Anastomosis device, tools and methods of using
OwnerRyan Abbott, Greg C. Liuinventors
Life of this patent
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Abstract
Anastomosis devices, tools and methods of performing sutureless anastomosis. Anastomosis devices are provided for fixing a first conduit to a second conduit in an anastomosis, where the conduits are joined by interfacing their inner walls together. The conduit which is loaded on the anastomosis device may be mounted in such a way that the internal wall of the conduit does not make contact with the anastomosis device.
Claims68
A method of performing an anastomosis to join a graft to a target vessel, said method comprising:
- inserting a free end of the graft through an annular space defined by an anastomosis device;
- everting the free end of the graft over a distal end portion of the anastomosis device;
- inserting at least the distal end portion of the device and an everted portion of the graft through an opening in the target vessel;
- compressing the device to buckle the distal end portion, wherein the distal end portion, upon buckling is no longer capable of passing back through the opening;
- and
- buckling a section portion of the device proximal of the distal end portion, to draw the graft and the target vessel together.
The method of claim 9, wherein the tool includes a cutting member, and wherein the opening in the target vessel is made using said cutting member, wherein said forming of the opening, inserting the device and compressing the device are performed sequentially using the tool.
A device holder for securing an anastomosis device for loading a graft thereon, said device holder comprising:
- a first portion dimensioned to receive a base portion of the anastomosis device;
- and
- a second portion adapted to interact with said first portion to apply a clamping force for retaining the anastomosis device between said first and second portions, wherein said device holder securely holds the anastomosis device without applying any hoop stress to the anastomosis device.
A graft loading tool for facilitating the loading of a graft on an anastomosis device to be used in the performance of an anastomosis of the graft to a vessel, wherein the device includes a main body disposed annularly about a longitudinal axis and having first and second end portions, the main body being disposed over at least one tubular portion of a deployment device and the at least one tubular portion having a longitudinally disposed slot therein, said graft loading tool comprising a long, thin member formed of a high tensile strength material having proximal and distal end portions;
- a hook formed at a distal end of said distal end portion;
- and a sheath surrounding a portion of said long, thin member and being axially slidable with respect thereto, wherein said hook is adapted to pierce a wall of the graft, and said long thin member is dimensioned to be threaded through the slot and axially through an interior of the device, wherein, upon threading said proximal end portion of said loading device through said anastomosis device, the graft can be pulled into the slot and through an internal space defined by the anastomosis device.
A graft loader for facilitating the loading of a graft on an anastomosis device to be used in the performance of an anastomosis of the graft to a vessel, wherein the device includes a main body disposed annularly about a longitudinal axis and having first and second end portions, the main body being disposed over at least one tubular portion of a deployment device and the at least one tubular portion having a longitudinally disposed slot therein, said loader comprising a main body having first and second portions configured to split apart, said main body being configured to be mounted over a distal end of the deployment device over the anastomosis device and the at least one tubular portion;
- each said portion comprising at least one slot for receiving and holding a long thin member having been threaded through the slot, at least one tube, and loader, wherein each long thin member includes a hook at a distal end thereof, adapted to pierce a wall of the graft, so that upon pulling the long thin members through the at least one tube and loader, the graft is pulled into the slot and through the at least one tube.
A pre-load tool for preparing a graft to be mounted on an anastomosis device, said pre-load tool comprising:
- a longitudinally extending main body portion having first and second ends, said first end being tapered and dimensioned to be at least partially received in an end of the graft;
- a first set of guides spaced about a first end portion of said main body, for receiving long thin member portions of graft loading tools and maintaining said long thin member portions in a spaced configuration;
- and
- a second set of guides spaced about a second end portion of said main body and axially aligned with said first set of guides, for receiving said long thin member portions and maintaining said long thin member portions substantially parallel to one another.
A graft sizing tool comprising:
- at least one first gauge adapted to measure an outside diameter of a graft;
- and
- at least one second gauge for measuring a wall thickness of the graft.
A device for use in making an anastomosis between tubular fluid conduits in the body of a patient, said device comprising a unitary structure having a main body disposed annularly about a longitudinal axis and having first and second end portions;
- a plurality of members extending radially outwardly from said first end portion;
- and said second end portion adapted to buckle in a radially outward direction upon axial compression of said device, said device adapted to be loaded with one of the two conduits to be joined by the anastomosis, wherein the conduit is loaded by passing a free end thereof through an internal space defined by said main body in a direction from said first end portion to said second end portion, and everting the free end over said second end portion, and wherein the internal wall of the loaded conduit is free from contact with said device.
A deployment instrument configured to capture and deploy an anastomosis device adapted for making an anastomosis between tubular fluid conduits in the body of a patient, said instrument comprising:
- a main body portion configured to be hand held by an operator;
- a distal tip portion configured to capture the anastomosis device;
- an opening in the distal tip portion permitting a first of the tubular conduits to be passed into the opening and through the anastomosis device;
- and
- a mechanism configured to compress the anastomosis device.
A loading tool for loading a vessel within an anastomosis device, said tool comprising:
- a main body including a proximal end portion adapted to be mated with a distal end portion of a deployment instrument, wherein the deployment instrument is adapted to capture and anastomosis device for deployment thereof;
- a plurality of elongated hooks slidably mounted within said main body, said hooks adapted to slide through an internal opening of the anastomosis device, and expanding to an open, unbiased position when slid proximally of the anastomosis device, said open configuration being dimensioned to receive a free end of a vessel to be loaded through the anastomosis device.
An assembly for use in performing an anastomosis, said assembly comprising:
- a deployment instrument configured to capture and deploy an anastomosis device adapted for making an anastomosis between tubular fluid conduits in the body of a patient;
- an anastomosis device captured at a distal end portion of said deployment instrument, said anastomosis device being adapted to maintain the tubular fluid conduits in an anastomosis;
- and
- a loading tool mounted over said distal end portion of said deployment instrument and said anastomosis device.
An eversion tool for everting a free end of a vessel over an anastomosis device, said eversion tool comprising:
- a main body portion;
- a proximal end portion adapted to guide said eversion tool into a distal end of the vessel to be everted;
- and
- an expandable member positioned between said proximal end portion and said main body portion, said expandable member having a first outside diameter when in an non-expanded state and a second outside diameter greater than said first outside diameter when in an expanded state, said expandable member being configured to slide within the vessel when in said non-expanded state, and to expand the free end of the vessel when in said expanded state.
An eversion tool for everting a free end of a vessel over an anastomosis device, said eversion tool comprising:
- a main body portion;
- a proximal end portion adapted to guide said eversion tool into a distal end of the vessel to be everted;
- and
- a plurality of elongated prong members extending proximally from said main body portion and moveable from a contracted configuration wherein proximal ends of said prong members closely surround a main shaft extending distally of said proximal end portion, so as to slide easily within the vessel, and an expanded configuration in which said proximal ends radially expand away from said main shaft to expand the end of the vessel.
A removable cutting tool adapted to be removably mounted to an anastomosis device deployment instrument for use in performing an anastomosis, said cutting tool comprising a main body portion configured to be removably fixed to the deployment instrument;
- and a blade arm having a blade at a free end thereof, said blade arm mounted to said main body portion via a linkage and moveable between a first position, in which said blade is aligned with a central axis of the deployment instrument and extends proximally therefrom, and a second position distal of said first position and radially removed from said central axis.
A method of loading a vessel in a deployment instrument having captured an anastomosis device for deployment of the anastomosis device to form an anastomosis between the vessel and a second vessel, said method comprising the steps of:
- inserting a plurality of grasping members through an interior opening in the anastomosis device from a distal end of the anastomosis device to extend from a proximal end of the anastomosis device;
- positioning a free end of the vessel between the grasping members;
- radially contracting the configuration of the grasping members to grasp the vessel and drawing the vessel through the anastomosis device;
- and
- radially expanding the configuration of the grasping members to release the vessel.
A method of everting a vessel over an anastomosis device, said method comprising the steps of:
- providing a vessel passing through an anastomosis device and having a free end extending therefrom;
- inserting an expandable member into the vessel through said free end;
- expanding said expandable member to expand the free end portion of the vessel;
- and
- rolling the expanded free end portion of the vessel off the expandable member, thereby everting the free end over the anastomosis device.
A method of everting a vessel over an anastomosis device, said method comprising the steps of:
- providing a vessel passing through an anastomosis device and having a free end extending distally therefrom;
- inserting an anchor member into the vessel through the free end and pressing the vessel against an inner surface of the anastomosis device to prevent the vessel from sliding with respect to the anastomosis device;
- expanding the free end portion of the vessel by radially expanding a plurality of expansion members;
- and
- driving the expanded free end proximally by proximal movement of the radially expanded expansion members.
Dependencies are inferred from the claim text.