Method and Device for Effecting Anastomosis of Hollow Organ Structures Using Adhesive and Fasteners

• US 20080114385A1
• Filed: 11/10/2006
• Published: 05/15/2008
• Est. Priority Date: 11/10/2006
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Ortiz, Mark S., Voegele, James W., Kelly, William D., Byrum, Randal T., Gill, Robert P., Kolata, Ronald J., Turner, Douglas J., Shelton, Frederick E.
• Granted Patent: US 8,834,498 B2
• Time in Patent Office: Days
• US Class Current: 606/154
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• 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 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• 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: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11

Abstract

A method and devices for accomplishing the successful anastomosis of two hollow organ structures are disclosed. The method includes bringing the structures together, applying at least one fastener to hold the structures together and form a connection site, and applying, as alternatives or in conjunction, an adhesive, a wrap and/or a buttress about the connection site. Various examples of fasteners, fastener appliers, adhesives, adhesive initiators and buttress rings also are disclosed.

Claims

1. A method for effecting anastomosis of two hollow organ structures, comprising:

bringing said hollow organ structures together;

providing at least one transformable fastener;

providing an applier operable to apply said at least one transformable fastener;

using said applier to apply said at least one transformable fastener to hold said structures together and form a connection site where said two structures are held together; and

placing a wrap over at least a portion of said connection site.

2. The method of claim 1 wherein said wrap comprises a material selected from the group consisting of a fabric, a mesh and a porous material.

3. The method of claim 1 wherein said wrap comprises a material selected from the group consisting of an adhesive, an initiator, an accelerator and an additive.

4. The method of claim 1 further comprising the steps of placing a buttress ring about at least one of said structures, and using said at least one transformable fastener to effect holding of said buttress ring proximate to said connection site.

5. The method of claim 1 wherein said at least one transformable fastener comprises a material selected from the group consisting of a bioabsorbable material and a degradable material.

6. The method of claim 1 wherein said applier comprises:

a first fastener transforming member having a first surface;

a second fastener transforming member having a second surface; and

a mechanism holding said first fastener transforming member and said second fastener transforming member in operable positions with respect to each other;

wherein said mechanism may be actuated so as to cause said first surface to move toward said second surface, and during actuation said first and second surfaces exert at least partially opposing forces that cause transformation of said at least one transformable fastener.

7. The method of claim 1 wherein said at least one transformable fastener comprises:

a first ring having a connecting member thereon; and

a second ring having a connecting feature formed to cooperate with said connecting member;

wherein bringing said first ring into proximity with said second ring will enable said connecting member to engage said connecting feature and effect a connection between said first ring and said second ring.

8. The method of claim 1 wherein said at least one transformable fastener comprises:

a first clamp ring;

a second clamp ring; and

a support member holding said first clamp ring in a position to cooperate with said second clamp ring to effect clamping.

9. A method for effecting anastomosis of two hollow organ structures, comprising:

bringing said hollow organ structures together;

placing a buttress ring about at least one of said structures;

providing at least one transformable fastener;

providing an applier operable to apply said at least one transformable fastener;

using said applier to apply at least one transformable fastener to hold said structures together, form a connection site where said two structures are held together, and effect holding of said buttress ring proximate to said connection site.

10. The method of claim 9 wherein said buttress ring comprises a material selected from the group consisting of a fabric, a mesh and a porous material.

11. The method of claim 10 wherein said buttress ring further comprises a material selected from the group consisting of an adhesive, an initiator, an accelerator, and an additive.

12. The method of claim 9 wherein said applier comprises:

a first fastener transforming member having a first surface;

a second fastener transforming member having a second surface; and

a mechanism holding said first fastener transforming member and said second fastener transforming member in operable positions with respect to each other;

wherein said mechanism may be actuated so as to cause said first surface to move toward said second surface, and during actuation said first and second surfaces exert at least partially opposing forces that cause transformation of said at least one transformable fastener.

13. The method of claim 9 wherein said at least one transformable fastener comprises:

a first ring having a connecting member thereon; and

a second ring having a connecting feature formed to cooperate with said connecting member;

wherein bringing said first ring into proximity with said second ring will enable said connecting member to engage said connecting feature and effect a connection between said first ring and said second ring.

14. The method of claim 9 wherein said at least one transformable fastener comprises:

a first clamp ring;

a second clamp ring; and

a support member holding said first clamp ring in a position to cooperate with said second clamp ring to effect clamping.

15. The method of claim 9 wherein said at least one transformable fastener comprises a material selected from the group consisting of a bioabsorbable material and a degradable material.

16. A method for effecting anastomosis of two hollow organ structures, comprising:

bringing said hollow organ structures together;

providing at least one transformable fastener;

providing an applier operable to apply said at least one transformable fastener;

using said applier to apply said at least one transformable fastener to hold said structures together and form a connection site where said two structures are held together; and

applying an adhesive at least partially about said connection site.

17. The method of claim 16 wherein said applier comprises:

a first fastener transforming member having a first surface;

a second fastener transforming member having a second surface; and

a mechanism holding said first fastener transforming member and said second fastener transforming member in operable positions with respect to each other;

wherein said mechanism may be actuated so as to cause said first surface to move toward said second surface, and during actuation said first and second surfaces exert at least partially opposing forces that cause transformation of said at least one transformable fastener.

18. The method of claim 16 wherein said at least one transformable fastener comprises:

a first ring having a connecting member thereon; and

a second ring having a connecting feature formed to cooperate with said connecting member;

wherein bringing said first ring into proximity with said second ring will enable said connecting member to engage said connecting feature and effect a connection between said first ring and said second ring.

19. The method of claim 16 wherein said at least one transformable fastener comprises:

a first clamp ring;

a second clamp ring; and

a support member holding said first clamp ring in a position to cooperate with said second clamp ring to effect clamping.

20. The method of claim 16 wherein said at least one transformable fastener comprises a material selected from the group consisting of a bioabsorbable material and a degradable material.