Anastomosis method utilizing tool with fluid-driven actuator

1. A method of performing anastomosis between a graft vessel and a target vessel, each having a circumferential wall and a lumen therethrough, the method comprising:

providing an anastomosis tool including a tissue effector and a fluid-driven actuator operationally connected to said tissue effector, wherein said tissue effector includes an anvil connected to a connector holder, and wherein said connector holder includes two arms spaced apart along at least part of their length;

connecting said fluid-driven actuator to an energy source;

sliding at least part of said anvil through an anvil entry hole in the wall of the target vessel;

creating at least one flap in an end of the graft vessel;

placing the end of the graft vessel in proximity to the wall of the target vessel;

actuating said fluid-driven actuator to connect the end of the graft vessel to the wall of the target vessel;

removing said anvil outward through the anvil entry hole in the wall of the target vessel; and

closing the anvil entry hole by deploying a sealer in proximity to the anvil entry hole.

2. The method of claim 1 , wherein said energy source is a gas cylinder connected to said anastomosis tool.

3. The method of claim 1 , wherein said energy source is an external utility.

4. The method of claim 1 , wherein said placing comprises moving said at least one flap onto an outer surface of the wall of the target vessel.

5. The method of claim 1 , further comprising creating an aperture in the wall of the target vessel at a site of the connection between the end of the graft vessel and the wall of the target vessel.

6. The method of claim 1 , wherein said actuating moves the end of the graft vessel into contact with the wall of the target vessel.

7. The method of claim 1 , wherein said connecting includes deploying at least one connector.

8. The method of claim 1 , wherein said anastomosis tool includes at least one force transmission member connected to said tissue effector and said fluid-driven actuator, and wherein said actuating moves said at least one force transmission member.

9. The method of claim 1 , further comprising providing an applier separate from said anastomosis tool, wherein said deploying said sealer is performed by said applier.

10. The method of claim 1 , wherein said anastomosis tool includes a sealer detachably connected to said anvil; and wherein the method further comprises engaging the wall of the target vessel with said sealer during said removing, and wherein closing the anvil entry hole comprises closing the hole with said sealer after said removing is complete.

11. The method of claim 1 , further comprising holding the graft vessel between said arms of said connector holder before said actuating.

12. The method of claim 1 , wherein said anastomosis tool further comprises a shaft connected to said tissue effector, said shaft having an articulation, and wherein the method further comprises moving said tissue effector about said articulation before said actuating.

13. The method of claim 12 , further comprising substantially locking said tissue effector relative to said articulation before said actuating.

14. The method of claim 1 , wherein said anastomosis tool further comprises:

a handle connected to said tissue effector, wherein said fluid-driven actuator is located in said handle; and

at least one cable connected to said tissue effector and said fluid-driven actuator, wherein said actuating pulls said at least one cable proximally toward said handle.

15. The method of claim 1 , wherein said actuating comprises first clamping said tissue effector, then deploying a plurality of staples from said tissue effector.