Medical snare loop with indentations for changing effective size of loop and associated method

• US 7,270,663 B2
• Filed: 10/16/2003
• Issued: 09/18/2007
• Est. Priority Date: 10/16/2003
• Status: Active Grant

• Current Assignee: Granit Medical Innovations LLC
• Original Assignee: Granit Medical Innovations LLC
• Inventors: Nakao, Naomi L.
• Primary Examiner(s): DESANTO, MATTHEW F
• Application Number:
  US10/687,281
• Publication Number:
  US 20050085808A1
• Time in Patent Office: 1,433 Days
• Field of Search: 606 41- 49, 606110-113, 606/114, 606/127, 607/96, 607/98, 607/99, 607/113, 607/116, 604/20, 604/22, 604/19
• US Class Current: 606/47
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2018/1407 Loop

Abstract

A medical cauterization snare includes a tubular member such as a catheter, a rod or wire disposed at least partially inside the tubular member, and a resilient loop of a first size attached to a distal end of the rod or wire. The loop includes a nose on a side of the loop opposite the wire. The loop further includes two loop sections each extending between the wire and the nose. The loop sections are each formed with a respective notch or dent for enabling a use of the loop in a second size smaller than the first size. Positioning the loop relative to the tubular member so that the notches or dents are disposed at a mouth opening of the tubular member generates this secondary deployment configuration.

Claims

1. A medical cauterization snare instrument comprising:

a tubular member;

an elongate member disposed at least partially inside said tubular member;

a resilient loop having a substantially planar fully expanded configuration of a first size attached to one end of said elongate member, said loop including a first bend on a side of said loop opposite said elongate member, said loop further including two loop sections each extending from said elongate member to said bend, at least one of said loop sections being formed with at least one notch or dent for enabling a use of said loop in at least one second size smaller than said first size upon a positioning of said loop by moving said elongate member and said tubular member relative to one another so that said notch or dent is disposed at a mouth opening of said tubular member, said two loop sections being disposed entirely outside of said tubular member in said fully expanded configuration of said loop, said one of said loop sections including, in the fully expanded configuration of said loop, a second bend or kink disposed between said first bend and said notch or dent, said second bend or kink defining a concavity facing towards the other of said loop sections, said loop being made of an electrically conductive material for cauterizing organic tissues of a patient, said notch or dent being so small relative to said loop that said loop in the fully expanded configuration takes the form of a single oval having a width that is substantially unaffected by said notch or dent so that said loop in the fully expanded configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop;

a connector electrically linked to said loop for operatively coupling said loop to a voltage source; and

wherein each of said notches or dents includes a pair of linear segments connected to one another by an arcuate bight, said segments being disposed at an angle of approximately 80°

to approximately 120°

relative to one another.

2. The instrument defined in claim 1 wherein each of said loop sections is formed with a respective notch or dent for enabling use of said loop in said second size upon a positioning of said loop relative to said tubular member so that the notches or dents are disposed at said mouth opening of said tubular member, said notches or dents both being so small relative to said loop that said loop in the fully expanded configuration takes the form of a single oval having a width that is substantially unaffected by said notches or dents so that said loop in the fully expanded configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop.

3. The instrument defined in claim 2 wherein the notches or dents are disposed at substantially the same first distance from said one end of said elongate member and substantially the same second distance from said first bend.

4. The instrument defined in claim 3 wherein said first distance is approximately 30% to approximately 40% of the sum of said first distance and said second distance.

5. The instrument defined in claim 4 wherein said first bend is part of a nose projection of said loop, each of said loop sections including a respective second bend or kink disposed between said nose projection and the respective one of said notches or dents.

6. The instrument defined in claim 5 wherein the respective second bends or kinks in said loop sections are located at approximately the same distance from said nose projection so that said loop is provided with an enlarged distal end portion.

7. The instrument defined in claim 2 wherein the notch or dent of each one of said loop sections extends toward the other loop section.

8. The instrument defined in claim 2 wherein said loop in said planar configuration lies in a single plane, said notches or dents being located in said plane.

9. The instrument defined in claim 2 wherein said loop has a relaxed configuration wherein said loop sections are spaced from one another by a loop width, each of said notches or dents having a width dimension measured in a direction from the respective loop section towards the other loop section, said width dimension being no larger than approximately fifteen percent of said loop width.

10. The instrument defined in claim 2 wherein said notches or dents each have a V shape.

11. The instrument defined in claim 1, further comprising a pouch slidably attached to said loop.

12. The instrument defined in claim 1 wherein said one of said loop sections is curved in a fully expanded configuration of said loop, the other of said loop sections being straight in said fully expanded configuration of said loop.

13. The instrument defined in claim 1 wherein said notch or dent is one of a plurality of notches or dents formed along said one of said loop sections, said notches or dents being so small relative to said loop that said loop in the fully expanded configuration takes the form of a single oval having a width that is substantially unaffected by said notches or dents so that said loop in the fully expanded configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop.

14. The instrument defined in claim 1 wherein said notch or dent is located at a first distance from said one end of said elongate member and a second distance from said first bend, said first distance being approximately 30% to approximately 40% of the sum of said first distance and said second distance.

15. The instrument defined in claim 1 wherein said loop in said planar configuration lies in a single plane, said notch or dent being located in said plane.

16. The instrument defined in claim 1 wherein said loop has a relaxed configuration wherein said loop sections are spaced from one another by a loop width, said notch or dent having a width dimension measured in a direction from said one of said loop sections towards the other of said loop sections, said width dimension being no larger than approximately fifteen percent of said loop width.

17. The instrument defined in claim 1 wherein said notch or dent has a V shape.

18. The instrument defined in claim 1 further comprising a pouch attached to said loop, said loop defining a mouth opening of said pouch.

19. A medical cauterization snare instrument comprising:

a tubular member;

an elongate member disposed at least partially inside said tubular member;

a resilient loop of a first size attached to one end of said elongate member, said loop including a first bend on a side of said loop opposite said elongate member, said loop further including two loop sections each extending from said elongate member to said bend, at least one of said loop sections being formed with at least one notch or dent for enabling a use of said loop in at least one second size smaller than said first size upon a positioning of said loop by moving said elongate member and said tubular member relative to one another so that said notch or dent is disposed at a mouth opening of said tubular member,

the notch or dent in said one of said loop sections extending toward the other loop section, said loop having a fully opened relaxed configuration wherein both said loop sections are disposed outside of said tubular member, said one of said loop sections including, in said fully expanded configuration of said loop, a second bend or kink disposed between said first bend and said notch or dent, said second bend or kink defining a concavity facing towards the other of said loop sections, said notch or dent being so small relative to said loop that said loop in the fully opened relaxed configuration takes the form of a single oval having a width that is substantially unaffected by said notch or dent so that said loop in the fully opened relaxed configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop,

said loop being made of an electrically conductive material for cauterizing organic tissues of a patient;

a connector electrically linked to said loop for operatively coupling said loop to a voltage source; and

wherein each of said notches or dents includes a pair of linear segments connected to one another by an arcuate bight, said segments being disposed at an angle of approximately 80°

to approximately 120°

relative to one another.

20. The instrument defined in claim 19 wherein each of said loop sections is formed with at least one respective notch or dent for enabling use of said loop in said second size upon a positioning of said loop relative to said tubular member so that the notches or dents are disposed at said mouth opening of said tubular member, each notch or dent in each of said loops sections extending toward the other loop section, each of said loop sections including, in said fully expanded configuration of said loop, a second bend or kink disposed between said first bend and the respective notch or dent and defining a concavity facing towards the other of said loop sections, said notches or dents being so small relative to said loop that said loop in the fully expanded configuration takes the form of a single oval having a width that is substantially unaffected by said notches or dents so that said loop in the fully expanded configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop.

21. The instrument defined in claim 19 wherein said loop has a relaxed configuration wherein said loop sections are spaced from one another by a loop width, said notch or dent having a width dimension measured in a direction from said one of said loop sections towards the other loop section, said width dimension being no larger than approximately fifteen percent of said loop width.

22. The instrument defined in claim 19 wherein said one of said loop sections is curved in a fully expanded configuration of said loop, the other of said loop sections being straight in said fully expanded configuration of said loop.

23. The instrument defined in claim 19 wherein said notch or dent is one of a plurality of notches or dents formed along said one of said loop sections, said notches or dents being so small relative to said loop that said loop in the fully expanded configuration takes the form of a single oval having a width that is substantially unaffected by said notches or dents so that said loop in the fully expanded configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop.

24. The instrument defined in claim 19 wherein said loop lies in a single plane, said notch or dent being located in said plane.

25. The instrument defined in claim 19 wherein said loop has a relaxed configuration wherein said loop sections are spaced from one another by a loop width, said notch or dent having a width dimension measured in a direction from said one of said loop sections towards the other of said loop sections, said width dimension being no larger than approximately fifteen percent of said loop width.

26. A medical cauterization snare instrument comprising:

a tubular member;

an elongate member disposed at least partially inside said tubular member;

a resilient loop of a first size attached to one end of said elongate member, said loop including a first bend on a side of said loop opposite said elongate member, said loop further including two loop sections each extending from said elongate member to said bend, at least one of said loop sections being formed with at least one indentation or dimple for enabling a use of said loop in at least one second size smaller than said first size upon a positioning of said loop by moving said elongate member and said tubular member relative to one another so that said indentation or dimple is disposed at a mouth opening of said tubular member, said two loop sections being disposed entirely outside of said tubular member in said fully expanded configuration of said loop, said one of said loop sections including, in the fully expanded configuration of said loop, a second bend or kink disposed between said first bend and said indentation or dimple, said second bend or kink defining a concavity facing towards the other of said loop sections, said indentation or dimple being so small relative to said loop that said loop in the fully opened relaxed configuration takes the form of a single oval having a width that is substantially unaffected by said indentation or dimple so that said loop in the fully opened relaxed configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop,

said loop being made of an electrically conductive material for cauterizing organic tissues of a patient;

a connector electrically linked to said loop for operatively coupling said loop to a voltage source; and

wherein each of said notches or dents includes a pair of linear segments connected to one another by an arcuate bight, said segments being disposed at an angle of approximately 80°

to approximately 120°

relative to one another.

27. The instrument defined in claim 26 wherein said indentation or dimple comprises at least three mutually proximate bends in said one of said loop sections, said mutually proximate bends being substantially closer to each other than to any other bend in said loop.

28. The instrument defined in claim 26 wherein said indentation or dimple faces an inside of said loop.

29. The instrument defined in claim 26 wherein said loop substantially lies in a single plane, said indentation or dimple being disposed in said plane.

30. A medical cauterization method comprising:

(a) providing a cauterization snare instrument including;

a tubular member;

an elongate member disposed at least partially inside said tubular member;

a resilient loop having a substantially planar fully expanded configuration of a first size attached to one end of said elongate member, said loop including a first bend on a side of said loop opposite said elongate member, said loop further including two loop sections each extending from said elongate member to said bend, at least one of said loop sections being formed with at least one notch or dent for enabling a use of said loop in at least one second size smaller than said first size upon a positioning of said loop by moving said elongate member and said tubular member relative to one another so that said notch or dent is disposed at a mouth opening of said tubular member, said two loop sections being disposed entirely outside of said tubular member in said fully expanded configuration of said loop, said one of said loop sections including, in the fully expanded configuration of said loop, a second bend or kink disposed between said first bend and said notch or dent, said second bend or kink defining a concavity facing towards the other of said loop sections, said loop being made of an electrically conductive material for cauterizing organic tissues of a patient, said notch or dent being so small relative to said loop that said loop in the fully expanded configuration takes the form of a single oval having a width that is substantially unaffected by said notch or dent so that said loop in the fully expanded configuration can be used to sever a polyp substantially larger than any polyp severable by said second size of said loop; and

a connector electrically linked to said loop for operatively coupling said loop to a voltage source; and

wherein each of said notches or dents includes a pair of linear segments connected to one another by an arcuate bight, said segments being disposed at an angle of approximately 80°

to approximately 120°

relative to one another;

(b) inserting a distal end portion of said tubular member into a patient, said loop being disposed inside said tubular member during the inserting of said distal end portion;

(c) thereafter ejecting said loop from said tubular member inside the patient;

(d) expanding said loop to said fully expanded configuration;

(e) placing the fully expanded loop over a first polyp;

(f) thereafter withdrawing said loop in a proximal direction and thereby closing said loop about said polyp;

(g) during the closing of said loop, conducting current through said loop to sever the polyp about a base region thereof, and alternatively to steps (d)-(g);

(h) expanding said loop to said second size;

(i) placing the loop expanded to said second size over a second polyp, said first polyp being larger than said second polyp;

(j) thereafter withdrawing said loop in a proximal direction and thereby closing said loop about said second polyp; and

(k) during the closing of said loop about said second polyp, conducting current through said loop to sever the second polyp about a base region thereof.

31. The method defined in claim 30 wherein each of said loop sections is formed with a respective notch or dent for enabling use of said loop in said second size upon a positioning of said loop relative to said tubular member so that said notches or dents are disposed at said mouth opening of said tubular member.