Method and apparatus for performing end-to-end and end-to-side anastomosis with eversion of tissue edges

An anastomosis element, comprising:

• a central portion extending at least partially around a central orifice and having a first end and a second end;
• and
• deformable tines extending from the central portion,
• wherein the central portion has a central hinge portion along which the central portion folds in response to torque, exerted on the central portion, tending to move the first end and the second end closer together.

A method for installing an anastomosis element in a body structure having a tubular end portion defining an open end, wherein the element has a central portion and deformable tines extending from the central portion, said method including the steps of:

• (a) inserting an anvil having a tine-curling surface into the open end of the body structure, so that tissue of the body structure's end portion covers the tine-curling surface;
• (b) after step (a), driving the element against the tissue covering the tine-curling surface, thereby causing the tines to pierce said tissue and engage the anvil, and causing the tines to curl radially outward from the central portion against the anvil thereby everting said tissue;
• and
• (c) after step (b), retracting the anvil from the body structure so that the element remains installed at the open end of the body structure.

A method for installing an anastomosis element in a body structure using a composite anvil comprising an intraluminal anvil having a first tine-forming surface and an extracorporeal anvil having a second tine-forming surface, wherein the body structure has a tubular end portion surrounding a lumen and defining an open end, and the element has a central portion with a heel end and a toe end and deformable tines extending from the central portion including the heel end and the toe end, said method including the steps of:

• (a) inserting the intraluminal anvil into the lumen through an incision in the end portion, wherein the incision is spaced from the open end;
• (b) advancing the extracorporeal anvil into engagement with an outer surface of the end portion without entering the lumen, until the first tine-forming surface is aligned with the second tine-forming surface, thereby forming an aligned anvil pair which pinches the body structure closed at a location between the incision and the open end;
• and
• (c) after step (b), orienting the element with the toe end facing the open end and the heel end facing away from the open end, and advancing the element toward the aligned anvil pairs until the tines at the heel end pierce a first side of the end portion of the body structure, the tines at the toe end pierce both the first side of the end portion and a second side of the end portion opposite to the first side, and all the tines curl radially outward in response to being forced against the first tine-forming surface and the second tine-forming surface.

A method for installing an anastomosis element in a body structure having a tubular portion surrounding a lumen and defining an open end, the element having a central portion with a first end and a second end and deformable tines extending from the central portion, said method including the steps of:

• (a) inserting an anvil through the open end into the lumen;
• (b) folding the central portion about a first axis between the first end and the second end, thus causing the tines to pierce the body structure and curl against the anvil;
• (c) removing the anvil from the lumen through the open end;
• and
• (d) after steps (b) and (c), folding the central portion along a second axis and a third axis by pinching together a first part of the central portion between the first axis and the second axis and a second part of the central portion between the first axis and the third axis.

A method for installing an anastomosis element in a body structure having a tubular portion surrounding a lumen and defining an open end, the element having a C-shaped, deformable central portion and deformable tines extending from the central portion, the central portion having a first open end and a second open end, said method including the steps of:

• (a) sliding the element onto the tubular portion of the body structure;
• (b) squeezing together the first open end of the element and the second open end of the element, to change the C-shaped, deformable central portion to an O-shaped central portion;
• (c) inserting an anvil into the lumen through the open end of the body structure, thereby flaring the tubular portion of the body structure;
• (d) after steps (b) and (c), advancing the element toward the open end to cause the tines to pierce the tubular portion of the body structure and curl against the anvil, so that the tines evert tissue of the body structure at the open end as a result of curling against the anvil.