Insertion instrument for a transanal anastomosis

摘要

A transanal insertion device (10) for surgically inserting an anastomosis ring having two unitary members (13',13'') into a tubular anatomic member comprises a distal adapter (12), a proximal adapter (14) and an actuator (16). The distal adapter (12) includes a hollow distal sleeve (26) and a spring-loaded distal spool (34) axially movable within the distal sleeve (26). The distal spool (34) is biased in a first direction by a distal spring and includes alignment fingers (38) pivotably connected thereon for aligning a first unitary member. The proximal adapter (14) has a hollow proximal sleeve (60) and a spring-loaded proximal spool (70) axially movable within the proximal sleeve. The proximal spool (70) is biased in a second direction by a proximal spring (72) and includes alignment fingers (78) connected thereon for aligning a second unitary member. The proximal member also includes a proximal gripper for securing the second unitary member on the proximal hollow sleeve. The actuator (16) includes an elongated tube (90) with a collar (94) connected to its distal end and a handle assembly (92) connected to its proximal end. First and second flexible rods (98,100) connected to the handle assembly extend through the elongated tube (90). The flexible rods (98,100) are manipulated to engage the distal adapter (12) and draw it relative to the proximal adapter (14). The rods are also manipulated to release the distal and proximal adapters from their respective unitary members so the distal adapter, the proximal adapter and the actuator can be withdrawn transanally. IMAGE