Resection and anastomosis devices and methods

• US 7,141,055 B2
• Filed: 04/24/2003
• Issued: 11/28/2006
• Est. Priority Date: 04/24/2002
• Status: Expired due to Fees

• Current Assignee: Surgical Connections, Inc.
• Original Assignee: Surgical Connections, Inc.
• Inventors: Robinson, Paul J., Abrams, Jerome H., Hovland, Claire T.
• Primary Examiner(s): Hayes, Michael J.
• Assistant Examiner(s): Mendoza, Michael G.
• Application Number:
  US10/422,598
• Publication Number:
  US 20040092960A1
• Time in Patent Office: 1,314 Days
• Field of Search: 606/110, 606/115, 606/139, 606/213, 606/219, 600201-246
• US Class Current: 606/115
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• 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 17/1285 for minimally invasive surgery
• 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 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/306 holding by means of suction

Abstract

According to embodiments of the invention, an apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure includes a first vacuum section adapted to apply vacuum force to and hold the healthy portion, and a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section.

Claims

1. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the first vacuum section and the second vacuum section are adapted for placement along a longitudinal direction of the anatomical structure, further wherein the second vacuum section defines a plurality of vacuum apertures disposed relative to each other along the longitudinal direction.

2. The apparatus of claim 1, wherein the second vacuum section is adapted to draw the diseased portion into contact with the second vacuum section and to withdraw the diseased portion within the healthy portion.

3. The apparatus of claim 1, wherein the healthy portion is a first healthy portion;

the apparatus further comprising a third vacuum section operably coupled with the first vacuum section and the second vacuum section, the third vacuum section being adapted to apply vacuum force to and hold a second healthy portion of the anatomical structure disposed on an opposite side of the diseased portion relative to the first healthy portion.

4. The apparatus of claim 1, further comprising a stapling device adapted to staple the anatomical structure and a cutting device adapted to cut the anatomical structure, the stapling device and the cutting device being operably coupled with the first vacuum section and the second vacuum section.

5. The apparatus of claim 1, wherein the first vacuum section and the second vacuum section are fluidly coupled with a common vacuum source.

6. The apparatus of claim 1, wherein the first vacuum section defines a first diameter and the second vacuum section defines a second diameter, the second diameter being less than about 60% of the first diameter.

7. The apparatus of claim 6, wherein the second diameter is less than about 40% of the first diameter.

8. The apparatus of claim 6, wherein the second diameter is less than about 20% of the first diameter.

9. The apparatus of claim 1, wherein the first vacuum section defines a plurality of vacuum apertures disposed relative to each other along the longitudinal direction.

10. The apparatus of claim 1, wherein the first vacuum section is adapted to hold the healthy portion against movement while the second vacuum section is withdrawn within the first vacuum section.

11. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the healthy portion is a first healthy portion;

the apparatus further comprising a third vacuum section operably coupled with the first vacuum section and the second vacuum section, the third vacuum section being adapted to apply vacuum force to and hold a second healthy portion of the anatomical structure disposed on an opposite side of the diseased portion relative to the first healthy portion;

wherein the third vacuum section is attached to the second vacuum section for movement therewith with respect to the first vacuum section.

12. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the healthy portion is a first healthy portion;

the apparatus further comprising a third vacuum section operably coupled with the first vacuum section and the second vacuum section, the third vacuum section being adapted to apply vacuum force to and hold a second healthy portion of the anatomical structure disposed on an opposite side of the diseased portion relative to the first healthy portion;

wherein the third vacuum section comprises a cutting blade adapted to cut away the diseased portion.

13. The apparatus of claim 12, further comprising a cutting actuator for actuating the cutting blade, the cutting actuator being disposed within the second vacuum section.

14. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the healthy portion is a first healthy portion;

the apparatus further comprising a third vacuum section operably coupled with the first vacuum section and the second vacuum section, the third vacuum section being adapted to apply vacuum force to and hold a second healthy portion of the anatomical structure disposed on an opposite side of the diseased portion relative to the first healthy portion;

wherein the third vacuum section comprises a stapling device adapted to fire at least one staple into the anatomical structure.

15. The apparatus of claim 14, further comprising a stapling actuator for actuating the stapling device, the stapling actuator being disposed within the second vacuum section.

16. The apparatus of claim 14, wherein the first vacuum section defines an anvil disposed to act as a backstop for the at least one staple fired by the stapling device.

17. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the healthy portion is a first healthy portion;

the apparatus further comprising a third vacuum section operably coupled with the first vacuum section and the second vacuum section, the third vacuum section being adapted to apply vacuum force to and hold a second healthy portion of the anatomical structure disposed on an opposite side of the diseased portion relative to the first healthy portion;

wherein the third vacuum section comprises an internal wall, the second vacuum section being supported by the internal wall.

18. The apparatus of claim 17, wherein the internal wall defines vacuum apertures therethrough, the vacuum apertures being adapted to transmit vacuum force in the second vacuum section through the internal wall.

19. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the first vacuum section is adapted to expand and contract with respect to the anatomical structure.

20. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion;

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

a stapling device adapted to staple the anatomical structure and a cutting device adapted to cut the anatomical structure, the stapling device and the cutting device being operably coupled with the first vacuum section and the second vacuum section; and

a support adapted for movement with the second vacuum section with respect to the first vacuum section, the support holding one or both of the stapling device and the cutting device.

21. Apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure, the apparatus comprising:

a first vacuum section adapted to apply vacuum force to and hold the healthy portion; and

a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section;

wherein the first vacuum section and the second vacuum section are fluidly coupled with a common vacuum source; and

wherein the vacuum source is adapted to create a vacuum force within the first vacuum section, further wherein the apparatus is adapted to transmit the vacuum force from the first vacuum section to the second vacuum section.

22. Resection apparatus for use with anatomical tissue, the apparatus comprising:

a proximal portion;

a distal portion operably coupled with the proximal portion;

an intermediate portion operably coupled with the proximal portion and the distal portion, the intermediate portion being adapted for movement within the proximal portion, the intermediate portion further being adapted to apply suction to attract anatomical tissue;

a cutting device adapted to cut anatomical tissue, the cutting device being supported by either the proximal portion or the distal portion; and

a stapling device adapted to staple anatomical tissue, the stapling device being supported by either the proximal portion or the distal portion;

wherein at least one of the proximal portion and the distal portion are adapted to apply suction to attract anatomical tissue;

wherein both the proximal portion and the distal portion are adapted to apply suction to attract anatomical tissue.

23. The apparatus of claim 22, wherein the intermediate portion supports the distal portion for movement therewith.

24. The apparatus of claim 23, wherein the distal portion comprises an internal support adapted to receive the intermediate portion;

further wherein the distal portion is adapted to apply suction on opposite sides of the internal support to attract anatomical tissue.

25. The apparatus of claim 22, wherein the proximal portion comprises an O-ring for providing a fluid seal relative to the intermediate portion.

26. The apparatus of claim 22, further comprising one or more collars adapted to hold the anatomical tissue with respect to the intermediate portion.

27. The apparatus of claim 26, wherein the one or more collars are adapted to move within the proximal portion as the intermediate portion moves within the proximal portion.

28. Device for moving anatomical tissue, the device comprising:

a proximal portion defining an interior adapted to receive involuted anatomical tissue;

a distal portion operably coupled with the proximal portion, the distal portion being supported for movement with respect to the proximal portion, the distal portion defining an interior adapted to receive involuted anatomical tissue; and

movement structure adapted to move anatomical tissue into the interior of the proximal portion and into the interior of the distal portion, the movement structure also being adapted to cause involution of the anatomical tissue in the interior of the proximal portion and in the interior of the distal portion;

wherein the proximal portion and the distal portion are adapted to be disconnected;

further wherein the proximal portion comprises structure for receiving the distal portion such that connection of the distal portion to the proximal portion initiates or allows involution of the anatomical tissue into the distal portion.

29. The device of claim 28, wherein the movement structure comprises vacuum apertures defined in the proximal portion and in the distal portion, the vacuum apertures being directed to the interior of the proximal portion and to the interior of the distal portion, respectively, the vacuum apertures being fluidly coupled with at least one vacuum source.

30. The device of claim 28, further comprising a fastening device, supported by one of the proximal portion and the distal portion, for fastening anatomical tissue.

31. The device of claim 30, further comprising a cutting device, supported by one of the proximal portion and the distal portion, for cutting the involuted anatomical tissue.

32. The device of claim 28, wherein the volume of the interior of the distal portion into which anatomical tissue can be moved is different than the volume of the interior of the proximal portion into which anatomical tissue can be moved.

33. Device for moving anatomical tissue, the device comprising:

a proximal portion defining an interior adapted to receive involuted anatomical tissue;

a distal portion operably coupled with the proximal portion, the distal portion being supported for movement with respect to the proximal portion, the distal portion defining an interior adapted to receive involuted anatomical tissue; and

movement structure adapted to move anatomical tissue into the interior of the proximal portion and into the interior of the distal portion, the movement structure also being adapted to cause involution of the anatomical tissue in the interior of the proximal portion and in the interior of the distal portion;

wherein the movement structure comprises vacuum apertures defined in the proximal portion and in the distal portion, the vacuum apertures being directed to the interior of the proximal portion and to the interior of the distal portion, respectively, the vacuum apertures being fluidly coupled with at least one vacuum source;

wherein the vacuum apertures are directed to both the interior and the exterior of the proximal portion and the distal portion.

34. Device for moving anatomical tissue, the device comprising:

a proximal portion defining an interior adapted to receive involuted anatomical tissue;

a distal portion operably coupled with the proximal portion, the distal portion being supported for movement with respect to the proximal portion, the distal portion defining an interior adapted to receive involuted anatomical tissue; and

movement structure adapted to move anatomical tissue into the interior of the proximal portion and into the interior of the distal portion, the movement structure also being adapted to cause involution of the anatomical tissue in the interior of the proximal portion and in the interior of the distal portion;

wherein the movement structure comprises at least one vacuum source and defines vacuum apertures fluidly coupled with the vacuum source, the vacuum apertures being defined in at least one of the proximal portion and distal portion;

further wherein the movement structure defines a longitudinal opening in said at least one portion through which anatomical tissue moves into the interior of said at least one portion;

further wherein a total cross-sectional area defined by the vacuum apertures of said at least one portion exceeds a total cross-sectional area of the longitudinal opening defined by said at least one portion such that total vacuum force per unit area applied to the tissue by said at least one portion is sufficient to hold anatomical tissue against the outer circumference of said at least one portion without allowing that anatomical tissue to be pulled into said at least one portion as tissue involution occurs.

35. Device for moving anatomical tissue, the device comprising:

a proximal portion defining an interior adapted to receive involuted anatomical tissue;

a distal portion operably coupled with the proximal portion, the distal portion being supported for movement with respect to the proximal portion, the distal portion defining an interior adapted to receive involuted anatomical tissue; and

movement structure adapted to move anatomical tissue into the interior of the proximal portion and into the interior of the distal portion, the movement structure also being adapted to cause involution of the anatomical tissue in the interior of the proximal portion and in the interior of the distal portion;

wherein the movement structure comprises at least one vacuum source fluidly coupled with the proximal portion and the distal portion for applying vacuum force;

further wherein the amount of vacuum force applied to the proximal portion and to the distal portion can be controlled individually.

36. The device of claim 35, wherein the movement structure comprises a control knob operably coupled with the vacuum source to individually control the amount of vacuum force applied to the proximal portion and to the distal portion.

37. Apparatus for insertion into anatomical tissue, the apparatus comprising:

a proximal portion;

a distal portion adapted for movement relative to the proximal portion;

at least one vacuum source fluidly coupled with the proximal portion and the distal portion, the at least one vacuum source being adapted to apply vacuum force to the proximal portion and the distal portion to draw anatomical tissue toward the proximal portion and distal portion, respectively; and

a controller operably coupled with the at least one vacuum source to adjust the balance of vacuum force applied by the at least one vacuum source between the proximal portion and the distal portion, to favor anatomical tissue movement toward either the proximal portion or distal portion.

38. The apparatus of claim 37, wherein both the proximal portion and the distal portion are adapted to receive involuted anatomical tissue therewithin in response to the application of vacuum force.

39. A method of holding anatomical structure, comprising:

inserting a first holding device into anatomical structure to be held;

involuting the anatomical structure within the first holding device by applying vacuum to the anatomical structure through the first holding device such that the first holding device holds the anatomical structure;

connecting a disconnected second holding device to the first holding device, the second holding device being adapted to hold the anatomical structure;

applying vacuum to the second holding device via the first holding device;

involuting the anatomical structure within the second holding device; and

moving the first holding device and the second holding device toward each other to join the anatomical structure held by the first holding device with the anatomical structure held by the second holding device.

40. The method of claim 39, further comprising tying the anatomical structure to the second holding device before the moving.