Urethral anastomosis device and method

Abstract

Provided herein is a two-part coupling assembly for re-connecting a first hollow body part to a second body part and an instrument and method for emplacement. The coupling assembly comprises coupling parts having securement elements that are actuated by separate deployment mechanisms of the instrument and attach to the first and second body parts. The first and second coupling parts having interconnecting elements that couple the two-part assembly together and re-connect the first and second body parts.

What is claimed is: 
     
         1 . An anastomosis device comprising:
 a first ring assembly comprising:
 a first ring having:
 a cylindrical wall defining a lumen therethrough and including a first end and a second end; 
 a plurality of guide structures in the cylindrical wall; 
 a plurality of first connecting elements extending from the first end; and 
 a plurality of mounting elements extending from the second end; and 
 
 a first central ring having (i) a cylindrical wall defining a lumen therethrough and including a first end and a second end, and (ii) a plurality of first securement elements extending from the first end, and 
   a second ring assembly comprising:
 a second ring having
 a cylindrical wall defining a lumen therethrough and including a first end and a second end, and 
 a plurality of axial slots in the cylindrical wall; and 
 
 a second central ring having (i) a cylindrical wall defining a lumen therethrough and including a first end and a second end, and (ii) a plurality of second securement elements extending from the first end. 
   
     
     
         2 . The anastomosis device of  claim 1 , wherein the first central ring is movable from a first position to a second position with respect to the first ring, and wherein the second position is closer to the second ring assembly than the first position. 
     
     
         3 . The anastomosis device of  claim 2 , wherein, when the first central ring is in the first position, the plurality of first securement elements are in an undeployed position. 
     
     
         4 . The anastomosis device of  claim 3 , the cylindrical wall of the first ring comprising an outer circumference; wherein, when the first central ring is in the first position, no portion of the plurality of first securement extends past the outer circumference of the cylindrical wall. 
     
     
         5 . The anastomosis device of  claim 4 , wherein, when the first central ring is in the first position, at least a portion of the plurality of first securement extends at least partially into the guide structures of the cylindrical wall. 
     
     
         6 . The anastomosis device of  claim 2 , the cylindrical wall of the first ring comprising an outer circumference;
 wherein, when the first central ring is in the second position, at least a portion of the plurality of first securement elements extends radially outward through the openings in the cylindrical wall of the first ring, past the outer circumference of the cylindrical wall.   
     
     
         7 . The anastomosis device of  claim 1 , wherein the plurality of second securement elements are movably connected to the second central ring. 
     
     
         8 . The anastomosis device of  claim 1 , the second ring comprising an outer circumference;
 wherein the second central ring is movable from a first position to a second position with respect to the second ring,
 wherein, when the second central ring is in the first position, the second securement elements are disposed generally within the plurality of axial slots in the cylindrical wall, and 
 wherein, when the second central ring is in the second position, the second securement elements extend at least partially through the plurality of axial slots radially outward past the outer circumference of the second central ring. 
   
     
     
         9 . The anastomosis device of  claim 1 , the second ring further comprising a plurality of second connecting elements adapted to matingly engage the plurality of first connecting elements extending from the first end of the first ring. 
     
     
         10 . The anastomosis device of  claim 1 , wherein, when the plurality of second connecting elements of the second ring engage the plurality of first connecting elements of the first ring, the lumen of the first ring and the lumen of the second ring are generally coaxial, thereby forming a single lumen extending through the anastomosis device. 
     
     
         11 . The anastomosis device of  claim 1 , wherein the first ring is adapted for insertion into a bladder neck and the second ring is adapted for insertion into a urethra. 
     
     
         12 . The anastomosis device of  claim 1 , wherein the first and second ring assemblies are formed from a biodegradable material. 
     
     
         13 . An anastomosis device for joining a first vessel portion to a second vessel portion comprising:
 a first ring assembly defining a first internal passageway therethrough and adapted to engage the first vessel portion, the first ring assembly comprising:
 a plurality of first securement elements being movable between a first position and a second position and adapted to at least partially penetrate tissue of the first vessel portion in the second position; and 
 at least one first connecting element; 
   a second ring assembly defining a second internal passageway therethrough and adapted to engage the second vessel portion, the second ring assembly comprising:
 a plurality of second securement elements being movable between a first position and a second position and adapted to at least partially penetrate tissue of the second vessel portion in the second position; and 
 at least one second connecting element adapted to engage the at least one first connecting element, wherein when the at least one first connecting element engages the at least one second connecting element, the first and second internal passageways are adjacent to each other to form a single anastomosis passageway extending through the first and second rings; and 
   wherein, prior to deployment of the first and second securement elements, the first and second ring assemblies are axially spaced apart from each other, and   wherein after deployment of at least one of the first and second securement elements, the first and second ring assemblies are drawn axially together towards each other until the first and second connecting elements engage each other.   
     
     
         14 . The anastomosis device of  claim 13 , wherein the first ring assembly further comprises:
 a cylindrical wall having a plurality of apertures extending therethough and an outer circumference; and   a first upper ring,   wherein the plurality of first securement elements are disposed within the outer circumference of the cylindrical wall when the plurality of securement elements are in the first position, and   wherein the plurality of first securement elements extend at least partially through the plurality of apertures in the second position.   
     
     
         15 . The anastomosis device of  claim 14 , wherein the plurality of first securement elements extend from the first ring at least partially into the plurality of apertures when the plurality of first securement elements are in the first position. 
     
     
         16 . The anastomosis device of  claim 14 , wherein the first and second ring assemblies are formed from a biodegradable material. 
     
     
         17 . A method for connecting a first hollow body part to a second hollow body part comprising:
 providing a first assembly comprising:
 a first ring having:
 a cylindrical wall defining a lumen therethrough and including a first end and a second end; 
 a plurality of first connecting elements extending from the first end; and 
 a plurality of mounting elements extending from the second end; and 
 
 a first central ring having (i) a cylindrical wall defining a lumen therethrough and including a first end and a second end, and (ii) a plurality of first securement elements extending from the first end, and 
   providing a second assembly comprising:
 a second ring having
 a cylindrical wall defining a lumen therethrough and including a first end and a second end, and 
 a plurality of axial slots in the cylindrical wall; 
 a plurality of second connecting elements adapted to matingly engage the plurality of first connecting elements; and 
 
 a second central ring having (i) a cylindrical wall defining a lumen therethrough and including a first end and a second end, and (ii) a plurality of second securement elements extending from the first end; 
   inserting the first assembly into the first hollow body part;   inserting the second assembly into the second hollow body part;   extending the plurality of first securement elements from the first central ring to engage tissue of the first hollow body part;   extending the plurality of second securement elements from the second central ring to engage tissue of the second hollow body part; and   moving the first assembly and the second assembly into contact with each other to matingly engage the plurality of second connecting elements with the plurality of first connecting elements.   
     
     
         18 . The method of  claim 17 , wherein, when the plurality of second connecting elements of the second ring matingly engage the plurality of first connecting elements of the first ring, the lumen of the first ring and the lumen of the second ring are generally coaxial, thereby forming a single lumen extending through the anastomosis device. 
     
     
         19 . The method of  claim 17 , wherein the first hollow body part is a bladder neck and the second hollow body part is a urethra. 
     
     
         20 . The method of  claim 17 , wherein the first and second assemblies are formed from a biodegradable material.