Apparatus and method for intraoperatively performing surgery
First Claim
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1. Apparatus for performing transmyocardial revascularization comprising:
- a housing;
a stationary shaft coupled to the housing, the stationary shaft including a first lumen and a distal end;
a drive tube disposed in the first lumen, the drive tube having a second lumen and a distal end, the drive tube arranged for sliding movement in distal and proximal directions within the first lumen;
a cutting head disposed from the distal end of the drive tube, the cutting head having an exposed cutting surface, the cutting head configured to be extended beyond the distal end of the stationary shaft a distance sufficient to cut a transmural channel in cardiac tissue the cutting head communicating with the second lumen so that tissue severed by the cutting head is evacuated through the second lumen; and
a stabilizing element that stabilizes the cardiac tissue against the distal end of the stationary shaft, the stabilizing element counteracting wall motion of the cardiac tissue.
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Abstract
Apparatus and methods for intraoperatively performing surgery to create transmural channels in tissue, for example, as in transmyocardial revascularization, are provided using a device including a mechanical end effector and means for stabilizing the end effector in contact with the tissue. The end effector is adapted to cooperate with a source of suction to evacuate tissue severed during the channel forming process, and may optionally include an electrode for cauterizing the tissue surrounding the channel.
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Citations
29 Claims
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1. Apparatus for performing transmyocardial revascularization comprising:
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a housing; a stationary shaft coupled to the housing, the stationary shaft including a first lumen and a distal end; a drive tube disposed in the first lumen, the drive tube having a second lumen and a distal end, the drive tube arranged for sliding movement in distal and proximal directions within the first lumen; a cutting head disposed from the distal end of the drive tube, the cutting head having an exposed cutting surface, the cutting head configured to be extended beyond the distal end of the stationary shaft a distance sufficient to cut a transmural channel in cardiac tissue the cutting head communicating with the second lumen so that tissue severed by the cutting head is evacuated through the second lumen; and a stabilizing element that stabilizes the cardiac tissue against the distal end of the stationary shaft, the stabilizing element counteracting wall motion of the cardiac tissue. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. Apparatus for forming a channel in tissue comprising:
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a housing, a stationary shaft having an angled sleeve portion, proximal and distal ends, and a first lumen extending from the proximal end to the distal end, the proximal end coupled to the housing; a drive tube disposed in the first lumen, the drive tube having a second lumen and a distal end, the drive tube comprising a portion formed of a coil spring having closely spaced adjacent turns, the drive tube arranged for sliding movement in distal and proximal directions within the first lumen, the coil spring portion being disposed within the first lumen of the angled sleeve portion; an end effector disposed from the distal end of the drive tube, the end effector including means for cutting a channel in the tissue, the means for cutting communicating with the second lumen so that tissue severed by the end effector is evacuated through the second lumen; and a vacuum source for drawing suction through the second lumen, wherein the coil spring portion of the drive tube passes in the proximal and distal directions through the angled sleeve portion without substantial loss of suction through the second lumen. - View Dependent Claims (21, 22, 23, 24, 25, 26, 27, 28, 29)
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Specification