WO1983003343A1 - Dispositif de prelevement d'echantillons de tissus - Google Patents

Dispositif de prelevement d'echantillons de tissus Download PDF

Info

Publication number
WO1983003343A1
WO1983003343A1 PCT/SE1983/000112 SE8300112W WO8303343A1 WO 1983003343 A1 WO1983003343 A1 WO 1983003343A1 SE 8300112 W SE8300112 W SE 8300112W WO 8303343 A1 WO8303343 A1 WO 8303343A1
Authority
WO
WIPO (PCT)
Prior art keywords
needle
triggering
driving means
sampling
propelling
Prior art date
Application number
PCT/SE1983/000112
Other languages
English (en)
Inventor
Ab Radiplast
Original Assignee
ALLARD, Jan, Hakan
Lindgren, Per, Gunnar
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by ALLARD, Jan, Hakan, Lindgren, Per, Gunnar filed Critical ALLARD, Jan, Hakan
Priority to AU13794/83A priority Critical patent/AU1379483A/en
Publication of WO1983003343A1 publication Critical patent/WO1983003343A1/fr

Links

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
    • 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
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • 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
    • A61B2010/0208—Biopsy devices with actuators, e.g. with triggered spring mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A61B2017/3413—Needle locating or guiding means guided by ultrasound

Definitions

  • the present invention relates to a device for taking tissue samples, and the invention more specifically relates to a device for facilitating and making possible for one person to take samples of tissue located inside the human body, such as from the kidney and liver, if pathological changes are suspected.
  • the location at which the sampling is to take place is best determined by means o ⁇ ultrasonic equipment.
  • the sampling which is carried out as puncture, i.e. piercing of the skin from the outside with a hollow needle which can be inserted to the location of the sampling where a tissue sample is taken, can be carried out under surveillance by the ultrasonic equipment.
  • Tissue sampling using so-called coarse needle puncture has become increasingly common.
  • Tissue samples which have been taken can be analyzed in various ways, for example by means of a microscope or chemically.
  • the sampling is carried out such that one doctor performs the very puncture and another doctor assists by operating the ultrasonic equipment used in order to localize the place of the sampling and to control that the tissue sample is taken from the correct place.
  • the doctor who carries out the puncture depresses a hollow needle from the exterior through the skin and to the intended sampling place, which is thus determined by the ultrasonic equipment, where tissue samples are taken. This is done by depressing an inner needle, which is located inside the hollow needle, a short distance further into the tissue from which it is desired to take a sample.
  • This inner needle has a pointed front part, which further has a reduced portion near the point.
  • the tissue expands into this portion, whereupon the outer hollow needle is applied, by which a tissue sample is cut out and accomodated in the reduced portion inside the front part of the inner needle. Thereafter the entire needle unit can be withdrawn, whereupon the tissue sample can be analyzed in various ways, for example microscopically or chemically.
  • THE OBJECT OF THE INVENTION aims at providing a device for use in connection with tissue sampling by means of puncture of the kind indicated above, wherein the previous drawback that two doctors have to take part in the sampling can be eliminated by means of a device according to the invention, which makes possible one-man controlled tissue sampling by means of puncture.
  • the tissue sampling is in accordance with the invention carried out in a manner such that the doctor handles and controls the ultrasonic equipment with his one hand for localization and surveillance, while at the same time the same doctor with his other hand performs the very puncture by inserting the needle unit such that its point will be at the correct sampling place, whereupon the doctor with the same hand triggers an automatic- sampling operation, by means of which the inner needle Is at first expelled a desired extent and the outer needle then automatically triggered, whereby the tissue sampling takes place. Thereafter the doctor can withdraw the needle unit, and the tissue sampling is finished.
  • the invention further aims at eliminating the above cited drawback as to the very handling procedure, viz. the risk of withdrawing, by mistake, the inner needle Instead of expelling the outer needle at the very sampling moment. This risk is eliminated by means of the present invention, which automatically ensures the correct sequence of the very sampling procedure.
  • Figure 1 in schematic perspective view illustrates how a device according to the invention is used together with an ultrasonic equipment for carrying out tissue sampling in accordance with the invention
  • Figure 2 in top plan view illustrates a device according to the invention, viewed from above, with the cover which can be opened shown in the open position and with the needle unit shown in its final condition, when the sampling has been carried out,
  • FIG 3 is a sectional view of the device according to Figure 1, with the needle unit shown in the same condition as in Figure 1,
  • Figure -- shows the device viewed from below with its bottom plate removed
  • Figure 5 in top plan view illustrates another embodiment according to the invention, wherein the device is viewed from above with the cover which can be opened shown in the open position and with the needle unit not yet having been put in place
  • Figure 6 in bottom plan view shows the embodiment of Figure 5, the bottom plate of the device being removed in order to make internal elements visible.
  • Figure 1 schematically illustrates how one single doctor can perform a puncture according to the invention, the doctor with his one hand controlling the ultrasonic equipment 29, which is connected to a monitoring screen, and with his other hand controlling the device 1 according to the invention.
  • Figure 1 further illustrates how a guiding device 30 is mounted at the ultrasonic equipment, which device 30 has an extension part
  • a needle unit comprises an outer tubular needle 2 and an inner needle 3 located therein.
  • the outer hollow needle 2 is retained in a holder , the front part of which has a flange 5, which upon manual handling is used as a finger grip, but which in accordance with the invention is used as a fixation part for the attachment part of the outer needle 2 in the device 1 according to the invention.
  • the inner needle 3 has its rearmost portion attached to a pressure plate 6 by means of the inner needle is manipulated.
  • the very device 1 comprises a casing or box 7, a cover 8 which can be opened and closed, and a lower bottom piece 33 which is normally screwed up on the casing or box 7 and which is to be loosened only in connection with possible service.
  • the rearward driving means consists of a spring 10 which in the shown embodiment is a pressure spring which can be biased from its inactive position, shown in the Figure, to an activated, compressed position in which the spring is retained behind a trigger lug 11.
  • the trigger lug 11 can be operated from the exterior of the device by means of a trigger knob 12 which preferably is spring biased against its locking position and is connected to the trigger lug 11 (the trigger lug II and the knob 12 can preferably be made in one single piece and be interconnected by means of an intermediate piece which is journalled around a fulcrum so that depression of the knob 12 results in lifting of the trigger lug 11 from the position illustrated in the Figure).
  • depression of the control knob 12 will actuate the trigger lug 11 so that the spring 10 is released from its compressed initial position and drives the reward pressure plate 6 for the inner needle 3 forwards to the desired extent.
  • the triggering mechanism such that the very trigger-knob has a so-called pressure point. This means that no triggering takes place during the initial depression of the knob, but when the knob has been depressed to a suitable degree the resistance is increased, and when the button is depressed further then the very triggering takes place.
  • the reason why a pressure point is desirable is that the user then will know with greater certainty when the very triggering will take place, at the same time avoiding unintentional triggering (e.g. by accident).
  • the outer needle 2 is driven by means of a forward driving means in the form of a spring 13, one end of which is firmly attached to a holding-up means 1* which is fixed in the box 7, the other end of the spring 13 contacting a cross-wall 15 of a displaceable slide 16, the front part of which has a lug 17 provided with two projections IS and 19 respectively, between which the flange 5 of the part - is retained.
  • the forward drive spring 13 can be compressed to a biased position by means of a tool, and the displaceable slide 16 has then been moved to the left in Figure 3 so far that a locking lip 20 of a locking and
  • Q ⁇ PI triggering mechanism 21 engages and Jocks the movable slide. In this position the locking lip 20 has been brought into a hole 22 provided in a cross-piece 23 of the movable slide and the locking lug in this position holds the movable slide in this position, in which the spring 13 is compressed.
  • the locking and triggering mechanism 21 has a trigger cam 2 at its lower part, which cam 2k extends through an intermediate partition 25 of the box 7 to be in the path of movement of the front end plate 26 of the rearward driving spring 10.
  • the device according to the invention When the device according to the invention is to be used, it is prepared in the following way.
  • the cover 8 is opened and the springs are tightened.
  • a special tool consisting of a goose-necked handle, by means of which the springs 10 and 13 respectively are conveniently tightened.
  • the spring 13 then moves the displaceable slide 16 to the left in the Figures, and the locking lip 20 will then snap-in through the hole 22 in the cross-piece 23 and lock the movable slide in the position in which the spring is tightened.
  • the locking and triggering mechanism 21 is biased to this locking position by means of a spring 27.
  • the rearward drive spring 10 is tightened upon compression to the left in the Figures, and it will snap over the locking lug 11 of the triggering mechanism 12. Also this one is kept biased to the locking position by means of a biasing spring 28.
  • the needle unit is inserted in the manner illustrated in Figure 1, the holder part of the outer needle 2 being put into the movable slide in a manner such that the flange 5 is in engagement with the projections 1Z and 19 respectively of the lug 17.
  • the rearward pressure plate 6 of the inner needle 3 is disposed adjacent the front end of the rearward drive spring 10 and it can suitably be kept in place by means of small lugs or ears, not shown, which are provided on the plate- 26 and form a retaining means.
  • the device is now prepared and ready for use.
  • Figures 5 and 6 show a second embodiment of the invention.
  • the very " basic construction is fully similar to that according to Figure 1, but the trigger knob 12 has been moved somewhat closer to the midpart of the device.
  • the drive springs for the two operational steps have been replaced, for the first step when the inner needle is to be brought forward by two draw springs 10A, 10B, while the spring which is to propel the outer needle 2 has been replaced by a pressure spring 13A.
  • the second embodiment functions exactly in the same way as the first embodiment, and the other elements, which have not been mentioned here, completely correspond to the corresponding elements of the first embodiment.
  • the spring 10 is then triggered and pushes the inner needle 3 to the right, and since the outer needle is not moved during this phase, the point of the inner needle will project a desired distance from the outer needle 2 and into the tissue from which a sample Is to be taken.
  • the spring 10 approaches the end of its movement stroke it contacts the trigger lip 24, pressing the same upwards and turning s the locking and triggering mechanism 21 counter-clockwise in Figure 3.
  • the locking lip 20 is lifted and leaves its engagement with the wall around the hole 22, thereby releasing the movable slide and pushing It forward under the action of the spring 13.
  • the outer needle 2 is propelled and pushed over the inner needle 3 so that a tissue sample will be cut and retained in the space between the outer needle and the inner needle at the portion 34 of reduced diameter of the latter.
  • the sampling has now been terminated and the doctor can withdraw the needle unit from the patient, leaving the tissue sample to a laboratory for testing.
  • a separate trigger knob (similar to the knob 12) for the driving means 10 for the inner needle 3, as well as a second separate trigger knob, which thus should be actuable from the outside of the unit, for triggering the propelling motion of the second driving means 13.
  • This latter case can make simplifications as to design possible, but at the same time there may arise a risk of faulty control since it is important, for achieving correct sampling, that the inner needle is triggered first to move a predetermined extent, whereafter the outer needle is to be propelled over the inner needle 3, so that a tissue sample can be caught in the space between the front part of the needles.
  • the entire device preferably ought to be made with an outer surface having good friction, for example being rifled or knurled, covered with friction- increasing projections or simply be provided with a stretched-on or glued-on friction material such as rough rubber material, for eliminating the risk that the user unintentionally slips with his hand during use....
  • the device should be clean and easy to sterilize, and the user ought to use rubber gloves during use.
  • the invention in its most general scope also comprises other driving means than springs.
  • rechargeable compressed-air assemblies can be used, wherein a compressed-air cylinder is used for each of the two driving steps, alternatively the same compressed-air cylinder can be used for both of the driving steps.
  • the invention has industrial utility in that the need for tissue sampling equipment is increasing considerably by the possibility of making use of ultrasonic equipment for correct localization of the sampling place and of the correct place to locate the needle unit on sampling, and in that the invention provides a device which both makes one-man control service possible and guarantees a properly conducted procedure.
  • This more .and more increasing need demands series production of an equipment which should be simple and inexpensive - to produce and easy and comfortable to -handle.
  • the invention offers such a device and may therefore find large industrial use by manufacture in large series. It is thus fully clear that the invention has industrial utility.

Abstract

Dispositif de prélèvement de tissus au moyen d'une ponction, c'est-à-dire en perçant la peau de l'extérieur au moyen d'une unité d'aiguilles, qui est insérée à l'endroit du prélèvement d'échantillon, le prélèvement étant exécuté sous le contrôle d'un équipement à ultrasons, l'unité d'aiguilles se composant d'une aiguille extérieure creuse (2) pouvant être actionnée indépendamment et d'une aiguille intérieure pouvant être actionnée indépendamment et possédant une partie réduite à proximité de sa pointe pour loger les échantillons de tissus après le prélèvement d'échantillon. Le dispositif (1) se compose d'une unité dans laquelle on peut placer l'aiguille, d'un organe d'entraînement pour l'avance de l'aiguille interne, d'un organe d'entraînement pour l'avance de l'aiguille extérieure (2) et d'une gâchette (12) pour le dispositif d'entraînement. Le dispositif comprend un carter ou un boîtier, dans lequel on peut placer l'aiguille, un couvercle pouvant être ouvert et fermé ainsi qu'une pièce de fond.
PCT/SE1983/000112 1982-03-31 1983-03-28 Dispositif de prelevement d'echantillons de tissus WO1983003343A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU13794/83A AU1379483A (en) 1982-03-31 1983-03-28 Anordning for vavnadsprovtagning

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE8202061 1982-03-31
SE8202061-1820331 1982-03-31

Publications (1)

Publication Number Publication Date
WO1983003343A1 true WO1983003343A1 (fr) 1983-10-13

Family

ID=20346430

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE1983/000112 WO1983003343A1 (fr) 1982-03-31 1983-03-28 Dispositif de prelevement d'echantillons de tissus

Country Status (2)

Country Link
EP (1) EP0105309A1 (fr)
WO (1) WO1983003343A1 (fr)

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0238461A1 (fr) * 1986-02-19 1987-09-23 C.R. Bard, Inc. Dispositif pour prélever des échantillons de tissu
EP0318447A1 (fr) * 1987-11-19 1989-05-31 C.R. Bard, Inc. Unité d'entraînement pour les dispositifs de prélèvement des échantillons
US4924878A (en) * 1988-11-07 1990-05-15 Nottke James E Actuating mechanism for biopsy needle
US4940061A (en) * 1989-11-27 1990-07-10 Ingress Technologies, Inc. Biopsy instrument
US4958625A (en) * 1989-07-18 1990-09-25 Boston Scientific Corporation Biopsy needle instrument
EP0444305A1 (fr) * 1990-02-28 1991-09-04 Angiomed Ag Dispositif pour le prélèvement d'un échantillon par biopsie
EP0677278A1 (fr) * 1994-04-13 1995-10-18 Carl Zeiss Adapteur stéréotactique et procédé pour son opération
US5507298A (en) * 1994-09-23 1996-04-16 M3 Systems, Inc., D/B/A/ Manan Medical Products, Inc. Forward-fired automatic tissue sampling apparatus
US5538010A (en) * 1994-10-05 1996-07-23 Proact Ltd. Biopsy needle device
US5752923A (en) * 1996-06-24 1998-05-19 Medical Device Technologies, Inc. Biopsy instrument with handle and needle set
EP0858774A3 (fr) * 1997-01-21 1998-09-16 Ethicon Endo-Surgery, Inc. Dispositifs de prélèvement de tissu mou
EP0868882A2 (fr) * 1997-04-03 1998-10-07 Alberto Bauer Appareil chirurgical pour biopsie
US5823970A (en) * 1996-03-22 1998-10-20 Medical Device Technologies, Inc. Biopsy needle set
US5842999A (en) * 1996-07-31 1998-12-01 C.R. Bard, Inc. Automated tissue sampling device
US5989196A (en) * 1994-10-31 1999-11-23 Boston Scientific Corporation Biopsy needle
US6083176A (en) * 1998-08-11 2000-07-04 Medical Device Technologies, Inc. Automated biopsy needle handle
US6106484A (en) * 1998-05-12 2000-08-22 Medical Device Technologies, Inc. Reusable automated biopsy needle handle
US6283925B1 (en) 1998-05-12 2001-09-04 Medical Device Technologies, Inc. Biopsy needle handle
EP1212982A2 (fr) * 1997-04-03 2002-06-12 Allegiance Healthcare Corporation Appareil chirurgical pour biopsie
US7329227B2 (en) 2004-10-21 2008-02-12 Inter-V-Manan Forward-fired automatic tissue sampling apparatus with safety lock
US7390306B2 (en) 2003-10-14 2008-06-24 Suros Surgical Systems, Inc. Vacuum assisted biopsy needle set
US8337416B2 (en) 2010-07-23 2012-12-25 Cook Medical Technologies Llc Biopsy device
EP3292822A3 (fr) * 2016-08-15 2018-05-23 Dune Medical Devices Ltd. Dispositif de biopsie
US11583442B2 (en) 2017-04-09 2023-02-21 Sanoculis Ltd. Device and method for creating a channel in soft tissue

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6142955A (en) 1997-09-19 2000-11-07 United States Surgical Corporation Biopsy apparatus and method

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH483829A (de) * 1968-05-03 1970-01-15 Hubert Dr Reinisch Biopsie-Entnahmegerät für Gewebeentnahme zur histologischen Untersuchung
DE2936259A1 (de) * 1979-09-07 1981-03-19 Siemens AG, 1000 Berlin und 8000 München Vorrichtung zum punktieren von koerperinternen organen, gefaessen o.dgl.

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH483829A (de) * 1968-05-03 1970-01-15 Hubert Dr Reinisch Biopsie-Entnahmegerät für Gewebeentnahme zur histologischen Untersuchung
DE2936259A1 (de) * 1979-09-07 1981-03-19 Siemens AG, 1000 Berlin und 8000 München Vorrichtung zum punktieren von koerperinternen organen, gefaessen o.dgl.

Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0238461A1 (fr) * 1986-02-19 1987-09-23 C.R. Bard, Inc. Dispositif pour prélever des échantillons de tissu
EP0590710A2 (fr) * 1987-11-19 1994-04-06 C.R. Bard, Inc. Unité d'entraînement pour les dispositifs de prélèvement des échantillons
EP0318447A1 (fr) * 1987-11-19 1989-05-31 C.R. Bard, Inc. Unité d'entraînement pour les dispositifs de prélèvement des échantillons
EP0590710A3 (en) * 1987-11-19 1994-06-01 Bard Inc C R Driving unit for sampling devices
US4924878A (en) * 1988-11-07 1990-05-15 Nottke James E Actuating mechanism for biopsy needle
US4958625A (en) * 1989-07-18 1990-09-25 Boston Scientific Corporation Biopsy needle instrument
EP0463120A4 (en) * 1989-07-18 1992-05-20 Boston Scientific Corporation Biopsy needle instrument
EP0463120A1 (fr) * 1989-07-18 1992-01-02 Boston Scient Corp Instrument a aiguille de biopsie.
US5368045A (en) * 1989-07-18 1994-11-29 Boston Scientific Corporation Biopsy needle instrument
US4940061A (en) * 1989-11-27 1990-07-10 Ingress Technologies, Inc. Biopsy instrument
EP0444305A1 (fr) * 1990-02-28 1991-09-04 Angiomed Ag Dispositif pour le prélèvement d'un échantillon par biopsie
EP0677278A1 (fr) * 1994-04-13 1995-10-18 Carl Zeiss Adapteur stéréotactique et procédé pour son opération
US5507298A (en) * 1994-09-23 1996-04-16 M3 Systems, Inc., D/B/A/ Manan Medical Products, Inc. Forward-fired automatic tissue sampling apparatus
US5538010A (en) * 1994-10-05 1996-07-23 Proact Ltd. Biopsy needle device
US5989196A (en) * 1994-10-31 1999-11-23 Boston Scientific Corporation Biopsy needle
US5823970A (en) * 1996-03-22 1998-10-20 Medical Device Technologies, Inc. Biopsy needle set
US5752923A (en) * 1996-06-24 1998-05-19 Medical Device Technologies, Inc. Biopsy instrument with handle and needle set
US5842999A (en) * 1996-07-31 1998-12-01 C.R. Bard, Inc. Automated tissue sampling device
EP0858774A3 (fr) * 1997-01-21 1998-09-16 Ethicon Endo-Surgery, Inc. Dispositifs de prélèvement de tissu mou
EP0868882A2 (fr) * 1997-04-03 1998-10-07 Alberto Bauer Appareil chirurgical pour biopsie
EP1212982A3 (fr) * 1997-04-03 2006-02-08 Allegiance Healthcare Corporation Appareil chirurgical pour biopsie
EP0868882A3 (fr) * 1997-04-03 1999-12-01 Corporation Allegiance Appareil chirurgical pour biopsie
EP1212982A2 (fr) * 1997-04-03 2002-06-12 Allegiance Healthcare Corporation Appareil chirurgical pour biopsie
US6120463A (en) * 1997-04-03 2000-09-19 Allegiance Corporation Biopsy surgical appliance
US6283925B1 (en) 1998-05-12 2001-09-04 Medical Device Technologies, Inc. Biopsy needle handle
US6106484A (en) * 1998-05-12 2000-08-22 Medical Device Technologies, Inc. Reusable automated biopsy needle handle
US6083176A (en) * 1998-08-11 2000-07-04 Medical Device Technologies, Inc. Automated biopsy needle handle
US7390306B2 (en) 2003-10-14 2008-06-24 Suros Surgical Systems, Inc. Vacuum assisted biopsy needle set
US7329227B2 (en) 2004-10-21 2008-02-12 Inter-V-Manan Forward-fired automatic tissue sampling apparatus with safety lock
US8337416B2 (en) 2010-07-23 2012-12-25 Cook Medical Technologies Llc Biopsy device
EP3292822A3 (fr) * 2016-08-15 2018-05-23 Dune Medical Devices Ltd. Dispositif de biopsie
US11583442B2 (en) 2017-04-09 2023-02-21 Sanoculis Ltd. Device and method for creating a channel in soft tissue
US11701257B2 (en) 2017-04-09 2023-07-18 Sanoculis Ltd. Device and method for creating a channel in soft tissue

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