Tissue positioner

• US 7,097,612 B2
• Filed: 07/29/2004
• Issued: 08/29/2006
• Est. Priority Date: 07/29/2003
• Status: Active Grant

• Current Assignee: Terumo Cardiovascular Systems Corporation (Terumo Corporation)
• Original Assignee: Endoscopic Technologies Incorporated (Atricure, Inc.)
• Inventors: Bertolero, Arthur A., Ibrahim, Tamer
• Primary Examiner(s): Lacyk, John P.
• Application Number:
  US10/903,732
• Publication Number:
  US 20050033110A1
• Time in Patent Office: 761 Days
• Field of Search: 600/37, 600/201, 600/206, 600/208, 600227-228, 600230-231, 601/132, 602/4.6, 602 60- 61, 602 75- 76, 602/903, 606/151, 128897-898
• US Class Current: 600/37
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 2017/0237 for heart surgery
• CPC Class Codes: A61B 2017/308 with suction cups

Abstract

Apparatus and methods for stabilizing and/or positioning tissues or organs during surgical procedures. One feature of the positioners of the invention includes the use of one or more suction elements used to grip the organ or tissue. The main body of the suction element comprises body defining a polyhedral shaped chamber, an elliptical ring structure and a vacuum port. The invention further includes structures to support the suction element and hold the suction element and attached tissue in a fixed position including catheters, lockable flexible arms, and retractors.

Claims

1. A suction element for gripping tissues comprising:

walls defining a polyhedral shaped chamber,

a vacuum port in gas communication with said chamber,

an elliptical shaped ring adapted for contacting the surface of the tissues to be positioned, said elliptical shaped ring positioned at an opening of said chamber.

2. The suction element of claim 1 further comprising a screen dividing said chamber into a first and second chamber.

3. The suction element of claim 1 wherein said walls comprise at least three walls.

4. The suction element of claim 3 wherein said walls comprise at least four walls.

5. The suction element of claim 1 wherein said elliptical shaped ring is circular.

6. The suction element of claim 1 wherein said polyhedral shape includes acute angles between said walls.

7. The suction element of claim 6 wherein said polyhedral shape is roughly a pyramid shape.

8. The suction element of claim 1 wherein said walls comprise a texture on an interior surface of at least one of said walls.

9. The suction element of claim 1 wherein said elliptical shaped ring is positioned inside said chamber at said opening of chamber.

10. The suction element of claim 9 wherein said elliptical shaped ring has a midline, whereby tissue may be drawn through said elliptical shaped ring above said midline of said elliptical shaped ring to enhance a grip of said suction element on the tissues.

11. The suction element of claim 1 in combination with a vacuum source.

12. The suction element of claim 1 wherein said suction element comprises a medical grade flexible polymeric material.

13. The suction element of claim 12 wherein when said flexible polymeric material allows said suction element to flex when attached to a beating heart to reduce impairment of heart function caused by using said suction element to position said heart.

14. The suction element of claim 1 wherein a ratio of an area of said vacuum port to an area of said opening of said chamber is approximately 1:

4.

15. The suction element of claim 1 in combination with a means for holding said suction element in a fixed position.

16. The suction element of claim 14 wherein said means for holding said suction element in a fixed position is selected from the group consisting of:

a lockable flexible arm, a retractor, a catheter, a vacuum tube, a rod, a cannula, and a fixed arm.

33. The tissue positioner of claim 1 wherein said at least one suction element comprises a suction assembly including two suction elements.

34. The tissue positioner of claim 33 wherein said two suction elements of said suction assembly are joined by a spacer holding said suction elements a fixed distance and orientation relative to each other.

35. The tissue positioner of claim 34 wherein each of said two suction elements comprise a central axis extending from a top of each said suction element through a bottom of each said suction element, and wherein said suction element is placed so said central axis of each suction element intersect.

36. The tissue positioner of claim 35 wherein an angle formed by said intersection of said central axes of each suction element ranges between 5 and 180 degrees.

17. A tissue positioner comprising

at least one suction element, said suction element including a polyhedral shaped chamber defined by at least three walls, a vacuum port in gas communication with said chamber, and an elliptical shaped ring adapted for contacting the surface of the tissues to be positioned, said elliptical shaped ring positioned at an opening to said chamber,

a conduit in gas communication with said vacuum port for providing vacuum to said chamber,

means for holding said suction element in a fixed position.

18. The tissue positioner of claim 17 wherein said suction element further comprises a screen dividing said chamber into a first and second chamber.

19. The tissue positioner of claim 17 wherein said at least three walls of said suction elements comprise four walls.

20. The tissue positioner of claim 17 wherein said elliptical shaped ring is circular.

21. The tissue positioner of claim 17 wherein said polyhedral shape includes acute angles between said walls.

22. The tissue positioner of claim 17 wherein said walls comprise a texture on an interior surface of at least one of said walls.

23. The tissue positioner of claim 17 wherein said elliptical shaped ring is positioned inside said chamber at said opening of chamber.

24. The tissue positioner of claim 23 wherein said elliptical shaped ring has a midline, whereby tissue may be drawn through said elliptical shaped ring above said midline of said elliptical shaped ring to enhance a grip of said suction element on the tissues.

25. The tissue positioner of claim 17 wherein said suction element comprises a medical grade flexible polymeric material.

26. The tissue positioner of claim 25 wherein said flexible polymeric material allows said suction element to flex when attached to a beating heart to reduce impairment of heart function caused by using said tissue positioner to position said heart.

27. The tissue positioner of claim 17 wherein a ratio of an area of said vacuum port to an area of said opening of said chamber is approximately 1:

4.

28. The tissue positioner of claim 17 wherein said means for holding said suction element in a fixed position is selected from the group consisting of:

a lockable flexible arm, a retractor, a catheter, a vacuum tube, a rod, a cannula, and a fixed arm.

29. The tissue positioner of claim 17 wherein said suction element is replaceable.

30. The tissue positioner of claim 17 comprising two suction elements.

31. The tissue positioner of claim 30 wherein said suction elements are attached to said positioner at a fixed distance and orientation relative to each other.

32. The tissue positioner of claim 31 wherein a portion of said positioner between said two suction elements is malleable, whereby said portion of said positioner between said two suction elements may be bent to alter said distance and orientation of said two suction elements relative to each other.

37. The tissue positioner of claim 17 wherein said suction element is sized to pass through an opening between 5 mm and 30 mm in diameter.

51. The method of claim 28 wherein said elliptical shaped ring has a midline, whereby tissue may be drawn through said elliptical shaped ring above said midline of said elliptical shaped ring to enhance a grip of said suction element on the tissues.

38. A method for positioning tissue, which method comprises the steps:

(a) positioning a tissue positioner on the tissue to be positioned, wherein said tissue positioner comprises at least one suction element comprising;

(i) walls defining a polyhedral shape chamber,

(ii) a vacuum port in gas communication with said chamber,

(iii) an elliptical shaped ring for contacting the surface of the tissues to be positioned, said elliptical shaped ring positioned at an opening to said chamber, and

(iv) means for holding said at least one suction element in a fixed position; and

(b) attaching a negative pressure source to the vacuum port of said suction element.

39. The method of claim 38 further comprising the step (c) manipulating said suction element to move said tissue into a desired configuration and position.

40. The method of claim 39 further comprising the step (d) holding said suction element in a selected position to hold said tissue in a selected position.

41. The method of claim 38 further comprising the step (c) holding said suction element in a selected position to hold said tissue in a selected position.

42. The method of claim 39, wherein the tissue is of an internal organ.

43. The method of claim 42, wherein said internal organ is a heart.

44. The method of claim 38 wherein said suction element further comprising a screen dividing said chamber into a first and a second chamber.

45. The method of claim 38 wherein said walls of said suction element comprise at least three walls.

46. The method of claim 38 wherein said walls of said suction element comprise at least four walls.

47. The method of claim 38 wherein said elliptical shaped ring is circular.

48. The method of claim 38 wherein said polyhedral shape includes acute angles between said walls.

49. The method of claim 38 wherein said walls of said suction element comprise a texture on an interior surface of at least one of said walls.

50. The method of claim 38 wherein said elliptical shaped ring of said suction element is positioned inside said chamber at said opening of chamber.

52. The method of claim 38 wherein said suction element comprises a medical grade flexible polymeric material.

53. The method of claim 52 wherein said flexible polymeric material allows said suction element to flex when attached to a beating heart to reduce impairment of heart function caused by using said tissue positioner to position said heart.

54. The method of claim 38 wherein a ratio of an area of said vacuum port to an area of said opening of said chamber of said suction element is approximately 1:

4.

55. The method of claim 38 wherein said means for holding said suction element in a fixed position is selected from the group consisting of:

a lockable flexible arm, a retractor, a catheter, a vacuum tube, a rod, a cannula, and a fixed arm.

56. The method of claim 38 wherein said suction element is replaceable.

57. The method of claim 38 comprising two suction elements.

58. The method of claim 57 wherein said suction elements are attached to said positioner at a fixed distance and orientation relative to each other.

59. The method of claim 58 wherein a portion of said positioner between said two suction elements is malleable.

60. The method of claim 58 further comprising the step:

bending said positioner between said two suction elements to alter said distance and orientation of said two suction elements relative to each other.

61. The method of claim 38 wherein said at least one suction element comprises a suction assembly including two suction elements.

62. The method of claim 61 wherein said two suction elements are joined by a spacer holding said suction elements a fixed distance and orientation relative to each other.

63. The method of claim 62 wherein each of said two suction elements comprise a central axis extending from a top of each said suction element through a bottom of each said suction element, and wherein said suction element is placed so said central axis of each suction element intersect.

64. The method of claim 63 wherein an angle formed by said intersection of said central axes of each suction element ranges between 5 and 180 degrees.

65. The method of claim 38 wherein said suction element is sized to pass through an opening between 5 mm and 30 mm in diameter.

66. A method for positioning tissue, which method comprises the steps:

(a) providing a positioner comprising at least one suction element comprising

(i) walls defining a polyhedral shape chamber,

(ii) a vacuum port in gas communication with said chamber,

(iii) an elliptical shaped ring for contacting the surface of the tissues to be positioned, said elliptical shaped ring positioned at an opening to said chamber, and

(iv) means for holding said at least one suction element in a fixed position; and

(b) introducing said suction elements of said positioner into a patient through a small incision or port;

(c) attaching at least one suction element to tissue under vacuum.

(d) manipulating said positioner to move said tissue into a selected position.

67. The method of claim 66 wherein said positioner comprises a first suction element and a second suction element.

68. The method of claim 67 wherein step (c) comprises the sub steps of attaching said first suction element to tissue via vacuum, then manipulating said positioner to conform to a topography of the tissue to be positioned and bringing said second suction element into contact the tissue.

69. A method for positioning tissue, which method comprises the steps:

(a) introducing a positioner into a patient through a small incision or port;

(b) Attaching at least one suction element to a portion of said positioner within the patient, said suction element comprising

(i) walls defining a polyhedral shape chamber,

(ii) a vacuum port in gas communication with said chamber,

(iii) an elliptical shaped ring for contacting the surface of the tissues to be positioned, said elliptical shaped ring positioned at an opening to said chamber, and

(iv) means for holding said at least one suction element in a fixed position; and

(c) applying vacuum to attach at least one suction element to tissue under vacuum.

(d) manipulating said move to position said tissue into a selected position.