Method and device for use in endoscopic organ procedures

• US 20040092974A1
• Filed: 01/24/2003
• Published: 05/13/2004
• Est. Priority Date: 10/23/2002
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Satiety, Inc.
• Inventors: Gerbi, Craig, Weller, Gary, Gannoe, Jamy, Collier, Matthew J.
• Granted Patent: US 7,220,237 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0079 Pyloric or esophageal obstructions
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

Methods and devices for use in tissue approximation and fixation are described herein. The present invention provides, in part, methods and devices for acquiring tissue folds in a circumferential configuration within a hollow body organ, e.g., a stomach, positioning the tissue folds for affixing within a fixation zone of the stomach, preferably to create a pouch or partition below the esophagus, and fastening the tissue folds such that a tissue ring, or stomas, forms excluding the pouch from the greater stomach cavity. The present invention further provides for a liner or bypass conduit which is affixed at a proximal end either to the tissue ring or through some other fastening mechanism. The distal end of the conduit is left either unanchored or anchored within the intestinal tract. This bypass conduit also includes a fluid bypass conduit which allows the stomach and a portion of the intestinal tract to communicate.

Claims

1. A bypass conduit for placement within a hollow body organ, comprising:

a tubular member which defines a main lumen therethrough,

wherein the main lumen maintains communication from proximal to distal of the hollow body organ; and

wherein at least a portion of an outer surface of the tubular member is adapted to maintain fluid communication therealong.

2. The bypass conduit of claim 1 further comprising a reinforcing member along at least a portion of the tubular member.

3. The bypass conduit of claim 2 wherein the reinforcing member comprises a coil.

4. The bypass conduit of claim 1 wherein the tubular member further defines at least one fenestration along a region of a wall of the tubular member.

5. The bypass conduit of claim 4 wherein the fenestration is adapted to allow one-way fluid flow therethrough.

6. The bypass conduit of claim 5 wherein the fenestration comprises a one-way valve.

7. The bypass conduit of claim 1 wherein the outer surface further comprises at least one region of fluid permeable material.

8. The bypass conduit of claim 1 wherein the outer surface defines at least one channel when placed against tissue of the hollow body organ.

9. The bypass conduit of claim 1 wherein the outer surface defines at least one channel along at least the portion of the outer surface.

10. The bypass conduit of claim 9 wherein the channel maintains fluid communication between the hollow body organ and a region distal of the hollow body organ through the channel.

11. The bypass conduit of claim 9 wherein the tubular member further defines a plurality of additional channels along the outer surface.

12. The bypass conduit of claim 9 wherein the at least one channel extends between the hollow body organ and a region distal of the hollow body organ.

13. The bypass conduit of claim 9 wherein the at least one channel extends between a first region distal of the hollow body organ and a second region distal of the first region.

14. The bypass conduit of claim 9 wherein the at least one channel extends along a length of the tubular member.

15. The bypass conduit of claim 9 wherein the at least one channel is defined longitudinally along the outer surface.

16. The bypass conduit of claim 1 wherein the tubular member has a length configured to extend through the hollow body organ.

17. The bypass conduit of claim 1 wherein a proximal end of the tubular member is adapted to be affixed to tissue adjacent to or within the hollow body organ.

18. The bypass conduit of claim 17 wherein the proximal end is affixed to the tissue via at least one fastener selected from the group consisting of hooks, barbs, clamps, sutures, staples, stents, bands, and adhesives.

19. The bypass conduit of claim 17 wherein the proximal end is affixed to the tissue which is formed in a circumferential ring.

20. The bypass conduit of claim 17 wherein the proximal end further comprises a first gasket and a second gasket positioned distal of the first gasket such that the tissue is secured between the first and the second gasket.

21. The bypass conduit of claim 1 wherein a distal end of the tubular member is positionable distal of the hollow body organ.

22. The bypass conduit of claim 21 wherein the distal end is affixed to tissue located distally of the hollow body organ.

23. The bypass conduit of claim 21 wherein the distal end is unanchored.

24. The bypass conduit of claim 1 wherein the tubular member comprises a braided tubular structure adapted to be resistant to kinking.

25. The bypass conduit of claim 24 wherein the braided tubular structure is comprised of a superelastic metal.

26. The bypass conduit of claim 24 wherein the braided tubular structure further comprises a lubricious coating.

27. The bypass conduit of claim 26 wherein the lubricious coating comprises a polymeric material selected from the group consisting of Teflon, Nylon, Dacron, PTFE, polyethylene, polystyrene, polyurethane, and polyethylene terephthalate.

28. A method of bypassing a hollow body organ, comprising:

securing a proximal end of a tubular member to an artificial narrowing created within the hollow body organ; and

positioning a distal end of the tubular member such that the distal end is distal of the hollow body organ.

29. The method of claim 28 further comprising creating a narrowing within or partially within the hollow body organ prior to securing the proximal end.

30. The method of claim 28 further comprising creating a narrowing of tissue proximal of or partially within the hollow body organ while securing the proximal end.

31. The method of claim 28 further comprising advancing the tubular member transesophageally to the hollow body organ.

32. The method of claim 28 wherein securing the proximal end further comprises securing the tubular member to a stoma created within the hollow body organ.

33. The method of claim 32 wherein the stoma is created by a band constricting the hollow body organ.

34. The method of claim 28 wherein securing the proximal end further comprises securing the tubular member to a narrowing of tissue created proximal of or partially within the hollow body organ.

35. The method of claim 28 wherein securing the proximal end further comprises securing the tubular member to at least one intragastric staple line created within the hollow body organ.

36. The method of claim 28 wherein securing the proximal end further comprises securing the tubular member to the hollow body organ with at least one fastener.

37. The method of claim 36 wherein the fastener is selected from the group consisting of hooks, barbs, clamps, sutures, staples, stents, bands, and adhesives.

38. The method of claim 28 wherein securing the proximal end further comprises securing the proximal end with a first gasket and a second gasket positioned distal of the first gasket such that tissue is secured between the first and the second gasket.

39. The method of claim 28 wherein positioning the distal end further comprises affixing the distal end to tissue distal of the hollow body organ.

40. The method of claim 28 wherein positioning the distal end further comprises leaving the distal end unanchored.

41. The method of claim 28 further comprising maintaining fluid communication between the hollow body organ and a region distal of the hollow body organ.

42. The method of claim 28 further comprising maintaining fluid communication between a first region distal of the hollow body organ and a second region distal of the first region.