Surgical cauterization snare with polyp capturing web net

• US 5,336,227 A
• Filed: 02/01/1993
• Issued: 08/09/1994
• Est. Priority Date: 11/05/1991
• Status: Expired due to Term

• Current Assignee: Granit Medical Innovations LLC
• Original Assignee: Wilk & Nakao Medical Technology Incorporated
• Inventors: Wilk, Peter J., Nakao, Naomi L.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Dawson, Glenn K.
• Application Number:
  US08/012,657
• Time in Patent Office: 554 Days
• Field of Search: 128/4, 128/6, 604/93, 604/171, 604/264, 606/37, 606/39, 606/40, 606/41-52, 606/106, 606/110, 606/113, 606/114, 606/127, 606/128, 606/170, 606/167
• US Class Current: 606/114
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/141 Snare

Abstract

A surgical instrument assembly for use in snare cauterization operations includes a tubular sheath member, a metallic cauterization loop, and a metal wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is operatively connectable to the wire for feeding an electrical current to the loop via the wire, while a manually actuatable shifter is operatively connected to the wire for longitudinally sliding the wire along the sheath in alternately opposite directions. A flexible web member is connected to the loop to form a capture pocket, the loop defining a mouth opening of the pocket. During use of the snare cauterization instrument, the loop is at least partially expanded from a collapsed configuration and passed over a polyp to be removed, so that the web member substantially surrounds the selected polyp. The loop is then closed to engage the polyp around a base region thereof and an electrical current is subsequently conducted through the loop to burn through the polyp at the base region thereof. Severance of the polyp occurs upon a closure of the cauterization loop by its being withdrawn or retracted into the tubular sheath member. The severed polyp is automatically captured by the web member.

Claims

1. A method for removing a selected portion of internal body tissues of a patient, comprising the steps of:

providing a conductive cauterization loop to which a flexible web member is connected to define an expandable pocket, said web member being attached to said loop in a manner so as to expose said loop to enable effective cauterization of organic tissues by said loop;

inserting an endoscope assembly into a patient;

using said endoscope assembly to visually monitor internal body tissues of the patient upon insertion of said endoscope assembly into the patient;

upon detecting selected internal body tissues to be removed from the patient, ejecting said loop with said web member from a distal end of a biopsy channel of said endoscope assembly;

upon ejection of said loop and said web member from said biopsy channel, at least partially expanding said loop and said web member from a collapsed configuration;

manipulating said loop from outside of the patient to pass the expanded loop over the selected internal body tissues to be removed, so that said web member substantially surrounds said selected internal body tissues;

closing said loop to engage said selected internal body tissues around a base region thereof;

conducting an electrical current through said loop to burn through said selected internal body tissues at said base region, thereby severing said selected internal body tissues at said base region; and

upon a completed burning of said loop through said base region, at least partially closing said loop, thereby capturing the severed internal body tissues.

2. The method defined in claim 1, further comprising the steps of ejecting an auxiliary instrument from a distal end of the endoscope assembly and operating said auxiliary instrument to apply a pair of markers to tissues on opposite sides of said base region, thereby enabling subsequent identification of the severed internal body tissues with a respective site within the patient.

3. The method defined in claim 2 wherein the step of operating includes the step of applying a biocompatible dye or ink to tissues on opposite sides of said base region.

4. The method defined in claim 1, further comprising the step of transferring a color patch from said loop during said step of conducting.

5. A surgical instrument assembly for use in snare cauterization operations, comprising:

an endoscope assembly including an endoscope insertion member having a biopsy channel and further having means disposed at a distal end of said endoscope insertion member for delivering light to and receiving light from a surgical site;

a tubular sheath member inserted through said biopsy channel;

a metallic cauterization loop;

a metal wire operatively connected to said loop, said wire passing longitudinally through said sheath;

electrical supply means operatively connected to said wire for feeding an electrical current to sail loop via said wire;

manually actuatable shifting means operatively connected to said wire for longitudinally sliding said wire along said sheath in alternately opposite directions; and

a flexible web member connected to said loop to form a capture pocket, said loop defining a mouth opening of said pocket, said web member being attached to said loop in a manner so as to expose said loop to enable effective cauterization of organic tissues by said loop.

6. The instrument assembly defined in claim 5 wherein said loop opens and closes in essentially a single plane.

7. The instrument assembly defined in claim 5 wherein said loop has a bend in an expanded configuration of said loop, said bend arcing out of a plane in which said loop opens and closes.

8. The instrument assembly defined in claim 5, further comprising identification means ejectable in part from a distal end of the endoscope assembly for applying a pair of markers to tissues on opposite sides of said base region, thereby enabling subsequent identification of the severed internal body tissues with a respective site within the patient.

9. The instrument assembly defined in claim 8 wherein said identification means includes means for applying a biocompatible dye or ink to tissues on opposite sides of said base region.

10. The instrument assembly defined in claim 5, further comprising means for transferring a color patch from said loop tissues on opposite sides of said base region during said step of conducting.

11. A method for removing a selected portion of internal body tissues of a patient, comprising the steps of:

providing a conductive cauterization loop to which a flexible web member is connected to define an expandable pocket, said web member being attached to said loop in a manner so as to expose said loop to enable effective cauterization of organic tissues by said loop;

at least partially expanding said loop and said web member from a collapsed configuration;

passing the expanded loop over the selected internal body tissues to be removed, so that said web member substantially surrounds said selected internal body tissues;

closing said loop to engage said selected internal body tissues around a base region thereof;

conducting an electrical current through said loop to burn through said selected internal body tissues at said base region, thereby severing said selected internal body tissues at said base region; and

operating an instrument to apply a pair of markers to tissues on opposite sides of said base region, thereby enabling subsequent identification of the severed internal body tissues with a respective site within the patient.

12. The method defined in claim 11 wherein said markers are colored staples, said step of operating including the step of applying said staples to the tissues on opposite sides of said base region.

13. The method defined in claim 12 wherein said staples are applied prior to said steps of expanding and passing.

14. The method defined in claim 12 wherein said staples are applied after said steps of expanding and passing.

15. The method defined in claim 11 wherein step of operating includes the step of applying a biocompatible dye or ink to tissues on opposite sides of said base region.

16. The method defined in claim 15 wherein said step of applying includes the step of injecting said biocompatible dye or ink into the tissues.

17. The method defined in claim 11 wherein said markers are areas of matching color.

18. The method defined in claim 11 wherein said step of operating includes the step of transferring a color patch from said loop during said step of conducting.

19. The method defined in claim 11, further comprising the steps of:

inserting an endoscope assembly into a patient;

using said endoscope assembly to visually monitor internal body tissues of the patient upon insertion of said endoscope assembly into the patient; and

upon detecting selected internal body tissues to be removed from the patient, ejecting said loop with said web member from a distal end of a biopsy channel of said endoscope assembly,

said step of expanding being performed upon ejection of said loop and said web member from said biopsy channel, a distal end portion of said instrument being ejected from a biopsy channel of said instrument assembly, said step of operating said instrument being implemented upon ejection of said distal end portion of said instrument.

20. A surgical assembly comprising:

a tubular sheath member;

a metallic cauterization loop, said loop having a bend in an expanded configuration of said loop, said bend arcing out of a plane in which said loop opens and closes;

a metal wire operatively connected to said loop, said wire passing longitudinally through said sheath;

electrical supply means operatively connected to said wire for feeding an electrical current to said loop via said wire;

manually actuatable shifting means operatively connected to said wire for longitudinally sliding said wire along said sheath in alternately opposite directions; and

a flexible web member connected to said loop to form a capture pocket, said loop defining a mouth opening of said pocket, said web member being attached to said loop in a manner so as to expose said loop to enable effective cauterization of organic tissues by said loop.