This disclosure relates to an apparatus and method for use of a multipurpose tissue sampling device and, more particularly, to a method and device for extracting multiple tissue samples.
Accurately diagnosing small pulmonary nodules may provide a diagnostic challenge for physicians, as many of the nodules are benign and may require no intervention. However, some nodules may be hard to identify as needing treatment because they appear on a computed tomography (“CT”) scan to be no different than benign nodules. In order to determine whether certain nodules are problematic, a physician may perform a tissue biopsy.
Biopsy needle position accuracy is important in extracting a desired sample (diagnostic accuracy) and reducing potential complications that follow a biopsy. Diagnostic accuracy becomes more difficult the smaller the nodule is. For example, according to some sources, when categorized for nodule size, overall, 73.5% of nodules greater than 1.5 cm yielded a diagnostic specimen. On the other hand, only 51.4% of nodules less than or equal to 1.5 cm yielded a diagnostic specimen. Biopsy needle position accuracy may also prevent oversampling, the extraction of tissue beyond the nodule, which can lead to such complications as hemorrhaging and pneumothorax. For various reasons, including avoidance of patient discomfort, many small nodules are not biopsied. Instead, these small nodules are watched, potentially delaying treatment and allowing small, localized malignancies to advance.
In an aspect, a multipurpose tissue sampling device is provided. The multipurpose tissue sampling device includes an outer sheath, an inner stylet, a fine needle aspiration (“FNA”) needle, and an actuator. The outer sheath has an outer sheath body and an outer sheath distal end. The outer sheath distal end has an outer sheath cutting surface. The outer sheath body defines an outer sheath lumen. The inner stylet has an inner stylet body and an inner stylet distal end. The inner stylet has a sampling notch positioned on at least one of the inner stylet body and the inner stylet distal end. The inner stylet body is configured to pass through the outer sheath lumen. The inner stylet has an inner stylet lumen that extends between the inner stylet body and the sampling notch. The FNA needle has an FNA needle body and a FNA needle distal end. The FNA needle body is configured to pass through the inner stylet lumen. The FNA needle body defines a FNA needle lumen. The FNA needle distal end has a sampling feature. The actuator is configured to accept a portion of at least one of the outer sheath, the inner stylet, and the FNA needle.
In an aspect, a method for extracting at least one tissue sample from a tissue sampling site is provided. A multipurpose tissue sampling device is provided. The multipurpose tissue sampling device includes an outer sheath, an inner stylet, a fine needle aspiration (“FNA”) needle, and an actuator. The outer sheath has an outer sheath body and an outer sheath distal end. The outer sheath distal end has an outer sheath cutting surface. The outer sheath body defines an outer sheath lumen. The inner stylet has an inner stylet body and an inner stylet distal end. The inner stylet has a sampling notch positioned on at least one of the inner stylet body and the inner stylet distal end. The inner stylet body is configured to pass through the outer sheath lumen. The inner stylet has an inner stylet lumen that extends between the inner stylet body and the sampling notch. The FNA needle has an FNA needle body and a FNA needle distal end. The FNA needle body is configured to pass through the inner stylet lumen. The FNA needle body defines a FNA needle lumen. The FNA needle distal end has a sampling feature. The actuator is configured to accept a portion of at least one of the outer sheath, the inner stylet, and the FNA needle. The outer sheath is attached to the actuator. The inner stylet is inserted through the actuator and into the outer sheath lumen. The multipurpose tissue sampling device is inserted into a desired patient tissue sampling site with the multipurpose tissue sampling device in an inserting position. The multipurpose tissue sampling device is actuated into a sampling position by pulling the outer sheath proximally. The FNA needle is inserted into the inner stylet lumen. A suction means is attached to the FNA needle. At least a portion of the desired patient tissue is suctioned from the patient tissue sampling site into the sampling notch of the multipurpose tissue sampling device via the suction means. The FNA needle is further inserted into the inner stylet lumen until the FNA needle contacts the desired patient tissue that was suctioned into the sampling notch. An FNA sample is obtained by at least one of shaving and cutting the desired patient tissue that was suctioned into the sampling notch of the inner stylet with the FNA needle sampling feature. The FNA needle, with the included FNA sample, is removed from the inner stylet lumen. A core tissue sample is obtained by actuating the multipurpose tissue sampling device to transition from the sampling position to the inserting position, wherein as the multipurpose tissue sampling device transitions from the sampling position to the inserting position, the core tissue sample is severed by the outer sheath cutting surface. The multipurpose tissue sampling device, with the included core tissue sample, is removed from the desired patient tissue sampling site.
In an aspect, a multipurpose tissue sampling device is provided. The multipurpose tissue sampling device includes an outer sheath, an inner stylet, a fine needle aspiration (“FNA”) needle, and an actuator. The outer sheath has an outer sheath proximal end and an outer sheath distal end. The outer sheath proximal and distal ends are separated longitudinally by an outer sheath body. The outer sheath proximal end has an outer sheath attachment hub. The outer sheath distal end has an outer sheath cutting surface. The outer sheath body has an outer sheath exterior wall. The outer sheath has an outer sheath lumen that extends between the outer sheath proximal end and the outer sheath distal end. The outer sheath lumen has an outer sheath lumen wall. The inner stylet has an inner stylet proximal end and an inner stylet distal end. The inner stylet proximal and distal ends are separated longitudinally by an inner stylet body. The inner stylet distal end has a solid inner stylet cutting tip. The sampling notch is longitudinally spaced from the inner stylet cutting tip. The sampling notch is positioned on at least one of the inner stylet body and the inner stylet distal end. The inner stylet body has an inner stylet exterior wall configured to pass through the outer sheath lumen. The inner stylet has an inner stylet lumen that extends between the inner stylet proximal end and the sampling notch. The inner stylet lumen has an inner stylet lumen wall. The FNA needle has an FNA needle proximal end and an FNA needle distal end separated longitudinally by an FNA needle body. The FNA needle body is configured to pass through the inner stylet lumen. The FNA needle body has an FNA needle lumen that extends between the FNA needle proximal end and the FNA needle distal end. The FNA needle distal end has a sampling feature. The actuator has an actuator proximal end and an actuator distal end separated longitudinally by an actuator body. The actuator proximal end has a proximal port. The actuator distal end has a distal port. The proximal and distal ports each have an inner port wall that is configured to accept at least a portion of at least one of the outer sheath and inner stylet.
For a better understanding, reference may be made to the accompanying drawings, in which:
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as is commonly understood by one of skill in the art to which the present disclosure pertains.
As used herein, the term “patient” can refer to any warm-blooded organism including, but not limited to, human beings, pigs, rats, mice, dogs, goats, sheep, horses, monkeys, apes, rabbits, cattle, farm animals, livestock, etc.
As used herein, the term “user” can be used interchangeably to refer to an individual who prepares for, assists, and/or performs a procedure.
As used herein, the singular forms “a,” “an” and “the” can include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” as used herein, can specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof.
As used herein, the term “and/or” can include any and all combinations of one or more of the associated listed items.
As used herein, phrases such as “between X and Y” and “between about X and Y” can be interpreted to include X and Y.
As used herein, phrases such as “between about X and Y” can mean “between about X and about Y.”
As used herein, phrases such as “from about X to Y” can mean “from about X to about Y.”
It will be understood that when an element is referred to as being “on,” “attached” to, “connected” to, “coupled” with, “contacting,” etc., another element, it can be directly on, attached to, connected to, coupled with or contacting the other element or intervening elements may also be present. In contrast, when an element is referred to as being, for example, “directly on,” “directly attached” to, “directly connected” to, “directly coupled” with or “directly contacting” another element, there are no intervening elements present. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed “directly adjacent” another feature may have portions that overlap or underlie the adjacent feature, whereas a structure or feature that is disposed “adjacent” another feature may not have portions that overlap or underlie the adjacent feature.
Spatially relative terms, such as “under,” “below,” “lower,” “over,” “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the Figures. It will be understood that the spatially relative terms can encompass different orientations of a device in use or operation, in addition to the orientation depicted in the Figures. For example, if a device in the Figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features.
It will be understood that, although the terms “first,” “second,” etc. may be used herein to describe various elements, these elements should not be limited by these terms. These terms are only used to distinguish one element from another. Thus, a “first” element discussed below could also be termed a “second” element without departing from the teachings of the present disclosure. The sequence of operations (or steps) is not limited to the order presented in the claims or Figures unless specifically indicated otherwise.
The invention comprises, consists of, or consists essentially of the following features, in any combination.
The outer sheath proximal end 310 has an outer sheath attachment hub 315, which attaches the outer sheath 102 to at least one of the inner stylet 104, the FNA needle 106, and the actuator 108. The outer sheath proximal end 310 may have finger grips (not shown). The outer sheath distal end 312 has an outer sheath cutting surface 316. The outer sheath cutting surface 316 can be, but is not limited to, a single- or multi-beveled cutting surface. The outer sheath body 314 has an outer sheath exterior wall 318. The outer sheath 102 has an outer sheath lumen 320 extending longitudinally between the outer sheath proximal end 304 and the outer sheath distal end 306. The outer sheath lumen 320 has an outer sheath lumen wall 322.
As shown in
The inner stylet body 428 has an inner stylet exterior wall 434 which is configured to pass through the outer sheath lumen 320. For example, the inner stylet exterior wall 434 may be smaller in diameter than the outer sheath lumen wall 322. The inner stylet 104 has an inner stylet lumen 436 extending between the inner stylet proximal end 424 and the sampling notch 432. The sampling notch 432 places the inner stylet exterior wall 434 in fluid connection with the inner stylet lumen 436. The inner style lumen 436 has an inner stylet lumen wall 438. The inner stylet 104 may have an attachment mechanism (not shown) for attaching to at least one of the outer sheath 102, the FNA needle 106, and the actuator 108.
As shown in
As shown in
The actuator 108 may also include a firing mechanism 662. The firing mechanism 662 has at least one biasing element 664, at least one triggering element 666, and at least one locking mechanism 667. The biasing element 664 can be any appropriate biasing element, such as a spring. The triggering element 666 may be configured to accept at least a portion of the outer sheath 102. The triggering element 666 may have finger grips (shown in
An example of the locking mechanism 667 is shown in
In use, the multipurpose tissue sampling device 100, as described above, is provided to the user. The user attaches the outer sheath 102 to the actuator 108. The user may insert the inner stylet 104 through the actuator 108 and into the outer sheath lumen 320. The user locates a desired patient tissue sampling site T through the use of any suitable means, such as a CT scanner.
As shown in
As shown in
If the user wants to take an FNA sample from the desired patient tissue sampling site T, the user inserts the FNA needle 106 into the inner stylet lumen 436 (shown in
As shown in
The multipurpose tissue sampling device 100 may be rotated within the desired patient tissue sampling site T following the removal of the FNA needle 106, in order to gain access to patient tissue that has not already been sampled by the FNA needle, before obtaining the core tissue sample. The user can obtain a core tissue sample by actuating the multipurpose tissue sampling device 100 to transition from the sampling position to the inserting position, wherein when the multipurpose tissue sampling device 100 transitions from the sampling position to the inserting position, the core tissue sample (which was previously suctioned into the sampling notch 432) is severed by the outer sheath cutting surface 316. For example, the user can unlock the triggering element 666 which causes the biasing element 664 within the actuator 108 to uncompress. Uncompressing the biasing element 664 causes the triggering element 666, with attached outer sheath 102, to move from the sampling position to the inserting position, as shown in
Depending upon factors including the strength of the biasing element 664, this movement of the triggering element 666 and outer sheath 102 between the sampling position and the inserting position could be quite rapid (a “snapping” motion). The multipurpose tissue sampling device 100, or components thereof, should be configured, for many use environments, to “trigger” and drive motion of the outer sheath 102 into the inserting position with sufficient force to sever the core tissue sample in a desired manner. As shown in
The main distinction of the multipurpose tissue sampling device 100′ of the second configuration from that of the multipurpose tissue sampling device 100 of the first configuration is the shape of at least one of the outer sheath body 314, inner stylet body 428, and FNA needle body 544. For example, as shown in
The multipurpose tissue sampling device 100′ of the second configuration may have a curved inner stylet body 428′, as shown in
The multipurpose tissue sampling device 100′ may have a curved FNA needle body (not shown). The curved FNA needle body allows the multipurpose tissue sampling device 100′ to access desired tissue sampling sites which may be inaccessible by the straight-line access path of the FNA needle body 544. The curved FNA needle body may be elastic. This elastic configuration allows the curved FNA needle body to first follow a straight path through the outer sheath body 314 of
The main distinction of the multipurpose tissue sampling device 100″ of the second configuration from that of the multipurpose tissue sampling device 100 of the first configuration is the addition of an inner stylet attachment hub 1174. As shown in
Although shown in the Figures as being solid, it is contemplated that the inner stylet cutting tip 430 of any configuration of the multipurpose tissue sampling device 100 may include a lumen (not shown) extending the inner stylet lumen 436 to from the inner stylet proximal end 424 and entirely through the inner stylet cutting tip 430.
The outer sheath 102, the inner stylet 104, the FNA needle 106, and/or the actuator can each be at least partially formed from silicone, polyethylene, polypropylene, stainless steel, titanium, any other biocompatible material, or any combination thereof. The outer sheath 102, the inner stylet 104, the FNA needle 106, and/or the actuator can each be at least partially formed from magnetic resonance imaging (“MRI”) and/or CT compatible materials such as, but not limited to, polyetheretherketone, nonmetal polymers, nonmetal ceramics, any other nonmetal material, or any combination thereof. The use of MRI and/or CT compatible materials may assist the user in reducing imaging artifacts on MRI and/or CT images that may be caused by using biopsy tools that contain metal. The term “artifact” is defined herein as a structure that is not anatomically present in a MRI and/or CT image, but is visible in the MRI and/or CT image.
While aspects of this disclosure have been particularly shown and described with reference to the example aspects above, it will be understood by those of ordinary skill in the art that various additional aspects may be contemplated. For example, the specific methods described above for using the apparatus are merely illustrative; one of ordinary skill in the art could readily determine any number of tools, sequences of steps, or other means/options for placing the above-described apparatus, or components thereof, into positions substantively similar to those shown and described herein. In an effort to maintain clarity in the Figures, certain ones of duplicative components shown have not been specifically numbered, but one of ordinary skill in the art will realize, based upon the components that were numbered, the element numbers which should be associated with the unnumbered components; no differentiation between similar components is intended or implied solely by the presence or absence of an element number in the Figures. Any of the described structures and components could be integrally formed as a single unitary or monolithic piece or made up of separate sub-components, with either of these formations involving any suitable stock or bespoke components and/or any suitable material or combinations of materials; however, the chosen material(s) should be biocompatible for many applications. Any of the described structures and components could be disposable or reusable as desired for a particular use environment. Any component could be provided with a user-perceptible marking to indicate a material, configuration, at least one dimension, or the like pertaining to that component, the user-perceptible marking potentially aiding a user in selecting one component from an array of similar components for a particular use environment. A “predetermined” status may be determined at any time before the structures being manipulated actually reach that status, the “predetermination” being made as late as immediately before the structure achieves the predetermined status. The term “substantially” is used herein to indicate a quality that is largely, but not necessarily wholly, that which is specified—a “substantial” quality admits of the potential for some relatively minor inclusion of a non-quality item. Though certain components described herein are shown as having specific geometric shapes, all structures of this disclosure may have any suitable shapes, sizes, configurations, relative relationships, cross-sectional areas, or any other physical characteristics as desirable for a particular application. Any structures or features described with reference to one aspect or configuration could be provided, singly or in combination with other structures or features, to any other aspect or configuration, as it would be impractical to describe each of the aspects and configurations discussed herein as having all of the options discussed with respect to all of the other aspects and configurations. A device or method incorporating any of these features should be understood to fall under the scope of this disclosure as determined based upon the claims below and any equivalents thereof.
Other aspects, objects, and advantages can be obtained from a study of the drawings, the disclosure, and the appended claims.
This application is a continuation-in-part of U.S. patent application Ser. No. 15/349,737, filed 11 Nov. 2016, and claiming priority from U.S. Provisional Application No. 62/253,881, filed 11 Nov. 2015, the subject matter of all of which is incorporated herein by reference in its entirety.
This invention was made with United States government support under contract R21 EB017952 awarded by the National Institutes of Health. The government has certain rights in the invention.
Number | Date | Country | |
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62253881 | Nov 2015 | US |
Number | Date | Country | |
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Parent | 15349737 | Nov 2016 | US |
Child | 15386170 | US |