Methods and apparatus for joining anatomical structures

Abstract

The invention provides encircling devices by which anatomical structures, such as blood vessels, fallopian tubes, ureters, vas deferens and outer nerve sheaths are anastomosed. Such an encircling device provides an opening that receives an end of a tubular anatomical structure having a prepared opening, and the tubular structure is anastomosed to a second anatomical structure having a prepared opening by tethering the two structures to the encircling device holding the structures under radial stress in apposition to each other to form a fluid-tight peripheral seal around their openings. Encircling devices are also used to join a tubular anatomical structure to a second anatomical structure having a cavity, e.g., a fallopian tube to a uterus or a uterer to the bladder. The tubular structure is received in the opening of the encircling device and tethered thereto to hold its end open, and then the encircling device is extended through a passageway in the second anatomical structure by means of a trocar, and when the trocar is withdrawn, the large size of the device compared to the passageway, which naturally constricts, prevents the device from removing itself. To hold anatomical structures in close proximity during anastomosis, a pneumatic or hydraulic clamping device is provided which grips the anatomical structures with a precise force according to the fluid pressure supplied thereto. Precise control of gripping force assures a firm grip that is not excessive and does not damage the structures.