Anastomosis instrument and method for performing same

Abstract

A surgical instrument for anastomosis of first and second blood vessels is provided. The surgical instrument includes a housing having distal and proximal ends and a handle and a disposable loading unit removably mounted to the distal end of the housing. The housing includes upper and lower fastener support members having a passage defined therethrough configured to receive an end of the second blood vessel and configured to releasably support a plurality of substantially L-shaped surgical fasteners and a retractable anvil located at a distal end of the loading unit, the anvil being movable relative to the fastener support members in response to actuation of the handle to simultaneously deform the surgical fasteners.

1 . A surgical instrument for anastomosis of first and second blood vessels, comprising:
 a housing having distal and proximal ends and a handle;
 a disposable loading unit removably mounted to the distal end of the housing having: 
 upper and lower fastener support members having a passage defined therethrough configured to receive an end of the second blood vessel and configured to releasably support a plurality of substantially L-shaped surgical fasteners; and 
 a retractable anvil located at a distal end of the loading unit, the anvil being movable relative to the fastener support members in response to actuation of the handle to simultaneously deform the surgical fasteners. 
   
   
   
       2 . A surgical instrument according to  claim 1  wherein the loading unit further comprises a first retracting sleeve which moves the anvil in response to actuation of the handle. 
   
   
       3 . A surgical instrument according to  claim 1  wherein the fastener support member supports the fasteners in an array-like manner. 
   
   
       4 . The surgical instrument according to  claim 1  wherein the distal end of the first sleeve includes a plurality of elongated channels which support the surgical fasteners. 
   
   
       5 . The surgical instrument according to  claim 4  wherein each of the channels includes a distal and proximal end wherein each distal end is radially offset from the proximal end such that the proximal and distal ends of the surgical fasteners are supported in a radially offset manner. 
   
   
       6 . A surgical instrument according to  claim 1  wherein the anvil has an angled surface such that the distal ends of the surgical fasteners deform proximally upon actuation of the handle. 
   
   
       7 . A surgical instrument according to  claim 4  further comprising:
 a second retracting sleeve which releasably retains the surgical fasteners within the elongated channels of the first retracting sleeve.   
   
   
       8 . A surgical instrument according to  claim 1  wherein the loading unit further comprises a second retracting sleeve which moves in response to actuation of the handle. 
   
   
       9 . A surgical instrument according to  claim 8  wherein continued movement of the handle moves the second retracting sleeve relative to the first retracting sleeve. 
   
   
       10 . A surgical instrument according to  claim 9  wherein movement of the second retracting sleeve relative to the first retracting sleeve releases the surgical fasteners. 
   
   
       11 . A surgical instrument according to  claim 8  wherein the second retracting sleeve includes a plurality of fingers which releasably retain the surgical fasteners against the anvil. 
   
   
       12 . A surgical instrument according to  claim 1  further comprising:
 an actuator which moves the first and second retracting sleeves in response to movement of the handle.   
   
   
       13 . A surgical instrument according to  claim 12  wherein the actuator includes a cam. 
   
   
       14 . A surgical instrument according to  claim 13  wherein the cam includes more than one cam follower. 
   
   
       15 . A surgical instrument according to  claim 13  wherein the cam includes multiple stages. 
   
   
       16 . A surgical instrument for anastomosis of first and second blood vessels, comprising:
 a housing having an actuator; and   a disposable loading unit removably mounted to the housing, the disposable loading unit having:
 a fastener support member configured to releasably support a plurality of substantially L-shaped surgical fasteners; and 
 a retractable anvil being movable relative to the fastener support member in response to the actuator to simultaneously deform the surgical fasteners. 
   
   
   
       17 . A surgical instrument according to  claim 16  wherein the fastener support member supports the fasteners in an array-like manner. 
   
   
       18 . A surgical instrument according to  claim 16  wherein each of the fasteners includes a distal and proximal end and the fastener support member supports the distal and proximal ends of each fastener in a radially offset manner. 
   
   
       19 . A surgical instrument according to  claim 16  wherein the anvil has an angled surface such that a distal end of each surgical fastener deforms proximally in response to the actuator. 
   
   
       20 . A surgical instrument according to  claim 16  wherein the loading unit further comprises:
 a first retracting sleeve which moves the anvil in response to the actuator.   
   
   
       21 . A surgical instrument according to  claim 20  wherein the first retracting sleeve includes a plurality of elongated channels which support the surgical fasteners. 
   
   
       22 . A surgical instrument according to  claim 20  wherein the loading unit includes a second retracting sleeve which is movable in response to the actuator. 
   
   
       23 . A surgical instrument according to  claim 22  wherein continued movement of the actuator moves the second retracting sleeve relative to the first retracting sleeve. 
   
   
       24 . A surgical instrument according to  claim 23  wherein movement of the second retracting sleeve relative to the first retracting sleeve releases the surgical fasteners. 
   
   
       25 . A surgical instrument according to  claim 16  wherein the actuator includes a cam. 
   
   
       26 . A surgical instrument according to  claim 25  wherein the cam includes more than one cam follower. 
   
   
       27 . A surgical instrument according to  claim 25  wherein the cam includes multiple stages. 
   
   
       28 . The surgical instrument according to  claim 16  wherein the loading unit includes two halves which are pivotable relative to one another. 
   
   
       29 . The surgical instrument according to  claim 28  wherein the two halves of the loading unit when closed form an elongated aperture which receives the second vessel therethrough. 
   
   
       30 . The surgical instrument according to  claim 29  wherein each half of the loading unit includes a fastener support. 
   
   
       31 . The surgical instrument according to  claim 16  wherein the loading unit includes a plurality of elongated channels which support the fasteners. 
   
   
       32 . The surgical instrument according to  claim 31  wherein each elongated channel includes a distal end and a proximal end which is radially offset relative to the distal end. 
   
   
       33 . The surgical instrument according to  claim 16  wherein the loading unit includes a first plurality of channels and a second plurality channels and wherein each channel of the first plurality of channels is configured to support a distal end of each fastener and a corresponding channel of the second plurality of channels is configured to support a proximal end of each fastener. 
   
   
       34 . The surgical instrument according to  claim 33  wherein the first plurality of channels is disposed substantially perpendicularly to the second plurality of channels. 
   
   
       35 . The surgical instrument according to  claim 1 , wherein the substantially L-shaped fasteners have a base leg, a support leg and a convexity projecting from the support leg in the direction of the base leg. 
   
   
       36 . The surgical instrument according to  claim 35 , wherein the upper and lower fastener support members and retractable anvil are arranged so that when the anvil is retracted, the fasteners are deformed with the convexity of each fastener cooperating with the base leg to retain the blood vessels. 
   
   
       37 . The surgical instrument according to  claim 16 , wherein the substantially L-shaped fasteners have a base leg, a support leg and a convexity projecting from the support leg in the direction of the base leg. 
   
   
       38 . The surgical instrument according to  claim 37 , wherein the upper and lower fastener support members and retractable anvil are arranged so that when the anvil is retracted, the fasteners are deformed with the convexity of each fastener cooperating with the base leg to retain the blood vessels.