The present disclosure provides description of applicators to implement modular magnetic anastomosis device. In one embodiment the delivery device is a laparoscopic instrument for MISS surgery, in another embodiment the delivery device is endoscopy or colonoscopy instrument for NOTES surgery.

A system for endoscopically forming an anastomosis between two naturally adjacent points in the digestive tract. The system utilizes elongate magnetic devices that, when connected across a tissue boundary, necrose tissue until an anastomosis forms and the devices are passed naturally. Despite the elongate shape of the devices, the resulting anastomosis is substantially round. As such, round anastomoses can be formed having increased diameters merely by increasing the lengths of the devices, obviating the need for wider endoscopes.

Methods and apparatus for safely forming anastomoses comprise magnetic members configured to accommodate different tissue types and patients of differing size and weight. The magnetic members may comprise first and second magnetic members configured to engage each other with a force sufficient to form anastomosis while taking a sufficiently long time to allow the intestinal walls to fuse together. The first and second magnetic members can be configured to form anastomoses between both similar and different types of intestinal tissue. An elongate surgical placement instrument can be configured to engage and manipulate the first and second magnet members through the intestinal wall from outside the intestinal wall in order to place each of the magnetic members at desired locations.

An exemplary tissue compression device for forming an anastomosis between first and second anatomical structures includes a first device portion having a first mating surface, and a second device portion having a second mating surface configured to mate with the first mating surface to compress tissue positioned therebetween. Each of the first and second mating surfaces includes a contoured portion, and the contoured portions are configured to mate with one another to facilitate alignment of the first and second device portions. A first one of the contoured portions may be formed with a concave contour and a second one of the contoured portions may be formed with a complementary convex contour. The device portions may further include first and second magnetic members configured to draw the device portions together to engage the first mating surface with the second mating surface.

The invention is an implantable magnetic anastomosis device having an exoskeleton that directs self-assembly. The design allows the device to be delivered in a linear configuration using a minimally-invasive technique, such as endoscopy or laparoscopy, whereupon the device self-assembles into, e.g., a polygon. A coupled set of polygons define a circumscribed tissue that can be perforated, or the tissue can be allowed to naturally necrose and perforate. The device can be used to create anastomoses in a variety of tissues, such as tissues found in the gastrointestinal, renal/urinary, and reproductive tracts. New procedures for using anastomoses, e.g., surgical bypass are also disclosed.

Apparatuses for placement of magnetic therapeutic devices are provided. Such apparatuses may include an actuation mechanism that includes a movable portion that is movable relative to another portion thereof between at least three different predetermined relative locations, each location associated with a different position of a magnet located within a therapeutic device interface of the apparatus. By moving the magnet between the different locations relative to the therapeutic device interface, different amounts of magnetic clamping force between the magnet and a therapeutic device interfaced with the therapeutic device interface may be developed.

A tissue-fastening tool indwelling system includes: a sheath; a needle tube disposed in the sheath; a tissue-fastening tool including a wire having a coil region disposable in the needle tube in a stretched state and restorable to a coil shape with the same winding diameter outside the needle tube; a stylet connected to the wire; and a manipulation part for manipulating the stylet to advance the wire and rotate the sheath in a first direction. In a state where a distal end of the needle tube is proximal of the distal end of the sheath, the manipulation part is designed to operate such that the wire is delivered from the sheath by a length of one winding of the coil region per rotation of the sheath by less than one turn, and the protruding coil region biased to have a diameter larger than the winding diameter.

The present disclosure provides modular magnetic anastomosis devices that can be implemented in digestive surgery or in any circumstance of anastomosis between adjacent organs or two hollow viscera. The device is minimally invasive and easily and quickly delivered using laparoscopic or endoscopic procedures.

A device for shearing tissue in a human or animal body may include a first member made of a first material and a second member made of a second material. A thread is connected to the first member and to the second member, and the first and second materials show magnetic attraction between one another. A means is provided for pulling the thread between the first and second members.

Magnetic anastomosis devices constructed from magnetic segments coupled together with members that help the devices spontaneously transform from a linear delivery configuration to a polygonal deployment configuration. When two devices are joined together over tissue(s), the compressive force causes the tissue(s) to necrose and form an anastomosis. By altering the arrangement of the magnetic poles of the magnetic segments in the devices, the magnetic interaction between paired devices can be altered. This property gives surgeons flexibility in choosing how much attractive force the devices will experience during a procedure.