WO2006064532A1

WO2006064532A1 - Biopsy instrument, particularly for uterine cavity

Info

Publication number: WO2006064532A1
Application number: PCT/IT2005/000740
Authority: WO
Inventors: Valentino Miranda
Original assignee: Valentino Miranda
Priority date: 2004-12-17
Filing date: 2005-12-16
Publication date: 2006-06-22
Also published as: ITNA20040071A1

Abstract

The present invention relates essentially to forceps (P) for cutting and taking at the same time small samples of tissue (9) to be subjected to histologic test, for example, from the uterine cavity.

Description

Biopsy instrument, particularly for uterine cavity

The present invention relates essentially to forceps for cutting and taking at the same time small samples of tissue to be subjected to histologic test, for example, from the uterine cavity. The finding is particularly indicated for gynaecological study but can be used without essential modifications in all endoscopic removals. It does not save the trouble of the tested subject but certainly halves the time of execution by the physicians involved in such diagnostics and then reduces the discomfort of the patient.

The conceiving of the surgical instrument of the present invention comes from the difficulty arising sometimes upon taking a fragment for biopsy from an atrophic or sclerotic endometrial tissue during a hysteroscopy test .

Such a difficulty is now overcome by carrying out after the endoscopy test an endocavity removal blindly by Novak's cannula, or an endocavity aspiration by pipets, or as it often occurs a cavity revision by courette after having expanded the cervical channel . The result is that in addition to the discomfort of the patient subjected to endoscopic test during an out-patient operation that does not require any anaesthesia, the need is often added to pass into surgery which requires for the patient to be anaesthetised with the relevant known risks and complications. The professional competence showed up that the use of traditional methods of exploring the uterine cavity by an endoscope provided with a conduit with a diameter of some millimetres through which several surgical instruments (such as biopsy forceps or scissors to cut the tissue to be subjected to test that shall then be replaced by other forceps to take the cut fragment) can be guided, causes discomfort to the patients as the described method requires a relative long execution time.

The presently known biopsy forceps often do not allow tissue fragments useful for the test to be taken. The acquired experience has brought to an instrument essentially consisting of innovative forceps allowing the sample of tissue to be cut and removed at the same time without the need for the instrument to be replaced, thus providing a considerable reduction in the operation time. According to the invention such forceps allow the operators to carry out the test with safety and precision; moreover, the time for the operation and the removal of the sample are cut by half. The ^" main object of the present invention is to overcome the problems mentioned above by providing an instrument for taking tissue samples which is provided with cutting means in distal position able to cut and excise a strip of tissue to be removed as well as means for seizing the strip of tissue. This has been accomplished according to the present invention by providing a surgical instrument including essentially three main portions: manipulator M, forceps P with at least three cavities and cutting means, rod S preferably equipped with ring G to rotate the forceps. The latter feature allows the operator not to rotate the whole instrument in case a sample placed asymmetrically with respect to the cutting means should be taken.

A better understanding of the invention will result from the following detailed description with reference to the accompanying drawings that show a preferred embodiment thereof only by way of a not limiting example. In the drawings:

Figure IA shows the forceps in opened condition;

Figures IB and 1C are details of figure 1;

Figures 2A shows the removal of a sample according to the invention;

Figure 2B shows a section view of the forceps with a sample in its interior;

Figure 3 is a perspective view of the whole instrument; and

Figure 4 is a cut-away view of the finding and its inside members.

Manipulator M of the instrument according to the present invention accomplishes two basic operations, i.e. guiding the instrument of the invention into the endoscopic conduit so as to reach the portion to be tested, and operating the forceps for cutting and taking the tissue by a suitable lever or trigger 13. Such manipulator is connected to one end of rod S consisting of a hollow pipe in the interior of which a thin connecting rod slides to ensure the transmission of the movement from the lever of the manipulator and forceps. Ring G placed on manipulator M allows the operator to rotate only forceps P instead of the whole instrument, in case the position of the end taking the sample should be corrected.

The forceps, the basic portion of the finding, has the following specific peculiarity: it consists of two main components, one is fixed, the second is hollow and mobile, the former consists of a thin sheet having a cutting edge at its distal end which consist of three blades in the embodiment shown: one central blade 4 and two side blades 9 and 11 that allow the operator to cut and excise the strip of tissue to be tested by a hand traverse of the whole forceps impressed by the operator to the longitudinal direction. In this way, the cut strip slips into a cavity formed in fixed portion 6 of forceps P. Hinged at the upper end of the hollow portion of forceps P is a second blade 2 which is able to excise the fragment to be sampled by operating lever 13 of manipulator M because of its lowering like a guillotine without leaving hanging appendages.

Figure 1 shows the details of the forceps which include essentially a rod S with a suitable length

(some decimetres) the distal end of which is fixed to fixed lower portion 6 of forceps P. Inside surface 5 of this fixed portion 6 is preferably shaped like a gutter to receive and guide the strip of tissue 9 which is removed by horizontal blade 4 and side blades 9 and 11.

Thus, the operator can excise the cut strip 9 by operating lever 13 which transmits a movement by an articulated joint 21 to the transmission bar 50-50', and controls the movement of second blade 2 which is hinged to fixed lower portion 6 of forceps P by a hinge consisting of support 7 and pin 8, thus causing second upper mobile blade 2 to lower like a guillotine and to excise previously cut strip 9 by its cutting edge.

According to a peculiar feature of the invention, cutting edge 3 of upper mobile blade 2 slips into a suitable abutting groove 10 arranged near the distal edge of fixed portion 6 of forceps P in order to excise the base of fragment 9 to be tested by a sharp cut.

Figure IB shows a section of the forceps in closed condition. Figure 1C is a top view showing the location of horizontal blade 4 and side blades 9 and 11 formed in fixed lower portion 6 of forceps P.

Figure 2B shows a section view of the closed forceps including the removed sample 9.

Thus, the taking system of sample 9 is self-evident. Sample 9 to be removed is provided by applying a light pressure by the handle of manipulator M which is integral with fixed lower portion 6, thus causing horizontal front blade 4 and side blades 9 and 11 to cut the strip of tissue 9 of interest. As the cut fragment 9 is guided by concave portion 5 of forceps P, it is correctly positioned such as to be ready to be excised into the cavity formed in upper mobile portion 2 of forceps P. Figure 3 shows a perspective view of the finding in which there is shown a sleeve or ring G to rotate forceps P including a rotating portion 22 integral with rod S which supports forceps P at the distal end of the latter. Such rotating portion 22 of ring G is provided with a roller bearing 23 which causes it to rotate with respect to a fixed ring 24 secured to handle M. Such rotation causes forceps P to rotate by ring G, thus allowing the operator to turn only forceps and not the whole instrument. Figure 4 shows a cat-away view of the instrument showing up its components.

Handle M allows the operator to accomplish all necessary movements. Connected thereto is a lever or trigger 13 which transmits the movement to the upper mobile portion 2 of forceps P by the aid of a proximal articulated joint 2 and a bar 50-50' inside rod S, thus allowing the forceps to be opened or closed (i.e. raised or lowered) .

Components 22-24 of ring G, as already described above, causes forceps P to rotate. Still in figure 4 a turntable joint 25 can be seen having the function to cause motion transmission bar 50-50' to rotate as forceps P is turned.

The hitherto disclosed surgical instrument is integrally made of antiallergic stainless metals and can be dipped into liquid substances or autoclave to be sterilized.

At last, it is suitable that the instrument of the finding has an essentially rounded outside shape such as not to cause damages if it accidentally would hit some body wall as it is slipped into it in closed condition.

As an alternative to the three (horizontal 4 and side

9 and 11) blades of fixed portion 6 of forceps P it is obviously possible to provide only one curved cutting edge. In this case, also cutting edge 3 of upper mobile blade 2 is correspondingly curved.

The present invention has been described and illustrated according to a preferred embodiment thereof, however, it is self-evident that anyone skilled in the art can make technically and functionally equivalent modifications and/or replacement without departing from the scope of the present industrial invention.

Claims

1. A surgical instrument for removing tissue samples (9) , characterized in that there is essentially- provided a proximal manipulator (M) and distal forceps

(P) provided with cutting/excising means (2, 4, 9, 11) and housing means for the cut and excised tissue strip (9) .

2. The instrument according to the preceding claim, characterized in that there is provided a rotation means (G) of forceps (P) able to allow the operator to rotate the forceps with respect to manipulator (M) .

3. The instrument according to claim 1 or 2, characterized in that said manipulator (M) and said forceps (P) are connected longitudinally, a rod (S) being provided which is interposed between said manipulator and forceps.

4. The instrument according to claim 1, characterized in that forceps (P) has such a size as to allow it to be slipped into an endoscopic conduit.

5. The instrument according to claim 1, characterized in that manipulator (M) is provided with a lever or trigger (13) to operate cutting/excising means (2, 4, 9, 11) of forceps (P) .

6. The instrument according to claim 2, 3 and 5, characterized in that said rod (S) consists of a pipe inside which a connecting bar (50, 50') slides for the transmission of the motion from lever (13) of s manipulator (M) to forceps (P) .

7. The instrument according to claim 1, characterized in that forceps (P) consist of a fixed portion (6) and a mobile hollow portion (2) , fixed portion (6) o consisting essentially of a thin sheet having a cutting edge at its distal end which preferably consist of three adjacent blades: one central blade (4) and two side vertical blades (9 and 11) that allow the operator to cut and excise the strip (9) of tissue 5 to be tested by a hand traverse of the whole forceps (P) impressed by the operator to the longitudinal direction.

8. The instrument according to the preceding claim, 0 characterized in that inside surface (5) of fixed portion (6) of forceps (P) is shaped like a gutter to receive and guide the strip of tissue (9) which is removed by horizontal blade (4) and side blades (9 and 11) • 5

9. The instrument according to claim 7 or 8, characterized in that said mobile portion (2) of forceps (P) is hinged at the upper side of fixed portion (6) and is able to excise the fragment of 0 tissue (9) to be removed because of its lowering like a guillotine without leaving hanging appendages.

10. The instrument according to claims 7 and 9, characterized in that the movement for excising the strip of tissue (9) is given by operating lever (13) which transmits a movement by an articulated joint (21) to the transmission bar (50-50'), and controls the movement of second blade (2) which is hinged to fixed lower portion (6) of forceps (P) by a hinge consisting of support (7) and pin (8) , thus causing second upper mobile blade (2) to lower like a guillotine and to excise previously cut strip (9) by its cutting edge (3) .

11. The instrument according to the preceding claim, characterized in that cutting edge (3) of upper mobile blade (2) slips into a suitable abutting groove (10) arranged near the distal edge of fixed portion (6) of forceps (P) in order to excise the base of fragment of tissue (9) by a sharp cut.

12. The instrument according to claims 2 and 3, characterized in that ring (G) for guiding forceps (P) includes a rotating portion (22) integral with rod (S) supporting forceps (P) at its distal end, which rotating portion (22) is provided with a roller bearing (23) which causes it to rotate with respect to a fixed ring (24) secured to handle (M) .

13. The instrument according to any preceding claim, characterized in that it is integrally made of antiallergic stainless metals and can be dipped into liquid substances or autoclave to be sterilized.

14. The instrument according to any preceding claim, characterized in that the instrument has an essentially rounded outside shape such as not to cause damages if it accidentally would hit some body wall as forceps (P) is slipped into it in closed condition.

15. A surgical instrument for removing tissue samples as essentially disclosed and shown in the present description and the accompanying drawings.