Surgical stabilizers and methods for use in reduced-access surgical sites

• US 20060270910A1
• Filed: 05/25/2005
• Published: 11/30/2006
• Est. Priority Date: 05/25/2005
• Status: Active Grant

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Cardiothoracic Systems, Inc. (Boston Scientific Corporation)
• Inventors: Davis, John W.
• Granted Patent: US 8,083,664 B2
• Time in Patent Office: Days
• US Class Current: 600/210
• 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 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 2017/2926 Details of heads or jaws
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/306 holding by means of suction

Abstract

Devices and methods for stabilizing tissue within a patient'"'"'s body. Such a device is adapted to assume a reduced configuration and an operating configuration. The device assumes the reduced configuration for passage through a small opening to deliver a working end of the device to a site of the tissue to be stabilized. Such a device may include first and second contact members that are mounted for rotation, with each having a contact surface adapted to contact a surface of the tissue. When the device is in the operating configuration, a largest cross-sectional dimension of the contact members may be greater than a largest dimension of an opening through which the contact members were passed.. However, when in the reduced configuration, largest cross-sectional dimension of the contact members is less than the largest dimension of the opening.

Claims

1. A device for stabilizing tissue within a patient'"'"'s body, said device adapted to assume a reduced configuration and an operating configuration, said device assuming said reduced configuration for passage through a small opening to deliver a working end of said device to a site of the tissue to be stabilized, said device comprising:

a base member;

first and second contact members extending distally from said base member, said contact members being mounted for rotation with respect to said base member;

said contact members each having a contact surface adapted to contact a surface of the tissue;

wherein when said device is in said operating configuration, said contact surfaces face in a direction to contact the tissue, and when in said reduced configuration, said contact members have been rotated with respect to one another so that said contact surfaces substantially face one another.

2. The device of claim 1, further comprising stops extending from said base member, said stops are adapted to be contacted by said contact members when rotating from said reduced configuration to said operating configuration.

3. The device of claim 1, further comprising biasing members adapted to bias said contact members toward said operating configuration.

4. The device of claim 2, further comprising biasing members adapted to bias said contact members toward said operating configuration and against said stops.

5. The device of claim 3, wherein said biasing members comprise torsion springs interconnecting said first and second contact members with said base member, respectively.

6. The device of claim 1, wherein said first and second contact members are further mounted for tilting with respect to said base member;

wherein when in said reduced configuration, said contact members are substantially aligned with a longitudinal axis of said device, and wherein when in said operating configuration, said contact members are angled with respect to said longitudinal axis.

7. The device of claim 6, wherein a longitudinal axis of at least one of said contact members forms an acute angle with said longitudinal axis of said device when said contact members are in said operating configuration.

8. The device of claim 6, further comprising stops extending from said base member, said stops adapted to be contacted by said contact members when rotating and tilting from said reduced configuration to said operating configuration.

9. The device of claim 6, further comprising at least one biasing member adapted to bias said contact members toward said operating configuration, said at least one biasing member biasing each said contact member about an axis of said tilting and biasing each said contact member about an axis of said rotating.

10. The device of claim 1, further comprising an arm attached to said base member and extending proximally therefrom.

11. The device of claim 10, wherein said arm is adapted to be locked to, and released from said base member.

12. The device of claim 10, wherein said arm is permanently connected to said base member.

13. The device of claim 10, wherein said arm is configured to assume an unlocked configuration and a locked configuration, wherein said arm is adjustable relative to said base member when in said unlocked configuration, and wherein said arm is fixed relative to said base member when in said locked configuration.

14. The device of claim 10, further comprising a locking member adapted to interact with locking of said arm, wherein upon locking said arm in said locked configuration, said contact members are also locked in said operating configuration.

15. The device of claim 6, further comprising an arm attached to said base member and extending proximally therefrom.

16. The device of claim 15, wherein said arm is adapted to be locked to, and released from said base member.

17. The device of claim 15, wherein said arm is permanently connected to said base member.

18. The device of claim 15, wherein said arm is configured to assume an unlocked configuration and a locked configuration, wherein said arm is adjustable relative to said base member when in said unlocked configuration, and wherein said arm is fixed relative to said base member when in said locked configuration.

19. The device of claim 15, further comprising a locking member adapted to interact with locking of said arm, wherein upon locking said arm in said locked configuration, said contact members are also locked in said operating configuration.

20. The device of claim 1, wherein, when in said operating configuration, the largest cross-sectional dimension of the working end of said device is greater than any cross-sectional dimension of the small opening.

21. The device of claim 1, wherein said first and second contact members are configured to be automatically driven to said reduced configuration when said device is drawn through an opening having a cross-section smaller than a cross-section of said contact members in said operating configuration.

22. The device of claim 21, wherein said first and second contact members are configured to apply suction to a surface of the tissue, said device further comprising first and second suction lines extending from said first and second contact members respectively, said first and second suction lines facilitating the driving to said reduced configuration as said first and second suction lines are drawn through said opening.

23. The device of claim 21, further comprising first and second substantially rigid members extending from said first and second contact members respectively, said first and second substantially rigid members facilitating the driving to said reduced configuration as said first and second substantially rigid members are drawn through said opening.

24. The device of claim 21, wherein proximal portions of said first and second contact members are tapered to facilitate automatic driving of said first and second contact members to said reduced configuration as said tapered portions are drawn into the opening.

25. The device of claim 6, wherein said first and second contact members are configured to be automatically driven to said reduced configuration when said device is drawn through an opening having a cross-section smaller than a cross-section of said contact members in said operating configuration.

26. The device of claim 25, wherein said first and second contact members are configured to apply suction to a surface of the tissue, said device further comprising first and second suction lines extending from said first and second contact members respectively, said first and second suction lines facilitating the driving to said reduced configuration as said first and second suction lines are drawn through said opening.

27. The device of claim 25, further comprising first and second substantially rigid members extending from said first and second contact members respectively, said first and second substantially rigid members facilitating the driving to said reduced configuration as said first and second substantially rigid members are drawn through said opening.

28. The device of claim 25, wherein proximal portions of said first and second contact members are tapered to facilitate automatic driving of said first and second contact members to said reduced configuration as said tapered portions are drawn into the opening.

29. The device of claim 10, wherein said first and second contact members are configured to be automatically driven to said reduced configuration when said device is drawn through an opening having a cross-section smaller than a cross-section of said contact members in said operating configuration.

30. The device of claim 29, wherein said first and second contact members are configured to apply suction to a surface of the tissue, said device further comprising first and second suction lines extending from said first and second contact members respectively, said first and second suction lines facilitating the driving to said reduced configuration as said first and second suction lines are drawn through said opening.

31. The device of claim 30, wherein said first and second suction lines follow external contours of said arm.

32. The device of claim 30, wherein said first and second suction lines pass within said arm.

33. The device of claim 29, further comprising first and second substantially rigid members extending from said first and second contact members respectively, said first and second substantially rigid members facilitating the driving to said reduced configuration as said first and second substantially rigid members are drawn through said opening.

34. The device of claim 33, further comprising a ring slidably positioned over said arm, wherein said first and second substantially rigid members connect to said ring.

35. The device of claim 29, wherein proximal portions of said first and second contact members are tapered to facilitate automatic driving of said first and second contact members to said reduced configuration as said tapered portions are drawn into the opening.

36. A device for stabilizing tissue within a patient'"'"'s body, said device adapted to assume a reduced configuration for passage through a small opening to deliver a working end of said device to a site of the tissue to be stabilized, said device comprising:

first and second contact members extending a base member, said contact members being mounted for rotation with respect to said base member, said contact members each having a contact surface adapted to contact a surface of the tissue, said contact members configured to assume a reduced configuration and an operating configuration, wherein when said contact members are in said operating configuration, said contact surfaces face in a direction to contact the tissue, and when in said reduced configuration, said contact members have been rotated with respect to one another so that said contact surfaces substantially face one another;

an arm extending proximally from said base member, said arm being configured to assume an unlocked configuration and a locked configuration, wherein said arm is adjustable relative to said contact members when in said unlocked configuration, and wherein said arm is fixed relative to said contact members member when in said locked configuration; and

a locking member configured to facilitate locking of said arm, wherein upon locking said arm in said locked configuration, said contact members are also locked against rotation with respect to said base member.

37. The device of claim 36, further comprising a tensioning member, wherein application of tension to said tensioning member draws said locking member, locking said arm and contact members.

38. The device of claim 37, wherein said tensioning member passes through said arm.

39. The device of claim 36, wherein said arm is flexible in said unlocked configuration and rigid in said locked configuration.

40. The device of claim 36, wherein said first and second contact members are further mounted for tilting with respect to said arm;

wherein when in said reduced configuration, said contact members are substantially aligned with a longitudinal axis of said device, and wherein when in said operating configuration, said contact members are angled with respect to said longitudinal axis.

41. A method of stabilizing tissue comprising,

providing a stabilizing device having contact members configured to assume a reduced configuration and an operating configuration;

positioning said contact members in said reduced configuration;

passing said contact members through an opening, wherein a largest cross-sectional dimension of said contact members in said reduced configuration is smaller than a largest cross-sectional dimension of the opening, and wherein a largest cross-sectional dimension of said contact members in said operating configuration is larger than said largest cross-sectional dimension of the opening; and

contacting the tissue with said contact surfaces of said contact members, with said contact members in said operating configuration, wherein said contact members automatically move from said reduced configuration to said operating configuration upon exiting the opening.

42. The method of claim 41, wherein when said device is in said operating configuration, said contact surfaces face in a direction to contact the tissue, and when in said reduced configuration, said contact members have been rotated with respect to one another so that said contact surfaces substantially face one another.

43. The method of claim 41, further comprising:

withdrawing said device through said opening after completion of a tissue stabilization procedure, wherein said contact members automatically move from said operating configuration to said reduced configuration upon being drawn into said opening.

44. The method of claim 41, further comprising:

withdrawing said device through a second opening after completion of a tissue stabilization procedure, wherein said contact members automatically move from said operating configuration to said reduced configuration upon being drawn into said second opening; and

wherein said largest cross-sectional dimension of said contact members in said reduced configuration is smaller than a largest cross-sectional dimension of the second opening, and wherein said largest cross-sectional dimension of said contact members in said operating configuration is larger than said largest cross-sectional dimension of the second opening.

45. The method of claim 41, wherein said device further comprises an arm extending proximally from said contact members, wherein said arm follows said contact members as they are passed through the opening.

46. The method of claim 41, wherein said opening comprises a first opening, and said device further comprises an arm that is attachable and detachable from said device, said arm extending proximally form said contact members when attached, said method further comprising:

passing said arm through a second opening; and

connecting said arm to said contact members having been passed through said first opening.

47. A method of manipulating a surgical device in a reduced-access surgical site, wherein the surgical device comprises a working end, in an operating configuration, having a largest cross-sectional dimension greater than a largest cross-sectional dimension of an opening provided in a patient, said method comprising the steps of:

withdrawing the device proximally in a direction out of the patient;

contacting a portion of the working end against a perimeter of the opening, wherein the working end automatically collapses from the operating configuration to a reduced configuration, and wherein a largest cross-sectional dimension of the working end, in the reduced configuration, is smaller that the largest cross-sectional dimension of the opening; and

removing the device from the surgical site by passing the working end in the reduced configuration through the opening.