Devices for blood vessel harvesting

Abstract

A device for blood vessel harvesting is disclosed. The device includes a distal housing, a dissector coupled to the distal housing, a drive element coupled to the dissector, and an actuator coupled to the drive element. The device may also include: a rotatable dissector; a shaft coupled to the distal housing, the shaft having a first articulated joint movable within a first plane and a second articulated joint movable within a second plane, the second plane being substantially perpendicular to the first plane; a drum chain drive element coupled to the rotatable dissector; and an actuator coupled to the drive element. The device may also include a member slidably engaged to the distal tip.

Description

[0001] Citation of Related Applications

[0002] This patent application claims priority to U.S. Provisional Patent Application No. 62 / 886,374, filed on August 14, 2019, entitled “DEVICE FOR VESSEL HARVESTING.” This patent application also claims priority to U.S. Provisional Patent Application No. 62 / 916,571, filed on October 17, 2019, entitled “DEVICE FOR VESSEL HARVESTING.” This patent application also claims priority to U.S. Provisional Patent Application No. 62 / 981,813, filed on February 26, 2020, entitled “DEVICE FOR VESSEL HARVESTING.” Applications 62 / 886,374, 62 / 916,571, and 62 / 981,813 are incorporated herein by reference in their entireties. Technical Field

[0003] The claimed invention relates to minimally invasive surgical devices, and more particularly, to a surgical device for use in blood vessel harvesting procedures. Background Art

[0004] Minimally invasive surgical approaches associated with coronary artery procedures are gaining increasing attention. Coronary revascularization procedures, such as grafting of the internal thoracic artery (ITA), have demonstrated excellent long-term patency and improved patient outcomes in coronary artery bypass graft (CABG) surgery. While traditional ITA harvesting methods include median sternotomy or multiple sternotomies, minimally invasive approaches are desirable. Minimally invasive procedures associated with revascularization using the left or right internal thoracic artery (ITA) or the left or right internal mammary artery (IMA) can utilize access to the ITA via a subxiphoid approach, where increased surgical space is gained by accessing the internal thoracic artery via an incision in the subxiphoid region.

[0005] Following harvesting of the left internal thoracic artery (LITA) or right internal thoracic artery (RITA), anastomosis to the left anterior descending (LAD) coronary artery and right coronary artery (RCA), respectively, can be performed without cardiopulmonary bypass (CPB). A significant advantage of this approach is that a perfectly harvested ITA graft can be perfectly anastomosed to the usual sites on the LAD artery or to the RCA artery. Minimally invasive ITA harvesting procedures involving a subxiphoid approach also have excellent cosmetic results, are fairly painless, and allow the arterial graft to be performed on a beating heart. Recent minimally invasive ITA harvesting surgical techniques have been shown to increase the effective length of the ITA bypass, reduce operative time, and improve patient recovery.

[0006] While less invasive surgical approaches for ITA harvesting and CABG have shown promise, visualization, maintenance of inflation, and distal suturing of the coronary anastomosis during fully endoscopic coronary artery bypass grafting on a beating heart are technically demanding. Minimally invasive surgical tools and procedures can create a larger working space to accommodate additional surgical tools, such as endoscopes and suturing tools. However, achieving a larger working space should ideally maintain chest wall integrity and avoid CPB. Similarly, minimally invasive surgical approaches should not compromise the reliability of cardiac repair. Therefore, appropriate surgical tools are needed to assist in the retrieval or harvesting of ITAs during minimally invasive harvesting and revascularization procedures. Summary of the Invention

[0007] A device for blood vessel harvesting is disclosed. The device for blood vessel harvesting may include a distal housing, a dissector coupled to the distal housing, a drive element coupled to the dissector, and an actuator coupled to the drive element.

[0008] Another device for blood vessel harvesting is disclosed and may include a distal housing defining a rotatable dissector; a shaft coupled to the distal housing and may further include a first articulated joint movable in a first plane and a second articulated joint movable in a second plane, the second plane being substantially perpendicular to the first plane; a drum chain drive element coupled to the rotatable dissector; and an actuator coupled to the drive element.

[0009] Another device for blood vessel harvesting is disclosed. The device for blood vessel harvesting may include a shaft and a dissector coupled to the shaft.

[0010] Another device for blood vessel harvesting is disclosed. The device for blood vessel harvesting may include a shaft, a distal tip defining arcuate fingers coupled to a distal end of the shaft, and a member slidably engaged to the distal tip. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] Figure 1 is an upper left front perspective view of one embodiment of a minimally invasive surgical device.

[0012] Figures 2A-2C It is an explanation Figure 1 A series of exploded views of the assembly steps of a minimally invasive surgical device.

[0013] Figure 3A and Figure 3B They are Figure 1 The side sectional view and top sectional view of the minimally invasive surgical device illustrate the working principle of the minimally invasive surgical device.

[0014] Figure 3C and Figure 3D They are Figure 1The side sectional view and top sectional view of the minimally invasive surgical device illustrate the working principle of the minimally invasive surgical device.

[0015] Figure 3E and Figure 3F They are Figure 1 The side sectional view and top sectional view of the minimally invasive surgical device illustrate the working principle of the minimally invasive surgical device.

[0016] Figures 4A-4C is a partial cross-sectional top view of an alternative embodiment of a drive mechanism for a minimally invasive surgical device.

[0017] Figures 5A-5H is a side view of an alternative embodiment of a dissector for a minimally invasive surgical device.

[0018] Figure 6 is an upper left front perspective view of another embodiment of a minimally invasive surgical device.

[0019] Figure 7 is an upper left front perspective view of another embodiment of a minimally invasive surgical device.

[0020] Figure 8 is an upper left front perspective view of another embodiment of a minimally invasive surgical device.

[0021] Figure 9 is an upper left front perspective view of another embodiment of a minimally invasive surgical device.

[0022] Figures 10A-10B yes Figure 9 Side partial cross-sectional views of the distal end of a minimally invasive surgical device, illustrating closed and open positions, respectively.

[0023] Figure 11 is an upper left front perspective view of another embodiment of a minimally invasive surgical device.

[0024] Figure 12 yes Figure 11 Exploded view of the distal end of a minimally invasive surgical device.

[0025] Figure 13A and Figure 13B is concentrated on Figure 11 Upper left front perspective view of the assembled distal end of a minimally invasive surgical device, in open and closed positions respectively.

[0026] Figure 14A and Figure 14B They are Figure 11 Side sectional view and front end view of a minimally invasive surgical device in an open position.

[0027] Figure 15A and Figure 15B They are Figure 11Side cross-sectional view and front end view of a minimally invasive surgical device in a closed position.

[0028] Figure 16 yes Figure 11 An enlarged side view of a portion of the shaft of a minimally invasive surgical device.

[0029] It will be appreciated that for clarity and where considered appropriate, reference numerals have been repeated in the drawings to indicate corresponding features and that various elements in the drawings have not necessarily been drawn to scale in order to better illustrate the features. DETAILED DESCRIPTION

[0030] Figure 1 FIG1 is a top left front perspective view of one embodiment of a minimally invasive vessel harvesting device 10. Minimally invasive vessel harvesting device 10 has a housing 12 that extends downward to form a handle 14. The device also has an actuation lever 16 pivotally coupled to handle 14. Minimally invasive vessel harvesting device 10 also has a shaft 18 coupled to housing 12. Minimally invasive vessel harvesting device 10 has a distal housing 20 on the opposite end of shaft 18, which defines a blunt dissector 22 used in minimally invasive surgical procedures involving harvesting an IMA for revascularization. Blunt dissector 22 is coupled to actuation lever 16, and movement of actuation lever 16 rotates blunt dissector 22 to achieve adjustable positioning of blunt dissector 22 during minimally invasive cardiovascular procedures, such as for harvesting an internal thoracic artery. This mechanism will be described in more detail. The blunt dissector 22 is an arcuate or curved appendage having a smooth, atraumatic tip that allows and enables gentle manipulation and separation of tissue while preventing damage to anatomical features and structures surrounding the tissue of interest. Generally speaking, blunt dissection refers to an element of a surgical procedure in which the careful separation of tissue is accomplished using the fingers or blunt surgical instruments. The blunt dissector tip is useful in procedures associated with ITA / IMA retrieval or harvesting procedures. The shape, maneuverability, and atraumatic nature of the blunt dissector 22 are features that contribute to increased utility, reduced risk of injury to surrounding tissue, and positive outcomes during minimally invasive surgical procedures. While Figure 1 The blunt dissector 22 shown in the figure is an atraumatic, arcuate appendage or soft finger, other embodiments may be blunt, partially blunt, or have a partial edge. Still other embodiments may have portions or edges that may be partially sharpened or shaped as needed for the surgical procedure intended. Although an actuator rod is shown in this embodiment, other embodiments may include an actuator such as a rod, sliding link, knob, pulley, gear, solenoid, motor, or other actuator known to those skilled in the art.

[0031] Figures 2A-2C It is an explanation Figure 1 A series of exploded views of the assembly steps of a minimally invasive surgical device. Figure 2A The assembly steps of distal tip housing 20 of minimally invasive blood vessel harvesting device 10 are shown. Blunt dissector 22, which defines upper dissector 28, lower dissector 30, and has inner surface 32, also defines dissector base 24 and hub 26. Gear assembly 34, which defines gear shaft 36 with upper gear 38, lower gear 40, and capstan 42, is placed within the inner diameter of hub 26 on blunt dissector 22. Upper gear 38 has a plurality of teeth 44 and recesses 45 between teeth 44. Similarly, gear 40 also has a plurality of teeth 46 and recesses 47 between teeth 46. Pin 84 is inserted into hole 25 on blunt dissector 22 and corresponding hole 37 on gear assembly 34. Although pins are used to assemble these components, other assembly methods may be used, such as gluing, welding, or using a single component in another embodiment to define the dissector and gear assembly. Next, blunt dissector 22 and gear assembly 34 are placed in hole 54 at distal end 48D of upper distal tip housing 48. Upper distal tip housing 48 also defines an alignment guide 50, a sidewall 56, and a tube portion 58 at proximal end 48P. Tube portion 58 further defines an interior passageway 52.

[0032] Figure 2B Shown Figure 1Assembly of minimally invasive blood vessel harvesting device 10 continues. A drive element (in this embodiment, a barrel chain 60) having several barrel 62 portions inserted between several tab 64 portions along a wall 66 of barrel chain 60 is placed within upper distal tip housing 48 such that wall 66 of barrel chain 60 rides on the sidewall of upper distal tip housing 48 opposite sidewall 56. Barrels 62 are captured in recesses 47 between teeth 46 on lower gear 40 and also in recesses 45 between teeth 44 on upper gear 38 (although not visible in this view), surrounding the gear assembly and against sidewall 56 of upper distal tip housing 48. It should be noted that tabs 64 are sized and configured so that they provide rigidity to barrel chain 60 and maintain alignment and tracking of barrel chain 60 within capstan 42 portion (not visible here) of gear assembly 34. Drive coupling 68 has a drive element coupler 70 and a drive link coupler 72 at the end of a drive link slot 74. Drive coupling 68 is coupled to the end of barrel chain 60 by fitting drive element coupler 70 of drive coupling 68 onto terminal barrel 62 in barrel chain 60. Drive link 76 has a ball end 78 at its distal end 76D. Drive link 76 is captured in drive link coupler 72 by placing ball end 78 into drive link coupler 72 and guiding drive link 76 through drive link slot 74 on drive coupling 68. Drive link 76 and driver coupling 68 are freely movable within passage 52 within tube portion 58 of upper distal tip housing 48. A lower distal tip housing 80, having tube portion 82 at proximal end 80P, is fixedly attached to upper distal tip housing 48, completing assembly of upper distal tip housing 48. Figure 2CAnother assembly step in minimally invasive blood vessel harvesting device 10 is shown. Distal end housing tube 86, from which drive link 76 projects, is inserted into shaft opening 90 at distal end 18D of shaft 18 on minimally invasive blood vessel harvesting device 10. Distal end housing tube 86 is fixedly attached to shaft 18 by welding, brazing, or other methods known to those skilled in the art. Further assembly steps for the device, including handles, levers, and other components, are well known to those skilled in the art of minimally invasive blood vessel harvesting devices. It should be noted that while a drum chain drive is described with respect to the embodiments described herein, other drive elements or mechanisms may be used in other embodiments of minimally invasive blood vessel harvesting devices. The illustrated embodiment features an integral or single-piece drum chain as the drive element. The drive element may include a chain or belt, a coupling, a drive link, or a combination thereof. Alternative drive attachments to the gear assembly including the capstan and gears shown herein may be used, such as slotted shafts or spools, cylindrical bearings or bushings, or other rotatable shafts known to those skilled in the art. Any structural element suitable for extending from or attaching to a blunt dissector to attach and rotate the drive element to the blunt dissector would be a suitable drive attachment. Alternative drive elements to the barrel chain and drive coupling may also be used as drive elements in other embodiments of the minimally invasive vessel harvesting devices described herein. In alternative embodiments, a rigid belt, connecting rod, wire, linked chain, or other linkage known in the art capable of pushing or pulling a drive attachment coupled to a blunt dissector may be used as the drive element.

[0033] Figure 3A and Figure 3B They are Figure 1 The side sectional view and top sectional view of the minimally invasive blood vessel collection device illustrate the working principle of the minimally invasive blood vessel collection device. Figure 3A The invasive vessel harvesting device 10 is shown in a neutral position relative to the position of the actuator rod 16 and the blunt dissector 22. The actuator rod 16 is in a position partially away from the handle 14, and the blunt dissector 22 is oriented in a position such that it is aligned with the shaft 18 of the minimally invasive vessel harvesting device 10. The internal components of the actuator rod 16 are in a neutral position. Figure 3A 9. The actuating lever 16 is pivotally coupled about a pivot axis 92 and further defines a lever gear 94 having a plurality of lever gear teeth 96. A drive gear 100 pivots about a pivot point 88 and defines a plurality of teeth 101 and a drive gear coupler 102. The teeth 101 on the drive gear 100 mesh with the teeth 96 on the lever gear 94. The drive link 76 has a drive link coupling ball 98 on its proximal end 76P, which is retained within the drive gear coupler 102.

[0034] Figure 3B is a top cross-sectional view of the upper distal tip housing 48, illustrating the locations of the components within the upper distal tip housing 48, particularly those corresponding to Figure 3A The blunt dissector 22 is shown in the rod position. It should be noted that Figure 3B In this illustrated position, blunt dissector 22 is oriented in such a manner that the arcuate portion of blunt dissector 22 is aligned with axis 18 of minimally invasive vessel harvesting device 10 relative to the axis 18 of minimally invasive vessel harvesting device 10. Figure 3B The angle indicators are shown aligned at an angle of approximately 0 degrees.

[0035] Figure 3C and Figure 3D They are Figure 1 The side sectional view and top sectional view of the minimally invasive blood vessel collection device illustrate the working principle of the minimally invasive blood vessel collection device. Figure 3C Invasive vessel harvesting device 10 is shown in a rotated position relative to the position of actuation rod 16 and blunt dissector 22. Actuation rod 16 is in a position squeezed in direction 104 toward handle 14, and blunt dissector 22 is oriented in a position such that it rotates clockwise relative to shaft 18 of minimally invasive vessel harvesting device 10. When rod 16 is pressed toward handle 14, rod gear 94 engages rod drive gear 100 and rotates rod drive gear 100 in direction 106. Because rod drive gear 100 is coupled to drive link 76, drive link 76 is pulled in direction 108. Figure 3D is a top cross-sectional view of the upper distal tip housing 48, illustrating the locations of the components within the upper distal tip housing 48, particularly those corresponding to Figure 3C Blunt dissector 22 with the rod in the position shown. When drive link 76 is pulled in direction 108, drive coupler 68 is also pulled in direction 108 because ball end 78 of drive link 76 is coupled to drive coupler 68. Barrel chain 60 is also pulled in direction 108 because barrel chain 60 is coupled to drive element coupler 70 on drive coupler 68. Thus, when barrel chain 60 is coupled to teeth 46 on lower gear 40 at reference Figure 3D Blunt dissector 22 is rotated in direction 110 with the angle indicator shown engaged at approximately 135 degrees.

[0036] Figure 3E and Figure 3F They are Figure 1 The side sectional view and top sectional view of the minimally invasive blood vessel collection device illustrate the working principle of the minimally invasive blood vessel collection device. Figure 3EInvasive vessel harvesting device 10 is shown in another rotational position relative to the position of actuation rod 16 and blunt dissector 22. Actuation rod 16 is in an open position, moved in direction 112 away from handle 14, and blunt dissector 22 is positioned such that it rotates counterclockwise relative to shaft 18 of minimally invasive vessel harvesting device 10. As rod 16 moves away from handle 14, rod gear 94 engages rod drive gear 100 and causes rod drive gear 100 to rotate in direction 114. Because rod drive gear 100 is coupled to drive link 76, drive link 76 is urged in direction 116. Figure 3F is a top cross-sectional view of the upper distal tip housing 48, illustrating the locations of the components within the upper distal tip housing 48, particularly those corresponding to Figure 3E . As the drive link 76 is pushed in direction 116, the drive coupler 68 is also pushed in direction 116 because the ball end 78 of the drive link 76 is coupled to the drive coupler 68. The barrel chain 60 is also pushed in direction 116 because the barrel chain 60 is coupled to the drive element coupler 70 on the drive coupler 68. As previously described, the tabs 64 on the barrel chain 60 provide additional support and rigidity to the barrel chain 60 and allow the chain to be pushed. Thus, when the barrel chain 60 is pushed in direction 116 relative to the barrel chain 60, the barrel chain 60 is pushed in direction 116. Figure 3F When the overlapping angle indicators shown in FIG. 1 engage the teeth 46 on the lower gear 40 at an angle of approximately -135 degrees, the blunt dissector 22 is rotated in direction 118. The embodiments described herein have a blunt dissector 22 that is pivotable relative to the distal housing and is movable relative to the distal housing. Figure 3B 、 Figure 3D and Figure 3F The blunt dissector 22 is pivotable within a rotational range of approximately 270 degrees, with overlapping angle indicators shown in FIG. This rotation of the blunt dissector 22 can be pivotal about a plane substantially parallel to the distal housing. Other embodiments, including rotatable dissectors such as those described herein, can be configured to rotate within a full range of approximately 210 degrees, approximately 270 degrees, or approximately 360 degrees. The range of rotation of the blunt dissector 22 enables precise control of the articulation and position of the blunt dissector during surgical procedures involving blood vessel harvesting.

[0037] Figures 4A-4C is a partial cross-sectional top view of an alternative embodiment of a drive mechanism for a minimally invasive blood vessel harvesting device. Figure 4A is a top view of a partial cross section of a belt drive element 120 coupled to a drive shaft 122 similar to Figure 1-3F The capstan of the embodiment of the blood vessel harvesting device is shown. The drive shaft 122 has a capstan slot 124 into which the belt drive element 120 is fixedly attached.

[0038] Figure 4Bis a partial cross-sectional top view of a segment chain drive 126 coupled to a gear assembly drive shaft 123 similar to Figure 1-3F The capstan of an embodiment of a blood vessel collection device is shown. The segmented chain drive 126 has a gear assembly drive shaft 123 about which the segmented chain drive 126 is coupled. The segmented chain drive 126 is made up of several links 128. Each link 128 defines a buckle 13 having a recess 132, a support tab 134, and a pin 136. Each link 128 is connected to another subsequent link 128 by connecting the tab 136 of one link 128 to the recess 132 on the subsequent link 128.

[0039] Figure 4C is a partial cross-sectional top view of another embodiment of a drum chain 138 constructed from a single piece having a plurality of drums 140 disposed on chain walls 142 and spaced apart so that they mesh and couple with the gears on the gear assembly drive shaft 125, similar to Figure 1-3F The capstan of an embodiment of a blood vessel collection device is shown in FIG.

[0040] Figures 5A-5H is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5A is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5A A dissector 144 is shown having a dissector base 146, an upper dissector 148, and a lower dissector 150. The dissector 144 also defines an inner surface 152. The dissector 144 has an arcuate, C-shaped profile with an opening on one side. Figure 5B is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5B A dissector 154 is shown having a dissector base 156, an upper dissector 158, and a lower dissector 160. The dissector 144 also defines an inner surface 152. The dissector 144 has an arcuate C-shaped profile with its opening facing at a slight downward angle. Figure 5C is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5C A dissector 164 is shown having a dissector base 166, an upper dissector 168, and a lower dissector 170. The dissector 164 also defines an inner surface 172. The dissector 164 has a square profile with a side-facing opening. Figure 5D is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5D A dissector 174 is shown having a dissector base 176, an upper dissector 178, and a lower dissector 180. The dissector 174 also defines an inner surface 182. The dissector 174 has an angular L-shaped profile. Figure 5Eis a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5E A dissector 184 is shown having a dissector base 186, an upper dissector 188, and a lower dissector 190. The dissector 184 also defines an inner surface 192. The dissector 184 has an arcuate C-shaped profile with a side-facing opening. Figure 5F is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5F A dissector 196 is shown having a dissector base 198, an upper dissector 200, and a lower dissector 202. The dissector 196 also defines an inner surface 204. The dissector 196 has an arcuate, C-shaped profile with a side-facing opening. Figure 5G is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5G A dissector 208 is shown having a dissector base 210, an upper dissector 212, and a lower dissector 214. The dissector 208 further defines an inner surface 216. The dissector 208 has an arcuate, C-shaped profile with a downwardly facing opening. Figure 5H is a side view of an alternative embodiment of a dissector for a minimally invasive blood vessel harvesting device. Figure 5H A dissector 226 is shown having a dissector base 222, an upper dissector 224, and a lower dissector 220. The dissector 224 also defines an inner surface 218. The dissector 224 has an arcuate, semi-C-shaped profile. Alternative embodiments of the dissector may have shapes such as L-shaped, spiral, or have sharper angles than the embodiments directly described herein. The inner surfaces of some alternative embodiments of the dissectors described herein may have smooth, textured, or compliant surfaces. Alternative embodiments of the dissector may be made of materials such as plastic, metal, ceramic, composite material, or a combination thereof.

[0041] Figure 6FIG2 is a top left front perspective view of another embodiment of a minimally invasive vessel harvesting device 228. Minimally invasive vessel harvesting device 228 has a housing 230 that extends downward to form a handle 232. The device also has an actuation lever 234 that operates in a manner similar to the previous embodiments described herein. Minimally invasive vessel harvesting device 228 also has a shaft 242 coupled to housing 230 via a rotation adapter, which is not fully visible in this view but is known to those skilled in the art. However, the indicator fins 236 of the rotation adapter are visible in this view. Minimally invasive vessel harvesting device 228 has a distal tip housing 254 pivotally coupled to distal shaft portion 244 via a second articulation joint 248. The distal tip housing has a blunt dissector 252 similar to those previously described herein. Distal shaft portion 244 is pivotally coupled to shaft 242 via a first articulation joint 246. The first articulation joint 246 is operably coupled to the first articulation knob 238 such that rotation of the first articulation knob 238 causes the first articulation joint 246 to articulate the distal shaft portion 244 in a first plane 250. The second articulation joint 248 is operably coupled to the second articulation knob 240 such that rotation of the second articulation knob 240 causes the second articulation joint to articulate the distal tip housing 254 in a second plane 256. In this example, the first plane 250 is substantially perpendicular to the second plane 256. In other embodiments having two articulation joints, the two articulation planes may not be substantially parallel. Other embodiments may have more or fewer articulation joints, including no articulation joints. The articulation joints in other embodiments may be capable of moving in more than one plane. Embodiments of the rotation adapter and minimally invasive surgical devices are known to those skilled in the art.

[0042] Figure 7FIG2 is a top left front perspective view of another embodiment of a minimally invasive surgical device. Minimally invasive blood vessel harvesting device 260 has a housing 262 that forms an ergonomic handle 264. The device also has a channel 266 configured to provide a path for a sliding member 270 to slide longitudinally along the device 260 from its distal end 260D to its proximal end 260P. Channel 266 also defines a plurality of detents 268 that correspond to mating features on sliding member 270. This aspect of the design provides a means for sliding member 270 along channel 260 while locking its position if desired. Minimally invasive blood vessel harvesting device 260 also has a shaft 274 coupled to housing 262. Shaft 274 extends toward distal end 260D of minimally invasive blood vessel harvesting device 260 and has an auxiliary shaft 276 coupled thereto. Coupled to auxiliary shaft 276 is a distal tip 278 that defines a U-shaped or protruding arcuate finger 280 extending in an arcuate manner. The arcuate curvature of finger 280 is formed in a direction substantially perpendicular to distal tip 278 and perpendicular to shaft 274 and auxiliary shaft 276, and can be considered and used as a blunt dissector. While arcuate finger 280 is not closed at both ends in contact with distal tip 278, sliding member 282 provides such closure. Sliding member 282 is coupled to sliding member 270 and is configured such that when sliding member 270 moves toward proximal end 260P, sliding member 282 also moves toward proximal end 260P of minimally invasive blood vessel harvesting device 260. When sliding member 282 moves in a direction toward proximal end 260P of minimally invasive blood vessel harvesting device 260, arcuate finger 280 opens. This open position allows minimally invasive vessel harvesting device 260 to be placed around a vessel, such as an IMA, to position arcuate fingers 280 around the vessel during a harvesting or retrieval procedure. When sliding member 282 is moved toward distal end 260D of minimally invasive vessel harvesting device 260, arcuate fingers 280 are positioned to form a closed loop in conjunction with the position of arcuate fingers 280. This closed loop position allows an operator of minimally invasive vessel harvesting device 260 to hold or secure a vessel, such as an IMA, in position within the closed loop formed by sliding member 282 and arcuate fingers 280 during a harvesting or retrieval procedure. In other embodiments, the loop formed by sliding member 282 and arcuate fingers 280 may be substantially parallel to axis 274 of minimally invasive vessel harvesting device 260, or at a position somewhere between substantially parallel and substantially perpendicular. Other embodiments may not form an arcuate loop and may form a closure or loop of a different shape.

[0043] Figure 8FIG2 is a top left front perspective view of another embodiment of a minimally invasive surgical device. Minimally invasive vessel harvesting device 286 has a housing 288 forming an ergonomic handle 290. Minimally invasive vessel harvesting device 286 also has a shaft 292 coupled to 288. Shaft 292 extends toward distal end 286D of minimally invasive vessel harvesting device 286. Coupled to shaft 292 are several arcuate blunt-tip dissector or omega (Ω)-shaped fingers 296, 302, 308. These are referred to as Ω-shaped due to their resemblance to the Greek letter Ω. They may also be referred to as C-shaped or U-shaped. The arcuate curvature of fingers 296, 302, 308 is formed in a direction substantially perpendicular to the shaft. First Ω-shaped finger 296 is coupled to shaft 292 via first tubular mounting member 294 and defines opening 298. Second Ω-shaped finger 302 is coupled to shaft 292 via tubular mounting member 300 and defines opening 304. A third omega-shaped finger 308 is coupled to shaft 292 via tubular mount 306 and defines an opening 310. The openings 298, 304, 310 formed by each of omega-shaped fingers 296, 302, 308 allow minimally invasive vessel harvesting device 286 to be placed at one or more locations around a vessel, such as an IMA, to temporarily hold or secure the vessel in a desired location or position during a harvesting or retrieval procedure. In other embodiments, the opening formed by fingers 296, 302, 308 may be substantially parallel to shaft 292 of minimally invasive vessel harvesting device 286, or at a position somewhere between substantially parallel and substantially perpendicular. Other embodiments of the fingers may not form an arcuate loop and may form closures or loops of different shapes.

[0044] Figure 9FIG3 is a top left front perspective view of another embodiment of a minimally invasive surgical device. Minimally invasive blood vessel harvesting device 312 has a housing 314 at a proximal end 312P, which forms an ergonomic handle 316. Device 312 also has an articulated rod 318 and a rotation adapter knob 320 disposed within housing 314. Rotation adapter knob 320 can be rotated about the longitudinal axis of an attached shaft 322 to enable rotational positioning of shaft 322 and, therefore, distal end 312D of device 312. Hollow shaft 322 is mounted to rotation adapter knob 320 and contains a rigid link or drive wire, which is not visible here but will be described in greater detail later. Along shaft 322, closer to housing 314, are a plurality of first horizontal articulation joints 324, each of which is comprised of a plurality of slits 324S. Further toward the distal end 312D of the device 312, also positioned along the axis 322 are a plurality of second vertical articulation joints 326, each vertical articulation joint 326 being comprised of a plurality of slits 326S. The plurality of first articulation joints 324 articulate in a plane that is substantially perpendicular or substantially horizontal relative to the plane of the bisecting housing 314 or a plane that is in line with the rod 318. The plurality of second articulation joints 326 articulate in a plane that is substantially parallel or substantially perpendicular relative to the plane of the bisecting housing 314. These articulation joints 324, 326 are comprised of slits 324S, 326S that are oriented along the desired articulation direction. It should be noted that as the rotary adapter knob 320 is rotated, the relationship between the aforementioned articulation direction and the articulation direction between the axis 322 shifts depending on the amount of rotation. Although alternative embodiments may have varying degrees of partial rotation, in Figure 9In the case of the illustrated embodiment, each partial rotation of the rotary adapter knob 320 rotates the shaft 322 60 degrees about the longitudinal axis defined by the shaft 322. Alternative embodiments of the articulating shaft 322 may include a different number of slits, for example, from about 1 to about 10, from about 3 to about 8, or from about 5 to about 7. The slits 324S, 326S are defined by partial circumferential segments of the outer surface of the hollow rigid shaft 322. While the articulation feature in this embodiment includes multiple slits for each joint, alternative embodiments may also include other similarly positioned articulation joint configurations, such as hinges, flexible shaft materials, and other types of articulation joint configurations known to those skilled in the art, and will also be configured such that the shaft 322 can be formed into a desired shape or approximate angle for a surgical procedure and will remain in the set configuration until intentionally moved to a different shape or angle of the shaft 322. While these articulation joints 324, 326 are movable and configured to be positioned in the aforementioned planes, alternative arrangements of articulation joints may be used in alternative device embodiments. For example, the horizontal articulation joint can be located closer to the distal tip 328, while the vertical articulation joint can be located closer to the housing 314, the vertical and horizontal articulation joints can alternate along the shaft, or there can be different numbers of each element in alternative device embodiments. Closer to the distal end 312D of the device 312 is the distal tip 328 fixedly mounted on the shaft 322. The distal tip 328 includes an arcuate finger 330 and a slidably engaged sliding member 332 that are arranged to move in a substantially horizontal direction. Figure 9 328 to open and allow a blood vessel, or other anatomical feature, to enter or pass through the channel or opening 334 defined by the distal end 328. Figure 10A and Figure 10B Describe the movement in further detail.

[0045] Figures 10A-10B yes Figure 9 Side partial cross-sectional views of the distal end of a minimally invasive surgical device showing closed and open positions, respectively. Figure 10AThe arrangement of distal tip 328 of device 312 is shown when rod 318 is in an unsqueezed position, with rod 318 positioned away from handle 316. Drive wire 342 is coupled to sliding member 332 and fully extends toward distal end 312D of device 312. This arrangement maintains sliding opening 334 at distal tip 328 of device 312, with sliding member 332 and arcuate fingers 330 completing a complete closure around passageway or opening 334. In this configuration, a blood vessel can be entrained within opening 334 for retention or other desired surgical manipulation, such as during a minimally invasive vessel harvesting procedure. When rod 318 is squeezed toward handle 316 of device 312, drive wire 342 and the connected sliding member 332 are caused to slide or move in direction 338 toward proximal end 312P of device 312.

[0046] Figure 10B 340 , the slide member 332 moves along the cam path 336 defined by the distal end 328. The cam path 336 is configured to cause the slide member 332 to rotate in a direction 340 away from the distal end 328 as the inner surface of the slide member 332 interferes with the defined path of the cam path 336. This movement in the direction 338 and the substantially simultaneous rotation in the direction 340 allow additional clearance to open the opening 334 for placement of a blood vessel or other anatomical feature within the opening 334 on the distal end 328 of the device 312. When the desired anatomical feature is placed in the opening 334, the rod 318 can be released by the user of the device 312 and the position of the distal end 328 returned to the original position. Figure 10A , effectively securely capturing or capturing the anatomical feature within the opening 334 of the distal tip 328 .

[0047] Figure 11FIG3 is a top left front perspective view of another embodiment of a minimally invasive surgical device. Minimally invasive blood vessel harvesting device 344 has a housing 346 at a proximal end 344P, which forms an ergonomic handle 348. Device 344 also has an articulated rod 350 and a rotation adapter knob 352 disposed within housing 346. Rotation adapter knob 352 can be rotated about the longitudinal axis of an attached shaft 354 to enable rotational positioning of shaft 354 and, therefore, distal end 344D of device 344. Hollow shaft 354 is mounted to rotation adapter knob 352 and contains a drive wire, which is not visible here but will be described in greater detail later. Along shaft 354, proximal to housing 346, are a plurality of first horizontal articulation joints 356, each consisting of a plurality of slits 358. Further toward the distal end 344D of the device 344, also positioned along the axis 354, are a plurality of second horizontal articulation joints 356, each of which is comprised of a plurality of slits 362. The plurality of first articulation joints 356 articulate in a plane that is substantially perpendicular or substantially horizontal with respect to a plane bisecting the housing 346 or a plane in line with the rod 350. The plurality of second articulation joints 360 articulate in a plane that is substantially parallel or substantially perpendicular with respect to a plane bisecting the housing 346. These articulation joints 356, 360 are comprised of slits 358, 362 that are oriented along the desired direction of articulation. It should be noted that as the rotary adapter knob 352 is rotated, the above-described relationship between the axis 354 and the direction of articulation is offset by the amount of rotation. Although alternative embodiments may have varying degrees of partial rotation, in Figure 11In the illustrated embodiment, each partial rotation of the rotary adapter knob 352 rotates the shaft 354 60 degrees about the longitudinal axis defined by the shaft 354. Alternative embodiments of the articulating shaft 354 may include a different number of slits, for example, from about 1 to about 10, from about 3 to about 8, or from about 5 to about 7. The slits 358, 362 are defined by partial circumferential segments of the outer surface of the hollow rigid shaft 354. These slits may be formed by laser cutting, machining, or other methods known to those skilled in the art. While the articulation feature in this embodiment includes multiple slits for each joint, alternative embodiments may also include other similarly positioned articulation joint configurations, such as hinges, flexible shaft materials, and other types of articulation joint configurations known to those skilled in the art. The articulation feature may also be configured such that the shaft 354 can be formed into the shape or approximate angle desired for the surgical procedure and will remain in the set configuration until the shaft 354 is intentionally moved to a different shape or angle. Although these articulating joints 356, 360 move and are configured to be positioned in the planes described above, alternative arrangements of the articulating joints may be used in alternative device embodiments. For example, the horizontal articulating joints may be positioned closer to the distal housing or distal tip 364, while the vertical articulating joints may be positioned closer to the housing 346, the vertical and horizontal articulating joints may alternate along the axis, or there may be different quantities of each element in alternative device embodiments. Closer to the distal end 344D of the device 344 is the distal tip 364 fixedly mounted on the shaft 354. The distal tip 364 includes an arcuate first blunt dissector 366 and an arcuate second blunt dissector 368 in an open position. Due to the sliding motion of the first cam portion 382 throughout the cam path, the first blunt dissector may also be referred to as an arcuate finger, and the second blunt dissector 368 may also be referred to as a fixed member or a sliding member. When open, as Figure 11 As shown, distal tip 364 is configured to receive a blood vessel, artery, or other anatomical feature within distal tip 364 when distal tip 364 is closed. By actuating rod 350 and placing first blunt dissector 366 and second blunt dissector 368 in a closed position, the blood vessel, artery, or other anatomical feature can be retained and releasably held. Figures 13A-13B as well as Figure 14A and Figure 14B Further details of this operating motion are described in detail.

[0048] Figure 12 yes Figure 11Exploded view of the distal end of a minimally invasive surgical device. A hollow shaft 354 is shown having a distal end 370 fixedly attached thereto, further defining a head 372 and a keyway 374. A flat distal key 376 having a drive coupler 378 and an actuator coupler 386 is inserted into the keyway 374 on the distal end 370. The flat distal key 376 is coupled to a drive wire, which is not shown in this view. An actuator pin 380, further defining a first cam portion 382 and a second cam portion 384, is attached to the actuator coupler 386 on the flat distal key 376. Next, a first guide tip section body 388 defining a first cam path 390, a channel 392, and a first blunt dissector 366 is placed over the distal end 370 on the hollow shaft 354. Then, a second guide tip section body 394 defining an inner cam path 396 and a second blunt dissector 368 is placed within the first guide tip section body 388, completing the distal tip 364 assembly.

[0049] Figure 13A and Figure 13B is concentrated on Figure 11 FIG2 is an upper left front perspective view of the assembled distal end of a minimally invasive surgical device in open and closed positions, respectively. When the minimally invasive device is in a resting state, the relative positions of the second blunt dissector 368 and the first blunt dissector 366 are in the open position, and the first cam portion 382 is positioned adjacent to the hollow shaft 354 within the first cam path 390 on the first guide tip portion body 388. A corresponding cam path may exist on the opposite side of the first guide tip portion body 388, not shown in this view. The corresponding cam path may simply be a straight path, rather than the curved path of the first cam path 390. The second blunt dissector 368 has a guide feature 398 that is positioned within a corresponding recess (not shown) on the first blunt dissector 366. Figure 13B The first and second blunt dissectors 366, 368 are shown in a closed position. Once the actuator rod is squeezed, the drive wire is pushed distally, and the first cam portion 382 is engaged in a distal direction away from the shaft within the first cam path 390, the first and second blunt dissectors 366, 368 are in the closed position. Figure 14A and Figure 14B This operational function is discussed further.

[0050] Figure 14A and Figure 14B They are Figure 11sectional side and front views of a minimally invasive surgical device in an open position. Within housing 346 of device 344, spring 402 is shown providing bias on actuator rod 350 when device 344 is in the open position, or a position in which actuator rod 350 is not actuated. Also visible is drive wire 400 coupled to ball end 406, which is captured in rod coupler 404 within actuator rod 350. Figure 14B 366, and second blunt dissector 368, and guide feature 398 when device 344 is in an open position. In this position, device 344 is configured to receive a blood vessel, artery, or other anatomical feature within opposing forceps or first and second blunt dissectors 366, 368.

[0051] Figure 15A and Figure 15B They are Figure 11 As the actuation rod 350 of the device 344 is squeezed or actuated in direction 408 toward the handle, the drive wire 400 moves in direction 410 toward the distal end of the device 344. Figure 13A and Figure 13B As depicted, when drive wire 400 and first cam portion 382 are coupled, movable second blunt dissector 368 is urged closed relative to fixed first blunt dissector 366 along first cam path 390, wherein in the closed position, device 344 can be used to hold and gently grasp a blood vessel, artery, or other anatomical feature within the closed structure defined by first and second blunt dissectors 366, 368.

[0052] Figure 16 yes Figure 11 An enlarged side view of a portion of the shaft of a minimally invasive surgical device. Figure 16 An enlarged side view of a hollow shaft 414 is shown highlighting a first set of slots 412, including a plurality of first slots 416 and a plurality of second slots 418. The hollow rod or shaft 414 has a length and a circumference. The first set of slots includes a plurality of first slots extending across the circumference, separating the vertices of the hollow rod, and a plurality of second slots oriented 180 degrees around the circumference of the hollow rod relative to the plurality of first slots. Figure 16 Each of the slits shown is made of a cross-sectional composite shape comprising a rectangular portion and a circular portion. The rectangular portion communicates with the periphery of the hollow connecting rod. Other embodiments may incorporate slits having alternating composite shapes or alternating orientations of portions of composite shapes (e.g., triangles, squares, and other multi-sided polygons to form a variety of composite shapes).

[0053] exist Figure 16Several parameters are noted in the figure, specifying important dimensional considerations related to the slit geometry and arrangement. The diameter d of the circular portion of the slit and the cross-sectional height h of each slit are noted. Several heights, h1, h2, h3, and h4, are specified individually as shown. Figure 16 The height of each of the plurality of first slots 416 and the plurality of second slots 418 shown in FIG. 4 illustrates an arched or parabolic arrangement formed by the plurality of adjacent slots. Other embodiments may have differently shaped arches or arcs, or may have the same height relative to adjacent slots. The width w of the rectangular portion of each slot is specified, as is the spacing s between each slot. Finally, the web distance We, the distance between the circular portion or inner boundary of each of the plurality of first slots 416 and the inner boundary or circular portion of each of the plurality of second slots, is specified in FIG. Figure 16 Indicated in the middle. The diameter d of the circular portion is believed to affect the stresses induced on the hollow shaft when bending. The circular portion is believed to reduce stress concentrations during multiple bending operations while articulating the shaft multiple times during use of the instrument. Larger diameter circles can reduce stresses induced during bending compared to smaller diameter circles. The cross-sectional heights h1, h2, h3, h4 of the slits are inversely proportional to the web distance We, and a balance between the heights and web distances can provide a compromise between bendability and yield strength in the operation and performance of the instrument shaft. This particular arrangement provides an instrument shaft that is configured to yield under bending stress without breaking. When We is larger, the stress that the instrument shaft can withstand under bending stress is greater, and when We is smaller, the stress that the instrument shaft can withstand under bending stress is less. The height h, width w, and spacing s between the slits affect the bending angle and bending radius of the portion of the hollow instrument shaft that includes a set of slits. A reduction in the dimensions of h, w, and s will provide a tighter bending radius, and vice versa. It is important to note that with Figure 16 Regardless of the relative sizes and arrangements of the various parameters shown above, in alternative embodiments of the articulatable instrument shaft, each slit may have a different value for each of the parameters described above. This combination of parameters and features as described can be combined to provide an articulatable instrument shaft having rigidity, ductility, and robustness that can articulate and bend, retain its shape, and be repeatedly manipulated during minimally invasive surgical procedures. Figure 11 As shown, for example, the instrument shaft may have multiple sets of slits having similar characteristics to those described above, such as a second set of slits, or a third set of slits, or a fourth set of slits, or more. These multiple sets of slits may all be similarly oriented, or as shown in FIG. Figure 11As in the example of , the multiple sets of slits are perpendicular to each other, for example, the second set of slits are oriented 90 degrees around the circumference of the hollow connecting rod relative to the first plurality of slits. In addition, alternative embodiments may have only one set of slits, or may be oriented to be 180 degrees apart or at different angles depending on application considerations. In addition, the slits can have alternative shapes (e.g., triangular, circular, polygonal (alternative composite shapes, such as dog bones, mushrooms, or hot dogs)) and alternative sizes compared to those characterized and defined herein. The overall shaft diameter also plays a role and interacts with each of the previously defined features and may have to be proportionally modified or scaled for different shaft diameters.

[0054] Various advantages of the apparatus for blood vessel harvesting have been discussed above. The embodiments discussed herein have been described in this specification by way of example. It will be apparent to those skilled in the art that the foregoing detailed disclosure is intended to be presented by way of example only and is not restrictive. As just one example, although the end effectors in the examples discussed are generally focused on the scope of use, such systems can be used to position other types of surgical equipment. Various changes, improvements, and modifications will occur and are directed to those skilled in the art, even though not expressly described herein. Such changes, improvements, and modifications are intended to be suggested hereby and are within the spirit and scope of the claimed invention. The drawings included herein are not necessarily drawn to scale. Furthermore, the order of the listed processing elements or sequences, or the use of numbers, letters, or other designations, is not intended to limit the claims to any order unless specified in the claims. Accordingly, the present invention is limited only by the appended claims and their equivalents.

Claims

1. A minimally invasive surgical device comprising: shell; an actuator coupled to the first portion of the housing; a shaft extending along a longitudinal axis from a proximal end to a distal end, wherein a first portion of the shaft is coupled to the second portion of the housing; and Distal tip assembly, including: a distal tip housing fixedly coupled to the distal end of the shaft; a first blunt dissector rotatably coupled to the distal tip housing, wherein the first blunt dissector is operably coupled to the actuator via a drive wire that is elongated and extends from a proximal end to a distal end, a proximal end of the drive wire being coupled to a portion of the actuator, and at least a portion of the drive wire extending through an interior portion of the shaft; and a second blunt dissector coupled to the distal tip housing, wherein the first blunt dissector is operably coupled to the actuator such that when the actuator is in a first position, the first blunt dissector is in a first rotational position relative to the distal tip housing, and when the actuator is in a second position, the first blunt dissector is in a second rotational position relative to the distal tip housing; and wherein the distal end of the drive wire is coupled to a first cam portion, the first cam portion being received in a first cam path formed in a guide tip portion body, the guide tip portion body being fixedly coupled to the first blunt dissector such that when the actuator is displaced from the first position to the second position, the first cam portion is displaced in the first cam path in a direction along the longitudinal axis of the shaft to rotate the guide tip portion body fixedly coupled to the first blunt dissector, and wherein the guide tip portion body is integrally formed with the first blunt dissector, and wherein the first blunt dissector is configured to rotate about a distal axis aligned with or parallel to a longitudinal axis of the shaft at a distal end of the shaft.

2. The minimally invasive surgical device according to claim 1, wherein: The second blunt dissector is rotatably coupled to the distal tip housing, the second blunt dissector being operably coupled to the actuator such that when the actuator is in a first position, the second blunt dissector is in a first rotational position relative to the distal tip housing, and when the actuator is in a second position, the second blunt dissector is in a second rotational position relative to the distal tip housing.

3. The minimally invasive surgical device according to claim 2, wherein: The second blunt dissector is configured to rotate about a distal axis.

4. The minimally invasive surgical device according to claim 1, wherein: The shaft is rotatably coupled to the second portion of the housing such that the first portion of the shaft is configured to rotate about the longitudinal axis.

5. The minimally invasive surgical device according to claim 1, wherein: The longitudinal axis is a straight line from the distal end of the shaft to the proximal end of the shaft.

6. The minimally invasive surgical device according to claim 1, wherein: The second blunt dissector is fixed relative to the distal tip housing.

7. The minimally invasive surgical device according to claim 1, wherein: The actuator includes a lever pivotally coupled to the first portion of the housing such that the lever pivots from the first position to the second position.

8. The minimally invasive surgical device according to claim 1, wherein: The first portion of the shaft is at or adjacent to the proximal end of the shaft.

9. The minimally invasive surgical device according to claim 1, further comprising a plurality of first slits formed in the second portion of the shaft, wherein All or a portion of the plurality of first slits cooperate to allow the second portion of the shaft to flex such that a portion of the longitudinal axis extending along the second portion of the shaft is not a straight line.

10. The minimally invasive surgical device according to claim 9, further comprising a plurality of second slits formed in the third portion of the shaft, wherein All or a portion of the second plurality of slits cooperate to allow the third portion of the shaft to flex such that a portion of the longitudinal axis extending along the second portion of the shaft is not a straight line.

11. The minimally invasive surgical device according to claim 10, wherein: Each of the plurality of first slits extends from a first end to a second end in a direction normal to the longitudinal axis of the shaft, and each of the plurality of second slits extends from a first end to a second end in a direction normal to the longitudinal axis of the shaft.

12. The minimally invasive surgical device according to claim 11, wherein: a first end of each of the plurality of first slits aligned along a first reference line parallel to the longitudinal axis, and a second end of each of the plurality of first slits aligned along a second reference line parallel to the longitudinal axis, wherein a first end of each of the plurality of second slits is aligned along a third reference line parallel to the longitudinal axis, a second end of each of the plurality of second slits is aligned along a fourth reference line parallel to the longitudinal axis, and The first reference line is not aligned with the third reference line, and the second reference line is not aligned with the fourth reference line.

13. The minimally invasive surgical device according to claim 1, wherein: The distal tip housing includes a tip portion fixedly attached to the distal end of the shaft.

14. The minimally invasive surgical device according to claim 1, wherein: The distal end of the drive wire is coupled to a second cam portion received in a second cam path formed in a second guide end portion body fixedly coupled to the second blunt dissector such that when the actuator is displaced from the first position to the second position, the second cam portion is displaced in the second cam path in a direction along the longitudinal axis of the shaft to rotate the second guide end portion body fixedly coupled to the second blunt dissector.

15. The minimally invasive surgical device according to claim 14, wherein: The second guide tip portion body is integrally formed with the second blunt dissector.

16. The minimally invasive surgical device according to claim 14, wherein: The first cam portion is a first portion of a cylindrical member, and the second cam portion is a second portion of the cylindrical member.

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