Method for end-to-end anastomosis

• US 7,347,864 B2
• Filed: 05/20/2005
• Issued: 03/25/2008
• Est. Priority Date: 02/26/2002
• Status: Expired due to Fees

• Current Assignee: Aesculap AG (B. Braun Holding GmbH & Co. KG)
• Original Assignee: Cardica Incorporated
• Inventors: Vargas, Jaime S.
• Primary Examiner(s): Woo; Julian W.
• Application Number:
  US11/133,621
• Publication Number:
  US 20050251179A1
• Time in Patent Office: 1,040 Days
• Field of Search: 606/153, 606/151, 606/157, 606/158, 606215-217, 606219-221, 606/213, 606/152, 227/175.1, 227/179.1, 227/180.1, 128/898, 623/23.64
• US Class Current: 606/153
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• 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 17/1152 applying the staples on the outside of the lumen
• 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 2017/1132 End-to-end connections
• CPC Class Codes: A61B 2017/2911 rings

Abstract

A method for performing anastomosis connects two tissue structures, such as blood vessels, end-to-end. At least two flaps may be created at the end of each tissue structure. Each flap of one tissue structure may be brought into contact with a corresponding flap of the other tissue structure. The corresponding flaps may be connected, such as by deploying one or more connectors therethrough.

Claims

1. A method for performing end-to-end anastomosis between a first tissue structure and a second tissue structure, comprising:

making at least two incisions extending from the edge at the end of each tissue structure, each in a generally longitudinal direction;

wherein said making creates at least two flaps at the end of each tissue structure;

bringing each flap of the first tissue structure into contact with a corresponding flap of the second tissue structure; and

connecting each flap of the first tissue structure to a corresponding flap of the second tissue structure.

2. The method of claim 1, further comprising selecting an interface dimension;

wherein said creating is based on said interface dimension.

3. The method of claim 1, wherein said connecting comprises deploying at least one connector through each pair of corresponding flaps.

4. The method of claim 3, wherein at least one said connector is a staple.

5. The method of claim 1, further comprising holding each flap of the first tissue structure on a first clamp and holding each flap of the second tissue structure on a second clamp.

6. The method of claim 5, wherein said bringing includes moving at least one of said first clamp and said second clamp toward the other.

7. The method of claim 5, further comprising holding at least one flap on the corresponding said clamp with a clip connected to said clamp.

8. The method of claim 1, further comprising cutting away excess flap tissue after said connecting.

9. A method for performing end-to-end anastomosis between a first tissue structure and a second tissue structure, comprising:

cutting an end of the first tissue structure at an angle to its longitudinal centerline, wherein the resultant cut has a length;

cutting an end of the second tissue structure at an angle to its longitudinal centerline, wherein the resultant cut has a length substantially equal to the length of the cut in the first tissue structure;

making at least two incisions extending from the edge at the end of each tissue structure, each in a generally longitudinal direction;

wherein said making creates at least two flaps in an end of each tissue structure; and

bringing the cut ends of the first tissue structure and the second tissue structure together, wherein said bringing moves each flap of the first tissue structure into contact with a corresponding flap of the second tissue structure.

10. The method of claim 9, wherein said length is a predetermined interface length.

11. The method of claim 9, further comprising measuring said length with a tissue preparation device.

12. The method of claim 11, wherein said tissue preparation device includes a pin and a measuring feature spaced apart from said pin a distance substantially equal to said length, and wherein said measuring includes placing the tissue structure between said pin and said measuring feature and moving the tissue structure relative to said pin and said measuring feature until one side of the tissue structure contacts said pin and the opposite side of the tissue structure contacts said measuring feature.

13. The method of claim 9, further comprising deploying at least one connector through each pair of corresponding flaps.

14. A method for connecting an end of a first tissue structure to an end of a second tissue structure, comprising:

providing a tool;

making two generally longitudinal incisions extending from the edge of an end of each tissue structure, the incisions substantially one hundred and eighty degrees apart from one another with regard to the circumference of the tissue structure, resulting in two flaps at an end of each tissue structure;

holding each flap with said tool; and

actuating said tool with a single motion, said single motion both bringing the flaps of the first tissue structure into contact with the flaps of the second tissue structure and connecting the flaps of the first tissue structure to the flaps of the second tissue structure.

15. The method of claim 14, wherein said tool includes at least one clip, and wherein said holding includes holding at least one flap with said clip.

16. The method of claim 14, wherein said connecting is performed by stapling together flaps in contact with one another.

17. The method of claim 14, further comprising cutting an end of each tissue structure at an angle to its longitudinal centerline, wherein each cut has substantially the same length.