Apparatus for formation of a hole in a blood vessel

• US 6,036,710 A
• Filed: 09/19/1997
• Issued: 03/14/2000
• Est. Priority Date: 10/04/1996
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Bayer, Hanspeter Robert, McGarry, Richard A.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Lewis, William W.
• Application Number:
  US08/933,892
• Time in Patent Office: 907 Days
• Field of Search: 606/1, 606/159, 606/170, 606/171, 606/180, 606/184, 604/22, 30/240, 30/263
• US Class Current: 606/184
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections

Abstract

An apparatus for forming a non-circular opening in tissue includes an elongate body having a first tissue engaging edge associated with a distal end portion thereof, a punch head disposed adjacent the distal end portion of the elongate body, and defining a second tissue engaging edge associated therewith. The first and second tissue engaging edges each define a general racetrack configuration characterized by first and second opposed straight edge portions interconnected by generally arcuate edge portions. At least one of the first and second tissue engaging edges is adapted to cut tissue. The elongate body and the punch head are adapted for relative movement such that the first and second tissue engaging edges cooperate to cut tissue disposed therebetween to thereby form a general racetrack-shaped opening in tissue.

Claims

1. An apparatus for forming a non-circular opening in tissue, which comprises:

a) an elongate body defining a longitudinal axis and having a proximal end portion and a distal end portion, the distal end portion having a first tissue engaging edge associated therewith;

b) a punch head disposed adjacent the distal end portion of the elongate body, the punch head defining a second tissue engaging edge associated therewith;

c) the first and second tissue engaging edges each defining a general racetrack configuration characterized by first and second opposed straight edge portions interconnected by generally arcuate edge portions;

d) at least one of the first and second tissue engaging edges being adapted to cut tissue; and

e) the elongate body and the punch head adapted for relative movement such that the first and second tissue engaging edges cooperate to cut tissue disposed therebetween to thereby form a general racetrack-shaped opening in tissue.

2. The apparatus according to claim 1 wherein the first and second tissue engaging edges are each adapted to cut tissue.

3. An apparatus for forming a non-circular opening in the wall of a blood vessel, which comprises:

a) a housing;

b) an elongate body mounted with respect to the housing and defining a longitudinal axis, and having proximal and distal end portions;

c) a cutting element associated with the distal end portion of the elongate body, the cutting element having a peripheral cutting edge defining a longitudinal opening in the cutting element, the peripheral cutting edge defining a general racetrack configuration;

d) a punch element disposed adjacent the distal end portion of the elongate body and operatively connected to the housing, the punch element having a punch head dimensioned to support tissue; and

e) at least one of the elongate body and the housing movable relative to the other between an unactuated position wherein the peripheral cutting edge of the cutting element and the punch head of the punch element are displaced and an actuated position wherein the peripheral cutting edge and the punch head are approximated to cooperate to cut tissue supported by the punch head.

4. The apparatus according to claim 3 wherein the peripheral cutting edge of the cutting element has opposed straight edge portions connected by arcuate edge portions.

5. The apparatus according to claim 3 wherein the cutting element defines a general dome-shape to thereby define sloped peripheral cutting edges.

6. The apparatus according to claim 4 wherein the punch head defines a cross-sectional dimension approximating an internal dimension of the longitudinal opening of the cutting element such that in the actuated position the punch head is at least partially received within the longitudinal opening.

7. The apparatus according to claim 6 wherein the punch head defines a peripheral cutting edge adapted to cooperate with the peripheral cutting edge of the cutting element to cut tissue.

8. The apparatus according to claim 7 wherein the peripheral cutting edge of the punch head defines a general racetrack configuration having opposed straight edge portions connected by arcuate edge portions.

9. The apparatus according to claim 3 further including an actuating member operatively connected to the elongate body.

10. The apparatus according to claim 3 further including an elongate member disposed within the elongate body for operatively connecting the housing and the punch head.

11. The apparatus according to claim 3 wherein the punch element includes a recessed portion adjacent the punch head, the recessed portion dimensioned to accommodate tissue portions.

12. The apparatus according to claim 3 including a resilient member for biasing the elongate body to the unactuated position.

13. An apparatus for facilitating the formation of an opening in the wall of a blood vessel, which comprises:

a) an elongate housing having a proximal end portion and a distal end portion and defining a longitudinal axis;

b) a cutting collar disposed at the distal end portion of the elongated housing and rotatably mounted thereto, the cutting collar having a longitudinal opening and defining an internal dimension;

c) an actuating rod at least partially disposed in the elongate housing, the actuating rod mounted for longitudinal movement relative to the elongate housing between an unactuated position and an actuated position;

d) a punch blade disposed at the distal end of the actuating rod, the punch blade defining a cross-sectional dimension having a major dimension greater than a minor dimension, the cross-sectional dimension approximating the internal dimension of the cutting collar such that upon movement of the elongate rod to the actuated position the punch blade is at least partially received in the cutting collar to a blood vessel wall disposed therebetween; and

e) a manually operable member disposed adjacent the proximal end portion of the elongate housing, the manually operable member operatively connected to the cutting collar and the punch blade and moveable to cause corresponding rotational movement of the cutting collar and the punch blade.

14. The apparatus according to claim 13 wherein the cutting collar has an internal dimension defining an arcuate configuration and wherein the punch blade defines an arcuate cross-sectional dimension approximating the internal dimension of the cutting collar to permit at least partial reception of the punch blade.

15. The apparatus according to claim 13 wherein the cutting collar has an internal dimension defining a general elliptical configuration and wherein the punch blade defines a general elliptical configuration approximating the internal dimension of the cutting collar.

16. The apparatus according to claim 13 further including an actuating member disposed adjacent the proximal end portion of the elongate housing, the actuating member operatively connected to the actuating rod and moveable to cause corresponding movement of the actuating rod between the unactuated position and the actuated position.

17. The apparatus according to claim 13 wherein the actuating rod includes a recessed portion adjacent the punch blade, the recessed portion dimensioned to accommodate at least a portion of the blood vessel wall.

18. The apparatus according to claim 13 wherein the manually operable member is mounted for rotational movement relative to the elongate housing.

19. The apparatus according to claim 18 including a resilient member for biasing the actuating rod to the unactuated position.

20. An apparatus for facilitating the formation of an opening in a wall of a blood vessel, which comprises:

a) an elongate housing having a proximal end portion and a distal end portion and defining a longitudinal axis;

b) a support collar mounted adjacent the distal end portion of the elongate housing and rotatably moveable relative to the elongated housing, the collar having a longitudinal opening and defining an internal dimension;

c) an elongate rod at least partially disposed in the elongate housing, the elongate rod and elongate housing adapted for relative movement;

d) a punch head disposed at a distal end portion of the elongate rod, the punch head defining a cross-sectional dimension having a major dimension greater than a minor dimension, the cross-sectional dimension approximating the internal dimension of the collar such that upon relative movement of the elongate rod and the elongate housing from a first position to a second position, the punch head is at least partially received within the longitudinal opening of the support collar to cut an opening in a blood vessel wall disposed therebetween, at least one of the collar and the punch head having a cutting edge; and

e) a manually operable member disposed adjacent the proximal end portion of the elongate housing, the manually operable member operatively connected to the collar and the punch head and moveable to cause corresponding rotational movement of the collar and the punch head.

21. The apparatus according to claim 20 wherein the internal dimension of the collar defines a general elliptical configuration and wherein the punch head defines a general elliptical configuration approximately the internal dimension of the collar.

22. The apparatus according to claim 20 further including an actuating member disposed adjacent the proximal end portion of the elongate housing, the actuating member operatively connected to one of the punch head and the collar, the actuating member moveable to cause the relative movement of the collar and the punch head between the first position and the second position.

23. The apparatus according to claim 21 wherein the collar includes a peripheral cutting edge and wherein the punch head includes a peripheral cutting edge, the peripheral cutting edges cooperating to form the opening in the blood vessel wall.

24. The apparatus according to claim 20 wherein the collar is stationary and the punch head is retractable to form the opening in the blood vessel wall.

25. The apparatus according to claim 23 wherein the elongate rod includes a recessed portion adjacent the punch blade, the recessed portion dimensioned to accommodate at least a portion of the blood vessel wall.

26. A method for forming an opening in a blood vessel wall, comprising the steps of:

a) providing an instrument including an elongate body having a first tissue engaging edge disposed at a distal end thereof, and a tissue supporting head disposed beyond the distal end of the elongate body and defining a second tissue engaging edge, the first and second tissue engaging edges each defining a general racetrack configuration having opposed straight edge portions connected by arcuate edge portions, at least one of the first and second tissue engaging edges being adapted to cut tissue;

b) positioning the tissue supporting head of the instrument through an incision in the blood vessel wall; and

c) moving at least one of the elongate body and the tissue supporting head relative to the other to cause the first and second tissue engaging edges to cooperate to cut vessel wall portions supported by the tissue supporting head to thereby form a general racetrack-shaped opening in the blood vessel wall.

27. The method according to claim 26 wherein each of the first and second tissue engaging edges are adapted to cut tissue and wherein the step of moving includes shearing the vessel wall portion through cooperation of the first and second tissue engaging edges.

28. The method according to claim 26 wherein the step of moving includes advancing the elongate body to cause corresponding advancing movement of the first tissue engaging edge to thereby cut the tissue.

29. The method according to claim 26 wherein the step of moving includes retracting the tissue supporting head to cause corresponding retracting movement of the second tissue engaging edge to thereby cut the tissue.