Taylor, Charles S. (San Francisco, CA, US)

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10/216616

02/26/2008

08/08/2002

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Cardiothoracic Systems, Inc. (San Jose, CA, US)

600/37

128/897, 606/1

A61F2/00; A13F13/00; A61B17/00; A61B19/00

600/37, 294/64.1-64.3

0452131		May, 1891	Haughawout
0810675		January, 1906	Richter
0820721		May, 1906	Kohlbach
0930236		August, 1909	Schacht
1202698		October, 1916	Ford
1706500	Surgical retractor	March, 1929	Smith
2082782	Vacuum tenaculum	June, 1937	Allen
2233561	Apparatus for indicating and/or controlling the concentration or viscosity of liquids or suspensions	March, 1941	Kalle
2296793	Surgical retractor	September, 1942	Kirschbaum
2590527	Suction massage device	March, 1952	Fluck
2693795	Surgical retractor	November, 1954	Grieshaber
2863444	Liver retractor for cholecystectomies	December, 1958	Winsten
3096962	Locking device for a measuring apparatus or the like	July, 1963	Meijs
3361133	Vacuum artery clamp	January, 1968	Kimberly et al.
3392722	Post-operative surgical valve	July, 1968	Jorgensen
3466079	PRESSURIZED FLUID PICKUP DEVICE	September, 1969	Mammel
3584822	FLEXIBLE COLUMNS	June, 1971	Oram
3680546	ILLUMINATED SURGICAL RETRACTOR	August, 1972	Asrican
3683926	TUBE FOR CONNECTING BLOOD VESSELS	August, 1972	Suzuki
3720433	MANIPULATOR APPARATUS FOR GRIPPING SUBMERGED OBJECTS	March, 1973	Rosfelder
3782387	APPARATUS AND METHODS FOR OBTAINING AND MAKING SKIN GRAFTS	January, 1974	Falabella	128/898
3783873	WEIGHTED SURGICAL CLAMP HAVING FOLDABLE PROP	January, 1974	Jacobs
3807393	SURGICAL RETRACTOR	April, 1974	McDonald
3807406	INSTRUMENT SURGICAL WITH SUCTION DEVICE	April, 1974	Rafferty et al.
3858926	VACUUM LIFTING DEVICE	January, 1975	Ottenhues
3882855	Retractor for soft tissue for example brain tissue	May, 1975	Shulte et al.
3912317	Vacuum suction type manipulator	October, 1975	Ohnaka et al.
3916909	Suction surgical instrument of the forceps type	November, 1975	Kletschka et al.
3983863	Heart support for coronary artery surgery	October, 1976	Janke et al.
4047532	Vacuum forcep and method of using same	September, 1977	Phillips et al.
4048987	Surgical acid	September, 1977	Hurson
4049000	Suction retraction instrument	September, 1977	Williams
4049002	Fluid conveying surgical instrument	September, 1977	Kletschka et al.
4049484	Vacuum transfer head and method of use	September, 1977	Priest et al.
4052980	Triaxial fiberoptic soft tissue retractor	October, 1977	Grams et al.
4094484	Balanced portable pedestals	June, 1978	Galione et al.
4096853	Device for the introduction of contrast medium into an anus praeter	June, 1978	Weigand
4096864	Fluid carrying surgical instrument of the forceps type	June, 1978	Kletschka et al.
4185636	Suture organizer, prosthetic device holder, and related surgical procedures	January, 1980	Gabbav et al.
4217890	Surgical sling for positioning a harvested kidney during surgical reattachment	August, 1980	Owens
4226228	Multiple joint retractor with light	October, 1980	Shin et al.
4230119	Micro-hemostat	October, 1980	Blum
4300541	Speculum lens structure	November, 1981	Burgin
4300564	Forceps for extracting stones in the pelvis of a kidney	November, 1981	Furihata
4306561	Holding apparatus for repairing severed nerves and method of using the same	December, 1981	de Medinaceli
4350160	Instrument for establishing vascular anastomoses	September, 1982	Kolesov et al.
4366819	Anastomotic fitting	January, 1983	Kaster
4368736	Anastomotic fitting	January, 1983	Kaster
4421107	Surgical retractor elements and assembly	December, 1983	Estes et al.
4428368	Massage device	January, 1984	Torii
4434791	Surgical retractor array system	March, 1984	Darnell
4457300	Surgical retractor	July, 1984	Budde
4461284	Surgical retaining device	July, 1984	Fackler
4492229	Suture guide holder	January, 1985	Grunwald
4582353	Suction cup for gripping small, delicate objects	April, 1986	Alvernhe	294/64.1
4597382	Medical speculum and procedure	July, 1986	Perez, Jr.
4617916	Retractor apparatus	October, 1986	LeVahn et al.
4627421	Sternal retractor	December, 1986	Symbas et al.
4637377	Pillow or support member for surgical use	January, 1987	Loop
4646747	Electrode for electrocardiographic examinations	March, 1987	Lundback
4688570	Ophthalmologic surgical instrument	August, 1987	Kramer et al.
4702230	Adapter for surgical retractor	October, 1987	Pelta
4708510	Ball joint coupling	November, 1987	McConnell et al.
D293470	Combined adjustable positioner and holder for surgical instruments	December, 1987	Adler
4718418	Apparatus for ophthalmological surgery	January, 1988	L'Esperance, Jr.
4724838	Footed forceps-type surgical instrument	February, 1988	Hasson
4726356	Cardiovascular and thoracic retractor	February, 1988	Santilli et al.
4726358	Manipulative treatment device having pivoting links between base and supports	February, 1988	Brady
4736749	Holder for medical use fixed by vacuum	April, 1988	Lundback
4747394	Spinal retractor	May, 1988	Watanabe
4747395	Surgical retractor for bone surgery	May, 1988	Brief
4754746	Self-retaining metatarsal spreader	July, 1988	Cox
4767142	Forceps for semiconductor silicon wafer	August, 1988	Takahashi et al.	294/64.1
4787662	Vacuum driven gripping tool	November, 1988	Dewez
4803984	Method for performing small vessel anastomosis	February, 1989	Narayanan et al.
4808163	Percutaneous venous cannula for cardiopulmonary bypass	February, 1989	Laub
4827926	Flexible support arm for medical instruments	May, 1989	Carol
4829985	Sternal retractor	May, 1989	Couetil
4841967	Positioning device for percutaneous needle insertion	June, 1989	Chang et al.
4852552	Sternal retractor	August, 1989	Chaux
4854318	Blood vessel holder and method of using in anastomosis	August, 1989	Solem et al.
4858552	Apparatus pelletizing particles	August, 1989	Glatt et al.
4863133	Arm device for adjustable positioning of a medical instrument or the like	September, 1989	Bonnell
4865019	Retractor apparatus for use in harvesting mammary arteries during heart by-pass surgery	September, 1989	Phillips
4884559	Surgical speculum	December, 1989	Collins
4904012	Suction device	February, 1990	Nishiguchi et al.
4925443	Biocompatible ventricular assist and arrhythmia control device	May, 1990	Heilman et al.
4931341	Elastic suction plates for delicate objects	June, 1990	Haffer et al.
4949707	Retractor apparatus	August, 1990	LeVahn et al.
4949927	Articulable column	August, 1990	Madocks et al.
4955896	Universal medical forcep tool	September, 1990	Freeman
4957477	Heart assist jacket and method of using it	September, 1990	Lundback
4962758	Vibratory device for releasing air bubbles trapped in the heart muscle	October, 1990	Lasner et al.
4971037	Surgical retractor support	November, 1990	Pelta
4973300	Cardiac sling for circumflex coronary artery surgery	November, 1990	Wright
4983093	Wafer transfer apparatus	January, 1991	Foulke et al.	414/416.08
4989587	Sternal retractor	February, 1991	Farley
4991566	Articulating mouth-prop device for use in the diagnosis and/or treatment of patients suffering from trismus or other medical or dental problems or for other purposes	February, 1991	Shulman et al.
4991578	Method and system for implanting self-anchoring epicardial defibrillation electrodes	February, 1991	Cohen
4993862	Clamp assembly for surgical retractor support	February, 1991	Pelta
5009660	Gas purging, eye fixation hand piece	April, 1991	Clapham
5011469	Peripheral cardiopulmonary bypass and coronary reperfusion system	April, 1991	Buckberg et al.
5019086	Manipulable vacuum extractor for childbirth and method of using the same	May, 1991	Neward
5025779	Device intended to be used for opening the chest during surgery	June, 1991	Bugge
5036868	Anastomosis preparation technique	August, 1991	Berggren et al.
5037428	Vessel approximation and alignment device	August, 1991	Picha et al.
5052373	Spinal retractor	October, 1991	Michelson
5053041	Vessel holder	October, 1991	Ansari et al.
5080088	Flexible retractor	January, 1992	LeVahn
5098369	Biocompatible ventricular assist and arrhythmia control device including cardiac compression pad and compression assembly	March, 1992	Heilman et al.
5098432	Device for positioning and securing a part having circular regions	March, 1992	Wagenknecht et al.
5119804	Heart massage apparatus	June, 1992	Anstadt
5125395	Deflectable sheath for optical catheter	June, 1992	Adair
5131905	External cardiac assist device	July, 1992	Grooters
5133724	Abdominal aortic clamp	July, 1992	Wilson, Jr. et al.
5139517	Orthotopic intraventricular heart pump	August, 1992	Corral
5150706	Cooling net for cardiac or transplant surgery	September, 1992	Cox et al.
5152777	Device and method for providing protection from emboli and preventing occulsion of blood vessels	October, 1992	Goldberg et al.
5159921	Surgical retractor	November, 1992	Hoover
RE34150	Cardiovascular and thoracic retractor	December, 1992	Santilli et al.
5167223	Heart valve retractor and sternum spreader surgical instrument	December, 1992	Koros et al.
5171254	Eye fixation device	December, 1992	Sher
5192070	Suction pad	March, 1993	Nagai et al.
5196003	Endoscopic surgical instrument for taking hold of tissue	March, 1993	Bilweis
5231974	Self retaining retractor	August, 1993	Giglio et al.
5256132	Cardiac assist envelope for endoscopic application	October, 1993	Snyders
5268640	Method and apparatus for the formation of a plurality of NMR images, each having a different characteristic, of the same slice, in a single sequence	December, 1993	Du et al.
5287861	Coronary artery by-pass method and associated catheter	February, 1994	Wilk
5290082	Battery operated hand held vacuum handling device	March, 1994	Palmer et al.	294/64.1
5290227	Method of implanting blood pump in ascending aorta or main pulmonary artery	March, 1994	Pasque
5293863	Bladed endoscopic retractor	March, 1994	Zhu et al.
5300087	Multiple purpose forceps	April, 1994	Knoepfler
5306234	Method for closing an atrial appendage	April, 1994	Johnson
5309896	Retraction methods using endoscopic inflatable retraction devices	May, 1994	Moll et al.
5318013	Surgical clamping assembly and associated method	June, 1994	Wilk
5336252	System and method for implanting cardiac electrical leads	August, 1994	Cohen
5337754	Inflatable isolation bag	August, 1994	Heaven et al.
5339801	Surgical retractor and surgical method	August, 1994	Poloyko et al.
5345935	Non-invasive medical probe provided with suction cup	September, 1994	Hirsch et al.
5348259	Flexible, articulable column	September, 1994	Blanco et al.
5363841	Retractor for spinal surgery	November, 1994	Coker
5363882	Bending device having a bellows	November, 1994	Chikama
5370685	Endovascular aortic valve replacement	December, 1994	Stevens
5375588	Method and apparatus for use in endoscopic procedures	December, 1994	Yoon
5381788	Surgical retractor	January, 1995	Matula et al.
5382756	Encapsulation closure for cables	January, 1995	Dagan
5383840	Biocompatible ventricular assist and arrhythmia control device including cardiac compression band-stay-pad assembly	January, 1995	Heilman et al.
5417709	Endoscopic instrument with end effectors forming suction and/or irrigation lumens	May, 1995	Slater
5425705	Thoracoscopic devices and methods for arresting the heart	June, 1995	Evard et al.
5433700	Method for intraluminally inducing cardioplegic arrest and catheter for use therein	July, 1995	Peters
5437651	Medical suction apparatus	August, 1995	Todd et al.
5452733	Methods for performing thoracoscopic coronary artery bypass	September, 1995	Sterman et al.
5453078	Endoscopic wedge and organ positioner	September, 1995	Valentine et al.
5467763	Surgical instruments	November, 1995	McMahon et al.
5480425	Integrated heart valve rotator and holder	January, 1996	Ogilive
5484391	Direct manual cardiac compression method	January, 1996	Buckman, Jr. et al.
5498256	Surgical instrument handle	March, 1996	Furnish
5503617	Retractor and method for direct access endoscopic surgery	April, 1996	Jako
5509890	Heart retractor	April, 1996	Kazama
5512037	Percutaneous surgical retractor	April, 1996	Russell et al.
5513827	Gooseneck surgical instrument holder	May, 1996	Michelson
5514075	Properitoneal mechanical retraction apparatus and methods of using	May, 1996	Moll et al.
5514076	Surgical retractor	May, 1996	Ley
5520609	Apparatus and method for peritoneal retraction	May, 1996	Moll et al.
5520610	Self retaining retractor	May, 1996	Giglio et al.
5522819	Dual coil medical retrieval device	June, 1996	Graves et al.
5529571	Surgical retractor/compressor	June, 1996	Daniel
5536251	Thoracoscopic devices and methods for arresting the heart	July, 1996	Evard et al.
5547458	T-shaped abdominal wall lift with telescoping member	August, 1996	Ortiz et al.
5549340	Suction pad	August, 1996	Nagai et al.	294/64.1
RE35352	Method for intraluminally inducing cardioplegic arrest and catheter for use therein	October, 1996	Peters
5564682	Wafer stage apparatus for attaching and holding semiconductor wafer	October, 1996	Tsuji
5569274	Endoscopic vascular clamping system and method	October, 1996	Rapacki et al.
5571074	Inflatable and expandable direct manual cardiac compression device	November, 1996	Buckman, Jr. et al.
5571215	Devices and methods for intracardiac procedures	November, 1996	Sterman et al.
5573496	Method of using a coil screw surgical retractor	November, 1996	McPherson et al.
5578061	Method and apparatus for cardiac therapy by stimulation of a physiological representative of the parasympathetic nervous system	November, 1996	Stroetmann et al.
5582580	Direct manual cardiac compression device	December, 1996	Buckman et al.	601/41
5584803	System for cardiac procedures	December, 1996	Stevens et al.
5607421	Myocardial revascularization through the endocardial surface using a laser	March, 1997	Jeevanandam et al.	606/15
5607446	Pupil dilator	March, 1997	Beehler et al.
5613937	Method of retracting heart tissue in closed-chest heart surgery using endo-scopic retraction	March, 1997	Garrison et al.
5613950	Multifunctional manipulating instrument for various surgical procedures	March, 1997	Yoon
5632746	Device or apparatus for manipulating matter	May, 1997	Middleman et al.
5651378	Method of using vagal nerve stimulation in surgery	July, 1997	Metheny et al.
5662300	Gooseneck surgical instrument holder	September, 1997	Michelson
5667480	Method and devices for endoscopic vessel harvesting	September, 1997	Knight et al.
5707362	Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member	January, 1998	Yoon
5713951	Thoracoscopic valve prosthesis delivery device	February, 1998	Garrison et al.
5722935	Laparoscopic retractor having a plurality of blades extending laterally from a handle	March, 1998	Christian
5727569	Surgical devices for imposing a negative pressure to fix the position of cardiac tissue during surgery	March, 1998	Benetti et al.
5728151	Intercostal access devices for less-invasive cardiovascular surgery	March, 1998	Garrison et al.
5730757	Access platform for internal mammary dissection	March, 1998	Benetti et al.
5735290	Methods and systems for performing thoracoscopic coronary bypass and other procedures	April, 1998	Sterman et al.
5749892	Device for isolating a surgical site	May, 1998	Vierra et al.
5755660	Combination surgical retractor, light source, spreader, and suction apparatus	May, 1998	Tyagi
5755682	Method and apparatus for performing coronary artery bypass surgery	May, 1998	Knudson
5766151	Endovascular system for arresting the heart	June, 1998	Valley et al.
5772583	Sternal retractor with attachments for mitral & tricuspid valve repair	June, 1998	Wright et al.
5782746	Local cardiac immobilization surgical device	July, 1998	Wright
5782813	Surgical instrument stabilizer	July, 1998	Yoon
5795291	Cervical retractor system	August, 1998	Koros et al.
5797934	Method, instrument and anastomotic fitting for use when performing an end-to-side anastomosis	August, 1998	Rygaard	606/153
5797960	Method and apparatus for thoracoscopic intracardiac procedures	August, 1998	Stevens et al.
5799661	Devices and methods for port-access multivessel coronary artery bypass surgery	September, 1998	Boyd et al.
5803902	Surgical retractor	September, 1998	Sienkiewicz et al.
5807243	Method for isolating a surgical site	September, 1998	Vierra et al.
5813410	Internal body pump and systems employing same	September, 1998	Levin
5818231	Quantitation and standardization of magnetic resonance measurements	October, 1998	Smith
5820555	Method for selectively creating and altering the shape of a body cavity	October, 1998	Watkins et al.
5836311	Method and apparatus for temporarily immobilizing a local area of tissue	November, 1998	Borst et al.
5846187	Redo sternotomy retractor	December, 1998	Wells et al.
5864275	Opposed magnet-type magnetic circuit assembly with permanent magnets	January, 1999	Ohashi et al.
5871489	Surgical implement particularly useful for implanting prosthetic heart valves, valve holder particularly useful therewith and surgical method including such implement	February, 1999	Ovil
5875782	Methods and devices for minimally invasive coronary artery revascularization on a beating heart without cardiopulmonary bypass	March, 1999	Ferrari et al.
5882345	Expandable endoscopic portal	March, 1999	Yoon
5885272	System and method for percutaneous myocardial revascularization	March, 1999	Aita et al.	606/7
5888247	Method for coronary artery bypass	March, 1999	Benetti
5891017	Surgical stabilizer and method for isolating and immobilizing cardiac tissue	April, 1999	Swindle et al.
5894843	Surgical method for stabilizing the beating heart during coronary artery bypass graft surgery	April, 1999	Benetti et al.
5904711	Expandable thoracoscopic defibrillation catheter system and method	May, 1999	Flom et al.	607/129
5906607	Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery	May, 1999	Taylor et al.
5921979	Apparatus and method for tissue and organ stabilization	July, 1999	Kovacs et al.
5927284	Method and apparatus for temporarily immobilizing a local area of tissue	July, 1999	Borst et al.
5947896	Heart stabilizer apparatus and method for use	September, 1999	Sherts et al.
5957832	Stereoscopic percutaneous visualization system	September, 1999	Taylor et al.
5961481	Systems for coronary bypass procedures	October, 1999	Sterman et al.
5976080	Surgical apparatus and method	November, 1999	Farascioni et al.
5976171	Access platform for internal mammary dissection	November, 1999	Taylor et al.
6010531	Less-invasive devices and methods for cardiac valve surgery	January, 2000	Donlon et al.
6015378	Method and apparatus for temporarily immobilizing a local area tissue	January, 2000	Borst et al.
6029671	System and methods for performing endovascular procedures	February, 2000	Stevens et al.
6032672	Surgical devices for imposing a negative pressure to stabilize cardiac tissue during surgery	March, 2000	Taylor
6042539	Vacuum-actuated tissue-lifting device and method	March, 2000	Harper et al.
6110187	Device and method for minimizing heart displacements during a beating heart surgical procedure	August, 2000	Donlon
6132370	Retractor-mounted coronary stabilizer	October, 2000	Furnish et al.
6139492	Device and method for isolating a surgical site	October, 2000	Vierra et al.
6149583	Device and method for isolating a surgical site	November, 2000	Vierra et al.
6183486	Device and method for minimizing heart displacements during a beating heart surgical procedure	February, 2001	Snow et al.
6210323	Surgical arm and tissue stabilizer	April, 2001	Gilhuly et al.
6213940	Surgical retractor including coil spring suture mount	April, 2001	Sherts et al.
6231585	Device for stabilizing a treatment site and method of use	May, 2001	Takahashi et al.
6251065	Methods and apparatus for stabilizing tissue	June, 2001	Kochamba
6264605	Surgical instrument	July, 2001	Scirica et al.
6315717	Surgical instruments for stabilizing the beating heart during coronary artery bypass graft surgery	November, 2001	Benetti et al.
6328688	Method and apparatus for temporarily immobilizing a local area of tissue	December, 2001	Borst et al.
6334843	Method and apparatus for temporarily immobilizing a local area of tissue	January, 2002	Borst et al.
6336898	Method and apparatus for temporarily immobilizing a local area of tissue	January, 2002	Borst et al.
6346077	Surgical instrument for stabilizing the beating heart during coronary artery bypass graft surgery	February, 2002	Taylor et al.
6350229	Method and apparatus for temporarily immobilizing a local area of tissue	February, 2002	Borst et al.
6364826	Method and apparatus for temporarily immobilizing a local area of tissue	April, 2002	Borst et al.
6371906	Method and apparatus for temporarily immobilizing a local area of tissue	April, 2002	Borst et al.
6371910	Inflatable manipulator for organ positioning during surgery	April, 2002	Zwart et al.
6375611	Organ stabilizer	April, 2002	Voss et al.
6394948	Method and apparatus for temporarily immobilizing a local area of tissue	May, 2002	Borst et al.
6394951	Surgical instruments and procedures for stabilizing the beating heart during coronary artery bypass graft surgery	May, 2002	Taylor et al.
6398726	Stabilizer for robotic beating-heart surgery	June, 2002	Romans et al.
6406424	Tissue stabilizer having an articulating lift element	June, 2002	Williamson et al.
6447443	Method for organ positioning and stabilization	September, 2002	Keogh et al.
6458079	Surgical retractor and method of use	October, 2002	Cohn et al.
6464629	Method and apparatus for temporarily immobilizing a local area of tissue	October, 2002	Boone et al.
6464630	Method and apparatus for temporarily immobilizing a local area of tissue	October, 2002	Borst et al.
6468265	Performing cardiac surgery without cardioplegia	October, 2002	Evans et al.
6478029	Devices and methods for port-access multivessel coronary artery bypass surgery	November, 2002	Boyd et al.
6478729	Device and method for isolating a surface of a beating heart during surgery	November, 2002	Rogers et al.
6482151	Method of performing a procedure on a coronary artery	November, 2002	Vierra et al.
6494211	Device and methods for port-access multivessel coronary artery bypass surgery	December, 2002	Boyd et al.
6503245	Method of performing port off-pump beating heart coronary artery bypass surgery	January, 2003	Palmer et al.
6506149	Organ manipulator having suction member supported with freedom to move relative to its support	January, 2003	Peng et al.
6537212	Surgical retractor	March, 2003	Sherts et al.
6565508	Surgical instrument	May, 2003	Scirica et al.
6589166	Cardiac stabilizer device having multiplexed vacuum ports and method of stabilizing a beating heart	July, 2003	Knight et al.
6592573	Through-port heart stabilization system	July, 2003	Castaneda et al.
6607479	Methods and apparatus for stabilizing tissue	August, 2003	Kochamba et al.
6610008	Device and method to permit offpump beating heart coronary bypass surgery	August, 2003	Spence et al.
6610009	Surgical instrument holder	August, 2003	Person et al.

DE3138589	April, 1983
DE9004513	June, 1990
DE4139695	June, 1993
EP0293760	December, 1988			Arm device for adjustable positioning of a medical instrument
EP0630629	May, 1994			Hydrogel wound dressing product
EP0668058	August, 1995			Electrophysiology positioning catheter.
EP0803228	October, 1997			Surgical retractor
EP0808606	November, 1997			Surgical retractor
GB473451	January, 1915
GB168216	September, 1921
GB2233561	January, 1991
GB2267827	December, 1993
SU938967	July, 1982
WO/1987/004081	July, 1987			ELECTRODE CATHETER FOR THE ABLATION OF THE HIS BUNDLE
WO/1988/000481	January, 1988			SURGICAL SUCTION DEVICE
WO/1992/021293	December, 1992			ENDOSCOPIC INFLATABLE RETRACTION DEVICE, METHOD OF USING, AND METHOD OF MAKING
WO/1993/009720	May, 1993			RETRACTOR FOR VIDEOSCOPY SURGERY
WO/1994/014383	July, 1994			HANDPIECE FOR TRANSMYOCARDIAL VASCULARIZATION HEART-SYNCHRONIZED PULSED LASER SYSTEM
WO/1994/018881	September, 1994			METHOD FOR PERFORMING THORACOSCOPIC CARDIAC BYPASS PROCEDURES
WO/1995/001757	January, 1995			ROBOTIC SYSTEM FOR CLOSE INSPECTION AND REMOTE TREATMENT OF MOVING PARTS
WO/1995/015715	June, 1995			DEVICES AND METHODS FOR INTRACARDIAC PROCEDURES
WO/1995/017127	June, 1995			METHOD AND INSTRUMENT FOR ESTABLISHING THE RECEIVING SITE OF A CORONARY ARTERY BYPASS GRAFT
WO/1996/000033	January, 1996			ENDOSCOPIC VASCULAR CLAMPING SYSTEM AND METHOD
WO/1996/032882	October, 1996			METHOD AND APPARATUS FOR THORACOSCOPIC INTRACARDIAC PROCEDURES
WO/1996/040354	December, 1996			DEVICES AND METHODS FOR PORT-ACCESS MULTIVESSEL CORONARY ARTERY BYPASS SURGERY
WO/1997/010753	March, 1997			METHOD AND APPARATUS FOR TEMPORARILY IMMOBILIZING A LOCAL AREA OF TISSUE
WO/1997/026828	July, 1997			LAPAROSCOPIC INSTRUMENT FOR HANDLING PARENCHYMATOUS AND CAVUM ORGANS
WO/1997/032514	September, 1997			RETRACTOR FOR PROVIDING SURGICAL ACCESS AND SUTURE ORGANIZER
WO/1997/040738	November, 1997			CORONARY STABILIZING RETRACTOR
WO/1997/040752	November, 1997			BALL AND SOCKET CORONARY STABILIZER
WO/1998/017182	April, 1998			ADJUSTABLE MULTI-PURPOSE CORONARY STABILIZING RETRACTOR
WO/1998/027869	July, 1998			MINIMALLY INVASIVE SURGICAL APPARATUS AND METHOD

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Marmor II, Charles A.

Law Office of Alan W. Cannon

The present application is a continuation of application Ser. No. 09/440,106, filed Nov. 15, 1999 now U.S. Pat. No. 6,852,075 and titled “Surgical Devices for Imposing a Negative Pressure To Stabilize Cardiac Tissue During Surgery,” pending, which is a divisional of application Ser. No. 08/870,687, filed Jun. 6, 1997, now U.S. Pat. No. 6,032,672, which is a divisional of application Ser. No. 08/603,328, filed Feb. 20, 1996, now U.S. Pat. No. 5,727,569, each of which are hereby incorporated by reference thereto, in their entireties.

The invention claimed is:

1. A method of guiding an instrument relative to an outer surface of a heart, comprising the steps of: providing an instrument guide having a plurality of suction ports open to a bottom surface of the instrument guide; locating the suction ports in proximity to a target area to be treated; applying a negative pressure through the suction ports, thereby applying negative pressure directly to an outer surface of the heart and fixing the instrument guide to the outer surface of the heart; introducing at least a portion of the instrument into said instrument guide by traversing a side wall of the instrument guide, such that a location of said at least a portion of the instrument relative to the target area is maintained by said instrument guide; and treating the target area with said instrument.

2. The method of claim 1, further comprising introducing at least a portion of a second instrument into said instrument guide such that a location of said at least a portion of the second instrument relative to the target area is maintained by said instrument guide.

3. The method of claim 2, further comprising treating the target area with said second instrument.

4. The method of claim 2, further comprising illuminating the target area with said instrument.

5. The method of claim 2, wherein said first and second instrument portions are introduced at different locations of said instrument guide.

6. The method of claim 5, wherein said first and second instrument portions are introduced through first and second instrument ports in said instrument guide.

7. The method of claim 1, wherein said treating comprises illuminating the target area.

8. The method of claim 1, further comprising fixing said instrument guide to a stable support.

9. The method of claim 8, wherein said fixing comprises fixing said instrument guide to a rib retractor.

10. The method of claim 1, wherein said treating comprises at least one of: cutting, illuminating, suturing, suctioning, blowing and irrigating.

11. The method of claim 1 wherein said instrument comprises a surgical instrument.

12. The method of claim 1, wherein said introducing comprises introducing said at least a portion of said instrument into an attachment means fixed to said instrument guide.

13. The method of claim 1, wherein said introducing comprises introducing said at least a portion of said instrument into a flexible or rigid shaft fixed transversely with respect to a main body of said instrument guide.

14. The method of claim 1, further comprising locking a position of said at least a portion of an instrument relative to said instrument guide.

15. The method of claim 1, wherein the heart is beating.

16. A method of guiding an instrument relative to the outer surface of a heart, comprising the steps of: providing an instrument guide having a plurality of suction ports; fixing the instrument guide to the outer surface of the heart, in proximity to a target area to be treated, by applying a negative pressure to the outer surface of the heart, through the suction ports in fluid communication with the outer surface of the heart; and introducing at least a portion of the instrument into said instrument guide by traversing a side wall of said instrument guide such that a location of said at least a portion of the instrument relative to the instrument guide is maintained by said instrument guide.

17. The method of claim 16, further comprising treating the target area with said instrument.

18. The method of claim 16, further comprising positioning said at least a portion of an instrument relative to the target area.

19. The method of claim 18, wherein said positioning comprises manipulating a shaft attached to said instrument guide, through which said at least a portion of an instrument has been inserted.

20. The method of claim 17, wherein said treating comprises at least one of: cutting, illuminating, suturing, suctioning, blowing and irrigating.

21. The method of claim 16, wherein said instrument comprises a surgical instrument.

22. The method of claim 16, further comprising fixing said instrument guide to a stable support.

23. The method of claim 22, wherein said fixing comprises fixing said instrument guide to a rib retractor.

24. The method of claim 16, further comprising locking a position of said at least a portion of an instrument relative to said instrument guide.

25. A method of guiding an operative element relative to the outer surface of a beating heart, comprising the steps of: providing an instrument guide having a plurality of suction ports; applying a negative pressure to the suction ports, thereby fixing the instrument guide to the outer surface of the beating heart; and introducing at least a portion of the operative element into said instrument guide by traversing a side wall of the instrument guide such that a location of said at least a portion of the operative element relative to the surface of the beating heart is maintained by said instrument guide.

26. The method of claim 25, wherein said operative element comprises a surgical instrument.

27. A method of guiding an instrument relative to the surface of a heart, comprising the steps of: providing an instrument guide having a plurality of suction ports; locating the suction ports in proximity to a target area to be treated; applying a negative pressure to the suction ports, thereby fixing the instrument guide to the surface of the heart; introducing at least a portion of the instrument into said instrument guide such that a location of said at least a portion of the instrument relative to the target area is maintained by said instrument guide; introducing at least a portion of a second instrument into said instrument guide such that a location of said at least a portion of the second instrument relative to the target area is maintained by said instrument guide; and treating the target area with at least one of said first and second instruments.

28. A method of guiding an instrument relative to an outer surface of a heart, comprising the steps of: providing an instrument guide having a plurality of suction ports; locating the suction ports in proximity to a target area to be treated; applying a negative pressure to the suction ports, thereby fixing the instrument guide to the outer surface of the heart; introducing at least a portion of the instrument into said instrument guide by traversing a side wall of the instrument guide, such that a location of said at least a portion of the instrument relative to the target area is maintained by said instrument guide; and treating the target area with said instrument, wherein said treating comprises illuminating the target area.

29. A method of guiding an instrument relative to the outer surface of a heart, comprising the steps of: providing an instrument guide having a plurality of suction ports; fixing the instrument guide to the outer surface of the heart, in proximity to a target area to be treated, by applying a negative pressure to the suction ports; introducing at least a portion of the instrument into said instrument guide by traversing a side wall of said instrument guide such that a location of said at least a portion of the instrument relative to the instrument guide is maintained by said instrument guide; and fixing said instrument guide to a stable support.

Surgeries to treat disease in the heart, particularly blockages in coronary vessels, are becoming increasingly common and necessary to treat atherosclerosis and other conditions causing reduced blood flow to the heart. For many years, surgeons have performed “open-heart” surgery to repair defects in the heart and the associated cardiovascular system. As these procedures have become more common and more costly, a need has developed for techniques to make cardiac surgical procedures less traumatic to the patient. The necessity of attaching a surgical patient to a cardiopulmonary bypass (CPB) apparatus is a primary contribution to the trauma inherent in traditional procedures. To attempt to alleviate the trauma and side effects of CPB, surgeons have begun performing cardiac surgeries without stopping the heart. To successfully perform such surgery, several challenges must be met. One particular problem confronting the surgeon who operates on the beating heart is the difficulty in performing extremely delicate surgical procedures while the contractions of the heart muscles cause the surface of the heart to continuously move.

To attempt to restrict the motion of heart at the particular area where the surgeon is working, the surgeon may pass at least a pair of sutures through the exterior tissue layers of the heart. By pulling the sutures in opposite directions, the tissue is stretched, and the motion caused by the contractions of the heart muscles is reduced or partially compensated. This technique is not completely effective in preventing the natural motion of the heart and requires extra time to place the sutures, and, additionally, may cause damage to the cardiac tissue when the sutures are placed or manipulated. Preferably, the surgeon would be able to fix the motion of the cardiac tissue containing or adjacent to an area where surgery is to be performed without the need to attach or manipulate additional sutures. The ability to fix the position of the cardiac tissue in a region of the heart would permit the surgeon to perform delicate surgical procedures on the beating heart while the portion of the heart on which the surgery is performed remains substantially motionless throughout the procedure.

SUMMARY OF THE INVENTION

This invention is devices and techniques which use a negative pressure (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 disclosed herein apply a negative pressure at several points on the outer surface of the heart such that a portion of the exterior tissue of the heart is fixed in place by the suction imposed through the surgical instrument. Because the negative pressure introduced through the instrument -s the position of a region of tissue, the instrument remains at a constant distance from the particular portion of the heart where the surgery is being performed. In this configuration, 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 the negative pressure instrument permits the surgeon to advantageously manipulate the other instruments used during the 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. The ports are preferably oriented such that the pressure is applied at several points over the target area to fix the position of the tissue and to reduce any trauma to the tissue caused by the negative pressure.

DESCRIPTION OF THE FIGURES

FIG. 1 is an embodiment of the invention having a substantially annular housing with a plurality of suction ports disposed about the periphery of the instrument and having openings in the bottom surface which contacts the heart.

FIG. 2 is a dome-shaped or semi-spherical embodiment having a plurality of suction ports disposed about the periphery of the bottom surface and having several instrument ports in the dome portion through which additional surgical instruments may be introduced, positioned, or manipulated.

FIG. 3 is a section of a substantially circular embodiment showing a preferred configuration for the suction ports and a pressure conducting chamber for introducing the negative pressure to each suction port.

FIG. 4 is an embodiment of the instrument, in use, which is fixed on the surface of the heart and has additional surgical instruments operably associated therewith to facilitate a graft being inserted to form an anastomosis between the internal mammary artery (IMA) and the left anterior descending (LAD) artery.

FIG. 5 is an alternative embodiment of the invention wherein the suction ports for imposing the negative pressure are affixed to a shaft which may be part of a hand-held device and are contained in a block where a plurality of individual suction ports are arranged in an array.

FIG. 6 is a plurality of suction ports contained within a block having attached thereto a pair of vacuum lines for introducing a negative pressure to each suction port.

FIGS. 7 and 7A are sectional views of the block showing an alternate configuration for the suction ports and the pressure conducting space.

FIG. 8 is an alternative embodiment for an array of suction ports having vacuum tubes which run the length of the block and are oriented to be substantially perpendicular to a passage space leading to each suction port.

FIGS. 9 and 9A are a hand held instrument having a removable block, wherein the instrument has a receiving means to reversibly receive the block.

DETAILED DESCRIPTION OF THE INVENTION

This invention is surgical instruments and techniques which advantageously apply a negative pressure to the surface of the heart so that a portion thereof is maintained at a fixed position during a surgical procedure. The negative pressure is introduced to the instrument and is applied at several points over the surface of the heart proximate to or surrounding the portion of the heart whose position is desired to be fixed during the procedure. The instruments feature several suction ports which are brought into contact with the heart, followed by the application of a negative pressure through the instruments, to fix the position of the tissue based on the placement of the instrument. The Instruments may also contain a sealed, airtight, pressure conducting chamber for operably connecting to a pressure inlet for communicating the negative pressure to the suction parts. Alternatively, each suction port may have a dedicated vacuum line attached thereto.

The shape of the instrument may be varied depending on the particular application or the clinical diagnosis for an individual patient. In some embodiments, the shape of the instrument is defined by a housing forming a complete or partial, substantially annular, ring having the suction ports disposed about the periphery of the bottom surface of the housing. The suction ports are contained within the base of the instrument and the opening of the suction ports are contained in the bottom surface of the instrument which may be substantially planar or may be shaped to conform to the surface of the heart.

In another embodiment, the operative portion of the instrument may be defined by one or more arrays of suction ports which are substantially linear. The suction ports may be contained in a block which has at least one vacuum line attached thereto. This design is particularly suitable for an instrument having a shaft affixed thereto for positioning the block containing the suction ports. The shaft may be fixed to a rigid support during the procedure or may be part of a hand-held instrument having a handle structure adapted to be grasped by the human hand. In a preferred embodiment, the hand-held instrument contains a pair of shafts having a block and suction port assembly at each end thereof. The shafts are connected at an intermediate portion by a pivot which allows the suction port assemblies to move relative to one another, to be oriented and manipulated by hand, and to be locked into place in a desired configuration.

An embodiment having more than one movable member in which suction ports are contained offers the advantage that a negative pressure may be first imposed through the suction ports of each movable member to fix the tissue, followed by manipulation of the individual members which causes the tissue to be stretched or oriented such that one portion of the cardiac tissue is fixed in position by one movable member and can be oriented relative to another portion fixed by a second movable member.

The negative or vacuum pressure imposed may be varied depending on the design of the instrument, the orientation of the ports, and the amount of pressure needed to hold a particular region of the heart in place. When manipulating the instruments of this invention, it is not, desired to exert a downward force on the instrument once the instrument engages the cardiac tissue because the tissue could be damaged by being drawn into the suction ports, thus risking interruption of blood flow and ischemic or reperfusion injury to the cardiac tissue. However, once a negative pressure is imposed, the instrument may be drawn away from the heart such that the portion of the surface tissue fixed by the suction ports is slightly elevated relative to the remainder of the heart.

Referring to FIGS. 1 and 3, an embodiment of the invention is an instrument comprised of an annular housing 1 which could have an alternate shape depending on the design and clinical application of the instrument. For example, the body of the instrument has a housing which may be a portion of a circle, an oval, semi-oval, U-shape, or linear member.

The portion of the housing 1 which contains the suction ports 2 has a bottom surface 6 which rests against the surface of the heart and therefore should be substantially planar or curved to the extent necessary to simultaneously bring the suction ports 2 into conforming contact with the heart. Referring to FIGS. 1 and 3, one embodiment of the invention has suction ports 2 equally spaced about the circumference of the housing 1. For purposes of stability, it is preferred that each suction port 2 be substantially equidistant from each adjacent port and spread over the entire portion of the instrument at the points of contact to the heart so that the instrument is more stably affixed to the surface of the heart when a negative pressure is imposed. As described in detail below, the housing 1 may also have one or more instrument ports 9 to facilitate introducing a surgical instrument to the site of the surgery to function on or in proximity to the fixed portion of the cardiac tissue.

The interior of the housing 1 may be further comprised of a means for introducing a negative pressure to the suction ports 2. For example, each suction port 2 may have a dedicated vacuum line 3 for introducing a negative pressure to each suction port 2. However, it is preferred that a single vacuum line 3 introduce the negative pressure via an inlet 5 which leads to an airtight, sealed, and pressure conducting chamber 4 contained within the annular housing 1 which in turn communicates the negative pressure to each suction port 2. Thus, by connecting a negative pressure source to the inlet 5, the negative pressure is introduced to the instrument through inlet 5, thereby creating a negative pressure in the pressure conducting chamber 4 which is communicated to each suction port 2. The housing may also have at least one instrument port 9 comprised of an opening that preferably traverses the width of the housing and is shaped to receive an instrument. In use, the surgeon may advantageously rely on the housing 1 as a platform for other instruments which may advantageously be used at the portion of the heart fixed in place by the negative pressure. The instrument port 9 may be a simple opening in the housing I or may be designed to operably receive a specific instrument as described in more detail below.

In use (See FIG. 4), the instrument is gently positioned on the surface of the heart by manipulating the position of the housing 1 such that each suction port 2 rests against the cardiac tissue. Once the instrument is positioned on the surface of the heart, the negative pressure is applied through vacuum line 3 and inlet 5 while the housing may be gently manipulated to insure that the negative pressure is causing the cardiac tissue to become fixed to each suction port 2. Once the suction ports become functionally attached to the surface of the heart, the portion of the surface of the heart becomes fixed relative to the instrument. Once the negative pressure is applied, the instrument may be attached to a stable support such as a rib retractor or other structure which does not move relative to the beating heart.

Referring to FIG. 2, a dome-shaped or semi-spherical embodiment of the invention has a plurality of suction ports 2 spaced about the periphery of the bottom surface 6 of the dome portion 8 such that the entire instrument is fixed to the cardiac tissue at the point of each of the several suction ports 2. As with the above embodiment, it is preferred that each suction port 2 be pneumatically connected via an air-tight pressure conducting chamber 4. The base of the instrument is comprised of a substantially flat bottom surface 6 wherein the opening of each of the suction ports 2 is flush at the bottom surface 6. The bottom surface 6 is preferably substantially flat because the bottom surface 6 will engage the surface of the heart when the negative pressure is imposed. Alternatively, depending on the size of the instrument and the location of placement on the surface of the heart, the bottom surface 6 may be contoured so that the suction ports 2 may engage a curved surface of the heart. The bottom surface 6 may also have a separate contact layer 7 to cushion the contact between the instrument and the heart tissue and to facilitate forming a tight seal when the negative pressure is imposed. The contact layer 7 may cover substantially the entire bottom surface 6 proximate to the openings of the suction ports 2. If the material surrounds the openings of the suction ports, it is preferable that the material not be air permeable to prevent the negative pressure from passing through the contact layer 7. Also, the contact layer 7 may be attached at the periphery of the bottom surface 6. The available materials for the contact layer 7 include the well-known and commercially available medical plastics such as TEFLON®, silicone, and others which are pliable and biocompatible.

The dome-shaped or semi-spherical embodiment of the invention advantageously has at least one instrument port 9 which may be placed in any of several locations but which is preferably located in the dome portion 8 of the apparatus. The instrument port 9 facilitates introducing the functional portion of an instrument 10 into the interior of the dome portion 8, such that the instrument 10 can perform any of several functions on the cardiac tissue. The instrument 10 could include a cutting apparatus, visual means, such as a scope or light, suturing instruments, suction, blowing, or irrigation apparatus or any like instrument used during a surgical procedure. Multiple instrument ports 9 disposed in the dome portion 8 allow several instruments 10 to be introduced to the surgical site from numerous directions and to be fixed in place relative to the heart.

The instrument ports 9 may be comprised of only a simple opening in the dome portion 8. Alternatively, the instrument ports 9 may also have a flexible or rigid shaft 11 or other attachment means fixed to the dome portion 8 to facilitate introducing an instrument or a member associated therewith such as wires, tubes, cables which comprise or are used to perform the function of the instrument 10. The shaft 11 may also comprise the inlet (not shown) for introducing negative pressure to the pressure conducting chamber 4. Because the dome portion 8 remains at a fixed distance to the heart, the instrument ports 9 or shaft 11 may have a collar 23 or stop associated therewith such that the distance between the instrument 10 and the heart can be predetermined and fixed by, for example, abutting a stop 12a on the instrument 10 against a stop 12b or collar on the instrument port 9.

The instrument ports may also contain a locking means which may be magnetic or suction-driven so that the instrument 10 can be locked into place on the dome-portion 8. For example, the surgeon may view the procedure via a scope 22 which communicates an image to a video monitor. This invention may be advantageously used to establish and maintain an optimal position for the scope by inserting the scope 22 through the instrument port and then fixing the position of the scope 22. The end of the scope 22 may have a collar 23 or other stop mechanism near its end, such that the scope 22 may be introduced through the instrument port 9 wherein the movement of the scope 22 toward the heart is terminated by the contact between the collar 23 of the scope 22 and the periphery of the instrument port 9.

Referring to FIG. 3, a sectional view through line A-A at FIG. 1 shows the interior of the pressure conducting chamber 4 and associated passages or conduits associated with the suction ports 2 such that the negative pressure in the pressure conducting chamber 4 is introduced from vacuum line 3, via inlet 5, and ultimately to the suction ports 2. The suction ports 2 have a substantially circular opening 12 disposed in the bottom surface 6. Although this embodiment has a single inlet 5 such that the pressure is introduced to each suction portion 2 via the pressure conducting chamber 4, one or more of the suction ports 2 may each have an independent inlet 5′ for a separate vacuum line 3′.

As noted above, the suction ports 2 are disposed within a bottom surface 6 which is preferably substantially flat. As noted above, the bottom surface 6 of the housing 1 may be a continuous ring or other annular shape which contacts the heart about the entire periphery of housing 1, but may also be comprised of a plurality of individual bases 13 which contain the one or more suction ports 2 and which contact the heart at several independent points which may be co-planar or which may be adapted to the contours of the heart.

Referring to FIG. 4, FIG. 4 shows an embodiment of the invention in use in a coronary artery bypass graft (CABG) procedure where an anastomosis is formed between the internal mammary artery IMA 13 and the left anterior descending artery LAD 14 and which is held open by vessel retractors 16a and 16b. One end of the anastomosis is sewn to the LAD 14 by sutures 17 being manipulated by instrument 10. A vacuum line 3 is attached to inlet 5, to introduce a negative pressure to the pressure conducting chamber 4. An instrument 10, which in this example is manipulating suture 17 for sewing the anastomosis at the LAD 14, is introduced via instrument port 9a located in the housing 1 of the apparatus. An instrument port 9a has a shaft 18 disposed within the instrument port 9a to facilitate positioning the instrument 10 relative to both the housing 1 and to the surgical site. The shaft 18 traverses all or a portion of the instrument port 9a and may be flexible such that the shaft 10 can be oriented in a fashion to direct the instrument 10 to the desired point within the surgical field. The shaft 18 may also be incorporated into a pivot 24 of any of several configurations including a ball 25 and socket 26 joint having a passage 27 running axially through the ball 25 wherein the shaft 18 is contained in the passage 27 such that the ball 25 is rotated within the socket 26 to rotate the instrument 10 about the pivot 24 to position the functional end of the instrument 10. An example of another instrument 19 is inserted through instrument port 9b by passing the instrument 19 through a rigid or flexible shaft 12 which is disposed within the instrument port 9b. In this example, the instrument 19 passes through the shaft 12 such that the position of the functional end of the instrument 19 is fixed. In the example shown in FIG. 4, the instrument 19 is being used to grasp the IMA 13 proximate to the attachment of the graft.

Referring to FIG. 5, pursuant to this invention, the suction ports 2 may be incorporated into a hand-held apparatus 20 having a shaft 21 attached to a suction part assembly 22 containing the suction ports 2, at least one vacuum line 3, and a block 23 wherein the suction ports 2 are contained. This embodiment may be operated by a surgeon or surgical assistant by hand grips 24 or the hand grips 24 may be replaced by a conventional attachment (not shown) for fixing the shaft 21 to a stable support such as a surgical retractor or other such fixed structure available during the surgical procedure. In a preferred embodiment, a pair of shafts 21 are interlinked by a pivot link 25 at an intermediate point in the shaft 21 such that each suction port assembly may be positioned independently of one another either before or after the negative pressure is applied. In this configuration, the cardiac tissue which is functionally attached to the instrument at the points of contact with the suction port assembly 22 may be drawn apart by imposing a negative pressure through the suction ports 2 and then manipulating the rigid shafts 21, or hand grips 24 of the instrument 20 such that each suction port assembly 22 is moved a distance from the other. The suction port assembly 22 is comprised of the block 23, in which the suction ports 2 are contained, and a receiving means 29 located at the terminal (lower) end at the shaft 21 which is shaped to receive the block 23 and to pen-nit introduction of the negative pressure from vacuum line 3 to the suction ports 2 contained within the block. The negative pressure is preferably, imposed by one or more vacuum lines 3 which may run parallel to the shaft 21 before terminating in the block 23 containing the suction ports 2 or at any convenient point in the suction port assembly 22. In a preferred embodiment, the blocks 23 are substantially rectangular structures wherein the suction parts 2 are placed in an array as described below.

Referring to FIG. 6, the block 23 is comprised of a plurality of suction ports 2 which are connected to vacuum line 3 to create a negative pressure at each suction port 2. The number of individual vacuum lines 3 may be any number less than or equal to the number of suction ports 2. An individual suction port 2 may be connected to negative pressure via the pressure conducting space 4 (See FIG. 7A) or by a passage 26 which communicates an individual suction port 2 directly to the vacuum line 3. The passage 26 is preferably smaller in circumference than the opening of the suction port 2. In the embodiment of FIG. 6, every other suction port 2 is connected to either of two vacuum lines 3 which traverse substantially the length of the block 23. Alternatively, each suction port may also be connected to a single suction line as shown in FIG. 8. In the embodiment of FIG. 6, the passages 26 are oriented off-center to the circumference of the opening of the suction port 2. In a preferred embodiment, the block 23 is a separate molded rubber unit which is configured to fit reversibly into a receiving means 29 at the terminal end of the shaft 21. In this configuration, the suction port assembly 22 may be disassembled and the block 23 disposed after a single use.

Referring to FIG. 7, a sectional view of the block 23 through line B-B of FIG. 6 shows the suction ports 2 disposed with the block 23 in a linear array such that each suction port is equidistant from each adjacent suction port 2. The openings 12 of the suction ports 2 are flush with the bottom surface 6 of the block 23. In this embodiment, a pair of vacuum lines 3 connects each suction port 2 to negative pressure via a single passage 26 which runs from the vacuum line 3 to the suction port 2 and is substantially perpendicular to the vacuum line 3. Alternatively, as shown in FIG. 8, a single vacuum line 3 may connect each suction port 2 to negative pressure.

Referring to FIG. 7A, the block 23 may also have an inlet 5 which introduces the negative pressure to the suction ports 2. The suction ports 2 are disposed within the bottom surface 6 of the block 23 which is to be affixed to the end of the shaft 21 (see FIG. 5). As will be readily appreciated, the negative pressure can be introduced to the suction ports 2 by a variety of techniques as described above. The vacuum line 3 may be attached to the apparatus 20 at several points such as the individual suction ports as illustrated in FIG. 7 or via a single inlet 5 and communicated to each suction port 2 via pressure conducting space 4 (FIG. 7A) such that the negative pressure is introduced to the block 23 and communicated to each suction port 2. Thus, the objective of communicating the negative pressure to the suction ports 2 to fix the position of the cardiac tissue may be achieved via several alternate techniques which are based on or may be developed from the embodiments disclosed herein.

Referring to FIGS. 9 and 9A, as noted above the block 23 may be removable from the apparatus 20. The terminal end of the apparatus 20 has a receiving means 29 which is adapted to reversibly receive the block 23. In a preferred embodiment, the receiving means 29 is comprised of a substantially parallel walls 27 having a grip means 28 associated therewith to maintain the position of the block 23 in place when attached to the receiving means 29. The grip means 28 may be one of several alternate designs. For example, the block 23 may have a ridge or indentation 30 which runs along the lateral exterior surface of the block 23 and fits conformingly in a groove or ridge 31 formed in the interior face of the wall 27.

The particular examples set forth herein are instructional and should not be interpreted as limitations on the applications to which those of ordinary skill are able to apply this invention. Modifications and other uses are available to those skilled in the art which are encompassed within the spirit of the invention as defined by the scope of the following claims.