Source: https://patents.google.com/patent/EP1929958B1/en
Timestamp: 2019-06-20 02:37:42
Document Index: 378734761

Matched Legal Cases: ['Application No. 2004', 'Application No. 2003', 'Application No. 2004', 'Application No. 2004', 'Application No. 2003', 'Application No. 2004']

EP1929958B1 - Insertion instrument - Google Patents
EP1929958B1
EP1929958B1 EP07254473.7A EP07254473A EP1929958B1 EP 1929958 B1 EP1929958 B1 EP 1929958B1 EP 07254473 A EP07254473 A EP 07254473A EP 1929958 B1 EP1929958 B1 EP 1929958B1
EP07254473.7A
EP1929958A3 (en
EP1929958A2 (en
2008-06-11 Publication of EP1929958A2 publication Critical patent/EP1929958A2/en
2008-12-03 Publication of EP1929958A3 publication Critical patent/EP1929958A3/en
2013-09-25 Publication of EP1929958B1 publication Critical patent/EP1929958B1/en
The formation of an anastomosis or an anastomotic site is often achieved by folding the free ends of the tissue sections radially inwardly and securing them together. The resultant anastomotic junction typically results in a stricture which is a circumscribed narrowing of the joined·hollow tissue structures. For example, in certain colorectal procedures a circular stapling apparatus is utilized to join the hollow tissue sections. The free ends of the tissue sections are everted radially inwardly and staples are passed through the everted edges. After stapling, the radially inwardly directed edges of the joined issues form a stricture which temporarily inhibit free flow of fluids or other materials through the tubular tissue sections.
US 2005/267498 discloses a stent for forming a vascular anastomises. The stent and graft vessel arc inserted into a hole in the target vessel via a holder tube and the stent is expanded to secure the graft vessel to the target vessel. The holder tube is disposed within the stent.
US 2006/200221 discloses a stent delivery and recapture catheter system using a hydraulically activated rolling membrane for the delivery and/or recapture of a stent in a body lumen.
There is disclosed a deployment cartridge as defined in claim 1 for use in inserting a stent into an anastomotic site to support the anastomotic site and facilitate the healing and joining of the tissues at the anastomotic site. The deployment cartridge generally includes a hollow pusher and a stent wholly supported within the hollow pusher. The stent is formed as a wire mesh cage having a coating formed on an outer surface. In one embodiment, the outer coating includes a tissue sealant. In an alternative embodiment, the outer coating includes a tissue adhesive. In a further embodiment, the stent includes an inner coating to facilitate the passage of materials through the stent.
The pusher includes support structure engageable with the stent to support the stent within the pusher. The support structure includes at least one radially inwardly directed projection engageable with a proximal end of the stent. In one embodiment, the pusher is formed with a sharp distal tip configured to cut tissue.
There is also disclosed an insertion instrument as defined in claim 10 for use in positioning a stent within an anastomotic site. The insertion instrument generally includes a handle having an elongate member extending distally from the handle and a head extending distally from the elongate member. A deployment cartridge is disposed within the head such that the deployment cartridge may be extended out of the head. The deployment cartridge generally includes a pusher and a stent contained within the pusher. The handle includes an actuator operable to advance the deployment cartridge out of the head.
As an example, there is also shown a method of supporting an anastomotic site with a stent. The method generally includes providing an insertion instrument having a deployment cartridge including a pusher and a stent. The insertion instrument is positioned within a first tubular tissue section and a second tubular tissue section is approximated adjacent the first tubular tissue section. The deployment cartridge is advanced into the junction formed between the first and second tubular tissue sections and the deployment cartridge is advanced into the junction.
Referring now to FIG. 6, there is disclosed an insertion instrument 36 particularly suited for insertion of adhesive coated stent 10 within an anastomotic site formed between two tubular tissue sections. Insertion instrument 36 generally includes a handle 38 having an elongate tubular member 40 extending distally from handle 38. A head portion 42 extends distally from elongate tubular member 40. Insertion instrument 36 additionally includes an anvil member 44 having a cap 46 and a shaft 48 extending proximally from cap 46. Cap 46 includes a proximal surface 50. Shaft 48 includes a proximal, tissue penetrating tip 52 for use in penetrating constricted areas of tubular tissue sections. In order to connect anvil 44 to head portion 42 of insertion instrument 36, head portion 42 includes a central bore 54 for receipt of shaft 48. Handle 38 includes an approximation knob 56 which, when actuated, serves to advance and retract shaft 48 within bore 54 so as to approximate anvil 44 relative to head portion 42 in a manner similar to that used for various commonly known surgical stapling or other fastener type apparatus. One such device, known as a EEA or end to end anastomosis instrument, is disclosed in U.S. Patent No. 6,959,851 .
Some specific materials which may be utilized include isocyanate terminated hydrophilic urethane prepolymers derived from organic polyisocyanates and oxyethylene-based diols or polyols, including those disclosed in U.S. Pat. Nos. 6,702,731 and 6,296,607 and U.S. Published Patent Application No. 2004/0068078 ; alpha-cyanoacrylate based adhesives including those disclosed in U.S. Pat. No. 6,565,840 ; alkyl ester based cyanoacrylate adhesives including those disclosed in U.S. Pat. No. 6,620,846 ; adhesives based on biocompatible cross-linked polymers formed from water soluble precursors having electrophilic and nucleophilic groups capable of reacting and cross-linking in situ, including those disclosed in U.S. Pat. No. 6,566,406 ; two part adhesive systems including those based upon polyalkylene oxide backbones substituted with one or more isocyanate groups in combination with bioabsorbable diamine compounds, or polyalkylene oxide backbones substituted with one or more amine groups in combination with bioabsorbable diisoycanate compounds as disclosed in U.S. Published Patent Application No. 2003/0032734 ; and isocyanate terminated hydrophilic urethane prepolymers derived from aromatic diisocyanates and polyols as disclosed in U.S. Published Patent Application No. 2004/0115229 .
Some specific materials which may be utilized as adhesives include isocyanate terminated hydrophilic urethane prepolymers derived from organic polyisocyanates and oxyethylene-based diols or polyols, including those disclosed in U.S. Pat. Nos. 6,702,731 and 6,296,607 and U.S. Published Patent Application No. 2004/0068078 ; alpha-cyanoacrylate based adhesives including those disclosed in U.S. Pat. No. 6,565,840 ; alkyl ester based cyanoacrylate adhesives including those disclosed in U.S. Pat. No. 6,620,846 ; adhesives based on biocompatible crosslinked polymers formed from water soluble precursors having electrophilic and nucleophilic groups capable of reacting and crosslinking in situ, including those disclosed in U.S. Pat. No. 6,566,406 ; two part adhesive systems including those based upon polyalkylene oxide backbones substituted with one or more isocyanate groups in combination with bioabsorbable diamine compounds, or polyalkylene oxide backbones substituted with one or more amine groups in combination with bioabsorbable diisoycanate compounds as disclosed in U.S. Published Patent Application No. 2003/0032734 ; and isocyanate terminated hydrophilic urethane prepolymers derived from aromatic diisocyanates and polyols as disclosed in U.S. Published Patent Application No. 2004/0115229 . It is contemplated that any known suitable adhesive may be used.
It will be understood that various modifications may be made to the embodiments disclosed herein. For example, various other support structure may be provided on the pusher to engage, support, and advance the adhesive coated stent out of the insertion instrument. Further, as noted hereinabove, the disclosed deployment cartridge, including the pusher and adhesive coated stent, may be utilized in insertion instruments other than stapling instruments. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope of the claims appended hereto.
A deployment cartridge (60) for use within an anastomotic site comprising:
a hollow pusher (74) including a support structure (82) including at least one radially inwardly directed projection (82); and
a stent (10) supported within the hollow pusher (74) the radially inwardly directed projection (82) being engageable with the stent (10) and for support of the stent (10).
An insertion instrument (36) for use in positioning a stent (10) within an anastomotic site comprising:
a handle (38);
an elongate member (40) extending distally from the handle (38);
a head (42) extending distally from the elongate member (40); and
a deployment cartridge (60) as defined in claim 1 disposed within the head (42).
The insertion instrument (36) as recited in claim 2, wherein the handle (38)
includes an actuator (62) operable to advance the deployment cartridge (60) out of the head (42).
The insertion instrument (36) as recited in claim 2 or claim 3, wherein the insertion instrument additionally includes an anvil member (44) engageable with the head (42).
The insertion instrument (36) as recited in any of claims 2 to 4, wherein the anvil member (44) includes an abutment surface (64) configured to engage the distal end of the stent (10).
The insertion instrument (36) as recited in any of claims 2 or 5, wherein the handle (38) includes an approximation knob (56) configured to approximate the anvil (44) relative to the head (42).
EP07254473.7A 2006-12-05 2007-11-16 Insertion instrument Expired - Fee Related EP1929958B1 (en)
EP11004916.0 Division-Into 2011-06-16
EP11004917.8 Division-Into 2011-06-16
EP11004919.4 Division-Into 2011-06-16
EP11004918.6 Division-Into 2011-06-16
EP1929958A2 EP1929958A2 (en) 2008-06-11
EP1929958A3 EP1929958A3 (en) 2008-12-03
EP1929958B1 true EP1929958B1 (en) 2013-09-25
EP1799125B8 (en) 2011-10-12 Seal element for anastomosis
2010-12-08 R17C Date of despatch of first examination report
2011-05-25 R17C Date of despatch of first examination report
Ref document number: 602007033010
Ipc: A61B 17/115 20060101ALI20130423BHEP
Ipc: A61F 2/82 20130101ALI20130423BHEP
Ipc: A61B 17/11 20060101AFI20130423BHEP
Ipc: A61F 2/95 20130101ALI20130423BHEP