Method and Devices for Improved Tissue Stabilization

Abstract

Devices and methods are disclosed for accessing and stabilizing an unstable or moving tissue structure within a patient's body, and in particular, for temporarily stabilizing a target site on the beating heart. The devices generally involve tissue stabilizers having at least one multiple link support member operably connecting a stabilizer foot to a retractor. The tissue stabilizer may have a stabilizer foot allowing for additional members to be connected to the stabilizer foot at discreet locations. The support member and the additional members may be attachable to a retractor. The support member and the additional members may be operably associated with attachments or mounts which provide additional degrees of freedom at a connection to the retractor.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of application Ser. No. 10 / 637,372 filed Aug. 7, 2003, pending, which is a continuation of application Ser. No. 09 / 452,760 filed Dec. 1, 1999 and which issued as U.S. Pat. No. 6,626,830 on Sep. 30, 2003, which is a continuation-in-part of application Ser. No. 09 / 372,661 filed Aug. 11, 1999, abandoned, which is a continuation-in-part of application Ser. No. 09 / 305,810 filed May 4, 1999 and which issued as U.S. Pat. No. 6,331,158 on Dec. 18, 2001. Application Ser. Nos. 09 / 452,760, 09 / 372,661, 09 / 305,810 and U.S. Pat. Nos. 6,331,158 and 6,626,830 are all hereby incorporated herein, in their entireties, by reference thereto.FIELD OF THE INVENTION[0002]The present invention relates generally to surgical instruments, and more particularly to methods and devices for improved tissue stabilization using multiple link support members. The tissue stabilizers described herein are particularly useful for stabilizing ...

AI Technical Summary

Benefits of technology

[0013]The devices and methods of the present invention involve tissue stabilizers which are constructed to provide superior maneuverability and improved tissue stabilization at a target site, for example on the beating heart. The present invention may involve stabilization devices that use at least one multiple link support member to operably connect a stabilizer foot to a stable support, such as a retractor. To minimize motion at the stabilizer foot and improve the overall stabilization of a target site, the present invention may involve a stabilizer foot having two or more multiple link support members. The stabilizer foot is typically positioned as desired at the surgical site with at least one support member connecting the stabilizer foot to a stable support. Subsequently, one or more additional support members may be provided and connected to the stabilizer foot, typically at different locations, to obtain optimum stabilization.

[0022]In a preferred embodiment, the first axis is at an angle relative to the second axis, the angle being between about 120 degrees and about 45 degrees, more preferably the angle being about 90 degrees. This dual axis articulation allows optimum access and positioning of the stabilizer foot and support member within the surgical field.

Problems solved by technology

Anastomosing two vessels in this manner is a particularly delicate procedure requiring the precise placement of tiny sutures in the tissue surrounding the arteriotomy in the coronary artery and in the source or graft vessel so that the two may be sutured together.

While the simple operation of multiple link devices have found some acceptance as suitable support members for use in connection with tissue stabilizers, it has proved very difficult to produce the required rigidity and maneuverability required in certain demanding surgical applications, such as stabilizing the beating heart during a CABG procedure.

To support these high loads, the links typically have a much greater diameter than their continuous shaft alternatives thus occupying a greater amount of space in the surgical field.

In addition, the ability to maneuver and position the distal end of a multiple link support member as desired within the surgical field is disadvantaged by the limited range of motion available between successive links along the support member.

Attempting to position device through tight turns often proves excessively difficult.

With such a configuration, articulating the support member through a 90 degree turn may involve six or more links, thus occupying an excessive amount of space in or near the operative field and resulting in a relatively large radius curve.

Because the rigidity is somewhat inefficient, requiring an increased device size and high forces, and because the maneuverability is limited by the relatively small range of motion between adjacent links, it can be quite difficult to reach and stabilize vessels of the beating heart which are remote from the access opening established by the retractor.

Multiple link support members may be unable to develop the rigidity required for optimum stabilization of the peripheral arteries of the beating heart and may be difficult to position at the remote locations which require tight turns or extreme angles of the support member or the contacting member relative to the support member.

Further, when the proximal end of the support member is attached to the retractor in a generally horizontal orientation, it is difficult for a multiple link support member to maneuver the initial roughly 90 degree or less turn required to position the distal end vertically down into the target surgical site.

If the multiple link support member is unable to form a sufficiently tight turn or angle relative to its attachment to the retractor, it will tend to occupy an excessive amount of space at the access opening thus blocking visual and instrument access to the target surgical site to be stabilized.

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