Apparatus and method for performing an anastomosis

An anastomosis joint comprising:

• A) a first vessel having an incision defined therein and an edge adjacent to said incision;
• B) a second vessel having an incision defined therein and an edge adjacent to the incision in the second vessel;
• and
• C) mounting structure secured to the first and second vessels, said structure placing said first vessel in contact with said second vessel with an inside surface of the first vessel adjacent to the incision in the first vessel in abutting contact with an inside surface of the second vessel adjacent to the incision in the second vessel to form a joint establishing sealed interior communication between the first and second vessels.

A method for performing an anastomosis comprising:

• A) defining an incision in a first vessel;
• B) defining an incision in a second vessel;
• C) mounting a first malleable mounting structure on the first vessel adjacent to the incision in the first vessel;
• D) mounting a second malleable mounting structure on the second vessel adjacent to the incision in the second vessel;
• E) guiding the first malleable mounting structure and the second malleable mounting structure into contact with each other;
• F) placing the first and second vessels against each other to form an area of in abutting contact therebetween adjacent to the first and second malleable mounting structures;
• and
• G) forming the area of abutting contact between the vessels into a generally sinusoidal shape.

A method for forming an anastomosis comprising:

• A) forming an incision in a first vessel;
• B) installing an anvil into the first vessel through the incision;
• C) mounting a first malleable mounting structure on the first vessel by setting fasteners on the first mounting structure into the first vessel adjacent to the incision;
• D) fully forming the fasteners by driving them against the anvil and gently turning them toward the incision;
• E) manipulating the first mounting structure into a configuration opening the incision in the first vessel;
• F) removing the anvil from the first vessel through the incision therein;
• G) forming an incision in a second vessel;
• H) installing an anvil into the second vessel through the incision in the second vessel;
• I) mounting a second malleable mounting structure on the second vessel by setting fasteners on the second mounting structure into the second vessel adjacent to the incision in the second vessel;
• J) fully forming the fasteners of the second mounting structure by driving them against the anvil in the second vessel and gently turning them toward the incision in the second vessel;
• K) manipulating the second mounting structure into a configuration opening the incision in the second vessel;
• L) removing the anvil from the second vessel through the incision therein;
• M) guiding the first and second mounting structures into contact with each other to bring the first and second vessels in abutting contact with each other;
• and
• N) connecting the first and second mounting structures together.

A process for forming a malleable anastomosis stent comprising:

• masking both sides of a sheet of malleable material using a photo negative mask in a pattern of an entire stent;
• immersing the sheet in a chemical bath;
• re-masking both sides of the sheet with a photo negative mask around a body portion of the stent being formed, except for tine areas associated with the stent;
• re-immersing the sheet into the chemical bath;
• removing the sheet from the chemical bath;
• passing the removed sheet through a progressive die to form tines on the stent;
• and
• removing the stent from the sheet.

An anastomosis stent formed by a process which comprises:

• providing a chemical double etch process which includes using a photo negative mask and forming a pattern of an anastomosis stent on a sheet of material;
• immersing the sheet in a chemical bath;
• re-masking the sheet with a photo negative around the pattern of an anastomosis stent except for tine areas associated with the stent;
• re-immersing the sheet into the-chemical bath;
• removing the sheet from the chemical bath;
• passing the removed sheet through a progressive die;
• and
• removing the stent from the sheet.

An anastomosis joint comprising:

• a first malleable mounting structure mounted on a first vessel;
• a second malleable mounting structure mounted on a second vessel;
• and
• means for joining said first and second malleable mounting structures and forming tissue associated with the first and second vessels adjacent to said first and second malleable mounting structures into a complimental shape for joinder.

A guide tool for use in performing an anastomosis comprising:

• a handle;
• a hand grip on one end of said handle;
• a nest on another end of said handle, said nest being sized and shaped to receive a malleable mounting structure and including leg retention members which releasably engage docking legs on a malleable mounting structure received within the nest;
• and
• means operably connecting said hand grip to said nest to release the mounting structure from said nest.

An installing tool for installing a malleable mounting structure on a vessel for use in performing an anastomosis comprising:

• a handle;
• a hand grip on one end of said handle;
• a cassette accommodating receiver on another end of said handle;
• and
• a lock for securing a cassette to the receiver, said lock being selectively operable to release the cassette.

A disposable cassette for use in performing an anastomosis comprising:

• a body;
• means on said body for mounting a malleable mounting structure on said body;
• and
• means carried by said body for releasably attaching said body to an installing tool.

An installing tool for installing a malleable mounting structure on a vessel for use in performing an anastomosis comprising:

• a handle;
• a hand grip on one end of said handle;
• means for releasably attaching a malleable mounting structure on said handle;
• and
• means on said handle for manipulating a malleable mounting structure attached to said handle to malleably configure the mounting structure.

A tool for use in performing an anastomosis comprising:

• A) a flexible outer shaft;
• B) an operating handle on one end of said outer shaft;
• C) a flexible core shaft slidably located in said outer shaft;
• D) an O-ring slidably mounted on a distal end of said core shaft;
• E) a countersink tip on said core shaft distal end for engagement with docking elements of two malleable mounting structures;
• and
• F) said operating handle being connected to said flexible core shaft to move said core shaft with respect to said outer shaft to force said O-ring off of said core shaft and onto docking elements engaged with said tip to attach the docking elements together.

A device for use in forming an anastomosis said device being comprised of a first malleable mounting structure comprising:

• A) a plurality of non-absorbable sections formed of material that is not absorbed by a patient's tissue;
• B) a plurality of absorbable sections connecting said non-absorbable sections together and formed of material that is absorbable by the patients tissue;
• and
• C) fasteners on said non-absorbable sections for attaching said non-absorbable sections to the patient's tissue.

An anastomosis joint comprising:

• A) a first mounting structure mounted on a first vessel of a patient, said first structure being comprised of a plurality of unconnected elements each having a fastener attaching the element to the first vessel;
• B) a second mounting structure on a second vessel of the patient, said second structure being comprised of a plurality of unconnected elements each having a fastener attaching the element to the second vessel;
• C) docking elements on each mounting structure;
• and
• D) coupling elements connecting the docking elements of said first and second mounting structures together.

An anastomosis joint comprising:

• A) a first mounting structure mounted on a first vessel of a patient, said structure being comprised of a plurality of non-absorbable elements each having a fastener attaching the element to the first vessel;
• B) a plurality of absorbable elements connecting the non-absorbable elements of the first mounting structure together;
• C) a second mounting structure on a second vessel of the patient, said structure being comprised by a plurality of non-absorbable elements each having a fastener attaching the element to the second vessel;
• D) a plurality of absorbable elements connecting the non-absorbable elements of the second mounting structure together;
• E) docking elements on each mounting structure;
• and
• F) coupling elements connecting the docking elements of said first and second mounting structures together.

A tool for securing tines extending from a malleable ring-shaped anastomotic stent to body tissue, said tool comprising:

• A) an elongate body having a surface at one end thereof for supporting the stent in a condition where the tines extend from said one end;
• B) an anvil carried by and mounted for movement relative to the body towards and away from the tines of a stent supported on said surface;
• and
• C) an operator to selectively move the anvil towards said surface to crimp the tines of a stent supported on said surface.

A tool for securing tines extending from a malleable ring-shaped anastomotic stent to body tissue, said tool comprising:

• A) an elongate body having a cassette pocket at one end thereof removably receiving a stent carrying cassette, said cassette having an end surface supporting a the stent in a condition where the tines extend from said one end;
• B) an anvil carried by said cassette and mounted for movement relative to the body towards and away from the tines of the stent supported on said surface;
• and
• C) an operator carried by the body and secured to the anvil to selectively move the anvil towards said surface to crimp the tines of a stent supported on said surface.

A method for preparing a vessel for anastomosis, said method comprising:

• A) forming an incision in the vessel;
• B) installing an anvil into the vessel through the incision;
• C) mounting a malleable mounting structure on the vessel by setting fasteners on the mounting structure into the vessel adjacent the incision;
• D) securing the mounting structure to the vessel by driving the fasteners against the anvil to crimp the fasteners into the vessel;
• E) manipulating the mounting structure into a configuration opening the incision;
• and
• F) removing the anvil from the vessel through the incision.