Methods and apparatus providing suction-assisted tissue engagement through a minimally invasive incision

• US 7,494,460 B2
• Filed: 09/30/2003
• Issued: 02/24/2009
• Est. Priority Date: 08/21/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Thomas, Ann M., Ross, Brian J., Steinberg, William J., Rothstein, Paul T., Haarstad, Philip J., Christian, Steven C., Daigle, Thomas P., Reetz, Robert H., Gubbin, Douglas H., Olig, Christopher P., Hobday, Michael J., Kim, David J. S.
• Primary Examiner(s): Gilbert; Samuel G
• Application Number:
  US10/675,815
• Publication Number:
  US 20040138522A1
• Time in Patent Office: 1,974 Days
• Field of Search: 128/897, 128/898, 600/37, 600201-205, 600/208, 600/210, 600/235, 606/1, 606/108, 606/191, 606/158
• 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 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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
• CPC Class Codes: A61M 1/84 Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32

Abstract

Suction-assisted tissue-engaging devices, systems, and methods are disclosed that can be employed through minimal surgical incisions to engage tissue during a medical procedure through application of suction to the tissue through a suction member applied to the tissue. A shaft is introduced into a body cavity through a first incision, and a suction head is attached to the shaft via a second incision. The suction head is applied against the tissue by manipulation of the shaft and suction is applied to engage the tissue while the medical procedure is performed through the second incision. A system coupled to the shaft and a fixed reference point stabilizes the shaft and suction head. When the medical procedure is completed, suction is discontinued, the suction head is detached from the shaft and withdrawn from the body cavity through the second incision, and the shaft is retracted through the first incision.

Claims

1. A method of performing a medical procedure on a body organ, accessed through first and second incisions into a body cavity comprising:

providing an elongated shaft having a shaft body extending between a proximal shaft handle and a shaft body distal end, the shaft body distal end supporting a shaft fastener element, providing a suction head having a suction pad adapted to be coupled to a source of suction to engage the body organ through the application of suction to the body organ and a suction head fastener element adapted to be attached to or detached from the shaft fastener element;

advancing the elongated shaft through both the first and second incision to dispose the shaft body distal end outside the body adjacent the second incision while the shaft handle is disposed outside the body adjacent the first incision;

attaching the suction head fastener element to the shaft fastener element to form a suction-assisted tissue-engaging device;

positioning the suction pad of the suction head against the body organ;

applying suction through the suction pad to engage the body organ; and

,

performing the medical procedure on the body organ via the second incision.

2. The method of claim 1, wherein the positioning step further comprises:

orienting the shaft body through the first incision into an operative vector in 3-D space for engagement of the suction head with the body organ; and

rigidly maintaining the operative vector to enable performance of the medical procedure on the body organ.

3. A method of performing a medical procedure on a body organ, accessed through first and second incisions into a body cavity comprising:

providing an elongated shaft having a shaft body extending between a proximal shaft handle and a shaft body distal end, the shaft body distal end supporting a shaft fastener element, providing a suction head having a suction pad adapted to be coupled to a source of suction to engage the body organ through the application of suction to the body organ and a suction head fastener element adapted to be attached to or detached from the shaft fastener element;

advancing the elongated shaft through the first incision to dispose the shaft body distal end within the body cavity or inserted through both the first and second incision to dispose the shaft body distal end outside the body adjacent the second incision while the shaft handle is disposed outside the body adjacent the first incision;

attaching the suction head fastener element to the shaft fastener element to form a suction-assisted tissue-engaging device;

positioning the suction pad of the suction head against the body organ;

applying suction through the suction pad to engage the body organ;

performing the medical procedure on the body organ via the second incision; and

further comprising upon completion of the medical procedure;

discontinuing application of suction;

repositioning the suction pad of the suction head away from the body organ;

detaching the suction head fastener element from the shaft fastener element; and

removing the shaft body from the chest cavity through the first incision.

4. The method of claim 3, further comprising coupling a blunting element to the shaft body distal end prior to advancing the shaft body through the first incision;

and decoupling the blunting element from the shaft body distal end prior to attaching the suction head fastener element to the shaft fastener element.

5. The method of claim 3 wherein the shaft fastener element is shaped to blunt the shaft body distal end during advancing the shaft body through the first incision.

6. The method of claim 3, wherein the positioning step further comprises:

orienting the shaft body through the first incision into an operative vector in 3-D space for engagement of the suction head with the body organ; and

rigidly maintaining the operative vector to enable performance of the medical procedure on the body organ.

7. The method of claim 3, wherein:

the shaft body comprises a shaft lumen extending from the shaft handle to the shaft body distal end;

the shaft fastener element further comprises;

an elongated rod extending through the shaft lumen from a rod proximal end and a rod distal end;

a distal hook at the elongated rod distal end shaped to engage the suction head fastener element; and

a toggle mounted to the shaft handle and coupled to the rod proximal end adapted to move between a neutral position, a locked position and an advanced position;

the advancing step comprises moving the toggle to the neutral position to dispose the distal hook substantially within the shaft body distal end the attaching step comprises moving the toggle to the advanced position to expose the hook, fitting the suction head fastener element into the hook, and moving the toggle to the locked position; and

the detaching step comprises moving the toggle to the advanced position to expose the hook, removing the suction head fastener element from the hook, and moving the toggle to the neutral position.

8. The method of claim 7, wherein the suction pad comprises first and second suction pods supported by the suction head fastener element to extend substantially in parallel and spaced apart from one another, and the suction applying step comprises applying suction through the suction pods to stabilize organ tissue between the first and second suction pods to facilitate performing the medical procedure upon the body organ employing the second incision.

9. The method of claim 8, wherein the first and second suction pods are elongated, and each comprise at least one suction port adapted to be applied against the body organ and a suction nozzle extending toward the shaft body distal end, and the suction applying step comprises attaching vacuum lines to the suction nozzles for application of suction to the body organ through the applied suction ports.

10. The method of claim 9, further comprising the step of extending the vacuum lines through the first incision.

11. The system of claim 8, wherein the first and second suction pods are elongated, and each comprise at least one suction port adapted to be applied against the body organ and a suction nozzle extending away from the shaft body distal end, and the suction applying step comprises attaching vacuum lines to the suction nozzles for application of suction to the body organ through the applied suction ports.

12. The method of claim 11, further comprising the step of extending the vacuum lines through the second incision.

13. The system of claim 8, wherein:

the first and second suction pods are elongated, and each comprise at least one suction port adapted to be applied against the body organ; and

a suction tube extends between the first and second suction ports, the suction tube supporting a suction nozzle; and

the suction applying step comprises attaching a vacuum line to the suction nozzle for application of suction to the body, organ through the applied suction ports.

14. The method of claim 13, further comprising the step of extending the vacuum line through one of the first and second incision.

15. The method of claim 7, wherein the suction pad is shaped to conform anatomically to an area of the body organ to enable the body organ to be moved into and maintained in a non-physiologic position within the body cavity to facilitate performing the medical procedure upon the body organ employing the second incision.

16. The method of claim 3, wherein the suction pad is shaped to conform anatomically to an area of the body organ to enable the body organ to be moved into and maintained in a non-physiologic position within the body cavity to facilitate performing the medical procedure upon the body organ employing the second incision.

17. The method of claim 3, wherein:

the suction pad comprises first and second suction pods supported by the suction head fastener element to extend substantially in parallel and spaced apart from one another;

the suction head comprises a spreading mechanism that selectively spreads the first and second suction pods apart; and

the suction applying step comprises;

applying suction through the suction pods to grasp the organ tissue; and

operating the spreading mechanism to spread the first and second suction pods apart to stretch the organ tissue between the first and second suction pods when suction is applied therethrough to the organ tissue to stabilize the organ tissue between the first and second suction pods to facilitate performing the medical procedure upon the body organ employing the second incision.

18. The method of claim 3, wherein the suction pad comprises first and second suction pods supported by the suction head fastener element to extend substantially in parallel and spaced apart from one another, and the suction applying step comprises applying suction through the suction pods to stabilize organ tissue between the first and second suction pods to facilitate performing the medical procedure upon the body organ employing the second incision.

19. The method of claim 18, wherein the first and second suction pods are elongated, and each comprise at least one suction port adapted to be applied against the body organ and a suction nozzle extending toward the shaft body distal end, and the suction applying step comprises attaching vacuum lines to the suction nozzles for application of suction to the body organ through the applied suction ports.

20. The method of claim 19, further comprising the step of extending the vacuum lines through the first incision.

21. The method of claim 18, wherein the first and second suction pods are elongated, and each comprise at least one suction port adapted to be applied against the body organ and a suction nozzle extending away from the shaft body distal end, and the suction applying step comprises attaching vacuum lines to the suction nozzles for application of suction to the body organ through the applied suction ports.

22. The method of claim 21, further comprising the step of extending the vacuum lines through the second incision.

23. The method of claim 18, wherein:

the first and second suction pods are elongated, and each comprise at least one suction port adapted to be applied against the body organ; and

a suction tube extends between the first and second suction ports, the suction tube supporting a suction nozzle; and

the suction applying step comprises attaching a vacuum line to the suction nozzle for application of suction to the body organ through the applied suction ports.

24. The method of claim 23, further comprising the step of extending the vacuum line through one of the first and second incision.

25. The method of claim 3, wherein the shaft body comprises a suction lumen of the shaft body extending from a suction fitting at the shaft handle adapted to be coupled to a vacuum source to a distal lumen end opening, and the attaching step further comprises coupling the distal lumen end opening to the suction head to enable application of suction from the vacuum source through the suction lumen to tissue of the body organ contacted by the suction pad to engage the body organ.

26. The method of claim 25, wherein:

the suction pad comprises first and second suction pods supported by the suction head fastener element to extend substantially in parallel and spaced apart from one another;

the suction head comprises a spreading mechanism that selectively spreads the first and second suction pods apart; and

the suction applying step comprises;

applying suction through the suction lumen and the suction pods to grasp the organ tissue; and

operating the spreading mechanism to spread the first and second suction pods apart to stretch the organ tissue between the first and second suction pods when suction is applied therethrough to the organ tissue to stabilize the organ tissue between the first and second suction pods to facilitate performing the medical procedure upon the body organ employing the second incision.

27. A method of performing a medical procedure on a body accesses through first and second incisions into a body cavity comprising:

providing an elongated shaft having a shaft body extending between a proximal shaft handle and a shaft body distal end, the shaft body distal end supporting a shaft fastener element, providing a suction head having a suction pad adapted to be coupled to a source of suction to engage the body organ through the application of suction to the body organ and a suction head fastener element adapted to be attached to or detached from the shaft fastener element;

advancing the elongated shaft through the first incision to dispose the shaft body distal end within the body cavity or inserted through both the first and second incision to dispose the shaft body distal end outside the body adjacent the second incision while the shaft handle is disposed outside the body adjacent the first incision;

attaching the suction head fastener element to the shaft fastener element to form a suction-assisted tissue-engaging device;

positioning the suction pad of the suction head against the body organ;

applying suction through the suction pad to engage the body organ;

performing the medical procedure on the body organ via the second incision; and

further comprising upon completion of the medical procedure;

discontinuing application of suction;

advancing the coupled together shaft body distal end and suction head of the suction-assisted tissue-engaging device through the second incision from the body cavity outside the body;

detaching the suction head fastener element from the shaft fastener element; and

removing the shaft body from the chest cavity through the first incision.

28. The method of claim 27, further comprising coupling a blunting element to the shaft body distal end prior to removing the shaft body through the first incision.

29. A method of performing a medical procedure on a body organ, accessed through first and second incisions into a body cavity comprising:

providing a first portion and a second portion of a suction-assisted tissue-engaging device;

advancing the first portion of the suction-assisted tissue-engaging device through the first incision into the body cavity and from the first incision through the second incision outside the body;

coupling the second portion of the suction-assisted tissue-engaging device to the first portion of the suction-assisted tissue-engaging device outside the body;

retracting the second portion through the second incision into the body cavity;

positioning the second portion of the suction-assisted tissue-engaging device against the body organ;

applying suction through the second portion of the suction-assisted tissue-engaging device to engage the body organ; and

,

performing the medical procedure on the body organ via the second incision.

30. The method of claim 29, further comprising upon completion of the medical procedure:

discontinuing application of suction;

repositioning the second portion of the suction-assisted tissue-engaging device from the body organ through the second incision outside the body;

uncoupling the second portion of the suction-assisted tissue-engaging device from the first portion of the suction-assisted tissue-engaging device via the second incision; and

removing the first portion of the suction-assisted tissue-engaging device from the chest cavity through the first incision.

31. The method of claim 30, wherein the positioning step further comprises:

orienting the first portion through the first incision into an operative vector in 3-D space for engagement of the second portion with the body organ; and

rigidly maintaining the operative vector to enable performance of the medical procedure on the body organ.

32. The method of claim 29, wherein the positioning step further comprises:

orienting the first portion through the first incision into an operative vector in 3-D space for engagement of the second portion with the body organ; and

rigidly maintaining the operative vector to enable performance of the medical procedure on the body organ.

33. The method of claim 29, wherein:

the first portion comprises an elongated shaft having a shaft body extending between a proximal shaft handle and a shaft body distal end, the shaft body distal end supporting a shaft fastener element, shaft body adapted to be selectively inserted through the first incision to dispose the shaft body distal end within the body cavity or inserted through both the first and second incision to dispose the shaft body distal end outside the body adjacent the second incision while the shaft handle is disposed outside the body adjacent the first incision; and

the second portion comprises a suction head having a suction pad adapted to be coupled to a source of suction to engage the body organ through the application of suction to the body organ and a suction head fastener element adapted to be attached to or detached from the shaft fastener element.