WO2001000108A1 - Dispositif destine a relier un implant a un canal corporel - Google Patents

Dispositif destine a relier un implant a un canal corporel Download PDF

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Publication number
WO2001000108A1
WO2001000108A1 PCT/EP2000/005868 EP0005868W WO0100108A1 WO 2001000108 A1 WO2001000108 A1 WO 2001000108A1 EP 0005868 W EP0005868 W EP 0005868W WO 0100108 A1 WO0100108 A1 WO 0100108A1
Authority
WO
WIPO (PCT)
Prior art keywords
gripping means
lumen
vessel
tissue
patch
Prior art date
Application number
PCT/EP2000/005868
Other languages
English (en)
Inventor
Carlo A. Adami
Roberto Calvi
Giuseppe Tuscano
Original Assignee
Contini, Emilio
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 Contini, Emilio filed Critical Contini, Emilio
Priority to AU58196/00A priority Critical patent/AU5819600A/en
Publication of WO2001000108A1 publication Critical patent/WO2001000108A1/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
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • 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
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • 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
    • A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • 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
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections

Definitions

  • This invention relates to a device for connecting at least one tissue-structure with a vessel for the conveyance of organic fluid, for example a blood vessel, a lymphatic vessel, a visceral conduit or similar.
  • aneurysms can form due to pathologies of the vascular system such as stenosis or atheromas.
  • Aneurysms, or saccular swellings caused by abnormal dilation of the walls of a blood vessel may even lead to the rupture of the vessel causing a haemorrhage, which may even be fatal.
  • the stenosis or the atheroma is removed using a probe and a vascular conduit is used to reconstruct the physiological tubular form of the vessel .
  • a vascular conduit is used to reconstruct the physiological tubular form of the vessel .
  • a vascular conduit or a tubular tissue- structure is sutured end-to-end or head-to-head to the end openings of the patient's recised vessel (terminal - termino anastomosis) .
  • the main difficulty with the above mentioned interventions is determined by the fact that the tissue- structure and the vascular conduit are currently connected to the vessel by suturing. This is a very invasive procedure for the patient, both due to the considerable length of time necessary for suturing the tissue-structure to the edges of the vessel, and due to the limited space in which the suture has to be made. These difficulties may cause corrugation or wrinkling of the wall of the vessel, even to the extent where an undesirable narrowing of the vessel's cross section occurs, with serious pathological consequences quoad valetudinem et vitam.
  • the aim of this invention is to create a device for connecting at least one tissue-structure to a vessel for the conveyance of organic fluids, as described above, which has the structural and functional characteristics needed to overcome the difficulties encountered in the prior art .
  • a device for connecting at least one tissue-structure to a lumen in a vessel for the conveyance of organic fluid comprising gripping means associated with said at least one tissue-structure and operatively movable between an open position, for a partially insertion into said lumen, and a closed position, in which a first portion of said gripping means grasps an external surface of a wall of the vessel and a second portion grasps an opposing internal surface of said wall, said gripping means being elastically influenced in said closed position and holding means removably holding said gripping means in said open position, characterised in that said holding means comprising circling means that are operatively releasable from a first position defining a closed ring for grouping in a bundle at least one of said first or second portions in said open position of the gripping means, to a second position of the circling means, in which the ring is open to perimetrically release the at least one of said first or second portions in said closed position of the gripping means.
  • Figure 1 shows a perspective view, partially in section, of a connecting device
  • Figures 2 and 3 show a perspective view of two details of the device in Figure 1;
  • Figure 4 shows a perspective view, partially in section, of another detail of the device shown in Figure 1;
  • Figure 5a shows a sectioned perspective view of a group of details of the device shown in Figures 2, 3 and 4;
  • Figure 5b shows a perspective view, partially in section, of the detail shown in Figure 5a according to a different embodiment
  • Figure 6 shows a first stage in the connection of the device in Figure 1;
  • Figure 7 shows the stage of insertion of the device in Figure 1 into a lumen in a vessel
  • Figure 8 shows a perspective view, marked by arrow VIII, of the device in Figure 1;
  • Figure 9 shows a perspective view, partially in section, of a detail of a device according to a further embodiment of the invention.
  • Figures 10 and 11 show a perspective view, partially in section, of the device in Figure 9;
  • Figure 12 shows a lateral section of a device according to a different embodiment of the invention.
  • Figure 13 shows, in lateral partial section, a stage of the connection of the device in Figure 12 ;
  • Figures 14, 15 and 16 show a perspective view of further embodiments of a detail of the device forming the subject of the invention.
  • Figure 17 shows a stage of the application of a device fitted with the detail in Figure 15;
  • Figure 18 shows a perspective view, partially in section, of another embodiment of the device
  • Figure 19 shows a perspective view, partially in section, of a device according to yet another embodiment of the invention.
  • Figure 20 shows a perspective view, partially in section, of an embodiment of the invention.
  • a vessel 26 for the conveyance of organic fluids for example a blood vessel 26 and in particular an artery.
  • the vessel 26 has a wall 24 defined by an external surface 40 and an internal surface 42.
  • Reference 20 indicates, as a whole, an anastomotic device, or a device for connection of a natural or synthetic tissue-structure 30 to the lumen 22 in the vessel 26.
  • the term connecting device 20 is used to identify in particular a component of a prosthesis for the connection, restoration or repair of vessels.
  • the connecting device 20 comprises gripping means or grips, indicated as a whole by 28, associated with the said tissue-structure 30.
  • the grips 28 comprise a plurality of clips 32.
  • Each clip 32 is a biocompatible structure and has arms 36, 38 placed radially around the edge 34 of vessel 26 surrounding the lumen 22.
  • the meaning of biocompatible structure is, for example, a thread or wire or plate of stainless steel (for example AISI 316) for biomedical use, or gold, platinum, titanium, polymer-based synthetic or similar biologically inert material .
  • the clip 32 has a first arm 36 and a second arm 38 which, when the clip 32 is closed, press, or grip, the external surface 40 and, respectively, the internal surface 42 of the wall 24 of the vessel 26.
  • the first and the second arms 36 and 38 are elastically biased in the closed position of the clip 32.
  • the arms 36 and 38 are joined at a central section 44.
  • the clip 32 therefore takes a shape of a letter C.
  • the central section 44 is placed transverse to the arms 36, 38, when they are in the closed position, and joins or links to said arms 36, 38 by means of curled portions or sections 46 or curls 46 delimiting openings 47.
  • the free ends 48 of the arms 36, 38 are bent towards each other inside the clip 32.
  • the said ends 48 are bent as a hook turned towards the surfaces 40,42.
  • the dimensions of the clip 32 vary according to the diameter of the vessel 26 and the lumen 22.
  • the arms 36, 38 of the clip 32 are of sufficient size to guarantee connection to the edge 34 of the lumen 22 in the vessel 26 equal at least to the extension of a stitch.
  • Connection to the edge 34 means, more precisely, a connection to the wall 24 of the vessel 26 in proximity to the edge 34 of the lumen 22.
  • the arms 36, 38 are between 1 mm and 40 mm in length, in particular between 2 mm and 15 mm and the structure of the clip 32 has cross sections of dimensions between 0.038 mm and 1.5 mm, in particular between 0.05 mm and 0.8 mm.
  • At least one arm 38 has a seat 50 designed to receive removable means for holding the clip 32 in the open position, as will be described in greater detail below.
  • the second arm 38, or arm 38 inside the vessel 26, has an arcuate section 52 placed on the outside of the clip 32, close to the hooked end 48, forming a dip which is the said seat 50 designed to receive the removable holding means ( Figure 2) .
  • These removable holding means are fitted with an element of control for their removal, which will be described in greater detail below.
  • a thread or wire ring 54 of biocompatible material is fitted into the opening 47 formed by the curls 46 of the plurality of clips 32 ( Figure 3) .
  • the wire ring 54 which links the curls 46 of the clips 32 follows the profile of the edges 34 of the lumen 22. Therefore, where the lumen 22 is made in the vessel 26 by a longitudinal incision, one of the transverse dimensions (Dl) of the connecting device 20 will be greater than the other dimension (D2) ( Figure 18) .
  • the tissue-structure 30 comprises biocompatible material shaped according to the operation to be carried out on the patient.
  • the tissue-structure 30 is shaped or cut in a sheet, in order to make a lateral connection to the vessel aimed at linking a by-pass created using a vascular prosthesis or vascular conduit 56, or by-pass connection ( Figures 1, 4, 5, 6, 7, 8, 17) .
  • the tissue-structure 30 is also shaped in such a way as to form a closure or patch-stop for a lumen in the wall of a vessel ( Figures 9, 10, 11, 18, 19 and 20), or so as to create a tubular head-to-head stretch connecting two vessels, or a end-to-end connection ( Figures 12 and 13) .
  • the tissue-structure 30 is of biocompatible material, for example of the type known as DACRO TM or other polyester materials, comprising the type known as TEFLONTM (polytetrafluoroetylene) or in TEFLONTM coated with DACRONTM, or porous polyurethane . This material is knitted or woven to form the tissue- structure 30.
  • the tissue-structure 30 comprises at least one ring patch 58 associated with grips 28 ( Figure 1) .
  • the ring patch 58 is associated with the second arm 38 of the clips 32, so as to result facing the internal surface 42 of vessel 26, when the device 20 is applied to it.
  • a tubular patch 62 is linked to the internal edge 60 of the ring patch 58.
  • Said tubular patch 62 has a first portion or stretch 64 transverse to the ring patch 58 and a second stretch 66 inclined according to the direction 67 previously established as the branching or attachment direction of the vascular conduit 56.
  • a second ring patch 70 is positioned facing the first ring patch 58 ( Figure 4) is connected to the upper edge 68 of the first stretch 64.
  • Said first ring patch 58, second ring patch 70 and said first tubular patch 64 are associated with gripping means 28, so as to hold them externally.
  • the second tubular stretch 66 is whereas associated with elastic means 72 for connection by pressure ( Figure 5) .
  • said elastic means 72 comprise at least one elastic ring with a biocompatible structure, for example a thread or a wire or a sheet of metal or synthetic biocompatible material.
  • Said biocompatible structure has a serpentine shape which extends circumferentially.
  • the various parts of the gripping means 28 and the elastic means 72 are fixed to the tissue-structure 30 so as to form a self-supporting structure. It is clear that said self-supporting structure forms an anastomosis connector for the connection of two vessels or of two sections of vessel.
  • the arms 36, 38 of the clips 32, the central section 44 of the clip 32 and the branches of the serpentine of the elastic means 72 are connected to the tissue-structure 30 by means of a series of stitches 75 in suture thread.
  • the stitches 75 in suture thread, or sutures 75 are distributed uniformly along the metallic wire of the gripping means 28 and the elastic means 72.
  • circular or elliptical patches 76 with the gripping means 28, and in particular patches in any other shape suitable for patching the lumen 22 in the wall 24 of the vessel 22, or a patch- stop ( Figures 9, 10 and 11) .
  • a circular patch 76 is associated by stitches 75 to the arm 38 to be connected internally to the vessel 26, so as to rebuild the internal wall 42 of the vessel 26 once the device 20 for connection to the lumen 22 is applied.
  • circular patches 76 are attached by stitches 75 to both the internal arm 38 and the external arm 36 of the gripping means 28, or only to the external arm 36 so as to be visible at the external surface 40 of the wall 24 of the vessel 26, once the device 20 for connection to the lumen 22 is applied.
  • the edge of the circular patch 76 is associated by stitches 75 to the central section 44 of the plurality of clips 32.
  • the gripping means 28 are associated, as described above, by means of their arm 36 external to the internal wall 82 of the free ends 84 of said patch 78 ( Figure 12) .
  • the connecting device 20 is previously prepared for the application and sealed in a sterile container, in the manner described below.
  • the plurality of clips 32 is positioned around a circumference, the arms 36, 38 are positioned radially.
  • the clips 32 are arranged equidistant from each other, with the opening of the 'C oriented for correct gripping of the edge 34 of the lumen.
  • the positioning of the clips 32 is made easier by inserting the wire rings 54, of dimensions equivalent to the perimeter of the lumen 22 to which the device 20 is to be connected, in the openings 47 of the curls 46 ( Figure 3) .
  • the ring patches 58, 70 and the tubular patches 64, 66 are linked together ( Figure 4) .
  • the tissue-structure 30 is then associated by stitches 75 to the gripping means 28 and, in this case, to the elastic means 72, creating the self-supporting structure of the connecting device 20 ( Figure 5a) .
  • the arms 38 of the clips 32 which must be introduced into the lumen 22 made in the wall 24 of the vessel 26, are grouped in a bundle or bundled and tied together using a suture thread 86, lodged in the prepared seat 50 to prevent the device 20 closing prematurely.
  • the thread 86 is wound on and then held in position by a quick release knot presenting a control end or quick release end 88.
  • the arms 38 are kept in an opening position by a releasable slipknot.
  • the ring patch 58 which circles the bundled arms 38 is placed inside the arms 38 forming lobes 90.
  • the tissue-structure 30 in this position resembles a closed umbrella ( Figure 5b) .
  • the tubular patch 66 associated with the elastic means 72 to be applied by pressure inside the end of the vascular conduit 56, is previously closed towards its axis exercising a radial pressure on the serpentine rings of the elastic means 72.
  • the end of the rings is fitted into an internal seat of an ogival applicator 92 fitted with a flexible control lever 94 positioned inside the device 20 ( Figure 6) .
  • the dimensions of the device 20 and therefore of the gripping means 28, of the tissue-structure 30, and of the elastic means 72 are decided on according to the dimensions of the vessel 26 and of the vascular conduit 56 which must be connected to it. Obviously, it may be advisable to build a plurality of devices 20 in different sizes storing them in sterile containers on the basis of the dimensions and the type of connection which can be realized with them.
  • the device is fixed to the free end of the vascular conduit 56.
  • the ogival applicator 92 is then introduced into the end opening of the vascular conduit 56 to be connected to the vessel 26 until the flange, comprising the upper ring patch 70 associated with the upper arms 36 of the gripping means 28, lies against the edge 96 of said vascular conduit 56. Then, acting on the control lever 94 (arrow “i” and w h" in Figure 6) the applicator 92 is removed from the end of the device .
  • the elastic means 72 no longer held in the applicator 92, will open radially against the internal surface of the vascular conduit 56 taking with them the tubular patch 66.
  • the applicator 92 is then extracted acting on the control lever 94 in order to pass it through the device 20 which is now spread and firmly fixed to the vascular conduit 56.
  • said elastic means 72 act by pressure against the internal surface of the vascular conduit 56 ensuring that the device 20 remains fixed to the vascular conduit 56.
  • This connection will be enveloped in the natural tissues which will form on the surfaces of the device and the conduit once these are lapped by the blood conveyed by the vessel 26. These natural tissues will create a seal between the internal surface of the vessel and the internal surface of the tissue-structure (which will eventually become enclosed in them) and the internal surface of the vascular conduit 56.
  • the device 20 fixed at the end of the vascular conduit 56 is then introduced into the lumen 22 previously made in the wall 24 of the exposed vessel 26 (arrow "g" of Figure 7) .
  • the quick release end 88 is carefully held outside the vessel 26.
  • the device 20 is introduced into the lumen 22 until the flange comprising the upper ring patch 70 associated with the upper arms 36 lies against the external surface 40 of the vessel 26.
  • the device 20 is then pressed against the wall 24 of the vessel 26 in order to anchor the hooked end 48 of the clips 32 in the wall 24.
  • the quick release end 88 in the suture thread 86 which bundles the lower arms 38
  • the quick release knot is released removing the suture thread 86, perimetrically releasing or opening the ring made by the suture thread around the device arms, and releasing the lower arms 38 of the clips 32.
  • the elastic action of the gripping means 28 pushes the lower ring patch 58 associated with the arms 38 against the internal surface 42 of the vessel 26 and anchors the hooked end 48 in the wall 24, firmly blocking the device 20 in the vessel 26 ( Figure 8) .
  • the procedure for the connection of the device 20, in the case of tissue-structure 30 as a patch-stop 74 on the lumen 22, is entirely identical to the procedure described above.
  • the device 20 for connecting at least one tissue-structure 30 on a lumen 22 in a vessel 26 for the conveyance of organic fluids is extremely rapid and precise to apply.
  • a further advantage of the invention is that the manual skill required for the application of the device is limited to the insertion of the same in the natural vessel 26 and the releasing of the threads 86, 98 and 102 which keep the arms 36 and 38 of the clips 32 bundled in an open position.
  • the device 20 forming the subject of this invention makes it possible to make connections with the same ease and efficiency as connections in larger size blood vessels 26, such as for example the aorta.
  • the reduction of the operating times also makes it possible to reduce the period for which the patient is kept under anaesthetic. Reduced operating times also make it possible to limit loss of blood and blood transfusions to the patient and, in some cases, to limit the times of extracorporeal circulation.
  • the device is to be fitted to vessels with thin walls, it is possible to use clips 32 without the central section 44.
  • the upper or external to the vessel 26 arm 36 is linked to the lower internal to the vessel 26 arm 38, by a curled stretch or a curl 110 ( Figure 14 ) .
  • the device 20 comprises two gripping means 28 positioned opposite each other and designed to hook the clips 32 into the edges of the free ends of the two vessels.
  • Said gripping means 28 are connected to one another by the use of the same wire rings 54 previously positioned alternately in the openings 47 of the curls 46 of the first of the gripping means 28 and in the corresponding openings 47 of the curls 46 of the second of the gripping means 28.
  • the arms are elastically influenced thanks to the elastic nature of the material of which the clips 32 are made.
  • separate elastic means can be used to influence the arms 36 and 38 when closing the clip 32.
  • the connecting device 20 has clips 32 in smart alloys with shape memory.
  • the clip 32 is of a smart alloy with shape memory with the phase transition in a temperature range which will hold the device in an open position when it is not installed, for example because it is cold, i.e. below the phase transition temperature, and in the closed position when it is warmed above the phase transition temperature.
  • the material in smart alloy has a phase transition temperature between 20°C and 36°C and in particular between 25°C and 30°C.
  • the connecting device is built in smart alloy with shape memory which has particular elastic characteristics throughout the working temperature range, for example from 15°C to 45°C.
  • shape memory which has particular elastic characteristics throughout the working temperature range, for example from 15°C to 45°C.
  • the gripping means 28 are formed of two opposed half-rings 120, 121 with arms 36, 38 projecting radially from the ends.
  • each half-ring 120 or 121 covers half of a circumference equal to the perimeter of the lumen 22 of the vessel 26 and lies more or less in a first plane P (more precisely the half-ring lies on a cylindrical surface corresponding to the external surface of the vessel) .
  • Two opposed arms 36 and 38 are present for each half-ring 120 or 121 at the free ends 122 and 124.
  • each clip 32 has an arm 36 protruding from the first half-ring 120 and a second arm 38 protruding from the second half-ring 121. Said first and second arms 36, 38 are opposed to each other.
  • tissue- structure 30 is associated to the gripping means 28 by means of biocompatible adhesive or glue.
  • the tissue-structure 30 can be associated to the gripping means 28 and the elastic means 72 either internally or externally.
  • the tissue-structure 30 can be placed between the gripping means 28 or the elastic means 72 and the wall 24 of the vessel 26 or the vascular conduit 56.
  • the gripping means 28 or the elastic means 72 may be placed between the tissue-structure 30 and the natural vessel 26 or the vascular conduit 56. In both cases the tissue-structure 30 will be enveloped in the natural tissues which in time will form in the area of the operation.
  • the gripping means 28 comprise a flat structure 128 of synthetic biocompatible material with elastic characteristics.
  • Said flat structure 128 comprises a circular crown 130 or ring from which a series of elastic lamellae 132 spread forming the arms 36, 38 of the clips 32 ( Figure 19) .
  • Said flat structure 128 of biocompatible synthetic material is easily constructed.
  • said flat structure can be obtained by cutting a sheet of biocompatible synthetic material, or by casting or pressing in a special die.
  • a patch 76 is associated with said flat structure.
  • the patch 76 is glued to the surface of the flat structure 128 which is placed towards the vessel.
  • the patch 76 for example a patch-stop, is glued to the surface of the circular crown 130 facing the vessel and to the lamellae 132 or arms 38 which grip the wall of the vessel from the inside ( Figure 20) .
  • a patch 76 of the same size is glued only to the circular crown 130, leaving the elastic lamellae 132 for gripping the wall of the vessel at least partially free. It is particularly advantageous, where the flat structure 128 is constructed by casting, for the patch 76 to be enveloped in the circular crown 130 during its construction ( Figure 19) .
  • Said suture thread 134 is tied in a quick release knot, so that the arms 36, 38 can be freed once the device has been inserted into the lumen closing with the pressure of the gripping means the wall of the vessel, firmly connecting the device fitted with the patch to the vessel.
  • the order in which the lamellae 132 are bundled may differ from the above description. For example, it is possible to bundle towards the side of the device which will remain outside the vessel every other lamella 132 or every third lamella 132.
  • the gripping means may comprise arms or elements which in the closed position exercise a gripping action thanks to opposing forces.
  • This closing action may be assisted by a hooking action, where suitable hook portions are provided on the arms or elements, such as, for example, the above mentioned hooked ends 48 on the arms 36, 38.
  • the proposed connecting device can be used to connect or to realise an anastomosis between conduit or vessel segments .
  • the surgical applications can be several.
  • the connecting device can be used in the abdomenal surgery or visceral surgery.
  • the proposed connecting device can be used to realise the anastomosis of intestine segments such as esophagus, stomach, duodeno, intestine, first, second and third part of small intestine, colon and rectum, as well as ureter, cistic, urinary bladder, gallbladder, and bile segments.
  • These applications can be end-to-end anastomosis (terminal-termino anastomosis) , end-to-side anastomosis (lateral-termino anastomosis) or patch-stop application to close a lumen in an analogue way as described above .

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pulmonology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un dispositif (20) destiné à relier une structure (30) tissulaire au moins à une lumière (22) à l'intérieur d'un vaisseau (26) en vue de l'acheminement de fluide organique, lequel dispositif peut être installé de manière particulièrement rapide et précise. Le dispositif comprend : des moyens de préhension associés à la structure tissulaire, pouvant fonctionnellement passer d'une position ouverte, destinée à une insertion partielle dans la lumière, à une position fermée, où une première partie de ces éléments de préhension sont en prise avec une surface externe d'une paroi du vaisseau et où une seconde partie de ces éléments sont en prise avec une surface interne opposée de ladite paroi, les moyens de préhension étant élastiquement sollicités en position fermée, et vice-versa ; et des moyens de maintien permettant de maintenir amovible les moyens de préhension en position ouverte, lesdits moyens de maintien comprenant des moyens de cerclage pouvant être fonctionnellement dégagés d'une première position définissant un anneau fermé destiné à regrouper en faisceau l'une au moins des première et seconde parties lorsque les moyens de préhension sont en position ouverte, pour passer à une seconde position, où l'anneau est ouvert de manière à libérer de façon périmétrique l'une des première et seconde parties au moins lorsque les moyens de préhension sont en position fermée.
PCT/EP2000/005868 1999-06-25 2000-06-23 Dispositif destine a relier un implant a un canal corporel WO2001000108A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU58196/00A AU5819600A (en) 1999-06-25 2000-06-23 Device for connecting an implant with a body channel

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITPCT/IT99/00189 1999-06-25
PCT/IT1999/000189 WO2001000110A1 (fr) 1999-06-25 1999-06-25 Dispositif pour poser un tampon sur un canal corporel

Publications (1)

Publication Number Publication Date
WO2001000108A1 true WO2001000108A1 (fr) 2001-01-04

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Family Applications (3)

Application Number Title Priority Date Filing Date
PCT/IT1999/000189 WO2001000110A1 (fr) 1999-06-25 1999-06-25 Dispositif pour poser un tampon sur un canal corporel
PCT/EP2000/005868 WO2001000108A1 (fr) 1999-06-25 2000-06-23 Dispositif destine a relier un implant a un canal corporel
PCT/EP2000/005927 WO2001001884A2 (fr) 1999-06-25 2000-06-26 Prothese destinee a la fermeture d'une lumiere dans un vaisseau permettant le transport d'un fluide organique

Family Applications Before (1)

Application Number Title Priority Date Filing Date
PCT/IT1999/000189 WO2001000110A1 (fr) 1999-06-25 1999-06-25 Dispositif pour poser un tampon sur un canal corporel

Family Applications After (1)

Application Number Title Priority Date Filing Date
PCT/EP2000/005927 WO2001001884A2 (fr) 1999-06-25 2000-06-26 Prothese destinee a la fermeture d'une lumiere dans un vaisseau permettant le transport d'un fluide organique

Country Status (2)

Country Link
AU (3) AU4646899A (fr)
WO (3) WO2001000110A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002058594A1 (fr) * 2001-01-26 2002-08-01 Jan Otto Solem Appareil de connexion pour anastomose
WO2010071676A3 (fr) * 2008-12-19 2010-08-19 St. Jude Medical, Inc. Systèmes, appareils et procédés pour conduits et raccords cardiovasculaires
WO2012117402A1 (fr) * 2011-03-01 2012-09-07 Seamvad Ltd. Dispositif d'anastomose
CN111249032A (zh) * 2020-01-18 2020-06-09 中国人民解放军陆军军医大学第一附属医院 腹动脉重塑装置
WO2020146763A3 (fr) * 2019-01-11 2020-09-03 The Regents Of The University Of Colorado, A Body Corporate Système et méthode de fixation d'un conduit de fluide à une structure anatomique

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US5709707A (en) * 1995-10-30 1998-01-20 Children's Medical Center Corporation Self-centering umbrella-type septal closure device
US5741297A (en) * 1996-08-28 1998-04-21 Simon; Morris Daisy occluder and method for septal defect repair
WO1998019631A1 (fr) * 1996-11-07 1998-05-14 Vascular Science Inc. Appareil et procedes de greffe chirurgicale artificielle
WO1998019629A2 (fr) * 1996-11-07 1998-05-14 Vascular Science Inc. Dispositifs de fixation et de raccord de greffes medicales
US5755775A (en) * 1995-01-23 1998-05-26 Schneider (Usa) Inc. Percutaneous stent-graft and method for delivery thereof
DE19732234A1 (de) * 1997-07-26 1999-01-28 Georg Dr Med Quatchadze Chirurgisches Instrument zur Verbindung zweier Hohlorgane
WO1999018887A1 (fr) * 1997-10-09 1999-04-22 St. Jude Medical Cardiovascular Group, Inc. Structures de connexion en fil metallique pour greffes tubulaires

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DE29714242U1 (de) * 1997-08-08 1998-12-10 Applied Biometrics, Inc., Burnsville, Minnesota Verschlußeinrichtung zum Verschließen einer körperlichen Anomalie wie Gefäßöffnung oder Öffnung in einer Scheidewand

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Publication number Priority date Publication date Assignee Title
US5242457A (en) * 1992-05-08 1993-09-07 Ethicon, Inc. Surgical instrument and staples for applying purse string sutures
US5755775A (en) * 1995-01-23 1998-05-26 Schneider (Usa) Inc. Percutaneous stent-graft and method for delivery thereof
US5709707A (en) * 1995-10-30 1998-01-20 Children's Medical Center Corporation Self-centering umbrella-type septal closure device
WO1997021403A1 (fr) * 1995-12-14 1997-06-19 Prograft Medical, Inc. Stent a greffer resistant aux plis
US5741297A (en) * 1996-08-28 1998-04-21 Simon; Morris Daisy occluder and method for septal defect repair
WO1998019631A1 (fr) * 1996-11-07 1998-05-14 Vascular Science Inc. Appareil et procedes de greffe chirurgicale artificielle
WO1998019629A2 (fr) * 1996-11-07 1998-05-14 Vascular Science Inc. Dispositifs de fixation et de raccord de greffes medicales
DE19732234A1 (de) * 1997-07-26 1999-01-28 Georg Dr Med Quatchadze Chirurgisches Instrument zur Verbindung zweier Hohlorgane
WO1999018887A1 (fr) * 1997-10-09 1999-04-22 St. Jude Medical Cardiovascular Group, Inc. Structures de connexion en fil metallique pour greffes tubulaires

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002058594A1 (fr) * 2001-01-26 2002-08-01 Jan Otto Solem Appareil de connexion pour anastomose
WO2010071676A3 (fr) * 2008-12-19 2010-08-19 St. Jude Medical, Inc. Systèmes, appareils et procédés pour conduits et raccords cardiovasculaires
US8905961B2 (en) 2008-12-19 2014-12-09 St. Jude Medical, Inc. Systems, apparatuses, and methods for cardiovascular conduits and connectors
WO2012117402A1 (fr) * 2011-03-01 2012-09-07 Seamvad Ltd. Dispositif d'anastomose
WO2020146763A3 (fr) * 2019-01-11 2020-09-03 The Regents Of The University Of Colorado, A Body Corporate Système et méthode de fixation d'un conduit de fluide à une structure anatomique
US11974748B2 (en) 2019-01-11 2024-05-07 The Regents Of The University Of Colorado System and method for attaching a fluid conduit to an anatomical structure
CN111249032A (zh) * 2020-01-18 2020-06-09 中国人民解放军陆军军医大学第一附属医院 腹动脉重塑装置
CN111249032B (zh) * 2020-01-18 2021-09-07 中国人民解放军陆军军医大学第一附属医院 腹动脉重塑装置

Also Published As

Publication number Publication date
WO2001001884A2 (fr) 2001-01-11
WO2001000110A1 (fr) 2001-01-04
AU4646899A (en) 2001-01-31
AU5535000A (en) 2001-01-22
WO2001001884A3 (fr) 2001-03-22
AU5819600A (en) 2001-01-31

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