CA2253646C - Optical biopsy forceps and methods of diagnosing tissue - Google Patents
Optical biopsy forceps and methods of diagnosing tissue Download PDFInfo
- Publication number
- CA2253646C CA2253646C CA002253646A CA2253646A CA2253646C CA 2253646 C CA2253646 C CA 2253646C CA 002253646 A CA002253646 A CA 002253646A CA 2253646 A CA2253646 A CA 2253646A CA 2253646 C CA2253646 C CA 2253646C
- Authority
- CA
- Canada
- Prior art keywords
- jaws
- optical fiber
- catheter body
- optical
- forceps
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00057—Light
- A61B2017/00061—Light spectrum
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
- A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre
Abstract
An integrated optical biopsy forceps device (10) and a method for tissue identification by optical analysis and biopsy sampling at a site within the body. The device includes an elongated catheter body for introduction into the body and navigation to an area of interest. An optical fiber (50) extends through the device, from the proximal end, whe re it may be connected to electro-optical spectral analysis equipment, to a distal tip for illuminating and receiving light energy from tissue at the location of the tip. The distal end of the device has a pair of cutting jaws (80, 81) pivotally mounted at the distal end of the catheter body and controlled by control wires (40, 41) extending through the catheter body to a control handle at the proximal end, or by the optical fiber. The device may be spectroscopically guided to a site of interest within the body. The fiber tip (50) is positioned coaxially with the jaws at the zone of contact and cutting of the jaws, and is retracted as the jaws close, so that the biopsy sample is taken exactly a t the spot being viewed by the optical fiber.
Description
OPTICAL BIOPSY FORCEPS AND
METHOD OF DIAGNOSING TISSUE
Field of the Invention This invention pertains to the field of medical diagnosis and treatment. More specifically, the invention pertains to a forceps device having integrated optical fiber and remotely controllable biopsy forceps functions, and to the use i:hereof in medical diagnosis. The catheter is adapted for in vivo tissue identification of tissue types through optical techniques using the optical fiber, and biopsy sampling of identified tissue areas for withdrawal from the body for conventional examination and analysis.
>f3ac ground of the Prior Art Numerous type of biopsy forceps devices have been developed for in vivo medical diagnosis and treatment of various conditions. Such devices are designed for sampling tissue within the body, for example in endoscopic, laparoscopic and vascular procedures to retrieve biopsy samples for analysis and identification of tissue types. These biopsy forceps devices generally include small cutting jaws at the distal end, operated remotely from the proximal end after the distal end of the device has been positioned or navigated to the site of interest.
One difficulty in using prior art biopsy forceps devices is in knowing for certain the cx:act positioning of the distal tip, in relation to the suspected disease area, especially when the area of interest is very small.
Various types of optical catheters or probes have been developed for use in locating or identifying sitca within the body. A method of diagnosing and treating tissue in vivo using an optical guidewire is disclosed in U. S.
Patent 5,439,000, assigned to SpectraScience, Inc. One type of prior art system for internal biopsy uses an optical catheter to locate the site, followed by replacement of the optical catheter with a biopsy forceps for taking a sample.
However, this can result in errors and uncertainties in the final placement of the biopsy jaws with respect 1:o a previously identified small structure or area.
METHOD OF DIAGNOSING TISSUE
Field of the Invention This invention pertains to the field of medical diagnosis and treatment. More specifically, the invention pertains to a forceps device having integrated optical fiber and remotely controllable biopsy forceps functions, and to the use i:hereof in medical diagnosis. The catheter is adapted for in vivo tissue identification of tissue types through optical techniques using the optical fiber, and biopsy sampling of identified tissue areas for withdrawal from the body for conventional examination and analysis.
>f3ac ground of the Prior Art Numerous type of biopsy forceps devices have been developed for in vivo medical diagnosis and treatment of various conditions. Such devices are designed for sampling tissue within the body, for example in endoscopic, laparoscopic and vascular procedures to retrieve biopsy samples for analysis and identification of tissue types. These biopsy forceps devices generally include small cutting jaws at the distal end, operated remotely from the proximal end after the distal end of the device has been positioned or navigated to the site of interest.
One difficulty in using prior art biopsy forceps devices is in knowing for certain the cx:act positioning of the distal tip, in relation to the suspected disease area, especially when the area of interest is very small.
Various types of optical catheters or probes have been developed for use in locating or identifying sitca within the body. A method of diagnosing and treating tissue in vivo using an optical guidewire is disclosed in U. S.
Patent 5,439,000, assigned to SpectraScience, Inc. One type of prior art system for internal biopsy uses an optical catheter to locate the site, followed by replacement of the optical catheter with a biopsy forceps for taking a sample.
However, this can result in errors and uncertainties in the final placement of the biopsy jaws with respect 1:o a previously identified small structure or area.
Other prior art systems have been proposed which use optical viewing or imaging and a cutting device in the same device, to visually locate and Lhel1 blVpstl a J4speVtel.J ~4i.A~~r4. ~~\/r N dal Lr 14, by Laserscope, Inc. relates to a surgical device for internal operations. A rigid tissue parting means is provided to enlarge a cavity which can be viewed by a viewing system. Tissue collecting means are provided adjacent to the viewing system. However, such devices have been hampered by their thickness which is needed to accommodate the imaging system and the cutting actuation system, and which precludes their use in very small areas.
Another shortcoming of such prior art systems is the offset or'parallax' between the viewing axis of the imaging system and the cutting position of the biopsy l sampling apparatus, such that the biopsy sample actually is taken from a zone slightly displaced from the zone being viewed by the optics. This can result in a loss of accuracy in the case of v~rv small structures of interest.
Summar"v of the Invention To overcome these and other problems, the present invention provides an integrated fiber optic biops.~ forceps device, which is very thin.
enabling it to be used in very small areas of interest, and which has accurate alignment of the optic field of view and the biopsy zone of sampling.
The present invention provides an optical biopsy forceps which is adapted for tissue identification both by optical techniques and biopsy sampling.
The forceps device includes an elongated catheter body for introduction into the body and navigation iu an area of interest. The distal end of the forceps device has a pair of cutting jaws, and flue tip of an optical fiber which runs through the forceps device. The proximal end has a control handle for manipulating the forceps device and actuating the jaws.
In accordance with one aspect of the invention, there is provided a method of diagnosing tissue at a site within a body. The method comprises introducing into the body an integrated optical biopsy forceps which includes a flexible catheter body with an optical fiber extending therethrough with the distal end of the optical fiber positioned with its optical view axis aligned for a tissue analysis zone adjacent the distal tip of the catheter body. The optical biopsy AMENDED SHEET
2/a,.
forceps additionally including cutting jaws mounted at the distal end of the catheter body for selective opening and closing in a biopsy cutting movement in the tissue analysis zone, acid an actuator mechanism operatively connected to the ~n,,EN~EO SNP .
Another shortcoming of such prior art systems is the offset or'parallax' between the viewing axis of the imaging system and the cutting position of the biopsy l sampling apparatus, such that the biopsy sample actually is taken from a zone slightly displaced from the zone being viewed by the optics. This can result in a loss of accuracy in the case of v~rv small structures of interest.
Summar"v of the Invention To overcome these and other problems, the present invention provides an integrated fiber optic biops.~ forceps device, which is very thin.
enabling it to be used in very small areas of interest, and which has accurate alignment of the optic field of view and the biopsy zone of sampling.
The present invention provides an optical biopsy forceps which is adapted for tissue identification both by optical techniques and biopsy sampling.
The forceps device includes an elongated catheter body for introduction into the body and navigation iu an area of interest. The distal end of the forceps device has a pair of cutting jaws, and flue tip of an optical fiber which runs through the forceps device. The proximal end has a control handle for manipulating the forceps device and actuating the jaws.
In accordance with one aspect of the invention, there is provided a method of diagnosing tissue at a site within a body. The method comprises introducing into the body an integrated optical biopsy forceps which includes a flexible catheter body with an optical fiber extending therethrough with the distal end of the optical fiber positioned with its optical view axis aligned for a tissue analysis zone adjacent the distal tip of the catheter body. The optical biopsy AMENDED SHEET
2/a,.
forceps additionally including cutting jaws mounted at the distal end of the catheter body for selective opening and closing in a biopsy cutting movement in the tissue analysis zone, acid an actuator mechanism operatively connected to the ~n,,EN~EO SNP .
jaws for se;lectively controlling the opening and closing of the cutting jaws.
Then, tissue in the tissue analysis zone adjacent the distal end of the forceps is spectroscopically analyzed through the use of an electro-optic tissue analysis system connected to the proximal end of the optical fiber. The optical biopsy S forceps is spectroscopically guided within the body to an area of interest as identified by the spectroscopic analysis of tissue type in the tissue analysis zone adjacent the distal tip of the catheter body. Then, a biopsy sample is cut from the location of the optical tissue analysis zone by actuating the actuator mechanism, and the biopsy sample is withdrawn from the body.
In one embodiment, the cutting jaws are mounted for pivoting or other movement bringing them together for cutting tissue placed therebetween.
and coupled to and controlled by the optical fiber that extends through the catheter body to the handle at the proximal end of the device. The optical fiber extends through the handle and the catheter body from its proximal end for I S connection to eleetro-optical analysis equipment, to a distal tip for transmitting andlor receiving light energy from tissue at the location of the tip. The fiber tip is positioned coaxially with the jaws at their zone of contact and cutting, so that the biopsy sample is taken exactly at the spot in the field of view of the optical fiber.
In another embodiment, the cutting jaws are mounted for pivoting or other cr~ovement bringing them together for cutting tissue placed therebetween, and controlled by wires extending through the catheter body to the control handle. The optical fiber extends through the device, from its proximal end for connection to elec;tro-optical analysis equipment, to a distal tip for transmitting and/or receiving light energy from tissue at the location of the tip.
The fiber tip is positioned coaxially with the jaws at their zone of contact and cutting, so that the biopsy sample is taken exactly at the spot in the field of view of the optical fiber.
One example of the utility of the invention is in the diagnosis of arterial or vascular obstc~~ctions, such as atherosclerotic lesions and thrombi.
After identification, the appropriate therapeutic catheter, whether balloon angioplasty, drug delivery ar laser ablation, can be advanced alon, a ~uidewire and employed to treat the patient. The present invention is also useful in many other fields in~ludin', but not limited to: oncolo~~y, urolo~;v.
~'astroenterolo~Tv, neurosurgery. general sur~~ery, obstetrics/gynecolo~~y, etc. It can also t-e used in laparoscopic procedures for additional dig<~nostic information. and/or ~~uidance of a therapeutic modality (e.g.. laser or cutting/coagulation devices. such as a bipolar electrocautery device).
These and other features and advanta~es of the invention will become apparent from the following description of the preferred embodiments of the invention.
Brief Descrirltion of the Drawing, Figure 1 is an overall view of the optical biopsy forceps accoc-din~~
to the present invention:
1 ~ Figure ? is a cross-sectional view at an enlarged scale of the distal end of the forceps of Fie. 1, with the forceps jaws open:
Figure 3 is a view of the distal end of the forceps of Fi'T. 1. with the forceps jaws closed:
Figure -l is a perspective view of the fiber tube assembl and ?0 related components, for the distal end of the device of Fia. ~:
Figure ~A is a top view, at an enlar~~ed scale. of a component of the distal end of the device of Fi<~. ?' Figure ~B i.s ~ side sectional view taken along the line ~B-sB of F; gnre _; ~:
Figure ~C is an end view of the component of the distal end of the device of Fig. ?;
Figure 6A and 6B are top and side views. respectively, of a ~~~~~f~ v~. ~Y ~.
S
cutting jav~r component of the distal end of the device of Fig. 2;
Figure 7 is an overall view of another embodiment of the optical biopsy forceps according to the present invention; and Figure 8 is a cross-sectional view of the distal end of an optical biopsy forceps provided in accordance with a further embodiment of the invention.
pescri ion o~~Jl~e Preferred Embodiments One prefewed embodiment of an integrated optical biopsy forceps of the present invention is generally indicated by reference number 10 in Fig.
I .
Forceps 10 is adapted for use internally of the body, for example in connection with endoscopic, laparoscopic or vascular procedures. Forceps 10 includes a control handle portion 12 at the proximal end, a middle portion 14 which extends over the main length of the device, and a distal end 16 which includes opposed forceps cutting jaws and distal end of the optical fiber, as is explained in greater 1 S detail below.
As seen in the left portion of Fig. 2, the main body or length of the forceps 10 consists of coaxial inner and an outer tubular members. In one preferred embodiment, the: inner tubular member is a hollow plastic tube 20, and the outer tubular member or catheter body is coil 22. The coil 22 is a finely wound spiral coil of stainless steel as is generally known and used in catheters and guidewires. Alternatively, the outer tubular member could be made using another plastic tube, or a plastic/metal composite structure, in place of coil 22.
The plastic tube 20 is positioned within coil 22 and these components are dimensioned with respect to each other so that tube 20 may be flee to move 2S axially within coil 22 during actuation of the jaws, as is explained below.
Positioned within inner tube 20 arc a pair of control wires 40, 41, and the optical fiber 50. 'lChese components, together with outer coil 22 and inner plastic tube 20 extend over the main length of the device, from the distal end 16 to the handle portion 12. At the handle, coil 22 and tube 20 pass through a plastic sleeve 24, which serves as a reinforcement and strain relief, into a bore 2S in the tip 13 of the handle 12. The plastic sleeve 24 and the proximal end of WO 97!41777 PC'TlUS97107784 the coil 22 are received and secured, as by bonding, in the tip 13 of the handle 12.
The inner plastic tube 20, control wires 40, 41 and fiber SO are not secured at tip 13, hut pass through bore 25, through a stainless steel reinforcing tube 29 to slider 30, which is movably received in a slot 28 in handle 12.
Reinforcing tube 29, tube 20 and control wires 40, 41 are secured to slider 30 which together form an actuator mechanism for the forceps 10. Movement of slider 30 causes axial moverr~ent of reinforcing tube 29, tube 20 and control wires 40, 41 relative to coil 22, which is used to actuate the cutting jaws.
Loops 26 and 27 are: provided in ha~~dle 12 and slider 30, to form finger holes useful in grasping and manipulating tine forceps.
Optical fiber _'i0 extends through slider 30, and out of handle 12.
in a protective cable or sheath 32, for connection to electro-optical units (not shown) which provide the illumination light to the fiber, and which receive and analyze the rcaurned right from the target at distal the end of the forceps.
'The optical biopsy forceps of the present invention may be used with any type of electro-optical technique for guiding the forceps. This may include systems which use vif~wing or imaging, systems which use illumination with white light to excite dyer in the area of interest, and spectroscopic techniques to identify tissue types )~~y spectral analysis of light returned from tissue illuminated with light of certain wavelengths. Such spectroscopic techniques utilize the property of certain tissue types to reflect or fluoresce light having characteristic wavelengths.
As seen in I~igs. 2, SA, SB and SC, the distal end 16 of the optical forceps includes a yoke 60, which serves as a mounting member for the cutting jaws. Yoke tiU may be machined from stainless steel or formed of other suitable material. It ~;enerally has a proximal portion or section indicated by reference number 61. a center section tie, and a distal section 63 having inwardly curved opposing distal end portions 63a and 63b. Yoke b0 has a bore 64 running therethrough. Each of the opposing distal end portions 63a and 63b has an arc shaped groove 65 (Figs. 5B and SC'.) formed therein which defines a guide slot WO 97!41777 PCT/US97/07784 for the distal end of the fiber 50. The diameter of the bore defined by the arcuate grooves 65 can be stepped to a smaller size at distal end portions 63a and 63b.
Sections 61 and 62 are generally circular in section. Section 61 has a diameter corresponding to the inside dimension of coil 22, while section 62 has a diameter corresponding to the outside dimension of coil 22, so that the end of coil 22 may be received and bonded to section 61. The proximal end surface 56 of the yoke 60 cooperates with the distal end 21 of the inner tube 20 to provide a limit stop for the fiber tube assembly 52 when it is being advanced within the outer tube to open the jaws. Center ;section 62 has a pair of holes 68, 69 which receive pins 72, 73 to hold the jaws in place.
Distal section 63 is stepped down relative to section 62, as seen in side view in Figs. 2 and SB, to allow the jaws 80 and 81 to fold against it when the jaws are closed (Fig. ?.) so as to have a thin profile for ease of introduction and navigation. Distal section 63 also has a vertical slot 70 provided therein which is dimensioned to the size of the mounting ends of the lever arms 85 of the jaws. The: inner wall 71 of distal section 63 is stepped outwardly relative to the slot 70 to provide clearance for the ends of control wires 40 and 41.
Because jaws 80 and 81 are similar only one is described in detail here. The two jaws are mirror-image identical, but with their serrations staggered so that they will mesh. As seen in Figs. 6A and 6B, jaw 80 has a rearward lever or mounting portion 85, and a distal cup or sample receiving portion 8~'., which has sharp serrations 83 used to cut the tissue sample. The lever portiion 85 has a hole 84 formed to receive the pin 72 which thus serves to retain the ,jaws, and also to acts as the pivot point. A hole 86 is provided at the forward apex of the relieved section, to receive the end of control wire 40 (or 41 ) which is crimped or bent .at a right angle at its tip to be effectively captured. The control wires are formed of wire which is stiff enough to push against the jaws to open there, but ilexibIe enough to flex as the wires are retracted to pull the jaws together.
As seen in Fig. 2, the distal end 16 of the optical forceps also includes a. fiber tube assembly 52. It includes a tube 54 which may be machined WO 97!41777 PC'T/US9710?784 from stainless steel, or formed of other suitable material. The end of plastic tube 20 overlaps .end SS of the tube 54 and is bonded to tube 54. The control wires 40, 41 and tle optical fiber '.i0 pass into it from the plastic tube 20. The optical fiber and the control wires pass axially through the tube 54 and are bonded to the S tube 54 by epoxy or other suitable adhesive. The optical fiber 50 includes a jacket 87 of polyamide or similar material and an outer protective tube 88 made of stainless :steel, for example. 'The jacket 87 extends the length of the optical fiber from its proximal end to its proximal end. The protective tube 88 extends from the distal end of the optical fiber to at least a point located within the distal end of tube >4. The distal end of the optical fiber 50 is flush with the end of the protective tube 88, and may have a lens or clear epoxy coating, depending on the optical properties desired. '!.'he protective tube 88 at the distal end of the optical fiber is desi~;ned to give strength to prevent damage to the fiber by tweezers and the like when tissue is removed from the biopsy jaws.
Referring to Figs. I and 2, in operation, the slider 30 is retracted toward the back of handle 12 to close the jaws. 'This causes movement (to the left in Fig. 2.) of plastic tube 20, the fiber tube assembly 52, the control wires 40, 41, and the optical fiber 50. 'This retracts the optical fiber into the yoke 60 and the pulling of the control wires closes the jaws. In this configuration, the distal end is of the: same narrow diameter as the main body of the forceps catheter, and the closed jaws have a smooth, rounded shape to facilitate introduction and navigation in the vascular, e;ndoscopic or laproscopic systems. Also, the cutting jaws are coaxially positioned with respect to the distal end of the optical fiber.
Once in place in the general area of interest, the forceps jaws can be opened b~y pushing slider 30 of the control handle forward. This causes movement (to the right in Fig. 2) of plastic tube 20, the fiber tube assembly 52, the control wires 40, 41, and the optical fiber 50. ~hhe control wires push against the jaws, causing them to open. Simultaneously, the tip of the optical fiber is axially extended. The distal end or tip of the optical fiber is positioned at the distal end of the catheter body with its optical view axis or view axis aligned for a tissue analysis zone adjacent the distal tip of~the catheter body and positioned WO 97/41777 PCTlUS97/07784 at the area, of contact of the cutting jaws when the cutting jaws are operated to their close;d cutting position. The device may then be used for optical tissue identification. When an area of disease is identified and a biopsy of it is needed, slider 30 is pulled, retracting the tip of the fiber and simultaneously causing the jaws to close and cut a biopsy sample at the exact place being viewed by the fiber. Thc~ biopsy sample is cut from the exact tissue site identified by the spectroscopic analysis step without requiring moving or repositioning of the catheter body. The forceps may then be withdrawn from the patient to recover the sample for analysis. The analysis of the withdrawn sample can be conducted using known laboratory techniques to confirm the identification of the tissue sample made by spectroscopic analysis.
The optical biopsy forceps of the invention is used for spectroscopically analyzing tissue in the tissue analysis zone adjacent the distal end of they forceps througlh the use of an electro-optic tissue analysis system connected to the proximal end of the optical fiber. The optical biopsy forceps are guided spectroscopically within the body to an area of interest as identified by the spt:ctroscopic analysis of tissue type in the tissue analysis zone adjacent the distal tip of the catheter body.
Referring to Fig. 7, another embodiment of an integrated optical biopsy forceps of the present invention is generally indicated by reference number 90. The optical forceps 90 is generally similar to the optical forceps shown in Fig. 1, and accordingly, corresponding elements have been given the same reference number. The optical biopsy forceps is adapted for use internally of the body, for example in connection with endoscopic, laparoscopic or vascular procedures. Forceps 90 includes a handle portion 91 and an operating lever 92 at the proximal end, a middle portion 14 which extends over the main length of the device, and a distal end 16. The distal end 16 includes forceps cutting jaws and 81 and the distal end of the optical fiber 50 which is contained within a plastic tube, corresponding to plastic tube 20 of forceps 10. and pass through a sleeve 24~ in the manner illustrated in Figs. 1-6 for the forceps 10.
WO 97141777 PC'T/US97107784 The operating lever 92 has its upper end 93 pivoted to the handle 91 by a pivot pin 94. The forceps 90 includes a reinforcing tube, corresponding to reinforcing; tube 29 of farc:eps 10, which encloses the fiber optical tube, and control wires 40 and 41. The; control wires pass around a post 95 and are secured 5 to the operating lever 92 near its upper end 93 located within the handle.
The optical fiber tube extends out of the handle in a protective sheath 32 as described above with reference to optical biopsy forceps 10. Loops 97 are provided in the handle 91 and the operating lever 92, forming finger holes useful in grasping and manipulating, the forceps. The operating Lever also has curved regions 99 10 forming finger rests, which t~ogethcr with the depending operating lever arrangement of the forceps 90, enhance the ergonomics of the instrument.
The jaws 80 a:nd 81 are open when the relative position between the handle 91 and the operating lever 92 is as illustrated in Fig. 6. When the operating lever 92 is moved rearwardly toward the handle, in the direction of the arrow 89, the' control wires 40 and 41 are drawn around the post 95, retracting the optical fiber and operating the jaws 80 and 81 closed in a manner similar to that described for the operation of forceps 10. When the operating lever is moved in the opposite direction, the cantrol wires arc advanced within tube 20, causing the jaws to open.
Referring to Fig. 8, there is illustrated the distal end 106 of an integrated optical biopsy forceps provided in accordance with a further embodiment of the invention. The optical biopsy forceps includes an optical fiber 150 and opposed forceps cutting jaws t 80 and 181, which can be similar to the optical fiber and the jaws of forceps 10 shown in figs. 1-6. The optical fiber 150 of the optical biopsy forceps includes an outer tubular, sheath-like member or catheter body 110, which corresponds to the outer sheath or coil 22 (Fig.
2), and a reinforcement cover 1 16, which, for example, can be a metal coil or cable, a nylon sheath, or any other suitable cover. The reinforced optical f ber is movable axially within the sheath 1 10. The optical biopsy forceps further includes a tubular slide mernber 120 connected to the optical fiber and movable therewith, and coupled to the jaws 180 and 181 for actuating the jaws 180 and WO 97141777 PCTlUS97107784 181 as the optical fiber is rnovcd within the outer sheath 110.
'Ihe optical biopsy forceps includes a suitable handle (not shown) for facilitating actuation of the tubular slide member 120. Preferably, the handle is similar to the handle 12 (Fig. 1 ) of the optical biopsyy forceps 10, but the handle can inehude any type of actuating mechanism capable of imparting bidirectional axial movement to the optical fiber 150 of the optical biopsy forceps. Referzing additionally to Fig. I, in such arrangement, the optical fiber 150 positioned within the outer sheath, extends over the main length of the device, from the distal end 106 to the handle. The proximal end of the sheath 110 passes through a sleeve, such as sleeve 24, and is secured to the tip of the handle. The sleeve provides reinforcement and strain relief where the sheath is attached to the handle. The proximal end of the optical fiber 150 also passes through sleeve 24 and is secured to the slider 30 of the handle 12 distally of the proximal end of the optical fiber 150, the end portion of which passes through I 5 the slider and out of the handle for connection to suitable electro-optical units in the manner that has been described for the optical fiber 50 of optical biopsy forceps 10. The slider 30 of the handle is adapted to push the reinforced optical fiber 150, which in turn pushes the tubular slide member 120, to open the jaws of the optical biopsy forceps and to~ pull the reinforced optical fiber, pulling the tubular slide member 120, to close the jaws.
The optical biopsy forceps of the present invention can be used with any type of electro-optical technique for guiding the forceps. This may include systems which use viewing or imaging, systems which use illumination with white light to excite dyes in the area of interest, and spectroscopic techniques to identify tissue types by spectral analysis of light returned from tissue illuminated with light of certain wavelengths. Such spectroscopic techniques utilize the property of certain tissue types to reflect or fluoresce light having characteristic wavelengdzs.
Considering the optical biopsy forceps in more detail, with reference to Fig. 8, the sheath 110 is a flexible hollow catheter which can be made a plastic tube, or a plastic~rmetal composite structure that defines an opening or tore therethrough. By way of example, the outer sheath 110 can be similar to those of disposable biopsy forceps commonly used with colonoscopes used in the upper and lower gastrointestinal tracts, and broncoscopes used in the trachea and bronchus. Alternatively, the outer sheath 110 can be a rigid tube, such as those of biopsy forceps commonly used with cystoscopes, colposcopes and laproscopes.
At its distal e;nd, the optical fiber 150 extends through a central bore 119 formed through a tubular slide member 120 which, in turn, is mounted in a mounting member or jaw support block 122 which serves as a mounting member for the cutting jaws. 180, 181. The jaw support block 122 can be machined from stainless steel or formed of other suitable material. Thc.jaw support block 122 has a bore 124 running therethrough which is generally circular in section. The inner dimension of the jaw support block 122 corresponds to the outer dimension of the outer sheath 110 which is secured to the support block in a suitable manner, such as with cement or by crimping.
'the jaws 180, I 81 are hinged to the support block 122 which has a pair of holes which receive pins 130, 132 which pass through ears 134 of the jaws to hold the jaws 180, 181 in place. The attachment of~the jaws to the support block by ears 134, as seen in side view in Fig. 8, allows the jaws 180, 181 to fold against the front end of the support block when closed so as to have a thin profile for the distal end of the forceps for ease of introduction and navigation. 'Fhe jaw support block 122 has a slot to control travel of the jaws 180 and 181.
The tubular slide member 120 is mounted in the bore 124 in the jaw support block 122 and is free to move axially within support block 122 during actuation of the jaws. The fiber 150 is secured to the tubular slide member 120 in a suitable manner such as with cement. The jaws 180, 181 are connected to the tubular slide member 120 by a pair of control links 136, 138, which are rigid members that function as a linkage mechanism connecting the cutting jaw~~ to the tubular slide member. Control link 136 has one end 139 connected to tubular slide member 120 by a pin 140. The other end 141 of the control link 136 is connected to jaw 180 by a pin 142. Similarly, control link 138 has one end 144 connected to tubular slide member 1?0 by a pin 146 and its other end 148 connected to jaw 181 by a pin 149. Thus, axial movement of the optical fiber in the direction of arrow 1 ~4, as the optical fiber is retracte 1. causes axial movement of tubular slide member 1?0, pivoting the control lima 136..
138, about their ends 139 ar;d 144, respectively, drawing the jaws together to actuate the cutting jaws 180, 181. The rearward surface 1 ~ 1 at the distal end I ~~
of the tubular slide member 1?0 is adapted to engage the forward surface 1 >;
of the jaw support block 1?~_. functioning.: as a travel limit stop surface to limit the axial movement of the tubular slide member 1?0 during retraction of the optical fiber 1 ~0. Similarly, when the optical fiber 1 ~0 is advanced into the sheath 1 1'_'.
the tubular slide member 120 is moved axially in the opposite direction.
causing the control links 136. 138 to move the jaws apart. The forward surface 161 at the proximal end 16~ of the tubular slide member 1?0 is adapted to enga~Te the 1 ~ rearward surface 16 3 of the jaw support block 1??. functioning as a tram.
e1 limit stop surface to limit the axial movement of the tubular slide member 1?0 during retraction of the optical fiber 1 ~0. Thus, both the proximal and distal ends of the tubular slide n_ember 1?0 include limit stops which prevent both over distention and over retraction of the optical fiber 1 ~0.
?0 Referring additionally to Fig. l, in operation of the optical biopsy forceps. initially, the optical fiber 1 ~0 is ftrllv retracted (bv retracting_> the slider 30 toward the back of the handle) to move the tubular slide member 1~0 in the direction of the arrow 1 ~4 until its rearward surface 1 ~ 1 en_aUes forward surface 1 ~~ Of the j2~.1' SLippOrt blOCl~:: ' ~'~. In this pOSitiOn, the COr1Lr01 lin~CS 1 36 arid 1 3Q
?~ have been drawn rearwardlv, drawing the jaws 180, 181 together so that the,jaws are closed. In this configuration. the distal end 106 of the forceps is substantially of the same narrow diameter as the outer sheath 116 which defines the main body portion of the optical biopsy forceps. and the closed jaws have a smooth, rounded shape to facilitate introduction and navi<~ation through the biopsy 30 channel of an endoscope, for example.
The endos;;opist advances the optical biopsy forceps through the biopsy channel of the endosc:ope to the general area of interest. i.e., such as a tissue site or tissue analysis zone with a body, represented by the reference numeral 17(1. Once in placf; in the general area of interest, the forceps jaws can be opened by advancing the slider 30, thereby advancing the optical fiber I 50 forwardly tl-trough the handle. This causes the tubular slide member 120 to move forwardly (to the right in Fig. 8), which in turn causes pivoting of the control links 136 anal 138. As the control links pivot, the control links push against the jaws, causing the jaws to o~>en. Simultaneously, the distal tip of the optical fiber 150 is axially extended forvvardly beyond the jaws. The forceps may then be used for optical tissue identification.
When an area of disease is identified and if a biopsy of it is needed, the slider 30 is retracted. retracting the optical fiber 150 and thus the tubular slid; member 120, retracting the tip of the optical fiber and simultaneously causing the jaws to close and cut a biopsy sample at the exact place that h~~s been located by viewing through the optical fiber. To take the i 5 tissue sample, the endoscopist holding the instrument by the handle, gently pulls back on the slider of the handle, retracting the optical fiber and tubular slide member 120, moving the optical fiber away from the tissue surface. As the optical fiber is being retracted, the jaws begin to close as the tubular slide member is moved in the direction of the arrow 154. While the jaws are being closed, the endoscopist gently pushes on the instrument to urge the jaws towards the tissue surface so that a tissue sample will be captured by the jaws as they close. When the jaws are closed, the endoscopist pulls the entire assembly away from the tissue surface and then withdraws the optical biopsy forceps from the endoscope so that the specimen tissue can be retrieved.
Thus, the present invention has provided an optical biopsy forceps. An important feature of the invention is that the tip of the optical fiber 50 (and optical fiber 150) is coaxial with, and perfectly aligned with, the cone where the two jaws 80, 81 (and jaws 180, 181 ) intersect and the sample is taken.
Thus, there is no offset or'parallax' error between the spot where the optical measurements were taken and the spot from which the biopsy sample will be taken. This, together with the slim and compact profile of the device when the ~ J 5-jaws are retracted, is a great improvement over prior art devices. In accordance with another feature, the fiber optic assembly, including the optical fiber and the tubular slide member of the biopsy forceps, can be produced as a disposable assembly, with the rest of the biopsy forceps being produced as a non-disposable unit. 'The major advantage of forceps 100 as compared to forceps 10 is, because the biopsy jaw control wires 40, 41 are not required, larger diameter optical fibers can be used to increase the detected signal relative to noise.
It will be appreciated from the foregoing that we have provided an improved optical biopsy forceps which provides the physician a greater degree of accuracy and control ovex the diagnosis process than was previously possible.
While we have illustrated the invention with two illustrative embodiments of the invention, it will be appreciated that variations of shapes, materials and assembly are possible, within the scope of the invention.
Then, tissue in the tissue analysis zone adjacent the distal end of the forceps is spectroscopically analyzed through the use of an electro-optic tissue analysis system connected to the proximal end of the optical fiber. The optical biopsy S forceps is spectroscopically guided within the body to an area of interest as identified by the spectroscopic analysis of tissue type in the tissue analysis zone adjacent the distal tip of the catheter body. Then, a biopsy sample is cut from the location of the optical tissue analysis zone by actuating the actuator mechanism, and the biopsy sample is withdrawn from the body.
In one embodiment, the cutting jaws are mounted for pivoting or other movement bringing them together for cutting tissue placed therebetween.
and coupled to and controlled by the optical fiber that extends through the catheter body to the handle at the proximal end of the device. The optical fiber extends through the handle and the catheter body from its proximal end for I S connection to eleetro-optical analysis equipment, to a distal tip for transmitting andlor receiving light energy from tissue at the location of the tip. The fiber tip is positioned coaxially with the jaws at their zone of contact and cutting, so that the biopsy sample is taken exactly at the spot in the field of view of the optical fiber.
In another embodiment, the cutting jaws are mounted for pivoting or other cr~ovement bringing them together for cutting tissue placed therebetween, and controlled by wires extending through the catheter body to the control handle. The optical fiber extends through the device, from its proximal end for connection to elec;tro-optical analysis equipment, to a distal tip for transmitting and/or receiving light energy from tissue at the location of the tip.
The fiber tip is positioned coaxially with the jaws at their zone of contact and cutting, so that the biopsy sample is taken exactly at the spot in the field of view of the optical fiber.
One example of the utility of the invention is in the diagnosis of arterial or vascular obstc~~ctions, such as atherosclerotic lesions and thrombi.
After identification, the appropriate therapeutic catheter, whether balloon angioplasty, drug delivery ar laser ablation, can be advanced alon, a ~uidewire and employed to treat the patient. The present invention is also useful in many other fields in~ludin', but not limited to: oncolo~~y, urolo~;v.
~'astroenterolo~Tv, neurosurgery. general sur~~ery, obstetrics/gynecolo~~y, etc. It can also t-e used in laparoscopic procedures for additional dig<~nostic information. and/or ~~uidance of a therapeutic modality (e.g.. laser or cutting/coagulation devices. such as a bipolar electrocautery device).
These and other features and advanta~es of the invention will become apparent from the following description of the preferred embodiments of the invention.
Brief Descrirltion of the Drawing, Figure 1 is an overall view of the optical biopsy forceps accoc-din~~
to the present invention:
1 ~ Figure ? is a cross-sectional view at an enlarged scale of the distal end of the forceps of Fie. 1, with the forceps jaws open:
Figure 3 is a view of the distal end of the forceps of Fi'T. 1. with the forceps jaws closed:
Figure -l is a perspective view of the fiber tube assembl and ?0 related components, for the distal end of the device of Fia. ~:
Figure ~A is a top view, at an enlar~~ed scale. of a component of the distal end of the device of Fi<~. ?' Figure ~B i.s ~ side sectional view taken along the line ~B-sB of F; gnre _; ~:
Figure ~C is an end view of the component of the distal end of the device of Fig. ?;
Figure 6A and 6B are top and side views. respectively, of a ~~~~~f~ v~. ~Y ~.
S
cutting jav~r component of the distal end of the device of Fig. 2;
Figure 7 is an overall view of another embodiment of the optical biopsy forceps according to the present invention; and Figure 8 is a cross-sectional view of the distal end of an optical biopsy forceps provided in accordance with a further embodiment of the invention.
pescri ion o~~Jl~e Preferred Embodiments One prefewed embodiment of an integrated optical biopsy forceps of the present invention is generally indicated by reference number 10 in Fig.
I .
Forceps 10 is adapted for use internally of the body, for example in connection with endoscopic, laparoscopic or vascular procedures. Forceps 10 includes a control handle portion 12 at the proximal end, a middle portion 14 which extends over the main length of the device, and a distal end 16 which includes opposed forceps cutting jaws and distal end of the optical fiber, as is explained in greater 1 S detail below.
As seen in the left portion of Fig. 2, the main body or length of the forceps 10 consists of coaxial inner and an outer tubular members. In one preferred embodiment, the: inner tubular member is a hollow plastic tube 20, and the outer tubular member or catheter body is coil 22. The coil 22 is a finely wound spiral coil of stainless steel as is generally known and used in catheters and guidewires. Alternatively, the outer tubular member could be made using another plastic tube, or a plastic/metal composite structure, in place of coil 22.
The plastic tube 20 is positioned within coil 22 and these components are dimensioned with respect to each other so that tube 20 may be flee to move 2S axially within coil 22 during actuation of the jaws, as is explained below.
Positioned within inner tube 20 arc a pair of control wires 40, 41, and the optical fiber 50. 'lChese components, together with outer coil 22 and inner plastic tube 20 extend over the main length of the device, from the distal end 16 to the handle portion 12. At the handle, coil 22 and tube 20 pass through a plastic sleeve 24, which serves as a reinforcement and strain relief, into a bore 2S in the tip 13 of the handle 12. The plastic sleeve 24 and the proximal end of WO 97!41777 PC'TlUS97107784 the coil 22 are received and secured, as by bonding, in the tip 13 of the handle 12.
The inner plastic tube 20, control wires 40, 41 and fiber SO are not secured at tip 13, hut pass through bore 25, through a stainless steel reinforcing tube 29 to slider 30, which is movably received in a slot 28 in handle 12.
Reinforcing tube 29, tube 20 and control wires 40, 41 are secured to slider 30 which together form an actuator mechanism for the forceps 10. Movement of slider 30 causes axial moverr~ent of reinforcing tube 29, tube 20 and control wires 40, 41 relative to coil 22, which is used to actuate the cutting jaws.
Loops 26 and 27 are: provided in ha~~dle 12 and slider 30, to form finger holes useful in grasping and manipulating tine forceps.
Optical fiber _'i0 extends through slider 30, and out of handle 12.
in a protective cable or sheath 32, for connection to electro-optical units (not shown) which provide the illumination light to the fiber, and which receive and analyze the rcaurned right from the target at distal the end of the forceps.
'The optical biopsy forceps of the present invention may be used with any type of electro-optical technique for guiding the forceps. This may include systems which use vif~wing or imaging, systems which use illumination with white light to excite dyer in the area of interest, and spectroscopic techniques to identify tissue types )~~y spectral analysis of light returned from tissue illuminated with light of certain wavelengths. Such spectroscopic techniques utilize the property of certain tissue types to reflect or fluoresce light having characteristic wavelengths.
As seen in I~igs. 2, SA, SB and SC, the distal end 16 of the optical forceps includes a yoke 60, which serves as a mounting member for the cutting jaws. Yoke tiU may be machined from stainless steel or formed of other suitable material. It ~;enerally has a proximal portion or section indicated by reference number 61. a center section tie, and a distal section 63 having inwardly curved opposing distal end portions 63a and 63b. Yoke b0 has a bore 64 running therethrough. Each of the opposing distal end portions 63a and 63b has an arc shaped groove 65 (Figs. 5B and SC'.) formed therein which defines a guide slot WO 97!41777 PCT/US97/07784 for the distal end of the fiber 50. The diameter of the bore defined by the arcuate grooves 65 can be stepped to a smaller size at distal end portions 63a and 63b.
Sections 61 and 62 are generally circular in section. Section 61 has a diameter corresponding to the inside dimension of coil 22, while section 62 has a diameter corresponding to the outside dimension of coil 22, so that the end of coil 22 may be received and bonded to section 61. The proximal end surface 56 of the yoke 60 cooperates with the distal end 21 of the inner tube 20 to provide a limit stop for the fiber tube assembly 52 when it is being advanced within the outer tube to open the jaws. Center ;section 62 has a pair of holes 68, 69 which receive pins 72, 73 to hold the jaws in place.
Distal section 63 is stepped down relative to section 62, as seen in side view in Figs. 2 and SB, to allow the jaws 80 and 81 to fold against it when the jaws are closed (Fig. ?.) so as to have a thin profile for ease of introduction and navigation. Distal section 63 also has a vertical slot 70 provided therein which is dimensioned to the size of the mounting ends of the lever arms 85 of the jaws. The: inner wall 71 of distal section 63 is stepped outwardly relative to the slot 70 to provide clearance for the ends of control wires 40 and 41.
Because jaws 80 and 81 are similar only one is described in detail here. The two jaws are mirror-image identical, but with their serrations staggered so that they will mesh. As seen in Figs. 6A and 6B, jaw 80 has a rearward lever or mounting portion 85, and a distal cup or sample receiving portion 8~'., which has sharp serrations 83 used to cut the tissue sample. The lever portiion 85 has a hole 84 formed to receive the pin 72 which thus serves to retain the ,jaws, and also to acts as the pivot point. A hole 86 is provided at the forward apex of the relieved section, to receive the end of control wire 40 (or 41 ) which is crimped or bent .at a right angle at its tip to be effectively captured. The control wires are formed of wire which is stiff enough to push against the jaws to open there, but ilexibIe enough to flex as the wires are retracted to pull the jaws together.
As seen in Fig. 2, the distal end 16 of the optical forceps also includes a. fiber tube assembly 52. It includes a tube 54 which may be machined WO 97!41777 PC'T/US9710?784 from stainless steel, or formed of other suitable material. The end of plastic tube 20 overlaps .end SS of the tube 54 and is bonded to tube 54. The control wires 40, 41 and tle optical fiber '.i0 pass into it from the plastic tube 20. The optical fiber and the control wires pass axially through the tube 54 and are bonded to the S tube 54 by epoxy or other suitable adhesive. The optical fiber 50 includes a jacket 87 of polyamide or similar material and an outer protective tube 88 made of stainless :steel, for example. 'The jacket 87 extends the length of the optical fiber from its proximal end to its proximal end. The protective tube 88 extends from the distal end of the optical fiber to at least a point located within the distal end of tube >4. The distal end of the optical fiber 50 is flush with the end of the protective tube 88, and may have a lens or clear epoxy coating, depending on the optical properties desired. '!.'he protective tube 88 at the distal end of the optical fiber is desi~;ned to give strength to prevent damage to the fiber by tweezers and the like when tissue is removed from the biopsy jaws.
Referring to Figs. I and 2, in operation, the slider 30 is retracted toward the back of handle 12 to close the jaws. 'This causes movement (to the left in Fig. 2.) of plastic tube 20, the fiber tube assembly 52, the control wires 40, 41, and the optical fiber 50. 'This retracts the optical fiber into the yoke 60 and the pulling of the control wires closes the jaws. In this configuration, the distal end is of the: same narrow diameter as the main body of the forceps catheter, and the closed jaws have a smooth, rounded shape to facilitate introduction and navigation in the vascular, e;ndoscopic or laproscopic systems. Also, the cutting jaws are coaxially positioned with respect to the distal end of the optical fiber.
Once in place in the general area of interest, the forceps jaws can be opened b~y pushing slider 30 of the control handle forward. This causes movement (to the right in Fig. 2) of plastic tube 20, the fiber tube assembly 52, the control wires 40, 41, and the optical fiber 50. ~hhe control wires push against the jaws, causing them to open. Simultaneously, the tip of the optical fiber is axially extended. The distal end or tip of the optical fiber is positioned at the distal end of the catheter body with its optical view axis or view axis aligned for a tissue analysis zone adjacent the distal tip of~the catheter body and positioned WO 97/41777 PCTlUS97/07784 at the area, of contact of the cutting jaws when the cutting jaws are operated to their close;d cutting position. The device may then be used for optical tissue identification. When an area of disease is identified and a biopsy of it is needed, slider 30 is pulled, retracting the tip of the fiber and simultaneously causing the jaws to close and cut a biopsy sample at the exact place being viewed by the fiber. Thc~ biopsy sample is cut from the exact tissue site identified by the spectroscopic analysis step without requiring moving or repositioning of the catheter body. The forceps may then be withdrawn from the patient to recover the sample for analysis. The analysis of the withdrawn sample can be conducted using known laboratory techniques to confirm the identification of the tissue sample made by spectroscopic analysis.
The optical biopsy forceps of the invention is used for spectroscopically analyzing tissue in the tissue analysis zone adjacent the distal end of they forceps througlh the use of an electro-optic tissue analysis system connected to the proximal end of the optical fiber. The optical biopsy forceps are guided spectroscopically within the body to an area of interest as identified by the spt:ctroscopic analysis of tissue type in the tissue analysis zone adjacent the distal tip of the catheter body.
Referring to Fig. 7, another embodiment of an integrated optical biopsy forceps of the present invention is generally indicated by reference number 90. The optical forceps 90 is generally similar to the optical forceps shown in Fig. 1, and accordingly, corresponding elements have been given the same reference number. The optical biopsy forceps is adapted for use internally of the body, for example in connection with endoscopic, laparoscopic or vascular procedures. Forceps 90 includes a handle portion 91 and an operating lever 92 at the proximal end, a middle portion 14 which extends over the main length of the device, and a distal end 16. The distal end 16 includes forceps cutting jaws and 81 and the distal end of the optical fiber 50 which is contained within a plastic tube, corresponding to plastic tube 20 of forceps 10. and pass through a sleeve 24~ in the manner illustrated in Figs. 1-6 for the forceps 10.
WO 97141777 PC'T/US97107784 The operating lever 92 has its upper end 93 pivoted to the handle 91 by a pivot pin 94. The forceps 90 includes a reinforcing tube, corresponding to reinforcing; tube 29 of farc:eps 10, which encloses the fiber optical tube, and control wires 40 and 41. The; control wires pass around a post 95 and are secured 5 to the operating lever 92 near its upper end 93 located within the handle.
The optical fiber tube extends out of the handle in a protective sheath 32 as described above with reference to optical biopsy forceps 10. Loops 97 are provided in the handle 91 and the operating lever 92, forming finger holes useful in grasping and manipulating, the forceps. The operating Lever also has curved regions 99 10 forming finger rests, which t~ogethcr with the depending operating lever arrangement of the forceps 90, enhance the ergonomics of the instrument.
The jaws 80 a:nd 81 are open when the relative position between the handle 91 and the operating lever 92 is as illustrated in Fig. 6. When the operating lever 92 is moved rearwardly toward the handle, in the direction of the arrow 89, the' control wires 40 and 41 are drawn around the post 95, retracting the optical fiber and operating the jaws 80 and 81 closed in a manner similar to that described for the operation of forceps 10. When the operating lever is moved in the opposite direction, the cantrol wires arc advanced within tube 20, causing the jaws to open.
Referring to Fig. 8, there is illustrated the distal end 106 of an integrated optical biopsy forceps provided in accordance with a further embodiment of the invention. The optical biopsy forceps includes an optical fiber 150 and opposed forceps cutting jaws t 80 and 181, which can be similar to the optical fiber and the jaws of forceps 10 shown in figs. 1-6. The optical fiber 150 of the optical biopsy forceps includes an outer tubular, sheath-like member or catheter body 110, which corresponds to the outer sheath or coil 22 (Fig.
2), and a reinforcement cover 1 16, which, for example, can be a metal coil or cable, a nylon sheath, or any other suitable cover. The reinforced optical f ber is movable axially within the sheath 1 10. The optical biopsy forceps further includes a tubular slide mernber 120 connected to the optical fiber and movable therewith, and coupled to the jaws 180 and 181 for actuating the jaws 180 and WO 97141777 PCTlUS97107784 181 as the optical fiber is rnovcd within the outer sheath 110.
'Ihe optical biopsy forceps includes a suitable handle (not shown) for facilitating actuation of the tubular slide member 120. Preferably, the handle is similar to the handle 12 (Fig. 1 ) of the optical biopsyy forceps 10, but the handle can inehude any type of actuating mechanism capable of imparting bidirectional axial movement to the optical fiber 150 of the optical biopsy forceps. Referzing additionally to Fig. I, in such arrangement, the optical fiber 150 positioned within the outer sheath, extends over the main length of the device, from the distal end 106 to the handle. The proximal end of the sheath 110 passes through a sleeve, such as sleeve 24, and is secured to the tip of the handle. The sleeve provides reinforcement and strain relief where the sheath is attached to the handle. The proximal end of the optical fiber 150 also passes through sleeve 24 and is secured to the slider 30 of the handle 12 distally of the proximal end of the optical fiber 150, the end portion of which passes through I 5 the slider and out of the handle for connection to suitable electro-optical units in the manner that has been described for the optical fiber 50 of optical biopsy forceps 10. The slider 30 of the handle is adapted to push the reinforced optical fiber 150, which in turn pushes the tubular slide member 120, to open the jaws of the optical biopsy forceps and to~ pull the reinforced optical fiber, pulling the tubular slide member 120, to close the jaws.
The optical biopsy forceps of the present invention can be used with any type of electro-optical technique for guiding the forceps. This may include systems which use viewing or imaging, systems which use illumination with white light to excite dyes in the area of interest, and spectroscopic techniques to identify tissue types by spectral analysis of light returned from tissue illuminated with light of certain wavelengths. Such spectroscopic techniques utilize the property of certain tissue types to reflect or fluoresce light having characteristic wavelengdzs.
Considering the optical biopsy forceps in more detail, with reference to Fig. 8, the sheath 110 is a flexible hollow catheter which can be made a plastic tube, or a plastic~rmetal composite structure that defines an opening or tore therethrough. By way of example, the outer sheath 110 can be similar to those of disposable biopsy forceps commonly used with colonoscopes used in the upper and lower gastrointestinal tracts, and broncoscopes used in the trachea and bronchus. Alternatively, the outer sheath 110 can be a rigid tube, such as those of biopsy forceps commonly used with cystoscopes, colposcopes and laproscopes.
At its distal e;nd, the optical fiber 150 extends through a central bore 119 formed through a tubular slide member 120 which, in turn, is mounted in a mounting member or jaw support block 122 which serves as a mounting member for the cutting jaws. 180, 181. The jaw support block 122 can be machined from stainless steel or formed of other suitable material. Thc.jaw support block 122 has a bore 124 running therethrough which is generally circular in section. The inner dimension of the jaw support block 122 corresponds to the outer dimension of the outer sheath 110 which is secured to the support block in a suitable manner, such as with cement or by crimping.
'the jaws 180, I 81 are hinged to the support block 122 which has a pair of holes which receive pins 130, 132 which pass through ears 134 of the jaws to hold the jaws 180, 181 in place. The attachment of~the jaws to the support block by ears 134, as seen in side view in Fig. 8, allows the jaws 180, 181 to fold against the front end of the support block when closed so as to have a thin profile for the distal end of the forceps for ease of introduction and navigation. 'Fhe jaw support block 122 has a slot to control travel of the jaws 180 and 181.
The tubular slide member 120 is mounted in the bore 124 in the jaw support block 122 and is free to move axially within support block 122 during actuation of the jaws. The fiber 150 is secured to the tubular slide member 120 in a suitable manner such as with cement. The jaws 180, 181 are connected to the tubular slide member 120 by a pair of control links 136, 138, which are rigid members that function as a linkage mechanism connecting the cutting jaw~~ to the tubular slide member. Control link 136 has one end 139 connected to tubular slide member 120 by a pin 140. The other end 141 of the control link 136 is connected to jaw 180 by a pin 142. Similarly, control link 138 has one end 144 connected to tubular slide member 1?0 by a pin 146 and its other end 148 connected to jaw 181 by a pin 149. Thus, axial movement of the optical fiber in the direction of arrow 1 ~4, as the optical fiber is retracte 1. causes axial movement of tubular slide member 1?0, pivoting the control lima 136..
138, about their ends 139 ar;d 144, respectively, drawing the jaws together to actuate the cutting jaws 180, 181. The rearward surface 1 ~ 1 at the distal end I ~~
of the tubular slide member 1?0 is adapted to engage the forward surface 1 >;
of the jaw support block 1?~_. functioning.: as a travel limit stop surface to limit the axial movement of the tubular slide member 1?0 during retraction of the optical fiber 1 ~0. Similarly, when the optical fiber 1 ~0 is advanced into the sheath 1 1'_'.
the tubular slide member 120 is moved axially in the opposite direction.
causing the control links 136. 138 to move the jaws apart. The forward surface 161 at the proximal end 16~ of the tubular slide member 1?0 is adapted to enga~Te the 1 ~ rearward surface 16 3 of the jaw support block 1??. functioning as a tram.
e1 limit stop surface to limit the axial movement of the tubular slide member 1?0 during retraction of the optical fiber 1 ~0. Thus, both the proximal and distal ends of the tubular slide n_ember 1?0 include limit stops which prevent both over distention and over retraction of the optical fiber 1 ~0.
?0 Referring additionally to Fig. l, in operation of the optical biopsy forceps. initially, the optical fiber 1 ~0 is ftrllv retracted (bv retracting_> the slider 30 toward the back of the handle) to move the tubular slide member 1~0 in the direction of the arrow 1 ~4 until its rearward surface 1 ~ 1 en_aUes forward surface 1 ~~ Of the j2~.1' SLippOrt blOCl~:: ' ~'~. In this pOSitiOn, the COr1Lr01 lin~CS 1 36 arid 1 3Q
?~ have been drawn rearwardlv, drawing the jaws 180, 181 together so that the,jaws are closed. In this configuration. the distal end 106 of the forceps is substantially of the same narrow diameter as the outer sheath 116 which defines the main body portion of the optical biopsy forceps. and the closed jaws have a smooth, rounded shape to facilitate introduction and navi<~ation through the biopsy 30 channel of an endoscope, for example.
The endos;;opist advances the optical biopsy forceps through the biopsy channel of the endosc:ope to the general area of interest. i.e., such as a tissue site or tissue analysis zone with a body, represented by the reference numeral 17(1. Once in placf; in the general area of interest, the forceps jaws can be opened by advancing the slider 30, thereby advancing the optical fiber I 50 forwardly tl-trough the handle. This causes the tubular slide member 120 to move forwardly (to the right in Fig. 8), which in turn causes pivoting of the control links 136 anal 138. As the control links pivot, the control links push against the jaws, causing the jaws to o~>en. Simultaneously, the distal tip of the optical fiber 150 is axially extended forvvardly beyond the jaws. The forceps may then be used for optical tissue identification.
When an area of disease is identified and if a biopsy of it is needed, the slider 30 is retracted. retracting the optical fiber 150 and thus the tubular slid; member 120, retracting the tip of the optical fiber and simultaneously causing the jaws to close and cut a biopsy sample at the exact place that h~~s been located by viewing through the optical fiber. To take the i 5 tissue sample, the endoscopist holding the instrument by the handle, gently pulls back on the slider of the handle, retracting the optical fiber and tubular slide member 120, moving the optical fiber away from the tissue surface. As the optical fiber is being retracted, the jaws begin to close as the tubular slide member is moved in the direction of the arrow 154. While the jaws are being closed, the endoscopist gently pushes on the instrument to urge the jaws towards the tissue surface so that a tissue sample will be captured by the jaws as they close. When the jaws are closed, the endoscopist pulls the entire assembly away from the tissue surface and then withdraws the optical biopsy forceps from the endoscope so that the specimen tissue can be retrieved.
Thus, the present invention has provided an optical biopsy forceps. An important feature of the invention is that the tip of the optical fiber 50 (and optical fiber 150) is coaxial with, and perfectly aligned with, the cone where the two jaws 80, 81 (and jaws 180, 181 ) intersect and the sample is taken.
Thus, there is no offset or'parallax' error between the spot where the optical measurements were taken and the spot from which the biopsy sample will be taken. This, together with the slim and compact profile of the device when the ~ J 5-jaws are retracted, is a great improvement over prior art devices. In accordance with another feature, the fiber optic assembly, including the optical fiber and the tubular slide member of the biopsy forceps, can be produced as a disposable assembly, with the rest of the biopsy forceps being produced as a non-disposable unit. 'The major advantage of forceps 100 as compared to forceps 10 is, because the biopsy jaw control wires 40, 41 are not required, larger diameter optical fibers can be used to increase the detected signal relative to noise.
It will be appreciated from the foregoing that we have provided an improved optical biopsy forceps which provides the physician a greater degree of accuracy and control ovex the diagnosis process than was previously possible.
While we have illustrated the invention with two illustrative embodiments of the invention, it will be appreciated that variations of shapes, materials and assembly are possible, within the scope of the invention.
Claims (11)
1. An integrated optical biopsy forceps, comprising:
a flexible catheter body having a bore therethrough, and having proximal and distal ends;
an optical fiber extending through the catheter body and adapted at its proximal end for connection to an electro-optic tissue analysis system, the distal end of the optical fiber positioned at the distal end of the catheter body with its optical view axis aligned for a tissue analysis zone adjacent the distal tip of the catheter body;
cutting jaws mounted at the distal end of the catheter body for selective opening and closing in a biopsy cutting movement, said cutting jaws positioned with their closed cutting position an the optical view axis and the field of view of the optical fiber in the tissue analysis zone: and an actuator mechanism operatively connected to the jaws for selectively controlling the opening and closing of the cutting jaws to cut a biopsy sample from the exact location of the optical tissue analysis zone.
a flexible catheter body having a bore therethrough, and having proximal and distal ends;
an optical fiber extending through the catheter body and adapted at its proximal end for connection to an electro-optic tissue analysis system, the distal end of the optical fiber positioned at the distal end of the catheter body with its optical view axis aligned for a tissue analysis zone adjacent the distal tip of the catheter body;
cutting jaws mounted at the distal end of the catheter body for selective opening and closing in a biopsy cutting movement, said cutting jaws positioned with their closed cutting position an the optical view axis and the field of view of the optical fiber in the tissue analysis zone: and an actuator mechanism operatively connected to the jaws for selectively controlling the opening and closing of the cutting jaws to cut a biopsy sample from the exact location of the optical tissue analysis zone.
2. A forceps according to claim 1 wherein the actuator mechanism includes a tubular slide member mounted in the distal end of the catheter body and adapted for axial movement relative to the catheter body, and a linkage mechanism connecting the cutting jaws to the tubular slide member.
3. A forceps according to claim 2 wherein the optical fiber is movable axially of the catheter body between an advanced position and a retracted position, the tubular slide member being secured to the optical fiber and movable with the optical fiber for selectively controlling from the proximal end of the catheter body the opening and closing of the cutting jaws.
4. A forceps according to claim 2 wherein the actuator mechanism is operatively coupled to the optical fiber to retract the distal tip of the optical fiber as the cutting jaws close together.
5. A forceps according to claim 2, including a mounting member secured to the catheter body at the distal end of the catheter body for mounting the jaws, said tubular slide member being movable axially relative relative to said mounting member; and said tubular slide member cooperating with said mounting member to define a first travel limit stop for preventing over distension of said optical fiber, and a second travel limit stop for preventing over retraction of said optical fiber.
6. A forceps according to claim 1, further comprising a mounting member connected to the catheter body at the distal end of the catheter body for mounting the jaws for selective opening and closing in a biopsy cutting movement, said cutting jaws positioned with their closed cutting position at the distal tip of the forceps.
7. A forceps according to claim 1, wherein the actuator mechanism includes a tubular slide member coupled to the jaws, the actuator mechanism causing opening and closing of the jaws by axial movement of the tubular slide member.
8. A forceps according to claim 7, further comprising a handle at the proximal end of the catheter body, the handle receiving the proximal end of the optical fiber for connection thereof to an electro-optic tissue analysis system, the catheter body being secured to the handle; the optical fiber being movable relative to the handle.
9. A forceps according to claim 5, wherein the linkage mechanism includes a first and a second link for connecting the cutting jaws to said tubular slide member.
10. A forceps according to claim 9, wherein each of the cutting jaws has a mounting portion and a sample receiving portion, the first and second links being connected to the jaws intermediate the mounting portion and the sample receiving portion.
11. A forceps according to claim 1, further including a mounting member secured to the catheter body at a distal end of the catheter body, and further including a tubular slide member mounted at the distal end of the catheter body, and wherein said tubular slide member is movable axially relative to said mounting member, said tubular slide member cooperating with said mounting member to define a first travel limit stop for preventing over distension of said optical fiber, and a second travel limit stop for preventing over retraction of said optical fiber.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/643,912 US5843000A (en) | 1996-05-07 | 1996-05-07 | Optical biopsy forceps and method of diagnosing tissue |
| US08/643,912 | 1996-05-07 | ||
| PCT/US1997/007784 WO1997041777A1 (en) | 1996-05-07 | 1997-05-07 | Optical biopsy forceps and methods of diagnosing tissue |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2253646A1 CA2253646A1 (en) | 1997-11-13 |
| CA2253646C true CA2253646C (en) | 2004-03-02 |
Family
ID=24582678
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002253646A Expired - Fee Related CA2253646C (en) | 1996-05-07 | 1997-05-07 | Optical biopsy forceps and methods of diagnosing tissue |
Country Status (7)
| Country | Link |
|---|---|
| US (1) | US5843000A (en) |
| EP (1) | EP0902647B1 (en) |
| JP (1) | JP3220165B2 (en) |
| AT (1) | ATE314008T1 (en) |
| CA (1) | CA2253646C (en) |
| DE (1) | DE69734978T2 (en) |
| WO (1) | WO1997041777A1 (en) |
Families Citing this family (152)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5762613A (en) * | 1996-05-07 | 1998-06-09 | Spectrascience, Inc. | Optical biopsy forceps |
| US6296608B1 (en) * | 1996-07-08 | 2001-10-02 | Boston Scientific Corporation | Diagnosing and performing interventional procedures on tissue in vivo |
| US6201989B1 (en) | 1997-03-13 | 2001-03-13 | Biomax Technologies Inc. | Methods and apparatus for detecting the rejection of transplanted tissue |
| US6174291B1 (en) * | 1998-03-09 | 2001-01-16 | Spectrascience, Inc. | Optical biopsy system and methods for tissue diagnosis |
| US6066102A (en) | 1998-03-09 | 2000-05-23 | Spectrascience, Inc. | Optical biopsy forceps system and method of diagnosing tissue |
| US6139508A (en) * | 1998-08-04 | 2000-10-31 | Endonetics, Inc. | Articulated medical device |
| US6149607A (en) * | 1998-08-04 | 2000-11-21 | Endonetics, Inc. | Multiple sample biopsy device |
| ITCE990004A1 (en) | 1999-10-25 | 2000-01-25 | Mario Immacolato Paternuosto | VALVE FOR BIOPSY FORCEPS IN DIGESTIVE ENDOSCOPY |
| US7228165B1 (en) | 2000-06-26 | 2007-06-05 | Boston Scientific Scimed, Inc. | Apparatus and method for performing a tissue resection procedure |
| JP4241038B2 (en) * | 2000-10-30 | 2009-03-18 | ザ ジェネラル ホスピタル コーポレーション | Optical method and system for tissue analysis |
| US9295391B1 (en) | 2000-11-10 | 2016-03-29 | The General Hospital Corporation | Spectrally encoded miniature endoscopic imaging probe |
| GB0103030D0 (en) | 2001-02-07 | 2001-03-21 | Univ London | Spectrum processing and processor |
| EP2333523B1 (en) | 2001-04-30 | 2020-04-08 | The General Hospital Corporation | Method and apparatus for improving image clarity and sensitivity in optical coherence tomography using dynamic feedback to control focal properties and coherence gating |
| US7865231B2 (en) | 2001-05-01 | 2011-01-04 | The General Hospital Corporation | Method and apparatus for determination of atherosclerotic plaque type by measurement of tissue optical properties |
| US7094245B2 (en) * | 2001-10-05 | 2006-08-22 | Scimed Life Systems, Inc. | Device and method for through the scope endoscopic hemostatic clipping |
| US6980299B1 (en) | 2001-10-16 | 2005-12-27 | General Hospital Corporation | Systems and methods for imaging a sample |
| US7169167B2 (en) * | 2001-12-04 | 2007-01-30 | Scimed Life Systems, Inc. | Endoscopic apparatus and method |
| WO2003060423A2 (en) | 2002-01-11 | 2003-07-24 | The General Hospital Corporation | Apparatus for low coherence ranging |
| US7355716B2 (en) | 2002-01-24 | 2008-04-08 | The General Hospital Corporation | Apparatus and method for ranging and noise reduction of low coherence interferometry LCI and optical coherence tomography OCT signals by parallel detection of spectral bands |
| JP4131011B2 (en) * | 2002-04-09 | 2008-08-13 | Ｈｏｙａ株式会社 | Endoscopic sputum treatment device |
| US7037276B2 (en) * | 2002-07-02 | 2006-05-02 | Precision Medical Devices, Inc. | Biopsy device |
| DE10255082A1 (en) * | 2002-11-20 | 2004-06-17 | Aesculap Ag & Co. Kg | endoscope |
| WO2004088361A2 (en) | 2003-03-31 | 2004-10-14 | The General Hospital Corporation | Speckle reduction in optical coherence tomography by path length encoded angular compounding |
| US8054468B2 (en) | 2003-01-24 | 2011-11-08 | The General Hospital Corporation | Apparatus and method for ranging and noise reduction of low coherence interferometry LCI and optical coherence tomography OCT signals by parallel detection of spectral bands |
| EP2319405B1 (en) | 2003-01-24 | 2013-09-18 | The General Hospital Corporation | System and method for identifying tissue using low-coherence interferometry |
| US7591783B2 (en) | 2003-04-01 | 2009-09-22 | Boston Scientific Scimed, Inc. | Articulation joint for video endoscope |
| US20050245789A1 (en) | 2003-04-01 | 2005-11-03 | Boston Scientific Scimed, Inc. | Fluid manifold for endoscope system |
| US8118732B2 (en) | 2003-04-01 | 2012-02-21 | Boston Scientific Scimed, Inc. | Force feedback control system for video endoscope |
| US7578786B2 (en) | 2003-04-01 | 2009-08-25 | Boston Scientific Scimed, Inc. | Video endoscope |
| US20040199052A1 (en) | 2003-04-01 | 2004-10-07 | Scimed Life Systems, Inc. | Endoscopic imaging system |
| KR101386971B1 (en) | 2003-06-06 | 2014-04-18 | 더 제너럴 하스피탈 코포레이션 | Process and apparatus for a wavelength tunning source |
| US8469993B2 (en) | 2003-06-18 | 2013-06-25 | Boston Scientific Scimed, Inc. | Endoscopic instruments |
| US20040260337A1 (en) | 2003-06-18 | 2004-12-23 | Scimed Life Systems, Inc. | Endoscopic instruments and methods of manufacture |
| US7588545B2 (en) | 2003-09-10 | 2009-09-15 | Boston Scientific Scimed, Inc. | Forceps and collection assembly with accompanying mechanisms and related methods of use |
| US7611473B2 (en) * | 2003-09-11 | 2009-11-03 | Ethicon, Inc. | Tissue extraction and maceration device |
| US8034003B2 (en) | 2003-09-11 | 2011-10-11 | Depuy Mitek, Inc. | Tissue extraction and collection device |
| US8012128B2 (en) * | 2003-09-30 | 2011-09-06 | Ethicon Endo-Surgery Inc. | Button latching system for a trocar |
| US7733497B2 (en) | 2003-10-27 | 2010-06-08 | The General Hospital Corporation | Method and apparatus for performing optical imaging using frequency-domain interferometry |
| US7942896B2 (en) | 2003-11-25 | 2011-05-17 | Scimed Life Systems, Inc. | Forceps and collection assembly and related methods of use and manufacture |
| EP1687587B1 (en) | 2003-11-28 | 2020-01-08 | The General Hospital Corporation | Method and apparatus for three-dimensional spectrally encoded imaging |
| AU2004320269B2 (en) | 2004-05-29 | 2011-07-21 | The General Hospital Corporation | Process, system and software arrangement for a chromatic dispersion compensation using reflective layers in optical coherence tomography (OCT) imaging |
| WO2006014392A1 (en) | 2004-07-02 | 2006-02-09 | The General Hospital Corporation | Endoscopic imaging probe comprising dual clad fibre |
| US8081316B2 (en) | 2004-08-06 | 2011-12-20 | The General Hospital Corporation | Process, system and software arrangement for determining at least one location in a sample using an optical coherence tomography |
| WO2006024014A2 (en) | 2004-08-24 | 2006-03-02 | The General Hospital Corporation | Process, system and software arrangement for measuring a mechanical strain and elastic properties of a sample |
| US8208995B2 (en) | 2004-08-24 | 2012-06-26 | The General Hospital Corporation | Method and apparatus for imaging of vessel segments |
| US7365859B2 (en) | 2004-09-10 | 2008-04-29 | The General Hospital Corporation | System and method for optical coherence imaging |
| EP2329759B1 (en) | 2004-09-29 | 2014-03-12 | The General Hospital Corporation | System and method for optical coherence imaging |
| WO2006039511A2 (en) | 2004-09-30 | 2006-04-13 | Boston Scientific Scimed, Inc. | System and method of obstruction removal |
| EP1799095A2 (en) | 2004-09-30 | 2007-06-27 | Boston Scientific Scimed, Inc. | Adapter for use with digital imaging medical device |
| US7241263B2 (en) | 2004-09-30 | 2007-07-10 | Scimed Life Systems, Inc. | Selectively rotatable shaft coupler |
| WO2006039267A2 (en) | 2004-09-30 | 2006-04-13 | Boston Scientific Scimed, Inc. | Multi-functional endoscopic system for use in electrosurgical applications |
| US7479106B2 (en) | 2004-09-30 | 2009-01-20 | Boston Scientific Scimed, Inc. | Automated control of irrigation and aspiration in a single-use endoscope |
| US8083671B2 (en) | 2004-09-30 | 2011-12-27 | Boston Scientific Scimed, Inc. | Fluid delivery system for use with an endoscope |
| JP5623692B2 (en) | 2004-11-02 | 2014-11-12 | ザ ジェネラル ホスピタル コーポレイション | Optical fiber rotator, optical system and method for sample imaging |
| US7995210B2 (en) | 2004-11-24 | 2011-08-09 | The General Hospital Corporation | Devices and arrangements for performing coherence range imaging using a common path interferometer |
| JP2008521516A (en) | 2004-11-29 | 2008-06-26 | ザ ジェネラル ホスピタル コーポレイション | Configuration, apparatus, endoscope, catheter, and method for performing optical image generation by simultaneously illuminating and detecting multiple points on a sample |
| US7794413B2 (en) * | 2005-04-19 | 2010-09-14 | Ev3, Inc. | Libraries and data structures of materials removed by debulking catheters |
| EP2325803A1 (en) | 2005-04-28 | 2011-05-25 | The General Hospital Corporation | Evaluating optical coherence tomography information for an anatomical structure |
| US7846107B2 (en) | 2005-05-13 | 2010-12-07 | Boston Scientific Scimed, Inc. | Endoscopic apparatus with integrated multiple biopsy device |
| US8097003B2 (en) | 2005-05-13 | 2012-01-17 | Boston Scientific Scimed, Inc. | Endoscopic apparatus with integrated variceal ligation device |
| US7762960B2 (en) | 2005-05-13 | 2010-07-27 | Boston Scientific Scimed, Inc. | Biopsy forceps assemblies |
| EP1887926B1 (en) | 2005-05-31 | 2014-07-30 | The General Hospital Corporation | System and method which use spectral encoding heterodyne interferometry techniques for imaging |
| US9060689B2 (en) | 2005-06-01 | 2015-06-23 | The General Hospital Corporation | Apparatus, method and system for performing phase-resolved optical frequency domain imaging |
| ES2354287T3 (en) | 2005-08-09 | 2011-03-11 | The General Hospital Corporation | APPARATUS AND METHOD FOR PERFORMING A DEMODULATION IN QUADRATURE BY POLARIZATION IN OPTICAL COHERENCE TOMOGRAPHY. |
| US8052597B2 (en) | 2005-08-30 | 2011-11-08 | Boston Scientific Scimed, Inc. | Method for forming an endoscope articulation joint |
| CN101365375B (en) | 2005-09-29 | 2013-09-11 | 通用医疗公司 | Method and apparatus for optical imaging via spectral encoding |
| US7889348B2 (en) | 2005-10-14 | 2011-02-15 | The General Hospital Corporation | Arrangements and methods for facilitating photoluminescence imaging |
| EP1948056A2 (en) * | 2005-10-24 | 2008-07-30 | Spectrascience, Inc. | System and method for non-endoscopic optical biopsy detection of diseased tissue |
| EP1971848B1 (en) | 2006-01-10 | 2019-12-04 | The General Hospital Corporation | Systems and methods for generating data based on one or more spectrally-encoded endoscopy techniques |
| PL1973466T3 (en) | 2006-01-19 | 2021-07-05 | The General Hospital Corporation | Ballon imaging catheter |
| US7967759B2 (en) | 2006-01-19 | 2011-06-28 | Boston Scientific Scimed, Inc. | Endoscopic system with integrated patient respiratory status indicator |
| US8145018B2 (en) | 2006-01-19 | 2012-03-27 | The General Hospital Corporation | Apparatus for obtaining information for a structure using spectrally-encoded endoscopy techniques and methods for producing one or more optical arrangements |
| WO2007149603A2 (en) | 2006-02-01 | 2007-12-27 | The General Hospital Corporation | Apparatus for applying a plurality of electro-magnetic radiations to a sample |
| WO2007149601A2 (en) | 2006-02-01 | 2007-12-27 | The General Hospital Corporation | Apparatus for controlling at least one of at least two sections of at least one fiber |
| JP5524487B2 (en) | 2006-02-01 | 2014-06-18 | ザ ジェネラル ホスピタル コーポレイション | A method and system for emitting electromagnetic radiation to at least a portion of a sample using a conformal laser treatment procedure. |
| JP5519152B2 (en) | 2006-02-08 | 2014-06-11 | ザ ジェネラル ホスピタル コーポレイション | Device for acquiring information about anatomical samples using optical microscopy |
| US7989207B2 (en) * | 2006-02-17 | 2011-08-02 | Tyco Healthcare Group Lp | Testing lumenectomy samples for markers of non-vascular diseases |
| EP1987318B1 (en) | 2006-02-24 | 2015-08-12 | The General Hospital Corporation | Methods and systems for performing angle-resolved fourier-domain optical coherence tomography |
| US8888684B2 (en) | 2006-03-27 | 2014-11-18 | Boston Scientific Scimed, Inc. | Medical devices with local drug delivery capabilities |
| JP5135324B2 (en) | 2006-04-05 | 2013-02-06 | ザ ジェネラル ホスピタル コーポレイション | Method, arrangement and system for polarization sensitive optical frequency domain imaging of samples |
| US7955255B2 (en) | 2006-04-20 | 2011-06-07 | Boston Scientific Scimed, Inc. | Imaging assembly with transparent distal cap |
| US8202265B2 (en) | 2006-04-20 | 2012-06-19 | Boston Scientific Scimed, Inc. | Multiple lumen assembly for use in endoscopes or other medical devices |
| EP2517616A3 (en) | 2006-05-10 | 2013-03-06 | The General Hospital Corporation | Processes, arrangements and systems for providing frequency domain imaging of a sample |
| WO2007133964A2 (en) * | 2006-05-12 | 2007-11-22 | The General Hospital Corporation | Processes, arrangements and systems for providing a fiber layer thickness map based on optical coherence tomography images |
| DE102006028001B4 (en) * | 2006-06-14 | 2009-11-26 | Paul Peschke Gmbh | Surgical grasping forceps |
| CN101589301B (en) | 2006-08-25 | 2012-11-07 | 通用医疗公司 | Apparatus and methods for enhancing optical coherence tomography imaging using volumetric filtering techniques |
| WO2008049118A2 (en) | 2006-10-19 | 2008-04-24 | The General Hospital Corporation | Apparatus and method for obtaining and providing imaging information associated with at least one portion of a sample and effecting such portion(s) |
| US7911621B2 (en) | 2007-01-19 | 2011-03-22 | The General Hospital Corporation | Apparatus and method for controlling ranging depth in optical frequency domain imaging |
| US7949019B2 (en) | 2007-01-19 | 2011-05-24 | The General Hospital | Wavelength tuning source based on a rotatable reflector |
| BRPI0807770A2 (en) * | 2007-02-19 | 2014-06-24 | Multi Biopsy Sampling Co Aps | Biopsy Forceps for one or more samples. |
| EP2602651A3 (en) | 2007-03-23 | 2014-08-27 | The General Hospital Corporation | Methods, arrangements and apparatus for utilizing a wavelength-swept laser using angular scanning and dispersion procedures |
| US10534129B2 (en) | 2007-03-30 | 2020-01-14 | The General Hospital Corporation | System and method providing intracoronary laser speckle imaging for the detection of vulnerable plaque |
| WO2008131082A1 (en) | 2007-04-17 | 2008-10-30 | The General Hospital Corporation | Apparatus and methods for measuring vibrations using spectrally-encoded endoscopy techniques |
| US8115919B2 (en) | 2007-05-04 | 2012-02-14 | The General Hospital Corporation | Methods, arrangements and systems for obtaining information associated with a sample using optical microscopy |
| BRPI0814191A2 (en) | 2007-06-26 | 2015-01-27 | Restoration Robotics Inc | FOLLICULAR UNIT CAPACITY TOOLS INCLUDING DEVICES AND THEIR USE TO REMOVE CONNECTIVE FABRIC |
| DE102007034577A1 (en) * | 2007-07-13 | 2009-01-15 | Karl Storz Gmbh & Co. Kg | Medical instrument |
| JP5917803B2 (en) | 2007-07-31 | 2016-05-18 | ザ ジェネラル ホスピタル コーポレイション | System and method for emitting a beam scanning pattern for fast Doppler optical frequency domain imaging |
| EP2191254B1 (en) | 2007-08-31 | 2017-07-19 | The General Hospital Corporation | System and method for self-interference fluorescence microscopy, and computer-accessible medium associated therewith |
| WO2009059034A1 (en) | 2007-10-30 | 2009-05-07 | The General Hospital Corporation | System and method for cladding mode detection |
| US20100198191A1 (en) | 2007-12-20 | 2010-08-05 | Acclarent, Inc. | Method and system for treating target tissue within the eustachian tube |
| US9332942B2 (en) | 2008-01-28 | 2016-05-10 | The General Hospital Corporation | Systems, processes and computer-accessible medium for providing hybrid flourescence and optical coherence tomography imaging |
| US11123047B2 (en) | 2008-01-28 | 2021-09-21 | The General Hospital Corporation | Hybrid systems and methods for multi-modal acquisition of intravascular imaging data and counteracting the effects of signal absorption in blood |
| US8221418B2 (en) | 2008-02-07 | 2012-07-17 | Tyco Healthcare Group Lp | Endoscopic instrument for tissue identification |
| EP2274572A4 (en) | 2008-05-07 | 2013-08-28 | Gen Hospital Corp | System, method and computer-accessible medium for tracking vessel motion during three-dimensional coronary artery microscopy |
| WO2009155536A2 (en) | 2008-06-20 | 2009-12-23 | The General Hospital Corporation | Fused fiber optic coupler arrangement and method for use thereof |
| WO2010009136A2 (en) | 2008-07-14 | 2010-01-21 | The General Hospital Corporation | Apparatus and methods for color endoscopy |
| US9610095B2 (en) | 2008-08-27 | 2017-04-04 | Spine View, Inc. | Retractor cannula system for accessing and visualizing spine and related methods |
| JP5731394B2 (en) | 2008-12-10 | 2015-06-10 | ザ ジェネラル ホスピタル コーポレイション | System, apparatus and method for extending imaging depth range of optical coherence tomography through optical subsampling |
| WO2010085775A2 (en) | 2009-01-26 | 2010-07-29 | The General Hospital Corporation | System, method and computer-accessible medium for providing wide-field superresolution microscopy |
| CN102308444B (en) | 2009-02-04 | 2014-06-18 | 通用医疗公司 | Apparatus and method for utilization of a high-speed optical wavelength tuning source |
| US9351642B2 (en) | 2009-03-12 | 2016-05-31 | The General Hospital Corporation | Non-contact optical system, computer-accessible medium and method for measurement at least one mechanical property of tissue using coherent speckle technique(s) |
| BR112012001042A2 (en) | 2009-07-14 | 2016-11-22 | Gen Hospital Corp | fluid flow measurement equipment and method within anatomical structure. |
| US9339341B2 (en) * | 2010-02-08 | 2016-05-17 | Intuitive Surgical Operations, Inc. | Direct pull surgical gripper |
| ES2831223T3 (en) | 2010-03-05 | 2021-06-07 | Massachusetts Gen Hospital | Apparatus for providing electromagnetic radiation to a sample |
| US9737320B2 (en) * | 2010-03-18 | 2017-08-22 | Covidien Lp | Surgical grasper with integrated probe |
| US9069130B2 (en) | 2010-05-03 | 2015-06-30 | The General Hospital Corporation | Apparatus, method and system for generating optical radiation from biological gain media |
| US9795301B2 (en) | 2010-05-25 | 2017-10-24 | The General Hospital Corporation | Apparatus, systems, methods and computer-accessible medium for spectral analysis of optical coherence tomography images |
| US9557154B2 (en) | 2010-05-25 | 2017-01-31 | The General Hospital Corporation | Systems, devices, methods, apparatus and computer-accessible media for providing optical imaging of structures and compositions |
| EP2575591A4 (en) | 2010-06-03 | 2017-09-13 | The General Hospital Corporation | Apparatus and method for devices for imaging structures in or at one or more luminal organs |
| WO2012033838A2 (en) * | 2010-09-07 | 2012-03-15 | Yacoubian Stephan V | Multiple purpose surgical instruments |
| BR112013006868A2 (en) * | 2010-09-23 | 2016-06-21 | Alphatec Spine Inc | interspinous spacer for fixation and methods of use |
| EP3378414B1 (en) | 2010-10-11 | 2019-11-20 | Cook Medical Technologies LLC | Medical devices with detachable pivotable jaws |
| US9510758B2 (en) | 2010-10-27 | 2016-12-06 | The General Hospital Corporation | Apparatus, systems and methods for measuring blood pressure within at least one vessel |
| EP2670317B1 (en) | 2011-01-31 | 2021-09-15 | Boston Scientific Scimed, Inc. | Medical devices having releasable coupling |
| WO2012149175A1 (en) | 2011-04-29 | 2012-11-01 | The General Hospital Corporation | Means for determining depth-resolved physical and/or optical properties of scattering media |
| WO2013013049A1 (en) | 2011-07-19 | 2013-01-24 | The General Hospital Corporation | Systems, methods, apparatus and computer-accessible-medium for providing polarization-mode dispersion compensation in optical coherence tomography |
| US10241028B2 (en) | 2011-08-25 | 2019-03-26 | The General Hospital Corporation | Methods, systems, arrangements and computer-accessible medium for providing micro-optical coherence tomography procedures |
| EP2769491A4 (en) | 2011-10-18 | 2015-07-22 | Gen Hospital Corp | Apparatus and methods for producing and/or providing recirculating optical delay(s) |
| US9861427B2 (en) | 2012-01-20 | 2018-01-09 | Koninklijke Philips N.V. | Electro-surgical system, an electro-surgical device, and a method for operating an electro-surgical system |
| US10398508B2 (en) * | 2012-02-07 | 2019-09-03 | Joe Denton Brown | Protective sheath and method of using same for laser surgery |
| CN102599941A (en) * | 2012-03-01 | 2012-07-25 | 王宝根 | Light-storing illumination biopsy forceps |
| WO2013148306A1 (en) | 2012-03-30 | 2013-10-03 | The General Hospital Corporation | Imaging system, method and distal attachment for multidirectional field of view endoscopy |
| WO2013177154A1 (en) | 2012-05-21 | 2013-11-28 | The General Hospital Corporation | Apparatus, device and method for capsule microscopy |
| JP6227652B2 (en) | 2012-08-22 | 2017-11-08 | ザ ジェネラル ホスピタル コーポレイション | System, method, and computer-accessible medium for fabricating a miniature endoscope using soft lithography |
| US9259211B2 (en) | 2012-12-24 | 2016-02-16 | Transmed7, Llc | Automated, selectable, soft tissue excision biopsy devices and methods |
| WO2014120791A1 (en) | 2013-01-29 | 2014-08-07 | The General Hospital Corporation | Apparatus, systems and methods for providing information regarding the aortic valve |
| US11179028B2 (en) | 2013-02-01 | 2021-11-23 | The General Hospital Corporation | Objective lens arrangement for confocal endomicroscopy |
| JP6378311B2 (en) | 2013-03-15 | 2018-08-22 | ザ ジェネラル ホスピタル コーポレイション | Methods and systems for characterizing objects |
| WO2014186353A1 (en) | 2013-05-13 | 2014-11-20 | The General Hospital Corporation | Detecting self-interefering fluorescence phase and amplitude |
| EP3021735A4 (en) | 2013-07-19 | 2017-04-19 | The General Hospital Corporation | Determining eye motion by imaging retina. with feedback |
| WO2015009932A1 (en) | 2013-07-19 | 2015-01-22 | The General Hospital Corporation | Imaging apparatus and method which utilizes multidirectional field of view endoscopy |
| EP3025173B1 (en) | 2013-07-26 | 2021-07-07 | The General Hospital Corporation | Apparatus with a laser arrangement utilizing optical dispersion for applications in fourier-domain optical coherence tomography |
| US11020182B1 (en) * | 2013-09-30 | 2021-06-01 | Michael Feloney | Tactile feedback for surgical robots |
| US9733460B2 (en) | 2014-01-08 | 2017-08-15 | The General Hospital Corporation | Method and apparatus for microscopic imaging |
| WO2015116986A2 (en) | 2014-01-31 | 2015-08-06 | The General Hospital Corporation | System and method for facilitating manual and/or automatic volumetric imaging with real-time tension or force feedback using a tethered imaging device |
| WO2015153982A1 (en) | 2014-04-04 | 2015-10-08 | The General Hospital Corporation | Apparatus and method for controlling propagation and/or transmission of electromagnetic radiation in flexible waveguide(s) |
| WO2016015052A1 (en) | 2014-07-25 | 2016-01-28 | The General Hospital Corporation | Apparatus, devices and methods for in vivo imaging and diagnosis |
| USD796676S1 (en) * | 2016-02-03 | 2017-09-05 | Karl Storz Gmbh & Co. Kg | Optical forceps |
| USD806873S1 (en) * | 2016-02-03 | 2018-01-02 | Karl Storz Gmbh & Co. Kg | Optical forceps |
| EP3661431A2 (en) | 2017-08-04 | 2020-06-10 | University College Cork-National University of Ireland Cork | Tissue penetrating surgical systems and methods |
| EP3709896A1 (en) * | 2017-11-15 | 2020-09-23 | United States Endoscopy Group, Inc. | End effectors actuation platform |
| CN108066017B (en) * | 2017-12-08 | 2023-10-17 | 苏州朗开医疗技术有限公司 | Method and device for detecting and positioning focus in television-assisted thoracoscopy |
Family Cites Families (23)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3074408A (en) * | 1961-05-22 | 1963-01-22 | Martin H Chester | Ureteral stone extractor and dilator |
| DE2424749B2 (en) * | 1973-05-23 | 1976-10-21 | Olympus Optical Co. Ltd., Tokio | ENDOSCOPE WITH A CHANNEL FOR INSERTING A FORCEPS AND SUCTIONING A LIQUID SUBSTANCE |
| DK131542C (en) * | 1974-02-06 | 1976-02-09 | Akad Tekn Videnskaber | SURGICAL INSTRUMENT FOR SAMPLING BIOLOGICAL SAMPLES |
| JPS5933388B2 (en) * | 1976-03-19 | 1984-08-15 | 高美 上原 | Single-operable biopsy fiberscope |
| GB2125702A (en) * | 1982-03-16 | 1984-03-14 | Laserscope Inc | Surgical device for internal operations |
| US4557255A (en) * | 1983-08-22 | 1985-12-10 | Goodman Tobias M | Ureteroscope |
| JPS60104915A (en) * | 1983-11-11 | 1985-06-10 | Fuji Photo Optical Co Ltd | Endoscope |
| DE3347671A1 (en) * | 1983-12-31 | 1985-07-11 | Richard Wolf Gmbh, 7134 Knittlingen | TISSUE SAMPLING INSTRUMENT |
| EP0150245A1 (en) * | 1984-01-30 | 1985-08-07 | Storz, Karl, Dr.med. h.c. | Endoscope for contact-viewing |
| DE3738692A1 (en) * | 1987-11-13 | 1989-06-01 | Hannes Dr Haberl | SURGICAL PLIERS |
| US4791913A (en) * | 1987-12-14 | 1988-12-20 | Baxter Travenol Laboratories, Inc. | Optical valvulotome |
| US4887612A (en) * | 1988-04-27 | 1989-12-19 | Esco Precision, Inc. | Endoscopic biopsy forceps |
| DE3920706A1 (en) * | 1989-06-24 | 1991-01-10 | Foerster Ernst | Catheter for carrying out a biopsy - has mini-endoscope and a forceps combined with an inner sheath which slides in an outer sheath |
| US5228451A (en) * | 1990-05-10 | 1993-07-20 | Symbiosis Corporation | Biopsy forceps device having stiff distal end |
| JP3003944B2 (en) * | 1990-10-04 | 2000-01-31 | オリンパス光学工業株式会社 | Solid-state imaging device |
| US5280788A (en) * | 1991-02-26 | 1994-01-25 | Massachusetts Institute Of Technology | Devices and methods for optical diagnosis of tissue |
| US5318023A (en) * | 1991-04-03 | 1994-06-07 | Cedars-Sinai Medical Center | Apparatus and method of use for a photosensitizer enhanced fluorescence based biopsy needle |
| US5439000A (en) * | 1992-11-18 | 1995-08-08 | Spectrascience, Inc. | Method of diagnosing tissue with guidewire |
| US5373854A (en) * | 1993-07-15 | 1994-12-20 | Kolozsi; William Z. | Biopsy apparatus for use in endoscopy |
| US5471992A (en) * | 1994-02-08 | 1995-12-05 | Boston Scientific Corporation | Multi-motion cutter multiple biopsy sampling device |
| US5562102A (en) * | 1994-11-21 | 1996-10-08 | Taylor; Thomas V. | Multiple biopsy device |
| US5558100A (en) * | 1994-12-19 | 1996-09-24 | Ballard Medical Products | Biopsy forceps for obtaining tissue specimen and optionally for coagulation |
| US5571129A (en) * | 1995-05-15 | 1996-11-05 | Portlyn Corporation | Surgical cutting instrument with improved cleaning capability and ease of use |
-
1996
- 1996-05-07 US US08/643,912 patent/US5843000A/en not_active Expired - Lifetime
-
1997
- 1997-05-07 WO PCT/US1997/007784 patent/WO1997041777A1/en active IP Right Grant
- 1997-05-07 DE DE69734978T patent/DE69734978T2/en not_active Expired - Lifetime
- 1997-05-07 CA CA002253646A patent/CA2253646C/en not_active Expired - Fee Related
- 1997-05-07 AT AT97925486T patent/ATE314008T1/en not_active IP Right Cessation
- 1997-05-07 EP EP97925486A patent/EP0902647B1/en not_active Expired - Lifetime
- 1997-05-07 JP JP54019497A patent/JP3220165B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| US5843000A (en) | 1998-12-01 |
| DE69734978T2 (en) | 2006-09-28 |
| ATE314008T1 (en) | 2006-01-15 |
| DE69734978D1 (en) | 2006-02-02 |
| EP0902647A1 (en) | 1999-03-24 |
| WO1997041777A1 (en) | 1997-11-13 |
| JP3220165B2 (en) | 2001-10-22 |
| EP0902647B1 (en) | 2005-12-28 |
| CA2253646A1 (en) | 1997-11-13 |
| JPH11509459A (en) | 1999-08-24 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CA2253646C (en) | Optical biopsy forceps and methods of diagnosing tissue | |
| CA2253643C (en) | Optical biopsy forceps | |
| EP1063921B1 (en) | Optical biopsy forceps system | |
| EP1383432B1 (en) | Biopsy forceps device with transparent outer sheath | |
| US7261728B2 (en) | Biopsy forceps device and method | |
| US6083150A (en) | Endoscopic multiple sample biopsy forceps | |
| CA2252598C (en) | Spring based multi-purpose medical instrument | |
| US20110060188A1 (en) | Low cost disposable medical forceps to enable a hollow central channel for various functionalities | |
| US7060024B2 (en) | Apparatus for guiding an instrument used with an endoscope | |
| EP2123225B1 (en) | Endoscope device | |
| JP3466196B2 (en) | Microsurgical instrument with ground distal coil section | |
| US20030176767A1 (en) | Method for controlling position of medical instruments | |
| WO2007050683A2 (en) | System and method for non-endoscopic optical biopsy detection of diseased tissue | |
| WO2008121143A1 (en) | Catheter with imaging capability acts as guidewire for cannula tools | |
| US20240016483A1 (en) | Optically enhanced instrument with laser fluorescing capabilities | |
| WO2023279055A1 (en) | Biopsy device with loose light conductor |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKLA | Lapsed |