Surgical device for creating an anastomosis between first and second hollow organs

• US 6,605,098 B2
• Filed: 09/28/2001
• Issued: 08/12/2003
• Est. Priority Date: 09/28/2001
• Status: Active Grant

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Hess, Christopher J., Schulze, Dale R., Nobis, Rudolph H., Knight, Gary W., Clem, Michael F.
• Primary Examiner(s): WOO, JULIAN W
• Application Number:
  US09/967,227
• Publication Number:
  US 20030065342A1
• Time in Patent Office: 683 Days
• Field of Search: 606/153, 606/184, 606/185, 606/167
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• 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 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• 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

Abstract

A surgical device including: a punch slidingly disposed in a housing for forming a hole in a first vessel; a cartridge movably disposed in the housing between a cutting and deploying positions, the cartridge having a second vessel and a coupler for coupling the first and second vessel loaded therein; a punch actuator for sliding the punch between the cutting and deploying positions; a cartridge actuator for moving the cartridge between the cutting and deploying positions, wherein while in the cutting position, the punch and cartridge are in position to permit the punch to form the hole in the first vessel and while in the deploying position, they are in position to deploy the second vessel; and a deployment mechanism for deploying the second vessel and coupler into the hole of the first vessel while the punch and cartridge are in the deploying position to create an anastomosis.

Claims

1. A surgical device for creating an anastomosis between first and second hollow organs, the device comprising:

a housing;

a punch slidingly disposed in the housing along a central axis for forming a hole in the first hollow organ;

a cartridge movably disposed in the housing between a position offset from the central axis and a position aligned with the central axis, the cartridge adapted to receive the second hollow organ and a coupler for coupling the first and second hollow organs loaded therein;

punch actuation means for sliding the punch between cutting and deploying positions, wherein while in the cutting position the punch is in position to form the hole in the first hollow organ and while in the deploying position, the punch is in position to permit the deployment of the second hollow organ;

cartridge actuation means for moving the cartridge between the cutting and deploying positions, wherein while in the cutting position the cartridge is in the position offset from the central axis and while in the deploying position, the cartridge is in the position aligned with the central axis; and

deploying means for deploying the second hollow organ and coupler into the hole while the punch and cartridge are in the deploying position to create the anastomosis.

2. The device of claim 1, wherein the punch comprises:

a shaft disposed along the central axis; and

a punch tip disposed at a distal portion of the shaft and having a pointed surface for piercing the first hollow organ.

3. The device of claim 2, wherein the punch tip has a proximal edge for cutting a wall of the first hollow organ, the punch further having a grooved portion proximate to the punch tip for capturing a wall of the first hollow organ, the punch further comprising means for retracting the punch tip to sandwich the wall between the proximal edge and a portion of the housing and to sever the wall around a periphery of the proximal edge.

4. The device of claim 1, further comprising means for retracting the pointed surface of the punch tip into a lumen of the shaft.

5. The device of claim 1, wherein the cartridge further comprises a seal for sealing liquid in the first internal organ from entering the device.

6. The device of claim 5, wherein the cartridge further comprises a splitting means for splitting the cartridge and seal subsequent to deployment of the second hollow organ and coupler for facilitating release of the second hollow organ from the device.

7. The device of claim 1, wherein the coupler has pins for securing the second hollow organ to the hole of the first hollow organ, the pins being biased in a bent position, the cartridge further comprises retaining means for retaining the pins in a substantially straight position prior to deployment of the second hollow organ and coupler.

8. The device of claim 1, wherein the punch actuation means comprises:

a punch lever rotatably disposed on a shaft of the punch, wherein pulling the punch lever in the proximal direction moves the punch from the cutting position to the deploying position; and

retainer means for retaining the punch lever in the housing as it is pulled in the proximal direction.

9. The device of claim 8, wherein the punch actuation means comprises locking means for locking the punch lever and punch in the deploying position.

10. The device of claim 1, wherein the cartridge is rotatably disposed in the housing and wherein the cartridge actuation means comprises;

a cradle rotatably disposed in the housing for accepting the cartridge; and

a shaft connected to the housing upon which the cradle rotates.

11. The device of claim 10, wherein the cartridge actuation means further comprises a locking means for locking the cartridge in the deploying position.

12. The device of claim 10, wherein the cradle has orientation means for orienting the cartridge in a predetermined position in the housing.

13. The device of claim 1, wherein the coupler has pins for securing the second hollow organ to the hole of the first hollow organ, the pins being biased in a bent position, the cartridge further comprises retaining means for retaining pins in a substantially straight position prior to deployment of the second hollow organ and coupler, wherein the deploying means comprises;

means for pushing a distal end of the second hollow organ and the coupler into the hole of the first hollow organ; and

means for releasing the restraint on the pins thereby fixing the second hollow organ to the hole of the first hollow organ.

14. The device of claim 13, wherein the means for pushing the distal end of the second hollow organ and coupler into the hole of the first hollow organ comprises a shaft operatively connected to the cartridge for sliding the cartridge along the central axis such that the distal end of the second hollow organ protrudes from the housing and into the hole of the first hollow organ.

15. The device of claim 13, wherein the means for releasing the restraint on the pins comprises:

a screw tube rotatably disposed in the housing and operatively connected to the cartridge;

a knob connected to a distal end of the screw tube, wherein rotation of the knob releases the restraint on the pins.

16. The device of claim 13, further comprising a restraint means for restraining the rotation of the knob in the direction that releases the restraint on the pins.

17. The device of claim 16, further comprising a restraint release means for releasing the restraint and allowing the knob to be reset to an initial position for subsequent operations of the device.

18. The device of claim 1, wherein the first hollow organ is the aorta of the heart and the second hollow organ is a harvested vessel.

19. The device of claim 1, wherein the coupler is an anastomotic device having a set of pins on each of two ends, one of the sets of pins coupling the anastomotic device to a distal end of the second hollow organ and the other set of pins coupling the anastomotic device to a wall of the second hollow organ about the hole.

20. A method for creating an anastomosis between first and second hollow organs, the method comprising:

providing a punch slidingly disposed in a housing along a central axis;

providing a cartridge movably disposed in the housing between a position offset from the central axis and a position aligned with the central axis;

loading the second hollow organ and a coupler for coupling the first and second hollow organs into the cartridge;

sliding the punch distally to create a hole in a wall of the first hollow organ;

sliding the punch proximally to provide clearance for rotation of the cartridge into the position aligned with the central axis;

moving the cartridge from the axis offset from the central axis to the position aligned with the central axis; and

deploying the second hollow organ and coupler into the hole to create the anastomosis.

21. The method of claim 20, wherein the punch comprises a shaft disposed along the central axis;

and a punch tip disposed at a distal portion of the shaft and having a pointed surface for piercing the first hollow organ, the method further comprising retracting the pointed surface of the punch tip into a lumen of the shaft.

22. The method of claim 21, wherein the punch tip has a proximal edge for cutting the wall of the first hollow organ, the punch further having a grooved portion proximate to the punch tip, the method further comprising:

capturing the wall of the first hollow organ in the grooved portion; and

retracting the punch tip to sandwich the wall between the proximal edge and a portion of the housing to sever the wall around a periphery of the proximal edge.

23. The method of claim 20, further comprising sealing liquid in the first internal organ from entering the device.

24. The method of claim 23, further comprising splitting the cartridge and seal subsequent to deployment of the second hollow organ and coupler for facilitating release of the second hollow organ from the device.

25. The method of claim 20, wherein the coupler has pins for securing the second hollow organ to the hole of the first hollow organ, the pins being biased in a bent position, the method further comprising retaining the pins in a substantially straight position prior to deployment of the second hollow organ and coupler.

26. The method of claim 25, further comprising;

pushing a distal end of the second hollow organ and the coupler into the hole of the first hollow organ; and

releasing the restraint on the pins thereby fixing the second hollow organ to the hole of the first hollow organ.

27. The method of claim 26, wherein a screw tube is rotatably disposed in the housing and operatively connected to the cartridge, wherein the releasing comprises rotating a knob connected to a distal end of a screw tube to release the restraint on the pins.

28. The method of claim 27, further comprising restraining the rotation of the knob in the direction that releases the restraint on the pins.

29. The method of claim 28, further comprising releasing the restraint and allowing the knob to be reset to an initial position for subsequent operations of the device.

30. The method of claim 25, further comprising preventing the loading of the cartridge into the housing unless a distal set of the pins are pierced through an everted portion of the second hollow organ by at least partly releasing the retaining of the pins.

31. A surgical device for creating an anastomosis between first and second hollow organs, the device comprising:

a housing with a central axis;

a punch slidingly disposed in the housing for forming a hole in the first hollow organ;

a cartridge movably disposed in the housing between a cutting position and a deploying position, the cartridge adapted to receive the second hollow organ and a coupler for coupling the first and second hollow organs loaded therein;

punch actuation means for sliding the punch between the cutting and deploying positions, wherein while in the cutting position the punch is in position to form the hole in the first hollow organ and while in the deploying position, the punch is in position to permit the deployment of the second hollow organ;

cartridge actuation means for moving the cartridge between the cutting and deploying positions, wherein while in the cutting position, the cartridge is in a position offset from the central axis to permit the punch to form the hole in the first hollow organ and while in the deploying position, the cartridge is in position to deploy the second hollow organ; and

deploying means for deploying the second hollow organ and coupler into the hole while the punch and cartridge are in the deploying position to create the anastomosis.