Luminal anastomotic device and method

Abstract

An end to end anastomotic stapling device connects two lumen sections avoiding constriction at the anastomotic ring. An intraluminal end to end anastomotic stapler includes an expanding head and anvil designed to fire an anastomotic ring having an inner diameter at least equal to the nominal inner diameter of the remaining lumen sections. An extraluminal end to end lumen stapler is described attaching the lumen sections with an exterior flange type connection having anastomotic rings with a diameter larger than the inner diameter of the lumen sections whereby the anastomotic site has a diameter at least as great as the adjacent lumen sections

1 .- 75 . (canceled)  
   
   
       76 . An external anastomotic stapler comprising two substantially identical, separate stapling units received around the lumen portions and coupled together with an alignment mechanism, wherein each stapling unit includes at least two sections, connected longitudinally by a hinge, said hinge extending longitudinally along the length of the stapling unit.  
   
   
       77 . The anastomotic stapler of  claim 76 , wherein each stapling unit includes two semi-circular sections connected longitudinally by a hinge, said hinge extending longitudinally along the length of the stapling unit.  
   
   
       78 . The anastomotic stapler of  claim 77 , wherein a first semi-circular section is formed as an anvil, and a second semi-circular section comprises a stapling mechanism and a knife portion.  
   
   
       79 . The anastomotic stapler of  claim 78 , wherein the first semi-circular section includes a series of staple receiving slots and a knife receiving groove, said knife receiving groove situated at the radially outer edge of the first semi-circular section, and wherein the second semi-circular section includes the knife portion situated at the radially outer edge thereof.  
   
   
       80 . The anastomotic stapler of  claim 78 , wherein the separate stapling units may be engaged face-to-face such that staples fired from the stapling mechanism of a first stapling unit may be received in the anvil of a second stapling unit upon firing, and staples fired from the stapling mechanism of a second stapling unit may be received in the anvil of the first stapling unit upon firing in the opposite direction.  
   
   
       81 . The anastomotic stapler of  claim 80 , further comprising at least pin forming the alignment and allowing for alignment of the separate stapling units when engaged face-to-face.  
   
   
       82 . The anastomotic stapler of  claim 76 , wherein said stapler may be fired from one end of the device.  
   
   
       83 . The anastomotic stapler of  claim 76 , wherein each stapling unit further comprises a plurality of tissue retraction members spaced around the periphery of each stapling unit.  
   
   
       84 .- 88 . (canceled)  
   
   
       89 . An extraluminal intestinal stapler for end to end anastomosis formed of two opposed stapling units; each unit clamping around a lumen section to be anastomized; wherein each said stapling unit comprises two halves hinged together, and wherein one half of each unit is a stapling unit and the other half is an anvil portion.  
   
   
       90 . The stapler of  claim 89 , further including a mechanism for pulling the lumen to be attached across the stapling face of each stapling unit.  
   
   
       91 . The stapler of  claim 89 , further including an alignment mechanism for aligning the two adjacent stapling units prior to firing a ring of staples.  
   
   
       92 .- 188 . (canceled)  
   
   
       189 . An extraluminal stapler for end to end anastomosis formed of two opposed generally identical, opposed stapling units; each unit clamping around a lumen section to be anastomized; wherein each said stapling unit comprises two halves, and wherein one half of each unit is a stapling unit and the other half is an anvil portion.  
   
   
       190 . The stapler of  claim 189 , further including a mechanism for pulling the lumen to be attached across the stapling face of each stapling unit.  
   
   
       191 . The stapler of  claim 190 , further including an alignment mechanism for aligning the two adjacent stapling units prior to firing a ring of staples.  
   
   
       192 . The stapler of  claim 190  wherein the tissue pulling mechanism includes a tissue grasping and positioning mechanism for positioning a lumen portion to be anastomized across the stapling face of the stapler in end to end anastomosis.  
   
   
       193 . The stapler of  claim 190  wherein the tissue pulling mechanism includes a series of identical tissue grasping clips, each clip formed of a flexible strip of material, the clips being secured around the edge of a lumen portion to be anastomized through snap fit connections with the clips providing for grasping and for positioning the lumen portion across the stapling face of a surgical sapling unit.  
   
   
       194 .- 200 . (canceled)  
   
   
       201 . The stapler of  claim 190  wherein the tissue pulling mechanism includes a tissue manipulator for attachment to tissue to be manipulated by a surgeon, the tissue manipulator comprising: 
 A) an elongated band attachable to the tissue;    B) a tissue attachment mechanism on a first side of the elongated band for attaching the tissue manipulator to the tissue; and    C) at least one manipulator on a second side of the elongated band, whereby the surgeon manipulates the tissue through the at least one manipulator that transfers the manipulation forces to the tissue generally evenly along the elongated band to minimize tissue damage.    
   
   
       202 . The stapler of  claim 201 , wherein the elongated band is a flexible member adapted to be folded along an axis thereof about the tissue.  
   
   
       203 . The stapler of  claim 202 , wherein the tissue attachment mechanism includes a plurality of snap fit connections.  
   
   
       204 . The stapler of  claim 202 , wherein the tissue attachment mechanism includes adhesive on the first side of the elongated band.  
   
   
       205 .- 207 . (canceled)