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公开(公告)号：US06746467B1
公开(公告)日：2004-06-08
申请号：US09431362
申请日：1999-11-01
申请人： Charles S. Taylor , Ivan Sepetka
发明人： Charles S. Taylor , Ivan Sepetka
IPC分类号： A61B1702
CPC分类号： A61B17/3423 , A61B17/0206 , A61B17/025 , A61B90/50 , A61B2017/3427 , A61B2017/349
摘要： An access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and support pads interconnected to a blade. A torsional member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor interconnected to the blades and is used to draw the soft tissue around an incision away from the surgeon's working area.
摘要翻译： 一种进入平台，其具有与扩展构件相互连接的第一和第二叶片，所述第一和第二叶片横向地驱动叶片彼此分离或一起，并且支撑与叶片互连的垫。 扭转构件可操作地连接到叶片和吊具构件，并且用于垂直地移位互连的叶片，并且因此增加外科医生的工作空间和用于内部乳房动脉解剖的视觉通路。 组织牵开器互连到叶片上，用于将软组织围绕切口远离外科医生的工作区域。
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公开(公告)号：US6110190A
公开(公告)日：2000-08-29
申请号：US243238
申请日：1999-02-03
申请人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
发明人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
CPC分类号： A61B17/00008 , A61B17/02 , A61B17/00234 , A61B17/320016 , A61B2017/00867 , A61B2017/00969 , A61B2017/2905 , A61B2017/2927 , A61B2018/00916 , A61B2018/1253 , A61B2018/1407 , A61B2018/1435
摘要： A surgical instrument is configured to aid in performing a procedure of detaching an internal mammary artery (IMA) and the like, from the connecting tissues and side branch vessels which surround the artery in its native location, wherein the detaching procedure is preliminary to the performing of a coronary artery bypass grafting procedure and wherein the IMA is detached via a minimally invasive thoracotomy. To this end, an elongated slender rod includes a handle at its proximal end and an artery engaging loop, arc, fork configuration, or hook at its distal working end. Embodiments may incorporate electrosurgical capability or electrical insulation. A surgeon thus has means for harvesting an intact and undamaged graft vessel from its native location through a minimally invasive incision with enhanced speed, visibility, and freedom of motion.
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公开(公告)号：US5891159A
公开(公告)日：1999-04-06
申请号：US850321
申请日：1997-05-02
CPC分类号： A61B17/0482 , A61B17/0469 , A61B17/1114 , A61B17/29 , A61B2017/00243 , A61B2017/1107 , A61B2017/3488
摘要： An automatic purse string suture device is disclosed that enables a surgeon to install a purse string suture in tissue structures, particularly for sealing the tissue about a cannula. The device is particularly suited for minimally invasive cardiothoracic procedures and is comprised of an applicator having an elongated structure with protrusions extending from the distal edge thereof. Also provided are means for advancing a needle through a passage to pass a suture through tissue that has been conformed to the distal edge of the device. Various means for conforming the tissue to the distal edge are disclosed as are methods for using the device to facilitate cardiothoracic surgery.
摘要翻译： 公开了一种自动钱包缝合装置，其使得外科医生能够在组织结构中安装钱包线缝合线，特别是用于在套管周围密封组织。 该装置特别适用于微创心胸手术，并且包括具有细长结构的施用器，其具有从其远端边缘延伸的突起。 还提供了用于使针穿过通道以使缝合线穿过已经符合设备的远侧边缘的组织的装置。 公开了用于使组织与远侧边缘一致的各种方法，如同使用该装置促进心胸外科手术的方法一样。
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24.发明授权公开(公告)号：US06387108B1
公开(公告)日：2002-05-14
申请号：US09541851
申请日：2000-04-03
IPC分类号： A61B1732
CPC分类号： A61B17/32 , A61B17/320016 , A61B2017/00243 , A61B2017/00703 , A61B2017/00778 , A61B2017/2925 , A61B2017/320052
摘要： The invention is surgical instruments which facilitate substantially linear incisions, especially through the wall of vessels, such as arteries, which have been specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The instruments of the invention are particularly useful to create the incision in the artery to which the bypass graft is sewed, typically the left anterior descending artery (LAD). The instruments of the invention allow incisions to be rapidly made, precisely measured, and cleanly formed so that a bypass graft can be rapidly sewn in place. In one embodiment, the invention is comprised of a hand-held instrument with a curved cutting edge formed on the interior edge of a curved or arcuitous segment located near the end of the instrument. The tip of the instrument has a point of penetrating the vessel wall. The point may have several alternate shapes to facilitate penetration of the vessel wall while maximizing the trauma to the surrounding tissue. Another embodiment is comprised of a hand-held instrument with moveable member such that the incision is created by engaging a cutting blade against a stop with the tissue being cut therebetween. This instrument is also constructed to facilitate a rapid linear incisions in a vessel while minimizing the possibility for damage to the surrounding tissue. In another embodiment, the instrument features a motion-cancelling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated form handle which is isolated from the movement of the tissue containing or proximate to the target of the incision. The instruments facilitate the invasive cardiac procedures by creating linear incisions quickly without undue trauma to surrounding tissue and without excess loss of blood.
摘要翻译： 本发明是促进基本上线性切口的手术器械，特别是通过在搏动心脏上专门设计用于冠状动脉旁路移植手术（CABG）的血管如动脉壁。 本发明的器械特别可用于在旁路移植物缝合的动脉中形成切口，通常为左前降支动脉（LAD）。 本发明的仪器允许快速地进行切割，精确地测量和清洁地形成切口，使得旁路移植物能够快速地缝合到位。 在一个实施例中，本发明包括具有弯曲切割边缘的手持式仪器，其形成在位于靠近仪器端部的弯曲或直立部分的内边缘上。 仪器的尖端具有穿透血管壁的点。 该点可以具有几种替代形状，以促进血管壁的穿透，同时使周围组织的创伤最大化。 另一个实施例包括具有可移动构件的手持式仪器，使得通过将切割刀片接合在止动件上而在其间切割的组织而产生切口。 该仪器还构造成便于在容器中快速线性切口，同时最小化对周围组织的损伤的可能性。 在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。 该实施例具有切割刀片，该切割刀片从手柄被操纵，所述切割刀片与包含或接近切口的靶标的组织的运动隔离。 这些仪器通过快速创建线性切口来促进侵入性心脏手术，而不会对周围组织造成不必要的创伤，而不会导致血液过多的流失。
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25.发明授权公开(公告)号：US06280455B1
公开(公告)日：2001-08-28
申请号：US09243742
申请日：1999-02-03
申请人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
发明人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
IPC分类号： A61B1700
CPC分类号： A61B17/00008 , A61B17/00234 , A61B17/02 , A61B17/320016 , A61B2017/00867 , A61B2017/00969 , A61B2017/2905 , A61B2017/2927 , A61B2018/00916 , A61B2018/1253 , A61B2018/1407 , A61B2018/1435
摘要： A surgical instrument is configured to aid in performing a procedure of detaching an internal mammary artery (IMA) and the like, from the connecting tissues and side branch vessels which surround the artery in its native location, wherein the detaching procedure is preliminary to the performing of a coronary artery bypass grafting procedure and wherein the IMA is detached via a minimally invasive thoracotomy. To this end, an elongated slender rod includes a handle at its proximal end and an artery engaging loop, arc, fork configuration, or hook at its distal working end. Embodiments may incorporate electrosurgical capability or electrical insulation. A surgeon thus has means for harvesting an intact and undamaged graft vessel from its native location through a minimally invasive incision with enhanced speed, visibility, and freedom of motion.
摘要翻译： 手术器械被配置为有助于执行从其周围的动脉周围的连接组织和侧分支血管分离内部乳腺动脉（IMA）等的步骤，其中分离程序是执行的初步 的冠状动脉旁路移植手术，其中通过微创开胸术分离IMA。 为此，细长杆在其近端包括手柄，在其远端工作端处包括动脉接合环，弧形，叉形结构或钩。 实施例可以包括电外科能力或电绝缘。 因此，外科医生具有通过具有增强的速度，可见性和运动自由的微创切口从其原始位置收集完整且未损坏的移植血管的手段。
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26.发明授权
公开(公告)号：US6113616A
公开(公告)日：2000-09-05
申请号：US27611
申请日：1998-02-23
CPC分类号： A61B17/32 , A61B17/320016 , A61B2017/00243 , A61B2017/00703 , A61B2017/00778 , A61B2017/2925 , A61B2017/320052
摘要： Surgical instruments and methods for making substantially linear incisions, especially through walls of vessels, such arteries, specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The invention is particularly useful to create the incision in the artery to which a bypass graft is sewn, typically the left anterior descending artery (LAD). The instruments allow incisions to be rapidly made, precisely measured and cleanly formed so that a bypass graft can be rapidly sewn in place, without undue trauma to surrounding tissue and excessive loss of blood. In one embodiment, a hand-held instrument has a cutting edge formed on the interior edge of a curved blade fixed near the end of the instrument. The tip of the blade has a point for penetrating the vessel wall which may have several alternate shapes to facilitate penetration of the vessel wall while minimizing to the surrounding tissue. In another embodiment the hand-held instrument includes a moveable member which creates an incision by engaging a cutting blade against a stop, cutting tissue therebetween, the stop including a pointed including a pointed tip similar to the previous embodiment. In another embodiment, the instrument features a motion-canceling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated from a handle which is isolated from the movement of the tissue containing or proximate to the target of the incision.
摘要翻译： 手术器械和方法，用于进行基本上线性的切口，特别是通过血管壁，这种动脉，专门设计用于搏动心脏上的冠状动脉旁路移植手术（CABG）。 本发明特别有用于在缝合旁路移植物的动脉中产生切口，通常为左前降支动脉（LAD）。 这些仪器允许快速地进行切割，精确测量和清洁地形成，使得旁路移植物可以快速缝合就位，而不会对周围组织造成过度的创伤和过度的血液损失。 在一个实施例中，手持式仪器具有形成在靠近仪器端部的弯曲刀片的内边缘上的切割刃。 叶片的尖端具有用于穿透血管壁的点，该点可以具有若干替代形状，以促进血管壁的穿透，同时使周围组织最小化。 在另一个实施例中，手持式器械包括可移动构件，其通过将切割刀片接合止挡件而形成切口，在其间切割组织，止动件包括类似于前述实施例的尖端，包括尖端。 在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。 该实施例具有从手柄操纵的切割刀片，该手柄与包含或接近切口目标的组织的运动隔离。
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公开(公告)号：US06381499B1
公开(公告)日：2002-04-30
申请号：US09574586
申请日：2000-05-17
IPC分类号： A61N132
CPC分类号： A61B17/122 , A61B17/1227 , A61B2017/0243 , A61N1/36014
摘要： A method and apparatus for facilitating coronary surgery on the beating heart wherein the vagus nerve is electrically stimulated to purposely temporarily stop or substantially reduce the beating of the heart under precisely controlled conditions. The apparatus controllably applies electrical stimulus to pre-selected locations along the vagus nerve and to pre-selected nerve branches related to the heart. The apparatus includes several clip and probe configurations for establishing electrical contact with the vagus nerve. Such purposely caused temporary stoppage or substantial reduction of the beating of the heart facilitates procedures such as suturing of an anastomosis which would otherwise be more difficult because of the motion induced by the beating heart.
摘要翻译： 一种用于促进搏动心脏的冠状动脉手术的方法和装置，其中电刺激迷走神经以故意暂时地停止或基本上减少在精确控制的条件下的心跳。 该装置可控制地将电刺激应用于沿着迷走神经的预先选择的位置和与心脏相关的预先选择的神经分支。 该装置包括用于建立与迷走神经的电接触的多个夹子和探针配置。 这样有意地引起临时停止或大幅度减少心脏搏动的方法有助于诸如缝合吻合术的过程，否则由于跳动心脏引起的运动将更加困难。
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28.发明授权Surgical devices for imposing a negative pressure to fix the position of cardiac tissue during surgery 失效用于施加负压以固定手术期间心脏组织位置的手术装置
公开(公告)号：US5727569A
公开(公告)日：1998-03-17
申请号：US603328
申请日：1996-02-20
CPC分类号： A61B17/00 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/306 , A61B2017/3488 , A61B90/40
摘要： The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site. In certain preferred embodiments, the devices described herein have structures to facilitate the use of additional surgical instruments such that the placement of negative pressure device permit the surgeon to advantageously manipulate the other instruments during surgery. The negative pressure is preferably imposed through a plurality of ports which may be disposed in a substantially planar surface of the instrument which contacts the cardiac tissue.
摘要翻译： 本发明是使用通过外科器械施加的负（吸力）压力或真空来固定跳动心脏表面的一部分的位置使得外科手术可以更容易地进行的装置和技术。 这些装置在心脏的外表面上的几个点处施加负压，使得心脏的一部分通过通过手术器械施加的抽吸被固定就位。 因为仪器固定组织的位置，并且因为仪器保持与正在执行手术的心脏的特定部分恒定的距离，所以该装置还可以用作支撑或平台，使得其它手术器械或装置 可以有利地在现场使用。 在某些优选实施例中，本文所述的装置具有便于使用额外外科器械的结构，使得负压装置的放置允许外科医生在手术期间有利地操纵其他器械。 负压优选通过多个端口施加，所述多个端口可以设置在与心脏组织接触的仪器的基本平坦的表面中。
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公开(公告)号：US06308104B1
公开(公告)日：2001-10-23
申请号：US09338303
申请日：1999-06-22
IPC分类号： A61N105
CPC分类号： A61B17/122 , A61B17/1227 , A61B2017/0243 , A61N1/36014
摘要： A method and apparatus for facilitating coronary surgery on the beating heart wherein the vagus nerve is electrically stimulated to purposely temporarily stop or substantially reduce the beating of the heart under precisely controlled conditions. The apparatus controllably applies the electrical stimulus to preselected locations along the vagus nerve and thus to preselected nerve branches related to the heart. The apparatus includes several clip and probe configurations for establishing electrical contact with the vagus nerve. Such purposely caused temporary stoppage or substantial reduction of the beating of the heart facilitates procedures such as suturing of an anastomosis which would otherwise be more difficult because of the motion induced by the beating heart.
摘要翻译： 一种用于促进搏动心脏的冠状动脉手术的方法和装置，其中电刺激迷走神经以故意暂时地停止或基本上减少在精确控制的条件下的心跳。 该装置可控制地将电刺激应用于沿着迷走神经的预选位置，并因此应用于与心脏相关的预选神经分支。 该装置包括用于建立与迷走神经的电接触的多个夹子和探针配置。 这样有意地引起临时停止或大幅度减少心脏搏动的方法有助于诸如缝合吻合术的过程，否则由于跳动心脏引起的运动将更加困难。
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公开(公告)号：US5913876A
公开(公告)日：1999-06-22
申请号：US935126
申请日：1997-09-22
IPC分类号： A61B17/02 , A61B17/122 , A61B17/125 , A61N1/36 , A61N1/368
CPC分类号： A61B17/122 , A61B17/1227 , A61B2017/0243 , A61N1/36014
摘要： A method and apparatus for facilitating coronary surgery on the beating heart wherein the vagus nerve is electrically stimulated to purposely temporarily stop or substantially reduce the beating of the heart under precisely controlled conditions. The apparatus controllably applies the electrical stimulus to preselected locations along the vagus nerve and thus to preselected nerve branches related to the heart. The apparatus includes several clip and probe configurations for establishing electrical contact with the vagus nerve. Such purposely caused temporary stoppage or substantial reduction of the beating of the heart facilitates procedures such as suturing of an anastomosis which would otherwise be more difficult because of the motion induced by the beating heart.
摘要翻译： 一种用于促进搏动心脏的冠状动脉手术的方法和装置，其中电刺激迷走神经以故意暂时地停止或基本上减少在精确控制的条件下的心跳。 该装置可控制地将电刺激应用于沿着迷走神经的预选位置，并因此应用于与心脏相关的预选神经分支。 该装置包括用于建立与迷走神经的电接触的多个夹子和探针配置。 这样有意地引起临时停止或大幅度减少心脏搏动的方法有助于诸如缝合吻合术的过程，否则由于跳动心脏引起的运动将更加困难。
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