Method and system for organ positioning and stabilization

• US 7,338,434 B1
• Filed: 08/19/2003
• Issued: 03/04/2008
• Est. Priority Date: 08/21/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Rothstein, Paul T., Keogh, James R., Haarstad, Philip J., Olig, Christopher P., Hobday, Michael J., Kim, David J. S.
• Primary Examiner(s): Lacyk; John P.
• Application Number:
  US10/643,299
• Time in Patent Office: 1,659 Days
• Field of Search: 128897-899, 600/16, 600 36- 37, 600/103, 600/114, 600/121, 600/125, 600/127, 600/129, 600/153, 600/160, 600/201, 600/204, 600/205, 600/210, 600/213, 600215-217, 600/219, 600227-229, 600231-235, 604/164, 604/264, 604/272, 604/280, 606/2, 606/7, 606 13- 16, 606/32, 606/41, 606/129, 606/139, 606/167, 606/185, 606/191, 606232-234
• US Class Current: 600/37
• 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 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 2017/00243 cardiac
• 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 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

This invention provides a heart positioning device, method and system for positioning, manipulating, holding, grasping, immobilizing and/or stabilizing a heart. The heart positioning device may include a suction head and a shaft with a means for remotely changing the position of the head from a first position axially aligned with the shaft to a second, unaligned position and a sleeve slideably positioned on the shaft and sized to receive the suction head in a compressed condition.

Claims

1. A heart positioning device for moving a heart to a non-physiological orientation comprising:

a suction head comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of the heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the target tissue on the surface of the heart;

a shaft having a vacuum lumen extending therethrough, the shaft coupled at a distal end to the suction head by a movable joint;

a handle coupled to a proximal end of the shaft for remote manipulation of the position of the suction head to effect movement of the heart to a non-physiological orientation; and

means on a proximal portion of the heart positioning device for remotely bending the movable joint from a first position in which the suction head is axially aligned with the shaft to a second, position in which the suction head is axially unaligned with the shaft.

2. A heart positioning device according to claim 1 wherein the suction head includes at least three resilient lobes in fluid communication with the vacuum passageway.

3. A heart positioning device according to claim 1 wherein the suction head is resiliently compressible from a first, uncompressed condition, to a second, compressed condition upon application of a constraint.

4. A heart positioning device according to claim 3 wherein the suction head is adapted at its second, compressed condition for slideable introduction of the compressed suction head through a port.

5. A heart positioning device according to claim 3 wherein the suction head in its compressed condition is adapted to resiliently return to the first, uncompressed condition upon release of the constraint.

6. A heart positioning device according to claim 1 wherein the means for remotely bending the movable joint comprises a wire.

7. A heart positioning device according to claim 6 wherein the means for bending the movable joint comprises spring means.

8. A heart positioning device according to claim 1 further comprising means for locking the position of the movable joint in the second, position.

9. A heart positioning device according to claim 1 wherein the second position is about 90 degrees from the first position.

10. A heart positioning device for moving a heart to a non-physiological orientation comprising:

a suction head having at least three lobes comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of the heart, the suction head having a vacuum passageway in fluid communication with the head to apply suction between the suction head and the surface of the heart;

a shaft having a vacuum lumen extending therethrough, the shaft coupled at a distal end to the suction head;

a handle coupled to a proximal end of the shaft for remote manipulation of the position of the suction head to effect movement of the heart to a non-physiological orientation; and

a sleeve slideably positioned on the shaft and sized to receive the suction head in a compressed condition such that the sleeve may be slideably advanced over the shaft to capture the suction head at the distal end thereof by allowing the lobes to be drawn against one another and also slideably released from capture with the sleeve by advancing the suction head distally from the sleeve such that the suction head resiliently returns to an uncompressed condition.

11. A heart positioning device according to claim 10 wherein the suction head is adapted at its compressed condition for slideable introduction of the compressed suction head through a port.

12. A heart positioning device according to claim 10 wherein the positioning device includes a retaining member for retaining the sleeve in a proximal position on the shaft.

13. A heart positioning device according to claim 10 wherein the sleeve is adapted for use as a port extending within an incision into a chest cavity of a patient.

14. A heart positioning device according to claim 10 wherein the sleeve is adapted to capture the suction head when the suction head is axially aligned with the shaft.

15. A heart positioning device for moving a heart to a non-physiological orientation comprising:

a suction head having at least three lobes comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of the heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the surface of the heart;

a shaft having a vacuum lumen extending therethrough, the shaft coupled at a distal end to the suction head;

a handle coupled to a proximal end of the shaft for remote manipulation of the position of the suction head to effect movement of the heart to a non-physiological orientation;

a sleeve slideably positioned on the shaft such that the suction head may be advanced or retracted with respect to the sleeve by manipulation of the handle; and

a retaining member for retaining the sleeve in a proximal position on the shaft.

16. A heart positioning device according to claim 15 wherein the sleeve is adapted for use as a port extending within an incision into a chest cavity of a patient.

17. A method of performing a surgical procedure on a heart, comprising:

providing a heart positioning device having a suction head comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of the heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the surface of the heart, a shaft having a vacuum lumen extending therethrough coupled at a distal end to the suction head by a movable joint and a handle coupled to a proximal end of the shaft;

introducing the suction head of the positioning device into a chest cavity of a patient through an incision by resiliently compressing the suction head from a first, uncompressed condition, to a second, compressed condition;

remotely changing the position of the suction head from a first position axially aligned with the shaft to a second, unaligned position by manipulating the movable joint from outside the chest cavity of the patient while the suction head is within the chest cavity;

engaging the heart with the suction head;

positioning the heart into a non-physiological orientation; and

performing a surgical procedure on the heart.

18. A method according to claim 17 wherein introducing the suction head includes compressing at least three resilient lobes of the suction head such that the lobes are drawn against one another.

19. A method according to claim 17 wherein the suction head is introduced into the chest cavity of the patient by slideably introducing it through a port.

20. A method according to claim 17 wherein the movable joint is remotely manipulated by activating a wire.

21. A method according to claim 17 wherein the movable joint is remotely manipulated from a control on the handle.

22. A method according to claim 17 further comprising returning the head from the second, unaligned position toward the first, axially aligned position and removing the suction head from the chest cavity through the incision.

23. A method according to claim 17 further comprising securing the position of the heart positioning device prior to the surgical procedure and releasing the position of the heart positioning device after the procedure.

24. A method according to claim 23 wherein securing the position of the heart positioning device is accomplished by clamping the heart positioning device to an arm.

25. A method according to claim 23 wherein securing the position of the heart positioning device is accomplished by actuating an arm attached to the heart positioning device to render the arm rigid.

26. A method of performing a surgical procedure on a heart, comprising:

providing a heart positioning device having a suction head comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of the heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the surface of the heart, a shaft having a vacuum lumen extending therethrough coupled at a distal end to the suction head, a handle coupled to a proximal end of the shaft and a sleeve slideably positioned on the shaft;

advancing the sleeve along the shaft to receive the suction head in a compressed condition;

introducing the sleeve and compressed suction head of the positioning device into an incision extending into a chest cavity of a patient;

advancing the suction head from the sleeve such that it achieves an uncompressed condition;

engaging the heart with the suction head;

positioning the heart into a non-physiological orientation; and

performing a surgical procedure on the heart.

27. A method according to claim 26 wherein engaging the heart with the suction head includes engaging the heart with at least three resilient lobes of the suction head.

28. A method according to claim 26 wherein positioning of the heart is accomplished by remotely manipulating the suction head by moving the handle.

29. A method according to claim 26 further comprising securing the position of the heart positioning device prior to the surgical procedure and releasing the position of the heart positioning device after the procedure.

30. A method according to claim 29 wherein securing the position of the heart positioning device is accomplished by clamping the heart positioning device to an arm.

31. A method according to claim 29 wherein securing the position of the heart positioning device is accomplished by actuating an arm attached to the heart positioning device to render the arm rigid.

32. A method of performing a surgical procedure on a heart, comprising:

providing a heart positioning device having a suction head comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of the heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the surface of the heart, a shaft having a vacuum lumen extending therethrough coupled at a distal end to the suction head, a handle coupled to a proximal end of the shaft and a sleeve slideably positioned on the shaft;

advancing the sleeve long the shaft to receive the suction head in a compressed condition;

introducing the sleeve and compressed suction head of the positioning device at least partially into a port extending into a chest cavity of a patient;

advancing the suction head from the sleeve into the port and into the chest cavity such that it achieves an uncompressed condition;

engaging the heart with the positioning device;

positioning the heart into a non-physiological orientation; and

performing a surgical procedure on the heart.

33. A method according to claim 32 wherein engaging the heart with the suction head includes engaging the heart with at least three resilient lobes of the suction head.

34. A method according to claim 32 wherein positioning of the heart is accomplished by remotely manipulating the suction head by moving the handle.

35. A method according to claim 32 further comprising securing the position of the heart positioning device prior to the surgical procedure and releasing the position of the heart positioning device after the procedure.

36. A method according to claim 35 wherein securing the position of the heart positioning device is accomplished by clamping the heart positioning device to an arm.

37. A method according to claim 35 wherein securing the position of the heart positioning device is accomplished by actuating an arm attached to the heart positioning device to render the arm rigid.

38. A system for performing a medical procedure comprising:

a suction head comprising a flexible, resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of a heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the surface of the heart;

a shaft having a vacuum lumen extending therethrough, the shaft coupled at a distal end by a movable joint to the suction head such that the suction head can be moved from a first position axially aligned with the shaft to a second, unaligned position by manipulating a control which is remote from the suction head to effect bending of the movable joint;

a handle coupled to a proximal end of the shaft for remote manipulation of the position of the suction head to effect movement of the heart to a non-physiological orientation;

a port adapted to receive the suction head with the suction head in a compressed condition when the suction head is in the first, axially aligned condition; and

a suction source in fluid communication with the heart positioning device.

39. A system for performing a medical procedure comprising:

a suction head having at least three lobes comprising a flexible resilient material that may be compressed and resiliently return to its original shape and may flex to permit the suction head to engage and conform to a target tissue on the surface of a heart, the suction head having a vacuum passageway in fluid communication with the suction head to apply suction between the suction head and the surface of the heart;

a shaft having a vacuum lumen extending therethrough, the shaft coupled at a distal end to the suction head, a handle coupled to a proximal end of the shaft for remote manipulation of the position of the suction head to effect movement of the heart to a non-physiological orientation and a sleeve slideably positioned on the shaft and sized to receive the suction head in a compressed condition such that the sleeve may be slideably advanced over the shaft to capture the suction head at the distal end thereof;

a port adapted to receive at least a portion of the sleeve and the suction head with the suction head in a compressed condition within the sleeve with the lobes drawn against one another; and

a suction source in fluid communication with the heart positioning device.