Method and apparatus for radical prostatectomy anastomosis including an anchor for engaging a body vessel and deployable sutures
View Patent ↗A device for joining a first body vessel to a second body vessel including a cartridge having a distal end and defining a longitudinal axis, a radially expandable anchor disposed at the distal end of the cartridge for engaging the first body vessel, the expandable anchor having an initial condition and an expanded condition wherein the expandable anchor is radially larger than the expandable anchor in the initial condition, and a plurality of sutures disposed within the cartridge and being deployable therefrom so as to engage the second body vessel, the sutures being threaded through the expandable anchor.
1. A device for joining a first body vessel to a second body vessel, comprising:
a) a cartridge having a distal end and defining a longitudinal axis, wherein the cartridge comprises an inner member and an outer member having a lumen dimensioned to receive the inner member;
b) a radially expandable anchor disposed at the distal end of the cartridge for engaging the first body vessel, wherein the expandable anchor having a plurality of arms connected by members, wherein the plurality of arms of the expandable anchor have an initial condition and an expanded condition such that in the expanded condition, the plurality of arms of the expandable anchor extend radially outward, and wherein the inner member includes a ring having connection features for engaging the plurality of arms of the radially expandable anchor;
c) a plurality of sutures disposed within the cartridge and being deployable therefrom so as to engage the second body vessel, the sutures being disposed in channels formed in the inner member and threaded through the expandable anchor; and
d) a plurality of needle anchors, wherein a needle anchor is attached to a distal end of a respective suture.
2. The device of claim 1 , wherein the expandable anchor comprises a plurality of flexible arms biased in an expanded position.
3. The device of claim 1 , wherein the anchor has a central passage and the sutures extend through the expandable anchor and proximally through the central passage.
4. The device of claim 1 , wherein the expandable anchor is disposed between the inner member and the outer member.
5. The device of claim 1 , wherein the anchors are deployable from the cartridge.
6. The device of claim 1 , further comprising a ring disposed within the outer member for securing the sutures to the expandable anchor.
7. The device of claim 1 , wherein the expandable anchor comprises a plurality of holes, each of the holes receiving one of the sutures.
8. The device of claim 1 , wherein the ring, expandable anchor and members are sized so that when the ring engages the arms, the members are broken and the arms remain attached to the ring.
9. The device of claim 1 , wherein the inner member has a tapered distal end.
10. A device for joining a first body vessel to a second body vessel, comprising:
a) a cartridge having a distal end and defining a longitudinal axis, wherein the cartridge comprises an inner member and an outer member having a lumen dimensioned to receive the inner member;
b) an anchor disposed at the distal end of the cartridge for engaging the first body vessel, wherein the anchor includes a plurality of outwardly extending arms, and wherein the outer member and the anchor are sized so that the anchor is disposed along the longitudinal axis within the outer member;
c) a plurality of sutures disposed within the cartridge and being deployable therefrom so as to engage the second body vessel, the sutures being disposed in channels formed in the inner member and threaded through the anchor; and
d) a plurality of needle anchors, wherein a needle anchor is attached to a distal end of a respective suture.
11. The device of claim 10 , wherein the anchor has a central passage and the sutures extend through the anchor and proximally through the central passage.
12. The device of claim 10 , wherein the anchors are deployable from the cartridge.
13. The device of claim 10 , further comprising a ring disposed within the outer member for securing the sutures to the expandable anchor.
14. The device of claim 10 , wherein the anchor comprises a plurality of holes, each of the holes receiving one of the sutures.
15. A device for joining a first body vessel to a second body vessel, the device comprising:
a tubular sleeve having a distal end, a proximal end and defining a lumen therethrough;
a tubular body slidably disposed within the tubular sleeve;
a radially expandable anchor deployably disposed in the distal end of the tubular sleeve at a location distal of the tubular body, the radially expandable anchor being deployable from the distal end of the tubular sleeve, wherein the expandable anchor includes:
a hub configured and dimensioned for disposition in the distal end of the tubular sleeve; and
a plurality of resilient arms radially disposed about the hub, wherein the plurality of resilient arms have a collapsed biased condition for disposition in the distal end of the tubular sleeve, and an expanded unbiased condition when disposed outside of the distal end of the tubular sleeve;
a plurality of needle anchors deployably supported in a distal end of the tubular body; and
a plurality of sutures, wherein each suture includes a first end connected to a respective one of the plurality of needle anchors, and wherein each suture includes a second end extending from a passage of the tubular body containing the respective needle anchor, through the expandable anchor, and then through a lumen of the tubular body.
16. The device according to claim 15 , wherein at least a portion of the expandable anchor is disposed between the tubular sleeve and the tubular body.
17. The device according to claim 15 , wherein when the plurality of resilient arms of the expandable anchor are in the collapsed biased condition, the plurality of resilient arms extend in a proximal direction.
18. The device according to claim 15 , further comprising a ring disposed within the tubular sleeve for connecting each suture to the expandable anchor.
19. A method of joining a first body vessel and a second body vessel, the method comprising the steps of:
providing a device for joining the first body vessel to the second body vessel, the device comprising:
a tubular sleeve having a distal end, a proximal end and defining a lumen therethrough;
a tubular body slidably disposed within the tubular sleeve;
a radially expandable anchor deployably disposed in the distal end of the tubular sleeve at a location distal of the tubular body, the radially expandable anchor being deployable from the distal end of the tubular sleeve, wherein the expandable anchor includes:
a hub configured and dimensioned for disposition in the distal end of the tubular sleeve; and
a plurality of resilient arms radially disposed about the hub, wherein the plurality of resilient arms have a collapsed biased condition for disposition in the distal end of the tubular sleeve, and an expanded unbiased condition when disposed outside of the distal end of the tubular sleeve;
a plurality of needle anchors deployably supported in a distal end of the tubular body; and
a plurality of sutures, wherein each suture includes a first end connected to a respective one of the plurality of needle anchors, and wherein each suture includes a second end extending from a passage of the tubular body containing the respective needle anchor, through the expandable anchor, and then through a lumen of the tubular body;
passing a distal end of the device through the first body vessel and into the second body vessel, wherein the expandable anchor is disposed in the distal end of the tubular sleeve and the plurality of needle anchors are loaded in the tubular body;
withdrawing the tubular sleeve relative to the tubular body to deploy the expandable anchor to the expanded condition in the second body vessel;
withdrawing the tubular body such that a distal end thereof is disposed within the first body vessel;
firing the plurality of needle anchors from the tubular body such that the plurality of needle anchors penetrate the first body vessel; and
withdrawing the second end of the plurality of sutures to approximate the first body vessel and the second body vessel.