Medical retrieval devices and methods

• US 20050154378A1
• Filed: 09/16/2004
• Published: 07/14/2005
• Est. Priority Date: 09/18/2003
• Status: Active Grant

• Current Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Curtis, Juli L., Teague, James A., Kear, Jason W., Segura, Joseph W., Cheng, Eric
• Granted Patent: US 7,727,227 B2
• Time in Patent Office: Days
• US Class Current: 606/2.500
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/00853 low friction, hydrophobic and corrosion-resistant fluorocarbon resin coating (ptf, ptfe, polytetrafluoroethylene)
• CPC Class Codes: A61B 2017/22074 the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
• CPC Class Codes: A61B 2017/22078 for rotating the instrument within a channel, e.g. an optical fibre
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2217 single wire changing shape to a gripping configuration
• CPC Class Codes: A61B 2017/2944 Translation of jaw members

Abstract

A medical device includes a sheath having a lumen and an elongate member disposed within the lumen of the sheath. The elongate member is moveable relative to the sheath and includes a retrieval assembly. The retrieval assembly has a collapsed position within the lumen of the sheath and an expanded position when extended beyond a distal end of the sheath. The elongate member defines a lumen configured to receive a laser.

Claims

1. A medical device, comprising;

a sheath having a lumen; and

an elongate member disposed within the lumen of the sheath and moveable relative to the sheath, the elongate member including a retrieval assembly having a collapsed position within the lumen of the sheath and an expanded position when extended beyond a distal end of the sheath, the elongate member defining a lumen configured to receive a laser.

2. The device of claim 1, further including a handle having an actuation mechanism configured to assist in transitioning the retrieval assembly between the collapsed position and the expanded position.

3. The device of claim 2, wherein at least one of the elongate member or the sheath is connected to the actuation mechanism to provide relative movement between the elongate member and the sheath.

4. The device of claim 2, wherein the device further includes a laser, and the handle further includes a knob operatively connected to the laser to assist in manipulating the laser.

5. The device of claim 4, wherein the knob is configured to rotate the laser relative to the sheath and the elongate member.

6. The device of claim 5, wherein the knob is configured to translate the laser longitudinally relative to the sheath and the elongate member.

7. The device of claim 2, wherein the handle further includes an adaptor defining an adaptor lumen configured to receive the laser.

8. The device of claim 7, wherein the sheath defines an orifice aligned with the adaptor lumen and configured to receive the laser.

9. The device of claim 1, wherein the retrieval assembly includes a plurality of legs.

10. The device of claim 9, wherein at least one of the plurality of legs includes a free distal end, the at least one of the plurality of legs defining a portion of the lumen of the elongate member configured to receive a laser.

11. The device of claim 10, wherein the at least one of the plurality of legs comprises a preformed shape and exits the sheath at a predetermined angle.

12. The device of claim 10, further including a laser disposed within the portion of the lumen of the at least one of the plurality of legs and moveable relative to the at least one of the plurality of legs.

13. The device of claim 12, wherein the laser exits the free distal end of the at least one of the plurality of legs to deliver energy to a material at a predetermined angle.

14. The device of claim 9, further including a laser disposed within the lumen of the elongate member, the laser and the elongate member being moveable relative to each other.

15. The device of claim 14, wherein the laser comprises a pre-formed shape and exits the lumen of the elongate member at a predetermined angle.

16. The device of claim 14, wherein the elongate member defines an inner surface angled relative to a longitudinal axis of the elongate member to direct the laser at a predetermined angle relative to the longitudinal axis of the elongate member.

17. The device of claim 16, wherein the predetermined angle is between approximately 20 degrees and approximately 60 degrees relative to the longitudinal axis of the elongate member.

18. The device of claim 14, wherein the laser includes a laser cannula.

19. The device of claim 9, wherein each of the plurality of legs is joined at a distal tip of the retrieval assembly.

20. The device of claim 1, wherein the retrieval assembly comprises a helical element having a lumen and at least one opening configured to permit the laser to exit the lumen of the helical element.

21. The device of claim 20, wherein the elongate member and the helical element are formed from the same piece of material, and the lumen of the elongate member is in communication with the lumen of the helical element.

22. The device of claim 20, wherein the laser includes a laser cannula.

23. The device of claim 20, wherein the at least one opening is configured to direct the laser to exit the lumen of the helical element at a predetermined angle.

24. The device of claim 1, wherein the retrieval assembly comprises a grasping assembly including a plurality of legs each having a free distal end, the grasping assembly being formed by removing at least a portion of the elongate member.

25. The device of claim 24, wherein at least a portion of the elongate member proximal to the plurality of legs is removed to increase the flexibility of the device.

26. The device of claim 24, wherein at least one of the plurality of legs includes a textured surface to assist in gripping a material.

27. The device of claim 26, wherein the textured surface includes teeth on an inner surface of the at least one of the plurality of legs.

28. The device of claim 24, further including a laser disposed within the lumen of the elongate member and moveable relative to the elongate member.

29. A medical device, comprising:

a sheath including a lumen, an opening on a side of the sheath at a distal end of the sheath, and an inner surface proximate the opening to direct a laser through the opening; and

an elongate member disposed within the lumen of sheath and moveable relative to the sheath, the elongate member including a retrieval assembly having a collapsed position within the lumen of the sheath and an expanded position when extended beyond the distal end of the sheath.

30. The device of claim 29, wherein the retrieval assembly comprises a first leg, a second leg, and a tip joining the first and second legs together.

31. The device of claim 29, wherein the inner surface is angled relative to a longitudinal axis of the sheath.

32. The device of claim 29, further including a laser disposed within the lumen of the sheath.

33. The device of claim 32, wherein a ramp-like structure defines the inner surface.

34. The device of claim 33, wherein the ramp-like structure is configured to direct the laser at an angle between approximately 20 degrees and approximately 60 degrees relative to a longitudinal axis of the sheath.

35. The device of claim 33, wherein at least a portion of the elongate member is disposed within a passage of the ramp-like structure, the elongate member being movable relative to the ramp-like structure.

36. The device of claim 32, wherein the laser is disposed within a laser cannula and is moveable relative to the laser cannula.

37. The device of claim 36, wherein the inner surface is positioned to direct the laser cannula to exit the lumen of the sheath through the opening at a predetermined angle relative to a longitudinal axis of the sheath.

38. A method of performing laser lithotripsy on a material, comprising:

providing a medical device comprising a sheath, an elongate member disposed within a lumen of the sheath, and a laser at least partially disposed within a lumen of the elongate member, the elongate member including a retrieval assembly at a distal end of the elongate member;

transitioning the retrieval assembly from a collapsed position within the lumen of the sheath to an expanded position;

capturing the material within the retrieval assembly;

positioning the laser to direct energy toward the material;

reducing the size of the captured material with the laser; and

removing the medical device.

39. The method of claim 38, wherein transitioning the retrieval assembly from the collapsed position to the expanded position includes moving the elongate member relative to the sheath.

40. The method of claim 39, wherein positioning the laser includes rotating the laser relative to the elongate member.

41. The method of claim 39, wherein positioning the laser includes moving the laser longitudinally relative to the elongate member.

42. The method of claim 38, wherein the retrieval assembly includes a plurality of legs, at least one of the plurality of legs including a free distal end and defining a portion of the lumen of the elongate member.

43. The method of claim 42, wherein the at least one of the plurality of legs comprises a preformed shape and exits the sheath at a predetermined angle.

44. The method of claim 43, wherein positioning the laser includes extending the laser through the portion of the lumen of the at least one of the plurality of legs.

45. The method of claim 44, wherein positioning the laser includes extending the laser beyond the free distal end of the at least one of the plurality of legs.

46. The method of claim 38, wherein the laser comprises a pre-formed shape and exits the lumen of the elongate member to direct energy toward the material at a predetermined angle.

47. The method of claim 38, wherein positioning the laser includes extending the laser against an inner surface of the elongate member angled relative to a longitudinal axis of the elongate member.

48. The method of claim 47, wherein the inner surface has an angle between approximately 20 degrees and approximately 60 degrees relative to the longitudinal axis of the elongate member.

49. The method of claim 38, wherein the laser includes a laser cannula.

50. The method of claim 38, wherein the retrieval assembly comprises a helical element having a lumen and at least one opening, and positioning the laser includes extending the laser through the lumen of the elongate member, through the lumen of the helical element, and through the at least one opening of the helical element.

51. The method of claim 50, wherein the elongate member and the helical element are formed from the same piece of material, and the lumen of the elongate member is in communication with the lumen of the helical element.

52. The method of claim 50, wherein the laser includes a laser cannula.

53. The method of claim 50, wherein the at least one opening is configured to direct the laser to exit the lumen of the helical element at a predetermined angle.

54. The method of claim 38, wherein the retrieval assembly comprises a grasping assembly including a plurality of legs each having a free distal end, the grasping assembly being formed by removing at least a portion of the elongate member.

55. The method of claim 54, wherein at least a portion of the elongate member proximal to the plurality of legs is removed to increase the flexibility of the device.

56. The method of claim 54, wherein at least one of the plurality of legs includes a textured surface to assist in gripping a material.

57. The method of claim 56, wherein the textured surface includes teeth on an inner surface of the at least one of the plurality of legs.

58. The method of claim 54, wherein capturing the material further includes gripping the material with the plurality of legs.

59. The method of claim 54, wherein positioning the laser includes extending the laser relative to the elongate member, beyond the lumen of the elongate member, and proximate the material.

60. A method of performing laser lithotripsy on a material, comprising:

providing a medical device, comprising;

a sheath including a lumen, an opening on a side of the sheath at a distal end of the sheath, and an inner surface proximate the opening to direct a laser through the opening,

an elongate member disposed within the lumen of sheath and moveable relative to the sheath, the elongate member including a retrieval assembly, and

a laser disposed within the lumen of the sheath;

transitioning the retrieval assembly from a collapsed position within the lumen of the sheath to an expanded position;

capturing the material within the retrieval assembly;

positioning the laser to direct energy toward the material;

reducing the size of the captured material with the laser; and

removing the medical device.

61. The method of claim 60, wherein the inner surface includes an angle between approximately 20 degrees and approximately 60 degrees relative to a longitudinal axis of the sheath.

62. The method of claim 61, wherein positioning the laser includes directing a portion of the laser along the inner surface.

63. The method of claim 62, wherein positioning the laser further includes extending a portion of the laser through the opening of the sheath.

64. The method of claim 61, wherein a ramp-like structure defines the inner surface, and at least a portion of the elongate member is disposed within a passage of the ramp-like structure, the elongate member being movable relative to the ramp-like structure.