Minimally invasive surgical

Abstract

A probe or sheath for use on a probe for detecting and removing radioactively tagged tissue, e.g., a sentinel lymph node, within the body of a living being. The probe or sheath and probe is arranged to be inserted through a small percutaneous portal into the patient's body and is movable to various positions adjacent the tagged tissue to detect the presence of radiation therefrom so that it can be positioned immediately adjacent that tissue to ensnare or trap that tissue. The probe or sheath and probe can then be removed from the being's body, carrying the tagged tissue with it. The probe may be constructed to make use of a scintillation crystal, a collimator, adjustable or fixed, and a backshielding lightpipe. A blunt dissecting device is provided as part of the sheath or as part of the probe itself to aid in separating the tagged tissue from adjacent tissue without injury to the adjacent tissue. The probe may be a fully integrated, self-powered unit.

We claim:  
     
         1 . An integrated radiation instrument probe having a small diameter body arranged to be held within the hand of a person for insertion into the body of a living being to locate radioactively tagged tissue therein and for removing such tissue from the body of the being, said probe comprising a radiation detector and associated electronic components for providing electrical signals in response to radiation emanating from the radioactively tagged tissue and which radiation is detected by said radiation detector, means for releasably securing said radioactively tagged tissue to said probe for enabling the secured tissue to be removed from the being's body with the probe, and signaling means for producing signals for providing information regarding the use of the probe to the person using the probe.  
     
     
         2 . The instrument of  claim 1  wherein said probe includes a visual display for providing visual signals to the person.  
     
     
         3 . The instrument of  claim 1  wherein said probe includes a sound generator for providing audible signals to the person.  
     
     
         4 . The instrument of  claim 2  wherein said probe also includes a sound generator for providing audible signals to the person.  
     
     
         5 . The instrument of  claim 1  wherein said probe additionally comprises a blunt tissue dissector arranged to bluntly separate the radioactively tagged tissue from adjacent tissue so that the radioactively tagged tissue may be readily removed from the being's body.  
     
     
         6 . The instrument of  claim 5  wherein said blunt tissue dissector includes an inflatable balloon.  
     
     
         7 . The instrument of  claim 5  wherein said probe includes a grabbing member for grabbing the radioactively tagged tissue.  
     
     
         8 . The instrument of  claim 7  wherein said grabbing member includes at least one extendable member to ensnare the radioactively tagged tissue.  
     
     
         9 . The instrument of  claim 8  wherein said at least one extendable member is arranged to pierce into the radioactively tagged tissue.  
     
     
         10 . The instrument of  claim 7  wherein said grabbing member includes plural extendable members to engage the radioactively tagged tissue from plural directions to ensnare it.  
     
     
         11 . The instrument of  claim 1  wherein said probe includes a wireless transmitter for transmitting wireless signals in response to operation of said probe.  
     
     
         12 . The instrument of  claim 11  additionally comprising a remote unit arranged to receive wherein said wireless signals.  
     
     
         13 . The instrument of  claim 12  wherein said remote unit includes a visual display for providing visual signals to the person.  
     
     
         14 . The instrument of  claim 12  wherein said probe includes a sound generator for providing audible signals to the person.  
     
     
         15 . The instrument of  claim 13  wherein said probe also includes a sound generator for providing audible signals to the person.  
     
     
         16 . An integrated radiation detecting probe having a small housing arranged to be held within the hand of a person for insertion into the body of a living being to locate radioactively tagged tissue therein, said probe comprising a radiation detector, associated signal processing components, and signaling means, said signal processing means being arranged for for providing electrical signals in response to radiation emanating from the radioactively tagged tissue and which radiation is detected by said radiation detector, said signaling means being responsive to said electrical signals for providing output signals to a user of said probe, said output signals providing information regarding the use of the probe.  
     
     
         17 . The instrument of  claim 16  wherein said probe includes a visual display for providing visually perceptible output signals.  
     
     
         18 . The instrument of  claim 17  wherein said probe includes a sound generator for providing audible output signals.  
     
     
         19 . The instrument of  claim 16  wherein said probe also includes a sound generator for providing audible output signals.  
     
     
         20 . The instrument of  claim 16  wherein said probe includes electric power supply means for powering said probe.  
     
     
         21 . The instrument of  claim 16  wherein said probe includes illumination means for illuminating the situs of the radioactively tagged tissue.  
     
     
         22 . The instrument of  claim 21  wherein said illumination means comprises a fiber-optic member.  
     
     
         23 . The instrument of  claim 16  wherein said probe includes visualization means for visualizing the situs of the radioactively tagged tissue.  
     
     
         24 . The instrument of  claim 23  wherein said visualization means comprises a fiber-optic member.  
     
     
         25 . A radiation detecting system comprising a probe and a remote signaling unit, said probe having a small housing arranged to be held within the hand of a person for insertion into the body of a living being to locate radioactively tagged tissue therein and comprising a radiation detector, associated signal processing components, and signaling means, said signal processing means being arranged for for providing electrical signals in response to radiation emanating from the radioactively tagged tissue and which radiation is detected by said radiation detector, said signaling means being responsive to said electrical signals for transmitting wireless signals to said remote signaling unit, said remote signaling unit being responsive to said wireless signals for providing output signals for a user of said system, said output signals providing information regarding the use of the probe.  
     
     
         26 . The system of  claim 25  wherein said unit includes a visual display for providing visually perceptible output signals.  
     
     
         27 . The system of  claim 25  wherein said unit includes a sound generator for providing audible output signals.  
     
     
         28 . The system of  claim 26  wherein said unit also includes a sound generator for providing audible output signals.  
     
     
         29 . The system of  claim 25  wherein said probe includes electric power supply means for powering said probe.  
     
     
         30 . The system of  claim 25  wherein said probe includes illumination means for illuminating the situs of the radioactively tagged tissue.  
     
     
         31 . The system of  claim 30  wherein said illumination means comprises a fiber-optic member.  
     
     
         32 . The system of  claim 25  wherein said probe includes visualization means for visualizing the situs of the radioactively tagged tissue.  
     
     
         33 . The system of  claim 32  wherein said visualization means comprises a fiber-optic member.  
     
     
         34 . A radiation detecting probe having a small housing arranged to be held within the hand of a person for insertion into the body of a living being to locate radioactively tagged tissue therein, said probe comprising a housing, a radiation detector located within said housing for detecting radiation emanating from the radioactively tagged tissue, and a collimator, said housing being formed of a radiation blocking material and having an opening therein forming a window through which radiation from the radioactively tagged tissue may pass, said collimator comprising at least one radiation blocking septa located adjacent said opening, said septum being adapted to be moved from a retracted position to an extended position, and vice versa, said septum when in said retracted position enabling said radiation detector to receives radiation emanating from the radioactively tagged source within a first solid angle of acceptance, said septum when in said extended position enabling said radiation detector to receives radiation emanating from the radioactively tagged source within a second solid angle of acceptance, said second solid angle of acceptance being narrower than said first solid angle of acceptance.  
     
     
         35 . The radiation detecting probe of  claim 34  wherein said collimator comprises plural septa.  
     
     
         36 . The radiation detecting probe of  claim 34  wherein said septum are arranged to fold outward into said opening to divide said window into plural passageways through which radiation may pass to said radiation detector.  
     
     
         37 . The radiation detecting probe of  claim 35  wherein said septa are arranged to fold outward into said opening to divide said window into plural passageways through which radiation may pass to said radiation detector.  
     
     
         38 . A radiation detecting probe having a small housing arranged to be held within the hand of a person for insertion into the body of a living being to locate radioactively tagged tissue therein, the radioactively tagged tissue having been tagged with a radioactive agent selected from the group consisting of Technetium 99 m and Indium 111, said probe comprising a housing, a radiation detector located within said housing for detecting radiation emanating from the radioactively tagged tissue, said radiation detector comprising a scintillation crystal of Gadolineum Orthosilicate.