Anastomosis formation with magnetic implant for accessory organ of digestion

Abstract

Systems and methods for forming an anastomosis between two adjacent walls of a digestive system are provided. The system can Include a cylindrical magnetic implant having a transverse section free of a longitudinally-extending through-hole to prevent fluid communication from a first end to a second end of the cylindrical magnetic implant. Alternatively, the cylindrical magnetic implant can include a tubular housing defining a magnet element-receiving cavity and a magnet element received within the magnet-receiving cavity and provided concentrically therein. The system can further include a second magnetic implant configured to magnetically couple with the cylindrical magnetic implant through the two adjacent walls of the digestive system to compress a portion of the two adjacent walls therebetween. In other implementations, the second magnetic implant can be coupled with a first magnetic implant shaped as an elongated prism having at least three outer lateral faces of substantially equal dimensions.

Description

ANASTOMOSIS FORMATION WITH MAGNETIC IMPLANT FOR ACCESSORY ORGAN OF DIGESTIONTECHNICAL FIELD

[0001] The technical field generally relates to medical techniques for treating digestive system conditions. In particular, the technical field relates to medical techniques including devices for forming an anastomosis in the digestive system.BACKGROUND

[0002] Digestive surgeries and medical procedures to treat conditions associated with the digestive system often require alteration of the various tracts of the digestive system through incisions, sutures, punctures and / or stapling, which can cause trauma to the organ being altered and lead to bleeding. For instance, known surgical procedures can be used to treat issues in accessory organs of digestion such as the gallbladder including, for instance, the treatment of impacted bile duct stones within the biliary tract in which a bypass of a portion of the biliary tract and / or hepatopancreatic ampulla is performed. Such medical procedures can also lead to an increased risk of infection or other complications.

[0003] Magnetic compression anastomosis can be used in the context of medical procedures to treat conditions associated with the digestive system. With magnetic compression anastomosis, necrosis is induced in tissue sandwiched between two magnets. A healing process takes place around the magnets, while the compressed tissue eventually dies and separates from surrounding living tissue. The magnets are released along with the necrotic tissue, leaving an open passage known as an anastomosis.

[0004] There remain a number of challenges with respect to surgery procedures in the digestive system, particularly in the formation of an anastomosis.SUMMARY

[0005] In accordance with an aspect, there is provided a system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising:a first magnetic implant having an outer lateral surface defining an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; and a second magnetic implant comprising a lumen-oriented portion and a tissue- oriented portion, the tissue-oriented portion comprising: a magnetic protrusion extending outwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnetic protrusion defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; and a tissue-oriented offset surface that is axially offset from the second anastomosis-forming surface and that extends radially from the magnetic protrusion; the magnetic protrusion being configured to magnetically couple with the first magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment or the first anastomosis-forming surface of the first magnetic implant faces the second anastomosis-forming surface of the magnetic protrusion of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

[0006] In some implementations, the first magnetic implant has a width sized to enable introduction thereof into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

[0007] In some implementations, a width of the first magnetic implant is less than 50% of a width of the second magnetic implant.

[0008] In some implementations, the width of the first magnetic implant is between 40% and 48% of the width of the second magnetic implant.

[0009] In some implementations, the second anastomosis-forming surface of the second magnetic implant is complimentary to the first anastomosis-forming surface of the first magnetic implant.

[0010] In some implementations, the second anastomosis-forming surface is substantially flat.

[0011] In some implementations, the second anastomosis-forming surface is a curvilinear surface that is curved inwardly.

[0012] In some implementations, the first magnetic implant is a cylindrical magnetic implant, and the outer lateral surface is a circumferential outer surface.

[0013] In some implementations, the first magnetic implant is shaped as an elongated prism and the outer lateral surface includes at least three outer lateral faces, the available tissue-contacting portion having one of the at least three outer lateral faces as the first anastomosis-forming surface.

[0014] In some implementations, the at least three outer lateral faces are of substantially equal dimensions.

[0015] In some implementations, the outer lateral surface of the first magnetic implant includes a convex surface and a flat surface.

[0016] In some implementations, the convex surface and the flat surface define the available tissue-contacting portion, the convex surface comprising the anastomosisforming longitudinal segment when magnetically coupled with the magnetic protrusion, and the flat surface comprising the first anastomosis-forming surface when magnetically coupled with the magnetic protrusion.

[0017] In some implementations, the flat surface defines the available tissuecontacting portion and comprises the first anastomosis-forming surface when magnetically coupled with the magnetic protrusion.

[0018] In some implementations, the outer lateral surface includes two or more flat surface, the available tissue-contacting portion having one of the two or more flat surface as the first anastomosis-forming surface.

[0019] In some implementations, the first magnetic implant is an elongated magnetic implant.

[0020] In some implementations, the second magnetic implant includes a magnet element and a housing configured to receive the magnet element therein, the housing defining the lumen-oriented portion and the tissue-oriented portion of the second magnetic implant.

[0021] In some implementations, the magnet element extends over a majority of an internal width of the housing.

[0022] In some implementations, the housing defines an internal recess, and wherein the magnet element includes a magnet element protrusion filing the internal recess of the housing to provide the magnetic protrusion when the second magnetic implant is assembled.

[0023] In some implementations, the magnetic protrusion of the second magnetic implant comprises one or more of bevelled edges, chamfered edges and rounded edges.

[0024] In some implementations, the magnetic protrusion of the second magnetic implant comprises atraumatic features.

[0025] In some implementations, the magnetic protrusion has a magnetic protrusion height ranging between about 0.3 mm and about 0.8 mm.

[0026] In some implementations, the magnetic protrusion height ranges between about 0.4 mm and about 0.7 mm.

[0027] In some implementations, the second anastomosis-forming surface of the second magnetic implant extends over between about 20% to about 40% of a surface area of the tissue-oriented portion.

[0028] In some implementations, the magnetic protrusion of the second magnetic implant has a magnetic protrusion width defined between two opposed sides thereof and a magnetic protrusion length defined between two opposed ends thereof, the magnetic protrusion length and the magnetic protrusion width of the magnetic protrusion providing a length / width ratio ranging between about 5:1 and about 20:1 .

[0029] In some implementations, the magnetic protrusion has a magnetic protrusion heigh and a magnetic protrusion width, and a width / height ratio ranging between about 2:1 and about 8:1.

[0030] In some implementations, the first magnetic implant comprises a transverse section that is free of a longitudinally-extending through-hole to prevent fluid communication from a first end of the first magnetic implant to a second end of the first magnetic implant.

[0031] In accordance with another aspect, there is provided a system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a first magnetic implant having an outer lateral surface defining an available tissue-oriented portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; and a second magnetic implant comprising a lumen-oriented portion and a tissue- oriented portion, the tissue-oriented portion comprising: a magnet-receiving recess extending inwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnet-receiving recess defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; and a tissue-oriented offset surface that is axially offset from the second anastomosis-forming surface and extending radially from the magnetreceiving recess; the magnet-receiving recess being configured to magnetically couple with the first magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment or the first anastomosis-forming surface of the first magnetic implant faces the second anastomosis-forming surface of the magnet-receiving recess of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

[0032] In some implementations, the first magnetic implant has a width sized to enable introduction thereof into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

[0033] In some implementations, the first magnetic implant has a width being less than 50% of a width of the second magnetic implant.

[0034] In some implementations, the width of the first magnetic implant is between 40% and 48% of the width of the second magnetic implant.

[0035] In some implementations, the second anastomosis-forming surface of the second magnetic implant is complementary to the first anastomosis-forming surface of the first magnetic implant.

[0036] In some implementations, the second anastomosis-forming surface is substantially flat.

[0037] In some implementations, the second anastomosis-forming surface is a concave surface.

[0038] In some implementations, the first magnetic implant is a cylindrical magnetic implant and the outer lateral surface is a circumferential outer surface.

[0039] In some implementations, the first magnetic implant is shaped as an elongated prism and the outer lateral surface includes at least three outer lateral faces, the available tissue-contacting portion having one of the at least three outer lateral faces as the first anastomosis-forming surface.

[0040] In some implementations, the at least three outer lateral faces are of substantially equal dimensions.

[0041] In some implementations, the outer lateral surface of the first magnetic implant includes a convex surface and a flat surface.

[0042] In some implementations, the convex surface and the flat surface define the available tissue-contacting portion, the convex surface comprising the anastomosisforming longitudinal segment when magnetically coupled with the magnet-receivingrecess, and the flat surface comprising the first anastomosis-forming surface when magnetically coupled with the magnet-receiving recess.

[0043] In some implementations, the flat surface defines the available tissuecontacting portion and comprises the first anastomosis-forming surface when magnetically coupled with the magnet-receiving recess.

[0044] In some implementations, the outer lateral surface includes two or more flat surface, the available tissue-contacting portion having one of the two or more flat surface as the first anastomosis-forming surface.

[0045] In some implementations, the first magnetic implant is an elongated magnetic implant.

[0046] In some implementations, the second magnetic implant includes a magnet element and a housing configured to receive the magnet element therein, the housing defining the lumen-oriented portion and the tissue-oriented portion of the second magnetic implant.

[0047] In some implementations, the magnet element extends over a majority of an internal width of the housing.

[0048] In some implementations, the magnet-receiving recess has a recess depth ranging between about 0.3 mm and about 0.8 mm.

[0049] In some implementations, the recess depth ranges between about 0.4 mm and about 0.7 mm.

[0050] In some implementations, the second anastomosis-forming surface of the second magnetic implant extends over between about 20% to about 40% of a surface area of the tissue-oriented portion.

[0051] In some implementations, the magnet-receiving recess of the second magnetic implant has a recess width defined between two opposed sides thereof and a recess length defined between two opposed ends thereof, the recess length and the recess width of the magnet-receiving recess providing a length / width ratio ranging between about 5:1 and about 20:1.

[0052] In some implementations, the magnet-receiving recess has a recess width and a recess depth, the recess width and the recess depth, and a width / depth ratio ranging between about 2:1 and about 8:1 .

[0053] In some implementations, the magnet-receiving recess has a recess length defined between two opposed ends thereof, the recess length being greater than a longitudinal length of the first magnetic implant.

[0054] In some implementations, the recess length is selected so as to limit a longitudinal displacement of the first magnetic implant relative to the second magnetic implant once magnetically coupled.

[0055] In some implementations, the recess length ranges between about 105% and about 115% of the longitudinal length of the first magnetic implant.

[0056] In some implementations, the first magnetic implant comprises a transverse section that is free of a longitudinally-extending through-hole to prevent fluid communication from a first end of the first magnetic implant to a second end of the first magnetic implant.

[0057] In accordance with another aspect, there is provided a method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a first magnetic implant into a lumen associated with an accessory organ of digestion, the first magnetic implant having an available tissuecontacting portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; delivering a second magnetic implant into the digestive tract, the magnetic implant comprising a lumen-oriented portion and a tissue-oriented portion, the tissue-oriented portion comprising: a magnetic protrusion extending outwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnetic protrusion defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; anda tissue-oriented offset surface axially offset from the second anastomosis-forming surface and extending radially from the magnetic protrusion; magnetically coupling the first magnetic implant and the second magnetic implant irrespective of a rotational orientation of the first magnetic implant such that the anastomosis-forming longitudinal segment or the first anastomosisforming surface of the first magnetic implant faces the magnetic protrusion of the second magnetic implant to compress a portion of the adjacent walls therebetween.

[0058] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the gallbladder.

[0059] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the common bile duct.

[0060] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the first magnetic implant.

[0061] In some implementations, delivering the first magnetic implant into the lumen associate with the accessory organ of digestion comprises endoscopically delivering the cylindrical magnetic implant.

[0062] In some implementations, delivering the first magnetic implant into the biliary tract comprises engaging a delivery wire to a second end delivery attachment of the first magnetic implant.

[0063] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the first magnetic implant.

[0064] In some implementations, the first magnetic implant includes a convex surface and a flat surface, the available tissue-contacting portion having the flat surface as the firstanastomosis-forming surface, and wherein magnetically coupling the first magnetic implant and the second magnetic implant comprises compressing a portion of the adjacent walls between the first and second anastomosis-forming surfaces.

[0065] In accordance with another aspect, there is provided a method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a first magnetic implant into a lumen associated with an accessory organ of digestion, the first magnetic implant having an available tissuecontacting portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; a second magnetic implant comprising a lumen-oriented portion and a tissue- oriented portion, the tissue-oriented portion comprising: a magnet-receiving recess extending inwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnet-receiving recess defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; and a tissue-oriented offset surface axially offset from the second anastomosis-forming surface and extending radially from the magnetreceiving recess; magnetically coupling the first magnetic implant and the second magnetic implant irrespective of a rotational orientation of the first magnetic implant such that the anastomosis-forming longitudinal segment or the first anastomosisforming surface of the first magnetic implant faces the magnet-receiving recess of the second magnetic implant to compress a portion of the adjacent walls therebetween.

[0066] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the gallbladder.

[0067] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the common bile duct.

[0068] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the first magnetic implant.

[0069] In some implementations, delivering the first magnetic implant into the lumen associate with the accessory organ of digestion comprises endoscopically delivering the cylindrical magnetic implant.

[0070] In some implementations, delivering the first magnetic implant into the biliary tract comprises securing a delivery wire to a second end delivery attachment of the first magnetic implant.

[0071] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the first magnetic implant.

[0072] In some implementations, the first magnetic implant includes a convex surface and a flat surface, the available tissue-contacting portion having the flat surface as the first anastomosis-forming surface, and wherein magnetically coupling the first magnetic implant and the second magnetic implant comprises compressing a portion of the adjacent walls between the first and second anastomosis-forming surfaces.

[0073] In accordance with another aspect, there is provided a system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming an anastomosis comprising: a cylindrical magnetic implant having a circumferential outer surface defining an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment, the cylindrical magnetic implant comprising: a transverse section that is free of a longitudinally-extending through- hole to prevent fluid communication from a first end of the cylindricalmagnetic implant to a second end of the cylindrical magnetic implant; and a magnetic implant comprising a lumen-oriented surface and a tissuecontacting surface, the magnetic implant being configured to magnetically couple with the cylindrical magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment of the cylindrical magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the two adjacent walls therebetween.

[0074] In some implementations, the cylindrical magnetic implant has a diameter sized to enable introduction of the cylindrical magnetic implant into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

[0075] In some implementations, the tissue-contacting surface of the magnetic implant is substantially flat.

[0076] In some implementations, the transverse section of the cylindrical magnetic implant extends from the first end to the second end of the cylindrical magnetic implant.

[0077] In some implementations, the transverse section of the cylindrical magnetic implant extends over a majority of a length of the cylindrical magnetic implant defined between the first end and the second end of the cylindrical magnetic implant.

[0078] In some implementations, the diameter of the cylindrical magnetic implant is between about 2 mm and about 5 mm.

[0079] In some implementations, the diameter of the cylindrical magnetic implant is between about 2.5 mm and about 4 mm.

[0080] In some implementations, the cylindrical magnetic implant comprises a tubular housing configured to receive a magnet element therein.

[0081] In some implementations, the magnet element is a cylindrical magnet element disposed concentrically within the tubular housing.

[0082] In some implementations, the cylindrical magnet element extends over a majority of an internal diameter of the tubular housing.

[0083] In some implementations, the tubular housing comprises four tubular housing quadrants, and the magnet element extends into at least two of the four tubular housing quadrants.

[0084] In some implementations, the magnet element extends into the four tubular housing quadrants.

[0085] In some implementations, the magnet element is made of a ferromagnetic material.

[0086] In some implementations, the magnet element has an annular transverse crosssection.

[0087] In some implementations, the available tissue-contacting portion of the cylindrical magnetic implant is defined over an entire circumferential outer surface of the cylindrical magnetic implant.

[0088] In some implementations, the magnet element is radially magnetized.

[0089] In some implementations, the cylindrical magnetic implant further comprises a non-magnetic core.

[0090] In some implementations, the magnet element is diametrically magnetized.

[0091] In some implementations, the magnet element comprises two halves each being diametrically magnetized.

[0092] In some implementations, the magnet element is free of a through-hole, thereby providing the transverse section of the cylindrical magnetic implant that is free of the longitudinally-extending through-hole.

[0093] In some implementations, the magnet element is diametrically magnetized.

[0094] In some implementations, the magnet element comprises two halves each being diametrically magnetized.

[0095] In some implementations, the magnet element comprises multiple magnets elements housed in the tubular housing in an end-to-end fashion along a longitudinal axis of the tubular housing.

[0096] In some implementations, a first set of the multiple magnet elements is provided on one side of the transverse section, and a second set of the multiple magnet elements is provided on another side of the transverse section.

[0097] In some implementations, the tubular housing is made of a housing material comprising a metal.

[0098] In some implementations, the metal comprises at least one of stainless steel, titanium and a medical implant grade metal.

[0099] In some implementations, the tubular housing is made of a flexible material configured to flex.

[0100] In some implementations, the tubular housing is made of a housing material comprising a polymer.

[0101] In some implementations, the polymer comprises at least one of silicone, Silastic™ and a medical implant grade polymer.

[0102] In some implementations, the cylindrical magnetic implant further comprises a first end cap engageable with the first end of the cylindrical magnetic implant.

[0103] In some implementations, the first end cap comprises atraumatic features.

[0104] In some implementations, the first end cap is dome-shaped.

[0105] In some implementations, the first end cap includes a first end tubular housing engaging portion configured for insertion into the tubular housing.

[0106] In some implementations, the cylindrical magnetic implant further comprising a second end delivery attachment engageable with the second end of the cylindrical magnetic implant.

[0107] In some implementations, the second end delivery attachment is tubular.

[0108] In some implementations, the second end delivery attachment comprises a second end tubular housing engaging portion configured for insertion into the tubular housing.

[0109] In some implementations, the magnetic implant is an elongated magnetic implant.

[0110] In accordance with another aspect, there is provided a system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a cylindrical magnetic implant having a circumferential outer surface defining an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment, the cylindrical magnetic implant comprising: a tubular housing defining a magnet element-receiving cavity; and a magnet element received within the magnet-receiving cavity and provided concentrically within the tubular housing; and a magnetic implant comprising a lumen-oriented surface and a tissuecontacting surface, the magnetic implant being configured to magnetically couple with the cylindrical magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment of the cylindrical magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the two adjacent walls therebetween.

[0111] In some implementations, the cylindrical magnetic implant has a diameter sized to enable introduction of the cylindrical magnetic implant into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

[0112] In some implementations, the magnet element extends over a majority of an internal diameter of the tubular housing.

[0113] In some implementations, the magnet element is made of a ferromagnetic material.

[0114] In some implementations, the tissue-contacting surface of the magnetic implant is substantially flat.

[0115] In some implementations, the magnet element has an annular cross-section.

[0116] In some implementations, the available tissue-contacting portion of the cylindrical magnetic implant is defined over an entire circumferential outer surface of the cylindrical magnetic implant.

[0117] In some implementations, the magnet element is radially magnetized.

[0118] In some implementations, the cylindrical magnetic implant further comprises a non-magnetic core.

[0119] In some implementations, the magnet element is diametrically magnetized.

[0120] In some implementations, the magnet element comprises two halves each being diametrically magnetized.

[0121] In some implementations, the cylindrical magnetic implant comprises a transverse section that is free of a longitudinally-extending through-hole to prevent fluid communication from a first end of the cylindrical magnetic implant to a second end of the cylindrical magnetic implant.

[0122] In some implementations, the transverse section of the cylindrical magnetic implant extends over a majority of a length of the cylindrical magnetic implant defined between the first end and the second end of the cylindrical magnetic implant.

[0123] In some implementations, the magnet element is free of a through-hole, thereby providing the transverse section of the cylindrical magnetic implant that is free of the longitudinally-extending through-hole.

[0124] In some implementations, the magnet element is diametrically magnetized.

[0125] In some implementations, the magnet element comprises two halves each being diametrically magnetized.

[0126] In some implementations, the transverse section of the cylindrical magnetic implant extends from the first end to the second end of the cylindrical magnetic implant.

[0127] In some implementations, the magnet element comprises a plurality of adjacent magnets provided in an end-to-end fashion.

[0128] In some implementations, the diameter of the cylindrical magnetic implant is between about 2 and about 5 mm.

[0129] In some implementations, the diameter of the cylindrical magnetic implant is between about 2.5 and about 3 mm.

[0130] In some implementations, the tubular housing is made of a housing material comprising a metal.

[0131] In some implementations, the metal comprises at least one of stainless steel, titanium and a medical implant grade metal.

[0132] In some implementations, the tubular housing is made of a flexible material configured to flex.

[0133] In some implementations, the tubular housing is made of a housing material comprising a polymer.

[0134] In some implementations, the polymer comprises at least one of silicone, Silastic™ and a medical implant grade polymer.

[0135] In some implementations, the cylindrical magnetic implant further comprises a first end cap engageable with a first end of the cylindrical magnetic implant.

[0136] In some implementations, the first end cap comprises atraumatic features.

[0137] In some implementations, the first end cap is dome-shaped.

[0138] In some implementations, the first end cap includes a first end tubular housing engaging portion configured for insertion into the tubular housing.

[0139] In some implementations, the cylindrical magnetic implant further comprises a second end delivery attachment engageable with a second end of the cylindrical magnetic implant.

[0140] In some implementations, the second end delivery attachment is tubular.

[0141] In some implementations, the second end delivery attachment comprises a second end tubular housing engaging portion configured for insertion into the tubular housing.

[0142] In some implementations, the magnetic implant is an elongated magnetic implant.

[0143] In accordance with another aspect, there is provided a system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a first magnetic implant shaped as an elongated prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being of substantially equal dimensions and defining an available tissue-contacting portion having one of the at least three outer lateral faces as an anastomosis-forming surface; and a second magnetic implant comprising a lumen-oriented surface and a tissuecontacting surface, the second magnetic implant being configured to magnetically couple with the first magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming surface of the first magnetic implant faces the tissue-contacting surface of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

[0144] In some implementations, the first magnetic implant has a width sized to enable introduction thereof into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

[0145] In some implementations, the first magnetic implant comprises a transverse section that is free of a longitudinally-extending through-hole to prevent fluid communication from the first end of the first magnetic implant to the second end of the first magnetic implant.

[0146] In some implementations, the transverse section of the first magnetic implant extends over a majority of a length of the first magnetic implant defined between the first end and the second end of the first magnetic implant.

[0147] In some implementations, the transverse section of the first magnetic implant extends from the first end to the second end of the first magnetic implant.

[0148] In some implementations, the system further comprises a first end cap engageable with the first end of the first magnetic implant.

[0149] In some implementations, the first end cap comprises atraumatic features.

[0150] In some implementations, the first end cap is dome-shaped.

[0151] In some implementations, the system further comprises a second end delivery attachment engageable with the second end of the first magnetic implant.

[0152] In some implementations, the second end delivery attachment is tubular.

[0153] In some implementations, the prism is one of a triangular prism, a pentagonal prism, a hexagonal prism, and heptagonal prism, and an octagonal prism.

[0154] In some implementations, a width of the first magnetic implant is between about 2 and about 5 mm.

[0155] In some implementations, the width of the first magnetic implant is between about 2.5 and about 3 mm.

[0156] In some implementations, the first magnetic implant comprises a housing configured to receive a magnet element therein.

[0157] In some implementations, the magnet element is an elongated magnet element provided concentrically within the housing.

[0158] In some implementations, the elongated magnet element has a cylindrical shape.

[0159] In some implementations, the elongated magnet element has a shape complimentary to the housing.

[0160] In some implementations, a width of the elongated magnet element extends over a majority of an internal width of the housing.

[0161] In some implementations, the magnet element is made of a ferromagnetic material.

[0162] In some implementations, the magnet element is free of a through-hole.

[0163] In some implementations, the magnet element comprises multiple magnet elements housed in the housing in an end-to-end fashion along a longitudinal axis of the housing.

[0164] In some implementations, the housing is made of a housing material comprising a metal.

[0165] In some implementations, the metal comprises at least one of stainless steel, titanium, and a medical implant grade metal.

[0166] In some implementations, the housing is made of a flexible material configured to flex.

[0167] In some implementations, the housing is made of a housing material comprising a polymer.

[0168] In some implementations, the polymer comprises at least one of silicone, Silastic™ and a medical implant grade polymer.

[0169] In some implementations, the tissue-contacting surface of the second magnetic implant is substantially flat.

[0170] In some implementations, each of the at least three outer lateral faces is substantially flat.

[0171] In accordance with another aspect, there is provided a system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: an elongated magnet assembly comprising: a plurality of magnet elements flexibly connected in series; a plurality of housings configured to receive therein a corresponding magnet element of the plurality of magnet elements, each of the housings comprising an anastomosis-forming surface; an elongated magnetic implant comprising a lumen-oriented surface and a tissue-contacting surface, the elongated magnetic implant being configured to magnetically couple with the elongated magnetic assembly through the two adjacent walls of the digestive system such that the anastomosis-forming surfaces of the plurality of housings face the tissue-contacting surface of the elongated magnetic implant to compress a portion of the two adjacent walls therebetween.

[0172] In some implementations, the elongated magnet assembly being implantable into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

[0173] In some implementations, each housing of the plurality of housings is tubular.

[0174] In some implementations, each housing of the plurality of housings is configured to receive the corresponding magnet element of the plurality of magnet elements concentrically within the housing.

[0175] In some implementations, at least one housing of the plurality of housings is shaped as a prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being of substantially equal dimensions and defining an available tissue-contacting portion having one of the at least three outer lateral faces as an anastomosis-forming surface.

[0176] In some implementations, the magnet elements of the plurality of magnet elements are flexibly connected in series via a resilient connector.

[0177] In some implementations, the resilient connector has a length that is less than 10 mm

[0178] In accordance with another aspect, there is provided a method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a cylindrical magnetic implant as a first magnetic implant into a lumen associated with an accessory organ of digestion, the cylindrical magnetic implant having an available tissue-contacting portion defined over an entire circumferential outer surface of the cylindrical magnetic implant and comprising an anastomosis-forming longitudinal segment; delivering a second magnetic implant into the digestive tract, the magnetic implant comprising a tissue-contacting surface; magnetically coupling the cylindrical magnetic implant and the second magnetic implant irrespective of a circumferential orientation of the cylindrical magnetic implant such that the anastomosis-forming longitudinal segment of the cylindrical magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the adjacent walls therebetween.

[0179] In some implementations, delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the cylindrical magnetic implant into the gallbladder.

[0180] In some implementations, delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the cylindrical magnetic implant into the common bile duct.

[0181] In some implementations, delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the cylindrical magnetic implant.

[0182] In some implementations, delivering the cylindrical magnetic implant into the lumen associate with the accessory organ of digestion comprises endoscopically delivering the cylindrical magnetic implant.

[0183] In some implementations, delivering the cylindrical magnetic implant into the biliary tract comprises securing a delivery wire to a second end delivery attachment of the cylindrical magnetic implant.

[0184] In some implementations, delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the cylindrical magnetic implant.

[0185] In some implementations, the cylindrical magnetic implant comprises a plurality of magnet elements flexibly connected in series.

[0186] In some implementations, delivering the magnetic implant into the digestive tract comprises delivering the magnetic implant into the duodenum.

[0187] In some implementations, the magnetic implant is an elongated magnetic implant.

[0188] In accordance with another aspect, there is provided a method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a first magnetic implant into a lumen associated with an accessory organ of digestion, the first magnetic implant being shaped as an elongated prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being substantially equilateral and defining an available tissue-contacting portion having one of the three outer later faces as an anastomosis-forming surface; delivering a second magnetic implant into the digestive tract, the magnetic implant comprising a tissue-contacting surface; magnetically coupling the first and second magnetic implants irrespective of a lateral orientation of the elongated prism such that the anastomosis-forming surface of the first magnetic implant faces the tissue-contacting surface of the second magnetic implant to compress a portion of the adjacent walls therebetween.

[0189] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the gallbladder.

[0190] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the common bile duct.

[0191] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the first magnetic implant.

[0192] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises endoscopically delivering the first magnetic implant.

[0193] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises securing a delivery wire to a second end delivery attachment of the first magnetic implant.

[0194] In some implementations, delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the first magnetic implant.

[0195] In some implementations, the cylindrical magnetic implant comprises a plurality of magnet elements flexibly connected in series.

[0196] In some implementations, delivering the second magnetic implant into the digestive tract comprises delivering the second magnetic implant into the duodenum.

[0197] In some implementations, the second magnetic implant is an elongated magnetic implant.BRIEF DESCRIPTION OF THE DRAWINGS

[0198] The attached figures illustrate various features, aspects and implementations of the technology described herein.

[0199] Fig 1 is an exploded perspective view of a first magnetic implant shown on one side of a desired site of an anastomosis and of a second magnetic implant shown on another side of the desired site of the anastomosis, with a vessel wall of a first hollow organ and a vessel wall of a second hollow organ being shown therebetween, in accordance with an implementation.

[0200] Fig 2 is a perspective view of the first and second magnetic implants shown in Fig 1 , with the first magnetic implant being shown in contact with the vessel wall of the first hollow organ and the second magnetic implant being shown in contact with the vessel wall of the second hollow organ, at the desired site of the anastomosis.

[0201] Fig 3 is a side view of the first and second magnetic implants shown in Fig 2, with the vessel wall of the first hollow organ and the vessel wall of the second hollow organ shown therebetween.

[0202] Fig 4 is a top perspective view of the first magnetic implant of Fig 1 , in accordance with an implementation.

[0203] Fig 5 is an exploded top perspective view of the first magnetic implant of Fig 4.

[0204] Fig 6 is a side elevation view of the first magnetic implant of Fig 4.

[0205] Fig 7 is a front elevation view of the first magnetic implant of Fig 4.

[0206] Fig 8 is a rear elevation view of the first magnetic implant of Fig 4.

[0207] Fig 9 is a cross-sectional side elevation view of the first magnetic implant of Fig 4, in accordance with an implementation.

[0208] Fig 10 is an exploded top perspective view of the first magnetic implant shown in Fig 4, in accordance with another implementation.

[0209] Fig 1 1 is a front view of a diametrically magnetized magnet element of a first magnetic implant, in accordance with an implementation.

[0210] Fig 11 B is a side view of the diametrically magnetized magnet element of Fig 18A.

[0211] Fig 11 C is a top perspective view of a diametrically magnetized magnet element of a first magnetic implant, in accordance with another implementation.

[0212] Fig 1 1 D is a top perspective view of a diametrically magnetized annular magnet element of a first magnetic implant, in accordance with yet another implementation.

[0213] Fig 1 1 E is a front view of a diametrically magnetized annular magnet element of a first magnetic implant, the diametrically magnetized annular magnet element including two stacked magnet elements, in accordance with yet another implementation.

[0214] Fig 11 F is a side view of the diametrically magnetized annular magnet element of Fig 18E.

[0215] Fig 1 1G is a top perspective view of a radially magnetized magnet element of a first magnetic implant, in accordance with an implementation.

[0216] Fig 12 illustrates a semitransparent front perspective view of a duodenum, a gallbladder, a pancreas, and a biliary tract, showing a first magnetic implant within the gallbladder on one side of a desired site of an anastomosis, and a second magnetic implant within the duodenum on another side of the desired site of the anastomosis, in accordance with an implementation.

[0217] Fig 13 illustrates a semitransparent front perspective view of a duodenum, a gallbladder, a pancreas, and a biliary tract, showing a first magnetic implant within the common bile duct of the biliary tract on one side of a desired site of an anastomosis, and a second magnetic implant within the duodenum on another side of the desired site of the anastomosis, in accordance with an implementation.

[0218] Fig 14 illustrates a semitransparent front perspective view of a duodenum, a gallbladder, a biliary tract, and the antrum of a stomach showing a first magnetic implant within the left hepatic duct of the biliary tract on one side of a desired site of an anastomosis, and a second magnetic implant within the antrum of the stomach on another side of the desired site of the anastomosis, in accordance with an implementation.

[0219] Fig 15 illustrates a semitransparent front perspective view of a duodenum, a gallbladder, a pancreas, and a biliary tract, showing a first magnetic implant having aplurality of magnet elements provided in an end-to-end fashion within the common bile duct of the biliary tract on one side of a desired site of an anastomosis, and a second magnetic implant within the duodenum on another side of the desired site of the anastomosis, in accordance with another implementation.

[0220] Fig 16 illustrates a front perspective view of a duodenum, a gallbladder, a pancreas, and a biliary tract, showing a first magnetic implant and a stent engaged therewith within the common bile duct of the biliary tract on one side of a desired site of an anastomosis, and a second magnetic implant within the duodenum on another side of the desired site of the anastomosis, in accordance with an implementation.

[0221] Fig 17 is an exploded top perspective view of a non-cylindrical magnetic implant shaped as an elongated prism and including six lateral faces, in accordance with another implementation.

[0222] Fig 18 is an exploded top perspective view of a non-cylindrical magnetic implant shaped as an elongated prism and including four lateral faces, in accordance with another implementation.

[0223] Fig 19 is an exploded top perspective view of a non-cylindrical magnetic implant shaped as an elongated prism and including four lateral faces, in accordance with another implementation.

[0224] Fig 20 is a top perspective view of a non-cylindrical magnetic implant and including four lateral faces, two being convex and two being flat, in accordance with another implementation.

[0225] Fig 21 is an exploded top perspective view of the non-cylindrical magnetic implant of Fig 20, showing a housing and a magnet element.

[0226] Fig 22 is a top perspective view of a first magnetic implant including a plurality of magnet elements flexibly connected in series, in accordance with another implementation.

[0227] Fig 23 is an exploded perspective view of a first magnetic implant shown on one side of a desired site of an anastomosis and of a second magnetic implant shown onanother side of the desired site of the anastomosis, with a vessel wall of a first hollow organ and a vessel wall of a second hollow organ being shown therebetween, in accordance with another implementation.

[0228] Fig 24 is a perspective view of the first and second magnetic implants shown in Fig 23, with the first magnetic implant being shown in contact with the vessel wall of the first hollow organ and the second magnetic implant being shown in contact with the vessel wall of the second hollow organ, at the desired site of the anastomosis.

[0229] Fig 25 is a side view of the first and second magnetic implants shown in Fig 24.

[0230] Fig 26 is a top perspective view of the second magnetic implant shown in Fig23, the second magnetic implant including a magnetic protrusion.

[0231] Fig 27 is an exploded top perspective view of the second magnetic implant of Fig 26.

[0232] Fig 28 is an exploded perspective view of a first magnetic implant shown on one side of a desired site of an anastomosis and of a second magnetic implant shown on another side of the desired site of the anastomosis, with a vessel wall of a first hollow organ and a vessel wall of a second hollow organ being shown therebetween, in accordance with another implementation.

[0233] Fig 29 is a top perspective view of the second magnetic implant shown in Fig 28, the second magnetic implant including a magnet receiving recess.

[0234] Fig 30 is an exploded top perspective view of the second magnetic implant of Fig 29.DETAILED DESCRIPTION

[0235] Techniques described herein relate to systems, devices and methods for forming an anastomosis between two adjacent walls of hollow structures of the digestive system of a patient, in the context of procedures to treat various medical conditions associated with the digestive system.

[0236] The formation of the anastomosis can be achieved by inserting a first magnetic implant into the lumen of a first hollow organ and a second magnetic implant into the lumen of a second hollow organ, positioning the first and second magnetic implants at a desired anastomosis site, and by magnetically coupling the first and second magnetic implants together to compress the tissue of the adjacent walls therebetween. Compression of the wall tissue between the two magnetic implants results in a necrotic area that corresponds approximately to the surface area of a compression surface of the magnetic implant pair. Over time, the necrotic area becomes surrounded by an edge of scar tissue, or scarred edge. The formation of scar tissue can include collagen fiber deposition, neovascularization, and epithelial regeneration, and represents a dynamic equilibrium involving cells, their milieu, and the extracellular matrix. Cytokines secreted by platelets and inflammatory cells can promote the formation of new blood vessels and collagen synthesis which, in dynamic balance with collagen degradation, can contribute to determining the healing response. Two components of collagen are hydroxyproline and hydroxylysine, with hydroxyproline being synthesized under conditions of oxidative stress via the hydroxylation of proline, and being involved in the cellular transport of collagen. The synthesis and transport of wound collagen can thus be understood by monitoring the hydroxyproline content of the wound. The edge of scar tissue can thus be characterized by the fusion, or mechanical bonding, of the walls of each hollow organ through which the anastomosis is formed that occurs in part via fibrosis mechanisms. The scarred edge can thus form a fluid-tight seal around the anastomosis.

[0237] The digestive system includes the digestive tract and accessory organs. In some implementations, it can be desirable to form an anastomosis between two distinct hollow organs of the digestive system, such as between the digestive tract and a lumen associated with an accessory organ of the digestive system (also referred to an accessory organ of digestion). Examples of accessory organs of the digestive system include the liver, the gallbladder, the bile ducts and the pancreas. As these accessory organs produce digestive fluids involved in the digestion process, it can be desirable to provide fluid communication between a lumen associated with an accessory organ of digestion and the digestive tract, for instance to bypass a clogged, restricted or otherwise ineffective natural channel of such accessory organ. Examples of procedures that can involve the formation of an anastomosis to provide fluid communication between the digestive tract and a lumen associated with an accessory organ of digestion can include, for instance, the treatmentof impacted bile duct stones, the obstruction of one or more of the bile ducts, pancreatitis, choledochal cysts, fistulas of one or more of the bile ducts, and / or a biliary obstruction. In some implementations, the treatment of these conditions can involve surgical procedures for the formation of an anastomosis between a hollow organ of the digestive tract and the gallbladder, one of the bile ducts, the pancreatic tract or the hepatopancreatic ampulla. Examples of such surgical procedures include cholescysto-duoedenostomies, choledochoduodenostomies and choledochojejunostomies.

[0238] The accessory organs of the digestive system and their associated natural channels typically have a lumen having a reduced diameter compared to the width or diameter of organs of the digestive tract. For instance, the internal diameter of the common bile duct in humans typically ranges between about 1 .8 mm and about 8 mm. In contrast, the internal diameter of the duodenum in humans can generally be considered as being between about 20 mm and about 30 mm. Therefore, in order to form an anastomosis between an organ of the digestive tract and a lumen associated with an accessory organ of digestion, the first magnetic implant can have a diameter sized to enable the insertion of the first magnetic implant into the lumen associated with the accessory organ of digestion ( / .e., be sufficiently small). In comparison, the second magnetic implant can have larger dimensions compared to the first magnetic implant, given the larger size of the hollow organs of the digestive tract. It is to be understood that the term “natural channel” refers to any a tubular passage or duct for providing fluid communication with or within an accessory organ of digestion. It is also to be understood that in the context of the present description, the use of the expression “lumen associated with an accessory organ” is intended to refer to any accessory organ with a lumen, i.e., a hollow accessory organ, and also includes ducts and channels associated with these accessory organs.

[0239] Each one of the first and second magnetic implants can be delivered to the site of the desired anastomosis using various techniques. For instance, the magnetic implants can be delivered to the site of the desired anastomosis endoscopically, or at least one of the first and second magnetic implants can be delivered to the site of the desired anastomosis laparoscopically. Examples of techniques for delivering at least one of the magnetic implants laparoscopically are described for instance in U.S. Patent No. 11 ,534,171 , which is hereby incorporated by reference in its entirety. Alternatively, in some implementations, the first magnetic implant can be delivered percutaneously within a firsthollow organ, i.e., an accessory organ, via a needle-puncture of the skin, for instance using a needle catheter.

[0240] Given the small dimensions of the accessory organs or of their associated natural channels, the positioning of the first magnetic implant once within the accessory organ or the natural channel of an accessory organ of digestion can be challenging. For instance, it may be difficult to deliver the first magnetic implant within a natural channel of an accessory organ of digestion according to a specific or desired orientation. To address this challenge, the first magnetic implant can be configured to be magnetically coupled to the second magnetic implant irrespective of an orientation of the first magnetic implant once within the natural channel or the accessory organ.

[0241] It will be appreciated that positional descriptions such as “above”, “below”, “left”, “right”, “inwardly”, “outwardly” and the like should, unless otherwise indicated, be taken in the context of the figures, and should not be considered limiting. The term “outwardly” is intended to refer to a feature that extends toward an exterior side of a reference axis. The term “inwardly” is intended to refer to a feature that extends toward an interior side of a reference axis. It should also be understood that elongated objects described herein are considered to have an implicit "longitudinal axis", “lateral axis” and “transverse axis”. The expression “longitudinal axis” is intended to refer to an axis extending along the length of the object (for instance along axis Y in the figures), the expression “lateral axis” (for instance along axis Z in the figures) is intended to refer to an axis extending perpendicularly to the longitudinal axis, along the width of the object, and the expression “transverse axis” (for instance along axis X in the figures) is intended to refer to an axis extending perpendicularly to the longitudinal axis, along the height of the object. When referring to a longitudinal direction, it is intended to refer to a direction that extends substantially parallel to the longitudinal axis of the object, encompassing as well as directions that deviate slightly from the longitudinal axis. When referring to a lateral direction, it is intended to refer to a direction that extends substantially parallel to the lateral axis of the object, encompassing as well as directions that deviate slightly from the lateral axis. When referring to an axial direction, it is intended to refer to a direction that extends substantially parallel to the transverse axis of the object, encompassing as well as directions that deviate slightly from the transverse axis. It is to be noted that the expression“outer lateral surface” is defined in detail hereinbelow in relation to various implementations of the magnetic implant.

[0242] Various implementations and features of the magnetic implants will now be described in greater detail in the following paragraphs.General description of the system for forming an anastomosis

[0243] With reference to Figs 1 to 3, a system 10 for forming an anastomosis between two adjacent walls of the digestive system is shown. The system 10 includes a first magnetic implant 20 and a second magnetic implant, each deliverable to a site of a desired anastomosis on their respective side of the walls of the digestive system. The first magnetic implant 20 can be implantable in a lumen associated with an accessory organ of digestion as a first hollow organ, and the second magnetic implant can be implantable in an organ of the digestive tract as a second hollow organ. Examples of first hollow organs include the biliary tract (including the gallbladder and the bile ducts), the pancreatic tract, and the hepatopancreatic ampulla. A site of desired anastomosis can be determined according to the condition of the patient, and this aspect will not be discussed further in the context of the present description.

[0244] It is to be understood that the term “implant” refers to a device that is implanted in the digestive system for a certain period of time, e.g., the healing time period, and that it can be used interchangeably with the term “device” or “component” for instance. As used herein, the expression “magnetic implant” refers to a structure that can be implanted into a chosen hollow organ of the digestive tract or an accessory organ of digestion, and that can be magnetically attracted to another magnetic implant due to magnetic forces. In some implementations, the magnetic implant can consist of a magnet. In some implementations, the magnetic implant can include a magnet element and one or more additional features, such as a housing and / or a connecting member. The two magnetic implants can be substantially the same as each other, or different, in terms of their shape, configuration, construction, and / or material make-up. These features will be discussed in greater detail below.

[0245] The first magnetic implant 20 is used with a second magnetic implant 70 to form a magnetic implant pair. The second magnetic implant 70 is a device implantable into asecond hollow organ forming part of the digestive tract of the patient to the site of the desired anastomosis via the lumen of the second hollow organ. An example of a hollow organ of the digestive tract includes the duodenum. The second hollow organ is located in sufficiently close proximity of the first hollow organ to enable the convergence of the respective wall tissue of the first and second hollow organs to eventually form the anastomosis. For example, in some implementations, the first hollow organ into which the first magnetic implant 20 can be implanted can be the biliary tract, and the second hollow organ into which the second magnetic implant 70 can be implanted can be the duodenum, so as to compress a portion of the biliary tract and a portion of the duodenum wall therebetween. As stated above, it is to be understood that the first hollow organ and the second hollow organ can be different than the biliary tract and the duodenum, and can refer to any accessory organ of digestion or any hollow organ of the digestive tract that can be joined together to form an anastomosis as desired by a healthcare provider, as described in further detail below.

[0246] The first and second magnetic implants 20, 70 are configured to remain within the digestive tract for at least a given healing time period. The healing time period enables necrosis of the anastomosis area while providing enough time for the edge of scar tissue to form. In some implementations, after approximately 3 to 5 days following implantation of the pair of magnetic implants at the desired site of the anastomosis, the periphery of the anastomosis is strengthened by collagen deposition, with the formation of an edge of scar tissue having an increased tensile strength occurring at approximately 7 to 10 days following implantation. The duration for forming the scar tissue can vary depending on the overall health of the individual patient and depending on the specific parts of the digestive tract being joined. The scar tissue can also gain strength over the course of several additional weeks. In some implementations, it can be desirable for the magnetic implants to be released and passed out of the body of the patient about two weeks after implantation. In some implementations, the healing time period can be about two weeks, or at least two weeks.

[0247] Each one of the first and second magnetic implants 20, 70 can have a shape and a size determined in accordance with their intended purpose. In some implementations, the size and the shape of the first and second magnetic implants can be determined for instance in accordance with the characteristics of the site of the desiredanastomosis, the delivery technique chosen to deliver a given one of the first and second magnetic implants to the site of the desired anastomosis, and so on. For instance, in some implementations, the first magnetic implant 20 can be a cylindrical magnetic implant or a non-cylindrical magnetic implant. When the first magnetic implant 20 is a non-cylindrical magnetic implant, the first magnetic implant 20 can be shaped as an elongated prism having a polygonal cross-section. In Figs 1 to 10, the first magnetic implant 20 is exemplified as a cylindrical magnetic implant sized for implantation in a lumen associated with an accessory organ of digestion as a first hollow organ, and the second magnetic implant 70 is exemplified as an elongated magnetic implant with a substantially flat contact surface for implantation in the second hollow organ.

[0248] In Figs 17 to 19, the first magnetic implant 20 is exemplified as an elongated prism sized for implantation in a lumen associated with an accessory organ of digestion as a first hollow organ, and can be used for instance with a second magnetic implant 70 that is elongated and has a substantially flat contact surface for implantation in the second hollow organ. In Fig 20, the first magnetic implant 20 is exemplified as a combination of some features of a cylindrical magnetic implant and some features of an elongated prism, in that the first magnetic implant is generally cylindrical but is longitudinally truncated to define a planar surface. This additional configuration of the first magnetic implant (designated as a “non-cylindrical magnetic implant” in the present description) makes it suitable for use also with a second magnetic implant 70 that can be elongated and that can have a substantially flat contact surface for implantation in the second hollow organ. It is to be understood that although a given configuration of second magnetic implant may be preferable for use with a given configuration of a first magnetic implant, the various implementations of the first magnetic implant and the second magnetic implant shown in Figs 1 to 30 can be used interchangeably (e.g., the first magnetic implant shown in Fig 1 with the second magnetic implant shown in Fig 26 or 29, or the first magnetic implant shown in Fig 21 with the second magnetic implant shown in Fig 1 , etc.). For ease of reference in the present description, the generic expressions “first magnetic implant” and “second magnetic implant” as used herein are intended to refer to all implementations described herein, unless otherwise specified. In addition, it is to be understood that the expression “substantially flat” used herein includes implementations where the surface is not curved (concave or convex), and implementations wherein the surface includes forinstance a surface roughness, or other features facilitating maintaining the first magnetic implant magnetically engaged with the second magnetic implant.

[0249] In some implementations, the second magnetic implant 70 can include a housing 72 that encloses a magnet element therein (not shown). The housing 72 can include an outward portion and an inward portion. In the context of the present description, the terms “outward” and “inward” when referring to the housing 72 are used in accordance with a radial reference system, in which the wall of the hollow organ is considered to be outwardly positioned relative to the lumen of the hollow organ. When the housing 72 is present, the inward portion of the housing 72 is the portion that includes a lumen-oriented surface 74 of the second magnetic implant 70, and the outward portion of the housing 72 is the portion that includes a tissue-contacting surface 76, or compression surface, of the second magnetic implant 70. Thus, the tissue-contacting surface 76 defines the portion of the housing that faces the first magnetic implant 20 when the first and second magnetic implants 20, 70 are magnetically coupled, and is involved in the magnetic compression of the tissue, while the lumen-oriented surface 74 is on the opposite side of the second magnetic implant 70 and facing away from the tissue being compressed, i.e., facing the lumen of the hollow organ. In this example, the outward portion and the inward portion of the housing 72 of the second magnetic implant 70 together fully enclose a magnet element, and can be coupled together around a periphery thereof. Other housing constructions are also possible, with one or more housing components being used to partially or fully enclose the magnet. Alternatively, the second magnetic implant 70 can be provided without a housing. Examples of the second magnetic implant 70 are described for instance in U.S. Patent Nos. 9,421 ,015, 11 ,576,676, and 1 1 ,583,280, which are hereby incorporated by reference in their entirety.

[0250] In some implementations, the tissue-contacting surface 76 of the second magnetic implant 70 can be substantially flat, or can include at least a portion that is substantially flat, as shown in Figs 1 , and 26 and 29, respectively. A tissue-contacting surface 76 that is flat can contribute to providing multiple locations over the tissuecontacting surface 76 for magnetically coupling with the first magnetic implant 20. In other implementations, the tissue-contacting surface 76 of the second magnetic implant 70 can have a complementary shape compared to the shape of the first magnetic implant 20. For example, the second magnetic implant 70 can have a curvilinear surface that is curvedinwardly, i.e., concave, to mate with the cylindrical shape of the first magnetic implant 20, or the cylindrical magnetic implant can be longitudinally truncated to facilitate mating with a flat surface of the second magnetic implant 70, whether the tissue-contacting surface 76 of the second magnetic implant 70 is entirely flat (as shown in Fig 1) or is part of a protrusion (as shown in Fig 26) or a recess (as shown in Fig 29). These aspects will be described in further detail below.

[0251] In some implementations, the tissue-contacting surface 76 of the second magnetic implant 70 can be larger than a projected area of the first magnetic implant 20 to facilitate excretion of the magnetically coupled first and second magnetic implants 20, 70 once the healing time period is completed into the second hollow organ rather than in the first hollow organ.

[0252] The first magnetic implant 20 for forming an anastomosis will now be described in further detail.Description of a cylindrical magnetic implant for forming an anastomosis

[0253] With reference to Figs 1 to 9, an implementation of a cylindrical magnetic implant 20 is shown. It is to be noted that in the following paragraphs, the expressions “cylindrical magnetic implant” and “first magnetic implant” can be used interchangeably to facilitate the understanding of the cooperation of the cylindrical magnetic implant 20 with the second magnetic implant 70 used for forming an anastomosis. In the implementation shown, the cylindrical magnetic implant 20 is elongated, and has a diameter sized to enable introduction of the cylindrical magnetic implant 20 into an accessory organ of digestion. For instance, in the implementations illustrated in Figs 12 and 13, a first magnetic implant 20 is shown implanted within the gallbladder and the common bile duct, respectively, and a second magnetic implant 70 is shown implanted within the duodenum and in sufficiently close proximity to the first magnetic implant 20 to enable the first and second magnetic implants 20, 70 to magnetically couple and compress the wall tissues therebetween. In the implementation shown in Fig 14, a first magnetic implant 20 is shown implanted within the left hepatic duct (or left bile duct) associated with the left lobe of the liver, and a second magnetic implant 70 is shown implanted within the stomach and in sufficiently close proximity to the first magnetic implant 20 to enable the first and second magnetic implants 20, 70 to magnetically couple and compress the walls of the left hepaticduct and the stomach therebetween. Alternatively, in another implementation, the first magnetic implant 20 can be implanted in a segmental intrahepatic duct of the biliary duct to enable a drainage of bile into a portion of the stomach (including, for instance, the antrum of the stomach). An example of a suitable segmental intrahepatic duct includes the segmental intrahepatic duct associated with segment III of the liver to drain bile produced by segment III of the liver into the antrum of the stomach. The diameter of the cylindrical magnetic implant 20 can thus depend on the accessory organ chosen as the first hollow organ. For instance, in some implementations, the diameter of the cylindrical magnetic implant 20 can be between about 1 mm and about 10 mm. In some implementations, the diameter of the cylindrical magnetic implant 20 can be between about 2 mm and about 5 mm. In some implementations, the diameter of the cylindrical magnetic implant 20 can be between about 2.5 mm and about 4 mm. It will be understood that the implementations shown in Figs 12 to 14 include examples of a first hollow organ of an accessory organ and a second hollow organ of the digestive tract for receiving the first and second magnetic implants 20, 70, respectively, and that, in other implementations, the first and second hollow organs may include any other suitable hollow organs to form an anastomosis in accordance with the treatment of a particular affection. For instance, in some implementations, the first and second magnetic implants 20, 70 can be implanted within the gallbladder and the antrum of the stomach, respectively, to form an anastomosis enabling a drainage of bile from the gallbladder into the stomach. In other implementations, the first magnetic implant 20 can be implanted within the right hepatic duct (or right bile duct), and the second magnetic implant 70 can be implanted within one of the duodenum and the antrum in sufficiently close proximity to the first magnetic implant 20. In still other implementations, the first and second magnetic implants 20, 70 can be implanted within the common bile duct and the antrum, respectively, to form an anastomosis enabling a drainage of bile from the common bile duct into the stomach.

[0254] In the implementation shown in Figs 1 to 9, the cylindrical magnetic implant 20 includes a housing 60 and a magnet element 64 configured to be housed within the housing 60. An example of housing 60 is shown in Fig 5. In this example, the housing 60 is shown as being substantially tubular and having open ends, i.e., as a tubular housing. The tubular housing 60 defines a magnet receiving cavity 62 configured to receive the magnet element 64 therein. In other implementations, the tubular housing 60 can include closed ends. In other words, the magnet element 64 can be fully enclosed in a tubularhousing 60 configured as a single-piece housing enclosing the magnet element 64, including at each of the opposed ends.

[0255] In some implementations, the housing 60 can be made of a housing material that is generally not susceptible to dissolution or degradation when subjected to physiological conditions. In some implementations, the housing material can include a metal or a polymer. Examples of suitable metals that can be used for the housing 60 include stainless steel, titanium, nitinol, and medical implant grade metal. Examples of suitable polymers that can be used for the housing 60 include silicone, Silastic™, a medical implant grade polymer such as polyether ether ketone (PEEK), polycarbonates, thermoplastic elastomers [e.g. polyamides (Pebax™), polyesters (Hytrel™), polyurethanes (Pellathane™), and thermosetting resins, including photopolymers suitable for 3D resin printing. The degree of rigidity of the polymer chosen can range from soft to stiff depending on the design of the housing 60 and on the desired flexibility of the cylindrical magnetic implant 20.

[0256] In some implementations, the accessory organ into which the cylindrical magnetic implant 20 is intended to be introduced can include a curvature, such as when the accessory organ is the biliary tract, the pancreatic tract or the hepatopancreatic ampulla. Accordingly, and as mentioned above, in some implementations, the housing 60 can be made of a flexible material configured to flex in accordance with the curvature of the accessory organ into which it is introduced. The flexibility of the housing 60 can be provided by a combination of the selection of a flexible material and by the configuration of the magnet element(s) 64 received within the housing 60. In such implementations, the housing material of the housing 60 can be a flexible housing material, such as a flexible housing material that includes one or more of the polymers mentioned above. In addition, the magnet element(s) 64 can include a plurality of magnet elements provided in an end- to-end fashion within the housing 60, such that when received with the housing 60 made of a flexible housing material, the cylindrical magnetic implant 20 can flex to adjust to the curvature of the accessory organ. Thus, providing a plurality of magnets elements 64 within the housing 60 can contribute to enhancing the flexibility of the cylindrical magnetic implant 20, to facilitate introduction into the accessory organ and adoption of the curvature of the accessory organ. Accordingly, although a single magnet element 64 is shown within the housing 60 of the cylindrical magnetic implant 20 in the implementation shown in Fig5, in other implementations, the housing 60 can include any other suitable number of magnet elements 64. For instance, in the implementation shown in Fig 10, a series of adjacent magnet elements 64are shown received within the housing 60 of the cylindrical magnetic implant 20, with the succession of adjacent magnet elements 64 being positioned longitudinally in an end-to-end fashion along a longitudinal axis of the housing 60.

[0257] Alternatively, and as shown in Fig 15, the housing can be omitted, and the plurality of magnet elements 64 can be delivered sequentially into the lumen of the accessory organ to obtain a desired length and / or thickness of a resulting first magnetic implant 20. Fig 15 shows an example of a first magnetic implant 20 delivered in the lumen associated with the accessory organ on one side of a desired anastomosis and of a second magnetic implant 70 delivered in the digestive tract on another side of the desired anastomosis. In Fig 15, the accessory organ corresponds to the common bile duct and the second magnetic implant 70 is shown within the duodenum, in sufficiently close proximity to the common bile duct to enable the first and second magnetic implants 20, 70 to magnetically couple and compress the walls of the common bile duct and the duodenum therebetween. This implementation of the first magnetic implant 20 is shown including multiple magnet elements 64 magnetically coupled in succession in an end-to-end fashion along a longitudinal axis of the first magnetic implant 20 to form a stacked magnet assembly. As mentioned above, in this implementation, the housing is omitted such that the magnet elements 64 are exposed, i.e., not housed within a housing 60, thereby allowing a relative displacement between the magnet elements 64 within the lumen associated with the accessory organ while each magnet element 64 is magnetically attracted to an adjacent magnet element 64, with each magnet element 64 being axially magnetized. A relative displacement between the magnet elements 64 can provide a flexibility of the cylindrical magnetic implant 20 to facilitate introduction thereof into the accessory organ and adoption of the curvature of the accessory organ. In some implementations, one or more of the magnet elements 64 can be magnetically coupled in a lateral configuration with adjacent magnet elements 64 being stacked along the lateral axis of the first magnetic implant 20 to increase the strength of the overall magnetic field generated by the first magnetic implant 20.

[0258] The cylindrical magnetic implant 20 includes an available tissue-contacting portion 23 defined over an entire circumferential outer surface 21 thereof. The available tissue-contacting portion 23 corresponds to the outer circumferential surface 21 of the housing 60, or of the magnet element 64 if the housing 60 is omitted, that is available for potentially contacting the wall of the first hollow organ, e.g., the accessory organ of digestion, when the first and second magnetic implants 20, 70 become magnetically coupled. The circumferential outer surface 21 of the cylindrical magnetic implant 20 includes a succession of longitudinal segments, i.e., longitudinal lines, extending between the two bases of the cylindrical magnetic implant 20 in a longitudinal direction substantially parallel to the axis Y in the coordinate system shown in Fig 4, the combination of all longitudinal segments covering the entire circumferential outer surface 21. One or more of these longitudinal segments can potentially become in contact with the wall of the first hollow organ prior to the magnetic coupling with the second magnetic implant 70, irrespective of the circumferential orientation, i.e., the rotational orientation, of the cylindrical magnetic implant 20 (given that the cylindrical magnetic implant 20 can potentially rotate on itself about a longitudinal axis thereof). Once the cylindrical magnetic implant 20 becomes magnetically coupled with the second magnetic implant 70, at least one of the longitudinal segments will be in contact with the wall tissue and will contribute to exerting a compression force onto the wall tissue, given the magnetic attraction with the second magnetic implant 70. Accordingly, the at least one of the longitudinal segments can be referred to as an anastomosis-forming longitudinal segment 24, the anastomosisforming longitudinal segment 24 being, in some implementations, provided at any location on the available tissue-contacting portion 23 of the cylindrical magnetic implant 20.

[0259] Fig 1 illustrates an example of an anastomosis-forming longitudinal segment 24 that extends longitudinally between the two opposite bases of the tubular housing 30. As mentioned above, the available tissue-contacting portion 23 being defined over the entire circumferential outer surface 21 of the housing 30, the anastomosis-forming longitudinal segment 24 could have extended between the two opposite bases of the cylinder at any tangential location of the available tissue-contacting portion 23. During the magnetic coupling of the first and second magnetic implants 20, 70, the anastomosis-forming longitudinal segment 24 extending along the available tissue-contacting portion 23 faces the tissue-contacting surface 76 of the second magnetic implant 70 to compress a portion of the two adjacent walls therebetween. In the illustrated implementation, theanastomosis-forming longitudinal segment 24 extends along the circumferential outer surface 21 of the first magnetic implant 20, and along a majority of a length of the first magnetic implant 20 in a direction being substantially parallel to a longitudinal axis of the first magnetic implant 20 ( / .e., in a direction substantially parallel to axis Y in the coordinate system shown in Fig 1). In some implementations, the cylindrical magnetic implant 20 can thus be configured to magnetically couple with the second magnetic implant 70 irrespective of a circumferential orientation of the first magnetic implant 20, as will be discussed in further detail below. In such implementations, the anastomosis-forming longitudinal segment 24 can be one of multiple possible longitudinal segments defined on the available tissue-contacting portion 23.Magnet element of the first magnetic implant

[0260] Referring now to Fig 5, an implementation of the magnet element 64 of the cylindrical magnetic implant 20 is shown. The magnet element 64 can be configured to be received within the housing 60 as described above. In the implementation shown, the magnet element 64 is a cylindrical magnet element defining a circumferential surface 65 and configured to be received in the magnet receiving cavity 62 of the housing 60. The magnet receiving cavity 62 has a circular cross-section sized to receive the cylindrical magnet element 64 therein. In other implementations, the magnet receiving cavity 62 can have a polygonal cross-section, and the magnetic element 64 can have a corresponding polygonal cross-section to enable insertion into the magnet receiving cavity 62. In yet other implementations, the configuration of the cross-section of the magnet receiving cavity 62 may not correspond to the configuration of the cross-section of the magnet element 64, for instance if the magnet receiving cavity 62 has a circular cross-section and the magnet element 64 has a square cross-section. In such implementations, the width of the magnet element 64 is nonetheless sized to enable insertion of the magnet element into the magnet receiving cavity 62.

[0261] In the implementation shown in Fig 5, the magnet element 64 is exemplified as being solid throughout, meaning that the magnet element 64 does not include a longitudinally extending through-hole. In alternative implementations, the magnet element 64 can include a longitudinally extending through-hole, thus forming an annular magnet element.

[0262] In some implementations, the magnet element 64 can have a magnet element width that corresponds to the internal width of the tubular housing 60, and thus to the width of the magnet receiving cavity 62. In such implementations, the magnet element 64 can thus be sized to provide a snug fit within the magnet receiving cavity 62, with only a negligible gap between the circumferential surface 65 of the magnet element 64 and an inner surface of the tubular housing 60. In other implementations, the magnet element width can be selected such that there is a given gap between the circumferential surface 65 of the magnet element 64 and the inner surface of the tubular housing 60. When the magnet element 64 includes a plurality of magnet elements 64 provided in an end-to-end fashion, providing a gap between the circumferential surface 65 of the magnet element 64 and the inner surface of the tubular housing 60 can facilitate the movement of the magnet elements 64 within the housing 60, which in turn can enhance the flexibility of the cylindrical magnetic implant 20 if the housing is made of a flexible material. In some implementations, a width of the magnet element 64, i.e., the magnet element width, can extend over a majority of an internal width of the housing 60, on either side of a central axis of the housing 60. Providing a magnet element 64 with a magnet element width that extends over the majority of an internal width of the housing 60 and on either side of a central axis of the housing is a feature that enables the entire circumferential outer surface 21 of the cylindrical magnetic implant 20 to be available as an available tissue-contacting portion 23, since there is a magnet present adjacent to the wall of the tubular housing 60 over an entire circumference of the tubular housing 60.

[0263] In some implementations, the magnet element 64 has a length that extends over a majority of a length of the housing 60. Providing a magnet element 64 with a length that extends over the majority of a length of the housing 60 can facilitate the magnetic interaction with the second magnetic implant 70. In some implementations, the length of the magnet element 64 can correspond to the length of the housing 60. In some implementations, when the length of the magnet element 64 corresponds to the length of the housing 60, the length of the magnet element 64 can be selected taking into consideration the length of the second magnetic implant 70. With this approach, the length of the portions of the walls of the hollow organs being compressed between the cylindrical magnetic implant 20 and the second magnetic implant 70 can be similar to the length of the cylindrical magnetic implant 20 and the second magnetic implant 70. Alternatively, for instance if an anastomosis with a smaller length or width than the length of the secondmagnetic implant 70 is desired, the length of the magnet element 64 of the cylindrical magnet implant 20 can be shorter than the length of the second magnetic implant 70. Furthermore, when the magnet element 64 includes a plurality of magnet elements provided in an end-to-end fashion, the overall length of the magnet elements can be shorter than the length of the housing 60, such that the magnet elements 64 can move relative to each other when the housing 60 is flexed.

[0264] The magnet element 64 can be any type of suitable magnet composed of the appropriate material. In some implementations, the magnet element 64 can be chosen according to its attractive force, i.e., according to the pressure that will be exerted on the surface area of the tissue that will eventually be compressed between the first and second magnetic implants 20, 70. Factors influencing the attractive force of the magnet element 64 can include the shape of the magnet 64, the dimensions of the magnet element 64, the material of which the magnet element 64 is made, etc. Example materials include ferromagnetic materials such as neodymium magnets (e.g., NdFeB magnets), rare earth magnets, and ferrite magnets. In some implementations, the magnet element 64 of the cylindrical magnetic implant 60 can be made of a magnetic material that is not permanently magnetized, such as soft magnetic alloys, e.g., nickel-iron, silicon iron, iron, iron-cobalt, and ferritic stainless steels. This type of magnetic material can be referred to as a magnetically susceptible material that is configured to be attracted to a magnetic field generated by the second magnetic implant 70. Thus, it is to be understood that the material from which the magnet element 64 is made can be any known material configured to be magnetically attracted to the second magnetic implant 70.

[0265] Referring to Figs 1 1A to 1 1G, examples of magnetization profiles that the magnet element 64 can have are shown. For instance, the magnet element 64 can be diametrically magnetized, i.e., can be a permanent magnet having a magnetic-pole distribution defining two magnetic portions each having a given polarity, such as shown in Figs 11A to 11 D. In such implementations, the diametrically-magnetized magnet element 64 includes a north pole 64A and a south pole 64B on either side of the diameter of the magnet element. Thus, in Figs 11 A to 11 D, the magnet element 64 can be considered to include two magnetic halves as the two magnetic portions, each having a corresponding polarity. With such a configuration, i.e., when the magnet element 64 is diametrically magnetized, the anastomosis-forming longitudinal segment 24 can be defined along theavailable tissue-contacting portion 23 in a region corresponding to the north pole 64A or the south pole 64B of the magnet element 64 that is attracted to the magnetic field generated by the second magnetic implant 70. For instance, the anastomosis-forming longitudinal segment 24 can be defined along the available tissue-contacting portion 23 in a region corresponding to the north pole 64A or the south pole 64B of the magnet element 64 depending on the polarity of the portion of the second magnetic implant 70 that includes the tissue-contacting surface 76 to enable the first and second magnetic implants 20, 70 to be magnetically attracted when placed in sufficiently close proximity. Alternatively, if the second magnetic implant 70 is made of a magnetically susceptible material, the anastomosis-forming longitudinal segment 24 of the first magnetic implant 20 can be defined along the available tissue-contacting portion 23 in any of the regions corresponding to the north pole 64A or south pole 34B of the magnet element 64.

[0266] Referring to Fig 1 1 G, an implementation of the magnet element 64 is shown having a north pole 64A and a south pole 64B in a radially-magnetized configuration such that the external magnetic field is strongest and substantially uniform along the circumferential surface 65 of the magnet element 64. With such a configuration, i.e., when the magnet element 64 is radially magnetized, the entire circumferential surface 65 of the magnet element 65 has a given polarity, i.e., can be a north pole or a south pole, and the anastomosis-forming longitudinal segment 24 can be one of multiple possible longitudinal segments defined on the available tissue-contacting portion 23.

[0267] In some implementations, the magnet element 64 can be sized to rotate freely within the magnet receiving cavity 62 of the first magnetic implant 20. In such implementations, the magnet element 64 can rotate relative to the housing 60 to orient itself through magnetic field alignment with the magnetic field generated by the second magnetic implant 70 to satisfy a north-south or south-north magnetic coupling of the first and second magnetic implants 20, 70 without requiring a rotation of the housing 60 within the first hollow organ.

[0268] In some implementations, the magnet element 64 can be annular. In such implementations, the magnet element 64 can include a non-magnetic core (not shown) in a central region of the magnet element 64. Accordingly, when the magnet element 64 is annular (as shown in Figs 1 1 D to 1 1 F), the magnet element 64 defines a cavity 64C thatcan receive a non-magnetic core therein. In such implementations and as shown in Figs 11 D to 11 F, the annular magnet element 64 can be diametrically magnetized, or the annular magnet element 64 can be radially magnetized, as shown in Fig 11 G.

[0269] In some implementations, the magnet element 64 can be provided concentrically within the housing 60. As used herein, the expression “concentrically” refers to the magnet element 64 sharing the same central axis with the housing 60. Referring to Fig 5, the magnet element 64 is provided within the magnet receiving cavity 62 of the housing 60 concentrically, the central axis of the magnet element 64 coinciding with the central axis of the housing 60. With such a configuration, i.e., when the magnet element 64 is provided concentrically within the housing 60, each longitudinal segment of the available tissue-contacting portion 23 extends parallel ly to the central axis of the cylindrical magnetic implant 20 (i.e., an axis extending through the centroid of the cylindrical magnetic implant 20 in a direction substantially parallel to axis Y in the coordinate system shown in Fig 5), and is substantially equidistant to the circumferential surface 65 of the magnet element 64. Accordingly, when the cylindrical magnetic implant 20 is magnetically attracted to the second magnetic implant 70, the cylindrical magnetic implant 20 can couple with the second magnetic implant 70 along any longitudinal segment of the available tissue-contacting portion 23 being nearest to the second magnetic implant 70. The cylindrical magnetic implant 20 is therefore configured to be magnetically coupled with the second magnetic implant 70 in any of multiple circumferential orientations of the cylindrical magnetic implant 20. More particularly, the cylindrical magnetic implant 20 can be magnetically coupled with the second magnetic implant 70 irrespective of its circumferential positioning within the first hollow organ, without requiring a rotation of the cylindrical magnetic implant 20 about its longitudinal axis.

[0270] In some implementations, the tubular housing 60 can be divided so as to define four tubular housing quadrants 68 (shown in Fig 5). In the context of the present description, the term “quadrant” refers to a quarter of the housing 60 defined by a set of two planes 69 perpendicular to each other and extending longitudinally in a direction substantially parallel to axis Y in the coordinate system shown in Fig 5, with each of the four tubular housing quadrants 68 extending about the centerline of the housing 60 over an equal arc length of the housing 60. In such implementations, the magnet element 64 can extend into at least two of the four tubular housing quadrants 68 to enable a couplingof the first and second magnetic implants 20, 70 in any of multiple circumferential orientations of the first magnetic implant 20. Still referring to Fig 5, in some implementations, the magnet element 64 can extend into the four tubular housing quadrants 68 to enable a coupling of the first and second magnetic implants 20, 70 in a greater number of circumferential orientations of the first magnetic implant 20.Additional features of the cylindrical magnetic implant

[0271] With reference to Figs 1 to 9, in some implementations, the cylindrical magnetic implant 20 can include a first end cap 12 engageable with a first end 66 of the housing 60. The first end cap 12 can include a first end tubular housing engaging portion 13 configured for insertion into the first end 66 of the housing 60 to enable the first end cap 12 to engage the housing 60 of the first magnetic implant 20. In some implementations, the first end cap 12 can include atraumatic features to contribute to minimizing tissue injury during delivery of the cylindrical magnetic implant 20 to the desired site for creating the anastomosis. For instance, and as shown in the example implementation of Figs 1 to 9, the first end cap 12 can be dome-shaped and / or can include a generally curved outer surface defining rounded corners devoid of sharp angles to facilitate navigation into the digestive system. The first end cap 12 can further include a tubular housing abutting wall 14 configured to abut the wall of the tubular housing 60 at the first end 66 thereof once the first end tubular housing engaging portion 13 is inserted into the first end 66 of the tubular housing 60.

[0272] Still referring to Figs 1 to 9, in some implementations, the cylindrical magnetic implant 20 can further include a second end delivery attachment 15 engageable with a second end 67 of the tubular housing 60. In Figs 1 to 9, the second end delivery attachment 15 is exemplified as including a second end tubular housing engaging portion16 configured for insertion into the second end 67 of the housing 60, and a connecting member 17 that can be releasably engageable with a connector (not shown) of a delivery system. In other words, the second end delivery attachment 15 can include a feature that enables its connection to a connector of a delivery system for delivering the cylindrical magnetic implant 20 to a desired site of the anastomosis. In turn, the connecting member17 can include any feature that enables a releasable connection between the second end delivery attachment 15 (and by association the cylindrical magnetic implant 20) and the connector. In Figs 1 to 9, the connecting member 17 is configured as a receiving cavitythat can receive a distal end of the connector therein. In some implementations, the delivery system can include a delivery catheter, and the delivery catheter can include the connector as described above.

[0273] In some implementations, the cylindrical magnetic implant 20 can include a transverse section (i.e., along axis X in Fig 1 for instance) that is free of a longitudinally- extending through-hole. In some implementations, the transverse section of the first magnetic implant 20 extends over a majority of a length (i.e., along axis Y in Fig 1 for instance) of the first magnetic implant 20 as defined between the first end 66 and the second end 67 of the tubular housing 60. Alternatively, the transverse section of the cylindrical magnetic implant 20 can extend over an entire length of the first magnetic implant 20, including the first end cap 52 and the second end delivery attachment 56, when present. In other implementations, the transverse section of the cylindrical magnetic implant 20 that is free of a longitudinally-extending through-hole can extend over a portion of the length of the cylindrical magnetic implant 20. When the transverse section that is free of longitudinally-extending through-hole extends over a portion of the length of the cylindrical magnetic implant 20 and is provided for instance in a central region, lengthwise, of the cylindrical magnetic implant 20, the combination of the housing 60 and such transverse section that is free of a longitudinally-extending through-hole together define two distinct magnet receiving cavities 62 on either side of the transverse section. In such implementations, a first set of one or more magnet elements 64 can be provided on one side of the transverse section, and a second set of one or more magnet elements 64 can be provided on another side of the transverse section. In some implementations, one or more of the magnet elements 64, the first end cap 52 and the second end delivery attachment 56 can be free of a longitudinally-extending through-hole, thereby preventing fluid communication from the first end 25 to the second end 26 of the first magnetic implant 20.Stent

[0274] In some implementations, the system 10 for forming an anastomosis can include a stent 18 configured to be inserted into the first hollow organ adjacent the first magnetic implant 20 to facilitate the flow of the digestive fluids in the first hollow organ through the section containing the first magnetic implant 20. An implementation of thestent 18 is shown in Fig 16. In the illustrated implementation, a second magnetic implant 70 is shown implanted within the duodenum and a first magnetic implant 20 is shown implanted within the common bile duct with the stent 18 positioned adjacent to the first magnetic implant 20, outwardly thereof, to enable the uninterrupted flow of digestive fluids through the section of the first hollow organ containing the first magnetic implant 20 during the formation of the anastomosis. The stent 18 can be a component that is distinct from the first magnetic implant 20, and optionally engaged therewith, and that is delivered within the first hollow organ prior to the delivery of the first magnetic implant 20, during the delivery of the first magnetic implant 20 or following the delivery of the first magnetic implant 20 to the desired site of the anastomosis.

[0275] In some implementations, the stent 18 can contain interconnecting metal struts configured to be self-expanding or that are expandable into an expanded configuration by a mechanical means, such as a balloon. When in the expanded configuration, the stent 18 can contribute to maintaining a pathway open for the flow of digestive fluids in the first hollow organ, such as bile.

[0276] In some implementations, the stent 18 can be made of self-expanding nitinol or another metal alloy, In some implementations, the stent can be made of a resorbable material such as a resorbable metal (e.g., magnesium) or a resorbable polymer including, for instance, poly(glycolide-co-lactide) (PGLA), poly lactic-co-glycolic acid (PLGA), polylactic acid (PLA), polydiacetylenes (PDA), polyethylene glycols (PEG), and poly-l- lactic acid (PLLA). When the stent 18 is made of a resorbable material, the stent 12 can be configured to resorb over the time period during which the anastomosis is being formed to eventually become entirely resorbed and thus no longer be present in the first hollow organ. Alternatively, if fragments of the stent 18 remain, such fragments can also be naturally expelled through the anastomosis or can be absorbed by the body.

[0277] In some implementations, the stent 18 can include a central core (not shown) defining one or more channels enabling the flow of digestive fluids between the central core and the wall of the hollow organ. In some implementations, the stent 18 can include a distal end having a generally curved shape defining rounded corners devoid of sharp angles to facilitate navigation into the digestive system.

[0278] In some implementations, the stent 18 can be a flexible stent 18 having a distal section and a proximal section with features conducive for introduction and anchoring within the first hollow organ, where the first magnetic implant 20 is releasably incorporated into the stent 18 for ease of introduction and placement of the combination of the stent 18 and the first magnetic implant 20.

[0279] In some implementations, the stent 18 and the first magnetic implant 20 can be engaged together and delivered as a single unit. In order to do so, the stent 18 can include a stent body 19 and a magnetic connector (not shown) configured to magnetically couple with the first magnetic implant 20 for ease of introduction and placement of the stent 18 and the first magnetic implant 20 within the first hollow organ. In some implementations, the magnetic connector of the stent 18 can be secured to the stent body 19 using a resorbable polymer or resorbable metal configured to lose its mechanical properties and / or disintegrate after a given period of time, which can correspond to a timepoint during the formation of the anastomosis, or a timepoint after the formation of the anastomosis is completed. For instance, the magnetic connector can be released from the stent 18 following the formation of the anastomosis to enable the release of the first and second magnetic implants 20, 70, while the stent 18 remains in place or is subsequently removed if not made of a resorbable material. As mentioned above, if fragments of the stent 18 remain, such fragments can also be naturally excreted through the anastomosis or can be absorbed by the body.

[0280] Still referring to Fig 16, the first magnetic implant 20 can be positioned adjacent, i.e., against, the stent body 19 of the stent 18 within the first hollow organ. In other implementations, the first magnetic implant 20 can be positioned within a stent lumen defined by the stent body 19 and configured to magnetically couple with the second magnetic implant 70 across the stent body 19 of the stent 18.

[0281] It is to be understood that the stent 18 described above can be implemented with any of the magnetic implants described herein destined to be implanted in an accessory organ (or other small organ of the digestive system).Description of a non-cylindrical magnetic implant for forming an anastomosis

[0282] In some implementations, the system 10 for forming an anastomosis between two adjacent walls of the digestive system can include a first magnetic implant having a non-cylindrical shape, i.e., a non-cylindrical magnetic implant. As used herein, the expression “non-cylindrical magnetic implant” refers to a magnetic implant having an outer lateral surface including two or more outer lateral faces intersecting along their respective lateral edges to collectively form the outer lateral surface defining an available tissuecontacting portion. Thus, the non-cylindrical magnetic implant can include a cross-section having any suitable non-circular shape, including a cross-section resulting from the combination of a substantially circular crescent (i.e., a lune) closed with at least one outer lateral face that is flat.

[0283] Referring now to Figs 17 to 21 , implementations of a non-cylindrical magnetic implant are shown. It is to be noted that in the following paragraphs, the expressions “non- cylindrical magnetic implant” and “first magnetic implant” can be used interchangeably to facilitate the understanding of the cooperation of the non-cylindrical magnetic implant with the second magnetic implant used for forming an anastomosis.Non-cylindrical magnetic implant shaped as an elongated prism

[0284] Referring to Figs 17 to 19, implementations of a non-cylindrical magnetic implant 30 are shown. In these example implementations, the non-cylindrical magnetic implant 30 is shaped as an elongated prism having outer lateral faces 31 of substantially equal dimensions extending between a first end 35A and a second end 35B of the first magnet implant 30, the outer lateral faces 31 together forming the outer lateral surface of the non-cylindrical magnetic implant 30. The outer lateral faces 31 of the elongated prism together define an available tissue-contacting portion 33 of the non-cylindrical magnetic implant 30, similarly to the available tissue-contacting portion 23 of the cylindrical magnetic implant 20 described above that is defined over an entire outer circumferential surface 21 of the cylindrical magnetic implant 20. In turn, the available tissue-contacting portion 33 of the non-cylindrical magnetic implant 30 includes one of the outer lateral faces 31 as an anastomosis-forming surface 34. Thus, similarly to the cylindrical magnetic implant 20 that includes a succession of longitudinal segments that can potentially become in contact with the wall of the first hollow organ prior to the magnetic coupling with the second magneticimplant 70 and become an anastomosis-forming segment 24 once coupled with the second magnetic implant 70, the non-cylindrical magnetic implant 30 includes the outer lateral faces 31 of substantially equal dimensions that can potentially become in contact with the wall of the first hollow organ prior to the magnetic coupling with the second magnetic implant 70, with one of the outer lateral faces 31 becoming an anastomosisforming surface 34 once coupled with the second magnetic implant 70.

[0285] It will be appreciated that while the implementations of the non-cylindrical magnetic implant 30 shown in Figs 17 and 18 are exemplified as having six and four outer lateral faces 31 , respectively, the non-cylindrical magnetic implant 30 can have any other suitable number of lateral faces 31 with some implementations of the non-cylindrical magnetic implant 30 having as little as three outer lateral faces 31. Thus, the elongated prism can be for instance a triangular prism, a rectangular prism (as shown in Fig 18), a pentagonal prism, a hexagonal prism (as shown in Fig 17), and heptagonal prism, or an octagonal prism.

[0286] In the implementations shown in Figs 17 to 19, the outer lateral faces 31 of the first magnetic implant 30 are substantially flat. In some implementations, an outer lateral face 31 that is substantially flat can contribute to provide a uniform compression of the wall tissue over the anastomosis-forming surface 34 when magnetically coupled with a second magnetic implant 70 having a substantially flat tissue-contacting surface 76. In alternative implementations, one or more of the outer lateral faces 31 can be curved inwardly or outwardly (be concave or convex), and have a complimentary shape with respect to the tissue-contacting surface 76 of the second magnetic implant 70 to facilitate the magnetic engagement between the first and second magnetic implants.Non-cylindrical magnetic implant shaped as an elongated body including convex surfaces

[0287] Referring to Figs 20 and 21 , another implementation of a non-cylindrical magnetic 40 implant is shown. The non-cylindrical magnetic implant 40 includes an elongated body 41 having outer lateral faces 46 together forming the outer lateral surface of the non-cylindrical magnetic implant 40. The outer lateral faces 46 of the elongated body 41 can include a combination of curved surfaces 48, and flat surfaces 47. For instance, in the implementation shown in Fig 20, the first magnetic implant 40 includes asuccession of a first flat surface 47, a first convex surface 48, a second flat surface 47 and a second convex surface 48, together forming the outer lateral surface of the first magnetic implant 40. The first and second flat surfaces 47 are two diametrically opposite flat surfaces 47 defined along a respective longitudinal plan extending through the elongated body 41 along a chord thereof, and the curved surfaces 48 are also diametrically opposite surfaces extending between the first and second flat surfaces 47. In such implementations, the first magnetic implant 40 thus includes four outer lateral faces 46, and can be considered as defining an obround, or oblong, cross-section.

[0288] In some implementations, the outer lateral faces 46 can collectively form an available tissue-contacting portion 43 such that, when the non-cylindrical magnetic implant 40 is magnetically attracted to the second magnetic implant 70, the non-cylindrical magnetic implant 40 can couple with the second magnetic implant 70 via any of the outer lateral faces 46 ( / .e., via a given one of the flat surfaces 47 or the convex surfaces 48 being nearest to the second magnetic implant 70), irrespective of a lateral positioning of the non-cylindrical magnetic implant 40, and without requiring a rotation of the non- cylindrical magnetic implant 40 about its longitudinal axis. In such implementations, each of the convex curvilinear faces 48 includes a succession of longitudinal segments, similarly to the circumferential outer surface 21 of the cylindrical magnetic implant 20 described above. In accordance with a given rotational orientation of the first magnetic implant 40 about its longitudinal axis, when a given one of the convex surfaces 48 is nearest to the second magnetic implant 70, one or more of these longitudinal segments can potentially become in contact with the wall of the first hollow organ to become an anastomosisforming longitudinal segment 49. Alternatively, when a given one of the flat surfaces 47 is nearest to the second magnetic implant 70, the given one of the flat surfaces 47 can become an anastomosis-forming surface 44 once the first magnetic implant 40 is coupled with the second magnetic implant 70.

[0289] In other implementations, a curvature of the convex surfaces 48 of the non- cylindrical magnetic implant 40 can enable a potential rotation of the non-cylindrical magnetic implant 40 about its longitudinal axis when subjected to a magnetic attraction with the second magnetic implant 70 to facilitate orienting any one of the two flat surfaces 47 toward the tissue-contacting surface 76 of the second magnetic implant 70 to become the anastomosis-forming surface 44, such that the anastomosis-forming surface 44 of thenon-cylindrical magnetic implant 40 can subsequently be magnetically coupled and mate with the tissue-contacting surface 76 of the second magnetic implant 70.

[0290] It will be appreciated that while the implementation of the non-cylindrical magnetic implant 40 shown in Figs 20 and 21 is exemplified as having four outer lateral faces 46 defining an obround cross-section, the non-cylindrical magnetic implant 40 can include any other number of outer lateral faces 46 that can be flat or convex (or even concave).

[0291] For instance, in some implementations, the non-cylindrical magnetic implant 40 can include two outer lateral faces 46. In such implementations, the outer lateral faces 46 of the non-cylindrical magnetic implant 40 can include a first flat surface 47, and a second convex surface 48 to provide a substantially semi-circular cross-section ( / .e., a lune closed by a straight line). This implementation would be similar to the one illustrated in Figs 20 and 21 , but without a second flat surface such that there would be a continuum between the two convex surfaces 48, thereby forming a cylinder longitudinally truncated. Alternatively, the non-cylindrical magnetic implant 40 can include more than four lateral faces according to any combination of flat surfaces, convex surfaces or concave surfaces.

[0292] In some implementations, the non-cylindrical magnetic implant 40 can include a shape that is substantially similar to a shape of the second magnetic implant 70, with the non-cylindrical magnetic implant 40 having a smaller width or diameter relative to the second magnetic implant 70. As mentioned above, the second magnetic implant 70 can have larger dimensions compared to the first magnetic implant 30, given the larger size of the hollow organs of the digestive tract. For instance, the first magnetic implant 40 can have a width being less than about 50% of a width of the second magnetic implant 70. In some implementations, the width, or diameter, of the first magnetic implant 40 can be between about 20% and 40% of the width of the second magnetic implant 70 to enable the insertion of the first magnetic implant 40 into the lumen associated with the accessory organ of digestion. In other implementations, the width, or diameter, of the first magnetic implant 40 can be between about 40% and 48% of the width of the second magnetic implant 70 to enable the insertion of the first magnetic implant 40 into the lumen associated with the accessory organ of digestionAdditional features of the non-cylindrical magnetic implant

[0293] Although not described in further detail in the present section, it is to be understood that the features described above in relation with the cylindrical magnetic implant 20 other than the outer circumferential surface 21 are also applicable to the non- cylindrical magnetic implants 30, 40. A brief overview of some of these features is nonetheless presented below.

[0294] The non-cylindrical magnetic implant 30, 40 has a width sized to enable introduction thereof into a lumen of an accessory organ of digestion, and can include a housing 60 configured to receive a magnet element 64. When the housing 60 is present, the cross-section of the magnet receiving cavity 62 can be circular as shown in Figs 17 and 18, while the cross-section of the non-cylindrical magnetic implant 30 can be polygonal, also as shown in Figs 17 and 18. Alternatively, the cross-section of the magnet element 64 can be non-circular, such as polygonal, and complimentary to the crosssection of the magnet receiving cavity 62. For instance, and referring to Fig 19, an implementation of a non-cylindrical magnetic implant 30 is shown being shaped as a rectangular prism. In this implementation, the non-cylindrical magnetic implant 30 defines a magnet receiving cavity 62 having a rectangular cross-section configured to receive a complimentary magnet element 64 shaped as a rectangular prism.

[0295] In some implementations, the magnet element 64 can be provided concentrically within the housing 60 of the non-cylindrical magnet implant 30, 40, the central axis of the magnet element 64 coinciding with the central axis of the housing 60. In this configuration, a center of each of the outer lateral faces 31 , 46 is equidistant from the magnet element 64. Accordingly, when the non-cylindrical magnetic implant 30, 40 is magnetically attracted to the second magnetic implant 70, the non-cylindrical magnetic implant 30, 40 can couple with the second magnetic implant 70 via any of the outer lateral faces 31 , 46 of the available tissue-contacting portion 33, 43 being nearest to the second magnetic implant 70. The non-cylindrical magnetic implant 30, 40 can therefore be configured to be magnetically coupled with the second magnetic implant 70 in any of multiple lateral orientations of the non-cylindrical magnetic implant 30, 40. More particularly, the non-cylindrical magnetic implant 30, 40 can be magnetically coupled withthe second magnetic implant 70 irrespective of its lateral positioning without requiring a rotation of the non-cylindrical magnetic implant 30, 40 about its longitudinal axis.Description of a magnet assembly for forming an anastomosis

[0296] Referring to Fig 22, an implementation of an elongated magnet assembly 50 is shown. It is to be noted that in the following paragraphs, the expressions “elongated magnetic assembly” and “first magnetic implant” can be used interchangeably to facilitate the understanding of the cooperation of the elongated magnet assembly 50 with the second magnetic implant 70 used for forming an anastomosis. The elongated magnet assembly 50 includes a plurality of magnet elements 52 flexibly connected in series, with adjacent magnet elements 52 being connected to each other via a resilient connector 54. In some implementations, each resilient connector 54 can be made of a flexible material configured to flex in accordance with the curvature of the accessory organ into which the elongated magnet assembly 50 is introduced. Examples of suitable flexible materials that can be used for the resilient connectors 54 include polymers, such as silicone, Silastic™, a medical implant grade polymer such as polyether ether ketone (PEEK), and thermosetting resins, including photopolymers suitable for 3D resin printing. In some implementations, each resilient connector 54 can have a length that is less than 10 mm for maintaining adjacent pairs of the magnet elements 52 at a distance suitable for the formation of a single continuous and uninterrupted anastomosis along the portion of the two adjacent walls compressed between the elongated magnet assembly 50 and the second magnetic implant 70. In some implementations, each resilient connector 54 can have a length that is less than 5 mm, or less than 2.5 mm. In some implementations, each resilient connector 54 can have a length ranging between about 8 mm and about 2 mm.

[0297] In some implementations, the elongated magnet assembly 40 can include a plurality of housings 56 configured to receive therein a corresponding magnet element of the plurality of magnet elements 52 within each of the housings 56. In the implementations shown, each of the multiple housings 56 is shaped as an elongated cylinder defining an available tissue-contacting portion 53, similarly to the cylindrical magnetic implant 20 defined above. In turn, the available tissue-contacting portion 53 of each respective housing 56 includes a succession of longitudinal segments that can potentially become in contact with the wall of the first hollow organ prior to the magnetic coupling with the secondmagnetic implant 70 and become an anastomosis-forming segment once coupled with the second magnetic implant 70. In other implementations, one or more of the multiple housings 56 can be shaped as an elongated prism, similarly to the non-cylindrical magnetic implant 30 defined above. In such implementations, the available tissuecontacting portion 53 of each respective housing 56, being shaped as an elongated prism, includes a plurality of outer lateral faces of substantially equal dimensions that can potentially become in contact with the wall of the first hollow organ prior to the magnetic coupling with the second magnetic implant 70, with one of the outer lateral faces becoming an anastomosis-forming surface once coupled with the second magnetic implant 70.

[0298] Although not described in further detail in the present section, it is to be understood that the features described above in relation with the cylindrical magnetic implant 20 and the non-cylindrical magnetic implant 30, 40 are also applicable to the elongated magnetic assembly 50. A brief overview of some of certain features is nonetheless presented below.

[0299] One or more of the housings 56 can be configured to receive the corresponding magnet element of the plurality of magnet elements 52 concentrically within the housing 56, the central axis of each of the plurality of magnet elements 52 coinciding with the central axis of the corresponding housing 56. In this configuration, each longitudinal segment or the outer lateral face of the available tissue-contacting portion 53 is substantially equidistant to an outer surface of the respective magnet element. Accordingly, when the elongated magnet assembly 50 is magnetically attracted to the second magnetic implant 70, each of the housings 56 can couple with the second magnetic implant 70 along any longitudinal segment or via any of the outer lateral faces of the available tissue-contacting portion 53 being nearest to the second magnetic implant 70. The elongated magnet assembly 50 is therefore configured to be magnetically coupled with the second magnetic implant 70 in any of multiple circumferential or lateral orientations of the housings 56.Description of a second magnet implant with an anastomosis-forming feature

[0300] Referring to Figs 23 to 30, a system 100 for forming an anastomosis between two adjacent walls of the digestive system according to various implementations is shown. The system 100 can include any one of the first magnetic implants 20, 30, 40 describedabove, and further includes a second magnetic implant having an anastomosis-forming feature that can contribute to facilitating and / or bolstering a magnetic coupling of the first and second magnetic implants. In such implementations, the inward portion of the second magnetic implant includes a lumen-oriented surface, and the outward portion of the second magnetic implant includes a tissue-oriented surface. The tissue-oriented portion of the second magnetic implant includes the anastomosis-forming feature mentioned above, which can the form of a protrusion or a recess, as described in greater detail below.Second magnetic implant having a magnetic protrusion

[0301] Referring to Figs 23 to 27, an implementation of a second magnetic implant 80 is shown. The second magnetic implant 80 includes a magnetic protrusion 87 as an anastomosis-forming feature. The magnetic protrusion 87 extends outwardly, in an axial direction A ( / .e., in a direction substantially parallel to axis X in the coordinate system shown in Fig 26), from a central region of the tissue-oriented portion 86 to define an anastomosis-forming surface 88 configured to magnetically couple with the first magnetic implant 20, 30, 40 through the two adjacent walls of the digestive system. The anastomosis-forming surface 88 of the second magnetic implant 80 is configured to be oriented toward the available tissue-contacting portion 43 of the first magnetic implant 40 once the first and second magnetic implants 40, 80 are delivered to the site of the desired anastomosis, in the first and second hollow organs respectively. When using the expression “central region”, it is understood to include regions of various sizes and configurations that are concentric with the center of the tissue-oriented portion 86 of the second magnetic implant 80, while also including regions that are radially offset from the center of the second magnetic implant 80 but still within the outer perimeter of the second magnetic implant 80 such that a tissue-oriented offset surface 89 is defined around the magnetic protrusion 87.

[0302] Depending on the spatial orientation of the first magnetic implant 40 when the magnetic coupling occurs, the anastomosis-forming surface 88 of the second magnetic implant 80 will face one of the outer lateral faces 46 of the first magnetic implant 40 that is either a flat surface 47 or a convex surface 48 (or a concave face, not shown). When the outer lateral face 46 facing the anastomosis-forming surface 88 of the second magnetic implant 80 is a convex surface 48, the convex surface 48 includes an anastomosis-forminglongitudinal segment 49. When the outer lateral face 46 is a flat surface 47, the flat surface 47 includes an anastomosis-forming surface 44.

[0303] The magnetic protrusion 87 is configured to magnetically couple with the first magnetic implant 40 through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment 49 or the anastomosis-forming surface 44 of the first magnetic implant 40 faces the anastomosis-forming surface 88 of the magnetic protrusion 87 of the second magnetic implant 40 to compress a portion of the two adjacent walls therebetween. When the flat surface 47 of the first magnetic implant 40 acts as the anastomosis-forming surface 44 configured to magnetically engaging the anastomosisforming surface 88 of the protrusion 87 of the second magnetic implant 80, these surfaces can be referred to as a first anastomosis-forming surface and a second anastomosisforming surface.

[0304] When the convex surface 48 of the first magnetic implant 40 faces the anastomosis-forming surface 88 of the protrusion 87 of the second magnetic implant 80, the anastomosis-forming longitudinal segment 49 can be referred to as a first anastomosis-forming segment and a second anastomosis-forming surface. It is to be understood that the second magnetic implant 80 can include two magnetic protrusions 87, one for each of the tissue-oriented portion 86 of the housing 82 and the lumen-oriented portion 84 of the housing 82, such that any of the tissue-oriented portion 86 and the lumen- oriented portion 84 of the second magnetic implant 80 can indeed become in contact with the tissue wall, become the anastomosis-forming surface 88 and contribute to the formation of the anastomosis.

[0305] The tissue-oriented portion 86 of the second magnetic implant 80 further includes the tissue-oriented offset surface 89 mentioned above, the tissue-oriented offset surface 89 being axially offset (i.e., along axis X in Fig 26) from the second anastomosisforming surface 88 and extending radially from the magnetic protrusion 87. When referring to the tissue-oriented offset surface 89 extending radially from the magnetic protrusion 87, it is intended to mean “around” the magnetic protrusion 87 (i.e., in a direction moving away from direction A, for instance in directions along axis Y and Z, toward the other perimeter of the second magnetic implant 80). Accordingly, when the first and second magnetic implants 40, 80 are magnetically coupled, the second anastomosis-forming surface 88 canbe in contact with the wall tissue of the second hollow organ and involved in the magnetic compression of the adjacent tissues while the tissue-oriented offset surface 89 may be either spaced apart from the wall tissue of the second hollow organ, or in contact with the wall tissue of the second hollow organ without exerting a pressure thereunto as high as the anastomosis-forming surface 88 of the protrusion 87. Thus, in contrast to the second magnetic implant 70 described above that includes a tissue-contacting surface 76 that is provided along a same plane and thus exerting a given magnetic pressure over an entire surface area of the tissue-contacting surface 76, the anastomosis-forming surface 88 of the magnetic protrusion 87 defines at least a portion of the tissue-oriented portion 86 that can be magnetically coupled with the first magnetic implant 40. Thus, although the second anastomosis-forming surface 88 is described as the portion of the tissue-oriented portion 86 that is in contact with the wall tissue, it is to be understood that, in some implementations, the tissue-oriented offset surface 89 may also be in contact with the wall tissue during magnetic compression. Once it is determined whether it may be beneficial to have the tissue-oriented offset surface 89 be in contact with the wall tissue of the second hollow organ, the height of the protrusion 87 can be adjusted accordingly, with a higher height reducing the probability that the tissue-oriented offset surface 89 becomes in contact with the wall tissue of the second hollow organ, and a lower height increasing the probability that the tissue-oriented offset surface 89 becomes in contact with the wall tissue of the second hollow organ. Factors such as a stiffness, geometry or other properties of the wall tissue of the second hollow organ may be taken into account when determining the height of the protrusion 87.

[0306] In some implementations, the second anastomosis-forming surface 88 of the magnetic protrusion 87 can be substantially flat or can include at least a portion that is substantially flat, as shown in Figs 26 and 27. A second anastomosis-forming surface 88 that is flat can contribute to provide a uniform compression of the wall tissue over the second anastomosis-forming surface 88 when magnetically coupled with a first magnetic implant 40 having a first anastomosis-forming surface 44 that is substantially flat. A second anastomosis-forming surface 88 that is substantially flat can further contribute to providing multiple available locations over the magnetic protrusion 87 for magnetically coupling with the first magnetic implant 40, as described above, for instance when the first tissuecontacting portion of the first magnetic implant 40 includes an anastomosis-forming longitudinal segment 49. In other implementations, the second anastomosis-formingsurface 88 of the magnetic protrusion 87 can have a complementary shape with respect to a shape of the first anastomosis-forming surface 44 of the first magnetic implant 40. For example, the second anastomosis-forming surface 88 can have a curvilinear surface that is curved inwardly, i.e., concave, to mate with one or more of the outer lateral faces 46 of the first magnetic implant 40 having a curvilinear surface that is curved outwardly including, for instance, one of the convex surfaces 48 of the first magnetic implant 40.

[0307] It will be appreciated that while the implementations of the second magnetic implant 80 described above are exemplified as being magnetically coupled with the first magnetic implant 40 having multiple outer lateral faces 46, in other implementations, the second magnetic implant 80 can be magnetically coupled with a cylindrical magnetic implant 20 having a cylindrical shape, or a non-cylindrical magnetic implant 30 shaped as an elongated prism. When magnetically coupled with the cylindrical magnetic implant 20, the second anastomosis-forming surface 88 of the second magnetic implant 80 can be substantially flat and configured to face one of multiple possible longitudinal segments of the available tissue-contacting portion 23 of the first magnetic implant 20 to define an anastomosis-forming longitudinal segment 24. Alternatively, the second anastomosisforming surface 88 can have a concave surface that is curved inwardly to mate with the cylindrical shape of the first magnetic implant 20.

[0308] As mentioned above, the magnetic protrusion 87 extends outwardly, in an axial direction A, from the central region of the tissue-oriented portion 86. In some implementations, the magnetic protrusion 87 can extend outwardly in the axial direction A at a magnetic protrusion height ranging between about 0.3 mm and about 0.8 mm. In some implementations, the magnetic protrusion 87 can extend outwardly in the axial direction A at a magnetic protrusion height ranging between about 0.4 mm and about 0.7 mm. The second anastomosis-forming surface 88 of the magnetic protrusion 87 can extend over a portion of a surface area of the tissue-oriented portion 86, with the tissue-oriented offset surface area 89 extending over a remainder portion of the tissue-oriented portion 86. For instance, in some implementations, the second anastomosis-forming surface 88 of the magnetic protrusion 87 can extend over a surface area of about 20% to about 40% of the surface area of the tissue-oriented portion 86. It will be appreciated that, in other implementations, the second anastomosis-forming surface 88 can extend over any other surface area of the tissue-oriented portion 86, taking into consideration a width or diameterof the first magnetic implant 20, 30, 40, to define a desirable compression surface of the second magnetic implant 80 with respect to the first magnetic implant 20, 30, 40. In some implementations, the magnetic protrusion 87 of the second magnetic implant 80 has a magnetic protrusion width defined between two opposed sides thereof and a magnetic protrusion length defined between two opposed ends thereof, the magnetic protrusion length and the magnetic protrusion width of the magnetic protrusion 87 providing a length / width ratio of between about 5:1 and about 20:1. In some implementations, the magnetic protrusion width and the magnetic protrusion height of the magnetic protrusion 87 can provide a width / height ratio of between about 2:1 and about 8:1 .

[0309] In some implementations, the magnetic protrusion 87 can include atraumatic features to contribute to minimizing tissue injury during delivery of the second magnetic implant 80 to the desired site of the anastomosis. For instance, the magnetic protrusion 87 can include a peripheral edge 87 A that is generally curved or devoid of sharp angles to facilitate navigation into the digestive system, including one or more of bevelled edges, chamfered edges, rounded edges, and the like.

[0310] Referring to Fig 27, in some implementations, the second magnetic implant 80 can include a housing 82 that encloses a magnet element 83 therein. When the housing 82 is present, the outward portion of the housing 82 is the portion that includes the tissue- oriented portion 86 and the magnetic protrusion 87 of the second magnetic implant 80. In this example, the lumen-oriented portion 84 and the tissue-oriented portion 86 of the housing 82 of the second magnetic implant 80 together fully enclose the magnet element 83, and can be coupled together around a periphery thereof using one or more fasteners, clip elements, an adhesive, or the like. In other implementations, the magnet element 83 can be fully enclosed in a single-piece housing 82, i.e., a housing 82 that is made of a single unit, the single unit including the lumen-oriented portion 84 and the tissue-oriented portion 86 in accordance with the description above. Yet other housing constructions are also possible, with one or more housing components being used to partially or fully enclose the magnet element 83.

[0311] The configuration of the magnet element 83 can vary, and in some implementations, can be chosen to facilitate a magnetic coupling and / or self-alignment of the first and second magnetic implants 40, 80. Fig 27 illustrates an implementation of sucha magnet element 83. In this implementation, the magnet element 83 extends over a majority of an internal width of the housing 82, and further includes a magnet element protrusion 85 extending in the axial direction A of the second magnetic implant 80 to fill an internal recess defined by the housing 82 to provide the magnetic protrusion 87 once the second magnetic implant 80 is assembled. Alternatively, the magnet element 83 can be configured to include a magnet element protrusion 85 only. In other words, the magnet element 83 can include a non-magnetic core, and at least one magnet element protrusion 85 to fill the magnetic protrusion 87 (two magnet element protrusions 85 if a protrusion 87 if provided on each side of the second magnetic implant 80 as shown in Figs 23 to 27). In such implementations, the tissue-oriented offset surface 89 of the second magnetic implant 80 may thus be non-magnetic, and accordingly contribute in a lesser extent to the magnetic compression of the wall tissue. This configuration of the magnet element 83 can also promote a selective magnetic engagement between the anastomosis-forming longitudinal segment 49 or the first anastomosis-forming surface 44 of the first magnetic implant 40 and the magnetic protrusion 87 of the second magnetic implant 80.

[0312] In some implementations, the second magnetic implant 80 can include a connecting member 81 that can be releasably engageable with a connector (not shown) of a delivery system. In other words, the second magnetic implant 80 can include a feature that enables its connection to a connector for navigating the magnetic implant 80 to a desired site for creating the anastomosis. In turn, the connecting member 81 can include any feature that enables a releasable connection of the second magnetic implant 80 with the connector. In Figs 26 and 27, the connecting member 81 is shown as a catheter attachment configured as a receiving cavity that can receive a distal end of the connector therein, which as mentioned above can be a delivery system such as, for example, a delivery catheter. It is to be noted that in other implementations, the second magnetic implant 80 may not include such feature.Second magnetic implant having a magnet-receivin recess

[0313] Referring to Figs 28 to 30, a second magnetic implant 90 is shown in accordance with another implementation. In this implementation, the second magnetic implant 90 includes a housing 92 that encloses a magnet element 93 and defines a lumen- oriented portion 94 and a tissue-oriented portion 96, similarly to the second magneticimplant 80 described above. The tissue-oriented portion 96 of the second magnetic implant 90 defines a magnet-receiving recess 97 as an anastomosis-forming feature. The magnet-receiving recess 97 extends inwardly, in the axial direction A ( / '.e., in a direction substantially parallel to axis X in the coordinate system shown in Fig 29), from a central region of the tissue-oriented portion 96. When using the expression “central region”, it is understood to include regions of various sizes and configurations that are concentric with the center of the tissue-oriented portion 96 of the second magnetic implant 90, while also including regions that are radially offset from the center of the second magnetic implant 90 but still within the outer perimeter of the second magnetic implant 90 such that a tissue- oriented offset surface is defined around the magnet-receiving recess 97.

[0314] The magnet-receiving recess 97 defines an anastomosis-forming surface 98 configured to contact the wall tissue of second hollow organ when the first and second magnetic implants 30, 90 are magnetically coupled. The second magnetic implant 90 further includes the tissue-oriented offset surface 99 mentioned above, the tissue-oriented offset surface 99 being axially offset from the second anastomosis-forming surface 98 and extending radially from the magnet-receiving recess 97. When referring to the tissue- oriented offset surface 99 extending radially from the magnet-receiving recess 97, it is intended to mean “around” the magnet-receiving recess 97 ( / .e., in a direction moving away from direction A, for instance in directions along axis Y and Z, toward the other perimeter of the second magnetic implant 90).

[0315] When the first and second magnetic implants 40, 90 are magnetically coupled, the magnet-receiving recess 97 is sized to receive at least a portion of the wall tissue therein, i.e., beyond a plane defined by the tissue-oriented offset surface 99 when the first and second magnetic implants 40, 90 are magnetically coupled together. In some implementations, the magnet-receiving recess 97 can be sized to further receive at least a portion of the first magnetic implant 40 therein. In such implementations, the magnetreceiving recess 97 can contribute to restricting a longitudinal displacement between the first and second magnetic implants 40, 90 when the first and second magnetic implants 40, 90 are magnetically coupled.

[0316] When the flat surface 47 of the first magnetic implant 40 acts as the anastomosis-forming surface 44 configured to magnetically engaging the anastomosis-forming surface 98 of the magnet-receiving recess 97 of the second magnetic implant 90, these surfaces can be referred to as a first anastomosis-forming surface 44 and a second anastomosis-forming surface 98.

[0317] The tissue-oriented offset surface 99 of the second magnetic implant 90 thus interfaces with the wall tissue of the second hollow organ when the first and second magnetic implants 40, 90 are magnetically coupled. In some implementations, the tissue- oriented offset surface 99 may or may not contribute (or partially contribute) to the magnetic compression of the wall tissue. Regardless, the magnet-receiving recess 97 provides at least the second anastomosis-forming surface 98 which is configured to magnetically couple with the first magnetic implant 40 through the two adjacent walls of the digestive system such that the first anastomosis-forming surface 44 of the first magnetic implant 40 faces the second anastomosis-forming surface 98 of the magnetreceiving recess 97 to compress a portion of the two adjacent walls therebetween. The contribution of the tissue-oriented offset surface 99 to the magnetic compression is thus optional, and can depend for instance of the depth of the magnet-receiving recess 97: the deeper the magnet-receiving recess 97, the increased potential contribution of the tissue- oriented offset surface 99 to the magnetic compression, and inversely. The potential contribution of the tissue-oriented offset surface 99 to the magnetic compression can also depend on the configuration of the magnet element 93, and whether the magnet element 93 extends to the lateral edges of the second magnetic implant 90 such that the tissue- oriented offset surface 99 can also exert a magnetic force. In the implementation shown in Figs 28 to 30, the magnet element 93 is a rectangular prism that extends over an entire internal width of the housing of the second magnetic implant 90, and can thus contribute to the magnetic compression if the magnet-receiving recess 97 is deep enough.

[0318] It is to be understood that the second magnetic implant 80 can include two magnet-receiving recesses 97, one for each of the tissue-oriented portion of the housing and the lumen-oriented portion of the housing, such that any of the tissue-oriented portion 96 and the lumen-oriented portion 94 of the second magnetic implant 90 can indeed become in contact with the tissue wall, become the anastomosis-forming surface 98 and contribute the formation of the anastomosis.

[0319] In some implementations, the magnet-receiving recess 97 extends inwardly in the axial direction A to a recess depth ranging between about 0.4 mm and about 0.8 mm. In some implementations, the magnet-receiving recess 97 extends inwardly in the axial direction A to a recess depth ranging between about 0.5 mm and about 0.7 mm. As stated above, in some implementations, the magnet-receiving recess 97 can be sized to receive at least a portion of the first magnetic implant 40 therein when the first and second magnetic implants 40, 90 are magnetically coupled, with wall tissue therebetween. For instance, the magnet-receiving recess 97 can have a recess width defined between two opposed sides thereof ranging between about 75% and 100% of a width or diameter of the first magnetic implant 20, 30, 40 measured at its widest. With this configuration, the first magnetic implant 20, 30, 40 can enter at least partially into the magnet-receiving recess 97, in an axial direction A (i.e., a lower quadrant or a lower half of the first magnetic implant defined by a plan extending longitudinally can be received in the magnet-receiving recess 97). In other implementations, the magnet-receiving recess 97 can have a recess width that corresponds to between about 92% and 98% of a width or diameter of the first magnetic implant 20, 30, 40. In some implementations, the magnet-receiving recess 97 can have a recess length defined between two opposed ends thereof, the recess length being greater than a longitudinal length of the first magnetic implant 40 to receive the first magnetic implant 20, 30, 40 therein. On the other hand, as mentioned above, the recess length can be chosen so as to limit a longitudinal displacement of the first magnetic implant relative to the second magnetic implant once magnetically coupled, and dock the first magnetic implant in place relative to the second magnetic implant. In some implementations, the recess length ranges between 1 15% and 105% of a longitudinal length of the first magnetic implant 20, 30, 40. The magnet-receiving recess 97 can thus facilitate alignment and docking of the first magnetic implant 20, 30, 40 relative to the second magnetic implant 90. In some implementations, the recess width and the recess depth of the magnet-receiving recess 97 can provide a width / depth ratio of between about 2:1 and about 8:1 .

[0320] The second anastomosis-forming surface 98 of the magnet-receiving recess 97 extends over a portion of a surface area of the tissue-oriented portion 96, with the tissue- oriented offset surface area 99 extending over a remainder portion of the tissue-oriented portion 96. For instance, in some implementations, the second anastomosis-forming surface 98 of the magnet-receiving recess 97 can extend over a surface area of about20% to about 40% of the surface area of the tissue-oriented portion 96. It will be appreciated that, in other implementations, the second anastomosis-forming surface 98 can extend over any other surface area of the tissue-oriented portion 96, taking into consideration the width or diameter of the first magnetic implant 20, 30, 40 to define a desirable compression surface of the second magnetic implant 90 with respect to the first magnetic implant 20, 30, 40.

[0321] Although not described in further detail in the present section, it is to be understood that the features described above in relation with the second magnetic implant 80 other than the magnetic protrusion 87 are also applicable to the second magnetic implant 90. A brief overview of some of these features is nonetheless presented below.

[0322] In some implementations, the second magnetic implant 90 can similarly include a connecting member 91 that can be releasably engageable with a connector of a delivery system. In Figs 29 and 30, the 91 is shown as a catheter attachment configured as a receiving cavity that can receive a distal end of the connector therein, which as mentioned above can be a delivery system such as, for example, a delivery catheter.

[0323] Referring now to Fig 30, an implementation of the second magnetic implant 90 is shown in which the lumen-oriented portion 94 and the tissue-oriented portion 96 of the housing 92 together fully enclose the magnet element 93. The portions of the housing 92 can be coupled together around a periphery of the magnet element 93 using one or more fasteners, clip elements, an adhesive, or the like. In other implementations, the magnet element 93 can be fully enclosed in a single-piece housing 92, i.e., a housing 92 that is made of a single unit, the single unit including the lumen-oriented portion 94 and the tissue-oriented portion 96 in accordance with the description above. In other implementations, the housing 93 can be omitted such that the magnet element 93 is exposed, i.e., not housed within a housing 92, and defines the lumen-oriented portion 94 and the tissue-oriented portion 96 of the second magnetic implant 90.

[0324] It will be appreciated that while the implementations of the second magnetic implant 90 described above is exemplified as being magnetically coupled with the first magnetic implant 40 having multiple outer lateral faces 46, in other implementations, the second magnetic implant 90 can be magnetically coupled with a first magnetic implant 20having a cylindrical shape or a non-cylindrical magnetic implant 30 shaped as an elongated prism.Methods for forming an anastomosis in the digestive system

[0325] A method for forming an anastomosis between two adjacent walls of a digestive system of a patient will now be described in further detail. The method can include delivering a first magnetic implant into a lumen associated with an accessory organ of a patient to a first location, on one side of a desired anastomose site, and delivering a second magnetic implant into the digestive tract of the patient to a second location on another side of the desired anastomose site, within the lumen of a second hollow organ. For instance, the first magnetic implant can be delivered into one of the gallbladder, the common bile duct and the hepatopancreatic ampulla.

[0326] Referring to Figs 12 to 14, examples of a first magnetic implant delivered in a lumen associated with an accessory organ on a one side of a desired anastomosis and of a second magnetic implant delivered in the digestive tract on another side of the desired anastomosis are shown. In particular, Fig 12 illustrates an implementation of the first magnetic implant delivered into the gallbladder, and the second magnetic implant being delivered in the duodenum in sufficiently close proximity to the gallbladder to enable the first and second magnetic implants to magnetically couple and compress the walls of the gallbladder and the duodenum therebetween. Fig 11 illustrates an implementation of the first magnetic implant delivered into the common bile duct with the second magnetic implant being delivered at a different location within the duodenum, in sufficiently close proximity to the common bile duct to enable the first and second magnetic implants to magnetically couple and compress the walls of the common bile duct and the duodenum therebetween. Fig 14 illustrates an implementation of the first magnetic implant delivered into the left hepatic duct with the second magnetic implant being delivered within the antrum, in sufficiently close proximity to the left lobe of the liver to enable the first and second magnetic implants to magnetically couple and compress the walls of the left hepatic duct and the stomach therebetween. It is to be understood that the first and second magnetic implants can be delivered to different locations than those presented above, which can be any location within a lumen associated with an accessory organ of digestion and within the digestive tract to enable a magnetic coupling of the first and secondmagnetic implants and a convergence of the respective wall tissues.

[0327] In some implementations, the first magnetic implant can be shaped as a cylindrical magnetic implant having an available tissue-contacting portion defined over an entire circumferential outer surface of the cylindrical magnetic implant and comprising an anastomosis-forming longitudinal segment as described above. Alternatively, the first magnetic implant can be shaped as an elongated prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being substantially equilateral and defining an available tissue-contacting portion having one of the three outer later faces as an anastomosis-forming surface, as described above.

[0328] Once the magnetic implants are delivered within their respective hollow organ and on their respective side the of the desired anastomosis, the first and second magnetic implants can be brought in close proximity to enable magnetic coupling of the first and second magnetic implants irrespective of a circumferential orientation or lateral orientation of the first magnetic implant such that the anastomosis-forming longitudinal segment or anastomosis-forming surface of the first magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the adjacent walls therebetween. The magnetic coupling of the two magnetic implants compresses a portion of the two adjacent walls therebetween, and the portion of the adjacent walls that is compressed between the respective compression surfaces of the magnetic implants eventually forms a necrotic area as the blood flood supply to this area progressively declines.

[0329] In some implementations, the second magnetic implant can include a magnetreceiving recess extending inwardly, in an axial direction A, from a central region of a tissue-oriented portion to define the second anastomosis-forming surface, as described above. In such implementations, once the magnetic implants are delivered within their respective hollow organ and on their respective side the of the desired anastomosis, the first and second magnetic implants can be brought in close proximity to enable magnetic coupling of the first and second magnetic implants such that the first anastomosis-forming surface of the first magnetic implant faces the second anastomosis-forming surface of the magnet-receiving recess of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

[0330] In other implementations, the second magnetic implant can include a magneticprotrusion extending outwardly, in an axial direction A, from a central region of a tissue- oriented portion to define a second anastomosis-forming surface, as described above. In such implementations, once the magnetic implants are delivered within their respective hollow organ and on their respective side the of the desired anastomosis, the first and second magnetic implants can be brought in close proximity to enable magnetic coupling of the first and second magnetic implants such that the first anastomosis-forming surface of the first magnetic implant faces the second anastomosis-forming surface of the magnetic protrusion of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

[0331] Various techniques can be used to deliver the first and second magnetic implants within the lumen of their respective hollow organ. For instance, the first and second magnetic implants can be delivered to the site of the desired anastomosis endoscopically or percutaneously. In some implementations, the percutaneous delivery of the first magnetic implant can be performed via a needle-puncture of the skin, for instance using a needle catheter. In some implementations, the first magnetic implant can be delivered by needle puncture with a guidewire introduction into the first hollow organ, followed by an exchange with an introducer dilator and sheath. In some implementations, following the placement of the sheath, the first magnetic implant can be delivered through the sheath via a pusher catheter or attached to a delivery system. In some implementation, the delivery of the first magnetic implant or the second magnetic implant can be performed via a natural cavity of the patient, i.e., the mouth or the anus, using for example an endoscopic device. In some implementations, the delivery of the first and second magnetic implants may be guided using fluoroscopy and / or ultrasound. It is to be noted that a chosen technique for delivering the first magnetic implant can be the same or different from the chosen technique for delivering the second magnetic implant.

[0332] In some implementations, delivering the first magnetic implant can include releasably engaging a connector of a delivery wire to a second end delivery attachment of the cylindrical magnetic implant or non-cylindrical magnetic implant, the remaining of the delivery wire being insertable in a working channel of an endoscope.

[0333] In some implementations, delivering the first magnetic implant can include flexing a housing of the first magnetic implant to facilitate its introduction into the lumenassociated with the accessory organ. In particular, the housing of the first magnetic implant can be flexed to adopt a curvature of the accessory organ. In some implementations, the housing of the first magnetic implant can be flexed when subjected to a reactive force generated by the wall tissue of the accessory organ. Alternatively, an endoscope can also be used to manipulate and flex the housing of the first magnetic implant to facilitate its introduction into the lumen associated with the accessory organ.

[0334] In some implementations, the first and second magnetic implants can be manipulated by using a magnet externally, for instance to position the respective first and second magnetic implants and facilitate their magnetic coupling and subsequently, to facilitate the passing of the coupled magnetic implants via the bowel lumen of the patient. An endoscope can also be used to manipulate the coupled magnetic implants internally, also to facilitate their passing via the bowel lumen of the patient.

[0335] Several alternative implementations and examples have been described and illustrated herein. The implementations of the technology described above are intended to be exemplary only. A person of ordinary skill in the art would appreciate the features of the individual implementations, and the possible combinations and variations of the components. A person of ordinary skill in the art would further appreciate that any of the implementations could be provided in any combination with the other implementations disclosed herein. It is understood that the technology may be embodied in other specific forms without departing from the central characteristics thereof. The present implementations and examples, therefore, are to be considered in all respects as illustrative and not restrictive, and the technology is not to be limited to the details given herein. Accordingly, while the specific implementations have been illustrated and described, numerous modifications come to mind.

Claims

CLAIMS1 . A system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a first magnetic implant having an outer lateral surface defining an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; and a second magnetic implant comprising a lumen-oriented portion and a tissue- oriented portion, the tissue-oriented portion comprising: a magnetic protrusion extending outwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnetic protrusion defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; and a tissue-oriented offset surface that is axially offset from the second anastomosis-forming surface and that extends radially from the magnetic protrusion; the magnetic protrusion being configured to magnetically couple with the first magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment or the first anastomosis-forming surface of the first magnetic implant faces the second anastomosis-forming surface of the magnetic protrusion of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

2. The system of claim 1 , wherein the first magnetic implant has a width sized to enable introduction thereof into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

3. The system of claim 1 or 2, wherein a width of the first magnetic implant is less than 50% of a width of the second magnetic implant.

4. The system of claim 3, wherein the width of the first magnetic implant is between 40% and 48% of the width of the second magnetic implant.

5. The system of any one of claims 1 to 4, wherein the second anastomosis-forming surface of the second magnetic implant is complimentary to the first anastomosisforming surface of the first magnetic implant.

6. The system of any one of claims 1 to 5, wherein the second anastomosis-forming surface is substantially flat.

7. The system of any one of claims 1 to 5, wherein the second anastomosis-forming surface is a curvilinear surface that is curved inwardly.

8. The system of any one of claims 1 to 5, wherein the first magnetic implant is a cylindrical magnetic implant, and the outer lateral surface is a circumferential outer surface.

9. The system of any one of claims 1 to 5, wherein the first magnetic implant is shaped as an elongated prism and the outer lateral surface includes at least three outer lateral faces, the available tissue-contacting portion having one of the at least three outer lateral faces as the first anastomosis-forming surface.

10. The system of claim 9, wherein the at least three outer lateral faces are of substantially equal dimensions.1 1 . The system of any one of claims 1 to 5, wherein the outer lateral surface of the first magnetic implant includes a convex surface and a flat surface.

12. The system of claim 1 1 , wherein the convex surface and the flat surface define the available tissue-contacting portion, the convex surface comprising the anastomosis-forming longitudinal segment when magnetically coupled with the magnetic protrusion, and the flat surface comprising the first anastomosis-forming surface when magnetically coupled with the magnetic protrusion.

13. The system of claim 11 , wherein the flat surface defines the available tissuecontacting portion and comprises the first anastomosis-forming surface when magnetically coupled with the magnetic protrusion.

14. The system of claim 11 , wherein the outer lateral surface includes two or more flat surface, the available tissue-contacting portion having one of the two or more flat surface as the first anastomosis-forming surface.

15. The system of any one of claims 1 to 14, wherein the first magnetic implant is an elongated magnetic implant.

16. The system of any one of claims 1 to 15, wherein the second magnetic implant includes a magnet element and a housing configured to receive the magnet element therein, the housing defining the lumen-oriented portion and the tissue- oriented portion of the second magnetic implant.

17. The system of claim 16, wherein the magnet element extends over a majority of an internal width of the housing.

18. The system of claim 16 or 17, wherein the housing defines an internal recess, and wherein the magnet element includes a magnet element protrusion filing the internal recess of the housing to provide the magnetic protrusion when the second magnetic implant is assembled.

19. The system of any one of claims 1 to 18, wherein the magnetic protrusion of the second magnetic implant comprises one or more of bevelled edges, chamfered edges and rounded edges.

20. The system of any one of claims 1 to 19, wherein the magnetic protrusion of the second magnetic implant comprises atraumatic features.

21. The system of any one of claims 1 to 20, wherein the magnetic protrusion has a magnetic protrusion height ranging between about 0.3 mm and about 0.8 mm.

22. The system of claim 21 , wherein the magnetic protrusion height ranges between about 0.4 mm and about 0.7 mm.

23. The system of any one of claims 1 to 22, wherein the second anastomosis-forming surface of the second magnetic implant extends over between about 20% to about 40% of a surface area of the tissue-oriented portion.

24. The system of any one of claims 1 to 23, wherein the magnetic protrusion of the second magnetic implant has a magnetic protrusion width defined between two opposed sides thereof and a magnetic protrusion length defined between two opposed ends thereof, the magnetic protrusion length and the magnetic protrusion width of the magnetic protrusion providing a length / width ratio ranging between about 5:1 and about 20:1 .

25. The system of any one of claims 1 to 20, wherein the magnetic protrusion has a magnetic protrusion heigh and a magnetic protrusion width, and a width / height ratio ranging between about 2:1 and about 8:1 .

26. The system of any one of claims 1 to 25, wherein the first magnetic implant comprises a transverse section that is free of a longitudinally-extending through- hole to prevent fluid communication from a first end of the first magnetic implant to a second end of the first magnetic implant.

27. A system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a first magnetic implant having an outer lateral surface defining an available tissue-oriented portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; and a second magnetic implant comprising a lumen-oriented portion and a tissue- oriented portion, the tissue-oriented portion comprising: a magnet-receiving recess extending inwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnet-receiving recess defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; and a tissue-oriented offset surface that is axially offset from the second anastomosis-forming surface and extending radially from the magnetreceiving recess;the magnet-receiving recess being configured to magnetically couple with the first magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment or the first anastomosis-forming surface of the first magnetic implant faces the second anastomosis-forming surface of the magnet-receiving recess of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

28. The system of claim 27, wherein the first magnetic implant has a width sized to enable introduction thereof into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

29. The system of claim 27 or 28, wherein the first magnetic implant has a width being less than 50% of a width of the second magnetic implant.

30. The system of claim 29, wherein the width of the first magnetic implant is between 40% and 48% of the width of the second magnetic implant.31 . The system of any one of claims 27 to 30, wherein the second anastomosis-forming surface of the second magnetic implant is complementary to the first anastomosisforming surface of the first magnetic implant.

32. The system of any one of claims 27 to 31 , wherein the second anastomosis-forming surface is substantially flat.

33. The system of any one of claims 27 to 31 , wherein the second anastomosis-forming surface is a concave surface.

34. The system of any one of claims 27 to 31 , wherein the first magnetic implant is a cylindrical magnetic implant and the outer lateral surface is a circumferential outer surface.

35. The system of any one of claims 27 to 31 , wherein the first magnetic implant is shaped as an elongated prism and the outer lateral surface includes at least three outer lateral faces, the available tissue-contacting portion having one of the at least three outer lateral faces as the first anastomosis-forming surface.

36. The system of claim 35, wherein the at least three outer lateral faces are of substantially equal dimensions.

37. The system of any one of claims 27 to 31 , wherein the outer lateral surface of the first magnetic implant includes a convex surface and a flat surface.

38. The system of claim 37, wherein the convex surface and the flat surface define the available tissue-contacting portion, the convex surface comprising the anastomosis-forming longitudinal segment when magnetically coupled with the magnet-receiving recess, and the flat surface comprising the first anastomosisforming surface when magnetically coupled with the magnet-receiving recess.

39. The system of claim 37, wherein the flat surface defines the available tissuecontacting portion and comprises the first anastomosis-forming surface when magnetically coupled with the magnet-receiving recess.

40. The system of claim 37, wherein the outer lateral surface includes two or more flat surface, the available tissue-contacting portion having one of the two or more flat surface as the first anastomosis-forming surface.41 . The system of any one of claims 27 to 40, wherein the first magnetic implant is an elongated magnetic implant.

42. The system of any one of claims 27 to 41 , wherein the second magnetic implant includes a magnet element and a housing configured to receive the magnet element therein, the housing defining the lumen-oriented portion and the tissue- oriented portion of the second magnetic implant.

43. The system of claim 42, wherein the magnet element extends over a majority of an internal width of the housing.

44. The system of any one of claims 27 to 43, wherein the magnet-receiving recess has a recess depth ranging between about 0.3 mm and about 0.8 mm.

45. The system of claim 44, wherein the recess depth ranges between about 0.4 mm and about 0.7 mm.

46. The system of any one of claims 27 to 45, wherein the second anastomosis-forming surface of the second magnetic implant extends over between about 20% to about 40% of a surface area of the tissue-oriented portion.

47. The system of any one of claims 27 to 46, wherein the magnet-receiving recess of the second magnetic implant has a recess width defined between two opposed sides thereof and a recess length defined between two opposed ends thereof, the recess length and the recess width of the magnet-receiving recess providing a length / width ratio ranging between about 5:1 and about 20:1.

48. The system of any one of claims 27 to 42, wherein the magnet-receiving recess has a recess width and a recess depth, the recess width and the recess depth, and a width / depth ratio ranging between about 2:1 and about 8:1.

49. The system of any one of claims 27 to 48, wherein the magnet-receiving recess has a recess length defined between two opposed ends thereof, the recess length being greater than a longitudinal length of the first magnetic implant.

50. The system of claim 49, wherein the recess length is selected so as to limit a longitudinal displacement of the first magnetic implant relative to the second magnetic implant once magnetically coupled.

51. The system of claim 49 or 50, wherein the recess length ranges between about 105% and about 115% of the longitudinal length of the first magnetic implant.

52. The system of any one of claims 27 to 51 , wherein the first magnetic implant comprises a transverse section that is free of a longitudinally-extending through- hole to prevent fluid communication from a first end of the first magnetic implant to a second end of the first magnetic implant.

53. A method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a first magnetic implant into a lumen associated with an accessory organ of digestion, the first magnetic implant having an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; delivering a second magnetic implant into the digestive tract, the magnetic implant comprising a lumen-oriented portion and a tissue-oriented portion, the tissue-oriented portion comprising: a magnetic protrusion extending outwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnetic protrusion defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; and a tissue-oriented offset surface axially offset from the second anastomosis-forming surface and extending radially from the magnetic protrusion; magnetically coupling the first magnetic implant and the second magnetic implant irrespective of a rotational orientation of the first magnetic implant such that the anastomosis-forming longitudinal segment or the first anastomosisforming surface of the first magnetic implant faces the magnetic protrusion of the second magnetic implant to compress a portion of the adjacent walls therebetween.

54. The method of claim 50, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the gallbladder.

55. The method of claim 50, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the common bile duct.

56. The method of any one of claims 50 to 52, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the first magnetic implant.

57. The method of any one of claims 50 to 52, wherein delivering the first magnetic implant into the lumen associate with the accessory organ of digestion comprises endoscopically delivering the cylindrical magnetic implant.

58. The method of any one of claims 50 to 54, wherein delivering the first magnetic implant into the biliary tract comprises engaging a delivery wire to a second end delivery attachment of the first magnetic implant.

59. The method of any one of claims 50 to 54, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the first magnetic implant.

60. The method of claim 50, wherein the first magnetic implant includes a convex surface and a flat surface, the available tissue-contacting portion having the flat surface as the first anastomosis-forming surface, and wherein magnetically coupling the first magnetic implant and the second magnetic implant comprises compressing a portion of the adjacent walls between the first and second anastomosis-forming surfaces.61 . A method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a first magnetic implant into a lumen associated with an accessory organ of digestion, the first magnetic implant having an available tissuecontacting portion comprising an anastomosis-forming longitudinal segment or a first anastomosis-forming surface; a second magnetic implant comprising a lumen-oriented portion and a tissue- oriented portion, the tissue-oriented portion comprising: a magnet-receiving recess extending inwardly, in an axial direction, from a central region of the tissue-oriented portion, the magnet-receiving recess defining a second anastomosis-forming surface configured to contact wall tissue of one of the two adjacent walls; anda tissue-oriented offset surface axially offset from the second anastomosis-forming surface and extending radially from the magnetreceiving recess; magnetically coupling the first magnetic implant and the second magnetic implant irrespective of a rotational orientation of the first magnetic implant such that the anastomosis-forming longitudinal segment or the first anastomosisforming surface of the first magnetic implant faces the magnet-receiving recess of the second magnetic implant to compress a portion of the adjacent walls therebetween.

62. The method of claim 58, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the gallbladder.

63. The method of claim 58, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the common bile duct.

64. The method of any one of claims 58 to 60, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the first magnetic implant.

65. The method of any one of claims 58 to 60, wherein delivering the first magnetic implant into the lumen associate with the accessory organ of digestion comprises endoscopically delivering the cylindrical magnetic implant.

66. The method of any one of claims 58 to 62, wherein delivering the first magnetic implant into the biliary tract comprises securing a delivery wire to a second end delivery attachment of the first magnetic implant.

67. The method of any one of claims 58 to 62, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the first magnetic implant.

68. The method of any one of claims 58 to 64, wherein the first magnetic implant includes a convex surface and a flat surface, the available tissue-contacting portionhaving the flat surface as the first anastomosis-forming surface, and wherein magnetically coupling the first magnetic implant and the second magnetic implant comprises compressing a portion of the adjacent walls between the first and second anastomosis-forming surfaces.

69. A system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming an anastomosis comprising: a cylindrical magnetic implant having a circumferential outer surface defining an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment, the cylindrical magnetic implant comprising: a transverse section that is free of a longitudinally-extending through- hole to prevent fluid communication from a first end of the cylindrical magnetic implant to a second end of the cylindrical magnetic implant; and a magnetic implant comprising a lumen-oriented surface and a tissuecontacting surface, the magnetic implant being configured to magnetically couple with the cylindrical magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment of the cylindrical magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the two adjacent walls therebetween.

70. The system of claim 69, wherein the cylindrical magnetic implant has a diameter sized to enable introduction of the cylindrical magnetic implant into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.71 . The system of claim 69 or 70, wherein the tissue-contacting surface of the magnetic implant is substantially flat.

72. The system of any one of claims 69 to 71 , wherein the transverse section of the cylindrical magnetic implant extends from the first end to the second end of the cylindrical magnetic implant.

73. The system of any one of claims 69 to 71 , wherein the transverse section of the cylindrical magnetic implant extends over a majority of a length of the cylindrical magnetic implant defined between the first end and the second end of the cylindrical magnetic implant.

74. The system of any one of claims 69 to 73, wherein the diameter of the cylindrical magnetic implant is between about 2 mm and about 5 mm.

75. The system of claim 74, wherein the diameter of the cylindrical magnetic implant is between about 2.5 mm and about 4 mm.

76. The system of any one of claims 69 to 75, wherein the cylindrical magnetic implant comprises a tubular housing configured to receive a magnet element therein.

77. The system of claim 76, wherein the magnet element is a cylindrical magnet element disposed concentrically within the tubular housing.

78. The system of claim 77, wherein the cylindrical magnet element extends over a majority of an internal diameter of the tubular housing.

79. The system of claim 76, wherein the tubular housing comprises four tubular housing quadrants, and the magnet element extends into at least two of the four tubular housing quadrants.

80. The system of claim 79, wherein the magnet element extends into the four tubular housing quadrants.81 . The system of any one of claims 76 to 80, wherein the magnet element is made of a ferromagnetic material.

82. The system of any one of claims 76 to 81 , wherein the magnet element has an annular transverse cross-section.

83. The system of claim 82, wherein the available tissue-contacting portion of the cylindrical magnetic implant is defined over an entire circumferential outer surface of the cylindrical magnetic implant.

84. The system of claim 82 or 83, wherein the magnet element is radially magnetized.

85. The system of any one of claims 82 to 84, wherein the cylindrical magnetic implant further comprises a non-magnetic core.

86. The system of claim 84, wherein the magnet element is diametrically magnetized.

87. The system of claim 84, wherein the magnet element comprises two halves each being diametrically magnetized.

88. The system of any one of claims 76 to 87, wherein the magnet element is free of a through-hole, thereby providing the transverse section of the cylindrical magnetic implant that is free of the longitudinally-extending through-hole.

89. The system of claim 88, wherein the magnet element is diametrically magnetized.

90. The system of claim 88, wherein the magnet element comprises two halves each being diametrically magnetized.91 . The system of any one of claims 76 to 90, wherein the magnet element comprises multiple magnets elements housed in the tubular housing in an end-to-end fashion along a longitudinal axis of the tubular housing.

92. The system of claim 91 , wherein a first set of the multiple magnet elements is provided on one side of the transverse section, and a second set of the multiple magnet elements is provided on another side of the transverse section.

93. The system any one of claims 76 to 92, wherein the tubular housing is made of a housing material comprising a metal.

94. The system of claim 93, wherein the metal comprises at least one of stainless steel, titanium and a medical implant grade metal.

95. The system of any one of claims 76 to 92, wherein the tubular housing is made of a flexible material configured to flex.

96. The system of claim 95, wherein the tubular housing is made of a housing material comprising a polymer.

97. The system of claim 96, wherein the polymer comprises at least one of silicone, Silastic™ and a medical implant grade polymer.

98. The system of any one of claims 76 to 97, wherein the cylindrical magnetic implant further comprises a first end cap engageable with the first end of the cylindrical magnetic implant.

99. The system of claim 98, wherein the first end cap comprises atraumatic features.

100. The system of claim 99, wherein the first end cap is dome-shaped.101 . The system of any one of claims 98 to 100, wherein the first end cap includes a first end tubular housing engaging portion configured for insertion into the tubular housing.

102. The system of any one of claims 76 to 101 , wherein the cylindrical magnetic implant further comprising a second end delivery attachment engageable with the second end of the cylindrical magnetic implant.

103. The system of claim 101 , wherein the second end delivery attachment is tubular.

104. The system of claim 102 or 103, wherein the second end delivery attachment comprises a second end tubular housing engaging portion configured for insertion into the tubular housing.

105. The system of any one of claims 69 to 104, wherein the magnetic implant is an elongated magnetic implant.

106. A system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a cylindrical magnetic implant having a circumferential outer surface defining an available tissue-contacting portion comprising an anastomosis-forming longitudinal segment, the cylindrical magnetic implant comprising: a tubular housing defining a magnet element-receiving cavity; anda magnet element received within the magnet-receiving cavity and provided concentrically within the tubular housing; and a magnetic implant comprising a lumen-oriented surface and a tissuecontacting surface, the magnetic implant being configured to magnetically couple with the cylindrical magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming longitudinal segment of the cylindrical magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the two adjacent walls therebetween.

107. The system of claim 106, wherein the cylindrical magnetic implant has a diameter sized to enable introduction of the cylindrical magnetic implant into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

108. The system of claim 106 or 107, wherein the magnet element extends over a majority of an internal diameter of the tubular housing.

109. The system of any one of claims 106 to 108, wherein the magnet element is made of a ferromagnetic material.

110. The system of any one of claims 106 to 109, wherein the tissue-contacting surface of the magnetic implant is substantially flat.

111. The system of any one of claims 106 to 110, wherein the magnet element has an annular cross-section.

112. The system of claim 111 , wherein the available tissue-contacting portion of the cylindrical magnetic implant is defined over an entire circumferential outer surface of the cylindrical magnetic implant.

113. The system of claim 11 1 or 1 12, wherein the magnet element is radially magnetized.

114. The system of any one of claims 111 to 1 13, wherein the cylindrical magnetic implant further comprises a non-magnetic core.

115. The system of claim 1 11 , wherein the magnet element is diametrically magnetized.

116. The system of claim 111 , wherein the magnet element comprises two halves each being diametrically magnetized.

117. The system of any one of claims 111 to 1 16, wherein the cylindrical magnetic implant comprises a transverse section that is free of a longitudinally-extending through-hole to prevent fluid communication from a first end of the cylindrical magnetic implant to a second end of the cylindrical magnetic implant.

118. The system of claim 1 17, wherein the transverse section of the cylindrical magnetic implant extends over a majority of a length of the cylindrical magnetic implant defined between the first end and the second end of the cylindrical magnetic implant.

119. The system of claim 117 or 118, wherein the magnet element is free of a through- hole, thereby providing the transverse section of the cylindrical magnetic implant that is free of the longitudinally-extending through-hole.

120. The system of claim 1 19, wherein the magnet element is diametrically magnetized.121 . The system of claim 119, wherein the magnet element comprises two halves each being diametrically magnetized.

122. The system of any one of claims 117 to 121 , wherein the transverse section of the cylindrical magnetic implant extends from the first end to the second end of the cylindrical magnetic implant.

123. The system of any one of claims 106 to 122, wherein the magnet element comprises a plurality of adjacent magnets provided in an end-to-end fashion.

124. The system of any one of claims 106 to 123, wherein the diameter of the cylindrical magnetic implant is between about 2 and about 5 mm.

125. The system of claim 124, wherein the diameter of the cylindrical magnetic implant is between about 2.5 and about 3 mm.

126. The system any one of claims 106 to 125, wherein the tubular housing is made of a housing material comprising a metal.

127. The system of claim 126, wherein the metal comprises at least one of stainless steel, titanium and a medical implant grade metal.

128. The system of any one of claims 106 to 125, wherein the tubular housing is made of a flexible material configured to flex.

129. The system of claim 128, wherein the tubular housing is made of a housing material comprising a polymer.

130. The system of claim 129, wherein the polymer comprises at least one of silicone, Silastic™ and a medical implant grade polymer.

131. The system of any one of claims 106 to 130, wherein the cylindrical magnetic implant further comprises a first end cap engageable with a first end of the cylindrical magnetic implant.

132. The system of claim 131 , wherein the first end cap comprises atraumatic features.

133. The system of claim 132, wherein the first end cap is dome-shaped.

134. The system of any one of claims 131 to 133, wherein the first end cap includes a first end tubular housing engaging portion configured for insertion into the tubular housing.

135. The system of any one of claims 106 to 134, wherein the cylindrical magnetic implant further comprises a second end delivery attachment engageable with a second end of the cylindrical magnetic implant.

136. The system of claim 135, wherein the second end delivery attachment is tubular.

137. The system of claim 135 or 136, wherein the second end delivery attachment comprises a second end tubular housing engaging portion configured for insertion into the tubular housing.

138. The system of any one of claims 106 to 137, wherein the magnetic implant is an elongated magnetic implant.

139. A system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: a first magnetic implant shaped as an elongated prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being of substantially equal dimensions and defining an available tissue-contacting portion having one of the at least three outer lateral faces as an anastomosis-forming surface; and a second magnetic implant comprising a lumen-oriented surface and a tissuecontacting surface, the second magnetic implant being configured to magnetically couple with the first magnetic implant through the two adjacent walls of the digestive system such that the anastomosis-forming surface of the first magnetic implant faces the tissue-contacting surface of the second magnetic implant to compress a portion of the two adjacent walls therebetween.

140. The system of claim 139, wherein the first magnetic implant has a width sized to enable introduction thereof into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

141. The system of claim 139 or 140, wherein the first magnetic implant comprises a transverse section that is free of a longitudinally-extending through-hole to prevent fluid communication from the first end of the first magnetic implant to the second end of the first magnetic implant.

142. The system of claim 141 , wherein the transverse section of the first magnetic implant extends over a majority of a length of the first magnetic implant defined between the first end and the second end of the first magnetic implant.

143. The system of claim 141 or 142, wherein the transverse section of the first magnetic implant extends from the first end to the second end of the first magnetic implant.

144. The system of any one of claims 141 to 143, further comprising a first end cap engageable with the first end of the first magnetic implant.

145. The system of claim 144, wherein the first end cap comprises atraumatic features.

146. The system of claim 145, wherein the first end cap is dome-shaped.

147. The system of any one of claims 139 to 146, further comprising a second end delivery attachment engageable with the second end of the first magnetic implant.

148. The system of claim 147, wherein the second end delivery attachment is tubular.

149. The system of any one of claims 139 to 178, wherein the prism is one of a triangular prism, a pentagonal prism, a hexagonal prism, and heptagonal prism, and an octagonal prism.

150. The system of any one of claims 139 to 149, wherein a width of the first magnetic implant is between about 2 and about 5 mm.151 . The system of claim 150, wherein the width of the first magnetic implant is between about 2.5 and about 3 mm.

152. The system of any one of claims 139 to 151 , wherein the first magnetic implant comprises a housing configured to receive a magnet element therein.

153. The system of claim 152, wherein the magnet element is an elongated magnet element provided concentrically within the housing.

154. The system of claim 153, wherein the elongated magnet element has a cylindrical shape.

155. The system of claim 153, wherein the elongated magnet element has a shape complimentary to the housing.

156. The system of any one of claims 139 to 152, wherein a width of the elongated magnet element extends over a majority of an internal width of the housing.

157. The system of any one of claims 152 to 156, wherein the magnet element is made of a ferromagnetic material.

158. The system of any one of claims 152 to 157, wherein the magnet element is free of a through-hole.

159. The system of claim 152, wherein the magnet element comprises multiple magnet elements housed in the housing in an end-to-end fashion along a longitudinal axis of the housing.

160. The system of any one of claims 152 to 159, wherein the housing is made of a housing material comprising a metal.

161. The system of claim 160, wherein the metal comprises at least one of stainless steel, titanium, and a medical implant grade metal.

162. The system of any one of claims 152 to 159, wherein the housing is made of a flexible material configured to flex.

163. The system of claim 162, wherein the housing is made of a housing material comprising a polymer.

164. The system of claim 164, wherein the polymer comprises at least one of silicone, Silastic™ and a medical implant grade polymer.

165. The system of any one of claims 139 to 164, wherein the tissue-contacting surface of the second magnetic implant is substantially flat.

166. The system of any one of claims 139 to 165, wherein each of the at least three outer lateral faces is substantially flat.

167. A system for forming an anastomosis at a target site between two adjacent walls of a digestive system, the system for forming the anastomosis comprising: an elongated magnet assembly comprising: a plurality of magnet elements flexibly connected in series;a plurality of housings configured to receive therein a corresponding magnet element of the plurality of magnet elements, each of the housings comprising an anastomosis-forming surface; an elongated magnetic implant comprising a lumen-oriented surface and a tissue-contacting surface, the elongated magnetic implant being configured to magnetically couple with the elongated magnetic assembly through the two adjacent walls of the digestive system such that the anastomosis-forming surfaces of the plurality of housings face the tissue-contacting surface of the elongated magnetic implant to compress a portion of the two adjacent walls therebetween.

168. The system of claim 167, the elongated magnet assembly being implantable into at least one of a biliary tract, a pancreatic tract and a hepatopancreatic ampulla.

169. The system of claim 167 or 168, wherein each housing of the plurality of housings is tubular.

170. The system of claim 169, wherein each housing of the plurality of housings is configured to receive the corresponding magnet element of the plurality of magnet elements concentrically within the housing.171 . The system of claim 167, wherein at least one housing of the plurality of housings is shaped as a prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being of substantially equal dimensions and defining an available tissue-contacting portion having one of the at least three outer lateral faces as an anastomosis-forming surface.

172. The system of any one of claims 167 to 171 , wherein the magnet elements of the plurality of magnet elements are flexibly connected in series via a resilient connector.

173. The system of claim 172, wherein the resilient connector has a length that is less than 10 mm.

174. A method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a cylindrical magnetic implant as a first magnetic implant into a lumen associated with an accessory organ of digestion, the cylindrical magnetic implant having an available tissue-contacting portion defined over an entire circumferential outer surface of the cylindrical magnetic implant and comprising an anastomosis-forming longitudinal segment; delivering a second magnetic implant into the digestive tract, the magnetic implant comprising a tissue-contacting surface; magnetically coupling the cylindrical magnetic implant and the second magnetic implant irrespective of a circumferential orientation of the cylindrical magnetic implant such that the anastomosis-forming longitudinal segment of the cylindrical magnetic implant faces the tissue-contacting surface of the magnetic implant to compress a portion of the adjacent walls therebetween.

175. The method of claim 174, wherein delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the cylindrical magnetic implant into the gallbladder.

176. The method of claim 174, wherein delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the cylindrical magnetic implant into the common bile duct.

177. The method of any one of claims 174 to 176, wherein delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the cylindrical magnetic implant.

178. The method of any one of claims 174 to 176, wherein delivering the cylindrical magnetic implant into the lumen associate with the accessory organ of digestion comprises endoscopically delivering the cylindrical magnetic implant.

179. The method of any one of claims 174 to 178, wherein delivering the cylindrical magnetic implant into the biliary tract comprises securing a delivery wire to a second end delivery attachment of the cylindrical magnetic implant.

180. The method of any one of claims 174 to 179, wherein delivering the cylindrical magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the cylindrical magnetic implant.

181. The method of any one of claims 174 to 180, wherein the cylindrical magnetic implant comprises a plurality of magnet elements flexibly connected in series.

182. The method of any one of claims 174 to 181 , wherein delivering the magnetic implant into the digestive tract comprises delivering the magnetic implant into the duodenum.

183. The method of any one of claims 174 to 182, wherein the magnetic implant is an elongated magnetic implant.

184. A method of forming an anastomosis at a target site between two adjacent walls of a digestive system, the method comprising: delivering a first magnetic implant into a lumen associated with an accessory organ of digestion, the first magnetic implant being shaped as an elongated prism having at least three outer lateral faces extending between a first end and a second end, the at least three outer lateral faces being substantially equilateral and defining an available tissue-contacting portion having one of the three outer later faces as an anastomosis-forming surface; delivering a second magnetic implant into the digestive tract, the magnetic implant comprising a tissue-contacting surface; magnetically coupling the first and second magnetic implants irrespective of a lateral orientation of the elongated prism such that the anastomosis-forming surface of the first magnetic implant faces the tissue-contacting surface of the second magnetic implant to compress a portion of the adjacent walls therebetween.

185. The method of claim 184, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the gallbladder.

186. The method of claim 184, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises delivering the first magnetic implant into the common bile duct.

187. The method of any one of claims 184 to 186, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises percutaneously delivering the first magnetic implant.

188. The method of any one of claims 184 to 186, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises endoscopically delivering the first magnetic implant.

189. The method of any one of claims 184 to 188, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises securing a delivery wire to a second end delivery attachment of the first magnetic implant.

190. The method of any one of claims 184 to 189, wherein delivering the first magnetic implant into the lumen associated with the accessory organ of digestion comprises flexing a housing of the first magnetic implant.

191. The method of any one of claims 184 to 190, wherein the cylindrical magnetic implant comprises a plurality of magnet elements flexibly connected in series.

192. The method of any one of claims 184 to 191 , wherein delivering the second magnetic implant into the digestive tract comprises delivering the second magnetic implant into the duodenum.

193. The method of any one of claims 184 to 192, wherein the second magnetic implant is an elongated magnetic implant.

Images