Anastomosis system and method for controlling a tissue site

• US 6,391,038 B2
• Filed: 07/28/1999
• Issued: 05/21/2002
• Est. Priority Date: 07/28/1999
• Status: Expired due to Term

• Current Assignee: Aesculap AG (Lonza Group AG)
• Original Assignee: Cardica Incorporated
• Inventors: Donohoe, Brendan, Yencho, Stephen A., Hausen, Bernard A., Hendricksen, Michael, Vargas, Jaime, Nielsen, Jamey
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/363,255
• Publication Number:
  US 20010023353A1
• Time in Patent Office: 1,028 Days
• Field of Search: 606/139, 606/153, 606/143-145, 606/175.1, 606/180.1, 227/175.1, 227/180.1
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1152 applying the staples on the outside of the lumen
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11

Abstract

An anastomosis system and method uses an anvil to control and support a tissue site during an anastomosis procedure. The anvil is particularly useful for supporting a wall of a coronary artery during attachment of a graft vessel to the coronary artery because the wall of the coronary artery is very thin, difficult to grasp, and susceptible to tearing. In one method, the anvil is inserted into a pressurized or unpressurized target vessel and is pulled against an inner wall of the target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the anastomosis site and an end of the graft vessel is positioned adjacent and exterior of the target vessel. Staples are inserted through the tissue of the graft vessel and the target vessel by pivoting the arms of a staple holder towards the anvil. When the ends of the staples engage staple bending features on the anvil, the ends of the staples bend over securing the graft vessel and target vessel together. After stapling is complete, an incision is formed in the wall of the target vessel to allow blood flow between the target vessel and the graft vessel.

Claims

1. A method of controlling a tissue site during an anastomosis procedure, the method comprising:

inserting an anvil into a pressurized vessel at an intended anastomosis site;

supporting a wall of the pressurized vessel at the intended anastomosis site with the anvil positioned adjacent an interior of the wall;

performing anastomosis; and

removing the anvil.

2. The method of claim 1, further comprising a step of forming an incision in the wall of the pressurized vessel after the step of performing the anastomosis to allow blood flow between the pressurized vessel and a graft vessel.

3. The method of claim 2, wherein the incision extends along the anvil from a puncture in the vessel where the anvil was inserted.

4. The method of claim 2, wherein the incision is made while removing the anvil.

5. The method of claim 2, wherein the incision is made before removing the anvil.

6. The method of claim 1, wherein the step of performing anastomosis includes inserting staples through a graft vessel and a target vessel and bending ends of the staples against the anvil.

7. The method of claim 1, wherein the step of performing anastomosis includes suturing a graft vessel and the pressurized vessel together.

8. The method of claim 1, further comprising a step of clamping a wall of the pressurized vessel between the anvil and a clamp, and forming an incision in the wall of the pressurized vessel before the step of performing the anastomosis.

9. The method of claim 1, wherein the anvil is an elongated member having substantially parallel features for supporting tissue of the pressurized vessel while puncturing the tissue during anastomosis.

18. The method of claim 1, wherein the step of performing anastomosis comprises connecting an end of a graft vessel to a side of the pressurized vessel.

19. The method of claim 18, wherein the step of performing anastomosis further comprises connecting the end of the graft vessel to the side of the pressurized vessel with a plurality of staples.

20. The method of claim 1, wherein the step of performing anastomosis comprises interconnecting a graft vessel and the pressurized vessel at a plurality of connection points arranged in two parallel lines.

21. The method of claim 1, further comprising holding tissue of the pressurized vessel and a graft vessel together at the anastomosis site along two parallel lines while performing anastomosis.

10. A method of controlling a tissue site during an anastomosis procedure, the method comprising:

inserting an anvil into a target vessel at an intended anastomosis site;

supporting a wall of the target vessel at the intended anastomosis site with the anvil positioned adjacent an interior of the wall;

performing anastomosis between a graft vessel and the target vessel; and

making an incision in the wall of the target vessel to allow blood flow between the graft vessel and the target vessel.

11. The method of claim 10, wherein the step of performing anastomosis comprises connecting an end of the graft vessel to a side of the target vessel.

12. The method of claim 11, wherein the step of performing anastomosis further comprises connecting the end of the graft vessel to the side of the pressurized vessel with a plurality of staples.

13. The method of claim 10, wherein the step of performing anastomosis comprises interconnecting the graft vessel and the target vessel at a plurality of connection points arranged in two parallel lines.

14. The method of claim 10, further comprising holding tissue of the target vessel and the graft vessel together at the anastomosis site along two parallel lines while performing anastomosis.

15. The method of claim 10, wherein the anastomosis is performed on a pressurized target vessel.

16. The method of claim 10, wherein the incision is made while removing the anvil from the target vessel.

17. The method of claim 10, wherein the incision is made before removing the anvil from the target vessel.