The present disclosure relates generally to medical devices comprising elongate bodies configured to be inserted into incisions or openings in anatomy of a patient to provide diagnostic or treatment operations.
More specifically, the present disclosure relates to medical devices that can be inserted into anatomy of a patient to perform a biological matter removal process, such as by cutting sample tissue for analysis.
Endoscopes can be used for one or more of 1) providing passage of other devices, e.g., therapeutic devices or tissue collection devices, toward various anatomical portions, and 2) imaging of such anatomical portions. Such anatomical portions can include gastrointestinal tract (e.g., esophagus, stomach, duodenum, pancreaticobiliary duct, intestines, colon, and the like), renal area (e.g., kidney(s), ureter, bladder, urethra) and other internal organs (e.g., reproductive systems, sinus cavities, submucosal regions, respiratory tract), and the like.
Conventional endoscopes can be involved in a variety of clinical procedures, including, for example, illuminating, imaging, detecting and diagnosing one or more disease states, providing fluid delivery (e.g., saline or other preparations via a fluid channel) toward an anatomical region, providing passage (e.g., via a working channel) of one or more therapeutic devices for sampling or treating an anatomical region, and providing suction passageways for collecting fluids (e.g., saline or other preparations) and the like.
In conventional endoscopy, the distal portion of the endoscope can be configured for supporting and orienting a therapeutic device, such as with the use of an elevator. In some systems, two endoscopes can be configured to work together with a first endoscope guiding a second endoscope inserted therein with the aid of the elevator. Such systems can be helpful in guiding endoscopes to anatomic locations within the body that are difficult to reach. For example, some anatomic locations can only be accessed with an endoscope after insertion through a circuitous path.
The present inventors have recognized that problems to be solved with conventional medical devices, and in particular endoscopes and duodenoscopes used to retrieve sample biological matter, include, among other things, 1) the difficulty in navigating endoscopes, and instruments inserted therein, to locations within anatomical regions deep within a patient, 2) the disadvantage of only being able to obtain small tissue sample sizes 3) the increased time and associated cost of having to repeatedly remove and reinsert medical devices to obtain a sufficient quantity of sample material, and 4), the difficulty of incorporating features (e.g., steerability and tissue collection features) into small-diameter devices. Such problems can be particularly present in duodenoscopy procedures (e.g., Endoscopic Retrograde Cholangio-Pancreatography, hereinafter “ERCP” procedures) where an auxiliary scope (also referred to as daughter scope, or cholangioscope) can be attached and advanced through the working channel of a “main scope” (also referred to as mother scope or duodenoscope). Furthermore, the tissue retrieval device used to remove the sample matter is inserted through the auxiliary scope. As such, the duodenoscope, auxiliary scope and tissue retrieval device become progressively smaller and more difficult to maneuver and perform interventions and treatments.
The present disclosure can help provide solutions to these and other problems by providing systems, devices and methods relating to inserting tissue retrieval devices, such as biopsy forceps, through a auxiliary scope having a small-diameter passage. The tissue retrieval devices can have a pressure-applying device that can be used to bias a tissue collector, e.g., a blade or auger, against target tissue. The pressure-applying device can facilitate the tissue collector removing a larger volume of sample material, such as by allowing the tissue collector to more deeply penetrate the target tissue. Furthermore, the tissue retrieval device can be used in conjunction with a receptacle that can hold one or more pieces of sample material, thereby allowing collection of multiple samples and larger samples. As such, the present disclosure can help solve the problems referenced above and other problems by 1) reducing the number of times a tissue retrieval device needs to be inserted and reinserted into the anatomy, and 2) increasing the volume of sample material collected with each insertion, among other things, as is described herein. The terms biological matter collection device, biological matter retrieval device, tissue collection device and tissue retrieval device are used interchangeably herein.
In an example, a tissue separation device can comprise an elongate body comprising a proximal end portion and a distal end portion, a tissue separator coupled to the distal end portion, the tissue separator configured to engage sample tissue for retrieval, and a pressure-applying device configured to bias the tissue separator against the sample tissue.
In another example, a method of collecting biological matter using a tissue retrieval device can comprise inserting the tissue retrieval device into anatomy of a patient, guiding a tissue collector of the tissue retrieval device to a target tissue area, activating a pressure applying device to bias the tissue collector into the target tissue, and collecting biological matter with the tissue retrieval device.
In an additional example, a tissue retrieval device can comprise an elongate shaft extending along an axis and configured for insertion into an anatomic duct, a tissue collection device coupled to the elongate shaft and configured to separate tissue from the anatomic duct, an energization device configured to improve engagement between the tissue collection device and the anatomic duct, and a control mechanism configured to selectively activate the energization device.
Imaging and control system 12 can comprise controller 16, output unit 18, input unit 20, light source 22, fluid source 24 and suction pump 26.
Imaging and control system 12 can include various ports for coupling with endoscopy system 10. For example, controller 16 can include a data input/output port for receiving data from and communicating data to endoscope 14. Light source 22 can include an output port for transmitting light to endoscope 14, such as via a fiber optic link. Fluid source 24 can include a port for transmitting fluid to endoscope 14. Fluid source 24 can comprise a pump and a tank of fluid or can be connected to an external tank, vessel or storage unit. Suction pump 26 can comprise a port used to draw a vacuum from endoscope 14 to generate suction, such as for withdrawing fluid from the anatomical region into which endoscope 14 is inserted. Output unit 18 and input unit 20 can be used by an operator of endoscopy system 10 to control functions of endoscopy system 10 and view output of endoscope 14. Controller 16 can additionally be used to generate signals or other outputs from treating the anatomical region into which endoscope 14 is inserted. In examples, controller 16 can generate electrical output, acoustic output, a fluid output and the like for treating the anatomical region with, for example, cauterizing, cutting, freezing and the like.
Endoscope 14 can comprise insertion section 28, functional section 30 and handle section 32, which can be coupled to cable section 34 and coupler section 36.
Insertion section 28 can extend distally from handle section 32 and cable section 34 can extend proximally from handle section 32. Insertion section 28 can be elongate and include a bending section, and a distal end to which functional section 30 can be attached. The bending section can be controllable (e.g., by control knob 38 on handle section 32) to maneuver the distal end through tortuous anatomical passageways (e.g., stomach, duodenum, kidney, ureter, etc.). Insertion section 28 can also include one or more working channels (e.g., an internal lumen) that can be elongate and support insertion of one or more therapeutic tools of functional section 30, such as auxiliary scope 134 of
Handle section 32 can comprise knob 38 as well as ports 40. Knob 38 can be coupled to a pull wire, or other actuation mechanisms, extending through insertion section 28. Ports 40 can be configured to couple various electrical cables, guide wires, auxiliary scopes, tissue collection devices of the present disclosure, fluid tubes and the like to handle section 32 for coupling with insertion section 28.
Imaging and control system 12, according to examples, can be provided on a mobile platform (e.g., cart 41) with shelves for housing light source 22, suction pump 26, image processing unit 42 (
Functional section 30 can comprise components for treating and diagnosing anatomy of a patient. Functional section 30 can comprise an imaging device, an illumination device and an elevator, such as is described further with reference to elevator 54 of
Image processing unit 42 and light source 22 can each interface with endoscope 14 (e.g., at functional unit 30) by wired or wireless electrical connections. Imaging and control system 12 can accordingly illuminate an anatomical region, collect signals representing the anatomical region, process signals representing the anatomical region, and display images representing the anatomical region on display unit 18. Imaging and control system 12 can include light source 22 to illuminate the anatomical region using light of desired spectrum (e.g., broadband white light, narrow-band imaging using preferred electromagnetic wavelengths, and the like). Imaging and control system 12 can connect (e.g., via an endoscope connector) to endoscope 14 for signal transmission (e.g., light output from light source, video signals from imaging system in the distal end, diagnostic and sensor signals from a diagnostic device, and the like).
Fluid source 24 (
In the example of
As can be seen in
Housing 52 can comprise accommodation space 53 that houses deflector 55. Instrument 63 can comprise forceps, a guide wire, a catheter, or the like that extends through lumen 62. Instrument 63 can additionally comprise auxiliary scope 134 of
Side-viewing endoscope camera module 50 of
Thus, as endoscope 100 is inserted further into the anatomy, the complexity with which it must be maneuvered and contorted increases, as described with reference to
Duodenum D can comprise duct wall 120, sphincter of Oddi 122, common bile duct 124 and main pancreatic duct 126. Duodenum D comprises an upper part of the small intestine. Common bile duct 124 carries bile from the gallbladder and liver (not illustrated) and empties the bile into the duodenum D through sphincter of Oddi 122. Main pancreatic duct 126 carries pancreatic juice from the exocrine pancreas (not illustrated) to common bile duct 124. Sometimes it can be desirable to remove biological matter, e.g., tissue, from bile duct 124 or pancreatic duct 126 to analyze the tissue to, for example, diagnose diseases or maladies of the patient such as cancer.
Functional module 102 can comprise elevator portion 130. Endoscope 100 can further comprise lumen 132 and auxiliary scope 134. Auxiliary scope 134 can comprise lumen 136. Though not shown for simplicity, auxiliary scope 134 can itself include functional components, such as a camera, to facilitate navigation of auxiliary scope 134 from endoscope 100 through the anatomy and to facilitate viewing of components extending from lumen 132.
In certain duodenoscopy procedures (e.g., Endoscopic Retrograde Cholangio-Pancreatography, hereinafter “ERCP” procedures) an auxiliary scope (also referred to as daughter scope, or cholangioscope), such as auxiliary scope 134, can be attached and advanced through lumen 132 (or central lumen 62 of insertion section 28 of endoscope 14 in
However, as mentioned above, the size of the additional device is typically small due to the progressively smaller sizes of endoscope 100, auxiliary scope 134 and the additional device. In examples, lumen 132 of endoscope 100 can typically be on the order of approximately 4.0 mm in diameter, while lumen 136 of auxiliary scope 134 can typically be on the order of approximately 1.2 mm. As such, with conventional devices, it can be difficult to obtain sufficiently large tissue sample sized to ensure accurate diagnoses without having to repeatedly remove and reinsert the additional device. However, with the systems and devices of the present disclosure it is possible to obtain sufficiently large tissue sample sizes with only a single insertion and removal of the additional device, when configured as a tissue retrieval device of the present disclosure, for example.
Tissue collection device 204 can be configured to do one or both of separate and retrieve biological matter from within a patient after being positioned within the patient by elongate body 202. Tissue collection device 204 can be configured to engage target tissue, aided by operation of pressure-applying device 214, separate the target tissue from the patient and store separated target tissue for removal from the patient, such as by removal of elongate body 202 from the patient.
Handpiece 218 can comprise any device suitable for facilitating manipulation and operation of surgical instrument 200. Handpiece 218 can be located at the proximal end of shaft 222 or another suitable location along shaft 222. In examples, handpiece 218 can comprise a pistol grip, a knob, a handlebar grip and the like. Actuation mechanism 216 can be attached to handpiece 218 to operate pressure-applying device 214. Actuation mechanism 216 can comprise one or more of buttons, triggers, levers, knobs, dials and the like. Actuation mechanism 216 can be coupled to pressure-applying device 214 and can comprise any suitable device for allowing operation of pressure-applying device 214 from handpiece 218. As such, actuation mechanism 216 can comprise a linkage located within lumen 224 of shaft 222 or alongside shaft 222. In examples, the linkage can be a mechanical linkage, an electronic linkage or an electric linkage, (such as a wire or cable), or an activation energy source, such as an electric source, a fluid source or a gas source (such as a tube or conduit).
Shaft 222 can extend from handpiece 218 and can comprise an elongate member configured to allow tissue collection device 204 to be inserted into a patient. In examples, shaft 222 can be sized for placement within an auxiliary scope, such as scope 134 of
Tissue collection device 204 can be located at the distal end of shaft 222 or another suitable location along shaft 222. Tissue collection device 204 can be sized to fit within lumen 136 (
Pressure-applying device 214 can comprise a component or system that can be operated to selectively apply directional pressure to tissue collection device 204, either directly or through shaft 222. Pressure-applying device 214 can be coupled to shaft 222 or tissue collection device 204 in a position to push against biological structure opposite tissue collection device 204. As such, pressure-applying device 214 can facilitate engagement of separator 212 with target tissue. Pressure-applying device 214 can comprise any suitable device for pushing tissue collection device 204. In examples, pressure-applying device 214 can comprise a biasing element, such as a spring-loaded deflector, as is described with reference to
Container 210 can comprise a walled element to hold and retain biological matter collected by tissue collection device 204. In an example, container 210 can comprise a flexible basket that can be deformed to allow separator 212 to be brought into close contact with target tissue. For example, container 210 can be fabricated from woven material such as strands of Kevlar, PVC, polyethylene, polycarbonate, PEEK and the like. Container 210 can be coupled to structural components, e.g., a frame, to facilitate coupling to shaft 222 and pressure-applying device 214, as well as to provide stability for separator 212. In additional examples, container 210 can comprise a structural element, such as a box fabricated from rigid and inflexible material.
Handpiece 218 can be operated by a user to operate tissue removal device 204. Handpiece 218 can be used to manipulate shaft 222 to push separator 212 against target tissue. For example, shaft 222 can be rotated, oscillated, reciprocated and the like move separator 212 along the target tissue to cause separator 212 to separate sample tissue from the target tissue attached to the patient. Activation mechanism 216 can be coupled to handpiece 218 and can be configured to operate pressure-applying device 214. Activation mechanism 216 can comprise any type of device suitable for activating the different types of pressure-applying devices described herein. In examples, activation mechanism 216 can comprise one or more of a lever, a trigger, a joystick, a button, a wheel and the like, as well as combinations thereof. In an example, activation mechanism 216 can comprise a wheel that can be rotated in one direction to activate or energize a pressure-applying mechanism and rotated in an opposite direction to deactivate or deenergize the pressure-applying mechanism. For example, the wheel can be rotated to push and/or pull a wire or open and close a valve. As shown in
As mentioned above and discussed in further detail below, tissue removal device 204 can be configured as a low-profile device so as to be able to be inserted through a small diameter lumen, such as lumen 136 of auxiliary scope 134 of
As shown in
Tissue retrieval device 250 can be inserted into anatomic duct 270 with sleeve 260 in a distal or disengaged position, as shown in
As shown in
Tissue retrieval device 300 can further comprise shaft 306, sleeve 308 and energization system 310. Boring device 302 can comprise container 312, boring lands 314, blade 316 and bore 318. Energization system 310 can comprise energy source 320, duct 322 and valve 324. Actuator 304 can comprise bladder 326.
Tissue retrieval device 300 can be configured to engage tissue in the axial direction of arrow B. For example, tissue retrieval device 300 can be positioned in front of a mound or protrusion of tissue (e.g., target tissue 274 of
Inflatable actuator 304 can comprise a pressure-applying device configured to be energized with a fluid or gas. Energy source 320 can comprise a source of pressurized fluid, such as air or saline. The pressurized fluid can flow from energy source 320 to bladder 326 through duct 322. Valve 324 can be positioned in duct 322 to selectively allow the pressurized fluid into the internal cavity of bladder 326. Valve 324 can be mechanically or electrically activated and can be controlled by an actuator connected to a handpiece (e.g., handpiece 218 of
In examples, boring device 302 can be configured as an auger. As such, container 312 can have a cone shape with lands 314 wrapped around container 312 in a spiral manner. Lands 314 can be configured to engage tissue to allow container 312 to penetrate the tissue in the direction of arrow B. Shaft 306 can be rotated by an operator to rotate container 312 and lands 314. Lands 314 can grab tissue while being rotated to cause further axial penetration of boring device 302 into the tissue. Bladder 326 can be mounted on sleeve 308 through which shaft 306 can pass to allow shaft 306 to rotate boring device 302 without affecting the directionality of inflatable actuator 304. As container 312 enters tissue, blade 316 can be configured to slice or shave tissue away from the patient. Blade 316 can comprise a sharpened edge of an opening in container 312 and can be configured similar to a potato peeler as discussed herein. Additionally, container 312 can include distal bore 318 that can be configured to punch through tissue to take a tissue sample similar to core sampling a tree, etc. As such, the distal or leading edge of bore 318 can be sharpened. In examples, only one of blade 316 and bore 318 can be used. In other examples, boring device 302 can be configured to simply punch into the tissue such that tissue enters bore 318. Thus, boring device 302 can be configured as a punch. In such a configuration, lands 314 and blade 316 can be omitted from container 312. In the various examples, container 312 can be configured to have an internal space to capture and retain sample tissue collected by bore 318 and/or blade 316.
In another example, inflatable actuator can be configured to be activated by magnetic repulsion. A first magnet can be attached to bladder 326 and a second magnet can be attached to sleeve 308. Sleeve 308 can be rotated to radially align the first and second magnets to push bladder 326 away from shaft 306. Sleeve 308 can be rotated to un-align the first and second magnets to allow bladder 326 to fall back toward shaft 306. In another example, first and second magnets can be stationarily aligned and can be electromechanically energized to produce a magnetic field.
At step 402, an endoscope can be inserted into and navigated through anatomy of a patient. For example, endoscope 14 (
At step 404, an auxiliary scope can be inserted into the endoscope to access anatomy located further in the duct. For example, auxiliary scope 134 (
At step 406, a tissue retrieval device can be inserted into the auxiliary scope to reach target tissue distal of the auxiliary scope. For example, surgical instrument 200 (
At step 408, the tissue collection device can be navigated to the location of target tissue within the patient. For example, tissue collection device 204 can be navigated through an anatomic duct to target tissue 274 (
At step 410, a pressure-applying device can be activated so as to push the tissue collection device against target tissue. For example, pressure-applying device 214 (
At step 412, a tissue collection device can be pushed, pressed or otherwise brought into pressurized contact with the target tissue. For example, tissue collection device 204 can be pushed by pressure-applying device 214 into target tissue 274. Thus, tissue collection device 204 can be reciprocated axially, or rotated, to cause blade 266 to slice, punch or shave, etc. one or more pieces of tissue away from the anatomy of the patient.
At step 414, sample tissue or biological matter separated or collected from the patient at step 412 can be stored within a space inside the tissue collection device. For example, as tissue collection device 204 is manipulated back-and-forth, or rotated, separated sample tissue 280 can slide past blade edge 278 into space 277 of container 264.
At step 416, the tissue collection device can be removed from the patient, such as by removal from the auxiliary scope, which can be left in place inside the anatomy. Safeguards can be put into place to ensure removal of the tissue collection device without inadvertently cutting anatomy of the patient. For example, sleeve 260 can be repositioned around housing 264 to cover blade 266 and retract projection 258.
At step 418, the collected sample tissue can be removed from the tissue collection device. For example, projection 258 can be rotated away from container 264 to allow user access to space 277 so that sample tissue 280 can be removed for analysis, etc.
Thereafter, method 400 can return to step 408 or can continue to step 420.
At step 420, the tissue collection device can be reinserted. From step 420, steps 408 to 418 can be repeated as many times as desired to achieve a suitable amount of sample tissue, such as a quantity sufficient to perform laboratory testing to ascertain a diagnosis to a high level of certainty. Note that the present disclosure is directed to systems and methods that reduce or eliminate the need to reinsert tissue retrieval devices. However, in some cases it may be desirable to do so in order to collect additional sample material from the same site or to collect sample material from a different site.
At step 422, the auxiliary scope can be removed from the endoscope.
At step 424, the endoscope can be removed from the patient.
As such, method 400 illustrates examples of a method of collecting biological matter from internal passages of a patient in large enough quantities, e.g., by using a directionally enhanced tissue removal device with internal storage, to eliminate or reduce insertion and removal of surgical devices from the patient.
Example 1 can include or use subject matter such as a tissue separation device comprising an elongate body comprising a proximal end portion and a distal end portion, a tissue separator coupled to the distal end portion, the tissue separator configured to engage sample tissue for retrieval by the tissue separator; and a pressure-applying device configured to bias the tissue separator against the sample tissue.
Example 2 can include, or can optionally be combined with the subject matter of Example 1, to optionally include a release mechanism to selectively activate the pressure-applying device from the proximal end portion of the elongate body.
Example 3 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 or 2 to optionally include a container to receive tissue retrieved by the tissue separator.
Example 4 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 3 to optionally include a tissue separator comprising a scraping device.
Example 5 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 4 to optionally include a scraping device comprising a blade.
Example 6 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 5 to optionally include a container comprises an opening, and a blade disposed along an edge of the opening.
Example 7 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 6 to optionally include a blade that is configured to cut tissue when the scraping device moves in a direction extending from the distal end toward the proximal end.
Example 8 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 3 to optionally include a tissue separator comprises a penetrating device.
Example 9 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 3 and 8 to optionally include a penetrating device comprises an auger.
Example 10 can include, or can optionally be combined with the subject matter of one or any combination of Examples 8 to 9 to optionally include a container comprising an opening, and an auger that wraps around the opening.
Example 11 can include, or can optionally be combined with the subject matter of one or any combination of Examples 8 through 10 to optionally include an auger that is configured to cut tissue when the tissue separator is rotated about a central axis.
Example 12 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 11 to optionally include a pressure-applying device comprising a biased actuator.
Example 13 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 12 to optionally include a spring-loaded actuator comprising a projecting member connected to the container at a pivot point, and a spring configured to bias the projecting member away from the housing.
Example 14 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 13 to optionally include a release mechanism comprising a sleeve configured to slide along the elongate body between a distal position and a proximal position, and a pull-cord connected to the sleeve and configured to extend along the elongate body to the proximal end, wherein in the distal position the sleeve is configured to press the projecting member against the tissue collector, and wherein the pull-cord is configured to move the sleeve to the proximal position to allow the projecting member to pivot away from the tissue collector.
Example 15 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 11 to optionally include a pressure-applying device comprising an expandable body.
Example 16 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 11 and 15 to optionally include an expandable body comprise an inflatable bladder.
Example 17 can include, or can optionally be combined with the subject matter of one or any combination of Examples 15 to 16 to optionally include a release mechanism that comprises a valve connected to the inflatable bladder, and a fluid tube extending from the valve.
Example 18 can include, or can optionally be combined with the subject matter of one or any combination of Examples 15 through 17 to optionally include a shield configured to selectively cover the tissue separator.
Example 19 can include, or can optionally be combined with the subject matter of one or any combination of Examples 3 through 18 to optionally include a container that is resiliently flexible.
Example 20 can include, or can optionally be combined with the subject matter of one or any combination of Examples 1 through 19 to optionally include an endoscope comprising a first longitudinal passage, and an auxiliary scope comprising a second longitudinal passage, where the auxiliary scope is configured to slide in the first longitudinal passage, wherein the tissue separation device is configured to slide in the second longitudinal passage.
Example 21 can include or use subject matter such as a method of collecting biological matter using a tissue retrieval device that can comprise inserting the tissue retrieval device into anatomy of a patient, guiding a tissue collector of the tissue retrieval device to a target tissue area, activating a pressure applying device to bias the tissue collector into the target tissue, and collecting biological matter with the tissue retrieval device.
Example 22 can include, or can optionally be combined with the subject matter of Example 21, to optionally include inserting the tissue retrieval device into the anatomy by extending an elongate shaft into a duct of the anatomy.
Example 23 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 or 22 to optionally include collecting biological matter with the tissue retrieval device by scraping the tissue retrieval device along the target tissue area.
Example 24 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 23 to optionally include collecting biological matter with the tissue retrieval device by advancing the tissue retrieval device in a direction to withdraw the tissue retrieval device from the anatomy.
Example 25 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 24 to optionally include collecting biological matter with the tissue retrieval device comprises pushing the tissue retrieval device into the target tissue area.
Example 26 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 25 to optionally include pushing the tissue retrieval device into the target tissue area comprises rotating an auger comprising the tissue retrieval device.
Example 27 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 26 to optionally include activating the pressure applying device to bias the tissue collector into the target tissue by releasing a spring-loaded deflector.
Example 28 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 27 to optionally include releasing the spring-loaded deflector by retracting a sleeve from around the spring-loaded deflector.
Example 29 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 28 to optionally include activating the pressure applying device to bias the tissue collector into the target tissue by expanding a body.
Example 30 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 29 to optionally include expanding the body by inflating a bladder.
Example 31 can include, or can optionally be combined with the subject matter of one or any combination of Examples 21 through 30 to optionally include inserting an endoscope comprising a first longitudinal passage into the anatomy of the patient, inserting an auxiliary scope comprising a second longitudinal passage into the first longitudinal passage, and inserting the tissue retrieval device into the second longitudinal passage to reach the target tissue.
Example 32 can include or use subject matter such as a tissue retrieval device that can comprise an elongate shaft extending along an axis and configured for insertion into an anatomic duct, a tissue collection device coupled to the elongate shaft and configured to separate tissue from the anatomic duct, an energization device configured to improve engagement between the tissue collection device and the anatomic duct, and a control mechanism configured to selectively activate the energization device.
Example 33 can include, or can optionally be combined with the subject matter of Example 32, to optionally include a shield to selectively prevent the tissue collection device from separating tissue from the anatomic duct.
Example 34 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 or 33 to optionally include a container having an interior space in communication with the tissue collection device.
Example 35 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 34 to optionally include an energization device that utilizes fluid pressure.
Example 36 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 35 to optionally include an energization device that comprises a bladder.
Example 37 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 36 to optionally include an energization device utilizes mechanical pressure.
Example 38 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 37 to optionally include an energization device that comprises a spring-loaded detent.
Example 39 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 38 to optionally include a tissue collection device that is configured to slice tissue from the anatomic duct in an axial direction.
Example 40 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 39 to optionally include a tissue collection device that is configured to bore tissue from the anatomic duct in an axial direction.
Example 41 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 42 to optionally include a tissue collection device that is configured to slice tissue from the anatomic duct in a circumferential direction.
Example 42 can include, or can optionally be combined with the subject matter of one or any combination of Examples 32 through 41 to optionally include a tissue collection device that is rotatable relative to the elongate shaft.
Each of these non-limiting examples can stand on its own, or can be combined in various permutations or combinations with one or more of the other examples.
The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventor also contemplates examples in which only those elements shown or described are provided. Moreover, the present inventor also contemplates examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.
In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.
In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.
Method examples described herein can be machine or computer-implemented at least in part. Some examples can include a computer-readable medium or machine-readable medium encoded with instructions operable to configure an electronic device to perform methods as described in the above examples. An implementation of such methods can include code, such as microcode, assembly language code, a higher-level language code, or the like. Such code can include computer readable instructions for performing various methods. The code may form portions of computer program products. Further, in an example, the code can be tangibly stored on one or more volatile, non-transitory, or non-volatile tangible computer-readable media, such as during execution or at other times. Examples of these tangible computer-readable media can include, but are not limited to, hard disks, removable magnetic disks, removable optical disks (e.g., compact disks and digital video disks), magnetic cassettes, memory cards or sticks, random access memories (RAMs), read only memories (ROMs), and the like.
The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
This application claims the benefit of priority to U.S. Provisional Patent Application Ser. No. 63/092,659, filed Oct. 16, 2020, the contents of which are incorporated herein by reference in their entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2021/071884 | 10/14/2021 | WO |
Number | Date | Country | |
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63092659 | Oct 2020 | US |