US20120184874A1 - Methods and devices for removing tissue from a patient and placing a marker in the patient - Google Patents
Methods and devices for removing tissue from a patient and placing a marker in the patient Download PDFInfo
- Publication number
- US20120184874A1 US20120184874A1 US13/433,275 US201213433275A US2012184874A1 US 20120184874 A1 US20120184874 A1 US 20120184874A1 US 201213433275 A US201213433275 A US 201213433275A US 2012184874 A1 US2012184874 A1 US 2012184874A1
- Authority
- US
- United States
- Prior art keywords
- tissue
- tubular element
- opening
- lumen
- introducer
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 239000003550 marker Substances 0.000 title claims abstract description 53
- 238000000034 method Methods 0.000 title claims description 27
- 230000009969 flowable effect Effects 0.000 claims description 33
- 239000000126 substance Substances 0.000 claims description 30
- 239000012530 fluid Substances 0.000 claims description 2
- 230000032258 transport Effects 0.000 description 39
- 239000000463 material Substances 0.000 description 12
- 210000000481 breast Anatomy 0.000 description 7
- 230000000994 depressogenic effect Effects 0.000 description 7
- 239000007788 liquid Substances 0.000 description 3
- 239000007787 solid Substances 0.000 description 3
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 2
- 238000001574 biopsy Methods 0.000 description 2
- 238000002604 ultrasonography Methods 0.000 description 2
- 102000008186 Collagen Human genes 0.000 description 1
- 108010035532 Collagen Proteins 0.000 description 1
- 229920000954 Polyglycolide Polymers 0.000 description 1
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 1
- 229910002092 carbon dioxide Inorganic materials 0.000 description 1
- 239000001569 carbon dioxide Substances 0.000 description 1
- 229920001436 collagen Polymers 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 239000004633 polyglycolic acid Substances 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- 239000007779 soft material Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 238000007794 visualization technique Methods 0.000 description 1
Images
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
- A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
-
- 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
-
- 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
- A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
- A61B10/0275—Pointed or sharp biopsy instruments means for severing sample with sample notch, e.g. on the side of inner stylet
-
- 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
- A61B10/0283—Pointed or sharp biopsy instruments with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B2017/32004—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes having a laterally movable cutting member at its most distal end which remains within the contours of said end
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320064—Surgical cutting instruments with tissue or sample retaining means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
- A61B2090/3908—Soft tissue, e.g. breast tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3933—Liquid markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
- A61B2090/395—Visible markers with marking agent for marking skin or other tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3987—Applicators for implanting markers
Definitions
- the present invention is directed to tissue removing devices and methods.
- the invention may be used to remove tissue from any part of the body and is particularly useful in removing tissue from the breast.
- the invention may be used in any other part of the body and use in the breast is merely exemplary.
- a tissue removal device which has a tubular element, a transport element and a cutting element.
- the tubular element has an open distal end.
- the transport element and the cutting element are positioned at least partially within the tubular element and are movable within the tubular element.
- the device is introduced into a patient and the tubular element is advanced so that tissue enters the tubular element through the open end.
- the cutting element is then used to cut or part-off the tissue which has entered the tubular element and the transport element is used to transport the tissue proximally to a tissue chamber.
- the transport element may take many forms.
- the transport element has an open end positioned proximal to the open end of the tubular element so that tissue enters the open end of the transport element when the tubular element is advanced into tissue.
- the transport element may also pierce the tissue being removed from the patient.
- the transport element may have a deployable anchor, which secures the tissue to the transport element.
- the anchor may take any suitable shape such as deployable barbs, wires or an inflatable balloon.
- the device may include a cutting element, which parts off the tissue, which enters the tubular element and also transports the tissue to the tissue chamber.
- the cutting element may have a first part and a second part, which move toward one another to a cutting position when cutting the tissue within the tubular element.
- the cutting element may be plastically or elastically deformed when moving to a cutting position.
- the device includes an opening through which tissue is introduced into the device. The tissue is then cut to separate a tissue mass from the surrounding tissue.
- the device also includes a solid marker housed within the device.
- the marker may be implanted into the patient at any time desired by the user.
- the marker may be delivered through the same opening through which tissue is removed or the device may include a separate opening for delivering the marker.
- the marker may be mounted to the introducer, stored in a storage area in the handle, or may even be stored at a location distal to the opening through which tissue is removed.
- a method of removing tissue and marking a tissue area in which the tissue marking element delivers a flowable material.
- the tissue marking element may have a plurality of outlets to form a recognizable pattern to help locate and orient the tissue area of interest at a later time when the flowable marking material is visualized.
- the tissue marking element may be advanced through the lumen of the tubular element until an outlet of the tissue marking element is positioned distal to the opening in the tubular element.
- the tissue marking element may also be part of the introducer with the introducer having one or more outlets through which the flowable substance is delivered.
- FIG. 1 shows a tissue removing device in accordance with the present invention.
- FIG. 2 shows another view of the device of FIG. 1 .
- FIG. 3 is a cross-sectional view of a distal end of the tissue removal device with a cutting element in a stored position.
- FIG. 4 is a cross-sectional view showing the cutting element in a cutting position.
- FIG. 5 shows the device being introduced into tissue.
- FIG. 6 shows an introducer withdrawn from the distal end.
- FIG. 7 shows a tubular element advanced into tissue.
- FIG. 8 shows a cutting element cutting tissue, which has entered the tubular element.
- FIG. 9 shows the tissue being transported proximally.
- FIG. 10 shows the tissue positioned over a tissue chamber and contacting a distal end of the introducer.
- FIG. 11 shows the tissue falling into the tissue chamber.
- FIG. 12 is a cross-sectional view of another tissue removal device.
- FIG. 13 shows the device of FIG. 12 introduced into tissue.
- FIG. 14 shows the introducer retracted.
- FIG. 15 shows the cutting element being advanced distally.
- FIG. 16 shows the cutting element in a cutting position.
- FIG. 17 shows the cutting element moving the tissue proximally toward the tissue chamber.
- FIG. 18 shows the tissue being released into the tissue chamber by the cutting element.
- FIG. 19 shows another device for removing tissue from a patient.
- FIG. 20 shows the cutting element cutting the tissue which has entered the tubular element.
- FIG. 21 shows still another device for removing tissue from a patient.
- FIG. 22 shows another anchor for the device of FIG. 21 .
- FIG. 23 shows still another anchor for the device of FIG. 21 .
- FIG. 24 is a cross-sectional view of another device for removing tissue from a patient and placing a marker in the patient.
- FIG. 25 shows the introducer moved to a position, which releases the marker.
- FIG. 26 shows still another device for removing tissue from a patient and placing a marker in the patient with the introducer withdrawn to permit tissue to be collected
- FIG. 27 shows the introducer withdrawn proximal to a marker storage area.
- FIG. 28 shows the introducer advancing the marker toward the open end.
- FIG. 29 shows yet another device for removing tissue from a patient and placing a marker in the patient with a cutting element cut tissue, which has entered the device through a side opening.
- FIG. 30 shows the marker being released from a marker storage area.
- FIG. 31 shows another device for removing tissue and marking a tissue area.
- FIG. 32 shows a tissue marking element entering the lumen.
- FIG. 33 shows the tissue marking element advanced to the distal end of the lumen with the introducer.
- FIG. 34 shows the introducer advanced to move a piston within the tissue marking element to force the flowable substance into the tissue area.
- FIG. 35 shows yet another device for removing tissue and marking a tissue area with an introducer having an outlet through which a flowable marker is delivered.
- FIG. 36 shows the device of FIG. 35 with the flowable material delivered.
- FIG. 37 shows still another device for removing tissue and marking a tissue area.
- FIG. 38 shows a tissue marking element moved to a working position within an introducer.
- FIG. 39 shows yet another device for removing tissue and marking a tissue area.
- FIG. 40 shows an external view of the device of FIG. 39 .
- tissue removing device 2 according to the present invention is shown.
- the devices and methods described herein may be used to remove tissue from any location in the body and an example of such a use is removal of tissue from the breast as described below.
- the tissue removal device 2 has a tubular element 4 which is advanced into tissue so that tissue is received through an open end 6 of the tubular element 4 .
- a transport element 7 is positioned within the tubular element 4 and is used to transport tissue back to a tissue sample chamber 30 as described below.
- the distal end of the tubular element 4 is beveled to form a sharp tip 11 but may take any other suitable configuration which penetrates tissue.
- the tubular element 4 may also be rotated when driven into the tissue.
- the tubular element 4 may be made of any suitable material such as stainless steel.
- the device 2 may also include an introducer 20 positioned in the tubular element 4 during introduction.
- the introducer 20 may have a sharp tip 22 which penetrates the tissue during introduction of the device 2 as shown in FIG. 5 .
- the device 2 may also be introduced through a sheath, trocar or cannula (not shown) which penetrates the tissue rather than using the device 2 itself to penetrate the tissue.
- the present invention may be used to collect tissue of any size, the invention is particularly useful in removing relatively small quantities of tissue such as required in breast biopsies.
- the inner diameter of the device 2 may be less than 5 mm or even less than 3.5 mm.
- the present invention provides the ability to obtain small, cylindrical tissue samples which are relatively undisturbed compared to many prior art solutions.
- the tubular element 4 may be driven forward a distance of 15-25 mm which may be selected by the user.
- the tissue removal device 2 also has a cutting element 10 which is used to cut or “part off” tissue which has entered the tubular element 4 from the surrounding tissue.
- the cutting element 10 is stored between the tubular element 4 and the transport element 7 and naturally assumes the position of FIG. 4 when advanced.
- the cutting element 10 also contacts a protrusion 11 on an inner surface 13 of the tubular element 4 which directs the cutting element 10 into the cutting position of FIG. 4 .
- the protrusion 11 may simply be a ring 15 of material attached to the inner surface of the tubular element 4 although any other structure may be used.
- the transport element 4 and cutting element 10 are then moved proximally to the tissue chamber with the cutting element 10 remaining in the cutting position of FIG. 4 as explained below.
- the tissue removal device 2 has a first actuator 24 and a second actuator 26 which are described further below in connection with use of the device 2 .
- fewer actuators may be used if the function of the actuators can be combined.
- the first actuator 24 is depressed, the introducer 20 is retracted proximally to the position shown in FIG. 6 so that the open end of the tubular element 4 is exposed to receive tissue.
- the second actuator 26 is depressed, the tubular element 4 is driven forward so that tissue enters the open end 6 .
- the cutting element 10 is then automatically advanced to part off tissue, which has entered the open end 10 and the transport element 7 then transports the tissue to the tissue chamber 30 .
- the first and second actuators 24 , 26 may be knobs, buttons, levers or triggers and FIGS. 1 and 2 show the first and second actuators 24 , 26 being buttons.
- the device 2 is introduced into the patient for removal of tissue such as breast tissue in a breast biopsy procedure.
- the device 2 is introduced directly into the tissue with the sharp tip 22 of the introducer 20 penetrating tissue as shown in FIG. 5 .
- the device 2 may also be introduced into the patient through a sheath, trocar or cannula (not shown).
- the first actuator 24 is depressed to withdraw the introducer 20 and expose the open end 6 as shown in FIG. 6 .
- the user may, of course, manipulate the device 2 as necessary so that the device 2 is directed toward the tissue to be removed.
- the introducer 20 may be withdrawn to a position proximal to the tissue chamber 30 or another suitable position.
- the second actuator 26 is then depressed which causes the tubular element 4 to be driven forward so that tissue enters the open end 6 as shown in FIG. 7 .
- the transport element 7 may be advanced with the tubular element 4 or may be driven independently of the tubular element 4 without departing from the invention.
- the transport element 7 may be driven into the position of FIG. 7 after the tubular element 4 has been driven into the tissue and even after the cutting element 10 has been deployed to the position of FIG. 8 .
- the tubular element 4 may also be rotated while being driven forward, for example, the tubular element 4 may be rotated 0.5 to 60 revolutions when driven forward.
- the tubular element 4 may also simply be translated (without rotating) without departing from numerous aspects of the present invention.
- the introducer 20 may be advanced with the tubular element 4 as shown in FIG. 7 .
- the cutting element 10 is then advanced until it contacts the protrusion 11 and is directed into the tissue which has entered the tubular element 4 as shown in FIGS. 4 and 8 .
- the cutting element 10 extends toward and through a longitudinal axis defined by the tubular element 4 and forms an angle of about 70 degrees with the longitudinal axis although any other suitable angle may be used.
- the cutting element 10 , transport element 7 and/or tubular element 4 may also be rotated to aid in cutting the tissue.
- the cutting element 10 may be rotated with the tubular element 4 in the same direction or in opposite directions when parting off the tissue which has entered the device 2 .
- the transport element 7 and cutting element 10 then move proximally toward the tissue chamber 30 as shown in FIG. 9 .
- the introducer 20 is positioned so that continued proximal movement of the transport element 7 brings the tissue into contact with the distal end of the introducer 20 as shown in FIG. 10 .
- Continued proximal movement of the transport element 7 completely exposes the tissue and permits the tissue to fall into the tissue chamber 30 as shown in FIG. 11 .
- the tubular element 4 has an opening 32 leading to the tissue chamber 30 to permit the tissue to fall into the tissue chamber 30 when the tubular element 4 is in the position of FIG. 11 .
- the cutting element 10 is straightened by withdrawing the cutting element 10 into a recess (not shown).
- the cutting element 10 and transport element 7 are then moved back to the position of FIG. 6 .
- the tubular element 4 may remain within the patient during transport of the tissue to the tissue chamber 30 so that the device 2 is ready to take another tissue mass without removing the device 2 from the patient.
- the user may re-orient the device 2 as necessary so that the tubular element 4 is directed at tissue to be removed.
- the user then actuates the second actuator 26 again which causes the tubular element 4 to be driven forward to collect another tissue mass. If a tissue mass is desired at another location, the user may actuate the first actuator 24 to move the introducer 20 back to the position of FIG. 5 .
- the device 2 may then be manipulated to position the device 2 at the next location where tissue is to be removed.
- the introducer 20 may also be automatically repositioned after each collecting each tissue mass.
- the cutting element 10 A has a first part 40 and a second part 42 which may be integrally formed or may be independent elements.
- the first and second parts 40 , 42 move inwardly to cut the tissue which has entered the tubular element 4 as shown in FIG. 12 .
- the first and second parts 40 , 42 move inwardly when they engage a protrusion 44 on an inner wall 46 of the tubular element 4 A as shown in FIG. 12 .
- the protrusion 16 may be a ring 21 which directs the first and second parts 40 , 42 inwardly.
- the first and second parts 40 , 42 may each include a portion 50 which undergoes plastic deformation when moving to the position of FIG. 12 .
- the first and second parts 40 , 42 remain in the closed position until they are withdrawn into recesses (not shown) which straighten the two parts 40 , 42 .
- the first and second parts 40 , 42 may also lock together or may be naturally biased to the position of FIG. 12 rather than being plastically deformed without departing from numerous aspects of the present invention.
- the cutting element 10 A is used to transport the tissue to the tissue chamber 30 after parting off the tissue.
- the cutting element 10 A moves proximally as shown in FIGS. 17 and 18 to transport the tissue to the tissue chamber 30 .
- the tissue may contact the introducer 20 or another part of the device 2 A as the tissue is moved proximally to help release the tissue from the cutting element 10 A.
- the first actuator 24 is depressed to retract the introducer 20 as shown in FIG. 14 .
- the second actuator 26 is then depressed which causes the tubular element 4 A to be advanced into tissue as shown in FIG. 14 .
- the cutting element 10 A is then advanced to part off the tissue which entered the open end as shown in FIGS. 12 and 16 .
- the cutting element 10 A may be moved together with the tubular element 4 A when the tubular element 4 A is advanced or may be driven over the tissue after the tissue has entered the tubular element 4 A.
- the cutting element 10 A then moves proximally toward the tissue chamber 30 as shown in FIG. 17 and deposits the tissue in the tissue chamber 30 as shown in FIG. 18 .
- the first and second parts 40 , 42 are opened when they are withdrawn into the recesses (not shown).
- the tubular element 4 A and cutting element 10 are then moved back into position to take another tissue mass.
- the tissue removal device 2 does not need to be removed from the patient so that the user may simply reorient the device 2 or move the device 2 to another location where tissue is to be removed as described above.
- the method described in connection with FIGS. 12-18 may also be accomplished with the device of FIGS. 2-11 in that the cutting element 10 may be used to transport the tissue mass by itself. Such a method and use of the device 2 of FIGS. 1-11 is expressly incorporated here.
- tissue removal device 2 B has a tubular element 4 B which is driven into tissue.
- the device 2 B also has the cutting element 10 which parts off the tissue in the tubular element 4 B and the tissue chamber 30 which receives the tissue (see FIGS. 1 and 2 ).
- the cutting element 10 and/or tubular element 4 B may be rotated to aid in cutting the tissue.
- the cutting element 10 may be rotated with the tubular element 4 in the same direction or in opposite directions when parting off the tissue which has entered the device 2 B.
- the device 2 B also has the first and second actuators 24 , 26 which function in the same manner as the first and second actuators 24 , 26 described above (also shown in FIGS. 1 and 2 ).
- the device 2 B also includes a transport element 60 which moves within the tubular element 4 B and engages the tissue.
- the transport element 60 may be any suitable element which engages and contacts the tissue mass.
- the transport element 60 may be a wire 62 having a sharp tip 64 which pierces the tissue.
- the wire 62 may be curved or helical so that the wire 62 may be pivoted or rotated into engagement with the tissue.
- the transport element 60 may be advanced into the tissue before the tubular element 4 B or may be driven into the tissue at the same time as the tubular element 4 A or even after the tubular element 4 B has been driven into the tissue.
- the transport element 60 moves proximally to carry the tissue toward the tissue chamber 30 .
- the transport element 60 may also be rotated in the same direction that was used to engage the tissue when transporting the tissue mass proximally to help maintain engagement with the tissue.
- the tissue is transported proximally until the tissue contacts the introducer 20 in the manner described above (see FIG. 11 ).
- the transport element 60 is then withdrawn thereby permitting the tissue mass to fall into the chamber 30 .
- the transport element 60 may be rotated when being withdrawn from the tissue so that the wire 62 withdraws smoothly from the tissue.
- the transport element 60 , tubular element 4 A and cutting element 10 are then moved back into position to take another tissue mass without removing the device 2 B from the patient as described above.
- the device 2 C has a piercing element 82 which pierces the tissue.
- the piercing element 82 also has a deployable anchor 83 which secures the tissue to the piercing element 82 .
- the anchor 83 may take any suitable form.
- the anchor 83 may be one or more retractable barbs 84 which hold the tissue as shown in FIG. 21 .
- the barbs 84 may be slightly curved to help hold the tissue on the piercing element 80 but may take any other suitable shape.
- the anchor 82 may also be one or more wires 86 extending from the piercing element 82 as shown in FIG. 22 or may be an inflatable balloon 88 as shown in FIG. 23 .
- the device 2 C also has the first and second actuators 24 , 26 (see FIGS. 1 and 2 ) which operate in the manner described above.
- the device also has a third actuator 27 which advances the piercing element 82 when actuated. The piercing element 82 is then moved proximally after the third actuator 27 is actuated again as described below to transport the tissue to the tissue chamber 30 .
- the device 2 C may be operated in a number of different ways including the two now described.
- the piercing element 82 is driven into the tissue before the tubular element 4 when the user actuates the third actuator 27 .
- the tubular element 4 is then driven over the piercing element 82 when the user actuates the second actuator 26 .
- the piercing element 82 is then moved proximally to tear the tissue from the surrounding tissue. This step may be performed manually or by actuating the third actuator 27 again.
- the tissue is then transported proximally by actuating the third actuator 27 again if the user has parted-off the tissue manually.
- the piercing element 82 moves proximally until the tissue is over the tissue chamber 30 at which time the anchor 83 is automatically released by withdrawing the barbs 84 or wires 86 or deflating the balloon 88 . Further retraction of the piercing element 80 withdraws the piercing element 80 completely thereby permitting the tissue to fall into the tissue chamber 30 as described above in connection with the other devices 2 , 2 A, 2 B. After the tissue has been deposited into the tissue chamber 30 , the device 2 C is ready to take another sample without removal from the patient as described above.
- the tubular element 4 is driven into the tissue first and the piercing element 82 is then driven into the tissue after the tissue has entered the tubular element 4 .
- the anchor 83 is then deployed to secure the tissue to the piercing element 80 .
- the tissue is then separated from the surrounding tissue and transported to the tissue chamber 30 as described above.
- tissue removing device 100 is shown.
- the device 100 may also be used to remove tissue and to place a marker 102 in the patient.
- the device 100 is similar to other devices described herein, such as the device 2 A of FIGS. 16-18 , and the same or similar reference numbers refer to the same or similar structure.
- the device 100 may include the same features and may be used in substantially the same manner as the device of FIGS. 16-18 and all disclosure related to the structure and use of device 2 A is incorporated here.
- the marker 102 may be any suitable marker such as a polylactic-polyglycolic acid copolymer with a metallic clip or a collagen material with a metallic clip contained therein and may be used for any purpose such as marking a breast.
- the marker 102 is preferably a solid marker rather than a dye or liquid.
- the term “solid” as used herein may include soft materials such as gel-like materials or otherwise flexible materials so long as the material is not a liquid which may disperse and/or reduce in concentration over time.
- the marker 102 may be delivered at a time selected by the user as described herein.
- the marker 102 is mounted to an introducer 104 which has a sharp distal end 106 to pierce tissue when introducing the device 100 .
- the device 100 may also be introduced through a trocar, sheath, cannula or the like as described above.
- the marker 102 is stored within a recess 106 in the introducer 104 .
- the introducer 104 also has a port 108 through which the marker 100 leaves the introducer 104 .
- a pusher 110 moves the marker 102 out of the port 108 when the port 108 is exposed as shown in FIG. 25 .
- the pusher 110 is biased by a spring 112 to automatically move the marker 102 out of the port 108 when the port 108 is exposed.
- the marker 102 may also be moved out of the opening by using a pulse of fluid (either a gas such as carbon dioxide or a liquid such as saline) to exert pressure on the marker 102 to force the marker out of the opening.
- a pulse of fluid either a gas such as carbon dioxide or a liquid such as saline
- the device 100 may be used to remove a number of tissue masses from a patient in the same manner as described above.
- the device 100 may include the cutting element 10 A (see FIGS. 16-18 ) or any other suitable structure or method may be used to cut, part-off or otherwise separate the tissue in the device 100 from the surrounding tissue including any of those described herein.
- the device 100 is shown having the open distal end 6 but may have a side opening rather the opening 6 at the distal end without departing from various aspects of the invention.
- an actuator is actuated which causes the introducer 104 to be advanced to the position of FIG. 24 which is essentially the same position used when introducing the device 100 into the patient.
- the introducer 104 may then continue to move distally thereby exposing the port 108 .
- the tubular element 4 may be withdrawn to expose the port 108 or the port 108 may be exposed by a combination of advancing the introducer 104 and withdrawing the tubular element 4 .
- FIGS. 26-28 another device 120 is shown which may be used to remove tissue from a patient and also place the marker 102 in the patient.
- the device 120 is also similar to the device 2 A of FIGS. 16-18 and discussion of the device 2 A and methods of use are expressly incorporated here.
- FIGS. 26-28 show a proximal part of the device 120 to illustrate storage and delivery of the marker 102 .
- the marker 102 is contained in a storage area 122 in the device 120 .
- the device 120 stores three markers 102 although any suitable number may be stored.
- the marker storage area 122 also has a pusher element 124 which is biased by a spring 126 to move the marker out of the area 122 and into a lumen 128 .
- the device 120 also has an introducer 129 which is withdrawn to the position of FIG. 27 so that one of the markers 102 may move into the lumen 128 . The marker 102 is then moved through the lumen 128 and ultimately out of the distal opening by the introducer 129 as shown in FIG. 28 .
- the device 120 also includes an actuator (not shown) which is actuated by the user when the user desires to implant the marker 102 . Upon actuation, the introducer 129 is automatically withdrawn to the position of FIG. 27 to permit one of the markers 102 to enter the lumen 128 . The introducer 129 then automatically moves distally to push the maker 102 out through the open end 6 of the tubular element 4 .
- the device 120 may be used to remove a number of tissue masses from a patient as described above. Although the device 120 is shown with the cutting element 10 A, any other suitable structure or method may be used to cut, part-off or otherwise separate the tissue in the device 120 from the surrounding tissue such as those described herein.
- the suitable actuator 24 , 26 , 27 is actuated.
- the introducer 129 is then retracted proximal to the marker storage area 122 as shown in FIG. 27 .
- One of the markers 102 is then moved into the lumen 128 by the pusher 124 .
- the introducer 129 is then automatically advanced so that the marker 102 is pushed out through the open end 6 of the device 120 as shown in FIG. 30 .
- the device 130 has a side opening 132 through which tissue enters the device 130 .
- a cutting element 134 shears off material which extends into the device 130 through the opening 132 as shown in FIG. 28 .
- the device 130 may use suction to draw tissue into the opening 132 or may be forced laterally so that tissue enters the opening 132 .
- the device 130 also includes the marker 102 housed in a marker storage area 136 positioned distal to the side opening 132 .
- the marker storage area 136 has an opening 138 which is covered with a sliding door 140 . When the door 140 is opened as shown in FIG.
- a spring-loaded pusher 142 forces the marker 102 out of the opening 138 .
- the marker 102 is released at the desired time by the user upon actuation of an actuator (see actuators 24 , 26 , 27 of FIG. 1 ).
- the marker 102 may also be delivered through the opening 132 through which tissue is removed without departing from various aspects of the invention.
- FIGS. 31-34 still another device 200 for removing tissue and marking a tissue area is shown wherein the same or similar reference numbers refer to the same or similar structure.
- the device 200 is similar to the devices described above and the features and use of the devices described above are incorporated here.
- the device 200 has a tissue marking element 202 which delivers a flowable substance 204 to mark tissue in the patient.
- the flowable substance 204 may be any suitable substance which may visualized after the procedure using a suitable technique such as x-ray or ultrasound.
- the tissue marking element 202 has a chamber 206 which holds the flowable substance 204 .
- the tissue marking element may also include a needle 208 having an outlet 210 through which the substance 204 is delivered.
- a piston or plunger 212 forces the flowable substance 204 through the outlet 210 as shown in FIG. 34 .
- the device 200 may be used to remove tissue using any suitable method including all of those described herein, which are expressly incorporated here.
- the flowable substance 204 may be applied when the user desires upon actuation of the appropriate actuator (see actuators 24 , 26 , 27 of FIG. 1 ). For example, the user may first remove a number of tissue masses as described herein followed by delivery of the flowable substance 204 to mark tissue. Alternatively, the flowable substance 204 may be automatically delivered after a set or predetermined number of tissue masses have been removed.
- the tissue marking element 202 is stored in a marker storage area 214 adjacent to a lumen 216 in a tubular element 218 similar to other embodiments described herein as shown in FIG. 31 .
- the device may include a storage area for a number of tissue marking elements 202 and FIG. 31 shows three tissue marking elements 202 in the storage area 214 .
- An introducer 220 is retracted to the position of FIG. 32 which permits the tissue marking element 202 to enter the lumen 216 .
- a spring 222 may be used to force the tissue marking element 202 into the lumen 216 .
- the tissue marking element 202 is then advanced through the lumen 216 by the introducer 220 until the needle 208 pierces the tissue as shown in FIG. 33 .
- the tissue marking element 202 and lumen 216 are configured so that the tissue marking element 202 cannot pass completely through an opening 224 at the distal end of the lumen 216 .
- the device 300 includes an introducer 302 which has container 303 which holds the flowable substance 307 .
- the container 303 may simply be a lumen 304 having one or more outlets 306 formed at the distal end of the introducer 302 through which the flowable substance 307 is delivered.
- a piston 308 is movable within the lumen 304 to force the flowable substance 307 through the outlets 306 .
- the outlets 306 may be formed by elastomeric portions 310 in a manner similar to a one-way valve, such as a duckbill valve, so that the outlets 306 are normally closed to prevent the flowable material 307 from escaping.
- the outlets 306 will also inhibit material from entering the lumen 304 .
- the lumen 304 may have one outlet 306 or a plurality of outlets 306 configured in a recognizable pattern, which may be useful to orient or otherwise help identify the position and/or orientation of the tissue area of interest when viewed at a later time.
- the outlets 306 may be configured in a triangle or any other suitable shape.
- the device 400 is similar to the devices described above and all common features and methods described above are incorporated here.
- the device includes an introducer 402 having a lumen 404 in which a tissue marking element 406 is positioned.
- the tissue marking element 406 has a plunger 408 which is depressed by a pusher element 411 to force the flowable substance through an outlet 412 in the tissue marking element 406 .
- a spring 414 holds the tissue marking element 406 in the stored position of FIG. 37 .
- the tissue marking element 406 may also include a needle 416 having the 412 which deposits the flowable substance into tissue when the needle 416 pierces tissue.
- FIGS. 39 and 40 still another device 450 for removing tissue and marking a tissue area is shown.
- the device 450 is similar to other devices described herein and all such uses and features of those devices are incorporated here.
- the device 450 may be used to remove and collect tissue in any manner described herein prior to marking of the tissue area.
- the device 450 has a chamber or container 452 which holds the flowable substance 307 .
- the container 452 which may simply be a length of tubing, is coupled to a lumen 454 through which the flowable substance 307 may be delivered.
- the container 452 and lumen 454 are coupled to a tubular element 456 but may also be integrated into the tubular element 456 .
- the lumen 454 has an outlet 460 through which the flowable substance 307 is delivered.
- the container 452 may be coupled to a series of lumens 454 each having one or more outlets 460 .
- the device may have three outlets positioned 120 degrees apart to form a recognizable pattern.
- the pattern may be used to orient and/or identify the tissue area which has been marked when viewed using ultrasound, x-ray or another suitable visualization technique at a later time.
- the outlets 460 are positioned on an outer surface of the tubular element 456 near a distal end of the tubular element 456 .
- the device 450 may include any number of outlets 460 including only one outlet 460 .
- the outlets 460 may also be normally closed similar to a one-way valve as described in connection with the outlets 306 of FIGS. 35 and 36 .
- a plunger 453 is used to force the flowable substance 307 through the outlets 460 .
- tissue removing devices described in FIGS. 31-40 may be used to collect a number of tissue masses in any suitable manner described herein and all such uses are incorporated here in combination with the structure and features associated with marking tissue.
- the piercing element may be adhered to the tissue in any other suitable manner other than using the deployable anchor.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Surgical Instruments (AREA)
Abstract
The device is used to remove tissue from a patient and to also place a marker in the patient. The device has an opening through which tissue enters the device. The tissue, which enters the opening is cut and the tissue is removed. The device may be used a number of times to remove a number of tissue masses. The device also includes a marker, which the user may release in the patient at the desired time.
Description
- This application claims priority to U.S. application Ser. No. 11/099,985, filed on Apr. 5, 1005. The complete disclosure of which is hereby incorporated for all purposes.
- The present invention is directed to tissue removing devices and methods. The invention may be used to remove tissue from any part of the body and is particularly useful in removing tissue from the breast. Of course, the invention may be used in any other part of the body and use in the breast is merely exemplary.
- In a first aspect of the present invention, a tissue removal device is provided which has a tubular element, a transport element and a cutting element. The tubular element has an open distal end. The transport element and the cutting element are positioned at least partially within the tubular element and are movable within the tubular element. The device is introduced into a patient and the tubular element is advanced so that tissue enters the tubular element through the open end. The cutting element is then used to cut or part-off the tissue which has entered the tubular element and the transport element is used to transport the tissue proximally to a tissue chamber.
- The transport element may take many forms. In one embodiment, the transport element has an open end positioned proximal to the open end of the tubular element so that tissue enters the open end of the transport element when the tubular element is advanced into tissue. The transport element may also pierce the tissue being removed from the patient. Furthermore, the transport element may have a deployable anchor, which secures the tissue to the transport element. The anchor may take any suitable shape such as deployable barbs, wires or an inflatable balloon.
- In another aspect of the present invention, the device may include a cutting element, which parts off the tissue, which enters the tubular element and also transports the tissue to the tissue chamber. The cutting element may have a first part and a second part, which move toward one another to a cutting position when cutting the tissue within the tubular element. The cutting element may be plastically or elastically deformed when moving to a cutting position.
- In another aspect of the present invention, devices and methods for removing tissue and placing a marker within the patient are described. The device includes an opening through which tissue is introduced into the device. The tissue is then cut to separate a tissue mass from the surrounding tissue. The device also includes a solid marker housed within the device. The marker may be implanted into the patient at any time desired by the user. The marker may be delivered through the same opening through which tissue is removed or the device may include a separate opening for delivering the marker. The marker may be mounted to the introducer, stored in a storage area in the handle, or may even be stored at a location distal to the opening through which tissue is removed.
- In still another aspect of the present invention, a method of removing tissue and marking a tissue area is provided in which the tissue marking element delivers a flowable material. The tissue marking element may have a plurality of outlets to form a recognizable pattern to help locate and orient the tissue area of interest at a later time when the flowable marking material is visualized. The tissue marking element may be advanced through the lumen of the tubular element until an outlet of the tissue marking element is positioned distal to the opening in the tubular element. The tissue marking element may also be part of the introducer with the introducer having one or more outlets through which the flowable substance is delivered.
- These and other aspects of the present invention shall become apparent from the following description, drawings and claims.
-
FIG. 1 shows a tissue removing device in accordance with the present invention. -
FIG. 2 shows another view of the device ofFIG. 1 . -
FIG. 3 is a cross-sectional view of a distal end of the tissue removal device with a cutting element in a stored position. -
FIG. 4 is a cross-sectional view showing the cutting element in a cutting position. -
FIG. 5 shows the device being introduced into tissue. -
FIG. 6 shows an introducer withdrawn from the distal end. -
FIG. 7 shows a tubular element advanced into tissue. -
FIG. 8 shows a cutting element cutting tissue, which has entered the tubular element. -
FIG. 9 shows the tissue being transported proximally. -
FIG. 10 shows the tissue positioned over a tissue chamber and contacting a distal end of the introducer. -
FIG. 11 shows the tissue falling into the tissue chamber. -
FIG. 12 is a cross-sectional view of another tissue removal device. -
FIG. 13 shows the device ofFIG. 12 introduced into tissue. -
FIG. 14 shows the introducer retracted. -
FIG. 15 shows the cutting element being advanced distally. -
FIG. 16 shows the cutting element in a cutting position. -
FIG. 17 shows the cutting element moving the tissue proximally toward the tissue chamber. -
FIG. 18 shows the tissue being released into the tissue chamber by the cutting element. -
FIG. 19 shows another device for removing tissue from a patient. -
FIG. 20 shows the cutting element cutting the tissue which has entered the tubular element. -
FIG. 21 shows still another device for removing tissue from a patient. -
FIG. 22 shows another anchor for the device ofFIG. 21 . -
FIG. 23 shows still another anchor for the device ofFIG. 21 . -
FIG. 24 is a cross-sectional view of another device for removing tissue from a patient and placing a marker in the patient. -
FIG. 25 shows the introducer moved to a position, which releases the marker. -
FIG. 26 shows still another device for removing tissue from a patient and placing a marker in the patient with the introducer withdrawn to permit tissue to be collected -
FIG. 27 shows the introducer withdrawn proximal to a marker storage area. -
FIG. 28 shows the introducer advancing the marker toward the open end. -
FIG. 29 shows yet another device for removing tissue from a patient and placing a marker in the patient with a cutting element cut tissue, which has entered the device through a side opening. -
FIG. 30 shows the marker being released from a marker storage area. -
FIG. 31 shows another device for removing tissue and marking a tissue area. -
FIG. 32 shows a tissue marking element entering the lumen. -
FIG. 33 shows the tissue marking element advanced to the distal end of the lumen with the introducer. -
FIG. 34 shows the introducer advanced to move a piston within the tissue marking element to force the flowable substance into the tissue area. -
FIG. 35 shows yet another device for removing tissue and marking a tissue area with an introducer having an outlet through which a flowable marker is delivered. -
FIG. 36 shows the device ofFIG. 35 with the flowable material delivered. -
FIG. 37 shows still another device for removing tissue and marking a tissue area. -
FIG. 38 shows a tissue marking element moved to a working position within an introducer. -
FIG. 39 shows yet another device for removing tissue and marking a tissue area. -
FIG. 40 shows an external view of the device ofFIG. 39 . - Referring to
FIGS. 1-11 , atissue removing device 2 according to the present invention is shown. The devices and methods described herein may be used to remove tissue from any location in the body and an example of such a use is removal of tissue from the breast as described below. Thetissue removal device 2 has atubular element 4 which is advanced into tissue so that tissue is received through anopen end 6 of thetubular element 4. Atransport element 7 is positioned within thetubular element 4 and is used to transport tissue back to atissue sample chamber 30 as described below. - The distal end of the
tubular element 4 is beveled to form asharp tip 11 but may take any other suitable configuration which penetrates tissue. Thetubular element 4 may also be rotated when driven into the tissue. Thetubular element 4 may be made of any suitable material such as stainless steel. Thedevice 2 may also include anintroducer 20 positioned in thetubular element 4 during introduction. Theintroducer 20 may have asharp tip 22 which penetrates the tissue during introduction of thedevice 2 as shown inFIG. 5 . Thedevice 2 may also be introduced through a sheath, trocar or cannula (not shown) which penetrates the tissue rather than using thedevice 2 itself to penetrate the tissue. - Although the present invention may be used to collect tissue of any size, the invention is particularly useful in removing relatively small quantities of tissue such as required in breast biopsies. When used for this purpose, the inner diameter of the
device 2 may be less than 5 mm or even less than 3.5 mm. The present invention provides the ability to obtain small, cylindrical tissue samples which are relatively undisturbed compared to many prior art solutions. Thetubular element 4 may be driven forward a distance of 15-25 mm which may be selected by the user. - The
tissue removal device 2 also has a cuttingelement 10 which is used to cut or “part off” tissue which has entered thetubular element 4 from the surrounding tissue. The cuttingelement 10 is stored between thetubular element 4 and thetransport element 7 and naturally assumes the position ofFIG. 4 when advanced. The cuttingelement 10 also contacts aprotrusion 11 on aninner surface 13 of thetubular element 4 which directs the cuttingelement 10 into the cutting position ofFIG. 4 . Theprotrusion 11 may simply be aring 15 of material attached to the inner surface of thetubular element 4 although any other structure may be used. Thetransport element 4 and cuttingelement 10 are then moved proximally to the tissue chamber with the cuttingelement 10 remaining in the cutting position ofFIG. 4 as explained below. - The
tissue removal device 2 has afirst actuator 24 and asecond actuator 26 which are described further below in connection with use of thedevice 2. Of course, fewer actuators may be used if the function of the actuators can be combined. When thefirst actuator 24 is depressed, theintroducer 20 is retracted proximally to the position shown inFIG. 6 so that the open end of thetubular element 4 is exposed to receive tissue. When thesecond actuator 26 is depressed, thetubular element 4 is driven forward so that tissue enters theopen end 6. The cuttingelement 10 is then automatically advanced to part off tissue, which has entered theopen end 10 and thetransport element 7 then transports the tissue to thetissue chamber 30. The first andsecond actuators FIGS. 1 and 2 show the first andsecond actuators - Use of the
tissue removal device 2 is now described in connection withFIGS. 5-11 . Thedevice 2 is introduced into the patient for removal of tissue such as breast tissue in a breast biopsy procedure. Thedevice 2 is introduced directly into the tissue with thesharp tip 22 of theintroducer 20 penetrating tissue as shown inFIG. 5 . Thedevice 2 may also be introduced into the patient through a sheath, trocar or cannula (not shown). Once the distal end is positioned proximal to the tissue to be removed, thefirst actuator 24 is depressed to withdraw theintroducer 20 and expose theopen end 6 as shown inFIG. 6 . After retracting theintroducer 20 the user may, of course, manipulate thedevice 2 as necessary so that thedevice 2 is directed toward the tissue to be removed. Theintroducer 20 may be withdrawn to a position proximal to thetissue chamber 30 or another suitable position. - The
second actuator 26 is then depressed which causes thetubular element 4 to be driven forward so that tissue enters theopen end 6 as shown inFIG. 7 . Thetransport element 7 may be advanced with thetubular element 4 or may be driven independently of thetubular element 4 without departing from the invention. For example, thetransport element 7 may be driven into the position ofFIG. 7 after thetubular element 4 has been driven into the tissue and even after the cuttingelement 10 has been deployed to the position ofFIG. 8 . Thetubular element 4 may also be rotated while being driven forward, for example, thetubular element 4 may be rotated 0.5 to 60 revolutions when driven forward. Thetubular element 4 may also simply be translated (without rotating) without departing from numerous aspects of the present invention. Theintroducer 20 may be advanced with thetubular element 4 as shown inFIG. 7 . - The cutting
element 10 is then advanced until it contacts theprotrusion 11 and is directed into the tissue which has entered thetubular element 4 as shown inFIGS. 4 and 8 . The cuttingelement 10 extends toward and through a longitudinal axis defined by thetubular element 4 and forms an angle of about 70 degrees with the longitudinal axis although any other suitable angle may be used. The cuttingelement 10,transport element 7 and/ortubular element 4 may also be rotated to aid in cutting the tissue. The cuttingelement 10 may be rotated with thetubular element 4 in the same direction or in opposite directions when parting off the tissue which has entered thedevice 2. - The
transport element 7 and cuttingelement 10 then move proximally toward thetissue chamber 30 as shown inFIG. 9 . Theintroducer 20 is positioned so that continued proximal movement of thetransport element 7 brings the tissue into contact with the distal end of theintroducer 20 as shown inFIG. 10 . Continued proximal movement of thetransport element 7 completely exposes the tissue and permits the tissue to fall into thetissue chamber 30 as shown inFIG. 11 . Thetubular element 4 has anopening 32 leading to thetissue chamber 30 to permit the tissue to fall into thetissue chamber 30 when thetubular element 4 is in the position ofFIG. 11 . - The cutting
element 10 is straightened by withdrawing the cuttingelement 10 into a recess (not shown). The cuttingelement 10 andtransport element 7 are then moved back to the position ofFIG. 6 . Thetubular element 4 may remain within the patient during transport of the tissue to thetissue chamber 30 so that thedevice 2 is ready to take another tissue mass without removing thedevice 2 from the patient. The user may re-orient thedevice 2 as necessary so that thetubular element 4 is directed at tissue to be removed. The user then actuates thesecond actuator 26 again which causes thetubular element 4 to be driven forward to collect another tissue mass. If a tissue mass is desired at another location, the user may actuate thefirst actuator 24 to move theintroducer 20 back to the position ofFIG. 5 . Thedevice 2 may then be manipulated to position thedevice 2 at the next location where tissue is to be removed. Of course, theintroducer 20 may also be automatically repositioned after each collecting each tissue mass. - Referring to
FIGS. 12-18 , anotherdevice 2A for removing tissue is shown wherein the same or similar reference numbers refer to the same or similar structure. The cuttingelement 10A has afirst part 40 and asecond part 42 which may be integrally formed or may be independent elements. The first andsecond parts tubular element 4 as shown inFIG. 12 . The first andsecond parts protrusion 44 on aninner wall 46 of the tubular element 4A as shown inFIG. 12 . The protrusion 16 may be a ring 21 which directs the first andsecond parts - The first and
second parts portion 50 which undergoes plastic deformation when moving to the position ofFIG. 12 . The first andsecond parts parts second parts FIG. 12 rather than being plastically deformed without departing from numerous aspects of the present invention. - The cutting
element 10A is used to transport the tissue to thetissue chamber 30 after parting off the tissue. The cuttingelement 10A moves proximally as shown inFIGS. 17 and 18 to transport the tissue to thetissue chamber 30. The tissue may contact theintroducer 20 or another part of thedevice 2A as the tissue is moved proximally to help release the tissue from the cuttingelement 10A. - Use of the
device 2A is similar to use of thedevice 2 described above. Thefirst actuator 24 is depressed to retract theintroducer 20 as shown inFIG. 14 . Thesecond actuator 26 is then depressed which causes the tubular element 4A to be advanced into tissue as shown inFIG. 14 . The cuttingelement 10A is then advanced to part off the tissue which entered the open end as shown inFIGS. 12 and 16 . The cuttingelement 10A may be moved together with the tubular element 4A when the tubular element 4A is advanced or may be driven over the tissue after the tissue has entered the tubular element 4A. The cuttingelement 10A then moves proximally toward thetissue chamber 30 as shown inFIG. 17 and deposits the tissue in thetissue chamber 30 as shown inFIG. 18 . The first andsecond parts - The tubular element 4A and cutting
element 10 are then moved back into position to take another tissue mass. As such, thetissue removal device 2 does not need to be removed from the patient so that the user may simply reorient thedevice 2 or move thedevice 2 to another location where tissue is to be removed as described above. The method described in connection withFIGS. 12-18 may also be accomplished with the device ofFIGS. 2-11 in that the cuttingelement 10 may be used to transport the tissue mass by itself. Such a method and use of thedevice 2 ofFIGS. 1-11 is expressly incorporated here. - Referring to
FIGS. 19 and 20 , anothertissue removal device 2B is shown wherein the same or similar reference numbers refer to the same or similar structure. Thetissue removal device 2B has a tubular element 4B which is driven into tissue. Thedevice 2B also has the cuttingelement 10 which parts off the tissue in the tubular element 4B and thetissue chamber 30 which receives the tissue (seeFIGS. 1 and 2 ). The cuttingelement 10 and/or tubular element 4B may be rotated to aid in cutting the tissue. The cuttingelement 10 may be rotated with thetubular element 4 in the same direction or in opposite directions when parting off the tissue which has entered thedevice 2B. Thedevice 2B also has the first andsecond actuators second actuators FIGS. 1 and 2 ). - The
device 2B also includes atransport element 60 which moves within the tubular element 4B and engages the tissue. Thetransport element 60 may be any suitable element which engages and contacts the tissue mass. For example, thetransport element 60 may be awire 62 having asharp tip 64 which pierces the tissue. Thewire 62 may be curved or helical so that thewire 62 may be pivoted or rotated into engagement with the tissue. Thetransport element 60 may be advanced into the tissue before the tubular element 4B or may be driven into the tissue at the same time as the tubular element 4A or even after the tubular element 4B has been driven into the tissue. - Once the
transport element 60 and the tubular element 4A are in the position ofFIG. 20 , thetransport element 60 moves proximally to carry the tissue toward thetissue chamber 30. Thetransport element 60 may also be rotated in the same direction that was used to engage the tissue when transporting the tissue mass proximally to help maintain engagement with the tissue. The tissue is transported proximally until the tissue contacts theintroducer 20 in the manner described above (seeFIG. 11 ). Thetransport element 60 is then withdrawn thereby permitting the tissue mass to fall into thechamber 30. Thetransport element 60 may be rotated when being withdrawn from the tissue so that thewire 62 withdraws smoothly from the tissue. Thetransport element 60, tubular element 4A and cuttingelement 10 are then moved back into position to take another tissue mass without removing thedevice 2B from the patient as described above. - Referring to
FIG. 21 , another tissue removal device 2C is shown wherein the same or similar reference numbers refer to the same or similar structure. The device 2C has a piercingelement 82 which pierces the tissue. The piercingelement 82 also has adeployable anchor 83 which secures the tissue to the piercingelement 82. Theanchor 83 may take any suitable form. For example, theanchor 83 may be one or more retractable barbs 84 which hold the tissue as shown inFIG. 21 . The barbs 84 may be slightly curved to help hold the tissue on the piercing element 80 but may take any other suitable shape. Theanchor 82 may also be one ormore wires 86 extending from the piercingelement 82 as shown inFIG. 22 or may be aninflatable balloon 88 as shown inFIG. 23 . - The device 2C also has the first and
second actuators 24, 26 (seeFIGS. 1 and 2 ) which operate in the manner described above. The device also has athird actuator 27 which advances the piercingelement 82 when actuated. The piercingelement 82 is then moved proximally after thethird actuator 27 is actuated again as described below to transport the tissue to thetissue chamber 30. - The device 2C may be operated in a number of different ways including the two now described. In one method, the piercing
element 82 is driven into the tissue before thetubular element 4 when the user actuates thethird actuator 27. Thetubular element 4 is then driven over the piercingelement 82 when the user actuates thesecond actuator 26. The piercingelement 82 is then moved proximally to tear the tissue from the surrounding tissue. This step may be performed manually or by actuating thethird actuator 27 again. The tissue is then transported proximally by actuating thethird actuator 27 again if the user has parted-off the tissue manually. - The piercing
element 82 moves proximally until the tissue is over thetissue chamber 30 at which time theanchor 83 is automatically released by withdrawing the barbs 84 orwires 86 or deflating theballoon 88. Further retraction of the piercing element 80 withdraws the piercing element 80 completely thereby permitting the tissue to fall into thetissue chamber 30 as described above in connection with theother devices tissue chamber 30, the device 2C is ready to take another sample without removal from the patient as described above. - In another method of operating the device 2C, the
tubular element 4 is driven into the tissue first and the piercingelement 82 is then driven into the tissue after the tissue has entered thetubular element 4. Theanchor 83 is then deployed to secure the tissue to the piercing element 80. The tissue is then separated from the surrounding tissue and transported to thetissue chamber 30 as described above. - Referring to
FIGS. 24 and 25 , anothertissue removing device 100 is shown. Thedevice 100 may also be used to remove tissue and to place amarker 102 in the patient. Thedevice 100 is similar to other devices described herein, such as thedevice 2A ofFIGS. 16-18 , and the same or similar reference numbers refer to the same or similar structure. Thedevice 100 may include the same features and may be used in substantially the same manner as the device ofFIGS. 16-18 and all disclosure related to the structure and use ofdevice 2A is incorporated here. Themarker 102 may be any suitable marker such as a polylactic-polyglycolic acid copolymer with a metallic clip or a collagen material with a metallic clip contained therein and may be used for any purpose such as marking a breast. Themarker 102 is preferably a solid marker rather than a dye or liquid. The term “solid” as used herein may include soft materials such as gel-like materials or otherwise flexible materials so long as the material is not a liquid which may disperse and/or reduce in concentration over time. - The
marker 102 may be delivered at a time selected by the user as described herein. Themarker 102 is mounted to anintroducer 104 which has a sharpdistal end 106 to pierce tissue when introducing thedevice 100. Of course, thedevice 100 may also be introduced through a trocar, sheath, cannula or the like as described above. Themarker 102 is stored within arecess 106 in theintroducer 104. Theintroducer 104 also has aport 108 through which themarker 100 leaves theintroducer 104. Apusher 110 moves themarker 102 out of theport 108 when theport 108 is exposed as shown inFIG. 25 . Thepusher 110 is biased by aspring 112 to automatically move themarker 102 out of theport 108 when theport 108 is exposed. Themarker 102 may also be moved out of the opening by using a pulse of fluid (either a gas such as carbon dioxide or a liquid such as saline) to exert pressure on themarker 102 to force the marker out of the opening. - Use of the
device 100 is now described. Thedevice 100 may be used to remove a number of tissue masses from a patient in the same manner as described above. Thedevice 100 may include the cuttingelement 10A (seeFIGS. 16-18 ) or any other suitable structure or method may be used to cut, part-off or otherwise separate the tissue in thedevice 100 from the surrounding tissue including any of those described herein. Furthermore, thedevice 100 is shown having the opendistal end 6 but may have a side opening rather theopening 6 at the distal end without departing from various aspects of the invention. When the user desires to place themarker 102 in the patient, an actuator is actuated which causes theintroducer 104 to be advanced to the position ofFIG. 24 which is essentially the same position used when introducing thedevice 100 into the patient. Theintroducer 104 may then continue to move distally thereby exposing theport 108. Alternatively, thetubular element 4 may be withdrawn to expose theport 108 or theport 108 may be exposed by a combination of advancing theintroducer 104 and withdrawing thetubular element 4. - Referring to
FIGS. 26-28 , anotherdevice 120 is shown which may be used to remove tissue from a patient and also place themarker 102 in the patient. Thedevice 120 is also similar to thedevice 2A ofFIGS. 16-18 and discussion of thedevice 2A and methods of use are expressly incorporated here.FIGS. 26-28 show a proximal part of thedevice 120 to illustrate storage and delivery of themarker 102. Themarker 102 is contained in astorage area 122 in thedevice 120. Thedevice 120 stores threemarkers 102 although any suitable number may be stored. Themarker storage area 122 also has apusher element 124 which is biased by aspring 126 to move the marker out of thearea 122 and into alumen 128. Thedevice 120 also has anintroducer 129 which is withdrawn to the position ofFIG. 27 so that one of themarkers 102 may move into thelumen 128. Themarker 102 is then moved through thelumen 128 and ultimately out of the distal opening by theintroducer 129 as shown inFIG. 28 . Thedevice 120 also includes an actuator (not shown) which is actuated by the user when the user desires to implant themarker 102. Upon actuation, theintroducer 129 is automatically withdrawn to the position ofFIG. 27 to permit one of themarkers 102 to enter thelumen 128. Theintroducer 129 then automatically moves distally to push themaker 102 out through theopen end 6 of thetubular element 4. - Use of the
device 120 is now described. Thedevice 120 may be used to remove a number of tissue masses from a patient as described above. Although thedevice 120 is shown with the cuttingelement 10A, any other suitable structure or method may be used to cut, part-off or otherwise separate the tissue in thedevice 120 from the surrounding tissue such as those described herein. When the user desires to place themarker 102 in the patient, thesuitable actuator introducer 129 is then retracted proximal to themarker storage area 122 as shown inFIG. 27 . One of themarkers 102 is then moved into thelumen 128 by thepusher 124. Theintroducer 129 is then automatically advanced so that themarker 102 is pushed out through theopen end 6 of thedevice 120 as shown inFIG. 30 . - Referring now to
FIGS. 29 and 30 , yet anotherdevice 130 for removing tissue and placing themarker 102 within a patient is shown. Thedevice 130 has aside opening 132 through which tissue enters thedevice 130. A cuttingelement 134 shears off material which extends into thedevice 130 through theopening 132 as shown inFIG. 28 . Thedevice 130 may use suction to draw tissue into theopening 132 or may be forced laterally so that tissue enters theopening 132. Thedevice 130 also includes themarker 102 housed in amarker storage area 136 positioned distal to theside opening 132. Themarker storage area 136 has anopening 138 which is covered with a sliding door 140. When the door 140 is opened as shown inFIG. 29 , a spring-loaded pusher 142 forces themarker 102 out of theopening 138. Themarker 102 is released at the desired time by the user upon actuation of an actuator (seeactuators FIG. 1 ). Themarker 102 may also be delivered through theopening 132 through which tissue is removed without departing from various aspects of the invention. - Referring to
FIGS. 31-34 , still anotherdevice 200 for removing tissue and marking a tissue area is shown wherein the same or similar reference numbers refer to the same or similar structure. Thedevice 200 is similar to the devices described above and the features and use of the devices described above are incorporated here. Thedevice 200 has atissue marking element 202 which delivers aflowable substance 204 to mark tissue in the patient. Theflowable substance 204 may be any suitable substance which may visualized after the procedure using a suitable technique such as x-ray or ultrasound. - The
tissue marking element 202 has achamber 206 which holds theflowable substance 204. The tissue marking element may also include aneedle 208 having anoutlet 210 through which thesubstance 204 is delivered. A piston orplunger 212 forces theflowable substance 204 through theoutlet 210 as shown inFIG. 34 . - The
device 200 may be used to remove tissue using any suitable method including all of those described herein, which are expressly incorporated here. Theflowable substance 204 may be applied when the user desires upon actuation of the appropriate actuator (seeactuators FIG. 1 ). For example, the user may first remove a number of tissue masses as described herein followed by delivery of theflowable substance 204 to mark tissue. Alternatively, theflowable substance 204 may be automatically delivered after a set or predetermined number of tissue masses have been removed. - The
tissue marking element 202 is stored in amarker storage area 214 adjacent to alumen 216 in atubular element 218 similar to other embodiments described herein as shown inFIG. 31 . The device may include a storage area for a number oftissue marking elements 202 andFIG. 31 shows threetissue marking elements 202 in thestorage area 214. An introducer 220 is retracted to the position ofFIG. 32 which permits thetissue marking element 202 to enter thelumen 216. Aspring 222 may be used to force thetissue marking element 202 into thelumen 216. Thetissue marking element 202 is then advanced through thelumen 216 by the introducer 220 until theneedle 208 pierces the tissue as shown inFIG. 33 . Thetissue marking element 202 andlumen 216 are configured so that thetissue marking element 202 cannot pass completely through anopening 224 at the distal end of thelumen 216. Once thetissue marking element 202 is positioned at theopening 224 as shown inFIG. 32 further distal movement of the introducer pushes theplunger 212 so that the flowable substance is delivered through the outlet and into the tissue as shown inFIG. 34 . - Referring to
FIGS. 35 and 36 , still anotherdevice 300 for removing tissue and marking a tissue site is shown wherein the same or similar reference numbers refer to the same or similar structure. Thedevice 300 is similar to the devices described above and all features and methods of use described herein are incorporated here. Thedevice 300 includes anintroducer 302 which hascontainer 303 which holds theflowable substance 307. Thecontainer 303 may simply be alumen 304 having one ormore outlets 306 formed at the distal end of theintroducer 302 through which theflowable substance 307 is delivered. Apiston 308 is movable within thelumen 304 to force theflowable substance 307 through theoutlets 306. Theoutlets 306 may be formed by elastomeric portions 310 in a manner similar to a one-way valve, such as a duckbill valve, so that theoutlets 306 are normally closed to prevent theflowable material 307 from escaping. Theoutlets 306 will also inhibit material from entering thelumen 304. Thelumen 304 may have oneoutlet 306 or a plurality ofoutlets 306 configured in a recognizable pattern, which may be useful to orient or otherwise help identify the position and/or orientation of the tissue area of interest when viewed at a later time. For example, theoutlets 306 may be configured in a triangle or any other suitable shape. - Referring to
FIGS. 37 and 38 , yet anotherdevice 400 for removing a tissue mass and marking a tissue area is shown. Thedevice 400 is similar to the devices described above and all common features and methods described above are incorporated here. The device includes anintroducer 402 having alumen 404 in which atissue marking element 406 is positioned. Thetissue marking element 406 has aplunger 408 which is depressed by apusher element 411 to force the flowable substance through anoutlet 412 in thetissue marking element 406. Aspring 414 holds thetissue marking element 406 in the stored position ofFIG. 37 . Thetissue marking element 406 may also include aneedle 416 having the 412 which deposits the flowable substance into tissue when theneedle 416 pierces tissue. - Referring now to
FIGS. 39 and 40 , still anotherdevice 450 for removing tissue and marking a tissue area is shown. Thedevice 450 is similar to other devices described herein and all such uses and features of those devices are incorporated here. For example, thedevice 450 may be used to remove and collect tissue in any manner described herein prior to marking of the tissue area. - The
device 450 has a chamber orcontainer 452 which holds theflowable substance 307. Thecontainer 452, which may simply be a length of tubing, is coupled to alumen 454 through which theflowable substance 307 may be delivered. Thecontainer 452 andlumen 454 are coupled to atubular element 456 but may also be integrated into thetubular element 456. Thelumen 454 has anoutlet 460 through which theflowable substance 307 is delivered. Thecontainer 452 may be coupled to a series oflumens 454 each having one ormore outlets 460. For example, the device may have three outlets positioned 120 degrees apart to form a recognizable pattern. The pattern may be used to orient and/or identify the tissue area which has been marked when viewed using ultrasound, x-ray or another suitable visualization technique at a later time. Theoutlets 460 are positioned on an outer surface of thetubular element 456 near a distal end of thetubular element 456. Of course, thedevice 450 may include any number ofoutlets 460 including only oneoutlet 460. Theoutlets 460 may also be normally closed similar to a one-way valve as described in connection with theoutlets 306 ofFIGS. 35 and 36 . Aplunger 453 is used to force theflowable substance 307 through theoutlets 460. - The tissue removing devices described in
FIGS. 31-40 may be used to collect a number of tissue masses in any suitable manner described herein and all such uses are incorporated here in combination with the structure and features associated with marking tissue. - The present invention has been described in connection with various preferred embodiments, however, it is understood that various modifications and alternative configurations are possible without departing from the scope of the invention. For example, the piercing element may be adhered to the tissue in any other suitable manner other than using the deployable anchor.
Claims (26)
1-45. (canceled)
46. A device for removing tissue from a patient and marking tissue which remains within the body, comprising:
a body;
a tubular element extending from the body, the tubular element having an opening, wherein tissue is received within the opening; and
a tissue marking element coupled to the tubular element, the tissue marking element including a container having an outlet, the container containing a flowable substance, the tissue marking element, the tissue marking element being movable within the tubular element from a stored position to a working position, the tissue marking element being closer to the opening when in the working position than in the stored position.
47. The device of claim 46 , wherein:
the tissue marking element is configured to deposit the flowable substance into the tissue to mark the tissue.
48. The device of claim 46 , wherein:
the tissue marking element moves distally within the lumen when moving from the stored position to the working position, the outlet of the tissue marking element being positioned distal to the opening in the tubular element when in the working position and proximal to the opening when in the stored position.
49. The device of claim 46 , further comprising:
an introducer movable from a first position to a second position, the introducer covering the opening when in the first position and being spaced apart from the opening when in the second position.
50. The device of claim 49 , wherein:
the tissue marking element is moved to the working position by the introducer.
51. The device of claim 49 , wherein:
the tissue marking element is formed by the introducer, the introducer having at least one channel in fluid communication with the outlet, the flowable substance being delivered through the channel and the outlet.
52. The device of claim 46 , wherein:
the tissue marking element has a plurality of outlets through which the flowable substance is delivered.
53. The device of claim 46 , wherein:
the tissue marking element having a needle, the outlet being formed in the needle, the outlet being moved to a position distal to the opening in the tubular element when the tissue marking element is in the working position.
54. The device of claim 46 , further comprising:
a marker storage area positioned outside the lumen, the tissue marking element being positioned in the marker storage area when in the stored position, the tissue marking element being moved inside the lumen and advanced distally through the lumen when moving to the working position.
55. The device of claim 46 , wherein:
the body includes a tissue storage area in which tissue removed from the patient through the opening in the tubular element is stored.
56. The device of claim 46 , wherein:
the tubular element is movable in a distal direction relative to the body, the tubular element moving distally so that tissue enters the tubular element through the opening.
57. The device of claim 46 , further comprising:
means for transporting a tissue mass proximally through the lumen in the tubular element, the tissue mass entering the tubular element through the opening and being separated from the surrounding tissue.
58. The device of claim 46 , further comprising:
a cutting element movable within the tubular element, the cutting element moving within the tubular element to sever tissue which has entered the tubular element through the opening.
59. The device of claim 46 , further comprising:
an introducer movable from a first position to a second position, the introducer covering the opening when in the first position and being spaced apart from the opening when in the second position;
the tissue marking element being positioned within the introducer.
60. The device of claim 59 , wherein:
the tissue marking element is movable within the introducer, the tissue marking element moving distally within the tissue marking element when moving from the stored position to the working position.
61. A method of removing tissue from a patient and marking tissue which remains within the body, comprising the steps of:
providing a tissue removing device having an opening and a tissue marking element, the tissue marking element including a container having an outlet, the container containing a flowable substance;
introducing the tissue removing device into a patient so that the opening is adjacent to a tissue area of interest in a patient;
passing a tissue mass through the opening and into the tissue removing device;
severing the tissue mass from surrounding tissue so that the tissue mass is at least partially contained in the tissue removing device; and
forcing the flowable substance through the outlet of the tissue marking element, the flowable substance being deposited in tissue thereby marking the tissue.
62. The method of claim 61 , wherein:
the providing step is carried out with the tissue removing device including a tubular element, the tubular element having a lumen with the opening being at a distal end of the lumen; and
the passing step is carried out by advancing the tubular element in a distal direction so that the tissue mass enters the lumen through the opening.
63. The method of claim 62 , wherein:
the providing step is carried out with the device having a plurality of outlets positioned on an external surface of the tubular element.
64. The method of claim 61 , wherein:
the providing step is carried out with the tissue marking element having a plurality of outlets; and
the forcing step is carried out with the flowable substance being delivered through the plurality of outlets.
65. The method of claim 61 , wherein:
the forcing step is carried out with the flowable substance being delivered through the plurality of outlets to form a pattern.
66. The method of claim 61 , wherein:
the passing and severing steps are carried out a plurality of times to collect a plurality of tissue masses before the injecting step, the plurality of tissue masses being stored in the tissue removing device, the passing and severing steps being carried out without removing a distal end of the device from the tissue.
67. The method of claim 61 , wherein:
the providing step is carried out with the tissue removing device including a tubular element having a lumen, the opening being at a distal end of the tubular element, the device also having a cutting element movable within the lumen; and
the severing step being carried out with the cutting element moving within the lumen to sever the tissue mass.
68. The method of claim 61 , further comprising the step of:
transporting the tissue mass which has been separated from surrounding tissue during the severing step proximally through the lumen.
69. The method of claim 61 , further comprising the step of:
transporting the tissue mass which has been separated from surrounding tissue during the severing step proximally through the lumen using a cutting element;
the severing step being carried out by severing the tissue with the cutting element.
70-75. (canceled)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/433,275 US20120184874A1 (en) | 2005-04-05 | 2012-03-28 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/099,985 US7635340B2 (en) | 2005-04-05 | 2005-04-05 | Methods and devices for removing tissue from a patient |
US11/245,998 US20060224082A1 (en) | 2005-04-05 | 2005-10-06 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
US12/655,394 US8167817B2 (en) | 2005-04-05 | 2009-12-30 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
US13/433,275 US20120184874A1 (en) | 2005-04-05 | 2012-03-28 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/655,394 Continuation US8167817B2 (en) | 2005-04-05 | 2009-12-30 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
Publications (1)
Publication Number | Publication Date |
---|---|
US20120184874A1 true US20120184874A1 (en) | 2012-07-19 |
Family
ID=38748029
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/245,998 Abandoned US20060224082A1 (en) | 2005-04-05 | 2005-10-06 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
US12/655,394 Expired - Fee Related US8167817B2 (en) | 2005-04-05 | 2009-12-30 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
US13/433,275 Abandoned US20120184874A1 (en) | 2005-04-05 | 2012-03-28 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/245,998 Abandoned US20060224082A1 (en) | 2005-04-05 | 2005-10-06 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
US12/655,394 Expired - Fee Related US8167817B2 (en) | 2005-04-05 | 2009-12-30 | Methods and devices for removing tissue from a patient and placing a marker in the patient |
Country Status (3)
Country | Link |
---|---|
US (3) | US20060224082A1 (en) |
EP (2) | EP1871235A4 (en) |
WO (1) | WO2006108100A2 (en) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2014197056A2 (en) | 2013-03-14 | 2014-12-11 | United Technologies Corporation | Twin target thrust reverser module |
WO2018145018A1 (en) * | 2017-02-06 | 2018-08-09 | Subedi Shree K | System, method and apparatus for integrated tissue sampling and tissue marker placement |
Families Citing this family (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8105243B2 (en) * | 2006-11-16 | 2012-01-31 | Rubicor Medical, Llc | Methods and devices for removing tissue from a patient and placing a marker in the patient |
DE102007014634B3 (en) * | 2007-03-23 | 2008-12-11 | Karl-Heinz Bachmann | Instrument for the medical examination of narrow body canals |
US20090216151A1 (en) * | 2008-02-27 | 2009-08-27 | Speeg Trevor W V | Biopsy Probe With Hypodermic Lumen |
WO2012015770A2 (en) | 2010-07-30 | 2012-02-02 | Cook Medical Technologies Llc | Coaxial incisional full-core biopsy needle |
EP2640287B1 (en) * | 2010-11-21 | 2023-01-18 | Merit Medical Systems, Inc. | Tissue removal device |
US9993585B2 (en) * | 2011-11-11 | 2018-06-12 | University Of Virginia Patent Foundation | Method suction device and related method thereof |
US9039633B2 (en) | 2012-12-24 | 2015-05-26 | Transmed7, Llc | Automated, selectable, soft tissue excision biopsy devices and methods |
JP6122510B2 (en) | 2013-01-18 | 2017-04-26 | メリット・メディカル・システムズ・インコーポレーテッド | Collision biopsy device and method of use |
US9204867B2 (en) | 2013-08-31 | 2015-12-08 | Robert Bilgor Peliks | Tissue removal device and method of use |
CN105491969B (en) * | 2013-08-31 | 2018-09-25 | 罗伯特·佩立克斯 | Organize eliminating equipment and application method |
DK3094262T3 (en) | 2014-01-17 | 2019-09-30 | Merit Medical Systems Inc | GLASS CUTTED BIOPSIN INJECTION UNIT |
WO2015112484A1 (en) | 2014-01-21 | 2015-07-30 | Merit Medical Systems, Inc. | Introducer sheath and methods |
CN104799886A (en) * | 2014-01-27 | 2015-07-29 | 浙江万马集团电子有限公司 | Piston cutting type biopsy needle |
US9993232B2 (en) | 2014-05-22 | 2018-06-12 | Andrew N. Ellingson | Biopsy with marker device and method |
US10231750B2 (en) * | 2014-09-29 | 2019-03-19 | Transmed7, Llc | Excisional device distal working end actuation mechanism and method |
EA033905B1 (en) * | 2014-11-28 | 2019-12-09 | Мед Италия Байомедика С.Р.Л. | Biopsy syringe |
CA2987330A1 (en) * | 2015-06-02 | 2016-12-08 | Becton, Dickinson And Company | Tissue removal device and method of use |
KR20180082444A (en) * | 2015-11-11 | 2018-07-18 | 데비코어 메디컬 프로덕츠, 인코포레이티드 | How to Place Marker Delivery Devices and Markers |
US11602336B2 (en) * | 2016-12-19 | 2023-03-14 | Intuitive Surgical Operations, Inc. | Sample retrieval tool with compliant retention member |
EP3687417A4 (en) * | 2017-09-28 | 2021-06-23 | Merit Medical Systems, Inc. | Biopsy needle sample retention system |
US20210030404A1 (en) * | 2018-04-18 | 2021-02-04 | C. R. Bard, Inc. | Dual lumen coaxial introducer having integrated tissue marker delivery |
WO2020259768A1 (en) * | 2019-06-24 | 2020-12-30 | Möller Medical Gmbh | Device for removing skin islands |
WO2024005783A1 (en) * | 2022-06-28 | 2024-01-04 | Bard Peripheral Vascular, Inc. | Biopsy devices having deployable markers and methods of using the same |
WO2024170445A1 (en) | 2023-02-14 | 2024-08-22 | Mosa Meat B.V. | Improvements to biopsy devices |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4785826A (en) * | 1987-03-02 | 1988-11-22 | Ward John L | Biopsy instrument |
US4900303A (en) * | 1978-03-10 | 1990-02-13 | Lemelson Jerome H | Dispensing catheter and method |
US5526822A (en) * | 1994-03-24 | 1996-06-18 | Biopsys Medical, Inc. | Method and apparatus for automated biopsy and collection of soft tissue |
US6142957A (en) * | 1993-09-20 | 2000-11-07 | Boston Scientific Corporation | Multiple biopsy sampling device |
US6228055B1 (en) * | 1994-09-16 | 2001-05-08 | Ethicon Endo-Surgery, Inc. | Devices for marking and defining particular locations in body tissue |
US20050113737A1 (en) * | 1998-05-01 | 2005-05-26 | Mark Ashby | Device and method for facilitating hemostasis of a biopsy tract |
Family Cites Families (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5534278A (en) * | 1994-01-06 | 1996-07-09 | De Ruyter; Peter W. | Process and apparatus for making meat analogs |
US6161034A (en) * | 1999-02-02 | 2000-12-12 | Senorx, Inc. | Methods and chemical preparations for time-limited marking of biopsy sites |
US6309380B1 (en) * | 1999-01-27 | 2001-10-30 | Marian L. Larson | Drug delivery via conformal film |
WO2001008578A1 (en) * | 1999-07-30 | 2001-02-08 | Vivant Medical, Inc. | Device and method for safe location and marking of a cavity and sentinel lymph nodes |
US6350244B1 (en) * | 2000-02-21 | 2002-02-26 | Biopsy Sciences, Llc | Bioabsorable markers for use in biopsy procedures |
US6712773B1 (en) * | 2000-09-11 | 2004-03-30 | Tyco Healthcare Group Lp | Biopsy system |
US20020115742A1 (en) * | 2001-02-22 | 2002-08-22 | Trieu Hai H. | Bioactive nanocomposites and methods for their use |
CA2456918C (en) * | 2001-09-28 | 2011-02-22 | Edward Parsonage | Medical devices comprising nanocomposites |
TWI236374B (en) * | 2003-02-13 | 2005-07-21 | Univ Nat Taiwan | Light curable epoxy nano composite for dental restorative material |
US7311673B2 (en) | 2003-04-24 | 2007-12-25 | Acueity, Inc. | Biopsy device |
US7001341B2 (en) * | 2003-08-13 | 2006-02-21 | Scimed Life Systems, Inc. | Marking biopsy sites |
US7226622B2 (en) | 2003-09-18 | 2007-06-05 | Boston Scientific Scimed, Inc. | Chemoablation of tissue using biodegradable, solid salt dosage forms |
-
2005
- 2005-10-06 US US11/245,998 patent/US20060224082A1/en not_active Abandoned
-
2006
- 2006-04-05 WO PCT/US2006/012819 patent/WO2006108100A2/en active Application Filing
- 2006-04-05 EP EP06740611A patent/EP1871235A4/en not_active Withdrawn
- 2006-04-05 EP EP12150387A patent/EP2520227A1/en not_active Withdrawn
-
2009
- 2009-12-30 US US12/655,394 patent/US8167817B2/en not_active Expired - Fee Related
-
2012
- 2012-03-28 US US13/433,275 patent/US20120184874A1/en not_active Abandoned
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4900303A (en) * | 1978-03-10 | 1990-02-13 | Lemelson Jerome H | Dispensing catheter and method |
US4785826A (en) * | 1987-03-02 | 1988-11-22 | Ward John L | Biopsy instrument |
US6142957A (en) * | 1993-09-20 | 2000-11-07 | Boston Scientific Corporation | Multiple biopsy sampling device |
US5526822A (en) * | 1994-03-24 | 1996-06-18 | Biopsys Medical, Inc. | Method and apparatus for automated biopsy and collection of soft tissue |
US5980469A (en) * | 1994-03-24 | 1999-11-09 | Ethicon Endo-Surgery, Inc. | Method and apparatus for automated biopsy and collection of soft tissue |
US6228055B1 (en) * | 1994-09-16 | 2001-05-08 | Ethicon Endo-Surgery, Inc. | Devices for marking and defining particular locations in body tissue |
US20050113737A1 (en) * | 1998-05-01 | 2005-05-26 | Mark Ashby | Device and method for facilitating hemostasis of a biopsy tract |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2014197056A2 (en) | 2013-03-14 | 2014-12-11 | United Technologies Corporation | Twin target thrust reverser module |
WO2018145018A1 (en) * | 2017-02-06 | 2018-08-09 | Subedi Shree K | System, method and apparatus for integrated tissue sampling and tissue marker placement |
US10285671B2 (en) | 2017-02-06 | 2019-05-14 | Device And Design, Llc | System, method and apparatus for integrated tissue sampling and tissue marker placement |
Also Published As
Publication number | Publication date |
---|---|
US20100113922A1 (en) | 2010-05-06 |
EP1871235A2 (en) | 2008-01-02 |
EP2520227A1 (en) | 2012-11-07 |
EP1871235A4 (en) | 2009-11-11 |
WO2006108100A2 (en) | 2006-10-12 |
WO2006108100A3 (en) | 2007-12-06 |
US8167817B2 (en) | 2012-05-01 |
US20060224082A1 (en) | 2006-10-05 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8167817B2 (en) | Methods and devices for removing tissue from a patient and placing a marker in the patient | |
US8105243B2 (en) | Methods and devices for removing tissue from a patient and placing a marker in the patient | |
US8337414B2 (en) | Methods and devices for removing tissue from a patient | |
US11779431B2 (en) | Marker delivery device for tissue marker placement | |
US8758369B2 (en) | Biopsy devices and methods | |
US5823970A (en) | Biopsy needle set | |
US5560373A (en) | Needle core biopsy instrument with durable or disposable cannula assembly | |
US5282476A (en) | Biopsy apparatus with tapered vacuum chamber | |
EP0720442B1 (en) | Multiple biopsy sampling coring device | |
US5848978A (en) | Surgical biopsy device | |
US20030050571A1 (en) | Biopsy marker delivery system | |
WO1992019170A1 (en) | Biopsy instrument with actuable stylet and cannula | |
US20120209140A1 (en) | Tissue Sampling Device | |
US20110288437A1 (en) | Tissue sampling device | |
CN110731801A (en) | suction biopsy needle | |
US9693757B2 (en) | Methods and devices for removing tissue from a patient | |
WO1993004629A1 (en) | Biopsy instrument with radius ground cutting edge |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: ENCAPSULE MEDICAL, LLC, CALIFORNIA Free format text: MERGER;ASSIGNOR:RUBICOR MEDICAL, LLC;REEL/FRAME:029342/0370 Effective date: 20120822 |
|
AS | Assignment |
Owner name: BECHTEL, DARREN, CALIFORNIA Free format text: LOAN AND SECURITY AGREEMENT;ASSIGNOR:ENCAPSULE MEDICAL, LLC;REEL/FRAME:029732/0360 Effective date: 20121226 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |