US20050113716A1 - Biopsy device having endoscope - Google Patents

Biopsy device having endoscope Download PDF

Info

Publication number
US20050113716A1
US20050113716A1 US11/028,131 US2813105A US2005113716A1 US 20050113716 A1 US20050113716 A1 US 20050113716A1 US 2813105 A US2813105 A US 2813105A US 2005113716 A1 US2005113716 A1 US 2005113716A1
Authority
US
United States
Prior art keywords
cutter
biopsy device
biopsy
sheath
introducer
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US11/028,131
Inventor
Richard Mueller
Paul Hsei
James Kermode
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Acueity Inc
Original Assignee
Acueity Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Acueity Inc filed Critical Acueity Inc
Priority to US11/028,131 priority Critical patent/US20050113716A1/en
Publication of US20050113716A1 publication Critical patent/US20050113716A1/en
Assigned to ACUEITY, INC. reassignment ACUEITY, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: MUELLER JR., RICHARD L., HSEI, PAUL K., KERMODE, JAMES
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/0233Pointed or sharp biopsy instruments
    • A61B10/0266Pointed or sharp biopsy instruments means for severing sample
    • A61B10/0275Pointed or sharp biopsy instruments means for severing sample with sample notch, e.g. on the side of inner stylet
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/0041Detection of breast cancer
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B2017/348Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484Anchoring means, e.g. spreading-out umbrella-like structure
    • A61B2017/3488Fixation to inner organ or inner body tissue

Definitions

  • the invention generally relates to a device for obtaining mammary duct tissue samples for analysis. More specifically, the invention relates to a biopsy device having an endoscope and an introducer therefor.
  • breast cancer is one of the health threats most feared by women, and is indeed the most common form of cancer in women.
  • a key to treatment is early detection.
  • an annual mammogram is a method that has been used in hopes of early detection of breast cancer.
  • One problem with mammography is that such an imaging technique can only find breast cancer once it has taken form. All too often, breast cancer is discovered at a stage that is too far advanced, when therapeutic options and survival rates are severely limited. While breast cancer is most common among women, in rare instances the human male may also have occurrences of breast cancer.
  • breast cancer begins in the lining of mammary ducts.
  • fluid within the mammary duct contains high levels of breast cancer markers, and that an estimated 80%-90% of all breast cancers occur within the intraductal epithelium of the mammary glands.
  • Fluid within the breast ducts contains an assemblage and concentration of hormones, growth factors and other potential markers comparable to those secreted by, or acting upon, the surrounding cells of the alveolar-ductal system.
  • mammary fluid typically contains cells and cellular debris or products that can also be used in cytological or immunological assays. As such, techniques such as ductal lavage, collection of mammary duct discharge, and brushing biopsies have been utilized to obtain such samples for diagnostic purposes.
  • a biopsy of the tissue may then be taken.
  • One biopsy device that has been utilized is the Mammotome® biopsy system available from Ethicon Endo-Surgery, Inc., Cincinnati, Ohio.
  • the Mammotome® probe a needle-like device with a hollow passage therethrough, is introduced through an incision cut into the breast and inserted further until the desired biopsy region is accessed.
  • tissue is received into a window in the probe with vacuum assist.
  • a cutter then cuts and removes tissue samples for examination.
  • the samples are passed through the hollow passage of the probe into a collection chamber. Because the Mammotome® probe is directional, multiple specimens can be collected without having to remove and reinsert the device.
  • the Mammotome® probe is removed after the samples have been collected, and the incision is closed.
  • Such a system significantly decreases the invasiveness of the biopsy procedure by only requiring a small incision and puncture, which may be done under local anesthetic.
  • the incision and probe insertion required with the Mammotome® is unnecessarily invasive and undesirable.
  • the present invention meets the foregoing desires and provides an improved device for taking a biopsy within a mammary duct, as well as a device that facilitates memorializing in the patient's records the location of the tissue sampled.
  • a biopsy device embodying the present invention comprises a biopsy instrument provided with a tissue cutter suitable for collecting at least one tissue sample from a body lumen, such as a mammary duct, and a cutter introducer sized for receiving the tissue cutter and guiding the tissue cutter into a mammary duct.
  • the biopsy instrument includes a holster, a housing reciprocably mounted in the holster, and an elongated hollow cutter that extends from the housing and is driven by a cutter drive motor situated within the housing.
  • a power connector operably connected to a power source, is associated with the cutter drive motor.
  • the hollow cutter rotates about a longitudinal axis thereof upon energization of the motor by activating a switch operably associated with the motor.
  • the hollow cutter also extends distally relative to the holster when the housing is urged into the holster.
  • An ejector assembly is removably mounted to the housing and received within the cutter.
  • the ejector assembly includes an endoscope which is slidably received within the hollow cutter and may be extended therethrough.
  • the endoscope serves the dual purpose of viewing the area to be biopsied, as well as serving as a piston for urging or expelling biopsied material from the cutter.
  • a power source such as a battery, which can be a primary battery, i.e., single use, or a secondary battery, i.e., rechargeable.
  • the power source may be external to the housing and the holster therefor, but operatively connected to the power connector.
  • the housing and holster are preferably formed of a lightweight rigid plastic.
  • the cutter is preferably formed of a lightweight metal such as stainless or surgical steel, or the like.
  • the other component of the biopsy device is the cutter introducer, which is comprised of a hollow handle, and an elongated sheath having open opposite ends, i.e., a distal end and a proximal end, mounted to the handle and adapted to receive the cutter element therewithin.
  • a window cut-out or aperture is provided at a distal end portion of the sheath.
  • the window or aperture preferably includes a hook portion for grasping and pulling the target tissue through the window and into the sheath.
  • a proximal end portion of the sheath is fixed within the handle.
  • the hollow handle further defines an axial passage leading to the sheath.
  • the handle of the cutter introducer preferably includes an integral azimuth indicator, which may be unitary with the handle.
  • the azimuth indicator can also be a pair of azimuth indices that can be aligned vis-a-vis one another, and the like.
  • the handle can also include a socket for receiving the coupling mount of the biopsy instrument.
  • the coupling socket on the handle may be an annular cavity which can receive the boss of the holster provided with a radially outwardly extending flange.
  • the handle is also preferably formed of a lightweight rigid plastic.
  • a tissue anchor extendable through the introducer is desirable in some cases.
  • the tissue anchor can comprise a hollow hub and flexible outwardly biased tines that extend from the hub and an optional retriever rod.
  • the tissue anchor is slidably and rotatably mounted within the sheath at the distal end portion thereof.
  • the tines of the anchor are extendable from the open distal end of the sheath and spread radially outwardly when so extended.
  • a distal end portion of the retriever rod, which retracts the anchor and the tines within the sheath, is configured to engage the anchor.
  • the cutter introducer In order to obtain a tissue sample with the biopsy device from a mammary duct the cutter introducer is first inserted into a nipple orifice at the nipple surface and then advanced into the mammary duct.
  • the endoscope may be utilized within the introducer to locate and view the biopsy site, if desired.
  • the tines of the anchor When a tissue mass of interest is located, and the distal end portion of the sheath positioned as desired, the tines of the anchor are extended beyond the open distal end by urging the hub of the tissue anchor to slide towards the distal end. The tines are pushed through the open distal end, and because they are outwardly biased, spread out radially to contact the walls of the mammary duct and immobilize the introducer.
  • the biopsy instrument in particular the cutter, is inserted into the introducer and extended towards the distal end portion thereof.
  • a tissue mass from the biopsy site is received within the introducer sheath through an aperture or cut-out at the distal end portion of the introducer sheath.
  • the motor for driving the cutter element is energized and rotates the cutter element. As the distal end of the cutter travels across the aperture, that portion of the tissue mass received within the introducer sheath is severed.
  • the biopsy instrument is withdrawn from the introducer sheath after the desired tissue samples have been taken.
  • the hollow cutter element receives the tissue mass within its interior, and the severed tissue is later ejected from the hollow cutter by the ejector assembly for analysis.
  • a retriever rod may be extended through the introducer sheath to engage the hub of the tissue anchor.
  • the retriever rod is then retracted and draws the anchor back into the sheath, thereby disengaging the tines from the mammary duct.
  • the introducer can then be withdrawn from the mammary duct.
  • the anchor can be urged past the distal end of the introducer and left in the mammary duct as a biopsy site marker or indicator.
  • FIG. 1 is a perspective view of an embodiment of a biopsy device
  • FIG. 2 is a partial cross sectional side view of the biopsy instrument
  • FIG. 3 is a partial cross sectional top view of the biopsy instrument of FIG. 2 ;
  • FIG. 4 is a cross sectional side view, partially broken, of the cutter introducer
  • FIG. 5 is an enlarged cross sectional view of the distal end portion of the cutter introducer and the tissue anchor in a retracted position
  • FIG. 6 is an enlarged cross sectional side view of the distal end portion of the cutter introducer with the tissue anchor in an extended position
  • FIG. 7 is an enlarged cross sectional side view of the distal end portion of the biopsy introducer with the tissue anchor in an extended position and a retriever rod engaged with a tissue anchor latch;
  • FIG. 8 is an enlarged cross sectional side view of the distal end portion of the cutter introducer with the tissue anchor extended and engaged with a mammary duct, and a cutter within the introducer;
  • FIG. 9 is an enlarged cross sectional side view of the distal end portion of the biopsy introducer with an alternate embodiment of the tissue anchor in an extended position and equipped with a retriever rod suitable for engaging the tissue anchor;
  • FIG. 10 is a schematic of a human breast having the biopsy device inserted therein, and an azimuth marker circumscribing a breast nipple;
  • FIG. 11 is a cross sectional side view of another embodiment of a biopsy device with an ejector assembly comprising an endoscope which is shown in an extended state;
  • FIG. 12 is a cross section side view of the biopsy device of FIG. 11 with the endoscope in a retracted state;
  • FIG. 13 is a perspective view of another embodiment of a biopsy device having an endoscope
  • FIG. 14 is an enlarged cross sectional view of the distal end portion of an embodiment of the biopsy device having a hooked window portion
  • FIG. 15 is an enlarged cross sectional view of the distal end portion of an embodiment of the biopsy device taking a core tissue sample.
  • Biopsy device 10 is comprised of a biopsy instrument 12 and a cutter introducer 14 removably carried by the biopsy instrument 12 and having hollow elongated sheath 26 mounted to handle 24 .
  • the biopsy instrument 12 comprises a holster 16 , a housing 18 that is slidably and reciprocably received in holster 16 , and a hollow elongated cutter 42 ( FIG. 2 ), slidably received within elongated sheath 26 of cutter introducer 14 .
  • the elongated cutter 42 is driven by cutter motor 38 ( FIG. 3 ) within housing 18 .
  • An end cap 22 removable to access various components within the housing 18 , seals the proximal end of housing 18 .
  • Elongated sheath 26 has open opposite ends, i.e., a distal end 28 and a proximal end that is mounted to handle 24 .
  • a cut-out or aperture 30 is provided at a distal end portion 32 of the sheath 26 .
  • Depth indicators 35 axially spaced from one another can also be provided on sheath 26 , if desired.
  • Handle 24 is adapted for rotatable as well as removable mounting to housing 18 , and includes a pair of integrally formed azimuth indicators, in particular, distal indicator 34 and proximal indicator 36 , that are axially aligned with one another.
  • the cutter or blade 42 is configured for sliding travel through the handle 24 and sheath 26 of the introducer 14 .
  • the outer diameter of the cutter 42 is smaller than the inner diameter of the sheath 26 .
  • the cutter 42 is also sufficiently long to extend to the distal end portion 32 of the sheath, and preferably such that when fully extended, the cutter element projects beyond the aperture 30 .
  • a power connector such as lead 40 for cutter drive motor 38 is also included in the housing 18 and is operably associated with the cutter drive motor 38 which drives hollow cutter 42 by rotating it about the longitudinal axis of the cutter introducer 14 .
  • motor 38 drives spur gear 39 , which in turn is engaged with spur gear 43 secured to the proximal end portion of cutter 42 .
  • the motor 38 can be energized by any switching mechanism available in the art.
  • a two-position switch 45 can be operatively connected in a circuit between a power source and the motor 38 , preferably biased in the OFF-position.
  • the switch may also be formed by a battery 38 that serves as the power source and a conductive post 71 surrounded by insulated spring 68 .
  • battery 38 contacts post 71 to complete an electrical circuit between the motor and the battery.
  • power lead 67 in cooperation with conductive post 71 , spring 68 and power lead 40 , form an electrical circuit between the cutter drive motor 38 and the battery 54 .
  • the switch and power supply can be operably connected to the motor, but situated external to the housing. For example, a foot-operated switch can be utilized in such instances.
  • a return spring Positioned between the distal end of holster 16 and distal end of housing 18 is a return spring, such as coil spring 56 .
  • the holster 16 further defines a groove 58 through which dorsal post 60 is positioned and extends therethrough from housing 18 ( FIG. 2 ).
  • the ventral post 60 within the groove 58 serves as a stop to limit the longitudinal movement of the housing 18 relative to the holster 16 , as well as to prevent rotational movement of the housing 18 relative to the holster 16 .
  • Coil spring 56 is axially aligned with the cutter 42 in holster 16 , through which cutter 42 is extended for axial reciprocation within elongated sheath 26 .
  • a hollow support or bearing 70 may also be provided within the holster 16 , through which cutter 42 passes.
  • a coupling mount 48 for removably attaching the biopsy instrument 12 to cutter introducer 14 .
  • the coupling mount 48 is preferably a boss 49 terminating in a distal, radially outwardly extending flange.
  • Coupling mount 48 may also include an o-ring seal 51 that circumscribes boss 49 .
  • a pusher rod assembly 46 includes elongated piston rod 62 and an actuator handle 63 , and is removably mounted within the housing 18 .
  • the piston rod 62 is slidably received within the hollow cutter 42 .
  • the pusher rod assembly 46 is slidably positioned within housing 18 , and actuator handle 63 is accessible from outside the housing for manual actuation.
  • Further disposed within housing 18 is a pusher rod coil spring 66 biased against forward axial movement of the pusher rod assembly 46 .
  • Piston rod 62 extends from actuator handle 63 into and through cutter 42 .
  • Piston rod 62 has an outer diameter that is smaller than the inner diameter of the hollow cutter 42 such that any material within the cutter 42 is pushed out by piston rod 62 when extended.
  • Housing 18 further includes pusher stop 65 which limits the extent to which the pusher rod assembly 46 can be moved distally.
  • the pusher rod assembly is guided by at least a holster track, defined by guide rail 75 and guide rail 77 ( FIG. 1 ).
  • the other major component of the biopsy device is a cutter introducer removably mounted to holster 16 .
  • a cross section of a preferred embodiment of the biopsy introducer 14 is shown in FIG. 4 .
  • the cutter introducer 14 comprises a number of components, including hollow handle 24 and elongated sheath 26 having an aperture 30 formed at a distal end portion 32 of the sheath 26 .
  • the distal end 28 of sheath 26 preferably terminates in an atraumatic tip, such as a circumferential bevel.
  • a proximal end portion 33 of the sheath 26 is fixed within the handle 24 .
  • An axial passage 25 is further defined by the hollow handle 24 and leads to sheath 26 .
  • the handle passage 25 is tapered so as to permit easier introduction of the cutter 42 or other instrument into the sheath 26 .
  • the handle 24 also defines an annular coupling socket 37 for rotatable mounting to coupling mount 48 of the biopsy instrument 12 .
  • the socket 37 is configured to receive coupling mount 48 on holster 16 ( FIGS. 2 and 3 ).
  • tissue anchor 76 is also shown within the distal end portion 32 of sheath 26 thereof.
  • Tissue anchor 76 is optional and aids the operator in maintaining penetration control as indicated by depth marker 35 .
  • An externally applied nipple clamp (not shown) may be optionally employed to clamp or retain introducer sheath 26 within the nipple duct sphincter muscle, thereby also aiding in penetration control.
  • Tissue anchor 76 comprises a hollow hub 78 , flexible, outwardly biased tines 80 that extend from the hub 78 , and a latch 82 which extends from the hub axially.
  • the tissue anchor 76 is slidably and rotatably mounted within the distal end portion 32 of the sheath 26 .
  • tissue anchor 76 may be extended through the sheath 26 after an endoscopic viewing procedure has located the biopsy site.
  • the anchor 76 can be partially or fully extendable through the open distal end 28 of the sheath 26 , as desired.
  • Latch 82 is configured to engage a distal end portion 86 of a retriever rod, which is discussed in further detail below.
  • the tissue anchor 76 is shown in a retracted position.
  • the tissue anchor 76 can be pushed partially through distal end 28 to extend the tines 80 until annular step 88 abuts beveled detent 90 .
  • the tissue anchor 76 may be pushed by any appropriate device, such as by an endoscope viewing assembly, push rod, or other instrument that is extendable through the sheath 26 to engage hub 78 .
  • the extent to which tissue anchor 76 can be extended through distal end 28 may be limited by hub 78 which includes an annular step 88 , in cooperation with beveled detent 90 formed about the distal end portion 32 .
  • hub 78 which includes an annular step 88 , in cooperation with beveled detent 90 formed about the distal end portion 32 .
  • the tines 80 are extended past the distal end 28 , their outward bias causes the tines 80 to spread radially and engage the interior of the mammary duct (not shown). As such, the axial position of the sheath 26 within the mammary duct is secured.
  • the hub 78 is sized to rotate relative to sheath 26 .
  • the sheath 26 may be rotated about hub 78 within the mammary duct to reposition the circumferential orientation of aperture 30 even after the tissue anchor 76 has been engaged by manipulation of the handle 24 ( FIG. 1 ).
  • rotatable repositioning the aperture 30 permits collection of multiple tissue samples from the same region of a mammary duct.
  • the annular step 88 and beveled detent 90 are contoured so that by application of additional force, the tissue anchor 76 can be urged past the distal end 28 of the sheath 26 and left in place as a marker for the biopsy site. Tactile feedback is provided to the operator by increased resistance from the interaction of annular step 88 and detent 90 when the anchor 76 is extended, but still within the sheath 26 .
  • tissue anchor 76 can be disengaged from sheath 26 by gently withdrawing sheath 26 from the biopsy site such that tissue anchor 76 is left behind still engaged with the mammary duct wall.
  • a retriever rod 84 is introduced through the sheath 26 .
  • the retriever rod 84 includes a detent 85 for engaging the latch 82 extending from the hub 78 as shown in FIG. 7 .
  • the retriever rod 84 is then retracted from the introducer 14 , thereby also retracting the anchor 76 .
  • the cutter introducer 14 is first inserted into a mammary duct via a nipple orifice.
  • the desired nipple orifice is first located through use of any means such as an illuminated nipple cup (not shown).
  • a nipple orifice dilator or catheter (not shown) may be used to dilate the nipple orifice, if desired, to permit easier insertion of the introducer.
  • An endoscope may be extended within the introducer to enable viewing of the biopsy site. When a desired mass of tissue is located, the anchor 76 is extended as described above, and as shown in FIG. 8 .
  • the hollow cutter 42 of the biopsy instrument is guided through the cutter introducer 14 and pushed towards the distal end portion 32 and the aperture 30 .
  • a tissue mass is received within the sheath 26 through the aperture or cut-out 30 at the distal end portion 32 .
  • the tissue mass can be urged into the aperture 30 by external pressure applied to the breast or alternatively with the aid of a vacuum, or by pressing the aperture against the desired biopsy area.
  • the cutter motor 38 for driving the cutter 42 of the biopsy instrument can then be energized. Driven by motor 38 , cutter 42 rotates and severs the portion of the tissue mass received within the sheath 26 as the distal end 72 of the cutter 42 travels across aperture 30 .
  • the hollow cutter 42 receives the tissue mass within its interior.
  • the biopsy instrument 12 is removed from the introducer 14 after the desired tissue sample is obtained, and the tissue sample is later expelled from the cutter 42 by piston rod 62 of the pusher rod assembly extending therethrough.
  • the hollow cutter 42 may be operatively connected to a vacuum source for removal of the severed tissue sample through a central passageway defined by the hollow cutter 42 .
  • Anchor 91 has a configuration similar to the anchor discussed above, but includes a base 92 defining a threaded hole 93 .
  • Retriever rod 94 has a threaded distal end 95 that is threadably engageable with threaded hole 93 .
  • Anchor 91 can thereby extended to a desired degree and retracted by threadedly engaging retriever rod 94 with anchor 91 and extending or retracting the retriever rod 94 .
  • an azimuth marker is provided.
  • an azimuth marker 98 having a plurality of circumferential marks 100 is provided and can be as part of a biopsy kit.
  • Azimuth marker 98 is removably secured about a nipple 102 , such as with a physiologically compatible pressure sensitive adhesive.
  • the clinician notes how azimuthal indicators 34 and 36 align with circumferential marks 100 while the microendoscope is still positioned within introducer 14 .
  • the cooperation of the azimuthal indicators 34 and 36 and depth markers 35 establishes the location of the target tissue so that the microendoscope can be removed and the biopsy instrument 12 inserted.
  • a tissue sample is obtained.
  • the practitioner aligns the distal azimuthal indicator 34 and proximal azimuthal indicator 36 with a mark on the azimuth marker 98 and notes the indicator position.
  • the biopsy instrument 12 is disengaged from the biopsy introducer 14 .
  • the practitioner extends the pusher rod assembly 46 by forwardly moving push rod handle 63 , and thereby causing piston rod 62 ( FIG. 8 ) to pass beyond the distal end of cutter 42 and eject the severed tissue sample.
  • the tissue sample or samples may be collected on a collection tray having multiple recesses or numbered slots for tracking the source of the tissue sample.
  • the biopsy instrument 12 can then be reinserted into the introducer 14 , which is still held in place at the biopsy site by the tissue anchor 76 , and rotated such that distal indicator 34 and proximal indicator 36 are aligned with a circumferential mark on azimuthal marker 98 different than that for prior tissue samples.
  • the aperture at the distal end portion of the introducer is repositioned to accept a tissue mass from a position adjacent to or near the previously excised tissue mass.
  • the cutter then excises and retains a portion of this particular tissue. This sampling process is repeated as desired.
  • the practitioner can obtain tissue samples by aligning the distal indicator 34 and proximal indicator 36 with successive circumferential markers in a clockwise direction.
  • multiple tissue samples can be obtained without retracting the biopsy instrument 12 from the introducer 14 .
  • the aperture 30 FIG. 8
  • the cutter 42 is rotated by the cutter drive motor 38 and passed across the aperture 30 , which is then rotatably repositioned and the cutter is again rotated and passed across the newly positioned aperture 30 .
  • multiple tissue samples are held within the hollow cutter 42 .
  • the cutter 42 is then removed and the multiple tissue samples ejected by the pusher rod assembly.
  • a retriever rod can be used to retract the anchor, and thereby, permit retraction of the introducer.
  • the rod 64 of the pusher rod assembly may also serve as the retriever rod.
  • Biopsy device 210 is comprised of a biopsy instrument 212 and a cutter introducer 214 removably carried by the biopsy instrument 212 and having hollow elongated sheath 226 mounted to handle 224 .
  • the cutter introducer 214 is essentially the same as described in the previous embodiment.
  • the biopsy instrument 212 comprises a holster 216 , a housing 218 that is slidably and reciprocably received in holster 216 , and a hollow elongated cutter 242 , slidably received within elongated sheath 226 of cutter introducer 214 .
  • An ejector assembly 261 is further provided, which comprises a rocker arm, such as ejector handle member 263 , a hinge member 267 , and a barrel member 269 .
  • the barrel member 269 further defines a passageway 271 including a collar portion 272 .
  • the ejector assembly 261 further comprises an endoscope 262 having an adapter, such as a Tuohy fitting 276 , that removably secures the endoscope to the collar portion 272 of the passageway 271 . Also provided is an ejector assembly coil spring 266 , which is biased against distal movement of the ejector assembly 261 towards the cutter introducer 214 . Since the endoscope 262 is secured within the ejector assembly, its movement corresponds to the movement of ejector assembly 261 . Operatively connected to the passageway 271 is a removable port member 273 , through which solution, such as irrigation liquids may be introduced. Port member 273 is also suitable for providing a conduit for a suctioning device. A return spring, such as coil spring 256 is also provided between the housing 218 and the holster 216 . Also, an on-off switch, such as button switch 245 is provided, which when actuated causes a motor to rotate cutter 242 such as described above.
  • an adapter
  • the ejector assembly handle 263 is engaged with end cap 222 , when the ejector assembly 261 is in a forward position thereby acting as a detent member.
  • the endoscope 262 is also positioned such that its distal end 275 is extended proximate to or beyond the distal end 277 of the cutter 242 . By positioning the endoscope 262 proximate the distal end 277 of the cutter 242 , the practitioner is able to view the biopsy site in real time up to the time the cutting operation takes place.
  • the endoscope 262 When the practitioner is ready to begin cutting, tissue is urged through the window 230 by manipulating the patient's breast.
  • the endoscope 262 In order to provide a collection reservoir 279 , the endoscope 262 is first retracted as shown in FIG. 12 .
  • the ejector assembly handle 263 is disengaged from the end cap 222 such that the ejector assembly coil spring 266 urges rearward movement of the ejector assembly 261 . Accordingly, the endoscope 262 is retracted such that reservoir 279 is created in the distal end portion of the cutter 242 .
  • excised tissue may be collected in this reservoir 279 .
  • One benefit of the present configuration is that a practitioner can retract the endoscope 262 by fingertip control by releasing the ejector handle 263 as described.
  • biopsy device 310 is similar to the biopsy device of FIGS. 11 and 12 .
  • biopsy device 310 comprises an introducer 314 and an instrument 312 having an ejector assembly (not shown) comprising an endoscope 362 .
  • One difference is the detent member used for positioning the ejector assembly and endoscope 362 .
  • a rotatable hub 380 having an arm member 382 is provided with end cap 322 .
  • Hub 380 further defines a passage 384 through which endoscope 362 is passed.
  • endoscope 362 is removably secured with the ejector assembly.
  • the arm member 382 is positioned such that the ejector assembly handle 363 is pushed up against the arm member 382 by the internal ejector assembly coil spring (not shown). With the arm member 382 so positioned, the ejector assembly and its endoscope 262 are held in the desired position within the introducer 314 . Also, the housing 318 is prevented from being moved relative to the holster 316 . When the practitioner is ready to begin the cutting operation, the hub 380 and arm member 382 are rotated such that the ejector assembly coil spring causes the ejector assembly to retract the endoscope such as described with the previous embodiment.
  • FIG. 14 another optional feature of the present invention is to provide a hook 431 in window 430 . Since the practitioner is able, with endoscope 462 to view the desired tissue passed through window 430 , the practitioner is also able to secure the tissue with hook 431 . The hook 431 better enables the practitioner to maintain the position of the desired tissue within the sheath 426 during the cutting process by the cutter 442 since the hook grasps the desired tissue as shown. In addition, hook 431 is utilized to pull tissue through window 430 into sheath 426 . This is accomplished by engaging tissue with the hook 431 and pulling on the tissue, which urges the tissue into the sheath 426 .
  • the hook in a 0.039 inch (0.09906 centimeter) diameter stainless tube having a wall thickness of 0.0025 inches (0.00635 centimeter) that the hook have a depth of between one-third and one-half the tube diameter, or in this example, 0.13 to 0.185 inches (0.3302 to 0.4699 centimeters). It is most desired that the hook depth be about one-half the tube diameter.
  • the hook 431 readily grasps the soft duct wall and pulls tissue into the cutter window 430 and supports the tissue such that its position within the window 430 is maintained as the cutter 442 is advanced. As pressure is increased, the hook 431 either pierces the tissue and thereafter begins tearing it off or the tissue slips off the hook 431 .
  • the practitioner Since the practitioner is able to view the biopsy site in real time with the endoscope 462 , the practitioner is able to best determine the amount of pulling force to exert without tearing the tissue, and to see when to advance the cutter 442 .
  • the viewing capability of the endoscope with the cutter in position to be activated for the cutting procedure also provides the practitioner with great flexibility in the size of the sample taken. For example, if the practitioner wishes to take a relatively small sample, the hook 431 is merely utilized to grasp tissue. On the other hand, if a larger tissue sample is desired, additional pressure is utilized so the hook pulls more tissue within the window 430 . Given the relatively small difference between the amount of pressure being exerted in these two situations, as discussed above, the real time visual inspection through the endoscope 462 allows such a procedure to take place.
  • the window 430 be relatively long. In the example being discussed of a 0.039 inch (0.09906 centimeter) diameter stainless tube having a wall thickness of 0.0025 inches (0.00635 centimeter), and hook depth of 0.13 to 0.185 inches (0.3302 to 0.4699 centimeters), it is preferred that the window have a length of greater than 0.197 inches (0.5 centimeter). The longer window 430 allows a desired amount of tissue to be pulled therein by hook 431 .
  • FIG. 15 Yet another type of sampling that is possible with the present biopsy device is shown in FIG. 15 .
  • the biopsy device may in some embodiments also act as a core type cutter.
  • the distal end 577 of cutter 542 can be urged beyond the distal end portion 532 of the sheath 526 to cut core samples of tissue.
  • endoscope 562 can be utilized by the practitioner to view the coring procedure.
  • the distal end 577 of the cutter 542 has an inner diameter that is 90% to 95% of inner diameter of the rest of the cutter 542 . It has been found that a fully parallel cutter sometimes results in a core sample that remains attached to the patient.
  • the reduced diameter distal end 542 creates a packing feature, which will tend to pull the tissue and tear away from the uncut end.
  • the endoscope is advanced to slightly compact the tissue against the distal end within the cutter to aid in sample removal.
  • Another alternative method is to insert a sharpened forward moving pin into the cutter after the core is cut by removing the endoscope. The moving pin acts to wedge the tissue sample within the cutter to aid in sample removal.

Abstract

A biopsy device having an endoscope comprises a biopsy instrument, suitable for collecting at least one tissue sample from a body lumen, such as a mammary duct, and a cutter introducer sized for receiving the biopsy instrument and introducing the biopsy instrument into a mammary duct to retrieve a tissue sample therefrom.

Description

    RELATED APPLICATION
  • This application is a continuation-in-part of application Ser. No. 10/422,381, filed on Apr. 24, 2003.
  • TECHNICAL FIELD OF THE INVENTION
  • The invention generally relates to a device for obtaining mammary duct tissue samples for analysis. More specifically, the invention relates to a biopsy device having an endoscope and an introducer therefor.
  • BACKGROUND OF THE INVENTION
  • Breast cancer is one of the health threats most feared by women, and is indeed the most common form of cancer in women. A key to treatment is early detection. For example, an annual mammogram is a method that has been used in hopes of early detection of breast cancer. One problem with mammography is that such an imaging technique can only find breast cancer once it has taken form. All too often, breast cancer is discovered at a stage that is too far advanced, when therapeutic options and survival rates are severely limited. While breast cancer is most common among women, in rare instances the human male may also have occurrences of breast cancer.
  • Other methods of detecting breast cancer are based on the fact that in a vast majority of instances breast cancer begins in the lining of mammary ducts. Studies have shown that fluid within the mammary duct contains high levels of breast cancer markers, and that an estimated 80%-90% of all breast cancers occur within the intraductal epithelium of the mammary glands. Fluid within the breast ducts contains an assemblage and concentration of hormones, growth factors and other potential markers comparable to those secreted by, or acting upon, the surrounding cells of the alveolar-ductal system. Likewise, mammary fluid typically contains cells and cellular debris or products that can also be used in cytological or immunological assays. As such, techniques such as ductal lavage, collection of mammary duct discharge, and brushing biopsies have been utilized to obtain such samples for diagnostic purposes.
  • If suspicious tissue is located, a biopsy of the tissue may then be taken. One biopsy device that has been utilized is the Mammotome® biopsy system available from Ethicon Endo-Surgery, Inc., Cincinnati, Ohio. After mapping an area to be biopsied, the Mammotome® probe, a needle-like device with a hollow passage therethrough, is introduced through an incision cut into the breast and inserted further until the desired biopsy region is accessed. When the probe is positioned at the region of concern, tissue is received into a window in the probe with vacuum assist. A cutter then cuts and removes tissue samples for examination. The samples are passed through the hollow passage of the probe into a collection chamber. Because the Mammotome® probe is directional, multiple specimens can be collected without having to remove and reinsert the device. The Mammotome® probe is removed after the samples have been collected, and the incision is closed.
  • Such a system significantly decreases the invasiveness of the biopsy procedure by only requiring a small incision and puncture, which may be done under local anesthetic. However, in certain situations, such as where the tissue to be biopsied is in a mammary duct, the incision and probe insertion required with the Mammotome® is unnecessarily invasive and undesirable.
  • What is needed is a biopsy device for conducting a minimally invasive biopsy procedure without the need for an incision. It is also desirable that the physician be able to take multiple tissue samples from a single biopsy site. It is further desirable for the physician to be able to identify and record the location of each sample of tissue extracted. The present invention meets the foregoing desires and provides an improved device for taking a biopsy within a mammary duct, as well as a device that facilitates memorializing in the patient's records the location of the tissue sampled.
  • SUMMARY OF THE INVENTION
  • A biopsy device embodying the present invention comprises a biopsy instrument provided with a tissue cutter suitable for collecting at least one tissue sample from a body lumen, such as a mammary duct, and a cutter introducer sized for receiving the tissue cutter and guiding the tissue cutter into a mammary duct.
  • The biopsy instrument includes a holster, a housing reciprocably mounted in the holster, and an elongated hollow cutter that extends from the housing and is driven by a cutter drive motor situated within the housing. A power connector, operably connected to a power source, is associated with the cutter drive motor. The hollow cutter rotates about a longitudinal axis thereof upon energization of the motor by activating a switch operably associated with the motor. The hollow cutter also extends distally relative to the holster when the housing is urged into the holster. An ejector assembly is removably mounted to the housing and received within the cutter. The ejector assembly includes an endoscope which is slidably received within the hollow cutter and may be extended therethrough. The endoscope serves the dual purpose of viewing the area to be biopsied, as well as serving as a piston for urging or expelling biopsied material from the cutter. A coupling mount for removably receiving the cutter introducer, such as a boss terminating in a distal, radially outwardly extending flange, is also provided on the biopsy cutter.
  • Preferably included within the housing is a power source, such as a battery, which can be a primary battery, i.e., single use, or a secondary battery, i.e., rechargeable. Alternatively, the power source may be external to the housing and the holster therefor, but operatively connected to the power connector. The housing and holster are preferably formed of a lightweight rigid plastic. The cutter is preferably formed of a lightweight metal such as stainless or surgical steel, or the like.
  • The other component of the biopsy device is the cutter introducer, which is comprised of a hollow handle, and an elongated sheath having open opposite ends, i.e., a distal end and a proximal end, mounted to the handle and adapted to receive the cutter element therewithin. A window cut-out or aperture is provided at a distal end portion of the sheath. The window or aperture preferably includes a hook portion for grasping and pulling the target tissue through the window and into the sheath. A proximal end portion of the sheath is fixed within the handle. The hollow handle further defines an axial passage leading to the sheath.
  • The handle of the cutter introducer preferably includes an integral azimuth indicator, which may be unitary with the handle. The azimuth indicator can also be a pair of azimuth indices that can be aligned vis-a-vis one another, and the like. The handle can also include a socket for receiving the coupling mount of the biopsy instrument. For example, the coupling socket on the handle may be an annular cavity which can receive the boss of the holster provided with a radially outwardly extending flange. The handle is also preferably formed of a lightweight rigid plastic. A tissue anchor extendable through the introducer is desirable in some cases. The tissue anchor can comprise a hollow hub and flexible outwardly biased tines that extend from the hub and an optional retriever rod. The tissue anchor is slidably and rotatably mounted within the sheath at the distal end portion thereof. The tines of the anchor are extendable from the open distal end of the sheath and spread radially outwardly when so extended. A distal end portion of the retriever rod, which retracts the anchor and the tines within the sheath, is configured to engage the anchor.
  • In order to obtain a tissue sample with the biopsy device from a mammary duct the cutter introducer is first inserted into a nipple orifice at the nipple surface and then advanced into the mammary duct. The endoscope may be utilized within the introducer to locate and view the biopsy site, if desired. When a tissue mass of interest is located, and the distal end portion of the sheath positioned as desired, the tines of the anchor are extended beyond the open distal end by urging the hub of the tissue anchor to slide towards the distal end. The tines are pushed through the open distal end, and because they are outwardly biased, spread out radially to contact the walls of the mammary duct and immobilize the introducer.
  • The biopsy instrument, in particular the cutter, is inserted into the introducer and extended towards the distal end portion thereof. A tissue mass from the biopsy site is received within the introducer sheath through an aperture or cut-out at the distal end portion of the introducer sheath. The motor for driving the cutter element is energized and rotates the cutter element. As the distal end of the cutter travels across the aperture, that portion of the tissue mass received within the introducer sheath is severed. The biopsy instrument is withdrawn from the introducer sheath after the desired tissue samples have been taken. The hollow cutter element receives the tissue mass within its interior, and the severed tissue is later ejected from the hollow cutter by the ejector assembly for analysis.
  • When it is desired to remove the introducer, a retriever rod may be extended through the introducer sheath to engage the hub of the tissue anchor. The retriever rod is then retracted and draws the anchor back into the sheath, thereby disengaging the tines from the mammary duct. The introducer can then be withdrawn from the mammary duct. Alternatively, the anchor can be urged past the distal end of the introducer and left in the mammary duct as a biopsy site marker or indicator.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • In the drawings,
  • FIG. 1 is a perspective view of an embodiment of a biopsy device;
  • FIG. 2 is a partial cross sectional side view of the biopsy instrument;
  • FIG. 3 is a partial cross sectional top view of the biopsy instrument of FIG. 2;
  • FIG. 4 is a cross sectional side view, partially broken, of the cutter introducer;
  • FIG. 5 is an enlarged cross sectional view of the distal end portion of the cutter introducer and the tissue anchor in a retracted position;
  • FIG. 6 is an enlarged cross sectional side view of the distal end portion of the cutter introducer with the tissue anchor in an extended position;
  • FIG. 7 is an enlarged cross sectional side view of the distal end portion of the biopsy introducer with the tissue anchor in an extended position and a retriever rod engaged with a tissue anchor latch;
  • FIG. 8 is an enlarged cross sectional side view of the distal end portion of the cutter introducer with the tissue anchor extended and engaged with a mammary duct, and a cutter within the introducer;
  • FIG. 9 is an enlarged cross sectional side view of the distal end portion of the biopsy introducer with an alternate embodiment of the tissue anchor in an extended position and equipped with a retriever rod suitable for engaging the tissue anchor;
  • FIG. 10 is a schematic of a human breast having the biopsy device inserted therein, and an azimuth marker circumscribing a breast nipple;
  • FIG. 11 is a cross sectional side view of another embodiment of a biopsy device with an ejector assembly comprising an endoscope which is shown in an extended state;
  • FIG. 12 is a cross section side view of the biopsy device of FIG. 11 with the endoscope in a retracted state;
  • FIG. 13 is a perspective view of another embodiment of a biopsy device having an endoscope;
  • FIG. 14 is an enlarged cross sectional view of the distal end portion of an embodiment of the biopsy device having a hooked window portion; and
  • FIG. 15 is an enlarged cross sectional view of the distal end portion of an embodiment of the biopsy device taking a core tissue sample.
  • DESCRIPTION OF THE PREFERRED EMBODIMENT OF THE INVENTION
  • The invention disclosed herein is susceptible of embodiment in many different forms. Shown in the drawings and described hereinbelow in detail are preferred embodiments of the invention. It is to be understood, however, that the present disclosure is an exemplification of the principles of the invention and does not limit the invention to the illustrated embodiments.
  • A preferred embodiment of a biopsy device is shown in FIG. 1. Biopsy device 10 is comprised of a biopsy instrument 12 and a cutter introducer 14 removably carried by the biopsy instrument 12 and having hollow elongated sheath 26 mounted to handle 24. The biopsy instrument 12 comprises a holster 16, a housing 18 that is slidably and reciprocably received in holster 16, and a hollow elongated cutter 42 (FIG. 2), slidably received within elongated sheath 26 of cutter introducer 14. The elongated cutter 42 is driven by cutter motor 38 (FIG. 3) within housing 18. An end cap 22, removable to access various components within the housing 18, seals the proximal end of housing 18. An on-off switch, such as button switch 45 for energizing cutter motor 38 extends from the cap 22. Elongated sheath 26 has open opposite ends, i.e., a distal end 28 and a proximal end that is mounted to handle 24. A cut-out or aperture 30 is provided at a distal end portion 32 of the sheath 26. Depth indicators 35, axially spaced from one another can also be provided on sheath 26, if desired. Handle 24 is adapted for rotatable as well as removable mounting to housing 18, and includes a pair of integrally formed azimuth indicators, in particular, distal indicator 34 and proximal indicator 36, that are axially aligned with one another.
  • The cutter or blade 42 is configured for sliding travel through the handle 24 and sheath 26 of the introducer 14. Specifically, the outer diameter of the cutter 42 is smaller than the inner diameter of the sheath 26. The cutter 42 is also sufficiently long to extend to the distal end portion 32 of the sheath, and preferably such that when fully extended, the cutter element projects beyond the aperture 30.
  • As can be seen in FIGS. 2 and 3, a power connector, such as lead 40 for cutter drive motor 38 is also included in the housing 18 and is operably associated with the cutter drive motor 38 which drives hollow cutter 42 by rotating it about the longitudinal axis of the cutter introducer 14. In particular, motor 38 drives spur gear 39, which in turn is engaged with spur gear 43 secured to the proximal end portion of cutter 42. The motor 38 can be energized by any switching mechanism available in the art. For example, a two-position switch 45 can be operatively connected in a circuit between a power source and the motor 38, preferably biased in the OFF-position. Alternatively, the switch may also be formed by a battery 38 that serves as the power source and a conductive post 71 surrounded by insulated spring 68. As the housing is moved axially into the holster, battery 38 contacts post 71 to complete an electrical circuit between the motor and the battery. Thus, power lead 67, in cooperation with conductive post 71, spring 68 and power lead 40, form an electrical circuit between the cutter drive motor 38 and the battery 54. As yet another alternative, the switch and power supply can be operably connected to the motor, but situated external to the housing. For example, a foot-operated switch can be utilized in such instances.
  • Positioned between the distal end of holster 16 and distal end of housing 18 is a return spring, such as coil spring 56. The holster 16 further defines a groove 58 through which dorsal post 60 is positioned and extends therethrough from housing 18 (FIG. 2). The ventral post 60 within the groove 58 serves as a stop to limit the longitudinal movement of the housing 18 relative to the holster 16, as well as to prevent rotational movement of the housing 18 relative to the holster 16.
  • Coil spring 56 is axially aligned with the cutter 42 in holster 16, through which cutter 42 is extended for axial reciprocation within elongated sheath 26. A hollow support or bearing 70 may also be provided within the holster 16, through which cutter 42 passes. Also provided by the holster 16 is a coupling mount 48 for removably attaching the biopsy instrument 12 to cutter introducer 14. The coupling mount 48 is preferably a boss 49 terminating in a distal, radially outwardly extending flange. Coupling mount 48 may also include an o-ring seal 51 that circumscribes boss 49.
  • A pusher rod assembly 46 includes elongated piston rod 62 and an actuator handle 63, and is removably mounted within the housing 18. The piston rod 62 is slidably received within the hollow cutter 42. The pusher rod assembly 46 is slidably positioned within housing 18, and actuator handle 63 is accessible from outside the housing for manual actuation. Further disposed within housing 18 is a pusher rod coil spring 66 biased against forward axial movement of the pusher rod assembly 46. Piston rod 62 extends from actuator handle 63 into and through cutter 42. Piston rod 62 has an outer diameter that is smaller than the inner diameter of the hollow cutter 42 such that any material within the cutter 42 is pushed out by piston rod 62 when extended. In particular, when pusher rod assembly 46 is pushed forward, piston rod 62 projects past the distal end 72 (FIG. 8) of the cutter 42, thereby clearing the hollow cutter 42 of any contents therein, such as tissue samples. Housing 18 further includes pusher stop 65 which limits the extent to which the pusher rod assembly 46 can be moved distally. The pusher rod assembly is guided by at least a holster track, defined by guide rail 75 and guide rail 77 (FIG. 1).
  • The other major component of the biopsy device is a cutter introducer removably mounted to holster 16. A cross section of a preferred embodiment of the biopsy introducer 14 is shown in FIG. 4. As discussed above, the cutter introducer 14 comprises a number of components, including hollow handle 24 and elongated sheath 26 having an aperture 30 formed at a distal end portion 32 of the sheath 26. The distal end 28 of sheath 26 preferably terminates in an atraumatic tip, such as a circumferential bevel. A proximal end portion 33 of the sheath 26 is fixed within the handle 24. An axial passage 25 is further defined by the hollow handle 24 and leads to sheath 26. Preferably the handle passage 25 is tapered so as to permit easier introduction of the cutter 42 or other instrument into the sheath 26. The handle 24 also defines an annular coupling socket 37 for rotatable mounting to coupling mount 48 of the biopsy instrument 12. In this embodiment, the socket 37 is configured to receive coupling mount 48 on holster 16 (FIGS. 2 and 3).
  • Also shown within the distal end portion 32 of sheath 26 thereof is tissue anchor 76. Tissue anchor 76 is optional and aids the operator in maintaining penetration control as indicated by depth marker 35. An externally applied nipple clamp (not shown) may be optionally employed to clamp or retain introducer sheath 26 within the nipple duct sphincter muscle, thereby also aiding in penetration control.
  • An enlarged view of the distal end portion 32 of the introducer is shown in FIGS. 5 and 6. Tissue anchor 76 comprises a hollow hub 78, flexible, outwardly biased tines 80 that extend from the hub 78, and a latch 82 which extends from the hub axially. The tissue anchor 76 is slidably and rotatably mounted within the distal end portion 32 of the sheath 26. Alternatively, tissue anchor 76 may be extended through the sheath 26 after an endoscopic viewing procedure has located the biopsy site. The anchor 76 can be partially or fully extendable through the open distal end 28 of the sheath 26, as desired. Latch 82 is configured to engage a distal end portion 86 of a retriever rod, which is discussed in further detail below.
  • Referring to FIG. 5, the tissue anchor 76 is shown in a retracted position. The tissue anchor 76 can be pushed partially through distal end 28 to extend the tines 80 until annular step 88 abuts beveled detent 90. The tissue anchor 76 may be pushed by any appropriate device, such as by an endoscope viewing assembly, push rod, or other instrument that is extendable through the sheath 26 to engage hub 78.
  • Referring to FIG. 6, the extent to which tissue anchor 76 can be extended through distal end 28 may be limited by hub 78 which includes an annular step 88, in cooperation with beveled detent 90 formed about the distal end portion 32. As the tines 80 are extended past the distal end 28, their outward bias causes the tines 80 to spread radially and engage the interior of the mammary duct (not shown). As such, the axial position of the sheath 26 within the mammary duct is secured. The hub 78, however, is sized to rotate relative to sheath 26. As such, the sheath 26 may be rotated about hub 78 within the mammary duct to reposition the circumferential orientation of aperture 30 even after the tissue anchor 76 has been engaged by manipulation of the handle 24 (FIG. 1). As will be discussed in further detail below, rotatable repositioning the aperture 30 permits collection of multiple tissue samples from the same region of a mammary duct.
  • Preferably, the annular step 88 and beveled detent 90 are contoured so that by application of additional force, the tissue anchor 76 can be urged past the distal end 28 of the sheath 26 and left in place as a marker for the biopsy site. Tactile feedback is provided to the operator by increased resistance from the interaction of annular step 88 and detent 90 when the anchor 76 is extended, but still within the sheath 26. Alternatively, tissue anchor 76 can be disengaged from sheath 26 by gently withdrawing sheath 26 from the biopsy site such that tissue anchor 76 is left behind still engaged with the mammary duct wall.
  • If it is desired to remove the anchor 76, preferably it is disengaged from the mammary duct by retraction into the sheath 26. In order to retract the anchor 76, a retriever rod 84 is introduced through the sheath 26. The retriever rod 84 includes a detent 85 for engaging the latch 82 extending from the hub 78 as shown in FIG. 7. The retriever rod 84 is then retracted from the introducer 14, thereby also retracting the anchor 76.
  • In order to obtain a tissue sample with the biopsy device 10 (FIG. 1), the cutter introducer 14 is first inserted into a mammary duct via a nipple orifice. The desired nipple orifice is first located through use of any means such as an illuminated nipple cup (not shown). A nipple orifice dilator or catheter (not shown) may be used to dilate the nipple orifice, if desired, to permit easier insertion of the introducer. An endoscope may be extended within the introducer to enable viewing of the biopsy site. When a desired mass of tissue is located, the anchor 76 is extended as described above, and as shown in FIG. 8. The hollow cutter 42 of the biopsy instrument is guided through the cutter introducer 14 and pushed towards the distal end portion 32 and the aperture 30. A tissue mass is received within the sheath 26 through the aperture or cut-out 30 at the distal end portion 32. The tissue mass can be urged into the aperture 30 by external pressure applied to the breast or alternatively with the aid of a vacuum, or by pressing the aperture against the desired biopsy area. The cutter motor 38 for driving the cutter 42 of the biopsy instrument can then be energized. Driven by motor 38, cutter 42 rotates and severs the portion of the tissue mass received within the sheath 26 as the distal end 72 of the cutter 42 travels across aperture 30. Preferably, the hollow cutter 42 receives the tissue mass within its interior. The biopsy instrument 12 is removed from the introducer 14 after the desired tissue sample is obtained, and the tissue sample is later expelled from the cutter 42 by piston rod 62 of the pusher rod assembly extending therethrough. Alternatively, the hollow cutter 42 may be operatively connected to a vacuum source for removal of the severed tissue sample through a central passageway defined by the hollow cutter 42.
  • An alternate embodiment of the tissue anchor and retriever rod are shown in FIG. 9. Anchor 91 has a configuration similar to the anchor discussed above, but includes a base 92 defining a threaded hole 93. Retriever rod 94 has a threaded distal end 95 that is threadably engageable with threaded hole 93. Anchor 91 can thereby extended to a desired degree and retracted by threadedly engaging retriever rod 94 with anchor 91 and extending or retracting the retriever rod 94.
  • To obtain multiple tissue samples from a biopsy site, and to discern the relative original locations of the tissue samples as part of the tissue analysis an azimuth marker is provided. To that end, and as illustrated in FIG. 10, an azimuth marker 98 having a plurality of circumferential marks 100, is provided and can be as part of a biopsy kit. Azimuth marker 98 is removably secured about a nipple 102, such as with a physiologically compatible pressure sensitive adhesive. The clinician notes how azimuthal indicators 34 and 36 align with circumferential marks 100 while the microendoscope is still positioned within introducer 14. The cooperation of the azimuthal indicators 34 and 36 and depth markers 35 establishes the location of the target tissue so that the microendoscope can be removed and the biopsy instrument 12 inserted. Utilizing the procedure discussed above, a tissue sample is obtained. As part of the procedure, the practitioner aligns the distal azimuthal indicator 34 and proximal azimuthal indicator 36 with a mark on the azimuth marker 98 and notes the indicator position. After a tissue sample is excised by the cutter 42, the biopsy instrument 12 is disengaged from the biopsy introducer 14. The practitioner extends the pusher rod assembly 46 by forwardly moving push rod handle 63, and thereby causing piston rod 62 (FIG. 8) to pass beyond the distal end of cutter 42 and eject the severed tissue sample. The tissue sample or samples may be collected on a collection tray having multiple recesses or numbered slots for tracking the source of the tissue sample. The biopsy instrument 12 can then be reinserted into the introducer 14, which is still held in place at the biopsy site by the tissue anchor 76, and rotated such that distal indicator 34 and proximal indicator 36 are aligned with a circumferential mark on azimuthal marker 98 different than that for prior tissue samples. In so doing, the aperture at the distal end portion of the introducer is repositioned to accept a tissue mass from a position adjacent to or near the previously excised tissue mass. The cutter then excises and retains a portion of this particular tissue. This sampling process is repeated as desired. For example, the practitioner can obtain tissue samples by aligning the distal indicator 34 and proximal indicator 36 with successive circumferential markers in a clockwise direction. Alternatively, multiple tissue samples can be obtained without retracting the biopsy instrument 12 from the introducer 14. In this case, the aperture 30 (FIG. 8) is positioned and the cutter 42 is rotated by the cutter drive motor 38 and passed across the aperture 30, which is then rotatably repositioned and the cutter is again rotated and passed across the newly positioned aperture 30. In so doing, multiple tissue samples are held within the hollow cutter 42. The cutter 42 is then removed and the multiple tissue samples ejected by the pusher rod assembly. As discussed, after the desired tissue samples are obtained, a retriever rod can be used to retract the anchor, and thereby, permit retraction of the introducer. If desired, the rod 64 of the pusher rod assembly may also serve as the retriever rod.
  • Another preferred embodiment of a biopsy device is shown in FIG. 11. Biopsy device 210 is comprised of a biopsy instrument 212 and a cutter introducer 214 removably carried by the biopsy instrument 212 and having hollow elongated sheath 226 mounted to handle 224. The cutter introducer 214 is essentially the same as described in the previous embodiment.
  • The biopsy instrument 212 comprises a holster 216, a housing 218 that is slidably and reciprocably received in holster 216, and a hollow elongated cutter 242, slidably received within elongated sheath 226 of cutter introducer 214. An ejector assembly 261 is further provided, which comprises a rocker arm, such as ejector handle member 263, a hinge member 267, and a barrel member 269. The barrel member 269 further defines a passageway 271 including a collar portion 272. The ejector assembly 261 further comprises an endoscope 262 having an adapter, such as a Tuohy fitting 276, that removably secures the endoscope to the collar portion 272 of the passageway 271. Also provided is an ejector assembly coil spring 266, which is biased against distal movement of the ejector assembly 261 towards the cutter introducer 214. Since the endoscope 262 is secured within the ejector assembly, its movement corresponds to the movement of ejector assembly 261. Operatively connected to the passageway 271 is a removable port member 273, through which solution, such as irrigation liquids may be introduced. Port member 273 is also suitable for providing a conduit for a suctioning device. A return spring, such as coil spring 256 is also provided between the housing 218 and the holster 216. Also, an on-off switch, such as button switch 245 is provided, which when actuated causes a motor to rotate cutter 242 such as described above.
  • As shown, the ejector assembly handle 263 is engaged with end cap 222, when the ejector assembly 261 is in a forward position thereby acting as a detent member. The endoscope 262 is also positioned such that its distal end 275 is extended proximate to or beyond the distal end 277 of the cutter 242. By positioning the endoscope 262 proximate the distal end 277 of the cutter 242, the practitioner is able to view the biopsy site in real time up to the time the cutting operation takes place.
  • When the practitioner is ready to begin cutting, tissue is urged through the window 230 by manipulating the patient's breast. In order to provide a collection reservoir 279, the endoscope 262 is first retracted as shown in FIG. 12. In this embodiment, the ejector assembly handle 263 is disengaged from the end cap 222 such that the ejector assembly coil spring 266 urges rearward movement of the ejector assembly 261. Accordingly, the endoscope 262 is retracted such that reservoir 279 is created in the distal end portion of the cutter 242. As discussed above, excised tissue may be collected in this reservoir 279. One benefit of the present configuration is that a practitioner can retract the endoscope 262 by fingertip control by releasing the ejector handle 263 as described.
  • Shown in FIG. 13 is another embodiment of a biopsy device having an endoscope. In many respects, biopsy device 310 is similar to the biopsy device of FIGS. 11 and 12. For example, biopsy device 310 comprises an introducer 314 and an instrument 312 having an ejector assembly (not shown) comprising an endoscope 362. One difference is the detent member used for positioning the ejector assembly and endoscope 362. In this embodiment, a rotatable hub 380 having an arm member 382 is provided with end cap 322. Hub 380 further defines a passage 384 through which endoscope 362 is passed. As before, endoscope 362 is removably secured with the ejector assembly. As shown, the arm member 382 is positioned such that the ejector assembly handle 363 is pushed up against the arm member 382 by the internal ejector assembly coil spring (not shown). With the arm member 382 so positioned, the ejector assembly and its endoscope 262 are held in the desired position within the introducer 314. Also, the housing 318 is prevented from being moved relative to the holster 316. When the practitioner is ready to begin the cutting operation, the hub 380 and arm member 382 are rotated such that the ejector assembly coil spring causes the ejector assembly to retract the endoscope such as described with the previous embodiment.
  • Referring to FIG. 14, another optional feature of the present invention is to provide a hook 431 in window 430. Since the practitioner is able, with endoscope 462 to view the desired tissue passed through window 430, the practitioner is also able to secure the tissue with hook 431. The hook 431 better enables the practitioner to maintain the position of the desired tissue within the sheath 426 during the cutting process by the cutter 442 since the hook grasps the desired tissue as shown. In addition, hook 431 is utilized to pull tissue through window 430 into sheath 426. This is accomplished by engaging tissue with the hook 431 and pulling on the tissue, which urges the tissue into the sheath 426. It is preferred that in a 0.039 inch (0.09906 centimeter) diameter stainless tube having a wall thickness of 0.0025 inches (0.00635 centimeter) that the hook have a depth of between one-third and one-half the tube diameter, or in this example, 0.13 to 0.185 inches (0.3302 to 0.4699 centimeters). It is most desired that the hook depth be about one-half the tube diameter. The hook 431 readily grasps the soft duct wall and pulls tissue into the cutter window 430 and supports the tissue such that its position within the window 430 is maintained as the cutter 442 is advanced. As pressure is increased, the hook 431 either pierces the tissue and thereafter begins tearing it off or the tissue slips off the hook 431. Since the practitioner is able to view the biopsy site in real time with the endoscope 462, the practitioner is able to best determine the amount of pulling force to exert without tearing the tissue, and to see when to advance the cutter 442. The viewing capability of the endoscope with the cutter in position to be activated for the cutting procedure also provides the practitioner with great flexibility in the size of the sample taken. For example, if the practitioner wishes to take a relatively small sample, the hook 431 is merely utilized to grasp tissue. On the other hand, if a larger tissue sample is desired, additional pressure is utilized so the hook pulls more tissue within the window 430. Given the relatively small difference between the amount of pressure being exerted in these two situations, as discussed above, the real time visual inspection through the endoscope 462 allows such a procedure to take place.
  • While it has been found that a deeper hook depth is generally more advantageous, various factor constrain the hook depth, including the marginal strength of the material forming the introducer, the wall thickness, and the outside diameter of the tube. This is because the hooking process causes a shaft deflection which may cause the advancing cutter to catch the hook causing damage thereto. Therefore, as little shaft deflection as possible is desired, and the dimensions described above provide satisfactory results.
  • It is also preferred that the window 430 be relatively long. In the example being discussed of a 0.039 inch (0.09906 centimeter) diameter stainless tube having a wall thickness of 0.0025 inches (0.00635 centimeter), and hook depth of 0.13 to 0.185 inches (0.3302 to 0.4699 centimeters), it is preferred that the window have a length of greater than 0.197 inches (0.5 centimeter). The longer window 430 allows a desired amount of tissue to be pulled therein by hook 431.
  • Yet another type of sampling that is possible with the present biopsy device is shown in FIG. 15. In addition to the sampling by urging tissue through a window and excising this tissue as discussed thus far, the biopsy device may in some embodiments also act as a core type cutter. For example, the distal end 577 of cutter 542 can be urged beyond the distal end portion 532 of the sheath 526 to cut core samples of tissue. As shown, endoscope 562 can be utilized by the practitioner to view the coring procedure.
  • Preferably, the distal end 577 of the cutter 542 has an inner diameter that is 90% to 95% of inner diameter of the rest of the cutter 542. It has been found that a fully parallel cutter sometimes results in a core sample that remains attached to the patient. The reduced diameter distal end 542 creates a packing feature, which will tend to pull the tissue and tear away from the uncut end. In other words, after the cutter has cut tissue, the endoscope is advanced to slightly compact the tissue against the distal end within the cutter to aid in sample removal. Another alternative method is to insert a sharpened forward moving pin into the cutter after the core is cut by removing the endoscope. The moving pin acts to wedge the tissue sample within the cutter to aid in sample removal.
  • The foregoing descriptions are to be taken as illustrative, but not limiting. Still other variants within the spirit and scope of the present invention will readily present themselves to those skilled in the art.

Claims (22)

1. A biopsy device suitable for collection of a tissue sample from a biopsy site in a body lumen, the biopsy device comprising:
a cutter introducer comprising an elongated, hollow sheath, the sheath rotatable about a longitudinal axis having a distal end portion and a proximal end portion, wherein the distal end portion defines an aperture for receiving a tissue mass, and a hollow handle about the proximal end portion of the sheath;
a biopsy instrument comprising an elongated cutter for severing the tissue sample, received through the aperture, the cutter element being sized for removable insertion in the cutter introducer; and
an endoscope, the endoscope being sized for removable insertion in the elongated cutter and having a distal end portion movably positionable proximate the aperture.
2. The biopsy device of claim 1, wherein the cutter is motor driven and the motor is actuated by a switch.
3. The biopsy device of claim 1, further comprising an ejector assembly, the ejector assembly including the endoscope which is suitable for ejecting the tissue sample from the cutter.
4. The biopsy device of claim 3, wherein the ejector assembly further comprises a detent member to restrict axial movement of the ejector assembly relative to the biopsy instrument.
5. The biopsy device of claim 4, wherein the detent member comprises a rotatable hub.
6. The biopsy device of claim 4, wherein the detent member comprises a rocker arm.
7. The biopsy device of claim 1, wherein the sheath further includes spaced depth indicators thereon.
8. The biopsy device of claim 1, further comprising a port member suitable for permitting the introduction of a solution to the biopsy site.
9. The biopsy device of claim 1, wherein the aperture comprises a hook portion.
10. The biopsy device of claim 9, wherein sheath has an inner diameter and the hook portion has a hook depth in a range of ⅓ to ½ the inner diameter.
11. The biopsy device of claim 9, wherein the aperture has a length greater than 0.197 inches (0.5 centimeter).
12. A biopsy device suitable for collection of at least one tissue sample from a biopsy site in a lumen, the biopsy device comprising:
a holster;
a housing reciprocably mounted with the holster;
a cutter drive motor in the housing;
a power source operably associated with the cutter drive motor;
a switch operably associated with the motor and the power source for energizing the cutter drive motor;
a hollow cutter driven by the cutter drive motor and rotatably mounted in the housing;
an endoscope removably mounted to the housing and slidably receivable within the hollow cutter; and
a coupling mount on the holster for removably receiving a biopsy introducer, the introducer comprising an elongated, apertured hollow sheath having a distal end portion and a proximal end portion, wherein the distal end portion defines an aperture for receiving the tissue sample.
13. The biopsy device of claim 12, wherein the power source is situated within the housing.
14. The biopsy device of claim 13, wherein the power source is a battery.
15. The biopsy device of claim 12, wherein the coupling mount is a boss terminating in an distal, radially outwardly extending flange.
16. The biopsy device of claim 12, further comprising an ejector assembly, the ejector assembly including the endoscope which is suitable for ejecting the tissue sample from the cutter.
17. The biopsy device of claim 16, wherein the ejector assembly comprises a detent member to restrict axial movement of the ejector assembly relative to the housing.
18. The biopsy device of claim 17, wherein the detent member comprises a rotatable hub.
19. The biopsy device of claim 17, wherein the detent member comprises a rocker arm.
20. A biopsy device suitable for collection of at least one tissue sample from a biopsy site in a lumen, the biopsy device comprising an introducer and an instrument:
the instrument further comprising:
a holster and a housing reciprocably mounted to the holster;
a cutter drive motor in the housing;
a power source operably associated with the cutter drive motor, the cutter drive motor and power source being operatively connected to a switch for energizing the cutter drive motor;
an elongated hollow cutter driven by the cutter drive motor and rotatably mounted in the housing;
an ejector assembly suitable for ejecting the tissue sample from the cutter, the ejector assembly including an endoscope piston removably mounted with the housing and slidably receivable within the hollow cutter; and
a coupling mount on the holster for removably receiving the introducer;
the introducer further comprising an elongated, hollow sheath having a distal end portion and a proximal end portion, wherein the distal end portion defines an aperture for receiving the tissue sample, the aperture comprising a hook portion, the sheath suitable for removably receiving the cutter therein.
21. The biopsy device of claim 20, wherein sheath has an inner diameter and the hook portion has a hook depth in a range of ⅓ to ½ the inner diameter.
22. The biopsy device of claim 20, wherein the aperture has a length greater than 0.197 inches (0.5 centimeter).
US11/028,131 2003-04-24 2005-01-03 Biopsy device having endoscope Abandoned US20050113716A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US11/028,131 US20050113716A1 (en) 2003-04-24 2005-01-03 Biopsy device having endoscope

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/422,381 US7311673B2 (en) 2003-04-24 2003-04-24 Biopsy device
US11/028,131 US20050113716A1 (en) 2003-04-24 2005-01-03 Biopsy device having endoscope

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US10/422,381 Continuation-In-Part US7311673B2 (en) 2003-04-24 2003-04-24 Biopsy device

Publications (1)

Publication Number Publication Date
US20050113716A1 true US20050113716A1 (en) 2005-05-26

Family

ID=33298870

Family Applications (2)

Application Number Title Priority Date Filing Date
US10/422,381 Expired - Fee Related US7311673B2 (en) 2003-04-24 2003-04-24 Biopsy device
US11/028,131 Abandoned US20050113716A1 (en) 2003-04-24 2005-01-03 Biopsy device having endoscope

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US10/422,381 Expired - Fee Related US7311673B2 (en) 2003-04-24 2003-04-24 Biopsy device

Country Status (2)

Country Link
US (2) US7311673B2 (en)
WO (1) WO2004096011A2 (en)

Cited By (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060167379A1 (en) * 2002-05-31 2006-07-27 Miller Larry J Apparatus and method to access the bone marrow for oncology and stem cell applications
US20060235298A1 (en) * 2005-03-31 2006-10-19 Robert Kotmel Internal biopsy marking
US20090118639A1 (en) * 2007-11-01 2009-05-07 Tyco Healthcare Group Lp Active Stylet Safety Shield
US20090125035A1 (en) * 2007-11-14 2009-05-14 Kennedy John S Surgical Cutting Instrument for Breast Surgery
US20090182366A1 (en) * 2007-11-14 2009-07-16 Kennedy John S Surgical Instrument for Detecting, Isolating and Excising Tumors
US7654735B2 (en) 2005-11-03 2010-02-02 Covidien Ag Electronic thermometer
US7731692B2 (en) 2005-07-11 2010-06-08 Covidien Ag Device for shielding a sharp tip of a cannula and method of using the same
US7811260B2 (en) 2002-05-31 2010-10-12 Vidacare Corporation Apparatus and method to inject fluids into bone marrow and other target sites
US7815642B2 (en) 2004-01-26 2010-10-19 Vidacare Corporation Impact-driven intraosseous needle
US7828773B2 (en) 2005-07-11 2010-11-09 Covidien Ag Safety reset key and needle assembly
US7850620B2 (en) 2002-05-31 2010-12-14 Vidacare Corporation Biopsy devices and related methods
US7850650B2 (en) 2005-07-11 2010-12-14 Covidien Ag Needle safety shield with reset
US7905857B2 (en) 2005-07-11 2011-03-15 Covidien Ag Needle assembly including obturator with safety reset
US7951089B2 (en) 2002-05-31 2011-05-31 Vidacare Corporation Apparatus and methods to harvest bone and bone marrow
US20110144533A1 (en) * 2009-12-15 2011-06-16 Rafal Chudzik Introducer cannula having a tissue anchor for use with a medical instrument
USD640977S1 (en) 2009-09-25 2011-07-05 C. R. Bard, Inc. Charging station for a battery operated biopsy device
US8002713B2 (en) 2002-03-19 2011-08-23 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US8012102B2 (en) 2005-01-31 2011-09-06 C. R. Bard, Inc. Quick cycle biopsy system
US8016772B2 (en) 2002-03-19 2011-09-13 C. R. Bard, Inc. Biopsy device for removing tissue specimens using a vacuum
US8052615B2 (en) 2004-07-09 2011-11-08 Bard Peripheral Vascular, Inc. Length detection system for biopsy device
US8142365B2 (en) 2002-05-31 2012-03-27 Vidacare Corporation Apparatus and method for accessing the bone marrow of the sternum
US8162851B2 (en) 2003-03-29 2012-04-24 C. R. Bard, Inc. Biopsy needle system having a pressure generating unit
US8251917B2 (en) 2006-08-21 2012-08-28 C. R. Bard, Inc. Self-contained handheld biopsy needle
US8262586B2 (en) 2006-10-24 2012-09-11 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US8262585B2 (en) 2005-08-10 2012-09-11 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device with linear drive
US8267868B2 (en) 2005-08-10 2012-09-18 C. R. Bard, Inc. Single-insertion, multiple sample biopsy device with integrated markers
US8282574B2 (en) 2005-08-10 2012-10-09 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US8419683B2 (en) 2004-11-12 2013-04-16 Vidacare Corporation Intraosseous device and methods for accessing bone marrow in the sternum and other target areas
US8430824B2 (en) 2009-10-29 2013-04-30 Bard Peripheral Vascular, Inc. Biopsy driver assembly having a control circuit for conserving battery power
US8454532B2 (en) 2007-12-27 2013-06-04 Devicor Medical Products, Inc. Clutch and valving system for tetherless biopsy device
US8485989B2 (en) 2009-09-01 2013-07-16 Bard Peripheral Vascular, Inc. Biopsy apparatus having a tissue sample retrieval mechanism
US8485987B2 (en) 2006-10-06 2013-07-16 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US8597206B2 (en) 2009-10-12 2013-12-03 Bard Peripheral Vascular, Inc. Biopsy probe assembly having a mechanism to prevent misalignment of components prior to installation
US8597205B2 (en) 2007-12-20 2013-12-03 C. R. Bard, Inc. Biopsy device
US8641715B2 (en) 2002-05-31 2014-02-04 Vidacare Corporation Manual intraosseous device
US8656929B2 (en) 2002-05-31 2014-02-25 Vidacare Corporation Medical procedures trays and related methods
US8668698B2 (en) 2002-05-31 2014-03-11 Vidacare Corporation Assembly for coupling powered driver with intraosseous device
US8690791B2 (en) 2002-05-31 2014-04-08 Vidacare Corporation Apparatus and method to access the bone marrow
US8690793B2 (en) 2009-03-16 2014-04-08 C. R. Bard, Inc. Biopsy device having rotational cutting
US8708929B2 (en) 2009-04-15 2014-04-29 Bard Peripheral Vascular, Inc. Biopsy apparatus having integrated fluid management
US8834417B2 (en) 2005-06-06 2014-09-16 Covidien Ag Needle assembly with removable depth stop
US8845548B2 (en) 2009-06-12 2014-09-30 Devicor Medical Products, Inc. Cutter drive assembly for biopsy device
US8944069B2 (en) 2006-09-12 2015-02-03 Vidacare Corporation Assemblies for coupling intraosseous (IO) devices to powered drivers
US8974410B2 (en) 2006-10-30 2015-03-10 Vidacare LLC Apparatus and methods to communicate fluids and/or support intraosseous devices
US9072506B1 (en) 2009-09-02 2015-07-07 C. R. Bard, Inc. Biopsy apparatus including a biopsy device having a sample receiving notch with a tissue anchor
US9072543B2 (en) 2002-05-31 2015-07-07 Vidacare LLC Vascular access kits and methods
US9173641B2 (en) 2009-08-12 2015-11-03 C. R. Bard, Inc. Biopsy apparatus having integrated thumbwheel mechanism for manual rotation of biopsy cannula
US9314228B2 (en) 2002-05-31 2016-04-19 Vidacare LLC Apparatus and method for accessing the bone marrow
CN105496346A (en) * 2016-01-20 2016-04-20 广州普露医疗科技有限公司 Vagina examining and sampling instrument
US9433400B2 (en) 2004-01-26 2016-09-06 Vidacare LLC Manual intraosseous device
US9439667B2 (en) 2002-05-31 2016-09-13 Vidacare LLC Apparatus and methods to install, support and/or monitor performance of intraosseous devices
US9451968B2 (en) 2002-05-31 2016-09-27 Vidacare LLC Powered drivers, intraosseous devices and methods to access bone marrow
US9504477B2 (en) 2003-05-30 2016-11-29 Vidacare LLC Powered driver
US9504829B2 (en) 2013-11-08 2016-11-29 Nuvectra Corporation Implantable medical lead with collapsible fixation member
US9510910B2 (en) 2006-09-12 2016-12-06 Vidacare LLC Medical procedures trays and related methods
US9545243B2 (en) 2002-05-31 2017-01-17 Vidacare LLC Bone marrow aspiration devices and related methods
US10285673B2 (en) 2013-03-20 2019-05-14 Bard Peripheral Vascular, Inc. Biopsy device
US10456120B2 (en) 2013-11-05 2019-10-29 C. R. Bard, Inc. Biopsy device having integrated vacuum
US10463350B2 (en) 2015-05-01 2019-11-05 C. R. Bard, Inc. Biopsy device
US10945713B2 (en) 2016-11-23 2021-03-16 C. R. Bard, Inc. Single insertion multiple sample biopsy apparatus
US10973532B2 (en) 2002-05-31 2021-04-13 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US10973545B2 (en) 2002-05-31 2021-04-13 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US20210121163A1 (en) * 2016-04-29 2021-04-29 Devicor Medical Products, Inc. Tissue sample holder with enhanced features
US11116483B2 (en) 2017-05-19 2021-09-14 Merit Medical Systems, Inc. Rotating biopsy needle
US11134830B2 (en) 2016-12-27 2021-10-05 Boston Scientific Scimed, Inc. Medical device delivery system and methods of use
US20220015787A1 (en) * 2020-07-16 2022-01-20 Endogear Llc Grasping Device For Independent Tissue Manipulation During Gastrointestinal Endoscopic Procedures And Methods Of Use
US11298202B2 (en) 2002-05-31 2022-04-12 Teleflex Life Sciences Limited Biopsy devices and related methods
US11337728B2 (en) 2002-05-31 2022-05-24 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US11793498B2 (en) 2017-05-19 2023-10-24 Merit Medical Systems, Inc. Biopsy needle devices and methods of use
US11844500B2 (en) 2017-05-19 2023-12-19 Merit Medical Systems, Inc. Semi-automatic biopsy needle device and methods of use

Families Citing this family (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE20305093U1 (en) 2003-03-29 2003-09-11 Heske Norbert F Coaxial cannula with sealing element
ITBO20040532A1 (en) * 2004-08-26 2004-11-26 Aticarta S P A RIGID WRAPPING FOR SMOKING ITEMS WITH HINGED COVER CONNECTED BY GLUING
US20060224082A1 (en) 2005-04-05 2006-10-05 Vetter James W Methods and devices for removing tissue from a patient and placing a marker in the patient
US20080262524A1 (en) * 2007-04-19 2008-10-23 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Systems and methods for closing of fascia
US8449478B2 (en) * 2008-05-16 2013-05-28 Conquest Medical Technologies Biopsy device
US20100160822A1 (en) * 2008-12-18 2010-06-24 Parihar Shailendra K Biopsy Device with Detachable Needle
US8366635B2 (en) 2008-12-18 2013-02-05 Devicor Medical Products, Inc. Biopsy probe and targeting set interface
US7862518B2 (en) * 2008-12-18 2011-01-04 Devicor Medical Products, Inc. Biopsy device with telescoping cutter cover
US8167815B2 (en) * 2008-12-18 2012-05-01 Devicor Medical Products, Inc. Biopsy device with retractable cutter
US7846109B2 (en) * 2008-12-18 2010-12-07 Devicor Medical Products, Inc. Biopsy device with sliding cutter cover
US20100241028A1 (en) * 2008-12-19 2010-09-23 Superdimension, Ltd. Navigable Tissue Treatment Tools
EP2934340B1 (en) * 2012-12-19 2023-09-27 Merit Medical Systems, Inc. Biopsy device
CA2890479C (en) 2013-01-18 2022-11-29 Merit Medical Systems, Inc. Impact biopsy device and method of use
EP3094262B1 (en) 2014-01-17 2019-07-03 Merit Medical Systems, Inc. Flush cut biopsy needle assembly
USD736923S1 (en) 2014-01-17 2015-08-18 Merit Medical Systems, Inc. Impact biopsy device
US11191938B2 (en) 2014-01-21 2021-12-07 Merit Medical Systems, Inc. Introducer sheath and methods
US9675371B2 (en) * 2014-03-03 2017-06-13 The Spectranetics Corporation Dilator sheath set
US10390806B2 (en) 2014-03-28 2019-08-27 Covidien Lp Devices, systems, and methods for obtaining a tissue sample using a biopsy tool
CA2975391A1 (en) 2015-02-26 2016-09-01 Merit Medical Systems, Inc. Multilayered vascular prosthesis and methods
AU2016226430B2 (en) 2015-03-04 2021-02-11 Merit Medical Systems, Inc. Dampened biopsy device and method of use
US10695038B2 (en) 2015-04-20 2020-06-30 Covidien Lp Devices, systems, and methods for obtaining a tissue sample
WO2018005962A1 (en) * 2016-07-01 2018-01-04 Devicor Medical Products, Inc. Integrated workflow for processing tissue samples from breast biopsy procedures
US20200029948A1 (en) * 2018-07-26 2020-01-30 Intuitive Surgical Operations, Inc. Systems and methods of steerable elongate device
CN111904622A (en) * 2020-07-31 2020-11-10 青岛市中心医院 Breast tumor positioning device
WO2023097284A1 (en) * 2021-11-24 2023-06-01 Bard Peripheral Vascular, Inc. Vacuum assisted biopsy device with valve-controlled venting and integrated marker delivery

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4620547A (en) * 1983-12-31 1986-11-04 Richard Wolf Gmbh Instrument for sampling tissue specimens
US4651753A (en) * 1984-10-12 1987-03-24 Jayco Pharmaceuticals Endoscopic multiple biopsy instrument
US4958625A (en) * 1989-07-18 1990-09-25 Boston Scientific Corporation Biopsy needle instrument
US5383859A (en) * 1992-02-06 1995-01-24 Sewell, Jr.; Frank Rotatable laparoscopic puncturing instrument
US5409013A (en) * 1989-11-06 1995-04-25 Mectra Labs, Inc. Tissue removal assembly
US5916175A (en) * 1996-01-26 1999-06-29 Allegiance Corporation Biopsy needle appliance and inserting guide with adjustable sample length and/or needle cutting stroke
US5916229A (en) * 1996-02-07 1999-06-29 Evans; Donald Rotating needle biopsy device and method
US6241744B1 (en) * 1998-08-14 2001-06-05 Fox Hollow Technologies, Inc. Apparatus for deploying a guidewire across a complex lesion
US6638235B2 (en) * 2000-11-06 2003-10-28 Suros Surgical Systems, Inc. Biopsy apparatus
US20040127767A1 (en) * 2002-12-30 2004-07-01 Fleener Richard P. Flexible endoscope capsule

Family Cites Families (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4781186A (en) * 1984-05-30 1988-11-01 Devices For Vascular Intervention, Inc. Atherectomy device having a flexible housing
US4926858A (en) * 1984-05-30 1990-05-22 Devices For Vascular Intervention, Inc. Atherectomy device for severe occlusions
US4979951A (en) * 1984-05-30 1990-12-25 Simpson John B Atherectomy device and method
USRE33569E (en) * 1986-02-28 1991-04-09 Devices For Vascular Intervention, Inc. Single lumen atherectomy catheter device
US5047040A (en) * 1987-11-05 1991-09-10 Devices For Vascular Intervention, Inc. Atherectomy device and method
US5053044A (en) * 1988-01-11 1991-10-01 Devices For Vascular Intervention, Inc. Catheter and method for making intravascular incisions
US5441510A (en) * 1993-09-01 1995-08-15 Technology Development Center Bi-axial cutter apparatus for catheter
US5571130A (en) * 1994-10-04 1996-11-05 Advanced Cardiovascular Systems, Inc. Atherectomy and prostectomy system
US5706812A (en) * 1995-11-24 1998-01-13 Diagnostic Instruments, Inc. Stereotactic MRI breast biopsy coil and method for use
US6749576B2 (en) * 1996-01-26 2004-06-15 Allegiance Corporation Biopsy device with adjustable sampling
US6022362A (en) * 1998-09-03 2000-02-08 Rubicor Medical, Inc. Excisional biopsy devices and methods
US6936014B2 (en) * 2002-10-16 2005-08-30 Rubicor Medical, Inc. Devices and methods for performing procedures on a breast
US6086544A (en) * 1999-03-31 2000-07-11 Ethicon Endo-Surgery, Inc. Control apparatus for an automated surgical biopsy device
US6120462A (en) * 1999-03-31 2000-09-19 Ethicon Endo-Surgery, Inc. Control method for an automated surgical biopsy device
US6514215B1 (en) * 1999-10-13 2003-02-04 Pentax Corporation Endoscopic tissue collecting instrument
US6432065B1 (en) * 1999-12-17 2002-08-13 Ethicon Endo-Surgery, Inc. Method for using a surgical biopsy system with remote control for selecting and operational mode
US6302852B1 (en) * 2000-04-25 2001-10-16 Manan Medical Products, Inc. Bone marrow biopsy device
US6432064B1 (en) * 2001-04-09 2002-08-13 Ethicon Endo-Surgery, Inc. Biopsy instrument with tissue marking element

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4620547A (en) * 1983-12-31 1986-11-04 Richard Wolf Gmbh Instrument for sampling tissue specimens
US4651753A (en) * 1984-10-12 1987-03-24 Jayco Pharmaceuticals Endoscopic multiple biopsy instrument
US4958625A (en) * 1989-07-18 1990-09-25 Boston Scientific Corporation Biopsy needle instrument
US5409013A (en) * 1989-11-06 1995-04-25 Mectra Labs, Inc. Tissue removal assembly
US5383859A (en) * 1992-02-06 1995-01-24 Sewell, Jr.; Frank Rotatable laparoscopic puncturing instrument
US5916175A (en) * 1996-01-26 1999-06-29 Allegiance Corporation Biopsy needle appliance and inserting guide with adjustable sample length and/or needle cutting stroke
US5916229A (en) * 1996-02-07 1999-06-29 Evans; Donald Rotating needle biopsy device and method
US6241744B1 (en) * 1998-08-14 2001-06-05 Fox Hollow Technologies, Inc. Apparatus for deploying a guidewire across a complex lesion
US6638235B2 (en) * 2000-11-06 2003-10-28 Suros Surgical Systems, Inc. Biopsy apparatus
US20040127767A1 (en) * 2002-12-30 2004-07-01 Fleener Richard P. Flexible endoscope capsule

Cited By (182)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8002713B2 (en) 2002-03-19 2011-08-23 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US11382608B2 (en) 2002-03-19 2022-07-12 C. R. Bard, Inc. Disposable biopsy unit
US10335128B2 (en) 2002-03-19 2019-07-02 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US10271827B2 (en) 2002-03-19 2019-04-30 C. R. Bard, Inc. Disposable biopsy unit
US9439631B2 (en) 2002-03-19 2016-09-13 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US9421002B2 (en) 2002-03-19 2016-08-23 C. R. Bard, Inc. Disposable biopsy unit
US9072502B2 (en) 2002-03-19 2015-07-07 C. R. Bard, Inc. Disposable biopsy unit
US8951209B2 (en) 2002-03-19 2015-02-10 C. R. Bard, Inc. Biopsy device and insertable biopsy needle module
US8172773B2 (en) 2002-03-19 2012-05-08 C. R. Bard, Inc. Biopsy device and biopsy needle module that can be inserted into the biopsy device
US8109885B2 (en) 2002-03-19 2012-02-07 C. R. Bard, Inc. Biopsy device for removing tissue specimens using a vacuum
US8052614B2 (en) 2002-03-19 2011-11-08 C. R. Bard, Inc. Biopsy device having a vacuum pump
US8016772B2 (en) 2002-03-19 2011-09-13 C. R. Bard, Inc. Biopsy device for removing tissue specimens using a vacuum
US9072543B2 (en) 2002-05-31 2015-07-07 Vidacare LLC Vascular access kits and methods
US8656929B2 (en) 2002-05-31 2014-02-25 Vidacare Corporation Medical procedures trays and related methods
US7850620B2 (en) 2002-05-31 2010-12-14 Vidacare Corporation Biopsy devices and related methods
US9393031B2 (en) 2002-05-31 2016-07-19 Vidacare LLC Apparatus and method to provide emergency access to bone marrow
US9439667B2 (en) 2002-05-31 2016-09-13 Vidacare LLC Apparatus and methods to install, support and/or monitor performance of intraosseous devices
US7951089B2 (en) 2002-05-31 2011-05-31 Vidacare Corporation Apparatus and methods to harvest bone and bone marrow
US20060167378A1 (en) * 2002-05-31 2006-07-27 Miller Larry J Apparatus and method to access the bone marrow for oncology and stem cell applications
US11337728B2 (en) 2002-05-31 2022-05-24 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US9451968B2 (en) 2002-05-31 2016-09-27 Vidacare LLC Powered drivers, intraosseous devices and methods to access bone marrow
US9545243B2 (en) 2002-05-31 2017-01-17 Vidacare LLC Bone marrow aspiration devices and related methods
US9078637B2 (en) 2002-05-31 2015-07-14 Vidacare LLC Apparatus and methods to harvest bone and bone marrow
US7811260B2 (en) 2002-05-31 2010-10-12 Vidacare Corporation Apparatus and method to inject fluids into bone marrow and other target sites
US8038664B2 (en) 2002-05-31 2011-10-18 Vidacare Corporation Apparatus and method to inject fluids into bone marrow and other target sites
US9717847B2 (en) 2002-05-31 2017-08-01 Teleflex Medical Devices S.Àr.L. Apparatus and method to inject fluids into bone marrow and other target sites
US20060167379A1 (en) * 2002-05-31 2006-07-27 Miller Larry J Apparatus and method to access the bone marrow for oncology and stem cell applications
US7699850B2 (en) 2002-05-31 2010-04-20 Vidacare Corporation Apparatus and method to access bone marrow
US11324521B2 (en) 2002-05-31 2022-05-10 Teleflex Life Sciences Limited Apparatus and method to access bone marrow
US8142365B2 (en) 2002-05-31 2012-03-27 Vidacare Corporation Apparatus and method for accessing the bone marrow of the sternum
US8992535B2 (en) 2002-05-31 2015-03-31 Vidacare LLC Apparatus and method to provide emergency access to bone marrow
US9314228B2 (en) 2002-05-31 2016-04-19 Vidacare LLC Apparatus and method for accessing the bone marrow
US9872703B2 (en) 2002-05-31 2018-01-23 Teleflex Medical Devices S.Àr.L. Vascular access kits and methods
US7670328B2 (en) 2002-05-31 2010-03-02 Vidacare Corporation Apparatus and method to provide emergency access to bone marrow
US11298202B2 (en) 2002-05-31 2022-04-12 Teleflex Life Sciences Limited Biopsy devices and related methods
US11291472B2 (en) 2002-05-31 2022-04-05 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US11266441B2 (en) 2002-05-31 2022-03-08 Teleflex Life Sciences Limited Penetrator assembly for accessing bone marrow
US11234683B2 (en) 2002-05-31 2022-02-01 Teleflex Life Sciences Limited Assembly for coupling powered driver with intraosseous device
US10016217B2 (en) 2002-05-31 2018-07-10 Teleflex Medical Devices S.À.R.L. Apparatus and methods to install, support and/or monitor performance of intraosseous devices
US9295487B2 (en) 2002-05-31 2016-03-29 Vidacare LLC Apparatus and method to inject fluids into bone marrow and other target sites
US11103282B1 (en) 2002-05-31 2021-08-31 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US8308693B2 (en) 2002-05-31 2012-11-13 Vidacare Corporation Bone penetrating needle with angled ports
US8876826B2 (en) 2002-05-31 2014-11-04 Vidacare Corporation Apparatus and method to access bone marrow
US11103281B2 (en) 2002-05-31 2021-08-31 Teleflex Life Sciences Limited Apparatus and methods to install, support and/or monitor performance of intraosseous devices
US10166332B2 (en) 2002-05-31 2019-01-01 Teleflex Medical Devices S.À R.L. Apparatus to inject fluids into bone marrow and other target sites
US10245010B2 (en) 2002-05-31 2019-04-02 Teleflex Medical Devices S.A.R.L Assembly for coupling powered driver with intraosseous device
US20080015467A1 (en) * 2002-05-31 2008-01-17 Miller Larry J Apparatus and Method to Access the Bone Marrow for Oncology and Stem Cell Applications
US11065382B2 (en) 2002-05-31 2021-07-20 Teleflex Life Sciences Limited Apparatus to inject fluids into bone marrow and other target sites
US10973545B2 (en) 2002-05-31 2021-04-13 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US8480632B2 (en) 2002-05-31 2013-07-09 Vidacare Corporation Cartridge apparatus for injecting fluids into bone
US10973532B2 (en) 2002-05-31 2021-04-13 Teleflex Life Sciences Limited Powered drivers, intraosseous devices and methods to access bone marrow
US10893875B2 (en) 2002-05-31 2021-01-19 Teleflex Life Sciences Limited Apparatus to access bone marrow
US8506568B2 (en) 2002-05-31 2013-08-13 Vidacare Corporation Apparatus and method to access bone marrow
US10413282B2 (en) 2002-05-31 2019-09-17 Teleflex Medical Devices S.Àr.L. Apparatus and methods to harvest bone and bone marrow
US10806491B2 (en) 2002-05-31 2020-10-20 Teleflex Life Sciences Limited Vascular access kits and methods
US10595896B2 (en) 2002-05-31 2020-03-24 Teleflex Life Sciences Limited Apparatus for accessing bone marrow including depth control mechanism
US8641715B2 (en) 2002-05-31 2014-02-04 Vidacare Corporation Manual intraosseous device
US9314270B2 (en) 2002-05-31 2016-04-19 Vidacare LLC Apparatus and method to access bone marrow
US8668698B2 (en) 2002-05-31 2014-03-11 Vidacare Corporation Assembly for coupling powered driver with intraosseous device
US8684978B2 (en) 2002-05-31 2014-04-01 Vidacare Corporation Apparatus and method to inject fluids into bone marrow and other target sites
US8690791B2 (en) 2002-05-31 2014-04-08 Vidacare Corporation Apparatus and method to access the bone marrow
US10512474B2 (en) 2002-05-31 2019-12-24 Teleflex Medical Devices S.À R.L. Powered drivers, intraosseous devices and methods to access bone marrow
US8715287B2 (en) 2002-05-31 2014-05-06 Vidacare Corporation Apparatus and method to provide emergency access to bone marrow
US10456149B2 (en) 2002-05-31 2019-10-29 Teleflex Medical Devices S.À R.L. Apparatus and method to access bone marrow
US10492830B2 (en) 2002-05-31 2019-12-03 Teleflex Medical Devices S.À R.L. Penetrator assembly for accessing bone marrow
US8162851B2 (en) 2003-03-29 2012-04-24 C. R. Bard, Inc. Biopsy needle system having a pressure generating unit
US8728004B2 (en) 2003-03-29 2014-05-20 C.R. Bard, Inc. Biopsy needle system having a pressure generating unit
US10052111B2 (en) 2003-05-30 2018-08-21 Teleflex Medical Devices S.À R.L. Powered driver
US9504477B2 (en) 2003-05-30 2016-11-29 Vidacare LLC Powered driver
US8870872B2 (en) 2004-01-26 2014-10-28 Vidacare Corporation Impact-driven intraosseous needle
US9433400B2 (en) 2004-01-26 2016-09-06 Vidacare LLC Manual intraosseous device
US7815642B2 (en) 2004-01-26 2010-10-19 Vidacare Corporation Impact-driven intraosseous needle
US10166011B2 (en) 2004-07-09 2019-01-01 Bard Peripheral Vascular, Inc. Transport system for biopsy device
US9872672B2 (en) 2004-07-09 2018-01-23 Bard Peripheral Vascular, Inc. Length detection system for biopsy device
US8052615B2 (en) 2004-07-09 2011-11-08 Bard Peripheral Vascular, Inc. Length detection system for biopsy device
US8366636B2 (en) 2004-07-09 2013-02-05 Bard Peripheral Vascular, Inc. Firing system for biopsy device
US8864680B2 (en) 2004-07-09 2014-10-21 Bard Peripheral Vascular, Inc. Transport system for biopsy device
US9456809B2 (en) 2004-07-09 2016-10-04 Bard Peripheral Vascular, Inc. Tissue sample flushing system for biopsy device
US8926527B2 (en) 2004-07-09 2015-01-06 Bard Peripheral Vascular, Inc. Tissue sample flushing system for biopsy device
US8992440B2 (en) 2004-07-09 2015-03-31 Bard Peripheral Vascular, Inc. Length detection system for biopsy device
US9345458B2 (en) 2004-07-09 2016-05-24 Bard Peripheral Vascular, Inc. Transport system for biopsy device
US10499888B2 (en) 2004-07-09 2019-12-10 Bard Peripheral Vascular, Inc. Tissue sample flushing system for biopsy device
US8157744B2 (en) 2004-07-09 2012-04-17 Bard Peripheral Vascular, Inc. Tissue sample flushing system for biopsy device
US8419683B2 (en) 2004-11-12 2013-04-16 Vidacare Corporation Intraosseous device and methods for accessing bone marrow in the sternum and other target areas
US8998848B2 (en) 2004-11-12 2015-04-07 Vidacare LLC Intraosseous device and methods for accessing bone marrow in the sternum and other target areas
US11166702B2 (en) 2005-01-31 2021-11-09 C.R. Bard, Inc. Quick cycle biopsy system
US9161743B2 (en) 2005-01-31 2015-10-20 C. R. Bard, Inc. Quick cycle biopsy system
US10058308B2 (en) 2005-01-31 2018-08-28 C. R. Bard, Inc. Method for operating a biopsy apparatus
US8702621B2 (en) 2005-01-31 2014-04-22 C.R. Bard, Inc. Quick cycle biopsy system
US8702622B2 (en) 2005-01-31 2014-04-22 C.R. Bard, Inc. Quick cycle biopsy system
US8012102B2 (en) 2005-01-31 2011-09-06 C. R. Bard, Inc. Quick cycle biopsy system
US20060235298A1 (en) * 2005-03-31 2006-10-19 Robert Kotmel Internal biopsy marking
US8834417B2 (en) 2005-06-06 2014-09-16 Covidien Ag Needle assembly with removable depth stop
US7731692B2 (en) 2005-07-11 2010-06-08 Covidien Ag Device for shielding a sharp tip of a cannula and method of using the same
US8419687B2 (en) 2005-07-11 2013-04-16 Covidien Ag Device for shielding a sharp tip of a cannula and method of using the same
US8523809B2 (en) 2005-07-11 2013-09-03 Covidien Ag Device for shielding a sharp tip of a cannula and method of using the same
US8162889B2 (en) 2005-07-11 2012-04-24 Covidien Ag Safety reset key and needle assembly
US7828773B2 (en) 2005-07-11 2010-11-09 Covidien Ag Safety reset key and needle assembly
US7976498B2 (en) 2005-07-11 2011-07-12 Tyco Healthcare Group Lp Needle assembly including obturator with safety reset
US7905857B2 (en) 2005-07-11 2011-03-15 Covidien Ag Needle assembly including obturator with safety reset
US8348894B2 (en) 2005-07-11 2013-01-08 Covidien Lp Needle assembly including obturator with safety reset
US7850650B2 (en) 2005-07-11 2010-12-14 Covidien Ag Needle safety shield with reset
US8721563B2 (en) 2005-08-10 2014-05-13 C. R. Bard, Inc. Single-insertion, multiple sample biopsy device with integrated markers
US11219431B2 (en) 2005-08-10 2022-01-11 C.R. Bard, Inc. Single-insertion, multiple sampling biopsy device with linear drive
US11849928B2 (en) 2005-08-10 2023-12-26 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US8771200B2 (en) 2005-08-10 2014-07-08 C.R. Bard, Inc. Single insertion, multiple sampling biopsy device with linear drive
US10010307B2 (en) 2005-08-10 2018-07-03 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device with linear drive
US8728003B2 (en) 2005-08-10 2014-05-20 C.R. Bard Inc. Single insertion, multiple sample biopsy device with integrated markers
US8282574B2 (en) 2005-08-10 2012-10-09 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US8961430B2 (en) 2005-08-10 2015-02-24 C.R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US8262585B2 (en) 2005-08-10 2012-09-11 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device with linear drive
US8267868B2 (en) 2005-08-10 2012-09-18 C. R. Bard, Inc. Single-insertion, multiple sample biopsy device with integrated markers
US10368849B2 (en) 2005-08-10 2019-08-06 C. R. Bard, Inc. Single-insertion, multiple sampling biopsy device usable with various transport systems and integrated markers
US7654735B2 (en) 2005-11-03 2010-02-02 Covidien Ag Electronic thermometer
US10617399B2 (en) 2006-08-21 2020-04-14 C.R. Bard, Inc. Self-contained handheld biopsy needle
US8251917B2 (en) 2006-08-21 2012-08-28 C. R. Bard, Inc. Self-contained handheld biopsy needle
US9439632B2 (en) 2006-08-21 2016-09-13 C. R. Bard, Inc. Self-contained handheld biopsy needle
US8951208B2 (en) 2006-08-21 2015-02-10 C. R. Bard, Inc. Self-contained handheld biopsy needle
US11426249B2 (en) 2006-09-12 2022-08-30 Teleflex Life Sciences Limited Vertebral access system and methods
US9510910B2 (en) 2006-09-12 2016-12-06 Vidacare LLC Medical procedures trays and related methods
US8944069B2 (en) 2006-09-12 2015-02-03 Vidacare Corporation Assemblies for coupling intraosseous (IO) devices to powered drivers
US9566045B2 (en) 2006-10-06 2017-02-14 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US8485987B2 (en) 2006-10-06 2013-07-16 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US10172594B2 (en) 2006-10-06 2019-01-08 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US11559289B2 (en) 2006-10-06 2023-01-24 Bard Peripheral Vascular, Inc. Tissue handling system with reduced operator exposure
US11583261B2 (en) 2006-10-24 2023-02-21 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US10149664B2 (en) 2006-10-24 2018-12-11 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US8262586B2 (en) 2006-10-24 2012-09-11 C. R. Bard, Inc. Large sample low aspect ratio biopsy needle
US11583668B2 (en) 2006-10-30 2023-02-21 Teleflex Life Sciences Limited Apparatus and methods to communicate fluids and/or support intraosseous devices
US10258783B2 (en) 2006-10-30 2019-04-16 Teleflex Medical Devices S.À R.L. Apparatus and methods to communicate fluids and/or support intraosseous devices
US8974410B2 (en) 2006-10-30 2015-03-10 Vidacare LLC Apparatus and methods to communicate fluids and/or support intraosseous devices
US11771439B2 (en) 2007-04-04 2023-10-03 Teleflex Life Sciences Limited Powered driver
US8357104B2 (en) 2007-11-01 2013-01-22 Coviden Lp Active stylet safety shield
US20090118639A1 (en) * 2007-11-01 2009-05-07 Tyco Healthcare Group Lp Active Stylet Safety Shield
US20090182366A1 (en) * 2007-11-14 2009-07-16 Kennedy John S Surgical Instrument for Detecting, Isolating and Excising Tumors
US8128647B2 (en) 2007-11-14 2012-03-06 Kennedy John S Surgical instrument for detecting, isolating and excising tumors
US20090125035A1 (en) * 2007-11-14 2009-05-14 Kennedy John S Surgical Cutting Instrument for Breast Surgery
US9775588B2 (en) 2007-12-20 2017-10-03 C. R. Bard, Inc. Biopsy device
US10687791B2 (en) 2007-12-20 2020-06-23 C. R. Bard, Inc. Biopsy device
US8858463B2 (en) 2007-12-20 2014-10-14 C. R. Bard, Inc. Biopsy device
US8597205B2 (en) 2007-12-20 2013-12-03 C. R. Bard, Inc. Biopsy device
US8454532B2 (en) 2007-12-27 2013-06-04 Devicor Medical Products, Inc. Clutch and valving system for tetherless biopsy device
US8864682B2 (en) 2007-12-27 2014-10-21 Devicor Medical Products, Inc. Clutch and valving system for tetherless biopsy device
US8690793B2 (en) 2009-03-16 2014-04-08 C. R. Bard, Inc. Biopsy device having rotational cutting
US8708929B2 (en) 2009-04-15 2014-04-29 Bard Peripheral Vascular, Inc. Biopsy apparatus having integrated fluid management
US8708930B2 (en) 2009-04-15 2014-04-29 Bard Peripheral Vascular, Inc. Biopsy apparatus having integrated fluid management
US8708928B2 (en) 2009-04-15 2014-04-29 Bard Peripheral Vascular, Inc. Biopsy apparatus having integrated fluid management
US8845548B2 (en) 2009-06-12 2014-09-30 Devicor Medical Products, Inc. Cutter drive assembly for biopsy device
US9468424B2 (en) 2009-06-12 2016-10-18 Devicor Medical Products, Inc. Cutter drive assembly for biopsy device
US10575833B2 (en) 2009-08-12 2020-03-03 C. R. Bard, Inc. Biopsy apparatus having integrated thumbwheel mechanism for manual rotation of biopsy cannula
US9173641B2 (en) 2009-08-12 2015-11-03 C. R. Bard, Inc. Biopsy apparatus having integrated thumbwheel mechanism for manual rotation of biopsy cannula
US9655599B2 (en) 2009-08-12 2017-05-23 C. R. Bard, Inc. Biopsy apparatus having integrated thumbwheel mechanism for manual rotation of biopsy cannula
US8485989B2 (en) 2009-09-01 2013-07-16 Bard Peripheral Vascular, Inc. Biopsy apparatus having a tissue sample retrieval mechanism
US9282949B2 (en) 2009-09-01 2016-03-15 Bard Peripheral Vascular, Inc. Charging station for battery powered biopsy apparatus
US9949726B2 (en) 2009-09-01 2018-04-24 Bard Peripheral Vscular, Inc. Biopsy driver assembly having a control circuit for conserving battery power
US9622728B2 (en) 2009-09-02 2017-04-18 C. R. Bard, Inc. Biopsy apparatus including a biopsy device having a sample receiving notch with a tissue anchor
US9072506B1 (en) 2009-09-02 2015-07-07 C. R. Bard, Inc. Biopsy apparatus including a biopsy device having a sample receiving notch with a tissue anchor
US10143449B2 (en) 2009-09-02 2018-12-04 C. R. Bard, Inc. Biopsy apparatus including a biopsy device having a sample receiving notch with a tissue anchor
US8283890B2 (en) 2009-09-25 2012-10-09 Bard Peripheral Vascular, Inc. Charging station for battery powered biopsy apparatus
USD640977S1 (en) 2009-09-25 2011-07-05 C. R. Bard, Inc. Charging station for a battery operated biopsy device
US8597206B2 (en) 2009-10-12 2013-12-03 Bard Peripheral Vascular, Inc. Biopsy probe assembly having a mechanism to prevent misalignment of components prior to installation
US8430824B2 (en) 2009-10-29 2013-04-30 Bard Peripheral Vascular, Inc. Biopsy driver assembly having a control circuit for conserving battery power
US8808197B2 (en) 2009-10-29 2014-08-19 Bard Peripheral Vascular, Inc. Biopsy driver assembly having a control circuit for conserving battery power
US8298157B2 (en) 2009-12-15 2012-10-30 C. R. Bard, Inc. Introducer cannula having a tissue anchor for use with a medical instrument
US20110144533A1 (en) * 2009-12-15 2011-06-16 Rafal Chudzik Introducer cannula having a tissue anchor for use with a medical instrument
US10285673B2 (en) 2013-03-20 2019-05-14 Bard Peripheral Vascular, Inc. Biopsy device
US11779316B2 (en) 2013-03-20 2023-10-10 Bard Peripheral Vascular, Inc. Biopsy device
US10456120B2 (en) 2013-11-05 2019-10-29 C. R. Bard, Inc. Biopsy device having integrated vacuum
US11534148B2 (en) 2013-11-05 2022-12-27 C. R. Bard, Inc. Biopsy device having integrated vacuum
US9504829B2 (en) 2013-11-08 2016-11-29 Nuvectra Corporation Implantable medical lead with collapsible fixation member
US9849278B2 (en) 2013-11-08 2017-12-26 Nuvectra Corporation Implantable medical lead with collapsible fixation member
US10463350B2 (en) 2015-05-01 2019-11-05 C. R. Bard, Inc. Biopsy device
US11179142B2 (en) 2015-05-01 2021-11-23 C.R. Bard, Inc. Biopsy device
CN105496346A (en) * 2016-01-20 2016-04-20 广州普露医疗科技有限公司 Vagina examining and sampling instrument
US20210121163A1 (en) * 2016-04-29 2021-04-29 Devicor Medical Products, Inc. Tissue sample holder with enhanced features
US10945713B2 (en) 2016-11-23 2021-03-16 C. R. Bard, Inc. Single insertion multiple sample biopsy apparatus
US11786226B2 (en) 2016-11-23 2023-10-17 C.R. Bard, Inc. Single insertion multiple sample biopsy apparatus
US11134830B2 (en) 2016-12-27 2021-10-05 Boston Scientific Scimed, Inc. Medical device delivery system and methods of use
US11116483B2 (en) 2017-05-19 2021-09-14 Merit Medical Systems, Inc. Rotating biopsy needle
US11793498B2 (en) 2017-05-19 2023-10-24 Merit Medical Systems, Inc. Biopsy needle devices and methods of use
US11844500B2 (en) 2017-05-19 2023-12-19 Merit Medical Systems, Inc. Semi-automatic biopsy needle device and methods of use
US20220015787A1 (en) * 2020-07-16 2022-01-20 Endogear Llc Grasping Device For Independent Tissue Manipulation During Gastrointestinal Endoscopic Procedures And Methods Of Use

Also Published As

Publication number Publication date
US20040215103A1 (en) 2004-10-28
WO2004096011A2 (en) 2004-11-11
WO2004096011A3 (en) 2005-07-07
US7311673B2 (en) 2007-12-25

Similar Documents

Publication Publication Date Title
US20050113716A1 (en) Biopsy device having endoscope
US7591790B2 (en) Micro-invasive device
US6280398B1 (en) Methods and devices for collection of soft tissue
US6083237A (en) Biopsy instrument with tissue penetrating spiral
US6142955A (en) Biopsy apparatus and method
US8128577B2 (en) Biopsy system
JP3706139B2 (en) Method and apparatus for automatic biopsy and collection of soft tissue
US6273861B1 (en) Pneumatically actuated tissue sampling device
US20040097981A1 (en) Biopsy devices and methods
US20050165329A1 (en) Multiple biopsy collection device
US20050070818A1 (en) Biopsy device with viewing assembly
EP0919192A2 (en) Biopsy instrument including tip for tissue dilation

Legal Events

Date Code Title Description
AS Assignment

Owner name: ACUEITY, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MUELLER JR., RICHARD L.;HSEI, PAUL K.;KERMODE, JAMES;REEL/FRAME:019661/0975;SIGNING DATES FROM 20041202 TO 20041230

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION