Heartport, Inc.

Hearport, Inc.

Other

Alan R Rapacki

Stephen W Boyd

William S Peters

Matthias Vaska

Brian S Donlon

John Henry Stevens

Lee R Bolduc

John B Holds

Valery Rubinchik

Sylvie Sim

Danny Shen

Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

Devices and methods for port-access multivessel coronary artery bypass surgery

Tunneling instrument for port access multivessel coronary artery bypass surgery

Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median stemotomy or other gross thoracotomy to expose the patient's heart, port-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

Device and methods for port-access multivessel coronary artery bypass surgery

Surgical methods and instruments are disclosed for performing port-access or closed-chest coronary artery bypass (CABG) surgery in multivessel coronary artery disease. In contrast to standard open-chest CABG surgery, which requires a median sternotomy or other gross thoracotomy to expose the patient's heart, post-access CABG surgery is performed through small incisions or access ports made through the intercostal spaces between the patient's ribs, resulting in greatly reduced pain and morbidity to the patient. In situ arterial bypass grafts, such as the internal mammary arteries and/or the right gastroepiploic artery, are prepared for grafting by thoracoscopic or laparoscopic takedown techniques. Free grafts, such as a saphenous vein graft or a free arterial graft, can be used to augment the in situ arterial grafts. The graft vessels are anastomosed to the coronary arteries under direct visualization through a cardioscopic microscope inserted through an intercostal access port. Retraction instruments are provided to manipulate the heart within the closed chest of the patient to expose each of the coronary arteries for visualization and anastomosis. Disclosed are a tunneler and an articulated tunneling grasper for rerouting the graft vessels, and a finger-like retractor, a suction cup retractor, a snare retractor and a loop retractor for manipulating the heart. Also disclosed is a port-access topical cooling device for improving myocardial protection during the port-access CABG procedure. An alternate surgical approach using an anterior mediastinotomy is also described.

A surgical instrument comprises a shaft, a clamp support at a distal end of the shaft, and a clamp comprising a pair of pivotally mounted jaws within the clamp support. A handle at a proximal end of the shaft comprises an actuator for both opening and closing the jaws of the clamp and for rotating the jaws of the clamp about a deflected axis defined by the clamp support. The actuator includes a lever and a rotatable wheel which are coupled to the clamp via a flexible drive cable extending through the shaft and clamp support. The device is particularly useful for manipulating and driving curved surgical needles in thoracoscopic, laparoscopic, and other endoscopic suturing procedures.

Apparatus and methods for rotationally deploying needles

Devices and methods for port-access multivessel coronary artery bypass

The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for temporarily occluding a blood vessel in an arterial graft in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a clamp (2) and an introducer (1) for introducing the clamp through a percutaneous penetration into the body cavity and applying the clamp to a tissue structure such as a blood vessel. The clamp has a pair of movable jaws (65, 67) coupled to one another, each jaw having a distal portion for engaging the tissue structure and a proximal portion having a camming surface (66, 68). The introducer has a longitudinal shaft (3) with a clamp engaging member (25) slidably coupled to the distal end of the shaft for releasably holding the clamp. A handle (11) is coupled to the proximal end of the shaft. The handle can be manipulated to axially slide the shaft with respect to the clamp engaging member so that the shaft engages the camming surfaces of the clamp to open and close the distal portions of the jaws without releasing the clamp from the introducer.

Endoscopic vascular clamping system and method

Growing community of inventors

San Francisco, CA, United States of America

Alan R Rapacki