Suction attachment and stabilizer

Abstract

In order to provide a suction attachment and a stabilizer having the same, which make it possible to sufficiently suppress vibration of the contact part of the suction attachment due to heartbeat during coronary artery bypass surgery and also to avoid the breakage problem after the coronary artery bypass surgery, a suction attachment (50) attached to a stabilizer (100) that suppresses vibration of a heart surface of a patient undergoing the coronary artery bypass surgery includes a flexible channel (60) that forms a suction channel (61) together with the heart surface when the suction attachment is brought into contact with the patient's heart surface, and the flexible channel (60) is configured to have a C-shaped tunnel shape to serve as a passage of a graft vessel.

Description

Suction attachment and stabilizer

[0001] The present invention relates to a suction attachment and stabilizer, and more particularly to a suction attachment and stabilizer used in coronary artery bypass surgery for humans and animals.

[0002] Patent Document 1 discloses a hemostasis and retention device for a vascular anastomosis used in coronary artery bypass surgery, which is characterized by a suction cup body having a flexible channel that can be attached to the heart wall while surrounding the coronary artery, a treatment opening provided in the center for exposing the anastomosis site of the coronary artery for treatment, and an exhaust tube communicating with the flexible channel for discharging air to the outside. Patent Document 1 discloses a donut-shaped flexible channel as shown in claim 2 and Figure 2, and a horseshoe-shaped flexible channel as shown in claim 3 and Figure 4.

[0003] Patent No. 3036686 specification

[0004] However, in the hemostatic maintenance device described in Patent Document 1, when the flexible channel is doughnut-shaped, the graft blood vessel is anastomosed to the cardiac surface located within the processing opening in the center of the flexible channel, and the flexible channel then surrounds the graft blood vessel, which requires subsequent breaking of the flexible channel to create space for the graft blood vessel to pass through and then removal of the flexible channel (see paragraph

[0030] of Patent Document 1).

[0005] However, if the flexible channel is broken, small fragments of the flexible channel that are difficult to see with the naked eye may be generated, and if these remain around the heart, they may damage the heart after surgery, which is a problem.

[0006] On the other hand, in the hemostasis device described in Patent Document 1, if the flexible channel is horseshoe-shaped, breaking processing is not necessary, but vibrations on the surface of the heart caused by the beating of the heart during surgery are transmitted into the processing opening through the relatively large open part of the horseshoe shape, and the device is unable to fully function as a stabilizer.

[0007] Therefore, an object of the present invention is to provide a suction attachment and a stabilizer equipped therewith that can sufficiently suppress vibrations caused by heartbeats on the contact part of the suction attachment during surgery and also avoid the problem of breakage after surgery.

[0008] To solve the above problems, the present invention provides a suction attachment that is attached to a stabilizer that suppresses vibrations of the heart surface of a patient undergoing coronary artery bypass surgery, and includes a flexible channel that forms a suction flow path together with the heart surface when brought into contact with the heart surface, and the flexible channel has a C-shaped tunnel shape that serves as a passage for the graft blood vessel.

[0009] In addition, a C-shaped flexible plate may be provided to support the shape of the flexible channel, and the gap between one end and the other end of the flexible channel may be aligned with the gap between one end and the other end of the flexible plate.

[0010] The width of the gap between one end and the other end of the flexible channel may be variable by deformation of the flexible channel.

[0011] Furthermore, the flexible channel may also have some locking portions at its outer upper corners.

[0012] The suction channel may have a relatively thick inner beveled portion having a straight cross section and a relatively thin outer beveled portion having a curved cross section.

[0013] The flexible channel may have a suction port connected to the suction passage.

[0014] In the stabilizer of the present invention, the suction attachment is connected to the main body via a universal joint. MODE FOR CARRYING OUT THE INVENTION

[0015] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0016] Fig. 1 is a perspective view showing a schematic appearance of a stabilizer 100 according to an embodiment of the present invention. Fig. 2(a) is a plan view of the stabilizer 100 shown in Fig. 1. Fig. 2(b) is a cross-sectional view of the stabilizer 100 shown in Fig. 2(a) taken along line A-A. Fig. 2(c) is a left side view of the stabilizer 100 shown in Fig. 2(a). Fig. 2(d) is a right side view of the stabilizer 100 shown in Fig. 2(a).

[0017] The stabilizer 100 shown in Figures 1 and 2(a) to 2(d) suppresses vibrations on the surface of a patient's heart during coronary artery bypass. Figures 1 and 2(a) to 2(d) show a clamp unit 10, a main body unit 20, an arm unit 30, a tube unit 40, and a suction attachment 50, which will be described below.

[0018] The clamp 10 is used to secure the stabilizer 100 to other surgical instruments, including a thoracotomy instrument (not shown), located near the operating table. The clamp 10 may be of any shape or mechanism to secure the stabilizer 100 as long as it does not interfere with the operation. The clamp 10 may be made of stainless steel, aluminum, titanium, resin, or the like, as is commonly used in medical instruments.

[0019] As shown in Fig. 1, the main body 20 is connected to the clamp 10 and the arm 30. As shown in Fig. 2(b), the main body 20 includes a grip 21 to be held by an operator such as a doctor, a handle 22 for fixing the arm 30 in a state where it has been deformed into a required shape, a spring-equipped part 23 screwed onto the handle 22, and a wire 24 that passes through the inside of the arm 30 and has one end fixed to the suction attachment 50 side and the other end fixed to the spring-equipped part 23.

[0020] As for each part of the main body 20, as is generally used in medical instruments, the grip part 21, the handle 22, and the spring-equipped part 23 may be made of, for example, resin, and the wire 24 may be made of, for example, stainless steel.

[0021] As shown in FIG. 1 , one end of the arm 30 is connected to the main body 20, and the other end is connected to the suction attachment 50. The arm 30 is flexible and can be deformed as needed. The flexibility of the arm 30 requires a degree of hardness that allows it to maintain its deformed shape unless an external force is applied. The arm 30 may also be made of stainless steel, aluminum, titanium, or the like, as is commonly used in medical instruments.

[0022] As shown in Fig. 2(a), one end of the tube portion 40 is connected to the suction attachment 50, and the other end is connected to a vacuum pump (not shown). The tube portion 40 is also flexible. The tube portion 40 may be made of vinyl chloride or the like, as is commonly used in medical devices.

[0023] The suction attachment 50 is connected to the arm portion 30 via a universal joint, and is also connected to the tube portion 40. The suction attachment 50 is characterized by having a C-shaped general shape and being flexible and deformable.

[0024] The suction attachment 50 may be sterilized for repeated use, or may be disposable and replaced for each patient.

[0025] Fig. 3(a) is a perspective photograph of the suction attachment 50 shown in Fig. 1 etc. Fig. 3(b) is a CAD plan view of the suction attachment 50 shown in Fig. 3(a). Fig. 3(c) is a CAD front view of the suction attachment 50 shown in Fig. 3(a). Fig. 3(d) is a CAD right side view of the suction attachment 50 shown in Fig. 3(a).

[0026] Fig. 4(a) is a plan view of the flexible channel 60 shown in Fig. 3(a). Fig. 4(b) is a front view of the flexible channel 60 shown in Fig. 4(a). Fig. 4(c) is a CC cross-sectional view of the flexible channel 60 shown in Fig. 4(a). Fig. 4(d) is a DD cross-sectional view of the flexible channel 60 shown in Fig. 4(a).

[0027] As shown in FIG. 3( a ) and other figures, the suction attachment 50 is roughly divided into a flexible channel 60 that comes into contact with the surface of the patient's heart, and a flexible plate 70 that supports the shape of the flexible channel 60 .

[0028] First, the flexible channel 60 will be described. The flexible channel 60 is the portion that comes into contact with the surface of the heart of a patient undergoing coronary artery bypass surgery. The flexible channel 60 can be made of, for example, silicone, urethane, vinyl chloride, or polycarbonate. One or both of the inner and outer surfaces of the flexible channel 60 can be textured as appropriate.

[0029] The flexible channel 60 has the advantage that the inner surface can be made matte by embossing or the like, which provides a non-slip effect on the contact surface with the heart surface, and the outer surface can be made matte, which improves handling when removing it from the mold during manufacturing.

[0030] The hardness of the flexible channel 60 varies depending on its dimensions, particularly its thickness, but may be, for example, about 50 to 90. As shown in Figures 3(b) and 4(a), the flexible channel 60 has a roughly C-shaped form.

[0031] The dimensions of the flexible channel 60 are not limited to these, but for example, the length equivalent to the outer diameter can be about 4.0 cm to 4.5 cm, the length equivalent to the inner diameter can be about 1.5 cm to 2.0 cm, and the height can be about 0.8 cm to 1.2 cm.

[0032] Furthermore, since the flexible channel 60 has a roughly C-shaped configuration, there is a gap between one end 62A and the other end 62B. In this embodiment, this gap can be used as a passage for a graft blood vessel anastomosed to the coronary artery.

[0033] In other words, the C-shape of the flexible channel 60 differs from a donut shape because of the passage of the graft vessel anastomosed to the cardiac surface, and also differs from a horseshoe shape because it does not have a relatively large open area.

[0034] Therefore, the width of this gap (the distance between one end 62A and the other end 62B) is set to, for example, about 0.15 cm to 0.40 cm, taking into account the diameter of a typical graft blood vessel, which is 0.1 cm to 0.25 cm, although this is not limited to this. Therefore, the flexible channel 60 has only a relatively small open portion.

[0035] The width of the gap is approximately 3% to 10% of the average circumferential length of the outer and inner circumferences of the flexible channel 60. This can be easily derived from the fact that the median value of the lengths equivalent to the outer diameter is 1.75 cm and the median value of the lengths equivalent to the inner diameter is 1.0 cm.

[0036] In other words, when the flexible channel 60 is considered to be a doughnut shape, the width of the gap, 0.15 cm to 0.40 cm, is about 3.4% to 9.3% of the average circumference of the outer and inner circumferences, which is about 4.32 cm, because the average outer and inner diameters are 1.375 cm when multiplied by pi.

[0037] Incidentally, Patent Document 1 does not seem to disclose the dimensions of the horseshoe-shaped open portion. However, as far as Figure 4 of Patent Document 1 is concerned, the width of the horseshoe-shaped open portion appears to be about 15% of the average circumference.

[0038] Furthermore, since the flexible channel 60 is flexible, it is also possible to widen or narrow one end 62A and the other end 62B in the planar or shear direction of the flexible channel 60. Therefore, if surgery is performed using a graft blood vessel that is thicker than usual, it is sufficient to appropriately widen the gap in the flexible channel 60 to ensure a sufficient passage for the graft blood vessel after anastomosis to the coronary artery.

[0039] Furthermore, even if a graft vessel thicker than a typical graft vessel is used, the curvature of the heart surface differs depending on the position where the graft vessel is to be attached, so the flexible channel 60 can be used by deforming in the shear direction according to the position.

[0040] 3(b) and 4(a), the flexible channel 60 has, at its outer upper corners, for example, four locking portions 64. Each locking portion 64 can be used to lock a surgical thread or the like that has been passed through the pericardium around the heart.

[0041] Therefore, the dimensions of the opening in each locking portion 64 are, for example, 0.10 cm to 0.80 cm, but are not limited to this. Each locking portion 64 can be easily cut off using ordinary or medical scissors if a doctor decides that it will not be used.

[0042] 3(c) and 4(c), etc., a suction flow path 61 is formed in the flexible channel 60. The suction flow path 61 is a closed space formed between the flexible channel 60 and the surface of the heart, and has a roughly C-shaped tunnel shape.

[0043] 3(d) and 4(b), etc., a connecting part 63 is attached to a suction port 65 of the flexible channel 60, which is in communication with the suction flow path 61. The connecting part 63 has a skirt-like shape at both the distal and proximal ends, and the tube part 40 is connected to the distal end, and the suction port 65 is connected to the proximal end.

[0044] With the flexible channel 60 in contact with the surface of the heart of a patient undergoing coronary artery bypass surgery, the suction flow path 61 is evacuated by depressurizing the air at a pressure of approximately 150 mmHg to 500 mmHg using the tube portion 40 connected via the connecting portion 63 and a decompression pump (not shown).

[0045] The suction flow path 61 may be a single C-shaped path that is directly connected to the suction port 65 in a 1:1 ratio, or it may be divided into N parts, with a common path provided for these parts, and connected in parallel to the suction port 65 in an N:1 ratio through the common path.

[0046] Furthermore, the manufacturing conditions for the suction port 65 are such that, when the center point of the flexible channel 60 in Figure 4(a) is taken as the origin, the angle formed by the axial line of the suction port 65 heading toward the origin and the center line heading toward the origin passing through the gap between one end 62A and the other end 62B is approximately 10°.

[0047] Furthermore, the suction port 65 has a two-stage structure in which the outer diameter is narrow, for example, about 0.3 cm to 0.4 cm when viewed from the origin, and the inner diameter is wide, for example, about 0.4 cm to 0.6 cm, and the base end of the connecting part 63 is positioned in the wide part to prevent it from falling off.

[0048] 4(c), a rib portion 66 is formed near the suction port 65 in the suction flow path 61. The rib portion 66 prevents the suction port 65 from being blocked by the surface of the patient's heart being sucked in when suction is performed through the tube portion 40 or the like, and prevents stress from concentrating near the suction port 65 from the tube portion 40 side.

[0049] 4(c) shows an example in which the rib portion 66 is configured with four ribs, but the number of ribs is not limited to this. In this example, each rib has a thickness of, for example, about 0.1 cm to 0.15 cm, and a dimension (length toward the center of the flexible channel 60) of about 0.4 cm to 0.6 cm.

[0050] As shown in FIG. 4(d), the suction flow path 61 has a relatively thick inner inclined portion 67 having a straight cross section, a relatively thin outer inclined portion 68 having a curved cross section, and a main body portion 69 connecting the inner inclined portion 67 and the outer inclined portion 68.

[0051] The dimensions of the inner inclined portion 67 are not limited to these, but for example, its thickness is 0.15 cm to 0.25 cm, it extends at an angle of, for example, 40° to 50° relative to the surface direction of the flexible channel 60, the thickness of the lower surface is 0.1 cm to 0.2 cm, the horizontal length is approximately 0.4 cm to 0.6 cm, and the vertical length is approximately 0.5 cm to 0.7 cm.

[0052] The dimensions of the outer inclined portion 68 are not limited to these, but for example, its thickness is 0.08 cm to 0.15 cm, which is about half the thickness of the inner inclined portion 67, and it hangs down to about half the height of the flexible channel 60 with the center of its thickness at a position, for example, 0.25 cm to 0.32 cm from the outer peripheral edge of the main body portion 69, and then curves outward with a radius of curvature of 0.6 cm to 0.8 cm, and the thickness of the underside is 0.1 cm to 0.2 cm.

[0053] As mentioned above, since the heart has a spherical shape, when the flexible channel 60 is brought into contact with the surface of the heart, in many cases a closed space is formed between the inner inclined portion 67, the outer inclined portion 68, and the surface of the heart, and this closed space becomes the suction flow path 61.

[0054] Therefore, when suction is subsequently performed via the tube portion 40 or the like, the suction flow path 61 is evacuated, and the relatively thick inner inclined portion 67 is slightly deformed into an arch shape, while the relatively thin outer inclined portion 68 is greatly deformed into an arch shape.

[0055] Since the portion of the heart surface near the suction flow path 61 is attracted to the suction flow path 61, the portion of the heart surface within the inner C-shaped region becomes flat, and vibrations caused by the beating of the patient's heart are less likely to be transmitted to the treatment opening.

[0056] Even if a gap is formed between the flexible channel 60 and the heart surface when the flexible channel 60 is brought into contact with the heart surface and a closed space is not formed, if the gap is narrow, the nearby heart surface is pulled in by suction, filling the gap. On the other hand, if the gap is wide, the flexible channel 60 can be deformed to narrow the gap.

[0057] Next, the flexible plate 70 will be described. The flexible plate 70 can be made of, for example, stainless steel, aluminum, titanium, etc. The flexible plate 70 can be manufactured by cutting a stainless steel plate or the like having a thickness of, for example, about 0.1 cm to 0.2 cm.

[0058] As shown in Figures 3(a) and 3(b), the flexible plate 70 has a pair of support parts 71 with one end 72A and the other end 72B and an overall C-shape, a joint part 74 that universally connects the suction attachment 50 and the arm part 30, a triangular base part 73 that connects the support parts 71 and the joint parts 74, and a pair of openings 75 formed in the base part 73.

[0059] The gap between one end 72A and the other end 72B of the flexible plate 70 and the gap between one end 62A and the other end 62B of the flexible channel 60 are aligned, so that these gaps can be used as a passage for the graft blood vessel, and the flexible channel 60 and the flexible plate 70 can be deformed in the planar direction or shear direction.

[0060] The dimensions of the support portion 71 are not limited to these, but for example, the length equivalent to the outer diameter can be approximately 2.8 cm to 4.3 cm, the length equivalent to the inner diameter can be approximately 1.3 cm to 1.8 cm, and the width between one end 72A and the other end 72B can be approximately 0.4 cm to 0.6 cm.

[0061] The dimensions of the base portion 73 are not limited to these, but for example, the length (vertical length in FIG. 3(b)) can be approximately 1.3 cm to 1.8 cm, and the width (horizontal length in FIG. 3(b)) can be approximately 2.5 cm to 3.5 cm.

[0062] The dimensions of the joint portion 74 are not limited to these, but for example, the diameter of the spherical portion at the tip can be approximately 0.4 cm to 0.6 cm, the diameter of the cylindrical portion connected to the base portion 73 can be approximately 0.25 cm to 0.3 cm, and the length can be approximately 0.8 cm to 1.2 cm.

[0063] The dimensions of opening 75 are not limited to these, but may be, for example, about 0.2 cm to 0.4 cm in diameter. Opening 75 functions as an insertion port for a positioning jig that holds flexible plate 70 when suction attachment 50 is manufactured, and functions as an insertion port for the tip of tweezers that grips flexible plate 70 when suction attachment 50 is in use.

[0064] The suction attachment 50 may be manufactured by integrally molding the flexible channel 60 and the flexible plate 70, or by manufacturing them as separate parts and assembling them by attaching the flexible plate 70 to the flexible channel 60.

[0065] In this embodiment, the stabilizer has been described assuming its use in cardiovascular surgery on humans, but it can also be used in coronary artery bypass surgery on animals other than humans, such as dogs, cats, horses, cows, and sheep.

[0066] As described above, with the suction attachment 50 of this embodiment, the flexible channel is not horseshoe-shaped, so vibrations caused by the beating of the heart during coronary artery bypass surgery can be sufficiently suppressed, and since the flexible channel is not ring-shaped, the problem of removing the graft blood vessel can also be avoided.

[0067] 1 is a perspective view showing a schematic appearance of a stabilizer 100 according to an embodiment of the present invention; FIG. 2 is a plan view, a cross-sectional view, and a side view of the stabilizer 100 shown in FIG. 1; FIG. 3 is a perspective photograph, a plan view, a front view, and a side view of a suction attachment 50 shown in FIG. 1 etc.; and FIG. 4 is a plan view, a front view, and a cross-sectional view of a flexible channel 60 shown in FIG.

[0068] REFERENCE SIGNS LIST 10 Clamp section 20 Main body section 21 Grip section 22 Handle 23 Spring-loaded part 24 Wire 30 Arm section 40 Tube section 50 Suction attachment 60 Flexible channel 61 Suction flow path 62A One end 62B Other end 63 Connecting section 64 Locking section 65 Suction port 66 Rib section 67 Inner inclined section 68 Outer inclined section 69 Main body section 70 Flexible plate 71 Support section 72A One end 72B Other end 73 Base section 74 Joint section 75 Opening 100 Stabilizer

Claims

1. A suction attachment attached to a stabilizer that suppresses vibrations on the surface of the heart of a patient undergoing coronary artery bypass surgery, a flexible channel that forms a suction channel together with the cardiac surface when brought into contact with the cardiac surface; The flexible channel has a C-shaped tunnel shape that serves as a passage for the graft blood vessel; The suction flow path has a relatively thick inner inclined portion having a straight cross section and a relatively thin outer inclined portion having a curved cross section. Suction attachment.

2. a C-shaped flexible plate that supports the shape of the flexible channel; a gap between one end and the other end of the flexible channel and a gap between one end and the other end of the flexible plate are aligned; 2. The suction attachment according to claim 1.

3. The width of the gap between one end and the other end of the flexible channel is variable depending on the deformation of the flexible channel.

2. The suction attachment according to claim 1.

4. The flexible channel has several locking portions at its outer upper corners.

2. The suction attachment according to claim 1.

5. The flexible channel has a suction port connected to the suction flow path.

2. The suction attachment according to claim 1.

6. A stabilizer, wherein the suction attachment according to any one of claims 1 to 5 is connected to a main body via a universal joint.