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US5415666A
Expired / Lapsed
US
⏱️ 0.0 years remaining
Tethered clamp retractor
Assignee: Heartport Inc
•
Filing: 1993-03-04
•
Granted: 1995-05-16
•
Expires: 2013-03-04
Abstract
Abstract The invention provides a tissue manipulation system including a tethered clamp, a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity, and a rigid positioning shaft for engaging the clamp and/or tether to manipulate the clamp. In a further embodiment, the tissue manipulation system includes an introducer through which the tether can be withdrawn from the abdominal cavity and a retainer attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.
Inventors
- 👤 Stuart J. Gourlay
- 👤 Terry Buelna
- 👤 Wayne A. Noda
- 👤 Paul Lubock
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 02:22
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/02; A61B17/0218; A61B17/00234; A61B17/12; A61B17/122; A61B17/1227; A61B17/128; A61B17/1285; A61B2017/00238; A61B2017/00265; A61B2017/00287; A61B2017/00349; A61B17/28; A61B2017/2808
Claims Analysis
Total Claims: 83
Claim 1
Independent Claim
155 words
A method of manipulating tissue comprising the steps of: introducing a clamp having one end of a flexible tether attached thereto through a percutaneous cannula to a tissue location in a body cavity so that the other end of the tether remains in the cannula; securing the clamp to the tissue at the tissue location; percutaneously introducing a rigid positioning shaft at a location on the patient distanced from the cannula; engaging the flexible tether with a distal end of the rigid positioning shaft; retracting the rigid positioning shaft until the free end of the tether is removed from the cannula to manipulate the tissue in a first direction; further retracting the positioning shaft until the positioning shaft and the free end of the tether are removed from the patient's body cavity; and introducing a positioning member along the tether and pushing on the positioning member to further manipulate the tissue in a second direction.
Claim 2
Independent Claim
155 words
A method of manipulating tissue comprising the steps of: introducing a clamp having one end of a flexible tether attached thereto through a percutaneous cannula to a tissue location in a body cavity so that the other end of the tether remains in the cannula; securing the clamp to the tissue at the tissue location; percutaneously introducing a rigid positioning shaft at a location on the patient distanced from the cannula; engaging the flexible tether with a distal end of the rigid positioning shaft; retracting the rigid positioning shaft until the free end of the tether is removed from the cannula to manipulate the tissue in a first direction; further retracting the positioning shaft until the positioning shaft and the free end of the tether are removed from the patient's body cavity; and introducing a positioning member along the tether and pushing on the positioning member to further manipulate the tissue in a second direction.
Claim 3
Dependent Claim
17 words
The method of claim 1 further comprising the step of securing the tether after the retracting step.
Claim 4
Dependent Claim
35 words
The method of claim 2 wherein the rigid positioning shaft is percutaneously introduced through a percutaneous introducer and wherein the step of retracting comprises pulling the free end of the tether through the percutaneous introducer.
Claim 5
Dependent Claim
24 words
The method of claim 3 wherein the step of securing the tether comprises actuating a retainer disposed at a proximal end of the introducer.
Claim 6
Dependent Claim
19 words
The method of claim 3 wherein the percutaneous introducer is positioned using an obturator removably mounted in the introducer.
Claim 7
Dependent Claim
49 words
The method of claim 3 wherein the tether is pulled through the percutaneous introducer by inserting a hook at the distal end of the positioning shaft through the introducer, engaging the tether with the hook, and retracting the positioning shaft with the tether in the hook through the introducer.
Claim 8
Dependent Claim
25 words
The method of claim 6 wherein the introducer is positioned by applying energy to tissue through an electrode at the distal end of the introducer.
Claim 9
Dependent Claim
11 words
The method of claim 7 wherein the energy is radiofrequency energy.
Claim 10
Dependent Claim
11 words
The method of claim 7 wherein the energy is ultrasonic energy.
Claim 11
Dependent Claim
11 words
The method of claim 7 wherein the energy is thermal energy.
Claim 12
Dependent Claim
22 words
The method of claim 3 wherein the distal end of the positioning shaft is introduced through an axial passage of the introducer.
Claim 13
Dependent Claim
30 words
The method of claim 11 wherein the tissue is pulled in a first direction by pulling the tether and positioned in a second direction by pushing on the positioning shaft.
Claim 14
Dependent Claim
34 words
The method of claim 11 wherein the step of introducing the clamp further comprises introducing the clamp to a tissue location having gallbladder tissue, and wherein said clamp is secured to said gallbladder tissue.
Claim 15
Dependent Claim
17 words
The method of claim 13 wherein the introducer is positioned in an abdominal region below the ribs.
Claim 16
Dependent Claim
22 words
The method of claim 11 further comprising gaseously sealing the axial passage of the introducer while the positioning shaft is positioned therethrough.
Claim 17
Dependent Claim
23 words
The method of claim 1 further comprising securing the free end of the tether to a second tissue location in the body cavity.
Claim 18
Dependent Claim
27 words
The method of claim 16 wherein the step of engaging further comprises using a hook at the distal end of the positioning shaft to engage the tether.
Claim 19
Dependent Claim
24 words
The method of claim 1 wherein the rigid positioning shaft is introduced by penetrating tissue with the distal end of the rigid positioning shaft.
Claim 20
Dependent Claim
18 words
The method of claim 18 wherein the rigid positioning shaft has a sharpened distal point to penetrate tissue.
Claim 21
Dependent Claim
21 words
The method of claim 18 wherein the rigid positioning shaft has an RF electrode on its distal end to penetrate tissue.
Claim 22
Dependent Claim
21 words
The method of claim 18 wherein the rigid positioning shaft has an ultrasonic transducer on its distal end to penetrate tissue.
Claim 23
Dependent Claim
21 words
The method of claim 18 wherein the rigid positioning shaft has a thermal electrode on its distal end to penetrate tissue.
Claim 24
Dependent Claim
36 words
The method of claim 1 further comprising passing a free end of the tether through an eye at a distal end of a positioning member and sliding the positioning member along the tether toward the clamp.
Claim 25
Dependent Claim
13 words
The method of claim 1 further comprising distending the body cavity by insufflation.
Claim 26
Dependent Claim
14 words
The method of claim 24 further comprising visualizing the tissue location using a laparoscope.
Claim 27
Dependent Claim
19 words
The method of claim 24 further comprising gaseously sealing the percutaneous cannula during the step of introducing the clamp.
Claim 28
Independent Claim
176 words
An apparatus in kit form for tissue manipulation comprising: a clamp having a pair of movable jaws and means for closing and opening the jaws; an applicator for applying the clamp through a percutaneous cannula to a first tissue site comprising an elongated body with a distal end, a proximal end and an axial passageway therebetween, a pair of movable arms disposed at the distal end configured to engage the means for closing and opening the jaws of the clamp, means at the proximal end of the body for actuating the arms, a linkage disposed in the axial passageway, the linkage connecting the arms to the means for actuating, and means for biasing the arms in an open configuration; a flexible tether having a first end attached to the clamp and a free end opposite the first end for manipulating the clamp in a first direction; and a rigid positioning shaft having a distal end for engaging the clamp, and a proximal end for pushing on the shaft to manipulate the clamp in a second direction.
Claim 29
Independent Claim
176 words
An apparatus in kit form for tissue manipulation comprising: a clamp having a pair of movable jaws and means for closing and opening the jaws; an applicator for applying the clamp through a percutaneous cannula to a first tissue site comprising an elongated body with a distal end, a proximal end and an axial passageway therebetween, a pair of movable arms disposed at the distal end configured to engage the means for closing and opening the jaws of the clamp, means at the proximal end of the body for actuating the arms, a linkage disposed in the axial passageway, the linkage connecting the arms to the means for actuating, and means for biasing the arms in an open configuration; a flexible tether having a first end attached to the clamp and a free end opposite the first end for manipulating the clamp in a first direction; and a rigid positioning shaft having a distal end for engaging the clamp, and a proximal end for pushing on the shaft to manipulate the clamp in a second direction.
Claim 30
Dependent Claim
17 words
The apparatus as in claim 27 further comprising means for retrieving the free end of the tether.
Claim 31
Dependent Claim
25 words
The apparatus as in claim 28 wherein the means for retrieving the tether comprises an elongated snare having a hooked end for grasping the tether.
Claim 32
Dependent Claim
29 words
The apparatus as in claim 27 further comprising means separated from the clamp for securing the tether in tension so as to maintain the tissue in a desired position.
Claim 33
Dependent Claim
55 words
The apparatus as in claim 30 wherein the means for securing the tether comprises an introducer having a distal end, a proximal end and an axial passage therebetween, and a retainer disposed at the proximal end of the introducer, whereby the tether may be passed through the axial passageway and detachably secured in the retainer.
Claim 34
Dependent Claim
18 words
The apparatus as in claim 31 wherein the introducer further comprises means for gaseously sealing the axial passage.
Claim 35
Dependent Claim
41 words
The apparatus as in claim 31 wherein the retainer comprises a stopcock having a housing with a bore therethrough and a valve for closing off the bore, whereby the tether may be positioned in the bore and engaged by the valve.
Claim 36
Dependent Claim
29 words
The apparatus as in claim 30 wherein the means for securing the tether comprises means attached to the tether for detachably securing the tether to a second tissue site.
Claim 37
Dependent Claim
20 words
The apparatus as in claim 37 wherein the clamp further comprises means for biasing the jaws in a closed configuration.
Claim 38
Dependent Claim
30 words
The apparatus as in claim 27, wherein the means for actuating the arms comprises a tubular handle and a plunger slidably mounted in the handle and coupled to the linkage.
Claim 39
Dependent Claim
24 words
The apparatus as in claim 27 wherein the positioning shaft further comprises means for guiding the positioning shaft along the tether toward the clamp.
Claim 40
Dependent Claim
38 words
The apparatus as in claim 37 wherein the means for guiding comprises a loop attached to the distal end of the positioning shaft, the loop having an eye through which the free end of the tether is passed.
Claim 41
Dependent Claim
19 words
The apparatus as in claim 38 wherein the loop engages a knot in the tether near the first end.
Claim 42
Independent Claim
155 words
An apparatus in kit form for tissue manipulation comprising: a clamp having a pair of movable jaws and means for opening and closing the jaws; a flexible tether having a first end attached to the clamp and a free end opposite the first end for manipulating the clamp in a first direction; an introducer having a proximal end, a distal end and an axial passage therebetween, wherein the distal end may be percutaneously positioned with the free end of the tether drawn through the axial passage; and a rigid positioning shaft having a rigid positioning means on a distal end for guiding the positioning shaft along the tether toward the clamp, the distal end being insertable through the axial passage while the free end of the tether is drawn through the axial passage for engaging the clamp and a proximal end for pushing on the positioning shaft to manipulate the clamp in a second direction.
Claim 43
Independent Claim
155 words
An apparatus in kit form for tissue manipulation comprising: a clamp having a pair of movable jaws and means for opening and closing the jaws; a flexible tether having a first end attached to the clamp and a free end opposite the first end for manipulating the clamp in a first direction; an introducer having a proximal end, a distal end and an axial passage therebetween, wherein the distal end may be percutaneously positioned with the free end of the tether drawn through the axial passage; and a rigid positioning shaft having a rigid positioning means on a distal end for guiding the positioning shaft along the tether toward the clamp, the distal end being insertable through the axial passage while the free end of the tether is drawn through the axial passage for engaging the clamp and a proximal end for pushing on the positioning shaft to manipulate the clamp in a second direction.
Claim 44
Dependent Claim
18 words
The apparatus as in claim 40 further comprising means for holding a portion of the tether in tension.
Claim 45
Dependent Claim
22 words
The apparatus as in claim 40 wherein the means for holding comprises a stopcock disposed at the proximal end of the introducer.
Claim 46
Dependent Claim
29 words
The apparatus as in claim 40 further comprising means for retrieving the free end of the tether and drawing the free end through the axial passage of the introducer.
Claim 47
Dependent Claim
31 words
The apparatus as in claim 43 wherein the means for retrieving and drawing comprises an elongated snare having a hooked end configured to pass through the axial passage of the introducer.
Claim 48
Dependent Claim
14 words
The apparatus as in claim 40 further comprising means for percutaneously inserting the introducer.
Claim 49
Dependent Claim
25 words
The apparatus as in claim 45 wherein the means for inserting the introducer comprises an obturator removably disposed in the axial passage of the introducer.
Claim 50
Dependent Claim
20 words
The apparatus as in claim 40 further comprising means for applying the clamp to the tissue through a percutaneous cannula.
Claim 51
Dependent Claim
83 words
The apparatus as in claim 47 wherein the means for applying comprises: an elongated body having a distal end, a proximal end and an axial passageway therebetween; a pair of movable arms disposed at the distal end of the body configured to engage the means for opening and closing the jaws of the clamp; means at the proximal end of the body for actuating the arms; and a linkage disposed in an axial passageway and connecting the arms to the means for actuating.
Claim 52
Dependent Claim
30 words
The apparatus as in claim 48, wherein the means for actuating the arms comprises a tubular handle and a plunger slidably mounted in the handle and coupled to the linkage.
Claim 53
Dependent Claim
17 words
The apparatus as in claim 40 wherein the introducer includes means for gaseously sealing the axial passage.
Claim 54
Dependent Claim
38 words
The apparatus as in claim 40 wherein the means for guiding comprises a loop attached to the distal end of the positioning shaft, the loop having an eye through which the free end of the tether is passed.
Claim 55
Dependent Claim
21 words
The apparatus as in claim 51 wherein the first end of the tether is connected to the clamp by a knot.
Claim 56
Dependent Claim
25 words
The apparatus as in claim 52 wherein the loop at the distal end of the positioning shaft is rigid to assist in engaging the knot.
Claim 57
Dependent Claim
39 words
The apparatus as in claim 40 wherein the means for opening and closing the jaws of the clamp comprises a pair of levers attached to the jaws and connected by a hinge disposed between the levers and the jaws.
Claim 58
Independent Claim
154 words
An apparatus in kit form for tissue manipulation comprising: a clamp having a pair of movable jaws and means for opening and closing the jaws; a flexible tether having a first end directly attached to the clamp and a free end opposite the first end for manipulating the clamp in a first direction; means for percutaneously applying the clamp to the tissue; an introducer separate from the clamp applying means having a proximal end, a distal end and an axial passage therebetween, whereby the tether may be passed through the axial passage; a rigid positioning shaft having a rigid distal end insertable through the axial passage while the tether extends through the passage for engaging the clamp and a proximal end for pushing on the positioning shaft to manipulate the clamp in a second direction; and means on the proximal end of the introducer for retaining the tether which passes through the axial passage.
Claim 59
Independent Claim
154 words
An apparatus in kit form for tissue manipulation comprising: a clamp having a pair of movable jaws and means for opening and closing the jaws; a flexible tether having a first end directly attached to the clamp and a free end opposite the first end for manipulating the clamp in a first direction; means for percutaneously applying the clamp to the tissue; an introducer separate from the clamp applying means having a proximal end, a distal end and an axial passage therebetween, whereby the tether may be passed through the axial passage; a rigid positioning shaft having a rigid distal end insertable through the axial passage while the tether extends through the passage for engaging the clamp and a proximal end for pushing on the positioning shaft to manipulate the clamp in a second direction; and means on the proximal end of the introducer for retaining the tether which passes through the axial passage.
Claim 60
Dependent Claim
83 words
The apparatus as in claim 55 wherein the means for applying comprises: an elongated body having a distal end, a proximal end and an axial passageway therebetween; a pair of movable arms disposed at the distal end of the body configured to engage the means for opening and closing the jaws of the clamp; means at the proximal end of the body for actuating the arms; and a linkage disposed in the axial passageway and connecting the arms to the means for actuating.
Claim 61
Dependent Claim
30 words
The apparatus as in claim 56, wherein the means for actuating the arms comprises a tubular handle and a plunger slidably mounted in the handle and coupled to the linkage.
Claim 62
Dependent Claim
24 words
The apparatus as in claim 56 wherein the means for applying a clamp further comprises means for biasing the arms in an open configuration.
Claim 63
Dependent Claim
29 words
The apparatus as in claim 55 further comprising means for retrieving the free end of the tether and drawing the free end through the axial passage of the introducer.
Claim 64
Dependent Claim
32 words
The apparatus as in claim 59 wherein the means for retrieving the free end comprises an elongated snare with a hooked end configured to pass through the axial passage of the introducer.
Claim 65
Dependent Claim
26 words
The apparatus as in claim 60 wherein the snare comprises means at a distal end thereof for penetrating tissue to facilitate percutaneous introduction of the snare.
Claim 66
Dependent Claim
15 words
The apparatus as in claim 61 wherein the means for penetrating comprises a sharpened point.
Claim 67
Dependent Claim
18 words
The apparatus as in claim 61 wherein the means for penetrating comprises means for applying energy to tissue.
Claim 68
Dependent Claim
16 words
The apparatus as in claim 63 wherein the means for applying energy comprises an RF electrode.
Claim 69
Dependent Claim
16 words
The apparatus as in claim 63 wherein the means for applying energy comprises an ultrasonic transducer.
Claim 70
Dependent Claim
16 words
The apparatus as in claim 63 wherein the means for applying energy comprises a thermal electrode.
Claim 71
Dependent Claim
17 words
The apparatus as in claim 55 further comprising means for percutaneously inserting the introducer into a patient.
Claim 72
Dependent Claim
23 words
The apparatus as in claim 67 wherein the means for inserting the introducer comprises an obturator having a distal point for piercing tissue.
Claim 73
Dependent Claim
33 words
The apparatus as in claim 67 wherein the means for inserting the introducer comprises means disposed at the distal end of the introducer for applying energy to tissue so as to penetrate therethrough.
Claim 74
Dependent Claim
16 words
The apparatus as in claim 69 wherein the means for applying energy comprises a radiofrequency electrode.
Claim 75
Dependent Claim
16 words
The apparatus as in claim 69 wherein the means for applying energy comprises an ultrasonic transducer.
Claim 76
Dependent Claim
16 words
The apparatus as in claim 69 wherein the means for applying energy comprises a thermal electrode.
Claim 77
Dependent Claim
20 words
The apparatus as in claim 55 wherein the clamp further comprises means for biasing the jaws in a closed configuration.
Claim 78
Dependent Claim
17 words
The apparatus as in claim 55 wherein the introducer includes means for gaseously sealing the axial passage.
Claim 79
Dependent Claim
24 words
The apparatus as in claim 55 wherein the positioning shaft further comprises means for guiding the positioning shaft along the tether toward the clamp.
Claim 80
Dependent Claim
38 words
The apparatus as in claim 75 wherein the means for guiding comprises a loop attached to the distal end of the positioning shaft, the loop having an eye through which the free end of the tether is passed.
Claim 81
Dependent Claim
21 words
The apparatus as in claim 76 wherein the first end of the tether is connected to the clamp by a knot.
Claim 82
Dependent Claim
25 words
The apparatus as in claim 77 wherein the loop at the distal end of the positioning shaft is rigid to assist in engaging the knot.
Claim 83
Dependent Claim
39 words
The apparatus as in claim 55 wherein the means for opening and closing the jaws of the clamp comprises a pair of levers attached to the jaws and connected by a hinge disposed between the levers and the jaws.
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USPTO Annuity & Maintenance Windows
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|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1998-05-15 | 1998-11-14 | 1999-05-16 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2002-05-15 | 2002-11-14 | 2003-05-16 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2006-05-15 | 2006-11-14 | 2007-05-16 | $7700.00 | Window Closed / Lapsed |