System and method for bracketing and removing tissue

• US 6,675,810 B2
• Filed: 09/14/2001
• Issued: 01/13/2004
• Est. Priority Date: 05/14/1998
• Status: Expired due to Term

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Calypso Medical Technologies, Inc. (Siemens AG)
• Inventors: Krag, David N.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/954,588
• Publication Number:
  US 20020013596A1
• Time in Patent Office: 851 Days
• Field of Search: 128/899, 600/420, 600/431, 600/424, 606/1, 606/130
• US Class Current: 128/899
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• 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 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3413 guided by ultrasound
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3995 Multi-modality markers
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A system and method for bracketing a tissue volume (22) and later locating the bracketed tissue volume. The system includes a plurality of markers (30) and a probe (32) and detector (34) for use in locating the markers by providing information usable by a surgeon that is representative of changes in proximity between the probe and the plurality of markers. The markers have various detection characteristics, e.g., they transmit gamma rays, that are detectable by an associated probe and detector. The tissue volume is removed by manipulating a cutting tool based on the proximity information provided by the detector which can be used by the surgeon to define the boundary of the tissue volume. A two-part cutting tool (200) is provided for removing the tissue volume, and a tissue anchor (300) is provided for stabilizing the tissue during removal. The system and method of the invention are particularly useful in bracketing and then removing a tissue volume from amorphous, pliable tissue such as breast tissue.

Claims

1. A system for locating a target volume in a patient, comprising:

a first active marker that generates a detectable energy in response to an excitation energy, the first active marker having a body without external lead wires projecting therefrom, and wherein the body comprises a biocompatible capsule having a cylindrical section with a diameter of 1-2 mm that is configured to fit in a standard implanter needle for implantation in the patient;

a second active marker that generates a detectable energy in response to an excitation energy, and wherein the second active marker is positionable relative to the first active marker; and

a detector configured to receive the detectable energy generated by the first and second active markers.

2. The system of claim 1 wherein:

the first active marker comprises a first power detector/regulator and a first RF generator coupled to the first power detector/regulator, wherein the first power detector/regulator generates power in response to an excitation energy, and wherein the first RF generator generates a detectable energy using the power generated by the first power detector/regulator; and

the second active marker comprises a second power detector/regulator and a second RF generator coupled to the second power detector/regulator, wherein the second power detector/regulator generates power in response to an excitation energy, and wherein the second RF generator generates a detectable energy using the power generated by the second power detector/regulator.

3. The system of claim 1 wherein the first marker generates a first detectable energy and the second marker generates a second detectable energy that is distinguishable from the first detectable energy.

4. The system of claim 1 wherein the first marker generates a first detectable energy and the second marker generates a second detectable energy that is the same as the first detectable energy.

5. A system for locating a target volume in a patient, comprising:

at least one marker defining a discrete element configured to be implanted and remain in the patient at a single location relative to the target volume, and wherein the at least one marker comprises an active marker that emits a detachable energy in response to an excitation energy and has a body without external lead wires projecting outwardly from the body, and wherein the body comprises a biocompatible capsule having a cylindrical section with a diameter of 1-2 mm that is configured to fit in a standard implanter needle for implantation in the patient;

a probe having a device that generates a location signal in response to the detectable energy generated by the active marker; and

a detector configured to receive the location signal from the probe, the detector providing an indication of the position of the probe relative to the at least one marker.

6. The system of claim 5 wherein:

the at least one marker comprises an active marker that generates a detectable energy in response to magnetic excitation energy; and

the detector comprises a sensor that detects the detectable energy generated by the active marker.

7. The system of claim 5 wherein:

the detector comprises an antenna configured to receive the detectable energy.

8. The system of claim 5 wherein:

the at least one marker comprises an active marker having a power detector/regulator and an RF generator coupled to the power detector/regulator, wherein the power detector/regulator generates power in response to the excitation energy, and wherein the RF generator generates a detectable energy using the power generated by the power detector/regulator; and

the detector comprises an antenna configured to receive the detectable energy generated by the RF generator.

9. The system of claim 5 wherein the at least one marker comprises a plurality of markers including:

a first active marker defining a discrete implantable element, wherein the first active marker generates a detectable energy in response to an excitation energy; and

a second active marker positionable relative to the first active marker, wherein the second active marker generates a detectable energy in response to an excitation energy.

10. A system for locating a target volume in a patient, comprising:

a plurality of markers including (a) a first active marker defining a discrete implantable element, wherein the first active marker generates a first detectable energy in response to a magnetic excitation energy, and wherein the first active marker has a first body comprising a first biocompatible capsule having a cylindrical section with a diameter of 1-2 mm that is configured to fit in a standard implanter needle for implantation in the patient; and

(b) a second active marker positionable relative to the first active marker, wherein the second active marker generates a second detectable energy different than the first detectable energy in response to another magnetic excitation energy, and wherein the second active marker has a second body comprising a second biocompatible capsule having a cylindrical section with a diameter of 1-2 mm that is configured to fit in a standard implanter needle for implantation in the patient; and

a detector comprising a sensor configured to distinguish the first detectable energy generated by the first active marker from the second detectable energy generated by the second active marker.

11. A system for locating a target volume in a patient, comprising:

a first active marker that generates a detectable energy in response to an excitation energy, the first active marker having a body without external lead wires projecting outwardly from the body, and wherein the body comprises a biocompatible capsule having a cylindrical section with a diameter of 1-2 mm that is configured to fit in a standard implanter needle for implantation in the patient;

a second active marker that generates a detectable energy in response to an excitation energy, and wherein the second active marker is positionable relative to the first active marker; and

a sensor configured to distinguish the first and second detectable energies generated by the first and second active markers.

12. The system of claim 11 wherein:

the first active marker comprises a first power detector/regulator and a first RF generator coupled to the first power detector/regulator, wherein the first power detector/regulator generates power in response to an excitation energy, and wherein the first RF generator generates a detectable energy using the power generated by the first power detector/regulator; and

the second active marker comprises a second power detector/regulator and a second RF generator coupled to the second power detector/regulator, wherein the second power detector/regulator generates power in response to an excitation energy, and wherein the second RF generator generates a detectable energy using the power generated by the second power detector/regulator.

13. A system for locating a target volume in a patient, comprising:

a first active marker that generates a detectable energy in response to a magnetic excitation energy, the first active marker having a body without external lead wires projecting outwardly from the body, and wherein the body comprises a biocompatible capsule having a cylindrical section with a diameter of 1-2 mm that is configured to fit in a standard implanter needle for implantation in the patient;

a second active marker that generates a detectable energy in response to another magnetic excitation energy, and wherein the second active marker is positionable relative to the first active marker; and

a sensor configured to distinguish the first and second detectable energies generated by the first and second active markers.