Device to permit offpump beating heart coronary bypass surgery

• US 7,476,196 B2
• Filed: 06/08/2004
• Issued: 01/13/2009
• Est. Priority Date: 09/17/1997
• Status: Expired due to Fees

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Inventors: Ortiz, Mark, Williamson, Warren P. IV, Spence, Paul A.
• Primary Examiner(s): Gilbert; Samuel G
• Application Number:
  US10/863,409
• Publication Number:
  US 20040225195A1
• Time in Patent Office: 1,680 Days
• Field of Search: 600/37, 600/201, 600/210, 600/228, 600/229, 600/231, 600/232, 600/235
• US Class Current: 600/37
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00305 Constructional details of the flexible means
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• 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 2017/308 with suction cups

Abstract

A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to beat. Various suction cups are described each including at least a first chamber having a flexible rim and configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, includes a suction cup and a support arm connected thereto. The suction cup has a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected therewith. The second chamber is adapted to fluidly connect the first chamber with a source of suction. The support arm is movable with the suction cup to effect movement of the beating heart after engagement of the suction cup to a surface of the beating heart. A method of manipulating a beating heart to orient the beating heart in a desired position for performing a surgical procedure includes providing a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected with the first chamber, the second chamber being further fluidly connected to a source of suction; contacting a surface of the beating heart with the first chamber; applying suction between the first chamber and the surface of the beating heart, thereby engaging the suction member with the surface of the beating heart; and moving the suction member while maintaining engagement with the surface of the beating heart, thereby moving the beating heart.

Claims

1. A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to beat, said suction cup comprising:

a first chamber having a flexible rim and configured to engage the surface of the beating heart; and

a second chamber smaller than said first chamber and fluidly connected therewith at a first end of said second chamber, and a suction line connected in fluid communication with said second chamber, wherein said second chamber provides a separation space between said first chamber and said suction line.

2. The suction cup of claim 1, wherein said suction line is adapted to connect with the source of suction.

3. The suction cup of claim 2, further comprising a reinforcing ring surrounding said suction line at a location where said suction line connects with said second chamber.

4. The suction cup of claim 1, further comprising a shoulder formed by a connection between said first and second chambers.

5. The suction cup of claim 4, further comprising a suction-permeable barrier adjacent to said shoulder and adapted to prevent entry of the surface of the heart into said second chamber.

6. The suction cup of claim 5, wherein said suction-permeable barrier spans said second chamber.

7. The suction cup of claim 5, wherein said suction-permeable barrier comprises a mesh grid element.

8. The suction cup of claim 1, wherein said flexible rim is flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact of said engagement of the flexible rim and first chamber with the surface of the beating heart.

9. The suction cup of claim 1, further comprising a suction-permeable barrier spanning said second chamber, said barrier adapted to prevent entry of the surface of the heart into said second chamber.

10. The suction cup of claim 9, wherein said suction-permeable barrier comprises a mesh grid element.

11. The suction cup of claim 1, further comprising at least one additional chamber fluidly interconnecting said first and second chambers.

12. The suction cup of claim 11, further comprising a plurality of shoulders, each said shoulder formed by a connection between two of said chambers.

13. The suction cup of claim 1, wherein said second chamber is axially offset from said first chamber, such that said first and second chambers are not coaxially aligned.

14. The suction cup of claim 1, comprising a pair of said second chambers fluidly connected with said first chamber.

15. The suction cup of claim 14, wherein each of said second chambers is fluidly connected with a suction line.

16. The suction cup of claim 14, wherein a first of said pair of second chambers is fluidly connected with a first suction line and a second of said pair of second chambers is connected with a second suction line.

17. The suction cup of claim 16, further comprising a reinforcing ring surrounding said first and second suction lines at a location where said suction lines connect with said pair of second chambers.

18. The suction cup of claim 1, wherein said flexible rim is kidney-shaped.

19. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, said device comprising:

a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than said first chamber and fluidly connected therewith at a first end of said second chamber, and a suction line connected in fluid communication with said second chamber, wherein said second chamber provides a separation space between said first chamber and said suction line; and

a support arm connected to said suction cup and movable therewith to effect movement of the beating heart after engagement of the suction cup to a surface of the beating heart.

20. The suspension device of claim 19, wherein said support arm is configured to lock to a relatively stationary object, into a desired position, to maintain said suction cup and the beating heart in a desired, suspended orientation.

21. The suspension device of claim 20, wherein said support arm is flexibly coupled to said suction cup, permitting multiplanar movement of said suction cup even after locking said support arm into said desired position.

22. The suspension device of claim 19, wherein said support arm is flexibly coupled to said suction cup.

23. The suspension device of claim 19, wherein said support arm is configured to assume a flexible condition for positioning of said suction cup, and a locked position for maintaining a desired position of said suction cup.

24. The suspension device of claim 23, wherein said support arm comprises a plurality of ball members interposed between link members.

25. The suspension device of claim 24, wherein said support arm further includes a flexible line extending through said ball and link members.

26. The suspension device of claim 19, further comprising a suction line extending from said second chamber, said suction line adapted to connect with the source of suction.

27. The suspension device of claim 26, further comprising a reinforcing ring surrounding said suction line at a location where said suction line connects with said second chamber.

28. The suspension device of claim 19, wherein said suction cup further comprises a shoulder formed by a connection between said first and second chambers.

29. The suspension device of claim 28, wherein said suction cup further comprises a suction-permeable barrier adjacent to said shoulder and adapted to prevent entry of the surface of the heart into said second chamber.

30. The suspension device of claim 29, wherein said suction-permeable barrier spans said second chamber.

31. The suspension device of claim 29, wherein said suction-permeable barrier comprises a mesh grid element.

32. The suspension device of claim 19, wherein said suction cup further comprises a flexible rim adapted to engage the surface of the beating heart.

33. The suspension device of claim 32, wherein said flexible rim is flexible in a plurality of planes to accommodate multiplanar movement of the surface of the beating heart without breaking contact of said engagement of the flexible rim with the surface of the beating heart.

34. The suspension device of claim 32, wherein said flexible rim is kidney-shaped.

35. The suspension device of claim 19, wherein said suction cup further comprises a suction-permeable barrier spanning said second chamber, said barrier adapted to prevent entry of the surface of the heart into said second chamber.

36. The suspension device of claim 35, wherein said suction-permeable barrier comprises a mesh grid element.

37. The suspension device of claim 19, wherein said suction cup further comprises at least one additional chamber fluidly interconnecting said first and second chambers.

38. The suspension device of claim 37, wherein said suction cup further comprises a plurality of shoulders, each said shoulder formed by a connection between two of said chambers.

39. The suspension device of claim 19, wherein said second chamber is axially offset from said first chamber, such that said first and second chambers are not coaxially aligned.

40. The suspension device of claim 19, wherein said suction cup comprises a pair of said second chambers fluidly connected with said first chamber.

41. The suspension device of claim 40, wherein each of said second chambers is fluidly connected with a suction line.

42. The suspension device of claim 40, wherein a first of said pair of second chambers is fluidly connected with a first suction line and a second of said pair of second chambers is connected with a second suction line.

43. The suspension device of claim 42, further comprising a reinforcing ring surrounding said first and second suction lines at a location where said suction lines connect with said pair of second chambers.

44. A method of manipulating a beating heart to orient the beating heart in a desired position for performing a surgical procedure, said method comprising the steps of:

providing a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected with the first chamber at a first end of said second chamber, and a suction line connected in fluid communication with said second chamber, wherein said second chamber provides a separation space between said first chamber and said suction line the suction line being further fluidly connected to a source of suction;

contacting a surface of the beating heart with the first chamber;

applying suction between the first chamber and the surface of the beating heart, thereby engaging the suction member with the surface of the beating heart; and

moving the suction member while maintaining engagement with the surface of the beating heart, thereby moving the beating heart.

45. The method of claim 44, wherein said moving comprises lifting the beating heart to an elevated position.

46. The method of claim 44, further comprising fixing the suction member in a displaced position to maintain the beating heart in the displaced position for performance of the surgical procedure.

47. The method of claim 44, further comprising providing a suction-permeable barrier between the first and second chambers, thereby preventing the surface of the heart from entering the second chamber during application of suction and engagement by the suction cup.

48. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, said device comprising:

a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than said first chamber and fluidly connected therewith, said second chamber being further adapted to fluidly connect said first chamber with a source of suction; and

a support arm connected to said suction cup and movable therewith to effect movement of the beating heart after engagement of the suction cup to a surface of the beating heart, wherein said support arm is flexibly coupled to said suction cup, permitting multiplanar movement of said suction cup even after locking said support arm into said desired position.