Barbed Cinching Member Radially Bunches Tissue for Anastomosis
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Solution Overview
Problem
Current surgical stapling instruments face challenges in ensuring a fluid-tight anastomosis without flap regions extending outwardly, which can compromise the integrity of the anastomosis over time, and may interfere with tissue compression and staple deployment.
Innovation Solution
The use of a barbed cinching member or staple array with a pull-through suture to radially bunch the tissue inwardly, forming pleats that fit within the diameter of the knife member, preventing flap regions and ensuring all tissue is within the cut line, thereby maintaining anastomosis integrity.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a circular stapler is used to perform end-to-end anastomosis, then the tissue can be clamped, cut, and stapled simultaneously to provide a sealed connection, but flap regions may extend outwardly from the cut line compromising anastomosis integrity
Solution Approach 1:
The cinching member is deployed around the tissue lumen before the cutting action occurs. By pre-cinching the tissue radially inward, the apparatus ensures that all tissue edges are positioned within the intended cut line before separation occurs, preventing flap formation that would compromise anastomosis integrity.
Solution Approach 2:
The cinching member applies a preliminary compressive force radially inward on the tissue to counteract the natural tendency of tissue to protrude or form flaps during the cutting and stapling process. This preliminary anti-action prevents the harmful effect of flap formation before it occurs.
2Ease of operation
If tissue is not radially bunched inwardly, then the procedure is simpler, but flap regions extend outwardly interfering with tissue compression and staple deployment
Solution Approach 1:
The cinching member is deployed and tightened around the tissue lumen before the stapling head assembly performs compression and staple deployment. This preliminary radial bunching of tissue ensures that all tissue is properly positioned and compressed within the intended area, facilitating successful staple formation without interference from protruding flaps.
3Reliability
If a cinching member is deployed to radially bunch tissue inwardly, then flap regions are prevented and anastomosis integrity is improved, but the device complexity increases
Solution Approach 1:
The cinching member deployment mechanism is integrated with the stapling head assembly, allowing both functions to be performed by a single coordinated device. The cinching member is advanced, deployed, and cinched through mechanisms that are part of the same apparatus that performs cutting and stapling, reducing the need for separate devices while maintaining anastomosis integrity.
Solution Approach 2:
The stapling head assembly is designed to perform multiple functions: deploying the cinching member, cinching the tissue radially inward, cutting the tissue, and deploying staples. This multi-functionality consolidates what could be separate devices into a single universal apparatus, mitigating the increase in device complexity while achieving improved anastomosis integrity.
Data Source
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AI summary
An apparatus includes a locking portion, a flexible pulling portion, a flexible body, and a plurality of barb features extending laterally from the body. The locking portion is configured to receive the pulling potion. The pulling portion is configured to engage and translate relative to the locking portion after the locking portion has received the pulling portion. The flexible body extends from the locking portion to the pulling portion. The flexible body is configured to form a loop when the pulling portion engages the locking portion. The loop is configured to decrease in size in response to pulling of the pulling portion relative to the locking portion. The barb features are configured to engage a tubular region of tissue and thereby form pleats in the tubular region of tissue.