Source: http://www.google.com/patents/US3908662?dq=6,332,126
Timestamp: 2017-10-18 06:45:15
Document Index: 396426706

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Patent US3908662 - Device for the eversion of hollow organs and vascular stapling instrument ... - Google Patents
The present invention relates to the field of medicine, and more particularly to vascular surgery, with particular reference to a device for the eversion of hollow organs and a vascular stapling instrument....http://www.google.com/patents/US3908662?utm_source=gb-gplus-sharePatent US3908662 - Device for the eversion of hollow organs and vascular stapling instrument incorporating same
Publication number US3908662 A
Also published as DE2338065A1, DE2338065B2, DE2338065C3
Publication number US 3908662 A, US 3908662A, US-A-3908662, US3908662 A, US3908662A
Inventors Mashinistov Boris Fedorovich, Potekhina Lidia Alexandrovna, Razgulov Mikhail Mikhailovich
Original Assignee Mashinistov Boris Fedorovich, Potekhina Lidia Alexandrovna, Razgulov Mikhail Mikhailovich
Patent Citations (4), Referenced by (325), Classifications (8)
US 3908662 A
The present invention relates to the field of medicine, and more particularly to vascular surgery, with particular reference to a device for the eversion of hollow organs and a vascular stapling instrument.
United States Patent 1 1 Razgulov et al.
[4 1 Sept. 30, 1975 1 1 DEVICE FOR THE EVERSION OF HOLLOW ORGANS AND VASCULAR STAPLING INSTRUMENT INCORPORATING SAME [76] Inventors: Mikhail Mikhailovich Razgulov,
ulitsa Mashinostroitelei, 32. kv. 80,
Podolsk, Moskovskoi oblasti; Lidia Alexandrovna Potekhina,
Mosfilmovskaya ulitsa, 27, RV. 27;
Boris Fedorovich Mashinistov,
Boitsovaya ulitsa, l3, korpus l. kv. 5, both of, Moscow, all of USSR.
[22] Filed: July 6, 1973 21 Appl. No.: 376,931
[52] US. Cl. 128/334 R; 128/334 [51] Int. Cl. A61B 17/11 [58] Field of Search 128/334 R, 334 C, 346
[56] References Cited UNITED STATES PATENTS 3,057.355 10/1962 Smialowski et all 128/334 R 3.144.654 8/1964 Mallina et al. 128/334 R UX 3.519.187 7/1970 Kapitanov et a1. 128/334 R X 3.606.888 9/1971 Wilkinson 128/334 R OTHER PUBLICATIONS Surgery- February 1962 Vol. 51, No. 2, pp. 2162l9.
Primary Examiner-Dalton L. Truluck Attorney Agent, or Firm-Waters. Schwartz & Nissen 57] ABSTRACT The present invention relates to the field of medicine,
and more particularly to vascular surgery, with particular reference to a device for the eversion of hollow organs and a vascular stapling instrument.
According to the invention, a device for the eversion of hollow organs, comprising a bush, whereinto the hollow organ end to be evcrtcd is introduce. is provided with spikes, whereon the edge of said hollow organ end is pinned, which spikes are arranged on their base along a contour conforming to the lateral guide surface of said bush, said base being mounted so as to move freely along said bush.
The disclosed device for the eversion of hollow organs is recommended for use in instruments for suturing of hollow organs and. inter alia, vascular stapling instruments.
27 Claims, 31 Drawing Figures U.S Patnt Sept. 30,1975 Sheet 1 of 8 3,908,662
US. Patent Sept. 30,1975 Sheet 2 of8 3,908,662
U.S. Patent Sept. 30,1975 Sheet3of8 3,908,662
FIE-i2! FIE.
Sept. 30,1975 Sheet 4 of 8 US Patent US. Patent Sept. 30,1975 Sheet 5 of 8 3,908,662
US. Patent Sept. 30,1975 Sheet 6 of8 3,908,662
US. Patent Sept. 30,1975 Sheet 7 of 8 3,908,662
mwmzk QN MEL U.S. Patent Sept. 30,1975 Sheet 8 of8 3,908,662
DEVICE FOR THE EVERSION OF HOLLOW ORGANS AND VASCULAR STAPLING INSTRUMENT INCORPORATING SAME The present invention relates generally to the field of medicine, more specifically to vascular surgery, and has particular reference to a device for the eversion of hollow organs and to a vascular stapling machine incorporating such a device.
The process of eversion employed, inter alia, in endto-end suturing of blood vessels is effected in this known device in the following manner.
Then the bush is put together by joining the two halfbushes, the end of the blood vessel being securely clamped inside the bush so that the end of the vessel to be everted should be left outside of the bush in sur mounting relation thereto. Then the loose end of the vessel is manually everted with pincers by turning it intima outwards and stretching it over said bush.
Also known is a vascular stapling instrument which incorporates a device for vessel eversion, formed as .a split bush, comprising two half-bushes, one for each end of the vessel (cf. USSR Authors Certificate NO. 127361, Cl.30a, 81 issued on Oct. 9, 1958). The vessel eversion procedure is performed in the abovedescribed sequence immediately prior to the stapling operation.
It is desirable that in the proposed device for the eversion of hollow organs, which incorporates a split bush comprising two half-bushes separated along a plane parallel to its longitudinal axis, the base, whereon said spikes are fixed, should be formed as two halfrings, each of which envelops one of the half-bushes and is connected by a hinge to the respective lever of the hand actuator.
FIG. 6 is a known split bush comprising two pivotally connected half-bushes, shown in axonometry (the halfbushes separated);
FIG. 8 is a known split bush comprising two halfbushes mechanically disengaged from each other (the half-bushes brought apart);
FIG. 10 is a general view of branches, with halfbushes according to FIG. 8 mounted on the working pieces thereof;
FIG. is a bush of the proposed device for the eversion of blood vessels with a haemostatic clamp, shown in axonometry;
FIG. 27 is the same view, but illustrating a largerdiameter blood vessel;
FIG. is a section taken on the line XXIV-XXIV of FIG. 23, illustrating a vascular stapler incorporating the device of this invention for the. eversion of blood vessels; and
In vascular surgery whenever hollow organs are to .be sutured, one of the most important procedures is their eversion, that is to say turning the internal layer (the intima in case of blood vessels) outwards in the form of a cuff.
According to one of these methods, the two hollow organ ends are sutured by a circular suture at the point where the everted ends of both hollow organ ends are bent over. Both ends of the hollow organ are pierced at the point of suture by staples whose ends are subsequently bent, the second segment of the hollow organ being everted on the second bush, as described hereinabove. Thus are hollow organs everted in all known instruments, including vascular staplers, as well as in the above-described known vascular stapler which embodies the USSR Authors Certificate No. 127361.
In the former case the half-bushes have an identical cross-section, whereas in the latter case one halfbush is larger than the other.
Since the half-bushes 8 and 9 are not pivotally connected, it is difficult to handle them during the process of hollow organ eversion. For this reason these halfbushes may be fixed, for example, on the working pieces of branches 10 and 11 (FIG. 10).
In one of the specific embodiments of the present invention, the device for the eversion of hollow organs comprises: a bush 12 (FIG. 11) having a longitudinal slot; spikes 13; a base 14 of the spikes 13, which base 14 envelops the bush l2 and has a longitudinal slot, whereof the width is equal to that of the longitudinal slot in the bush 12.
The base 14 of the spikes 13 is so disposed on the bush 12 that its longitudinal slot should be opposite the corresponding slot in the bush 12. In order to prevent the base 14 from turning around the bush l2 and also to ensure that said base 14 can only move lengthwise 'said bush 12, the latter is provided with a longitudinal slot 15. The base 14 of the spikes 13 is provided with a set screw 16 which fixes said base 14 in its extreme upper and lower positions.
' The hollow organ end to be everted is introduced into the bush 12 through the longitudinal slot therein.
The base 14 with the spikes 13 is moved to its extreme upper position and fixed therein by the set screw 16.
Another embodiment of the device for the eversion of hollow organs in accordance with the invention comprises: two branches 17 and 18 (FIGS. 12, 13) interconnected by an axle 19; a split bush 20 consisting of a larger half-bush 20 mounted on the working piece of the branch 17 and a smaller half-bush 20" mounted on the working piece of the branch 18; spikes 21 and 21; a base of the spikes 21 and 21, which base consists of a half-ring 22 enveloping the half-bush 20' and carrying the spikes 21 fixed thereon, and a half-ring 22' enveloping the half-bush 20" and carrying the spike 21' fixed thereon; a hand actuator formed as first-order levers 23 and 23', the lever 23 being mounted by a pivot 24, serving as the fulcrum therefor, on the working piece of the branch 18. One arm of the first-order lever 23 is movably connected with the half-ring 22 by a hinge 25, while the similar arm of the first-order lever 23' is movably connected to the half-ring 22' by a hinge (not shown).
The other arms of the first-order levers 23 and 23' are provided at the free ends thereof with keys 26 and 26' (top) and 27 and 27' (bottom). The keys 27 and 27 (lower) in FIG. 12 are hidden from view by the keys 26 and 26 (upper), which is the reason why their location is indicated by dotted lines.
By depressing the upper keys 26 and 26, the levers 23 and 23' are turned clockwise, thereby causing the half-ring 22 with the spikes 21 and the half-ring 22 with the spike 21' to move the extreme upper position, wherein the spikes 21 and 21' will be positioned above the bush 20. The branches l7 and 18 are separated, thereby causing the half-bushes 20 and 20" of the bush 20 mounted on these branches to separate. One of the ends 28 (FIG. 14) of a hollow organ 28 is interposed between the half-bushes 20' and 20 so that its edge should extend upwards therefrom.
The branches 17 and 18 are brought together, thereby causing the half-bushes 20' and 20" of the bush 20 fixed on these branches, to be brought together and clamp the end 28' of the hollow organ 28. The edge of one segment 28' and then the edge of the other end 28" of the hollow organ 28 are pinned with pincers on the spikes 21 and 21 (FIGS. 12, 13). Then the levers 23 and 23' are turned counterclockwise by simultaneously depressing the lower keys 27 and 27'. As a result, the half-ring 22 with the spikes 21 and the halfring 22' with the spike 21 will move to the extreme lower position.
The edge of one of the ends 28' (FIG. 16) of the hollow organ 28 is everted, whereupon the edge of the other end 28" of the hollow organ 28 is stretched over the everted edge of the end 28.
The edges of the ends 28 and 28" of the hollow organ 28 are securely held on the bush 20 by the spikes 21 and 21.
After the hollow organ 28 has been sutured, the levers 23 and 23 are turned clockwise by depressing the upper keys 26 and26, which causes the half-ring 22 with the spikes 21 and the half-ring 22' with the spike 21 to move to the extreme upper position. The spikes 21 and 21', carrying the edges of the joined ends 28' and 28" of the hollow organ 28 pinned thereon, will be positioned above the bush 20. Then, using pincers, the hollow organ 28 is taken off the spikes 21 and 21, the branches 17 and 18 separated and the hollow organ 28 withdrawn out of the bush 20.
In one embodiment of the disclosed device for the eversion of hollow organs, wherein the spikes are rigidly mounted on the base, spikes 29 (FIGS. 16, 17) are integral with a half-ring 30 of a base 30, while a spike 29' is integral with a half-ring 30" of the base 30.
The spikes 29 and 29' are arranged along a circumference, whereof the diameter corresponds to the external diameter of a bush 31 made to split into two halfbushes 31' and 31". The distance L between the diametrically opposite spikes 29. is equal to the outer diameter of the bush 31 and remains constant throughout the process of eversion.
In another embodiment of the proposed device for the eversion of hollow organs, wherein the spikes are spring-loaded relative to their base, each spike 32, 32' (FIGS. 18, 19) is made of an elastic steel ribbon (flat spring) which, together with another steel ribbon 33 forcing thereagainst, is anchored to a base 34 by a screw 35. The base 34 is formed as two half-rings, one half-ring 34' with the spikes 32 enveloping a half-bush 36' of a bush 36, while the other half-ring 34" with the spike 32, envelops a half-bush 36" of the bush 36.
Prior to the process of eversion, when the spikes 32 and 32 are disposed above the bush resting on its edge, the spikes are arranged along a circumference, whereof the diameter corresponds to the inner diameter of the bush. The distance 1 between the diametrically opposite spikes 32 and 32' is equal to the inner diameter of the bush 36, which facilitates the pinning of the hollow organ end to be everted on the spikes 32 and 32'.
In the course of eversion, the spikes 32 and 32 together with the basev 34 move downwards and away from each other, so that at the end of the eversion process the spikes 32 and 32' are arranged along a circumference, whereof the diameter corresponds to the outer diameter of the bush 36, thereby ensuring reliable fixation of the hollow organ segment pinned on the spikes 32 and 32'.
The base 38 is formed as two half-rings, one half-ring 38' with the spikes 37 enveloping a half-bush 40' of a bush 40, while the other half-ring 38" with the spike 37 envelops a half-bush 40" of the bush 40.
Prior to the eversion process, the hinges spikes 37 and 37 extend outwards above the bush.
An improved modification of the latter embodiment of the disclosed device with hinged spikes is a device for the eversion of hollow organs comprising a split bush 41 (FIGS. 22 24) which consists of two halfbushes 41' and 41". The half-bushes 41 and 41 of the bush 41 respectively have replaceable upper parts 42' and 42" and basic lower parts 43 and 43". Hinged spikes 44 and 44 are movably mounted on a base 46 by means of hinges 45. The base 46 is formed as two half-rings, one half-ring 46' with the spikes 44 enveloping one basic lower part 43 of the half-bush 41' of the bush 41, while the other half-ring 46" with the spike 44' envelops the other basic lower part 43 of the halfbush 41" of the bush 41.
A wedge-shaped projection 46 positioned immediately adjacent the hinge 46 with its tapered portion towards the bush 41, serves as the smaller arm of said S-shaped lever of the first order. The other, larger, arm of said S'shaped lever of the first order is positioned above the hinge 45 and ends in a sharp point, whereon the edge of the hollow organ end to be everted is pinned when being fixed on the spikes 44 and 44. The wedge-shaped projection 47 of each spike 44 and 44 provides for an interaction with the replaceable parts 42' and 42" of the respective half-bushes 41 and 42" so that the spikes 44 and 44 are drawn together while being moved to the initial (extreme upper) position thereof.
The device for the eversion of hollow organs illustrated in FIGS. 22 24 operates in the following manner.
First, the replaceable parts 42' and 42" of the halfbushes 41 and 41", respectively are installed. These replaceable parts 42 and 42" of the half-bushes 41' and 41" are so selected that their diameter should correspond to that of the hollow organ to be everted. Then the base 46 with the spikes 44 and 44' is raised to the initial (upper position thereof. This causes the spikes 44 and 44' to be drawn together as a result of interaction between the spikes 44 and 44, end the replaceable parts 42' and 42" of the half-bushes 41 and 41" so that the distance 1 between the opposite spikes 44 becomes equal to the inner diameter of the replaceable part 42 of the half-bush 41'. 4
The above-mentioned interaction of the spikes 44 and 44 with the replaceable parts 42 and 42" of the half-bushes 41 and 41" respectively occurs in the fol lowing sequence.
When the base 46 is in its lower position, the spikes 44 and 44' may occupy any random position whatever usually they are fully swung back, i.e. brought maximum apart. As the base 46 carrying the spikes 44 and 44 approaches its extreme upper position, the wedgeshaped projections 47 of the spikes 44 and 44' thrust against the end faces 48 of the replaceable parts 42 and 42" of the half-bushes 41 and 41" and begin turning round the hinges 46, drawing together.
The end face 48 of the replaceable part of each halfbush is made sloping at such an angle that, when the replaceable parts 42 and 42" of the half-bushes 41 and 41" are installed in the eversion device, the spikes 44 and 44 in their upper position will be so disposed that the distance between the diametrically opposite spikes 44 and 44' will become equal to the inner diameter of the replaceable part 42' of the half-bush 41'.
The device for the eversion of hollow organs (FIGS. 22 24) is simple in design, reliable in operation and, what with the replaceable parts in the bushes, may be employed for the eversion of a variety of hollow organs, inter alia, vessels of various diameters. Furthermore, with the foregoing embodiment of the disclosed device for the eversion of hollow organs, the entire eversion procedure is in fact mechanized, thereby substantially simplifying the process of eversion and the associated surgical procedure. for example vascular stapling. Hence, the said surgical procedure may be carried out with much less effort on the part of the operating surgeon.
If, on the other hand, a blood vessel 59 (FIG. 27) has a large diameter, then, on the union of the half-bushes 51 and 55, the Hat spiral spring 45 experiences a comparatively large amount of deformation and accordingly exerts a comparatively large force on the blood vessel 59, thereby ensuring haemostasis in this case,
In the device for the eversion of blood vessels of the design illustrated in FIGS. 22 24, the haemostatic clamp is disposed at the bottom of the basic part of the bush 41, over an area 60 (FIG. 22).
It should be noted that the proposed device for the eversion of hollow organs may be incorporated in said instruments for anastomosis of hollow organs as a self contained unit (eversion unit), whereof the elements take no part in any operations not involved in the eversion of a hollow organ, or else it may form a unit kinematically connected to the other units of said anastomosing instruments, the latter design ensuring the required sequence of operations of all the elements of the instrument. In the latter case, individual elements of such an eversion unit way take part in operations not involved in the eversion of a hollow organ.
The branches 61 and 62 are provided with a lock 66 which keeps the branches closed (as indicated in the drawing) and prevents them from spontaneous open- The branch 61 consists of a working piece 67 and a handle 68. The branch 62 has a working piece 69 and a handle 70. The handles 68 and 70 of the respective branches 61 and 62 are formed as rings.
As staples are placed in the slot 98, the plate 96 aligns itself at the same angle at which the staple is bent, thereby making it possible to fix the staple rela; tive to the bush (the drawings illustrate the half-bushes 71 and 71 making up the bush).
The actuator of the mechanism 65 for feeding and directional bending of the staples is manual and comprises: a lever 101 movably mounted by a pivot 102 on the working piece 67 of the branch 61; a lever 103 movably mounted by a pivot 104 on the working piece 69 of the branch 62; a flat spring 105 loading the lever 101; a flat spring 106 loading the lever 103; a fork 107 movably mounted by a pivot 108 on the free end of the lever 101; and a fork 109 movably mounted by pivot 110 on the free end of the lever 103. The ends of the brackets 107 and 109 enter the holes 100 (FIG. in the sliders 94, thereby providing for the kinematic connection of these sliders with the hand actuator. There are screws 111 turned into the faces of the free ends of the forks 107 (FIG. 24) and 109. The screws 111 provided for the movement of the sliders 94 from the bush centre towards the periphery as the levers 101 and 103 are respectively urged by the springs 105 and 106 to return to their initial positions.
The branches 61 and 62 are separated. As a result, the smaller half-bush 71 and the larger half-bush 72, respectively mounted on the working pieces 67 and 69 of the branches 61 and 62, are separated, the small levers 78 and 79 are turned counterclockwise, the halfrings 74 with the spike 75 and 76 with the spikes 77 are in the extreme lower position, and the mechanism 65 for feeding and directional bending of the staples is in the initial position (the levers 101 and 103 are drawn off by the springs and the sliders 94 are at a maximum distance from the bush centre). The staples are placed in the slots 98 of the plates 96.
By depressing the upper keys 88 and 90, the small levers 78 and 79 are turned clockwise, thereby causing the half-ring 74 with the spike 75 and the half-ring 76 with the spikes 77 to move to the extreme upper posi tion. One end (usually the shorter) of the blood vessel to be sutured is inserted into the larger half-bush 72. Actuating the handles 68 and 70, the branches 61 and 62 are brought together, thereby causing the smaller half-bush 71 and larger half-bush 72 to unite and envelop said end of the blood vessel. In this position the branches 61 and 62 are fixed by the lock 66. The said end of the blood vessel enveloped by the half-bushes 71 and 72 is securely clamped by the haemostatic clamp 73. On the side of the adventitia the protruding edge of this end of the blood vessel is pinned at regular intervals on the spikes 75 and 77. Then the edge of the other end of the blood vessel is pinned on these same spikes 75 and 77. The ends of the blood vessel to be sutured are usually pinned on the spikes 75 and 77 with pincers a simple enough matter for the operating surgeon.
The sliders 94, kinematically connected via the forks 107 and 109 with the levers 101 and 103, move along the grooves 95 toward the bush centre (the drawings illustrate the smaller half-bush 71 and the larger halfbush 72 of the bush).
It has been shown experimentally that the proposed device permits everting, and hence suturing, short vessel ends (of the order of 4 to 5 mm), whereas prior-art devices could only handle at least -mm long ends of the vessels to be everted and subsequently sutured. Experiments indicate that the proposed device is suitable for the eversion of a great range of vessels, including the thinnest and severely sclerosed ones.
1. A device for the eversion of hollow organs, such as a blood vessel, comprising: a hollow bush member having a peripheral outer surface, the hollow organ end to be everted adapted to be introduced into said bush member; means within said bush member for clamping said hollow organ; spikes adapted to have the edge of said hollow organ end pinned thereto; a base movably secured around the outer surface of the bush member, said spikes arranged about said base along a contour conforming to the outer peripheral surface of said bush member; and means for moving said base, and thereby said spikes, axially along said bush member.
2. A device for the eversion of hollow organs as of claim 1, in which the spikes, whereon the edge of the hollow organ end to be everted is fixed, are rigidly mounted on said base.
3. A device for the eversion of hollow organs as of claim 2, wherein said means for moving the base comprises at least one manually-operable lever with a fixed fulcrum relative to said bush member, which lever carries on one arm thereby said movably mounted base with spikes, while the other arm of said lever is manually operable to transmit motion to said base in the course of eversion of a hollow organ end, whereof the edge is fixed on the spikes mounted on said base.
4. A device for the eversion of hollow organs as of claim 3 said bush member being a split bush consisting of two half-bushes separated along a plane parallel to the longitudinal axis of said bush, in which the base carrying the spikes is formed as two half-rings, each halfring enveloping one of the half-bushes and connected by a hinge with the respective arm of the lever of the hand actuator.
5. A device for the eversion of blood vessels as of claim 4, which incorporates means for clamping a ho]- low organ mounted in said bush at the base thereof.
6. A device for the eversion of blood vessels as of claim 5 with the clamping means formed as a flat spiral spring, whereof the outer end is attached to the bush while the inner end is left loose.
7. A device for the eversion of hollow organs as of claim 1, in which the spikes, whereon the edge of the hollow organ end to be everted is fixed, are springloaded relative to said base so that the diameter of the contour along which the spikes are arranged prior to the process of eversion should be less than the diameter of the contour along which the spikes are arranged at the end of the eversion process.
8. A device for the eversion of hollow organs as of claim 7, wherein the means for moving the base comprises at least one manually-operable lever with a fixed fulcrum relative to said bush member, which lever carries on one arm thereof said movably mounted base with spikes, while the other arm of said lever is manually operable to transmit motion to said base in the course of eversion of a hollow organ end, whereof the edge is fixed on the spikes mounted on said base.
9. A device for the eversion of hollow organs as of claim 8 said such member being a split bush consisting of two half-bushes separated along a plane parallel to the longitudinal axis of said bush, in which the base carrying the spikes is formed as two half-rings, each halfring enveloping one of the half-bushes and connected by a hinge with the respective arm of the lever of the hand actuator.
10. A device for the eversion of blood vessels as of claim 9, which incorporates means for clamping a hol low organ mounted in said bush at the base thereof.
11. A device for the eversion of blood vessels as of claim 10 with the clamping means formed as a flat spiral spring, whereof the outer end is attached to the bush while the inner end is left loose.
12. A device for the eversion of hollow organs as of claim 1, in which the spikes, whereon the edge of the hollow organ end to be everted is fixed, are movably mounted on said base by hinges so that said spikes could be drawn together prior to the eversion process.
13. A device for the eversion of hollow organs as of claim 12, wherein the means for moving the base comprises at least one manually-operable lever, whereof the fulcrum is fixed relative to said bush member, which lever carries on one arm thereof said movably mounted based with spikes, while the other arm of said lever is manually operable to transmit motion to said base in the course of eversion of a hollow organ end, whereof the edge is fixed on the spikes mounted on said base.
14. A device for the eversion of hollow organs as of claim 13 said bush member being a split bush consisting of two half-bushes separated along a plane parallel to the longitudinal axis of said bush, in which the base carrying the spikes is formed as two half-rings, each halfring enveloping one of the half-bushes and connected by a hinge with the respective arm of the lever of the hand actuator.
15. A device for the eversion of blood vessels as of claim 14, which incorporates means for clamping a hollow organ mounted in said bush at the base thereof.
16. A device for the eversion of blood vessels as of claim with the clamping means formed as a flat spiral spring, whereof the outer end is attached to the bush while the inner end is left loose.
17. A device for the eversion of hollow organs as of claim 1, which comprises a hand drive incorporating at least one lever with a fixed fulcrum relative to said bush member, which lever carries on one arm thereof said movably mounted base with said spikes, while the other arm of said lever is made so that it could be manually actuated to transmit motion to said base in the course of eversion of a hollow organ end, whereof the edge is fixed on the spikes mounted on said base.
18. A device for the eversion of hollow organs as of claim 17 said bush member being a split bush consisting of two half-bushes separated along a plane parallel to the longitudinal axis of said bush, in which the base carrying the spikes is formed as two half-rings, each halfring enveloping one of the half-bushes and connected by a hinge with the respective arm of the lever of the hand actuator.
19. A device for the eversion of blood vessels as of claim 18, which incorporates means for clamping a ho]- low organ mounted in said bush member at the base thereof.
20. A device for the eversion of blood vessels as of claim 19 with the clamping means formed as a flat spiral spring, whereof the outer end is attached to the bush while the inner end is left loose.
21. A device for the eversion of hollow organs according to claim 1, wherein said spikes comprise S- shaped fulcrum levers, each having a fulcrum in the form of a hinge, one, smaller arm of said lever comprising a wedge-shaped projection disposed below immediately adjacent to the hinge and facing said bush member, the other, larger arm of said lever being disposed above said hinge and tapering down to a point whereon said edge of the hollow organ to be everted is pinned,
the base to which said spikes are movably mounted embracing the lower part of the bush member, so as to be axially movable therealong, the upper part of the bush member being made replaceable with the inside diameter substantially equal to the outside diameter of the hollow organ to be everted, the surface of the lower end of said replaceable part of the bush member conforming to the surface of the wedge-shaped projections of the spikes so that with the spikes being in the uppermost position the larger arms thereof should be drawn together and thrust against the upper edge of the replaceable part of the bush member.
22. A device for the eversion of hollow organs as of claim 21, wherein the means for moving the base comprises at least one manually-operable lever, whereof the fulcrum is fixed relative to said bush member, which lever carried on one arm thereof said movably mounted base with spikes, while the other arm of said lever is manually operable to transmit motion to said base in the course of eversion of a hollow organ end, whereof the edge is fixed on the spikes mounted on said base.
23. A device for the eversion of hollow organs as of claim 22 said bush member being a split bush consisting of two half-bushes separated along a plane parallel to the longitudinal axis of said bush, in which the base carrying the spikes is formed as two half-rings, each halfring enveloping one of the half-bushes and connected by a hinge with the respective arm of the lever of the hand actuator.
24. A device for the eversion of blood vessels as of claim 25, which incorporates means for clamping a ho]- low organ mounted in said bush at the base thereof.
25. A device for the eversion of blood vessels as of claim 24 with the clamping means formed as a flat spiral spring, whereof the outer end is attached to the bush while the inner end is left loose.
26. A device for the eversion of blood vessels as of claim 22, which incorporates means for clamping a hollow organ mounted in said bush member at the base thereof.
US3144654 * Nov 22, 1961 Aug 18, 1964 Foundation For Medical Technol Medical staplers
US3606888 * Jun 30, 1969 Sep 21, 1971 Jack E Wilkinson Stapling apparatus for anastomosis of hollow viscera
US8066724 * Jan 10, 2003 Nov 29, 2011 Medtronic, Inc. Anastomosis apparatus and methods
US20140257341 * Mar 5, 2014 Sep 11, 2014 St. Jude Medical, Cardiology Division, Inc. Pmvr clip configurations for mitral leaflet
DE102008039523A1 * Aug 23, 2008 Feb 25, 2010 S & C Systems Gmbh Blutgefäßanschluss für eine Gefäßprothese
DE102008039523B4 * Aug 23, 2008 Jun 16, 2011 S & C Systems Gmbh Blutgefäßanschluss für eine Gefäßprothese
EP0688544A2 Mar 8, 1989 Dec 27, 1995 Endovascular Technologies, Inc. Artificial graft and implantation method
WO2001041654A2 * Nov 8, 2000 Jun 14, 2001 Vascular Innovations, Inc. Everter and threadthrough system for attaching graft vessel to anastomosis device
WO2001041654A3 * Nov 8, 2000 Feb 7, 2002 Vascular Innovations Inc Everter and threadthrough system for attaching graft vessel to anastomosis device
WO2002030172A3 * Sep 25, 2001 Aug 21, 2003 By Pass Inc Anastomotic connection system
U.S. Classification 606/149, 606/155
International Classification A61B17/03, A61B17/11, A61B17/115
Cooperative Classification A61B2017/1125, A61B17/1152