U.S. patent number 3,590,808 [Application Number 04/757,366] was granted by the patent office on 1971-07-06 for biopsy tool.
This patent grant is currently assigned to United States Catheter & Instrument Corporation. Invention is credited to Wolf F. Muller.
United States Patent |
3,590,808 |
Muller |
July 6, 1971 |
BIOPSY TOOL
Abstract
A biopsy tool that includes a rigid tip affixed to the distal
end of a flexible intestinal intubation tube and is provided with a
body portion having a longitudinal duct for the passage of an
exchange guide and a radial cavity connected through the lumen of
the tube to a vacuum source to draw a tissue sample thereinto. A
pneumatically operable knife is longitudinally reciprocable across
the open end of the cavity to sever the tissue sample contained
therein.
Inventors: |
Muller; Wolf F. (Southampton,
NY) |
Assignee: |
United States Catheter &
Instrument Corporation (Glens Falls, NY)
|
Family
ID: |
25047548 |
Appl.
No.: |
04/757,366 |
Filed: |
September 4, 1968 |
Current U.S.
Class: |
600/565;
606/171 |
Current CPC
Class: |
A61B
10/04 (20130101); A61B 2017/306 (20130101); A61B
17/320783 (20130101); A61B 2017/00535 (20130101) |
Current International
Class: |
A61B
10/00 (20060101); A61B 17/30 (20060101); A61B
17/22 (20060101); A61B 17/00 (20060101); A61b
010/00 () |
Field of
Search: |
;128/2,2B,349,356,305,309,303--314 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Howell; Kyle L.
Claims
I claim:
1. A biopsy tool comprising a generally cylindrical body having a
smoothly rounded distal end, a proximal end and a longitudinal
axis, a plane surface extending proximally from the distal end of
said body, a sample-receiving cavity extending into said body from
said plane surface, a flat-bladed knife reciprocable across said
cavity along said surface, knife actuating means adjacent to said
surface, a first bore extending axially from end-to-end of the body
and open at both ends, and a second bore extending axially from the
proximal end of the body to a point adjacent said cavity and being
in communication with said cavity.
2. A biopsy tool according to claim 1 in which said surface lies
parallel to said axis and said knife is reciprocable axially.
3. A biopsy tool according to claim 1 in which the knife actuating
means includes a piston fixed to the knife, a cylinder adapted to
receive said piston and a fitting for connection of the cylinder to
a source of actuating fluid.
4. A biopsy tool according to claim 3 in which the cylindrical body
is longitudinally recessed adjacent its proximal end, the cylinder
is formed in the distal end of a separate cylinder block, said
block is fitted in said longitudinal recess, and which includes
releasable means for holding said block in said recess.
5. A biopsy tool according to claim 4 in which said releasable
means is a rotatable collar.
6. A biopsy tool according to claim 2 in which the knife has
parallel sides and a double bevel spear point cutting edge, the
distance between said sides being greater than the corresponding
dimension of the sample-receiving cavity.
7. A biopsy tool according to claim 6 in which the plane surface is
bounded by a U-shaped rim around the distal and lateral edges of
said surface, the lateral portions of said rim being parallel and
spaced to guide freely the parallel sides of the knife.
8. A biopsy tool according to claim 4 in which the cylinder block
is provided with a distally extending portion slotted in a plane
parallel to the axis of the cylinder, the knife being slidable in
said slot.
9. A biopsy tool according to claim 1 which includes a fitting at
the proximal end of said second bore for connection thereof to a
source of vacuum.
Description
THE INVENTION
This invention relates generally to new and useful improvements in
biopsy tools and particularly seeks to provide a novel biopsy tool
that is affixed to and forms the distal tip of a flexible
intestinal intubation tube, particularly of the type of intubation
tube that is adapted to be advanced along a previously inserted
exchange guide.
Heretofore it has been a long and difficult procedure to insert
intubation tubes into the upper gastrointestinal tract through a
patient's nostril because it was necessary to slowly advance (over
a period of several hours) the tube under fluoroscopic control
while manipulating the patient through many difficult postures or
positions so that the distal end of the tube would follow the
desired path of travel into the stomach and the several sections of
the duodenum.
More recently techniques have been developed through which a soft
woven catheter containing a proximally controllable distal tip
spring guide may be fully inserted into a patient in from 10--15
minutes under fluoroscopic control with a minimum of manipulation
of the patient. After this initial insertion has been completed the
spring guide is withdrawn from its associated catheter and is
replaced by an exchange guide normally having a length somewhat
greater than twice the inserted length of the catheter so that its
exposed proximal end portion is sufficiently long to accept the
full length of the intubation tube to be inserted. Then the
catheter is withdrawn over the exchange guide, leaving the exchange
guide in place ready to receive and lead the intubation tube into
its fully inserted position.
A particularly suitable type of controllable tip spring guide for
these techniques is disclosed and claimed in my copending
application Ser. No. 563,927, filed June 29, 1966, now U.S. Pat.
No. 3,452,742 and a particularly suitable exchange guide therefor
is disclosed and claimed in my copending application Ser. No.
757,326, filed Sept. 4, 1968.
Although the above-described techniques and equipment are effective
for the simple and rapid insertion of intubation tubes, the problem
still remains of how to quickly and safely obtain biopsy samples,
especially from locations in the upper gastrointestinal tract.
A past approach to solving this problem has been through the use of
an intubation tube having its distal end closed by a rigid hollow
tip with a radial aperture extending through the wall of the tip
and of the tube. A wire-operated cylindrical knife is reciprocable
within the tip to sever a tissue sample that has been drawn through
the wall aperture by vacuum applied from within the tube.
Even though such knife-containing tubes are believed to be the best
currently available for obtaining biopsy samples, several
objections have been made thereto; principally that they can be
inserted only through the above-mentioned hours long technique and
cannot be used with the short time exchange guide technique, and
that there is no way to control the total force of the vacuum so
that there is a substantial risk of rupturing the tissue wall by
drawing too much tissue through the wall aperture of the tube.
Furthermore, there is no positive control over operation of the
cylinder knife and it is difficult to determine whether or not a
tissue sample has been fully and cleanly severed.
However, a biopsy tool constructed in accordance with this
invention overcomes the above-discussed problems and is fully
compatible with the exchange guide technique of insertion.
Therefore, an object of this invention is to provide a novel tool
for taking biopsy samples, especially those from the upper
gastrointestinal tract.
Another object of this invention is to provide a tool of the
character stated that may be quickly and simply inserted to its
final position over a prepositioned exchange guide.
Another object of this invention is to provide a tool of the
character stated that includes a rigid tip affixed to the distal
end of a flexible intubation tube and is provided with a body
portion having a longitudinal duct for the passage of an exchange
guide.
Another object of this invention is to provide a tool of the
character stated in which the body portion thereof is provided with
a radial cavity having a flat outer end and having its inner end
connected through the lumen of the tube to a source of vacuum
whereby a predetermined and controllable quantity of tissue sample
is drawn into the cavity.
A further object of this invention is to provide a tool of the
character stated that includes a pneumatically operated knife
assembly removably attached to the tip body to clearly and
positively sever the tissue sample contained within the radial
cavity.
A further object of this invention is to provide a tool of the
character stated in which a friction-reducing tube is positioned
within the lumen of the tube and extends from the proximal end of
the exchange guide-receiving duct in the tip body to the proximal
end of the tube to facilitate advance of the tube over the
guide.
A further object of this invention is to provide a tool of the
character stated in which vacuum is applied to the radial cavity
through the lumen of the tube and air under positive or negative
pressure is supplied to the knife assembly for reciprocation of the
knife through a separate tube positioned within the lumen of the
tube and extending from the proximal end of the knife assembly to
the proximal end of the tube.
A further object of this invention is to provide a tool of the
character stated in which the reciprocable knife is a flat
spear-pointed blade arranged to have its point pass across a
diameter of the body cavity whereby to first pierce the tissue
sample and then clearly sever same as the knife is advanced.
With these and other objects in view, the nature of which will
become apparent, the invention will be more fully understood by
reference to the drawings, the accompanying detailed description
and the appended claims.
IN THE DRAWINGS:
FIG. 1 is a side elevation of an assembled unit constructed in
accordance with this invention;
FIG. 2 is a top plan view of the body of the biopsy tool;
FIG. 3 is a transverse section taken along line 3-3 of FIG. 2;
FIG. 4 is a side elevation of the body thereof;
FIG. 5 is a left end elevation of the body thereof;
FIG. 6 is a right end elevation of the body thereof;
FIG. 7 is a top plan view of the operating cylinder;
FIG. 8 is a side elevation of the operating cylinder;
FIG. 9 is a left end elevation of the cylinder;
FIG. 10 is a top plan view of the piston and knife blade
assembly;
FIG. 11 is a side elevation of the piston and knife blade assembly;
and
FIG. 12 is an isometric view of the cylinder retaining split
sleeve.
Referring to the drawings in detail, the invention as illustrated
is embodied in a biopsy tool assembly generally designated 5 and
includes a body 6 (see FIGS. 2--6) machined from solid rod stock
and having a rounded distal end 7 and a flanged proximal end 8
adapted to be secured within the distal end of a long flexible
plastic catheter or intestinal intubation tube indicated at 9 by
dotted lines on FIG. 1.
A transverse channel 10 of rectangular cross section is machined
across the top of the body 6 intermediate the ends thereof and has
its flat bottom 11 forming a plane surface passing through the
centerline of the body. The channel 10 is adapted to receive the
knife guiding portion of an operating cylinder as will be
hereinafter more fully explained. A longitudinal channel 12 of
rectangular cross section is machined along the top of the body 6
at the proximal end thereof and has its flat bottom 13 lying in a
plane slightly above that of the channel bottom 11.
The top of the distal end of the body 6 is machined to a flat
surface 14 which in turn is machined to define an open-ended
U-shaped pocket 15 having undercut lateral walls 16 to receive and
guide the lateral edges of a knife blade as will be hereinafter
more fully described.
A cylindrical cavity 17 for receiving and retaining a biopsy sample
extends downwardly from the surface 14 and terminates at a plane
slightly below that containing the centerline of the body 6. A
short radial duct 18, located adjacent the wall of the cavity 17,
has its upper end in open communication with the cavity and its
lower end in open communication with a longitudinal duct 19
extending therefrom to the proximal end of the body 6. A fitting 20
is affixed within the proximal end of the duct 19 for connection
through tubing (not shown) to a source of vacuum so that a biopsy
sample may be drawn into the cavity 17 when the tool has become
properly positioned within a patient.
A duct 21 is disposed in spaced parallel relation to the duct 19
and extends the full length of the body 6 to permit passage of an
exchange guide therethrough. The proximal end of the duct 21 is
provided with a fitting 22 for connection with the distal end of a
friction-reducing tubular sheath (not shown) so that the tool 5 and
its associated intubation tube 9 may be more readily advanced over
the exchange guide.
The body 6 also carries a pneumatically operable knife to sever the
biopsy sample that has been drawn into the cavity 17. To this end
(see FIGS. 7, 8 and 9) a cylinder having a generally
hemicylindrical distal portion 23 and a tubular proximal extension
24, is fitted in the transverse and longitudinal channels 10 and 12
and is provided with a horizontal knife receiving and guiding slot
25, the bottom of which is coplanar with the bottom of the U-shaped
pocket 15. The upper portion of the distal end portion 23 is
bevelled as at 26 to reduce resistence when the tool is being
inserted into a patient.
A cylindrical piston 27 is reciprocable within the bore of the
cylinder 24 and is provided at its distal end with a flat knife
blade 28 having a double bevel spear point cutting edge 29.
The cylinder and knife assembly is removably retained within the
body 6 by a sleeve 30 (see FIG. 1 and 12) having a longitudinal
split 31 of a width somewhat greater than the outside diameter of
the tubular extension 24 so that when the sleeve is rotated until
the split 31 is aligned therewith, the entire cylinder and knife
assembly may be readily removed for cleaning and for replacement of
the knife whenever it becomes too dull for further use. The
proximal end 8 of the body 6 is provided with a round-headed stud
32 that is received within the split 31 when the sleeve 30 has been
rotated to its cylinder-securing position. Springiness of the
sleeve 30 permits the edge of the split 31 to ride up over the stud
32 when the sleeve is rotated.
A fitting 33 is affixed to the proximal end of the tubular
extension 24 for connection through suitable tubing to an air
syringe (not shown) for actuation of the piston 27 and its knife
blade 28. Advancement of the plunger of the syringe will compress
air to effect advancement of the knife to sever the tissue sample
that has been drawn into the cavity 17, and withdrawal of the
syringe plunger will create a vacuum to retract the knife. After
the knife has thus been reciprocated one or two times, it is again
advanced to cover the cavity 17 and the biopsy sample contained
therein and is kept in this advanced position until the tool has
been withdrawn from the patient, thus assuring retention of the
sample and preventing it from being contaminated during withdrawal
of the tool.
It will be appreciated from the foregoing description that the
biopsy tool of this invention must be quite small, otherwise it
would not be readily insertable through the designated internal
passages. Typically, the body 6 would have an outside diameter in a
range of 0.10 inch to 0.65 inch, preferably about 0.25 inch and a
length in a range of 0.30 inch to 2.0 inch, preferably about 0.75
inch.
Thus it will be seen that this invention provides a novel biopsy
tool in which a tissue sample is vacuum displaced within a cavity
of fixed volume and severed by a reciprocable knife that can be
actuated to close the sample-containing cavity as the tool is
withdrawn.
It is, of course, to be understood that variations in arrangement
and proportions of parts may be made within the scope of the
appended claims.
* * * * *