Abstract:
A stabilizing device having a flexible shaft with a terminal connector and surgical tools used therewith. The flexible shaft is responsive to a tension element connected to a distal end of the shaft and in communication with a proximal end of the shaft. An elastic means interfacing between the proximal end of the tension element and an actuating cam cause the shaft to adapt for differences in activating tension between straight and curved positions. Accordingly, stretching and deformation of the tensioning element is reduced and shaft stiffness upon activation of the tensioning element is repeatable. The terminal connector includes a ball-and-socket arrangement adapted to resiliently absorb movement of an organ during surgery. A bendable suction stabilizer foot adaptable to contours of an organ is also provided as an attachment to the stabilizer device.

Description:
BACKGROUND OF THE INVENTION  
       [0001]     1. Field of Invention  
         [0002]     The invention relates to the field of surgical instruments, and more specifically to improvements in flexible shaft stabilizer devices and surgical tools usable in conjunction therewith.  
         [0003]     2. Description of Related Art  
         [0004]     In the field of medical instrumentation, flexible shaft stabilization devices are known in the art. Such devices are sold under the name OCTOPUS by the MEDTRONIC company and AXIUS by the GUIDANT company. Particularly in Coronary Artery Bypass Graft (CABG) procedures, such devices are used to stabilize the surface of the beating heart muscle at the site where an anastomosis will be formed. The devices commonly have a malleable shaft of a certain length, with a stabilizer foot or other apparatus at a distal end of the shaft. The apparatus is positioned as required, then a lead screw at a proximal end of the shaft is turned by some manner of handle to secure the shaft rigidly in place. The turning of the lead screw commonly applies tension to a fiber, such as a metal wire or braided cable. Tensioning of the cable compresses the flexible shaft, and secures it rigidly into an intended straight or curved position. These devices are considered an improvement over other stabilizers, because the length of the shaft can be positioned away from the surgical field, as compared to fixed-arm stabilizers that may impede access and vision to the surgical site.  
         [0005]     These devices are not without drawbacks, however. Among the drawbacks are difficulties with tensioning the fiber or cable that compresses the flexible shaft. It has also been observed that after the first actuation of the shaft in such devices, subsequent actuations with equal turning of the actuator as the first actuation did not achieve the desired or necessary stiffness to hold the intended straight or curved position of the shaft. Further, currently available shafts are often not conducive to convenient positioning of the distal end of the flexible shaft at the surgical site by the surgeon, even when the shaft is in the relaxed state. Further, still detrimental wearing and gall can occur at the cam of the tensioning mechanism, including the generation of metal particulate that may compromise an otherwise sterile surgical field. Turning of the handle to tension the fiber and position the shaft appropriately is also a time consuming and cumbersome task often requiring assistance from a second medical professional. A great deal of force is typically required to actuate the handles of known flexible shaft devices having high shaft stiffness.  
         [0006]     In addition to the drawbacks of known flexible shaft devices, a surgical apparatus secured to a distal end of a flexible shaft, or even a rigid retractor, may have its own drawbacks. A suction device for grasping and manipulating tissue such as those sold by the MEDTRONIC company under the brands STARFISH or URCHIN, or those sold by the GUIDANT company under the brand XPOSE may be used with a flexible shaft. The former lack the ability to dynamically adapt to moving tissue, such as the beating heart, however, and rely instead on the resiliency of the material comprising the suction device to better conform to the targeted tissue. The latter, on the other hand, are awkward, difficult to manipulate, and prone to user error.  
         [0007]     Another apparatus that may be used in conjunction with a flexible shaft, though also with other devices, is a bendable suction bridge. Suction bridge stabilizers are used to immobilize tissue at a surgical site, for example the surface of the beating heart. These bridge devices typically place a stabilizing arm on either side of the target vessel, and use downward pressure to immobilize the tissue. Suction may be provided to secure the tissue to the stabilizer. However, it is desirable to position the suction devices perpendicularly to the heart surface, which itself is curved, the particular curvature individual to each patient. Rigid devices cannot accommodate this curvature in the heart. Moreover, is cumbersome to provide a suction line individually to each arm, however, as is commonly done in such devices. Likewise, it is desirable to avoid obstructing the vessel between the arms of the bridge, as a flat transverse bridge of known bridge devices might do.  
         [0008]     Some devices in the prior art, including those sold under the OCTOPUS and ACROBAT brands, do not present a bendable bridge, and are therefore less able to adapt to the variety of tissue configurations a surgeon finds in practice. Others, such as those sold under the FLEXITE brand, are bendable at the bridge but not at the pods surrounding the arms, and require multiple vacuum inlets to each arm. Accordingly, an improved suction foot device that better conforms to the targeted tissue is desirable in the art.  
       BRIEF SUMMARY OF THE INVENTION  
       [0009]     The present invention provides an improved design in the flexible shaft of a stabilizing device and surgical tools used therewith. Particularly, the current invention addresses the problem of the marginally longer tensioning element that often occurs when the shaft is in a straight position.  
         [0010]     According to the present invention, a stabilizing device having a flexible shaft is provided. The flexible shaft has a tension element secured to a distal end of and in communication with a proximal end of the flexible shaft. A cam positioned at the proximal end of the flexible shaft is operative to displace a proximal end of the tension element. A lever is operative to displace the cam, and elastic means interface between the proximal end of the tension element and the cam to displace the shaft as desired. Ideally, the stabilizing device is operative by a single medical professional.  
         [0011]     An elastic means, or spring mechanism, is provided at a proximal end of the shaft to absorb the tension force applied to the tensioning element when the handle is actuated to lock the shaft in a rigid position. In this manner the tensioning element, or cable, does not get stretched as much and permanent deformation of the tensioning element is minimized even when numerous activations of the handle are performed. Higher repeatability of positioning a rigid shaft in a desired position is thus more readily achieved. The spring mechanism also provides improved flexibility in the shaft by permitting a gap to occur at the proximal end of the tensioning element, or cable, between the uncompressed spring and a radial flange when the handle is not actuated and the shaft is in its relaxed state. In this manner, the shaft may accommodate more surgical environments by unlocking the tensioning element, without compromising the rigidity of the shaft by locking the tensioning element when desired.  
         [0012]     Additionally, the present invention provides a terminal connector for holding a surgical tool apparatus to a distal end of the flexible shaft. The terminal connector provides rotational movement to the surgical tool according to the beating of the heart, or other movements of an organ the tool is attached to. The terminal connector comprises a socket providing at least a portion of a spherical surface in its interior, a ball sized to fit within the interior of the socket, the ball having an axial hole extending at least partially therethrough, a stem extending outward from the ball and having a flange adjacent one end, the flange being retained in the axial hole, and an elastic means within the axial hole acting on the flange. The surgical tool held at the terminal connection may be a suction cup device or other device for use with the flexible shaft according to the invention.  
         [0013]     Additionally, the present invention provides a bendable suction stabilizer foot for use with the flexible shaft. The bendable stabilizer foot comprises at least two bendable arms extending from a bendable bridge, each arm having a fluid passage in fluid communication with a bendable suction pod having at least one outlet thereon, a flexible passage connecting the at least two fluid passages, and an inlet in fluid communication with at least one fluid passage. Alternately, a bendable suction stabilizer foot comprises at least two bendable arms, each arm having a fluid passage within itself and at least one outlet thereon, a bendable bridge passage connecting the at least two fluid passages, and an inlet in fluid communication with at least one fluid passage. The bendable stabilizer foot is attached to the flexible shaft by the terminal connection. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0014]     These and other features, aspects and advantages of the present invention will be made apparent with reference to the following description and accompanying figures, wherein like reference numerals refer to like structures across the several views, and wherein:  
         [0015]      FIG. 1  illustrates a cross-sectional view of the stabilization device according to one embodiment of the invention;  
         [0016]      FIG. 2 , illustrates another embodiment of the stabilization device in cross-section according to the invention;  
         [0017]      FIG. 3  illustrates another embodiment of the stabilization device in cross-section according to the invention;  
         [0018]     FIGS.  4 A-D illustrate the operation of the flexible shaft of the stabilization device of  FIG. 1 ;  
         [0019]      FIG. 5  illustrates a flexible shaft having a terminal connector according to another aspect of the invention;  
         [0020]      FIG. 6  illustrates the terminal connector of  FIG. 5  in partially exploded assembly view;  
         [0021]      FIG. 7  illustrates the terminal connecter of  FIG. 5  in additional detail in a further exploded assembly view;  
         [0022]      FIG. 8  illustrates a suction foot stabilizer device according to another aspect of the present invention;  
         [0023]      FIG. 9  illustrates the suction foot stabilizer device of  FIG. 8  in partial cutaway view;  
         [0024]      FIG. 10  illustrates the suction foot stabilizer device of  FIG. 8  in exploded assembly view;  
         [0025]      FIG. 11  illustrates an alternate embodiment of a suction foot stabilizer device; and  
         [0026]      FIG. 12  illustrates the suction foot stabilizer device of  FIG. 11  in partial cutaway view. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0027]     Experimentation has shown that for the certain shaft size and cam mechanism under test, using a wire-braided cable as a tension element, pre-loaded with 150 lbs of tension in a rigid straight configuration required 340 lbs. of tensile load to activate in a curved configuration. This additional loading exceeded the elastic limit of the cable, and stretched the cable by 0.06 in., which stretching degraded the shaft stiffness of subsequent activations. To accommodate for this, this invention provides an elastic means allowing compliance in the flexible shaft device without stretching the tension element.  
         [0028]     Turning now to  FIG. 1 , shown is the proximal base  12  of the flexible shaft, generally  10 . The shaft portion  14  extends distally from the proximal base  12 . The proximal base  12  may include a mounting bracket  16 , in this exemplary embodiment along an underside thereof. The mounting bracket  16  facilitates the use of the flexible shaft  10  in conjunction with a retractor, rib-spreader or other thoracic surgical apparatus in a manner generally known in the art.  
         [0029]     The flexible shaft  10  includes a tension element  18 . The tension element may be a braided cable having strands of metal and/or other material, exclusively or in combination, or a single filament of metal or other material known in the art, which is both flexible and suitable to transmit a tensile load along a length of the flexible shaft  10 . The tension element  18  is secured at a distal end of the shaft portion  14  and is in communication with a proximal end of a cam  20 , generally, though not exclusively, via a longitudinal passage therethrough. An alternate embodiment of the shaft portion  14  is disclosed in the commonly assigned co-pending patent application Ser. No. 10/736,199, entitled VARIALE STIFFNESS SHAFT, filed 15 Dec. 2003, the complete disclosure of which is hereby incorporated herein by reference for all purposes.  
         [0030]     In operation, a proximal end of the tension element  18  is displaced proximally to transition the shaft portion  14  from a relaxed to a rigid state. To achieve this displacement, this exemplary embodiment has a cylindrical cam  20 . The cylindrical cam  20  includes a cam groove  22  around its outer surface, which works in cooperation with one or more cam followers (not shown) to displace the cam as it is rotated about its cylindrical axis. A transverse through hole  24  may be present to receive a lever  25  (See  FIG. 5 ) to obtain mechanical advantage and assist in the rotation of the cylindrical cam  20 . The lever may extend beyond the body of the proximal base through opening  26  provided for that purpose. Alternate embodiments of the cam mechanism are disclosed in the commonly assigned co-pending patent application Ser. No. 10/609,726, entitled VARIABLE-PITCH CAM MECHANISM FOR TENSION DEVICES, filed 30 Jun. 2003, the complete disclosure of which is hereby incorporated herein by reference for all purposes.  
         [0031]     The tension element  18  extends to a proximal terminus  32 . The cylindrical cam  20  has an axial passage  28  to facilitate the interface of the tension element  18  with the cylindrical cam  20 . A radial flange  30  may be secured to the tension element  18  at its proximal terminus to facilitate the interface with the cylindrical cam  20 . For example, the flange  30  may be crimped, soldered, or welded to the tension element, as would be apparent to one of ordinary skill. An elastic means  40  provides an interface between the radial flange  30  and the cylindrical cam  20 . As shown in the embodiment of  FIG. 1 , the elastic means  40  may comprise one or more disk springs  42 . In some embodiments, five (5) disk springs  42  are formed of 301 stainless steel each have a OD of 0.472 in., an ID of 0.165 in., a thickness of 0.024 inches, and a free height of 0.039 in., compressing to a solid height equal to their thickness. As an alternate 17-7 steel may be used, notwithstanding potential for corrosion. In other embodiments, disk springs  42  of 17-7 steel may be provided with surface treatment to prevent corrosion. As illustrated, disk springs  42  are preferably arranged in alternating directions, though they need not be. Neither must each disk spring  42  of a plurality comprising an elastic means  40  be identical. This configuration may be varied in accordance with the requirements of stiffness in the flexible shaft  10  and the space available in the proximal base  12 . In still other embodiments, the elastic means  40  comprises one or more coil springs, and/or one or more elastomeric elements, as will be described.  
         [0032]     The elastic means  40 , or spring mechanism, is provided at a proximal end of the cam  20  to absorb this tension force applied to the tensioning element  18 , when the tensioning element is actuated to lock the shaft  14  in a rigid position. When actuated, tensile force applied to the tensioning element  18  by the action of the cam  20 , is absorbed by deformation in the elastic means  40 . In this manner stretching or permanent deformation of the tensioning element  18 , or cable, is minimized even when numerous activations are performed. Higher repeatability of positioning a rigid shaft in a desired position is thus more readily achieved. The spring mechanism also provides improved flexibility in the shaft by permitting a gap (g) (see  FIGS. 4C, 4D ) to occur at the proximal end of the tensioning element, or cable, between the uncompressed spring and a radial flange  32  when the shaft is in its relaxed state. In this manner, the shaft portion  14  may be manipulated about the surgical environment by unlocking the tensioning element  18 , without compromising the rigidity of the shaft when locking the tensioning element  18  as desired.  
         [0033]     To provide the gap (g), the elastic means  40  is preferably designed to deform less than the total displacement of the cam  20 . The difference between the total displacement of the cam  20  and the cumulative deformation of the elastic means  40  provides flexibility in to the shaft portion  14  in its relaxed state. Greater difference provides a larger gap (g), and greater flexibility of the shaft portion  14  in the relaxed state. Increasing numbers of spring elements also decreases the activation force necessary because the spring rate decreases with the increase in spring numbers. However, the size and/or number of spring elements is constrained by the space available within the proximal base  12 .  
         [0034]     Referring now to  FIG. 2 , an embodiment of the stabilizing device having a coil spring  40   a,  as elastic means  40  is shown. A relief  44   a  is provided in the cylindrical cam  20   a  in order to accommodate the coil spring  40   a  while reducing the overall axial length of the cam. In addition, a key  46   a  on the radial flange  32   a  is shown in  FIG. 2 . Key  46   a  engages a keyway  48   a  provided in proximal base  12   a  to prevent rotation of the radial flange  32   a  along the axial travel of the cylindrical cam  20   a.  This key and keyway may be provided in other embodiments as well. The exemplary coil spring  40   a  of  FIG. 2 . is formed of 301 Stainless steel and has an OD of 0.375 in, and ID of 0.2 in., a wire diameter of 0.083 in., a free length of 0.55 in., and a solid length of 0.37 in., which gives a spring rate of 1,100 lbs./in. As an alternate, 17-7 steel may be used for the coilspring  40   a,  notwithstanding potential for corrosion. The embodiment shown in  FIG. 2  is otherwise similar to that shown in  FIG. 1 .  
         [0035]     Referring to  FIG. 3 , another embodiment of the stabilizing device is shown. The stabilizing device of  FIG. 3  has an elastomer element  40   b  as elastic means  40 . Similar to the embodiment of  FIG. 2 , a relief  44   b  is provided in the cylindrical cam  20   b  in order to accommodate the elastomer element  40   b  while reducing the overall axial length of the cam of  FIG. 3 . The elastomer element  40   b  may comprise urethane, or a material exhibiting similar compressive yield characteristics. The stabilizing device of  FIG. 3  is otherwise similar to that shown in  FIG. 1 .  
         [0036]     The operation of the flexible shaft  10  will be explained with reference to FIGS.  4 A-D and the embodiment of  FIG. 1 .  FIG. 4A  illustrates the position of the cylindrical cam  20  with the shaft portion locked in a curved position. Note that the elastic means  40  is nearly fully compressed. Compare this to  FIG. 4B , which illustrates the position of the cylindrical cam  20  with the shaft portion locked in a straight position. Note that in  FIG. 4B , the elastic means is not as fully compressed as in  FIG. 4A , the curved position. Moving on to  FIGS. 4C and 4D , shown is the position of the cylindrical cam  20  with the shaft portion  14  unlocked in curved and straight positions, respectively. Note that in both cases, the elastic means  40  is uncompressed. The gap (g) induced between the radial flange  32  and the elastic means  40  may vary between the straight and curved positions as seen in the figures. This gap, indicating an unloading of the elastic means  40 , gives added flexibility to the shaft portion in the relaxed state. The tensile force in the tensioning element  18  is proportional to the deformation in the elastic means  40 . In a curved, locked position, the elastic means  40  prefereable is at its maximum deformation. Accordingly, the tensile force in the tensioning element  18  is also maximized in this state, which provides desirable rigidity to the shaft portion  14  when locked in a curved position.  
         [0037]     Referring again to  FIG. 1 , the cylindrical cam is guided by a friction plate  54  to smooth the cam actuation. Friction plate  54  is preferably formed of a Nylon Resin, such as ZYTEL 101 L, however the friction plate may also be formed of a 300 series Stainless steel. A cam ring  50  includes one or more cam followers (not shown) that follow the cam groove  22  of cylindrical cam  20 . The outer surface  52  of the cam ring  50  may be knurled to assist in maintaining its location in the proximal base  12 . The cam followers carry the axial load of the tension element  18 , and may be subject to wearing and galling. To minimize this effect, the cam followers can preferably comprise 440C Stainless steel, tempered to a Rockwell C hardness of about 56. Additionally, the cylindrical cam  20  may be formed of 316 steel, exhibiting a Rockwell B harness of 91. Alternately, the materials may be exchanged, the cam followers of 316 steel and the cylindrical cam  20  of 440C Stainless steel. Additionally, the surface finish of either or both of the cam followers and the cam groove  22  may be polished in order to further reduce friction and/or wear. However, beyond a certain surface finish, increased polishing can promote detrimental galling. The balance of reduced friction and galling will be taken into account by those skilled in the art in selecting an parropriate surface finish for a given application.  
         [0038]     Moreover, a lubricant may be introduced on the rubbing surfaces, cam followers and cam groove  22 . For example, DOW CORNING DC-360, which is a biocompatible medical fluid, having a viscosity of about 1,000 to about 12,000 centistokes may be used as the lubricant. DC-360 is a preferred lubricant over the also-acceptable DOW CORNING DC-111, which is a silicone grease whose very high-viscosity was less effective in reducing friction than the DC-360. In addition to prolonging the life of the mechanism, the reduced friction at the cam followers improved the ease of actuating the mechanism, thereby improving overall performance.  
         [0039]     Variable stiffness shafts are typically used in combination with certain surgical tools carried on a distal end thereof. More particularly, the variable stiffness flexible shaft is used to position such surgical tools at the surgical site, and to maintain the position of such surgical tools through the rigidity of the shaft when actuated. Certain among these tools direct a negative suction pressure to hold the heart in a desired position for a better approach to the surgical site.  
         [0040]     For example, during a CABG surgery, it is commonly necessary to access the surface beneath the heart. It is also known to use a suction cup device to hold a portion of the heart, typically the apex, to lift the beating heart muscle. The suction cup device must be capable of holding the heart muscle in an elevated position notwithstanding the beating motion of the heart. It is also desired that the surgical tool, such as the suction lifting device, attach to the variable stiffness shaft to facilitate the grasping and positioning of the suction cup or other surgical tool on the heart. The artisan should appreciate that the suction cup device may be used on other organs as well.  
         [0041]     Referring now to  FIG. 5 , shown is a flexible shaft  10  as described, for example, with reference to  FIG. 1 . A terminal connector  50  is positioned at a distal end of shaft portion  14 . The terminal connection  50  connects suction cup  52  to the shaft portion  14  via stem  64 . A suction conduit  54  extends proximally from an inlet  66  (see  FIG. 6 ) projecting from the stem  64 .  
         [0042]     Referring now to  FIG. 6 , the terminal connector  50  is illustrated in a partially exploded assembly view. Terminal connector  50  comprises a ring  56  and a cap  58 . An interior surface of the ring  56  comprises a portion of a spherical surface  60 . The interior of cap  58  (not shown) likewise comprises a portion of a spherical surface. The assembled ring  56  and cap  58  form a socket that accepts ball  62 . Extending from the ball  62  is a stem  64 , connecting the ball with suction cup  52 . Positioned on the stem  64  is an inlet  66  for introducing vacuum pressure, as from suction conduit  54  (see  FIG. 5 ). Conduit  54  need not provide suction, but instead could provide air, oxygen, or any fluid generally, as a routing conduit to the distal end of the flexible shaft, as would be apparent to one of ordinary skill in light of the desired application.  
         [0043]     Referring still to  FIG. 6 , a ball  72  is provided on one end of the mounting rod  68  passes through hole  70  in the ring  56  for connection to the shaft portion  14 . As assembled, ring  56  is generally free to rotate around mounting rod  68 . Alternately, the mounting rod  68  may be configured to restrict rotation of the ring  56  after the shaft portion  14  is activated to a rigid state. In the latter example, mounting rod  68  and hole  70  would both be at least slightly conically shaped, and/or have surfaces designed to engage to restrict motion, the activation of tension element  18  initiating the restriction.  
         [0044]     The ring  56  and cap  58 , as assembled, provide a handhold to grasp the assembly forming the ball-and-socket connection, and may be provided with a friction-enhancing surface for that purpose. Furthermore, by positioning the suction inlet  66  below the terminal connector  50 , the likelihood of improperly grasping the inlet  66 , and potentially releasing the suction conduit  54 , is reduced.  
         [0045]     Referring now to  FIG. 7 , shown is the suction cup  52 , stem  64 , and ball  62  in a further exploded assembly view. A flange  80  is positioned adjacent one end of stem  64 , and is inserted through hole  74  in ball  62 . The fit may be an interference fit, to capture the flange  80  within the ball  62 . Alternately a closure may be provided as is known in the art. An elastic member  76 , shown as a coil spring, is inserted into the hole  74 , and engages the flange  80 . In alternate embodiments, elastic member  76  can be an elastomer compression element, a disk spring, a trapped gas spring assembly, or other compliant device. The elastic member  76  may bias the flange upward and/or downward, and may engage the flange  80  from above and/or below. A closure  78 , in this case a ring, but alternately a cap, is provided to retain the elastic member  76  within the ball  62 .  
         [0046]     Referring to  FIGS. 5-7  once assembled, the suction cup  52  is positioned on the organ and the suction pressure applied. Most commonly, the cup  52  is placed on the apex of the heart, though other organs and locations may be engaged by the suction cup device. The ball  62  is free to rotate inside the ring  56  and cap  58 . Ring  56  is free to rotate about the axis of mounting rod  68 . Additionally, the suction cup  52  and stem  64  are free to move axially under the bias of elastic member  76 . Each of these allow the device to hold the heart in position while accommodating the beating motion of the heart.  
         [0047]     Referring now to  FIG. 8 , shown is a suction foot stabilizer device, generally  100 . A stabilizer foot is used, for example, to immobilize a portion of the heart surface for the attachment of a bypass graft to a coronary artery during a beating-heart surgery. Foot  100  comprises two arms  102  connected to a bendable bridge member  104  having opposed ends and an outer covering  108 . The arms  102  are generally positioned along either side of the target coronary artery. The arms  102  each comprise internal pod passages  103 . A fluid inlet  109  admits suction pressure to the passages  103 . Bendable will be taken in its ordinary sense, and malleable will be taken to mean bendable in a fashion that generally holds its bent configuration when a bending force is removed, e.g., as a metal material might. Components described as bendable may also be malleable.  
         [0048]     A mounting ball  106  is provided to attach the foot  100  to the terminal connector of a flexible shaft, a retractor, or other surgical positioning or stabilizing device as described with reference to  FIGS. 1 , and  4 - 6  for example. Each arm  102  includes a bendable pod  122 , that allows the arms to shape and conform to the curvature of the heart surface. Suction provided to arms  102  through the inlet  109  is directed through passages  103  to malleable suction pods  122 . The malleable suction pods  122  additionally have outlets on an underside thereof to engage the heat tissue surface to further immobilize the surgical site.  
         [0049]     Referring now to  FIG. 9 , the outer covering  108  ( FIG. 8 ) having been removed, a bridge link member  110  is shown. The bridge link member  110  is generally stamped from an annealed metal plate. The reduced dimension neck  112  between the extremities of the bridge link  110  facilitates bending the bendable bridge  104  to form an arch connecting the arms  102  according to the contours of the heart, or other organ, the stabilizing foot is engaged with. Additionally, each arm may be made to perpendicularly engage to the surface of the patient&#39;s heart, notwithstanding the curvature of the heart surface.  
         [0050]     Referring now to  FIG. 10 , foot  100  is shown in exploded assembly view. Inlet  109  leads to a T-shaped connector  114 , connecting a first pod passage  103   a  with a bridge passage  116 . An L-shaped connector  118  connects bridge passage  116  with a second pod passage  103   b.  Bridge passage  116  may be a flexible or soft plastic tube, or alternately a braided metal tube. A stent  120  that is flexible or bendable, but more rigid than bridge passage  116 , may be inserted into the bridge passage  116  to prevent collapse or kinks during the bending process.  
         [0051]     Referring now to  FIG. 11 , shown is an alternate embodiment of a suction foot stabilizer device, generally  200 .  FIG. 12  illustrates in partial cutaway, the suction foot stabilization device of  FIG. 11  with a soft bendable covering  208  and bendable suction pods  222  removed. In  FIG. 12 , shown is a manifold, generally  226 , including passages  216 ,  203 , formed of a bendable material. Therefore, arms  202  ( FIG. 11 ) and bridge  204  ( FIG. 11 ) may be bent to conform to the working surface at the surgical site.  
         [0052]     In embodiments of the suction foot stabilizer device, some aspect of the arms and bridge are bendable to conform to the surface of the heart muscle. The malleable bridge member thus helps to alleviate obstruction across the target artery or other vessel.  
         [0053]     The present invention has been described herein with respect to certain exemplary and/or preferred embodiments. Certain alterations or modifications will be apparent to those of ordinary skill in the art in light of the disclosed invention. The embodiments described are offered as illustrative, and not limiting, on the scope of the present invention, which is defined with reference to the appended claims.