WO1998019608A1 - Medical instrument with extendable snare - Google Patents
Medical instrument with extendable snare Download PDFInfo
- Publication number
- WO1998019608A1 WO1998019608A1 PCT/US1997/020468 US9720468W WO9819608A1 WO 1998019608 A1 WO1998019608 A1 WO 1998019608A1 US 9720468 W US9720468 W US 9720468W WO 9819608 A1 WO9819608 A1 WO 9819608A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- snare
- sleeve
- instrument
- wire
- body member
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32056—Surgical snare instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0152—Tip steering devices with pre-shaped mechanisms, e.g. pre-shaped stylets or pre-shaped outer tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
- A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2002/826—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents more than one stent being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/02—Holding devices, e.g. on the body
- A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M25/09016—Guide wires with mandrils
- A61M25/09025—Guide wires with mandrils with sliding mandrils
Definitions
- This invention relates to medical instruments, and more particularly to elongated medical instruments with distal image receptors and snares.
- Elongated medical instruments are widely used in modern medical procedures for surgery, drug delivery, imaging, and other functions. Certain procedures require the use of a snare located on the distal portion of the instrument (see, for example, Goldsteen et al . U.S. patent application No. 08/745,618, filed November 7, 1996, which is hereby incorporated by reference herein in its entirety) .
- the snaring operation can be viewed using a fiber optic scope or other image receptor also located on the distal portion of the instrument.
- the image receptor is fixed to the same structure to which the snare is fixed, it can be difficult to maneuver the snare without disturbing the field of view covered by the image receptor.
- an elongated instrument having a distal snare that can be advanced beyond the distal portion of the remainder of the instrument, for example, by extending a sleeve which houses the snare per se.
- the axial position of the snare can be adjusted independent of the axial position of the sleeve. If desired, the snare may be closed by distally advancing the sleeve while holding the snare, or by proximally retracting the snare while the sleeve is maintained in a fixed position.
- the snare may also be closed by distally advancing the sleeve while proximally retracting the snare. Because the snare and the sleeve are independently axially movable relative to the remainder of the instrument, any of these motions of the snare and sleeve can be accomplished without disturbing the remainder of the instrument. Because the distal portion of the remainder of the instrument can thus remain stationary during the snaring procedure, the field of view from an image receptor on the instrument is not disturbed.
- the snare may be formed of a continuous elongated member (e.g., a wire) that is doubled back on itself to form first and second legs or wire portions, each of which extends between the proximal and distal portions of the instrument, and each of which is independently axially movable along the length of the instrument.
- the size and lateral position of the loop in the snare can be adjusted by controlling the amount that the distal portion of each wire portion is distally advanced beyond the sleeve.
- FIG. 1 is a simplified perspective view of an illustrative instrument constructed in accordance with the invention.
- FIGS. 2a and 2b are simplified perspective views showing how an illustrative instrument constructed in accordance with the present invention can be provided with steering capabilities.
- FIGS. 3a and 3b are simplified diagrams showing how the size of an illustrative snare loop can be adjusted.
- FIGS. 4a and 4b are simplified diagrams showing how either side of another illustrative snare loop can be selectively opened.
- FIGS. 5a and 5b are simplified diagrams illustrating the capture of another structure such as a wire by the snare.
- FIG. 6 is a simplified diagram showing a snare in which the axial position of the snare is controlled by a loop positioning member.
- Body member 12 of instrument 10 is preferably an elongated body member suitable for longitudinal insertion into the body of a patient during a medical procedure.
- body member 12 may be a multilumen structure of polyurethane .
- the site at which a given medical procedure is being performed may be viewed with a fiber optic scope which includes video imaging device 14, optical fiber 16, image receptor 18. If body member 12 is a multilumen structure, lumen 20 may be provided for optical fiber 16. (Although lumen 20 and the other lumens in FIG. 1 are only partly shown to avoid over- complicating the drawing, it will be understood that these lumens extend through the entire length of body member 12. )
- the physician may position distal instrument portion 22 by manipulating the proximal portion 24 of body member 12, which is not inserted into the body of the patient.
- instrument 10 may be provided with the capability to steer tip 22 using conventional steering mechanisms or using the curved wire steering arrangement described in Bachinski et al .
- An illustrative medical instrument 54 having such a curved wire steering arrangement is shown in FIG. 2a and 2b.
- the wire steering features of illustrative medical instrument 54 are shown separately from the snare features of the present invention to avoid overcomplicating the drawings. However, the wire steering features and extendable snare features of the invention are preferably incorporated into the same medical instrument .
- member 56 has lumen 58 (partly shown) in which wire 60 reciprocates. Wire 60 is inserted into lumen 58 through proximal opening 62. Lumen 58 is preferably closed at distal end 64, but it may instead be open if desired.
- Stiffening member 66 which may be, for example, a tubular stiffening cage formed of a stainless steel braid with a polyimide covering, is approximately two inches (5 cm) long and is preferably located a comparable axial distance from distal end 68 of member 56. These dimensions are only illustrative and any other suitable dimensions may be used.
- the portion 70 of instrument 54 between medial stiffening member 66 and proximal end 72 of instrument 54 is preferably flexible enough to allow portion 70 to flex during insertion through narrow and twisted body organ structures such as blood vessels, but is stiff enough to allow instrument 54 to be advanced into various organ structures by the physician.
- the distal portion 69 of member 56 between stiffening member 66 and distal end 68 is preferably stiff enough to assume the straight, undeflected alignment shown in FIG. 2a when wire 60 is withdrawn from within portion 69.
- Distal portion 74 of wire 60 has a predefined curved shape when not confined by stiffening member 66.
- the position of wire 60 within member 56 may be controlled by the physician by manipulating wire positioning member 76.
- distal wire portion 74 is pushed beyond edge 78 of stiffening member 66, distal wire portion 74 begins to assume its natural curved shape and deflects distal member portion 69, as shown in FIG. 2b.
- the angular orientation of distal member portion 69 can be controlled by rotating wire positioning member 76 and thereby rotating the curved distal wire portion 74.
- the extent of the lateral or angular deflection of distal member portion 69 can be adjusted by controlling the length of distal wire portion 74 that extends beyond edge 78.
- the lateral or angular deflection of distal member portion 69 is greatest when all of distal wire portion 74 extends beyond edge 78.
- a lumen such as lumen 80 or 82 may be used to house snare 26 (FIG. 1)
- snare 26 can be extended out from distal portion 22 by distally advancing sleeve 28, as shown in FIG. 1.
- the physician can control the position of sleeve 28 by manipulating proximal portion 30 of sleeve 28 where it protrudes from proximal end 32 of body member 12.
- Snare 26 is independently controlled.
- Sleeve 28 is preferably formed from plastic (e.g., polyimide) tubing. With the snare arrangement shown in FIG. 1, snare 26 is formed from a continuous single wire 34 that is doubled back on itself within body member 12 and sleeve 28.
- Wire positioning members 36 and 38 can be directly manipulated by the physician or can be manipulated by a suitable mechanism controlled by the physician.
- Wire 34 is preferably formed from nitinol or stainless steel and has sufficient torsional stiffness to translate torque from wire positioning members 36 and 38 to snare 26 when snare 26 is to be rotated.
- a distal portion of snare 26 may be resiliently biased to open out in the form of a loop as shown in FIG. 1.
- This loop is preferably closed by maintaining the loop of snare 26 at a fixed location while sleeve 28 is advanced distally.
- Distal end 40 of sleeve 28 forces snare 26 to close.
- Closing snare 26 by advancing sleeve 28 prevents snare 26 from moving away from the object that is being snared while snare 26 is closing.
- the position of the distal portion 22 of body 12 is not disturbed, thereby allowing the image seen by image receptor 18 and displayed by video imaging device 14 remain steady and undisturbed.
- snare 26 can be closed by proximally withdrawing wire 34 relative to body member 12 while sleeve 28 is maintained in a fixed position. This retracts snare 26 into distal end 40 of sleeve 28 and forces snare 26 to close.
- Another way in which to close snare 26 is to proximally withdraw wire 34 while simultaneously distally advancing sleeve 28.
- Forming snare 26 from a continuous length of wire 34 is one way to allow the size of the loop in snare 26 to be adjusted. As shown in FIG. 3a, advancing wire 34 slightly beyond distal end 40 of sleeve 28 creates a relatively small loop. As shown in FIG. 3b, advancing wire 34 farther beyond distal end 40 creates a relatively large loop.
- FIGS. 4a and 4b Another illustrative embodiment of snare wire 34 is shown in FIGS. 4a and 4b.
- the two legs 34a and 34b of wire 34 are joined at their distal ends in a fairly sharp crease 42.
- the distal portion of wire 34 is not resiliently biased to open into a loop. Instead, an open loop is formed by shifting either one of legs 34a or 34b distally relative to the other leg.
- FIG. 4a shows the result of shifting upper leg 34a distally relative to lower leg 34b
- FIG. 4b shows the result of shifting lower leg 34b distally relative to upper leg 34a.
- Whichever leg is shifted distally bulges out away from the other leg to produce an open loop which may have the shape of a duck head.
- the size of this loop depends on the amount of relative shift between legs 34a and 35b, and the lateral direction of the loop depends on which leg 34a or 34b is shifted distally relative to the other leg.
- FIGS. 5a and 5b A typical snaring operation is illustrated in FIGS. 5a and 5b.
- snare 26 is extended and the physician has manipulated snare 26 so that it surrounds another structure (e.g., wire 44).
- Wire 44 may be, for example, a guidewire that is being maneuvered through the patient's body.
- the physician has retracted snare 26 into sleeve 28 by retracting wire 34 and/or by extending sleeve 28.
- FIG. 5b shows how the relatively narrow inner diameter of sleeve 28 causes wire 44 to fold over on itself, so that wire 44 is held firmly in sleeve 28 and securely interengages with wire 34.
- Snare 26 is preferably formed from a single continuous wire 34 that doubles back on itself within body member 12 to form independently controllable wire portions 34a and 34b (as shown, e.g., in FIGS. 4a and 4b) . If desired, however, snare 26 may be formed (as shown in FIG. 6) from a separate wire loop 46 that is attached to loop positioning member 48 at connection
- Loop positioning member 48 may be formed from wire or hypotube.
- instrument 10 may be provided with additional capabilities.
- instrument 10 can be provided with illuminating, surgical, or drug delivery capabilities.
- One or more lumens such as lumen 52 (FIG. 1) may be provided in body member 12 to support these functions.
- Lumen 52 may contain fiber optics for illumination or laser ablation, may form a passage for irrigation and/or drainage, a cutting or biopsy tool, or an anchoring wire.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Vascular Medicine (AREA)
- Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Pulmonology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Gastroenterology & Hepatology (AREA)
- Biophysics (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU52514/98A AU5251498A (en) | 1996-11-07 | 1997-11-05 | Medical instrument with extendable snare |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/745,618 | 1996-11-07 | ||
US08/745,618 US5976178A (en) | 1996-11-07 | 1996-11-07 | Medical grafting methods |
US84491097A | 1997-04-23 | 1997-04-23 | |
US08/844,910 | 1997-04-23 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1998019608A1 true WO1998019608A1 (en) | 1998-05-14 |
Family
ID=27114491
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1997/020468 WO1998019608A1 (en) | 1996-11-07 | 1997-11-05 | Medical instrument with extendable snare |
Country Status (2)
Country | Link |
---|---|
AU (1) | AU5251498A (en) |
WO (1) | WO1998019608A1 (en) |
Cited By (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5989276A (en) * | 1996-11-08 | 1999-11-23 | Advanced Bypass Technologies, Inc. | Percutaneous bypass graft and securing system |
WO1999060935A1 (en) * | 1998-05-26 | 1999-12-02 | Krahn Henry P | Soft tissue morsellator |
EP0997106A1 (en) * | 1998-10-26 | 2000-05-03 | Boston Scientific Limited | Injection snare |
US6110188A (en) * | 1998-03-09 | 2000-08-29 | Corvascular, Inc. | Anastomosis method |
US6149681A (en) * | 1996-09-20 | 2000-11-21 | Converge Medical, Inc. | Radially expanding prostheses and systems for their deployment |
WO2001035830A1 (en) * | 1999-11-15 | 2001-05-25 | Instruments Medicaux G.B. Inc. | Surgical extractor |
US6241741B1 (en) | 1998-03-09 | 2001-06-05 | Corvascular Surgical Systems, Inc. | Anastomosis device and method |
US6379319B1 (en) | 1996-10-11 | 2002-04-30 | Transvascular, Inc. | Systems and methods for directing and snaring guidewires |
US6432127B1 (en) | 1996-10-11 | 2002-08-13 | Transvascular, Inc. | Devices for forming and/or maintaining connections between adjacent anatomical conduits |
US6443959B1 (en) | 1999-02-16 | 2002-09-03 | Instruments Medicaux Gb Inc. | Surgical extractor |
US7226410B2 (en) | 2002-12-05 | 2007-06-05 | Ethicon-Endo Surgery, Inc. | Locally-propelled, intraluminal device with cable loop track and method of use |
EP1839555A1 (en) * | 2006-03-30 | 2007-10-03 | Ethicon Endo-Surgery, Inc. | Medical snaring device |
US7288074B2 (en) | 2003-04-03 | 2007-10-30 | Ucl Business Plc | Guide wire structure for insertion into an internal space |
US7351202B2 (en) | 2002-12-05 | 2008-04-01 | Ethicon Endo-Surgery, Inc. | Medical device with track and method of use |
US7527620B2 (en) | 2004-05-14 | 2009-05-05 | Ethicon Endo-Surgery, Inc. | Medical instrument having a medical guidewire |
US7758564B2 (en) | 2004-05-14 | 2010-07-20 | Ethicon Endo-Surgery, Inc. | Medical instrument having a catheter and a medical guidewire |
US7771396B2 (en) | 2006-03-22 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Intubation device for enteral feeding |
US7803137B2 (en) | 2006-03-22 | 2010-09-28 | Ethicon Endo-Surgery, Inc. | Intubation system for use with an endoscope |
EP2258272A1 (en) * | 2006-04-28 | 2010-12-08 | Ethicon Endo-Surgery, Inc. | Apparatus for deploying a cutting element during an endoscopic mucosal resection |
US8070693B2 (en) | 2004-09-30 | 2011-12-06 | Cook Medical Technologies Llc | Articulating steerable wire guide |
EP2438882A1 (en) * | 2010-10-06 | 2012-04-11 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
WO2013043820A1 (en) * | 2011-09-23 | 2013-03-28 | Cook Medical Technologies Llc | Snare system |
US8715205B2 (en) | 2006-08-25 | 2014-05-06 | Cook Medical Tecnologies Llc | Loop tip wire guide |
CN105286966A (en) * | 2015-09-14 | 2016-02-03 | 上海形状记忆合金材料有限公司 | Size-controllable multi-ring snare |
US9282991B2 (en) | 2010-10-06 | 2016-03-15 | Rex Medical, L.P. | Cutting wire assembly with coating for use with a catheter |
US9532798B2 (en) | 2010-10-06 | 2017-01-03 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
US9615849B2 (en) | 2010-11-18 | 2017-04-11 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
CN106821283A (en) * | 2017-03-09 | 2017-06-13 | 陈怡� | A kind of comprehensive transfer of endoscope-use |
US9737330B2 (en) | 2010-11-22 | 2017-08-22 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4033331A (en) * | 1975-07-17 | 1977-07-05 | Guss Stephen B | Cardiac catheter and method of using same |
US4840176A (en) * | 1986-11-06 | 1989-06-20 | Olympus Optical Co., Ltd. | Treating instrument for use with an endoscope |
US5171233A (en) * | 1990-04-25 | 1992-12-15 | Microvena Corporation | Snare-type probe |
US5387219A (en) * | 1992-09-23 | 1995-02-07 | Target Therapeutics | Medical retrieval snare with coil wrapped loop |
US5522819A (en) * | 1994-05-12 | 1996-06-04 | Target Therapeutics, Inc. | Dual coil medical retrieval device |
US5535759A (en) * | 1994-11-02 | 1996-07-16 | Wilk; Peter J. | Endoscopic method of cleaning and operating on a site within a patient |
-
1997
- 1997-11-05 WO PCT/US1997/020468 patent/WO1998019608A1/en active Application Filing
- 1997-11-05 AU AU52514/98A patent/AU5251498A/en not_active Abandoned
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4033331A (en) * | 1975-07-17 | 1977-07-05 | Guss Stephen B | Cardiac catheter and method of using same |
US4840176A (en) * | 1986-11-06 | 1989-06-20 | Olympus Optical Co., Ltd. | Treating instrument for use with an endoscope |
US5171233A (en) * | 1990-04-25 | 1992-12-15 | Microvena Corporation | Snare-type probe |
US5387219A (en) * | 1992-09-23 | 1995-02-07 | Target Therapeutics | Medical retrieval snare with coil wrapped loop |
US5522819A (en) * | 1994-05-12 | 1996-06-04 | Target Therapeutics, Inc. | Dual coil medical retrieval device |
US5535759A (en) * | 1994-11-02 | 1996-07-16 | Wilk; Peter J. | Endoscopic method of cleaning and operating on a site within a patient |
Cited By (39)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6149681A (en) * | 1996-09-20 | 2000-11-21 | Converge Medical, Inc. | Radially expanding prostheses and systems for their deployment |
US7316655B2 (en) | 1996-10-11 | 2008-01-08 | Medtronic Vascular, Inc. | Systems and methods for directing and snaring guidewires |
US6379319B1 (en) | 1996-10-11 | 2002-04-30 | Transvascular, Inc. | Systems and methods for directing and snaring guidewires |
US6432127B1 (en) | 1996-10-11 | 2002-08-13 | Transvascular, Inc. | Devices for forming and/or maintaining connections between adjacent anatomical conduits |
US5989276A (en) * | 1996-11-08 | 1999-11-23 | Advanced Bypass Technologies, Inc. | Percutaneous bypass graft and securing system |
US6110188A (en) * | 1998-03-09 | 2000-08-29 | Corvascular, Inc. | Anastomosis method |
US6241741B1 (en) | 1998-03-09 | 2001-06-05 | Corvascular Surgical Systems, Inc. | Anastomosis device and method |
WO1999060935A1 (en) * | 1998-05-26 | 1999-12-02 | Krahn Henry P | Soft tissue morsellator |
EP0997106A1 (en) * | 1998-10-26 | 2000-05-03 | Boston Scientific Limited | Injection snare |
US6443959B1 (en) | 1999-02-16 | 2002-09-03 | Instruments Medicaux Gb Inc. | Surgical extractor |
WO2001035830A1 (en) * | 1999-11-15 | 2001-05-25 | Instruments Medicaux G.B. Inc. | Surgical extractor |
US7226410B2 (en) | 2002-12-05 | 2007-06-05 | Ethicon-Endo Surgery, Inc. | Locally-propelled, intraluminal device with cable loop track and method of use |
US7351202B2 (en) | 2002-12-05 | 2008-04-01 | Ethicon Endo-Surgery, Inc. | Medical device with track and method of use |
US7288074B2 (en) | 2003-04-03 | 2007-10-30 | Ucl Business Plc | Guide wire structure for insertion into an internal space |
US8100882B2 (en) | 2004-05-14 | 2012-01-24 | Ethicon Endo-Surgery, Inc. | Guidewire structure |
US7527620B2 (en) | 2004-05-14 | 2009-05-05 | Ethicon Endo-Surgery, Inc. | Medical instrument having a medical guidewire |
US7758564B2 (en) | 2004-05-14 | 2010-07-20 | Ethicon Endo-Surgery, Inc. | Medical instrument having a catheter and a medical guidewire |
US7828791B2 (en) | 2004-05-14 | 2010-11-09 | Ethicon Endo-Surgery, Inc. | Medical instrument having a guidewire and articulated catheter |
US7785269B2 (en) | 2004-05-14 | 2010-08-31 | Ethicon Endo-Surgery, Inc. | Medical instrument having a guidewire and an add-to catheter |
US7896862B2 (en) | 2004-05-14 | 2011-03-01 | Ethicon Endo-Surgery, Inc. | Medical instrument having a controlled guidewire drive |
US8070693B2 (en) | 2004-09-30 | 2011-12-06 | Cook Medical Technologies Llc | Articulating steerable wire guide |
US7771396B2 (en) | 2006-03-22 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Intubation device for enteral feeding |
US7803137B2 (en) | 2006-03-22 | 2010-09-28 | Ethicon Endo-Surgery, Inc. | Intubation system for use with an endoscope |
JP2007268269A (en) * | 2006-03-30 | 2007-10-18 | Ethicon Endo Surgery Inc | Medical snaring device |
EP1839555A1 (en) * | 2006-03-30 | 2007-10-03 | Ethicon Endo-Surgery, Inc. | Medical snaring device |
EP2258272A1 (en) * | 2006-04-28 | 2010-12-08 | Ethicon Endo-Surgery, Inc. | Apparatus for deploying a cutting element during an endoscopic mucosal resection |
US8715205B2 (en) | 2006-08-25 | 2014-05-06 | Cook Medical Tecnologies Llc | Loop tip wire guide |
US9282991B2 (en) | 2010-10-06 | 2016-03-15 | Rex Medical, L.P. | Cutting wire assembly with coating for use with a catheter |
EP2438882A1 (en) * | 2010-10-06 | 2012-04-11 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
US9532798B2 (en) | 2010-10-06 | 2017-01-03 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
US9622771B2 (en) | 2010-10-06 | 2017-04-18 | Rex Medical, L.P. | Cutting wire assembly with coating for use with a catheter |
US10327802B2 (en) | 2010-10-06 | 2019-06-25 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
US9615849B2 (en) | 2010-11-18 | 2017-04-11 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
US10548627B2 (en) | 2010-11-18 | 2020-02-04 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
US9737330B2 (en) | 2010-11-22 | 2017-08-22 | Rex Medical, L.P. | Cutting wire assembly for use with a catheter |
WO2013043820A1 (en) * | 2011-09-23 | 2013-03-28 | Cook Medical Technologies Llc | Snare system |
US9936965B2 (en) | 2011-09-23 | 2018-04-10 | Cook Medical Technologies Llc | Snare system |
CN105286966A (en) * | 2015-09-14 | 2016-02-03 | 上海形状记忆合金材料有限公司 | Size-controllable multi-ring snare |
CN106821283A (en) * | 2017-03-09 | 2017-06-13 | 陈怡� | A kind of comprehensive transfer of endoscope-use |
Also Published As
Publication number | Publication date |
---|---|
AU5251498A (en) | 1998-05-29 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
WO1998019608A1 (en) | Medical instrument with extendable snare | |
CN111246908B (en) | Steerable catheter | |
EP1161174B1 (en) | Controllable endoscopic sheath | |
US5396880A (en) | Endoscope for direct visualization of the spine and epidural space | |
US6458074B1 (en) | Endoscope | |
US5318526A (en) | Flexible endoscope with hypotube activating wire support | |
JP5213380B2 (en) | Medical instruments | |
JP6205344B2 (en) | Occlusion crossing device, imaging device and atherectomy device | |
KR101527734B1 (en) | Flexible endoscopic suture anchor applier | |
JP5997272B2 (en) | Arthroscopic surgery probe | |
JP2009512497A (en) | Device, system and method for guiding a surgical instrument to a body site | |
EP0938871A2 (en) | Surgical apparatus | |
US20200360013A1 (en) | Steerable suture retriever | |
US11273025B2 (en) | Expandable implant delivery device | |
EP3737303B1 (en) | Systems for connecting non-adherent structures | |
AU2007201543A1 (en) | Medical instrument having a medical needle-knife | |
WO2017066253A1 (en) | Steerable medical instrument | |
EP4297659A1 (en) | Steerable suture retriever | |
WO1998019732A1 (en) | Steerable instrument for use in medical procedures | |
CN110177507A (en) | That sharply turns turns to needle | |
US20210015348A1 (en) | Endoscopic tool stabilization and related methods of use | |
EP3781044B1 (en) | Pericardial access | |
JP5647349B2 (en) | Endoscopic system for tissue resection | |
US20240138984A1 (en) | Device, system, and method for intravascularly delivering an intravascular device to a targeted cardiac valve | |
US11134830B2 (en) | Medical device delivery system and methods of use |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): AL AM AT AU AZ BA BB BG BR BY CA CH CN CU CZ DE DK EE ES FI GB GE GH HU ID IL IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK SL TJ TM TR TT UA UG UZ VN YU ZW AM AZ BY KG KZ MD RU TJ TM |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): GH KE LS MW SD SZ UG ZW AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application | ||
REG | Reference to national code |
Ref country code: DE Ref legal event code: 8642 |
|
NENP | Non-entry into the national phase |
Ref country code: JP Ref document number: 1998521839 Format of ref document f/p: F |
|
122 | Ep: pct application non-entry in european phase |