Methods and apparatus for endoscopic cardiac surgery
First Claim
1. A method of performing a surgical procedure on the heart of a patient under visualization through an endoscope, the method comprising:
- establishing a working cavity through tissue between the heart and an entry location;
inserting through the entry location and in the working cavity a first cannula including an instrument channel disposed between proximal and distal ends thereof and including an endoscope positioned in the first cannula to provide a visual field forward of the distal end;
slidably positioning a second cannula in the instrument channel of the first cannula, with a channel of the second cannula extending between distal and proximal ends thereof, and with a suction port positioned on the distal end of the second cannula;
contacting a target site on the heart with the suction port, and supplying suction thereto; and
extending an instrument through the channel of the second cannula beyond the distal end of the second cannula into contact with the heart within the visual field of the endoscope.
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Accused Products
Abstract
Apparatus and surgical methods establish temporary suction attachment to a target site on the surface of a bodily organ for enhancing accurate placement of a surgical instrument maintained in alignment with the suction attachment. A suction port on the distal end of a supporting cannula provides suction attachment to facilitate accurate positioning of a needle for injection penetration of tissue at the target site on the moving surface of a beating heart. Force applied via the suction attachment to the surface of the heart promotes perpendicular orientation of the surface of the myocardium for enhanced accuracy of placement of a surgical instrument thereon.
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Citations
34 Claims
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1. A method of performing a surgical procedure on the heart of a patient under visualization through an endoscope, the method comprising:
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establishing a working cavity through tissue between the heart and an entry location;
inserting through the entry location and in the working cavity a first cannula including an instrument channel disposed between proximal and distal ends thereof and including an endoscope positioned in the first cannula to provide a visual field forward of the distal end;
slidably positioning a second cannula in the instrument channel of the first cannula, with a channel of the second cannula extending between distal and proximal ends thereof, and with a suction port positioned on the distal end of the second cannula;
contacting a target site on the heart with the suction port, and supplying suction thereto; and
extending an instrument through the channel of the second cannula beyond the distal end of the second cannula into contact with the heart within the visual field of the endoscope. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method of performing a surgical procedure on the heart of a patient under visualization through an endoscope, the method comprising:
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forming a working cavity in tissue between the heart and a subxiphoid entry location;
advancing a surgical instrument including the endoscope through the subxiphoid entry location and working cavity toward the heart;
establishing a suction attachment to a target site on the epicardium below the pericardium under visualization through the endoscope; and
contacting the epicardium below the pericardium at a location referenced to the target site of the suction attachment for performing a surgical procedure thereat under visualization through the endoscope. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 27, 28)
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26. Surgical apparatus comprising:
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an elongated cannula having first and second separate channels therein and including a suction port at a distal end of the elongated cannula in fluid communication with the first lumen; and
the second lumen having a distal end thereof displaced from the suction port for slidably extending a surgical instrument therethrough forward of the suction port. - View Dependent Claims (29, 30, 31, 32, 33, 34)
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Specification