Systems and methods for creating anastomoses

• US 8,603,121 B2
• Filed: 04/13/2011
• Issued: 12/10/2013
• Est. Priority Date: 04/14/2010
• Status: Active Grant

• Current Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Original Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Inventors: Surti, Vihar C., McLawhorn, Tyler Evans
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US13/086,097
• Publication Number:
  US 20110257668A1
• Time in Patent Office: 972 Days
• Field of Search: 606/139, 606/142, 606/144, 606/153, 606/213, 606/215, 606/216, 606/232, 227/175.1, 128/898
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

Medical system and methods are provided for forming an Anastomosis, such as an intestinal bypass anastomosis for treatment of obesity or diabetes. The medical devices and methods are minimally invasive and reduce complications. One embodiment of the method includes forming a first opening in the first section and forming a second opening in the first section. A proximal portion of the second section is moved to a position adjacent the first opening, and a distal portion of the second section is moved to a position adjacent the second opening. In this manner, an intermediate portion of the second section extends along the first section and an anastomosis can then be formed between the first section and the second section.

Claims

1. A method of forming an anastomosis between a first section of the digestive tract and second section of the digestive tract, the method comprising the steps of:

forming a first opening in the first section;

forming a second opening in the first section;

moving a proximal portion of the second section to a position adjacent the first opening;

moving a distal portion of the second section to a position adjacent the second opening, whereby an intermediate portion of the second section extends along the first section between the first and second openings; and

forming an anastomosis between the first section and the intermediate portion of the second section.

2. The method of claim 1, further comprising the step of attaching the proximal portion of the second section to the first section adjacent the first opening.

3. The method of claim 2, wherein the step of attaching includes applying at least one of a tack, a suture, and a clip to the first and second sections.

4. The method of claim 2, further comprising the step of attaching the distal portion of the second section to the first section adjacent the second opening.

5. The method of claim 4, wherein the steps of attaching includes applying at least one of a tack, a suture, and a clip to the first and second sections.

6. The method of claim 1, further comprising the steps of deploying a first tissue anchor within the proximal portion of the second section, and deploying a second tissue anchor within the distal portion of the second section.

7. The method of claim 6, wherein the first and second tissue anchors each include an engagement member connect to suture, and further comprising the step of tensioning the sutures to position the intermediate portion of the second section alongside the first section.

8. The method of claim 1, further comprising the step of closing the first and second openings in the first section.

9. The method of claim 1, further comprising the step of placing an anastomotic device within the anastomosis.

10. The method of claim 1, wherein the step of forming an anastomosis includes forming a third opening in the first section and a fourth opening in the second section, and placing an anastomotic device within the third and fourth openings to approximate the first and second sections.

11. A method of forming an anastomosis between a first section of the digestive tract and second section of the digestive tract, the method comprising the steps of:

forming a first opening in the first section;

forming a second opening in the first section;

moving a proximal portion of the second section to a position adjacent the first opening and through the first opening to form a first loop in the second section; and

moving a distal portion of the second section to a position adjacent the second opening and through the second opening to form a second loop in the second section; and

forming an anastomosis between the first section and the second section.

12. The method of claim 11, wherein the moving steps include deploying a first tissue anchor within the proximal portion of the second section and deploying a second tissue anchor within the distal portion of the second section, and tensioning the first and second tissue anchors to move the proximal and distal portions.

13. The method of claim 11, wherein the first and second loops are positioned on an interior side of the first section, and the intermediate portion of the second section is positioned on an exterior side of the first section.

14. The method of claim 13, further comprising the step of maintaining the position of the first and second loops on the interior side of the first section.

15. The method of claim 14, wherein the step of maintaining the position of the first loop includes applying at least one of a tack, a suture, and a clip to the first loop and second section, and wherein the step of maintaining the position of the second loop includes applying at least one of a tack, a suture, and a clip to the second loop and second section.

16. The method of claim 14, wherein the step of maintaining the position of the first and second loops includes placing a tissue anchor within the first and second loops, and applying tension on the tissue anchors.

17. The method of claim 14, wherein the step of maintaining the position of the first and second loops includes passing an elongate member through both the first and second loops and applying tension on the elongate member.

18. The method of claim 14, wherein the step of maintaining the position of the first loop includes passing a first elongate member through the first loop and applying tension to the first elongate member, and includes passing a second elongate member through the second loop and applying tension to the second elongate member.

19. The method of claim 11, further comprising the step of repositioning the first and second loops of the proximal and distal portions of the second section on the exterior side of the first section.