Abstract: A method and apparatus for establishing an end-to-side anastomosis by using an instrument (501) is disclosed. The instrument has a passage (502D) for a bypass vessel, terminated by a circumferential anvil (502A, 503B), about which the end of the bypass vessel may be everted and then inserted through an anastomosis opening in a second vessel, such as a coronary artery. After insertion, the tissue edges to be joined are first clamped together by clamping slides (505) and then stapled together by stapling plungers (506) so as to interconnect the two vessels. The stapling plungers (506) are arranged to move at an angle to the passage (502D) instead of parallel to it. With this arrangement, it is possible to use a greater number of staples than has been possible in previous related methods. Preferably also, the instrument is adapted to be divided lengthwise of the passage (502D).

Abstract: When performing an end-to-side anastomosis connecting the end of a first vessel to the edge region around an opening in the side wall of a second vessel, an instrument is used having a circumferential stapling anvil secured to an anvil tube accommodating the first vessel, the end of which is everted about the anvil with the intima of the end region facing the intima of the edge region, when the instrument with the first vessel in place has been inserted into the opening in the second vessel. Then, a clamping tube is advanced towards the anvil, clamping the end and edge region together against the anvil. In the next step, a number of stapling plungers carrying staples are advanced towards the anvil, the latter having staple-bending surfaces, thus stapling the two vessels together in a manner not shown. Finally, the clamping tube and the stapling plungers are withdrawn, and the whole instrument removed from the anastomosis.

Abstract: An anastomotic instrument (201) and a method for establishing an end-to-side anastomosis. The instrument includes an anvil assembly (202A, 203, 203A), having stapling recesses (204), a clamping assembly (205B, 205A) adapted to be advanced towards the rear face of the anvil (203), and a stapling assembly (206, 206A), to be moved towards the anvil (203). All three assemblies can be split along a common dividing surface, and during the operation, the separable parts of the assemblies are held together by a common elastic rubber sheath (410), to ensure a correct sequence of relative movement when the three assemblies are pressed together by a manual implement having jaws (202C, 206C). After the anastomosis has been established, the rubber sheath (410) may be cut open to enable the separable parts to be separated from each other.