Experience with a high speed biopsy gun in breast cancer diagnosis

Bioinspired Crown-Cutter—The Impact of Tooth Quantity and Bevel Type on Tissue Deformation, Penetration Forces, and Tooth Collapsibility

Current keyhole biopsy devices are rather ungainly, inaccurate, and limited in application. A keyhole biopsy harvester was designed to facilitate peripheral cancerous tissue detection and resection at high speed and accuracy. The harvester's cutting tool, the crown-cutter, was bioinspired by the sea urchin's chewing organ—Aristotle's lantern. This paper focuses on the optimization of the crown-cutter with regard to the impact of different tooth quantity and bevel type on tissue deformation, penetration forces, and tooth collapsibility. Two sets of crown-cutter designs were manufactured and tested in push-in experiments using gelatin—the first set having no bevel and differing tooth quantity (4, 6, 8, 10 teeth) and the second set of constant tooth quantity and differing bevel type (no, inner, outer, and inner and outer bevel). The gelatin surface deformation and the penetration forces were evaluated utilizing a high speed camera and a universal testing machine, respectively. The experimental results on the crown-cutters of different tooth quantity (no bevel) showed a steady increase in the tissue deformation with the increasing amount of teeth. Unlike the bevel type, the different tooth quantity revealed significant differences with regard to the tissue deformation in between 4 versus 6-teeth and 10 versus 6-teeth cutters. As for the penetration forces, the significant difference was found only between 10 and 6-teeth cutters. In conclusion, reducing the cutter's tooth quantity resulted in lower tissue deformation, whereas differing the bevel type was found to have a negligible influence. Ultimately, a high ratio of outward to inward tooth collapsibility and a relatively low inner moment of inertia proved the 6-teeth cutter to be the most optimal.

Minimally invasive surgical instruments with an accessory channel capable of integrating fibre-optic cable for optical biopsy: A review of the state of the art

This review article provides a comprehensive overview and classification of minimally invasive surgical instruments with an accessory channel incorporating fibreoptics or another auxiliary device for various purposes. More specifically, this review was performed with the focus on the newly emerging field of optical biopsy, its objective being to discuss primarily the instruments capable of carrying out the optical biopsy and subsequent tissue resection. Instruments housing the fibreoptics for other uses, as well as instruments with an accessory channel capable of housing the fibreoptics instead of their original auxiliary device after relevant design modifications, supplement the review. The entire Espacenet and Scopus databases were searched, yielding numerous patents and articles on conceptual and existing instruments satisfying the criteria. The instruments were categorised based on the function the fibreoptics or the auxiliary device serves. On the basis of their geometrical placement with respect to the tissue resector or manipulator, the subcategories were further defined. This subdivision was used to identify the feasibility of performing the optical biopsy and the tissue resection in an accurate and successive fashion. In general, the existing concepts or instruments are regarded as limited with regard to such a functionality, either due to the placement of their accessory channel with or without the fibreoptics or due to the operational restrictions of their tissue manipulators. A novel opto-mechanical biopsy harvester, currently under development at Delft University of Technology, is suggested as a promising alternative, ensuring a fast and accurate succession of the optical and the mechanical biopsies of a flat superficial tissue.

Bioinspired Spring-Loaded Biopsy Harvester—Experimental Prototype Design and Feasibility Tests

Current minimally invasive laparoscopic tissue–harvesting techniques for pathological purposes involve taking multiple imprecise and inaccurate biopsies, usually using a laparoscopic forceps or other assistive devices. Potential hazards, e.g., cancer spread when dealing with tumorous tissue, call for a more reliable alternative in the form of a single laparoscopic instrument capable of repeatedly taking a precise biopsy at a desired location. Therefore, the aim of this project was to design a disposable laparoscopic instrument tip, incorporating a centrally positioned glass fiber for tissue diagnostics; a cutting device for fast, accurate, and reliable biopsy of a precisely defined volume; and a container suitable for sample storage. Inspired by the sea urchin's chewing organ, Aristotle's lantern, and its capability of rapid and simultaneous tissue incision and enclosure by axial translation, we designed a crown-shaped collapsible cutter operating on a similar basis. Based on a series of in vitro experiments indicating that tissue deformation decreases with increasing penetration speed leading to a more precise biopsy, we decided on the cutter's forward propulsion via a spring. Apart from the embedded spring-loaded cutter, the biopsy harvester comprises a smart mechanism for cutter preloading, locking, and actuation, as well as a sample container. A real-sized biopsy harvester prototype was developed and tested in a universal tensile testing machine at TU Delft. In terms of mechanical functionality, the preloading, locking, and actuation mechanism as well as the cutter's rapid incising and collapsing capabilities proved to work successfully in vitro. Further division of the tip into a permanent and a disposable segment will enable taking of multiple biopsies, mutually separated in individual containers. We believe the envisioned laparoscopic optomechanical biopsy device will be a solution ameliorating time-demanding, inaccurate, and potentially unsafe laparoscopic biopsy procedures.