Method and device for organ positioning

• US 6,676,597 B2
• Filed: 06/12/2001
• Issued: 01/13/2004
• Est. Priority Date: 01/13/2001
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Guenst, Gary W., Jahns, Scott E., Gubbin, Douglas H., Daigle, Thomas, Pignato, Paul A., Olig, Christopher, Jolly, Katherine, Montpetit, Karen
• Primary Examiner(s): Gilbert, Samuel G.
• Application Number:
  US09/879,293
• Publication Number:
  US 20020095067A1
• Time in Patent Office: 945 Days
• Field of Search: 600/37, 600/231-234, 600/201, 600/227-229, 600/235, 128/898, 128/644, 601/1, 601/166, 606/191, 606/158, 606/1, 606/108
• US Class Current: 600/37
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• 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 2017/2905 flexible
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

This invention provides an organ positioning device and method that employs suction to hold organ tissue to the device. The device allows the organ, for example, heart to be positioned in a desired orientation but otherwise allowing movement of the heart as the heart beats. The device is designed to be relatively atraumatic to heart tissue. Generally, the device comprises a resiliently flexible suction head having a plurality of legs that flex to conform to the surface of the heart. The suction head has vacuum passageways in fluid communication with the legs to apply suction between the legs and the surface of the heart.

Claims

1. A heart positioning device comprising:

a resiliently-flexible suction pad having a plurality of legs that flex to conform to the surface of the heart, the suction pad having vacuum passageways in fluid communication with the legs to apply suction between the legs and the surface of the heart;

a vacuum line connected to the vacuum passageway; and

a support arm connected to the suction pad to position the suction pad to thereby position or hold the heart;

wherein the suction pad is integrally molded with a resiliently-flexible suspension element connecting the suction pad to the support arm, the suction pad and suspension element being molded of the same material.

2. The heart positioning device according to claim 1 wherein the legs are configured and sufficiently flexible that they can be drawn against one another to a collapsed position for entering into thoracic cavity through a small incision, cannula or port.

3. The heart positioning device according to claim 1 wherein the plurality of legs consist essentially of 2-4 legs.

4. The heart positioning device according to claim 3 wherein the plurality of legs consist essentially of 3 legs.

5. The heart positioning device according to claim 1 wherein the suction pad is formed of a polymeric material.

6. The heart positioning device according to claim 1 wherein the suspension element comprises a bellows-type structure that flexes to allow the suction pad to move in response to beating of the heart.

7. The heart positioning device according to claim 6 wherein the suspension element flexes to allow the suction pad to rotate about an axis defined by the suspension element.

8. The heart positioning device according to claim 7 wherein the suspension element and suction pad resiliently flex in response to beating of the heart.

9. The heart positioning device according to claim 1 wherein the suction pad has:

a surface with channels formed in the surface in fluid communication with the vacuum passageway for drawing vacuum between the suction pad and tissue to grasp the tissue; and

at least one tissue-engaging structure within each channel to prevent the channels from being closed off as the tissue and suction pad are drawn together to allow continued fluid communcation along the channels.

10. The heart positioning device according to claim 9 wherein the vacuum passageway has an orifice in fluid communication with the channels, the suction pad further including a plurality of tissue engaging structures adjacent the orifice to prevent the orifice and tissue being drawn together to close the orifice, thereby maintaining fluid communication between the vacuum passageway and the channels.

11. The heart positioning device according to claim 10 if wherein each legs includes at least one of the channels.

12. The heart positioning device according to claim 11 wherein the suction pad is sufficiently resiliently flexible that the suction pad draws down toward the surface of the heart more than the surface of the heart is pulled into the channels.

13. The heart positioning device according to claim 1 wherein the support arm can be changed between a flexible condition for moving the suction pad, and a rigid position for maintaining the end of the support arm connected to the suction pad in a stationary position, the suction pad including suspension means for accommodating motion of the heart.

14. The heart positioning device according to claim 13 wherein suction pad is permitted to rotate relative to the support arm along a first axis.

15. The heart positioning device according to claim 1 wherein the suction pad has a tissue-engaging porous mesh in fluid communication with the vacuum passageway for drawing vacuum between the suction pad and tissue to grasp the tissue and for preventing the vacuum passageway from being closed off as the tissue and suction pad are drawn together.

17. The heart positioning device according to claim 15 wherein the mesh is formed of a metallic, ceramic or polymeric material.

16. A heart positioning device comprising:

a resiliently-flexible suction pad having a plurality of legs that flex to conform to the surface of the heart, the suction pad having vacuum passageways in fluid communication with the legs to apply suction between the legs and the surface of the heart;

a vacuum line connected to the vacuum passageway;

a support arm connected to the suction pad to position the suction pad to thereby position or hold the heart such that the support arm can be changed between a flexible condition for moving the suction pad, and a rigid position for maintaining the end of the support arm connected to the suction pad in a stationary position, the suction pad including suspension means for accommodating motion of the heart, the suction pad permitted to rotate relative to the support arm along a first axis; and

wherein the support arm includes a pivotable element connected to the suction pad that is free to pivot along a second axis generally perpendicular to the first axis.

18. A suction pad for use in a heart positioning device, the suction pad being formed of resiliently flexible material and having a plurality of legs that flex to conform to the surface of the heart, the suction pad having vacuum passageways in fluid communication with the legs to apply suction between the legs and the surface of the heart wherein the suction pad is integrally molded with a resiliently-flexible suspension element connecting the suction pad to the support arm, the suction pad and suspension element being molded of the same material.

19. The suction pad according to claim 18 wherein the legs are configured and sufficiently flexible that they can be drawn against one another to a collapsed position for entering into thoracic cavity through a small incision, cannula or port.

20. The suction pad according to claim 18 wherein the plurality of legs consist essentially of 2-4 legs.

21. The suction pad according to claim 20 wherein the plurality of legs consist essentially of 3 legs.

22. The suction pad according to claim 18 wherein the suction pad is formed of a polymeric material.

23. The suction pad according to claim 18 wherein the suspension element comprises a bellows-type structure that flexes to allow the suction pad to move in response to beating of the heart.

24. The suction pad according to claim 23 wherein the suspension element flexes to allow the suction pad to rotate about an axis defined by the suspension element.

25. The suction pad according to claim 24 wherein the suspension element and suction pad resiliently flex in response to beating of the heart.

26. The suction pad according to claim 18 having:

a surface with channels formed in the surface in fluid communication with the vacuum passageway for drawing vacuum between the suction pad and tissue to grasp the tissue; and

at least one tissue-engaging structure within each channel to prevent the channels from being closed off as the tissue and suction pad are drawn together to allow continued fluid communcation along the channels.

27. The suction pad according to claim 26 wherein the vacuum passageway has an orifice in fluid communication with the channels, the suction pad further including a plurality of tissue engaging structures adjacent the orifice to prevent the orifice and tissue being drawn together to close the orifice, thereby maintaining fluid communication between the vacuum passageway and the channels.

28. The suction pad according to claim 27 wherein the suction pad has a tissue-engaging porous mesh positioned on the tissue-engaging structures and in fluid communication with the vacuum passageway.

29. The suction pad according to claim 28 wherein the mesh is formed of a metallic, ceramic or polymeric material.

30. The suction pad according to claim 29 wherein each legs includes at least one of the channels.

31. The suction pad according to claim 30 wherein the suction pad is sufficiently resiliently flexible that the suction pad draws down toward the surface of the heart more than the surface of the heart is pulled into the channels.

32. A method of using the suction pad of claim 31 comprising the following steps:

placing the suction pad against the surface of the heart; and

drawing suction through the vacuum passageway to draw the suction pad down towards the surface of the heart.

33. The suction pad according to claim 31 wherein the suction pad includes a resiliently flexible peripheral flange.

34. A method of using the suction pad of claim 33 comprising the following steps:

placing the suction pad against the surface of the heart; and

drawing suction through the vacuum passageway to draw the suction pad down towards the surface of the heart and flex the peripheral flange against the surface of the heart.

35. The suction pad according to claim 32 wherein the resiliently flexible peripheral flange includes an inner surface having a texture that tends to grip the surface of the heart when suction is drawn through the vacuum passageway.

36. A method of using the suction pad of claim 35 comprising the following steps:

placing the suction pad against the surface of the heart; and

drawing suction through the vacuum passageway to draw the suction pad down towards the surface of the heart and flex the peripheral flange until the bumps engage the surface of the heart.

37. The suction pad according to claim 35 wherein the texture comprises a plurality of bumps formed along the inner surface of the peripheral flange.

38. A method of using the suction pad of claim 37 comprising the following steps:

placing the suction pad against the surface of the heart; and

drawing suction through the vacuum passageway to draw the suction pad down towards the surface of the heart and flex the peripheral flange against the surface of the heart until the texture of the inner wall of the peripheral flange engages the surface of the heart.

39. A heart positioning device comprising:

a suction head having a vacuum passageway for applying suction between the suction head and the surface of the heart;

a vacuum line connected to the vacuum passageway;

a support arm connected to the suction head to position the suction head to thereby position or hold the heart; and

a bellows-type suspension element connecting the suction head and support arm, the bellows-type suspension element flexing to allow the suction head to move in response to beating of the heart.

40. The device of claim 39 wherein the bellows-type suspension element and suction head are integrally molded of elastomeric material.

41. The device of claim 40 wherein the vacuum passageway further extends through the bellows.

42. A suction device for positioning and holding a beating heart, the suction device comprising:

a suction head having a vacuum passageway for applying suction between the suction head and the surface of the heart; and

a bellows-type suspension element extending from the suction head for connecting the suction head to a support arm, the bellows-type suspension element flexing to allow the suction head to move in response to beating of the heart.

43. The device of claim 42 wherein the bellows-type suspension element and suction head are integrally molded of elastomeric material.

44. The device of claim 43 wherein the vacuum passageway further extends through the bellows.

45. The device of claim 44 wherein the suction head has a tissue-engaging porous mesh in fluid communication with the vacuum passageway.

46. The device of claim 45 wherein the mesh is formed of a metallic, ceramic or polymeric material.

47. A medical device for contacting a surface of a heart comprising:

a resiliently-flexible suction pad having at least one vacuum passageway to apply suction between a portion of the suction pad and the surface of the heart;

a porous material disposed on the suction pad between the vacuum passageway and the surface of the heart;

a vacuum line connected to the vacuum passageway; and

a support arm connected to the suction pad to position the suction pad relative to the heart, wherein the suction pad is permitted to rotate relative to the support arm along a first axis,

wherein the support arm includes a pivotable element connected to the suction pad that is free to pivot along a second axis generally perpendicular to the first axis.

48. The medical device according to claim 47 wherein the legs are configured and sufficiently flexible that they can be drawn against one another to a collapsed position for entering into thoracic cavity through a small incision, cannula or port.

49. The medical device according to claim 47 wherein the vacuum passageway has an orifice in fluid communication with a plurality of channels, the porous material located adjacent the orifice to prevent the orifice and tissue being drawn together to close the orifice, thereby maintaining fluid communication between vacuum passageway and the channels.

50. The medical device according to claim 47 wherein the porous material is recessed within the suction pad and wherein the suction pad is sufficiently resiliently flexible that the suction pad draws down toward the surface of the heart as vacuum is applied.

51. The medical device according to claim 47 wherein the support arm can be changed between a flexible condition for moving the suction pad, and a rigid position for maintaining the end of the support arm connected to the suction pad in a stationary position, the suction pad including suspension means for accommodating motion of the heart.

52. The medical device according to claim 47 wherein the porous material is a mesh.

53. The medical device according to claim 47 wherein the porous material is an open cell foam.

54. The medical device according to claim 47 wherein the porous material has about 10 to about 50 openings per inch.

55. The medical device according to claim 47 wherein the porous material engages heart tissue upon application of a vacuum.

56. The medical device according to claim 55 wherein the porous material has a textured surface to promote frictional contact with the heart tissue.

57. The medical device according to claim 47 wherein the porous material is separated from portions of the suction pad by standoffs.