WO1997016122A1 - Method and anastomotic instrument for use when performing an end-to-side anastomosis - Google Patents

Method and anastomotic instrument for use when performing an end-to-side anastomosis Download PDF

Info

Publication number
WO1997016122A1
WO1997016122A1 PCT/DK1995/000430 DK9500430W WO9716122A1 WO 1997016122 A1 WO1997016122 A1 WO 1997016122A1 DK 9500430 W DK9500430 W DK 9500430W WO 9716122 A1 WO9716122 A1 WO 9716122A1
Authority
WO
WIPO (PCT)
Prior art keywords
anvil
elongate member
vessel
instrument
stapling
Prior art date
Application number
PCT/DK1995/000430
Other languages
French (fr)
Inventor
Jørgen A. RYGAARD
Original Assignee
Oticon A/S
Bernafon Ag
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority to KR1019980703130A priority Critical patent/KR100269077B1/en
Application filed by Oticon A/S, Bernafon Ag filed Critical Oticon A/S
Priority to US09/065,042 priority patent/US5993468A/en
Priority to AT95935866T priority patent/ATE188862T1/en
Priority to DK95935866T priority patent/DK0859572T3/en
Priority to AU38017/95A priority patent/AU701033B2/en
Priority to CA002234148A priority patent/CA2234148C/en
Priority to JP51699597A priority patent/JP3207436B2/en
Priority to PCT/DK1995/000430 priority patent/WO1997016122A1/en
Priority to DE69514694T priority patent/DE69514694T2/en
Priority to EP95935866A priority patent/EP0859572B1/en
Priority to ES95935866T priority patent/ES2145303T3/en
Publication of WO1997016122A1 publication Critical patent/WO1997016122A1/en
Priority to NO981922A priority patent/NO981922L/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135End-to-side connections, e.g. T- or Y-connections

Definitions

  • the present invention relates to a method of the kind set forth in the preamble of claim 1.
  • the parts concerned of the two vessels to be joined are connected to each other through a stapling operation based on the same principles as other surgical stapling devices and - incidentally - ordinary office staplers.
  • the use of stapling devices in surgical work is not unknown, but until now only in situations, in which it is possible to move the organ or organs to be operated upon from their normal position in the patient's body, such as in the abdominal cavity, to a position - not infrequently outside the patient's body - in which the anvil member, against which the staples are bent (corresponding to the lower part of an office stapler) , can be placed on the side of the joint concerned facing away from the stapling plungers (corresponding to the plunger in the top part of an office stapler) .
  • the present invention is the first to offer what could be called "in-situ stapling".
  • an anastomosis instrument capable of performing the following four functions : a guiding function, i.e. guiding the instrument carrying the first vessel into the opening having been formed in the side of the second vessel, - an arranging function, i.e.
  • a stapling function in which the parts of the two vessels having been brought into contact through the arranging function are positively joined by a stapling operation, and a removal function, in which the instrument after completion of the stapling operation is removed from the joint formed by being luxated out of the pocket formed on the everted end of the first vessel, said pocket then unfolding simultaneously with a slight withdrawal of the first vessel.
  • both the guiding function and the arranging function referred to above may be carried out with the best possible "feel", as the surgeon will be able to sense manually any objects encountered by the anvil member, including - of course - the second vessel and the anastomotic opening formed therein.
  • the present invention also relates to an anastomotic instrument for carrying out the method according to the invention, and this instrument is characterized by the features set forth in claim 2.
  • Advantageoous embodiments of the anastomotic instrument according to the invention the effects of which - beyond what is self-evident - are explained in the following detailed part of the present description, are set forth in claims 3-12.
  • FIGS 9-12 in perspective and with certain parts cut away show a practical embodiment of an anastomotic instrument with the various possible relative positions of the relatively movable parts
  • Figure 13 at a highly enlarged scale shows a part of the instrument shown in Figure 1 with modified clamping surfaces .
  • Figure 1 shows an anastomosis instrument 1 consisting of three main components that are movable relative to each other in the longitudinal direction, i.e. in the direction shown as the vertical direction in Figure 1 :
  • the anvil tube 2 On its lower end, the anvil tube 2 carries an anvil 3, the upper side of which is provided with a number of staple- bending recesses 4 adapted to cooperate with and bend an equal number of staples 7, in the situation shown in Figure 1 being temporarily held lightly in an equal number of staple-holding recesses 8 formed in the lower ends of the stapling plungers 6.
  • FIG. 2 shows the situation, in which the instrument is made ready for use by the operating surgeon.
  • the anastomosis instrument according to the present invention is primarily developed for use when performing coronary bypass operations, and to this end, a bypass vessel 9 - that may be a vein taken from some other part of the patient's body - has been inserted in the anvil tube with its lower end everted about the anvil 3 and with its end region 10 covering the staple-bending recesses 4 in the upper surface of the anvil 3.
  • bypass vessel 9 may have a considerably larger circumference than the inside of the anvil tube 2, consequently lying more or less folded in the longitudinal direction in the latter, for which reason the action of everting its end region 10 about the anvil 3 does not necessarily entail undue stretching of the bypass vessel 9.
  • FIG 3 shows the instrument having been made ready as shown in Figure 2 inserted in an opening in a coronary artery 11, said opening having an edge region 12 which, due to the elasticity of the tissue of the coronary artery 11, will embrace the anvil tube 2 in a location close to the anvil 3 _
  • the opening in the coronary artery 11 may e.g. have been formed according to the method described in the international application with publication No. WO 95/17127 with the title "Method and instrument for establishing the receiving side of a coronary artery bypass graft".
  • Figure 7 shows the situation, in which the operation of removing the anastomosis instrument 1 from the coronary artery 11 and its anastomosis with the bypass vessel 9 has begun.
  • the circumferential pocket formed by the eversion of the lower end of the bypass vessel 9 will now open and allow the anvil 3 to be removed by luxation
  • Figure 8 showing the situation after such removal, resulting in a finished anastomosis of the intima-to-intima type considered most desirable for this type of operation.
  • the three main components of the anastomosis instrument 1 referred to above, i.e. the anvil tube 2, the clamping tube 5 and the set of stapling plungers 6, will, of course, have to be connected to some kind of operating members to enable the operating surgeon and his or her assistants to carry out the steps shown in Figures 1-8.
  • these operating members could consist of three tubes (not shown), viz.
  • Figures 9-12 illustrate an embodiment of an anastomosis instrument according to the present invention, that is highly suitable for creating an end-to-side anastomosis in a very short time.
  • the anastomosis instrument 101 comprises a number of parts functionally corresponding to parts of the instrument shown in Figures 1-7, viz. :
  • the anvil tube 102 of Figure 9 extends on the outside of the instrument and is terminated by an end wall 102A, to which the anvil 103 is secured at a distance by means of two columns, viz. an upstream column 103A and a downstream column 103B.
  • upstream and downstream refer to the direction of blood flow in the artery, in which the instrument 101 is intended to be used in creating an end-to-side anastomosis.
  • all transversely oriented components have suitable openings, of which the forwardmost opening 103C is formed in the anvil 103, the latter being provided with staple-bending recesses 104 having the same function as the staple-bending recesses 4 shown in Figure 1.
  • the various components are not rotationally symmetrical about the longitudinal axis of the instrument, as the anvil 103 has been made "boat-shaped" to make it easier to insert it in the opening in the artery and to make it easier for the edges of the opening to fit in with the upper side of the anvil 103 with the stapling recesses 104.
  • the clamping tube 105 Due to the arrangement of the anvil tube 102 as the outermost component terminated by the end wall 102A, it is not possible in this embodiment to let the clamping tube 105 extend in its full circumferential width all the way towards the upper face of the anvil 103. For this reason, the clamping tube 105 is terminated by an end wall 105A, from which a set of clamping columns 105B extend in the forward (downward) direction through suitable openings in the anvil tube end wall 102A.
  • the stapling plungers 106 are guided in the longitudinal direction in suitable guides in the clamping columns 105B, and their rearmost (uppermost) ends are secured to a stapling plunger carrier 106A, itself secured to and terminating a stapling tube 106B, through which the force for actuating the stapling plungers 106 may be transmitted from a suitable operating device.
  • Figures 9-12 show neither staples corresponding to the staples 7 of Figure 1 nor staple-holding recesses corresponding to the staple- holding recesses 8 shown in Figure 1, but it will be understood that the forwardmost (lowermost) ends of the stapling plungers 106 will be provided with suitable staple-holding recesses capable of holding staples in such a position, that when the stapling plungers 106 are advanced towards the anvil 103, the staples will be bent by the staple-bending recesses 104 in the usual manner.
  • FIG. 10 The situation shown in Figure 10 corresponds to that shown in Figure 4, i.e. the clamping columns 105B have been advanced towards the anvil 103, in Figure 10 leaving a gap symbolizing the presence of the end region of the bypass vessel and the edge region of the coronary artery (all not shown) .
  • the movement of the clamping columns 105B has, of course, been effected by advancing the clamping tube 105 to the same extent.
  • suitable stops are adapted to stop the movement of the clamping columns 105B towards the anvil 103 so as to leave a gap just sufficient to hold them firmly together.
  • the clamping surfaces may be provided with elastically flexible fins or fingers.
  • Figure 13 shows how this concept could be applied to the embodiment shown in Figures 1-7, it being - of course - equally applicable to that shown in Figures 9-12.
  • the anvil tube 102 which is rigidly connected to the anvil 103 through the columns 103A and 103B, so that he or she will be able to move the anvil 103 with the everted end of the bypass vessel into the opening in the coronary artery by direct manual control, and - not least - by "direct mechanical feedback", as the rigid mechanical interconnec- tion between the anvil 103 og the anvil tube 102 enables the surgeon to "feel" whatever object is encountered by the anvil.
  • the rearward (upper) part (not shown) of the instrument may comprise suitable operating devices and/or mechanisms for moving the clamping tube 105 and the stapling plungers 106 relatively to the anvil tube 102 and hence relatively to the anvil 103. Due to the extremely limited time available for performing coronary bypass operations, these operating devices and/or mechanisms should be designed to enable the operating surgeon to initiate the requisite movements rapidly and with a minimum of effort.
  • the operating devices and/or mechanisms could be arranged to function under the control of a single operating member, such as a push-button on the rear

Abstract

When performing an end-to-side anastomosis connecting the end (10) of a first vessel (9) to the edge region (12) around an opening in the side wall of a second vessel (11), an instrument (1) is used having a circumferential stapling anvil (3) secured to an anvil tube (2) accommodating the first vessel (9), the end of which is everted about the anvil (3) with the intima of the end region (10) facing the intima of the edge region (12), when the instrument (1) with the first vessel (9) in place has been inserted into the opening in the second vessel (11). Then, a clamping tube (5) is advanced towards the anvil (3), clamping the end (10) and edge region (12) together against the anvil (3). In the next step, a number of stapling plungers (6) carrying staples (7) are advanced towards the anvil (3), the latter having staple-bending surfaces (4), thus stapling the two vessels together in a manner not shown. Finally, the clamping tube (5) and the stapling plungers (6) are withdrawn, and the whole instrument removed from the anastomosis.

Description

METHOD AND ANASTOMOTIC INSTRUMENT FOR USE WHEN PERFORMING AN END-TO-SIDE ANASTOMOSIS
TECHNICAL FIELD
The present invention relates to a method of the kind set forth in the preamble of claim 1.
BACKGROUND ART
A method of this kind is disclosed in the international application having the publication No. WO 95/17128. In this previously known method, the means used for inter¬ connecting the two vessels consisted of an open springy brace carrying spikes and being capable of being bent elastically so as to make its free ends cross each other, said spikes forming angles with the brace gradually diminishing from acute angles at the free ends to substantially right angles mid-way between them. When released from the anastomotic instrument holding the brace in the elastically bent condition, it would bring the spikes into engagement with the regions to be joined so as to penetrate the latter and so to speak nail them together.
Extra-clinical trials have, however, shown that one can not always be certain that all the spikes have penetrated through the parts concerned of the two vessels to be joined, this probably being due to the limited elastic force available from the springy brace.
DISCLOSURE OF THE INVENTION
It is the object of the present invention to provide a method of the kind referred to above, with which it is possible to achieve a more reliable connection between the two vessels forming the anastomosis, and this object is achieved by proceeding as set forth in the characteriz¬ ing clause of claim 1. With this arrangement, the parts concerned of the two vessels to be joined are connected to each other through a stapling operation based on the same principles as other surgical stapling devices and - incidentally - ordinary office staplers.
As already indicated above, the use of stapling devices in surgical work is not unknown, but until now only in situations, in which it is possible to move the organ or organs to be operated upon from their normal position in the patient's body, such as in the abdominal cavity, to a position - not infrequently outside the patient's body - in which the anvil member, against which the staples are bent (corresponding to the lower part of an office stapler) , can be placed on the side of the joint concerned facing away from the stapling plungers (corresponding to the plunger in the top part of an office stapler) . Thus, the present invention is the first to offer what could be called "in-situ stapling". To make this possible, the present invention prescribes the use of an anastomosis instrument capable of performing the following four functions : a guiding function, i.e. guiding the instrument carrying the first vessel into the opening having been formed in the side of the second vessel, - an arranging function, i.e. urging the edge of the opening to the second vessel into a shape and position corresponding to the shape and position of the end region of the first vessel preparatory to a stapling function, in which the parts of the two vessels having been brought into contact through the arranging function are positively joined by a stapling operation, and a removal function, in which the instrument after completion of the stapling operation is removed from the joint formed by being luxated out of the pocket formed on the everted end of the first vessel, said pocket then unfolding simultaneously with a slight withdrawal of the first vessel.
At this point it should be emphasized that, using a preferred embodiment of the instrument, in which there is a rigid mechanical connection between the anvil member and the part of the instrument adapted to be gripped manually by the operating surgeon, both the guiding function and the arranging function referred to above may be carried out with the best possible "feel", as the surgeon will be able to sense manually any objects encountered by the anvil member, including - of course - the second vessel and the anastomotic opening formed therein.
All the functions described above may be carried out without removing the organs concerned through any significant distance away from their normal functional position in the body, making the method according to the invention eminently suitable for coronary by-pass operations. Thus, the expression "in-situ stapling" would appear justified.
The present invention also relates to an anastomotic instrument for carrying out the method according to the invention, and this instrument is characterized by the features set forth in claim 2. Advantageoous embodiments of the anastomotic instrument according to the invention, the effects of which - beyond what is self-evident - are explained in the following detailed part of the present description, are set forth in claims 3-12.
BRIEF DESCRIPTION OF THE DRAWINGS
In the following detailed part of the present description, the invention will be explained in more detail with reference to the exemplary embodiments of an anastomotic instrument according to the invention shown in the drawings, in which Figures 1-8 show the process of performing an end-to- side anastomosis using an anastomotic instrument according to the invention, in Figures 1-7 being drawn in a highly simplified manner for ease of understanding,
Figures 9-12 in perspective and with certain parts cut away show a practical embodiment of an anastomotic instrument with the various possible relative positions of the relatively movable parts, and
Figure 13 at a highly enlarged scale shows a part of the instrument shown in Figure 1 with modified clamping surfaces .
DESCRIPTION OF THE PREFERRED EMBODIMENTS
As mentioned above, the embodiment shown in Figures 1-8 of the anastomosis instrument according to the present invention constitutes a simplified version with the primary purpose of explaining the invention; this does not, however, preclude the possibility of using this embodiment in actual practice.
Thus, Figure 1 shows an anastomosis instrument 1 consisting of three main components that are movable relative to each other in the longitudinal direction, i.e. in the direction shown as the vertical direction in Figure 1 :
- an anvil tube 2, - a clamping tube 5, and
- a set of stapling plungers 6.
On its lower end, the anvil tube 2 carries an anvil 3, the upper side of which is provided with a number of staple- bending recesses 4 adapted to cooperate with and bend an equal number of staples 7, in the situation shown in Figure 1 being temporarily held lightly in an equal number of staple-holding recesses 8 formed in the lower ends of the stapling plungers 6.
Figure 2 shows the situation, in which the instrument is made ready for use by the operating surgeon. As mentioned initially, the anastomosis instrument according to the present invention is primarily developed for use when performing coronary bypass operations, and to this end, a bypass vessel 9 - that may be a vein taken from some other part of the patient's body - has been inserted in the anvil tube with its lower end everted about the anvil 3 and with its end region 10 covering the staple-bending recesses 4 in the upper surface of the anvil 3. At this point it should be noted that the bypass vessel 9 may have a considerably larger circumference than the inside of the anvil tube 2, consequently lying more or less folded in the longitudinal direction in the latter, for which reason the action of everting its end region 10 about the anvil 3 does not necessarily entail undue stretching of the bypass vessel 9.
Figure 3 shows the instrument having been made ready as shown in Figure 2 inserted in an opening in a coronary artery 11, said opening having an edge region 12 which, due to the elasticity of the tissue of the coronary artery 11, will embrace the anvil tube 2 in a location close to the anvil 3 _ The opening in the coronary artery 11 may e.g. have been formed according to the method described in the international application with publication No. WO 95/17127 with the title "Method and instrument for establishing the receiving side of a coronary artery bypass graft".
As soon as the operating surgeon in the situation shown in Figure 3 has ascertained that the edge region 12 embraces the anvil tube 2 closely on all sides, he or she will proceed to the situation shown in Figure 4, in which the clamping tube 5 has been moved towards the anvil 3 so as to clamp the edge region 12 on the coronary artery 11 and the end region 10 on the bypass vessel 9 firmly together in readiness for the next step shown in Figure 5, in which the stapling plungers 6 have been moved downwardly so as to cause the staples 7 to penetrate the edge region 12 and the end region 10 and engage the staple-bending recesses 4, by which they will be bent in a tangential direction in a similar manner as is known from both surgical staplers and ordinary office staplers.
In the situation shown in Figure 6, the clamping tube 5 together with the stapling plungers 6 have been moved outwardly and away from the staples 7, the staple-holding recesses 8 due to their light holding action having let go of the staples 7, the latter also having been anchored in the end region 10 by their bent ends.
Figure 7 shows the situation, in which the operation of removing the anastomosis instrument 1 from the coronary artery 11 and its anastomosis with the bypass vessel 9 has begun. As will be seen from Figures 6 and 7, the circumferential pocket formed by the eversion of the lower end of the bypass vessel 9 will now open and allow the anvil 3 to be removed by luxation, Figure 8 showing the situation after such removal, resulting in a finished anastomosis of the intima-to-intima type considered most desirable for this type of operation.
The three main components of the anastomosis instrument 1 referred to above, i.e. the anvil tube 2, the clamping tube 5 and the set of stapling plungers 6, will, of course, have to be connected to some kind of operating members to enable the operating surgeon and his or her assistants to carry out the steps shown in Figures 1-8. Theoretically, these operating members could consist of three tubes (not shown), viz.
- a relatively long holding tube in continuation of the anvil tube 2,
- a somewhat shorter clamping tube in continuation of the clamping tube 5, and
- an even shorter stapling tube, to which the stapling plungers 6 are connected.
As is well-known, however, coronary bypass operations, especially according to the method of the international application referred to above, should be carried out as rapidly as possible, and for this reason, the "theoretical" embodiment shown in Figures 1-7 is too cumbersome to work with to ensure a sufficiently rapid operating procedure. As mentioned above, Figures 9-12 illustrate an embodiment of an anastomosis instrument according to the present invention, that is highly suitable for creating an end-to-side anastomosis in a very short time.
Due to the construction of the instrument shown in Figures 9-12 it is not possible to make an easily understandable drawing in the nature of the simple drawings of Figures 1-7. For this reason, the "active" parts of the instrument have been shown in perspective, and with the exception of the anvil and its supporting columns, with one half removed along a longitudinal sectional plane, so that the remaining half can be seen partly from the inside, partly from the outside. In Figures 9-12, those of the components functionally corresponding to components shown in Figures 1-7 have been given the same reference numbers with 100 added, whereas components not having "opposite numbers" in Figures 1-7 have been given the reference numbers of the components, with which they are most closely associated, with the addition of a capital letter.
As shown in Figure 9, the anastomosis instrument 101 comprises a number of parts functionally corresponding to parts of the instrument shown in Figures 1-7, viz. :
- an anvil tube 102,
- an anvil 103,
- a clamping tube 105, and - a set of stapling plungers 106.
Although the basic functions of these parts are the same as the basic functions of the corresponding parts in the embodiment of Figures 1-7, the arrangement differs somewhat from that of the latter, as will be evident from the following.
In contrast to the anvil tube 2 of Figure 1, the anvil tube 102 of Figure 9 extends on the outside of the instrument and is terminated by an end wall 102A, to which the anvil 103 is secured at a distance by means of two columns, viz. an upstream column 103A and a downstream column 103B. The expressions "upstream" and "downstream" refer to the direction of blood flow in the artery, in which the instrument 101 is intended to be used in creating an end-to-side anastomosis.
To make it possible to insert the bypass vessel (not shown) corresponding to the bypass vessel 9 shown in Figures 1-8, all transversely oriented components have suitable openings, of which the forwardmost opening 103C is formed in the anvil 103, the latter being provided with staple-bending recesses 104 having the same function as the staple-bending recesses 4 shown in Figure 1.
As will be seen from Figures 9-12, the various components are not rotationally symmetrical about the longitudinal axis of the instrument, as the anvil 103 has been made "boat-shaped" to make it easier to insert it in the opening in the artery and to make it easier for the edges of the opening to fit in with the upper side of the anvil 103 with the stapling recesses 104.
Due to the arrangement of the anvil tube 102 as the outermost component terminated by the end wall 102A, it is not possible in this embodiment to let the clamping tube 105 extend in its full circumferential width all the way towards the upper face of the anvil 103. For this reason, the clamping tube 105 is terminated by an end wall 105A, from which a set of clamping columns 105B extend in the forward (downward) direction through suitable openings in the anvil tube end wall 102A.
The stapling plungers 106 are guided in the longitudinal direction in suitable guides in the clamping columns 105B, and their rearmost (uppermost) ends are secured to a stapling plunger carrier 106A, itself secured to and terminating a stapling tube 106B, through which the force for actuating the stapling plungers 106 may be transmitted from a suitable operating device. Figures 9-12 show neither staples corresponding to the staples 7 of Figure 1 nor staple-holding recesses corresponding to the staple- holding recesses 8 shown in Figure 1, but it will be understood that the forwardmost (lowermost) ends of the stapling plungers 106 will be provided with suitable staple-holding recesses capable of holding staples in such a position, that when the stapling plungers 106 are advanced towards the anvil 103, the staples will be bent by the staple-bending recesses 104 in the usual manner.
The relative positions of the various parts as shown in Figure 9 correspond to those shown in Figures 1-3, i.e. there is a sufficient distance between the rearward (upper) face of the anvil 103 and the forward (downward) ends of the clamping columns 105B to accomodate the everted end region of the bypass vessel corresponding to the end region 10 shown in Figure 2, as well as the edge region of the coronary artery concerned corresponding to the edge region 12 of the coronary artery 11 shown in Figure 3.
The situation shown in Figure 10 corresponds to that shown in Figure 4, i.e. the clamping columns 105B have been advanced towards the anvil 103, in Figure 10 leaving a gap symbolizing the presence of the end region of the bypass vessel and the edge region of the coronary artery (all not shown) . The movement of the clamping columns 105B has, of course, been effected by advancing the clamping tube 105 to the same extent. To prevent said end and edge regions being crushed in the clamping operation, suitable stops (not shown) are adapted to stop the movement of the clamping columns 105B towards the anvil 103 so as to leave a gap just sufficient to hold them firmly together. To improve the grip, the clamping surfaces may be provided with elastically flexible fins or fingers. Figure 13 shows how this concept could be applied to the embodiment shown in Figures 1-7, it being - of course - equally applicable to that shown in Figures 9-12.
The relative positions shown in Figure 11 correspond to those shown in Figure 5, i.e. the stapling plungers 106 have now been advanced, guided by the clamping columns 105B so as to bring the staples (not shown) into engage¬ ment with the staple-bending recesses 104, thus joining the end region of the bypass vessel to the edge region of the coronary artery (all not shown) .
The relative positions shown in Figure 12 correspond to those shown in Figures 6 and 7 and with the exception that in Figure 12, the stapling plungers 106 have not only been withdrawn from the staples joining the two vessels, but have in fact been removed completely from the instrument to make it possible to insert a new set of staples, that may be of the disposable or semi-disposable type. With the arrangement shown in Figures 9-12, the operating surgeon may literally have a firm grip on the situation by holding the outermost component, i.e. the anvil tube 102, which is rigidly connected to the anvil 103 through the columns 103A and 103B, so that he or she will be able to move the anvil 103 with the everted end of the bypass vessel into the opening in the coronary artery by direct manual control, and - not least - by "direct mechanical feedback", as the rigid mechanical interconnec- tion between the anvil 103 og the anvil tube 102 enables the surgeon to "feel" whatever object is encountered by the anvil. Advantageously, the rearward (upper) part (not shown) of the instrument may comprise suitable operating devices and/or mechanisms for moving the clamping tube 105 and the stapling plungers 106 relatively to the anvil tube 102 and hence relatively to the anvil 103. Due to the extremely limited time available for performing coronary bypass operations, these operating devices and/or mechanisms should be designed to enable the operating surgeon to initiate the requisite movements rapidly and with a minimum of effort.
Thus, the operating devices and/or mechanisms could be arranged to function under the control of a single operating member, such as a push-button on the rear
(upper) end of the instrument adapted to be operated by the surgeon's thumb, in the following manner:
- firstly, when the operating member is moved in a first direction, e.g. a push-button is depressed, the clamping columns 105B will be advanced to their forwardmost
(lower) position, in which they clamp the end region of the bypass vessel and the edge region of the opening in the artery together until said stop is reached, and then the stapling plungers 106 will immediately be actuated to staple the two regions together, after which both the clamping columns 105B and the stapling plungers 106 are withdrawn, e.g. by releasing said push-button, and - secondly, immediately upon the operating member moving in the opposite direction, e.g. when the push-button has been released, the mechanism is re-set in readiness for a movement in the first direction, after which the instrument can be removed as described above with reference to Figure 7.
It should be possible for a technician skilled in the art of designing and making surgical instruments comprising operating mechanisms to design and construct an operating device or mechanism capable of operating in the manner described above, for which reason these parts have not been described or shown in detail .
List of Parts
1 anastomosis instrument
2 anvil tube
3 anvil
5 4 staple-bending recess
5 clamping tube
6 stapling plunger
7 staple
8 staple-holding recess 10 9 bypass vessel
10 end region
11 coronary artery
12 edge region
13 fin or finger 15
101 anastomosis instrument
102 anvil tube
102A (anvil tube) end wall
103 anvil
20 103A (anvil) upstream column
103B (anvil) downstream column
103C (anvil) opening
104 staple-bending recess
105 clamping tube
25 105A (clamping tube) end wall
105B clamping column
(and stapling-plunger guide)
106 stapling plunger
106A stapling plunger carrier 30 106B stapling tube

Claims

1. Method of connecting an end region (10) of a first vessel (9) to the side of a second vessel (11) by carrying out an end-to-side anastomosis, said method being of the kind comprising the following steps a-d: a) forming an opening in the side of said second vessel
(11) , b) inserting in said opening a generally tubular anastomosis instrument (1; 101) carrying said first vessel (9) in its central longitudinal cavity and with said end region (10) everted about a circum¬ ferential member (3; 103) constituting a forward portion of said instrument (1; 101) in such a manner, that the intima side of said end region (10) comes into contact with the intima side of said second vessel (11) at an edge region (12) of said opening, c) joining said end region (10) to said edge region
(12) by inserting penetratingly therethrough and leaving therein a plurality of spiked members (7) , and d) removing said instrument (1; 101) from the joint formed between said first (9) and second (11) vessels, characterized by e) the use of an anastomosis instrument (1; 101) comprising el) a first elongate member (2; 102) , to one end of which is rigidly secured a circumferential anvil member (3; 103) in such a manner, that said first vessel (9) may be placed within said first elongate member (2; 102) with its end region (10) everted about said anvil member (3; 103) with the terminal part of said end region facing towards the opposite end of said first elongate member (2; 102) , e2) staple-bending recesses (4; 104) provided in said anvil member (3; 103) and facing towards said opposite end, e3) a second elongate member (5; 105, 105A, 105B) longitudinally moveable relative to said first elongate member (2; 102) and adapted to be moved towards said anvil member (3; 103) so as to make it possible to clamp together therebetween said end region (10) on said first vessel (9) and an edge region (12) on said second vessel (11), and e4) stapling plungers (6; 106) longitudinally moveable relative to said first (2; 102) and second (5; 105, 105A, 105B) elongate members and adapted to insert staples (7) penetratingly through said clamped end (10) and edge (12) regions into engagement with said stapling-bending recesses (4; 104) so as to bend permanently said staples (7) into a shape, in which they hold said end (10) and edge (12) regions together.
2. Anastomotic instrument (1; 101) for carrying out the method of claim 1, characterized bv a) a first elongate member (2; 102) , to one end of which is rigidly secured a circumferential anvil member (3; 103) in such a manner, that said first vessel (9) may be placed within said first elongate member (2; 102) with its end region (10) everted about said anvil member (3; 103) with the terminal part of said end region facing towards the opposite end of said first elongate member (2; 102) , b) staple-bending recesses (4; 104) provided in said anvil member (3; 103) and facing towards said opposite end, c) a second elongate member (5; 105, 105A, 105B) longitudinally moveable relative to said first elongate member (2; 102) and adapted to be moved towards said anvil member (3; 103) so as to make it possible to clamp together therebetween said end region (10) on said first vessel (9) and an edge region (12) on said second vessel (11) , and d) stapling plungers (6; 106) longitudinally moveable relative to said first (2; 102) and second (5; 105, 105A, 105B) elongate members and adapted to insert staples (7) penetratingly through said clamped end
(10) and edge (12) regions into engagement with said stapling-bending recessses (4; 104) so as to bend permanently said staples (7) into a shape, in which they hold said end (10) and edge (12) regions together.
3. Anastomotic instrument (101) according to claim 2, characterized in that the external surface of said first elongate member (102) constitutes at least a part of the external surface of said instrument (101) , so as to make it possible to hold the latter by manually gripping the former.
4. Anastomotic instrument according to claim 3, characterized in that said first elongate member (102) is rigidly connected to said anvil member (103) through an end wall (102A) rigidly secured to or integral with the end of said first elongate member (102) and at least one connecting member (103A, 103B) rigidly secured to said end wall (102A) and said anvil member (103) .
5. Anastomotic instrument according to claim 4, characterized in that said second elongate member (105, 105A, 105B) comprises a) a rearward part (105) longitudinally moveable in said first elongate member (102) , b) an intermediate part (105A) rigidly secured to or integral with said rearward part (105) and c) a plurality of forward clamping columns, each at the end (105B) being rigidly secured to said intermediate part (105A) , extending through said end wall (102A) and each on the opposite end having a clamping surface facing said anvil member (103) .
6. Anastomotic instrument according to any one or any of the claims 2-5, characterized in that each said stapling plunger (106) with a rear end is rigidly secured to a stapling plunger carrier (106A) rigidly secured to a third elongate member (106B) longitudinally moveable in said rearward part (105) of said second elongate member
(105, 105A, 105B) and with the remainder extending moveably through said intermediate part (105A) and said clamping columns (105B) .
7. Anastomotic instrument (1; 101) according to any one or any of the claims 2-6, charazterized bv such an arrangement that said second elongate member (5; 105, 105A, 105B) can only be advanced relative to said first elongate member (2; 102) and said anvil member (3; 103) to an extent leaving a gap slightly smaller than the combined thickness of said end region (10) and said edge region (12) , said movement being limited e.g. by a suitable stop member.
8. Anastomotic instrument according to claim 7, characterized bv a mechanism adapted to move said second elongate member (105, 105A, 105B) and said stapling plungers (106) relative to said first elongate member (102) and said anvil member (103) in dependence on the movement of a single operating member moveable in a first direction and then returnable in the opposite direction in the following manner: a) when said operating member is moved in said first direction, said second elongate member (105, 105A, 105B) is advanced to said limiting position leaving said gap immediately upon which said stapling plungers (106) are actuated to join said end region (10) to said edge region (12) , immediately upon which both said second elongate member (105, 105A, 105B) and said stapling plungers (106) are withdrawn to leave a large gap between said clamping plungers (105B) and said anvil member (103) allowing the instrument (101) to be removed from the joint, and b) when said operating member is moved in said second direction, the mechanism is re-set in readiness for a new movement in said first direction.
9. Anastomotic instrument (101) according to claim 8, characterized bv means, such as a spring, adapted to move said operating member in said second direction, as soon as the force moving it in said first direction is removed.
10. Anastomotic instrument (1; 101) according to any one or any of the claims 2-9, characterized in that at least one of the mutually cooperating clamping surfaces on said anvil member (3; 103) and the said second elongate member (5; 105, 105A, 105B) are modified to improve the gripping effect on the tissue parts (10, 12) to be joined.
11. Anastomotic instrument according to claim 10, characterized in that said mutually cooperating clamping surfaces are roughened or embossed with a grip-improving pattern.
12. Anastomotic instrument according to claim 10, characterized in that said mutually cooperating clamping surfaces are provided with elastically flexible fins or fingers (13) in the relaxed state extending obliquely inwardly (Figure 13).
PCT/DK1995/000430 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis WO1997016122A1 (en)

Priority Applications (12)

Application Number Priority Date Filing Date Title
CA002234148A CA2234148C (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis
US09/065,042 US5993468A (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis
AT95935866T ATE188862T1 (en) 1995-10-31 1995-10-31 ANASTOMOTIC INSTRUMENT FOR USE IN A TERMINOLATERAL ANASTOMOSIS
DK95935866T DK0859572T3 (en) 1995-10-31 1995-10-31 Anastomosis instrument for use in providing an end-to-side anastomosis
AU38017/95A AU701033B2 (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis
KR1019980703130A KR100269077B1 (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis
JP51699597A JP3207436B2 (en) 1995-10-31 1995-10-31 Anastomotic device for use in performing an end-to-side anastomosis
EP95935866A EP0859572B1 (en) 1995-10-31 1995-10-31 Anastomotic instrument for use when performing an end-to-side anastomosis
DE69514694T DE69514694T2 (en) 1995-10-31 1995-10-31 ANASTOMOSIS INSTRUMENT FOR USE IN A TERMINOLATERAL ANASTOMOSIS
PCT/DK1995/000430 WO1997016122A1 (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis
ES95935866T ES2145303T3 (en) 1995-10-31 1995-10-31 INSTRUMENT THAT ALLOWS TO PERFORM AN END-TO-SIDE ANASTOMOSIS.
NO981922A NO981922L (en) 1995-10-31 1998-04-28 Method and Anastomosis Instrument for Use in Performing an End-to-Side Anastomosis

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/DK1995/000430 WO1997016122A1 (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis

Publications (1)

Publication Number Publication Date
WO1997016122A1 true WO1997016122A1 (en) 1997-05-09

Family

ID=8155380

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DK1995/000430 WO1997016122A1 (en) 1995-10-31 1995-10-31 Method and anastomotic instrument for use when performing an end-to-side anastomosis

Country Status (12)

Country Link
US (1) US5993468A (en)
EP (1) EP0859572B1 (en)
JP (1) JP3207436B2 (en)
KR (1) KR100269077B1 (en)
AT (1) ATE188862T1 (en)
AU (1) AU701033B2 (en)
CA (1) CA2234148C (en)
DE (1) DE69514694T2 (en)
DK (1) DK0859572T3 (en)
ES (1) ES2145303T3 (en)
NO (1) NO981922L (en)
WO (1) WO1997016122A1 (en)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0931512A1 (en) 1998-01-23 1999-07-28 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US6066144A (en) * 1997-10-07 2000-05-23 Ethicon Endo-Surgery, Inc. Surgical anastomosis method
US6293955B1 (en) 1996-09-20 2001-09-25 Converge Medical, Inc. Percutaneous bypass graft and securing system
US6361559B1 (en) 1998-06-10 2002-03-26 Converge Medical, Inc. Thermal securing anastomosis systems
WO2002096298A1 (en) * 2001-05-31 2002-12-05 Hb Medicals Corporation Vascular anastomosis device
US6695859B1 (en) 1999-04-05 2004-02-24 Coalescent Surgical, Inc. Apparatus and methods for anastomosis
US8518060B2 (en) 2009-04-09 2013-08-27 Medtronic, Inc. Medical clip with radial tines, system and method of using same
US8668704B2 (en) 2009-04-24 2014-03-11 Medtronic, Inc. Medical clip with tines, system and method of using same

Families Citing this family (271)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6440146B2 (en) 1996-07-23 2002-08-27 United States Surgical Corporation Anastomosis instrument and method
US6036702A (en) * 1997-04-23 2000-03-14 Vascular Science Inc. Medical grafting connectors and fasteners
AU721415B2 (en) 1996-11-08 2000-07-06 Converge Medical, Inc. Percutaneous bypass graft and securing system
US6726704B1 (en) 1998-05-29 2004-04-27 By-Pass, Inc. Advanced closure device
WO2001041623A2 (en) * 1999-05-30 2001-06-14 By-Pass, Inc. Anastomotic devices and methods
US6641593B1 (en) 1998-06-03 2003-11-04 Coalescent Surgical, Inc. Tissue connector apparatus and methods
US6613059B2 (en) 1999-03-01 2003-09-02 Coalescent Surgical, Inc. Tissue connector apparatus and methods
US6945980B2 (en) 1998-06-03 2005-09-20 Medtronic, Inc. Multiple loop tissue connector apparatus and methods
US6261304B1 (en) 1998-09-10 2001-07-17 Percardia, Inc. Delivery methods for left ventricular conduit
US6203553B1 (en) * 1999-09-08 2001-03-20 United States Surgical Stapling apparatus and method for heart valve replacement
US6146393A (en) * 1998-12-18 2000-11-14 Wakabayashi; Akio External tubular stapling device for anastomosing a vascular graft to an anastomosing sheath
US8118822B2 (en) 1999-03-01 2012-02-21 Medtronic, Inc. Bridge clip tissue connector apparatus and methods
US6623494B1 (en) 1999-04-16 2003-09-23 Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) Methods and systems for intraluminally directed vascular anastomosis
US7981126B2 (en) 1999-04-16 2011-07-19 Vital Access Corporation Locking compression plate anastomosis apparatus
WO2000072764A1 (en) * 1999-05-28 2000-12-07 The Board Of Trustees Of The Leland Stanford Junior University Anastomosis system and methods for use
US6253768B1 (en) 1999-08-04 2001-07-03 Percardia, Inc. Vascular graft bypass
US6494889B1 (en) 1999-09-01 2002-12-17 Converge Medical, Inc. Additional sutureless anastomosis embodiments
US6702828B2 (en) * 1999-09-01 2004-03-09 Converge Medical, Inc. Anastomosis system
US20020173809A1 (en) * 1999-09-01 2002-11-21 Fleischman Sidney D. Sutureless anastomosis system deployment concepts
US8529583B1 (en) 1999-09-03 2013-09-10 Medtronic, Inc. Surgical clip removal apparatus
US6605053B1 (en) 1999-09-10 2003-08-12 Percardia, Inc. Conduit designs and related methods for optimal flow control
US6926730B1 (en) 2000-10-10 2005-08-09 Medtronic, Inc. Minimally invasive valve repair procedure and apparatus
US20040068278A1 (en) * 1999-12-06 2004-04-08 Converge Medical Inc. Anastomosis systems
US6461364B1 (en) 2000-01-05 2002-10-08 Integrated Vascular Systems, Inc. Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use
US9579091B2 (en) 2000-01-05 2017-02-28 Integrated Vascular Systems, Inc. Closure system and methods of use
US6391048B1 (en) 2000-01-05 2002-05-21 Integrated Vascular Systems, Inc. Integrated vascular device with puncture site closure component and sealant and methods of use
US6942674B2 (en) 2000-01-05 2005-09-13 Integrated Vascular Systems, Inc. Apparatus and methods for delivering a closure device
US7842068B2 (en) 2000-12-07 2010-11-30 Integrated Vascular Systems, Inc. Apparatus and methods for providing tactile feedback while delivering a closure device
US8758400B2 (en) 2000-01-05 2014-06-24 Integrated Vascular Systems, Inc. Closure system and methods of use
CA2397121C (en) 2000-01-18 2009-04-07 Tyco Healthcare Group Lp Anastomosis instrument and method for performing same
US6916327B2 (en) * 2000-03-07 2005-07-12 Metacardia, Inc. Device for creating an anastomosis, including penetration structure and eversion structure
US6551332B1 (en) 2000-03-31 2003-04-22 Coalescent Surgical, Inc. Multiple bias surgical fastener
AU2001288006A1 (en) 2000-09-08 2002-03-22 Thomas Anthony Device for locating a puncture hole in a liquid-carrying vessel
US6626918B1 (en) 2000-10-06 2003-09-30 Medical Technology Group Apparatus and methods for positioning a vascular sheath
US6746459B2 (en) 2000-10-19 2004-06-08 Terumo Kabushiki Kaisha End-to-side blood vessel anastomosis method and instruments therefor
US6695867B2 (en) 2002-02-21 2004-02-24 Integrated Vascular Systems, Inc. Plunger apparatus and methods for delivering a closure device
US7806904B2 (en) 2000-12-07 2010-10-05 Integrated Vascular Systems, Inc. Closure device
US8690910B2 (en) 2000-12-07 2014-04-08 Integrated Vascular Systems, Inc. Closure device and methods for making and using them
US7211101B2 (en) 2000-12-07 2007-05-01 Abbott Vascular Devices Methods for manufacturing a clip and clip
US6623510B2 (en) 2000-12-07 2003-09-23 Integrated Vascular Systems, Inc. Closure device and methods for making and using them
US7905900B2 (en) 2003-01-30 2011-03-15 Integrated Vascular Systems, Inc. Clip applier and methods of use
JP4130584B2 (en) 2001-01-24 2008-08-06 タイコ ヘルスケア グループ リミテッド パートナーシップ Anastomosis instrument and method for performing anastomosis
US6945444B2 (en) 2001-04-03 2005-09-20 Tyco Healthcare Group, Lp Surgical stapling device for performing circular anastomoses
IES20010547A2 (en) 2001-06-07 2002-12-11 Christy Cummins Surgical Staple
US6626920B2 (en) 2001-07-05 2003-09-30 Converge Medical, Inc. Distal anastomosis system
US20030229365A1 (en) * 2002-06-10 2003-12-11 Whayne James G. Angled vascular anastomosis system
US6858035B2 (en) 2001-07-05 2005-02-22 Converge Medical, Inc. Distal anastomosis system
US6972023B2 (en) * 2001-07-05 2005-12-06 Converge Medical, Inc. Distal anastomosis system
US20060064119A9 (en) * 2001-07-05 2006-03-23 Converge Medical, Inc. Vascular anastomosis systems
US20070060952A1 (en) 2005-09-02 2007-03-15 Roby Mark S Surgical stapling device with coated knife blade
WO2003030745A1 (en) * 2001-10-05 2003-04-17 Tyco Healthcare Group Lp Tilt top anvil for a surgical fastener device
US6981979B2 (en) * 2001-12-14 2006-01-03 Enrico Nicolo Surgical anastomotic devices
US6769594B2 (en) 2002-05-31 2004-08-03 Tyco Healthcare Group, Lp End-to-end anastomosis instrument and method for performing same
JP4508866B2 (en) 2002-06-04 2010-07-21 アボット ヴァスキュラー デヴァイシス Vascular closure clip and delivery device
ES2364043T3 (en) 2002-07-31 2011-08-23 Tyco Healthcare Group Lp TOOL COATING ELEMENT AND COATING DEPLOYMENT DEVICE.
US8066724B2 (en) 2002-09-12 2011-11-29 Medtronic, Inc. Anastomosis apparatus and methods
CA2501049C (en) 2002-10-04 2012-01-03 Tyco Healthcare Group Lp Surgical stapling device
US8105345B2 (en) 2002-10-04 2012-01-31 Medtronic, Inc. Anastomosis apparatus and methods
US7108710B2 (en) 2002-11-26 2006-09-19 Abbott Laboratories Multi-element biased suture clip
JP2006509595A (en) * 2002-12-16 2006-03-23 エドリッチ・ヴァスキュラー・ディヴァイシズ,インコーポレイテッド Multiple stapling instruments for narrow vessels
US8398656B2 (en) 2003-01-30 2013-03-19 Integrated Vascular Systems, Inc. Clip applier and methods of use
US8821534B2 (en) 2010-12-06 2014-09-02 Integrated Vascular Systems, Inc. Clip applier having improved hemostasis and methods of use
US8202293B2 (en) 2003-01-30 2012-06-19 Integrated Vascular Systems, Inc. Clip applier and methods of use
US7857828B2 (en) 2003-01-30 2010-12-28 Integrated Vascular Systems, Inc. Clip applier and methods of use
US8758398B2 (en) 2006-09-08 2014-06-24 Integrated Vascular Systems, Inc. Apparatus and method for delivering a closure element
US8905937B2 (en) 2009-02-26 2014-12-09 Integrated Vascular Systems, Inc. Methods and apparatus for locating a surface of a body lumen
US7168604B2 (en) 2003-06-20 2007-01-30 Tyco Healthcare Group Lp Surgical stapling device
US7794471B1 (en) * 2003-06-26 2010-09-14 Cardica, Inc. Compliant anastomosis system
US7182769B2 (en) 2003-07-25 2007-02-27 Medtronic, Inc. Sealing clip, delivery systems, and methods
US20050043749A1 (en) * 2003-08-22 2005-02-24 Coalescent Surgical, Inc. Eversion apparatus and methods
US8394114B2 (en) 2003-09-26 2013-03-12 Medtronic, Inc. Surgical connection apparatus and methods
JP4604040B2 (en) 2003-10-17 2010-12-22 タイコ ヘルスケア グループ リミテッド パートナーシップ Surgical stapling device
US7879047B2 (en) 2003-12-10 2011-02-01 Medtronic, Inc. Surgical connection apparatus and methods
AU2005226643B2 (en) 2004-03-19 2010-07-22 Covidien Lp Anvil assembly with improved cut ring
US8181840B2 (en) 2004-03-19 2012-05-22 Tyco Healthcare Group Lp Tissue tensioner assembly and approximation mechanism for surgical stapling device
IES20040368A2 (en) 2004-05-25 2005-11-30 James E Coleman Surgical stapler
US8926633B2 (en) 2005-06-24 2015-01-06 Abbott Laboratories Apparatus and method for delivering a closure element
US8313497B2 (en) 2005-07-01 2012-11-20 Abbott Laboratories Clip applier and methods of use
US9456811B2 (en) 2005-08-24 2016-10-04 Abbott Vascular Inc. Vascular closure methods and apparatuses
US8920442B2 (en) 2005-08-24 2014-12-30 Abbott Vascular Inc. Vascular opening edge eversion methods and apparatuses
US20070060895A1 (en) 2005-08-24 2007-03-15 Sibbitt Wilmer L Jr Vascular closure methods and apparatuses
US8808310B2 (en) 2006-04-20 2014-08-19 Integrated Vascular Systems, Inc. Resettable clip applier and reset tools
US8540132B2 (en) 2006-05-16 2013-09-24 Covidien Lp Tilt anvil assembly
USD611144S1 (en) 2006-06-28 2010-03-02 Abbott Laboratories Apparatus for delivering a closure element
US8556930B2 (en) 2006-06-28 2013-10-15 Abbott Laboratories Vessel closure device
DE602007012771D1 (en) 2007-03-07 2011-04-07 Covidien Ag CLAMP DEVICE FOR MUCOSEKTOMY
US8226681B2 (en) 2007-06-25 2012-07-24 Abbott Laboratories Methods, devices, and apparatus for managing access through tissue
US8893947B2 (en) 2007-12-17 2014-11-25 Abbott Laboratories Clip applier and methods of use
US20090157101A1 (en) 2007-12-17 2009-06-18 Abbott Laboratories Tissue closure system and methods of use
US7841502B2 (en) 2007-12-18 2010-11-30 Abbott Laboratories Modular clip applier
US8011554B2 (en) 2008-01-09 2011-09-06 Tyco Healthcare Group, Lp Raised boss for staple guide
US8177836B2 (en) 2008-03-10 2012-05-15 Medtronic, Inc. Apparatus and methods for minimally invasive valve repair
US9282965B2 (en) 2008-05-16 2016-03-15 Abbott Laboratories Apparatus and methods for engaging tissue
US8181838B2 (en) 2008-09-10 2012-05-22 Tyco Healthcare Group Lp Surgical stapling device
US8398676B2 (en) 2008-10-30 2013-03-19 Abbott Vascular Inc. Closure device
US8231042B2 (en) 2008-11-06 2012-07-31 Tyco Healthcare Group Lp Surgical stapler
US8323312B2 (en) 2008-12-22 2012-12-04 Abbott Laboratories Closure device
US8858594B2 (en) 2008-12-22 2014-10-14 Abbott Laboratories Curved closure device
US9414820B2 (en) 2009-01-09 2016-08-16 Abbott Vascular Inc. Closure devices, systems, and methods
US9486191B2 (en) 2009-01-09 2016-11-08 Abbott Vascular, Inc. Closure devices
US20100179589A1 (en) 2009-01-09 2010-07-15 Abbott Vascular Inc. Rapidly eroding anchor
US9173644B2 (en) 2009-01-09 2015-11-03 Abbott Vascular Inc. Closure devices, systems, and methods
US9089311B2 (en) 2009-01-09 2015-07-28 Abbott Vascular Inc. Vessel closure devices and methods
US8281974B2 (en) 2009-01-14 2012-10-09 Tyco Healthcare, Group LP Surgical stapler with suture locator
US20100185234A1 (en) 2009-01-16 2010-07-22 Abbott Vascular Inc. Closure devices, systems, and methods
US8453913B2 (en) 2009-02-06 2013-06-04 Covidien Lp Anvil for surgical stapler
KR101069603B1 (en) * 2009-02-17 2011-10-05 (주)트리플씨메디칼 End-to-Side TUBULAR ANASTOMOSIS DEVICE
US8146790B2 (en) 2009-07-11 2012-04-03 Tyco Healthcare Group Lp Surgical instrument with safety mechanism
US8328062B2 (en) 2009-07-21 2012-12-11 Covidien Lp Surgical instrument with curvilinear tissue-contacting surfaces
US8267301B2 (en) 2009-08-19 2012-09-18 Tyco Healthcare Group Lp Surgical stapler
US20110054492A1 (en) 2009-08-26 2011-03-03 Abbott Laboratories Medical device for repairing a fistula
US8430292B2 (en) 2009-10-28 2013-04-30 Covidien Lp Surgical fastening apparatus
US8322590B2 (en) 2009-10-28 2012-12-04 Covidien Lp Surgical stapling instrument
US8413872B2 (en) 2009-10-28 2013-04-09 Covidien Lp Surgical fastening apparatus
US8303624B2 (en) 2010-03-15 2012-11-06 Abbott Cardiovascular Systems, Inc. Bioabsorbable plug
US8758399B2 (en) 2010-08-02 2014-06-24 Abbott Cardiovascular Systems, Inc. Expandable bioabsorbable plug apparatus and method
US8603116B2 (en) 2010-08-04 2013-12-10 Abbott Cardiovascular Systems, Inc. Closure device with long tines
US8617184B2 (en) 2011-02-15 2013-12-31 Abbott Cardiovascular Systems, Inc. Vessel closure system
US9149276B2 (en) 2011-03-21 2015-10-06 Abbott Cardiovascular Systems, Inc. Clip and deployment apparatus for tissue closure
US8708212B2 (en) 2011-10-18 2014-04-29 Covidien Lp Tilt top anvil with torsion spring
US9016547B2 (en) 2011-10-26 2015-04-28 Covidien Lp EEA tilt top anvil with ratchet/locking mechanism
US9332976B2 (en) 2011-11-30 2016-05-10 Abbott Cardiovascular Systems, Inc. Tissue closure device
US9010605B2 (en) 2012-01-12 2015-04-21 Covidien Lp Sliding sleeve for circular stapling instrument reloads
US9022274B2 (en) 2012-02-15 2015-05-05 Covidien Lp Circular stapler with increased lumen diameter
US9351734B2 (en) 2012-06-19 2016-05-31 Covidien Lp Spring loaded anvil retainer
US10213205B2 (en) 2012-07-06 2019-02-26 Covidien Lp T-slot tilt anvil for circular stapling instrument
US9675359B2 (en) 2012-10-10 2017-06-13 Covidien Lp Surgical instrument with preload assembly
US9572572B2 (en) 2012-11-09 2017-02-21 Covidien Lp Circular stapler mechanical lockout
US9364209B2 (en) 2012-12-21 2016-06-14 Abbott Cardiovascular Systems, Inc. Articulating suturing device
US9351724B2 (en) 2013-01-11 2016-05-31 Covidien Lp Circular stapling instrument
US9592056B2 (en) 2013-03-14 2017-03-14 Covidien Lp Powered stapling apparatus
CN104042292A (en) 2013-03-15 2014-09-17 柯惠Lp公司 Surgical anastomosis device comprising assemblies capable of being repeatedly utilized
US9532780B2 (en) 2013-06-12 2017-01-03 Covidien Lp EEA anvil snap ring activator
US9668740B2 (en) 2013-06-14 2017-06-06 Covidien Lp Anvil assembly with sliding sleeve
US10271843B2 (en) 2013-06-17 2019-04-30 Covidien Lp Surgical instrument with lockout mechanism
US9750503B2 (en) 2013-07-11 2017-09-05 Covidien Lp Methods and devices for performing a surgical anastomosis
US9693773B2 (en) 2013-09-11 2017-07-04 Covidien Lp Anvil assembly with sliding sleeve
US9517070B2 (en) 2013-11-13 2016-12-13 Covidien Lp Anvil assembly and delivery system
US9554802B2 (en) 2013-11-13 2017-01-31 Covidien Lp Anvil assembly with frangible retaining member
US9913643B2 (en) 2014-05-09 2018-03-13 Covidien Lp Interlock assemblies for replaceable loading unit
EP3154448B1 (en) 2014-06-12 2019-08-28 Covidien LP Surgical stapling apparatus
US9861367B2 (en) 2014-06-24 2018-01-09 Covidien Lp Anvil assembly delivery systems
US9867619B2 (en) 2014-06-24 2018-01-16 Covidien Lp System for delivering an anvil assembly to a surgical site
US10405864B2 (en) 2014-07-04 2019-09-10 Covidien Lp Loading unit with shipping member for surgical stapling device
US9757133B2 (en) 2014-07-09 2017-09-12 Covidien Lp Methods and devices for performing a surgical anastomosis
US10898196B2 (en) 2014-11-21 2021-01-26 Covidien Lp Cleaning apparatus for surgical instruments
US10085744B2 (en) 2014-12-08 2018-10-02 Covidien Lp Loading unit attachment band for surgical stapling instrument
US9855045B2 (en) 2014-12-09 2018-01-02 Covidien Lp Anvil assembly delivery system
WO2016090600A1 (en) 2014-12-11 2016-06-16 Covidien Lp Stapler with auto-matic lockout mechanism
US10499916B2 (en) 2014-12-11 2019-12-10 Covidien Lp Surgical stapling loading unit
CN106999189B (en) 2014-12-17 2020-05-26 柯惠有限合伙公司 Surgical stapling device with firing indicator
US10022126B2 (en) 2015-01-07 2018-07-17 Covidien Lp Loading unit locking collar
US10039549B2 (en) 2015-01-07 2018-08-07 Covidien Lp Loading unit retention clip for surgical stapling instrument
US10117656B2 (en) 2015-01-07 2018-11-06 Covidien Lp Loading unit locking collar
WO2016127433A1 (en) 2015-02-15 2016-08-18 Covidien Lp Surgical stapling device with firing indicator of unitary construction
US10881408B2 (en) 2015-04-22 2021-01-05 Covidien Lp Interlock assembly for replaceable loading units
US10426480B2 (en) 2015-04-29 2019-10-01 Covidien Lp Cutting ring assembly with rigid cutting member
US9987001B2 (en) 2015-06-12 2018-06-05 Covidien Lp Surgical anastomosis apparatus
US10111668B2 (en) 2015-07-02 2018-10-30 Covidien Lp Anvil assembly with snap backup ring
US9974536B2 (en) 2015-07-02 2018-05-22 Covidien Lp Anvil assemblies and delivery systems
US10117655B2 (en) 2015-07-22 2018-11-06 Covidien Lp Loading unit locking band for surgical stapling instrument
US10085756B2 (en) 2015-07-24 2018-10-02 Covidien Lp Anvil assembly and anvil assembly delivery system
US10117675B2 (en) 2015-07-28 2018-11-06 Covidien Lp Trocar tip protector
US9980730B2 (en) 2015-09-21 2018-05-29 Covidien Lp Loading unit locking collar with rotational actuated release
US10111684B2 (en) 2015-09-25 2018-10-30 Covidien Lp Adapter assembly including a removable trocar assembly
US10542992B2 (en) 2015-10-19 2020-01-28 Covidien Lp Loading unit with stretchable bushing
WO2017066918A1 (en) 2015-10-20 2017-04-27 Covidien Lp Circular stapler with tissue gap indicator assembly
US10842495B2 (en) 2015-10-21 2020-11-24 Covidien Lp Annular knife for a surgical stapler
US10512466B2 (en) 2015-11-05 2019-12-24 Covidien Lp Adapter assembly for surgical device
CN108289683B (en) 2015-11-13 2021-06-25 柯惠有限合伙公司 Circular stapler with audible indicator mechanism
ES2821891T3 (en) 2015-12-07 2021-04-28 Covidien Lp Anvil Assembly and Delivery System
US10390835B2 (en) 2015-12-10 2019-08-27 Covidien Lp Surgical fastener apparatus with linear position sensor
US10524797B2 (en) 2016-01-13 2020-01-07 Covidien Lp Adapter assembly including a removable trocar assembly
EP3410957B1 (en) 2016-02-04 2020-06-03 Covidien LP Circular stapler with visual indicator mechanism
US10398439B2 (en) 2016-02-10 2019-09-03 Covidien Lp Adapter, extension, and connector assemblies for surgical devices
US10603042B2 (en) 2016-02-10 2020-03-31 Covidien Lp Flexible circular stapler
EP3422986B1 (en) 2016-03-04 2023-12-27 Covidien LP Robotic surgical assemblies
US10595871B2 (en) 2016-05-10 2020-03-24 Covidien Lp Insertion instrument, adapter assemblies and protector assemblies for a flexible circular stapler
US11141162B2 (en) 2016-07-08 2021-10-12 Covidien Lp Loading unit locking collar with linearly actuated release
US11452522B2 (en) 2016-08-15 2022-09-27 Covidien Lp Circular stapling device with articulating anvil retainer assembly
US10426470B2 (en) 2016-11-04 2019-10-01 Covidien Lp Stapling device with releasable knife carrier
US10499922B2 (en) 2016-11-04 2019-12-10 Covidien Lp Stapling device with self-releasing knife carrier pusher
US11241232B2 (en) 2017-01-24 2022-02-08 Covidien Lp Surgical stapling device with resettable anvil assembly
WO2018140066A1 (en) 2017-01-25 2018-08-02 Covidien Lp Circular stapling device and method of use
US10542993B2 (en) 2017-02-24 2020-01-28 Covidien Lp Anvil assembly of circular stapling device including alignment splines
EP3592252B1 (en) 2017-03-09 2023-10-25 Covidien LP End effector assembly for circular stapler apparatus
US11382629B2 (en) 2017-03-09 2022-07-12 Covidien Lp Surgical stapling device with audible indicator mechanism
US11071549B2 (en) 2017-03-23 2021-07-27 Covidien Lp Circular stapling device with alignment splines
US10342534B2 (en) 2017-03-23 2019-07-09 Covidien Lp Surgical stapling device with releasable knife carrier
US10881409B2 (en) 2017-05-02 2021-01-05 Covidien Lp Rotation assembly for a surgical device
US11596400B2 (en) 2017-06-09 2023-03-07 Covidien Lp Handheld electromechanical surgical system
US11045199B2 (en) 2017-06-09 2021-06-29 Covidien Lp Handheld electromechanical surgical system
US10932784B2 (en) 2017-06-09 2021-03-02 Covidien Lp Handheld electromechanical surgical system
US10987107B2 (en) 2017-07-05 2021-04-27 Covidien Lp Surgical stapling device
WO2019023841A1 (en) 2017-07-31 2019-02-07 Dow Silicones Corporation Process and apparatus to make liquid silicone rubber compositions
US11090054B2 (en) 2017-08-07 2021-08-17 Covidien Lp Stapling device with resettable tilt anvil assembly
US10828026B2 (en) 2017-08-08 2020-11-10 Covidien Lp Tiltable anvil assembly
US10695069B2 (en) 2017-08-23 2020-06-30 Covidien Lp Circular stapling device with offset spline tip
US11234703B2 (en) 2017-09-01 2022-02-01 Covidien Lp Circular stapling device with position ribs
US11324507B2 (en) 2017-11-03 2022-05-10 Covidien Lp Device and method for attachment of a stomal sleeve
US11497501B2 (en) 2018-03-26 2022-11-15 Covidien Lp Circular stapling device with A-frame splines
US11006960B2 (en) 2018-03-28 2021-05-18 Covidien Lp Surgical anvil assemblies for surgical stapling instruments
US10952734B2 (en) 2018-04-23 2021-03-23 Covidien Lp Stapling device with cut ring biasing member
US11197676B2 (en) 2018-06-28 2021-12-14 Covidien Lp Tie-down method for anvil assembly delivery system
US11241234B2 (en) 2018-08-14 2022-02-08 Covidien Lp Anvil assembly with self-retaining backup member
US11564691B2 (en) 2018-08-24 2023-01-31 Covidien Lp Powered circular stapling device
US10973544B2 (en) 2018-10-02 2021-04-13 Covidien Lp Retaining mechanism for trocar assembly
US11141163B2 (en) 2018-10-04 2021-10-12 Covidien Lp Circular stapling device with anvil rotation locking structure
US11065005B2 (en) 2018-11-07 2021-07-20 Covidien Lp Reload assembly for a circular stapling device
US11147561B2 (en) 2018-11-28 2021-10-19 Covidien Lp Reload assembly for a circular stapling device
US11389263B2 (en) 2018-12-13 2022-07-19 Covidien Lp Lockout mechanisms for surgical instruments
US11166728B2 (en) 2019-02-08 2021-11-09 Covidien Lp Reload assembly for a circular stapling device
US11529144B2 (en) 2019-02-22 2022-12-20 Covidien Lp Encapsulated plug assembly for electromechanical surgical devices
US11547411B2 (en) 2019-02-22 2023-01-10 Covidien Lp Anastomosis wound protector
US11337701B2 (en) 2019-03-01 2022-05-24 Covidien Lp Devices and methods for assembling adapter assemblies
US11331782B2 (en) 2019-03-01 2022-05-17 Covidien Lp Reload assembly for a circular stapling device
US11457921B2 (en) 2019-03-26 2022-10-04 Covidien Lp Anvil assembly for surgical stapling instrument
US11534164B2 (en) 2019-04-05 2022-12-27 Covidien Lp Strain gauge stabilization in a surgical device
US11596410B2 (en) 2019-04-05 2023-03-07 Covidien Lp Surgical stapling device
US11317945B2 (en) 2019-04-16 2022-05-03 Covidien Lp Trocar assemblies for adapter assemblies for surgical stapling instruments
US11344330B2 (en) 2019-04-16 2022-05-31 Covidien Lp Trocar assemblies for adapter assemblies for surgical stapling instruments
US11660116B2 (en) 2019-04-16 2023-05-30 Covidien Lp Trocar assemblies for adapter assemblies for surgical stapling instruments
US11419631B2 (en) 2019-04-16 2022-08-23 Covidien Lp Trocar assemblies for adapter assemblies for surgical stapling instruments
US11839378B2 (en) 2019-04-19 2023-12-12 Covidien Lp Circular stapling instruments
US11399838B2 (en) 2019-04-22 2022-08-02 Covidien Lp Reload assembly for circular stapling devices
US11246599B2 (en) 2019-04-25 2022-02-15 Covidien Lp End effector for circular stapling instrument
JP2022543958A (en) 2019-05-31 2022-10-17 コヴィディエン リミテッド パートナーシップ circular stapling device
US11690624B2 (en) 2019-06-21 2023-07-04 Covidien Lp Reload assembly injection molded strain gauge
US11446035B2 (en) 2019-06-24 2022-09-20 Covidien Lp Retaining mechanisms for trocar assemblies
US11123101B2 (en) 2019-07-05 2021-09-21 Covidien Lp Retaining mechanisms for trocar assemblies
US11357509B2 (en) 2019-07-11 2022-06-14 Covidien Lp Reload assembly for a circular stapling device
US11192227B2 (en) 2019-07-16 2021-12-07 Covidien Lp Reload assembly for circular stapling devices
US11253255B2 (en) 2019-07-26 2022-02-22 Covidien Lp Knife lockout wedge
US11464510B2 (en) 2019-07-26 2022-10-11 Covidien Lp Reload assembly with knife carrier lockout
US11399825B2 (en) 2019-10-28 2022-08-02 Covidien Lp Reload assembly with knife carrier lockout
US11553918B2 (en) 2019-12-16 2023-01-17 Covidien Lp Reload assembly with knife carrier lockout
US11730481B2 (en) 2020-01-06 2023-08-22 Covidien Lp Assemblies for retaining a trocar assembly
US11517317B2 (en) 2020-01-06 2022-12-06 Covidien Lp Trocar release assemblies for a surgical stapler
US11911038B2 (en) 2020-01-13 2024-02-27 Covidien Lp Cut optimization for excessive tissue conditions
US11523828B2 (en) 2020-01-28 2022-12-13 Covidien Lp Sealed reload assembly for stapling device
US11622767B2 (en) 2020-02-19 2023-04-11 Covidien Lp Sealed trocar assembly for stapling device
US11547438B2 (en) 2020-02-24 2023-01-10 Covidien Lp Tip protector for ensuring trocar insertion
US11382630B2 (en) 2020-02-25 2022-07-12 Covidien Lp Surgical stapling device with two part knife assembly
US11779343B2 (en) 2020-02-26 2023-10-10 Covidien Lp Staple reload assembly with releasable knife
US11298152B2 (en) 2020-02-28 2022-04-12 Covidien Lp Trocar retaining mechanism including band support
US11272998B2 (en) 2020-03-04 2022-03-15 Covidien Lp Strain gage fixation in tension
US11350939B2 (en) 2020-03-24 2022-06-07 Covidien Lp Retaining mechanisms for trocar assemblies
US11426169B2 (en) 2020-03-24 2022-08-30 Covidien Lp Retaining mechanisms for trocar assemblies
US11426170B2 (en) 2020-03-24 2022-08-30 Covidien Lp Retaining mechanisms for trocar assemblies
US11653925B2 (en) 2020-05-21 2023-05-23 Covidien Lp Tissue relaxation monitoring for optimized tissue stapling
US11547405B2 (en) 2020-05-22 2023-01-10 Covidien Lp Surgical stapling device
US11553921B2 (en) 2020-07-15 2023-01-17 Covidien Lp Surgical stapling device with flexible shaft
US11547412B2 (en) 2020-07-22 2023-01-10 Covidien Lp Surgical instruments and methods of assembly
US11877744B2 (en) 2020-08-14 2024-01-23 Covidien Lp Low-cost powered stapler with end stop selection
US11627966B2 (en) 2020-08-26 2023-04-18 Covidien Lp Surgical stapling device
US11801054B2 (en) 2020-09-22 2023-10-31 Covidien Lp Surgical stapler with oval tool assembly
US11712509B2 (en) 2020-10-02 2023-08-01 Covidien Lp Seal assembly for circular stapling instrument
US11627967B2 (en) 2020-11-23 2023-04-18 Covidien Lp Trans-anastomotic insertion device
US11877750B2 (en) 2021-01-21 2024-01-23 Covidien Lp Surgical stapler with powered and manual functions
US11786241B2 (en) 2021-02-16 2023-10-17 Covidien Lp Surgical stapling device including a hydraulic staple formation mechanism
US11553920B2 (en) 2021-05-03 2023-01-17 Covidien Lp Trocar retainer assembly for surgical stapler
US11490894B1 (en) 2021-05-12 2022-11-08 Covidien Lp Surgical device with grease filter
US11642131B2 (en) 2021-05-17 2023-05-09 Covidien Lp Devices and methods for shortening a rectal stump during a lower anterior resection procedure
US11612400B2 (en) 2021-05-24 2023-03-28 Covidien Lp Trocar assembly with bearing assembly for load sharing
US11819208B2 (en) 2021-08-05 2023-11-21 Covidien Lp Handheld electromechanical surgical device with strain gauge drift detection
US11737759B2 (en) 2021-08-05 2023-08-29 Covidien Lp Surgical stapling device accommodating prolapsed tissue
US11744592B2 (en) 2021-08-05 2023-09-05 Covidien Lp Handheld electromechanical stapler with tissue thickness detection
US20230047471A1 (en) * 2021-08-13 2023-02-16 Cilag Gmbh International Staple forming features for circular surgical stapler
US11911039B2 (en) 2021-08-13 2024-02-27 Cilag Gmbh International Circular surgical stapler having staples with expandable crowns
US11883028B2 (en) 2021-09-08 2024-01-30 Covidien Lp Systems and methods for post-operative anastomotic leak detection
US11717299B2 (en) 2021-10-12 2023-08-08 Covidien Lp Surgical stapling device with probiotics

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0270260A1 (en) * 1986-11-13 1988-06-08 United States Surgical Corporation Surgical stapler for performing end-to-end anastomosis
EP0554990A1 (en) * 1992-02-06 1993-08-11 Andreas G. Tzakis Apparatus for anastomosis
US5366462A (en) * 1990-08-28 1994-11-22 Robert L. Kaster Method of side-to-end vascular anastomotic stapling

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4576167A (en) * 1981-09-03 1986-03-18 United States Surgical Corporation Surgical stapler apparatus with curved shaft
US5119983A (en) * 1987-05-26 1992-06-09 United States Surgical Corporation Surgical stapler apparatus
US5234447A (en) * 1990-08-28 1993-08-10 Robert L. Kaster Side-to-end vascular anastomotic staple apparatus
DK145593A (en) * 1993-12-23 1995-06-24 Joergen A Rygaard Surgical double instrument for performing connection mlm. arteries (end-to-side anastomosis)

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0270260A1 (en) * 1986-11-13 1988-06-08 United States Surgical Corporation Surgical stapler for performing end-to-end anastomosis
US5366462A (en) * 1990-08-28 1994-11-22 Robert L. Kaster Method of side-to-end vascular anastomotic stapling
EP0554990A1 (en) * 1992-02-06 1993-08-11 Andreas G. Tzakis Apparatus for anastomosis

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6293955B1 (en) 1996-09-20 2001-09-25 Converge Medical, Inc. Percutaneous bypass graft and securing system
US6066144A (en) * 1997-10-07 2000-05-23 Ethicon Endo-Surgery, Inc. Surgical anastomosis method
EP0931512A1 (en) 1998-01-23 1999-07-28 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US6361559B1 (en) 1998-06-10 2002-03-26 Converge Medical, Inc. Thermal securing anastomosis systems
US6740101B2 (en) 1998-06-10 2004-05-25 Converge Medical, Inc. Sutureless anastomosis systems
US6695859B1 (en) 1999-04-05 2004-02-24 Coalescent Surgical, Inc. Apparatus and methods for anastomosis
WO2002096298A1 (en) * 2001-05-31 2002-12-05 Hb Medicals Corporation Vascular anastomosis device
US8518060B2 (en) 2009-04-09 2013-08-27 Medtronic, Inc. Medical clip with radial tines, system and method of using same
US8668704B2 (en) 2009-04-24 2014-03-11 Medtronic, Inc. Medical clip with tines, system and method of using same

Also Published As

Publication number Publication date
CA2234148C (en) 2002-01-08
JPH11502753A (en) 1999-03-09
AU701033B2 (en) 1999-01-21
CA2234148A1 (en) 1997-05-09
AU3801795A (en) 1997-05-22
US5993468A (en) 1999-11-30
ATE188862T1 (en) 2000-02-15
DE69514694D1 (en) 2000-02-24
DE69514694T2 (en) 2000-07-27
DK0859572T3 (en) 2000-06-26
EP0859572B1 (en) 2000-01-19
NO981922L (en) 1998-06-30
ES2145303T3 (en) 2000-07-01
JP3207436B2 (en) 2001-09-10
EP0859572A1 (en) 1998-08-26
KR19990067179A (en) 1999-08-16
KR100269077B1 (en) 2000-11-01
NO981922D0 (en) 1998-04-28

Similar Documents

Publication Publication Date Title
EP0859572B1 (en) Anastomotic instrument for use when performing an end-to-side anastomosis
AU715311B2 (en) Method and anastomotic instrument for use when performing an end-to-side anastomosis
EP0904019B1 (en) Anastomotic instrument for use when performing an end-to-side anastomosis
US5314436A (en) Method and apparatus for performing end-to-end anastomoses
US6962595B1 (en) Integrated anastomosis system
EP1808135B1 (en) Mechanical anastomosis system for hollow structures
JP4393742B2 (en) Surgical stapling instrument
US4703887A (en) Collapsible purse string aid for use with intraluminal stapling device
EP1683491B1 (en) Anstomosis connector applicator
US5403333A (en) Side-to-end vascular anastomotic staple apparatus
US20040220597A1 (en) Method and apparatus for performing anastomosis with eversion of tissue edges and joining of exposed intima of the everted tissue
US20110101069A1 (en) Surgical Stapler with Direct Sled to Staple Contact
US7018387B2 (en) Mechanical anastomosis system for hollow structures
JPH06277221A (en) Apparatus for operation
CA2093490A1 (en) Transanal anastomosis ring insertion device
EP1173098A4 (en) Vascular incisor and method
WO2001015607A9 (en) Method and apparatus for performing anastomosis
WO2023238142A1 (en) A device for manually performing anastomosis

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AL AM AT AU BB BG BR BY CA CH CN CZ DE DK EE ES FI GB GE HU IS JP KE KG KP KR KZ LK LR LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK TJ TM TT UA UG US UZ VN

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): KE LS MW SD SZ UG AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
ENP Entry into the national phase

Ref document number: 2234148

Country of ref document: CA

Ref country code: CA

Ref document number: 2234148

Kind code of ref document: A

Format of ref document f/p: F

WWE Wipo information: entry into national phase

Ref document number: 1995935866

Country of ref document: EP

ENP Entry into the national phase

Ref country code: JP

Ref document number: 1997 516995

Kind code of ref document: A

Format of ref document f/p: F

WWE Wipo information: entry into national phase

Ref document number: 1019980703130

Country of ref document: KR

WWP Wipo information: published in national office

Ref document number: 1995935866

Country of ref document: EP

REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

WWE Wipo information: entry into national phase

Ref document number: 09065042

Country of ref document: US

WWP Wipo information: published in national office

Ref document number: 1019980703130

Country of ref document: KR

WWG Wipo information: grant in national office

Ref document number: 1995935866

Country of ref document: EP

WWG Wipo information: grant in national office

Ref document number: 1019980703130

Country of ref document: KR