Surgical devices for imposing a negative pressure to stabilize the cardiac tissue during surgery

Abstract

The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site. In certain preferred embodiments, the devices described herein have structures to facilitate the use of additional surgical instruments such that the placement of negative pressure device permit the surgeon to advantageously manipulate the other instruments during surgery. The negative pressure is preferably imposed through a plurality of ports which may be disposed in a substantially planar surface of the instrument which contacts the cardiac tissue.

1 - 14 . (canceled)  
   
   
       15 . A method of stabilizing a portion of a beating heart, comprising: 
 providing an instrument having first and second ends, a first array of suction ports and a second array of suction ports at said first end, said first and second arrays being connected to each other at a location intermediate of said first and second ends of the instrument, said first and second arrays being connected to each other such that said first array and said second array are moveable relative to each other, wherein said first array is moveable with respect to the location of connection by articulation at the location of connection and wherein said second array is moveable relative to the location of connection by articulation at the location of connection, said first and second arrays being adapted to engage a beating heart when a source of negative pressure is connected in fluid communication therewith;    contacting a surface of the beating heart with each of said first and second arrays;    imposing a negative pressure through said first and second arrays to engage said first and second arrays with the surface of the beating heart; and    moving said first and second arrays apart from each other by moving a portion of said instrument having a location selected from the group consisting of locations defined between the location of connection of said first and second arrays and said second end, wherein said moving a portion of said instrument effects articulation at the location of connection, while maintaining engagement of the first and second arrays with the heart surface.    
   
   
       16 . The method of  claim 15 , further comprising locking said first and second arrays in position relative to one another, thereby preventing further relative movement of said first and second arrays with respect to one another.  
   
   
       17 . The method of  claim 16 , further comprising fixing the instrument to a stable support.  
   
   
       18 . A method of stabilizing a portion of a beating heart, comprising: 
 providing an instrument having a first array of suction ports and a second array of suction ports, said first and second arrays being connected to each other such that said first array and said second array are moveable relative to each other, said first and second arrays being adapted to engage a beating heart when a source of negative pressure is fluidly connected thereto;    contacting a surface of the beating heart with each of said first and second arrays;    imposing a negative pressure through said first and second arrays to engage said first and second arrays with the surface of the beating heart; and    moving said first and second arrays apart from each other while maintaining engagement with the heart surface.    
   
   
       19 . The method of  claim 18 , further comprising locking said first and second arrays in position relative to one another, thereby preventing further relative movement of said first and second arrays with respect to one another.  
   
   
       20 . The method of  claim 19 , further comprising fixing the instrument to a stable support.  
   
   
       21 . A method of grasping tissue of a portion of a beating heart, said method comprising the steps of: 
 providing an instrument having a contact surface adapted to substantially surround a portion of beating heart tissue; and    applying a negative pressure through said instrument, thereby causing said heart tissue to be drawn against and temporarily fixed to the contact surface.    
   
   
       22 . The method of  claim 21 , wherein the instrument further comprises a flexible shaft, the heart and contact surface being movable with respect to the shaft after said applying a negative pressure.  
   
   
       23 . The method of  claim 21 , wherein the contact surface comprises a pliable material that is substantially impermeable to air, said method further comprising deforming the pliable material upon said applying a negative pressure.  
   
   
       24 . A device for stabilizing a portion of a beating heart by imposing a negative pressure on the surface of the heart, said device comprising: 
 an elongate member removably attached to at least one substantially linear array of suction ports and means for introducing a negative pressure to the surface of the beating heart, said at least one substantially linear array being removable for disposal after a single use.    
   
   
       25 . The device of  claim 24 , further comprising at least one block, containing said at least one substantially linear array, respectively, and wherein each said block is adapted to removably receive a vacuum line.  
   
   
       26 . The device of  claim 25 , wherein each of said plurality of suction ports is connected to the vacuum line by a pressure conduction space in fluid connection with the interior of said block which respectively contains said suction ports.  
   
   
       27 . The device of  claim 24 , wherein said elongate member has a receiving means at a distal end thereof for releasable attachment of said at least one substantially linear array of suction ports.  
   
   
       28 . An instrument for stabilizing a portion of a beating heart by imposing a negative pressure on the surface of the heart, said instrument comprising a first array of suction ports and a second array of suction ports, said first and second arrays being connected to each other such that said first array and said second array are moveable relative to each other, said first and second arrays being adapted to engage a beating heart when a source of negative pressure is connected in fluid communication therewith, and being adapted to be moved apart from one another after engagement with the beating heart.  
   
   
       29 . The instrument of  claim 28 , further comprising at least one elongated member connected to the first and second arrays.  
   
   
       30 . The instrument of  claim 28 , wherein said first array of suction ports is connected in fluid communication with a first pressure conducting space, said first pressure conducting space connectable in fluid communication with the source of negative pressure.  
   
   
       31 . The instrument of  claim 30 , wherein said second array of suction ports is in fluid communication with a second pressure conducting space, said second pressure conducting space being connectable in fluid communication with the source of negative pressure.  
   
   
       32 . The instrument of  claim 28 , wherein said first and second arrays comprise first and second linear arrays.  
   
   
       33 . The instrument of  claim 31 , further comprising passages interconnecting said ports of said first and second arrays with said first and second pressure conducting spaces, respectively.  
   
   
       34 . The instrument of  claim 33 , wherein said passages each have a diameter smaller than a diameter of said port connected therewith, respectively.  
   
   
       35 . The instrument of  claim 33 , wherein said passages connect with said ports such that at least one of said passages is oriented off-center to a center of said port to which it respectively connects.  
   
   
       36 . The instrument of  claim 35 , wherein all of said passages are oriented off-center to said ports, respectively.  
   
   
       37 . An instrument for stabilizing a portion of a beating heart by imposing a negative pressure on the surface of the heart, said instrument comprising a first array of suction ports and a second array of suction ports, said first and second arrays being physically connected within said instrument and adapted for movement relative to one another, said first and second arrays being adapted to engage a beating heart when a source of negative pressure is fluidly connected thereto.  
   
   
       38 . The instrument of  claim 37 , further comprising an elongated member connected to said first and second arrays and extending away from said first and second arrays.  
   
   
       39 . An instrument for stabilizing a portion of a beating heart by imposing a negative pressure on the surface of the heart, said instrument comprising a working end adapted to be applied to the surface of the beating heart, and an elongated member connected to and extending from said working end, said working end comprising a first array of suction ports and a second array of suction port, said first and second arrays being physically connected at said working end and adapted for movement relative to one another, said first and second arrays being adapted to engage a beating heart when a source of negative pressure is fluidly connected thereto.  
   
   
       40 . An instrument for stabilizing a portion of a beating heart by imposing a negative pressure on the surface of the heart, said instrument comprising a first array of suction ports and a second array of suction ports, said first and second arrays being connected to each other at a location proximal of said suction ports and intermediate of first and second end of the instrument, such that said first array and said second array are remotely controllable for movement relative to each other, wherein the remote controlling is effected at a location proximal of the connection of said first and second arrays, said first and second arrays being adapted to engage a beating heart wherein a source of negative pressure is fluidly connected thereto.  
   
   
       41 . An instrument for stabilizing a portion of a beating heart by imposing a negative pressure on the surface of the heart, said instrument comprising a housing having a plurality of suction ports disposed therein and a plurality of passages respectively interconnecting said plurality of ports with pressure conducting means adapted to connect with a source of negative pressure, at least some of said plurality of suction ports being adapted to be moved apart from a remainder of said plurality of suction ports after engagement of said plurality of suction ports with the beating heart by imposition of the negative pressure.  
   
   
       42 . The instrument of  claim 41 , further comprising an elongate member connected to said housing.  
   
   
       43 . The instrument of  claim 41 , wherein said housing has a shape selected from the group consisting of a circle, an oval, a semi-oval, a U-shape, and at least one linear member.  
   
   
       44 . The instrument of  claim 41 , wherein said housing comprises at least one block containing a substantially linear array of said suction ports.  
   
   
       45 . The instrument of  claim 44 , wherein each said block is adapted to receive a vacuum line connectable to the source of negative pressure.  
   
   
       46 . The instrument of  claim 41 , wherein said housing comprises a substantially U-shaped member.