Endoscopic stone extraction device with rotatable basket

• US 6,419,679 B1
• Filed: 05/30/2001
• Issued: 07/16/2002
• Est. Priority Date: 01/17/2001
• Status: Active Grant

• Current Assignee: Stone Basket Innovations LLC (Empire IP LLC)
• Original Assignee: Avtar S. Dhindsa
• Inventors: Dhindsa, Avtar S.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US09/870,348
• Time in Patent Office: 412 Days
• Field of Search: 606/113, 606/114, 606/110, 606/131, 606/47, 606/37, 606/108, 606/127, 606/128, 606/106
• US Class Current: 606/127
• 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 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

An endoscopic stone extraction device includes a handle that supports a sheath, and a filament such as a wire slidably disposed in the sheath. One end of the wire is mounted to the handle for rotation with respect to the handle and the other end of the handle supports a stone extraction basket. A manipulator is provided on the wire to allow a user to rotate the filament and therefore the basket with respect to the handle. The basket can have a side-facing opening or a rear-facing opening. In either case, a stone retention region is provided with relatively small openings sized to retain stones smaller than two millimeters in diameter.

Claims

1. An endoscopic stone-extraction device comprising:

a filament comprising a first end portion and a second end portion;

a sheath comprising a lumen, said filament disposed in the lumen such that the sheath is slideable with respect to the filament;

a stone-extraction basket carried by the first end portion of the filament;

a handle coupled with the second end portion of the filament, said handle comprising a front portion and a rear portion, said basket positioned nearer the front portion than the rear portion, measured along the filament; and

a manipulator coupled with the filament and exposed for manual manipulation adjacent the front portion of the handle, said manipulator rotatable with respect to the handle such that rotation of the manipulator rotates the filament and the basket relative to the handle.

2. The device of claim 1 wherein the manipulator is removably attached to the filament.

3. The device of claim 1 wherein the manipulator comprises first and second elements removably secured together, thereby clamping the filament therebetween, further wherein the handle and the manipulator are positioned in the device to allow a user to rotate the manipulator with the same hand used to hold the handle.

4. The device of claim 1 wherein the manipulator comprises an element hinged to the filament to move between an extended position, in which the element extends away from the filament for manipulation, and a retracted position, in which the element extends along the filament for passage through the handle, further wherein the handle and the manipulator are positioned in the device to allow a user to rotate the manipulator with the same hand used to hold the handle.

5. The device of claim 4 wherein the element comprises a free end and a hinged end, and wherein the free end is closer than the hinged end to the second end of the filament.

6. The device of claim 1 further comprising:

a rotatable joint interconnecting the second end portion of the filament and the handle such that the second end portion of the filament is rotatable with respect to the handle, said rotatable joint substantially preventing translational movement between the second end portion of the filament and the handle along a direction oriented parallel to the second end portion of the filament.

8. The device of claim 1 or 7 wherein the handle comprises a slide and a grip, wherein the slide is mounted for translation relative to the grip, wherein the sheath is coupled with the slide, and wherein the filament is coupled with the grip.

9. The device of claim 6 or 7 wherein the rotatable joint comprises a chuck removably clamped to the second end portion of the filament.

10. The device of claim 9 wherein the chuck comprises a convex surface shaped for rotation relative to the handle.

11. The device of claim 1 or 6 wherein said basket comprises a stone-entrance region and a stone-retention region, said stone-entrance region comprising a first opening sized to admit a stone into the basket, said stone-retention region comprising a plurality of second openings, all of the second openings being smaller than the first opening;

said first opening facing the first end portion of the support filament, said stone-retention region positioned on a side of the basket opposite the first end portion of the support filament.

12. The device of claim 1 or 6 wherein said basket comprises a stone-entrance region and a stone-retention region, said stone-entrance region comprising a first, larger opening sized to admit a stone into the basket, said stone-retention region comprising a plurality of second openings, all of the second openings being smaller than the first opening;

said first opening facing laterally away from a longitudinal axis extending through the basket and passing through the first end portion of the support filament,

said stone-retention region extending over more than one-half of a total surface area defined by the basket.

13. The device of claim 11 wherein the stone-retention region defines an internally concave surface facing the first end portion of the support filament.

14. The device of claim 11 wherein the basket comprises a set of longitudinal basket filaments radiating from the first end portion of the support filament and a set of lateral basket filaments extending between the longitudinal basket filaments, said lateral basket filaments positioned substantially entirely in the stone-retention region of the basket, further wherein the handle and the manipulator are positioned in the device to allow a user to rotate the manipulator with the same hand used to hold the handle.

15. The device of claim 11 wherein the second openings are all smaller than 2 mm in minimum dimension.

16. The device of claim 15 wherein the first opening is larger than 2 mm in minimum dimension.

17. The device of claim 11 wherein the basket is configured to collapse into the lumen when the basket is moved into the lumen, and to expand to an operational shape when the basket is moved out of the lumen.

18. The device of claim 11 wherein the filament and the basket are free of attachment to the sheath, such that the entire basket is movable into the lumen of the sheath.

19. The device of claim 12 wherein the basket comprises a set of longitudinal basket filaments radiating from the first end portion of the support filament and a set of lateral basket filaments extending between the longitudinal basket filaments, said lateral basket filaments positioned substantially entirely in the stone-retention region of the basket, further wherein the handle and the manipulator are positioned in the device to allow a user to rotate the manipulator with the same hand used to hold the handle.

20. The device of claim 12 wherein the second openings are all smaller than 2 mm in minimum dimension.

21. The device of claim 20 wherein the first opening is larger than 2 mm in minimum dimension.

22. The device of claim 12 wherein the basket is configured to collapse into the lumen when the basket is moved into the lumen, and to expand to an operational shape when the basket is moved out of the lumen.

23. The device of claim 12 wherein the filament and the basket are free of attachment to the sheath, such that the entire basket is movable into the lumen of the sheath.

24. The device of claim 1 or 7 wherein the filament carries an elongated lithothripter component that passes through the handle and extends adjacent to the stone extraction basket.

30. The device of claim 1, wherein the handle and the manipulator are positioned in the device to allow a user to rotate the manipulator with the same hand used to hold the handle.

7. An endoscopic stone-extraction device comprising:

a filament comprising a first end portion and a second end portion;

a sheath comprising a lumen, said filament disposed in the lumen such that the sheath is slideable with respect to the filament;

a stone-extraction basket carried by the first end portion of the filament;

a handle;

a rotatable joint interconnecting the second end portion of the filament and the handle such that the second end portion of the filament is rotatable with respect to the handle, said rotatable joint substantially preventing translational movement between the second end portion of the filament and the handle along a direction oriented parallel to the second end portion of the filament; and

a manipulator coupled with the filament and exposed for manual manipulation adjacent a front portion of the handle, the manipulator rotatable with respect to the handle such that rotation of the manipulator rotates the filament and the basket relative to the handle, wherein the handle and the manipulator are positioned in the device to allow a user to rotate the manipulator with the same hand used to hold the handle.

25. A method for fragmenting a biological stone situated in a tract, said method comprising:

(a) positioning a stone in a basket with an endoscopic device inserted into a tract;

(b) partially fragmenting the stone after (a);

(c) rotating the basket after (b), thereby repositioning the partially-fragmented stone of (b); and

then

(d) further fragmenting the stone positioned in the basket.

26. The method of claim 25 wherein the basket of (a) comprises a laterally-facing stone-entrance region.

27. The method of claim 25 wherein the basket of (a) comprises a stone-entrance region facing the endoscopic device.

28. The method of claim 25 wherein (b) and (d) comprise transmitting laser pulses through an optical fiber carried by a filament that supports the basket.

29. The method of claim 25 wherein (b) and (d) comprise transmitting energy to the stone via an elongated component carried by a filament that supports the basket.