Method and apparatus for creating abdominal visceral anastomoses

• US 5,690,656 A
• Filed: 06/27/1995
• Issued: 11/25/1997
• Est. Priority Date: 06/27/1995
• Status: Expired due to Term

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Cope, Constantin, Timmermans, Hans A.
• Primary Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US08/496,125
• Time in Patent Office: 882 Days
• Field of Search: 606/156, 606/155, 606/153, 606/151, 128/898, D13/183, 403/DIG. 1, 335/285, 335/302-306
• US Class Current: 606/153
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/1117 adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
• 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 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

A method and apparatus for creating abdominal visceral anastomoses. A first magnet is placed within a first viscera and a second, larger magnet is placed within a second viscera. The magnets each have a raised rim around their perimeters. The two magnets couple to each other by virtue of their mutual attraction, thereby capturing a portion of the intervening visceral walls between them. The coupling of the magnets is automatically self-centering, as the smaller magnet is forced to rest within the raised rim of the larger magnet. Additionally, the raised rim of the smaller magnet acts as a fine cutting edge in order to accelerate the process of ischemic necrosis of the tissue captured between the two magnets, thereby forming the anastomosis. Use of the present invention avoids the need for general anasthesia and a laparotic incision, resulting in fewer surgical and post-surgical complications.

Claims

1. A method for forming an anastomoses between first and second adjacent viscera, comprising the steps of:

(a) inserting a first magnet into a viscera adjacent a digestive tract;

(b) inserting a second magnet into a stomach of the digestive tract, wherein at least one of the first and second magnets includes means for self-centering engagement during magnetic attraction, so that the second magnet travels down the digestive tract until it is attracted to the first magnet and is coupled thereto through a digestive tract wall and a visceral wall in a self-centering engagement; and

(c) allowing tissue compressed between the first and second magnets by magnetic attraction between the first and second magnets to undergo ischemic necrosis.

2. The method of claim 1, further comprising the step of:

(d) flushing the first and second magnets out of the digestive tract.

3. The method of claim 1, wherein step (a) is performed percutaneously.

4. The method of claim 1, wherein step (b) is performed by having a patient swallow the second magnet.

5. The method of claim 1, wherein the self-centering engagement is produced by a peripheral raised rim on the second magnet, the rim forcing the first magnet into centered alignment with the second magnet when the first and second magnet engage.

6. The method of claim 1, wherein step (a) further comprises inserting the first magnet into a gallbladder.

7. The method of claim 1, wherein step (a) further comprises inserting the first magnet into a common bile duct.

8. A method for forming an anastomoses between first and second adjacent viscera, comprising the steps of:

(a) inserting a first magnet into a first viscera;

(b) inserting a second magnet into a second viscera, wherein at least one of the first and second magnets includes means for self-centering engagement during magnetic attraction, so that the second magnet is attracted to the first magnet and is coupled thereto through first and second visceral walls in a self-centering engagement; and

(c) allowing tissue compressed between the first and second magnets by magnetic attraction between the first and second magnets to undergo ischemic necrosis.

9. The method of claim 8, further comprising the step of:

(d) removing the first and second magnets after the anastomosis has formed.

10. The method of claim 8, wherein step (a) is performed percutaneously.

11. The method of claim 8, wherein steps (a) and (b) are performed percutaneously.

12. The method of claim 8, wherein the self-centering engagement is produced by a peripheral raised rim on the second magnet, the rim forcing the first magnet into centered alignment with the second magnet when the first and second magnet engage.

13. The method of claim 8, wherein step (a) further comprises inserting the first magnet into a jejunum and step (b) further comprises inserting the second magnet into a stomach.

14. The method of claim 8, wherein step (a) further comprises inserting the first magnet into a common bile duct and step (b) further comprises inserting the second magnet into a duodenum.

15. A method for form jug an anastomoses between first and second portions of a digestive tract, comprising the steps of:

(a) inserting a first magnet into a stomach;

(b) waiting a period of time while the first magnet travels down the digestive tract;

(c) inserting a second magnet into the stomach, wherein at least one of the first and second magnets includes means for self-centering engagement during magnetic attraction, so that the second magnet is attracted to the first magnet and is coupled thereto through first and second walls of the digestive tract in a self-centering engagement; and

(d) allowing tissue compressed between the first and second magnets by magnetic attraction between the first and second magnets to undergo ischemic necrosis.

16. The method of claim 15, further comprising the step of:

(e) flushing the first and second magnets out of the digestive tract.

17. The method of claim 15, wherein step (a) is performed with a guide wire.

18. A device for forming an anastomoses between adjacent viscera, comprising:

a first magnet having opposing first and second faces;

a first jacket having opposing first and second rims, said first jacket formed around a first periphery of the first magnet on a first surface connecting the first and second faces, wherein the first and second jacket rims are spaced farther apart than the first and second magnet faces wherein said first and second rims include means for promoting tissue necrosis;

a second magnet having opposing third and fourth faces; and

a second jacket having opposing third and fourth rims, said second jacket formed around a second periphery of the second magnet on a second surface connecting the third and fourth faces, wherein the third and fourth jacket rims are spaced farther apart than the third and fourth magnet faces;

wherein the second periphery is smaller than the first periphery, such that the first and second magnets are self-centering when they are magnetically coupled through walls of the adjacent viscera.

19. The device of claim 18, wherein the first and second magnets are rare-earth magnets.

20. The device of claim 18, wherein:

the first rim extends beyond the first face;

the second rim extends beyond the second face;

the third rim extends beyond the third face; and

the fourth rim extends beyond the fourth face.

21. The device of claim 18, wherein the first and second jackets are formed from a nonferrous metal.

22. The device of claim 18, further comprising:

a first coating surrounding the first magnet and first jacket assembly; and

a second coating surrounding the second magnet and second jacket assembly;

wherein the first and second coatings are acid resistant.

23. The device of claim 18, wherein:

the first magnet includes a first axial hole formed between the first and second faces; and

the second magnet includes a second axial hole formed between the third and fourth faces.