Mechanical anastomosis system for hollow structures

• US 7,666,198 B2
• Filed: 03/22/2004
• Issued: 02/23/2010
• Est. Priority Date: 10/24/1997
• Status: Expired due to Fees

• Current Assignee: Innovative Interventional Technologies BV
• Original Assignee: Innovative Interventional Technologies BV
• Inventors: Suyker, Wilhelmus Joseph Leonardus, Suyker, Paulus Thomas Wilhelmus
• Primary Examiner(s): Woo; Julian W
• Assistant Examiner(s): DANG, PHONG SON H
• Application Number:
  US10/805,714
• Publication Number:
  US 20040215221A1
• Time in Patent Office: 2,164 Days
• Field of Search: 606153-155, 623/1.36
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• 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 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• 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 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: Y10S 227/901 Surgical clip appliers
• CPC Class Codes: Y10S 227/902 Surgical clips or staples

Abstract

A system for making anastomoses between hollow structures by mechanical means is provided with a device in the shape of an annular or tubular element comprising circumferentially provided means, such as pin-shaped elements, for joining the abutting walls of the hollow structures together. An applicator is intended for moving said annular or tubular element in position and activating the joining means thereof, so as to make the anastomosis. Possibly, intraluminal joining means can be inserted without using an annular or tubular element.

Claims

1. An applicator for use in a system including joining elements for making an anastomosis between hollow structures, said applicator comprising:

a head provided with a plurality of arms connected thereto, each said arm having a proximal end and a distal end, and wherein each said arm is movable from a first position at which the distal ends of the arms are separated by a first distance, to a second position, at which the distal ends of said arms are separated by a second distance, the second distance being greater than the first distance; and

a shank-like element comprising a part located proximal to a distal end of said shank-like element for causing movement of the arms from the first position toward the second position, said shank-like element being associated with said head such that movement of one of said shank-like element and said bead relative to the other of said shank-like element and said head, causes said arms to move from said first position toward said second position, and

wherein the distal ends of the arms are adapted to support at least a portion of said hollow structures and hold said joining elements while positioning at least one said hollow structure relative to said joining elements for making an anastomosis between the hollow structures, and said positioning of said hollow structures is accomplished by moving said arms from said first position to said second position.

2. The applicator according to claim 1, wherein a proximal portion of each said arm is attached to an attachment member.

3. The applicator according to claim 2, wherein at locations of attachment of said arms to said attachment member, said arms are arranged around a portion of said shank-like element such that relative movement of said head and said shank-like element expand the arms radially outwardly, relative to an axis of said shank-like element.

4. The applicator according to claim 3, wherein said arms expand from said first position to said second position by deformation.

5. The applicator according to claim 1, wherein the part proximal to the distal end of the shank-like element comprises a surface portion in engagement with each said arm such that relative movement between the shank-like element and the head results in movement of the arms from the first position toward the second position.

6. The applicator according to claim 5, wherein the arms move from the first position to the second position by deformation.

7. The applicator according to claim 1, wherein said applicator further comprises a detainer for controlling movement of said joining elements.

8. The applicator according to claim 7, wherein the detainer comprises a plurality of surface portions positioned to engage surface portions of said joining elements to thereby limit the movement of said joining elements relative to the detainer.

9. The applicator according to claim 7, wherein said detainer is axially movable relative to said arms.

10. The applicator according to claim 9, wherein said detainer is associated with said arms such that axial movement of said detainer results in positioning of said joining elements for making an anastomosis by engagement between a surface of each said joining element and a surface of each said arm.

11. The applicator according to claim 10, wherein said surface portions of said arms which engage said joining elements are arranged such that said joining elements deform towards a joining position as said detainer is moved axially relative to said arms.

12. The applicator according to claim 10, wherein said surface portions of said detainer are arranged such that said joining elements can become disengaged from said detainer when said joining elements are in the joining position.

13. The applicator according to claim 7, further comprising a plurality of surface portions positioned to limit the extent of movement of said arms.

14. The applicator according to claim 13, wherein said surface portions positioned to limit the extent of movement of said arms form part of said detainer.

15. The applicator according to claim 13, wherein said surface portions positioned to limit the extent of movement of said arms form part of said head.

16. The applicator according to claim 1, wherein the first distance of separation between said arms is less than a distance of separation between the proximal ends of said arms when said arms are in the first position.

17. An applicator for use in a system including joining elements for making an anastomosis between hollow structures, said applicator comprising:

a head provided with a plurality of arms connected thereto, each said arm having a proximal end and a distal end, and wherein each said arm is movable from a first position at which the distal ends of the arms are separated by a first distance, to a second position, at which the distal ends of said arms are separated by a second distance, the second distance being greater than the first distance; and

a shank-like element associated with said head such that movement of one of said shank-like element and said head relative to the other of said shank-like element and said head, causes said arms to move from said first position toward said second position;

a detainer axially movable relative to said arms for controlling movement of said joining elements; and

wherein the distal ends of the arms are adapted to support at least a portion of said hollow structures and hold said joining elements while positioning at least one said hollow structure relative to said joining elements for making an anastomosis between the hollow structures, and said positioning of said hollow structures is accomplished by moving said arms from said first position to said second position.

18. The applicator according to claim 17, wherein said detainer is associated with said arms such that axial movement of said detainer results in positioning of said joining elements for making an anastomosis by engagement between a surface of each said joining element and a surface of each said arm.

19. The applicator according to claim 18, wherein said surface portions of said arms which engage said joining elements are arranged such that said joining elements deform towards a joining position as said detainer is moved axially relative to said arms.

20. The applicator according to claim 18, wherein said surface portions of said detainer are arranged such that said joining elements can become disengaged from said detainer when said joining elements are in the joining position.

21. The applicator according to claim 17, wherein the detainer comprises a plurality of surface portions positioned to engage surface portions of said joining elements to thereby limit the movement of said joining elements relative to the detainer.

22. The applicator according to claim 17, wherein a proximal portion of each said arm is attached to an attachment member.

23. The applicator according to claim 22, wherein at locations of attachment of said arms to said attachment member, said arms are arranged around a portion of said shank-like element such that relative movement of said head and said shank-like element expand the arms radially outwardly, relative to an axis of said shank-like element.

24. The applicator according to claim 23, wherein said arms expand from said first position to said second position by deformation.

25. The applicator according to claim 17, wherein the part proximal to the distal end of the shank-like element comprises a surface portion in engagement with each said arm such that relative movement between the shank-like element and the head results in movement of the arms from the first position toward the second position.

26. The applicator according to claim 25, wherein the arms move from the first position to the second position by deformation.

27. The applicator according to claim 17, further comprising a plurality of surface portions positioned to limit the extent of movement of said arms.

28. The applicator according to claim 27, wherein said surface portions positioned to limit the extent of movement of said arms form part of said detainer.

29. The applicator according to claim 27, wherein said surface portions positioned to limit the extent of movement of said arms form part of said head.

30. An applicator for use in a system including joining elements for making an anastomosis between hollow structures, said applicator comprising:

a head provided with a plurality of arms connected thereto, each said arm having a proximal end and a distal end, and wherein each said arm is movable from a first position at which the distal ends of the arms are separated by a first distance, to a second position, at which the distal ends of said arms are separated by a second distance, the second distance being greater than the first distance; and

a shank-like element associated with said head such that movement of one of said shank-like element and said head relative to the other of said shank-like element and said head, causes said arms to move from said first position toward said second position;

a detainer for controlling movement of said joining elements and including a plurality of surface portions positioned to limit the extent of movement of said arms; and

wherein the distal ends of the arms are adapted to support at least a portion of said hollow structures and hold said joining elements while positioning at least one said hollow structure relative to said joining elements for making an anastomosis between the hollow structures, and said positioning of said hollow structures is accomplished by moving said arms from said first position to said second position.