Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS3608539 A
Publication typeGrant
Publication dateSep 28, 1971
Filing dateNov 6, 1968
Priority dateNov 6, 1968
Publication numberUS 3608539 A, US 3608539A, US-A-3608539, US3608539 A, US3608539A
InventorsMiller Daniel G
Original AssigneeMiller Daniel G
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Method for the biopsy of subcutaneous masses
US 3608539 A
Images(2)
Previous page
Next page
Description  (OCR text may contain errors)

United States Patent [72] lnventor Daniel G. Miller 430 E. 86th St., New York, N.Y. 10028 [21] Appl. No. 773,787 [22] Filed Nov. 6, 1968 [45] Patented Sept. 28, 1971 [54] METHOD FOR THE BIOPSY OF SUBCUTANEOUS MASSES 6 Claims, 9 Drawing Figs.

[52] 11.8. CI. 128/2, 128/314, 128/329, 128/347 [51] Int. Cl ..A61bl0/00, A61b 17/34, A61b 17/32 [50] Field of Search 128/2, 305, v 314, 329, 347

[56] References Cited UNITED STATES PATENTS 2,919,692 l/1960 v Ackermann 128/314 X 3,342,175 9/1967 Bulloch 128/2 1,485,298 2/l924 Schroyer 128/347 UX 2,865,374 12/1958 Brown et al.... 128/347 X 3,496,932 2/1970 Prisk et a1. 129/347 X Primary Examiner-Channing L. Pace Attorney-Howard C. Miskin ABSTRACT: An instrument for the biopsy of subcutaneous masses includes an arcuate cannula having a serrated distal cutting end and is provided for alternative insertion, a correspondingly curved pointed stylet and a flexible ejector element. In performing a biopsy, and the skin is punctured and the cannula engaged stylet inserted through the puncture into the surface of the mass from its lateral or inferior aspect. The stylet is removed and the cannula advanced through the mass to cut and draw a specimen thereof into the cannula and the cannula is pushed through the overlying tissue to the skin. which is then punctured and the distal end of the cannula pushed through the puncture. The ejector is then pushed through the proximal end of the cannula to eject the specimen.

PATENTED SEP28I9TI 3.808.539

SHEET 1 BF 2 INVEN'I'OR. DANIEL G. MILLER AT TORNEY PATENTED SEP28 I97! 3.608.539

sum 2 0F 2 EN'I'UR. DAME MILLER ATTORNEY METHOD FOR THE BIOPSY OF SUBCUTANEOUS MASSES BACKGROUND OF THE INVENTION The present invention relates generally to improvements in sampling methods and instruments and it relates particularly to an improved method and instrument for obtaining biopsy specimens from subcutaneous masses, such as lymph nodes or tumors. I

The procedures conventionally employed for obtaining biopsy specimens pose numerous drawbacks and disadvantages, particularly when applied to subcutaneous masses. They are usually accompanied by damage to the surrounding tissue as the result of surgical incision and disection, and frequently effect the transfer of some of the sampled mass to the surrounding tissue, a consequence which is highly undesirable and should be assiduously avoided. Moreover, when straight needles are employed to obtain biopsies of lymph nodes or subcutaneous masses, the plug which is impaled in the barrel, in most instances will remain in situ when the needle is withdrawn, because its distal end has not been severed from the bulk of the mass. These tissues possess an inherent elasticity and connective tissue framework, which is resilient and has sufficient strength to retain a specimen which is cut on only three sides. It is because of this common experience that needles previously used for this purpose employed various undercutting mechanisms for retaining the cut plug, e.g. a screw, a hook, compressible jaws or a side cutting device.

SUMMARY OF THE INVENTION It is a principal object of the present invention to provide an improved sampling method and instrument.

Another object of the present invention is to provide an improved method and instrument for obtaining biopsy specimens.

Still another object of the presentinvention is to provide an improved method and instrument for obtaining biopsy specimens of subcutaneous masses.

A further object of the present invention is to provide an improved method and instrument for obtaining biopsy specimens of subcutaneous masses with a minimum of damage to the surrounding tissue and the obviation of any transfer of the sampled mass to the surrounding tissue.

Still a further object of the present invention is to provide a method of the above nature, characterized by its convenience, simplicity, high reliability, versatility and minimum discomforture to the subject.

The above and other objects of the present invention will become apparent from a reading of the following description taken in conjunction with the accompanying drawing, which illustrates a preferred embodiment thereof.

In a sense the present invention contemplates the provision of the method for obtaining a biopsy of a subcutaneous masscomprising the steps of advancing a curved cannula through a first area of the skin, through said mass to cut and receive a specimen thereof, and thence through a second area of the skin, and thereafter ejecting said specimen from said cannula while projecting through the skin of the second area. The cannula is advantageously curved and preferably arcuate with a radius of curvature advantageously between 3 and centimeters and advantageously extends between 45 and 180 preferably between 120 and 130, and is of a length between 5 and 12 centimeters. The distal end of the cannula is provided with a serrated cutting edge and the proximal end is provided with finger engageable wings. A similarly curved stylet is slidably received within the cannula and is provided with a proximal button and a distal pointed tip projecting through the cannula distal end. A blunt ended flexible ejector is slidably received within the cannula alternatively with the stylet. According to the preferred procedure, the skin on one side of the mass is punctured and the stylet engaged cannula inserted therethrough and advanced into engagement with the mass. The stylet is then removed and the cannula advanced through The improved procedure is simple, rapid, convenient, versatile and reliable. It results in a minimum of damage to the surrounding tissue and prevents any transfer of the biopsied mass to the surrounding tissue.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a front elevational view of the cannula section of an instrument embodying the present invention;

FIG. 2 is a front elevational view of the stylet section thereof;

FIG. 3 is a front elevational view of the ejector section thereof;

FIG. 4 is a enlarged longitudinal sectional view of the distal end of the assembled instrument;

FIG. 5 is an elevational view illustrating a step of preparing the site in the practice of the improved process;

FIG. 6 illustrates the insertion of the cannula into the explored mass;

FIG. 7 illustrates the obtaining of the biopsy specimen;

FIG. 8 illustrates the preparation of the skin exit site; and

FIG. 9 illustrates the ejection of the biopsy specimen.

DESCRIPTION THE PREFERRED EMBODIMENT Referring now to the drawing, and particularly FIGS. 1 to 4 thereof, which illustrate an instrument embodying the present invention, the improved instrument includes a cannula 11, a stylet or piercing member 12, and an ejector member 13. The cannula 11 comprises an arcuate tubular body member or barrel 14, provided at its distal end with a sharp serrated cutting edge 16, as bestseen in FIG. I. The bore of the cannula barrel 14 is uniform throughout its length, the outer face at the distal end being tapered to the cutting edge 16.

An annulus 17 is fitted over the proximal end of the barrel 14 and a wing-shaped finger piece provided with a medial opening is also fitted over the proximal border of the barrel l4 and rests on the annulus 17. A standard Luer-lok receptacle or coupling collar 19engages the distal end of the barrel l4 and is affixed to the barrel 14 with the annulus l7 and finger piece 18, by soldering, welding or the like.

The stylet 12 includes an accurately shaped rod 20 of the same curvature as the cannula barrel l4, and is of lesser crosssectional diameter than the bore of the barrel 14. The rod 20 terminates at its distal end in an enlarged pointed tip 21 and is provided at its proximal end with a thumb rest or button 22. The cannula l1 and stylet 12 are so dimensioned that when the stylet 12 is fully inserted in the cannula 11, the button 22 rests on the coupling collar 19 and the tip 21 projects through the distal end of the cannula barrel 14 with its face forming a smooth continuous surface with the outside face of the cannula barrel distal border, as seen best in FIG. 4.

The ejector member 13, is a flexible rod or wire of an outside diameter, about equal to the inside diameter of the barrel l4, and is provided with a blunt distal end face 23. The ejector member 13 is advantageously formed of Teflon rod or other suitable material.

As a specific example, the cannula barrel 14 is formed of stainless steel with an inside diameter of 3 millimeters and an outside diameter of 4 millimeters. The overall length of the cannula barrel 14 is 10 centimeters and the chord distance from end to end is about 9 centimeters. It has a radius of curvature of about 4.5 cm. and extends for about 120. The taper leading to the cutting edge 16 is about 4 millimeters long. The rod 20 is stainless steel of 2 millimeters diameter and the conical tip 21 is 6 millimeter long.

Considering now the practice of the improved method employing the instrument described above, and referring to FIGS. 5-.-9 of the drawing, the skin S, about 2 centimeters from the mass M which is to be biopsied, is infiltrated with procaine and from this side additional procaine is injected subcutaneously about mass M. Skin S is punctured, as seen in FIG. 5, with a surgical blade 26 in an area slightly offset from the side of mass M. The opening in the skin is further enlarged by stretching with a small curved hemostat or pointed scissors, not shown. With the same instrument a tract is made to the mass M by penetration and separation of the subutaneous tissue. The cannula l l with the pointed stylet 12 in place is then inserted along the prepared tract and inserted into the side of or the undersurface of the mass M, as seen in P10. 6. The free hand can often assist by holding the mass. After entry has been confirmed by moving the cannula 11 and mass M as one, the pointed stylet 12 is removed. With the thumb of the free hand, the mass M is pushed down and in this manner the open cannula ll traverses one entire diameter of the mass M, as seen in H0. 7. ln some situations it is advantageous to rock the proximal end of the cannula to and fro; this turns serrated cutting edge 16 of barrel l4 and facilitates its passage through the mass M. When the mass M has been penetrated, the arc is further extended to raise the skin S at the opposite side of the mass M. With procaine, puncture and tract prepared as above, as seen in FIG. 8, the specimen loaded cannula 11 emerges. The clearing stylet or ejector 13 is inserted in the cannula 11, as shown in FIG. 9, and the specimen is picked up on either a square of blotting paper or with thumb forceps and dropped into a bottle containing the fixing solution. The cannula 11, is easily withdrawn by reversing the direction of the arc. Pressure is applied to the punctures for 2 minutes and two Band- Aids are applied to each of the two puncture sites and left in place for 24 hours.

In employing the improved instrument in the method described above, highly satisfactory biopsy specimens were obtained and the proper diagnosis made in a large number of patients. No false negative diagnosis were encountered. It is important to note that there were no complications associated with the improved procedure. The specimens biopsied represented a variety of lesions from the point of view of size, consistency and diagnosis and the improved method has proven sufficiently versatile to adapt to most of the situations encountered.

While there has been described and illustrated a preferred embodiment of the present invention, it is apparent that numerous alterations, omissions and additions may be made without departing from the spirit thereof.

What I claim is:

l. The method for obtaining a biopsy of a subcutaneous mass comprising the steps of advancing a cannula inwardly through a first area of the skin laterally of the area above the mass and through said mass to undercut and receive a specimen from said mass and thence advancing outwardly cannula with the specimen therein out through a second area of the skin, on the side of the area above the mass opposite the first area and thereafter ejecting said specimen from said cannula while projecting through said skin.

2. The method of claim 1 wherein said cannula is advanced through said first skin area to said mass, while engaged by a stylet provided with a pointed end positioned at the distal end of said cannula, and removing said stylet from said cannula prior to said cannula being advanced through said mass.

3. The method of claim 1 wherein said specimen is ejected through said cannula by advancing a plunger through said cannula.

4. The method of claim 1 including the step of puncturing said first area of said skin with a sharp instrument prior to the insertion of said cannula.

5. The method of claim 1, including the step of puncturing the skin at said second area following the penetration of the mass by the cannula and before the emergence of the cannula through said second area.

6. The method of claim 1, including the step of applying pressure to said mass through the surrounding tissue in a direction towards said cannula during the advance of said cannula through said mass.

mg? NITEE STATES PATENT @F'FECE (IERHFECATE @F GORREQTEGN Patent No. 3,608, 539 Dated Becember 13, 1971 It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

Abstract: 1. 5 "ment. In performing a biopsy, and

the skin is punctured and" Change to ment. In performing a biopsy, the skin is punctured, end-- Column 2, 1.. l9 "Fig. t is e enlarged longitudinal" Change to Fig. t is an enlarged longitudinal-- Column 4, l. i i-l5 said mess and thence advancing outwardly cannula with the specimen therein out through second area of the skin, on the Change to --said mass and thence advancing said cannula with the specimen therein outwardly through a second area of the skin, on the-- Signed and sealed this 25th day of April 1%?2.

At to e L:

MJNARD MJLEJJ EMEJR. ROBERT GOTTSCHALK Attesting Officer Commissioner of Patents

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US1485298 *Apr 26, 1923Feb 26, 1924William O SchroyerEmbalming implement
US2865374 *Sep 16, 1957Dec 23, 1958Sierra Eng CoTracheotomy instrument
US2919692 *Feb 23, 1956Jan 5, 1960Wolfgang AckermannVertebral trephine biopsy instruments
US3342175 *Nov 23, 1964Sep 19, 1967Bulloch Robert TCardiac biopsy instrument
US3496932 *Dec 22, 1967Feb 24, 1970Gen Motors CorpMethod and apparatus for substernal cardiac massage
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3870043 *Mar 28, 1974Mar 11, 1975Dunn Allan RU-shaped intravenous needle structure
US4013080 *Jun 5, 1975Mar 22, 1977Froning Edward CCannula connector and direction indicator means for injection system
US4244370 *Nov 20, 1978Jan 13, 1981American Medical Systems, Inc.Tool for positioning implantable medical prosthetic device _and method of using same
US4493323 *Dec 13, 1982Jan 15, 1985University Of Iowa Research FoundationSuturing device and method for using same
US4530359 *Feb 8, 1983Jul 23, 1985Helfgott Maxwell AOphthalmic perforating instrument and surgical method employing said instrument
US4684369 *Aug 19, 1985Aug 4, 1987Wildemeersch Dirk A AInstrument for suprapubic drainage of the bladder, inserted through the urethra
US4802475 *Jun 22, 1987Feb 7, 1989Weshahy Ahmed H A GMethods and apparatus of applying intra-lesional cryotherapy
US4842589 *Nov 26, 1986Jun 27, 1989Sherwood Medical CompanyIntercavity catheter
US5025797 *Mar 29, 1989Jun 25, 1991Baran Gregory WAutomated biopsy instrument
US5047040 *Feb 16, 1989Sep 10, 1991Devices For Vascular Intervention, Inc.Atherectomy device and method
US5125413 *Apr 17, 1991Jun 30, 1992Baran Gregory WAutomated biopsy instrument
US5342376 *May 3, 1993Aug 30, 1994Dermagraphics, Inc.Inserting device for a barbed tissue connector
US5417700 *Mar 25, 1993May 23, 1995Thomas D. EganAutomatic suturing and ligating device
US6241747Oct 18, 1994Jun 5, 2001Quill Medical, Inc.Barbed Bodily tissue connector
US6264675 *Feb 4, 2000Jul 24, 2001Gregory R. BrotzSingle suture structure
US6364859May 31, 2000Apr 2, 2002Robbins Scientific CorporationLocking cap for replaceable needle assembly
US6478809 *Jul 23, 2001Nov 12, 2002Gregory R. BrotzSuture and method of use
US6599310Jun 29, 2001Jul 29, 2003Quill Medical, Inc.Suture method
US6942684 *Feb 19, 2002Sep 13, 2005Bonutti Ip, LlcMethod and apparatus for positioning an anchor member
US7056331Sep 30, 2002Jun 6, 2006Quill Medical, Inc.Suture method
US7225512Aug 29, 2002Jun 5, 2007Quill Medical, Inc.Method of forming barbs on a suture and apparatus for performing same
US7226468Apr 21, 2003Jun 5, 2007Quill Medical, Inc.Barbed bodily tissue connector
US7624487May 13, 2003Dec 1, 2009Quill Medical, Inc.Apparatus and method for forming barbs on a suture
US7758614Apr 5, 2002Jul 20, 2010Tornier, Inc.Coupling member for knotless sutures and ligatures
US7806908Jan 2, 2008Oct 5, 2010Quill Medical, Inc.Barbed tissue connector
US7857827Apr 14, 2006Dec 28, 2010Ethicon Endo-Surgery, Inc.Endoscopic device
US7857829May 11, 2007Dec 28, 2010Quill Medical, Inc.Suture method
US7913365Mar 27, 2007Mar 29, 2011Quill Medical, Inc.Method of forming barbs on a suture and apparatus for performing same
US7996967Aug 4, 2010Aug 16, 2011Quill Medical, Inc.System for variable-angle cutting of a suture to create tissue retainers of a desired shape and size
US7996968Aug 4, 2010Aug 16, 2011Quill Medical, Inc.Automated method for cutting tissue retainers on a suture
US7998167Apr 14, 2006Aug 16, 2011Ethicon Endo-Surgery, Inc.End effector and method of manufacture
US8011072Aug 4, 2010Sep 6, 2011Quill Medical, Inc.Method for variable-angle cutting of a suture to create tissue retainers of a desired shape and size
US8015678Aug 4, 2010Sep 13, 2011Quill Medical, Inc.Method for cutting a suture to create tissue retainers of a desired shape and size
US8020263Aug 4, 2010Sep 20, 2011Quill Medical, Inc.Automated system for cutting tissue retainers on a suture
US8025664Jul 31, 2007Sep 27, 2011Innovative Spine, LlcSystem and method for providing surgical access to a spine
US8028387Aug 4, 2010Oct 4, 2011Quill Medical, Inc.System for supporting and cutting suture thread to create tissue retainers thereon
US8028388Aug 4, 2010Oct 4, 2011Quill Medical, Inc.System for cutting a suture to create tissue retainers of a desired shape and size
US8032996May 13, 2004Oct 11, 2011Quill Medical, Inc.Apparatus for forming barbs on a suture
US8034070Feb 24, 2006Oct 11, 2011Yale UniversityVaricose vein dissector and removal apparatus
US8057481Jul 31, 2007Nov 15, 2011Innovative Spine, LlcSystem and method for providing surgical access to a spine
US8083770May 13, 2008Dec 27, 2011Quill Medical, Inc.Suture anchor and method
US8118834Dec 19, 2008Feb 21, 2012Angiotech Pharmaceuticals, Inc.Composite self-retaining sutures and method
US8216273Feb 25, 2009Jul 10, 2012Ethicon, Inc.Self-retainers with supporting structures on a suture
US8246652Aug 4, 2010Aug 21, 2012Ethicon, Inc.Suture with a pointed end and an anchor end and with equally spaced yieldable tissue grasping barbs located at successive axial locations
US8313500Apr 14, 2006Nov 20, 2012Ethicon Endo-Surgery, Inc.Endoscopic device
US8496657Aug 29, 2008Jul 30, 2013P Tech, Llc.Methods for utilizing vibratory energy to weld, stake and/or remove implants
US8597299Nov 2, 2007Dec 3, 2013Innovative Spine, LlcInstrumentation and method for providing surgical access to a spine
US8608767Jul 21, 2011Dec 17, 2013Yale UniversityVaricose vein dissector and removal apparatus
US8615856Jan 30, 2009Dec 31, 2013Ethicon, Inc.Apparatus and method for forming self-retaining sutures
US8617185Feb 13, 2008Dec 31, 2013P Tech, Llc.Fixation device
US8632550Sep 27, 2011Jan 21, 2014Innovative Spine LLC.System and method for providing surgical access to a spine
US8641732Feb 25, 2009Feb 4, 2014Ethicon, Inc.Self-retaining suture with variable dimension filament and method
US8652170Aug 4, 2010Feb 18, 2014Ethicon, Inc.Double ended barbed suture with an intermediate body
US8679158Aug 4, 2010Mar 25, 2014Ethicon, Inc.Multiple suture thread configuration with an intermediate connector
US8690914Aug 4, 2010Apr 8, 2014Ethicon, Inc.Suture with an intermediate barbed body
US8721664Mar 12, 2013May 13, 2014Ethicon, Inc.Suture methods and devices
US8721681Jun 30, 2009May 13, 2014Ethicon, Inc.Barbed suture in combination with surgical needle
US8734485Aug 4, 2010May 27, 2014Ethicon, Inc.Sutures with barbs that overlap and cover projections
US8734486Aug 4, 2010May 27, 2014Ethicon, Inc.Multiple suture thread configuration with an intermediate connector
US8740853Apr 14, 2006Jun 3, 2014Ethicon Endo-Surgery, Inc.Endoscopic device and method of packaging
US8747437Aug 4, 2010Jun 10, 2014Ethicon, Inc.Continuous stitch wound closure utilizing one-way suture
US8747439Jul 10, 2006Jun 10, 2014P Tech, LlcMethod of using ultrasonic vibration to secure body tissue with fastening element
US8764776Aug 4, 2010Jul 1, 2014Ethicon, Inc.Anastomosis method using self-retaining sutures
US8764796Feb 10, 2006Jul 1, 2014Ethicon, Inc.Suture method
US20060241695Jul 10, 2006Oct 26, 2006Bonutti Peter MMethod of using ultrasonic vibration to secure body tissue with fastening element
US20080027390 *Jun 28, 2007Jan 31, 2008Carlos JaramilloCatheterization device and method
USRE30966 *Dec 8, 1980Jun 15, 1982The Regents Of The University Of CaliforniaWick catheter pressure sensing probe and method of use
WO1999065545A1 *Jun 15, 1999Dec 23, 1999Robbins Paul BSyringe with various needle assemblies
WO2006093787A2 *Feb 24, 2006Sep 8, 2006Michael G TalVaricose vein dissector and removal apparatus
Classifications
U.S. Classification600/567, 606/187, 606/117
International ClassificationA61B10/02, A61B10/00
Cooperative ClassificationA61B10/0266
European ClassificationA61B10/02P6