Mechanical anastomosis system for hollow structures

• US 6,485,496 B1
• Filed: 04/21/2000
• Issued: 11/26/2002
• Est. Priority Date: 10/24/1997
• Status: Expired due to Term

• Current Assignee: Innovative Interventional Technologies BV
• Original Assignee: Innovative Interventional Technologies BV
• Inventors: Suyker, Wilhelmus Joseph Leonardus, Suyker, Paulus Thomas Wilhelmus
• Primary Examiner(s): Schaetzle, Kennedy
• Assistant Examiner(s): DROESCH, KRISTEN L
• Application Number:
  US09/529,900
• Time in Patent Office: 949 Days
• Field of Search: 606/148, 606/150-156, 606/213, 606/215-216, 606/219, 606/221, 606/198, 606/139, 606/140, 606/419, 606/151, 606/153, 606/155, 623/1.14, 623/1.13, 623/1.21, 604/104, 227/175.1, 227/179.1, 227/181.1, 227/901, 227/902
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• 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 2017/0641 having at least three legs as part of one single body
• 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 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: Y10S 227/901 Surgical clip appliers
• CPC Class Codes: Y10S 227/902 Surgical clips or staples

Abstract

A system for making anastomoses between hollow structures by mechanical means is provided with a device in the shape of an annular or tubular element comprising circumferentially provided means, such as pin-shaped elements, for joining the abutting walls of the hollow structures together. An applicator is intended for moving said annular or tubular element in position and activating the joining means thereof, so as to make the anastomosis. Possibly, intraluminal joining means can be inserted without using an annular or tubular element.

Claims

1. A device for use in a system for making anastomoses between hollow structures having walls, comprising:

a hollow element having a tubular or annular shape and a longitudinal axis, said hollow element being movable from a starting position having a first cross-sectional area to a joining position having a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction; and

a plurality of joining elements distributed circumferentially on the hollow element, as viewed in an axial direction, and which are movable from a starting position to a joining position in order to hold the abutting walls of said hollow structures together, and wherein each said joining element has at least two free ends associated as a set at a single position on the hollow element and each set of at least two free ends of said joining elements are spaced apart when the joining elements are positioned in the starting position and each set of at least two free ends of each said joining element are positioned closer together when the joining elements are positioned in the joining position than said free ends are positioned when said joining elements are in the starting position in order to hold the walls of said hollow structures together.

2. A device as claimed in claim 1, wherein each said hollow element has a substantially circular cross-sectional shape, as viewed in an axial direction.

3. A device as claimed in claim 1, wherein each said hollow element has a substantially elliptical cross-sectional shape, as viewed in an axial direction.

4. A device as claimed in claim 1, wherein each said hollow element has a substantially polygonal cross-sectional shape, as viewed in an axial direction.

5. A device as claimed in claim 1, wherein each said joining element comprises a plurality of pin-shaped elements and each said pin-shaped element is movable from a starting position to a joining position.

6. A device as claimed in claim 5, wherein each said pin-shaped element extends in a substantially axial direction relative to said hollow element, when said hollow element is in the starting position and wherein each said pin-shaped element is caused to deform to extend in a direction relative to said hollow element, which is selected from a substantially radial direction and a substantially tangential direction, when said hollow element is in said joining position.

7. A device as claimed in claim 1, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

8. A device for use in a system for making anastomoses between hollow structures having walls, comprising:

a hollow element having a tubular or annular shape and a longitudinal axis, said hollow element being made up only of two elongate elements, each said elongate element having vertices, and a shape selected from the group consisting of zigzag-like and sinusoidal, said elongate elements being arranged side-by-side in an axial direction and being interconnected at or near the vertices of said elongate elements that face each other, said hollow element being movable from a starting position having a first cross-sectional area to a joining position having a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction; and

a plurality of joining elements distributed circumferentially on the hollow element, as viewed in the axial direction, and which are movable from a starting position to a joining position in order to hold the abutting walls of said hollow structures together, and said joining elements being fixed only at the vertices of the elongate elements that face away from each other.

9. A device as claimed in claim 8, wherein said hollow element is deformable from said starting position to said joining position by causing each elongate element to be straighter when in said joining position than the same said elongate element when in said starting position.

10. A device as claimed in claim 8, wherein each said elongate element has a zigzag-like shape, as viewed from a side.

11. A device as claimed in claim 8, wherein each said elongate element has a sinusoidal shape, as viewed from a side.

12. A device as claimed in claim 8, wherein each said hollow element has a substantially circular cross-sectional shape, as viewed in an axial direction.

13. A device as claimed in claim 8, wherein each said hollow element has a substantially elliptical cross-sectional shape, as viewed in an axial direction.

14. A device as claimed in claim 8, wherein each said hollow element has a substantially polygonal cross-sectional shape, as viewed in an axial direction.

15. A device as claimed in claim 8, wherein each said joining element comprises a plurality of pin-shaped elements and each said pin-shaped element is movable from a starting position to a joining position.

16. A device as claimed in claim 15, wherein each said pin-shaped element extends in a substantially axial direction relative to said hollow element, when said hollow element is in the starting position and wherein each said pin-shaped element is deformed to extend in a direction relative to said hollow element, which is selected from a substantially radial direction and a substantially tangential direction, when said hollow element is in said joining position.

17. A device as claimed in claim 15, wherein two of said pin-shaped elements are associated as a pair at a single position on said hollow element and each said pin-shaped element includes a free end, and wherein the free ends of each said associated pair of pin-shaped elements are spaced apart from one another in the starting position, as measured in an axial direction, and said free ends are closer together in the joining position than in said starting position, as measured in an axial direction.

18. A device as claimed in claim 8, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

19. A device as claimed in claim 18, wherein said elongate element has a length which is greater than a circumference of said hollow element, as measured when said hollow element is in the starting position, and said elongate element has a length which is substantially the same as a circumference of said hollow element when said hollow element is in the joining position.

20. A device as claimed in claim 18, wherein each said elongate element is straighter when in a joining position than the same elongate element when in a starting position.

21. A device for use in a system for making anastomoses between abutting walls of hollow structures, comprising:

a hollow element having an annular or tubular shape and including only a pair of primary elements arranged side-by-side along the circumference of the hollow element to form the annular or tubular hollow element, each said primary element having an elongate shape deviating from a straight line to form primary vertices on a first side of said primary element, and secondary vertices on a second, opposite side of said primary element, as viewed in an axial direction relative to each said primary element, said primary and secondary vertices being staggered about the circumference of said hollow element, said primary elements being interconnected at the secondary vertices to form a pair, and said hollow element is movable from a starting position wherein said device has a first cross-sectional area to a joining position wherein said device has a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction relative to said anastomosis device, by increasing the distance between said secondary vertices, as viewed in an axial direction relative to said hollow element; and

joining elements formed circumferentially on the hollow element for joining the abutting walls of the hollow structures together, said joining elements being fixed only at the primary vertices of each of said primary elements that face away from each other, said joining elements being movable between a starting position and a joining position in order to hold the abutting walls of the hollow structures together.

22. A device as claimed in claim 21, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

23. A device as claimed in claim 22, wherein said elongate element has a length which is greater than a circumference of said hollow element, as measured when said hollow element is in the starting position, and said elongate element has a length which is substantially the same as a circumference of said hollow element when said hollow element is in the joining position.

24. A device as claimed in claim 22, wherein each said elongate element is straighter when in a joining position than the same elongate element when in a starting position.

25. A device as claimed in claim 24, wherein each said pin-shaped element extends in a substantially axial direction relative to said hollow element, when said hollow element is in the starting position and wherein each said pin-shaped element is deformed to extend in a direction relative to said hollow element, which is selected from a substantially radial direction and a substantially tangential direction, when said hollow element is in said joining position.

26. An applicator for use with a device for intraluminally making anastomoses between abutting walls of hollow structures, said device including joining elements to hold the abutting walls of the hollow structures together, said applicator comprising:

a shank-like element;

a head located at a distal end of the shank-like element for supporting the device to be positioned thereon and for activating the joining elements, said head being radially expandable, and having an axially-contractible element adapted to move said joining elements of the device from a starting position to a joining position in order to hold the abutting walls of the hollow structures together;

a control element for controlling the radial expansion of the head of the applicator, and for controlling the axially-contractible element of the head;

wherein the joining elements comprise a plurality of pin-shaped elements which are provided in associated pairs on a hollow element, and each associated pair of said pin-shaped elements has two free ends which are spaced apart when said applicator is in a starting position; and

wherein the axially-contractible element of said applicator is adapted to move at least the free ends of each associated pair of pin-shaped elements towards each other to a joining position.

27. A method for making anastomoses intraluminally between abutting walls of hollow structures, said method comprising the steps of:

providing an applicator and associated joining means for joining the abutting walls of the hollow structures together,

placing said joining means around the applicator in a starting position,

inserting said applicator and said joining means into each of said hollow structures to a location internal to the wall of each said hollow structure, and

activating said applicator to move said joining means by expanding the cross-sectional area of said applicator, as viewed in an axial direction, and consecutively moving each joining means from the starting position to the joining position by moving at least a portion of at least one of an associated pair of joining means closer to a portion of the other of an associated pair of joining means to thereby clamp the abutting walls of the hollow structures in sealing contact with each other.

28. The method according to claim 27, used to make side-to-side anastomoses.

29. The method according to claim 27, used to make end-to-side anastomoses.

30. A method for making anastomoses intraluminally between abutting walls of hollow structures, said method comprising the steps of:

providing an applicator and an associated anastomosis device having a plurality of joining elements for joining the abutting walls of the hollow structures together,

placing said anastomosis device around the applicator in a starting position,

inserting said applicator and said anastomosis device into each of said hollow structures to a location internal to the wall of each said hollow structure, and

activating said applicator to move the anastomosis device from a starting position wherein said device has a first cross-sectional area to a joining position wherein said device has a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction relative to said anastomosis device, and simultaneously moving pairs of the joining elements towards each other to clamp the abutting walls of said hollow structures in sealing contact with each other.

31. The method according to claim 30, used to make side-to-side anastomoses.

32. The method according to claim 30, used to make end-to-side anastomoses.

33. The method according to claim 30, wherein the anastomosis device has a cross-sectional shape selected from the group consisting of substantially circular, substantially elliptical and substantially polygonal, as viewed in an axial direction relative to said anastomosis device.

34. The method according to claim 33, wherein the joining elements include pin-shaped elements provided circumferentially around the anastomosis device, and wherein the pin-shaped elements are moved together in an axial direction to clamp the abutting walls therebetween in said step of activating the applicator.

35. A method as claimed in claim 30, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

36. A method for making anastomoses intraluminally between abutting walls of hollow structures, said method comprising the steps of:

providing an applicator and an associated anastomosis device having a plurality of joining elements for joining the abutting walls of the hollow structures together,

placing said anastomosis device around the applicator in a starting position,

inserting said applicator and said anastomosis device into each of said hollow structures to a location internal to the wall of each said hollow structure, and

activating said applicator to move the anastomosis device from a starting position wherein said device has a first cross-sectional area to a joining position wherein said device has a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction relative to said anastomosis device, and subsequently moving pairs of the joining elements towards each other to clamp the abutting walls of said hollow structures in sealing contact with each other.

37. A method as claimed in claim 36, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

38. The method according to claim 36, used to make side-to-side anastomoses.

39. The method according to claim 36, used to make end-to-side anastomoses.

40. The method according to claim 36, wherein the anastomosis device has a cross-sectional shape selected from the group consisting of substantially circular, substantially elliptical and substantially polygonal, as viewed in an axial direction relative to said anastomosis device.

41. The method according to claim 40, wherein the joining elements include pin-shaped elements provided circumferentially around the anastomosis device, and wherein the pin-shaped elements are moved together in an axial direction to clamp the abutting walls therebetween in said step of activating the applicator.

42. A method for making anastomoses intraluminally between abutting walls of hollow structures, said method comprising the steps of:

providing an applicator and an associated anastomosis device for joining the abutting walls of the hollow structures together, said device including a hollow element and a plurality of joining elements provided circumferentially on said hollow element,

placing said hollow element around the applicator in a starting position,

inserting said applicator and said device into each of said hollow structures to a location internal to the wall of each said hollow structure, and

activating said applicator to first expand the hollow element from a starting position wherein said device has a first cross-sectional area to a joining position wherein said device has a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction relative to said anastomosis device, and subsequently moving the joining elements towards each other from a starting position to a joining position to thereby clamp the abutting walls of said hollow structures in sealing contact with each other.

43. A method as claimed in claim 42, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

44. The method according to claim 42, used to make side-to-side anastomoses.

45. The method according to claim 42, used to make end-to-side anastomoses.

46. The method according to claim 42, wherein said hollow element is annular or tubular.

47. The method according to claim 46, wherein the anastomosis device has a cross-sectional shape selected from the group consisting of substantially circular, substantially elliptical and substantially polygonal, as viewed in an axial direction relative to said anastomosis device.

48. The method according to claim 47, wherein the joining elements include pin-shaped elements provided circumferentially around the anastomosis device, and wherein the pin-shaped elements are moved together in an axial direction to clamp the abutting walls therebetween in said step of activating the applicator.

49. A method for intraluminally making anastomoses between abutting walls of hollow structures, said method comprising the steps of:

providing an applicator and an associated anastomosis device for joining the abutting walls of the hollow structures together, said device including a hollow element and a plurality of associated pairs of joining elements provided circumferentially thereon,

placing said hollow element around the applicator in a starting position,

inserting said applicator and said device into each of said hollow structures to a location internal to the wall of each said hollow structure, and

activating said applicator to first expand the hollow element from a starting position wherein said device has a first cross-sectional area to a joining position wherein said device has a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction relative to said anastomosis device, and simultaneously moving the joining elements from a starting position to a joining position whereby the associated pairs of joining elements move towards each other such as to clamp the abutting walls of the hollow structures in sealing contact with each other.

50. A method as claimed in claim 49, wherein said hollow element is permanently deformed when moved from said starting position to said joining position.

51. The method according to claim 49, used to make side-to-side anastomoses.

52. The method according to claim 49, used to make end-to-side anastomoses.

53. The method according to claim 49, wherein said hollow element is annular or tubular.

54. The method according to claim 53, wherein the anastomosis device has a cross-sectional shape selected from the group consisting of substantially circular, substantially elliptical and substantially polygonal, as viewed in an axial direction relative to said anastomosis device.

55. The method according to claim 54, wherein the joining elements include pin-shaped elements provided circumferentially around the anastomosis device, and wherein the pin-shaped elements are moved together in an axial direction to clamp the abutting walls therebetween in said step of activating the applicator.

56. A method for intraluminally making anastomoses between abutting walls of hollow structures, said method comprising the steps of:

providing an applicator and an associated anastomosis device for joining the abutting walls of the hollow structures together, said device including a hollow element and joining elements provided circumferentially thereon,

placing said hollow element around the applicator in a starting position,

inserting said applicator and said device into each of said hollow structures to a location internal to the wall of each said hollow structure, and

activating said applicator to first move associated pairs of the joining elements towards each other from a starting position to a joining position to thereby clamp the abutting walls of the hollow structures in sealing contact with each other, and subsequently expanding the hollow element from a starting position wherein said device has a first cross-sectional area to a joining position wherein said device has a second, larger cross-sectional area, said cross-sectional areas being viewed in an axial direction relative to said anastomosis device.

57. The method according to claim 56, used to make side-to-side anastomoses.

58. The method according to claim 56, used to make end-to-side anastomoses.

59. The method according to claim 56, wherein said hollow element is annular or tubular.

60. The method according to claim 59, wherein the anastomosis device has a cross-sectional shape selected from the group consisting of substantially circular, substantially elliptical and substantially polygonal, as viewed in an axial direction relative to said anastomosis device.

61. The method according to claim 60, wherein the joining elements include pin-shaped elements provided circumferentially around the anastomosis device, and wherein the pin-shaped elements are moved together in an axial direction to clamp the abutting walls therebetween in said step of activating the applicator.