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USRE36043E - Endoscope and method for vein removal - Google Patents

Endoscope and method for vein removal Download PDF

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Publication number
USRE36043E
USRE36043E US08585410 US58541096A USRE36043E US RE36043 E USRE36043 E US RE36043E US 08585410 US08585410 US 08585410 US 58541096 A US58541096 A US 58541096A US RE36043 E USRE36043 E US RE36043E
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vessel
blood
body
tool
section
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US08585410
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David R. Knighton
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Embro Vascular LLC
Maquet Cardiovascular LLC
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Embro Vascular LLC
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00008Vein tendon strippers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00969Surgical instruments, devices or methods, e.g. tourniquets used for transplantation

Abstract

An endoscope for use in harvesting blood vessels includes a scope body of the type having a lumen extending longitudinally therethrough which itself has a proximal and a distal end. The endoscope includes means for viewing an area adjacent the distal end of the lumen, and the lumen has a lateral dimension of a size sufficient to accommodate the blood vessel being harvested and at least one tool for use in harvesting the blood vessel. A first end of the blood vessel section to be harvested is exposed through an incision in the patient's body. A dissecting tool and a gripping tool are inserted through the lumen of the endoscope and used to dissect the blood vessel away from the surrounding connective tissue of the patient's body, using the viewing means of the endoscope to view this dissection in process within the patient's body. Additional tools are provided for use through the lumen of the endoscope to remove body fluids and coagulate bleeding tissue, and to sever side branches from the blood vessel to be harvested, as well as to sever a distal end of the blood vessel to be harvested when a desired length of blood vessel has been dissected. Only a single small incision in the patient's body is necessary to harvest a relatively long length of blood vessel in a precise and controlled manner through endoscopic vision using the inventive endoscope and its related tools.
.Iadd.The questions raised in reexamination request No. 90/004,301, filed Jul. 12, 1996, have been considered and the results thereof are reflected in this reissue patent which constitutes the reexamination certificate required by 35 U.S.C. 307 as provided in 37 CFR 1.570(e). .Iaddend.

Description

BACKGROUND OF THE INVENTION

The present invention relates generally to surgical instruments. In particular, the present invention relates to a method and instrument for harvesting a section of a blood vessel from a patient.

In certain surgical procedures, it is necessary to remove a section of a blood vessel from a patient for use in another part of the patient's body or for transplanting into a second patient's body. For example, a section of the saphenous vein may be removed for use in coronary bypass surgery. Previously, it has been necessary to make an incision along the full length of the vein section to be removed. The vein is then freed by severing and ligating the branches of the vein, after which the section of the vein can be removed from the patient. The full length incision must then be closed, for example by suturing or staples. Obviously, the harvesting of the vein in this manner leaves disfiguring scars which are cosmetically undesirable. Additionally, the large incision creates a risk of infection to the patient and may not heal properly, especially with those patients who have poor circulation in their extremities. Such an incision may create a chronic wound which will not heal.

Devices for harvesting a section of a blood vessel without creating a full length incision have been suggested. U.S. Pat. No. 4,793,346 to Mindich discloses a device for harvesting a section of a blood vessel by making only small incisions at opposite ends of the blood vessel section. The device includes a guide rod which fits inside of the vein section and a tube having an inner diameter slightly larger than the outer diameter of the vein section to be harvested. The tube has one or more knife blades at the leading edge which are connected to an electrical supply. The vein section is removed by making the incision sufficiently deep so as to expose the ends of the blood vessel section to be harvested. The blood vessel is cut to expose one end, the guide rod is inserted inside the blood vessel section, and the tube is placed over the end of the blood vessel section to be removed. The tube is then pushed along the blood vessel (into the patient) while rotating the tube to sever the branches of the blood vessel with the knife blades mounted at the leading edge of the tube. Electrical current is supplied to the knife blades to heat the blades and thereby cauterize the ends of the severed branches of the blood vessel. The procedure is continued until the tube has reached the second of the two incisions. The blood vessel is exposed and cut from the patient at the second incision, and the tube is then removed from the patient with the blood vessel section inside of the tube. The blood vessel section is then removed from the tube for further treatment and used as desired.

UK Patent Application GB 20 82 459A discloses a device for harvesting a section of a blood vessel similar to that disclosed in the Mindich patent. Again, two incisions are made, one at each end of the blood vessel section to be harvested. A guide rod is inserted into the blood vessel section through one of the incisions and a tube having a cutting element at its operative end is passed over the blood vessel section and guide rod assembly. The tube is rotated as it passes over the blood vessel section to sever the connecting branches. After the tube has passed the entire length of the blood vessel section, the section is cut away through the second incision and the tube is removed from the patient with the harvested section inside the tube.

The blood vessel harvesting devices of the prior art have certain distinct disadvantages. While the prior art devices eliminate the need for a full length incision to remove the blood vessel segment, two incisions, one at each end of the segment to be harvested, are required in order to remove the blood vessel segment. For patients likely to develop chronic wounds, each additional incision increases the risk to the patient, and it is desirable to keep such incisions as close to the patient's trunk as possible and to minimize the number and size of such incisions. Additionally, the prior art devices do not allow for the viewing of the dissection of the blood vessel segment. The physician operating the removal device is unable to see the progression of the dissection and must rely on the guide rod inserted within the blood vessel to guide the cutting instrument in the proper direction. The inability to view the dissection directly increases the risk of damaging the blood vessel segment and the risk of causing injury to the patient.

In addition, it is critical that the segment of blood vessel being harvested is handled with great care since it is destined for reuse (e.g., as an arterial bypass). The blind insertion of a guide rod into the blood vessel damages and likely destroys the endothelium of the vessel. The prior art devices also have the disadvantage of being unable to adequately close off severed branches of the blood vessel and thus are unable to adequately control bleeding. As a result, the patient suffers greater blood loss than is necessary. The prior art devices also may remove more tissue than is necessary because the size of the cutting device is not readily adaptable to changes in the size of the blood vessel.

There is a need for an efficient and effective means for harvesting a section of a blood vessel from the body of a patient. Specifically, there is a need for a device that does not require insertion of any component within the vessel being harvested, and that allows direct viewing of the dissection of the blood vessel segment while at the same time minimizing the size of the incision into the patient's body. Such a device would allow the physician to be much more precise in this procedure, minimize the risk of the patient developing a chronic wound that will not heal, minimize the amount of scarring to the patient's body and maintain the internal integrity of the blood vessel being harvested.

SUMMARY OF THE INVENTION

The present invention is a device and method for harvesting a section of a blood vessel from a patient's body. The invention includes an endoscope of the type having a scope body with a lumen extending longitudinally therethrough, with the lumen having a proximal end and a distal end. The endoscope includes means for viewing an area adjacent to the distal end of the lumen. The lumen has a lateral dimension of size sufficient to accommodate a blood vessel and at least one tool for use in harvesting the blood vessel.

This endoscope for harvesting a blood vessel is relatively uncomplicated. The endoscope allows a section of a blood vessel to be removed by making only a small incision at one end of the blood vessel section to be harvested. The incision exposes a first end of the blood vessel section to be harvested and the first end is inserted through the lumen of the endoscope. The blood vessel is then dissected away from surrounding connective tissue of the patient's body with a dissecting tool inserted through the lumen of the endoscope, using the viewing means to view the dissection in process as the endoscope is advanced along the blood vessel into the patient's body.

In one preferred embodiment, the endoscope is used with a tool for ligating and cutting branches of the blood vessel segment or a second end of the blood vessel segment. The tool has a distal operative tip with means on the distal tip for applying a ligation clip to a section of the blood vessel specimen which is to be sealed. There are also means on the distal tip for cutting the blood vessel segment between the clip and the first end of the blood vessel segment. The tool eliminates the requirement of making a second incision at the second end of the blood vessel segment to cut the blood vessel segment at the second end so that it may be removed.

The endoscope is ideally suited for patients likely to develop chronic wounds, such as diabetics or other persons with poor circulation, because only one small incision is required to remove the blood vessel segment. The endoscope also allows the physician to directly view the dissection of the blood vessel segment. The ability to directly view the dissection allows the physician to conduct the vessel harvesting procedure much more efficiently and precisely, minimizing the risk of damage the blood vessel and minimizing the risk of injury to the patient.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will further be described with reference to the accompanying drawings where like numbers refer to like parts in several views, and wherein:

FIG. 1 is a perspective view of the inventive endoscope and some related tools, along with a portion of a patient's leg;

FIG. 2 is a side elevational view of a dissecting tool of the present invention, with its distal end enlarged in perspective;

FIG. 3 is a side elevational view of a gripping tool of the present invention, with its distal end enlarged in perspective;

FIG. 4 is a side elevational view of a ligation-cutting tool of the present invention, with its distal end shown enlarged in perspective;

FIG. 4A is a top plan view of the distal end of the ligation-cutting tool of FIG. 4;

FIG. 4B is a side elevational view of the distal end of the ligation-cutting tool of FIG. 4;

FIG. 5 is a side elevational view of a side-biting ligation-cutting tool of the present invention, with its distal end enlarged in perspective;

FIG. 6 is a side elevational view of a suction-coagulator tool of the present invention;

FIG. 7 is an enlarged perspective view of the endoscope of the present invention;

FIG. 8 is a perspective view of the endoscope of the present invention, showing its two-part assembly;

FIGS. 9-13 are enlarged perspective illustrations showing the distal end of the inventive endoscope and the tools of FIGS. 2-6 in use during the harvesting of a blood vessel; and

FIG. 14 illustrates the partial removal of a partially dissected blood vessel through a second incision, when a long continuous segment of blood vessel is desired to be dissected from the patient's body.

While the above-identified drawing figures set forth one preferred embodiment of the invention, other embodiments are also contemplated, as noted in the discussion. In all cases, this disclosure presents the present invention by way of representation and not limitation. It should be understood that numerous other modifications and embodiments can be devised by those skilled in the art which fall within the scope and spirit of the principles of this invention. It should be specifically noted that the figures have not been drawn to scale as it has been necessary to enlarge certain portions for clarity.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention is a device and method for harvesting a section of a vessel from a patient's body for use in another part of the patient's body or for transplanting into a second patient's body. For example, a section of the saphenous vein may be removed for use in coronary bypass surgery. The blood vessel needs to be removed without undue damage to the blood vessel, as well as with minimal damage and trauma to the patient. Although the description herein is directed to the harvesting of the saphenous vein, it is contemplated that the present invention be used in connection with the efficient and effective harvesting of the other lumens and vessels from a patient's body.

THE TOOLS

In FIG. 1, a saphenous vein 20 (shown in phantom) and endoscope 30 are shown. The saphenous vein 20 travels along the medial side of the foot, leg, and thigh, where it joins with the femoral vein near the groin.

When used to harvest a blood vessel, the endoscope 30 is used in conjunction with several tools. A dissecting tool 100 (FIG. 2) is used to separate the blood vessel from the surrounding connective tissue. A gripping forceps 150 (FIG. 3) is used by the physician to hold the blood vessel 20 during the procedure. A ligation-cutting tool 200 (FIG. 4) is used when severing side branches 22 from the blood vessel 20. A side-biting ligation-cutting tool 250 (FIG. 5) is used to transect the blood vessel 20 when the dissection is completed. Finally, a suction-coagulator tool 300 (FIG. 6) is used to control bleeding during the procedure. Each of these tools is described in detail in the succeeding discussions.

As illustrated in FIGS. 1 and 7, the endoscope 30 includes an elongated scope body 34 and a handle 36. A lumen 38 extends longitudinally through the scope body 34 and has a cross-sectional shape which is substantially elliptical. The lumen 38 is of a size large enough to accommodate the blood vessel 20 which is to be harvested and one or more of the tools 100, 150, 200, 250 and 300 longitudinally therein. In one embodiment, the size of the lumen 38 in the scope body 34 is 2 cm wide by 1 cm deep in an elliptical shape, while the scope body 34 itself is 30 to 90 centimeters long. Each of the tools is at least 2 cm longer than the scope body 34. As illustrated in FIG. 8, the scope body 34 of the endoscope 30 is selectively securable to the handle 36. The scope body 34 can thus be made as a disposable unit to eliminate problems with re-sterilization of the portion of the endoscope 30 that enters the patient's body. After use, the endoscope is disassembled, the scope body 34 disposed of, and the handle 36 (containing power connections, lighting means, etc.) saved for repeated use with a new scope body. Alternatively, the scope body has a longitudinal channel therein for reception of the viewing and illumination portions of the endoscope, so that those components are reused while the scope body is disposed after each use. The scope body is provided in a variety of lengths and sizes (cross-sectional) to accommodate patients of different sizes and different blood vessel lengths.

As seen in FIG. 7, fiber optics illumination source 40 and a fiber optics viewing device 42 are located at the distal end of the endoscope 30 and positioned adjacent each other such that the area immediately adjacent the distal end of endoscope 30 can be illuminated and viewed by the physician. When connected to the handle 36, the source 40 is operably connected to an external light source 43 by a suitable light transmission conduit 44 which extends through the endoscope 30. Similarly, the viewing device 42 is operably connected to an external monitor 45 by a suitable image transmission conduit 46 which extends through the endoscope 30. The physician views the area adjacent the distal end of endoscope 30 using the illumination source 40 and the viewing device 42 by use of the viewing monitor 45 (FIG. 1) which is connected to the endoscope handle 36 through the conduit 46. The monitor 45 may take several forms, such as a television monitor or an eye-piece worn by the physician, as is conventional. The endoscope body 34 also has an irrigation channel 48 extending therethrough. The irrigation channel is operably coupled to an external source of irrigant 49 via a suitable conduit 50. A distal open end of the irrigation channel is positioned adjacent the distal ends of the fiber-optic illumination source 40 and the viewing device 42, as seen in FIG. 1.

Each of the tools 100, 150, 200, 250 and 300 to be used with the endoscope 30 are of a size small enough to fit through the lumen 38 of the scope body 34 while a blood vessel 20 is also in the lumen 38. The tools 100, 150, 200, 250 and 300 are also long enough to allow the physician to comfortably manipulate them through the lumen 38 (i.e., the tools 100, 150, 200, 250 and 300 are longer than the lumen 38).

The dissecting tool 100 (FIG. 2) is used to aid in separating the vessel being harvested from the surrounding tissue. The dissection tool 100 has an elongated shaft 105, with a handle 106 attached to the proximal end of the shaft 105 and an annular dissecting ring 110 attached to the distal end of shaft 105. The dissecting ring 110 is oriented such that a plane defined by the dissecting ring 110 is generally perpendicular to the longitudinal axis of the shaft 105. The size of dissecting ring 110 is large enough to fit over the exterior of the blood vessel 20. The dissecting ring 110 has a rounded distal edge 112 used to separate the blood vessel 20 from the surrounding connective tissue as the dissecting tool 100 is advanced over the blood vessel 20. The dissecting tool 100 is provided in a plurality of sizes for different sizes of blood vessels. Typical sizes for such tools would have inside diameters of 4 mm, 5 mm, and 6 mm.

The gripping tool 150 (FIG. 3) is used to hold and retain the vessel being harvested during the procedure. The gripping tool 150 has an elongated shaft 155, with a handle 156 attached to a proximal end of the shaft 155 and a gripping mechanism 160 attached to a distal end of the shaft 155. The handle 156 is preferably a scissors-type handle to actuate the gripping mechanism 160 at the distal end of the body 158 and includes a latching mechanism 157 which allows the gripping mechanism to be locked in a set position (e.g., in a "gripping" position). The shaft 155 transmits the actuating movement from the handle 156 to the gripping mechanism 160. The gripping mechanism 160 includes a first jaw 162 and a second jaw 164 which oppose each other. When the gripping handle 156 is operated by the physician, the first jaw 162 and the second jaw 164 are moved toward each other and may be used to grip the blood vessel 20 between gripping surfaces 166 and 168 thereon. The jaws 162 and 164 are small enough to fit through the dissecting ring 110 on the dissecting tool 100.

The ligation-cutting tool 200 (FIGS. 4, 4A and 4B) is used to sever and seal side branches on the vessel being harvested. The ligation-cutting tool 200 has an elongated shaft 201, with a ligation clip applicator 202 and a cutting mechanism 204 at the distal end of the shaft 201. The ligation clip applicator 202 includes a first yoke 208 and a second opposed yoke 210. Each yoke 208 and 210 is in turn divided into two sections; each yoke 208 and 210 is forked at its distal end, forming two opposed prongs 212A and 212B on the yokes 208 and 210, respectively. The prongs 212A and 212B on yokes 208 and 210 are parallel to each other and generally aligned with the longitudinal axis of the ligation-cutting tool 200. The yoke 208 and 210 and the prongs 212A and 212B thereon oppose each other and serve to apply ligation clips 216 (see FIGS. 4A and 4B) to a side branch 22 being severed. The opposing prongs 212A and 212B of each yoke 208 and 210 contain grooves 214A and 214B, respectively, to securely hold a ligation clip 216 therein. When the ligation clips 216 are thus held between the opposing prongs 212A and 212B of yokes 208 and 210, the generally U-shaped ligation clips 216 aid the physician in properly aligning the ligation-cutting tool 200 and the side branch 22 to be ligated by providing an abutment for the side branch 22 when the side branch 22 is positioned between the yokes 208 and 210. When the yokes 208 and 210 are biased towards each other in a conventional manner, the ligation clips 216 are deformed to clamp onto the side branch 22 therebetween and the blood flow through the side branch 22 is halted at two slightly spaced apart points (e.g., two clips are applied approximately 0.25 inches apart). When the ligation clip applicator 202 is activated and the yokes 208 and 210 clamp the ligation clips 216 onto the side branch 22, the side branch 22 is also held securely for cutting the side branch 22.

The cutting mechanism 204 on the ligation-cutting tool 200 includes a cutting blade 230 aligned between the prongs 212A and 212B and proximal to the ligation clips 216. The cutting blade 230 is normally retracted (as seen in FIGS. 4, 4A and 4B) to allow the side branch 22 to be positioned properly between the yokes 208 and 210. A cutting edge 232 of the blade 230 faces the distal end of the ligation-cutting tool 200, and the cutting motion of the blade 230 is in a distal direction (e.g., towards the side branch 22). The blade 230 is wide enough to completely sever the side branch 22 between the two yokes 208 and 210. The cutting mechanism 204 is activated by the physician (as described below) after the side branch 22 has been ligated (i.e., the side branch 22 has been clipped shut and blood flow halted) and while the side branch is still held securely in the yokes 208 and 210. After the blade 230 has severed the side branch 22, the blade 230 returns into its original retracted position.

The ligation clip applicator 202 and the cutting mechanism 204 are both actuated by mechanisms at the proximal end of the shaft 201 of the ligation-cutting tool 200. The ligation clip applicator 202 is preferably actuated by a scissors-type handle 220. By squeezing the scissors-type handle 220, the physician causes each set of prongs 212A and 212B on the yokes 208 and 210 to be moved together, thereby compressing their respective ligation clips 216 about the side branch 22 of the blood vessel 20, as described above. The scissors-type handle 220 includes a latching mechanism 222 which serves to secure the handle 220 and thus the ligation clip applicator 202 in a closed or clamped position. While the ligation clip applicator 202 is held in a clamped position, the cutting mechanism 204 is actuated, preferably by a plunger 224 located at the proximal end of the ligation-cutting tool 200. The plunger 224 is operably connected to the cutting blade 230, and biased proximally to urge the blade 230 into its normally retracted position. By moving the plunger 224 distally, the physician causes the cutting blade 230 to likewise move distally and cut the side branch 22 of the blood vessel 20 which is retained between the yokes 208 and 210. When the physician releases the plunger 224, the plunger 224 (and thus the cutting blade 230) retracts to its original position. Manipulation of the handle 220 then separates the prongs 212A and 212B, leaving the clip in place on the severed portions of the side branch 22, and the ligation-cutting tool 200 is removed or relocated for reuse (the clips may be fed into place in the grooves of the prongs from a suitable clip magazine (not shown) to enable multiple ligations without removing the tool from the body).

The shaft 201 of the ligation-cutting tool 200 is a slender member that is longer than the lumen 38 of the endoscope 30. A housing 209 covers those mechanisms on the shaft 201 that transmit the manipulations of the handle 220 and the plunger 224 at the proximal end of the ligation-cutting tool 200 to the clipping and cutting motions, respectively, at the distal end of the ligation-cutting tool 200.

The side biting ligation-cutting tool 250 (FIG. 5) is used to sever and seal the distal end of the vessel being harvested. The side-biting ligation-cutting tool 250 is identical in operation to the ligation tool 200, except that the operative components at the distal end of the tool 250 are oriented generally normally to the axis of the tool 250. As seen in FIG. 5, the side biting ligation-cutting tool 250 has an elongated shaft 251, with a ligation clip applicator 252 and a cutting mechanism 254 at the distal end of shaft 251. The ligation clip applicator 252 includes a first yoke 258 and a second, opposed yoke 260. Each yoke in turn is forked at its distal end, forming two opposed prongs 262A and 262B, respectively. The prongs are aligned generally parallel and each has inner grooves 264 to retain ligation clips between each opposed pair of prongs 262A and 262B. The structure and operation of the ligation clip applicator 252 is similar to that illustrated in FIGS. 4A and 4B for the ligation-cutting tool 200.

The yokes 258 and 260 and the prongs 262A and 262B thereon oppose each other and serve to apply ligation clips (not shown in FIG. 5) to the distal end of the segment of the blood vessel being severed. When the ligation clips are thus held between the opposing prongs 262A and 262B of yokes 258 and 260, the generally U-shaped ligation clips aid in positioning and properly aligning the side biting ligation-cutting tool 250 and the blood vessel to be transected by providing an abutment for the blood vessel when the blood vessel is positioned between the yokes 258 and 260. When the yokes 258 and 260 are moved towards each other, the ligation clips are clamped onto the blood vessel therebetween and the blood flow through the blood vessel is halted at two slightly spaced-apart points (e.g., two clips are applied approximately 0.25 inches apart). When the ligation clip applicator 252 is activated and the yokes 258 and 260 clamp the ligation clips onto the blood vessel, the blood vessel is also held securely for cutting the blood vessel.

The cutting mechanism 254 on the side biting ligation cutting tool 250 includes a cutting blade 280 aligned between the prongs 262A and 262B. Again, the structure of the cutting mechanism for the tool 250 is quite similar to that illustrated in FIGS. 4A and 4B for the ligation-cutting tool 200. The blade 280 is positioned such that a cutting edge 282 of the blade 280 does not interfere with the alignment of the blood vessel between the yokes 258 and 260. The cutting blade 280 is normally retracted (as seen in FIG. 5) to allow the blood vessel to be positioned properly between the yokes 258 and 260. The cutting edge 282 of the blade 280 faces in a transverse direction from the shaft 251 of the side biting ligation-cutting tool 250, and the cutting motion of the blade 280 is in a transverse direction (e.g., toward the blood vessel). The blade 280 is wide enough to complete sever the blood vessel between the two yokes 258 and 260. The cutting mechanism 254 is activated after the blood vessel has been ligated (i.e., the blood vessel has been clipped shut and blood flow halted) and while the blood vessel is still held securely in the yokes 258 and 260. After the blade 280 has severed the blood vessel, the blade 280 returns to its original retracted position.

The primary difference between the tool 200 and tool 250 is that the distal operative portion of the tool 250 is oriented at an angle generally ninety degrees opposed to the axis of the shaft 251 of the tool 250. The yokes 258 and 260 are thus oriented to straddle a blood vessel extending generally parallel to the shaft 251 to apply ligation clips thereto. After clips are applied, the yokes continue to hold the blood vessel to permit severing of the vessel using the blade 280. Other than the revision in orientation of the distal portion of the ligation-cutting tool 250, it operates in the same manner as the ligation-cutting tool 200.

The ligation clip applicator 252 and the cutting mechanism 254 are both actuated by mechanisms at the proximal end of the shaft 251 of the ligation-cutting tool 250. The ligation clip applicator 252 is preferably actuated by a scissors-type handle 270. Squeezing of the scissors-type handle 270 causes each pair of prongs 262A and 262B on the yokes 258 and 260 to move together, thereby compressing their respective ligation clips about the blood vessel. The scissors-type handle 270 includes a latching mechanism 272 which serves to secure the handle 270 and thus the ligation clip applicator 252 in a closed or clamped position. While the ligation clip applicator is held in a clamped position, the cutting mechanism 254 is actuated, preferably by a plunger 274 located at the proximal end of the ligation-cutting tool 250. The plunger 274 is operably connected to the cutting blade 280, and biased proximally to urge the blade 280 into its normally retracted position. By moving the plunger 274 distally, the physician causes the cutting blade 280 to likewise move distally and cut the blood vessel which is retained between the yokes 258 and 260. When the physician releases the plunger 274, the plunger 274 (and thus the cutting blade 280) retracts to its original position. Manipulation of the handle 270 then separates the prongs 262A and 262B, leaving the clips in place on the severed portions of the blood vessel, and the ligation cutting tool 250 is removed.

The shaft 251 of the side biting ligation-cutting tool 250 is a slender member that is longer than the lumen 38 of the endoscope 30. A housing 259 covers those mechanisms on the shaft 251 that transmit the manipulations of the handle 270 and the plunger 274 at the proximal end of the side biting ligation-cutting tool 250 to the clipping and cutting motions, respectively, at the distal end of the side biting ligation-cutting tool 250.

The suction-coagulator tool 300 (FIG. 6) is used to remove body fluids (e.g., blood) and reduce bleeding during the vessel harvesting procedure, and is of the type generally known in the art for this procedure. The suction-coagulator tool 300 has an elongated shaft 301 and includes a handle 310 attached to the proximal end of shaft 301. A suction tube 302 is attached to the proximal end of shaft 301 and extends to the distal end of shaft 301. At the distal end of shaft 301 the suction tube 302 is open for suctioning body fluids. Also attached to the proximal end of shaft 301 is a power cable 304 for supplying power for tissue coagulation. When button 308 on handle 310 is activated, the power is supplied to the distal end of shaft 301 to cauterize bleeding tissue, and thus to stop bleeding. The suction-coagulator tool 300 controls bleeding in two ways. The suction tube 302 may be used alone to suction any body fluids from the dissection area, or the coagulator may be used to cauterize the bleeding tissue.

METHOD OF USE

The endoscope 30 and accompanying tools 100, 150, 200, 250 and 300 are used in combination for harvesting a vessel. After proper preparation of the incision site, the physician makes a small incision 350 (e.g., 3 cm long) over the proximal aspect of the blood vessel to be harvested (see FIGS. 1 and 9). The blood vessel 20 is exposed and dissected for a short length under direct vision. As seen in FIG. 9, the blood vessel 20 is then severed to expose a free end 352 and a free end 353 (which may be clipped as shown in FIG. 9). For example, to remove a saphenous vein, the incision 350 will be made at the groin over the saphenous vein and the vein will be dissected free from the junction of the common femoral vein. As shown in FIGS. 1 and 9, the gripping forceps 150 is inserted through the dissecting ring 110 of the dissecting tool 100, and the assembly of the dissecting tool 100 and the gripping forceps 150 is inserted through the lumen 38 of the endoscope 30 such that the distal ends of the dissecting tool 100 and gripping forceps 150 extend beyond the distal end of the lumen 38. The physician then grasps the free end 352 of the blood vessel 20 with the gripping forceps 150 and holds it under tension. The dissecting tool 100 is then advanced distally (together with the endoscope 30) over the distal end of the gripping forceps 150 and over the blood vessel 20. As the dissecting tool 100 is manipulated by the physician, the blood vessel 20 is dissected away from the surrounding connective tissue.

As illustrated in FIG. 10 (which has a portion of the patient's body broken away to show the invention in operation), the dissection process proceeds distally along the blood vessel 20, and the endoscope 30 is advanced along with the dissecting tool 100 into the incision 350. Until this point, the physician has been viewing the procedure under direct vision. Now, the physician switches to viewing the dissection process (occurring at the area immediately adjacent the distal end of the lumen 38) through the fiber optic viewing device 42 located at the distal end of the scope body 34 of the endoscope 30. The illumination source 40 provides adequate lighting for the physician to view the dissection and tool operations occurring within the patient via the monitor. Irrigant is introduced as necessary through the irrigation channel 48 of the endoscope 30 to keep blood or other body tissue from obscuring vision adjacent the distal end of the scope body 34 of the endoscope.

As the dissection tool 100 is advanced along the blood vessel 20, a side branch 22 of the blood vessel 20 may be encountered before the desired length of blood vessel 20 has been dissected. When the physician reaches a side branch 22 before obtaining the desired length of blood vessel 20, the ligation-cutting tool 200 is employed to sever the side branch 22 from the vessel being harvested (blood vessel 20).

When a side branch 22 is reached, the physician stops advancing the dissecting tool 100 and endoscope 30 and, if necessary, withdraws the dissecting tool 100 proximally from the side branch 22 to provide room for operation of the ligation-cutting tool 200. The ligation-cutting tool 200 is inserted into the proximal end of the lumen 38 and advanced distally through the lumen 38 and into the area distal of the scope body 34 of the endoscope 30. Using the illumination source 40 and the viewing device 42, the physician positions the ligation-cutting tool 200 over the side branch 22 such that the side branch 22 is sitting in the yokes 208 and 210 (see FIG. 11). The physician then manipulates the handle 220 of the ligation-cutting tool 200 to actuate the ligation clip applicator 202. As the prongs 212A and 212B on each of the yokes 208 and 210 move toward each other, the ligation clips 216 are clamped about the side branch 22, thereby stopping blood flow through the side branch 22.

While the side branch 22 is held securely between the yokes 208 and 210 of the ligation clip applicator 202, the physician pushes the plunger 224 to activate the cutting mechanism 204. As shown in FIG. 12, the cutting blade 230 thus moves distally into and through the side branch 22, thereby severing the side branch 22 from the blood vessel 20 between the ligation clips 216. When the plunger 224 is released by the physician, the cutting blade 230 returns to its original retracted position. The handle 220 is then manipulated to separate the prongs 212A and 212B, and the ligation-cutting tool 200 is withdrawn proximally through the lumen 38 of the endoscope 30. The ligation-cutting tool 200 may then be prepared to be used again later in the procedure (i.e., reloaded with additional clips 216), if required.

After the ligation-cutting tool 200 has been removed from the endoscope, the dissecting tool 100 and endoscope 30 are again advanced distally along the blood vessel 20 (as previously described) until another side branch is reached. In this regard, the dissecting ring 110 is large enough to pass over the clipped and severed stumps of any side branches 22 which extend from the blood vessel 20. The ligation-cutting tool 200 is then used as previously described to sever additional side branches from the blood vessel 20. The procedure is repeated until the desired length of blood vessel 20 has been dissected free from the surrounding tissue and side branches. During the dissection procedure, the suction-coagulator tool 300 is used as required to control bleeding, again under the constant vigilance of the physician through the endoscope 30. During the entire procedure, the blood vessel 20 has been held in tension by the physician via the gripping tool 150. In addition, as more and more of the blood vessel 20 becomes dissected, the endoscope 30 is advanced distally into the patient's body and the blood vessel 20 is moved into the lumen 38 of the scope body 34.

When the desired length of blood vessel 20 has been dissected free from the surrounding connective tissue, the dissecting tool 100 is moved proximally away from the distal end of the dissected segment, and the side-biting ligation-cutting tool 250 is inserted into the proximal end of the lumen 38 and advanced distally through the lumen 38 into the area adjacent the distal end of the scope body 34 and the distal end of the dissected blood vessel 20. The side-biting ligation-cutting tool 250 is positioned such that the blood vessel 20 is between the first yoke 258 and the second yoke 260 of the ligation clip applicator 252. When the blood vessel 20 is properly positioned between yokes 258 and 260, the physician manipulates the handle 270 to actuate the ligation clip applicator 252. As the yokes 258 and 260 move toward each other, the yokes 258 and 260 act to pinch the ligation clips 266 over the distal end of the dissected blood vessel 20 (thus stopping blood flow through the blood vessel 20). While the blood vessel 20 is held securely by the ligation clip applicator 252, the physician pushes the plunger 274 to activate the cutting mechanism 254. The cutting blade 280 advances between the ligation clips 266 and through the blood vessel 20 to sever the blood vessel 20 into a freed section 360 having free end 352 (FIG. 10) and a free end 361 (FIG. 13) and a remaining section 362. When the plunger 274 is released by the physician, the cutting blade 280 returns to its retracted position. The handle 270 is manipulated to separate the prongs 262A and 262B, and the side-biting ligation-cutting tool 250 is withdrawn proximally through the lumen 38 of the endoscope 30. The tool 250 may apply ligation clips on sections 360 and 362, or just one clip on the remaining section 362 of the blood vessel 20.

The freed section 360 of the blood vessel 20 is now free of all connections to the patient's body and is substantially within the lumen 38 of the endoscope 30. While gripping the now dissected blood vessel 20 with the gripping forceps 150, the physician may simultaneously remove the scope body 34 of the endoscope 30 and the enclosed segment of blood vessel 20 from the body of the patient. After the endoscope 30 and freed section 360 of blood vessel 20 are removed from the patient, the physician closes the incision 350 in the patient's body to complete the vessel harvesting procedure. The freed section 360 of the blood vessel 20 may then be removed from the lumen 38 of the endoscope 30 and prepared for its intended end use. The vessel harvesting procedure has been accomplished with only a single small incision, yet the physician can see the entire working portion of the procedure for manipulation of the tools to accomplish dissection, ligation and severing of the freed section 360 of the blood vessel 20. This results in less trauma to the patient than was previously attainable, with a much more precise and efficient procedure, both in terms of affecting the tissue surrounding the dissected vessel, and in terms of the timing and control of the procedure by the physician.

Occasionally, it is desired to remove a continuous length of a blood vessel that is longer than the scope body of the inventive endoscope. In this instance, the physician is unable to advance the endoscope and its related tools far enough from the original small incision into the patient to harvest a segment of the desired length. If no endoscope scope body is long enough to harvest a blood vessel segment of the desired length, the physician may make a second incision in the patient adjacent that point on the blood vessel where the dissection has reached via the use of the endoscope and related tools through the first incision. This is illustrated in FIG. 14.

FIG. 14 illustrates a portion of a patient's leg. A first incision 350 has been made in the patient and the blood vessel 20 severed to create free ends 353 and 352. A portion of the desired segment of the blood vessel (to the left of the incision 350 in FIG. 14) has been dissected, ligated and clipped from the surrounding tissue and side branches 22, using the inventive endoscope and tools in a manner as discussed above. The desired segment of the blood vessel (designated as segment 400 in FIG. 14) is not severed using the side-biting ligation-cutting tool 250 through the scope body 34 of the endoscope 30. Instead, a second incision 450 is made in the patient adjacent that point where the dissection of the blood vessel 20 has reached. This second incision thus exposes that portion of the blood vessel 20 which has been dissected from the surrounding connective tissue of the patient's body (segment 400). The physician releases the free end 352 of the blood vessel 20 (which has been continually held by the gripping forceps 150) and proximally withdraws the endoscope 30 and all of its associated tools which are still in the patient's body. Working through the second incision 450, the physician then grips the exposed portion of the blood vessel 20 and pulls the dissected segment 400 of the blood vessel 20 through the second incision, in direction of arrow 455 as illustrated in FIG. 14.

Once the entire dissected segment 400 has been pulled out of the patient through the second incision 450, further dissection of the remaining portion of the blood vessel 20 within the patient can continue using the inventive tools and method. As previously described, the gripping forceps 150 is inserted through the dissecting ring 110 of the dissecting tool 100 and the assembly of the dissecting tool 100 and the gripping forceps 150 is inserted into the proximal end of the lumen 38 and advanced distally through the lumen 38. The gripping forceps 150 is again used to hold the free end 352 of the segment 400 of the blood vessel 20 during the continued procedure. The endoscope 30 and dissecting tool 100 are distally advanced over the blood vessel 20 and into the patient's body through the second incision 450. The physician then continues to dissect the blood vessel 20 away from the surrounding connective tissue with the dissecting tool 100, ligating and severing side branches 22 as they are encountered using the ligation-cutting tool 150. The suction-coagulator tool 300 is also used as necessary during continued dissection and side branch severing. This process may be repeated until the desired length of blood vessel 20 has been harvested. At this point, the side-biting ligation-cutting tool 250 is employed through the second incision 450 and endoscope 30 to sever the blood vessel 20 from the patient in the desired length. The severed blood vessel is then withdrawn, along with the endoscope 30 and any related tools remaining within the patient, from the patient through the second incision 450. The severed blood vessel is removed from the endoscope and then treated as necessary for further use. The incisions 350 and 450 are then closed up, with minimal trauma to the patient. For instance, a two-step vessel harvesting procedure such as illustrated in FIG. 14 may result in the harvesting of a vessel as long as twelve to fifteen inches, with only two separate 3 cm long incisions made in the patient's skin. The entire procedure, as conducted using the inventive endoscope and its related tools, has been conducted under direct vision or endoscopic vision by the physician and is thus much more effective, efficient and elegant than prior vessel harvesting techniques.

CONCLUSION

The present invention permits a discrete segment of a blood vessel to be harvested with only a small incision in the body of a patient (or more than one small incision if a very long segment is desired). The inventive endoscope and its unique tools eliminate the need for a full length incision along the length of the blood vessel in order to harvest a segment of the blood vessel. Use of the inventive endoscope and tools eliminates the need for a second incision at the distal end of the desired segment of the blood vessel in order to sever the desired segment from the patient's body, and also allows vessel harvesting with a relatively small incision. Proximal incisions heal easier and more readily than distal incisions in most patients, and particularly for those with poor circulation in their extremities. The illumination source and the viewing device of the inventive endoscope allow the physician to directly view the dissection in process, which results in a very precise and controlled dissection of the blood vessel. At the same time, the use of the ligation-cutting tool and the side-biting ligation-cutting tool allows the physician to control bleeding by cutting and sealing off side branches to the blood vessel and the vessel itself in a secure and permanent manner. Nothing is inserted within the blood vessel being harvested during the procedure, so vessel integrity is maintained. Accordingly, undesired trauma to the vessel being harvested and to its surrounding connective tissue is minimized.

Although the present invention has been described with reference to preferred embodiments, workers skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.

Claims (23)

What is claimed:
1. A method of harvesting a section of a vessel from a patient's body as living tissue for use in a different environment of the patient's body comprising:
providing an endoscope of the type having a scope body with a lumen extending longitudinally therethrough, with the lumen having a proximal end and a distal end, and means for viewing an area adjacent the distal end of the lumen, the lumen having a lateral dimension of size sufficient to accommodate the vessel and a tool for use in harvesting the vessel;
exposing a first end of the vessel section to be harvested through an incision in the patient's body;
gripping the first end with a gripping tool that has been inserted through the lumen of the endoscope; and
dissecting the vessel away from surrounding connective tissue of the patient's body with a dissecting tool inserted through the lumen of the endoscope, using the viewing means to view the dissection in process.Iadd.;
cutting the vessel at proximal and distal ends of the vessel section; and
removing the vessel section from the patient's body, the steps of exposing, gripping, dissecting, cutting and removing being performed in a manner that minimizes damage to the endothelium of the vessel.Iaddend..
2. The method of harvesting a vessel according to claim 1, including:
advancing the endoscope and the dissecting tool along the vessel until a side branch of the vessel is encountered.
3. The method of harvesting a vessel according to claim 2, including:
applying a ligation member to the branch and cutting the branch between the vessel and the ligation member with a ligating-cutting tool inserted through the lumen.
4. The method of harvesting a vessel according to claim 3, including:
repeating the advancing and applying steps until the endoscope is fully inserted or a desired length of the vessel is reached.
5. The method of harvesting a vessel according to claim 1, including:
controlling bleeding as necessary with a bleeding control tool inserted through the lumen.
6. The method of harvesting a vessel according to claim 1, including:
ligating and cutting the distal end of the vessel with a transecting tool inserted through the lumen, allowing a segment of the vessel to be removed without making a second incision in the patient's body.
7. The method of harvesting a vessel according to claim 1, including:
making a second incision in the patient's body spaced from the first incision;
exposing that portion of the vessel which has been dissected from surrounding tissue of the patient's body through the second incision in the patient's body;
gripping the exposed portion of the vessel which has been dissected and that has been inserted through the lumen of the endoscope;
advancing the endoscope over the vessel and into the patient's body through the second incision; and
continuing to dissect the vessel away from surrounding connective tissue of the patient's body with a dissecting tool inserted through the lumen of the endoscope, using the viewing means to view the continued dissection in process.
8. A method of removing a section of a vessel from a patient's body for use in a different environment comprising:
providing an endoscope of the type having a scope body with a lumen extending longitudinally therethrough, with the lumen having a proximal end and a distal end, and means for viewing an area adjacent to the distal end of the lumen, the lumen having a lateral dimension of size sufficient to accommodate that section of the vessel which is being removed and a tool for use in removing the section of the vessel;
exposing a portion of the section of the vessel to be removed through an incision in the patient's body;
gripping the exposed portion with a gripping tool that has been inserted through the lumen of the endoscope; and
dissecting the section of the vessel which is being removed from the patient's body with a dissecting tool also inserted through the lumen of the endoscope, using the viewing means to view the dissection process.Iadd.;
cutting the vessel at proximal and distal ends of the vessel section; and
removing the vessel section from the patient's body, the steps of exposing, gripping, dissecting, cutting and removing being performed in a manner that minimizes damage to the endothelium of the vessel.Iaddend..
9. The method of removing a section of a vessel according to claim 8, and further including:
removing the section of the vessel through the lumen of the endoscope.
10. The method of removing a section of a vessel according to claim 8, and further including:
advancing the endoscope and the dissecting tool along the vessel until a branch of the vessel is encountered.
11. The method of removing a section of a vessel according to claim 10, and further including:
applying a ligation member to the vessel branch and cutting the branch with a ligating-cutting tool inserted through the lumen.
12. The method of removing a section of a vessel according to claim 11, and further including:
repeating the advancing and applying steps until the endoscope is fully inserted or the desired amount of the vessel is dissected.
13. The method of removing a section of a vessel according to claim 8, and further including:
controlling bleeding as necessary with a bleeding control tool inserted through the lumen. .Iadd.
14. The method of claim 1 further comprising re-using the vessel section as a fluid conduit in another part of the patient's body. .Iaddend..Iadd.15. The method of claim 8 further comprising re-using the vessel section as a fluid conduit in a human body. .Iaddend..Iadd.16. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
making an incision over a first end of the vessel section to be harvested, the length of the incision being sufficient to accommodate at least one tool used in harvesting the vessel section but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section through the incision;
dissecting the vessel away from surrounding tissue of the patient's body until a desired length of vessel which exceeds the length of the incision has been dissected free from surrounding tissue;
severing the vessel at proximal and distal ends of the vessel section with at least one tool inserted through the incision; and
removing the vessel section through the incision, the steps of making an incision, exposing, dissecting, severing, and removing being performed in a manner that minimizes damage to the endothelium of the vessel. .Iaddend..Iadd.17. The method of harvesting a vessel according to claim 16, including:
applying a ligation member to the vessel in a position distal to the distal end of the vessel section. .Iaddend..Iadd.18. The method of harvesting a vessel according to claim 16, including;
controlling bleeding as necessary. .Iaddend..Iadd.19. The method of harvesting a vessel according to claim 16, including:
applying a ligation member to a side branch of the vessel; and
severing the side branch of the vessel between the ligation member and the
vessel. .Iaddend..Iadd.20. The method of claim 16 further comprising re-using the vessel section as a fluid conduit in a human body. .Iaddend..Iadd.21. The method of claim 16 further comprising re-using the vessel section as a fluid conduit in another part of the patient's body. .Iaddend..Iadd.22. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
making an incision in the patient's body over a first end of the vessel section to be harvested, the length of the incision being sufficient to accommodate at least one tool used in harvesting the vessel section but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section to be harvested through the incision in the patient's body;
dissecting the vessel away from surrounding tissue of the patient's body; and
viewing the dissection of the vessel with a viewing device inserted through the incision;
severing the vessel at proximal and distal ends of the vessel section; and
removing the vessel section from the patient's body, the steps of making an incision, exposing, dissecting, viewing, severing and removing being performed in a manner that minimizes damage to the endothelium of the vessel. .Iaddend..Iadd.23. The method of harvesting a vessel according to claim 22, including:
applying a ligation member to a side branch of the vessel; and
severing the side branch between the vessel and the ligation member. .Iaddend..Iadd.24. The method of harvesting a vessel according to claim 23, including;
repeating the dissecting step until a desired length of the vessel section has been dissected. .Iaddend..Iadd.25. The method of harvesting a vessel according to claim 24, including:
severing the distal end of the vessel section; and
removing the vessel section through the incision. .Iaddend..Iadd.26. The method of harvesting a vessel according to claim 22, including;
repeating the dissecting step until a desired length of the vessel section
has been dissected. .Iaddend..Iadd.27. The method of harvesting a vessel according to claim 26, including:
severing the distal end of the vessel section; and
removing the vessel section through the incision. .Iaddend..Iadd.28. The method of harvesting a vessel according to claim 22, including:
controlling bleeding as necessary. .Iaddend..Iadd.29. The method of claim 20 further comprising re-using the vessel section as a fluid conduit in a human body. .Iaddend..Iadd.30. The method of claim 22 further comprising re-using the vessel section as a fluid conduit in another part of the patient's body. .Iaddend..Iadd.31. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
providing a device having an elongated body, the body having a lumen extending longitudinally therethrough, the lumen having a proximal end and a distal end and having a lateral dimension of size sufficient to accommodate the vessel and a tool for use in harvesting the vessel;
exposing a first end of the vessel section to be harvested through an incision in the patient's body;
gripping the first end with a gripping tool that has been inserted through the lumen of the elongated body;
dissecting the vessel away from surrounding tissue of the patient's body with a dissecting tool inserted through the incision; and
viewing the dissection of the vessel from an area adjacent the distal end of the lumen of the elongated body;
severing the vessel at proximal and distal ends of the vessel section; and
removing the vessel section from the patient's body, the steps of exposing, gripping, dissecting, viewing, severing and removing being performed in a manner that minimizes damage to the endothelium of the vessel. .Iaddend..Iadd.32. The method of harvesting a vessel according to claim 31, including:
advancing the elongated body and the dissecting tool along the vessel until
a side branch of the vessel is encountered. .Iaddend..Iadd.33. The method of harvesting a vessel according to claim 32, including:
applying a ligation member to the branch and cutting the branch between the vessel and the ligation member with a ligating-cutting tool inserted through the lumen. .Iaddend..Iadd.34. The method of harvesting a vessel according to claim 33, including:
repeating the advancing and applying steps until the elongated body is fully inserted or a desired length of the vessel is reached. .Iaddend..Iadd.35. The method of harvesting a vessel according to claim 31, including:
controlling bleeding as necessary with a bleeding control tube inserted through the lumen. .Iaddend..Iadd.36. The method of harvesting a vessel according to claim 31, including:
ligating and cutting the distal end of the vessel with a transecting tool inserted through the lumen, allowing the vessel section to be removed without making a second incision in the patient's body. .Iaddend..Iadd.37. The method of harvesting a vessel according to claim 31, including:
making a second incision in the patient's body spaced from the first incision;
exposing that portion of the vessel which has been dissected from surrounding tissue of the patient's body through the second incision in the patient's body;
gripping the exposed portion of the vessel which has been dissected with a gripping tool that has been inserted through the lumen of the elongated body;
advancing the elongated body over the vessel and into the patient's body through the second incision; and
continuing to dissect the vessel away from surrounding tissue of the patient's body with a dissecting tool inserted through the second
incision. .Iaddend..Iadd.38. The method of claim 31 further comprising re-using the vessel section as a fluid conduit in a human body. .Iaddend..Iadd.39. The method of claim 3 further comprising re-using the vessel section as a fluid conduit in another part of the patient's body. .Iaddend..Iadd.40. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
making an incision over a first end of the vessel section to be harvested, the length of the incision being sufficient to accommodate at least one tool used in harvesting the vessel section but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section through the incision;
dissecting the vessel away from surrounding tissue of the patient's body with a dissecting tool inserted through the incision until a desired length of vessel which exceeds the length of the incision has been dissected free from surrounding tissue;
viewing the dissection of the vessel with a viewing device inserted through the incision;
severing the vessel at proximal and distal ends of the vessel; and
removing the vessel section from the patient's body, the steps of making an incision, exposing, dissecting, viewing, severing, and removing being performed in a manner that minimizes damage to the endothelium of the vessel. .Iaddend..Iadd.41. The method of claim 40 further comprising re-using the vessel section as a fluid conduit in a human body. .Iaddend..Iadd.42. The method of claim 40 further comprising re-using the vessel section as a fluid conduit in another part of the patient's body. .Iaddend..Iadd.43. The method of harvesting a vessel according to claim 40, including:
applying a ligation member to the vessel in a position distal to the distal end of the vessel section. .Iaddend..Iadd.44. The method of harvesting a vessel according to claim 40, including;
controlling bleeding as necessary. .Iaddend..Iadd.45. The method of harvesting a vessel according to claim 40, including:
litigating a branch of the vessel; and
severing the branch of the vessel between the ligation and the vessel.
.Iaddend..Iadd.46. The method of harvesting a vessel according to claim 40 including maintaining the lumen of the vessel clear of any tools and other objects used in the harvesting procedure. .Iaddend..Iadd.47. The method of harvesting a vessel according to claim 40 including making a second incision in the patient's body spaced from the first incision, the second incision being substantially smaller than the length of the vessel section, and wherein the vessel section is removed through the second
incision. .Iaddend..Iadd.48. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
making an incision over a first end of the vessel section to be harvested, the length of the incision being sufficient to accommodate at least one tool used in harvesting the vessel section but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section through the incision;
dissecting the vessel away from surrounding tissue of the patient's body until a desired length of vessel which exceeds the length of the incision has been dissected free from surrounding tissue;
severing the vessel at proximal and distal ends of the vessel section with at least one tool inserted through the incision;
removing the vessel section through the incision; and
re-using the vessel section as a fluid conduit in a human body.
.Iaddend..Iadd.49. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
making an incision in the patient's body over a first end of the vessel section to be harvested, the length of the incision being sufficient to accommodate at least one tool used in harvesting the vessel section but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section to be harvested through the incision in the patient's body;
dissecting the vessel away from surrounding tissue of the patient's body; and
viewing the dissection of the vessel with a viewing device inserted through the incision;
severing the vessel at proximal and distal ends of the vessel section;
removing the vessel section from the patient's body; and
re-using the vessel section as a fluid conduit in a human body. .Iaddend..Iadd.50. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
providing a device having an elongated body, the body having a lumen extending longitudinally therethrough, the lumen having a proximal end and a distal end and having a lateral dimension of size sufficient to accommodate the vessel and a tool for use in harvesting the vessel;
exposing a first end of the vessel section to be harvested through an incision in the patient's body;
gripping the first end with a gripping tool that has been inserted through the lumen of the elongated body;
dissecting the vessel away from surrounding tissue of the patient's body with a dissecting tool inserted through the incision; and
viewing the dissection of the vessel from an area adjacent the distal end of the lumen of the elongated body;
severing the vessel at proximal and distal ends of the vessel section;
removing the vessel section from the patient's body; and
re-using the vessel section as a fluid conduit in a human body.
.Iaddend..Iadd.51. A method of harvesting a section of a vessel from a patient's body for use in a different environment comprising:
making an incision over a first end of the vessel section to be harvested, the length of the incision being sufficient to accommodate at least one tool used in harvesting the vessel section but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section through the incision;
dissecting the vessel away from surrounding tissue of the patient's body with a dissecting tool inserted through the incision until a desired length of vessel which exceeds the length of the incision has been dissected free from surrounding tissue;
viewing the dissection of the vessel with a viewing device inserted through the incision;
severing the vessel at proximal and distal ends of the vessel;
removing the vessel section from the patient's body; and
re-using the vessel section as a fluid conduit in a human body.
.Iaddend..Iadd.52. A method of re-using a section of a vessel from a patient's body in the patient's body comprising:
making an incision over a first end of the vessel section, the length of the incision being sufficient to accommodate at least one tool used in the method but being substantially smaller than the length of the vessel section;
exposing the first end of the vessel section through the incision;
dissecting the vessel away from surrounding tissue of the patient's body with a tool inserted through the incision until a desired length of vessel which exceeds the length of the incision has been dissected free from surrounding tissue;
severing the first end of the vessel section with a tool inserted through the incision; and
re-using the vessel section as a fluid conduit in the patient's body. .Iaddend.
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Cited By (55)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6206823B1 (en) 1999-08-02 2001-03-27 Ethicon Endo-Surgery, Inc. Surgical instrument and method for endoscopic tissue dissection
EP1090593A2 (en) 1999-10-05 2001-04-11 Ethicon Endo-Surgery Surgical device with integrally mounted image sensor
US6319265B1 (en) 1998-02-27 2001-11-20 Cardiothoracic Systems, Inc. Dissecting retractor for harvesting vessels
US6358244B1 (en) 1996-07-12 2002-03-19 Endo Surgical Devices, Inc. Endarterectomy surgical instrument and procedure
WO2002039882A2 (en) 2000-11-17 2002-05-23 Embro Vascular Vein harvesting system and method
US6443970B1 (en) 2001-01-24 2002-09-03 Ethicon, Inc. Surgical instrument with a dissecting tip
US6451035B1 (en) 1995-05-19 2002-09-17 General Surgical Innovations, Inc. Methods and devices for blood vessel harvesting
US6458128B1 (en) 2001-01-24 2002-10-01 Ethicon, Inc. Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element
US6464702B2 (en) 2001-01-24 2002-10-15 Ethicon, Inc. Electrosurgical instrument with closing tube for conducting RF energy and moving jaws
US6511494B1 (en) 2000-11-17 2003-01-28 Embro Corporation Vein harvesting system and method
US6520975B2 (en) * 1999-02-04 2003-02-18 Antonio Carlos Branco Kit for endovascular venous surgery
US20030045812A1 (en) * 1995-12-11 2003-03-06 Knighton David R. Apparatus and method for vein removal
US6551314B1 (en) 2002-04-03 2003-04-22 Thomas J. Fogarty Methods and systems for vein harvesting
US6554829B2 (en) 2001-01-24 2003-04-29 Ethicon, Inc. Electrosurgical instrument with minimally invasive jaws
US20030125733A1 (en) * 2001-09-28 2003-07-03 Ethicon, Inc. Surgical device for applying radio frequency energy to a portion of a captured vessel
US6589168B2 (en) 1996-02-07 2003-07-08 Robert Lee Thompson Video gynecological examination apparatus
US6592604B2 (en) 2001-09-28 2003-07-15 Ethicon, Inc. Vessel harvesting retractor with dissection element
US6592582B2 (en) 2001-09-28 2003-07-15 Ethicon, Inc. Vessel harvesting retractor with electrosurgical plunger
US6620161B2 (en) 2001-01-24 2003-09-16 Ethicon, Inc. Electrosurgical instrument with an operational sequencing element
US6652521B2 (en) 2001-01-24 2003-11-25 Ethicon, Inc. Surgical instrument with a bi-directional cutting element
US6656176B2 (en) 2001-09-28 2003-12-02 Ethicon, Inc. Vessel harvesting retractor with integral electrosurgical clamping elements
US20030225426A1 (en) * 2002-04-03 2003-12-04 Thomas J. Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
US20040049208A1 (en) * 2002-04-03 2004-03-11 Thomas Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
WO2004028590A2 (en) 2002-09-27 2004-04-08 Ethicon, Inc. Portable, reusable visualization system
US6764497B2 (en) 1994-06-29 2004-07-20 General Surgical Innovations, Inc. Extraluminal balloon dissection
US20040225317A1 (en) * 2003-05-05 2004-11-11 Rehnke Robert D. Apparatus for use in fascial cleft surgery for opening an anatomic space
US20040236231A1 (en) * 2003-05-23 2004-11-25 Embro Corporation Light catheter for illuminating tissue structures
US20050065398A1 (en) * 1998-06-19 2005-03-24 Ronald Adams Non-circular resection device and endoscope
US20050096671A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Control mechanism for a surgical instrument
US20050096670A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Surgical end effector
US20050096677A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Space-creating retractor with vessel manipulator
US20050096645A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Multitool surgical device
US20050096646A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Surgical system for retracting and severing tissue
US20050149094A1 (en) * 2003-10-31 2005-07-07 Olympus Corporation Trocar
US20050148817A1 (en) * 2003-10-31 2005-07-07 Olympus Corporation Living-body tissue removing apparatus
US20050154257A1 (en) * 2003-10-31 2005-07-14 Olympus Corporation Living-body tissue removing apparatus
US20050273125A1 (en) * 2004-05-13 2005-12-08 Opie John C Percutaneous vein harvester with shielded blade
US20060030756A1 (en) * 2004-06-25 2006-02-09 Usher Raymond W Vein harvesting system including dilator shaft and removable retractor housing
US20060036274A1 (en) * 2004-06-25 2006-02-16 Usher Raymond W One-piece vessel harvester
US20060074444A1 (en) * 2004-09-28 2006-04-06 Lin Arthur M Modular vessel harvesting system and method
US20060116746A1 (en) * 2003-01-17 2006-06-01 Chin Albert K Cardiac electrode attachment procedure
US20060173474A1 (en) * 2003-10-31 2006-08-03 Parris Wellman Surgical device having a track to guide an actuator
US20070005084A1 (en) * 2004-06-16 2007-01-04 Clague Cynthia T Minimally invasive coring vein harvester
US7384423B1 (en) 1995-07-13 2008-06-10 Origin Medsystems, Inc. Tissue dissection method
US20080161843A1 (en) * 2006-10-16 2008-07-03 Clague Cynthia T Vessel support device and method of vessel harvesting
US20080306333A1 (en) * 1999-08-10 2008-12-11 Chin Albert K Apparatus and Method for Endoscopic Surgical Procedures
US20090131907A1 (en) * 1999-08-10 2009-05-21 Maquet Cardiovascular Llc Endoscopic Cardiac Surgery
US20090131747A1 (en) * 1998-06-22 2009-05-21 Maquet Cardiovascular Llc Instrument And Method For Remotely Manipulating A Tissue Structure
US7645289B2 (en) 2001-06-26 2010-01-12 Tyco Healthcare Group Lp Conduit harvesting instrument and method
US20110046624A1 (en) * 2009-08-21 2011-02-24 Maquet Cardiovascular Llc Single handled endoscopic vessel harvesting system with rotation control
US7938842B1 (en) 1998-08-12 2011-05-10 Maquet Cardiovascular Llc Tissue dissector apparatus
US20110124958A1 (en) * 2009-11-23 2011-05-26 Nelson Dvora Y Device and method for extracting tubular structures
US7972265B1 (en) 1998-06-22 2011-07-05 Maquet Cardiovascular, Llc Device and method for remote vessel ligation
US20110172688A1 (en) * 2010-01-11 2011-07-14 Tyco Healthcare Group Lp Conduit Harvesting Instrument and Method
US8241210B2 (en) 1998-06-22 2012-08-14 Maquet Cardiovascular Llc Vessel retractor

Families Citing this family (122)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5373840A (en) * 1992-10-02 1994-12-20 Knighton; David R. Endoscope and method for vein removal
US5667478A (en) * 1992-11-06 1997-09-16 Clarus Medical Systems, Inc. Surgical instrument with stick-on fiber-optic viewing system and method of using
US5667472A (en) * 1994-03-18 1997-09-16 Clarus Medical Systems, Inc. Surgical instrument and method for use with a viewing system
US5857961A (en) * 1995-06-07 1999-01-12 Clarus Medical Systems, Inc. Surgical instrument for use with a viewing system
US5653722A (en) * 1995-01-03 1997-08-05 Kieturakis; Maciej J. Anterograde/retrograde spiral dissector and method of use in vein grafting
US5591183A (en) * 1995-04-12 1997-01-07 Origin Medsystems, Inc. Dissection apparatus
US5593418A (en) * 1995-05-19 1997-01-14 General Surgical Innovations, Inc. Methods and devices for harvesting blood vessels with balloons
US6004340A (en) * 1995-05-22 1999-12-21 General Surgical Innovations, Inc. Balloon dissecting instruments
US5702417A (en) * 1995-05-22 1997-12-30 General Surgical Innovations, Inc. Balloon loaded dissecting instruments
US7037317B2 (en) * 1995-05-22 2006-05-02 United States Surgical Corporation Balloon dissecting instruments
US5893866A (en) * 1995-05-22 1999-04-13 General Surgical Innovations, Inc. Balloon dissecting instruments
US6596010B1 (en) 1995-05-22 2003-07-22 General Surgical Innovations, Inc. Balloon dissecting instruments
US5944734A (en) * 1995-05-22 1999-08-31 General Surgical Innovations, Inc. Balloon dissecting instruments
US5993472A (en) * 1995-05-22 1999-11-30 General Surgical Innovations, Inc. Balloon dissecting instruments
US6179854B1 (en) 1995-05-22 2001-01-30 General Surgical Innovations, Inc. Apparatus and method for dissecting and retracting elongate structures
US5707389A (en) * 1995-06-07 1998-01-13 Baxter International Inc. Side branch occlusion catheter device having integrated endoscope for performing endoscopically visualized occlusion of the side branches of an anatomical passageway
US5979452A (en) 1995-06-07 1999-11-09 General Surgical Innovations, Inc. Endoscopic linton procedure using balloon dissectors and retractors
US5759150A (en) * 1995-07-07 1998-06-02 Olympus Optical Co., Ltd. System for evulsing subcutaneous tissue
US5797946A (en) * 1995-07-13 1998-08-25 Origin Medsystems, Inc. Method for arterial harvest and anastomosis for coronary bypass grafting
US7001404B1 (en) 1995-07-13 2006-02-21 Origin Medsystems, Inc. Tissue separation cannula and method
US5968065A (en) 1995-07-13 1999-10-19 Origin Medsystems, Inc. Tissue separation cannula
US5928138A (en) * 1996-08-15 1999-07-27 Ethicon Endo-Surgery, Inc. Method and devices for endoscopic vessel harvesting
US5782753A (en) 1995-10-20 1998-07-21 United States Surgical Corporation Surgical retractor
US5667480A (en) 1995-10-20 1997-09-16 Ethicon Endo-Surgery, Inc. Method and devices for endoscopic vessel harvesting
CA2244164A1 (en) 1996-01-24 1997-07-31 Albert K. Chin Tissue separation cannula with dissection probe and method
US5817013A (en) * 1996-03-19 1998-10-06 Enable Medical Corporation Method and apparatus for the minimally invasive harvesting of a saphenous vein and the like
US5913870A (en) * 1996-08-13 1999-06-22 United States Surgical Corporation Surgical dissector
US6152936A (en) 1996-09-23 2000-11-28 Esd Medical, Llc Surgical loop delivery device
US6019771A (en) * 1996-12-02 2000-02-01 Cardiothoracic Systems, Inc. Devices and methods for minimally invasive harvesting of a vessel especially the saphenous vein for coronary bypass grafting
WO1998036692A1 (en) * 1997-02-20 1998-08-27 Perkins Rodney C Biological vessel harvesting device and method
US5970982A (en) * 1997-02-20 1999-10-26 Perkins; Rodney C. Minimally invasive biological vessel harvesting method
DE19707374C2 (en) * 1997-02-25 2000-10-26 Storz Karl Gmbh & Co Kg Medical dissection with spreadable spatula jaw
DE19717977A1 (en) * 1997-04-23 1998-05-28 Rainer Prof Dr Dr Schmelzeisen Lining=up fixture device used to treat jaw or face fractures
US5913818A (en) * 1997-06-02 1999-06-22 General Surgical Innovations, Inc. Vascular retractor
US5938680A (en) * 1997-06-19 1999-08-17 Cardiothoracic Systems, Inc. Devices and methods for harvesting vascular conduits
US5902315A (en) 1997-08-28 1999-05-11 Ethicon Endo-Surgery, Inc. Optical tissue dissector/retractor
US5922004A (en) * 1997-08-28 1999-07-13 Ethicon Endo-Surgery, Inc. Method for performing optical tissue dissection/retraction
US6436116B1 (en) * 1997-10-06 2002-08-20 Smith & Nephew, Inc. Methods and apparatus for removing veins
CA2310426A1 (en) * 1997-11-18 1999-05-27 Emory University Device for endoscopic vessel harvesting
US5899912A (en) * 1997-12-17 1999-05-04 Eaves, Iii; Felmont F. Apparatus and method for endoscopic harvesting of elongate tissue structure
US6632171B2 (en) 1997-12-22 2003-10-14 Given Imaging Ltd. Method for in vivo delivery of autonomous capsule
CA2315727A1 (en) * 1997-12-22 1999-07-01 Gavriel J. Iddan System and method for in vivo delivery of autonomous capsule
US6193653B1 (en) 1998-02-06 2001-02-27 Ethicon Endo-Surgery, Inc. Methods and devices for visualizing, dissecting and harvesting vessels and the like
US5957927A (en) * 1998-02-24 1999-09-28 Synthes (Usa) Bone fixation device introducer
US6129661A (en) * 1998-04-09 2000-10-10 Smith & Nephew, Inc. Endoscopic instrumentation with working channel
DE19827360C2 (en) * 1998-06-19 2000-05-31 Storz Karl Gmbh & Co Kg A medical instrument for endoscopic removal of the great saphenous vein
US6648815B2 (en) 1998-06-19 2003-11-18 Karl Storz Gmbh & Co. Kg Medical instrument and method for endoscopic removal of the saphenous vein
US6045561A (en) * 1998-06-23 2000-04-04 Orthopaedic Biosystems Ltd., Inc. Surgical knot manipulator
US6042538A (en) * 1998-11-18 2000-03-28 Emory University Device for endoscopic vessel harvesting
US6159146A (en) * 1999-03-12 2000-12-12 El Gazayerli; Mohamed Mounir Method and apparatus for minimally-invasive fundoplication
US6488689B1 (en) * 1999-05-20 2002-12-03 Aaron V. Kaplan Methods and apparatus for transpericardial left atrial appendage closure
US8721663B2 (en) 1999-05-20 2014-05-13 Sentreheart, Inc. Methods and apparatus for transpericardial left atrial appendage closure
WO2000071033A1 (en) * 1999-05-21 2000-11-30 Cardiothoracic Systems, Inc. Refractor apparatus for use in harvesting mammary arteries during heart by-pass surgery
US7996067B2 (en) * 1999-06-15 2011-08-09 Given Imaging Ltd. In-vivo imaging device, optical system and method
ES2257299T3 (en) * 1999-06-15 2006-08-01 Given Imaging Ltd. optical system.
US7813789B2 (en) * 1999-06-15 2010-10-12 Given Imaging Ltd. In-vivo imaging device, optical system and method
US7264587B2 (en) * 1999-08-10 2007-09-04 Origin Medsystems, Inc. Endoscopic subxiphoid surgical procedures
US7597698B2 (en) 1999-08-10 2009-10-06 Maquet Cardiovascular Llc Apparatus and method for endoscopic encirclement of pulmonary veins for epicardial ablation
US7398781B1 (en) 1999-08-10 2008-07-15 Maquet Cardiovascular, Llc Method for subxiphoid endoscopic access
US7526342B2 (en) 1999-08-10 2009-04-28 Maquet Cardiovascular Llc Apparatus for endoscopic cardiac mapping and lead placement
US6231561B1 (en) 1999-09-20 2001-05-15 Appriva Medical, Inc. Method and apparatus for closing a body lumen
US6352544B1 (en) 2000-02-22 2002-03-05 Gregory A. Spitz Apparatus and methods for removing veins
US6736773B2 (en) * 2001-01-25 2004-05-18 Scimed Life Systems, Inc. Endoscopic vision system
GB0111683D0 (en) * 2001-05-12 2001-07-04 Menon Johansson Anatole S Device for assisting laparoscopic surgery
US6887251B1 (en) * 2001-07-12 2005-05-03 William D. Suval Method and apparatus for vessel harvesting
WO2003013367A3 (en) 2001-08-10 2003-07-03 Gen Surgical Innovations Inc Vascular harvesting tool and methods
DE60231283D1 (en) 2001-12-27 2009-04-09 Olympus Corp Shell, with devices for endoscopic blood vessel gains
US7001329B2 (en) * 2002-07-23 2006-02-21 Pentax Corporation Capsule endoscope guidance system, capsule endoscope holder, and capsule endoscope
JP4746876B2 (en) 2002-10-15 2011-08-10 ギブン イメージング リミテッドGiven Imaging Ltd. Apparatus for transferring a signal to a mobile device, system and method
US7056329B2 (en) * 2002-10-23 2006-06-06 Intellimed Surgical Solutions, Llc Laparoscopic direct vision dissecting port
US20040093000A1 (en) * 2002-10-23 2004-05-13 Stephen Kerr Direct vision port site dissector
US7309342B2 (en) * 2003-01-16 2007-12-18 Mark Genovesi Heatless blood vessel harvesting device
US6818003B2 (en) 2003-01-16 2004-11-16 Mark H. Genovesi Blood vessel harvesting device
US20050137468A1 (en) * 2003-12-18 2005-06-23 Jerome Avron Device, system, and method for in-vivo sensing of a substance
US20050195785A1 (en) * 2004-03-08 2005-09-08 Pentax Corporation Image signal processing device
JP2005245938A (en) * 2004-03-08 2005-09-15 Pentax Corp Clothing for diagnosis, system of clothing for diagnosis and endoscope system
JP2005245937A (en) * 2004-03-08 2005-09-15 Pentax Corp Clothing with communication function and endoscope system
US20060004410A1 (en) * 2004-05-14 2006-01-05 Nobis Rudolph H Suture locking and cutting devices and methods
US7860555B2 (en) 2005-02-02 2010-12-28 Voyage Medical, Inc. Tissue visualization and manipulation system
US7918787B2 (en) 2005-02-02 2011-04-05 Voyage Medical, Inc. Tissue visualization and manipulation systems
US8221310B2 (en) 2005-10-25 2012-07-17 Voyage Medical, Inc. Tissue visualization device and method variations
US9510732B2 (en) 2005-10-25 2016-12-06 Intuitive Surgical Operations, Inc. Methods and apparatus for efficient purging
US8137333B2 (en) 2005-10-25 2012-03-20 Voyage Medical, Inc. Delivery of biological compounds to ischemic and/or infarcted tissue
US8050746B2 (en) 2005-02-02 2011-11-01 Voyage Medical, Inc. Tissue visualization device and method variations
US9055906B2 (en) 2006-06-14 2015-06-16 Intuitive Surgical Operations, Inc. In-vivo visualization systems
US8078266B2 (en) 2005-10-25 2011-12-13 Voyage Medical, Inc. Flow reduction hood systems
US7860556B2 (en) 2005-02-02 2010-12-28 Voyage Medical, Inc. Tissue imaging and extraction systems
US7930016B1 (en) 2005-02-02 2011-04-19 Voyage Medical, Inc. Tissue closure system
US20060224040A1 (en) * 2005-03-31 2006-10-05 Given Imaging Ltd. In vivo imaging device and method of manufacture thereof
US8632520B2 (en) * 2005-11-10 2014-01-21 Mayo Foundation For Medical Education And Research Vein closure and injection kits and methods
US7918783B2 (en) 2006-03-22 2011-04-05 Boston Scientific Scimed, Inc. Endoscope working channel with multiple functionality
CA2650474A1 (en) 2006-04-24 2007-11-08 Synecor, Llc Natural orifice surgical system
US8518024B2 (en) 2006-04-24 2013-08-27 Transenterix, Inc. System and method for multi-instrument surgical access using a single access port
JP2010502313A (en) 2006-09-01 2010-01-28 ボエッジ メディカル, インコーポレイテッド Method and apparatus for the treatment of atrial fibrillation
US8131350B2 (en) 2006-12-21 2012-03-06 Voyage Medical, Inc. Stabilization of visualization catheters
US8758229B2 (en) 2006-12-21 2014-06-24 Intuitive Surgical Operations, Inc. Axial visualization systems
JP4662374B2 (en) * 2007-03-26 2011-03-30 オリンパス株式会社 Endoscopic vessel harvesting equipment
JP2010524651A (en) 2007-04-27 2010-07-22 ボエッジ メディカル, インコーポレイテッド Steerable tissue visualization and manipulation the catheter with a complex shape
US8657805B2 (en) 2007-05-08 2014-02-25 Intuitive Surgical Operations, Inc. Complex shape steerable tissue visualization and manipulation catheter
EP2155036B1 (en) 2007-05-11 2016-02-24 Intuitive Surgical Operations, Inc. Visual electrode ablation systems
US8235985B2 (en) 2007-08-31 2012-08-07 Voyage Medical, Inc. Visualization and ablation system variations
US8858609B2 (en) 2008-02-07 2014-10-14 Intuitive Surgical Operations, Inc. Stent delivery under direct visualization
US8515507B2 (en) 2008-06-16 2013-08-20 Given Imaging Ltd. Device and method for detecting in-vivo pathology
US9101735B2 (en) 2008-07-07 2015-08-11 Intuitive Surgical Operations, Inc. Catheter control systems
US8333012B2 (en) 2008-10-10 2012-12-18 Voyage Medical, Inc. Method of forming electrode placement and connection systems
US9468364B2 (en) 2008-11-14 2016-10-18 Intuitive Surgical Operations, Inc. Intravascular catheter with hood and image processing systems
WO2011088441A3 (en) * 2010-01-18 2011-11-24 Ceramoptec Industries, Inc. Improved device and method for removing veins
US8694071B2 (en) 2010-02-12 2014-04-08 Intuitive Surgical Operations, Inc. Image stabilization techniques and methods
US9814522B2 (en) 2010-04-06 2017-11-14 Intuitive Surgical Operations, Inc. Apparatus and methods for ablation efficacy
US20120016203A1 (en) * 2010-07-17 2012-01-19 King Debra A Methods and systems for minimally invasive endoscopic surgeries
US9119900B2 (en) 2011-12-23 2015-09-01 Saphena Medical, Inc. Unitary endoscopic vessel harvesting devices
US20130282009A1 (en) * 2012-04-18 2013-10-24 Cardica, Inc. Endoscopic vein harvesting system
US9724122B2 (en) * 2012-09-14 2017-08-08 The Spectranetics Corporation Expandable lead jacket
US9198681B2 (en) * 2012-10-12 2015-12-01 Cook Medical Technologies Llc Device and method for removing tissue inside a body vessel
US9814481B2 (en) 2013-03-14 2017-11-14 Saphena Medical, Inc. Unitary endoscopic vessel harvesting devices
US9498246B2 (en) 2013-03-14 2016-11-22 Saphena Medical, Inc. Unitary endoscopic vessel harvesting devices
US20150073207A1 (en) * 2013-09-09 2015-03-12 Terumo Cardiovascular Systems Corporation Single-pass endoscopic vessel harvesting
WO2015147157A1 (en) * 2014-03-27 2015-10-01 富士フイルム株式会社 Surgical operation device for endoscope, endoscope, and endoscope operational tool
WO2016027489A1 (en) * 2014-08-21 2016-02-25 テルモ株式会社 Method for stripping blood vessel and device for stripping blood vessel
US9833233B2 (en) 2014-09-30 2017-12-05 Covidien Lp Methods and devices for tissue suturing
US20160100827A1 (en) 2014-10-14 2016-04-14 Covidien Lp Methods and devices for vein harvesting
US20170020494A1 (en) 2015-07-22 2017-01-26 Covidien Lp Methods and devices for vein harvesting

Citations (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1867624A (en) * 1930-04-01 1932-07-19 Memorial Hospital For The Trea Device for obtaining biopsy specimens
US2001169A (en) * 1934-11-01 1935-05-14 Oscar R Wallace Building structure
US2011169A (en) * 1932-04-13 1935-08-13 Wappler Frederick Charles Forcipated surgical electrode
US2028635A (en) * 1933-09-11 1936-01-21 Wappler Frederick Charles Forcipated surgical instrument
US2316297A (en) * 1943-01-15 1943-04-13 Beverly A Southerland Surgical instrument
US2868206A (en) * 1956-07-25 1959-01-13 Frederick G Stoesser Intra luminal vein stripper
US2944552A (en) * 1958-12-29 1960-07-12 Richard B Wilk Surgical instrument
US3185155A (en) * 1963-03-13 1965-05-25 Slaten Vein stripper
US3336916A (en) * 1963-10-30 1967-08-22 Richard F Edlich Electrocautery process
US3856016A (en) * 1972-11-03 1974-12-24 H Davis Method for mechanically applying an occlusion clip to an anatomical tubular structure
US3882854A (en) * 1973-08-23 1975-05-13 Research Corp Surgical clip and applicator
US3934115A (en) * 1973-09-25 1976-01-20 Peterson Gerald H Method and apparatus for electric singe cutting
USRE29088E (en) * 1972-10-10 1976-12-28 Surgical cutting instrument having electrically heated cutting edge
US4038987A (en) * 1974-02-08 1977-08-02 Olympus Optical Co., Ltd. Forceps device for endoscope
GB2082459A (en) * 1980-08-26 1982-03-10 Atrium Medical Corp Apparatus for vein removal
US4362160A (en) * 1979-07-24 1982-12-07 Richard Wolf Gmbh Endoscopes
US4369768A (en) * 1980-07-30 1983-01-25 Marko Vukovic Arthroscope
US4440170A (en) * 1979-03-06 1984-04-03 Ethicon, Inc. Surgical clip applying instrument
US4493321A (en) * 1982-05-25 1985-01-15 Leather Robert P Venous valve cutter for the incision of valve leaflets in situ
US4499899A (en) * 1983-01-21 1985-02-19 Brimfield Precision, Inc. Fiber-optic illuminated microsurgical scissors
US4499898A (en) * 1982-08-23 1985-02-19 Koi Associates Surgical knife with controllably extendable blade and gauge therefor
US4516575A (en) * 1982-06-03 1985-05-14 Coopervision, Inc. Surgical scalpel
US4556058A (en) * 1983-08-17 1985-12-03 United States Surgical Corporation Apparatus for ligation and division with fixed jaws
US4586919A (en) * 1984-04-06 1986-05-06 Taheri Syde A External shunt and method for procuring and preserving the endothelium of a vein used in arterial bypass
US4597389A (en) * 1982-09-30 1986-07-01 Ibrahim Adel A Device for removing objects from tubular body passages
US4638802A (en) * 1984-09-21 1987-01-27 Olympus Optical Co., Ltd. High frequency instrument for incision and excision
US4653476A (en) * 1984-07-05 1987-03-31 Richard Wolf Gmbh Instrument insert for a uretero-renoscope
GB2195540A (en) * 1986-09-19 1988-04-13 Anthony John Milne Vein stripper
US4745908A (en) * 1987-05-08 1988-05-24 Circon Corporation Inspection instrument fexible shaft having deflection compensation means
US4759364A (en) * 1985-09-19 1988-07-26 Richard Wolf Gmbh Pincers attachment for a surgical handle to be used in endoscopy
US4759348A (en) * 1981-09-28 1988-07-26 Cawood Charles David Endoscope assembly and surgical instrument for use therewith
US4762120A (en) * 1983-11-08 1988-08-09 Laserscope, Inc. Endoscopic device having handle assembly and catheter assembly
US4768508A (en) * 1986-06-06 1988-09-06 Thomas J. Fogarty Vein valve cutting method
US4793346A (en) * 1986-09-04 1988-12-27 Bruce Mindich Process and apparatus for harvesting vein
US4858595A (en) * 1987-12-18 1989-08-22 Gerhard Buess Mediastinoscope
US4862874A (en) * 1987-06-10 1989-09-05 Kellner Hans Joerg Endoscope for removal of thrombi from pulmonary arterial vessels
US4869268A (en) * 1987-05-14 1989-09-26 Inbae Yoon Multi-functional instruments and stretchable ligating and occluding devices
US4877016A (en) * 1988-07-29 1989-10-31 Kantor Edward A Video endoscopic microscope
US4932952A (en) * 1988-12-20 1990-06-12 Alto Development Corporation Antishock, anticlog suction coagulator
US4997436A (en) * 1988-06-03 1991-03-05 Oberlander Michael A Arthroscopic clip insertion tool
US5013312A (en) * 1990-03-19 1991-05-07 Everest Medical Corporation Bipolar scalpel for harvesting internal mammary artery
US5020514A (en) * 1989-07-19 1991-06-04 Richard Wolf Gmbh Endoscope for nasal surgery
DE3942589A1 (en) * 1989-12-22 1991-07-04 Olympus Optical Europ Venous valve cutter
US5037433A (en) * 1990-05-17 1991-08-06 Wilk Peter J Endoscopic suturing device and related method and suture
US5047038A (en) * 1985-07-01 1991-09-10 Edward Weck Incorporated Automatic hemostatic clip applier
US5049154A (en) * 1989-08-07 1991-09-17 Berkshire Research & Development, Inc. Adjustable intra-luminal valvulotome
US5213093A (en) * 1991-05-29 1993-05-25 Applied Vascular Devices, Inc. Endoscope with non-circular probe and method of making same
US5284478A (en) * 1992-06-08 1994-02-08 Nobles Anthony A Detachable tip optical valvulotome
US5373840A (en) * 1992-10-02 1994-12-20 Knighton; David R. Endoscope and method for vein removal
US5425355A (en) * 1991-01-28 1995-06-20 Laserscope Energy discharging surgical probe and surgical process having distal energy application without concomitant proximal movement
US5447513A (en) * 1992-05-06 1995-09-05 Ethicon, Inc. Endoscopic ligation and division instrument
US5549637A (en) * 1994-11-10 1996-08-27 Crainich; Lawrence Articulated medical instrument

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4754754A (en) * 1984-08-20 1988-07-05 Garito Jon C Electrosurgical handpiece for blades and needles

Patent Citations (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1867624A (en) * 1930-04-01 1932-07-19 Memorial Hospital For The Trea Device for obtaining biopsy specimens
US2011169A (en) * 1932-04-13 1935-08-13 Wappler Frederick Charles Forcipated surgical electrode
US2028635A (en) * 1933-09-11 1936-01-21 Wappler Frederick Charles Forcipated surgical instrument
US2001169A (en) * 1934-11-01 1935-05-14 Oscar R Wallace Building structure
US2316297A (en) * 1943-01-15 1943-04-13 Beverly A Southerland Surgical instrument
US2868206A (en) * 1956-07-25 1959-01-13 Frederick G Stoesser Intra luminal vein stripper
US2944552A (en) * 1958-12-29 1960-07-12 Richard B Wilk Surgical instrument
US3185155A (en) * 1963-03-13 1965-05-25 Slaten Vein stripper
US3336916A (en) * 1963-10-30 1967-08-22 Richard F Edlich Electrocautery process
USRE29088E (en) * 1972-10-10 1976-12-28 Surgical cutting instrument having electrically heated cutting edge
US3856016A (en) * 1972-11-03 1974-12-24 H Davis Method for mechanically applying an occlusion clip to an anatomical tubular structure
US3882854A (en) * 1973-08-23 1975-05-13 Research Corp Surgical clip and applicator
US3934115A (en) * 1973-09-25 1976-01-20 Peterson Gerald H Method and apparatus for electric singe cutting
US4038987A (en) * 1974-02-08 1977-08-02 Olympus Optical Co., Ltd. Forceps device for endoscope
US4440170A (en) * 1979-03-06 1984-04-03 Ethicon, Inc. Surgical clip applying instrument
US4362160A (en) * 1979-07-24 1982-12-07 Richard Wolf Gmbh Endoscopes
US4369768A (en) * 1980-07-30 1983-01-25 Marko Vukovic Arthroscope
GB2082459A (en) * 1980-08-26 1982-03-10 Atrium Medical Corp Apparatus for vein removal
US4759348A (en) * 1981-09-28 1988-07-26 Cawood Charles David Endoscope assembly and surgical instrument for use therewith
US4493321A (en) * 1982-05-25 1985-01-15 Leather Robert P Venous valve cutter for the incision of valve leaflets in situ
US4516575A (en) * 1982-06-03 1985-05-14 Coopervision, Inc. Surgical scalpel
US4499898A (en) * 1982-08-23 1985-02-19 Koi Associates Surgical knife with controllably extendable blade and gauge therefor
US4597389A (en) * 1982-09-30 1986-07-01 Ibrahim Adel A Device for removing objects from tubular body passages
US4499899A (en) * 1983-01-21 1985-02-19 Brimfield Precision, Inc. Fiber-optic illuminated microsurgical scissors
US4556058A (en) * 1983-08-17 1985-12-03 United States Surgical Corporation Apparatus for ligation and division with fixed jaws
US4762120A (en) * 1983-11-08 1988-08-09 Laserscope, Inc. Endoscopic device having handle assembly and catheter assembly
US4586919A (en) * 1984-04-06 1986-05-06 Taheri Syde A External shunt and method for procuring and preserving the endothelium of a vein used in arterial bypass
US4653476A (en) * 1984-07-05 1987-03-31 Richard Wolf Gmbh Instrument insert for a uretero-renoscope
US4638802A (en) * 1984-09-21 1987-01-27 Olympus Optical Co., Ltd. High frequency instrument for incision and excision
US5047038A (en) * 1985-07-01 1991-09-10 Edward Weck Incorporated Automatic hemostatic clip applier
US4759364A (en) * 1985-09-19 1988-07-26 Richard Wolf Gmbh Pincers attachment for a surgical handle to be used in endoscopy
US4768508A (en) * 1986-06-06 1988-09-06 Thomas J. Fogarty Vein valve cutting method
US4793346A (en) * 1986-09-04 1988-12-27 Bruce Mindich Process and apparatus for harvesting vein
GB2195540A (en) * 1986-09-19 1988-04-13 Anthony John Milne Vein stripper
US4745908A (en) * 1987-05-08 1988-05-24 Circon Corporation Inspection instrument fexible shaft having deflection compensation means
US4869268A (en) * 1987-05-14 1989-09-26 Inbae Yoon Multi-functional instruments and stretchable ligating and occluding devices
US4862874A (en) * 1987-06-10 1989-09-05 Kellner Hans Joerg Endoscope for removal of thrombi from pulmonary arterial vessels
US4858595A (en) * 1987-12-18 1989-08-22 Gerhard Buess Mediastinoscope
US4997436A (en) * 1988-06-03 1991-03-05 Oberlander Michael A Arthroscopic clip insertion tool
US4877016A (en) * 1988-07-29 1989-10-31 Kantor Edward A Video endoscopic microscope
US4932952A (en) * 1988-12-20 1990-06-12 Alto Development Corporation Antishock, anticlog suction coagulator
US5020514A (en) * 1989-07-19 1991-06-04 Richard Wolf Gmbh Endoscope for nasal surgery
US5049154A (en) * 1989-08-07 1991-09-17 Berkshire Research & Development, Inc. Adjustable intra-luminal valvulotome
DE3942589A1 (en) * 1989-12-22 1991-07-04 Olympus Optical Europ Venous valve cutter
US5013312A (en) * 1990-03-19 1991-05-07 Everest Medical Corporation Bipolar scalpel for harvesting internal mammary artery
US5037433A (en) * 1990-05-17 1991-08-06 Wilk Peter J Endoscopic suturing device and related method and suture
US5425355A (en) * 1991-01-28 1995-06-20 Laserscope Energy discharging surgical probe and surgical process having distal energy application without concomitant proximal movement
US5213093A (en) * 1991-05-29 1993-05-25 Applied Vascular Devices, Inc. Endoscope with non-circular probe and method of making same
US5447513A (en) * 1992-05-06 1995-09-05 Ethicon, Inc. Endoscopic ligation and division instrument
US5284478A (en) * 1992-06-08 1994-02-08 Nobles Anthony A Detachable tip optical valvulotome
US5373840A (en) * 1992-10-02 1994-12-20 Knighton; David R. Endoscope and method for vein removal
US5549637A (en) * 1994-11-10 1996-08-27 Crainich; Lawrence Articulated medical instrument

Non-Patent Citations (28)

* Cited by examiner, † Cited by third party
Title
"Angioscopic Preparation for Saphenous Vein in Situ Bypass Grafting," A. K. Chin et al.,Endovascular Surgery, 1989, pp. 74-81.
"Incision Decision", Atrium Medical Corporation advertisement, appearing in J. Thorac. Cardiovasc. Surg., 83(4), 1982.
"Reversed Saphenous Vein for Femoropopliteal Bypass Grafting," K. G. Burnand, Vascular Surgical Techniques An Atlas, K. G. Burnand et al., 1989, pp. 228-234.
"Saphenous vein grafts are number 1. Period.", Atrium Medical Corporation advertisement, appearing in J. Thorac. Cardiovasc. Surg., 81(6), 1982.
"The in Situ Saphenous Vein Arterial; Bypass by Valve Incision," R. P. Leather et al., Vascular Surgical Techniques An Atlas, 1989, pp. 255-262.
Angioscopic Preparation for Saphenous Vein in Situ Bypass Grafting, A. K. Chin et al., Endovascular Surgery, 1989, pp. 74 81. *
DeLaria, G.A., et al., "Leg Wound Complications Associated With Coronary Revascularization", J. Thorac. Cardiovasc. Surg., 81:403-407, 1981.
DeLaria, G.A., et al., Leg Wound Complications Associated With Coronary Revascularization , J. Thorac. Cardiovasc. Surg., 81:403 407, 1981. *
Dmitri et al., "A quick and atraumatic method of autologous vein harvesting using the subcutaneous extraluminal dissector", J. Cardiovasc. Surg. 28:103-111 (1987).
Dmitri et al., A quick and atraumatic method of autologous vein harvesting using the subcutaneous extraluminal dissector , J. Cardiovasc. Surg. 28:103 111 (1987). *
Hauer et al., "Endoscopic subfacial discission of perforating veins", Surgical Endosc. 2:5-12 (1988).
Hauer et al., Endoscopic subfacial discission of perforating veins , Surgical Endosc. 2:5 12 (1988). *
Incision Decision , Atrium Medical Corporation advertisement, appearing in J. Thorac. Cardiovasc. Surg., 83(4), 1982. *
J. Sklar Mfg. Co., Inc., "Surgical Instruments", Long Island City, NY; 1973.
J. Sklar Mfg. Co., Inc., Surgical Instruments , Long Island City, NY; 1973. *
Lor e , John Marion, Tender Grip Forceps , American Journal of Surgery; vol. 104; 7/1962. *
Lore, John Marion, "Tender Grip Forceps", American Journal of Surgery; vol. 104; 7/1962.
Meldrum Hanna et al., Long Saphaneous Vein Harvesting , J. Surg. 56:923 924 (1986). *
Meldrum-Hanna et al., "Long Saphaneous Vein Harvesting", J. Surg. 56:923-924 (1986).
Moazami, Nader, Ph.D., et al., "Minimally Invasive Greater Saphenous Vein Harvesting for Coronary Artery Bypass Surgery", Surgical Rounds, pp. 94-98, Mar. 1997.
Moazami, Nader, Ph.D., et al., Minimally Invasive Greater Saphenous Vein Harvesting for Coronary Artery Bypass Surgery , Surgical Rounds, pp. 94 98, Mar. 1997. *
Rashid, A., et al., "Subcutaneous Technique for Saphenous Vein Harvest", Ann. Thorac. Surg., 37(2):169-170, 1984.
Rashid, A., et al., Subcutaneous Technique for Saphenous Vein Harvest , Ann. Thorac. Surg., 37(2):169 170, 1984. *
Reversed Saphenous Vein for Femoropopliteal Bypass Grafting, K. G. Burnand, Vascular Surgical Techniques An Atlas, K. G. Burnand et al., 1989, pp. 228 234. *
Saphenous vein grafts are number 1. Period. , Atrium Medical Corporation advertisement, appearing in J. Thorac. Cardiovasc. Surg., 81(6), 1982. *
The in Situ Saphenous Vein Arterial; Bypass by Valve Incision, R. P. Leather et al., Vascular Surgical Techniques An Atlas, 1989, pp. 255 262. *
Wheatley, D.J., ed., Surgery of Coronary Artery Disease, C.V. Mosby Co., pp. 348 349, 374 375. *
Wheatley, D.J., ed., Surgery of Coronary Artery Disease, C.V. Mosby Co., pp. 348-349, 374-375.

Cited By (121)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8062323B2 (en) 1994-06-29 2011-11-22 Tyco Healthcare Group Lp Extraluminal balloon dissection
US8016850B2 (en) 1994-06-29 2011-09-13 General Surgical Innovations, Inc. Extraluminal balloon dissection
US6764497B2 (en) 1994-06-29 2004-07-20 General Surgical Innovations, Inc. Extraluminal balloon dissection
US6989018B2 (en) 1994-06-29 2006-01-24 General Surgical Innovations, Inc. Extraluminal balloon dissection
US8500770B2 (en) 1994-06-29 2013-08-06 Covidien Lp Extraluminal balloon dissection
US8323304B2 (en) 1994-06-29 2012-12-04 Covidien Lp Extraluminal balloon dissection
US7314475B2 (en) 1994-06-29 2008-01-01 General Surgical Innovations, Inc. Extraluminal balloon dissection
US20080097507A1 (en) * 1994-06-29 2008-04-24 Fogarty Thomas J Extraluminal balloon dissection
US20060106414A1 (en) * 1994-06-29 2006-05-18 General Surgical Innovations, Inc. Extraluminal balloon dissection
US8133248B2 (en) 1995-05-19 2012-03-13 Tyco Healthcare Group Lp Methods and devices for blood vessel harvesting
US20050154415A1 (en) * 1995-05-19 2005-07-14 Fogarty Thomas J. Methods and devices for blood vessel harvesting
US6527787B1 (en) 1995-05-19 2003-03-04 General Surgical Innovations, Inc. Methods and devices for blood vessel harvesting
US20100049235A1 (en) * 1995-05-19 2010-02-25 General Surgical Innovations Inc. Methods and devices for blood vessel harvesting
US7473262B2 (en) 1995-05-19 2009-01-06 General Surgical Innovations, Inc. Methods and devices for blood vessel harvesting
US6451035B1 (en) 1995-05-19 2002-09-17 General Surgical Innovations, Inc. Methods and devices for blood vessel harvesting
US7588584B2 (en) 1995-05-19 2009-09-15 General Surgical Innovations, Inc. Methods and devices for blood vessel harvesting
US7077852B2 (en) 1995-05-19 2006-07-18 General Surgical Innovations Methods and devices for blood vessel harvesting
US6840946B2 (en) 1995-05-19 2005-01-11 General Surgical Innovations, Inc. Methods and devices for blood vessel harvesting
US7981133B2 (en) 1995-07-13 2011-07-19 Maquet Cardiovascular, Llc Tissue dissection method
US20090024156A1 (en) * 1995-07-13 2009-01-22 Chin Albert K Tissue Dissection Method
US7384423B1 (en) 1995-07-13 2008-06-10 Origin Medsystems, Inc. Tissue dissection method
US20030045812A1 (en) * 1995-12-11 2003-03-06 Knighton David R. Apparatus and method for vein removal
US7066875B2 (en) * 1995-12-11 2006-06-27 Cardio Thoracic Systems, Inc. Apparatus and method for vein removal
US6589168B2 (en) 1996-02-07 2003-07-08 Robert Lee Thompson Video gynecological examination apparatus
US6358244B1 (en) 1996-07-12 2002-03-19 Endo Surgical Devices, Inc. Endarterectomy surgical instrument and procedure
US6319265B1 (en) 1998-02-27 2001-11-20 Cardiothoracic Systems, Inc. Dissecting retractor for harvesting vessels
US20050065398A1 (en) * 1998-06-19 2005-03-24 Ronald Adams Non-circular resection device and endoscope
US8043207B2 (en) * 1998-06-19 2011-10-25 Boston Scientific Scimed, Inc. Non-circular resection device and endoscope
US20090131747A1 (en) * 1998-06-22 2009-05-21 Maquet Cardiovascular Llc Instrument And Method For Remotely Manipulating A Tissue Structure
US7867163B2 (en) 1998-06-22 2011-01-11 Maquet Cardiovascular Llc Instrument and method for remotely manipulating a tissue structure
US7972265B1 (en) 1998-06-22 2011-07-05 Maquet Cardiovascular, Llc Device and method for remote vessel ligation
US8241210B2 (en) 1998-06-22 2012-08-14 Maquet Cardiovascular Llc Vessel retractor
US9730782B2 (en) 1998-08-12 2017-08-15 Maquet Cardiovascular Llc Vessel harvester
US7938842B1 (en) 1998-08-12 2011-05-10 Maquet Cardiovascular Llc Tissue dissector apparatus
US8460331B2 (en) 1998-08-12 2013-06-11 Maquet Cardiovascular, Llc Tissue dissector apparatus and method
US9700398B2 (en) 1998-08-12 2017-07-11 Maquet Cardiovascular Llc Vessel harvester
US8986335B2 (en) 1998-08-12 2015-03-24 Maquet Cardiovascular Llc Tissue dissector apparatus and method
US6520975B2 (en) * 1999-02-04 2003-02-18 Antonio Carlos Branco Kit for endovascular venous surgery
US6206823B1 (en) 1999-08-02 2001-03-27 Ethicon Endo-Surgery, Inc. Surgical instrument and method for endoscopic tissue dissection
US20090131907A1 (en) * 1999-08-10 2009-05-21 Maquet Cardiovascular Llc Endoscopic Cardiac Surgery
US20080306333A1 (en) * 1999-08-10 2008-12-11 Chin Albert K Apparatus and Method for Endoscopic Surgical Procedures
EP1090593A2 (en) 1999-10-05 2001-04-11 Ethicon Endo-Surgery Surgical device with integrally mounted image sensor
US7211040B2 (en) 2000-11-17 2007-05-01 Embro Corporation Vein harvesting system and method
WO2002039882A2 (en) 2000-11-17 2002-05-23 Embro Vascular Vein harvesting system and method
US8777835B2 (en) 2000-11-17 2014-07-15 Embro Corporation Vein harvesting system and method
US7959553B2 (en) 2000-11-17 2011-06-14 Embro Corporation Vein harvesting system and method
US6705986B2 (en) 2000-11-17 2004-03-16 Embro Corporation Vein harvesting system and method
US20090023981A1 (en) * 2000-11-17 2009-01-22 Embro Corporation Vein harvesting system and method
US6511494B1 (en) 2000-11-17 2003-01-28 Embro Corporation Vein harvesting system and method
US6558313B1 (en) 2000-11-17 2003-05-06 Embro Corporation Vein harvesting system and method
US20070208230A1 (en) * 2000-11-17 2007-09-06 Embro Corporation Vein harvesting system and method
US6773435B2 (en) 2001-01-24 2004-08-10 Ethicon, Inc. Electrosurgical instrument with closing tube for conducting RF energy and moving jaws
US6652521B2 (en) 2001-01-24 2003-11-25 Ethicon, Inc. Surgical instrument with a bi-directional cutting element
US6464702B2 (en) 2001-01-24 2002-10-15 Ethicon, Inc. Electrosurgical instrument with closing tube for conducting RF energy and moving jaws
US6623482B2 (en) 2001-01-24 2003-09-23 Ethicon, Inc. Electrosurgical instrument with minimally invasive jaws
US6458128B1 (en) 2001-01-24 2002-10-01 Ethicon, Inc. Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element
US6620161B2 (en) 2001-01-24 2003-09-16 Ethicon, Inc. Electrosurgical instrument with an operational sequencing element
US20040236326A1 (en) * 2001-01-24 2004-11-25 Schulze Dale R. Electrosurgical instrument with closing tube for conducting RF energy and moving jaws
US6554829B2 (en) 2001-01-24 2003-04-29 Ethicon, Inc. Electrosurgical instrument with minimally invasive jaws
US7063699B2 (en) 2001-01-24 2006-06-20 Ethicon, Inc. Electrosurgical instrument with minimally invasive jaws
US6695840B2 (en) 2001-01-24 2004-02-24 Ethicon, Inc. Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element
US6443970B1 (en) 2001-01-24 2002-09-03 Ethicon, Inc. Surgical instrument with a dissecting tip
US6790217B2 (en) 2001-01-24 2004-09-14 Ethicon, Inc. Surgical instrument with a dissecting tip
US7699861B2 (en) 2001-06-26 2010-04-20 Tyco Healthcare Group Lp Conduit harvesting instrument and method
US7645289B2 (en) 2001-06-26 2010-01-12 Tyco Healthcare Group Lp Conduit harvesting instrument and method
EP1435853A1 (en) * 2001-09-28 2004-07-14 Ethicon, Inc. Vessel harvesting retractor with integral electrosurgical clamping elements
US20030125733A1 (en) * 2001-09-28 2003-07-03 Ethicon, Inc. Surgical device for applying radio frequency energy to a portion of a captured vessel
US6592604B2 (en) 2001-09-28 2003-07-15 Ethicon, Inc. Vessel harvesting retractor with dissection element
US6656176B2 (en) 2001-09-28 2003-12-02 Ethicon, Inc. Vessel harvesting retractor with integral electrosurgical clamping elements
EP1435853A4 (en) * 2001-09-28 2006-06-07 Ethicon Inc Vessel harvesting retractor with integral electrosurgical clamping elements
US6835195B2 (en) 2001-09-28 2004-12-28 Ethicon, Inc. Surgical device for applying radio frequency energy to a portion of a captured vessel
US20040097921A1 (en) * 2001-09-28 2004-05-20 Ethicon, Inc. Vessel harvesting retractor with electrosurgical plunger
US20040106938A1 (en) * 2001-09-28 2004-06-03 Hess Christopher J. Vessel harvesting retractor with integral electrosurgical clamping elements
US6592582B2 (en) 2001-09-28 2003-07-15 Ethicon, Inc. Vessel harvesting retractor with electrosurgical plunger
US20030195544A1 (en) * 2001-09-28 2003-10-16 Ethicon, Inc. Vessel harvesting retractor with dissection element
US6551314B1 (en) 2002-04-03 2003-04-22 Thomas J. Fogarty Methods and systems for vein harvesting
US7074220B2 (en) 2002-04-03 2006-07-11 Thomas J. Fogarty Methods and systems for vein harvesting and fistula creation
US20030225426A1 (en) * 2002-04-03 2003-12-04 Thomas J. Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
US20040049208A1 (en) * 2002-04-03 2004-03-11 Thomas Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
WO2004028590A2 (en) 2002-09-27 2004-04-08 Ethicon, Inc. Portable, reusable visualization system
US20060116746A1 (en) * 2003-01-17 2006-06-01 Chin Albert K Cardiac electrode attachment procedure
US20040225317A1 (en) * 2003-05-05 2004-11-11 Rehnke Robert D. Apparatus for use in fascial cleft surgery for opening an anatomic space
US20080045994A1 (en) * 2003-05-05 2008-02-21 Rehnke Robert D Apparatus for use in fascial cleft surgery for opening an anatomic space
US7967835B2 (en) 2003-05-05 2011-06-28 Tyco Healthcare Group Lp Apparatus for use in fascial cleft surgery for opening an anatomic space
US8048087B2 (en) 2003-05-05 2011-11-01 Tyco Healthcare Group Lp Apparatus for use in fascial cleft surgery for opening an anatomic space
US20040236231A1 (en) * 2003-05-23 2004-11-25 Embro Corporation Light catheter for illuminating tissue structures
US20090318816A1 (en) * 2003-05-23 2009-12-24 Embro Corporation Light catheter for illuminating tissue structures
US7314479B2 (en) 2003-10-31 2008-01-01 Parris Wellman Space-creating retractor with vessel manipulator
US20050096671A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Control mechanism for a surgical instrument
US20050096670A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Surgical end effector
US20050096677A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Space-creating retractor with vessel manipulator
US20050096646A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Surgical system for retracting and severing tissue
US20050149094A1 (en) * 2003-10-31 2005-07-07 Olympus Corporation Trocar
US20050148817A1 (en) * 2003-10-31 2005-07-07 Olympus Corporation Living-body tissue removing apparatus
US20050154257A1 (en) * 2003-10-31 2005-07-14 Olympus Corporation Living-body tissue removing apparatus
US8105231B2 (en) 2003-10-31 2012-01-31 Olympus Corporation Living-body tissue removing apparatus
US7662164B2 (en) 2003-10-31 2010-02-16 Olympus Corporation Living-body tissue removing apparatus
US20060173474A1 (en) * 2003-10-31 2006-08-03 Parris Wellman Surgical device having a track to guide an actuator
US20050096645A1 (en) * 2003-10-31 2005-05-05 Parris Wellman Multitool surgical device
US20050273125A1 (en) * 2004-05-13 2005-12-08 Opie John C Percutaneous vein harvester with shielded blade
US20100305594A1 (en) * 2004-05-13 2010-12-02 Scottsdale Medical Devices, Inc. Percutaneous vein harvester with shielded blade
US8480696B2 (en) 2004-06-16 2013-07-09 Medtronic, Inc. Minimally invasive coring vein harvester
US20070005084A1 (en) * 2004-06-16 2007-01-04 Clague Cynthia T Minimally invasive coring vein harvester
US20070015970A1 (en) * 2004-06-25 2007-01-18 Usher Raymond W Vein harvesting system including dilator shaft and removable retractor housing
US7909762B2 (en) 2004-06-25 2011-03-22 Medtronic, Inc. Vein harvesting system including dilator shaft and removable retractor housing
US20060036274A1 (en) * 2004-06-25 2006-02-16 Usher Raymond W One-piece vessel harvester
US20060030756A1 (en) * 2004-06-25 2006-02-09 Usher Raymond W Vein harvesting system including dilator shaft and removable retractor housing
US7762951B2 (en) 2004-06-25 2010-07-27 Medtronic, Inc. Vein harvesting system including dilator shaft and removable retractor housing
US8906048B2 (en) 2004-09-28 2014-12-09 Maquet Cardiovascular Llc Modular vessel harvesting system and method
US7887558B2 (en) 2004-09-28 2011-02-15 Maquet Cardiovascular Llc Modular vessel harvesting system and method
US20060074444A1 (en) * 2004-09-28 2006-04-06 Lin Arthur M Modular vessel harvesting system and method
US20080161843A1 (en) * 2006-10-16 2008-07-03 Clague Cynthia T Vessel support device and method of vessel harvesting
US20080167669A1 (en) * 2006-10-16 2008-07-10 Clague Cynthia T Vessel tensioning handle and method of vessel harvesting
US20080161841A1 (en) * 2006-10-16 2008-07-03 Clague Cynthia T Cutting device and method of vessel harvesting
US20100121362A1 (en) * 2006-10-16 2010-05-13 Scottsdale Medical Devices, Inc. Vessel support device and method of vessel harvesting
US20100114136A1 (en) * 2006-10-16 2010-05-06 Scottsdale Medical Devices, Inc. Cutting device and method of vessel harvesting
US20110046624A1 (en) * 2009-08-21 2011-02-24 Maquet Cardiovascular Llc Single handled endoscopic vessel harvesting system with rotation control
US8657818B2 (en) 2009-08-21 2014-02-25 Maquet Cardiovascular Llc Single handled endoscopic vessel harvesting system with rotation control
US8926642B2 (en) 2009-11-23 2015-01-06 Nelson Medical Enterprises, Llc Method for extracting tubular structures
US20110124958A1 (en) * 2009-11-23 2011-05-26 Nelson Dvora Y Device and method for extracting tubular structures
US20110172688A1 (en) * 2010-01-11 2011-07-14 Tyco Healthcare Group Lp Conduit Harvesting Instrument and Method

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