Anatomical Extraction Device

Abstract

The medical extraction device includes: (a) a sheath having a distal end configured to be inserted into a patient and a proximal end configured to be retained outside the patient; (b) a basket extending from the distal end of the sheath and configured to be repositionable between an extended position and a retracted position, the basket having at least three loops and including a first guide and a second guide, the first guide receiving portions of the first loop and the third loop, the second guide receiving portions of the first loop and the second loop, and the second loop and the third loop being fixedly attached to each other at a position between the first guide and the second guide; and (c) a handle control operatively coupled to the proximal end of the sheath and to the basket, the handle control configured to facilitate repositioning of the basket relative to the sheath between the retracted position and the extended position.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Patent Application No. 62 / 643,644, entitled "ANATOMICAL EXTRACTION DEVICE," filed March 15, 2018, the disclosure of which is incorporated herein by reference.

[0002] The present disclosure relates to anatomical extraction devices, and more particularly, to anatomical extraction devices that may be used to extract objects in body vessels and body reservoirs. [Background technology]

[0003] Small stones in the distal ureter can be reliably and definitively extracted by ureteroscopic stone basketing. Today, a variety of ureteroscopic baskets are available on the market. Many of these baskets are composed of wires slidably mounted in a tubular sleeve forming a cannula. The distal ends of these wires may have free ends or may be fixed relative to each other, allowing them to expand upon outward extension due to the elasticity of the material that composes the wires. In the case of interconnected wires, a distal plug may be present at the most distal tip of the basket. It has been theorized by those skilled in the art that the presence of a distal end of the basket is a disadvantage because it creates a distance from the end to the functional engagement portion of the basket, thus making stone capture more difficult. It has also been complained by those skilled in the art that some baskets with a distal tip may puncture the calyx urothelial lining, resulting in bleeding that interferes with visualization, resulting in premature termination of stone extraction. Similar shortcomings have been noted in the art with baskets having free ends, an example of which is disclosed in US Pat. No. 5,393,633.

[0004] As a means to address the perceived shortcomings of baskets with distal tips or free distal ends, several "open-ended" baskets have been developed. Among these "open-ended" baskets are the embodiments disclosed in U.S. Pat. No. 6,399,343. However, the embodiments according to U.S. Pat. No. 6,399,343 have one very notable shortcoming: they are unable to securely grasp the object intended for removal. Rather than extending beyond the intended object and grasping it by closing the tips around it, all of the embodiments according to U.S. Pat. No. 6,399,343 operate to pinch the object from the side of the object. Not surprisingly, this pinching action is not shown in U.S. Pat. No. 6,399,343. Moreover, this pinching action is highly inefficient, as ambient pressure on the basket according to U.S. Pat. No. 6,399,343 (which may result from pulling the basket through a relatively small diameter renal conduit) causes the object to eject from the distal end of the basket. In other words, because the basket of US Patent No. 5,399,633 does not extend distally beyond the distal end of the object to be captured, such as a kidney stone, it is practically unable to slow distal movement of the object relative to the basket when ambient or proximal pressure is applied to the basket. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] U.S. Patent No. 6,416,519 [Patent Document 2] U.S. Patent No. 5,906,622 Summary of the Invention [Problem to be solved by the invention]

[0006] Therefore, a need exists to provide an anatomical extraction device that provides a basket that extends beyond and securely grasps the intended object while having an open ended arrangement that at the same time overcomes the problems noted above. [Means for solving the problem]

[0007] A first aspect of the present invention provides a medical extraction device comprising a hollow sheath having a distal end from which a basket can extend when in an extended position, the basket being repositionable between a retracted position and an extended position, the basket comprising (i) a first guide and a second guide surrounded by the hollow sheath, (ii) a first loop, a second loop and a third loop, the first loop extending between the first guide and the second guide, (iii) a first anchor fixing a relative position of a distal portion of the second loop with respect to a distal portion of the third loop, (iv) a first joint joining the second loop and the third loop proximal to the first anchor, and (v) a second joint connecting the second loop and the third loop proximal to the first anchor. a second anchor that fixes a relative position of the distal portion of the first loop with respect to a portion of the first guide; and (vi) a line operatively coupled to proximal portions of at least two of the first loop, the second loop, and the third loop such that repositioning the line acts to at least one of increase or decrease a length of at least two of the first loop, the second loop, and the third loop extending from the distal end.

[0008] In a more detailed embodiment of the first aspect, the extraction device further comprises a fourth loop and a third guide, the fourth loop extending between the fourth guide and the first guide, and the second loop extending between the second guide and the third guide. In yet another more detailed embodiment, the extraction device further comprises a handle control attached to a proximal portion of the hollow sheath and configured as a handheld, the handle control comprising an actuator operatively coupled to the line, whereby repositioning of the actuator acts to command repositioning of the line. In a further detailed embodiment, the extraction device further comprises a handle control repositionably attached to a proximal portion of the hollow sheath, the handle control operatively coupled to the line, such that repositioning of the handle control relative to the hollow sheath acts to command repositioning of the line. In yet another detailed embodiment, the line comprises a plurality of lines, each of the plurality of lines operatively coupled to at least one of the first loop, the second loop, and the third loop. In further detailed embodiments, at least one of the first guide and the second guide comprises a duct, and portions of at least two of the first, second, and third loops extend through the duct. In further detailed embodiments, the first guide comprises a first duct, and portions of the first and second loops extend through the first duct, and the second guide comprises a second duct, and portions of the first and second loops extend through the second duct. In other further detailed embodiments, at least one of the first guide and the second guide defines a channel, and portions of at least two of the first, second, and third loops extend along the channel. In yet other more detailed embodiments, the first guide comprises a first channel, with the first loop and a portion of the second loop extending along the first channel, and the second guide comprises a second channel, with the first loop and a portion of the second loop extending along the second channel. In still other more detailed embodiments, at least one of the first loop, the second loop, and the third loop are discontinuous.

[0009] In yet another more detailed embodiment of the first aspect, the first guide and the second guide are at least one of repositionably 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 glue, a solder, a wire twist, and a wire interweaving. In a further detailed embodiment, the first anchor comprises at least one of a weld, a glue, a solder, a wire twist, and a wire interweaving fixed relative to at least one of the first guide, the second guide, and the hollow sheath. In yet another detailed embodiment, the first anchor and the second anchor comprise a common anchor. In a further detailed embodiment, a proximal portion of the first loop and a proximal portion of the third loop are freely repositionable relative to the second guide. In a further detailed embodiment, the first loop is independently repositionable relative to the second loop and the third loop. In another further detailed embodiment, the first loop is rearrangeable dependently with respect to the second loop and the third loop by the line.

[0010] A second aspect of the present invention provides a method of operating a medical extraction device, the method comprising: (a) increasing an exposed length of a first loop, a second loop, and a third loop extending from a hollow sheath, wherein the first loop, the second loop, and the third loop have a first surface spanning an arcuate portion of the first loop, a second surface spanning an arcuate portion of the second loop, a third surface spanning an arcuate portion of the third loop, and a distal-most point of the first loop, a distal-most point of the second loop, and a distal-most point of the third loop. (b) altering the exposed lengths of the second and third loops to reposition the joints, wherein the second and third loops are joined in an arcuate path to reduce a cross-sectional area of ​​the fourth face at a greater percentage than the cross-sectional area of ​​the longitudinal mid-section.

[0011] In a further detailed embodiment of the second aspect, increasing the exposed length of the first loop, the second loop, and the third loop includes maintaining a relative position of the first guide and the second guide with respect to the hollow sheath, the first loop extending between the first guide and the second guide. In yet another more detailed embodiment, increasing the exposed length of the first loop, the second loop, and the third loop includes repositioning the first guide and the second guide with respect to the hollow sheath, the exposed length comprising a length of each loop extending from each guide beyond the hollow sheath.

[0012] A third aspect of the invention provides a method of operating a medical extraction device, the method including the steps of: (a) rearranging a first loop, a second loop, and a third loop to define a receiving area extending beyond a distal end of a hollow sheath, the receiving area in a stationary state being tapered and having a cross-sectional area that decreases in a direction toward the hollow sheath, the first loop, the second loop, and the third loop cooperating to define an opening at the distal end that allows an object to pass therethrough and into the receiving area, and (b) rearranging the joints, where at least two of the first loop, the second loop, and the third loop are joined in an arcuate path to reduce a size of the opening and prevent an object in the receiving area from passing through the reduced size opening.

[0013] A fourth aspect of the present invention is to provide a method of making a medical extraction device, the method comprising the steps of: (a) arranging at least one of a first loop, a second loop, and a third loop in a geometric configuration, where at least two of the loops are angled relative to one another utilizing the equation A=360 / N, where A denotes the angle between the at least two loops and N denotes the total number of loops; (b) positioning at least a first portion of the first loop and a first portion of the third loop at least one of along and within the first guide, such that the first portion of the first loop and the first portion of the third loop are repositionable relative to the first guide and relative to one another; and (c) positioning at least a first portion of the first loop and a first portion of the third loop at least one of along and within the first guide, such that the second portion of the first loop is fixed relative to the second guide and the first portion of the second loop is repositionable relative to the second guide and relative to the first loop. (d) directly coupling at least a first portion of the second loop and a second portion of the first loop at a joint; (e) positioning the first loop, the second loop, and the third loop at least partially within the hollow sheath such that the hollow sheath at least partially surrounds the first loop, the second loop, and the third loop; and (f) operatively coupling a drive line to a first portion of each of the first loop, the second loop, and the third loop such that repositioning of the drive line acts to simultaneously increase or decrease an exposed length of the first loop, the second loop, and the third loop that extends beyond the hollow sheath.

[0014] A fifth aspect of the present invention is to provide a medical extraction device comprising: (a) a sheath having a distal end configured to be inserted into a patient and a proximal end configured to be retained outside the patient, (b) a basket extending from the distal end of the sheath and configured to be repositionable between an extended position and a retracted position, the basket comprising at least three loops and comprising a first guide and a second guide, the first guide receiving a portion of the first loop and a third loop, the second guide receiving a portion of the first loop and the second loop, the second loop and the third loop being fixedly attached to one another at a position between the first guide and the second guide, and (c) a handle control operatively coupled to the proximal end of the sheath and operatively coupled to the basket, the handle control configured to facilitate repositioning of the basket relative to the sheath between the retracted position and the extended position. [Brief description of the drawings]

[0015] [Figure 1] 1 is a top perspective view of a first exemplary medical extraction device according to the present disclosure; FIG. [Diagram 2] 2 is a cutaway perspective view of a distal end of the first exemplary medical extraction device of FIG. 1 showing a basket extending beyond a sheath; FIG. [Diagram 3] 1 is a cross-sectional view of a sheath of a first exemplary medical extraction device. [Figure 4] FIG. 2 is a cross-sectional view of exemplary components extending through a sheath, with the wire and guide shown, and the guide fixed relative to the sheath of a first exemplary medical extraction device, at a position just prior to the distal end of the sheath. [Diagram 5] FIG. 1 is a cross-sectional view of exemplary components extending through a sheath, with the wire and guide respectively shown, the guide being repositionable relative to the sheath of an alternative first exemplary medical extraction device, at a position just prior to the distal end of the sheath. [Figure 6]FIG. 1 is a cross-sectional view of an exemplary sheath and a perspective view of exemplary components extending through the sheath, with the wire and guide respectively shown and the guide fixed relative to the sheath of a first exemplary medical extraction device, at a position just prior to the distal end of the sheath. [Figure 7] 1 is a side view of a distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal passageway just before the basket reaches the object to be removed. FIG. [Figure 8] 1 is a side view of a distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal passageway, with a basket open to receive an object to be removed. FIG. [Figure 9] 1 is a side view of the distal end of a first exemplary medical extraction device extending through a ureteroscope within a renal passageway with the basket repositioned to an encircling position to encircle the object to be removed. FIG. [Figure 10] FIG. 1 is a side 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 encircling position surrounding the object to be removed, illustrating an optional repositioning to position the guide closer to the object to be removed immediately prior to object removal. [Figure 11] 1 is a top perspective view of a second exemplary medical extraction device according to the present disclosure. FIG. [Figure 12] 12 is a cutaway perspective view of the distal end of the second exemplary medical extraction device of FIG. 11 showing the basket extending beyond the sheath. [Figure 13] FIG. 13 is a cross-sectional view of exemplary components extending through a sheath, with the wire and guide shown, and the guide fixed relative to the sheath of a second exemplary medical extraction device, at a position just prior to the distal end of the sheath. [Figure 14] FIG. 13 is a cross-sectional view of exemplary components extending through a sheath, at a position just prior to the distal end of the sheath, where the wire and guide are shown, and the guide is repositionable relative to the sheath of an alternative second exemplary medical extraction device. [Figure 15A]FIG. 13 is a cross-sectional view of an exemplary sheath and a perspective view of exemplary components extending through the sheath, with the wire and two guides respectively shown, the guides fixed relative to the sheath of a second exemplary medical extraction device, at a position just prior to the distal end of the sheath. [Figure 15B] 15B is a cross-sectional view of an exemplary sheath and a perspective view of several other exemplary components extending through the sheath of FIG. 15A , with the wire and two other guides each shown and the guides fixed relative to the sheath of a second exemplary medical extraction device, just prior to the distal end of the sheath. [Figure 16] 1 is a side view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within the renal pathway, with only the basket in a retracted position. FIG. [Figure 17] 1 is a side view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within a renal passageway, with the basket open to receive the object to be removed. FIG. [Figure 18] 1 is a side view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within a renal passageway with a basket open to receive the object to be removed. FIG. [Figure 19] 1 is a side view of the distal end of a second exemplary medical extraction device extending through a ureteroscope within the renal passage with the basket retracted to hold the object to be removed. FIG. [Figure 20] 1A-1C are top perspective views of alternative exemplary embodiments of a first exemplary medical extraction device and a second exemplary medical extraction device according to the present disclosure. [Figure 21] FIG. 1 is a cross-sectional view of an example sheath and a perspective view of several other example components extending through the sheath, where the device comprises dual lines and a separate actuator for each line. [Figure 22] 2 is a top perspective view of the basket of the first exemplary medical extraction device of FIG. 1 in an open or extended position. [Figure 23] 2 is a top perspective view of the basket of the first exemplary medical extraction device of FIG. 1 in a closed or retracted position. FIG. [Figure 24] 2 is a top perspective view of the basket of the first exemplary medical extraction device of FIG. 1 in a closed or retracted position with an object captured by the basket. [Diagram 25] 12 is a top perspective view of the basket of the second exemplary medical extraction device of FIG. 11 in an open or extended position. [Figure 26] FIG. 13 is a top perspective view of the basket of the second exemplary medical extraction device in an intermediate position between the closed and open positions. [Figure 27] FIG. 13 is a top perspective view of the basket of the second exemplary medical extraction device in a closed or retracted position. [Figure 28] FIG. 13 is a top perspective view of the basket of the second exemplary medical extraction device in a closed or retracted position with an object captured by the basket. [Figure 29] 2 is a top perspective view of the basket of the first exemplary medical extraction device of FIG. 1 in an open or extended position, with the same exemplary basket shown in phantom in a closed or retracted position; FIG. [Diagram 30] 12 is a top perspective view of the basket of the second exemplary medical extraction device of FIG. 11 in an open or extended position, with the same exemplary basket shown in phantom in a closed or retracted position. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0016] It should be understood that the following detailed description of the embodiments of the present invention is exemplary in nature and is not intended to constitute a limitation on the present invention. It should also be understood that modifications of the exemplary embodiments anticipated by those skilled in the art are simultaneously included within the scope and spirit of the present invention. It should also be understood that combinations, rearrangements, and / or exchanges of features between the embodiments may be made without departing from the scope of the present disclosure.

[0017] 1-10 and 22-24, a first exemplary embodiment of a medical extraction device 100 comprises an elongated hollow sheath 102 at a distal end of which a repositionable basket 104 extends. The basket 104 is operatively coupled to a handle control 106 by a line 108 (which may consist of one or more lines) that extends through a hollow portion of the sheath and is longitudinally repositionable relative to the sheath to facilitate opening (i.e., an extended position) and closing (i.e., a retracted position) of the basket. A proximal face of the sheath 102 may be fixed or repositionably attached to the handle control 106.

[0018] By way of example, and referring to FIG. 3, the sheath 102 may be fabricated to form a generally smooth arcuate outer periphery and a hollow interior channel. By way of example, the sheath 102 may be comprised of a multi-layer structure including, from outermost to innermost, a Teflon layer 120, a first polyimide layer 122, a stainless steel braided layer 124, and a second polyimide layer 126 defining a hollow interior channel. In an exemplary form, the sheath 102 may have a substantially constant cross-section or a cross-section that varies along its length. Additionally, the sheath 102 may have a circular cross-section, an oval cross-section, or any other shape that forms a longitudinal channel within which the line 108 may be repositionable. As a further example, the sheath 102 may optionally have a maximum outer dimension within the range of 1.0-12.0 Fr that accommodates all or a portion of the basket 104 when in the retracted position.

[0019] In an exemplary embodiment, referring to FIG. 4, the basket 104 may include two or more guides 130, 132 with two or more flexible wires 140, 142, 144 extending therethrough. By way of example, each of the guides 130, 132 may be made from a suitable plastic material, such as, but not limited to, polyethylene, polypropylene, polyester, polyvinyl chloride, or polyimide. However, it should be noted that the guides 130, 132 may also be made from materials other than plastic, such as, but not limited to, metals and alloys. The guides 130, 132 may be deformable, or alternatively may be elastically deformable. Each of the guides 130, 132 may be deterministically fixed 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 guides 130, 132 may be surrounded by the sheath 102. In the illustrated form, guides 130, 132 each define a hollow conduit extending therethrough, sized to permit repositioning of one or more wires 140, 142, 144 that extend through or around the guides.

[0020] The wires 140, 142, 144 of the basket 104 may be operatively coupled to the line 108 to facilitate repositioning of the basket between a closed or retracted position and an open or extended position. In an exemplary form, each wire 140, 142, 144 may consist of a single wire strand or multiple wire strands that can be repositioned and optionally elastically deformed. By way of example, the wires 140, 142, 144 may include a metal, alloy, polymer, or polymer alloy and may be shape-hardened to optionally embody a curved (non-linear) shape. Exemplary alloys that may be used to make the wires 140, 142, 144 include, but are not limited to, Nitinol. The wires or wire strands may embody 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 wires or wire strands may be circular, oval, semicircular, triangular, rectangular, star-shaped, or any other cross-section. As a further example, wires 140, 142, 144 may be comprised of a single strand of Nitinol having a uniform circular cross-section and an outer diameter ranging between 0.0001 inch and 0.05 inch, such as, for example, 0.003 inch. As a further example, each wire may have an overall length that is more than twice the major longitudinal dimension of guides 130, 132.

[0021] In this exemplary embodiment, the basket 104 comprises three wires 140, 142, 144, each of which forms a loop that is repositionable relative to the sheath 102 to capture objects within an interior region defined by the loop. By way of example, the loops may be arranged in a triangular configuration. By way of example, the first wire 140 and the second wire 142 may be joined in a fixed relationship relative to one another at a location 154 (i.e., the junction). This fixed relationship may be achieved as a result of welding, gluing, soldering, twisting, interweaving, or any other means to prevent longitudinal repositioning of the first wire 140 and the second wire 142 at the junction 154. Alternatively, the first wire 140 and the second wire 142 may comprise an integral single wire upstream of the junction 154 and branch downstream of the junction 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 guides 130, 132. When used in connection with this first exemplary extraction device, "upstream" refers to the portions of the first wire 140 and the second wire 142 between the junction 154 and the anchor 158, where the anchor holds the first wire and the second wire in a fixed position.

[0022] The downstream portions of the first wire 140 and the second wire 142 may extend into one of the guides 130, 132. In an illustrated form, the downstream portions of the first wire 140 and the second wire 142 may be freely repositionable along or within each of the guides 130, 132, or the downstream portion of either the first wire 140 and the second wire 142 may be fixed relative to the guides 130, 132 (e.g., attached to the anchor location 158), while a second downstream portion of the other of the first wire 140 and the second wire 142 is freely repositionable and operatively coupled to the line 108. In this manner, the downstream portions of both the first wire 140 and the second wire 142 exposed from the distal ends of the guides 130, 132 operate to form first and second loops. When used in connection with this first exemplary extraction device 100, “downstream” refers to the portions of the first wire 140 and the second wire 142 between the junction 154 and the location where the wires are operatively coupled to the line 108.

[0023] A third wire 144 may also be operatively coupled to the line 108 and at an opposing end to an anchor 158. In an exemplary embodiment, the third wire 144 may form a third loop. By way of example, opposing portions of the third wire 144 extend through or along a respective one of the guides 130, 132. Where the first wire 140 and the second wire 142 are each freely repositionable within the guides 130, 132, at least a portion of the third wire 144 may be fixedly attached to the anchor 158 and another portion of the third wire may be freely repositionable along or within at least one of the guides 130, 132. As a result, one guide 130 may house two or more wires 140, 144 that are freely repositionable along or within the guide, while the other guide 132 may have a wire 142 that is freely repositionable relative to the guide 132 and a second wire 142 that is not freely repositionable relative to the guide 132. In an exemplary embodiment, the wire 144 fixedly attached to the anchor 158 may be secured to the anchor 158 utilizing an adhesive 160 or any other joining or retaining means such as, but not limited to, welding and brazing. As referenced above, the line 108 may be operatively coupled to at least two of the three wires 140, 142, 144 to allow an operator to reposition the basket 104 between a fully retracted position and a fully extended position using the handle control 106. By way of example, the line 108 may comprise any number of materials and configurations, including, but not limited to, metals, alloys, single wires, multiple wires, either parallel, twisted, or braided. In the illustrated form, the line 108 comprises a single wire of Nitinol having a circular cross section and a diameter of approximately 0.015 inches. However, it should be noted that the diameter of the line 108 may be proportional or sized relative to the size of the sheath 102 such that a larger sheath diameter may correspond to a larger line diameter and vice versa.

[0024] In the illustrated form, the handle control 106 includes complementary housing halves 202, 204 attached to one another, which may be fixedly or repositionably attached to the sheath 102. The housing halves 202, 204 define an interior region within which a first actuator 210 may be repositioned. The first actuator 210 extends through an opening 212 in at least one of the halves 202, 204 (and the halves 202, 204 may cooperate to define the opening 212) and may be operatively coupled to the line 108. In this manner, repositioning of the actuator 210 may cause longitudinal repositioning of the line 108 relative to the sheath 102.

[0025] It is also within the scope of the present disclosure to operatively couple the line 108 to the housing halves 202, 204 rather than to the first actuator 210. In this case, the housing halves may be repositionable relative to the sheath 102 and spring biased relative to the sheath 102 to achieve either an open basket biased position or a closed basket biased position. In such a configuration, the first actuator 210 may be operatively coupled to the sheath 102. Thus, longitudinal motion of the housing halves 202, 204 relative to the sheath 102 acts to transmit corresponding longitudinal motion relative to the sheath 102 to the line 108. Furthermore, this longitudinal motion of the line 108 is correspondingly translated into motion of at least two of the three wires 140, 142, 144 (and optionally all three wires) to open and close the basket 104.

[0026] In any of the example controls discussed immediately above, the movement of the first actuator 210 or housing halves 202, 204 relative to the sheath 102 may be limited such that this range of motion / movement corresponds to the range of movement of the basket 104 between fully extended and fully retracted (i.e., between open and closed). In other words, when the first actuator 210 or housing halves 202, 204 is located at one extreme of its range of motion relative to the sheath 102, the basket 104 may be fully retracted, while when the first actuator or housing half is located at the other extreme of its range of motion relative to the sheath, the basket may be fully extended. As a result, repositioning the first actuator 210 or housing halves 202, 204 relative to the sheath 102 acts to manipulate the relative shape of the basket 104 by repositioning it between a fully retracted position and a fully extended position.

[0027] Referring to FIG. 11, although not required, the handle control 106 may include a second actuator 220 that is also repositionable relative to the housing halves 202, 204. In situations where one or more of the guides 130, 132 are not rigidly attached to the sheath 102 but may be longitudinally repositionable relative to the sheath, the second actuator 220 may be operatively coupled to a hollow conduit 230 that extends along the interior of the sheath. In an exemplary embodiment, the conduit 230 may have an outer major axial dimension that is smaller than the smallest inner major axial dimension of the sheath 102, thereby allowing the conduit to be longitudinally repositionable relative to the sheath. Additionally, the conduit 230 may have a continuous interior longitudinal cavity through which the line 108 may extend. In such situations, the line 108 may be longitudinally repositionable independently relative to the conduit 230 and the sheath 102. Similarly, the conduit 230 may be independently longitudinally repositionable relative to the line 108 and the sheath 102. In this manner, longitudinal motion of the second actuator 220 relative to the halves 202, 204 may act to transmit a corresponding longitudinal motion to the conduit 230 within the sheath 102. Furthermore, this longitudinal motion of the conduit 230 may correspondingly translate into motion of the guides 130, 132 extending and retracting them relative to the sheath 102. In this exemplary embodiment, the movement of the second actuator 220 may be 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 extreme of its range of motion, the guides 130, 132 may be fully retracted within the sheath 102, while when the second actuator is at the other extreme of its range of motion, the guides 130, 132 may be fully (or nearly fully) extended out of the sheath 102. As a result, repositioning the second actuator 220 with respect to the housing halves 202, 204 may act to manipulate the relative shape of the basket 104.

[0028] With particular reference to Figures 1, 7-10, 22-24, and 29, the first medical extraction device 100 described above may be used to extract various objects from within an anatomical cavity. By way of exemplary illustration, the use of the extraction device 100 is described 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 100 is not limited to kidney stone removal procedures, but rather this description is merely one of many procedures for which the extraction device 100 may be used.

[0029] First, the appropriate renal pathway 180 within the patient's body to the kidney is surveyed, and suitable visualization may be achieved with a scope 190 (e.g., a ureteroscope) traversing the renal pathway. Once the location of the target object 170 (e.g., a kidney stone) has been estimated, the end of the basket 104 of the extraction device 100 coupled to the sheath 102 may be advanced through the scope 190. At this time, the basket is in a retracted position as shown in Figures 7 and 23 for advancing the distal end of the basket and sheath past the distal end of the scope 190. Continued advancement of the sheath 102 and basket 104 may be continued 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 with the scope 190, the operator may reposition the basket from the retracted position to the open position by grasping the handle control 106 (i.e., the complementary housing halves 202, 204) and repositioning one or both of the actuators 210, 220 relative to the housing halves 202, 204 (or repositioning the handle housing relative to the sheath) to reposition the line 108 relative to the sheath 102.

[0030] In situations where the handle control 106 includes a second actuator 220, the second actuator and the first actuator 210 may be repositioned simultaneously or independently of one another to move the basket from a closed or retracted position to an open or extended position. In an exemplary embodiment, the second actuator 220 may be repositionable distally (toward the basket 104 and relative to the handle housing 202, 204) such that the conduit 230 is moved longitudinally through the sheath 102 and routes the guides 130, 132 to extend beyond (or further beyond) the sheath. An operator of the handle control 106 may then reposition the first actuator 210 distally (toward the basket 104 and relative to the handle housing 202, 204) such that the line 108 is moved longitudinally through the sheath 102, increasing the length of the wires 140, 144 that extend beyond the guides 130, 132 and increasing the length of the wire 142. 7 and 8 show an example position of the basket 104 with the guides 130, 132 at least partially extended from the sheath 102 (either via the second actuator 220 or by default if not actuated) and the wires 140, 142, 144 at least partially extended, which corresponds to a partially open or fully open position (i.e., an extended position). This open or extended position may be maintained while the entire distal portion of the extraction device 100 is repositioned such that a target object 170 (e.g., a kidney stone) intended for capture may be received in the open basket 104 as shown in FIG.

[0031] After the target object 170 is at least partially received in the open basket 104, the first actuator 210 may be repositioned proximally (away from the basket 104 and relative to the handle housings 202, 204) to move the lines 108 longitudinally through the sheath 102, reducing the length of the wires 140, 142, 144 that extend beyond the guides 130, 132 and reducing the length of the wires associated with the loops. This reduced length of the wires 140, 144 corresponds to the length of the junctions 154 with their tips arcing and moving in an arcuate path to reach behind the target object 170, thereby forming a backstop to prevent the object from exiting the basket, as shown in FIGS. 9, 24, and 29. Depending on the size of the target object 170 and the operator's confidence as to whether the object will remain within the basket 104 when the entire distal portion of the extraction device 100 is repositioned proximally (e.g., for eventual removal of the basket 104 and object 170 from the renal passage 180), the operator can reposition the second actuator 220 distally (toward the basket 104 and relative to the handle housings 202, 204), thereby moving the guides 130, 132 further longitudinally through the sheath 102 and reducing the length of the wires 140, 142, 144 that extend beyond the guides 130, 132 and reducing the length of the wires associated with the loops, thereby tightening the loops around the target object as shown in FIG. 10. After the target object 170 is captured within the basket 104, the extraction device 100 and object 170 can be removed from the renal passage 180.

[0032] Alternatively, in situations where the guides 130, 132 are not repositionable relative to the sheath 102, the first actuator 210 may be repositioned such that the basket is moved from a closed or retracted position to an open or extended position once the basket reaches the target object 170. In an exemplary configuration, an operator of the handle control 106 may reposition the first actuator 210 distally (toward the basket 104), thereby moving the lines 108 longitudinally through the sheath 102 to increase the length of the wires 140, 144 that extend beyond the guides 130, 132, and increase the length of the wire 142, thereby increasing the length of each of the three loops that extend from the sheath. FIGS. 7, 8, and 22 show exemplary open or extended positions of the basket 104, with the guides 130, 132 partially extended from the sheath 102 and the wires 140, 142, 144 partially extended from the guides and the sheath. This open or expanded position may be maintained while the entire distal portion of the extraction device 100 is repositioned further distally so that a target object 170 to be captured (e.g., a kidney stone) may be received within the open basket 104, as shown in Figure 8. After the target object 170 is at least partially received within the open basket 104, the first actuator 210 may be repositioned proximally (away from the basket 104), thereby moving the lines 108 longitudinally through the sheath 102 to reduce the length of the wires 140, 142, 144 extending beyond the guides 130, 132 and correspondingly reduce the length of the loops extending beyond the guides. This reduced length of the wires 140, 142, 144 matches the length of the joints 154 with their tips bending in an arcuate path to reach behind the target object 170, thereby creating a backstop to prevent the object from exiting the basket 104, as shown in Figures 9, 23, and 29. After the joints 154 have been repositioned behind the target object 170, the extraction device 100 and the target object 170 may be removed from the renal passage 180.

[0033] 11-20, 25-28, and 30, a second exemplary embodiment of a medical extraction device 300 comprises an elongated hollow sheath 102 at a distal end of which a repositionable basket 304 extends. Herein, reference numerals common to the first exemplary embodiment refer to elements that are identical or not substantially different from the elements of the first exemplary embodiment. Thus, for purposes of brevity, a description of elements common between the two embodiments has been omitted.

[0034] The basket 304 is operatively coupled to the handle control 106 by a line 108 (which may consist of one or more lines) that extends through a hollow portion of the sheath and is longitudinally repositionable relative to the sheath to facilitate opening (i.e., extended position) and closing (i.e., retracted position) of the basket. The proximal face of the sheath 102 may be fixed or repositionably attached to the handle control 106.

[0035] 12, the basket 304 may include three or more guides 130, 132, 334, 336 with two or more flexible wires 140, 142, 344, 346 extending therethrough, respectively. For example, each of the guides 130, 132, 334, 336 may be made from a suitable plastic material, such as, but not limited to, polyethylene, polypropylene, polyester, polyvinyl chloride, or polyimide. However, it should be noted that the guides 130, 132, 334, 336 may also be made from materials other than plastic, such as, but not limited to, metals and alloys. The guides 130, 132, 334, 336 may be deformable, or alternatively elastically deformable. Each of the guides 130, 132, 334, 336 may be deterministically fixed 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 guides 130, 132, 334, 336 may be surrounded by sheath 102. In the illustrated configuration, guides 130, 132, 334, 336 each define a hollow conduit extending therethrough and are sized to permit repositioning of one or more wires 140, 142, 344, 346 extending therethrough.

[0036] The wires 140, 142, 344, 346 of the basket 304 may be operatively coupled to the line 108 to facilitate repositioning of the basket between a closed or retracted position and an open or extended position. In an exemplary form, each wire 140, 142, 344, 346 may consist of a single wire or multiple wire strands that can be repositioned and optionally elastically deformed. By way of example, these wires 140, 142, 344, 346 may include a metal or alloy and may be shape-hardened to optionally embody a curved (non-linear) shape. Exemplary alloys that may be used to make the wires 140, 142, 344, 346 include, but are not limited to, Nitinol. The wires or wire strands may embody 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 wire or wire strand may be circular, oval, semicircular, triangular, rectangular, star-shaped, or any other cross-section. By way of further example, the wires 140, 142, 344, 346 may be comprised of a single strand of Nitinol having a uniform circular cross-section and an outer diameter ranging between 0.0001 inches and 0.05 inches, such as 0.003 inches. By way of further example, each wire may have an overall length that is more than twice the major longitudinal dimension of the guide 130, 132, 334, 336.

[0037] 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 are repositionable relative to the sheath 102 to capture objects therein. In the exemplary embodiment, the loops may be arranged in a rectangular configuration. By way of example, the first wire 140 and the second wire 142 are joined in a fixed relationship relative to one another at a joint 154. This fixed relationship may be achieved as a result of welding, gluing, soldering, twisting, interweaving, or any other means such that longitudinal repositioning of the first wire 140 and the second wire 142 is not independent of one another at the joint location 154. Alternatively, the first wire 140 and the second wire 142 may comprise an integral single wire upstream of the junction 154 and branch downstream of the junction 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. When used in connection with this second exemplary extraction device 300, "upstream" refers to the portions of the first wire 140 and the second wire 142 between the junction 154 and the anchor 158, where the anchor holds the first wire and the second wire in a fixed position. When used in connection with the second exemplary extraction device 300, "downstream" refers to the portions of the first wire 140 and the second wire 142 between the junction 154 and the location where the wires are operatively coupled to the line 108. In any case, the downstream portions of the first wire 140 and the second wire 142 may extend through one of the guides 130, 132 and may be operatively coupled to the line 108 such that retraction of the line retracts the downstream portions of the first wire 140 and the second wire 142 into the guides 130, 132 and extension of the line (longitudinal repositioning of the line toward the distal end of the sheath 102) extends the wires 140, 142 further beyond the guides 130, 132.In contrast, the upstream portions of the first wire 140 and the second wire 142 extend through the other guide 334 and are operatively coupled to the anchor 158 such that the length of the wires extending from the guide 334 remains relatively constant.

[0038] As previously described, the downstream portions of the first wire 140 and the second wire 142 each extend into one of the guides 130, 132. In an illustrative form, the downstream portions of the first wire 140 and the second wire 142 may be freely repositionable along or within each of the guides 130, 132, or the downstream portions of either the first wire 140 and the second wire 142 may be fixed relative to the guides 130, 132 and the second downstream portions of the first wire 140 and the second wire 142 may be freely repositionable and operatively coupled to the line 108. In this manner, the first wire 140 and the second wire 142 operate to form a first loop 150 and a second loop 152.

[0039] A third wire 344 may also be operatively coupled to the line 108 and operable to form a third loop 354. By way of example, opposing ends of the third wire 344 extend through each of the guides 132, 336. Where the first wire 140 and the second wire 142 are freely repositionable within their respective guides 130, 132, at least one opposing end of the third wire 344 may be fixedly attached to the anchor 158, while the other portion of the third wire may be freely repositionable within the guide 336 (see FIG. 15B). As a result, one guide 336 will house two wires that may be freely repositionable within that guide, two other guides 130, 132 may have a first wire 140, 142 that is freely repositionable therein and a second wire 344, 346 that is not freely repositionable therein, and a fourth guide 334 will house two wires that may be fixed in place relative to it via anchors 158. In an exemplary form, the wires 140, 142, 344 may each be attached to the anchors 158 using various mounting or joining forms such as, but not limited to, adhesives, welding, and brazing.

[0040] Finally, a fourth wire 346 may also be operatively coupled to the line 108 and operative to form a fourth loop 356. By way of example, both opposing portions of the fourth wire 346 extend through one of the guides 130, 336. If the first wire 140 and the second wire 142 are freely repositionable within their respective guides 130, 336, then at least one of the aforementioned portions of the fourth wire 344 is fixedly attached to the anchor 158, and the other end of the fourth wire is freely repositionable within the guide 336. As a result, the guide 336 will house two wires that are freely repositionable within the guide, and an 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 embodiment, the fourth wire 346 may be fixedly attached to the anchor 158 utilizing an adhesive 160 or any other joining means such as, but not limited to, welding and brazing. As mentioned above, the line 108 is operatively coupled to at least three of the four wires 140, 142, 344, 346 such that manipulation of the handle control 106 by an operator repositions the basket 304 between a retracted / closed position and an open / extended position. By way of example, the line 108 may comprise any number of materials and configurations, including, but not limited to, metals, alloys, a single wire, multiple wires, either parallel, twisted, or braided. In an exemplary embodiment, the line 108 comprises a single wire of Nitinol having a circular cross section and a diameter of about 0.015 inches. However, it should be noted that the diameter of the line 108 may be proportional or sized relative to the size of the sheath 102 such that a larger sheath diameter may correspond to a larger line diameter, and vice versa.

[0041] In the illustrated form, the second exemplary embodiment medical extraction device 300 includes a handle control 106 that includes complementary, mutually attached housing halves 202, 204 that may be fixedly or repositionably attached to the sheath 102. The housing halves 202, 204 define an interior region within which a first actuator 210 may be repositioned. The first actuator 210 extends through an opening 212 in at least one of the halves 202, 204 (and the halves 202, 204 may cooperate to define the opening 212) and may be operatively coupled to the line 108. In this manner, repositioning of the actuator 210 may cause longitudinal repositioning of the line 108 relative to the sheath 102. Moreover, this longitudinal motion of the line 108 is correspondingly translated into motion of at least three of the four wires 140, 142, 344, 346 to extend and retract the basket 304. In this exemplary embodiment, the movement of the first actuator 210 may be limited such that its range of motion corresponds to the range of extension and retraction of the basket 304. In other words, when the first actuator 210 is located at one end of its range of motion, the basket 304 may be fully retracted, while when the first actuator is located at the other end of its range of motion, the basket may be fully extended. As a result, repositioning the first actuator 210 acts to manipulate the relative shape of the basket 304.

[0042] It is also within the scope of the present disclosure to operatively couple the lines 108 to the housing halves 202, 204 rather than to the first actuator 210. In this case, the housing halves may be repositionable relative to the sheath 102 and spring biased relative to the sheath 102 to achieve either an open basket 304 position or a closed basket 304 position. In such a situation, the first actuator 210 may be operatively coupled to the sheath 102. Thus, longitudinal motion of the housing halves 202, 204 relative to the sheath 102 may act to transmit corresponding longitudinal motion relative to the sheath 102 to the lines 108. Furthermore, this longitudinal motion of the lines 108 is correspondingly translated into motion of at least three of the four wires 140, 142, 344, 346 (and optionally all four wires) to open and close the basket 304.

[0043] In any of the example controls discussed immediately above, the movement of the first actuator 210 or housing halves 202, 204 relative to the sheath 102 may be limited such that this range of motion / movement corresponds to the range of movement of the basket 304 between fully extended and fully retracted (i.e., between open and closed). In other words, when the first actuator 210 or housing halves 202, 204 is located at one extreme of its range of motion relative to the sheath 102, the basket 304 may be fully retracted, while when the first actuator or housing half is located at the other extreme of its range of motion relative to the sheath, the basket may be fully extended. As a result, repositioning the first actuator 210 or housing halves 202, 204 relative to the sheath 102 acts to manipulate the relative shape of the basket 304 by repositioning it between a fully retracted position and a fully extended position.

[0044] Although not required, the handle control 106 may include a second actuator 220 that is also repositionable relative to the housing halves 202, 204. In situations where one or more of the guides 130, 132, 334, 336 are not rigidly attached to the sheath 102 but may be longitudinally repositionable relative to the sheath, the second actuator 220 may be operatively coupled to a hollow conduit 230 that extends along the interior of the sheath 102. In an exemplary embodiment, the conduit 230 may have an exterior maximum dimension that is smaller than a minimum interior dimension of the sheath 102, thereby allowing the conduit to be longitudinally repositionable relative to the sheath. Additionally, the conduit 230 may have a continuous interior cavity extending longitudinally therethrough, through which the line 108 may extend. In such situations, the line 108 may be longitudinally repositionable independently relative to the conduit 230 and the sheath 102. Similarly, the conduit 230 may be independently longitudinally repositionable relative to the line 108 and the sheath 102. In this manner, longitudinal motion of the second actuator 220 acts to transmit a corresponding longitudinal motion to the conduit 230 within the sheath 102. Furthermore, this longitudinal motion of the conduit 230 is correspondingly translated into motion of the guides 130, 132, 334, 336 that extends and retracts the guides relative to the sheath 102. In this exemplary embodiment, the movement of the second actuator 220 may be limited such 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 may be fully (or nearly fully) retracted within the sheath 102, while when the second actuator is at the other end of its range of motion, the guides 130, 132, 334, 336 may be extended fully (or nearly) out of the sheath 102. As a result, repositioning the second actuator 220 distally may act to manipulate the relative shape of the basket 304.

[0045] The second medical extraction device 300 described above can be used to extract various objects from within an anatomical cavity. By way of exemplary illustration, the use of the extraction device 300 is described 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 is not limited to kidney stone removal procedures, but rather, this description is merely one of many procedures for which the extraction device 300 may be used.

[0046] First, the appropriate renal pathway 180 within the patient's body to the kidney is surveyed, and suitable visualization may be achieved with a scope 190 (e.g., a ureteroscope) traversing the renal pathway. Once the location of the target object 170 (e.g., a kidney stone) has been estimated, the end of the basket 304 of the extraction device 300 coupled to the sheath 102 may be advanced through the scope 190. At this time, the basket is in a retracted position as shown in FIG. 16 for advancing the distal end of the basket and sheath past the distal end of the scope 190. Continued advancement of the sheath 102 and basket 304 may be continued 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 with the scope 190, the operator may reposition the basket from the retracted position to the open position by grasping the handle control 106 (i.e., the complementary housing halves 202, 204) and repositioning one or both of the actuators 210, 220 relative to the housing halves 202, 204 (or repositioning the handle housing relative to the sheath) to reposition the line 108 relative to the sheath 102.

[0047] In situations where the handle control 106 includes a second actuator 220, the second actuator and the first actuator 210 may be repositioned simultaneously or independently of one another to move the basket from a closed or retracted position to an open or extended position. In an exemplary form, the second actuator 220 may be repositionable distally (towards the basket 304 and relative to the handle housings 202, 204) such that the conduit 230 is moved longitudinally through the sheath 102 and sends the guides 130, 132, 334, 336 extending beyond (or further beyond) the sheath. An operator of the handle control 106 can then reposition the first actuator 210 distally (towards the basket 304 and relative to the handle housings 202, 204) such that the lines 108 are moved longitudinally through the sheath 102, increasing the length and loop size of the wires 140, 142, 344, 346 that extend beyond the guides 130, 132, 334, 336. Figures 17 and 25 show example positions of the basket 304 in which the guides 130, 132, 334, 336 are at least partially extended from the sheath 102 (either via the second actuator 220 or by default if not actuated) and the wires 140, 142, 344, 346 are at least partially extended, which corresponds to a partially open or fully open position (i.e., an extended position). This open or expanded position may be maintained while the entire distal portion of the extraction device 300 is repositioned so that a target object 170 (e.g., a kidney stone) intended for capture may be received in the open basket 304, as shown in FIG. 18.

[0048] 16 shows an example position of the basket 304 with the guides 130, 132, 334, 336 partially extended from the sheath 102 (via the second actuator 220) and the wires 140, 142, 344, 346 partially extended, which corresponds to a retracted position. This retracted position may be maintained while the entire distal portion of the extraction device 300 is repositioned to reach the vicinity of the target object 170 (e.g., a kidney stone). As shown in FIG. 17, when the basket 304 is located in the vicinity of the target object 170, the first actuator 210 may be repositioned relative to the housing halves 202, 204 to expand or open the basket 304. After opening the basket 304, the basket may be positioned further distally such that the target object 170 is received within the open basket as shown in FIG. 18.

[0049] After the object 170 is at least partially received in the open basket 304, the first actuator 210 is repositioned proximally (away from the basket 304 and relative to the handle housings 202, 204) to move the lines 108 longitudinally through the sheath 102, reducing the length of the wires 140, 142, 344, 346 that extend beyond the guides 130, 132, 334, 336 and reducing the length of the wires associated with the loops 150, 152, 354, 356. This reduced length of the wires 140, 142, 344, 346 matches the length of the junctions 154 that form tips that arc and move in an arcuate path to reach behind the target object 170, thereby forming a backstop to prevent the object from exiting the basket 304 (see FIGS. 19, 28, and 30). Depending on the size of the target object 170 and the operator's confidence as to whether the object will remain within the basket 304 when the entire distal portion of the extraction device 300 is repositioned proximally (e.g., for the purpose of eventual removal of the basket 304 and the target object 170 from the renal passage 180), the operator can reposition the second actuator 220 distally (toward the basket 304), thereby moving the guides 130, 132, 334, 336 further longitudinally through the sheath 102 to reduce the length of the wires 140, 142, 344, 346 that extend beyond the guides 130, 132, 334, 336 and reduce the length of the wires associated with the loops 150, 152, 354, 356, thereby tightening the loops 150, 152, 354, 356 around the object (see FIG. 28 ). After the target object 170 is captured within the basket 304 , the extraction device 300 and the target object may be removed from the renal passage 180 .

[0050] Alternatively, in situations where the guides 130, 132, 334, 336 are not repositionable relative to the sheath 102, the first actuator 210 may be repositioned such that it is moved from a closed or retracted position to an open or extended position once the basket reaches the target object 170. In an illustrated form, an operator of the handle control 106 can reposition the first actuator 210 distally (towards the basket 304), thereby moving the line 108 longitudinally through the sheath 102 to increase the length of the wires 140, 142, 344, 346 that extend beyond the guides 130, 132, 334, 336, thereby increasing the length of each loop 150, 152, 354, 356 that extends from the sheath. 17 and 25 show an example position of the basket 304 with the guides 130, 132, 334, 336 extended partially from the sheath 102 and the wires 140, 142, 344, 346 extended from the guides and sheath, which corresponds to an open or extended position of the basket. This open or extended position may be maintained while the entire distal portion of the extraction device 300 is repositioned further distally such that a target object 170 to be captured (e.g., a kidney stone) may be received within the open basket 304 as shown in FIG. After the target object 170 is at least partially received in the open basket 304, the first actuator 210 is repositioned proximally (away from the basket 304), which causes the lines 108 to move longitudinally through the sheath 102, reducing the length of the wires 140, 142, 344, 346 that extend beyond the guides 130, 132, 334, 336 and may reduce the length of the wires associated with the loops 150, 152, 354, 356. This reduced length of the wires 140, 142, 344, 346 matches the length of the junctions 154 that form tips that arc and move in an arcuate path to reach behind the target object 170, thereby forming a backstop to prevent the target object from exiting the basket 304 (see FIGS. 19, 28, and 30). After the joint 154 has been repositioned behind the target object 170 , the extraction device 300 and object 170 may be removed from the renal passage 180 .

[0051] It is also within the scope of the present disclosure to reposition the actuator 210 in the opposite direction from that described above in the situation where the actuator 210 is attached to the sheath 102 and the lines 108 are attached to the housing halves 202, 204. By way of example, in such a situation, the first actuator 210 may be repositioned proximally (away from the basket 104 and relative to the handle housings 202, 204) to open or expand the basket, and distally (towards the basket) to retract or close the basket.

[0052] 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, as shown in Figures 20 and 21. This third control 260 is attached to a second line 262 that extends through the sheath 102 and is operatively coupled to at least a portion of the wires 140, 142, 144, 344, 346 that may otherwise be coupled to the anchor 158. In this manner, to the extent that an operator of the device 100, 300 desires to extend the joint 154 further outwardly while holding the target object 170, the operator can reposition the third control 260 distally (towards the basket 104, 304) or proximally (away from the basket) to reposition the joint 154 further from or closer to one or more of the guides 130, 132, 334, 336.

[0053] Also, while each basket 104, 304 has been illustratively described as having a single junction, it should be understood that it is within the scope of this disclosure for the basket 104, 304 to have multiple junctions where the loops are joined to one another. The additional junctions may be formed similarly to junctions 154 disclosed herein.

[0054] Additionally, although each extraction device 100, 300 has been described as having an anchor 158, it should be understood that it is within the scope of the present disclosure to provide these extraction devices 100, 300 with multiple anchors, each anchor being attached to one or more wires.

[0055] From the above description and summary of the invention, it will be apparent to those skilled in the art that the methods and devices described herein form exemplary embodiments of the invention, but that it should be understood that the invention contained herein is not limited to the precise embodiments described above, and that modifications may be made without departing from the scope of the invention as defined by the novelty points proposed below. Similarly, it will be understood that it is not necessary to meet any or all of the specific advantages or objectives of the invention disclosed herein in order to be included within the scope of the invention, since inherent and / or unexpected advantages of the invention may exist even if not expressly discussed herein. [Explanation of symbols]

[0056] 100 Medical Extraction Device 102 Long and thin hollow sheath 104 Basket 106 Steering control section 108 Line 120 Teflon layer 122 First polyimide layer 124 Stainless Steel Braided Layer 126 Second polyimide layer 130 Guide 132 Guide 140 Flexible Wire 142 Flexible Wire 144 Flexible Wire 150 Loops 152 Loops 154 Joint, joint position 158 Anchor, Anchor Position 160 Adhesive 170 Target object 180 Renal Pathway 190 Scope 202 Complementary housing half, handle housing 204 Complementary housing half, handle housing 210 First Actuator 212 Aperture 220 Second Actuator 230 Hollow conduit 260 Third Control Section 262 Second Line 300 medical extraction device, second medical extraction device 304 Rearrangeable Basket 334 Guide 336 Guide 344 Wire 346 Wire 354 Loop 356 Loops

Claims

1. 1. A medical extraction device comprising: a hollow sheath having a distal end from which a basket can extend when in an extended position, the basket being repositionable between a retracted position and the extended position, the basket comprising: a first guide and a second guide surrounded by the hollow sheath; a first wire, a second wire, and a third wire, the first wire extending through the first guide and the second guide, the first wire forming a first loop between the first guide and the second guide, the second wire extending from a distal end of the second guide forming a second loop, and the third wire extending from a distal end of the first guide forming a third loop; a first anchor attaching the second wire to the hollow sheath; a first junction joining the second wire and the third wire, the first junction being disposed along the second wire between a location of the first anchor and a location where the second wire initially extends from a distal end of the second guide; a second anchor attaching the first wire to the hollow sheath; a third anchor attaching the third wire to the hollow sheath; a line operatively coupled to the first wire, the second wire, and the third wire such that repositioning the line acts to at least one of increase or decrease the length of the first loop, the second loop, and the third loop extending from the distal end of the hollow sheath; A medical extraction device comprising:

2. Further comprising a fourth wire extending through the third guide; the fourth wire extends between the third guide and the first guide to form a fourth loop; The medical extraction device of claim 1 , wherein the second wire extends between the second guide and the third guide.

3. 3. The medical extraction device of claim 1 or 2, further comprising a handle control attached to a proximal portion of the hollow sheath and configured to be handheld, the handle control comprising an actuator operatively coupled to a line, repositioning of the actuator acting to command repositioning of the line.

4. 4. The medical extraction device of claim 1, further comprising a handle control repositionably attached to a proximal portion of the hollow sheath, the handle control operatively coupled to the line such that repositioning the handle control relative to the hollow sheath acts to command repositioning of the line.

5. 5. The medical extraction device of claim 1, wherein the line comprises a plurality of lines, each of the plurality of lines being operatively coupled to at least one of the first wire, the second wire, and the third wire.

6. 6. The medical extraction device of claim 1, wherein at least one of the first guide and the second guide comprises a duct, and a portion of at least two loops of the first wire, the second wire, and the third wire extend through the duct.

7. the first guide includes a first duct, and portions of the first wire and the third wire extend through the first duct; 6. The medical extraction device of claim 1, wherein the second guide comprises a second duct, and portions of the first wire and the second wire extend through the second duct.

8. 6. The medical extraction device of claim 1, wherein at least one of the first guide and the second guide defines a channel, and portions of loops of at least two of the first wire, the second wire, and the third wire extend along the channel.

9. the first guide includes a first channel, a portion of the first wire and the third wire extending along the first channel; 6. The medical extraction device of claim 1, wherein the second guide comprises a second channel, and a portion of the first wire and the second wire extend along the second channel.

10. 10. The medical extraction device of claim 1, wherein the first guide and the second guide are at least one of repositionably and fixedly positioned relative to the hollow sheath.

11. 11. The medical extraction device of claim 1, wherein the first joint comprises at least one of a weld, a glue, a solder, a wire twist, and a wire interweave.

12. 12. The medical extraction device of any one of claims 1 to 11, wherein the first anchor comprises at least one of a weld, a glue, a soldered portion, a wire twist, and a wire interwoven portion.

13. The medical extraction device of claim 1 , wherein the first anchor and the second anchor comprise a common anchor.

14. 14. The medical extraction device of any one of claims 1 to 13, wherein a proximal portion of the first wire and a proximal portion of the third wire are freely repositionable relative to the second guide.

15. 15. The medical extraction device of any one of claims 1 to 14, wherein the first wire is independently repositionable relative to the second wire and the third wire.

16. 15. The medical extraction device of claim 1, wherein the first wire is repositionable dependently relative to the second and third wires by the line.

17. 1. A method of making a medical extraction device, comprising: arranging a first loop, a second loop, and a third loop in a geometric configuration, at least two of the loops being angled relative to one another utilizing the equation A=360 / N, where A represents an exterior angle from directly above between at least two of the adjacent loops, and N represents a total number of loops, the first loop comprising a first wire, the second loop comprising a second wire, and the third loop comprising a third wire; positioning at least the downstream portion of the first wire and the downstream portion of the third wire along and / or within the first guide such that the downstream portion of the first wire and the downstream portion of the third wire are repositionable relative to the first guide and relative to each other; disposing the first wire, the second wire, and the third wire at least partially within a hollow sheath such that the hollow sheath at least partially surrounds the first wire, the second wire, and the third wire; positioning at least the downstream portion of the second wire and the upstream portion of the first wire along or within the second guide such that the upstream portion of the first wire is fixed relative to the hollow sheath and / or the second guide and the downstream portion of the second wire is repositionable relative to the second guide and relative to the first wire; directly bonding the third wire and the second wire at a junction; operatively coupling the drive line to the downstream portions of each of the first wire, the second wire, and the third wire such that repositioning of the drive line acts to simultaneously increase or decrease the exposed lengths of the first wire, the second wire, and the third wire that extend beyond the hollow sheath. Including, The method, wherein an upstream portion of the second wire and an upstream portion of the third wire are fixed relative to at least one of the hollow sheath and the second guide.

18. 1. A medical extraction device comprising: a sheath having a distal end adapted to be inserted into a patient and a proximal end adapted to be retained outside the patient; a basket extending from the distal end of the sheath and configured to be repositionable between an extended position and a retracted position, the basket comprising at least three wires, the basket comprising a first guide and a second guide each guiding at least two of a first wire, a second wire, and a third wire, the first wire extending between the first guide and the second guide forming a first loop, the second wire extending from the first guide forming a second loop, the third wire extending from the second guide forming a third loop, the first guide receiving a portion of the first loop and the second loop, the second loop and the third loop being fixedly attached relative to one another at a location between the first guide and the second guide; a handle control operatively coupled to the first wire, the second wire, and the third wire via control lines, the handle control configured to facilitate repositioning of the basket relative to the sheath between the retracted position and the extended position by repositioning the control lines to vary the lengths of the first wire, the second wire, and the third wire that extend beyond the distal end of the sheath; Equipped with A medical extraction device, wherein a portion of the first wire, the second wire and the third wire are fixed relative to at least one of the sheath, the first guide and the second guide.

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