WO2006000121A1 - Dispositif concu pour stabiliser la surface du coeur lors d'une intervention chirurgicale - Google Patents

Dispositif concu pour stabiliser la surface du coeur lors d'une intervention chirurgicale Download PDF

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Publication number
WO2006000121A1
WO2006000121A1 PCT/CH2005/000353 CH2005000353W WO2006000121A1 WO 2006000121 A1 WO2006000121 A1 WO 2006000121A1 CH 2005000353 W CH2005000353 W CH 2005000353W WO 2006000121 A1 WO2006000121 A1 WO 2006000121A1
Authority
WO
WIPO (PCT)
Prior art keywords
retractor
heart
support
attached
cords
Prior art date
Application number
PCT/CH2005/000353
Other languages
German (de)
English (en)
Inventor
Bekim Osmani
Charles Brom
Original Assignee
Zürcher Hochschule Winterthur
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Zürcher Hochschule Winterthur filed Critical Zürcher Hochschule Winterthur
Publication of WO2006000121A1 publication Critical patent/WO2006000121A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B2017/0237—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B2017/0237—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery
    • A61B2017/0243—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for heart surgery for immobilizing local areas of the heart, e.g. while it beats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction

Definitions

  • the invention relates to a device for stabilizing the heart surface during a surgical procedure, with a retractor and a stabilizer arm attached to this with suction elements for resting on the heart surface.
  • the thorax Prior to performing beating heart bypass surgery, the thorax is spread using a retractor after previously splitting the sternum.
  • a retractor flexible stabilizer arm To stabilize the surgical field on the exposed heart serves a mounted on the retractor flexible stabilizer arm with arranged at its end circular suction cups haf ⁇ tend the heart surface, so that when stiffened stabilizer arm to be revascularized vessel is immobilized.
  • the invention is based on the object of designing a device of the type mentioned at the outset such that the deflections caused by the beating heart can be further reduced in the surgical field.
  • the essential essence of the invention is that the heart resting on its own weight on the elastic support element can strike downwards and the impacts are largely absorbed, damped and absorbed by the support element.
  • the suction cups on the stabilizer arm are used only for local fixation of the heart surface in the operating area and exert no pressure on the heart surface. If necessary, even a slight lifting of the heart surface may be desired.
  • the support device is height adjustable and releasably secured to the retractor.
  • the carrying device has a rigid support frame with Stützschnü ⁇ attached to principleo ⁇ the frame parts and extending between them from an elastic material as a support element.
  • the extending between the frame parts support cords are preferably stretched.
  • the clamping force of the support cords is expediently adjusted so that there is an optimum relationship between vibration damping and deflection.
  • the support device is preferably attached hanging by means of carrying cords on the retractor.
  • the support cords consist of a preferably inelastic material.
  • four carrying cords are fastened with one end to the support element at four points corresponding to the corner points of a rectangle.
  • the other ends of the four support cords are preferably in pairs on two expansion rails of the retractor set, wherein the four attachment points also form the Eck ⁇ points of a rectangle.
  • FIG. 1 shows an oblique view of a retractor with a carrying device for the heart and a stabilizer arm with suction fingers
  • FIG. 2 shows an oblique view of a carrying device
  • FIG. - Figure 3 is an oblique view of a Aufsteckteil with clamping element.
  • FIG. 4 shows an oblique view from below of the suction fingers of FIG. 1.
  • a retractor 10 used for carrying out a bypass operation on the beating heart has, as shown in FIG. 1, a base rail 12 with ratchet teeth 14. From one end of the base rail 12 protrudes a fixed Sp Dahl ⁇ rail 16 at right angles.
  • the heart bed 26 consists of a substantially U-shaped frame 28, between the parallel leg portions 30, 32 support cords 33 of a elastic material are clamped. At both ends of each leg part 30, 32, support cords 34 for hanging fastening of the heart bed 26 to the retractor 10 or to its expansion rails 16, 18 are arranged via connecting members 36.
  • Each Sp Schwarzschiene 16, 18 is equipped with two Aufsteck tone 38 - also called clips.
  • the clips 38 can be attached laterally from the outside on the Sp Schwarzschienen 16, 18 and are longitudinally displaceable on these.
  • a clip 38 shown in detail in FIG. 3, consists of an approximately U-shaped strip of an elastic material, preferably of stainless spring steel, and can be pushed laterally from the outside onto the retractor rails 16, 18.
  • Each clip 38 is equipped with a clamping element 40 with a für ⁇ guide channel 42 for each support line 34. About a arranged in the clamping element 40 and with its tip into the feed-through channel 42 screwed clamping screw 44, the support cord 34 in Klemmele ⁇ ment 40 are releasably fixed.
  • a flexible stabilizer arm 46 composed alternately of hollow spherical segments 48 and rings 50 is fastened at one end to a stabilizer housing 52.
  • the displaceable on the movable spreader bar 18 stabilizer housing 52 can be fixed by means of clamping levers 54 operable eccentric at any position of the retractor rail 18.
  • an end piece 56 is mounted at the other end of the stabilizer arm 46.
  • toggle mechanism can be clamped by means of clamping levers 58 a running between the stabilizer housing 52 and the end piece 56 in the stabilizer arm 46 tensioning cable and the stabilizer arm 46 are stiffened in any desired position.
  • suction fingers 60, 62 From the stabilizer arm 46 protrude two suction fingers 60, 62 arranged parallel to one another and laterally spaced from one another.
  • the suction fingers 60, 62 stuck aus ⁇ exchangeable on pipe socket 66, 68 of a suction tube holder 64 which is releasably secured with a clamping element 70 on the end piece 56.
  • suction tubes 76, 78 projecting into each suction finger 60, 62 are connected via flexible suction lines 72, 74 to a vacuum source, not shown in the drawing, e.g. a vacuum pump, connected.
  • a vacuum source not shown in the drawing, e.g. a vacuum pump, connected.
  • the suction fingers 60 62 have circular openings or suction cups 82 on a support surface 80 provided for resting on the heart surface.
  • FIGS. 1 to 4 The handling of the device illustrated in FIGS. 1 to 4 for the case of a bypass operation on the heart is explained in more detail below.
  • the spreader parts 22, 24 are inserted into the breastbite gap and the thorax of the patient is spread apart by moving the two spreader bars 16, 18 of the retractor 10 apart.
  • the four clips 38 with the carrying straps 34 already drawn into the clamping elements 40 are slipped onto the retractor rails 16, 18.
  • the heart is raised slightly and the pre-assembled heart bed 26 is pushed under the heart. Subsequently, the heart is lifted by pulling on the support cords 34 to the height desired for the operation. With the clamping screws 44, the carrying cords 34 are then clamped firmly in the clamping elements 40, so that the heart is held in the desired position.
  • the flexible stabilizer arm 46 with the two terminal suction fingers 60, 62 is brought from above to the heart, that the two suction fingers 60, 62 rest on the heart surface and the surgical field between the two suction fingers 60, 62 is located. Now the stabilizer arm 46 is fixed by means of the clamping lever 54 on the spreader rail 18 and stiffened by means of the clamping lever 58. A suction pressure is generated in the suction fingers 60, 62 via the suction lines 72, 74, as a result of which the suction cups 82 become firmly attached to the heart surface and in this way stabilize the surgical field between the two suction fingers 60, 62.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un dispositif conçu pour stabiliser la surface du coeur lors d'une intervention chirurgicale. Ce dispositif comprend un écarteur (10) et un bras de stabilisateur (46) qui est fixé à l'écarteur et qui présente des éléments d'aspiration conçus pour s'appuyer à la surface du coeur. Un dispositif de support (26) fixé sur l'écarteur (10) est équipé d'un élément de soutien élastique (33) conçu pour soutenir le coeur. Le coeur qui repose avec son propre poids sur l'élément de soutien élastique peut battre vers le bas de manière que les battements sont en majeure partie captés, amortis et absorbés par l'élément de soutien. Cette invention permet ainsi de diminuer nettement les déports engendrés par le coeur qui bat dans le champ opératoire.
PCT/CH2005/000353 2004-06-28 2005-06-27 Dispositif concu pour stabiliser la surface du coeur lors d'une intervention chirurgicale WO2006000121A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH10842004 2004-06-28
CH1084/04 2004-06-28

Publications (1)

Publication Number Publication Date
WO2006000121A1 true WO2006000121A1 (fr) 2006-01-05

Family

ID=34970677

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH2005/000353 WO2006000121A1 (fr) 2004-06-28 2005-06-27 Dispositif concu pour stabiliser la surface du coeur lors d'une intervention chirurgicale

Country Status (1)

Country Link
WO (1) WO2006000121A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11578372B2 (en) 2012-11-05 2023-02-14 Foundation Medicine, Inc. NTRK1 fusion molecules and uses thereof

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1002498A1 (fr) * 1998-06-05 2000-05-24 Sumitomo Bakelite Co., Ltd. Dispositif auxiliaire de pontage aorto-coronaire pulsatoire
US6234960B1 (en) * 1998-09-30 2001-05-22 A-Med Systems, Inc. Heart stabilizer apparatus
US6371910B1 (en) * 1997-10-16 2002-04-16 General Surgical Innovations, Inc. Inflatable manipulator for organ positioning during surgery
US20020115911A1 (en) * 2001-02-16 2002-08-22 Gary Knight Cardiac stabilizer device having multiplexed vacuum ports
US6705988B2 (en) * 1997-09-17 2004-03-16 Origin Medsystems, Inc. Device to permit offpump beating heart coronary bypass surgery
US20040087834A1 (en) * 1996-02-20 2004-05-06 Benetti Federico J. Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040087834A1 (en) * 1996-02-20 2004-05-06 Benetti Federico J. Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery
US6705988B2 (en) * 1997-09-17 2004-03-16 Origin Medsystems, Inc. Device to permit offpump beating heart coronary bypass surgery
US6371910B1 (en) * 1997-10-16 2002-04-16 General Surgical Innovations, Inc. Inflatable manipulator for organ positioning during surgery
EP1002498A1 (fr) * 1998-06-05 2000-05-24 Sumitomo Bakelite Co., Ltd. Dispositif auxiliaire de pontage aorto-coronaire pulsatoire
US6234960B1 (en) * 1998-09-30 2001-05-22 A-Med Systems, Inc. Heart stabilizer apparatus
US20020115911A1 (en) * 2001-02-16 2002-08-22 Gary Knight Cardiac stabilizer device having multiplexed vacuum ports

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11578372B2 (en) 2012-11-05 2023-02-14 Foundation Medicine, Inc. NTRK1 fusion molecules and uses thereof

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