Surgical instrumentation for performing endoluminal and/or transluminal anastomosis

A method for performing an endoluminal or transluminal anstomosis, such as e.g. a gastro-jejunostomy, a jejuno-jejunostomy, a colo-proctostomy, a jejuno-colostomy or anastomoses of the chole duct, comprising the following steps:

• creating a loop of guide wire by placing a guide wire (1, 2) in the body of a patient in a way that the guide wire (1, 2) extends from an extracorporeal proximal end (1′, 2′) into the body where it goes through a proximal tissue portion (3) and through a distal tissue portion (4) which are planned to be joined in anastomosis and out of the body up to an extracorporeal distal end (1″, 2″),
• fixing a proximal ring (5) of an anastomotic ring device to the proximal end (1′, 2′) of the guide wire (1, 2) and delivering the proximal ring (5) to the proximal tissue portion (3) by pulling the distal extracorporeal end (1″, 2″) of the guide wire (1, 2) in a distal direction until the proximal ring (5) reaches the proximal tissue portion (3),
• slidably connecting a distal ring (6) of the anastomotic ring device to the distal end (1″, 2″) of the guide wire (1, 2) and pushing it proximally along the guide wire until it reaches the distal tissue portion (4),
• contemporaneously pulling the distal end (1″, 2″) of the guide wire (1, 2) distally and pushing the distal ring (6) proximally to approximate the proximal and distal rings, thereby tearing the proximal and distal tissue portions (3, 4) situated upon the guide wire between the distal and proximal rings (5, 6) in contact to another,
• snap-connecting the distal ring (6) with the proximal ring (5), thereby clamping the distal and proximal tissue portions between them,
• cutting the tissue internally overhanging the anastomotic ring device to open the anastomotic lumen,
• pulling the proximal end (1′, 2′) of the guide wire (1, 2) to remove guide wire (1, 2) from the body,
• characterized in that the endoluminal introduction of one of the guide wire (1,2) and the proximal ring (5) is assisted by laparoscopically manipulating the natural duct.