阅读说明：本技术 提取网篮 (Extraction basket ) 是由 J·E·富兰克林 于 2019-12-26 设计创作，主要内容包括：一种示例提取装置可包括：大致管状的轴,其包括被构造成插入到患者中的远端和被构造成保持在患者外部的近端；从轴的远端延伸的网篮,该网篮包括多个柔性的、向远侧延伸的支腿,这些支腿包括大致径向向外偏置以至少部分地限定网篮远侧开口的相应的远端；手柄,其设置在轴的近端处；致动器,其设置在手柄上；和/或操作性地联接到致动器的闭合线,该闭合线向远侧延伸穿过轴,穿过设置在轴的远端上的闭合线引导件,并且绕网篮远侧开口大致周向地延伸,该闭合线在每个支腿的相应的支腿远端附近可滑动地联接到每个支腿。(An example extraction apparatus may include: a generally tubular shaft including a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient; a basket extending from the distal end of the shaft, the basket including a plurality of flexible, distally extending legs including respective distal ends biased generally radially outward to at least partially define a basket distal opening; a handle disposed at the proximal end of the shaft; an actuator disposed on the handle; and/or a closure wire operatively coupled to the actuator, the closure wire extending distally through the shaft, through a closure wire guide disposed on a distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire being slidably coupled to each leg near a respective leg distal end of each leg.)

1. An extraction device, the extraction device comprising:

a generally tubular shaft including a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient;

a basket extending from the distal end of the shaft, the basket including a plurality of flexible, distally extending legs including respective distal ends that are generally biased radially outward to at least partially define a basket distal opening;

a handle disposed at the proximal end of the shaft;

an actuator disposed on the handle; and

a closure wire operatively coupled to the actuator, the closure wire extending distally through the shaft, through a closure wire guide disposed on the distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire being slidably coupled to each leg near a respective leg distal end thereof;

wherein the actuator operates between an open position and a closed position to extend and withdraw the closure wire, thereby moving the basket between the open and closed configurations, respectively.

2. The extraction device of claim 1 further comprising at least one substantially circumferential wall disposed on at least one of the legs.

3. The extraction device of claim 2, wherein the wall comprises at least one of a wire mesh and an elastomeric film.

4. The extraction apparatus according to claim 1, wherein at least two of the legs are substantially identical to each other and are arranged substantially symmetrically on the shaft.

5. The extraction device of claim 1 wherein the closure wire guide is generally tubular, slidably receives the closure wire therein, and extends substantially from the distal end of the shaft to a distal end of one of the gripper legs.

6. The extraction device of claim 1 wherein at least one of the legs comprises a distally extending flap-shaped annulus.

7. The extraction device of claim 1, further comprising a lock on the handle operatively coupled to the actuator to lock the actuator in at least one of an open position and a closed position.

8. The extraction device of claim 1, wherein the closure wire is slidably coupled to each leg in a drawstring manner near a respective leg distal end of each leg.

9. The extraction device of claim 1 wherein the closed wire guide is flexible such that the closed wire guide curves radially inward when the basket is in the closed configuration.

10. A method of operating an extraction device, the method comprising:

advancing a retrieval device into a patient's body until a basket of the retrieval device reaches a target area containing an object, the basket including a plurality of flexible, distally extending legs including respective distal ends that are biased generally radially outward to at least partially define a basket distal opening;

manipulating the extraction device to position the object at least partially within the basket; and

capturing the object by proximally withdrawing a closure wire extending through a closure wire guide and extending generally circumferentially about the basket distal opening, the closure wire slidably coupled to each leg near the respective leg distal end of each leg, the closure wire drawing the leg distal ends together in a drawstring manner.

11. The method of claim 10, further comprising: after capturing the object, removing the extraction device and the object from the patient's body.

12. The method of claim 10, further comprising: placing the basket in an open configuration by moving the closure line distally prior to manipulating the extraction device to position the object at least partially within the basket.

13. The method of claim 10, wherein the first and second light sources are selected from the group consisting of,

wherein the extraction device comprises:

a generally tubular shaft including a distal end configured to be inserted into the patient's body and a proximal end configured to remain outside the patient's body, an

A handle disposed at the proximal end of the shaft;

wherein the basket extends from the distal end of the shaft;

wherein the closure wire guide is disposed on the distal end of the shaft; and

wherein proximally withdrawing the closure wire comprises: the closure wire is proximally withdrawn through the closure wire guide and the shaft by operating an actuator disposed on the handle.

14. The method of claim 10, wherein the advancing operation comprises: advancing the extraction device through a working channel in a ureteroscope.

15. The method of claim 10, wherein the first and second light sources are selected from the group consisting of,

wherein the extraction device comprises at least one substantially circumferential wall provided on at least one of the legs; and is

Wherein capturing the object comprises: capturing the object using the at least one wall.

16. The method of claim 10, wherein at least partially closing the basket distal opening comprises: causing the closure wire guide to bend radially inward.

17. An extraction device, the extraction device comprising:

a generally tubular shaft including a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient;

a basket extending from the distal end of the shaft, the basket comprising:

a plurality of flexible, distally extending extension legs including respective distal ends that are biased generally radially outward, an

A plurality of flexible, distally extending gripper legs, each gripper leg mounted to a distal end of a respective extension leg, the respective distal ends of the gripper legs at least partially defining a basket distal opening;

a handle disposed at the proximal end of the shaft;

a closure actuator disposed on the handle;

a closure wire operatively coupled to the closure actuator, the closure wire extending distally through the shaft, through a closure wire guide disposed on the distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire being slidably coupled to each gripper leg near a respective leg distal end thereof; and

a retraction actuator disposed on the handle and operatively coupled to the extension leg to at least partially extend the extension leg distally from the distal end of the shaft and to at least partially retract the extension leg proximally into the shaft;

wherein the closure actuator operates between an open position and a closed position to extend and withdraw the closure wire, thereby moving the basket between the open and closed configurations, respectively.

18. The extraction apparatus of claim 17 wherein the basket includes at least one substantially circumferential gripper leg wall disposed on at least one of the gripper legs.

19. The extraction device of claim 18, wherein the gripper leg walls comprise at least one of a wire mesh and an elastomeric film.

20. The extraction apparatus of claim 17 wherein the basket includes at least one substantially circumferential extension leg wall disposed on at least one of the extension legs.

21. The extraction device of claim 20, wherein the extension leg wall comprises at least one of a wire mesh and an elastomeric film.

22. The extraction device of claim 17 wherein the closure wire guide is generally tubular, slidably receives the closure wire therein, and extends substantially from the distal end of the shaft to a distal end of one of the gripper legs.

23. The extraction device of claim 17, wherein the closure wire is slidably coupled to each gripper leg in a drawstring manner near a respective leg distal end of each gripper leg.

24. The extraction device of claim 17 wherein the closed wire guide is flexible such that the closed wire guide curves radially inward when the basket is in the closed configuration.

25. A method of operating an extraction device, the method comprising:

advancing a retrieval device into a patient's body until a basket of the retrieval device reaches a target area containing an object, the retrieval device comprising:

a generally tubular shaft including a distal end configured to be inserted into the patient's body and a proximal end configured to remain outside the patient's body; the basket extending from the distal end of the shaft, the basket comprising: a plurality of flexible, distally extending extension legs including respective distal ends that are generally biased radially outward; and a plurality of flexible, distally extending gripper legs, each gripper leg mounted to a distal end of a respective extension leg, the respective distal ends of the gripper legs at least partially defining a basket distal opening;

manipulating the extraction device to position the object at least partially within the basket;

capturing the object by proximally withdrawing a closure wire at least partially closing the basket distal opening, the closure wire extending distally through the shaft, through a closure wire guide disposed on the distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire slidably coupled to each gripper leg near its respective gripper leg distal end, the closure wire pulling the gripper leg distal ends together in a drawstring manner; and

retracting the extension leg at least partially proximally into the shaft.

26. The method of claim 25, further comprising: after retracting the extension legs, removing the extraction device and the object from the patient's body.

27. The method of claim 25, further comprising: placing the basket in an open configuration by moving the closure line distally prior to manipulating the extraction device to position the object at least partially within the basket.

28. The method of claim 25, wherein the first and second portions are selected from the group consisting of,

wherein the extraction device comprises a handle disposed at the proximal end of the shaft;

wherein proximally withdrawing the closure wire comprises: proximally withdrawing the closure wire through the closure wire guide and the shaft by operating a closure actuator disposed on the handle; and is

Wherein retracting the extension leg comprises: operating a retraction actuator disposed on the handle.

29. The method of claim 25, wherein the advancing operation comprises: advancing the extraction device through a working channel in a ureteroscope.

30. The method of claim 25, wherein the first and second portions are selected from the group consisting of,

wherein the basket comprises at least one substantially circumferential gripper leg wall disposed on at least one of the gripper legs;

wherein the basket comprises at least one substantially circumferential extension leg wall disposed on at least one of the extension legs; and is

Wherein capturing the object comprises: capturing the object using at least one of the at least one gripper leg wall and the at least one extension leg wall.

31. The method of claim 25, wherein at least partially closing the basket distal opening comprises: causing the closure wire guide to bend radially inward.

32. An extraction device, the extraction device comprising:

a generally tubular shaft comprising a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient, the distal end of the shaft comprising a distal opening;

a flap grasper extending from the distal end of the shaft, the flap grasper comprising a plurality of distally extending flaps including respective distal ends that are generally biased radially outward, the distal ends of the flaps at least partially defining a grasper distal opening when the flap grasper is in an open configuration;

a handle disposed at the proximal end of the shaft;

an actuator disposed on the handle; and

an actuator wire operatively coupled to the actuator and the plurality of petals to move the petal grasper between the open configuration and the closed configuration in which the plurality of petals are at least partially withdrawn into the shaft at the distal opening;

wherein, in the closed configuration, the flap substantially completely encloses an object contained therein.

33. The extraction device as claimed in claim 32,

wherein the flap grasper comprises at least one substantially circumferential wall disposed on at least one of the flaps; and is

Wherein the wall comprises at least one of a wire mesh and an elastomeric film.

34. The extraction device of claim 32, wherein in the closed configuration the distal ends of the flaps are substantially in contact with each other.

35. A method of operating an extraction device, the method comprising:

advancing an extraction device into a patient's body until a flap gripper of the extraction device reaches a target region containing an object, the flap gripper comprising a plurality of distally extending flaps including respective distal ends that are substantially radially outwardly biased, the distal ends of the flaps at least partially defining a gripper distal opening when the flap gripper is in an open configuration;

manipulating the extraction device to position the object at least partially within the flap gripper; and

capturing the object by proximally withdrawing an actuator wire at least partially closing the distal opening of the flap grasper, the actuator wire operatively coupled to the plurality of flaps to move the flap grasper between the open and closed configurations.

36. The method of claim 35, further comprising: after capturing the object, removing the extraction device and the object from the patient's body.

37. The method of claim 35, further comprising: placing the flap gripper in the open configuration prior to manipulating the extraction device to position the object at least partially within the flap gripper.

38. The method of claim 35, wherein the first and second components are selected from the group consisting of,

wherein the extraction device comprises:

a generally tubular shaft including a distal end configured to be inserted into the patient's body and a proximal end configured to remain outside the patient's body, an

A handle disposed at the proximal end of the shaft;

wherein the flap grasper extends from the distal end of the shaft; and is

Wherein at least partially closing the distal opening of the flap grasper comprises: withdrawing the plurality of petals at least partially into the shaft at the distal end of the shaft.

39. The method of claim 35, wherein the advancing operation comprises: advancing the extraction device through a working channel in a ureteroscope.

40. The method of claim 35, wherein the first and second components are selected from the group consisting of,

wherein the flap grasper comprises at least one substantially circumferential wall disposed on at least one of the flaps; and is

Wherein capturing the object comprises: capturing the object using the at least one wall.

41. Any apparatus, method, or combination thereof as disclosed herein.

42. Any two or more of the preceding claims in any combination.

43. Any combination of elements from one or more of the preceding claims.

Technical Field

The present disclosure relates to medical devices and instruments, and more particularly to extraction devices that may be used, for example, to extract objects from within bodily conduits and/or bodily reservoirs.

Background

The present disclosure contemplates that small stones in the distal ureter may be reliably and positively extracted using ureteroscopic basket cover lithology. Currently, a wide variety of ureteroscopic baskets are commercially available. Many of these ureteroscopic baskets include wires (wires) that are slidably mounted in a tubular sleeve that forms the cannula. The distal ends of the wires may have free ends or may be secured to each other and may be expandable when extended outwardly due to the elasticity of the material comprising the wires. For those filaments that are connected to each other, a distal plug may be present at the more distal tip of the basket. The person skilled in the art has proposed the following theories: the presence of a distal tip of the basket may be disadvantageous because the tip may create a distance from the end of the basket to the functional engagement portion, thus making stone entrapment more difficult. Moreover, those skilled in the art unfortunately, certain baskets with distal tips can puncture the renal calyx urothelial lining, thereby causing bleeding that is obscured from visualization, and can lead to premature termination of the stone extraction procedure. Similar disadvantages have been noted in the art with regard to baskets having free ends, an example of which is disclosed in us patent No. 6,416,519.

The present disclosure contemplates that certain "open-ended" baskets have been developed as a means of addressing the perceived shortcomings of baskets having distal tips or having free distal ends. Among these "open-ended" baskets are the embodiments disclosed in U.S. patent No. 5,906,622. The embodiment of us patent No. 5,906,622 has a very significant disadvantage in that it does not positively grip the intended object to be removed. The embodiments of the' 622 patent all operate to pinch the object from its side, rather than grasp the intended object by extending beyond the object and wrapping (cinch) around the object. Such pinching operations may not be satisfactory because circumferential pressure on the basket of the embodiment of the' 622 patent (which may be the result of pulling the basket through a relatively small diameter renal catheter) may cause objects to be ejected from the distal end of the basket. In other words, the embodiment of the' 622 patent may not be able to avoid distal movement of an object relative to the basket when circumferential or proximal pressure is applied to the basket.

Disclosure of Invention

A first aspect of the present invention provides an extraction apparatus comprising: a generally tubular shaft including a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient; a basket extending from the distal end of the shaft, the basket including a plurality of flexible, distally extending legs including respective distal ends biased generally radially outward to at least partially define a basket distal opening; a handle disposed at the proximal end of the shaft; an actuator disposed on the handle; and/or a closure wire operatively coupled to the actuator, the closure wire extending distally through the shaft, through a closure wire guide disposed on a distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire being slidably coupled to each leg near a respective leg distal end of each leg. An actuator is operable between an open position and a closed position to extend and withdraw the closure wire, thereby moving the basket between the open configuration and the closed configuration, respectively.

In a more detailed embodiment of the first aspect, the extraction device may comprise at least one substantially circumferential wall provided on at least one of the legs. The wall may include at least one of a wire mesh and an elastomeric film. At least two of the legs may be substantially identical to each other and/or may be arranged substantially symmetrically on the shaft. The closure wire guide may be generally tubular, may slidably receive the closure wire therein, and/or may extend substantially from the distal end of the shaft to the distal end of one of the gripper legs. At least one of the legs may comprise a distally extending flap-shaped loop. The extraction device may include a lock on the handle operatively coupled to the actuator to lock the actuator in at least one of the open position and the closed position. The closure wire may be slidably coupled to each leg in a drawstring manner near a respective leg distal end of each leg. The closing wire guides may be flexible such that the closing wire guides flex radially inward when the baskets are in the closed configuration.

A second aspect of the present disclosure is to provide a method of operating an extraction device, the method comprising: advancing a retrieval device into the patient's body until a basket of the retrieval device reaches a target area containing the object, the basket including a plurality of flexible, distally extending legs including respective distal ends biased generally radially outward to at least partially define a basket distal opening; manipulating the extraction device to position the object at least partially within the basket; and capturing the object by proximally withdrawing a closure wire extending through the closure wire guide and extending generally circumferentially about the basket distal opening at least partially closing the basket distal opening of the basket, the closure wire being slidably coupled to each leg near the respective leg distal end of each leg. The closing wire may pull the distal ends of the legs together in a drawstring fashion.

In a more detailed embodiment of the second aspect, the method may comprise: after capturing the object, the extraction device and the object are removed from the patient's body. The method can comprise the following steps: the basket is placed in the open configuration by moving the closure wire distally prior to manipulating the extraction device to position the object at least partially within the basket. The extraction device may include: a generally tubular shaft including a distal end configured to be inserted into a patient's body and a proximal end configured to remain outside the patient's body; and/or a handle disposed at the proximal end of the shaft. The basket may extend from the distal end of the shaft. The closure wire guide may be disposed on the distal end of the shaft. Proximally withdrawing the closure wire may comprise: the closure wire is withdrawn proximally through the closure wire guide and the shaft by operating an actuator disposed on the handle. The propelling operation may include: the extraction device is advanced through a working channel in the ureteroscope. The extraction means may comprise at least one substantially circumferential wall provided on at least one of the legs. Capturing the object may include: capturing an object using the at least one wall. At least partially closing the basket distal opening may comprise: causing the closing wire guide to flex radially inward.

A third aspect of the present disclosure is to provide an extraction device, including: a generally tubular shaft including a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient; a basket extending from the distal end of the shaft, the basket comprising: a plurality of flexible, distally extending extension legs including respective distal ends that are generally biased radially outward; and/or a plurality of flexible, distally extending gripper legs, each gripper leg mounted to a distal end of a respective extension leg, the respective distal ends of the gripper legs at least partially defining a basket distal opening; a handle disposed at the proximal end of the shaft; a closure actuator disposed on the handle; a closure wire operatively coupled to the closure actuator, the closure wire extending distally through the shaft, through a closure wire guide disposed on the distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire being slidably coupled to each gripper leg near a respective leg distal end of each gripper leg; and/or a retraction actuator disposed on the handle and operatively coupled to the extension leg to extend the extension leg at least partially distally from the distal end of the shaft and retract the extension leg at least partially proximally into the shaft. A closure actuator is operable between an open position and a closed position to extend and withdraw the closure wire, thereby moving the basket between the open and closed configurations, respectively.

In more detailed embodiments of the third aspect, the basket may comprise at least one substantially circumferential gripper leg wall provided on at least one of the gripper legs. The gripper leg walls may include at least one of a wire mesh and an elastomeric film. The basket may include at least one substantially circumferential extension leg wall disposed on at least one of the extension legs. The extension leg wall may include at least one of a wire mesh and an elastomeric film. The closure wire guide may be generally tubular, may slidably receive the closure wire therein, and/or may extend substantially from the distal end of the shaft to the distal end of one of the gripper legs. The closure wire may be slidably coupled to each gripper leg in a drawstring manner near a respective leg distal end of each gripper leg. The closing wire guides may be flexible such that the closing wire guides flex radially inward when the baskets are in the closed configuration.

A fourth aspect of the present disclosure is to provide a method of operating an extraction device, the method comprising: advancing a retrieval device into the body of the patient until a basket of the retrieval device reaches a target area containing the object, the retrieval device comprising: a generally tubular shaft including a distal end configured to be inserted into a patient's body and a proximal end configured to remain outside the patient's body; a basket extending from the distal end of the shaft, the basket comprising: a plurality of flexible, distally extending extension legs including respective distal ends that are generally biased radially outward; and a plurality of flexible, distally extending gripper legs, each gripper leg mounted to a distal end of a respective extension leg, the respective distal ends of the gripper legs at least partially defining a basket distal opening; manipulating the extraction device to position the object at least partially within the basket; capturing an object by proximally withdrawing a closure wire at least partially closing a basket distal opening of the basket, the closure wire extending distally through the shaft, through a closure wire guide disposed on a distal end of the shaft, and extending generally circumferentially about the basket distal opening, the closure wire slidably coupled to each gripper leg near a respective gripper leg distal end of each gripper leg, the closure wire pulling the gripper leg distal ends together in a drawstring manner; and/or retracting the extension leg at least partially proximally into the shaft.

In a more detailed embodiment of the fourth aspect, the method may comprise: after retracting the extension legs, the extraction device and the object are removed from the patient's body. The method can comprise the following steps: the basket is placed in the open configuration by moving the closure wire distally prior to manipulating the extraction device to position the object at least partially within the basket. The extraction device may include a handle disposed at the proximal end of the shaft. Proximally withdrawing the closure wire may comprise: the closure wire is withdrawn proximally through the closure wire guide and shaft by operation of a closure actuator disposed on the handle. Retracting the extension leg may include: a retraction actuator disposed on the handle is operated. The propelling operation may include: the extraction device is advanced through a working channel in the ureteroscope. The basket may include at least one substantially circumferential gripper leg wall disposed on at least one of the gripper legs. The basket may include at least one substantially circumferential extension leg wall disposed on at least one of the extension legs. Capturing the object may include: capturing an object using at least one of the at least one gripper leg wall and the at least one extension leg wall. At least partially closing the basket distal opening may comprise: causing the closing wire guide to flex radially inward.

A fifth aspect of the present disclosure is to provide an extraction device, including: a generally tubular shaft including a distal end configured to be inserted into a patient and a proximal end configured to remain outside the patient, the distal end of the shaft including a distal opening; a flap grasper extending from the distal end of the shaft, the flap grasper comprising a plurality of distally extending flaps including respective distal ends that are generally biased radially outward, the distal ends of the flaps at least partially defining a grasper distal opening when the flap grasper is in an open configuration; a handle disposed at the proximal end of the shaft; an actuator disposed on the handle; and/or an actuator wire operatively coupled to the actuator and the plurality of petals to move the petal grasper between an open configuration and a closed configuration in which the plurality of petals are at least partially withdrawn into the shaft at the distal opening. In the closed configuration, the flaps may substantially completely enclose the object contained therein.

In a more detailed embodiment of the fifth aspect, the flap grasper may include at least one substantially circumferential wall disposed on at least one of the flaps. The wall may include at least one of a wire mesh and an elastomeric film. In the closed configuration, the distal ends of the flaps may substantially contact each other.

A sixth aspect of the present disclosure provides a method of operating an extraction device, the method comprising: advancing the extraction device into the patient's body until a flap gripper of the extraction device reaches a target region containing the object, the flap gripper comprising a plurality of distally extending flaps including respective distal ends that are generally biased radially outward, the distal ends of the flaps at least partially defining a gripper distal opening when the flap gripper is in an open configuration; manipulating the extraction device to position the object at least partially within the flap gripper; and/or capturing the object by proximally withdrawing an actuator wire operatively coupled to the plurality of flaps to move the flap grasper between the open configuration and the closed configuration to at least partially close the distal opening of the flap grasper.

In a more detailed embodiment of the sixth aspect, the method may comprise: after capturing the object, the extraction device and the object are removed from the patient's body. The method can comprise the following steps: the flap gripper is placed in the open configuration prior to manipulating the extraction device to position the object at least partially within the flap gripper. The extraction device may include: a generally tubular shaft including a distal end configured to be inserted into a patient's body and a proximal end configured to remain outside the patient's body; and/or a handle disposed at the proximal end of the shaft. The flap grasper may extend from a distal end of the shaft. At least partially closing the distal opening of the flap grasper may include: withdrawing the plurality of petals at least partially into the shaft at the distal end of the shaft. The propelling operation may include: the extraction device is advanced through a working channel in the ureteroscope. The flap gripper may comprise at least one substantially circumferential wall provided on at least one of the flaps. Capturing the object may include: capturing an object using the at least one wall.

Drawings

Example embodiments are described with reference to the accompanying drawings, in which:

FIG. 1 is a front perspective view of an exemplary extraction device;

fig. 2 is a detailed perspective view of an example extraction device with an example basket in an open configuration;

FIG. 3 is a detailed perspective view of an example extraction device with an example basket in a closed configuration;

FIG. 4 is a front perspective view of an example extraction device including an example dual mode basket;

FIG. 5 is a detailed perspective view of an example dual mode basket in an open configuration;

FIG. 6 is a detailed perspective view of an example dual mode basket in a closed configuration;

FIG. 7 is a detailed perspective view of an example dual mode basket in a retracted configuration;

FIG. 8 is a cross-sectional view of an exemplary shaft of the dual mode basket extraction device;

FIG. 9 is a detailed perspective view of an alternative example basket in the form of a flap gripper in an open configuration;

FIG. 10 is a cross-sectional view of an example flap gripper in an open configuration; and

FIG. 11 is a cross-sectional view of an example flap gripper in a closed configuration; all in accordance with at least some aspects of the present disclosure.

Detailed Description

The following describes and illustrates example embodiments in accordance with the present disclosure to encompass devices, methods, and techniques related to medical and surgical procedures. Of course, it will be apparent to those of ordinary skill in the art that the embodiments discussed below are examples and may be reconfigured by incorporating features across embodiments without departing from the scope and spirit of the present disclosure. For clarity, it is within the scope of the invention to combine one or more features across embodiments, and this disclosure should be read with this intent. It is also to be understood that variations of the example embodiments contemplated by those skilled in the art will also comprise a part of the present disclosure. However, for the sake of clarity and accuracy, the example embodiments as discussed below may include alternative steps, methods, and features that one of ordinary skill in the art would recognize are not a requirement that fall within the scope of the present disclosure.

The present disclosure includes, among other things, medical devices and instruments, and more particularly, extraction devices that may be used to extract objects from within bodily conduits and/or bodily reservoirs.

Fig. 1 is a front perspective view of an example extraction device 100, according to at least some aspects of the present disclosure. The extraction device 100 may comprise a shaft 200, which may be in the form of an elongated, hollow, generally tubular sheath. The shaft 200 may be generally configured for insertion of its distal end 201 into a patient and retention of its proximal end 204 outside the patient. A reconfigurable basket 300 may be disposed at the distal end 201 of the shaft 200. Handle 400 may be disposed at proximal end 204 of shaft 200. The actuator 500 may be movably disposed on the handle 400 and/or may be operatively coupled to the basket 300. As used herein, "distal" may refer to a direction generally toward the basket 300, and "proximal" may refer to a direction generally toward the handle 400.

Fig. 2 and 3 are detailed perspective views of an example extraction device 100 according to at least some aspects of the present disclosure, with the baskets 300 in an open configuration and a closed configuration, respectively. In some example embodiments, the basket 300 may include two or more legs 302, 304, 306, 308, 310. The legs 302, 304, 306, 308, 310 may be mounted to the shaft 200 at or near the shaft distal end opening 202. For example, the legs 302, 304, 306, 308, 310 may be substantially evenly circumferentially spaced and/or may be mounted within the shaft distal end opening 202. The legs 302, 304, 306, 308, 310 may be flexible (compare fig. 2 and 3) and/or may be biased to an open configuration (fig. 2). For example, the legs 302, 304, 306, 308, 310 may be formed such that their respective distal ends 303, 305, 307, 309, 311 are biased generally radially outward (e.g., biased open) to form the basket distal opening 301. In some example embodiments, for example, the legs 302, 304, 306, 308, 310 may be at least partially constructed of spring grade stainless steel and/or nickel titanium alloys (e.g., nitinol) in the superelastic range.

Referring to fig. 2, some example embodiments may include walls 312, 314, 316, 318, 320 disposed on respective legs 302, 304, 306, 308, 310. For example, the legs 302, 304, 306, 308, 310 of the distally extending ring generally formed in a petal shape may have walls 312, 314, 316, 318, 320 generally disposed in a generally circumferential manner within the petal ring. In some example embodiments, the walls 312, 314, 316, 318, 320 may be constructed from a mesh (e.g., wire mesh) and/or an elastomeric film (e.g., which may be laser cut and/or may be porous).

Referring to fig. 2 and 3, in some example embodiments according to at least some aspects of the present disclosure, the basket 300 may include a closed line 322 that may extend generally circumferentially around the basket distal opening 301, such as near the distal ends 303, 305, 307, 309, 311 of some or all of the legs 302, 304, 306, 308, 310. The closing wire 322 may be operatively coupled to some or all of the legs 302, 304, 306, 308, 310, such as by being slidably attached to the distal ends 303, 305, 307, 309, 311 in a drawstring (e.g., a purse string). For example, the closure wire 322 may extend substantially circumferentially around the basket 300 in a substantially circular path near the distal ends 303, 305, 307, 309, 311 of the legs 302, 304, 306, 308, 310, such that when the closure wire 322 is tightened, the distal ends 303, 305, 307, 309, 311 are drawn together and/or closed, thereby at least partially closing the basket distal opening 301.

In some example embodiments, the closure wire 322 may extend from the legs 302, 304, 306, 308, 310 through a closure wire guide 324, which may be disposed on at least one of the legs 302, 304, 306, 308, 310 and/or the shaft 200, such as near the shaft distal end opening 202. For example, the closure wire guide 324 may extend generally distally from the shaft distal end opening 202 to near the distal end 303 of the leg 302. The closure wire guide 324 may include a closure wire guide distal opening 325 through which the closure wire 322 may extend generally circumferentially outward about the distal ends 303, 305, 307, 309, 311 of the legs 302, 304, 306, 308, 310. In some example embodiments, the closure wire guide 324 may be generally tubular (e.g., may have a longitudinal channel therethrough). In some example embodiments, the closure wire guide 324 may be substantially flexible (e.g., substantially as flexible as the legs 302, 304, 306, 308, 310) such that it bends radially inward in the closed configuration (fig. 3).

In some example embodiments, the closure wire 322 may be operably coupled to the actuator 500 and/or may extend from the handle 400, extend distally through the shaft 200, extend distally through the closure wire guide 324, and extend outwardly through the closure wire guide distal end opening 325.

In some example embodiments, the actuator 500 may be configured for user manipulation (such as by rotating, sliding, and/or pivoting) to extend and/or retract the closure wire 322 to open and/or close the basket 300. In some example embodiments, when the basket 300 is in the open configuration (fig. 2), operating the actuator 500 from the open position (fig. 2) toward the closed position (fig. 3) may pull the closure wire 322 proximally through the shaft 200, which may pull the distal ends 303, 305, 307, 309, 311 of the legs 302, 304, 306, 308, 310 radially inward, generally in the manner of a drawstring (e.g., a purse string), thereby substantially reducing and/or at least partially closing the basket distal opening 301.

Some example embodiments may include a lock 502 on the handle 400 that may be operatively coupled to the actuator 500 to lock the actuator 500 in the open position, the fully closed position, and/or between the open and closed positions (e.g., in the partially closed position).

In some example embodiments, in the fully closed configuration, the walls 312, 314, 316, 318, 320 may substantially completely enclose (e.g., encapsulate) the object 600 held within the basket 300. In some example embodiments, in the fully closed configuration, the walls 312, 314, 316, 318, 320 may partially enclose the object 600 held within the basket 300. In some example embodiments, in the partially closed configuration, the walls 312, 314, 316, 318, 320 may partially enclose the object 600 held within the basket 300.

In some example embodiments, operating the actuator 500 from the closed configuration (fig. 3) toward the open configuration (fig. 2) may allow the closure wire 322 to move distally when the basket 300 is in the closed configuration (fig. 3), which may be tensioned distally by the opening bias of the legs 302, 304, 306, 308, 310. Distal movement of the closure wire 322 may allow the distal ends 303, 305, 307, 309, 311 of the legs 302, 304, 306, 308, 310 to move radially outward, thereby generally circumferentially expanding and/or opening the basket distal opening 301.

In some example embodiments, the legs 302, 304, 306, 308, 310 and/or the walls 312, 314, 316, 318, 320 may be substantially identical to one another and/or may be arranged substantially symmetrically about the shaft distal opening 202. In some example embodiments, one or more of the legs 302, 304, 306, 308, 310 and/or the walls 312, 314, 316, 318, 320 may be different from the other legs and/or walls and/or may be disposed substantially asymmetrically about the shaft distal opening 202.

Referring to fig. 1-3, an example method of operating an extraction device 100 including a basket 300 is described. The extraction device 100 may be utilized to extract various objects 600 from within the interior of an anatomical cavity. As an example, the use of the extraction device 100 will be explained in the context of a kidney stone removal procedure. However, those skilled in the art will appreciate that the use of the extraction device 100 is not limited to kidney stone removal procedures, but rather the description is only one of a wide variety of procedures for which the extraction device 100 is suitable.

In some example methods, a suitable path to a kidney stone in the patient's body is established, and appropriate visualization may also be established, such as with a ureteroscope. Thereafter, the extraction device 100 is advanced until the basket 300 reaches the target area where the object 600 to be removed is located. In some exemplary embodiments, this advancement may be accomplished by manually feeding the shaft 200 through a working channel in the ureteroscope.

Upon reaching the object 600, the basket 300 is placed in the open configuration if it is not already in the open configuration (fig. 2). For example, in some cases, it may be desirable to insert the extraction device 100 with the basket 300 in a closed configuration. The extraction device 100 can then be manipulated to position the object 600 (e.g., a kidney stone) at least partially within the basket 300. The actuator 500 may then be operated to proximally withdraw the closure wire 322, which may draw the distal ends 303, 305, 307, 309, 311 together and/or close, thereby at least partially closing the basket distal end opening 301 and/or at least partially capturing the object 600 within the basket 300 (fig. 3). With the object 600 retained within the basket 300, the extraction device 100 may be removed from the patient, thereby removing the object 600 from the patient.

Fig. 4 is a front perspective view of an example extraction device 1100 including a dual mode basket 1300, in accordance with at least some aspects of the present disclosure. The extraction device 1100 can include a shaft 1200, which can be in the form of an elongated, hollow, generally tubular sheath. The shaft 1200 may be generally configured for insertion of its distal end 1201 into a patient and retention of its proximal end 1204 outside the patient. A reconfigurable basket 1300 may be disposed at the distal end 1201 of the shaft 1200. A handle 1400 may be provided at the proximal end 1204 of the shaft 1200. The closure actuator 1500 and/or the retraction actuator 1502 may be movably disposed on the handle 1400 and/or may be operatively coupled to the basket 1300.

Fig. 5-7 are detailed perspective views of an example dual mode basket 1300 in an open configuration, a closed configuration, and a retracted configuration, respectively, in accordance with at least some aspects of the present disclosure. In some example embodiments, the dual mode basket 1300 may be disposed at the distal end 1201 of the shaft 1200. The dual mode basket 1300 may include two or more extension legs 1302, 1304, 1306, 1308 that may be axially (longitudinally) slidably mounted to the shaft 1200 at or near the shaft distal end opening 1202. For example, the extension legs 1302, 1304, 1306, 1308 may be substantially evenly circumferentially spaced apart and/or may be partially disposed within the shaft distal end opening 1202. The extension legs 1302, 1304, 1306, 1308 may be flexible (compare fig. 5 and 7) and/or may be biased to an open configuration (fig. 5). For example, the extension legs 1302, 1304, 1306, 1308 can be formed such that their respective distal ends 1303, 1305, 1307, 1309 are biased generally radially outward (e.g., biased open). In some example embodiments, for example, the extension legs 1302, 1304, 1306, 1308 may be at least partially constructed of spring grade stainless steel and/or nickel titanium alloys (e.g., nitinol) in the superelastic range.

In some example embodiments, the dual mode basket 1300 may include two or more gripper legs 1310, 1312, 1314, 1316 that may extend distally from the distal ends 1303, 1305, 1307, 1309 of the respective extension legs 1302, 1304, 1306, 1308. The gripper legs 1310, 1312, 1314, 1316 may be flexible (compare fig. 5 and 6) and/or may be biased to an open configuration (fig. 5). For example, the gripper legs 1310, 1312, 1314, 1316 may be formed such that their respective distal ends 1311, 1313, 1315, 1317 are biased generally radially outward (e.g., biased open). The gripper legs 1310, 1312, 1314, 1316 may be formed such that their respective distal ends 1311, 1313, 1315, 1317 are biased generally radially outward (e.g., biased open) to form the basket distal opening 1301. In some example embodiments, for example, the gripper legs 1310, 1312, 1314, 1316 may be constructed at least partially from spring grade stainless steel and/or nickel titanium alloys (e.g., nitinol) in the super elastic range.

In some example embodiments, the dual mode basket 1300 may include a closed wire 1322 that extends generally circumferentially around the basket distal opening 1301, such as near the distal ends 1311, 1313, 1315, 1317 of some or all of the gripper legs 1310, 1312, 1314, 1316. The closure wire 1322 may be operatively coupled to some or all of the gripper legs 1310, 1312, 1314, 1316, such as by being slidably attached to the distal ends 1311, 1313, 1315, 1317 in a drawstring (e.g., purse string) manner. For example, the closure wires 1322 may extend generally circumferentially around the basket 1300 in a generally circular path near the distal ends 1311, 1313, 1315, 1317 of the gripper legs 1310, 1312, 1314, 1316 such that when the closure wires 1322 are pulled taut, the distal ends 1311, 1313, 1315, 1317 are drawn together and/or closed, thus at least partially closing the basket distal opening 1301 (fig. 6 and 7).

Referring to fig. 5-7, in some example embodiments, the closing wire 1322 may extend from the gripper legs 1310, 1312, 1314, 1316 through a closing wire guide 1324, which may be disposed on at least one of the extension legs 1302, 1304, 1306, 1308, gripper legs 1310, 1312, 1314, 1316 and/or the shaft 1200, such as near the shaft distal end opening 1202. For example, the closure wire guide 1324 may extend generally distally from the shaft distal end opening 1202 to near the distal end 1315 of the leg 1314. The closure wire guide 1324 may include a closure wire guide distal opening 1325 through which the closure wire 1322 may extend generally circumferentially outward about the distal ends 1311, 1313, 1315, 1317 of the gripper legs 1310, 1312, 1314, 1316. In some example embodiments, the closure wire guide 1324 may be generally tubular (e.g., may have a longitudinal channel therethrough). In some example embodiments, the closure wire guide 1324 may be generally flexible (e.g., generally as flexible as the gripper legs 1310, 1312, 1314, 1316 and/or the extension legs 1302, 1304, 1306, 1308) such that it bends (e.g., radially inward) in the closed configuration (fig. 6) and/or the retracted configuration (fig. 7) as desired.

Fig. 8 is a cross-sectional view of an example shaft 1200 of a dual mode basket 1300 extraction device 1100 in accordance with at least some aspects of the present disclosure. The shaft 1200 may be utilized in some example extraction devices, such as the extraction device 1100 including the dual mode basket 1300. In some example embodiments, the shaft 1200 may include an outer sheath 1206, which may be generally tubular and/or may define a longitudinal lumen 1207 therein. A generally tubular catheter 1208 may be slidably disposed within the lumen 1207 of the outer sheath 1206. The catheter 1208 may be generally tubular and/or may define a longitudinal lumen 1209 therein. The catheter 1208 may be axially (e.g., longitudinally) slidable, such as proximally and distally, relative to the outer sheath 1206. The extension legs 1302, 1304, 1306, 1308 may be mounted to the conduit 1208, such as within the cavity 1209. A closure wire guide 1324 (which may include a closure wire 1322 extending therethrough) may extend within the lumen 1209 of the catheter 1208.

4-8, in some example embodiments, the closure wire 1322 can be operably coupled to the closure actuator 1500 and/or can extend from the handle 1400, extend distally through the shaft 1200, extend distally through the closure wire guide 1324, and extend outwardly through the closure wire guide distal end opening 1325. In some example embodiments, the closure actuator 1500 may be configured for user manipulation (such as by rotating, sliding, and/or pivoting) to extend or withdraw the closure wire 1322 to open and/or close the basket 1300. In some example embodiments, when the basket 1300 is in the open configuration (fig. 5), operating the closure actuator 1500 from the open position toward the closed position may pull the closure wire 1322 proximally through the shaft 1200, which may pull the distal ends 1311, 1313, 1315, 1317 of the gripper legs 1310, 1312, 1314, 1316 radially inward, generally in a drawstring (e.g., purse string) manner, thereby generally reducing and/or at least partially closing the basket distal opening 1301 (fig. 6).

In some example embodiments, operating the closure actuator 1500 from the closed position toward the open position may allow the closure wire 1322 to move distally, which may be tensioned distally by the gripper legs 1310, 1312, 1314, 1316 and/or the opening bias of the extension legs 1302, 1304, 1306, 1308 when the dual mode basket 1300 is in the closed configuration (fig. 6) and/or the retracted configuration (fig. 7). Distal movement of the closure lines 1322 may allow the distal ends 1311, 1313, 1315, 1317 of the gripper legs 1310, 1312, 1314, 1316 to move radially outward, thereby generally circumferentially expanding and/or opening the basket distal opening 1301 (fig. 6).

In some example embodiments, the extension legs 1302, 1304, 1306, 1308 may be axially (longitudinally) slidable relative to the shaft 1200. For example, the extension legs 1302, 1304, 1306, 1308 can be mounted to a conduit 1208, which can be slidably disposed within the shaft 1200 (fig. 8). Referring to fig. 6, in an example extended configuration, the extension legs 1302, 1304, 1306, 1308 can extend distally from the shaft distal end opening 1202. Referring to fig. 7, in an example retracted configuration, the extension legs 1302, 1304, 1306, 1308 may be at least partially contained within the shaft 1202. For example, the extension legs 1302, 1304, 1306, 1308 can be substantially contained within the shaft, with only a relatively short portion near the distal ends 1303, 1305, 1307, 1309 of the respective extension legs 1302, 1304, 1306, 1308 extending distally from the shaft distal end opening 1202.

In some example embodiments, retracting the extension legs 1302, 1304, 1306, 1308 at least partially into the shaft 1202 may cause the distal ends 1303, 1305, 1307, 1309 of the extension legs 1302, 1304, 1306, 1308 to move radially closer together (fig. 7). Extending the extension legs 1302, 1304, 1306, 1308 at least partially out of the shaft 1202 may allow the distal ends 1303, 1305, 1307, 1309 of the extension legs 1302, 1304, 1306, 1308 to move radially farther, such as by the biased open nature of the extension legs 1302, 1304, 1306, 1308 (fig. 5 and 6).

In some example embodiments, the retraction actuator 1502 on the handle 1400 may be repositionable relative to the handle 1400 to extend (fig. 5 and 6) and/or retract (fig. 7) the extension legs 1302, 1304, 1306, 1308 relative to the shaft 1200. Referring to fig. 8, for example, the retraction actuator 1502 may be operatively coupled to a conduit 1208 to which the extension legs 1302, 1304, 1306, 1308 may be mounted. The outer largest dimension of the catheter 1208 may be less than the smallest inner dimension of the sheath 1206, thereby allowing the catheter 1208 to be longitudinally repositionable relative to the sheath 1206. In some example embodiments, the closure wire 1322 may be independently longitudinally repositionable relative to the catheter 1208 and/or the sheath 1206, such as by action of the closure actuator 1500. Similarly, the conduit 1208 may be longitudinally repositionable independently relative to the closure wire 1322 and/or the sheath 1206, such as by action of the retraction actuator 1502. In this manner, movement of the retraction actuator 1502 relative to the handle 1400 is operable to transmit corresponding longitudinal movement to the catheter 1208 within the sheath 1206, which causes corresponding longitudinal movement (extension and/or retraction) of the extension legs 1302, 1304, 1306, 1308. In some example embodiments, the travel of the retraction actuator 1502 may be limited such that its range of motion corresponds to the range of extension and retraction of the extension legs 1302, 1304, 1306, 1308. In other words, the extension legs 1302, 1304, 1306, 1308 can be in the retracted configuration (fig. 7) when the retraction actuator 1502 is at one end of its range of motion, and/or the extension legs 1302, 1304, 1306, 1308 can be in the extended configuration (fig. 5 and 6) when the retraction actuator 1502 is at the other end of its range of motion.

Referring to fig. 4-8, an example method of operating an extraction device 1100 including a dual mode basket 1300 is described. The extraction device 1100, including the dual mode basket 1300, can be utilized to extract various objects 600 from within the interior of an anatomical cavity. As an example, the use of the extraction apparatus 1100 including the dual mode basket 1300 will be explained in the context of a kidney stone removal procedure. However, those skilled in the art will appreciate that the use of the extraction device 1100 including the dual mode basket 1300 is not limited to kidney stone removal procedures, but rather the description is only one of a wide variety of procedures for which the extraction device 1100 including the dual mode basket 1300 is suitable.

In some example methods, a suitable path to a kidney stone in the patient's body is established, and appropriate visualization may also be established, such as with a ureteroscope. Thereafter, the dual mode basket 1300 of the extraction device 1100 is advanced until the dual mode basket 1300 of the extraction device 1100 reaches the target area where the object 600 to be removed is located. In some example embodiments, this advancement may be accomplished by manually feeding the shaft 1200 through a working channel in the ureteroscope.

Upon reaching the object 600, the dual mode basket 1300 is placed in the open configuration if it is not already in the open configuration (fig. 5). For example, in some instances, it may be desirable to insert the extraction device 1100 with the dual mode basket 1300 in a closed configuration and/or a retracted configuration. The extraction device 1100 can then be manipulated to position the object 600 (e.g., a kidney stone) substantially within the dual mode basket 1300 (fig. 5). The closure actuator 1500 may then be operated to proximally withdraw the closure wire 1322, which may draw the distal ends 1311, 1313, 1315, 1317 together and/or close, thereby at least partially closing the basket distal opening 1301 and/or at least partially capturing the object 600 within the dual-mode basket 1300 (fig. 6). The retraction actuator 1502 may then be operated to at least partially retract the extension legs 1302, 1304, 1306, 1308 (fig. 7). With the object 600 retained within the dual mode basket 1300, the extraction device 1100 may be removed from the patient, thereby removing the object 600 from the patient.

Referring to fig. 5, some example embodiments may include one or more webs or walls disposed on one or more of the extension legs 1302, 1304, 1306, 1308 and/or the gripper legs 1310, 1312, 1314, 1316. For example, fig. 5 illustrates a mesh or wall 1312a disposed on the gripper legs 1312, 1314 and a mesh or wall 1302a disposed on the extension legs 1302, 1308. Although the mesh or walls are omitted from the other several figures for clarity and are shown only on some of the extension legs and gripper legs in fig. 5, it is within the scope of the present disclosure to include the mesh or walls on any or all of the extension legs and/or on any or all of the gripper legs. In some example embodiments, the walls and/or mesh (e.g., mesh or walls 1312a, 1302 a) may be constructed from a mesh (e.g., wire mesh) and/or an elastomeric film (e.g., which may be laser cut and/or may be porous).

Fig. 9 is a detailed perspective view of an alternative example basket in the form of a flap gripper 2300 in an open configuration according to at least some aspects of the present disclosure. Fig. 10 and 11 are cross-sectional views of an example flap grasper 2300 in an open configuration and a closed configuration, respectively, in accordance with at least some aspects of the present disclosure. In general, the flap grasper 2300 may be an alternative basket structure that may be utilized in place of the basket 300 in the extraction device 100 (fig. 1).

Referring to fig. 9-11, in some example embodiments, flap grasper 2300 may include two or more flaps 2302, 2304, 2306, 2308. Some example embodiments may include three or more flaps 2302, 2304, 2306, 2308, such as four flaps 2302, 2304, 2306, 2308. For clarity, fig. 10 and 11 illustrate petals 2302 and 2304; however, one skilled in the art will recognize that any other flaps (e.g., flaps 2306, 2308) may operate in substantially the same manner as flaps 2302 and/or 2304. Petals 2302, 2304, 2306, 2308 can be mounted to shaft 200 at or near shaft distal end 201. For example, the petals 2302, 2304, 2306, 2308 can be substantially evenly circumferentially spaced apart at the shaft distal opening 202. The flaps 2302, 2304, 2306, 2308 can be longitudinally slidable (e.g., proximally and/or distally) relative to the shaft 200.

In some example embodiments, the flaps 2302, 2304, 2306, 2308 may be bendable and/or pivotable (compare fig. 10 and 11) and/or biasable to an open configuration (fig. 9 and 10). For example, the flaps 2302, 2304, 2306, 2308 can be formed such that their respective distal tips 2303, 2305, 2307, 2309 are biased generally radially outward (e.g., biased open) to form the grasper distal opening 2301. In some example embodiments, for example, the petals 2302, 2304, 2306, 2308 can be at least partially constructed of a nickel-titanium alloy (e.g., nitinol) in a super elastic range.

Referring to fig. 9, some example embodiments may include walls 2316, 2318 disposed on respective flaps 2306, 2308. For example, the flaps 2306, 2308, which are generally formed as distally extending rings in a flap shape, may have walls 2316, 2318 that are generally disposed circumferentially within the flap rings. In some example embodiments, the walls 2316, 2318 may be constructed of a mesh (e.g., a wire mesh) and/or an elastomeric film (e.g., which may be laser cut and/or may be porous). Referring to fig. 2 and 9, in some example embodiments according to at least some aspects of the present disclosure, the walls 312, 314, 316, 318, 320, 2316, 2318 may partially cover the respective legs 302, 304, 306, 308, 310 and/or the flaps 2302, 2304, 2306, 2308 (see, e.g., wall 2316 in fig. 9) or completely cover the respective legs 302, 304, 306, 308, 310 and/or the flaps 2302, 2304, 2306, 2308 (see, e.g., wall 2318 in fig. 9). It is within the scope of the present disclosure to utilize any of the walls described herein with any of the example embodiments described herein.

Referring to fig. 1, 10, and 11, in some example embodiments according to at least some aspects of the present disclosure, the actuator wire 2322 may extend longitudinally through the shaft 200 from the actuator 500 on the handle 400 to the flap grasper 2300. The actuator wire 2322 may be operatively connected to the actuator 500 and/or the flaps 2302, 2304, 2306, 2308 such that when the actuator 500 is in the open position, the flaps 2302, 2304, 2306, 2308 are in the open configuration (fig. 9 and 10) and/or when the actuator 500 is in the closed position, the flaps 2302, 2304, 2306, 2308 are in the closed configuration (fig. 11). In the closed configuration, the flaps 2302, 2304, 2306, 2308 can be generally drawn together and/or closed, thereby at least partially closing the grasper distal opening 2301.

In some example embodiments, in the fully closed configuration, the flaps 2302, 2304, 2306, 2308 may substantially completely enclose (e.g., encapsulate) the object 600 held within the flap grasper 2300. For example, the distal ends 2303, 2305, 2307, 2309 of the flaps 2302, 2304, 2306, 2308 may substantially contact one another, thereby substantially closing the gripper distal opening 2301. In some example embodiments, the distal ends 2303, 2305, 2307, 2309 of the flaps 2302, 2304, 2306, 2308 can at least partially overlap one another and/or can be locked together in the closed configuration (fig. 11).

In some example embodiments, in the fully closed configuration, the flaps 2302, 2304, 2306, 2308 may partially enclose the object 600 held within the flap grasper 2300. In some example embodiments, in a partially closed configuration (e.g., a configuration between an open configuration and a closed configuration), the flaps 2302, 2304, 2306, 2308 can partially enclose the object 600 held within the flap grasper 2300.

In some example embodiments, when the flap grasper 2300 is in the open configuration (fig. 9 and 10), operating the actuator 500 from the open position toward the closed position may cause the actuator wire 2322 to move proximally, which may be tensioned proximally by the opening bias of the flaps 2302, 2304, 2306, 2308. Proximal movement of the actuator wire 2322 may cause the flaps 2302, 2304, 2306, 2308 to at least partially withdraw into the shaft distal opening 202, thereby contacting the shaft distal opening 202 and causing the flaps 2302, 2304, 2306, 2308 to rotate such that the distal ends 2303, 2305, 2307, 2309 of the flaps 2302, 2304, 2306, 2308 move radially inward, thereby substantially circumferentially reducing and/or closing the grasper distal opening 2301. In some example embodiments, in the closed configuration (fig. 11), the petals 2302, 2304, 2306, 2308 can be at least partially within the shaft 200 and extend at least partially distally from the shaft distal end 201.

In some example embodiments, operating the actuator 500 from the closed position toward the open position may allow the actuator wire 2322 to move distally when the flap grasper 2300 is in the closed configuration (fig. 11), which may be tensioned distally by the opening bias of the flaps 2302, 2304, 2306, 2308. Distal movement of the actuator wire 2322 may allow the distal ends 2303, 2305, 2307, 2309 of the flaps 2302, 2304, 2306, 2308 to move radially outward, thereby generally circumferentially expanding and/or opening the grasper distal opening 2301.

In some example embodiments, the flaps 2302, 2304, 2306, 2308 may be substantially identical to one another and/or may be arranged substantially symmetrically about the shaft distal opening 202. In some example embodiments, one or more of the flaps 2302, 2304, 2306, 2308 can be different from the other flaps and/or can be arranged substantially asymmetrically about the shaft distal opening 202.

Referring to fig. 1 and 9-11, an example method of operating an extraction device 100 including a flap gripper 2300 is described. In some example methods, a suitable path to a kidney stone in the patient's body is established, and appropriate visualization may also be established, such as with a ureteroscope. Thereafter, the extraction device 100 is advanced until the flap gripper 2300 reaches the target area where the object 600 to be removed is located. In some exemplary embodiments, this advancement may be accomplished by manually feeding the shaft 200 through a working channel in the ureteroscope.

Upon reaching object 600, flap gripper 2300 is placed in the open configuration if it is not already in the open configuration (fig. 9 and 10). For example, in some cases, it may be desirable to insert the extraction device 100 with the flap grasper 2300 in a closed configuration. The extraction device 100 can then be manipulated to position the object 600 (e.g., a kidney stone) substantially within the flap grasper 2300. The actuator 500 can then be operated to proximally withdraw the actuator wire 2322, which can cause the flaps 2302, 2304, 2306, 2308 to be at least partially withdrawn into the shaft distal opening 202, thereby contacting the shaft distal opening 202 and causing the flaps 2302, 2304, 2306, 2308 to rotate such that the distal ends 2303, 2305, 2307, 2309 of the flaps 2302, 2304, 2306, 2308 move radially inward, thereby substantially circumferentially reducing and/or closing the grasper distal opening 2301 and/or at least partially capturing the object 600 within the flap grasper 2300 (fig. 11). With the object 600 retained within the flap gripper 2300, the extraction device 100 can be removed from the patient, thereby removing the object 600 from the patient.

In some example embodiments according to at least some aspects of the present disclosure, the shaft 200, 1200 may be manufactured to provide a substantially smooth outer periphery and a hollow interior. For example, the shaft 200, 1200 and/or the outer jacket 1206 may comprise a multi-layer construction that may include a polytetrafluoroethylene (e.g., teflon) outer layer, a polyimide layer, a stainless steel braid layer, and/or a polyimide inner layer, thereby demarcating a hollow interior. The shaft 200, 1200 and/or the outer sheath 1206 may have a substantially constant cross-section or a cross-section that varies along a longitudinal length thereof. Further, the shaft 200, 1200 and/or the outer sheath 1206 may have a circular cross-section, an elliptical cross-section, or any other shape that provides a longitudinal conduit therethrough.

In some example embodiments according to at least some aspects of the present disclosure, the closure wire 322, 1322 and/or the actuator wire 2322 may be at least partially constructed from a wire and/or cable. In some example embodiments, the closure threads 322, 1322 may be at least partially constructed from a suture material.

From the above description and summary of the invention, it should be apparent to those skilled in the art that, although the methods and apparatus described herein constitute example embodiments in accordance with the present disclosure, it will be understood that the scope of the present disclosure contained herein is not limited to the precise embodiments described above, and that changes may be made without departing from the scope. The various features and characteristics described herein are designed to be combined with each other and utilized in conjunction with other embodiments described herein. Likewise, it will be appreciated that it is not necessary to meet any or all of the identified advantages or objects disclosed herein in order to fall within the scope of the present disclosure, since inherent and/or unforeseen advantages may exist even though they may not have been explicitly discussed herein.