Method and apparatus for severing and capturing polyps

• US 5,846,248 A
• Filed: 04/13/1995
• Issued: 12/08/1998
• Est. Priority Date: 04/13/1995
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Corporation
• Inventors: Chin, Yem, Chu, Michael S. H.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/421,409
• Time in Patent Office: 1,335 Days
• Field of Search: 606/113, 606/114, 606/110, 606/46
• US Class Current: 606/114
• 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 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/320084 Irrigation sleeves

Abstract

A method and apparatus for managing polyps by which an elongated tubular member generally positionable within the working channel of an endoscopic device. The tubular member carries a selectively extendable severing device and capturing device at its distal end. Control apparatus at the proximal end of the tubular member enables a physician to extend and retract the severing and capturing devices. The physician retracts the capturing device to grasp the portion of the polyp to be severed and retracts the severing device to sever the polyp. The capturing device retains the severed portion of the polyp for removal with the tubular member. In one embodiment the capturing device includes an injection needle.

Claims

1. Apparatus for severing and retrieving a polyp for withdrawal from a patient comprising:

a catheter device extending between a distal end and a proximal end, for positioning said distal end proximate a polyp;

means for severing and means for retrieving a polyp, said means for severing and said means for retrieving being extensible from, and retractable into, said distal end of said catheter device, said means for severing including a self-expanding continuous wire connected to a distal end of a first proximally extending cable disposed in said catheter device and said means for retrieving including a needle supported at a distal end of a second proximally extending cable disposed in said catheter device, said needle having a projection on an outer surface of a distal portion thereof for retrieving a portion of a polyp into which said distal portion of said needle is inserted; and

a means for extending and retracting said means for severing and said means for retrieving relative to said distal end of said catheter device.

2. An instrument as recited in claim 1 wherein said needle includes a means for injection for enabling the selective injection of the polyp with a solution for swelling the polyp.

3. A method wherein for severing and retrieving polyps in a patient comprising the steps of:

inserting a catheter within the patient with a distal end disposed proximate a selected polyp;

extending a self-expansive severing device from the catheter and positioning the severing device so as to encompass the selected polyp proximate the base of the polyp;

extending a retrieving device having a needle from the distal end of the catheter;

positioning and manipulating the retrieving device so as to pierce the polyp with the needle to engage the polyp proximate a free end thereof; and

retracting the severing device into the catheter to sever the selected polyp proximate the base of the polyp such that the retrieving device retains a severed portion including the free end of the selected polyp.

4. A method as recited in claim 3 further comprising repeating said steps of extendings, positioning and manipulating, and retracting to thereby collect a plurality of severed polyp portions.

5. A method as recited in claim 4 further comprising the step of removing the catheter after collection of a plurality of severed polyps portions wherein said repeating of said steps of extending, positioning and manipulating, and retracting causes the severed polyps portions to be retained by the retrieving device in an order corresponding to the order of severing.

6. A method as recited in claim 3 further comprising the step of injecting fluid through the needle into the pierced polyp to enlarge the polyp.

7. An apparatus for severing and retrieving a polyp for withdrawal from a patient comprising:

a catheter device extending between a distal end and a proximal end, for positioning said distal end proximate a polyp;

a self-expanding severing device for severing the polyp, said severing device extensible from said distal end of said catheter device in an expanded form and retractable into said distal end in a compacted form, said severing device connected to a distal end of a first proximally extending cable disposed in said catheter device;

a retrieving device for retrieving the severed portion of the polyp, said retrieving device extensible from, and retractable into, said distal end of said catheter device, said retrieving device connected to a distal end of a second proximally extending cable disposed in said catheter device, said retrieving device including a needle apparatus having a projection on an outer surface of a distal portion thereof for retrieving a portion of the polyp into which said distal portion of said needle apparatus is inserted; and

a mechanism for extending and retracting said severing device and said retrieving device relative to said distal end of said catheter device.

8. The instrument of claim 7 wherein said needle is hollow for enabling the injection of the polyp with a solution for swelling the polyp.

9. Apparatus for severing and retrieving a polyp for withdrawal from a patient, the apparatus comprising:

a catheter device extending between a distal end and a proximal end, said distal end for positioning proximate a polyp;

means for severing and means for retrieving a polyp, said means for severing and said means for retrieving being self-expansible, extensible from said distal end of said catheter device in an expanded form and retractable into said distal end in a compacted form, said means for severing including a continuous wire connected to a distal end of a first proximally extending cable disposed in said catheter device and said means for retrieving including a plurality of legs connected to a distal end of a second proximally extending cable disposed in said catheter device, each leg having a length and a distal end, the legs being unconnected to each other at their distal ends and along substantially their entire lengths, wherein said means for retrieving further includes a needle, the needle including a projection on an outer surface of a distal portion thereof for retrieving a portion of a polyp into which the distal portion of the needle is inserted; and

a means for extending and retracting said means for severing and said means for retrieving relative to said distal end of said catheter device.

10. A surgical instrument for severing a polyp within a patient and retrieving the severed portion of such polyp from the patient, said instrument comprising:

an elongated tubular member extending proximally from a distal end;

a means for severing within said tubular member, the means for severing for encompassing and severing a polyp proximate the base of the polyp, said means for severing including a snare connected to a distal end of a first proximally extending cable such that retraction of said snare into said distal end of said tubular member severs the polyp; and

a means for retrieving a polyp, the means for retrieving being within said tubular member independent of said means for severing, said means for retrieving connected to a distal end of a second proximally extending cable and selectively extensible relative to said distal end of said tubular member, said means for retrieving including a plurality of generally axially extending legs with inwardly extending projections, said legs being positioned in said tubular member in a compact condition and upon extension therefrom assuming an expanded condition such that relative retraction of said legs into said distal end of said tubular member urges said projections proximate one another so as to grasp a polyp disposed therebetween, and wherein the means for retrieving further includes a needle, the needle including a projection on an outer surface of a distal portion thereof for retrieving a portion of a polyp into which the distal portion of the needle is inserted, wherein the polyp is retrieved when the means for retrieving is withdrawn from the patient'"'"'s body.