An orbitoclast is a surgical instrument used for performing transorbital lobotomies. It was invented by Dr. Walter Freeman in 1948 to replace the unique form of leucotome

Leucotome

A leucotome or McKenzie Leucotome is a surgical instrument used for performing leucotomies, lobotomies and other forms of psychosurgery.Invented by Canadian neurosurgeon Dr. Kenneth G...

 used up until that point for the transorbital lobotomy procedure. This instrument is an ice pick 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 pick would then be swung medially and laterally to separate the frontal lobes from the thalamus

Thalamus

The thalamus is a midline paired symmetrical structure within the brains of vertebrates, including humans. It is situated between the cerebral cortex and midbrain, both in terms of location and neurological connections...

. In 1948, he 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.

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".
The Nobel Prize for Physiology or Medicine of 1949 was awarded to Egas Moniz

Egas Moniz

António Caetano de Abreu Freire Egas Moniz , known as Egas Moniz , was a Portuguese neurologist and the developer of cerebral angiography...

 "for his discovery of the therapeutic value of leucotomy in certain psychoses".