Transrectal prostate biopsy device and method

• US 4,600,014 A
• Filed: 02/10/1984
• Issued: 07/15/1986
• Est. Priority Date: 02/10/1984
• Status: Expired due to Fees

• Current Assignee: Dan Beraha
• Original Assignee: Dan Beraha
• Inventors: Beraha, Dan
• Primary Examiner(s): Shay, David
• Application Number:
  US06/579,158
• Time in Patent Office: 886 Days
• Field of Search: 128/749, 128/751, 128/752, 128/753, 128/754, 128/303.15, 128/310
• US Class Current: 600/567
• CPC Class Codes: A61B 10/0241 for prostate
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/00547 Prostate

Abstract

An improved biopsy needle suitable for obtaining a core sample from a prostate gland. A handle which may be held in the palm of the physician'"'"'s hand is provided with a forward extending guide tube. A cannula with a sharpened distal end is slidably disposed within the guide tube and is movable by a thumb tab from a retracted position within the guide tube to an extended position in which the cutting edge extends from the guide tube. A sampling stylet having a sharpened distal end and a sample-collecting slot therein is telescopically disposed within the cannula and projects from the rear of the handle. A knob at the proximal end of the stylet permits movement from a retracted position in which the pointed tip of the stylet projects slightly from the distal end of the guide tube to an extended position in which the pointed distal end extends from the guide tube distal end. The physician holding the handle in the palm of his hand places his index finger at the distal end of the guide tube and guides the distal end to a selected point on the prostate gland transrectally. Upon locating the desired point, the hand holds the instrument steady while the other hand pushes the stylet forward into the tissue, pushes the cannula forward to sever tissue within the sampling slot, and the device is then withdrawn with the desired sample.

Claims

1. A biopsy device comprising:

(a) a handle formed to fit an operator'"'"'s head;

(b) a set of three telescoping elements projecting from said handle in which

(i) an outer one of said elements is a cylindrical guide tube having distal and proximal ends, said proximal end fixedly attached to said handle,

(ii) a middle one of said elements is a cutting cannula slidably disposed within said guide tube and having a sharpened distal end thereof which in a first position is retracted into the distal end of said guide tube and which in a second position is extended a preselected distance from the distal end of said guide tube, and a proximal end within said handle said proximal end including means slidably attached to said handle,

(iii) an inner one of said elements is a sampling stylet slidably disposed within said cannula and having a pointed distal end, a transverse sampling notch adjacent said stylet distal end, and a proximal end projecting through said handle;

(c) a push knob attached to said proximal end of said stylet, said knob having a first position in which the pointed distal end of said stylet projects slightly beyond said distal end of said guide tube and a second position in which said pointed distal end of said stylet projects beyond said distal end of said guide tube a distance to expose said sampling notch when said cannula is in its first position; and

(d) means associated with said handle for moving said cannula between said first position and said second position, said cannula in said second position covering said sampling notch of said stylet.

2. A transrectal biopsy device for obtaining core samples of prostatic tissue comprising:

an elongate handle formed to fit the palm of a human hand and having a longitudinal opening therethrough;

a cylindrical hollow fixed guide tube inserted in said longitudinal opening and attached to a forward end of said handle;

said guide tube extending forwardly therefrom;

a hollow cannula disposed in a telescoping arrangement within said guide tube, said cannula having a cutting distal end thereof and having means slidably attached to said handle for retracting said distal end of said cannula so as to be within said guide tube and for moving said cutting distal end thereof to a position extending from the distal end of said guide tube;

a sampling stylet having a sharpened distal end and a transverse sampling notch therein adjacent said distal end, said stylet disposed in a telescoping arrangement within said cannula and having a proximal end extending from said longitudinal opening at a rear end of said handle and said distal end extending slightly from said distal end of said guide tube;

a push knob attached to said proximal end of said stylet, said push knob having a rearward position in which the distal end of said stylet projects slightly from the distal end of said fixed guide tube in which said sampling notch is within said guide tube and said cannula, when said cannula is retracted and a forward position in which the distal end of said stylet projects a second distance from said distal end of said guide tube thereby exposing said sample notch and in which said cannula when in its extended position covers said sampling notch; and

said handle and said guide tube thereby permitting and operator to hold said handle in one hand and to contact the distal end of said guide tube with the index finger of that hand and thereby guide the distal ends of said stylet and said cannula to a selected point on a prostate gland transrectally.

3. A device for collection of a sample from human tissue for biopsy purposes comprising:

a handle formed to be held in the human hand and having a forward end and a rearward end;

a hollow guide tube having a proximal end attached to said handle and a distal end projecting a preselected distance from said forward end of said handle, said guide tube fixed to and stationary with respect to said handle;

a cannula telescopically disposed within said guide tube and having a proximal end within said handle and a distal end adjacent the distal end of said guide tube, said distal end sharpened to provide a cutting edge thereof;

cannula moving means disposed in said handle and attached to the proximal end of said cannula, said cannula moving means including means slidably attached to said handle for moving said cannula from a retracted first position in which said cutting edge thereof is within said guide tube to an extended second position in which said cutting edge projects a preselected distance from said distal end of said guide tube;

a stylet telescopically disposed within said cannula and having a proximal end extending through said rearward end of said handle and a distal end sharpened to a point, said stylet having a tissue-collecting notch adjacent said distal end thereof; and

a push knob attached to said proximal end of said stylet for moving said stylet from a retracted first position in which said point projects slightly from the distal end of said guide tube to an extended second position in which said point projects a preselected distance from said distal end of said guide tube; and

said push knob is adapted to move said stylet from its retracted first position to its extended second position when said cannula is in said first position and when said distal end of said stylet is in contact with tissue to be sampled to thereby cause tissue to project into said notch, and said cannula moving means is adapted to thereafter move said cannula to its extended second position thereby cutting a core sample of the tissue extending into said notch.

4. The device as defined in claim 3 in which said handle includes a convexly curved portion adapted to fit the palm of the hand.

5. The device as defined in claim 3 which further comprises:

first stop means for defining said retracted position and said extended position of said cannula; and

second stop means for defining said retracted position and said extended position of said stylet.

6. The device as defined in claim 5 in which said second stop means includes a stopbar attached to said push knob and having a first stop limiting the movement of said stylet in the retracted direction and a second stop limiting the movement of said stylet in the extended direction.

7. The device as defined in claim 5 in which:

said handle includes an aperture therein; and

in which said cannula moving means includes a thumb tab slidably disposed in said aperture, the proximal end of said cannula attached to said thumb tab, said aperture serving as said first stop means.

8. The device as defined in claim 7 which further comprises:

bias means for urging said thumb tab and said cannula in the extended direction;

detent means for holding said thumb tab and said cannula in the retracted position; and

release means for releasing said detent to permit said cannula to sharply extend.

9. A method of obtaining a tissue sample from a prostate gland utilizing a biopsy device having a guide tube attached to a handle, an extendable cannula telescopically disposed in the guide tube and having a sharpened distal end thereof and a thumb tab at its proximal end for extending the cannula, and an extendable sampling stylet telescopically disposed in the cannula having a sharpened distal end, a sampling notch adjacent the distal end, and a knob at its proximal end for extending the stylet, comprising the steps of:

placing the handle of the biopsy device in the palm of one hand with the distal end of the guide tube held in contact with the tip of the index finger of that hand;

inserting the index finger and the guide tube transrectally to contact the rectal wall adjacent the prostate gland of the patient;

locating a desired area of the gland with the tip of the finger and holding the distal end of the guide tube at a desired point in the area;

holding the handle and guide tube steady with the hand;

moving the stylet knob in the extending direction using the other hand so as to cause the sharpened distal end of the stylet to penetrate the gland at the desired point and to cause tissue of the gland to project into the notch;

slicing a core of tissue in the stylet sampling notch by moving the cannula by means of the thumb tab in the extending direction into the tissue of the gland using the other hand; and

withdrawing the index finger, the guide tube, the stylet and the cannula from the gland and the rectum.