CA1156897A - Counter rotating biopsy needle - Google Patents
Counter rotating biopsy needleInfo
- Publication number
- CA1156897A CA1156897A CA000381986A CA381986A CA1156897A CA 1156897 A CA1156897 A CA 1156897A CA 000381986 A CA000381986 A CA 000381986A CA 381986 A CA381986 A CA 381986A CA 1156897 A CA1156897 A CA 1156897A
- Authority
- CA
- Canada
- Prior art keywords
- recited
- biopsy needle
- tubes
- gear
- tube
- 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.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other 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
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
- F16H—GEARING
- F16H3/00—Toothed gearings for conveying rotary motion with variable gear ratio or for reversing rotary motion
- F16H3/02—Toothed gearings for conveying rotary motion with variable gear ratio or for reversing rotary motion without gears having orbital motion
- F16H3/08—Toothed gearings for conveying rotary motion with variable gear ratio or for reversing rotary motion without gears having orbital motion exclusively or essentially with continuously meshing gears, that can be disengaged from their shafts
- F16H3/14—Gearings for reversal only
- F16H3/145—Gearings for reversal only with a pair of coaxial bevel gears, rotatable in opposite directions
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T408/00—Cutting by use of rotating axially moving tool
- Y10T408/89—Tool or Tool with support
- Y10T408/895—Having axial, core-receiving central portion
- Y10T408/8957—Having axial, core-receiving central portion and having stepped cutting edges
Abstract
ABSTRACT OF THE DISCLOSURE
A universally applicable biopsy needle includes two counter-rotating tubes having oppositely facing sawteeth formed on the distal ends thereof. A gear system transmits a driving force to the tubes, causing the counter-rotation which permits the sawteeth to act in a sawing manner for penetration of bone samples and in a cutting manner for soft tissues. Use of an outer cannula allows safe insertion of the needle to the location of the desired sample, and various grasping means are used to extract the sample core. The concentric, telescoping needles provide a sample preserving the natural architecture and orientation of the tissue or cell types, while minimizing harming and maceration of the same.
A universally applicable biopsy needle includes two counter-rotating tubes having oppositely facing sawteeth formed on the distal ends thereof. A gear system transmits a driving force to the tubes, causing the counter-rotation which permits the sawteeth to act in a sawing manner for penetration of bone samples and in a cutting manner for soft tissues. Use of an outer cannula allows safe insertion of the needle to the location of the desired sample, and various grasping means are used to extract the sample core. The concentric, telescoping needles provide a sample preserving the natural architecture and orientation of the tissue or cell types, while minimizing harming and maceration of the same.
Description
~L~568~3~7 l BACKGROUND OF TH~ INVE~TION
¦1. Field of the Invention I
¦ This invention relates to biopsy needles, and more specifi-¦cally to concentric biopsy needles adapted for counter-¦rotating moven~ent for cutting through soft tissue and sawing through bone to obtain the desired sample.
l 2. Prior Art A variety of needles is available Lo obtain samples of soft tissue. One standard class includes a closed tip needle with a side slot or opening near the tip. Soft tissue is sucked into the slot by means of applied vacuum. A cutter is used to seDarate the material which has been sucked in from the surrounding tissue. This ~ype of needle is used predo~inantly for biopsy of the synovial lining of joints, but may also be used for liver, spleen, kidney and other soft tissues or organs.
A needle disclosed in Perez et al, U. S. patent 2,541~542 utilizes a loop of thread, extending from a cannula which has been advanced to a desired position with the aid of a style, to cut a section of tissue. The thread is tensioned to cut the tissue and to hold the same during withdrawal of the needle.
Baylis et al provide an elongated inner needle for initial penetration of body tissue in U.S. patent 4,177,797.
An outer hollow cylindrical cutting tube is slidably recei~ed
¦1. Field of the Invention I
¦ This invention relates to biopsy needles, and more specifi-¦cally to concentric biopsy needles adapted for counter-¦rotating moven~ent for cutting through soft tissue and sawing through bone to obtain the desired sample.
l 2. Prior Art A variety of needles is available Lo obtain samples of soft tissue. One standard class includes a closed tip needle with a side slot or opening near the tip. Soft tissue is sucked into the slot by means of applied vacuum. A cutter is used to seDarate the material which has been sucked in from the surrounding tissue. This ~ype of needle is used predo~inantly for biopsy of the synovial lining of joints, but may also be used for liver, spleen, kidney and other soft tissues or organs.
A needle disclosed in Perez et al, U. S. patent 2,541~542 utilizes a loop of thread, extending from a cannula which has been advanced to a desired position with the aid of a style, to cut a section of tissue. The thread is tensioned to cut the tissue and to hold the same during withdrawal of the needle.
Baylis et al provide an elongated inner needle for initial penetration of body tissue in U.S. patent 4,177,797.
An outer hollow cylindrical cutting tube is slidably recei~ed
-2-~LS6837 over the needle member until it also penetrates the body tissue. Both the tube and needle are then simultaneously withdrawn with the sample collected interiorly of the tube.
Banko patent 3,732,858 teaches the possible use of an electric motor for revolution of inner and outer j aws relative to one another, from an open to a closed position, as disclosed at columns 7 and 11 therein, for example. Relative rotation of a drill-like structure in conjunction with suction means is used to contain and progressively remove portions of a cutting.
}~allac patent 3,605,721 discloses a fixedly connected (soldered) coaxial inner and outer combination of needles 16 and 12 in conjunction with trochar 20. Needle 16 is telescopically received within needle 12. Both needles are provided with generally V-shaped coincident prongs.
The connection between the needles collapses upon relative motion therebetween, thus capturing the biopsy specimen Jamshidi patent 3,628,524 provides a double sawtooth cutting edge in a biopsy needle for cutting soft tissue, such as liver, kidne~, spleen, skin, muscle, etc., while a rasplike exterior surface is used for bone specimens.
The needle is described as providing specimen~ without damage through crushing.
A variety of sawtooth ended cannulas, with or without outer sleeves or inner trochars, have been devised to obtain bone samples and samples of the intervertebral disc. Ackermann patent 2,919,692, for example, manually rotates a trephine c 9, having six very fine sharp teeth undercut on their leading Il , , Il -3-` ~ ~G~
edges, for sawing purposes in a vertebral biopsy, within a guide 3.
Hofsess patent 3,~93,445 is a further disclosure of a trephine cannula with ~ultiple sawtooth design.
~ nother soft tissue device, disclosed in Steward patent
Banko patent 3,732,858 teaches the possible use of an electric motor for revolution of inner and outer j aws relative to one another, from an open to a closed position, as disclosed at columns 7 and 11 therein, for example. Relative rotation of a drill-like structure in conjunction with suction means is used to contain and progressively remove portions of a cutting.
}~allac patent 3,605,721 discloses a fixedly connected (soldered) coaxial inner and outer combination of needles 16 and 12 in conjunction with trochar 20. Needle 16 is telescopically received within needle 12. Both needles are provided with generally V-shaped coincident prongs.
The connection between the needles collapses upon relative motion therebetween, thus capturing the biopsy specimen Jamshidi patent 3,628,524 provides a double sawtooth cutting edge in a biopsy needle for cutting soft tissue, such as liver, kidne~, spleen, skin, muscle, etc., while a rasplike exterior surface is used for bone specimens.
The needle is described as providing specimen~ without damage through crushing.
A variety of sawtooth ended cannulas, with or without outer sleeves or inner trochars, have been devised to obtain bone samples and samples of the intervertebral disc. Ackermann patent 2,919,692, for example, manually rotates a trephine c 9, having six very fine sharp teeth undercut on their leading Il , , Il -3-` ~ ~G~
edges, for sawing purposes in a vertebral biopsy, within a guide 3.
Hofsess patent 3,~93,445 is a further disclosure of a trephine cannula with ~ultiple sawtooth design.
~ nother soft tissue device, disclosed in Steward patent
3,175,554, includes a first needle which is introduced to the area of interest along with a fitted stylet. A hollow bifurcated inner need~e is inserted through and beyond the first needle, Cam~ing action causes the needle to spread and to capture a sample of soft tissue. Withdrawal of the bifurcated needle leads, by camming action, to contraction of the portions thereof to contact each other, thus severing and trapping the biopsy within the split needle.
Hevesy U. S. patent 3,949,747 teaches the use of inter-changeable ends in a biopsy set.
Other U. S. patents known to relate to biopsy devices include Cromer et al patent 2,710,000; F.skridge et al patent 3,683,8~1j Jamshidi.patent 3,800,783 ancl Lacey patent 3,913,566.
A United Kingdom Patent Application SGB 2,~22,421) discloses the use of a punch assembly 3, axially extensible from a shaft 1 having a prong-shaped cutting edge la. The apparatus requires successive punching operations to extract a sample, However, none of the suction-type devices can penetrate cortical bone dependably. None preserve the natural architecture or orientation of tissue or cell types within the specimen.
Since an accurate diagnosis frequently depends on an appreciation for the geometric relationships of one or more tissue types t ~thers, it r~ay occur that, even in soft tissue, no dia~nosis can be made.
The forked needle type of needle also cannot biopsy bone and te~ds to mutilate the architecture of the specimen.
All of the sawtooth tip bone biopsy needles macerate and destroy much of the organization and architecture of the soft tissue and often the tumor system being examined. In essence, these devices saw a core of bone, cortical and/or trabecular, but work poorly with soft tissues. All presently used sawtooth ended trephines and needles grossly macerate the soft tissue or tumor tissue, thus destroying the organization and architecture, the relations of one tissue type to another, and make diagnosis of many tumors or pathologic conditions difficult or impossible.
The thin, small soft tissue needles, whether suction or mechanical in action, are not strong enough or appropriate for bone biopsy. Any attempt to use such needles in this way may subject them to a great risk of breakage within the patient.
All such soft tissue needles compress, harm, and macerate the tissue to some extent, such that diagnosis dependent upon tissue architecture may be impossible to be made reliably.
Si~ple needlesJ while useful in the diagnosis of infection, rarely obtain enough tissue for tumor diagnosis. Such simple ¦ needles are typically useful only for aspiration of cavities ¦ where a diagnosis can be made from a smear of diseased cells.
¦ SU~ARY AN~ OBJECTS OF THE INVENTION
¦ It is accordingly a primary object of the invention ¦ to proYide a biopsy needle capable of withdrawing a sample ¦ of tissue without maceration, thus overcoming many of the ¦ disadvantages of the prior art.
l It is st~ll another object of the invention to provide ¦ a single bioRsy needle which may be used for obtaining both bone and soft tissue samples.
Yet another object of the invention is the provision of an easily cared for and easily sterilized biopsy instrument.
~ further object of the invention is the provision of an easily inserted biopsy needle, using electric or air powered motors for rotation and freeing the operating surgeon to concentrate on guidance, rather than penetration of the needle.
Still ~ further object of the invention is the provision of a needle capable of withdrawing longer specimens than may typically be obtained by the prior art.
It is another object of the invention to provide a ¦ biopsy device which may be used under image intensifier control to biopsy lumbar vertebral bodies and/or intervertebral discs .
Yet another object of the invention is the provision of a gear arrangement for providing counter rotating biopsy needles.
Still a further obj ect of the invention is the provision of interchangeable biopsy needles for use in obtaining biopsy samples.
-~ 156~37 In accordance with the foregoing objects, ~he present invention provides a counter-rotating set of concentric tubes, having sawteeth at the distal ends thereof for sawing through bone or cutting through tissue, and a means for rotating the tubes, the rotating means being connected to the proximate ends of the tubes. A means for severing and extracting the core of biopsy rnaterial is provided in conjunction with the counter-rotating sawteeth.
The provided sawteeth face in opposite directions on the two tubes to provide the desired sawing and cutting operation for bone and soft tissuesJ respectively. The rotating means typically comprises a gear system which includes a bevelled gear driving each tube, and an idler gear engaging both the bevelled driving gears to provide opposite rotation for the two gears. One of the gears is driven by a rotor shaft which may be driven by an electric or an air motor.
`In accordance with still further objects of the invention, t~o elon~ated concentric tubes which are interchangeable with other similar tubes are provided with clockwise and counter-clockwise facing teeth on their respective distal ends. A gear system includes matching bevelled gears connected to the two tubes, along with at least one bevelled idler gear engaging the matching bevelled gears. One of the gears is driven by a rotor shaft thereby rotating one of the tubes in a clockwise direction and the other of the tubes in a counter-clockwise direction.
The device may be provided with interchangeable tubes which are coupled at their proximate ends to the gear system by a coupling means. The coupling means includes inner ~ - ~ 156~7 and outer rotor shaft adaptors driven by the two bevelled gears, and inner and outer rotor heads connected to the respective rotor shaft adaptors. The tubes, which are concentrically and telescopically disposed, include coupling heads for coupling the inner tube with the inner rotor head and for coupling the outer tube with the outer rotor head.
The foregoing and other objects, features and advantages of the present invention will become more readily apparent to those skilled in the art from the following specification and claims, when considered in conjunction with the accompanying drawlngs .
BRIEF DESCRIPTION OF THE DP~INGS
FIG. 1 shows an outer tube for use with the present invention;
FIG. 2 shows an inner tube for use with the present invention;
FIG. 3 illustrates, partially in cross section, a counter rotating biopsy needle assembly according to the present invention;
FIG. 4 shows the tubes of Figs. 1 and 2 in telescoping engagement;
FIG. 5 shows an exploded vi~w and Fig. 6 shows an assembled view, partially in cross section, of a modified arrangement of the counter rotating biopsy needle, including the various components of the gear assembly9 changeable coupling, tubes and rotor shaft used in the present invention.
6~3~
DETAILED DESCRIPTIO~I OF A PRE~ERRED EMBODIMENT
I . ' . l ¦ In accordance with the above described objects of the ¦ invention, a counter~rotating universal needle provides a pathologist with a core of tissue containing normal tissue, the , surface of a lesion, the active outer layer and the inner core of a tu~or, all in one cylinder without separation or maceration.
The needle structure permits cutting samples of skin, muscle, fascia, trabecular bone or cortical bone. Specially designed cutter tubes make the instrument appropriate for disk lesions, very soft lesions, or breast biopsy. Because of its simple structure, the instrument may be sterilized using a standard autoclave.
The inventive structure includes two thin walled, telescopin~
concentric tubes which fit accurately together. The tubes are shown in ~igs. 1 and 2, while Fig. 4 illustrates the inner and outer tubes telescoped together for use.
~ s seen in Fig. 1, an outer tube :L0 is provided with sawteeth 12 facing in a counter-clockwise rotational direction, formed on i~s distal tip. Si~ilar sawteeth 14 facing in the opposite rotational direction (clockwise) are formed on the distal end of the inner t~be 16. The directions are established when viewed from the proximal to the distal end. The two tubes are concentrically disposed in a telescoping fashion as shown in Fig. 4.
It ~s appreciated, however, that the sawteeth 12 on the tube 10 could face in a clockwise rotational direction. Similar sawteeth 14 on the distal end of the tube 1~ would then face in a counter-clockwise rotational direction and the tubes would be made to counter-rotate appropriately to assure the described cutting and sawing action.
Mechanical interconnection of the tubes is provided by a gear system, broadly shown in Fig. 3 at reference numeral 20.
_g_ ~ 5~3~
'Fhe connecting gear system is contained in a housing 22 which may be circular. A pair of covers 24 and 26 enclose the housing and the gears situated therein.
A pair of large rnatching bevel gears 28, 30 are enclosed within housing 22 by covers 24 and 26. Gear 28 includes a central openlng with a diameter sufficiently large to engage the oute~ diameter of outer tube 10, while gear 30 includes a smaller opening, sufficient to engage the outer diameter of inner tube 16. Also enclosed within housing 22 is at least a single idler gear 32, also bevelled for engaging gears 28 and 30.
. Idler gear 32 is preferably mounted on a bearing shaft 34 formed ~Jithin the housing, although other supporting means may be used, At the diametrically opposed location in housing 22J a $econd gear may be located for separating and supporting gears 28 and 30. It is appreciated, however, that rather than a gear 36, other support members may be used. For example, a bearing surface ~ay be provided within the housing to separate and . ~gidly maintain the positioning of the large bevelled gears.
Tubes 10 and 16 a~e mounted in a gear case by inserting the tubes within one another as shown in Fig. 4, with an extension of inner tube 16 passing through the outer tube 10, through gear 28, and into driving contact with gear 30. Tube 10, however, extends only as far as gear 28 in order not to interfere with the gears in housing 22. Both tubes 10 and 16 may be retained in the respective gears 28 and 30 by conventional means, such as set screws, keyed shafts or the like.
As shown in Fig. 3, inner tube 16 may extend substantially beyond beyel gear 30 and may receive a driving force directly for imparting rotation to bevel gear 30 through support bearing 41. In turn, idler gear 32 is rotated causing bevel gear 28 to rotlte ou~c~ tub~ lO in the opposite direction through support ll -10-~ 37 bearing 43. Alternatively, inner tube 16 can terminate below outer tube 10 in the space between bevel gears 28 and 30. In this case, a separate drive shaft ~not shown) can be connected by suitable coupling means to the exposed end of tube 16. , In the embodiment of Figs. 5 and 6, where the same reference numerals have been used for the same components, a modified form of drive system is illustrated for use in conjunction with the interchangeable cutting tubes. A separate drive or rotor shaft 39 is attached in driving relationship to lower bevel gear 30 and also in driving relationship with driven shaft 38 via adaptor 42. Rotation of shaft 38 is transmitted to tube 16 in one direction and tube 10 in the opposite direction by virtue of the interchangeable coupling system to be described belo~. In general, however, application of rotary driving force by rotor shaft 39 to bevel gear 30 causes transmission of the resulting rotary motion, in a reverse direction, to gear 28 by way of idler gears 32 and 36, as with the embodiment of Fig. 3.
The rotary driving force provided to the rotor shaft may be manually applied or may be applied by an air or electrically powered motor. While such rotation is intended to be applied to the rotor shaft 39 or extended inner t~be 16 with respect to a stationary housing, it is clear that slippage of the housing will merely result in reduction of the relative speed be~ween the tubes, and may in fact be used to control such relative speeds.
As an alternative source of rotary power, it is possible that gear mount 40 for idler 36 may, in fact be a driven rotor.
In ~hat event, the gear system will continue to provide the counter-rotating motion to the two tubes 10 and 16. Such a d~iving rëlationship may be achieved by penetrating housing 22 with a driye shaft for con~acting and driving mount 40 and, in turn, idle~ 36.
Of course, the use of additional idler bevel gears may be desired, such additional idler gears being preferably equally spaced about the periphery of housing 22.
Not shown in the figures, but contemplated ~or use in conjunction with the foregoing structure is a thin-walled cannula or tube and matching blunt or sharp trochar or obdurator.
With the trochar positioned in the cannula, said cannula can be inserted safely through normal tissue to the position where the planned biopsy should start. The trochar or obdurator is removed and the biopsy needle inserted through the positioned tube or cannula.
Thus, having reached the desired location, the tubes may be made to rotate in opposite directions, thereby causing sawteeth 12 and 14 to act as scissors when passing through soft tissue, muscle, fat, skin, tendons, kidney, liver, as well as tumor, while also cleanly sa~7ing through both cortical and tra-becular bone.
Also contempla-ted for use, but not shown in the figures, is an inner plunger or rod of length equal to or 2~ slightly greater than the described tubes 10 and 16. After removal of the biopsy device, the plunger rod can be inserted from the driven end into tube 16 toward the cutting tips.
This plunger is used to propulse the biopsy specimen material out from the inner tube.
A further feature of the device is the availability of an option for interchangeable tubes or cutting heads. As shown in Figs. 5 and 6, a coupling system may be interposed between the tubes and the gear system, to enable quick de-coupling and recoupling of varying tubes and cutters to the gears. Specifically~ a first ro-tor shaft adaptor 42 may be inserted in bevel gear 30, while a second rotor shaft adaptor 44 is inserted in bevel gear 28. Adaptor 44 is attached to an ~L~
opening in an outer rotor head 48 and transmits rotary motion thereto. Adaptor 42 is connected to shaft 38 which is connected in an inner rotor head 46 which is rotated by the action of the gear system as previously described. The outer tube 10 and inner tube 16 are provided, respectively, with outer needle head 50 and inner needle head 52 for coupling to rotor heads 48 and 46, respectively.
Therefore, in operation, rotation of shaft 39 is transmitted in the same direction to adaptor 42 and rotor shaft 38 and causes rotation of bevel gear 30. The rotation of the shaft 38 is transmitted to rotor head 46, needle head 52 and inner tube 10, all in the same rotary direction as shaft 39.
At the same time, rotation of bevel gear 30 cause the opposite rotation of upper bevel gear 2~ through provision of idler gear 32. This reverse rotation is transmitted to second rotor shaft adaptor 44, rotor head 48, outer needle head 50 and outer tube 10. Opposite rotation of the inner and outer cutting teeth 14 and 12, is, thus obtained.
Accordingly, it is seen tha-t diEferent length tubes may be easily coupled to the present biopsy needle, as well as diEferent diameter cutters to be substltuted. Alternatively, the tubes may be removed for sharpening of the cutters or for replacement by new, sharpened cutters.
Typical diameters for the outer tube may be approxi-mately 5-6 millimeters, while the inner tube will be selected for a close fi~ with the inner dimensions of the outer tube.
However, various sizes of biopsy needles can be adapted to the same gear housing. For example 3/16" outer diameter needles for disc space biopsies; 1/4" outer diameter needles may be a standard needle size, and 3/8" outer diameter needles may be used for soft tissue biopsy.
In view of the disclosed structure, it is further apparent that cores of substantially longer specimens may be obtained than by othex present means, the length depending upon the length of the tubes used for the specific procedur~.
Further, the rotary nature of the device readily lends itself to the use of external motor driving power, so that the surgeon can concentrate on positioning on accurate direction of the cutting edge instead of on twisting a T-handle or manually turning a crank. The present needle can often be used with biplanar image intensification to provide an ample specimen and at the same time to document the exact location from which the tissue was obtained. Such image in-tensifier control may be used, for example, to biopsy lumbar vertebral bodies and/or intervertebral discs. Such a safe and certain biopsy procedure could thus eliminate the need for "open" biopsy in many cases, and should, therefore, save operating room time for more extensive surgical procedures.
Having penetrated and obtained the sample, the present device may further include any of a variety of grabbers, screw devices or forceps, as known in the art, to extract the core of biopsy material.
It is also appreciated that liquid gases or other sources of cold may be used to preserve the tissue core architec-ture and organization during extrusion from the present device.~
The preceding specification describes, by way of illustration and not of limitation, a preferred embodiment of the invention. Equivalent variations of the described embodiment will occur to those skilled in the art. For example, any of a number of differential, spider, or spur gear arrangements could be designed to accomplish the desired counter-rotation of -the tubes, such alternative arrangements providing ease of manu-facture, greater dependability or a more pleàsing appearance.
~ - 14 -l ~
Other variations may include a pistol grip design for l greater surgical control; a small spur idler gear could be .
powered to offset the motor and provide a slde grip; replaceable or disposable cutter tubes may be developed; any tooth size or configuration could be manufactured; any length of concentric tubes could be provided, and any appropriate outside diameter of the concentric tubes might be preferred.
.Such modifications, variations and equivalents are ~ithin the $cope of the invention as recited with greater particularity in the following claims, when interpreted to obtain the benefits . of all equivalents to which the invention is fairly entitled.
Hevesy U. S. patent 3,949,747 teaches the use of inter-changeable ends in a biopsy set.
Other U. S. patents known to relate to biopsy devices include Cromer et al patent 2,710,000; F.skridge et al patent 3,683,8~1j Jamshidi.patent 3,800,783 ancl Lacey patent 3,913,566.
A United Kingdom Patent Application SGB 2,~22,421) discloses the use of a punch assembly 3, axially extensible from a shaft 1 having a prong-shaped cutting edge la. The apparatus requires successive punching operations to extract a sample, However, none of the suction-type devices can penetrate cortical bone dependably. None preserve the natural architecture or orientation of tissue or cell types within the specimen.
Since an accurate diagnosis frequently depends on an appreciation for the geometric relationships of one or more tissue types t ~thers, it r~ay occur that, even in soft tissue, no dia~nosis can be made.
The forked needle type of needle also cannot biopsy bone and te~ds to mutilate the architecture of the specimen.
All of the sawtooth tip bone biopsy needles macerate and destroy much of the organization and architecture of the soft tissue and often the tumor system being examined. In essence, these devices saw a core of bone, cortical and/or trabecular, but work poorly with soft tissues. All presently used sawtooth ended trephines and needles grossly macerate the soft tissue or tumor tissue, thus destroying the organization and architecture, the relations of one tissue type to another, and make diagnosis of many tumors or pathologic conditions difficult or impossible.
The thin, small soft tissue needles, whether suction or mechanical in action, are not strong enough or appropriate for bone biopsy. Any attempt to use such needles in this way may subject them to a great risk of breakage within the patient.
All such soft tissue needles compress, harm, and macerate the tissue to some extent, such that diagnosis dependent upon tissue architecture may be impossible to be made reliably.
Si~ple needlesJ while useful in the diagnosis of infection, rarely obtain enough tissue for tumor diagnosis. Such simple ¦ needles are typically useful only for aspiration of cavities ¦ where a diagnosis can be made from a smear of diseased cells.
¦ SU~ARY AN~ OBJECTS OF THE INVENTION
¦ It is accordingly a primary object of the invention ¦ to proYide a biopsy needle capable of withdrawing a sample ¦ of tissue without maceration, thus overcoming many of the ¦ disadvantages of the prior art.
l It is st~ll another object of the invention to provide ¦ a single bioRsy needle which may be used for obtaining both bone and soft tissue samples.
Yet another object of the invention is the provision of an easily cared for and easily sterilized biopsy instrument.
~ further object of the invention is the provision of an easily inserted biopsy needle, using electric or air powered motors for rotation and freeing the operating surgeon to concentrate on guidance, rather than penetration of the needle.
Still ~ further object of the invention is the provision of a needle capable of withdrawing longer specimens than may typically be obtained by the prior art.
It is another object of the invention to provide a ¦ biopsy device which may be used under image intensifier control to biopsy lumbar vertebral bodies and/or intervertebral discs .
Yet another object of the invention is the provision of a gear arrangement for providing counter rotating biopsy needles.
Still a further obj ect of the invention is the provision of interchangeable biopsy needles for use in obtaining biopsy samples.
-~ 156~37 In accordance with the foregoing objects, ~he present invention provides a counter-rotating set of concentric tubes, having sawteeth at the distal ends thereof for sawing through bone or cutting through tissue, and a means for rotating the tubes, the rotating means being connected to the proximate ends of the tubes. A means for severing and extracting the core of biopsy rnaterial is provided in conjunction with the counter-rotating sawteeth.
The provided sawteeth face in opposite directions on the two tubes to provide the desired sawing and cutting operation for bone and soft tissuesJ respectively. The rotating means typically comprises a gear system which includes a bevelled gear driving each tube, and an idler gear engaging both the bevelled driving gears to provide opposite rotation for the two gears. One of the gears is driven by a rotor shaft which may be driven by an electric or an air motor.
`In accordance with still further objects of the invention, t~o elon~ated concentric tubes which are interchangeable with other similar tubes are provided with clockwise and counter-clockwise facing teeth on their respective distal ends. A gear system includes matching bevelled gears connected to the two tubes, along with at least one bevelled idler gear engaging the matching bevelled gears. One of the gears is driven by a rotor shaft thereby rotating one of the tubes in a clockwise direction and the other of the tubes in a counter-clockwise direction.
The device may be provided with interchangeable tubes which are coupled at their proximate ends to the gear system by a coupling means. The coupling means includes inner ~ - ~ 156~7 and outer rotor shaft adaptors driven by the two bevelled gears, and inner and outer rotor heads connected to the respective rotor shaft adaptors. The tubes, which are concentrically and telescopically disposed, include coupling heads for coupling the inner tube with the inner rotor head and for coupling the outer tube with the outer rotor head.
The foregoing and other objects, features and advantages of the present invention will become more readily apparent to those skilled in the art from the following specification and claims, when considered in conjunction with the accompanying drawlngs .
BRIEF DESCRIPTION OF THE DP~INGS
FIG. 1 shows an outer tube for use with the present invention;
FIG. 2 shows an inner tube for use with the present invention;
FIG. 3 illustrates, partially in cross section, a counter rotating biopsy needle assembly according to the present invention;
FIG. 4 shows the tubes of Figs. 1 and 2 in telescoping engagement;
FIG. 5 shows an exploded vi~w and Fig. 6 shows an assembled view, partially in cross section, of a modified arrangement of the counter rotating biopsy needle, including the various components of the gear assembly9 changeable coupling, tubes and rotor shaft used in the present invention.
6~3~
DETAILED DESCRIPTIO~I OF A PRE~ERRED EMBODIMENT
I . ' . l ¦ In accordance with the above described objects of the ¦ invention, a counter~rotating universal needle provides a pathologist with a core of tissue containing normal tissue, the , surface of a lesion, the active outer layer and the inner core of a tu~or, all in one cylinder without separation or maceration.
The needle structure permits cutting samples of skin, muscle, fascia, trabecular bone or cortical bone. Specially designed cutter tubes make the instrument appropriate for disk lesions, very soft lesions, or breast biopsy. Because of its simple structure, the instrument may be sterilized using a standard autoclave.
The inventive structure includes two thin walled, telescopin~
concentric tubes which fit accurately together. The tubes are shown in ~igs. 1 and 2, while Fig. 4 illustrates the inner and outer tubes telescoped together for use.
~ s seen in Fig. 1, an outer tube :L0 is provided with sawteeth 12 facing in a counter-clockwise rotational direction, formed on i~s distal tip. Si~ilar sawteeth 14 facing in the opposite rotational direction (clockwise) are formed on the distal end of the inner t~be 16. The directions are established when viewed from the proximal to the distal end. The two tubes are concentrically disposed in a telescoping fashion as shown in Fig. 4.
It ~s appreciated, however, that the sawteeth 12 on the tube 10 could face in a clockwise rotational direction. Similar sawteeth 14 on the distal end of the tube 1~ would then face in a counter-clockwise rotational direction and the tubes would be made to counter-rotate appropriately to assure the described cutting and sawing action.
Mechanical interconnection of the tubes is provided by a gear system, broadly shown in Fig. 3 at reference numeral 20.
_g_ ~ 5~3~
'Fhe connecting gear system is contained in a housing 22 which may be circular. A pair of covers 24 and 26 enclose the housing and the gears situated therein.
A pair of large rnatching bevel gears 28, 30 are enclosed within housing 22 by covers 24 and 26. Gear 28 includes a central openlng with a diameter sufficiently large to engage the oute~ diameter of outer tube 10, while gear 30 includes a smaller opening, sufficient to engage the outer diameter of inner tube 16. Also enclosed within housing 22 is at least a single idler gear 32, also bevelled for engaging gears 28 and 30.
. Idler gear 32 is preferably mounted on a bearing shaft 34 formed ~Jithin the housing, although other supporting means may be used, At the diametrically opposed location in housing 22J a $econd gear may be located for separating and supporting gears 28 and 30. It is appreciated, however, that rather than a gear 36, other support members may be used. For example, a bearing surface ~ay be provided within the housing to separate and . ~gidly maintain the positioning of the large bevelled gears.
Tubes 10 and 16 a~e mounted in a gear case by inserting the tubes within one another as shown in Fig. 4, with an extension of inner tube 16 passing through the outer tube 10, through gear 28, and into driving contact with gear 30. Tube 10, however, extends only as far as gear 28 in order not to interfere with the gears in housing 22. Both tubes 10 and 16 may be retained in the respective gears 28 and 30 by conventional means, such as set screws, keyed shafts or the like.
As shown in Fig. 3, inner tube 16 may extend substantially beyond beyel gear 30 and may receive a driving force directly for imparting rotation to bevel gear 30 through support bearing 41. In turn, idler gear 32 is rotated causing bevel gear 28 to rotlte ou~c~ tub~ lO in the opposite direction through support ll -10-~ 37 bearing 43. Alternatively, inner tube 16 can terminate below outer tube 10 in the space between bevel gears 28 and 30. In this case, a separate drive shaft ~not shown) can be connected by suitable coupling means to the exposed end of tube 16. , In the embodiment of Figs. 5 and 6, where the same reference numerals have been used for the same components, a modified form of drive system is illustrated for use in conjunction with the interchangeable cutting tubes. A separate drive or rotor shaft 39 is attached in driving relationship to lower bevel gear 30 and also in driving relationship with driven shaft 38 via adaptor 42. Rotation of shaft 38 is transmitted to tube 16 in one direction and tube 10 in the opposite direction by virtue of the interchangeable coupling system to be described belo~. In general, however, application of rotary driving force by rotor shaft 39 to bevel gear 30 causes transmission of the resulting rotary motion, in a reverse direction, to gear 28 by way of idler gears 32 and 36, as with the embodiment of Fig. 3.
The rotary driving force provided to the rotor shaft may be manually applied or may be applied by an air or electrically powered motor. While such rotation is intended to be applied to the rotor shaft 39 or extended inner t~be 16 with respect to a stationary housing, it is clear that slippage of the housing will merely result in reduction of the relative speed be~ween the tubes, and may in fact be used to control such relative speeds.
As an alternative source of rotary power, it is possible that gear mount 40 for idler 36 may, in fact be a driven rotor.
In ~hat event, the gear system will continue to provide the counter-rotating motion to the two tubes 10 and 16. Such a d~iving rëlationship may be achieved by penetrating housing 22 with a driye shaft for con~acting and driving mount 40 and, in turn, idle~ 36.
Of course, the use of additional idler bevel gears may be desired, such additional idler gears being preferably equally spaced about the periphery of housing 22.
Not shown in the figures, but contemplated ~or use in conjunction with the foregoing structure is a thin-walled cannula or tube and matching blunt or sharp trochar or obdurator.
With the trochar positioned in the cannula, said cannula can be inserted safely through normal tissue to the position where the planned biopsy should start. The trochar or obdurator is removed and the biopsy needle inserted through the positioned tube or cannula.
Thus, having reached the desired location, the tubes may be made to rotate in opposite directions, thereby causing sawteeth 12 and 14 to act as scissors when passing through soft tissue, muscle, fat, skin, tendons, kidney, liver, as well as tumor, while also cleanly sa~7ing through both cortical and tra-becular bone.
Also contempla-ted for use, but not shown in the figures, is an inner plunger or rod of length equal to or 2~ slightly greater than the described tubes 10 and 16. After removal of the biopsy device, the plunger rod can be inserted from the driven end into tube 16 toward the cutting tips.
This plunger is used to propulse the biopsy specimen material out from the inner tube.
A further feature of the device is the availability of an option for interchangeable tubes or cutting heads. As shown in Figs. 5 and 6, a coupling system may be interposed between the tubes and the gear system, to enable quick de-coupling and recoupling of varying tubes and cutters to the gears. Specifically~ a first ro-tor shaft adaptor 42 may be inserted in bevel gear 30, while a second rotor shaft adaptor 44 is inserted in bevel gear 28. Adaptor 44 is attached to an ~L~
opening in an outer rotor head 48 and transmits rotary motion thereto. Adaptor 42 is connected to shaft 38 which is connected in an inner rotor head 46 which is rotated by the action of the gear system as previously described. The outer tube 10 and inner tube 16 are provided, respectively, with outer needle head 50 and inner needle head 52 for coupling to rotor heads 48 and 46, respectively.
Therefore, in operation, rotation of shaft 39 is transmitted in the same direction to adaptor 42 and rotor shaft 38 and causes rotation of bevel gear 30. The rotation of the shaft 38 is transmitted to rotor head 46, needle head 52 and inner tube 10, all in the same rotary direction as shaft 39.
At the same time, rotation of bevel gear 30 cause the opposite rotation of upper bevel gear 2~ through provision of idler gear 32. This reverse rotation is transmitted to second rotor shaft adaptor 44, rotor head 48, outer needle head 50 and outer tube 10. Opposite rotation of the inner and outer cutting teeth 14 and 12, is, thus obtained.
Accordingly, it is seen tha-t diEferent length tubes may be easily coupled to the present biopsy needle, as well as diEferent diameter cutters to be substltuted. Alternatively, the tubes may be removed for sharpening of the cutters or for replacement by new, sharpened cutters.
Typical diameters for the outer tube may be approxi-mately 5-6 millimeters, while the inner tube will be selected for a close fi~ with the inner dimensions of the outer tube.
However, various sizes of biopsy needles can be adapted to the same gear housing. For example 3/16" outer diameter needles for disc space biopsies; 1/4" outer diameter needles may be a standard needle size, and 3/8" outer diameter needles may be used for soft tissue biopsy.
In view of the disclosed structure, it is further apparent that cores of substantially longer specimens may be obtained than by othex present means, the length depending upon the length of the tubes used for the specific procedur~.
Further, the rotary nature of the device readily lends itself to the use of external motor driving power, so that the surgeon can concentrate on positioning on accurate direction of the cutting edge instead of on twisting a T-handle or manually turning a crank. The present needle can often be used with biplanar image intensification to provide an ample specimen and at the same time to document the exact location from which the tissue was obtained. Such image in-tensifier control may be used, for example, to biopsy lumbar vertebral bodies and/or intervertebral discs. Such a safe and certain biopsy procedure could thus eliminate the need for "open" biopsy in many cases, and should, therefore, save operating room time for more extensive surgical procedures.
Having penetrated and obtained the sample, the present device may further include any of a variety of grabbers, screw devices or forceps, as known in the art, to extract the core of biopsy material.
It is also appreciated that liquid gases or other sources of cold may be used to preserve the tissue core architec-ture and organization during extrusion from the present device.~
The preceding specification describes, by way of illustration and not of limitation, a preferred embodiment of the invention. Equivalent variations of the described embodiment will occur to those skilled in the art. For example, any of a number of differential, spider, or spur gear arrangements could be designed to accomplish the desired counter-rotation of -the tubes, such alternative arrangements providing ease of manu-facture, greater dependability or a more pleàsing appearance.
~ - 14 -l ~
Other variations may include a pistol grip design for l greater surgical control; a small spur idler gear could be .
powered to offset the motor and provide a slde grip; replaceable or disposable cutter tubes may be developed; any tooth size or configuration could be manufactured; any length of concentric tubes could be provided, and any appropriate outside diameter of the concentric tubes might be preferred.
.Such modifications, variations and equivalents are ~ithin the $cope of the invention as recited with greater particularity in the following claims, when interpreted to obtain the benefits . of all equivalents to which the invention is fairly entitled.
Claims (23)
OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A biopsy needle for cutting and removal of a core sample of bone or tissue comprising:
(a) first and second tubes comprised of elongated concentric tubular components each having distal and proximate ends;
(b) rotating means connected to said components at the proximate ends thereof for providing counter-rotating motion to said first and second tubes;
and (c) sawteeth provided at the distal ends of said first and second tubes for sawing through bone or cutting through tissue.
(a) first and second tubes comprised of elongated concentric tubular components each having distal and proximate ends;
(b) rotating means connected to said components at the proximate ends thereof for providing counter-rotating motion to said first and second tubes;
and (c) sawteeth provided at the distal ends of said first and second tubes for sawing through bone or cutting through tissue.
2. A biopsy needle as recited in Claim 1 wherein said sawteeth include a first set of teeth facing in a clockwise rotational direction and a second set of teeth facing in a counter-clockwise rotational direction, said first set being formed on the distal end of one of said first and second tubes, said second set being formed on the distal end of the other of said first and second tubes.
3. A biopsy needle as recited in Claim 2 wherein said one of said first and second tubes is the inner tube.
4. A biopsy needle as recited in Claim 1 wherein said rotating means comprises a gear system for counter rotation.
5. A biopsy needle as recited in Claim 4 wherein said gear system includes a housing, said housing having a first gear connected to said first tube and a second gear connected to said second tube, said first tube being disposed internally of said second tube.
6. A biopsy needle as recited in Claim 5 wherein said first and second gears are matching bevelled gears, said gear system further including at least one bevelled idler gear engaging said first and second bevelled gears.
7. A biopsy needle as recited in Claim 6 wherein said at least one idler gear is mounted on a bearing shaft associated with a surface of said housing.
8. A biopsy needle as recited in Claim 7 further comprising a driving pinion for said first and second matching bevelled gears, said driving pinion being driven by an external drive shaft driven, in turn, by a driving motor.
9. A biopsy needle as recited in Claim 7 comprising two idler gears, at least one of said idler gears mounted on a bearing shaft associated with said housing.
10. A biopsy needle as recited in Claim 7 comprising three idler gears, at least one of said idler gears mounted on a bearing shaft associated with said housing.
11. A biopsy needle as recited in Claim 7 further comprising a rotor shaft for driving one of said first and second gears, whereby the tube connected to said one driven gear is driven in one rotational direction and the tube driven by the other of said first and second gears is driven in an opposite rotational direction.
12. A biopsy needle as recited in Claim 7 further comprising a rotary shaft for driving one of said idler gears whereby the tube connected to said first gear is driven in one rotational direction and the tube connected to said second gear is driven in the opposite rotational direction.
13. A biopsy needle as recited in Claim 11 wherein said one driven gear is said first gear connected to said first tube disposed internally of said second tube.
14. A biopsy needle as recited in Claim 11 further comprising a motor means for driving said rotor shaft.
15. A biopsy needle as recited in Claim 14 wherein said motor means comprises an electrically driven motor unit.
16. A biopsy needle as recited in Claim 14 wherein said motor means comprises an air powered motor unit.
17. A biopsy needle as recited in Claim 7 further comprising an outer cannula and matched trochar for enabling insertion of the apparatus to a position where a desired biopsied specimen is located.
18. A biopsy needle for cutting and removal of a core sample of bone or tissue comprising:
(a) first and second changeable elongated concentric tubes eaching having distal and proximate ends;
(b) a first set of teeth facing in a clockwise rotational direction and a second set of teeth facing in a counter clockwise rotational direction said first set being formed on the distal end of one of said first and second tubes, said second set being formed on the distal end of the other of said first and second tubes;
(c) a gear system for providing counter-rotating motions to said first and second tubes, including a housing having:
i) a first bevelled gear connected to said first tube, ii) a second matching bevelled gear connected to said second tube, and iii) at least one bevelled idler gear engaging said first and second bevelled gears;
(d) wherein a means for driving one of said first and second bevelled gears rotates said one of said first and second tubes in a clockwise direction and said other of said first and second tubes in a counter-clockwise direction.
(a) first and second changeable elongated concentric tubes eaching having distal and proximate ends;
(b) a first set of teeth facing in a clockwise rotational direction and a second set of teeth facing in a counter clockwise rotational direction said first set being formed on the distal end of one of said first and second tubes, said second set being formed on the distal end of the other of said first and second tubes;
(c) a gear system for providing counter-rotating motions to said first and second tubes, including a housing having:
i) a first bevelled gear connected to said first tube, ii) a second matching bevelled gear connected to said second tube, and iii) at least one bevelled idler gear engaging said first and second bevelled gears;
(d) wherein a means for driving one of said first and second bevelled gears rotates said one of said first and second tubes in a clockwise direction and said other of said first and second tubes in a counter-clockwise direction.
19. A gear system as recited in Claim 18 wherein said means for driving is a rotor shaft connected to one of said first and second bevelled gears.
20. A gear system as recited in Claim 18 wherein said means for driving is a rotor shaft connected to one of said at least one bevelled idler gear.
21. A biopsy needle as recited in Claim 18 further comprising means for changeably coupling proximate ends of said tubes to said gear system.
22. A biopsy needle as recited in Claim 21 wherein said means for changeably coupling comprises:
(a) first rotor shaft adaptor driven by said first bevelled gear;
(b) second rotor shaft adaptor driven by said second bevelled gear;
(c) outer rotor head means connected to said second rotor shaft adaptor, and (d) inner rotor head means connected to said first rotor shaft adaptor.
(a) first rotor shaft adaptor driven by said first bevelled gear;
(b) second rotor shaft adaptor driven by said second bevelled gear;
(c) outer rotor head means connected to said second rotor shaft adaptor, and (d) inner rotor head means connected to said first rotor shaft adaptor.
23. A biopsy needle as recited in Claim 22 wherein said first tube is an inner tube located concentrically and telescopically within said second tube, said first tube including an inner needle head for coupling with said inner rotor head means, said second tube including an outer needle head for coupling with said outer rotor head means, whereby said rotor and needle heads may be decoupled from each other for substituting a different set of tubes and heads for coupling to said gear system.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US06/179,753 US4306570A (en) | 1980-08-20 | 1980-08-20 | Counter rotating biopsy needle |
US179,753 | 1980-08-20 |
Publications (1)
Publication Number | Publication Date |
---|---|
CA1156897A true CA1156897A (en) | 1983-11-15 |
Family
ID=22657851
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA000381986A Expired CA1156897A (en) | 1980-08-20 | 1981-07-17 | Counter rotating biopsy needle |
Country Status (2)
Country | Link |
---|---|
US (1) | US4306570A (en) |
CA (1) | CA1156897A (en) |
Families Citing this family (299)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4383527A (en) * | 1981-02-20 | 1983-05-17 | Howmedica, Inc. | Device for guiding the insertion of surgical wires into bone tissue |
US4450835A (en) * | 1981-02-20 | 1984-05-29 | Howmedica, Inc. | Method and system for inserting a surgical wire |
US4601290A (en) * | 1983-10-11 | 1986-07-22 | Cabot Medical Corporation | Surgical instrument for cutting body tissue from a body area having a restricted space |
US5041082A (en) * | 1986-06-16 | 1991-08-20 | Samuel Shiber | Mechanical atherectomy system and method |
US4842579B1 (en) * | 1984-05-14 | 1995-10-31 | Surgical Systems & Instr Inc | Atherectomy device |
FR2585233A1 (en) * | 1985-07-26 | 1987-01-30 | Orlovic Radmila | Surgical apparatus for performing biopsies and its various applications |
US4696308A (en) * | 1986-04-09 | 1987-09-29 | The Cleveland Clinic Foundation | Core sampling apparatus |
US4913143A (en) * | 1986-05-28 | 1990-04-03 | The United States Of America As Represented By The Secretary Of The Air Force | Trephine assembly |
FR2610508A1 (en) * | 1987-02-10 | 1988-08-12 | Orlovic Radmila | Bone biopsy apparatus |
ATE124232T1 (en) * | 1989-04-07 | 1995-07-15 | Univ Melbourne | IMPROVED SURGICAL INSTRUMENT. |
WO1990011723A1 (en) * | 1989-04-07 | 1990-10-18 | The University Of Melbourne | Improved surgical instrument |
US5112299A (en) * | 1989-10-25 | 1992-05-12 | Hall Surgical Division Of Zimmer, Inc. | Arthroscopic surgical apparatus and method |
US5341816A (en) * | 1989-11-06 | 1994-08-30 | Allen William C | Biopsy device |
US5353804A (en) * | 1990-09-18 | 1994-10-11 | Peb Biopsy Corporation | Method and device for percutaneous exisional breast biopsy |
US5111828A (en) * | 1990-09-18 | 1992-05-12 | Peb Biopsy Corporation | Device for percutaneous excisional breast biopsy |
WO1992008410A1 (en) * | 1990-11-14 | 1992-05-29 | Kedem, Hadar | Hard tissue biopsy instrument |
IL96352A (en) * | 1990-11-14 | 1994-11-11 | Du Kedem Tech Ltd | Hard tissue biopsy instrument |
DE9114443U1 (en) * | 1991-01-25 | 1992-01-23 | Wisap Gesellschaft Fuer Wissenschaftlichen Apparatebau Mbh, 8029 Sauerlach, De | |
FR2676108B1 (en) * | 1991-05-02 | 1993-07-16 | Pont A Mousson | REMOTE CONTROL VALVE HANDLING DEVICE. |
US5324300A (en) * | 1991-10-25 | 1994-06-28 | Elias Elias G | Device for the controlled excision of tissue from a living body |
SE470177B (en) * | 1992-03-23 | 1993-11-29 | Radi Medical Systems | Device for punching in hard tissue and puncture needle |
WO1993025151A1 (en) * | 1992-06-12 | 1993-12-23 | Larry Steven Nichter | Wire driver and method |
DE59303074D1 (en) * | 1992-08-17 | 1996-08-01 | Martin Brun | DEEP HOLE DRILL |
US5331972A (en) * | 1992-12-03 | 1994-07-26 | Baxter International Inc. | Bone marrow biopsy, aspiration and transplant needles |
SE9304261D0 (en) * | 1993-12-22 | 1993-12-22 | Radi Medical Systems | Biopsy sampling device |
US5526822A (en) * | 1994-03-24 | 1996-06-18 | Biopsys Medical, Inc. | Method and apparatus for automated biopsy and collection of soft tissue |
US5649547A (en) * | 1994-03-24 | 1997-07-22 | Biopsys Medical, Inc. | Methods and devices for automated biopsy and collection of soft tissue |
CA2146585A1 (en) * | 1995-04-07 | 1996-10-08 | David E. Gibbs | Catheterized, targeted infusion of medication |
US5618293A (en) * | 1995-06-06 | 1997-04-08 | Smith & Nephews Dyonics, Inc. | Surgical instrument |
US5857982A (en) * | 1995-09-08 | 1999-01-12 | United States Surgical Corporation | Apparatus and method for removing tissue |
US5817034A (en) | 1995-09-08 | 1998-10-06 | United States Surgical Corporation | Apparatus and method for removing tissue |
US5782775A (en) * | 1995-10-20 | 1998-07-21 | United States Surgical Corporation | Apparatus and method for localizing and removing tissue |
US5709697A (en) * | 1995-11-22 | 1998-01-20 | United States Surgical Corporation | Apparatus and method for removing tissue |
US6027458A (en) * | 1996-12-23 | 2000-02-22 | Janssens; Jacques Phillibert | Device for taking a tissue sample |
US5938635A (en) * | 1996-12-30 | 1999-08-17 | Kuhle; William G. | Biopsy needle with flared tip |
US5772664A (en) * | 1997-02-12 | 1998-06-30 | Wright Medical Technology, Inc. | Instrument for harvesting bone grafts having substantially cylindrical bone plugs |
US6017316A (en) * | 1997-06-18 | 2000-01-25 | Biopsys Medical | Vacuum control system and method for automated biopsy device |
US6080113A (en) | 1998-09-11 | 2000-06-27 | Imagyn Medical Technologies California, Inc. | Incisional breast biopsy device |
US6383145B1 (en) | 1997-09-12 | 2002-05-07 | Imagyn Medical Technologies California, Inc. | Incisional breast biopsy device |
US6551253B2 (en) | 1997-09-12 | 2003-04-22 | Imagyn Medical Technologies | Incisional breast biopsy device |
DE19803439A1 (en) * | 1998-01-29 | 1999-08-05 | Sachse Hans E | Bone removal appliance of hollow cylinder with inner dia. deviating from circular cross section |
US6247928B1 (en) | 1998-04-09 | 2001-06-19 | Moshe Meller | Disposable anesthesia delivery system |
AU760879B2 (en) | 1998-11-25 | 2003-05-22 | United States Surgical Corporation | Biopsy system |
US6402701B1 (en) | 1999-03-23 | 2002-06-11 | Fna Concepts, Llc | Biopsy needle instrument |
US6575745B2 (en) | 2000-12-05 | 2003-06-10 | Tulsa Dental Products Inc. | Titanium alloy intraosseous anesthesia delivery device |
US6287114B1 (en) | 1999-06-09 | 2001-09-11 | X-Tip Technologies, Llc | Disposable anesthesia delivery system with shortened outer sleeve and inner solid drill |
US6547561B2 (en) | 1999-06-09 | 2003-04-15 | Tulsa Dental Products Inc. | Disposable anesthesia delivery system with shortened outer sleeve and inner hollow drill |
US6273715B1 (en) | 1999-06-09 | 2001-08-14 | X-Tip Technologies, Llc | Disposable anesthesia delivery system with shortened outer sleeve and inner hollow drill |
US7713279B2 (en) * | 2000-12-20 | 2010-05-11 | Fox Hollow Technologies, Inc. | Method and devices for cutting tissue |
US7708749B2 (en) | 2000-12-20 | 2010-05-04 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US6299622B1 (en) * | 1999-08-19 | 2001-10-09 | Fox Hollow Technologies, Inc. | Atherectomy catheter with aligned imager |
US6702761B1 (en) | 2000-03-06 | 2004-03-09 | Fonar Corporation | Vibration assisted needle device |
US6679886B2 (en) | 2000-09-01 | 2004-01-20 | Synthes (Usa) | Tools and methods for creating cavities in bone |
US6712773B1 (en) | 2000-09-11 | 2004-03-30 | Tyco Healthcare Group Lp | Biopsy system |
US6602203B2 (en) | 2000-10-13 | 2003-08-05 | Ethicon Endo-Surgery, Inc. | Remote thumbwheel for a surgical biopsy device |
US6517561B1 (en) * | 2000-10-16 | 2003-02-11 | Robert E. Phillips | Motorized specimen cutter |
JP3996057B2 (en) | 2000-11-27 | 2007-10-24 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Tissue extractor |
US7004173B2 (en) * | 2000-12-05 | 2006-02-28 | Lumend, Inc. | Catheter system for vascular re-entry from a sub-intimal space |
ATE499054T1 (en) | 2000-12-20 | 2011-03-15 | Fox Hollow Technologies Inc | REDUCTION CATHETER |
US6673023B2 (en) * | 2001-03-23 | 2004-01-06 | Stryker Puerto Rico Limited | Micro-invasive breast biopsy device |
US6626848B2 (en) | 2001-03-30 | 2003-09-30 | Eric M. Neuenfeldt | Method and device to reduce needle insertion force |
US11229472B2 (en) | 2001-06-12 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with multiple magnetic position sensors |
JP4058614B2 (en) * | 2001-08-09 | 2008-03-12 | 株式会社Jimro | Bone marrow needle |
WO2003077768A1 (en) | 2002-03-19 | 2003-09-25 | Bard Dublin Itc Limited | Biopsy device and biopsy needle module that can be inserted into the biopsy device |
ATE303099T1 (en) | 2002-03-19 | 2005-09-15 | Bard Dublin Itc Ltd | VACUUM BIOPSY DEVICE |
US8641715B2 (en) | 2002-05-31 | 2014-02-04 | Vidacare Corporation | Manual intraosseous device |
US8142365B2 (en) | 2002-05-31 | 2012-03-27 | Vidacare Corporation | Apparatus and method for accessing the bone marrow of the sternum |
US7811260B2 (en) | 2002-05-31 | 2010-10-12 | Vidacare Corporation | Apparatus and method to inject fluids into bone marrow and other target sites |
US10973532B2 (en) | 2002-05-31 | 2021-04-13 | Teleflex Life Sciences Limited | Powered drivers, intraosseous devices and methods to access bone marrow |
US9314228B2 (en) | 2002-05-31 | 2016-04-19 | Vidacare LLC | Apparatus and method for accessing the bone marrow |
US9072543B2 (en) | 2002-05-31 | 2015-07-07 | Vidacare LLC | Vascular access kits and methods |
US20070049945A1 (en) | 2002-05-31 | 2007-03-01 | Miller Larry J | Apparatus and methods to install, support and/or monitor performance of intraosseous devices |
US11298202B2 (en) | 2002-05-31 | 2022-04-12 | Teleflex Life Sciences Limited | Biopsy devices and related methods |
US7951089B2 (en) | 2002-05-31 | 2011-05-31 | Vidacare Corporation | Apparatus and methods to harvest bone and bone marrow |
CA2485904C (en) | 2002-05-31 | 2013-05-21 | Vidacare Corporation | Apparatus and method to access the bone marrow |
US9545243B2 (en) | 2002-05-31 | 2017-01-17 | Vidacare LLC | Bone marrow aspiration devices and related methods |
US8668698B2 (en) | 2002-05-31 | 2014-03-11 | Vidacare Corporation | Assembly for coupling powered driver with intraosseous device |
US8656929B2 (en) | 2002-05-31 | 2014-02-25 | Vidacare Corporation | Medical procedures trays and related methods |
US8690791B2 (en) | 2002-05-31 | 2014-04-08 | Vidacare Corporation | Apparatus and method to access the bone marrow |
US10973545B2 (en) | 2002-05-31 | 2021-04-13 | Teleflex Life Sciences Limited | Powered drivers, intraosseous devices and methods to access bone marrow |
US11337728B2 (en) | 2002-05-31 | 2022-05-24 | Teleflex Life Sciences Limited | Powered drivers, intraosseous devices and methods to access bone marrow |
US7258694B1 (en) | 2002-06-17 | 2007-08-21 | Origin Medsystems, Inc. | Medical punch and surgical procedure |
DE10314240A1 (en) | 2003-03-29 | 2004-10-07 | Bard Dublin Itc Ltd., Crawley | Pressure generating unit |
US8246640B2 (en) | 2003-04-22 | 2012-08-21 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue at a vascular location |
US9504477B2 (en) | 2003-05-30 | 2016-11-29 | Vidacare LLC | Powered driver |
US7641620B2 (en) * | 2003-12-23 | 2010-01-05 | Vance Products Incorporated | Rotatable sampling apparatus |
ES2607206T3 (en) | 2004-01-26 | 2017-03-29 | Vidacare LLC | Manual interosseous device |
US7815642B2 (en) | 2004-01-26 | 2010-10-19 | Vidacare Corporation | Impact-driven intraosseous needle |
US8182501B2 (en) | 2004-02-27 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical shears and method for sealing a blood vessel using same |
EP1776047B1 (en) | 2004-07-09 | 2012-12-05 | Bard Peripheral Vascular, Inc. | Transport system for biopsy device |
JP5009159B2 (en) | 2004-10-08 | 2012-08-22 | エシコン・エンド−サージェリィ・インコーポレイテッド | Ultrasonic surgical instrument |
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 |
US7517321B2 (en) | 2005-01-31 | 2009-04-14 | C. R. Bard, Inc. | Quick cycle biopsy system |
WO2007021905A2 (en) | 2005-08-10 | 2007-02-22 | C.R. Bard Inc. | Single-insertion, multiple sample biopsy device with integrated markers |
US8262585B2 (en) | 2005-08-10 | 2012-09-11 | C. R. Bard, Inc. | Single-insertion, multiple sampling biopsy device with linear drive |
EP1921999B1 (en) | 2005-08-10 | 2015-08-05 | C.R.Bard, Inc. | Single-insertion, multiple sampling biopsy device usable with various transport systems |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
WO2007070584A2 (en) * | 2005-12-16 | 2007-06-21 | Access Scientific | Needle constructed with a transparent or translucent material |
US7621930B2 (en) | 2006-01-20 | 2009-11-24 | Ethicon Endo-Surgery, Inc. | Ultrasound medical instrument having a medical ultrasonic blade |
US20070276419A1 (en) | 2006-05-26 | 2007-11-29 | Fox Hollow Technologies, Inc. | Methods and devices for rotating an active element and an energy emitter on a catheter |
US20090031871A1 (en) * | 2006-06-08 | 2009-02-05 | Malandain Hugues F | Dual cutting element tool for debulking bone |
WO2008024684A2 (en) | 2006-08-21 | 2008-02-28 | C.R. Bard, Inc. | Self-contained handheld biopsy needle |
US8944069B2 (en) | 2006-09-12 | 2015-02-03 | Vidacare Corporation | Assemblies for coupling intraosseous (IO) devices to powered drivers |
ES2609923T3 (en) | 2006-09-12 | 2017-04-25 | Vidacare LLC | Bone marrow biopsy and aspiration device |
ES2805203T3 (en) | 2006-09-12 | 2021-02-11 | Teleflex Medical Devices S A R L | Bone marrow aspiration and biopsy apparatus |
US8485987B2 (en) | 2006-10-06 | 2013-07-16 | Bard Peripheral Vascular, Inc. | Tissue handling system with reduced operator exposure |
WO2008051987A2 (en) | 2006-10-24 | 2008-05-02 | C.R. Bard Inc. | Large sample low aspect ratio biopsy needle |
US8974410B2 (en) | 2006-10-30 | 2015-03-10 | Vidacare LLC | Apparatus and methods to communicate fluids and/or support intraosseous devices |
US20080161644A1 (en) * | 2006-12-29 | 2008-07-03 | Ghabrial Ragae M | Method of and apparatus for attaching an instrument to an organ wall |
DE102007049796A1 (en) * | 2007-05-18 | 2009-04-23 | Wisap Gesellschaft für wissenschaftlichen Apparatebau mbH | Apparatus for cutting and removing tissue cylinders from a tissue and their use |
US20110060357A1 (en) * | 2007-02-22 | 2011-03-10 | WISAP Gesellschaft fuer wissenschaftlichen Apparat ebau mbH | Device for cutting out and removing cylinders of tissue from a tissue and the use thereof |
US8057498B2 (en) | 2007-11-30 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument blades |
US8911460B2 (en) | 2007-03-22 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8142461B2 (en) | 2007-03-22 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US20080234709A1 (en) | 2007-03-22 | 2008-09-25 | Houser Kevin L | Ultrasonic surgical instrument and cartilage and bone shaping blades therefor |
US8226675B2 (en) | 2007-03-22 | 2012-07-24 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
WO2008124463A2 (en) | 2007-04-04 | 2008-10-16 | Vidacare Corporation | Powered drivers, intraosseous devices and methods to access bone marrow |
US8348967B2 (en) | 2007-07-27 | 2013-01-08 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8882791B2 (en) | 2007-07-27 | 2014-11-11 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8523889B2 (en) | 2007-07-27 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Ultrasonic end effectors with increased active length |
US8808319B2 (en) | 2007-07-27 | 2014-08-19 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8252012B2 (en) | 2007-07-31 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument with modulator |
US9044261B2 (en) | 2007-07-31 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Temperature controlled ultrasonic surgical instruments |
US8512365B2 (en) | 2007-07-31 | 2013-08-20 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8430898B2 (en) | 2007-07-31 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8623027B2 (en) | 2007-10-05 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
WO2009058436A1 (en) * | 2007-11-02 | 2009-05-07 | Sharp Surgical Devices, Inc. | Devices, methods, and kits for a biopsy device |
US10010339B2 (en) | 2007-11-30 | 2018-07-03 | Ethicon Llc | Ultrasonic surgical blades |
US8241225B2 (en) | 2007-12-20 | 2012-08-14 | C. R. Bard, Inc. | Biopsy device |
US7854706B2 (en) | 2007-12-27 | 2010-12-21 | Devicor Medical Products, Inc. | Clutch and valving system for tetherless biopsy device |
US8784440B2 (en) | 2008-02-25 | 2014-07-22 | Covidien Lp | Methods and devices for cutting tissue |
TW201000160A (en) * | 2008-06-25 | 2010-01-01 | Univ Nat Taiwan | The control system of catheter feeder |
US20100030216A1 (en) * | 2008-07-30 | 2010-02-04 | Arcenio Gregory B | Discectomy tool having counter-rotating nucleus disruptors |
DE102008036420A1 (en) * | 2008-08-05 | 2010-02-11 | Wisap Gesellschaft für wissenschaftlichen Apparatebau mbH | Tissue cylinders cutting and removing apparatus for e.g. laparascopic for treatment of myomas of patient, has drive accommodated by housing, where drive is brought in mutual engagement with driving device by coupling device |
US8058771B2 (en) | 2008-08-06 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic device for cutting and coagulating with stepped output |
US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
KR101645754B1 (en) * | 2008-10-13 | 2016-08-04 | 코비디엔 엘피 | Devices and methods for manipulating a catheter shaft |
US8142463B2 (en) * | 2009-03-13 | 2012-03-27 | Kyphon Sarl | Battery operated nucleus disruptor device for intervertebral disc |
US8690793B2 (en) | 2009-03-16 | 2014-04-08 | C. R. Bard, Inc. | Biopsy device having rotational cutting |
AU2009344276B2 (en) | 2009-04-15 | 2014-06-05 | C.R. Bard, Inc. | Biopsy apparatus having integrated fluid management |
CN102625673B (en) | 2009-04-29 | 2014-12-24 | 泰科保健集团有限合伙公司 | Methods and devices for cutting and abrading tissue |
AU2010248909B2 (en) | 2009-05-14 | 2013-03-21 | Covidien Lp | Easily cleaned atherectomy catheters and methods of use |
US9700339B2 (en) | 2009-05-20 | 2017-07-11 | Ethicon Endo-Surgery, Inc. | Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments |
CN101899386B (en) * | 2009-06-01 | 2013-12-04 | 上海日泰医药设备工程有限公司 | Sanitary cell sampling valve |
US8206316B2 (en) | 2009-06-12 | 2012-06-26 | Devicor Medical Products, Inc. | Tetherless biopsy device with reusable portion |
US8344596B2 (en) | 2009-06-24 | 2013-01-01 | Ethicon Endo-Surgery, Inc. | Transducer arrangements for ultrasonic surgical instruments |
US8461744B2 (en) | 2009-07-15 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Rotating transducer mount for ultrasonic surgical instruments |
US9017326B2 (en) | 2009-07-15 | 2015-04-28 | Ethicon Endo-Surgery, Inc. | Impedance monitoring apparatus, system, and method for ultrasonic surgical instruments |
US8663220B2 (en) | 2009-07-15 | 2014-03-04 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
EP3572002A1 (en) | 2009-08-12 | 2019-11-27 | 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 |
US8430824B2 (en) * | 2009-10-29 | 2013-04-30 | Bard Peripheral Vascular, Inc. | Biopsy driver assembly having a control circuit for conserving battery power |
US9168054B2 (en) | 2009-10-09 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US8986302B2 (en) | 2009-10-09 | 2015-03-24 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
USRE47996E1 (en) | 2009-10-09 | 2020-05-19 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
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 |
US20110105946A1 (en) * | 2009-10-31 | 2011-05-05 | Sorensen Peter L | Biopsy system with infrared communications |
AU2010326063B2 (en) | 2009-12-02 | 2013-07-04 | Covidien Lp | Methods and devices for cutting tissue |
JP5511107B2 (en) | 2009-12-11 | 2014-06-04 | コヴィディエン リミテッド パートナーシップ | Substance removal device and method with improved substance capture efficiency |
US8579928B2 (en) | 2010-02-11 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Outer sheath and blade arrangements for ultrasonic surgical instruments |
US8419759B2 (en) * | 2010-02-11 | 2013-04-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument with comb-like tissue trimming device |
US9259234B2 (en) | 2010-02-11 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with rotatable blade and hollow sheath arrangements |
US8951272B2 (en) | 2010-02-11 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Seal arrangements for ultrasonically powered surgical instruments |
US8323302B2 (en) | 2010-02-11 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Methods of using ultrasonically powered surgical instruments with rotatable cutting implements |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
US8531064B2 (en) | 2010-02-11 | 2013-09-10 | Ethicon Endo-Surgery, Inc. | Ultrasonically powered surgical instruments with rotating cutting implement |
US8961547B2 (en) | 2010-02-11 | 2015-02-24 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with moving cutting implement |
US8382782B2 (en) | 2010-02-11 | 2013-02-26 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with partially rotating blade and fixed pad arrangement |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
US8409235B2 (en) * | 2010-04-30 | 2013-04-02 | Medtronic Xomed, Inc. | Rotary cutting tool with improved cutting and reduced clogging on soft tissue and thin bone |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US9119662B2 (en) | 2010-06-14 | 2015-09-01 | Covidien Lp | Material removal device and method of use |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
CA2815186C (en) * | 2010-10-28 | 2015-12-29 | Covidien Lp | Material removal device and method of use |
AU2011326420B2 (en) | 2010-11-11 | 2014-11-27 | Covidien Lp | Flexible debulking catheters with imaging and methods of use and manufacture |
KR102102708B1 (en) | 2010-11-15 | 2020-04-21 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | Decoupling instrument shaft roll and end effector actuation in a surgical instrument |
US9492130B2 (en) | 2010-11-24 | 2016-11-15 | Hologic, Inc. | System for improved tissue-handling and in line analysis of the tissue |
CN103534053A (en) * | 2011-03-08 | 2014-01-22 | 注入品牌公司 | Dual blade hole saw |
WO2012129278A2 (en) * | 2011-03-22 | 2012-09-27 | Alcon Research, Ltd. | Pneumatically driven ophthalmic scanning endoprobe |
DE102011100278A1 (en) * | 2011-04-28 | 2012-10-31 | C. & E. Fein Gmbh | Drilling machine, in particular hand-held drilling machine |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
US8992717B2 (en) | 2011-09-01 | 2015-03-31 | Covidien Lp | Catheter with helical drive shaft and methods of manufacture |
EP2811932B1 (en) | 2012-02-10 | 2019-06-26 | Ethicon LLC | Robotically controlled surgical instrument |
US9237921B2 (en) | 2012-04-09 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US9724118B2 (en) | 2012-04-09 | 2017-08-08 | Ethicon Endo-Surgery, Llc | Techniques for cutting and coagulating tissue for ultrasonic surgical instruments |
US9439668B2 (en) | 2012-04-09 | 2016-09-13 | Ethicon Endo-Surgery, Llc | Switch arrangements for ultrasonic surgical instruments |
US9241731B2 (en) | 2012-04-09 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Rotatable electrical connection for ultrasonic surgical instruments |
US9226766B2 (en) | 2012-04-09 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Serial communication protocol for medical device |
US20140005705A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulating shafts |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9820768B2 (en) | 2012-06-29 | 2017-11-21 | Ethicon Llc | Ultrasonic surgical instruments with control mechanisms |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US9393037B2 (en) | 2012-06-29 | 2016-07-19 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US9283045B2 (en) | 2012-06-29 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Surgical instruments with fluid management system |
US9351754B2 (en) | 2012-06-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with distally positioned jaw assemblies |
EP2698115A1 (en) | 2012-08-16 | 2014-02-19 | AprioMed AB | Biopsy device |
US9579157B2 (en) | 2012-09-13 | 2017-02-28 | Covidien Lp | Cleaning device for medical instrument and method of use |
BR112015007010B1 (en) | 2012-09-28 | 2022-05-31 | Ethicon Endo-Surgery, Inc | end actuator |
US10201365B2 (en) | 2012-10-22 | 2019-02-12 | Ethicon Llc | Surgeon feedback sensing and display methods |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
US9943329B2 (en) | 2012-11-08 | 2018-04-17 | Covidien Lp | Tissue-removing catheter with rotatable cutter |
US20140135804A1 (en) | 2012-11-15 | 2014-05-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic and electrosurgical devices |
JP2015536805A (en) * | 2012-12-12 | 2015-12-24 | コヴィディエン リミテッド パートナーシップ | Debulking catheter |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
US9241728B2 (en) | 2013-03-15 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument with multiple clamping mechanisms |
EP3498176B1 (en) | 2013-03-20 | 2021-04-28 | Bard Peripheral Vascular, Inc. | Biopsy device |
US9814514B2 (en) | 2013-09-13 | 2017-11-14 | Ethicon Llc | Electrosurgical (RF) medical instruments for cutting and coagulating tissue |
EP3808281B1 (en) | 2013-11-05 | 2024-01-10 | C. R. Bard, Inc. | Biopsy device having integrated vacuum |
US9265926B2 (en) | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
GB2521228A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
GB2521229A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
US9795436B2 (en) | 2014-01-07 | 2017-10-24 | Ethicon Llc | Harvesting energy from a surgical generator |
WO2015134277A1 (en) | 2014-03-05 | 2015-09-11 | Faxitron Bioptics, Llc | System and method for multi-axis imaging of specimens |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US9737355B2 (en) | 2014-03-31 | 2017-08-22 | Ethicon Llc | Controlling impedance rise in electrosurgical medical devices |
US9913680B2 (en) | 2014-04-15 | 2018-03-13 | Ethicon Llc | Software algorithms for electrosurgical instruments |
WO2015200702A1 (en) | 2014-06-27 | 2015-12-30 | Covidien Lp | Cleaning device for catheter and catheter including the same |
US10285724B2 (en) | 2014-07-31 | 2019-05-14 | Ethicon Llc | Actuation mechanisms and load adjustment assemblies for surgical instruments |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US10321950B2 (en) | 2015-03-17 | 2019-06-18 | Ethicon Llc | Managing tissue treatment |
US10342602B2 (en) | 2015-03-17 | 2019-07-09 | Ethicon Llc | Managing tissue treatment |
US10595929B2 (en) | 2015-03-24 | 2020-03-24 | Ethicon Llc | Surgical instruments with firing system overload protection mechanisms |
US10314667B2 (en) | 2015-03-25 | 2019-06-11 | Covidien Lp | Cleaning device for cleaning medical instrument |
PL3288467T3 (en) | 2015-05-01 | 2022-03-07 | C. R. Bard, Inc. | Biopsy device |
US10034684B2 (en) | 2015-06-15 | 2018-07-31 | Ethicon Llc | Apparatus and method for dissecting and coagulating tissue |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
US11129669B2 (en) | 2015-06-30 | 2021-09-28 | Cilag Gmbh International | Surgical system with user adaptable techniques based on tissue type |
US11141213B2 (en) | 2015-06-30 | 2021-10-12 | Cilag Gmbh International | Surgical instrument with user adaptable techniques |
US10034704B2 (en) | 2015-06-30 | 2018-07-31 | Ethicon Llc | Surgical instrument with user adaptable algorithms |
JP6876005B2 (en) * | 2015-06-30 | 2021-05-26 | コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. | Coaxial reverse rotation cutting assembly |
US10357303B2 (en) | 2015-06-30 | 2019-07-23 | Ethicon Llc | Translatable outer tube for sealing using shielded lap chole dissector |
US11051873B2 (en) | 2015-06-30 | 2021-07-06 | Cilag Gmbh International | Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
US10292721B2 (en) | 2015-07-20 | 2019-05-21 | Covidien Lp | Tissue-removing catheter including movable distal tip |
WO2017040977A1 (en) | 2015-09-04 | 2017-03-09 | Faxitron Bioptics, Llc | Multi-axis specimen imaging device with embedded orientation markers |
US11033322B2 (en) | 2015-09-30 | 2021-06-15 | Ethicon Llc | Circuit topologies for combined generator |
US10314664B2 (en) | 2015-10-07 | 2019-06-11 | Covidien Lp | Tissue-removing catheter and tissue-removing element with depth stop |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
US10716615B2 (en) | 2016-01-15 | 2020-07-21 | Ethicon Llc | Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade |
US11051840B2 (en) | 2016-01-15 | 2021-07-06 | Ethicon Llc | Modular battery powered handheld surgical instrument with reusable asymmetric handle housing |
US11129670B2 (en) | 2016-01-15 | 2021-09-28 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
US10555769B2 (en) | 2016-02-22 | 2020-02-11 | Ethicon Llc | Flexible circuits for electrosurgical instrument |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
US10245064B2 (en) | 2016-07-12 | 2019-04-02 | Ethicon Llc | Ultrasonic surgical instrument with piezoelectric central lumen transducer |
US10893883B2 (en) | 2016-07-13 | 2021-01-19 | Ethicon Llc | Ultrasonic assembly for use with ultrasonic surgical instruments |
US10842522B2 (en) | 2016-07-15 | 2020-11-24 | Ethicon Llc | Ultrasonic surgical instruments having offset blades |
US10376305B2 (en) | 2016-08-05 | 2019-08-13 | Ethicon Llc | Methods and systems for advanced harmonic energy |
US10285723B2 (en) | 2016-08-09 | 2019-05-14 | Ethicon Llc | Ultrasonic surgical blade with improved heel portion |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US10828056B2 (en) | 2016-08-25 | 2020-11-10 | Ethicon Llc | Ultrasonic transducer to waveguide acoustic coupling, connections, and configurations |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
WO2018085719A1 (en) | 2016-11-04 | 2018-05-11 | Hologic, Inc. | Specimen radiography system |
US10603064B2 (en) | 2016-11-28 | 2020-03-31 | Ethicon Llc | Ultrasonic transducer |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
EP3338646A1 (en) | 2016-12-21 | 2018-06-27 | National University of Ireland Galway | A biopsy device |
US11116483B2 (en) | 2017-05-19 | 2021-09-14 | Merit Medical Systems, Inc. | Rotating biopsy needle |
EP3624698A4 (en) | 2017-05-19 | 2021-06-09 | Merit Medical Systems, Inc. | Semi-automatic biopsy needle device and methods of use |
EP3624697B1 (en) | 2017-05-19 | 2024-02-14 | Merit Medical Systems, Inc. | Biopsy needle devices and methods of use |
US10820920B2 (en) | 2017-07-05 | 2020-11-03 | Ethicon Llc | Reusable ultrasonic medical devices and methods of their use |
US11317881B2 (en) | 2017-09-11 | 2022-05-03 | Faxitron Bioptics, Llc | Imaging system with adaptive object magnification |
US10751077B2 (en) * | 2017-10-09 | 2020-08-25 | Gyrus Acmi, Inc. | Tissue Resection Device |
US10813659B2 (en) * | 2018-03-22 | 2020-10-27 | Spiration, Inc. | Rotational tissue cutting device |
US11229424B2 (en) | 2018-04-04 | 2022-01-25 | Praxis Holding Llc | Rotatable syringe system |
JP2022526076A (en) | 2019-04-10 | 2022-05-23 | アブソリューションズ メッド,インク. | Modifications of abdominal closure methods and devices that close abdominal hernias and reduce recurrence |
US11744636B2 (en) | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Electrosurgical systems with integrated and external power sources |
US20210196361A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with monopolar and bipolar energy capabilities |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11911063B2 (en) | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US11779329B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a flex circuit including a sensor system |
US11684412B2 (en) | 2019-12-30 | 2023-06-27 | Cilag Gmbh International | Surgical instrument with rotatable and articulatable surgical end effector |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11786294B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Control program for modular combination energy device |
US11937866B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Method for an electrosurgical procedure |
US11950797B2 (en) | 2019-12-30 | 2024-04-09 | Cilag Gmbh International | Deflectable electrode with higher distal bias relative to proximal bias |
US11805998B2 (en) * | 2020-04-20 | 2023-11-07 | Covidien Lp | Devices and methods for obtaining adenomyosis and other biopsy samples |
US11304723B1 (en) | 2020-12-17 | 2022-04-19 | Avantec Vascular Corporation | Atherectomy devices that are self-driving with controlled deflection |
WO2023023486A2 (en) * | 2021-08-16 | 2023-02-23 | Absolutions Med, Inc. | Nipple areolar grafting methods and apparatus |
Family Cites Families (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2919692A (en) * | 1956-02-23 | 1960-01-05 | Ackermann Wolfgang | Vertebral trephine biopsy instruments |
US3587560A (en) * | 1969-04-07 | 1971-06-28 | Jacob A Glassman | Biopsy instrument and method of obtaining biopsy |
US3778179A (en) * | 1972-09-06 | 1973-12-11 | D Rivas | Dual replaceable holesaw bit |
US4177797A (en) * | 1977-03-04 | 1979-12-11 | Shelby M. Baylis | Rotary biopsy device and method of using same |
US4142517A (en) * | 1976-07-23 | 1979-03-06 | Contreras Guerrero De Stavropo | Apparatus for extracting bone marrow specimens |
US4230123A (en) * | 1978-10-31 | 1980-10-28 | Hawkins Jr Irvin F | Needle sheath complex and process for decompression and biopsy |
-
1980
- 1980-08-20 US US06/179,753 patent/US4306570A/en not_active Expired - Lifetime
-
1981
- 1981-07-17 CA CA000381986A patent/CA1156897A/en not_active Expired
Also Published As
Publication number | Publication date |
---|---|
US4306570A (en) | 1981-12-22 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CA1156897A (en) | Counter rotating biopsy needle | |
JP4156806B2 (en) | Device with flexible shaft for taking bone sections | |
US5251641A (en) | Biopsy needle | |
US6315737B1 (en) | Biopsy needle for a biopsy instrument | |
EP1509140B1 (en) | Apparatus to access the bone marrow | |
JP4306969B2 (en) | Device for collecting bone sections | |
US5423824A (en) | Method of accessing hard tissue | |
EP0751744B1 (en) | Apparatus for automated biopsy | |
JP4541897B2 (en) | Biopsy device with sample tube | |
US5916229A (en) | Rotating needle biopsy device and method | |
US8192370B2 (en) | Biopsy apparatus | |
US6626848B2 (en) | Method and device to reduce needle insertion force | |
JP4638051B2 (en) | Biopsy needle | |
JPS61170449A (en) | Gripping type surgical machine | |
CA2044848A1 (en) | Surgical cutting instrument | |
WO2004075719A3 (en) | Biopsy device with inner cutting member | |
CN211243478U (en) | Negative pressure rotary-cut puncture cannula for bone tumor puncture biopsy | |
CN2402273Y (en) | Automatic cervical intervertebral disc rotary-removal and aspiration therapeutical apparatus | |
JP2563980B2 (en) | Puncture needle | |
CN219814189U (en) | Rotary bone tissue biopsy device | |
RU88262U1 (en) | DRILL MEDICAL | |
CA1129746A (en) | Biopsy apparatus and methods of constructing and utilizing same | |
RU2033758C1 (en) | Needle for puncture biopsy of thyroid gland | |
SU1598984A1 (en) | Device for bone biopsy |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
MKEX | Expiry |