The present invention concerns a method for endoluminally or laparoscopically excising a tissue sample from areas in a patient's body.
In accordance with a further aspect, the present invention also concerns traction means for excising a tissue sample and a kit for endoluminally or laparoscopically excising a tissue sample from areas in a patient's body.
In particular, the present invention concerns a method suitable for covering low and high gastrointestinal portions, laparoscopic approaches and more advanced transgastric, transvaginal or transanal/rectal approaches.
There is a great need for a method and instruments suitable for endoluminally or laparoscopically excising a tissue sample from areas in a patient's body so as to allow the safe and effective removal of a tissue sample, for example a lesion. In particular, there is a need for a method and instruments for excising a determined and precise amount of tissue allowing better control of the visual field during each step of the method.
Even if surgical methods for excising tissue samples have been applied, they do not allow endoluminal or laparoscopic approaches. The disadvantages of conventional surgical methods are well known; for example, they are very invasive, the patient needs to be anaesthetised and the post-operation recovery time is long.
It is an object of the present invention to foresee a method for endoluminally or laparoscopically excising a tissue sample, having a determined amount and volume, from areas in a patient's body.
Another object of the present invention is to foresee a method for endoluminally or laparoscopically excising a tissue sample suitable for being made both for large and small amounts of tissue.
A further object of the present invention is to foresee a method for endoluminally or laparoscopically excising a tissue sample allowing better control of the visual field during each step of the method.
Yet another object of the present invention is to foresee a method for endoluminally or laparoscopically excising a tissue sample carried out along the entire length of the colon up to the caecum.
Yet another object of the present invention is to foresee a safe method for endoluminally or laparoscopically excising a tissue sample avoiding perforations.
According to a further aspect, an object of the present invention is to provide instruments like traction means or a kit suitable for being used in a laparoscopic or endoluminal method as indicated previously. A further object of the present invention is to provide instruments as indicated previously, to allow the safe and effective traction and removal of a tissue sample.
In brief, the present invention concerns a method for endoluminally or laparoscopically excising a tissue sample from areas in a patient's body comprising the steps of cutting and stapling an appropriate amount of tissue pulled through a window of a surgical stapling device by means of traction means.
Advantageously, the traction means comprise at least one clip connected to a suture for putting into traction the tissue through said window. The suture can be pulled directly from outside the patient or can be pulled by grasping means.
Each step of the present method can be carried out by means of or under the control of a visualization device (endoscope or laparoscope) for displaying the field and/or for arranging means suitable for carrying out the steps of the present method.
Advantageously, the step of introducing said at least one clip into the patient's body and fixing it to the tissue that must be excised is carried out by means of grasping means that grasp the tissue before fixing said clip to it.
In accordance with an embodiment of the invention, a sheath is introduced into the patient's body as a first step. The sheath defines a work channel for receiving the devices that carry out the method, particularly the traction means and the surgical stapling device. Moreover, the sheath is particularly advantageous to avoid perforations of the walls, in particular of the walls of the colon when the present method is carried out to endoluminally excise a tissue sample of the colon. Preferably, the sheath is introduced by means of and under the control of a visualization device fixed to the sheath. Advantageously, the surgical stapling device is guided along the work channel of the sheath, sliding on a track of the sheath.
In accordance with another embodiment of the present invention, the sheath defines a first work channel and a second work channel. The first work channel is suitable for receiving said traction means and said surgical stapling device, the second work channel is suitable for receiving a visualization device. The suture of the traction means can be fixed to the inside of the first work channel during the introduction of the sheath or else it can be introduced through the first work channel by means of positioning grasping means or of a visualization device.
Generally, a proximal portion of the traction means is inserted through the window of the surgical stapling device by which the surgical stapling device is guided by the traction means.
Advantageously, in particular when a large amount of tissue must be excised, the step of fixing said traction means to at least one portion of tissue that must be excised comprises the step of fixing a plurality of clips of said traction means to the tissue that must be excised.
Each clip of said plurality of clips is connected to a suture to put into traction the tissue through said window. The clips can be fixed along the border of the portion of tissue that must be excised. Otherwise one or more clips can be fixed directly to the portion of tissue that must be excised.
In accordance with an embodiment of the present invention, the tissue that must be excised is highlighted through a mark or tattoo and the amount of tissue pulled through the window of the surgical stapling device is monitored by checking the position of the marks or tattoos.
The aforementioned purposes, the characteristics and advantages of the invention shall become clear from the following description with reference to the attached drawings, in which:
The following description refers both to laparoscopic and endoluminal approaches in which some steps are carried out by means of and under the control of a visualization device (generic term to indicate a visualization device suitable for the chosen approach). In particular, in the case of the endoluminal approach, the steps are carried out through an endoscope.
A portion of tissue comprising the portion of tissue to be excised 12 has been generically indicated with 10. This portion can correspond to a lesion or other abnormalities that need to be examined.
Generally, the method according to the present invention comprises the steps of:
foreseeing traction means 14 having a distal portion 14a, suitable for being fixed to at least one portion 12 of the tissue to be excised, and a proximal portion,
introducing said distal portion 14a of said traction means 14 into the patient's body and positioning said distal portion 14a of said traction means 14 close to the tissue to be excised 12, by which at least one portion of said traction means 14 that extends from said distal portion 14a is positioned in the patient's body,
fixing said distal portion 14a of said traction means 14 to at least one portion of tissue to be excised 12,
foreseeing a surgical stapling device 16 having a distal end 16a with a window 18 for receiving the tissue to be excised 12 and comprising cutting and stapling means that act through said window 18,
introducing said surgical stapling device 16 into the patient's body and positioning said distal end 16a of the surgical stapling device close to the tissue to be excised 12,
exerting traction on said traction means 14 by which an amount of tissue is pulled through said window 18,
cutting and stapling said tissue by actuating said cutting and stapling means of said surgical stapling device 16 through said window 18.
Finally, all of the devices are withdrawn and the sample fixed to the traction means is removed from the patient's body.
The example of
Preferably, the clip 20 of said traction means 14 is connected to a ring 24 formed at a distal end 24a of said suture 22 to pull the tissue through said window 18.
As shall be described in greater detail, the step of exerting traction on said traction means 14 can comprise the step of pulling said proximal end of the suture 22 from outside the patient.
According to a different embodiment of the invention, not shown in
Preferably, the step of exerting traction on said traction means is carried out under the control of a visualization device 26. In particular, during the step of exerting a traction on said traction means 14, a portion of said suture 22 extends through said visualization device 26 (
According to a different embodiment of the invention, not shown in
As for example shown in
In the case in which said grasping means 28 are used, the ring 24 of the suture 22 is positioned in jaws 30 of said grasping means 28 (
Preferably, as shown in
The method according to the present invention preferably also comprises the step of withdrawing said grasping means 28 and said visualization device 26 after having fixed said means to the tissue to be excised (
According to a generic embodiment of the present invention, the present method also comprises the step of inserting said proximal portion of said traction means 14 into the window 18 of the surgical stapling device 16, outside of the patient's body, before introducing the surgical stapling device 16 into the patient's body. The surgical stapling device 16 is then guided by said traction means 14 whilst it is introduced into the patient's body (
If the traction means 14 comprise at least one clip 20 connected to the suture 22, the last described step is carried out by inserting said proximal end of said suture 22 into the window 18 of said surgical stapling device 16, outside of the patient's body, before introducing said surgical stapling device 16 into the patient's body. In this case, the surgical stapling device 16 is guided by the suture 22 whilst said surgical stapling device 16 is introduced into the patient's body.
Following
According to a generic embodiment of the invention, the present method can also comprise a first step of foreseeing a sheath 34 having a distal end 34a and a proximal end 34b. Said sheath defines a work channel 36 for receiving in particular said traction means 14 and said surgical stapling device 16. Moreover, the sheath is particularly suitable for protecting the walls from perforations, in particular the walls of the colon when the present method is carried out endoluminally in order to excise a tissue sample of the colon. Moreover, said sheath 34 is introduced into the patient's body, positioning said distal end 34a of the sheath 34 close to the portion of the tissue to be excised 12, before fixing said traction means 14 to the tissue to be excised. An example of this embodiment has been shown in
The sheath 34 is preferably made from flexible transparent material. The drawings show a schematic view of the sheath 34 after having been insufflated; however, it is possible to foresee a sheath of flexible material that naturally expands without insufflation when the devices, particularly the surgical stapling device and the visualization device, are introduced.
According to a generic embodiment of the invention, the sheath 34 is introduced into the patient's body by means of a visualization device that can be the same visualization device referred to as 26 and used in different steps of the present invention.
The visualization device 26 is introduced through the sheath 34, from the proximal end and to the distal end of the sheath, before introducing said sheath into the patient's body. The visualization device 26 has a distal end 26a and a proximal end.
Thereafter, the visualization device 26 is fixed to the sheath 34. The sheath 34 with the visualization device 26 is then introduced into the patient's body (
Advantageously, the step of fixing the sheath to the visualization device can be carried out as follows. The visualization device 26 is introduced through the sheath 34 from the proximal end to the distal end of the sheath 34 by which the distal end of the visualization device comes out from the distal end of the sheath. Then the visualization device 26 is fixed to the sheath 34 placing an elastic connection sheath 38 on the distal end 34a of the sheath 34 and on the distal end 26a of the visualization device 26, before introducing said sheath 34 into the patient's body (
According to an example of the present invention, the visualization device 26 is withdrawn from the sheath 34 before introducing said traction means 14 through the sheath 34 (
After the positioning of the sheath 34, the step of introducing said traction means 14 into the patient's body is carried out by introducing said traction means into the work channel 36 of said sheath 34, from the proximal end to the distal end of the sheath, before said traction means are fixed to the tissue to be excised (
If the traction means comprise at least one clip 20 connected to the suture as described above and the step of introducing said at least one clip 20 into the patient's body and of fixing it to the tissue to be excised is carried out by grasping means 28, the grasping means are preferably introduced into the work channel 36 of said sheath 34 to grasp the tissue to be excised before fixing said clip to it. As described above, the ring 24 of the suture 22 is preferably arranged in the jaws 30 of said grasping means 28 and then said jaws 30 are closed around said ring 24 before introducing the grasping means 28 into the patient's body (
Preferably, said grasping means 28 and said visualization device are withdrawn from the sheath before inserting said surgical stapling device.
According to a possible embodiment (not shown), the suture is inserted into the patient's body before introducing said grasping means. The grasping means grasp the distal end of the suture before fixing the at least one clip to the tissue to be excised. In particular, the suture can be fixed to the sheath during the introduction of the sheath into the patient's body.
According to an embodiment of the invention in which the sheath 34 is introduced into the patient's body, the step of introducing said surgical stapling device 16 into the patient's body is generically carried out by inserting said surgical stapling device 16 through the sheath 34, into the work channel 36, from the proximal end 34b to the distal end 34a of the sheath 34, before pulling the tissue to be excised through said window 18 of the surgical stapling device 16 and before cutting the tissue pulled through said window 18.
Preferably, the step of introducing said surgical stapling device 16 into the patient's body is carried out by guiding said surgical stapling device 16 inside the work channel 36 of the sheath 34. The surgical stapling device 16 is for example guided in the work channel 36 sliding along a track 40 of the sheath 34, the track extending longitudinally along the sheath. Particularly, the surgical stapling device 16 comprises an extension 42 suitable for coupling with the track 40 in order to radially exert a restriction for the surgical stapling device 16 with respect to the sheath 34.
Even when the surgical stapling device 16 is guided by the sheath 34 as described above, the proximal portion of said traction means 14 is inserted into the window 18 of the surgical stapling device 16, outside of the patient's body, before introducing said surgical stapling device into said sheath. Thus, the surgical stapling device 16 is further guided by said traction means 14 whilst said surgical stapling device 16 is introduced through said sheath 34.
In particular, a preferred embodiment of the present invention can be carried out as follows (
The first steps of the method according to the present invention comprise the steps of:
foreseeing traction means 14 having a distal end 14a suitable for being fixed to at least one portion of tissue to be excised and a proximal portion,
foreseeing a surgical stapling device 16 having a distal end 16a with a window 18 for receiving the tissue to be excised and comprising cutting and stapling means operating through said window,
foreseeing a sheath 34 having a distal end 34a and a proximal end 34b and defining a work channel 36 to receive said traction means 14 and said surgical stapling device 16.
Then the method is carried out, as shown in
introducing a visualization device 26 through the sheath 34 from the proximal end to the distal end of the sheath, before introducing said sheath into the patient's body,
fixing the visualization device 26 to the sheath 34 and introducing said sheath with the visualization device into the patient's body, said distal end of said sheath being positioned close to the portion of tissue to be excised (
withdrawing the visualization device 26 from the sheath 34 (
These last steps can be carried out as described above, using an elastic connection sheath 38 as shown in
Then the method is carried out as shown in
inserting said traction means 14 through the sheath 34, inside the work channel 36, from the proximal end to the distal end of the sheath, and
fixing said traction means 14 to the at least one portion of tissue to be excised.
In particular, as described earlier, said distal portion 14a of said traction means 14 comprises at least one clip 20 by which the step of fixing said distal portion of said traction means to the at least one portion of tissue to be excised is carried out by fixing said at least one clip 20 of said traction means to the tissue to be excised. Said clip 20 is connected to the distal end of a suture 22 of said traction means 14 to pull the tissue through said window 18, said suture extending between said distal end 22a and a proximal end corresponding to the proximal portion of said traction means. The step of introducing said at least one clip 20 into the patient's body and of fixing it to the tissue to be excised is preferably carried out by means of grasping means 28 that grasp the tissue before fixing said clip to it. More preferably the step of introducing said traction means 14 into the patient's body comprises the step of inserting said grasping means 28 through a visualization device 26 outside of the patient's body, and then introducing said visualization device 26 and said grasping means 28 through the work channel 36, from the proximal end to the distal end of the sheath 34. The grasping means 28 and the visualization device 26 are then withdrawn from the patient's body, leaving the suture in the sheath with the clip fixed to the tissue to be excised.
Then the method comprises the step of inserting said proximal end of said suture into the window 18 of said surgical stapling device, outside of the patient's body, before introducing said surgical stapling device 16 into said sheath 34. Preferably the proximal end of the suture 22 is re-inserted into the visualization device 26 and the visualization device 26 is arranged in a concavity of the surgical stapling device.
The method also comprises the steps of:
inserting said surgical stapling device 16 through the work channel 36 of said sheath 34, sliding on the suture from the proximal end to the distal end of the sheath, whilst the visualization device follows the surgical stapling device, and
positioning said distal end of the surgical stapling device close to the tissue to be excised (
Preferably, said surgical stapling device 16 is also guided inside the work channel 36 sliding along a track 40 of the sheath 34.
Finally, the method comprises the steps of:
exerting a traction on said traction means 14 by which an appropriate amount of tissue is pulled through said window 18 (
cutting and stapling said tissue by actuating said cutting and stapling means of said surgical stapling device 16 through said window 18 (
Than all of the devices are withdrawn from the patient's body and the excised sample is taken out by means of the traction means.
The method described earlier is particularly suitable for being carried out according to an endoluminal approach, using natural or artificial orifices. However, the method described can also be carried out according to a laparoscopic approach.
In accordance with this embodiment, the method comprises the step of foreseeing a sheath 44 having a distal end 44a and a proximal end 44b. The sheath 44 defines a first work channel 46 and a second work channel 48. The first work channel 46 is suitable for receiving said traction means 14 and said surgical stapling device 16, the second work channel 48 is suitable for receiving a visualization device 50.
The sheath is preferably made from flexible transparent material. The drawings show a schematic view of the sheath 44 after having been insufflated; however, it is possible to foresee a sheath of flexible material that expands naturally without insufflation when the devices, particularly the surgical stapling device and the visualization device, are introduced.
Then the sheath 44 is introduced into the patient's body and the distal end 44a of the sheath 44 is positioned close to the portion of tissue to be excised before fixing said traction means 14 to the tissue to be excised 12 (
Also in this case, said distal portion 14a of said traction means 14 comprises at least one clip 20 by which the step of fixing said distal portion 14a of said traction means 14 to the at least one portion of tissue to be excised is carried out by fixing said at least one clip 20 of said traction means 14 to the tissue to be excised (
As shown in
According to an embodiment of the invention, not illustrated, the suture 22 is fixed inside said first work channel 46 whilst said sheath 44 is introduced into the patient's body. The distal end 22a of said suture 22 extends from the distal end 44a of the sheath 44.
According to a different embodiment, shown in
If the traction means comprise at least one clip 20, the step of introducing said at least one clip 20 into the patient's body and of fixing it to the tissue to be excised is carried out by means of grasping means 28 that are preferably introduced through said sheath 44 (
After the clip has been fixed to the tissue to be excised, said proximal end 22b of said suture 22 is inserted into the window 18 of said surgical stapling device 16, outside of the patient's body, before said surgical stapling device 16 is introduced through said first work channel 46 of said sheath 44, by which said surgical stapling device 16 is guided by said suture 22 (
The insertion of the surgical stapling device can be carried out under the visual control of the visualization device 50, or else it is possible to insert the suture 22 into a different visualization device, after having introduced a proximal end of the suture into the window 18 of the surgical stapling device 16, outside of the patient's body. The visualization device shall preferably be arranged in a concavity of the surgical stapling device and shall follow the surgical stapling device 16 through the sheath sliding on the suture inside the first work channel. According to a different embodiment that is not illustrated, the suture can extend outside of the visualization device.
The surgical stapling device reaches the tissue to be excised (
The tissue pulled by the traction means is then cut and stapled by actuating said cutting and stapling means of said surgical stapling device 16 through said window 18 (
As an example, this further embodiment can be carried out as follows. The first steps comprise the steps of:
foreseeing traction means 14 having a distal portion 14a suitable for being fixed to at least one portion of the tissue to be excised and a proximal portion 14b,
foreseeing a surgical stapling device 16 having a distal end 16a with a window 18 for receiving the tissue to be excised and comprising cutting and stapling means operating through said window 18, foreseeing a sheath 44 having a distal end 44a and a proximal end 44b and defining a first work channel 46 and a second work channel 48. Said first work channel 46 is suitable for receiving said traction means 14 and said surgical stapling device 16; said second work channel 48 is suitable for receiving said visualization device 50.
Said visualization device 50 is inserted through said second work channel 48 of said sheath 44 from a proximal end 44b to a distal end 44a of the sheath, before inserting said sheath into the patient's body. In particular, the visualization device 50 is fixed to the sheath 44 and said sheath with the visualization device 50 is then introduced into the patient's body, said distal end of the sheath being positioned close to the portion of tissue to be excised. Then the visualization device 50 is withdrawn from the sheath.
The following steps of the method comprise:
inserting said traction means through said first work channel 46 of said sheath 44, from the proximal end to the distal end of the sheath, and
fixing said traction means 14 to the at least one portion of the tissue to be excised.
Said distal portion of said traction means comprises at least one clip 20 by which the step of fixing said distal portion of said traction means to at least one portion of the tissue to be excised is carried out by fixing said at least one clip of said traction means to the tissue to be excised. Said clip is connected to a distal end 22a of a suture 22 of said traction means 14 to pull the tissue through said window 18 (said suture extends between said distal end 22a and a proximal end 22b corresponding to the proximal portion 14b of said traction means 14). Said suture 22 of said traction means 14 can be inserted through said first work channel 46 of said sheath 44 and fixed to it, from the proximal end to the distal end of the sheath, before introducing said sheath into the patient's body. Alternatively, said suture 22 of said traction means 14 is inserted through said first work channel 46 of said sheath 44, from the proximal end to the distal end of the sheath introduced into the patient's body (
The step of introducing said at least one clip 20 into the patient's body and of fixing it to the tissue to be excised is carried out by means of grasping means 28 that grasp the tissue before fixing said clip to it. Said grasping means 28 can be inserted through a visualization device 50 outside of the patient's body, by which said visualization device 50 and said grasping means 28 are then introduced through said second work channel 48, from the proximal end to the distal end of the sheath.
Jaws 30 of the grasping means 28 grasp the distal end 22a of the suture 22 (in particular a ring formed at the distal end 22a of the suture 22) inside the patient's body. Then the grasping means 28 grasp the tissue and fix the clip to it.
The following steps of the method comprise:
inserting said proximal end 22b of said suture 22 into the window 18 of said surgical stapling device 16, outside of the patient's body, before introducing said surgical stapling device 16 into the sheath 44 (
inserting said surgical stapling device 16 through said first work channel 46 of said sheath 44, from the proximal end to the distal end of the sheath, and positioning said distal end of the surgical stapling device 16 close to the tissue to be excised (
exerting a traction on said traction means 14 by which an appropriate amount of tissue is pulled through said window 18 (
cutting and stapling said tissue by actuating said cutting and stapling means of said surgical stapling device 16 through said window 18 (
After having introduced the proximal end 22b of the suture 22 into the window 18, the proximal end 22b of the suture 22 can be inserted into a visualization device suitable for being arranged in a concavity of the surgical stapling device 16. The visualization device shall follow the surgical stapling device during introduction through the sheath.
With reference to all of the embodiments described, the step of fixing said traction means 14 to at least one portion of the tissue to be excised 12 can comprise the step of fixing a plurality of clips 20 of said traction means to the tissue to be excised. Each clip 20 of said plurality of clips is connected to a suture 22 to pull the tissue through said window 18. All of the sutures are inserted into the window 18.
According to a possible embodiment, said clips are fixed along a border of the portion of tissue to be excised. Alternatively, at least one clip 20 of said plurality of clips is fixed directly to the portion of tissue to be excised.
With reference to all of the embodiments described, the method according to the present invention can comprise the step of highlighting the tissue to be excised through marks or tattoos and, whilst a traction is exerted on said traction means, of monitoring the amount of tissue pulled through the window 18 of the surgical stapling device 16 checking the position of said marks or of said tattoos.
Preferably, in all of the embodiments described, the surgical stapling device is in an open configuration when it is outside of the patient's body (the window 18 is open and preferably has greater dimensions). This configuration allows easy introduction of the suture through the window 18. Then the window is closed so that the stapling device is in a closed configuration whilst it is introduced through the sheath (or generically into the patient's body). This configuration is less invasive. Then when the surgical stapling device reaches the tissue to be cut, the window 18 is reopened in order to cut and staple the tissue.
More advantageously, the surgical stapling device comprises an elongated structure, not shown, connected to a handle. The elongated structure is preferably flexible.
In accordance with a further aspect, the present invention concerns traction means 14 for excising a tissue sample comprising a distal portion 14a, comprising at least one clip 20 suitable for being fixed to at least one portion 12 of tissue to be excised, and a proximal portion 14b suitable for being subjected to traction.
Preferably, said at least one clip 20 is suitable for being connected to a distal end 22a of a suture 22 to pull the tissue to be excised. The suture 22 extends between said distal end 22a and a proximal end 22b corresponding to the proximal portion of said traction means 14.
In accordance with a possible embodiment, said at least one clip 20 is connected to a ring 24 formed at a distal end 24a of said suture 22 to pull the tissue to be excised.
Advantageously, grasping means 28 are foreseen that are suitable for grasping and pulling said proximal end of the suture 22. Moreover, a visualization device can be foreseen that is suitable for receiving a portion of said suture 22 that extends through a channel of said visualization device 26 or else suitable for cooperating with a portion of said suture 22 that extends along an outer surface of a visualization device 26.
In accordance with a possible embodiment, grasping means 28 are foreseen that are suitable for fixing said clip 20 to the at least one portion of tissue to be excised and for connected said clip to said suture 22.
According to yet another aspect, the present invention concerns a kit for endoluminally or laparoscopically excising a tissue sample from areas in a patient's body comprising traction means 14, for example as described above, and a surgical stapling device 16 having a distal end 16a with a window 18 for receiving the tissue to be excised 12 and comprising cutting and stapling means that act through said window 18. The traction means are suitable for being inserted through said window 18 starting from a proximal portion 14b of the traction means themselves.
In accordance with a possible embodiment, the kit also comprises a sheath 34 having a distal end 34a and a proximal end 34b. Said sheath defines a work channel 36 for receiving the traction means 14 and the surgical stapling device 16.
In accordance with a different embodiment the kit comprises a sheath 44 having a distal end 44a and a proximal end 44b, in which said sheath 44 defines a first work channel 46 and a second work channel 48. The first work channel 46 is suitable for receiving the traction means 14 and the surgical stapling device 16; the second work channel 48 is suitable for receiving a visualization device 50.
Preferably, the sheath is made from flexible transparent material suitable for being insufflated or else suitable for being naturally widened through the insertion of the devices (traction means, stapling device, visualization devices, . . . )
In accordance with a possible embodiment, said sheath comprises a track 40 that extends longitudinally along the sheath itself and the surgical stapling device 16 is suitable for sliding inside the sheath along said track. Preferably, the surgical stapling device 16 comprises an extension 42 suitable for coupling with the track 40 in order to radially exert a restriction for the surgical stapling device 16 with respect to the sheath 34.
In accordance with a possible embodiment, the kit according to the present invention also comprises an elastic connection sheath 38 suitable for slotting onto the distal end 34a of the sheath 34 and onto a distal end 26a of a visualization device 26 to connect them in the insertion step.
From the above description, it is clear that an improved method for endoluminally or laparoscopically excising a tissue sample is foreseen, having a specific amount and volume, from areas in a patient's body. Traction means and a kit are also foreseen that allow precise and safe traction of the tissue. Even if the aforementioned invention has been described in detail for the sake of clarity, it is obvious that modifications can be made without departing from the attached claims.
Number | Date | Country | Kind |
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MI2006A000411 | Mar 2006 | IT | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP2006/011347 | 11/27/2006 | WO | 00 | 11/6/2008 |