Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
  • A61B10/02—Instruments for taking cell samples or for biopsy
  • A61B10/0233—Pointed or sharp biopsy instruments
  • A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
  • A61B10/02—Instruments for taking cell samples or for biopsy
  • A61B10/0233—Pointed or sharp biopsy instruments
  • A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
  • A61B2010/0258—Marrow samples

Definitions

• the present invention relates to a trocar for osteo-medullary biopsy.
• hematology physicians and other specialists commonly perform osteo-medullary biopsies using a bone marrow harvesting instrument consisting of a hollow tube 1 made of steel and a removable punch 2 arranged to be able to slide in said tube ( Figure 1).
• the hollow tube 1 having a diameter of a few millimeters and a standardized length of 130 millimeters, has a very sharp lower distal end 3 so as to be able to saw the bone circularly to penetrate into the marrow at the inside to make a borehole to access the bone marrow, then cut into it a carrot cylindrical in shape of 1.5 to 2 centimeters in length and 3 to 4 millimeters in diameter in one piece.
• the opposite end of the hollow tube 1 is provided with a plastic holding handle 4 perpendicular to the tube situated at its center and making it possible to manipulate said tube by exerting a pressure force and by semicircular movements to be able to penetrate the tube in the bone to saw circularly the periosteum, cortex and bone marrow in the form of cylinder (coring).
• the punch 2 which has a handle 5 at its proximal end, is initially threaded inside the tube 1 (FIG. 2), which makes it possible to penetrate the cutaneous surface and to traverse the muscles until contact with the bone surface without invasion of the interior of said tube. The punch is then removed from the tube and the penetration movements in contact with the bone begin.
• the practitioner When he reaches the depth he deems sufficient and the bone marrow section is inside the hollow tube 1, the practitioner must detach the bone marrow core from the rest of the marrow which is a fibrous substance hard and resistant. To achieve this, H is forced to make large, circular and pendular movements with the holding handle 4 to try to separate the bone marrow core from the rest of the bone marrow.
• the intervention is also long, which is difficult for the practitioner and can exceed the duration of action of a local anesthesia, which must then be renewed periodically.
• the patent No. EP 1 175 866 (Worldwide Medical Technologies) describes a bone marrow extraction instrument comprising an inner cannula sliding in the outer hollow tube and having a distal end provided with longitudinal slots defining flexible sectors. Said end of the inner cannula is determined to decrease in diameter when it is forced towards the end of the outer tube, so as to grip the marrow to maintain it during its extraction.
• Patent Nos WO01 0 78 590 and 01 78 608 show a biopsy trocar from the bone marrow including an internal tube whose distal end forms a cutting finger acting by rotation. These instruments, if they facilitate interventions, do not eliminate the need for pulling the carrots by pendular or rotary movements.
• the bone biopsy trocar bearing the patent N 0 FR 2 610 508 comprises a tube provided with a cutting end and driven in rotation by a motor, the end of an internal element housed in said tube making protruding beyond said cutting end during the passage of the soft tissues and being erased during drilling of the bone tissue, said end of the inner member being formed by a plurality of folded end metal strips simultaneously sliding inside the tube rotating between an output position in which said lamellae form, due to their folding, a protruding tip at the end of the rotary tube and an erased position, wherein said lamellae are housed inside the tube and elastically deformed of way that their originally folded end came in the extension of the rest of the lamella.
• the tip formed by the lamellae perforates the soft tissues and prevents them from penetrating into the tube, as is the case of the usual punch.
• the operator raises • the lamellae in the erased position, so that they do not interfere with the cutting of the core by the tube.
• the operator brings out the slats in the output position so that their ends come together through the core.
• the core is thus cut at its base and it remains held in the trocar by the slats during extraction of the device. This is a complex and very expensive device whose use can only be considered for major interventions performed in the operating room.
• the device according to the present invention aims to overcome the disadvantages associated with known trolleys while allowing the realization of an easy to use instrument and affordable. 11 allows in particular:
• an osteomedullary biopsy trocar comprising, on the one hand, an outer hollow tube provided with a sharpened distal end having an eccentric orifice whose diameter is smaller than the initial diameter of the tube. and, on the other hand, an inner hollow tube located inside the first tube and whose distal end has a crescent-shaped sharp blade perpendicular to the trocar axis and arranged to be laterally positioned on the side of the first tube. opposed to the eccentric port so as to allow the penetration of the bone marrow into the trocar during coring and cutting the core at its base by causing the axial rotation of the inner tube and thus the blade.
• FIG. 1 is a side elevational view of an existing osteo-medullary biopsy trocar with the punch separated from the outer tube
• Figure 2 also mentioned, shows the two elements of Figure 1 assembled
• Figure 3 shows in the same conditions an osteo-medullary biopsy trocar according to the invention
• Figure 4 is an enlarged side view of the distal end of the outer tube of the trocar of FIG. 3
• FIG. 5 is an end view along the arrow F1 of FIG. 4
• FIG. 6 is an enlarged partial side view of the inner tube of FIG. trocar of FIG. 3
• FIG. 7 is an end view along the arrow F2 of FIG. 6;
• FIG. 1 is a side elevational view of an existing osteo-medullary biopsy trocar with the punch separated from the outer tube
• Figure 3 shows in the same conditions an osteo-medullary biopsy trocar according to the invention
• Figure 4 is an enlarged side view of the distal end of the outer tube of the trocar of FIG. 3
• FIG. 5 is an end view along the arrow
• FIGS. 3 to 9 consists of the assembly of an outer hollow tube 11 and of an inner hollow tube 12 located inside the first tube and adapted to receive a removable punch 2 of the standard type used for penetrate the cutaneous surface and traverse the muscles until contact with the bone surface.
• the outer hollow tube 11 comprises a proximal end equipped with a handle 14 allowing the manipulation of said trocar and a sharp distal lower end 13 which can penetrate a bone by drilling and having an eccentric orifice 16 whose diameter is smaller than the initial internal diameter of the tube external. This end gradually widens on the outer half of the circumference of the tube to a height of a few millimeters so as to constitute, inside the tube, a crescent moon base 17 having a flat surface perpendi ⁇ cular to the axis of said tube.
• the orifice 16 will preferably be circular.
• the proximal end of the inner hollow tube 12 is provided with a button 18 or integral operating handle for imparting an axial rotational movement.
• the distal end of said inner hollow tube comprises a crescent-shaped blade 19 perfectly matching the base of the base 17 situated at the lower end of the outer tube 11 and of a lateral opening 20 diametrically opposite to the blade, from a height of a few centimeters.
• the blade 19 will support the bone marrow core to protect and ensure its extraction.
• the inner hollow tube 12 may be removable to facilitate cleaning and disinfection of the apparatus, in the case where the material is reusable.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Rheumatology (AREA)
• Pathology (AREA)
• Immunology (AREA)
• Engineering & Computer Science (AREA)
• Hematology (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Surgery (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (2)

Publications (1)

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Family Applications (1)

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• 2004
  • 2004-07-23 FR FR0408216A patent/FR2873282B1/fr not_active Expired - Fee Related
• 2005
  • 2005-07-22 US US11/632,915 patent/US20080139961A1/en not_active Abandoned
  • 2005-07-22 WO PCT/FR2005/001905 patent/WO2006030078A1/fr not_active Application Discontinuation
  • 2005-07-22 EP EP05793572A patent/EP1771114A1/de not_active Withdrawn

Non-Patent Citations (1)

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