Insertable endoscopic instrument for tissue removal
An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.
1. An flexible endoscopic instrument insertable within a single instrument channel of a flexible endoscope, the endoscopic instrument comprising:
a cutting assembly configured to resect material at a site within a subject, the cutting assembly including an outer cannula and an inner cannula disposed within the outer cannula, the outer cannula defining an opening through which the material to be resected enters the cutting assembly;
a flexible outer tubing coupled to the outer cannula and configured to cause the outer cannula to rotate relative to the inner cannula, the flexible outer tubing having an outer diameter that is smaller than the instrument channel in which the flexible endoscopic instrument is insertable;
a flexible torque coil having a portion disposed within the flexible outer tubing, the flexible torque coil having a distal end coupled to the inner cannula, the flexible torque coil configured to rotate the inner cannula relative to the outer cannula to resect the material to be resected;
a proximal connector coupled to a proximal end of the flexible torque coil and configured to engage with a drive assembly that is configured to cause the proximal connector, the flexible torque coil and the inner cannula to rotate upon actuation;
an aspiration channel having an aspiration port configured to engage with a vacuum source, the aspiration channel partially defined by an inner wall of the flexible torque coil and an inner wall of the inner cannula and extending from an opening defined in the inner cannula to the aspiration port; and
an irrigation channel having a first portion defined between an outer wall of the flexible torque coil and an inner wall of the flexible outer tubing and configured to carry irrigation fluid to the aspiration channel.
2. The endoscopic instrument of claim 1 , wherein the proximal connector is hollow and an inner wall of the proximal connector defines a portion of the aspiration channel.
3. The endoscopic instrument of claim 1 , wherein the proximal connector is a rigid cylindrical structure, the proximal connector is configured to be positioned within a drive receptacle of the drive assembly, the proximal connector including a coupler configured to engage with the drive assembly and a tensioning spring configured to bias the inner cannula towards a distal end of the outer cannula.
4. The endoscopic instrument of claim 3 , wherein the tensioning spring is sized and biased such that the tensioning spring causes a cutting portion of the inner cannula to be positioned adjacent to the opening of the outer cannula.
5. The endoscopic instrument of claim 1 , wherein the proximal connector is rotationally and fluidly coupled to the flexible torque coil.
6. The endoscopic instrument of claim 1 , further comprising:
a lavage connector including an irrigation entry port; and
a tubular member coupled to the lavage connector and the flexible outer tubing, an inner wall of the tubular member and the outer wall of the flexible torque coil defining a second portion of the irrigation channel that is fluidly coupled to the first portion of the irrigation channel.
7. The endoscopic instrument of claim 6 , further comprising a rotational coupler coupling the flexible outer tubing to the tubular member, the rotational coupler configured to cause the flexible outer tubing to rotate relative to the tubular member and the opening defined in the outer cannula to rotate relative to the inner cannula.
8. The endoscopic instrument of claim 6 , wherein the lavage connector defines an inner bore within which the flexible torque coil is disposed.
9. The endoscopic instrument of claim 1 , further comprising a lining within which the flexible torque coil is disposed, an outer wall of the lining configured to define a portion of the irrigation channel.
10. The endoscopic instrument of claim 1 , wherein the inner cannula is configured to rotate axially relative to the outer cannula and the aspiration channel is configured to provide a suction force at the opening of the inner cannula.
11. The endoscopic instrument of claim 1 , wherein the flexible torque coil includes a plurality of threads, each of the plurality of threads is wound in a direction opposite to a direction in which one or more adjacent threads of the plurality of threads is wound.
12. The instrument of claim 1 , wherein the flexible outer tubing has a length that exceeds the length of the flexible endoscope.
13. An endoscopic instrument insertable within a single instrument channel of a flexible endoscope, the endoscopic instrument comprising:
a cutting assembly configured to resect material at a site within a subject, the cutting assembly including an outer cannula and an inner cannula disposed within the outer cannula, the outer cannula defining an opening through which the material to be resected enters the cutting assembly;
a flexible outer tubing coupled to the outer cannula and configured to rotate the outer cannula relative to the inner cannula, the flexible outer tubing having an outer diameter that is smaller than the instrument channel in which the endoscopic instrument is insertable;
a flexible torque coil having a portion disposed within the flexible outer tubing, the flexible torque coil having a distal end coupled to the inner cannula, the flexible torque coil configured to rotate the inner cannula relative to the outer cannula to resect the material to be resected, the flexible torque coil includes a plurality of layers of one or more threads, each of the plurality of layers is wound in a direction opposite to a direction in which one or more adjacent layers of the plurality of layers is wound;
a proximal connector coupled to a proximal end of the flexible torque coil and configured to engage with a drive assembly that is configured to cause the proximal connector, the flexible torque coil and the inner cannula to rotate upon actuation, the proximal connector including a tensioning spring sized and biased such that the tensioning spring causes a cutting portion of the inner cannula to be positioned adjacent to the opening of the outer cannula;
an aspiration channel having an aspiration port configured to engage with a vacuum source, the aspiration channel partially defined by an inner wall of the flexible torque coil and an inner wall of the inner cannula and extending from an opening defined in the inner cannula to the aspiration port; and
an irrigation channel having a first portion defined between an outer wall of the flexible torque coil and an inner wall of the flexible outer tubing and configured to carry irrigation fluid to the aspiration channel.
14. The endoscopic instrument of claim 13 , wherein the proximal connector is hollow and an inner wall of the proximal connector defines a portion of the aspiration channel.
15. The endoscopic instrument of claim 13 , wherein the proximal connector is a rigid cylindrical structure.
16. The endoscopic instrument of claim 13 , wherein the proximal connector is configured to be positioned within a drive receptacle of the drive assembly, the proximal connector including a coupler configured to engage with the drive assembly.
17. The endoscopic instrument of claim 13 , wherein the proximal connector is rotationally and fluidly coupled to the flexible torque coil.
18. The endoscopic instrument of claim 13 , further comprising:
a lavage connector including an irrigation entry port; and
a tubular member coupled to the lavage connector and the flexible outer tubing, an inner wall of the tubular member and the outer wall of the flexible torque coil defining a second portion of the irrigation channel that is fluidly coupled to the first portion of the irrigation channel.
19. The endoscopic instrument of claim 18 , further comprising a rotational coupler coupling the flexible outer tubing to the tubular member, the rotational coupler configured to cause the flexible outer tubing to rotate relative to the tubular member and the opening defined in the outer cannula to rotate relative to the inner cannula.
20. The endoscopic instrument of claim 19 , wherein the lavage connector defines an inner bore within which the flexible torque coil is disposed.