Surgical biopsy device

• US 6,626,903 B2
• Filed: 04/27/2001
• Issued: 09/30/2003
• Est. Priority Date: 07/24/1997
• Status: Expired due to Fees

• Current Assignee: REX Medical LP
• Original Assignee: REX Medical LP
• Inventors: Defonzo, Stephan A., McGuckin, James F. Jr., Hinchliffe, Peter W. J.
• Primary Examiner(s): ROLLINS, ROSILAND STACIE
• Application Number:
  US09/844,729
• Publication Number:
  US 20010047169A1
• Time in Patent Office: 886 Days
• Field of Search: 600/562, 600/564, 600/567, 606/39, 606/40, 606/45, 606/46, 606/47, 606/48, 606/49.5, 606/110
• US Class Current: 606/45
• CPC Class Codes: A61B 10/0041 Detection of breast cancer mammography by transillumination A61B5/0091, by X-rays A61B6/502, by ultrasonic means A61B8/0825
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 10/0266 means for severing sample
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/00796 Breast surgery
• CPC Class Codes: A61B 2017/008 Removal of tumors
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 having an open distal end
• 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 2018/1407 Loop
• CPC Class Codes: A61B 2018/2238 with means for selectively laterally deflecting the tip of the fibre
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

Abstract

A surgical biopsy apparatus for cutting tissue comprising a housing having a longitudinal axis, first and second members movable from a retracted position to an extended position with respect to the housing, a third member slidably positioned and extendable with respect to the first member, a fourth member slidably positioned and extendable with respect to the second member, and an electrocautery cutting wire slidable with respect to the third and fourth members to surround a region of tissue positioned between the third and fourth members to cut the tissue.

Claims

1. A surgical biopsy apparatus for cutting tissue comprising:

a housing having a longitudinal axis;

first and second members movable distally from a retracted position to an extended position with respect to the housing;

third and fourth members, the third member slidably positioned with respect to the first member and extendable with respect to the first member and the fourth member slidably positioned with respect to the second member and extendable with respect to the second member; and

an electrocautery cutting wire movable distally with respect to the third and fourth members to surround a region of tissue positioned between the third and fourth members to cut the tissue, the wire formed into a loop open to cut tissue in a distal direction.

2. The apparatus of claim 1, further comprising a tissue retrieval bag movable with respect to the third and fourth members to surround a region of tissue positioned between the third and fourth members to remove the cut tissue.

3. The apparatus of claim 2, wherein the electrocautery wire and the tissue retrieval bag are movable from a retracted position within the housing to an extended position distally of the housing for cutting the tissue and retrieving the cut tissue.

4. The apparatus of claim 3, wherein the electrocautery wire and tissue retrieval bag are advanced together from the housing.

5. The apparatus of claim 3, further comprising a first carrier slidably positioned over the first and third member, the first carrier supporting the electrocautery wire and advancing the electrocautery wire as the first carrier is advanced.

6. The apparatus of claim 5, further comprising a suture for closing the tissue retrieval bag, the suture supported by the first carrier and advancable by advancement of the first carrier.

7. The apparatus of claim 6, further comprising a second carrier slidably positioned over the fourth member and further supporting the electrocautery wire and tissue retrieval bag, the second carrier being advanceable along with the first carrier to advance the electrocautery wire and the tissue retrieval bag.

8. The apparatus of claim 1, wherein the first and second members move radially outwardly away from the longitudinal axis of the housing and the third and fourth members initially move radially outwardly away from the longitudinal axis of the housing followed by movement inwardly towards the longitudinal axis of the housing.

9. The apparatus of claim 1, wherein the third member is telescopingly received within a first channel in the first member and the fourth member is telescopingly received within a second channel in the second member.

10. A surgical biopsy apparatus for cutting a tissue mass comprising:

a housing having a longitudinal axis;

a plurality of first members extendable with respect to the housing, the first members movable in a first direction at a first angle to the longitudinal axis of the housing;

a plurality of second members movable with respect to the first members in a second direction different than the first direction and at an angle to the first angle, the second members having tips configured to penetrate tissue as moved with respect to the first members; and

a cutting wire movable longitudinally with respect to the first and second members to cut the tissue mass.

11. The surgical apparatus of claim 10, wherein the plurality of second members surround the tissue mass to form a substantially spherical tissue cutting area, the cutting area having a diameter greater than the diameter of the housing.

12. The surgical apparatus of claim 11, wherein the plurality of second members surround the tissue mass to form a tissue cutting area having a substantially circular cross section, the cutting area having a diameter greater than the diameter of the housing.

13. The surgical apparatus of claim 10, wherein the cutting wire is an electrocautery wire.

14. The surgical apparatus of claim 10, further comprising a tissue retrieval bag movable longitudinally with respect to the first and second members to remove the tissue mass cut by the cutting wire.

15. The surgical apparatus of claim 14, wherein a loop of the cutting wire and a mouth of the tissue retrieval bag are enlarged by the plurality of first and second members.

16. The apparatus of claim 14, wherein the plurality of first and second members are composed of shape memory material.

17. A surgical biopsy apparatus comprising:

a housing;

at least three members advanceable with respect to the housing to provide a three-dimensional boundary for an area of tissue to be removed, at least a portion of the at least three members extending in different directions;

a cutting wire loop advanceable with respect to the plurality of members to cut the area of tissue wherein the cutting wire loop is moved to a larger diameter as it is advanced with respect to the members and is supported by at least one carrier, the at least one carrier advanceable over one of the plurality of members; and

a tissue retrieval bag operatively connected to the at least one carrier, wherein advancement of the at least one carrier with respect to the plurality of members advances the cutting wire and the tissue retrieval bag toward the target tissue.

18. The apparatus of claim 17, wherein a mouth of the tissue retrieval bag is moved to a larger diameter as it is advanced with respect to the members.

19. A surgical biopsy apparatus comprising:

a housing having a longitudinal axis;

a plurality of members advanceable with respect to the housing to provide a boundary for an area of tissue to be removed;

a tissue retrieval bag having an opening facing in a distal direction, the opening expanding in a plane substantially perpendicular to the longitudinal axis of the housing as it advances distally with respect to the plurality of members to remove the area of tissue.

20. The apparatus of claim 19, wherein a mouth of the tissue retrieval is moved to a progressively larger diameter as it is advanced with respect to the plurality of members.

21. The apparatus of claim 20, wherein the tissue retrieval bag is supported by at least one carrier, the at least one carrier advancable over one of the plurality of members.

22. A surgical biopsy apparatus comprising:

a housing having a longitudinal axis;

a plurality of tissue penetrating members extendable with respect to the housing at an angle to the longitudinal axis;

a carrier slidable with respect to the tissue penetrating members for advancing and expanding a wire to cut tissue; and

a tissue containment bag, the tissue containment bag operatively associated with the carrier so that slidable movement of the carrier advances the tissue containment bag to the target tissue.

23. A method for removing a tissue mass for biopsy comprising:

inserting a cannula to a position proximal of the target tissue mass;

advancing a plurality of tissue penetrating members from the cannula to an angular position to create a boundary area around the tissue mass; and

subsequently advancing distally an electrocautery cutting wire with respect to the tissue penetrating members to surround the tissue mass defined within the boundary area.

24. The method of claim 23, further comprising the step of advancing a tissue containment bag with respect to the tissue penetrating members to encapsulate the cut tissue mass for removal.

25. The method of claim 24, wherein the cutting wire and tissue containment bag are advanced substantially simultaneously.

26. The method of claim 25, further comprising the step of passing radio frequency energy through the cutting wire as the cutting wire is advanced.

27. A method for performing breast biopsy comprising:

inserting into breast tissue a housing having a diameter smaller than a diameter of the tissue to be biopsied;

advancing penetrating members through the breast tissue to create a tissue boundary area having a transverse cross-sectional length greater than the diameter of the housing; and

advancing a cutting wire so a loop of the cutting wire moves to a diameter greater than the diameter of the housing is an opening of the loop expands in a plane substantially perpendicular to a longitudinal axis of the housing as the wire moves distally with respect to the penetrating members; and

advancing a tissue retrieval bag so a mouth of the bag moves to a diameter greater than the diameter of the housing.

28. A surgical biopsy apparatus comprising:

a housing;

a plurality of members advanceable with respect to the housing to initially provide a boundary for an area of tissue to be removed;

a cutting loop advanceable with respect to the plurality of members and directed by the plurality of members to increase the transverse opening of the loop to cut the area of tissue.

29. The surgical biopsy apparatus of claim 28, further a tissue retrieval bag advanceable with respect to the plurality of members directed by the plurality of members to increase the transverse opening of a mouth of the bag to retrieve the cut tissue.

30. A surgical biopsy apparatus for cutting an area of tissue comprising:

a housing;

a plurality of members advanceable with respect to the housing to initially provide a boundary for an area of tissue to be removed;

a tissue retrieval member advanceable with respect to the plurality of members and directed by the plurality of members to increase the transverse opening of a mouth of the tissue retrieval member to retrieve the cut tissue.

31. A surgical biopsy apparatus comprising:

a housing;

an electrocautery cutting loop advanceable from the housing and having a transverse opening expandable to a larger diameter as it is advanced distally to cut an area of tissue; and

a tissue retrieval member having a mouth and advanceable from the housing so a transverse opening of the mouth expands to a larger diameter as it is advanced distally to retrieve the cut tissue.

32. The apparatus of claim 31, wherein the cutting loop and tissue retrieval member are initially retained in the housing in a collapsed position.

33. The apparatus of claim 32, wherein the culling loop and tissue retrieval member are advanced together from the housing.