Systems, devices and methods for tissue removal and analysis

Abstract

Systems, devices, and methods for performing tissue removal and analysis based on the in-situ optical analysis of tissue and liquid collected from a tissue region. A tissue removal and analysis probe involves an elongate tissue removal device, an optical fiber, and a fluid fillable conduit, wherein distal ends of the optical fiber and the conduit are in communication with an external region that is adjacent to a distal functional portion of the tissue removal device. The optical analysis results of at least one of external tissue and collected fluid is employed to determine whether tissue removal is to be performed. Various devices are interfaced with the conduit for optical analysis of the collected fluid. The tissue removal device is movable relative to the optical fiber and conduit.

What is claimed: 
     
         1 . A tissue removal and optical detection probe, the probe comprising:
 an optical fiber configured to optically interrogate a tissue sample, the optical fiber having a distal end in optical communication with an external region; and   a conduit having a distal aperture in fluid communication with the external region for collecting a fluid sample from a tissue sample,   the optical fiber externally spaced away, and parallel, in relation to the conduit,   the conduit coupled with a flow mechanism for drawing the fluid sample therein by one of passively collecting the fluid sample using a capillary action and actively collecting the fluid sample using a pumping action, the flow mechanism comprising a fluid processing device, the fluid processing device comprising a microfluidic device, the microfluidic device comprising a plurality of channels performing a plurality of distinct preprocessing functions prior to analytical interrogation, the plurality of distinct preprocessing functions comprising at least one of separation, extraction, assay, and lysis, and   the conduit coupled with an optical detection subsystem, the optical detection subsystem configured to optically interrogate the fluid sample collected in the conduit, whereby the fluid sample forms an optical waveguide.   
     
     
         2 . The probe of  claim 1 , wherein the conduit comprises one of a hollow optical fiber and a photonic crystal fiber. 
     
     
         3 . The probe of  claim 1 , wherein each channel of the plurality of channels comprises a dimension in a range of up to approximately 1 mm. 
     
     
         4 . The probe of  claim 1 , further comprising an elongate tissue removal device having a distal portion comprising a sampling region, the sample region having the external region, the external region configured to contact the tissue sample. 
     
     
         5 . The probe of  claim 1 , wherein at least one of the fluid-Tillable conduit and the optical fiber is retractable relative to the distal portion. 
     
     
         6 . The probe of  claim 4 , wherein the elongate tissue removal device comprises: a cannula having sampling region configured to receive a tissue sample at the distal portion; and a cutting mechanism associated with the cannula for cutting tissue received within the sampling region. 
     
     
         7 . The probe of  claim 6 , wherein the cannula is configured to couple with a suction mechanism for drawing tissue into the sampling region. 
     
     
         8 . The probe of  claim 1 ,
 wherein one distinct preprocessing function of the plurality of distinct preprocessing functions comprises lysis, and   wherein the lysis comprises one of mechanical lysis, electrical lysis, and ultrasonic lysis.   
     
     
         9 . A method of performing tissue removal, based on optical tissue analysis, using a tissue removal and analysis probe, the method comprising:
 providing the probe, providing the probe comprising:
 providing an optical fiber configured to optically interrogate a tissue sample, providing the optical fiber comprising providing the optical fiber with a distal end in optical communication with an external region; and 
 providing a conduit having a distal aperture in fluid communication with the external region for collecting a fluid sample from a tissue sample, 
 providing the optical fiber comprising disposing the optical as externally spaced away, and parallel, in relation to the conduit, 
 providing the conduit comprising coupling the conduit with a flow mechanism for drawing the fluid sample therein by one of passively collecting the fluid sample using a capillary action and actively collecting the fluid sample using a pumping action, the flow mechanism comprising a fluid processing device, the fluid processing device comprising a microfluidic device, the microfluidic device comprising a plurality of channels performing a plurality of distinct preprocessing functions prior to analytical interrogation, each channel of the plurality of channels having a dimension in a range of up to approximately 1 mm, the plurality of distinct preprocessing functions comprising at least two of separation, extraction, assay, and lysis, and 
 providing the conduit comprising coupling the conduit with an optical detection subsystem, the optical detection subsystem configured to optically interrogate the fluid sample collected in the conduit, whereby the fluid sample forms an optical waveguide; 
   positioning a distal portion of the probe adjacent a tissue region;   collecting, within the conduit, the fluid sample from the tissue region;   directing first incident optical energy into the optical fiber and detecting first received optical energy responsively produced within the tissue region, thereby obtaining first received signals; and   directing second incident optical energy into the fluid collected by the conduit and detecting second received optical energy responsively produced within the fluid sample, thereby obtaining second received signals;   processing the first received signals and the second received signals to determine whether one more pre-selected criteria are met; and   in the event that the one or more criteria are satisfied, employing a tissue removal device to perform tissue removal.   
     
     
         10 . The method of  claim 9 , wherein providing the conduit comprises providing one of a hollow optical fiber and a photonic crystal fiber. 
     
     
         11 . The method of  claim 9 , wherein providing the conduit, each channel of the plurality of channels comprises a dimension in a range of up to approximately 1 mm. 
     
     
         12 . The method of  claim 9 , further comprising providing an elongate tissue removal device having a distal portion comprising a sampling region with an external region configured to contact a tissue sample of a patient. 
     
     
         13 . The method of  claim 9 , wherein at least one of providing the conduit and providing the optical fiber respectively comprises providing the conduit and providing the optical fiber as retractable relative to the distal portion. 
     
     
         14 . The method of  claim 12 , wherein providing the elongate tissue removal device comprises:
 providing a cannula having sampling region configured to receive a tissue sample at the distal portion; and   providing a cutting mechanism associated with the cannula for cutting tissue received within the sampling region.   
     
     
         15 . The method of  claim 14 , wherein providing the cannula comprises configuring the cannula to couple with a suction mechanism for drawing tissue into the sampling region. 
     
     
         16 . The method of  claim 9 ,
 wherein one distinct preprocessing function of the plurality of distinct preprocessing functions comprises lysis, and   wherein the lysis comprises one of mechanical lysis, electrical lysis, and ultrasonic lysis.   
     
     
         17 . A method of providing a tissue removal and optical detection probe, the method comprising providing the probe, providing the probe comprising:
 providing an optical fiber configured to optically interrogate a tissue sample, providing the optical fiber comprising providing the optical fiber with a distal end in optical communication with an external region; and   providing a conduit having a distal aperture in fluid communication with the external region for collecting a fluid sample from a tissue sample,   providing the optical fiber comprising disposing the optical as externally spaced away, and parallel, in relation to the conduit,   providing the conduit comprising coupling the conduit with a flow mechanism for drawing the fluid sample therein by one of passively collecting the fluid sample using a capillary action and actively collecting the fluid sample using a pumping action, the flow mechanism comprising a fluid processing device, the fluid processing device comprising a microfluidic device, the microfluidic device comprising a plurality of channels performing a plurality of distinct preprocessing functions prior to analytical interrogation, each channel of the plurality of channels having a dimension in a range of up to approximately 1 mm, the plurality of distinct preprocessing functions comprising at least two of separation, extraction, assay, and lysis, and   providing the conduit comprising coupling the conduit with an optical detection subsystem, the optical detection subsystem configured to optically interrogate the fluid sample collected in the conduit, whereby the fluid sample forms an optical waveguide.   
     
     
         18 . The method of  claim 17 , further comprising providing an elongate tissue removal device having a distal portion comprising a sampling region, the sampling region having the external region, the external region configured to contact the tissue sample. 
     
     
         19 . The method of  claim 18 , further comprising providing a body portion configured to robotically support the elongate tissue removal device,
 wherein providing the conduit comprises providing one of: a hollow optical fiber and a photonic crystal fiber,   wherein providing the optical fiber comprises configuring the optical fiber as retractable relative to the distal portion,   wherein providing the conduit comprises configuring the fluid-Tillable conduit as retractable relative to the distal portion,   wherein providing the elongate tissue removal device comprises: providing a cannula having sampling region configured receive a tissue sample at the distal portion; and providing a cutting mechanism associated with the cannula for cutting tissue received within the sampling region, and   wherein providing the cannula comprises configuring the cannula to couple with a suction mechanism for drawing tissue into the sampling region.