Articulating needle

Abstract

To provide a medical device capable of optimizing a device so as to pass through an anatomical structure meandering in a flexible state and optimizing the device so as to perform a clinical task when distally positioned at a distal end of a scope in a rigid state.SOLUTION: A medical device 100 may include a needle that includes a plurality of links 108 and a distal tip 110 and is reciprocally movable between a first configuration and a second configuration, and a conduit 122 that includes a lumen 116 extending through the needle, the conduit being coupled to the distal tip, wherein a longitudinal movement of the conduit is configured to transition the needle between the first configuration and the second configuration.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] Aspects of the present disclosure relate to articulating needles and related methods of use. [Background technology]

[0002] A biopsy involves the surgical removal of tissue or cells from a patient's body for pathological examination of the collected sample. The purpose of taking a biopsy sample is often to look for cell shape changes that appear within the collected sample. Identifying specific cell shape changes in the collected specimen can aid in identifying cancer in a patient.

[0003] During medical procedures, endoscopes are often used to access and visualize anatomical lumens in patients. After the endoscope is positioned within the desired body portion, a biopsy instrument can be advanced through the working channel of the endoscope to the desired body portion. The endoscopic instrument and biopsy instrument may then be manipulated as desired for visualization and specimen collection, respectively.

[0004] Smaller diameter endoscopes help reduce unnecessary trauma to patient tissue and provide access to a wider range of patient body lumens. These endoscopes often have smaller working channels, which limit the size of auxiliary instruments that can be used with the endoscope. This, in turn, limits the size, and often the quality, of the biopsy specimens that can be collected.

[0005] Needle biopsies can be performed with a stylet needle shaft having a tissue-retaining recess formed on the side near the needle tip. When the needle is inserted into the tissue from which it is desired to take a sample, a portion of the tissue extends into the recess. Such needle biopsy devices often cannot be positioned within a flexible, small-diameter positioning device due to the rigidity of the penetrating stylet needle. Summary of the Invention

[0006] In one aspect, the present disclosure is directed to a medical device that may include a needle including a plurality of links and a distal tip, the needle being reciprocally movable between a first configuration and a second configuration, and a conduit including a lumen extending through the needle, the conduit coupled to the distal tip, wherein longitudinal movement of the conduit is configured to transition the needle between the first configuration and the second configuration.

[0007] The needle may have a first stiffness in the first configuration and a second stiffness higher than the first stiffness in the second configuration. Applying a force to the distal tip in the first configuration can cause the links and distal tip to reorient relative to one another, and applying a force to the distal tip in the second configuration can prevent the links and distal tip from reorienting relative to one another. Fluid flow through the needle can pass through the lumen of the conduit and exit the needle only at the distal tip. The links can rest loosely along the outer surface of the conduit in the first configuration. The medical device may include a spring configured to bias the needle to the first configuration. A proximal force applied to the conduit while the needle is in the first configuration can compress the spring and transition the needle to the second configuration. Releasing the proximal force while the needle is in the second configuration can return the needle to the first configuration. The medical device may include a handle having a body, an actuator movable relative to the body, a first stop on an outer surface of the conduit, and a second stop extending radially inward from an inner surface of the body, and the spring may be between the first and second stops. The conduit may be coupled to a distal end of the actuator. The longitudinal movement of the conduit may be relative to a plurality of links. The conduit may be fixed to the distal tip. At least one of the plurality of links may have a protrusion that engages with a surface of an adjacent link. The needle may include a radius of curvature in the second configuration. The needle may have a longer length in the first configuration than in the second configuration. The needle tip may include a distal-most point extending obliquely radially outward from the remainder of the distal tip, and the distal-most point may be located at the end of a path along the entire length of the needle.

[0008] In another aspect, the present disclosure is directed to a medical device that may include a needle including a plurality of links and a distal tip, the needle being reciprocally movable between a first configuration and a second configuration, the second configuration being stiffer than the first configuration, and a conduit including a lumen extending through the needle, the conduit being secured to the distal tip, wherein applying a proximal pulling force to the conduit may be configured to transition the needle from the first configuration to the second configuration, and releasing the proximal pulling force may be configured to transition the needle from the second configuration to the first configuration.

[0009] Applying a force to the distal tip in the first configuration can cause the plurality of links and the distal tip to turn relative to one another, and applying a force to the distal tip in the second configuration can cause the plurality of links and the distal tip not to turn relative to one another. Fluid flow through the needle can pass through the lumen of the conduit and can exit the needle only at the distal tip.

[0010] In yet another aspect, the present disclosure is directed to a medical device, the medical device comprising: a needle including a plurality of links and a distal tip, reciprocally movable between a first configuration and a second configuration, the needle including a radius of curvature in the second configuration and a distal-most point extending obliquely radially outward from a remainder of the distal tip, the distal-most point being at an end of a path along the entire needle; and a conduit including a lumen extending through the needle, the conduit secured to the distal tip, wherein applying a proximal pulling force on the conduit may be configured to transition the needle from the first configuration to the second configuration, and releasing the proximal pulling force may be configured to transition the needle from the second configuration to the first configuration.

[0011] Fluid flow through the needle can pass through the lumen of the conduit and exit the needle only at the distal tip. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various aspects and, together with the description, serve to explain the principles of the disclosed aspects. [Brief explanation of the drawings]

[0012] [Figure 1] 1 is a side cross-sectional view of a medical device in a first configuration according to one embodiment of the present disclosure. [Figure 2] 2 is a side cross-sectional view of the medical device of FIG. 1 in a second configuration. [Figure 3] FIG. 1 is a side cross-sectional view of a medical device in a first configuration according to another embodiment of the present disclosure. [Figure 4] 4 is a side cross-sectional view of the medical device of FIG. 3 in a second configuration. [Figure 5] FIG. 10 is a side cross-sectional view of a medical device according to another aspect of the present disclosure. [Figure 6] FIG. 10 is a perspective view of a needle according to another aspect of the present disclosure. [Figure 7A] FIG. 1 is a perspective view of a link according to one aspect of the present disclosure. [Figure 7B] FIG. 1 is a perspective view of a needle according to one aspect of the present disclosure. [Figure 8A] FIG. 1 is a perspective view of a link according to one aspect of the present disclosure. [Figure 8B] FIG. 1 is a perspective view of a needle according to one aspect of the present disclosure. [Figure 9A] FIG. 1 is a side view of a needle in a first configuration, according to one embodiment of the present disclosure. [Figure 9B] 9B is a side view of the needle of FIG. 9A in a second configuration. [Figure 10] 1 is a side cross-sectional view of a medical device in a first configuration according to one embodiment of the present disclosure. [Figure 11] 11 is a side cross-sectional view of the medical device of FIG. 10 in a second configuration. [Figure 12] FIG. 10 is a side cross-sectional view of a medical device according to another aspect of the present disclosure. [Figure 13] FIG. 1 is a side view of a needle according to one aspect of the present disclosure. [Figure 14] FIG. 10 is a perspective view of a medical device according to another aspect of the present disclosure. [Figure 15] FIG. 10 is a perspective view of a medical device according to another aspect of the present disclosure. [Figure 16] 1 is a flowchart of a method according to one aspect of the present disclosure. [Figure 17] 10 is a flowchart of a method according to another aspect of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0013] Reference will now be made in detail to the aspects of the present disclosure that are illustrated in the accompanying drawings. Whenever possible, the same reference numerals will be used throughout the drawings to refer to the same or like parts or components. The term "distal" refers to a direction away from the user or operator and into the patient's body. In contrast, the term "proximal" refers to a direction closer to the user or operator and away from the patient's body.

[0014] Aspects of the present disclosure are directed to medical devices configured to pass through a scope in a relaxed, flexible state and extend beyond the distal end of the scope in a rigid state to perform various medical procedures, such as collecting tissue in a biopsy procedure or deflecting tissue from one location to another. The ability of the device to retain multiple configurations with different sizes and stiffnesses allows the device to be optimized to negotiate tortuous anatomical structures in a flexible state and to perform clinical tasks when positioned distally relative to the distal end of the scope in a rigid state.

[0015] A medical device 100 is shown in a first, relaxed configuration in FIG. 1 and in a second, rigid configuration in FIG. 2. The medical device 100 may be reciprocally movable between the first and second configurations and may be configured to extend through an endoscopic device. The medical device 100 may extend from a proximal end 102 toward a distal end 104. The medical device 100 may include a handle 106 at the proximal end 102, a plurality of links 108, and a distal tip 110. The plurality of links 108 and the distal tip 110 may form a needle 109 when the medical device 100 is in the second configuration of FIG. 2.

[0016] The handle 106 may include a body 112 and an actuator 114 that is slidable or otherwise movable relative to the body 112. The body 112 may include a lumen 116 and two diametrically opposed grips 118. In some embodiments, the grips 118 may be held by a physician or other suitable operator using the index and middle fingers with the actuator 114 being held by the thumb of the same hand. A stop 120 may extend from an inner circumferential surface of the body 112 into the lumen 116.

[0017] The links 108 and distal tip 110 may be formed from any suitable material, such as, for example, a metal, an alloy (such as stainless steel, Nitinol, or the like), or a polymer. Each link 108 and distal tip 110 may include a lumen therethrough. The distal tip 110 may include a needle tip at its distal end having any suitable shape, such as, for example, a bevel tip (shown in FIGS. 1 and 2), multiple bevels, a cone, a Sprott, a diamond, a Franseen, a Tuohy, or any other suitable needle tip shape. In a rigid configuration, the links 108 and distal tip 110 form a needle 109 suitable for injecting fluids, performing aspiration, collecting biopsy samples, and any other suitable technique using a needle. Any suitable number of links 108 may be used, including, but not limited to, one, two, three, four, eight, or more links 108.

[0018] The conduit 122 may extend from the proximal end 102 toward the distal end 104. The conduit 122 may be fixedly or otherwise coupled to the actuator 114 at the proximal end 102 and to the distal tip 110 at the distal end 104 by any suitable mechanism, such as, for example, a snap fit, a mechanical fastener, a biocompatible adhesive, etc. One or more of the links 108 may ride loosely along the conduit 122 in a relaxed configuration. The conduit 122 may include a lumen 124 therethrough and a stop 130 disposed on an outer circumferential surface of the conduit 122. The stop 130 may be distal to the stop 120. The conduit 122 may be formed from any suitable fluid-impermeable material, including, for example, a metal, a polymer, etc. The conduit 122 may be biased in a straight configuration (shown in FIGS. 1 and 2 ), but may also be configured to flex for navigating through tortuous anatomy. However, after deflection, the conduit 122 can return to the straight configuration shown in Figures 1 and 2. Additionally, the conduit 122 can be rigid enough to compress the spring 132 when the medical device 100 is transitioned from the relaxed configuration to the rigid configuration. The spring 132 can be disposed between the stop 120 of the handle 106 and the stop 130 of the conduit 122.

[0019] The lumen 124 of the conduit 122 may allow the flow of fluid and / or tissue through the needle 109 while the needle 109 is in any configuration, including the relaxed, loose configuration of FIG. 1 and the rigid configuration of FIG. 2 . Without the conduit 122, fluid and / or tissue passing through the needle 109 may escape the needle 109 through gaps between adjacent links 108. Even in the rigid configuration, small gaps due to manufacturing imperfections may exist between adjacent links 108, rendering the needle 109 unsuitable for biopsy or fluid delivery without the conduit 122. However, in other embodiments, the needle 109 may be fluid-tight while in the rigid configuration without the conduit 122. A fluid delivery and / or aspiration device may be coupled to the proximal end of the conduit 122 to enable sample collection, irrigation, and / or nebulization of the target site. The conduit 122 may include multiple lumens to perform one or more of these functions, sequentially or simultaneously.

[0020] The relaxed configuration (FIG. 1) may aid in navigating the medical device 100 through tortuous paths in the body or through the tortuous paths of an artificial lumen of a scope that extends through tortuous paths in the body. The medical device 100 may also be used to deflect tissue or other body structures while disposed in the rigid, compact state (FIG. 2).

[0021] In the relaxed configuration, the various links 108 may be spaced apart from adjacent links 108 and may rest loosely along the conduit 122. In the relaxed configuration, the distal-most link 108 may also be spaced apart from the distal tip 110. However, in the rigid configuration, the links 108 of the medical device 100 may be in direct nested contact with one another, and the distal-most link 108 may be in nested contact with the distal tip 110. In the relaxed configuration, the links 108 and distal tip 110 of the medical device 100 may reorient relative to one another in response to an external force acting on one or more of the links 108 or the distal tip 110. In the rigid configuration, the links 108 and distal tip 110 of the medical device 100 cannot reorient relative to one another in response to an external force acting on one or more of the links 108 or the distal tip 110 (such as the same external force (magnitude and direction) described in the previous sentence). That is, in the rigid configuration, the links 108 and distal tips 110 can form a rigid member that is substantially straight and remains substantially straight when contacting tissue or another object. Thus, the distal end 104 of the medical device 100, comprising the plurality of links 108 and distal tips 110, can have a higher rigidity in the rigid configuration than in the relaxed configuration. Furthermore, the plurality of links 108 and distal tips 110 can be fixed to one another in the rigid configuration and movable relative to one another in the relaxed configuration. The needle 900 (measured from the distal end of the handle 106) can also have a greater length in the relaxed configuration than in the rigid configuration because gaps between adjacent links 108 and / or distal tips 110 present in the relaxed configuration can be closed after transitioning to the rigid configuration.

[0022] Movement of the actuator 114 relative to the body 112 can be configured to transition the medical device 100 between a relaxed configuration and a rigid configuration. When the medical device 100 is in the relaxed configuration of FIG. 1 , a proximal force can be applied to the conduit 122 by the actuator 114. Furthermore, because the distal tip 110 is fixed to the conduit 122, proximal movement of the conduit 122 also causes proximal movement of the distal tip 110. The distal tip 110 can then abut the distal-most link of the plurality of links 108, closing the gap that existed between the distal tip 110 and the distal-most link 108 in the relaxed configuration. The distal-most link 108 can then abut the link 108 immediately proximal to the distal-most link, and this pattern can be repeated until the gap between each adjacent link 108 is closed. Thus, in response to a proximal force, the medical device 100 can move from the relaxed configuration of FIG. 1 to the rigid configuration of FIG. 2 by compressing the spring 132 and closing the gap between the distal tip 110 and the distal-most link 108 and gaps between other adjacent links of the plurality of links 108. In some embodiments, the proximal force must be maintained to keep the medical device 100 in the rigid configuration, but a locking device (not shown) can be used to keep the medical device in the rigid configuration. The medical device 100 can be returned to the relaxed configuration by releasing the proximal force acting on the conduit 122, allowing the spring 132 to expand longitudinally and pull the links 108 and distal tip 110 of the medical device 100 away from each other. The links 108 and distal tip 110 may be relaxed and slack in the relaxed configuration. One or more springs (not shown) may be disposed between adjacent links to bias the adjacent links away from each other.

[0023] The medical device 300 is shown in a first, relaxed configuration in FIG. 3 and in a second, rigid configuration in FIG. 4. The medical device 300 may be reciprocally movable between a first configuration and a second configuration like the medical device 100, but the medical device 300 may use one or more actuation members 324 instead of the conduit 122 to effectuate the reciprocating movement between the two configurations. The medical device 300 may extend from a proximal end (not shown) toward a distal end 304. The medical device 300 may include a handle (not shown) at the proximal end, a plurality of links 308, and a distal tip 310. The plurality of links 308 and the distal tip 310 may form a needle 309 when the medical device 300 is in the second configuration of FIG. 4. The medical device 300 may have elasticity, stiffness, and other properties substantially similar to those described above with respect to the medical device 100 in the relaxed and rigid configurations.

[0024] The links 308 may be substantially similar to the links 108 described above, except that the links 308 may also include one or more actuating lumens 326. In the embodiment shown in FIGS. 3 and 4 , each link 308 includes two actuating lumens 326 that are diametrically opposed from one another (e.g., separated by an arc length of 180 degrees). However, it is contemplated that other suitable numbers of actuating lumens and / or spacings may be used. Each link 308 may also include a fluid lumen 328 extending through the center of the link 308. When the medical device 300 is in the rigid configuration, the actuating lumens 326 of the links 308 may be aligned with one another to form an actuating lumen 330, and the fluid lumens 328 may be aligned with one another to form a fluid lumen 332. The distal tip 310 may be substantially similar to the distal tip 110 described above with reference to FIGS. 1 and 2 .

[0025] Actuation member 324 extends through each of actuation lumens 330 (and 326) and may be coupled at their proximal ends to an actuation mechanism and / or a handle. The distal end of actuation member 324 may be coupled to a proximally-facing surface of distal tip 310. Actuation member 324 may be a wire, cable, rod, tube, or any other suitable member configured to receive a proximal pulling force from the actuation mechanism. The actuation mechanism may include any suitable features configured to apply a proximal pulling force to actuation member 324, including, for aspect, one or more of gears, pulleys, wheels, shafts, etc. Actuation mechanism 124 may be motor-driven and / or electrically driven in some embodiments and / or may be manually actuated by an operator.

[0026] The medical device 300 may include a sleeve 322 that extends through the needle 309 from the proximal end to the distal end 304. The sleeve 322 may be formed from a polymeric material, such as, for example, an elastic polymeric material. Examples of polymers that can be used to form the sleeve 322 include Teflon®, PTFE, FEP, polyethylene and polypropylene, silicone, polyurethane, and polyether block amide, among others. The sleeve 322 may be a flexible, compliant, conformable, and / or impermeable membrane. That is, the sleeve 322 may have a sheet-like structure configured to collapse when no external force is applied to the sleeve 322. In some embodiments, the sleeve 322 may include an elastic and / or resilient material. The sleeve 322 may be a long, flexible rubber tube.

[0027] FIG. 5 illustrates a medical device 500 that is substantially similar to medical device 300, except that multiple seals 522 are used instead of a single sleeve 322 to facilitate fluid flow through the medical device 500. That is, the seals 522, which may be formed from a material substantially similar to the sleeve 322, may be bonded to the inner surfaces of adjacent links 308 and to the inner surfaces of the distal-most link 308 and the distal tip 310 to form an air-tight and liquid-tight seal. The seals 522 may be configured to extend axially to allow the needle to attain a relaxed configuration (not shown). In another embodiment, the seals 522 may be disposed longitudinally between adjacent links 108 and between the distal-most link 308 and the distal tip 310. In this embodiment, the seals 522 may be annular O-rings or gaskets. The gaskets may be formed from a somewhat compressible, resilient material to allow the gaskets to provide a substantially air-tight and liquid-tight seal between adjacent links 108 or between the distal-most link 308 and the distal tip 310. In other embodiments, a sealing coating may be applied to the inner and / or end surfaces of the links 308.

[0028] A needle 600 having an articulating joint 650 is shown in FIG. 6. The articulating joint 650 may allow the needle 600 to bend and return, for example, through an arc of 180 degrees. The articulating joint 650 may be generally cylindrical in shape and may include a central lumen 652 and one or more actuating lumens 654 located within the wall of the articulating joint 650. There are three actuating lumens 654 within each joint 650, spaced 120 degrees apart from one another. However, other suitable numbers of actuating lumens may alternatively be used.

[0029] To facilitate bending of the articulation joint 650, one or more living hinges 660 may be formed along the length of the articulation joint 650. Each living hinge 660 may include a pair of opposing V-shaped notches 670 on either side of the articulation joint 650. The notches 670 may extend circumferentially around the articulation joint. Longitudinally adjacent living hinges 660 may be circumferentially offset by 90 degrees from each other.

[0030] The articulation joint can be formed by extruding a cylinder with the central lumen and actuation lumens in place and then cutting the cylindrical tube with a knife, laser, milling tool, water jet, or other material removal mechanism to form the living hinges. Alternatively, the articulation joint 650 can be molded with the living hinges in place. The angle of the V-shaped notches 670 that form these hinges can be uniform or can vary along the length of the articulation joint 650. Similarly, the distance between adjacent living hinges 660 can be uniform or can vary to tailor the bending and torque characteristics of the articulation joint 650. In one embodiment, each living hinge 660 has a 30-degree closure angle, resulting in six hinges being required to provide 180 degrees of movement. The actuation lumen 654 can be aligned with the widest spacing of the living hinges 660. However, it may be desirable to offset the actuation lumen 654 relative to the hinges to reduce potential binding of the actuation members at the hinges. The articulation joint 650 may comprise a biocompatible material that flexes but does not collapse. Suitable materials include polyurethane, polyethylene, polypropylene, or other biocompatible polymers. In another embodiment, the articulation joint 650 may be formed by 3D printing or other additive manufacturing techniques.

[0031] A distal tip 610, substantially similar to distal tip 110, may be positioned at the distal end of articulating joint 650. Additionally, a sleeve, substantially similar to sleeve 322, may extend through needle 600 to facilitate fluid flow therethrough. Thus, in some embodiments, fluid and / or tissue acquired during a biopsy with needle 600 must pass through sleeve 322. Distal tip 610 may be sufficiently long so that no portion of articulating joint 650 needs to be inserted through tissue during acquisition of a biopsy sample. In other embodiments, articulating joint 650 may be inserted through tissue during sample acquisition.

[0032] 7A and 7B, needle 700 (shown in FIG. 7B) is made up of a series of stacked links 750 positioned adjacent to one another and movable relative to one another. As shown in FIG. 7A, links 750 may include an annular ring 752 having a pair of distally facing rocker surfaces or cams 754 and a pair of proximally facing rocker surfaces or cams 756. The distally facing cams 754 may be positioned 180 degrees apart on the distal surface of annular ring 752, while the proximally facing cams 756 may be positioned 180 degrees apart on the proximal surface of annular ring 752. In the illustrated embodiment, the proximally facing cams 756 may be oriented at 90 degrees relative to the distally facing cams 754. Each cam 754 or 756 engages with a flat section of the adjacent link 750 and can rock relative thereto. A hole 760 is drilled through the annular ring and through cams 754 and 756 to allow passage of the actuation member. When the actuation member is tensioned, link 750 will rock on the surfaces of cams 754, 756, thereby bending needle 700 in the desired direction. When needle 700 is assembled, distally facing cams 754 can be aligned with other distally facing cams 754, and proximally facing cams 756 can be aligned with other proximally facing cams 756. A distal tip 710, substantially similar to distal tip 110, can be positioned at the distal end of needle 700. Additionally, a sleeve, substantially similar to sleeve 322, can extend through needle 700 to facilitate fluid flow therethrough.

[0033] FIG. 8A shows a link 880, and FIG. 8B shows a needle 800 including a series of stacked links 880. Each link 880 may include an annular ring having a pair of concave pockets 882 on its proximal surface and a pair of correspondingly shaped convex cams 884 on its distal surface. On a given link 880, the concave pockets 882 may be offset 90 degrees from the convex cams 884. However, the concave pockets 882 of a given link are aligned with and can receive the convex cams 884 of an adjacent link. The correspondingly shaped cams 884 and pockets 882 help prevent the stacked links 880 from rotating relative to one another. A hole or lumen 886 is formed through the ring 880 for passage of one or more actuating members 890. The hole or lumen 886 may be positioned in the center of the cams and pockets. However, the hole for the actuating member may be offset from the location of the cams and pockets, if desired. Link 880 may be molded from a biocompatible polymer having a relatively smooth surface, such as polyurethane, polypropylene, or polyethylene, that reduces friction between adjacent cams and pockets. A distal tip 810, substantially similar to distal tip 110, may be positioned at the distal end of needle 800. Additionally, a sleeve, substantially similar to sleeve 322, may extend through needle 800 to facilitate fluid flow therethrough.

[0034] 9A and 9B show a needle 900 including a series of stacked links 980 and 981, each link including an annular ring with at least one pocket 982 on its proximal surface and at least one correspondingly shaped cam 984 on its distal surface. Link 981 may include an additional cam 985 extending from the distal surface of link 981 and circumferentially offset from cam 984. Cam 985 may not be aligned with any corresponding pocket on an adjacent link, but instead may engage and rock with a flat section on the proximal surface of the distally adjacent link 980 or 981. The cams 985 of adjacent links 981 may, in some embodiments, be positioned diametrically opposite each other, as shown in FIGS. 9A and 9B. Alternatively, the cams 985 of adjacent links 981 may be positioned on the same side of the needle 900 to partially create a greater curvature in the needle 900. The cams 985 can drive the length and accuracy of the articulating sections of the needle 900. Lengthening the cams 985 can allow for a longer length of the needle 900, increasing the angle that the needle 900 can achieve. Also, positioning the various cams 985 in different planes allows the articulating sections to take on different shapes other than a single radius curve, such as an S-curve, for example.

[0035] Adjacent links 980 may be fully nested such that there are no gaps between adjacent links 980 when in the rigid configuration (shown in FIG. 9B ). However, link 981 may be only partially nested or not nested at all with adjacent links 980 or 981. The combination of fully nested and non-nested links may allow needle 900 to have some portions with high stiffness in the rigid configuration and other portions that may provide the ability to change the shape and orientation of needle 900. Needle 900 may be transitioned between the relaxed configuration (shown in FIG. 9A ) and the rigid configuration by actuating actuation member 924 in a manner substantially similar to that described above with respect to medical device 300 described with reference to FIGS. 3 and 4 . A distal tip 910, substantially similar to distal tip 110, may be positioned at the distal end of needle 900. Additionally, a sleeve, substantially similar to sleeve 322, may extend through needle 900 to facilitate fluid flow therethrough.

[0036] A medical device 1000 is shown in a first, flexible configuration in FIG. 10 and in a second, rigid configuration in FIG. 11. The medical device 1000 may be reciprocatable between the first and second configurations and may be configured to extend through an endoscopic device. The medical device 1000 may extend from a proximal end 1002 toward a distal end 1004. The medical device 1000 may include a handle 1006 at the proximal end 1002 and a needle 1009 extending distally from the handle 1006.

[0037] The handle 1006 may include a body 1012 and an actuator 1014 that is slidable or otherwise movable relative to the body 1012. The body 1012 may include a lumen 1016 and two diametrically opposed grips 1018. The handle 1006 may be substantially similar to the handle 106 described with reference to Figures 1 and 2. A stop 1020 may extend from an inner circumferential surface of the body 1012 into the lumen 1016.

[0038] The needle 1009 may be formed from any suitable material, such as, for example, a metal, an alloy (such as stainless steel, Nitinol, or the like), or a polymer. The distal end of the needle 1009 may also include a needle tip having any suitable shape, such as, for example, a beveled tip, multiple bevels, a cone, a Sprott, a diamond, a Franseen, a Tuohy, or any other suitable needle tip shape. In the rigid configuration, the needle 1009 may be suitable for injecting fluids, aspirating, collecting biopsy samples, and any other suitable technique using a needle. The needle 1009 may include one or more notches 1026 positioned on the same side of the needle 1009.

[0039] An actuation member 1024 extends distally from the actuator and may be coupled to the distal end 1004 of the needle 1009. In one embodiment, the medical device 1000 includes only one actuation member, although other suitable actuation members may be used. A spring 1032 may be disposed between the stop 1020 of the handle 1006 and the actuator 1014. The spring 1032 is longitudinally compressed in the flexible configuration of FIG. 10 and longitudinally extended to a resting configuration when the medical device 1000 is in the rigid configuration of FIG. 11.

[0040] Movement of the actuator 1014 and actuation member 1024 relative to the body 1012 can be configured to transition the medical device 1000 between a relaxed configuration and a rigid configuration. As described above, the spring 1032 is longitudinally compressed in the relaxed configuration. The actuation member 1024 is relaxed in the same configuration of the medical device 1000. When the medical device 1000 is in the relaxed configuration of FIG. 10 , a distally directed force on the actuator 1014 can be released, moving the actuator 1014 proximally and allowing the spring 1032 to extend to the rest position shown in FIG. 11 . Proximal movement of the actuator 1014 can increase tension in the actuation member 1024 until it becomes taut. This can deflect the distal end of the needle 1009, which is coupled to the actuation member 1024, away from the longitudinal axis of the medical device 1000, closing the notch 1026. The deflected configuration of the needle 1009 may include a radius of curvature such that the needle 1009 resembles an arc. The medical device 100 can be returned to a relaxed configuration by reapplying a distally directed force acting on the actuator 1014, compressing the spring 1032. This compression causes the actuation member 1024 to move from the tensioned configuration to the relaxed configuration, re-exposing the notch 1026 and returning the needle 1009 to the relaxed configuration of FIG.

[0041] The operator may need to maintain a distal force on the actuator 1014 to advance the needle 1009 through the tortuous anatomy. Then, when the needle 1009 has been advanced outside of the introduction device, e.g., endoscope, the operator may release the distal force and perform a biopsy procedure with the needle 1009.

[0042] A medical device 1200 is shown in Figure 12. The medical device 1200 is reciprocatable between a first, flexible configuration (not shown) and a second, rigid configuration shown in Figure 12. The medical device 1200 may extend from a proximal end 1202 toward a distal end 1204. The medical device 1200 may include a handle 1206 at the proximal end 1202, a needle 1209 extending distally from the handle 1206, and an actuating member 1224. The needle 1209 and the actuating member 1224 may be substantially similar to the needle 1009 and the actuating member 1024 described with reference to Figures 10 and 11.

[0043] The handle 1206 may include a body 1212 and an actuator 1214 that is slidable or otherwise movable relative to the body 1212. The body 1212 may include a lumen 1216. A stop 1220 may extend from an inner circumferential surface of the body 1212 into the lumen 1216. The actuator 1214 may be disposed distal to the stop 1220.

[0044] An actuation member 1224 may extend distally from the actuator 1214 and be coupled to the distal end 1204 of the needle 1209. A spring 1232 may be disposed between the stop 1220 of the handle 1206 and a proximally facing surface of the actuator 1214. The spring 1232 is longitudinally extended at a rest position while the medical device 1200 is in a flexible configuration (not shown) and is longitudinally compressed in the rigid configuration of FIG.

[0045] Movement of the actuator 1214 and actuation member 1224 relative to the body 1212 can be configured to transition the medical device 1200 between a relaxed configuration and a rigid configuration. As described above, the spring 1232 extends longitudinally in the relaxed configuration of the medical device 1200. When the medical device 1200 is in the relaxed configuration, a proximal force can be applied to the actuator 1214, moving the actuator 1214 proximally and compressing the spring 1232. Proximal movement of the actuator 1214 can deflect the distal end of the needle 1209, which is coupled to the actuation member 1224, away from the longitudinal axis of the medical device 1200, closing the notch in the needle 1209. The needle 1209 can have a radius of curvature or otherwise resemble an arc in this configuration. Thus, in response to a proximal force, the medical device 1200 can move from the relaxed configuration to the rigid configuration of FIG. 12 by compressing the spring 1232. In some embodiments, the proximal force must be maintained to keep the medical device 1200 in the rigid configuration. The medical device 1200 can be returned to the relaxed configuration by releasing the proximal force acting on the actuation member 1224 and the actuator 1214, allowing the spring 1232 to extend longitudinally, re-exposing the notch and returning the needle 1209 to a relaxed configuration similar to that shown in FIG. 10.

[0046] The medical device 1200 may be configured so that no additional force (other than that required to move the medical device 1200 itself) needs to be applied to navigate the medical device 1200 through tortuous anatomy. Instead, after the medical device 1200 is positioned adjacent the work site, a proximal force can be applied to the actuator 1214 to transition the needle 1209 to a stiffness configuration suitable for collecting a biopsy sample.

[0047] A needle 1300 is shown in FIG. 13 . The needle 1300 may extend from a proximal end 1302 toward a distal end 1304. The needle 1300 may be substantially similar to any of the needles described herein and may include a distal point 1308 that extends diagonally radially outward from a distal tip 1306 of the needle 1300. The distal point 1308 may be the most distal point of a path traveled along the entirety of the needle 1300. The distal point 1308 may be a permanent part of the needle 1300 that is present in all configurations of the needle 1300, rather than being present in only some configurations of the needle 1300. Thus, the distal point 1308 may remain unchanged relative to the remainder of the distal tip 1306 as the needle 1300 travels, curves, stretches, or compresses through tortuous anatomy. Distal point 1308 may be the initial portion of needle 1300 that pierces tissue, and its radially outward orientation may cause the remainder of needle 1300 to follow a path 1311 through tissue that is offset from a central longitudinal axis 1310 of needle 1300. That is, after distal point 1308 pierces tissue, in response to a force directed along central longitudinal axis 1310, needle 1300 may deflect and follow path 1311 through tissue.

[0048] A scope 1400 is shown in FIG. 14. The scope 1400 may include a flexible shaft 1401 extending from a proximal end 1402 to a distal end 1404. The shaft 1401 may be configured to navigate tortuous anatomy within a patient. In some embodiments, the shaft 1401 may be uniformly flexible or include sections with varying flexibility. In some cases, the distal end 1404 of the shaft 1401 may be more flexible than the proximal end 1402. The scope 1400 may be any suitable medical scope, such as an endoscope, ureteroscope, colonoscope, hysteroscope, bronchoscope, or cystoscope. The shaft 1401 may be inserted directly into the patient's body or may extend over a guidewire using one or more lumens. The shaft 1401 may also be inserted into a laparoscopic port, a single incision port, an overtube, a bushing, or any other suitable member.

[0049] The shaft 1401 may include a single lumen 1412 (e.g., only one lumen), although any other suitable number of lumens may be used. In some cases, the additional lumen 1415 may be configured to accommodate any suitable vision device. In some cases, the lumen 1415 may be configured to include a vision device that allows a user to view an area adjacent to the distal end 1404 of the scope 1400 from a distal area up to and including the distal end 1404. The vision device may be integrated into the scope 1400 and may include a light source, lenses, fiber optics, and / or any suitable electronic vision components known in the art, for viewing a work site within a patient's body lumen. In other embodiments, a separate imaging device may be used. Still further, an additional lumen (not shown) may be used for any other suitable purpose, such as irrigation, aspiration, suction, delivery of additional tools, delivery of a therapy, or as a guiding lumen used to guide the shaft 1401 over a guidewire.

[0050] A tool 1414 may extend through the lumen 1412. The tool 1414 may include a blade, a cutting wire, a syringe needle, a needle knife, a snare, or other therapeutic or diagnostic device, including any of the devices described herein.

[0051] A deflection tool 1416 can be coupled to the outer surface of the shaft 1401. The deflection tool 1416 can be substantially similar to any of the medical devices and / or needles described herein that are movable between a relaxed configuration and a rigid configuration. However, in some embodiments, the deflection tool 1416 can have a blunt, atraumatic distal tip instead of a sharp distal tip. The atraumatic tip can be configured to reduce or prevent damage to tissue contacted by the atraumatic tip. In some embodiments, the atraumatic tip can include a polymeric material having a relatively low durometer or hardness. In other embodiments, the atraumatic tip can include a ball tip or any other feature, such as a rounded edge, configured to reduce damage to tissue contacting the tip.

[0052] The deflection tool 1416 may be used to deflect tissue or other body structures while positioned in a rigid configuration, and may also be used to hold and position tissue before or during manipulation or resection. As part of the deflection tool 1416, it may be positioned adjacent to or in contact with tissue to be resected or biopsied and transitioned to a rigid state to push or deflect the tissue into an optimal cutting position. In some embodiments, the deflection tool may be used to tension the target tissue, facilitating cutting of the target tissue.

[0053] 15 is a scope 1500 that is substantially similar to scope 1400, but the scope 1500 may include at least one additional lumen 1513. A deflection tool 1516 may extend through the additional lumen 1513. The deflection tool 1516 may be substantially similar to and may be used in a substantially similar manner as deflection tool 1416. The opening of lumen 1513 at the distal end of scope 1500 may lie in a plane, and the deflection tool 1516 may be configured to extend distally away from the distal end 1504 along a trajectory that is substantially perpendicular to the plane of the opening.

[0054] The articulating needles of the present disclosure may include only two configurations in some embodiments. In some, the two configurations of the needle may be offset 45 degrees from each other. In other embodiments, the articulating needles may be continuously variable using back-tension springs or partial cut links that will allow the needles to return to their initial shape when no tension is applied by the user.

[0055] One or more portions of the disclosed medical devices and needles may include a lubricious coating to reduce friction between the medical device or needle and the tissue it contacts. Any suitable lubricious coating may be used, including water-soluble, biocompatible compounds that provide lubricity to otherwise non-lubricious surfaces. One type of hydrophilic coating includes hydrogels, which swell in an aqueous environment and exhibit lubricity while in a wet or hydrated state. When hydrated, these materials have low friction in bodily fluids, including saline, digestive fluids, and blood, as well as in saline and water. The hydrogels optionally include poly(meth)acrylate polymers or copolymers, copolymers of maleic anhydride, (meth)acrylamide polymers and copolymers, (meth)acrylic acid copolymers, polyurethanes, poly(vinyl pyrrolidone), and blends or interpolymers of polyurethanes, polysaccharides, and mixtures thereof, and polyethylene oxide crosslinked or interpolymerized with the substrate surface through urethane or ureido linkages.

[0056] The medical devices of the present disclosure may also be coated with an antimicrobial coating to prevent bacterial colonization on their surfaces. The antimicrobial coating may include an inorganic antimicrobial agent disposed within a polymer matrix that adheres the agent to the device surface. Additionally, a drug-releasing coating may be applied to the device surface to aid in the delivery of the drug to the biopsy site. In another alternative, imaging markers may be applied to various medical devices to aid in locating the medical device within the body. Radiopaque, sonoreflective, and / or any other suitable marker may be used.

[0057] Method 1600 is shown in FIG. 16. Method 1600 can begin at step 1602, where an endoscope or other suitable member can be inserted into the body and advanced to a target area. In some cases, the endoscope can be inserted into the body through a natural anatomical orifice, such as the mouth, anus, nose, or vagina. Alternatively, the endoscope can be inserted into the body through an incision. The operator can advance the endoscope from the insertion point to the target area (e.g., work site) within the body by traversing a body passageway, such as the biliary tree. In other aspects, the work site can include lymph nodes or any other tissue that may be potentially cancerous and has been identified for biopsy and further investigation.

[0058] After the distal tip of the endoscope is adjacent to or otherwise close to the target area, a needle according to any of the aspects of the present disclosure may be inserted through a port in the endoscope while in a relaxed configuration in step 1604. The relaxed needle may then be pushed toward the distal tip of the endoscope. After the needle exits the distal tip of the endoscope, the method may proceed to step 1606, where the needle may be transitioned from the relaxed configuration to a rigid configuration. After the needle is in the rigid configuration, the needle may be extended further distally from the scope to puncture tissue and collect a sample in step 1608. Step 1608 may be repeated several times around and / or through the same target area (e.g., an eccentric lesion) to obtain tissue samples from multiple portions of the target area (e.g., a sector). Multiple samples can be taken while the introducing endoscope is held in a fixed position, which can significantly reduce procedure time.

[0059] Method 1700 is shown in FIG. 17. Step 1702 may be substantially similar to step 1602 of method 1600, except that a scope 1400 or 1500 may be used in place of the endoscope described with reference to method 1600. After the scope 1400 or 1500 is adjacent to the target or otherwise proximate the target area, the deflectable tool 1416 or 1516 may be transitioned from a relaxed configuration to a rigid configuration in step 1704 to prepare the tissue for manipulation, cutting, or ablation. After the tissue is prepared, a subsequent procedure (e.g., cutting) may be performed by the tool 1414 in step 1706.

[0060] Those skilled in the art will appreciate that the above-described medical devices can be implemented in any suitable body lumen (e.g., blood vessels, biliary tract, urinary tract, gastrointestinal lumen, etc.) without departing from the scope of the present disclosure, as defined by the claims. In particular, construction details, including manufacturing techniques and materials, are well within the understanding of those skilled in the art and are not described in detail herein. These and other modifications and variations are well within the scope of the present disclosure and can be anticipated and implemented by those skilled in the art.

[0061] Other aspects of the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the embodiments disclosed herein. It is intended that the specification and embodiments be considered as merely examples of implementations, and departures in form and detail may be made without departing from the scope and spirit of the present disclosure as defined by the following claims.

Claims

1. a tool including at least a first link and at least a second link, the tool having a slack configuration and a rigid configuration, the first link and the second link being movable relative to one another when the tool is in the slack configuration; a conduit extending through each of the first link and the second link, the tool transitioning between the relaxed configuration and the rigid configuration in response to movement of the conduit relative to the tool; a distal tip disposed distally from the first link and the second link, the conduit extending at least partially through the distal tip, and the conduit secured to the distal tip; the first link and the second link are spaced apart from one another in the relaxed configuration such that the tool includes a gap between the first link and the second link; A medical device, wherein the first link, the second link, and the distal tip are coaxial with respect to one another when the tool is in the rigid configuration.

2. The medical device of claim 1 , wherein the first link and the second link are configured to move along an outside of the conduit when the tool is in the relaxed configuration.

3. The medical device of claim 1 or 2, wherein the first link and the second link are linearly aligned relative to one another when the tool is in the relaxed configuration.

4. The medical device of claim 1 , wherein the first link and the second link contact each other when the tool is in the rigid configuration such that the gap is closed.

5. The medical device of claim 1 , wherein the conduit is fixed to the distal tip such that the distal tip is immobile relative to the conduit.

6. The medical device of claim 1 or 5, wherein the tool defines a lumen configured to provide fluid flow through each of the first link, the second link, and the distal tip.

7. 7. The medical device of claim 1, 5, or 6, wherein the first link includes a first lumen, the second link includes a second lumen, and an actuating member extends through the first lumen and the second lumen.

8. The medical device of claim 7 , wherein a distal end of the actuation member is bonded to a proximally-facing surface of the distal tip.

9. The medical device of claim 1 , wherein the tool has a higher stiffness in the rigid configuration than in the relaxed configuration.

10. 10. The medical device of claim 1, further comprising a spring, the conduit configured to compress the spring when the tool is in the rigid configuration.

11. 11. The medical device of claim 1, wherein the tool has a first length in the relaxed configuration and a second length in the rigid configuration that is shorter than the first length.

12. 12. The medical device of claim 1, wherein the conduit and the distal tip are configured such that proximal movement of the conduit and the distal tip relative to the first link and the second link transitions the tool from the relaxed configuration to the rigid configuration, and distal movement of the conduit and the distal tip relative to the first link and the second link transitions the tool from the rigid configuration to the relaxed configuration.

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