A biopsy is the removal of a tissue sample from a patient to enable examination of the tissue for signs of cancer or other disorders. Tissue samples may be obtained in a variety of ways using various medical procedures involving a variety of the sample collection devices. For example, biopsies may be open procedures (surgically removing tissue after creating an incision) or percutaneous procedures (e.g. by fine needle aspiration, core needle biopsy, or vacuum assisted biopsy). After the tissue sample is collected, the tissue sample is typically analyzed at a lab (e.g. a pathology lab, biomedical lab, etc.) that is set up to perform the appropriate tests (such as histological analysis).
Biopsy samples have been obtained in a variety of ways in various medical procedures including open and percutaneous methods using a variety of devices. For instance, some biopsy devices may be fully operable by a user using a single hand, and with a single insertion, to capture one or more biopsy samples from a patient. In addition, some biopsy devices may be tethered to a vacuum module and/or control module, such as for communication of fluids (e.g., pressurized air, saline, atmospheric air, vacuum, etc.), for communication of power, and/or for communication of commands and the like. Other biopsy devices may be fully or at least partially operable without being tethered or otherwise connected with another device.
One technique for collecting a breast biopsy is to use a core needle biopsy device. One such device is the MAX-CORE disposable core biopsy instrument manufactured by Bard Biopsy Systems. Core needle biopsy devices frequently use a sharp, solid piercer equipped with a lateral tissue receiving notch positioned adjacent to the distal end of the piercer. When tissue is received within the notch, an elongate hollow cutting sheath is translated over the notch to sever a tissue sample. The severed tissue sample is then stored within the notch until both the piercer and the cutting sheath are removed from the patient. Thus, in core-needle biopsy devices, only one tissue sample can be collected per insertion of the piercer and cutting sheath.
Another technique for conducting a breast biopsy is to conduct a breast biopsy using a vacuum-assisted breast biopsy device. A current textbook in this area is “Vacuum-Assisted Breast Biopsy with Mammotome®” available Nov. 11, 2012, copyright 2013 by Devicor Medical Germany GmBh, published in Germany by Springer Medizin Verlag, Authors: Markus Hahn, Anne Tardivon and Jan Casselman, ISBN 978-3-642-34270-7.
In contrast to core needle breast biopsy procedures, state of the art vacuum-assisted breast biopsy devices permit the probe to remove multiple samples without requiring the probe be removed from the breast after every sample is collected. For instance, in a vacuum assisted breast biopsy device, a hollow needle is used to penetrate tissue. The hollow needle includes a lateral aperture adjacent to a sharp distal tip. A hollow cutter is disposed within the hollow needle and is moved axially relative to the lateral aperture of the needle to sever tissue samples. Once a tissue sample is severed by the hollow cutter, the tissue sample is transported axially though the cutter and collected in a tissue collection feature.
Examples of vacuum assisted biopsy devices and biopsy system components are disclosed in U.S. Pat. No. 5,526,822, entitled “Method and Apparatus for Automated Biopsy and Collection of Soft Tissue,” issued Jun. 18, 1996; U.S. Pat. No. 6,086,544, entitled “Control Apparatus for an Automated Surgical Biopsy Device,” issued Jul. 11, 2000; U.S. Pat. No. 6,162,187, entitled “Fluid Collection Apparatus for a Surgical Device,” issued Dec. 19, 2000; U.S. Pat. No. 6,432,065, entitled “Method for Using a Surgical Biopsy System with Remote Control for Selecting an Operational Mode,” issued Aug. 13, 2002; U.S. Pat. No. 6,752,768, entitled “Surgical Biopsy System with Remote Control for Selecting an Operational Mode,” issued Jun. 22, 2004; U.S. Pat. No. 7,442,171, entitled “Remote Thumbwheel for a Surgical Biopsy Device,” issued Oct. 8, 2008; U.S. Pat. No. 7,854,706, entitled “Clutch and Valving System for Tetherless Biopsy Device,” issued Dec. 1, 2010; U.S. Pat. No. 7,914,464, entitled “Surgical Biopsy System with Remote Control for Selecting an Operational Mode,” issued Mar. 29, 2011; U.S. Pat. No. 7,938,786, entitled “Vacuum Timing Algorithm for Biopsy Device,” issued May 10, 2011; U.S. Pat. No. 8,083,687, entitled “Tissue Biopsy Device with Rotatably Linked Thumbwheel and Tissue Sample Holder,” issued Dec. 21, 2011; U.S. Pat. No. 8,118,755, entitled “Biopsy Sample Storage,” issued Feb. 1, 2012; U.S. Pat. No. 8,206,316, entitled “Tetherless Biopsy Device with Reusable Portion,” issued on Jun. 26, 2012; U.S. Pat. No. 8,702,623, entitled “Biopsy Device with Discrete Tissue Chambers,” issued on Apr. 22, 2014; U.S. Pat. No. 8,858,465, entitled “Biopsy Device with Motorized Needle Firing,” issued Oct. 14, 2014; and U.S. Pat. No. 9,326,755, entitled “Biopsy Device Tissue Sample Holder with Bulk Chamber and Pathology Chamber,” issued May 3, 2016. The disclosure of each of the above-cited U.S. patents is incorporated by reference herein.
Additional examples of vacuum assisted biopsy devices and biopsy system components are disclosed in U.S. Pub. No. 2006/0074345, entitled “Biopsy Apparatus and Method,” published Apr. 6, 2006 and now abandoned; U.S. Pub. No. 2009/0131821, entitled “Graphical User Interface for Biopsy System Control Module,” published May 21, 2009, now abandoned; U.S. Pub. No. 2010/0152610, entitled “Hand Actuated Tetherless Biopsy Device with Pistol Grip,” published Jun. 17, 2010, now abandoned; U.S. Pub. No. 2010/0160819, entitled “Biopsy Device with Central Thumbwheel,” published Jun. 24, 2010, now abandoned; and U.S. Pub. No. 2013/0324882, entitled “Control for Biopsy Device,” published Dec. 5, 2013. The disclosure of each of the above-cited U.S. patent application Publications is incorporated by reference herein.
Exemplary core needle biopsy devices are disclosed in U.S. Pat. No. 5,560,373, entitled “Needle Core Biopsy Instrument with Durable or Disposable Cannula Assembly,” issued on Oct. 1, 1996; U.S. Pat. No. 5,817,033, entitled “Needle Core Biopsy Device,” issued on Oct. 6, 1998; U.S. Pat. No. 5,971,939, entitled “Needle Core Biopsy Device,” issued on Oct. 26, 1999; and U.S. Pat. No. 5,511,556, entitled “Needle Core Biopsy Instrument,” issued on Apr. 30, 1996. The disclosure of each of the above-cited U.S. patents is incorporated by reference herein.
While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the present invention will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements. In the drawings some components or portions of components are shown in phantom as depicted by broken lines.
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the invention may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present invention, and together with the description serve to explain the principles of the invention; it being understood, however, that this invention is not limited to the precise arrangements shown.
The following description of certain examples of the invention should not be used to limit the scope of the present invention. Other examples, features, aspects, embodiments, and advantages of the invention will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the invention. As will be realized, the invention is capable of other different and obvious aspects, all without departing from the invention. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
Biopsy devices may be used to collect tissue samples in a variety of ways. For example, in some instances tissue samples are collected into a single tissue basket such that all tissue samples collected during a given biopsy procedure are deposited into the single tissue sample basket. In some other instances, tissue samples are collected into a tissue sample holder having separate compartments for each collected tissue sample. Such a multi-compartment tissue sample holder may additionally include trays or strips that individually hold each tissue sample separately from the other tissue samples. Such trays or strips may be removable or otherwise separable from the tissue sample holder at the conclusion of a biopsy procedure.
Regardless of the structure in which the tissue samples are stored, tissue samples may be collected using biopsy devices under the guidance of various imaging modalities such as ultrasound image guidance, stereotactic (X-ray) guidance, MRI guidance, Positron Emission Mammography (“PEM” guidance), Breast-Specific Gamma Imaging (“BSGI”) guidance, or otherwise. Each procedure has its own methodology based on the form of imaging guidance used. The following text briefly describes ultrasound image guided biopsy procedures, stereotactic guided biopsy procedures and MRI guided biopsy procedures.
In an ultrasound image guided breast biopsy procedure, the operator may position an ultrasound transducer on the patient's breast and maneuver the transducer while viewing an ultrasound image display screen to locate suspicious tissue in the patient's breast. Once the operator locates the suspicious tissue, the operator may anesthetize the target region of the breast. Once the breast has been anesthetized, the operator may create an initial incision using a scalpel at a location on the exterior of the breast offset from the transducer. A needle of a breast biopsy probe disposed coaxially within an introducer cannula is then inserted into the breast through the initial incision. The operator continues to hold the ultrasound transducer with one hand while maneuvering the biopsy probe with the other hand. While viewing the ultrasound image on the display screen, the operator guides the needle to a position adjacent to the suspicious tissue. A cutter within the needle of the probe is used to remove tissue which is then conveyed either to a manual pick-up location on the breast biopsy device or to a tissue sample chamber. The needle of the breast biopsy device is then removed, leaving the introducer cannula disposed within the breast. The introducer cannula may then be used to introduce a biopsy marker cannula for deploying a biopsy site marker at the biopsy site. Once a marker has been deployed at the biopsy site, the biopsy marker cannula and the introducer cannula are both removed from the breast and the incision is closed using a medically acceptable way to close breaks in the skin.
In a stereotactic image guided breast biopsy procedure, the patient is first positioned relative to x-ray equipment, which includes a breast localization assembly. In some procedures, the patient is oriented in a prone position, with the patient lying face down on a procedure table with at least one breast hanging pendulously through an aperture in the procedure table. The breast is then compressed between a compression paddle and an x-ray receptor of a localization assembly that is positioned under the procedure table. A breast biopsy device is positioned on an automatic guide device in front of the compression paddle and between the breast and an x-ray source. Once positioning of the patient and localization of the breast are complete, a scout image is acquired with the x-ray receptor in a zero-degree angular position (i.e., the x-rays are emitted along an axis normal relative to the x-ray receptor). If the scout image indicates that the patient has been positioned in a desired position, the procedure may proceed with the acquisition of stereotactic image pairs. Stereotactic image pairs are acquired by orienting the x-ray source at various complementary angular positions relative to the x-ray receptor (e.g., +15° and)−15°, with at least one x-ray image acquired at each position.
Further in the stereotactic image guided breast biopsy procedure, once a suitable stereotactic image pair is acquired, an operator may identify a target site where biopsy sampling is desired by examining the stereotactic image pair. The target site is marked on each stereotactic image and a precise location of the target site on a Cartesian coordinate system is computed using an image processing module. The computed location of the target site is then communicated to the automatic guide device. The automatic guide device is responsive to this information to position the breast biopsy probe into a position that aligns with the target site. With the breast biopsy device positioned, an operator may then fire a needle of the biopsy probe into the breast of the patient, thereby positioning the needle at the target site. A cutter within the needle of the probe is used to remove tissue, which is then conveyed either to a manual pick-up location on the breast biopsy device or to a tissue sample chamber. After the biopsy tissue is removed, a biopsy marker cannula is inserted into the needle and is used to deploy a biopsy site marker at the biopsy site. Once a marker has been deployed at the biopsy site, the needle is removed from the breast and the incision is closed using a medically acceptable way to close breaks in the skin.
In an MRI guided breast biopsy procedure, after the patient is properly positioned on the table and a targeting device (e.g., a grid and cube combination or a pillar, post and cradle support combination) has been deployed and used, a baseline MRI image is taken to verify the target location. After that, a scalpel is used to incise the skin of the breast. Next, an assembly, formed by an obturator disposed in a sleeve, is inserted through the incision to penetrate the breast tissue under the skin. In some acceptable surgical techniques, the obturator is removed and an imaging rod is inserted into the sleeve in place of the obturator. An imaging rod is defined simply as an appropriately shaped rod that includes a feature that is detectable by an imaging technique being used for the biopsy procedure. The MRI image of the imaging rod is used to locate the site to which the sleeve/obturator assembly has penetrated. In some other acceptable surgical techniques, the obturator cooperates with the breast tissue to provide a visually observable artifact in an MRI image. With both of these techniques, after the location within the breast where the biopsy is to be taken is confirmed, the obturator or the imaging rod is removed.
Further in the MRI guided breast biopsy procedure, after the obturator or imaging rod has been removed, it is replaced in the sleeve with the needle of a breast biopsy probe. A cutter within the needle of the probe is used to remove tissue, which is then conveyed either to a manual pick up location on the breast biopsy device or to a breast biopsy device sample chamber. After the biopsy tissue is removed, a biopsy marker cannula is inserted into the needle and is used to deploy a biopsy site marker at the biopsy site. The needle is then removed from the sleeve. Optionally, the imaging rod or the obturator is put back into the breast for reimaging of the biopsy site. Then the imaging rod or obturator and the sleeve are removed.
Vacuum assisted biopsy devices and core needle biopsy devices both may have various advantages over the other, depending on context. For instance, one advantage of vacuum assisted biopsy devices is that vacuum assistance permits removal of multiple tissue samples using a single insertion. However, while core needle biopsy devices lack this feature, use of core needle biopsy devices may still be desirable. For instance, core needle biopsy devices are generally capable of having smaller needles relative to core needle biopsy devices, thereby reducing patient anxiety and increasing the capacity of the needle to penetrate a lesion. Therefore, in some instances it may be desirable to incorporate the feature of multiple sample removal of a vacuum assisted biopsy device into a core needle biopsy device to achieve the benefits present in both styles of biopsy device.
A desirable feature of the device described herein, which is a core needle biopsy device is that the device allows for single insertion with multiple samples being obtained whilst using a core needle type device. Currently, it is believed that only vacuum assisted biopsy devices have this ability.
Later in this application specific means and ways to move needle assembly (20) forward and backwards within core needle biopsy device (10) are described. At this point Applicants wish to point out that although they have included specific ways and means to move needle assembly (20) forwards and backwards, they believe, without intending to be bound thereby, that there are many alternative way to move needle assembly (20) backwards and forwards and these alternative ways should be known to people of ordinary skill in the art of designing biopsy devices.
An end portion (30) is disposed on the proximal end of piercer (22). End portion (30) of the present example is overmolded onto the proximal end of piercer (22) and is generally configured to enhance the manipulability of piercer (22). In particular, end portion (30) comprises a receiving feature (32) in the form of a lateral notch. Receiving feature (32) is configured to receive a portion of a piercer drive assembly (300). As will be described in greater detail below, this permits piercer drive assembly (300) to drive movement of piercer (22) through a predetermined sequence of movement.
Cutter (40) comprises a generally hollow cylindrical tube that is configured to receive piercer (22) therein. Cutter (40) comprises an open distal end (42), a cannula portion (44) and an end portion (50). Open distal end (42) is configured to permit at least a portion of piercer (22) to protrude from cutter (40) when piercer (22) is moved relative to cutter (40). As will be described in greater detail below, this configuration permits needle assembly (20) to move through the cutting cycle and the tissue acquisition cycle by permitting notch (26) of piercer (22) to move relative to distal end (42) of cutter (40).
Open distal end (42) of the present example includes a tapered edge (43). Tapered edge (43) is generally configured to slice through tissue to separate tissue samples when cutter (40) is moved relative to notch (26) of piercer (22). Thus, it should be understood that tapered edge (43) is generally configured to act a blade. Although the present example is described and shown as using a tapered configuration, it should be understood that in other examples various alternative configurations can be used. For instance, in some examples tapered edge (43) includes a plurality of serrations in addition or in alternative to the taper shown. In still other examples, tapered edge (43) can include any other additional or alternative cutting surface as will be apparent to those of ordinary skill in the art in view of the teachings herein.
Cannula portion (44) of cutter (40) extends proximally from distal end (42) through end portion (50) such that piercer (22) can be received with the proximal end of cutter (40). Unlike end portion (30) of piercer (22), end portion (50) of cutter (40) is generally elongate such that at least a portion of end portion (50) extends distally relative to outer housing (14). As will be described in greater detail below, this distal extension relative to outer housing (14) permits a portion of end portion (50) to be accessible to an operator for tissue sample collection purposes.
End portion (50) of cutter (40) comprises a receiving feature (52) and a tissue collection feature (54). As with receiving feature (32) of piercer (22), receiving feature (52) of end portion (50) comprises a lateral slot or other receiving feature that is configured to receive at least a portion of a cutter drive assembly (200). As will be described in greater detail below, receiving feature (52) is configured to receive at least a portion of cutter drive assembly (200) to permit cutter drive assembly (200) to move cutter (40) through a predetermined sequence of movement.
Tissue collection feature (54) is disposed distally relative to receiving feature (52). Tissue collection feature (54) generally defines an elongate notch that is open to cannula portion (44) of cutter (40). Correspondingly, cannula portion (44) includes a cutout portion (46) that is adjacent to tissue collection feature (54). Accordingly, it should be understood that tissue collection feature (54) is in communication with the hollow interior, or a lumen, defined by cannula portion (44). As will be described in greater detail below, this relationship between tissue collection feature (54) and cannula portion (44) permits an operator to remove tissue samples from cutter (40) as they are collected by piercer (22).
Drive assembly (100) comprises a needle cocking assembly (110), a cutter drive assembly (200), a piercer drive assembly (300), and a release assembly (400). Generally, and as will be described in greater detail below, needle cocking assembly (110) engages cutter drive assembly (200) and piercer drive assembly (300) to cock cutter drive assembly (200) and piercer drive assembly (300), which correspondingly cock cutter (40) and piercer (22). Release assembly (400) also engages cutter drive assembly (200) and piercer drive assembly (300) to selectively release and fire cutter drive assembly (200) and piercer drive assembly (300) to thereby selectively release and fire cutter (40) and piercer (22).
Needle cocking assembly (110) is best seen in
Distal end (114) of lead screw (112) generally comprises a cylindrical shape extending distally from first threaded portion (116). Distal end (114) is configured to be received by at least a portion of outer housing (14) or another intermediate connecting member, such as a bearing, to permit lead screw (112) to rotate about a fixed axis. Thus, it should be understood that distal end (114) generally acts as a boss or locating feature to permit rotation of lead screw (112).
First threaded portion (116) is disposed proximally of distal end (114). First threaded portion (116) includes threads (117) which have a relatively fine pitch. As will be described in greater detail below, threads (117) are generally configured to engage a portion of cutter drive assembly (200) to convert rotational motion of lead screw (112) into translation of at least a portion of cutter drive assembly (200). This conversion of motion generally results in proximal and distal translation of at least a portion of cutter drive assembly (200), which results in cocking of cutter drive assembly (200).
Slide stop portion (118) is disposed proximally of first threaded portion (116) and distally of keyway (122), second threaded portion (124) and proximal end (126). Slide stop portion (118) comprises a generally cylindrical shape. The diameter of slide stop portion (118) generally corresponds to the major pitch diameter of first threaded portion (116). As will be described in greater detail below, these size and shape characteristics of slide stop portion (118) permit slide stop portion (118) to provide coaxial support of at least a portion of cutter drive assembly (200) as cutter drive assembly (200) moves relative to lead screw (112).
The diameter of slide stop portion (118) is also generally greater than the diameter of non-threaded portion (120) of lead screw (112). As will be understood, this differential in diameter between slide stop portion (118) and non-threaded portion (120) permits slide stop portion (118) to act as a mechanical stop feature. As will be described in greater detail below, this mechanical stop feature is configured to limit distal translation of carriage nut (130) as carriage nut (130) moves along lead screw (112).
Between slide stop portion (118) and first threaded portion (116), lead screw (112) defines an indented portion (119). As will be described in greater detail below, indented portion (119) is generally configured to permit a portion of cutter drive assembly (200) to “free-wheel” when cutter drive assembly (200) is disposed in axial alignment with indented portion (119). It should be understood that the term “free-wheel” used herein refers to the ability of lead screw (112) to continue to rotate without additional proximal translation of cutter drive assembly (200) and without binging between lead screw (112) and at least a portion of cutter drive assembly (200). It should be understood that during free-wheeling, at least a portion of cutter drive assembly (200) is generally disengaged from first threaded portion (116) of lead screw (112). However, it should be understood that the length of indented portion (119) is sufficiently limited such that when rotation of lead screw (112) is reversed, at least a portion of cutter drive assembly (200) reengages with first threaded portion (116) of lead screw (112). Further details of the relationship between indented portion (119), first threaded portion (116) and cutter drive assembly (200) will be described in greater detail below.
As shown in
Second threaded portion (124) is disposed between non-threaded portion (120) and proximal end (126), with non-threaded portion (120) distal of second threaded portion (124) and proximal end (126) proximal of non-threaded portion (120). Second threaded portion (124) includes a plurality of relatively course threads (125). Threads (125) are generally course relative to threads (117) of first threaded portion (116). Thus it should be understood that with both threads (125, 117) acting to transfer rotary movement into axial translation, threads (125) of second threaded portion (124) will generally provide faster translation from the same rotary input relative to threads (117) of first threaded portion (116).
Second threaded portion (124) of the present example is configured to engage at least a portion of piercer drive assembly (300). As will be described in greater detail below, threads (125) of second threaded portion (124) are generally configured to convert rotatory motion of lead screw (112) into axial translation of at least a portion of piercer drive assembly (300). This conversion of rotary motion into translation permits piercer drive assembly to translate piercer (22) for the purpose of tissue collection via tissue collection feature (54).
In the present example, second threaded portion (124) and non-threaded portion (120) are arranged such that non-threaded portion (120) defines a length. The length of non-threaded portion (120) is generally just greater than the approximate length of carriage nut (130). As will be understood, the length of non-threaded portion permits carriage nut (130) to be axially translated by piercer drive assembly (300) until being stopped by slide stop portion (120). Once translation is ceased by slide stop portion (120), however, non-threaded portion (120) permits lead screw (112) to “free-wheel” relative to piercer drive assembly (300). It should be understood that the term “free-wheel” used herein refers to the ability of lead screw (112) to continue to rotate without additional translation of piercer drive assembly (300) and without binding between lead screw (112) and piercer drive assembly (300). During free-wheeling, piercer drive assembly (300) generally disengaged from second threaded portion (124). However, it should be understood that the length of non-threaded portion remains limited to an extent such that when rotation of lead screw (112) is reversed, piercer drive assembly (300) reengages with second threaded portion (124). Further details of the relationship between non-threaded portion (120), second threaded portion (124) and piercer drive assembly (300) will be described in greater detail below.
Returning to
As described above, motor assembly (160) includes a rotary communication feature (162). Additionally, motor assembly (160) includes a rotary power source (164). Rotary power source (164) of the present example includes an electric motor. In other examples, rotary power source (164) may include any other suitable power source such as a pneumatic motor, a piezo electric motor, and/or etc.
On the exterior of carriage nut (130), carriage nut (130) defines a threaded portion (136) and a slide portion (140). Threaded portion (136) includes a plurality of threads (138). Threads (138) generally include a pitch that is relatively fine and generally equivalent to the pitch of threads (117) of first threaded portion (116) described above with respect to lead screw (112). As will be described in greater detail, threads (138) of threaded portion (136) are generally configured to engage at least a portion of piercer drive assembly (300) to move at least a portion of piercer drive assembly (300) thorough a variety of positions to thereby cock and fire piercer (22).
Slide portion (140) defines a generally cylindrical shape having an outer diameter. The outer diameter of slide portion (140) approximately corresponds to the major diameter of threaded portion (136). As will be described in greater detail below, this correspondence in diameters permits at least a portion of cutter drive assembly (200) to freely slide over both slide portion (140) and threaded portion (136), while remaining generally coaxial with carriage nut (130).
Adjacent to the proximal end of carriage nut (130), slide portion (140) defines an annular channel (142). As will be described in greater detail below, annular channel (142) is configured to receive at least a portion of piercer drive assembly (300) to axially secure at least a portion of piercer drive assembly (300) to carriage nut (130). However, as will also be described in greater detail below, any portion of cutter drive assembly (300) axially secured to carriage nut (130) via cannula channel (142) is rotatably unsecured such that carriage nut (130) can rotate relative to piercer drive assembly (300).
Disposed between slide portion (140) and threaded portion (136), carriage nut (130) defines an indented portion (144). Indented portion (144) is defined by an outer diameter that is generally less than the major diameter of threaded portion (136) and the outer diameter of slide portion (140). In addition, indented portion (144) defines a length. As will be described in greater detail below, the length of indented portion (144) is generally approximately equivalent to at least a portion of piercer drive assembly (300) to permit a portion of piercer drive assembly (300) to free-wheel relative to carriage nut (130).
As will be described in greater detail below, indented portion (144) is generally configured to permit a portion of piercer drive assembly (300) to free-wheel when piercer drive assembly (300) is disposed in axial alignment with indented portion (144). As similarly discussed above with respect to non-threaded portion (120) of lead screw (112), the term “free-wheel” used herein refers to the ability of carriage nut (130) to continue to rotate without additional proximal translation of piercer drive assembly (300) and without binging between carriage nut (130) and at least a portion of piercer drive assembly (300). It should be understood that during free-wheeling, at least a portion of piercer drive assembly (300) is generally disengaged from threaded portion (136) of carriage nut (130). However, it should be understood that the length of indent portion (144) is sufficiently limited such that when rotation of carriage nut (130) is reversed, at least a portion of piercer drive assembly (300) reengages with threaded portion (136) of carriage nut (130). Further details of the relationship between indented portion (144), threaded portion (136) and piercer drive assembly (300) will be described in greater detail below.
Stop portion (212) further defines an alignment tab (214) extending upwardly relative to bore (220). Alignment tab (214) comprises a generally rectangular or cubic shape. In other examples, alignment tab (214) may comprise any other suitable shape such as cylindrical, ball-shaped, triangular, and/or etc. Although not shown, it should be understood that alignment tab (214) is configured to be received within a corresponding channel or track disposed within outer housing (14) or an intermediate housing (not shown). Such a channel or track is configured to restrict motion of cocking member (210) to a particular predetermined axial path. Such a channel or track is further configured to prevent rotation of cocking member (210) relative to lead screw (112) to thereby permit lead screw (112) to drive axial motion of cocking member (210), as will be described in greater detail below.
Slide portion (216) of cocking member (210) extends proximally from stop portion (212). Slide portion (216) comprises a generally cylindrical outer surface that is configures to receive actuation member (230). As will be described in greater detail below, actuation member (230) is generally coaxially slidable on slide portion (216) to actuate cutter (40) through a predetermined sequence of motion. However, slide portion (216) has a diameter that is less than the size or diameter of stop portion (212). Accordingly, it should be understood that actuation member (230) is generally coaxially slidable on slide portion (216) until actuation member (230) reaches stop portion (212). At which point, any additional distal sliding relative to slide portion (216) is ceased by stop portion (212).
As described above, bore (220) of cocking member (210) extends through both stop portion (212) and slide portion (216). Bore (220) defines a plurality of threads (222) extending inwardly into bore (220). As best seen in
Bore (220) is configured to receive at least a portion of lead screw (112). In particular, bore (220) is configured to receive first threaded portion (116), indented portion (119), and/or slide stop portion (118) of lead screw (112) at various stages during the cutting cycle and the tissue acquisition cycle, as will be described in greater detail below. As will be understood, threads (222) are configured to engage threads (117) of first threaded portion (116). Thus, it should be understood that rotation of lead screw (112) relative to cocking member (210) will generally result in axial translation of cocking member (210) relative to lead screw (112).
As described above, threads (222) of bore (220) are generally limited to the length of stop portion (212). Because a portion of bore (220) in the present example is un-threaded (e.g., the portion corresponding to slide portion (216)), it should be understood that bore (220) can receive at least a portion of slide stop portion (118) of lead screw (112). However, because slide stop portion (118) defines a diameter approximately equivalent to the major diameter of first threaded portion (116) of lead screw (112), it should be understood that as cocking member (210) moves proximally relative to lead screw (112) such relative motion will only be permitted until threads (222) reach slide stop portion (118) of lead screw (112). Once threads (222) reach slide stop portion (118) of lead screw (112), an interference between the major diameter of threads (222) and the outer diameter of slide stop portion (118) will prevent further proximal movement of cocking member (210). Moreover, threads (222) at this stage will be adjacent to intended portion (119) and therefore disengaged with threads (117) of first threaded portion (116).
Actuation member (230) comprises a body (232), an alignment tab (236), and an actuation tab (240). Body (232) comprises a shape that is generally similar to stop portion (212) described above with respect to cocking member (210). Like with stop portion (212), body (232) defines a bore (234) extending through body (232). Bore (234) of body (232) is configured to receive slide portion (216) of cocking member (210). Thus, it should be understood that actuation member (230) is generally coaxially slidable with slide portion (216) of cocking member (210).
Alignment tab (236) extends upwardly from body (232). Like with alignment tab (214) of cocking member (210), alignment tab (236) of actuation member (230) is configured to engage a channel or track disposed in outer housing (14) or an intermediate housing (not shown). As similarly discussed above, this configuration generally permits such a channel or tack to restrict the motion of actuation member (230) to a predetermined path. However, unlike alignment tab (214) discussed above, alignment tab (236) of actuation member (230) only extends for a relatively small distance from body (232). Instead of alignment tab (236) extending for the full extent as seen with alignment tab (214), a portion of alignment tab (236) of actuation member (230) is replaced with a release member (238). Release member (238) comprises a generally cylindrical shape. As will be described in greater detail below, release member (238) is generally configured to be received by release assembly (400) to temporarily hold actuation member (230) in a cocked position and then selectively release actuation member (230) via actuation of release assembly (400).
Actuation tab (240) extends downwardly from body (232). Actuation tab (240) comprises an upper portion (242) and a lower portion (244). Upper portion (242) comprises a generally rectangular shape. Although not shown, it should be understood that in some examples upper portion (242) can be configured to be received within a cannel or track of outer housing (14) or an intermediate internal housing (not shown) thereof. In such examples, upper portion (242) functions to restrict motion of actuation member (230) to a predetermined path.
Lower portion (244) of actuation tab (240) extends downwardly from upper portion (242). Lower portion (244) is generally configured to be received within receiving feature (52) of cutter (40). As will be described in greater detail below, when lower portion (244) is received within receiving feature (52) of cutter (40), actuation member (230) is generally permitted to drive cutter (40) through a predetermined sequence of movements via lower portion (244). Although not show, it should be understood that in examples where upper portion (242) is received within a channel or track of outer housing (14) or an intermediate internal housing, such a channel or track may include an opening or additional channel to prevent lower portion (244) to extend through such a channel or track to receiving feature (52) of cutter (40).
When cutter drive assembly (200) is assembled (e.g., as seen in
Stop portion (312) further defines an alignment tab (314) extending upwardly relative to bore (320). Alignment tab (314) comprises a generally rectangular or cubic shape. In other examples, alignment tab (314) may comprise any other suitable shape such as cylindrical, ball-shaped, triangular, and/or etc. Although not shown, it should be understood that alignment tab (314) is configured to be received within a corresponding channel or track disposed within outer housing (14) or an intermediate housing (not shown). Such a channel or track is configured to restrict motion of cocking member (310) to a particular predetermined axial path. Such a channel or track is further configured to prevent rotation of cocking member (310) relative to lead screw (112) and carriage nut (130) to thereby permit lead screw (112) and carriage nut (130) to drive axial motion of cocking member (310), as will be described in greater detail below.
Slide portion (316) of cocking member (310) extends proximally from stop portion (312). Slide portion (316) comprises a generally cylindrical outer surface that is configures to receive actuation member (330). As will be described in greater detail below, actuation member (330) is generally coaxially slidable on slide portion (316) to actuate cutter (40) through a predetermined sequence of motion. However, slide portion (316) has a diameter that is less than the size or diameter of stop portion (312). Accordingly, it should be understood that actuation member (330) is generally coaxially slidable on slide portion (316) until actuation member (330) reaches stop portion (312). At which point, any additional distal sliding relative to slide portion (316) is ceased by stop portion (312).
As described above, bore (320) of cocking member (310) extends through both stop portion (312) and slide portion (316). Bore (320) defines a plurality of threads (322) extending inwardly into bore (320). As can best be seen in
Bore (320) is configured to receive at least a portion of carriage nut (130). In particular, bore (320) is configured to receive threaded portion (136), indented portion (144), and/or slide portion (140) of carriage nut (130) at various stages during the cutting cycle and the tissue acquisition cycle, as will be described in greater detail below. As will be understood, threads (322) are configured to engage threads (138) of threaded portion (136) of carriage nut (130). Thus, it should be understood that rotation of carriage nut (130) via lead screw (112) relative to cocking member (310) will generally result in axial translation of cocking member (310) relative to carriage nut (130) and lead screw (112).
As described above, threads (322) of bore (320) are generally limited to the length of stop portion (312). Because a portion of bore (320) in the present example is un-threaded (e.g., the portion corresponding to slide portion (316)), it should be understood that bore (320) can receive at least a portion of slide portion (140) of carriage nut (130). However, because slide portion (140) defines a diameter approximately equivalent to the major diameter of threaded portion (136) of carriage nut (130), it should be understood that as cocking member (310) moves proximally relative to carriage nut (130) and lead screw (112) such relative motion will only be permitted until threads (322) reach slide portion (140) of carriage nut (130). Once threads (322) reach slide portion (140) of carriage nut (130), an interference between the major diameter of threads (322) and the outer diameter of slide portion (140) will prevent further proximal movement of cocking member (310). Moreover, threads (322) at this stage will be adjacent to intended portion (144) and therefore disengaged with threads (138) of threaded portion (136).
Actuation member (330) comprises a body (332), an alignment tab (336), and an actuation tab (340). Body (332) comprises a shape that is generally similar to stop portion (312) described above with respect to cocking member (310). Like with stop portion (312), body (332) defines a bore (334) extending through body (332). Bore (334) of body (332) is configured to receive slide portion (316) of cocking member (310). Thus, it should be understood that actuation member (330) is generally coaxially slidable with slide portion (316) of cocking member (310).
Alignment tab (336) extends upwardly from body (332). Like with alignment tab (314) of cocking member (310), alignment tab (336) of actuation member (330) is configured to engage a channel or track disposed in outer housing (14) or an intermediate housing (not shown). As similarly discussed above, this configuration generally permits such a channel or tack to restrict the motion of actuation member (330) to a predetermined path. However, unlike alignment tab (314) discussed above, alignment tab (336) of actuation member (330) only extends for a relatively small distance from body (332). Instead of alignment tab (336) extending for the full extent as seen with alignment tab (314), a portion of alignment tab (336) of actuation member (330) is replaced with a release member (338). Release member (338) comprises a generally cylindrical shape. As will be described in greater detail below, release member (338) is generally configured to be received by release assembly (400) to temporarily hold actuation member (330) in a cocked position and then selectively release actuation member (330) via actuation of release assembly (400).
Actuation tab (340) extends downwardly from body (332). Actuation tab (340) comprises an upper portion (342) and a lower portion (344). Upper portion (342) comprises a generally rectangular shape. Although not shown, it should be understood that in some examples upper portion (342) can be configured to be received within a cannel or track of outer housing (14) or an intermediate internal housing (not shown) thereof. In such examples, upper portion (342) functions to restrict motion of actuation member (330) to a predetermined path.
Lower portion (344) of actuation tab (340) extends downwardly from upper portion (342). Lower portion (344) is generally configured to be received within receiving feature (32) of piercer (22). As will be described in greater detail below, when lower portion (344) is received within receiving feature (32) of piercer (22), actuation member (330) is generally permitted to drive piercer (22) through a predetermined sequence of movements via lower portion (344). Although not show, it should be understood that in examples where upper portion (342) is received within a channel or track of outer housing (14) or an intermediate internal housing, such a channel or track may include an opening or additional channel to prevent lower portion (344) to extend through such a channel or track to receiving feature (32) of piercer (22).
Piercer retraction assembly (350) is disposed proximally of cocking member (310) and actuation member (330). As will be described in greater detail below, piercer retraction assembly (350) is generally configured to axially translate piercer drive assembly (300) relative to lead screw (112). Piercer retraction assembly (350) comprises a first retraction member (352) and a second retraction member (370), and a retainer (390) disposed between first retraction member (352) and second retraction member (370).
First retraction member (352) comprises a body (354) and a support arm (360). Body (354) defines a bore (356) extending entirely through body (354). Body (354) further includes a counter-bore (358) disposed adjacent to bore (356). Counter-bore (358) extends distally only partially though body (354) from the proximal end thereof. As will be described in greater detail below, bore (356) and counter-bore (358) are generally sized to receive slide portion (316) of cocking member (310) and slide portion (140) of carriage nut (130). Bore (356) defines a diameter that is generally undersized relative to a diameter defined by retainer (390), while counter-bore (358) defines a diameter that is generally oversized relative to the diameter defined by retainer (390). As will be described in greater detail below, this difference in diameter between bore (356) and counter-bore (358) is configured to secure retainer (390) between first retraction member (352) and second retraction member (370).
Support arm (360) of first retraction member (352) extends distally from body (354). The distal extension of support arm (360) defines a length that is generally equivalent to spring (302) in a compressed state. On the distal end of support arm (360), support arm (360) defines a receiving indentation (362). Receiving indentation (362) is generally configured to receive at least a portion of release member (338) of actuation member (330). As will be described in greater detail below, receiving indentation (362) is generally configured to operate in conjunction with at least a portion of release assembly (400) to selectively hold release member (338) in a predetermined position relative to first retraction member (352).
Second retraction member (370) comprises a body (372) having a generally rectangular shape. Body (372) defines a bore (374) and a counter-bore (376) disposed coaxially with bore (374). Bore (374) extends entirely though body (372), while counter-bore (376) extends distally through only a portion of body (372) from the distal end thereof. Bore (374) and counter-bore (376) are both configured to receive at least a portion of lead screw (112) such that lead screw (112) can extend entirely though second retraction member (370). However, a diameter defined by counter-bore (376) is larger than a diameter defined by bore (374) to accommodate retainer (390) within counter-bore (376). It should be understood that this differential in the diameters of bore (374) and counter-bore (376) is configured to prevent proximal movement of retainer (390) relative to second retraction member (370) such that retainer (390) is generally held between first retraction member (352) and second retraction member (370).
Bore (374) further includes a protrusion (378) extending downwardly into the space defined by bore (374). Protrusion (378) comprises a generally cylindrical shape, although any other suitable shape may be used. As will be described in greater detail below, protrusion (378) is configured to engage threads (125) of lead screw (112) to drive translation of second retraction member (370) in response to rotation of lead screw (112).
As described above, retainer (390) is disposed between first retraction member (352) and second retraction member (370). Retainer (390) generally comprises a circular shape similar to a washer or other similar structure. Retainer (390) includes a bore (392) extending entirely though retainer (390). Bore (392) of retainer (390) is sized to permit retainer (390) to fit within annular channel (142) of carriage nut (130). Because retainer (390) is secured between first retraction member (352) and second retraction member (370), it should be understood that when retainer (390) generally axially secures movement of carriage nut (130) relative to piercer retraction assembly (350) via engagement between retainer (390) and annular channel (142). Thus, it should be understood that axial movement of carriage nut (130) will generally result in axial movement of piercer retraction assembly (350). As will be described in greater detail below, this relationship between movement of carriage nut (130) and piercer retraction assembly (350) generally results in retraction of piercer (22) during the tissue acquisition cycle.
While retainer (390) axially secures movement of carriage nut (130) relative to piercer retraction assembly (350), it should be understood that carriage nut (130) is rotatably movable relative to piercer retraction assembly (350). In other words, retainer (390) only secures axial movement of carriage nut (130), not rotational movement. Although not shown, it should be understood that in some examples retainer (390) can be adjacent to one or more bearings to disposed within either or both counter-bores (358, 376) of first retraction member (352) and second retraction member (370), respectively. In such examples, bearings can be used to promote the rotatability of carriage nut (130) relative to piercer retraction assembly (350). Additionally, although retainer (390) is shown as having a generally circular shape, it should be understood that in some examples retainer (390) may comprise a variety of other shapes. For instance, in other examples retainer (390) comprises a c-washer, a snap-on washer, a circlip, a Jesus clip, and/or any other suitable retaining feature as will be apparent to those of ordinary skill in the art in view of the teachings herein.
When piercer drive assembly (300) is assembled (e.g., as seen in
Nut member (410) further includes a first latch actuator (416) and a second latch actuator (418) extending downwardly from body (412). Both first latch actuator (416) and second latch actuator (418) comprise a generally cylindrical shape, although any other suitable shape may be used. First latch actuator (416) is associated with first latch member (440), while second latch actuator (418) is associated with second latch member (450). As will be described in greater detail below, latch actuators (416, 418) are generally configured to engage with a corresponding latch member (440, 450) to release cutter drive assembly (200) and piercer drive assembly (300) to fire cutter (40) and piercer (22), respectively.
Secondary lead screw (420) comprises a drive rod (422) and a drive member (426). Drive rod (422) defines a generally cylindrical shape with a plurality of threads (424) extending along at least a portion of the length of drive rod (422). Threads (424) are configured to engage corresponding threads disposed within nut member (410). This engagement between threads (424) of drive rod (422) and the threads of nut member (410) generally results in the conversion of rotation motion of secondary lead screw (420) into translation of nut member (410). As will be described in greater detail below, this motion of nut member (410) via lead screw (420) is generally configured to selectively initiate firing of cutter (40) and piercer (22).
Drive member (426) of secondary lead screw (420) is fixedly secured to the proximal end of drive rod (422). Drive member (426) is configured to impart rotary motion onto drive rod (422) from motor assembly (430). In particular, drive member (426) comprises a plurality of teeth (428). As will be described in greater detail below, teeth (428) are configured to engage at least a portion of motor assembly (430) such that rotatory motion provided by motor assembly (430) is communicated to drive rod (422) via teeth (428) of drive member (426).
Motor assembly (430) assembly comprises a rotary power source (432) and a drive member (434) in rotary communication with rotary power source (432). Rotary power source (432) in the present example is configured as an electrical motor. In other examples, rotary power source (432) can be configured as a variety of other rotary power sources such as pneumatic motors, piezoelectric motors, and/or etc.
Drive member (434) of motor assembly (430) is configured to communicate rotary power from rotary power source (432) to secondary lead screw (420). In particular, drive member (434) comprises a plurality of teeth (436) that are configured to engage with teeth (428) of drive member (426) described above with respect to secondary lead screw (420). Though engagement between teeth (428, 436), drive members (426, 434) are rotated, thereby communicating rotary power from motor (432) to drive member (426) of secondary lead screw (420). Although drive members (426, 434) are described herein as being essentially gears with teeth (428, 436), it should be understood that in other examples any other suitable rotary transmission may be used. By way of example only, suitable rotary transmissions may include a belt drive, a drive with additional gears to provide a gear ratio between motor (432) and drive rod (422), and/or etc.
First latch member (440) comprises lever portion (442), a pivot portion (444), and a catch portion (446). Lever portion (442), pivot portion (444), and catch portion (446) are all integrally connected to form L-shaped structure. Lever portion (442) and catch portion (446) each define one leg of the L-shape, pivot portion (444) is disposed between lever portion (442) and catch portion (448). Pivot portion (444) includes an opening (445) extending entirely through latch member (440) such that a pin or other similar structure may be received by opening (445) for pivoting of first latch member (440) about an axis defined by opening (445). As will be described in greater detail below, this pivoting action generally permits first latch member (440) to selectively catch and release release member (238) of cutter drive assembly (200).
Catch portion (446) defines a ramp feature (448) and a recessed feature (449). Ramp feature (448) is generally triangular in shape, while adjacent recessed feature (449) is generally semicircular. Both ramp feature (448) and recessed feature (449) are configured to engage release member (238) of cutter drive assembly (200). For instance, and as will be described in greater detail below, ramp feature (448) functions to pivot first latch member (440) away from release member (238) to a receiving or releasing position so that release member (238) can enter recessed feature (449). Similarly, recessed feature (449) catches or otherwise selectively secures release member (238) when first latch member (440) is pivoted to a cocked position. Although not shown herein, it should be understood that in some examples, first latch member (440) may include a resilient feature to resiliently bias first latch member (440) toward the cocked position once release member (238) is received by recessed feature (449).
Second latch member (450) comprises lever portion (452), a pivot portion (454), and a catch portion (456). Lever portion (452), pivot portion (454), and catch portion (456) are all integrally connected to form an L-shaped structure. Lever portion (452) and catch portion (456) each define one leg of the L-shape, pivot portion (454) is disposed between lever portion (452) and catch portion (458). Pivot portion (454) includes an opening (455) extending entirely through latch member (450) such that a pin or other similar structure may be received by opening (455) for pivoting of second latch member (450) about an axis defined by opening (455). As will be described in greater detail below, this pivoting action generally permits second latch member (450) to selectively catch and release release member (338) of piercer drive assembly (300).
Catch portion (456) defines a ramp feature (458) and a recessed feature (459). Ramp feature (458) is generally triangular in shape, while adjacent recessed feature (459) is generally semicircular. Both ramp feature (458) and recessed feature (459) are configured to engage release member (338) of piercer drive assembly (300). For instance, and as will be described in greater detail below, ramp feature (458) functions to pivot second latch member (450) away from release member (338) to a receiving or releasing position so that release member (338) can enter recessed feature (459). Similarly, recessed feature (459) catches or otherwise selectively secures release member (338) when second latch member (450) is pivoted to a cocked position. Although not shown herein, it should be understood that in some examples, first latch member (450) may include a resilient feature to resiliently bias first latch member (450) toward the cocked position once release member (338) is received by recessed feature (459).
When cutter drive assembly (200) is in the distal position, cocking member (210) is positioned on the distal end of first threaded portion (116) of lead screw (112). Actuation member (230) is positioned adjacent to stop portion (212) of cocking member (210) via spring (202). In particular, because release member (238) of actuation member (230) is disengaged from release assembly (400), release member (238) is freely movable along the axis of lead screw (112). Despite actuation member (230) being freely movable along the axis of lead screw (112), spring (202) is resiliently biased to urge actuation member (230) distally into the position shown in
When piercer drive assembly (300) is in the distal position, cocking member (310) is positioned on the distal end of threaded portion (136) of carriage nut (130). Carriage nut (130) is correspondingly positioned on the distal end of second threaded portion (124) of lead screw (112) such that cocking member (310) is in the distal most position relative to both carriage nut (130) and lead screw (112). Actuation member (330) is positioned adjacent to stop portion (312) of cocking member (310) via spring (302). In particular, because release member (338) of actuation member (330) is disengaged from release assembly (400), release member (338) is freely movable along the axis of lead screw (112) and carriage nut (130). Despite actuation member (330) being freely movable along the axis of lead screw (112) and carriage nut (130), spring (302) is resiliently biased to urge actuation member (330) distally into the position shown in
In the initial position, piercer retraction assembly (350) of piercer drive assembly (300) is also in a distal position. However, when piercer retraction assembly (350) is in the distal position, piercer retraction assembly (350) is generally separate from cocking member (310) and actuation member (330). As described above, piercer retraction assembly (350) is axially fixed relative to carriage nut (130) by engagement between retainer of retraction assembly (350) and annular channel (142) of carriage nut (130). Because of this, piercer retraction assembly (350) is axially fixed near the distal end of carriage nut (130) with axial movement of piercer retraction assembly (350) only resulting from axial movement of carriage nut (130).
To move drive assembly (100) into the cocked position, an operator may actuate actuation member (16) on the exterior of outer housing (14). Actuation of actuation member (16) then provides a signal to rotary power source (164) of needle cocking assembly (110). Upon receiving such a signal, rotary power source (164) begins rotating lead screw (112) via rotary communication features (152, 162) in a first direction as shown in
Rotation of lead screw (112) in the first direction generally causes cutter drive assembly (200) and piercer drive assembly (300) to translate proximally. In particular, rotation of lead screw (112) causes threads (117) of first threaded portion (118) to engage threads (222) of cocking member (210). This engagement between threads (117, 222) causes cocking member (210) to translate proximally. As cocking member (210) is translated proximally, stop portion (212) of cocking member (210) engages actuation member (230) to correspondingly push actuation member (230) proximally. Actuation member (230) in turn acts on spring (202) to thereby compress spring (202).
Proximal translation of cocking member (210) and actuation member (230) continues until release member (238) contacts first latch member (440) of release assembly (410). Once such contact is made, release member (238) of actuation member (230) engages ramp feature (448) of first latch member (440) to pivot first latch member (440) outwardly (e.g., into the page of
Once release member (238) of actuation member (230) is adjacent to recessed feature (449) of first latch member (440), rotation of lead screw (112) and corresponding proximal translation of actuation member (230) via cocking member (210) will stop. At this stage, first latch member (440) will have pivoted inwardly (e.g., out of the page of
Rotation of lead screw (112) also rotates carriage nut (130) via key (134) of carriage nut (130) and keyway (122) of lead screw (112). Upon rotation of carriage nut (130) piercer drive assembly (300) is generally translated proximally. In particular, upon rotation of carriage nut (130), threads (138) of carriage nut (130) engage threads (322) disposed within bore (320) of cocking member (310). The engagement between threads (138, 322) causes cocking member (310) to translate proximally. As cocking member (310) is translated proximally, stop portion (312) of cocking member (310) engages actuation member (330) to correspondingly push actuation member (330) proximally. Actuation member (330) in turn acts on spring (302) to thereby compress spring (302).
Proximal translation of cocking member (310) and actuation member (330) continues until release member (338) contacts second latch member (450) of release assembly (410). Once such contact is made, release member (338) of actuation member (330) engages ramp feature (458) of second latch member (450) to pivot second latch member (450) outwardly (e.g., into the page of
Once release member (338) of actuation member (330) is adjacent to recessed feature (459) of second latch member (450), rotation of carriage nut (130) via lead screw (112) and corresponding proximal translation of actuation member (330) via cocking member (310) will stop. At this stage, second latch member (450) will have pivoted inwardly (e.g., out of the page of
Once both cutter drive assembly (200) and piercer drive assembly (300) are translated to the proximal positions shown in
While drive assembly (100) is in the cocked position, an operator may inert needle assembly (20) into tissue of a patient. As shown in
To prepare needle assembly (20) for firing, an operator may transition drive assembly (100) from the cocked position shown in
Rotation of lead screw (112) in the opposite direction generally causes cocking member (210) of cutter drive assembly (200) and cocking member (310) of piercer drive assembly (300) to each translate distally relative to lead screw (112). In particular, threads (117) of first threaded portion (116) again engage threads (222) of cocking member (210). However, due to rotation of lead screw (112) in the second direction, this engagement causes cocking member (210) to translate distally. Because actuation member (230) and spring (202) are not fixedly secured to cocking member (210), actuation member (230) and spring (202) remain held in position by first latch member (440) of release assembly (400). Translation of cocking member (210) continues until cocking member (210) reaches the distal end of first threaded portion (116) of lead screw (112) as shown in
Similarly, with respect to piercer drive assembly (300), threads (138) of carriage nut (130) again engage threads (322) of cocking member (310). As described above, rotation of lead screw (112) results in rotation of carriage nut (130) via engagement between key (134) and keyway (122). Accordingly, rotation of lead screw (112) causes carriage nut (130) to rotate in the second direction. Rotation of carriage nut (130) in the second direction causes cocking member (310) to translate distally via engagement of threads (138, 322). Because actuation member (330) and spring (302) are not fixedly secured to cocking member (310), actuation member (330) and spring (302) remain held in position by second latch member (450) of release assembly (400). Translation of cocking member (310) continues until cocking member (310) reaches the distal end of threaded portion (136) of carriage nut (130) as shown in
Once cocking member (210) of cutter drive assembly (200) and cocking member (310) of piercer drive assembly (300) are positioned in the distal position as shown in
With drive assembly (100) in the ready position (
Engagement between threads (424) of secondary lead screw (420) and the threads of nut member (410) during rotation of secondary lead screw (420) causes nut member (410) to retract proximally. As nut member (410) retracts proximally, second latch actuator (418) first comes into contact with lever portion (452) of second latch member (450). Due to the spacing between first latch actuator (416) and second latch actuator (418), it should be understood that only second latch actuator (418) contacts second latch member (450) initially. As will be described in greater detail below, further proximal actuation of nut member (410) is needed for first latch actuator (416) to engage lever portion (442) of first latch member (440).
As nut member (410) continues to translate proximally, second latch actuator (418) engages lever portion (452) of second latch member (450) to begin to pivot second latch member (450) away from release member (338) of piercer drive assembly (300). Further proximal translation of nut member (410) eventually results in second latch member (450) fully pivoting to disengage release member (338) from recessed feature (459) of second latch member (450) as shown in
Once release member (338) is disengaged from recessed feature (459) of second latch member (450), actuation member (330) is free to translate axially relative to lead screw (112). Because spring (302) was previously compressed during cocking, spring (302) will now rapidly urge actuation member (330) distally. As described above, actuation member (330) includes actuation tab (340), which is secured to receiving feature (32) of piercer (22). Thus, it should be understood that rapid translation of actuation member (330) will result in corresponding rapid translation of piercer (22). Rapid translation of piercer (22) will result in distal tip (24) and notch (26) of piercer (22) penetrating through suspicious lesion (LE) as shown in
Once firing of piercer (22) has occurred, motor (432) of release assembly (400) will stop, thereby stopping further proximal movement of nut member (410) via secondary lead screw (420). In the present use, proximal translation of nut member (410) will stop prior to first latch actuator (416) reaching first latch member (440) for firing of cutter (40). In other words, after piercer (22) is fired, the firing sequence is paused prior to firing cutter (40). Alternatively, in some uses, motor (432) may continue rotating without stopping after firing of piercer (22). In these uses, piercer (22) is fired first, followed by a relatively short delay, and then cutter (40) is fired using the sequence described below.
To fire cutter (40) under the present use, an operator may reinitiate rotation of motor (432) and corresponding proximal translation of nut member (410) by pressing actuation member (16) on outer housing (14) a fourth time. This causes motor (432) of release assembly (400) to continue rotation of secondary lead screw (420). As similarly described above, engagement between threads (424) of secondary lead screw (420) and the threads of nut member (410) during rotation of secondary lead screw (420) causes nut member (410) to retract proximally. As nut member (410) continues to retract proximally first latch actuator (416) will engage lever portion (442) of first latch member (440). Further proximal translation of nut member (410) will result in first latch actuator (416) pushing lever portion (442) to pivot first latch member (440) away from release member (238) of actuation member (230) as shown in
With release member (238) of actuation member (230) disengaged from first latch member (440), actuation member (230) is free to translate axially relative to lead screw (112). Because spring (202) was previously compressed during cocking, spring (202) will now rapidly urge actuation member (230) distally. As described above, actuation member (230) includes actuation tab (240), which is secured to receiving feature (52) of cutter (40). Thus, it should be understood that rapid translation of actuation member (230) will result in corresponding rapid translation of cutter (40). Rapid translation of cutter (40) will result in distal end (42) of cutter (40) penetrating through suspicious lesion (LE) as shown in
The piercer (22) retraction sequence begins by returning drive assembly (100) to the cocked position described above with respect to
Once drive assembly (100) is returned to the cocked position as shown in
As cocking members (210, 310) begin to free-wheel as described above, piercer retraction assembly (350) will begin to engage second threaded portion (124) of lead screw (112). In particular, protrusion (378) of second retraction member (370) is received by threads (125) of second threaded portion (124). As lead screw (112) rotates, engagement between protrusion (378) and threads (125) pulls second retraction member (370) proximally as shown in
Proximal translation of piercer retraction assembly (350), piercer drive assembly (300), and piercer (22) continues until piercer retraction assembly (350) reaches the distal position shown in
When piercer drive assembly (300) is in the distal position, piercer (22) is also in a distal position as shown in
After having acquired a tissue sample, an operator may complete the biopsy procedure by removing biopsy device (10) from the patient. Alternatively, in some instances an operator may desire to collect additional samples using a single insertion of needle assembly (20) into a patient. In such instances, an operator may press actuation member (16) on outer housing (14) a sixth time. This will cause rotation communication feature (162) of needle cocking assembly to reactivate and return drive assembly (100) to the initial position or the cocking position via rotation of lead screw (112). An operator may then follow the same procedure described above one or more times until a desired number of tissue samples are collected.
Exemplary Combinations
The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to restrict the coverage of any claims that may be presented at any time in this application or in subsequent filings of this application. No disclaimer is intended. The following examples are being provided for nothing more than merely illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in numerous other ways. It is also contemplated that some variations may omit certain features referred to in the below examples. Therefore, none of the aspects or features referred to below should be deemed critical unless otherwise explicitly indicated as such at a later date by the inventors or by a successor in interest to the inventors. If any claims are presented in this application or in subsequent filings related to this application that include additional features beyond those referred to below, those additional features shall not be presumed to have been added for any reason relating to patentability.
A core needle biopsy device, comprising: a needle assembly, wherein the needle assembly includes a piercer and a hollow cutter, wherein the piercer includes a sharp distal tip and a notch proximal to the distal tip, wherein the piercer is slidably disposed within the cutter to sever a tissue sample into the notch of the piercer; a cutter drive assembly, wherein the cutter drive assembly is configured to selectively fire the cutter; a piercer drive assembly, wherein the piercer drive assembly is configured to selectively fire the piercer; and a piercer retraction assembly, wherein the piercer retraction assembly is configured to retract the piercer independently of the cutter while the needle assembly is disposed within a patient to expose the notch of the piercer to an exterior of a patient while at least a portion of the piercer remains within the cutter.
The core needle biopsy device of Example 1, further comprising a needle cocking assembly, wherein the needle cocking assembly is configured to move at least a portion of the cutter drive assembly, the piercer drive assembly, and the piercer retraction assembly.
The core needle biopsy device of Example 2, wherein the needle cocking assembly includes a lead screw, wherein the lead screw includes a first threaded portion and a second threaded portion, wherein the first threaded portion includes threads having a first pitch, wherein the second threaded portion includes threads having a second pitch, wherein the first pitch is different relative to the second pitch.
The core needle biopsy device of Example 3, wherein the first threaded portion is configured to engage the cutter drive assembly, wherein the second threaded portion is configured to engage the piercer retraction assembly.
The core needle biopsy device of Example 4, wherein the needle cocking assembly further includes a carriage nut disposed on the lead screw, wherein the carriage nut includes a threaded portion.
The core needle biopsy device of Example 5, wherein the threaded portion of the carriage nut is configured to engage the piercer drive assembly.
The core needle biopsy device of Example 6, wherein the carriage nut is axially movable with the piercer retraction assembly.
The core needle biopsy device of Example 6, wherein the piercer drive assembly is axially movable in response to axial movement of the carriage nut.
The core needle biopsy device of Example 6, wherein the piercer drive assembly is axially movable in response to rotational movement of the carriage nut.
The core needle biopsy device of any one or more of Examples 1 through 9, further comprising a release assembly, wherein the release assembly is in communication with at least a portion of the cuter drive assembly and the piercer drive assembly to selectively initiate firing of the cutter and the piercer.
The core needle biopsy device of Example 10, wherein the release assembly includes a secondary lead screw and a nut member, wherein the nut member is responsive to rotation of the secondary lead screw to initiate firing of the cutter and the piercer in a predetermined sequence.
The core needle biopsy device of any one or more of Examples 1 through 11, wherein at least a portion of the cutter drive assembly and the piercer drive assembly is driven by a spring.
The core needle biopsy device of any one or more of Examples 1 through 11, wherein at least a portion of the cutter drive assembly and the piercer drive assembly is driven by a motor.
The core needle biopsy device of Example 13, wherein the motor is an electric motor.
The core needle biopsy device of any one or more of Examples 1 through 14, wherein the piercer retraction assembly is configured to retract at least a portion of the piercer drive assembly when retracting the piercer.
A core needle biopsy device, comprising: a body; a cutter extending from the body, wherein the cutter includes an open distal end defined by a sharp edge; a piercer disposed within the cutter, wherein the piercer comprises a notch, wherein the piercer is movable relative to the cutter to sever a tissue sample into the notch via the sharp edge; and a drive assembly, comprising; a first spring loaded mechanism, wherein the first spring loaded mechanism is in communication with the cutter to selectively fire the cutter; a second spring loaded mechanism, wherein the second spring loaded mechanism is in communication with the piercer to selectively fire the piercer; a first motor driven mechanism, wherein the first motor driven mechanism is configured to drive the first spring loaded mechanism and the second spring loaded mechanism through a first range of motion, wherein the first motor driven mechanism is further configured to drive the second spring loaded mechanism through a second range of motion while the first spring loaded mechanism remains stationary, and a second motor driven mechanism, wherein the second motor driven mechanism is in communication with the first spring loaded mechanism and the second spring loaded mechanism to selectively initiate firing of the cutter and the piercer.
The core needle biopsy device of Example 16, wherein the cutter comprises an end portion associated with the body, wherein the end portion defines a tissue collection feature.
The core needle biopsy device of Example 17, wherein the first motor driven mechanism is configured to drive the piercer between a distal position and a proximal position when moving second spring loaded mechanism through the second range of motion, wherein the notch of the piercer is aligned with the tissue collection feature when in the proximal position.
The core needle biopsy device of Example 17, wherein the cutter further comprises a cutout portion, wherein the cutout portion is longitudinally aligned with the tissue collection feature.
A method for collecting a tissue sample using a core needle biopsy device, the method comprising: firing a piercer distally from a cocked position to a distal position, wherein the piercer is disposed within a hollow cutter, wherein the piercer comprises a notice that is movable relative to a distal end of the cutter; firing the cutter distally from a cocked position to a distal position after firing the piercer to sever a first tissue sample into the notch of the piercer; retracting the piercer while the cutter remains in the distal position to collect the first tissue sample severed into the notch of the piercer; collecting the first tissue sample through a tissue window defined by the cutter; and repeating steps of firing the piercer, firing the cutter, retracting the piercer, and collecting a tissue sample to collect a second tissue sample.
Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.
It should be understood that any of the versions of instruments described herein may include various other features in addition to or in lieu of those described above. By way of example only, any of the instruments described herein may also include one or more of the various features disclosed in any of the various references that are incorporated by reference herein. It should also be understood that the teachings herein may be readily applied to any of the instruments described in any of the other references cited herein, such that the teachings herein may be readily combined with the teachings of any of the references cited herein in numerous ways. Other types of instruments into which the teachings herein may be incorporated will be apparent to those of ordinary skill in the art.
It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
The present application claims priority to US Provisional Patent Application No. 62/407,201, entitled “CORE NEEDLE BIOPSY DEVICE FOR COLLECTING MULTIPLE SAMPLES IN A SINGLE INSERTION,” filed on Oct. 12, 2016, the disclosure of which is hereby incorporated by reference.
Number | Date | Country | |
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62407201 | Oct 2016 | US |
Number | Date | Country | |
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Parent | PCT/US2017/056123 | Oct 2017 | US |
Child | 16381573 | US |