# US 2012/0083664 A1 · Methods and devices for cardiac surgery > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2012/0083664 A1 - Document ID: US20120083664A1 - Status: Published application - Kind: A1 - Application number: 13/325,236 - Filed: 2011-12-14 - Published: 2012-04-05 - Earliest claimed: 2002-12-06 - Assignees: ESTECH, Inc. (Endoscopic Technologies, Inc.) - Inventors: Art Bertolero; Steve Geyster - Web page: https://patentgrep.com/patent/US20120083664A1 ## CPC - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 2017/0243: {for immobilizing local areas of the heart, e.g. while it beats} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Methods for performing minimally invasive heart surgery include accessing a heart of a patient through a first incision on the left thorax of the patient, contacting the heart through the incision with a heart stabilizing device and/or a heart positioning device, introducing at least one coupling device through a second incision on the patient located apart from the first incision, coupling the coupling device with the heart stabilizing device or the heart positioning device, and performing a surgical procedure on the heart. Systems may include a retractor device, a heart stabilizing device, and a coupling device, for enhancing cardiac surgery. Any suitable heart surgery may be performed using methods, devices or systems of the present invention. In one embodiment, a CABG procedure is performed. ## Claims ### Claim 1 A system for enhancing minimally invasive heart surgery, the device comprising: a surgical tool comprising a ball; an elongate coupling member comprising a proximal end, a distal end, a flexible rigidifying portion comprising a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion into place, a coupling means near the distal end for coupling with the surgical tool, and an actuation device near the proximal end that can tighten the coupling means to the ball of the surgical tool and loosen the coupling means from the ball of the surgical tool; and an elongate flexible arm for coupling the elongate coupling member with a stable object, the elongate flexible arm comprising a distal clamp configured to clamp the elongate coupling member and a proximal clamp configured to clamp the stable object. ### Claim 2 (depends on 1) A system as in claim 1 wherein the surgical tool comprises a heart stabilizing member. ### Claim 3 (depends on 2) A system as in claim 2, wherein the heart stabilizing member comprises: at least one tissue contacting surface; at least one suction aperture for applying suction force to enhance contact between the tissue contacting surface and heart tissue; and at least one suction port for coupling with a source of suction. ### Claim 4 (depends on 2) A system as in claim 2, wherein the heart stabilizing member comprises: at least one inflatable tissue contacting surface; and at least one port for allowing inflation of the tissue contacting surface. ### Claim 5 (depends on 2) A system as in claim 2, wherein the coupling means comprises a collet or socket for coupling with the ball on the heart stabilizing member. ### Claim 6 (depends on 2) A system as in claim 2, wherein the coupling means comprises a clamp. ### Claim 7 (depends on 2) A system as in claim 2, wherein the coupling means comprises a slot for coupling with a surface feature on the heart stabilizing member. ### Claim 8 (depends on 2) A system as in claim 2, wherein the coupling means comprises threads for coupling with complementary threads on the heart stabilizing member. ### Claim 9 (depends on 1) A system as in claim 1, wherein the elongate coupling member further includes at least one flexible joint between the proximal end and the distal end. ### Claim 10 (depends on 9) A system as in claim 9, wherein the at least one joint comprises a collet or socket and ball joint. ### Claim 11 (depends on 9) A system as in claim 9, wherein the at least one joint comprises multiple flexible beads. ### Claim 12 (depends on 1) A system as in claim 1, further comprising a heart positioning member. ### Claim 13 (depends on 12) A system as in claim 12, wherein the heart positioning member comprises: at least one tissue contacting surface; at least one suction aperture for applying suction force to enhance contact between the tissue contacting surface and heart tissue; and at least one suction port for connecting with a source of suction. ### Claim 14 (depends on 12) A system as in claim 12, wherein the heart positioning member comprises: at least one inflatable tissue contacting surface; and at least one port for allowing inflation of the tissue contacting surface. ### Claim 15 (depends on 12) A system as in claim 12, further comprising a second elongate coupling member that couples with the heart positioning member, wherein the second elongate coupling member comprises a collet or socket for coupling with a ball on the heart positioning member. ### Claim 16 (depends on 15) A system as in claim 15, wherein the second elongate coupling member couples with the heart positioning member via a clamp. ### Claim 17 A system for enhancing minimally invasive heart surgery, the system comprising: a retractor device; a heart stabilizing device comprising a tissue contacting surface, a suction aperture adjacent the tissue contacting surface, and a complementary coupling means; a first coupling device comprising an elongate shaft having a proximal end, a distal end, and at least one flexible rigidifying portion comprising a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion into place, a distal coupling means at or near the distal end, and an actuation device at or near the proximal end that can tighten the distal coupling means relative to the complementary coupling means of the heart stabilizing device and that can loosen the distal coupling means relative to the complementary coupling means of the heart stabilizing device; and a first flexible arm coupled with the first coupling device via a first clamp, wherein the first flexible arm can be rigidified by applying suction. ### Claim 18 (depends on 17) A system as in claim 17, further comprising: a heart positioning device comprising a tissue contacting surface, a suction aperture adjacent the tissue contacting surface, and a complementary coupling means; a second coupling device comprising an elongate shaft having a proximal end, a distal end, and at least one flexible rigidifying portion comprising a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion into place, a distal coupling means at or near the distal end, and an actuation device at or near the proximal end that can tighten the distal coupling means relative to the complementary coupling means of the heart positioning device and that can loosen the distal coupling means relative to the complementary coupling means of the heart positioning device; and a second flexible arm coupled with the second coupling device via a second clamp. ### Claim 19 (depends on 17) A system as in claim 17, wherein the plurality of pieces comprises a plurality of beads. ### Claim 20 A system for enhancing minimally invasive heart surgery, the device comprising: a surgical tool comprising a ball; an elongate coupling member having a proximal end, a distal end, a flexible rigidifying portion comprising a plurality of pieces and a wire that when tightened locks the pieces of the rigidifying portion into place, and means near the distal end for coupling with the surgical tool, and an actuation device near the proximal end that can tighten the coupling means to the ball of the surgical tool and loosen the coupling means from the ball of the surgical tool; and an elongate flexible arm having a clamp, wherein the elongate flexible arm is coupled with the elongate coupling member via the clamp at a position on the elongate coupling member proximal to the surgical tool and distal to the actuation device