Sliding suture anchor

#Because of the invasive nature of traditional surgery there are inherent risk and objectionable side effects associated therewith. For example if a patient is found to have an inflammatory stricture in the small intestine and it is decided to surgically remove the section of the intestine containing the stricture and reconnect the severed ends of the intestine by sutures. Such invasive surgery requires a general anesthesia, is time consuming, expensive and is painful and requires a long healing process. As a result less invasive procedures are being developed as alternatives to traditional surgical procedures.

#Draining viscera, such as the stomach or gall bladder, can be performed through a track inserted percutaneous into the viscera, however, there is the danger that gastric juices, bile or infected fluids could spill into the peritoneal cavity. To prevent this, procedures and devices have been developed to pull and anchor the wall of the viscera into contact with the abdominal wall using sutures anchor devices that are inserted into the cavity of the viscera through thin hollow needles. With the viscera thus stabilized with its wall held flush against the abdominal wall, drain tubes can be inserted into the viscera without the danger of spillage into the peritoneal cavity. Examples of viscera anchor of this type are shown in U.S. Pat. Nos. 5,123,914 and 6,110,183. The anchors disclosed in U.S. Pat. Nos. 5,123,914 and 6,110,183 are constructed to prevent damage to the interior of the viscus and can be inserted and removed through small diameter needles

#Another method and device, now in use, that avoid the trauma of traditional surgery, is a method and apparatus for creating abdominal visceral anastomoses. This method and device, is disclosed in U.S. Pat. No. 5,690,656, uses a pair of powerful magnets, each having a raised rim around their perimeter. The patient swallows one magnet, then waits until it has worked its way into the jejunum, then the patient swallows the second magnet which works its way into the stomach. The location of the magnets can be monitored and manipulated such that they become attracted to each through the walls of the stomach and the jejunum. The magnets apply pressure to the tissue that is held between the raised rims. After a few days, the tissue between the magnets becomes necrotic and the two magnets together pass into the jejunum and eventually pass through the bowel. A stent can then be endoscopically placed in the resulting opening, to prevent the opening from closing. The procedure disclosed in U.S. Pat. No. 5,690,656, although less invasive than traditional surgery, extends over a several day period and the precise placement of the magnets is problematic. Thus, a one-step procedure and apparatus for anastomosing two hollow viscera by a percutaneous technique in which the surgeon has greater control over the location of the anastomosis is needed.

#FIG. 1 is a perspective view of the sliding anchor with the coils of the spring closed around the suture.

#FIG. 2 is a perspective view of the sliding anchor with the coils of the spring opened to better show the suture that is held between the spring and the mandrel.

#FIG. 3 is a perspective illustration of the stomach and the jejunum.

#Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings; however, the present invention is not limited to the embodiments described below.

#This invention concerns a technique, using a sliding anchor 30, for anastomosing two hollow viscera. The invention will be illustrated and will be described, with reference to a percutaneous technique for anastomosing the stomach 10 and the jejunum 12 through the body wall. However, the same technique could be performed through the patients mouth by using a gastroscope with appropriately sized equipment. Other applications for this technique are for example cholecystoduodenostomy, cholecystodochotom, choledochogastrostomy, ileocolostomy, portocaval shunt, and percutaneous colostomy.

#An embodiment of the sliding anchor 30 will be describe with reference to FIGS. 1 and 2. The sliding anchor as seen in FIG. 1 comprises a segment of a hollow helical spring 32 that is about ¾ to 1¼ inches long and a mandrel 36. The helical spring 32 has an outer diameter of about 0.038 inches in diameter which is the type of springs used in some conventional guide wires. A suture 34 is pushed between two coils near the center of the spring 32 such that the suture extends through the coil spring between two adjacent coils, wraps around one of these coils and extends out of the coil spring on opposite sides of the coil that it has wrapped around. After the suture has been wrapped around the coil the cylindrical-shaped mandrel 36, having a diameter of about 0.018 inches is inserted within the hollow helical spring 32. In FIG. 2, the spring 32 has been expanded to better show the relationship between the spring 32, suture 34 and mandrel 36. As can be best seen in FIG. 2, the spring 32 exerts pressure on the suture 34 against the mandrel 36. This pressure results in friction that resists relative movement of the suture 34 relative to the spring 32. It should be noted that when the spring is in its normal unexpanded state, as seen in FIG. 1, the suture is also pinched between adjacent coils of the spring 32 which results in additional friction and further resists relative movement of the suture 34 relative to the spring 32. However, when a sufficient force is applied, the anchor 30 can be slid along the suture 34. The mandrel also functions to provide rigidity to the central portion of the anchor 30, and by utilizing a mandrel that is shorter than the spring 32, it allows the anchor 30 to have floppy tips. As best seen in FIG. 1, this attachment of the sliding anchor to the suture 32 allows the suture 32 to extend perpendicular to the axial extent of the spring 32.