Sutureless Percutaneous Sutureless Percutaneous Anastamosis DeviceAnastamosis Device

Steve ChenSteve Chen

Jamal SiddiquiJamal Siddiqui

AdvisorAdvisor

Dr. Raul GuzmanDr. Raul Guzman– Assistant Professor of Assistant Professor of

Surgery and Cell Biology, Surgery and Cell Biology, Vanderbilt UniversityVanderbilt University

– Division of Vascular Division of Vascular SurgerySurgery

– Vanderbilt University Vanderbilt University Medical CenterMedical Center

Peripheral Arterial DiseasePeripheral Arterial Disease

Narrowing of the arteries that Narrowing of the arteries that supply the legs with blood.supply the legs with blood.

8-12 million affected8-12 million affected

Risk factorsRisk factors

Symptoms:Symptoms:– Leg/Buttock pain and numbnessLeg/Buttock pain and numbness– ClaudicationClaudication– StrokeStroke– Heart AttackHeart Attack

Alternative MethodsAlternative Methods

Healthy DietHealthy Diet

Refrain from smokingRefrain from smoking

Regular exerciseRegular exercise

AngioplastyAngioplasty

ProblemProblem

Current aortobifemoral bypass surgeries Current aortobifemoral bypass surgeries are invasive and require long recovery are invasive and require long recovery periods.periods.

Current MethodCurrent Method

Problems with Current MethodProblems with Current Method

InvasiveInvasive

Long Recovery Time Long Recovery Time in Hospitalin Hospital– 5 - 7 days5 - 7 days– Bedrest 2 - 4Bedrest 2 - 4

Long Recovery Time Long Recovery Time outside Hospitaloutside Hospital

Prominent ScarringProminent Scarring

Risk of infectionRisk of infection

SolutionSolution

To create a sutureless percutaneous To create a sutureless percutaneous anastomosis device to allow the anastomosis device to allow the aortobifemoral bypass surgery to be aortobifemoral bypass surgery to be performed laparoscopically.performed laparoscopically.

Laparoscopic MethodLaparoscopic Method

AnesthesiaAnesthesia

Insufflation w/ CO2 Insufflation w/ CO2 ~15mmHg~15mmHg

Camera and 2-3 Camera and 2-3 trocars insertedtrocars inserted

Corrections madeCorrections made

Sew back upSew back up

Design ConstraintsDesign Constraints

Tube inside diameter 6mmTube inside diameter 6mm

Account for variety of thicknesses of Account for variety of thicknesses of vessel wallvessel wall

BiocompatibleBiocompatible

Very stableVery stable

Safe shapeSafe shape

Head piece: nitinolHead piece: nitinol

Plastic tubingPlastic tubing

Anchor pieceAnchor piece

Design StagesDesign Stages

Infrarenal Aorta

MarketMarket

26,200 surgeries per year26,200 surgeries per year

Only severely diseased need surgeryOnly severely diseased need surgery

Men/Women over 50Men/Women over 50– DiabeticsDiabetics– SmokersSmokers– High cholesterolHigh cholesterol– High blood pressureHigh blood pressure

Future ApplicationsFuture Applications

MicrolaparoscopyMicrolaparoscopy

Computer MotionComputer Motion– Robotic surgeryRobotic surgery– Minimally invasiveMinimally invasive– Accurate dissectionAccurate dissection

ReferencesReferences

http://www.lapsurgery.net/how_lapsurg.asphttp://www.lapsurgery.net/how_lapsurg.asphttp://www.vascularlaparoscopy.org/ilvc_techniques.htmlhttp://www.vascularlaparoscopy.org/ilvc_techniques.htmlhttp://my.webmd.com/hw/health_guide_atoz/aa118239.ahttp://my.webmd.com/hw/health_guide_atoz/aa118239.aspsphttp://computermotion.wwwa.com/clinicalapplications/puhttp://computermotion.wwwa.com/clinicalapplications/publications/vascular_abstracts.cfmblications/vascular_abstracts.cfmhttp://www.understandingpad.com/webcast_transcript.ashttp://www.understandingpad.com/webcast_transcript.asp?f=pad_comprehend&b=understandingpad&c=cardio_pp?f=pad_comprehend&b=understandingpad&c=cardio_padaware&transcript=yes&spg=VIDadaware&transcript=yes&spg=VIDhttp://www.nlm.nih.gov/medlineplus/tutorials/aortobifemohttp://www.nlm.nih.gov/medlineplus/tutorials/aortobifemoralbypass/vs019101.htmlralbypass/vs019101.htmlwww.laparoscopy.comwww.laparoscopy.com