This invention relates generally to medical instrumentation, and more particularly to biopsy devices.
Biopsy devices are used to obtain tissue samples, usually for purposes of performing testing on these samples. In order to obtain a biopsy sample, the biopsy device must be inserted into the body to reach the tissue for which the biopsy is to be taken. The device must be positioned next to the tissue, the sample taken, and the device removed. Some biopsy protocols require multiple samples to be taken. In the case of a body canal, samples from different positions on the circumference of the canal are sometimes required for each axial position along the canal length. This can require multiple devices if sterility and sample integrity are to be maintained, or multiple procedures if more than one biopsy site is required to be sampled.
It is difficult to maintain the stability and position of a biopsy device upon insertion into the body. Biopsy procedures usually involve small incisions such that manipulation of the device at the point of the biopsy is not directly possible. It is possible for the biopsy sample to become dislodged from the biopsy device during removal of the device from the body. Secure retention of the sample is necessary to avoid repeating the process.
A biopsy device includes a housing and at least one biopsy mechanism connected to the housing. The biopsy mechanism can be provided on a biopsy arm that is connected to the housing. An actuator is provided for moving the biopsy arm and operating the biopsy mechanism.
The biopsy mechanism can comprise jaws adapted to engage and remove a biopsy sample. The jaws can be biased to an open position. The actuator can contact the jaws, a cam, or other structure connected to the jaws, such that movement of the actuator opens the jaws.
The actuator can comprise a moveable plunger. The housing can include an open interior and the plunger can be provided in the open interior. Movement of the plunger contacts the cam or other structure to operate the biopsy mechanism. Movement of the plunger can also move the biopsy arm radially outward relative to the housing. This movement will position the biopsy mechanism against the tissue to be sampled. Thus, a single stroke of the actuator can move the biopsy mechanism into position and operate the biopsy mechanism to take the sample. Gripping structure can be provided on the housing and the plunger so as to facilitate relative movement of the plunger within the housing.
Movement of the actuator in a first direction can force the biopsy arm radially outward and causes the biopsy mechanism to open. Movement of the actuator in a second direction causes the biopsy arm to move radially inward and the biopsy mechanism to close. Alternatively, the actuator can be constructed such that movement in one direction will in one position open the biopsy mechanism, and movement to another position, but in the same direction, will close the biopsy mechanism.
The biopsy mechanism can be biased to an open position or a closed position. A cam can be operatively connected to the biopsy mechanism. Contact between the actuator and the cam causes the biopsy mechanism to open or close against the biasing. The biopsy mechanism should be in the closed position prior to the biopsy arm moving radially inward such that the sample will be securely retained.
In a preferred embodiment, a plurality of biopsy arms are provided. A plurality of radially disposed biopsy arms can be spaced about an end of the housing. A first end of each arm can be connected to the housing. Each biopsy arm has a biopsy mechanism such that movement of the actuator actuates each of the biopsy arms and the respective biopsy mechanism. The biopsy mechanism can be provided at or near an opposing end of the biopsy arm. Two or more arms are preferred. Four or more radially disposed arms permit sampling about the circumference of a canal or orifice, such as the esophagus.
The biopsy arms can be provided on a head that is removably attached to the housing. In this manner, the head can be removed after the biopsy is performed and the housing and related actuator mechanism can be refitted with another head for taking another sample. The removed head with the biopsy samples is then processed to remove the samples for laboratory analysis.
A biopsy method includes the steps of providing a biopsy device with a housing and at least one biopsy mechanism connected to the housing. Structure is provided for moving the biopsy mechanism and actuating the biopsy mechanism. The biopsy mechanism can be provided on a biopsy arm that is connected to the housing. The device is inserted adjacent to tissue and the actuator is manipulated in order to move the biopsy mechanism into position and to operate the biopsy mechanism to obtain a sample.
There are shown in the drawings embodiments which are presently preferred, it being understood however, that the invention is not limited to the precise arrangements and instrumentalities shown, wherein:
a)–(c) are cross sections depicting successive steps in a biopsy procedure according to the invention.
a)–(b) are cross sections depicting the operation of a biopsy mechanism according to the invention.
a)–(b) are enlarged cross sections of the biopsy mechanism of
a)–(b) are exploded perspective views illustrating an alternative embodiment of the invention.
a)–(c) are cross sections illustrating a biopsy procedure utilizing an alternative biopsy mechanism according to the invention.
a)–(b) are cross sections illustrating the operation of an alternative embodiment.
A biopsy device 10 according to the invention is shown in
An actuator is provided for moving the biopsy mechanism outward relative to the housing 12 and operating the biopsy mechanism 18. The actuator can be a single mechanism or multiple mechanisms. Any suitable actuator mechanism(s) can be utilized. In one embodiment, the actuator comprises a plunger 22 which is moveable within an open interior 26 of the housing 12. Suitable structure such as handle 23 can be provided for manipulating the plunger 22. Movement of the actuator operates the biopsy mechanism 18 as shown in
The biopsy mechanism 18 can be of any design that is suitable to remove a biopsy sample when actuated. The biopsy mechanism 18 is provided by suitable structure such that the biopsy mechanism is moved into position and operated to take the sample, preferably in a single action. In one design, the biopsy mechanism 18 comprises forceps 36. As shown in
In operation, the biopsy device 10 is positioned in a portion of the body such as canal 50, although it will be appreciated that the biopsy device 10 of the invention can be utilized to biopsy tissues throughout the body. The plunger 22 is initially in the retracted position. When the biopsy device 10 has been properly positioned, movement of the plunger 22 causes the plunger 22 to contact wedge portions 55 of the biopsy arms 14 to move the biopsy arms 14 radially outward toward the walls of the canal 50 as shown in
In some biopsy protocols, it is necessary to repeatedly biopsy in incremental lengths. For example, in a biopsy for Barretts Metaplasia (cancer of the esophagus), the protocol requires that a biopsy be taken every 5–20 mm. The repetition of the sampling can be tedious and time consuming. The biopsy device 10 according to the invention permits the sampling of the esophageal tissue about the circumference of the esophagus in a single action. Further, according to another embodiment of the invention, the removal of the biopsy sample 54 can be readily obtained. In this embodiment, shown in
The operation of an alternative embodiment of a biopsy mechanism according to the invention is shown in
There is shown in
In an alternative embodiment, the biopsy device 10 permits the outward movement of the biopsy arms 14, operation of the biopsy mechanisms 18, followed by the closing of the biopsy mechanisms 18 and radially inward movement of the biopsy arms 14, in a single action, that is, without retraction of the plunger 22. Such a device could be provided with suitable grooves or openings on the sides of the plunger 22 to permit the biopsy mechanisms 18 and biopsy arms 14 to retract into the sides of the plunger 22 when the plunger 22 has been moved forward a given distance.
Although the invention has been described with reference to a device with biopsy arms 14, the invention is not limited in this regard. The biopsy mechanisms 18 can be provided on other structure or on the housing 12, so long as suitable structure is provided to cause the outward movement of the biopsy mechanisms 18 upon actuation of the device.
The biopsy device 10 according to the invention can be made from any suitable material. Also, the device can be made in a variety of different dimensions and designs without departing from the spirit or essential attributes of the invention. Accordingly, reference should be had to the following claims, rather than to the foregoing specification, as defining the scope of the invention.
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Number | Date | Country | |
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20040006284 A1 | Jan 2004 | US |