MXPA06008309A - Resposable anastomotic ring applier device - Google Patents

Abstract

A surgical instrument that is operable to deploy an anastomotic ring device comprises a proximal portion and a distal portion. The distal portion comprises a ring deployment mechanism, which is configured to receive and deploy an anastomotic ring. The proximal portion comprises a mechanism that is operable to remotely actuate the ring deployment mechanism. The distal portion is removable from the proximal portion. The distal portion may be selectively engaged with the proximalportion by a series of annular flanges and clamp arms that are configured to engage the annular flanges. The ability to remove the distal portion of the instrument permits the replacement of the ring deployment mechanism without requiring the replacement of the instrument in its entirety.

Description

APPLIED APPLIANCE OF REMOVABLE ANASTOMOTIC RING FIELD OF THE INVENTION The present invention relates, in general, 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 suffering from pathological obesity is steadily increasing. Severely obese people may be susceptible to increased risk of heart disease, stroke, diabetes, lung disease and accidents. Due to the effects of pathological obesity on the patient's life, treatment methods of pathological obesity have been the subject of intense research. A known method for the treatment of pathological obesity, includes the use of anastomotic rings. Devices for the application of anastomotic rings are known in the art. Devices of this nature are commonly adapted to insert an compressed anastomotic ring into an anastomotic opening formed between adjacent gastrointestinal tissue walls. These applicator devices may use 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 shaped compressed position, to a position in the form of a hollow rivet operated. It may be desirable to have an applicator device having one or more removable portions. For example, it may be desirable to have an applicator with a ring deployment mechanism that can be separated from the rest of the applicator device, such as the handle. Said elimination or separability may be desirable for a variety of purposes. By way of example only, a handle portion of an applicator device can be reusable, while the ring deployment mechanism of the applicator device is disposable. In other words, by configuring the applicator device so that the ring deployment mechanism is removable, the ring deployment mechanism can be replaced instead of replacing the applicator device in its entirety. As another illustrative example only, several distal ends of the applicator devices can be modular, so that the same handle can be used with various types of distal ends. Other advantages that may result from having an applicator device with one or more removable parts will be apparent to those skilled in the art.

BRIEF DESCRIPTION OF THE INVENTION Various embodiments of the present invention provide an anastomotic ring applicator device that allows replacement of a distal portion of the device, while retaining the proximal portion of the device. In one embodiment, a surgical instrument for deploying an anastomotic ring device at an anastomosis site, comprises a distal portion and a proximal portion. The distal portion comprises a ring deployment mechanism. The ring deployment mechanism is configured to receive and deploy an anastomotic ring. The proximal portion is in communication with the distal portion. The proximal portion comprises one or more drive members operable to drive at least a portion of the ring deployment mechanism. The distal portion is selectively removable from the proximal portion. In another embodiment, a surgical instrument is operable to deploy an anastomotic ring device at an anastomosis site. The 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 riveter forming position in response to at least one driving force. The instrument further comprises a handle that includes a drive mechanism which is operable to produce the driving force (at least one). The instrument further comprises an elongated shaft that connects the handle to the drive member. The shaft is configured to transfer the driving force (at least one) of the handle to the driving member. The elongated shaft comprises a first portion and a second portion. At least a portion of the first portion of the shaft is adjacent to the drive member. At least a portion of the second portion of the shaft is adjacent to the handle. The first portion of the shaft is configured to selectively engage with the second portion of the shaft. In another modality, a surgical instrument is operable to deploy an anastomotic fixation device at an anastomosis site. The instrument comprises deployment means for the deployment of an anastomotic fixation device in response to one or more driving forces. The instrument further comprises drive means for providing the one or more driving forces. The instrument further comprises coupling means for selectively coupling and uncoupling the deployment means with the driving means. More modalities will be described below. Other modalities will be apparent to those skilled in the art.

BRIEF DESCRIPTION OF THE FIGURES The accompanying drawings, which are incorporated in this specification, and constitute a part thereof, 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, shown with a retracted tip. Figure 2 is a partial perspective view of the distal portion of an anastomotic ring applicator device holding an anastomotic ring in a non-actuated position. Figure 3 is a partial perspective view of the distal portion of the device of Figure 2 holding 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 device of Figure 1, shown with the tip extended. Figure 6 is a perspective view of the device of the figure 1, shown with the cover retracted. Figure 7 is a perspective view of the device of Figure 1, shown with a distal portion of the partially driven ring deployment mechanism. Figure 8 is a perspective view of the device of Figure 1, shown with a distal portion and a proximal portion of the partially driven ring deployment mechanism. Figure 9 is a perspective view of the device of the figure 1, shown with a distal portion and a proximal portion of the fully-actuated ring deployment mechanism. Fig. 10 is a partial schematic view of the device of Fig. 1; Fig. 11 is a schematic view of a drive mechanism of the device of Fig. 1; Fig. 12 is a cross-sectional view of a proximal portion of the device; Figure 1. Figure 13 is a partial cross-sectional view of the device of Figure 1, shown with a retracted tip. Fig. 14 is a partial cross-sectional view of the device of Fig. 1, shown with the tip extended. Figure 15 is a partial cross-sectional view of the device of Figure 1, shown with the cover retracted. Figure 16 is a partial cross-sectional view of the device of Figure 1, shown with a distal portion of the partially driven ring deployment mechanism. Figure 17 is a partial cross-sectional view of the device of Figure 1, shown with a distal portion and a proximal portion of the partially driven ring deployment mechanism. Figure 18 is a partial cross-sectional view of the device of Figure 1 disposed in an anastomotic opening, shown with a distal portion and a proximal portion of the fully-actuated ring deployment mechanism. Figure 19 is a partial cross-sectional view of the device of Figure 1. Figure 20 is a cross-sectional view taken in the plane 20 of the device of Figure 13. Figure 21 is a cross-sectional view taken in the plane 21 of the device of figure 13. Figure 22 is a cross-sectional view taken in the plane 22 of the device of figure 13.

DETAILED DESCRIPTION PE THE MODALITIES OF THE INVENTION Returning to the drawings, in which like numbers denote similar components throughout the various views, FIG. 1 describes an applicator 10 that is operable to deploy and operate an anastomotic ring device (not illustrated in FIG. 1) in a manner generally cylindrical to one having properties of a hollow rivet, or ring, capable of forming an anastomotic fixation at a target anastomosis site, such as in a bariatric gastric bypass of a pathologically obese patient. Figure 2 describes another applicator 12. It will be appreciated that the applicators 10, 12 can be used in a variety of ways including, but not limited to, 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 cylindrically shaped compressed position. In Figure 3, the deployment mechanism 16 of the applicator 12 has moved the anastomotic ring 14 towards the position in the form of a hollow rivet operated. Figure 4 is a close-up view of the anastomotic ring 14 in the actuated position. The anastomotic ring 14 can compress a shape memory effect material (SME), such as nitinol, only by way of example, which further aids in the actuation, a hollow rivet form of engagement. Other suitable anastomotic ring materials 14 will be apparent to those skilled in the art. An example of an anastomotic ring 14 is described in detail in the patent application of E.U.A. Publication number US 2003/0032967 to Park et al. It will be appreciated that the terms "prol" and "distal" are used herein in relation to a clinician holding a handle of the applicator 10. It will further be appreciated that for convenience and clarity, spatial terms such as "right", "left" "," vertical "and" horizontal ", are used in the present with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and 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 one of these similar terms or terms herein should not be considered to limit the present invention for use in only one category of surgical procedure. As shown in Figures 1 and 5 to 10, the applicator 10 of the present example includes a tip driver 18 located on a handle 19. The tip driver 18 is operable to move the tip 13 from a retracted position to an extended position . The applier 10 of the present example also has an axis 15 comprising a prol cover portion 24A and a distal cover portion 24B (the prol and distal cover portions referred to collectively as "cover"). The cover 24A, 24B is movable from a first position to a second position. In the first position, the cover 24A, 24B is configured so that the distal cover portion 20B selectively covers a portion of the ring deployment mechanism 26 (Figures 1 and 13) which prevents tissue from being caught in the deployment mechanism of ring 26 during the insertion and removal of the applicator 10. The applicator 10 further comprises a cover actuator 28 operable to move the cover 24A, 24B between the first and second positions. As shown, the tip 13 is also configured to selectively cover a portion of the ring deployment mechanism 26. The cover 24A, 24B and tip 13 are configured so that the deployment mechanism 26 is exposed and is free to actuate when the cover 24A, 24B is in the second position and the tip is in the extended position. Suitable alternatives to the cover 24A, 24B, cover actuator 28, tip 13 and / or tip driver 18, will be apparent to those skilled in the art. Referring now to Figures 6 to 11 and 13 to 19, the ring deployment mechanism 26 of the present example comprises a prol portion 30 and a distal portion 32. The applicator 10 further comprises a pair of deployment actuators 34, 36. As described in more detail below, the first deployment actuator 34 is operable to drive the prol portion 30 of the ring deployment mechanism 26.; and the second deployment actuator 36 is operable to drive the distal portion 32. In FIGS. 7 and 16, the distal portion 32 is shown in a partially driven position to partially deploy a distal portion of an anastomotic ring 14. Arrow 42 describes the actuation movement of the second actuator 36. In Figures 8 and 17, the proximal portion 30 is shown in a partially actuated position to partially deploy a proximal portion of the anastomotic ring 14 that partially completes an anastomotic fixation between the proximal tissue walls. , 48. The arrow 50 describes the actuation movement of the first actuator 34. Figures 9 and 18 show the distal portion 32 and the proximal portion 30, each in a fully actuated position. It will be appreciated that the proximal portion 30 may be actuated before the distal portion 32, or that the proximal portion 30 and the distal portion 32 may be actuated concomitantly. In the present example, the proximal portion 30 of the ring deployment mechanism 26 comprises a plurality of fingers 60; and the distal portion 32 also comprises a plurality of fingers 62. The fingers 60, 62 are configured to support an anastomotic ring 14, engaging petals 51 before deployment of the anastomotic ring 14, and during the same, and releasing the petals 51 afterwards. deployment of the anastomotic ring 14. The proximal fingers 60 and the distal fingers 62 are in a double articulated relationship with a stationary central ring 64 of the ring deployment mechanism 26. The proximal fingers 60 are configured to slide towards the central ring 64 in response to the engagement of the first actuator 34, which causes the proximal fingers 60 to act outwardly from the shaft 15. The central ring 64 is held stationary by a stationary distal base tube portion 65B. Also, the distal fingers 62 are configured to slide towards the central ring 64 in response to the actuation of the second actuator 36, which causes the distal fingers 62 to act outwardly of the shaft 15. As shown in Figures 11 and 13 to 19, and as will be described in more detail below, the drive components of the ring deployment mechanism described above, comprise a series of concentric distal tube portions 82B, 65B, 80B within the shaft 15. A bushing 66 is included within the shaft 15 to keep concentric distal tube portions 82B, 65B, 80B centered. However, it will be appreciated that the components described above need not be concentrically aligned, and that any suitable alternative to the hub 66 may be used. It will also be appreciated that any suitable alternative to the ring deployment mechanism 26 and / or deployment actuators may be used. , 36. In order to prevent inadvertent deployment of the ring deployment mechanism 26, the applicator 10 of the present example is provided with a fixing element 52. In the present example, the fixing element 52 is operable to move from an immobilized position to a non-immobilized position. In Figures 1, 5, 6, 10, 13 to 15 and 19, the fixing element 52 is shown in an immobilized position preventing the actuation movement of the first actuator 34 and second actuator 36. In figures 7, 8 and 15, the fixing element 52 is shown in the non-immobilized position, which allows the actuators 34, 36 to move towards the actuated position. In the present example, the fixing element 52 is resiliently pushed towards the immobilized position, and can be placed in the non-immobilized position by the use of a downward force on the fixing element 52. In fact, the fixing element 52 does not necessarily it needs to take the form of the fixing element 52 described in the figures (ie, that of a button), and any suitable structure or mechanism can be used to provide a fixing element 52. It will also be appreciated that the fixing element 52 can be removed or complement. As noted above, the first deployment actuator 34 of the present example is operable to control the proximal fingers 60, and the second deployment actuator 36 is operable to control the distal fingers 62. As shown in FIG. 12, the first and second deployment actuators. of ring 34, 36, each comprise a pair of slots 67 which are configured to slide on a sliding guide 68 of the handle 19. The reach of the first actuator 34 is limited by the width of an opening 70, while the range of the second actuator 36 is limited by the width of an opening 72. As mentioned above, the fastener 52 can be used to prevent inadvertent movement of the first or second actuators 34, 36 within the openings 70, 72, respectively. In the present example, with reference to Figures 12 and 22, the first actuator 34 is attached in a manner that can be fixed to a proximal portion 74 of the slide 68. The slide 68 is slidable within the handle 19. A distal portion 76 of the slide 68 is slidably attached to a slider 78, which is slidably engaged within the handle 19. The slider 78 is connectable so that it can be fixed to the proximal outer tube portion. 80A. The longitudinal movement of the first actuator 34 is thus operable to cause the corresponding longitudinal movement of the sliding guide 68, slider 78 and proximal outer tube portion 80A. The proximal outer tube portion 80A is operable to communicate movement to the proximal fingers 60, as will be described later.

Other suitable relationships between these components, as well as alternative components, will be apparent to those skilled in the art. Referring to FIGS. 12 and 21, the proximal end of a proximal base tube portion 65A is attached in a manner that can be fixed to an anchor member 84. The anchor member 84 is configured to engage with enhancements 86, which are integral with the handle 19. Accordingly, in the present example, the anchor member 84 and the lugs 86 are configured to prevent relative longitudinal movement between the proximal base tube portion 65A and the handle 19. In fact, any another configuration In the present example, the second actuator 36 is secured so that it can be fixed to a portion of the proximal inner tube 82A. The proximal inner tube portion 82A extends longitudinally through the proximal base tube portion 65A. The proximal inner tube portion 82A is operable to communicate movement to the distal fingers 62, as will be described later. Other suitable relationships between these components, as well as alternative components, will be apparent to those skilled in the art. Accordingly, in this example, it will be appreciated that the first actuator 34 controls the actuation of the proximal fingers 60, and the second actuator 36 controls the actuation of the distal fingers 62.

It should be noted that although the second actuator 36 is configured to slide on the slide 68 in the present example, the second actuator 36 is not statically attached to the slide 68. Therefore, the longitudinal movement of the slide guide 68 caused by the movement of the first actuator 34, does not cause the longitudinal movement of the second actuator 36. In fact, the handle 19 and components thereof can be configured in any other suitable manner. By way of example only, the first actuator 34 may be configured to control the actuation of the distal fingers 62, and the second actuator 36 may be configured to control the actuation of the proximal fingers 60. Other, more suitable alternative configurations will be apparent to the experts in the art. In the present example, a proximal tip tube portion 56A is securely fastened to the tip driver 18. The tip driver 18 is slidably engaged with the handle 19. The proximal end of the tip tube portion proximal 56A is secured in a shape that can be attached to tip driver 18. A bracket 100 is positioned at the distal end of proximal tip tube portion 56A. The distal end of a distal tip tube portion 56B is secured so that it can be fixed to the tip 13. The proximal end of the distal tip tube portion 56B comprises a clamp member 102. The clamp member 102 and the clamp 100 is configured to engage, such as by the clamp member 102 snapping into the clamp 100, thereby attaching the proximal tip tube portion 56B and the distal tip tube portion 56A. Accordingly, with clamp 100 and clamp member 102 engaged, tip driver 18 is operable to move tip 13 from a retracted position to an extended position. In fact, any suitable alternative can be used to join the proximal tip tube portion 56B and the tip tip tube portion 56A. In addition, it will be appreciated that any other structure, mechanism or configuration for effecting mechanical communication of the tip driver 18 with the tip 13 may be used. The proximal tip tube portion 56A is coaxially positioned within the proximal inner tube portion 82A. As indicated above, the proximal end of the proximal inner tube portion 82A is secured in a manner that can be secured to the second actuator 36. The distal end of the proximal inner tube portion 82A comprises a pair of clamp arms 104 that is they extend longitudinally from it. In alternative form, any other number of clamp arms 104 or alternative clamp arms 104 may be used. In the present example, each clamp arm 104 has a recessed portion 106. The applicator 10 further comprises a portion of distal inner tube 82B, which is positioned coaxially around the distal tip tube portion 56B. The distal end of the distal inner tube portion 82B is secured so that it can be fixed to the distal portion 32 of the ring deployment mechanism 26. The proximal end of the distal inner tube portion 82B comprises an annular flange 108. annular flange 108 is dimensioned to fit into recesses 106. In other words, clamp arms 104 are configured to mesh with annular flange 108. Accordingly, proximal inner tube portion 82A and distal inner tube portion 82B can be joined selectively by engaging the clamp arms 104 with the annular flange 108. With the proximal inner tube portion 82A thereby attached to the distal inner tube portion 82B, the second actuator 36 is operable to effect movement of the distal portion 32. of the ring deployment mechanism 26. In fact, any suitable alternative can be used to join the proximal inner tube portion 82A and the portion n of distal inner tube 82B. Furthermore, it will be appreciated that any other structure, mechanism or configuration for effecting mechanical communication of the second actuator 36 with the distal portion 32 of the ring deployment mechanism 26 may be used. The proximal inner tube portion 82A is coaxially positioned within the portion of 65A proximal base tube. As indicated above, the proximal end of the proximal base tube portion 65A is secured so that it can be fixed to the anchor member 84, which is engaged with lugs 86 formed in the handle. The distal end of the proximal base tube portion 65A comprises a pair of clamp arms 110 extending longitudinally therefrom. Alternatively, any other number of clamp arms 110 or alternative clamp arms 110 may be used. In the present example, each clamp arm 110 has a recessed portion 112. The applicator 10 further comprises a portion of distal base tube 65B , which is positioned coaxially around the distal inner tube portion 82B. The distal end of the distal base tube portion 65B is secured so that it can be fixed to the central ring 64 of the ring deployment mechanism 26. The proximal end of the distal base tube portion 65B comprises an annular flange 114. The flange annular 114 is dimensioned to fit into recesses 112. In other words, clamp arms 110 are configured to mesh with annular flange 114. Accordingly, proximal base tube portion 65A and distal base tube portion 65B may selectively bond by engagement of clamp arms 110 with annular flange 114. With the proximal base tube portion 65A thereby joined to the distal base tube portion 65B, the engagement of the anchor member 84 with enhancements 86 is operable to prevent movement longitudinal of the central ring 64 of the ring deployment mechanism 26 relative to the handle 19. In fact, any suitable alternative can be used to join the base tube portion p roximal 65A and the distal base tube portion 65B. In addition, it will be appreciated that any other structure, mechanism or configuration may be used to prevent longitudinal movement of the central ring 64 of the ring deployment mechanism 26 relative to the handle 19. The proximal base tube portion 65A is positioned coaxially within the portion of 80A proximal outer tube. As indicated above, the proximal end of the proximal outer tube portion 80A is secured in a form that can be fixed to the first actuator 34. The distal end of the proximal outer tube portion 80A comprises a pair of clamp arms 116 that is they extend longitudinally from it. In alternative form, any other number of clamp arms 116 or alternative clamp arms 116 can be used. In the present example, each clamp arm 116 has a recessed portion 118. The applicator 10 further comprises a portion of distal outer tube 80B, which is positioned coaxially around the distal base tube portion 65B. The distal end of the distal outer tube portion 80B is secured so that it can be fixed to the proximal portion 30 of the ring deployment mechanism 26. The proximal end of the distal outer tube portion 80B comprises an annular flange 120. annular flange 120 is dimensioned to fit into recesses 118. In other words, clamp arms 116 are configured to mesh with annular flange 120. Accordingly, the proximal outer tube portion 80A and the outer tubular portion 80B can be joined selectively by engagement of the clamp arms 116 with the annular flange 120. With the proximal outer tube portion 80A thereby attached to the distal outer tube portion 80B, the first actuator 34 is operable to effect movement of the proximal portion 30. of the ring deployment mechanism 26. In fact, any suitable alternative can be used to join the proximal outer tube portion 80A and the porc distal outer tube ion 80B. In addition, it will be appreciated that any other structure, mechanism or configuration may be used to effect mechanical communication of the first actuator 34 with the proximal portion 30 of the ring deployment mechanism 26. The proximal end of the proximal cover portion 24A is secured in a manner that it can be fixed to the cover actuator 28. The distal end of the proximal cover portion 24A comprises a pair of clamp arms 122 extending longitudinally therefrom. Alternatively, any other number of clamp arms 122 or alternative clamp arms 122 may be used. In the present example, each clamp arm 122 has a projection 124 extending outwardly therefrom. The proximal end of the distal cover portion 24B comprises a pair of openings 126 which are dimensioned and spaced apart to receive by means of meshing projections 124. Accordingly, the proximal cover portion 24A and the distal cover portion 24B can be selectively joined by adjustment of projections 124 of the clamp arms 122, with openings 126 in the distal cover portion 24B. With the proximal cover portion 24A and the distal cover portion 24B joined in this manner, the cover actuator 28 is operable to effect movement of the distal cover portion 24B. In fact, any suitable alternative can be used to join the proximal cover 24A and the distal cover 24B. In addition, it will be appreciated that any other structure, mechanism or configuration can be used to effect mechanical communication of the cover actuator 28 with the distal cover portion 24B. In the present example, the clamp arms 104, 110 and 116 comprise elastic and yet flexible plastic materials. The clamp arms 104, 110 and 116 are configured to be bent outward to engage and be released with the flanges 108, 114 and 120; however, they are biased inwardly in response to said bending, to maintain said adjustment. The clamp arms 104, 110 and 116 are sufficiently rigid to transfer longitudinal forces to the flanges 108, 114 and 120, without substantial bending of the clamp arms 104, 110 and 116. Alternatively, the clamp arms 104, 110 and 116 may have any other property, characteristic or suitable configuration. In light of the above, it will be appreciated that the applicator 10 of the present invention can be provided in separate portions - a proximal portion 200 and a distal portion 300. Said partition or quality of separable can be provided by the selective decoupling of flanges 108, 114 and 120 with clamp arms 104, 110 and 116, respectively, as well as the selective decoupling of openings 126 with clamp arms 124. In other words, the applicator 10 can "disintegrate" into a proximal portion 200 and a distal portion 300. , by break contact of the components mentioned above. With said capacity, after the applicator 10 has been used, the distal portion 300 used can be discarded, and a new distal portion 300 can be attached to the proximal portion 200 used. In fact, a distal portion 300 used need not be discarded, and it will be appreciated that a capacity to separate the distal and proximal portions 300, 200 of an applicator 10, may offer a variety of advantages and functions. By way of example only, the separability of the portions 300, 200 may allow a modularity of the distal portions 300. In other words, a variety of distal portions 300, each distal portion 300 having features, functions, advantages, configurations or unique capabilities , may be coupled with a proximal portion 200, as desired. Also, the same distal portion 300 may be coupled with a variety of proximal portions 200, each proximal portion 200 having unique features, functions, advantages, configurations or capabilities. Modes of said modular variation will be apparent to those skilled in the art, as will other possibilities provided by having separable portions 200, 300. In the present example, with reference to Figure 20, the clamp arms 104, 110 and 116 are sized so that their respective outermost surfaces are positioned adjacent the inner diameter of the cover 24A, 24B when the applicator 10 is completely assembled. Also, the clamp 100 is dimensioned so that its outermost surface is positioned adjacent the inner diameter of the distal inner tube portion 82B, when the applicator 10 is fully assembled. It will be appreciated that such a configuration of the above components can reduce the likelihood of inadvertent contact breakage of the flanges 108, 114 and 120 with the clamp arms 104, 110 and 116, respectively, as well as the inadvertent contact breakage of the clamp 100. with the clamp member 102. In fact, such prevention can be provided by any other structure or configuration, or it can be eliminated altogether. Referring to Figures 10 and 19, applicator 10 of the present example can be disassembled by release lugs 124 of clamp arms 122 with openings 126 in distal cover portion 24B. Said contact rupture can be effected by the depression of the projections 124 inward, while separating the proximal and distal cover portions 24A, 24B. After the separation of the cover portions 24A, 24B, each group of clamp arms 116, 110 and 104 can be released from the respective annular flanges 120, 114 and 108; and the clamp 100 can be released from the clamp member 102. The applicator 10 can be reassembled, reversing the previous steps. In fact, any other method for disassembling and / or assembling / reassembling the applicator 10 can be used., in the present example, the distal and proximal portions 300, 200 are separable near the distal end of the applicator 10, it will be appreciated that the applicator 10 can be configured so that the distal and proximal portions 300, 200 are separable at some other position or longitudinal positions along the axis 15 or the applicator 10. Only by way of example, the flanges 108, 114 and 120 can be positioned longitudinally as shown (ie, closer to the distal end of the shaft 15 than the proximal end of the shaft ), so that tubes 56A and 56B, 82A and 82B, 65A and 65B and 80A and 80B can be coupled and uncoupled near the distal end of the shaft.; while the cover portions 24A and 24B can be configured so that they can be coupled and uncoupled near the proximal end of the shaft 15. In this manner, several portions of the distal and proximal portions 300, 200 can be coupled and uncoupled in different longitudinal regions of the applicator 10. Other longitudinal positions suitable for coupling and disengagement of the distal and proximal portions 300, 200 including, but not limited to, different longitudinal positions for coupling and uncoupling of various portions or components of the distal and proximal portions 300, 200, they will be apparent to those skilled in the art. In use, the applicator 10 can be inserted adjacent an anastomotic opening in proximal tissue walls 46, 48. Once the tip 13 is inserted through the anastomotic opening, the tip 13 can be extended using the tip driver 18, exposing in this manner a portion of the distal fingers 62, as shown in FIGS. 5 and 14. The cover actuator 28 can be used to retract the cover 24A, 24B to expose the ring deployment mechanism 26, as shown in FIGS. Figures 6 and 15. With the ring deployment mechanism 26 exposed, the fixing element 52 can be depressed to allow actuation of the deployment actuators 34, 36; and the second deployment actuator 36 may be partially driven to partially drive the distal portion 32 of the ring deployment mechanism 26, as shown in FIGS. 7 and 16, thereby performing partial activation of the distal portion of the anastomotic ring 14. The first deployment actuator 34 can be partially driven to partially drive the proximal portion 30 of the ring deployment mechanism 26, as shown in FIGS. 8 and 17, thereby performing partial actuation of the proximal portion of the anastomotic ring 14. The first and second deployment actuators 34, 36 can be fully actuated, as shown in FIGS. 9 and 18, to effect the complete actuation and deployment of the anastomotic ring 14. The above steps can be reversed to allow removal of the applicator 10. of the anastomosis site. After such use, the distal portion 300 of the applicator 10 can be removed from the proximal portion 200, and the distal portion 300 can be disposed or otherwise addressed. Another distal portion 300 (or the same distal portion 300) may be attached to the proximal portion 300 for subsequent use. In another embodiment of the use of the applicator 10, a plurality of distal portions 300 are provided, each being preloaded with a respective anastomotic ring 14. The same proximal portion 200 is successively coupled with each of the distal portions 300 to deploy the anastomotic rings 14 in an individual patient. The steps of the deployment of the anastomotic ring 14 discussed above are followed by each distal portion 300, each dystal portion 300 being decoupled from the same proximal portion 200 after the anastomotic ring 14 has been deployed from the diastere portion 300; and a new distal portion 300 engages the same proximal portion 200 to deploy the next anastomotic ring 14. In this embodiment, each distal portion 300 acts as a rechargeable cartridge member for deployment of a plurality of anastomotic rings 14. Other variations of use of the applicator 10 will be apparent to those skilled in the art. Having shown and described various embodiments and concepts of the invention, one skilled in the art can achieve, by suitable modifications, other adaptations of the methods and systems described herein, without departing from the scope of the invention. Several such alternatives, modifications and potential variations have been mentioned, and others will be apparent to those skilled in the art in light of the above teachings. Accordingly, it is intended that the invention encompass said alternatives, modifications and variations that may be within the spirit and scope of the appended claims, and it is understood that they will not be limited to the details of structure and operation shown and described in the specification and drawings. Other advantages may readily appear to those skilled in the art.

Claims (20)

NOVELTY OF THE INVENTION CLAIMS

1. - A surgical instrument for deploying an anastomotic ring device at an anastomosis site, the instrument comprising: (a) a distal portion, the distal portion comprising a ring deployment mechanism, wherein the ring deployment mechanism is configured to receive and deploy an anastomotic ring; and (b) a proximal portion in communication with the distal portion, the proximal portion comprising one or more operating members operable to drive at least a portion of the ring deployment mechanism; wherein the distal portion is selectively removable from the proximal portion.

2.- The surgical instrument in accordance with the claim 1, characterized in that it comprises an axis, wherein the distal portion and the proximal portion are in communication by means of an axis.

3.- The surgical instrument in accordance with the claim 2, further characterized in that the shaft comprises a distal portion and a proximal portion, wherein the distal portion of the shaft is selectively removable from the proximal portion of the shaft.

4.- The surgical instrument in accordance with the claim 3, further characterized in that the shaft comprises a plurality of tubes.

5. - The surgical instrument according to claim 4, further characterized in that the plurality of tubes is concentrically aligned.

6. The surgical instrument according to claim 4, further characterized in that a first portion of the plurality of tubes is positioned in the distal portion of the instrument, wherein a second portion of the plurality of tubes is positioned in the proximal portion of the instrument. instrument.

7. The surgical instrument according to claim 6, further characterized in that each tube of the first portion of the plurality of tubes is configured to be selectively coupled with a corresponding tube of the second portion of the plurality of tubes.

8. The surgical instrument according to claim 2, further characterized in that the shaft further comprises a retractable cover, wherein the cover is operable to selectively cover at least a portion of the ring deployment mechanism.

9. The surgical instrument according to claim 8, further characterized in that the cover comprises a distal portion and a proximal portion, wherein the distal portion of the cover is selectively removable from the proximal portion of the cover.

10. The surgical instrument according to claim 1, further characterized in that the distal portion further comprises a tip, wherein the tip is configured to selectively cover at least a portion of the ring deployment mechanism.

11. The surgical instrument according to claim 10, further characterized in that the tip is movable from a retracted position to an extended position by means of at least one tube.

12. The surgical instrument according to claim 1, further characterized in that the distal portion comprises a flange, wherein the proximal portion comprises a clamp arm configured to engage selectively with the flange, wherein the flange and the clamp arm they are configured to allow selective engagement of the distal portion with the proximal portion.

13. The surgical instrument according to claim 12, further characterized in that the clamp arm is configured to transfer at least one longitudinal force to the flange.

14. The surgical instrument according to claim 13, further characterized in that at least one of the one or more drive members is operable to provide the longitudinal force (at least one) to the clamp arm.

15. The surgical instrument according to claim 14, further characterized in that the flange is configured to communicate the longitudinal force (at least one) to at least a portion of the ring deployment mechanism.

16. - The surgical instrument according to claim 15, further characterized in that the ring deployment mechanism is configured to deploy at least a portion of an anastomotic ring in response to the longitudinal force (at least one).

17. The surgical instrument according to claim 1, further characterized in that the proximal portion comprises a handle, wherein the handle comprises the one or more drive members.

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

19. A surgical instrument operable to deploy an anastomotic ring device at an anastomosis site, the instrument comprising: (a) a drive member configured to receive an anastomotic ring and movable between a cylindrical non-driven position and a shaping position; hollow rivet in response to at least one driving force; (b) a handle including a drive mechanism operable to produce the driving force (at least one); and (c) an elongate shaft that connects the handle to the drive member and operatively configured to transfer the driving force (at least one) of the handle to the drive member, wherein the elongated shaft comprises a first portion and a second portion. , wherein at least a portion of the first portion of the shaft is adjacent to the drive member, wherein at least a portion of the second portion of the shaft is adjacent to the handle; wherein the first portion of the shaft is configured to selectively couple with the second portion of the shaft.

20. An operable surgical instrument for deploying an anastomotic fixation device at an anastomosis site, the instrument comprising: (a) deployment means for deployment of an anastomotic fixation device in response to one or more actuation forces; (b) driving means for providing the one or more driving forces; and (c) coupling means for selectively coupling and uncoupling the deployment means with the driving means.