Design of a Surgical Port for Minimally Invasive Beating-Heart Intracardial Procedures

Abstract

Direct-access, minimally invasive, beating-heart intracardial procedures have the potential to replace many traditional surgical procedures requiring cardio-pulmonary bypass as long as micro-emboli are prevented from entering the cardiovascular system. A new surgical port was developed to introduce surgical instruments into chambers of the beating heart during minimally invasive, intracardial surgical procedures without allowing the introduction of micro-emboli 0.1 mm or larger in size. The design consists of an outer port body that is secured to the heart wall using a purse string suture and a series of inner tubular sleeves that form the interface between the port and the transecting instrument. The design enables rapid tool changes and accommodates a wide variety of instruments. The port uses a fluid purging system to dislodge and remove emboli from a surgical instrument. Laboratory and clinical tests show that the port adequately seals around a surgical instrument and prevents the introduction of emboli with diameters greater than 0.1 mm into the heart while minimizing hemorrhage.