Laparoscopic or endoscopic anastomosis technique and associated instruments
First Claim
1. An endoscopic surgical assembly comprising:
- an anastomoses stapling device having;
a flexible shaft,an anvil portion and a stapling portion at a distal end of said shaft,first actuator means, disposed in part at a proximal end of said shaft and operatively connected to said anvil portion and said stapling portion, for moving said anvil portion and said stapling portion towards one another to clamp at least one tubular organ segment in a stapling operation, andsecond actuator means, disposed in part at said proximal end of said shaft and operatively connected to said stapling portion, for ejecting a plurality of staples essentially simultaneously from said stapling portion towards said anvil portion upon a clamping of a tubular organ segment, said staples being arranged in an endless type configuration in said stapling portion, said staples being oriented in a transverse direction relative to said shaft and concomitantly ejected from said stapling portion in said transverse direction;
an illumination guide connected to said stapling device for guiding light from said proximal end to said distal end; and
an image guide connected to said stapling device for transmitting an image from said distal end to said proximal end.
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Accused Products
Abstract
A laparoscopic surgical technique for performing an anastomosis comprises the steps of disposing a laparoscopic trocar sleeve in a patient'"'"'s abdominal wall, inserting a distal end of a laparoscopic instrument into an abdominal cavity of the patient through the trocar sleeve, and manipulating the instrument from outside the patient to loop a purse-string-type suture through a free end of a first severed intestinal segment of the patient. In other steps of the laparoscopic surgical technique, a flexible anastomosis-forming device is inserted through the patient'"'"'s rectum so that an end cap at a distal end of the anastomosis device protrudes from a free end of a second severed intestinal segment of the patient. The anastomosis-forming device is shifted further through the patient'"'"'s rectum so that the end cap is inserted into the first severed intestinal segment through the free end thereof. During the shifting of the end cap, the first severed intestinal segment is held with a laparoscopic tool from outside the patient to facilitate insertion of the end cap into the first severed intestinal segment. Upon insertion of the end cap into the first severed intestinal segment, the purse-string-type suture is drawn via a laparoscopic member to close the free end of the first severed intestinal segment about the end cap. The anastomosis-forming device is operated from outside the patient to connect the intestinal segments to one another in an anastomosis.
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Citations
31 Claims
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1. An endoscopic surgical assembly comprising:
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an anastomoses stapling device having; a flexible shaft, an anvil portion and a stapling portion at a distal end of said shaft, first actuator means, disposed in part at a proximal end of said shaft and operatively connected to said anvil portion and said stapling portion, for moving said anvil portion and said stapling portion towards one another to clamp at least one tubular organ segment in a stapling operation, and second actuator means, disposed in part at said proximal end of said shaft and operatively connected to said stapling portion, for ejecting a plurality of staples essentially simultaneously from said stapling portion towards said anvil portion upon a clamping of a tubular organ segment, said staples being arranged in an endless type configuration in said stapling portion, said staples being oriented in a transverse direction relative to said shaft and concomitantly ejected from said stapling portion in said transverse direction; an illumination guide connected to said stapling device for guiding light from said proximal end to said distal end; and an image guide connected to said stapling device for transmitting an image from said distal end to said proximal end. - View Dependent Claims (2, 3)
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4. A method for connected two hollow organs so that the organs communicate with one another, comprising the steps of:
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inserting a flexible fiber optic endoscope assembly through an opening in a patient into a first hollow organ of the patient; during said step of inserting, utilizing light-transmitting componentry of said endoscope assembly to visually inspect said first hollow organ internally; upon insertion of said endoscope assembly to a desired surgical site inside said first hollow organ, as determined during said step of utilizing, ejecting from a distal end of said endoscope assembly a stapling device having a flexible shaft and a first staple forming member at a distal end of said shaft; inserting a cooperating second staple forming member into a second hollow organ; moving said first staple forming member towards a cooperating second staple forming member disposed in said second hollow organ, thereby clamping walls of said first and said second hollow organ to one another between said first and said second staple forming member; in essentially a single stapling operation, firing a plurality of staples in an endless type configuration from one of said first and said second staple forming member through said walls towards the other of said first and said second staple forming member; closing said staples during said step of firing, thereby stapling said first hollow organ to said second hollow organ at said surgical site; in an area enclosed by the fired staples, cutting substantially aligned apertures in said first hollow organ and said second hollow organ; and removing said first staple forming member and said second staple forming member from said first and said second hollow organ. - View Dependent Claims (5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method for forming an anastomosis, comprising the steps of:
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inserting into a first hollow organ part a stapling device including a stapling member with a plurality of staples in an endless type configuration, said stapling member being attached to a distal end of an elongate shaft; inserting into a second hollow organ part an anvil member; juxtaposing a first side wall of said first hollow organ part to a second side wall of said second hollow organ part; clamping said first side wall and said second side wall to one another between said stapling member and said anvil member; in essentially a single stapling operation, firing, from said stapling member towards said anvil member, said plurality of staples in a common direction transverse relative to said shaft at the distal end thereof; closing said staples during said step of firing, thereby stapling said first hollow organ part to said second hollow organ part; in an area enclosed by the fired staples, cutting substantially aligned apertures in said first hollow organ part and said second hollow organ part; and removing said stapling member and said anvil member from said first and said second hollow organ part. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29)
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30. A method for performing a choledocoduodenostomy, comprising the steps of:
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inserting a flexible fiber optic endoscope assembly through a patient'"'"'s mouth, the esophagus, and the stomach; during said step of inserting, utilizing light-transmitting componentry of said endoscope assembly to visually inspect tissues along an insertion path; upon insertion of said endoscope assembly to a desired surgical site inside the duodenum of the patient, as determined by utilizing the light-transmitting componentry of said endoscope assembly, ejecting from a distal end of said endoscope assembly a stapling device having a flexible shaft and a first staple forming member at a distal end of said shaft; inserting a second staple forming member through an abdominal wall and the liver of the patient and into the common bile duct; clamping walls of the common bile duct and the duodenum to one another between said first and said second staple forming member; in essentially a single stapling operation, firing a plurality of staples in an endless type configuration from one of said first and said second staple forming member through said walls towards the other of said first and said second staple forming member; closing said staples during said step of firing, thereby stapling said duodenum to said common bile duct; cutting substantially aligned apertures in the walls of the duodenum and the common bile duct; and removing said first and said second staple forming member from the duodenum and the common bile duct. - View Dependent Claims (31)
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Specification