Percutaneous tissue removal device

• US 6,136,014 A
• Filed: 09/01/1998
• Issued: 10/24/2000
• Est. Priority Date: 09/01/1998
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Vivant Medical, Inc. (Johnson Controls International plc)
• Inventors: Sutton, Douglas S., Sirimanne, D. Laksen, Fawzi, Natalie V.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Ngo, Lien
• Application Number:
  US09/145,487
• Time in Patent Office: 784 Days
• Field of Search: 606/185, 606/170-184, 606/113, 606/127, 606/128, 606/129, 606/200, 604/22-24
• US Class Current: 606/185
• CPC Class Codes: A61B 10/0266 means for severing sample
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/320082 for incising tissue
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

This is a device for percutaneous tissue sampling or excision. In particular, it uses a rotating cutter which produces a helically cut, discrete tissue mass that is removable through a comparatively much smaller access member. The tissue mass is easily reconstructed to its original form and orientation once taken from the body for further study.

Claims

1. A tissue removal assembly, comprising:

a.) a tubular tissue removal member having a wall, a distal diameter, a proximal end, a distal end, and a longitudinal axis extending between said proximal end and said distal end;

an open, distally located tissue entry opening;

a relatively more proximal, tissue exit port; and

a tissue removal passageway extending between said tissue entry opening and said tissue exit port;

b.) a cutting member having a generally rounded "J" shape, a generally square "J" shape, or an "L" shape, said cutting member being rotatable with respect to said tubular tissue removal member in a diameter greater than the tubular tissue removal member distal diameter, extendible beyond said distally located tissue entry opening, and having a cutting surface, where upon rotation of said cutting member and extension of said cutting member distally beyond said tissue entry opening within a tissue region, said cutting surface cuts a discrete tissue mass having an overall diameter measured generally orthogonal to the tubular tissue removal member axis which is greater than said tubular tissue removal member distal diameter and which discrete tissue mass is in a configuration removable through said tissue entry opening.

2. The tissue removal assembly of claim 1 wherein said cutting surface is configured to cut a radial, helical path through discrete tissue mass.

3. The tissue removal assembly of claim 1 wherein said cutting member is manually manipulatable from the proximal end of said tubular tissue removal member.

4. The tissue removal assembly of claim 1 wherein said cutting member has an axis of rotation and a distal extention along said axis of rotation.

5. The tissue removal assembly of claim 1 wherein said cutting member is at least partially radio-opaque.

6. The tissue removal assembly of claim 4 wherein said cutting member is at least partially radio-opaque.

7. The tissue removal assembly of claim 4 wherein said cutting member distal extension is at least partially radio-opaque.

8. The tissue removal assembly of claim 1 wherein said cutting member is a wire cutting member.

9. The tissue removal assembly of claim 1 wherein said cutting member is a ribbon cutting member.

10. The tissue removal assembly of claim 1 wherein said cutting member comprises a material selected from the group consisting of titanium, nickel, stainless steel, cobalt, tantalum, and nickel and mixture and alloys of thereof.

11. The tissue removal assembly of claim 1 wherein said cutting member comprises titanium and nickel.

12. The tissue removal assembly of claim 1 wherein said cutting member is an RF cutter utilizing radio-frequency energy to cut said discrete tissue mass.

13. The tissue removal assembly of claim 12 further comprising an RF source connected to said cutting member which is suitable for cutting said discrete tissue mass.

14. The tissue removal assembly of claim 1 wherein said cutting member is a mechanical blade.

15. The tissue removal assembly of claim 14 wherein said mechanical blade cutting member is vibrated.

16. The tissue removal assembly of claim 1 wherein said cutting member is an RF cutter having a sharp mechanical cutting surface.

17. The tissue removal assembly of claim 1 wherein said cutting member is an ultrasound cutter utilizing high frequency audio energy to cut said discrete tissue mass.

18. The tissue removal assembly of claim 17 further comprising an ultrasound source connected to said cutting member which is suitable for cutting said discrete tissue mass.

19. The tissue removal assembly of claim 1 wherein said tubular tissue removal member further includes a shaft passageway exterior to said tissue removal passageway and generally parallel to said tubular tissue removal member longitudinal axis and said cutting member includes a shaft extending between said cutting surface and said tubular tissue removal member proximal end and is slideable within and rotatable within said shaft passageway to advance said cutting surface.

20. The tissue removal assembly of claim 1 wherein said tubular tissue removal member further includes a shaft passageway interior to said tissue removal passageway and generally parallel to said tubular tissue removal member longitudinal axis and said cutting member includes a shaft extending between said cutting surface and said tubular tissue removal member proximal end and is slideable within and rotatable within said shaft passageway to advance said cutting surface.

21. The tissue removal assembly of claim 1 further comprising a pick locatable within said tissue removal passageway which pick is configured for removing said discrete tissue mass.

22. The tissue removal assembly of claim 1 further comprising a manipulatable grasping tool locatable within said tissue removal passageway which grasping tool is configured for removing said discrete tissue mass.

23. The tissue removal assembly of claim 22 wherein said manipulatable grasping tool comprises a pair of opposing jaws suitable for grasping said discrete tissue mass.

24. The tissue removal assembly of claim 22 wherein said manipulatable grasping tool comprises a grasping braid suitable for grasping said discrete tissue mass.

25. The tissue removal assembly of claim 1 further comprising a manipulatable suction tool locatable within said tissue removal passageway which suction tool is configured for removing said discrete tissue mass.

26. The tissue removal assembly of claim 1 further comprising a trocar sized to fit within said tissue removal passageway.

27. The tissue removal assembly of claim 26 wherein said trocar includes a leading cutting edge and a slot in said leading cutting edge and said cutting surface fits in said trocar slot.

28. The tissue removal assembly of claim 26 wherein said trocar is extendible distally though said tissue entry opening.

29. The tissue removal assembly of claim 1 wherein said tissue entry opening is open along the axis of said tubular tissue removal member.

30. The tissue removal assembly of claim 1 wherein said tissue entry opening is open generally perpendicular to the axis of said tubular tissue removal member.

31. The tissue removal assembly of claim 1 further comprising a rotatable auger situated within said tubular tissue removal member for moving excised tissue along said tubular tissue removal member to said tissue exit port.

32. A procedure for removing tissue from a selected internal tissue region, comprising the steps of:

introducing a tissue removal assembly to a region adjacent a selected internal tissue region, said tissue removal assembly comprising;

a.) a tubular tissue removal member having a wall, a distal diameter, a proximal end, a distal end and a longitudinal axis extending between said proximal end and said distal end;

an open, distally located tissue entry opening;

a relatively more proximal, tissue exit port; and

a tissue removal passageway extending between said tissue entry opening and said tissue exit port,

b.) a cutting member having a generally rounded "J" shape, a generally square "J" shape, or an "L" shape, said cutting member being rotatable with respect to said tubular tissue removal member in a diameter greater than the tubular tissue removal member distal diameter, extendible beyond said distally located tissue entry opening, and having a cutting surface, where upon rotation of said cutting member and extension of said cutting member distally beyond said tissue entry opening within said tissue region, said cutting surface cuts a discrete tissue mass having an over all diameter measured generally orthogonal to the tubular tissue removal member axis which is greater than said tubular tissue removal member distal diameter and which discrete tissue mass is in a configuration removable through said tissue entry opening,

rotating said cutting member and said cutting surface to form a discrete tissue mass having an overall diameter measured generally orthogonal to the tubular tissue removal member axis which is greater than said tubular tissue removal member distal diameter and which discrete tissue mass is in a configuration removable through said tissue entry opening, and

removing said discrete tissue mass through said tissue entry opening, through said tissue removal passageway, and out through said tissue exit port.

33. The procedure of claim 32 wherein the cutting member is rotated to form a helical cut in said discrete tissue mass.

34. The procedure of claim 32 wherein said cutting member has an axis of rotation and a distal extension along said axis of rotation.

35. The procedure of claim 32 wherein said cutting member is at least partially radio-opaque.

36. The procedure of claim 32 wherein said cutting member is a wire cutting member.

37. The procedure of claim 32 wherein said cutting member comprises a material selected from the group consisting of titanium, nickel, stainless steel, cobalt, tantalum, and nickel and mixture and alloys of thereof.

38. The procedure of claim 37 wherein said cutting member comprises titanium and nickel.

39. The procedure of claim 32 wherein said cutting member is an RF cutter utilizing radio-frequency energy to cut said discrete tissue mass and wherein said step of rotating said cutting member and said cutting surface to form a discrete tissue mass includes the imposition of radio-frequency energy to effectuate said cutting.

40. The procedure of claim 32 wherein said cutting member is a mechanical blade.

41. The procedure of claim 40 wherein said mechanical blade cutting member is vibrated.

42. The procedure of claim 32 wherein said cutting member is a is an RF cutter having a sharp with mechanical cutting surface.

43. The procedure of claim 32 wherein said cutting member is an ultrasound cutter utilizing high frequency audio energy to cut said discrete tissue mass and further including the step of applying ultrasound energy to said cutting member.

44. The procedure of claim 32 wherein said trocar includes a leading cutting edge and a slot in said leading cutting edge and said cutting surface fits in said trocar slot.

45. The procedure of claim 32 wherein said tissue removal assembly further comprises a rotatable auger situated within said tubular tissue removal member for moving excised tissue along said tubular tissue removal member to said tissue exit port and wherein said procedure includes rotating said auger to remove excised tissue.

46. The procedure of claim 45 further comprising the step of reconstituting the excised tissue to the form as found prior to the cutting step.