None.
The present invention relates to a lung access procedure, such as a lung biopsy, and, more particularly, to an implant and system to facilitate access across pleura layers.
Pneumothorax is a problematic complication of the lung biopsy procedure where air or fluid is allowed to pass into the pleural space as a result of the puncture of the parietal pleura and visceral pleura. Pneumothorax and, more so, pneumothorax requiring chest tube placement, are significant concerns for clinicians performing, and patients undergoing, percutaneous lung biopsies. The incidence of pneumothorax in patients undergoing percutaneous lung biopsy has been reported to be anywhere from 9-54%, with an average of around 15%. On average, 6.6% of all percutaneous lung biopsies result in pneumothorax requiring a chest tube to be placed, which results in an average hospital stay of 2.7 days.
Factors that increase the risk of pneumothorax include increased patient age, obstructive lung disease, increased depth of a lesion, multiple pleural passes, increased time that an access needle lies across the pleura, and traversal of a fissure. Pneumothorax may occur during or immediately after the procedure, which is why typically a CT scan of the region is performed following removal of the needle. Other, less common, complications of percutaneous lung biopsy include hemoptysis (coughing up blood), hemothorax (a type of pleural effusion in which blood accumulates in the pleural cavity), infection, and air embolism.
What is needed in the art is an implant and system to facilitate access across pleura layers, which aids in the prevention of pneumothorax.
The present invention provides an implant and system to facilitate access across pleura layers, which aids in the prevention of pneumothorax.
The invention, in one form, is directed to an implant device to facilitate access across pleura layers. The implant includes a tube having a side wall, a lumen, a proximal end portion, a distal end portion, and a central portion interposed between the proximal end portion and the distal end portion. The tube has a longitudinal extent, wherein each of the proximal end portion and the distal end portion extends outwardly from the central portion. The side wall has a longitudinal split to define a first lateral edge surface and a second lateral edge surface. Each of the first lateral edge surface and the second lateral edge surface longitudinally extends through each of the proximal end portion, the central portion, and the distal end portion.
The invention, in another form, is directed to a system to facilitate access across pleura layers. The system includes an implantable tube, a stylet assembly, and a cannula assembly. The implantable tube has a tubular side wall, a tubular lumen, a proximal end portion, a distal end portion, and a central portion interposed between the proximal end portion and the distal end portion. The implantable tube has a longitudinal extent, wherein each of the proximal end portion and the distal end portion extends outwardly from the central portion. The tubular side wall has a longitudinal split to define a first lateral edge surface and a second lateral edge surface. Each of the first lateral edge surface and the second lateral edge surface longitudinally extends through each of the proximal end portion, the central portion, and the distal end portion. The stylet assembly has a stylet and a stylet handle. The stylet has a distal tip, and has an exterior surface and a longitudinal recess formed along the exterior surface. The longitudinal recess has a longitudinal edge surface. The tubular lumen of the implantable tube is configured to be received over the exterior surface of the elongate member, with the first lateral edge surface of the tubular side wall of the implantable tube configured to be engaged by the longitudinal edge surface of the longitudinal recess of the stylet. The cannula assembly has a cannula and a cannula handle. The cannula has a cannula side wall and a cannula lumen. The cannula side wall has a distal end and a longitudinal slotted opening proximal to the distal end. The implantable tube and at least a portion of the stylet are configured to be received in the cannula lumen, with the second lateral edge surface of the tubular side wall of the implantable tube configured to be received through the longitudinal slotted opening of the cannula side wall.
An advantage of the present invention is that the implant device facilitates access across pleura layers to aid in preventing pneumothorax, before, or coincident with, the performing of a lung biopsy.
The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate several embodiments of the invention, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
Referring now to the drawings, and more particularly to
Implant introducer device 12 includes a stylet assembly 16 and a cannula assembly 18. Stylet assembly 16 and cannula assembly 18 are arranged along a longitudinal axis 20, such that stylet assembly 16 and cannula assembly 18 are coaxial. Stylet assembly 16 and cannula assembly 18 are configured to rotate relative to each other around longitudinal axis 20, e.g., in opposite rotational directions, so to deploy, i.e., expel, the implant device 14 from cannula assembly 18. Rotational deployment allows implant device 14 to be pre-positioned longitudinally, prior to deployment.
Referring to
Stylet handle 16-2 is fixedly connected to proximal end portion 16-3 of stylet 16-1. The term “fixedly connected” means a coupling between two or more components wherein the respective components are not readily separated from each other. For example, the fixed connection of stylet handle 16-2 to stylet 16-1 may be achieved, for example, by adhesive, weld, press fit, or screw connection.
Referring particularly to
Referring to
Referring again to
Cannula side wall 18-5 includes distal end 18-4, and has a longitudinal slotted opening 26 that is proximal to distal end 18-4. As best shown in
Referring to
Referring to
In the present embodiment, each of proximal end portion 14-4 and distal end portion 14-5 flares outwardly from central portion 14-6. Also, in the present embodiment, proximal end portion 14-4 and distal end portion 14-5 are symmetrical, on opposite ends of central portion 14-6.
Tubular side wall 14-2 has a longitudinal split 14-7 to define a first lateral edge surface 14-8 and a second lateral edge surface 14-9. Each of first lateral edge surface 14-8 and second lateral edge surface 14-9 longitudinally extends through each of the proximal end portion 14-4, the central portion 14-6, and the distal end portion 14-5. Also, each of first lateral edge surface 14-8 and second lateral edge surface 14-9 form a circumferential termination end surface of implant device 14.
Implant device 14, in the form of rolled tube 14-1, is shaped as a roll that overlaps on itself, wherein one of first lateral edge surface 14-8 and second lateral edge surface 14-9 is positioned on an exterior of implant device 14 and the other of first lateral edge surface 14-8 and second lateral edge surface 14-9 is positioned in an interior of implant device 14, depending on the direction of the roll. In the present embodiment, implant device 14 is shaped as a roll that overlaps on itself, wherein first lateral edge surface 14-8 is positioned in the interior, i.e., at tubular lumen 14-3, of implant device 14, and second lateral edge surface 14-9 is positioned at an exterior of implant device 14.
Referring again to
Referring to
As shown in
Referring to
In accordance with the present embodiment, a diameter of implant device 14 when entirely contained in cannula lumen 18-6 of the cannula 18-1 (pre-deployment; see, e.g.,
A lung access procedure, such as a lung biopsy, may be carried out by removing stylet 16-1 of stylet assembly 16 from cannula assembly 18 of implant introducer device 12, and then inserting a lung biopsy device through cannula lumen 18-6 of cannula 18-1 of cannula assembly 18 and into the lung. Alternatively, the lung access procedure may be carried out by removing the entirety of implant introducer device 12 from tubular lumen 14-3 of implant device 14, and a lung biopsy device may be inserted through tubular lumen 14-3 of implant device 14 and into the lung.
Referring to
Implant device 100 is formed as an implant tube 100-1, which may be made from a biocompatible material, such as a biocompatible polymer. Also, implant tube 100-1 may be made from a bioabsorbable material. Such a bioabsorbable material may be, for example, polyglycolic acid (PGA) or polylactic acid (PLA), or a combination (PLA-PGA). Further, implant tube 100-1 may be made from a shape-memory polymer.
Implant tube 100-1 is in the form of a single-piece structure, and includes a tubular side wall 100-2, a tubular lumen 100-3, a proximal end portion 100-4, a distal end portion 100-5, and a central portion 100-6. Central portion 100-6 is interposed between proximal end portion 100-4 and distal end portion 100-5. Implant tube 100-1 has a longitudinal extent 104, wherein each of proximal end portion 100-4 and distal end portion 100-5 extends outwardly, i.e., radially, from the central portion 100-6.
In the present embodiment, each of proximal end portion 100-4 and distal end portion 100-5 flares outwardly from central portion 100-6. Also, in the present embodiment, proximal end portion 100-4 and distal end portion 100-5 are symmetrical, on opposite ends of central portion 100-6. Further, referring to
Tubular side wall 100-2 has a longitudinal split 100-7 to define a first lateral edge surface 100-8 and a second lateral edge surface 100-9. Each of first lateral edge surface 100-8 and second lateral edge surface 100-9 form a circumferential termination end surface of implant tube 100-1. In the present embodiment, first lateral edge surface 100-8 and the second lateral edge surface 100-9 are spaced apart to define a longitudinal gap 106 between the first lateral edge surface 100-8 and the second lateral edge surface 100-9, wherein the longitudinal gap 106 longitudinally extends through each of the proximal end portion 100-4, the central portion 100-6, and the distal end portion 100-5. Likewise, each of first lateral edge surface 100-8 and second lateral edge surface 100-9 longitudinally extends through each of the proximal end portion 100-4, the central portion 100-6, and the distal end portion 100-5.
In the present embodiment, implant tube 100-1 is shaped such that first lateral edge surface 100-8 and second lateral edge surface 100-9 face one another across longitudinal gap 106. However, as best shown in
Referring to
Referring to
Implant device 120 is formed as an implant tube 120-1, which may be made from a biocompatible material, such as a biocompatible polymer. Also, implant tube 120-1 may be made from a bioabsorbable material. Such a bioabsorbable material may be, for example, polyglycolic acid (PGA) or polylactic acid (PLA), or a combination (PLA-PGA). Further, implant tube 120-1 may be made from a shape-memory polymer.
Implant tube 120-1 is in the form of a single-piece structure, and includes a tubular side wall 120-2, a tubular lumen 120-3, a proximal end portion 120-4, a distal end portion 120-5, and a central portion 120-6. Central portion 120-6 is interposed between proximal end portion 120-4 and distal end portion 120-5. Implant tube 120-1 has a longitudinal extent 124, wherein each of proximal end portion 120-4 and distal end portion 120-5 extends outwardly, i.e., radially, from the central portion 120-6.
In the present embodiment, each of proximal end portion 120-4 and distal end portion 120-5 flares outwardly from central portion 120-6. Each of the proximal end portion 120-4 and the distal end portion 120-5 includes a respective plurality of finger members 126-1, 126-2 that are spaced around a periphery of each of proximal end portion 120-4 and distal end portion 120-5. The plurality of finger members 126-1, 126-2 may extend, e.g., both longitudinally and radially, from at least one of the proximal end portion 120-4 and distal end portion 120-5. When implant device 120 is deployed, the plurality of finger members 126-1, 126-2 may serve as anchors to resist migration of implant device 120 along an access opening, such as access opening 54 (see, e.g.,
Each of the plurality of finger members 126-1, 126-2 may be formed integral with proximal end portion 120-4 and the distal end portion 120-5 during a polymer molding process. Alternatively, for example, each of the plurality of finger members 126-1, 126-2 may be formed by removing material from proximal end portion 120-4 and the distal end portion 120-5. It is further contemplated that in some implementations, only one of proximal end portion 120-4 and the distal end portion 120-5 may include the plurality of finger members.
In the present embodiment, proximal end portion 120-4 and distal end portion 120-5 are symmetrical, on opposite ends of central portion 120-6. Further, in the present embodiment, each of proximal end portion 120-4, distal end portion 120-5, and central portion 120-6 has a substantially planar exterior surface profile, as shown for example, in
Tubular side wall 120-2 has a longitudinal split 120-7 to define a first lateral edge surface 120-8 and a second lateral edge surface 120-9. Each of first lateral edge surface 120-8 and second lateral edge surface 120-9 form a circumferential termination end surface of implant tube 120-1. In the present embodiment, first lateral edge surface 120-8 and the second lateral edge surface 120-9 are spaced apart to define a longitudinal gap 128 between the first lateral edge surface 120-8 and the second lateral edge surface 120-9, wherein the longitudinal gap 128 longitudinally extends through each of the proximal end portion 120-4, the central portion 120-6, and the distal end portion 120-5. Likewise, each of first lateral edge surface 120-8 and second lateral edge surface 120-9 longitudinally extends through each of the proximal end portion 120-4, the central portion 120-6, and the distal end portion 120-5.
In the present embodiment, implant tube 120-1 is shaped such that first lateral edge surface 120-8 and second lateral edge surface 120-9 face one another across longitudinal gap 128. However, as best shown in
Following deployment of implant device 120 in an access opening, such as access opening 54 (see, e.g.,
Referring to
Implant device 140 is formed as an implant tube 140-1, which may be made from a biocompatible material, such as a biocompatible polymer. Also, implant tube 140-1 may be made from a bioabsorbable material. Such a bioabsorbable material may be, for example, polyglycolic acid (PGA) or polylactic acid (PLA), or a combination (PLA-PGA). Further, implant tube 140-1 may be made from a shape-memory polymer.
Implant tube 140-1 is a single-piece structure, and includes a tubular side wall 140-2, a tubular lumen 140-3, a proximal end portion 140-4, a distal end portion 140-5, and a central portion 140-6. Central portion 140-6 is interposed between proximal end portion 140-4 and distal end portion 140-5. Implant tube 140-1 has a longitudinal extent 144, wherein each of proximal end portion 140-4 and distal end portion 140-5 extends outwardly, i.e., radially, from the central portion 140-6.
In the present embodiment, each of proximal end portion 140-4 and distal end portion 140-5 flares outwardly from central portion 140-6. Also, in the present embodiment, proximal end portion 140-4 and distal end portion 140-5 are symmetrical, on opposite ends of central portion 140-6.
For example, in the present embodiment, each of the proximal end portion 140-4 and the distal end portion 140-5 includes a respective enlarged annular portion 146-1, 146-2. Each of enlarged annular portion 146-1 and enlarged annular portion 146-2 has a greater outer diameter than the outer diameter of central portion 140-6. Each of the enlarged annular portion 146-1, 146-2 has a curved exterior surface and has a longitudinal radius that extends from tubular lumen 140-3 around a thickness of tubular side wall 140-2 at central portion 140-6 at respective proximal end portion 140-4 and distal end portion 140-5. When implant device 140 is deployed, each enlarged annular portion 146-1, 146-2 may serve as an anchor to resist migration of implant device 140 along an access opening, such as access opening 54 (see, e.g.,
Tubular side wall 140-2 has a longitudinal split 140-7 to define a first lateral edge surface 140-8 and a second lateral edge surface 140-9. Each of first lateral edge surface 140-8 and second lateral edge surface 140-9 form a circumferential termination end surface of implant tube 140-1. In the present embodiment, first lateral edge surface 140-8 and the second lateral edge surface 140-9 are spaced apart to define a longitudinal gap 148 between the first lateral edge surface 140-8 and the second lateral edge surface 140-9, wherein the longitudinal gap 148 longitudinally extends through each of the proximal end portion 140-4, the central portion 140-6, and the distal end portion 140-5. Likewise, each of first lateral edge surface 140-8 and second lateral edge surface 140-9 longitudinally extends through each of the proximal end portion 140-4, the central portion 140-6, and the distal end portion 140-5.
In the present embodiment, implant tube 140-1 is shaped such that first lateral edge surface 140-8 and second lateral edge surface 140-9 face one another across longitudinal gap 148. However, as best shown in
Following deployment of implant device 140 in an access opening, such as access opening 54 (see, e.g.,
The following items also relate to the invention:
In one form, the invention relates to an implant device to facilitate access across pleura layers. The implant device includes a tube having a side wall, a lumen, a proximal end portion, a distal end portion, and a central portion interposed between the proximal end portion and the distal end portion. The tube has a longitudinal extent. Each of the proximal end portion and the distal end portion extends outwardly from the central portion. The side wall has a longitudinal split to define a first lateral edge surface and a second lateral edge surface, wherein each of the first lateral edge surface and the second lateral edge surface longitudinally extends through each of the proximal end portion, the central portion, and the distal end portion.
In some embodiments, the first lateral edge surface and the second lateral edge surface may be spaced apart to define a longitudinal gap between the first lateral edge surface and the second lateral edge surface, wherein the longitudinal gap may longitudinally extend through each of the proximal end portion, the central portion, and the distal end portion.
In some other embodiments, the tube may be shaped as a roll that overlaps on itself, wherein one of the first lateral edge surface and the second lateral edge surface may be positioned on an exterior of the tube and the other of the first lateral edge surface and the second lateral edge surface may be positioned in an interior of the tube.
In any of the embodiments, each of the proximal end portion and the distal end portion optionally may flare outwardly from the central portion.
In any of the embodiments, the proximal end portion and the distal end portion optionally may be symmetrical, on opposite ends of the central portion.
In at least one embodiment, a plurality of finger members optionally may extend from at least one of the proximal end portion and the distal end portion.
In at least one embodiment, each of the proximal end portion and the distal end portion optionally may include a respective plurality of finger members that are spaced around a periphery of each of the proximal end portion and the distal end portion.
In any of the embodiments, the implant may be made from a memory material.
In any of the embodiments, the implant may be made from a bioabsorbable material.
In any of the embodiments, the implant may be made from one of a metal or a polymer.
In another form, the invention relates to a system to facilitate access across pleura layers. The system includes an implantable tube having a tubular side wall, a tubular lumen, a proximal end portion, a distal end portion, and a central portion interposed between the proximal end portion and the distal end portion. The implantable tube has a longitudinal extent, wherein each of the proximal end portion and the distal end portion extends outwardly from the central portion. The tubular side wall has a longitudinal split to define a first lateral edge surface and a second lateral edge surface, wherein each of the first lateral edge surface and the second lateral edge surface longitudinally extends through each of the proximal end portion, the central portion, and the distal end portion. The system may include a stylet assembly having a stylet and a stylet handle. The stylet has a distal tip. The stylet has an exterior surface and a longitudinal recess formed along the exterior surface of the stylet. The longitudinal recess has a longitudinal edge surface. The tubular lumen of the implantable tube may be configured to be received over the exterior surface of the stylet, with the first lateral edge surface of the tubular side wall of the implantable tube configured to be engaged by the longitudinal edge surface of the longitudinal recess of the stylet. The system may include a cannula assembly having a cannula and a cannula handle. The cannula has a cannula side wall and a cannula lumen. The cannula side wall has a distal end and a longitudinal slotted opening proximal to the distal end. The implantable tube and at least a portion of the stylet may be configured to be received in the cannula lumen, with the second lateral edge surface of the tubular side wall of the implantable tube configured to be received through the longitudinal slotted opening of the cannula side wall.
In any of the embodiments of the system above, the stylet and cannula may be arranged along a longitudinal axis, and the stylet and cannula may be configured to rotate relative to each other to deploy the implantable tube through the longitudinal slotted opening of the cannula side wall.
In any of the embodiments of the system above, the implantable tube may be fully deployed when the first lateral edge surface of the tubular side wall of the implantable tube exits the longitudinal slotted opening of the cannula side wall.
In any of the embodiments of the system above, when the implantable tube is fully deployed, the cannula may be positioned in the tubular lumen of the implantable tube.
In at least some of the embodiments of the system above, the longitudinal slotted opening may include a ramp that extends from the cannula lumen to an outer surface of the cannula. The ramp may be configured to guide the second lateral edge surface of the tubular side wall of the implantable tube into and through the longitudinal slotted opening.
In any of the embodiments of the system above, a diameter of the implantable tube when contained in the cannula lumen of the cannula may be smaller than the diameter of the implantable tube when fully deployed and external to the cannula.
In any of the embodiments of the system above, the implantable tube may be shaped as a roll that overlaps on itself, wherein the first lateral edge surface may be positioned in an interior of the implantable tube and the second lateral edge surface may be positioned on an exterior of the implantable tube.
In any of the embodiments of the system above, each of the proximal end portion and the distal end portion optionally may flare outwardly from the central portion.
In any the embodiments of the system above, the proximal end portion and the distal end portion optionally may be symmetrical, on opposite ends of the central portion.
In any of the embodiments of the system above, the implantable tube may be made from a memory material.
As used herein, “substantial”, “substantially,” and other words of degree are relative modifiers intended to indicate permissible variation from the characteristic so modified. It is not intended to be limited to the absolute value or characteristic which it modifies, but rather, possessing more of the physical or functional characteristic than its opposite, and approaching or approximating such a physical or functional characteristic.
While this invention has been described with respect to at least one embodiment, the present invention can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains and which fall within the limits of the appended claims.
Filing Document | Filing Date | Country | Kind |
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PCT/US2019/051287 | 9/16/2019 | WO |