WO2006081174A2 - Procedes et dispositifs d'agrafage de tissus mous - Google Patents

Procedes et dispositifs d'agrafage de tissus mous Download PDF

Info

Publication number
WO2006081174A2
WO2006081174A2 PCT/US2006/002270 US2006002270W WO2006081174A2 WO 2006081174 A2 WO2006081174 A2 WO 2006081174A2 US 2006002270 W US2006002270 W US 2006002270W WO 2006081174 A2 WO2006081174 A2 WO 2006081174A2
Authority
WO
WIPO (PCT)
Prior art keywords
soft tissue
cartridge
stapling
staples
sleeve
Prior art date
Application number
PCT/US2006/002270
Other languages
English (en)
Other versions
WO2006081174A3 (fr
Inventor
Brian Kelleher
Bryan Knodel
Original Assignee
Brian Kelleher
Bryan Knodel
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 Brian Kelleher, Bryan Knodel filed Critical Brian Kelleher
Publication of WO2006081174A2 publication Critical patent/WO2006081174A2/fr
Publication of WO2006081174A3 publication Critical patent/WO2006081174A3/fr

Links

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
    • 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
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • 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
    • A61B2017/1157—Staplers for performing anastomosis in a single operation applying the staples radially

Definitions

  • the present invention relates to devices and methods for placing staples into soft tissues and in particular, to stapling columns of staples.
  • the preferred methods and devices described herein provide for improved methods and devices for tissue stapling, and, in particular, for stapling single or multiple columns of staples into soft tissue.
  • the device is sized to be positioned in the body with the aid of an endoscope and in one embodiment the device is coupled directly to the end of an endoscope for placement into the body.
  • the device has a housing containing multiple staple cartridges positioned within the housing and arranged radially around the housing with each cartridge capable of delivering a column of staples.
  • a further aspect of the invention is a stapler that has a first configuration in which the radially arranged cartridges form essentially the same outside diameter as the housing.
  • the device uses an activation member capable of moving the cartridges radially outward from the housing to a second configuration where the cartridges are adjacent to soft tissue.
  • the activation member is also capable of deploying a column of staples from the cartridges into the soft tissue.
  • a further aspect of the invention is a stapler that is capable of delivering a single column of staples to soft tissue or a circular array of staples to surrounding soft tissue.
  • One possible benefit of the circular array is to staple to a tubular body organ such as an esophagus, intestine, duct or vessel.
  • a further aspect of the invention is a stapler that may also be used to drive staples through a tubular sleeve covering the stapling mechanism and into surrounding tissue. The device may be useful in attaching a sleeve to a tubular organ such as an esophagus, intestine, duct or vessel.
  • the device may be effective in attaching a sleeve to a tubular body organ such as a duodenum, jejunum, ileum or colon.
  • a sleeve so attached to the small intestine could be useful to limit the amount of nutrients that could be absorbed by the body in a procedure to control obesity.
  • the sleeve could also be used as a shield to protect the lining of the intestines from normal digestive flow so that a portion of the intestines could heal after infection, trauma, wounds, anastomosis or disease such as inflammatory bowel disease.
  • FIG. Ia is a schematic view of one embodiment of a stapling device shown coupled to the end of a flexible endoscope
  • FIG. Ib is a schematic view of another embodiment of a stapling device shown coupled to the end of a flexible endoscope
  • FIG. 2 is a close-up perspective view of the stapling device showing an array of staple rows in a retracted configuration
  • FIG. 3 is a schematic view of the stapling device of FIG. 1 showing the actuating wires extending from the working lumen of a flexible endoscope;
  • FIG. 4 is a perspective view of the stapling device of FIG. 2 in an expanded condition
  • FIG. 5 is a schematic view of the stapling device of FIG. 4 with the staples fully formed;
  • FIG. 6 is a partial schematic view of a single staple cartridge assembly with the staples fully formed;
  • FIG. 7 is a section view of the staple cartridge
  • FIG. 8 is a detailed section view of the stapling mechanism
  • FIG. 9 is an alternate detailed section view of the stapling mechanism
  • FIG. 10a is a schematic view of the staple cartridge in a collapsed configuration with the cartridge body and casing removed;
  • FIG. 10b is a schematic view of the staple cartridge of FIG. 10a with the staple in the fully formed position;
  • FIG. 11 is a schematic view of the staple cartridge with the staple in the fully formed position
  • FIG. 12 is a section view of the staple in the fully formed position
  • FIG. 13 is a perspective view of the stapler of FIG. 4 showing an array of staple rows in an expanded configuration and the staples deployed;
  • FIG. 14a is a perspective view of an alternative embodiment of the stapling device with a sleeve encasing a retracted staple cartridge
  • FIG. 14b is a perspective view of an alternative embodiment of the stapling device with a sleeve encasing an expanded staple cartridge
  • FIG. 15a is a perspective view of FIG. 14b with staples deployed through the sleeve;
  • FIG. 15b is a section view of FIG. 15a with staples deployed through the sleeve and soft tissue;
  • FIG. 16 is a perspective view of an alternate embodiment of FIG. 15a with a sleeve encasing an expanded array and with staples deployed through the sleeve.
  • FIG. 1-13 depict one embodiment of a stapling device 100 for placing staples into soft tissue.
  • the stapling device 100 is sized to be able to be introduced to the patient through the esophagus or rectum.
  • the stapling device 100 may also be sized to accommodate other anatomical vessels, passageways, ducts or tubular organs of the body. In other words, although a particular size is illustrated, it is expected that the size can be increased or further reduced to be compatible with the anatomical conditions necessary.
  • the stapling device has an approximate outer diameter similar to an endoscope 200.
  • the stapling device 100 has a generally cylindrical shape and is designed to be passed easily into a body organ or particularly a tubular organ. The stapling device 100 is particularly suited for the use in the esophagus, stomach or intestines.
  • the stapling device 100 is shown in Figure 1 coupled to the end of an endoscope 200.
  • the stapling device 100 has a center axis that may be coincident with the center axis of the endoscope 200 or may be offset from the axis of the endoscope as will be further explained later.
  • the locational terms proximal and distal used herein refer to the location of the device relative to the entrance point in the body. That entrance point i may be the mouth, nose, anus, urethra or a surgical puncture or cut.
  • a proximal location would refer to a position closer to the body entrance site and distal would refer to a position inside the body and further away from the body entrance site.
  • the stapling device 100 is coupled to the endoscope 200 with an attachment element 102.
  • the attachment element 102 is designed to couple the stapling device 100 to the end of the endoscope 200.
  • the stapling device 100 would have an opening down the center of the device that would permit the use of the endoscope optical system. In this way the operator would be able to visualize the target location for the application of the staples and then direct the stapling device 100 to that site.
  • the stapling device 100 may also be attached to the side of the endoscope 200 using other attachment means. In this configuration the stapling device 100 could be coupled to the endoscope in a side-by-side orientation whereby the device is positioned alongside one of the outside edges of the endoscope.
  • the stapling device 100 is coupled to the endoscope such that the device partially overlaps the diameter of the endoscope in a manner that the working lumens of the endoscope are covered but the optics and light source lumens are unrestricted.
  • the attachment element 102 may be a flexible collar that attaches to the end of the stapling device 100 and endoscope 200 with friction.
  • Other mechanical attachments are possible including but not limited to bayonet, press fit, threaded, or screwed attachments. The attachment should be secure so that the stapling device 100 does not separate under normal endoscopic manipulations of the endoscope 200.
  • the stapling device 100 may be coupled to the endoscope prior to introduction to the patient's body or may be introduced separately and then coupled to the endoscope inside the body. However it is also anticipated that the stapling device may be operated without direct attachment to the endoscope but still use endoscopic guidance for positioning inside the body.
  • the stapling device 100 is constructed with a generally cylindrical housing 121 that is shown coupled to the attachment element 102.
  • the housing 121 has openings 122 formed or cut into its sides. These openings 122 are rectangular shaped and are sized to accommodate at least one elongated staple cartridge 120 that is arranged parallel to the long axis of the housing 121.
  • multiple staple cartridges 120 are positioned in the housing in multiple openings 122 located in the housing 121 and arranged around the long axis of the housing 121 as shown in Figure 2. These cartridges 120 are coupled to the housing but the position of these cartridges 120 relative to the housing 121 can change.
  • the cartridges 120 are shown having a first configuration or a retracted position in which the outside diameter of the cartridges 120 is essentially the same as the outside diameter of the housing 121 and close to the diameter of the endoscope. In this first configuration, the cartridges 120 lie along the longitudinal axis of the stapling device 100.
  • the stapling cartridges 120 have a deployment and stapling mechanism that is actuated by actuation members 105 as shown in Figures 2 and 3. These members 105 are coupled to the stapling cartridges 120 at one end and may pass through the housing 121 the collar 102 and into the working lumen 106 of the flexible endoscope 200 so that they can be manipulated by the operator outside the patient's body. Alternatively these members 105 could pass alongside the outside of the stapling device and/or endoscope. Each stapling cartridge 120 may be coupled to an individual actuation member 105.
  • actuation member 105 This permits the activation of a single actuation member 105 at one time for activation of a single cartridge 120 and deployment of a single column of staples.
  • more than one member 105 can be activated at a time for activation of multiple cartridges 120 for simultaneous deployment of more than one column of staples.
  • all the stapling cartridges 120 may be coupled to a single actuation member 105 so that all the stapling cartridges 120 may be activated together as one unit.
  • the position of the cartridges 120 relative to the housing 121 may be modified so that the stapling cartridges 120 are positioned in a second or expanded configuration as shown in Figure 4.
  • the stapling cartridges 120 form an outer diameter that is larger than the outer diameter of the housing 121.
  • the stapling device 100 can be small enough for introduction through an esophagus in the first or retracted configuration and can expand to a second configuration with a larger diameter that is beneficial to position the stapling cartridges 120 next to soft tissue.
  • the stapling device 100 can be expanded 0.5-3 times its original diameter to bring the stapling cartridges 120 adjacent to the inner walls of the soft tissue such as an esophagus, stomach or intestine.
  • the cartridges 120 are coupled to the housing 121 of the stapling device with a linkage system 126 as shown in Figure 5.
  • the linkage system 126 is comprised of an upper linkage pair 130 and a lower linkage pair 132. These linkage pairs have holes at both the inside 131 and outside 133 ends and are hingedly attached to the upper cartridge end 134 and the lower cartridge end 136 with outside pivot elements 137.
  • the upper linkage pairs 130 and the lower linkage pairs 132 are also hingedly attached to the side walls 139 of the openings 122 in the housing 121 with inside pivot elements 138.
  • pivot elements 137 and 138 act as pivot pins that can be driven through the holes in the linkage pairs 130 and 132 and through holes in the stapling cartridges 120 and the side walls 139 of the openings 122.
  • the actuation member 105 enters the cartridge at point A and its distal end is attached to the inside mechanism of the cartridge.
  • the actuation members 105 are initially positioned on the outside of the housing 121 but then re-enter the housing 121 through window 141 and travel through the stapling device 100 and into the working lumen 106 of the endoscope 200.
  • the cartridges move between a first or collapsed configuration and a second or expanded configuration.
  • the cartridges and their linkages pairs can be coupled to the housing in such a way that as the actuation member 105 is moved in a distal direction parallel to the axis of the housing 121, the cartridges move between a first or collapsed configuration and a second or expanded configuration.
  • the cartridges 120 house a staple mechanism that deploys box type staples 140 into soft tissue adjacent to the expanded cartridge. This mechanism is actuated by the operator by pulling on at least one of the actuation members 105.
  • the cartridges 120 are shown in the expanded condition with the staples 140 deployed in Figure 5.
  • a single cartridge is enabled at a time so that one column of staples is deployed at once.
  • more than one cartridge is enabled at a time thus deploying several columns of staples at a time.
  • the soft tissue is not shown in Figure 5 but the staples would be embedded in surrounding adjacent tissue when deployed as shown.
  • Figure 6 shows a close-up view of an isolated cartridge assembly with an upper linkage pair 130, pivot element 137 and formed staples 140.
  • the cartridge 120 is designed to form a box staple 140 from a piece of wire.
  • the stapling cartridge 120 is an assembly constructed using a casing 150 that is attached to the linkage system 126 using pivot elements 138.
  • the casing 150 encloses the body 152, driver 154, former 156, the wedge 158 and the distal end of the actuation member 105 as shown in Figure 7.
  • the wedge 158 is attached to the distal end of the actuating member 105 and the wedge 158 can be configured so that it can move along a small track 160 formed along the inside edge of the casing 150.
  • actuation members could be provided with one actuation member to move the stapling cartridges 120 from the retracted position to the expanded position and another to actuate the staple forming process independently from each other.
  • a pulling force is applied to the actuation member 105, a force is transferred to the wedge 158 that moves it forward in the direction of arrow A until it contacts the first driver 154.
  • the linkage system 126 first rotates about the pivot element 138 and the casing 150 moves from the retracted position to the expanded position. The linkage system 126 continues to rotate as shown until the rotational movement is prevented.
  • the housing has a stopper 151, shown in Figure 5 that is formed on the side of the opening 122 that prevents the linkage system 126 from rotating more than 90°.
  • This stopper may be a welded bump or a formed or bent piece of the housing openingl22 that is positioned on the opening edge.
  • the stapler cartridge 120 moves from the retracted to the expanded configuration, it is possible that the cartridge will contact the inner walls of a tubular body organ such as an esophagus or intestine before one of the linkage pairs contacts the stopper. In this case the body organ will stop the movement of the cartridge 120. This is an advantageous condition because it insures that the stapler cartridge 120 will be firmly seated against the target tissue site before the stapler is activated.
  • the driver moves upward in the direction of arrow C until it hits the bottom of the staple 140 and it begins to move the pre-formed staple 140 upward.
  • the upward movement of the staple is next prevented by the end 159 of the former 156.
  • the staple 140 is now confined between the driver 154 and the end of the former 159.
  • the middle of the staple 140 is bent flat which forces the outside edges to move outward eventually forming a box shape.
  • the former 156 is moved in the direction of the arrow D as shown in Figure 9. This moves the former 156 out of way of the now fully formed staple 140.
  • the wedge is designed to pass under the driver 154 and be pulled until the next driver 154a is contacted.
  • the wedge 158 moves driver 154a in a similar manner as driver 154. This occurs in sequence until the last driver in the column is moved and the last staple in the cartridge is driven into the adjacent soft tissue.
  • a stapling cartridge 120 may have as many wedges as there are drivers in the stapling mechanism so that every staple can be driven into adjacent soft tissue in the cartridge column at the same time.
  • the stapling cartridge 120 can be returned back to the retracted position by pushing on the actuation member 105 opposite to arrow A. Because the wedge 158 is prevented from moving opposite to arrow A by the driver 154, as the actuation member 105 is pushed, the linkage system 126 now rotates in the opposite direction as arrow B and causes the casing to move until the cartridge 120 is once again retracted inside the housing 121. In this configuration, the cartridge and the housing once again have a similar outside diameter. Alternatively, the cartridge 120 could employ a spring system to return the cartridge 120 back to the retracted position once the force on the actuation member 105 is released. [40] Figure 10a shows a cartridge assembly with the casing 150 and the body 152 removed for clarity.
  • the pre-formed shape of the staple 140 is shown prior to bending.
  • the driver 154 As the wedge 158 moves in the direction of the arrow, the driver 154 is moved in a direction perpendicular to the arrow and strikes the staple 140 at points 180 and 181. Since the staple apex 183 is restrained by the end of the former 159, the staple bends about its apex 183 until formed into a box shape as shown in Figure 10b. As the movement of the driver continues as described, the driver 154 next contacts the former 156. At this point the end of the former 159 is shown retracted away from the apex 183 of staple 140.
  • the stapling cartridge 120 is shown in Figure 11 with the former 156 retracted and the fully formed box staple 140 protruding out of the casing 150. As the stapling cartridge is retracted, the staple which is attached to soft tissue remains behind attached to the soft tissue.
  • a stapling cartridge 120 may have only one staple mechanism but preferably more than one staple mechanism is configured inside each casing 150.
  • FIG. 12 The assembly of all the working parts of the stapling mechanism except the wedge is shown in Figure 12.
  • the driver 154 is shown displaced upward by the wedge 158 the maximum distance until it contacts the body 152 at plane 185.
  • the former 156 is displaced by the driver 154 until it contacts the body 152 at plane 186 and the staple 140 is fully formed.
  • the staple 140 is formed perpendicular to the stapling device 100 axis.
  • the staple 140 could be formed parallel to the cable axis. This is accomplished by rotating the staple mechanism 90° as compared to the cable axis.
  • the fully deployed stapling device 100 is shown in Figure 13 with the stapling cartridges 120 extended, the staples deployed and the actuation member 105 outside the lower portion of the. housing 121 but inside the upper portion of the housing 121.
  • the extension of the stapling cartridges 120 and the deployment of the staple 140 can be actuated independently with independent actuation members 105. This would allow the location of the extended stapling cartridges 120 to be confirmed prior to stapling.
  • a single stapling cartridge 120 can be actuated independently from other stapling cartridges 120.
  • the extension of the stapling cartridges 120 and the deployment of the staple 140 can also be actuated at the same time utilizing the same or different actuation members.
  • multiple stapling cartridges 120 can be actuated simultaneously so as to deploy staples in columns around a cylinder.
  • the stapling device 100 may be used to attach sleeves to the soft tissue walls found inside cavities or vessels of the body. Examples of these are the esophagus, smaller portions of the stomach, the small and large intestines or blood vessels.
  • a sleeve 300 as shown in Figure 14a may be positioned over the stapling device 100 prior to insertion into the body or placed over the stapling device 100 once inside the body.
  • the sleeve 300 has a collapsed configuration that has an effective diameter similar to that of the retracted stapling cartridges 120.
  • the sleeve 300 can be expanded to a second configuration with a larger diameter by the cartridges 120 when they are expanded as previously described.
  • the sleeve 300 may be folded in the collapsed state and then unfolded to its maximum diameter when the cartridges 120 expand.
  • the sleeve 300 may also be constructed from an elastic material so that the sleeve expands from a first configuration with a diameter close to that of the retracted cartridge 120 to a second expanded condition when the cartridge subassembly is expanded.
  • the cartridges 120 are shown in Figure 14a in the collapsed condition.
  • the cartridges 120 can then be expanded until the cartridges 120 approximate the diameter of the inside diameter of the target organ. In this expanded condition, the sleeve 300 is positioned between the expanded cartridges 120 and the inside diameter of the target organ as shown without any staples in Figure 14b.
  • the staple 140 pierces the sleeve 300 before penetrating the tissue as shown in Figure 15a. This action attaches the sleeve 300 to the soft the tissue with multiple staples placed in columns around the perimeter of the sleeve.
  • the staple is sized to penetrate the sleeve 300 and multi layers of soft tissue 350 as shown in Figure 15b. By penetrating the tissue layers a firm anchor to the tissue is possible.
  • the placement of multiple columns of staples may provide a secure and stable attachment to the target organ or vessel and may prevent the leakage of body fluids or food in between the organ or vessel and the sleeve.
  • the staples 140 can also be formed longitudinally so that they are formed parallel to the actuating cable axis.
  • Figure 16 illustrates this condition when used in conjunction with a sleeve 300.
  • the staples 140 are placed through the sleeve 300 in a similar fashion to the configuration shown in Figure 15 a.
  • the column of staples is perpendicular to the staples shown in Figure 15 a.
  • the staples can be placed at any angle convenient and are not limited to any particular orientation.
  • the sleeve 300 can be manufactured from various materials to modify the permeability of the sleeve 300 so that the sleeve 300 restricts the passage of substances across it or enhances the passage of others.
  • the sleeve 300 is made of a non-permeable material that does not allow the passage of biochemical substances, nutrients, liquids or gases to diffuse across it.
  • the sleeve is made of a semi-permeable membrane that selectively permits certain biochemical substances, nutrients, liquids and gases to diffuse across it.
  • the permeability of the sleeve 300 may be engineered to restrict molecules of a certain molecular weight or size.
  • the sleeve 300 may be designed to chemically bond with certain substances so that they are not able to pass through the sleeve 300.
  • the sleeve 300 may be coated with various pharmacological agents or chemical coatings enhance or inhibit biological or chemical reactions. Varying the permeability of the sleeve 300 may have important uses. For example it may be beneficial to staple a tubular membrane to the inside of the intestine that selectively permits the passage of certain vitamins, amino acids, hormones, biochemicals or nutrients that are generally good for the body while blocking the passage of other substances across the membrane. Particularly this may be useful for the treatment of obesity.
  • the sleeve 300 could be positioned along portions of the stomach or the small or large intestines as a way to modify the digestion of food by an obese patient.

Abstract

Les procédés et dispositifs selon l'invention constituent des procédés et des dispositifs améliorés d'agrafage de tissus, et, en particulier, d'agrafage d'un réseau circulaire d'agrafes. Lesdits procédés et dispositifs peuvent être particulièrement utiles pour le placement de colonnes d'agrafes dans un manchon qui recouvre le mécanisme d'agrafage et dans les tissus environnants. Ceci peut être utile pour l'agrafage de manchons tubulaires sur des organes tubulaires.
PCT/US2006/002270 2005-01-24 2006-01-23 Procedes et dispositifs d'agrafage de tissus mous WO2006081174A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US64635605P 2005-01-24 2005-01-24
US60/646,356 2005-01-24

Publications (2)

Publication Number Publication Date
WO2006081174A2 true WO2006081174A2 (fr) 2006-08-03
WO2006081174A3 WO2006081174A3 (fr) 2007-07-12

Family

ID=36740975

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2006/002270 WO2006081174A2 (fr) 2005-01-24 2006-01-23 Procedes et dispositifs d'agrafage de tissus mous

Country Status (1)

Country Link
WO (1) WO2006081174A2 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008120184A3 (fr) * 2007-03-29 2008-12-11 Es Vascular Ltd Dispositif pour attacher un accessoire médical tubulaire à un passage corporel
EP2352437A1 (fr) * 2008-11-10 2011-08-10 Barosense, Inc. Systèmes d'agrafage à déclenchement multiple et procédés d'apport d'ensembles d'agrafes
US9089326B2 (en) 2011-10-07 2015-07-28 Ethicon Endo-Surgery, Inc. Dual staple cartridge for surgical stapler
EP3097866A1 (fr) * 2015-05-27 2016-11-30 Covidien LP Dispositif d'agrafage de tige-poussoir en rafale
US9999408B2 (en) 2011-09-14 2018-06-19 Ethicon Endo-Surgery, Inc. Surgical instrument with fluid fillable buttress
WO2022130274A1 (fr) * 2020-12-16 2022-06-23 Medizinische Universität Wien Dispositif de pose d'un implant

Families Citing this family (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8998059B2 (en) 2011-08-01 2015-04-07 Ethicon Endo-Surgery, Inc. Adjunct therapy device having driver with cavity for hemostatic agent
US9492170B2 (en) 2011-08-10 2016-11-15 Ethicon Endo-Surgery, Inc. Device for applying adjunct in endoscopic procedure
US9101359B2 (en) 2011-09-13 2015-08-11 Ethicon Endo-Surgery, Inc. Surgical staple cartridge with self-dispensing staple buttress
US8998060B2 (en) 2011-09-13 2015-04-07 Ethicon Endo-Surgery, Inc. Resistive heated surgical staple cartridge with phase change sealant
US9254180B2 (en) 2011-09-15 2016-02-09 Ethicon Endo-Surgery, Inc. Surgical instrument with staple reinforcement clip
US9125649B2 (en) 2011-09-15 2015-09-08 Ethicon Endo-Surgery, Inc. Surgical instrument with filled staple
US9393018B2 (en) 2011-09-22 2016-07-19 Ethicon Endo-Surgery, Inc. Surgical staple assembly with hemostatic feature
US9198644B2 (en) 2011-09-22 2015-12-01 Ethicon Endo-Surgery, Inc. Anvil cartridge for surgical fastening device
US8985429B2 (en) 2011-09-23 2015-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling device with adjunct material application feature
US8899464B2 (en) 2011-10-03 2014-12-02 Ethicon Endo-Surgery, Inc. Attachment of surgical staple buttress to cartridge

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5957363A (en) * 1994-06-17 1999-09-28 Elf Atochem S.A. Method of performing vascular anastomosis

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5957363A (en) * 1994-06-17 1999-09-28 Elf Atochem S.A. Method of performing vascular anastomosis

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8042720B2 (en) 2007-03-29 2011-10-25 Es Vascular Ltd. Device for affixing of tubular medical accessory to a body passage
WO2008120184A3 (fr) * 2007-03-29 2008-12-11 Es Vascular Ltd Dispositif pour attacher un accessoire médical tubulaire à un passage corporel
US10368862B2 (en) 2008-11-10 2019-08-06 Boston Scientific Scimed, Inc. Multi-fire stapling methods
EP2352437A4 (fr) * 2008-11-10 2014-04-16 Barosense Inc Systèmes d'agrafage à déclenchement multiple et procédés d'apport d'ensembles d'agrafes
US9451956B2 (en) 2008-11-10 2016-09-27 Boston Scientific Scimed, Inc. Multi-fire stapling systems
EP2352437A1 (fr) * 2008-11-10 2011-08-10 Barosense, Inc. Systèmes d'agrafage à déclenchement multiple et procédés d'apport d'ensembles d'agrafes
US11202627B2 (en) 2008-11-10 2021-12-21 Boston Scientific Scimed, Inc. Multi-fire stapling systems and methods for delivering arrays of staples
US9999408B2 (en) 2011-09-14 2018-06-19 Ethicon Endo-Surgery, Inc. Surgical instrument with fluid fillable buttress
US9089326B2 (en) 2011-10-07 2015-07-28 Ethicon Endo-Surgery, Inc. Dual staple cartridge for surgical stapler
EP3097866A1 (fr) * 2015-05-27 2016-11-30 Covidien LP Dispositif d'agrafage de tige-poussoir en rafale
US10172615B2 (en) 2015-05-27 2019-01-08 Covidien Lp Multi-fire push rod stapling device
US10912564B2 (en) 2015-05-27 2021-02-09 Covidien Lp Multi-fire push rod stapling device
WO2022130274A1 (fr) * 2020-12-16 2022-06-23 Medizinische Universität Wien Dispositif de pose d'un implant

Also Published As

Publication number Publication date
WO2006081174A3 (fr) 2007-07-12

Similar Documents

Publication Publication Date Title
WO2006081174A2 (fr) Procedes et dispositifs d'agrafage de tissus mous
US7757924B2 (en) Single fold system for tissue approximation and fixation
US7229428B2 (en) Method and device for use in endoscopic organ procedures
CN101044973B (zh) 用于与内窥镜连接的连接装置
CN101044972B (zh) 带有辅助真空源的内窥镜器械
CN102186436B (zh) 用于管状体部的衬垫以及用于施加衬垫的设备和方法
JP5172209B2 (ja) 内視鏡胃制限法および装置
CN101045003B (zh) 用于外科缝合器械的可调节真空室
JP4531514B2 (ja) 内腔間吻合のための単一内腔配置用リング
CN101045001B (zh) 带有可拆卸的手柄的外科缝合器械
JP4658556B2 (ja) 単一内腔アクセス吻合術用のファスナーアプライヤー
US7097650B2 (en) System for tissue approximation and fixation
JP4331496B2 (ja) 案内管
JP2008502421A (ja) 経管腔胃腸手順を実施するための装置および方法
US20090012356A1 (en) Endoscopic delivery devices and methods
EP2427152B1 (fr) Système d'implant endoscopique
EP2352436A1 (fr) Méthode et dispositif d'acquisition de tissu
JP2010503460A (ja) 内視鏡的褶襞形成術装置および方法
WO2013026474A1 (fr) Dispositifs et procédés d'ancrage d'un manchon endoluminal dans le tractus gastro-intestinal
RU2426508C2 (ru) Сгибающийся аппликатор анастомозного кольца
JP5389319B2 (ja) 可撓性内視鏡吻合リングアプライヤー装置
BRPI0601512B1 (pt) Instrumento cirúrgico para implantar um dispositivo de anel anastomótico em um campo de anastomose
EP4302731A1 (fr) Dispositif de fourniture d'un implant gastro-intestinal
ES2341786T3 (es) Dispositivo de plegado simple para la fijacion de tejidos.
WO2012007050A1 (fr) Système et procédé pour modifier le site auquel les sécrétions biliopancréatiques interagissent avec le tractus gastro-intestinal

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application
122 Ep: pct application non-entry in european phase

Ref document number: 06719219

Country of ref document: EP

Kind code of ref document: A2