Abstract: A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: A union for connection of artificial vessel to human vessel is provided. The union is made of a biocompatible material, such as titanium, for fixedly positioning in an open end of an artificial vessel before a cut human vessel is put around the same open end of the artificial vessel and fixedly connected thereto with a binding string wound around the human vessel against a predetermined location on the union. The union allows the artificial vessel to be quickly connected to the cut human vessel to reduce bleeding and time needed to complete a surgical operation. And, the positioning of the union in the artificial vessel also reduces the difference between an outer diameter of the human vessel and an inner diameter of the artificial vessel at the joint of the two vessels.

Abstract: A tubular support for supporting vessels made of living tissue in an anastomosis procedure is disclosed. The support is biased so as to resiliently and elastically maintain a predetermined length and diameter. The support has ends insertable into the lumens of the vessels through openings, either in the end or in an incision in the vessel sidewall. The ends are compressed radially to a smaller diameter upon insertion and expand due to the biasing force to engage each vessel and support them in proximity to one another for surgically joining, for example, by suturing. The tubular support is formed by braiding elastic filamentary members into a tubular configuration under tension to provide the biasing force or by braiding resilient filamentary members into a tubular configuration. The tubular support may be made of bio-absorbable material or it may have an elastic, fluid impermeable membrane.

Abstract: A medical graft connector or plug is made, for example, by cutting end portions of a tube of highly elastic material axially at numerous locations spaced circumferentially around the tube to produce a plurality of fingers which extend axially from each end of an uncut medial portion of the tube. The fingers are deflected radially outwardly from the medial portion and set in that condition. For a graft connector, the medial portion is coaxially connected to an end portion of a tubular graft. The connector is then installed through an aperture in the side wall of a patient's tubular body conduit, for example, by using a delivery tube in which the fingers are elastically deflected back to approximately their initial positions. When the delivery conduit is withdrawn from the connector, the fingers spring out to engage the inner and outer surfaces of the body conduit wall.

Abstract: An instrument for attaching a graft to an aorta includes a first needle assembly for breaching the aorta to provide a hole in a wall thereof, and a carrier portion for insertion of an end of a tubular graft through the hole and into the aorta. Arms are pivotally mounted on the instrument and are moveable from a position extending axially of the carrier to a position extending radially from the carrier to spread the end of the graft radially outwardly from a tubular portion of the graft to form an annular flange extending outwardly from the tubular portion, and to support the flange within the aorta and around the hole therein. A second needle assembly retains the suture material and advances the suture material into engagement with the aorta wall and the graft flange for suturing the graft flange to the aorta wall.

Abstract: A medical graft connector or plug is made, for example, by cutting end portions of a tube of highly elastic material axially at numerous locations spaced circumferentially around the tube to produce a plurality of fingers which extend axially from each end of an uncut medial portion of the tube. The fingers are deflected radially outwardly from the medial portion and set in that condition. For a graft connector, the medial portion is coaxially connected to an end portion of a tubular graft. The connector is then installed through an aperture in the side wall of a patient's tubular body conduit, for example, by using a delivery tube in which the fingers are elastically deflected back to approximately their initial positions. When the delivery conduit is withdrawn from the connector, the fingers spring out to engage the inner and outer surfaces of the body conduit wall.

Abstract: A method and apparatus for performing coronary artery bypass surgery establishes a channel leading directly from a chamber of a heart into a coronary artery with said channel retained open during both diastole and systole. The coronary artery bypass procedure may be performed with or without cardiopulmonary bypass.

Abstract: A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: A method for implanting a medical set in a human blood vessel, the medical set comprising a prosthesis adapted to be introduced in the vessel, the prosthesis having a first end and a second end, and being adapted to be disposed against an inner wall of the vessel at least at one of the ends, the prosthesis comprising a tubular sleeve and a strap adapted to be disposed against the vessel at a location adjacent one of the ends of the tubular sleeve, the strap having a hemostatic covering for reducing any blood leakage at the location of the strap.

Abstract: A connector for use in providing an anastomotic connection between two tubular body fluid conduits in a patient. The connector is preferably a single, integral, plastically deformable structure that can be cut from a tube. The connector has axial spaced portions that include members that are radially outwardly deflectable from other portions of the connector. The connector is annularly enlargeable so that it can be initially delivered and installed in the patient in a relatively small annular size and then annularly enlarged to provide the completed anastomosis. The radially outwardly deflected members of the first and second portions respectively engage the two body fluid conduits connected at the anastomosis and hold those two conduits together in fluid-tight engagement. Apparatus for use in delivering and deploying a connector is also disclosed.

Abstract: An end-side anastomosis system including a fitting comprising: a base for attachment to a graft, said base be configured to form a seal with an opening in a host vessel wall; a leading petal having a cross-section with a radius of curvature approximating a radius of curvature of the host vessel, said leading petal being configured to dilate the host vessel wall opening while advancing said fitting through the opening; and a rear petal, said rear petal being deflectable to be advanced through the host vessel opening.

Abstract: The present invention provides an implant device and an associated method for interconnecting human vessels rapidly, safely and in a minimally invasive manner. The device comprises a first segment, a second segment, and a flow opening along the periphery of the two connected segments. The first and second segments are bendable for easy insertion into an incision made within each vessel. Upon release, each bendable segment subsequently conforms to the interior walls of a vessel to provide a sealing contact along the contact surface of the segment inserted within. The flow opening provides fluid interconnectivity between the vessels connected by the implant device.

Abstract: A ligating clip includes a first leg and a second leg defining therebetween a tissue clamping zone; and a deformable head portion connecting the first leg and the second leg and deformable from an open position wherein the first leg and the second leg are spaced to receive tissue to a closed position wherein the first leg and the second leg are closed to clamp tissue, wherein the deformable head portion defines deforming force receiving surfaces which are outside the tissue clamping zone.

Abstract: The present invention provides an implant device and an associated method for interconnecting human vessels rapidly, safely and in a minimally invasive manner. The device comprises a first segment, a second segment, and a flow opening along the periphery of the two connected segments. The first and second segments are bendable for easy insertion into an incision made within each vessel. Upon release, each bendable segment subsequently conforms to the interior walls of a vessel to provide a sealing contact along the contact surface of the segment inserted within. The flow opening provides fluid interconnectivity between the vessels connected by the implant device.

Abstract: The anastomosis device according to the present invention is a one piece device for connecting a graft vessel to a target vessel without the use of conventional sutures. The anastomosis device includes a frame for receiving and holding the end of a graft vessel in an everted position and first and second spreading members configured to be inserted into an opening in the target vessel. The first and second spreading members are arranged substantially in a plane for insertion into an opening in a target vessel, and are moved away from one another to capture the edges of the opening in the target vessel securing the graft vessel to the target vessel. One version of the anastomosis device includes a plurality of linkages arranged in two rows for grasping opposite sides of an opening in the target vessel. A portion of the linkages fold outward to trap vessel walls on opposite sides of the opening in the target vessel.

Abstract: A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member. forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: The present invention provides an implant device and an associated method for interconnecting human vessels rapidly, safely and in a minimally invasive manner. The device comprises a first segment, a second segment, and a flow opening along the periphery of the two connected segments. The first and second segments are bendable for easy insertion into an incision made within each vessel. Upon release, each bendable segment subsequently conforms to the interior walls of a vessel to provide a sealing contact along the contact surface of the segment inserted within. The flow opening permanently connects the segments and provides fluid interconnectivity between the vessels connected by the implant device.

Abstract: Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.

Abstract: A device for assisting in anastomosis of tubular structures. The basic device has a generally cylindrical shape with a pair of insertion arms connected by a bridge and two or more depressions that provide space for the needle to move through within the tubular structures. The device aids in preventing the needle from inadvertent contact with the wall opposite that of the wall being sutured. The method includes an initial suture to join the structures, inserting the device into the openings of the two structures, placing sutures in the walls adjacent to a depression, optionally rotating the device so one of the depressions is aligned with each suture as it is being placed, removing the device, and tightening the sutures to complete the anastomosis.

Abstract: A surgical clip set including an elongated main member, transversely extending stabilizer members at or adjacent each end of the main body. A plurality of surgical clips extending outwardly from each side of the main member with each clip being detachably secured to the main member and all the clips being located within the transversely extending stabilizer members.

Abstract: Innovative fasteners are disclosed for use in repairing a vessel having an aneurysm. The fasteners comprise either coiled spring or ring type fasteners. An attachment assembly and repair graft are also disclosed for use in the repair of the vessel. An attachment assembly comprises an attachment cuff such that the graft is not dimensionally dependent upon the size of the vessel. A visualization apparatus is also disclosed for real time direct viewing of an interior of a vessel. A penetration apparatus is disclosed for use in forming treatment specific holes in a potentially calcified vessel wall which facilitates thereafter the securing of the graft and attachment assembly to the vessel wall. An introducer sheath device is also disclosed that comprises a sealing assembly for preventing the loss of blood during the insertion and subsequent removal of surgical components during the surgical procedure.

Abstract: A guidance channel or conduit for promoting nerve regeneration includes a body constructed of a biocompatible polymeric material and having a first end for connection to a proximal stump of a severed nerve and a second end for connection to a distal stump of the severed nerve. The body includes a plurality of internal lumens extending between the first and second end to facilitate rejoining of the proximal and distal stumps of the severed nerve by providing increased surface area for Schwann cell adherence. A method for promoting nerve regeneration using a multi-lumen nerve guidance channel is also disclosed.

Abstract: A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: The invention relates to a vascular prosthesis capable of being anastomosed onto a tubular pipe with a side opening or an end opening. The prothesis having, at at least one of its ends, an annular sheet delimited by a free edge designed to be positioned in the immediate vicinity of opening in the pipe. The sheet is shaped so that it can be applied around the opening in the pipe against the inside or outside wall of the latter, while preserving its free edge in the immediate vicinity of the periphery of the opening in the pipe.

Abstract: Surgical method and apparatus for resectioning tissue, preferably lumenal tissue, with a remaining portion of an organ being anastomized with staples or other fastening means, preferably endolumenally. The apparatus may be inserted via a naturally occurring body orifice or a surgical incision and then advanced using either endoscopic or radiological imaging guidance to an area where surgery is to be performed. Under endoscopic or diagnostic imaging guidance the apparatus is positioned so tissue to be resected is manipulated into an inner cavity of the apparatus. The apparatus then cuts the diseased tissue after stapling and retains the diseased tissue within the apparatus. The rent resulting in a border of healthy tissue is anastomosed with surgical staples.

Abstract: A device for assisting in anastomosis of tubular structures. The basic device has a generally cylindrical shape with a pair of insertion arms and a central depression that provides a space for the needle to move through within the tubular structures while simultaneously providing support so that the suture needle thrust does not collapse the tubular structure wall. The depression may be configured to guide the path of the needle. A bridge connects the arms and prevents the needle from inadvertently coming in contact with the wall opposite that of the wall being sutured. The method includes an initial suture to join the structures, inserting the device into the openings of the two structures, placing sutures in the walls adjacent to the depression, optionally rotating the device so the depression is aligned with each suture as it is being placed, removing the device, and tightening the sutures to complete the anastomosis.

Abstract: The present invention on embodies a device and method for creating a bloodless field at an incision site in a blood vessel. The invention includes a perfusion tube for allowing perfusion of blood past the incision site. A pair of conical occlusive members are mounted on either end of the perfusion tube for preventing blood from flowing into the surgical site. A tubular stem depends from the tube, and includes a movable stopper which may be moved between a first position for blocking blood flow through the perfusion tube, and a second position for enabling blood to perfuse through the perfusion tube. With the movable stopper in the first position, a first end of the device may be inserted through a small incision into the upstream side of a blood vessel so that the blood flow is blocked. The second end of the device may then be inserted in the downstream side of the incision. The stopper may then be moved to the second position so that blood is free to flow through the perfusion tube.

Abstract: Continuously flat-woven implantable tubular prostheses have seamless woven sections which gradually change the number of warp yarns to smoothly transition, i.e., taper, from one diameter to another. Multi-diameter endoluminal grafts having a variety of shapes and configurations are made using a seamless weaving process without unacceptable voids or gaps in the tubular wall.

Abstract: An end-to-side anastomosis between a first vessel (27) and a second vessel (51) is carried out using an anastomosis instrument comprising a tube (20) in which the first vessel (27) is inserted and everted at the end of the tube (20) to form a collar (28), a springy anastomotic fitting (30) with outwardly directed spikes (32) having previously been placed under elastic bending in a circumferential recess (22). The tube (20) is inserted in a previously made incision in the second vessel (51), a guide member (35) ensuring that the wall region (53) around the incision contacts the everted collar (28). Then, an ejector (23) is operated to liberate the fitting (30) from the recess (22), releasing the fitting to expand quickly, so the spikes (32) penetrate the collar (28) and the wall region (53). Finally, the tube (20) and the ejector (23) are removed, and so is the guide member (35) having previously been made to collapse in a manner not shown to allow it to be removed through the first vessel (27).

Abstract: A heart valve can be replaced using minimally invasive methods which include a sutureless sewing cuff that and a fastener delivery tool that holds the cuff against the patient's tissue while delivering fasteners, two at a time in opposite directions, to attach the cuff to the tissue from the inside out. Drawstrings are operated from outside the patient's body and cinch the sewing cuff to the valve body. The cuff is releasably mounted on the tool. The tool stores a plurality of fasteners thereon. Two rows of staggered fasteners are formed whereby fasteners are located continuously throughout the entire circumference of the cuff. A minimally invasive surgical method is disclosed, and a method and tool are disclosed for repairing abdominal aortic aneurysms in a minimally invasive manner.

Abstract: An anastomosis cuff for performing a vascular anastomosis procedure includes a ridge of material that extends in the radial direction. The ridge can be easily grasped with forceps or a hemostat to immobilize the cuff during an anastomosis procedure. Alternately, the anastomosis cuff can be grasped between gripping fingers of a manipulator tool designed to surround the cuff such that the ridge is trapped between and grasped by the gripping fingers.

Abstract: A bilateral intra-aortic bypass graft and method and apparatus for repairing an abdominal aortic aneurysm includes two tubular grafts which are intraluminally delivered to the aorta and secured to the aorta by the expansion and deformation of two expandable and deformable tubular members.

Abstract: A surgical stent is provided for use in supporting the walls of a tubular organ during anastomosis. The stent includes a tubular body having a diameter adapted to be about equal to the diameter of the organ and having opposed axial ends a circumferential ridge intermediate the ends. The ridge has a diameter adapted to be greater than the diameter of the tubular organ so that when the tubular organ is supported on the body, the ends of the tubular organ may be joined together along the ridge, and are everted to facilitate suturing.

Abstract: A stent or support is disclosed for use in the connection or anastomosis of severed vessels to support and seal the anastomotic site. The stent includes substantially cylindrical sections separated by a tapered transitional region. The cylindrical sections are provided with flanges that define tapered sealing surfaces. The dimensions of the two sections are selected to correspond with the diameter of the portions of the vessel to be supported. The stent is preferably made of polyglycolic acid and the dimensions of the stent are selected to provide optimal support and sealing characteristics with a minimum of damage to the epithelial lining of the vas deferens. In three preferred applications, the stent is used in anastomosis of the severed ends of a vas deferens, a Fallopian tube, and a blood vessel. A gauge is used to measure the severed ends and, in that manner, determine the appropriate dimensions of the stent. A technique of forming porous stents, and other structures, is also disclosed.

Abstract: Implant with through passage (11) and intended to be applied as a through passage in the skin or in a membrane of the human body. The implant comprises a tubular body (10) provided with a radially protruding circular protruding flange (12), the perforation of flange (12) as least closest to the tubular body comprising slots (15) extending in the peripherical direction of the flange.

Abstract: A method of using a staple for joining first and second blood vessels. A staple having an open center is provided to staple the two vessels together. One end of the first blood vessel is placed through the staple and then pierced by an end of the staple. An opening in the side of the second blood vessel is formed and the pierced end of the first blood vessel is inserted into the hole. A second end of the staple is then deflectively bent and pierces the outer wall of the second vessel to staple the two vessels together.

Abstract: A bilateral intra-aortic bypass graft and method and apparatus for repairing an abdominal aortic aneurysm includes two tubular grafts which are intraluminally delivered to the aorta and secured to the aorta by the expansion and deformation of two expandable and deformable tubular members.

Abstract: An atherectomy catheter includes a catheter body having a cylindrical housing at its distal end. The cylindrical housing includes an elongate cutting aperture on one side thereof and a mechanism for severing atheroma which enters within the opening. In a first embodiment, the cutting mechanism comprises a circular cutting blade which is advanced over an elongate guide member which defines a path for the blade. Use of the guide means helps assure that the cutting blade will not be lost from the housing during use. In a second embodiment, a rotatable helical cutting blade is mounted within the housing. In that particular embodiment, the helical cutting blade can serve as the guide member for the circular cutting blade.

Abstract: An anvil bushing for use with a surgical circular stapler used to perform an anastomosis. The anvil bushing is mounted to the anvil shaft of the stapler. The bushing has a tubular member having an axial pathway therethrough. The tubular member has a proximal end, a distal end and an exterior surface. A first flange member having a first diameter is mounted to the distal end of the tubular member. A second flange member having a second diameter is mounted to the proximal end of the tubular member. The second diameter is larger than the first diameter. Legs for locating the bushing on an anvil shaft extend axially from the first flange member. Tissue notches are contained in the second flange member.

Abstract: A device for closing or connecting blood vessels has a plurality of micro miniature barb which pierce the wall of the blood vessel and anchor the device in place. In one embodiment the fastener is comprised of a male member and a female member which are fastened to blood vessel segments with the micro miniature barbs. The male and female members are joined together by inserting the male member into the female member to form a permanent coupling. The device can also be used for opening a blood vessel which has been narrowed by disease or trauma.

Abstract: A device for closing or connecting blood vessels has a plurality of micro miniature barb which pierce the wall of the blood vessel and anchor the device in place. In one embodiment the fastener is comprised of a male member and a female member which are fastened to blood vessel segments with the micro miniature barbs. The male and female members are joined together by inserting the male member into the female member to form a permanent coupling. The device can also be used for opening a blood vessel which has been narrowed by disease or trauma.

Abstract: A tapered stent made of resilient material for interconnecting portions of a Fallopian tube after a resection procedure. The stent is tapered to conform to the tapered inner surface of the Fallopian tube and is provided with at least one suture on at least one end for use in inserting the stent within the Fallopian tube and to secure the stent in place.

Abstract: A stent or support is disclosed for use in the connection or anastomosis of severed vessels to support and seal the anastomotic site. The stent includes substantially cylindrical sections separated by a tapered transitional region. The cylindrical sections are provided with flanges that define tapered sealing surfaces. The dimensions of the two sections are selected to correspond with the diameter of the portions of the vessel to be supported. The stent is preferably made of polyglycolic acid and the dimensions of the stent are selected to provide optimal support and sealing characteristics with a minimum of damage to the epithelial lining of the vas deferens. In two preferred applications, the stent is used in anastomosis of the severed ends of a vas deferens and a Fallopian tube. A gauge is used to measure the severed ends and, in that manner, determine the appropriate dimensions of the stent.

Abstract: A prosthesis for use in joining hollow, e.g. tubular, organ parts or systems, said prosthesis comprising a fragmentable body defining outer organ-supporting surface parts thereon adapted to be arranged in abutting relationship with inner surface parts of the organs to be joined, said body having a compressive strength sufficiently low to allow fragmentation of the body by application of a pressure to the outer surface of the tubular organs subsequently to the joining of the same, said pressure being below a pressure causing any substantial lesion of the tissue of the tubular organ parts. The material of the prosthesis is preferably one or more degradable and/or erodable and/or water-soluble, essentially non-toxic materials which are solid at a temperature of 40.degree. C. or higher, in particular 60.degree. C.

Abstract: A surgical clip formed from a continuous, resilient member and having a coil spring and two arms supporting clamping jaws. The coil spring forces the clamping jaws together. One arm has a guide section, through which the guided element of the second arm extends, to guide and restrict movement of the second arm, thereby correctly engaging the clamping jaws.

Abstract: A vessel approximator for use in anastomosis has a pair of opposed arms, each adapted to fit within the end of a vessel segment to be anastomosed. The tips of the arms are tapered to assist in placing an end of a vessel segment onto the arm. A stem extends from the junction of the arms to form a T shape. The stem is substantially thinner than the arms to permit the ends of the vessel segments placed over the arms to be proximate to each other to be sutured together. A ring on the end of the stem allows the device to be sutered in place in the surgical field. A notch at the junction of the arms opposite the stem permits the arms to collapse together when the device is removed from the vessel segments by pulling on the stem.

Abstract: The neural cell adhesion molecule is used in nerve prostheses for the repair of peripheral nerve damage in mammals, both animal and man. In particular, in a process wherein a crushed or severed nerve ending is entubulated by use of a prosthetic device, a neural cell adhesion protein is added to the prosthetic device to increase the rate of growth of the fibrous components of the nerve, to more rapidly regenerate the nerve, and provide a more complete restitution of the function of the muscle served by the regenerated nerve.

Abstract: A surgical clip is disclosed having a pair of spaced arms joined by a bridge that is deformed by pulling on a tang, which is connected to the bridge by a frangible neck. Also disclosed is a tool for pulling the tang, and an anastomosis procedure that may be quickly performed using the clip and tool.

Abstract: A technique whereby leakage from an anastomosis and problems directly resulting from such leakage are eliminated. The technique is an anastomosis procedure for securing intraintestinal bypass graft formed preferably of a soft latex or silastic tube with a radiopaque axial line for x-ray observation after implantation. The ends of the tube are sutured or stapled to the mucosal or submucosal linings, and after a period of about 10 to 15 days during which the anastomosis is healing, the bypass graft separates naturally from the wall of the intestine, and is finally expelled naturally from the anus. This graft prevents leakage at the anastomosis and thus substitutes for and makes unnecessary a colostomy or any other diversionary procedure.

Abstract: A device for assisting in anastomosis of tubular structures. The basic device has a generally cylindrical shape with a pair of insertion arms and a central depression that provides a space for the needle to move through within the tubular structures while simultaneously providing support so that the suture needle thrust does not collapse the tubular structure wall. The depression may be configured to guide the path of the needle. A bridge connects the arms and prevents the needle from inadvertently coming in contact with the wall opposite that of the wall being sutured. The method includes an initial suture to join the sutures, inserting the device into the openings of the two structures, placing sutures in the walls adjacent to the depression, optionally rotating the device so the depression is aligned with each suture as it is being placed, removing the device, and tightening the sutures to complete the anastomosis.