Tissue stabilizer having an articulating lift element

Abstract

Devices and methods are disclosed for stabilizing tissue within a patient's body during a surgical operation to provide a relatively motionless surgical field, such as during a coronary artery bypass graft procedure. The devices include tissue stabilizers which engage and provide stabilization to a targeted area of tissue and further have the ability to engage and manipulate some portion of tissue within or adjacent the targeted area to improve the surgical presentation of that portion of tissue. The tissue stabilizer typically has one or more stabilizer feet which have a first foot portion configured to provide stabilization to the targeted tissue and a second foot portion moveable relative to the first foot portion for manipulating a portion of tissue to improve the surgical presentation.

1 . A device for stabilizing tissue within a patient's body for performing a surgical procedure on said tissue comprising: 
 at least one stabilizer foot having a first portion and a second portion coupled to said first portion, said first portion being substantially rigid and having a tissue engaging surface adapted to engage a first area on the surface of said tissue; and    said second portion having a vacuum chamber with at least one opening adapted to engage a second area on the surface of said tissue, said second portion being moveable relative to said first portion whereby movement of said second portion relative to said first portion manipulates the second area of tissue relative to said first area of tissue.    
   
   
       2 . The device of  claim 1  wherein said second portion moves upwardly relative to said first portion.  
   
   
       3 . The device of  claim 1  wherein said first portion has a vacuum chamber and said tissue engaging surface has at least one opening in fluid communication with said vacuum chamber.  
   
   
       4 . The device of  claim 2  further comprising a raised seal disposed around the perimeter of said tissue engaging surface.  
   
   
       5 . The device of  claim 4  wherein said raised seal is compressible.  
   
   
       6 . The device of  claim 1  wherein said tissue engaging surface comprises a textured surface adapted to frictionally engage said first area on the surface of said tissue.  
   
   
       7 . The device of  claim 1  further comprising a tension member having a proximal end and a distal end, said distal end of said tension member connected to said second portion.  
   
   
       8 . The device of  claim 7  wherein said proximal end of said tension member is connected to a tensioning mechanism.  
   
   
       9 . The device of  claim 8  wherein said tensioning mechanism comprises a channel adapted to receive said tension member and a locking member positioned at an angle relative to said channel and having a free end biased against the interior of said channel.  
   
   
       10 . The device of  claim 8  wherein said tensioning mechanism comprises a pivoting member having a pivot axis and said proximal end of said tension member is attached to said pivoting member at a predetermined distance from said pivot axis.  
   
   
       11 . The device of  claim 8  wherein said tensioning mechanism comprised a spool having an outer surface, said proximal end of said tension member being operably connected to said outer surface.  
   
   
       12 . The device of  claim 7  wherein said tension member is a thread material.  
   
   
       13 . The device of  claim 7  wherein said tension member is a flexible wire.  
   
   
       14 . The device of  claim 7  wherein said tension member is a cable.  
   
   
       15 . The device of  claim 1  wherein said second portion is made of a flexible material.  
   
   
       16 . The device of  claim 15  wherein said flexible material is an elastomer.  
   
   
       17 . The device of  claim 15  wherein said flexible material is selected from the group consisting of silicone, urethane rubber, nitrile rubber, hytrel, and kraton.  
   
   
       18 . The device of  claim 1  wherein said device comprises a first stabilizer foot and a second stabilizer foot substantially parallel to said first stabilizer foot, each of said first stabilizer foot and said second stabilizer foot having a first portion and a second portion coupled to said first portion, said first portion being substantially rigid and having a tissue engaging surface adapted to engage a first area on the surface of said tissue; and 
 said second portion having a vacuum chamber with at least one opening adapted to engage a second area on the surface of said tissue, said second portion being moveable relative to said first portion whereby movement of said second portion relative to said first portion manipulates the second area of tissue relative to said first area of tissue.    
   
   
       19 . A device for stabilizing tissue within a patient's body comprising at least one stabilizer foot having a first foot portion adapted to engage a first portion of tissue and a second foot portion having a vacuum space having at least one opening adapted to engage a second portion of tissue immediately adjacent said first portion of tissue, said second foot portion being flexibly coupled to said first foot portion.  
   
   
       20 . The device of  claim 19  further comprising a tension member having a proximal end and a distal end, said distal end being operably connected to said second foot portion, whereby pulling on said proximal end causes said second foot portion to move relative to said first foot portion.  
   
   
       21 . The device of  claim 19  wherein said first foot portion has a vacuum chamber having at least one opening adapted to engage said first portion of tissue.  
   
   
       22 . The device of  claim 19  wherein said first foot portion has a textured surface adapted to frictionally engage said first portion of tissue.  
   
   
       23 . The device of  claim 19  wherein said second foot portion defines a vacuum space having a perimeter edge adapted to seal against said second portion of tissue.  
   
   
       24 . The device of  claim 19  wherein said second foot portion comprises an elastomeric material.  
   
   
       25 . A device for stabilizing tissue within a patient's body for performing a surgical procedure on said tissue comprising: 
 a base member having an interior chamber and a substantially cylindrical bore, said bore having a first end in fluid communication with said interior chamber and a second end open to the exterior of said base member;    a stabilizer foot having a substantially cylindrical fitting having a longitudinal axis, at least a portion of said fitting positioned within said bore and being rotatable within said bore about said longitudinal axis; and    said stabilizer foot having a first foot portion adapted to engage a first portion of tissue and a second foot portion adapted to engage a second portion of tissue adjacent said first portion of tissue, said second foot portion being flexibly coupled to said first foot portion.    
   
   
       26 . The device of  claim 25  further comprising a tension member having a proximal end and a distal end, said distal and being operably connected to said second foot portion, whereby pulling on said proximal end causes said first second foot portion to move relative to said first foot portion.  
   
   
       27 . The device of  claim 25  wherein said second foot portion comprises an elastomer.  
   
   
       28 . The device of  claim 25  wherein said second foot portion defines a vacuum space having at least one opening in fluid communication with said second portion of tissue.  
   
   
       29 . The device of  claim 28  wherein said vacuum space has a perimeter edge adapted to seal against said second portion of tissue.  
   
   
       30 . A device for stabilizing tissue within a patient's body for performing a surgical procedure on said tissue comprising: 
 a base member having a shaft mounted for rotation relative to said base member, said shaft having a longitudinal axis and at least one threaded portion;    a first stabilizer foot having a first tissue engaging surface and a second stabilizer foot having a second tissue engaging surface, said first and second tissue engaging surfaces extending generally perpendicular to said longitudinal axis, at least one of said stabilizer feet being operably associated with said threaded portion of said shaft such that rotation of said shaft causes said at least one of said stabilizer feet to move relative to the other.    
   
   
       31 . The device of  claim 30  wherein said shaft has a first threaded portion and a second threaded portion and said first stabilizer foot is adapted to receive and traverse along said first threaded portion and said second stabilizer foot is adapted to receive and traverse along said second threaded portion.  
   
   
       32 . The device of  claim 31  wherein said second threaded portion has threads which are opposite-handed to that of the threads of said first portion.  
   
   
       33 . The device of  claim 30  wherein at least one of said first and second stabilizer feet further comprise a flexible member coupled thereto, said flexible member having a vacuum chamber having at least one opening for engaging a portion of tissue with negative pressure.  
   
   
       34 . The device of  claim 33  wherein said flexible member comprises an elastomer.  
   
   
       35 . A method of stabilizing a coronary artery on a beating heart for performing a surgical procedure on the coronary artery comprising the steps of: 
 providing a tissue stabilizer having at least one stabilizer foot having a first portion adapted to engage a first area on the surface of the heart adjacent said coronary artery and a second portion adapted to engage a second area on the surface of the heart, said second portion being coupled to said first portion and moveable relative to said first portion;    engaging said first area with said first portion to substantially stabilize at least a portion of the heart;    engaging said second area with said second portion;    moving said second portion relative to said first portion whereby said second area of said heart is moved relative to said first area of said heart.    
   
   
       36 . The method of  claim 35  wherein said second area includes at least a portion of said coronary artery.  
   
   
       37 . The method of  claim 34  wherein further including the step of creating an arteriotomy having a first side and a second side in said coronary artery after engaging said first area with said first portion.  
   
   
       38 . The method of  claim 37  wherein said second area includes a portion of said coronary artery adjacent said first side of said arteriotomy whereby the step of moving said second portion relative to said first portion moves said first side of said arteriotomy relative to said second side of said arteriotomy.  
   
   
       39 . The method of  claim 38  further comprising the step of placing at least one suture through a said first side of said arteriotomy.