Surgery – Instruments – Cutting – puncturing or piercing
Reexamination Certificate
2000-06-22
2001-06-19
Truong, Kevin (Department: 3731)
Surgery
Instruments
Cutting, puncturing or piercing
C606S185000
Reexamination Certificate
active
06248119
ABSTRACT:
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a device and a method for preparing a site along a wall of a receiving blood vessel for connecting a prospective blood vessel thereto without interrupting the flow of blood through the receiving blood vessel. The device comprises an elongated member and a sealing means.
BACKGROUND ART
Currently, the standard treatment of narrow and blocked arteries is to bypass the narrow part of the vessel with an additional vessel. When such an operation is to be performed the blood flow at the site where the additional vessel should be connected has to be excluded to prohibit bleeding. To exclude the blood flow, clamps normally are applied to the vessel which is to be connected to the additional vessel, either on one or both sides of the connection site. This can also be achieved by means of a side-clamp that excludes a part of the lumen around the intended opening.
Today, surgery is heading towards endoscopic surgery, also called keyhole surgery. To apply clamps on arteries through endoscopic ports is very demanding and sometimes impossible, especially on the aorta.
One way of reducing the problems described above is by using the device described in WO 98/52475. However, the preparation of a site for connecting a prospective blood vessel using this device is complicated and time-consuming. This results in the fact that the time for sealing is long and thus blood will be leaking out of the receiving blood vessel. Further, the device in WO 98/52475 is complicated because of its design, which makes it difficult to maintain, sterilize, and manufacture.
SUMMARY OF THE INVENTION
It is an object of the present invention to provide a device and a method for preparing a site along a wall of a receiving blood vessel for connecting a prospective blood vessel thereto without interrupting the flow of blood through the receiving blood vessel, and further to achieve this preparation by endoscopic surgery. Another object of the present invention is to provide a device and a method that will facilitate fast sealing of the receiving blood vessel for minimizing the amount of blood leaking out before the prospective blood vessel is connected.
These objects are achieved by a device according to claim
1
and by a method according to claim
14
. Preferred embodiments of the present invention are defined in the dependent claims.
A device according to the invention comprises an elongated member and a sealing means and is characterized by a head portion to which the elongated member is connected, and a cutting means provided at a distal part of the head portion for making an initial opening in the receiving blood vessel, the sealing means being provided on the head portion proximally of the cutting means. An advantage of providing a cutting means and a sealing means like this is that the initial opening that is made by the cutting means may be sealed very fast by the sealing means, because both are arranged in the same device as mentioned above. The fast sealing of the initial opening results in a minimum of bleeding through this opening. Further advantages are that a hole for connecting a prospective blood vessel may be made without the use of clamps and thus very few instruments are required, which makes it easier to prepare said site.
In a preferred embodiment of the invention, a needle is provided on the head portion distally of the cutting means for penetrating the wall of the receiving blood vessel before the initial opening is made by the cutting means. By having the needle penetrate the wall of the receiving blood vessel at the site before any cutting or sealing is performed, the initial opening can be positioned with great accuracy. Further, the risk of the cutting means drifting away from a predestined position is minimized.
In another preferred embodiment of the invention, the cutting means comprises at least one cutting edge provided distally of the head portion. This facilitates the preparation of said site by making it possible for a user to both cut and seal during a single advancement of the device. Thus, the time between cutting an initial opening and sealing the same can be reduced to a very short time. Further, the head portion preferably tapers distally to facilitate the cutting of the initial opening and the advancement of the device through said opening.
In yet another preferred embodiment, the sealing means is a flexible disc extending radially outwards from the head portion in a relaxed state. As a result, the sealing means does not require any mechanical controlling means for sealing the opening in the blood vessel. In yet another preferred embodiment, the flexible disc is flexible in a way that makes it bend backwards along the elongated member as a result of the flexible disc making contact with the receiving blood vessel during the advancement of the head portion through the initial opening of the receiving blood vessel and makes the flexible disc resume its relaxed state when the disc has passed through the initial opening for sealing the initial opening from inside the receiving blood vessel. By designing the sealing means like this, the operation of cutting an initial opening and sealing it can be performed by involving very few and simple operations. It is even possible to perform the cutting and sealing by just advancing the device through the wall of a receiving blood vessel.
REFERENCES:
patent: 5595193 (1997-01-01), Walus et al.
patent: 5725544 (1998-03-01), Rygaard
patent: 5766220 (1998-06-01), Moenning
patent: 5893369 (1999-04-01), Le Mole
patent: 0 544 485 (1993-06-01), None
patent: 95 17127 (1995-06-01), None
patent: 98 52475 (1998-11-01), None
patent: 58 52475 (1998-11-01), None
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