WO2006078743A1 - Biopsy forceps - Google Patents

Biopsy forceps Download PDF

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Publication number
WO2006078743A1
WO2006078743A1 PCT/US2006/001775 US2006001775W WO2006078743A1 WO 2006078743 A1 WO2006078743 A1 WO 2006078743A1 US 2006001775 W US2006001775 W US 2006001775W WO 2006078743 A1 WO2006078743 A1 WO 2006078743A1
Authority
WO
WIPO (PCT)
Prior art keywords
grasping members
shaft
biopsy forceps
sheath
biopsy
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.)
Ceased
Application number
PCT/US2006/001775
Other languages
English (en)
French (fr)
Inventor
Vihar C. Surti
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cook Endoscopy
Original Assignee
Wilson Cook Medical Inc
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 Wilson Cook Medical Inc filed Critical Wilson Cook Medical Inc
Priority to AU2006206544A priority Critical patent/AU2006206544B2/en
Priority to DE602006008740T priority patent/DE602006008740D1/de
Priority to CA2595379A priority patent/CA2595379C/en
Priority to AT06718796T priority patent/ATE440552T1/de
Priority to EP06718796A priority patent/EP1838229B1/en
Priority to JP2007552238A priority patent/JP4982699B2/ja
Publication of WO2006078743A1 publication Critical patent/WO2006078743A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2937—Transmission of forces to jaw members camming or guiding means with flexible part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2944—Translation of jaw members

Definitions

  • This invention generally relates to medical devices, and particularly to forceps used for obtaining biopsy samples.
  • Common endoscopic biopsy forceps are formed from a long shaft that extends between a proximal end and a distal end.
  • the proximal end includes an actuator mechanism that a physician uses to control a small pair of biopsy jaws.
  • the jaws are located at the distal end of the biopsy forceps, and are provided with teeth to cut, shear, or tear away tissue samples.
  • the shaft of the biopsy forceps is longer than the endoscope so that the biopsy forceps jaws can extend out of the distal end of the endoscope and reach the target tissue. Shorter biopsy forceps are used to take biopsies from locations where introduction of the biopsy forceps through an endoscope is unnecessary.
  • the foregoing object is obtained by providing a biopsy forceps having a sheath and an inner shaft slidably disposed within the sheath.
  • the shaft has a longitudinal axis defined therethrough and a plurality of grasping members that are movable between an open configuration and a closed configuration. At least one of the plurality of grasping members is biased outwardly from the longitudinal axis when in the open configuration. At least one of the plurality of grasping members is unrestricted by the sheath when in the open configuration and is constrained by the sheath when in the closed configuration.
  • the plurality of grasping members can be formed so that when they are in a closed configuration, they form a receptacle for retaining one or more biopsy samples.
  • One or more of the grasping members may further be provided with a cutting edge to more easily remove a tissue sample.
  • the shaft may be connectable to an electrocautery device. As a result, the shaft may be energized by the electrocautery device to electrosurgically cut the tissue.
  • a method of performing a tissue biopsy is provided. The biopsy forceps can be introduced into a patient such that the grasping members are adjacent a target tissue. The sheath is then actuated, thereby closing the grasping members around the tissue. Once the grasping members are closed around the tissue, the shaft can be retracted to remove a portion of the target tissue. This procedure can be repeated to take multiple tissue biopsies. BRIEF DESCRIPTION OF THE DRAWINGS
  • Figure 1 is a perspective side view of a biopsy forceps head according to an embodiment of the present invention.
  • Figure 2 is a side view of a biopsy forceps head and a handle
  • Figure 3 A is a cross-sectional view of a biopsy forceps head according to an embodiment of the present invention showing an open configuration taken along line 3 — 3 of Figure 2;
  • Figure 3B is an end view of the embodiment shown in Figure 3A in a closed configuration having rectangularly shaped edges;
  • Figure 3C is an end view of an alternative embodiment of the embodiment shown in Figure 3 A in a closed configuration having triangularly shaped edges;
  • Figure 4 is a flow-chart of a method of using a biopsy forceps according to one embodiment of the present invention.
  • Figure 5 is a side view of a biopsy forceps according to an embodiment of the present invention.
  • Figure 6 is a cross-sectional front view of a biopsy forceps head according to an embodiment of the present invention.
  • Figure 7 is an end view of a biopsy forceps head according to an embodiment of the present invention.
  • Figure 8 A is an end view of an embodiment in the closed configuration having two grasping members with rectangularly shaped edges;
  • Figure 8 A is an end view of an embodiment in the closed configuration having two grasping members with curved edges;
  • Figure 8 A is an end view of an embodiment in the closed configuration having two grasping members with triangularly shaped edges.
  • the medical device 10 includes a catheter 11 having a distal end 12.
  • the distal end 12 includes an inner shaft 16 and grasping members 26 extending from a distal end 17 of the shaft 16.
  • a longitudinal axis A is defined through the shaft 16 as shown in Figures 1 and 2.
  • the grasping members 26 are biased outwardly relative to the longitudinal axis A in an open configuration.
  • the distal end 12 further includes an outer sheath 18 having a lumen 19 defined therein.
  • the shaft 16 is slidably received in the sheath 18 ( i.e., within the lumen 19).
  • the shaft 16 may be slidable relative to the sheath 18 so that the shaft 16 may be retracted at least partially into the sheath 18 to cam the grasping members 26 into a closed, contracted configuration.
  • a conventional handle 40 (shown in Figure 2) may be operably connected to a proximal end 36 of the catheter 11. The handle 40 may be used to control the movement of the shaft 16 relative to the sheath 18 and to control the movement of the grasping members 26 between the open configuration where the grasping members 26 are biased outwardly and the closed configuration where the grasping members 26 are cammed together.
  • the distal end 12 of the catheter 11 includes the inner shaft 16, grasping members 26 and the sheath 18.
  • three grasping members 26 may extend from the shaft 16, although two, three, four, five or more grasping members 26 are possible, as will be understood by one skilled in the art.
  • the grasping members 26 include a proximal portion 27 connected to the distal portion 17 of the shaft 16 and a distal portion 28 extending distally.
  • the grasping members 26 are shown having a curvilinear profile in the open configuration where the distal portion 28 is biased away from the longitudinal axis A ( Figure 1) and a substantially straight profile in the closed configuration ( Figure 5).
  • Alternative profiles for the grasping members are also possible including bent profiles and the like.
  • the grasping members 26 may extend from the distal portion 17 of the shaft 16 and be formed by unitary construction with the shaft 16 from a single elongate member such as a tube described below.
  • the grasping members 26 and the shaft 16 may be formed from different components and connected together.
  • the proximal portions 27 of the grasping members 26 formed separately and may be connected to the shaft 16 at the distal portion 17 of the shaft 16, extending at an angle outward from the longitudinal axis A.
  • the grasping members 26 may have a straight profile or a curvilinear or bent profile and the like.
  • the grasping members 26 include an outer surface 31 that can be seen in Figure 2.
  • One or more of the grasping members 26 may be provided with a distal edge 32.
  • the distal edge 32 may be bent inwardly relative to the grasping member 26 and toward the longitudinal axis A, as shown in Figure 2.
  • the distal edge 32 may be bent at a 90° angle with respect to the grasping member 26.
  • the distal edge 32 may be adapted for shearing, grasping, tearing, or cutting tissue.
  • the edge 32 may further include a blade portion 33 having a cutting surface.
  • the edge 32 and blade portion 33 may be formed in any shape and configuration, including, but not limited to, a single blade or cutting surface, a crenate tooth configuration, straight, angular or curved.
  • FIGS 3A-C illustrate an embodiment having three grasping members.
  • Figure 3A shows a cross-sectional view of the open configuration.
  • Figure 3B shows an end view having distal edges 32 with a rectangularly shaped portions that overlap in the closed configuration.
  • Figure 3C shows an alternatively shaped distal portion 28 having triangularly shaped distal edges 32 that overlap in the closed configuration.
  • the embodiments shown in Figures 3B and 3C may also include the blade 33 on the distal edge 32. End views for alternative embodiments having two grasping members with alternatively shaped distal edges 32 are shown in Figures 8A-8C.
  • the distal edges 32 may be formed by removing material from the distal edge 32 to appropriately size and shape the edge 32 for fitting together, for example when the distal edge 32 is formed by bending a portion of the distal portion 28 of the grasping member 26 toward the longitudinal axis A.
  • the blade 33 may be sized and shaped to fit together similarly to the distal edge 32.
  • the distal edge 32 or the blade 33 or both may be formed by adding material to the distal portion 28 of the grasping members 26 in the desired size and shape.
  • the distal edges 32 may be sized and shaped to overlap each other as shown in Figures 5 and 7.
  • the opposite pairs of distal edges 32 may meet together with one pair extending further distally than the other pair so that the pairs overlap.
  • each distal edge 32 or blade 33 may overlap in the closed configuration, for example where three grasping members 26 are included with the device 10, the distal edges 32 may be triangularly shaped and overlap each other to fo ⁇ n a generally triangularly shaped end of the receptacle, shown in end view in the closed configuration of Figure 3B.
  • the edge 32 and the blade 33 may be formed so that in the closed configuration, the sample may be held within the chamber formed by the grasping members 26 and the edges 32 that meet or overlap in the closed configuration.
  • the edges 32 may be blunt or may include blades 33 to remove the tissue sample from the patient.
  • the grasping members 26 may be curved around the longitudinal axis A to form a generally annular profile similar to shaft 16 when the shaft 16 is a cylindrically shaped cross section.
  • the shaft 16 and the sheath 18 may also have alternatively shaped cross-sectional shapes, including polygonal and oval, and the like.
  • the distal portion 28 of the grasping members 26 may be flattened with the distal edges 32 being rectangularly shaped as shown in Figure 2.
  • the grasping members 26 may be relatively wide.
  • the grasping members 26 may be used to capture a tissue sample within a chamber or receptacle formed by the grasping members 26 when the grasping members 26 are cammed together in the closed configuration.
  • Longitudinal edges 29 of the grasping members 26 may be sized and shaped such that the longitudinal edges 29 of adjacent grasping members meet or are in proximity to form the chamber to hold the tissue sample when the device 10 is in the closed configuration.
  • An example of the closed configuration is shown in Figure 5.
  • the configurations described above may allow the edges 32 to firmly grasp and cut or tear the tissue to be biopsied and may prevent the tissue sample from dislodging from the device 10.
  • the grasping members 26 and the shaft 16 may be formed from resilient materials known to one of skill in the art. Any elastic material that can retain bending stresses and resiliently return to its preformed shape may be used.
  • metal may be used to form the device 10 or components thereof. Exemplary metals include stainless steel or an alloy having superelastic properties such as nitinol (NiTi).
  • the shaft 16 and the grasping members 26 may be formed from a single piece of stainless steel tubing.
  • a conventional programmable laser cutter can be programmed to laser-cut the tubing into the desired configuration. The laser cutter may be programmed to cut the desired shape repeatedly from a single length of tubing.
  • the laser cutter may similarly be programmed to cut the shaft 16 to form any number of grasping members 26 (e.g., two, three, four, five, six, or more grasping members).
  • the grasping members 26 may be welded or otherwise attached to the shaft 16 using techniques known to one skilled in the art.
  • the grasping members 26 may be equally sized and shaped, or the grasping members 26 may be differently sized and shaped, for example, alternating between wider and narrower grasping members 26 or longer and shorter pairs of grasping members 26.
  • the laser cutter may also be used to form the distal edges 32 and the blades 33 into any desired size and shape, for example, by removing a portion of material of the edges 32.
  • the sheath 18 may be slidably disposed over a portion of the shaft 16 to constrain the grasping members 26.
  • the sheath 18 may slide relative to the shaft 16 to engage at least a portion of the outer surface 31 of the grasping members 26 to constrain the grasping members 26 in the closed configuration.
  • the sheath 18 may slide a distance between about 2 millimeters and 10 millimeters relative to the shaft 16, although a person of ordinary skill could alter the distance that the sheath 18 slides relative to the shaft 16.
  • the sheath 18 may cam the grasping members 26 into a closed configuration and constrain the grasping members 26.
  • the shaft 16, the sheath 18 or both may include a portion having a thin layer of lubricious material, such as polytetrafluoroethylene (PTFE) on surfaces that may contact each other, including the outer surface 31 of the grasping members 26. Sliding the sheath 18 in relation to the shaft 16 causes the grasping members 26 and the edges 32 to firmly grasp and cut, shear, or tear the tissue to be biopsied.
  • PTFE polytetrafluoroethylene
  • the closed configuration with the sheath 18 slidably disposed over at least a portion of the grasping members 26 in the closed configuration may also allow for a narrower configuration for easy of delivery through a medical device, such as the working channel of an endoscope.
  • a medical device such as the working channel of an endoscope.
  • the overall size and shape of the device 10 will depend on the location in which the device 10 will be used.
  • Operation of the biopsy forceps device 10 may be performed by any means known to one skilled in the art.
  • remote operation of the biopsy forceps device 10 may be controlled via a handle 40 at the proximal end 36 ( Figure 2, showing an enlarged distal portion 12).
  • the handle 40 may be a thumb ring, a scissors-type handle, a pin vise, or any other conventional handle suitable for moving a sheath relative to a control wire or shaft.
  • the handle 40 may also be connected to a control wire which is connected to the shaft 16 or the sheath 18.
  • the handle 40 is used to actuate the control wire, which in turn controls the movement of one of the shaft 16 or sheath 18 in relation to the other.
  • the handle 40 may be used to maneuver the biopsy forceps device 10.
  • An electrical connector may be provided to energize the shaft 16 and grasping members 26 of the device 10.
  • the electrical connector may conveniently form a male plug, which receives an electrical cord (sometimes called an 'active cord').
  • the electrical cord is connectable to a standard electrosurgical generator, such as those manufactured by Valleylab, Inc. (Boulder, CO).
  • a physician via the generator, controls whether current is applied to the device 10, typically using a foot pedal to electrify the control wire and ablate tissue coming in contact with the stem, grasping members, or cutting edges. This allows a physician to cut or cauterize bleeding tissues with the shaft 16, grasping members 26, or cutting edges 32.
  • the biopsy forceps device 10 may be operably connected to an infusion source or a suction source.
  • a suction device such as a vacuum or a syringe may be connected to the shaft 16 to assist in tissue removal or general fluid removal around the biopsy site.
  • the suction source may also be used to pull the biopsy sample back into the shaft 16 for removal or for taking multiple biopsy samples.
  • the biopsy forceps device 10 may be operably connected to an infusion source such as a syringe or a pump to provide fluid to the biopsy site through the shaft 16.
  • an infusion source such as a syringe or a pump to provide fluid to the biopsy site through the shaft 16.
  • saline, dye or medication may be infused through the shaft 16 to the biopsy site.
  • Alternative lumens may be provided in the biopsy device 10 in addition to the shaft 16 to provide infusion or suction as needed.
  • Any infusion device or suction source known to one skilled in the art may be operably connected to the biopsy device 10.
  • Figure 4 illustrates one method of utilizing the present invention to remove a biopsy sample from a target tissue. As illustrated in step 80, the target tissue is located, for example by using an endoscope.
  • the biopsy forceps device 10 may be delivered to the target tissue, for example, by introducing the biopsy forceps device 10 through the working channel of the endoscope as illustrated in step 84. Alternatively the device 10 may be delivered to the tissue at the same time the tissue is being located. When the target tissue is located, the device 10 may be advanced toward the target biopsy tissue until the cutting edges 32 and/or the grasping members 26 are in contact with the target biopsy tissue, as shown in step 88.
  • a physician may manipulate the handle so as to slide either the shaft 16 or the sheath 18 to manipulate the grasping members 26 into position and then cam the grasping members 26 at least partially into the sheath 18 to move the grasping members 26 into the closed configuration, thereby grasping the targeted biopsy tissue, as shown in step 92.
  • the physician may energize the grasping members 26 and shaft 16 with the energizing source, or simply tear, shear, or cut off a biopsy sample by pulling the device 10 away from the tissue, as shown in step 96.
  • the physician may take additional samples of the target tissue by repeating steps 88-96, as illustrated by step 98. Once the desired number of biopsy samples is taken, the physician can withdraw the device 10 and retrieve the biopsy sample for analysis, as shown in step 100.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Biodiversity & Conservation Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)
  • Photoreceptors In Electrophotography (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)
PCT/US2006/001775 2005-01-20 2006-01-19 Biopsy forceps Ceased WO2006078743A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
AU2006206544A AU2006206544B2 (en) 2005-01-20 2006-01-19 Biopsy forceps
DE602006008740T DE602006008740D1 (de) 2005-01-20 2006-01-19 Biopsiezange
CA2595379A CA2595379C (en) 2005-01-20 2006-01-19 Biopsy forceps
AT06718796T ATE440552T1 (de) 2005-01-20 2006-01-19 Biopsiezange
EP06718796A EP1838229B1 (en) 2005-01-20 2006-01-19 Biopsy forceps
JP2007552238A JP4982699B2 (ja) 2005-01-20 2006-01-19 生検鉗子

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US64610405P 2005-01-20 2005-01-20
US60/646,104 2005-01-20

Publications (1)

Publication Number Publication Date
WO2006078743A1 true WO2006078743A1 (en) 2006-07-27

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ID=36177328

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2006/001775 Ceased WO2006078743A1 (en) 2005-01-20 2006-01-19 Biopsy forceps

Country Status (8)

Country Link
US (1) US20060178699A1 (enExample)
EP (1) EP1838229B1 (enExample)
JP (1) JP4982699B2 (enExample)
AT (1) ATE440552T1 (enExample)
AU (1) AU2006206544B2 (enExample)
CA (1) CA2595379C (enExample)
DE (1) DE602006008740D1 (enExample)
WO (1) WO2006078743A1 (enExample)

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USRE46855E1 (en) 2009-06-26 2018-05-22 Orthovita, Inc. K-wire and method for surgical procedures
USRE46872E1 (en) 2009-06-26 2018-05-29 Orthovita, Inc. Guidewire and method for surgical procedures
SE1751639A1 (en) * 2017-12-22 2019-06-23 Multi4 Ab An endosurgical device
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US7811282B2 (en) 2000-03-06 2010-10-12 Salient Surgical Technologies, Inc. Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
US6558385B1 (en) 2000-09-22 2003-05-06 Tissuelink Medical, Inc. Fluid-assisted medical device
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CN102573622B (zh) 2009-08-03 2016-01-27 沙丘医疗设备有限公司 用于对受试者进行测量的电磁传感器
EP2461755A4 (en) 2009-08-03 2017-07-12 Dune Medical Devices Ltd. Surgical tool
WO2011123342A1 (en) * 2010-03-29 2011-10-06 Cook Medical Technologies Llc Device and method for positioning an implanted structure to facilitate removal
WO2013168498A1 (ja) * 2012-05-10 2013-11-14 オリンパスメディカルシステムズ株式会社 内視鏡用処置具
US9301738B2 (en) 2013-05-14 2016-04-05 Donald R. Waxler Tissue sample securement and extraction apparatus and method
KR101652477B1 (ko) * 2014-12-02 2016-08-31 주식회사 인코아 자궁경부 조직적출기용 니들
US20160354101A1 (en) * 2015-06-02 2016-12-08 Cook Medical Technologies Llc Laparoscopic medical device assembly with detachable end effector, and method of using same
KR102030376B1 (ko) 2017-09-25 2019-10-11 재단법인대구경북과학기술원 돌출 블레이드와 흡입 수단을 구비한 내시경용 생검 모듈
US20200345382A1 (en) * 2019-05-01 2020-11-05 Bibianna Cha Inline cutter for cutting and retrieving implanted microsurgical devices
CN111481304B (zh) * 2020-05-09 2024-08-09 南微医学科技股份有限公司 一种三臂夹
JPWO2022191076A1 (enExample) * 2021-03-08 2022-09-15
JP7619880B2 (ja) * 2021-04-26 2025-01-22 朝日インテック株式会社 穿刺デバイス
CN120477835B (zh) * 2025-05-22 2025-10-17 中国医学科学院阜外医院 一种旋切式心肌活检钳

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ATE440552T1 (de) 2009-09-15
JP4982699B2 (ja) 2012-07-25
CA2595379A1 (en) 2006-07-27
JP2008528109A (ja) 2008-07-31
EP1838229B1 (en) 2009-08-26
CA2595379C (en) 2011-10-11
AU2006206544A1 (en) 2006-07-27
US20060178699A1 (en) 2006-08-10
EP1838229A1 (en) 2007-10-03
AU2006206544B2 (en) 2010-08-26
DE602006008740D1 (de) 2009-10-08

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