Surgical stabilizer devices and methods

• US 6,740,098 B2
• Filed: 08/24/2001
• Issued: 05/25/2004
• Est. Priority Date: 05/11/1998
• Status: Expired due to Fees

• Current Assignee: Surgical Connections, Inc.
• Original Assignee: Surgical Connections, Inc.
• Inventors: Hovland, Claire T., Abrams, Jerome H., Robinson, Paul J.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US09/939,052
• Publication Number:
  US 20020072761A1
• Time in Patent Office: 1,005 Days
• Field of Search: 606/139, 128/898, 128/148
• US Class Current: 606/148
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• 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 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• 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 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61F 2/0022 placed deep in the body opening occluding blood vessels by internal devices A61B17/12022

Abstract

Surgical devices and methods achieve a desired configuration of one or more anatomical structures, e.g. by suction or inflation, and then optionally deploy a stabilizing or fastening agent or holding device, for example a helical staple, to stabilize the anatomical structure in the desired configuration. Aspects of the invention can be used in the treatment of incontinence, coronary artery blockage, and blockages or strictures in other anatomical structures. Additionally, embodiments of the invention also can be used to create anastomoses between anatomical structures, and/or to create or reverse functional vasectomies, tubal ligations and the like. Aspects of the invention are particularly (though not exclusively) applicable in minimally invasive surgical settings.

Claims

1. Apparatus for treatment of anatomical structure having a lumen, the apparatus comprising:

a pressure differential device constructed to create a pressure differential with respect to the lumen of the anatomical structure, to cause movement of the anatomical structure to a desired configuration for treatment; and

a stabilizing device, operably coupled with the pressure differential device, constructed to stabilize the anatomical structure in the desired configuration.

2. The apparatus of claim 1, wherein the pressure differential device is constructed to create a negative pressure differential relative to luminal pressure of the anatomical structure.

3. The apparatus of claim 2, wherein the pressure differential device comprises a vacuum source or suction source.

4. The apparatus of claim 3, wherein the pressure differential device is constructed and arranged to cause constriction of the anatomical structure to the desired configuration.

5. The apparatus of claim 4, wherein the pressure differential device is constructed and arranged to aid in performing at least one of treatment of incontinence, tubal ligation, vasectomy, treatment of morbid obesity, and treatment of varicose veins.

6. The apparatus of claim 4, wherein the pressure differential device is also constructed and arranged to create a positive pressure differential relative to luminal pressure of the anatomical structure to cause dilation of the anatomical structure.

7. The apparatus of claim 3, constructed to cause the anatomical structure to close tightly on itself upon application of the negative pressure.

8. The apparatus of claim 7, wherein the stabilizing device comprises a helical staple and helical-staple applicator, the applicator applying the helical staple to the anatomical structure after the anatomical structure has closed upon itself.

9. The apparatus of claim 7, constructed to cause at least one of a fallopian tube and a vas deferens to close tightly on itself upon application of the negative pressure.

10. The apparatus of claim 7, further comprising a wire constructed to deploy within the lumen of the anatomical structure to damage the anatomical structure before the anatomical structure is stabilized by the stabilizing device.

11. The apparatus of claim 10, wherein the wire is a resistive wire for applying heat to the anatomical structure.

12. The apparatus of claim 1, wherein the pressure differential device is constructed to create a positive pressure differential relative to luminal pressure of the anatomical structure.

13. The apparatus of claim 12, wherein the pressure differential device is constructed and arranged to cause dilation of the anatomical structure to the desired configuration.

14. The apparatus of claim 13, wherein the pressure differential device is constructed and arranged to aid in performing at least one of an angioplasty procedure in a coronary artery, a reversal of functional tubal ligation, a reversal of functional vasectomy, and functional stenting of an anatomical structure having a stricture without using a stent.

15. The apparatus of claim 12, wherein the pressure differential device comprises an inflatable balloon.

16. The apparatus of claim 1, wherein the stabilizing device comprises structure for applying a holding device to the anatomical structure, the holding device being constructed to remain applied to the anatomical structure after removal of the apparatus from the vicinity of the anatomical structure.

17. The apparatus of claim 1, wherein the stabilizing device comprises a holding device for application to the anatomical structure, the holding device remaining applied to the anatomical structure after removal of the apparatus from the vicinity of the anatomical structure.

18. The apparatus of claim 17, wherein the holding device remains completely outside of the lumen.

19. The apparatus of claim 1, wherein the lumen of the anatomical structure is reduced when the anatomical structure is in the desired configuration.

20. The apparatus of claim 1, wherein the lumen of the anatomical structure is enlarged when the anatomical structure is in the desired configuration.

21. The apparatus of claim 1, wherein the stabilizing device comprises a helical staple.

22. The apparatus of claim 21, wherein the helical staple remains completely outside of the lumen.

23. The apparatus of claim 1, wherein the pressure differential device comprises a set of suction apertures fluidly coupled to a suction source, the set of suction apertures constructed and arranged to cause movement of the anatomical structure to the desired configuration.

24. The apparatus of claim 23, wherein the set of suction apertures is a first set of suction apertures, the pressure differential device further comprising a second set of suction apertures fluidly coupled to a suction source, the first set of suction apertures and the second set of suction apertures being constructed and arranged to cause relative movement of two portions of the anatomical structure toward each other to facilitate formation of an anastomosis.

25. The apparatus of claim 24, wherein at least one of the sets of suction apertures is constructed to move toward the other of the sets of suction apertures to form the anastomosis.

26. The apparatus of claim 25, wherein said at least one set of suction apertures is constructed to be moved by an operator of the apparatus simultaneously with application of suction via the suction apertures to form the anastomosis.

27. The apparatus of claim 1, wherein the pressure differential device comprises a plurality of suction apertures fluidly coupled with a suction source, the plurality of suction apertures being constructed and arranged to cause relative movement of two portions of the anatomical structure toward each other to facilitate formation of an anastomosis.

28. The apparatus of claim 27, wherein at least one of the suction apertures is constructed to move toward at least one other of the suction apertures to form the anastomosis.

29. The apparatus of claim 28, wherein the stabilizing device comprises a surgical fastener and an applicator for applying the surgical fastener to the anatomical structure.

30. The apparatus of claim 29, further comprising a generally cylindrical member operably coupled with the stabilizing device and pressure differential device, further wherein the surgical fastener, the applicator and at least one of the suction apertures are disposed around the generally cylindrical member.

31. The apparatus of claim 30, wherein the generally cylindrical member is a first generally cylindrical member, the apparatus further comprising a second generally cylindrical member operably coupled with the stabilizing device and the pressure differential device, further wherein at least another of the suction apertures is disposed around the second generally cylindrical member, the first generally cylindrical member and the second generally cylindrical member being generally concentric and disposed for relative movement between them.

32. The apparatus of claim 1, further comprising a guide operably coupled with the stabilizing device to guide movement of the anatomical structure.

33. The apparatus of claim 32, wherein the guide is movable between a deployed configuration and an non-deployed configuration.

34. The apparatus of claim 33, wherein the guide comprises one of an inflatable material, memory material, and spring material.

35. The apparatus of claim 34, wherein the guide in the deployed configuration defines a generally conical-shaped opening for receiving anatomical structure therein.

36. The apparatus of claim 32, wherein the stabilizing device comprises a helical staple, further wherein the guide defines indentations for at least partially receiving the helical staple.

37. The apparatus of claim 32, wherein the guide defines a general cone shape when in the deployed configuration.

38. The apparatus of claim 32, constructed for at least one of vascular closure, wound closure, and ligation of gastrointestinal hemorrhage.

39. The apparatus of claim 1, further comprising a cutting device, operably coupled with the pressure differential device and the stabilizing device, for cutting the anatomical structure.

40. The apparatus of claim 39, further wherein the stabilizing device comprises repair material and structure for applying the repair material to the anatomical structure in the vicinity of the cut anatomical structure, the repair material remaining applied to the anatomical structure after removal of the apparatus from the vicinity of the anatomical structure.

41. Apparatus for treatment of anatomical structure having a lumen, the apparatus comprising:

a movement device constructed to cause movement of the anatomical structure to a desired configuration for treatment; and

a stabilizing device, operably coupled with the movement device, constructed to stabilize the anatomical structure in the desired configuration;

wherein the movement device comprises a cutting device for cutting the anatomical structure.

42. The apparatus of claim 41, further wherein the stabilizing device comprises structure for applying repair material to the anatomical structure in the vicinity of the cut anatomical structure, the repair material for remaining applied to the anatomical structure after removal of the apparatus from the vicinity of the anatomical structure.

43. The apparatus of claim 42, wherein the stabilizing device further comprises a surgical fastening agent to hold the repair material in place with respect to the anatomical structure.

44. The apparatus of claim 43, constructed and arranged for use in a blocked coronary artery.

45. The apparatus of claim 43, wherein the surgical fastening agent defines a helical shape.

46. The apparatus of claim 43, wherein the surgical fastening agent comprises a helical staple.

47. The apparatus of claim 41, wherein the stabilizing device comprises a helical staple and an advancement member for contacting the helical staple and advancing the helical staple into the anatomical structure after the cutting device has cut the anatomical structure.

48. The apparatus of claim 47, wherein the helical staple is constructed to hold repair material in place on the anatomical structure.

49. The apparatus of claim 42, constructed to cut anatomical structure and to apply repair material simultaneously due to a single continuous motion by an operator of the apparatus.

50. The apparatus of claim 42, further comprising a cutting device advancement mechanism for advancing the cutting device relative to the anatomical structure.

51. The apparatus of claim 50, wherein the cutting device advancement mechanism comprises a threaded screw.

52. The apparatus of claim 41, constructed to simultaneously cut the anatomical structure and apply the repair material to the anatomical structure.

53. The apparatus of claim 41, further comprising a cutting device advancement mechanism for advancing the cutting device relative to the anatomical structure.

54. The apparatus of claim 41, wherein the movement device further comprises a suction device for applying suction in the vicinity of the anatomical structure.

55. The apparatus of claim 42, wherein the movement device further comprises a suction device for applying suction in the vicinity of the anatomical structure.

56. The apparatus of claim 41, wherein the stabilizing device is constructed to remain completely outside of the lumen.

57. Apparatus for stabilizing an anatomical structure, the apparatus comprising:

means for moving the anatomical structure to or holding the anatomical structure in a desired configuration; and

means for deploying a stabilizing device into contact with the anatomical structure to hold the desired configuration;

wherein the stabilizing device can be deployed in a direction either toward an operator of the apparatus or away from an operator of the apparatus.

58. Apparatus for facilitating treatment of anatomical structure having a lumen, the apparatus comprising a pressure differential device constructed to cause movement of the anatomical structure to a desired, generally stabilized configuration by creating pressure differential from within the lumen, the desired configuration being suitable for further stabilization or treatment, the apparatus further comprising a member constructed to support the pressure differential device from within the lumen.

59. The apparatus of claim 58, wherein the pressure differential device comprises a suction device for drawing the anatomical structure toward the pressure differential device and into the desired configuration.