An orbitoclast was a

surgical instrument A surgical instrument is a tool or device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of ...

used for performing transorbital lobotomies. Because actual ice picks were used in initial experimentation and because of continued close resemblance to ice pick shafts, the procedure was dubbed "ice pick lobotomy".

History and description

It was invented by Dr. Walter Freeman in 1948 to replace the unique form of

leucotome A leucotome or McKenzie Leucotome is a surgical instrument used for performing leucotomies (also known as lobotomy) and other forms of psychosurgery. Invented by Canadian neurosurgeon Dr. Kenneth G. McKenzie in the 1940s, the leucotome has a n ...

used up until that point for the transorbital lobotomy procedure. This instrument is, essentially, an

ice pick The ice pick is a pointed metal tool used from the 1800s to the 1900s to break, pick or chip at ice. The design consists of a sharp metal spike attached to a wooden handle. The tool's design has been relatively unchanged since its creation. The ...

with some gradation marks etched onto the shaft. The operation involved placing the pick behind the eye socket of the patient and breaking through the thin layer of bone found there by applying a hammer to the end of the pick and driving the instrument into the

frontal lobes The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a groove betwe ...

. The pick would then be swung medially and laterally to separate the

from the

thalamus The thalamus (from Greek θάλαμος, "chamber") is a large mass of gray matter located in the dorsal part of the diencephalon (a division of the forebrain). Nerve fibers project out of the thalamus to the cerebral cortex in all directions, ...

. In 1948, Freeman embellished the procedure by adding the deep frontal cut, an additional swing of the pick deep into the lobe which placed such an increase of strain on the instrument that it occasionally snapped off while in the patient's head, necessitating surgical retrieval. Thus, Freeman had the orbitoclast specially commissioned as a more durable and reliable replacement. The

Nobel Prize for Physiology or Medicine The Nobel Prize in Physiology or Medicine is awarded yearly by the Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single prize, but five separate prizes that, according ...

of 1949 was awarded to Egas Moniz "for his discovery of the therapeutic value of

leucotomy A lobotomy, or leucotomy, is a form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy) that involves severing connections in the brain's prefrontal cortex. The surgery causes most of the connections to ...

in certain psychoses."

References

Surgical instruments Lobotomy {{Medical-equipment-stub

History and description

See also

References