US3289669A - Biopsy capsule arrangement - Google Patents

Biopsy capsule arrangement Download PDF

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US3289669A
US3289669A US347270A US34727064A US3289669A US 3289669 A US3289669 A US 3289669A US 347270 A US347270 A US 347270A US 34727064 A US34727064 A US 34727064A US 3289669 A US3289669 A US 3289669A
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shell
capsule
blade
port
members
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Donald J Dwyer
Raymond C Piccony
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other 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
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/04Endoscopic instruments

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  • This invention relates to apparatus of the type employed to -obtain a specimen of body tissue, known as a biopsy, from the lining of the human gastrointestinal tract, and more particularly to an improved biopsy capsule.
  • the invention comprehends an instrument adapted to greatly facilitate investigation of the human gastrointestinal tract for medical purposes.
  • Apparatus of this type currently in use includes a capsule or cutting and receiving device which is attached to the lower end of a multi-lumen tube and one -or more syringes or other hydraulic instruments which are connected to the upper end of the tube.
  • the hydraulic instruments are manipulated to cause the cutting element of the capsule to sever a porti-on of the lining from the gastrointestinal tract. This severed specilmen is retained within the capsule which is withdrawn from the body.
  • a great disadvantage of the equipment presently available for this type of work is that the capsule must be removed from the body of the patient in order to determine absolutely whether a biopsy was successfully performed.
  • the specimen taken In order for the biopsy to be successful, the specimen taken must be retrieved without being damaged or mutilated, so that it will be of value for histological study. Also, it is highly desirable to take more than one biopsy at different locations in the gastrointestinal tract with one insertion of the biopsy equipment.
  • ⁇ It is therefore a primary object of this invention to provide an improved biopsy capsule arrangement of simple design, construction, and operation which will make it possible for any physician to take a successful biopsy as a routine matter.
  • a further object of the invention is the provision of a biopsy capsule arrangement which is acceptable to the patient on whom the biopsy is to be performed.
  • Another object of the invention is to provide a biopsy capsule which will permit the taking and retrieving of one or more biopsys from the gastrointestinal tract of a person without requiring removal of the capsule and attached tube.
  • Still another object of the invention is the provision of a biopsy capsule especially adapted to insure the preservation of architecture and detail of the specimens taken for histological study.
  • a more specic object of the invention is the provision of a biopsy apparatus including a capsule having a hollow cylindrical shell member with a port having a cutting edge, a telescoping hollow cylindrical blade member with a cooperating cutting edge; linternal spring means operable to urge the members away from each .other to maintain the capsule in an open .position until it is in position for a biopsy; and hydraulic -means operable to draw a portion of the lining of the .gastrointestinal tract through the port into the capsule shell to overcome the resistance of the spring means to close the capsule and sever the tissue which -has been drawn into the capsule, and to retrieve the tissue through a tube without removing the capsule.
  • FIGURE 1 is a perspective View of a biopsy capsule embodying features of the invention, shown attached to the equipment with which it is normally used;
  • FIGURE 2 is an enlarged front elevation of the capsule illustrated in FIGURE 1;
  • FIGURES 3 and 4 are transverse sections taken on lines 3 3 and 44, respectively of FIGURE 2;
  • FIGURE 5 is a side elevation of the blade of the capsule illustrated in FIGURE 2;
  • FIGURE 6 is a top plan of the structure illustrated in FIGURE 5;
  • FIGURE 7 is a longitudinal section take on line 7-7 of FIGURE 2, with the blade of the capsule shown in the lowered or open position;
  • FIGURE 8 is a view similar to FIGURE 7, but with ,the blade of the capsule shown in the raised or closed position;
  • FIGURES 9, l0, 1l, and 12 are side elevations of the capsule of FIGURE 1, with portions of the structure broken away, illustrating various positions of the capsule elements as it is used to take a biopsy.
  • FIGURE 1 a biopsy capsule, indicated generally at C, is shown in FIGURE 1 attached to the Vlower end of a double-lumen, plastic tube the upper end of which is attached to a syringe,indicated gene-rally at S and a bottle, indicated generally at B, in a manner described in detail later in the specification.
  • the capsule as best seen in FIGURE 2, ⁇ includes a hollow, cylindrical shell 10 ⁇ which is open at both its upper and lower ends.
  • At its upper end shell 10 presents a threaded shoulder portion 12 adapted for connection to a cap 30 in a manner hereinafter described.
  • shell 10 At its lower end shell 10 presents an integrally formed boss or cam lug 14 which projects a slight distance into the interior cavity or bore 16 of the shell for cooperation with a complementary cam track of a blade 50, in a manner hereinafter described.
  • outer surface of shell 10 may be provided with a knurled or otherwise roughened surface, as at 18,
  • FIGURE 2 there is provided in the side of the shell downwardly adjacent shoulder portion 12, a somewhat triangularly or tear drop shaped opening or port 20, through which the specimen passes as the biopsy is taken, as shown in FIGURE l0, in a manner hereinafter described.
  • the lower edge 22 of port 20 is preferably V-shaped and is tapered to present an inwardly inclined surface to facilitate entry of the body tissue into the port.
  • the upper edge 24 of the port is the tissue cutting edge of the shell which is adapted to cooperate with a related cutting edge of the blade in a scissor-like action, as hereinafter described.
  • Shell cutting edge 24 is generally straight and flat and is inclined at an angle relative to the longitudinal axis of the shell.
  • the threaded shoulder portion 12 of the cap is detachably secured within a telescoping skirt portion 32 of a cap 30, to close the upper end of the shell.
  • Cap 30 includes a downwardly and outwardly aring funnel shaped top wall or dome portion 34 which is formed integrally with skirt portion 32. It will be noted that the outer diameter of the cap skirt Iportion is the same as that of the main portion f the shell, so that when the cap and shell are threaded together they present an uninterrupted cylindrical outer surface.
  • the dome portion of the cap presents a hollow neck or nozzle 36, having a throat or bore 38 extending therethrough in communication with the interior of the shell.
  • the neck projects above the remainder of the dome portion of the cap and is adapted to be telescopically received within the first or larger of the lumens of tube T, as hereinafter described.
  • the engagement between the cap neck and the tube is a friction t wherein the tube, which has the same inner diameter as the bore of the neck, is forced over the end of the neck.
  • the former may be provided with one or more external, annular beads or ridges 40.
  • Dome portion 34 of the cap is also provided with a relatively small opening or passageway 42 disposed on the side of the neck opposite from the side in which the shell port is located. Opening 42 is disposed to afford communication between the second or smaller lumen of tube T and the interior of the shell. Opening 42 also has an additional function which is to receive and position the upper end of a spring in a manner hereinafter described in the specification.
  • the capsule includes a generally cylindrical, hollowpblade 50 open at the upper end and closed at the lower end by a smooth spherical bottom wall 52.
  • the side wall 54 of the cap has an outer diameter only slightly less than the inside diameter of the shell, so that when the blade is telescoped within the shell the former is afforded limited rotative and axial movement relative to the latter.
  • Side wall 54 of the blade is provided with a generally vertically disposed, spiral, outer groove or cam track 56, adapted to receive and cooperate with cam lug 14 to effect relative rotative movement between the blade and shell as the former moves axially up into the latter.
  • Cam track 56 is open at its lower end to permit the cam lug to enter the cam track as Athe lower end of the blade is inserted into the shell through the upper end of the latter, and the cam track is closed at its upper end to retain the cam lug of the shell within the cam track and thereby prevent the blade from passing completely out of the lower end ofthe shell.
  • approximately two thirds of the upper end of the blade, on the side remote from the cam track, is recessed and presents a at cutting edge 58 which is preferably inclined at an angle of approximately l5 degrees relative to the longitudinal axis of the blade.
  • the cutting edge 58 of the blade is arranged and disposed to cooperate with shell cutting edge 24 to create a scissorlike cutting movement as the blade ascends into the shell from the position shown in FIGURE 7 to the position shown in FIGURE 8.
  • FIGURE 7 iby rniean's of a spiral wound band spring 60 which is positioned within the capsule with its larger, lower end or base 62 seated against the inside surface of the bottom wall of the blade and with its smaller, upper end or tip seated within opening 42 of the cap dome.
  • opening 42 is on the opposite side of the capsule from port 20, so that the upper end of the spring is inclined away from the port at all times.
  • the purpose of this arrangement is to afford a maximum amount of clearance in the capsule adjacent the port, so that as a specimen of tissue enters the capsule through the port it can pass freely out of the capsule through the bore 38 of the cap neck in a manner hereinafter described.
  • the capsule is connected to the syringe S and bottle B by means of the double lumen tube T which may be formed of any one of several relatively inexpensive plastic materials which are semi-radiopaque and which are soft, smooth, and flexible enough to be readily acceptable to the patient.
  • the tube includes a pair of lumens or passageways 70 and 72 which are separated by a common wall 74.
  • the lower end of the tube is connected to the capsule, with the neck of the cap being forced up linto the larger lumen 70 and the smaller lumen 72 disposed to cover the smaller opening 42 in the cap dome as shown in FIG- URES 7 and 8.
  • a small portion may be cut off the lower extremity of the larger lumen. This will accommodate a snug t between the tube and capsule cap.
  • the upper end of the tube may be connected to a standard Ihydraulic: syringe S by means of a conventional LUER-LOK fitting 76 the free end of which is forced into the upper end of a larger lumen 70.
  • the smaller lumen 72 may be connected either to a second syringe (not shown) or to the bottle B (as shown) by means of a standard 18 gauge needle 80 which may be inserted through the outer wall of the turbe into the smaller lumen 72.
  • Needle 80 is connected to a conventional off-on valve or stop cork 82 which is in turn connected to an inverted bottle B of saline solution in a conventional manner such as that employed for intra-venous transfusions.
  • the upper exrremity of smaller lumen 72 is open, as seen in FIGURE 1, this does not matter, because the insertion of the needle 80 into the tube effectively closes off that portion of the lumen above the needle.
  • tubing is relatively inexpensive, a new sterile section of tubing can be cut from a roll of stock each time the biopsy capsule is used.
  • the capsule is swallowed by the patient in the same manner as a capsule of medicine.
  • the capsule in the fully extended or open position may be only 17 millimeters in length with an outside diameter of 71/2 millimeters, which is not much greater, if at all, than several types of medicine capsules currently being used.
  • the capsule with the tube attached After the capsule with the tube attached has been swallowed by the patient it eventually passes to the point in the gastrointestinal tract where the biopsy is to be taken.
  • the exact location of the position of the capsule in the gastrointestinal tract may be readily determined by uoroscopy.
  • the bottle is filled with saline solution and the syringe, which preferably has a 50 cc. capacity, is filled with ap proximately 2O cc.-30 cc. of saline solution.
  • Valve 82 is closed at this time,
  • the plunger of the syringe is depressed and the saline solution is forced from the syringe, through the larger lumen 70 of the tube, through the capsule, and out of the port 20 into the gastrointestinal tract in the area of the capsule to ush away any material which might possibly obstruct the shell port.
  • the plunger is then slowly withdrawn to aspirate any liquid or gas from the tract in the area next to the capsule and in the capsule itself up through the large lumen of the tube and into the syringe.
  • the plunger of the syringe is then withdrawn rapidly, which creates a vacuum in the capsule and accomplishes two things.
  • a small portion of the gastrointestinal tract mucosa or lining is drawn through port Ztl and into the interior of the capsule, as illustrated in FIGURE 10.
  • this :happens there is a scissorlike cooperative action between blade cutting edge 58 and shell port cutting edge 24 which severs that portion of the mucosal tissue Y which has -been drawn into the capsule from the remainder of the mucosal tissue in the tract.
  • the capsule is in the completely closed position, as illustrated in FIGURE 11, with the biopsy specimen Y disposed within the capsule.
  • valve 82 is opened to permit saline solution to pass from the bottle down through the small lumen 72 of the tube into the c-apsule. While valve 82 is open the operator continues to withdraw the plunger of the syringe. Thus, the saline solution is drawn into the capsule through the small lumen of the tube and from the capsule back up through the large lumen of the tube and into the syringe.
  • the negative pressure created by the syringe is greater than any pressure caused by opening valve 82, so that the capsule remains in the closed position, and the biopsy specimen Y is carried with the saline solution up into the syringe where it can be Iretrieved for microscopic study.
  • the syringe can be refilled with 20 ctx-30 cc. of saline solution, and the entire operation may be repeated to take ⁇ another 'biopsy with the capsule in the same location or in a different location in the gastrointestinal tract.
  • the inside diameters of the syringe fitting, the large lumen 80 of the tube, and the bore 3S of the capsule cap neck be equal and preferably in the range of from .070 inch to .130 inch.
  • the most preferable dimension for the inside diameter has been found to be .100 ⁇ inch.
  • novel capsule when used in connection with the other equipment in the man- 56E ner previously described greatly facilitates the taking of multiple biopsys in simple but precise operation heretofore impossiblein the art.
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said shell presenting at the upper edge of said port a generally flat cutting portion inclined wit-h respect to the longitudinal axis of the shell;
  • said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the 4blade to rotate as it moves axially relative to the shell;
  • said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the Iblade, adapted to cooperate with the cutting portion of the ⁇ shell port upper edge in ea scissor-like action to sever body tissue projecting through the port into the shell as the cutting edge portion of the 'blade passes over the port when the blade ascends into the shell the maximum distance permitted by Ithe engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
  • said cap aperture being located on the opposite side of the capsule from said shell port, so that the upper portion of said spring will be deected away from said shell port to afford a maximum amount of free space within the shell adjacent said port.
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprismg:
  • said shell presenting at the upper edge of said port a generally fiat cutting portion inclined with respect to the longitudinal axis of the shell;
  • a dome-shaped cap threada-bly mounted within the upper end of said shell including:
  • said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and Iblade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
  • said blade presenting an upper edge having a c-utting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to .sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
  • a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade, respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position.
  • a biopsy capsule for taking a specimen of body tissue from the lining of a ⁇ gastrointestinal tract comprising:
  • said shell presenting at the upper edge of said port a generally at cutting portion inclined with respect to the longitudinal axis of the shell;
  • said blade presenting in its outer surface an inclined cam groove, closed ⁇ at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
  • said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as t'he cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said blade presenting an upper edge having 1a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said shell presenting at the upper edge of said port a generally hat cutting portion inclined with respect to the longitudinal axis of the shell;
  • said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissor-like action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
  • a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade,'respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position;
  • said cap aperture being located on the opposite side of the lcapsule from said shell port, so that the upper portion of said spring will be deflected away from said shell port to afford a maximum amount of free space within the shell adjacent said port.
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
  • said blade presenting an upper edge having a cutting portion adaptedto cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted -by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
  • said cap aperture being located on the opposite side of the capsule from said shell port, so that the upper portion of said spring will be deflected away from said shell port to afford a maximum amount of free space within the shell adjacent said port.
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said blade presenting an upper edge having a cutting portion adapted to cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising: i
  • said blade presenting in its outer surface an ⁇ inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
  • said blade presenting an upper edge having a cutting portion adapted to cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said shell presenting at the upper edge of said port a generally fiat cutting portion inclined with respect to the longitudinal axis of the shell;
  • said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
  • said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
  • a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade, respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position.
  • a biopsy capsule for taking a specimen of body tissue from the lining f a gastrointestinal tract comprising:
  • said shell presenting at the upper edge of said port a generally flat cutting portion inclined with respect to the longitudinal axis of the shell;
  • said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
  • a biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract comprising:
  • said blade presenting an upper edge having a cutting portion adapted to cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
  • a spring disposed to extend through the shell operable to urge the blade and shell in opposite directions to move the capsule to open position.
  • a biopsy capsule arrangement comprising:
  • said retaining means including a projection on one member received with a spiral cam groove in the other member operable to cause relative rotative movement between the members as they move axially relative to each other.
  • a biopsy capsule arrangement comprising:
  • said spring means including a compression spring having its end which engages the closed end of said one member inclined away from the opening in said one member.
  • a biopsy capsule arrangement comprising:
  • said hydraulic means including a pair of separate lumens each communicating with the interior of said capsule through separate openings in the closed end of said one member.
  • a biopsy capsule arrangement comprising:

Description

2 Sheets-Sheet l onczd A hymond C Pif@ MKM @fz-ffy.
Dec. 6, 1966 D. J. DWYER ETAL BloPsY CAPSULE ARRANGEMENT Filed Feb. 25, 1964 Dec. 6, 1966 D. J. Dvx/YER ETAL,
BIO'SY CAPSULE ARRANGEMENT 2 Sheets-Sheet 2 Filed Feb. 25, 1964 Raynonc C. Piaf/Ong by M/MWZD United States Patent O Ill.
Filed Feb. 25, 1964, Ser. No. 347,27@ Claims. (Cl. 128-2) This invention relates to apparatus of the type employed to -obtain a specimen of body tissue, known as a biopsy, from the lining of the human gastrointestinal tract, and more particularly to an improved biopsy capsule.
The invention comprehends an instrument adapted to greatly facilitate investigation of the human gastrointestinal tract for medical purposes.
Investigation of the gastrointestinal tract has been stimulated in recent years by the availability of various instruments which make it possible to obtain `a specimen of living body tissue from the lining of the gastrointestinal tract without the necessity of performing conventional surgery from the exterior of the body.
Unfortunately the equipment which has been developed to date for this type of work has been so intricate and complex, in both construction and opera-tion, that its use has of necessity been limited largely to the realm of the gastroenterologist or highly specialized research teams.
Apparatus of this type currently in use includes a capsule or cutting and receiving device which is attached to the lower end of a multi-lumen tube and one -or more syringes or other hydraulic instruments which are connected to the upper end of the tube.
After the capsule has been swallowed by the pa-tient and has worked its way to that portion of the gastrointestinal tract where the biopsy is to be taken, the hydraulic instruments are manipulated to cause the cutting element of the capsule to sever a porti-on of the lining from the gastrointestinal tract. This severed specilmen is retained within the capsule which is withdrawn from the body.
A great disadvantage of the equipment presently available for this type of work is that the capsule must be removed from the body of the patient in order to determine absolutely whether a biopsy was successfully performed.
Inasmuch as it requires .several hours to introduce a capsule into the intestinal tract of a patient, it is most desirable, if not essential, for the operator to know that a successful biopsy has been performed before the capsule is removed, so that the process will not have to be repeated.
In order for the biopsy to be successful, the specimen taken must be retrieved without being damaged or mutilated, so that it will be of value for histological study. Also, it is highly desirable to take more than one biopsy at different locations in the gastrointestinal tract with one insertion of the biopsy equipment.
`It is therefore a primary object of this invention to provide an improved biopsy capsule arrangement of simple design, construction, and operation which will make it possible for any physician to take a successful biopsy as a routine matter.
A further object of the invention is the provision of a biopsy capsule arrangement which is acceptable to the patient on whom the biopsy is to be performed.
Another object of the invention is to provide a biopsy capsule which will permit the taking and retrieving of one or more biopsys from the gastrointestinal tract of a person without requiring removal of the capsule and attached tube.
rice
Still another object of the invention is the provision of a biopsy capsule especially adapted to insure the preservation of architecture and detail of the specimens taken for histological study.
A more specic object of the invention is the provision of a biopsy apparatus including a capsule having a hollow cylindrical shell member with a port having a cutting edge, a telescoping hollow cylindrical blade member with a cooperating cutting edge; linternal spring means operable to urge the members away from each .other to maintain the capsule in an open .position until it is in position for a biopsy; and hydraulic -means operable to draw a portion of the lining of the .gastrointestinal tract through the port into the capsule shell to overcome the resistance of the spring means to close the capsule and sever the tissue which -has been drawn into the capsule, and to retrieve the tissue through a tube without removing the capsule.
These and other objects of the invention will be apparent from an examination of the following description and drawings, wherein:
FIGURE 1 is a perspective View of a biopsy capsule embodying features of the invention, shown attached to the equipment with which it is normally used;
FIGURE 2 is an enlarged front elevation of the capsule illustrated in FIGURE 1;
FIGURES 3 and 4 are transverse sections taken on lines 3 3 and 44, respectively of FIGURE 2;
FIGURE 5 is a side elevation of the blade of the capsule illustrated in FIGURE 2;
FIGURE 6 is a top plan of the structure illustrated in FIGURE 5;
FIGURE 7 is a longitudinal section take on line 7-7 of FIGURE 2, with the blade of the capsule shown in the lowered or open position;
FIGURE 8 is a view similar to FIGURE 7, but with ,the blade of the capsule shown in the raised or closed position; and
FIGURES 9, l0, 1l, and 12 are side elevations of the capsule of FIGURE 1, with portions of the structure broken away, illustrating various positions of the capsule elements as it is used to take a biopsy.
It will be understood that, for purposes of clarity, certain elements have been intentionally omitted from certain views where they are illustrated to better advantage in other views.
Referring now to the drawings for a better understanding of the invention, it will be seen Ithat a biopsy capsule, indicated generally at C, is shown in FIGURE 1 attached to the Vlower end of a double-lumen, plastic tube the upper end of which is attached to a syringe,indicated gene-rally at S and a bottle, indicated generally at B, in a manner described in detail later in the specification.
The capsule, as best seen in FIGURE 2,` includes a hollow, cylindrical shell 10 `which is open at both its upper and lower ends.
It will be understood that, although the capsule may assume various positions while in use, for the sake of clarity and understanding the capsule will be described throughout the specication as being vertically disposed, as it is shown in FIGURES 1 8 of the drawings.
At its upper end shell 10 presents a threaded shoulder portion 12 adapted for connection to a cap 30 in a manner hereinafter described.
At its lower end shell 10 presents an integrally formed boss or cam lug 14 which projects a slight distance into the interior cavity or bore 16 of the shell for cooperation with a complementary cam track of a blade 50, in a manner hereinafter described.
If desired the outer surface of shell 10 may be provided with a knurled or otherwise roughened surface, as at 18,
the purpose of which is to improve traction and thereby facilitate movement of the capsule through the gastrointestinal tract.
As best seen in FIGURE 2, there is provided in the side of the shell downwardly adjacent shoulder portion 12, a somewhat triangularly or tear drop shaped opening or port 20, through which the specimen passes as the biopsy is taken, as shown in FIGURE l0, in a manner hereinafter described.
As best seen in FIGURES 2 and 7, the lower edge 22 of port 20 is preferably V-shaped and is tapered to present an inwardly inclined surface to facilitate entry of the body tissue into the port. The upper edge 24 of the port is the tissue cutting edge of the shell which is adapted to cooperate with a related cutting edge of the blade in a scissor-like action, as hereinafter described.
Shell cutting edge 24 is generally straight and flat and is inclined at an angle relative to the longitudinal axis of the shell.
Still referring to FIGURE 7, it will be seen that the threaded shoulder portion 12 of the cap is detachably secured within a telescoping skirt portion 32 of a cap 30, to close the upper end of the shell.
Cap 30 includes a downwardly and outwardly aring funnel shaped top wall or dome portion 34 which is formed integrally with skirt portion 32. It will be noted that the outer diameter of the cap skirt Iportion is the same as that of the main portion f the shell, so that when the cap and shell are threaded together they present an uninterrupted cylindrical outer surface.
At its upper end the dome portion of the cap presents a hollow neck or nozzle 36, having a throat or bore 38 extending therethrough in communication with the interior of the shell. The neck projects above the remainder of the dome portion of the cap and is adapted to be telescopically received within the first or larger of the lumens of tube T, as hereinafter described. The engagement between the cap neck and the tube is a friction t wherein the tube, which has the same inner diameter as the bore of the neck, is forced over the end of the neck. In order to prevent the accidental disengagement of the cap neck from the tube the former may be provided with one or more external, annular beads or ridges 40.
Dome portion 34 of the cap is also provided with a relatively small opening or passageway 42 disposed on the side of the neck opposite from the side in which the shell port is located. Opening 42 is disposed to afford communication between the second or smaller lumen of tube T and the interior of the shell. Opening 42 also has an additional function which is to receive and position the upper end of a spring in a manner hereinafter described in the specification.
As best seen in FIGURE 2, the capsule includes a generally cylindrical, hollowpblade 50 open at the upper end and closed at the lower end by a smooth spherical bottom wall 52.
The side wall 54 of the cap has an outer diameter only slightly less than the inside diameter of the shell, so that when the blade is telescoped within the shell the former is afforded limited rotative and axial movement relative to the latter.
Side wall 54 of the blade is provided with a generally vertically disposed, spiral, outer groove or cam track 56, adapted to receive and cooperate with cam lug 14 to effect relative rotative movement between the blade and shell as the former moves axially up into the latter.
Cam track 56 is open at its lower end to permit the cam lug to enter the cam track as Athe lower end of the blade is inserted into the shell through the upper end of the latter, and the cam track is closed at its upper end to retain the cam lug of the shell within the cam track and thereby prevent the blade from passing completely out of the lower end ofthe shell.
As best seen in FIGURE 5, approximately two thirds of the upper end of the blade, on the side remote from the cam track, is recessed and presents a at cutting edge 58 which is preferably inclined at an angle of approximately l5 degrees relative to the longitudinal axis of the blade. The cutting edge 58 of the blade is arranged and disposed to cooperate with shell cutting edge 24 to create a scissorlike cutting movement as the blade ascends into the shell from the position shown in FIGURE 7 to the position shown in FIGURE 8.
Except when pressure is applied to close the capsule, as hereinafter described, the capsule is maintained in the open position, as seen in FIGURE 7, iby rniean's of a spiral wound band spring 60 which is positioned within the capsule with its larger, lower end or base 62 seated against the inside surface of the bottom wall of the blade and with its smaller, upper end or tip seated within opening 42 of the cap dome. As best seen in FIGURE 7, opening 42 is on the opposite side of the capsule from port 20, so that the upper end of the spring is inclined away from the port at all times. The purpose of this arrangement is to afford a maximum amount of clearance in the capsule adjacent the port, so that as a specimen of tissue enters the capsule through the port it can pass freely out of the capsule through the bore 38 of the cap neck in a manner hereinafter described.
The capsule is connected to the syringe S and bottle B by means of the double lumen tube T which may be formed of any one of several relatively inexpensive plastic materials which are semi-radiopaque and which are soft, smooth, and flexible enough to be readily acceptable to the patient.
As best seen in FIGURE 3, the tube includes a pair of lumens or passageways 70 and 72 which are separated by a common wall 74.
The lower end of the tube is connected to the capsule, with the neck of the cap being forced up linto the larger lumen 70 and the smaller lumen 72 disposed to cover the smaller opening 42 in the cap dome as shown in FIG- URES 7 and 8. To facilitate the tting of the tubes lower end to the `capsule a small portion may be cut off the lower extremity of the larger lumen. This will accommodate a snug t between the tube and capsule cap.
The upper end of the tube may be connected to a standard Ihydraulic: syringe S by means of a conventional LUER-LOK fitting 76 the free end of which is forced into the upper end of a larger lumen 70.
The smaller lumen 72 may be connected either to a second syringe (not shown) or to the bottle B (as shown) by means of a standard 18 gauge needle 80 which may be inserted through the outer wall of the turbe into the smaller lumen 72. Needle 80 is connected to a conventional off-on valve or stop cork 82 which is in turn connected to an inverted bottle B of saline solution in a conventional manner such as that employed for intra-venous transfusions. Although, the upper exrremity of smaller lumen 72 is open, as seen in FIGURE 1, this does not matter, because the insertion of the needle 80 into the tube effectively closes off that portion of the lumen above the needle.
Inasmuch as the tubing is relatively inexpensive, a new sterile section of tubing can be cut from a roll of stock each time the biopsy capsule is used.
Now to describe the actual operation of the capsule and related equipment, it will be understood that the capsule is swallowed by the patient in the same manner as a capsule of medicine. The capsule in the fully extended or open position may be only 17 millimeters in length with an outside diameter of 71/2 millimeters, which is not much greater, if at all, than several types of medicine capsules currently being used.
After the capsule with the tube attached has been swallowed by the patient it eventually passes to the point in the gastrointestinal tract where the biopsy is to be taken. The exact location of the position of the capsule in the gastrointestinal tract may be readily determined by uoroscopy.
When the capsule is in the proper position for the biopsy, as illustrated in FIGURES 940, with poirt of the capsule shell disposed against the lining of the gastrointestinal tract, indicated generally at L, the procedure for taking of the specimen may be commenced.
The bottle is filled with saline solution and the syringe, which preferably has a 50 cc. capacity, is filled with ap proximately 2O cc.-30 cc. of saline solution. Valve 82 is closed at this time,
The plunger of the syringe is depressed and the saline solution is forced from the syringe, through the larger lumen 70 of the tube, through the capsule, and out of the port 20 into the gastrointestinal tract in the area of the capsule to ush away any material which might possibly obstruct the shell port.
After the tiushing operation has been completed and the syringe is empty, with the plunger in the fully depressed position, the plunger is then slowly withdrawn to aspirate any liquid or gas from the tract in the area next to the capsule and in the capsule itself up through the large lumen of the tube and into the syringe.
As soon as the tract and capsule have been cleared of liquid and gas the aspiration into the syringe ceases, and it is known that the mucosal surface or lining of the tract has been dr-awn up against the capsule to close off the port, as illustrated in FIGURE 9. At this time the capsule is still in the open position because the spring 60 is operative to urge the shell and blade in opposite directions.
The plunger of the syringe is then withdrawn rapidly, which creates a vacuum in the capsule and accomplishes two things. First, a small portion of the gastrointestinal tract mucosa or lining is drawn through port Ztl and into the interior of the capsule, as illustrated in FIGURE 10. Second, as the outside pressure increases, because of the vacuum in the capsule, sufficiently to overcome the force of the spring, the blade is urged into the shell with a rapid movement. As this :happens there is a scissorlike cooperative action between blade cutting edge 58 and shell port cutting edge 24 which severs that portion of the mucosal tissue Y which has -been drawn into the capsule from the remainder of the mucosal tissue in the tract.
At this time the capsule is in the completely closed position, as illustrated in FIGURE 11, with the biopsy specimen Y disposed within the capsule.
At this time valve 82 is opened to permit saline solution to pass from the bottle down through the small lumen 72 of the tube into the c-apsule. While valve 82 is open the operator continues to withdraw the plunger of the syringe. Thus, the saline solution is drawn into the capsule through the small lumen of the tube and from the capsule back up through the large lumen of the tube and into the syringe. The negative pressure created by the syringe is greater than any pressure caused by opening valve 82, so that the capsule remains in the closed position, and the biopsy specimen Y is carried with the saline solution up into the syringe where it can be Iretrieved for microscopic study.
As soon as the biopsy specimen has been removed from the syringe, the syringe can be refilled with 20 ctx-30 cc. of saline solution, and the entire operation may be repeated to take `another 'biopsy with the capsule in the same location or in a different location in the gastrointestinal tract.
In order to insure complete success of the hydraulic system employed with the capsule of the invention, it is essential that the inside diameters of the syringe fitting, the large lumen 80 of the tube, and the bore 3S of the capsule cap neck be equal and preferably in the range of from .070 inch to .130 inch. The most preferable dimension for the inside diameter has been found to be .100` inch.
Thus, it will be understood that the novel capsule when used in connection with the other equipment in the man- 56E ner previously described greatly facilitates the taking of multiple biopsys in simple but precise operation heretofore impossiblein the art.
We claim:
l. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a generally teardropshaped cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally flat cutting portion inclined wit-h respect to the longitudinal axis of the shell;
(c) said shell having, adjacent its lower end, a cam lug'projecting into the interior of the shell;
(d) a dome-shaped cap threadably mounted within the upper end of said shell, including:
(i) a central, hollow neck;
(ii) a transverse wall liaring downwardly and outwardly from said neck and having an aperture extending therethrough adjacent one side of said neck;
(e) a hollow, cylindrical cutting blade7 open at its upper end `and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial and rotative movement therebetween;
(f) said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the 4blade to rotate as it moves axially relative to the shell;
(g) said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the Iblade, adapted to cooperate with the cutting portion of the `shell port upper edge in ea scissor-like action to sever body tissue projecting through the port into the shell as the cutting edge portion of the 'blade passes over the port when the blade ascends into the shell the maximum distance permitted by Ithe engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
(h) a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the fblade, respectively, operable to urge the Lblade and shell in opposite directions to move the capsule to open position;
(i) said cap aperture being located on the opposite side of the capsule from said shell port, so that the upper portion of said spring will be deected away from said shell port to afford a maximum amount of free space within the shell adjacent said port.
2. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprismg:
(a) a hollow, cylindrical shell, open at opposite ends, i
having, adjacent its upper end, a .generally teardropshaped cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally fiat cutting portion inclined with respect to the longitudinal axis of the shell;
(c) said `shell having, adjacent its lower end, a cam lug projecting into the interior of the shell;
(d) a dome-shaped cap threada-bly mounted within the upper end of said shell, including:
(i) a central, hollow neck;
(ii) a transverse wall aring downwardly and outwardly from said neck and lhaving an aperture extending therethrough adjacent one side of said neck;
(e) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial and rotative movement therebetween;
(f) said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and Iblade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
(g) said blade presenting an upper edge having a c-utting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to .sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
(h) a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade, respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position.
3. A biopsy capsule for taking a specimen of body tissue from the lining of a `gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a generally teardropshaped cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally at cutting portion inclined with respect to the longitudinal axis of the shell;
(c) said shell having, adjacent its lower end, a cam lug projecting into the interior of the shell;
(d) a dome-shaped cap threadably mounted within the upper end of said shell, including: i
(i) a central, hollow neck;
(ii) a -transverse Wall aring downwardly and outwardly from said neck and having an aperture extending therethrough adjacent one side of said neck;
(e) a hollow, cylindrical cutting blade, open at its upper end and closed `at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial and rotative movement therebetween;
(f) said blade presenting in its outer surface an inclined cam groove, closed `at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
(g) said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as t'he cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
(h) a spiral wound, compression spring disposed to extend through the shell operable to urge the blade and shell in opposite directions to move the capsule to open position.
4. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a generally teardropshaped cutting port extending therethrough;
(b) said shell lpresenting at the upper edge of said port a generally at cutting portion inclined with respect to the longitudinal axis of the shell;
(c) a dome-shaped cap threadably mounted within the upper end of said shell, including:
(i) a central, hollow neck;
(ii) a transverse wall Haring downwardly and outwardly from said neck and having an aper- -ture extending therethrough adjacent one side of said neck;
(d) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial movement therebetween; v
(e) said blade presenting an upper edge having 1a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
(f) a spiral wound, compression spring disposed to extend through the shell operable to urge the blade and shell in opposite directions to move the capsule to open position.
5. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
,'(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a generally teardropshaped cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally hat cutting portion inclined with respect to the longitudinal axis of the shell;
(c) a dome-shaped cap threadably mounted within the upper end of said shell, including:
I (i) a central, hollow neck;
(ii) a transverse wall aring downwardly and outwardly from said neck and having an aperture extending therethrough adjacent one side of said neck;
l`(d) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial movement therebetween;
(e) said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissor-like action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
(f) a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade,'respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position;
(g) said cap aperture being located on the opposite side of the lcapsule from said shell port, so that the upper portion of said spring will be deflected away from said shell port to afford a maximum amount of free space within the shell adjacent said port.
6. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a cutting port extending therethrough;
`(b) said shell presenting at the upper edge of said port a cutting portion;
(c) said shell having, adjacent its lower end, a cam lug projecting into the interior of the shell;
(d) a dome-shaped cap threadably mounted within the upper end of said shell, including:
(i) a central, hollow neck;
(ii) a transverse wall flaring downwardly and outwardly from said neck and having an aperture extending therethrough adjacent one side of said neck;
(e) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said -shell for relative axial and rotative movement therebetween;
(f) said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
(g) said blade presenting an upper edge having a cutting portion adaptedto cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted -by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
(h) a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade, respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position;
(i) said cap aperture being located on the opposite side of the capsule from said shell port, so that the upper portion of said spring will be deflected away from said shell port to afford a maximum amount of free space within the shell adjacent said port.
7. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a cutting portion;
(c) a dome-shaped cap threadably mounted within the upper end of said shell, including:
(i) a central, hollow neck;
(ii) a transverse wall flaring downwardly and outwardly from said neck and having an aperture extending therethrough adjacent one side of said neck;
(d) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial movement therebetween;
(e) said blade presenting an upper edge having a cutting portion adapted to cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
(f) a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade, respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position;
(g) said cap aperture being located on the opposite side of the capsule from said shell port, so that the l@ upper portion of said spring will be deflected away from said shell port to afford a maximum amount of free space within the shell adjacent said port. 8. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising: i
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a cutting .port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally fiat cutting portion;
(c) said shell having, adjacent its lower end, a cam lug projecting into the interior of the shell;
(d) a dome-shaped cap threadably mounted within the upper end of said shell, including:
(i) a central, hollow neck;
(ii) a transverse wall flaring downwardly and outwardly from said neck and having an aperture extending therethrough adjacent one side of said neck;
(e) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial and rotative movement therebetween;
(f) said blade presenting in its outer surface an `inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
(g) said blade presenting an upper edge having a cutting portion adapted to cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
(h) a spiral wound, compression spring disposed to extend through the shell operable to urge the blade and shell in opposite directions to move the capsule to open position.
9. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally fiat cutting portion inclined with respect to the longitudinal axis of the shell;
(c) said shell having, adjacent its lower end, a cam lug projecting into the interior of the shell;
(d) a cap threadably connected to the upper end of said shell;
(e) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial and rotative movement therebetween;
(f) said blade presenting in its outer surface an inclined cam groove, closed at its upper end, adapted to receive and cooperate with the cam lug of the shell to maintain the shell and blade in telescopic relation and to cause the blade to rotate as it moves axially relative to the shell;
(g) said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell the maximum distance permitted by the engagement between the shell cam lug and the blade cam groove when the capsule is in closed position;
(h) a spiral wound, compression spring disposed to extend through the shell with its upper and lower ends disposed in said cap aperture and against the closed end of the blade, respectively, operable to urge the blade and shell in opposite directions to move the capsule to open position.
10. A biopsy capsule for taking a specimen of body tissue from the lining f a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, adjacent its upper end, a cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a generally flat cutting portion inclined with respect to the longitudinal axis of the shell;
(c) a cap threadably mounted on the upper end of said shell;
(d) a hollow, cylindrical cutting blade, open at its upper end and closed at its lower end, having its upper end telescopically received within the lower end of said shell for relative axial movement therebetween;
(e) said blade presenting an upper edge having a cutting portion, inclined with respect to the longitudinal axis of the blade, adapted to cooperate with the cutting portion of the shell port upper edge in a scissorlike action to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
(f) a spring operable to urge the blade and shell in Opposite directions to move the capsule to open position.
11. A biopsy capsule for taking a specimen of body tissue from the lining of a gastrointestinal tract, comprising:
(a) a hollow, cylindrical shell, open at opposite ends,
having, a cutting port extending therethrough;
(b) said shell presenting at the upper edge of said port a cutting portion;
(c) a cap threadably mounted on the upper end of said shell;
(d) a hollow, cylindrical cutting blade, open at its upper end and closed atits lower end, having its upper end telescopically received within the lower end of said shell for relative axial movement therebetween;
(e) said blade presenting an upper edge having a cutting portion adapted to cooperate with the cutting portion of the shell port upper edge to sever body tissue projecting through the port into the shell as the cutting edge portion of the blade passes over the port when the blade ascends into the shell;
(f) a spring disposed to extend through the shell operable to urge the blade and shell in opposite directions to move the capsule to open position.
12. A biopsy capsule arrangement, comprising:
(a) a pair of hollow, cylindrical members each having an open end and a closed end;
(b) one `of said members having extending through a side thereof adjacent its closed end an opening presenting a cutting edge;
(c) the other of said members having its open end telescopically received within the open end of said one member for relative axial movement between the members and presenting on its open end a cutting edge disposed for cooperation with the cutting edge -of said one member as the members are urged toward each other;
' (d) retaining means for preventing the separation of the members as llily are urged away from each other;
(e) spring means reacting between the closed ends of the members for urging them away from each other; and
(f) hydraulic means in communication with the interior of the capsule through the closed end of said one member for urging said members toward each other;
(g) said retaining means including a projection on one member received with a spiral cam groove in the other member operable to cause relative rotative movement between the members as they move axially relative to each other.
13. A biopsy capsule arrangement, comprising:
(a) a pair of hollow, cylindrical members each having an open end and a closed end;
(b) one of said members having extending through a side thereof adjacent its closed end an opening presenting a cutting edge;
(c) the other of said members having its open end telescopically received within the open end of said one member for relative axial movement between the members and presenting on its open end a cutting edge disposed for cooperation with the cutting edge of said one member as the members are urged toward each other;
(d) retaining means for preventing the separation of the members as they are urged away from each other;
(e) spring means reacting between the closed ends of the members for urging them away from each other; and
(f) hydraulic means in communication with the interior of the capsule through the closed end of said one member for urging said members toward each other;
(g) said spring means including a compression spring having its end which engages the closed end of said one member inclined away from the opening in said one member.
14. A biopsy capsule arrangement, comprising:
(a) a pair of hollow, cylindrical members each having an open end and a closed end;
(b) one of said members having extending through a side thereof adjacent its closed end an opening presenting a cutting edge;
(c) the other of said members having its open end telescopically received within the open end of said one member for relative axial movement between the members and presenting 0n its open end a cutting edge disposed for cooperation with the cutting edge of said one member as the members are urged toward each other;
(d) retaining means for preventing the separation of the members as they are urged away from each other;
(e) spring means reacting between the closed ends of the members for urging them away from each other; and
(f) hydraulic means in communication With the interior of the capsule through the closed end of said one member for urging said members toward each other;
(g) said hydraulic means including a pair of separate lumens each communicating with the interior of said capsule through separate openings in the closed end of said one member.
15. A biopsy capsule arrangement, comprising:
(a) a pair of hollow, cylindrical members each having an open end and a closed end;
(b) one of said members having extending through a side thereof adjacent its closed end an opening presenting a cutting edge;
(c) the other of said members having its open end telescopically received within the open end of said one member for relative axial movement between the members and presenting on its open end a cut- References Cited bythe Examiner UNITED STATES PATENTS Shaw 128-221 Silverman 12S- 2 McClure 12S-2 Royce 146-68 Rodriguez 12S-2 RICHARD A. GAUDET, Primary Examiner. SMON BRODER, Examiner.

Claims (1)

15. A BIOPSY CAPUSLE ARRANGEMENT, COMPRISING: (A) A PAIR OF HOLLOW, CYLINDRICAL MEMBERS EACH HAVING AN OPEN END AND A CLOSED END; (B) ONE OF SAID MEMBERS HAVING EXTENDING THROUGH A SIDE THEREOF ADJACENT ITS CLOSED END AN OPENING PRESENTING A CUTTING EDGE; (C) THE OTHER OF SAID MEMBERS HAVING ITS OPEN END TELESCOPICALLY RECEIVED WITHIN THE OPEN END OF SAID ONE MEMBER FOR RELATIVE AXIAL MOVEMENT BETWEEN THE MEMBERS AND PRESENTING ON ITS OPEN END A CUTTING EDGE DISPOSED FOR COOPERATION WITH THE CUTTING EDGE OF SAID ONE MEMBER AS THE MEMBERS ARE URGED TOWARD EACH OTHER; (D) RETAINING MEANS FOR PREVENTING THE SEPARATION OF THE MEMBERS AS THEY ARE URGED AWAY FROM EACH OTHER; (E) SPRING MEANS REACTING BETWEEN THE CLOSED ENDS OF THE MEMBERS FOR URGING THEM AWAY FROM EACH OTHER; AND (F) HYDRAULIC MEANS IN COMMUNICATION WITH THE INTERIOR OF THE CAPSULE THROUGH THE CLOSED END OF SAID ONE MEMBER FOR URGINE SAID MEMBER TOWARD EACH OTHER.
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US3401684A (en) * 1965-12-16 1968-09-17 Weck & Co Edward Biopsy capsules
US3590808A (en) * 1968-09-04 1971-07-06 Us Catheter & Instr Corp Biopsy tool
US3815604A (en) * 1972-06-19 1974-06-11 Malley C O Apparatus for intraocular surgery
US5226910A (en) * 1989-07-05 1993-07-13 Kabushiki Kaisha Topcon Surgical cutter
US5368603A (en) * 1990-06-05 1994-11-29 Halliburton; Alexander G. Endarterectomy catheter, and method of use thereof
US5423844A (en) * 1993-10-22 1995-06-13 Promex, Inc. Rotary surgical cutting instrument
US5674232A (en) * 1990-06-05 1997-10-07 Halliburton; Alexander George Catheter and method of use thereof
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US5897507A (en) * 1996-11-25 1999-04-27 Symbiosis Corporation Biopsy forceps instrument having irrigation and aspiration capabilities
US6156049A (en) * 1997-04-11 2000-12-05 Coherent Inc. Method and apparatus for transurethral resection of the prostate
US6926676B2 (en) 1996-11-25 2005-08-09 Boston Scientific Scimed, Inc. Biopsy instrument having irrigation and aspiration capabilities
US20050272972A1 (en) * 2004-06-07 2005-12-08 Iddan Gavriel J Method, system and device for suction biopsy
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US20080287826A1 (en) * 2004-07-09 2008-11-20 Bard Peripheral Vasular, Inc. Transport System for Biopsy Device
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US20110087131A1 (en) * 2009-10-12 2011-04-14 Videbaek Karsten Biopsy probe assembly having a mechanism to prevent misalignment of components prior to installation
US20110105946A1 (en) * 2009-10-31 2011-05-05 Sorensen Peter L Biopsy system with infrared communications
US20110208085A1 (en) * 2005-01-31 2011-08-25 C.R. Bard, Inc. Quick cycle biopsy system
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US8690793B2 (en) 2009-03-16 2014-04-08 C. R. Bard, Inc. Biopsy device having rotational cutting
US8708929B2 (en) 2009-04-15 2014-04-29 Bard Peripheral Vascular, Inc. Biopsy apparatus having integrated fluid management
US8721563B2 (en) 2005-08-10 2014-05-13 C. R. Bard, Inc. Single-insertion, multiple sample biopsy device with integrated markers
US8728004B2 (en) 2003-03-29 2014-05-20 C.R. Bard, Inc. Biopsy needle system having a pressure generating unit
US8771200B2 (en) 2005-08-10 2014-07-08 C.R. Bard, Inc. Single insertion, multiple sampling biopsy device with linear drive
US8808197B2 (en) 2009-10-29 2014-08-19 Bard Peripheral Vascular, Inc. Biopsy driver assembly having a control circuit for conserving battery power
US8932232B2 (en) 2009-03-31 2015-01-13 Arch Medical Devices Ltd. Tissue sampling device and method
US8951209B2 (en) 2002-03-19 2015-02-10 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US8951208B2 (en) 2006-08-21 2015-02-10 C. R. Bard, Inc. Self-contained handheld biopsy needle
US9072502B2 (en) 2002-03-19 2015-07-07 C. R. Bard, Inc. Disposable biopsy unit
US9173641B2 (en) 2009-08-12 2015-11-03 C. R. Bard, Inc. Biopsy apparatus having integrated thumbwheel mechanism for manual rotation of biopsy cannula
US9241692B2 (en) 2010-04-28 2016-01-26 Sanovas, Inc. Pressure/vacuum actuated catheter forceps
US9282949B2 (en) 2009-09-01 2016-03-15 Bard Peripheral Vascular, Inc. Charging station for battery powered biopsy apparatus
US9566045B2 (en) 2006-10-06 2017-02-14 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US9655596B2 (en) 2012-05-10 2017-05-23 Arch Medical Devices Ltd. Biopsy needle with a laterally expandable distal portion
US10149664B2 (en) 2006-10-24 2018-12-11 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US10285673B2 (en) 2013-03-20 2019-05-14 Bard Peripheral Vascular, Inc. Biopsy device
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US3590808A (en) * 1968-09-04 1971-07-06 Us Catheter & Instr Corp Biopsy tool
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US5226910A (en) * 1989-07-05 1993-07-13 Kabushiki Kaisha Topcon Surgical cutter
US5368603A (en) * 1990-06-05 1994-11-29 Halliburton; Alexander G. Endarterectomy catheter, and method of use thereof
US5674232A (en) * 1990-06-05 1997-10-07 Halliburton; Alexander George Catheter and method of use thereof
US5423844A (en) * 1993-10-22 1995-06-13 Promex, Inc. Rotary surgical cutting instrument
US7347828B2 (en) 1996-11-25 2008-03-25 Boston Scientific Miami Corporation Suction adapter for medical instrument
US6544194B1 (en) 1996-11-25 2003-04-08 Symbiosis Corporation Proximal actuation handle for a biopsy forceps instrument having irrigation and aspiration capabilities
US7833167B2 (en) 1996-11-25 2010-11-16 Boston Scientific Miami Corporation Proximal actuation handle for a biopsy forceps instrument having irrigation and aspiration capabilities
US5897507A (en) * 1996-11-25 1999-04-27 Symbiosis Corporation Biopsy forceps instrument having irrigation and aspiration capabilities
US7297121B2 (en) 1996-11-25 2007-11-20 Boston Scientific Scimed, Inc. Biopsy instrument having irrigation and aspiration capabilities
US6142956A (en) * 1996-11-25 2000-11-07 Symbiosis Corporation Proximal actuation handle for a biopsy forceps instrument having irrigation and aspiration capabilities
US7204811B2 (en) 1996-11-25 2007-04-17 Boston Scientific Miami Corporation Proximal actuation handle for a biopsy forceps instrument having irrigation and aspiration capabilities
US6174292B1 (en) 1996-11-25 2001-01-16 Symbiosis Corporation Biopsy forceps instrument having irrigation and aspiration capabilities
US6926676B2 (en) 1996-11-25 2005-08-09 Boston Scientific Scimed, Inc. Biopsy instrument having irrigation and aspiration capabilities
US6832990B2 (en) 1996-11-25 2004-12-21 Symbiosis Corporation Biopsy instrument having aspiration capabilities
EP1419740A2 (en) * 1997-02-03 2004-05-19 Symbiosis Corporation Proximal actuation handle for a biospy forceps instrument having aspiration capability
AU745113B2 (en) * 1997-02-03 2002-03-14 Symbiosis Corporation Proximal actuation handle for a biopsy forceps instrument having irrigation and aspiration capabilities
WO1998033436A1 (en) * 1997-02-03 1998-08-06 Symbiosis Corporation Proximal actuation handle for a biopsy forceps instrument having irrigation and aspiration capabilities
EP1419740A3 (en) * 1997-02-03 2006-02-08 Symbiosis Corporation Proximal actuation handle for a biospy forceps instrument having aspiration capability
WO1998046147A1 (en) * 1997-04-11 1998-10-22 Coherent Inc. Method and apparatus for transurethral resection of the prostate
US6156049A (en) * 1997-04-11 2000-12-05 Coherent Inc. Method and apparatus for transurethral resection of the prostate
US6024751A (en) * 1997-04-11 2000-02-15 Coherent Inc. Method and apparatus for transurethral resection of the prostate
WO1999007288A1 (en) 1997-08-08 1999-02-18 Endonetics, Inc. Multiple sample biopsy forceps
US10335128B2 (en) 2002-03-19 2019-07-02 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US11382608B2 (en) 2002-03-19 2022-07-12 C. R. Bard, Inc. Disposable biopsy unit
US10271827B2 (en) 2002-03-19 2019-04-30 C. R. Bard, Inc. Disposable biopsy unit
US9439631B2 (en) 2002-03-19 2016-09-13 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US9421002B2 (en) 2002-03-19 2016-08-23 C. R. Bard, Inc. Disposable biopsy unit
US9072502B2 (en) 2002-03-19 2015-07-07 C. R. Bard, Inc. Disposable biopsy unit
US8951209B2 (en) 2002-03-19 2015-02-10 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US8728004B2 (en) 2003-03-29 2014-05-20 C.R. Bard, Inc. Biopsy needle system having a pressure generating unit
US20050272972A1 (en) * 2004-06-07 2005-12-08 Iddan Gavriel J Method, system and device for suction biopsy
US8926527B2 (en) 2004-07-09 2015-01-06 Bard Peripheral Vascular, Inc. Tissue sample flushing system for biopsy device
US8992440B2 (en) 2004-07-09 2015-03-31 Bard Peripheral Vascular, Inc. Length detection system for biopsy device
US10166011B2 (en) 2004-07-09 2019-01-01 Bard Peripheral Vascular, Inc. Transport system for biopsy device
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US8728003B2 (en) 2005-08-10 2014-05-20 C.R. Bard Inc. Single insertion, multiple sample biopsy device with integrated markers
US8961430B2 (en) * 2005-08-10 2015-02-24 C.R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US10010307B2 (en) 2005-08-10 2018-07-03 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device with linear drive
US20120330185A1 (en) * 2005-08-10 2012-12-27 C.R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US20150223787A1 (en) * 2005-08-10 2015-08-13 C.R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US8721563B2 (en) 2005-08-10 2014-05-13 C. R. Bard, Inc. Single-insertion, multiple sample biopsy device with integrated markers
US11219431B2 (en) 2005-08-10 2022-01-11 C.R. Bard, Inc. Single-insertion, multiple sampling biopsy device with linear drive
US8771200B2 (en) 2005-08-10 2014-07-08 C.R. Bard, Inc. Single insertion, multiple sampling biopsy device with linear drive
US8951208B2 (en) 2006-08-21 2015-02-10 C. R. Bard, Inc. Self-contained handheld biopsy needle
US10617399B2 (en) 2006-08-21 2020-04-14 C.R. Bard, Inc. Self-contained handheld biopsy needle
US9439632B2 (en) 2006-08-21 2016-09-13 C. R. Bard, Inc. Self-contained handheld biopsy needle
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US11559289B2 (en) 2006-10-06 2023-01-24 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US9566045B2 (en) 2006-10-06 2017-02-14 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US10149664B2 (en) 2006-10-24 2018-12-11 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US11583261B2 (en) 2006-10-24 2023-02-21 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US8444572B2 (en) * 2007-11-29 2013-05-21 Olympus Medical Systems Corp. Capsule medical device and body-tissue obtaining method
US20090143697A1 (en) * 2007-11-29 2009-06-04 Olympus Medical Systems Corp. Capsule medical device and body-tissue obtaining method
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US8690793B2 (en) 2009-03-16 2014-04-08 C. R. Bard, Inc. Biopsy device having rotational cutting
US8932232B2 (en) 2009-03-31 2015-01-13 Arch Medical Devices Ltd. Tissue sampling device and method
US8708930B2 (en) 2009-04-15 2014-04-29 Bard Peripheral Vascular, Inc. Biopsy apparatus having integrated fluid management
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US9173641B2 (en) 2009-08-12 2015-11-03 C. R. Bard, Inc. Biopsy apparatus having integrated thumbwheel mechanism for manual rotation of biopsy cannula
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US10285673B2 (en) 2013-03-20 2019-05-14 Bard Peripheral Vascular, Inc. Biopsy device
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US10456120B2 (en) 2013-11-05 2019-10-29 C. R. Bard, Inc. Biopsy device having integrated vacuum
US11534148B2 (en) 2013-11-05 2022-12-27 C. R. Bard, Inc. Biopsy device having integrated vacuum
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