Method and apparatus for performing anastomosis with eversion of tissue edges and joining of exposed intima of the everted tissue
First Claim
1. A ring for use in preparing a first organ for anastomosis with a second organ, wherein the first organ has an orifice, and wherein said ring consists of:
- a malleable ring portion sized to extend around the orifice; and
docking members and malleable tines that extend out from the ring portion, wherein the tines are movable relative to the ring portion into positions in which said tines can pierce tissue of the first organ around the orifice and, when an anvil has been positioned within the first organ for receiving tips of the tines advancing against the anvil after piercing the tissue around the orifice, said tines are configured to curl against the anvil so as to evert said tissue around the orifice.
6 Assignments
0 Petitions
Accused Products
Abstract
A ring for use in anastomosis. Preferably, the ring is integrally formed from metal, and includes a ring portion and tines and docking members that extend from the ring portion. The ring portion and tines are malleable, and preferably also the docking members are malleable. The ring portion and tines are malleable in the sense that once deformed from a first shape into a second shape, they will not relax back into the first shape from the second. To install the ring in a vessel with the ring portion extending around an incision or other orifice, the tines pierce the tissue around the orifice and are curled against an anvil. The action of curling the tines inverts the tissue near the orifice edges to expose the inside surface of the vessel or organ. Other aspects of the invention are a method and apparatus for installing an anastomosis ring in an incision or other orifice in a vessel or other organ, a method and apparatus for precisely aligning two anastomosis rings (each installed in an incision or other orifice of a different organ) and fastening the aligned rings together. The clips can be crimped onto the aligned rings, or they can be spring clips which are sprung onto the aligned rings to clamp the rings together by spring force. Also within the scope of the invention are crimping and spring clips for use in listening together two aligned anastomosis rings. In other embodiments, the invention is a method for performing an anastomosis by installing an anastomosis ring in an orifice in an organ, installing another anastomosis ring in an orifice in another organ, precisely aligning the two installed anastomosis rings, and fastening the aligned rings together.
86 Citations
32 Claims
-
1. A ring for use in preparing a first organ for anastomosis with a second organ, wherein the first organ has an orifice, and wherein said ring consists of:
-
a malleable ring portion sized to extend around the orifice; and
docking members and malleable tines that extend out from the ring portion, wherein the tines are movable relative to the ring portion into positions in which said tines can pierce tissue of the first organ around the orifice and, when an anvil has been positioned within the first organ for receiving tips of the tines advancing against the anvil after piercing the tissue around the orifice, said tines are configured to curl against the anvil so as to evert said tissue around the orifice. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
-
-
9. A method for preparing a first organ having an orifice for anastomosis with a second organ, using a ring consisting of a malleable ring portion, sized to extend around the orifice, and docking members and malleable tines extending out from the ring portion, said method including the steps of:
-
(a) positioning an anvil within the first organ; and
(b) positioning the ring so that the ring portion extends around the orifice, advancing the ring toward the anvil to cause tips of the tines to pierce tissue of the first organ around the orifice and advance into engagement with the anvil, and continuing to advance the ring toward the anvil thereby causing the tines to curl against the anvil after piercing the tissue around the orifice so as to evert said tissue around the orifice. - View Dependent Claims (10)
-
-
11. A method for performing an anastomosis, including the steps of:
-
(a) installing an anastomosis ring in an orifice in a first organ such that the anastomosis ring everts tissue of the first organ around the orifice;
(b) installing a second anastomosis ring in a second orifice in a second organ such that the second anastomosis ring everts tissue of the second organ around the second orifice;
(c) aligning the installed first anastomosis ring with the installed second anastomosis ring; and
(d) fastening the aligned, installed rings together, thereby forming an anastomosis joining the first organ in fluid communication with the second organ. - View Dependent Claims (12, 13, 14)
-
-
15. An apparatus for aligning and fastening together a first anastomosis ring installed in a first organ, and a second anastomosis ring installed in a second organ, wherein each of the first anastomosis ring and the second anastomosis ring has a ring portion, a first docking member extending out from the ring portion and a second docking member extending out from the ring portion, said apparatus comprising:
-
forceps having a first arm configured to engage and align the first docking member of the first anastomosis ring and the first docking member of the second anastomosis ring, and a second arm configured to engage and align the second docking member of the first anastomosis ring and the second docking member of the second anastomosis ring; and
a fastening assembly, comprising a fastener-receiving surface, a hammer which is translatable relative to the fastener-receiving surface, and a fastener positioned between the hammer and the fastener-receiving surface, wherein the hammer is configured to be fired against the fastener-receiving surface when aligned portions of the first anastomosis ring and the second anastomosis ring are positioned between said hammer and said fastener-receiving surface, thereby crimping the fastener around said aligned portions of the first anastomosis ring and the second anastomosis ring.
-
-
16. An apparatus for aligning and fastening together a first anastomosis 25 ring installed in a first organ, and a second anastomosis ring installed in a second organ, wherein each of the first anastomosis ring and the second anastomosis ring has a ring portion, and a first docking member and a second docking member extending out from the ring portion, said apparatus comprising:
-
a forceps assembly having a first arm configured to engage and align the first docking member of the first anastomosis ring with the first docking member of the second anastomosis ring, and a second arm configured to engage and align the second docking member of the first anastomosis ring with the second docking member of the second anastomosis ring; and
a carriage configured to releasably hold a spring clip such that the spring clip can be advanced into engagement with aligned portions of the first anastomosis ring and the second anastomosis ring to cause the spring clip to relax, in response to exertion of force thereon by at least one of the first anastomosis ring and the second anastomosis ring, into a configuration in which said spring clip holds together said aligned portions.
-
-
17. A spring clip for use in fastening together a pair of anastomosis rings installed respectively in a first organ and a second organ, thereby forming an anastomosis joining the first organ in fluid communication with the second organ, said spring clip comprising:
-
a back portion configured to be releasably held by a clip installation device; and
spring portions extending out from the back portion, the spring portions having a relaxed configuration and a nonrelaxed configuration, wherein the spring portions are configured to be brought into engagement with the rings while in the nonrelaxed configuration so that force exerted on the spring portions by at least one of the rings causes the spring portions to relax toward the relaxed configuration thereby wrapping themselves around the rings to hold said rings together by spring force. - View Dependent Claims (18, 19, 20, 21)
-
-
22. An apparatus for preparing a first organ having an orifice for anastomosis with a second organ, by installing at the orifice a ring consisting of a malleable ring portion, sized to extend around the orifice, and docking members and malleable tines extending out from the ring portion, said apparatus comprising:
-
a ring-mounting assembly configured to releasably mount the ring;
an anvil mounting assembly configured to releasably mount an anvil in such a position that the anvil can be advanced into the first organ; and
a cam-driven assembly configured to advance the anvil toward the anvil, after the anvil has been positioned in the first organ and the ring has been positioned so that the ring portion extends around the orifice, to cause tips of the tines to pierce tissue of the first organ around the orifice and then to advance into engagement with the anvil, and to then continue to advance the ring toward the anvil thereby causing the tines to curl against the anvil after piercing the tissue around the orifice so as to evert said tissue around the orifice. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
-
Specification