Full eversion anastomosis juncture formation and suturing

Patent metadata

Field	Value
Publication number	US-2022022874-A1
Application number	US-202117499245-A
Country	US
Kind code	A1
Filing date	Oct 12, 2021
Priority date	May 8, 2018
Publication date	Jan 27, 2022
Grant date	—

Abstract

Disclosed embodiments include apparatuses, systems, and methods for facilitating anastomosis between bodily passages. In an illustrative embodiment, an eversion mechanism is configured to engage a first external surface of a receiving passage adjacent a first opening in the receiving passage in order to create a receiving flange presenting a first interior face. A donor support mechanism is configured to support a donor passage with an opening in an end in an everted position that forms a donor flange presenting a second interior face. The donor support mechanism is further configured to present the second interior face of the donor flange against the first interior face of the receiving flange to present a passage juncture. A suturing mechanism is configured to motivate a filament through a helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage.

First claim

1 - 20 . (canceled)

21 . A method comprising:
at a first opening in a side of a receiving passage, everting a first edge of the first opening around a periphery of the first opening to form a receiving flange that presents a first interior face; providing a donor passage that has an end that terminates in a second opening; everting a second edge of the second opening to form a donor flange that presents a second interior face; positioning the second interior face of the donor passage adjacent the first interior face of the receiving passage to form a passage juncture; and motivating a filament along a helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage.

22 . The method of claim 21 , further comprising applying opposing guide sections to opposing sides of the passage juncture, wherein opposing interior faces of the opposing guide sections define a helical channel.

23 . The method of claim 22 , wherein motivating the filament is performed by moving a flexible needle configured to receive an end of the filament.

24 . The method of claim 23 , wherein motivating the filament along the helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage is performed by driving the flexible needle through the helical channel.

25 . The method of claim 21 , further comprising forming the first opening in a side of a receiving passage.

26 . The method of claim 21 , wherein everting the first edge of the first opening is performed by applying suction to a first exterior surface of the receiving passage around the periphery of the first opening.

27 . The method of claim 21 , wherein everting the second edge around the opening in the end of the donor passage is performed by applying suction to a second exterior surface around the opening in the end of the donor passage.

28 . The method of claim 21 , wherein everting the second edge around the end of the donor passage is performed by mechanically everting the opening in the end of the donor passage.

29 . The method of claim 21 , wherein the receiving passage includes a coronary artery and the donor passage includes a saphenous vein.

30 . The method of claim 29 , further comprising making a subxiphoid incision to provide access to a heart.

31 . An apparatus comprising:
a first mechanism configured to engage a first external surface of a first tissue and to hold the first external surface in place in order to present a first flange presenting a first interior face opposite the first external surface; a second mechanism configured to engage a second external surface of a second tissue and to hold the second external surface in place in order to present a second flange presenting a second interior face opposite the second exterior surface and to position the second interior surface of the second flange against the first interior face of the first flange at a juncture; and at least one guide section configured to be disposed adjacent to the juncture of the first flange and the second flange and having an interior surface configured to guide a needle and a filament drawn by the needle through at least one of the first flange and the second flange.

32 . The apparatus of claim 31 , wherein the first mechanism includes a first suction device configured to apply suction to the first external surface to hold the first tissue in place to present the first interior face.

33 . The apparatus of claim 31 , wherein the at least one guide section includes a first guide section operably coupled with the first mechanism and having a first inner face configured to receive the needle and guide the needle through the first flange.

34 . The apparatus of claim 33 , wherein the at least one guide section includes a second guide section operably coupled with the second mechanism and having a second inner face configured to receive the needle and guide the needle through the second flange.

35 . The apparatus of claim 34 , wherein the first inner face of the first guide section and the second inner face of the second guide section are configured to be opposingly positioned to define a helical channel to guide the needle alternately through the first flange and the second flange, wherein the filament drawn by the needle forms a suture joining the first flange and the second flange.

36 . A system comprising:
a first mechanism configured to engage a first external surface of a first tissue and to hold the first external surface in place in order to present a first flange presenting a first interior face opposite the first external surface; a second mechanism configured to engage a second external surface of a second tissue and to hold the second external surface in place in order to present a second flange presenting a second interior face opposite the second exterior surface and to position the second interior surface of the second flange against the first interior face of the first flange at a juncture; a first guide section operably coupled with the first mechanism and having a first inner face disposable adjacent to the first flange at the juncture and configured to receive a needle and guide the needle through the first flange; a second guide section operably coupled with the second mechanism and having a second inner face disposable adjacent to the second flange at the juncture and configured to receive the needle and guide the needle through the second flange; and a suturing mechanism configured to motivate the needle through the first guide section and the second guide section, wherein a filament drawn by the needle to form a suture joining the first flange and the second flange.

37 . The system of claim 36 , wherein the first mechanism includes a first suction device configured to apply suction to the first external surface to hold the first tissue in place to present the first interior face.

38 . The system of claim 36 , wherein the first inner face of the first guide section and the second inner face of the second guide section are configured to be opposingly positioned to define a helical channel to guide the needle alternately through the first flange and the second flange, wherein the filament drawn by the needle forms a suture joining the first flange and the second flange.

39 . The system of claim 36 , wherein the needle includes a flexible needle.

40 . The system of claim 36 , wherein the needle includes a helical needle.

Assignees

• Gyrus Acmi Inc Dba Olympus Surgical Technologies America

Inventors

• Smith Adam Lee
• Alferness Clifton A
• Muia-Longman Gina M
• Finger Clinton L

Classifications

• A61B2017/0243

  for immobilizing local areas of the heart, e.g. while it beats · CPC title

• A61B2017/06095

  pliable · CPC title

• A61B2017/306

  holding by means of suction · CPC title

• A61B17/11 Primary

  for performing anastomosis; Buttons for anastomosis · CPC title

• A61B2017/06076

  helically or spirally coiled · CPC title