Everted Anastomosis Flange Suturing for Minimally Invasive Grafting
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Solution Overview
Problem
Conventional surgical anastomosis procedures, such as coronary artery bypass grafting, involve significant invasiveness, leading to scarring, discomfort, and prolonged recovery due to large incisions and sternum division.
Innovation Solution
An apparatus and method utilizing an eversion mechanism to create flanges on both the donor and receiving passages, followed by a suturing mechanism to suture these flanges together via a helical path, all performed through minimally invasive subxiphoid incisions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If conventional surgical anastomosis is performed with large incisions and sternum division, then the surgeon can access the heart and arteries to perform grafting, but the patient experiences significant scarring, discomfort, and prolonged recovery
Solution Approach 1:
The surgical procedure is divided into multiple minimally invasive access points rather than one large incision. The delivery catheter is inserted through a small incision in the femoral artery, and the anastomosis is performed internally without requiring sternum division, thus avoiding the harmful effects of large incisions while maintaining surgical accessibility
Solution Approach 2:
A delivery catheter serves as an intermediary tool to deliver the graft and positioning mechanisms internally. The catheter allows the surgeon to perform the anastomosis procedure through a small external incision by guiding the graft and eversion mechanisms through the bloodstream to the target site, eliminating the need for large incisions and sternum division
2Ease of operation
If a median sternotomy is performed to provide surgical access, then the surgeon can perform the anastomosis, but the incision size increases leading to more scarring and infection risk
Solution Approach 1:
The need for large incisions and sternum division is extracted and removed from the procedure. The anastomosis is performed entirely through catheter-based delivery through a small femoral artery incision, eliminating the harmful large incision approach while maintaining the ability to perform the surgical connection
Solution Approach 2:
The surgical approach transitions from a two-dimensional large incision on the chest to a one-dimensional catheter pathway through the bloodstream. The graft is delivered through the vascular system to the heart, allowing access to the coronary arteries without external incisions near the heart site
3Ease of manufacture
If the donor passage is everted to form a flange for anastomosis, then the suturing can be performed on the interior faces, but the eversion mechanism adds complexity to the apparatus
Solution Approach 1:
The eversion mechanism and the anastomosis suturing function are merged into a single integrated device. The delivery catheter incorporates both the eversion mechanism that inverts the passage ends and the suturing mechanism that connects them, allowing both functions to be performed through one access point without requiring separate complex devices
Solution Approach 2:
The eversion mechanism is designed to be self-contained within the delivery catheter, where the catheter itself performs the eversion action by expanding or deploying the inverted flanges at the target site. The mechanism uses its own structural components to achieve eversion without requiring external manipulation or additional complex apparatus
Data Source
AI summary
Disclosed embodiments include apparatuses, systems, and methods for facilitating anastomosis between bodily passages. In an illustrative embodiment, an eversion mechanism is configured to engage a first external surface of a receiving passage adjacent a first opening in the receiving passage in order to create a receiving flange presenting a first interior face. A donor support mechanism is configured to support a donor passage with an opening in an end in an everted position that forms a donor flange presenting a second interior face. The donor support mechanism is further configured to present the second interior face of the donor flange against the first interior face of the receiving flange to present a passage juncture. A suturing mechanism is configured to motivate a filament through a helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage.