摘要:
A two-axis angular rate gyroscopic apparatus is provided having a rotatable dish. The dish has a central hub portion and a plurality of flexible members, each of which extends from the hub portion. The entire disk is electrically conductive and connected to a reference potential. A plurality of electrically conductive members which are mounted end-to-end are located on an insulated plate mounted adjacent to the disk. A motor is provided for rotating the disk at approximately 2000 rpm. In addition, each of the flexible members in the disk has a pie-shaped section removed therefrom in order to increase its flexibility. By increasing the flexibility of the movable members, performance at low motor speeds is facilitated. An electronic circuit provides an output corresponding to the differential capacitance between the rotating disk and the members on the plate mounted adjacent thereto.
摘要:
Forming a proximal anastomosis on an aortic wall includes method and instrumentation and apparatus for forming an aortic puncture and inserting into the vessel through the puncture a fluid-impervious sealing element with a protruding retainer. An anastomosis of a graft vessel over the puncture is partially completed with the retainer of the sealing element protruding through the partial anastomosis. The retainer facilitates removal of the sealing element from the partial anastomosis prior to completion of the procedure.
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:
Surgical devices for stabilizing the heart are disclosed which facilitate anastomosis under beating heart conditions. Various instruments or devices may be maneuvered and secured on a retractor device to provide stabilization of the heart. An instrument mount is provided which is preferably configured to accept a surgical instrument, such as a tissue stabilizer, and to allow the instrument to be easily maneuvered to a desired position and subsequently locked into position with a simple operation of a single locking actuator. Further disclosed are stabilizer devices each having at least one surface for contacting the heart and each being adapted to be mounted to the retractor while having the ability to be positioned in the desired location against the heart.
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:
Stabilization devices, systems and methods for stabilizing tissue to perform a surgical operation while the heart of the patient continues to beat. A stabilization system including a tissue contact member having a surface adapted to contact the tissue and temporarily maintain the tissue in a relatively immobilized state; and a maneuverable arm attached to the tissue contact member, which includes at least one articulating joint formed by a link having a male articulating surface composed of angled teeth and a female articulating surface having angled trenches adapted to receive the angled teeth.
摘要:
In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. The apparatus may involve a tissue stabilizer, and in particular a tissue stabilizer for use in immobilizing or stabilizing a portion of the beating heart using a compressive force delivered to the heart via the tissue stabilizer. The stabilizer may include a stabilizer base and a shaft. The shaft may be secured within an appropriate instrument mount preferably fixed to a retractor or other stable platform as disclosed herein. The stabilizers of the present invention provide improved access to a surgical site at a target vessel on the surface of the heart and may include features which facilitate optimal presentation of the target vessel.
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:
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:
The invention is a method to perform a surgical procedure within the beating heart. The instrument provides a seal to surround cardiac tissue, thereby defining a segregated surgical field within the body of the instrument. A suction device is preferred to remove blood and fluids from the surgical field so that a surgical procedure can be performed while the heart continues to beat. The instrument is particularly suitable for a procedure to repair defective or diseased cardiac valves, such as the mitral valve; a procedure which previously required that the heart be stopped so that the corrective surgical procedure could be performed.