Apparatus and methods for treatment of morbid obesity
First Claim
1. A method of treating a patient, comprising the steps of:
- providing an elongate tubular body, having a proximal end, a distal end, and a flow restrictor; and
positioning the tubular body in the patient such that the distal end is in the intestine, and the flow restrictor is in the stomach, spaced apart from the pylorus.
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Abstract
Apparatus and methods are described for treatment of morbid obesity using minimally invasive techniques. The apparatus includes a system of components that may be used separately or in combination for effectively reducing stomach volume, bypassing a portion of the stomach and/or small intestines, reducing nutrient absorption in the stomach and/or small intestines and/or depositing minimally or undigested food farther than normal into the intestines, thereby stimulating intestinal responses. The components described include an artificial stoma device, a gastric sleeve device, an intestinal sleeve device, a combined gastrointestinal sleeve device and permanent and detachable attachment systems. Also described are devices for delivering and deploying the components of the system.
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Citations
42 Claims
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1. A method of treating a patient, comprising the steps of:
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providing an elongate tubular body, having a proximal end, a distal end, and a flow restrictor; and
positioning the tubular body in the patient such that the distal end is in the intestine, and the flow restrictor is in the stomach, spaced apart from the pylorus. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method of treating a patient, comprising the steps of:
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establishing a flow restriction within the stomach, in between the LES and pylorus; and
positioning a tube between the flow restriction and the intestine. - View Dependent Claims (11, 12, 13)
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14. A method of treating a patient, comprising the steps of:
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providing a tube, having a proximal end, a distal end and a lumen extending therethrough;
positioning the proximal end in the stomach and the distal end in the intestine; and
preventing gastric juices expressed from the wall of the stomach distally of the proximal end from entering the lumen. - View Dependent Claims (15)
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16. An endolumenal bypass method for treating obesity in a mammal, comprising the steps of:
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establishing a pseudo stomach within the mammal, having a restricted distal opening;
establishing a flow path between the restricted opening and a point in the intestine distal to the duodenum. - View Dependent Claims (17, 18)
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19. An upper gastrointestinal implant, comprising:
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an elongate, tubular body, having a proximal end and a distal end;
a funnel opening on the proximal end; and
a support structure, spaced distally apart from the proximal end;
wherein the implant is dimensioned such that the proximal end is positioned in between the antrum and the lower esophageal sphincter when the support structure is positioned in the antrum. - View Dependent Claims (20, 21, 22, 23)
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24. A method of treating a patient, comprising the steps of:
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providing an elongate tubular body, having a proximal end and a distal end;
positioning the tubular body such that the proximal end is within the stomach and the distal end is in the intestine; and
retaining the tubular body in position by engaging an anchor on the tubular body with adjacent tissue;
wherein the anchor is spaced distally apart from the proximal end of the tubular body. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35)
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36. A method of transesophageally deploying a tubular implant within a patient, comprising the steps of:
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providing a tubular implant, having a proximal end, a distal end, and a central lumen;
the distal end initially positioned within the central lumen such that the distal most aspect of the implant is initially an intermediate portion of the implant;
transesophageally advancing the implant, intermediate portion first, through the stomach at least as far as the antrum; and
everting the distal end of the implant from the central lumen and into the intestine.
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37. A method of increasing the effective length of an endolumenal intestinal bypass, comprising the steps of:
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positioning an endolumenal bypass tube within an intestine such that a distal end of the bypass tube is initially positioned at a first point in the intestine;
anchoring the tube against distal migration with respect to the stomach; and
permitting peristalsis to draw the intestine proximally with respect to the tube, thereby locating the distal end at a position within the intestine which is distal to the first point.
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38. A method of positioning a tubular implant within an intestine of a patient, comprising the steps of:
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providing an elongate, tubular body, having a proximal end, a distal end, and a first magnet secured to the distal end;
transesophageally introducing the distal end into the stomach;
advancing the distal end into the pylorus; and
advancing the distal end from the pylorus into the intestine;
wherein at least the advancing the distal end from the pylorus into the intestine step is accomplished using a second magnet, external to the patient.
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39. A method of treating a patient, comprising the steps of:
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providing a gastrointestinal sleeve, having a proximal end, a distal end and a length of at least about 50 cm;
positioning the sleeve with the proximal end adjacent an attachment site in the vicinity of the lower esophageal sphincter, with the distal end extending transluminally at least as far as the jejunum;
forming at least one plication at the attachment site; and
securing the sleeve to the plication. - View Dependent Claims (40, 41, 42)
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Specification