WO1991007136A1

WO1991007136A1 - Instrument for anastomosis

Info

Publication number: WO1991007136A1
Application number: PCT/SE1990/000737
Authority: WO
Inventors: Billy Nilsson
Original assignee: Immuno Sweden Ab
Priority date: 1989-11-17
Filing date: 1990-11-15
Publication date: 1991-05-30
Also published as: SE8903871D0; SE8903871L; SE465201B; AU6881691A

Abstract

An anastomosis-instrument having means which permit folding of outermost end portions of first and second tubular tissues over clamping surfaces (16, 17) on the instrument to form annular flange portions for application of a bonding agent, and means for closing up the clamping surfaces towards each other with the annular flange portions lying therebetween. The instrument has means (12, 13, 14, 15) for admission of bonding agent to the connection area through the instrument, preferably from the rearmost end thereof to the tip portion (10) of the instrument, preferably in the shape of a thin, flexible hose (13) which is passed through the instrument.

Description

INSTRUMENT FOR ANASTOMOSIS

The present invention relates generally to an instru¬ ment for surgical stitching together portions of body flesh, tissue, membranes, etc.

The invention is a result of certain investigations in connection with anastomosis, and will be discussed below predominantly with reference had thereto, although the invention is by no means restricted only to that particular field. To facilitate, the instrument according to the inven¬ tion will be called anastomosis-instrument hereinafter.

One object of the invention has been to provide an anastomosis-instrument which is so simple and inexpensive to manufacture that it may be used as a disposable instru¬ ment.

Another object of the invention has been to provide an anastomosis-instrument which is easy to handle, and which may be handled in a very reliable manner.

Still another object of the invention has been to provide an anastomosis-instrument which permits a simple and reliable application of a binding agent at the intended position whithin the anastomosis area.

A further object of the invention has been to provide an anastomosis-instrument which has some built-in safety functions or features.

To the just mentioned end the anastomosis-instrument according to the present invention has been designed so as is defined in principle in the characterizing clause of claim 1.

Preferred embodiments, alternatives and constructive detail solutions are defined in the following specification and are shown in the accompanying drawings, and are also defined in the subclaims.

The invention will be disclosed in more details below with reference had to the accompanying drawings.

Fig. 1 is a schematic side view of one embodiment of an anastomosis-instrument according to the invention, picked as an example; Fig. 2 is a plan view, from above, of the instrument in fig. 1, where, however, the binding agent supplier has been omitted for clarity;

Fig. 3 - 6 illustrate the anastomosis-instrument ac¬ cording to the invention, partly in axial longitudinal section, in four different operation positions.

The anastomosis-instrument according to the invention has a tip end, generally denoted 11. In the embodiment shown the instrument has a bonding agent applicator, generally denoted 12, which may be of any known type. In the instant case the applicator 12 is devised for admission of a two component bonding agent, preferably of the kind which is sold by IMMUNO AG, ien, Austria, under the registered Trade Mark "TISSUECOL" or under the registered Trade Mark "TISEEL".

An important feature of the anastomosis-instrumenmt according to the invention is the possibility to admit the bonding agent to the stitching area through the instrument, preferably all the way from the rear end of the handle portion 11 out to and through the tip portion. In the ex¬ ample this takes place in that a thin flexible hose 13 is passed from an adaptor 14 for the applicator 12 through the rear end of the handle portion 11 and through the instrument to the tip end 10 where the hose in the example is formed into an almost entirely closed ring 15, disposed between two opposing anvil or clamping surfaces 16, 17, as is shown in figs. 1, 2, 3, and 4. The hose ring 15 is provided with suitable slots or other holes which serve as outlets for the bonding agent.

The hose 13 is comparatively rigid, so it may retain the toroid shape as shown in fig. 2, but still it is flex¬ ible enough to permit withdrawal axially in its channel 18 for a purpose which will be disclosed in more details below.

In the example the instrument has a replaceable tip cone 19 which may be easily replaced after depressing a locking button 20.

The instrument which is preferably slightly angled as shown in figs. 1 and 3 - 6, e.g. by an angle of about 30°, comprises an outer tube 21, which is provided with a handle 22, e.g. in the shape of two opposite tabs or loops. The handle end 11 comprises an operation grip 23 which is mov¬ able in relation to the outer tupe 21 and is connected to the tip cone 19 to permit operation thereof in such a manner that the clamping surfaces 16, 17 may be closed up toward each other, fig. 3 and 4. The movement of the operation grip 23 is controlled and locked by means of a latch 24 which is movable in a slot 25 in the outer tube. The latch may coope¬ rate with stop means (not shown) which may on one hand permit feeling of various positions of the tip cone 19 and thus the distance of the claimping surfaces 16, 17 from each other, and on the other hand may lock the movement of the grip 23 in closing direction beyond a predetermined limit position, viz. to prevent squeezing injuries by an undue closing up of the surfaces 16, 17.

The handle portion 11 also comprises an operation button 26 which over a flexible tube 27 is connected to a ring knife 28 at the tip end 10 of the instrument. The ring knife 28 serves to cut off "dough-nuts" as is well known to those skilled in the art. Normally the button 26 is axially movable in relation to the reminder of the grip portion without causing any displacement of the tube 27 and ~hus of the knife 28. This is a safety feature. To permit the neces¬ sary movement of the knife 28 it is necessary for a pair of axially directed carrier fingers 29 within the button 26 to be pivoted apart from each other to engage with engagement surfaces 30, to permit axial displacement of the tube 27. This pivoting of the fingers apart from each other may be effected by means of a wedge member 31 secured to the hose 13, which wedge on withdrawal of the hose 13 enteras at least partially between the fingers 29 and pivots these apart from each other. In this manner it is prevented that the ring knife 28 is pushed forwardly and possibly cuts off a portion of the hose 13 for admission of the bonding agent, which portion might runt the hazard of being left behind in the operation area.

A number of modifications and alterations as to details may be caried out within the scope of the invention.

Claims

1. Anastomosis-instrument to be used for connecting first and second portions of live tubular tissues with each other, comprising means permitting folding of outermost end portions of said first and second tubular tissues over clamping surfaces (16, 17) on the instrument to form oppos¬ ing tissue surfaces or ring shaped flange portions for application of a bonding agent and means for closing up said clamping surfaces (16, 17) towards each other with said ring shaped flange portions lying therebetween, characterized by means (12, 13, 14, 15) for admission of the bonding agent to the connection area through the instrument, preferably from the rearmost end thereof to the tip portion (10) of the instrument.

2. An instrument as claimed in claim 1, characterized in that the said admission means comprise a thin, flexible hose (13) which has, at the outermost end thereof, a connec¬ tion means (14) for connection of a bonding agent applicator (12) , and which is passed entirely tjhrough the instrument, and which, at the innermost end (15) thereof, is e.g. toro- id-shaped and provided with suitable outlet openings, e.g. slots.

3. An instrument as claimed in claim 1 or 2, charac¬ terized in that an operating means (26) for a clean cutting knife (28) is interlocked to the admission hose (13) for the bonding agent in such a manner that operation of the clean cutting knife is possible only when the admission hose (13) is at least partially retracted from its position for admis¬ sion of the bonding agent.