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31. 发明授权

US5871496A Surgical instrument for facilitating the detachment of an artery and the like 失效
公开(公告)号：US5871496A
公开(公告)日：1999-02-16
申请号：US835675
申请日：1997-04-10
申请人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
发明人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
IPC分类号： A61B17/00 , A61B17/02 , A61B17/28 , A61B17/32 , A61B18/14
CPC分类号： A61B17/00008 , A61B17/02 , A61B17/00234 , A61B17/320016 , A61B2017/00867 , A61B2017/00969 , A61B2017/2905 , A61B2017/2927 , A61B2018/00916 , A61B2018/1253 , A61B2018/1407 , A61B2018/1435
摘要： A surgical instrument is configured to aid in performing a procedure of detaching an internal mammary artery (IMA) and the like, from the connecting tissues and side branch vessels which surround the artery in its native location, wherein the detaching procedure is preliminary to the performing of a coronary artery bypass grafting procedure and wherein the IMA is detached via a minimally invasive thoracotomy. To this end, an elongated slender rod includes a handle at its proximal end and an artery engaging loop, arc, fork configuration, or hook at its distal working end. Embodiments may incorporate electrosurgical capability or electrical insulation. A surgeon thus has means for harvesting an intact and undamaged graft vessel from its native location through a minimally invasive incision with enhanced speed, visibility, and freedom of motion.

32. 发明授权

US06280455B1 Surgical instrument for facilitating the detachment of an artery and the like 失效
标题翻译：用于促进动脉等的分离的手术器械
公开(公告)号：US06280455B1
公开(公告)日：2001-08-28
申请号：US09243742
申请日：1999-02-03
申请人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
发明人： Richard S. Ginn , Hani Shennib , Charles S. Taylor , Ivan Sepetka
IPC分类号： A61B1700
CPC分类号： A61B17/00008 , A61B17/00234 , A61B17/02 , A61B17/320016 , A61B2017/00867 , A61B2017/00969 , A61B2017/2905 , A61B2017/2927 , A61B2018/00916 , A61B2018/1253 , A61B2018/1407 , A61B2018/1435
摘要： A surgical instrument is configured to aid in performing a procedure of detaching an internal mammary artery (IMA) and the like, from the connecting tissues and side branch vessels which surround the artery in its native location, wherein the detaching procedure is preliminary to the performing of a coronary artery bypass grafting procedure and wherein the IMA is detached via a minimally invasive thoracotomy. To this end, an elongated slender rod includes a handle at its proximal end and an artery engaging loop, arc, fork configuration, or hook at its distal working end. Embodiments may incorporate electrosurgical capability or electrical insulation. A surgeon thus has means for harvesting an intact and undamaged graft vessel from its native location through a minimally invasive incision with enhanced speed, visibility, and freedom of motion.
摘要翻译：手术器械被配置为有助于执行从其周围的动脉周围的连接组织和侧分支血管分离内部乳腺动脉（IMA）等的步骤，其中分离程序是执行的初步的冠状动脉旁路移植手术，其中通过微创开胸术分离IMA。为此，细长杆在其近端包括手柄，在其远端工作端处包括动脉接合环，弧形，叉形结构或钩。实施例可以包括电外科能力或电绝缘。因此，外科医生具有通过具有增强的速度，可见性和运动自由的微创切口从其原始位置收集完整且未损坏的移植血管的手段。

33. 发明授权

US5776154A Surgical instruments for making precise incisions in a cardiac vessel 失效
标题翻译：用于在心脏血管中进行精确切口的手术器械
公开(公告)号：US5776154A
公开(公告)日：1998-07-07
申请号：US603329
申请日：1996-02-20
申请人： Charles S. Taylor , John J. Frantzen , Ivan Sepetka
发明人： Charles S. Taylor , John J. Frantzen , Ivan Sepetka
IPC分类号： A61B17/00 , A61B17/28 , A61B17/32
CPC分类号： A61B17/32 , A61B17/320016 , A61B2017/00243 , A61B2017/00703 , A61B2017/00778 , A61B2017/2925 , A61B2017/320052
摘要： Surgical instruments and methods for making substantially linear incisions, especially through the wall of vessels, such as arteries, specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The invention is particularly useful to create the incision in the artery to which a bypass graft is sewn, typically the left anterior descending artery (LAD). The instruments allow incisions to be rapidly made, precisely measured, and cleanly formed so that a bypass graft can be rapidly sewn in place, without undue trauma to surrounding tissue and excessive loss of blood. In one embodiment, a hand-held instrument has a cutting edge formed on the interior edge of a curved blade fixed near the end of the instrument. The tip of the blade has a point for penetrating the vessel wall which may have several alternate shapes to facilitate penetration of the vessel wall while minimizing trauma to the surrounding tissue. In another embodiment the hand-held instrument includes a moveable member which creates an incision by engaging a cutting blade against a stop, cutting tissue therebetween, the stop including a pointed tip similar to the previous embodiment. In another embodiment, the instrument features a motion-canceling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated from a handle which is isolated from the movement of the tissue containing or proximate to the target of the incision.
摘要翻译：用于进行基本上线性切口的手术器械和方法，特别是通过专门设计用于搏动心脏上的冠状动脉旁路移植手术（CABG）的诸如动脉的血管壁。本发明特别有用于在缝合旁路移植物的动脉中产生切口，通常为左前降支动脉（LAD）。这些仪器允许快速地进行切割，精确测量和清洁地形成，使得旁路移植物可以快速缝合就位，而不会对周围组织造成过度的创伤和过度的血液损失。在一个实施例中，手持式仪器具有形成在靠近仪器端部的弯曲刀片的内边缘上的切割刃。叶片的尖端具有穿透血管壁的点，该点可以具有若干替代形状，以促进血管壁的穿透，同时最小化对周围组织的创伤。在另一个实施例中，手持式仪器包括可移动构件，其通过将切割刀片接合止挡件而形成切口，在其间切割组织，止动件包括类似于先前实施例的尖端。在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。该实施例具有从手柄操纵的切割刀片，该手柄与包含或接近切口目标的组织的运动隔离。

34. 发明授权

US06387108B1 Surgical instruments for making precise incisions in a cardiac vessel 有权
标题翻译：用于在心脏血管中进行精确切口的手术器械
公开(公告)号：US06387108B1
公开(公告)日：2002-05-14
申请号：US09541851
申请日：2000-04-03
申请人： Charles S. Taylor , John J. Frantzen , Ivan Sepetka
发明人： Charles S. Taylor , John J. Frantzen , Ivan Sepetka
IPC分类号： A61B1732
CPC分类号： A61B17/32 , A61B17/320016 , A61B2017/00243 , A61B2017/00703 , A61B2017/00778 , A61B2017/2925 , A61B2017/320052
摘要： The invention is surgical instruments which facilitate substantially linear incisions, especially through the wall of vessels, such as arteries, which have been specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The instruments of the invention are particularly useful to create the incision in the artery to which the bypass graft is sewed, typically the left anterior descending artery (LAD). The instruments of the invention allow incisions to be rapidly made, precisely measured, and cleanly formed so that a bypass graft can be rapidly sewn in place. In one embodiment, the invention is comprised of a hand-held instrument with a curved cutting edge formed on the interior edge of a curved or arcuitous segment located near the end of the instrument. The tip of the instrument has a point of penetrating the vessel wall. The point may have several alternate shapes to facilitate penetration of the vessel wall while maximizing the trauma to the surrounding tissue. Another embodiment is comprised of a hand-held instrument with moveable member such that the incision is created by engaging a cutting blade against a stop with the tissue being cut therebetween. This instrument is also constructed to facilitate a rapid linear incisions in a vessel while minimizing the possibility for damage to the surrounding tissue. In another embodiment, the instrument features a motion-cancelling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated form handle which is isolated from the movement of the tissue containing or proximate to the target of the incision. The instruments facilitate the invasive cardiac procedures by creating linear incisions quickly without undue trauma to surrounding tissue and without excess loss of blood.
摘要翻译：本发明是促进基本上线性切口的手术器械，特别是通过在搏动心脏上专门设计用于冠状动脉旁路移植手术（CABG）的血管如动脉壁。本发明的器械特别可用于在旁路移植物缝合的动脉中形成切口，通常为左前降支动脉（LAD）。本发明的仪器允许快速地进行切割，精确地测量和清洁地形成切口，使得旁路移植物能够快速地缝合到位。在一个实施例中，本发明包括具有弯曲切割边缘的手持式仪器，其形成在位于靠近仪器端部的弯曲或直立部分的内边缘上。仪器的尖端具有穿透血管壁的点。该点可以具有几种替代形状，以促进血管壁的穿透，同时使周围组织的创伤最大化。另一个实施例包括具有可移动构件的手持式仪器，使得通过将切割刀片接合在止动件上而在其间切割的组织而产生切口。该仪器还构造成便于在容器中快速线性切口，同时最小化对周围组织的损伤的可能性。在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。该实施例具有切割刀片，该切割刀片从手柄被操纵，所述切割刀片与包含或接近切口的靶标的组织的运动隔离。这些仪器通过快速创建线性切口来促进侵入性心脏手术，而不会对周围组织造成不必要的创伤，而不会导致血液过多的流失。

35. 发明授权

US6113616A Surgical instruments for making precise incisions in a cardiac vessel 失效
标题翻译：用于在心脏血管中进行精确切口的手术器械
公开(公告)号：US6113616A
公开(公告)日：2000-09-05
申请号：US27611
申请日：1998-02-23
申请人： Charles S. Taylor , John J. Frantzen , Ivan Sepetka
发明人： Charles S. Taylor , John J. Frantzen , Ivan Sepetka
IPC分类号： A61B17/00 , A61B17/28 , A61B17/32
CPC分类号： A61B17/32 , A61B17/320016 , A61B2017/00243 , A61B2017/00703 , A61B2017/00778 , A61B2017/2925 , A61B2017/320052
摘要： Surgical instruments and methods for making substantially linear incisions, especially through walls of vessels, such arteries, specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The invention is particularly useful to create the incision in the artery to which a bypass graft is sewn, typically the left anterior descending artery (LAD). The instruments allow incisions to be rapidly made, precisely measured and cleanly formed so that a bypass graft can be rapidly sewn in place, without undue trauma to surrounding tissue and excessive loss of blood. In one embodiment, a hand-held instrument has a cutting edge formed on the interior edge of a curved blade fixed near the end of the instrument. The tip of the blade has a point for penetrating the vessel wall which may have several alternate shapes to facilitate penetration of the vessel wall while minimizing to the surrounding tissue. In another embodiment the hand-held instrument includes a moveable member which creates an incision by engaging a cutting blade against a stop, cutting tissue therebetween, the stop including a pointed including a pointed tip similar to the previous embodiment. In another embodiment, the instrument features a motion-canceling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated from a handle which is isolated from the movement of the tissue containing or proximate to the target of the incision.
摘要翻译：手术器械和方法，用于进行基本上线性的切口，特别是通过血管壁，这种动脉，专门设计用于搏动心脏上的冠状动脉旁路移植手术（CABG）。本发明特别有用于在缝合旁路移植物的动脉中产生切口，通常为左前降支动脉（LAD）。这些仪器允许快速地进行切割，精确测量和清洁地形成，使得旁路移植物可以快速缝合就位，而不会对周围组织造成过度的创伤和过度的血液损失。在一个实施例中，手持式仪器具有形成在靠近仪器端部的弯曲刀片的内边缘上的切割刃。叶片的尖端具有用于穿透血管壁的点，该点可以具有若干替代形状，以促进血管壁的穿透，同时使周围组织最小化。在另一个实施例中，手持式器械包括可移动构件，其通过将切割刀片接合止挡件而形成切口，在其间切割组织，止动件包括类似于前述实施例的尖端，包括尖端。在另一个实施例中，仪器具有补偿待切割的目标表面的移动的运动消除构件。该实施例具有从手柄操纵的切割刀片，该手柄与包含或接近切口目标的组织的运动隔离。

36. 发明授权

US06758808B2 Surgical instruments for stabilizing a localized portion of a beating heart 有权
标题翻译：用于稳定跳动心脏的局部化部分的手术器械
公开(公告)号：US06758808B2
公开(公告)日：2004-07-06
申请号：US09769964
申请日：2001-01-24
申请人： David J. Paul , Joshua K. Wallin , Eugene E. Reis , Alfredo R. Cantu , Harry L. Green , Harry Ino , Charles S. Taylor
发明人： David J. Paul , Joshua K. Wallin , Eugene E. Reis , Alfredo R. Cantu , Harry L. Green , Harry Ino , Charles S. Taylor
IPC分类号： A61B132
CPC分类号： A61B17/0206 , A61B2017/0243 , A61B2017/306 , A61G13/12
摘要： Stabilization devices, systems and methods for stabilizing tissue to perform a surgical operation while the heart of the patient continues to beat. A stabilization system including a tissue contact member having a surface adapted to contact the tissue and temporarily maintain the tissue in a relatively immobilized state; and a maneuverable arm attached to the tissue contact member, which includes at least one articulating joint formed by a link having a male articulating surface composed of angled teeth and a female articulating surface having angled trenches adapted to receive the angled teeth.
摘要翻译：稳定装置，系统和方法，用于在患者的心脏继续击打的同时稳定组织以执行外科手术。一种稳定系统，包括具有适于接触组织并暂时维持组织处于相对固定状态的表面的组织接触构件; 以及附接到组织接触构件的可机动臂，其包括由具有由成角度的齿组成的阳性关节表面的连杆形成的至少一个铰接接头和具有适于接收成角度的齿的具有成角度的沟槽的阴性铰接表面。

37. 发明授权

US5727569A Surgical devices for imposing a negative pressure to fix the position of cardiac tissue during surgery 失效
标题翻译：用于施加负压以固定手术期间心脏组织位置的手术装置
公开(公告)号：US5727569A
公开(公告)日：1998-03-17
申请号：US603328
申请日：1996-02-20
申请人： Federico J. Benetti , Robert G. Matheny , Charles S. Taylor
发明人： Federico J. Benetti , Robert G. Matheny , Charles S. Taylor
IPC分类号： A61B17/00 , A61B17/02 , A61B17/30 , A61B17/34 , A61B19/00
CPC分类号： A61B17/00 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/306 , A61B2017/3488 , A61B90/40
摘要： The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site. In certain preferred embodiments, the devices described herein have structures to facilitate the use of additional surgical instruments such that the placement of negative pressure device permit the surgeon to advantageously manipulate the other instruments during surgery. The negative pressure is preferably imposed through a plurality of ports which may be disposed in a substantially planar surface of the instrument which contacts the cardiac tissue.
摘要翻译：本发明是使用通过外科器械施加的负（吸力）压力或真空来固定跳动心脏表面的一部分的位置使得外科手术可以更容易地进行的装置和技术。这些装置在心脏的外表面上的几个点处施加负压，使得心脏的一部分通过通过手术器械施加的抽吸被固定就位。因为仪器固定组织的位置，并且因为仪器保持与正在执行手术的心脏的特定部分恒定的距离，所以该装置还可以用作支撑或平台，使得其它手术器械或装置可以有利地在现场使用。在某些优选实施例中，本文所述的装置具有便于使用额外外科器械的结构，使得负压装置的放置允许外科医生在手术期间有利地操纵其他器械。负压优选通过多个端口施加，所述多个端口可以设置在与心脏组织接触的仪器的基本平坦的表面中。

38. 发明授权

US6050266A Procedures for stabilizing the beating heart during coronary artery bypass graft surgery 失效
标题翻译：在冠状动脉旁路移植手术期间稳定跳动心脏的程序
公开(公告)号：US6050266A
公开(公告)日：2000-04-18
申请号：US99855
申请日：1998-06-18
申请人： Federico J. Benetti , Charles S. Taylor
发明人： Federico J. Benetti , Charles S. Taylor
IPC分类号： A61B17/00 , A61B17/02 , A61B17/064 , A61B17/11 , A61B17/12 , A61B17/28 , A61B17/30 , A61B17/34 , A61B19/00
CPC分类号： A61B17/0218 , A61B17/00234 , A61B17/0206 , A61B17/3423 , A61B90/00 , A61B17/02 , A61B17/0642 , A61B17/12 , A61B17/3421 , A61B2017/00243 , A61B2017/00557 , A61B2017/00703 , A61B2017/00858 , A61B2017/0243 , A61B2017/1139 , A61B2017/2825 , A61B2017/2913 , A61B2017/2929 , A61B2017/306 , A61B2017/349
摘要： The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes only minimal excess motion at the surgery site. By fixing the position of the stabilizing means in a configuration where the motion of the beating heart is effectively eliminated, the surgeon is able to stabilize the beating heart for the duration of the procedure. The stabilizing means may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically, or by human intervention. In certain preferred embodiments, the stabilizing means is affixed to a semi-rigid support which is caused to become rigid, by any of a variety of techniques, such that the position of the stabilizing means becomes fixed by the support, and the heart remains substantially motionless for the duration of the procedure.
摘要翻译：本发明是外科医生可以在心脏手术过程中稳定跳动心脏的方法和装置。根据本发明，稳定装置通过胸部的开口引入并与打浆心接触。通过将心脏与装置接触并且通过在装置上施加稳定力，由心脏肌肉收缩引起的心脏的运动被有效地消除，使得心脏稳定，并且手术部位仅在最小程度上移动，如果在所有。通常，在单独的步骤中，外科医生将心脏与稳定装置接触，评估吻合部位的移动程度，并对稳定装置施加力，使得跳动心脏的收缩在手术时仅引起极小的过度运动现场。通过将稳定装置的位置固定在跳动心脏的运动被有效地消除的构造中，外科医生能够在手术期间稳定跳动的心脏。稳定装置可以附接到刚性支撑件，或者可以附接到半刚性支撑件，其通过机械，化学方式或通过人为干预使其不动。在某些优选实施例中，稳定装置通过各种技术中的任一种被固定到半刚性支撑件上，使其变得刚性，使得稳定装置的位置由支撑件固定，并且心脏基本保持在程序期间不动。

39. 发明授权

US5906607A Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery 失效
公开(公告)号：US5906607A
公开(公告)日：1999-05-25
申请号：US790828
申请日：1997-01-23
申请人： Charles S. Taylor , Federico J. Benetti , Robert G. Matheny
发明人： Charles S. Taylor , Federico J. Benetti , Robert G. Matheny
IPC分类号： A61B17/00 , A61B17/02 , A61B17/30 , A61B17/34 , A61B19/00
CPC分类号： A61B17/00 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/306 , A61B2017/3488 , A61B90/40
摘要： The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site. In certain preferred embodiments, the devices described herein have structures to facilitate the use of additional surgical instruments such that the placement of negative pressure device permit the surgeon to advantageously manipulate the other instruments during surgery. The negative pressure is preferably imposed through a plurality of ports which may be disposed in a substantially planar surface of the instrument which contacts the cardiac tissue.

40. 发明授权

US06736774B2 Xyphoid access for cardiac surgical procedures 失效
标题翻译：用于心脏外科手术的螺钉通道
公开(公告)号：US06736774B2
公开(公告)日：2004-05-18
申请号：US09757128
申请日：2001-01-08
申请人： Federico J. Benetti , Charles S. Taylor , Michael V. Morejohn
发明人： Federico J. Benetti , Charles S. Taylor , Michael V. Morejohn
IPC分类号： A61B132
CPC分类号： A61B17/0206 , A61B17/02 , A61B17/0293 , A61B2017/0237 , A61B2017/0243
摘要： Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.
摘要翻译：在心脏跳动的外科手术可以通过在假体区域中进行的切口和专门设计的牵开器和相关装置来促进心脏手术。具体来说，冠状动脉旁路移植手术（CABG）使用垂直抵消的牵开器或进入平台与跳动心脏稳定器组合来实现。手术方法允许诸如CABG手术的过程，而不穿透肋骨架或执行胸骨切开术或胸腔切开术。

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