Device and method for the surgical anastomasis of tubular structures

Abstract

A device for assisting in anastomosis of tubular structures. The basic device has a generally cylindrical shape with a pair of insertion arms and a central depression that provides a space for the needle to move through within the tubular structures while simultaneously providing support so that the suture needle thrust does not collapse the tubular structure wall. The depression may be configured to guide the path of the needle. A bridge connects the arms and prevents the needle from inadvertently coming in contact with the wall opposite that of the wall being sutured. The method includes an initial suture to join the sutures, inserting the device into the openings of the two structures, placing sutures in the walls adjacent to the depression, optionally rotating the device so the depression is aligned with each suture as it is being placed, removing the device, and tightening the sutures to complete the anastomosis.

What is claimed is:  
     
       1. A device to aid in surgically joining a pair of tubular structures at openings thereof, said device consisting of comprising: 
       (a) a generally cylindrical body having a pair of opposed arms, a bridge between said arms, and a depression between said arms;  
       (b) said arms having free extremities that are adapted for insertion into said tubular structure openings;  
       (c) said depression being adapted to allow a suturing needle to pass through a wall of each of said tubular structures; and  
       (d) said bridge being adapted to prevent trauma to said wall from said needle opposite where said needle passes through said wall.  
     
     
       2. The device of claim  1  wherein said extremities are convexly rounded. 
     
     
       3. The device of claim  1  wherein said extremities are tapered. 
     
     
       4. The device of claim  1  wherein said arms are substantially the same size. 
     
     
       5. The device of claim  1  wherein said arms are different sizes. 
     
     
       6. The device of claim  1  wherein said arms have a round cross-section. 
     
     
       7. The device of claim  1  wherein said arms have an oval cross-section. 
     
     
       8. The device of claim  1  wherein said arms have a C-shaped cross-section to permit said device to be compressible. 
     
     
       9. The device of claim  1  wherein one of said arms has a maximum cross-sectional area approximately that of the inside cross-sectional area of one of said tubular structures and the other of said arms has a maximum cross-sectional area approximately that of the inside cross-sectional area of the other of said tubular structures. 
     
     
       10. The device of claim  1  wherein said arms are solid. 
     
     
       11. The device of claim  1  wherein said arms include an axial bore. 
     
     
       12. The device of claim  1  wherein said bridge is substantially straight. 
     
     
       13. The device of claim  1  wherein said bridge is curved. 
     
     
       14. The device of claim  1  wherein said bridge is flexible. 
     
     
       15. The device of claim  1  wherein said depression is adapted to place counter pressure on said tubular structure wall when said needle is thrust through said wall in order to prevent said wall from collapsing against pressure from said needle thrust. 
     
     
       16. The device of claim  1  wherein said depression is configured to guide the path of said needle. 
     
     
       17. The device of claim  1  wherein said device is composed substantially of a biologically inert material. 
     
     
       18. The device of claim  1  wherein said device is composed substantially of a non-resorbable material. 
     
     
       19. The device of claim  1  wherein said device is composed substantially of a resorbable material. 
     
     
       20. The device of claim  1  wherein at least a portion of said device is radioopaque. 
     
     
       21. The device of claim  1  wherein at least a portion of said device is magnetized. 
     
     
       22. The device of claim  1  wherein at least a portion of said device includes at least one material selected from the group consisting of an anticoagulant, an antibiotic, an antiseptic, a lubricant, and a vascular spasm inhibitor. 
     
     
       23. The device of claim  1  wherein said device is  includes a structure for grasping. 
     
     
       24. A device to aid in surgically joining a pair of tubular structures at openings thereof, said device consisting of comprising: 
       (a) a generally cylindrical body having a pair of opposed arms, a bridge between said arms, and a depression between said arms;  
       (b) said arms having free extremities that are adapted for insertion into said tubular structure openings, one of said arms having a maximum cross-sectional area approximately that of the inside cross-sectional area of one of said tubular structures and the other of said arms having a maximum cross-sectional area approximately that of the inside cross-sectional area of the other of said tubular structures;  
       (c) said depression being adapted to allow a suturing needle to pass through a wall of each of said tubular structures; and  
       (d) said bridge being flexible and substantially straight and being adapted to prevent trauma to said wall from said needle opposite where said needle passes through said wall.  
     
     
       25. The device of claim  24  wherein said extremities are convexly rounded. 
     
     
       26. The device of claim  24  wherein said extremities are tapered. 
     
     
       27. The device of claim  24  wherein said arms are substantially the same size. 
     
     
       28. The device of claim  24  wherein said arms are different sizes. 
     
     
       29. The device of claim  24  wherein said arms have a round cross-section. 
     
     
       30. The device of claim  24  wherein said arms have an oval cross-section. 
     
     
       31. The device of claim  24  wherein said arms have a C-shaped cross-section to permit said device to be compressible. 
     
     
       32. The device of claim  24  wherein said arms are solid. 
     
     
       33. The device of claim  24  wherein said arms include an axial bore. 
     
     
       34. The device of claim  24  wherein said depression is adapted to place counter pressure on said tubular structure wall when said needle is thrust through said wall in order to prevent said wall from collapsing against pressure from said needle thrust. 
     
     
       35. The device of claim  24  wherein said depression is configured to guide the path of said needle. 
     
     
       36. The device of claim  24  wherein at least a portion of said device includes at least one material selected from the group consisting of an anticoagulant, an antibiotic, an antiseptic, a lubricant, and a vascular spasm inhibitor. 
     
     
       37. The device of claim  24  wherein said device is  includes a structure for grasping. 
     
     
       38. A method for surgically joining a pair of tubular structures at openings thereof, said method comprising the steps of: 
       (a) providing a device with a generally cylindrical body having a pair of opposed arms, a bridge between said arms, and a depression between said arms, said arms having free extremities that are adapted for insertion into said tubular structure openings, said depression being adapted to allow a suturing needle to pass through a wall of each of said tubular structures, and said bridge being adapted to prevent trauma to said wall from said needle opposite where said needle passes through said wall;  
       (b) placing a single suture at said tubular structure openings to hold said tubular structures together at a single point;  
       (c) inserting said device arm extremities into said tubular structure openings;  
       (d) positioning said device in a working position such that said depression straddles said tubular structure openings;  
       (e) introducing sutures into said tubular structure walls at suture positions adjacent to said depression for permitting the suturing needle to traverse through said walls;  
       (f) removing said device; and  
       (g) tightening said sutures.  
     
     
       39. The method of claim  38  wherein inserting and positioning said device includes inserting said device substantially fully into a first of said tubular structures, aligning said openings, and sliding said device into a second of said tubular structures until said device is in said working position. 
     
     
       40. The method of claim  38  wherein inserting said device includes the use of a grasping tool. 
     
     
       41. The method of claim  38  wherein said device is rotated prior to introducing each of said sutures such that said depression is aligned with said suture position. 
     
     
       42. The method of claim  38  wherein said bridge is flexible and removing said device includes bending said device at said bridge such that said bridge extends outwardly through said sutures. 
     
     
       43. The method of claim  38  wherein removing said device includes the use of a grasping tool.