BONE BIOPSY DEVICE AND RELATED METHODS
20220395261 · 2022-12-15
Inventors
- Clark Ragsdale (Herriman, UT, US)
- Michael D. Ehninger (South Jordan, UT, US)
- Ricardo Rufino (Sandy, UT, US)
Cpc classification
A61B2010/0208
HUMAN NECESSITIES
A61B17/1637
HUMAN NECESSITIES
A61B10/025
HUMAN NECESSITIES
A61B17/3476
HUMAN NECESSITIES
A61B17/162
HUMAN NECESSITIES
A61B2017/00398
HUMAN NECESSITIES
International classification
A61B10/02
HUMAN NECESSITIES
A61B17/16
HUMAN NECESSITIES
Abstract
Devices and methods used to obtain core tissue samples are disclosed. The devices may be configured to drill into cortical bone and saw a hole into a bone lesion and/or bone marrow while obtaining the core tissue sample. The devices can include a motor and a clutch configured to rotate a trocar having a tip configured for drilling and an outer coax cannula having a trephine tip configured for sawing. The core tissue sample may be received within an inner cannula as an intermediate cannula cuts a hole in the bone lesion and/or bone marrow. The devices can include a spacer.
Claims
1. A bone biopsy device, comprising: a handle housing; a powertrain assembly; a tissue sampling assembly configured to be rotated about a longitudinal axis by the powertrain assembly; a coax assembly selectively couplable to the handle housing; and a spacer longitudinally disposed between the handle housing and the coax assembly and selectively coupleable to the handle housing and the coax assembly.
2. The bone biopsy device of claim 1, wherein the tissue sampling assembly comprises: an intermediate cannula configured to cut a hole in a tissue; an inner cannula coaxially disposed within the intermediate cannula and configured to receive a tissue sample; a trocar coaxially disposed within the inner cannula; and a trocar displacement member coupled to the trocar and configured to longitudinally displace the trocar relative to the inner cannula.
3. The bone biopsy device of claim 2, wherein the inner cannula comprises at least one slot extending through a wall of a distal portion, and wherein the at least one slot is configured to allow radial expansion of the distal portion.
4. The bone biopsy device of claim 2, wherein the tissue sampling assembly further comprises an inner cannula displacement member operably coupled to the trocar displacement member, and wherein the inner cannula displacement member is configured to longitudinally displace the inner cannula relative to the intermediate cannula.
5. The bone biopsy device of claim 2, wherein the trocar comprises: a longitudinal groove configured to receive a guidewire; and a multi-faceted penetrating tip.
6. The bone biopsy device of claim 2, wherein the trocar displacement member comprises: a guide track comprising a plurality of segments; and a proximal recess and a distal recess for engagement with an inner cannula displacement member.
7. The bone biopsy device of claim 6, further comprising a track arm coupleable to the guide track and configured to control longitudinal movement of the trocar.
8. The bone biopsy device of claim 7, wherein the plurality of segments of the guide track comprise: a first segment; a second segment; a third segment; and a fourth segment; wherein when the track arm is disposed in the first segment, the trocar is in a first extended position; wherein when the track arm is disposed in the second segment, the trocar is in a first retracted position; wherein when the track arm is disposed in the third segment, the trocar is in a second retracted position; and wherein when the track arm is disposed in the fourth segment, the trocar is in a second extended position.
9. The bone biopsy device of claim 2, further comprising an inner cannula displacement member, wherein the trocar displacement member comprises a proximal recess and a distal recess configured to engage with the inner cannula displacement member, wherein the inner cannula displacement member distally displaces the inner cannula to an extended position when the inner cannula displacement member is engaged with the distal recess, and wherein the inner cannula displacement member proximally displaces the inner cannula to a retracted position when the inner cannula displacement member is engaged with the proximal recess.
10. The bone biopsy device of claim 8, further comprising a slider comprising a proximally facing ramp, wherein the track arm comprises a distally facing ramp, and wherein the track arm is displaced from the first track segment to the second track segment when the slider is displaced proximally causing the proximally facing ramp to slidingly engage with the distally facing ramp.
11. The bone biopsy device of claim 1, wherein the powertrain assembly comprises a reusable component comprising: a motor; a power source; and a controller, wherein the motor, power source, and controller are disposed within a housing, and wherein the housing is removable from the handle housing.
12. The bone biopsy device of claim 1, wherein the powertrain assembly comprises a clutch configured to selectively rotate at least a portion of the tissue sample assembly and the coax assembly.
13. The bone biopsy device of claim 12, wherein the clutch comprises: a sleeve comprising sleeve ramps; a driver comprising driver ramps, wherein the sleeve ramps operably engage with the driver ramps to displace the sleeve into engagement with a clutch gear when the sleeve and driver are rotated in a first direction, and wherein the sleeve ramps operably engage with the driver ramps to displace the sleeve away from engagement with the gear when the sleeve and the driver are rotated in a second direction.
14. The bone biopsy device of claim 1, wherein the coax assembly comprises: a connector; and a coax cannula coupled to the connector and comprising a trephine tip.
15. A bone biopsy system, comprising: a bone biopsy device comprising: a handle housing; a tissue sampling assembly configured to be rotated about a longitudinal axis; a coax assembly selectively couplable to the handle housing; a spacer longitudinally disposed between the handle housing and the coax assembly and selectively coupled to the handle and the coax assembly; and a powertrain assembly comprising a reusable portion and a disposable portion.
16. The bone biopsy system of claim 15, wherein the reusable portion of the powertrain assembly comprises: a housing containing: a motor configured to rotate at least a portion of the tissue sampling assembly about a longitudinal axis; a power source configured to power the motor; and a controller configured to control rotation speed and rotation direction of the motor.
17. The bone biopsy system of claim 15, wherein the disposable portion of the powertrain assembly comprises a clutch configured to selectively engage with a drive train.
18. The bone biopsy system of claim 15, further comprising a trocar assembly comprising: a handle configured to be gripped by a user; and a trocar coupled to the handle.
19. The bone biopsy system of claim 15, further comprising an aspiration device comprising a male Luer fitting coupleable to a female Luer fitting of a connector of the coax assembly.
20. A method of obtaining a core tissue sample from a patient, comprising: setting a bone biopsy device to a ready state; activating the bone biopsy device, wherein an outer coax cannula, an inner cannula, an intermediate cannula, and a trocar rotate during insertion to a first position in the patient; removing the inner cannula, the intermediate cannula, and the trocar from the outer coax cannula, wherein the outer coax cannula remains inserted in the patient; removing a spacer from the bone biopsy device; retracting the trocar from a first extended configuration to a retracted configuration; reinserting the inner cannula, the intermediate cannula, and the trocar into the outer coax cannula; activating the bone biopsy device, wherein the inner cannula, the intermediate cannula, and the trocar rotate; further inserting the inner cannula and the intermediate cannula to a second position, wherein a first core tissue sample is obtained within the inner cannula; removing the inner cannula, the intermediate cannula, and the trocar from the patient; displacing the inner cannula relative to the intermediate cannula to extend from the intermediate cannula; and displacing the trocar relative to the inner cannula from the retracted configuration to a second extended configuration to eject the first core tissue sample from the inner cannula.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0003] The embodiments disclosed herein will become more fully apparent from the following description and appended claims, taken in conjunction with the accompanying drawings. These drawings depict only typical embodiments, which will be described with additional specificity and detail through use of the accompanying drawings in which:
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DETAILED DESCRIPTION
[0027] A bone biopsy device may include a handle, a tissue sampling assembly, a coax assembly, and a powertrain assembly. The handle may include a handle configured to hold the tissue sampling assembly, the coax assembly, and the powertrain assembly. The tissue sampling assembly can include an inner cannula coaxially and slidably disposed within an intermediate cannula. The inner cannula may extend distally from the handle and may be configured to receive a core tissue sample. The intermediate cannula can extend from the handle and its tip (e.g., trephine tip) can be configured to drill into a tissue (e.g., a lesion or bone marrow) when rotated by the powertrain assembly. A trocar with a penetrating tip may be coaxially and slidably disposed within a lumen of the inner cannula. The tissue sampling assembly may include a trocar displacement member configured to displace the trocar relative to the inner cannula from a first extended position where the trocar can drill into a bone to a retracted position to a second extended position where the trocar can eject the core tissue sample from the inner cannula. The coax assembly may be selectively detachable from the handle housing. The coax assembly may include an outer coax cannula extending distally from a coax connector. The inner and intermediate cannulae may be coaxially disposed within a lumen of the outer coax cannula. A tip of the outer coax cannula may be a cutting tip (e.g., a trephine tip) and may be configured to saw into a bone lesion and/or bone marrow. In certain embodiments, a spacer can be selectively disposed between the handle housing and the coax assembly.
[0028] The powertrain can include a power source, a motor, and a drivetrain disposed within the handle housing. The power source and motor may be selectively removable from the handle housing such that the power source and motor may be reusable components. The powertrain assembly may be configured to rotate one or more of the trocar, inner cannula, intermediate cannula, and coax assembly. In certain instances, the powertrain may include a clutch to selectively allow power rotation of the trocar, inner cannula, intermediate cannula, and coax assembly and not allow manual rotation via the handle housing. In other instances, the powertrain may include a gear box.
[0029] The bone biopsy device may be used by a practitioner to obtain a core tissue sample of a bone lesion and/or bone marrow. In other instances, the bone biopsy device may be used to obtain a core tissue sample of other tissues within a patient, such as a soft tissue sample. In use, the trocar, inner cannula, intermediate cannula, and outer coax cannula may be rotated by the powertrain assembly and drilled through a cortical bone layer adjacent into a lesion and/or bone marrow. The bone biopsy device may be removed from the outer coax cannula and the spacer removed from the handle housing and the coax assembly. The trocar may be retracted and the intermediate and inner cannulae inserted into the outer coax cannula. The intermediate and inner cannulae can be rotated by the powertrain to saw or otherwise obtain a core tissue sample of the lesion and/or bone marrow that is collected in the inner cannula. The intermediate and inner cannulae with the core tissue sample may be removed from the coax assembly. The inner cannula can be advanced to extend from the intermediate cannula and the trocar can be advanced to extend from the inner cannula to eject the core tissue sample from the inner cannula. A slot through a wall of the inner cannula may allow radial expansion of the inner cannula to facilitate core tissue sample ejection. The radial expansion allowed by the slot can also facilitate obtaining and retaining a core tissue sample as the inner cannula can flex outward and then apply an inwardly directed pressure on a core tissue sample retained therein. In certain instances, a medical device (e.g., syringe) can be coupled to a connector of the coax assembly to collect or aspirate bone marrow, blood, and/or tissue cells or to infuse or inject a substance (such as a medicament) into the patient.
[0030] Embodiments may be understood by reference to the drawings, wherein like parts are designated by like numerals throughout. It will be readily understood by one of ordinary skill in the art having the benefit of this disclosure that the components of the embodiments, as generally described and illustrated in the figures herein, could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description of various embodiments, as represented in the figures, is not intended to limit the scope of the disclosure but is merely representative of various embodiments. While the various aspects of the embodiments are presented in drawings, the drawings are not necessarily drawn to scale unless specifically indicated.
[0031] It will be appreciated that various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure. Many of these features may be used alone and/or in combination with one another. Reference throughout this specification to “an embodiment” or “the embodiment” means that a particular feature, structure, or characteristic described in connection with that embodiment is included in at least one embodiment. Thus, the quoted phrases, or variations thereof, as recited throughout this specification are not necessarily all referring to the same embodiment.
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[0034] As depicted in an exploded view of the bone biopsy device 100 of
[0035] The handle housing 111 may be formed of two separate halves that may be coupled using any suitable technique. For example, in the illustrated embodiment of
[0036] In the depicted embodiment, at least a portion of the powertrain assembly 120 can be disposed within the grip portion 113. The powertrain assembly 120 includes a reusable housing 121, a motor 122, a power source 123, and a controller 124, one or more of which may be disposed within the housing 121. The housing 121 and one or more components of the powertrain assembly 120 may be selectively removed from the handle housing 111 through a selectively openable door 114 following a bone biopsy procedure (as is shown in
[0037] The motor 122 may be any suitable type of rotatory motor. For example, the motor 122 may be a DC brushed motor, a DC brushless motor, a stepper motor, a servo motor, a pneumatic motor, or an AC powered motor, etc. The motor 122 may also be bi-directional. The motor 122 can include a drive shaft extending from the motor 122. The motor 122 may rotate the drive shaft at a speed ranging from about 0 rpm to about 50,000 rpm, or from about 15 rpm to about 20,000 rpm. The motor 122 can be electrically coupled to the power source 123 and to a motor activation switch 130 (e.g., trigger).
[0038] As depicted in the illustrated embodiment of
[0039] As set forth above, in certain embodiments following a bone biopsy procedure, the motor 122, power source 123, and controller 124 (which can be contained within a reusable housing 121) may be selectively removed from the bone biopsy device 100 and the handle assembly 110. The bone biopsy device 100, handle assembly 110, and outer coax assembly 190 may thereafter be disposed of in a safe manner. When removed, the motor 122, power source 123, and/or controller 124 may be refurbished for use in a subsequent procedure. Refurbishment may include cleaning, sterilizing, recharging, or replacing the motor 122, power source 123, and/or controller 124.
[0040] Referring to
[0041] In the embodiment illustrated in
[0042] Referring to
[0043] Referring to
[0044] As illustrated in the embodiment of
[0045] A guide track 153 may be disposed on at least one lateral side of the trocar displacement member 151. The guide track 153 can include a plurality of segments, a first track segment 153a, a second track segment 153b, a third track segment 153c, and a fourth track segment 153d to guide movement of a track arm 163 when the trocar displacement member 151 is longitudinally displaced relative to the track arm 163. The track arm 163 may include forked arms configured to extend along lateral sides of the trocar displacement member 151. A protrusion 164 extends radially inward from each proximal end of the forked arms. The protrusions 164 engage with the guide track 153 and are guided through the track segments 153a, 153b, 153c, 153d to control longitudinal movement of trocar displacement member 151. For example, the protrusions 164 can be guided from 153a to 153b as the trocar displacement member 151 is displaced proximally and from 153b to 153c as the trocar displacement member 151 is displaced distally. A distal end of the track arm 163 is pivotably coupled to the handle housing 111.
[0046] A proximal recess 154 and a distal recess 155 are disposed in a top surface of the trocar displacement member 151 to selectively receive a protrusion 178 extending downward from a proximal end of the inner cannula displacement member 177. The inner cannula displacement member 177 can include an engagement portion 180 disposed at a distal end and configured to selectively engage with a flange 174 of the inner cannula hub 173 to longitudinally displace the inner cannula 175. The engagement portion 180 can include a recess disposed between two downwardly extending legs. A torsion spring 181 is coupled to the proximal end of the inner cannula advancement member 177 to bias the protrusion 178 into the recesses 154, 155.
[0047] A slider 167 may be slidingly coupled to the handle housing 111. A grip 168 configured to be gripped or otherwise engaged by a hand of a user can extend through a longitudinal slot of the handle housing 111. A saddle portion 169 can extend downwardly from the grip 168 and at least partially surround the trocar displacement member 151. A proximally facing ramp 170 may be disposed on each leg of the saddle portion 169. The ramps 170 may be configured to engage with distally facing ramps 165 of the track arm 163 when the slider 167 is moved from a distal position to a proximal position. When the ramps 170 engage with the ramps 165, the proximal end of the track arm 163 is displaced downwardly within the track 153. A tension spring 172 may be coupled to the slider 167 and to the handle housing 111 to bias the slider 167 distally.
[0048] As illustrated in
[0049] As illustrated in
[0050] As illustrated in
[0051] When the spacer 185 is coupled to the handle housing 111, the bone biopsy device 100 can be inserted into a patient to a first depth. When the spacer 185 is removed from the handle housing 111, the bone biopsy device 100 can be inserted into the patient to a second depth. A distance of the difference between the first insertion depth and the second insertion depth can be up to a length of the spacer 185. In some embodiments, the length of the spacer 185 may be shortened without removal from the handle housing 111, allowing for the second insertion depth to be deeper than the first insertion depth. For example, the spacer 185 may include a distal portion and a proximal portion that are threadingly coupled allowing for length adjustment by rotating the proximal portion relative to the distal portion.
[0052] As illustrated in
[0053] A proximal end of the outer coax cannula 194 is fixedly coupled to the coax connector 191. The outer coax cannula 194 includes a lumen extending therethrough allowing the intermediate cannula 182 to be coaxially disposed within the outer coax cannula 194. A distal end of the outer coax cannula 194 includes a hole cutting tip 195 configured to cut a hole in bone when the outer coax cannula 194 is rotated. In certain embodiments, the hole cutting tip 195 is a trephine tip having a plurality of serrated or jagged teeth.
[0054] In use, the bone biopsy device 100 can be used to obtain a core tissue sample from a bone lesion and/or bone marrow.
[0055] As depicted in
[0056] When the bone biopsy device 100 is activated, the trigger 130 is displaced proximally by a user's finger causing electricity to flow from the power source 123 to the motor 122. When energized, the motor 122 rotates in the first direction causing the driver 133 of the clutch system 131 to rotate in the first direction. In some embodiments, the user can control the motor speed through the trigger 130. For example, the user may partially actuate the trigger 130 to run the motor 122 at a first speed and actuate the trigger 130 further to run the motor 122 at a second speed, third speed, fourth speed, etc. When the driver 133 is rotated, the driver ramps 134 (not shown) engage with the sleeve ramps 137 (not shown) causing the sleeve 136 to be displaced distally. When the sleeve 136 is displaced distally, the sleeve 136 engages with the clutch gear 139 to rotate the drive train 126 in the first direction. When the drive train 126 is rotated in the first direction, the trocar 159, the inner cannula 175, the intermediate cannula 183, and the outer coax cannula 194 are rotated in the first direction.
[0057] When the trephine tip 195 is in the bone lesion and/or bone marrow 104, the bone biopsy device 100 is de-activated by release of the trigger 130 by the finger of the user. When de-activated, the controller 124 (not shown) causes the motor 122 to briefly rotate in the second direction. When the motor rotates in the second direction, the driver 133 is rotated in the second direction. The spring 141 (not shown) applies a proximally directed force to the sleeve 136, causing the sleeve 136 to move proximally and disengage the clutch gear 139. When the clutch gear 139 is disengaged, the drive train 126 can be freely rotated, not allowing the trocar 159, the inner cannula 175, the intermediate cannula 183, and the outer coax cannula 194 to be rotated via the handle assembly 110.
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[0062] Following core tissue sample ejection, the trocar displacement member 151 is displaced proximally by the spring 152 as the track arm 163 moves from the fourth track segment 153d to the first track segment 153a. The inner cannula displacement member 177 engages the proximal recess 154 to move the inner cannula 175 proximally from the core tissue sample ejection position to a retracted position. In this configuration, the bone biopsy device 100 is returned to its ready state
[0063] In some instances, as depicted in
[0064] In certain embodiments, as illustrated in
[0065] In certain instances, a trocar assembly 196 may be selectively coupled to the coax assembly 190 to facilitate manual positioning of the coax assembly 190 prior to using the bone biopsy device 100. As illustrated in
[0066] In other embodiments, the trocar assembly 196 can be used to reposition or redirect the coax assembly 190 within the bone lesion and/or bone marrow to obtain subsequent tissue samples. For instance, after using the bone biopsy device 100 (as previously discussed), the trocar assembly 196 can be inserted into and coupled to the coax assembly 190 to aid in manually repositioning and/or redirecting the coax assembly 190 prior to obtaining a subsequent core tissue sample or tissue sample using the bone biopsy device 100 or an aspiration device 108.
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[0070] Referring to
[0071] Similarly, as shown for the bone biopsy device 100 in
[0072] Any methods disclosed herein comprise one or more steps or actions for performing the described method. The method steps and/or actions may be interchanged with one another. In other words, unless a specific order of steps or actions is required for proper operation of the embodiment, the order and/or use of specific steps and/or actions may be modified. For example, a method of obtaining a core tissue sample from a patient may include one or more of the following steps: setting a bone biopsy device to a ready state; activating the bone biopsy device, wherein an outer coax cannula, an inner cannula, an intermediate cannula, and a penetration member are rotated during insertion to a first position in the patient; removing the inner cannula, the intermediate cannula, and the trocar from the outer coax cannula, wherein the outer coax cannula remains inserted in the patient; removing a spacer from the bone biopsy device; retracting the trocar from a first extended position to a retracted position; reinserting the inner cannula, the intermediate cannula, and the trocar into the outer coax cannula; activating the bone biopsy device, wherein the inner cannula, the intermediate cannula, and the trocar are rotated; further inserting the inner cannula and the intermediate cannula to a second position, wherein a first core tissue sample is obtained within the inner cannula; removing the inner cannula, the intermediate cannula, and the trocar from the patient; displacing the inner cannula to extend from the intermediate cannula; and displacing the trocar from the retracted position to a second extended position to eject the first core tissue sample from the inner cannula. Other steps are also contemplated.
[0073] The phrase “coupled to” refers to any form of interaction between two or more entities, including mechanical, electrical, magnetic, electromagnetic, fluid, and thermal interaction. Two components may be coupled to each other even though they are not in direct contact with each other. For example, two components may be coupled to each other through an intermediate component.
[0074] The directional terms “distal” and “proximal” are given their ordinary meaning in the art. That is, the distal end of a medical device means the end of the device furthest from the user during use. The proximal end refers to the opposite end, or the end nearest the user during use. As specifically applied to the bone biopsy device, the proximal end of the device refers to the end nearest the handle housing and the distal end refers to the opposite end, the end nearest the end of the outer coax cannula. Thus, if at one or more points in a procedure the user changes the orientation of the device, as used herein, the term “proximal end” always refers to the handle housing end of the device (even if the distal end is temporarily closer to the user).
[0075] References to approximations are made throughout this specification, such as by use of the term “substantially.” For each such reference, it is to be understood that, in some embodiments, the value, feature, or characteristic may be specified without approximation. For example, where qualifiers such as “about” and “substantially” are used, these terms include within their scope the qualified words in the absence of their qualifiers.
[0076] In the above description of embodiments, various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure. This method of disclosure, however, is not to be interpreted as reflecting an intention that any claim requires more features than those expressly recited in that claim. Rather, as the following claims reflect, inventive aspects lie in a combination of fewer than all features of any single foregoing disclosed embodiment.
[0077] The terms “a” and “an” can be described as one, but not limited to one.
[0078] Unless otherwise stated, all ranges include both endpoints and all numbers between the endpoints.
[0079] Recitation in the claims of the term “first” with respect to a feature or element does not necessarily imply the existence of a second or additional such feature or element. Elements recited in means-plus-function format are intended to be construed in accordance with 35 U.S.C. § 112 6. It will be apparent to those having skill in the art that changes may be made to the details of the above-described embodiments without departing from the underlying principles of the invention. Embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows.
[0080] The claims following this written disclosure are hereby expressly incorporated into the present written disclosure, with each claim standing on its own as a separate embodiment. This disclosure includes all permutations of the independent claims with their dependent claims. Moreover, additional embodiments capable of derivation from the independent and dependent claims that follow are also expressly incorporated into the present written description.
[0081] Without further elaboration, it is believed that one skilled in the art can use the preceding description to utilize the invention to its fullest extent. The claims and embodiments disclosed herein are to be construed as merely illustrative and exemplary, and not a limitation of the scope of the present disclosure in any way. It will be apparent to those having ordinary skill in the art, with the aid of the present disclosure, that changes may be made to the details of the above-described embodiments without departing from the underlying principles of the disclosure herein. In other words, various modifications and improvements of the embodiments specifically disclosed in the description above are within the scope of the appended claims. Moreover, the order of the steps or actions of the methods disclosed herein may be changed by those skilled in the art without departing from the scope of the present disclosure. In other words, unless a specific order of steps or actions is required for proper operation of the embodiment, the order or use of specific steps or actions may be modified. The scope of the invention is therefore defined by the following claims and their equivalents.