Xyphoid access for surgical procedures

Abstract

Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

1 - 12 . (Canceled)  
     
     
         13 . Surgical apparatus for accessing a beating heart via a xyphoid incision, said apparatus comprising: 
 a main body configured to rest against the frontal body of a patient; and    a lifting arm movably mounted to said main body and adapted to engage and lift at least a portion of the ribs of the patient, relative to reminder of the patient's body below the rib cage, when the patient is positioned horizontally.    
     
     
         14 . The apparatus of  claim 13 , further comprising at least one contact point through which said main body rests against the frontal body of the patient, said at least one contact point providing support and stabilization during lifting by said lifting arm.  
     
     
         15 . The apparatus of  claim 14 , comprising two contact points, and wherein said lifting arm is mounted to said body at a location intermediate of said two contact points.  
     
     
         16 . The apparatus of  claim 14 , comprising three contact points, wherein said lifting arm engages the ribs in a location that is intermediate to said three contact points.  
     
     
         17 . The apparatus of  claim 13 , further comprising a retractor arm mounted to said main body and adapted to engage and spread a portion of the ribs with respect to the remainder of the ribs, in a direction different from a direction of said lifting.  
     
     
         18 . The apparatus of  claim 17 , wherein said retractor arm comprises a hinge to enhance positioning of a distal end of said retractor arm to engage the ribs.  
     
     
         19 . The apparatus of  claim 17 , further comprising a first driving mechanism for driving said lifting arm with respect to said body to perform lifting, and a second driving mechanism for driving said retractor arm with respect to said body to perform said spreading.  
     
     
         20 . The apparatus of  claim 17 , further comprising a driving mechanism for driving said lifting arm and said retractor arm with respect to said body to perform lifting and spreading.  
     
     
         21 . The apparatus of claim  1 , further comprising a driving mechanism for driving said lifting arm with respect to said body to perform lifting.  
     
     
         22 . The apparatus of  claim 17 , wherein said retractor arm is rotatably mounted to said body.  
     
     
         23 . The apparatus of  claim 22 , wherein said retractor arm is mounted to said body via a hinge.  
     
     
         24 . The apparatus of  claim 13 , further comprising a beating heart stabilizer mounted on said body.  
     
     
         25 . The apparatus of  claim 17 , further comprising a beating heart stabilizer mounted on said body.  
     
     
         26 . The apparatus of  claim 17 , further comprising a beating heart stabilizer mounted on said retractor arm.  
     
     
         27 . The apparatus of  claim 13 , further comprising an organ positioner fixed to said body.  
     
     
         28 . The apparatus of  claim 13 , further comprising a tissue positioner fixed to said body.  
     
     
         29 . The apparatus of  claim 13 , further comprising a light mounted to said apparatus.  
     
     
         30 . The apparatus of  claim 29 , wherein said light comprises a fiber optic light.  
     
     
         31 . Surgical apparatus for use in performing surgery by accessing a beating heart via a xyphoid incision, said apparatus comprising: 
 an offsetting retractor configured to rest against the frontal body of a patient to provide stability during lifting at least a portion of the lower ribs of the patient, and having a lifting arm configured to engage and lift at least the portion of the lower ribs.    
     
     
         32 . The apparatus of  claim 31 , further comprising a beating heart stabilizer mounted on said retractor.  
     
     
         33 . The apparatus of  claim 31 , further comprising an organ positioner fixed to said retractor.  
     
     
         34 . The apparatus of  claim 31 , further comprising a tissue positioner fixed to said retractor.  
     
     
         35 . The apparatus of  claim 31 , further comprising a light mounted to said retractor.  
     
     
         36 . The apparatus of  claim 31 , wherein said retractor further comprises a retractor arm adapted to engage and spread a portion of the ribs with respect to the remainder of the ribs, in a direction different from a direction of lifting by said lifting arm.