Source: http://www.google.com/patents/US6936002?dq=U.S.+Patent+
Timestamp: 2016-10-25 19:42:53
Document Index: 596489805

Matched Legal Cases: ['art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70']

Patent US6936002 - Stabilizing tissue method and apparatus - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsA tissue stabilizer includes a pneumatic rigidifying bladder which is flexible when at ambient pressure and rigid when at negative pressure or evacuated. Structure such as straps with hook-and-eye fasteners attaches the rigidifying bladder to tissue to be stabilized, such as a broken arm. When positioned...http://www.google.com/patents/US6936002?utm_source=gb-gplus-sharePatent US6936002 - Stabilizing tissue method and apparatusAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS6936002 B2Publication typeGrantApplication numberUS 10/387,745Publication dateAug 30, 2005Filing dateMar 12, 2003Priority dateMar 17, 1998Fee statusPaidAlso published asEP1063951A1, EP1063951A4, EP1063951B1, US6890292, US6902523, US7237555, US7594915, US20030125604, US20040181118, US20040181119, US20040181120, US20050059853, US20070233226, WO1999047085A1Publication number10387745, 387745, US 6936002 B2, US 6936002B2, US-B2-6936002, US6936002 B2, US6936002B2InventorsGary S. Kochamba, Suzanne E. KochambaOriginal AssigneeKochamba Family TrustExport CitationBiBTeX, EndNote, RefManPatent Citations (41), Non-Patent Citations (3), Referenced by (21), Classifications (23), Legal Events (7) External Links: USPTO, USPTO Assignment, EspacenetStabilizing tissue method and apparatus
US 6936002 B2Abstract
1. A method for positioning a beating heart, said method comprising:
placing a cardiac stabilizer on an epicardium of the beating heart; applying a vacuum to the stabilizer to contour the stabilizer to a surface topography of the epicardium of the beating heart; applying a vacuum to rigidify the stabilizer; moving the beating heart with the stabilizer from the anatomical position to the anastomosis position while the heart remains securely retained by the stabilizer. 2. A method as in claim 1, wherein the cardiac stabilizer is positioned through a sternotomy.
5. A method as in claim 1, further comprising anchoring the stabilizer to an external support structure after the beating heart has been moved to a desired position.
6. A method as in claim 1, further comprising monitoring hemodynamic stability of the heart and returning the heart to the anatomical position if hemodynamic instability is observed.
7. A method for temporarily stabilizing tissue comprising:
providing a conformable tissue stabilizer including: a rigidifying bladder component; a port through which said bladder is evacuatable; and vacuum attaching means for applying a vacuum for securing said rigidifying bladder to tissue; positioning said tissue stabilizer on tissue to be stabilized;
attaching said tissue stabilizer to the tissue with said attaching means; and rigidifying said tissue stabilizer by applying suction at said port. 8. A method for stabilizing tissue as claimed in claim 7, further comprising the de-rigidifying said tissue stabilizer.
10. A method for stabilizing tissue as claimed in claim 7, wherein said rigidifying and attaching steps are facilitated by applying suction through a suction apparatus comprised of the a second bladder bladder, the suction apparatus configured to be attached to tissue for stabilization, the suction apparatus facilitating creation of sub-atmospheric pressure between tissue and the suction apparatus, enabling attachment of said conformable tissue stabilizer to tissue.
In addition to these examples of external tissue stabilization, internal organs may also need to be stabilized for specific medical procedures. For example, the heart may need to be stabilized during cardiac procedures. One such procedures is coronary artery bypass graft surgery (CABG), which is the most commonly performed cardiac operation, accounting for over 80% of all cardiovascular surgery. Indeed, more than 400,000 CABG operations were performed in 1997 alone. The clinical spectrum of presenting problems resulting in consideration for CABG includes angina, unstable angina, congestive heart failure due to ischemia, myocardial infarction, survival of sudden cardiac death, and asymptomatic ischemia. In recent years, the profile of a typical CABG patient has expanded to include higher-risk patients, such as older patients and patients with more advanced stages of coronary artery disease, as well as patients for “re-do” operations who have already had at least one CABG operation. The effect of these changes is reflected in the higher morbidity and mortality associated with these higher-risk patients.
In this regard, an alternative embodiment of the tissue stabilizer of the present invention for cardiac applications includes a flexible first bladder for attaching the cardiac stabilizer to the heart and a flexible second bladder for rigidifying the stabilizer. Both bladders include an inner chamber and a port through which the chamber may be evacuated. The first bladder includes a plurality of openings which apply suction in response to suction applied at the port thereof. The second bladder includes rigidifying structure which rigidifies in response to suction applied at the port thereof The cardiac stabilizer may include retaining structure which may be engaged with an external support for retaining the tissue stabilizer in a desired position when rigid. The cardiac stabilizer may also include a window for providing access to a surgical site.
FIG. 4 is a cross-sectional view of the cardiac stabilizer taken along line 4—4 of FIG. 3C;
Referring more particularly to the drawings, an exemplary tissue stabilizer 10 configured in accordance with the teachings of the present invention is illustrated in FIGS. 1 and 2. For descriptive purposes and without limiting the scope of the present invention, exemplary stabilizer 10 is illustrated as a cardiac stabilizer for stabilizing a heart during surgical procedures, particularly surgical procedures which are performed on a heart which is not immobilized but rather which is warm and beating. Tissue stabilizers configured for alternative functions are contemplated as being within the scope of the invention as will be understood by those skilled in the art. Those skilled in the art will also appreciated that exemplary tissue stabilizer 10 utilized during cardiac procedures must be biocompatible and possess substantially a traumatic features. However, these additional properties may not be essential to all tissue stabilizers produced in accordance with the teachings of the invention.
Exemplary tissue stabilizer 10 is substantially flexible and is conformable to the shape or anatomical topography of a particular piece or section of tissue, such as the epicardium of the left ventricle of a heart. Tissue stabilizer 10 is also attachable to tissue in a substantially a traumatic manner through, for example, the use of suction apparatus. Furthermore, stabilizer 10 may be rigidified to maintain a desired shape through the use of auxiliary suction apparatus. Each of these features of the present invention will be described in detail below.
In order to perform a coronary anastomosis, a stable operating platform must be provided for the surgeon; that is, the heart 70 must be stabilized. This may be accomplished by placing the patient on a heart-lung machine and stopping the heart from beating with cardioplegia. Alternatively, coronary anastomosis may be performed on a heart which not stopped but which is warm and beating. Prior to utilizing the tissue stabilizer of the invention, access to the heart 70 is provided as known in the art, such as through a medial stemotomy or thoracotomy, which may also involve a retractor. Referring to FIG. 24, access may also be provided in a substantially minimally invasive manner, such as intercostally through a trocar sheath 67 or a “mini” thoracotomy.
The applied suction may attach stabilizer 10 to the heart 70 with a level of force which allows the stabilizer to be moved or slid across the tissue under hand pressure. This feature facilitates the positioning of stabilizer 10 to a desired location. It also enables flexible stabilizer 10 to be contoured to the anatomical topography of the heart 70, providing optimal contact or incidence of the openings 20 on the surface of the epicardium. As shown in FIG. 10, stabilizer 10 conforms to the left ventricle much like a patch, substantially “wrapping” around a portion thereof. The U-shape configuration of stabilizer 10 allows the surgeon to place a hand on the stabilizer with his or her fingers straddling window 56, which ergonomically facilitates the positioning and contouring thereof. Only one hand is need to position the cardiac stabilizer on the heart.
During the coronary anastomosis, the heart 70 may be repositioned as desired by bending or repositioning articulated arm 98. Alternatively, the heart 70 may be repositioned by releasing stabilizer 10 from support arm 98, repositioning the stabilizer and heart as desired, and then reattaching the stabilizer to the arm. After the coronary anastomosis is completed, stabilizer 10 may be detached from the external support structure 96, allowing the heart 70 to be returned to the normal cardiac anatomical position. The suction may then be disconnected from ports 16 and 22 by actuating valves 92 and 94. Accordingly, stabilizer 10 becomes flexible and unattached to the heart 70 and may be removed. As many patients require more than one bypass to be performed, the surgeon may then reapply stabilizer 10 to another portion of the heart 70 to performed another CABG procedure, such as on the right coronary artery 74, in the manner described above. This reapplying of the stabilizer 10 may continued a plurality of times to perform as many CABG are necessary for the patient.
Another exemplary embodiment of the tissue stabilizer of the present invention is illustrated in FIG. 22, which is referenced by numeral 160. In this embodiment, tissue stabilizer 160 is configured to be incorporated into footwear, such as an athletic shoe 162. Many athletic shoes attempt to support a user's ankle to prevent injury. Athletic shoe 162 of the present invention supports the ankle by including tissue stabilizer 160 which may be configured like a sock or a shoe liner to fit around a user's heel and/or ankel. Tissue stabilizer 160 includes a valve 164 through which rigidifying bladder (not shown) may be deflated or evacuated and for sealing the bladder. In addition to athletic shoes such as basketball shoes, the tissue stabilizer of the invention may be incorporated into skates (both in-line and ice), ski boots, hiking shoes, and so on. Alternatively, tissue stabilizer may be configured as an insole so that when rigidified, the stabilizer serves as an orthotic device.
As previously mentioned, the rigidifying bladder may be made from silicone impregnated with nylon (with the nylon comprising at least a portion of the rigidifying structure). The rigidifying bladder may be include natural fibers such as cotton (e.g., canvas) or metallic fibers such as stainless-steel mesh to provide durability. Alternatively, tissue stabilizer may be made from substantially resilient material, such as certain silicones, so as to stretch under sufficient force. In addition, rather than pneumatic evacuation of rigidifying bladder of the invention, fluids other than air, such as hydraulics may be used. As an alternative means for attaching the rigidifying bladder to tissue, rather than including straps 112, tissue stabilizer 110 may include a layer of adhesive coated onto one side of the rigidifying bladder 114 with a peel-away backing.
Patent CitationsCited PatentFiling datePublication dateApplicantTitleUS3745998Jan 6, 1971Jul 17, 1973Bio Medical Syst IncVacuum formed support structures and immobilizer devicesUS3762404Jul 22, 1971Oct 2, 1973Olympic Surgical Co IncPositioning aidUS4299213Feb 4, 1980Nov 10, 1981Violet James TLeg stabilizer constructionUS4447227Jun 9, 1982May 8, 1984Endoscopy Surgical Systems, Inc.Multi-purpose medical devicesUS4657003Jan 24, 1986Apr 14, 1987Cramer Products, Inc.Immobilizer deviceUS5159921Nov 27, 1990Nov 3, 1992Hoover Rocklin LSurgical retractorUS5290082Jul 6, 1992Mar 1, 1994Palmer Harold DBattery operated hand held vacuum handling deviceUS5695514Mar 15, 1996Dec 9, 1997Guidant CorporationMethod and apparatus for harvesting blood vesselsUS5727569Feb 20, 1996Mar 17, 1998Cardiothoracic Systems, Inc.Surgical devices for imposing a negative pressure to fix the position of cardiac tissue during surgeryUS5782746Feb 15, 1996Jul 21, 1998Wright; John T. M.Local cardiac immobilization surgical deviceUS5807243Feb 20, 1996Sep 15, 1998Heartport, Inc.Method for isolating a surgical siteUS5836311Sep 20, 1995Nov 17, 1998Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS5865730Oct 7, 1997Feb 2, 1999Ethicon Endo-Surgery, Inc.Tissue stabilization device for use during surgery having remotely actuated feetUS5868763Sep 16, 1996Feb 9, 1999Guidant CorporationMeans and methods for performing an anastomosisUS5894843Feb 20, 1996Apr 20, 1999Cardiothoracic Systems, Inc.Surgical method for stabilizing the beating heart during coronary artery bypass graft surgeryUS5921979Dec 18, 1996Jul 13, 1999Guidant CorporationApparatus and method for tissue and organ stabilizationUS5927284Aug 21, 1997Jul 27, 1999Medtronic, IncMethod and apparatus for temporarily immobilizing a local area of tissueUS5957835May 16, 1997Sep 28, 1999Guidant CorporationApparatus and method for cardiac stabilization and arterial occlusionUS5976069Jul 24, 1997Nov 2, 1999Guidant CorporationEpicardial immobilization deviceUS5984864Oct 7, 1997Nov 16, 1999Ethicon Endo-Surgery, Inc.Tissue stabilization device for use during surgeryUS6007486Oct 7, 1997Dec 28, 1999Ethicon Endo-Surgery, Inc.Tissue stabilization device for use during surgery having a segmented shaftUS6015378Oct 3, 1996Jan 18, 2000Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area tissueUS6019722Sep 17, 1997Feb 1, 2000Guidant CorporationDevice to permit offpump beating heart coronary bypass surgeryUS6032672Jun 6, 1997Mar 7, 2000Cardiothoracic Systems, Inc.Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgeryUS6036641 *Sep 16, 1997Mar 14, 2000Cardiothoracic System, Inc.Surgical instruments for stabilizing the beating heart during coronary artery bypass graft surgeryUS6050266Jun 18, 1998Apr 18, 2000Cardiothracic Systems, Inc.Procedures for stabilizing the beating heart during coronary artery bypass graft surgeryUS6066107Jul 14, 1994May 23, 2000Habermeyer; PeterApparatus for the surroundive fixation of extremitiesUS6193652Oct 7, 1997Feb 27, 2001Ethicon Endo-Surgery, Inc.Tissue stabilization device for use during surgery having spherical curved feetUS6206827Feb 26, 1999Mar 27, 2001Guidant CorporationApparatus and method for tissue and organ stabilizationUS6328688Jan 28, 2000Dec 11, 2001Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6334843Jan 28, 2000Jan 1, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6336898Jan 28, 2000Jan 8, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6338712 *May 29, 1998Jan 15, 2002Origin Medsystems, Inc.Device to permit offpump beating heart coronary bypass surgeryUS6346077Jan 27, 1997Feb 12, 2002Cardiothoracic Systems, Inc.Surgical instrument for stabilizing the beating heart during coronary artery bypass graft surgeryUS6350229Jan 28, 2000Feb 26, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6364826Jun 16, 1999Apr 2, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6371906Jan 28, 2000Apr 16, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6394948Jan 28, 2000May 28, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6464630Jan 28, 2000Oct 15, 2002Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS6506149Sep 7, 1999Jan 14, 2003Origin Medsystems, Inc.Organ manipulator having suction member supported with freedom to move relative to its supportUS6514250Apr 27, 2000Feb 4, 2003Medtronic, Inc.Suction stabilized epicardial ablation devices* Cited by examinerNon-Patent CitationsReference1Borst et al.; "Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass and Without Interruption of Native Coronary Flow Using a Novel Anastomosis Site Restraining Device ("'Octopus'");" JACC; vol. 27, No. 6; May 1996; pp. 1356-1364.2Jansen et al.; "Less Invasive Off-Pump CABG Using a Suction Device for Immobilization: The 'Octopus' Method;" European Journal of Cardio-Thoracic Surgery: vol. 12; 1997. pp. 406-412.3Octopus.TM; "Tissue Stabilizer and Accessory Products, Defining the Future of Minimally Invasive and Beating Heart Cardiac Surgery," Jan. 15, 1998; Medtronic Advertisement; Aug. 1997; The Annals of Thoracic Surgery.Referenced byCiting PatentFiling datePublication dateApplicantTitleUS7766817Aug 3, 2010Maquet Cardiovascular LlcOrgan manipulator having suction member supported with freedom to move relative to its supportUS8092369Jul 15, 2010Jan 10, 2012Maquet Cardiovascular LlcOrgan manipulator having suction member supported with freedom to move relative to its supportUS8162817Apr 24, 2012Maquet Cardiovascular LlcDevice to permit offpump beating heart coronary bypass surgeryUS8251931 *Apr 27, 2009Aug 28, 2012Bing-Tang ZhongCasting apparatus and method for using the sameUS8382654Feb 26, 2013Maquet Cardiovascular LlcSurgical devices for imposing a negative pressure to stabilize the cardiac tissue during surgeryUS8641598Dec 18, 2008Feb 4, 2014Maquet Cardiovascular LlcOrgan manipulator apparatusUS8715160Feb 6, 2012May 6, 2014Mardil, Inc.Method and apparatus for external stabilization of the heartUS8715174 *Jun 26, 2012May 6, 2014Ashutosh KaulSuction-based tissue manipulatorUS8753266Feb 7, 2007Jun 17, 2014Maquet Cardiovascular LlcDevice to permit offpump beating heart coronary bypass surgeryUS8814788 *May 13, 2011Aug 26, 2014Livac Pty LtdSuction retractorUS9022998Feb 26, 2010May 5, 2015Maquet Cardiovascular LlcBlower instrument, apparatus and methods of usingUS9289298Mar 17, 2014Mar 22, 2016Mardil, Inc.Method and apparatus for external stabilization of the heartUS9402608Feb 3, 2014Aug 2, 2016Maquet Cardiovascular LlcOrgan manipulator apparatusUS20040171917 *Mar 13, 2004Sep 2, 2004Paul David J.Surgical instruments for stabilizing a localized portion of a beating heartUS20060270909 *May 25, 2005Nov 30, 2006Davis John WSurgical instruments and methods for use in reduced-access surgical sitesUS20070244476 *Feb 12, 2007Oct 18, 2007Kochamba Gary STissue stabilization and ablation deviceUS20070244534 *Feb 12, 2007Oct 18, 2007Kochamba Gary STissue stabilization and ablation methodsUS20080064919 *Nov 2, 2007Mar 13, 2008Williamson Warren P IvTissue stabilizer having an articulating lift elementUS20080269653 *Apr 25, 2007Oct 30, 2008Bing-Tang ZhongCasting Apparatus and Method for Using the SameUS20130030252 *Jun 26, 2012Jan 31, 2013Ashutosh KaulSuction-Based Tissue ManipulatorUS20130109924 *May 13, 2011May 2, 2013Livac Pty LtdSuction retractor* Cited by examinerClassifications U.S. Classification600/37International ClassificationA61F2/00, A61B17/00, A61F5/055, A61B17/30, A61B17/02, A61F5/058, A61F5/01Cooperative ClassificationA61B2017/00247, A61F5/0104, A61F5/055, A61B2017/306, A61F5/05833, A61B2018/00392, A61F2/2481, A61B17/02, A61B2017/00243, A61B2017/0243European ClassificationA61F2/24W2, A61B17/02, A61F5/055, A61F5/01D1, A61F5/058GLegal EventsDateCodeEventDescriptionJan 27, 2005ASAssignmentOwner name: KOCHAMBA FAMILY TRUST, CALIFORNIAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:KOCHAMBA, GARY S.;KOCHAMBA, SUZANNE E.;REEL/FRAME:015617/0007Effective date: 20050108Mar 9, 2009REMIMaintenance fee reminder mailedMar 20, 2009SULPSurcharge for late paymentMar 20, 2009FPAYFee paymentYear of fee payment: 4Feb 8, 2013FPAYFee paymentYear of fee payment: 8Oct 25, 2013ASAssignmentOwner name: TERUMO CARDIOVASCULAR SYSTEMS CORPORATION, MICHIGAFree format text: ASSIGNMENT AND ASSUMPTION AGREEMENT OF LICENSE OF PATENTS;ASSIGNOR:ENDOSCOPIC TECHNOLOGIES, INC. D/B/A ESTECH;REEL/FRAME:031495/0062Effective date: 20131011Dec 11, 2013ASAssignmentOwner name: TERUMO CARDIOVASCULAR SYSTEMS CORPORATION, MICHIGAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ENDOSCOPIC TECHNOLOGIES, INC.;REEL/FRAME:031758/0276Effective date: 20131011RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services