Surgical devices and methods using magnetic force to form an anastomosis

• US 20080200934A1
• Filed: 02/15/2007
• Published: 08/21/2008
• Est. Priority Date: 02/15/2007
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Fox, William D.
• Application Number:
  US11/706,685
• Publication Number:
  US 20080200934A1
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/1117 adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

A method for forming an anastomosis between first and second organs in a patient using a hollow receptacle that is inflatable with magnetic material. The method may include forming openings through the first and second organs utilizing a hole-forming instrument inserted into the organs through a natural orifice in the patient. The hollow receptacle may be supported on a catheter assembly that is also inserted through the patient'"'"'s natural orifice and through the openings in the first and second organs and is positioned within the second organ. The hollow receptacle is then inflated with magnetic material and magnetic force is applied within the force organ to draw the inflated receptacle toward the first organ such that the inflated receptacle retains the second organ in sealing contact with the first organ while maintaining the alignment between the first and second openings to create an anastomosis between the first and second organs.

Claims

1. A method for forming an anastomosis between first and second organs in a patient, comprising:

forming a first opening in the first organ;

forming a second opening in the second organ;

inserting an inflatable receptacle into the second organ;

injecting a magnetic material into the inflatable receptacle to inflate the receptacle within the second organ;

positioning the second organ-adjacent to the first organ; and

using magnetic force to draw the inflated receptacle toward the first organ such that the inflated receptacle retains the second organ in sealing contact with the first organ while creating an anastomosis between the first and second organs.

2. A method according to claim 1 wherein said forming a first opening comprises:

passing a hole-forming instrument through a natural orifice in the patient into the first organ;

creating the first opening in the first organ using the hole-forming instrument.

3. A method according to claim 2 wherein said forming a second opening comprises:

passing the hole-forming instrument through the first opening; and

creating the second opening in the second organ using the hole-forming instrument.

4. A method according to claim 3 further comprising passing a guide member through the natural orifice into the first and second openings.

5. A method according to claim 4 wherein said inserting an inflatable receptacle into the second organ comprises:

providing a catheter assembly having a distal portion and a proximal portion and a guide lumen extending therethrough wherein the inflatable receptacle is supported on the distal portion and is in fluid communication with a supply lumen in the catheter assembly;

inserting a proximal end of the guide member protruding from the natural orifice into the guide lumen in the catheter assembly; and

moving the catheter on the guide member until the distal portion of the catheter assembly supporting the hollow receptacle is located within the second organ and the proximal portion of the catheter is accessible through the natural orifice.

6. A method according to claim 5 wherein said injecting a magnetic material into the inflatable receptacle comprises:

providing the magnetic material within the supply lumen; and

forcing the magnetic material through the supply lumen into the inflatable receptacle.

7. A method according to claim 6 wherein said forcing comprises injecting a medium under pressure into the supply lumen to cause the magnetic material to enter the inflatable receptacle.

8. A method according to claim 6 wherein said using magnetic force to draw the inflated receptacle toward the first organ comprises advancing a magnet on the catheter assembly into a position on the distal portion of the catheter assembly adjacent the inflated receptacle located in the second organ such that said magnet draws the inflated receptacle toward the magnet and traps portions of the first and second organs therebetween while retaining the first opening and second opening in substantial alignment.

9. A method according to claim 8 further comprising installing a retention member through the distal portion of the catheter assembly to temporarily retain the distal portion of the catheter assembly within the first and second openings.

10. A method according to claim 9 further comprising:

withdrawing the guide member out through the natural orifice;

detaching the proximal portion of the catheter assembly from the distal portion of the catheter assembly such that the distal portion of the catheter assembly, magnet, inflated receptacle and retention member collectively form an anastomosis assembly temporarily supported within the aligned first and second openings; and

withdrawing the detached proximal portion of the catheter assembly through the natural orifice.

11. A method according to claim 10 further comprising passing the anastomosis assembly out through the second organ after a period of time.

12. A method according to claim 2 wherein the natural orifice comprises the patient'"'"'s mouth and wherein the first organ comprises the patient'"'"'s stomach and wherein the second organ comprises the patient'"'"'s jejunum.

13. A method for forming an anastomosis between first and second organs in a patient, comprising:

inserting a hole-forming instrument through a natural orifice in the patient to form aligned holes through the first and second organs;

withdrawing the hole-forming instrument out through the natural orifice;

inserting a catheter assembly supporting an inflatable receptacle thereon through the natural orifice and the aligned holes to position the inflatable receptacle within the second organ;

injecting the inflatable receptacle with magnetic material;

using magnetic force to attract the receptacle inflated with magnetic material into sealing engagement with a corresponding portion of the first organ while maintaining the alignment between the first and second holes to create an anastomosis between the first and second organs; and

withdrawing a proximal portion of the catheter assembly out through the natural orifice.

14. A surgical instrument for creating an anastomosis between two organs, comprising:

a catheter assembly having a distal end portion and a proximal end portion and configured for insertion through a first organ into a second organ adjacent the first organ, said catheter assembly further having a supply lumen extending therethrough;

magnetic material supported within said supply lumen;

an inflatable receptacle extending around a portion of said distal end portion of said catheter assembly and defining a substantially fluid-tight hollow space therebetween, wherein said space is in communication with said supply lumen and is configured to receive said magnetic material therein upon application of a pressure medium to said supply lumen; and

a magnet movably receivable on a proximal portion of said catheter assembly located within the first organ such that said magnet may be positioned within the first organ and magnetically attract the receptacle inflated with said magnetic material thereto and thereby draw a portion of the second organ containing the inflated receptacle toward a corresponding portion of the first organ into sealing engagement therewith.

15. A surgical instrument according to claim 14 further comprising a second lumen in said catheter assembly for receiving a guide member therethrough.

16. A surgical instrument according to claim 14 wherein said magnetic material comprises material selected from the group of materials consisting of magnetic beads, magnetic pellets, magnetic particles, and magnetic dust.

17. A surgical instrument according to claim 16 wherein said pressure medium comprises air or a fluid solution.

18. A surgical instrument according to claim 14 further comprising a luer fitting in fluid communication with said supply lumen.

19. A surgical instrument according to claim 14 wherein said proximal end portion of said catheter assembly is removably coupled to said distal end portion of said catheter assembly.

20. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 14;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.