URETER TO ILEAL CONDUIT ANASTOMOSIS USING MAGNETIC COMPRESSION AND RELATED DELIVERY DEVICES AND METHODS

• US 20120197062A1
• Filed: 12/22/2011
• Published: 08/02/2012
• Est. Priority Date: 12/30/2010
• Status: Active Grant

• Current Assignee: Wake Forest University Health Sciences
• Original Assignee: Wake Forest University Health Sciences
• Inventors: Requarth, Jay Anthony
• Granted Patent: US 9,332,990 B2
• Time in Patent Office: Days
• US Class Current: 600/12
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/22065 Functions of balloons dilating A61M29/02
• CPC Class Codes: A61M 25/0127 Magnetic means; Magnetic markers
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters
• CPC Class Codes: A61N 5/1001 using radiation sources introduced into or applied onto the body; brachytherapy

Abstract

Magnetic compression anastomosis can be carried out by placing cooperating magnets, one in the ileal conduit and one in the ureter, to lock together and form the anastomosis. The magnets may be placed to form a side-to-side anastomosis. At least one of the magnets can include radioactive material. Catheters may be used to place the magnets, and the catheters may have at least one deflatable or retractable tissue spacer.

Claims

1. A method of forming an anastomosis comprising:

placing a first magnet in a ureter of a patient proximate an ileal conduit;

placing a second magnet in the ileal conduit of a patient proximate the ureter;

compressing tissue trapped between the first and second magnets based on a magnetic attraction force generated by the magnets, the compressing performed with sufficient force to form an anastomosis.

2. The method of claim 1, wherein the placing steps are carried out to create a side-to-side anastomosis upstream of an original anastomosis or a sutured end of the ureter.

3. The method of claim 1, wherein at least one of the first and second magnets comprises a radioactive material, the method further comprising exposing the trapped tissue to radiation from the at least one magnet, wherein the forming step is carried out based on the locking and the exposing steps.

4. The method of claim 1, wherein at least one of the placing the first magnet or the placing the second magnet is carried out using a catheter with a tissue spacer, wherein at least one of the placing steps includes retracting or deflating the tissue spacer from an extended or inflated configuration prior to the magnet contacting local tissue.

5. The method of claim 1, wherein the steps of placing the first and second magnets are carried out using respective catheters, at least one of the catheters having a magnet exit window with at least one inflatable tissue spacer proximate the window, the method further comprising deflating the tissue spacer to position the ureter side or ileal conduit side magnet in alignment with the other magnet.

6. A ureter catheter, comprising:

a catheter body sized and configured to travel through a ureter of a patient, the catheter body having an inner channel and an outer wall enclosing the inner channel; and

a rare earth magnet releasably held in the catheter body adapted for positioning in a distal end of the ureter proximate an ileal conduit.

7. The catheter of claim 6, wherein the catheter body comprises either a longitudinally extending magnet exit window extending through the outer wall having opposing first and second ends extending a defined length of the catheter body or a tip exit window, the magnet exit window configured to place the magnet on a sidewall of the ureter facing the ileal conduit to form a side-to-side anastomosis.

8. The catheter of claim 6, wherein the catheter body comprises at least one inflatable tissue spacer proximate a magnet exit window.

9. The catheter of claim 6, wherein the at least one tissue spacer comprises a first inflatable tissue spacer proximate one end of a magnet exit window and a second inflatable tissue spacer proximate an opposing longitudinal end of the window.

10. The catheter of claim 6, wherein the rare earth magnet comprises neodymium.

11. The catheter of claim 6, wherein the magnet comprises a radioactive material.

12. The catheter of claim 11, wherein the radioactive material comprises a beta emitter having a half-life that is between about 24 to about 120 hours.

13. The catheter of claim 11, wherein the radioactive material comprises Yttrium-90.

14. The catheter of claim 6, further comprising a magnetic force sensor held by the catheter body proximate the window.

15. A catheter, comprising:

a catheter body sized and configured to travel through a stoma and a distance through an ileal conduit of a patient, the catheter body having an inner channel and an outer wall enclosing the inner channel; and

a rare earth magnet releasably held in the catheter body adapted for positioning in a the ileal conduit proximate a ureter.

16. The catheter of claim 15, wherein catheter body comprises a longitudinally extending window extending through the outer wall having opposing first and second ends extending a defined length of the catheter body, and a first tissue spacer proximate the first end of the window and a second tissue spacer proximate the second end of the window.

17. The catheter of claim 15, wherein the at least one tissue spacer is an inflatable tissue spacer.

18. The catheter of claim 15, wherein the at least one tissue spacer comprises a first inflatable tissue spacer proximate one end of the window and a second inflatable tissue spacer proximate an opposing longitudinal end of the window.

19. The catheter of claim 15, wherein the rare earth magnet comprises neodymium.

20. The catheter of claim 15, wherein the magnet comprises a radioactive material.

21. The catheter of claim 15, wherein the radioactive material comprises a beta emitter having a half-life that is between about 24 to about 120 hours.

22. The catheter of claim 15, wherein the radioactive material comprises Yttrium-90.

23. The catheter of claim 15, further comprising a magnetic force sensor on the catheter body proximate the window.

24. A delivery system for placing ureter and ileal conduit magnets for generating magnetic compression, the system comprising:

a ureter catheter having a magnet held therein for percutaneous delivery to a ureter then to a distal end of the ureter; and

an ileal conduit catheter having a magnet held therein for delivery to a target intrabody site;

wherein, the ureter and ileal conduit catheters deliver respective magnets to cooperate and lock together on opposing sides of tissue and generate magnetic compression on trapped tissue.

25. The system of claim 24, wherein the ureter catheter and the ileal conduit catheter are configured to generate a side-to-side anastomosis using a portion of the ureter that is upstream but proximate a caudal cut end of the ureter.

26. The system of claim 24, wherein the ureter and/or ileal conduit catheter has at least one inflatable tissue spacer thereon.

27. The system of claim 26, further comprising:

at least one conduit attached to the first catheter in fluid communication with the at least one inflatable tissue spacer.

28. The system of claim 24, further comprising a control circuit in communication with the ureter and/or ileal conduit catheter, configured to:

(a) monitor magnetic force data sensed by a sensor on the ureter and/or ileal conduit catheters; and

(b) generate an alert when magnetic force is detected to be insufficient and/or sufficient to thereby guide proper alignment and/or placement.

29. The system of claim 24, wherein the ureter and ileal conduit catheters each comprise a magnet exit window on a side or tip portion thereof, and wherein at least one of the ureter or ileal conduit catheters comprises spaced apart first and second inflatable tissue spacers proximate the window.

30. The system of claim 24, wherein at least one of the magnets of the first and second catheter comprises a radioactive material.

31. The system of claim 30, wherein the radioactive material comprises a beta emitter, and at least one of the magnets further comprises a string attached to the magnet.

32. A delivery system for placing intrabody magnets for generating magnetic compression, the system comprising:

a first catheter having a magnet held therein;

a second catheter having a magnet held therein for delivery to a target intrabody site, wherein, the first and second catheters deliver respective magnets to cooperate and lock together on opposing sides of tissue and generate magnetic compression on trapped tissue; and

a control circuit in communication with the first and/or second catheter, configured to;

(a) monitor magnetic force data sensed by a sensor on the first and/or second catheters; and

(b) generate an alert when magnetic force is detected to be insufficient and/or sufficient.