Title of Invention

AN ANASTOMOTIC DEVICE FOR JOINING OF LUMENS OR HOLLOW VISCERA WHICH IS ADAPTED TO BE DEPLOYED AT A LUMINAL INTERFACE OF TWO ADJACENT LUMENS

Abstract The present invention is directed to gastrointestinal or enteric (including biliary) anastomosis and the like. The anastomotic device of the invention is a three dimensional woven tube (10) of wire preferably formed from a thermal, smart memory metal. The outer loops or ends (20) of the tube fold or loop back on deployment in a manner which holds the luminal interface of the anastomotic site into apposition at the deployment site. The women tube (10) is deployed using a canula (24) with a retractable outer sleeve (26).
Full Text AN ANASTOMOTIC DEVICE fOR JOINING OF LUMENS OR
HOLLOW VISCERA WHICH IS ADAPTED TO BE DEPLOYED AT A LUMINAL
INTERFACE OR TWO ADJACENT LUMENS
Background of the Invention
1. Field of the Invention
The present invention is directed to gastrointestinal and enteric (including biliary)
anastomoses and the like. The woven tube of wire of the invention is a three
dimensional structure wherein the outer loops or ends of the woven tube fold or loop
back in a manner which holds the luminal interface of the anastomotic site into
apposition at the deployment site.
2. Description of the Related Art
Surgical procedures often require the joining (anastamosis) of two vessels or
hollow vicera. For example, a permanent anastomosis between the stomach and intestine
may be required in the performance of gastric bypass surgery for the morbidly obese as
well as to alleviate blockage in the common bile duct by draining bile from the duct to
the small intestine during surgery for pancreatic cancer. Surgical anastomosis generally
involves manual suturing of the two structures. This process can be technically
demanding and time consuming. This complex surgical procedure is even more
challenging during minimally invasive surgery (MIS) where the surgeon is required to
use instruments that are poorly designed for this task.

Summary of the Invention
The present invention is directed to a woven tube of wire for use in an automated
anastomotic delivery device for surgery with special emphasis on MIS. The primary
component is the woven tube of wire which deforms to make an anastomotic device
when inserted into the walls of two adjacent vessels or lumens. The use of such a device
for joining (anastomosing) two gastrointestinal or enteric (including biliary) vessels or
lumens or the like is new.
The anastomotic delivery device is designed to allow the wire mesh tube to be.
slipped over a canula and pulled longitudinally, causing the tube to become longer and
very small in diameter. After the wire mesh tube is loaded onto the canula, an outer
sleeve is pushed over the tube up to the streamlined end of the delivery device, thereby
providing a smooth surface for inserting into a vessel or lumen in the body. After the
loaded canula is inserted into the appropriate vessel or lumen, a small sharp pointed wire,
initially retracted in the center of the canula, is exposed at the tip (such as by pushing on
a button in the handle) in order to assist the surgeon when passing the canula through the
walls of the vessels or lumens. Once the canula/sleeve has penetrated both walls and is
properly positioned, the outer sleeve is retracted. The wire mesh tube is constructed
from a thermal, shape memory alloy such as nitinol such that when the sleeve is
retracted, heat from the body causes the wire mesh tube to contract longitudinally to
produce the anastomosis. This design eliminates the necessity for using a mechanical
compression component in the delivery system and, therefore, reduces the complexity
and size of the delivery system. Sufficient force is applied to the wall tissues such that

the holes between the two lumens is enlarged (for drainage) and leakage outside the two
lumens does not occur.
Additional objects, advantages and other novel features of the invention will be
set forth in part in the description that follows and in part will become apparent to those
skilled in the art upon examination of the foregoing or may be learned with the practice
of the invention.
ACCOMPANYING
Brief Description of the Drawings
Figure 1 is a front view of the woven tube of wire in its deployed form in which
the outer loops or ends of the woven tube have deformed and everted to form petals
which hold the walls of the lumens into apposition, the front and back petals of the
deployed anastomotic device being shown as dark black and light gray lines,
respectively.
Figure 2 is a side view of the woven tube prior to being slipped over a canula of
the delivery device.
Figure 3A is a front view of the woven tube similar to Figure 1 with the walls of
the lumens being omitted.
Figure 3B is a side view of the woven tube of Figure 3A.
Figure 4A shows the delivery device having the woven tube loaded and the
sleeve pushed over the tube up to the end of the delivery device.

Figure 4B shows the delivery device inserted into a body cavity to a
predetermined puncture site and further shows the tip of a wire, initially retracted in the
canula, passed through the walls of the lumens.
Figure 4C shows the end of the delivery device passed through the walls of the
lumens with the sheath partially retracted to expose the woven tube slipped over the
canula.
Figure 4D shows the woven tube positioned at the juncture of the opposing
puncture holes in the tissue, the walls of the lumens being held in a predetermined
position guided by the delivery device.
Figure 4E shows the initial stage of deployment of the woven tube as the ends of
the woven tube begin forming a petal configuration.
Figure 4F shows the woven tube in its deployed, flattened form gripping the
walls of the lumens.
Figure 4G shows the delivery device being retracted from the body cavity
through the opening in the flattened woven tube, the left-hand side portion of Figure 4G
showing an end view of the deployed woven tube in the same manner as shown in Figure
1.

Description of the Preferred Embodiments
The tube 10 has an overlapping wire mesh design. The woven tube is designed to
produce a round opening 12 between two layers of tissue 14,16 and to hold the layers of
tissue together for a watertight seal. The deployed anastomic device is essentially a
woven tube 10 of wire 18 that is axially compressed as shown in Figure 1.
The woven tube 10 is defined by the wire diameter, number of circumferential
and longitudinal openings or diamonds 20, the tube length and the center diameter. The
openings or diamonds 20' at the longitudinal ends of the elongated woven tube are
referred to as petals when the device is in the deployed shape (see Figure 1).
In use, the woven tube is forced into an elongated form (with much smaller
diameter than that shown in Figure 2), placed through openings between the wall tissues
of two lumens and allowed to return to the flattened shape of Figure 1. In the process,
the tissues of both lumen walls are compressed between the petals of the flattened tube
(see Figure 1) with the center diameter 12 of the flattened tube forming an opening
between the lumens.
The woven tube can be applied, for example, through the common bile duct, and
pushed through so that it connects the duct to the jejunum. After the connection has been
made, the tube can be caused to deform and evert so that the ends spread out like the
petals of a flower and form a connection between the two ducts. Since the tube is made
of a wire mesh, scar tissue will grow around the flattened tube and eventually form a
permanent connection.

The woven tube is made out of a shape memory metal. A shape memory metal is
an alloy that changes its plasticity as heat is applied, allowing it to change shape. If a
shape memory metal is annealed in a desired form (in a longitudinally compressed form),
after it is reshaped (in a cylindrical tube form) it will return to its annealed shape
(flattened form) if it is reheated at a significantly lower temperature. The very special
property of thermal memory is especially helpful in the design of a low profile and
flexible delivery system. The preferred shape memory metal is a titanium-nickel alloy,
most preferably a nearly equiatomic alloy of titanium and nickel called nitinol. Specific
nitinol alloys, which also have superelastic properties, can reshape at body temperature.
One embodiment of the delivery device 22 of the invention comprises a woven
tube 10 mounted on a canula or delivery rod 24 covered by a retractable sheath 26 as
shown in Figure 4A. In use in a side-to-side intestinal anastomosis, for example, the
delivery device 22 is inserted into the body cavity through a trochar or tube (not shown)
and the end 30 of the delivery device 22 is positioned at a predetermined puncture site in
a first intestinal segment 28 either proximal or distal to the desired anastomotic site and
the delivery device 22 is advanced intraluminally to the anastomotic site.
The second intestinal segment 32 is brought into close apposition to the first
segment at the anastomotic site and the sharp tip of a wire 34, initially retracted in the
center of the canula 24, is used to pierce through the wall of the first segment 28 and the
wall of the second segment 32 and into the lumen of the second segment as shown in
Figure 4B. The sheath 26 is retracted and the woven tube 10 is deployed as shown in the
sequence of Figures 4C, 4D, 4E and 4F at the juncture of the apposing holes created by
the tip of the wire 34 and assumes the petal configuration at the site to hold the two

pieces of intestine in apposition. The woven tube deployed through two layers of
intestine is shown in Figures 4F and 4G. The opposed petals 20 on opposite sides of the
two layers of intestine 28,32 are preferably interdigitated as shown in Figures 1,3A and
B and 4G.
The foregoing description of a preferred embodiment of the invention has been
presented for purposes of illustration and description. It is not intended to be exhaustive
or to limit the invention to the precise form disclosed. Obvious modifications or
variations are possible in light of the above teachings. The embodiment was chosen and
described to provide the best illustration of the principles of the invention and its
practical application to thereby enable one of ordinary skill in the art to utilize the
invention in various embodiments and with various modifications as are suited to the
particular use contemplated. All such modifications and variations are within the scope
of the invention as determined by the appended claims when interpreted in accordance
with the breadth to which they are fairly, legally and equitably entitled.

WE CLAIM:
1. An anastomotic device for joining of lumens or hollow viscera which is adapted
to be deployed at a luminal interface of two adjacent lumens, comprising a woven tube
(10) of wire with longitudinally spaced ends having an overlapping wire mesh design and
having an unobstructed exterior and interior, the tube being longitudinally extendable to
cause the tube to become longer in length and smaller in diameter, the tube being
constructed from a thermal, shape memory alloy having circumferentially spaced outer
loops (20) at each of the longitudinally spaced ends of the woven tube of wire such that
heat causes the tube to become larger in diameter and to contract longitudinally and
become axially compressed and flattened and the outer loops of the tube to deform and
evert after being inserted into holes of walls of the two adjacent lumens, the loops of the
tube thermally deforming and everting to form petals in a manner directly opposed or
interdigitated with each other which compresses and holds the walls of the two adjacent
lumens in apposition, sufficient force being applied to the walls of the two adjacent
lumens such that the holes between the two adjacent lumens are enlarged for drainage and
leakage outside the two adjacent lumens is prevented.
2. The device as claimed in claim 1, wherein the thermal, shape memory alloy is a
titanium-nickel alloy.
3. The device as claimed in claim 1. wherein the opposed petals are interdigitated.
4. An anastomotic delivery device having a streamlined end, comprising a woven
tube (10) of wire with longitudinally spaced ends having an overlapping wire mesh
design and having an unobstructed exterior and interior, the tube having circumferentially
spaced outer loops (20) at each of the longitudinally spaced ends of the woven tube of
wire, a canula (24) having an end designed to allow the tube to be slipped over the
canula and pulled longitudinally causing the tube to become longer in length and smaller
in diameter, outer sleeve (26) adapted to be pushed over the tube up to the . streamlined


WE CLAIM :
1. An anastomotic device for joining of lumens or hollow viscera which is adapted
to be deployed at a luminal interface of two adjacent lumens, comprising a woven tube
(10) of wire with longitudinally spaced ends having an overlapping wire mesh design and
having an unobstructed exterior and interior, the tube being longitudinally extendable to
cause the tube to become longer in length and smaller in diameter, the tube being
constructed from a thermal, shape memory alloy having circumferentially spaced outer
loops (20) at each of the longitudinally spaced ends of the woven tube of wire such that
heat causes the tube to become larger in diameter and to contract longitudinally and
become axially compressed and flattened and the outer loops of the tube to deform and
evert after being inserted into holes of walls of the two adjacent lumens, the loops of the
tube thermally deforming and everting to form petals in a manner directly opposed or
interdigitated with each other which compresses and holds the walls of the two adjacent
lumens in apposition, sufficient force being applied to the walls of the two adjacent
lumens such that the holes between the two adjacent lumens are enlarged for drainage and
leakage outside the two adjacent lumens is prevented.
2. The device as claimed in claim I, wherein the thermal, shape memory alloy is a
titanium-nickel alloy.
3. The device as claimed in claim 1. wherein the opposed petals are interdigitated.
4. An anastomotic delivery device having a streamlined end, comprising a woven
tube (10) of wire with longitudinally spaced ends having an overlapping wire mesh
design and having an unobstructed exterior and interior, the tube having circumferentially
spaced outer loops (20) at each of the longitudinally spaced ends of the woven tube of
wire, a canula (24) having an end designed to allow the tube to be slipped over the
canula and pulled longitudinally causing the tube to become longer in length and smaller
in diameter, outer sleeve (26) adapted to be pushed over the tube up to the . streamlined


end of the device thereby providing a smooth surface for inserting through walls of two
adjacent lumens at a luminal interface in a body, and subsequently retracted, a wire
having a tip, initially retracted in the canula, and adapted to be exposed at the tip to create
holes in the walls of the two adjacent lumens to assist a surgeon when passing the device
through the walls of the lumens, the tube being constructed from a thermal, shape
memory alloy such that when the sleeve is retracted heat from the body causes the tube to
become larger in diameter and to contract longitudinally and become axially compressed
and fattened and causes the outer loops of the tube to deform and evert to form petals in a
manner directly opposed or interdigitated with each other which compresses and holds
the walls of the two adjacent lumens in apposition, sufficient force being applied to the
walls of the two adjacent lumens such that the holes between the two adjacent lumens are
enlarged for drainage and leakage outside the two adjacent lumens is prevented,
5. The device as claimed in 4, wherein the thermal, shape memory alloy is a
titanium-nickel alloy.
6. The device as claimed in claim 4, wherein the opposed petals are interdigitated.
7. The device as claimed in claim 4, wherein the streamlined end is moveable in a
direction opposed to the retractable sleeve when the sleeve is retracted to expose both of
the longitudinally spaced ends of the woven tube of wire to the body heat.

The present invention is directed to gastrointestinal or enteric (including biliary) anastomosis and the like. The
anastomotic device of the invention is a three dimensional woven tube (10) of wire preferably formed from a thermal, smart memory
metal. The outer loops or ends (20) of the tube fold or loop back on deployment in a manner which holds the luminal interface of
the anastomotic site into apposition at the deployment site. The women tube (10) is deployed using a canula (24) with a retractable
outer sleeve (26).

Documents:

1637-KOLNP-2003-CORRESPONDENCE.pdf

1637-KOLNP-2003-FORM 27.pdf

1637-KOLNP-2003-FORM-27.pdf

1637-kolnp-2003-granted-abstract.pdf

1637-kolnp-2003-granted-assignment.pdf

1637-kolnp-2003-granted-claims.pdf

1637-kolnp-2003-granted-correspondence.pdf

1637-kolnp-2003-granted-description (complete).pdf

1637-kolnp-2003-granted-drawings.pdf

1637-kolnp-2003-granted-examination report.pdf

1637-kolnp-2003-granted-form 1.pdf

1637-kolnp-2003-granted-form 18.pdf

1637-kolnp-2003-granted-form 3.pdf

1637-kolnp-2003-granted-form 5.pdf

1637-kolnp-2003-granted-gpa.pdf

1637-kolnp-2003-granted-reply to examination report.pdf

1637-kolnp-2003-granted-specification.pdf


Patent Number 227784
Indian Patent Application Number 1637/KOLNP/2003
PG Journal Number 04/2009
Publication Date 23-Jan-2009
Grant Date 20-Jan-2009
Date of Filing 17-Dec-2003
Name of Patentee PARK MEDICAL, LLC
Applicant Address 218 WIND HAVEN DRIVE, NICHOLASVILLE, KY
Inventors:
# Inventor's Name Inventor's Address
1 PARK ADRIAN EDWARD 218 WIND HAVEN DRIVE, NICHOLASVILLE, KY 40356
2 KNAPP CHARLES FRANCIS 100 SHELDRAKE COURT, GEORGETOWN, KY 43024
3 CHARASH WILLIAM EDWARD 2 SKYVIEW LANE, SUDBURY, MA 01776
4 CUI HUA 2224 DOGWOOD TRACE BLVD., LEXINGTON, KY 40514
PCT International Classification Number A61B 17/11
PCT International Application Number PCT/US2002/19566
PCT International Filing date 2002-06-20
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 60/299,618 2001-06-20 U.S.A.