Surgical retrieval assembly and associated method

• US 5,741,271 A
• Filed: 08/08/1996
• Issued: 04/21/1998
• 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): Hafer, Robert A.
• Assistant Examiner(s): YU, JUSTINE ROMANG
• Application Number:
  US08/700,562
• Time in Patent Office: 621 Days
• Field of Search: 606/110, 606/113, 606/114, 606/127, 606/37-46, 604/280, 604/264
• US Class Current: 606/114
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/018 for receiving instruments
• 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 17/221 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 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/22072 with an instrument channel, e.g. for replacing one instrument by the other in cannulas A61B17/3417
• CPC Class Codes: A61B 2018/00535 Biliary tract
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/141 Snare
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61M 3/0279 Cannula; Nozzles; Tips; their connection means

Abstract

A surgical instrument assembly for a snare cauterization operation comprises a tubular member having a diameter sufficiently small so that the tubular member can be inserted through a biopsy channel of a flexible endoscope. Multiple endoscopic instrument including a cauterization loop, a flexible web member connected to the cauterization loop or to an auxiliary loop so as to form a capture pocket, and an elongate flexible fluid feed tube provided at a distal end with a needle point and an aperture, are slidably disposed in the tubular member. The fluid feed instrument is used to expand a flat or nonprojecting polyp prior to severing thereof with the cauterization loop and capture of the severed polyp with the web member or pocket.

Claims

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

a tubular member, said tubular member having a diameter sufficiently small so that said tubular member can be inserted through a biopsy channel of a flexible endoscope;

a cauterization loop;

an electrically conductive wire operatively connected to said cauterization loop, said cauterization loop and said wire being disposed at least partially in said tubular member;

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

an auxiliary loop;

an elongate flexible shifting member connected at one end to said auxiliary loop, said auxiliary loop and said shifting member being at least partially disposed in said tubular member;

a flexible web member connected to said auxiliary loop so as to form a capture pocket, said auxiliary loop defining a mouth opening of said pocket;

an elongate flexible tube provided at a distal end with a needle point and an aperture, said flexible tube being disposed at least partially in said tubular member; and

fluid feed means operatively connected to said flexible tube for feeding fluid thereto for ejection through said aperture.

2. The instrument assembly defined in claim 1, further comprising a first additional flexible tube and a second additional flexible tube each extending slidably through said tubular member, said cauterization loop and said wire being disposed at least partially in said first additional flexible tube, said auxiliary loop and said shifting member being at least partially disposed in said second additional flexible tube.

3. The instrument assembly defined in claim 2 wherein said tubular member is provided with septum means defining at least three separate longitudinally extending lumens, the flexible tubes extending through respective ones of said lumens.

4. The instrument assembly defined in claim 1 wherein said tubular member is provided with septum means defining at least three separate longitudinally extending lumens, said cauterization loop and said wire being disposed at least partially in a first one of said lumens, said auxiliary loop and said shifting member being at least partially disposed in a second one of said lumens, said flexible tube being disposed at least partially in a third one of said lumens.

5. The instrument assembly defined in claim 1, further comprising at least one flexible tensile member connected to said flexible web member at a proximal end thereof and to said tubular member at a point spaced from a distal end thereof.

6. The instrument assembly defined in claim 1 wherein said web member is slidably connected to said auxiliary loop at a plurality of spaced locations.

7. The instrument assembly defined in claim 1 wherein said flexible web member is a net.

8. The instrument assembly defined in claim 1 wherein said flexible web member is a continuous film of polymeric material.

9. The instrument assembly defined in claim 1 wherein said web member is disposed in a collapsed configuration together with said auxiliary loop inside said tubular member.

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

a tubular member, said tubular member having a diameter sufficiently small so that said tubular member can be inserted through a biopsy channel of a flexible endoscope;

a cauterization loop;

an electrically conductive wire operatively connected to said cauterization loop, said cauterization loop and said wire being disposed at least partially in said tubular member;

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

a flexible web member connected to said cauterization loop so as to form a capture pocket, said cauterization loop defining a mouth opening of said pocket;

an elongate flexible tube provided at a distal end with a needle point and an aperture, said flexible tube being disposed at least partially in said tubular member; and

fluid feed means operatively connected to said flexible tube for feeding fluid thereto for ejection through said aperture.

11. The instrument assembly defined in claim 10, further comprising an additional flexible tube extending slidably through said tubular member, said cauterization loop and said wire being disposed at least partially in said additional flexible tube.

12. The instrument assembly defined in claim 11 wherein said tubular member is provided with septum means defining at least two separate longitudinally extending lumens, the flexible tubes each extending through a respective one of said lumens.

13. The instrument assembly defined in claim 10 wherein said tubular member is provided with septum means defining at least two separate longitudinally extending lumens, said cauterization loop and said wire being disposed at least partially in a first one of said lumens, said flexible tube being disposed at least partially in a second one of said lumens.

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

providing (I) a flexible conductive cauterization loop, (ii) a flexible tube provided at a distal end with a needle point and an aperture, and (iii) a flexible auxiliary loop to which a flexible web member is connected to define an expandable pocket, said cauterization loop, said flexible tube and said auxiliary loop being disposed in a common tubular member, said common tubular member in turn being disposed in a biopsy channel of an endoscope;

inserting said endoscope into a patient;

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

upon detecting selected internal tissues to be removed from the patient, shifting said flexible tube in the distal direction to eject said needle point from said tubular member;

inserting said needle point and said aperture into the selected internal tissues of the patient, the selected internal tissues being disposed along an internal organic wall of the patient;

forcing liquid through said flexible tube and said aperture into the selected internal tissues of the patient to expand the tissues and thereby induce the tissues to stand away from said internal organic wall;

shifting said cauterization loop in a distal direction relative to said tubular member to eject said cauterization loop from said tubular member;

upon ejection of said cauterization loop from said tubular member, at least partially expanding said cauterization loop from a collapsed configuration;

manipulating the expanded cauterization loop from outside of the patient to pass the expanded cauterization loop over the expanded internal tissues of the patient;

upon a passing of the expanded cauterization loop over the expanded internal tissues, closing the cauterization loop about the expanded internal tissues;

conducting an electrical current along said wire and to the closed cauterization loop to sever the expanded internal tissues;

ejecting said auxiliary loop from said tubular member;

upon ejection of said auxiliary loop from said tubular member, at least partially opening said auxiliary loop from a folded configuration;

maneuvering the opened auxiliary loop from outside of the patient to pass the opened auxiliary loop over the expanded internal tissues so that said web member substantially surrounds the expanded internal tissues; and

upon the severing of the expanded internal tissues by said cauterization loop and upon maneuvering of the auxiliary loop over the expanded internal tissues, at least partially closing said auxiliary loop to capture the severed internal body tissues in said pocket.

15. The method defined in claim 14, further comprising an ejecting of said tubular member from said biopsy channel prior to ejection of said auxiliary loop from said tubular member.

16. The method defined in claim 15 wherein the closing of said cauterization loop about the expanded internal tissues is effectuated by a relative motion of said tubular member and said cauterization loop towards one another and a resultant partial drawing of said cauterization loop into said tubular member.

17. The method defined in claim 15 wherein the closing of said auxiliary loop about the expanded internal tissues is effectuated by a relative motion of said tubular member and said auxiliary loop towards one another and a resultant partial drawing of said auxiliary loop into said tubular member.

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

providing (i) a flexible conductive cauterization loop to which a flexible web member is connected to define an expandable pocket, and (ii) a flexible tube provided at a distal end with a needle point and an aperture, said cauterization loop, said flexible tube and said web member being disposed in a common tubular member, said common tubular member in turn being disposed in a biopsy channel of an endoscope;

inserting said endoscope into a patient;

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

upon detecting selected internal tissues to be removed from the patient, shifting said flexible tube in the distal direction to eject said needle point from said tubular member;

inserting said needle point and said aperture into the selected internal tissues of the patient, the selected internal tissues being disposed along an internal organic wall of the patient;

forcing liquid through said flexible tube and said aperture into the selected internal tissues of the patient to expand the tissues and thereby induce the tissues to stand away from said internal organic wall;

shifting said cauterization loop in a distal direction relative to said tubular member to eject said cauterization loop from said tubular member;

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

manipulating the expanded cauterization loop from outside of the patient to pass the expanded cauterization loop and the expanded web member over the expanded internal tissues of the patient;

upon a passing of the expanded cauterization loop and the expanded web member over the expanded internal tissues, closing the cauterization loop about the expanded internal tissues; and

conducting an electrical current along said wire and to the closed cauterization loop to sever the expanded internal tissues.

19. The method defined in claim 18, further comprising the ejecting of said tubular member from said biopsy channel prior to ejection of said needle point, said cauterization loop and said web member from said tubular member.

20. The method defined in claim 19 wherein the closing of said cauterization loop about the expanded internal tissues is effectuated by a relative motion of said tubular member and said cauterization loop towards one another and a resultant partial drawing of said cauterization loop into said tubular member.