Tissue Stabilizer and Methods of Use

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. The devices involve tissue stabilizers which provide superior engagement with a tissue structure to be stabilized, for example the beating heart. The tissue stabilizer may have one or more stabilizer feet which provide for adjustment of the orientation of the features which engage the surface of the tissue structure. In one instance, the orientation may be adjusted to ensure the engaging features will be properly aligned with the surface of the tissue structure before engagement. In addition, once engaged with or connected to the tissue structure the orientation may be adjusted to yield an optimum surgical presentation of a portion of the tissue structure, for instance a coronary artery or the like. The tissue stabilizer may be configured to use friction, negative pressure, or both to engage the surface of the heart.

1 - 42 . (canceled) 
   
   
       43 . A device for stabilizing tissue within a patient's body, said device comprising:
 a base member defining a base vacuum chamber and having a distal surface; and   at least one elongated stabilizer foot extending outwardly from said distal surface of said base member in a first direction and fluidically connected with said base vacuum chamber, said at least one stabilizer foot being rotatable, in its entirety, relative to said base member about an axis of rotation.   
   
   
       44 . The device according to  claim 43 , wherein said stabilizer foot is connected to said base member through a dynamically sealed rotating connection. 
   
   
       45 . The device according to  claim 44 , wherein connection allows for rotation of said stabilizer foot without incurring any vacuum loss. 
   
   
       46 . The device according to  claim 45 , wherein said stabilizer foot may be rotated without incurring any vacuum loss when said stabilizer foot is operably engaged to tissue. 
   
   
       47 . The device according to  claim 44 , wherein said connection is a dynamic annular or shaft seal that allows for rotation of said stabilizer foot without incurring any vacuum loss. 
   
   
       48 . The device according to  claim 43 , wherein said axis of rotation is oriented in substantially the same direction as said first direction. 
   
   
       49 . The device according to  claim 43 , wherein said axis of rotation is oriented at an angle of no more than about 25 degrees to said first direction. 
   
   
       50 . The device according to  claim 43 , wherein said stabilizer foot comprises features adapted to engage a surface of the tissue, said features approximating the surface, and wherein said axis of rotation is angled with respect to said surface. 
   
   
       51 . The device according to  claim 43 , wherein said elongated stabilizer foot comprises a hollow chamber extending substantially over the length of said elongated stabilizer foot. 
   
   
       52 . The device according to  claim 43 , wherein said device comprises two elongated stabilizer feet. 
   
   
       53 . The device according to  claim 43 , wherein said at least one elongated stabilizer foot comprises a tissue engaging feature with a non-planar perimeter. 
   
   
       54 . The device according to  claim 53 , wherein said tissue engaging feature has a constant radius of curvature. 
   
   
       55 . The device according to  claim 53 , wherein said tissue engaging feature has variable radius of curvature. 
   
   
       56 . A device for stabilizing tissue within a patient's body, said device comprising:
 a base member defining a base vacuum chamber and having a distal surface; and   at least one elongated stabilizer foot comprising a plurality of individual vacuum ports said stabilizer foot extending outwardly from said distal surface of said base member in a first direction and fluidically connected with said base vacuum chamber, said at least one stabilizer foot being rotatable, in its entirety, relative to said base member about an axis of rotation which is oriented in substantially the same direction as said first direction. (page 30 lines 8-10).   
   
   
       57 . The device of  claim 56 , wherein said individual vacuum ports independently engage said tissue. 
   
   
       58 . The device of  claim 57 , wherein each of said individual vacuum ports has a compressible perimeter seal. 
   
   
       59 . The device of  claim 56 , wherein said elongated stabilizer foot comprises a first foot portion comprising at least one vacuum port and a second foot portion comprising at least one vacuum port, wherein said first and said second foot portions are adjustable relative to one another. 
   
   
       60 . The device of  claim 59 , wherein said first and said second foot portions are adjustable relative to one another by way of one or more malleable joints. 
   
   
       61 . The device of  claim 59 , wherein said first and said second foot portions are rigid. 
   
   
       62 . The device of  claim 56 , wherein said elongated stabilizer foot is rotatably mounted on said base member and rotation of said stabilizer foot does not incur any vacuum loss. 
   
   
       63 . A device for stabilizing tissue within a patient's body, said device comprising:
 a base member; and   an elongated stabilizer foot extending outwardly from said base member in a first direction and fluidically connected with said base member, said foot having non-planar tissue-engaging features, said foot being rotatable, in its entirety, relative to said base member, about an axis of rotation.   
   
   
       64 . The device of  claim 63 , wherein said axis of rotation is oriented relative to a best-fit plane approximating the tissue engaging features. 
   
   
       65 . The device of  claim 63 , wherein said axis of rotation is oriented relative to a central tangent plane of the tissue engaging features. 
   
   
       66 . The device of  claim 63 , wherein said base is a common tube. 
   
   
       67 . The device of  claim 66 , wherein said device further comprises a housing connected to said foot which rotates around said base. 
   
   
       68 . The device of  claim 63 , wherein said tube is flanged, and said tube is connected to said base member using a shaft seal. 
   
   
       69 . The device of  claim 68 , wherein said shaft seal is an O-ring. 
   
   
       70 . The device of  claim 63 , wherein said elongated stabilizer foot has an elongated perimeter adapted to contact the tissue. 
   
   
       71 . A device for stabilizing tissue within a patient's body, said device comprising:
 a base member; and   an elongated stabilizer foot extending outwardly from said base member in a first direction and fluidically connected with said base member, said foot having non-planar tissue-engaging features comprising a perimeter seal having a variable height around its perimeter, said foot being rotatable, in its entirety, relative to said base member, about an axis of rotation.   
   
   
       72 . The device of  claim 71 , wherein said stabilizer foot further comprises a perforated screen recessed from the perimeter seal. 
   
   
       73 . The device of  claim 71 , wherein said perimeter seal is retained within a groove in the stabilizer foot. 
   
   
       74 . The device of  claim 71 , wherein said perimeter seal is higher at a front tip of said stabilizer foot as compared to a midpoint of said stabilizer foot. 
   
   
       75 . The device of  claim 71 , wherein said perimeter seal is higher at a rear end of said stabilizer foot as compared to a midpoint of said stabilizer foot. 
   
   
       76 . The device of  claim 71 , wherein said height varies to form a contoured shape adapted to remain sealed against a tissue surface. 
   
   
       77 . A device for stabilizing tissue within a patient's body, said device comprising:
 a base member; and   an elongated stabilizer foot extending outwardly from said base member in a first direction and fluidically connected with said base member, said foot having a non-planar tissue-engaging feature comprising a perimeter seal having a variable height around its perimeter, said foot being rotatable, in its entirety, relative to said base member, about an axis of rotation;   wherein said perimeter seal is a flexible seal having first and second legs disposed in an angular relationship.   
   
   
       78 . The device of  claim 77 , wherein said perimeter seal comprises a plurality of legs angularly disposed in a bellows arrangement. 
   
   
       79 . The device of  claim 77 , wherein said perimeter seal is made from an elastomeric material selected from the group consisting of: silicone, urethane rubber, neoprene, nitrile rubber, hytrel, and kraton.