Stapling apparatus for anastomosis, in particular for urethra-bladder anastomosis

摘要

Apparatus for effecting anastomosis of the distal urethra (U) and the bladder (B) neck includes a tubular ureteral sound (12) with a threaded socket (13) on its distal end. An inflatable anvil (23) is connected to the threaded socket (13) on the ureteral sound (12) through an opening (130) in the urethra (U) adjacent the prostate (P) and the sound (12) is then retracted outwardly to position the inflatable anvil (23) in the urethra (U). A second implement (32) is passed downwardly through an incision (140) in the bladder (B) and is connectable to the inflatable anvil (23) by alignment (108, 110) and locking (96) means following surgical removal of the prostate (P). The inflatable anvil (23) and the second implement (32) respectively mount female (26) and male (28) connector members formed of material which will eventually dissolve in the human body. The male (28) and female (26) connector members are driven toward each other by the second implement (32) and male (28) means penetrates the tissue of the urethra (U) and the bladder (B) neck and then moves into the female (26) connector for engagement with locking means (68, 53) holding the two connector members (26, 28) together to clamp the urethra (U) to the bladder (B) neck to automatically provide an anastomosis. The second implement (32) for severing the tissue in a circular manner, radially inward from the male/female members (26, 28) to provide a clear internal opening (158, 160) for flow from the bladder (B) to the urethra (U). A catheter (30) is attached to the inflatable anvil (23) and upon removal of the second implement (32) is positioned in the bladder (B) which is then closed (151) by conventional surgical procedures. The anvil (23) is deflated and withdrawn outwardly through the urethra (U) to position the catheter (30) for bladder (B) drainage during healing of the anastomosis.