Surgery – Instruments – Means for removing tonsils – adenoids or polyps
Reexamination Certificate
2002-09-17
2004-12-21
Peffley, Michael (Department: 3739)
Surgery
Instruments
Means for removing tonsils, adenoids or polyps
C606S047000
Reexamination Certificate
active
06833000
ABSTRACT:
FIELD OF THE INVENTION
This invention generally relates to a surgical instrument assembly for use in cutting and retrieving objects from internal body cavities and, more specifically, to a surgical instrument assembly for use in snare cauterization procedures. The present invention also relates to a method for cutting and retrieving objects from internal body cavities and, in a preferred form, to a method for cutting, capturing and/or retrieving polyps and other aggregates of organic tissue from a patient's internal organs via a snare cauterization procedure.
BACKGROUND OF THE INVENTION
A wire snare has been used in many different configurations and for many different medical uses. The snare, when equipped for use with cautery, has been used for polypectomies. For example, during a colonoscopy, or other endoscopic procedures, a wire loop or snare, combined with cautery, is frequently used to biopsy or excise lesions. While a wire loop or snare is very effective at cutting free a lesion, it has substantially no ability to capture and/or retrieve the excised lesion.
Typically, a second instrument is used to retrieve the excised lesion. The second instrument most often is provided in the form of a wire basket having several loops angularly offset and preferably, but not necessarily, perpendicular to each other in the case of two loops and designed to trap the excised lesion, such as a stone basket used in urology and gastroenterology. The use of two different instruments, one instrument to cut and a second instrument to retrieve, however, is inconvenient, inefficient, time consuming and can sometimes lead to the loss of the excised lesion.
What is still desired is a single instrument that can snare and retrieve a lesion. Preferably, the instrument will be simple in design and reliable in use, and will allow repeated use of a snare or a retrieval configuration, as required, by simple mechanical means.
SUMMARY OF THE INVENTION
The present invention provides a simple, but elegant solution to this problem by providing a device for selectively capturing, cutting and retrieving tissue, wherein the device includes a cutting snare, or cauterization wires, that can be incorporated into a retrieval basket configuration also including a basket snare, or basket wires, without removing the cutting snare from a patient's body. It also allows repeated use of the basket or the snare configuration, as required, by simple mechanical means.
According to one aspect of the present invention, the device includes a handle having an elongated, flexible tube extending therefrom along a central axis to a distal end, a first set of elongated, flexible wires slidingly positioned within the tube and extending along the central axis from the handle to distal ends for extending out of the distal end of the tube, a control tip secured to the distal ends of the first set of wires, the control tip having a slot, and a second set of elongated, flexible wires slidingly positioned within the tube and extending along the central axis from the handle, through the slot in the control tip, to distal ends, the second set of wires being coupled at the distal ends. A retaining pin is secured to the control tip and extends transversely through the slot of the control tip and between the second set of wires. The retaining pin allows the coupled distal ends of the second set of wires to be extended from the control tip, and prevents the coupled distal ends of the second set of wires from being withdrawn from the slot of the control tip and into the tube. In addition, the retaining pin drives the coupled distal ends of the second set of wires from the distal end of the tube upon the distal ends of the first set of wires being driven from the distal end of the tube.
According to one aspect of the present invention, the first and second sets of wires have a preset shape, preferably curving in an arc near their distal ends, so that when within the tube, the wires are substantially coaxial with the tube, but when extended from the tube, their distal ends form a loop.
According to an additional aspect of the present invention, the control tip is a discrete element that is secured to the first set of wires and the slot of the control tip is oriented such that a first reference plane formed by the loops of at least two of the wires of the first set and a second reference plane formed by the loops of at least two of the wires of the second set are angularly offset. According to a further aspect, the first reference plane is substantially perpendicular to the second reference plane.
According to still another aspect of the present invention, the first set of wires includes only two wires. According to an additional aspect, the second set of wires includes only two wires.
According to another aspect of the present invention, two single wires with distal ends bent to form loops are provided to be used to cut and retrieve tissue instead of two sets of wires. Preferably, the wire includes a front portion with an expanded distal end and a rear portion with an expanded proximal end. The distal end of the front portion and the proximal end of the rear portion are joined by a tube with crimped ends, wherein the front portion and the rear portion are relatively rotatable with each other.
According to another aspect of the present invention, the first set of wires of the device is formed by a single continuing wire folded at a distal end, instead of two wires connected to a discrete contral tip. The distal end of the continuing retrieving wire forms a “control tip”, preferably an “S” or “8-like” shape structure having two apertures and one effective retaining pin portion in the middle. Two wires of the second set of wires (cutting wires) are joined at a distal end and are slidingly positioned within the tube, extending along the central axis from the handle, and wherein each wire of the set passes through one of the two apertures of the control tip. The distal end of the cutting wires is retained by the retaining pin. The “S” or “8-like” shape control tip replaces the discrete control tip of the previously described embodiment, functioning as a retaining pin for retaining the cutting wires, and also as a bottom a “basket” formed by the retrieving wires and the cutting wires, used to retrieve tissues.
According to a further aspect of the present invention, the device includes a first deployment assembly operatively connected to the first set of wires and allowing a user to selectively extend and withdraw the distal ends of the first set of wires from the distal end of the tube, and a second deployment assembly operatively connected to the second set of wires and allowing a user to selectively extend and withdraw the distal ends of the second set of wires from the distal end of the tube. According to another aspect, a latching mechanism is provided for connecting the first and second deployment assemblies. In accordance with an additional aspect, a locking mechanism is provided for preventing movement of the first deployment assembly.
According to another aspect of the present invention, the handle of the present invention includes an elongated shaft extending along a central axis, a tube connected to a distal end of the shaft, a first sleeve member disposed over the shaft and a second sleeve member disposed over the shaft. The shaft has a front portion, rear portion, and a central portion. The shaft defines an elongated slot through the central portion and an interior channel through the rear portion. The tube connects to and extends from a distal end of the interior channel and forms a elongated continuing passageway with the slot and the interior channel of the shaft for the two sets of wires to pass through. The first set of wires is attached to a first terminal lock which extends from an inner surface of the first sleeve member into the slot of the shaft. The second set of wires is attached to a second terminal lock which extends from an inner surface of the second sleeve member into the slot. Preferably, the second terminal lock d
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