DE102005062740B3 - Biopsy needle set, gun and biopsy device for the minimally invasive removal of tissue samples - Google Patents

Abstract

A biopsy needle set (200, 200 ') for the minimally invasive removal of tissue samples is described with a hollow shaft, a holding area (211, 211', 221, 221 ', 231, 231') and a holding area (211, 211 ') , 221, 221 ', 231, 231') opposite distal end (212, 212 ', 222, 222', 232, 232 ') having first needle (210, 210', 220, 220 ', 230, 230') and one in the hollow shaft of the first needle (210, 210 ') movable to and fro, a holding area (211, 211', 221, 221 ', 231, 231') and one in the holding area (211, 211 ', 221, 221') , 231, 231 ') opposite distal end (212, 212', 222, 222 ', 232, 232') having second needle (220, 220 '), which in the region of its distal end (222, 222') longitudinally in at least is divided into two halves of the needle. The biopsy needle set (200, 200 ') is characterized by a third needle (230, 230') having a holding area (231, 231 ') and a distal end (232, 232') opposite the holding area, the second needle (220, 220 ') has a hollow shaft for receiving the third needle (230, 230') and both needles (220, 220 ', 230, 230') are arranged to be movable to and fro relative to one another. A shooting device (100, 300) for such a biopsy needle set (200, 200 ') and a biopsy device are also described.

Description

The The invention relates to a biopsy needle set for minimally invasive removal of tissue samples (puncture) with a hollow shaft, a holding area and a distal end having the holding portion first needle and one in the hollow shaft of the first needle back and forth movably arranged, a holding area and a holding area opposite distal end having second needle, which is divided longitudinally in at least two needle halves in the region of its distal end. The invention further relates to a firing apparatus for such Biopsy needle set and a biopsy device.

Such a biopsy needle set is known as a Silverman needle and is used in US 3,001,522 described. In addition, there are essentially two more needle systems for puncture. One is known as the Menghini Needle. A hollow needle is advanced in this Biopsiemethode into the tissue to be examined and then tissue is sucked by means of negative pressure in the needle. The needles used have a comparatively small diameter. This has the advantage that the injury and thus the risk of bleeding is relatively low. On the other hand, no larger tissue samples can be removed in this way.

From the DE 198 06 693 A1 a device for the removal of tumorous tissue is known with an outer, longitudinally slotted hollow needle, an inner expansion needle located in the outer hollow needle and a guide needle guided in the inner expansion needle. This device is typically used for tissue examination of breast cancer. The inner guide needle is brought to the tumor, then introduced the inner expansion needle via the guide needle into the tissue. Thereafter, the outer hollow needle is pushed over the expansion needle and passed over the tumor, which is then located within the distal end of the outer hollow needle. If the expansion needle is then withdrawn, the outer hollow needle contracts radially due to an elastic bias and clamps the tissue around the tumor so that it can be removed.

Furthermore, from the US 5,573,008 a biopsy device for taking tissue samples with an inner cylindrical portion and an inner hollow part surrounding the outer hollow shaft having at its distal end two cutting elements known. The cutting elements are made of an elastic memory alloy and are biased in the closed state. The inner part and the hollow shaft are axially displaceable, it being possible to open the outer hollow shaft by advancing the inner part. If this device is advanced into the tissue and then pulled back the inner part, the cutting elements close, separate the tissue and close it inside so that it can be removed.

Furthermore, the so-called Tru-cut method using the Veres needle is known. Examples of this can be found in the patents US 5,507,298 . US 4,600,014 . US 6,328,701 or in WO 01/54574 A1. All of these systems have a massive inner needle in common, which has a radial recess in the region of its distal end and is arranged to be movable back and forth in an outer hollow needle. The needle system is brought up to the tissue to be removed. Then the inner needle is pushed into the tissue to be examined. The tissue surrounding the inner needle is pressed into the recess due to its elasticity. Subsequently, the hollow outer needle is advanced beyond the region of the recess via the inner needle, wherein the tissue located in the recess is cut and stored in a sealed manner by the outer needle. Subsequently, the needle system is completely removed from the body. Automatic needle guns are known for these needle systems.

This Needle system or the described method is often in particular used for removal of breast tissue. In a liver biopsy (laparoscopy) whereas, i. in the removal of liver tissue, it is often necessary larger tissue samples refer to. So have to here typically tissue cylinder of a length of 16 mm to 18 mm and a diameter of 1.4 mm to 1.8 mm are examined. Especially cirrhotic liver tissue which due to its decomposition does not enough inherent stability and predominantly consists of loose tissue material, can with the described method not be removed in sufficient quantity.

For this purpose, the aforementioned Silverman needle set is much better. When using this system, however, usually a trocar must be used, which is understood as an additional sleeve, which is first pushed through the abdominal wall. Through this trocar, the Silverman needle is then inserted and advanced to the organ tissue in the abdominal cavity. The trocar serves as an insertion aid for fixing the needle. The outer first needle has an obliquely cut tip. In its hollow shaft is an inner needle, which is usually solid at its distal end or at least formed so that the opening of the hollow shaft of the first needle is closed so that when Ein can not already store unwanted tissue material. After the outer needle has been pushed through the trocar into the tissue to be examined up to or already a few millimeters, the inner needle is removed and replaced by a second inner needle, which is divided in its longitudinal direction at least in the region of its distal end. This needle is cut in the area of its tip so that the two halves of the needle spread apart from the hollow needle during further manual advancement. Subsequently, the first needle is advanced with or without a rotating movement over the spread-out needle halves of the second needle. The tissue located between the spread needle halves is compressed and enclosed within the cavity of the outer needle. Thereafter, the needle system is pulled out of the trocar.

adversely is that the stabilization of the second needle is insufficient succeed and therefore a trocar must be used. The advancing the second needle while this spreads out, happens by hand with simultaneous observation the puncture site so that the tissue to be examined does not miss becomes. Automatic actuators are for the Silverman needle not known because the two-part second needle no sufficient inherent stability for one has targeted automatic tissue removal. Without using a Trokars insists on replacing the inner needle with the Silverman needle the risk that the needle assembly is moved unintentionally, so that the tissue to be taken at the puncture site be damaged can.

One Another disadvantage of the known Silverman needle is that the removed tissue sample from the inner needle mechanically by means of a Tool must be removed. This process usually turns up as problematic and leads not infrequently to damage the tissue sample.

Known biopsy devices, like those in the US 3,001,522 presented Silverman needle, are complete disposable systems. Another biopsy device with interchangeable needles, for example, from the US 5,507,298 known. In the latter case, the lid of the actuator must be opened to remove the needles, so that the entire inner life of the actuator is exposed. This results in a not insignificant risk of contamination.

task The present invention is a biopsy needle set, a biopsy device and to create a shotgun easy and safe to handle for this purpose with what in one possible gentle intervention, especially in liver biopsy, a sufficient great and as possible undamaged tissue piece can be removed in a reproducible manner.

The Task is a biopsy needle set of the type mentioned solved, which one a holding area and the holding area opposite distal end having third needle, wherein the second Needle has a hollow shaft and both needles relative to each other is arranged movable back and forth.

By a biopsy needle set consisting of three needles co-linear with each other arranged and relative to each other, i. independently of each other, movable are, the well-known Silverman needle set to be further developed, that a trocar can be dispensed with. One of these three needles serves for prefixing and thus for stabilizing the needle set, by placing a small piece into the tissue before taking the tissue to be examined tissue or organ is inserted. hereby The entire biopsy needle set engages and engages the organ Slippage of the needle assembly during the Gewebent acquisition can be prevented. By waiving one Trocar, the puncture site can be kept relatively small.

Preferably For example, the distal end of the third needle is closed be formed solid.

If closing the distal ends of the three needles substantially flush closes the third Needle the hollow shaft of the split second needle, which in turn closes the hollow shaft of the first needle. Thus, all three needles at once pushed through the abdominal wall and are advanced to the organ to be examined without that this is undesirable Tissue attaches. Replacing the inner needle is not necessary which makes the removal of tissue easier and more precise.

Especially Preferably, the third needle is formed as a hollow needle.

On this way, it can be used to record optical elements for observation and / or lighting or a channel for charging the Examination area with gases, liquids or the like or Have material removed.

Preferably the third needle has an obliquely cut at its distal end Needle point up. This is particularly advantageous if the third needle is used for prefixing.

advantageously, have the three needles at their holding areas each have a connection piece for connection with a gun.

The fittings are preferably arranged coaxially with each other and movable relative to each other.

The third needle preferably has a third in its holding area connector for connecting the third needle with a firing apparatus. The second needle has in its holding area a second connecting piece for connection the second needle with the firing apparatus, wherein the second connector a Cavity for receiving and guiding of the third connector longitudinal the third needle and a passage for the third needle. The first needle has in its holding area a first connection piece for connection the first needle with the firing apparatus, wherein the first connector a Cavity for receiving and guiding of the second connector longitudinal the second needle and a passage for the second needle.

hereby the biopsy needle set forms a separate assembly from the firing apparatus. It can be inclusive the fittings be designed as a disposable part and disposed of after tissue removal be while the firing apparatus disinfected and reusable designed is.

The three needles can also detachable with their fittings be connected so that only the needles after tissue removal to be disposed of. The needles can for example, be plugged onto the connectors.

Around To facilitate the replacement of the biopsy needle set, the three fittings through a detachable Mounting bracket in a mounting position relative to each other fixable be.

Under Mounting position is a position of the three connectors to understand in which the entire biopsy needle set thanks to the fixed relative position preferably connected to the actuator in one step can be.

For this have the first, second and third fittings according to a Beerorzugten embodiment in the mounting position aligned bores, in which the mounting bracket in the form of a mounting pin can be inserted.

Around the assembly of the biopsy needle set with the shooting apparatus continues to facilitate, the first, second and third fittings each first element of a bayonet lock on.

The Task is further by a shot gun for one of the aforementioned Biopsienadelsets with solved three coaxially arranged needles, of which at least two needles are arranged linearly displaceable, with a housing, in a first receptacle for connection to the first needle, a second Recording for connection with the second needle, a third recording are arranged for connection to the third needle and a tensioning device, wherein at least the first and second receivers collinear in the housing arranged and Federdruck- can be acted upon and wherein the tensioning device at least a first and a second clamping device for independently biasing two needles, one acting on the clamping devices common actuated Clamping element which is movable relative to the housing, and at least two trigger elements has, of which a first trigger element to trigger a Vorfixierschusses and a second triggering element for triggering the Sampling shot are provided.

Preferably is the third receptacle in the housing fixed and arranged the firing apparatus with a first operable locking element for holding the first receptacle in a Federdruckbeaufschlagten first clamping position and releasing the first receptacle from the first clamping position, a third actuable Locking element, which is connected to the first triggering element, for Holding the second receptacle in a spring-loaded second Clamping and releasing the second shot from the second Clamping position, a stop element for stopping the second shot in a spring-loaded intermediate position and a second actuated Latching element, which is connected to the second triggering element, for Releasing the second receptacle from the intermediate position.

Becomes an above-described biopsy needle set with such a shooting apparatus according to the invention connected, is a biopsy device ready, which is a tissue sampling on the principle of Silverman needle For the first time also automatically and thus reproducibly exactly possible.

The biopsy will be described below. After the biopsy needle set was first brought to the organ from which tissue is to be removed, the second receptacle is released by actuating the first triggering element and thus the third latching element and the second (middle) needle from the second clamping position by means of spring pressure in the Intermediate position advanced. The second needle penetrates only a few millimeters into the organ and thus fixes the relative position of the biopsy needle set to the organ, without the needle due to their Longitudinal division is already significantly spread.

One then Actuate of the second triggering element and thus the second catch element releases the second receptacle, causing the second needle to continue to be driven by the spring force penetrates into the organ and in the manner described above spreads (removal position). Organ material is now between the needle halves. By subsequent Actuate of the first latching element through the second receptacle becomes the first Recording released and thus the first needle due to spring pressure promoted. It will be between the needle halves of the second needle located organ material compressed and enclosed in the cavity of the second needle.

The third shot and thus the third needle remain stationary relative to the housing the actuator. This needle serves to close the cavity of the second Needle piercing the abdominal wall, eliminating unwanted tissue in the cavity the second needle is accumulated. Furthermore, it serves the simple Delivery of the removed tissue sample from the hollow shaft of the second Needle without that additionally Tools or tools would be needed. For this be in reverse order or at the same time the first and second needle retracted to the first needle, causing the tissue sample is released.

Of the Shot apparatus according to the invention comprises in an alternative embodiment one in the case colinear to the first and second recording reciprocating and spring pressure - actable, third recording, a first actuatable locking element for holding the first receptacle in a spring-loaded first cocking position and releasing the first shot from the first Clamping position, a second actuatable Latching element, which is connected to the second triggering element, for Holding the second receptacle in a spring-loaded second Clamping and releasing the second shot from the second Clamping position and a third actuatable locking element, with connected to the first trigger element is to hold the third intake in a spring-loaded third cocking position and releasing the third shot from the third Clamping position on.

in the Difference to the first alternative of the shooting apparatus or the biopsy device is in this embodiment not the second prefixing needle connected to the firing apparatus of the needle set provided in the organ to be examined, but the third, now also relative to the housing movable needle. These is due to the spring pressure after pressing the first trigger element and thus the third locking element in the intermediate or Vorfixierungsstellung advanced. Subsequently is activated by pressing the second trigger element and thus the second locking element, the second needle on the advanced third needle into the removal position, so that it in turn spreads in the manner described above. Subsequently, will as in the first alternative by operating the first locking element through the second receptacle, the first, outer needle via the second needle by spring pressure pushed into the removal position.

The Advantages of this embodiment are the same as those of the first alternative, namely on the one hand Vorfixierung the needle set is achieved and on the other hand a easy and clean removal of the tissue sample from the cavity of the second Needle by returning the three shots and needles in their initial or clamping position.

In an advantageous development of both the first and the second alternative of the firing apparatus, the first latching element is adapted to after releasing the second recording of this actuated to be and release the first shot.

This allows an automatic triggering of first shot and thus the first needle after the second needle into its spread position in the tissue of the examined Organs has penetrated. While the surgeon in each case when bringing the needles to the organ, before triggering the Vorfixierschusses and the triggering of the removal shot of the second needle can optically track the position of the needles and must, for the quality To ensure the tissue sample, this is before pressing the first locking element no longer necessary. Already by the advance and spreading of the second needle is the tissue sample to be taken namely already set and the location of the second needle anyway no longer visible. A quick one activity the third needle for the removal shot is now even desired and is therefore automatic to avoid unnecessary traumatization.

In a preferred embodiment one of the aforementioned guns, the housing has a central longitudinal axis on, with the linear direction of movement of the images so with the longitudinal axis coincides that the needles are in the longitudinal axis are arranged. The focus of the gun should be on lie a point of the linear direction of movement.

This provides, together with the preferably substantially cylindrical and coaxial ineinan the movably arranged first, second and third connecting pieces of the biopsy needle set for a better balance of the shot apparatus or the entire biopsy specimen. Advantageously, therefore, little or no turning or tilting moments occur during actuation and the risk of an offset of the needles by the actuation of the device is reduced.

In an advantageous development of the shooting apparatus have the three receptacles each one protruding from the housing first, second or third connector, which with the respective associated first, second and third connecting piece connectable is.

The Further development of the firing apparatus or the biopsy device makes it possible that the biopsy needle set from the outside be attached to the firing apparatus and more precisely to the connectors can. The connectors can in each case a second element of a bayonet closure for connection with the first element of the bayonet closure of the associated connecting piece exhibit.

The Biopsy needle set can be disposed of as disposable after tissue removal be while the actuator only in the area of the connecting pieces outside of the housing comes in contact with the needles and thus easy to disinfect is. This results in costs and time advantages in and follow-up of a puncture.

Preferably are the two trigger elements at the front of the case arranged one behind the other.

Preferably is the first trigger element behind the second trigger element arranged. When the firing apparatus is held in the hand, lies the first trigger element the next hand.

The first trigger element is preferably a push button. The first triggering element can thus be simple Way, z. B. with the thumb, are triggered.

Around the second of the first trigger element clearly to distinguish, the second trigger element is preferably as a slide educated.

In order to an unintentional actuation of the second trigger element before the operation of the first triggering element is avoided, the second trigger element by means of a locking plate be covered, preferably mounted slidably on the housing is.

The Backup plate can in a further embodiment, both triggering elements cover.

Preferably the common clamping element is a rotatable about the longitudinal axis of the housing Housing part. With that you can all needles by pressing a single clamping element moves in its initial position and be tense.

to Determining the front end position of the recordings is at least in the housing arranged a stop. For Each recording can be provided with its own stop. This Stop or these attacks subject by the sudden load high wear, so that the stop or the stops preferably arranged interchangeable.

According to one particular embodiment a joint attack for all recordings provided, which may also be arranged interchangeable can.

Of the or the attacks can at least one side with a damping lining, z. B. an elastomeric pad, be provided. When triggering the Needles become the forces mitigated when striking the recordings on the attack or the attacks. The Handling the gun with the forces necessary for Punktionen large spring forces is so simplified and safer. Furthermore, the shotgun becomes less huge forces exposed, especially when triggered without puncture, for example before changing the needles or after taking the sample.

Of the damping coating can also be interchangeable mounted on the stop. A two-sided Assignment of the attack (s) by means of a damping lining is an advantage, even during the clamping process on the stop acting forces mitigate. By double-sided or multi-sided occupancy with Damping pads can the Stopped stop be stored so that the shocks when Trigger the shooting apparatus not or only to a small extent on the Housing transferred become.

The Providing a common stop has the further advantage that he is centric in the case can be arranged, creating a one-sided load on the record abutting shots and thus prevents tilting becomes.

Of the Stop may be, for example, a bolt that extends through the with, for. B. oblong holes, provided Shooting extends

The biopsy device according to the invention is formed by the firing apparatus with the biopsy needle set attached thereto.

Further Advantages and features of the biopsy needle set according to the invention, the firing apparatus according to the invention and the biopsy device according to the invention from the following description of the figures of individual embodiments.

It demonstrate:

1 a schematic representation of the biopsy device according to the invention according to a first embodiment with a fixed third needle;

2 the biopsy device according to 1 after manual insertion through the abdominal wall;

3 the biopsy device according to 1 after actuation of the third latching element in the prefixed intermediate position;

4 the biopsy device according to 1 after actuation of the second locking element with spread second needle;

5 the biopsy device according to 1 after actuation of the first locking element with advanced first needle;

6 the biopsy device according to 1 after tissue sampling;

7 the biopsy device according to 1 with needles placed in clamping position and approved trial cylinder;

8th a schematic representation of a second embodiment of the biopsy device with a hollow inner needle;

9 a schematic representation of a third embodiment of the biopsy device with movable inner needle;

10 the biopsy device according to 9 after it has been manually inserted through the abdominal wall;

11 the biopsy device according to 9 after pressing the third locking element with advanced third needle for prefixing;

12 the biopsy device according to 9 after actuation of the second locking element with spread second needle;

13 the biopsy device according to 9 after actuation of the first locking element with advanced first needle;

14 the biopsy device according to 9 with needle in clamping position and released sample cylinder;

15 a cutaway detail view of the fittings of the biopsy needle set according to the invention;

16 a detailed view of the distal needle ends of the biopsy needle set according to the invention;

17 an embodiment of the shot apparatus partially in a sectional view;

18 the firing apparatus according to 17 in another illustration without locking plate;

19 a cutout enlargement 18 and

20 a schematic representation of the shooting apparatus with a single stop.

The biopsy device according to 1 has a gun 100 and a biopsy needle set connected thereto 200 on. The shotgun 100 has a housing 102 in which a tensioning device 103 with two clamping devices 119 . 129 is arranged. In the housing is a first shot 110 for connection to a first needle 210 of the biopsy needle set 200 linearly arranged to and fro. The first shot 110 is in accordance with 1 in a relaxed front position, which is also a front removal position of the first needle 210 and one on the first shot 110 acting elongated first compression spring 114 equivalent.

The housing 102 also includes a second shot 120 for a second needle 220 of the biopsy needle set 200 one. Also the second shot 120 is in accordance with 1 in a front relaxed position and the second needle 220 in the corresponding front removal position (see also 5 ). A compression spring acting on the second receptacle 124 is stretched too.

The pictures 110 . 120 lie in the described positions on the associated attacks 118 . 128 at.

The shotgun 100 also has a in the housing 102 fixedly arranged third recording 130 for connection with a third needle 230 of the biopsy needle set 200 on. The pictures 110 . 120 . 130 are coaxially arranged and movable relative to each other in the axial direction. They are located in the longitudinal axis 106 of the housing 102 of the shooting apparatus 100 ,

In the case 102 are also a first, second and third actuable locking element 112 . 122 . 132 arranged, wherein the second locking element 122 Part of the second trigger element 105 and the third locking element 132 Part of the first trigger element 104 is.

In 2 the biopsy device is shown in action. The first shot 110 and the first needle 210 are in their (first) clamping position and are in this by means of the first locking element 112 held. In this first clamping position is the first shot 110 by means of the first spring 114 in the direction of the biopsy needles 210 . 220 . 230 biased.

Also the second shot 120 is in accordance with 1 in its (second) clamping position in which they by means of the third locking element 132 is held. In this position, the second shot 120 by means of the second spring 124 with a spring force in the direction of the biopsy needles 210 . 220 . 230 applied.

The biopsy device is in 2 after manual insertion through the abdominal wall 10 of a patient to the edge of the organ to be examined 20 advanced. In the fully tensioned state of the gun are those with the three shots 110 . 120 . 130 Connected biopsy needles 210 . 220 . 230 relative to each other so arranged that their distal ends 212 . 222 . 232 essentially flush. This ensures that it is in the area of the distal ends 212 . 222 . 232 do not form any cavities in which the puncture and delivery of the biopsy needle set 200 through the abdominal wall to accumulate unwanted tissue material to the organ to be examined.

In 3 is the second shot 120 after triggering the Vorfixierungsschusses shown in their intermediate position. The movement into the intermediate position takes place by actuating the first triggering element 104 and thus the third latching element 132 due to the spring force of the spring 124 , A latch 136 on the third locking element 132 is by engaging the same out of engagement with the second receptacle 120 weggeschwenkt so that it is released. The second shot 120 is from the second locking element 122 , ie more precisely of a molded on this third pawl 126 stopped and held in the intermediate position.

In this position is the second needle 220 advanced into a Vorfixierstellung in which they with their distal end 222 a few millimeters into the organ to be examined 20 and thus the biopsy needle set 200 relative to the organ 20 holds in position. Depending on the nature of the organ, a penetration depth of 10 mm, preferably 5 mm and particularly preferably 3 mm is sufficient. The surgeon can now endoscopically the proper location of the biopsy needles 210 . 220 . 230 check and if necessary repeat the prefixing. Here, only a minor tissue damage is accepted. On the other hand, an organ removal with known silverman biopsy needles involves the risk that, due to the lack of prefixing, the needles may have missed the organ site to be examined and yet a removal of a tissue sample can no longer be prevented. The resulting organ damage is significantly reduced when using the biopsy device according to the invention.

By pressing the second trigger element 105 and thus the second locking element 122 becomes its catch 126 swung away and the second shot 120 released until the second stop 128 vorschnellt. In 4 is shown a snapshot in which after actuation of the second locking element 122 the still tensioned spring in the intermediate position 124 by means of the second shot 120 the second needle 220 continue into the organ 20 pushed on. In the illustrated end or removal position of the second needle 220 this is in the area of its distal end 222 spread in the needle halves 227a . 227b , The typically 10 to 30 mm long puncture cylinder 30 is now punched out.

In 5 is the biopsy device in the fully relaxed state after pressing the first locking element 112 shown. In this position is also the first shot 110 moved forward to the front end or removal position, in which they to the first stop 118 rests, causing the first needle 210 the second needle 220 again almost completely encloses. As a result, this is in the previously spread distal region of the second needle 220 located tissue compressed and fixed there by wall friction forces. To remove the tissue sample 30 becomes the biopsy needle set 200 simply from the organ 20 and the abdomen of the patient. The tissue is torn off, causing only minimal damage to the organ, cf. 6 ,

The actuation of the first locking element 112 takes place in the illustrated embodiment automatically by the second recording 120 after manual actuation of the second latching element 122 to the first locking element 112 drives up. Here she gets into engagement with a projection 117 on the first latching element 112 which then performs a pivoting movement. A lead 117 opposite to the first locking element 112 molded latch 116 So gives the first shot 110 free to move. The movement is due to the previously still completely strained on the first shot 110 acting spring 114 set in motion.

To remove the sample, the biopsy device is returned to its original state 1 transferred by the recordings in their tensioned position and the springs are tensioned. This happens, for example, by a rotary movement of an outer sleeve of the firing apparatus 100 , which generates a linear movement of the recordings by means of a screw curve, as in connection with 17 will be explained in more detail. In 7 the transfer of the biopsy specimen is shown in this starting position. It can be seen that the retraction of the first and second needles 210 . 220 relative to the third needle 230 causes with the latter also the removed tissue sample 30 automatically from the hollow shaft of the second needle 220 is released. In this way, the tissue sample becomes 30 Removed particularly gently and without the aid of a tool from the biopsy needle set.

Another embodiment of the biopsy device according to the invention is in 8th shown. It differs from the previous one in that also the inner, third needle 230 ' as well as the third needle holder 130 ' have a hollow profile. Shown is an embodiment with two channels formed in this way 140 . 142 which can be used to supply an optical image capture device, a lighting device (both for example in the form of fiberglass or other optical fiber elements), for the introduction of gases, liquids or the like., Or the removal of material. Due to the multi-functionality thus obtained, the use of a trocar can be completely dispensed with. Due to the small cross section of the needle assembly, stitching of the puncture site can even be avoided.

A further embodiment of the biopsy device according to the invention is in the 9 to 14 shown. It is described only insofar as it according to that 1 to 7 otherwise, the description above applies.

The biopsy device according to 9 differs from that of the embodiment according to 1 to 7 on the one hand by the interchangeability of the biopsy needle set 200 ' , which is demonstrated by the exploded view. On the other hand, the biopsy device points 300 a different kinematics of the shooting apparatus 300 on. The interchangeability of the therefore designed as a disposable biopsy needle set 200 ' However, in principle it is not due to the different kinematics of the gun 300 conditionally, but only by the out of the housing of the shotgun 300 outstanding connectors 311 . 321 . 331 the needle recordings, cf. 15 ,

The shotgun 300 differs from the previous shooting apparatus 100 constructive in that a coaxial with the first and second recording 310 . 320 movable third shot 330 and a third spring driving them 334 is provided. Thus, now all three needle holders and needles are included in the kinematics. In 9 are all three shots for mounting the needle set 200 ' shown in the front end position. Here are the shots 310 . 320 . 330 at these associated attacks 318 . 328 . 338 at. All three associated springs 314 . 324 . 334 are stretched, though not completely relaxed. The tensioning device 303 thus has a total of three clamping devices 319 . 329 . 339 on.

In 10 the biopsy device is already through the abdominal wall 10 to the organ 20 introduced. It is ready to use, ie fully tensioned. The third recording 330 is in its tension position by means of the third locking element 332 or by means of the management on the third Rastele 332 arranged latch 336 held. Will be the first trigger element 304 with the third locking element 332 pressed to release, accelerates the third spring 334 the third recording 330 , which together with the third needle to the third with the housing 302 connected stop 338 by a distance of a few millimeters forward, with the third needle penetrating the organ about this way and pre-fixing the needle set relative to the organ. This position is in 11 shown.

By actuating the second trigger element 305 with the second locking element 322 becomes the second shot in the manner described above 320 released for forward movement. This ends at the second with the housing 302 connected stop 328 , In this removal position of the recording 320 is the second needle 220 ' again typically 10 to 30 mm into the organ 20 penetrated and spread at its distal end, cf. 12 ,

As described above operated at the end of its forward movement, the second shot 320 over the lead 317 automatically the first locking element 312 , see. 12 which is the first recording 310 in the manner described above for forward movement releases. This ends again with the case 302 associated associated stop 318 , In this position is the second needle 220 ' almost completely in the hollow shaft of the first needle 210 ' arranged and between the previously spread distal ends of the second needle 220 ' located tissue material compressed and fixed by the wall friction in the hollow shaft, see. 13 ,

After removing the biopsy needle set from the abdomen, the tissue sample taken is 30 through the needles 210 ' . 220 ' . 230 ' released by now all three shots 310 . 320 . 330 be returned to their clamping position either simultaneously or in reverse order, as 14 can be seen.

15 shows the needles 210 ' . 220 ' . 230 ' according to a further embodiment in the region of its holding sections 211 ' . 221 ' . 231 ' in a detailed view. The needles have there respectively a first, second and third connection piece 214 ' . 224 ' . 234 ' for connection to the shotgun 300 on. The needles and connecting pieces can be arranged in a mounting position in which they can be fixed relative to one another by means of a mounting bracket. For this purpose, the first, second and third connection piece 214 ' . 224 ' . 234 ' in this mounting position mutually aligned bores (not shown), in which a mounting pin (not shown) can be inserted.

In this mounting position, the three needles can be attached sequentially from the inside to the outside of the gun. This can be found on the sides facing away from the needles of all three connectors 214 ' . 224 ' . 234 ' each a first element of a bayonet closure 216 ' . 226 ' . 236 ' , This corresponds with a respective second element of the bayonet closure 311 . 321 . 331 , which in each case one assigned, from the housing 302 outstanding first, second and third connector of the recordings 310 . 320 . 330 (not shown) is arranged. Alternatively to the in 15 illustrated mounting position of the needle set 200 ' Also, all three needles can be connected at once, for example by the screw or bayonet with the firing apparatus.

Good to see is the coaxial arrangement of all fasteners and the needles and the shotgun 300 This ensures the highest degree of balance in handling and thus a low risk of slippage or blurring of Biop siegeräts or needles due to turning or tilting moments during its operation.

16 shows the distal needle ends 212 . 222 . 232 of the biopsy needle set according to the invention in a detailed view. All needle tips 213 . 223 . 233 are bevelled. The second, middle needle 220 is in her distal section 222 divided in two. The tips 223 the needle halves 227a , B are cut obliquely on the sides facing each other, so that they form a V-shape. As a result, force components act on the second end of the needle when penetrating into the organ tissue 222 through which the second needle automatically spreads.

In 17 is the shotgun 300 shown in a partially sectioned illustration. It becomes such a tensioning device 303 recognizable by means of a rotary movement of an outer sleeve 352 generates an axial translational movement of the outer first, the middle second and the inner third needle receptacles and needles. This is in the sleeve 352 a screw curve 354 incorporated into the one with the recordings (you can see only the third shot 310 ) connected pin or cam 356 intervenes. At the end of the linear movement, ie in the clamping position of the recordings, they snap back into the assigned first, second and third latching elements. This clamping position is in 17 shown. The rotatable sleeve can then be turned back, for example, acted upon by a spring force. In this basic position of the sleeve gives a straight slot 358 the pencil 356 for forward movement upon actuation of the locking elements free.

Good to see is a coaxial arrangement of all moving drive elements of the shotgun 300 namely the recordings 310 . 320 . 330 and the springs 314 . 324 . 334 , whereby turning or tilting moments are largely avoided when operating the Biopsiegeräts and so the handling is facilitated.

The second and third locking elements 322 . 332 are by means connected to these first and second triggering elements 304 . 305 which is on the top of the housing 302 stand out, actuated. In this case, the second trigger element 305 designed as a slide and the first trigger element 304 as a push button, to avoid confusion during operation. The two trigger elements 304 . 305 can only be operated when the backup plate 306 has been pushed back.

In the 18 is the in 17 shown firing apparatus 300 shown again, with the backup plate 306 was omitted and the shooting apparatus against the representation in 17 has been turned. In the 18 is behind the first trigger element 304 the stop common to all recordings 348 arranged in the enlarged detail view according to 19 can be seen more clearly. The joint attack 348 consists essentially of a cuboidal element, which at the two longitudinal end faces in each case with a damping strip 341 . 342 is occupied. Of the 19 it can be seen that these damping strips 341 . 342 a semicircle have a shaped cross-section. The joint attack 348 is in the center of the shotgun 300 arranged and extends through the shots 310 . 320 . 330 , The pictures 310 . 320 . 330 have corresponding slots 349 . 350 . 351 and are in clamping position with the front end of the slots 349 . 350 . 351 on the damping pad 342 and in its front end position with its rear end 343 . 344 . 345 on the damping pad 341 at.

In the 20 concerning the position of the needles of the needle set 13 matches, it can be seen that the three shots 310 . 320 . 330 with the respective rear end 343 . 344 . 345 their longholes 349 . 350 . 351 together by the housing 302 extending stop 348 issue. The long holes 349 . 350 . 351 are different lengths.

10

abdominal wall

20

organ

30

sample cylinder

100

shooting mechanism

102

casing

103

jig

104

first trigger element

105

second trigger element

106

longitudinal axis

110

first admission

112

first locking element

114

first feather

116

first pawl

117

head Start

118

first attack

119

tensioning device

120

second admission

122

second locking element

124

second feather

126

second pawl

128

second attack

129

tensioning device

130

third admission

132

third locking element

136

third pawl

140

channel

142

channel

200 200 '

Biopsienadelset

210 210 '

first needle

211 211 '

(First) holding area

212 212 '

(First) distal end

213

pinpoint

214 '

first connector

216 '

bayonet catch

220 220 '

second needle

221 221 '

(Second) holding area

222 222 '

(Second) distal end

223

pinpoint

224 '

second connector

226 '

bayonet catch

227a, b

needle half

230 230 '

third needle

231 231 '

(Third) holding area

232 232 '

(Third) distal end

233

pinpoint

234 '

third connector

236 '

bayonet catch

300

shooting mechanism

302

casing

303

jig

304

first triggering element

305

second triggering element

306

locking plate

310

first admission

311

joint

312

first locking element

314

first feather

316

first pawl

317

head Start

318

first attack

319

jig

320

second admission

321

second joint

322

second locking element

324

second feather

326

second pawl

328

second attack

329

tensioning device

330

third admission

331

third joint

332

third locking element

334

third feather

336

third pawl

338

third attack

339

tensioning device

341

bumper strips

342

bumper strips

343

rear The End

344

rear The End

345

rear The End

348

attack

349

Long hole

350

Long hole

351

Long hole

352

Sleeve, clamping element

354

screw curve

356

Pen, cam

358

slot

Claims (27)

Biopsy needle set for the minimally invasive removal of tissue samples with a hollow shaft, a holding area ( 211 . 211 ' ) and a holding area opposite distal end ( 212 . 212 ' ) having a first needle ( 210 . 210 ' ) and one in the hollow shaft of the first needle ( 210 . 210 ' ) arranged to move back and forth, a holding area ( 221 . 221 ' ) and a holding area opposite distal end ( 222 . 222 ' ) having a second needle ( 220 . 220 ' ), which at least in the region of its distal end ( 222 . 222 ' ) longitudinally in at least two needle halves ( 223a , b) is divided, characterized by a holding area ( 231 . 231 ' ) and a holding area opposite distal end ( 232 . 232 ' ) third needle ( 230 . 230 ' ), the second needle ( 220 . 220 ' ) a hollow shaft for receiving the third needle ( 230 . 230 ' ) and both needles ( 220 . 220 ' . 230 . 230 ' ) are arranged to be movable relative to each other back and forth. Biopsy needle set according to claim 1, characterized in that the distal end ( 232 . 232 ' ) of the third needle ( 230 . 230 ' ) closed is. Biopsy needle set according to one of the preceding claims, characterized in that the third needle ( 230 . 230 ' ) is designed as a hollow needle. Biopsy needle set according to one of claims 1 to 2, characterized in that the third needle ( 230 . 230 ' ) at its distal end ( 232 . 232 ' ) an obliquely cut needle point ( 233 ) having. Biopsy needle set according to one of claims 1 to 4, characterized in that the three needles ( 210 . 210 ' . 220 . 220 ' . 230 . 230 ' ) at their holding areas ( 211 . 211 ' . 221 . 221 ' . 231 . 231 ' ) each a connector ( 214 ' . 224 ' . 234 ' ) for connection to a gun. Biopsy needle set according to claim 5, characterized in that the connecting pieces ( 214 ' . 224 ' . 234 ' ) are arranged coaxially with each other and movable with each other. Biopsy needle set according to one of claims 5 to 6, characterized in that at least one needle ( 210 . 210 ' . 220 . 220 ' . 230 . 230 ' ) detachable with its connection piece ( 214 ' . 224 ' . 234 ' ) connected is. Biopsy needle set according to one of claims 5 to 7, characterized in that the first, second and third connecting piece ( 214 ' . 224 ' . 234 ' ) each a first element of a bayonet closure ( 216 ' . 226 ' . 236 ' ) having. Biopsy needle set according to one of claims 5 to 7, characterized in that the first, second and third connecting pieces ( 214 ' . 224 ' . 234 ' ) are fixable relative to each other by a detachable mounting bracket in a mounting position. Biopsy needle set according to claim 9, characterized in that the first, second and third connecting pieces ( 214 ' . 224 ' . 234 ' ) in the mounting position mutually aligned bores ( 240 ), in which the mounting bracket in the form of a mounting pin can be inserted. Firing apparatus ( 100 . 300 ) for a biopsy needle set ( 200 . 200 ' ) with three coaxially arranged needles ( 210 . 210 ' . 220 . 220 ' . 230 . 230 ' ), of which at least two needles are arranged linearly displaceable, with a housing ( 102 . 302 ), in which a first photograph ( 110 . 310 ) for connection to the first needle ( 210 . 210 ' ), a second recording ( 120 . 320 ) for connection to the second needle ( 220 . 220 ' ), a third recording ( 130 . 330 ) for connection to the third needle ( 230 . 230 ' ) and a tensioning device ( 103 . 303 ) are arranged. wherein at least the first and the second receptacle are arranged co-linearly movable in the housing and can be acted upon by spring pressure, and wherein the tensioning device comprises at least a first and a second tensioning device ( 119 . 129 . 319 . 329 . 339 ) for independently biasing two needles, one on the tensioning devices ( 119 . 129 . 319 . 329 . 339 ) engaging jointly actuable clamping element ( 352 ), which relative to the housing ( 102 . 302 ) is movable, and at least two triggering elements ( 104 . 105 . 304 . 305 ), of which a first triggering element ( 104 . 304 ) for triggering a Vorfixierschusses and a second trigger element ( 105 . 305 ) are provided for triggering the sampling shot. Firing apparatus ( 100 . 300 ) according to claim 11, characterized in that the third receptacle ( 130 . 330 ) in the housing ( 102 . 302 ) is arranged stationary, wherein the firing apparatus a first actuatable locking element ( 112 . 312 ) to hold the first shot ( 110 . 310 ) in a spring-loaded first clamping position and releasing the first receptacle ( 110 . 310 ) from the first clamping position, a third actuatable locking element ( 132 . 332 ) connected to the first triggering element ( 104 . 304 ) for holding the second recording ( 120 . 320 ) in a spring-loaded second clamping position and releasing the second receptacle ( 120 . 320 ) from the second clamping position, a stop element for stopping the second receptacle ( 120 . 320 ) in a spring-loaded intermediate position and a second actuatable locking element ( 122 . 322 ), which with the second trigger element ( 105 . 305 ) for releasing the second recording ( 120 . 320 ) has from the intermediate position. Firing apparatus ( 100 . 300 ) according to claim 11, characterized that the third recording ( 130 . 330 ) in the housing ( 102 . 302 ) colinear to the first and second recordings ( 110 . 120 . 310 . 320 ) and spring pressure can be acted upon, wherein the firing apparatus a first actuatable locking element ( 112 . 312 ) to hold the first shot ( 110 . 310 ) in a spring-loaded first clamping position and releasing the first receptacle ( 110 . 310 ) from the first clamping position, a second actuatable locking element ( 122 . 322 ), which with the second trigger element ( 105 . 305 ) for holding the second recording ( 120 . 320 ) in a spring-loaded second clamping position and releasing the second receptacle ( 120 . 320 ) from the second clamping position, and a third actuatable locking element ( 132 . 332 ) connected to the first triggering element ( 104 . 304 ) for holding the third recording ( 130 . 330 ) in a spring-loaded third clamping position and releasing the third receptacle ( 130 . 330 ) has from the third clamping position. Firing apparatus ( 100 . 300 ) according to claim 12 or 13, wherein the first latching element ( 112 . 312 ) after releasing the second recording ( 120 . 320 ) to be actuated by this and the first recording ( 110 . 310 ). Firing apparatus ( 100 . 300 ) according to one of claims 11 to 14, wherein the housing ( 102 . 302 ) a central longitudinal axis ( 106 ), and wherein the linear direction of movement of the images ( 110 . 120 . 130 . 310 . 320 . 330 ) coincides with the longitudinal axis so that the needles ( 210 . 210 ' . 220 . 220 ' . 230 . 230 ' ) are arranged in the longitudinal axis. Firing apparatus ( 100 . 300 ) according to one of claims 11 to 15, wherein the first, second and third recordings ( 110 . 120 . 130 . 310 . 320 . 330 ) one each out of the housing ( 102 . 302 ) outstanding first, second or third connector ( 311 . 321 . 331 ), which with the respectively associated first, second and third connecting piece ( 214 ' . 224 ' . 234 ' ) is connectable. Firing apparatus ( 100 . 300 ) according to claim 16, wherein the first, second and third connecting pieces ( 311 . 321 . 331 ) each have a second element of a bayonet closure for connection to the first element of the bayonet closure ( 216 ' . 226 ' . 236 ' ), of the associated connection piece ( 214 ' . 224 ' . 234 ' ) having. Firing apparatus ( 100 . 300 ) according to one of claims 11 to 17, wherein the two triggering elements ( 104 . 105 . 304 . 305 ) at the front of the housing ( 102 . 302 ) are arranged one behind the other. Firing apparatus ( 100 . 300 ) according to claim 18, wherein the first triggering element ( 104 . 304 ) behind the second trigger element ( 105 . 305 ) is arranged. Firing apparatus ( 100 . 300 ) according to one of claims 18 or 19, wherein the first triggering element ( 104 . 304 ) is a push button. Firing apparatus ( 100 . 300 ) according to one of claims 18 to 20, wherein the second triggering element ( 105 . 305 ) is a slider. Firing apparatus ( 100 . 300 ) according to one of claims 18 to 21, wherein at least the second triggering element ( 105 . 305 ) by means of a locking plate ( 306 ) is coverable. Firing apparatus ( 100 . 300 ) according to one of claims 11 to 22, wherein the common clamping element ( 352 ) one about the longitudinal axis ( 106 ) of the housing ( 102 . 302 ) is rotatable housing part. Firing apparatus ( 100 . 300 ) according to one of claims 11 to 23, characterized in that in the housing ( 102 . 302 ) at least one stop ( 118 . 128 . 318 . 328 . 338 . 348 ), on which the recordings ( 110 . 120 . 130 . 310 . 320 . 330 ) abut in their front end position. Firing apparatus ( 100 . 300 ) according to claim 24, characterized in that the stop ( 118 . 128 . 318 . 328 . 338 . 348 ) is arranged interchangeably. Firing apparatus ( 100 . 300 ) according to claim 24 or 25, characterized in that the stop ( 118 . 128 . 318 . 328 . 338 . 348 ) at least one side a damping pad ( 341 . 342 ) having. Biopsy device for the minimally invasive removal of tissue samples with a firing apparatus ( 100 . 300 ) according to one of claims 11 to 26 and with an associated biopsy needle set ( 300 . 300 ' ) according to one of claims 1 to 10.