Surgical retrieval assembly and associated method

• US 5,759,187 A
• Filed: 11/02/1994
• Issued: 06/02/1998
• 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:
  US08/333,363
• Time in Patent Office: 1,308 Days
• Field of Search: 606/113, 606/114, 606/21, 606/2, 606/24, 606/14, 606/110, 606/127, 606/47, 606/41, 606/32, 604/21, 604/52, 600/104
• 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 method for removing a polyp from a patient utilizes (i) a flexible conductive cauterization loop and (ii) a flexible auxiliary loop to which a flexible web member is connected to define an expandable pocket, the cauterization loop and the auxiliary loop being disposed in a common tubular member. Upon insertion of an endoscope assembly into a patient and a locating of the polyp, the tubular member is moved through the biopsy channel of the endoscope to eject a distal end portion of the tubular member from the biopsy channel. The cauterization loop is then shifted in a distal direction relative to the ejected tubular member to eject the cauterization loop from the tubular member. The cauterization loop is manipulated from outside of the patient to pass the loop over the polyp and to at least partially close the loop to engage the polyp around a base region thereof. Upon a subsequent conducting of an electrical current through the cauterization loop to burn through the polyp at the base region, thereby severing the polyp at the base region, the cauterization loop is retracted into the tubular member and the auxiliary loop is ejected and maneuvered to enclose the severed polyp in the capture pocket. The auxiliary loop is at least partially closed to capture the severed internal body tissues in the pocket. The captured polyp is removed in the pocket from the patient.

Claims

1. A surgical instrument assembly, comprising:

a tubular member defining at least one longitudinally extending lumen, 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 flexible loop having two free ends;

an elongate flexible shifting member connected at one end to said free ends of said loop, said free ends of said loop and said shifting member being at least partially disposed in said lumen;

a flexible web member connected to said loop so as to form a capture pocket, said web member being movably Attached to said loop so as to slide in a distal direction along said loop during a retraction of said free ends of said loop into said tubular member, thereby closing said pocket; and

reopening means for pulling said web member in a proximal direction along said loop during an extension of said loop from said tubular member after said retraction, said reopening means including at least one flexible tensile member connected to said flexible web member and to said tubular member at a point spaced from a distal end thereof, said tensile member extending from said flexible web member into said lumen.

2. The instrument assembly defined in claim 1 wherein said flexible tensile member is one of a plurality of flexible tensile member segments each connected to said flexible web member and to said tubular member, said tensile member segments each extending from said flexible web member into said lumen.

3. The instrument assembly defined in claim 2 wherein said segments are parts of a single flexible tensile member, said tubular member being provided with a pair of holes at about said point, said single flexible tensile member extending through said holes.

4. The instrument assembly defined in claim 3, further comprising a patch disposed on an outer surface of said tubular member over said holes.

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

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

providing a flexible auxiliary loop to which a flexible web member is connected to define an expandable pocket, said auxiliary loop being disposed in a tubular member said auxiliary loop having two free ends fastened to an elongate shifting member at least partially disposed in said tubular member;

inserting an endoscope assembly into a patient;

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

after detecting selected internal body tissues to be removed from the patient, moving said tubular member in a distal direction through a biopsy channel of said endoscope to eject a distal end portion of said tubular member from said biopsy channel;

after ejection of the distal end portion of said tubular member from said biopsy channel, shifting said shifting member, said free ends of said loop and said loop in a distal direction relative to said tubular member to eject said loop from said tubular member;

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

manipulating the expanded loop from outside of the patient to pass the expanded loop and the pocket over the selected internal body tissues to be removed;

after a passing of the expanded loop over the selected internal body tissues to be removed, retracting said loop into said tubular member by moving said loop and said free ends of said loop relative to said tubular member;

during the retraction of said loop into said tubular member, sliding said pocket in a distal direction about said loop to at least partially close said pocket to enclose the internal body tissues in said pocket;

subsequently to the retraction of said loop and said free ends of said loop and the closing of said pocket, again shifting said loop in a distal direction relative to said tubular member to eject said loop from said tubular member; and

during the shifting of said loop subsequently to the retraction of said loop and the closing of said pocket, pulling said pocket in a proximal direction about said loop to reopen said pocket, thereby enabling a repositioning of said loop and said pocket relative to the selected internal body tissues.

7. The method defined in claim 6 wherein the pulling of said pocket is implemented by a flexible tether member connected to said pocket and to said tubular member.