Obesity treatment tools and methods

• US 20030120265A1
• Filed: 12/05/2002
• Published: 06/26/2003
• Est. Priority Date: 05/30/2001
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Bernard H. Andreas, Douglas S. Sutton, Hanson S. Gifford III, Mark E. Deem, Ronald G. French
• Inventors: French, Ronald G., Sutton, Douglas S., Gifford, Hanson S. III, Andreas, Bernard H., Deem, Mark E.
• Granted Patent: US 7,288,099 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Claims

1. A system for organ volume reduction, comprising:

an elongate tubular device having a proximal end, a distal end, with a length therebetween and a lumen defined throughout the length, wherein the device is adapted for insertion into an hollow body organ, the device being further adapted to draw up a portion of an interior wall of the hollow body organ to be rotated about a longitudinal axis of the device; and

a fastening device adapted to fasten the rotated portion of the interior wall.

2. The system of claim 1 wherein the device for insertion is inserted into the hollow body organ endoscopically via an esophageal passageway.

3. The system of claim 1 wherein the lumen defines a passageway for drawing up the portion of the interior wall of the organ via a vacuum.

4. The system of claim 1 wherein the fastening device comprises an elastic band disposed about the distal end of the device, wherein the band is adapted to slide over and secure the portion of the interior wall.

5. The system of claim 1 wherein the device for insertion comprises at least two elongate members, each member having a proximal end and a distal end with a length therebetween, the members being rotatably connected at the proximal end and the distal end such that the members are biased towards each other.

6. The system of claim 5 wherein the elongate members define an uneven surface.

7. The system of claim 1 wherein the device for insertion comprises an instrument having manipulatable grasping members at the distal end for grasping the portion of the interior wall of the hollow body organ.

8. The system of claim 7 wherein the fastening device comprises a catheter having a cinching distal end adapted to cinch the portion of the interior of the organ.

9. The system of claim 1 wherein the fastening device comprises a clip adapted to be inserted into the lumen.

10. The system of claim 9 wherein the clip comprises two adjacent members attached at a proximal end, the distal ends of each member being configured to pierce tissue.

11. The system of claim 1 wherein the fastening device comprises a screw configured to be inserted into a channel defined within the device.

12. The system of claim 11 wherein the screw comprises a helical shape.

13. The system of claim 12 wherein a diameter of a distal end of the screw is larger than a diameter of a proximal end of the screw.

14. The system of claim 13 wherein a length between the distal end of the screw and the proximal end of the screw is tapered.

15. The system of claim 14 wherein the screw is configured to alternatingly pierce a first area of tissue and a second area of tissue while approximating the first area of tissue and the second area of tissue together.

16. The system of claim 1 further comprising a plurality of additional fastening devices, each of the fastening devices being configured to fasten the portion of interior while juxtaposed linearly to form a continuous fixation line.

17. The system of claim 1 wherein the fastening device comprises at least one staple.

18. The system of claim 1 wherein the device defines a slot along the length for drawing up the portion of the interior wall, wherein the slot is in fluid communication with the lumen.

19. The system of claim 18 further comprising at least one attachment point positioned adjacent to the channel.

20. The system of claim 1 wherein the device comprises a tubular member that is longitudinally splittable, wherein each tubular half has at least one attachment point positioned thereon such that the attachment points are in apposition to one another when the tubular member is joined together.

21. The system of claim 1 wherein the device comprises at least two elongate members, each member having a proximal end, a distal end, with a length therebetween and a lumen defined throughout each length, the members being rotatably connected at the proximal ends to a handle, each member defining a slot along each length in communication with each respective lumen, wherein each member is adapted to counter-rotate relative to one another about a longitudinal axis defined by each member.

22. The system of claim 21 wherein each member is parallel to one another.

23. The system of claim 21 further comprising a vacuum pump in fluid communication with each slot through each respective lumen.

24. A method of creating a narrowing of an hollow body organ having a main lumen, comprising:

adhering a portion of an interior wall of the hollow body organ to a device adapted to rotate about a longitudinal axis defined by the device;

rotating the device about the longitudinal axis while maintaining adherence to the portion of interior wall, the device being rotated until a narrowing of the hollow body organ is defined; and

fastening the portion of interior wall to the hollow body organ such that the narrowing of the hollow body organ is maintained.

25. The method of claim 24 wherein the device comprises a tube having a proximal end and a distal end with a lumen defined therebetween, the tube defining an opening proximal of the distal end.

26. The method of claim 24 wherein adhering the portion of interior wall comprises adhering the wall to the device via a vacuum created in at least one opening defined along the device.

27. The method of claim 26 further comprising adhering the portion of interior wall to the device via a plurality of attachment points disposed adjacent to the opening.

28. The method of claim 27 wherein the attachment points are selected from the group consisting of tines, barbs, and hooks.

29. The method of claim 24 wherein adhering the portion of interior wall comprises adhering a first portion of the wall to a first elongate member and adhering a second portion of the wall to a second elongate member, wherein the first and second elongate members are each adapted to counter-rotate relative to one another about a longitudinal axis defined by each elongate member.

30. The method of claim 24 wherein the portion of interior wall is fastened to the hollow body organ by a mechanical fastener selected from the group consisting of staples, blind staples, clips, tags, screws, and adhesives.

31. The method of claim 24 wherein rotating the device comprises rotating the device up to 360°

.

32. The method of claim 24 wherein rotating the device comprises rotating the device 360°

or more.