CA1135456A - Anastomotic coupling device - Google Patents
Anastomotic coupling deviceInfo
- Publication number
- CA1135456A CA1135456A CA000340842A CA340842A CA1135456A CA 1135456 A CA1135456 A CA 1135456A CA 000340842 A CA000340842 A CA 000340842A CA 340842 A CA340842 A CA 340842A CA 1135456 A CA1135456 A CA 1135456A
- Authority
- CA
- Canada
- Prior art keywords
- everted
- adaptors
- connector
- adaptor
- cylinder
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/10—Tube connectors; Tube couplings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/305—Snap connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/10—Tube connectors; Tube couplings
- A61M2039/1077—Adapters, e.g. couplings adapting a connector to one or several other connectors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M25/0905—Guide wires extendable, e.g. mechanisms for extension
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S285/00—Pipe joints or couplings
- Y10S285/921—Snap-fit
Abstract
ABSTRACT
ANASTOMOTIC COUPLING DEVICE
A three-piece anastomotic coupling device for end-to-end anastomosis of tubular members consisting of two open bore cylindrical adaptors and an open bore cylindrical connector. Each end of a tubular member is passed through the axial bore of an adaptor and everted over the end thereof. The adaptors are then inserted into opposite ends of the connector until the everted ends of the vessel abut under light compression. Integral locking means are pro-vided to secure the adaptors and tubular members of the connector piece.
ANASTOMOTIC COUPLING DEVICE
A three-piece anastomotic coupling device for end-to-end anastomosis of tubular members consisting of two open bore cylindrical adaptors and an open bore cylindrical connector. Each end of a tubular member is passed through the axial bore of an adaptor and everted over the end thereof. The adaptors are then inserted into opposite ends of the connector until the everted ends of the vessel abut under light compression. Integral locking means are pro-vided to secure the adaptors and tubular members of the connector piece.
Description
ETH-~7 ANASTOMOTIC COUPLING DEVICE
BACXGROUND OF THE INVENTION
The present invention relates to devices for end-to-end anastomosis of tubular organs, and more particularly, to anastomotic coupling devices for reconnecting the ends of severed blood vessels in a manner to promote the healing thereof.
End-to-end anastomosis of sevexed vessels may be accomplished either by suturing, stapling or mechanical coupling. Suturing is generally-difficult to perform, especially when very small vessels are involved, and re-quires great skill and experience on the part o the surgeon.
Suturing is also susceptible to complications resulting from damage to the vascular wall, leakage, and potential harboring of infection around the suture material.
Stapling and mechanical coupling of bloGd vessels has been suggested to avoid the disadvantages of 5Ut uring, and to provide a faster, more reliable and relatively sim-ple mothod of anastomosis. Various designs for mechanical couplins devices have been proposed, as for example, in U.S. Patents Nos. 2,453,056; 3,221,746; 3,254,650; 3,774,515;
and 3,974,835.
The ideal anastomotic coupling device should pro~
vide perfect adap~ation of the vascular members without damage to tne vascula~ wall, and be completely external of the vascular lumen. In addi~ion, the device must provide for auick, sure placement with a minimal posslbility for error on the part o the su-geon.
It is accordingly an object of th present inven-tion to provide an anastomotic coupling device providing ~..
: , , . -, , .
BACXGROUND OF THE INVENTION
The present invention relates to devices for end-to-end anastomosis of tubular organs, and more particularly, to anastomotic coupling devices for reconnecting the ends of severed blood vessels in a manner to promote the healing thereof.
End-to-end anastomosis of sevexed vessels may be accomplished either by suturing, stapling or mechanical coupling. Suturing is generally-difficult to perform, especially when very small vessels are involved, and re-quires great skill and experience on the part o the surgeon.
Suturing is also susceptible to complications resulting from damage to the vascular wall, leakage, and potential harboring of infection around the suture material.
Stapling and mechanical coupling of bloGd vessels has been suggested to avoid the disadvantages of 5Ut uring, and to provide a faster, more reliable and relatively sim-ple mothod of anastomosis. Various designs for mechanical couplins devices have been proposed, as for example, in U.S. Patents Nos. 2,453,056; 3,221,746; 3,254,650; 3,774,515;
and 3,974,835.
The ideal anastomotic coupling device should pro~
vide perfect adap~ation of the vascular members without damage to tne vascula~ wall, and be completely external of the vascular lumen. In addi~ion, the device must provide for auick, sure placement with a minimal posslbility for error on the part o the su-geon.
It is accordingly an object of th present inven-tion to provide an anastomotic coupling device providing ~..
: , , . -, , .
2--the afore6aid characteristics. It is a further o~ject of this invention to provide an anastomotic ccupling device particularly adapted for joining small blood vessels. A
yet further object of this invention is to provide a de-vice for joining the ends of interrupted tubular organs ofvarious sizes and functions, including, for example, veins, arteries, lymphatic ducts, oviducts, ureters, intestin2s~
and the like. These and other objects of the present in-vention will be evident from the ensuing description and claims.
SUMMARY
~ he anastomotic coupling device of the present in-vention consists of three pieces: two tubular adaptors and one intexlocking connector piece. Preferred adaptors con-si3t of an open cylindrical section terminating at one end in an expanding truncated conical section. The exterior surface of the conical section is provided with means for interlocking with said connector piece as hereinafter de-scribed.
The connector piece preferably consists of an open cylinder terminating at each end in extensions having meaTls thereon for interlocking with said adaptors when said adaptors are inserted into said conn2ctor.
In application, one end of the tubular member to be joined i~ passed through the conical sec.ion and cylin~
drical saction of one adap.or and everted over the end of the cylindrical section. The exterior surface of the cy-lindrical section is preferably provided with means for gripping the everted end of the tubular member.
The second adaptor is secured to the end of the other tubular member in a like manner.
One adaptox with the tubular member everted thereon is inserted into one end of the connector and Ihe locking means on the conical sec ion of said adaptor inter--locked with the locking means on the extensions of said connector. The se~-ond adaptor with the tubul2r member everted thereon is inserted into the other end of the - ~3~5~
connector and interlocked therewith in a like manner to com-plete the connection of the tubular member.
The inside diameter of the cylindrical section of the connector is greater than the outside diameter of the cylindrical section of the adaptor by an amount sufficient to accommodate the wall thickness of the everted tubular member. Preferably, the diameters are sized so that a small compressive force is exerted on the wall of the tubular mem-ber in the assembled connector.
The length of the cylindrical section of each adaptor is sized so that when assembled in the connector, the ends of the adaptors are spaced apart by a distance slightly less than twice the wall thickness of the tubular member. In this manner, the intimal surfaces of the everted ends of the tubular member are brought into contact under light compression which is effective to prevent leakage and is desirable to promote healing of the joined tissue.
The coupling device is completely external to the lumen of the tubular organ, and intraIuminal juncture be-tween the two ends is smooth and uniform. The flow ofblood or other fluid through the tubular organ is thereby maintained without disruption or stagnation which could re-sult in thrombosis or promote infec~ion.
In accordance with a particular embodiment of the invention, a three piece anastomotic coupling device for end-to-end anastomosis of tubular members comprises two adaptors and a connector, each of said adaptors comprising a cylinder having an axial bore therethrough sized to receive one tubular member with the end of said member everted over the end of said adaptor, said connector comprising a cylinder having an axial bore therethrough sized to receive each of said adaptors and the tubular member everted thereover in opposing ends of said cylinder with the everted ends of the tubular members in abutting contact within said cylinder, and means for inter-locking said adaptors and said connector to maintain the evertedends of the tubular mem~ers in contact.
. ~
~S~i6 - 3a -In accordance with a further embodiment of the invention, a three-piece anastomotic coupling device for joining the severed ends of a tubular member comprises ~wo adaptors and an interlocking connector, each of said adaptors comprising a cylinder having an axial bore therethrough terminating at one end in a plane normal to the axis of the bore and at the other end in an e~panding truncated conical member, means on the exterior s~rface of said conical member for interlocking with corresponding means on said connector piece, and means on the exterior surface of the plane end of said cylinder for gripping a tubular member everted thereover, said connector comprising a cylinder having an axial bore therethrough, and terminating at each end in appenda~es extending therefrom and having means on the interior surfaces at the distal ends thereof for interlocking with corresponding means on said adaptors, the inside diameter of the cylinder of said connector being larger than the maximum outside diameter of the cylinder of the adaptor, and the length of each adaptor being such that the ends of the adaptors are spaced apart when interlocked with said connector in the assembled coupling device, whereby each end of the tubular member to be joined may be passed through the conical member and cylinder of each adaptor and everted over the end thereo~, and said ends of said adaptors and everted tubular members thereon may be inserted into opposite ends o~
said connector and interlocked therewith with the intimal sur-faces of the everted tubular members abutting one another.
DESCRIPTION OF DRAWINGS
-Figure 1 is a plan view in partial cross section of an adaptor for the coupling device.
Figure 2 is a view in cross section of a connector for the coupling device.
Figure 3 is a plan view in partial cross section of the connector of Figure 2, rotated 90 degrees.
Figure 4 is a view in cross section of an assembled coupling device with the tubular member omitted for clarity.
Figure 5 is a view in perspective of one adaptor ~. ~
- ~3L;35~6 - 3b -attached to the end of a tubular vessel.
Figure 6 is a view in perspective of a tubular member connected by means of the coupling device of Figure 4.
Figure 7 is a plan view in partial cross section of a variation of the adaptor of Figure 1.
~, ETH--45 ~
~:~3~
DESCRlPTTON OF PREFERRED EMBODIMENTS
Referrlng now to Figure 1, there is il1ustrated in partial cross section adaptor 10 cons sting of cylindrica section 11 and expanding truncated conical section 12. A
plurality of annular ridges 13 circumscribe the outer circum-ference of section 11 over an area extending from the open end thereof. A single annular recess 14 circumscribes coni-cal section 12 and forms lockins ridge 15, the surface of which is in a plane substantially vertical to the axis of the adaptor.
Figure 2 illustrates in cross section a connector indicated generally as 16 for use with the adaptor o~
Figure 1. Connector 16 consists of a central cylindrical section 17 having locking appendages 18 and guiding append-ages 19 extendins from either end thereof. As illusLrated,locking appendages 18 are located on the vertical axis of the connector, and each appendage has distal locking means consisting of a beveled surface 20 forming ridge 21 on the inner surface thereof, the surface of ridge 21 being in a plane substantially vertical to the axis of the connector.
Also, as illustrated in Figure 2, guiding append-ages 19 are located on the horizontal axis of the connector.
Appendages 19 serve as guides during the assembly of the coupling and are not provided with locking means as best ~5 sean in the cross-sectional view of Figure 3.
Referring urther to Figure 2 and Figure 3, ap-pendages 18 and 19 are ~eveled at 22 in order ~o increase the effective inside diameter of the partial cylinder de-fined by the appendages and thereby facilitate and guide the insertion of the adaptors into the connector.
Referring now to Figure 4, there is illustrated a fully assembled coupling device according to Figures 1 and 2 with the tubular member omitted for clarity. Adaptors 10 are inserted into connector 16 until locking appendages 18 engage annular recess 14 in the adaptor, at which ~ime ridge 21 of appendage 18 abuts ridge 15 of the adaptor locking the adaptor securely in place. Bevel 20 on append~
age 18 guides the distal end of the appendage over the conical se_tion ~f the adaptor and into annlllar recess 1~.
S~
Guide appendages 19 (not shown in Figure 4), in cooperation with lock~ng appendages 18, assure positive positioning of the adaptor in the connector, and the dual locking appendages on opposing sides of the adaptor secure the adaptor firmly in position.
In the assembled coupling there is provided a de-sign space 23 between the outside diameter of the cylindri-cal section of the adaptor and the inside diameter of the cylindrical section of the connector. Space 23 serves to accommodate the wall o the tubular member which is everted over the end of the adaptor before assembly of the coupling.
Preferably, the width of space 23 is slightly less than the wall thickness in order to apply a light compressive force on the everted wall of the tubular member.
The assembled coupling also provides design space 24 between opposing ends of the adaptors in order to accom-modate the double wall thic~ness of the everted ends of the tubular mambers. The width of space 24 is preferably slightly less than twice the wall thic~ness in order to apply a compressive force on the everted walls o the tubu-lar members sufficient to prevent leakage through the junc-tion. A light compressive force also assures a smooth, con-tinuous, intraluminal junction between the everted ends of the tubular members and minimize any disruption of laminar flow within the lumen of the vessel.
The assembly of an adaptor to a severed end of a tubular member is illustrated in Figure 5 where vessel 25 is passed through the cylindrical bore of adaptor 10 and end 26 of vessel 25 is everted over the cylindrical section of the adaptor. Preferably, the everted portion of the vessel extends at least half way over the cylindrical sec-tion of the adaptor and sufficiently over gripping means 13 on the external surface of the adaptor to secure the adaptor on the vessel.
A fully assembled anastomotic coupling device joining the severed ends of a tubular member is illustrated in Figure 6.
The adaptor OL Figure 1 may be simplified by omit~
ting all or a major portion of the conical section as ~3~
illustrated in Figure 7. This design simplifies abrication of the piece and reduces the mass of foreign material to be implanted in the body which may be desirable under certain circumstances. The simplified design has a disadvantage, however, in being more difficult to handle and to assemble in the coupling device.
The anastomotic coupling device of the present invention may be construct~d in a variety of sizes, and is especially useful in connecting very small vessels, i.e., 1 ~o 5 mm OD, which are particularly difficult to suture.
The adaptors of the coupling device should have an inside diameter approximately equal to the outside diameter of the vessel for best results.
The coupling device may also be fabricated in larger sizes corresponding to the ou~side diameters of large veins, arteries, and intestines, and may furthermore be used to join natural tubular members to synthetic de-vices such as vascular prostheses of Dacron~or Teflon~
The coupling devices may be fabricated by any convenient means such às machining or molding, and of a variety of materials which are known to be biocompatible in surgical applications. Nyl~n, polypropylene, and poly-sulfone are illustrative of polymeric materials which are readily shaped into the miniature pieces of the coupling device. The device may also be fabricated of stainless steel, or of biologically absorbable materials such as polylactide, polyglycolide, and copolvmers of lactide alld glycolide which are known to hydrolyze in tissue with eventual complete absorption by the body.
The preceding description has been largely di-rected to preferred embodiments of the present invention, and many variations thereof will be apparent to those skilled in the art. For example, one or more locking ap-pendages 18 may be substituted for each guiding appendage 19 illustrated in Figure 4, and various means for inter-locking the end pieces and the connec~or piece may ba em-ployed withou~ departing from the spirit or scope o the present invention. In additlon, vessel gripping means 13 illustrated in Figure 1 may be omit.ed, or other gripping ~3~
means such as a knurled surface or miniature spikes may be substituted for the annular rings of the illustration.
The essential element of the present invention is a three-piece coupling device for end-to-end anastomosis of tubular members comprising two adaptors, each sized to receive the severed end of a tubular member with the end of the member everted over the adaptor, and a cylindrical con-nector sized to receive and secure each adaptor individually with the everted ends of the tubular member in abutment within said connector.
yet further object of this invention is to provide a de-vice for joining the ends of interrupted tubular organs ofvarious sizes and functions, including, for example, veins, arteries, lymphatic ducts, oviducts, ureters, intestin2s~
and the like. These and other objects of the present in-vention will be evident from the ensuing description and claims.
SUMMARY
~ he anastomotic coupling device of the present in-vention consists of three pieces: two tubular adaptors and one intexlocking connector piece. Preferred adaptors con-si3t of an open cylindrical section terminating at one end in an expanding truncated conical section. The exterior surface of the conical section is provided with means for interlocking with said connector piece as hereinafter de-scribed.
The connector piece preferably consists of an open cylinder terminating at each end in extensions having meaTls thereon for interlocking with said adaptors when said adaptors are inserted into said conn2ctor.
In application, one end of the tubular member to be joined i~ passed through the conical sec.ion and cylin~
drical saction of one adap.or and everted over the end of the cylindrical section. The exterior surface of the cy-lindrical section is preferably provided with means for gripping the everted end of the tubular member.
The second adaptor is secured to the end of the other tubular member in a like manner.
One adaptox with the tubular member everted thereon is inserted into one end of the connector and Ihe locking means on the conical sec ion of said adaptor inter--locked with the locking means on the extensions of said connector. The se~-ond adaptor with the tubul2r member everted thereon is inserted into the other end of the - ~3~5~
connector and interlocked therewith in a like manner to com-plete the connection of the tubular member.
The inside diameter of the cylindrical section of the connector is greater than the outside diameter of the cylindrical section of the adaptor by an amount sufficient to accommodate the wall thickness of the everted tubular member. Preferably, the diameters are sized so that a small compressive force is exerted on the wall of the tubular mem-ber in the assembled connector.
The length of the cylindrical section of each adaptor is sized so that when assembled in the connector, the ends of the adaptors are spaced apart by a distance slightly less than twice the wall thickness of the tubular member. In this manner, the intimal surfaces of the everted ends of the tubular member are brought into contact under light compression which is effective to prevent leakage and is desirable to promote healing of the joined tissue.
The coupling device is completely external to the lumen of the tubular organ, and intraIuminal juncture be-tween the two ends is smooth and uniform. The flow ofblood or other fluid through the tubular organ is thereby maintained without disruption or stagnation which could re-sult in thrombosis or promote infec~ion.
In accordance with a particular embodiment of the invention, a three piece anastomotic coupling device for end-to-end anastomosis of tubular members comprises two adaptors and a connector, each of said adaptors comprising a cylinder having an axial bore therethrough sized to receive one tubular member with the end of said member everted over the end of said adaptor, said connector comprising a cylinder having an axial bore therethrough sized to receive each of said adaptors and the tubular member everted thereover in opposing ends of said cylinder with the everted ends of the tubular members in abutting contact within said cylinder, and means for inter-locking said adaptors and said connector to maintain the evertedends of the tubular mem~ers in contact.
. ~
~S~i6 - 3a -In accordance with a further embodiment of the invention, a three-piece anastomotic coupling device for joining the severed ends of a tubular member comprises ~wo adaptors and an interlocking connector, each of said adaptors comprising a cylinder having an axial bore therethrough terminating at one end in a plane normal to the axis of the bore and at the other end in an e~panding truncated conical member, means on the exterior s~rface of said conical member for interlocking with corresponding means on said connector piece, and means on the exterior surface of the plane end of said cylinder for gripping a tubular member everted thereover, said connector comprising a cylinder having an axial bore therethrough, and terminating at each end in appenda~es extending therefrom and having means on the interior surfaces at the distal ends thereof for interlocking with corresponding means on said adaptors, the inside diameter of the cylinder of said connector being larger than the maximum outside diameter of the cylinder of the adaptor, and the length of each adaptor being such that the ends of the adaptors are spaced apart when interlocked with said connector in the assembled coupling device, whereby each end of the tubular member to be joined may be passed through the conical member and cylinder of each adaptor and everted over the end thereo~, and said ends of said adaptors and everted tubular members thereon may be inserted into opposite ends o~
said connector and interlocked therewith with the intimal sur-faces of the everted tubular members abutting one another.
DESCRIPTION OF DRAWINGS
-Figure 1 is a plan view in partial cross section of an adaptor for the coupling device.
Figure 2 is a view in cross section of a connector for the coupling device.
Figure 3 is a plan view in partial cross section of the connector of Figure 2, rotated 90 degrees.
Figure 4 is a view in cross section of an assembled coupling device with the tubular member omitted for clarity.
Figure 5 is a view in perspective of one adaptor ~. ~
- ~3L;35~6 - 3b -attached to the end of a tubular vessel.
Figure 6 is a view in perspective of a tubular member connected by means of the coupling device of Figure 4.
Figure 7 is a plan view in partial cross section of a variation of the adaptor of Figure 1.
~, ETH--45 ~
~:~3~
DESCRlPTTON OF PREFERRED EMBODIMENTS
Referrlng now to Figure 1, there is il1ustrated in partial cross section adaptor 10 cons sting of cylindrica section 11 and expanding truncated conical section 12. A
plurality of annular ridges 13 circumscribe the outer circum-ference of section 11 over an area extending from the open end thereof. A single annular recess 14 circumscribes coni-cal section 12 and forms lockins ridge 15, the surface of which is in a plane substantially vertical to the axis of the adaptor.
Figure 2 illustrates in cross section a connector indicated generally as 16 for use with the adaptor o~
Figure 1. Connector 16 consists of a central cylindrical section 17 having locking appendages 18 and guiding append-ages 19 extendins from either end thereof. As illusLrated,locking appendages 18 are located on the vertical axis of the connector, and each appendage has distal locking means consisting of a beveled surface 20 forming ridge 21 on the inner surface thereof, the surface of ridge 21 being in a plane substantially vertical to the axis of the connector.
Also, as illustrated in Figure 2, guiding append-ages 19 are located on the horizontal axis of the connector.
Appendages 19 serve as guides during the assembly of the coupling and are not provided with locking means as best ~5 sean in the cross-sectional view of Figure 3.
Referring urther to Figure 2 and Figure 3, ap-pendages 18 and 19 are ~eveled at 22 in order ~o increase the effective inside diameter of the partial cylinder de-fined by the appendages and thereby facilitate and guide the insertion of the adaptors into the connector.
Referring now to Figure 4, there is illustrated a fully assembled coupling device according to Figures 1 and 2 with the tubular member omitted for clarity. Adaptors 10 are inserted into connector 16 until locking appendages 18 engage annular recess 14 in the adaptor, at which ~ime ridge 21 of appendage 18 abuts ridge 15 of the adaptor locking the adaptor securely in place. Bevel 20 on append~
age 18 guides the distal end of the appendage over the conical se_tion ~f the adaptor and into annlllar recess 1~.
S~
Guide appendages 19 (not shown in Figure 4), in cooperation with lock~ng appendages 18, assure positive positioning of the adaptor in the connector, and the dual locking appendages on opposing sides of the adaptor secure the adaptor firmly in position.
In the assembled coupling there is provided a de-sign space 23 between the outside diameter of the cylindri-cal section of the adaptor and the inside diameter of the cylindrical section of the connector. Space 23 serves to accommodate the wall o the tubular member which is everted over the end of the adaptor before assembly of the coupling.
Preferably, the width of space 23 is slightly less than the wall thickness in order to apply a light compressive force on the everted wall of the tubular member.
The assembled coupling also provides design space 24 between opposing ends of the adaptors in order to accom-modate the double wall thic~ness of the everted ends of the tubular mambers. The width of space 24 is preferably slightly less than twice the wall thic~ness in order to apply a compressive force on the everted walls o the tubu-lar members sufficient to prevent leakage through the junc-tion. A light compressive force also assures a smooth, con-tinuous, intraluminal junction between the everted ends of the tubular members and minimize any disruption of laminar flow within the lumen of the vessel.
The assembly of an adaptor to a severed end of a tubular member is illustrated in Figure 5 where vessel 25 is passed through the cylindrical bore of adaptor 10 and end 26 of vessel 25 is everted over the cylindrical section of the adaptor. Preferably, the everted portion of the vessel extends at least half way over the cylindrical sec-tion of the adaptor and sufficiently over gripping means 13 on the external surface of the adaptor to secure the adaptor on the vessel.
A fully assembled anastomotic coupling device joining the severed ends of a tubular member is illustrated in Figure 6.
The adaptor OL Figure 1 may be simplified by omit~
ting all or a major portion of the conical section as ~3~
illustrated in Figure 7. This design simplifies abrication of the piece and reduces the mass of foreign material to be implanted in the body which may be desirable under certain circumstances. The simplified design has a disadvantage, however, in being more difficult to handle and to assemble in the coupling device.
The anastomotic coupling device of the present invention may be construct~d in a variety of sizes, and is especially useful in connecting very small vessels, i.e., 1 ~o 5 mm OD, which are particularly difficult to suture.
The adaptors of the coupling device should have an inside diameter approximately equal to the outside diameter of the vessel for best results.
The coupling device may also be fabricated in larger sizes corresponding to the ou~side diameters of large veins, arteries, and intestines, and may furthermore be used to join natural tubular members to synthetic de-vices such as vascular prostheses of Dacron~or Teflon~
The coupling devices may be fabricated by any convenient means such às machining or molding, and of a variety of materials which are known to be biocompatible in surgical applications. Nyl~n, polypropylene, and poly-sulfone are illustrative of polymeric materials which are readily shaped into the miniature pieces of the coupling device. The device may also be fabricated of stainless steel, or of biologically absorbable materials such as polylactide, polyglycolide, and copolvmers of lactide alld glycolide which are known to hydrolyze in tissue with eventual complete absorption by the body.
The preceding description has been largely di-rected to preferred embodiments of the present invention, and many variations thereof will be apparent to those skilled in the art. For example, one or more locking ap-pendages 18 may be substituted for each guiding appendage 19 illustrated in Figure 4, and various means for inter-locking the end pieces and the connec~or piece may ba em-ployed withou~ departing from the spirit or scope o the present invention. In additlon, vessel gripping means 13 illustrated in Figure 1 may be omit.ed, or other gripping ~3~
means such as a knurled surface or miniature spikes may be substituted for the annular rings of the illustration.
The essential element of the present invention is a three-piece coupling device for end-to-end anastomosis of tubular members comprising two adaptors, each sized to receive the severed end of a tubular member with the end of the member everted over the adaptor, and a cylindrical con-nector sized to receive and secure each adaptor individually with the everted ends of the tubular member in abutment within said connector.
Claims (20)
1. A three-piece anastomotic coupling device for end-to-end anastomosis of tubular members comprising two adaptors and a connector, each of said adaptors comprising a cylinder having an axial bore therethrough sized to re-ceive one tubular member with the end of said member everted over the end of said adaptor, said connector comprising a cylinder having an axial bore therethrough sized to receive each of said adapt-ors and the tubular member everted thereover in opposing ends of said cylinder with the everted ends of the tubular members in abutting contact within said cylinder, and means for interlocking said adaptors and said con-nector to maintain the everted ends of the tubular members in contact.
2. A device of Claim 1 wherein said adaptors in-clude means for gripping the everted end of the tubular member received therein.
3. A device of Claim 2 wherein said gripping means comprise a plurality of raised annular rings around the outer circumference of said adaptor.
4. A device of Claim 1 wherein the inside dia-meter of the axial bore of the connector exceeds the out-side diameter of the cylinder of the adaptor by an amount sufficient to accommodate the wall thickness of the everted tubular member.
5. A device of Claim 1 wherein the ends of the adaptors in the assembled device are spaced apart by a dis-tance sufficient to accommodate the combined wall thickness of the everted tubular members.
6. A device of Claim 1 wherein said means for interlocking said adaptors and said connector comprise ap-pendages extending from each end of said cylindrical con-nector piece, said appendages having an inward facing lip on the distal end thereof, and an annular ridge having an outward facing surface circumscribing each of said adaptors, said ridge being engaged by said lip to retain said adaptor in said connector.
7. A device of Claim 1 fabricated of a biocompat-ible polymeric material.
8. A device of Claim 7 wherein said material is absorbable in a biological system.
9. A device of Claim 8 wherein said material is selected from the group consisting of homopolymers and co-polymers of lactide and glycolide.
10. A device of Claim 7 wherein said material is selected from the group consisting of nylon, polypropylene and polysulfone.
11. A device of Claim 1 wherein the diameter of the axial bore in the cylinder of the adaptor is 1 to 5 mm.
12. A three-piece anastomotic coupling device for joining the severed ends of a tubular member comprising two adaptors and an interlocking connector, each of said adapt-ors comprising a cylinder having an axial bore therethrough terminating at one end in a plane normal to the axis of the bore and at the other end in an expanding truncated conical member, means on the exterior surface of said conical member for interlocking with corresponding means on said connector piece, and means on the exterior surface of the plane end of said cylinder for gripping a tubular member everted thereover, said connector comprising a cylinder having an axial bore therethrough, and terminating at each end in ap-pendages extending thereform and having means on the inte-rior surfaces at the distal ends thereof for interlocking with corresponding means on said adaptors, the inside diameter of the cylinder of said con-nector being larger than the maximum outside diameter of the cylinder of the adaptor, and the length of each adaptor being such that the ends of the adaptors are spaced apart when in-terlocked with said connector in the assembled coupling device, whereby each end of the tubular member to be joined may be passed through the conical member and cylinder of each adaptor and everted over the end thereof, and said ends of said adaptors and everted tubular members thereon may be in-serted into opposite ends of said connector and interlocked therewith with the intimal surfaces of the everted tubular members abutting one another.
13. A device of Claim 12 wherein the gripping means for the everted tubular members comprise a plurality of raised, annular rings around the outer circumference of the cylinder of the adaptor.
14. A device of Claim 12 wherein the inside dia-meter of the connector is larger than the outside diameter of the adaptor by an amount sufficient to accommodate the wall thickness of the everted tubular member.
15. A device of Claim 12 where the adaptors in the assembled coupling device are spaced apart by a distance sufficient to accommodate the combined wall thickness of the everted tubular members.
16. A device of Claim 12 fabricated of a biocom-patible polymeric material.
17. A device of Claim 16 wherein said material is absorbable in a biological system.
18. A device of Claim 17 wherein said material is selected from the group consisting of homopolymers and co-polymers of lactide and glycolide.
19. A device of Claim 16 wherein said material is selected from the group consisting of nylon, polypropylene and polysulfone.
20. A device of Claim 12 wherein the diameter of the axial bore in the cylinder of the adaptor is 1 to 5 mm.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US965,448 | 1978-11-30 | ||
US05/965,448 US4214586A (en) | 1978-11-30 | 1978-11-30 | Anastomotic coupling device |
Publications (1)
Publication Number | Publication Date |
---|---|
CA1135456A true CA1135456A (en) | 1982-11-16 |
Family
ID=25509974
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA000340842A Expired CA1135456A (en) | 1978-11-30 | 1979-11-28 | Anastomotic coupling device |
Country Status (17)
Country | Link |
---|---|
US (1) | US4214586A (en) |
JP (1) | JPS5576649A (en) |
AU (1) | AU527800B2 (en) |
BE (1) | BE880378A (en) |
BR (1) | BR7907751A (en) |
CA (1) | CA1135456A (en) |
CH (1) | CH643452A5 (en) |
DE (1) | DE2948145A1 (en) |
ES (1) | ES486424A1 (en) |
FR (1) | FR2442621A1 (en) |
GB (1) | GB2039652B (en) |
IN (1) | IN151573B (en) |
IT (1) | IT1120638B (en) |
NL (1) | NL7908653A (en) |
SE (1) | SE7909863L (en) |
SU (1) | SU1144613A3 (en) |
ZA (1) | ZA796478B (en) |
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US11020252B2 (en) | 2018-01-10 | 2021-06-01 | Cook Medical Technologies Llc | Longitudinally folded stent and method of using same |
US11376410B2 (en) * | 2018-05-07 | 2022-07-05 | Boston Scientific Scimed, Inc. | Bodily implant with a tubing connector |
CA3139379A1 (en) | 2019-05-07 | 2020-11-12 | Easyflomicro Inc. | Apparatuses for anastomosis of tubular vessels and related methods |
US11708924B2 (en) * | 2020-06-26 | 2023-07-25 | Carefusion 303, Inc. | Connector coupling assembly |
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US517192A (en) * | 1894-03-27 | Hose-coupling | ||
US824753A (en) * | 1904-09-30 | 1906-07-03 | John H Stephens | Hose-coupling. |
US2388992A (en) * | 1944-03-31 | 1945-11-13 | Resistoflex Corp | Hose coupling |
US2453056A (en) * | 1947-03-12 | 1948-11-02 | Zack William Edwin | Surgical anastomosis apparatus and method |
US3155095A (en) * | 1961-02-07 | 1964-11-03 | Adolph M Brown | Anastomosis method and means |
US3254650A (en) * | 1962-03-19 | 1966-06-07 | Michael B Collito | Surgical anastomosis methods and devices |
US3226137A (en) * | 1962-04-16 | 1965-12-28 | Otto A Trnka | Fire-hose mender |
US3221746A (en) * | 1963-01-25 | 1965-12-07 | Noble John William | Surgical connecting device |
FR1518083A (en) * | 1967-03-03 | 1968-03-22 | Pfau Wanfried G M B H H | Device for anastomosis of blood vessels |
US3496939A (en) * | 1967-08-09 | 1970-02-24 | Carlos E Odiaga | Surgical anastomotic sleeve coupling |
GB1251205A (en) * | 1968-04-02 | 1971-10-27 | ||
US3640552A (en) * | 1969-08-13 | 1972-02-08 | Amp Inc | Vacuum or pressure coupling devices |
US3588149A (en) * | 1969-08-13 | 1971-06-28 | Amp Inc | Vacuum or pressure coupling devices |
US3797499A (en) * | 1970-05-13 | 1974-03-19 | Ethicon Inc | Polylactide fabric graphs for surgical implantation |
US3683926A (en) * | 1970-07-09 | 1972-08-15 | Dainippon Pharmaceutical Co | Tube for connecting blood vessels |
US3774615A (en) * | 1971-02-08 | 1973-11-27 | Ceskoslovenska Akademie Ved | Device for connecting or joining the ends of interrupted tubular organs in surgical operations without stitching |
US3974835A (en) * | 1972-11-30 | 1976-08-17 | Hardy Jr Thomas G | Anastomotic apparatus and method |
US4137921A (en) * | 1977-06-24 | 1979-02-06 | Ethicon, Inc. | Addition copolymers of lactide and glycolide and method of preparation |
-
1978
- 1978-11-30 US US05/965,448 patent/US4214586A/en not_active Expired - Lifetime
-
1979
- 1979-09-21 IN IN989/CAL/79A patent/IN151573B/en unknown
- 1979-09-27 AU AU51252/79A patent/AU527800B2/en not_active Ceased
- 1979-11-27 IT IT50919/79A patent/IT1120638B/en active
- 1979-11-28 FR FR7929274A patent/FR2442621A1/en active Granted
- 1979-11-28 JP JP15307379A patent/JPS5576649A/en active Pending
- 1979-11-28 ES ES486424A patent/ES486424A1/en not_active Expired
- 1979-11-28 CA CA000340842A patent/CA1135456A/en not_active Expired
- 1979-11-29 ZA ZA00796478A patent/ZA796478B/en unknown
- 1979-11-29 BR BR7907751A patent/BR7907751A/en unknown
- 1979-11-29 SE SE7909863A patent/SE7909863L/en not_active Application Discontinuation
- 1979-11-29 NL NL7908653A patent/NL7908653A/en not_active Application Discontinuation
- 1979-11-29 DE DE19792948145 patent/DE2948145A1/en not_active Withdrawn
- 1979-11-30 BE BE0/198383A patent/BE880378A/en not_active IP Right Cessation
- 1979-11-30 SU SU792850128A patent/SU1144613A3/en active
- 1979-11-30 CH CH1068479A patent/CH643452A5/en not_active IP Right Cessation
- 1979-11-30 GB GB7941384A patent/GB2039652B/en not_active Expired
Also Published As
Publication number | Publication date |
---|---|
SU1144613A3 (en) | 1985-03-07 |
FR2442621A1 (en) | 1980-06-27 |
DE2948145A1 (en) | 1980-06-12 |
JPS5576649A (en) | 1980-06-09 |
SE7909863L (en) | 1980-05-31 |
CH643452A5 (en) | 1984-06-15 |
AU5125279A (en) | 1980-06-26 |
BR7907751A (en) | 1980-07-22 |
US4214586A (en) | 1980-07-29 |
FR2442621B1 (en) | 1983-12-30 |
ZA796478B (en) | 1981-07-29 |
GB2039652B (en) | 1983-01-06 |
ES486424A1 (en) | 1980-06-16 |
IT1120638B (en) | 1986-03-26 |
GB2039652A (en) | 1980-08-13 |
IT7950919A0 (en) | 1979-11-27 |
IN151573B (en) | 1983-05-28 |
AU527800B2 (en) | 1983-03-24 |
NL7908653A (en) | 1980-06-03 |
BE880378A (en) | 1980-05-30 |
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