Gastrointestinal approximating and tissue attaching device

Claim 2

An endoscopic surgical anatomotic device, comprising, (a) anastomotic approximating assembly for approximating two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; and (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; (b) moving means operatively connected with said anastomotic approximating assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating assembly being positioned at and cooperating with said distal end of said elongated member; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.

Claim 3

The endoscopic device according to claim 1, wherein the first member comprises a first tissue clamping device and the second member comprises a second tissue clamping device, said first clamping device having a ratchet surfaced central shaft adapted to be received in a correspondingly arranged ratchet surfaced central opening.

Claim 4

The endoscopic device according to claim 1, wherein the moving means comprises a cable attached at one end to the second member, and operatively attached at the other end to means for pulling the cable at the handpiece.

Claim 5

The endoscopic device according to claim 3, further comprising means operatively connected with the cable for cutting the cable when the first and second members are disposed in the second approximated position.

Claim 6

The endoscopic device according to claim 1, further comprising means operatively connected with the first and second members for selectively disengaging the first and second members from the elongated member.

Claim 7

The endoscopic device according to claim 1, wherein the first and second members are made of biofragmentable material, having weakened portions which break down under bodily fluids.

Claim 8

The endoscopic device according to claim 1, further comprising means operatively connected with the anastomotic approximating assembly for impaling at least one tissue end and drawing it toward the other tissue end.

Claim 9

The endoscopic device according to claim 7, further comprising means operatively connected with the anastomotic approximating assembly for impaling both tissue ends and drawing them toward each other to an approximated position.

Claim 10

The endoscopic device according to claim 1, further comprising means operatively connected with the anastomotic approximating assembly for injecting a tissue bonding or soldering agent to at least one of the tissue ends.

Claim 11

The endoscopic device according to claim 1, further comprising means operatively connected with at least one of the first and second members for applying energy to the approximated tissues to facilitate attaching of the tissues.

Claim 12

The endoscopic device according to claim 10, wherein the means for applying energy comprises laser fiber cables.

Claim 13

The endoscopic device according to claim 10, wherein the means for applying energy comprises an electrical coil in at least one of the first and second members.

Claim 14

The endoscopic device according to claim 7, wherein the means for impaling comprises at least one barb mounted on a toothed wheel, and means for rotating the toothed wheel to carry tissue impaled on the barb to an approximated position.

Claim 15

The endoscopic device according to claim 7, wherein the means for impaling comprises at least one tissue grabber spring-biased to a retracted position, and a pull means to pull the grabber to overcome the spring force to grab the tissue and pull it toward an approximated position.

Claim 16

The anastomotic device according to claim 14, wherein the means for impaling comprises at least two grabbers operatively arranged to pivot about a common point, and a pull means to pull both grabbers to pull the tissue toward an approximated position.

Claim 17

The anastomotic device according to claim 7, wherein the means for impaling comprises at least one barb mounted on an inflatable balloon and disposed to a first retractable position when the balloon is deflated, and to move along a path to grab the tissue by impaling it and pulling it to an approximated position as the balloon is inflated, and means for inflating the balloon.

Claim 18

The anastomotic device according to claim 1, further comprising an electromagnet in at least one of the first and second members for generating an attraction force to pull the other of said members, when energized, to hold the tissue in an approximated position.

Claim 19

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating assembly for approximating two ends of anastomotic tissue, for attaching operations which includes: (i) a first member which defines a tissue engaging surface; and (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; (b) moving means operatively connected with said anastomotic approximating assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) an elongated member having a proximal and distal end, said anastomotic approximating assembly being positioned at and cooperating with said distal end of said elongated member; (d) steering means for pivoting said anastomotic approximating assembly relative to said elongated member, to thereby steer the anastomotic approximating assembly in a body cavity; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; and steering control means operatively connected through said elongated member with said steering means for controlling the steering of said anastomotic approximating assembly.

Claim 20

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating assembly for approximating two ends of anastomotic tissue, for attaching operations which includes: (i) a first member which defines a tissue engaging surface; and (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; (b) moving means operatively connected with said anastomotic approximating assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) an elongated member having a proximal and distal end, said anastomotic approximating assembly being positioned at and cooperating with said distal end of said elongated member; (d) steering means for pivoting said anastomotic approximating assembly relative to said elongated member, to thereby steer the anastomotic approximating assembly in a body cavity; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; and steering control means operatively connected through said elongated member with said steering means for controlling the steering of said anastomotic approximating assembly.

Claim 21

The anastomotic device according to claim 18, wherein the first member comprises a first tissue clamping device and the second member comprises a second tissue clamping device, said first clamping device having a ratchet surfaced central shaft adapted to be received in a correspondingly arranged ratchet surfaced central opening.

Claim 22

The anastomotic device according to claim 18, wherein the moving means comprises a cable attached at one end to the second member, and operatively attached at the other end to a means for pulling the cable at the handpiece.

Claim 23

The anastomotic device according to claim 20, further comprising means operatively connected with the cable for cutting the cable when the first and second members are disposed in the second approximated position.

Claim 24

The anastomotic device according to claim 18, further comprising means operatively connected with the anastomotic approximating assembly for selectively disengaging the first and second members from the elongated member.

Claim 25

The anastomotic device according to claim 18, wherein the first and second members are made of biofragmentable material, having weakened portions which break down under bodily fluids.

Claim 26

The endoscopic device according to claim 18, further comprising an electromagnet in at least one of the first and second members for generating an attraction force to pull the other of said members, when energized, to hold the tissue in an approximated position.

Claim 27

The endoscopic device according to claim 18, wherein the means for impaling comprises at least one barb mounted on an inflatable balloon and disposed to a first retractable position when the balloon is deflated, and to move along a path to grab the tissue by impaling it and pulling it to an approximated position as the balloon is inflated, and means for inflating the balloon.

Claim 28

The anastomotic device according to claim 18, further comprising means operatively connected with the anastomotic approximating assembly for impaling at least one tissue end and drawing it toward the other tissue end.

Claim 29

The endoscopic device according to claim 26, wherein the means for impaling comprises at least two grabbers operatively arranged to pivot about a common point, and a pull means to pull both grabbers to pull the tissue toward an approximated position.

Claim 30

The anastomotic device according to claim 26, further comprising means operatively connected with the anastomotic approximating assembly for impaling both tissue ends and drawing them toward each other to an approximate position.

Claim 31

The anastomotic device according to claim 26, wherein the means for impaling comprises at least one barb mounted on a toothed wheel, and means for rotating the toothed wheel to carry tissue impaled on the barb to an approximated position.

Claim 32

The anastomotic device according to claim 26, wherein the means for impaling comprises at least one tissue grabber spring-biased to a retracted position, and a pull means to pull the grabber to overcome the spring force to grab the tissue and pull it toward an approximated position.

Claim 33

The anastomotic device according to claim 18, further comprising means operatively connected with the anastomotic approximating assembly for injecting a tissue bonding or soldering agent to at least one of the tissue ends.

Claim 34

The anastomotic device according to claim 18, further comprising means operatively connected with at least one of the first and second members for applying energy to the approximated tissues to facilitate attaching of the tissues.

Claim 35

The anatomotic device according to claim 32, wherein the means for applying energy comprises laser fiber cables.

Claim 36

The anastomotic device according to claim 32, wherein the means for applying energy comprises an electrical coil in at least one of the first and second members.

Claim 37

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating assembly for approximating two ends of anastomotic tissue, for attaching portions which includes: (i) a first member which defines a tissue engaging surface; and (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; (b) moving means operatively connected with said anastomotic approximating assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating assembly being positioned at and cooperating with said distal end of said elongated member; (e) steering means for pivoting said anastomotic approximating assembly relative to said elongated member, to thereby steer the anastomotic approximating assembly in a body cavity; and (f) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; steering control means operatively connected through said elongated member and said steering means for controlling the steering of said anastomotic approximating assembly; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.

Claim 38

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating assembly for approximating two ends of anastomotic tissue, for attaching portions which includes: (i) a first member which defines a tissue engaging surface; and (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; (b) moving means operatively connected with said anastomotic approximating assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating assembly being positioned at and cooperating with said distal end of said elongated member; (e) steering means for pivoting said anastomotic approximating assembly relative to said elongated member, to thereby steer the anastomotic approximating assembly in a body cavity; and (f) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; steering control means operatively connected through said elongated member and said steering means for controlling the steering of said anastomotic approximating assembly; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.

Claim 39

An endoscopic surgical anastomotic device, comprising: (a) anastomotic approximating and attaching assembly for approximating and attaching two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; and (iii) tissue attaching means operatively connected with at least one of said first member and second member for attaching the two ends of anastomotic tissue together; (b) moving means operatively connected with said anastomotic approximating and attaching assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating and attaching assembly being positioned at and cooperating with said distal end of said elongated member; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; second control means operatively connected through said elongated member with said second member for causing said tissue attaching means to effect attachment of the two ends of tissue to each other when the first member and second member are in the second position; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.

Claim 40

An endoscopic surgical anastomotic device, comprising: (a) anastomotic approximating and attaching assembly for approximating and attaching two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; and (iii) tissue attaching means operatively connected with at least one of said first member and second member for attaching the two ends of anastomotic tissue together; (b) moving means operatively connected with said anastomotic approximating and attaching assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating and attaching assembly being positioned at and cooperating with said distal end of said elongated member; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; second control means operatively connected through said elongated member with said second member for causing said tissue attaching means to effect attachment of the two ends of tissue to each other when the first member and second member are in the second position; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.

Claim 41

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating and attaching assembly for approximating and attaching two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; and (iii) tissue attaching means operatively connected with at least one of said first member and second member for attaching the two ends of anastomotic tissue together; (b) moving means operatively connected with said anastomotic approximating and attaching assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) an elongated member having a proximal and distal end, said anastomotic approximating and attaching assembly being positioned at and cooperating with said distal end of said elongated member; (d) steering means for pivoting said anastomotic approximating and attaching assembly relative to said elongated member, to thereby steer the anastomotic approximating and attaching assembly in a body cavity; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; second control means operatively connected through said elongated member with said second member for causing said tissue attaching means to effect attachment of the two ends of tissue to each other when the first member and second member are in the second position; and steering control means operatively connected through said elongated member with said steering means for controlling the steering of said anastomotic approximating and attaching assembly.

Claim 42

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating and attaching assembly for approximating and attaching two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; and (iii) tissue attaching means operatively connected with at least one of said first member and second member for attaching the two ends of anastomotic tissue together; (b) moving means operatively connected with said anastomotic approximating and attaching assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) an elongated member having a proximal and distal end, said anastomotic approximating and attaching assembly being positioned at and cooperating with said distal end of said elongated member; (d) steering means for pivoting said anastomotic approximating and attaching assembly relative to said elongated member, to thereby steer the anastomotic approximating and attaching assembly in a body cavity; and (e) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; second control means operatively connected through said elongated member with said second member for causing said tissue attaching means to effect attachment of the two ends of tissue to each other when the first member and second member are in the second position; and steering control means operatively connected through said elongated member with said steering means for controlling the steering of said anastomotic approximating and attaching assembly.

Claim 43

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating and attaching assembly for approximating and attaching two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; and (iii) tissue attaching means operatively connected with at least one of said first member and second member for attaching the two ends of anastomotic tissue together; (b) moving means operatively connected with said anastomotic approximating and attaching assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating and attaching assembly being positioned at and cooperating with said distal end of said elongated member; (e) steering means for pivoting said anastomotic approximating and attaching assembly relative to said elongated member, to thereby steer the anastomotic approximating and attaching assembly in a body cavity; and (f) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; second control means operatively connected through said elongated member with said second member for causing said tissue attaching means to effect attachment of the two ends of tissue to each other when the first member and second member are in the second position; steering control means operatively connected through said elongated member and said steering means for controlling the steering of said anastomotic approximating and attaching assembly; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.

Claim 44

A steerable surgical anastomotic device, comprising: (a) anastomotic approximating and attaching assembly for approximating and attaching two ends of anastomotic tissue, which includes: (i) a first member which defines a tissue engaging surface; (ii) a second member defining a tissue contacting surface which is adapted to align with said tissue engaging surface; and (iii) tissue attaching means operatively connected with at least one of said first member and second member for attaching the two ends of anastomotic tissue together; (b) moving means operatively connected with said anastomotic approximating and attaching assembly for moving said first member and said second member relative to one another between a first, spaced position in which said tissue engaging surface is spaced from said tissue contacting surface for receiving tissue therebetween, and a second approximated position in which said tissue engaging surface and said tissue contacting surface are in close cooperative alignment; (c) imaging means operatively connected with one of said first member and said second member for obtaining an image of an interior body region; (d) an elongated member having a proximal and distal end, said anastomotic approximating and attaching assembly being positioned at and cooperating with said distal end of said elongated member; (e) steering means for pivoting said anastomotic approximating and attaching assembly relative to said elongated member, to thereby steer the anastomotic approximating and attaching assembly in a body cavity; and (f) a handpiece positioned at and cooperating with said proximal end of said elongated member, said handpiece including first control means operatively connected through said elongated member with said moving means for causing said first member and said second member to move between said first and second positions; second control means operatively connected through said elongated member with said second member for causing said tissue attaching means to effect attachment of the two ends of tissue to each other when the first member and second member are in the second position; steering control means operatively connected through said elongated member and said steering means for controlling the steering of said anastomotic approximating and attaching assembly; and viewing means operatively connected through said elongated member with said imaging means for viewing said interior body region image.