WO1987004915A1 - Dispositif pour raccordement macro et microchirurgical d'extremites de vaisseaux - Google Patents

Dispositif pour raccordement macro et microchirurgical d'extremites de vaisseaux Download PDF

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Publication number
WO1987004915A1
WO1987004915A1 PCT/EP1987/000093 EP8700093W WO8704915A1 WO 1987004915 A1 WO1987004915 A1 WO 1987004915A1 EP 8700093 W EP8700093 W EP 8700093W WO 8704915 A1 WO8704915 A1 WO 8704915A1
Authority
WO
WIPO (PCT)
Prior art keywords
vessel
clip
ring
connection
ring sleeve
Prior art date
Application number
PCT/EP1987/000093
Other languages
German (de)
English (en)
Inventor
Ekkehard Euler
Dietmar Wilker
Original Assignee
Ekkehard Euler
Dietmar Wilker
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ekkehard Euler, Dietmar Wilker filed Critical Ekkehard Euler
Publication of WO1987004915A1 publication Critical patent/WO1987004915A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive

Definitions

  • the invention relates to a device for the macrosurgical and microsurgical connection of vessel ends using a ring cuff, the inside diameter of which corresponds essentially to the outside diameter of at least one of the vessel ends to be anastomized and the outside surface of which is a support surface for the inverted end of the one guided through the ring cuff Forms the vessel end and the expanded other end of the vessel, as well as at least one Fiisrein ⁇ it enclosing the ring cuff for the vessel ends located on the bearing surface.
  • the so-called suturing technique is most widespread, in which the ends to be anastomized are connected by means of single-head sutures.
  • the suturing technique in particular in micro-vascular surgery, not only requires a high level of skill of the respective surgeon, but it also has the general disadvantage that damage to the inner wall of the vessel always occurs and such damage to the inner wall of the vessel Accumulation of platelets predisposes to the risk of thrombus formation and thus the risk of vascular occlusion.
  • the suturing technique is comparatively time-consuming, since several sutures always have to be made and, for example, in the case of vessel diameters of 1 mm to 2 mm, about six sutures are required in microsurgery.
  • the object of the invention is to design a device of the type specified at the outset in such a way that the implementation of vascular anastomoses is further simplified, possible damage to the inner walls of the vessel and fluctuations in the lumen of the anastomosis are avoided, and yet no disturbing foreign materials have to remain permanently in the body.
  • both the ring sleeve and the fixing unit consist of resorbable material.
  • connection point Since the connection point has a comparatively high intrinsic strength after only a few days, comparatively weakly dimensioned material can be used for both the ring sleeve and the fixing unit, but due to the ring structure it can easily absorb the holding forces that occur exclusively in the radial direction.
  • the small amount of resorbable material that is used per anastomosis has a very advantageous overall effect.
  • the support surface of the annular sleeve is expediently provided with friction-increasing unevenness in the form of grooves, knurls and the like to increase the adhesion of the everted part of the vessel up to the attachment of the Fi ⁇ xierillon improve *.
  • the edge region of the ring sleeve which is enclosed by the inverted section of the one vessel end and is preferably downstream in the connection is designed to taper conically from the support surface to the free end. This tapering of the ring cuff on the push-on side not only makes it easier to turn the first end of the vessel up and down /
  • a clip which can be locked in the closed position as the fixing unit.
  • a clip is preferably at least essentially rigid and is provided with a swivel joint and a circular receiving opening.
  • the system of ring cuff and clip leads to essential advantages, which mainly consist in the fact that the vessel ends already on the ring cuff can be fixed extremely simply and quickly by simply snapping on the clip, and no unusual skill is required and an exact fixation with a predeterminable radial pressure that is practically independent of the respective surgeon is always obtained.
  • the swivel joint is expediently formed by a notch in the material of the annular clip, and the swivel joint and the clip latching are diametrically opposite one another.
  • a clip of this type can be handled problem-free, for example, with appropriate spreading pliers.
  • the clip latching preferably consists of a snap latching connection with at least one latching projection which engages in a form-fitting manner in an associated recess.
  • a snap-lock connection of this type ensures on the one hand a simple coupling of the two parts of the clip, which are initially movable relative to one another, but after latching, represents a practically inseparable connection, which ensures that the ring opening of the clip extends over the entire circumference and with the application of the required radial pressure, the two vessel ends, namely the everted ends Vessel part and the drawn-up part of the vessel, encloses.
  • FIG. 1 shows a schematic representation of two vessel ends with a ring sleeve applied to one end of the vessel
  • FIG. 2 shows a representation corresponding to FIG. 1, but in which a part of a vessel end is put over the ring cuff
  • FIG. 3 shows a schematic sectional view of an anastomosis according to the invention still without a fixing unit
  • FIG. 4 shows a schematic, perspective representation of a fixing unit which is held in a spreading pliers, partly shown, and
  • FIG. 5 shows a perspective illustration of the vascular anastomosis according to FIG. 3 provided with the fixing unit according to FIG. 4.
  • FIG. 1 schematically shows two vessel ends 1, 2 to be connected to one another, an annular collar 3 having already been pushed onto the vessel end 1. If the vessel ends to be connected have different diameters, the annular sleeve 3 is at least generally applied to the vessel end which has the smaller diameter.
  • the cylindrical ring cuff 3 is provided on its outer circumference with friction-increasing bumps in the form of roughening, grooves and the like, and it forms a support surface 4 for the end of the vessel protruding over the ring cuff 3.
  • the inversion movement to be carried out starting from the illustration in FIG. 1 is indicated in this FIG. 1 by double arrows.
  • FIG. 2 shows the arrangement according to FIG. 1 after the inverting process has taken place, and it can be seen that the inverted region 5 of the vessel end 1 rests with its outer surface on the carrier surface of the ring sleeve 3.
  • the ring sleeve 3 which preferably has a roughened carrier surface 4, is provided with a smooth inner surface, and it consists of resorbable material, for example of polydioxanone.
  • the wall thickness of the ring sleeve 3 is preferably chosen to be as small as possible and has, for example, a value of approximately 0.2 mm, in which case the outer diameter of the ring sleeve can be approximately 1.8 mm.
  • the ratio of the diameter to the length of the ring sleeve is expediently in the range from 1 to 1.5 to 2. However, these values do not constitute any restrictive information, they only serve to explain the subject of the application.
  • Fig. 3 shows a longitudinal sectional view of the connection at - 3- -
  • the edge region 11 of the ring sleeve 3, which is enclosed by the inverted section 5 of the vessel end 1 and is therefore located on the push-on side, is designed to taper towards the free end, which not only makes it easier to flip the vessel end 1 and pull the vessel end 2 open, but above all, a very desirable improvement in the flow conditions is achieved, since dead spaces in the transition area of the two vessel ends 1, 2 are minimized or largely excluded, and thus vortex formation and associated undesirable deposits are prevented.
  • the inverted area 5 and the expanded area 6 of the two vessel ends 1, 2 can be fixed on the ring cuff 3 by means of at least one ligature, but is preferably carried out by means of a clip, which likewise consists of resorbable material and of which one Example is shown in Fig. 4.
  • the clip 7 held by a partially schematically illustrated spreading pliers 8 is formed in a ring and is provided with a swivel joint 13 realized by a notch, which is approximately diametrically opposed by a snap-locking connection 9, 10.
  • the circular receiving opening 12 of the clip 7 is preferably roughened, and the axial width of the clip 7 is preferably approximately one third of the axial length of the ring sleeve 3.
  • the snap-lock connection comprises a recess 10 and a shoulder 9, the shoulder 9 - as can be clearly seen in FIG. 5 - essentially fit into the recess 10 in a form-fitting manner.
  • the snap-lock connection can also be designed in a different way to that shown in FIG. 4, but it is essential in all cases that the clip 7 is permanently fixed in its ring structure after the snap-in process has been completed and that the snap-in connection is released. Snap connection is not possible at least without the use of special tools. By providing appropriate approaches or undercuts, an additional locking in the axial direction is preferably carried out.
  • FIG. 5 The arrangement of the clip 7 in the closed state on the prepared connection according to FIG. 3 can be seen in FIG. 5. Since the respective clip is selected in dependence on the respective outer diameter of the annular collar 3 7 and the diameter of the receiving opening 12 is defined of the clip 7 in the ge closed state clearly ', this can be also the respective radial pressing force by the clip 7 to which vascular ends located on the support surface of the ring cuff is exerted exactly, and this contact pressure, in contrast to ligatures, is independent of the person performing the anastomosis.
  • the device according to the invention is also suitable for connecting thinner and thicker vessel ends, and - in contrast to the seam technique - it can also be used without problems if vessel ends to be joined together should be under a certain longitudinal tension.
  • the device according to the invention is characterized by its technical simplicity and unproblematic usability and enables the advantages of avoiding lumen fluctuations in the anastomosis and any damage to the inner walls of the vessel to be realized in a particularly economical manner. - 3 -

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Un dispositif pour raccordement macro et microchirurgical d'extrémités de vaisseaux utilise un manchon annulaire (3) dont la surface extérieure forme une surface de support pour l'extrémité retroussée (5) d'un vaisseau (1) et pour l'extrémité élargie (6) de l'autre vaisseau (2). Les extrémités des vaisseaux situées sur la surface de support sont fixées par une agrafe (7). Le manchon annulaire (3) et l'agrafe (7) sont composés d'un matériau résorbable.
PCT/EP1987/000093 1986-02-19 1987-02-18 Dispositif pour raccordement macro et microchirurgical d'extremites de vaisseaux WO1987004915A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP3605306.6 1986-02-19
DE19863605306 DE3605306A1 (de) 1986-02-19 1986-02-19 Vorrichtung zur makro- und mikrochirurgischen verbindung von gefaessenden

Publications (1)

Publication Number Publication Date
WO1987004915A1 true WO1987004915A1 (fr) 1987-08-27

Family

ID=6294470

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1987/000093 WO1987004915A1 (fr) 1986-02-19 1987-02-18 Dispositif pour raccordement macro et microchirurgical d'extremites de vaisseaux

Country Status (3)

Country Link
EP (1) EP0263122A1 (fr)
DE (1) DE3605306A1 (fr)
WO (1) WO1987004915A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2683141A1 (fr) * 1991-11-05 1993-05-07 Richard Thierry Dispositif de raccordement de protheses de vaisseaux organiques.
EP0554990A1 (fr) * 1992-02-06 1993-08-11 Andreas G. Tzakis Appareil pour l'anastommose
EP0591692A1 (fr) * 1992-09-08 1994-04-13 United States Surgical Corporation Dispositif chirurgical avec endume détachable
US5500014A (en) * 1989-05-31 1996-03-19 Baxter International Inc. Biological valvular prothesis
US5609626A (en) * 1989-05-31 1997-03-11 Baxter International Inc. Stent devices and support/restrictor assemblies for use in conjunction with prosthetic vascular grafts
FR2751867A1 (fr) * 1996-08-05 1998-02-06 Leriche Rene Ass Prothese collerette
US6896688B2 (en) 2002-09-12 2005-05-24 Edrich Health Technologies, Inc. Prosthetic vascular graft connector

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1275344A1 (fr) * 2001-07-09 2003-01-15 Bioring SA Dispositif pour l'anastomose, la maintenance et la protection vasculaire

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2453056A (en) * 1947-03-12 1948-11-02 Zack William Edwin Surgical anastomosis apparatus and method
US3254650A (en) * 1962-03-19 1966-06-07 Michael B Collito Surgical anastomosis methods and devices
US3435823A (en) * 1966-04-11 1969-04-01 Miles Lowell Edwards Anastomotic coupling with anti-pulse ring means
DE1957855A1 (de) * 1969-11-18 1971-05-27 Bleier Waldemar Spezialklemme zum Unterbrechen von Leitungsbahnen im menschlichen oder tierischen Organismus
DE2101284A1 (de) * 1970-01-14 1971-07-22 Vorrichtung zur nahtlosen Vereinigung der zwei Enden eines unterbrochenen
US3620218A (en) * 1963-10-31 1971-11-16 American Cyanamid Co Cylindrical prosthetic devices of polyglycolic acid
US4112944A (en) * 1976-12-13 1978-09-12 Williams Gayland M Tube clamp and piercing device
DE3118484A1 (de) * 1981-05-09 1982-11-25 Steven Lee 95814 Sacramento Calif. Archibald Vorrichtung zum zusammenfuegen von arterien und dergleichen
US4519392A (en) * 1982-10-12 1985-05-28 Lingua Robert W Hemostasing muscle clips for needleless surgery
EP0154103A1 (fr) * 1984-02-22 1985-09-11 Antonio Di Mezza Prothèse physiologiquement absorbable pour l'anastomose de vaisseaux et de canaux chez l'homme et l'animal

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2453056A (en) * 1947-03-12 1948-11-02 Zack William Edwin Surgical anastomosis apparatus and method
US3254650A (en) * 1962-03-19 1966-06-07 Michael B Collito Surgical anastomosis methods and devices
US3620218A (en) * 1963-10-31 1971-11-16 American Cyanamid Co Cylindrical prosthetic devices of polyglycolic acid
US3435823A (en) * 1966-04-11 1969-04-01 Miles Lowell Edwards Anastomotic coupling with anti-pulse ring means
DE1957855A1 (de) * 1969-11-18 1971-05-27 Bleier Waldemar Spezialklemme zum Unterbrechen von Leitungsbahnen im menschlichen oder tierischen Organismus
DE2101284A1 (de) * 1970-01-14 1971-07-22 Vorrichtung zur nahtlosen Vereinigung der zwei Enden eines unterbrochenen
US4112944A (en) * 1976-12-13 1978-09-12 Williams Gayland M Tube clamp and piercing device
DE3118484A1 (de) * 1981-05-09 1982-11-25 Steven Lee 95814 Sacramento Calif. Archibald Vorrichtung zum zusammenfuegen von arterien und dergleichen
US4519392A (en) * 1982-10-12 1985-05-28 Lingua Robert W Hemostasing muscle clips for needleless surgery
EP0154103A1 (fr) * 1984-02-22 1985-09-11 Antonio Di Mezza Prothèse physiologiquement absorbable pour l'anastomose de vaisseaux et de canaux chez l'homme et l'animal

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5824061A (en) * 1989-05-31 1998-10-20 Baxter International Inc. Vascular and venous valve implant prostheses
US5997573A (en) * 1989-05-31 1999-12-07 Baxter International, Inc. Stent devices and support/restrictor assemblies for use in conjunction with prosthetic vascular grafts
US5500014A (en) * 1989-05-31 1996-03-19 Baxter International Inc. Biological valvular prothesis
US5609626A (en) * 1989-05-31 1997-03-11 Baxter International Inc. Stent devices and support/restrictor assemblies for use in conjunction with prosthetic vascular grafts
FR2683141A1 (fr) * 1991-11-05 1993-05-07 Richard Thierry Dispositif de raccordement de protheses de vaisseaux organiques.
EP0554990A1 (fr) * 1992-02-06 1993-08-11 Andreas G. Tzakis Appareil pour l'anastommose
US5368215A (en) * 1992-09-08 1994-11-29 United States Surgical Corporation Surgical apparatus and detachable anvil rod therefor
US5718360A (en) * 1992-09-08 1998-02-17 United States Surgical Corporation Surgical apparatus and detachable anvil rod therefor
EP0591692A1 (fr) * 1992-09-08 1994-04-13 United States Surgical Corporation Dispositif chirurgical avec endume détachable
EP0824012A1 (fr) * 1996-08-05 1998-02-18 Association René Leriche Prothèse collerette
FR2751867A1 (fr) * 1996-08-05 1998-02-06 Leriche Rene Ass Prothese collerette
US5893886A (en) * 1996-08-05 1999-04-13 Association Rene Leriche Vascular prosthesis
US6896688B2 (en) 2002-09-12 2005-05-24 Edrich Health Technologies, Inc. Prosthetic vascular graft connector
US6929648B2 (en) 2002-09-12 2005-08-16 Edrich Vascular Devices, Inc. Prosthetic vascular graft connector

Also Published As

Publication number Publication date
EP0263122A1 (fr) 1988-04-13
DE3605306A1 (de) 1987-08-20

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