Mechanical anastomosis system for hollow structures

Abstract

A system for making anastomoses between hollow structures by mechanical means is provided with a device in the shape of an annular or tubular element comprising circumferentially provided means, such as pin-shaped elements, for joining the abutting walls of the hollow structures together. An applicator is intended for moving said annular or tubular element in position and activating the joining means thereof, so as to make the anastomosis. Possibly, intraluminal joining means can be inserted without using an annular or tubular element.

1 . A method for intraluminally attaching an annular or tubular element to at least one hollow structure having a lumen, said method comprising the steps of:
 a. providing an applicator;   b. placing said annular or tubular element around the applicator in a first position, said annular or tubular element having a plurality of joining elements for clamping at least a part of the hollow structure, wherein said joining elements are positioned around a circumference of said annular or tubular element such that there is a distance between said joining elements when said annular or tubular element is in said first position;   c. inserting said applicator and said annular or tubular element at least partly into the lumen of said hollow structure;   d. activating said applicator to move the annular or tubular element from the first position wherein said annular or tubular element has a first diameter to a second position wherein said annular or tubular element has a larger diameter and said joining elements are closer to said hollow structure than when said annular or tubular element is in said first position; and   e. subsequently sufficiently reducing said distance between said joining elements to clamp at least part of said hollow structure with said joining elements.   
   
   
       2 . A method as claimed in  claim 1 , wherein the annular or tubular element has a cross-sectional shape selected from the group consisting of circular, elliptical and polygonal, as viewed in an axial direction relative to said annular or tubular element. 
   
   
       3 . A method as claimed in  claim 1 , wherein the joining elements include pin-shaped elements provided circumferentially around the annular or tubular element. 
   
   
       4 . A method as claimed in  claim 3 , wherein, in step (e), the pin-shaped elements are moved closer together in an axial direction, relative to said annular or tubular element. 
   
   
       5 . A method as claimed in  claim 4 , wherein each of said pin-shaped elements is provided with a point or projection at a free end thereof. 
   
   
       6 . A method as claimed in  claim 3 , wherein step (e) results in a reduction of an angle between pin-shaped elements. 
   
   
       7 . A method as claimed in  claim 3 , wherein each of the pin-shaped elements are bent radially outwards relative to the annular or tubular element as a result of step (e). 
   
   
       8 . A method as claimed in  claim 3 , wherein the annular or tubular element comprises an assembly of a plurality of zig-zag shaped elongate elements or a sinusoidal element, said zig-zag shaped elongate elements and sinusoidal element having a plurality of vertices, and wherein said joining elements are located proximate to vertices of said elongate elements. 
   
   
       9 . A method as claimed in  claim 3 , wherein in step (e) said pin-shaped elements penetrate into said hollow structure. 
   
   
       10 . A method as claimed in  claim 1 , wherein said annular or tubular element is permanently deformed when moved from said first position to said second position. 
   
   
       11 . A method as claimed in  claim 1 , wherein the hollow structure is clamped at a plurality of locations along the circumference of the annular or tubular element 
   
   
       12 . A method as claimed in  claim 11 , wherein each clamping location is separated by a distance from each other clamping location. 
   
   
       13 . A method as claimed in  claim 1 , wherein in step (e), said joining elements are deformed. 
   
   
       14 . A method as claimed in  claim 1 , further comprising the step of:
 f. removing the applicator from the hollow structure.   
   
   
       15 . A method as claimed in  claim 1 , wherein step (d) is carried out by radial expansion of at least a portion of said applicator. 
   
   
       16 . A method as claimed in  claim 15 , further comprising the steps of:
 f. radially contracting the portion of the applicator expanded in step (d), and   g. removing the applicator from the hollow structure.   
   
   
       17 . A method as claimed in  claim 1 , wherein in step (d) said annular or tubular element is deformed by plastic deformation. 
   
   
       18 . A method as claimed in  claim 1 , wherein said method results in a reduction in an axial length of said annular or tubular element. 
   
   
       19 . A method as claimed in  claim 1 , wherein said applicator comprises a guide wire and said guide wire is used to place said applicator and annular or tubular element in step (c). 
   
   
       20 . A method as claimed in  claim 1 , wherein said annular or tubular element is located on an outer surface of said applicator during steps (b)-(e). 
   
   
       21 . A method as claimed in  claim 8 , wherein said joining elements are located proximate to vertices of said elongate elements that face away from each other. 
   
   
       22 . A method as claimed in  claim 21 , wherein said annular or tubular element comprises an assembly of a plurality of zig-zag shaped elongate elements and said elongate elements are arranged side-by-side in an axial direction and are interconnected proximate to the vertices of said elongate elements that face each other. 
   
   
       23 . A method as claimed in  claim 21 , wherein said annular or tubular element comprises a sinusoidal element.