Surgical instruments, systems and methods of use

• US 9,655,605 B2
• Filed: 06/14/2011
• Issued: 05/23/2017
• Est. Priority Date: 06/14/2010
• Status: Active Grant

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Inventors: Klein, Kyle, Serowski, Andrew, Yee, Kristopher, Perez, Juan I., Jambunathan, Kumar
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): ECKMAN, MICHELLE CHRISTINE
• Application Number:
  US13/160,445
• Publication Number:
  US 20120157788A1
• Time in Patent Office: 2,170 Days
• Field of Search: 600201-249, 600141-142, 403 52- 55, 403 79, 403 91, 403112-113, 403116
• 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 2017/0237 for heart surgery
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2090/508 with releasable brake mechanisms
• CPC Class Codes: A61B 2090/571 for clamping a support arm to a bed or other supports
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61B 90/57 Accessory clamps

Abstract

A surgical instrument includes a mount body, a joint member, an arm, and a working end. The mount body has a top portion, a distal end, a proximal end and a bottom portion. The joint member is pivotally mounted at a distal end portion of the mount body, to allow positioning of a proximal portion of an arm extending distally from the joint member. The joint member is also configured to at least partially constrain movement of the proximal portion of the arm to a plane. The working end is mounted to a distal end portion of the arm. The surgical instrument can be configured as a heart stabilizer or a heart positioner. The joint member may further be configured as a slotted ball, a disk member, or a combination thereof.

Claims

1. A surgical instrument comprising:

a mount body having a top portion, a distal end, a proximal end and a bottom portion wherein the bottom portion comprises a mounting mechanism configured to reversibly clamp the surgical instrument to a retractor system;

an actuator mounted to the mount body at a proximal end region of the mount body;

a joint member pivotally mounted at a distal end portion of the mount body to allow positioning of a proximal portion of an arm extending distally from the joint member from a left distal region of the mount body to a right distal region of the mount body and vice versa without causing movement of the actuator, the joint member configured to at least partially constrain movement of the proximal portion of the arm to a plane, wherein a proximal link of the arm immediately adjacent to the joint member is pivotable to a substantially perpendicular position with respect to the mount body; and

a working end mounted to a distal end portion of the arm, wherein the actuator is rotatably mounted to the mount body at the proximal end of the mount body, wherein the actuator is configured to change a state of the arm from a flexible state to a rigid state by rotation of the actuator in a first rotational direction, and from the rigid state to the flexible state by rotation of the actuator in a counter-rotational direction.

2. The instrument of claim 1, wherein the joint member comprises a disk member that is received within a cavity of the mount body, and a slotted ball connected to the disk member.

3. The instrument of claim 2, wherein the slotted ball forms a joint with the proximal portion of the arm.

4. The instrument of claim 2, wherein upper and lower surfaces of the disk member are substantially parallel with the top portion of the mount body, and wherein the proximal portion of the arm is attached to the slotted ball and capable of pivoting to a position substantially perpendicular to the upper and lower surfaces of the disk member.

5. The instrument of claim 1, further comprising a vacuum tube in fluid communication with the working end, and the working end is configured to reversibly attach to the exterior surface of a human'"'"'s heart.

6. The instrument of claim 1, further comprising a suction tube in fluid communication with the working end, and a clip configured to receive and temporarily hold the suction tube to maintain the suction tube in a low profile with the instrument, wherein the clip is formed with or connected to the mount body, the actuator, or both the mount body and the actuator.

7. The instrument of claim 1, wherein the instrument is an organ stabilizer and the working end comprises at least one contact member configured to be exerted against a tissue surface to stabilize the tissue surface.

8. The instrument of claim 1, wherein the instrument is an organ positioner and the working end comprises a suction member defining a vacuum space therein, wherein the suction member is configured to receive the apex of a human heart.

9. The instrument of claim 1, wherein the arm comprises an intermediate link disposed between a distal portion of the arm and a proximal portion of the arm, the intermediate link is capable of adjusting one of the distal and proximal portions of the arm to assume a flexible configuration in a first configuration, and to assume a rigid configuration in a second configuration, while allowing a portion of the arm proximal of the intermediate link to remain flexible during both the first configuration and the second configuration, and wherein the actuator is capable of adjusting the proximal portion or distal portion of the arm that is not capable of being adjusted by the intermediate link.

10. The instrument of claim 1, wherein a portion of the joint member constrains movement of the proximal portion of the arm to a single plane when the joint member is movably mounted to the mount body.

11. The instrument of claim 1, wherein the substantially perpendicular position is a position in which the proximal link is at an angle of about 80 degrees to about 90 degrees to the mount body.

12. The instrument of claim 1, wherein the top portion of the mount body extending from a central body portion to a distal end portion is smooth and comprises a flat portion with no obstructions thereon.

13. A surgical instrument comprising:

a flexible arm comprising a distal end, a proximal end, and a plurality of joint members located therebetween whereby at least a portion of adjoining joint members can form articulating joints;

a working end configured to engage a surface of a human'"'"'s heart, wherein the working end is connected to the distal end of the flexible arm;

a mount body having a central body portion, a distal end portion located distal to the central body portion, and a proximal portion located proximal to the central body portion; and

a mount body joint operatively associated with the mount body to constrain movement of the mount body joint to a single plane, wherein the mount body joint comprises a first joint and a second joint, and wherein the first joint is moveable about an axis that is different from an axis of movement of the second joint, and the first joint is disposed within the mount body at the distal end portion of the mount body, and the second joint is in proximity to the first joint and at a constant distance with respect thereto, and wherein the proximal end of the flexible arm is connected to the mount body through the mount body joint.

14. The instrument of claim 13, wherein the actuator is rotatably mounted to the mount body at the proximal end of the mount body, the actuator being configured to change a state of the arm from a flexible state to a rigid state by rotation of the actuator in a first rotational direction, and from the rigid state to the flexible state by rotation of the actuator in a counter-rotational direction.

15. The surgical instrument of claim 13, wherein the minimum mount body angle is substantially perpendicular, and wherein a top surface of the mount body along the central body portion is smooth and flat with no obstructions thereon.

16. The surgical instrument of claim 13, wherein the first joint is configured for controlled planar translation or pivoting along a first plane, and the second joint is configured for controlled movement along a second plane that is substantially perpendicular to the first plane.

17. The instrument of claim 13, wherein the mount body joint forms a mount body angle between the proximal end of the flexible arm and a lower surface of the mount body, wherein a minimum mount body angle is at most 120 degrees, wherein a reference angle is defined as 180 degrees between any two unstressed articulating joint members.

18. The instrument of claim 13, wherein the first joint is a swivel joint having a sweep of about 150°

.

19. The instrument of claim 13, wherein a portion of the first joint in contact with the second joint is positionable so as to be flush with respect to a distal portion of the mount body.

20. A surgical instrument comprising:

a flexible arm comprising a distal end, a proximal end, and a plurality of articulating links located therebetween whereby at least a portion of adjoining articulating links form articulating joints, the articulating joints capable of establishing a plurality of arm joint angles each having a minimum achievable angle value, the angle being defined as 180 degrees between any two unstressed articulating joints, wherein the plurality of articulating links include alternating ball joints and biconcave disks;

a working end configured to engage a surface of a human'"'"'s heart, wherein the working end is connected to the distal end of the flexible arm; and

a mount body joint joining a mount body to the proximal end of the flexible arm, wherein the mount body comprises a distal end portion, a proximal end portion, and a central body portion extending between the distal end portion and the proximal end portion, and wherein the mount body joint is located at the distal end portion of the mount body and is distal to the central body portion, and the mount body joint does not extend from a top surface of the mount body above the central body portion.

21. The instrument of claim 20, wherein the mount body joint forms a mount body angle between the proximal end of the flexible arm and a lower surface of a mount body, wherein a minimum mount body angle is a substantially smaller angle than a smallest of the minimum achievable angle values.

22. The instrument of claim 20, wherein the mount body joint comprises a first joint and a second joint, wherein the second joint comprises a ball and socket articulation of a ball to a most proximal articulating link of the flexible arm.

23. The instrument of claim 20, further comprising a cable and an actuator, the actuator is located at the proximal end of the mount body, wherein the cable extends from the actuator to the flexible arm by passing through the mount body and mount body joint.

24. A surgical instrument comprising:

a mount body having a top portion, a distal end, a proximal end and a bottom portion wherein the bottom portion comprises a mounting mechanism configured to reversibly clamp the surgical instrument to a retractor system;

an actuator mounted to the mount body at a proximal end region of the mount body;

a joint member pivotally mounted at a distal end portion of the mount body to allow positioning of a proximal portion of an arm extending distally from the joint member from a left distal region of the mount body to a right distal region of the mount body and vice versa without causing movement of the actuator, the joint member configured to at least partially constrain movement of the proximal portion of the arm to a plane, wherein a proximal link of the arm immediately adjacent to the joint member is pivotable to a substantially perpendicular position with respect to the mount body;

a working end mounted to a distal end portion of the arm, wherein the joint member comprises a disk member that is received within a cavity of the mount body, and a slotted ball connected to the disk member, and wherein the actuator is rotatably mounted to the mount body; and

a cable extending from the actuator through the mount body, the slotted ball and the arm, wherein the actuator and the cable are configured to change a state of the arm from a flexible state to a rigid state by movement of the actuator in a first direction, and from the rigid state to the flexible state by movement of the actuator in a second direction opposite the first direction.

25. The instrument of claim 24, wherein movement of the actuator involves rotation, the first direction is a first rotational direction, and the second direction is a counter-rotational direction.

26. A surgical instrument comprising:

a mount body having a top portion, a distal end, a proximal end and a bottom portion wherein the bottom portion comprises a mounting mechanism configured to reversibly clamp the surgical instrument to a retractor system;

an actuator mounted to the mount body at a proximal end region of the mount body;

a joint member pivotally mounted at a distal end portion of the mount body to allow positioning of a proximal portion of an arm extending distally from the joint member from a left distal region of the mount body to a right distal region of the mount body and vice versa without causing movement of the actuator, the joint member configured to at least partially constrain movement of the proximal portion of the arm to a plane, wherein a proximal link of the arm immediately adjacent to the joint member is pivotable to a substantially perpendicular position with respect to the mount body; and

a working end mounted to a distal end portion of the arm, wherein the joint member comprises a first member and a second member, wherein the first member confines movement of the proximal portion of the arm to yawing, and the second member confines movement of the proximal portion of the arm to pitching.

27. A surgical instrument comprising:

a mount body having a top portion, a distal end, a proximal end and a bottom portion wherein the bottom portion comprises a mounting mechanism configured to reversibly clamp the surgical instrument to a retractor system;

an actuator mounted to the mount body at a proximal end region of the mount body;

a joint member pivotally mounted at a distal end portion of the mount body to allow positioning of a proximal portion of an arm extending distally from the joint member from a left distal region of the mount body to a right distal region of the mount body and vice versa without causing movement of the actuator, the joint member configured to at least partially constrain movement of the proximal portion of the arm to a plane, wherein a proximal link of the arm immediately adjacent to the joint member is pivotable to a substantially perpendicular position with respect to the mount body; and

a working end mounted to a distal end portion of the arm, wherein the joint member comprises a disk member that is received within a socket of the mount body, and the disk member is at a lower elevation than a top surface of the distal end portion of the mount body.

28. A surgical instrument comprising:

a flexible arm comprising a distal end, a proximal end, and a plurality of joint members located therebetween whereby at least a portion of adjoining joint members can form articulating joints;

a working end configured to engage a surface of a human'"'"'s heart, wherein the working end is connected to the distal end of the flexible arm;

a mount body having a central body portion, a distal end portion located distal to the central body portion, and a proximal portion located proximal to the central body portion; and

a mount body joint operatively associated with the mount body to constrain movement of the mount body joint to a single plane, wherein the mount body joint comprises a first joint and a second joint, and wherein the first joint is moveable about an axis that is different from an axis of movement of the second joint, and the first joint is disposed within the mount body at the distal end portion of the mount body, and the second joint comprises a slotted ball in proximity to the first joint and at a constant distance with respect thereto, and wherein the proximal end of the flexible arm is connected to the mount body through the mount body joint.