Full eversion anastomosis juncture formation and suturing
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.
1 . A method for facilitating anastomosis between bodily passages, the 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;
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; and
applying opposing guide sections to opposing sides of the passage juncture, wherein opposing interior faces of the opposing guide sections define a helical channel.
2 . The method of claim 1 , wherein motivating the filament is performed by moving a flexible needle configured to receive an end of the filament.
3 . The method of claim 2 , 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.
4 . The method of claim 1 , further comprising forming the first opening in a side of a receiving passage.
5 . The method of claim 1 , 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.
6 . The method of claim 1 , 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.
7 . The method of claim 1 , 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.
8 . The method of claim 1 , wherein the receiving passage includes a coronary artery and the donor passage includes a saphenous vein.
9 . The method of claim 8 , further comprising making a subxiphoid incision to provide access to a heart.