Surgery – Diagnostic testing – Sampling nonliquid body material
Reexamination Certificate
2001-09-07
2002-05-14
Hindenburg, Max (Department: 3736)
Surgery
Diagnostic testing
Sampling nonliquid body material
Reexamination Certificate
active
06387057
ABSTRACT:
TECHNICAL FIELD
The present invention relates to a device for the minimal-invasive removal of tissue from animal or human tissue, which device has a hollow needle provided with a hollow channel.
State of the Art
There are numerous known different methods and devices employed to examine tissue for the selective removal of tissue from animal or human bodies. Starting with the familiar classical surgical procedure using a scalpel to provide a passage to the to-be-severed and to-be-examined tissue area in order to sever this tissue area with selective cuts and to remove it from the body through the work passage, one proceeded, due to the many drawbacks related to this classical surgical procedure, to design a suited instrument for minimal-invasive surgery. Although, it is possible to extract sufficiently large amounts of tissue material from the body for examination with the classical method, the surgery and the related tissue sections involve irreversible tissue irritation, which takes much time to heal. Moreover, there is the danger of cell displacement in that tissue that may be tumorous is severed and removed through the work passage is carried to nonmalignant tissue.
In order to rule out the drawbacks described above, punch biopsy devices are known which permit removing tissue at selected intracorporal tissue areas by means of a single incision with a needle. This comprises a combination of a hollow needle having a mandrel running inside the hollow needle. This mandrel is provided with a recess at the distal end in which tissue, that can be severed with the aid of the sharpened distal end of the hollow needle, can be stored. Although this type of tissue removal is minimal-invasive and involves only minor tissue irritation caused by the injection of the needle arrangement into the body and the needle arrangement largely rules out the problem of cell displacement because the tissue severed in the to-be-examined tissue is enclosed in order to be safely removed from the body. The disadvantage of the known punch biopsy, however, is that only a small amount of tissue can be removed with a single incision of the hollow needle. Although the amount of the to-be-examined tissue can be increased by multiple successive biopsies, the tissue is greatly stressed and irritated by the numerous incisions. On the other hand, hollow needle arrangements with increasingly larger cross sections can be resorted to, however, this raises the danger of bleeding and consequently hematoma formation leading to unavoidable side effects.
DESCRIPTION OF THE INVENTION
The object of the present invention is to design a device for minimal-invasive removal of tissue from animal or human tissue, which device has a hollow needle provided with a hollow channel, in such a manner that the afore-described drawbacks can largely be prevented. In particular, the aim is to reduce to a minimum irreversible tissue irritation caused by the surgical operation by means of a minimal-invasive surgical procedure in the to-be-examined tissue area. Injury to the tissue cells from the surgical procedure should also be minimized and the danger of bleeding should be reduced to a minimum. Despite the minimal-invasive surgical procedure, it should still be possible to remove from inside the body a minimum amount of tissue material required for unequivocal determination of the tissue respectively examination of the tissue.
The solution to the object of the present invention is given in claim
1
. Advantageous features that further develop the inventive idea are the subject matter of the subclaims and are disclosed in the description as well as in the preferred embodiment with reference to the accompanying drawing.
An element of the present invention is to design a device for minimal-invasive removal of tissue from animal or human tissue, which has a hollow needle provided with a hollow channel, in such a manner that the hollow needle is designed as a multi-wall hollow needle and is provided with at least two hollow needle walls enclosing at least one intermediate space which is designed open at the distal end. Extending at the distal end from this intermediate space is a cutting wire that can be supplied with electric energy and is preferably designed with a shape corresponding to the contour of the cross section of the intermediate space and is located at a distance opposite this intermediate space. A supply line for a material flow ends in the proximal end of the intermediate space of the multi-wall hollow needle, with the supply line and the intermediate space being connected and designed in such a manner that that the material flow flows through the intermediate space and exits at the distal end. Preferably an electrically nonconductive scavenging fluid, for example a glycol solution, is employed as the material flow. Moreover, the scavenging fluid should possess approximately the same mineral content as the human or animal tissue fluid or at least be chemically inert so that the intracorporal scavenging has no negative influence on the mineral content of the surrounding tissue.
Gases, for instance inert gases such as argon can also be used. Finally a vacuum source can be connected at the proximal end of the hollow channel of the preferably double-walled multi-wall hollow needle.
The multi-wall hollow needle preferably designed as a double-walled hollow cylinder is preferably provided with an exterior contour matching the interior contour of a hollow channel designed as a sluice serving as the work channel for intracorporal insertion of endosurgical instruments into the body, thus also for insertion of the invented hollow needle. To keep tissue and cell irritation to a minimum when inserting such a type of sluice, for example, through the various layers of the skin down to the to-be-examined tissue area, there are known sluice arrangements which are provided with a helical screw thread on their exterior and a tapering-to-a-tip screw thread at the distal end, with the screw tip being the distal end part of a mandrel extending through the sluice, which is led through for the purpose of entering the sluice arrangement inside the body. Such a type of sluice arrangement is described in DE 199 35 976.8. The particular advantage of such a type of sluice arrangement is that the tissue is not cut when the sluice arrangement is inserted, but rather is dilated by the spiral-like designed tip so that natural interfaces in the tissue respectively in the cell structures entered by the distal screw tip give way thus permitting to largely avoid severing blood vessels, nerves or cells. Positioning such a sluice can be controlled using ultrasonic, X-ray or MR monitoring methods to check the position relative to the to-be-examined tissue area.
If the sluice arrangement is positioned accordingly and the central mandrel is removed from the hollow channel, a work channel is created through which the invented tissue removal device can be placed accordingly. Fundamentally, leading the invented tissue removal device described in the following through other work channels or the work channel can even be completely obviated. This however is connected with distinct drawbacks during the surgical operation. For selective tissue removal, the multi-wall hollow needle is preferably double walled and designed as a hollow cylinder whose needle length is selected larger than the length of the sluice so that the multi-wall hollow needle extends out of the sluice at the distal end and can enter the to-be-examined tissue area accordingly. Entry of the distal end of the multi-wall hollow needle occurring into the tissue area is distinguished, in particular, by the cutting wire, which is disposed immediately before the open distal end of the intermediate space of the multi-wall hollow needle and whose shape essentially corresponds to that of the cross section of the intermediate space and is positioned at a slight distance therefrom, having electric energy, preferably HF current, applied to it and being heated thereby. The tissue coming into contact with the cutting wire is
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