1. Sutureless Percutaneous Anastamosis Device
Steve Chen
Jamal Siddiqui

2. Advisor
Dr. Raul Guzman
Assistant Professor of Surgery and Cell Biology, Vanderbilt University
Division of Vascular Surgery
Vanderbilt University Medical Center

3. Peripheral Arterial Disease
Narrowing of the arteries that supply the legs with blood.
8-12 million affected
Risk factors
Symptoms:
Leg/Buttock pain and numbness
Claudication
Stroke
Heart Attack
How many actually get surgery or need it?
8.6 million of these people are without symptoms
PAD is a narrowing of the arteries that supply the legs with blood. The arteries can fill up with plaque or calcium and other kinds of things that will narrow the arteries in the legs.
ANNOUNCER:  This narrowing of the arteries in the legs leads to inadequate blood flow. (leads to atherosclerosis: hardening of arteries due to calcium deposition)
This atherosclerotic blockage, by itself, is usually considered to be irreversible, but the rate at which it develops can be markedly blocked by a good, healthy lifestyle and by the use of medications that lower the importance of these risk factors.
These risk factors include smoking, diabetes, high blood pressure and high blood cholesterol.
Claudication is a discomfort that is sometimes described as a fatigue, a numbness, a cramping, or may actually be a severe pain that occurs in these muscles with walking and that is relieved when the patient stops to rest.  Unfortunately, when the patient begins to walk again, claudication reappears and limits the patient's ability to perform their activities of daily living.
Symptoms are hard to find.

4. Alternative Methods Healthy Diet Refrain from smoking Regular exercise
Angioplasty

5. Problem
Current aortobifemoral bypass surgeries are invasive and require long recovery periods.
Say how our device itself is not going to cut down recovery time, but it’ll make it easier for laparoscopy, which is the ultimate goal, to cut down on recovery time.

6. Current Method
Incision, expose artery, clamp, suture, close up

7. Problems with Current Method
Invasive
Long Recovery Time in Hospital
5 - 7 days
Bedrest 2 - 4
Long Recovery Time outside Hospital
Prominent Scarring
Risk of infection

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

9. Laparoscopic Method Anesthesia Insufflation w/ CO2 ~15mmHg
Camera and 2-3 trocars inserted
Corrections made
Sew back up
Don’t have to separate skin from muscle tissue
Suflation to 15mmHg

10. Design Constraints Tube inside diameter 6mm
Account for variety of thicknesses of vessel wall
Biocompatible
Very stable
Safe shape

11. 2003-2004 Project Infrarenal Aorta Plastic tubing Anchor
Proximal Balloon
Distal Balloon
Infrarenal Aorta

12. Design Stages Head piece: nitinol Plastic tubing Anchor piece
Infrarenal Aorta

13. Market 26,200 surgeries per year Only severely diseased need surgery
Men/Women over 50
Diabetics
Smokers
High cholesterol
High blood pressure

14. Future Applications Microlaparoscopy Computer Motion Robotic surgery
Minimally invasive
Accurate dissection
Laparoscope 10-12mm down to 3mm, also trocars are smaller.

15. References http://www.lapsurgery.net/how_lapsurg.asp