WO1999011178A1 - Anastomotic coupler - Google Patents

Anastomotic coupler Download PDF

Info

Publication number
WO1999011178A1
WO1999011178A1 PCT/US1998/018471 US9818471W WO9911178A1 WO 1999011178 A1 WO1999011178 A1 WO 1999011178A1 US 9818471 W US9818471 W US 9818471W WO 9911178 A1 WO9911178 A1 WO 9911178A1
Authority
WO
WIPO (PCT)
Prior art keywords
device
jaws
staple
end
staple cartridge
Prior art date
Application number
PCT/US1998/018471
Other languages
French (fr)
Inventor
Alexander Vladimorvich Reztov
Evgeniy Alexeevich Karpov
Original Assignee
Mgf Group, Inc.
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
Priority to US5791297P priority Critical
Priority to US60/057,912 priority
Priority to US7438198P priority
Priority to US60/074,381 priority
Application filed by Mgf Group, Inc. filed Critical Mgf Group, Inc.
Publication of WO1999011178A1 publication Critical patent/WO1999011178A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135End-to-side connections, e.g. T- or Y-connections

Abstract

An anastomotic coupler (10) includes an elongated body (12) having a head end (14) and a control end (16). At least two jaws (38, 40) for engaging the tubular tissue vessels to be connected are located at the head end (14). Control of the jaws (38, 40) and advancement of a staple cartridge (46, 48) and driver (54, 56) are achieved remotely from the control end (16) of the elongated body (12).

Description

ANASTOMOTIC COUPLER Related Applications

This application claims priority to U.S. Provisional Application Serial Numbers 60/057,912 filed September 4, 1997, and 60/074,381 filed February 11, 1998.

Technical Field This invention relates to a device for inserting surgical staples in an anastomotic coupling. Specifically, it provides a single-use staple cartridge which can be replaced on a multiple- use, single-procedure instrument.

Background of the Invention

Anastomosing (i.e., joining or connecting) tubular structures is an essential part of many surgical procedures. Currently, surgical devices are

available which connect larger lumen (i.e., diameter) tubular structures together,

generally in the esophageal, gastric and intestinal tracts. The use of these devices

has been limited, however, to traditional open surgical procedures. With the

trend towards less-invasive, lower trauma procedures, the need has increased for an analogous device that can join together smaller lumen structures such as veins

and arteries. Despite the efforts of many developers, and the presence of other patents, such as U.S. Patent No. 4,930,674, directed toward solving this

problem, no such small lumen anastomotic device has gained clinical acceptance. None of the current devices satisfy the following five criteria. The first is reduced technique sensitivity. Manual suturing of vessels requires a great deal of manual dexterity and acquired skill. The ideal device can be used by a high percentage of surgeons without an inordinate amount of training and practice.

The second is reduced time. Connecting a number of vessels in a

single surgical procedure can be time-consuming and laborious. This can lead to surgeon fatigue and increased patient risk. The ideal device should reduce the time to complete an anastomosis.

Third, it provides intima-to-intima closure. While it is much easier to join the external surfaces of vessels to one another, long-term patency and tissue viability are compromised. The ideal device would uniformly connect the

internal surfaces (intima) of vessels via an everted anastomosis.

Fourth, it provides secure, patent closure. The ideal anastomotic device must join the vessels securely enough to prevent leaking without overly traumatizing the tissue and with a high level of reliability. This includes

achieving consistantly accurate alignment of the surgical staples and the staple-

forming surfaces of the anvil.

Fifth, it must be economic to use. Cost containment pressures make it important that the ideal device be designed in a manner that minimizes its cost on a per-procedure basis. Summary of the Invention

The present invention is a reusable or disposable anastomotic coupler

surgical device that satisfies the above five criteria and may be used on either small or large lumen vessels. The present invention may be constructed for either single-procedure or multi-procedure use. The single-procedure version is disposable (i.e., thrown away after one procedure) and can be configured to be

used either once or multiple times within the one procedure. The multi- procedure version is reusable (i.e., capable of being processed to permit its use in multiple procedures) and can be used multiple times within a single procedure. To permit multiple applications, individual components may be disposable or reusable.

Brief Description of the Drawing Like reference numerals are used to indicate like parts throughout the various figures of the drawing, wherein: Fig. 1 shows a pictorial view of a preferred embodiment of the present

invention;

Fig. 2 shows a pictorial close-up of the head and an preferred

embodiment;

Fig. 3 shows a longitudinal sectional view of a replaceable staple

cartridge according to a preferred embodiment of the present invention in an

open position; Fig. 4 shows a view similar to Fig. 3 wherein jaws of the replaceable staple cartridge are in a closed position;

Fig. 5 shows a view similar to Fig.3 & 4 in which the staple housing is

advanced forward toward the anvil;

Fig. 6 shows a view similar to Figs. 3-5 wherein the staple pusher is advanced forward to drive legs of the staples into the forming surface of the

anvil;

Figs. 7-9 shows a preferred mechanism for inserting and engaging a disposable staple cartridge according to a preferred embodiment of the present

invention;

Fig. 10 is an exploded view showing the internal parts of the elongated

body; -

Fig. 11 is a longitudinal sectional view of the control end of the present

invention; Figs. 12-14 are enlarged views of the head portion an alternate embodiment according to the present invention;

Fig. 15 shows a manner in which a mobilized vessel is placed within the

jaws;

Figs. 16 & 17 show the manner in which the open end of vessel is

everted over the anvil flanges for anastomosis with the end or side of another

vessel; and Figs. 18-20 show sequential sectional views of an end-to-side anastomosis.

Detailed Description of the Preferred Embodiment

In a preferred embodiment of the invention, the disclosed surgical

instrument can connect large or small lumen vessels in either an end-to-end or an end-to-side manner by:

1. Grasping the first vessel near its ligated end with a rotatable pair of jaws that are flanged at their ends.

2. Closing the jaws and everting the end of the first vessel back and over the flanged end of the closed jaws, using a purse string suture when necessary to facilitate the eversion and to secure the end of the vessel around the flanged end.

3. a. End-to-Side Anastomosis — Inserting the flanged end of the first

vessel into an incision along the longitudinal axis of the second

vessel.

b. End-to-End Anastomosis — Inserting the ligated end of the

second vessel over the flanged end of the jaws containing the everted end of the first vessel.

4. Advancing the staple cartridges and staple drivers aligned on both jaws until the vessels are trapped between the inner surface of flanged

head of the jaws and the staple cartridges. . Advancing the staples in the staple cartridge until the staple legs pass

through the trapped tissue and are bent inward by the forming

surfaces located on the inner surface of the flanged end of the closed

jaws.

6. Retracting the staple cartridges and staple drivers, and opening the

jaws, releasing the joined (i.e., anastomosed) vessels.

7. If the device is either a single-procedure, disposable multi-use device

or a multi-procedure, reusable device, replacing the spent empty

staple cartridges with cartridges containing staples.

8. If the device is a reusable device, processing the instrument in order

to permit its use in multiple procedures

In a preferred embodiment of the present invention, the instrument may

be disposable (single procedure use) or reusable (multiple procedure use). Both

versions function in the same manner by connecting vessels with the interaction

of six structural elements:

1. A pair of jaws containing integral flanges at their ends.

2. A staple cartridge and driver on each jaw which are connected to

each other as well as to their respective jaws.

3. A means for controllably advancing the cartridge/driver assemblies

on the closed jaws. 4. A means for advancing the staple drivers in order to drive the legs of

the staples through the vessels at the point where they are to be anastomosed.

5. (optional) A means for rotating the shaft of the instrument.

6. A means for replacing the spent (i.e., fired) staple cartridges with

new cartridges containing staples.

Referring to the various figures of the drawing, and first to Fig. 1 , therein is shown at 10 a device according to the preferred embodiment of the invention. The device 10 includes an elongated body 12 having a head end 14 and a control end 16. The elongated body 12 includes a hollow barrel 18

through which control actuation members pass to connect control triggers to various components of the staple cartridge 20 at the head end 14.

Generally, the control end 16 includes a jaw-closing trigger 22 which is movable toward the main instrument body 24 as shown by arrow 25. The

movement advances member 26 to remotely operate jaws of the head portion 14 into a closed position. In the closed position, a handle latch 28 will releasably engage with a main body latch component 30 such that closure of the jaws is firmly, but releasably, achieved.

A second component of the control end 16 is the cartridge/driver

advancement knob 32. Rotation of this knob 32 causes the staple cartridge and

driver to advance against tissue, clamping it against an anvil portion of the jaws

(described below). The final component of the control end 16 is the firing trigger 34.

Movement of the trigger 34 toward a transverse handle 36 will result in firing of the disposable staple cartridge.

Referring now to Fig. 2, therein is shown a pictorial view of the head

end 14 of a preferred embodiment of the invention. The head end includes a

pair of jaws 38, 40 each having an axially-directed, aligned groove 42, 44

which, when the jaws 38,40 are closed, creates an axially-oriented passageway

45. On each jaw 38, 40 is mounted a staple cartridge 46, 48 which includes a staple-carrying housing 50, 52 and a driver member 54, 56. Referring now also to Figs. 3-6, therein is shown a longitudinal sectional view of the entire disposable staple cartridge/jaw unit 58 in sequential stages of

operation.

Fig. 3 shows the jaws 38, 40 in an open position. As the tubular barrel

18 of the elongated body is advanced relative to the staple cartridge 58 (or staple cartridge 58 is retracted relative to the barrel 18), the jaws are moved together

into a closed position as shown in Fig. 4. Referring to Fig. 5, the cartridge unit

46, 48 is advanced forward so as to clamp layers of tissue to be coupled against the outwardly-extending flange or anvil 60 of the jaws 38, 40. Advancement of this cartridge unit 46 causes spring 62 to be compressed. The purpose of this spring 62 is to retract the staple cartridge unit 46 after firing. Fig. 6 shows the unit 58 in the fired position. In this position, the staple

drivers 54, 56 have been axially advanced relative to the staple housing 50,52 so

as to drive legs of the staples against a forming surface on the anvil flange 60.

In preferred form, the entire staple cartridge unit 58, with the exception

of the staples themselves and possibly the spring 62, is made of surgical or

spring steel or may be made of a thermoplastic or polymeric material. The two

halves of the jaws 38, 40 are hinged together at a bight portion 68 which

includes "living" hinges. A "living" hinge indicates a portion which is

constructed of like material but which is shaped and sized to be particularly

flexible relative to the rest of the member. A medial portion 70 of the staple

housing unit also includes "living hinges" which allows it to flex with the jaws

38, 40 during opening and closing.

As shown in Fig. 5, the driver members 54, 56 are advanced with the

staple housing portions 50, 52 by engagement of notches 72, 74 against proximal

ends of the driver members 54, 56. As shown in Fig. 6, the driver members 54,

56 are independently axially advancable relative to the staple housing 50, 52 so

as to advance the surgical staples out of channels 53 in the staple housing 50, 52,

through the tissue to be connected and against the anvil 60. As can be

appreciated by a comparison of Fig. 2 to Figs. 3-6, an axially-oriented

passageway 76 is provided to guide the longitudinal advancement of the

respective members of the staple cartridge unit 58. This novel structure assures

that the staple housing 50, 52 and each individual staple is correctly aligned against the anvil 60 and each staple-forming surface when advanced against

tissue to be joined. This is important because current devices are subject to rotational misalignment.

One feature provided by a preferred embodiment of the present invention

is that the staple cartridge/jaw unit 58 is easily and quickly replaceable. A

preferred mechanism for achieving this feature is illustrated in Figs. 7-9. A tang

portion 78 of the unit 58 is inserted into the open end of the barrel 18. The tang

includes a opening or notch which engages a hook or pawl of a hinged engagement member 80. Engagement member 80 pivots on an internal pivot pin 82 and is spring biased into engaging position by a resilient spring member 84. A button portion 86 projects outwardly through an opening 88 in the barrel 18

such that it can be manipulated by the user to release engagement between the pawl member 88 and the opening or notch 90 in the tang 78.

Also in preferred form, the tang portion 78 is relatively flat or includes flat portions such that the rotational orientation of the cartridge unit 58 may be

controlled relative to the barrel 18. The extreme end 92 of the tang 78 may be beveled on one or both sides so as to ease engagement with the pawl member 88. If desired, this bevel can be designed to restrict the orientation of the replaceable

unit 58 to designate a particular "up" side or may be designed such that no particular orientation is required. The entire jaw assembly can be rotated by

turning a jaw assembly rotating knob 94. Referring to Fig. 10, therein is shown an exploded view of the elongated

body 18, disposable staple cartridge unit 20 and internal control members.

These members include a staple cartridge assembly puller shaft 96 which grips the replaceable staple cartridge unit 20 and advances or retracts it relative to the

barrel 18 in response to rotation of the control knob 32. A pair of cartridge-

positioning bars 98 bear against a proximal end 100 of staple cartridge housing

50 for advancement of the staple cartridge housing 50 52, and pusher members

54, 56 relative to the jaws 38, 40. This can be seen clearly in Figs. 6 & 8. Advancement of these members 98 causes compression of the spring 62. The

spring biases the end 100 back when the control bars 98 are retracted. A pair of

pusher control bars 102 are used to advance the pushers 54, 56 independently of

the staple cartridge housing 50, 52 for firing.

Referring now to Figs. 12-14, therein is shown an alternate design of the

preferred embodiment of the present invention. In this alternate design, the central axial passageway 45 is shaped to be greater in depth than its width relative to the jaws 38, 40 additionally, an annular groove 104 is formed at the base of the anvil flange 60. This groove 104 provides space for edges of the tissue being anastomomically joined to prevent damage thereto and helps to maintain alignment of the staple cartridge housing 50, 52 relative to staple forming surfaces 106 of the anvil face. In all respects, the version of Figs. 12- 14 is the same and, therefore, will be used to explain detail of the staple

cartridge unit. Each cartridge is preloaded with a series of surgical staples 108 which

are symmetrically aligned around the jaws when closed. Each staple 108 will

typically include a pair of legs and a connector portion there between. The

staples 108 are held in grooves 53 which axially-align the staple legs in

orientation toward the anvil surface 60. The staple pushers 54, 56 include

projections into the grooves 53 in order to symmetrically and evenly drive or

push the staples 108 forwardly out of the groove, through the tissue being

connected, and into the staple-forming surface 106 of the anvil 60.

Referring now to Figs. 15-20, the first step in the operation of the instrument 10 is to grasp the first vessel 110 with the instrument jaws 38, 40.

This may be done externally to the body {ex vivo) if the vessel 110 is sufficiently

mobilized. The jaws 38, 40 are closed around the first vessel 110, trapping it in

the passageway 45, and causing the flanges 60 at the jaw ends to come together. The captured vessel 110 is ligated at an angle a short distance beyond the

flanged end of the jaws 38, 40. Using a purse string suture, if necessary, the end of the vessel is pulled back over the flanged end 60 of the jaws 38, 40, everting and securing the vessel 110. The rotatable shaft is used to facilitate positioning the jaws and to improve visibility. For an end-to-side anastomosis (Figs. 18-20), a longitudinal slit is placed in the second vessel at the point where the anastomosis is to occur. The slit should be kept as small as possible. The flanged head 60 of the jaws 38, 40 upon which the everted end of the first vessel 110 is located is inserted into the slit in

a manner similar to inserting a button into a buttonhole. For an end-to-end

anastomosis, the prepared end of the second vessel is positioned over the everted

end of the first vessel.

Once the vessels have been properly positioned, the staple cartridge 50,

52 and driver assemblies 54, 56 on both jaws 38, 40 are advanced until the two

vessels are trapped between the staple cartridge 50, 52 and the flanged end 60 of

the closed jaws 38, 40 at the point where the anastomosis is to occur. The staple

drivers 54, 56 move forward, advancing the staple legs through the vessels 110,

112 until they bend against the staple forming surface 106 on the flanged end 60

of the jaws 38,40.

Once the staples have formed, the staple firing trigger is released, the

staple firing return spring 62 expands, the staple cartridges 50, 52 and drivers 54,

56 are retracted and the jaws 38, 40 are opened, releasing the joined vessels 110,

112. The surgeon can then remove the instrument 10 from the anastomotic site.

The empty staple cartridge 58 can then be replaced when necessary to permit

multiple actuations.

It is to be understood that many variations and modifications of the

disclosed preferred embodiment may be made without departing from the spirit

and scope of the inventions. It is to be understood that the invention concept is

greater in scope than the embodiments described above and that patent rights are

to be defined by the following claim or claims interpreted according to accepted doctrines of claims inteφretation, including the doctrine of equivalents and

reversal of parts.

Claims

What is claimed is:
1. An anastomotic staple coupler, comprising: an elongated body having a head end and a control end;
at least two jaws at the head end which when open allow lateral access
between the jaws and when closed form a axial passageway for receiving a first
tubular tissue vessel;
an anvil on each jaw in the form of an outwardly-directed flange having a
staple-forming surface; and an axially-advancable staple cartridge associated with each jaw including
a plurality of surgical staples aligned in a staple housing and a driver, axially- advanceable independent of the staple cartridge as a whole, positioned to drive
legs of the staples through the tissue and against the anvil for coupling of first
and second tubular tissue vessels;
wherein opening and closing of the jaws, advancement of the staple
cartridge and advancement of the driver being actuated remotely from the
control end of the elongated body.
2. The device of claim 1, wherein the jaws and staple cartridge releasably
engaged to the body such that they can be removed and replaced as a pre¬
loaded single-use disposable unit.
3. The device of claim 2, wherein the pre-loaded single-use disposable unit
includes an elongated tang which is engaged by a holding means at the
head end of the body.
4. The device of claim 3, wherein an actuator for releasing engagement of the holding means extends outwardly of the body.
5. The device of claim 2, wherein the jaws are hinged relative to one another at a proximal end.
6. The device of claim 1, wherein the jaws are hinged relative to one another at a proximal end.
7. The device of claim 1, wherein the staple-forming surface is directed
axially toward the control end of the body.
8. The device of claim 7, wherein the anvil includes an annular groove
radially inwardly of the staple-forming surface.
9. The device of claim 1, wherein the axial advancement of the staple
cartridge is selectively controlled from the control end of the body.
10. The device of claim 1, wherein the body includes an axial passageway
through which control actuators extend from the control end to the head
end for remotely controlling closure of the jaws.
11. The device of claim 10, further comprising control actuators extending
through the passageway to remotely and independently control
advancement of the staple cartridge and driver.
12. The device of claim 1, wherein rotational orientation of the jaws is
controlled from the control end of the body.
13. The device of claim 1, wherein the staple cartridge includes axially-
oriented grooves for guiding the staples.
14. The device of claim 1, wherein the staples are evenly spaced
circumferentially around the jaws when closed.
15. The device of claim 1 , wherein each jaw includes an axially-oriented guide for mating each staple to a correponding staple-forming surface.
PCT/US1998/018471 1997-09-04 1998-09-04 Anastomotic coupler WO1999011178A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
US5791297P true 1997-09-04 1997-09-04
US60/057,912 1997-09-04
US7438198P true 1998-02-11 1998-02-11
US60/074,381 1998-02-11

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
AU93036/98A AU9303698A (en) 1997-09-04 1998-09-04 Anastomotic coupler

Publications (1)

Publication Number Publication Date
WO1999011178A1 true WO1999011178A1 (en) 1999-03-11

Family

ID=26737020

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1998/018471 WO1999011178A1 (en) 1997-09-04 1998-09-04 Anastomotic coupler

Country Status (2)

Country Link
AU (1) AU9303698A (en)
WO (1) WO1999011178A1 (en)

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1088519A1 (en) * 1999-10-01 2001-04-04 United States Surgical Corporation Anastomosis instrument and method for performing same
WO2001008601A3 (en) * 1999-07-28 2001-08-16 Vascular Innovations Inc Anastomosis system and method of use
WO2002032323A2 (en) * 2000-10-18 2002-04-25 Tyco Healthcare Group Lp Anastomosis instrument and method for performing same
US6440146B2 (en) 1996-07-23 2002-08-27 United States Surgical Corporation Anastomosis instrument and method
US6905504B1 (en) 2002-02-26 2005-06-14 Cardica, Inc. Tool for performing end-to-end anastomosis
WO2007138571A2 (en) * 2006-06-01 2007-12-06 Mor Research Applications Ltd. Membrane augmentation, such as of for treatment of cardiac valves, and fastening devices for membrane augmentation
US20110101069A1 (en) * 1999-07-28 2011-05-05 Cardica, Inc. Surgical Stapler with Direct Sled to Staple Contact
US8915934B2 (en) 2003-11-24 2014-12-23 Cardica, Inc. Anastomosis system with anvil entry hole sealer
US9144427B2 (en) 2007-09-06 2015-09-29 Cardica, Inc. Surgical method utilizing a true multiple-fire surgical stapler
US9168039B1 (en) 2007-09-06 2015-10-27 Cardica, Inc. Surgical stapler with staples of different sizes
US9345478B2 (en) 2007-09-06 2016-05-24 Cardica, Inc. Method for surgical stapling
US9408603B2 (en) 2009-10-28 2016-08-09 Covidien Lp Surgical fastening apparatus

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US5551622A (en) * 1994-07-13 1996-09-03 Yoon; Inbae Surgical stapler
US5669918A (en) * 1995-03-16 1997-09-23 Deutsche Forschungsanstalt Fur Luft-Und Raumfahrt E.V. Surgical instrument for preparing an anastomosis in minimally invasive surgery
US5709335A (en) * 1994-06-17 1998-01-20 Heartport, Inc. Surgical stapling instrument and method thereof

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US5709335A (en) * 1994-06-17 1998-01-20 Heartport, Inc. Surgical stapling instrument and method thereof
US5551622A (en) * 1994-07-13 1996-09-03 Yoon; Inbae Surgical stapler
US5669918A (en) * 1995-03-16 1997-09-23 Deutsche Forschungsanstalt Fur Luft-Und Raumfahrt E.V. Surgical instrument for preparing an anastomosis in minimally invasive surgery

Cited By (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6440146B2 (en) 1996-07-23 2002-08-27 United States Surgical Corporation Anastomosis instrument and method
US9622748B2 (en) 1999-07-28 2017-04-18 Dextera Surgical Inc. Anastomosis system with flexible shaft
WO2001008601A3 (en) * 1999-07-28 2001-08-16 Vascular Innovations Inc Anastomosis system and method of use
US6398797B2 (en) 1999-07-28 2002-06-04 Cardica, Inc. Tissue bonding system and method for controlling a tissue site during anastomosis
US20110101069A1 (en) * 1999-07-28 2011-05-05 Cardica, Inc. Surgical Stapler with Direct Sled to Staple Contact
DE10084856B4 (en) * 1999-07-28 2010-08-05 Cardica, Inc. (n.d.Ges.d.Staates Delaware), Menlo Park Anastomosesystem for joining a graft blood vessel to a target blood vessel
EP1088519A1 (en) * 1999-10-01 2001-04-04 United States Surgical Corporation Anastomosis instrument and method for performing same
EP2172158A1 (en) * 1999-10-01 2010-04-07 United States Surgical Corporation Anastomosis instrument and method for performing same
WO2002032323A3 (en) * 2000-10-18 2002-07-18 Lisa W Heaton Anastomosis instrument and method for performing same
WO2002032323A2 (en) * 2000-10-18 2002-04-25 Tyco Healthcare Group Lp Anastomosis instrument and method for performing same
AU2002213339B2 (en) * 2000-10-18 2005-02-24 Covidien Lp Anastomosis instrument and method for performing same
US6942675B1 (en) 2002-02-26 2005-09-13 Cardica, Inc. Tool for performing end-to-end anastomosis
US6905504B1 (en) 2002-02-26 2005-06-14 Cardica, Inc. Tool for performing end-to-end anastomosis
US7347864B2 (en) 2002-02-26 2008-03-25 Cardica, Inc. Method for end-to-end anastomosis
US8915934B2 (en) 2003-11-24 2014-12-23 Cardica, Inc. Anastomosis system with anvil entry hole sealer
WO2007138571A3 (en) * 2006-06-01 2008-02-14 Mor Research Applic Ltd Membrane augmentation, such as of for treatment of cardiac valves, and fastening devices for membrane augmentation
WO2007138571A2 (en) * 2006-06-01 2007-12-06 Mor Research Applications Ltd. Membrane augmentation, such as of for treatment of cardiac valves, and fastening devices for membrane augmentation
US9144427B2 (en) 2007-09-06 2015-09-29 Cardica, Inc. Surgical method utilizing a true multiple-fire surgical stapler
US9168039B1 (en) 2007-09-06 2015-10-27 Cardica, Inc. Surgical stapler with staples of different sizes
US9345478B2 (en) 2007-09-06 2016-05-24 Cardica, Inc. Method for surgical stapling
US9655618B2 (en) 2007-09-06 2017-05-23 Dextera Surgical Inc. Surgical method utilizing a true multiple-fire surgical stapler
US9408603B2 (en) 2009-10-28 2016-08-09 Covidien Lp Surgical fastening apparatus
US9872686B2 (en) 2009-10-28 2018-01-23 Covidien Lp Surgical fastening apparatus

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