Anastomosis reinforcement using biosurgical adhesive and device

• US 8,876,844 B2
• Filed: 11/01/2006
• Issued: 11/04/2014
• Est. Priority Date: 11/01/2006
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Ortiz, Mark S., Shelton, Fredrick E. IV
• Primary Examiner(s): Dornbusch, Dianne
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US11/555,392
• Publication Number:
  US 20080147101A1
• Time in Patent Office: 2,925 Days
• Field of Search: 606/151, 606/153, 606/139, 606/142, 606/155, 606/157, 606/158, 606213-215
• US Class Current: 606/153
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• 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 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections

Abstract

An exemplary anastomosis device comprises a proximal ring, a distal ring, and a middle ring. The middle ring has apertures configured to communicate a fluid such as an adhesive. The exemplary anastomosis device also has arms joining the proximal ring to the center member and arms joining the distal ring to the center member. The anastomosis device is configured to move from an unactuated position, where it has a generally cylindraceous configuration, to an actuated position, where it has a generally rivet-like configuration. The anastomosis device may be used to provide and secure an anastomosis between adjacent tissue walls. Adhesive may be communicated through the apertures of the middle ring of the anastomosis device to seal or strengthen the anastomosis. An applier may be used to deploy the anastomosis device and to communicate the adhesive through the apertures.

Claims

1. An anastomosis device operable to provide an anastomosis between two tissue walls, the anastomosis device comprising:

an anastomotic ring device, the anastomotic ring device comprising;

(a) a proximal ring defining a first opening,

(b) a distal ring defining a second opening, wherein the second opening is substantially coaxially aligned with the first opening,

(c) a center member positioned longitudinally between the proximal ring and the distal ring, wherein the center member comprises at least one transverse fluid port, wherein the fluid port is configured to communicate a fluid medium, wherein the center member defines a third opening, wherein the third opening is substantially coaxially aligned with the first and second openings,

(d) a proximal expandable portion joining the proximal ring to the center member, and

(e) a distal expandable portion joining the distal ring to the center member;

wherein the anastomotic ring device is configured to move from an unactuated position to an actuated position, wherein a first portion the anastomotic ring device has a first width when the anastomotic ring device is in the unactuated position, wherein the first portion of the anastomotic ring device has a second width when the anastomotic ring device is in the actuated position, wherein the second width is greater than the first width, wherein a second portion of the anastomotic ring device has a third width when the anastomotic ring device is in the unactuated position and when the anastomotic ring device is in the actuated position, wherein the second width is greater than the third width, wherein the first, second, and third openings together define an open passageway when the anastomotic ring device is in the actuated position, wherein the open passageway is configured to permit fluid communication through the proximal and distal rings, through the center member, and through the two tissue walls, wherein the transverse fluid port is transverse to the open passageway; and

an applier, wherein the anastomotic ring device is engaged with the applier, wherein the applier has at least one radial adhesive port, wherein the at least one radial adhesive port of the applier is radially aligned with the at least one transverse fluid port of the center member of the anastomotic ring device.

2. The anastomosis device of claim 1, wherein the distal expandable portion comprises a plurality of segmented arms.

3. The anastomosis device of claim 2, wherein each of the segmented arms comprises a pair of segments, wherein each segment of a pair is hingedly joined with the other segment of the corresponding pair.

4. The anastomosis device of claim 2, wherein the each of the segmented arms is hingedly connected with one or both of the distal ring or the center member.

5. The anastomosis device of claim 1, wherein the third width is substantially equal to the first width when the anastomosis device is in the unactuated position.

6. The anastomosis device of claim 1, wherein the center member comprises a center ring.

7. The anastomosis device of claim 6, wherein the at least one transverse fluid port comprises at least one aperture extending radially through the center ring.

8. The anastomosis device of claim 1, wherein the anastomotic ring device is resiliently biased toward the actuated position.

9. The anastomosis device of claim 1, wherein the anastomotic ring device is formed from a biodegradable material.

10. The anastomosis device of claim 1, wherein the at least one transverse fluid port is in fluid communication with an adhesive source.

11. The anastomosis device of claim 1, wherein the applier further comprises a conduit in fluid communication with the at least one radial adhesive port of the applier.

12. The anastomosis device of claim 1, wherein the anastomotic ring device is resiliently biased toward the actuated position, wherein the applier is operable to hold the anastomotic ring device in the unactuated position in resistance to the resilient bias toward the actuated position.

13. The anastomosis device of claim 1, wherein the applier further comprises a shaft, wherein the anastomotic ring device is engaged with the shaft of the applier, wherein the applier is operable to deploy the anastomotic ring device at an anastomosis site.

14. The anastomosis device of claim 13, wherein the applier further comprises a plurality of retaining members, wherein the retaining members are configured to selectively maintain the longitudinal position of each of the distal ring, proximal ring, and center member relative to the shaft of the applier.

15. The anastomosis device of claim 14, wherein the retaining members are generally annular, wherein the retaining members are configured to radially expand or contract.

16. The anastomosis device of claim 15, wherein the applier further comprises a retractable member, wherein the retractable member is operable to selectively engage the retaining members in order to selectively effect radial expansion or contraction of the retaining members.

17. A method of using the anastomosis device of claim 13 to anastomose tissue at an anastomosis site, the method comprising:

positioning the anastomotic ring device at an anastomosis site;

deploying the anastomotic ring device at the anastomosis site, using the applier, to create an anastomosis; and

applying an adhesive at the anastomosis site, wherein the adhesive is applied adjacent to the anastomotic ring device.

18. The method of claim 17, wherein the act of applying the adhesive comprises communicating the adhesive radially outwardly through the at least one transverse fluid port of the anastomotic ring device.

19. The method of claim 18, wherein the shaft of the applier comprises at least one conduit in fluid communication with the at least one transverse fluid port of the anastomotic ring device, wherein the act of applying the adhesive further comprises communicating the adhesive through the at least one conduit of the applier.