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

4. Alternative Methods Preventative measures –Healthy Diet –Refrain from smoking –Regular exercise Angioplasty BIOTRONIK Absorbable Metal Stent (78% success) Metal Stent (78% success) Surgery (>98% success)

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

6. Current Method

7. Problems with Current Method Invasive Long Recovery Time in Hospital –5 to 7 days Prominent Scarring Risk of infection ~2.6% Long Recovery Time outside Hospital

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

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

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

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

13. Prototype

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

15. Future Applications Microlaparoscopy Computer Motion –Robotic surgery –Minimally invasive –Accurate dissection

16. References http://www.lapsurgery.net/how_lapsurg.asp http://www.vascularlaparoscopy.org/ilvc_techniques.html http://my.webmd.com/hw/health_guide_atoz/aa118239.a sp http://my.webmd.com/hw/health_guide_atoz/aa118239.a sp http://computermotion.wwwa.com/clinicalapplications/pu blications/vascular_abstracts.cfm http://computermotion.wwwa.com/clinicalapplications/pu blications/vascular_abstracts.cfm http://www.understandingpad.com/webcast_transcript.as p?f=pad_comprehend&b=understandingpad&c=cardio_p adaware&transcript=yes&spg=VID http://www.understandingpad.com/webcast_transcript.as p?f=pad_comprehend&b=understandingpad&c=cardio_p adaware&transcript=yes&spg=VID http://www.nlm.nih.gov/medlineplus/tutorials/aortobifemo ralbypass/vs019101.html http://www.nlm.nih.gov/medlineplus/tutorials/aortobifemo ralbypass/vs019101.html www.laparoscopy.com