CA2443966A1 - Surgical biopsy device - Google Patents

Surgical biopsy device Download PDF

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Publication number
CA2443966A1
CA2443966A1 CA002443966A CA2443966A CA2443966A1 CA 2443966 A1 CA2443966 A1 CA 2443966A1 CA 002443966 A CA002443966 A CA 002443966A CA 2443966 A CA2443966 A CA 2443966A CA 2443966 A1 CA2443966 A1 CA 2443966A1
Authority
CA
Canada
Prior art keywords
tissue
members
housing
respect
carrier
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.)
Granted
Application number
CA002443966A
Other languages
French (fr)
Other versions
CA2443966C (en
Inventor
James F. Mcguckin, Jr.
Peter W. J. Hinchliffe
Stephan A. Defonzo
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Rex Medical LP
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2443966A1 publication Critical patent/CA2443966A1/en
Application granted granted Critical
Publication of CA2443966C publication Critical patent/CA2443966C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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
    • 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
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/32056—Surgical snare instruments
    • 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
    • A61B10/0041—Detection of breast cancer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00287—Bags for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00796—Breast surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00796—Breast surgery
    • A61B2017/008—Removal of tumors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B2017/32004—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes having a laterally movable cutting member at its most distal end which remains within the contours of said end
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2238—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with means for selectively laterally deflecting the tip of the fibre
    • 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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • 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
    • A61B90/40—Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

Abstract

A surgical biopsy apparatus for cutting tissue (10) comprising a housing (12) having a longitudinal axis (2), first and second members (50) movable from a retracted position to an extended position with respect to the housing, a third member (60) slidably positioned and extendable with respect to the first member, a fourth member (60) slidably positioned and extendable with respect to the second member, and an electrocautery cutting wire (86) slidable with respect to the third and fourth members to surround a region of tissue positioned between the third and fourth members (60) to cut the tissue.

Claims (34)

WHAT IS CLAIMED IS:
1. A surgical biopsy apparatus for cutting tissue comprising:
a housing having a longitudinal axis;

first and second members movable from a retracted position to an extended position with respect to the housing;
third and fourth members, the third member slidably positioned with respect to the first member and extendable with respect to the first member and the fourth member slidably positioned with respect to the second member and extendable with respect to the second member; and an electrocautery cutting wire movable with respect to the third and fourth members to surround a region of tissue positioned between the third and fourth members to cut the tissue.
2. The apparatus of claim 1, further comprising a tissue retrieval bag movable with respect to the third and fourth members to surround a region of tissue positioned between the third and fourth members to remove the cut tissue.
3. The apparatus of claim 2, wherein the electrocautery wire and the tissue retrieval bag are movable from a retracted position within the housing to an extended position distally of the housing for cutting the tissue and retrieving the cut tissue.
4. The apparatus of claim 1, further comprising an ultrasonic transducer mounted at a distal portion of the housing for imaging the tissue adjacent the distal portion.
The apparatus of claim 3, wherein the electrocautery wire and tissue retrieval bag are advanced together from the housing.
6. The apparatus of claim 6, further comprising a first carrier slidably positioned over the first and third member, the first carrier supporting the electrocautery wire and advancing the electrocautery wire as the first carrier is advanced.
7. The apparatus of claim 6, further comprising a suture for closing the tissue retrieval bag, the suture supported by the first carrier and advancable by advancement of the first carrier.
8. The apparatus of claim 7, further comprising a second carrier slidably positioned over the fourth member and further supporting the electrocautery wire and tissue retrieval bag, the second carrier being advanceable along with the first carrier to advance the electrocautery wire and the tissue retrieval bag.
9. The apparatus of claim 1, wherein the first and second members move radially outwardly away from the longitudinal axis of the housing and the third arid fourth members initially move radially outwardly away from the longitudinal axis of the housing followed by movement inwardly towards the longitudinal axis of the housing.
10. The apparatus of claim 1, wherein the third member is telescopingly received within a first channel in the first member and the fourth member is telescopingly received within a second channel in the second member.
11. A surgical biopsy apparatus for cutting a tissue mass comprising:
a housing having a longitudinal axis;
a plurality of first members extendable with respect to the housing, the first members movable in a first direction at a first angle to the longitudinal axis of the housing;
a plurality of second members movable with respect to the first members in a second direction different than the first direction and at an angle to the first angle; and a cutting wire movable longitudinally with respect to the first and second members to cut the tissue mass.
12. The surgical apparatus of claim 11, wherein the plurality of second members surround the tissue mass to form a substantially spherical tissue cutting area, the cutting area having a diameter greater than the diameter of the housing.
13. The surgical apparatus of claim 12, wherein the plurality of second members surround the tissue mass to form a tissue cutting area having a substantially circular cross section, the cutting area having a diameter greater than the diameter of the housing.
14. The surgical apparatus of claim 11, wherein the cutting wire is an electrocautery wire.
15. The surgical apparatus of claim 11, further comprising a tissue retrieval bag movable longitudinally with respect to the first and second members to remove the tissue mass cut by the cutting wire.
16. The surgical apparatus of claim 15, wherein a loop of the cutting wire and a mouth of the tissue retrieval bag are enlarged by the plurality of first and second members.
17. The apparatus of claim 16, further comprising a marker supported within the housing and insertable into the tissue mass, the marker composed of shape memory material and the first and second members surrounding the marker.
18. The apparatus of claim 17, wherein the plurality of first and second members are composed of shape memory material.
19. A surgical biopsy apparatus comprising:
a housing;
a plurality of members advanceable with respect to the housing to provide a boundary for an area of tissue to be removed;
a cutting wire loop advanceable with respect to the plurality of members to cut the area of tissue.
20. The apparatus of claim 19, wherein the cutting wire loop is moved to a larger diameter as it is advanced with respect to the members.
21. The apparatus of claim 20. wherein the cutting wire loop is supported by at least one carrier, the at least one carrier advanceable over one of the plurality of members.
22. The apparatus of claim 21, further comprising a tissue retrieval bag operatively connected to the at least one carrier, wherein advancement of the at least one carrier with respect to the plurality of members advances the cutting wire and the tissue retrieval bag toward the target tissue.
23. The apparatus of claim 22, wherein a mouth of the tissue retrieval bag is moved to a larger diameter as it is advanced with respect to the members.
24. A surgical biopsy apparatus comprising:

a housing;

a plurality of members advanceable with respect to the housing to provide a boundary for an area of tissue to be removed;

a tissue retrieval bag advancable with respect to the plurality of members to remove the area of tissue.
25. The apparatus of claim 24, wherein a mouth of the tissue retrieval bag is moved to a larger diameter as it is advanced with respect to the plurality of members.
26. The apparatus of claim 25, wherein the tissue retrieval bag is supported by at least one, carrier, the at least one carrier advancable over one of the plurality of members.
27. A surgical biopsy apparatus comprising:

a housing having a longitudinal axis;

a plurality of tissue penetrating members extendable with respect to the housing at an angle to the longitudinal axis; and a carrier slidable with respect to the tissue penetrating members for advancing a wire to cut tissue.
28. The surgical biopsy apparatus of claim 27, further comprising a tissue containment bag, the tissue containment bag operatively associated with the carrier so that slidable movement of the carrier advances the tissue containment bag to the target tissue.
29. A method for removing a tissue mass for biopsy comprising:

inserting a cannula to a position proximal of the target tissue mass;
advancing a plurality of tissue penetrating members from the cannula to an angular position to create a boundary area around the tissue mass; and advancing an electrocautery cutting wire with respect to the tissue penetrating members to surround the tissue mass defined within the boundary area.
30. The method of claim 29, further comprising the step of advancing a tissue containment bag with respect to the tissue penetrating members to encapsulate the cut tissue mass for removal.
31. The method of claim 30, wherein the cutting wire and tissue containment bag are advanced substantially simultaneously.
32. The method of claim 31, further comprising the step of passing radiofrequency energy through the cutting wire as the cutting wire is advanced.
33. A method for performing breast biopsy comprising:

inserting into breast tissue a housing having a diameter smaller than a diameter of the tissue to be biopsied;

advancing penetrating members through the breast tissue to create a tissue boundary area having a transverse cross-sectional length greater than the diameter of the housing; and advancing a cutting wire so a loop of the cutting wire moves to a diameter greater than the diameter of the housing.
34. The method of claim 33, further comprising the step of advancing a tissue retrieval bag so a mouth of the bag moves to a diameter greater than the diameter of the housing.
CA2443966A 2001-04-27 2002-04-18 Surgical biopsy device Expired - Fee Related CA2443966C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/844,729 US6626903B2 (en) 1997-07-24 2001-04-27 Surgical biopsy device
US09/844,729 2001-04-27
PCT/US2002/012325 WO2002087447A1 (en) 2001-04-27 2002-04-18 Surgical biopsy device

Publications (2)

Publication Number Publication Date
CA2443966A1 true CA2443966A1 (en) 2002-11-07
CA2443966C CA2443966C (en) 2011-05-17

Family

ID=25293486

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2443966A Expired - Fee Related CA2443966C (en) 2001-04-27 2002-04-18 Surgical biopsy device

Country Status (8)

Country Link
US (3) US6626903B2 (en)
EP (1) EP1392172B1 (en)
JP (1) JP4271946B2 (en)
AU (1) AU2002258866B2 (en)
CA (1) CA2443966C (en)
DE (1) DE60233724D1 (en)
ES (1) ES2331563T3 (en)
WO (1) WO2002087447A1 (en)

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