Method and apparatus for performing anastomosis with eversion of tissue edges and joining of exposed intima of the everted tissue
First Claim
1. An apparatus for preparing a first organ having an orifice for anastomosis with a second organ, by installing at the orifice a ring consisting of a malleable ring portion, sized to extend around the orifice, and docking members and malleable tines extending out from the ring portion, said apparatus comprising:
- a ring-mounting assembly configured to releasably mount the ring;
an anvil extending transversely across a distal end of an anvil stem;
an anvil mounting assembly configured to releasably mount the anvil in such a position that the anvil can be advanced into the first organ; and
a cam-driven assembly comprising a cam element having cam tracks and configured to advance the anvil mounting assembly toward the anvil, after the anvil has been positioned in the first organ and the ring has been positioned so that the ring portion extends around the orifice, to cause tips of the tines to pierce tissue of the first organ around the orifice and then to advance into engagement with the anvil, and to then continue to advance the ring toward the anvil thereby causing the tines to curl against the anvil after piercing the tissue around the orifice so as to evert said tissue around the orifice.
6 Assignments
0 Petitions
Accused Products
Abstract
A ring for use in anastomosis. Preferably, the ring is integrally formed from metal, and includes a ring portion and tines and docking members that extend from the ring portion. The ring portion and tines are malleable, and preferably also the docking members are malleable. The ring portion and tines are malleable in the sense that once deformed from a first shape into a second shape, they will not relax back into the first shape from the second. To install the ring in a vessel with the ring portion extending around an incision or other orifice, the tines pierce the tissue around the orifice and are curled against an anvil. The action of curling the tines inverts the tissue near the orifice edges to expose the inside surface of the vessel or organ. Other aspects of the invention are a method and apparatus for installing an anastomosis ring in an incision or other orifice in a vessel or other organ, a method and apparatus for precisely aligning two anastomosis rings (each installed in an incision or other orifice of a different organ) and fastening the aligned rings together. The clips can be crimped onto the aligned rings, or they can be spring clips which are sprung onto the aligned rings to clamp the rings together by spring force. Also within the scope of the invention are crimping and spring clips for use in listening together two aligned anastomosis rings. In other embodiments, the invention is a method for performing an anastomosis by installing an anastomosis ring in an orifice in an organ, installing another anastomosis ring in an orifice in another organ, precisely aligning the two installed anastomosis rings, and fastening the aligned rings together.
133 Citations
13 Claims
-
1. An apparatus for preparing a first organ having an orifice for anastomosis with a second organ, by installing at the orifice a ring consisting of a malleable ring portion, sized to extend around the orifice, and docking members and malleable tines extending out from the ring portion, said apparatus comprising:
-
a ring-mounting assembly configured to releasably mount the ring; an anvil extending transversely across a distal end of an anvil stem; an anvil mounting assembly configured to releasably mount the anvil in such a position that the anvil can be advanced into the first organ; and a cam-driven assembly comprising a cam element having cam tracks and configured to advance the anvil mounting assembly toward the anvil, after the anvil has been positioned in the first organ and the ring has been positioned so that the ring portion extends around the orifice, to cause tips of the tines to pierce tissue of the first organ around the orifice and then to advance into engagement with the anvil, and to then continue to advance the ring toward the anvil thereby causing the tines to curl against the anvil after piercing the tissue around the orifice so as to evert said tissue around the orifice. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
-
-
12. An apparatus for preparing a first organ having an orifice for anastomosis with a second organ, by installing at the orifice a ring consisting of a malleable ring portion, sized to extend around the orifice, and docking members and malleable tines extending out from the ring portion, said apparatus comprising:
-
an anvil extending transversely across a distal end of an anvil stem; a ring-mounting assembly configured to releasably mount the ring; an anvil mounting assembly configured to releasably mount the anvil in such a position that the anvil can be advanced into the first organ; and a cam-driven assembly including cam tracks and configured to advance the anvil mounting assembly toward the anvil, after the anvil has been positioned in the first organ and the ring has been positioned so that the ring portion extends around the orifice, to cause tips of the tines to pierce tissue of the first organ around the orifice and then to advance into engagement with the anvil, to then continue to advance the ring toward the anvil thereby causing the tines to curl against the anvil after piercing the tissue around the orifice so as to evert said tissue around the orifice, and to advance the anvil distally away from the ring after the tines of said ring have been curled against the anvil, before the ring portion is spread.
-
-
13. An apparatus for preparing a first organ having an orifice for anastomosis with a second organ, by installing at the orifice a ring consisting of a malleable ring portion, sized to extend around the orifice, and docking members and malleable tines extending out from the ring portion, said apparatus comprising:
-
a ring-mounting assembly configured to releasably mount the ring; an anvil mounting assembly configured to releasably mount an anvil in such a position that the anvil can be advanced into the first organ; and a cam-driven assembly configured to advance the anvil mounting assembly toward the anvil, after the anvil has been positioned in the first organ and the ring has been positioned so that the ring portion extends around the orifice, to cause tips of the tines to pierce tissue of the first organ around the orifice and then to advance into engagement with the anvil, and to then continue to advance the ring toward the anvil thereby causing the tines to curl against the anvil after piercing the tissue around the orifice so as to evert said tissue around the orifice;
wherein the apparatus also includes a housing in which the cam-driven assembly is mounted, and wherein said cam-driven assembly includes;
a trigger assembly;
a set of cam followers;
a cam element defining cam tracks, wherein the cam followers are engaged with the cam tracks and the cam element is coupled to the trigger assembly such that actuation of the trigger assembly moves the cam element relative to the cam follower to cause said cam followers to move relative to the housing; andelements coupled between the cam followers and the ring-mounting assembly, wherein the elements are configured to respond to motion of the cam followers to complete timed, programmed, forceful actions of the ring;
wherein said elements include spreading pins having free ends that are configured to be releasably engaged with said ring, and wherein the cam-driven assembly is configured to respond to motion of at least one of the cam followers by causing the spreading pins to advance the ring toward the anvil, moving at least one of the spreading pins away from at least one other of the spreading pins to spread the ring portion, and then causing the spreading pins to retract away from the ring and the anvil.
-
Specification