Claims
- 1. A system for anastomosing a first tubular structure to a second tubular structure having an opening formed therein, the system comprising:
a support device having a proximal portion and a distal portion, said distal portion comprising a plurality of arms, each having a proximal end coupled to said proximal portion and a distal end, said plurality of arms being arranged to form a space between adjacent arms where said space extends to the distal end of said adjacent arms such that the distal ends of adjacent arms are separated, said arms further being arranged to form a surface configured to support an everted portion of said first tubular structure thereover; a plurality of fasteners adapted to pass through the spaces formed between adjacent arms and the first and second tubular structures; wherein the first tubular structure can be everted over the arms said support device, the support device passed through the opening in the second tubular structure, and the fasteners passed through the spaces and tubular structures to anatomies the first tubular structure to the second tubular structure.
- 2. The system of claim 1 wherein said support device comprises a tube having a plurality of slots forming said spaces.
- 3. The system of claim 1 wherein said arms are arranged in an annular configuration, each arm having a depression extending radially inward.
- 4. The system of claim 1 further including a plurality of graft piercing members, each graft piercing member extending from one of said plurality of arms and adapted to pierce and bold a portion of said first tubular structure.
- 5. The system of claim 3 wherein said support device has a longitudinal axis and said graft piercing members extend parallel to said longitudinal axis.
- 6. The system of claim 1 wherein said fasteners comprise sutures.
- 7. The system of claim 1 wherein said fasteners comprise clips.
- 8. The system of claim 1 wherein said fasteners comprise self-closing surgical clips.
- 9. A system for anastomosing a first tubular structure to a second tubular structure having an opening formed therein, the system comprising:
a support device having a plurality of arms arranged to form a space between adjacent arms, said arms being configured to support said first tubular structure; a plurality of graft piercing members, each graft piercing member extending from one of said plurality of arms and adapted to pierce and hold a portion of said first tubular structure; a plurality of fasteners adapted to pass through said spaces and the first and second tubular structures; and wherein the first tubular structure can be everted over the support device, the support device passed through the opening in the second tubular structure, and the fasteners passed through the spaces and tubular structures to anatomies the first and second structures.
- 10. The system of claim 9 wherein said support device has a longitudinal axis and said graft piercing members extend parallel to said longitudinal axis.
- 11. The system of claim 9 wherein said support device is tubular.
- 12. The system of claim 9 wherein said fasteners comprise sutures.
- 13. The system of claim 9 wherein said fasteners comprise surgical clips.
- 14. The system of claim 9 wherein said fasteners comprise self-closing surgical clips.
- 15. A method of anastomosing a first tubular structure having an end portion to a second tubular structure having an opening formed therein where at least one of the structures comprises tissue, the method comprising:
everting the end portion of the first tubular structure over a support device including a plurality of arms, each having a proximal end and a distal end; positioning the support device so that a portion of the first tubular structure forms a seal with a portion of the second tubular structure surrounding the opening therein; passing a plurality of fasteners between selected arms and through the tubular structures in the vicinity of the opening to secure the tubular structures together; and removing the support member from the tubular structures.
- 16. The method of claim 15 wherein the support device is positioned within the opening formed in the second tubular structure.
- 17. The method of claim 15 wherein the support device is positioned so that at least a portion of the everted end portion of the first tubular structure forms a seal with the portion of the second tubular structure surrounding the opening therein.
- 18. The method of claim 15 wherein passing surgical fasteners between selected arms and through the tubular structures comprises passing sutures between selected arm and through the tubular structures to secure the structures together.
- 19. The method of claim 15 wherein passing surgical fasteners between selected arms and through and tubular structures comprises passing surgical clips between selected arms and through the tubular structures to secure the structures together.
- 20. The method of claim 15 wherein passing surgical fasteners between selected arms and through the tubular structures comprises passing self-closing surgical clips through the spaces and the tubular structures to secure the structures together.
- 21. A method of anastomosing a first tubular structure having an end portion to a second tubular structure having an opening formed therein, where at least one of the structures is tissue, the method comprising:
providing a support device including a plurality of arms having a proximal end, a distal end, and a plurality of piercing members extending therefrom; securing the first tubular structure to the plurality of piercing members; positioning the support device so that the tubular structures contact one another; passing a plurality of surgical fasteners between selected arms of the support device and through the tubular structures to secure the tubular structures together; and removing the support device from the tubular structures.
- 22. The method of claim 21 wherein the support member is positioned to form a seal between the tubular structures in the region adjacent the opening in the second tubular structure.
- 23. The method of claim 21 wherein the end portion of the first tubular structure is everted over the distal ends of the arms and the support device is positioned to form a seal between at least a portion of the everted portion of the first and second tubular structures in the vicinity of the opening.
- 24. The method of claim 21 wherein a portion of the support device is introduced through the opening in the second tubular structure and positioned therein.
- 25. The method of claim 21 wherein passing surgical fasteners between selected arms and the tubular structures comprises passing sutures between selected arms and the tubular structures to secure the structures together.
- 26. The method of claim 21 wherein passing surgical fasteners between selected arms and through the tubular structures comprises passing surgical clips between selected arms and through the tubular structures to secure the structures together.
- 27. The method of claim 21 wherein passing surgical fasteners between selected arms and through the tubular structures comprises passing self-closing surgical clips between selected arms and through the tubular structures to secure the structures together.
- 28. The method of claim 21 including moving the arms radially inward and introducing the distal ends of the support device arms into the opening in the second tubular structure.
- 29. The method of claim 28 including radially expanding the support device arms after introducing the distal ends of the arms into the opening in the second tubular structure.
- 30. The method of claim 21 wherein positioning the distal ends of the support device arms includes introducing the distal ends of the arms into the opening in the second tubular structure and radially expanding the arms from a first state to a second state so that a portion of the first tubular structure is forced against the region of the second tubular structure that surrounds the opening.
- 31. The method of claim 30 wherein the support device arms are returned to the first state before removing the support device from the tubular structures.
- 32. A method of anastomosing a first tubular structure having an end portion to a second tubular structure having an opening formed therein, where at least one of the structures is tissue, the method comprising:
providing a support device including a plurality of arms having a proximal end, a distal end, and a plurality of piercing members having a first deformed shape and a second looped memory shape; securing the first tubular structure to the plurality of piercing members; securing the second tubular structure to the plurality of piercing members; and removing the support device from said piercing members and allowing the piercing members to return to their second memory loop shape.
- 33. A method of anastomosing a first tubular structure, having an end portion, to a second tubular structure, having fluid flowing therethrough, comprising:
forming an opening in the second tubular structure, while maintaining fluid flow therethrough; placing the end portion of the first tubular structure in the opening in the second tubular structure such that a seal is formed between the first tubular structure and the second tubular structure, while maintaining fluid flow through the first tubular structure, and securing the first tubular structure to the second tubular structure with fasteners.
- 34. The method of claim 33 wherein the first tubular structure is a graft and the second tubular structure is a vessel.
- 35. The method of claim 33 wherein the second tubular structure is an aorta.
- 36. The method of claim 33 wherein blood is flowing through the second tubular structure.
- 37. A method of anastomosing a first tubular structure, having an end portion, to a second tubular structure, having fluid flowing therethrough, comprising:
placing the end portion of the first tubular structure in an opening formed in the second tubular structure such that a seal is formed between the first tubular structure and the second tubular structure; securing the first tubular structure to the second tubular structure with fasteners; and performing the foregoing steps without clamping the second tubular structure to interrupt fluid flow therethrough.
- 38. The method of claim 37 wherein the first tubular structure is a graft and the second tubular structure is a vessel.
- 39. The method of claim 37 wherein the second tubular structure is an aorta.
- 40. The method of claim 37 wherein blood is flowing through the second tubular structure.
CROSS-REFERENCE
[0001] This application is a continuation-in-part application of Ser. No. 10/243,290, filed Sep. 12, 2002, which is incorporated herein by reference in its entirety and to which application we claim priority under 35 USC § 120. This application also claims the benefit of U.S. Provisional Application No. 60/415,997, filed Oct. 4, 2002, which application is incorporated herein by reference.
Provisional Applications (1)
|
Number |
Date |
Country |
|
60415997 |
Oct 2002 |
US |
Continuation in Parts (1)
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Number |
Date |
Country |
Parent |
10243290 |
Sep 2002 |
US |
Child |
10340164 |
Jan 2003 |
US |