STAPLING METHOD AND APPARATUS FOR VESICLE-URETHAL 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 ureteral sound with a threaded socket on its distal end. An inflatable anvil is connected to the threaded socket on the ureteral sound through an opening in the urethra adjacent the prostate and the sound is then retracted outwardly to position the inflatable anvil in the urethra. A second implement is passed downwardly through an incision in the bladder and is connectable to the inflatable anvil by alignment and locking means following surgical removal of the prostate. The inflatable anvil and the second implement respectively mount female and male connector members formed of material which will eventually dissolve in the human body. The male and female connector members are driven toward each other by the second implement and male means penetrates the tissue of the urethra and the bladder neck and then moves into the female connector for engagement with locking means holding the two connector members together to clamp the urethra to the bladder neck to automatically provide an anastomosis. The second implement for severing the tissue in a circular manner, radially inward from the male/female members to provide a clear internal opening for flow from the bladder to the urethra. A catheter is attached to the inflatable 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 The anvil is deflated and withdrawn outwardly through the urethra to position the catheter for bladder drainage during healing of the anastomosis.