The present disclosure relates generally to introducer stylets and cannulas used for biopsy systems.
Medical procedures have advanced to stages where less invasive or minimally invasive surgeries, diagnostic procedures and exploratory procedures have become desired and demanded by patients, physicians, and various medical industry administrators. To meet these demands, improved medical devices and instrumentation have been developed, such as cannulae or micro-cannulae, medical introducers, vacuum assisted biopsy apparatus, and other endoscopic related devices.
During certain biopsy procedures, an introducer stylet may be used to create a pathway to access the biopsy site. The introducer stylet is inserted into body tissue with a cannula mounted thereon. After the pathway is created, the introducer stylet is removed, but the cannula is left within the tissue pathway providing access to the biopsy area and further minimizing movement of the biopsy device adjacent a target lesion. To further locate the introducer stylet near an excision site, different systems have been used, such as open surgical procedures, mammography or magnetic resonance imaging (MRI). Ultrasonography may also be used to further assess target areas found and further used as a guidance method to better guide the introducer stylet adjacent suspect tissue.
In recent years, ultrasound-guided biopsy of breast lesions has been used for diagnostic purposes, partially replacing open surgical intervention. Ultrasound guidance is also often used for needle localization of some lesions prior to biopsy, as well as for cyst aspiration. Ultrasound guidance for such interventions, however, is difficult to learn and perform. One needs good hand-eye coordination and three-dimensional visualization skills to guide the biopsy needle to the target tissue area with the aid of ultrasound imagery. Devices have been developed that try to create a higher reflective property for viewing with the ultrasonic wave. However, these devices do not allow the operator to pinpoint exactly where the device sampling aperture is in relation to the lesion site nor do they afford the operator the ability to place the introducer stylet with the biopsy aperture up prior to inserting the biopsy device providing exact location to the tissue to be sampled.
Therefore, what is needed is an introducer stylet having an imagable feature capable of replicating the biopsy tool's aperture image signature, thus effectively identifying the location of the excision site while maintaining the ability to remove the introducer stylet. There is also a separate need for an introducer stylet having an orientation indicator with a selectively lockable and removable cannula introducer capable of receiving and orienting a biopsy device after removal of the introducer stylet. Finally, there is also a need for a selectively lockable cannula that may be selectively used with different types of medical devices.
In one exemplary arrangement, an introducer stylet is disclosed. The introducer stylet comprises an introducer stylet body defined by a proximal end and a distal end. The distal end further includes an imagable feature. The imagable feature may be configured with a predetermined size that generally corresponds to a portion of a medical device.
Also disclosed are various embodiments of introducer cannulas for use with various introducer stylets, including, but not limited to, the imagable introducer stylet also disclosed herein. The introducer cannulas disclosed also include various configurations of introducer hubs for attaching to various medical devices.
Referring now to the drawings, illustrative and exemplary embodiments of the present disclosure are shown in detail. Although the drawings represent some embodiments of the present disclosure, the drawings are not necessarily to scale and certain characteristics may be exaggerated to better illustrate and explain the present disclosure. Further, the embodiments set forth herein are not intended to be exhaustive or otherwise limit or restrict the disclosure to the precise forms and configurations disclosed in the following detailed description.
Turning now to the drawings, and in particular to
In the embodiment illustrated, introducer stylet body 22 extends from a handle 26 positioned opposite distal end 32. The handle 26 may include a latching tab interference portion 30, to be explained below in further detail. In one exemplary arrangement, handle 26 is fixed with respect to introducer stylet body 22 such that rotation of handle 26 causes introducer stylet body 22 to rotate as well.
In one exemplary arrangement, introducer stylet body 22 is provided with an imagable feature 36, disposed adjacent to distal end 32. In certain arrangements, imagable feature 36 (to be discussed in further detail below) may be, but is not required to be, configured so as to represent the size, as well as an orientation of an aperture of a biopsy device. In embodiments where an imagable feature 36 is provided that is configured to represent an orientation of an aperture of a biopsy device, an imagable feature orientation indicator 28 may be provided. In one specific, but exemplary arrangement, the imagable feature orientation indicator 28 may be configured as an ergonomic thumb pad. Imagable feature orientation indicator 28 provides a visual position of the imagable feature 36 (to be discussed in further detail below) on the introducer stylet body 22, relative to the handle 26 position. Alternatively, the imagable feature orientation indicator 28 may be configured by printing a mark on the handle (not shown) that allows the operator to orient the imagable feature 36 to a target tissue area prior to removal of the introducer stylet body 22 and insertion of a core biopsy device within an introducer cannula 42, to be explained in further detail below. An exemplary core biopsy apparatus may be seen by way of example in U.S. Pat. Nos. 6,638,235 and 6,744,824, which are commonly owned by the assignee of the present disclosure and are incorporated herein by reference in their entirety.
Turning now to
As will be described in detail, introducer assembly 20 is particularly, but not necessarily, suited for use in biopsy procedures that identify a target biopsy site using various imaging modalities such as ultrasonography or magnetic resonance imaging (MRI). Indeed, in one exemplary arrangement, the imagable feature 36 is an echogenic feature, particularly suitable with ultrasonography. In another alternative arrangement, the imagable feature 36 is a radio-opaque feature particularly suitable with mammography. The assembly 20 may also be made of a MRI compatible, medical grade material, such as 316 stainless steel or Inconel™ 625. In one specific embodiment, the introducer stylet body 22 and the introducer cannula 42 are made of stainless steel.
In one exemplary configuration, latching hub 46 includes a generally annular hub portion 47 and a latch portion 48. The annular hub portion 47 includes a hub outer surface 82, a hub mating surface 84, (best seen in
The latching hub 46 of the introducer cannula 42 defines an entrance opening 49 for receiving the introducer stylet 22 (and other medical devices).
In one configuration, the distal end 40 of the introducer cannula 42 may include a sharpened tapered edge 41 defining an exit opening 43. In one embodiment, (best seen in
In one embodiment, entry into the tissue area begins when the introducer cannula 42 is attached to the introducer stylet 22 with the latch hub 46. Because the introducer stylet 22 is positively latched to the latch hub 46 of the introducer cannula 42, the assembled assembly 20 provides for a predetermined length that permits more accurate location identification of treatment area. More specifically, as the imagable feature 36 is visible under one or more imaging modalities, once inserted, the operator will be able to visual verify the location of the imagable feature 36 prior to inserting a medical device into a patient.
After the introducer cannula 42 is positively attached to the introducer stylet 22, the operator grasps the handle 26 and presses the piercing tip 34 into the tissue. The piercing tip 34 enters the tissue and the operator applies further pressure sliding the assembly 20 into the tissue. The introducer cannula 42 enters skin and the operator applies further pressure while watching an imaging device as the assembly 20 creates an entry path to the targeted tissue area. The operator will complete the entry by applying continuous pressure to the assembly 20 until the imagable feature 36 reaches the target tissue. As stated above, in one specific configuration, the imagable feature 36 is sized to generally represent the size of an aperture of a biopsy device. Accordingly, the imagable feature 36 will provide visual confirmation of the location from which biopsy samples will be taken, i.e., the depth into which a distal end of a medical device will extend through the introducer cannula 42.
Once the operator verifies that the imagable feature 36 has reached the target area, the operator may release the introducer stylet 22 from the introducer cannula 42. Separation of the assembly 20 is accomplished when the operator holds the latching hub 46 and presses the release button 85, causing disengagement of the latch tab 89 from the latch tab interference portion 30. The operator then grasps the handle 26 and slides introducer stylet 22 out of the introducer cannula 42 and ultimately out of the tissue leaving the introducer cannula 42 within the patient's body. Thus, the introducer cannula 42 creates a direct pathway for the introduction of other medical devices, such as a biopsy device, for example. Upon completion of the medical procedure the operator will then slide the introducer cannula 42 and the medical device out of the body.
In some embodiments, the imagable feature 36 may be configured to also represent an orientation of an aperture of a medical device, such as a biopsy device. For example, as seen in
The imagable features 36, 136 and 236 are all created using material removal techniques, including but not limited to, rough surface grinding with a carbon nitride grinding wheel, milling or turning the diameter on a lathe or other suitable material removal device. The imagable feature 36 may also be created through surface treatments such as but not limited to, grit blast, bead blast, laser abrasion, dimpling, or by applying an imagable coating or any other suitable method creating a surface capable of displaying a larger imagable reflective signature when using a suitable imaging device.
In the embodiment illustrated, introducer stylet body 522 extends from a handle 526. The introducer stylet body 522 may include an introducer stylet shaft 521 moveably received within the handle 526 and a firing mechanism 552 fixedly attached to a portion of the introducer stylet shaft 521. The handle 526 may include a latching tab interference portion 530 that operatively connects to the firing mechanism 552. The handle 526 may also include an imagable feature orientation indicator 528 so as to provide a visual orientation position of an imagable feature 536 on the distal end 532 of introducer stylet body 522 relative to the handle 526 (for those embodiments that include a generally planar reflective surface). In one exemplary arrangement, the imagable feature orientation indicator 528 may be configured as an ergonomic thumb pad. Alternatively, the imagable feature orientation indicator 528 may also be attained by printing a mark on the handle (not shown) that allows the operator to orient the imagable feature 536 to a target tissue area prior to the removal of the introducer stylet body 522 and the insertion of a core biopsy device within an introducer cannula 42 such as shown in
The firing mechanism 552 includes a generally annular hub portion 547 that carries latch portion 548. The annular hub portion 547 includes a hub outer surface 582, a hub mating surface 584, a hub proximal end 586, and a hub distal end 588. A first spring locator (shown in phantom as 590) is mounted on a proximal end 524 of the introducer stylet body 521. A second spring locator (also shown in phantom as 590) is mounted to an inside surface of the handle 526. A spring 550 is secured to the spring locators 590. A retaining collar 591 is fixedly secured to the introducer stylet body 521 and disposed with the handle 526 to prevent the proximal end 524 of the introducer stylet body 521 from disengaging from the handle 526. The latch portion 548 includes a release button 585 and a latch 587 having a latch tab 589 (as seen best in
The firing mechanism 552 prevents the introducer stylet body 522 from extending into a tissue area prematurely during a procedure. During a procedure, the introducer stylet 522 is mounted within a sterotactic cradle (not shown) having an upwardly extending wall portion (not shown), against which a proximal end of handle 526 is mounted. Once mounted, the introducer stylet 522 enters into the tissue area when the spring 550 is released from a pre-fire, compressed position (
Indeed, in operation, the operator grasps the handle 526, paying particular attention to the orientation indicator 528 as related to the imagable feature 536, and forces the piercing tip 534 into the tissue. The piercing tip 534 enters the tissue and the operator presses the release button 585, causing disengagement of the latch tab 589 from the latch tab interference portion 530. The force from the spring 550, releasing from a compressed position, (best seen in
Once the operator has released the spring 550 to the fully extended position the operator will apply further pressure, while watching the imaging device, to guide the imagable feature 536 adjacent the targeted tissue. After the imagable feature 536 reaches the targeted area the operator will rotate the handle 526 to orient the imagable feature 536 in the direction of the sample to be taken. Upon proper orientation the operator may remove the introducer stylet 522 or leave the introducer stylet 522 in place while evaluating other procedures. To remove the introducer stylet 522 the operator grasps the handle 526 and slides the introducer stylet 522 out of the tissue leaving a path for the introduction of other medical devices, as stated above.
Referring now to
In the illustrated arrangement, introducer stylet body 622 is positioned in sliding arrangement through a handle 626. A firing button 652 (to be explained in further detail below) is provided that extends through an opening 651 (best seen in
Introducer stylet assembly 600 may also be used with an introducer assembly 20 (described in greater detail in connection with
As best shown in
Slidable carriage 688 is fixedly secured to a portion of introducer stylet body 622a and disposed within a chamber 690 formed within handle 626. Biasing member 650 is also positioned within chamber 690, adjacent a proximal end 692 of handle 626. Biasing member 650 is positioned between body member 682 of carriage 688 and an internal surface 694 of chamber 690.
In operation, when introducer stylet assembly 600 is in the “pre-fire” configuration (
To move introducer stylet assembly 600 into a “fired” configuration (see
Further, proximal end 624 of introducer stylet body 622 may also be configured with a stop member 698 that serves to prevent introducer stylet body 622 from exiting handle 626 during the firing process. For example, as may be seen in
Referring now to
Introducer hub 804 further includes a proximal portion 814. Proximal portion 814 further includes a gripping member 816 that is disposed around a mounting groove 818. In one exemplary embodiment, gripping member 816 is configured as an annular member that extends around mounting groove 818. In another embodiment, gripping member 816 may be configured as a series of projections positioned around mounting groove 818. Gripping member 816 is constructed of a compressible material, as will be explained in further detail below.
Introducer hub 804 is designed to allow selective fixed engagement with a variety of medical devices. More specifically, gripping member 816 is sized to engage both luer lock type syringes 900, as well as luer taper type syringes 950. However, unlike traditional fittings for introducers that are threaded or require a twist-type engagement (such as bayonet fittings), gripping member 816 is designed to fit multiple types of medical devices with a quick interference-type fit.
For example, referring to
Referring to
In addition to gripping members 816 and mounting groove 818, introducer hub 804 may also be optionally provided with a latch portion 822, similar to those described above in connection with
While the present disclosure has been particularly shown and described with reference to the foregoing preferred embodiments, it should be understood by those skilled in the art that various alternatives to the embodiments of the disclosure described herein may be employed in practicing the disclosure without departing from the spirit and scope of the disclosure as defined in the following claims. It is intended that the following claims define the scope of the disclosure embodiments within the scope of these claims and their equivalents be covered thereby. This description of the disclosure should be understood to include all novel and non-obvious combinations of elements described herein, and claims may be presented in this or a later application to any novel and non-obvious combination of these elements. The foregoing embodiment is illustrative, and no single characteristic or element is essential to all possible combinations that may be claimed in this or a later application.
This application claims the benefit of U.S. Provisional Application Ser. Nos. 61/111,604 filed Nov. 5, 2008, and 61/122,172 filed Dec. 12, 2008, which applications are hereby incorporated by reference in their entirety.
Number | Date | Country | |
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61111604 | Nov 2008 | US | |
61122172 | Dec 2008 | US |