Device and procedure for joining hollow organs

Abstract

The invention relates to a device for joining hollow organs with an elongated holder and a needle carrier which is positioned at one end of the holder, where the needle seat extends radially, forming an overhang projecting beyond the periphery of the holder, as well as with a plurality of needles which are disposed standing vertically on the project overhang of the needle seat, surrounding the holder.

What is claimed is:  
     
         1 . Device with a lengthy holder for joining hollow organs, 
 a needle carrier, which is located at one end of the holder, where the needle seat forming an overhanging projection projects radially beyond the periphery of the holder, and    a plurality of needles which are disposed surrounding the holder standing vertical on the overhanging projection of the needle seat.    
     
     
         2 . Device in accordance with the preceding claim, characterized by a device to deploy the needles at a predetermined angle to the axial direction of the holder in a radial direction.  
     
     
         3 . Device in accordance with the preceding claim, characterized in that the device for deploying the needles in a radial direction is a sleeve which surrounds the holder and is movable in such a way between the needles and the holder that the needles are inclined outwards.  
     
     
         4 . Device in accordance with one of the preceding claims, characterized in that adjacent to the holder and above the points of the needles an insertion aid is located for one of the hollow organs to be joined, extending radially beyond the particular needle adjacent to it or expandable in such a way that it extends radially beyond the particular needle adjacent to it.  
     
     
         5 . Device in accordance with one of the preceding claims, characterized in that the insertion aid has radial notches or holes aligned in a straight line with the individual needles to permit passage of the individual needles.  
     
     
         6 . Device in accordance with one of the preceding claims, characterized by a needle cap which covers the needles detachably.  
     
     
         7 . Device in accordance with one of the preceding claims, characterized by a needle seat positionable above the needle points and surrounding the holder, which can be pushed onto the needle points or onto which the needle points can be pushed.  
     
     
         8 . Device under one of the two preceding claims, characterized in that the needle cap and/or the needle seat can be separated and/or opened up along its periphery.  
     
     
         9 . Device in accordance with the preceding claim, characterized in that the needle cap and/or the needle seat is can be divided into two parts along its periphery.  
     
     
         10 . Device in accordance with one of the preceding claims, characterized by a retraction device to remove the needle cap from the needles and/or a motion device to move the sleeve between the needles and the holder and/or a pressure device to press the needle seat onto the needle points or the needle points onto the needle seat.  
     
     
         11 . Device in accordance with the preceding claim, characterized in that the holder has controls to move the retraction device, the motion device and/or the pressure device.  
     
     
         12 . Device in accordance with the preceding claim, characterized in that the controls have push buttons which are located at the opposite end of the handle to the needle holder.  
     
     
         13 . Device in accordance with one of the preceding claims characterized in that a foot is located on the holder below the shoe.  
     
     
         14 . Device in accordance with one of the preceding claims, characterized by a separate needle seat cradle for one or two needle seat.  
     
     
         15 . Device in accordance with one of the preceding claims, characterized by a separate connecting device for attaching the ends of a suture.  
     
     
         16 . Device in accordance with one of the preceding claims, characterized in that the specific ends of a suture can be joined by means of a clip using the connecting device.  
     
     
         17 . Set with at least two devices in accordance with one of the preceding claims.  
     
     
         18 . Set in accordance with the preceding claim, characterized in that in each case one end of a needle of one device is connected by a suture with one end of a needle of the other device.  
     
     
         19 . Procedure to join a first opening in a hollow organ with a second opening in a second hollow organ, 
 characterized in that    a first array of needles is inserted into the first opening,    a second array of needles with the ends of the needles in front is inserted into the second opening,    where the end of each needle in the first array is connected to the end of a needle in the second array by means of a suture,    the needles of each array for each array are pushed jointly through the wall of the particular hollow organ along its opening with the needle points in front in each case, and subsequently the sutures are pulled tight and the two ends of each suture are tied together.    
     
     
         20 . Procedure in accordance with the preceding claim, characterized in that the needles of one or both arrays are disposed in a ring.  
     
     
         21 . Procedure in accordance with one of the two preceding claims, characterized in that the needles of at least one of the arrays, after being inserted into the opening of the hollow organ, are splayed out from each other with their points in a radial direction.  
     
     
         22 . Procedure in accordance with one of the three preceding claims, characterized in that the opening of at least one hollow organ is expanded such that it can be slipped over one of the arrays of needles.  
     
     
         23 . Procedure in accordance with one of the  claims 19  to  22 , characterized in that in order to push the needle points of at least one array through the wall of the hollow organ, a needle seat is pressed against the wall and the needle points on the side opposite the needle points, and/or the needle points are pushed against the wall and into a needle seat located on the opposite side to the needle points.  
     
     
         24 . Procedure in accordance with one of the preceding claims, characterized in that the needle seat is pushed onto the needle points, or the needle points are pushed onto the needle seat in such a way that the needles remain embedded in the needle seat, and the needle seat is then pulled away from the wall of the hollow organ.  
     
     
         25 . Procedure in accordance with one of the  claims 19  to  24 , characterized in that in conclusion the ends of the sutures are detached from the needles and attached, for example, knotted, clipped, bonded or laser welded.  
     
     
         26 . Use of a device, a set and/or a procedure in accordance with one of the preceding claims for joining hollow organs, in the field of vascular surgery for connecting vessels, in particular in by-pass surgery on the heart and for the treatment of stenoses, occlusions, strictures and thromboses in peripheral arteries and in surgery of the gastrointestinal tract.  
     
     
         27 . Use in accordance with the preceding claim in minimally invasive and endoscopic surgery.