Apparatuses and methods for percutaneously implanting objects in patients

• US 20090209804A1
• Filed: 07/25/2005
• Published: 08/20/2009
• Est. Priority Date: 07/23/2004
• Status: Abandoned Application

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Calypso Medical Technologies, Inc. (Siemens AG)
• Inventors: Seiler, Keith, Hadford, Eric, Gisselberg, Margo
• Application Number:
  US11/658,331
• Publication Number:
  US 20090209804A1
• Time in Patent Office: Days
• US Class Current: 600/7
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• CPC Class Codes: A61M 37/0069 Devices for implanting pellets, e.g. markers or solid medicaments for introducing of radioactive sources for interstitial radiation therapy, i.e. brachytherapy A61N5/1027
• CPC Class Codes: A61N 2005/1011 Apparatus for permanent insertion of sources
• CPC Class Codes: A61N 5/1027 Interstitial radiation therapy

Abstract

Apparatuses and methods for percutaneously implanting objects, such as radioactive seeds or markers, in patients. In one embodiment, a device for percutaneously implanting an object in a patient includes a handle, a cannula projecting outwardly from the handle, and an actuator movably disposed relative to the handle. In one aspect of this embodiment, the cannula can be configured to releasably hold the object and percutaneously penetrate the patient. In another aspect of this embodiment, the actuator can be operably connected to the cannula and operable to move the cannula relative to the handle and release the object within the patient. In a further aspect of this embodiment, the cannula can include a tip portion having a restriction configured to releasably hold the object for implantation in the patient.

Claims

1. A device for percutaneously implanting marker in a patient, the device comprising:

an elongated stylet having a proximal section and a distal section;

a first handle attached to the proximal section of the stylet;

a cannula having a proximal portion configured to receive the stylet and a distal portion configured to retain the marker;

a second handle attached to the proximal portion of the cannula; and

a retainer engaged with the first and the second handles, the retainer being configured to restrict relative movement between the first and second handles in a longitudinal direction.

2. The device of claim 1 wherein the retainer is configured to move between a first position in which the first handle is prevented from moving longitudinally relative to the second handle, and a second position in which the first and second handles can move longitudinally relative to each other.

3. The device of claim 2 wherein the retainer comprises a first C-clamp engaged with the first handle and second C-clamp engaged with the second handle, the first and second C-clamps being detachable from the first and second handles.

4. The device of claim 2 wherein:

the first handle has a first collar;

the second handle has a second collar; and

the retainer further comprises a first C-clamp engaged with the first handle next to the first collar, and a second C-clamp engaged with the second handle next to the second collar.

5. The device of claim 2 wherein the retainer comprises a tether having a first section attached to the first handle and a second section attached to the second handle.

6. The device of claim 2 wherein the retainer is pivotally attached to one of the first and second handles and the retainer contacts the other of the first and second handles in the first position.

7. The device of claim 2 where the retainer has a channel that removably receives the proximal section of stylet adjacent to the first handle.

8. The device of claim 2 wherein the retainer has a body portion with a channel that removably receives the stylet and a grip portion coupled to the body portion.

9. The device of claim 1 wherein the retainer comprises a flexible sleeve having a bulbous portion.

10. The device of claim 1, further comprising a marker having a unique characteristic loaded in the device, and wherein the retainer further comprises an indicator identifying the unique characteristic of the marker.

11. A device for implanting a marker into a patient, the marker having an alternating magnetic transponder that wirelessly transmits a location signal in response to a wirelessly transmitted excitation energy, the device comprising:

a cannula having a wall, a proximal portion, and a distal portion;

a marker holder at the proximal portion and/or the distal, portion of the cannula, wherein the marker holder is configured so that the location signal can propagate through the marker holder to a sensor.

12. The device of claim 11 wherein the marker holder comprises a testing region of the distal portion of the cannula, and the testing region has holes through the wall of the cannula.

13. The device of claim 12 wherein the holes comprise elongated slots through the wall of the cannula.

14. The device of claim 12 wherein the marker holder has three holes in the testing region arranged at 120°

increments around the cannula.

15. The device of claim 11 wherein the marker holder comprises:

a dielectric housing having a chamber configured to receive the marker; and

a retaining element in the cavity for releasably retaining the marker in the cavity.

16. The device of claim 11 wherein the marker holder is carried at the distal portion of the cannula and the marker comprises:

a dielectric housing having a cavity configured to contain a marker and an opening in which the distal portion of the cannula is positioned; and

a first retaining element in the cavity.

17. The device of claim 16 wherein a marker is loaded in the marker holder such that the first retaining element contacts the marker.

18. The device of claim 17 wherein the marker holder further comprises a second retaining element in the cavity contacting the distal portion of the cannula.

19. The device of claim 18 wherein the first and second retaining elements comprise elastic members.

20. The device of claim 16 wherein the marker holder further comprises a stop element distally of the first retaining element and an annulus around at least a proximal portion of the stop element.

21. The device of claim 16 wherein the marker holder further comprises a sleeve extending proximally of the dielectric housing and over the cannula.

22. The device of claim 16 wherein the marker holder further comprises a second retaining element in the cavity contacting the distal portion of the cannula, a stop element distally of the first retaining element, an annulus around at least a proximal portion of the stop element, and a sleeve extending proximally of the dielectric housing and over a section of the cannula.

23. The device of claim 11 wherein the marker. holder is carried at the proximal end of the cannula and the marker holder further comprises:

a dielectric housing having a cavity configured to contain a marker and an opening configured to receive a stylet; and

a retaining element in the cavity for holding the marker.

24. The device of claim 23 wherein the marker is loaded in the marker holder such that the retaining element contacts the marker.

25. The device of claim 23 wherein the retaining element comprises a resilient member.

26. A device for implanting marker in a patient, the device comprising:

a cannula having an interior channel, a proximal portion, and a distal portion configured to retain the marker,

a handle attached to the proximal portion of the cannula, the handle having a hub in communication with the interior channel; and

a marker container having a connection portion and a chamber coupled to the connection portion, the connection portion being releasably coupleable to the hub with the chamber in communication with the interior channel to deliver the marker from the chamber into the interior channel.

27. The device of claim 26 wherein the marker container includes a closure device releasably attachable to the connection portion to close the chamber.

28. The device of claim 26 wherein the marker container has a threaded receiving area and a projection extending into the receiving area, at least a portion of the chamber extends through the projection, and the hub is configured to extend into the receiving area and threadably engage the marker container.

29. The device of claim 26 wherein the marker container has a annular receiving area and a locking luer projecting into the receiving area, at least a portion of the chamber extends through the locking luer, and the hub is configured to extend into the annular with the chamber and engage the locking luer.

30. A device for percutaneously Implanting an object in a patient, the device comprising:

a handle having an opening;

a stylet having a proximal section fixed to the handle, a medial section through the opening in the handle, and a distal section outside of the handle;

a cannula over at least a portion of the stylet, the cannula having a proximal portion slidably received through the opening of the handle and a distal portion configured to releasably hold the object; and

an actuator connected to the proximal portion of the cannula and received in the handle.

31. The device of claim 30 wherein the actuator further comprises a button configured to be pressed into the handle and an extension projecting from the button to limit the distance that the button can be pressed into the handle.

32. The device of claim 30, further comprising a cam member attached to the handle, and wherein the actuator further comprises a follower.

33. The device of claim 31 wherein the cam member comprises a button pivotally attached to the handle and the follower comprises an inclined surface on the actuator.

34. The device of claim 30, further comprising a button moveably attached to the handle and a plurality of teeth on the actuator, wherein the button is configured to engage the teeth to incrementally move the actuator proximally within the handle.

35. The device of claim 30 wherein the handle is configured to be held in a single hand of an operator, and wherein the actuator is configured to be manipulated by a digit of the single hand of an operator to slide the cannula relative to the handle and release the object within the patient.

36. The device of claim 30, further comprising an interface element coupled to the actuator, the interface element comprising a position selector that is manually operable to move the actuator from a first position to a second position, wherein the cannula at least generally retains the object when the actuator is in the first position, and wherein the cannula releases the object when the actuator is moved to the second position.

37. The device of claim 30 wherein the distal portion of the cannula includes a tip portion configured to percutaneously penetrate the patient, and wherein the tip portion is configured to releasably hold the object for implantation in the patient.

38. The device of claim 37 wherein the tip portion includes a restriction configured to releasably hold the object for implantation in the patient.

39. A device for percutaneously implanting an object in a patient, the device comprising:

a handle; and

a cannula having a wall and distal portion configured to releasably hold the object, wherein the cannula has a hole through the wall through which an electromagnetic signal can propagate.

40. The device of claim 39 wherein the hole is an elongated slot.

41. The device of claim 39 further comprising a plurality of holes arranged radially around the wall.

42. A device for holding a marker and loading the marker into a cannula, the device comprising:

a dielectric housing having a cavity and an opening at one end of the cavity; and

a resilient retaining element in the cavity having an inner diameter less than a diameter of the marker.

43. The device of claim 42 wherein the marker is in the cavity and the retaining element contacts the marker.

44. The device of claim 42 wherein the resilient member comprises an elastic O-ring.

45. The device of claim 42 wherein the opening is at a proximal end of the housing and the retaining element comprises a first retaining element at a distal portion of the cavity, and wherein the device further comprises a second retaining element at a proximal portion of the cavity.

46. The device of claim 42 wherein the opening is at a proximal end of the housing and the retaining element comprises a first retaining element at a distal portion of the cavity, and wherein the device further comprises:

a second retaining element at a proximal portion of the cavity;

a stop element distally of the first retaining element; and

an annulus around the stop element.

47. An assembly, comprising:

a marker having a casing and an alternating magnetic transponder in the casing, the transponder having a ferrite core and a coil wrapped around the core, and wherein the transponder wirelessly transmits a resonating location signal in response to a wirelessly transmitted excitation energy; and

a marker holder having a dielectric housing, a cavity in the housing in which the marker is received, an opening at a proximal end of the housing, and a retaining element in the cavity having a resilient contact surface contacting the casing of the marker.

48. The assembly of claim 47 wherein the resilient member comprises an elastic O-ring.

49. The assembly of claim 47 wherein the retaining element comprises a first retaining element at a distal portion of the cavity and the device further comprises a second retaining element at a proximal portion of the cavity.

50. The assembly of claim 47 wherein the retaining element comprises a first retaining element at a distal portion of the cavity and the device further comprises:

a second retaining element at a proximal portion of the cavity;

a stop element distally of the first retaining element; and

an annulus around the stop element.

51. A cannula for use in percutaneously implanting an object in, a patient, the cannula comprising a tube having a wall, a proximal inlet configured to receive the object, an intermediate portion extending distally from the proximal inlet, a distal portion extending distally from the intermediate portion, a tip with a cutting edge configured to penetrate the skin of the patient at the distal portion, a restriction at the cutting edge configured to releasably hold the object within the cannula, and a hole through the wall proximate to the distal tip to allow an electromagnetic signal to propagate from the cannula.

52. A method for percutaneously implanting an object in a patient, the method comprising:

restricting relative movement between a cannula and a stylet in a longitudinal direction with respect to a longitudinal axis of the cannula by engaging a retainer with the cannula and the stylet;

driving the cannula and the stylet into the patient while restricting relative longitudinal movement therebetween;

releasing the retainer to allow relative movement between the cannula and the stylet; and

drawing the cannula proximally over the stylet.

53. A method for handling a marker configured to be implanted into a patient, the marking having a transponder configured to wirelessly transmit a location signal in response to a wirelessly transmitted excitation energy, the method comprising:

loading the marker into a marker holder through which the location signal can propagate;

energizing the marker by wirelessly transmitting the excitation energy to the marker; and

sensing the location signal wirelessly transmitted from the marker through the marker holder.

54. The method of claim 53 wherein the marker holder comprises a dielectric housing carried at a proximal end of a cannula and the method further comprises loading the marker into the housing before energizing the marker and sensing the location signal.

55. The method of claim 54, further comprising inserting a stylet through the housing and the cannula after sensing the location signal to drive the marker through the cannula.

56. The method of claim 53 wherein the marker holder comprises a dielectric housing having a cavity containing the marker and a distal portion of a cannula is received in the cavity, and wherein the method further comprises positioning the distal portion of the cannula proximally of the marker such that at least a portion of the marker is outside of the cannula.

57. The method of claim 56 wherein the marker is energized and the location signal is sensed while at least a portion of the marker is outside of the cannula.

58. The method of claim 56, further comprising inserting a stylet into the cannula before energizing the marker.

59. The method of claim 58, further comprising shipping the marker while the marker is loaded in the cavity, the distal portion of the cannula is in the cavity, and the stylet is in the cannula.

60. The method of claim 56, further comprising removing the marker from the housing by moving the cannula distally so that restrictions at the distal portion of the cannula are located distally of the marker and then moving the cannula proximally until the distal portion of the cannula is withdrawn from the housing.

61. The method of claim 53 further comprising loading the market into a cannula having a wall, positioning the marker adjacent to a hole through the wall of the cannula, and propagating the location signal through the hole in the wall of the cannula.

62. A method for testing a marker and percutaneously implanting the marker in a patient, the method comprising:

energizing the marker while in a non-conducting container coupled to a proximal end and/or a distal end of a cannula;

loading the marker into the cannula;

driving cannula and the marker into the patient; and

moving the cannula in a proximal direction relative to a stylet in the cannula to release the marker within the patient.