Method and apparatus for severing and capturing polyps

• US 6,010,512 A
• Filed: 09/03/1998
• Issued: 01/04/2000
• Est. Priority Date: 04/13/1995
• Status: Expired due to Term

• Current Assignee: Boston Scientific Corporation
• Original Assignee: Boston Scientific Corporation
• Inventors: Chin, Yem, Chu, Michael S. H.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/146,105
• Time in Patent Office: 488 Days
• Field of Search: 606/113, 606/114, 606/110, 606/46
• US Class Current: 606/113
• 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 extending between a distal end tip and a proximal end, for positioning proximate a polyp;

a self-expansible severing and capturing device for retrieving a polyp, said severing and capturing device being extensible from said distal end of said catheter in an expanded form and retractable into said distal end in a compacted form; and

a control device at the proximal end of said catheter for selectively extending and retracting said severing and capturing device relative to said distal end of said catheter, wherein said severing and capturing device includes, in said expanded form, a wire forming a complete loop portion lying in a first plane to receive a polyp therethrough and a substantially planar collar portion fixed to and disposed distally from said complete loop portion and lying in a second plane such that retraction of said wire urges the closing of said complete loop portion to sever a polyp extending therethrough and urges the severed polyp into said collar portion.

2. Apparatus for severing and retrieving a polyp as recited in claim 1 wherein said collar portion is elongated to receive therein and retain a plurality of severed polyps.

3. Apparatus for severing and retrieving a polyp as recited in claim 1 wherein said control device includes a slider at a proximal end of said catheter and an axially stiff, laterally flexible cable extending through said catheter, said cable connecting said slider and said severing and capturing device such that displacement of said slider urges like displacement of said severing and capturing device.

4. A surgical instrument for severing and capturing a polyp, the instrument comprising:

an elongated tubular member having a distal end,

a snare forming a complete loop portion, said snare for extension in a first plane in an enlarged condition from and retraction in a compact condition into said distal end of said tubular member,

a control device for selectively extending said snare relative to said distal end so as to enable positioning said snare to encompass a polyp and for selectively retracting said snare relative to said distal end so as to sever such polyp, and

a substantially planar capturing device fixed to and disposed distally from said snare and connected to said control device such that said capturing device is extended with said snare in substantially a second plane wherein upon extension, said snare defines a first plane and a portion of said capturing device defines a second plane substantially parallel with said first plane and upon retraction of said snare by said control device said capturing device grasps the polyp outside the first plane so that upon severing of the polyp by said snare said capturing device retains the severed portion of the polyp.

5. An instrument as recited in claim 4 wherein said control device includes a cable supporting said snare at a distal end thereof.

6. An instrument as recited in claim 5 further comprising a handle supporting a proximal end of said tubular member wherein said control device includes an actuator slidably disposed in said handle for enabling displacement along the axis of said tubular member to selectively extend and retract said snare relative to said distal end of said tubular member.

7. An instrument as recited in claim 5 wherein said capturing device comprises a closed distal end clip structure with proximally extending spaced legs secured to said snare intermediate a distal end of said snare and said cable.

8. An instrument as recited in claim 7 wherein each of said legs comprising a first generally planar extending portion proximate said closed distal end of said clip structure and a second generally vertically extending portion remote from said closed distal end of said clip structure such that said first generally planar extending portion of said clip structure defines the second plane that is generally parallel to said first plane.

9. A method for managing polyps in a patient comprising the steps of:

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

extending in a first plane a self-expansive severing device forming a complete loop from the catheter and positioning the severing device so as to encompass the selected polyp proximate a base of the selected polyp;

extending a substantially planar holding device in a second plane from the distal end of the catheter said holding device being fixed to said severing device, said second plane being substantially parallel to said first plane;

positioning and manipulating the holding device so as to engage the selected polyp proximate a free end of the selected polyp; and

retracting the severing device into the catheter to sever the selected polyp proximate the base such that the holding device retains a severed portion including the free end of the selected polyp, wherein said step of retracting the severing device also retracts the holding device such that the engagement of the holding device with the portion of the selected polyp is promoted thereby.

10. A method for managing polyps in a patient comprising the steps of:

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

B) extending a severing and holding device with a severing portion forming a complete loop and with a substantially planar holding portion fixed to the severing portion and lying in a plane offset from the severing portion;

C) orienting the severing and holding device with the severing portion of the severing and holding device encompassing the polyp and the holding portion engaging the polyp proximate a free end thereof; and

D) retracting the severing portion to sever the polyp with the holding portion retaining a severed portion including the free end of the selected polyp.

11. A method as recited in claim 10 further comprising:

E) removing the catheter from the patient to retrieve the retained polyp.

12. A method as recited in claim 11 wherein said step of B) through D) are repeated so as to retain a plurality of polyps prior to step E).

13. A method as recited in claim 12 wherein said step of retracting retains polyps in an order corresponding to the order in which each polyp is retained thereby upon repetition of said steps B) through D).