U.S. patent number 3,583,390 [Application Number 04/751,948] was granted by the patent office on 1971-06-08 for biopsy device.
Invention is credited to Mario Enrique Jascalevich.
United States Patent |
3,583,390 |
Jascalevich |
June 8, 1971 |
BIOPSY DEVICE
Abstract
A biopsy device, primarily for cervical biopsy, comprising a
generally arrowhead-shaped tool substantially V-shaped in cross
section and having outer longitudinal knife edges intersecting at
the sharp tip of the device. In use, the device is inserted into
the tissue from which the specimen is to be taken. To separate the
specimen from the adjacent tissue, a scalpel is run forwardly along
longitudinal converging guide means-- a groove or rib-- provided on
each inside face of the device just below each knife edge. The two
converging guide grooves or ribs terminate at a central hole, which
functions as a stop to limit forward movement of the scalpel. The
separated specimen is thus held in the receptacle provided by the
V-cross section tool, in which it is carried for removal from the
body.
Inventors: |
Jascalevich; Mario Enrique
(West New York, NJ) |
Family
ID: |
25024210 |
Appl.
No.: |
04/751,948 |
Filed: |
August 12, 1968 |
Current U.S.
Class: |
600/564; 30/287;
606/170 |
Current CPC
Class: |
A61B
10/0291 (20130101) |
Current International
Class: |
A61B
10/00 (20060101); A61b 010/00 (); A61b
017/32 () |
Field of
Search: |
;128/2,2B,305,305.5,311,303.14,314,329 ;30/25,286,287,294,279,289
;144/136.3 ;145/25,122,24 ;83/12 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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|
|
|
|
4,160 |
|
1901 |
|
GB |
|
158,983 |
|
Jul 1962 |
|
SU |
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Other References
Hallac, I., SURGERY, April, 1962, Vol. 51, No. 4, pp. 515--517,
(copy in Gr. 335, 128/2B).
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Howell; Kyle L.
Claims
I claim:
1. In a biopsy instrument, a generally pointed device having
converging cutting knife edges, means defining a receptacle between
said knife edges comprising two substantially flat planar portions
disposed at an angle to each other intersecting along a
longitudinally extending line to provide a tapered, substantially
V-shape in transverse cross section, said converging cutting knife
edges being respectively positioned at the outermost longitudinal
edges of the planar portions, and means disposed between the knife
edges for guiding a cutting tool.
2. The combination according to claim 1 wherein said knife edges
are substantially linear and meet at the point of said device to
from a sharp tip.
3. The combination according to claim 2 wherein the knife edges and
said longitudinally extending line meet at said tip.
4. The combination according to claim 3 wherein said angle is
substantially a right angle.
5. The combination according to claim 1 including means for
stopping movement of a cutting tool.
6. The combination according to claim 5 wherein said guide means
comprises elongated groove means provided on said planar
portions.
7. The combination according to claim 6 wherein said groove means
comprises converging grooves, one disposed adjacent each knife
edge.
8. The combination according to claim 7 wherein said stopping means
comprises means defining a hole in said device, said converging
grooves terminating at said hole.
9. The combination according to claim 6 wherein said stopping means
comprises means defining a hole in said device.
10. The combination according to claim 5 wherein said guide means
comprises elongated rib means provided on said planar portions.
11. The combination according to claim 10 wherein said rib means
comprises converging ribs, one disposed adjacent each knife
edge.
12. The combination according to claim 11 wherein said stopping
means comprises means defining a hole in said device, said
converging ribs terminating at said hole.
13. The combination according to claim 10 wherein said stopping
means comprises means defining a hole in said device.
14. The combination according to claim 5 wherein said stopping
means comprises means defining a hole in said device.
Description
BACKGROUND OF THE INVENTION
This invention relates to taking biopsy specimens, particularly of
the uterine cervical area. In testing for carcinoma of the uterus,
the critical area is the entrance to the cervix--the squamous
columnar junction. It is here that 90 percent of uterine cancer is
present.
The exposed tissue at this area, called the "epithelium," is the
critical layer of tissue which it is desired to test for cancer,
together with some of the underlying tissue called the "stroma"
which is examined for depth of cancer spread, if any.
Presently used techniques have various disadvantages. For example,
in one known technique, a punch is employed. The punch removes a
complete circumferential ring of tissue from the cervical canal,
and cuts in from the canal itself through the epithelium. Taking a
complete ring of tissue is undesirable. One of the serious after
effects can be closure of the cervical canal as a result of scar
tissue formation. Cutting through the epithelium lined canal is
undesirable as the biopsy instrument preferably should not touch
the surface of the tissue to be examined.
Another technique involves using an ordinary surgeon's knife or
scalpel to cut off a segment of the cervix at the canal entrance.
However, in this technique, the surgeon is unable to control the
depth of the cut, and it is extremely difficult to retrieve the cut
sample.
Other techniques have one or more of the various foregoing
disadvantages.
SUMMARY OF THE INVENTION
The biopsy device of the present invention comprises a generally
pointed instrument having converging side knife edges. The device
is shaped to provide a recess or receptacle for defining and
holding the biopsy sample. In the preferred form of the invention,
the recess or receptacle is provided by virtue of the instrument
being substantially V-shaped in transverse cross section.
In use, the device is inserted into the tissue area from which a
biopsy specimen is to be taken. For example, for a cervical biopsy,
it is inserted into the cervical wall just below the epithelial
surface to be sampled. Then, to cut the specimen free, a scalpel is
run forwardly along a guide groove or rib provided on each of the
two opposed inside converging faces of the instrument just below
and parallel to the adjacent knife edges. The forward cutting
movement of the scalpel is automatically stopped by a hole at which
the two converging guide grooves or ribs meet.
The specimen has now been cut free, and is held in the recess of
the instrument by which it is carried outside the body for
examination.
It is therefore the primary object of the present invention to
provide a novel biopsy device.
It is a further object to provide a biopsy device which will not
touch the surface of the tissue to be sampled.
It is a further object to provide a biopsy device which will avoid
taking a completely annular specimen, but will rather take multiple
selective transverse specimens.
It is a further object to provide a biopsy device the use of which
will promote rapid healing of the area from which the specimen is
taken.
It is a further object to provide a biopsy device which provides
accurate control of the specimen taken even though the surgeon
cannot easily see the biopsy area.
The above and other objects, advantages, and features of the
invention will become apparent to those skilled in the art from the
following detailed description of preferred embodiments of the
invention when read in conjunction with the accompanying
drawing.
DESCRIPTION OF THE FIGURES
FIG. 1 is a top plan view of the novel biopsy device of the
invention.
FIG. 2 is a elevational view looking in a longitudinal direction
from the rear toward the front of the device.
FIG. 3 is a longitudinal sectional view taken on line 3-3 of FIG.
1.
FIG. 4 is a partial transverse sectional view taken on line 4-4 of
FIG. 3, showing one of the grooves for guiding a scalpel to cut off
one side of the biopsy sample.
FIG. 5 is a view similar to FIG. 4 of a modified form of the
invention in which ribs are employed instead of grooves.
FIG. 6 is a side elevational view of the uterine-cervical area of
the body, showing the technique of using the biopsy device of the
invention.
FIG. 7 is an enlarged front view of FIG. 6, further showing a
scalpel cutting through one side of the biopsy sample.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring to the drawing, the reference numeral 2 designates a
handle to which the biopsy device 4 of the present invention is
attached. Handle 2 may be of any suitable size and shape. The
device 4 may be permanently or removably attached to the
handle.
The biopsy device 4 itself, as best seen in FIGS. 1 and 2,
comprises two thin-walled flat or planar sections 6 and 8 which are
disposed at an angle to each other and intersect along a central
longitudinal line 10. Preferably the dihedral angle between
sections 6 and 8 is approximately 90 degrees, as shown in FIG.
2.
The respective outer side edges 12 and 14 of sections 6 and 8 are
each sharpened to a fine cutting knife edge. Knife edges 12 and 14
converge forwardly and downwardly to meet at and form the sharp tip
16 of the device.
It will be seen from the foregoing description that the biopsy
device 4 is generally like an arrowhead in overall shape. Further,
the angularly disposed sections 6 and 8 making up the body of the
device provide it in the form of a recess or receptacle which is
generally wedge-shaped. As will be described shortly, this
receptacle aspect of the invention greatly simplifies retention of
the cut biopsy sample and its removal from the body.
Guide means are provided to control movement of a scalpel along
predetermined paths to sever the biopsy specimen from the adjacent
tissue. Such guide means comprises guide grooves 18 and 20 provided
on the respective opposed inside faces of sections 6 and 8. Grooves
18 and 20 are parallel with and closely adjacent to the related
knife edges 12 and 14 respectively. The converging grooves
terminate at a small hole 22 formed on centerline 10 adjacent tip
16. Hole 22 automatically stops the scalpel being moved forwardly
along groove 18 or 20.
As shown in FIG. 5, raised ribs 24 may be employed as the scalpel
guide means instead of the depressed grooves 18, 20. Here, the
scalpel is held pressed downwardly and against the rib so as to be
guided thereby in its forward movement.
The device 2 is made of any suitable material, e.g., stainless
steel. It can be fabricated by any suitable techniques. For
example, it can be formed as an integral device by first stamping a
blank of the appropriate shape, which is then bent and otherwise
worked, and sharpened, to produce the final device.
A typical use of the biopsy device of the invention for taking a
cervical epithelial specimen will now be described. Referring to
FIGS. 6 and 7, numeral 26 designates the cervix and 28 the cervical
canal. The device is held by handle 4 and inserted tip first into
the cervical area just underlying the section of epithelial
cervical canal tissue to be sampled. The device is inserted to the
desired depth, the penetration being facilitated by the sharp tip
16 and the sharp knife edges 12, 14. Then, the surgeon places the
cutting edge of a scalpel 30 (FIG. 7) on the exposed
(nonpenetrating) portion of groove 18 or 20 and runs the scalpel
forwardly along the groove until the scalpel is automatically
stopped by reaching hole 22. This stopping is further signalled to
the surgeon by virtue of the different sensation that he feels
through his fingers when the scalpel hits the hole. This step has
cleanly severed one side of the biopsy specimen from the adjacent
tissue without jagged edges. The surgeon then repeats the process
using the other groove, whereby the specimen has now been
completely separated from the adjoining tissue, and is held in the
receptacle provided by the V cross section of the biopsy
device.
It should be noted that the cutting path, and its length and depth,
of the scalpel 30 to sever the sides of the specimen are accurately
guided and controlled by the guide grooves 18, 20 (or ribs 24), and
the stop hole 22, even though the surgeon is cutting essentially
blind into the tissue.
The device 2 carrying the specimen within it is now removed from
the body and the specimen then removed for examination.
Usually, four, but possibly more, specimens will be taken at spaced
locations around the cervical canal. This provides a good sampling
while leaving bridges of tissue intact to facilitate healing
without the danger of stricture or closing of the canal by scar
tissue formation as would be likely if a completely annular sample
or set of tissue samples were taken.
The fact that the tissue specimen taken by the present device is
wedge-shaped is advantageous for several reasons. For one thing,
this shape enables the surgeon to determine by mere visual
inspection of the specimen its orientation, i.e., which is the more
significant epithelial face and which is the less significant,
underlying stroma. The large broadest surface of the specimen will
of course be the exposed epithelium of the cervical canal, while
the narrow tapering portion will be the stroma. Further, the
wedge-shaped inwardly tapering crevice left by the removal of the
specimen helps facilitate healing.
While intended primarily for cervical biopsy, the principles of the
present invention can also advantageously be used for biopsy of
other portions of the body, e.g., the surface of the ovaries, the
uterus, liver, kidney, lung, etc.
While there have been shown and described two preferred embodiments
of the invention, it will be understood and apparent to those
skilled in the art that numerous variations and modifications, in
form and application, can be made without departing from the spirit
and scope of the invention and its features. Accordingly, it is
intended that the foregoing disclosure be exemplary only, and not
in any way limitative of the following claims.
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