Anastomosis apparatus and methods
First Claim
1. A method of anastomosing a first tubular structure having an end portion to a second tubular structure having an opening formed therein where at least one of the structures comprises tissue, the method comprising:
- prior to placing the first tubular structure into the opening of the second tubular structure;
everting the end portion of the first tubular structure over a distal end of each of a plurality of arms provided with a support device,distally advancing a piercing member from within each of the arms to piece the first tubular structure and secure the first tubular structure to the support device;
introducing the distal end of the arms into the opening;
radially expanding the arms from a first state to a second state so that a portion of the first tubular structure is forced against a region of the second tubular structure that surrounds the opening;
passing a plurality of fasteners through the tubular structures in the vicinity of the opening to secure the tubular structures together; and
removing the support device from the tubular structures.
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Abstract
A system for anastomosing a first tubular structure to a second tubular structure having an opening formed therein comprises a support device having a plurality of arms forming spaces therebetween. The support device is adapted to support the first tubular structure within an opening in the second tubular structure to facilitate anastomosing the tubular structures together. The arms can be configured to urge the first tubular structure against the portion of the second tubular structure surrounding the opening to form a seal therebetween. According to one embodiment, a plurality of discrete fasteners are provided to pass through the support device spaces and the first and second tubular structures.
541 Citations
20 Claims
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1. A method of anastomosing a first tubular structure having an end portion to a second tubular structure having an opening formed therein where at least one of the structures comprises tissue, the method comprising:
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prior to placing the first tubular structure into the opening of the second tubular structure; everting the end portion of the first tubular structure over a distal end of each of a plurality of arms provided with a support device, distally advancing a piercing member from within each of the arms to piece the first tubular structure and secure the first tubular structure to the support device; introducing the distal end of the arms into the opening; radially expanding the arms from a first state to a second state so that a portion of the first tubular structure is forced against a region of the second tubular structure that surrounds the opening; passing a plurality of fasteners through the tubular structures in the vicinity of the opening to secure the tubular structures together; and removing the support device from the tubular structures. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method of anastomosing a first tubular structure having an end portion to a second tubular structure having an opening formed therein, where at least one of the structures is tissue, the method comprising:
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providing a support device including a plurality of arms having a proximal end, a distal end, and a plurality of piercing members extendable therefrom; prior to placing the first tubular structure into the opening of the second tubular structure, everting the end portion of the first tubular structure over the distal end of each of the plurality of arms, extending the piercing members relative to the arms to pierce the first tubular structure with the piercing members and secure the first tubular structure to the plurality of piercing members; moving the arms radially inward and introducing the distal ends of the arms into the opening in the second tubular structure; positioning the support device so that the tubular structures contact one another; passing a plurality of surgical fasteners through the tubular structures to secure the tubular structures together; and removing the support device from the tubular structures. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method of anastomosing a first tubular structure, having an end portion, to a second tubular structure, having fluid flowing therethrough, comprising:
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forming an opening in the second tubular structure, while maintaining fluid flow therethrough; prior to placing the first tubular structure into the opening of the second tubular structure;
everting the end portion of the first tubular structure over a distal end of each of a plurality of arms provided with a support device, distally advancing a piercing member from within each of the arms to piece the first tubular structure and secure the first tubular structure to the support device;moving the arms radially inward and introducing the arms into the opening in the second tubular structure; placing the end portion of the first tubular structure in the opening in the second tubular structure such that a seal is formed between the first tubular structure and the opening in the second tubular structure, while maintaining fluid flow through the first tubular structure, and securing the first tubular structure to the second tubular structure with fasteners after the step of forming a seal between the first and second tubular structures. - View Dependent Claims (18, 19, 20)
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Specification