The trephine is a neurosurgical instrument used to create burr holes in the calvarium. A modern trephine normally has an automatic stop mechanism that activates once the end of the bony calvarium is reached, in order to avoid injury to the brain and the Dura mater. Depending on the attachment, a trephine can be used to create burr holes of various sizes.
Hand trephine
A hand trephine can be used to manually create a burr hole at the bedside without electricity. For example, for placement of an external ventricular drain or ICP probe.
Photograph of a hand trephine used in neurosurgery.