A surgical device is disclosed. The surgical device comprises a housing, a cutting element, a spool, a piston, and a spring. The cutting element extends from the housing at the distal end of the housing. The cutting element comprises an outer cannula and an inner cannula. The spool is engaged with the outer cannula. The piston is engaged with the inner cannula. A spring is positioned between the spool and the piston. The spool is translated distally to translate the outer cannula towards the distal end. And the piston translates the inner cannula towards the distal end to sever tissue.
A tissue removal device used for breast biopsy is attached to a stereotactic table for positioning A patient's target area for tissue removal is immobilized (e.g., a breast) in relation to the tissue removal device. The stereotactic table allows precise positioning of a biopsy device, or any other device, at a known target area. Moreover, the stereotactic table allows for visualization of a known location for confirmation or for providing a three-dimensional location future analysis and/or treatment. In many cases, the tissue removal device is a surgical device, such as is described in detail below and in the drawings.
Referring now to the drawings, FIG. 1 shows a surgical device 100. Surgical device 100 includes an outer sleeve 102, an introducer cannula 104, and a rotator 106. Further, surgical device 100 is positioned on a cradle top 114. An adapter 112 connects cradle top 114 to a bracket 110. In an embodiment, surgical device 100 including outer sleeve 102, introducer cannula 104, rotator 106, and cradle top 114 are disposable. Adapter 112 is positioned underneath surgical device 100 (explained in detail below with respect to FIGS. 7, 9A, and 9E) and is typically left attached to a positioning table for reuse with another surgical device 100. A latch lever 108 is operable to release cradle top 114 from adapter 112. Outer sleeve 102 is a housing that is provided to hold moving components and seals internal to surgical device 100 and between a proximal cap 120 and a front cap 124. Introducer cannula 104 is fixed to an introducer hub 126 that removably attaches cutting element 132 and adapter 112. During a procedure, introducer cannula 104 is positioned to allow for the insertion of surgical device 100 near the target site. When surgical device is positioned, a cutting element 132 protrudes (shown here in a fired position and explained below in detail with respect to FIG. 4) at a distal end 130 of introducer cannula 104. In one embodiment, cutting element 132 also includes a trocar tip 134 that is designed to easily penetrate tissue with minimal damage.
Referring back to FIG. 1, a saline line 154, a firing line 152, a motor line 150, and a biopsy line 156 are attached to the surgical device. Lines 150-156 are also attached to a control console (not shown) for controlling surgical device 100. Cradle top 114 is a housing that receives, secures, and covers the internal attachment of saline line 154, firing line 152, motor line 150, and biopsy line 156. Cradle top 114 may be constructed of plastic or other suitable materials, In the representative embodiment shown, bracket 110 is configured as a “Fisher” style bracket and attaches to adapter 112 by a screw. The shown bracket 110 is engaged or disengaged from a stereotactic table by rotating attachment wheel 142. It is appreciated, however, that the bracket 110 may be of other suitable configurations to permit use of the surgical device with other surgical tables.
Rotator 106 includes a fitting 140 where a vacuum line attaches to provide vacuum to cutting element 132. A rotation indicator 122 may be provided that describes the rotary position of cutting element 132. Rotation indicator 122 is a window that is cut through outer sleeve 102 so as to expose an inner portion having indicia that rotates along with rotator 106. In general, when rotator 106 is turned by a user, the rotary position of cutting element 132 is shown by rotation indicator 122. Typically, a numeral is shown at rotation indicator 122 describing the position of cutting element 132 in a manner similar to a clock face. For example, the indicia of rotation indicator 122 may include numerals such as one (1) through twelve (12) o'clock. In this way, a surgeon can immediately and intuitively determine the rotary position of cutting element 132 by viewing rotation indicator 122. Moreover, rotation indicator 122 is highly visible and does not require special training to determine the angular position of cutting element 132. Alternatively, any indicia may be used for rotation indicator 122 to indicate the position of cutting element 132.
Fitting 140 includes a glue well 220 or barb that is used to connect to tubing that leads to a remote tissue collection canister (see FIG. 11B) or other tissue collection systems. When a vacuum is applied to inner cannula 162, resected tissue is drawn through the length of inner cannula 162 from cutting element 132 to tubing and the remote tissue collection canister mentioned above. An example of a suitable collection canister and filter media is described in co-pending U.S. patent application Ser. No. 11/132,034, entitled “SELECTIVELY OPENABLE TISSUE FILTER,” filed Dec. 16, 2005 by Joseph L. Mark et al., the contents of which are included in their entirety herein.
Air motor 200 further includes a pass-through 770 for inner cannula 162 to extend through. Inner cannula 162 extends from cutting element 132 (see FIG. 1), through air motor 200, to fitting 140. Additionally, inner cannula 162 is fixedly attached to air motor 200 by glue or other suitable material in pass-through 770. Additionally, an inner cannula seal 772 is used to seal air motor 200 with inner cannula 162. Sealing cap 750A further includes a spring guide 778 and sealing cap 750B further includes a rear face 774. Air motor 200 also includes a rotor 780, explained in detail below with respect to FIG. 10B, that provides for rotary motion of inner cannula 162. As shown in FIG. 7C, rear face 774 forms a movable boundary for biopsy cavity 808. Thus, when biopsy cavity 808 is sufficiently pressurized, the force applied to rear face 774 translates air motor 200 distally. Alternatively, when biopsy cavity 808 is vented, spring 462 (see FIG. 7B) translates air motor 200 proximally. Thus, air motor 200 provides a rotary motion to inner cannula 162, as well as translation distally and proximally.
When mounting surgical device 100 to adapter 112, a cradle 114 of surgical device 100 is slid along edges 746 of adapter 112 until a front face surgical device 100 engages wall portion 408 and latch tongue 470 engages latch slot 472. Further, while surgical device 100 is slid along adapter 112, outer cannula 160 is inserted into introducer cannula 104 and is moved therethrough. When surgical device 100 is moved and locked into position on adapter 112, cutting element 132 of outer cannula 160 extends outwardly from a distal end of introducer cannula 104 (see FIG. 1). Once surgical device 100 is mounted to adapter 112, the process follows steps 2070-2130 described in connection with FIG. 16.
wherein said spool is translated distally to translate said outer cannula towards said distal end, and said piston translates said inner cannula towards said distal end to sever tissue.
2. The device of claim 1, wherein said piston comprises a rotary motor for rotating said inner cannula.
4. The device of claim 1, wherein said spool and piston are pneumatically operated.
5. The device of claim 4, further comprising a remote valve for controlling the translation of said pneumatically operated spool and piston, said remote valve selectively operable in a first position to provide pressure to move said pneumatic spool and piston to place the spool and piston in a cocked position, and said remote valve selectively operable in a second position to vent pressure and move said pneumatic spool and inner cannula to a fired position.
6. The device of claim 1, further comprising a fluid line for delivering fluid to said cutting element.
7. The device of claim 1, wherein said outer cannula is rotatable relative to said housing.
8. The device of claim 7, wherein said housing includes an indicator for verifying the radial position of said tissue receiving aperture of the outer cannula.
9. The device of claim 8, wherein the indicator is configured as one of visual or tactile feedback.
10. The device of claim 1, further including a cradle that receives a portion of said housing.
11. The device of claim 1, further including a rotator operably connected to the cutting element and to a suction line, wherein the rotator is free to rotate to at least limit twisting of the suction line.
12. The device of claim 1, further comprising a collection port operably connected with said inner cannula, wherein said collection port receives tissue resected by said cutting element.
wherein said inner cannula and said outer cannula cooperate to resect tissue.
14. The device of claim 13, further comprising a pneumatic motor for selectively rotating said inner cannula.
15. The device of claim 13, further including a rotator operable connected to the cutting element and to a suction line, wherein the rotator is free to rotate to at least limit twisting of the suction line.
16. The device of claim 13, further including a remote valve for controlling said pneumatic spool and said pneumatic piston, said remote valve selectively operable in a first position to provide pressure to move said pneumatic spool and piston to place the spool and piston in a cocked position, and said remote valve selectively operable in a second position to vent pressure and move said pneumatic spool and inner cannula to a fired position.
17. The device of claim 13, further comprising a fluid port for providing fluid in a gap positioned between said inner cannula and said outer cannula.
18. The device of claim 17, further comprising a collection port for receiving tissue resected by said cutting element.
19. The device of claim 13, further comprising a spring positioned between and operatively connected to said piston and said spool, said spring translating said spool toward said distal end for placing the outer cannula in a firing position and pushing the piston to a retracted position that places the tissue opening in an open state.
20. The device of claim 16, further comprising a retaining mechanism to hold the spool and piston in the cocked position until a predetermined time.