Method and apparatus for radical prostatectomy anastomosis

Abstract

Apparatus for performing a surgical anastomosis include a tubular body having an expandable anchor operatively coupled near a distal end thereof. The apparatus further includes a sleeve slidably received about the tubular body. The sleeve has an expandable anchor operatively coupled near a distal end thereof. The expandable anchor of the tubular body has an annular ring concentric with a longitudinal axis defined by the tubular body.

1 - 18 . (canceled) 
     
     
         19 . A method for joining a first body vessel and a second body vessel, the method comprising the steps of:
 passing an apparatus through the first body vessel and into the second body vessel such that an inflatable anchor on a tubular body of the apparatus is positioned distally of the second body vessel;   inflating the inflatable anchor of the tubular body to engage the second body vessel;   positioning a sleeve of the apparatus so that an inflatable anchor on the sleeve is located near the first body vessel, the sleeve being slidably received around the tubular body;   inflating the inflatable anchor of the sleeve to engage the first body vessel and to fix a location of the sleeve relative to the first body vessel;   withdrawing the tubular body relative to the sleeve until the second body vessel contacts the first body vessel;   fixing the tubular body relative to the sleeve; and   draining fluid from the second body vessel through an opening that provides access to a central lumen of the tubular body.   
     
     
         20 . The method according to  claim 19 , wherein the method is a radical prostatectomy. 
     
     
         21 . The method according to  claim 20 , wherein the first body vessel is a urethra, and the second body vessel is a bladder. 
     
     
         22 . The method of  claim 21 , further comprising the step of removing a prostate gland by freeing the urethra from the prostate gland to thereby define a urethral stump, and freeing the prostate gland from the bladder to thereby define a bladder neck. 
     
     
         23 . The method of  claim 22 , further comprising the step of maintaining the tubular body and sleeve within the bladder and urethra for a period of time sufficient for the bladder neck and urethral stump to heal and grow together. 
     
     
         24 . The method according to  claim 19 , further comprising the step of rotating at least one of the inflatable anchor on the tubular body and the inflatable anchor on the sleeve with respect to first and second body vessels to alter areas of contact between the inflatable anchor on the tubular body or the inflatable anchor on the sleeve and the first or second body vessel. 
     
     
         25 . A method of joining a first body vessel and a second body vessel, the method comprising the steps of:
 providing a surgical apparatus for joining the first body vessel and the second body vessel, the surgical apparatus including;
 a tubular body having an inflatable anchor supported thereon; and 
 a sleeve having an inflatable anchor supported thereon, wherein the sleeve is slidably received around the tubular body; 
   passing the tubular body through the second body vessel and into the first body vessel such that the tubular body extends at least partially through the second body vessel and a distal end of the tubular body is disposed within the first body vessel;   positioning the sleeve around the tubular body such that the inflatable anchor of the sleeve engages the second body vessel and maintains a position of the sleeve with respect to the second body vessel;
 expanding the inflatable anchor disposed at a distal end of the tubular body; 
   drawing the inflatable anchor of the tubular body proximally by drawing the tubular body proximally through the sleeve until the inflatable anchor of the tubular body contacts the first body vessel;   drawing the first body vessel proximally by drawing the tubular body proximally through the sleeve until the first body vessel contacts the second body vessel; and   maintaining a position of the tubular body with respect to the sleeve within the first and second body vessels with the first and second body vessels in contact with one another second body vessel for a period of time sufficient for first and second body vessels to grow together.   
     
     
         26 . The method according to  claim 25 , wherein the step of maintaining a position of the tubular body with respect to the sleeve includes maintaining the position for about two weeks. 
     
     
         27 . The method according to  claim 25 , further comprising the step of draining fluid from the first body vessel through the tubular body while maintaining the position of the tubular body with respect to the sleeve. 
     
     
         28 . The method according to  claim 25 , further comprising the steps of:
 partially deflating the inflatable anchor of the tubular body;   radially repositioning the inflatable anchor of the tubular body with respect to the first body vessel; and   re-inflating the inflatable anchor of the tubular body.   
     
     
         29 . The method according to  claim 25 , further comprising the step of rotating the sleeve about the tubular body. 
     
     
         30 . The method according to  claim 25 , wherein the first body vessel is a bladder and the second body vessel is a urethra. 
     
     
         31 . A method of joining a first body vessel and a second body vessel, the method comprising the steps of:
 passing a tubular body through the second body vessel and into the first body vessel such that the tubular body extends at least partially through the second body vessel and a distal end of the tubular body is disposed within the first body vessel, the distal end of the tubular body including an inflatable anchor thereon for selectively engaging the first body vessel;   positioning a sleeve around the tubular body such that an inflatable anchoring mechanism on the sleeve is disposed within the second body vessel;   engaging the second body vessel with the inflatable anchoring mechanism;   engaging the first body vessel with the inflatable anchor of the tubular body;   drawing the first body vessel proximally by drawing the tubular body proximally through the sleeve until the first body vessel contacts the second body vessel;   maintaining engagement of the inflatable anchor of the tubular body with the first body vessel and engagement of the inflatable anchoring mechanism with the second body vessel for a period of time sufficient for first and second body vessels to grow together; and   rotating at least one of the inflatable anchor and the inflatable anchoring mechanism with respect to first body vessel and the second body vessel to alter areas of contact between the inflatable anchor or the inflatable anchoring mechanism and the first body vessel or the second body vessel.   
     
     
         32 . The method according to  claim 31 , further comprising the step of folding or unfolding the plurality of discrete radially spaced segments of the anchoring mechanism along a fold line to alter areas of contact between the inflatable anchoring mechanism and the second body vessel. 
     
     
         33 . The method according to  claim 31 , further comprising the step of draining fluid from the second body vessel through an opening that provides access to a central lumen of the tubular body. 
     
     
         34 . The method according to  claim 31 , wherein the method is a radical prostatectomy. 
     
     
         35 . The method according to  claim 34 , wherein the first body vessel is a urethra, and the second body vessel is a bladder. 
     
     
         36 . The method of  claim 35 , further comprising the step of removing a prostate gland by freeing the urethra from the prostate gland to thereby define a urethral stump, and freeing the prostate gland from the bladder to thereby define a bladder neck. 
     
     
         37 . The method of  claim 36 , further comprising the steps of:
 maintaining the tubular body within the bladder by expanding the inflatable anchor;   maintaining the sleeve within the urethra by expanding the inflatable anchor mechanism;   approximating the bladder neck of the bladder and the urethral stump of the urethra into contact with one another; and   maintaining the bladder and the urethra into contact with one another for a period of time sufficient for the bladder neck and urethral stump to heal and grow together.