Method, instrument and anastomotic fitting for use when...

A - Human Necessities – 61 – B

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A61B 17/11 (2006.01) A61B 17/115 (2006.01) A61B 17/32 (2006.01) A61B 17/00 (2006.01) A61B 17/02 (2006.01) A61B 17/22 (2006.01) A61B 17/30 (2006.01) A61B 18/24 (2006.01)

Patent

CA 2179507

An end-to-side anastomosis between a first vessel (27) and a second vessel (51) is carried out using an anastomosis instrument comprising a tube (20) in which the first vessel (27) is inserted and everted at the end of the tube (20) to form a collar (28) a springy anastomotic fitting (30) with outwardly directed spikes (32) having previously been placed under elastic bending in a circumferential recess (22). The tube (20) is inserted in a previously made incision in the second vessel (51), a guide member (35) ensuring that the wall region (53) around the incision contacts the everted collar (28). Then, an ejector (23) is operated to liberate the fitting (30) from the recess (22), releasing the fitting to expand quickly, so the spikes (32) penetrate the collar (28) and the wall region (53). Finally, the tube (20) and the ejector (23) are removed, and so is the guide member (35) having previously been made to collapse in a manner not shown to allow it to be removed through the first vessel (27).

On réalise une anastomose terminolatérale entre un premier vaisseau (27) et un deuxième vaisseau (51) au moyen d'un instrument d'anastomose comprenant un tube (20) dans lequel on introduit le premier vaisseau (27) que l'on retourne à l'extrémité dudit tube (20), afin de former un col (28), un raccord anastomotique élastique (30) pourvu de pointes (32) dirigées vers l'extérieur ayant été préalablement placé sous incurvation élastique dans un évidement circulaire (22). On introduit le tube (20) dans une incision pratiquée au préalable dans le deuxième vaisseau (51), tandis qu'un élément de guidage (35) permet le contact de la région de paroi (53) située autour de l'incision avec le col retourné (28). On utilise ensuite un éjecteur (23) afin de libérer le raccord (30) de l'évidement (22), ce qui provoque la dilatation rapide dudit raccord, de telle manière que les pointes (32) pénètrent dans le col (28) et dans la région de paroi (53). On enlève ensuite le tube (20) et l'éjecteur (23), ainsi que l'élément de guidage (35) qu'on a laissé s'affaisser préalablement, d'une façon non représentée par la figure, afin de pouvoir le retirer par le premier vaisseau (27).

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