Minimally invasive cardiovascular support system with true haptic coupling

• US 8,942,828 B1
• Filed: 04/13/2012
• Issued: 01/27/2015
• Est. Priority Date: 04/13/2011
• Status: Active Grant

• Current Assignee: Stuart Schecter, LLC
• Original Assignee: Stuart Schecter, LLC
• Inventors: Schecter, Stuart O.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): EDWARDS, PHILIP CHARLES
• Application Number:
  US13/447,064
• Time in Patent Office: 1,019 Days
• Field of Search: 607/122, 607/119, 607/116
• US Class Current: 607/122
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00946 malleable
• CPC Class Codes: A61B 2017/0237 for heart surgery endoscopic heart surgery A61B2017/00243; endoscopic access devices, i.e. trocars, A61B17/34
• CPC Class Codes: A61B 2018/00297 Means for providing haptic feedback
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2034/302 specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/066 for measuring torque
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61H 2201/10 with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 2201/105 with means for delivering media, e.g. drugs or cosmetics
• CPC Class Codes: A61H 2201/1253 driven by a human being, e.g. hand driven
• CPC Class Codes: A61H 2201/1678 Means for angularly oscillating massage elements
• CPC Class Codes: A61H 2201/5023 : Interfaces to the user
• CPC Class Codes: A61H 2201/5061 : Force sensors
• CPC Class Codes: A61H 2201/5092 : Optical sensor
• CPC Class Codes: A61H 2230/04 : Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
• CPC Class Codes: A61H 2230/207 : partial O2-value
• CPC Class Codes: A61H 31/004 : Heart stimulation
• CPC Class Codes: A61H 31/005 : with feedback for the user
• CPC Class Codes: A61H 31/006 : Power driven
• CPC Class Codes: A61H 31/007 : Manual driven
• CPC Class Codes: A61N 1/05 : for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/056 : Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0595 : Temporary leads
• CPC Class Codes: A61N 1/0597 : Surface area electrodes, e.g. cardiac harness

Abstract

A family of minimally-invasive surgical (MIS) cardiac interventional tools with tactile feedback based upon cardiac mechanical data and physiologic parameters derived from sensors positioned upon the tools are configurable for optimal placement of an end-effector to provide acute cardiac resuscitation and/or remote cardiovascular intervention for a subject. A haptic interface (e.g., a haptic handle, haptic glove or a simulated haptic heart) provides a clinician with real, not virtual, interaction with the cardiovascular anatomy (including intrathoracic organs) of the subject to optimize end-effector placement. The MIS tools optionally include webbed blade portions for exploration of extracardiac or intrathoracic spaces. The blade portions are initially collapsed but expand into an array of finger-like projections that function as sensors, dilatation and/or dissection tools, pharmacological delivery tools, and/or electrodes for sensing, pacing and defibrillation, and/or as a manual, semi-automatic or fully automatic mechanical support system for cardiac resuscitation and/or for restoring intrathoracic organ function(s).

Claims

1. A minimally invasive surgical (MIS) instrument configured to provide mechanical and electrical support and acquire sensor-based physiologic signals from an intrathoracic organ of a patient while providing haptic feedback to an operator, comprising:

an end-effector system adapted for transthoracic insertion into the patient and having a collapsed configuration for deployment and retraction, an expanded working configuration wherein the expanded working configuration provides a receiving location, and a partially-collapsed deployment configuration that compresses a portion of the intrathoracic organ disposed in the receiving location;

a plurality of transducers coupled to the end-effector system, each transducer providing at least one output signal therefrom;

a haptic interface operably coupled to the plurality of transducers, said haptic interface including at least one processor configured to transform the output signals from the plurality of transducers into a haptic response that provides the operator with feedback that the operator utilizes to position the receiving location of the end-effector system and monitor or adjust control of the end-effector system; and

a control circuit configured to increase and decrease a volume of fluid in the end-effector system, wherein the control circuit senses electrical or mechanical activity of a heart or a lung as sensed activity and, in response, the control circuit periodically increases and decreases the volume or pressure of fluid disposed within the end-effector system based at least in part upon the sensed activity.

2. A MIS instrument according to claim 1, wherein the intrathoracic organ comprises one of a mammalian heart, a portion of lung tissue, and an innervated portion of diaphragm tissue.

3. A MIS instrument according to claim 1, wherein the end-effector system includes a pair of elongate finger-like elements or elongate ribs.

4. A MIS instrument according to claim 3, wherein the pair of elongate finger-like elements or elongate ribs are adjacent one another and include a web of material therebetween.

5. A MIS instrument according to claim 4, wherein the web of material comprises opposing sheets of material.

6. A MIS instrument according to claim 5, wherein the web of material includes a port for receiving a fluid.

7. A minimally invasive surgical (MIS) instrument configured to provide mechanical and electrical support and acquire sensor-based physiologic signals from an intrathoracic organ of a patient while providing haptic feedback to an operator, comprising:

an end-effector system adapted for transthoracic insertion into the patient and having a collapsed configuration for deployment and retraction, an expanded working configuration wherein the expanded working configuration provides a receiving location, and a partially-collapsed deployment configuration that compresses a portion of the intrathoracic organ disposed in the receiving location;

a plurality of transducers coupled to the end-effector system, each transducer providing at least one output signal therefrom;

a haptic interface operably coupled to the plurality of transducers, said haptic interface including at least one processor configured to transform the output signals from the plurality of transducers into a haptic response that provides the operator with feedback that the operator utilizes to position the receiving location of the end-effector system and monitor or adjust control of the end-effector system;

wherein the end-effector system includes a pair of elongate finger-like elements or elongate ribs that are adjacent one another and include a web of material therebetween, the web of material comprising opposing sheets of material and includes a port for receiving a fluid; and

a control circuit configured to increase and decrease a volume of fluid disposed within the web of material via the port, wherein the control circuit senses electrical or mechanical activity of a heart or a lung as sensed activity and, in response, the control circuit periodically increases and decreases the volume of fluid disposed within the opposing sheets or increases and decreases the pressure of the fluid disposed within the opposing sheets based at least in part upon the sensed activity.

8. A MIS instrument according to claim 7, further comprising a physiologic delay circuit operable to temporally synchronize or temporally adjust an electrical cardiac signal with a mechanical cardiac signal.