Soft anvil apparatus for cutting anastomosis fenestra
First Claim
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1. A cutting apparatus comprising:
- anvil means for engaging the interior surface of a first vessel at an anastomosis site, anvil pull means for holding an engaging end of the anvil means against the interior of the first vessel, the anvil pull means extending from an engaging end of the anvil means; and
cutting means for forming a first vessel opening in the wall of the first vessel at the anastomosis site through engagement with the anvil means;
wherein the cutting means includes a cutting tube that terminates at cutting knife with a cutting edge that defines the shape of the first vessel opening, wherein the anvil pull means extends within the cutting tube to enable the anvil pull means and the cutting means to be moved relative to each other, wherein the cross-sectional area defined by the perimeter of the cutting edge of the cutting knife is smaller than a cross-sectional area of the engaging end such that portions of the engaging end of the anvil means extend beyond the cutting edge when the cutting means engages the anvil means and forms the first vessel opening, wherein the engaging end is uncoated and is sufficiently soft to enable the cutting means to depress into the engaging end such that the cutting means cuts completely through the first vessel and forms the first vessel opening and wherein the engaging end of the anvil means is adapted to engage an area of the interior surface of the wall of the first vessel which is greater than the cross-sectional area defined by the cutting edge of the cutting knife.
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Abstract
The present invention is directed to a cutting apparatus for cutting an opening in a vessel for subsequent anastomosis. The cutting apparatus includes an anvil, an anvil pull and a cutter. The anvil is inserted through a small incision at the anastomosis site and brought into contact with the interior wall of a vessel so that the anvil distends the wall of the vessel. The cutter is then urged against the portion of the vessel wall that is distended by the anvil to form an opening in the vessel wall. The anvil has a surface that is softer than the cutter so that the cutter can cut completely through the vessel and depress into the anvil.
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Citations
38 Claims
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1. A cutting apparatus comprising:
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anvil means for engaging the interior surface of a first vessel at an anastomosis site, anvil pull means for holding an engaging end of the anvil means against the interior of the first vessel, the anvil pull means extending from an engaging end of the anvil means; and
cutting means for forming a first vessel opening in the wall of the first vessel at the anastomosis site through engagement with the anvil means;
wherein the cutting means includes a cutting tube that terminates at cutting knife with a cutting edge that defines the shape of the first vessel opening, wherein the anvil pull means extends within the cutting tube to enable the anvil pull means and the cutting means to be moved relative to each other, wherein the cross-sectional area defined by the perimeter of the cutting edge of the cutting knife is smaller than a cross-sectional area of the engaging end such that portions of the engaging end of the anvil means extend beyond the cutting edge when the cutting means engages the anvil means and forms the first vessel opening, wherein the engaging end is uncoated and is sufficiently soft to enable the cutting means to depress into the engaging end such that the cutting means cuts completely through the first vessel and forms the first vessel opening and wherein the engaging end of the anvil means is adapted to engage an area of the interior surface of the wall of the first vessel which is greater than the cross-sectional area defined by the cutting edge of the cutting knife. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cutting apparatus comprising:
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an anvil adapted to engage the interior surface of a first vessel at an anastomosis site, an anvil pull extending from an engaging end of the anvil that is adapted to hold the engaging end of the anvil against the interior of the first vessel; and
a cutting device that is adapted to engage the anvil and form a first vessel opening in the wall of the first vessel at the anastomosis site, the cutting device including a cutting tube that terminates at cutting knife with a cutting edge that defines the shape of the first vessel opening, wherein the anvil pull extends within the cutting tube to enable the anvil pull and the cutting device to be moved relative to each other, wherein the cross-sectional area defined by the perimeter of the cutting edge of the cutting knife is smaller than a cross-sectional area of the engaging end such that portions of the engaging end of the anvil extend beyond the cutting edge when the cutting device engages the anvil and forms the first vessel opening, wherein the anvil is uncoated and is sufficiently soft to enable the cutting edge to depress into the anvil such that the cutting edge cuts completely through the first vessel and forms the first vessel opening. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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20. A cutting apparatus comprising:
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an anvil adapted to engage the interior surface of a first vessel at an anastomosis site, and an anvil pull extending from an engaging end of the anvil that is adapted to hold the engaging end of the anvil against the interior of the first vessel;
a cutting device that is adapted to engage the anvil and form a first vessel opening in the wall of the first vessel at the anastomosis site, the cutting device including a cutting tube that terminates at cutting knife with a cutting edge that defines the shape of the first vessel opening, wherein the anvil pull extends within the cutting tube to enable the anvil pull and the cutting device to be moved relative to each other, wherein the cross-sectional area defined by the perimeter of the cutting edge of the cutting knife is smaller than a cross-sectional area of the engaging end such that portions of the engaging end of the anvil extend beyond the cutting edge when the cutting device engages the anvil and forms the first vessel opening, wherein the engaging end is uncoated and is sufficiently soft to enable the cutting edge to depress into the engaging end such that the cutting edge cuts completely through the first vessel and forms the first vessel opening, and wherein the cross-sectional area of the engaging end of the anvil combined with the shape of the engaging end enables the cutting edge to cut against the engaging end at any position in which the cutting edge is initially set against the engaging end.
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21. A method for forming an opening in a vessel comprising the steps of
identifying an anastomosis site in a first vessel; -
forming an insertion opening in a wall of the first vessel;
inserting an anvil through the insertion opening into a lumen of the first vessel;
positioning an engaging end of the anvil against an interior surface of the wall of the first vessel wherein the engaging end of the anvil is uncoated;
distending the wall of the first vessel at the anastomosis site by pulling the anvil against the wall of the first vessel; and
creating a first vessel opening in the wall of the first vessel at the anastomosis site by positioning a cutting device at the anastomosis site and depressing the cutting device into the engaging end of the anvil such that the cutting device cuts completely through the wall of the first vessel, wherein the cutting device has a cutting perimeter with a cross-sectional area that is smaller than a cross-sectional area of the engaging end of the anvil such that portions of the engaging end of the anvil extend beyond the cutting perimeter when the cutting device is depressed into the engaging end of the anvil to create the first vessel opening, and wherein the engaging end of the anvil is sufficiently soft to enable the cutting device to depress into the engaging end of the anvil such that the cutting device cuts completely through the first vessel and forms the first vessel opening. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 31, 32, 36, 37)
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30. A method for forming an opening in a vessel comprising the steps of
identifying an anastomosis site in a first vessel; -
forming an insertion opening in a wall of the first vessel;
inserting an anvil means for engaging an interior surface of a wall of the first vessel into a lumen of the first vessel, wherein the anvil means is inserted through the insertion opening, wherein the anvil means has an engaging end, and wherein the engaging end is uncoated, positioning the engaging end of the anvil means against an interior surface of the wall of the first vessel;
distending the wall of the first vessel at the anastomosis site by pulling the anvil means against the wall of the first vessel; and
creating a first vessel opening in the wall of the first vessel at the anastomosis site by positioning cutting means for forming a first vessel opening in the wall of the first vessel at the anastomosis site and depressing the cutting means into the engaging end of the anvil means such that the cutting means cuts completely through the wall of the first vessel, wherein the cutting means has a cutting perimeter with a cross-sectional area that is smaller than a cross-sectional area of the engaging end of the anvil means such that portions of the engaging end of the anvil means extend beyond the cutting perimeter when the cutting means is depressed into the engaging end of the anvil means to create the first vessel opening, and wherein the engaging end of the anvil means is sufficiently soft to enable the cutting means to depress into the engaging end such that the cutting means cuts completely through the first vessel and forms the first vessel opening. - View Dependent Claims (33, 34, 35, 38)
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Specification