Devices and methods for forming an anastomosis

Patent metadata

Field	Value
Publication number	US-11039838-B2
Application number	US-201816014640-A
Country	US
Kind code	B2
Filing date	Jun 21, 2018
Priority date	Feb 21, 2013
Publication date	Jun 22, 2021
Grant date	Jun 22, 2021

Abstract

Devices and methods for deploying an anastomotic stent between portions of the gastro-intestinal (GI) tract are disclosed. The anastomotic stents are configured to atraumatically engage the tissue walls and to permit the flow of fluid, partially digested food, and food. The stents can be deployed using endoscopic catheter devices, laparoscopic tools, and combinations of both endoscopic tools and laparoscopic tools. Examples of anastomoses include anastomoses between the stomach and a portion of the intestines such as the jejunum. Anastomoses can also be formed between two closed ends of the intestines, such as two closed ends of the colon formed during a colon resection procedure. Anastomoses can also be formed between a fundal pouch formed during a gastric bypass procedure and the jejunum. Laparoscopic tools are disclosed to deploy a stent by selectively removing a radial restraint on a self expanding stent with the restraint removed through the laparoscopic access points.

First claim

What is claimed is:

1. A device having a self-expanding body that comprises:
a middle region having a lumen and defining a longitudinal axis and a center plane perpendicular to the longitudinal axis;
a proximal end region and a distal end region that extend away from the longitudinal axis into retention configurations on opposite ends of the middle region when the body expands;
each retention configuration comprising at least first and second points of inflection that define first and second segments of the retention configuration;
the first segments extending from the first points of inflection toward the center plane along at least a portion of a length of the first segments, the second segments extending from the second points of inflection away from the center plane along at least a portion of a length of the second segments; and
wherein an angle of the first points of inflection defined by the first segments and the middle region is at least as great as an opposing angle of the second points of inflection defined by the first segments and the second segments.

2. The device of claim 1 , wherein the first and second segments are curved along a portion of the length of each segment.

3. The device of claim 1 , wherein the first and second points of inflection have a curved surface.

4. The device of claim 3 , wherein the curved surfaces of the first points of inflection of each retention configuration face away from the center plane and the curved surfaces of the second points of inflection of each retention configuration face toward the center plane.

5. The device of claim 1 , wherein a line passing through at least a portion of each retention configuration along a plane perpendicular to the longitudinal axis will intersect the retention configuration at four discrete points.

6. The device of claim 1 , wherein the first and second points of inflection and first and second segments of each retention configuration above or below the longitudinal axis form an S-shape or Z-shape.

7. The device of claim 1 , wherein the retention configurations on opposite ends of the middle region are configured to appose adjacent layers of bodily tissue.

8. The device of claim 1 , wherein the retention configurations are flanges.

9. The device of claim 1 , wherein each retention configuration has a diameter greater than one and one-half times a diameter of the middle region.

10. A drainage stent having a self-expanding stent body that comprises:
a middle region having a lumen and defining a longitudinal axis;
proximal and distal end regions that extend radially from the longitudinal axis into retention configurations on opposite ends of the middle region when expanded, each retention configuration defining at least first and second segment lengths of the stent body;
wherein the first segment lengths of each retention configuration extend from the middle region and the second segment lengths of each retention configuration extend from respective first segment lengths;
wherein the intersection of the middle region and the first segment lengths defines a first inflection point and the intersection of the first segment lengths and second segment lengths defines a second inflection point; and
wherein an angle of the first inflection point is 90 degrees or less, and an opposing angle of the second inflection point is 90 degrees or less.

11. The drainage stent of claim 10 , wherein the second segment lengths are shorter than the first segment lengths.

12. The drainage stent of claim 10 , wherein the first and second inflection points and first and second segment lengths of each retention configuration above or below the longitudinal axis form an S-shape or Z-shape.

13. The drainage stent of claim 10 , wherein an end of the first segment length of each retention configuration that is furthest from the longitudinal axis terminates at a distance along the longitudinal axis that is closer to a center plane of the middle region than the first inflection point.

14. The drainage stent of claim 10 , wherein the retention configurations on opposite ends of the middle region are configured to appose adjacent layers of bodily tissue.

15. The drainage stent of claim 10 , wherein the retention configurations are flanges.

16. The drainage stent of claim 10 , wherein each retention configuration has a diameter greater than one and one-half times a diameter of the middle region.

17. A drainage device having a device body that comprises:
a middle region having a lumen and defining a longitudinal axis and a center plane perpendicular to the longitudinal axis;
proximal and distal end regions that extend radially from the longitudinal axis into flanges on opposite ends of the middle region when expanded, each flange comprising at least first and second points of inflection that define first and second segments of the flange, the second points of inflection being further spaced radially from the longitudinal axis than the first points of inflection, and the second points of inflection closer than the first points of inflection to the center plane along the longitudinal axis; and
wherein the flanges on the opposite ends of the middle region touch planes that are parallel to the longitudinal axis, at least one plane each above and below the longitudinal axis, at at least two separate points along the parallel planes.

18. The device of claim 17 , wherein the device body is self-expanding and comprises a woven nitinol filament braid of a shape memory material, and wherein the woven nitinol filament braid comprises multiple filaments or a single filament.

19. The device of claim 17 , wherein the flanges on opposite ends of the middle region are configured to appose adjacent layers of bodily tissue.

20. The device of claim 17 , wherein each flange has a diameter greater than one and one-half times a diameter of the middle region.

Assignees

• Boston Scient Scimed Inc

Inventors

• Binmoeller Kenneth F
• Brown Peter
• Lepulu Keke
• Donovan Ryan

Classifications

• A61B17/1114 Primary

  of the digestive tract, e.g. bowels or oesophagus · CPC title

• A61B2017/0034

  adapted to be inserted through a working channel of an endoscope · CPC title

• A61B2017/00867

  shape memory effect · CPC title

• A61B2090/378

  using ultrasound · CPC title

• A61B2017/1135

  End-to-side connections, e.g. T- or Y-connections · CPC title