IPC분류정보
국가/구분 |
United States(US) Patent
등록
|
국제특허분류(IPC7판) |
|
출원번호 |
US-0136713
(2002-04-30)
|
발명자
/ 주소 |
- Borst,Cornelius
- Mansvelt Beck,Hendricus J.
- Grundeman,Paul F.
- Jansen,Erik W. L.
|
출원인 / 주소 |
|
인용정보 |
피인용 횟수 :
13 인용 특허 :
121 |
초록
▼
A method and apparatus for temporarily immobilizing a local area of tissue. In particular, the present invention provides a method and apparatus for temporarily immobilizing a local area of heart tissue to thereby permit surgery on a coronary vessel in that area without significant deterioration of
A method and apparatus for temporarily immobilizing a local area of tissue. In particular, the present invention provides a method and apparatus for temporarily immobilizing a local area of heart tissue to thereby permit surgery on a coronary vessel in that area without significant deterioration of the pumping function of the beating heart. The local area of heart tissue is immobilized to a degree sufficient to permit minimally invasive or micro-surgery on that area of the heart. The present invention features a suction device to accomplish the immobilization. The suction device is coupled to a source of negative pressure. The suction device has a series of suction ports on one surface. Suction through the device causes suction to be maintained at the ports. The device further is shaped to conform to the surface of the heart. Thus, when the device is placed on the surface of the heart and suction is created, the suction through the ports engages the surface of the heart. The suction device is further fixed or immobilized to a stationary object, such as an operating table or a sternal or rib retractor. Thus, the local area of the heart near the suction device is temporarily fixed or immobilized relative to the stationary object while suction is maintained. In such a fashion, the coronary artery may be immobilized even though the heart itself is still beating so that a bypass graft may be performed. In addition the suction device may be used in either a conventional, open-chest environment or in a minimally-invasive environment, e.g. endoscopic.
대표청구항
▼
The invention claimed is: 1. A device for temporarily immobilizing an area of tissue comprising: a suction source; a member having a lumen, the lumen coupled to a suction port, the suction port positioned along a surface of the member, the surface being sized, shaped and oriented in a suitable fash
The invention claimed is: 1. A device for temporarily immobilizing an area of tissue comprising: a suction source; a member having a lumen, the lumen coupled to a suction port, the suction port positioned along a surface of the member, the surface being sized, shaped and oriented in a suitable fashion to allow the suction port to engage tissue via suction, the lumen coupled to the suction source, wherein suction to the lumen is communicated to the suction port; wherein the member is coupled to an arm via a coupling which allows the member to bend or flex in substantially all directions relative to the arm; and means for fixing the member to an operating table wherein the means comprises at least one mounting rail or beam. 2. The device of claim 1 wherein the member is coupled to an arm via a hinge or joint thereby permitting the member to move relative to the arm. 3. The device of claim 2 wherein the hinge or joint comprises a pin thereby permitting the member to swivel relative to the arm. 4. A device for temporarily immobilizing an area of tissue comprising: an operating table; a suction source; a member having a lumen, the lumen coupled to a suction port, the suction port being positioned along a surface of the member, the surface being sized and shaped to engage tissue; the lumen coupled to the suction source, wherein suction to the lumen is communicated to the suction port, wherein the member is coupled to an arm via a coupling which allows the member is free bend or flex in substantially all directions relative to the arm: and means for fixing the member to the operating table wherein the means comprises at least one mounting rail or beam. 5. The device of claim 4 wherein the means for fixing the member to the operating table comprises a clamping means for clamping the member to the mounting rail or beam. 6. The device of claim 5 wherein the clamping means comprises one or more clamps. 7. The device of claim 4 wherein the device is used to move or reposition the heart to achieve better access to areas of the heart which would otherwise be difficult to access. 8. The device of claim 4 wherein the member is coupled to the arm via a bendable or flexible neck. 9. The device of claim 4 wherein the arm comprises: a plurality of joints, the joints being free to move relative to one another; a cable located within the arm; and, a locking actuator coupled to the cable to tighten the cable, thereby locking the arm. 10. The device of claim 9 wherein the arm comprises a plurality of tube elements having ends, the joints comprising interengaging concave and convex surfaces linking the ends of the tubes. 11. The device of claim 10 further comprising a means for maintaining the same length of the cable within the arm regardless of the orientation of any tube element to an adjacent joint. 12. The device of claim 11 wherein the convex surfaces are provided by a plurality of ball elements between the tube elements, each ball element having a lumen; the means for maintaining the same length of the cable within the arm comprises tapered bushings positioned within the lumen of the ball elements, the tapered bushings having a passageway with a first diameter at a first end, a second diameter in the middle and a first diameter at an end opposite the first end, the first diameter being larger than the second diameter. 13. The device of claim 9 wherein the locking actuator comprises a rotatable handle coupled to the proximal end of the arm wherein rotating the handle locks and unlocks the arm. 14. The device of claim 4 wherein the member comprises a plurality of suction ports coupled to the lumen. 15. The device of claim 4 wherein the means for fixing the member to the operating table comprises one or more slip-grip type holders. 16. The device of claim 4 wherein the suction port is cylindrical-shaped. 17. The device of claim 4 wherein the suction port is cone-shaped. 18. The device of claim 4 wherein the suction port is dome-shaped. 19. A device for temporarily immobilizing an area of tissue comprising: an operating table: a suction source: a member having a lumen, the lumen coupled to a suction port, the suction port positioned along a surface of the member, the surface being sized and shaped to engage tissue, the lumen coupled to the suction source, wherein suction to the lumen is communicated to the suction port, wherein the member is coupled to an arm via a ball bearing joint thereby permitting the member to rotate relative to the arm; and, means for fixing the member to the operating table wherein the means comprises at least one mounting rail or beam. 20. The device of claim 19 wherein the member is coupled to the ball bearing joint via a rigid neck, the lumen extending through the neck. 21. The device of claim 19 wherein the means for fixing the member to the operating table comprises a clamping means for clamping the member to the mounting rail or beam. 22. The device of claim 21 wherein the clamping means comprises one or more clamps. 23. The device of claim 19 wherein the device is used to move or reposition the heart to achieve better access to areas of the heart which would otherwise be difficult to access. 24. The device of claim 19 wherein the arm comprises: a plurality ofjoints, the joints being free to move relative to one another; a cable located within the arm; and, a locking actuator coupled to the cable to tighten the cable, thereby locking the arm. 25. The device of claim 24 wherein the arm comprises a plurality of tube elements having ends, the joints comprising interengaging concave and convex surfaces linking the ends of the tubes. 26. The device of claim 25 further comprising a means for maintaining the same length of the cable within the arm regardless of the orientation of any tube element to an adjacent joint. 27. The device of claim 26 wherein the convex surfaces are provided by a plurality of ball elements between the tube elements, each ball element having a lumen; the means for maintaining the same length of the cable within the arm comprises tapered bushings positioned within the lumen of the ball elements, the tapered bushings having a passageway with a first diameter at a first end, a second diameter in the middle and a first diameter at an end opposite the first end, the first diameter being larger than the second diameter. 28. The device of claim 24 wherein the locking actuator comprises a rotatable handle coupled to the proximal end of the arm wherein rotating the handle locks and unlocks the arm. 29. The device of claim 19 wherein the member comprises a plurality of suction ports coupled to the lumen. 30. The device of claim 19 wherein the means for fixing the member to the operating table comprises one or more slip-grip type holders. 31. The device of claim 19 wherein the suction port is cylindrical-shaped. 32. The device of claim 19 wherein the suction port is cone-shaped. 33. The device of claim 19 wherein the suction port is dome-shaped. 34. The device of claim 19 wherein the member is coupled to the ball bearing joint via a bendable or flexible neck. 35. The device of claim 34 wherein the lumen extends through the neck. 36. The device of claim 19 wherein the member is coupled to the ball bearing joint via a rigid neck. 37. A device for temnorarily immobilizing an area of tissue comprising: a suction source: a member having a lumen, the lumen coupled to a suction port, the suction port positioned along a surface of the member, the surface being sized and shaped to engage tissue, the lumen coupled to the suction source, wherein suction to the lumen is communicated to the suction port, wherein the member is coupled to an arm, the aim having a proximal end and a distal end, the arm comprising: a plurality of joints, the joints being free to move relative to one another; a cable located within the arm; and, a locking actuator coupled to the cable to tighten the cable, thereby locking the arm; and means for fixing the member to an operating table wherein the means comprises at least one mounting rail or beam. 38. The device of claim 37 wherein the arm comprises a plurality of tube elements having ends, the joints comprising interengaging-concave and convex surfaces linking the ends of the tubes. 39. The device of claim 38 further comprising a means for maintaining the same length of the cable within the arm regardless of the orientation of any tube element to an adjacent joint. 40. The device of claim 39 wherein the convex surfaces are provided by a plurality of ball elements between the tube elements, each ball element having a lumen; the means for maintaining the same length of the cable within the arm comprises tapered bushings positioned within the lumen of the ball elements, the tapered bushings having a passageway with a first diameter at a first end, a second diameter in the middle and a first diameter at an end opposite the first end, the first diameter being larger than the second diameter. 41. The device of claim 37 wherein the locking actuator comprises a rotatable handle coupled to the proximal end of the arm wherein rotating the handle locks and unlocks the arm. 42. The device of claim 37 wherein the member comprises a plurality of suction ports coupled to the lumen. 43. The device of claim 37 wherein the means for fixing the member to the operating table comprises one or more slip-grip type holders. 44. The device of claim 37 wherein the suction port is cylindrical-shaped. 45. The device of claim 37 wherein the suction port is cone-shaped. 46. The device of claim 37 wherein the suction port is dome-shaped. 47. The device of claim 37 wherein the means for fixing the member to the operating table comprises a clamping means for clamping the member to the mounting rail or beam. 48. The device of claim 47 wherein the clamping means comprises one or more clamps. 49. The device of claim 37 wherein the device is used to move or reposition the heart to achieve better access to areas of the heart which would otherwise be difficult to access. 50. A device of for temporarily immobilizing an area of tissue comprising: an operating table: a suction source: a member having a lumen, the lumen coupled to a suction port, the suction port positioned along a surface of the member, the surface being sized and shaped to engage tissue, the lumen coupled to the suction source, wherein suction to the lumen is communicated to the suction port, one or more electrodes positioned along the surface of the member; and, means for fixing the member to the operating table wherein the means comprises at least one mounting rail or beam. 51. The device of claim 50 wherein the one or more electrodes are coupled by a lead to a pulse generator. 52. A medical device for temporarily grasping an area of tissue of a beating heart to move or reposition the heart to achieve better access to areas of the heart while the heart is beating comprising: a suction device having an arm and a suction member, the suction member having a contact surface adapted to be placed against the heart, the contact surface being shaped to conform to the surface of the heart, the suction member having a neck, the neck having a suction lumen open to the atmosphere through the contact surface, the neck movably coupled to the arm by a hinge or joint comprising a ball bearing or a pin such that the suction member is free to move relative to the arm; a suction line coupled to the suction lumen wherein suction to the suction line is communicated to the suction lumen; a suction source coupled to the suction lumen; and, a securing device coupled to the arm of the suction device, the securing device being adapted for fixing the suction device to an operating table. 53. The medical device of claim 52 wherein the hinge or joint comprises a pin thereby permitting the suction member to swivel relative to the arm. 54. The medical device of claim 52 wherein the hinge or joint is actuable remotely from outside a patient's body. 55. The medical device of claim 52 wherein the suction member may be fixed in an angular relationship to the arm by the hinge or joint. 56. The medical device of claim 52 wherein the suction member is rotatably coupled to the arm such that the suction member is free to rotate relative to the arm. 57. The medical device of claim 52 wherein the contact surface of the suction member is curved. 58. The medical device of claim 52 wherein the neck is bendable or flexible. 59. The medical device of claim 52 wherein the neck is rigid. 60. The medical device of claim 52 wherein the securing device comprises one or more clamps. 61. The medical device of claim 52 wherein the clamp is adapted to clamp on the operating table. 62. The medical device of claim 52 wherein the suction member comprises at least one suction port coupled to the lumen. 63. The medical device of claim 62 wherein the at least one suction port is cylindrical-shaped. 64. The medical device of claim 62 wherein the at least one suction port is cone-shaped. 65. The medical device of claim 62 wherein the at least one suction port is dome-shaped. 66. The medical device of claim 52 wherein the securing device comprises at least one mounting rail or beam. 67. The medical device of claim 66 wherein the arm is clamped to the at least one mounting rail or beam. 68. The medical device of claim 52 wherein a slip-grip type holder is used to couple the securing device to the arm. 69. The medical device of claim 52 wherein the suction source provides suction at a negative pressure between about 200 and about 600 mm Hg. 70. The medical device of claim 52 wherein the suction member is coupled relatively perpendicular to the arm. 71. A medical device for temporarily grasping an area of tissue of a beating heart to move or reposition the heart to facilitate access to areas of the heart while the heart is beating comprising: a suction device having an arm and a suction member, the suction member having a contact surface adapted to be placed against the heart, the contact surface being shaped to generally conform to the surface of the heart, the contact surface comprising one or more electrodes; the suction member having a neck, the neck having a suction lumen open to the atmosphere through the contact surface, the neck movably coupled to the arm such that the suction member is free to move relative to the arm; a suction line coupled to the suction lumen wherein suction to the suction line is communicated to the suction lumen; a suction source coupled to the suction lumen; and, a securing device coupled to the arm of the suction device, the securing device being adapted for fixing the suction device to an operating table. 72. The medical device of claim 71 wherein the electrodes are coupled by a lead to a pulse generator. 73. A medical device for temporarily grasping an area of tissue of a beating heart to move or reposition the heart to facilitate access to areas of the heart while the heart is beating comprising: a suction device having an arm and a suction member, the suction member having a contact surface adapted to be placed against the heart, the contact surface being shaped to conform to the surface of the heart, the suction member having a neck, the neck having a suction lumen open to the atmosphere through the contact surface, the neck movably coupled to the arm such that the suction member is free to move relative to the arm, the arm has a proximal end and a distal end, the arm comprising: a plurality of links, the links being free to move relative to one another so that the arm articulates; a cable extending through the links, the cable having a distal end and a proximal end; and, a locking actuator coupled to the proximal end of the cable and the proximal end of the arm to tension the cable thereby locking the links relative to one another so that the arm changes from an articulating condition to a locked rigid condition; a suction line coupled to the suction lumen wherein suction to the suction line is communicated to the suction lumen; a suction source coupled to the suction lumen; and a securing device coupled to the arm of the suction device, the securing device being adapted for fixing the suction device to an operating table. 74. The medical device of claim 73 wherein the links comprise tube elements jointed together by ball elements, the tube elements having socket ends shaped to mate with the ball elements. 75. The medical device of claim 74 further comprising a means for maintaining the same length of the cable within the arm regardless of the orientation of any tube element to an adjacent ball element. 76. The medical device of claim 75 wherein the means for maintaining the same length of the cable within the arm comprises tapered bushings positioned within the lumen of the ball elements, the tapered bushings having a passage way thereout which has a first diameter at a first end, a second diameter in the middle and the first diameter at an end opposite the first end, the first diameter being larger than the second diameter. 77. The medical device of claim 73 wherein the locking actuator comprises a rotatable handle coupled to the proximal end of the arm wherein rotating the handle changes the arm from the articulating condition to the locked rigid condition. 78. The medical device of claim 73 wherein the member comprises at least one suction port coupled to the lumen. 79. The medical device of claim 78 wherein the suction port is cylindrical-shaped. 80. The medical device of claim 78 wherein the suction port is cone-shaped. 81. The medical device of claim 78 wherein the suction port is dome-shaped. 82. The medical device of claim 73 wherein the neck is bendable or flexible. 83. The medical device of claim 73 wherein the neck is rigid. 84. The medical device of claim 73 wherein the neck is coupled to the arm via a hinge or joint. 85. The medical device of claim 73 wherein the securing device comprises one or more clamps. 86. The medical device of claim 73 wherein the securing device comprises one or more slip-grip type holders. 87. The medical device of claim 73 wherein the contact surface comprises one or more electrodes. 88. The medical device of claim 87 wherein the electrodes are coupled by a lead to a pulse generator. 89. An apparatus adapted to be connected to an operating table, the apparatus adapted to temporarily grasp an area of tissue, the apparatus comprising: a suction device comprising an arm, a suction member, and a ball bearing joint for coupling the suction member to the arm thereby permitting the suction member to move relative to the arm, the suction member having a contact surface adapted to grasp tissue and a lumen open to the atmosphere along the contact surface, the lumen being adapted to be coupled to a suction source wherein suction to the lumen is communicated through the contact surface; and means for fixing the suction device to the operating table. 90. The apparatus of claim 89 wherein the suction member is coupled to the ball bearing joint via a malleable or bendable neck. 91. The apparatus of claim 89 wherein the means for fixing the suction device to the operating table comprises at least one mounting rail or beam. 92. The apparatus of claim 89 wherein the means for fixing the suction device to the operating table comprises a clamping means for clamping the suction device to the mounting rail or beam. 93. The apparatus of claim 92 wherein the clamping means comprises at least one clamp. 94. The apparatus of claim 89 wherein the ball bearing joint is actuable remotely from outside a patient's body. 95. The apparatus of claim 89 wherein the suction member comprises at least one suction port coupled to the lumen. 96. The apparatus of claim 95 wherein the suction port is cylindrical-shaped. 97. The apparatus of claim 95 wherein the suction port is cone-shaped. 98. The apparatus of claim 95 wherein the suction port is dome-shaped. 99. The apparatus of claim 89 wherein the means for fixing the suction device to the operating table comprises one or more slip-grip type holders. 100. An apparatus adapted to be connected to an operating table, the apparatus adapted to temporarily grasp an area of tissue, the apparatus comprising: a suction device comprising an arm, a suction member, and a coupling means for permitting the suction member to move relative to the arm, the suction member having a contact surface having at least one electrode, the contact surface adapted to grasp tissue and a lumen open to the atmosphere along the contact surface, the lumen being adapted to be coupled to a suction source wherein suction to the lumen is communicated through the contact surface: and means for fixing the suction device to the operating table. 101. The apparatus of claim 100 wherein the coupling means comprises a neck, the neck having a proximal end and a distal end, the proximal end coupled to the arm, the distal end coupled to the suction member. 102. The apparatus of claim 101 wherein the neck is malleable or bendable. 103. The apparatus of claim 100 wherein the means for fixing the suction device to the operating table comprises at least one mounting rail or beam. 104. The apparatus of claim 103 wherein the means for fixing the suction device to the operating table comprises a clamping means for clamping the suction device to the mounting rail or beam. 105. The apparatus of claim 104 wherein the clamping means comprises at least one clamp. 106. The apparatus of claim 101 wherein the coupling means comprises a hinge or joint thereby permitting the suction member to move relative to the arm. 107. The apparatus of claim 106 wherein the hinge or joint comprises a pin thereby permitting the suction member to swivel relative to the arm. 108. The apparatus of claim 106 wherein the hinge or joint is actuable remotely from outside a patient's body. 109. The apparatus of claim 100 wherein the suction member comprises at least one suction port coupled to the lumen. 110. The apparatus of claim 109 wherein the suction port is cylindrical-shaped. 111. The apparatus of claim 109 wherein the suction port is cone-shaped. 112. The apparatus of claim 109 wherein the suction port is dome-shaped. 113. The apparatus of claim 100 wherein the means for fixing the suction device to the operating table comprises one or more slip-grip type holders. 114. The apparatus of claim 100 wherein the at least one electrode is coupled by a lead to a pulse generator.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.