Endovascular stapler

Abstract

An endovascular stapler for securing an endograft to a vessel is disclosed. The stapler includes a staple housing adapted for storing at least one staple therein, the staple housing having an exit area for discharge of the at least one staple therethrough, an actuating assembly adapted for discharging the at least one staple through the exit area, and a displacement mechanism in operative association with the staple housing near the exit area. The displacement member is operative for pushing the exit area against the endograft when discharging the at least one staple therethrough. The discharged staple forms a plurality of opposed loops connected by a central element upon discharge. Also disclosed are staples and displacement mechanisms adapted for use with surgical instruments such as the present endovascular staplers. The staples may be formed from memory metal or other metal. The displacement mechanisms disclosed include balloons and rigid offsetting devices.

1 . A method of attaching an endograft to a vessel wall with an endovascular stapler having a distal end and a proximal end with a biasing mechanism associated therewith, said method comprising: 
 inserting the distal end of the endovascular stapler into the endograft;    activating the biasing mechanism so as to push the distal end of the endovascular stapler against the endograft;    discharging a first staple having a pair of legs connected by a central portion from the endovascular stapler into the endograft and vessel such that the staple legs form a pair of circular loops connected by the central portion.    
   
   
       2 . The method of  claim 1 , further comprising the steps of: 
 partially deactivating the biasing mechanism to permit rotation of the distal end of the endovascular stapler;    rotating the distal end of the endovascular stapler;    reactivating the biasing mechanism so as to push the distal end of the endovascular stapler against the endograft;    discharging a second staple having a pair of legs connected by a central portion from the endovascular stapler into the endograft and vessel such that the staple legs form a pair of circular loops connected by the central portion.    
   
   
       3 . The method of  claim 1 , wherein the first staple is constructed from a memory alloy.  
   
   
       4 . The method of  claim 3 , wherein the legs of the first staple are predominantly straight while within the stapler prior to said step of discharging.  
   
   
       5 . The method of  claim 4 , wherein the natural condition of the first staple is where the legs form circular loops.  
   
   
       6 . The method of  claim 5 , wherein the step of discharging permits the first staple to return to its natural condition.  
   
   
       7 . The method of  claim 5 , wherein said step of discharging serves to advance a staple pusher within said stapler for discharging the first staple.  
   
   
       8 . The method of  claim 7 , wherein the first staple advances along a staple guide, the staple guide retarding the return of the first staple to its natural condition.  
   
   
       9 . The method of  claim 8 , wherein the staple pusher includes a pivoting portion and the step of discharging rotates the pivoting portion into the central portion of the first staple such that the central portion of the first staple abuts the endograft.  
   
   
       10 . The method of  claim 4 , wherein the straight legs are substantially parallel to the longitudinal axis of the endograft during said step of inserting.  
   
   
       11 . The method of  claim 1 , wherein the endovascular stapler includes a removable cartridge containing a plurality of staples, each of the staples having a pair of legs connected by a central portion.  
   
   
       12 . The method of  claim 11 , wherein the legs of the plurality of staples are predominantly straight while within the stapler cartridge.  
   
   
       13 . The method of  claim 12 , wherein the natural condition of the plurality of staples is where the legs form circular loops, and said step of discharging permits the first staple to return to its natural condition.  
   
   
       14 . The method of  claim 11 , wherein the cartridge is replaceable.  
   
   
       15 . The method of  claim 1 , wherein the vessel flows blood from a heart and said step of discharging drives the first staple toward the heart against the direction of blood flow.  
   
   
       16 . The method of  claim 15 , wherein said step of discharging is conducted by a trigger mechanism that pushes a staple pusher.  
   
   
       17 . The method of  claim 1 , wherein the vessel flows blood from a heart and said step of discharging drives the first staple away from the heart in the direction of blood flow.  
   
   
       18 . The method of  claim 17 , wherein said step of discharging is conducted by a trigger mechanism that pulls a staple pusher.  
   
   
       19 . The method of  claim 1 , wherein the legs of the discharged first staple form a plane extending parallel to the longitudinal axis of the endograft following said step of discharging.  
   
   
       20 . The method of  claim 1 , wherein the step of discharging advances the staple through a staple exit area, the staple exit area being radio opaque.  
   
   
       21 . The method of  claim 1 , wherein the vessel flows blood and said step of activating the biasing mechanism does not completely inhibit blood flow.  
   
   
       22 . The method of  claim 2 , wherein the vessel flows blood and said steps of activating the biasing mechanism and reactivating the biasing mechanism do not completely inhibit blood flow.  
   
   
       23 . The method of  claim 1 , wherein the pair of circular loops are closed.  
   
   
       24 . The method of  claim 1 , wherein the circular loops are partial circular loops.  
   
   
       25 . A method of attaching an endograft to a vessel wall with an endovascular stapler having a distal end forming a staple exit area along a side thereof, a proximal end with a trigger for deploying staples, and a balloon near the staple exit area, said method comprising: 
 inserting the distal end of the endovascular stapler into the endograft;    inflating the balloon to push the staple exit area against the endograft; and,    deploying a first staple from the staple exit area into the endograft and the vessel wall such that the first staple forms a pair circular loops connected by a central portion.    
   
   
       26 . The method of  claim 25 , wherein the circular loops are partial circular loops.  
   
   
       27 . The method of  claim 25 , wherein the circular loops are closed.  
   
   
       28 . The method of  claim 25 , further comprising: 
 partially deflating the balloon;    rotating the endovascular stapler;    inflating the balloon so as to push the staple exit area against the endograft in a location different from but adjacent to the deployed first staple; and,    deploying a second staple from the staple exit area through the endograft and the vessel wall, the second staple forming a pair of loops connected by a central portion upon deployment.    
   
   
       29 . The method of  claim 25 , wherein the first staple is constructed from a memory alloy.  
   
   
       30 . The method of  claim 29 , wherein the natural condition of the first staple is where the legs form circular loops.  
   
   
       31 . The method of  claim 25 , wherein the step of deploying is conducted by activating the trigger to manipulate a staple pusher, the staple pusher pushing the first staple.  
   
   
       32 . The method of  claim 31 , wherein the staple pusher includes a pivoting portion and the step of deploying rotates the pivoting portion into the staple such that the central portion of the staple abuts the endograft.  
   
   
       33 . The method of  claim 25 , wherein the vessel flows blood from a heart and said step of deploying drives the first staple toward the heart against the direction of blood flow.  
   
   
       34 . The method of  claim 25 , wherein the vessel flows blood from a heart and said step of deploying drives the first staple away from the heart in the direction of blood flow.  
   
   
       35 . The method of  claim 25 , wherein the circular legs of the first staple form planes extending parallel to the longitudinal axis of the endograft following said step of discharging.  
   
   
       36 . The method of  claim 25 , wherein the staple exit area is radio opaque.  
   
   
       37 . The method of  claim 25 , wherein the endovascular stapler includes a removable cartridge containing a plurality of staples, each of the staples having a pair of legs connected by a central portion.  
   
   
       38 . The method of  claim 37 , wherein the removable cartridge is replaceable.  
   
   
       39 . The method of  claim 25 , wherein said step of deploying serves to advance a staple pusher within said stapler for deploying the first staple.  
   
   
       40 . The method of  claim 39 , wherein the first staple is formed from a memory alloy and the natural condition of the first staple is where the legs form circular loops, the first staple legs being predominantly straight while within the stapler, the first staple advancing along a staple guide during said step of deploying, the staple guide retarding the return of the first staple to its natural condition.  
   
   
       41 . A method of performing surgery on a vessel having an endograft therein, said method comprising: 
 providing a plurality of staplers, each stapler having a stapler housing storing a U-shaped staple having a pair of legs connected by a central portion and a balloon capable of being inflated and deflated;    inserting the stapler housing of the first of said plurality of staplers into said endograft;    inflating the balloon of said first of said plurality of staplers so as to push the stapler housing against the endograft;    advancing the first staple from within the stapler housing such that the legs of the first staple form loops piercing the endograft and the vessel.    
   
   
       42 . The method of performing surgery of  claim 41 , further comprising: 
 deflating the balloon;    removing the stapler housing of said first of said plurality of staplers from said endograft;    inserting the second of said plurality of stapler housings into said endograft;    inflating the balloon so as to push the second of said plurality of stapler housings against the endograft in an area other than at the location of the first staple;    advancing the staple of the second of said plurality of staplers from within the stapler housing such that the legs of the second staple form loops piercing the endograft and the vessel.    
   
   
       43 . The method of  claim 41 , wherein the loops are closed loops.