Method for Hybrid Gastro-Jejunostomy

• US 20060217748A1
• Filed: 03/23/2006
• Published: 09/28/2006
• Est. Priority Date: 09/30/2003
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Ortiz, Mark S.
• Granted Patent: US 8,211,142 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

Disclosed herein are methods for joining one piece to tissue to another piece of tissue. In one embodiment, the method can include inserting an applier device having an actuation portion into a first body lumen through a natural body orifice, forming a first opening in a first piece of tissue within the first lumen and a second opening in a second piece of tissue defining a portion of a second lumen adjacent to the first piece of tissue, and inserting the applier device through the first and second openings such that the actuation portion is between the first and second piece of tissue. The method can further include deploying a fastener into the first and second pieces of tissue through the actuation portion of the applier device, thereby joining the first and second pieces of tissue to form an anastomosis between the first and second lumens.

Claims

1. A method for joining tissue, comprising:

inserting an applier device having an actuation portion into a first body lumen through a natural body orifice;

forming a first opening in a first piece of tissue within the first lumen and a second opening in a second piece of tissue defining a portion of a second lumen adjacent to the first piece of tissue;

inserting the applier device through the first and second openings such that the actuation portion is between the first and second pieces of tissue; and

deploying a fastener into the first and second pieces of tissue through the actuation portion of the applier device, thereby joining the first and second pieces of tissue to form an anastomosis between the first and second lumens.

2. The method of claim 1, wherein the first and second openings are formed via a laparoscopic surgical procedure.

3. The method of claim 1, wherein the first opening is formed using a cutting member associated with a distal end of the applier device and the second opening is formed using a cutting element that accesses a site of the second opening by a laparoscopic port.

4. The method of claim 1, wherein a distal end of the applier device is used as a marker for forming the first opening.

5. The method of claim 1, further comprising expanding the first and second openings using a tapered distal end of the applier device, such that the applier device can be inserted through the first and second openings.

6. The method of claim 1, further comprising expanding the second opening using at least one grasping element such that the applier device can be inserted through the second opening.

7. The method of claim 1, wherein the actuation portion includes at least one fastener having proximal and distal ring members joined by a connecting element, the proximal and distal ring members each having a plurality of arms extending therefrom that are adapted to engage tissue.

8. The method of claim 7, wherein positioning the actuation portion includes positioning the distal ring member of the fastener such that it is adjacent to the second piece of tissue and positioning the proximal ring member of the fastener such that it is adjacent to the first piece of tissue, such that the connecting element extends between the first and second pieces of tissue.

9. The method of claim 7, wherein deploying the fastener includes moving the plurality of arms of the proximal and distal ring members from a first resting position to a second actuated position such that the plurality of arms engage and hold together the first and second pieces of tissue.

10. The method of claim 9, wherein the plurality of arms of the proximal and distal ring members are independently actuated to engage the first and second pieces of tissue.

11. The method of claim 9, wherein the plurality of arms of the proximal and distal ring members are simultaneously actuated to engage the first and second pieces of tissue.

12. The method of claim 7, wherein deploying the fastener includes disengaging the fastener from a catch located on the actuation portion that holds the fastener to the actuation portion.

13. The method of claim 1, wherein the applier device endoscopically accesses a stomach through an esophagus.

14. The method of claim 1, wherein the first piece of tissue is part of a stomach and the second piece of tissue is part of a jejunum.

15. A method for forming an anastomosis, comprising:

endoscopically inserting an applier device through a natural body orifice, through a lumen and through a first opening formed in a first piece of tissue and a second opening formed in a second piece of tissue;

positioning an actuation portion of the applier device between the first and second pieces of tissue; and

deploying a fastener into the first and second pieces of tissue through the actuation portion of the device to form an anastomosis therebetween.

16. The method of claim 15, wherein the first and second openings are formed via a laparoscopic surgical procedure.

17. The method of claim 15, wherein the first opening is formed using a cutting member associated with a distal end of the applier device and the second opening is formed using a cutting element that accesses a site of the second opening laparoscopically.

18. The method of claim 15, further comprising expanding the first and second openings such that the applier device can be inserted therethrough.

19. The method of claim 15, wherein the actuation portion includes at least one deployable fastener having proximal and distal ring members joined by a connecting element, the proximal and distal ring members each having a plurality of arms extending therefrom that are adapted to engage tissue.

20. The method of claim 19, wherein deploying the fastener includes moving the plurality of grasping arms of the proximal and distal ring members from a resting position to an actuating position such that the plurality of grasping arms engage the first and second pieces of tissue.