Endoscopic beating-heart stabilizer and vessel occlusion fastener

• US 8,870,900 B2
• Filed: 03/21/2007
• Issued: 10/28/2014
• Est. Priority Date: 11/09/1999
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Julian, Christopher A., Ikeda, Michael, Ramans, Andris D., Hoornaert, Dean F., Isaac, Margaret M.
• Primary Examiner(s): Dowe, Katherine
• Assistant Examiner(s): MENDOZA, MICHAEL G
• Application Number:
  US11/689,287
• Publication Number:
  US 20070208223A1
• Time in Patent Office: 2,778 Days
• Field of Search: 606/151, 606/157, 606/158, 128/898, 600/229
• US Class Current: 606/158
• 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 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1327 Tensioning clamps
• 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 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2932 Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/2933 camming or guiding means
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/35 : for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms

Abstract

Devices, systems and methods related to endoscopic surgery, particularly related to robotic surgical operations, provide a tissue stabilizer for endoscopically stabilizing a target tissue within a patient'"'"'s body. For stabilizing a beating heart during a closed-chest coronary artery bypass grafting procedure, a stabilizer is inserted through an endoscopic cannula and provides sufficient surface area to contact the heart and effectively stabilize the target tissue area. The stabilizer can straddle a blood vessel, such as a coronary artery, which is targeted for an anastomosis. Vessel occlusion fasteners may occlude the target blood vessel prior to the anastomosis procedure.

Claims

1. A method of endoscopically preparing a blood vessel associated with a target tissue for a surgical procedure, said method comprising:

endoscopically positioning first and second toe portions of a tissue stabilizer against the target tissue to stabilize the tissue while the first and second toe portions straddle the blood vessel so that the first toe portion is positioned on one side of the blood vessel and the second toe portion is positioned on an opposite side of the blood vessel so as not to engage the blood vessel, wherein the tissue stabilizer comprises a shaft sized to allow insertion through an endoscopic cannula and a manipulable foot connected with the shaft, wherein the foot comprises the first toe portion rotatably joined with the second toe portion by a shell, wherein each toe portion comprises at least one suction port to apply suction to the target tissue during stabilization, and wherein the first toe portion and second toe portion are rotatable to a first arrangement wherein the foot is insertable through the endoscopic cannula;

endoscopically positioning at least one vessel occlusion device around the blood vessel to restrict blood flow therethrough;

removing the tissue stabilizer from the target tissue while the vessel occlusion device remains in place.

2. A method as in claim 1, further comprising repositioning the tissue stabilizer to a second location against the target tissue while the vessel occlusion device remains in place.

3. A method as in claim 1, wherein the vessel occlusion device comprises a plate-like body having a bore intersecting a radial slot and a flexible member having a free end and fixed end, wherein the fixed end is fixedly attached to the body, and wherein endoscopically positioning at least one vessel occlusion device comprises passing the free end of the flexible member around the blood vessel and into the radial slot so that the member is frictionally held.

4. A method of controlling blood flow in a blood vessel, said method comprising:

providing a vessel occlusion device comprising

a plate-like body having a bore intersecting a radial slot, and

a flexible member having a free end and fixed end, wherein the fixed end is fixedly attached to the body;

passing the free end of the flexible member around the blood vessel and through the bore so that the blood vessel is encircled by the flexible member and the plate-like body;

pulling the flexible member so that the blood flow is restricted in the blood vessel; and

sliding the flexible member into the radial slot so that the member is frictionally held; and

inserting a locking pin through a transverse aperture in the plate-like body after sliding the flexible member into the radial slot so that the flexible member is prevented from sliding back into the bore.

5. A method as in claim 4, further comprising:

removing the locking pin from the transverse aperture in the plate-like body; and

sliding the flexible member out of the radial slot to release the flexible member so that blood flow through the blood vessel is increased.

6. A method as in claim 4, further comprising:

removing the locking pin from the transverse aperture in the plate-like body; and

adjusting the position of the flexible member by sliding the flexible member out of the radial slot and re-sliding the flexible member into the radial slot.

7. A method as in claim 4, further comprising:

providing a tissue stabilizer for endoscopically stabilizing a target tissue within or upon which the blood vessel is disposed; and

positioning the tissue stabilizer against the target tissue to stabilize the tissue.