Patent Publication Number: US-2023157779-A1

Title: Pivoting surgical implant placement tool

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
     NOT APPLICABLE 
     STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED RESEARCH AND DEVELOPMENT 
     NOT APPLICABLE 
     BACKGROUND 
     A fundamental technical barrier to understanding and repairing the brain (and brain function) is the limited availability to develop data related to neural activity. Often, information received from monitoring a single neuron in isolation is not helpful to understanding brain activity overall. Thus, neural implant operations may include monitoring a plurality of neurons throughout the brain. Accessing data from multiple electrodes, and thus, multiple neurons, typically requires support circuitry connecting with a central unit. Thus, communication with the brain may be provided by support circuitry, such as wires in ribbon cables, that allow for receiving electrode signals to a central unit (the brain implant device) within the cranium. These electrodes are typically fragile, due to their desirable small sizing, which allows for receiving and sending signals to an individual neuron. 
     Support circuitry is often desirable for increased sensor accuracy to specifically identify which individual electrodes are responding to a neuron in a group of electrodes. Support circuitry (like the electrodes themselves) is also often fragile, and once implantation is complete, is not easily reparable. Given the size, fragility and complexity of such electrodes and support circuitry, precision and delicate control are necessary to ensure electrodes are properly and individually attached to their respective neurons. To help ensure this, alignment and stability of the central unit during the implantation process are both important factors to ensure no pinching, crimping, or damage is caused to the support circuitry and electrodes, which may otherwise require subsequent procedures and intervention. 
     Current methods for electrode implantation rely heavily on the capabilities of the physician or technician performing the procedure. While such technicians may be assisted by robotic or animated tools, human intervention is generally required for many steps which are not performed by an animated or robotic device, such as positioning of the implant device. As such, current brain implant procedures rely heavily and often hinge on the qualifications and skills of the physician or technician performing the procedure. While a fully robotic or animated procedure may not be possible or suitable in many situations, devices and tools which limit or assist in limiting the complexity of human intervention by the physician or technician during the positioning and alignment of the brain implant device may prevent or reduce potentials for error or failure of the procedure. 
     Therefore, there is a need in the art for an improved mechanism of brain implantations which allows for greater control and stability without risking damage to electrodes and accompanying support circuitry. 
     BRIEF SUMMARY 
     Implementations of the present disclosure are related to a brain implantation tool having a base member that fits to the cranium of an implantation subject (patient), with an apparatus for stabilizing and controlling implantation, and methods of use for the same. 
     In various implementations, the present disclosure is related to a brain implant apparatus, designed to allow ease of maneuverability and positioning of an implant, with a compact design to allow access and visibility to the implant placement site. More specifically, the brain implant apparatus according to the implementations discussed herein allows the implant to be rotated or pivoted in use, such that the implant may be initially inverted or partially inverted to allow ease of access to the embeddable portion of the implant during installation of the electrodes into the implant placement site. 
     The brain implant (also “implant”) is described herein as being of cylindrical or mostly cylindrical shape configured to be inserted into a round opening in the cranium of a patient, the implant placement site. As described, the implant has an embeddable portion, configured to be inserted into the cranium of a patient, a top portion opposite the embeddable portion, and a cylindrical side portion. While described as being cylindrical herein, it should be understood that various implementations may be of cubic, rectangular, oval, or other suitable shape, as is understood by one skilled in the art. The implant may further include mounting eyelets protruding from the sides of the implant, which may be configured to receive screws for securing the implant to the exterior surface of the cranium of the patient. 
     In one aspect, the brain implant apparatus may include a base member dimensioned and configured to be positioned on the cranium of a patient. The base member may include one or more attachment holes which may be sized to receive fastening screws (“apparatus screws”). In various implementations, such fastening may include use of biocompatible materials and devices, including biocompatible screws. The base member may be of suitable shape to partially or completely surround the implant placement site. For example, the base member may be U-shaped, rectangular, semi-circular, or circular. 
     In another aspect, the brain implant apparatus may include a pivot arm which hingedly couples to the base member. The pivot arm may attach to the base member via one, two, or more hinge locations. In some implementations, the hinge may operate by use of screws or bolts which connect the base member to the pivot arm. The pivot arm may be configured to allow the implant to pivot by 180 degrees or more, or, in various implementations, to pivot between 90 and 180 degrees. For example, in use, the pivot arm may be positioned in a first configuration such that the embeddable portion of the implant is facing upward or mostly upward (away from the cranium of the patient). The pivot arm may then be pivoted to a second configuration, where the embeddable portion of the implant is facing substantially downward (towards the cranium of the patient). In some implementations, the second configuration allows the implant to be positioned concentrically with the implant placement site, such as directly aligned with and above the implant placement site. 
     The pivot arm may further include a locking screw, wherein the locking screw fastens the pivot arm to the base member, preventing rotation of the pivot arm. For example, in use, the locking screw, when fastened, prevents the pivot arm from rotating from the first position to the second position. While described as a locking screw herein, other means of preventing movement of the pivot arm are contemplated, including other fasteners, clips, latches, or locks. Further, in various implementations the locking screw may be positioned on the base member and function similarly to the locking screw previously described. 
     In another aspect, the brain implant apparatus may include an implant attachment member which may couple with the pivot arm. The implant attachment member may include a receiving portion which may be configured to removably couple with the brain implant. In various implementations, the implant attachment member may be rotatable or allowed to swivel, such as by a screw or other suitable means, to allow the implant to be rotated. 
     The receiving member may include one or more protruding pegs, extending outwardly from the implant attachment member and may be dimensioned such that the implant is releasably secured by the pegs. For example, the receiving member may have four pegs which are circumferentially positioned around the edge of the receiving member, creating an opening of the same or similar size as the implant. In operation, the implant may be frictionally secured between the pegs, and may be released from the receiving member by overcoming the friction applied by the pegs. In other implementations, suitable alternatives for the pegs may be provided, such as a circular or semi-circular ridge which similarly applies friction to the edge of the implant. 
     In another aspect, the implant attachment member may be movably attached to the pivot arm via a lowering assembly. The lowering assembly may include a lowering plate which couples to the implant attachment member. The plate may be vertically movable by one or more screws. For example, a lowering screw may attach the plate to the pivoting arm such that by actuating the screw, the lowering plate is moved, creating a space between the pivot arm and the lowering plate. In operation, while in the second configuration, the actuating (e.g. tightening) of the screw may extend the implant towards (or into) the implant placement site, to be placed in position to be secured to the cranium. The lowering screw may then be retracted such that the plate is pulled away from the implant and towards the pivot arm. 
     In another aspect, the brain implant assembly may include a mount attachment, which may be removably attached to the base member. The mount attachment may provide a linear or semi linear arm which is configured to span parallel with the cranium near the implant placement site. In various implementations, the mount attachment may include one or more nozzle holders. The nozzle holders may act to receive one or more nozzles which are configured to provide suction and/or saline for the implant placement site. Such nozzles may include a proximal end, such as a threadable opening, to attach to supply tubing, and a distal end, such as a spout which may extend proximally to the implant placement site. In some implementations, a nozzle intended for suction may have a distal end which may extend within the implant placement site, such that the suction nozzle is proximal to the brain. In some aspects, the nozzle holders may be moveable or adjustable, including being moveable vertically, relative to the mount attachment. For example, the nozzle holders may be adjustable vertically such that they can be positioned closer to or farther from the implant placement site. 
     In another aspect, the brain implant may include a plurality of flexible electrodes which electrically connect with the brain implant by a plurality of wires. For example, the plurality of wires may extend from the embeddable portion of the brain implant, and the plurality of flexible electrodes may be configured to be inserted into the brain of the patient. In some aspects, the pivot axis of the pivot arm may extend through the flexible electrodes. 
     In another aspect, the apparatus may include a cartridge, which may be removably coupled with the receiving portion of the implant attachment member. The cartridge may be configured to position each of the plurality of flexible electrodes into a linear or semi-linear array, such as to assist in the insertion of each of the plurality of flexible electrodes into the brain of the patient. The cartridge may further include an identification pattern located on an external face of the cartridge. For example, the identification pattern may provide a visual indicia to assist in locating the position of the cartridge to assist in the process of inserting the electrodes into the cranium. In some implementations, the identification pattern may be visible to a computer. 
     In another aspect, the apparatus may include a cover which may be removably attached to the pivot arm when the pivot arm is in the first configuration. The cover may protect the implant and/or other electronic or fragile elements of the apparatus from inadvertent damage, including during packaging, shipping, and during implanting into the cranium, for example. The cover may be made of a variety of materials, and may for example be transparent or translucent to allow for a user to see through the cover for better positioning of the apparatus on the cranium, or for positioning relative to the implant placement site. In various implementations, the cover may allow access to certain parts of the apparatus while attached to the pivot arm. For example, a user may be able to fasten screws through the attachment holes of the base member while the cover is still removably attached to the pivot arm. The cover may be attached to the pivot arm by various means, including frictionally attaching to the pivot arm based on the dimensions of the cover and pivot arm. 
     The cover may further include various features which are configured to assist in the positioning and tilting of the implant to better align with the implant placement cite. For example, the cover may include a level positioned on the exterior surface of the cover, such as a bullseye level, which shows the relative tilt of the implant. The cover may be shaped such as to assist in the placement of the apparatus relative to the implant placement site. For example, the cover may have a distal edge which is shaped to align with the edge of the implant placement site, such that the distal edge of the cover aligns with the brain implant when the pivot arm is rotated to the second position. 
     Implementations of the invention covered by this patent are defined by the claims below, not this summary. This summary is a high-level overview of various aspects of the invention and introduces some of the concepts that are further described in the Detailed Description section below. This summary is not intended to identify key or essential features of the claimed subject matter, nor is it intended to be used in isolation to determine the scope of the claimed subject matter. The subject matter should be understood by reference to the entire specification of this patent, all drawings and each claim. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The features and components of the following figures are illustrated to emphasize the general principles of the present disclosure. Corresponding features and components throughout the figures can be designated by matching reference characters for the sake of consistency and clarity. 
         FIG.  1    is a top perspective view of a brain implant apparatus with a cover according to implementations of the present technology; 
         FIG.  2    is a top perspective view of the brain implant apparatus of  FIG.  1    without the cover in a first configuration; 
         FIG.  3    is a perspective view of the brain implant apparatus of  FIG.  1    without the cartridge and mount attachment and in the first configuration; 
         FIG.  4    is a perspective view of the brain implant apparatus of  FIG.  1    in the second configuration; 
         FIG.  5    is a top perspective view of the brain implant apparatus of  FIG.  1    in the second configuration with the lowering assembly extended; 
         FIG.  6    is a top perspective view of the brain implant apparatus of  FIG.  1    back in the first configuration with the implant positioned within the implant placement site; 
         FIG.  7    is a top perspective view of the implant attached to the cranium; 
         FIG.  8    is an exemplary flowchart of a method of use of the brain implant apparatus; 
     
    
    
     DETAILED DESCRIPTION OF THE DRAWINGS 
     Implementations of the present disclosure are related to a brain implantation tool having a base member that fits to the head of an implantation subject, with an apparatus for stabilizing implantation, and methods of use for the same. 
     Conventional approaches to implanting a brain implant into the cranium suffer from several limitations. For example, a need has existed for an brain implant apparatus which allows for improved maneuverability and control, to assist with ease of installation of the flexible electrodes into the implant placement site. There is further need for a brain implant apparatus which provides a semi-automated structure which promotes movement which is assistive to the implantation process while preventing undesirable excess movement. More specifically, robotic and computer controlled systems are frequently used for assisting in implanting electrodes within the brain. To aid in providing access to the electrodes as well as the embeddable portion of the implant, a pivotable mechanism which allows the implant to be positioned in an inverted or semi-inverted fashion for the electrode installation process and then pivoted to be positioned proximal to the implant placement site is desirable. Such a pivot or rotation provides desirable access and exposure to the embeddable portion of the implant, as well as a desirable working surface in which a cartridge can be placed to assist the electrode implantation process. 
       FIG.  1    illustrates a brain implant apparatus  100  intended primarily for placement onto the cranium  102  of a patient or subject proximally to an implant placement site  104 . As shown in  FIG.  1   , the brain implant apparatus  100  includes a cover  106  to protect various aspects of the brain implant apparatus  100  prior to and during initial stages of the installation process. The cover  106  may be transparent such as to assist in the positioning of the brain implant apparatus  100  relative to the implant placement site  104 . The cover  106  may further include a level  108 , such as a circular or bullseye level, such as to measure and adjust the tilt of the brain implant apparatus  100  relative to the implant placement site  104 . 
     In various implementations, the cover  106  may be dimensioned such that various elements of the brain implant apparatus  100  are exposed when the cover is detached to the remainder of the brain implant apparatus  100 . For example, the attachment holes  109  of the base member  110  may be exposed such that apparatus screws  112  can be inserted into the cranium  102  to secure the brain implant apparatus  100 , such as with a screwdriver or similar device. Other means of attaching the base member  110  to the cranium  102  are further contemplated other than (or in combination with) apparatus screws  112 , such as nails, pins, or other fasters, as may be appreciated by one skilled in the art. Further, the apparatus screws  112  may be biocompatible such that the material and physical properties (e.g. texture) of the apparatus screws  112  prevent or limit negative reactions with the patient when introduced into the cranium  102 . Such negative reactions may include, for example, immunological responses within the patient. 
     The cover  106  may also be dimensioned such that a portion of the cover  106  covers the implant placement site  104  when the brain implant apparatus  100  is installed into the cranium  102 . One advantage which may be provided from such dimensioning is to protect the implant placement site  104  from unintended objects for entering the implant placement site  104 . The cover  106  being dimensioned to overlap the implant placement site  104  may also provide an alignment advantage. For example, the distal edge  114  of the cover  106  may assist in the placement of the brain implant apparatus  100 , such as by the distal edge  114  being dimensioned a specific distance from the base member  110  such that a user knows the base member  110  is correctly positioned for the remainder of the brain implantation process. 
       FIG.  2    shows the brain implant apparatus  100  positioned on the cranium  102  of the patient with the cover removed. The brain implant apparatus  100  may further comprise a pivot arm  202  rotatably attached to the base member  110 , such as by means of hinge screws  204 . As such, the pivot arm  202  is rotatable about a pivot axis which is concentric with the hinge screws  204 . As shown in the figure, there are two hinge screws  204  positioned on each side of the base member  110 . However, it should be understood that a similar rotation of the pivot arm  202  may be achieved with one screw or with a plurality of screws (e.g.  3  or  4  hinge screws  204 . Further, other means can be utilized to provide rotation of the pivot arm  202 , such as a swivel joint, swing hinge, or similar mechanism as would be appreciated by one skilled in the art. 
     As shown in the figure, the pivot arm  202  is positioned in a first configuration  206 , such that the pivot arm  202  is positioned substantially above the base member  110 . The pivot arm  202  may further include an implant attachment member  208  which may have a receiving portion  209  which releasably attaches to the brain implant  210 . In various implementations, the receiving portion  209  of the implant attachment member  208  may include one or more pegs  212  which may frictionally hold the brain implant  210 . In various implementations, the implant attachment member  208  may attach to the pivot arm  202  via a lowering assembly  214 , which may include a lowering movement screw  216 , which is discussed further below. 
     The brain implant apparatus  100  may further include a cartridge  218 , which may be removably attachable to the brain implant  210 , such that in the first configuration  206  the implant may be vertically positioned above the brain implant  210  or above other aspects of brain implant apparatus  100 . In various implementations, the cartridge  218  may be additionally or alternatively removably attached to the pivot arm  202 . 
     The brain implant  210  may include a plurality of flexible electrodes  220  which may be designed for implantation within the implant placement site  104  of the cranium  102 . The flexible electrodes  220  may be in the form of wires from a flexible ribbon cable and attach to an implantable portion of the brain implant  210 . The cartridge  218  may assist with the process of inserting the flexible electrodes  220  into the implant placement site  104 . For example, prior to insertion within the implant placement site  104 , the flexible electrodes  220  may be attached to the cartridge  218  in a position ready to be engaged by a needle and implanted into the implant placement site  104 . In various implementations, each of the plurality of flexible electrodes  220  may be positioned on the cartridge  218  in an array such that the needle can more easily retract each of the plurality of flexible electrodes  220  individually. Additional details generally regarding flexible electrodes, and the brain implant  210 , for example, may be found in U.S. Patent Publication No. 20180296243, published Oct. 18, 2018, which is hereby incorporated by reference in its entirety. 
     The cartridge  218  may further include an identification pattern  222  located on the cartridge  218 . For example, the identification pattern  222  may provide a visual indicia to assist in locating the position of the cartridge  218  to assist in the process of inserting the plurality of flexible electrodes  220  into the cranium  102 . In various implementations, the identification pattern may be visible to a computer, and/or may include a computer-readable pattern, such as a quick response “QR” code, or other barcode. Additional details regarding the cartridge  218  and other features of the present disclosure, for example, may be found in U.S. Pat. No. 11,103,695, issued Aug. 31, 2021, which is hereby incorporated by reference in its entirety. 
     In various implementations the brain implant apparatus  100  may include a mount attachment  224 . The mount attachment  224  may span linearly or semi-linearly near the implant placement site  104 , and provide a location to position one or more nozzle holders  226  designed to hold one or more nozzles  228 . For example, a suction nozzle  228 A may be provided which has a tip  230 A which may be positioned inside the implant placement site  104  proximal to the brain  232 , such that the nozzle may vacuum any excess fluids from the implantation process. One of the nozzle holders  226  may be designed to hold a saline nozzle  228 B to provide saline or other sanitary fluids to assist in cleanliness during the implantation process. 
     In various implementations, the nozzle holders  226  may be vertically adjustable for better placement of the one or more nozzles  228  relative to the implant placement site  104 . For example, the nozzle holders  226  may be moveable or adjustable vertically such that the suction nozzle  228 A can be placed in close proximity to the brain  232  of the patient within the implant placement site  104 . The saline nozzle  228 B may have a shorter tip  230 B than the tip  230 A of the suction nozzle  228 A, as the saline nozzle  228 B may not need to be placed in as close of proximity to the brain  232  than the suction nozzle  228 A. The one or more nozzles  228  may be configured to receive tubing, which provides the respective saline and suction. To attach the tubing to the one or more nozzles  228 , the ends of the nozzles  228  may have threading, barbs, or other suitable means to removably attach the tubing to the nozzles  228 . 
     In various implementations the mount attachment  224  may removably attach to the base member  110 . Allowing the mount attachment  224  to be removable from the base member  110  to provide additional space proximal to the implant placement site  104  when the one or more nozzles  228  are no longer needed in the procedure. In various implementations, the mount attachment  224  may additionally or alternatively attach to the cranium  102 , such as with biocompatible screws. 
       FIG.  3    shows the brain implant apparatus  100  with the mount attachment removed. In addition, the figure shows the brain implant apparatus  100  with the cartridge removed, such that the embeddable portion  302  (the portion ultimately to be received within the implant placement site  104 ) of the brain implant  210  is clearly visible. 
     In various implementations, the pivot arm  202  may include a locking screw  304 , which acts to secure the pivot arm  202  to the base member  110  in the first configuration  206 . As shown in the figure, the locking screw  304  may be inserted through an opening in the pivot arm  202  and thread into the base member  110  to releasably secure the pivot arm  202  to the base member  110 . In other implementations, other locations may be suitable to achieve the same function, including a locking screw  304  positioned on the base member  110  itself. Other implementations may also use other means to secure the pivot arm  202  to the base member  110  in the first configuration  206 , including a clip, latch, lock, or other suitable means as would be appreciated by one skilled in the art. 
       FIG.  4    shows the brain implant apparatus  100 . The pivot arm  202  has been rotated about the pivot axis by means of the hinge screws  204  to a second configuration  402 . In the second configuration  402 , the pivot arm  202  may be positioned such that the brain implant  210  is concentric with the implant placement site  104 . In various implementations, the brain implant  210  may be positioned directly above the implant placement site  104 . 
     The implant attachment member  208  may be attached to the pivot arm  202  by a rotating attachment mechanism  404 . The rotating attachment mechanism  404  may allow the implant attachment member  208  (and thus the brain implant  210 ) to rotate. In use, the rotating attachment mechanism  404  may allow the brain implant  210  be rotated while concentric with the implant placement site  104 , to assist in positioning the brain implant  210 . For example, the brain implant  210  may include one or more mounting eyelets  406  to provide a means to securely attach the brain implant  210  to the exterior surface of the cranium  102 . The mounting eyelets  406  may be dimensioned to receive screws, nails, or other suitable means to attach the brain implant  210  to the cranium  102 . The rotating attachment mechanism may allow the mounting eyelets  406  to be rotated about the circumference of the implant placement site  104 . Such rotation, for example, may allow the mounting eyelets  406  to be placed in a preferred position for ease of attachment to the cranium  102 . Specifically, the rotating attachment mechanism  404  may allow for the mounting eyelets  406  to be located such that they can be easily accessed by a screwdriver or other suitable tool. 
       FIG.  5    shows that the lowering assembly  214  allows for the brain implant  210  to be vertically lowered into the implant placement site  104 . The lowering assembly  214 , may include a lowering plate  408  which is operably attached to the pivot arm  202  by a lowering movement screw  216  (as discussed previously). The lowering movement screw  216  may be actuated to lower the lowering plate  408  away from the remainder of the pivot arm  202  and towards the implant placement site  104 . 
     Referring back to  FIG.  4   , the brain implant  210  is attached to the implant attachment member  208  and the brain implant  210  is shown positioned vertically above (and concentric with) the implant placement site  104 . The embeddable portion  302  of the brain implant  210  may be lowered into the implant placement site  104  by actuating the lowering movement screw  216  to lower the lowering plate  408 . The lowering movement screw  216  may be actuated such that the mounting eyelets  406  of the brain implant  210  contact with the outer surface of the cranium  102 . 
     The brain implant  210  may then be detached from the implant attachment member  208 . For example, a screwdriver or other tool may be used to overcome the friction between the pegs  212  (see  FIG.  5   ) and the brain implant  210  such that the brain implant  210  is released. Once the brain implant  210  is released, the implant attachment member  208  and lowering plate  408  may be retracted by actuating the lowering movement screw  216  in the reversed direction. 
       FIG.  6    shows that the brain implant apparatus  100  may be rotated back to the first configuration  206 , while the brain implant  210  is maintained within the implant placement site  104 . The apparatus screws  112 , which removably secured the base member  110  to the cranium  102  may be removed from the attachment holes  109 , allowing for the brain implant apparatus  100  to be removed from the cranium  102  (as shown in  FIG.  7   ). 
       FIG.  7    shows that the brain implant  210  may be secured within the implant placement site  104  by inserting one or more implant attachment screws  702  through the mounting eyelets  406 . As discussed with regards to the apparatus screws  112 , the implant attachment screws  702  may be biocompatible. 
       FIG.  8    illustrates a flowchart for an example process  800  for implanting a brain implant  210  within an implant placement site  104  of a cranium  102 . In some implementations, one or more process blocks of the figure may be performed by a medical professional (e.g. a doctor, physician, or medical assistant), or other human. In some implementations, one or more process blocks of the figure may be performed by a computer controlled device, including for example an automated or semi-automated, computer controlled device (e.g. a robot). 
     At block  810 , the process  800  may include fastening the brain implant apparatus  100  (see previous FIGS.) to the cranium  102  in the first configuration  206 . For example, the base member  110  may be attached to the cranium  102  with screws (e.g. apparatus screws  112 ), such as biocompatible screws. In the first configuration  206 , the brain implant  210  may be facing upwards or substantially upwards, such that the embeddable portion of the brain implant  210  is facing away from the cranium  102 . In some implementations, positioning the brain implant apparatus  100  for attachment may include determining both the position on the cranium  102  as well as a tilt angle. The brain implant apparatus  100  may be positioned by using aspects of the brain implant apparatus  100  to determine relative position to the implant placement site  104 . For example, the shape of various aspects of the brain implant apparatus  100  may include alignment features to aid in alignment with the implant placement site  104 . Further, for example, the brain implant apparatus  100  may include a level, such as a circular or bullseye level (e.g. level  108 ), to assist in measuring the tilt of the brain implant apparatus  100  in comparison to the implant placement site  104 . 
     In some implementations, the process  800  may include implanting electrodes (e.g. flexible electrodes  220 ) into the brain  232  within the implant placement site  104  while the pivot arm  202  is in the first configuration. The plurality of electrodes may be operably coupled with the brain implant  210 . The implantation process may include positioning a robotic surgical tool above the brain implant apparatus  100 . The implant process may further include receiving an electrode of the plurality of electrodes from a cartridge  218  with the robot. The cartridge  218  may be coupled to the embeddable portion  302  of the implant, and/or the cartridge  218  may be positioned relatively above the brain implant  210  while the pivot arm  202  is in the first configuration  206 . The process  800  may further include inserting the electrode from the cartridge  218  into the brain  232  within the cranium  102  with the robot. The implantation process may include repeating the steps of receiving the electrode and inserting the electrode from the plurality of electrodes. In some implementations, the implantation process described may be performed after the brain implant apparatus  100  is fastened to the cranium  102 . The implantation process may further occur after a cover (e.g. cover  106 ) is removed from the brain implant apparatus  100 . 
     In some implementations, the process  800  may include positioning a distal end of a suction nozzle  228 A proximal to the brain  232  in the implant placement site  104 . The suction nozzle  228 A may be operably coupled to the base member  110  with a suction nozzle holder (e.g. nozzle holders  226 ). In some implementations, the position of the suction nozzle holder may be adjustable, such as adjustable vertically, relative to the implant placement site  104 . 
     The process  800  may include activating a vacuum coupled to the suction nozzle  228 A by tubing to provide suction through the distal end of the suction nozzle  228 A. The vacuum may be configured to remove fluid from within the cranium  102  at the implant placement site  104 . The process  800  may include adjusting the height of the distal end of the suction nozzle  228 A in the implant placement site  104 , such as, for example, such that the distal end is making contact with the brain  232  of the patient, but not providing pressure against the brain  232  (or piercing the brain  232 ). In addition, the suction nozzle  228 A may not work to vacuum material (such as fluids) from the implant placement site  104  if the distal end of the suction nozzle  228 A is too distant from the materials and brain  232 . The suction nozzle holder may be adjustable such that the optimal or preferred height of the distal end of the suction nozzle  228 A is achieved. 
     In some implementations, the process  800  may include positioning a distal end of a saline nozzle  228 B proximal to the cranium  102  in the implant placement site  104 . The saline nozzle  228 B may be operably coupled to the base member  110  with a saline nozzle holder (e.g. nozzle holders  226 ). The process  800  may include activating a saline source coupled to the saline nozzle  228 B by tubing to provide an outflow of saline through the distal end of the saline nozzle  228 B. The saline source may be configured to provide saline within the cranium  102  at the implant placement site  104 . 
     The process  800  may include adjusting the height of the distal end of the saline nozzle  228 B in the implant placement site  104 , such as, for example, such that the distal end is near enough to the brain  232  of the patient such that the outflow of saline does not excessively splash or splatter when the saline contacts the brain  232 , but also not too close to the brain  232  such that the outflow of saline is hindered by contact with the brain  232 , or that the pressure of the outflowing saline damages the brain  232  or other tissue. 
     At block  820 , the process  800  can include rotating the pivot arm  202  from the first configuration  206  to a second configuration  402 . In the second configuration  402 , the embeddable portion  302  of the brain implant  210  is facing downward (or substantially downward) towards the cranium  102  such that the embeddable portion  302  is above an implant placement site  104  in the cranium  102 . In some implementations, the embeddable portion  302  is located directly above the implant placement site  104  in the cranium  102 . Further, the embeddable portion  302  may be located slightly above the exterior surface of the cranium  102 , such that no contact is made between the brain implant  210  and the cranium  102 . 
     In some implementations, the process  800  may include disengaging a lock (e.g. locking screw  304 ) prior to rotating the pivot arm  202  from the first configuration  206  to the second configuration  402 . The lock may be configured to releasably secure the pivot arm  202  to the base member  110  in the first configuration  206 . As such, the lock secures the pivot arm  202  to the base member  110  to prevent rotation while the brain implant apparatus  100  is in the first configuration  206 . The process of disengaging may include unscrewing a screw, bolt, or similar mechanism. The process of disengaging may, alternatively or in addition, include releasing a latch, hook, clip, or other similar locking structure. 
     At block  830 , the process  800  can include actuating the height adjustment mechanism (e.g. lowering assembly  214 ), which may be coupled with the pivot arm  202 , while the pivot arm  202  is in the second configuration  402 , such that the embeddable portion  302  of the brain implant  210  is lowered into the cranium  102  at the implant placement site  104 . The actuating may be achieved, for example, by rotating a screw or bolt such that a distance is created between the receiving portion and the pivot arm. Other similar means are contemplated to achieve actuating the function of height adjustment mechanism, including for example, a sliding mechanism which includes a lock to prevent height adjustment when not actuated. 
     At block  840 , the process  800  can include releasing the brain implant  210  from the receiving portion of the brain implant apparatus  100 . As described previously, the brain implant  210  may be removably attached to the receiving portion using various means, including for example, friction, magnetics, adhesives, screws, or similar mechanisms as would be appreciated by one skilled in the art. In some implementations, the releasing the brain implant  210  can be achieved by providing pressure between the receiving portion  209  and the brain implant, such that the force securing the implant (friction, magnetic force, etc.) is overcome. For example, a standard screwdriver, or other thin tool may be inserted between the implant and the receiving portion, and force can be applied to pry or dislodge the brain implant  210 . 
     At block  850 , the process  800  can include actuating the height adjustment mechanism (e.g. the lowering assembly  214 ), while the pivot arm is in the second configuration, such that the implant attachment member  208  is raised upward relative to the brain implant  210 . The actuating may be achieved, for example, by rotating a screw or bolt (as described above) in the opposite direction from block  830 , such that the between the receiving portion  209  and the pivot arm  202  is reduced. Other mechanisms, such as a slide can be actuated, for example, by applying a force in the opposite direction from the block  830 . 
     In some implementations, the process  800  may include securing the brain implant  210  within the implant placement site  104  by fastening a screw (e.g. implant attachment screws  702 ) through an eyelet (e.g. mounting eyelets  406 ) of the brain implant  210 . The eyelets  406  may provide a means to secure the brain implant  210  to the exterior surface of the cranium  102 . The screw or screws may be biocompatible, as described herein. The eyelets  406  may extend radially from the brain implant  210 , similar to a tab, and have a hole of suitable size to receive an implant attachment screw  702 . 
     The detailed description of example implementations refers to the accompanying drawings. The same reference numbers in different drawings may identify the same or similar elements. In the following description, for the purpose of explanation, numerous specific details are set forth in order to provide an understanding of various implementations of the subject matter. It will be evident, however, to those skilled in the art, that implementations of the inventive subject matter may be practiced without these specific details. In general, well-known structures and techniques are not necessarily shown in detail. 
     As will be apparent to those of skill in the art upon reading this disclosure, each of the individual implementations described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several implementations without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order that is logically possible. 
     It is understood that the examples and implementations described herein are for illustrative purposes and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application and the scope of the appended claims. 
     Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, some potential and preferred methods and materials are now described. All publications mentioned herein are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited. It is understood that the present disclosure supersedes any disclosure of an incorporated publication to the extent there is a contradiction. 
     It must be noted that as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. Although the terms “first”, “second”, etc. may be used herein to describe various elements, components, regions, layers and/or sections, it should be understood that they should not be limited by these terms. These terms are used only to distinguish one element, component, region, layer, or section from another region, layer, or section. Thus, a first element, component, region, layer, or section discussed below could be termed a second element, component, region, layer, or section without departing from the teachings of the present invention. 
     As used herein, “removably attached,” “removably coupled,” “releasably attached,” or “releasably coupled” may refer to components that are attached and can be detached relatively easily. For example, magnetically attached components, and components snapped together via mechanical attachments that are loosened with a simple motion.