System and Method for Bracketing and Removing Tissue

• US 20010018594A1
• Filed: 03/22/2001
• Published: 08/30/2001
• Est. Priority Date: 05/14/1998
• Status: Active Grant

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Calypso Medical, Inc.
• Inventors: Krag, David N.
• Granted Patent: US 6,918,919 B2
• Time in Patent Office: Days
• US Class Current: 606/185
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3413 guided by ultrasound
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3995 Multi-modality markers
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

Abstract of Disclosure

A system and method for bracketing a tissue volume (22) and later locating the bracketed tissue volume. The system includes a plurality of markers (30) and a probe (32) and detector (34) for use in locating the markers by providing information usable by a surgeon that is representative of changes in proximity between the probe and the plurality of markers. The markers have various detection characteristics, e.g., they transmit gamma rays, that are detectable by an associated probe and detector. The tissue volume is removed by manipulating a cutting tool based on the proximity information provided by the detector which can be used by the surgeon to define the boundary of the tissue volume. A two-part cutting tool (200) is provided for removing the tissue volume, and a tissue anchor (300) is provided for stabilizing the tissue during removal. The system and method of the invention are particularly useful in bracketing and then removing a tissue volume from amorphous, pliable tissue such as breast tissue.

Claims

1. Canceled

2. Canceled

3. Canceled

4. Canceled

5. Canceled

6. Canceled

7. Canceled

8. Canceled

9. Canceled

10. Canceled

11. Canceled

12. Canceled

13. Canceled

14. Canceled

15. Canceled

16. Canceled

17. Canceled

18. Canceled

19. Canceled

20. Canceled

21. Canceled

22. Canceled

23. Canceled

24. Canceled

25. Canceled

26. Canceled

27. Canceled

28. Canceled

29. Canceled

30. Canceled

31. Canceled

32. A tissue anchor comprising:

33. A tissue anchor according to

claim 32

, further wherein said elongate tube has an outside diameter ranging 0.5mm to 12mm.

34. A tissue anchor according to

claim 32

, wherein said outside diameter ranges from 1mm to 3mm.

35. A tissue anchor according to

claim 32

, wherein said at least one anchor member includes four anchor members.

36. A tissue anchor according to

claim 32

, wherein said at least one anchor member has a curved configuration when said portion is in said second position.

65. A tissue anchor according to

claim 35

, wherein said at least one aperture includes four apertures, with one aperture being associated with each anchor member.

66. A tissue anchor according to

claim 65

, wherein each anchor member projects from its associated aperture when the elongate member is in its first position.

67. A tissue anchor according to

claim 32

, wherein said at least one anchor member includes a barb adjacent an end thereof.

68. A tissue anchor according to

claim 32

, wherein the distal end of the elongate tube is adapted to be advanced into a volume of tissue to position the at least one anchor member for stabilizing deployment into the tissue.

69. A tissue anchor according to

claim 68

, wherein the distal end of the elongate tube is closed, said at least one aperture being spaced proximally from the distal end.

70. A tissue anchor according to

claim 69

, wherein said at least one anchor member extends distally beyond a distal end of the elongate member when the elongate member is in its first position.

71. A tissue anchor according to

claim 70

, wherein said at least one anchor member is curved when in an unbiased state.

72. A tissue anchor according to

claim 71

, wherein said at least one anchor member is in its unbiased state when the elongate member is in its second position.

73. A tissue anchor according to

claim 71

, wherein said at least one anchor member curves proximally when the elongate member is in its second position.

74. A tissue anchor according to

claim 32

, wherein said portion of the elongate member is sized for a close sliding fit within the central bore of the elongate tube.

37. Canceled

38. Canceled

39. Canceled

40. Canceled

41. Canceled

42. Canceled

43. Canceled

44. Canceled

45. Canceled

46. Canceled

47. Canceled

48. Canceled

49. Canceled

50. Canceled

51. Canceled

52. Canceled

53. Canceled

54. Canceled

55. Canceled

56. Canceled

57. Canceled

58. Canceled

59. Canceled

60. Canceled

61. Canceled

62. Canceled

63. Canceled

64. Canceled

75. A tissue anchor for stabilizing a tissue mass for surgical excision, comprising:

76. A tissue anchor according to

claim 75

, wherein the apertures of the elongate tube are spaced proximally of the distal end.

77. A tissue anchor according to

claim 75

, wherein the actuator comprises an elongate member sized for a close sliding fit within the central bore of the elongate tube.

78. A tissue anchor according to

claim 77

, wherein the actuator further comprises a ring carried adjacent a proximal end of the elongate member.

79. A tissue anchor according to

claim 75

, wherein the actuator further comprises a stop, the stop cooperating with the elongate tube to limit movement of the elongate member with respect to the elongate tube, thereby defining the second position of the actuator.

80. A tissue anchor according to

claim 75

, wherein the actuator comprises an elongate member slidably received within the central bore of the elongate tube, each of the anchor means being attached to the elongate member for movement therewith.

81. A tissue anchor according to

claim 80

, wherein the elongate member is moved distally as the actuator moves from its first position to its second position.

82. A tissue anchor according to

claim 75

, wherein each anchor member projects from its associated aperture when the actuator is in its first position.

83. A tissue anchor for stabilizing a tissue mass for surgical excision, comprising:

84. A tissue anchor according to

claim 83

, wherein the apertures of the elongate tube are spaced proximally of the distal end.

85. A tissue anchor according to

claim 83

, wherein the rod further comprises a stop, the stop cooperating with the elongate tube to limit movement of the rod with respect to the elongate tube, thereby defining the second position of the rod.

86. A tissue anchor according to

claim 83

, wherein the anchor members are attached to the rod and extend distally beyond a distal end of the rod.

87. A tissue anchor according to

claim 83

, wherein a small portion of each anchor member projects from its associated aperture when the rod is in its first position.

88. A method of stabilizing a tissue mass using the tissue anchor of

claim 83

, comprising:

89. A method according to

claim 88

, further comprising drawing the tissue anchor proximally after the anchor members are deployed in the tissue mass to apply tension to the tissue mass.

90. A method according to

claim 88

, further comprising leaning the elongate tube and the elongate rod after the anchor members are deployed in the tissue mass to facilitate surgical removal of the tissue mass.

91. A method of removing a tissue mass from a tissue using the tissue anchor of

claim 83

, comprising:

92. A tissue anchor for stabilizing a tissue mass for surgical excision, comprising:

94. A method according to

claim 92

, wherein stabilizing the tissue mass includes drawing the tissue anchor proximally, thereby tensioning the tissue mass.

95. A method according to

claim 92

, further comprising leaning the elongate tube and the elongate rod after the anchor members are deployed in the tissue mass to facilitate surgical removal of the tissue mass.

97. A method according to

claim 95

, further comprising drawing the tissue anchor proximally after deploying the anchor members, thereby tensioning the tissue mass.

93. A method of removing a tissue mass from a tissue, comprising:

96. A method of stabilizing a tissue mass during a medical procedure using a tissue anchor which includes an elongate tube having a distal end and a plurality of apertures;

a manually controllable actuator; and

a plurality of anchor members operatively connected to the actuator, the method comprising;