Circumferential Full Thickness Resectioning Device

Abstract

An apparatus for performing endoluminal anastomosis of an organ comprises an operative head including an endoscope receiving lumen for slidably receiving a flexible endoscope therein, the operative head including an annular tissue receiving space extending around a circumference of a distal end thereof and a stapling mechanism for firing staples around an entire circumference of the tissue receiving space and a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ.

1 - 30 . (canceled) 
     
     
         31 . An operative head for an apparatus performing endoluminal anastomosis of an organ, comprising:
 a housing including an endoscope receiving lumen for slidably receiving a flexible endoscope therein;   a tissue receiving space formed in a distal end of the housing;   a stapling mechanism mounted within the housing for firing staples in a plane perpendicular to a longitudinal axis of the housing through the tissue receiving space around an entire circumference thereof; and   a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ.   
     
     
         32 . The operative head of  claim 31 , wherein the stapling mechanism rotates about a longitudinal axis of the operative head so that the stapling of the tissue is performed sequentially around a circumference thereof. 
     
     
         33 . The operative head of  claim 32 , wherein an anvil is coupled to the stapling mechanism and rotates therewith. 
     
     
         34 . The operative head of  claim 31 , further comprising staple openings formed in a predetermined pattern around a radially inward facing surface of the tissue receiving space. 
     
     
         35 . The operative head of  claim 31 , further comprising a cartridge extending around an inner surface of the tissue receiving space and including staple openings facing radially outward into the tissue receiving space. 
     
     
         36 . The operative head of  claim 35 , further comprising an annular staple driving plunger housed radially within the cartridge and including a tapered distal tip so that moving the staple driving plunger distally relative to the cartridge drives the staples radially outward from the staple openings. 
     
     
         37 . The operative head of  claim 31 , wherein the tissue gripping mechanism includes a plurality of gripping jaws spaced from one another around a circumference of the tissue receiving space. 
     
     
         38 . The operative head of  claim 31 , wherein the tissue gripping mechanism includes a suction gripper. 
     
     
         39 . The operative head of  claim 31 , further comprising a tissue cutting mechanism proximal of the staple mechanism for severing from the organ tissue within the tissue receiving space proximal of a line of staples deployed in the staples. 
     
     
         40 . The operative head of  claim 31 , further comprising a tissue clamping mechanism for holding the tissue within the tissue receiving space. 
     
     
         41 . The operative head of  claim 31 , further comprising a distal cap moveable between an insertion position in which the distal cap covers the tissue receiving space and an operative position in which the distal cap is withdrawn to expose the tissue receiving space. 
     
     
         42 . A method for performing a circular anastomosis of a substantially tubular body organ, comprising the steps of:
 inserting an operative head slidably coupled to an endoscope into a substantially tubular organ, wherein the operative head includes a stapling mechanism and a tissue receiving space extending around a distal end thereof;   drawing a portion of tissue from the organ into the tissue receiving space, wherein the portion of tissue extends around an entire circumference of the organ; and   firing a plurality of staples into the tissue receiving space in a plane perpendicular to the longitudinal axis of the housing through the tissue received in the tissue receiving space.   
     
     
         43 . The method of  claim 42 , further comprising cutting away from the stapled portion of tissue, a portion of tissue proximal to a line of staples deployed in the tissue. 
     
     
         44 . The method of  claim 42 , wherein the stapling mechanism is coupled to a controller which remains outside the body by at least one torsionally rigid, longitudinally flexible drive shaft. 
     
     
         45 . The method of  claim 42 , wherein the entire procedure is performed endoluminally. 
     
     
         46 . The method of  claim 45 , wherein the operative head is maneuvered into a desired position adjacent to the tissue to be resected by steering the flexible endoscope through the body organ to visually locate the tissue to be resectioned and then sliding the operative head along the endoscope to the desired position. 
     
     
         47 . The method of  claim 46 , wherein a longitudinally flexible sheath surrounds the endoscope and the drive shaft. 
     
     
         48 . A system for endoluminally performing an anastomosis of a substantially tubular organ, comprising:
 a flexible endoscope;   an operative head slidably mountable over the endoscope, the operative head including a tissue receiving space formed in a distal end thereof and a stapling mechanism for firing staples into the tissue receiving space in a plane perpendicular to a longitudinal axis of the head around an entire circumference thereof; and   a tissue gripping mechanism for drawing into the tissue receiving space a portion of tissue extending around an entire circumference of the organ   
     
     
         49 . The system of  claim 48 , further comprising a tissue cutting mechanism which, when actuated, severs a portion of tissue proximal to a portion of tissue through which staples were driven. 
     
     
         50 . The system of  claim 48 , further comprising a control handle which remains outside a patient's body while the system is in use. 
     
     
         51 . The system of  claim 50 , further comprising a flexible sheath extending between the operative head and the control handle and enclosing therein connections between the operative head and the control handle.