Method of performing anastomosis

• US 7,699,859 B2
• Filed: 11/12/2004
• Issued: 04/20/2010
• Est. Priority Date: 07/28/1999
• Status: Active Grant

• Current Assignee: Aesculap AG (B. Braun Holding GmbH & Co. KG)
• Original Assignee: Cardica Incorporated
• Inventors: Bombard, David L., Knodel, Bryan D., Yencho, Stephen A., Bender, Theodore M., Hausen, Bernard A., Manoux, Philipe R., Vargas, Jaime S., Chang, Tenny, White, Nathan H., Nielsen, James T., Donohoe, Brendan M.
• Primary Examiner(s): Manahan; Todd E
• Assistant Examiner(s): Mendoza; Michael G
• Application Number:
  US10/988,325
• Publication Number:
  US 20050075657A1
• Time in Patent Office: 1,985 Days
• Field of Search: 606/139, 606/153, 227/180.1
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/1152 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• 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 Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2090/037 with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61F 2/064 with special features to facilitate anastomotic coupling anastomosis of natural blood vessels A61B17/11

Abstract

A method for anastomosing a first vessel to a second vessel may include connecting an end of the first vessel to the side of the second vessel and creating an opening in the wall of the second vessel from within the lumen of the second vessel, where that opening allows fluid communication between the lumen of the first vessel and the lumen of the second vessel.

Claims

1. A method for end-to-side anastomosis of a first vessel to a second vessel, each vessel having a wall surrounding a lumen, comprising:

providing a cutter and placing said cutter inside the lumen of the second vessel;

connecting an end of the first vessel to the side of the second vessel to form a generally I-shaped junction; and

creating only one opening in the wall of the second vessel with said cutter, said creating performed by moving said cutter upward into, longitudinally along, and then downward out of the wall of the second vessel only after said placing said cutter inside the lumen of the second vessel, wherein the opening allows fluid communication between the lumen of the first vessel and the lumen of the second vessel.

2. The method of claim 1, wherein said connecting is performed before said creating.

3. The method of claim 1, wherein at least part of said connecting is performed simultaneously with at least part of said creating.

4. The method of claim 1, further comprising providing a cutter;

wherein said creating includes moving said cutter relative to the wall of the second vessel.

5. The method of claim 4, wherein said cutter includes a projection extending therefrom, and wherein said moving causes said projection to engage the wall of the second vessel.

6. The method of claim 5, wherein said moving includes sliding.

7. The method of claim 4, further comprising

providing an anvil;

and

inserting at least part of said anvil through the wall of the second vessel into the lumen of the target vessel, wherein said moving is performed relative to said anvil.

8. The method of claim 7, wherein said anvil includes a channel defined therein, and wherein said moving includes moving said cutter along said channel.

9. The method of claim 1, wherein said connecting includes deploying a plurality of connectors through an end of the first vessel and into the wall of the second vessel.

10. The method of claim 9, wherein said connectors are staples.

11. The method of claim 9, wherein said deploying includes deploying at least one said connector at a different time than at least one other connector.

12. The method of claim 9, further comprising, before said connecting,

making at least one incision at one end of the first vessel to create at least one flap;

and

placing each flap against the outer surface of the wall of the second vessel.

13. A method for end-to-side anastomosis of a first vessel to a second vessel, each vessel having a wall surrounding a lumen, comprising:

connecting an end of the first vessel to the side of the second vessel to form a generally T-shaped junction;

providing a cutter;

moving at least part of said cutter into the lumen of the second vessel; and

actuating said cutter only after said moving at least part of said cutter into the lumen of the second vessel;

wherein said actuating said cutter creates only a single opening in the second vessel with said cutter by moving said cutter upward into, longitudinally along, and then downward out of the wall of the second vessel, whereby said actuating brings the lumen of the first vessel and the lumen of the second vessel into fluid communication.

14. The method of claim 13, wherein said cutter includes a projection extending therefrom, and wherein said moving causes said projection to engage the wall of the second vessel.

15. The method of claim 14, wherein said moving includes sliding.

16. The method of claim 14, wherein said projection has a sharp edge configured to engage the wall of the second vessel.

17. The method of claim 14, wherein said actuating including flexing at least part of said cutter.

18. The method of claim 13, further comprising

providing an anvil;

and

inserting at least part of said anvil through the wall of the second vessel into the lumen of the second vessel, wherein said moving is performed relative to said anvil.

19. The method of claim 18, wherein said anvil includes a channel defined therein, and wherein said moving includes moving said cutter along said channel.

20. A method for anastomosing a graft vessel to a target vessel, each vessel having a wall surrounding a lumen, comprising:

providing a cutter and placing said cutter inside the lumen of the second vessel;

securing an end of the graft vessel to a first location on the side of the target vessel, wherein the end of the graft vessel encloses a perimeter on the side of the target vessel at said first location; and

creating, with said cutter, only a single passage in the wall of the target vessel at said first location and within said perimeter, said creating performed from inside the target vessel only after said placing said cutter inside the lumen of the second vessel by moving said cutter upward into, longitudinally along, and then downward out of the wall of the second vessel, wherein said creating brings the lumen of the first vessel and the lumen of the second vessel into fluid communication through the passage.

21. The method of claim 20, further comprising providing a cutter and placing at least part of said cutter in the lumen of the target vessel;

wherein said creating includes moving said cutter.

22. The method of claim 21, wherein said moving includes sliding.

23. The method of claim 21, wherein said cutter includes a projection extending therefrom, and wherein said moving causes said projection to engage the wall of the second vessel.

24. The method of claim 23, wherein said projection has a sharp edge configured to engage the wall of the second vessel.

25. The method of claim 21, wherein said actuating including flexing at least part of said cutter.

26. The method of claim 21, further comprising

providing an anvil;

and

inserting at least part of said anvil through the wall of the target vessel into the lumen of the target vessel, wherein said moving is performed relative to said anvil.

27. The method of claim 26, wherein said anvil includes a channel defined therein, and wherein said moving includes moving said cutter along said channel.

28. The method of claim 26, further comprising penetrating the wall of the target vessel with said anvil at a second location spaced apart from said first location.

29. The method of claim 28, wherein the distal end of said anvil is sharp, and wherein said penetrating comprises pushing said sharp distal end of said anvil through intact tissue of the wall of the target vessel.