Apparatus and method for performing a bypass procedure in a digestive system

An apparatus for facilitating performance of a gastroplasty procedure, which comprises:

• an outer guide member dimensioned for insertion and passage through an esophagus of a patient, the outer guide member having a proximal and distal ends, and defining an opening therein extending at least along a portion of the length of the outer guide member;
• an elongate anvil delivery member at least partially disposed within the opening of the outer guide member, the delivery member adapted for longitudinal movement within the outer guide member between an initial position and an actuated position;
• and
• an anvil operatively engageable with the delivery member, the anvil including an anvil rod defining a longitudinal axis and an anvil head connected to the anvil rod, the anvil head being at least partially disposed within the opening of the outer guide member when in the initial position of the delivery member and being fully exposed from the distal end of the outer guide member upon movement of the delivery member to the actuated position, the anvil head being pivotally mounted to the anvil rod, the anvil head pivotally movable between a non-operative position and an operative position.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil including an anvil head and an anvil rod extending from the anvil head through an esophagus of a patient and into a first digestive tissue portion;
• inserting an anastomosis instrument into a second digestive tissue portion displaced from the first digestive tissue portion;
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• engaging the anvil rod of the anvil with the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the first and second digestive tissue portions.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil including an anvil rod and an anvil head pivotally mounted to the anvil rod through an esophagus of a patient and into a first digestive tissue portion;
• inserting an anastomosis instrument into a second digestive tissue portion displaced from the first digestive tissue portion;
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• pivoting the anvil head from a non-operative position to an operative position;
• and
• firing the anastomosis instrument to connect the first and second digestive tissue portions.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil through an esophagus of a patient and into a first digestive tissue portion, the anvil being pivotally mounted to a support member;
• inserting an anastomosis instrument into a second digestive tissue portion displaced from the first digestive tissue portion;
• manipulating the anvil from a proximal location by pivoting the anvil relative to the support member to orient the anvil to a desired position with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the first and second digestive tissue portions.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil through an esophagus of a patient and into a first digestive tissue portion;
• inserting an anastomosis instrument through a trocar into a second digestive tissue portion displaced from the first digestive tissue portion;
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the first and second digestive tissue portions.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil through an esophagus of a patient and at least partially positioning the anvil into a stomach tissue portion;
• at least partially positioning an anastomosis instrument into an intestinal tissue portion
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the stomach tissue portion and the intestinal tissue portion.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil through an esophagus of a patient and at least partially positioning the anvil into an esophageal tissue portion;
• at least partially positioning an anastomosis instrument into one of a stomach tissue portion and an intestinal tissue portion
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the esophageal tissue portion to the one of the stomach portion and the intestinal tissue portion.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• introducing an anvil through an esophagus of a patient and at least partially positioning the anvil into a first stomach tissue portion,
• at least partially positioning an anastomosis instrument into a second stomach tissue portion
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the first stomach tissue portion and the second stomach tissue portion.

An anvil delivery instrument which comprises:

• an elongated outer member defining a general longitudinal axis and having proximal and distal ends, and defining a longitudinal bore;
• a pivot member at least partially disposed within the longitudinal bore of the outer member, the pivot member adapted for longitudinal movement within the outer member;
• and
• an anvil mounted to the outer member and operatively connected to the pivot member, the anvil including an anvil rod and an anvil head pivotally mounted to the anvil rod, the anvil head pivotally movable from a non-operative position to an operative position upon longitudinal movement of the pivot member, the anvil rod being mountable with respect to an end to end anastomosis instrument.

A method for performing a bypass procedure in a digestive system, comprising the steps of:

• providing an outer guide including an anvil movably and at least partially disposed therein;
• concurrently advancing the outer guide and the anvil through an esophagus of a patient and into a first digestive tissue portion;
• inserting an anastomosis instrument into a second digestive tissue portion displaced from the first digestive tissue portion;
• manipulating the anvil from a proximal location to position the anvil at a desired orientation with respect to the anastomosis instrument;
• connecting the anvil to the anastomosis instrument;
• and
• firing the anastomosis instrument to connect the first and second digestive tissue portions.