Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Patent
1998-08-24
1999-09-21
Jackson, Gary
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
A61B 1704
Patent
active
059547359
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
The present invention relates to a method and instrument for connecting an end region of a first vessel to the side of a second vessel by carrying out an end-to-side anastomosis.
BACKGROUND ART
A method closely related to the one referred to above is described in the international application WO-A-97/16122. In this previous method, the various relatively movable assemblies, viz. the anvil assembly, the clamping assembly and the stapling assembly, extended circumferentially all the way around the internal space in the instrument accommodating the first vessel or graft vessel, for which reason it was necessary when removing the instrument from the anastomosis having been established to move it along the graft vessel to the latter's free end or to pull the graft vessel out of the instrument.
This means, of course, that the instrument of said application WO-A-97/16122 can only be used with totally free graft vessels leaving one free end after anastomosis, making it possible to use the instrument for establishing anastomoses at both ends of an originally free graft vessel--or at the only free end of a closely situated anatomical artery (typically, but not exclusively the Internal Mammarian Artery--the socalled IMA vessel), such as may be required in coronary surgery.
U.S. Pat. No. 3,519,187 and U.S. Pat. No. 4,076,162 disclose methods comprising the use of instruments for connecting an end region of a first vessel to the side of a second vessel by carrying out an end-to-side anastomosis, in which the anvil assemblies can be split lengthwise. This is not, however, sufficient to overcome the limitation explained above, as other active assemblies necessitate having a free end on the graft vessel to enable them to be removed.
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 use the instrument for establishing anastomoses at any free end of a graft vessel, such as may be required in coronary surgery, and this object is achieved by proceeding as set forth hereinbelow. In this manner, all active parts of the instrument may be divided along the internal space accommodating the graft vessel, the two parts arising out of this dividing being removable sideways from the graft vessel, so that the latter does not necessarily have to have a free end.
The present invention also relates to an anastomotic instrument for carrying out the method according to the invention. This instrument is for connecting an end region of a first vessel to the side of a second vessel by carrying out an end-to-side anastomosis, corresponding to the Prior Art as disclosed in the above-mentioned U.S. Pat. No. 3,519,187, and according to the invention, it also comprises the features set forth hereafter.
Advantageous embodiments of the method and the anastomotic instrument according to the invention, and the effects of which (beyond what is self-evident) are explained in the following detailed part of the present description.
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
FIGS. 1-8 show the process of performing an end-to-side anastomosis using an anastomotic instrument according to the invention subject of the application WO-A-97/16122 referred to initially, FIGS. 1-7 being drawn in a highly simplified manner for ease of understanding,
FIGS. 9-12 in perspective and with certain parts cut away show a practical embodiment of an anastomotic instrument according to the aforesaid invention with the various possible relative positions of the relatively movable parts,
FIG. 13 at a highly enlarged scale shows a part of the instrument shown in FIG. 1 with modified clamping surfaces, and
FIGS. 14-18 show the anastomotic instrument according to the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
As me
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Bernafon AG
Jackson Gary
Oticon A/S
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