element has bored through the bone tissue of the femur and has reached the marrow or the vicinity of the marrow, in response to the parameter that is detected by the sensor. For example, in response to the boring element having bored through the bone tissue and having reached the bone marrow, the impedance measured between sensor 25 (which may be an electrode disposed on the distal tip of the boring element) and an electrode disposed on the subject's skin will decrease. In response to determining that the boring element has reached the marrow (e.g., by detecting a decrease in impedance between sensor 25 and an electrode disposed on the subject's skin), the control unit terminates the boring of the boring element.
  • Fig. 2 is a schematic illustration of a boring element 20 configured to bore through the inferior maxillary bone 30, the boring element being disposed in a housing 31 , in accordance with some applications of the present invention.
  • Boring element 20 as shown in Fig. 2 is generally similar to boring element 20, as described hereinabove with reference to Fig. 1.
  • control unit 26 (which may be disposed in housing 31 , for example) is configured to determine when the boring element has bored through inferior maxillaiy bone 30, and has reached the vicinity of mandibular nerve 32.
  • the control unit typically terminates the boring.
  • the senor is an electrode
  • the control unit determines that the boring element has reached the vicinity of the mandibular nerve by detecting, via the electrode, action potentials that are transmitted through the mandibular nerve.
  • tissue of the subject is stimulated in order to generate the action potentials at the mandibular nerve, which are then detected via sensor 25.
  • a hole is bored in inferior maxillary bone 30 in order to prepare the bone for the placement of a dental implant in the bone, at a location where there is a missing tooth.
  • housing 31 is mounted onto teeth 34 that are adjacent to the location at which the implant is to be implanted, as shown in Fig. 2.
  • a mechanism 40 couples the boring element to housing 31.
  • the mechanism controls the boring of the boring element, such that when the housing is pressed with a pressure that is below a threshold pressure, the boring element is not activated to bore through bone 30.
  • the mechanism controls the boring of the boring element, such that when the housing is pressed with a pressure that is greater than the threshold pressure, the boring element is activated to bore into the bone, and is applied to the bone with a constant pressure, irrespective of the extent to which the pressure with which the housing is pressed is greater than the threshold pressure.
  • FIG. 3 is a schematic illustration of a plurality of boring elements 20 disposed in housing 31 , in accordance with some applications of the present invention.
  • two or more boring elements are disposed in the housing, for example, such that a plurality of holes may be bored in bone 30, simultaneously.
  • each of the boring elements is spaced from an adjacent boring element by a distance D that is greater than 1 mm, and/or less than 10 mm, e.g., 3 mm to 5 mm.
  • the boring elements shown in Fig. 3 are disposed in a linear configuration with respect to one another, in accordance with some applications, a plurality of boring elements are disposed in alternative configurations, such as in a triangular configuration.
  • the boring of the boring element in response to a sensor associated with a given boring element detecting that the distal end of the boring element is in the vicinity of the mandibular nerve, the boring of the boring element is terminated (in accordance with the techniques described hereinabove).
  • the boring of all of the boring elements is terminated.
  • the scope of the present invention includes the application of the apparatus and methods described herein to any adjacent first and second portions of a subject's body, mutatis mutandis.
  • the apparatus and methods described herein may be applied to boring a hole in a subject's skull, the apparatus being configured to automatically stop the boring in response to detecting that the boring element is in the vicinity of brain tissue or surrounding layers.
  • the scope of the present invention includes applying the apparatus and methods described herein to boring holes in non-biological matter.
  • a boring element that is used in carpentry may be configured to bore through a first material (e.g., wood), but to stop boring in response to detecting that the boring element is in the vicinity of a second material (e.g., metal).

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgical Instruments (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

Apparatus and methods are provided for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body. A boring element (20) is configured to bore a hole through the first portion of the subject's body. A housing (31) houses the boring element, the housing being shaped to accommodate and at least partially surround the first and second portions of the subject's body. A sensor (25) is coupled to the boring element and is configured to sense a parameter in a vicinity of the distal end of the boring element. A control unit (26) is configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is in a vicinity of the second portion.

Description

BORING ELEMENT FOR SELECTIVE BORING
CROSS REFERENCES TO RELATED APPLICATIONS
The present application claims priority from US Provisional Patent Application 61/418,459 to Gross, filed December 01, 2010, which is incorporated herein by reference.
FIELD OF EMBODIMENTS OF THE INVENTION
Some applications of the present invention generally relate to external medical apparatus. Specifically, some applications of the present invention relate to apparatus for selectively boring holes in a subject's body.
BACKGROUND
In allogeneic bone marrow transplants, hematopoietic stem cells are removed from the bone marrow of a healthy patient in order to transplant the cells to a diseased patient. The hematopoietic stem cells are typically removed from the bone marrow of a large bone of the healthy subject, such as the pelvis or the femur.
A dental implant is an artificial root that is used to support dental prostheses, such as crowns, bridges, and/or dentures. Many implants are root-form endosseous implants, which are placed into a hole that has been bored in the patient's mandible.
SUMMARY OF EMBODIMENTS
For some applications, apparatus and methods are provided for use with a first portion of a subject's body that is adjacent to a second portion of the subject's body, it being desirable to bore a hole through the first portion, but not to bore through the second portion. For example, the first and second portions may be, respectively, bone and bone marrow, or the inferior maxillary bone and the mandibular nerve.
Typically, a boring element bores a hole through the first portion of the subject's body. A sensor coupled to the boring element senses a parameter (e.g., an electrical parameter) at the distal end of the boring element. A control unit terminates the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is at, or in the vicinity of, the second portion. For some applications, the boring element is housed in a housing that is shaped to accommodate the first and second portions of the subject's body.
There is therefore provided, in accordance with some applications of the present invention, apparatus for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus including:
a boring element configured to bore a hole through the first portion of the subject's body;
a housing configured to house the boring element, the housing being shaped to accommodate and at least partially surround the first and second portions of the subject's body;
a sensor coupled to the boring element and configured to sense a parameter in a vicinity of the distal end of the boring element; and
a control unit configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is in a vicinity of the second portion.
For some applications, the first portion includes an inferior maxillary bone of the subject, the second portion includes a mandibular nerve of the subject, and the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
For some applications, the first portion includes bone tissue of a femur of the subject, the second portion includes marrow of the subject's femur, and the control unit is configured to prevent boring of the marrow by terminating the boring.
For some applications, the sensor includes an ultrasound probe.
For some applications, the sensor includes a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
For some applications, the boring element is configured to act as an electrode, and the sensor is configured to sense the electrical parameter via the boring element. There is further provided, in accordance with some applications of the present invention, apparatus for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus including: a housing;
a plurality of boring elements configured to bore respective holes through the first portion of the subject's body, each of the boring elements being coupled to the housing at a distance from an adjacent one of the boring elements that is 1-10 mm; a sensor, coupled to each boring element and configured to sense a parameter at the distal end of the boring elements; and
a control unit configured to terminate the boring of a given one of the boring elements in response to the parameter that is sensed by the sensor indicating that the distal end of the given boring element is in a vicinity of the second portion.
For some applications, each of the boring elements is coupled to the housing at a distance from an adjacent one of the boring elements that is 3-5 mm.
For some applications, the plurality of boring elements are disposed in a triangular configuration.
For some applications, the control unit is configured to terminate the boring of all of the boring elements in response to the parameter that is sensed by the sensor indicating that the distal end of any one of the boring elements is in the vicinity of the second portion.
For some applications, the first portion includes an inferior maxillary bone of the subject, the second portion includes a mandibular nerve of the subject, and the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
For some applications, the first portion includes bone tissue of a femur of the subject, the second portion includes marrow of the subject's femur, and the control unit is configured to prevent boring of the marrow by terminating the boring.
For some applications, the sensor includes an ultrasound probe. For some applications, the sensor includes a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
For some applications, the boring element is configured to act as an electrode, and the sensor is configured to sense the electrical parameter via the boring element.
There is additionally provided, in accordance with some applications of the present invention, apparatus for use wit a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus including:
a housing;
a boring element configured to bore a hole through the first portion of the subject's body;
a sensor coupled to the boring element and configured to sense a parameter at the distal end of the boring element;
a control unit configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is at a vicinity of the second portion; and
a mechanism configured to couple the boring element to the housing such that: when the housing is pressed with a pressure that is below a threshold pressure, the boring element is not activated to bore the first portion of the subject's body, and
when the housing is pressed with a pressure that is greater than the threshold pressure, the boring element is applied to the first portion of the subject's body with a constant pressure, irrespective of the extent to which the pressure with which the housing is pressed is greater than the threshold pressure.
For some applications, the first portion includes an inferior maxillary bone of the subject, the second portion includes a mandibular nerve of the subject, and the control unit is configured to prevent boring of the mandibular nerve by terminating the boring. For some applications, the first portion includes bone tissue of a femur of the subject, the second portion includes marrow of the subject's femur, and the control unit is configured to prevent boring of the marrow by terminating the boring.
For some applications, the sensor includes an ultrasound probe.
For some applications, the sensor includes a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
For some applications, the boring element is configured to act as an electrode, and the sensor is configured to sense the electrical parameter via the boring element.
The present invention will be more fully understood from the following detailed description of embodiments thereof, taken together with the drawings, in which:
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 is a schematic illustration of a boring element boring through a subject's femur, in order to extract marrow from the femur, in accordance with some applications of the present invention;
Fig. 2 is a schematic illustration of a boring element configured to bore through the inferior maxillary bone, the boring element being disposed in a housing, in accordance with some applications of the present invention; and
Fig. 3 is a schematic illustration of a plurality of boring elements disposed in a housing, in accordance with some applications of the present invention.
DETAILED DESCRIPTION OF EMBODIMENTS
Reference is now made to Fig. 1, which is a schematic illustration of a boring element 20 boring through a subject's femur 22 (or a different bone, such as the pelvis), in order to allow extraction of marrow 24 from the femur, in accordance with some applications of the present invention. For some applications, the boring element includes a sensor 25 (for example, at a distal end thereof), the sensor being configured to detect a parameter in the vicinity of the distal end of the boring element. For example, the sensor may be configured to detect an electrical parameter, such as electrical impedance. Or, the sensor may be an ultrasound sensor. For some applications, the boring element itself acts as an electrical sensor, or the boring element acts as an electrode, which sends an electrical signal to a sensor that is part of a control unit 26 (e.g., a control unit that is disposed in the handle of the boring element).
In response to the parameter that is detected by the sensor, control unit 26 controls the boring of the boring element. Typically, the control unit is configured to determine when the boring element has bored through the bone tissue of the femur and has reached the marrow or the vicinity of the marrow, in response to the parameter that is detected by the sensor. For example, in response to the boring element having bored through the bone tissue and having reached the bone marrow, the impedance measured between sensor 25 (which may be an electrode disposed on the distal tip of the boring element) and an electrode disposed on the subject's skin will decrease. In response to determining that the boring element has reached the marrow (e.g., by detecting a decrease in impedance between sensor 25 and an electrode disposed on the subject's skin), the control unit terminates the boring of the boring element.
Fig. 2 is a schematic illustration of a boring element 20 configured to bore through the inferior maxillary bone 30, the boring element being disposed in a housing 31 , in accordance with some applications of the present invention. Boring element 20 as shown in Fig. 2 is generally similar to boring element 20, as described hereinabove with reference to Fig. 1. In response to a parameter that is sensed by sensor 25, control unit 26 (which may be disposed in housing 31 , for example) is configured to determine when the boring element has bored through inferior maxillaiy bone 30, and has reached the vicinity of mandibular nerve 32. In response to determining that the boring element has reached the vicinity of the mandibular nerve, the control unit typically terminates the boring. For some applications, the sensor is an electrode, and the control unit determines that the boring element has reached the vicinity of the mandibular nerve by detecting, via the electrode, action potentials that are transmitted through the mandibular nerve. For some applications, tissue of the subject is stimulated in order to generate the action potentials at the mandibular nerve, which are then detected via sensor 25.
For some applications, a hole is bored in inferior maxillary bone 30 in order to prepare the bone for the placement of a dental implant in the bone, at a location where there is a missing tooth. For some applications, housing 31 is mounted onto teeth 34 that are adjacent to the location at which the implant is to be implanted, as shown in Fig. 2.
For some applications, a mechanism 40 (e.g., a spring mechanism, as shown) couples the boring element to housing 31. The mechanism controls the boring of the boring element, such that when the housing is pressed with a pressure that is below a threshold pressure, the boring element is not activated to bore through bone 30. Furthermore, the mechanism controls the boring of the boring element, such that when the housing is pressed with a pressure that is greater than the threshold pressure, the boring element is activated to bore into the bone, and is applied to the bone with a constant pressure, irrespective of the extent to which the pressure with which the housing is pressed is greater than the threshold pressure.
Reference is now made to Fig. 3, which is a schematic illustration of a plurality of boring elements 20 disposed in housing 31 , in accordance with some applications of the present invention. For some applications, two or more boring elements are disposed in the housing, for example, such that a plurality of holes may be bored in bone 30, simultaneously. For some applications, each of the boring elements is spaced from an adjacent boring element by a distance D that is greater than 1 mm, and/or less than 10 mm, e.g., 3 mm to 5 mm. Although the boring elements shown in Fig. 3 are disposed in a linear configuration with respect to one another, in accordance with some applications, a plurality of boring elements are disposed in alternative configurations, such as in a triangular configuration. For some applications, in response to a sensor associated with a given boring element detecting that the distal end of the boring element is in the vicinity of the mandibular nerve, the boring of the boring element is terminated (in accordance with the techniques described hereinabove). Alternatively, in response to a sensor associated with any one of the boring elements detecting that the distal end of the boring element is in the vicinity of the mandibular nerve, the boring of all of the boring elements is terminated.
It is noted that although some applications of the present invention have been described as being applied to specific portions of the body, the scope of the present invention includes the application of the apparatus and methods described herein to any adjacent first and second portions of a subject's body, mutatis mutandis. For example, the apparatus and methods described herein may be applied to boring a hole in a subject's skull, the apparatus being configured to automatically stop the boring in response to detecting that the boring element is in the vicinity of brain tissue or surrounding layers. Furthermore, for some applications, the scope of the present invention includes applying the apparatus and methods described herein to boring holes in non-biological matter. For example, a boring element that is used in carpentry may be configured to bore through a first material (e.g., wood), but to stop boring in response to detecting that the boring element is in the vicinity of a second material (e.g., metal).
It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description.

Claims

1. Apparatus for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus comprising: a boring element configured to bore a hole through the first portion of the subject's body;
a housing configured to house the boring element, the housing being shaped to accommodate and at least partially surround the first and second portions of the subject's body;
a sensor coupled to the boring element and configured to sense a parameter in a vicinity of the distal end of the boring element; and
a control unit configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring element is in a vicinity of the second portion.
2. The apparatus according to claim 1 , wherein the first portion includes an inferior maxillary bone of the subject, wherein the second portion includes a mandibular nerve of the subject, and wherein the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
3. The apparatus according to claim 1 , wherein the first portion includes bone tissue of a femur of the subject, wherein the second portion includes marrow of the subject's femur, and wherein the control unit is configured to prevent boring of the marrow by terminating the boring.
4. The apparatus according to claim 1, wherein the sensor comprises an ultrasound probe.
5. The apparatus according to any one of claims 1-4, wherein the sensor comprises a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
6. The apparatus according to claim 5, wherein the boring element is configured to act as an electrode, and wherein the sensor is configured to sense the electrical parameter via the boring element.
7. Apparatus for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus comprising: a housing;
a plurality of boring elements configured to bore respective holes through the first portion of the subject's body, each of the boring elements being coupled to the housing at a distance from an adjacent one of the boring elements that is 1-10 mm; a sensor, coupled to each boring element and configured to sense a parameter at the distal end of the boring elements; and
a control unit configured to terminate the boring of a given one of the boring elements in response to the parameter that is sensed by the sensor indicating that the distal end of the gi ven boring element is in a vicinity of the second portion.
8. The apparatus according to claim 7, wherein each of the boring elements is coupled to the housing at a distance from an adjacent one of the boring elements that is 3-5 mm.
9. The apparatus according to claim 7, wherein the plurality of boring elements are disposed in a triangular configuration.
10. The apparatus according to claim 7, wherein the control unit is configured to terminate the boring of all of the boring elements in response to the parameter that is sensed by the sensor indicating that the distal end of any one of the boring elements is in the vicinity of the second portion.
1 1. The apparatus according to claim 7, wherein the first portion includes an inferior maxillary bone of the subject, wherein the second portion includes a mandibular nerve of the subject, and wherein the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
12. The apparatus according to claim 7, wherein the first portion includes bone tissue of a femur of the subject, wherein the second portion includes marrow of the subject's femur, and wherein the control unit is configured to prevent boring of the marrow by terminating the boring.
13. The apparatus according to claim 7, wherein the sensor comprises an ultrasound probe.
14. The apparatus according to any one of claims 7-13, wherein the sensor comprises a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
15. The apparatus according to claim 14, wherein the boring element is configured to act as an electrode, and wherein the sensor is configured to sense the electrical parameter via the boring element.
16. Apparatus for use with a first portion of a subject's body, the first portion being adjacent to a second portion of the subject's body, the apparatus comprising: a housing;
a boring element configured to bore a hole through the first portion of the subject's body;
a sensor coupled to the boring element and configured to sense a parameter at the distal end of the boring element;
a control unit configured to terminate the boring of the boring element in response to the sensed parameter indicating that the distal end of the boring el ement is at a vicinity of the second portion; and
a mechanism configured to couple the boring element to the housing such that: when the housing is pressed with a pressure that is below a threshold pressure, the boring element is not activated to bore the first portion of the subject's body, and
when the housing is pressed with a pressure that is greater than the threshold pressure, the boring element is applied to the first portion of the subject's body with a constant pressure, irrespective of the extent to which the pressure with which the housing is pressed is greater than the threshold pressure.
17. The apparatus according to claim 16, wherein the first portion includes an inferior maxillary bone of the subject, wherein the second portion includes a mandibular nerve of the subject, and wherein the control unit is configured to prevent boring of the mandibular nerve by terminating the boring.
18. The apparatus according to claim 16, wherein the first portion includes bone tissue of a femur of the subject, wherein the second portion includes marrow of the subject's femur, and wherein the control unit is configured to prevent boring of the marrow by terminating the boring.
19. The apparatus according to claim 16, wherein the sensor comprises an ultrasound probe.
20. The apparatus according to any one of claims 16-19, wherein the sensor comprises a sensor that is configured to sense an electrical parameter in the vicinity of the distal end of the boring element.
21. The apparatus according to claim 20, wherein the boring element is configured to act as an electrode, and wherein the sensor is configured to sense the electrical parameter via the boring element.
PCT/IL2011/000919 2010-12-01 2011-12-01 Boring element for selective boring Ceased WO2012073240A2 (en)

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CN104287836A (en) * 2014-10-24 2015-01-21 南开大学 Surgical robot semi-rigid intelligent instrument arm capable of achieving drilling and grinding state monitoring
DE102015014656A1 (en) * 2015-11-13 2017-05-18 Wieland Heuer Drills for dental implantology with internal, insulated by the cutting / grooves, electrical conduction path for triggering action potentials in intraosseous nerve tracts to avoid nerve damage

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US6678552B2 (en) * 1994-10-24 2004-01-13 Transscan Medical Ltd. Tissue characterization based on impedance images and on impedance measurements
DE10303964A1 (en) * 2003-01-31 2004-08-19 Wolfgang Prof. Dr. Oettinger Medical drilling device and medical drilling method

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104287836A (en) * 2014-10-24 2015-01-21 南开大学 Surgical robot semi-rigid intelligent instrument arm capable of achieving drilling and grinding state monitoring
CN104287836B (en) * 2014-10-24 2017-02-01 南开大学 Surgical robot semi-rigid intelligent instrument arm capable of achieving drilling and grinding state monitoring
DE102015014656A1 (en) * 2015-11-13 2017-05-18 Wieland Heuer Drills for dental implantology with internal, insulated by the cutting / grooves, electrical conduction path for triggering action potentials in intraosseous nerve tracts to avoid nerve damage

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