Piercing Forceps for Mitral Valve Suture Placement
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Solution Overview
Problem
Current surgical forceps struggle to adequately expose and secure the mitral valve during cardiac surgery due to its difficult access and proximity to critical cardiac structures, leading to potential misplacement of prosthetic valves and bleeding complications.
Innovation Solution
A piercing forceps with a dynamic handle and L-shaped static handle, featuring a primary slide for clamping and a secondary slide with needles that can be inserted through the tissue, allowing for secure clamping and piercing of the tissue simultaneously.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional grasping forceps are used to manipulate the valve annulus, then tissue clamping is achieved, but proper exposure and secure placement of sutures is difficult due to the hidden fibrous skeleton and proximity to critical structures
Solution Approach 1:
The patent combines clamping and piercing functions into a single forceps device. The forceps includes a first jaw for clamping tissue and a second jaw with a needle holder for inserting piercing needles through the clamped tissue. This integration allows simultaneous securement of tissue through both mechanical clamping and needle piercing, resolving the contradiction between achieving reliable suture placement and dealing with exposure difficulties.
Solution Approach 2:
The forceps allows the operator to first clamp the tissue with the first jaw, thereby exposing and securing the target site, and then insert the piercing needle through the clamped tissue. This preliminary clamping action provides stable exposure and control before the piercing operation, addressing the exposure difficulty while ensuring accurate suture placement.
2Productivity
If multiple separate surgical tools are used for clamping and piercing, then each function can be performed, but the procedure becomes more complex and time-consuming
Solution Approach 1:
The patent merges multiple surgical functions (clamping and piercing) into a single forceps device. The forceps comprises a first jaw for clamping and a second jaw with an integrated needle holder for piercing. This consolidation reduces the number of separate tools needed, simplifies the procedure, and improves operational efficiency without compromising functional capability.
Solution Approach 2:
The forceps is designed as a multi-functional instrument that can perform both clamping and piercing operations. The first jaw provides clamping function while the second jaw with needle holder provides piercing function. This universal design allows a single device to replace multiple specialized tools, enhancing productivity while managing device complexity.
3Reliability
If the fibrous annulus is embedded within 2-3 mm of atrial myocardium, then anatomical integrity is maintained, but access to the mitral valve becomes difficult without damaging neighboring structures
Solution Approach 1:
The forceps combines clamping and piercing in a single integrated action. The first jaw clamps the tissue containing the fibrous annulus, providing secure hold and exposure, while the second jaw inserts a piercing needle through the clamped tissue. This combined approach ensures the needle passes through the intended target (the fibrous annulus within 2-3 mm of myocardium) without deviating to damage neighboring structures, thereby enhancing tissue security while minimizing harmful effects.
Solution Approach 2:
The forceps applies clamping force locally at the first jaw on the target tissue, and the piercing needle is inserted locally through the clamped area. This localized application of force and piercing ensures that the needle passes through the fibrous annulus embedded within the myocardium without affecting distant or neighboring critical structures, addressing the concern about damage to adjacent tissues.
Data Source
AI summary
A piercing forceps includes a dynamic handle and an L-shaped static handle connected to the dynamic handle. The static handle supports a primary slide with a clamping end and a secondary slide supporting needles. The dynamic handle may be operated to bring a distal end of the primary slide toward a distal end of the static handle to provide a tissue clamp. A trigger supported by the static handle may be operated to bring a distal end of the secondary slide toward the distal end of the static handle and primary slide, thus resulting in the needles of the secondary slide distally extending from the secondary slide to pierce tissue clamped between the static handle and primary slide. As a result, the tissue can be secured by being clamped between the static handle and primary slide, as well as by the needles of the secondary slide being inserted therethrough.