# US 5,700,259 A · Thoracoscopic transmyocardial revascularization handpiece assembly > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 5,700,259 A - Document ID: US5700259A - Status: Granted - Kind: A - Application number: 08/541,793 - Filed: 1995-10-10 - Granted: 1997-12-23 - Earliest claimed: 1990-09-24 - Assignees: PLC Medical Systems, Inc. - Inventors: Charles Christopher Negus; Stephen J. Linhares - Web page: https://patentgrep.com/patent/US5700259A ## CPC - A61B 18/201: {with beam delivery through a hollow tube, e.g. forming an articulated arm (through a flexible conduit A61B18/22); Hand-pieces therefor} - A61B 2017/00243: {cardiac} - A61B 2017/00247: {Making holes in the wall of the heart, e.g. laser Myocardial revascularization} - A61B 2018/00392: {Transmyocardial revascularisation} - A61B 2090/036: {abutting on tissue or skin} - A61B 2218/006: for smoke evacuation - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A thoracoscopic transmyocardial revascularization handpiece assembly for a medical laser system which includes a barrel which fits between the patient's ribs, a handpiece which fits between the ribs, a contacting surface on one end of the handpiece with a width which fits between the patient's ribs, and a contacting surface which has a length larger than the width resulting in a contact surface with a surface area which is greater than the cross-sectional area of the handpiece and which yet still fits between the patient's ribs. ## Claims ### Claim 1 A thoracoscopic transmyocardial revascularization handpiece assembly for a medical laser system, comprising: an elongate barrel having a narrow width sized to fit between the ribs of a patient and having a first passage therethrough for conducting a surgical laser beam; an elongate handpiece extending from said barrel and having a similarly narrow width commensurate with said barrel and having a second passage therethrough connecting with said first passage for conducting a surgical laser beam; a contacting surface on a distal end of said handpiece for contacting the wall of the patient's heart; said contacting surface having a width in a first dimension which is approximately that of said handpiece for fitting between the ribs of a patient and having a width in a second dimension which is larger to effect an area of said contacting surface which is substantially larger than the cross-sectional area of said handpiece to provide a more stable platform to maintain perpendicularity between the laser beam and the wall of the heart; an aperture substantially centered in said contacting surface communicating with said second passage for transmitting the laser beam; and focusing means in said barrel for focusing the laser beam proximate to the aperture to ablate the tissue of the heart wall and create a hole to the interior heart chamber. ### Claim 2 (depends on 1) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 1 in which said barrel and said handpiece are separate and there is further included means for coupling a proximal end of said handpiece to the distal end of said barrel. ### Claim 3 (depends on 1) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 1 in which said barrel and said handpiece are integral. ### Claim 4 (depends on 1) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 1 in which said contacting surface is knurled for preventing movement of said contacting surface with respect to the heart wall during surgery. ### Claim 5 (depends on 1) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 1 in which said contacting surface is at an angle to the longitudinal axis of said handpiece. ### Claim 6 (depends on 4) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 4 in which said contacting surface is perpendicular to the longitudinal axis of said handpiece. ### Claim 7 (depends on 6) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 6 in which said handpiece further includes a cutout portion proximate said contacting surface. ### Claim 8 (depends on 7) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 7 in which said barrel includes means for introducing a purge gas into said handpiece to create a back pressure to force said ablated tissue out of said cutout portion and to keep said ablated tissue away from said focusing means. ### Claim 9 (depends on 4) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 4 in which said contacting surface is parallel to the longitudinal axis of said handpiece. ### Claim 10 (depends on 9) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 9 in which said handpiece further includes deflecting means for directing said laser beam to said aperture. ### Claim 11 (depends on 10) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 10 in which said handpiece further includes at least one port for exhausting said ablated tissue. ### Claim 12 (depends on 11) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 11 in which said barrel includes means for introducing a purge gas into said handpiece to create a back pressure to force said ablated tissue out of said at least one port and to keep said ablated tissue away from said focusing means. ### Claim 13 (depends on 2) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 2 in which said means for coupling includes a friction fit between a proximal end of said handpiece and said distal end of said barrel. ### Claim 14 The thoracoscopic transmyocardial with said second passage for transmitting the laser beam; and focusing means in said barrel for focusing the laser beam proximate to the aperture to ablate the tissue of the heart wall and create a hole to the interior heart chamber. ### Claim 15 A thoracoscopic transmyocardial revascularization handpiece assembly for a medical laser system, comprising: an elongate barrel having a narrow width sized to fit between the ribs of a patient and having a first passage therethrough for conducting a surgical laser beam; an elongate handpiece having a similarly narrow width commensurate with said barrel and having a second passage therethrough connecting with said first passage for conducting a surgical laser beam; means for coupling the proximal end of said handpiece to the distal end of said barrel; a contacting surface on the distal end of said handpiece for contacting the wall of the patient's heart; said contacting surface having a width in a first dimension which is approximately that of said handpiece for fitting between the ribs of a patient and having a width in a second dimension which is larger to effect an area of said contacting surface which is substantially larger than a cross-sectional area of said handpiece to provide a more stable platform to maintain perpendicularity between the laser and the wall of the heart; an aperture substantially centered in said contacting surface communicating with said second passage for transmitting the laser beam; and focusing means in said barrel for focusing the laser beam proximate to the aperture to ablate the tissue of the heart wall and create a hole to the interior heart chamber. ### Claim 16 A thoracoscopic transmyocardial revascularization handpiece assembly for a medical laser system, comprising: an elongate barrel having a narrow width sized to fit between the ribs of a patient and having a first passage therethrough for conducting a surgical laser beam; an elongate handpiece extending from said barrel and having a similarly narrow width commensurate with said barrel and having a second passage therethrough connecting with said first passage for conducting a surgical laser beam; a knurled contacting surface on a distal end of said handpiece for contacting the wall of the patient's heart, said contacting surface being parallel to the longitudinal axis of said handpiece and having a width in a first dimension which is approximately that of said handpiece for fitting between the ribs of a patient and having a width in a second dimension which is larger to effect an area of said contacting surface which is substantially larger than a cross-sectional area of said handpiece to provide a more stable platform to maintain perpendicularity between the laser and the wall of the heart; an aperture substantially centered in said contacting surface communicating with said second passage for transmitting the laser beam; and focusing means in said barrel for focusing the laser beam proximate to the aperture to ablate the tissue of the heart wall and create a hole to the interior heart chamber. ### Claim 17 (depends on 16) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 16 in which said handpiece further includes deflecting means for directing said laser beam to said aperture. ### Claim 18 (depends on 17) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 17 in which said handpiece further includes at least one port for exhausting said ablated tissue. ### Claim 19 (depends on 18) The thoracoscopic transmyocardial revascularization handpiece assembly of claim 18 in which said barrel includes means for introducing a purge gas into said handpiece to create a back pressure to force said ablated tissue out of said at least one port and to keep said ablated tissue away from said focusing means.