Surgical system and method for connecting hollow tissue structures

• US 7,300,444 B1
• Filed: 11/24/2003
• Issued: 11/27/2007
• Est. Priority Date: 07/28/1999
• Status: Expired due to Term

• Current Assignee: Aesculap AG (Lonza Group AG)
• Original Assignee: Cardica Incorporated
• Inventors: Bombard, David L., Knodel, Bryan D., Bender, Theodore M., Manoux, Philipe R., White, Nathan H., Nielsen, James T., Donohoe, Brendan M.
• Primary Examiner(s): Ho; (Jackie) Tan-Uyen
• Assistant Examiner(s): RYCKMAN, MELISSA K
• Application Number:
  US10/720,618
• Time in Patent Office: 1,464 Days
• Field of Search: 606/155, 606/170, 606143-145, 606/139, 606/153, 606/184, 606/185, 227/175.1, 600/36
• US Class Current: 606/153
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• 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 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• 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 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0688 Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/1103 : Approximator
• 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
• CPC Class Codes: A61B 2017/1157 : applying the staples radially
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms

Abstract

A system for performing anastomosis between a graft vessel and a target vessel includes a tissue effector that may be configured to deploy a user-selectable number of connectors. The system includes an anvil that enters the wall of the target vessel through an entry hole that is spaced apart from the anastomosis site, and at least one anvil entry hole sealer may be utilized to substantially seal the anvil entry hole upon withdrawal of the anvil. The system may include a shield and a cutter, both of which are movable relative to the anvil, where the shield is configured to protect the graft vessel from the cutter. The cutter may include an incising element movable from a stowed position to an active position.

Claims

1. A surgical method for manipulating a graft vessel and a target vessel, comprising:

placing an end of the graft vessel against the side of the target vessel;

inserting an anvil through the side of the target vessel, wherein said anvil includes a channel defined therein;

placing a shield between the end of the graft vessel and the side of the target vessel, wherein said shield is connected to said anvil; and

moving a cutter to incise the target vessel, wherein said shield protects the graft vessel from the cutter, and wherein said cutter is connected to a member movable along at least a portion of said channel.

2. The method of claim 1, further comprising removing said shield from between the end of the graft vessel and the side of the target vessel, after said moving.

3. The method of claim 2, wherein at least a part of said shield is deformable, and wherein at least part of said shield is deformed during said removing.

4. The method of claim 1, wherein said shield is rotatable relative to said anvil.

5. The method of claim 1, wherein said shield includes an aperture defined therein, said aperture substantially aligned with said channel.

6. The method of claim 5, wherein said aperture receives at least part of said cutter during said moving.

7. The method of claim 1, wherein the proximal end of said shield is connected to said anvil, and wherein the distal end of said shield is free.

8. The method of claim 7, further comprising biasing said free end of said shield away from said anvil.

9. The method of claim 1, wherein said inserting and said placing are performed substantially simultaneously.

10. The method of claim 1, wherein said shield is out of contact with said cutter during said moving.

11. A surgical method for manipulating a graft vessel and a target vessel, comprising:

placing an end of the graft vessel against the side of the target vessel;

placing a shield between the end of the graft vessel and the side of the target vessel;

moving a cutter to incise the target vessel, wherein said shield protects the graft vessel from the cutter;

removing said shield from between the end of the graft vessel and the side of the target vessel, after said moving wherein at least a part of said shield is deformed during said removing.

12. The method of claim 11, further comprising inserting an anvil through the side of the target vessel, wherein said shield is connected to said during said inserting.