Method and anastomotic instrument for use when performing an end-to-side anastomosis

Claim 1

Method of connecting an end region (10) of a first vessel (9) to the side of a second vessel (11) by carrying out an end-to-side anastomosis, said method being of the kind comprising the following steps a-d: a) forming an opening in the side of said second vessel (11), b) inserting in said opening an anastomosis instrument (201) carrying said first vessel (9) in a central longitudinal cavity and with said end region (10) everted about a circumferential member (203, 303) constituting a forward portion of said instrument (201) in such a manner, that the intima side of said end region (10) comes into contact with the intima side of said second vessel (11) at an edge region (12) of said opening, c) joining said end region (10) to said edge region (12) by inserting penetratingly therethrough and leaving therein a plurality of spiked members, and d) removing said instrument (201) from the joint formed between said first (9) and second (11) vessels, said steps a-d being carried out by e) the use of an anastomosis instrument (201) comprising e1) an anvil assembly (202A, 302A, 203, 303, 203A, 303A) comprising a circumferential anvil member (203, 303) and in which said first vessel (9) may be placed with its end region (10) everted about said anvil member (203, 303) with the terminal part of said end region facing rearwardly, said anvil assembly being capable of being divided and the divided parts separated along said central longitudinal cavity, e2) rearwardly facing staple-bending recesses (204, 304) provided in said anvil member (203, 303), e3) a clamping assembly (205A, 305A, 205B, 305B) movable relative to said anvil assembly and comprising clamping members (205B, 305B) adapted to be moved towards said anvil member (203, 303) so as to make it possible to clamp together therebetween said end region (10) on said first vessel (9) and an edge region (12) on said second vessel (11), and e4) a stapling assembly (206, 306, 206A, 306A) comprising stapling plungers (206, 306) movable relative to said anvil assembly and said clamping assembly and adapted to insert staples (7) penetratingly through said clamped end (10) and edge (12) regions into engagement with said stapling-bending recesses (204, 304) so as to bend permanently said staples (7) into a shape, in which they hold said end (10) and edge (12) regions together, characterized by f) the use of an instrument (201), in which in addition to said anvil assembly, said clamping and stapling assemblies are capable of being divided and the divided parts separated along said central longitudinal cavity extending generally in the direction of relative movement of said three assemblies and dividing said assemblies in a manner allowing the separated parts to be removed from said first vessel (9) in a transverse direction.