Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
  • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
  • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
  • A61B17/1155—Circular staplers comprising a plurality of staples
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
  • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
  • A61B2017/1157—Staplers for performing anastomosis, e.g. in a single operation applying the staples radially

Definitions

• the present invention relates to medical techniques, in particular,
• the present invention relates to
• An aortic aneurysm (or its rupture) is a . most common form of
• the aortic aneurysm is a ballooning of the wall of an artery
• the aorta is the main artery, which supplies blood to the
• the aorta arises from the left ventricle of the heart
• the abdominal aorta supplies two side vessels
• the renal arteries To the kidneys, the renal arteries. Below the level of the renal arteries, the renal arteries, the renal arteries.
• abdominal aorta continues to about the level of the fourth lumbar
• portion of the abdominal aorta is particularly susceptible to weakening
• an aneurysm is often located near
• aneurysm may rupture, resulting in rapid, and usually fatal
• Aneurysrns in the abdominal aorta are associated with a
• a prosthetic device typically a synthetic tube
• the graft serves to exclude the aneurysm
• intravascular devices of the "stent-graft" type. They are inserted and
• the stent-graft are insufficient for its fixation in a blood vessel, the stent-graft
• the common repair means is to deploy of a stent-
• Parodi discloses a stent-graft device for locating inside an aorta
• the graft has
• the limbs having respective distal end portion having
• This frame is covered by a sheath which can
• Aforesaid stent-grafts are provided with means for mechanical
• Fixation Means [0013] The problem of fixation of stents and stent-grafts inside the aorta
• the stent can be expanded from a
• Samuels in U.S. 5423851 discloses a method and apparatus for
• This stent-graft can bend to
• components for treating aortic aneurysrns includes a reinforcing graft and
• branch vessels for example the iliac, and renal arteries.
• tubular graft member tubular graft member.
• the structural support forms a spiral about the
• tubular graft tubular graft
• hooks and anchor members integral or not integral with the stent-graft
• EP 657147 A2 EP 466518A2, U.S. 5669936, U.S. 6004347, U.S.
• Taheri, Syde in U.S. 5843169 discloses an apparatus for stapling
• graft material to a blood vessel wall comprising a stapling device, a
• Tanner, Howard in U.S. 5944750 discloses an attachment
• the attachment assembly comprises an attachment cuff
• the apparatus also comprises a visualization apparatus for real
• a penetration apparatus is
• the fastener assemblies are shaped as a
• fasteners including a plurality of rings.
• Tanner can be used only inside the aorta and not inside iliac arteries.
• the stent-graft may be displaced from its
• the staple inserter ejects staples in a radial direction
• it includes a staple
• the staple inserter also includes an anvil outside the organic duct, and a
• Pat. FR 2746292 describes the surgical staple, which has a circular
• the staple can have a barbed end.
• a device for this staples inserting comprises a guide tube, extending
• the device has several drawbacks. It is rather difficult to set the
• An object of the present invention is to provide reliable and
• intravascular devices to the wall of the aorta, iliac arteries or other
• Another object of the present invention is to provide suturing of a
• the present invention includes a method for mttaluminal fixation
• intravascular devices such as grafts, stent-grafts.
• the method includes several successive steps. At the first step a
• substantially graft or stent-graft is fitted over the body of this stapler
• the fitted intravascular device is secured on the stapler body via
• corresponding intravascular device substantially a graft or stent-graft
• this intravascular device is set in a desired
• a graft on the wall of a blood vessel, substantially the aorta. Then there is
• intravascular device the place of its supposed attachment to to the blood
• the stapler is brought into inoperative position necessary for its free removal and is removed from the intravascular
• This stapler is brought into operative position, whereupon its
• intravascular device such as a graft or stent graft to a blood vesel wall via
• an intravascular device such as a stent graft having a broad
• proximal part and bifurcated distal part is secured to the wall of a blood
• the set contains at least one
• first stapler for securing the broad proximal part of the stent-graft to the
• aorta wall and at least one second stapler for securing to the bifurdates
• proximal end of the stent-graft having a broad proximal part is secured to
• staplers comprised in the set of staplers, and using simultaneously at least
• the stent-graft may be
• both branches of the bifurcated distal part of a stent-graft are both branches of the bifurcated distal part of a stent-graft.
• the claimed invention also includes a stapler for mfraluminal
• This stapler contains a substantially cylindrical hollow body
• the die of the claimed stapler is intended for locating fastener
• proximal end proximal end, distal end, a substantially cylindrical generatrix and an
• This bottom has a through axial
• these recesses with grooves have different depth relative to
• the recesses with grooves may have at
• the fastener means substantially U-shaped staples, are arranged
• the die lid has a through axial hole, substantially cylindical
• All these means are disposed in the lid body near the points of
• the means for holding the free ends of U-shaped staples are
• torsion spring members located near the points of intersection of radial slots with the distal end face and and cylindrical generatrix of the die lid.
• the die lid may be
• the stapler further contains a pressure rod located inside the stapler
• hollow body having a longitudinal axis, a proximal end and a distal
• the pressure rod is operatively connected via its distal end with the
• control lever spring-loaded, has a thrust collar near jits distal end and is
• this pressure rod is shaped substantially as a cone and is disposed in the
• This pressure rod has an
• angle at cone vertex from about 3 degrees to approximately 35 degrees
• the stapler further contains means for thransmitting axial force
• the curved L-shaped levers are pivotally mounted by the end of
• shaped levers are configured to periodically engage via the inner surface
• the flange has evenly arranged radial slots, and in each
• the curved L-shaped levers are pivotally
• the body and the inner ribs of this die extending from the wall of its inner axial cavity in direction to the longitudinal axis of the die.
• ribs have evenly disposed radial slots, and in each of the latter there is
• intravascular devices substantially grafts or stent-grafts. This means
• the claimed stapler is provided with an
• This additional device contains a stepped rod, thin-wall bush and
• the stepped rod has a first end and a second end, and
• the stepped rod is twice that of inclination angles of outer surfaces of the
• the additional device further contains a thin-wall bush the inner
• the thin-wall bush has a thrust collar at one its end.
• the additional device contains a pressure bush with a
• FIG. 1 is a perspective view of a stapler apparatus according the
• FIG. 2 is the longitudinal section of the stapler, according to the
• FIG. 3 is the front view of the claimed stapler according to the
• FIG. 4 is the longitudinal section of the stapler according to the
• FIG. 5 - 7 is the first embodiment of the stapler die - its
• FIG. 8 - 11 is the second embodiment of the stapler die - its
• FIG. 12 - 14 is the Ud of the stapler die - its longitudinal section
• FIG. 15 is the pressure rod, side view
• FIG. 16 is a U-shaped staple
• FIG. 17 is an L-shaped lever and diagram of its engagement with
• FIG. 18 is a diagram of securing L-shaped levers on a ring
• FIG. 19 - 20 are the longitudinal and cross sections of an aditional bush
• FIG. 21 - 23 are elements of the additional device for the claimed
• stapler stepped rod, thin-waU rod and pressure bush
• FIG. 24 is a diagram of the additional device operation.
• FIG. 25 - 26 are diagrams of setting a graft and stent-graft using a
• the present invention (FIG. 1) comprises a stapler 1 for
• intraluminal fixation of intravascular devices substantially grafts or stent ⁇
• Stapler 1 comprises a substantially cylindrical hollow body 10
• FIG. 1 having an inner axial cavity, a proximal end 12 and distal end
• FIG. 2, 3 show the longitudinal section of stapler 1, according to
• Lock 26 (FIG. 2) of stapler 1 is pivotaUy mounted on pin 28 and
• Control lever 18 is pivotaUy mounted on pin 32.
• pressure rod 34 is a means for transmitting the axial force from control
• Pressure rod 34 (FIG. 2, 3) is operatively connected via its distal end 40
• control lever 18 loaded by spring 44, has a thrust coUar 46 near its
• Pressure rod 34 (FIG. 2) is reciprocable inside die 20 and die Ud 22.
• the stapler is provided
• Die 20 is secured on body 10 via screws 54.
• Die 20 may be made of
• FIG.4 shows the longitudinal section of stapler 1 according to the
• Stapler 1 according to this embodiment differs only
• Control lever 18 is pivotaUy mounted on pin 32. Inside hollow body
• This pressure rod 34 is a means for
• Pressure rod 34 (FIG. 2, 4) is operatively
• control lever 18 connected via its distal end 40 with control lever 18, loaded with spring
• the stapler is also provided with curved L-shaped levers
• Levers 48 are movably disposed in slots
• Die 20 is mounted on body 10 via
• Die 20 of the claimed stapler serves for locating fastener means
• barrel 60 having a proximal end 62, distal end 64, cylindrical generatrix
• bottom 70 has through evenly arranged radial slots 72 (FIG. 6, 7), and on
• proximal end 62 is also shaped as a barrel 60 having a proximal end 62, distal end 64,
• This bottom 70 has through evenly arranged radial
• levers 48 (FIG. 8 - 9).
• grooves 78 have substantiaUy the same depth relative to the end face
• grooves 78 have substantially different depths relative o end face 74
• Recesses 76 with grooves 78 may have at least
• U-shaped staples 42 are disposed radially in grooves 78 of die 20
• SubstantiaUy V-shaped guiding surfaces 80 have guiding sides
• Die Ud 22 (FIG. 12 - 14) has a through axial hole 82, substantiaUy
• FIG. 15 shows in more detaU the pressure rod 34 operatively
• control lever 18 connected via its distal end 40 with control lever 18, loaded by spring 44,
• Proximal end 38 of pressure rod 34 is substantiaUy
• pressure rod 34 has an angle A at the cone vertex ranging from about
• FIG. 16 shows in more detaU a U-shaped staple 42.
• staple 42 has sUghtly bent and pointed ends 96 and is substantially
• Stapler 1 comprises curved L-shaped levers 48 (FIG. 17) serving
• Levers 48 are movably disposed in slots 58
• Curved L-shaped levers 48 are pivotally
• L-shaped levers 48 are adapted to periodicaUy engage via inner sides 106
• stapler 1 may comprise a die 20, die Ud 22 and
• fastener means substantiaUy U-shaped staples 42 located in grooves 78
• control lever 18 disposed on the other side of the working end of control lever 18, as weU
• fastener means U- shaped staples 42, with which lock screw 110 is
• control lever 18 operatively connected via the working end of control lever 18 and
• This additional device contains a stepped
• FIG. 21 has a first end 122 and second end 124 contains on its outer
• step of this rod by a value exceeding four depths of waUs of said
• the additional device further contains a thin-waU bush 130 (FIG.
• bush 130 is smaUer than the outer diameter of the last step of rod 120 at
• Thin-waU bush 130 is provied with a coUar 132 at
• the ad nonal device contains a pressure bush 140 (FIG. 22).
• the claimed invention includes a method
• an intravascular device such as graft or stent-graft 3
• the method comprises several successive steps (FIG. 25). At the
• U-shaped staples 42 (if it is loaded or not), and if necessary, it is loaded.
• intravascular device substantially graft or stent-graft, with partial
• graft 3 may be more securely fixed on body 10 of
• lock screw 110 By screwing in this lock screw 110 until stop
• This stapler 1 is brought into operative position, whereupon its actuator with U-shaped staples 42 located in die
• shaped staples 42 partly project outside aorta 200 and bend on its outer
• the set contains at least one first stapler for securing
• bifurcated istal part 224 and 226 of stent-graft 220 Securing the end of
• stent-graft having a broad proximal part 222 to the wall of aorta 200 in
• the neck area 228 of aorta 200 is performed by the first of staplers 1

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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)
• Prostheses (AREA)

Applications Claiming Priority (3)

Publications (1)

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ID=32109298

Family Applications (1)

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Family Cites Families (3)

• 2003
  • 2003-09-25 AU AU2003264848A patent/AU2003264848A1/en not_active Abandoned
  • 2003-09-25 WO PCT/IL2003/000766 patent/WO2004034868A2/en not_active Ceased
  • 2003-09-25 EP EP03788710A patent/EP1860984A2/de not_active Withdrawn

Non-Patent Citations (1)

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