Single-pass endoscopic vessel harvesting with inductive cutting
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Solution Overview
Problem
Existing endoscopic vessel harvesting techniques are cumbersome, require high skill, and often result in endothelial damage and thermal spreading due to multiple device passes and CO2 insufflation, failing to maintain surrounding tissue for improved patency.
Innovation Solution
A single-pass endoscopic device with a sheath and ring-shaped blade that creates a flanking tunnel around the vessel, using inductively-heated ferromagnetic cutting to make a vasiform cut with a pedicle, minimizing direct contact and thermal injury, and automatically severing and cauterizing side branches.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple separate endoscopic devices are used for vessel harvesting, then the vessel can be dissected and side branches can be severed, but the procedure becomes cumbersome and requires high skill level
Solution Approach 1:
The patent combines multiple separate endoscopic devices (dissector, cutter, coagulator) into a single integrated endoscopic vessel harvesting device. The device includes a sheath with a dissector that can create a tunnel, a cutter that can sever side branches, and a coagulator that can seal vessels, all within one instrument that can be inserted through a single incision.
Solution Approach 2:
The endoscopic device is designed to perform multiple functions: dissection of the vessel from surrounding tissue, cutting of side branches, and coagulation of severed vessels. This multi-functional design eliminates the need for multiple separate devices and reduces the skill level required for the procedure.
2Manufacturing precision
If multiple passes of separate devices are used, then vessel dissection can be achieved, but endothelial damage occurs
Solution Approach 1:
The dissector component of the device creates a tunnel or pathway around the vessel before the cutting and coagulation functions are activated. This preliminary dissection action separates the vessel from surrounding tissue in advance, allowing subsequent cutting and coagulation to occur without direct contact with the vessel wall, thereby preventing endothelial damage.
Solution Approach 2:
The dissector acts as an intermediary element that creates a protective barrier or tunnel between the cutting/coagulation components and the vessel. This intermediary structure allows the cutting and coagulation functions to be performed on side branches without direct contact with the main vessel, preventing endothelial injury.
3Area of stationary object
If CO2 insufflation is used to create working space, then visualization and tissue separation can be achieved, but tissue acidosis and CO2 embolism occur
Solution Approach 1:
The patent removes the CO2 insufflation component from the endoscopic vessel harvesting system. By eliminating the need for CO2 insufflation, the device avoids the harmful effects of tissue acidosis and CO2 embolism while still achieving adequate visualization and working space through the integrated design of the sheath and dissector.
4Reliability
If electrocauterization is used for cutting and coagulating side branches, then sealing can be achieved, but thermal spreading damages the harvested vessel
Solution Approach 1:
The coagulator component is designed to apply thermal energy locally to side branches for sealing, with the heat application confined to the immediate area of the side branch. The device structure ensures that thermal energy does not spread to the main harvested vessel, achieving effective sealing of side branches while protecting the vessel from thermal damage.
5Reliability
If conventional endoscopic devices are used, then vessel harvesting can be performed, but surrounding tissue is not maintained for improved patency
Solution Approach 1:
The dissector creates a tunnel around the vessel in advance, preserving a layer of surrounding tissue or pedicle around the harvested vessel. This preliminary dissection action maintains the protective tissue envelope, which improves vessel patency and reduces trauma while still allowing for complete harvesting.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The device allows for user-friendly vessel harvesting with reduced trauma and improved patency, eliminating the need for extensive training and minimizing complications like endothelial damage and thermal spreading, while maintaining surrounding tissue for better graft outcomes.
Implementation Method 1
The blade comprises an inductively-heated ferromagnetic member configured to make a vasiform cut including a pedicle around the vessel as the sheath advances
Implementation Method 2
The blade comprises an inductively-heated ferromagnetic member configured to make a vasiform cut
Data Source
AI summary
An endoscopic harvesting device removes a vessel from a body. The vessel has an anterior side closest to the skin. A sheath extends in a longitudinal direction with a dissector tip for advancing along the vessel substantially along the anterior side to create a flanking tunnel spaced away from the vessel. A ring-shaped blade is mounted to the sheath and is disposed in a plane substantially perpendicular to the longitudinal direction and proximal of the dissector tip. The blade forms a lateral loop to encircle the vessel from the flanking tunnel. The blade comprises an inductively-heated ferromagnetic member configured to make a vasiform cut including a pedicle around the vessel as the sheath advances.