Blood vessel harvesting device

Surgery – Instruments – Blood vessel – duct or teat cutter – scrapper or abrader

Reexamination Certificate

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Details

C600S114000

Reexamination Certificate

active

06818003

ABSTRACT:

TECHNICAL FIELD
The present invention is related to devices and methods of utilizing such devices for harvesting blood vessels. More specifically, the present invention is directed at a device and method particularly useful in separating a desired artery or vein from lateral branch vessels so as to allow excision of such for use as, for example, a graft.
BACKGROUND OF THE INVENTION
It is a fairly common procedure to utilize viable healthy blood vessels from one part of a patient's circulatory system as a graft in order to replaced a blocked, damaged or diseased vessel at another location. For example, the coronary arteries are especially prone and subject to atherosclerosis as well as other vessel damaging and occluding diseases. Coronary bypass surgery commonly utilizes healthy segments of the radial artery, saphenous vein and other blood vessels as grafts to replace such diseased vessels.
In order to obtain a suitable length of a given artery or vein for use as a graft, a harvesting procedure in which a surgeon excises a desired length of donor vessel must first be accomplished. In accomplishing such harvesting procedures, the selected donor vessel must be safely separated from lateral (or branch) vessels arising from the main vessel to be harvested. Also, the donor vessel must be cleaved, at a proximal and distal point from them main vessel from which it arises in order to fully free the segment for use as a graft.
Harvesting procedures involve obtaining access to the donor vessel. In the past, such access has been accomplished with lengthy skin incisions made along the length of vessel to be harvested. Thereafter, blunt dissection of the vessel from connective tissue, fat and other structures adherent upon it, followed by cleavage of branch vessels was commonly performed. Recently, endoscopic approaches have been utilized to harvest vessels. Such procedures typically commence with small skin incisions made at locations in close proximity to the proximal and distal extent of the graft desired are first made. Thereafter, an endoscope is utilized along with instruments, especially designed for endoscopic surgery, to accomplish blunt dissection and severing of the vessel from lateral branches. Such techniques are far more conservative in nature and involve substantially reduced skin incisions—and concomitant prolonged healing and pain—as compared to open techniques. However, the relatively small enclosed field in which multiple instruments must be utilized makes the procedure somewhat less than ideal. U.S. Pat. No. 5,899,912, Eaves III (the “'912 patent”) discloses a harvesting apparatus utilized in endoscopic removal of blood vessels. The disclosed harvesting instrument includes a harvesting head with a channel for receiving a blood vessel as well as at least one slot extending from the channel to the outer surface of the harvesting head for receipt of side branches of the vessel. The slot contains a blade for severing side branches and electro cautery for sealing the cut ends of the vessel. The outside surface of the harvesting head may be utilized for blunt dissection about the vessel to be harvested. Although the '912 patent discloses a harvesting instrument which provides blunt dissection as well as cleavage and sealing of side branches, the device does not provide any means of operator control or guidance of the position of vessels within the harvesting head save through the gross manipulation of a handle depending from the harvesting head. Also, no means is disclosed for retaining a vessel within the instrument during the cufting/cautery procedure.
SUMMARY OF THE INVENTION
Now in accordance with the present invention, a blood vessel harvesting device is disclosed. The harvesting device of the present invention is comprised of a harvesting cannula generally configured as an elongated, hollow tube having a longitudinal axis. The cannula includes an outer wall, a central bore, a proximal and a distal terminus. The cannula is comprised of three sections: a harvesting head, a tubular control segment and a sliding operation arm. The tubular control segment and harvesting head are contiguous structures which form a portion of the hollow, tubular cannula structure discussed above.
The tubular control segment is located and forms, in combination with a proximal portion of the sliding operation arm, the proximal portion of the harvesting cannula. The control segment joins distally and is continuous with the harvesting head which is located at the distal end of the cannula. The sliding operation arm is slidably affixed and completes a superior portion of the outer walls of both the control segment and harvesting head. The outer walls of the harvesting head, tubular control segment, and sliding operation arm define the elongated, hollow harvesting cannula and surround, so as to form the central bore there within.
As mentioned above, when positioned in a forward (or fore) position, the distal terminus of the sliding operation arm comes into contact with and completes a superior aspect of the distal portion of the outer wall of the harvesting head. When positioned in a rearward or aft position, a space is formed between the harvesting head and sliding operation arm so as to form the lateral branch capture notch, discussed below. Therefore, in the fore position, the sliding operation arm provides completion of the outer cannula walls save for the main vessel alignment slot, discussed below. The term “aft”, as utilized throughout this specification and in the claims is a directional term which refers to the proximal end of the cannula. Thus, the term “aft direction” means towards the proximal end of the cannula. The term “fore”, as utilized throughout this specification and in the claims is a directional term referring to the refers to the distal end of the cannula. Thus the term “fore direction” means towards the distal end of the cannula.
The harvesting head, located at and forming the distal portion of the cannula includes a central bore, proximal and distal terminus, and may be described as including superior and inferior portions. The harvesting head may advantageously include an opening (or “distal aperture”) at the distal terminus thereof (which is also the distal terminus of the entire device). The distal aperture is contiguous with the central bore of the cannula.
The outer wall of the harvesting head is interrupted by a main vessel alignment slot penetrating through the outer wall of both the harvesting head and the distal portion of the sliding operation arm (which, in a fore position, completes the proximal extent of the superior outer wall of the harvesting head). The alignment slot communicates freely with the central bore. The main vessel alignment slot may be advantageously configured at an angular (non-parallel) relation with the longitudinal axis of the cannula so as to assist vessel retention as discussed below. The slot extends from the distal terminus of the cannula (distal terminus of the harvesting head) proximally and terminates in the proximal/superior portion of the outer wall of the harvesting head completed by the sliding operation arm.
The specific width and length of the main vessel alignment slot is configured so as to provide—as discussed below—efficient capture and retention of vessels to be harvested. Retention of the vessel to be harvested is aided by both the skewed position of the main alignment slot—in embodiments incorporating such configuration—as well as engagement of the vessel by the vessel capture and manipulation means or, in certain alternative embodiments, the main vessel retention gate(s), discussed below.
In preferred embodiments of the present invention, the distal portion of the cannula comprising the harvesting head exhibits a greater diameter relative to the remainder of the cannula. Increased diameter provides an increased central bore area for accommodating branch arteries, increasing the operative field thereby enhancing visualization of the procedure and providing more area for manipulation of vessels (as discusse

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