Mechanical anastomosis system for hollow structures

• US 20030055441A1
• Filed: 06/04/2002
• Published: 03/20/2003
• Est. Priority Date: 10/24/1997
• Status: Active Grant

• Current Assignee: Innovative Interventional Technologies BV
• Original Assignee: Innovative Interventional Technologies BV
• Inventors: Suyker, Wilhelmus Joseph Leonardus, Suyker, Paulus Thomas Wilhelmus
• Granted Patent: US 8,182,498 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: Y10S 227/901 Surgical clip appliers
• CPC Class Codes: Y10S 227/902 Surgical clips or staples

Abstract

A system for making anastomoses between hollow structures by mechanical means is provided with a device in the shape of an annular or tubular element comprising circumferentially provided means, such as pin-shaped elements, for joining the abutting walls of the hollow structures together. An applicator is intended for moving said annular or tubular element in position and activating the joining means thereof, so as to make the anastomosis. Possibly, intraluminal joining means can be inserted without using an annular or tubular element.

Claims

1. A system for making anastomoses between hollow structures by mechanical means, characterized by a device in the shape of an annular or tubular element comprising circumferentially provided means for joining the abutting walls of the hollow structures together, as well as an applicator for moving said annular or tubular element in position and activating the joining means thereof.

2. A device for use in the system for making anastomoses between hollow structures by mechanical means according to claim 1, characterized by an annular or tubular element comprising joining means provided circumferentially thereon for joining the abutting walls of the hollow structures together.

3. A device according to claim 2, wherein said joining means comprise a number of pin-shaped elements which are circumferentially provided on said annular element, which pin-shaped elements can be moved or deformed between a starting position and a joining position.

4. A device according to claim 3, which is intended for intraluminal side-to-side anastomosis, wherein respectively two pin-shaped elements are provided at the same position, seen in circumferential direction, wherein at least the free ends of two associated pin-shaped elements are spaced apart in the starting position, seen in axial direction, whilst they have been moved together in the joining position.

5. A device according to any one of the preceding claims, which is intended for intraluminal placement, wherein said annular element can be permanently deformed from a first diameter in the starting position to a second, larger diameter in the joining position.

6. A device according to claim 5, wherein said annular element is made up of at least one elongated element having a length dimension which is greater than the circumferential dimension of said annular element in the first diameter and which is at least equal to the circumferential dimension of said annular element in the second diameter, which element extends along a line which deviates from a contour line in the first diameter and which can be straightened so as to extend along a line which resembles the contour line more closely.

7. A device according to claim 6, wherein said elongated element extends sinusoidally or in a different, zigzag-like fashion.

8. A device according to claims 5 and 7, wherein two zigzag-like elements are arranged side by side in axial direction, which elements are interconnected near their vertices facing each other, and wherein the pin-shaped elements are fixed to the vertices that face away from each other.

9. A device according to claim 3, which is intended for making an intraluminal side-to-side anastomosis or an end-to-side anastomosis, wherein the pin-shaped elements extend at least substantially axially in the starting position and wherein said pin-shaped elements can be bent to the joining position deviating from the axial position, for example a substantially radial or tangential position or the like, so as to make a joint.

10. An applicator for use in the system according to claim 1, which is intended for placing the device according to any one of the claims 2-9, which applicator is provided with means for positioning said annular or tubular element and activating the joining means thereof.

11. An applicator according to claim 10, which is intended for placing the device according to claim 3, which applicator is provided with a, preferably rigid, shank-like element and with a head, which head can be adjusted in such a manner that the pin-shaped elements of the device are moved or deformed from the starting position to the joining position when said adjusting takes place.

12. An applicator according to claim 11, which is intended for placing the device according to claim 4, wherein said head is provided with means for moving associated pin-shaped elements towards each other.

13. An applicator according to claim 11 or 12, which is intended for placing the device according to any one of the claims 5-8, wherein the head of the applicator can also expand in radial direction from a first diameter to a second diameter.

14. An applicator according to claim 13, wherein said head is provided with two axially spaced-apart hubs comprising arms arranged in a star-like fashion thereon, which hubs are movable in axial direction with respect to each other, wherein the arms of the two hubs are pivotally interconnected at a point some distance away from their free ends so as to form clamps.

15. An applicator according to claim 13, wherein said head is circumferentially provided with a number of equally spaced elements, such as wedges, around which the device can be placed, and which can be moved axially and radially outwards by means of a control element, whereby the device is expanded in radial direction and contracted in axial direction.

16. An applicator according to claim 13, wherein said head is provided with an isovolumetrically deformable element, for example of rubber, on which the annular or tubular element of the device can be placed, and which can be axially contracted and be outwardly expanded so as to cause the device to expand in radially outward direction.

17. An applicator according to claim 16, wherein said head is provided with two axially spaced-apart hubs, which are axially movable with respect to each other, with a number of outwardly pivotable elements, which are equally spaced over the circumference, as well as the isovolumetric element, which is positioned inwardly thereof, present therebetween.

18. An applicator according to claim 11, which is intended for placing the device according to claim 9, which applicator comprises a shank-like element and a head, which is fitted with a detainer for stopping the device in axial direction, and axially movable deflector means for deflecting the pin-shaped elements.

19. An applicator according to claim 18, wherein said detainer is a hollow shaft or ring, and wherein said axially movable deflector means are provided with two axially spaced-apart hubs which are axially movable with respect to each other and to the detainer, on which hubs arms are arranged in a star-like fashion, wherein the arms of the two hubs are pivotally interconnected.

20. An applicator according to claim 18, wherein said detainer is a hollow shaft or ring, and wherein said axially movable deflector means are provided with a number of circumferentially provided, substantially radially disposed wedges on the hub, which are each capable of pivoting movement about a substantially tangential axis in the direction of said detainer.

21. An applicator for use in the system for making anastomoses between hollow structures by mechanical means according to claim 1, characterized by a shank-like element and by a head for supporting and activating the joining means provided thereon, in such a manner that said joining means are moved or deformed from the starting position to the joining position upon activation as a result of expansion of the head in radial direction from a first diameter to a second diameter and of axial contraction in two separate steps.

22. An applicator according to claim 21, wherein said head is provided with first, second and third parts which are capable of axial movement relative to each other, wherein relative movement of said first and said second parts causes the joining means to move in radial direction and wherein relative movement of said first and said third parts causes the joining means to contract in axial direction.

23. An applicator according to claim 21, wherein said head is circumferentially provided with a number of equally spaced elements, such as wedges, around which the device can be placed, which elements can be moved axially and radially outwards by means of a control element, whereby the device is expanded in radial direction and contracted in axial direction.

24. A method for making intraluminal side-to-side or side-to-end anastomoses between hollow structures by mechanical means, characterized by providing of an applicator and associated joining means for joining the abutting walls of the hollow structures together, placing said joining means round the applicator, inserting said applicator and said joining means into one of said hollow structures to a location internally of the abutting walls of the hollow structures, and activating said applicator, and thus the passing of said joining means through said abutting walls or the clamping of said joining means against said abutting walls for the purpose of keeping said abutting walls in sealing contact with each other.

25. A method according to claim 24, wherein joining means are used which are formed on a single annular or tubular element.

26. A method according to claim 24, wherein a number of loose staples are used as the joining means.