URETHRAL ANASTOMOSIS DEVICE AND METHOD OF USING THE SAME

• US 20110196393A1
• Filed: 10/20/2009
• Published: 08/11/2011
• Est. Priority Date: 10/20/2008
• Status: Abandoned Application

• Current Assignee: Keren Medical Ltd.
• Original Assignee: Keren Medical Ltd.
• Inventors: Lilach, Nir, Sade Hochstadter, Dan, Yossepowitch, Ofer, Eliachar, Eliahu
• Application Number:
  US13/123,755
• Publication Number:
  US 20110196393A1
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• 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 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising

Abstract

The present invention provides a urethral catheter 200 adapted for anastomosis following radical prostatectomy, comprising an inflated activating balloon 60 adapted for concurrently (i) pressing said-bladder neck 140 to saidurethra stub 120; (ii) effectively stretching suture 90; (iii) activating locks 80 that non-reversibly catch saidsutures 90; and (iv) cutting saiddistal portion thereof.

Claims

1. A urethral catheter 200 adapted for anastomosis following radical prostatectomy, comprising an inflated activating balloon 60 adapted for concurrently (i) pressing saidbladder neck 140 to saidurethra stub 120;

(ii) effectively stretching suture 90;

(iii) activating locks 80 that non-reversibly catch saidsutures 90; and

(iv) cutting saiddistal portion thereof.

2. A semi-rigid urethral catheter 200 as defined in claim 1, adapted for beingconsecutively inserted into patient'"'"'s urethra 120 and urinary bladder 130 detached after radical prostatectomy;

catheter 200 further comprising outer and inner members 10 and 20, respectively;

said outer member 10 is provided at said side thereof with a special mark enabling a surgeon performing an anastomosis procedure under laparoscopic video control to insert said catheter 200 into said patient'"'"'s urethra precisely, specifically, up to superimposing a rim of said patient'"'"'s urethra and said aforesaid mark;

said inner member 20 is provided at a distal end thereof with an anchoring balloon 100 covered when inserting/withdrawing said catheter 200 within patient'"'"'s urinary tract by a cap 110;

a needle assembly comprises a plurality of needles 30 disposed parallel to a generatrix of said catheter 200;

said needle assembly is remotely controlled by said surgeon performing said anastomosis procedure;

a plurality of U-shaped sutures 90 is also disposed parallel to generatrix of said catheter 200;

each U-shaped suture has two ends;

a first end of said suture 90 is releasably connected to a needle extremity 35;

a second end of said suture 90 is connected to a non-reversible lock 80 releasably disposed at a sidely deployable activating means 70;

wherein said needles 30, when inserted into said urethral stump, keep said position of said latter constat relative to said catheter 200, said course of said needles is predetermined by means selected from a group consisting of said shape of curved tunnel 37A;

utilizing needles that characterized by shape memory properties or a combination of said two;

wherein said anchoring balloon 100 is adapted to be inserted into said urinary bladder 130 through said bladder neck 140 and to partially inflate said anchoring balloon 100 within said bladder 130;

in a manner that reciprocally actuatable shaft 110A is provided in its extended configuration;

wherein said inflation of anchoring balloon 100 is provided by forcing a fluid throughout fluid inlet 160 at a given pressure, via conduit 50 positioned inside and along said main axis of catheter 200;

wherein activating means 70 is adapted for being deployed in an approximate perpendicular manner, in respect to said main axis of said catheter, in a manner that balloon 100 is deflated, and shaft 110A is again in its elongated configuration;

means 70 comprises an activating balloon 60 which is adapted to activate, inter alia, said non-reversible locks 80;

wherein locks are adapted for non-reversibly locking said suture 90 when pressurized by said balloon 60; and

wherein passage 40 is designed for delivering compressed air to said balloon 60;

wherein needles 30 are configured so that they are advanced into said urinary bladder 120 through said non-reversible locks 80, possibly towards catchers 25 that disposed at said distal portion of said inner member 20;

catchers 25 are further adapted to catch said sutures 90 delivered by said needles 30;

and wherein said non-reversible locks 80 are adapted for pressure-induced activation due to inflation of said activating balloon 60 in a manner that when said balloon 60 is further inflated, it urges said urethra stub 120 and said bladder neck to conjoin while starching suture 90, said non-reversible locks 80 non-reversibly lock said sutures 90 and cut a distal portion of said sutures 90 roved through said non-reversible locks, and simultaneously said catchers 25 hold said proximal portions of said sutures 90 during cutting thereof.

3. The urethral catheter 200 as defined in claim 1, comprising:

a. a semi-rigid catheter body constituting a telescopic structure further comprising inner and outer members;

said inner member is provided at a distal end thereof with an inflatable anchoring balloon adapted for fixating said bladder neck;

said outer member includes a plurality of apertures on a side surface of said member thereof;

b. a remotely controlled needle assemble comprising a plurality of needles;

an extremity of each said needle is positioned at said corresponding aperture and adapted for directing outward through said aperture and an adjacent tissue;

c. a plurality of U-shaped sutures having two ends;

each first end thereof is releasably connected to an distal extremity of corresponding said needle;

each said U-shaped suture is longitudinally placed in said outer member and adapted to be driven by corresponding said needle extremity through corresponding aperture into said adjacent tissue.

4. A method of performing anastomosis following radical prostatectomy comprising said steps of (a) obtaining urethral catheter having at least one inflatable activating balloon 60;

and (b) concurrently (i) pressing said bladder neck 140 to said urethra stub 120;

(ii) effectively stretching suture 90;

(iii) activating locks 80 that non-reversibly catch said sutures 90; and

(iv) cutting said distal portion thereof.

5. A method of performing anastomosis following radical prostatectomy comprising the steps of:

a. providing a urethral catheter 200 comprising

i. a catheter body constituting a telescopic structure further comprising inner and outer members;

said inner member is provided at a distal end thereof with an inflatable anchoring balloon adapted for fixating said bladder neck;

said outer member includes a plurality of apertures on a side of said member thereof;

ii. a remotely controlled needle assemble comprising a plurality of needle;

an extremity of each said needle is positioned at said corresponding aperture and adapted for directing outward through said aperture and an adjacent tissue;

iii. a plurality of U-shaped sutures having two ends;

each first end thereof is releasably connected to an distal extremity of corresponding said needle;

each said U-shaped suture is longitudinally placed in said outer member and adapted to be driven by corresponding said needle extremity through corresponding aperture into, said adjacent tissue;

each said U-shaped suture is provided at a second end thereof with a non-reversible lock;

each said needle is configured for advancing through corresponding said non-reversible lock;

each said non-reversible lock is adapted to catch and non-reversibly fixate said first end of corresponding said suture end when driven by corresponding said needle extremity, said outer member is provided at distal end thereof with activating means adapted for remotely activating said non-reversible locks;

b. consecutively inserting said catheter into patient'"'"'s urethra and urinary bladder;

c. deploying said needles and sutures driven by said needles into patient'"'"'s urethra stub;

d. inflating said anchoring balloon;

e. drawing together of patient'"'"'s bladder neck and urethra stub by backwardly displacing said inner member carrying said balloon relative to said outer member;

f. deflating said anchoring balloon;

g. advancing said needles and sutures driven be said needles through patient'"'"'s bladder wall and corresponding said non-reversible suture locks;

h. withdrawing said needles from said patient'"'"'s bladder;

i. conjoining said bladder neck and urethra stub;

j. activating said non-reversible locks;

k. cutting off suture distal portions roved through said non-reversible locks; and

l. withdrawing said catheter from said patient'"'"'s urinary tract.