Abstract:
A system for stabilizing the heart via a helical needle, providing access to the interior of the heart via an introducer sheath, and forming a purse string suture using suture delivered by the helical needle. A helical needle projects distally from the device in a helical shape and terminates in a sharp distal tip. The helical needle is advanced into the heart wall, and is used to stabilize the heart and to pass a purse string suture through the heart tissue. An access port provides access to the interior of the heart via an opening passing through the heart wall in an area circumscribed by the helical needle. A length of suture may pass through the helical needle and exit at an opening at or near the needle distal tip. A free end of the length of suture may extend out of the distal tip and back into the hollow suture needle through the opening. The helical needle may have a deflection segment adjacent the distal tip that is more flexible than the rest of the helical distal portion of the helical needle.
Abstract:
A surgical access device (10 or 10') includes a frame defining an access port and a pair of flanges are carried on the lower surface of the frame. The flanges are pivotable between an insertion position, where their leading edges are optimally placed adjacent one another to assist in inserting the device in an incision, and a retracting position, where both flanges optimally urge upwardly against the internal surface of the patient's tissue to seat the access port. A method of the invention involves making an incision at least as long as the leading edge of such a device and inserting the leading edge of the device into the incision. The flanges are moved laterally away from one another to expand the opening in the tissue and center the access port laterally within the opening.
Abstract:
A method for closed chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope (34) or other viewing scope and endovascularly partitioning the patient's arterial system at a location within the ascending aorta. The cardiopulmonary bypass (56) and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia.
Abstract:
A method of accessing a thoracic cavity; inserting, in an insertion direction, a thin elongated body, from outside the body, through a space between adjacent ribs, to within the thoracic cavity; expanding the elongated body in a direction including a component perpendicular to the insertion direction to generate an elongated body lumen therein.
Abstract:
A surgical rib retractor is disclosed. The surgical rib retractor includes a housing having at least one cam surface. The surgical rib retractor also includes an anterior arm unit configured to receive one rib. The surgical rib retractor further includes a posterior arm unit configured to receive another rib. The surgical rib retractor also has an actuator movable relative to the housing and operationally coupled to at least one of the anterior and posterior arm units to move said at least one of the anterior and posterior arm units against the at least one cam surface to create a relative movement between the anterior and posterior arm units, said relative movement comprising at least two directional components.
Abstract:
A surgical access system including an access port device. The port device has a port member, a plurality of blades, and an articulation mechanism. The blades are circumferentially arranged about a longitudinal axis of the port member to collectively define an access region. The articulation mechanism defines a pivot point along a length of each blade, and is operable to articulate the blades between collapsed and expanded states. The blade tips collectively define a diameter in the collapsed state that is less than that in the expanded state. The blades rotate about the corresponding pivot point, and the pivot points move longitudinally relative to the port member, in transitioning between the contracted and expanded states. Light source(s) can be integrated with the blades or separately provided to enhance surgical field visibility.
Abstract:
Trocar for instrument access to body cavities in minimally invasive surgery, the trocar comprising: - a body having a first access opening and at least one second access opening, each for inserting an instrument; - a cannula arranged with a proximal end to the body and having a distal end suitable for insertion into body cavities in minimally invasive surgery, wherein the cannula has a substantially constant out of round cross-section along is length, wherein a channel in the cannula is connected to the first access opening to provide a first passageway for an instrument and to the second access opening to provide at least one second passageway separate from said first passageway; and - a gas inlet arranged at the body and in fluid connection with the at least one passageway for inflating the body cavity with a gas, such as carbon dioxide gas.
Abstract:
A rib retractor (1) comprises a pair of L-shaped members (2, 4) able to be pivoted between an inserting and a working shape. Each member (2, 4) comprises a detachable handle (6) at a proximal side and a stretching jaw (18) at a distal side. The members (2, 4) are linked at their corners by pivoting joining means (10). Each stretching jaw (18) comprises a distal blade part (16) and a curved section (18), the latter acting as a cam to stretch apart the ribs (14) when the retractor (1) is brought from inserting to working shape and which define the operating field.
Abstract:
This invention is a flexible, length-adjustable suture organizer (200) coupled to a retractor (202) having a number of flexible straps (224). The straps are tensioned to retract tissue, while the suture organizer is used to retain sutures extending through an opening created by the retractor. The retractor includes a holder (226) which retains the suture organizer.
Abstract:
The invention provides devices and methods for thoracoscopically arresting the heart and establishing cardiopulmonary bypass, thus facilitating a variety of less invasive surgical procedures on and within the heart and great vessels of the thorax. In one embodiment, the invention provides a thoracoscopic system for arresting a patient's heart including a clamp (32) configured for introduction into the patient's thoracic cavity through a percutaneous intercostal penetration in the patient's chest. The clamp is positionable about the patient's ascending aorta between the coronary arteries and the brachio-cephalic artery. The clamp (32) is coupled to the distal end of an elongated handle means (36) for manipulating the clamp (32) from a location outside of the patient's thoracic cavity. A means for actuating the clamp (36) is coupled to the proximal end (23) of the handle means (36). When actuated, the clamp (32) blocks blood flow through the ascending aorta. A delivery cannula (44) may be used to deliver cardio-plegic fluid into the ascending aorta upstream from the clamp (32) to arrest cardiac function.