Multi-size reusable aortic punch

Surgery – Instruments – Cutting – puncturing or piercing

Reexamination Certificate

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Reexamination Certificate

active

06176867

ABSTRACT:

FIELD OF THE INVENTION
This invention relates to surgery generally and, more specifically to cardiovascular surgery and to instruments for attaching vessels to the aorta, and in analogous surgical procedures wherein on cannula-like vessel is attached to another cannula or to a tissue by a surgical procedure.
BACKGROUND OF THE INVENTION
This invention is an improvement over the aortic punches described and disclosed in the following U.S. Pat. No. 3,776,237, December 1973, Hill et al; U.S. Pat. No. 4,018,228, April 1977, Goosen; and U.S. Pat No. 5,827,316, October 1998, Young et al.
Aortic punches are used in coronary artery bypass grafting when a section of saphenous vein graft is anastomosed to the aorta. Aortic punches have been in widespread clinical use for more than fifteen years.
Reusable aortic punches were initially used, however, they had at least two disadvantages. The first disadvantage was that several different sizes of instruments were necessary to provide adequate size range. The other main drawback was that some surgeons felt that there was uncertainty concerning how sharp the instrument was after a period of prolonged usage, and whether the instrument had become damaged during cleansing and handling since last used.
When disposable aortic punches were introduced, they soon found widespread favor, because they were readily available in a wide range of sizes, generally from about 2.5 mm to 6.5 mm diameters. Initially, the high cost of the single patient use device was not of major concern. However, with the ever spiraling cost of healthcare, clinical institutions seek ways to reduce costs.
This invention addresses the disadvantages of the early generation of reusable aortic punches and the high recurrent cost of the current disposable products.
It is an objective of this invention to provide a simple, reusable surgical tool for punching an aperture in the aorta for coronary artery bypass surgery using a saphenous vein graft.
It is a further objective of this invention to provide an aortic punch in which the punch and die portions may be easily and simply interchanged for a replacement set at the operating table under sterile conditions.
It is a further objective of this invention to provide an aortic punch in which the punch and die portions of a range of useful sizes may be easily and simply be fitted at the operating table under sterile conditions.
It is a further objective of this invention to provide an aortic punch in which the interchangeable punch and die portions have a surface treatment that aids in the retention of a sharp cutting edge, and reduced wear, galling and tissue adhesion.
It is an additional objective of this invention to provide an aortic punch in which the interchangeable punch and die portions when removed from the punch body have a sufficient restraining force so the punch will not fall out of the die under the influence of gravity.
Other objectives and advantages of this invention will be more apparent from the detailed description of the device which follows.
SUMMARY OF THE INVENTION
This invention relates to a reusable punch with interchangeable die and punch portions. Punches of the type described are most commonly used as aortic punches but, of course, they can be used whenever it is desired to punch a generally round hole through any thin walled tissue structure. The punch consists of a cylindrical tubular body with internal threads at either end, a cylindrical internal actuating rod member incorporating a “Tee” slot at one end and a threaded cross hole near the other, a die portion with an external thread at one end, a punch incorporating a retaining ring groove and a flange at one end and a disk shaped cutting flange at the other, a retaining ring, a finger actuating bar with a threaded central portion, a finger guard, a return spring and a thumb screw spring stop with an external threaded portion.


REFERENCES:
patent: 3949747 (1976-04-01), Hevesy
patent: 4122855 (1978-10-01), Tezel
patent: 4216776 (1980-08-01), Downie et al.
patent: 5129913 (1992-07-01), Ruppert
patent: 5910153 (1999-06-01), Mayenberger

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