The various embodiments relate to forceps in general and more particularly to avulsion forceps to be used endoscopically, having a pair of jaws, which can be opened and closed to grab and tear tissue.
Conventional endoscopic forceps devices, such as biopsy forceps, typically contain jaws or forceps at the distal end. More specifically, these endoscopic forceps devices have an outer sheath, a base, at least two jaw components, and a driving mechanism. The proximal portion of the jaw components are connected to the base such that the jaw components can move between open and closed positions, and the driving mechanism is utilized to engage the proximal portion of the driving components to facilitate this movement. As the driving mechanism moves the jaw components from the closed position to the open position, the proximal end of the jaw components extend outward beyond a longitudinal axis of the wall of the outer sheath.
In some embodiments, conventional forceps devices are charged with an electric current to help facilitate removal of the tissue from a patient. Because the proximal ends of jaw components for conventional endoscopic forceps extend outward beyond a longitudinal axis of a wall of an outer sheath, the proximal ends of the jaw components, due to their intimate contact with current and their material properties, conduct current when the device is energized.
Improvements to avulsion forceps may be made by improving the design of the jaw components, such that, when in an open position, the proximal ends of the jaw components are not extending outward beyond a longitudinal axis of the outer wall of the sheath. Improvements of the avulsion forceps may also be made by insulating a majority of the length of the base and/or at least a portion of the proximal ends of the jaw components when the device is charged with electric current.
An exemplary device for obtaining a tissue sample includes a spring sheath, an outer sheath, a base, a pair of jaws, and an actuator assembly. The outer sheath has a wall extending along a longitudinal axis. The base is connected to at least one of the spring sheath and the outer sheath. The pair of jaws is operatively connected to the base such that the pair of jaws can be moved between an open position and a closed position. Each jaw has a proximal portion and a distal portion, in which the proximal portion includes at least one arm having an internally extending piece, an externally extending projection, and a curved surface. The proximal portion of each jaw is connected to the base such that the curved external surface pivots about the base to move the pair of jaws between the open and closed positions. The actuator assembly includes a driver that extends through the base and is configured to engage the internally extended piece of each jaw to move the pair of jaws between the open and closed positions. When the pair of jaws are in a fully opened position, the proximal portion of each jaw does not extend beyond the longitudinal axis of the wall of the outer sheath.
Another exemplary device for obtaining a tissue sample includes a spring sheath, a dielectric sheath, a base, a pair of jaws, and an actuator assembly. The dielectric sheath at least partially surrounds the spring sheath. The base has a proximal portion and a distal portion, in which the proximal portion is connected to at least one of the spring sheath and the dielectric sheath. A length of the proximal portion of the base is greater than a length of the distal portion of the base. The pair of jaws is operatively connected to the distal portion of the base such that the pair of jaws can be moved between an open position and a closed position. The actuator assembly includes a driver that extends through the base and is configured to engage the pair of jaws to move the pair of jaws between the open and closed positions. The dielectric sheath surrounds the proximal portion of the base.
Another exemplary embodiment of a device for obtaining a tissue sample includes a spring sheath, an outer sheath, a base, a pair of jaws, an actuator assembly, and an insulating coating. The outer sheath has a wall extending along a longitudinal axis. The base is connected to at least one of the spring sheath and the outer sheath such that a distal portion of the base is not surrounded by the outer sheath. The pair of jaws is operatively connected to the base such that the pair of jaws can be moved between an open position and a closed position. Each jaw has a proximal portion and a distal portion, and the pair of jaws is connected to the base such that the proximal portion of each jaw pivots in an outward direction beyond the longitudinal axis of the wall of the outer sheath when the pair of jaws is in the open position. The actuator assembly has one or more drive wires that engage the pair of jaws to move the pair of jaws between the open and closed positions. The insulating coating at least partially covers at least one of the distal portion of the base, the one or more drive wires, and the proximal portion of the pair of jaws.
These and other aspects of the exemplary embodiments will become apparent from the following detailed description, taken in conjunction with the accompanying drawings, illustrating by way of example the principles of the various exemplary embodiments.
In order to facilitate a fuller understanding of the exemplary embodiments, reference is now made to the appended drawings. These drawings should not be construed as limiting, but are intended to be exemplary only.
The following description is intended to convey a thorough understanding of the embodiments by providing various embodiments and details involving an avulsion forceps device that is configured to minimize thermal injury during use on a patient. It is understood, however, that the invention is not limited to these specific embodiments and details, which are exemplary only. It is further understood that one possessing ordinary skill in the art, in light of known devices, systems and methods, would appreciate the use of the invention for its intended purposes and benefits in any number of alternative embodiments.
Generally speaking, the various exemplary embodiments of the avulsion forceps described herein have an outer sheath, a base, a pair of jaws connected to the base such that the jaws can be moved between open and closed positions, and an actuating assembly that is configured to move the jaws between the open and closed positions. The avulsion forceps can be configured such that, when the jaw are in an open position, a proximal end of the jaws can extend outward beyond a longitudinal axis of the wall of the outer sheath, or such that the proximal end of the jaws do not extend outward past a longitudinal axis of the wall of the outer sheath. Embodiments in which the proximal end of the jaws do not extend beyond the walls of the outer sheath can be advantageous because less protrusions are extending from the device that could inadvertently contact tissue of a patient during use of the device.
Certain embodiments of the avulsion forceps in which the proximal ends of the jaws do not extend beyond the walls of the outer sheath (when the jaws are in the open position) include a first jaw and a second jaw, in which each jaw has a proximal portion and a distal portion, the proximal portion of each jaw having at least one internally extending arm with a curved proximal surface and an angled inner surface. Each jaw also has one externally extending projection with a curved external surface. The jaws can be combined with any actuating assembly having a driver, in which the driver is configured to engage and open the jaws such that the proximal portions of the jaw do not extend beyond the walls of the outer sheath.
Both embodiments of avulsion forceps described above (i.e., embodiments in which the proximal ends of the jaws extend beyond a wall of the outer sheath and embodiments in which the proximal ends of the jaws do not extend beyond a wall of the outer sheath) can be charged with electric current to facilitate removal of tissue. For example, the avulsion forceps can be biopsy forceps that are charged with electric current for tearing the tissue. The biopsy forceps can receive steady electric current or short bursts (or impulses) of electric current. Impulses of electric current, rather than steady electric current, prevents electrical current from inducing injury to surrounding tissue. In some of these embodiments, tissue is removed by both the electric current provided to the biopsy forceps and mechanical force applied to the avulsion forceps assembly.
Various embodiments described herein include features that minimize the potential for thermal injury as a result of the electric charge. For example, in embodiments in which the proximal ends of the jaws do not extend beyond a wall of the outer sheath, the outer sheath can be a dielectric sheath, and the dielectric sheath surrounds a majority of the length of the base. In another example, in embodiments in which the proximal ends of the jaws do extend beyond a wall of the outer sheath, a majority of the base and/or at least a portion of the proximal ends of the jaws can be coated with an insulating coating that insulates the coated portions of the jaws.
Generally speaking, a method of using an exemplary embodiment of the jaw assembly for avulsion forceps to obtain a tissue sample includes the step of opening a pair of jaws by pushing at least one drive wire in a distal direction to cause a drive member to move in a distal direction and engage the pair of jaws.. A method of using an exemplary embodiment of the invention to obtain a tissue sample also includes closing the pair of jaws around a volume of tissue, and includes the steps of pulling the at least one drive wire in a proximal direction, to cause the jaws to move to a closed position and grasp a volume of tissue. The tissue can be torn or removed from the body.
The various exemplary embodiments generally described devices that have a pair of jaws that may be used to tear or pull a volume of tissue away from a greater volume of tissue. However, the various embodiments are not so limited. For example, the jaws can be hot biopsy jaws, and the device can be configured to cut a volume of tissue by supplying short bursts of current to the biopsy jaws and also applying a mechanical force to the biopsy jaws. In some embodiments, the jaw assembly can be used to cut or cauterize tissue, or to reveal additional tools such as a cauterization tip or a needle for injection purposes.
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The drive cable 104 and the driver 105 may take any suitable form, such as, for example, any commercially available form that is capable of being used to engage the jaws 106, 107. In embodiments in which the driver is intended to have electric current run through it, the driver 105 can be made of stainless steel or other conducting medium, and, in embodiments in which the driver 105 is not intended to have electric current run through it, the driver 105 can be made of a non-conductive material. The driver 105, however, can be made of any suitable material that allows for the driver 105 to function as desired. The drive cable 104 is connected to the driver 105 such that movement of the drive cable 104 in the distal direction causes the driver 105 to move in the distal direction, and movement of the drive cable 104 in the proximal direction causes the driver 105 to move in the proximal direction. Referring to
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While the illustrated embodiment shows the exemplary embodiment of the driver 105 engaging the jaws 106, 107, it should be understood that any other suitable embodiment for a driver 105 that is capable of engaging the jaws 106, 107 to move the jaws between the open and closed positions can be used. While the illustrated embodiment shown in
The base 34 has a proximal portion that is connected to at least one of the spring sheath 16 and/or the outer sheath 15, and a distal portion that is operatively connected to the jaws 36, 38 such that the jaws are movable between the open and closed position. In the illustrated embodiment, the jaws 36, 38 are connected the base 34 at a pivot point 40 such that the jaws can move between the open and closed positions. The drive cables 18, 19 are connected to the jaw components 36, 38 such that movement of the drive cables 18, 19 in the distal direction causes the corresponding jaw components 36, 38 to move to the open position (as shown in
In the illustrated embodiment, each jaw 36, 38 has a proximal portion 36b, 38b and a distal portion having teeth 36a, 36b. The proximal portions 36b, 38b are connected to the base 34 and operatively connected to the drive wires 18, 19. This connection between the proximal portions 36b, 38b and the base 34 is configured such that movement of the drive wires 18, 19 in the distal direction causes the proximal portions 36b, 38b to move outward beyond the edge of the base 34 and beyond a longitudinal axis 33 of the wall of the outer sheath 15.
The insulating coating 14 is disposed over at least one of the base 34, drive wires 18, 19, and proximal portions 36b, 38b of the jaws 36, 38 to prevent these electrically charged components of the device 10 from inducing injury to surrounding tissue. In certain embodiments, the insulating coating 14 is applied to the portion of the base 34 that extends past the distal end of the outer sheath 15. In certain embodiments, the insulating coating 14 is applied to the portions of the drive wires 18, 19 and/or the portions of the proximal ends 36b, 38b that extend beyond the longitudinal axis 33 when the device 10 is in an open position. The insulating coating can be, for example, polytetrafluorethylene (PTFE), parylene, or any other suitable coating. It is advantageous to apply a coating to the device as described with the various embodiments above because these components are not protected by the dielectric sheath 15, and these components are in a position to contact surrounding tissue during use of the device 10.
The various embodiments are not to be limited in scope by the specific embodiments described herein. Further, although some of the embodiments have been described herein in the context of a particular implementation in a particular environment for a particular purpose, those of ordinary skill in the art should recognize that its usefulness is not limited thereto and that the various embodiments can be beneficially implemented in any number of environments for any number of purposes. Accordingly, the claims set forth below should be construed in view of the full breadth and spirit of the embodiments as disclosed herein. While the foregoing description includes many details and specificities, it is to be understood that these have been included for purposes of explanation only, and are not to be interpreted as limitations of the various embodiments. Many modifications to the embodiments described above can be made without departing from the spirit and scope of this description.
The present application claims benefits and priority to U.S. Provisional Patent Application No. 62/586,573, filed on Nov. 15, 2017, the entire disclosure of which is incorporated herein by reference.
Number | Date | Country | |
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62586573 | Nov 2017 | US |