Anatomical extraction device

Abstract

A medical extraction device comprises: (a) a sheath comprising a distal end configured to be inserted into a patient's body and a proximal end configured to be retained outside the patient's body; (b) a basket configured to extend from the distal end of the sheath and be capable of being repositioned between a deployed position and a retracted position, the basket comprising at least three rings, the basket further comprising a first guide and a second guide, wherein the first guide receives portions of the first ring and the third ring, wherein the second guide receives portions of the first ring and the second ring, wherein the second ring and the third ring are fixedly mounted to each other at a position between the first guide and the second guide; and (c) a handle control operatively connected to the proximal end of the sheath and operatively connected to the basket, the handle control being configured to facilitate repositioning of the basket relative to the sheath between the retracted position and the deployed position.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of U.S. Provisional Patent Application Serial No. 62 / 643,644, filed on March 15, 2018, entitled “ANATOMICAL EXTRACTION DEVICE,” the disclosure of which is incorporated herein by reference.

[0003] Introduction of the invention

[0004] The present disclosure relates to anatomical extraction devices, and more particularly to anatomical extraction devices that can be used to extract objects within body conduits and body reservoirs.

[0005] Small stones in the distal ureter can be reliably and definitively extracted using a ureteroscopic basket lithotripsy. Currently, a wide variety of ureteroscopic baskets are commercially available. Many such ureteroscopic baskets consist of filaments slidably mounted within a tubular sleeve forming a cannula. The distal ends of the filaments may be free or fixedly connected to one another and are capable of expanding when extended outward due to the elasticity of the material comprising the filaments. For those filaments that are connected to one another, a distal plug may be present at the more distal tip of the basket. Those skilled in the art have theorized that the presence of a distal tip in the basket is disadvantageous because it creates a distance from the end to the functional engagement portion of the basket, thereby making stone entrapment more difficult. Furthermore, those skilled in the art have regretted that some baskets with distal tips can pierce the calyceal urothelial lining, resulting in bleeding that obscures visualization and can lead to premature termination of stone extraction. Similar disadvantages have been noted in the art with baskets having free ends, an example of which is disclosed in U.S. Patent No. 6,416,519.

[0006] As a means of addressing the significant drawbacks of baskets with distal tips or free distal ends, certain "open-ended" baskets have been developed. Among these "open-ended" baskets is the embodiment disclosed in U.S. Patent No. 5,906,622. However, the embodiments of U.S. Patent No. 5,906,622 suffer from a very significant drawback—the inability to reliably grasp the intended object for removal. All embodiments of the '622 patent operate to clamp the object from the side, rather than by extending beyond and around the object to grasp the intended object. Not surprisingly, such a clamping operation is not depicted in the '622 patent. Furthermore, such a clamping operation is highly unsatisfactory, as the circumferential pressure on the basket of the '622 patent (presumably the result of pulling the basket through the relatively small diameter of the renal catheter) causes the object to be ejected from the distal end of the basket. In other words, because the basket of the '622 patent does not extend distally beyond the distal end of the object to be captured (such as a kidney stone), it has no real ability to resist distal movement of the object relative to the basket when circumferential or proximal pressure is applied thereto.

[0007] Therefore, there is a need for an anatomical extraction device that is open ended but overcomes the aforementioned problems and provides a basket that extends beyond and positively grasps the intended object.

[0008] A first aspect of the present invention is to provide a medical extraction device comprising a hollow sheath including a distal end from which a basket can extend in a deployed position, the basket being capable of being repositioned between a retracted position and a deployed position, the basket comprising: (i) a first guide and a second guide circumscribed by the hollow sheath; (ii) a first ring, a second ring, and a third ring, wherein the first ring extends between the first guide and the second guide; (iii) a first anchor that fixes the relative position of a distal portion of the second ring relative to a distal portion of the third ring; (iv) a first joint that connects the second ring and the third ring proximal to the first anchor; (v) a second anchor that fixes the relative position of the distal portion of the first ring relative to a portion of the first guide; and (vi) a wire that is operatively connected to the proximal portions of at least two of the first, second, and third rings such that repositioning of the wire is operable to at least one of increase and decrease the length of at least two of the first, second, and third rings extending from the distal end.

[0009] In a more detailed embodiment of the first aspect, the extraction device further comprises a fourth ring and a third guide, wherein the fourth ring extends between the fourth guide and the first guide, and the second ring extends between the second guide and the third guide. In yet another more detailed embodiment, the extraction device further comprises a handle control mounted to the proximal portion of the hollow sheath and configured to be handheld, the handle control comprising an actuator operatively coupled to the wire such that repositioning of the actuator is operable to guide repositioning of the wire. In yet another more detailed embodiment, the extraction device further comprises a handle control repositionably mounted to the proximal portion of the hollow sheath, the handle control operatively coupled to the wire such that repositioning of the handle control relative to the hollow sheath is operable to guide repositioning of the wire. In yet another more detailed embodiment, the wire comprises a plurality of wires, each of the plurality of wires being operatively coupled to at least one of the first ring, the second ring, and the third ring. In yet another more detailed embodiment, at least one of the first guide and the second guide comprises a conduit through which portions of at least two of the first ring, the second ring, and the third ring extend. In a more detailed embodiment, the first guide comprises a first conduit through which portions of the first and second rings extend, and the second guide comprises a second conduit through which portions of the first and second rings extend. In another more detailed embodiment, at least one of the first and second guides defines a channel along which portions of at least two of the first, second, and third rings extend. In yet another more detailed embodiment, the first guide comprises a first channel along which portions of the first and second rings extend, and the second guide comprises a second channel along which portions of the first and second rings extend. In yet another more detailed embodiment, at least one of the first, second, and third rings is discontinuous.

[0010] In yet another more detailed embodiment of the first aspect, the first guide and the second guide are at least one of repositionable and fixedly positioned relative to the hollow sheath. In yet another more detailed embodiment, the first joint comprises at least one of a weld, a glued head, a soldered portion, a twisted wire, and a wire braid. In yet another more detailed embodiment, the first anchor comprises at least one of a weld, a glued head, a soldered portion, a twisted wire, and a wire braid, which is secured to at least one of the first guide, the second guide, and the hollow sheath. In yet another more detailed embodiment, the first anchor and the second anchor comprise a common anchor. In a more detailed embodiment, the proximal portion of the first ring and the proximal portion of the third ring are freely repositionable relative to the second guide. In a more detailed embodiment, the first ring is independently repositionable relative to the second and third rings. In another more detailed embodiment, the first ring is repositionable relative to the second and third rings via a wire dependency.

[0011] A second aspect of the present invention is to provide a method for operating a medical extraction device, which includes: (a) increasing the exposed length of a first ring, a second ring, and a third ring extending from a hollow sheath, wherein the first ring, the second ring, and the third ring are operatively connected to form a basket in an open position, the basket including an internal cavity, which is primarily defined by a first plane spanning an arcuate portion of the first ring, a second plane spanning an arcuate portion of the second ring, a third plane spanning an arcuate portion of the third ring, and a fourth plane spanning a distal-most point of the first ring, a distal-most point of the second ring, and a distal-most point of the third ring, wherein a mid-longitudinal cross-section of the cavity is taken at a midpoint of a longitudinal axis perpendicular to the fourth plane; and (b) changing the exposed length of the second ring and the third ring so as to reposition the joint at the junction of the second ring and the third ring in an arcuate path, thereby reducing the cross-sectional area of ​​the fourth plane at a rate greater than the cross-sectional area of ​​the mid-longitudinal cross-section.

[0012] In a more detailed embodiment of the second aspect, increasing the exposed length of the first, second, and third loops comprises maintaining a relative position of the first guide and the second guide relative to the hollow sheath, wherein the first loop extends between the first guide and the second guide. In yet another more detailed embodiment, increasing the exposed length of the first, second, and third loops comprises repositioning the first guide and the second guide relative to the hollow sheath, wherein the exposed length comprises a length of each loop extending from the corresponding guide beyond the hollow sheath.

[0013] A third aspect of the present invention is to provide a method of operating a medical extraction device, comprising: (a) repositioning a first ring, a second ring, and a third ring to define a receiving area extending beyond the distal end of a hollow sheath, the receiving area in a static state being tapered and having a cross-sectional area that decreases in a direction toward the hollow sheath, wherein the first ring, the second ring, and the third ring cooperate to define an opening at the distal end, wherein the opening allows an object to pass through the opening into the receiving area; and (b) repositioning a joint at at least two of the junctions of the first ring, the second ring, and the third ring in an arcuate path to reduce the size of the opening and prevent objects in the receiving area from passing through the reduced size opening.

[0014] A fourth aspect of the present invention is to provide a method of manufacturing a medical extraction device comprising: (a) arranging at least one of a first ring, a second ring, and a third ring into a geometric configuration wherein at least two of the rings are angled relative to each other using the following equation: A = 360 / N, where A is the angle between the at least two rings and N is the total number of rings; (b) positioning at least a first portion of the first ring and a first portion of the third ring in at least one of a manner along a first guide and within the first guide such that the first portions of the first ring and the third ring are repositionable relative to the first guide and relative to each other; (c) positioning at least a first portion of the second ring and a second portion of the first ring in at least one of a manner along a second guide and within the second guide such that the second portion of the first ring is fixed relative to the second guide and the first portion of the second ring is repositionable relative to the second guide and relative to the first ring; (d) directly coupling at least the second portion of the third ring and the second portion of the second ring at a joint; (e) positioning the first, second, and third rings at least partially within a hollow sheath such that the hollow sheath at least partially circumscribes the first, second, and third rings; and (f) operatively coupling a drive wire to the first portions of the first, second, and third rings such that repositioning the drive wire is operable to simultaneously increase or decrease the exposed length of the first, second, and third rings extending beyond the hollow sheath.

[0015] A fifth aspect of the present invention is to provide a medical extraction device comprising: (a) a sheath comprising a distal end configured to be inserted into a patient's body and a proximal end configured to be maintained outside the patient's body; (b) a basket configured to extend from the distal end of the sheath and to be repositionable between a deployed position and a retracted position, the basket comprising at least three rings, the basket further comprising a first guide and a second guide, wherein the first guide receives portions of the first and third rings, wherein the second guide receives portions of the first and second rings, wherein the second and third rings are fixedly mounted to each other at a position between the first and second guides; and (c) a handle control operatively coupled to the proximal end of the sheath and operatively coupled to the basket, the handle control being configured to facilitate repositioning of the basket relative to the sheath between a retracted position and a deployed position. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] Figure 1 is a front perspective view of a first exemplary medical extraction device according to the present disclosure.

[0017] Figure 2 yes Figure 1 An isolated perspective view of the distal end of a first exemplary medical extraction device showing the basket extending beyond the sheath.

[0018] Figure 3is a cross-sectional view of a sheath of a first exemplary medical extraction device.

[0019] Figure 4 is a cross-sectional view of exemplary components extending through the sheath, shown with respective wires and guides, taken immediately before the distal end of the sheath, wherein the guides are secured relative to the sheath of a first exemplary medical extraction device.

[0020] Figure 5 is a cross-sectional view of exemplary components extending through the sheath, taken immediately before the distal end of the sheath, illustrating respective wires and a guide, wherein the guide is repositionable relative to the sheath of a first alternative exemplary medical extraction device.

[0021] Figure 6 is a cross-sectional view of an exemplary sheath taken immediately before the distal end of the sheath and a perspective view of exemplary components extending through the sheath showing respective wires and guides, wherein the guides are secured relative to the sheath of a first exemplary medical extraction device.

[0022] Figure 7 is a longitudinal cross-sectional view of the distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal pathway just before the basket reaches the object to be removed.

[0023] Figure 8 is a longitudinal cross-sectional view of the distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal pathway with the basket open to receive an object to be removed.

[0024] Figure 9 is a longitudinal cross-sectional view of the distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal pathway with the basket repositioned to an enclosed position to surround an object to be removed.

[0025] Figure 10 is a longitudinal cross-sectional view of the distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal pathway with the basket repositioned to an enveloping position to surround an object to be removed and showing optional repositioning of the guide closer to the object to be removed just prior to removal of the object.

[0026] Figure 11 is a front perspective view of a second exemplary medical extraction device according to the present disclosure.

[0027] Figure 12 yes Figure 11 An isolated perspective view of the distal end of a second exemplary medical extraction device showing the basket extending beyond the sheath.

[0028] Figure 13is a cross-sectional view of exemplary components extending through the sheath, showing corresponding wires and a guide, taken just before the distal end of the sheath, wherein the guide is secured relative to the sheath of a second exemplary medical extraction device.

[0029] Figure 14 is a cross-sectional view of exemplary components extending through the sheath, taken immediately before the distal end of the sheath, illustrating respective wires and a guide, wherein the guide is repositionable relative to the sheath of a second alternative exemplary medical extraction device.

[0030] Figure 15A is a cross-sectional view of an exemplary sheath taken immediately before the distal end of the sheath and a perspective view of exemplary components extending through the sheath showing respective wires and two guides, wherein the guides are secured relative to the sheath of a second exemplary medical extraction device.

[0031] Figure 15B is a cross-sectional view of an exemplary sheath taken immediately before the distal end of the sheath and extending through Figure 15A A perspective view of certain other exemplary components of a sheath of a second exemplary medical extraction device is shown, illustrating corresponding wires and two additional guides, wherein the guides are secured relative to a sheath of a second exemplary medical extraction device.

[0032] Figure 16 is a longitudinal cross-sectional view of the distal end of a second exemplary medical retrieval device, with the basket just in a retracted position, the medical retrieval device extending through a ureteroscope within a renal pathway.

[0033] Figure 17 is a longitudinal cross-sectional view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within a renal pathway with the basket open to receive an object to be removed.

[0034] Figure 18 is a longitudinal cross-sectional view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within a renal pathway with the basket open and receiving an object to be removed.

[0035] Figure 19 is a longitudinal cross-sectional view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within a renal pathway with the basket retracted to retain an object to be removed.

[0036] Figure 20 is a front perspective view of an alternative exemplary embodiment of first and second exemplary medical extraction devices according to the present disclosure.

[0037] Figure 21 is a cross-sectional view of an exemplary sheath and a perspective view of certain other exemplary components extending through the sheath, wherein the device includes dual wires and a separate actuator for each wire.

[0038] Figure 22 Is in the open or expanded position Figure 1 A front perspective view of a basket of a first exemplary medical extraction device.

[0039] Figure 23 Is in the closed or retracted position Figure 1 A front perspective view of a basket of a first exemplary medical extraction device.

[0040] Figure 24 Is in the closed or retracted position Figure 1 A front perspective view of the basket of a first exemplary medical extraction device, but with an object captured by the basket.

[0041] Figure 25 Is in the open or expanded position Figure 11 A front perspective view of a basket of a second exemplary medical extraction device.

[0042] Figure 26 is a front perspective view of the basket of a second exemplary medical extraction device in an intermediate position between a closed position and an open position.

[0043] Figure 27 is a front perspective view of a basket of a second exemplary medical extraction device in a closed or retracted position.

[0044] Figure 28 is a front perspective view of the basket of a second exemplary medical extraction device in a closed or retracted position, but with an object captured by the basket.

[0045] Figure 29 Is in the open or expanded position Figure 1 A front perspective view of a basket of a first exemplary medical extraction device is shown with the same exemplary basket shown in phantom in a closed or retracted position.

[0046] Figure 30 Is in the open or expanded position Figure 11 A front perspective view of a basket of a second exemplary medical extraction device is shown with the same exemplary basket shown in phantom lines in a closed or retracted position. DETAILED DESCRIPTION

[0047] It should be understood that the following detailed description of the embodiments of the present invention is illustrative in nature and is not intended to limit the present invention. It should also be understood that variations of the exemplary embodiments contemplated by those of ordinary skill in the art will fall within the scope and spirit of the present invention. It should also be understood that features of the various embodiments may be combined, rearranged, and / or interchanged without departing from the scope of this disclosure.

[0048] refer to Figures 1 to 10 and Figures 22 to 24 A first exemplary embodiment of a medical extraction device 100 includes an elongated, hollow sheath 102 with a repositionable basket 104 extending from a distal end of the sheath. The basket 104 is operatively connected to a handle control 106 via a wire 108 (which may include one or more wires) that extends through the hollow portion of the sheath and is longitudinally repositionable relative to the sheath to facilitate opening (i.e., a deployed position) and closing (i.e., a retracted position) of the basket. A proximal aspect of the sheath 102 may be fixed to or repositionably mounted to the handle control 106.

[0049] For example, go to Figure 3 The sheath 102 can be manufactured to provide a generally smooth, curved outer perimeter and a hollow interior passageway. For example, the sheath 102 can include a multi-layer construction comprising, from outermost to innermost, a Teflon layer 120, a first polyimide layer 122, a braided stainless steel layer 124, and a second polyimide layer 126, with these layers defining the hollow interior passageway. In exemplary forms, the sheath 102 can have a substantially constant cross-section or a cross-section that varies along its longitudinal length. Furthermore, the sheath 102 can have a circular cross-section, an oblong cross-section, or any other cross-section that provides a longitudinal passageway within which the wire 108 can be repositioned. As a further example, the sheath 102 can have a maximum outer dimension ranging from 1.0 to 12.0 Fr, optionally to accommodate all or a portion of the basket 104 when in the retracted position.

[0050] Reference Figure 4 In an exemplary form, the basket 104 may include two or more guide members 130, 132 through which two or more flexible filaments 140, 142, 144 extend. For example, the guide members 130, 132 may each be made of a suitable plastic material, such as, but not limited to, polyethylene, polypropylene, polyester, polyvinyl chloride, polyimide, and the like. However, it should also be noted that the guide members 130, 132 may be made of materials other than plastic, such as, but not limited to, metals and metal alloys. The guide members 130, 132 may be deformable and, alternatively, elastically deformable. Each of the guide members 130, 132 may be fixedly attached to the sheath 102 (such as by adhesive 160 or other bonding means), or may be repositionable relative to the sheath. As a further example, at least a portion of the guide members 130, 132 may be circumscribed by the sheath 102. In exemplary forms, each of the guides 130 , 132 defines a hollow conduit extending therethrough, thereby being sized to permit repositioning of one or more wires 140 , 142 , 144 extending therethrough or thereabout.

[0051] The wires 140, 142, 144 of the basket 104 are operably coupled to the line 108 to facilitate repositioning of the basket between a closed or retracted position and an open or deployed position. In an exemplary form, each wire 140, 142, 144 may comprise a single filament or a multifilament bundle that is repositionable and optionally elastically deformable. For example, the wires 140, 142, 144 may comprise a metal, a metal alloy, a polymer, or a polymer alloy, and may be optionally shaped to embody a curved (non-linear) form. Exemplary metal alloys that may be used to manufacture the wires 140, 142, 144 include, but are not limited to, Nitinol. The wires or bundles may have a uniform cross-section along the longitudinal length, or may have a cross-section that varies along the longitudinal length. The cross-section of the wires or bundles may be circular, oblong, semicircular, triangular, rectangular, star-shaped, or any other cross-section. As a further example, the wires 140, 142, 144 may comprise a single bundle of nitinol having a uniform circular cross-section and an outer diameter in a range between 0.0001 inches and 0.05 inches, such as 0.003 inches. As a further example, each wire may have a total length exceeding twice the longitudinal dominant dimension of the guides 130, 132.

[0052] In this exemplary embodiment, the basket 104 includes three wires 140, 142, 144, each of which forms a loop that can be repositioned relative to the sheath 102 to capture an object within the internal area defined by the loop. For example, the loop can be arranged in a triangular configuration. For example, the first wire 140 and the second wire 142 can be fixedly joined to each other at a location 154 (i.e., a joint). This fixed relationship can be the result of welding, gluing, soldering, twisting, braiding, or any other means to prevent the first wire 140 and the second wire 142 from being longitudinally repositioned at the joint 154. Alternatively, the first wire 140 and the second wire 142 can include a single, integrated filament upstream of the joint 154 and split downstream of the joint 154 to form two separate wires 140, 142. In any case, the upstream portions of the first wire 140 and the second wire 142 are operatively coupled to an anchor 158 associated with at least one of the sheath 102 or the guides 130, 132. As used with respect to this first exemplary extraction device 100, "upstream" refers to the portion of the first and second wires 140, 142 between the connector 154 and the anchor 158, wherein the anchor holds the first and second wires in a fixed position.

[0053] In one embodiment, the first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means. The first and second wires 140 and 142 are connected to each other by a plurality of means.

[0054] The third wire 144 is also operatively coupled to the line 108 and can be operatively coupled to the anchor 158 at the opposite end. In an exemplary form, the third wire 144 can form a third loop. For example, the opposite portion of the third wire 144 extends through or along the corresponding guide in the guides 130, 132. When the first wire 140 and the second wire 142 can be freely repositioned in the corresponding guides 130, 132, at least a portion of the third wire 144 can be fixedly mounted to the anchor 158, and another portion of the third wire can be freely repositioned along at least one of the guides 130, 132 or therein. As a result, a guide 130 can accommodate two or more wires 140, 144 that can be freely repositioned along the guide or in the guide, while another guide 132 can have a wire 142 that can be freely repositioned relative to it and a second wire 142 that cannot be freely repositioned relative to it. In an exemplary form, the wire 144, fixedly mounted to the anchor 158, may be secured thereto using an adhesive 160 or any other bonding or retaining means, such as, but not limited to, welding and brazing. As previously described, the wire 108 is operatively coupled to at least two of the three wires 140, 142, 144, allowing an operator to reposition the basket 104 between a fully retracted position and a fully deployed position using the handle control 106. For example, the wire 108 may comprise any number of materials and configurations, such as, but not limited to, metals, metal alloys, monofilaments, or multiple wires, whether parallel, twisted, or braided. In an exemplary form, the wire 108 comprises a nitinol monofilament having a circular cross-section and a diameter of approximately 0.015 inches. However, it should be noted that the diameter of the wire 108 may be proportional to or sized relative to the size of the sheath 102, such that a larger sheath diameter can accommodate a larger wire diameter, and vice versa, a smaller sheath diameter can accommodate a smaller wire diameter.

[0055] In an exemplary form, the handle control 106 includes complementary housing halves 202, 204 mounted to each other, which can be fixedly or repositionably mounted to the sheath 102. These housing halves 202, 204 define an interior region within which a first actuator 210 can be repositioned. The first actuator 210 can extend through an opening 212 in at least one of the halves 202, 204 (the halves 202, 204 can also cooperate to define the opening 212) and can be operatively coupled to the wire 108. In this manner, repositioning the actuator 210 can result in longitudinal repositioning of the wire 108 relative to the sheath 102.

[0056] It is also within the scope of the present disclosure to operatively couple the wire 108 to the housing halves 202, 204 rather than the first actuator 210, wherein the housing halves are repositionable relative to the sheath 102 and can be spring-biased relative to the sheath 102 to provide a biased open or biased closed basket position. In this case, the first actuator 210 can be operatively coupled to the sheath 102. Thus, longitudinal movement of the housing halves 202, 204 relative to the sheath 102 can be operable to transmit corresponding longitudinal movement relative to the sheath 102 to the wire 108. Such longitudinal movement of the wire 108 is then carried over into the movement of at least two (and optionally all three) of the three wires 140, 142, 144 to open and close the basket 104.

[0057] In any of the example controls discussed immediately above, the travel of the first actuator 210 or housing halves 202, 204 relative to the sheath 102 can be limited such that the range of motion / travel corresponds to the range of travel between fully extended and fully retracted (i.e., open and closed) the basket 104. In other words, when the first actuator 210 or housing halves 202, 204 are at one end of their range of motion relative to the sheath 102, the basket 104 can be fully retracted, and when the first actuator or housing halves are at the opposite end of their range of motion relative to the sheath, the basket can be fully extended. Thus, repositioning the first actuator 210 or housing halves 202, 204 relative to the sheath 102 can operate to manipulate the relative shape of the basket 104 by repositioning the basket between a fully retracted position and a fully extended position.

[0058] Go to Figure 11Although not required, handle control 106 may include a second actuator 220 that is also repositionable relative to housing halves 202, 204. Where one or more of guides 130, 132 are not rigidly mounted to sheath 102 and are longitudinally repositionable relative to the sheath, second actuator 220 may be operatively coupled to a hollow conduit 230 extending along the interior of the sheath. In an exemplary embodiment, conduit 230 may have an outer axial dominant dimension that is smaller than the smallest inner axial dominant dimension of sheath 102, thereby allowing the conduit to be longitudinally repositionable relative to the sheath. Furthermore, conduit 230 may have a longitudinally extending, continuous internal lumen through which wire 108 may extend. In this case, wire 108 may be longitudinally repositionable independently of conduit 230 and sheath 102. Similarly, conduit 230 may be longitudinally repositionable independently of wire 108 and sheath 102. In this manner, longitudinal movement of the second actuator 220 relative to the housing halves 202, 204 is operable to impart corresponding longitudinal movement to the conduit 230 within the sheath 102. This longitudinal movement of the conduit 230 is correspondingly carried over into the movement of the guides 130, 132 to extend and retract the guides relative to the sheath 102. In this exemplary embodiment, the stroke of the second actuator 220 is limited such that its range of motion corresponds to the range of extension and retraction of the guides 130, 132 relative to the sheath 102. In other words, when the second actuator 220 is at one end of its range of motion, the guides 130, 132 are fully retracted within the sheath 102, while when the second actuator is at the opposite end of its range of motion, the guides 130, 132 are fully (or nearly fully) extended from the sheath 102. Thus, repositioning the second actuator 220 relative to the housing halves 202, 204 is operable to manipulate the relative shape of the basket 104.

[0059] Specific reference Figure 1 、 Figures 7 to 10 、 Figures 22 to 24 and Figure 29 The aforementioned first medical extraction device 100 can be used to extract various objects from within an anatomical cavity. As an exemplary explanation, the use of the extraction device 100 will be explained in the context of a kidney stone removal procedure. However, those skilled in the art will understand that the use of the medical extraction device 100 should not be limited to kidney stone removal procedures, and that this description is merely one of many procedures in which the extraction device 100 has applications.

[0060] Initially, a suitable renal pathway 180 to the patient's kidney may be explored, and appropriate visualization may also be provided with the aid of a scope 190 (e.g., a ureteroscope) traversing the renal pathway. Figure 7 and Figure 23As shown, when the basket is in the retracted position, the end of the basket 104 of the extraction device 100 coupled to the sheath 102 can be advanced through the mirror 190 to advance the distal end of the basket and sheath beyond the distal end of the mirror 190. Continued advancement of the sheath 102 and basket 104 can continue until the basket 104 reaches the target area where the object 170 to be removed is located. After the basket 104 reaches the desired area as determined by visual inspection of the mirror 190, the operator can grasp the handle control 106 (i.e., the complementary housing halves 202, 204) and reposition one or both of the actuators 210, 220 relative to the housing halves 202, 204 (or reposition the handle housing relative to the sheath) to reposition the wire 108 relative to the sheath 102, thereby repositioning the basket from its retracted position toward the open position.

[0061] Where the handle control 106 includes a second actuator 220, the second actuator and the first actuator 210 can be repositioned simultaneously or independently of each other to move the basket from a closed or retracted position to an open or deployed position. In an exemplary form, the second actuator 220 can be repositioned distally (toward the basket 104 and relative to the handle housings 202, 204), thereby causing the catheter 230 to move longitudinally through the sheath 102 and directing the guides 130, 132 to extend beyond (or further beyond) the sheath. The operator of the handle control 106 can then reposition the first actuator 210 distally (toward the basket 104 and relative to the handle housings 202, 204), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the length of the wires 140, 144 extending beyond the guides 130, 132 to increase, and increasing the length of the wire 142. Figure 7 and Figure 8 An exemplary position of the basket 104 is depicted wherein the guides 130, 132 are at least partially extended from the sheath 102 (via the second actuator 220, or by default if not actuated) and the wires 140, 142, 144 are at least partially extended, consistent with a partially open or fully open (i.e., deployed) position. Figure 8 As shown, this open or deployed position can be maintained when the entire distal portion of the extraction device 100 is repositioned so that a target object 170 (eg, a kidney stone) intended to be captured can be received within the open basket 104 .

[0062] After the target object 170 is at least partially received within the opened basket 104, the first actuator 210 can be repositioned proximally (away from the basket 104 and relative to the handle housings 202, 204), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the wire length 140, 142, 144 extending beyond the guides 130, 132 to decrease, and reducing the wire length associated with the loop. Figure 9 、 Figure 24 and Figure 29 As shown, this reduced length of the wires 140, 144 coincides with the joint 154 including a tip that arches and moves in an arcuate path behind the target object 170, which creates a stop that prevents the object from exiting the basket. Depending on the size of the target object 170 and the operator's confidence that the object will remain within the basket 104 when the entire distal portion of the extraction device 100 is repositioned proximally (e.g., to ultimately remove the basket 104 and object 170 from the renal path 180), the operator can reposition the second actuator 220 distally (toward the basket 104 and relative to the handle housings 202, 204), thereby causing the guides 130, 132 to move further longitudinally through the sheath 102 and causing the length of the wires 140, 142, 144 extending beyond the guides 130, 132 to decrease, thereby reducing the wire length associated with the loop, thereby tightening the loop around the target object, as shown. Figure 10 After the target object 170 is captured within the basket 104 , the extraction device 100 and object 170 may be removed from the renal pathway 180 .

[0063] Alternatively, in the event that the guides 130, 132 cannot be repositioned relative to the sheath 102, the first actuator 210 can be repositioned to move the basket from the closed or retracted position to the open or deployed position upon reaching the target object 170. In an exemplary form, an operator of the handle control 106 can reposition the first actuator 210 distally (toward the basket 104), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the length of the wires 140, 144 extending beyond the guides 130, 132 to increase, and increasing the length of the wire 142, thereby increasing the length of each of the three loops extending from the sheath. Figure 7 、 Figure 8 and Figure 22 An exemplary open or deployed position of the basket 104 is depicted, wherein the guides 130, 132 partially extend from the sheath 102, and the wires 140, 142, 144 partially extend from the guides and the sheath. Figure 8 As shown, this open or deployed position can be maintained when the entire distal portion of the extraction device 100 is further repositioned distally so that a target object 170 (e.g., a kidney stone) to be captured can be received within the open basket 104. After the target object 170 is at least partially received within the open basket 104, the first actuator 210 can be repositioned proximally (away from the basket 104), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the length of the wires 140, 142, 144 extending beyond the guides 130, 132 to decrease, and correspondingly reducing the length of the loop extending beyond the guides. Figure 9、 Figure 23 and Figure 29 As shown, this reduced length of the wires 140, 142, 144 coincides with the connector 154 including a tip that arches and moves in an arcuate path behind the target object 170, which creates a stop that prevents the object from exiting the basket 104. After the connector 154 has been repositioned behind the target object 170, the extraction device 100 and the target object 170 can be removed from the renal path 180.

[0064] refer to Figures 11 to 20 、 Figures 25 to 28 and Figure 30 The second exemplary embodiment of a medical extraction device 300 includes an elongated hollow sheath 102 with a repositionable basket 304 extending from a distal end thereof. As used herein, reference numerals common to the first exemplary embodiment denote elements that are identical to or insubstantially different from those of the first exemplary embodiment. Therefore, for the sake of brevity, discussion of common elements between the two embodiments has been omitted.

[0065] The basket 304 is operatively connected to the handle control 106 via a wire 108 (which may include one or more wires) that extends through the hollow portion of the sheath and is longitudinally repositionable relative to the sheath to facilitate opening (i.e., deployed position) and closing (i.e., retracted position) of the basket. The proximal aspect of the sheath 102 may be fixed to or repositionably mounted to the handle control 106.

[0066] For example, go to Figure 12The basket 304 may include three or more guide members 130, 132, 334, 336, each of which has two or more wires 140, 142, 344, 346 extending therethrough. For example, the guide members 130, 132, 334, 336 may each be made of a suitable plastic material, such as, but not limited to, polyethylene, polypropylene, polyester, polyvinyl chloride, polyimide, or the like. However, it should also be noted that the guide members 130, 132, 334, 336 may be made of materials other than plastic, such as, but not limited to, metals and metal alloys. The guide members 130, 132, 334, 336 may be deformable and, alternatively, elastically deformable. Each of the guide members 130, 132, 334, 336 may be fixedly attached to the sheath 102 (such as by adhesive 360 ​​or other bonding means), or may be repositionable relative to the sheath. As a further example, at least a portion of the guides 130, 132, 334, 336 can be circumscribed by the sheath 102. In exemplary forms, the guides 130, 132, 334, 336 define respective hollow conduits extending therethrough, thereby being sized to allow repositioning of one or more wires 140, 142, 344, 346 extending therethrough.

[0067] The filaments 140, 142, 344, 346 of the basket 304 are operably coupled to the wire 108 to facilitate repositioning of the basket between a closed or retracted position and an open or extended position. In exemplary forms, the filaments 140, 142, 344, 346 may comprise a filament or bundle of filaments that is repositionable and optionally elastically deformable. For example, the filaments 140, 142, 344, 346 may comprise a metal or metal alloy and may be optionally shaped to embody a curved (non-linear) form. Exemplary metal alloys that may be used to manufacture the filaments 140, 142, 344, 346 include, but are not limited to, Nitinol. The filaments or bundles may have a uniform cross-section along their longitudinal length, or may have a cross-section that varies along their longitudinal length. The cross-section of the filaments or bundles may be circular, oblong, semicircular, triangular, rectangular, star-shaped, or any other cross-section. As a further example, the wires 140, 142, 344, 346 can comprise a single bundle of nitinol having a uniform circular cross-section and an outer diameter in a range between 0.0001 inches and 0.05 inches, such as 0.003 inches. As a further example, each wire can have a total length that exceeds twice the longitudinal dominant dimension of the guides 130, 132, 334, 336.

[0068] In this exemplary embodiment, the basket 304 includes four wires 140, 142, 344, 346 that cooperate to form four loops 150, 152, 354, 356 that can be repositioned relative to the sheath 102 to capture objects within the loops. In an exemplary form, the loops can be arranged in a rectangular configuration. For example, the first wire 140 and the second wire 142 are joined to each other at a joint 154 in a fixed relationship. This fixed relationship can be the result of welding, gluing, soldering, twisting, braiding, or any other means, so that the longitudinal repositioning of the first wire 140 and the second wire 142 at the joint 154 is not independent of each other. Alternatively, the first wire 140 and the second wire 142 can include an integral monofilament upstream of the joint 154 and split downstream of the joint 154 to form two separate wires 140, 142. In any case, the upstream portion of the first and second wires 140, 142 is operatively coupled to an anchor 158 associated with at least one of the sheath 102 or guides 130, 132. As used with respect to this second exemplary extraction device 300, "upstream" refers to the portion of the first and second wires 140, 142 between the connector 154 and the anchor 158, wherein the anchor holds the first and second wires in a fixed position. And as used with respect to this second exemplary extraction device 300, "downstream" refers to the portion of the first and second wires 140, 142 between the connector 154 and the location where the wires are operatively coupled to the line 108. In any event, downstream portions of the first and second wires 140, 142 may extend through one of the guides 130, 132 and be operatively coupled to the wire 108 such that retraction of the wire causes the downstream portions of the first and second wires 140, 142 to retract into the guides 130, 132, while extension of the wires (longitudinally repositioning the wires toward the distal end of the sheath 102) causes the wires 140, 142 to extend further beyond the guides 130, 132. Conversely, upstream portions of the first and second wires 140, 142 extend through a different guide 334 and are operatively coupled to the anchor 158 such that the length of the wires extending from the guide 334 is relatively constant.

[0069] As mentioned, downstream portions of the first and second wires 140, 142 extend into respective ones of the guides 130, 132. In exemplary forms, the downstream portions of the first and second wires 140, 142 may be freely repositionable along or within the respective guides 130, 132, or one downstream portion of either the first and second wires 140, 142 may be stationary relative to the guides 130, 132 while the second downstream portions of the first and second wires 140, 142 are freely repositionable and operatively coupled to the wire 108. In this manner, the first and second wires 140, 142 are operable to form the first and second loops 150, 152.

[0070] A third wire 344 is also operatively coupled to the wire 108 and operable to form a third loop 354. For example, opposite ends of the third wire 344 extend through respective ones of the guides 132, 336. Where the first and second wires 140, 142 are freely repositionable within the respective guides 130, 132, at least one opposite end of the third wire 344 may be fixedly mounted to the anchor 158, while another portion of the third wire may be freely repositionable within the guide 336 (see FIG. Figure 15B ). As a result, one guide 336 will house two wires that are freely repositionable within the guide, while the other two guides 130, 132 may have one wire 140, 142 that is freely repositionable therein and a second wire 344, 346 that is not freely repositionable therein, while the fourth guide 334 will house two wires that are fixed in position relative to the guide via the anchor 158. In exemplary forms, the respective wires 14, 142, 344 may be mounted to the anchor 158 using various forms of attachment or bonding, such as, but not limited to, adhesives, welding, and brazing.

[0071] Finally, a fourth wire 346 is also operatively coupled to the wire 108 and operable to form a fourth loop 356. For example, opposing portions of the fourth wire 346 extend through respective ones of the guides 130 and 336. While the first and second wires 140 and 142 are freely repositionable within their respective guides 130 and 336, at least a portion of the fourth wire 344 is fixedly mounted to the anchor 158, while the other end of the fourth wire is freely repositionable within the guide 336. As a result, the guide 336 will accommodate two wires that are freely repositionable within the guide, while the adjacent guide 130 may have one wire 140 that is freely repositionable therein and a second wire 346 that is not freely repositionable therein. In an exemplary form, the fourth wire 346 may be fixedly mounted to the anchor 158 using an adhesive 160 or any other bonding means such as, but not limited to, welding and brazing. As previously described, the wire 108 is operatively coupled to at least three of the four wires 140, 142, 344, 346, such that operator manipulation of the handle control 106 repositions the basket 304 between the retracted / closed position and the open / deployed position. For example, the wire 108 can comprise any number of materials and configurations, such as, but not limited to, metals, metal alloys, monofilaments, multiple filaments, whether parallel, twisted, or braided. In an exemplary form, the wire 108 comprises a nitinol monofilament having a circular cross-section and a diameter of approximately 0.015 inches. However, it should be noted that the diameter of the wire 108 can be proportional to or sized relative to the size of the sheath 102, such that a larger sheath diameter can accommodate a larger wire diameter, and vice versa, a smaller sheath diameter can accommodate a smaller wire diameter.

[0072] In exemplary form, a second exemplary embodiment of a medical extraction device 300 includes a handle control 106 comprising complementary housing halves 202, 204 mounted to one another, which can be fixedly or repositionably mounted to the sheath 102. These housing halves 202, 204 define an interior region within which a first actuator 210 can be repositioned. The first actuator 210 can extend through an opening 212 within at least one of the halves 202, 204 (the halves 202, 204 can also cooperate to define the opening 212) and can be operatively coupled to the wire 108. In this manner, repositioning the actuator 210 can result in longitudinal repositioning of the wire 108 relative to the sheath 102. This longitudinal movement of the wire 108, in turn, carries over into the movement of at least three of the four wires 140, 142, 344, 346 to deploy and retract the basket 304. In this exemplary embodiment, the stroke of first actuator 210 can be limited so that its range of motion corresponds to the range of deployment and retraction of basket 304. In other words, when first actuator 210 is at one end of its range of motion, basket 304 can be fully retracted, while when first actuator 210 is at the opposite end of its range of motion, the basket can be fully deployed. Thus, repositioning of first actuator 210 operates to manipulate the relative shape of basket 304.

[0073] It is also within the scope of the present disclosure to operatively couple the wire 108 to the housing halves 202, 204 rather than the first actuator 210, wherein the housing halves are repositionable relative to the sheath 102 and can be spring-biased relative to the sheath 102 to provide a biased open or biased closed position for the basket 304. In this case, the first actuator 210 can be operatively coupled to the sheath 102. Thus, longitudinal movement of the housing halves 202, 204 relative to the sheath 102 can be operable to transmit corresponding longitudinal movement relative to the sheath 102 to the wire 108. Such longitudinal movement of the wire 108 is then carried over into the movement of at least three (and optionally all four) of the four wires 140, 142, 344, 346 to open and close the basket 304.

[0074] In any of the exemplary controls discussed immediately above, the travel of the first actuator 210 or housing halves 202, 204 relative to the sheath 102 can be limited such that the range of motion / travel corresponds to the range of travel between fully extended and fully retracted (i.e., open and closed) basket 304. In other words, when the first actuator 210 or housing halves 202, 204 are at one end of their range of motion relative to the sheath 102, the basket 304 can be fully retracted, and when the first actuator or housing halves are at the opposite end of their range of motion relative to the sheath, the basket can be fully extended. Thus, repositioning the first actuator 210 or housing halves 202, 204 relative to the sheath 102 can operate to manipulate the relative shape of the basket 304 by repositioning the basket between a fully retracted position and a fully extended position.

[0075] Although not required, handle control 106 may include a second actuator 220 that is also repositionable relative to housing halves 202, 204. Where one or more of guides 130, 132, 334, 336 are not rigidly mounted to sheath 102 and are longitudinally repositionable relative to the sheath, second actuator 220 may be operatively coupled to a hollow conduit 230 extending along the interior of sheath 102. In an exemplary form, conduit 230 may have an outer maximum dimension that is smaller than the smallest inner dimension of sheath 102, thereby allowing the conduit to be longitudinally repositionable relative to the sheath. Furthermore, conduit 230 may have a longitudinally extending, continuous internal lumen through which wire 108 may extend. In this case, wire 108 may be longitudinally repositionable independently of conduit 230 and sheath 102. Similarly, conduit 230 may be longitudinally repositionable independently of wire 108 and sheath 102. In this manner, the longitudinal movement of the second actuator 220 operates to impart corresponding longitudinal movement to the catheter 230 within the sheath 102. And this longitudinal movement of the catheter 230 correspondingly carries over into the movement of the guides 130, 132, 334, 336 to extend and retract the guides relative to the sheath 102. In this exemplary embodiment, the stroke of the second actuator 220 can be limited so that its range of motion corresponds to the range of extension and retraction of the guides 130, 132, 334, 336 relative to the sheath 102. In other words, when the second actuator 220 is at one end of its range of motion, the guides 130, 132, 334, 336 can be fully (or nearly fully) retracted into the sheath 102, while when the second actuator is at the opposite end of its range of motion, the guides 130, 132, 334, 336 can be fully (or nearly) extended out of the sheath 102. Thus, distal repositioning of the second actuator 220 can be used to manipulate the relative shape of the basket 304.

[0076] The aforementioned second medical extraction device 300 can be used to extract various objects from within an anatomical cavity. As an exemplary explanation, the use of the extraction device 300 will be explained in the context of a kidney stone removal procedure. However, those skilled in the art will appreciate that the use of the medical extraction device 300 should not be limited to kidney stone removal procedures, and rather, this description is merely one of many procedures in which the extraction device 300 has applications.

[0077] Initially, a suitable renal pathway 180 to the patient's kidney may be explored, and appropriate visualization may also be provided with the aid of a scope 190 (e.g., a ureteroscope) traversing the renal pathway. Figure 16 As shown, when the basket is in the retracted position, the end of the basket 304 of the extraction device 300 coupled to the sheath 102 can be advanced through the mirror 190 to advance the distal end of the basket and sheath beyond the distal end of the mirror 190. Continued advancement of the sheath 102 and basket 304 can continue until the basket 304 reaches the target area where the object 170 to be removed is located. After the basket 304 reaches the desired area as determined by visual inspection of the mirror 190, the operator can grasp the handle control 106 (i.e., the complementary housing halves 202, 204) and reposition one or both of the actuators 210, 220 relative to the housing halves 202, 204 (or reposition the handle housing relative to the sheath) to reposition the wire 108 relative to the sheath 102, thereby repositioning the basket from its retracted position toward the open position.

[0078] In the case where the handle control 106 includes the second actuator 220, the second actuator and the first actuator 210 can be repositioned simultaneously or independently of each other to move the basket from the closed or retracted position to the open or deployed position. In an exemplary form, the second actuator 220 can be repositioned distally (toward the basket 304 and relative to the handle housings 202, 204), thereby causing the catheter 230 to move longitudinally through the sheath 102 and direct the guides 130, 132, 334, 336 to extend beyond (or further beyond) the sheath. The operator of the handle control 106 can then reposition the first actuator 210 distally (toward the basket 304 and relative to the handle housings 202, 204), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the length of the wire 140, 142, 344, 346 extending beyond the guides 130, 132, 334, 336 to also increase the size of the loop. Figure 17 and Figure 25An exemplary position of the basket 304 is depicted wherein the guides 130, 132, 334, 336 are at least partially extended from the sheath 102 (via the second actuator 220, or by default if not actuated) and the wires 140, 142, 344, 346 are at least partially extended, consistent with a partially open or fully open (i.e., deployed) position. Figure 18 As shown, this open or deployed position can be maintained when the entire distal portion of the extraction device 300 is repositioned so that the target object 170 (e.g., a kidney stone) intended to be captured can be received within the open basket 304.

[0079] Figure 16 An exemplary position of the basket 304 is depicted wherein the guides 130, 132, 334, 336 are partially extended from the sheath 102 (via the second actuator 220) and the wires 140, 142, 344, 346 are partially extended, which wire position corresponds to a retracted position. This retracted position may be maintained while the entire distal portion of the extraction device 300 is repositioned to approach the target object 170 (e.g., a kidney stone). When the basket 304 approaches the target object 170, as shown in FIG. Figure 17 As depicted, the first actuator 210 can be repositioned relative to the housing halves 202, 204 to deploy or open the basket 304. After the basket 304 is opened, the basket can be further positioned distally so that the target object 170 is received within the opened basket, as shown. Figure 18 Depicted.

[0080] After the object 170 is at least partially received within the opened basket 304, the first actuator 210 can be repositioned proximally (away from the basket 304 and relative to the handle housings 202, 204), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the wire length 140, 142, 344, 346 extending beyond the guides 130, 132, 334, 336 to decrease, and reducing the wire length associated with the loops 150, 152, 354, 356. This reduced length of the wire 140, 142, 344, 346 coincides with the joint 154 forming a tip that arches and moves in an arcuate path behind the target object 170, which creates a stop that prevents the object from exiting the basket 304 (see FIG. Figure 19 、 Figure 28 and Figure 30Depending on the size of the object 170 and the operator's confidence that the object will remain within the basket 304 when the entire distal portion of the extraction device 300 is repositioned proximally (in order to ultimately remove the basket 304 and the target object 170 from the renal pathway 180), the operator may reposition the second actuator 220 distally (toward the basket 304), thereby causing the guides 130, 132, 334, 336 to move further longitudinally through the sheath 102 and causing the filament lengths 140, 142, 344, 346 extending beyond the guides 130, 132, 334, 336 to decrease, and reducing the filament lengths associated with the loops 150, 152, 354, 356, thereby tightening the loops 150, 152, 354, 356 around the object (see FIG. Figure 28 After the target object 170 is captured within the basket 304 , the extraction device 300 and the target object can be removed from the renal pathway 180 .

[0081] Alternatively, in the event that the guides 130, 132, 334, 336 cannot be repositioned relative to the sheath 102, the first actuator 210 can be repositioned to move the basket from the closed or retracted position to the open or extended position upon reaching the target object 170. In an exemplary form, an operator of the handle control 106 can reposition the first actuator 210 distally (toward the basket 304), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the length of the wire 140, 142, 344, 346 to extend beyond the guides 130, 132, 334, 336, thereby increasing the length of each loop 150, 152, 354, 356 extending from the sheath. Figure 17 and Figure 25 An exemplary position of the basket 304 is depicted with guides 130, 132, 334, 336 partially extending from the sheath 102 and wires 140, 142, 344, 346 extending from the guides and the sheath, consistent with an open or deployed position of the basket. Figure 18As shown, the open or deployed position can be maintained when the entire distal portion of the extraction device 300 is further repositioned distally, so that a target object 170 to be captured (e.g., a kidney stone) can be received within the open basket 304. After the target object 170 is at least partially received within the open basket 304, the first actuator 210 can be repositioned proximally (away from the basket 304), thereby causing the wire 108 to move longitudinally through the sheath 102 and causing the wire length 140, 142, 344, 346 extending beyond the guides 130, 132, 334, 336 to decrease, and reducing the wire length associated with the loops 150, 152, 354, 356. This reduced length of the wires 140, 142, 344, 346 coincides with the joint 154 forming a tip that arches and moves in an arcuate path behind the target object 170, which creates a stop that prevents the target object from exiting the basket 304 (see FIG. Figure 19 、 Figure 28 and Figure 30 After the connector 154 has been repositioned behind the target object 170 , the extraction device 300 and object 170 may be removed from the renal pathway 180 .

[0082] It is also within the scope of the present disclosure to reposition the actuator 210 in an opposite direction compared to the aforementioned direction when the actuator 210 is mounted to the sheath 102 and the wire 108 is mounted to the housing halves 202, 204. For example, in this case, the first actuator 210 can be repositioned proximally (away from the basket 104 and relative to the handle housings 202, 204) to open or deploy the basket and distally (toward the basket) to retract or close the basket.

[0083] like Figure 20 and Figure 21 As depicted, it is also within the scope of the present disclosure to provide a third control 260 as part of the handle control 106 of the extraction device 100, 300. The third control 260 can be mounted to a second wire 262 that extends through the sheath 102 and is operatively coupled to a portion of at least one of the wires 140, 142, 144, 344, 346 that might otherwise be coupled to the anchor 158. In this manner, if an operator of the device 100, 300 desires that the joint 154 extend further outward during retention of the target object 170, the operator can reposition the third control 260 distally (toward the basket 104, 304) or proximally (away from the basket) to reposition the joint 154 further away from or closer to one or more of the guides 130, 132, 334, 336.

[0084] It should also be understood that while each basket 104, 304 has been illustratively described as having a single joint, it is within the scope of the present disclosure for the baskets 104, 304 to have multiple joints in which corresponding rings are coupled to each other. Each additional joint can be created similarly to the joint 154 disclosed herein.

[0085] It should also be understood that while each extraction device 100 , 300 has been described as having an anchor 158 , it is within the scope of the present disclosure to provide these extraction devices 100 , 300 with multiple anchors, with each anchor mounted to one or more wires.

[0086] From the foregoing description and summary of the invention, it should be apparent to those skilled in the art that, while the methods and apparatus described herein constitute exemplary embodiments of the invention, it should be understood that the inventions contained herein are not limited to the precise embodiments described above and that variations may be made without departing from the scope of the invention as defined by the novel points set forth below. Likewise, it should be understood that it is not necessary to meet any or all of the identified advantages or objects of the invention disclosed herein in order to fall within the scope of the invention, as inherent and / or unforeseen advantages of the invention may exist even though they may not be explicitly discussed herein.

Claims

1. A medical extraction device, comprising: A hollow sheath including a distal end from which a basket can extend in a deployed position, the basket being repositionable between a retracted position and the deployed position, the basket comprising: a first guide and a second guide, which are circumscribed by the hollow sheath; a first ring, a second ring, and a third ring, wherein the first ring extends between the first guide and the second guide; a first anchor point that fixes the relative positions of the upstream portion of the second ring and the upstream portion of the third ring; a first joint coupling the second ring and the third ring downstream from the first anchor point; a second anchor point that fixes a relative position of an upstream portion of the first ring relative to a portion of the first guide; a wire operatively coupled to a downstream portion of at least two of the first, second, and third loops such that repositioning of the wire can be used to at least one of increase and decrease a length of at least two of the first, second, and third loops extending from a distal end of the hollow sheath; Wherein, the downstream portion of the first ring and the downstream portion of the third ring are freely repositionable relative to the second guide.

2. The medical extraction device according to claim 1, further comprising a fourth ring and a third guide, wherein: The second ring extends between the second guide and the third guide.

3. The medical extraction device of claim 1 , further comprising a handle control mounted to a proximal portion of the hollow sheath and configured to be hand-held, the handle control comprising an actuator operatively coupled to the wire such that repositioning of the actuator can be used to guide repositioning of the wire.

4. The medical extraction device of claim 1 , further comprising a handle control repositionably mounted to a proximal portion of the hollow sheath, the handle control operatively coupled to the wire such that repositioning of the handle control relative to the hollow sheath can be used to guide repositioning of the wire.

5. The medical extraction device of claim 2, further comprising a handle control mounted to a proximal portion of the hollow sheath and configured to be hand-held, the handle control comprising an actuator operatively coupled to the wire such that repositioning of the actuator can be used to guide repositioning of the wire.

6. The medical extraction device of claim 2, further comprising a handle control repositionably mounted to a proximal portion of the hollow sheath, the handle control operatively coupled to the wire such that repositioning of the handle control relative to the hollow sheath can be used to guide repositioning of the wire.

7. A medical extraction device according to any one of the preceding claims, wherein: The wire includes a plurality of wires, each of the plurality of wires being operatively coupled to at least one of the first ring, the second ring, and the third ring.

8. The medical extraction device according to any one of claims 1 to 6, wherein: At least one of the first guide and the second guide defines a channel along which portions of at least two of the first ring, the second ring, and the third ring extend.

9. The medical extraction device according to any one of claims 1 to 6, wherein: The first guide includes a first channel along which portions of the first ring and the second ring extend; and The second guide includes a second channel along which portions of the first ring and the third ring extend.

10. The medical extraction device according to any one of claims 1 to 6, wherein: The first guide and the second guide are at least one of repositionable and fixedly positioned relative to the hollow sheath.

11. The medical extraction device according to any one of claims 1 to 6, wherein: The first joint includes at least one of a weld, a glued joint, a soldered joint, a twisted wire, and a wire braid.

12. The medical extraction device according to any one of claims 1 to 6, wherein: The first anchor point includes at least one of a weld, a glued head, a soldered portion, a twisted wire, and a wire braid secured to at least one of the first guide, the second guide, and the hollow sheath.

13. The medical extraction device according to any one of claims 1 to 6, wherein: The first ring is independently repositionable relative to the second ring and the third ring.

14. The medical extraction device according to any one of claims 1 to 6, wherein: The first ring is repositionable relative to the second ring and the third ring dependently via the wire.

15. The medical extraction device according to claim 1, wherein: The first anchor point and the second anchor point comprise a common anchor.

16. A method of manufacturing a medical extraction device, comprising: Arranging at least one of the first ring, the second ring, and the third ring into a geometric configuration wherein each ring is angled relative to two adjacent rings using the following equation: A=360 / N, wherein A refers to the angle between each ring and one of the two adjacent rings, and N refers to the total number of the rings; positioning at least a first portion of the first ring and a first portion of the third ring at least one of along and within a first guide such that the first ring and the first portions of the third ring are repositionable relative to the first guide and relative to each other; positioning at least a first portion of the second ring and a second portion of the first ring at least one of along and within a second guide such that the second portion of the first ring is fixed relative to the second guide and the first portion of the second ring is repositionable relative to the second guide and relative to the first ring; directly coupling at least the second portion of the third ring and the second portion of the second ring at a joint; positioning the first ring, the second ring, and the third ring at least partially within a hollow sheath such that the hollow sheath at least partially circumscribes the first ring, the second ring, and the third ring; A drive wire is operatively coupled to the first portions of the first, second, and third loops such that repositioning the drive wire may be used to simultaneously increase or decrease an exposed length of the first, second, and third loops extending beyond the hollow sheath.

17. A medical extraction device, comprising: a sheath comprising a distal end configured to be inserted into a patient's body and a proximal end configured to be retained outside the patient's body; a basket configured to extend from the distal end of the sheath and to be repositionable between a deployed position and a retracted position, the basket comprising at least a first ring, a second ring, and a third ring, the basket further comprising a first guide and a second guide, wherein the first guide receives a repositionable portion of the first ring and the third ring, wherein the second guide receives a portion of the first ring and the second ring, wherein the second ring and the third ring are fixedly mounted to each other at a position between the first guide and the second guide; and A handle control is operatively coupled to the proximal end of the sheath and to the basket, the handle control being configured to facilitate repositioning of the basket relative to the sheath between the retracted position and the deployed position.

18. The medical extraction device of claim 17, further comprising a third guide, wherein the second loop extends between the second guide and the third guide, wherein the at least three loops include a fourth loop.

19. The medical extraction device according to claim 17, wherein: The handle control includes an actuator that operatively couples a wire to a proximal portion of at least two of the first, second, and third loops such that repositioning the wire is operable to at least one of: increase and decrease a length of at least two of the first, second, and third loops extending from a distal end of the sheath.

20. The medical extraction device according to claim 19, wherein: The wire includes a plurality of wires, each of the plurality of wires being operatively coupled to at least one of the first ring, the second ring, and the third ring.

21. The medical extraction device according to claim 17, wherein: At least one of the first guide and the second guide includes a conduit through which portions of at least two of the first ring, the second ring, and the third ring extend.

22. The medical extraction device of claim 21, wherein: The first guide comprises a first conduit through which portions of the first ring and the third ring extend; and The second guide includes a second conduit through which portions of the first ring and the second ring extend.

23. The medical extraction device according to claim 17, wherein: The first guide and the second guide are at least one of repositionable and fixedly positioned relative to the sheath.

24. The medical extraction device according to claim 17, wherein: The second ring and the third ring are mounted to each other at a first joint, the first joint comprising at least one of a weld, a glued joint, a soldered joint, a twisted wire, and a wire braid.

25. The medical extraction device according to claim 17, wherein: The downstream portion of the first ring and the downstream portion of the third ring are freely repositionable relative to the first guide.

26. The medical extraction device according to claim 17, wherein: The first ring is independently repositionable relative to the second ring and the third ring.

27. The medical extraction device according to claim 17, wherein: The first ring is repositionable relative to the second ring and the third ring via a wire dependent mechanism.

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