The present disclosure generally relates to the field of soft tissue sampling and harvesting. More specifically, the disclosure relates to needle tip designs for biopsy needles, needle sets, and/or devices capable of sampling soft tissue.
The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter described in any way.
In the practice of diagnostic medicine, it is often necessary or desirable to perform a biopsy, or to sample selected tissue from a living patient for medical evaluation. Cytological and histological studies of the biopsy sample can then be performed as an aid to the diagnosis and treatment of disease. Biopsies can be useful in diagnosing and treating various forms of cancer, including, for example, breast cancer, as well as other diseases in which a localized area of affected tissue can be identified.
Preoperative diagnosis with a percutaneous biopsy is generally preferred over surgical biopsy. With a percutaneous biopsy, a surgeon takes a tissue sample through the skin with a needle set, as opposed to making an actual surgical excision. One known needle set includes an elongate outer cannula (needle) having a pointed tissue piercing (penetrating) tip and a receiving aperture defined near its distal end (adjacent to the tissue piercing tip), and an inner cannula having an open distal end surrounded by an annular cutting blade. The inner cannula is slidably disposed within the outer cannula so that it can close the tissue receiving aperture, thereby cutting tissue prolapsing into the lumen of the outer cannula (needle) through the tissue receiving aperture.
Percutaneous image-guided needle biopsy, for example, has become the preferred biopsy method in the management of suspicious breast lesions detected by screening or during the assessment of clinical abnormalities. Percutaneous image-guided needle biopsy is recognized as a safe and cost-effective procedure, which allows for accurate diagnosis, decision-making, and when indicated treatment planning. Consequently, percutaneous image-guided breast biopsies have almost entirely replaced diagnostic surgical excisions, which were associated with longer hospital stays, higher costs, and possible complications, and have become the standard of care in the medical community.
There are also different technical options for breast tissue sampling, including, for example: fine-needle sampling (FNS), core needle biopsy (CNB), and vacuum-assisted biopsy (VAB), which may be used in conjunction with various imaging modalities for guidance. These different techniques are all available to diagnose palpable and nonpalpable breast lesions, with each generally be used for a different purpose. Accordingly, the different biopsy techniques adopt needles of different sizes and lengths. The diameter of a needle's lumen (opening) is described by gauge numbers, with smaller gauge numbers indicating larger needle diameters. Commonly applied needles, for example, have a lumen diameter ranging from about 0.4 mm (27 gauge) to about 4.6 mm (7 gauge).
VAB procedures generally require needle sets having a relatively small gauge ranging from about 12 to 7 gauge. Furthermore, the standard of care for breast biopsies has shifted to utilizing smaller gauge needles. Smaller gauge needles (with larger lumen diameters) are desirable, for example, to extract larger amounts of tissue and to collect multiple samples sequentially without having to remove the needle from the patient to provide enough tissue for the pathologists to make a diagnosis, thereby reducing the risk of false-negative results or pathological underestimation. Larger needles (having smaller gauges), however, also raise issues with patient comfort, as it is generally more difficult to penetrate a patient's skin with such needles.
It may, therefore, be desirable to provide needle tips for biopsy needles and/or needle sets, including, for example, small gauge biopsy needles and needle sets, having a design that improves the patient experience and facilitates patient comfort by more easily penetrating a patient's skin to collect soft tissue samples, while also enabling large scale manufacturing of the needles and/or needle sets for commercial use. It may be further desirable to provide needle tips for biopsy needles and/or needle sets that allow for decreased insertion forces as the needle enters the soft tissue, while simultaneously not increasing the length of the needle.
The present disclosure addresses one or more of the above-mentioned problems and/or achieves one or more of the above-mentioned desirable features. Other features and/or advantages may become apparent from the description which follows.
In accordance with various exemplary embodiments of the present disclosure, a biopsy needle for penetrating soft tissue includes an elongate body extending between a proximal end and a distal end. The elongate body has a central longitudinal axis. The biopsy needle also includes a tissue piercing tip at a distal end of the elongate body. The tissue piercing tip includes a first set of facets defined by three first faces and three first cutting edges. Each first cutting edge is formed by adjacent faces of the three first faces and each first cutting edge forms a first angle relative to the central longitudinal axis. The tissue piercing tip also includes a second set of facets positioned distal to the first set of facets. The second set of facets is defined by three second faces and three second cutting edges. Each second cutting edge is formed by adjacent faces of the three second faces and each second cutting edge forms a second angle relative to the central longitudinal axis. The second angle is smaller than the first angle. The three second cutting edges converge to form a distal end point of the biopsy needle. In an example, the biopsy needle is a nine-gage (9-G) needle. In another example, the biopsy needle is a seven-gauge (7-G) needle. In still another example, the first angle of the biopsy needle ranges between about 17 degrees and about 23 degrees relative to the central longitudinal axis, and the second angle ranges between about 9 degrees and about 15 degrees relative to the central longitudinal axis.
In another example, a diameter of the elongate body is greater than a diameter of the tissue piercing tip. In another example, the elongate body includes a sidewall defining a lumen. In yet another example, the elongate body includes a tissue receiving aperture in the sidewall, the tissue receiving aperture being positioned adjacent to the tissue piercing tip in the distal end of the elongate body. In still another example, a distance between the distal end point and the tissue receiving aperture defines a dead space, the dead space ranging from about 8 mm to about 11 mm. In one example, the first angle is about 20 degrees, the second angle is about 9 degrees, and the dead space is about 8.4 mm. In a second example, the first angle is about 20 degrees, the second angle is about 12 degrees, and the dead space is about 8.4 mm. In a third example, the first angle is about 20 degrees, the second angle is about 15 degrees, and the dead space is about 8.4 mm.
In a further example, the three first faces are all symmetrical to each other and the three first cutting edges are all symmetrical to each other. In an additional example, the three second faces are all symmetrical to each other and the three second cutting edges are all symmetrical to each other.
In another example, the tissue piercing tip comprises one or more reliefs. In still another example, the tissue piercing tip comprises three reliefs extending along the central longitudinal axis, each of the reliefs extending along a respective facet surface of the tissue piercing tip that is formed by a respective pair of first and second facets. In yet another example, each of the reliefs forms a concave surface extending along the facet surface between the cutting edges, the concave surface being defined by a radius of curvature and a lateral span. In yet another example, the radius of curvature is between about 1.9 mm to about 3.7 mm and the lateral span is between about 6.4 mm and about 8.3 mm.
In accordance with various additional exemplary embodiments of the present disclosure, a biopsy needle set for penetrating soft tissue includes an outer cannula extending between a proximal end and a distal end. The outer cannula defines a central lumen extending along a longitudinal axis. The outer cannula includes a tissue piercing tip at a distal end of the outer cannula and a tissue receiving aperture adjacent the tissue piercing tip. The tissue piercing tip includes a first set of facets defined by three first faces and three first cutting edges. Each first cutting edge is formed by adjacent faces of the three first faces and each first cutting edge forms a first angle relative to the longitudinal axis. The tissue piercing tip also includes a second set of facets positioned distal to the first set of facets. The second set of facets is defined by three second faces and three second cutting edges. Each second cutting edge is formed by adjacent faces of the three second faces and each second cutting edge forms a second angle relative to the longitudinal axis. The second angle is smaller than the first angle. The three second cutting edges converge to form a distal end point of the outer cannula. The biopsy needle set also includes an inner cannula disposed within the central lumen of the outer cannula. The inner cannula is configured to slide relative to the outer cannula to close the tissue receiving aperture. In an example, the first angle ranges between about 17 degrees and about 23 degrees relative to the longitudinal axis. In another example, the second angle ranges between about 9 degrees and about 15 degrees relative to the longitudinal axis.
In another example, the inner cannula includes an open distal end that is surrounded by an annular cutting blade. In still another example, the outer cannula includes a cutting board disposed in the central lumen in a position distal to the tissue receiving aperture, the cutting board being configured to seal the open distal end of the inner cannula when the inner cannula is in contact with the cutting board. In yet another example, the tissue piercing tip comprises one or more reliefs. In yet another example, the tissue piercing tip comprises three reliefs extending along the longitudinal axis, each of the reliefs extending along a respective facet surface of the tissue piercing tip that is formed by a respective pair of first and second facets. In yet another example, each of the reliefs forms a concave surface extending along the facet surface between the cutting edges, the concave surface being defined by a radius of curvature and a lateral span. The radius of curvature, for example, is between about 1.9 mm to about 3.7 mm and the lateral span is, for example, between about 6.4 mm and about 8.3 mm.
In an example, a biopsy device, comprises a body portion; and the biopsy needle set as described above attached to the body portion, the body portion including a drive assembly configured to drive movement of the outer cannula and the inner cannula of the biopsy needle set. In another example, the biopsy needle set is disposable. In still another example, the first angle ranges between about 17 degrees and about 23 degrees relative to the longitudinal axis, and the second angle ranges between about 9 degrees and about 15 degrees relative to the longitudinal axis.
In accordance with various further exemplary embodiments of the present disclosure, a multi-faceted soft tissue piercing element includes three distal planar cutting edges converging to form a sharp, distal point of the tissue piercing element. Each distal cutting edge forms a first angle with respect to a central longitudinal axis of the tissue piercing element. The tissue piercing element also includes three proximal planar cutting edges. Each proximal cutting edge extends proximally from a respective one of the three distal planar cutting edges. Each proximal cutting edge forms a second angle relative to the central longitudinal axis of the tissue piercing element. The second angle is larger than the first angle. In an example, the first angle ranges between about 9 degrees and about 15 degrees. In an additional example, the second angle ranges between about 17 degrees and about 23 degrees.
In another example, a maximum diameter of the multi-faceted tissue piercing element is less than or equal to a seven-gauge (7-G) needle. In still another example, the three proximal planar cutting edges extend distally from a body of a biopsy needle or trocar. In yet another example, the multi-faceted tissue piercing element further comprises three distal faces, each face positioned between two of the three distal planar cutting edges to form a distal pyramid of the tissue piercing element. In yet another example, the multi-faceted tissue piercing element further comprises three reliefs, each relief positioned between two of the three distal planar cutting edges.
Additional objects and advantages will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the present teachings. At least some of the objects and advantages of the present disclosure may be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the present disclosure and claims, including equivalents. It should be understood that the present disclosure and claims, in their broadest sense, could be practiced without having one or more features of these exemplary aspects and embodiments.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate some exemplary embodiments of the present disclosure and together with the description, serve to explain certain principles. These drawings depict only typical embodiments of the disclosed inventions and are not therefore to be considered limiting of its scope. In the drawings:
As described above, small gauge needles, having larger lumen diameters, have become the standard of care for breast biopsies. Smaller gauge needles, for example, may extract larger amounts of tissue and collect multiple samples sequentially without having to remove the needle from the patient. Such biopsy techniques may, therefore, improve the patient experience (i.e., by reducing the number of needle sticks required during the biopsy), while also reducing the risk of false-negative results or pathological underestimation (i.e., since more tissue may be collected during the biopsy procedure). It is, however, generally more difficult to penetrate a patient's skin with such needles, as the penetration force required to insert the needle also increases with the size (i.e., diameter) of the needle. Accordingly, to improve the functionality of a biopsy device and to improve the patient experience, it is desirable that biopsy needle designs and, in particular, small gauge biopsy needle designs, minimize the forces required to insert the needle into a patient's soft tissue (i.e., are designed to have relatively small insertion forces into soft tissue). As sharper needles generally have smaller insertion forces, exemplary embodiments of the present disclosure contemplate a needle tip design that results in a sharp needle, and which may be used with both small and large gauge needles.
Embodiments of the present disclosure contemplate, for example, a distal needle tip portion having a multi-faceted tissue piercing element with three distal planar cutting edges converging to form a sharp, distal point and three proximal planar cutting edges extending proximally from a respective one of the three distal planar cutting edges. Each of the distal cutting edges may form a first angle with respect to a central longitudinal axis of the tissue piercing element and each proximal cutting edge may form a second angle relative to the central longitudinal axis of the tissue piercing element, wherein the second angle is larger than the first angle. In this manner, biopsy needles having a distal tip portion formed in accordance with the present disclose have a multi-faceted tissue piercing (penetrating) tip, such that a cross-section of the biopsy needle is minimized at the distal tip. In accordance with various example embodiments, the present disclosure contemplates that the distal tip portion described herein may be used, for example, in biopsy needles, trocars, and needle sets, each having a distal tissue piercing (penetrating) tip including a first transitional facet and a second piercing facet, wherein an angle of a transitional facet (a first angle) is greater than an angle of a piercing facet (a second angle). Further, the distal tip may include a plurality (or set) of transitional facets and a plurality (or set) of piercing facets, wherein the plurality of transitional facets are positioned immediately adjacent to the plurality of piercing facets, with the piercing facets forming the distal end point of the distal tip of the biopsy needle and being configured to pierce (penetrate) the tissue of the patient's skin. The distal needle tip described herein can be used on biopsy needles of any size (i.e., any gauge) and any configuration (e.g., can be used as the penetrating tip on any stylet, inner cannula, outer cannula, or trocar) that is used to penetrate or pierce soft tissue including, but not limited to, breast tissue.
In one example embodiment, the contemplated multi-faceted needle tips may be used in conjunction with needle sets including an elongate outer cannula or trocar that functions as a needle, and an inner cannula that is slidably disposed within the outer cannula. As described above, the elongate outer cannula has, at the distal end, a tissue piercing tip and a tissue receiving aperture, and the inner cannula has an open distal end surrounded by an annular cutting blade. In this manner, a physician may collect a tissue sample by: (1) piercing a patient's skin with the tissue piercing tip of the outer cannula, (2) positioning the receiving aperture of the outer cannula such that tissue for collection prolapses into the aperture, and (3) sliding the inner cannula within the outer cannula to close the tissue receiving aperture, thereby cutting the prolapsing tissue with the annular cutting blade of the inner cannula. Various known biopsy devices, such as those described in U.S. Pat. No. 9,456,808, entitled “Biopsy Device with Automatic Biopsy Parameter Adjustment” and issued Oct. 4, 2016; U.S. Pat. No. 10,022,110, entitled “Biopsy Device” and issued on Jul. 17, 2018; and U.S. Pat. No. 8,808,200, entitled “Surgical Device and Method of Using Same” and issued on Aug. 19, 2014, the entire contents each of which are incorporated by reference herein, may utilize such needle sets.
As shown in
Other aspects of the exemplary biopsy devices are described in U.S. Pat. No. 9,585,639, entitled “Biopsy Device Arming Mechanism” and dated Mar. 7, 2017; U.S. Pat. Nos. 10,022,110; 9,456,808; 8,808,200; and 9,844,363, entitled “Biopsy Device with Aspiration Valve” and dated Dec. 19, 2017. The above-referenced patent applications are assigned to the assignee of the instant application, and the full contents thereof are hereby incorporated by reference as though fully set forth herein.
Those of ordinary skill in the art will understand that the biopsy device 10, including body portion 12 and needle set 14 illustrated in
In accordance with standard practice, as will be understood by those of ordinary skill in the art, embodiments of the present disclosure contemplate that the needle tips (e.g., trocars, stylets, cannulas) of the present disclosure may be used in conjunction with various needles having various sizes and shapes (i.e., gauges and cross-sectional shapes), including, for example, needles having dimensions (e.g., widths and heights) corresponding to a 7-gauge needle through a 12-gauge needle. With reference to the embodiment of
As best illustrated perhaps in the enlarged view of
As further illustrated in
Those of ordinary skill in the art will understand that the outer cannula 16 illustrated in
As discussed above, it will also be understood by those of ordinary skill in the art that the needle tips contemplated by the present disclosure may be used in conjunction with needles having various gauges, including but not limited to the 7-gauge needles discussed above, and, for example, also contemplate using such trocars with 8 through 12-gauge needles. In one example embodiment of the present disclosure, the outer cannula is a 7-gauge to an 8-gauge needle, with piercing faucets having a width W (see
Those of ordinary skill in the art will also understand that the tissue piercing tip of the outer cannula or trocar may be made from various materials, including, for example, surgical stainless steel (e.g., 17-4 stainless steel). And, that the transitional and piercing facets may be formed on the tissue piercing tip using various known manufacturing methods and/or techniques, including, for example, by being ground into the tissue piercing tip via, for example, a grinding wheel. In various embodiments, the faces of the facets may then be electro-polished to increase the sharpness of the cutting edges.
As discussed above, although using smaller gauge needles (needles with larger widths/diameters) offer certain benefits, it is generally more difficult to penetrate a patient's skin with such needles, as the penetration force required to insert the needle also increases with the size (i.e., diameter) of the needle. Accordingly, it is desirable that the first and second angles θ1 and 02 of the tissue piercing tip be relatively small to minimize the forces required to insert the needle into a patient's tissue. Angle selection, however, also involves other considerations and factors, including, for example, a dead space D that is created by the tissue piercing tip and the fragility of the tissue piercing tip. Although not wanting to be bound by any theories, the inventors found that: (1) the range discussed above for the first angle θ1 allows the first set of transitional facets to penetrate tissue, while not excessively increasing the dead space D of the outer cannula. In other words, the disclosed range creates a transitional portion of the distal tip of the outer cannula that results in an acceptable dead space D (as will be understood by those of ordinary skill in the art and explained further below), without requiring a user to exert excessive penetration forces to insert the outer cannula, and (2) the above discussed range for the second angle θ2 optimizes the second set of piercing facets ability to penetrate tissue, while not making the distal end point of the outer cannula too fragile.
As used herein, the term “dead space” refers to a distance D between the distal end point 19, 119, 219 of the outer cannula 16, 116, 216 and a distal edge 21, 121, 221 of a tissue receiving aperture 20, 120, 220 (see
The example outer cannulas of
As discussed above, those of ordinary skill in the art will understand that the embodiments illustrated and described with relation to
As shown best in the cross-sectional view of
Illustrative examples of the needle tips and sets described herein are provided below. An embodiment of the needle tip and needle set described herein may include any one or more, and any combination of, the clauses described below:
This disclosure described some examples of the present technology with reference to the accompanying drawings, in which some of the possible examples were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the examples set forth herein. Rather, these examples were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible examples to those skill in the art.
All numeric values are herein assumed to be modified by the term “about,” whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the terms “about” may include numbers that are rounded to the nearest significant figure.
The recitation of numerical ranges by endpoints includes all numbers within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
This description and the accompanying drawings that illustrate exemplary embodiments should not be taken as limiting. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the scope of this description and the claims, including equivalents. In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. Furthermore, elements and their associated features that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment, the element may nevertheless be included in the second embodiment.
It is noted that, as used herein, the singular forms “a,” “an,” and “the,” and any singular use of any word, include plural referents unless expressly and unequivocally limited to one referent. As used herein, the term “include” and its grammatical variants are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items.
Further, this description's terminology is not intended to limit the disclosure. For example, spatially relative terms-such as “beneath,” “below,” “lower,” “above,” “upper,” “forward,” “front,” “behind,” and the like—may be used to describe one element's or feature's relationship to another element or feature as illustrated in the orientation of the figures. These spatially relative terms are intended to encompass different positions and orientations of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is inverted, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. A device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
Further modifications and alternative embodiments will be apparent to those of ordinary skill in the art in view of the disclosure herein. For example, the systems may include additional components that were omitted from the diagrams and description for clarity of operation. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the systems and methods of the present disclosure. It is to be understood that the various embodiments shown and described herein are to be taken as exemplary. Elements and materials, and arrangements of those elements and materials, may be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the present teachings may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of the description herein. Changes may be made in the elements described herein without departing from the scope of the present disclosure.
It is to be understood that the particular examples and embodiments set forth herein are non-limiting, and modifications to structure, dimensions, materials, and methodologies may be made without departing from the scope of the present disclosure. Other embodiments in accordance with the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with being entitled to their full breadth of scope, including equivalents.
This application claims priority to U.S. Provisional Application No. 63/284,820, filed Dec. 1, 2021, the entire contents of which is incorporated by reference herein.
Filing Document | Filing Date | Country | Kind |
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PCT/US2022/080633 | 11/30/2022 | WO |
Number | Date | Country | |
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63284820 | Dec 2021 | US |