Barrett's esophagus cytology device

• US 20030208134A1
• Filed: 11/06/2002
• Published: 11/06/2003
• Est. Priority Date: 05/07/2001
• Status: Active Grant

• Current Assignee: United States Endoscopy Group Incorporated
• Original Assignee: United States Endoscopy Group Incorporated
• Inventors: Secrest, Dean J., Younker, Marlin
• Granted Patent: US 7,108,661 B2
• Time in Patent Office: Days
• US Class Current: 600/562
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2010/0216 Sampling brushes
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 penetration depth

Abstract

A method and apparatus for obtaining esophageal cells for diagnostic purposes comprises inserting the distal end of a flexible support body in a patient'"'"'s stomach via the esophagus and mouth so that the proximal support body end projects from the mouth. A balloon at the distal support body end is inflated and the support body is withdrawn until the inflated balloon engages the sphincter at the stomach entrance. A support body location is marked that is a predetermined distance from the patient'"'"'s dental arch when the inflated balloon engages the sphincter at the stomach entrance. The balloon is deflated and the support body is withdrawn so that the marked locatin is adjacent the patient'"'"'s dental arch. The support body is withdrawn a second predetermined distance and a second support body location, adjacent the patient'"'"'s dental arch, is marked. A cell collecting element is deployed from within the distal end of the support body so that the cell collecting element is disposed in the esophagus within the predetermined distance from the sphincter. The support body is reciprocated through the second predetermined distance with the cell collecting element deployed so that cells from the esophagus within the second predetermined distance from the sphincter are deposited on the cell collecting element. The cell collecting element is retracted into the body so that it does not engage the esophagus wall, and the body is withdrawn from the patient.

Claims

1. A method of obtaining esophageal cells for diagnostic purposes comprising:

a. inserting the distal end of a flexible support body into a patient'"'"'s stomach via the esophagus and mouth so that the proximal support body end projects from the mouth;

b. expanding an expandable member at the distal support body end and withdrawing the support body until the expanded member engages the sphincter at the stomach entrance;

c. marking a support body location that is a predetermined distance from the patient'"'"'s dental arch when the expanded member engages the sphincter at the stomach entrance;

d. contracting the expanded member and withdrawing the support body so that the marked location is adjacent the patient'"'"'s dental arch;

e. withdrawing the support body a second predetermined distance and marking a second support body location that is adjacent the patient'"'"'s dental arch;

f. deploying a cell collecting element from the distal end of the support body so that the cell collecting element is disposed in the esophagus within the predetermined distance from the sphincter;

g. reciprocating the support body through the second predetermined distance with the cell collecting element deployed so that cells from the esophagus within the second predetermined distance from the sphincter are deposited on the cell collecting element;

h. conditioning the cell collecting element so that it does not engage the esophagus wall; and

,

i. withdrawing the support body from the patient.

2. The method claimed in claim 1 wherein marking the support body comprises frictionally securing first and second marker elements to the support body at said first and second support body locations, respectively.

3. The method claimed in claim 1 wherein marking the support body at said first support body location further comprises frictionally securing a third marker element to the support body in alignment with the patient'"'"'s dental arch when said balloon is located at the patient'"'"'s sphincter and thereafter positioning the first marker element the first predetermined distance from said third marker element.

4. The method claimed in claim 3 wherein marking said support body at said second predetermined distance comprises frictionally securing a third marker to said support body at said second predetermined distance from said first marker.

5. The method claimed in claim 2 wherein said first and second marker elements are frictionally secured to said support body, and further including sliding said marker elements along said support body to said first and second support body locations.

6. A Barrett'"'"'s cytology device comprising:

a. a flexible support body having a distal end that is insertable into a patient'"'"'s stomach via the esophagus and a proximal end that projects from the patient'"'"'s mouth when the distal end is in the patient'"'"'s esophagus;

b. a stomach sphincter locating system comprising an expandable member attached to the support body at the distal end, and an expander system by which expansion of the expandable member is controlled;

c. a cell collecting system comprising a brush disposed at the distal support body end, a brush actuator extending from the brush to the proximal support body end, and a handle connected to the brush actuator for shifting the brush axially relative to the support body between a retracted position where the brush is disposed within the support body and a deployed position where the brush is disposed beyond and adjacent the distal end; and

,

d. first and second marker elements attached to the support body for movement along the support body between adjusted positions that are located between the support body ends.

7. The device claimed in claim 6 wherein the expandable member comprises a balloon attached to said support body at the distal end, said expander unit comprises an inflation system at said proximal support body end, and an inflation channel communicating said balloon with said inflation system.

8. The device claimed in claim 7 wherein said inflation channel is defined by a passageway in the wall of said support body.

9. The device claimed in claim 8 wherein said inflation system comprises a syringe providing fluid for inflating said balloon and a blunt needle connected to said syringe and extending into said inflation channel for communicating inflation fluid from the syringe to said balloon via said inflation channel.

10. The device claimed in claim 7 wherein said inflation system further comprises a check valve between said syringe and said blunt needle, and coupling structure for detachably securing said syringe to said check valve, said check valve maintained in an open condition by said syringe when said syringe is coupled to said check valve, said valve blocking communication to said balloon when said syringe is detached from said valve.

11. The device claimed in claim 7 further comprising an inflation signaling mechanism providing a visual indication when the balloon is inflated.

12. The device claimed in claim 11 wherein said inflation signaling mechanism comprises an element that shifts from a first position to a second position in response to inflation of said balloon.

13. The device claimed in claim 6 further comprising an indicator mechanism for producing a signal in response to the stomach sphincter locating system being enabled.

14. The device claimed in claim 6 wherein said first and second marker elements are fixed to a common marker member that is slidably supported on said support body for moving said elements relative to said support body.

15. The device claimed in claim 14 further comprising a third marker element fixed to said marker member, said first, second and third marker elements marking respective locations on said support body.

16. A Barrett'"'"'s cytology device comprising:

a. a flexible support body having a distal end that is insertable into a patient'"'"'s stomach via the esophagus and a proximal end that projects from the patient'"'"'s mouth when the distal end is in the patient'"'"'s esophagus;

b. a stomach sphincter locating system comprising a balloon attached to the support body at the distal end, and an inflation system for inflating and deflating the balloon; and

,

c. a cell collecting system comprising a brush disposed at the distal support body end, a brush actuator extending between the brush to the proximal support body end, and a handle connected to the brush actuator for shifting the brush axially relative to the support body between a retracted position where the brush is disposed within the support body and a deployed position where the brush is disposed beyond the distal end in position for collecting cells for cytological examination.

17. The device claimed in claim 16 wherein said support body is a tubular member having an open distal end through which said brush is deployed from the retracted position by said brush actuator, said brush actuator disposed within said body.

18. The device claimed in claim 17 further comprising a cell recovery system connected to the proximal end of said support body for producing a vacuum pressure within said support body when said brush is retracted into said body.

19. The device claimed in claim 16 further comprising an inflation signaling mechanism-for providing a visual indication when the balloon is inflated and deflated.