Multiple biopsy sampling device

• US 6,142,957 A
• Filed: 01/27/1997
• Issued: 11/07/2000
• Est. Priority Date: 09/20/1993
• Status: Expired due to Term

• Current Assignee: Boston Scientific Corporation
• Original Assignee: Boston Scientific Corporation
• Inventors: Dassa, Alyssa J., Robinson, Donald E., Warich, Charles, Diamond, Bruce H.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US08/789,949
• Time in Patent Office: 1,380 Days
• Field of Search: 600/564-567, 606/167, 606/170
• US Class Current: 600/567
• CPC Class Codes: A61B 10/0266 means for severing sample
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 2010/0225 for taking multiple samples
• CPC Class Codes: A61B 2010/045 Needles pointed biopsy devices with vacuum aspiration A61B10/0283
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2937 with flexible part
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2017/2944 Translation of jaw members
• CPC Class Codes: A61B 2017/306 holding by means of suction
• 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 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue

Abstract

In an aspect, the invention relates to an instrument for obtaining tissue samples from a site deep within the body. The instrument has an elongated proximal portion that is constructed to follow a long, torturous path to the site and has a distal end constructed to sever and remove a tissue sample from the body, including tissue specimens, polyps or the like. The improvement includes that the instrument is constructed to take multiple biopsy samples without being withdrawn from the body. The instrument includes a tissue sample retractor. The retractor is axially movable between an extended tissue-engaging position and a retracted position. There is an open passage into which the retractor moves when moving from the extended to the retracted position. The retractor has a distal end portion constructed to engage tissue and apply axial transporting force thereto while moving from the extended to the retracted position. The retractor is constructed to be advanced and retracted repeatedly to accumulate a series of samples in the instrument.

Claims

1. In an instrument for obtaining tissue samples from a site deep within the body, the instrument having an elongated proximal portion that is constructed to follow a long, torturous path to said site, and having a distal end constructed to sever and remove a tissue sample from the body, including tissue specimens, polyps or the like, the improvement wherein said instrument is constructed to take multiple biopsy samples without being withdrawn from the body, said instrument including an actuatable severing member for severing said sample and a separately actuatable tissue sample retractor, said retractor being axially movable between an extended tissue-engaging position and a retracted position, there being an open passage into which said retractor moves when moving from said extended to said retracted position, said retractor having a distal end portion constructed to engage tissue and apply axial transporting force thereto while moving from said extended to said retracted position, said retractor constructed and arranged to be advanced and retracted repeatedly to accumulate a series of samples in said instrument without withdrawing the instrument from the body.

2. The instrument of claim 1 having a severing device comprising at least one pivotable jaw, the jaw having a pair of pivotable jaw support portions lying close to respective sides of a supporting structure, there being an open space for multiple tissue sample storage between said support portions.

3. The instrument of claim 1 wherein said retractor comprises a tissue-penetrating element.

4. The instrument of claim 3 wherein said tissue-penetrating element has a barb formation arranged to facilitate entry into tissue during advancement against the tissue and to apply axial transporting force to said tissue during retraction movement.

5. The instrument of claim 3 wherein said tissue penetrating element is constructed and arranged to penetrate a mid-portion of the sample of tissue being taken.

6. The instrument of claim 5 wherein said penetrating element is elongated and constructed to spear and securely store thereupon, in stacked relationship, a series of tissue samples in the order in which said samples have been taken.

7. The instrument of claim 6 wherein said element is sufficiently long to store a series on the order of three or more tissue samples.

8. The instrument of claim 6 wherein multiple barbs are disposed along the length of said element, constructed to enable a specimen to be advanced progressively over said barbs as additional samples are taken as a result of pressure transmitted through the previously taken samples during the spearing action on the next sample.

9. The instrument of claim 3 wherein said retractor comprises a helical cork-screw-like projection constructed to be rotated to enter tissue and constructed to move axially to retract the tissue sample.

10. The instrument of claim 9 wherein said cork-screw-like projection is sufficiently long to store thereupon a series on the order of five or more tissue samples, in the sequence in which said samples have been taken.

11. The instrument of claim 10 in which helical threads extend along the length of said projection along which previously-taken samples advance when, upon further rotation, additional samples are taken.

12. The instrument of claim 1 wherein said retractor is constructed to extend along the side of a sample being severed and having a laterally-extending dragger formation constructed to engage the sample and apply proximally-directed transporting force thereto.

13. The instrument of claim 12 wherein said retractor is constructed and arranged relative to said open passage to drag successive severed samples into the passage and stack them therein in the order in which said samples have been taken.

14. The instrument of claim 12 having a severing device comprising at least one pivotable jaw and one stationary jaw, said retractor being of generally tongue form and during severing action lying along said stationary jaw.

15. The instrument of claim 12 where said retractor is of wire form and has a distal hook formation constructed to apply proximally-directed transporting force to said sample.

16. The instrument of claim 1 wherein said retractor comprises an axially displaceable grasper constructed to grasp said tissue sample by pinching action for transport of said sample.

17. The instrument of claim 16 wherein said grasper comprises tong-like grippers constructed to grasp and transport a tissue sample.

18. The instrument of claim 17 wherein said grippers are closed upon a sample by axial movement of an actuating tube slidingly disposed over structure connected to said grippers.

19. The instrument of claim 1 in which said movable retractor is constructed to draw the severed sample into said passage away from a severing device of the instrument to prepare the instrument to take further samples.

20. The instrument of claim 19 wherein said severing device comprises at least one actuatable cutting jaw.

21. The instrument of claim 2 or 20 wherein said jaw is supported on the distal end of a tubular structure, an internal portion of said structure providing space for tissue sample storage.

22. The instrument of claim 20 wherein said severing device comprises opposed actuatable cutting jaws.

23. The instrument of claim 22 wherein said jaws are constructed to be closed upon a sample by axial movement of an actuating tube slidingly disposed over supporting arms of said jaws.

24. The instrument of claim 20 wherein said jaw is pivotably supported by supporting structure and control means extend along the instrument for pivoting said jaw.

25. The instrument of claim 1 comprising a severing device in the form of a snare loop projectable from the instrument over tissue to be removed.

26. The instrument of claim 1 wherein said instrument is sized and constructed to pass through the working channel of an endoscope to take multiple samples under endoscopic guidance without being withdrawn from the endoscope.

27. In an instrument for obtaining tissue samples, the instrument sized and constructed to pass through the working channel of an endoscope to take samples including tissue specimens, polyps or the like, under endoscopic guidance and having a distal end constructed to sever and remove a tissue sample from the body, the improvement wherein said instrument is constructed to take multiple biopsy samples without being withdrawn from the endoscope, said instrument including a severing member for severing said sample and a separate tissue sample storage device, said tissue sample storage device comprising a tissue-penetrating element having a distal barb formation, said barb formation constructed and arranged to facilitate entry into tissue and to resist distal dislodgment of said sample after said barb has penetrated said tissue to accumulate a series of samples without withdrawing the instrument from the endoscope.

28. The instrument of claim 27 wherein said penetrating element is elongated and constructed to spear and store thereupon, in stacked relationship, a series of tissue samples in the order in which said samples have been taken.

29. The instrument of claim 27 wherein multiple barbs are disposed along the length of said element, constructed to enable a specimen to be advanced progressively over said barbs as additional samples are taken as a result of pressure transmitted through the previously taken samples during the spearing action on the next sample.

30. In an instrument for obtaining tissue samples, the instrument sized and constructed to pass through the working channel of an endoscope to take samples including tissue specimens, polyps or the like, under endoscopic guidance and having a distal end constructed to sever and remove a tissue sample from the body, the improvement wherein said instrument is constructed to take multiple biopsy samples without being withdrawn from the endoscope, said instrument including a tissue sample storage device, said sample storage device comprising an elongated tissue penetrating element of length sufficient to accommodate at least three samples and constructed to spear a sample and enable the sample to be slidably advanced progressively thereover away from a separate severing device of the instrument as additional samples are taken as a result of pressure transmitted through the previously taken samples during the spearing action on the next sample, thereby to prepare the instrument to take further samples without withdrawing the instrument from the endoscope.

31. The instrument of claim 30 wherein said tissue penetrating element, upon completion of taking of said samples, is constructed to be detached from the instrument and be sent to the pathology laboratory with said samples intact upon said element in the order in which said specimens were taken.

32. The instrument of claim 30 wherein said element is constructed and arranged, upon completion of use and withdrawal from the body, to extend distally beyond sample severing mechanism of the instrument to enable said multiple samples to be removed therefrom.