MINIMALLY INVASIVE METHODS AND APPARATUS

• US 20090054805A1
• Filed: 07/26/2006
• Published: 02/26/2009
• Est. Priority Date: 07/26/2005
• Status: Active Grant

• Current Assignee: Precision Thoracic, LLC
• Original Assignee: Precision Thoracic Corporation
• Inventors: Boyle, Edward M. JR.
• Granted Patent: US 8,734,362 B2
• Time in Patent Office: Days
• US Class Current: 600/564
• CPC Class Codes: A61B 10/0266 means for severing sample
• CPC Class Codes: A61B 10/0283 with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe A61B10/025, A61B10/0266 take precedence
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12159 Solid plugs; being solid before insertion
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/32093 for skin incisions
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2010/0006 involving a colour change
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00296 : mounted on an endoscope
• CPC Class Codes: A61B 2017/00535 : pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00575 : for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00592 : Elastic or resilient implements
• CPC Class Codes: A61B 2017/00606 : Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00809 : Lung operations
• CPC Class Codes: A61B 2017/22034 : for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22038 : with a guide wire
• CPC Class Codes: A61B 2017/22061 : for spreading elements apart
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2018/00029 : open
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00595 : Cauterization
• CPC Class Codes: A61B 2018/0063 : Sealing
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61M 2025/1013 : with concentrically mounted balloons, e.g. being independently inflatable
• CPC Class Codes: A61M 2025/105 : having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
• CPC Class Codes: A61M 2025/1081 : having sheaths or the like for covering the balloon but not forming a permanent part of the balloon, e.g. retractable, dissolvable or tearable sheaths
• CPC Class Codes: A61M 2025/1086 : having a special balloon surface topography, e.g. pores, protuberances, spikes or grooves
• CPC Class Codes: A61M 25/0045 : multi-layered, e.g. coated coating materials A61L29/08
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00

Abstract

Methods and apparatus are provided to facilitate the minimally invasive removal of tissue biopsies and to facilitate the direct approach to anesthetizing the chest wall, in accordance with embodiments of the present invention. A pull-type cutting device 1 comprises two coaxially nested tubes, each extending from a proximal end 21 to a distal end 22. The first tube 61 defines a guide wire lumen 23 for slidingly receiving a guide wire. The second tube 63 extends over the first tube 60 and coupled thereto at the distal end 22 defining an expandable portion 13 adjacent the distal end 22. The second tube 63 defines an inflation lumen 25 extending from the shaft proximal end 21 to the expandable portion 13. The inflation lumen 25 communicates inflation fluid from the proximal end 21 to the expandable portion 13 so as to inflate and deploy the expandable portion 13. Disposed adjacent the shaft distal end 22 is a cutting head 10 comprising the expandable portion 13 having a cutting portion 11 distal from the shaft distal end 22.

Claims

1-20. -20. (canceled)

21. A biopsy device comprising:

a biopsy tool and a pull-type cutting device, the biopsy tool comprising;

a hollow needle having a needle distal end; and

a deployable and retractable snare, the needle distal end sharpened so as to pass through tissue, the needle defining a needle bore, the snare including a snare shaft and a snare head at a distal end of the snare shaft, the snare head adapted to collapse to a low-profile state when housed within the needle bore and deploy to a higher profile when extended from the needle bore, the snare adapted to be advanced beyond the needle distal end after the needle distal end is advanced beyond the target tissue, the snare having a snare coupling element;

the pull-type cutting device comprising;

a shaft having a shaft distal end and a shaft proximal end and a lumen extending there through;

a cutting head disposed about the shaft distal end, the cutting head including an expandable portion having a cutting portion proximal from the shaft distal end, the expandable portion in fluid communication with a fluid lumen which is adapted to supply fluid to the expandable portion so as to inflate the expandable portion, the lumen adapted to pass over a guide wire or snare shaft, at the shaft distal end the expandable portion defining a cavity, extending from the cutting portion are a plurality of cutting elements, the expandable portion distal end including a cutting device coupling element adapted to couple with the snare coupling element, the expandable portion adapted to couple with the snare head.

22. The device of claim 21, the snare head further comprising a sealing element adapted to seal the tissue as it is drawn past and through tissue.

25. The device of claim 21, wherein the cutting elements are stand-off blades extending from the cutting portion.

26. The device of claim 21, wherein the cutting elements are stand-off blades and a loop cutting element, the stand-off blades extending from the cutting portion supporting the loop cutting element.

27. The device of claim 21, wherein the cutting elements are radiofrequency cutting elements.

28. The device of claim 21, wherein the cutting elements are laser cutting elements.

29. The device of claim 21, wherein the cutting elements are electrocautery cutting elements.

30. The device of claim 21, wherein the snare comprises a snare head having a proximal end comprising a snare head coupling element, the expandable portion comprising an expandable portion coupling element, the snare head coupling element adapted to couple with the expandable portion coupling element.

31. The device of claim 22, wherein the sealing element is an energy imparting element adapted to cauterize tissue.

32. The device of claim 22, wherein the sealing element is an energy imparting element adapted to produce radiofrequency energy suitable to cauterize tissue.

33. The device of claim 22, wherein the sealing element is an energy imparting element adapted to produce laser energy suitable to cauterize tissue.

34. The device of claim 22, wherein the sealing element is adapted to extrude polymer sealing material.

35. The device of claim 22, wherein the sealing element is adapted to expel a sealing fluid suitable to seal tissue.

36. The device of claim 35, wherein the sealing fluid is a biodegradable material suitable to form a plug.

37. The device of claim 22, wherein the sealing element is adapted to extrude a biodegradable material suitable to form a plug.

23. A method for obtaining a biopsy comprising:

using a biopsy tool comprising a hollow needle having a needle distal end, and a deployable and retractable snare, the needle distal end sharpened so as to pass through tissue, the needle defining a needle bore, the snare including a snare shaft and a snare head at a distal end of the snare shaft, the snare head adapted to collapse to a low-profile state when housed within the needle bore and deploy to a higher profile when extended from the needle bore, the snare adapted to be advanced beyond the needle distal end after the needle distal end is advanced beyond the target tissue, the snare having a snare coupling element;

advancing the biopsy tool through to the target tissue;

advancing the snare beyond the needle distal end;

deploying the snare head such that the target tissue is between the snare head and the operator;

withdrawing the needle along the snare shaft and removing there from leaving the snare in place;

advancing a pull-type cutting device along the snare shaft, the pull-type cutting device comprising a shaft having a shaft distal end and a shaft proximal end and a lumen extending there through, a cutting head disposed about the shaft distal end, the cutting head including an expandable portion having a cutting portion proximal from the shaft distal end, the expandable portion in fluid communication with a fluid lumen which is adapted to supply fluid to the expandable portion so as to inflate the expandable portion, the lumen adapted to pass over a guide wire or snare shaft, at the shaft distal end the expandable portion defining a cavity, extending from the cutting portion are a plurality of cutting elements, the expandable portion distal end including a cutting device coupling element adapted to couple with the snare coupling element, the expandable portion adapted to couple with the snare head;

advancing the pull-type cutting device along the snare shaft such that the cutting head is adjacent the target tissue;

deploying the expandable portion including the cutting portion;

pulling the snare towards the cutting head with the snare head proximal end placed into engagement with and coupled to the expandable portion distal end;

pulling the pull-type cutting device and the snare as a unit toward the operator cutting a tract into the tissue.

24. The method of claim 23, further comprising:

activating the sealing element on the snare prior to pulling the pull-type cutting device and the snare as a unit toward the operator cutting a tract into the tissue, whereby sealing the tract as the snare is withdrawn to prevent bleeding and/or air leakage.