1. A tool for performing anastomosis between a graft vessel and a target vessel, comprising:
an anvil arm including
a channel defined therein,
a contact surface, and
at least one upper opening defined through said contact surface into said channel; wherein said upper opening faces in a direction away from the longitudinal centerline of said channel; and
a cutting element movable along said channel in said anvil arm, said cutting element including a projection extending therefrom; and wherein said cutting element is movable perpedicular to the longitudinal centerline of said channel through said upper opening from a position in which substantially all of said projection is located within said channel to a position in which at least part of said projection is located outside said channel.
2. The tool of claim 1, wherein said projection extends upward from said cutting element.
3. The tool of claim 1, wherein said projection is positioned in proximity to the distal end of said cutting element.
4. The tool of claim 1, wherein at least the distal end of said cutting element is biased downward.
5. The tool of claim 4, further comprising
a staple holder movable relative to said anvil arm; and
a biasing element having two ends, wherein one end of said biasing element is connected to said staple holder and the other end of said biasing element engages said cutting element to bias downward at least the distal end of said cutting element.
6. The tool of claim 5, further comprising a post connected to said staple holder, wherein one end of said biasing element is fixed to said post.
7. The tool of claim 4, wherein an upper surface of said cutting element proximal to said projection is substantially planar.
8. The tool of claim 4, wherein said cutting element further comprises a keel extending downwardly therefrom.
9. The tool of claim 8, wherein said keel is located substantially at the distal end of said cutting element.
10. The tool of claim 8, wherein said anvil arm has a lower surface; further comprising at least one lower opening through said lower surface of said anvil arm into said channel, wherein said lower opening is sized to admit said keel at least partially.
11. The tool of claim 8, further comprising a first lower opening and a second lower opening through said lower surface of said anvil arm into said channel, wherein said first lower opening and said second lower opening are sized to admit said keel at least partially.
12. The tool of claim 11, wherein the distance between the distal end of said first lower opening and the proximal end of said second lower opening defines the length of an incision in the wall of the target vessel made by said projection.
13. The tool of claim 1, wherein at least the distal end of said cutting element is biased upward.
14. The tool of claim 13, further comprising an anvil insert connected to said anvil arm, said anvil insert having a hollow space defined therein and an aperture connecting said space to said channel.
15. The tool of claim 14, further comprising a cam connected to said anvil insert, said cam located substantially adjacent to said aperture.
16. The tool of claim 15, wherein said cam is located above said aperture.
17. The tool of claim 15, further comprising a first cam follower on the upper surface of said cutting element, said first cam follower configured to engage said cam as said cutting element moves within said channel.
18. The tool of claim 17, further comprising a second cam follower on the upper surface of the cutting element, said second cam follower positioned proximal to said first cam follower and configured to engage said cam as said cutting element moves within said channel.
19. The tool of claim 18, wherein the distance between the proximal end of said first cam follower and the distal end of said second cam follower defines the length of an incision in the wall of the target vessel made by said projection.
20. The tool of claim 1, wherein said cutting element further comprises a safety recess defined therein; further comprising a safety feature connected to said anvil arm, said safety feature disengageable from said safety recess.
21. The tool of claim 20, wherein said safety feature includes a tip disengageable from said safety recess.
22. The tool of claim 21, wherein said tip is oriented substantially transverse to the longitudinal centerline of said cutting element.
23. The tool of claim 21, wherein said safety recess is defined on the bottom surface of said cutting element.
24. The tool of claim 1, wherein said cutting element further comprises a second projection, said second projection extending substantially distally from the distal end of said cutting element.
25. The tool of claim 1, further comprising a tissue stop connected to said anvil arm.
26. The tool of claim 25, wherein said tissue stop extends above said anvil arm.
27. The tool of claim 1, wherein said cutting element comprises a foot at its proximal end.
28. The tool of claim 27, further comprising an anvil insert connected to said anvil arm, said anvil insert having a hollow space defined therein connected to said channel, wherein said anvil insert further comprises a cutting element stop configured to engage said foot.
29. The tool of claim 1, wherein said anvil arm has a sharp distal end.
30. The tool of claim 1, further comprising a moveable incising element at the distal end of said anvil arm.
31. The tool of claim 1, further comprising a staple holder moveable relative to said anvil arm.
32. The tool of claim 31, wherein said staple holder is rotatable relative to said anvil arm.
33. The tool of claim 31, wherein said cutting element further comprises an engagement member; and wherein said staple holder includes a receiver configured to engage said engagement member.
34. The tool of claim 33, wherein said receiver is translatable, and wherein translation of said receiver causes translation of said engagement member.
35. The tool of claim 33, wherein said engagement member extends substantially upward from said cutting element.
36. The tool of claim 31, wherein said staple holder further comprises a rail along which said receiver translates.
37. The tool of claim 31, further comprising a pin about which said anvil arm and said staple holder are configured to rotate relative to one another.
38. The tool of claim 37, wherein said pin is fixed to said staple holder.
39. The tool of claim 31, further comprising an interface structure connected to said staple holder.
40. The tool of claim 31, further comprising an interface structure proximal to said anvil arm.
41. The tool of claim 31, wherein said staple holder comprises two arms spaced apart from one another, wherein each said arm is configured to deploy at least one staple into said target vessel and said graft vessel.
42. The tool of claim 31, wherein a plurality of flaps are present at the end of the graft vessel, and wherein said staple holder comprises a plurality of clamping elements for holding the flaps of the graft vessel in place relative to the side of the target vessel.
43. The tool of claim 1, further comprising an energy source connected to said cutting element.
44. The tool of claim 43, wherein said cutting element is configured to transmit energy into the wall of the target vessel.
45. The tool of claim 1, further comprising
an ultrasound generator connected to said cutting element; and
a source of electrical energy connected to said ultrasound generator.
46. An anvil for use in performing anastomosis between a vessel and a target vessel, comprising:
an anvil arm;
a channel defined within said anvil arm; and
a cutting element moveable perpendicular to a longitudinal centerline of said channel and along said anvil arm through said channel;
wherein said anvil arm has a lower surface; further comprising at least one lower opening through said lower surface of said anvil arm into said channel.
47. The anvil of claim 46, wherein said cutting element further comprises a projection extending upward therefrom.
48. The anvil of claim 47, wherein said projection is located substantially at the distal end of said cutting element.
49. The anvil of claim 47, wherein said cutting element further comprises a second projection, said second projection extending substantially distally from the distal end of said cutting element.
50. The anvil of claim 46, wherein said cutting element further comprises a keel extending downward therefrom.
51. The anvil of claim 50, wherein said keel is located substantially at the distal end of said cutting element.
52. The system of claim 43, wherein said energy source is a source of laser energy.
53. The system of claim 43, wherein said energy source is a source of RF energy.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. A cover member for a fluid-dispensing power toothbrush, which includes a handle portion, a head portion and a fluid system which in turn includes a fluid reservoir which extends substantially entirely along an outer surface of the handle in operation of the toothbrush, comprising:
a cover member configured to overlay and mate with a portion of the handle, forming an exterior surface of a lower portion of the toothbrush when the cover member is in a closed position, wherein the cover member is configured relative to the outer surface of the handle to define a space therebetween to accommodate the fluid reservoir when the cover member is in a closed position, and wherein the fluid reservoir is accessible for removal when the cover member is in its open position; and
a connector assembly for movably attaching the cover member to the handle to permit the cover member to move between said open and closed positions.
2. The cover member of claim 1, wherein the connector assembly is located near the bottom of the cover member and the handle, permitting pivoting movement of the cover member between open and closed positions relative to the handle.
3. The cover member of claim 1, wherein the connector assembly is located near the top of the cover member and the handle, permitting pivoting movement of the cover member between open and closed positions relative to the handle.
4. The cover member of claim 2, wherein the cover member includes a latch member near the top end thereof and the handle includes a receiving member for the latch member, to secure the cover in its closed position.
5. The cover member of claim 3, wherein the cover member includes a latch member near the lower end thereof and the handle includes a receiving member for the latch member, to secure the cover in its closed position.
6. The cover member of claim 1, wherein the connector assembly is located at one side edge of the cover member.
7. The cover member of claim 2, wherein the connector assembly includes two opposing tapered pin elements which extend inwardly toward each other from an interior surface of the cover member, and further includes two mating tapered openings in the handle portion for rotatably receiving said pin elements.
8. The cover member of claim 7, wherein the pin elements are approximately 116-inch high.
9. The cover member of claim 1, wherein the cover member has a curved configuration which forms a part of the exterior surface of a lower portion of the toothbrush.
10. The cover member of claim 1, wherein the cover member has an interior surface which is configured and arranged such that when the cover member moves into its closed position, the cover member shapes the reservoir against an exterior surface of the handle portion, thereby minimizing the space required for the reservoir in the toothbrush.
11. The cover member of claim 10, wherein the interior surface of the cover member is configured to move a portion of fluid to the pump when the cover member moves into its closed position, thereby priming the pump, following installation of a new reservoir in the toothbrush.
12. The cover member of claim 1, wherein the cover member has a lower end element configured such that, when the cover member is open, it acts as a stop against a lower end of the handle portion to stop further rotation of the cover member when the cover member reaches a selected angle relative to the handle portion.
13. The cover member of claim 10, wherein the angle is approximately 120\xb0.
14. The cover member of claim 1, wherein the cover member includes a button member as part of its surface, overlaying an actuation button for the pump, and wherein the cover button is adapted and constructed such that it moves inwardly under pressure against a pump actuation element and rebounds to an original shape when pressure on the button is released.
15. The cover member of claim 1, wherein the cover member includes an opening in registry with an actuation member on the pump, permitting a user to actuate the pump when the cover is in a closed position.