Laparoscopic or endoscopic anastomosis technique and associated instruments

[54] LAPAROSCOPIC OR ENDOSCOPIC ANASTOMOSIS TECHNIQUE AND ASSOCIATED INSTRUMENTS

[76] Inventor: Peter J. Wilk, 185 West End Ave., New York, N.Y. 10023

[21] Appl.No.: 212,104

[22] Filed: Apr. 11,1994

Related U.S. Application Data

[60] Division of Ser. No. 981,251, Nov. 25, 1992, Pat. No. 5,330,486, which is a continuation-in-part of Ser. No. 921,510, Jul. 29, 1992, Pat. No. 5,258,008.

[51] Int. Cl.« A61B 17/04

[52] U.S. CI 606/139; 128/898

[58] Field of Search 606/139, 144-148,

606/151, 153, 219; 128/898; 227/179-181

[56] References Cited

U.S. PATENT DOCUMENTS

4,473,077 9/1984 Noiles 227/179

4,477,007 10/1984 Foslien 227/19

4,485,817 12/1984 Swiggett 227/179

4,488,523 12/1984 Shichman 227/179

5,042,707 8/1991 Taheri 227/179

5,197,649 3/1993 Bessler et al 227/179

5,205,459 4/1993 Brinkerhoff et al 227/179

5,261,920 11/1993 Main et al 606/153

5,309,927 5/1994 Welch 128/898

5.314.435 5/1994 Green et al 606/153

5.314.436 5/1994 Wilk 606/153

5,346,501 9/1994 Regula et al 606/151

Primary Examiner—Gary Jackson

A laparoscopic surgical technique for performing an anastomosis comprises the steps of disposing a laparoscopic trocar sleeve in a patient's abdominal wall, inserting a distal end of a laparoscopic instrument into an abdominal cavity of the patient through the trocar sleeve, and manipulating the instrument from outside the patient to loop a purse-string-type suture through a free end of a first severed intestinal segment of the patient. In other steps of the laparoscopic surgical technique, a flexible anastomosis-forming device is inserted through the patient's rectum so that an end cap at a distal end of the anastomosis device protrudes from a free end of a second severed intestinal segment of the patient. The anastomosis-forming device is shifted further through the patient's rectum so that the end cap is inserted into the first severed intestinal segment through the free end thereof. During the shifting of the end cap, the first severed intestinal segment is held with a laparoscopic tool from outside the patient to facilitate insertion of the end cap into the first severed intestinal segment. Upon insertion of the end cap into the first severed intestinal segment, the purse-string-type suture is drawn via a laparoscopic member to close the free end of the first severed intestinal segment about the end cap. The anastomosis-forming device is operated from outside the patient to connect the intestinal segments to one another in an anastomosis.

9 Claims, 10 Drawing Sheets

144