Skin lesion exciser and skin-closure device therefor

Abstract

A device for excising tissue and closing a wound that results from excision of the tissue includes structure defining an aperture into which tissue to be excised is exposed. The device also includes a cutting member for excising the tissue, a closure member for closing the wound, and an actuatable drive member associated with the structure. The drive member is actuatable to move the cutting member relative to the aperture for excising the tissue that is exposed in the aperture and for closing the wound with the closure member.

1 . A device for excising tissue and closing a wound that results from excision of the tissue, the device comprising:
 structure defining an aperture for completely framing tissue to be excised;   a cutting member for excising the tissue;   a closure member for closing the wound; and   an actuatable drive member associated with the structure, the drive member being actuatable to move the cutting member relative to the aperture for excising the tissue that is framed by the aperture and for closing the wound with the closure member.   
     
     
         2 . The device of  claim 1  wherein the drive member moves the cutting member relative to the structure defining the aperture and closes the wound with the closure member at a location adjacent the structure defining the aperture. 
     
     
         3 . The device of  claim 1  wherein the drive member includes first and second portions, the first portion of the drive member supporting the cutting member and the second portion of the drive member moving the closure member from an open condition to a closed condition, the closure member, when in the closed condition, closing the wound. 
     
     
         4 - 8 . (canceled) 
     
     
         9 . The device of  claim 3  wherein the first portion of the drive member moves the cutting member relative to the structure defining the aperture so that the structure guards against cutting any tissue other than the tissue that is framed by the aperture. 
     
     
         10 - 11 . (canceled) 
     
     
         12 . The device of  claim 1  wherein the drive member moves the cutting member relative to the structure defining the aperture so that only the tissue that is framed by the aperture is cut. 
     
     
         13 . The device of  claim 1  wherein the drive member includes first and second portions, the first portion of the drive member supporting the cutting member and the second portion of the drive member moving the closure member from an open condition to a closed condition in which the closure member closes the wound, the second portion of the drive member surrounding the structure defining the aperture. 
     
     
         14 . (canceled) 
     
     
         15 . The device of  claim 1  wherein the drive member supports the cutting member, the drive member beginning to move the closure member toward the closed condition prior to excising the tissue that is framed by the aperture with the cutting member. 
     
     
         16 . The device of  claim 1  wherein a single actuator handle is attached to the drive member, the drive member being actuated in response to movement of the single actuator handle relative to the structure defining the aperture. 
     
     
         17 . The device of  claim 1  wherein first and second actuator handles are attached to opposite ends of the drive member, the drive member being actuated in response to movement of the first and second actuator handles toward one another. 
     
     
         18 . The device of  claim 1  wherein the closure member includes a planar body portion, the body portion including first and second retaining portions and a deformable portion that connects the first and second retaining portions, the closure member having an open condition in which the deformable portion spaces the first and second retaining portions apart from one another and a closed condition in which the deformable portion is elastically deformed to bring the first and second retaining portions together to close the wound, the body portion of the closure member being planar in both the open and closed conditions. 
     
     
         19 . The device of  claim 18  wherein the closure member further includes first and second sets of tines, the first set of tines extending outwardly of the first retaining portion and the second set of tines extending outwardly of the second retaining portion, at least one of the first and second sets of tines including skin-piercing portions that, when the closure member is in the closed condition, engage tissue adjacent the wound to secure the body portion of the closure member relative to the tissue. 
     
     
         20 . The device of  claim 19  wherein the first and second sets of tines are located within a plane of the body portion of the closure member. 
     
     
         21 . A method for excising tissue and closing a wound that results from excision of the tissue, the method comprising the steps of:
 framing the tissue to be excised with an aperture formed in a structure;   moving a portion of a drive member over a first distance to move a closure member into engagement with the tissue that is framed by the aperture;   moving the drive member over a second distance beyond the first distance so as to move a cutting member relative to the aperture for excising the tissue that is framed by the aperture; and   moving the drive member over a third distance beyond the second distance after the tissue is at least partially excised, for closing the wound with the closure member.   
     
     
         22 . The method of  claim 21  wherein the steps of moving the drive member each include the steps of:
 engaging a single actuator handle associated with the drive member; and   moving the single actuator handle relative to the structure.   
     
     
         23 . The method of  claim 21  wherein the steps of moving the drive member each include the steps of:
 engaging a first actuator handle associated with a portion of the drive member located on a first side of the aperture;   engaging a second actuator handle associated with a portion of the drive member located on a second side of the aperture; and   moving the first and second actuator handles together.   
     
     
         24 . A method for excising tissue and closing a wound that results from excision of the tissue, the method comprising the steps of:
 completely framing the tissue to be excised with an aperture formed in a structure;   moving a portion of a drive member over a first distance to move a closure member into a closed condition for clamping the tissue that is framed by the aperture;   moving the drive member over a second distance beyond the first distance so as to move a cutting member relative to the aperture for excising the tissue that is framed by the aperture.   
     
     
         25 . The method of  claim 24  wherein the steps of moving the drive member each include the steps of:
 engaging a single actuator handle associated with the drive member; and   moving the single actuator handle relative to the structure.   
     
     
         26 . The method of  claim 24  wherein the steps of moving the drive member each include the steps of:
 engaging a first actuator handle associated with a portion of the drive member located on a first side of the aperture;   engaging a second actuator handle associated with a portion of the drive member located on a second side of the aperture; and   moving the first and second actuator handles together.   
     
     
         27 . An exciser for excising tissue, the exciser comprising:
 structure defining an aperture into which tissue to be excised is exposed;   a cutting member for excising the tissue;   an actuatable drive member associated with the structure, the drive member being actuatable to move the cutting member relative to the aperture for excising the tissue that is exposed in the aperture; and   an actuator handle associated with the drive member, movement of the actuator handle relative to the structure actuating the drive member.   
     
     
         28 . The exciser of  claim 27  wherein the drive member moves the cutting member relative to the structure defining the aperture so that only the tissue that is exposed in the aperture is cut. 
     
     
         29 . The exciser of  claim 27  wherein the drive member includes a support portion for supporting the cutting member, the actuator handle being fixedly attached to the support portion so that the cutting member is interposed between the support portion and the actuator handle. 
     
     
         30 . The exciser of  claim 29  wherein the drive member further includes an end wall that is spaced from the support portion and a pair of collapsible legs that connect the support portion and the end wall, the cutting member, when attached to the support portion extending outwardly of the support portion and toward the end wall, movement of the actuator handle causing the pair of collapsible legs to collapse and moving the support portion toward the endwall, the cutting member excising the tissue that is exposed in the aperture during movement of the support portion toward the end wall. 
     
     
         31 . The exciser of  claim 30  further including a top plate that overlies the base plate to form a housing, the drive member being located in the recess of the base plate and between the base plate and the top plate, the actuator handle being located on a side of the top plate opposite the base plate, the top plate including an elongated slot through which the actuator handle is attached to the drive member, movement of the actuator handle through the slot of the top plate actuating the drive member. 
     
     
         32 . The exciser of  claim 31  wherein the cutting member is also located between the base plate and the top plate, the cutting member engaging only the tissue that is exposed in the aperture of the structure. 
     
     
         33 . The exciser of  claim 27  wherein the actuator handle is a first actuator handle and wherein the exciser further includes a second actuator handle, the second actuator handle being located on a side of the aperture opposite the first actuator handle, the drive member being actuated in response to movement of the first and second actuator handles toward one another. 
     
     
         34 . A method of excising tissue, the method comprising the steps of:
 exposing tissue into an aperture defined in a structure;   supporting a cutting member on an actuatable drive member that is movable relative to the structure;   associating an actuator handle to the drive member; and   moving the actuator handle to actuate the drive member to move the cutting member relative to the aperture for excising the tissue that is exposed in the aperture.   
     
     
         35 . A closure member for clamping tissue adjacent a wound, the closure member comprising:
 a planar body portion including first and second retaining portions and a deformable portion that connects the first and second retaining portions, the closure member having an open condition in which the deformable portion spaces the first and second retaining portions apart from one another so that the tissue to be clamped may be placed between the first and second retaining portions, the closure member also having a closed condition in which the deformable portion is elastically deformed to bring the first and second retaining portions together to clamp the tissue between the first and second retaining portions, the body portion of the closure member being planar in both the open and closed conditions, the closure member further including a first set of tines that extends outwardly of the first retaining portion and a second set of tines that extends outwardly of the second retaining portion, the first and second sets of tines engaging the tissue to secure the body portion to the tissue when the closure member is in the closed condition.   
     
     
         36 . The closure member of  claim 35  wherein the first set of tines includes multiple tissue engaging members and wherein the second set of tines also includes multiple tissue engaging members. 
     
     
         37 . The closure member of  claim 35  wherein the first and second sets of tines are located within a plane of the body portion. 
     
     
         38 . The closure member of  claim 35  wherein the first and second sets of tines are positioned relative to one so as to mesh together when the closure member is in the closed condition. 
     
     
         39 . The closure member of  claim 35  wherein the deformable portion includes multiple deformation zones, a width, measured in the plane of the body portion, of the material within the deformation zones being less than a material thickness of the body portion, measured in a direction perpendicular to the plane of the body portion. 
     
     
         40 . The closure member of  claim 35  further including structure for locking the closure member in the closed condition. 
     
     
         41 . The closure member of  claim 40  wherein the structure for locking the closure member in the closed condition includes first and second toothed members, the first and second toothed members meshing together when the closure member is in the closed condition. 
     
     
         42 . The closure member of  claim 35  wherein the deformable portion is a first deformable portion and the closure member also includes a second deformable portion, the first deformable portion connecting a first end of the first retaining portion to a first end of the second retaining portion, the second deformable portion connecting a second end of the first retaining portion to a second end of the second retaining portion. 
     
     
         43 . The closure member of  claim 42  wherein an oblong opening is defined in the closure member when the closure member is in the open condition, the oblong opening being adapted for accepting tissue and having a length that is defined between the first and second deformable portions and a width that is defined between the first and second retaining portions, the length of the oblong opening being greater than the width of the oblong opening. 
     
     
         44 . The closure member of  claim 35  wherein the closure member is formed from a polymeric material that degrades after a predetermined time period for releasing the closure member from the tissue. 
     
     
         45 . The closure member of  claim 35  wherein the body portion remains planar during movement between the open and closed conditions. 
     
     
         46 . The method of  claim 21  wherein the closure member further includes at least one skin-piercing portion adapted to engage tissue adjacent the wound to secure the closure member relative to the tissue when the closure member is closing the wound. 
     
     
         47 . A device for excising tissue and closing a wound that results from excision of the tissue, the device comprising:
 structure defining a completely framing aperture into which tissue to be excised is exposed, the aperture being in contact with the tissue to limit at least one of a size and a shape of the tissue;   a cutting member for excising the tissue;   a closure member for closing the wound; and   an actuatable drive member associated with the structure, the drive member being actuatable to move the cutting member relative to the aperture for excising the tissue that is exposed in the aperture and for closing the wound with the closure member.   
     
     
         48 . The device of  claim 47 , including a housing member within which the closure member is at least partially located and wherein the structure defining an aperture is associated with at least one of the closure member and the housing. 
     
     
         49 . The device of  claim 47 , wherein the tissue is pulled through the aperture and the aperture limits at least one of a size and a shape of the tissue at least partially by resisting tension resulting from the pulling of the tissue through the aperture.