CA1175315A - Anastomotic device and method - Google Patents
Anastomotic device and methodInfo
- Publication number
- CA1175315A CA1175315A CA000388222A CA388222A CA1175315A CA 1175315 A CA1175315 A CA 1175315A CA 000388222 A CA000388222 A CA 000388222A CA 388222 A CA388222 A CA 388222A CA 1175315 A CA1175315 A CA 1175315A
- Authority
- CA
- Canada
- Prior art keywords
- ring members
- tubular member
- free end
- members
- ring
- 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
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
Abstract
28,216 ANASTOMOTIC DEVICE AND METHOD
ABSTRACT
An anastomotic device and method for receiving the free ends of anatomic tubular structures to be anas-tomosed, the device having a pair of ring members for securement to the free end of each of the tubular members to be anastomosed and the ring members having annular con-necting means which mate with each other to connect the ring members. Novel securement means are associated with the annular connecting means to enable the securement of the ring members in a fixed relationship at a predetermined distance from each other. Means are provided to connect each tubular member free end over a ring member so that the free ends are positioned contiguous to each other around the connecting means to enable the ends to grow together and approximate the outer surface of the tubular member.
ABSTRACT
An anastomotic device and method for receiving the free ends of anatomic tubular structures to be anas-tomosed, the device having a pair of ring members for securement to the free end of each of the tubular members to be anastomosed and the ring members having annular con-necting means which mate with each other to connect the ring members. Novel securement means are associated with the annular connecting means to enable the securement of the ring members in a fixed relationship at a predetermined distance from each other. Means are provided to connect each tubular member free end over a ring member so that the free ends are positioned contiguous to each other around the connecting means to enable the ends to grow together and approximate the outer surface of the tubular member.
Description
3 ~ ~
28,216 This. invention relates to an anastomotic de.vice and method and particularly to a surgi.cal clamp and method for using same for ana~tomo~ing one ~ollo.w or tu~ular member to anoth~r such as, for example, the ~evered end~ of the intestine after surgery.
The prior art techni~ues for joining the severed : ends of the inte5tine include stitchin.g the severed ends.
of the vessel together or ucing stapling instruments all of which have some inherent disadvantages. Technical ~ difficulties in utilizlng suturing techlliques often occur : because of the inaccessi~ility of ona or ~oth of the ends ;to ~e joined or the time involved for anastomo.sis. Stapling instruments al50 h~ve~some inherent dis.advantagesL:
t i.s desirable~that a non-permanent connector or : junction devi:ce ~e used to:join the vessel ends in anas-tomotic ~urgery, since a permanent connector will tend to : prevent the:changès in diameter which are nece~saxy ~or the proper functioning of th.e intestine. Any foreign su~stance~u~ed in anastomotic~surgery ideally should dis-integrate in a relatively.;short period of ti~e once : h~aling of~th vesseL~ends~ is:~initiated.
The present invention~has~been developed:to meet the cuxrent requirements of anastomotic surgery and to provide a afe, relatively inexpensive and easy manner to : : u5e an ana~tomotic device and~method. It is a disintegrata~le : ana~tomotic;article ~hich:has a locking fea~ure to accom-modate a~Dtting ends of tu~.ing ~ithin a range of tu~ing .
, 175~1~
wall thicknesses.
The invention provides in an anastomosis device for use in the surgical joining of the ~ree ends of two tubular members to be anastomosed including: a pair of ring members for securement to the free end of each of the tubular members to be anastomosed, each of said ring members having an inner and an outer surface;
annular connecting means joined to each of said ring members cooperatively mating with each other to connect said ring members;
and means associated with said annular connecting means enabling the securement of said ring members at a distance each from the other whereby said tubular member free ends are positioned con-tiguous to each other over said ring members and around said con-necting means to enable the ends to grow together and approximate the outer surface of the tubular member, the improvement to said means enabling the securement of said ring members a-t a distance each from the other comprising means for attachment of said ring members in a fixed relationship at a predetermined distance each from the other; and means connecting each tubular member free end over a ring member and to said connecting means, said ring members, annular connecting means, and said securement enabling means being formed of a disintegratable material.
The device may include an engageable locking notch :: :
carried by mating prongs joining each of the two ring membèrs which retain the ring members in a preselected relationship with each other after being closed from the open position. Because the distance between the ring members can be varied in the manufactur-ing process to accommodate different thicknesses of tubular member walls, the device can be used in a variety of differing circum-~ 17531 ~
stances~ The ring members and affixed mating prongs are so designed that they consist of primarily a singular part that can be injection molded. Two such molded parts can be put together without complications, so that an anastomotic device susceptible to mass production and easy assembly is provided.
Further details are explained below with the help of examples illustrated in the attached drawing wherein like characters of reference designate like parts throughout the several views and in which:
Figure 1 is a perspective view of the anastomotic device according to the present invention shown in broken lines in the closed position and positioned to join the free ends of a tubular member contiguous with each other;
Figure 2 is a plan view of a single unitary member of the anastomotic device according to the present invention;
Figure 3 is a side view of the anastomotic device accord-: ing to the present invention shown in solid lines in an engaged but unlocked position and in broken lines in an engaged and locked position, 20~ ~ Figure 4 is a side elevational view of the single unitary member of Figure 2 having a single ring member and an associated -~ mating prong with locking notches designed therein;
: Figure 5 is a top view of the single unitary member according to Figure 4;
Figure 6 is an enlarged fra~mentary view of the locking notches carried by the mating prong according to Figure 4;
Figure 7 is an isolated side elevational view of the receiving slot of the single unitary member according to Figure 4;
~,~
~ 4 -531~
Figure 8 (on the same sheet as Figure l) is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of a tubular member with the device in the open or unlocked position.
FIGURE 9 (on the same sheet as Figure 1) is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of a tubular member with ; the device in thP closed position.
FIGURE 10 is a plan view of a single unitary member of a second embodiment of the anastomotic device comprising the present invention;
: FIGURE 11 is a side view of a second embodiment of the anastomotic device according to the present invention shown in solid lines in an engaged but unlocked position and in broken lines in an engaged and locked position;
FIGURE 12 is a side elevational view of the single `~ unitary member of FIGURE 2 having a single ring member and an associated mating prong with locking notches designed therein;
~;~ FIGURE 13 is a top view of the single unitary member shown in FIGURE 12;
FIGURE 14 is a fragmentary sectional view of the single unitary member shown in FIGURE 5 taken along line 14-14;
.
~ - 4a -17531 ~
Figure 15 is an isolated side elevational view of the single unitary member shown in Figure 5 taken along line 15-15;
Figure 16 is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of a tubular member with the device in the open or unlocked position.
Figure 17 is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of the tubular member with the device in the closed position.
Figure 18 is a perspective view of the anastomotic device forming the present invention functionally displaced from the free ends of a tubular member to be attached thereto~
Figure 19 is a perspective view similar to Figure 18 where-in the anastomotic device has been attached to one end of the tub-ular member.
Figure 20 is a perspective view similar to Figures 18 and 19 wherein one end of the tubular member has been tightened about the anastomotic device forming the present invention by a purse ~20 string sutureO
Figure 21 is a perspective view of the anastomotic device forming the present invention wherein the second end of a severed tubular member is being pulled across the free ring member for subsequent connection thereto;
Figure 22 is a perspective view of the anastomotic device forming the present invention which is functionally positioned to join the free ends of a tubular member for coupling in the closed position.
. :
~ 17531~ .
Referring now to the drawings and particularly to Figure 1, the free end~ 2Q and 22 of two tubular tissue members, sho~n here as cut ends of intestinal tracts and referred to generall~ a& 24 and 26, have been anastomosed ~y using the device comprising th~ present invention shown by broken lines in outline form and designated generally a~ 28.
A first embodiment of anastomotic device 28 is shown in complete form in Fig. 3 while a single unitary member, two of which make up device 28, is shown generally as 30 and is illustrated in FIGS. 2, 4, and 5. Member 30 is made up of a ring member 32 having a plurality of slots 34 and apertures 36 about its periphery and carries a mating prong 38 which extends from ring member 32 ina direction substantially parallel to the cen-terline of the ring member. ~ating prong 38 extending from the circular ring forms approximately one~half of annular coupling ; tube 40 since it is affixed to approximately one-half of ring member 32 as illustrated in FIG. 5.
'~ ~ Each mating prong 38 carries a locking notch 42 designed and positioned to mate cooperatively with an engaging slot 43 e~tendin~ outwardly from ring member 32~as a part of prong 38. The locking notch 42 is designed with a sloping for~ard edge, 44 to facilitate easy relative motion when the two mem~ers 3~ are joined and urged operatively , together. ThQ notches 42 each then have a vertical en-gaging edge 46 which functions with slots 43 to lock mem~er_ 30 in place and form anastomotic device 28.
A second embodiment of anastomotic device 28 as shown in ' complete Eorm in FIG~ 11 while a single unitary member, two of whi~ch make up device 28, is shown generally as 56 and is illustrated in FIGS~ 10 and 13. Member 56 is made up of a ring member 58 having a plurality of slots 60 and apertures 62 about `:
- 7 ~
its periphery and carries a pair of oppositely positioned depending legs 64 each supporting a plurality of mating slots 66. Alternately positioned between Legs 64 and opposite each other are depending members 68 which forms notch engaging recesses 70 to cooperatively receive notches 66 when the two uni-tary members 56 are joined together to form anastomotic device 28.
The notch 66 carried by depending legs 64 are designed with partially sloped forward edge of 72 to facilitate easy motion.
when the two unitary members 56 are joined and urged together.
Each notch 66 has a somewhat inwardly curved engaging edge 74 as shown in FIG.12 which functions with notch receiving recesses 70 to lock unitary members 56 in place and form anastomotic device 28.
In the second embodiment of the anastomotic device notches 66 are strategically positioned on each depending legs 64 of unitary member 56 to enable the anastomotic device 28 formed from two members 5~ to be positioned in a first fixed arrangement as shown in solid lines in FIG. 11 or in a second fixed position with~the members closer together as shown in combined solid and broken lines in FIG. 11. Obviously any number of notches can be positioned on depending legs 65 to achieve other desired posi-ions.t i5 ne~ess.ar~ that mem~ers 30 and 56 forming d~vice 28 he.made from a material that ~ill permit dis~
integration of the device i.~ a relatively short period of time once healing of t~e ve sel ends. comme~ces. Acceptable ~aterials for forming the de~ice are e.g, a homopolymer of ~ ~7531~ .
polyhydroxyacetic ester, and lactide copolymers thereof.
Molded surgical arti.cles. ~ade ~rom a wlde range of glycolide/lactïde.copolymers have been kno~n and utilized for quite. some. time~
The utilization.of the a~as-tomotic device accord~
ing to the present inventi.on i5 shown in Figures 10 through 14 wherein the free ends 2~ and 2~ of two tubular mem~ers 24 and 26 are ætitched ~ith a purse string suture 52. Use of this suture permits engaging the very edge of the free e~d of the vessel wall 50 that the suturing material can ~ pulled and the vessel end contracted much in the way th~ top of a purse or string closed ~.ag is manipulated.
Th~ ends 2~ and 22 are then pulled over ring member 32 so that a~ the suture is tightened, and the ends 2~ and 22 of the ve~el 24 and 26 are turned inwardly over ring members 32 as shown in Figure 8. The members 32 are then urged togeth~r until the notches 42 are engaged within the slots 43 t~us ~orming thQ connected annular coupling tube 4~
of the~'de.vlce 28. When members 32 are in the appropriate relationship by the formation of annular coupling tu~e 40, the free ends of the two tuhular members are contiguously positioned in a manner that ~ill enable them to grow to-gether p~rmanently- as sho~n in Figure q.
Th~ devi.ce 28 provides ample space for the anas-tomosis to be performed ater the mem~ers 32 are urged ::
: tog~ther and thR mating prongs 38 engage ~ith each other to ~: : foxm the. annular coupling tu~ 4Q. Bowel tissue is mech-anically held together ~y the orce of the purse string ~sutura against the annular coupling tube 40, and the clamp-; Lng force of the ring memkers compresses the t~o ends to-gether. ~
A variety of diameters and spacings for the : ring mem~ers and diameters for the annular coupling tube are. de.s.irable to provide needed versatility of use within the needed sizes for a~imals and humans. Moreover, there are certain unusual tubular configurations within humans and animals that might ~etter use a similar anastomotic ~, ~175315 de~ice h~Ying ellip~i.cally shaped ring members and resulting annular coupling tubes rather than the circular configuration shown in t~e. accompanying drawings. Such embodiments are vie~ed as heing ~ithin the scope of this disclosure and thP. accompanying claims.
It ;s to be understood that the anastomotic device made. of the. materials referenced above can be designed to disinte.grate in a given peri.od of time~ Other matexi.als which can be deslgned to dl~integrate. in a given period of time include e.g. a mixture comprising up to about 5~% ~y ~eight of an inert filler and a polymer ~hich i5 subject to h~drolytic degradation into non toxic, tissue-compati~le a~sor~a~le components, said polymer having a glycolic acid ester linkage. Such material offers many ~advantages over conventional anastomotic devices and permits~ ~imple, rapid anastomosis in difficult areas.
For example, it permLts a simpler anastomosi.s in a low rectosigmoid ana~tomosis ~hich ordinarily would ~e quite time consuming and difficult perhaps requiring temporary colostomy, or eve.n heing impossible in those cases neces-sitating a permanent colostomy.
It ~ill ~e apparent that the present invention is comprised ~asi.cally of t~o single unitary members each haYing a disintegratable ring mem~er and connected mating prong ~hich cooperatively unite to form the embodiment de-scri~ed herein. However, the invention in its broader aspects i5 not limi.ted to the specific embodiment herein s.~ow.n and descri~ed, and~departures may be made therefrom w.ithin the. scope of the accompanying claim without departing from its principles and ~ithout sacrificlng its chief ad-vantages.
28,216 This. invention relates to an anastomotic de.vice and method and particularly to a surgi.cal clamp and method for using same for ana~tomo~ing one ~ollo.w or tu~ular member to anoth~r such as, for example, the ~evered end~ of the intestine after surgery.
The prior art techni~ues for joining the severed : ends of the inte5tine include stitchin.g the severed ends.
of the vessel together or ucing stapling instruments all of which have some inherent disadvantages. Technical ~ difficulties in utilizlng suturing techlliques often occur : because of the inaccessi~ility of ona or ~oth of the ends ;to ~e joined or the time involved for anastomo.sis. Stapling instruments al50 h~ve~some inherent dis.advantagesL:
t i.s desirable~that a non-permanent connector or : junction devi:ce ~e used to:join the vessel ends in anas-tomotic ~urgery, since a permanent connector will tend to : prevent the:changès in diameter which are nece~saxy ~or the proper functioning of th.e intestine. Any foreign su~stance~u~ed in anastomotic~surgery ideally should dis-integrate in a relatively.;short period of ti~e once : h~aling of~th vesseL~ends~ is:~initiated.
The present invention~has~been developed:to meet the cuxrent requirements of anastomotic surgery and to provide a afe, relatively inexpensive and easy manner to : : u5e an ana~tomotic device and~method. It is a disintegrata~le : ana~tomotic;article ~hich:has a locking fea~ure to accom-modate a~Dtting ends of tu~.ing ~ithin a range of tu~ing .
, 175~1~
wall thicknesses.
The invention provides in an anastomosis device for use in the surgical joining of the ~ree ends of two tubular members to be anastomosed including: a pair of ring members for securement to the free end of each of the tubular members to be anastomosed, each of said ring members having an inner and an outer surface;
annular connecting means joined to each of said ring members cooperatively mating with each other to connect said ring members;
and means associated with said annular connecting means enabling the securement of said ring members at a distance each from the other whereby said tubular member free ends are positioned con-tiguous to each other over said ring members and around said con-necting means to enable the ends to grow together and approximate the outer surface of the tubular member, the improvement to said means enabling the securement of said ring members a-t a distance each from the other comprising means for attachment of said ring members in a fixed relationship at a predetermined distance each from the other; and means connecting each tubular member free end over a ring member and to said connecting means, said ring members, annular connecting means, and said securement enabling means being formed of a disintegratable material.
The device may include an engageable locking notch :: :
carried by mating prongs joining each of the two ring membèrs which retain the ring members in a preselected relationship with each other after being closed from the open position. Because the distance between the ring members can be varied in the manufactur-ing process to accommodate different thicknesses of tubular member walls, the device can be used in a variety of differing circum-~ 17531 ~
stances~ The ring members and affixed mating prongs are so designed that they consist of primarily a singular part that can be injection molded. Two such molded parts can be put together without complications, so that an anastomotic device susceptible to mass production and easy assembly is provided.
Further details are explained below with the help of examples illustrated in the attached drawing wherein like characters of reference designate like parts throughout the several views and in which:
Figure 1 is a perspective view of the anastomotic device according to the present invention shown in broken lines in the closed position and positioned to join the free ends of a tubular member contiguous with each other;
Figure 2 is a plan view of a single unitary member of the anastomotic device according to the present invention;
Figure 3 is a side view of the anastomotic device accord-: ing to the present invention shown in solid lines in an engaged but unlocked position and in broken lines in an engaged and locked position, 20~ ~ Figure 4 is a side elevational view of the single unitary member of Figure 2 having a single ring member and an associated -~ mating prong with locking notches designed therein;
: Figure 5 is a top view of the single unitary member according to Figure 4;
Figure 6 is an enlarged fra~mentary view of the locking notches carried by the mating prong according to Figure 4;
Figure 7 is an isolated side elevational view of the receiving slot of the single unitary member according to Figure 4;
~,~
~ 4 -531~
Figure 8 (on the same sheet as Figure l) is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of a tubular member with the device in the open or unlocked position.
FIGURE 9 (on the same sheet as Figure 1) is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of a tubular member with ; the device in thP closed position.
FIGURE 10 is a plan view of a single unitary member of a second embodiment of the anastomotic device comprising the present invention;
: FIGURE 11 is a side view of a second embodiment of the anastomotic device according to the present invention shown in solid lines in an engaged but unlocked position and in broken lines in an engaged and locked position;
FIGURE 12 is a side elevational view of the single `~ unitary member of FIGURE 2 having a single ring member and an associated mating prong with locking notches designed therein;
~;~ FIGURE 13 is a top view of the single unitary member shown in FIGURE 12;
FIGURE 14 is a fragmentary sectional view of the single unitary member shown in FIGURE 5 taken along line 14-14;
.
~ - 4a -17531 ~
Figure 15 is an isolated side elevational view of the single unitary member shown in Figure 5 taken along line 15-15;
Figure 16 is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of a tubular member with the device in the open or unlocked position.
Figure 17 is a sectional view of a first embodiment of the anastomotic device comprising the present invention joining the free ends of the tubular member with the device in the closed position.
Figure 18 is a perspective view of the anastomotic device forming the present invention functionally displaced from the free ends of a tubular member to be attached thereto~
Figure 19 is a perspective view similar to Figure 18 where-in the anastomotic device has been attached to one end of the tub-ular member.
Figure 20 is a perspective view similar to Figures 18 and 19 wherein one end of the tubular member has been tightened about the anastomotic device forming the present invention by a purse ~20 string sutureO
Figure 21 is a perspective view of the anastomotic device forming the present invention wherein the second end of a severed tubular member is being pulled across the free ring member for subsequent connection thereto;
Figure 22 is a perspective view of the anastomotic device forming the present invention which is functionally positioned to join the free ends of a tubular member for coupling in the closed position.
. :
~ 17531~ .
Referring now to the drawings and particularly to Figure 1, the free end~ 2Q and 22 of two tubular tissue members, sho~n here as cut ends of intestinal tracts and referred to generall~ a& 24 and 26, have been anastomosed ~y using the device comprising th~ present invention shown by broken lines in outline form and designated generally a~ 28.
A first embodiment of anastomotic device 28 is shown in complete form in Fig. 3 while a single unitary member, two of which make up device 28, is shown generally as 30 and is illustrated in FIGS. 2, 4, and 5. Member 30 is made up of a ring member 32 having a plurality of slots 34 and apertures 36 about its periphery and carries a mating prong 38 which extends from ring member 32 ina direction substantially parallel to the cen-terline of the ring member. ~ating prong 38 extending from the circular ring forms approximately one~half of annular coupling ; tube 40 since it is affixed to approximately one-half of ring member 32 as illustrated in FIG. 5.
'~ ~ Each mating prong 38 carries a locking notch 42 designed and positioned to mate cooperatively with an engaging slot 43 e~tendin~ outwardly from ring member 32~as a part of prong 38. The locking notch 42 is designed with a sloping for~ard edge, 44 to facilitate easy relative motion when the two mem~ers 3~ are joined and urged operatively , together. ThQ notches 42 each then have a vertical en-gaging edge 46 which functions with slots 43 to lock mem~er_ 30 in place and form anastomotic device 28.
A second embodiment of anastomotic device 28 as shown in ' complete Eorm in FIG~ 11 while a single unitary member, two of whi~ch make up device 28, is shown generally as 56 and is illustrated in FIGS~ 10 and 13. Member 56 is made up of a ring member 58 having a plurality of slots 60 and apertures 62 about `:
- 7 ~
its periphery and carries a pair of oppositely positioned depending legs 64 each supporting a plurality of mating slots 66. Alternately positioned between Legs 64 and opposite each other are depending members 68 which forms notch engaging recesses 70 to cooperatively receive notches 66 when the two uni-tary members 56 are joined together to form anastomotic device 28.
The notch 66 carried by depending legs 64 are designed with partially sloped forward edge of 72 to facilitate easy motion.
when the two unitary members 56 are joined and urged together.
Each notch 66 has a somewhat inwardly curved engaging edge 74 as shown in FIG.12 which functions with notch receiving recesses 70 to lock unitary members 56 in place and form anastomotic device 28.
In the second embodiment of the anastomotic device notches 66 are strategically positioned on each depending legs 64 of unitary member 56 to enable the anastomotic device 28 formed from two members 5~ to be positioned in a first fixed arrangement as shown in solid lines in FIG. 11 or in a second fixed position with~the members closer together as shown in combined solid and broken lines in FIG. 11. Obviously any number of notches can be positioned on depending legs 65 to achieve other desired posi-ions.t i5 ne~ess.ar~ that mem~ers 30 and 56 forming d~vice 28 he.made from a material that ~ill permit dis~
integration of the device i.~ a relatively short period of time once healing of t~e ve sel ends. comme~ces. Acceptable ~aterials for forming the de~ice are e.g, a homopolymer of ~ ~7531~ .
polyhydroxyacetic ester, and lactide copolymers thereof.
Molded surgical arti.cles. ~ade ~rom a wlde range of glycolide/lactïde.copolymers have been kno~n and utilized for quite. some. time~
The utilization.of the a~as-tomotic device accord~
ing to the present inventi.on i5 shown in Figures 10 through 14 wherein the free ends 2~ and 2~ of two tubular mem~ers 24 and 26 are ætitched ~ith a purse string suture 52. Use of this suture permits engaging the very edge of the free e~d of the vessel wall 50 that the suturing material can ~ pulled and the vessel end contracted much in the way th~ top of a purse or string closed ~.ag is manipulated.
Th~ ends 2~ and 22 are then pulled over ring member 32 so that a~ the suture is tightened, and the ends 2~ and 22 of the ve~el 24 and 26 are turned inwardly over ring members 32 as shown in Figure 8. The members 32 are then urged togeth~r until the notches 42 are engaged within the slots 43 t~us ~orming thQ connected annular coupling tube 4~
of the~'de.vlce 28. When members 32 are in the appropriate relationship by the formation of annular coupling tu~e 40, the free ends of the two tuhular members are contiguously positioned in a manner that ~ill enable them to grow to-gether p~rmanently- as sho~n in Figure q.
Th~ devi.ce 28 provides ample space for the anas-tomosis to be performed ater the mem~ers 32 are urged ::
: tog~ther and thR mating prongs 38 engage ~ith each other to ~: : foxm the. annular coupling tu~ 4Q. Bowel tissue is mech-anically held together ~y the orce of the purse string ~sutura against the annular coupling tube 40, and the clamp-; Lng force of the ring memkers compresses the t~o ends to-gether. ~
A variety of diameters and spacings for the : ring mem~ers and diameters for the annular coupling tube are. de.s.irable to provide needed versatility of use within the needed sizes for a~imals and humans. Moreover, there are certain unusual tubular configurations within humans and animals that might ~etter use a similar anastomotic ~, ~175315 de~ice h~Ying ellip~i.cally shaped ring members and resulting annular coupling tubes rather than the circular configuration shown in t~e. accompanying drawings. Such embodiments are vie~ed as heing ~ithin the scope of this disclosure and thP. accompanying claims.
It ;s to be understood that the anastomotic device made. of the. materials referenced above can be designed to disinte.grate in a given peri.od of time~ Other matexi.als which can be deslgned to dl~integrate. in a given period of time include e.g. a mixture comprising up to about 5~% ~y ~eight of an inert filler and a polymer ~hich i5 subject to h~drolytic degradation into non toxic, tissue-compati~le a~sor~a~le components, said polymer having a glycolic acid ester linkage. Such material offers many ~advantages over conventional anastomotic devices and permits~ ~imple, rapid anastomosis in difficult areas.
For example, it permLts a simpler anastomosi.s in a low rectosigmoid ana~tomosis ~hich ordinarily would ~e quite time consuming and difficult perhaps requiring temporary colostomy, or eve.n heing impossible in those cases neces-sitating a permanent colostomy.
It ~ill ~e apparent that the present invention is comprised ~asi.cally of t~o single unitary members each haYing a disintegratable ring mem~er and connected mating prong ~hich cooperatively unite to form the embodiment de-scri~ed herein. However, the invention in its broader aspects i5 not limi.ted to the specific embodiment herein s.~ow.n and descri~ed, and~departures may be made therefrom w.ithin the. scope of the accompanying claim without departing from its principles and ~ithout sacrificlng its chief ad-vantages.
Claims (5)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. In an anastomosis device for use in the surgical joining of the free ends of two tubular members to be anastomosed including: a pair of ring members for securement to the free end of each of the tubular members to be anastomosed, each of said ring members having an inner and an outer surface; annular connecting means joined to each of said ring members cooperatively mating with each other to connect said ring members; and means associated with said annular connecting means enabling the securement of said ring members at a distance each from the other whereby said tubular member free ends are positioned contiguous to each other over said ring members and around said connecting means to enable the ends to grow together and approximate the outer surface of the tubular member, the improvement to said means enabling the securement of said ring members at a distance each from the other comprising means for attachment of said ring members in a fixed relationship at a predeter-mined distance each from the other; and means connecting each tubular member free end over a ring member and to said connecting means, said ring members, annular con-necting means, and said securement enabling means being formed of a disintegratable material.
2. The improvement as claimed in claim 1 further comprising at least two mating prongs joining said ring members and extending therefrom substantially parallel to the center line of said ring members having locking slots formed therein, at least two separate prongs joining said ring members and extending therefrom substantially parallel to the center line of said ring members, said mating and separate prongs cooperatively connecting with each other to form an annular coupling tube.
3. The improvement as claimed in claim 2 wherein said securement enabling means includes a plurality of engaging pawls formed on said separate prongs and positioned to mate cooperatively with said locking slots on said mating prongs to secure said prongs and ring members in a preselected relationship and thereby retain said ring members at a preselected distance from each other to accommodate the free ends of the two tubular members.
4. The improvement as claimed in claim 3 wherein said con-necting means includes a purse string suture extending around each tubular member free end pulling said free end over said ring member and in close engagement with said annular coupling tube and contiguous to the other tubular member free end thereby enabling the tubular member free ends to grow together.
5. The improvement as claimed in claim 1 wherein said con-necting means includes a purse string suture extending around each tubular member free end pulling said free end over said ring member and in close engagement with said annular connecting means and con-tiguous to the other tubular member free end thereby enabling the tubular member free end to grow together.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US19844880A | 1980-10-20 | 1980-10-20 | |
| US198,448 | 1980-10-20 | ||
| US287,500 | 1981-07-27 | ||
| US06/287,500 US4467804A (en) | 1980-10-20 | 1981-07-27 | Anastomotic device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1175315A true CA1175315A (en) | 1984-10-02 |
Family
ID=23103177
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000388222A Expired CA1175315A (en) | 1980-10-20 | 1981-10-19 | Anastomotic device and method |
Country Status (13)
| Country | Link |
|---|---|
| US (1) | US4467804A (en) |
| EP (1) | EP0070923B1 (en) |
| AR (1) | AR227334A1 (en) |
| AU (1) | AU550705B2 (en) |
| BR (1) | BR8106726A (en) |
| CA (1) | CA1175315A (en) |
| DE (1) | DE3175732D1 (en) |
| DK (1) | DK157232C (en) |
| ES (1) | ES8206969A1 (en) |
| FI (1) | FI69242C (en) |
| IL (1) | IL64059A (en) |
| MX (1) | MX153608A (en) |
| NO (1) | NO156593C (en) |
Families Citing this family (48)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA1243246A (en) * | 1983-03-17 | 1988-10-18 | Robert W. Mericle | Anastomotic coupling device |
| JPS6129720U (en) * | 1984-07-28 | 1986-02-22 | 高砂医科工業株式会社 | Intestinal anastomosis aid |
| CN85106639B (en) * | 1985-09-03 | 1988-08-03 | 第三军医大学野战外科研究所 | Instrument for blood vessel anastomosis |
| US4716900A (en) * | 1986-05-09 | 1988-01-05 | Pfizer Hospital Products Group, Inc. | Intraintestinal bypass graft |
| US4873977A (en) * | 1987-02-11 | 1989-10-17 | Odis L. Avant | Stapling method and apparatus for vesicle-urethral re-anastomosis following retropubic prostatectomy and other tubular anastomosis |
| DK50588D0 (en) * | 1988-02-01 | 1988-02-01 | Einar Skeie | SURGICAL PROCESS |
| US5180392A (en) * | 1988-02-01 | 1993-01-19 | Einar Skeie | Anastomotic device |
| US4931057A (en) * | 1988-03-29 | 1990-06-05 | Pfizer Hospital Products Group, Inc. | Compression anastomosis coupling assembly |
| US4930502A (en) * | 1989-01-26 | 1990-06-05 | Chen Fusen H | Anastomosis device |
| US5222963A (en) * | 1991-01-17 | 1993-06-29 | Ethicon, Inc. | Pull-through circular anastomosic intraluminal stapler with absorbable fastener means |
| US5250058A (en) * | 1991-01-17 | 1993-10-05 | Ethicon, Inc. | Absorbable anastomosic fastener means |
| EP0548521A1 (en) * | 1991-12-26 | 1993-06-30 | American Cyanamid Company | Anastomotic device |
| US5282810A (en) * | 1992-04-08 | 1994-02-01 | American Cyanamid Company | Surgical anastomosis device |
| US5346501A (en) * | 1993-02-05 | 1994-09-13 | Ethicon, Inc. | Laparoscopic absorbable anastomosic fastener and means for applying |
| US5503635A (en) * | 1993-11-12 | 1996-04-02 | United States Surgical Corporation | Apparatus and method for performing compressional anastomoses |
| US5562690A (en) * | 1993-11-12 | 1996-10-08 | United States Surgical Corporation | Apparatus and method for performing compressional anastomoses |
| US20020019642A1 (en) | 1996-07-23 | 2002-02-14 | Keith Milliman | Anastomosis instrument and method for performing same |
| DE69824137T2 (en) | 1997-10-02 | 2005-05-25 | Sherwood Services Ag | INTRODUCTION DEVICE FOR A TRANSANAL ANASTOMOSE RING |
| US7981126B2 (en) | 1999-04-16 | 2011-07-19 | Vital Access Corporation | Locking compression plate anastomosis apparatus |
| US6623494B1 (en) | 1999-04-16 | 2003-09-23 | Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) | Methods and systems for intraluminally directed vascular anastomosis |
| EP1251786B1 (en) * | 2000-01-18 | 2007-03-14 | Tyco Healthcare Group Lp | Anastomosis instrument |
| US6503259B2 (en) | 2000-12-27 | 2003-01-07 | Ethicon, Inc. | Expandable anastomotic device |
| US7097665B2 (en) | 2003-01-16 | 2006-08-29 | Synecor, Llc | Positioning tools and methods for implanting medical devices |
| CN101810521B (en) | 2001-08-27 | 2015-05-13 | 辛尼科有限责任公司 | Satiation devices and methods |
| US6675809B2 (en) | 2001-08-27 | 2004-01-13 | Richard S. Stack | Satiation devices and methods |
| US6845776B2 (en) | 2001-08-27 | 2005-01-25 | Richard S. Stack | Satiation devices and methods |
| US7146984B2 (en) | 2002-04-08 | 2006-12-12 | Synecor, Llc | Method and apparatus for modifying the exit orifice of a satiation pouch |
| US6769594B2 (en) | 2002-05-31 | 2004-08-03 | Tyco Healthcare Group, Lp | End-to-end anastomosis instrument and method for performing same |
| US7195142B2 (en) | 2003-05-30 | 2007-03-27 | Tyco Healthcare Group Lp | End-to-end anastomosis instrument and method for performing same |
| US20040143342A1 (en) * | 2003-01-16 | 2004-07-22 | Stack Richard S. | Satiation pouches and methods of use |
| US8206456B2 (en) | 2003-10-10 | 2012-06-26 | Barosense, Inc. | Restrictive and/or obstructive implant system for inducing weight loss |
| US20050247320A1 (en) | 2003-10-10 | 2005-11-10 | Stack Richard S | Devices and methods for retaining a gastro-esophageal implant |
| EP1740132B1 (en) | 2004-04-26 | 2014-12-31 | Synecor, LLC | Restrictive and/or obstructive implant for inducing weight loss |
| EP1802237B1 (en) * | 2004-10-18 | 2018-08-08 | Covidien LP | Compression anastomosis device |
| US9055942B2 (en) * | 2005-10-03 | 2015-06-16 | Boston Scienctific Scimed, Inc. | Endoscopic plication devices and methods |
| US20070142850A1 (en) * | 2005-12-15 | 2007-06-21 | David Fowler | Compression anastomosis device |
| EP2572673B1 (en) | 2006-09-02 | 2015-08-19 | Boston Scientific Scimed, Inc. | Intestinal sleeves and associated deployment systems and methods |
| WO2008033474A2 (en) | 2006-09-15 | 2008-03-20 | Synecor, Llc | System for anchoring stomach implant |
| US20090030284A1 (en) | 2007-07-18 | 2009-01-29 | David Cole | Overtube introducer for use in endoscopic bariatric surgery |
| CN101827559B (en) | 2007-07-18 | 2013-05-29 | 压力感应器公司 | Endoscopic implant system |
| US7850706B2 (en) * | 2007-08-08 | 2010-12-14 | Board Of Trustees Of The University Of Arkansas | Pancreatic-enteric fistulary catheterization system |
| US9301761B2 (en) * | 2007-10-22 | 2016-04-05 | James E. Coleman | Anastomosis devices and methods |
| US20090171383A1 (en) | 2007-12-31 | 2009-07-02 | David Cole | Gastric space occupier systems and methods of use |
| US8020741B2 (en) | 2008-03-18 | 2011-09-20 | Barosense, Inc. | Endoscopic stapling devices and methods |
| US7934631B2 (en) | 2008-11-10 | 2011-05-03 | Barosense, Inc. | Multi-fire stapling systems and methods for delivering arrays of staples |
| US8961539B2 (en) | 2009-05-04 | 2015-02-24 | Boston Scientific Scimed, Inc. | Endoscopic implant system and method |
| US8413872B2 (en) | 2009-10-28 | 2013-04-09 | Covidien Lp | Surgical fastening apparatus |
| AU2016323425B2 (en) * | 2015-09-15 | 2020-10-22 | Savage Medical, Inc. | Devices and methods for anchoring a sheath in a tissue cavity |
Family Cites Families (15)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE357306C (en) * | 1922-08-21 | M Favarger Dr | Pluggable button with transfer channel for insertion between the intestine pieces to be connected during intestinal operations | |
| US1470707A (en) * | 1922-10-12 | 1923-10-16 | Bates Samuel Allen | Surgical appliance |
| US2428918A (en) * | 1944-09-12 | 1947-10-14 | Grover C Miller | Anastomosis ring |
| US2453056A (en) * | 1947-03-12 | 1948-11-02 | Zack William Edwin | Surgical anastomosis apparatus and method |
| US2638901A (en) * | 1951-07-30 | 1953-05-19 | Everett D Sugarbaker | Surgical clamp |
| FR1127438A (en) * | 1954-03-29 | 1956-12-17 | Lameris Instr N V | Medical device for interconnecting two sections of the digestive tract |
| US3254650A (en) * | 1962-03-19 | 1966-06-07 | Michael B Collito | Surgical anastomosis methods and devices |
| US3496939A (en) * | 1967-08-09 | 1970-02-24 | Carlos E Odiaga | Surgical anastomotic sleeve coupling |
| US3683926A (en) * | 1970-07-09 | 1972-08-15 | Dainippon Pharmaceutical Co | Tube for connecting blood vessels |
| US3771526A (en) * | 1972-02-07 | 1973-11-13 | P Rudie | Anastomosis clamp |
| US3974835A (en) * | 1972-11-30 | 1976-08-17 | Hardy Jr Thomas G | Anastomotic apparatus and method |
| US4055186A (en) * | 1976-02-11 | 1977-10-25 | Leveen Harry H | Anastomosis button |
| US4154241A (en) * | 1977-07-29 | 1979-05-15 | Rudie Peter S | Anastomosis clamp |
| US4182339A (en) * | 1978-05-17 | 1980-01-08 | Hardy Thomas G Jr | Anastomotic device and method |
| US4214586A (en) * | 1978-11-30 | 1980-07-29 | Ethicon, Inc. | Anastomotic coupling device |
-
1981
- 1981-07-27 US US06/287,500 patent/US4467804A/en not_active Expired - Lifetime
- 1981-10-16 IL IL64059A patent/IL64059A/en not_active IP Right Cessation
- 1981-10-19 ES ES506351A patent/ES8206969A1/en not_active Expired
- 1981-10-19 DK DK460781A patent/DK157232C/en not_active IP Right Cessation
- 1981-10-19 FI FI813260A patent/FI69242C/en not_active IP Right Cessation
- 1981-10-19 MX MX189703A patent/MX153608A/en unknown
- 1981-10-19 NO NO813516A patent/NO156593C/en unknown
- 1981-10-19 AU AU76573/81A patent/AU550705B2/en not_active Ceased
- 1981-10-19 CA CA000388222A patent/CA1175315A/en not_active Expired
- 1981-10-19 BR BR8106726A patent/BR8106726A/en unknown
- 1981-10-19 AR AR287136A patent/AR227334A1/en active
- 1981-10-26 EP EP81108903A patent/EP0070923B1/en not_active Expired
- 1981-10-26 DE DE8181108903T patent/DE3175732D1/en not_active Expired
Also Published As
| Publication number | Publication date |
|---|---|
| ES506351A0 (en) | 1982-09-01 |
| NO813516L (en) | 1982-04-21 |
| IL64059A (en) | 1985-03-31 |
| NO156593C (en) | 1987-10-21 |
| EP0070923A3 (en) | 1984-02-01 |
| NO156593B (en) | 1987-07-13 |
| AU7657381A (en) | 1982-04-29 |
| FI69242C (en) | 1986-01-10 |
| EP0070923B1 (en) | 1986-12-30 |
| DK157232B (en) | 1989-11-27 |
| AU550705B2 (en) | 1986-04-10 |
| BR8106726A (en) | 1982-07-06 |
| US4467804A (en) | 1984-08-28 |
| DK157232C (en) | 1990-04-30 |
| DE3175732D1 (en) | 1987-02-05 |
| ES8206969A1 (en) | 1982-09-01 |
| FI813260L (en) | 1982-04-21 |
| AR227334A1 (en) | 1982-10-15 |
| FI69242B (en) | 1985-09-30 |
| DK460781A (en) | 1982-04-21 |
| IL64059A0 (en) | 1982-01-31 |
| EP0070923A2 (en) | 1983-02-09 |
| MX153608A (en) | 1986-12-03 |
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| MKEC | Expiry (correction) | ||
| MKEX | Expiry |