摘要:
Anastomotic connectors and apparatus for forming and/or maintaining connections between openings formed in anatomical structures, such as blood vessels. The apparatus is initially deployed in a first configuration which is sufficiently compact to be delivered through the lumen of a catheter or cannula. Thereafter, the device is expanded to a second configuration whereby it engages the anatomical structures and forms or maintains the desired connection between openings in the anatomical structures.
摘要:
The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration. An actuator, at the proximal end of the shaft, can be rotated to pivot the foot about a transverse axis so that the contact surfaces are oriented generally parallel to the surgical site to apply pressure to the tissue structure on both sides of the surgical site.
摘要:
Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.
摘要:
A retracting tip trocar assembly including a trocar tube and a shaft having a piercing tip at one end thereof. The device includes a retracting mechanism which allows the piercing tip to be held in a cutting position upon application of an insertion force such as when the piercing tip is pressed against a wall of a human body cavity. Upon release of the insertion force, such as when the piercing tip passes through the wall, the retracting mechanism causes the piercing tip to be retracted into the trocar tube.
摘要:
A method is provided for obtaining cervical cell culture specimens. The method makes use of a test device which may be used in conjunction with the manual cervical examination prior to delivery. The device includes an elastically resilient sheath adapted to grip a finger and a sterile pad of absorbent material on one end adapted to collect and retain the cell culture specimen. A kit is provided as well, the kit including a support member for maintaining the device in an unrolled, elongated, unrolled configuration and is designed so as to maintain sterile conditions and minimize contamination during storage and transport.
摘要:
A trocar assembly consisting of a trocar tube subassembly and a separable, interfitting trocar subassembly is described. The trocar tube assembly includes a hollow body having a first front opening in which a trocar tube is mounted, a second rear opening for receiving the trocar subassembly, and a manually pivotable flap valve mechanism mounted within the body. The trocar subassembly includes a head having a central bore in which are mounted the (1) rear ends of an elongated obturator having a pyramidal-shaped piercing head with a triangular-shaped base, and a concentric tubular shield having a triangular shaped front opening for the piercing head that is formed by bevels in its leading edge that have approximately the same slope as the surfaces that define the three sides of the piercing head, and (2) a coil spring backing the shield for biasing the shield between retracted and extended positions. When the two subassemblies are fit together, the obturator and concentric shield extend through the hollow body with the front wall of the head fitting within a recess in the rear wall of the hollow body such that the trocar assembly cannot be rotated without disengaging the two subassemblies. The shield has a slot in its outer wall that is engaged by the flap valve to lock the shield in its extended position. The shield may be unlocked by pivoting the flap valve out of the slot, sliding the trocar assembly rearwardly so that the front wall of the head is clear of the recess in the rear wall of the hollow body, rotating the trocar subassembly to a position in which the flap valve and slot are not aligned and sliding the front wall of the trocar assembly back into the recess in the rear wall of the hollow body.