MXPA06008305A - Anastomotic ring applier for use in colorectal applications - Google Patents

Abstract

A surgical tool or applier operable to deploy an anastomotic ring comprises a handle connected to an elongate shaft. The elongate shaft comprises an anastomotic ring deployment mechanism on a distal portion of the shaft. The ring deployment mechanism is moveable from an unactuated position to an actuated position. The elongate shaft comprises a rigid, curved member, thereby rendering the tool applicable for colorectal applications. In one embodiment, the tool comprises an actuating mechanism that is operable to transfer an actuating force to the ring deployment mechanism via a flexible connecting member.

Description

ANASTOMOTIC RING APPLICATOR FOR USE IN COLORECTAL APPLICATIONS FIELD OF THE INVENTION The present invention relates, in general, to surgery, and more particularly, to a device for carrying out the surgical procedure in the digestive system.

BACKGROUND OF THE INVENTION The percentage of the population in the world that suffers from morbid obesity is increasing continuously. Severely obese people may be susceptible to an increased risk of heart disease, heart attack, diabetes, lung disease, and accidents. Due to the effects of morbid obesity in the patient's life, methods to treat morbid obesity have been the subject of intense research. One of the known methods for treating morbid obesity includes the use of anastomotic rings. The devices for applying the anastomotic rings are known in the art. Devices of this nature are commonly adapted to insert an anastomotic ring compressed into an anastomotic opening formed between the proximal walls of the gastrointestinal tissue. These applicator devices may utilize ring developing mechanisms that comprise an expansion element that is activated once the ring is compressed in place in the anastomotic opening, causing the anastomotic ring to expand from its position in cylindrical form, compressed towards a hollow rivet position. There may be circumstances where it would be advantageous to have a compatible anastomotic ring applicator for use in colorectal applications. However, the elongated shaft of a conventional anastomotic ring applicator device may not be suitable for colorectal applications. In particular, a conventional anastomotic ring applicator device may lack a desirable curvature and / or may not provide the ideal leverage for such applications. In addition, the activation mechanism used by a conventional ring applicator may be unsuitable for use in colorectal applications. A conventional ring applicator may be inadequate or otherwise less than ideal for colorectal applications for a variety of other reasons. Consequently, it may be desirable to have an anastomotic ring applicator device that is adapted for use in colorectal applications. Specifically, it may be desirable to have an anastomotic ring applicator device comprising an elongated shaft that is suitable for colorectal applications. In addition, it may be desirable to have an anastomotic ring applicator device that includes an activation mechanism suitable for use in colorectal applications.

BRIEF DESCRIPTION OF THE INVENTION In one embodiment, an anastomotic ring applicator device comprises a handle connected through an elongated shaft to a mechanism for deploying the configured ring, to move an anastomotic ring from a generally cylindrical, non-activated position to a hollow rivet forming position. , activated. The instrument further comprises an activation mechanism for communicating an activation force of the ring deployment mechanism. The elongated shaft comprises a curved, rigid element. The curved, rigid element of the elongated shaft can enable the instrument to be used in colorectal applications, or on the contrary facilitates the use, to deploy the anastomotic ring. In another embodiment, the instrument comprises a handle connected to a mechanism for deploying the ring through an elongated shaft comprising the proximal portion of a distal portion. The ring deployment mechanism comprises a plurality of fingers adapted to articulate outwardly from the elongated shaft to deploy an anastomotic ring. The elongated shaft comprises a curved, rigid member. This modality may also be suitable for use in colorectal applications. In yet another modality, the instrument comprises a handle connected to a proximal portion of an elongated shaft, which further comprises a ring deployment mechanism located in the distal portion thereof. The ring deployment mechanism comprises a longitudinal end and a central portion, wherein the longitudinal end is adapted to move toward the central portion in order to deploy a portion of an anastomotic ring. The instrument further comprises an activation mechanism that includes a flexible connecting member adapted to move the longitudinal end of the deployment mechanism toward the central portion. The elongated shaft comprises a curved, rigid member. This embodiment includes a curved, rigid component of the elongated shaft, as well as the flexible connection member. This modality is therefore configured to be used in the deployment of an anastomotic ring during colorectal applications.

BRIEF DESCRIPTION OF THE FIGURES The accompanying drawings, which are incorporated and constitute a part of this specification, illustrate the versions of the invention, and, together with the description of the invention given above, and the detailed description of the versions given below, serve to explain the principles of the present invention. Figure 1 is a perspective view of an anastomotic ring applicator device.

Figure 2 is a partial perspective view of the distal portion of an anastomotic ring applicator device that controls an anatomical ring in an inactive position. Figure 3 is a partial perspective view of the distal portion of the device of Figure 2 which controls an anastomotic ring in the activated position. Figure 4 is a front view of an activated anastomotic ring. Figure 5 is a perspective view of the device of Figure 1, shown with the ring deployment mechanism in the activated position. Figure 6 is an enlarged view of the distal portion of the device of Figure 1, shown with the deployment mechanism fully activated. Figure 7 is an enlarged cross-sectional view of a proximal portion of the device of Figure 1. Figure 8 is a cross-sectional view of a distal portion of the device of Figure 1. Figure 9 is a cross-sectional view of a proximal portion of the device. of Figure 1. Figure 10 is a cross-sectional view of a distal portion of the device of Figure 1, with the deployed ring mechanism fully activated.

Figure 11 is a cross-sectional view of a proximal portion of the device of Figure 1, with the activation members in the activated position. Figure 12 is a cross-sectional view of a proximal portion of the device of Figure 1, taken along the plane 12 of Figure 9.

DETAILED DESCRIPTION OF THE MODALITIES OF THE INVENTION Turning now to the drawings, in which similar numbers denote similar components throughout the various views, Figure 1 describes an applicator 10 that is operable to deploy and activate an anastomotic ring device (not exemplified in Figure 1) from a generally cylindrical shape, to one having properties of a hollow rivet, or ring, capable of forming an anastomotic junction at a target anastomosis site, such as in a bariatric gastric bypass of a morbidly obese patient. Figure 2 describes another applicator 12. It will be appreciated that applicators 10, 12 can be used in a variety of ways, including but not limited to, laparoscopic or endoscopically. The applicator 12 is shown in Figure 2 with an anastomotic ring 14 in a deployment mechanism 16. In Figure 2, the anastomotic ring 14 is shown in a cylindrical, compressed position. In Figure 3, the deployment mechanism 16 of the applicator 12 has moved the anastomotic ring 14 to a hollow rivet-activated position. Figure 4 is a close view of the anastomotic ring 14 in the activated position. The anastomotic ring 14 may comprise a material with the memorized effect (SME), such as nitinol by way of example only, which further aids in the activation of the connection of the hollow rivet form. Other materials for the appropriate anastomotic ring 14 will be apparent to those skilled in the art. An illustrative anastomotic ring 14 is described in detail in the publication of the patent application of E. U. A. No. 2003/0032967, by Park et al. It will be appreciated that the terms "proximal" and "distal" are used herein with reference to a physician holding a handle of the applicator 10. Furthermore it will appreciate that for convenience and clarity, spatial terms such as "right", "left" , "vertical", and "horizontal", are used here with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting or absolute. In addition, the aspects of the invention have application to surgical procedures performed endoscopically and laparoscopically, as well as to an open procedure and other procedures. As used herein, one of these terms, or similar terms, should not be construed to limit the present invention for use in only one category of the surgical procedure. Referring to Figures 1, 5 and 6, the applicator 10 comprises a handle 13 and an elongated shaft 15 having a proximal end 17 and the distal end 18. The handle 13 is connected by means of the shaft 15 to a deployment mechanism of ring 20. The handle 13 comprises an activating member 22 operable to communicate activation forces to the ring deployment mechanism 20. In the present example the applicator 10 further includes a second activation member 24, which is optional. The activation members 22, 24 comprise sliders. The second slider 24 is located distal to the first slider 22. Those skilled in the art will appreciate, however, that the handle 13 can have any suitable number of activating members 22, 24, that the activating members 22, 24 can take a variety in alternative ways, and that handle 13, and / or activation members 22, 24, can be configured in a variety of alternative ways. As shown in Figure 5, the sliders 22, 24 are adapted to slide from a first non-activated position (Figure 9) to an activated position (Figure 11) to activate the ring deployment mechanism 20. As best shown in Figure 6, the deployment mechanism 20 comprises proximal fingers 26 and distal fingers 28. The fingers 26, 28 are configured to maintain an anastomotic ring through the connecting petals 51 prior to and during deployment of the anastomotic ring, and releasing petals 51 after deployment of the anastomotic ring. The applicator 10 includes a tip 30 located distal to the deployment mechanism 20. The tip 30 can be attached to the distal fingers 26 and / or can be connected through a bar (not exemplified) for the handle 13. In the present example, the ring deployment mechanism 20 comprises stationary middle rings 32 (Figure 8). The middle ring 32 is held immobile through a base tube 34. The proximal and distal fingers 26, 28 are each in a double hinge relationship with the middle ring 32. The fingers 26, 28 each comprise holding grooves 36. configured to control anastomotic ring before deployment of the ring, as well as during the intermediate stages of ring deployment. The fingers 26, 28 comprise internally directed tips 38 configured to allow the anastomotic ring to slide out of the connection with the fingers 26, 28 when the ring is fully deployed. The proximal and distal fingers 26, 28 are adapted to receive a proximal and distal portion, respectively, of an anastomotic ring. The proximal and distal fingers 26, 28 are further adapted to move from a first non-activated position (Figure 8) towards a middle ring 32 to a second activated position (Figure 10) to deploy the anastomotic ring. When the rings of the fingers 26, 28 move toward the middle rings 32, they are configured to articulate outwardly in an umbrella shape due to their hinge relation with the middle ring 32, moving the anastomotic ring from the compressed position to the position in the form of a deployed rivet. Of course, the ring deployment mechanism 20 may comprise a variety of alternative components and / or configurations. Said alternatives will be apparent to those skilled in the art. Referring now to Figures 7, 9, 11, and 12, a mechanism configured to transmit the user inputs for the ring deployment mechanism 20 is shown. In the present example, a first deployment activator 22 is operable to control the proximal fingers 26, and a second deployment activator 24 is operable to control the distal fingers 28. Alternatively, the first deployment activator 22 can control the distal fingers 28 and the second trigger 24 can control the proximal fingers 26. In the present example, the first and second ring deployment activators 22, 24 each comprise a pair of slots 40 that are configured to slide on the rail 42. The rail 42 also it is configured to slide inside the handle 13. Other suitable configurations will be apparent to those skilled in the art. In the present example, the first actuator 22 is fixedly attached to a proximal portion 48 of the rail 42. A distal portion 50 of the rail 42 is fixedly attached to a slider 53 that is slidably attached to the handle 13. The slider 53 is connected to an outer tube 54. The longitudinal movement of the first actuator 22 can therefore cause the corresponding longitudinal movement of the rail 42, the slider 53, and the outer tube 54. The outer tube 54 is connected to the proximal fingers 26. The outer tube 54 is therefore operable to communicate movement to the proximal fingers 26. The second activator 24 is connected to an inner tube 56. The inner tube 56 extends longitudinally through the base tube 34, which extends longitudinally. through the outer tube 54. The inner tube 56 is connected to the distal fingers 28. The inner tube 56 is therefore operable to communicate the movement to the distal fingers 28. In this way, the first activator 22 is operable to control the activation of the proximal fingers 26, and a second activator 24 is operable to control the activation of the distal fingers 28. The base tube 34, which is fixed to the middle ring 32 in the distal end of the base tube 34 is fixedly attached to the anchor member 58 at the proximal end of the base tube 34. The anchor member 58 is configured to be connected to the controllers 60 on the handle 13, thereby preventing the Relative movement between the handle 13 and the base tube 34. In the present example, it should be noted that although the second actuator 24 is configured to slide on the rail 42, it is not statically attached thereto. Accordingly, the longitudinal movement of the rail 42 due to the movement of the first trigger 22 will not cause the longitudinal movement of the second trigger 24. Those skilled in the art will appreciate, however, that a variety of components and / or alternative configurations can be used. to effect the activation of the distal fingers 28 and / or the proximal fingers 26. By way of example only, an alternative configuration may include configuring a first trigger 22 to be operable to control the activation of the distal fingers 28 and configure the second activator 24 to be operable to control the activation of the next fingers 26. Other suitable variations will be apparent to those skilled in the art.

The base tube 34 of the present example is rigid and comprises a curved portion. It will be appreciated that the base tube 34 of this form is suitable for colorectal applications. The inner tube 56 and the outer tube 54 are flexible, which allows them to follow the curve of the base tube 34 as they move longitudinally in response to activation of the first and second activators 22, 24. In one embodiment, the internal tubes and external 54, 56 are comprised of tightly woven cables. Other configurations of suitable features of tubes 34, 54, and 56 will be apparent to those skilled in the art. Having shown and written, various embodiments and concepts of the invention, further adaptations of the methods and systems described herein can be achieved through appropriate modifications through one skilled in the art without departing from the scope of the invention. Several of the said alternatives, modifications and potential variations have been mentioned, and others will be evident to those with experience in the art in light of the previous teachings. Accordingly, the invention is intended to embrace all such alternatives, modifications and variations as they fall within the spirit and scope of the appended claims and is meant not to be limited to the details of structure and operation shown and described in the specification and drawings. Additional advantages will readily appear to those skilled in the art.

Claims (20)

NOVELTY OF THE INVENTION CLAIMS

1. - A surgical instrument for implanting an anastomotic ring device, comprising: (i) a handle; (ii) a ring deployment mechanism configured to receive an anastomotic ring, wherein the ring deployment mechanism is adapted to move between a generally cylindrical, non-activated position and a hollow rivet forming position; (iii) an operable activation mechanism for communicating the activation force to the ring deployment mechanisms; and (iv) an elongated shaft connecting the handle to the ring deployment mechanism; wherein the elongated shaft comprises one or more curved, rigid members.

2. The surgical instrument according to claim 1, further characterized in that it comprises a trigger member operable to activate the ring deployment mechanism.

3. The surgical instrument according to claim 2, further characterized in that the activation member is connected to the ring deployment mechanism through a flexible tube.

4. The surgical instrument according to claim 3, further characterized in that the flexible tube comprises woven cables.

5. The surgical instrument according to claim 1, further characterized in that the ring deployment mechanism further comprises a motionless non-activating element.

6. The surgical instrument according to claim 5, further characterized in that the ring deployment mechanism further comprises a displacement element.

7. The surgical instrument according to claim 6, further characterized in that the displacement element is in a hinge relationship with the non-motionless activation element.

8. The surgical instrument according to claim 7, further characterized in that the displacement element is configured to move toward the immobile element in response to the activation force, causing the displacement element to articulate outwardly from the axis. elongated to deploy a portion of the anastomotic ring.

9. A surgical instrument for implanting an anastomotic ring device, comprising: (i) a handle; (ii) an elongated shaft comprising a proximal portion and a distal portion, wherein the proximal portion is attached to the handle, wherein the elongate shaft comprises at least one curved, rigid member; (Ii) a ring deployment mechanism located in the distal portion of the shaft, the ring deployment mechanism comprises a first plurality of rings configured to receive an anastomical ring, the fingers move from a first longitudinally aligned position with the shaft to a second position wherein the rings are activated outwardly from a longitudinal axis of the elongated shaft to activate at least a portion of the anastomotic ring.

10. The surgical instrument according to claim 9, further characterized in that the first plurality of fingers is configured to receive and deploy a proximal portion of the anastomotic ring, wherein the ring deployment mechanism further comprises a second plurality of fingers configured to receive and deploy a distal portion of the anastomotic ring.

11. The surgical instrument according to claim 10, further characterized in that it comprises a first activating member operable to activate the first plurality of fingers and a second activating member operable to activate the second plurality of fingers.

12. The surgical instrument according to claim 11, further characterized in that the first activation member is connected to the first plurality of fingers through a first flexible tube and the second activation member is connected to the second plurality of fingers. through a second flexible tube.

13. The surgical instrument according to claim 12, further characterized in that the first and second flexible tubes are comprised of woven cables.

14. The surgical instrument according to claim 13, further characterized in that the ring deployment mechanism comprises an immobile element positioned between the first plurality of fingers and the second plurality of fingers.

15. The surgical instrument according to claim 14, further characterized in that the immobile element is held in place through the curved, rigid element. 16.- A surgical instrument to implant an anastomotic ring that includes: (i) a handle; (ii) an elongated shaft comprising a proximal portion and a distal portion, wherein the proximal portion is attached to the handle, wherein the elongate shaft comprises a curved, rigid element; (iii) a ring deployment mechanism comprising a longitudinal end and a central portion, wherein the ring deployment mechanism is positioned on the distal portion of the elongated shaft, wherein the ring deployment mechanism is configured to receive a compressed anastomotic ring; and (iv) an activation mechanism comprising a flexible connection member, wherein the connecting member is operable to move the longitudinal end of the ring deployment mechanism toward the central portion of the ring deployment mechanism to activate at least a portion of an anastomotic ring. 17. The surgical instrument according to claim 16, further characterized in that the ring deployment mechanism further comprises a second longitudinal end operable to move from an initial position toward the central position of the ring deployment mechanism, to activate a second one. portion of the anastomotic ring. 18. The surgical instrument according to claim 17, further characterized in that the first longitudinal end is connected to a first activation member through the flexible connection member. 19. The surgical instrument according to claim 18, further characterized in that the second longitudinal end is connected to a second activation member through a second flexible connection member. 20. The surgical instrument according to claim 19, further characterized in that the first connection member and the second connection member are configured to move longitudinally within the elongated shaft.