Harness and balloon catheter assembly and method for use in anastomosis procedures

• US 20060224169A1
• Filed: 11/07/2005
• Published: 10/05/2006
• Est. Priority Date: 03/30/2005
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Voegele, James W., Hess, Christopher J., Weisenburgh, William B. II, Gill, Robert P., Issa, Muta M.
• Granted Patent: US 7,789,890 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• 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 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• 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 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/047 having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body J-shaped suture needles A61B2017/0608
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2018/00547 Prostate

Abstract

Disclosed is an instrument, assembly, and method for use in a procedure to effect anastomosis of a patient'"'"'s bladder and urethra following a prostatectomy. The instrument comprises a tube assembly having an end effector assembly operably supported thereby, where the end effector assembly includes a harness adapted to receive a balloon portion of a balloon catheter assembly.

Claims

1. An instrument for use in a procedure to effect anastomosis of a patient'"'"'s bladder and urethra following a prostatectomy, comprising:

a tube assembly, comprising a spine member, a first rod, and a second rod, wherein said rods are movable with respect each other and to said spine member;

an end effector assembly operably supported by said tube assembly, further comprising;

a positioner assembly in operable mechanical communication with said first rod so as to be actuable by movement of said first rod with respect to said spine member;

an anchor driver assembly in operable mechanical communication with said second rod so as to be actuable by movement of said second rod with respect to said spine member;

an anchor releasably held by said anchor driver assembly for insertion from within the bladder lumen through the bladder wall into the pelvic floor; and

a harness releasably held by said end effector assembly, wherein said harness is attached to said anchor and is adapted to retain a balloon portion of a balloon catheter assembly.

2. The instrument of claim 1 wherein said harness is attached to said anchor with a bioabsorbable coupling.

3. The instrument of claim 1 wherein said harness comprises a guide wire affixed thereto.

4. The instrument of claim 1 wherein said harness has a plurality of expansion holes therein.

5. The instrument of claim 4 wherein said harness has a circumference, and said expansion holes are positioned substantially symmetrically about said circumference.

6. The instrument of claim 1 wherein said harness comprises a harness tip having a guide wire affixed thereto and a drainage hole therein.

7. The instrument of claim 3 wherein said guide wire is adapted to extend outside the patient'"'"'s body after installation of said harness.

8. The instrument of claim 1 wherein at least a portion of said harness comprises a bioabsorbable material.

9. An assembly placed within a patient'"'"'s bladder for effecting the anastomosis of the patient'"'"'s bladder and urethra following a prostatectomy, comprising:

an anchor installed through the bladder wall and into the pelvic floor;

a harness attached to said anchor; and

a balloon catheter having a balloon portion and a catheter tube portion;

wherein said balloon portion is inserted into said harness and inflated.

10. The assembly of claim 9 wherein said balloon is inflated with a saline solution.

11. The assembly of claim 9 wherein said balloon is inflated with water.

12. The assembly of claim 9 wherein said balloon portion is affixed to said catheter tube portion such that the surfaces of said balloon portion are substantially flush with the surfaces of said catheter tube portion.

13. The assembly of claim 9 wherein said balloon portion is substantially pear-shaped before inflation.

14. The assembly of claim 9 further comprising a guide wire attached to said harness.

15. The assembly of claim 9 wherein said balloon portion comprises a permeable material.

16. The assembly of claim 10 wherein said balloon portion comprises a semi-permeable material.

17. A method for effecting the anastomosis of a patient'"'"'s bladder and pelvic floor following a prostatectomy, comprising the steps of:

urging the bladder wall proximate to the bladder opening toward the pelvic floor proximate to the urethra opening;

driving an anchor, having attached thereto a harness, into and through the bladder wall and into the pelvic floor, and thereby affixing said harness within the bladder at a location proximate to the bladder opening;

inflating a balloon within said harness, and thereby applying pressure against the bladder wall proximate to the bladder opening to urge the bladder wall into contact with the pelvic floor at a location proximate to the urethra opening;

maintaining said harness and said balloon in place within the patient for a period of time sufficient for the tissues of the bladder wall and pelvic floor to effectively knit; and

removing said balloon from the patient.

18. The method of claim 17 wherein said inflating step comprises inflating said balloon with saline solution.

19. The method of claim 17 wherein said inflating step comprises inflating said balloon with water.

20. The method of claim 17 wherein said maintaining step comprises decreasing the pressure within said balloon over said period of time.