The disclosure generally relates to medical retrieval devices such as, for example, baskets, for retrieving material from a body of a patient. More particularly, the disclosure generally relates to medical retrieval baskets that may be inverted within the body, and methods of use.
Medical retrieval devices are often utilized for removing organic material (e.g., blood clots, tissue, and biological concretions such as urinary, biliary, and pancreatic stones) and/or inorganic material (e.g., components of a medical device or other foreign matter), which may obstruct or otherwise be present within a patient's body cavities or lumens. For example, concretions can develop in certain parts of the body, such as in the kidneys, pancreas, ureter, and gallbladder. Minimally invasive medical procedures are sometimes used to remove these concretions using medical retrieval baskets inserted into the body through natural orifices, or through an incision.
In some cases, the stone may be too large to be removed intact from the body tract after it has been captured within the basket. In such cases, the user (doctors, medical professionals, etc.) may attempt to dislodge the stone (or other material) from the basket. If the stone cannot be removed from the basket in this manner, the user may try to break, or otherwise fragment, the stone in the basket. However, in some cases, parts of the basket may break and may be released in the body. In such cases, surgery may be required to remove the broken pieces.
Embodiments of the present disclosure relate to, among other things, medical retrieval devices and related methods of use. Each of the embodiments disclosed herein may include one or more of the features described in connection with any of the other disclosed embodiments.
In one embodiment, a medical retrieval device is disclosed. The retrieval device may include an elongate sheath, a first and a second control wire extending through the sheath, and a basket coupled to a distal end of the first control wire. The retrieval device may additionally include an engaging member coupled to a distal end of the second control wire and the basket. The engaging member may be configured to transform from a constrained configuration within the sheath to an unconstrained configuration outside to the sheath, wherein transforming the engaging member from the unconstrained configuration to the constrained configuration may rotate the basket about an axis perpendicular to a longitudinal axis of the sheath.
Additionally or alternatively, embodiments of the retrieval device may include one or more of the following features: the basket may be configured to transform from a compressed configuration within the sheath to an expanded configuration outside the sheath; the basket may extend from a proximal end to a distal end, wherein a first end of the engaging member is connected to the proximal end of the basket and an opposite second end of the engaging member is connected to the distal end of the second control wire; in the unconstrained configuration, the engaging member may be substantially U-shaped, and in the constrained configuration, the engaging member may have an elongated shape; the retrieval device may include an elastic wire connecting a distal end of the first control wire and the basket, wherein the elastic wire is more elastic than the first control wire; the elastic wire may be a coiled wire.
Additionally or alternatively, embodiments of the retrieval device may include one or more of the following features: pulling the engaging member into the sheath may transform the engaging member to the constrained configuration and rotate the basket to an inverted configuration; the basket may have a proximal portion and a distal portion, wherein, in the inverted configuration, the proximal portion may be positioned distal to the distal portion; the basket may include a shape-memory material; the engaging member may include a shape-memory material or a spring material; the basket may be configured to extend from within the sheath to outside the sheath, wherein extending the basket from within the sheath to outside the sheath may rotate the basket about the axis; the basket may include a plurality of legs joined together at opposite ends; the basket may include a proximal portion having a first plurality of legs and a distal portion having a second plurality of legs, wherein a gap between adjacent legs of the first plurality of legs may be greater than a gap between adjacent legs of the second plurality of legs; the basket may include an atraumatic tip; the engaging member is a flat wire.
In another embodiment, a medical retrieval device is disclosed. The retrieval device may include a sheath having a lumen, and a basket having a proximal end and a distal end. The basket may be configured to transition between a first configured within the lumen to a second configuration outside the lumen. Wherein in the second configuration, the proximal end of the basket may be positioned proximal to the distal end, and in the first configuration, the proximal end of the basket may be positioned distal to the distal end. The retrieval device may also include an engaging member coupled to the basket and configured to rotate the basket about an axis perpendicular to a longitudinal axis of the sheath as the basket emerges from within the lumen.
Additionally or alternatively, embodiments of the retrieval device may include one or more of the following features: a first control wire and a second control wire extending through the sheath, wherein, a distal end of the first control wire may be coupled to the proximal end of the basket, and a distal end of the second control wire may be connected to a second end of the engaging member; a first end of the engaging member opposite the second end may be connected to the proximal end of the basket; an elastic wire connecting the distal end of the first control wire to the proximal end of the basket; and retracting the engaging member from outside the lumen into the lumen may be configured to rotate the basket about the axis.
In another embodiment, a method of using a medical retrieval device to manipulate an object within a body of a patient is disclosed. The method may include directing a distal end of an elongate hollow sheath into the body, the sheath may including a basket in a first configuration loaded therein. Wherein in the first configuration, a proximal end of the basket may be positioned distal to a distal end of the basket. The method may also include extending the basket from within the sheath to rotate the basket from the first configuration to a second configuration outside the sheath, wherein in the second configuration, the proximal end of the basket is positioned proximal to the distal end. The method may also include capturing the object within the basket.
Additionally or alternatively, the method may include one or more of the following features: the medical retrieval device may include an engaging member coupled to the basket, the engaging member may be configured to transform from an elongated shape within the sheath to a curved shape outside the sheath, and wherein extending the basket includes extending the engaging member out of the sheath; the method may further include retracting the engaging member into the sheath to rotate the basket about an axis perpendicular to a longitudinal axis of the sheath after capturing the object within the basket; the method may also include releasing the object from within the basket; the method may also include inverting the basket after capturing the object to release the object from the basket; and extending the basket from within the sheath may transform the basket from a compressed configuration within the sheath to an expanded configuration outside the sheath.
It may be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary embodiments of the present disclosure and together with the description, serve to explain the principles of the disclosure.
Sheath 140 may include an elongate tube that extends from the handle 120 to a distal end that may be positionable within the body of the patient. A lumen may extend along the length of the sheath 140. In some embodiments, sheath 140 may include a plurality of lumens extending therethrough. Sheath 140 may include any appropriate polyimide tube or a hollow member of another material that exhibits suitable radial flexibility, axial stiffness, and biocompatibility. In general, sheath 140 may have any outer dimension (e.g., diameter) and cross-sectional shape configured for insertion into a body lumen directly or through a channel of an insertion device such as, for example, a scope device (such as a ureteroscope, endoscope, colonoscope, etc.), a catheter, or the like. The sheath 140 may have an inner dimension and cross-sectional shape suitable for the insertion of a basket 130 therethrough.
Basket 130 may include a plurality of legs 136 joined together to form a cage that extends from a proximal end 132 to a distal end 134. In general, basket 130 may have any number or pattern of legs 136. The number and/or pattern of the legs 136 may be selected on the basis of a number of parameters such as, for example, the size of the body lumen/cavity into which the basket 130 is inserted, the size of the stone or other material to be removed, the consistency of the stone or other material, the position of the stone or other material, and the location and/or orientation of the stone or other material within a patient.
The distal portion 148 of the basket 130 may include a plurality of distal legs 136b extending distally of the proximal legs 136a. In some embodiments, as illustrated in
The distal legs 136b may be coupled together at the distal end 134, and the proximal legs 136a may be coupled together at the proximal end 132, by any appropriate method including, for example, welding, adhesives, and/or tying. In some embodiments, collars or crimped hypo-tubes at the proximal and/or distal ends 132, 134 may join the respective legs together. In some embodiments, the distal end 134 of the basket 130 may form a tip. In some embodiments, the tip may be rounded to form an atraumatic surface. An atraumatic tip may prevent inadvertent damage to tissue during movement of the basket 130 within a body lumen. In some embodiments, the tip may include a cap with a rounded or otherwise atraumatic end. In some embodiments, the basket 130 may not include a tip. Instead, each distal leg 136b may extend from the distal end of a proximal leg 136a to the distal end of another proximal leg 136a to form a loop.
It should be noted that the pattern of basket 130 illustrated in
The basket 130 may be coupled to the handle 120 (see
Device 100 may also include an engaging member 150 (or a forcing member) coupled to the basket 130. In some embodiments, engaging member 150 may include a substantially U-shaped strip (e.g., a flat strip) of an elastic material having a first end 152 and a second end 154. In its normal or unstressed state (that is, when a force is not applied to it), the engaging member 150 may have a substantially U-shaped configuration (as illustrated in
The first end 152 of the engaging member 150 may be connected to the proximal end 132 of the basket 130 and the distal end of the elastic wire 160. As illustrated in
When the second control wire 170 is pulled proximally, the second end 154 of the engaging member 150 may be pulled into the sheath 140 thereby applying a force on the engaging member 150.
As the engaging member 150 continues to be pulled into the sheath 140, the first portion 156 of the engaging member 150 continues to rotate about axis 14, causing the basket 130 to invert (or flip) by rotating about axis 14.
When the basket 130 is in its inverted configuration, a stone captured in the basket 130 may escape from the basket 130 through the gap between its proximal legs 136a. In some embodiments, moving the sheath 140 along with the inverted basket 130 in the proximal direction, allows a captured stone in the basket 130 to be released back into the body lumen.
Pushing the second control wire 170 in a distal direction may extend the straightened engaging member 150 out of the sheath 140, thereby allowing the engaging member 150 to transform back to its unstressed U-shaped configuration, and the basket 130 back to its normal configuration (
Engaging member 150 may have any suitable size and/or cross-sectional shape (round, rectangular, etc.). In general, the size and/or shape of engaging member 150 may be such that its memory force (force required to transform the engaging member 150 between its stressed and unstressed configurations) is high enough to invert the basket 130 and low enough to be applied through the second control wire 170. In some embodiments, engaging member 150 may be a wire made of a shape-memory material. The thickness and/or shape of the wire may be adapted to provide the desired memory force. Although the unstressed configuration of engaging member 150 is described as being U-shaped, this is only exemplary. In general, engaging member 150 may have any suitable shape (e.g., S-shaped) in its unstressed configuration.
An exemplary method of using a medical device 100 of the current disclosure will be described below with reference to
In the normal configuration, the basket 130 may be configured to capture and retrieve the stone 300. To capture the stone 300, the user may manipulate the basket 130 to trap the stone therein. In some embodiments, the user may pull the expanded basket in a distal direction over the stone 300 to sweep the stone 300 into the basket 130 through the gap between its proximal legs 136a.
If, however, the stone 300 is too large to be removed intact from the body lumen 200 after it has been captured within the basket 130, the user may invert the basket 130 to release the stone 300 back into the body lumen 200. To invert the basket 130, as discussed with reference to
While principles of the present disclosure are described herein with reference to illustrative embodiments for particular applications, it should be understood that the disclosure is not limited thereto. Those having ordinary skill in the art and access to the teachings provided herein will recognize additional modifications, applications, embodiments, and substitution of equivalents all fall within the scope of the embodiments described herein. Accordingly, the invention is not to be considered as limited by the foregoing description.
The application claims the benefits of priority from U.S. Provisional Application No. 62/057,773, filed on Sep. 30, 2014, which is incorporated by reference herein in its entirety.
Number | Date | Country | |
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62057773 | Sep 2014 | US |