METHODS AND APPARATUS FOR MAGNET-INDUCED COMPRESSION ANASTOMOSIS BETWEEN ADJACENT ORGANS

• US 20110295285A1
• Filed: 01/05/2011
• Published: 12/01/2011
• Est. Priority Date: 01/05/2010
• Status: Active Grant

• Current Assignee: G.I. Windows, Inc.
• Original Assignee: Boston Endoscopic Engineering Corp. (Medtronic Plc)
• Inventors: THOMPSON, Christopher C., MCWEENEY, John, LANG, Jeffrey H., RYOU, Marvin, CANTILLON-MURPHY, Padraig
• Granted Patent: US 8,828,032 B2
• 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 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/1117 adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
• CPC Class Codes: A61B 2017/1132 End-to-end connections
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

Methods and apparatus for creating an anastomosis or fistula between the gallbladder and an adjacent organ are disclosed. First, a parent magnet, typically a permanent magnet, is deployed in the stomach, small intestine, or another organ adjacent to the gallbladder, and a mating daughter material is deployed in the gallbladder in order to create a magnet-compression anastomosis. The gallbladder may then be ablated or otherwise functionally inactivated through the anastomosis. Another aspect of the invention relates to an all-in-one surgical kit that contains all the necessary specialized tools for a surgeon to perform the procedure.

Claims

1. A method of creating a compression anastomosis between a gallbladder and an adjacent organ, said method comprising the steps of:

a) placing a first magnet within the adjacent organ such that the first magnet is proximate to a wall of the organ and adjacent to the gallbladder;

b) placing one or more second magnets or magnetic materials in the gallbladder such that the first magnet and the one or more second magnets are magnetically attracted to one another through a defined tissue area of the combined thickness of a wall of the gallbladder and the wall of the adjacent organ and exert compressive forces on the defined area; and

c) removing the first magnet and the one or more second magnets when a compression anastomosis has formed in the defined tissue area.

2. The method of claim 1, wherein placing the first magnet comprises introducing the first magnet into the adjacent organ endoscopically.

3. The method of claim 2, wherein the first magnet is sized and adapted to fit within and to be delivered by an endoscope.

4. The method of claim 1, wherein placing the one or more second magnets comprises introducing the one or more second magnets into the gallbladder through a catheter or an endoscope.

5. The method of claim 4, wherein the one or more second magnets are introduced into the gallbladder through a biliary catheter or an endoscopic ultrasound guided fine needle aspiration needle and/or system.

6. The method of claim 1, wherein placing the one or more second magnets comprises injecting the one or more second magnets from the adjacent organ through the combined thickness of the wall of the gallbladder and the wall of the adjacent organ into the gallbladder.

7. The method of claim 6, wherein placing the one or more second magnets further comprises introducing the one or more second magnets into the adjacent organ using an instrument capable of injecting the one or more second magnets from the adjacent organ into the gallbladder.

8. The method of claim 7, wherein the instrument comprises an endoscope.

9. The method of claim 1, wherein the one or more second magnets or magnetic materials comprise a plurality of magnetic materials sized and adapted to fit within a biliary catheter or fine needle aspiration needle.

10. The method of claim 1, wherein the adjacent organ is selected from the group consisting of the small intestine and the stomach.

11. A kit for creating a compression anastomosis between adjacent gastrointestinal organs, comprising:

a parent magnet being sized to fit within an introducing instrument and adapted to create a compression anastomosis;

one or more second magnets or magnetic materials adapted to be attracted to the parent magnet; and

an introducing device selected from the group consisting of a biliary catheter, and an endoscopic ultrasound guided fine needle aspiration needle and/or system, said instrument being loaded with one or more second magnets or magnetic materials,

wherein the parent magnet and the one or more second magnets are made of or coated with biocompatible materials.

12. The kit of claim 11, wherein the adjacent gastrointestinal organs are selected from the group consisting of the gallbladder and the stomach, the stomach and the duodenum, and the ileum and the colon.

13. The kit of claim 11, wherein the introducing device comprises an endoscope.

14. The kit of claim 11, wherein the parent magnet comprises a permanent magnet.

15. The kit of claim 14, wherein the parent magnet is generally disc-shaped.

16. The kit of claim 11, wherein the parent magnet further comprises tissue attaching structure connected thereto.

17. The kit of claim 16, wherein the tissue-attaching structure comprises a clip.

18. The kit of claim 11, wherein the one or more second magnets comprise a plurality of ball-bearings.

19. The kit of claim 11, wherein the one or more second magnets are further adapted to self-assemble into a larger magnetic structure upon introduction into an organ.

20. The kit of claim 11, wherein the one or more second magnets comprise a magnetic slurry or paste.

21. The kit of claim 11, further comprising a grasping snare or pinchers.

22. A method of at least partially inactivating a gallbladder, comprising:

placing a first magnet proximate to a wall of an adjacent organ proximate to the gallbladder;

introducing one or more second magnets or magnetic materials into the

gallbladder such that the first magnet and the one or more second magnets are magnetically attracted to one another through a defined tissue area of the combined thickness of a wall of the gallbladder and the wall of the adjacent organ and exert compressive forces on the defined area;

allowing the tissue in the defined area to necrose to create an anastomosis between the gallbladder and the adjacent organ;

removing the first magnet and the one or more second magnets; and

selectively inducing gallbladder scarring or damage through the anastomosis.

23. The method of claim 22, wherein placing the first magnet comprises introducing the first magnet into the adjacent organ endoscopically.

24. The method of claim 23, wherein the first magnet is sized and adapted to fit within and to be delivered by an endoscope.

25. The method of claim 22, wherein placing the one or more second magnets comprises introducing the one or more second magnets into the gallbladder through a catheter.

26. The method of claim 25, wherein the catheter is a biliary catheter.

27. The method of claim 22, wherein placing the one or more second magnets comprises injecting the one or more second magnets from the adjacent organ through the combined thickness of the wall of the gallbladder and the wall of the adjacent organ into the gallbladder.

28. The method of claim 27, wherein placing the one or more second magnets further comprises introducing the one or more second magnets into the adjacent organ using an instrument capable of injecting the one or more second magnets from the adjacent organ into the gallbladder.

29. The method of claim 28, wherein the instrument comprises an endoscope.

30. The method of claim 22, wherein the one or more second magnets or magnetic materials comprise a plurality of magnetic materials sized and adapted to fit within a biliary catheter.

31. The method of claim 22, wherein the adjacent organ is selected from the group consisting of the small intestine and the stomach.

32. An apparatus for creating a fistula between two adjacent organs, comprising:

a parent magnet sized and adapted to be introduced into an organ through an introducing device, the parent magnet including a magnetic portion adapted to generate a magnetic field and an attachment portion connected to the magnetic portion, the attachment portion being constructed and adapted to attach the parent magnet to a tissue; and

one or more daughter magnets or magnetic materials, the daughter magnets or magnetic materials being responsive to the magnetic field of the parent magnet so as to be attracted to the parent magnet through one or more thicknesses of tissue,

wherein the parent magnet and the one or more daughter magnets are made of biocompatible materials or covered with respective biocompatible coatings.

33. The apparatus of claim 32, wherein the magnetic portion of the parent magnet comprises a permanent magnet.

34. The apparatus of claim 32, wherein the magnetic portion comprises a neodymium-boron-iron or samarium-cobalt magnet.

35. The apparatus of claim 32, wherein the magnetic portion of the parent magnet is in the form of a ring or disc about 1 mm to about 3 mm in diameter.