Laser device with auto-piercing tip for myocardial revascularization procedures
First Claim
1. A hand held auto-piercing mechanism comprising:
- a handle assembly having a head portion whose distal end is configured to engage tissue;
a channel forming device extending through the handle assembly and head portion, the channel forming device comprising an optical fiber;
a piercing means surrounding the channel forming device for making an initial opening in tissue, the piercing means includes a piercing tubular member which is retractable into the head portion, the piercing tubular member has a tapered tip portion and an internal bore for allowing slidable displacement of the optical fiber, a distal section of the piercing tubular member includes a means for axially bending of the piercing tubular member, and the optical fiber therein; and
a movement means operatively attached to the piercing means and the channel forming device for independently controlling the movement of the piercing means and the channel forming device, the movement means comprises an adjustment means for moving the optical fiber within the handle assembly and head portion, the adjustment means forms part of the handle assembly, whereby the optical fiber'"'"'s distal end can move beyond the head portion, and a means for presetting displacement of the optical fiber, thereby limiting the optical fiber'"'"'s displacements.wherein the piercing means is wholly responsive to the movement means for making an initial opening in tissue.
1 Assignment
0 Petitions
Accused Products
Abstract
The apparatus for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically auto-piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient'"'"'s heart, and the distal end of the energy delivery device such as an optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said energy delivery device such as an optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed. The apparatus includes a hand-held device controllable by the physician having a removable distal head portion with an auto-piercing mechanism and can use a vacuum source to provide a suction force at the head portion. The auto-piercing mechanism is implemented by various ways such as a spring-biased actuating member in the TMR hand-held device and an electro-mechanical operated piercing mechanism. The hand-held TMR device with handle assembly can also be controlled by a computer to provide auto- sequencing of the auto-piercing needle mechanism and the laser firing with auto-fiber advancement.
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Citations
28 Claims
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1. A hand held auto-piercing mechanism comprising:
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a handle assembly having a head portion whose distal end is configured to engage tissue; a channel forming device extending through the handle assembly and head portion, the channel forming device comprising an optical fiber; a piercing means surrounding the channel forming device for making an initial opening in tissue, the piercing means includes a piercing tubular member which is retractable into the head portion, the piercing tubular member has a tapered tip portion and an internal bore for allowing slidable displacement of the optical fiber, a distal section of the piercing tubular member includes a means for axially bending of the piercing tubular member, and the optical fiber therein; and a movement means operatively attached to the piercing means and the channel forming device for independently controlling the movement of the piercing means and the channel forming device, the movement means comprises an adjustment means for moving the optical fiber within the handle assembly and head portion, the adjustment means forms part of the handle assembly, whereby the optical fiber'"'"'s distal end can move beyond the head portion, and a means for presetting displacement of the optical fiber, thereby limiting the optical fiber'"'"'s displacements. wherein the piercing means is wholly responsive to the movement means for making an initial opening in tissue. - View Dependent Claims (2, 3, 4)
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5. A hand held auto-piercing mechanism comprising:
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a handle assembly having a head portion whose distal end is configured to engage tissue; a channel forming device extending through the handle assembly and head portion; a piercing means surrounding the channel forming device for making an initial opening in tissue; and a movement means operatively attached to the piercing means and the channel forming device for independently controlling the movement of the piercing means and the channel forming device, the movement means comprising a controlling means for controllably advancing the channel forming device at a rate coordinated with a laser energy source, wherein the piercing means is wholly responsive to the movement means for making an initial opening in tissue.
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6. A surgical device for treating myocardium comprising:
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a handle assembly with a distal end configured to engage epicardium including at least one distal opening communicating through the hand assembly; a piercing mechanism within the distal end of the handle assembly, movement of said piercing mechanism relative to and translatable through said opening; a substance delivery conduit distally connected to the handle assembly through to the opening and proximally connected to a source; and an acceleration mechanism operatively coupled to the handle assembly for controllably advancing the piercing mechanism through the opening and epicardium to myocardium; wherein the piercing mechanism is wholly responsive to the acceleration mechanism.
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7. A hand held auto-piercing mechanism comprising:
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a handle assembly having a head portion whose distal end is configured to engage tissue; a channel forming device extending through the handle assembly and head portion; a piercing means surrounding the channel forming device for making an initial opening in tissue; and a movement means operatively attached to the piercing means and the channel forming device for independently controlling the movement of the piercing means and the channel forming device, the movement means further comprising an actuating means, wherein the piercing means is wholly responsive to the movement means for making an initial opening in tissue and operation of the actuating means triggers a spontaneous advancement of the piercing means. - View Dependent Claims (8, 9)
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10. A hand held auto-piercing mechanism comprising:
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a handle assembly having a head portion whose distal end is configured to engage tissue; a channel forming device extending through the handle assembly and head portion; a piercing means surrounding the channel forming device for making an initial opening in tissue; and a movement means operatively attached to the piercing means and the channel forming device for independently controlling the movement of the piercing means and the channel forming device, the movement means further comprising an actuating means, wherein the piercing means is wholly responsive to the movement means for making an initial opening in tissue and operation of the actuating means results in a first event followed by a second event, the first event resulting in a spontaneous advancement of the piercing means, the channel forming device remaining at least in the piercing means, the second event resulting in the continued displacement of the channel forming device. - View Dependent Claims (11, 12)
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13. A hand held auto-piercing mechanism comprising:
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a handle assembly having a head portion whose distal end is configured to engage tissue; a channel forming device extending through the handle assembly and head portion; a piercing means surrounding the channel forming device for making an initial opening in tissue; and a movement means operatively attached to the piercing means and the channel forming device for independently controlling the movement of the piercing means and the channel forming device, the movement means comprising a first displacement mechanism which advances and retracts the piercing means, and a second displacement mechanism which advances and retracts the channel forming device; wherein the piercing means is wholly responsive to the movement means for making an initial opening in tissue. - View Dependent Claims (14, 15, 16, 17, 18, 19)
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20. A handheld myocardial revascularization device comprising:
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a handle assembly with a head portion whose distal end is configured to engage the heart; a channel forming device extending through the handle assembly and head portion; a piercing means surrounding the channel forming device for making an initial opening in tissue, the piercing means moves relative to the head portion and is translatable through the head portion; and an advancing means for controllably advancing the piercing means, the advancing means comprising an actuator means for advancing the piercing means, the actuator means comprising a thumbwheel attached to the handle assembly, a belt drive that rides on a pair of gear members, and a rotatably mounted needle piercing element that translates within one of the gear members bore with internal threads, whereby the advancing means enables initial tissue piercing.
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21. A handheld myocardial revascularization device comprising:
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a handle assembly with a head portion whose distal end is configured to engage the heart; a channel forming device extending through the handle assembly and head portion; a piercing means surrounding the channel forming device for making an initial opening in tissue, the piercing means moves relative to the head portion and is translatable through the head portion, the piercing means and the channel forming device moving independently with respect to one another; and an advancing means for controllably advancing the piercing means, the advancing means comprising an actuator means for advancing the piercing means, the actuator means comprising a motor operatively attached to the piercing means, whereby the advancing means enables initial tissue piercing. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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Specification