Elongated-member-driving apparatus – Surgical stapler – With magazine
Patent
1995-02-03
1997-12-30
Hall, III, Joseph J.
Elongated-member-driving apparatus
Surgical stapler
With magazine
227 19, 2271751, 2271761, 606143, 606220, A61B 17068
Patent
active
057020485
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
1. Field of the Invention
Blood vessels are sutured in most cases using needles and nonabsorbable sutures. This technique is satisfactory for the most part, but principally for vascular surgery of large vessels, that is, vessels having a diameter greater than 3 mm. This technique is fast and reliable.
2. Description of the Prior Art
By contrast, in vascular microsurgery, i.e., for arteries and veins between 3 mm and 0.5 mm in diameter, this technique requires lengthy training in the laboratory because it relies on magnification instruments, lenses and particularly microscopes, microsurgical instruments and especially needles and very fine threads. Thus, clinical application of such vascular sutures on human patients is still at present subject to limitations: the lengthy training period, prolonged operating times with a minimum of fifteen minutes for each vascular suture and, finally, a moderately high risk of thrombosis.
Other techniques for vascular micro-sutures have been proposed over the years to mitigate these limitations:
The Nakayama ring suture which allows the two ends of the vessel to be joined by means of a male ring and female ring provided with barbs on which the vessel wall is everted.
The coupler developed more recently by the 3M company which utilizes the same principle.
Vascular anastomosis by laser.
Use of biological glues.
Vascular anastomosis with Nakayama's rings or couplers cannot be used for vessels less than one millimeter and can only be used for terminoterminal or end-to-end anastomoses. They have no practical use for terminolateral or end-to-side anastomoses.
The advantages of laser anastomosis are limited in that its use requires placement of at least three traditional sutures.
Anastomosis by biological adhesive presents the same disadvantages because of inadequate tensioning force to maintain contact between the two ends and due to the fact that associated stitches are also indispensable.
SUMMARY OF THE INVENTION
Therefore, the present invention proposes a new method for quick, simple and dependable vascular microanastomoses which does not have the limits and drawbacks of previous methods, as well as a gripper for implementing this method. The method and gripper are characterized by the features contained in the claims and in the following description.
The object of the present invention is a method for microanastomosis of blood vessels in particular, characterized in that the two ends of the vessel to be joined are placed end to end and the wails of the vessel which are placed end to end are joined in several places by bending or crimping a metallic micro-staple.
Another object of the invention is a device for carrying out this method having a housing which is provided with a gripper for grasping and crimping staples and contains a mechanism for crimping the staples by actuating the gripper, which mechanism has a control member which is accessible from outside the housing; a staple magazine and a mechanism for transferring a staple from the magazine to a position between the jaws of the gripper which is likewise controlled by a control member accessible from outside the housing.
BRIEF DESCRIPTION OF THE DRAWINGS
An embodiment form of the gripper according to the invention, the staples used by the gripper and the procedure for placing these staples are illustrated by way of example in the accompanying schematic drawings.
FIG. 1 shows a general perspective view of the gripper according to the invention;
FIG. 2 is an enlarged view showing the jaws of the gripper holding a staple to be fastened;
FIG. 3a is an enlarged view of a staple;
FIG. 3b shows a detail of a point of the staple shown in FIG. 3a;
FIGS. 4, 5, 6 show the gripper in three different operating positions in section along a plane of symmetry;
FIGS. 7, 8, 10 show sections along a plane perpendicular to the plane of symmetry of the gripper corresponding to the views shown in FIGS. 4, 5, 6, respectively;
FIG. 9 shows the gripper in partial section similar to FIGS. 4 to 6 with an enlar
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Hall, III Joseph J.
Stelacone Jay A.
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