Devices with a bendable tip for medical procedures

• US 6,743,239 B1
• Filed: 05/25/2000
• Issued: 06/01/2004
• Est. Priority Date: 05/25/2000
• Status: Expired due to Term

• Current Assignee: St Jude Medical Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: St Jude Medical Incorporated (Abbott Laboratories Incorporated)
• Inventors: Montpetit, Karen P., Kuehn, Stephen T.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/578,984
• Time in Patent Office: 1,468 Days
• Field of Search: 606/1, 606/51, 606/52, 606/108, 606/170, 606/171, 606/174, 606/180, 606/169, 606/205-210, 604/22, 600/101, 600/139, 600/146, 600/147, 600/562-567
• US Class Current: 606/139
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00327 with actuating members moving in opposite directions
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2912 transmission of forces to actuating rod or piston

Abstract

An improved device for performing medical procedures, preferably minimally invasive medical procedures, includes a shaft with a proximal and distal end and a bendable tip extending from the distal end of the shaft. In some preferred embodiments, a fastener applicator extends from the bendable tip. In other preferred embodiments, a malleable section is located between the bendable tip and the shaft. The bendable tip can include a plurality of articulating segments. The improved directional device can be used to repair native valves in a patient, especially heart valves.

Claims

1. A device for medical procedures comprising:

a shaft having a rigid section at a proximal end;

a bendable tip comprising a plurality of articulated segments arranged at a distal end of the shaft; and

an end segment extending from the bendable tip, wherein the end segment comprises a plurality of instrument deploying elements.

2. The device of claim 1 wherein the bendable tip has suitable dimensions for insertion into a human heart.

3. The device of claim 1 wherein the bendable tip can bend in either of two opposite directions in a plane relative to a linear configuration.

4. The device of claim 1 wherein the bendable tip further comprises a plurality of independent pivoting segments pivotable with respect to adjacent segments.

5. The device of claim 4 wherein each pivoting segment of the bendable tip is connected to an adjacent segment at two coaxial hinges.

6. The device of claim 1 wherein the bendable tip can be locked at a selected degree of bend.

7. The device of claim 1 further comprising two communicating elements extending from the bendable tip to the proximal end of the shaft, the communicating elements connecting to the bendable tip such that each communicating element functions as an opposing lever arm with respect to the bending of the tip.

8. The device of claim 1 further comprising a single communicating element extending from the bendable tip to the proximate end of the shaft, the communicating element being connected to the bendable tip such that tension on the communicating element tends to bend the bendable tip in one direction relative to a linear configuration.

9. The device of claim 1 further comprising a malleable section between the rigid section and the bendable tip.

10. The device of claim 1 further comprising:

a handle having an elongated grip generally coaxial with the shaft and being attached to the rigid section of the shaft;

the grip comprising a knob rotatable about the longitudinal axis of the handle; and

a first cord connecting the bendable tip with the knob such that rotation of the knob changes the position and degree of bending of the tip.

11. The device of claim 10 further comprising a second cord connecting the bendable tip with the knob wherein rotation of the knob in one direction extends the first cord while retracting the second cord and rotation of the knob in the other direction extends the second cord while retracting the first cord.

12. The device of claim 1 wherein the plurality of instrument deploying elements at least include a first instrument deploying element and a second instrument deploying element, wherein the first instrument deploying element comprises a lumen centrally located in the end segment, the lumen being adapted for introducing an instrument through the end of the bendable tip, and the second instrument deploying element comprises at least two tabs extending from the end segment, the tabs being adapted to releasably secure another instrument therebetween.

13. The device of claim 12 further comprising a gripper extendible through the lumen from the end segment of the bendable tip.

14. The device of claim 1 wherein the articulated segments comprise at least one off-center channel having a cord extending through the channel to the proximal end of the shaft.

15. The device of claim 1 wherein the bendable tip has an asymmetric opening extending therethrough.

16. The device of claim 1 wherein the articulating elements have a central lumen with an elongated cross section with the major axis of the lumen being perpendicular to a pivot axis.

17. The device of claim 1 wherein adjacent articulating segments have hinge elements that snap into position.

18. The device of claim 1 wherein the plurality of instrument deploying elements at least includes a first instrument deploying element wherein the first instrument deploying element comprises a lumen centrally located in the end segment, the lumen being adapted for introducing an instrument through the end of the bendable tip.

19. The device of claim 1 wherein the plurality of instrument deploying elements at least includes a second instrument deploying element, wherein the second instrument deploying element comprises at least two tabs extending from the end segment, the tabs being adapted to releasably secure another instrument therebetween.

21. The device of claim 18 wherein the malleable section comprises a spring metal.

22. The device of claim 18 wherein the malleable section comprises a soft metal.

23. The device of claim 18 wherein the malleable section comprises a flexible polymer.

24. The device of claim 18 wherein a straight section connects the malleable section and the tip.

25. The device of claim 18 wherein the bendable tip comprises an end segment comprising a plurality of instrument deploying elements.

27. The device of claim 24 further comprising a second cord connecting the tip with the knob wherein rotation of the knob in one direction extends the first cord while retracting the second cord and rotation of the knob in the opposite direction extends the second cord while retracting the first cord.

28. The device of claim 24 wherein the cord is connected to the tip such that tension on the cord tends to bend the tip in one direction relative to its linear configuration.

29. The device of claim 24 wherein the end segment further comprises at least two tabs extending from the end segment, the tabs being adapted to releasably secure a medical instrument comprising a fastener applicator.

30. The device of claim 24 wherein the end segment further comprises a lumen centrally located in the end segment, the lumen being adapted for introducing a medical instrument comprising a gripper through the end of the bendable tip.

31. The device of claim 24 wherein the end segment further comprises a medical instrument deploying element for deploying an endoscope.

32. The device of claim 24 wherein the end segment further comprises a medical instrument deploying element for deploying an ablation element.

33. The device of claim 24 wherein the end segment further comprises a medical instrument deploying element for deploying an ultrasound probe.

34. The device of claim 24 wherein the end segment further comprises a medical instrument deploying element for deploying a transducer.

35. The device of claim 24 wherein the tip comprises a plurality of articulating segments.

36. The device of claim 24 wherein a lumen extends from the handle through the shaft to the tip.

37. The device of claim 34 further comprising a medical instrument extending from the tip, the medical instrument having a control element extending from the medical instrument to the handle through the lumen.

39. The method of claim 37 further comprising extending a catheter within the heart and wherein inserting the device into the heart comprises introducing the device through the catheter.

43. The method of claim 37 further comprising locking the bendable tip at a desired degree of bending.

44. The method of claim 37 wherein the bendable tip can bend in a plane in either of two opposite directions in a plane relative to a linear configuration.

45. The method of claim 37 wherein the bendable tip comprises a plurality of articulating segments.

46. The method of claim 44 wherein the device further comprises a malleable section between the shaft and the articulating segments.

47. The method of claim 37 wherein the device further comprises:

a handle having a grip generally coaxial with the shaft wherein the handle is attached to the proximal end of the shaft;

a knob rotating around the axis of the grip; and

a cord connecting the bendable tip with the knob such that rotation of the knob changes the position of the cord to control the degree of bending of the bendable tip.

48. The method of claim 37 wherein the repair comprises fastening together the leaflets of a heart valve.

49. The method of claim 46 wherein the instrument comprises a fastener applicator.

20. A device for medical procedures comprising:

a shaft having a rigid section;

a malleable section extending from the rigid section of the shaft;

a bendable tip comprising a plurality of articulated segments extending from the malleable section; and

a control mechanism arranged at a proximal end of the shaft and being connected to the bendable tip by at least one cord, the control mechanism comprising a knob rotatable about the longitudinal axis of the shaft, wherein adjustment of the knob controls the position and degree of bending of the bendable tip by manipulation of the cord.

26. A device for medical procedures comprising:

a shaft with a distal end and a proximal end;

a bendable tip extending from the distal end of the shaft, wherein the bendable tip can bend in either of two opposite directions in a plane relative to a linear direction;

a handle having a grip generally coaxial with the shaft wherein the handle is attached to the proximal end of the shaft;

the grip comprising a knob rotating around the axis of the grip;

a first cord connecting the tip with the knob such that rotation of the knob in one direction retracts the cord to bend the tip; and

an end segment extending from the bendable tip, wherein the end segment comprises a plurality of medical instrument deploying elements extending from the end segment.

38. A method of repairing a heart valve comprising:

inserting a device into the heart, the device including a shaft, a bendable tip extending from the distal end of the shaft, an end segment extending from the bendable tip, the end segment being adapted to position and deploy a combination of different medical instruments, at least one medical instrument extending from the bendable tip; and

performing a repair of the heart valve with the medical instrument.

40. The method of claim 38 wherein the catheter extends into the heart through the wall of the heart.

41. The method of claim 38 wherein the catheter extends into the heart from the precava.

42. The method of claim 38 wherein the catheter extends through the septum separating the right atrium and the left atrium.