Intussusception and anastomosis apparatus

• US 7,094,247 B2
• Filed: 09/09/2002
• Issued: 08/22/2006
• Est. Priority Date: 07/22/2002
• Status: Expired due to Fees

• Current Assignee: Niti Surgical Solutions Ltd.
• Original Assignee: NITI Medical Technologies Limited
• Inventors: Arad, Michael, Ne'eman, Ronen, Monassevitch, Leonid, Spenser, Benjamin
• Primary Examiner(s): Woo, Julian W.
• Application Number:
  US10/237,505
• Publication Number:
  US 20040015179A1
• Time in Patent Office: 1,443 Days
• Field of Search: 606/151, 606/153, 606/156, 606/213, 606/215, 606/185, 623/1.1, 623/1.11
• US Class Current: 606/153
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/1117 adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
• CPC Class Codes: A61B 2017/1132 End-to-end connections

Abstract

Apparatus for intratubular intussusception and anastomosis of a hollow organ portion including a cylindrical enclosure, coaxial intratubular intussusception device, for intussusception and clamping means. The apparatus also includes an intratubular anastomosis apparatus for joining organ portions after intussusception thereof with an anastomosis ring and crimping support element. The ring is formed of a shape memory alloy wire, for crimping adjacent organ portions against the crimping support element so as to cause anastomosis therebetween. The ring assumes a plastic or malleable state, at a lower temperature and an elastic state at a higher temperature. The apparatus further includes the crimping support element for intratubular insertion so as to provide a support for crimping the organ portions against the support element. The apparatus additionally includes a surgical excising means, for excising an intussuscepted organ portion, after crimping adjacent intussuscepted organ walls against the crimping support element with the anastomosis ring.

Claims

1. An intratubular anastomosis apparatus for joining organ wall portions of a hollow organ after intussusception, said apparatus including:

a) an anastomosis ring, including a length of a wire formed of a shape memory alloy defining a closed generally circular shape, having a central opening, and having overlapping end portions, said anastomosis ring for crimping adjacent intussuscepted organ wall portions against a crimping support element so as to cause anastomosis therebetween,

 

wherein, said anastomosis ring and said shape memory alloy assumes

i) a plastic or malleable state, when at a first, lower temperature; and

ii) an elastic state, when reaching at least a second, higher temperature,

 

thereby enabling said anastomosis ring to retain a preselected configuration at the first, lower temperature, and an elastic crimping configuration upon reverting to the second, higher temperature; and

b) said crimping support element for intratubular insertion so as to provide a support for crimping said organ wall portions against said support element, said crimping support element having;

i) a generally cylindrical side-wall;

ii) proximal and distal end walls formed generally transversely to said side-wall, thereby to define therewith said crimping support element;

iii) a generally axial aperture for providing flow communication therethrough; and

iv) an attachment means for operationally engaging said crimping support element to a crimping applicator member so as to position said crimping support element adjacent to said anastomosis ring for facilitating crimping of preselected wall portions of a hollow organ therebetween.

2. An intratubular anastomosis apparatus according to claim 1, wherein said length of wire is formed having a cross-sectional shape substantially as selected from the group including:

a) circular; and

b) elliptical,

thereby to control pressure applied to tissue compressed between said anastomosis ring and said crimping support element.

3. An intratubular anastomosis apparatus according to claim 1, wherein said anastomosis ring is a contracting anastomosis ring at the second higher temperature.

4. An intratubular anastomosis apparatus according to claim 3, wherein said crimping support element has an circumferential recess formed in an outer surface thereof for facilitating retaining said contracting anastomosis ring in a predetermined position therein.

5. An intratubular anastomosis apparatus according to claim 1, wherein said anastomosis ring is an expanding anastomosis ring at the second higher temperature.

6. An intratubular anastomosis apparatus according to claim 5, wherein said crimping support element has an circumferential recess formed in an inner surface thereof for facilitating retaining said expanding anastomosis ring in a predetermined position therein.

7. An intratubular anastomosis apparatus according to claim 1, wherein said crimping support element is configured as a crimping support helix including at least one coil formed of a shape memory alloy such that said crimping support helix is an expanding support helix at the second higher temperature.

8. Apparatus for intratubular intussusception and anastomosis of a preselected wall portion of a hollow organ, said apparatus including:

a) a generally cylindrical enclosure member having a proximal and a distal end;

b) an intratubular intussusception device, generally coaxially disposed within said enclosure member, for intussusception of a preselected hollow organ portion to be excised from the hollow organ, said intussusception device including;

i) clamping means disposed at a distal end of said device; and

ii) activating means, operationally connected to said clamping means, disposed at a proximal end of said device;

c) an intratubular anastomosis apparatus disposed within said enclosure member for joining the wall portions of the hollow organ after intussusception, said anastomosis apparatus including;

i) an anastomosis ring, including a length of a wire formed of a shape memory alloy defining a closed generally circular shape, having a central opening, and having overlapping end portions, said anastomosis ring for crimping adjacent intussuscepted organ wall portions against a crimping support element so as to cause anastomosis therebetween,

 

wherein, said anastomosis ring and said shape memory alloy assumes

(1) a plastic state, when at a first, lower temperature; and

(2) an elastic state, when reaching at least a second, higher temperature,

 

thereby enabling said anastomosis ring to retain a preselected configuration at the first, lower temperature, and an elastic crimping configuration upon reverting to the second, higher temperature; and

ii) said crimping support element for intratubular insertion so as to provide a support for crimping said organ wall portions against said support element, said crimping support element having;

(1) a generally cylindrical side-wall;

(2) proximal and distal end walls arranged generally transversely to said side-wall, thereby to define therewith said crimping support element;

(3) a generally axial aperture for providing flow communication therethrough; and

(4) an attachment means for operationally engaging said crimping support element to a crimping support element applicator member so as to position said crimping support element adjacent to said anastomosis ring; and

d) a surgical excising means, for excising the preselected intussuscepted hollow organ portion, said excising means operatively associated with said intratubular anastomosis apparatus, selectably operable, after crimping adjacent intussuscepted organ wall portions against said crimping support element with said anastomosis ring.

9. Apparatus for intratubular intussusception and anastomosis according to claim 8, wherein said clamping means includes a coaxial pair of jaw elements having a generally disc-like configuration operatively disposed to move relative to each other and to said apparatus.

10. Apparatus for intratubular intussusception and anastomosis according to claim 8, wherein said activating means, operationally connected to said clamping means, is remotely disposed therefrom.

11. Apparatus for intratubular intussusception and anastomosis according to claim 8, wherein said surgical excising means includes a generally cylindrical cutting blade member operative axially.

12. Apparatus for intratubular intussusception and anastomosis according to claim 8, wherein said surgical excising means is operatively associated with an excising controller remotely disposed therefrom.

13. Apparatus for intratubular intussusception and anastomosis according to claim 8, wherein said apparatus includes an optical device, said optical device affixed to said apparatus, for permitting viewing of the organ being intussuscepted and anastomosed.

14. A method for intratubular intussusception and anastomosis of a hollow organ wall portion, said method includes:

a) inserting a distal end portion of an apparatus for intratubular intussusception and anastomosis a preselected distance into a hollow organ;

b) clamping a preselected portion of the hollow organ utilizing a clamping means of the intussusception and anastomosis apparatus;

c) intussuscepting the preselected organ portion by withdrawing the clamping means a preselected distance into an enclosure member;

d) disengaging an anastomosis ring from an anastomosis ring applicator member so as to crimp the intussuscepted organ portion against a crimping support element; and

e) excising the intussuscepted organ portion,

wherein said step of inserting includes a step of demountably engaging the anastomosis ring formed of a shape memory alloy to the anastomosis ring applicator member.

15. The method according to claim 14, wherein said step of demountably engaging includes a step of cooling the anastomosis ring below a first transition temperature so as to assume a plastic state thereof.

16. A method for intratubular intussusception and anastomosis of a hollow organ wall portion, said method includes:

a) inserting a distal end portion of an apparatus for intratubular intussusception and anastomosis a preselected distance into a hollow organ;

b) clamping a preselected portion of the hollow organ utilizing a clamping means of the intussusception and anastomosis apparatus;

c) intussuscepting the preselected organ portion by withdrawing the clamping means a preselected distance into an enclosure member;

d) disengaging an anastomosis ring from an anastomosis ring applicator member so as to crimp the intussuscepted organ portion against a crimping support element; and

e) excising the intussuscepted organ portion,

wherein said step of clamping a preselected portion of the hollow organ includes a step of drawing a substantially middle portion of the preselected organ portion within the clamping means.