Lateral-and posterior-aspect method and apparatus for laser-assisted transmyocardial revascularization and other surgical applications

• US 5,725,523 A
• Filed: 03/29/1996
• Issued: 03/10/1998
• Est. Priority Date: 03/29/1996
• Status: Expired due to Fees

• Current Assignee: Eclipse Surgical Technologies, Inc. (Cryolife Incorporated)
• Original Assignee: Eclipse Surgical Technologies, Inc. (Cryolife Incorporated)
• Inventors: Mueller, Richard L.
• Primary Examiner(s): Bahr, Jennifer
• Assistant Examiner(s): YARNELL, BRYAN KEITH
• Application Number:
  US08/627,704
• Time in Patent Office: 711 Days
• Field of Search: 606/2, 606/3, 606/7, 607/13-17, 607/89, 128/642
• US Class Current: 606/15
• CPC Class Codes: A61B 1/00098 Deflecting means for inserted tools
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/267 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A balloon end contact scope device for performing laser-assisted transmyocardial revascularization (TMR) or other surgical and catheter procedures, the device particularly adapted for delivery of laser energy via a laser delivery means and configured to reach inside a body cavity or organ chamber at a point not directly accessible, either visually or otherwise, such as in a lateral or posterior position, the device having a hollow outer lumen, a balloon scope portion with an internal guide tube extending through the balloon portion for directing a laser delivery means or other surgical or catheter device through the visualization balloon toward the area being visualized. The balloon scope portion may have a plurality of guide holes extending therethrough. On the essentially transparent contact viewing surface a friction surface may be applied to facilitate precise positioning and treatment therethrough.

Claims

1. A contact scope device for performing a transmyocardial revasculariztion (TMR) procedure comprising:

a hollow outer lumen having a proximal end and a distal end;

a scope portion located at the distal end of the contact scope device, the scope portion including;

a contact viewing portion for contact with a wall of the heart, the contact viewing portion defining at least one port adapted for receiving at least one TMR working component for performing TMR on the wall of the heart, the contact viewing portion further including a friction surface area for gripping tissue adjacent the heart wall and providing stability for the contact viewing scope during the TMR procedure;

a main body portion disposed between the contact viewing portion and the distal end of the outer lumen; and

visualization means for viewing tissue of the wall of the heart through the contact viewing portion.

2. The device of claim 1 wherein at least a portion of the outer lumen is rigid.

3. The device of claim 1 wherein at least a portion of the outer lumen is flexible.

4. The device of claim 1 further comprising at least one guide tube extending at least through the scope portion and providing a pathway for the at least one TMR working component.

5. The device of claim 4 having a plurality of guide tubes and ports, the guide tubes having proximal ends and distal ends the distal ends of the guide tubes communicating with the ports in the contact viewing portion, the proximal ends of the guide tubes positioned to receive the distal ends of multiple TMR working components, whereby the plurality of guide tubes convey the multiple TMR working components through the scope portion to the tissue being visualized.

6. The device of claim 5 further comprising a plurality of inner lumens, the inner lumens having proximal ends and distal ends, the proximal ends of the guide tubes being attached to the distal ends of the inner lumens such that the multiple TMR working components can extend through the inner lumens, through the guide tubes in the scope portion to a surface of the tissue being visualized.

7. The device of claim 5 wherein the multiple TMR working components are a plurality of laser delivery devices.

8. The device of claim 1 wherein the at least one TMR working component is at least one laser delivery device extending through the outer lumen of the scope device and through the scope portion for delivery of laser energy to tissue.

9. The device of claim 1 wherein the visualization means is a viewing fiber optic bundle within the scope portion.

10. The device of claim 1 wherein the scope portion is inflatable by an inflating means for introducing a fluid into the scope portion.

11. The device of claim 1 wherein the friction surface area has a relatively high friction surface area and a low friction surface area, the friction surface area is on peripheral portions of the contact viewing portion, whereby when the scope portion has a relatively low internal pressure, the low friction surface area contacts observed tissue and when the scope portion has a relatively higher internal pressure, the high friction surface area of the contact viewing portion contacts the tissue.

12. The device of claim 1 wherein the device is a surgical instrument insertable through a trocar.

13. The device of claim 1 wherein the device is a catheter instrument.

14. A contact scope device with a tissue ablation device for performing a transmyocardial revasculariztion (TMR) procedure comprising:

a hollow outer lumen having a proximal end and a distal end;

a scope portion located at the distal end of the contact scope device, the scope portion including;

a contact viewing portion for contact with a wall of the heart, the contact viewing portion defining at least one port adapted for receiving at least one optical fiber for performing tissue ablation using laser irradiation on the wall of the heart, the contact viewing portion further including a friction surface area for gripping tissue adjacent the heart wall and providing stability for the contact viewing scope during the TMR procedure;

a main body portion disposed between the contact viewing portion and the distal end of the outer lumen; and

visualization means for viewing tissue of the wall of the heart through the contact viewing portion.