Medcanica, Inc.

Popcab, LLC

Medcania, Inc.

Ralph De La Torre

Matthew A Palmer

Jose Luis Francese

Javier Casta&ntilde;eda

William E Cohn

Javier E Castañeda

A surgical retractor includes a 'swivel' having a string extending from one end and a string extending from the midpoint between the two ends. The swivel is delivered by pushing it out of a tube which is inserted through a small incision between the ribs of the patient. After the swivel is deployed, the tube is removed and the string which is attached to the center of the swivel is pulled to lift the pericardium. When the procedure is complete, the swivel is removed from the patient by pulling the string attached to the end of the swivel. According to one embodiment, the swivel is a cylinder with a blunt conical end. According to another embodiment, the swivel has a sharp end which is covered by a spring loaded collar.

Method for retracting tissue during surgery

An improved surgical port device includes a port body with a tubular section having a distal end. A flexible flange is disposed at the distal end. A retention member is slidably mated along the tubular section such that a distance between the retention member and the flexible flange can be adjusted. In this manner, the position of the retention member with respect to the flexible flange is adjustably fixed to clamp portions of a body wall disposed therebetween, thus effectively clamping the port body in place. The flexible flange has an adaptable diameter that is reduced when the port body passes through a narrow opening in the body wall. Preferably, the flexible flange has a conically-shape that butts up against the inner surface of the body wall during use to thereby provide a seal between the body wall and the frusto-conical flange. It may also have an annular projection that projects radially outward from the conical surface of the flange to provide a drip edge that directs fluids around its periphery and thus prevent fluids from flowing over the projection. This reduces the smearing of optical imaging devices that are disposed in the vicinity of the distal end of the device. The surgical port device of the present invention may also be operated to provide improved fields of view for such optical imaging devices.

Surgical port device

Pericardial retractor

An endoscopic retractor includes a tube having a proximal end and a distal end with a push rod extending therethrough. The proximal ends of the push rod is provided with a threaded portion. A rotatable handle is coupled to the proximal end of the tube and threadably engages the threaded portion of the push rod such that rotation of the handle causes a translation of the push rod. The distal end of the tube is provided with a clevis through which the distal end of the push rod extends. A multi-segment canopy is coupled to the clevis and the push rod via an articulate linkage. Translation of the push rod in the distal direction causes the canopy to be moved from a starting substantially cylindrical configuration with its axis nearly collinear with the axis of the tube to an opened quasi-planar configuration. Further translation of the push rod in the distal direction causes the quasi-planar canopy to be rotated in the clevis to an angle of approximately ninety degrees relative to the axis of the tube.

Endoscopic retractor

A device for holding a blood vessel (and corresponding method of operation) includes a mandrel having a proximal end opposite a distal end. A tube houses a portion of the mandrel. A tip assembly, which is operably coupled to the distal end of the mandrel, comprises a sheath having a tapered portion and a cylindrical portion. The sheath is adapted to be inserted into a lumen of a blood vessel such that an end of the blood vessel is supported by the tapered portion. The elastic nature of the blood vessel holds the end of the blood vessel in place with respect to the tip assembly. The tapered portion includes an exterior surface with a plurality of needle-guide-grooves that extend along such exterior surface. A needle is driven through the blood vessel while being guided by a needle-guide groove such that the needle is driven through the blood vessel near the end of the blood vessel.

Device and method for holding a blood vessel

A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also adapted to be deployed into an open configuration and then manipulated by actuation of a proximal control and actuation handle into a selected orientation.

Through-port heart stabilization system

A port device includes a tubular body sized to be inserted through a pair of ribs in a chest wall of a patient, a ball provided about the body, and a base defining a socket in which the ball is provided. Detent structure permits but limits longitudinal movement of the body relative to the ball. The base includes a clamping system which compresses the ball to lock the ball at a selected orientation within the socket and also immobilizes the port body relative to the ball. The distal end of the body includes a pair of swivels rotatably attached thereto. An obturator is extendable within the body maneuvers the swivels between a closed position (in which the swivels are oriented substantially parallel to the axis of the body), and an open position (in which the swivels are directed outward from the port).

Intercostal lockable directable port device

A system for performing through port off-pump coronary artery bypass surgery includes a port insertable between ribs into a chest wall of a patient, a heart stabilizer extendable through and stably couplable to the port, and an instrument stabilizer adapted to dampen extraneous movement to which a surgical instrument extending through the stabilizer is subject.

System for performing port off-pump beating heart coronary artery bypass surgery

A method for performing through-port off-pump beating heart coronary artery bypass surgery is provided. A port device is positioned in the chest wall and directed as necessary. A heart stabilizer is coupled to the port, and operated to apply a compressive force against the heart wall surrounding a location the required bypass such that the location is substantially immobilized. An instrument stabilizer includes a cannula which is inserted through a hole in the chest cavity, and the distal tip of the cannula is located adjacent the surgical site. The instrument stabilizer dampens movement of a surgical instrument, e.g., a scalpel or needle holder, extended therethrough. Once the bypass procedure is complete, the instruments, heart stabilizer, instrument stabilizers, and port are removed from the body of the patient.

Method of performing port off-pump beating heart coronary artery bypass surgery

A port device is insertable between the ribs of a patient and functions as an entryway for surgical instruments. The port device includes a tubular body having proximal and distal portions. The distal portion of the tubular body is coupled to a swivel adapted to be moved between a first orientation in which the swivel extends in substantially a same direction as the body, and a second orientation at an angle relative to, and preferably substantially perpendicular to, the first orientation. In the second orientation, the swivel engages the inside of the chest wall. The proximal portion of the tubular body has a clamping assembly which clamps the chest wall against the swivels to secure the port in its location. The port body can be anchored in a various angular positions.

Port device for port off-pump beating heart coronary artery bypass surgery system

A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to provide a stabilized area sufficiently large to allow an accurate anastomosis to be performed. According to preferred aspects of the invention, the stabilizer is particularly adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also preferably adapted to be automatically deployed into its final configuration by release of a lock actuated at a proximal portion of stabilizer extending outside the port. In addition, the stabilizer is adapted to automatically fold when being pulled back through the port. According to various embodiments of the heart stabilizer, the feet of the stabilizer may be further adapted to facilitate immobilization of the heart wall between the feet.

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Charlestown, MA, United States of America

Ralph De La Torre