WO1991006246A1 - Dispositif de biopsie - Google Patents

Dispositif de biopsie Download PDF

Info

Publication number
WO1991006246A1
WO1991006246A1 PCT/US1990/006268 US9006268W WO9106246A1 WO 1991006246 A1 WO1991006246 A1 WO 1991006246A1 US 9006268 W US9006268 W US 9006268W WO 9106246 A1 WO9106246 A1 WO 9106246A1
Authority
WO
WIPO (PCT)
Prior art keywords
biopsy
trocar
specimen holder
cannula
biopsy device
Prior art date
Application number
PCT/US1990/006268
Other languages
English (en)
Inventor
William C. Allen
Original Assignee
Allen William C
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 Allen William C filed Critical Allen William C
Publication of WO1991006246A1 publication Critical patent/WO1991006246A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections

Definitions

  • the present invention relates to devices for taking hard tissue or soft tissue biopsy specimens.
  • Biopsies are taken when a small tissue specimen is required for examination, e.g., by a pathologist, particularly in cases where cancer is suspected.
  • tissue (hard and soft) biopsies are presently performed each year in the United States.
  • Soft tissue biopsies are performed by surgeons of all specialties as well as by some oncologists.
  • Hard tissue (bone) biopsies are performed primarily by three types of physicians: orthopaedic surgeons, oncologists (usually orthopaedic), and radiologists. Although the vast majority of all biopsies performed are of soft tissue biopsies, the number of bone biopsies has been growing rapidly over the past few years. Biopsies are used in both human and veterinary medicine.
  • a general feature of the invention is a biopsy device for obtaining either hard (bone) or soft tissue biopsy specimens including a biopsy trocar adapted for insertion into a cannula, and a biopsy specimen holder removably attached, preferably by threaded engagement, to one end of the biopsy trocar.
  • the specimen holder has an inside diameter on the order of 2.4 mm. (1.2 mm. in a sternal version), and includes an elongated, substantially transparent, plastic tubular portion which fits within the biopsy trocar, and a cutting portion, having either a serrated or slicing edge, which extends from one end of the biopsy trocar.
  • the biopsy trocar includes a handle and at least one viewing portal for viewing a biopsy specimen held within the tubular portion of the specimen holder.
  • the specimen holder includes a plurality of inwardly extending scallop-like retaining members formed by perforations in the cutting portion, or fishscale-like retaining members formed by machining material from the interior of the cutting portion, either of which is adapted to inhibit movement of the biopsy specimen in at least one longitudinal direction.
  • the biopsy device also preferably includes a sharply pointed starter trocar (obturator) which may be inserted into the cannula in place of the biopsy trocar.
  • Another general feature of the invention is a method for obtaining either a soft or hard tissue biopsy specimen from a surgical site, which includes the steps of inserting a sharply-pointed starter trocar into a cannula, whereby the sharply pointed end of the trocar extends from the cannula; pushing the cannula-enclosed starter trocar into the surgical site; removing the starter trocar from the cannula; inserting a biopsy trocar having a removable specimen holder into the cannula, the specimen holder having a cutting portion which extends from the biopsy trocar; twisting the biopsy trocar within the cannula against tissue, whereby the tissue is cut by the cutting portion and the cut tissue is held within the specimen holder; removing the biopsy trocar from the surgical site; removing the specimen holder from the biopsy trocar; and pushing the tissue out of the specimen holder, whereby the tissue may be examined by a pathologist.
  • Preferred methods of performing the invention include pushing the cannula-enclosed starter trocar against a
  • FIGS. 1A-1C are perspective views showing the interrelationship among two components of a biopsy device in accordance with a preferred embodiment of the present invention
  • FIGs. 2A-2C are perspective views showing the interrelationship among three further components of a biopsy device in accordance with a preferred embodiment of the present inven ion;
  • Figs. 3A-3B are side elevation and end views, respectively, of a portion of a biopsy device in accordance with a preferred embodiment of the present invention
  • Fig. 4 is a cross-sectional view of a portion of a biopsy device taken along the line 4-4 of Fig. 3B;
  • Fig. 5 is a cross-sectional view of a portion of a biopsy device in accordance with an alternate preferred embodiment of the present invention.
  • Fig. 6 is a schematic view, with internal structure in phantom, of a portion of a biopsy device in accordance with another preferred embodiment of the present invention.
  • FIGs. 1A-4 depict one embodiment of a biopsy device in accordance with the present invention.
  • a hollow, cylindrical cannula 10 having a tapered end 12.
  • a solid cylindrical starter trocar 14, having a sharply pointed end 16 and a stop member 18, is insertable into the cannula 10 as indicated by assembly arrow 20.
  • the stop member 18 serves to limit the extent to which the sharply pointed end 16 of the starter trocar 14 extends from the cannula 10, as can be most clearly seen from Fig. lC.
  • a biopsy trocar 22 having cylindrical body portion 24 and a T-handle end 26.
  • the biopsy trocar 24 is insertable into the cannula 10.
  • the end of the body portion 24 opposite the T-handle end 26 is hollow, as shown by the dashed line 28 in Fig. 2A.
  • the cannula 10, starter trocar 14, and biopsy trocar 22 are all fabricated from surgical-grade stainless steel, and can all be used to obtain either hard tissue or soft tissue biopsy specimens.
  • the cartridge assembly 36 includes an elongated clear plastic tubular portion 38 and a stainless steel cutting portion 40.
  • the cutting portion 40 has a serrated cutting edge 42, an external thread 44, a pair of holes 46, and a plurality of scallop retaining members 48.
  • the scallop retaining members 48 which are formed by perforations in the wall of the cutting portion 40, extend inwardly and away from the serrated cutting edge 42. -Thus, they permit a biopsy specimen to easily slide into the cartridge assembly 36, but act to prevent the specimen from sliding out of the cartridge, e.g. , when the biopsy trocar is removed from the bone.
  • the blade/cartridge assembly 36 may be removably attached to the biopsy trocar 24 by inserting the tubular portion 38 into the hollow area 28 and engaging external thread 44 with internal thread 32.
  • the holes 46 facilitate disassembly of the blade/cartridge assembly 36 from the biopsy trocar 24, by permitting a pin (not shown) to be inserted therein to serve as a lever to aid in unscrewing the cartridge assembly from the trocar.
  • a plastic pusher 54 is shown which, in accordance with assembly arrow 56, may be inserted into the cartridge assembly 36 to push out the biopsy specimen.
  • fishscale retaining members 60 may be used as shown in the alternate embodiment of a bone blade/cartridge assembly 62 of in Fig. 5. Except for the use of fishscale retaining members 60 in place of scallop retaining members 48, the bone blade/cartridge assembly 62 corresponds generally to the bone blade cartridge assembly 36, and includes a cutting portion 40', a serrated cutting edge 42', an external thread 44', and a pair of holes 46', all of which correspond respectfully to the elements 40, 42, 44 and 46 of the bone blade/cartridge assembly 36.
  • the fishscale retaining members 60 are formed by machining annular grooves into the interior surface of the cutting portion 40' of the bone blade/cartridge assembly 62. As shown, the fishscale retaining members 60 extend inwardly and away from the serrated cutting edge 42' .
  • FIG. 6 there is a soft-tissue blade/cartridge assembly 66 in accordance with an alternate embodiment of the present invention.
  • the soft-tissue blade/cartridge assembly 66 is generally similar to the bone blade/cartridge assembly 36, and may be threaded into the biopsy trocar 22.
  • the major difference between the bone blade/cartridge assembly 36 and the soft-tissue blade/cartridge assembly 66 is that the former has a serrated cutting edge 42 for sawing through bone, whereas the latter has a sharp knife-like slicing edge 68 for cutting soft tissue.
  • the soft-tissue blade/cartridge assembly 66 includes a clear plastic tubular portion 38" ', an external thread 44'', a pair of holes 46' ' to assist in unscrewing, and a plurality of scallop retaining members 48'", all of which correspond generally to the elements 38, 44, 46 and 48 of the bone blade/cartridge assembly 36.
  • the patient is first properly positioned, a surgical scrub done and, using the proper anesthetic in the proper setting (such as the operating room or clinic), a small incision is made in the skin. Aseptic technique is used throughout the procedures.
  • the starter trocar 14 is first inserted into the cannula 10 with the sharp end 16 of the starter trocar extending from the cannula.
  • the sharp end 16 is then inserted into the incision at the surgical site and gently pushed through the soft tissues until it abuts bone.
  • the cannula 10 is then slipped down over the starter trocar 14 the last few millimeters until it is also abutting bone.
  • a bone blade/cartridge assembly 36 has previously been screwed onto the end of the biopsy trocar 22 opposite the T-handle end 26.
  • the starter trocar 14 is then removed from the cannula 10, and the biopsy trocar 22 inserted down to the bone.
  • the -operator continues to hold the cannula 10 snugly against the bone and removes the biopsy trocar 22 by pulling on the T-handle end 26 and removing it from the bone.
  • gentle clockwise motion may facilitate removal of the biopsy trocar.
  • Counterclockwise motion should be avoided as it potentially could cause the blade/cartridge assembly 36 to unscrew from the biopsy trocar 22.
  • the longitudinal slots 30 in the end of the biopsy trocar 22 permit viewing of the clear plastic tubular portion 38 of the bone blade/cartridge assembly 36 allowing the operator to observe that a tissue specimen has been obtained.
  • the scallop retaining members 48 along the inner surface of the bone blade/cartridge assembly 36 allows the biopsied bone specimen to slide into the cartridge easily; but, because of the shape of the scallop (or fishscale) retaining members, the bone is securely held in the cartridge when the biopsy trocar 22 is pulled out of the bone.
  • the bone blade/cartridge assembly 36, containing the biopsied bone specimen, is then unscrewed from the biopsy trocar 22 and sent to the pathologist with the biopsy tissue intact within the cartridge.
  • the pathologist then inserts the plastic pusher 54 into the serrated cutting edge end (42) of the bone blade/cartridge assembly 36 to remove the biopsy specimen.
  • the pathologist can better understand the normal alignment of the bony tissue which is biopsied.
  • the bone blade/cartridge assembly 36 may then be discarded. By so doing, a new sharp blade is available for use for each biopsy.
  • the same procedure is used for obtaining soft tissue biopsy specimens.
  • the only difference being that the soft-tissue blade/cartridge assembly 66 is used in place of the bone blade/cartridge assembly 36.
  • the soft-tissue blade/cartridge assembly 66 has a sharp cutting or slicing edge 68 instead of a serrated cutting edge 42, making the biopsy of soft tissue easier.

Landscapes

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

Abstract

Un dispositif (22) de biopsie permettant d'obtenir des échantillons de biopsie de tissus durs ou tendres, comprend un trocart (22) de biopsie pouvant être inséré dans une canule, ainsi qu'un support (36) d'échantillon de biopsie amovible, lequel est de préférence fileté dans le trocart de biopsie. Le support d'échantillon comprend de préférence un bord coupant (42) (par exemple, denté pour les tissus durs, tranchant pour les tissus tendres), ainsi que des écailles de poisson ou des dents (48) de rétention maintenant fermement l'échantillon de biopsie. Une fois l'échantillon biopsié coupé des tissus, on peut l'envoyer, dans le support d'échantillon amovible, au pathologiste afin de l'analyser.
PCT/US1990/006268 1989-11-06 1990-10-29 Dispositif de biopsie WO1991006246A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US43213289A 1989-11-06 1989-11-06
US432,132 1989-11-06

Publications (1)

Publication Number Publication Date
WO1991006246A1 true WO1991006246A1 (fr) 1991-05-16

Family

ID=23714892

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1990/006268 WO1991006246A1 (fr) 1989-11-06 1990-10-29 Dispositif de biopsie

Country Status (2)

Country Link
AU (1) AU6722590A (fr)
WO (1) WO1991006246A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0824893A2 (fr) * 1996-08-16 1998-02-25 Arthrex Inc Appareil pour la transplantation d'autogreffes ostéochondrales
US6592588B1 (en) 1995-02-16 2003-07-15 Arthrex, Inc. Apparatus for osteochondral autograft transplantation
US7550007B2 (en) 2005-10-26 2009-06-23 Biomet Sports Medicine, Llc Osteochondral allografts
US8162967B1 (en) 2003-10-16 2012-04-24 Biomet Sports Medicine Llc Method and apparatus for coring and reaming of bone
US8641718B2 (en) 2010-10-19 2014-02-04 Biomet Manufacturing, Llc Method and apparatus for harvesting cartilage for treatment of a cartilage defect
WO2015084881A1 (fr) 2013-12-04 2015-06-11 Trinity Orthopedics, Llc Dispositif de pénétration d'os amovible et procédés
CN111493942A (zh) * 2020-05-28 2020-08-07 中国医科大学 医用全封闭式病理取材装置

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4696308A (en) * 1986-04-09 1987-09-29 The Cleveland Clinic Foundation Core sampling apparatus
US4798213A (en) * 1987-09-09 1989-01-17 Doppelt Samuel H Bone biopsy apparatus
US4873991A (en) * 1988-09-21 1989-10-17 Skinner Bruce A J Biopsy needle

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4696308A (en) * 1986-04-09 1987-09-29 The Cleveland Clinic Foundation Core sampling apparatus
US4798213A (en) * 1987-09-09 1989-01-17 Doppelt Samuel H Bone biopsy apparatus
US4873991A (en) * 1988-09-21 1989-10-17 Skinner Bruce A J Biopsy needle

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5919196A (en) * 1995-02-16 1999-07-06 Arthrex, Inc. Method and apparatus for osteochondral autograft transplantation
US6592588B1 (en) 1995-02-16 2003-07-15 Arthrex, Inc. Apparatus for osteochondral autograft transplantation
EP0824893A3 (fr) * 1996-08-16 1998-04-29 Arthrex Inc Appareil pour la transplantation d'autogreffes ostéochondrales
EP0824893A2 (fr) * 1996-08-16 1998-02-25 Arthrex Inc Appareil pour la transplantation d'autogreffes ostéochondrales
US8162967B1 (en) 2003-10-16 2012-04-24 Biomet Sports Medicine Llc Method and apparatus for coring and reaming of bone
US8882774B2 (en) 2005-10-26 2014-11-11 Biomet Sports Medicine, Llc Instrumentation for the preparation and transplantation of osteochondral allografts
US8523864B2 (en) 2005-10-26 2013-09-03 Biomet Sports Medicine, Llc Instrumentation for the preparation and transplantation of osteochondral allografts
US7550007B2 (en) 2005-10-26 2009-06-23 Biomet Sports Medicine, Llc Osteochondral allografts
US8641718B2 (en) 2010-10-19 2014-02-04 Biomet Manufacturing, Llc Method and apparatus for harvesting cartilage for treatment of a cartilage defect
US9456900B2 (en) 2010-10-19 2016-10-04 Biomet Manufacturing, Llc Method and apparatus for harvesting cartilage for treatment of a cartilage defect
WO2015084881A1 (fr) 2013-12-04 2015-06-11 Trinity Orthopedics, Llc Dispositif de pénétration d'os amovible et procédés
JP2017501782A (ja) * 2013-12-04 2017-01-19 トリニティ・オーソペディックス・リミテッド・ライアビリティ・カンパニーＴｒｉｎｉｔｙ Ｏｒｔｈｏｐｅｄｉｃｓ Ｌｌｃ 着脱式骨穿通装置及び方法
EP3076877A4 (fr) * 2013-12-04 2017-10-18 Trinity Orthopedics, LLC Dispositif de pénétration d'os amovible et procédés
US10292688B2 (en) 2013-12-04 2019-05-21 Trinity Orthopedics, Llc Removable bone penetrating device and methods
CN111493942A (zh) * 2020-05-28 2020-08-07 中国医科大学 医用全封闭式病理取材装置
CN111493942B (zh) * 2020-05-28 2024-06-04 中国医科大学 医用全封闭式病理取材装置

Also Published As

Publication number Publication date
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