MXPA06005164A - Screw tip control for anastomotic ring applier - Google Patents

Abstract

A surgical instrument for applying an anastomotic ring device comprises a handle connected to an anastomotic ring deployment mechanism by a shaft. The shaft has at least one torsion member that is capable of communicating a torsional actuating force from the handle to the ring deployment mechanism. The ring deployment mechanism is configured to actuate in response to torsional actuating force communicated from the torsion member. A threaded shaft or rod may be positioned in the ring deployment mechanism to effect actuation of the ring deployment mechanism in response to torsion.

Description

THREAD CONTROL FOR ANASTOMOTIC RING APPLICATOR FIELD OF THE INVENTION In general, the present invention relates to surgery and, more particularly, to a device for performing a surgical procedure in the digestive system.

BACKGROUND OF THE INVENTION The percentage of the world population that suffers from morbid obesity is constantly growing. Severely obese people may be at increased risk of heart disease, stroke, diabetes, lung disease, and accidents. Due to the effects of morbid obesity on the patient's life, methods of treating morbid obesity have been the subject of intense research. A known method for treating morbid obesity includes the use of anastomotic rings. The devices for applying the anastomotic rings are known. Devices of this nature are commonly adapted to insert an anastomotic ring compressed into an anastomotic opening, formed between proximal walls of gastrointestinal tissue. These applicator devices may utilize a ring deployment mechanism comprising an expansion element that is actuated once the compressed ring is placed in the anastomotic opening, causing the anastomotic ring to expand from its cylindrically compressed position to a hollow rivet driven position. Some conventional flexible applicator devices that employ force transmission through cables to control the ring deployment mechanism, may exhibit the undesirable potential of cable buckling or straightening of the device. Consequently, it may be desirable to have an applicator employing torsional force transfer, for example by means of one or more threaded members.

BRIEF DESCRIPTION OF THE INVENTION The embodiments of the invention provide an anastomotic ring applicator device having a threaded shaft that is operable to transfer a torsional force to a ring deployment mechanism, thereby effecting actuation of the ring deployment mechanism. In one embodiment, a surgical instrument is provided for applying an anastomotic ring device, comprising a handle attached to a ring deployment mechanism by an elongated arrow. The ring deployment mechanism is configured to receive and deploy an anastomotic ring. The elongated shaft is configured to transfer a torsional driving force from the handle to the ring deployment mechanism. In another embodiment, an instrument comprises a drive member configured to receive an anastomotic ring. The actuating member is movable between a non-driven cylindrical position and a hollow rivet formation shape, in response to one or more driving forces. The instrument also comprises a handle that includes a drive mechanism. The drive mechanism is operable to produce at least one of the driving forces. The instrument also comprises an elongated arrow joining the handle to the drive member. The elongated shaft is operatively configured to transfer the driving forces (at least one) of the handle to the drive member. The instrument also comprises at least one threaded member operable to communicate at least one of the driving forces to the driving member. In another embodiment, an instrument comprises a drive member configured to receive an anastomotic ring. The actuating member is movable between a non-driven cylindrical position and a hollow rivet formation shape, in response to one or more linear driving forces. The instrument also comprises a handle having a drive mechanism that is operable to produce a torsional force. The instrument also comprises one or more transformation members in communication with the driving member. The transformation members (one or more) are configured to transform the torsional force into the linear drive forces (one or more). The instrument also comprises an elongated arrow joining the handle to the drive member. The arrow has at least one transfer member that is operatively configured to transfer the torsional force to the transformation member. In another modality, a method for deploying an anastomotic ring comprises placing an anastomotic ring applicator at an anastomosis site. The applicator comprises a handle that includes an actuator that is operable to generate a torsional force. The applicator also comprises a ring deployment mechanism comprising an anastomotic ring. The ring deployment mechanism is operable to deploy the anastomotic ring in response to one or more driving forces. The applicator also comprises an arrow connecting the handle to the ring deployment mechanism. The arrow comprises a torsion member that is operable to communicate the torsional force. The applicator also comprises a transformation member that is in communication with the ring deployment mechanism and the torsion member. The transformation member is configured to transform the torsional force into one or more driving forces. The method also involves manipulating the actuator to generate the torsional force. In addition, the method comprises inactivating the ring deployment mechanism and removing the applicator from the site of the anastomosis.

BRIEF DESCRIPTION OF THE FIGURES The accompanying drawings that are incorporated and constitute a part of this specification, illustrate versions of the invention, and together with the general description of the invention given above and the detailed description of the versions given below, serve to explain the principles of the present invention. Figure 1 is a perspective view of an anastomotic ring applicator device. Figure 2 is a partial perspective view of the distal portion of an anastomotic ring applicator device, retaining an anastomotic ring in an unactuated position. Figure 3 is a partial perspective view of the distal portion of the device of Figure 2, retaining an anastomotic ring in the actuated position. Figure 4 is a front view of an operated anastomotic ring. Figure 5 is a perspective view of the anastomotic ring applicator device of Figure 1, with the distal portion of its partially driven ring deployment mechanism. Figure 6 is a perspective view of the device of Figure 1, with the distal portion and the proximal portion of its partially driven ring deployment mechanism.

Figure 7 is a perspective view of the device of Figure 1, with the distal portion and the proximal portion of its ring deployment mechanism fully actuated. Fig. 8 is a perspective view of separate parts of the anastomotic ring deployment mechanism of the device of Fig. 1. Fig. 9 is a cross-sectional perspective view of separate portions of a proximal portion of the device of Fig. 1 with one left housing half omitted. Figure 10 is a cross-sectional view of the anastomotic ring deployment mechanism of the device of Figure 1, in a non-actuated position. Figure 11 is a cross-sectional view of the proximal portion of Figure 9. Figure 12 is the anastomotic ring deployment mechanism of Figure 10, with its distal portion in a partially driven position. Figure 13 is the anastomotic ring deployment mechanism of Figure 12, with a traction indication for coupling the threads. Fig. 14 is the anastomotic ring deployment mechanism of Fig. 10, with its portions remote and proximal in a partially driven position. Fig. 15 is the anastomotic ring deployment mechanism of Fig. 14, with a traction indication for coupling the threads. Figure 16 is the anastomotic ring deployment mechanism of Figure 10, with its remote and proximal portions in a fully actuated position. Figure 17 is the anastomotic ring deployment mechanism of Figure 10, with its portions remote and proximal in a first partially inactivated position. Figure 18 is the anastomotic ring deployment mechanism of Figure 10, with its distant and proximal portions in a second partially inactivated position. Figure 19 is the anastomotic ring deployment mechanism of Figure 10, with its remote and proximal portions in a completely inactivated position. Figure 20 is a cross-sectional view taken along the plane 20 of Figure 11. Figure 21 is a cross-sectional view of the anastomotic ring deployment mechanism of an alternative anastomotic ring applicator device in an inactivated position. Fig. 22 is the anastomotic ring deployment mechanism of Fig. 21 in a partially driven position. Figure 23 is the anastomotic ring deployment mechanism of Figure 21 is a fully actuated position.

DETAILED DESCRIPTION OF THE MODALITIES OF THE INVENTION Returning to the drawings, where similar numbers denote similar components in all the various views, Figure 1 represents an applicator, 10, which is operable to deploy and actuate an anastomotic ring device (not shown in Figure 1), in a generally cylindrical fashion to a shape having properties of a hollow rivet, or ring, capable of forming an anastomotic junction in an objective site of anastomosis, for example in a gastric bariatric bypass of a morbidly obese patient. Figure 2 depicts another applicator, 12. It will be appreciated that the applicators, 10, 12, can be used in a variety of ways including, without limitation, laparoscopically or endoscopically. The applicator 12 is shown in Figure 2 with an anastomotic ring, 14, in a deployment mechanism, 16. In Figure 2, the anastomotic ring 14 is shown in the cylindrical, compressed position. In Figure 3, the deployment mechanism 16 of the applicator 12 has moved the anastomotic ring 14 to the hollow rivet-shaped position, actuated. Figure 4 is a close-up view of the anastomotic ring 14 in the actuated position. The anastomotic ring 14 may comprise a shape memory effect material (SME), such as nitinol by way of example only, which further aids the actuation to a hollow rivet coupling shape. Other suitable anastomotic ring materials 14 will be apparent to those of ordinary skill in the art. An exemplary anastomotic ring 14 is described in detail in the publication of the U.S. patent application. 2003/0032967, by Park and others. It will be appreciated that the terms "near" and "distant" are used herein to refer to a clinician holding a handle of the applicator 10. It will also be appreciated that for convenience and clarity, spatial terms such as "right" and "left" , "vertical" and "horizontal", are used here with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting or absolute. In addition, aspects of the invention have application to surgical procedures performed endoscopically and laparoscopically, as well as an open procedure or other procedures. The use of these similar terms or terms should not be considered to limit the present invention to only one category of surgical procedure. Referring to Figures 1, 5 and 6, the applicator 10 of the present example comprises a handle, 13, attached to an elongated arrow, 15. The elongated arrow 15 comprises a proximal portion, 17, and a distal portion, 18. Distant portion 18 has a ring deployment mechanism, 20, attached thereto. Figure 8 depicts an exemplary embodiment of the ring deployment mechanism 20. As shown, the ring deployment mechanism 20 comprises a plurality of distal fingers, 32, attached to a distal ring member, 52, a plurality of proximal fingers , 38, attached to a proximal ring member, 58, and a half ring, 84, positioned between the remote ring member 52 and the proximal ring member 58. The remote ring member 52 has a threaded opening, 54, formed in the same. Similarly, the proximal ring member 58 has a threaded opening, 56, formed therein. The distal fingers 32 are in a double-hinged relationship with the ring means 84, such that proximal movement of the distant ring member 52 causes the tips of the distal fingers 32 to articulate outwardly and deploy a distal portion of an anastomotic ring. . The distal fingers 32 are configured to retain the distal portion of the anastomotic ring 14, engaging the petals 51 before and during deployment of the anastomotic ring 14, and releasing the petals 51 after deployment of the anastomotic ring 14. Similarly, the proximal fingers 38 and the middle ring 84 is in a double hinged relationship, such that the distant movement of the proximal ring member 58 causes the tips of the proximal fingers 38 to articulate externally and deploy a proximal portion of an anastomotic ring 14. The proximal fingers 38 are configured to retain the proximal portion of the anastomotic ring 14, engaging the petals 51 before and during the deployment of the anastomotic ring 14, and releasing the petals 51 after deployment of the anastomotic ring 14. Of course, any suitable alternative fingers 32, 38 may be used to retain or deploy a ring anastomotic 14 As shown in Figures 8, 10, 12-19 and 21-23, a fixed washer, 22, is positioned within the ring deployment mechanism 20. The washer 22 is fixed within the ring means 84 to substantially restrict movement longitudinal of the washer 22 with respect to the ring means, although the rotation of the washer 22 may be possible with respect to the ring means 84. A proximal sheath 24 is placed adjacent and next to the washer 22, while a distant sheath 26 is placed adjacent and distant from the washer 22. The ring deployment mechanism 20, the washer 22 and the covers 24, 26, are positioned longitudinally around the rod 28. The rod 28 has a threaded end member, 40, attached in its the distal end, and the threaded sleeve, 42, attached at its proximal end. The threaded end member 40 is fixedly inserted into a threaded opening at the distal end of the rod 28. It will be appreciated that the threaded end member 40 or the threaded sleeve 42 can be fixedly secured to the rod 28 in any suitable manner, which includes, without limitation, the use of a permanent adhesive. The threaded sleeve 42 has a first set of threads, 44, and a second set of threads, 46, next to the first set of threads 44. As shown, the threads of the first set of threads 44 and the threads of the second set of threads 46, have an inverted orientation with respect to the threads of the threaded end member 40. The distal end of the threaded sleeve 42 is fixedly attached to the proximal end of the rod 28, while the proximal end of the threaded sleeve 42 is fixedly attached to the end Distant from a torsion member, 48. The torsion member 48, the threaded sleeve 42 (with the thread sets 44, 46), the rod 28 and the threaded end member 40, are thus all configured to rotate unitarily. The torsion member 48 extends through the arrow 15. In the present example, the torsion member 48 comprises a cable. However, it will be appreciated that the torsion member 48 may be in any other suitable manner, such as an arrow, by way of example only, or may have any suitable functionality. The driving member, 50, is attached to the next ring member 58, and has a threaded opening, 60, formed therein. In one embodiment, the driving member 50 is fixed on the proximal ring member 58, such that the rotation of the driving member 50 with respect to the near ring member 58 is prevented. As shown in Figures 1, 5-7 and 12-19, the driving member 50 can abut the distal end of the arrow 15, but is not fixedly attached thereto. As used herein, the term "threaded member" is considered to include anything having one or more inclined threads formed in or on it. Accordingly, by way of example only, the threaded end member 40, the distant ring member 52, the proximal ring member 58, the threaded sleeve 42, and the drive member 50 can all be considered as "threaded members". . It will be appreciated that the threaded members are operatively configured to transform torsional forces into linear or longitudinal forces. The threaded members, thus, can be considered as "transformation members", which includes anything capable of transforming torsional forces into linear or longitudinal forces. As used herein, the term "member" is not considered to be limited to a single piece or a continuous homogenous piece of material. In other words, a "member" may comprise, but not necessarily, a plurality of parts joined together in any suitable manner. Suitable examples of threaded members and transformation members will be apparent to those of ordinary skill in the art. It will be appreciated that when the torsion member 48 rotates, the friction between the second set of threads 46 and the threaded opening 60 of the drive member 50, may impel the thrust member 50 to rotate with respect to the arrow 15. Similarly, the friction between the first series of threads 44 and the threaded opening 56 of the proximal ring member, as well as the friction between the threaded end member 40 and the threaded opening 54 of the distal ring member 52, can drive the ring deployment mechanism to rotate with respect to the arrow 15, after rotation of the torsion member 48. Accordingly, it will be appreciated that one or more components or features can be added to the distal portion 18 of the arrow 15 or the thrust member 50, to prevent rotation of the thrust member 50 and the ring deployment mechanism 20 with respect to the arrow 15, when the torsion member rotates 48. In one embodiment, such components allow at least some longitudinal movement of the driving member 50 with respect to the arrow 15. Suitable components or features to prevent rotation However, allowing longitudinal movement, or other ways to handle the aforementioned friction, if necessary or desired in a different way, will be evident for those with average knowledge in the matter. Alternatively, the normal or frictional forces exerted by the adjacent tissue during the use of the applicator 10, may be sufficient to overcome the friction between the threads 40, 44, 46, and the openings 54, 56, 60, during rotation of the limb member. twist 48. Figures 9, 11 and 20 show an exemplary configuration of the handle 13, which can be used to effect rotation of the torsion member 48. As shown, the handle 13 comprises a knob, 86, a screw cap, 88, a spring, 90, and a handle rod, 92. The handle rod 92 has a circumferential flange, 94. The proximal end of the torsion member 48 terminates at the distal end of the handle rod 92 and is securely secured therein, such that the handle rod 92 and the torsion member 48 are configured to rotate unitarily. The handle 13 further comprises a cylindrical cavity, 96, which is dimensioned to receive the handle rod 92. The cylindrical cavity 96 has a radius that is approximately equal to the radius of the flange 94, such that the longitudinal movement of the rod of handle 92 will be prevented by engagement of the flange 94 with the distal surface of the cylindrical cavity 96. The proximal end of the cylindrical cavity 96 is threaded to receive the screw cap 88. The handle rod 92 has a length that is greater than the length of the cylindrical cavity 96, such that a proximal portion of the handle rod 92 will protrude from the handle 13 with the handle rod 92 disposed therein. The threaded cap 88 has an opening through which this proximal portion of the handle rod 92 can pass. The spring, 90, is dimensioned to fit into the cylindrical cavity 96 between the flange 94 and the screw cap 88, with an inclination to expand. The knob 86 is fixedly secured to a protruding portion of the handle rod 92. It will be appreciated that the knob 86 can be used to generate a torsional force. Of course, there is a variety of alternatives for generating torsional force, including without limitation cranks, motors, and the like. Other suitable members operable to generate a torsional force will be apparent to those of average skill in the art. In this embodiment, rotation of the knob 86 will cause rotation of the torsion member 48. Of course, a variety of alternative configurations of the handle 13 can be used to effect rotation of the torsion member 48, most of which, if not all, will be evident to those who have average knowledge in the matter. In use, the applicator 10, loaded with the anastomotic ring 14, is placed in an anastomosis site in a patient while the ring deployment mechanism 20 is in an unactuated configuration. An exemplary non-driven configuration is shown in Figures 1 and 10 (the anastomotic ring 14 is omitted). With the applicator 10 properly positioned, the knob 86 is rotated clockwise, which will cause the handle rod 92, the torsion member 48, the threaded sleeve 42, the rod 28 and the threaded end member 40 to rotate unitarily with the same in the direction of the hands of the clock. During this initial rotation, the threaded end member 40 will engage with the threaded opening 54 in the distal ring member 52, thereby urging the distal ring member 52 proximally with respect to the threaded end member 40. After the complete passage of the member of threaded end 40 through the threaded opening 54, the ring deployment mechanism 20 will reach a first partially driven configuration. An exemplary first partially actuated configuration is shown in Figures 5 and 12. In the next use step, the user pulls the knob 86 proximally, which will cause the pulling of the threaded sleeve 42 and the aforementioned components therebetween. As shown in FIG. 13, where the pulse member 50 is abutting the distal end of the arrow 15, such traction will also cause engagement of the first set of threads 44 with the threaded opening 56 of the proximal ring member 58. The knob 86 is then turned again clockwise, which will cause the rotation of the threaded sleeve 42 and the aforementioned components therebetween. Of course, the knob 86 can be pulled proximally and rotated clockwise, concomitantly. During the rotation of the first set of threads 44 while the first set of threads 44 engages with the threaded opening 56, the first set of threads 44 will urge the proximal ring member 58 away from the first set of threads 44. After the step complete of the first set of threads 44 through the opening 56, the ring deployment mechanism 20 will reach a second partially driven configuration. A second exemplary partially driven configuration is shown in Figures 6 and 14. As shown, the pulse member 50 no longer abuts the distal end of the arrow 15 when the ring deployment mechanism 20 has reached the second partially driven configuration. . Although not shown, it will be appreciated that a ring type seal may be provided at the distal end of the arrow 15, to prevent material from entering the far, otherwise open, end of the arrow 15, when the deployment mechanism of the ring 20 has reached the second partially driven configuration. In the next use step, the user again pulls the knob 86 proximally, which will cause the pulling of the threaded sleeve 42 and the aforementioned components between them. As shown in FIG. 15, this also causes the thrust member 50 to again abut the distal end of the arrow 15, and will also lead to engagement of the second set of threads 46 with the threaded opening 60 of the thrust member 50. Then the knob 86 is turned clockwise again, which will cause the rotation of the threaded sleeve 42 and the aforementioned components between them. Of course, the knob 86 can be pulled proximally and rotated in a clockwise direction, concomitantly. During the rotation of the second set of threads 46, while the second set of threads 46 engages with the threaded opening 60, the second set of threads 46 will urge the thrust member 50 distantly with respect to the second set of threads 46. This momentum will that the ring deployment mechanism 20 reaches a fully actuated configuration. An exemplary fully actuated configuration is shown in Figures 7 and 16. It will be appreciated that during or between any of the aforementioned deployment stages, and particularly between the second partially driven configuration and the fully driven configuration., the distant cover 26 or the proximal cover 24 will come into contact with the distant ring member 52, or with the proximal ring member 58 (respectively), before the other cover 26, 24, comes into contact with its ring member respective 52, 58. The presence of the covers 26, 24, will thus prevent further activation of the respective fingers 32, 38, and will ensure that each group of fingers 32, 38, finally reaches an approximately equal degree of actuation at the moment when the ring deployment mechanism 20 reaches the fully actuated configuration. The sheaths 26, 24, will also prevent "overdriving" of the fingers 32, 38. Furthermore, when the covers 26, 24 are both engaged with respective ring members 52, 58, further rotation of the knob 86 and all of them will be prevented. the unitary remote components, 92, 48, 42, 28, 40, thus providing a tactile feedback to the user indicating that the ring deployment mechanism 20 has reached a fully actuated configuration. Of course, any other feature or component can be used as an alternative to the covers 26, 24, to provide drive limitation or tactile feedback. After the ring deployment mechanism 20 has reached a fully actuated configuration, and the resulting deployment of an anastomotic ring 14, the applicator 10 can be removed from the patient in a reverse of several of the previous steps. In other words, the applicator 10 can be extracted after the "inactivation" of the ring deployment mechanism 20. As used herein, the term "inactivation" and its variants refer to a process by which the mechanism of deployment of ring 20 is carried from a fully driven configuration to a non-driven configuration. An "inactivated" configuration is thus a kind of non-driven configuration, whereby the ring deployment mechanism 20 has been previously placed in a fully actuated configuration. As shown in Fig. 17, inactivation of the ring deployment mechanism 20 can be effected by rotating the knob 86 clockwise in the counterclockwise direction. Such rotation will cause the second series of threads 46 to drive the member. of impulse 50 proximally. It will also be appreciated that, in the present example, the elasticity of the material comprising the ring deployment mechanism 20 will propel the threaded opening 54 of the distal ring member 53 into engagement with the threaded end member 40, whereby rotation of the member threaded end (effected by knob 86) will remotely propel the disigning ring member 53. As the pulse member 50 and the proximal ring member 58 are propelled proximally, while the distal ring member 52 is driven distally, the Ring deployment mechanism 20 will approach an inactivated configuration. The intermediate stages of said inactivation are shown in Figures 17-18, while in Figure 19 a completely inactivated configuration is shown. The applicator 10 can be removed from the patient after complete inactivation of the deployment mechanism 20. It will be appreciated that several of the features, components and steps above can be varied. By way of example only, the threads of the threaded end member 40, the first set of threads 44 and the second set of threads 46, can be configured in such a way that the actuation is effected by means of the rotation of the knob 86 in the counterclockwise direction, with the inactivation effected by the rotation of the knob 86 in the clockwise direction. In addition, the threads of the threaded end member 40, the first set of threads 44 and the second set of threads 48, or the respective threaded openings 54, 56, 60, can be spaced apart so that close traction of the knob 86 during operation. Other variations will be evident for those who have average knowledge in the subject. In Figs. 21-23 there is shown an applicator 10 having an alternating driving member 51 and an alternating rod 29. The alternating driving member 51 is similar to the driving member 60, except that the alternate drive member 51 has no threaded opening 60. It should be noted that in this embodiment, the threaded sleeve 42 is also absent. Instead, the alternating rod 29 has an alternating thread set formed thereon, in addition to having the threaded end member 40 inserted atomisably at its distal end. In this way, the alternating rod 29 is a threaded member. As shown, the threads of the game alternate thread 47 have inverted with respect to the threads of member threaded end 40. Orientation The game alternate thread 47 is configured to engage the threaded opening 56 of the member proximal end 58. In the embodiment shown in Figure 21, the applicator 10 is in a non-driven configuration. Although in this configuration a portion of the threaded end member 40 is coupled with a portion of the threaded opening 54 of the distal ring member 52. Similarly, although the applicator 10 is in the non-driven configuration, a portion of the thread series alternates 47 is engaged with a portion of the proximal ring member 58. As with the embodiments discussed above, when the knob 86 is rotated, the torsion member 48 rotates unitarily therewith. Since torsion member 48 is fixedly coupled with alternate rod 29, alternate rod 29, alternate set of threads 47, and the member threaded end 40, also rotate unitarily with knob 86. As shown in Figure 22, showing an intermediate stage of actuation of deployment mechanism ring 20, rotation of the knob 86 in the diren of clockwise effected simultaneously proximal movement of member distal ring 52 and distal movement of the ring member next 58. After a sufficient rotation of the knob 86, the ring deployment mechanism 20 will reach a complete actuation stage, which is shown in Figure 23. As with the previously discussed embodiments, the covers 26, 24, will prevent the "overdrive" of the ring deployment mechanism 20, while also providing full-an tae feedback, preventing a or rotation of the knob 86. The applicator 10 of this example can be placed in an inaated configuration by simply turning the knob 86 in the opposite diren (in the present example in the counter-clockwise diren). It will be appreciated that in the embodiment depicted in Figures 21-23, is not necessary for the user 86 pull knob proximally during actuation of ring deployment mechanism 20. In another embodiment, the torsion member 48 extends complete through the distant ring member 52, and has at least two threaded portions formed thereon in place of the threaded end member 40 and the sets of threads 44, 46, 47. Other variations will be apparent to those with knowledge means in the matter. Having shown and described various embodiments and concepts of the invention, a person of ordinary skill in the art can make further adaptations of the methods and systems described herein by appropriate modifications, without departing from the scope of the invention. Several of these alternatives, modifications and potential variations have been mentioned, and others will be apparent to the expert in light of the above teachings. Accordingly, it is considered that the invention encompasses all of these alternatives, modifications and variations that may be within the spirit and scope of the appended claims, and is understood to be not limited to the details of the structure and operation shown and described in specification and drawings. Additional advantages may easily appear for those skilled in the art.

Claims (20)

NOVELTY OF THE INVENTION CLAIMS

1. - An operable surgical instrument for implanting an anastomotic ring device, comprising: (a) a handle; (b) a ring deployment mechanism configured to receive and deploy an anastomotic ring; and (c) an elongated arrow joining the handle to the ring deployment mechanism, wherein the elongated shaft is configured to transfer a torsional driving force of the handle to the ring deployment mechanism.

2. The instrument according to claim 1, further characterized in that the handle comprises a knob, wherein the knob is operable to generate the torsional driving force.

3. The instrument according to claim 1, further characterized in that the ring deployment mechanism comprises a plurality of fingers.

4. The instrument according to claim 3, further characterized in that the plurality of fingers comprises a first group of fingers and a second group of fingers, wherein the first group of fingers and the second group of fingers are placed around a group of fingers. common axis.

5. - The instrument according to claim 4, further characterized in that the ring deployment mechanism also comprises a ring means, the ring means being positioned around the common axis and between the first group of fingers and the second group of fingers.

6. The instrument according to claim 5, further characterized in that the first group of fingers and the second group of fingers are in a double hinged relationship with the ring means.

7. The instrument according to claim 1, further characterized in that the arrow comprises at least one torsional member operable to communicate the torsional driving force through the arrow.

8. The instrument according to claim 7, further characterized in that the torsion member is in communication with a rod, wherein the rod is in communication with the ring deployment mechanism.

9. The instrument according to claim 8, further characterized in that the rod comprises one or more sets of threads.

10. The instrument according to claim 9, further characterized in that at least one of the sets of threads is configured to communicate the torsional driving force to the ring deployment mechanism.

11. - The instrument according to claim 10, further characterized in that the ring deployment mechanism is operable to deploy an anastomotic ring in response to the torsional driving force.

12. The instrument according to claim 9, further characterized in that it comprises at least one threaded member in communication with the rod.

13. An operative surgical instrument for implanting an anastomotic ring, comprising: (a) an actuator member configured to receive an anastomotic ring, wherein the actuator member is movable between an undriven cylindrical position and a form of hollow rivet, in response to one or more driving forces; (b) a handle including a drive mechanism operable to produce at least one of the driving forces; (c) an elongated arrow joining the handle to the drive member and operatively configured to transfer at least one of the drive forces of the handle to the drive member; and (d) at least one threaded member operable to communicate at least one of the driving forces to the driving member.

14. The surgical instrument according to claim 13, further characterized in that the actuating member comprises a plurality of fingers configured to retain and deploy an anastomotic ring.

15. - The surgical instrument according to claim 13, further characterized in that it comprises at least two sets of threads, wherein the threaded member (at least one) comprises at least one of the sets of threads.

16. The surgical instrument according to claim 15, further characterized in that the sets of threads (at least two) are operable to transform a torsional driving force into two longitudinal driving forces, wherein a first set of threads of the sets of threads (at least two) is configured to transform the torsional driving force into a longitudinally oriented longitudinal force, wherein a second set of threads of the sets of threads (at least two) is configured to transform the force of torsional drive in a proximally oriented longitudinal force, wherein the drive member is configured to actuate in response to the longitudinally oriented and proximally oriented longitudinal forces.

17. An operative surgical instrument for implanting an anastomotic ring, comprising: (a) a drive member configured to receive an anastomotic ring, wherein the actuating member is movable between a non-driven cylindrical position and a form of hollow rivet, in response to one or more linear drive forces; (b) a handle including a drive mechanism, operable to produce a torsional force; (c) one or more transformation members in communication with the drive member, the transformation members (one or more) being configured to transform the torsional force into linear drive forces (one or more); and (d) an elongated arrow joining the handle to the drive member, and having at least one transfer member operatively configured to transfer the torsional force to the transformation member.

18. The instrument according to claim 17, further characterized in that the drive mechanism comprises a knob.

19. The instrument according to claim 17, further characterized in that at least one of the transformation members comprises a threaded member.

20. The instrument according to claim 17, further characterized in that at least one of the transformation members comprises a plurality of sets of threads.