Tissue sampling devices, systems and methods
Methods, devices, and systems are described herein that allow for improved sampling of tissue from remote sites in the body. A tissue sampling device comprises a handle allowing single hand operation. In one variation the tissue sampling device includes a blood vessel scanning means and tissue coring means to excise a histology sample from a target site free of blood vessels. The sampling device also includes an adjustable stop to control the depth of needle penetration. The sampling device may be used through a working channel of a bronchoscope.
1. A tissue sampling system for obtaining a core of tissue from a sample area, the system comprising:
a tissue sampling device, the device comprising:
an elongate sheath having a flexibility to advance through tortuous airway anatomy;
a shaft removably disposed with the sheath, wherein the shaft and sheath are moveable relative to one another, the shaft comprising a proximal section and a distal section, and a lumen extending there through;
a coring tip located at the distal section of the shaft, the coring tip having a tissue cutting distal end, and a cavity therein adapted to cut and capture a tissue sample shaped as a long core upon advancement of the coring tip through a target tissue, the cavity being in fluid communication with the lumen;
a vacuum source connectable with the proximal section of the lumen of the shaft and operable to create a negative pressure in the cavity to facilitate capture of the core of tissue;
a handle comprising a single-handed actuation assembly operative to advance the coring tip a pre-determined distance from the sheath at a velocity and force which penetrates the target tissue surface and captures the tissue sample in the shape of the long core; and
at least one device advanceable from the shaft.
2. The system of claim 1 , wherein the at least one device is an optical fiber.
3. The system of claim 1 , wherein the at least one device is an ultrasound probe.
4. The system of claim 1 , wherein the at least one device is a fiducial.
5. The system of claim 1 , wherein the at least one device is a brachytherapy seed.
6. The system of claim 1 , further comprising a flexibility means to adjust the flexibility of the tissue sampling device.
7. The system of claim 6 , wherein the flexibility means comprises a stylet, said stylet comprising a stylet tip, and said stylet adapted to be locked in a position within said lumen of the shaft such that the stylet tip is in the vicinity of said coring tip and proximal to the coring tip.
8. The system of claim 1 , wherein the at least one device is a scanning catheter.
9. The system of claim 8 , wherein the scanning catheter is a doppler catheter.
10. The system of claim 1 , wherein the handle comprises a sheath hub and a coring hub moveably coupled thereto, wherein the sheath hub and coring hub each include a digit grip surface located on the respective hubs to allow for the single handed movement of the coring hub relative to the sheath hub by the pre-determined distance for moving the sheath relative to the shaft.
11. A method for obtaining a core shaped tissue sample comprising:
advancing a tissue sampling catheter to a target site for obtaining the core shaped tissue sample, wherein the tissue sampling catheter comprises a sheath having a shaft extending therethrough, the shaft having a coring tip comprising a tissue penetrating distal end to penetrate tissue and a cavity to excise the tissue sample, wherein the coring tip is retracted within the sheath when the tissue sampling catheter is advanced into the lung and to the target site;
positioning a distal end of the shaft in the vicinity of the target site;
advancing a scanning device from the shaft and scanning the target site;
retracting the scanning device from the shaft;
setting an adjustable stop on a handle of the tissue sampling catheter, wherein a location of the adjustable stop on the handle determines a pre-determined distance that the coring tip extends from the sheath; and
actuating the handle to extend the coring tip from the sheath by the pre-determined distance thereby penetrating tissue with the coring tip such that the sample of tissue is located within the cavity of the coring tip.
12. The method of claim 11 , wherein penetrating tissue with the coring tip comprises actuating the handle to drive the coring tip to penetrate tissue, wherein the handle comprises a sheath hub and a coring hub moveably coupled thereto, wherein the sheath hub and coring hub each include a digit grip surface located on the respective hubs to allow for single handed movement of the coring hub relative to the sheath hub by the pre-determined distance for moving the sheath relative to the shaft.
13. The method of claim 11 , wherein said shaft further comprises a contiguous lumen to hold multiple samples of tissue, and further comprising obtaining multiple samples of tissue from multiple penetration sites.
14. The method of claim 11 , wherein advancing a tissue sampling catheter into an airway of the lung, comprises advancing the tissue sampling catheter through tortuous anatomy to access the tissue sample.
15. The method of claim 11 , wherein the scanning device comprises a doppler catheter.
16. The method of claim 11 , wherein the scanning device comprises an optical fiber.
17. The method of claim 11 , wherein the scanning device is adapted to perform forward scanning on structures directly in front of the scanning device.
18. The method of claim 13 , further comprising applying vacuum to a proximal end of the contiguous lumen to facilitate obtaining the multiple samples of tissue therein.
19. The system of claim 1 , wherein the vacuum source is a syringe.
20. The system of claim 19 , wherein the tissue sampling device further comprises a stopcock for fluidly sealing the cavity from the lumen.