Guide for assisting with arrangement of a stock instrument with respect to a patient tissue

Abstract

A stock instrument includes at least one guide interacting feature. A lower instrument surface of the stock instrument is placed into contact with the patient tissue. A guide has a lower guide surface contoured to substantially mate with at least a portion of an upper instrument surface of the stock instrument. A predetermined instrument orientation upon the patient tissue is defined, which is preselected responsive to preoperative imaging of the patient tissue. The guide and instrument are mated in a predetermined relative guide/instrument orientation wherein at least one guide interacting feature of the instrument is placed into engagement with at least one instrument guiding feature of the guide. The guide is moved into a predetermined guide orientation with respect to the patient tissue and concurrently the instrument is moved into a predetermined instrument orientation with respect to the patient tissue.

1 . A guide for assisting with arrangement of a stock instrument with respect to a patient tissue, the guide comprising:
 a lower guide surface configured to contact an upper instrument surface of the stock instrument when a lower instrument surface of the stock instrument is in contact with the patient tissue, the lower guide surface being contoured to substantially mate with at least a portion of the upper instrument surface;   an upper guide surface spaced longitudinally apart from the lower guide surface by a guide body, the upper guide surface being accessible to a user when the lower guide surface is in contact with the upper instrument surface; and   an orienting feature; wherein   the orienting feature is configured to enter a predetermined orienting relationship with a previously placed landmark while the lower guide surface is in mating contact with at least a portion of the upper instrument surface in a predetermined relative guide/instrument orientation, the predetermined orienting relationship indicating that the instrument has achieved a predetermined instrument relationship with the patient tissue.   
     
     
         2 . The guide of  claim 1 , wherein the stock instrument includes at least one guide interacting feature, and the guide includes at least one instrument guiding feature at a predetermined feature location with respect to the guide body, at least one guide interacting feature of the instrument being configured for engagement with at least one instrument guiding feature of the guide when the guide and the instrument are in the predetermined relative guide/instrument orientation. 
     
     
         3 . The guide of  claim 1 , wherein at least one previously placed landmark is affixed to the patient tissue at a location spaced from a location of the stock instrument. 
     
     
         4 . The guide of  claim 1 , wherein a chosen one of the guide interacting feature and the instrument guiding feature is a protrusion and the other one of the guide interacting feature and the instrument guiding feature is a cavity, and the protrusion enters the cavity to engage the guide and the instrument in the mating contact in the predetermined relative guide/instrument orientation. 
     
     
         5 . The guide of  claim 1 , being at least one of custom-manufactured and modified from a stock guide, responsive to at least one of preoperative imaging of the patient tissue and preoperative selection of the stock instrument. 
     
     
         6 . The guide of  claim 5 , wherein a custom-manufactured orienting feature is provided to a stock guide. 
     
     
         7 . The guide of  claim 1 , wherein the orienting feature includes an orienting indicator, and the orienting indicator achieves a predetermined signaling relationship with the landmark while the guide and stock instrument are in the predetermined relative guide/instrument orientation to indicate that the instrument has achieved a predetermined instrument relationship with the patient tissue. 
     
     
         8 . The guide of  claim 1 , wherein the stock instrument and the guide are moved concurrently to move both the guide and stock instrument into predetermined guide and instrument orientations with respect to the patient tissue. 
     
     
         9 . The guide of  claim 1 , wherein the stock instrument contains at least one patient tissue modification feature which indicates a predetermined location for a patient tissue modification procedure when the instrument is in the predetermined instrument orientation with respect to the patient tissue.