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AssigneeSciMed Life Systems, Inc.
InventorsJohn A. Griego, Yem Chin
Estimating the term…
The present invention relates to methodology of and apparatus for accurately positioning devices for performing endoscopic cannulation, papillotomy and sphincterotomy and similar procedures. The sphincterotome with a steerable or adjustable distal segment of the present invention allows the physician to control the position of the distal tip of the device independently of the endoscope and adjust for inconsistencies in the device and the anatomy. According to one embodiment of the present invention, a threaded portion of a cable assembly cooperates with a torque transmission element and a cog to enable the operator to rotate a cutting wire into a desired position relative to the catheter. Alternate embodiments allow the operator to fix the depth of a needle knife while allowing, if desired, accurate rotational positioning of the associated catheter. Threaded stabilizing elements, pivot elements and a steering wire may be used together or individually to accomplish these features. Presently available products that may be modified according to the present invention include, but are not limited to, Boston Scientific Sphincterotomes and Needle Knives.
In an endoscopic catheter having a distally located tissue cutting device in a first lumen thereof, the improvement for orienting the cutting device which comprises:
In an endoscopic catheter having a distally located tissue cutting device in a first lumen thereof, the improvement for orienting the cutting device which comprises:
Method for orientating a tissue cutting device located in a distal portion of a first lumen of an endoscopic catheter which comprises:
Method for orientating a tissue cutting device located in a distal portion of a first lumen of an endoscopic catheter which comprises:
In an endoscopic catheter having a cable actuated needle knife in a lumen thereof, said needle knife being deployable from a distal end of said catheter, the improvement for substantially preventing movement of said needle knife after deployment which comprises a distally positioned fixed stabilizing element in said lumen internally engaging said needle knife cable to prevent such movement.
In an endoscopic catheter having a cable actuated needle knife in a first lumen thereof, said needle knife being deployable from a distal end of said catheter, the improvement for orienting the cutting device and for substantially preventing movement of said needle knife after deployment which comprises:
In an endoscopic catheter having a cable actuated needle knife in a first lumen thereof, said needle knife being deployable from a distal end of said catheter, the improvement for orienting the cutting device and for substantially preventing movement of said needle knife after deployment which comprises:
Dependencies are inferred from the claim text.
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From the US filing history. Foreign family members aren’t listed.
Backward citations are indexed for grants only.
Probes or electrodes therefor: having a flexible, catheter-like structure, e.g. for heart ablation
Surgical cutting instruments: endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
Excision instruments: surgical snare instruments
Mounted on or guided by flexible, e.g. catheter-like, means: steerable
Term end not estimated
1. Field of the Invention
This invention generally relates to apparatus that is useful in performing diagnostic and therapeutic modalities in the biliary tree and more particularly to apparatus that is adapted for facilitating the diagnosis of gallstones in the bile duct and other portions of the biliary tree and the removal of such gallstones.
2. Description of Related Art
The various objects, advantages and novel features of this invention will be more fully apparent from a reading of the following detailed description in conjunction with the accompanying drawings in which like reference numerals refer to like parts, and in which:
FIG. 1 is a plan view of one embodiment of apparatus constructed in accordance with this invention;
FIG. 2 is a cross-section taken along lines 2—2 in FIG. 1;
FIG. 1 depicts catheter apparatus 100 that has the capability of injecting a contrast agent into the biliary tree, accurately positioning a cutting wire, of performing a sphincterotomy and of dislodging a gallstone into the duodenum. Apparatus 100 includes a catheter 101 which, for purposes of definition, includes proximal portion 102 extending from proximal end 103 and distal end 104 with distal portion 105 extending a short distance from distal end 104. In a typical application, the catheter will have a working length of 200 cm and distal portion 105 will have a length of 6 cm to 9 cm. Normally distal portion 105 will have a diameter that is smaller than the diameter of proximal portion 102 to increase the flexibility of distal portion 105. The reduction in diameter also makes distal end 104 less traumatic and allows distal portion 105 to reach smaller passages while allowing the larger proximal portion 102 to provide necessary hoop strength and rigidity, particularly where proximal portion 102 is coextensive with the working channel of a duodenoscope. For example, the proximal and distal portions might have diameters corresponding to 7 Fr and 5.5 Fr catheter sizes (i.e., 0.09″ and 0.07″ respectively).
As shown particularly in FIG. 2, catheter 101 has three lumens. First lumen 201 has a diameter that is greater than either second lumen 202 or third lumen 203. In one particular embodiment first lumen 201 is square shaped with each side approximately 0.040″ in proximal portion 102 that reduces to about 0.037″ in distal portion 105 to receive a standard 0.035″ guidewire. In addition first lumen 201 may be, and as shown in FIG. 2, is offset from the center of the catheter 101.
The cross section of both second lumen 202 and third lumen 203 are each smaller than the cross section of first lumen 201 and are radially offset from the centerline of catheter 101, from each other and from first lumen 201. In one particular embodiment the cross section of third lumen 203 has a diameter of 0.028″ in proximal portion 102 that reduces to about 0.020″ in distal portion 105 and second lumen 202 has an internal diameter of 0.028″ in proximal portion 102 that reduces to about 0.020″ in distal portion 105. As described later, this third lumen 203 carries a cutting wire for performing a sphincterotomy and for allowing the infusion of a contrast agent at reasonable rates. The cutting wire can also be positioned, as described later, as desired. While the description contained herein describes the first lumen 201 having a square cross section shape, it would be apparent to one of ordinary skill in the art that the invention may be practiced in any of the lumens by changing the cross section of the lumen to a shape other than a circle. The angular spacing between second lumen 202 and third lumen 203 is about 45 degrees and the angular spacing between first lumen 201 and each of lumens 202 and 203 each is about 157.5 degrees. In this configuration and with these dimensions proximal portion 102 readily passes through the working channel of any duodenoscope. These angular relationships have been used in the past to position the device. While the invention may be used with these angular relationships, the invention itself allows the device to be positioned which reduces the necessity of strict adherence to the previously used angular relationships.