U.S. patent number 3,598,108 [Application Number 04/803,193] was granted by the patent office on 1971-08-10 for biopsy technique and biopsy device.
Invention is credited to Khosrow Jamshidi, William R. Swaim, Harold E. Windschitl.
United States Patent |
3,598,108 |
Jamshidi , et al. |
August 10, 1971 |
BIOPSY TECHNIQUE AND BIOPSY DEVICE
Abstract
A biopsy needle device and method of using the same includes an
elongate needle having a tapered distal end portion which
terminates in a distal cutting edge. An elongate sleeve member is
inserted into the needle and corresponds in shape and length to the
needle. An elongate stylet is positioned interiorly of the
telescopically disposed needle and sleeve member and projects from
the needle to close the distal end thereof so that the needle
assembly may penetrate exterior tissue when a specimen is to be
taken from a deeply located organ or tissue of a patient. The
stylet is first removed and the biopsy specimen is collected in the
sleeve member which is then removed from the needle while the
needle is allowed to remain in place so that a heat transfer means
such as a microcauter or a cryoprobe may be introduced into the
needle. The distal end of the microcauter or cryoprobe projects
into the biopsy track, and the needle and heat transfer means are
removed as a unit whereby cauterization or cooling of the biopsy
track occurs and intro-organ bleeding is prevented. The expanding
or tapered distal end portions of the sleeve and biopsy needle
permit the specimen to be collected in the sleeve with little if
any damage to the specimen.
Inventors: |
Jamshidi; Khosrow (Minneapolis,
MN), Swaim; William R. (Fort Snelling, Minneapolis, MN),
Windschitl; Harold E. (West St. Paul, MN) |
Family
ID: |
25185844 |
Appl.
No.: |
04/803,193 |
Filed: |
February 28, 1969 |
Current U.S.
Class: |
600/567; 219/229;
219/230; 606/21; 606/23; 606/29 |
Current CPC
Class: |
A61B
10/0233 (20130101); A61B 18/082 (20130101); A61B
18/00 (20130101); A61B 2017/12004 (20130101); A61B
2018/00041 (20130101); A61B 18/02 (20130101) |
Current International
Class: |
A61B
18/08 (20060101); A61B 18/04 (20060101); A61B
10/00 (20060101); A61B 17/12 (20060101); A61B
18/00 (20060101); A61B 18/02 (20060101); A61b
010/00 () |
Field of
Search: |
;128/2,2B,303.1,303.13,303.17,303.14,347,310 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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|
|
|
|
|
135,689 |
|
May 1952 |
|
SW |
|
142,879 |
|
Nov 1953 |
|
SW |
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Howell; Kyle L.
Claims
We claim:
1. A method of obtaining a biopsy specimen from an organ such as a
spleen, thyroid or the like, said method comprising
penetrating and progressively advancing the distal end portion of
an elongate hollow biopsy instrument assembly into a patient, but
with the proximal end of the instrument assembly located exteriorly
of the patient, the instrument assembly including a biopsy needle
having a tissue-collecting medium located interiorly thereof, and
an obstructing medium positioned interiorly of the
tissue-collecting medium and obstructing the open end of the biopsy
needle assembly,
continuing the advancement of the distal end portion of the needle
assembly until the distal end portion of the assembly is disposed
in close proximal relation to the organ from which the tissue is to
be removed,
removing the obstructing medium from the assembly, and thereafter
advancing the needle and tissue-collecting medium as a unit into
the tissue whereby a tissue specimen is cut and collected in the
tissue-collecting medium,
retracting the tissue-collecting medium from the needle through the
proximal end thereof,
inserting a heat transfer medium into the needle and exteriorly of
the distal end thereof, the heat transfer medium having a
temperature substantially higher or substantially lower than the
body temperature of the patient to perform cauterization of the
tissue, retracting the needle and heat transfer medium from the
biopsy track whereby the heat transfer medium serves to stop
bleeding of the tissue, and continuing retractive movement of the
needle and its heat transfer medium from the patient.
2. The method as defined in claim 1 wherein the tissue specimen
collected in the tissue-collecting medium is progressively urged
into an expanding collection zone during removal of the specimen
from the patient.
3. The method as defined in claim 1 wherein said heat transfer
medium heats the tissue defining the biopsy track to a differential
temperature level sufficient to cauterize the same.
4. The method as defined in claim 1 wherein said heat transfer
medium cools the tissue defining the biopsy track to a differential
temperature level sufficient to completely stop any bleeding of the
tissue.
5. A biopsy needle device comprising,
an elongate hollow biopsy needle having open distal and proximal
ends, said distal end defining a cutting edge, said needle being of
uniform cylindrical configuration throughout the major portion of
its length, and having a distal end portion tapered generally
uniformly toward the tip of the distal end,
an elongate hollow sleeve member positioned within said needle and
corresponding in length and shape to said needle, said sleeve
member having a bore formed therein and being of uniformly
cylindrical configuration throughout the major portion of its
length and defining a biopsy tissue receiving and retaining cavity
adjacent the distal end thereof, and having a distal end portion
with inner and outer diameters tapered generally uniformly toward
the tip of the distal end and defining an opening to said bore,
an elongate stylet positioned within said sleeve and having a
length dimension slightly greater than said sleeve and an outer
diameter substantially equal to the inner diameter of said sleeve
at the distal end thereof so that said stylet obstructs the distal
end of the needle and sleeve to facilitate insertion of the needle,
sleeve member, and stylet as a unit into a patient, whereby when
said stylet is removed from the needle and sleeve after insertion
into a tissue, and upon manipulation of the needle, the distal
cutting edge of the needle will cut a tissue sample and the tissue
sample will be collected in the tapered distal end portion of the
sleeve.
Description
SUMMARY OF THE INVENTION
Although there are many kinds specialized biopsy instruments used
for obtaining biopsy specimens from various organs, it has been
found that such instruments are quite often unsatisfactory in
obtaining biopsy specimens from organs such as the spleen, thyroid
or other organs which tend to bleed profusely if a biopsy specimen
is taken. Therefore when biopsy specimens are taken from the
spleen, thyroid or similar organ, it is necessary to resort to a
surgical procedure in order to manage and prevent bleeding after
removal of the biopsy specimen.
It is therefore a general object of this invention to provide a
novel biopsy technique and device for obtaining an effective biopsy
specimen from an organ such as a spleen or thyroid which tends to
bleed profusely but in a manner in which bleeding is minimized if
not substantially precluded.
The present biopsy technique and device involves the insertion of a
biopsy needle into the tissue from which the specimen is to be
taken, the needle having a sleeve member and stylet therein, the
stylet being removed and the biopsy being collected in the sleeve
which is also thereafter removed. A heat transfer means such as a
microcauter or a cryoprobe is inserted through the needle to
project from the distal end thereof, and which serves to cauterize
the biopsy track as the needle and heat transfer means are removed
as a unit.
Through the use of this technique and device, biopsy specimens may
be obtained from organs such as the spleen or thyroid without
requiring surgical procedures which is normally required when
obtaining such biopsy specimens.
BRIEF DESCRIPTION OF THE FIGURES OF THE DRAWING
FIG. 1 is an exploded perspective view illustrating the biopsy
needle device including the biopsy needle, sleeve member and
stylet,
FIG. 2 is a cross-sectional view illustrating the microcauter
projecting through the needle,
FIG. 3 is a side-elevational view of a cryoprobe which may be used
as an alternative to the microcauter and,
FIG. 4 is a fragmentary perspective view of a modified form of the
cutting edge of a biopsy needle.
DETAILED DESCRIPTION OF THE INVENTION
Referring now to the drawings and most specifically to FIG. 1, it
will be seen that one embodiment of the novel biopsy needle device,
designated generally by the reference numeral 10 is there shown.
The biopsy needle device 10 is comprised of an elongate biopsy
needle 11 having an elongate cylindrical body 12 which terminates
in a uniformly distal tapered end portion 13. Opposite ends of the
needle 11 are open and it will be noted that a cutting edge 14 is
defined by the distal end. The biopsy needle 11 is preferably
formed of a suitable metallic material and the lumen 12a of the
cylindrical body portion communicates smoothly with the lumen or
interior 13a of the tapered distal end portion 13. In the
embodiment shown, the cutting edge defined by the distal end is
bevelled or obliquely disposed with respect to the longitudinal
axis of the needle 11.
The biopsy needle 11 is also provided with a pair of outwardly
projecting oppositely disposed finger grip elements 15 and
terminates in an enlarged cylindrical proximal end portion 16. It
will be noted that the enlarged cylindrical proximal end portion 16
has a distal end wall 17 which in the embodiment shown engages the
finger grip elements 15. This proximal end portion 16 also has a
notch 18 therein which extends in a general longitudinal direction
and which terminates in an offset portion.
The biopsy needle device also includes an elongate sleeve member 19
which serves as a tissue-collecting medium and which is adapted to
be positioned interiorly of the needle 11. The sleeve member 19
includes an elongate cylindrical body 20 which terminates in a
uniformly tapered distal end portion 21. Opposite ends of this
sleeve member 19 are also open and it will be noted that the distal
end 22 also defines a cutting edge which is bevelled or obliquely
disposed with respect to the longitudinal axis of the sleeve
member. The cylindrical body 20 of the sleeve member 19 also
communicates smoothly with the lumen of the tapered distal end
portion 21 in the manner of the needle 11.
The sleeve member also has an enlarged cylindrical proximal end
portion 23 which is provided with a radially projecting locking pin
24. The locking pin 24 is adapted to engage in the notch 18 to
releasably interlock the sleeve member 19 within the needle 11. The
proximal end portion 23 also has a generally axially extending
notch 25 therein which also terminates in an offset portion. It
will be noted that the pin 24 and notch 25 are spaced axially from
each other.
The sleeve member 19 is also preferably formed of a suitable
metallic material and is adapted to receive therein an elongate
metallic stylet 26 which in the embodiment shown is preferably of
cylindrical configuration and terminates in a bevelled or obliquely
disposed distal end 27. The stylet is also provided with an
enlarged cylindrical proximal end portion 28 and terminates in a
finger grip portion or handle 29. A locking pin 30 is affixed to
the proximal end portion 28 and projects radially therefrom. This
locking pin is adapted to engage in the notch 25 of the sleeve
member 19. It is pointed out that the sleeve member will have its
distal end 22 disposed in substantially aligned relation with the
distal end 14 of the needle 11. However, the stylet 26 when
interlocked with the sleeve 19 will project approximately one
millimeter beyond the end of the biopsy needle 12 and this serves
to obstruct the distal end of the assembled biopsy needle
device.
Heat transfer means is also provided so that the temperature of the
biopsy track may be radically changed to prevent intraorgan
bleeding after the removal of the biopsy specimen.
Referring now to FIG. 2, it will be seen that such a heat transfer
means may include a microcauter 31 which includes an elongate
hollow probe 32 having a closed distal end or tip 33 in which is
disposed a resistance element. A pair of electrical conductors 34
extend through the handle 35 of the microcauter into the hollow
probe 32 and are connected to the resistance element at the tip
interiorly of the probe. The electrical conductors are connected to
a suitable source of electrical current so that when current is
supplied to the tip, it will be heated rapidly to a temperature
sufficient to produce cauterization of the tissue defining the
biopsy track. In this regard, it will be noted that the microcauter
may be inserted into and through the biopsy needle 11 so that the
tip 31 of the microcauter projects exteriorly thereof. The probe 32
is provided with a small cylindrical spacer element 36 which is
adapted to engage the inner surface of the needle adjacent the
proximal end thereof to space the the probe from the inner surface
of the biopsy needle.
An alternative heat transfer means comprises a cryoprobe
illustrated in FIG. 3 and designated generally by the reference
numeral 37. The cryoprobe 37 includes an elongate substantially
solid metallic probe 38 which is preferably formed of a material
such as silver or the like which is characterized by its high
thermal conductivity. The probe is of a length corresponding to the
length of the hollow probe 32 of the microcauter 31. The proximal
end portion of the probe 38 is connected to a reservoir 39 and a
handle 40 is secured to the proximal end portion of the reservoir
39. A small cylindrical spacer element 41 is positioned
concentrically around the proximal end portion of the probe 38 and
serves to space the probe from the inner surface of the needle 11
when the cryoprobe is inserted into the needle.
A pair of conduits 42 extend through the handle 40 and communicate
with the interior of the reservoir 39 to circulate liquid nitrogen
through the reservoir 39 from a source of supply. In this regard,
the conduits are also connected to a source of supply of liquid
nitrogen with suitable means being provided to force the liquid
nitrogen through the conduits. Suitable valving will also be
provided. It will therefore be seen that when liquid nitrogen is
circulated through the reservoir, because of the high thermal
conductivity of the probe 38, the probe will be cooled to a
temperature of approximately -180.degree. C. so that the
temperature of the tip of the probe is approximately -100.degree.
C. This is sufficiently cold enough to produce freezing of the
tissue defining the biopsy track and to prevent any further
bleeding thereof.
Referring now to FIG. 4, it will be seen that a modified form of
the distal cutting edge of the biopsy needle is there shown and
this cutting edge is designated by the reference numeral 42. It is
pointed out that the biopsy needle of which the cutting edge 42
constitutes the distal end thereof is otherwise of identical
construction to the biopsy needle illustrated in FIGS. 1 and 2, and
includes a tubular body (not shown) having a uniformly tapered
distal end portion 43. The cutting edge 42 is provided with a pair
of diametrically opposed teeth 44 which project axially of the
needle. Each tooth 44 defines an axial cutting edge 45 which is
disposed substantially parallel to the longitudinal axis of the
needle. These axial cutting edges 45 are of substantially the same
length and the points of the teeth are disposed in substantially
coplanar relation.
The cutting surface defined between each axial cutting edge 45 is
generally of spiralled configuration and facilitates the cutting of
a tissue as the needle is urged forwardly in an axial direction.
However, the axial cutting edges 45 permit radial cutting when the
needle is revolved about its longitudinal axis. It is also pointed
out that the needle illustrated in FIG. 4 will also be provided
with a stylet having a distal end configuration which will present
a closed end surface to facilitate insertion of the needle for
access to a deeply located organ.
In use, the sleeve member 19 will be releasably interlocked within
the biopsy needle 11 and the stylet 26 will be interlocked within
the sleeve member 19. The assembled needle device 10 will then be
inserted from the exterior through the exterior tissue to the more
deeply located organ such as a thyroid or spleen. When the distal
end 14 of the needle 11 is disposed in close proximal relation to
the organ from which the tissue specimen is to be taken the stylet
26 will be unlocked from the sleeve member 19 and retracted
therefrom. The interlocked biopsy needle 11 and sleeve member 19
will then be advanced into the organ while simultaneously producing
a revolving or oscillating movement of the assembly about its
longitudinal axis. A tissue specimen will be cut by this augering
action and will be collected in the distal end portion of the
sleeve member 19 which, as set forth above, expands uniformly in a
proximal direction. Because of this expansion configuration of the
sleeve member, the tissue specimen will not be subjected to any
compression as it is collected in the sleeve member, and the tissue
specimen will therefore not be damaged. After the specimen has been
collected within the sleeve member 19, the sleeve member will then
be unlocked and retracted from the needle 11.
Thereafter, the microcauter 31 will be inserted through the needle
so that the tip thereof projects into the biopsy track. The
microcauter will be energized so that the tip instantaneously heats
to a temperature sufficient to cauterize the biopsy track. The
biopsy needle 11 and microcauter will be retracted as a unit thus
producing cauterization of the entire biopsy track and thereby
preventing any further bleeding of the organ.
As an alternative, the cryoprobe 37 may be inserted into the needle
and the liquid nitrogen may then be circulated through the
reservoir 39 so that instantaneous cooling of the probe 38 occurs.
As pointed out above, the temperature of the liquid nitrogen is
approximately -180.degree. C. and the temperature of the distal tip
of the probe 38 is approximately -100.degree. C. This is sufficient
to produce cooling to the degree necessary to prevent any further
bleeding of the tissue. The biopsy needle 11 and cryoprobe 37 will
also be retracted as a unit so that the biopsy track is
progressively and effectively cooled.
It has been found that through the use of the above-described
technique and biopsy device, not only can highly effective tissue
specimens be obtained, but biopsies may be performed on such organs
as the spleen, thyroid and the like through nonsurgical techniques.
Profuse bleeding of such organs is prevented by the unique
application of heat transfer means such as a cryoprobe or
microcauter, which are introduced through the biopsy needle.
Therefore, biopsy specimens may be taken from the spleen, thyroid
or similar organs with a minimum of discomfort to the patient.
Since little damage occurs to the specimen taken, it has been found
that there is little, if any, occasion to repeat the biopsy.
It will therefore be seen from the preceding paragraphs that we
have provided a novel technique and biopsy needle device which not
only permits excellent specimens to be obtained but such specimens
may be obtained from organs such as the spleen, the thyroid and the
like through nonsurgical techniques.
It will, of course, be understood that various changes may be made
in the form, details, arrangement and proportions of the various
parts without departing from the scope of my invention.
* * * * *