WO2005000127A1 - Appareil pour effectuer une anastomose - Google Patents

Appareil pour effectuer une anastomose Download PDF

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Publication number
WO2005000127A1
WO2005000127A1 PCT/CH2004/000395 CH2004000395W WO2005000127A1 WO 2005000127 A1 WO2005000127 A1 WO 2005000127A1 CH 2004000395 W CH2004000395 W CH 2004000395W WO 2005000127 A1 WO2005000127 A1 WO 2005000127A1
Authority
WO
WIPO (PCT)
Prior art keywords
holder
anvil
hollow
guide
hollow organ
Prior art date
Application number
PCT/CH2004/000395
Other languages
German (de)
English (en)
Inventor
Petr Medricky
Roger Von Mentlen
Charles Brom
Original Assignee
Zürcher Hochschule Winterthur
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Zürcher Hochschule Winterthur filed Critical Zürcher Hochschule Winterthur
Publication of WO2005000127A1 publication Critical patent/WO2005000127A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06042—Means for attaching suture to needle located close to needle tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/06076—Needles, e.g. needle tip configurations helically or spirally coiled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/061—Needles, e.g. needle tip configurations hollow or tubular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections

Definitions

  • the invention relates to a device for performing an anastomosis with a sewn connection between a terminal stump of a first hollow organ and a side wall of a second hollow organ.
  • the chest When performing an anastomosis according to the classic surgical procedure, the chest must be opened by dividing the breastbone so that the surgeon has direct access to the heart.
  • a telemanipulation system in which the operator controls the intervention from a master console using two instrument handles.
  • Motion sensors perceive the surgeon's movements on the instrument handles and transfer them process-controlled to three manipulators, which operate a videoscope and two interchangeable endoscopic instruments.
  • the instruments have a miniaturized mechanical wrist at the tip, which enables even the finest movements, such as are required to sew an anastomosis.
  • a major disadvantage of today's telemanipulation systems is that complex movements, such as those on which a sewing process is based, are difficult and require a lot of practice from the operator to precisely control a desired movement sequence via the videoscope. The surgeon has to perform the sewing process visually without any tactile feedback.
  • the invention has for its object to provide a device of the initially to create named type with which the production of the sewn connection can be simplified and thus the work by hand, with telemanipulators or with robots can be made easier.
  • a device comprises - a holder with a guide slot passing through it from an inlet side to an outlet side for carrying out the terminal stump of the first hollow organ, - an anvil arranged on the outlet side of the holder for flipping over the terminal stump of the first hollow organ outside against an outer wall of the anvil and inserting it into an opening in the side wall of the second hollow organ, - two clamping jaws pivotably articulated on the holder, each with one opposite the outer wall of the anvil in a closed position and the end stump of the first hollow organ lying around in the region of the opening Side wall of the second hollow organ adjacent clamping surface, - two guide channels formed in the area of the anvil in the closed position by the holder and the clamping jaws and - two helical needles which can be inserted into the guide channels for piercing the a Parts of the hollow organs lying on top of one another in the outer wall of the anvil and introduction of a thread connecting the hollow organs.
  • the anvil comprises two webs arranged on the outlet side of the holder on both sides of the guide slot.
  • the guide slot is expediently widened on the entry side of the holder, the opening of the guide slot generally having a ratio of length to width of approximately 1: 3 to 1:20, ie the guide slot has a flat cross section. Since the smallest possible entry angle of the first hollow organ into the side wall of the second hollow organ is desired for fluidic reasons, the preferred ratio of length to width is in many cases between about 1:10 and 1:20.
  • Positioning hooks projecting from the outer wall of the anvil and from the clamping surfaces can be provided for positioning and securing the hollow organs.
  • a helical guide groove is arranged in the wall of each guide channel and the side walls of the guide groove are formed by a guide web serving as a support surface for the hollow organs.
  • the helical needles and the guide channels can have a straight or a curved shape.
  • each helical needle projects laterally from each clamping jaw and is arranged coaxially to the guide channel.
  • each receiving part is assigned a hollow cylindrical shell part which projects from it and is arranged coaxially to the guide channel.
  • a holding wing protrudes from one side of the holder.
  • two positioning aids for the holder which are provided for insertion into the second hollow organ, can be fixed in the region of the guide slot, each using a preferably flexible fastening wire.
  • FIG. 1 is an oblique view from above of a device for performing an anastomosis with an open and a closed jaw.
  • FIG. 2 shows an oblique view from below of the device from FIG. 1;
  • FIG. 3 shows an enlarged detail of area A from FIG. 2;
  • FIG. 5 shows an oblique view from above of the device from FIG. 1 with both clamping jaws in the closed position
  • FIG. 6 is an oblique view from below of the device of FIG. 5;
  • FIG. 7 is a top view of the device of FIG. 5;
  • FIG. 8 is a bottom view of the device of FIG. 5;
  • FIG. 9 shows a section through the device from FIG. 8 along the line 1-1 thereof with the hollow organs positioned for performing an anastomosis, with the clamping jaws in the open position;
  • FIG. 10 shows the device from FIG. 9 with the clamping jaws in the closed position
  • 11 shows a plan view of a first embodiment of a helical needle
  • 12 shows a plan view of a second embodiment of a helical needle
  • FIG. 13 shows a plan view of a third embodiment of a helical needle
  • FIG. 14 is an oblique view of a device for holding, opening and closing the device of FIG. 1;
  • FIG. 15 is an enlarged detail of area A of FIG. 14; 16 shows the detail of FIG. 15 from a different angle;
  • FIG. 17 shows a longitudinal section through a device for holding and rotating a helical needle
  • FIG. 19 shows an enlarged detail of area B of FIG. 17; 20 shows the longitudinal section through the detail of FIG. 19 rotated by 90 °;
  • 21 shows part of the detail of FIG. 18 with a connecting link to the releasably attaching a helix needle; 22 shows the part of FIG. 21 with the connecting member in the fixing position.
  • an apparatus 10 for performing an anastomosis between a terminal stump 14 of an artery responsible for supplying the left half of the chest with arterial blood (Left Infernal Mammary Artery, LIMA) 12 and a coronary artery (Coronary Artery, CA) 16 via an opening 18 cut into it has a holder 20 with a guide slot 26 passing through it from an inlet side 22 to an outlet side 24 for the passage of the terminal stump 14 of the LIMA 12.
  • the opening of the guide slot 26 in the present example has a ratio of length I to width b of approximately 1: 7 and is generally between approximately 1: 3 and 1:20, i.e. the LIMA 12 has a flat cross section through the guide slot 26.
  • the guide slot 26 On the entry side 22 of the holder 20, the guide slot 26 has correspondingly curved inner walls 28, 30 for widening and thus for easier insertion of the terminal stump 14 of the LIMA 12.
  • the inner walls 28, 30 of the guide slot 26 On the outlet side 24 of the holder 20, the inner walls 28, 30 of the guide slot 26 also form inner walls of two webs 32, 34 protruding from the holder 20 with outer walls 36, 38 running parallel to the inner walls 28, 30. Via the free ends 40, 42 of the webs 32, 34 forming an anvil, the terminal stump 14 of the LIMA 12 inserted through the guide slot 26 is folded outwards.
  • a clamping jaw 44, 46 is pivotally mounted on both sides of the guide slot 26 about axes of rotation 48, 50 lying parallel to the longitudinal side of the guide slot 26.
  • the clamping jaws 44, 46 each have a clamping surface 52, 54 which, when the clamping jaws 44, 46 are in the closed position, lie opposite the outer walls 36, 38 of the webs 32, 34 of the anvil.
  • Recesses 45, 47 are provided on the back of the clamping jaws 44, 46, so that the guide slot 26 is accessible even when the clamping jaws are open.
  • a helical guide groove 60 is located in the cylindrical wall of each guide channel 56, 58. 62 for a helical needle 98 (FIGS. 11 to 13) with values for diameter D and pitch a given according to the dimensions of the guide groove. These parameters are used to set the stitch spacing and stitch height.
  • a first part of the guide groove 60, 62 lies in the corresponding clamping jaw 44, 46, the second part in the holder 20 including the webs 32, 34.
  • the guide groove 60, 62 results as a whole only in the closed position of the clamping jaws 44, 46.
  • Die Side walls of the guide groove 60, 62 form a guide web 64, 66 which extends helically in accordance with the guide groove, the free end 68, 70 of which offers a support surface for the LIMA 12 or the CA 16 at the tissue entry and exit points of the needle tip.
  • the desired stitch distance from the edge of the LIMA 12 and the CA 16 can be set by a defined change in the distance e from the center of the guide channel to the free ends 40, 42 of the webs 32, 34.
  • each receiving part 76, 78 is assigned a hollow cylindrical shell part 80, 82 which projects therefrom and is arranged coaxially to the guide channel 56, 58 for supporting the helical needle emerging from the guide channel 56, 58.
  • the shell part 80, 82 separates the helix needle from the tissue of the CA 16 and prevents the helix needle from getting caught when the needle is unscrewed.
  • Small positioning hooks 72 and 74 protrude from the outer walls 36, 38 of the webs 32, 34 and the clamping surfaces 52, 54 (FIGS. 3 and 4).
  • the positioning hooks 72 on the webs 32, 34 serve to fix the LIMA 12 folded over on the webs and, with a corresponding hook length, also the CA 16, the position tioning hook 74 on the clamping surface 52, 54 for fixing the CA 16 in the area of the opening 18 of the LIMA 12 and, with a corresponding hook length, also the LIMA 12 (FIGS. 9 and 10).
  • a holding wing 84 projects upwards at an angle of approximately 60 °.
  • the holding wing 84 is equipped at its free end with a stop 86 and with a clamping plate 88, on which the device 10 can be clamped, for example with an operating forceps or with a robot gripper.
  • the hollow cylindrical receiving parts 76, 78 make it possible to guide the device 10 with prepositioned helical needles into the operating area.
  • two positioning aids 90, 92 of different lengths projecting obliquely downwards and outwards are fixed in the region of the narrow sides of the guide slot 26, each via a flexible fastening wire 94, 96.
  • the positioning aids 90, 92 serve to position the holder 20 with the LIMA 12 clamped in the CA 16 and are inserted into the CA 16 through the opening 18 in both directions.
  • the LIMA 12 is inserted into the guide slot 26 from the entry side 22 of the holder 20 and is thereby compressed to a flat cross section.
  • the end stump 14 is folded outwards around the webs 32, 34 and is positioned over the positioning hooks 72 to prevent it from folding back into its starting position and from slipping off on the outer walls 36, 38 Bridges 32, 34 secured.
  • the holder 20 is guided over the opening 18 of the CA 16.
  • the longer positioning aid 90 is first inserted into the CA 16 through the opening 18 in one direction.
  • the shorter positioning aid 92 is introduced into the CA 16 through the opening 18 in the other direction.
  • the prepared terminal stump 14 of the LIMA 12 is now positioned in the opening 18 of the CA 16 in such a way that the inside of the CA 16 rests on the inside of the LIMA 12 which has been folded outwards and the CA 16 is secured via the positioning hooks 72.
  • the clamping jaws 44, 46 are closed one after the other, and the CA 16 and the LIMA 12 are secured against slipping by the positioning hooks 74 projecting from the clamping surfaces 52, 54.
  • the helical needles 98 shown by way of example in FIGS. 11 to 13 are connected to an axis 102 at the end remote from the needle tip 100 and are rotated by the axis by hand or by an electrical, pneumatic, hydraulic or other type of drive through the guide grooves 60 , 62 moves.
  • the helix needle 98 is used in the guide groove 60, 62, the LIMA 12 and the CA 16 are pierced in the area of the webs 32, 34 and the needle tip 100 emerges in the area of the clamping surfaces 52, 54.
  • the helix needle 98 screws through the tissue.
  • a thread 104 carried by the helix needle 98 leads to the desired sewing connection.
  • the thread 104 can be fastened to the needle end of the helix needle 98 and pulled by the needle (FIG. 11). Another One possibility is to carry the thread 104 in a hollow helical needle 98 (FIG. 12), but it is also possible to attach the thread 104 to the needle tip 100 (FIG. 13). 62, the thread 104 is gripped and the helix needle 98 is then rotated out of the guide groove 60, 62 in the reverse direction of rotation.
  • the stitch spacing and the stitch height in the case of a sewing connection can be correspondingly
  • the choice of the slope a and the diameter D of the helix needle 98 can be specified.
  • FIG. 22 An alternative connection of the helix needle 98 to a drive unit is shown in FIG. 22 and described in more detail below in connection with the device according to FIGS. 17 to 22. It goes without saying that the ends of the threads remaining in the fabric must be secured against slipping out.
  • Known fuses are, for example, knots, clips, clips, clamps and adhesive or welded connections.
  • the device 10 can be separated into two parts, for example at a predetermined breaking point, and removed from the operating area.
  • the device 10 can also be cut open.
  • a device for opening and closing the clamping jaws 44, 46 shown in FIGS. 14 to 16 enables the device 10 to be handled safely during the duration of the medical intervention.
  • the basis of the device is formed by an endoscopic forceps 108 with forceps jaws 112, 113 arranged at one end of a first guide tube 110, which jaws move towards and away from one another via a cable pull running in the guide tube 110 by means of an actuating handle 114 fixed at the other end of the guide tube 110 and by means of an Locking lever 116 can be locked in any clamping position.
  • the jaws 112, 113 rest against the stop 86 on the holding wing 84 of the device 10 and clasp the clamping plate 88.
  • two further guide tubes 118, 120 extend along the guide tube 110 to the area of the forceps jaws 112, 113. These two guide tubes 118, 120 are each penetrated by a control wire 122, 124.
  • Each control wire 122, 124 is equipped with a control disk 126, 128 at its end close to the actuating handle 114 of the endoscopy forceps 108.
  • an end piece 130, 132 is offset by a double opposite bend parallel to the control wire axis and at its free end with a bore 134, 136 provided.
  • tension thread 138, 140 One end of a tension thread 138, 140 is fastened to the rear of each clamping jaw 44, 46 of the device 10 held by the two jaws 112, 113.
  • Each tensioning thread 138, 140 passes through the bore 134, 136 of one of the control wires 122, 124 and is attached with its other end to a spring arranged in a tubular thread receptacle 142 arranged parallel to the two guide tubes 118, 120.
  • the control wires 122, 124 are rotated by rotating the control discs 126, 128 by about a quarter turn against the force of a torsion spring acting on the control discs 126, 128 and displaced in the direction of the clamping jaws 44, 46 , whereby these are rotated about their axis of rotation 48, 50 into the closed position.
  • the control disks 126, 128 are released, the end pieces 130, 132 automatically put on the back of the clamping jaws 44, 46 and lock them in their closed position.
  • the control wires 130, 132 are withdrawn.
  • the clamping jaws 44, 46 are opened by the tension threads 138, 140 under tension.
  • a device for holding, positioning and executing the rotary movement of a helical needle 98 to be used with the device 10 shown in FIGS. 17 to 22 has a tubular guide 144 with a conical end piece 146.
  • a flexible hollow shaft 148 with a central tensioning wire 150 is supported in the guide 144.
  • the hollow shaft 148 At its end emerging from the conical end piece 146 of the guide 144, the hollow shaft 148 has a stopper 152 with a stop surface 154 for a hollow cylindrical expanding part 156 made of rubber and penetrated by the tensioning wire 150.
  • the end of the tensioning wire 150 emerging from the rubber expansion part 156 is a closing part 158 with a counter abutment surface 160 put on for the expansion part 156.
  • the hollow shaft 148 is connected to a shaft 162 with a longitudinal slot 164 emerging from the guide 144.
  • a clamping piece 166 enclosing the shaft 162 and displaceable thereon has two grip parts 168, 170 projecting laterally from it.
  • a locking screw 172 is arranged in one of the handle parts 168 for fixing the tensioning wire 150 emerging from the hollow shaft 148 and continuing in the longitudinal slot 164 in the shaft 162 on the tensioning piece 166.
  • the free end of the shaft 162 is equipped with a rotary knob 174.
  • the expanding part 156 made of rubber surrounding the tensioning wire 150 is inserted into the helical needle 98 from the end in order to produce a drive coupling when the tensioning wire 150 is not tensioned.
  • the tensioning wire 150 is then pulled back by moving the tensioning piece 166 on the shaft 162 against the rotary knob 174.
  • the end part 158 with the counter abutment surface 160 sitting on the end of the tensioning wire 150 is displaced in the direction of the stopper 152 with the abutment surface 154.
  • the rubber expansion part 156 compressed in the tensioning wire axis deviates in the radial direction and lies down with the formation of a non-positive connection Connection to the turns of the helix needle 98 (Fig. 22).
  • the clamping piece 166 is fixed on the shaft 162 by means of a locking screw 176, and the helix needle 98 can be set into a corresponding rotary movement by manually actuating the rotary knob 174.
  • the shaft 162 can also be connected to a drive motor.
  • the expansion part 156 is relieved by loosening the locking screw 176 and can thus be pulled out of the end of the helix needle 98 again.
  • a rubber expansion part 156 it is also possible, for example, to use multi-part expansion bodies with wedge surfaces sliding on one another.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif servant à effectuer une anastomose avec un raccord cousu entre un moignon terminal (14) d'un premier organe creux (12) et une paroi latérale d'un deuxième organe creux (16). Le dispositif selon l'invention comprend un support (20) pourvu d'une fente de guidage (26) traversant le support d'un côté d'entrée (22) jusqu'à un côté de sortie (24) et servant à guider le moignon terminal (14) du premier organe creux (12) ; une enclume (32, 34) placée sur le côté de sortie (24) du support (20) et servant à rabattre le moignon terminal (14) du premier organe creux (12) vers l'extérieur contre une paroi extérieure (36, 38) de l'enclume (32, 34) et à l'introduire dans une ouverture (18) de la paroi latérale du deuxième organe creux (16) ; deux mâchoires de serrage (44, 46) articulées pivotantes sur le support (20) et présentant chacune une surface de serrage (52, 54) faisant face, dans une position fermée, à la paroi extérieure (36,38) de l'enclume (32,34) et s'appuyant à la paroi latérale du deuxième organe creux (16) plaquée sur le moignon terminal rabattu (14) du premier organe creux (12) dans la zone de l'ouverture (18) ; deux conduits de guidage (56, 58) formés dans la zone de l'enclume (32, 34) par le support (20) et les mâchoires de serrage (44, 46) dans la position fermée ; ainsi que deux aiguilles hélicoïdales (98) insérables dans les conduits de guidage (56, 58) et servant à transpercer les parties, superposées au niveau de la paroi extérieure (36, 38) de l'enclume (32, 34), des organes creux (12,16) et à introduire un fil reliant les organes creux (12,16).
PCT/CH2004/000395 2003-06-27 2004-06-25 Appareil pour effectuer une anastomose WO2005000127A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH11392003 2003-06-27
CH1139/03 2003-06-27

Publications (1)

Publication Number Publication Date
WO2005000127A1 true WO2005000127A1 (fr) 2005-01-06

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0938870A1 (fr) * 1998-02-26 1999-09-01 Ethicon Endo-Surgery, Inc. Dispositif chirurgical d'anastomose
US6066148A (en) * 1996-04-30 2000-05-23 Oticon A/S Method and anastomotic instrument for use when performing an end-to-side anastomosis
DE10147632A1 (de) * 2001-06-08 2003-01-09 Fraunhofer Ges Forschung Vorrichtung und Verfahren zum Verbinden von Hohlorganen und/oder Verschließen von Wanddefekten von Hohlorganen
US6520973B1 (en) * 2000-08-30 2003-02-18 Ethicon Endo-Surgery, Inc. Anastomosis device having an improved needle driver

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6066148A (en) * 1996-04-30 2000-05-23 Oticon A/S Method and anastomotic instrument for use when performing an end-to-side anastomosis
EP0938870A1 (fr) * 1998-02-26 1999-09-01 Ethicon Endo-Surgery, Inc. Dispositif chirurgical d'anastomose
US6520973B1 (en) * 2000-08-30 2003-02-18 Ethicon Endo-Surgery, Inc. Anastomosis device having an improved needle driver
DE10147632A1 (de) * 2001-06-08 2003-01-09 Fraunhofer Ges Forschung Vorrichtung und Verfahren zum Verbinden von Hohlorganen und/oder Verschließen von Wanddefekten von Hohlorganen

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