BIOPSY DEVICE WITH APERTURE ORIENTATION AND IMPROVED TIP
20220125417 · 2022-04-28
Assignee
Inventors
- Martin V. Shabaz (Lake Forest, CA, US)
- Richard L. Quick (Mission Viejo, CA, US)
- Frank R. Louw (Carlsbad, CA, US)
- Paul Lubock (Monarch Beach, CA, US)
- Jason H. Safabash (Alison Viejo, CA, US)
Cpc classification
A61B10/0275
HUMAN NECESSITIES
A61B17/32053
HUMAN NECESSITIES
A61B2010/0208
HUMAN NECESSITIES
A61B10/0283
HUMAN NECESSITIES
A61B17/3417
HUMAN NECESSITIES
International classification
Abstract
A biopsy device for accessing and collecting multiple tissue specimens includes a probe component and a drive component. The probe component includes a probe housing that fits within a housing cover, an elongated distal shaft with a tubular section proximal to a penetrating distal tip, an elongated tissue cutting member, and a first probe gear. The tubular section having an inner lumen, an open tissue receiving aperture, and a proximal extremity configured to be operatively connected to the drive component. The elongated distal shaft secured to the probe housing. The elongated tissue cutting member is slidably disposed within the tubular section. The elongated tissue cutting member having at least one tissue cutting edge and a cutting member inner lumen extending therein. The drive component has a first driver motor and a first driving gear configured to drive the first probe gear in order to orient the open tissue receiving aperture.
Claims
1-69. (canceled)
70. A biopsy device for accessing and collecting multiple tissue specimens from a target site within a patient, comprising: a probe component comprising: a housing cover, a probe housing having a longitudinal axis extending in a proximal direction and a distal direction, the probe housing configured to fit within the housing cover, an elongated distal shaft having a penetrating distal tip, a tubular section proximal to the penetrating distal tip, an inner lumen extending within the tubular section, an open tissue receiving aperture in the tubular section configured to provide access to tissue at the target site, and a proximal extremity configured to be operatively connected to a drive component, the elongated distal shaft secured to the probe housing, an elongated tissue cutting member configured to be slidably disposed within the tubular section, the elongated tissue cutting member having at least one tissue cutting edge and a cutting member inner lumen extending therein, and a first probe gear; and the drive component configured to receive a proximal portion of the probe component in an operational relationship, the drive component configured to interfit with the housing cover, the drive component comprising: a first driver motor, and a first driving gear configured to engage the first probe gear to rotate the probe housing in order to orient the open tissue receiving aperture, wherein the probe housing is interposed between the housing cover and the drive component.
71. The biopsy device of claim 70, wherein the probe component further comprising a second probe gear configured to be rotated, and the drive component further comprising: a second driver motor, and a second driving gear configured to engage the second probe gear to drive the elongated tissue cutting member longitudinally within the inner lumen of the tubular section to cut tissue extending through the open tissue receiving aperture.
72. The biopsy device of claim 71, wherein the probe component further comprising a third probe gear configured to be rotated, and the drive component further comprises a third driver motor configured to rotate the third probe gear, the third probe gear configured to rotate the elongated tissue cutting member within the tubular section.
73. The biopsy device of claim 72, wherein the second driver motor and the third driver motor are operable together so that the third driver motor is configured to rotate the elongated tissue cutting member within the tubular section as second driver motor is configured to move the elongated tissue cutting member longitudinally within the inner lumen of the tubular section.
74. The biopsy device of claim 73, wherein the third driver motor is configured to oscillate the elongated tissue cutting member within the tubular section as the elongated tissue cutting member moves longitudinally therein.
75. The biopsy device of claim 71, wherein the drive component further comprises: a cutter traverse nut connected to the second probe gear, a cutter screw threadably connected to the cutter traverse nut, the cutter screw having a distal end provided with a recess, and a cutter shuttle having a rib, the recess is configured to receive the rib of the cutter shuttle the cutter shuttle being secured to the elongated tissue cutting member.
76. The biopsy device of claim 75, wherein the second driver motor is configured to rotate the second probe gear that is configured to rotate the cutter traverse nut, the second probe gear configured to adjust a relative axial position of the cutter screw with respect to the cutter traverse nut.
77. The biopsy device of claim 75, wherein the drive component is configured to longitudinally move the cutter shuttle via rotation of the cutter screw, and the cutter shuttle is configured to move the elongated tissue cutting member longitudinally.
78. The biopsy device of claim 75, wherein the cutter traverse nut comprises an internal thread configured to threadably engage an external thread of the cutter screw.
79. The biopsy device of claim 70, wherein the first driver motor is configured to rotate the tubular section in discrete steps about the longitudinal axis thereof.
80. The biopsy device of claim 70, wherein the housing cover, the probe housing, the elongated distal shaft, the elongated tissue cutting member, and the first probe gear are arranged coaxially along the longitudinal axis of the probe component.
81. A probe component of a biopsy device for accessing and collecting multiple tissue specimens from a target site within a patient, comprising: a housing cover, a probe housing having a longitudinal axis extending in a proximal direction and a distal direction, the probe housing configured to fit within the housing cover, a cannula having a cannula inner lumen extending proximally from a closed tissue penetrating distal tip, the cannula having an open tissue receiving aperture configured to provide access to tissue at the target site, and a proximal extremity configured to be operatively connected to a drive component, the cannula secured to the probe housing, an elongated tissue cutting member coaxially arranged within the cannula inner lumen, the elongated tissue cutting member having at least one tissue cutting edge and a cutting member inner lumen extending therein, and a first probe gear arranged coaxially with the cannula, the first probe gear configured to be driven by the drive component to rotate the probe housing to control an angular position of the open tissue receiving aperture.
82. The probe component of claim 81, wherein the closed tissue penetrating distal tip has a plurality of concave surfaces annularly arranged to form at least three adjacent pairs of concave surfaces.
83. The probe component of claim 81, further comprising a second probe gear configured to be rotated by the drive component, the second probe gear is configured to move the elongated tissue cutting member longitudinally.
84. The probe component of claim 83, further comprising a third probe gear configured to be rotated by the drive component, the third probe gear configured to rotate the elongated tissue cutting member within the tubular section.
85. The probe component of claim 84, wherein the second probe gear and the third probe gear are operable together so that the probe component is configured to rotate the elongated tissue cutting member about the longitudinal axis of the probe component and to move the elongated tissue cutting member longitudinally simultaneously.
86. The probe component of claim 81, wherein the housing cover, the probe housing, the cannula, the elongated tissue cutting member, and the first probe gear are arranged coaxially along the longitudinal axis of the probe component.
87. A biopsy device for accessing and collecting multiple tissue specimens from a target site within a patient, comprising: a probe component comprising: a housing cover, a probe housing having a longitudinal axis extending in a proximal direction and a distal direction, the probe housing configured to fit within the housing cover, an elongated distal shaft having a closed penetrating distal tip, a tubular section proximal to the closed penetrating distal tip, an inner lumen extending within the tubular section, an open tissue receiving aperture in the tubular section configured to provide access to tissue at the target site, and a proximal extremity configured to be operatively connected to a drive component, the elongated distal shaft secured to the probe housing, an elongated tissue cutting member which is slidably disposed within the tubular section, the elongated tissue cutting member having at least one tissue cutting edge and a cutting member inner lumen extending therein, a first probe gear, and a second probe gear; the drive component configured to receive a proximal portion of the probe component in an operational relationship, the drive component configured to interfit with the housing cover, the drive component comprising: a first driver motor, a first driving gear configured to engage the first probe gear to rotate the probe housing in order to orient the open tissue receiving aperture, a second driver motor, and a second driving gear configured to engage the second probe gear to drive the elongated tissue cutting member longitudinally within the inner lumen of the tubular section to cut tissue extending through the open tissue receiving aperture, wherein the probe housing is interposed between the housing cover and the drive component.
88. The biopsy device of claim 87, wherein the closed tissue penetrating distal tip has a plurality of concave surfaces annularly arranged to form at least three adjacent pairs of concave surfaces.
89. The biopsy device of claim 87, wherein the drive component further comprises: a cutter traverse nut connected to the second probe gear, a cutter screw threadably connected to the cutter traverse nut, the cutter screw having a distal end provided with a recess, and a cutter shuttle having a rib, the recess is configured to receive the rib of the cutter shuttle the cutter shuttle being secured to the elongated tissue cutting member, wherein the second driver motor is configured to rotate the second probe gear that is configured to rotate the cutter traverse nut, the second probe gear configured to adjust a relative axial position of the cutter screw with respect to the cutter traverse nut, wherein the cutter shuttle is configured to move the elongated tissue cutting member longitudinally.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION
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[0045] The probe component 11 generally includes an elongated distal shaft 14 having a tubular section or cannula 15 with a tissue penetrating tip 16 on the distal end thereof and an open, tissue receiving aperture 17. The probe component 11 also includes a probe housing 18 with a housing cover 19 which is configured to interfit with the driver component 12. A tissue cutter 20 is slidably disposed within the probe and has a distal cutting surface 21 which severs tissue which extends through the tissue receiving aperture 17.
[0046] Details of the probe component 11 are further shown in
[0047] The mechanical system of the driver component 12 has first driving gear 22 that is configured to engage the probe gear 23 and rotate the probe housing 18 so as to adjust the orientation of aperture 17 in the distal extremity of the tubular section 15. The probe gear 23 is secured to the rotating connector body 24 by adhesive 25. The proximal extremity of the tubular section 15 is secured to the rotating connector body 24 by adhesive 26. An end cap 27 retains the connector body 24 within the probe housing 18. Rotation of the probe gear 23 rotates the connector body 24 and the attached tubular section 15. The rotation is preferably controlled so that the tubular section 15 rotates in discrete steps about the longitudinal axis 28 to adjust the angular orientation of the aperture 17 about the longitudinal axis. Preferably these discrete orientations may be provided in increments of 30° which can be readily indicated by arrow 29 at the distal end of the probe housing 18 as shown in
[0048] The second driving gear 30 is configured to drive the tissue cutter 20 longitudinally. The driving gear 30 engages probe gear 31 which drives cutter traverse nut 32 and cutter screw 33 threadably connected to the cutter traverse nut. The distal end of the cutter screw 33 is provided with a recess 34 which receives the rib 35 of the cutter shuttle 36. The cutter shuttle 36 is secured to the tissue cutter 20 by adhesive 37. The probe gear 31 is secured to the cutter traverse nut 32 by adhesive 38. Rotation of the probe gear 31 adjusts the relative axial position of the cutter screw 33 with respect to the cutter traverse nut 32 which is secured to the cutter shuttle 36. Longitudinal movement of the tissue cutter 20 follows the longitudinal movement of the cutter shuttle 36 resulting from the movement of cutter screw 33. The length of the tissue receiving aperture 17, and as a result the length of the specimen, can be controlled by adjusting the initial longitudinal position of the distal end of the tissue cutter 20 within the aperture, before cutting.
[0049] The third driving gear 40 is configured to rotate or oscillate the tissue cutter 20 as the cutter moves along the longitudinal axis 28 to facilitate the cutting action of the cutting surface 21 on the distal end of the cutter. The third driving gear 40 engages probe gear 41 which is secured to cutter oscillation shaft 42 by adhesive 43. The probe gear 41 may be oscillated back and forth about the longitudinal axis 28 or rotated continuously in a single direction about the longitudinal axis, or both depending upon the desired rotational movement of the tissue cutter.
[0050] A biased valve assembly 44 is provided in the distal end of the probe housing 18 to ensure sealing when a vacuum is developed within the interior 45 of the tissue cutter 20 while providing an atmospheric vent 46 between the interior surface 47 of the tubular section 15 and the exterior surface 48 of the tissue cutter 20. The valve assembly 44 includes a spring 49, valve body 50 and a valve collar 51 which is secured to the proximal end of the tubular section 15 by adhesive 52. The proximal end of the valve spring 49 rests against the shoulder 53 provided in the exterior of the valve body 50. A biased cutter shaft seal 54 slidably engages the exterior 48 of the tissue cutter 20.
[0051] The tissue specimen collector 13 is secured to the proximal end of the housing of probe component 11 and has an interior 55 in fluid communication with the inner lumen 56 extending within the tissue cutter 20 and has a removable proximal wall 57 of specimen receiving cartridge 58 which gives access to the interior 55 and any tissue specimens which may have been drawn therein. A vacuum is generated within the interior 55 to draw tissue specimens through the inner lumen 45 into the interior 55. Tubular member 59 has a distal end which is in fluid communication with the interior 55 of the tissue specimen collector 13 and has a proximal end (not shown) which is configured to be connected to a vacuum source. Application of a vacuum within the tubular member 59 aids in pulling tissue into the interior 17 of the tubular section 15 and transfer of the severed tissue specimen through the inner lumen 45 of the tissue cutter 20 to the specimen cartridge 58.
[0052] The driver 12 has a housing 60 with an upper concave surface 61 which is configured to receive the lower surface 62 of the probe housing 18. Three partially exposed driving gears 22, 30 and 40 are provided on the proximal end of the driver 12 which are configured to engage the probe gears 23, 31 and 41 respectively. The drive 12 is provided with three separately operating drive motors (not shown) which drive the drive gears 22, 30 and 40. The separate drive motors (not shown) are connected to and the operation thereof controlled by a control module, such as described in copending application Ser. No. 10/847,699, filed on May 17, 2004. The control module controls the motors which move the individual drive gears 22, 30 and 40. The gear 22 engages gear 23 in the probe 11 to control the rotation of the probe housing 18 and the location and orientation of the tissue receiving aperture 17. The drive gear 30 engages probe gear 31 to control the longitudinal position and motion of the tissue cutter 20 along the longitudinal axis 28. Drive gear 40 engages probe gear 41 to control the oscillation or rotation of the tissue cutter 20 about the longitudinal axis 28.
[0053] As shown in
[0054] The tissue penetrating distal tip 16 may have a variety of tip shapes. A particularly suitable distal tip embodying features of the invention is shown in
[0055] The intersection between the first concave surface 72 and the second concave surface 73 forms the first curved cutting edge 75. The intersection between the second concave surface 73 and the third concave surface 74 forms the second curved cutting edge 76. The intersection between the third concave surface and the first concave surface 72 forms the third curved cutting surface 77.
[0056] The concave surfaces 72, 73 and 74 are hollow ground and the pentrating tip 16 is then electro-polished to increase the sharpness of the cutting edges 75, 76 and 77. The penetrating distal tip 16 may be formed of suitable surgical stainless steel such as 17-4 stainless steel. Other materials may be suitable. The penetrating distal tip 16 is preferably electro-polished in an acidic solution to sharpen the curved cutting edges and thereby facilitate tissue penetration. Suitable electro-polishing solutions include Electro Glo sold by the Electro Glo Distributing Co.
[0057] The base 70 of the tissue penetrating tip 16 may be secured to the distal end of the elongated shaft of the biopsy device 10 for accessing and collecting tissue from a target site within a patient. The sharp distal tip 16 embodying features of the invention readily penetrates a patient's tissue, particularly breast tissue and facilitates guiding the distal end of the biopsy or other device to a desired intracorporeal location.
[0058] The tissue penetrating tips may also be employed on biopsy devices such as those described in co-pending application Ser. No. 10/642,406, filed on Aug. 15, 2003, which is assigned to the present assignee. Alternatively, the distal tip may be provided with an arcuate RF electrode such as disclosed in U.S. Pat. Nos. 6,261,241, and 6,471,700, both assigned to the present assignee.
[0059] The separate driver component 12 allows the probe unit 11 to be disposable. The drive gears of the drive component 12 control the motion of the tissue cutting member 20 for cutting and the motion of the tubular section 15 to orient the aperture 17. Other means (not shown) may provide mechanical and electrical power, vacuum, and control to the probe device. Examples of replaceable snap-in type probe units are disclosed in Burbank et al., U.S. patent application Ser. No. 10/179,933, “Apparatus and Methods for Accessing a Body Site”. Drive units such as that described in WO 02/069808 (which corresponds to co-pending U.S. application Ser. No. 09/707,022, filed Nov. 6, 2000 and U.S. application Ser. No. 09/864,021, filed May 23, 2001), which are assigned to the present assignee, may be readily modified by those skilled in the art to accommodate the movement of the cutting member 20.
[0060] In use, the distal end of the probe component 11 is advanced within the patient with the tissue cutter 20 in a forward or closed position (
[0061] The biopsy system 10 may be hand held for some biopsy procedures or the system may be mounted on a stereotactic mounting stage 80 as shown in
[0062] As mentioned above, positive pressure or even ambient conditions will aid in passing the severed tissue specimen through the inner lumen 45 of tissue cutter 20 into the cartridge 58 of specimen collector 13. As shown in
[0063] The distal cutting edge 21 of the tissue cutter 20 may initially be located proximal to the aperture 17 to provide a full aperture for receiving tissue or it can be initially located within the aperture 17 in order to control the length of the specimen. The cutting action of tissue cutter 20 preferably continues until the beveled cutting surface 21 has completely traversed the aperture 17 to ensure that the tissue drawn through the aperture is completely severed from supporting tissue at the biopsy site. A vacuum may be applied to aspirate the severed tissue specimen through the inner lumen of the tissue cutter 20 to the cartridge in the specimen collector at the proximal end of the biopsy device. Positive pressure or access to ambient conditions may be provided in the distal end of the tubular section to aid in the specimen transfer.
[0064] After the removable wall 57 of the specimen receiving cartridge 58 is removed and the specimens therein removed, it is frequently desirable to deliver one or more markers to the target site from which the specimens have been removed. Such marker delivery devices are shown in co-pending application Ser. No. 10/753,694, filed on Jan. 7, 2004 and co-pending application Ser. No. 10/444,770, filed May 23, 2003. However, the distal ends of these marker delivery devices are very small and they can be difficult to insert into the proximal end of the tissue cutter 20 which is just slightly larger to accommodate the marker delivery shaft.
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[0066] While the slidably mounted, flared proximal guide 102 is described with respect to being disposed on the shaft 103 of marker delivery device 101, the flared guide 102 has wide application within a variety of biopsy and other devices where one small diameter tubular member is to be inserted into a slightly larger, but still small diameter second tubular member.
[0067] The elongated probe component 11 of the biopsy system 10 has a length of about 3 to about 20 cm, preferably, about 5 to about 13 cm, and more specifically, about 8 to about 9 cm for breast biopsy use. To assist in properly locating the probe 11 during advancement thereof into a patient's body, the distal extremity of the tubular section may be provided with a marker at a desirable location that provide enhanced visualization by eye, by ultrasound, by X-ray, MRI or other imaging or visualization means. Manual palpation may also be employed. An echogenic polymer coating that increases contrast resolution in ultrasound imaging devices (such as ECHOCOAT™ by STS Biopolymers, of Henrietta, N.Y.) is suitable for ultrasonic visualization. Radiopaque markers may be made with, for example, stainless steel, platinum, gold, iridium, tantalum, tungsten, silver, rhodium, nickel, bismuth, other radiopaque metals, alloys and oxides of these metals. In addition, the surfaces of the device in contact with tissue or other components of the device may be provided with a suitable lubricious coating such as a hydrophilic material or a fluoropolymer.
[0068] The tubular section and the tissue cutter are preferably formed of a surgical grade stainless steel. However, other high strength materials such as MP35N, other cobalt-chromium alloys, NiTi alloys, ceramics, glasses, and high strength polymeric materials or combinations thereof may be suitable.
[0069] A patient's skin usually must be breached in order to gain access to a body site where a tissue specimen is to be obtained. A scalpel or other surgical instrument may be used to make an initial incision in the skin. After the specimens have been taken, the biopsy device may be removed from the patient. The entire device may be removed; however, in some embodiments, the cartridge 58 may be removed from the system 10 and a delivery cannula may be inserted through the inner lumen of the cutter 20 to deliver markers to the biopsy site through the aperture 17. In addition, it will be readily appreciated that other types of instruments may be inserted into the tissue site through the tissue cutter in addition to or in place of the instruments described above. Moreover, therapeutic or diagnostic agents may be delivered through the tissue cutter 20 or the tubular section 15.
[0070] While particular forms of the invention have been illustrated and described herein, it will be apparent that various modifications and improvements can be made to the invention. For example, while the various embodiments of the invention have been described herein in terms of a biopsy device, it should be apparent that the devices and methods of utilizing the device may be employed to remove tissue for purposes other than for biopsy, i.e. for treatment or other diagnoses. Additionally, the tissue penetrating distal tip design may be employed on probes for other uses. Other modifications include, for example, a tissue cutter slidably mounted around the tubular section of the probe component rather than within the tubular section. Moreover, individual features of embodiments of the invention may be shown in some drawings and not in others, but those skilled in the art will recognize that individual features of one embodiment of the invention can be combined with any or all the features of another embodiment. Accordingly, it is not intended that the invention be limited to the specific embodiments illustrated.
[0071] Terms such a “element”, “member”, “device”, “section”, “portion”, “means”, “step” and words of similar import, when used in the following claims, shall not be construed as invoking the provisions of 35 U.S.C. § 112(6) unless the claims expressly use the term “means” followed by a particular function without specific structure or the term “step” or “steps” followed by a particular function without specific action. All patents and patent applications referred herein are incorporated by reference in their entirety.