ANASTOMOTIC DEVICE PROMOTING TISSUE NECROSIS

• US 20070123917A1
• Filed: 11/29/2005
• Published: 05/31/2007
• Est. Priority Date: 11/29/2005
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Ortiz, Mark, Plescia, David, Simms, Robert, Eke, Soane, Ditter, Tom
• Application Number:
  US11/164,574
• Publication Number:
  US 20070123917A1
• 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 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

Embodiments of the present invention generally provide an anastomosis device that can be used to couple two or more layers of tissue in apposition. In an exemplary embodiment, the device can be formed from one or more woven wires that can be configured to have a generally tubular shape in a first, expanded position for insertion to an anastomosis site and a generally annular, ring-shape in a second, resting position for securing tissue in apposition at the anastomosis site. The device can be adapted either to cause necrosis of the tissue layers around an outer periphery of the device or to promote growth of tissue about an inner periphery of the device.

Claims

1. An anastomosis device, comprising:

a body formed from a woven shape-memory wire and defining a central lumen, the body being configurable between an expanded position in which the body assumes a generally tubular configuration having a wire mesh wall adapted for insertion into a lumen of an anastomotic site and a rest position in which the body assumes an annular configuration having a plurality of petals with petal tips that define an outer periphery, the rest position being effective to hold opposed tissues of the anastomotic site in apposition and to apply a pressure to the opposed tissues such that the pressure decreases from an outer periphery to an inner periphery of the device.

2. The anastomosis device of claim 1, wherein the plurality of petals are configured to apply the pressure to the opposed tissues to cause necrosis of the opposed tissues in a contact region.

3. The anastomosis device of claim 1, wherein the plurality of petals comprise a superior set of adjacent petals and an inferior set of adjacent petals, and the device is adapted to receive the opposed tissues between the inferior and superior sets of petals.

4. The anastomosis device of claim 3, wherein, in a rest position, each petal of the superior set and inferior set of adjacent petals is formed by adjacent arms connected by a tip that extends along a portion of the outer periphery of the device, the tip having a first radius and each arm being connected to the tip at a bend that has a second radius, the first radius being greater than the second radius.

5. The anastomosis device of claim 4, wherein, when the device is configured in the rest position, the adjacent arms and tip of each petal are oriented in a substantially planar configuration in a plane that is substantially perpendicular to a central axis extending through the central lumen of the device.

6. The anastomosis device of claim 4, wherein the adjacent arms of each petal are oriented in a plane that is substantially perpendicular to a central axis extending through the central lumen of the device, at least a portion of the adjacent arms of the superior set of petals including an arc portion having an inferior facing opening, and at least a portion of the adjacent arms of the inferior set of petals including an arc portion having a superior facing opening.

7. The anastomosis device of claim 6, wherein the adjacent arms of the superior set of petals include a bend portion disposed between the arc portion and the tip, the bend portion of the adjacent arms orienting the tip in the plane that is substantially perpendicular to a central axis extending through the central lumen of the device and wherein the adjacent arms of the inferior set of petals include a bend portion disposed between the arc portion and the tip, the bend portion of the adjacent arms orienting the tip in the plane that is substantially perpendicular to a central axis extending through the central lumen of the device

8. The anastomosis device of claim 4, wherein the tip of each petal has a peak portion defining an inferior facing opening and a trough portion defining a superior facing opening.

9. The anastomosis device of claim 4, wherein the tips of the superior set of adjacent petals have midpoints that are staggered about a circumference of the device relative to midpoints of the tips of the inferior set of adjacent petals.

10. The anastomosis device of claim 4, wherein the tips of the superior set of adjacent petals have midpoints that are substantially aligned with midpoints of the tips of the inferior set of adjacent petals.

11. The anastomosis device of claim 4 wherein the tips of the petals are adapted to contact the opposed tissues along a distance greater than approximately 5% of the circumference of the outer periphery of the device when configured in the rest position.

12. The anastomosis device of claim 3, further comprising:

a first wire circumferentially coupled to the petal tips of the superior set of adjacent petals; and

a second wire circumferentially coupled to the petal tips of the inferior set of adjacent petals, wherein the first wire and the second wire are adapted to contact the opposed tissues along a distance greater than approximately 90% of the circumference of the outer periphery of the device when configured in the rest position.

13. An anastomosis device, comprising:

a body formed from a woven shape-memory wire and defining a central lumen, the body being configurable between an expanded position in which the body assumes a generally tubular configuration having a wire mesh wall adapted for insertion into a lumen of an anastomotic site and a rest position in which the body assumes an annular configuration having a plurality of petals with petal tips that define an outer periphery, the rest position being effective to hold opposed tissues of the anastomotic site in apposition and to allow the petal tips to contact the opposed tissues along a distance greater than approximately 5% of the outer periphery of the device.

14. The anastomosis device of claim 13, wherein the plurality of petals are configured to apply the pressure to the opposed tissues to cause necrosis of the opposed tissues.

15. The anastomosis device of claim 13, wherein the plurality of petals comprise a superior set of adjacent petals and an inferior set of adjacent petals, and the device is adapted to receive the opposed tissues between the inferior and superior sets of petals.

16. The anastomosis device of claim 15, wherein, in a rest position, each petal of the superior set and inferior set of adjacent petals is formed by adjacent arms connected by a tip that extends along a portion of the outer periphery of the device, the tip having a first radius and each arm being connected to the tip at a bend that has a second radius, the first radius being greater than the second radius.

17. The anastomosis device of claim 15, wherein the tips of the superior set of adjacent petals have midpoints that are staggered about a circumference of the device relative to midpoints of the tips of the inferior set of adjacent petals.

18. The anastomosis device of claim 15, wherein the tips of the superior set of adjacent petals have midpoints that are substantially aligned with midpoints of the tips of the inferior set of adjacent petals.

19. An anastomosis device, comprising:

a body formed from a woven shape-memory wire and defining a central lumen, the body being configurable between an expanded position in which the body assumes a generally tubular configuration having a wire mesh wall adapted for insertion into a lumen of an anastomotic site and a rest position in which the body assumes an annular configuration with an inner periphery and having a plurality of petals with petal tips that define an outer periphery, the inner periphery being configured to allow tissue overgrowth of the device at the inner periphery.

20. The anastomosis device of claim 19, wherein, when configured in the rest position, the body forms opposed petals configured to apply a pressure to the tissues less than approximately 2.0 pounds per square inch.

21. The anastomosis device of claim 19, wherein the inner periphery is free of overlying wire segments of opposed superior and inferior portions of the device.

22. A method for anastomosing tissue layers, comprising:

delivering an anastomosis device formed from a woven shape-memory wire having a wire mesh wall defining a central lumen and configured in an expanded, tubular position through a lumen defined by two opposed tissues; and

deploying the anastomosis device to hold the opposed tissues in apposition such that, upon deployment, the device assumes an annular configuration having a plurality of petals with petal tips that define an outer periphery, the device applying a pressure to the opposed tissues such that the pressure decreases from the outer periphery to an inner periphery of the device.