DE8623592U1 - Device for removing liquids, tissue, etc. - Google Patents

Description

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Josef Lrndenberg

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Device for removing liquids, tissue or the like

The invention relates to a device for removing liquids, tissue or the like from the interior of a body such as a living being, with at least one elongated first hollow body, such as a hose or a hollow tube, and with a suction device, wherein an obturator which is substantially attached to the hollow space of the hollow body is guided in the hollow body and a first seal is arranged in an area of the hollow body which is adjacent to an insertion end.

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For example, biopsy instruments with a hollow needle as a hollow body are known, which is sharpened in a specific shape at one end to be inserted into the body*, whereby a stylet is also located in the hollow needle - at least during the insertion - which can be pointed like a stylet at its front distal end and is also referred to as a stylet. At its rear, proximal end, it can have a handle. When the distal end is in the area where the tissue sample is to be taken, the stylet is at least partially or completely withdrawn and a tissue sample is taken for histological and/or cytological examination by further piercing or pressureless cutting, with a medical syringe attached for additional aspiration of the biopsy after piercing the steel needle and subsequent removal of the stylet. The syringe is then drawn up, the entire assembly is rotated to cut out a cylinder of material and finally the assembly is withdrawn from the body and the cylinder of material is ejected from the hollow needle by pressing down on the syringe. The procedure described for the removal can easily lead to a displacement of the hollow needle, which can lead to misdirection with complications and the causing of pain. Until the medical syringe is attached, the end inserted into the lung, for example during a lung puncture, is in a disadvantageous position.

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The tissue fluid cannot be removed using this biopsy set. A different biopsy set is provided for this purpose in which the hollow needle is attached to the cylinder of a medical syringe and a hollow stylet guided in the hollow needle is attached to the plunger of the syringe, so that when the syringe is drawn up, tissue fluid is sucked into the cylinder of the syringe by the resulting negative pressure. ^This syringe has the disadvantage that a relatively large amount of tissue fluid is sucked up due to the large volume created in the cylinder when sucking it up. This can lead to traumatization of the tissue being examined. However, due to the relatively large initial volume before sucking up, a relatively slight negative pressure is already present when sucking up, which can be detrimental. The latter in particular is also good for suctioning fluids, be it from wounds, effusions, body cavities or the like using tubes such as catheter tubes and medical syringes.

The device mentioned above makes it possible to conveniently remove tissue or fluid from the body in a defined and gentle manner, so that the removal is carried out efficiently and more quickly than was previously the case. Furthermore, the removal is less strenuous for the patient and the risk of trauma and accuracy at the removal sites are significantly reduced due to the reduced manipulation. If tissue fluid or tissue is to be removed from two areas at different depths inside the body, two punctures are always required.

The invention is therefore based on the object of creating a device for removing fluid and/or tissue from the body, with which two samples, for example a fluid and a tissue sample or two tissue samples, can be removed separately from one another at the same time.

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According to the invention, the above-mentioned task is carried out in a device
according to the type mentioned above by the first
The hollow body is arranged as an obturator in another elongated hollow body, which also has a second seal in an area facing away from the insertion end , which tightly surrounds the first hollow body. In addition to the possibility of taking samples from two different areas at once, ie through a puncture 1, the design of the device according to the invention basically allows two samples to be taken, for example a replacement sample. Furthermore ,
The device according to the invention offers the possibility of, for example, separately collecting liquid in the first elongated cavity and tissue biopsy in the second cavity.

Both tissue samples for histological examination and &rgr;

Tissue fluid for cytological examination or g

Other liquids are in the device according to the invention in the cavity released when the obturator is pulled up in the hollow body.
qevidenced cavity with strong suction power and qeqe-

While the device according to the invention in particular,

for the ripsy of living beings, it can also be sent by post.

mortal biopsy and for taking samples from other suitable dead material, such as those used for material testing

The procedural procedure is based on the
The device according to the invention is much easier.

After inserting the elongated hollow bodies into the body, whereby
the obturator is in the inner hollow body and this in the
second outer hollow body, is first placed ^{in the} obturator and then completely removed,
In the latter case, the seal is self-closing, so that it closes completely after removal of the obturator and therefore the negative pressure in the first hollow body
is maintained. So that \» &igr;&tgr; ■■* possibly absorbed

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Fluid is retained in the hollow body and can be removed from the body with it.

When puncturing to take tissue using a biopsy set with two hollow needles, one inside the other, with a stylet inserted into the first, the latter is first pulled up and, if necessary, completely removed, which sucks in fluid and maintains the negative pressure created. Then, for example, the first inner hollow needle can be completely removed or just slightly retracted into the second hollow needle. This creates a negative pressure in the second hollow needle. To take tissue, the second hollow needle, which is sharpened on its front, is simply pushed in over the length of a desired tissue plug, and rotated if necessary; in any case, when pushed in slightly, a tissue plug is drawn into the second hollow needle using negative pressure. After removing the entire biopsy set from the body, the fluid in the first hollow needle can be expelled by reinserting and/or inserting the stylet. The biopsy can then be expelled from the second hollow needle either by inserting a separate stylet with a larger diameter or by inserting the first hollow needle with the stylet inserted.

By means of the device according to the invention, the tissue samples are preserved in the vessel much better than was previously the case, regardless of the consistency of the tissue, be it lung, kidney or liver tissue.

This is due to the fact that when removing a tissue sample, when cutting or punching out the tissue plug from the tissue area to be examined, the absorption of the tissue is supported by the negative pressure in the hollow needle, which cuts out the tissue plug from the tissue

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is sucked into the hollow needle so that it is not compressed. There is no disadvantageous trauma to the biopsy specimen, as the cut-out tissue cylinder cannot shoot into a syringe. The fact that the seal is formed at a distance from the end of the hollow needle inserted into the body and preferably in the area of the opposite end, but inside it, if necessary inside an extended attachment or similar, results in the advantage that after the mandrel cloth is pulled back when removing tissue fluid, a well-defined amount of the same is sucked into the free area of the hollow needle with a higher negative pressure than with the state of the art, but is then absorbed by an air cushion in front of the seal, which is flat and remains flat before the obturator is pulled up. This well-defined, small amount, which is sufficient for examination, does not lead to excessive traumatization of the removed tissue. The hollow needle according to the invention therefore also leads to less stress for the patient when used. Basically, the design according to the invention improves the performance and yield - namely a longer, intact tissue cylinder - of the biopsy due to its ease of use. It has surprisingly been found that the device according to the invention has a significantly higher suction force at the distal end of the hollow body.

than is the case when using conventional medical syringes to generate the vacuum. This is probably due to the fact that, due to the usually tightly fitted obturator in the hollow body - both can be adjusted to one another with small tolerances - the ratio of the residual volume containing residual air before the obturator is pulled up to the suction volume resulting when pulled up is very small or the reciprocal is large.

No material can be sucked out through the seal, because even after removing the stylet, the hollow channel is closed again. In contrast to the state of the art, a medical syringe

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I is no longer essential. Better target accuracy is required.

I ness and greater sensitivity, e.g. when pushing but

': also when turning the hollow needle for rotary cutting.

I · In particular, all different types of cutting formations at the distal end of the hollow needle can be made with the inventive design.

i ^! design can be combined.

I According to a preferred embodiment, it is provided that the seal

f is made of rubber or has a silicone seal or other

ij material. Preferably, the seal is completely

'' closed sealing disc inserted into the interior of the hollow body

: and then pierced by the stylet, wob//. the sealq

I completely surrounds it in a reliably sealed manner. The seal

\ remains when the obturator is partially pulled out or removed

inevitably sealed. If the obturator or stylet is to be completely removed, then when it is completely pulled out

i of the mandreljthe sealing disc remains tight due to self-sealing,

'■ seals the hollow space of the needle completely again and

thus maintains the vacuum that creates the suction effect in the hollow body I. In a preferred development, it is provided that

I the hollow body has an extended cavity, for example in

&bull; inside an adapter such as a Luer adapter and that

the seal is formed in the expanded cavity. In a fcar -like design, the seal is procedurally

to introduce compartments _, with the additional advantage that the larger diameter of the seal above the stylet pierced through it means that more sealing mass is available in order to achieve a reliable seal when the stylet is completely pulled out. The seal is advantageously held in place by a holder or by gluing. In addition to the aforementioned advantages of using the hollow needle according to the invention, the fact that no medical syringe has to be used to draw up the stylet or stylet - and for optimal use of all advantages

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the invention should not be used - nor the advantage of saving material and thus greater cost-effectiveness. The device according to the invention can also be designed in particular for use with an endoscope and, if necessary, can be designed accordingly. Due to the rigid bend of conventional endoscopes, the device can have an angularly sufficiently flexible, axially but as stiff as possible guide tube for insertion through the endoscope. The tube is preferably a metal tube with a rigid front, i.e. distal, sharpened end, i.e. designed as a hollow needle, the length of which is determined depending on its diameter in the dimensions of the endoscope curvature. The metal tube can be designed, for example, by a coil spring or in another suitable manner. If necessary, it has a ring seal at the transition point between the flexible tube and the rigid hollow needle to ensure the required negative pressure in the withdrawal area. A marking or stop can be provided at the proximal actuating end to control the length of the pull-up.

Further advantages and features of the invention emerge from the claims and from the following description, in which an embodiment of the device according to the invention is explained in detail with reference to the drawing. The single figure shows

a preferred embodiment of the biopsy kit according to the invention.

The biopsy set shown in Fig. 1 has an elliptical cannula or hollow needle 4, which consists of a metal shaft 44 and a handle part 16, in which the metal shaft 44 is firmly inserted and to which the metal shaft 44 is connected, for example by means of a casting compound 46. The handle part 16 consists of a suitable, relatively stable plastic.

It also has handle wings 51. The handle part 16 could of course also be designed differently than is the case in Figure 1. The biopsy instrument 1 also has a stylet or mandrin 12 which is guided in the hollow needle 4. The hollow needle 4 and mandrin 12 are pointed and sharpened at their end 21 facing away from the handle part 16. The mandrin 12 has a handle 17 at its proximal end which is also provided with handle wings 52. It is also made of plastic, preferably the same plastic as the handle part 16 of the hollow needle 4. The mandrin 12 is also firmly inserted into the handle 17 and secured, for example, by means of a casting compound 18. When the stylet 12 is fully inserted into the hollow needle 4, the tip of the stylet 12 protrudes slightly from the end of the hollow needle 4 that is to be inserted into the body. A seal 47 is inserted into the handle part 16 of the hollow needle 4. It rests on the one hand on a shoulder 48 formed in the interior of the handle part 16 and is held on the other hand on its side facing the shoulder 48 by an inserted, relatively stable ring 49, for example made of hard plastic, which is firmly connected to the handle part, for example welded. The seal 47 is preferably a plug or a disk made of a suitable, elastic material, such as plastic, rubber, caoutchouc, e.g. silicone rubber or the like. When the mandrel 12 is inserted into the hollow needle 4, the sealing disk 47 is pierced and then surrounds the mandrel 12 with an extraordinarily high degree of tightness. When the mandrel 12 is pulled out, the sealing disk closes again in its pierced area so that it also |

remains tight.

The hollow needle 4 as the first elongated or stretched hollow body is inserted into a further or second hollow needle 4&iacgr; which also has a pointed or

sharpened, for example with trocar grinding or internal grinding, metal shaft 44' and: a firmly connected

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Handle part 16' made of a suitable, relatively stable plastic, preferably the same plastic from which the handle part 16 is made. The handle part 16 can, for example, be designed in the form of an adapter, such as a pneumatic adapter, but even then has the function of a handle part in the embodiment shown in the figure, but could also be connected to a syringe plunger or the like with suitable handles 16 and handles 17, as is described in detail in PCT/EP20/0020 for a micropsy set with an elongated hollow body.

But the handle part 16' could of course also be designed differently than is the case in Fig. 1, for example also with radially projecting handle wings, similar to the handle wings 51 of the handle part 16 etc. A seal 47' is also inserted in the handle part 16' of the hollow needle 4'. It is also inserted into the lower end of the hollow handle part 16' and is held on its proximal side by a ring 49' which is firmly connected to the handle part 16', for example also welded. The seal 47' is made of the same material as the seal 47. When the hollow needle 4 is inserted, or more precisely its shaft 44, which serves as an obturator of the hollow needle 4', the sealing disk 47' is pierced into it and then surrounds the metal shaft 44 with an extraordinarily high degree of tightness. Even when the needle 4 is pulled out with the metal shaft 44, the sealing disk closes again in its pierced area so that it also remains tight, since the cross-sectional dimensions of the metal shaft 44 are still relatively small. Thus, preferred embodiments provide that the metal shaft 4 has an outer diameter of 0.7 or 0.95 mm and in this _case the outer diameter of the metal shaft 44 is 0.95 or 1.2 mm. In both cases, due to the small wall thickness of the metal shafts 44, 44'c, the shaft 44 can still be easily inserted into the shaft 44*

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The micropsy set 1 according to the invention is used for taking body fluid to be examined cytologically and/ ^or tissue to be examined histologically from body samples into which the hollow needle 4' with the hollow needle 4 inserted and the mandrel 12 inserted further therein, i.e. in the representation of the figure - if necessary* with the aid of a ^guide needle - is inserted.

To take a sample, particularly of liquid for cytological examination, first hold the hollow needle 4 by its handle 16 and pull up the Mahdrin 12 by grasping its handle 17, and thus liquid is sucked into the front cavity ff of the hollow needle 4. If necessary, the

Mandrin 12 can also be completely removed, whereby the seal

47 then automatically seals the interior of the hollow needle 4 reliably ^& ;. The hollow needle 4 is then pulled over its handle

16 is pulled up a little in the hollow needle 4', so that a negative pressure is created by the double sealing of the seal 47 and 47' in the metal shaft 44' of the hollow needle 4'. To take up tissue, the hollow needle 4' is then turned and/or pressed deeper into the body, particularly if the inserted end of the hollow needle 4' is suitably ground, whereby a tissue plug is cut out of the tissue as a biopsy and inserted into the hollow needle

4' is sucked in. The hollow needle 4 can also be completely removed from the hollow needle 4'. After removing the two hollow needles 4, 4', on the one hand the tissue fluid is dispensed from the hollow needle 4 onto a corresponding carrier and on the other hand the biopsy is pressed out of the hollow needle 4' onto a carrier, for which either a separate stylet or a separate mandrin or, after removing the tissue fluid from the hollow needle 4, the latter can be inserted together with its associated mandrin.

Claims (1)

Protection claims 1. Device for removing liquids, tissue or the like from the interior of a body such as a living being, with at least one elongated first hollow body, such as a tube or a hollow needle and with a suction device, wherein an elongated obturator substantially adapted to the hollow space of the hollow body is guided in the hollow body and a first seal is arranged in a region of the hollow body facing away from an inserter, characterized in that the first hollow body (4, 44) is designed as the obturator in a further elongated hollow body (4', 44') is arranged, which also has a second seal (47) in a region facing away from the insertion end (21, 21*), which seals tightly around the first hollow body (4, 44). 2. Device according to claim 1, characterized in that at least one hollow body is a tube, such as a catheter tube. 3. Device according to claim 1 or 2, characterized in that at least one hollow body is a hollow needle (i:, 44; 4', 44 ) as part of a biopsy set and the opturator is a stylet (12) guided in the first hollow needle (4, 44). 4. Device according to one of claims 1 to 3 ₇ , characterized in that at least one seal (47, 47') consists of rubber. 5. Device according to one of claims 1 to 4, characterized in that at least one seal (47, 47') consists of relatively soft plastic. 6. Device according to claim 5, characterized in that the seal (47, 47') consists of silicone. 7. Device according to one of the preceding claims, characterized in that at least one hollow body (&eeacgr;_; 44. 4") 44") has an enlarged cavity, for example in the interior of an adapter (43), such as a Luer adapter, in the region of its end facing away from the end (21, 21') to be inserted into the body, and that the seal (47, 47') is formed in the enlarged cavity. 6. Device according to claim 7, characterized in that the seal (47, 47') has its receiving cavity hollow t I I II* I t * * ifSit·« äi «j &igr; Ii a« t taiaaa _ &igr; |3* ·■· · lit· at a I <t a I Ii Il ti Il Il al u I side completely filled out« 9. Device according to one of the preceding claims, characterized in that the seal (47, 47') is
Holding fihg (49j 49") is held* iO.. Device according to one of the preceding claims, characterized in that the seal (47, 47') is held by a, in particular annular, ultrasonic welding
is. ii. Device according to one of the preceding claims, characterized in that the seal (47, 47') is self-closing.