Stapling method and apparatus for vesicle-urethral re-anastomosis following retropubic prostatectomy and other tubular anastomosis

摘要

Apparatus for effecting anastomosis of the distal urethra and the bladder neck includes a tubular urethral sound. An inflatable anvil is selectively connected to the sound through an opening in the urethra adjacent the prostate. The sound is then retracted outwardly to position the anvil in the urethra. A second implement is passed downwardly through an incision in the bladder and is connectable to the anvil by alignment and locking means following surgical removal of the prostate. Male and female connectors mounted respectively on the anvil and the second implement and formed of a material which dissolves in the human body are driven toward each other by the second implement. The male connector penetrates the urethra and the bladder neck and then moves into the female connector for engagement with locking means holding the two connectors together to clamp the urethra to the bladder neck to automatically provide an anastomosis. The second implement also includes a circular blade for severing the tissue inwardly from the male/female connectors to provide a clear, circular internal opening for flow from the bladder to the urethra. A catheter is attached to the anvil and upon removal of the second implement is positioned in the bladder which is then closed by conventional surgical procedures. The anvil is deflated and withdrawn outwardly through the urethra to position the catheter for bladder drainage during healing of the anastomosis.