Surgical instrument for graft harvesting
US-2016354069-A1 · Dec 8, 2016 · US
US2017347996A1 · US · A1
| Field | Value |
|---|---|
| Publication number | US-2017347996-A1 |
| Application number | US-201715686703-A |
| Country | US |
| Kind code | A1 |
| Filing date | Aug 25, 2017 |
| Priority date | Jun 1, 2006 |
| Publication date | Dec 7, 2017 |
| Grant date | — |
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Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy.
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1 - 62 . (canceled) 63 . A vessel dissector that is used in conjunction with an endoscope, comprising: an elongated cannula including a lumen therein for receiving the endoscope; a transparent blunt dissecting tip provided on a distal end of the elongated cannula that permits an operator of the vessel dissector to dissect tissue while viewing internal body structures via an objective lens of the endoscope, wherein the blunt dissection tip has a conical exterior surface; a vessel holding tool extending through the elongated cannula and adapted for longitudinal movement therein; and a vessel severing tool extending through the elongated cannula and adapted for longitudinal movement therein, wherein the dissecting tip includes apertures for passage of the vessel holding tool and the vessel severing tool, and wherein each of the vessel holding tool and the vessel severing tool docks into a corresponding recess in the dissecting tip in a retracted position and has an exterior shape that is configured to match the conical exterior surface of the dissecting tip when in the retracted position. 64 . The vessel dissector of claim 63 , wherein the exterior shape of each of the vessel holding tool and the vessel severing tool is configured to be flush with the conical exterior surface of the dissecting tip when in the retracted position. 65 . The vessel dissector of claim 64 , wherein the vessel holding tool and the vessel severing tool are each configured to move axially out of the corresponding recess in order to engage a blood vessel. 66 . The vessel dissector of claim 65 , wherein the blunt dissection tip is dimensioned to receive the endoscope therein. 67 . The vessel dissector of claim 66 , wherein when the endoscope is received within the blunt dissection tip, the endoscope is disposed between the vessel holding tool and the vessel severing tool. 68 . The vessel dissector of claim 63 , wherein the vessel severing tool is a tissue welder. 69 . A tissue dissector, comprising: an elongated cannula including a distal end and a lumen for receiving an endoscope; a tissue dissection tip configured for dissecting tissue, wherein the tissue dissection tip comprises a conical one piece structure tapering to a blunt end configured for tissue dissection, and is coupled to the distal end of the elongated cannula; an articulation interface between the elongated cannula and the tissue dissection tip, the articulation interface comprising an articulation body; and a first control member comprising a first elongated body extending through the elongated cannula and connected to the tissue dissection tip, wherein the first control member engages and applies a force to the tissue dissection tip and is configured to tilt the tissue dissection tip relative to a longitudinal axis of the elongated cannula so as to directionally orient and facilitate maneuverability of the tissue dissection tip; wherein the articulation body is configured to change an angle of the tissue dissection tip relative to the longitudinal axis of the elongated cannula and wherein the articulation interface exerts a force sufficient to revert the tissue dissection tip back to axial alignment with the longitudinal axis of the elongated cannula when the force applied by the first control member is released; and wherein the first control member occupies a space in the elongated cannula, and the tissue dissection tip is transparent. 70 . The tissue dissector of claim 69 , further comprising a second control member comprising an elongated body extending through the elongated cannula and connected to the tissue dissection tip, wherein the second control member applies a force to the tissue dissection tip for tilting the transparent structure relative to the elongated cannula. 71 . The tissue dissector of claim 69 , wherein the articulation interface comprises an accordion-like flexible sleeve that is coupled between the tissue dissection tip and the elongated cannula. 72 . The tissue dissector of claim 69 , wherein the articulation interface comprises a spherical bearing surface coupled between the tissue dissection tip and the elongated cannula. 73 . The tissue dissector of claim 69 , further comprising an opening disposed to deliver insufflation gas, wherein the opening is located at the tissue dissection tip. 74 . The tissue dissector of claim 73 , further comprising a barrier covering the opening. 75 . The tissue dissector of claim 69 , further comprising an opening for delivering gas, wherein the opening is located at a side of the elongated cannula. 76 . The tissue dissector of claim 75 , further comprising a barrier covering the opening. 77 . The tissue dissector of claim 69 , wherein the first control member is configured to tilt the tissue dissection tip about an axis that is perpendicular to the longitudinal axis of the elongated cannula. 78 . The tissue dissector of claim 69 , wherein the endoscope and the first control member occupy different respective space in the elongated cannula. 79 . The tissue dissector of claim 69 , wherein the first control member is spaced apart from the endoscope and comprises a steering wire. 80 . The tissue dissector of claim 69 , wherein the tissue dissection tip has an inner surface that is aligned with a center of the lumen, the inner surface oriented to prevent light from being reflected towards the center of the lumen. 81 . The tissue dissector of claim 69 , wherein the first control member extends through the tissue dissection tip and is connected to a surface of the tissue dissection tip under tension and wherein the first control member applies a pull force with respect to the tissue dissection tip for tilting the tissue dissection tip relative to the longitudinal axis of the elongated cannula. 82 . A tissue dissector, comprising: an elongated cannula including a distal end and a lumen for receiving an endoscope; a tissue dissection tip configured for dissecting tissue, wherein the tissue dissection tip comprises a conical one piece structure tapering to a blunt end configured for tissue dissection, and is coupled to the distal end of the elongated cannula; an articulation interface between the elongated cannula and the tissue dissection tip, the articulation interface comprising an articulation body; a first control member comprising a first elongated body extending through the elongated cannula and connected to the tissue dissection tip, wherein the first control member applies a force to the tissue dissection tip and is configured to tilt the tissue dissection tip relative to a longitudinal axis of the elongated cannula so as to directionally orient and facilitate maneuverability of the tissue dissection tip; and a second control member comprising an elongated body extending through the elongated cannula and connected to the tissue dissection tip, wherein the second control member applies a force to the tissue dissection tip and is configured to tilt the tissue dissection tip relative to the longitudinal axis of the elongated cannula so as to directionally orient and facilitate maneuverability of the tissue dissection tip; wherein the articulation body is configured to change an angle of the tissue dissection tip relative to the longitudinal axis of the elongated cannula; and wherein the first control member and the second control member each occupies a space in the elongated cannula. 83 . 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