Method of performing port off-pump beating heart coronary artery bypass surgery

• US 6,503,245 B2
• Filed: 12/08/2000
• Issued: 01/07/2003
• Est. Priority Date: 10/11/2000
• Status: Expired due to Term

• Current Assignee: Medici Life Sciences Licensing Company LLC (The Medici Portfolio LLC)
• Original Assignee: Medcanica LLC
• Inventors: Palmer, Matthew A., Castaneda, Javier E., Francese, Jose Luis, de la Torre, Ralph
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): RAM, JOCELYN D
• Application Number:
  US09/733,498
• Publication Number:
  US 20020042595A1
• Time in Patent Office: 760 Days
• Field of Search: 128/898, 600/201, 600/208, 600/210, 600/215, 600/235, 606/108, 606/1, 604/513, 604/533, 604/539, 604/174, 604/164.04
• US Class Current: 606/1
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3492 against the outside of the body

Abstract

A method for performing through-port off-pump beating heart coronary artery bypass surgery is provided. A port device is positioned in the chest wall and directed as necessary. A heart stabilizer is coupled to the port, and operated to apply a compressive force against the heart wall surrounding a location the required bypass such that the location is substantially immobilized. An instrument stabilizer includes a cannula which is inserted through a hole in the chest cavity, and the distal tip of the cannula is located adjacent the surgical site. The instrument stabilizer dampens movement of a surgical instrument, e.g., a scalpel or needle holder, extended therethrough. Once the bypass procedure is complete, the instruments, heart stabilizer, instrument stabilizers, and port are removed from the body of the patient.

Claims

1. A method of performing a port off-pump beating heart coronary artery bypass surgical procedure through a chest wall, comprising:

a) inserting a first port device into the chest wall; and

b) extending a heart stabilizer through said first port device and locking said heart stabilizer to said first port device such that sufficient pressure is applied to a beating heart wall surrounding a location of the required bypass such that the location is substantially immobilized.

2. A method according to claim 1, further comprising:

c) inserting a second port device into the chest wall; and

d) extending a surgical instrument through said second port device.

3. A method according to claim 2, further comprising:

e) prior to extending said surgical instrument through said second port device, extending an instrument stabilizer having a tubular portion through said second port device,

wherein when said surgical instrument is extended through said second port device, said surgical instrument is also extended through said tubular portion of said instrument stabilizer,

said instrument stabilizer adapted to provide a damping force to said surgical instrument to reduce extraneous movement at a distal end of said surgical instrument.

4. A method according to claim 3, further comprising:

f) using said surgical instrument to at least partly perform a coronary artery bypass procedure.

5. A method according to claim 2, further comprising:

e) rigidly fixing at least one of said first port device and said second port device to the chest wall.

6. A method according to claim 5, further comprising:

f) angularly directing at least one of said first port device and said second port device relative to the chest wall.

7. A method according to claim 2, further comprising:

e) angularly directing at least one of said first port device and said second port device relative to the chest wall.

8. A method according to claim 1, further comprising:

c) extending at least a portion of a cannula of an instrument stabilizer through tissue of the patient and into a chest cavity; and

d) extending a surgical instrument through said cannula of said instrument stabilizer,

wherein said instrument stabilizer is adapted to provide a damping force to said surgical instrument to reduce extraneous movement at a distal end of said surgical instrument.

9. A method according to claim 8, wherein:

said extraneous movement reduced is longitudinal relative to said cannula.

10. A method according to claim 8, wherein:

said extraneous movement reduced is non-parallel relative to said cannula.

11. A method according to claim 8, wherein:

said cannula is provided with a distal boring tip adapted to puncture the tissue of the patient thereby permitting the extension of said at least said portion of said cannula through the tissue.

12. A method according to claim 8, further comprising:

e) using said surgical instrument to at least partly perform a coronary artery bypass procedure.

13. A method according to claim 8, further comprising:

e) coupling said instrument to the patient with sutures or adhesive.

14. A method of performing a port off-pump beating heart coronary artery bypass surgical procedure through a chest wall, comprising:

a) inserting a first port device into the chest wall;

b) clamping the first port device about the chest wall; and

c) extending a heart stabilizer through said first port device and locking said heart stabilizer to said first port device such that sufficient pressure is applied to a beating heart wall surrounding a location of the required bypass such that the location is substantially immobilized.

15. A method according to claim 14, further comprising:

d) inserting a second port device into the chest wall; and

e) extending a surgical instrument through said second port device.

16. A method according to claim 15, further comprising:

f) prior to extending said surgical instrument through said second port device, extending an instrument stabilizer having a tubular portion through said second port device,

wherein when said surgical instrument is extended through said second port device, said surgical instrument is also extended through said tubular portion of said instrument stabilizer,

said instrument stabilizer adapted to provide a damping force to said surgical instrument to reduce extraneous movement at a distal end of said surgical instrument.

17. A method according to claim 16, further comprising:

g) using said surgical instrument to at least partly perform a coronary artery bypass procedure.

18. A method according to claim 15, further comprising:

f) angularly directing at least one of said first port device and said second port device relative to the chest wall; and

g) fixing said at least one of said first port device and said second port device to the chest wall at a first angle which is oblique relative to a normal of the chest wall at a location of the chest wall at which said at least one of said first port device and said second port device is located.

19. A method according to claim 14, wherein:

said clamping occurs about at least one rib.

20. A method according to claim 14, further comprising:

d) prior to said clamping, angularly directing said first port device relative to the chest wall.