Methods for performing anastomosis
First Claim
Patent Images
1. A ring for use in preparing a first organ having an orifice for anastomosis with a second organ, said ring comprising:
- a ring portion sized to extend around the orifice; and
malleable tines extending out from the ring portion, wherein the tines are movable relative to the ring portion from an initial configuration into a final configuration in which the tines can hold tissue of the first organ around the orifice in an everted state, the tines are configured to grab and evert the tissue as they move from the initial configuration to the final configuration, each of the tines has a free distal end and a weak portion between the ring portion and the free distal end, and said each of the tines preferentially folds at the weak portion in response to being subjected to bending force.
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Accused Products
Abstract
Methods of performing an anastomosis. A ring is installed at an incision or other orifice in a vessel or other organ, for use in performing an anastomosis. To install the ring, tines are advanced against an anvil to cause them to grab tissue around the orifice and curl radially. The anvil is then retracted to fold the tines so their curled ends move radially outward. A sleeve may be advanced to fold or bend the tines as their curled ends move further radially outward. The folding, curling, and further bending of the tines evert tissue near the orifice edges to expose the vessel'"'"'s or organs'"'"' intima.
135 Citations
73 Claims
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1. A ring for use in preparing a first organ having an orifice for anastomosis with a second organ, said ring comprising:
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a ring portion sized to extend around the orifice; and
malleable tines extending out from the ring portion, wherein the tines are movable relative to the ring portion from an initial configuration into a final configuration in which the tines can hold tissue of the first organ around the orifice in an everted state, the tines are configured to grab and evert the tissue as they move from the initial configuration to the final configuration, each of the tines has a free distal end and a weak portion between the ring portion and the free distal end, and said each of the tines preferentially folds at the weak portion in response to being subjected to bending force. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A ring for use in preparing a first organ having an orifice for anastomosis with a second organ, said ring comprising:
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a ring portion sized to extend around the orifice; and
malleable tines extending out from the ring portion, wherein the tines are movable relative to the ring portion from an initial configuration into a final configuration in which said tines can hold tissue of the first organ around the orifice in an everted state, the tines are configured to grab and evert the tissue as they move from the initial configuration to the final configuration, each of the tines in the final configuration has a proximal portion which extends radially inward away from the ring portion, a distal portion shaped for holding said tissue in said everted state, and a central portion between the proximal portion and the distal portion, and said each of the tines in the final configuration is bent radially outward at said central portion toward the ring portion. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33)
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34. A method for preparing a first organ having an orifice for anastomosis with a second organ, using a ring having a ring portion sized to extend around the orifice and malleable tines that extend out from the ring portion, said method including the steps of:
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(a) inserting an anvil into the first organ through the orifice, said anvil having a tine-forming surface;
advancing the ring toward the tine-forming surface of the anvil to cause distal ends of the tines to grab tissue of the first organ around the orifice and curl against the tine-forming surface while gripping the tissue, thereby forming a curled tine structure including curled tine ends and portions of the tissue; and
(c) after step (b), retracting the anvil so that said anvil exerts force on the curled tine structure to cause the curled tine ends of the curled tine structure to move radially outward away from each other. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41)
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42. A tool for installing an anastomosis ring at an orifice of a first organ to prepare the first organ for anastomosis with a second organ, wherein the anastomosis ring has a ring portion sized to extend around the orifice and malleable tines extending out from the ring portion, the tool comprising:
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an anvil having a tine-forming surface, wherein the anvil is sized for insertion into the first organ through the orifice;
a set of independently movable sleeves around the anvil, wherein the sleeves are concentric with each other and with the anvil; and
a control assembly coupled to the anvil and the sleeves and configured to advance and retract individual ones of the anvil and the sleeves relative to other ones of the anvil and the sleeves to advance the ring toward the tine-forming surface of the anvil to cause distal ends of the tines to grab tissue of the organ around the orifice and curl against the tine-forming surface while gripping the tissue, thereby forming a curled tine structure including curled tine ends and portions of the tissue, and to retract the anvil such that the anvil exerts force on the curled tine structure to cause the curled tine ends of the curled tine structure to move radially outward away from each other. - View Dependent Claims (43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54)
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55. A method for installing an anastomosis ring at an orifice of a first organ using a tool, to prepare the first organ for anastomosis with a second organ, wherein the anastomosis ring has a ring portion sized to extend around the orifice and malleable tines extending out from the ring portion, the tool includes an anvil and a set of independently movable sleeves around the anvil, the anvil has a tine-forming surface, the sleeves are concentric with each other and with the anvil, the sleeves include an outermost sleeve and additional sleeves, and the outermost sleeve defines a tine-engaging surface, said method including the steps of:
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(a) releasably mounting the ring to the tool such that tips of the tines extend away from the sleeves in a distal direction, the ring portion is releasably engaged with at least one of the sleeves, and the tine-engaging surface of the outermost sleeve exerts holding force on at least one of the tines;
(b) inserting the anvil into the first organ through the orifice;
(c) after steps (a) and (b), advancing at least some of the sleeves in the distal direction, thereby advancing the ring toward the tine-forming surface of the anvil to cause the tips of the tines to grab tissue of the first organ around the orifice, and curl against the tine-forming surface while gripping the tissue, thereby forming a curled tine structure including curled tine ends and portions of the tissue;
(d) after step (c), retracting the anvil away from at least one of the sleeves such that said anvil exerts force on the curled tine structure to cause the curled tine ends of the curled tine structure to move radially outward away from each other; and
(e) after step (d), advancing at least one of the additional sleeves relative to the outermost sleeve into engagement with the curled tine structure to fold said tines so their curled ends move further radially outward, wherein movement of the tines in steps (c), (d), and (e) everts the tissue around the orifice sufficiently to expose an inner surface of the first organ which can be joined with tissue of the second organ. - View Dependent Claims (56, 57, 58, 59, 60, 61, 62, 63, 64)
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65. A method for installing a first anastomosis ring at an orifice of a first organ, aligning the installed ring with a second anastomosis ring that has been installed at an orifice of a second organ, and fastening the aligned rings together, wherein the first anastomosis ring has a ring portion sized to extend around the orifice of the first orifice, and malleable tines and at least one fastener element that extend out from the ring portion, said method including the steps of:
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(a) inserting an anvil having a tine-forming surface into the first organ through the orifice of said first organ;
(b) advancing the first anastomosis ring toward the tine-forming surface of the anvil to cause distal ends of the tines to grab tissue of the first organ around the orifice, and curl against the tine-forming surface while gripping the tissue, thereby forming a curled tine structure including curled tine ends and portions of the tissue;
(c) after step (b), retracting the anvil relative to the first anastomosis ring such that the anvil exerts force on the curled tine structure to cause the curled tine ends of the curled tine structure to move radially outward away from each other;
(d) after step (c), aligning the installed first anastomosis ring with the second anastomosis ring; and
(e) fastening together the aligned first and second anastomosis rings by coupling each said fastener element of the first anastomosis ring to the second anastomosis ring, thereby forming an anastomosis joining the first organ in fluid communication with the second organ. - View Dependent Claims (66, 67, 68, 69, 70, 71, 72, 73)
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Specification