Patent Publication Number: US-2019183600-A1

Title: Device for anchoring and identifying multiple suspected lesions anchoring devices

Description:
The present invention relates to a radiological and surgical device, and more particularly a device for anchoring and registering pulmonary nodules in order for them to be surgically removed, and a placement apparatus. 
     Lung cancer is a cancer affecting a large number of patients and reflecting the highest mortality rate. The use of biopsy for histological diagnosis has therefore become an essential procedure and all the more so given that the rate of malignancy in pulmonary nodules is very high. The biopsies are traditionally performed by transbronchial pathway or by percutaneous pathway using fine needles under a scanner. However, the increasingly early screening of the nodules and their geography can limit these traditional biopsy techniques making surgical intervention de facto necessary. 
     When surgery is possible, there are two techniques: thoracotomy and thoracoscopy. 
     Thoracotomy consists in making a surgical incision in the thoracic wall. The surgery may require the opening of the thorax or simply an incision between the sides. This so-called “open” surgery is invasive and difficult for the patient to withstand. 
     Thoracoscopy is a minimally invasive surgery of the thorax. It is a so-called “video-assisted” surgery involving making several small incisions (approximately 2 cm long) using long and fine instruments. The light and the vision are supplied by an optical device introduced through one of these incisions. This latter technique is therefore very advantageous but necessarily requires the nodule or nodules that have to be removed to be located and registered beforehand. 
     The registering of the nodules is thus entrusted, prior to the surgical act, to radiologists, who have recourse to preoperative registration techniques more often than not using a spear placed, under tomodensitometric control, in proximity to the nodules being removed. 
     Currently, most of the spears used in a pulmonary nodule registration procedure have been designed to register lesions and microcalcifications of the breast and are not suited for use in thoracoscopy. Indeed, to be put in place by the radiologist in total safety under tomodensitometric control and to provide reliable registration to the surgeon during the ablation, the registration system must first of all include a placement apparatus in which the outer diameter of the needle is suited to the surgical constraints, preferably less than 1.25 mm (18 gauge), and in particular in order to reduce the risks of pneumothorax; the system must then be able to adapt to the movements of amplitude induced by the inflation and the deflation of the lung and of the thoracic cage during the ventilation phases imposed by the thoracoscopy; this is in order to ensure the durability of the anchoring in the tissues throughout the procedure. Finally the device must offer an exceptional quality of anchoring in the pulmonary tissues whose very composition and texture make any catching difficult, and to do so in order to avoid any risk of migration of the device and therefore of loss of registration before and during the surgery. 
     An example of a known anchoring device is described in the document FR 2 731 343 A. This anchoring device comprises a sleeve of which one end is secured to a wire and the other, opposite end is secured to a strand of circular or rectangular section suitable for being anchored in the breast tissues to register a nodule. To secure the strand inside the sleeve, the strand is crimped in the sleeve so as to secure them to one another. The anchoring device can comprise several strands crimped inside the sleeve. In the latter case, the dimensions of the sleeve must be adapted to accommodate all of the strands. As indicated above, such an anchoring device is not however suited for use in thoracoscopy. Indeed, it has been found that by using such an anchoring device having dimensions suited to thoracoscopy, that is to say when it comprises only a single strand, its anchoring capacity is too weak such that the anchoring device has a tendency to migrate. 
     There is therefore a need for a device for anchoring and registering pulmonary nodules for the surgical ablation thereof having dimensions suited to thoracoscopy, also capable of absorbing the amplitudes associated with thoracoscopy and finally having an anchoring capacity suited to the structure of the pulmonary tissues making it possible to avoid the migration of the anchoring device before and during the surgery. 
     For that, the invention relates to an anchoring device for registering lesions or microcalcification in a biological tissue, comprising:
         a guide wire,   at least two anchoring members for anchoring in a biological tissue connected to the guide wire, and   a connecting ring connecting the guide wire to the anchoring members, in which each anchoring member comprises a connecting end extending along a longitudinal axis and configured to be arranged inside the connecting ring, each connecting end having a transverse section forming an angular segment, the sum of the angular segments being equal to or less than 360° in one and the same plane transversal to the longitudinal axis.       

     This configuration of the anchoring device makes it possible to produce the connection of a plurality of anchoring members inside a connecting ring having dimensions similar to those used when the anchoring device comprises a single anchoring member. In other words, this configuration makes it possible to reduce the bulk of the anchoring members inside the connecting ring. Now, increasing the number of anchoring members makes it possible to improve the anchoring capacity of the device. Thus, the anchoring capacity of the anchoring device can be improved while having an anchoring device whose dimensions are conformal with thoracoscopy. 
     According to an embodiment of the anchoring device, the connecting ends are complementary to one another so as to form a circular section when the connecting ends are arranged in contact with one another. 
     According to an embodiment of the anchoring device, each connecting end comprises an outer surface in contact with the connecting ring and at least one inner surface arranged in contact with at least one other connecting end. 
     According to an embodiment of the anchoring device, the outer surface is curved and the inner surface is planar. 
     According to an embodiment of the anchoring device, the anchoring members comprise an anchoring portion formed in the extension of the connecting end, the anchoring portion comprising at least one planar surface extending transversely to the longitudinal axis. 
     According to an embodiment of the anchoring device, the anchoring members comprise, at an end opposite the connecting end, a leading edge for perforating the biological tissue, formed by at least one facet. 
     According to an embodiment of the anchoring device, each anchoring member is configured to be arranged in:
         a first position in which the anchoring member has a configuration making it possible to insert the anchoring member into a biological tissue, and   a second position in which the anchoring member has a configuration making it possible to retain the anchoring member in a biological tissue.       

     According to an embodiment of the anchoring device, the anchoring members are configured to extend in different directions from one another when the anchoring members are each arranged in their second position. 
     According to an embodiment of the anchoring device, the anchoring members are each produced in an elastic material allowing the anchoring members to be deformed between the first and second positions. 
     According to an embodiment of the anchoring device, the latter further comprises an abutment forming a bearing surface for the longitudinal driving of the anchoring device. 
     According to an embodiment of the anchoring device, the guide wire comprises at least one graduated portion for determining the anchoring depth of the anchoring device. 
     According to an embodiment of the anchoring device, the graduated portion is planar. 
     According to an embodiment of the anchoring device, the graduated portion comprises a local widening of the transverse section of the wire forming the abutment. 
     According to an embodiment of the anchoring device, the graduated portion is arranged at a predetermined length from the connecting ring. 
     The invention relates also to an anchoring system for registering lesions or microcalcification in a biological tissue, comprising:
         a hollow positioning needle,   an anchoring device according to any one of the preceding claims configured to slide inside the hollow positioning needle,   a mandrel configured to slide inside the hollow positioning needle so as to drive the anchoring members out of the hollow positioning needle.       

     According to an embodiment of the anchoring system, at least one out of the two anchoring members of the anchoring device comprises a transverse section equal to or less than half the inner diameter of the hollow positioning needle. 
     According to an embodiment of the anchoring system, the mandrel comprises a through-hole allowing the mandrel to slide around and along the guide wire of the anchoring device. 
     According to an embodiment of the anchoring system, the mandrel is configured to drive the anchoring members by bearing on the abutment. 
     According to an embodiment of the anchoring system, the hollow positioning needle is configured to arrange the anchoring members in the first position when the anchoring members are arranged inside the hollow positioning needle, the anchoring members being configured to be deformed in order to adopt the second position once driven out of the hollow positioning needle. 
    
    
     
       Other features and advantages of the invention will become apparent on reading the following description of preferred embodiments of the invention, given by way of example and with reference to the attached drawings. 
         FIG. 1  represents a perspective view of an anchoring system comprising a mandrel and an anchoring device arranged inside a hollow needle. 
         FIG. 2  represents a perspective view of the mandrel out of the hollow needle. 
         FIG. 3  represents a front view of the anchoring device of  FIG. 1  out of the hollow needle. 
         FIGS. 4 and 5  represent a perspective view of an embodiment of an anchoring member of the anchoring device of  FIGS. 1 and 3 . 
         FIG. 6  represents a perspective view of another embodiment of an anchoring member of the anchoring device of  FIGS. 1 and 3 . 
     
    
    
     As represented in  FIG. 1 , an anchoring system  10  for registering lesions or microcalcification in a biological tissue comprises a hollow positioning needle  2  and an anchoring device  4  configured to slide inside the hollow positioning needle  2 . The anchoring system  10  also comprises a mandrel  3  configured to slide inside the hollow positioning needle  2  so as to drive the displacement of the anchoring device  4  out of the hollow positioning needle  2 . The displacement of the anchoring device  4  by the mandrel  3  is done by sliding along the hollow positioning needle  2 . 
     To allow the sliding of the mandrel  3  and of the anchoring device  4  inside the hollow positioning needle  2 , the latter forms a longitudinally-extending through-hole  22 . The hollow positioning needle  2  comprises a perforation end  23  configured to perforate one or more types of tissues. In particular, the perforation end  23  is bevelled so as to form a point capable of perforating the tissues. The perforation end  23  constitutes an end for the anchoring device  4  to enter when it is mounted in the hollow positioning needle  2  and for the anchoring device  4  to exit from the hollow positioning needle  2  when it is driven by the mandrel  3 . The hollow positioning needle  2  also comprises an end  24  for insertion of the mandrel  3 . The insertion end  24  is opposite the perforation end  23 . The through-hole  22  extends between the perforation  23  and insertion  24  ends. The hollow positioning needle  2  extends preferably over a length between 100 mm and 150 mm. The inner diameter of the hollow positioning needle  2  is preferably equal to or less than 0.95 mm. For the manipulation of the anchoring system  10 , the hollow positioning needle  2  also comprises a handle  21  arranged at the insertion end  24 . The handle  21  is configured to receive, on either side of the handle, two fingers of a user to produce a force for retaining the hollow positioning needle  2  when the mandrel  3  is pushed inside the hollow positioning needle  2 . Preferably, the user places his index and middle fingers under the handle  21  so as to actuate the mandrel  3  with his or her thumb, like a syringe. The handle  21  is for example overmoulded around a needle body  25  forming the through-hole  22 . Preferably, the handle  21  is made of plastic material and the needle body  25  is made of metal material. 
     The needle body  25  is preferably of circular section. Alternatively, the needle body  25  can be of any section, for example rectangular, square or oval. 
     As represented in  FIG. 2 , the mandrel  3  comprises a mandrel body  31  and a plunger  33  mounted on the mandrel body  31 . The plunger  33  is preferably overmoulded on the mandrel body  31 . More preferably, the mandrel body  31  is produced in a metal material and the plunger  33  is produced in a plastic material. The plunger  33  is configured such that the finger of a user can act on a distal portion of the plunger  33  so as to drive the anchoring device  4 . Thus, in combination with the handle  21 , the anchoring system  10  can be used with the use of only three fingers, preferably the middle finger, the index finger and the thumb, like a syringe. The anchoring system  10  is thus simple to use because it is configured to be used with the use of only one hand. 
     The mandrel  3  also comprises a driving end  32  capable of cooperating with an abutment of the anchoring device  4  to drive the sliding of the anchoring device  4  inside the hollow positioning needle  2 . 
     As represented in  FIG. 3 , the anchoring device  4  also comprises a guide wire  7  and two anchoring members  5  for anchoring in a biological tissue connected to the guide wire  7 . The two anchoring members  5  are assembled at one end of the guide wire  7  using a connecting ring  6 . In particular, an end of the guide wire  7  is crimped inside an end of the connecting ring  6 . Likewise, an end of each of the anchoring members  5  is crimped inside the ring at an end of the connecting ring  6  opposite the guide wire  7 . Thus, the guide wire  7 , the connecting ring  6  and the anchoring members  5  form an integral assembly. 
     This integral assembly formed by the guide wire  7 , the connecting ring  6  and the anchoring members  5  is intended to be inserted inside the hollow positioning needle  2  and the mandrel  3  to be introduced into the tissues of a patient. Alternatively, the guide wire  7 , the connecting ring  6  and the anchoring members  5  can be assembled together by any means allowing this integral assembly to be inserted into the mandrel  3 . 
     The guide wire  7  comprises at least three portions, a proximal portion  73  intended to be crimped in the connecting ring  6 , the graduated portion  72  configured for centimetric marking and whose outer diameter is greater than the outer diameter of the proximal portion  73  and greater than the inner diameter of the body of the mandrel  31 , and a distal portion  71  configured to slide in the body of the mandrel  31 . The guide wire  7  preferably corresponds to a flexible wire whose intermediate portion between its ends is flattened to form the graduated portion  72 . “Flexible” is understood to mean the fact that the wire can be wound on itself so as to form a loop of a diameter less than 10 cm, preferably less than 6 cm, without plastic deformation of the wire. As an example, the flexible wire can be made of polymer material, such as biocompatible polyamide. The wire can also be metal and braided, i.e. composed of several strands interwoven with one another. Of the three portions of the guide wire  7 , at least the graduated portion  72  of the guide wire  7  is flexible. As a comparison, a “rigid” wire corresponds to a solid metal wire of the same outer diameter. 
     The guide wire  7  comprises at least one graduated portion  72  for determining the anchoring depth of the anchoring device  4 . For that, said graduated portion comprises graduations  74 , for example centimetric, formed on the graduated portion  72 . Furthermore, the graduated portion  72  is arranged at a predetermined length from the connecting ring  6 . When the anchoring device  4  is arranged inside the biological tissues, the guide wire  7  extends out of the incision made for the insertion of the anchoring device  4 . In particular, the guide wire  7  is configured such that the graduated portion  72  extends out of this incision such that the surgeon can know the anchoring depth of the anchoring device  4 . Preferably, the graduated portion  72  is planar or comprises a planar graduated surface to facilitate the production of the graduation  74 . The graduated portion  72  is preferably produced by a localized flattening of the guide wire  7  to obtain a planar graduated portion  72 . The guide wire  7  can comprise a plurality of graduated portions  72  to form a discontinuous graduation zone. In the latter case, each graduated portion  72  can comprise one or more graduations  74  while retaining a predefined distance between each graduation  74 . 
     The guide wire  7  also comprises an abutment  75  forming a bearing surface for the longitudinal driving of the anchoring device  4 . The abutment  75  forms a protuberance transversal to the direction of extension of the guide wire  7 . When the anchoring device  4  is arranged inside the hollow positioning needle  2  with the mandrel  3  mounted on the distal portion  71  of the guide wire  7 , this protuberance is configured to form a longitudinal bearing abutment for the driving end  32  so as to drive the anchoring device  4  inside the hollow positioning needle  2 . Thus, the mandrel  3  is preferably arranged around the guide wire  7  in an upper part of the guide wire  7  arranged above the abutment  75 . 
     The abutment  75  is preferably produced by the graduated portion  72 . In effect, the graduated portion  72  can comprise a local widening of the transverse section of the guide wire  7  forming the abutment  75 . The abutment  75  is preferably produced by an end of the graduated portion  72 . When the guide wire  7  is flattened, a local increase in a transverse dimension of the guide wire  7  is generated to form the abutment  75 . To allow the abutment  75  to perform its function of bearing abutment, this dimension transversal to the direction of extension of the wire is greater than the inner diameter of the mandrel body  31 . For the sliding of the anchoring device  4  inside the hollow positioning needle  2 , this transverse dimension is also less than the inner diameter of the needle body  25 . 
     The guide wire  7  is produced in a flexible material used for suturing threads, preferably made of biocompatible polyamide. Thus, the guide wire  7  makes it possible not to injure the patient while he or she is breathing and to exert no force on the anchoring device  4  and therefore reduce the risks of migration. The production of a graduated portion  72  in the material of the guide wire  7  makes it possible to conserve its advantages while providing information to the surgeon on the anchoring depth. 
     The dimensions of the mandrel  3  are configured to allow the mandrel  3  to be arranged inside the hollow positioning needle  2 , between the anchoring device  4  and the hollow positioning needle  2 . For that, the outer diameter of the mandrel body  31  is less than the inner diameter of the needle body  25  and the inner diameter of the mandrel body  31  is greater than the outer diameter of the distal portion  71  of the guide wire  7  of the anchoring device  4  while being less than the transverse section of the abutment  75  of the guide wire  7 . The mandrel body  31  is preferably of circular section. Alternatively, the mandrel body  31  can be of any section allowing the mandrel  3  to slide inside the hollow positioning needle  2  and, at the distal portion  71  of the guide wire  7  of the anchoring device  4 , to slide inside the mandrel  3 . 
     Each anchoring member  5  is configured to be arranged in a first or a second position. In the first position, the anchoring member  5  has a configuration making it possible to insert the anchoring member  5  into a biological tissue. In other words, the anchoring member  5  is configured to be arranged in an extended position allowing it to be inserted into the hollow positioning needle  2 . The hollow positioning needle  2  can therefore be inserted into the biological tissues of the patient with the anchoring member  5  arranged within it. In this first position, the anchoring member  5  does not itself perforate the biological tissues of the patient. The first position can thus be qualified as inactive or as position of non-retention of the biological tissues. In the second position, the anchoring member  5  has a configuration making it possible to retain the anchoring member  5  in a biological tissue. In other words, the anchoring member  5  is configured to be arranged in a retention position capable of being set in opposition relative to biological tissues in which it is inserted. In this retention position, the anchoring member  5  can take the form of a hook. The second position can therefore be qualified as active or position of retention of the biological tissues of the patient. Consequently, each anchoring member  5  is configured to be arranged in extended position inside the hollow positioning needle  2  before anchoring and in retention position when the anchoring device  4  is driven by the mandrel  3  inside the hollow positioning needle  2 . Thus, when the hollow positioning needle  2  is inserted into the body of a patient, the actuation of the mandrel  3  makes it possible to deploy the anchoring members  5  out of the hollow positioning needle  2  to anchor them in the biological tissues. In other words, the hollow positioning needle  2  is configured to arrange the anchoring members  5  in the first position when the anchoring members  5  are arranged inside the hollow positioning needle  2 , the anchoring members  5  being configured to be deformed in order to adopt the second position once driven out of the hollow positioning needle  2 . 
     According to a preferred configuration, the anchoring member  5  comprises a free end configured to perforate the biological tissues. In other words, the anchoring member  5  has an open profile with a proximal end secured to the guide wire  7  and a distal end for perforation of the biological tissues. Thus, when the anchoring member  5  is moved from the first position to the second position, the free distal end allows the anchoring member  5  to perforate the biological tissues and to be held therein once in the second position. This configuration with a free end allows the anchoring member  5  to be anchored in a portion of biological tissue without having to deform it or pinch it. 
     To enhance the anchoring of the anchoring members  5 , the latter can be configured to extend in directions different from one another when the anchoring members  5  are each arranged in their second position. The anchoring members  5  are preferably each produced in an elastic material allowing the anchoring members  5  to be deformed between the first and second positions. More preferably, the anchoring members  5  are produced in polymer with shape memory, in organic or metal alloy with shape memory, in polyethylene or in a nickel/titanium alloy. 
     Each anchoring member  5  comprises a connecting end  51  extending along a longitudinal axis A and configured to be arranged inside the connecting ring  6 . When the connecting ends  51  are arranged inside the connecting ring  6  and the anchoring device is arranged inside the hollow positioning needle  2 , the longitudinal axis A coincides with the axis of extension of the hollow positioning needle  2 . Furthermore, each connecting end  51  has a transverse section forming an angular segment, the sum of the angular segments being equal or less than 360° in one and the same plane transversal to the longitudinal axis A. In other words, each connecting end  51  occupies only a portion of the inner space of the connecting ring  6 , in a plane transversal to the longitudinal axis A. Thus, it is possible to occupy a maximum of space inside the connecting ring  6  such that the securing of each of the anchoring members  5  can be accomplished efficiently. This configuration makes it possible to reduce the bulk of the anchoring members  5  inside the connecting ring  6 . This is particularly useful because the radial dimensions of the connecting ring  6  are constrained by the use of the anchoring device  4  in thoracoscopy. Thus, it is possible to improve the fixing of a plurality of anchoring members  5  inside the connecting ring  6 . 
     Furthermore, the connecting ends  51  are preferably complementary to one another so as to form a circular section when the connecting ends  51  are arranged in contact with one another. Preferably, the circular section formed by the connecting ends  51  is smaller than the inner diameter of the connecting ring  6 . As an example, when the anchoring device  4  comprises two anchoring members  5 , the anchoring members  5  comprise a connecting end  51  of semicircular section. As another example, when the anchoring device  4  comprises three anchoring members  5 , the anchoring members  5  comprise a connecting end  51  whose section forms an angular segment of 120°. Each connecting end  51  comprises an outer surface  511  in contact with the connecting ring  6  and at least one inner surface  512  arranged in contact with at least one other connecting end  51 . The outer surface  511  is preferably curved and the inner surface  512  is preferably planar. The outer or inner nature of the outer  511  and inner  512  surfaces is defined by considering the anchoring member  5  when it is arranged inside the hollow positioning needle  2 . To improve the mutual grip of the anchoring members  5  inside the connecting ring  6 , the inner surface  512  can include a relief, provided for example by a surface roughness, grooves, ridges or notches. Preferably, each anchoring member  5  comprises an identical connecting end  51 . Alternatively, each connecting end  51  can be different, in particular by forming an angular segment of different value. As an example, with two anchoring members  5 , one of the connecting ends  51  can exhibit an angular segment less than 180° and the other of the connecting ends  51  can exhibit an angular segment greater than 180°. The anchoring members  5  are preferably assembled in the connecting ring  6  by crimping, gluing, welding or by collapsing of the connecting ring  5  on the connecting ends  51 . 
     The anchoring member  5  also comprises an anchoring portion  52  formed in the extension of the connecting end  51 . The anchoring portion  52  comprises at least one planar surface extending transversely to the longitudinal axis A to improve the capacity of the anchoring member  5  to be retained in the biological tissues. Thus, this planar surface allows an effective anchoring of the anchoring member  5  in the tissues such that the risks of a migration of the anchoring device  4  is reduced. The anchoring portion  52  also comprises an outer surface  522  and an inner surface  523 . The outer or inner nature of the inner  523  and outer  522  surfaces is defined by considering the anchoring member  5  when it is out of the hollow positioning needle  2 . Preferably, the planar surface is formed by the outer surface  522 . More preferably, the outer surface  522  is produced in the extension of the inner surface  512  of the connecting end  51 . This anchoring portion  52  is preferably curved when the anchoring member  5  is in the second position so as to form a hook and thus improve the anchoring of the anchoring member  5 . According to the embodiment represented in  FIGS. 4 and 5 , at least one of the anchoring members  5  has a transverse section forming a parallelogram, preferably a rectangle. For example, the anchoring portion  52  can be obtained from a flattened semicircular form. The thickness of the anchoring portion  52  in a direction transversal to the longitudinal axis A is chosen as a function of the grip on deployment that is required to be given to the anchoring portion  52 . When the anchoring device  4  comprises two anchoring members  5 , this thickness is equal to or less than half the inner diameter of the hollow positioning needle  2 . All the forms contained in this half-diameter are allowed. According to a preferential embodiment, the deployed form of the anchoring member  5  is produced by stamping a cylindrical axis whose diameter is previously defined in order to obtain the different sections. 
     The anchoring members  5  also comprise, at an end opposite the connecting end  51 , a leading edge  521  for perforating the biological tissue, formed by at least one facet or bevel. This facet or bevel is for example formed by the anchoring portion  52 . The main facet or bevel of this tapering is produced on the inner surface of the anchoring member  5  so as to favour the slip of the anchoring member  5  when it is ejected from the hollow positioning needle  2 . This leading edge  521  also allows the anchoring embers  5  to perforate the biological tissues to place the anchoring device  4  in anchoring position. 
     According to  FIG. 6 , the anchoring members  5  can be produced according to another embodiment in which the anchoring portion  52  has a semicircular transverse section. Preferably, the anchoring members  5  have a continuous semicircular section. In other words, the connecting end  51  and the anchoring portion  52  can have a semicircular transverse section. In this way, when the anchoring device  4  comprises two anchoring members  5 , the latter can be formed by a rod of semicircular section whose end forms the connecting end  51 , the rest being formed by the anchoring portion  52 . The embodiment of  FIG. 6  makes it possible to obtain an economical anchoring member  5  obtained with few manufacturing operations while guaranteeing a good retention of the anchoring member  5  in the biological tissues with a planar outer surface  522 . The anchoring member according to the embodiment of  FIG. 6  differs from the embodiment of  FIGS. 4 and 5  in that the transverse section of the anchoring portion  52  is semicircular and produced in the extension of the connecting end  51 . However, all of the other features described for the anchoring member  5  of  FIGS. 4 and 5  are compatible with the embodiment of  FIG. 6 . Obviously, when the anchoring device  4  comprises three anchoring members  5  according to the embodiment of  FIG. 6 , the transverse section of the anchoring portion  52  and of the connecting end  51  form an angular portion corresponding to a third of a circle. 
     As illustrated in  FIGS. 4 to 6 , the end opposite the connecting end  51  forms a free end, i.e. it is not linked or secured to the connecting end  51 . This end opposite the connecting end  51  is configured to perforate biological tissues, in particular by the presence of the leading edge  521 . 
     Also proposed is a first alternative anchoring device according to the following items:
         Item 1: Anchoring device for registering lesions or microcalcification in a biological tissue, comprising:
           a guide wire comprising at least one graduated portion for determining the anchoring depth of the anchoring device,   at least two anchoring members for anchoring in a biological tissue connected to the guide wire.   
           Item 2: Anchoring device according to item 1, in which the graduated portion is planar.   Item 3: Anchoring device according to item 1 or 2, in which the graduated portion is obtained by flattening of the guide wire.   Item 4: Anchoring device according to any one of the preceding items, also comprising an abutment forming a bearing surface for the longitudinal driving of the anchoring device.   Item 5: Anchoring device according to item 4, in which the graduated portion comprises a local widening of the transverse section of the wire forming the abutment.   Item 6: Anchoring device according to one of the preceding items, comprising a connecting ring for connecting the guide wire to the anchoring members, in which the graduated portion is arranged at a predetermined length from the connecting ring.   Item 7: Anchoring device according to one of the preceding items, in which the guide wire is produced in a flexible material, preferably in biocompatible polyamide.       

     Moreover, also proposed is a second alternative anchoring device according to the following items:
         Item 1: Anchoring device for registering lesions or microcalcification in a biological tissue, comprising:
           a guide wire,   at least two anchoring members for anchoring in a biological tissue connected to the guide wire, each anchoring member comprising a connecting end extending along a longitudinal axis, the anchoring members comprising a planar retaining surface extending transversely to the longitudinal axis.   
           Item 2: Anchoring device according to item 1, in which at least one of the anchoring members has a transverse section forming a parallelogram, preferably a rectangle.   Item 3: Anchoring device according to item 1 or 2, in which the anchoring members comprise, at an end opposite the connecting end, a leading edge for perforating the biological tissue, formed by at least two facets.       

     Moreover, also proposed is a third alternative anchoring device according to the following items:
         Item 1: Anchoring device for registering lesions or microcalcification in a biological tissue, comprising:
           a guide wire,   at least two anchoring members for anchoring in a biological tissue connected to the guide wire, and   a connecting ring connecting the guide wire to the anchoring members, in which each anchoring member comprises a connecting end extending along a longitudinal axis and configured to be arranged inside the connecting ring, each connecting end having a transverse section forming an angular segment, the sum of the angular segments being equal to or less than 360° in one and the same plane transversal to the longitudinal axis.   
           Item 2: Anchoring device ( 4 ) according to item 1, in which the connecting ends ( 51 ) are complementary to one another so as to form a circular section when the connecting ends ( 51 ) are arranged in contact with one another.   Item 3: Anchoring device ( 4 ) according to item 1 or 2, in which each connecting end ( 51 ) comprises an outer surface ( 511 ) in contact with the connecting ring ( 6 ) and at least one inner surface ( 512 ) arranged in contact with at least one other connecting end ( 51 ).   Item 4: Anchoring device ( 4 ) according to item 3, in which the outer surface ( 511 ) is curved and the inner surface ( 512 ) is planar.   Item 5: Anchoring device ( 4 ) according to any one of the preceding items, in which the anchoring members ( 5 ) comprise an anchoring portion ( 52 ) formed in the extension of the connecting end ( 51 ), the anchoring portion ( 52 ) comprising at least one planar surface extending transversely to the longitudinal axis (A).   Item 6: Anchoring device ( 4 ) according to any one of the preceding items, in which the anchoring members ( 5 ) comprise, at an end opposite the connecting end ( 51 ), a leading edge ( 521 ) for perforating the biological tissue, formed by at least one facet.   Item 7: Anchoring device ( 4 ) according to any one of the preceding items, in which each anchoring member ( 5 ) is configured to be arranged in:
           a first position in which the anchoring member ( 5 ) has a configuration making it possible to insert the anchoring member ( 5 ) into a biological tissue, and   a second position in which the anchoring member ( 5 ) has a configuration making it possible to retain the anchoring member ( 5 ) in a biological tissue.   
           Item 8: Anchoring device ( 4 ) according to item 7, in which the anchoring members ( 5 ) are configured to extend in directions that are different from one another when the anchoring members ( 5 ) are each arranged in their second position.       

     The first, second and third alternative anchoring devices can also comprise one or more of the features described in the present description taken in any technically admissible combination. 
     It should be noted that each of the alternative anchoring devices presented according to the preceding items is configured to be implemented in an anchoring system as described hereinabove and compatible with all of the features of the anchoring device  4  presented hereinabove.