WO1989010091A1 - Dispositif de prelevement d'echantillon, en particulier pour l'examen histologique d'organes humains - Google Patents

Dispositif de prelevement d'echantillon, en particulier pour l'examen histologique d'organes humains Download PDF

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Publication number
WO1989010091A1
WO1989010091A1 PCT/HU1988/000022 HU8800022W WO8910091A1 WO 1989010091 A1 WO1989010091 A1 WO 1989010091A1 HU 8800022 W HU8800022 W HU 8800022W WO 8910091 A1 WO8910091 A1 WO 8910091A1
Authority
WO
WIPO (PCT)
Prior art keywords
needle
cutting tube
spring
cutting
sampling device
Prior art date
Application number
PCT/HU1988/000022
Other languages
German (de)
English (en)
Inventor
Sándor LOVÁSZ
Original Assignee
Zalaform Kft.
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 Zalaform Kft. filed Critical Zalaform Kft.
Priority to PCT/HU1988/000022 priority Critical patent/WO1989010091A1/fr
Publication of WO1989010091A1 publication Critical patent/WO1989010091A1/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

Definitions

  • the invention relates to a biopsy sampling device for the histological examination of various organs (liver, muscle, kidney, prostate gland, etc.), with the aid of which an adjustable amount of tissue sample can be easily taken, the device can be removed using only one hand, with a significantly increased accuracy .
  • tissue samples in order to determine the nature of the disease, to determine the diagnosis, tissue samples must be taken from the organs to be examined, and information about the curability of the disease and the type of treatment can be obtained on the basis of these tissue samples using various examination methods .
  • the course or the degree of progress of various diseases is controlled by repeated sampling.
  • the oldest method of sampling is surgery, whereby the tissue sample to be examined is removed from the organ by an open operation that is extremely stressful for the patient.
  • a more modern and widespread method today is the so-called sampling with a biopsy needle.
  • a variant of this method is the sampling with the so-called Tru-Cut needle from TRAVENOL, whereby without an open operation, i.e. without major intervention, a thin tube with a sharp end edge, the diameter of which is approximately 2 mm, has a sharp cutting edge at its tip and in its end region with a lateral recess, a needle with a diameter of approximately 1.5 mm is inserted into the organ to be examined.
  • the desired puncture depth ie the organ to be examined or its specific part
  • the depth of the tube is fixed with one hand and the inner needle, the so-called stylet, is advanced with the other hand. Then the position of the stylet is fixed and the previously fixed tube with the cutting edge is pushed onto the stylet with a quick movement.
  • the tissue cylinder to be examined which has penetrated into the recess in this way, is cut off and this can be pulled out of the cutter with the stylet, or the whole can be removed together.
  • One of the main disadvantages is that both hands of the doctor performing the procedure are required to use this device, so that in certain areas of application such as when taking samples from the prostate when penetrating through the perineum or rectum, the organ-supporting function of one hand fails and the position of the biopsy needle cannot be checked at the moment of cutting. This has the consequence - especially if the stitch is to be moved to a smaller area described in more detail - that the probability of being hit is reduced.
  • the biopsy needle consists of the fact that there is no supportive - targeted physical contact between the patient and the doctor performing the procedure, especially at the moment of cutting, so that if the cutting edge is suddenly pushed forward, it can accidentally cause serious injury to the vital neighboring organs, e.g. one Prostate biopsy is the injury to the bladder and intestines, in the case of a kidney and liver biopsy the injury to the intestines and / or the large veins supplying these organs with blood.
  • Another disadvantage of this method is that when the cutting edge is suddenly pushed forward, the stylet - due to its inadequate fixation - is inevitably moved backwards, which reduces the size of the tissue cylinder that can be cut out.
  • Another major disadvantage of this method is that the cutting process (the excision) is relatively slow, so that the tissues partially jam in front of the cutting edge and so only a minimal amount of test material can be obtained. In some cases - in the case of tissues with a loose structure - the tissue is pushed out of the cutout of the stylet by the cutting edge and in this way the attempt to take the sample remains unsuccessful.
  • US Pat. No. 4,256,119 describes a biopsy needle construction, the stylet (inner needle) of which, together with the tissue sample removed thereby, is torn back into the interior of the cutting tube provided with a sharp end edge by a tension spring.
  • This solution also has the disadvantage that both hands are required to operate it and a large part of the tissues during the return of the stylet to its original one Position before the stitch returned, so that only a very small amount of tissue sample can be obtained through a relatively large excision and destruction.
  • the aim of the invention is to remedy the shortcomings of the known solutions, that is to say to ensure the operation of the device with only one hand, to aim more precisely, to reduce the risk to vital organs and at the same time to obtain a sufficiently large tissue sample - if necessary with a continuous touch account - roll through the other hand.
  • the invention is based on the knowledge that the sampling can also be carried out with one hand and the advancing of the tube provided with the cutting edge can be omitted if an external force source which ensures a movement of adjustable length is used to move the tube.
  • such a device for taking samples from organs for histological examination, which has a needle in a cutting tube provided with a cutting edge at one end thereof and / or can be moved independently of it and in its one end region it contains a recess for the tissue sample and has a needle moving handle attached to the other end of the needle.
  • the other end of the cutting tube is provided with a stop collar, and on the needle section between the needle-moving handle and the stop collar there is a spring which is subjected to pressure, the cutting tube having an element which limits the axial overflow.
  • the device can be produced with optimal dimensions if a steel coil spring is used as the spring a spring constant of 0.1 m / kg is used.
  • the advancement of the cutting tube that is to say the rapid excision of the tissue sample, is started with the aid of a trigger bar which can be pressed on with the hand holding the device.
  • a toothed bar movable by a toothed segment is attached to the end of the cutting tube and a leaf spring provided with hooks is attached to the end of the needle.
  • the toothed segment can be fastened to the release bar and a screw that adjusts the stroke length can be arranged at the end of the toothed segment.
  • the overflow of the cutting tube that is to say the damage to the other parts of the organism to be protected, which are located behind the organs to be examined, can advantageously be prevented with the aid of a limiting end face which determines the stroke length and is formed in the needle-moving handle.
  • FIG. 1 is a side view of a sampling device according to the invention
  • FIG. 2 shows the rear of the sampling device according to Fig.1
  • Fig. 3 shows the top view of the sampling device
  • Fig. 1 partially in section
  • Fig. 4 is a side view of a sampling device with a pistol grip.
  • a cutting tube 1 the lower end of which is provided with a stop collar 16, is located in a plastic-made handle of a sampling device according to the invention.
  • a needle 2 with sharp cutting edges at its tip 3, the lower end of which is attached to a needle-moving handle 21.
  • the handle 21 is provided with an end surface 21a which receives the palm pressure.
  • a helical spring 17 is arranged on the section of the needle 2 between the stop collar 16 and the handle 21, the spring constant of which was chosen to exert a force of at least 0.5 N to a value of 0. m / kg.
  • a stop screw 9 is embedded, at the front end face of which is provided with a limiting groove 12 - rod 11.
  • the axial movement of the stop screw 9 can be achieved with the aid of the position-adjusting nut 10 arranged thereon.
  • the slipping out of the handle 21 moving from the handle 8 is prevented by a limiting screw 7 located behind the handle 21.
  • An element 18 limiting the end position is fastened to the needle-moving handle 21 and one is the overflow in the handle 8 of the cutting tube 1 preventing end face 25 is formed.
  • the advanced position of the needle is fixed by the stroke length-adjusting bolt 15 which is stuck in the limiting groove 12 and which can be pivoted about the axis 13 by pressing in a push button 15a.
  • the needle 2 can be advanced during a gripping movement by pressing the end face 21a.
  • the middle finger of the right hand should be placed in the handle 23a shown in FIG.
  • Fig. 3 shows in detail the formed at the front end of the cutting tube 1 cutting edge 6 and the needle tip 3 at the front end of the needle 2. Behind the sharp cutting needle tip 3 is formed on the needle 2, a recess 5 for the tissue sample, which is actually an axial Represents flattening of the needle body.
  • the handle 23a receiving the middle finger of the right hand is located symmetrically to the handle 23b.
  • a stop collar 16 is fastened to the end of the cutting tube 1.
  • a helical spring 17 is arranged on the section of the needle 2 between the stop collar 16 and the handle 21.
  • the advanced position of the needle 2 can be stopped in the limiting groove 12 by stopping the stroke-length-adjusting bolt 15 are locked, the bolt 15 is held in a locking (locking) position by a winding on the axis 13 and supported on the handle 8 or on the side surface of the stroke-length-adjusting bolt 15.
  • the pushing of the cutting tube 1 can be started by the push button 19a.
  • the push button 19a is located on the side of the release bar 19 which can be pivoted about the axis 24.
  • the release bar 19 is pressed in the rest position by a spring 20 against the stop collar 16 and by pressing the push button 19a it is possible for the cutting tube 1 to be moved by the spring 17 can be advanced. A possible overflow of the cutting tube 1 is prevented by a boundary face 25.
  • the device shown in FIG. 4 differs from the exemplary embodiment described above in that the handle 8 looks similar to a pistol handle, the trigger bar 19 of which can be pivoted about the axis 24.
  • a toothed segment 27 is fastened in the trigger bar 19, while a toothed rack 26 is fastened to the needle 2.
  • a leaf spring 28 provided with a hook 29 is connected to the end of the cutting tube 1.
  • a screw 30 which adjusts the stroke length is arranged at the rear section of the handle 8, a window 31 allowing the movement of the screw 30 is provided.
  • the stroke length ie the size of the sample to be examined, is set to 1 cm e with the position-adjusting nut 10 Thereafter, the entire length of the needle 2 is pushed into the cutting tube 1 when the push button 15a is pressed.
  • the stroke length can of course also be set larger or smaller as desired.
  • the needle 2 located in the cutting tube 1 is to be inserted at a depth by grasping the handle 8 with the right hand into the, for example bulging organ to be examined, so that the tip 3 of the needle 2 reaches the tumor (the tumor).
  • the index finger of the right hand is placed on the handle 23b, while the middle finger is placed on the handle 23a, and the end face 21a of the needle-moving handle 21 is pushed forward with the palm until the stroke-length-adjusting bolt 15 gets stuck in the limiting groove 12.
  • the needle 2 extends in the predetermined length of 1 cm into the tumor and part of the tumor penetrates into the recess 5 of the needle 2.
  • the advance of the handle 21 simultaneously causes the spring 17 to be compressed.
  • the handle 8 should also be gripped from below with the right hand and the push button 19a pressed with the thumb, as a result of which the release latch 19 releases the stop collar 16 and the spring 17 releases it
  • the cutting tube 1 pushes forward, as a result of which the tumor part which has penetrated into the recess 5 is cut off by the cutting edge 6 of the cutting tube 1.
  • the tissue sample is taken with the embodiment of the sampling device according to the invention shown in FIG. 4 in such a way that with one hand the pistol grip-like handle 8 is firmly inserted into the cutting tube 1 receiving the needle 2 as far as the organ to be examined. Thereafter, the needle 2 is pushed forward by pulling the trigger bar 19 through the toothed segment 27 together with the toothed strip 26 and after reaching the through the. stroke length-adjusting screw 30 of predetermined depth, the screw 30 extending through the window 31 moves the hook 29 of the leaf spring 28. Accordingly, the envy tube 1 is released and pushed forward by the spring 17 and the tissue sample to be examined is paced through the cutting tube 1. In the end position of the cutting, the stop collar 16 of the cutting tube 1 is stopped by the limiting face 25 of the handle 8.
  • the device containing the tissue sample can be pulled out of the tumor or from the examined organ and the tissue sample obtained in this way can be subjected to the known histological examinations.
  • the sampling device according to the invention can be operated with one hand; when used, the risk of damage to the other organs located near the organ to be examined is practically completely eliminated and with continuous tactile control by the other A quick excision of a tissue sample with a preset size is guaranteed by hand.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Sampling And Sample Adjustment (AREA)

Abstract

L'invention concerne un dispositif de prélèvement d'échantillon en vue d'une biopsie, en particulier pour l'examen histologique d'organes humains, présentant un tube de découpe (1) comportant à l'une de ses extrémités une arête tranchante (6), mobile et, dans sa zone terminale, un évidement (5) pour l'aiguille (2) contenant le tissu échantillon, une poignée (21) de déplacement de l'aiguille, fixée à l'autre extrémité de l'aiguille (2), ainsi qu'un ressort (17) modifiant la position mutuelle de l'aiguille (2) et du tube de découpe (1). L'invention réside dans le fait que l'autre extrémité du tube de découpe (1) est munie d'un collet de butée (16), que le ressort sollicité à la compression (17) est disposé sur le parcours de l'aiguille (2), entre la poignée (21) de déplacement de l'aiguille et le collet de butée (16), et que le tube de découpe (1) présente une surface frontale de délimitation (25) empêchant son débordement. Avantageusement, une crémaillère (26), déplaçable par un segment denté (27), est fixée à l'extrémité de l'aiguille (2), et un ressort à lame (28), muni de crochets, est fixé à l'extrémité du tube de découpe (1), cependant qu'il est prévu, à l'extrémité du segment denté (27), une vis (30) coopérant avec le ressort à lame (28), pour le réglage de la course d'avancement de l'aiguille (2).
PCT/HU1988/000022 1988-04-19 1988-04-19 Dispositif de prelevement d'echantillon, en particulier pour l'examen histologique d'organes humains WO1989010091A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/HU1988/000022 WO1989010091A1 (fr) 1988-04-19 1988-04-19 Dispositif de prelevement d'echantillon, en particulier pour l'examen histologique d'organes humains

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/HU1988/000022 WO1989010091A1 (fr) 1988-04-19 1988-04-19 Dispositif de prelevement d'echantillon, en particulier pour l'examen histologique d'organes humains

Publications (1)

Publication Number Publication Date
WO1989010091A1 true WO1989010091A1 (fr) 1989-11-02

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Application Number Title Priority Date Filing Date
PCT/HU1988/000022 WO1989010091A1 (fr) 1988-04-19 1988-04-19 Dispositif de prelevement d'echantillon, en particulier pour l'examen histologique d'organes humains

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5127419A (en) * 1991-07-02 1992-07-07 Antoine Kaldany Biopsy instrument with slotted driving member
FR2688681A1 (fr) * 1992-03-23 1993-09-24 Lebosse Guy Manche universel pour instrumentation de cóoeliochirurgie.
US5358474A (en) * 1991-07-02 1994-10-25 Intermed, Inc. Subcutaneous drug delivery device
WO1995022943A1 (fr) * 1994-02-24 1995-08-31 Medl Maximilian J Pince de resection des tissus pour traiter les stenoses des canaux mammaires
US5562613A (en) * 1991-07-02 1996-10-08 Intermed, Inc. Subcutaneous drug delivery device
US5830153A (en) * 1994-04-26 1998-11-03 Kass; Erik S. Controlled surgical core biopsy system
US6659996B1 (en) 1995-11-09 2003-12-09 Intermed, Inc. Device for delivering biological agents

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DD141108A1 (de) * 1978-12-28 1980-04-16 Heinz Kuhn Exzisionsinstrument
EP0153047A2 (fr) * 1984-02-10 1985-08-28 Dan Beraha Dispositif pour biopsie transrectale de la prostate
WO1987006815A1 (fr) * 1986-05-14 1987-11-19 Dan Beraha Instrument pour biopsie

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DD141108A1 (de) * 1978-12-28 1980-04-16 Heinz Kuhn Exzisionsinstrument
EP0153047A2 (fr) * 1984-02-10 1985-08-28 Dan Beraha Dispositif pour biopsie transrectale de la prostate
WO1987006815A1 (fr) * 1986-05-14 1987-11-19 Dan Beraha Instrument pour biopsie

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5127419A (en) * 1991-07-02 1992-07-07 Antoine Kaldany Biopsy instrument with slotted driving member
US5358474A (en) * 1991-07-02 1994-10-25 Intermed, Inc. Subcutaneous drug delivery device
US5501664A (en) * 1991-07-02 1996-03-26 Intermed, Inc. Subcutaneous drug delivery device
US5562613A (en) * 1991-07-02 1996-10-08 Intermed, Inc. Subcutaneous drug delivery device
FR2688681A1 (fr) * 1992-03-23 1993-09-24 Lebosse Guy Manche universel pour instrumentation de cóoeliochirurgie.
WO1995022943A1 (fr) * 1994-02-24 1995-08-31 Medl Maximilian J Pince de resection des tissus pour traiter les stenoses des canaux mammaires
US5830153A (en) * 1994-04-26 1998-11-03 Kass; Erik S. Controlled surgical core biopsy system
US6659996B1 (en) 1995-11-09 2003-12-09 Intermed, Inc. Device for delivering biological agents

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