Medical grafting methods and apparatus

A method for installing a tubular graft between first and second spaced locations in a patient's tubular body structure comprising:

• providing an aperture through a wall of the tubular body structure at the first location with a distal portion of an elongated structure inserted into and along a lumen of the tubular body structure to the first location;
• advancing an elongated guide member along and through the interior of the elongated structure such that a distal portion of the elongated guide member is positioned adjacent the first location;
• providing a surgical access opening in the patient adjacent one of the first and second locations;
• moving the distal portion of the elongated guide member into the tubular body structure by piercing the tubular body structure at the second location;
• passing the graft along the lumen of the tubular body structure and over the elongated guide member, through the wall at one of the first and second locations to the other of the locations;
• and
• attaching axially spaced portions of the graft to the tubular body structure adjacent the first and second locations.

A method for installing a tubular graft between first and second spaced locations in a patient's tubular body structure comprising:

• providing an aperture through a wall of the tubular body structure at the first location with a distal portion of an elongated structure inserted into and along a lumen of the tubular body structure to the first location;
• providing a surgical access opening in the patient adjacent one of the first and second locations;
• inserting the graft through the surgical access opening;
• moving a first end portion of the graft to the first location;
• moving a second end portion of the graft to the second location;
• and
• attaching axially spaced portions of the graft to the tubular body structure adjacent the first and second locations.

A method of providing a tubular connection between a patient's first tubular body conduit and a second tubular body conduit via an aperture in a side wall of the second tubular body conduit, comprising the steps of:

• providing a surgical access opening in the patient adjacent the aperture;
• providing an annular cut in the first conduit, thereby forming a free end portion thereof;
• inserting an elongated structure into and axially along the first conduit such that a distal portion extends to the free end portion of the first conduit;
• providing an aperture in the side wall of the second tubular body conduit;
• advancing the distal portion of the elongated structure to the second tubular body conduit adjacent the aperture in the side wall thereof;
• attaching a connector to the end portion of the first conduit;
• shifting the free end portion of the first conduit and the connector to a new location in the patient's body adjacent the aperture in the second conduit with instrumentation inserted in the surgical access opening;
• and
• attaching the end portion of the first conduit to the aperture of the second conduit with the connector.