Apparatus and methods for mapping out endoluminal gastrointestinal surgery

• US 20050203488A1
• Filed: 03/09/2004
• Published: 09/15/2005
• Est. Priority Date: 03/09/2004
• Status: Abandoned Application

• Current Assignee: USGI Medical, Inc., USGI Medical Incorporated
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Brenneman, Rodney, Michlitsch, Kenneth J., Maahs, Tracy
• Application Number:
  US10/797,910
• Publication Number:
  US 20050203488A1
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00244 adapted to separate target tissue from other tissue
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00494 Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1415 multiple blades
• CPC Class Codes: A61B 2018/144 Wire
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/3912 Body cavities
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3987 : Applicators for implanting markers
• CPC Class Codes: A61B 2090/3991 : having specific anchoring means to fixate the marker to the tissue, e.g. hooks
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 5/1076 : for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

Apparatus and methods are provided for mapping out endoluminal gastrointestinal surgery, including endoluminal gastric reduction. Mapping is achieved by locally marking the interior of the gastrointestinal lumen at specified locations. In a first embodiment, the surgical map comprises localized RF scarring or mucosal ablation. In an alternative embodiment, the map comprises pegs. In another alternative embodiment, the map comprises dye and/or spheres injected into at least the submucosa. As a still further alternative, the map may comprise the shaft of an endoluminal surgical tool having specified dimensions and/or color-coding, etc. In another alternative embodiment, the map may be formed from surgical mesh. In one preferred embodiment, placement of the map is accurately achieved by approximating the interior of the stomach with an endoluminal support via suction ports and/or via an inflatable member disposed along the support. Methods of using apparatus of the present invention are provided.

Claims

1. Apparatus for mapping out endoluminal gastrointestinal surgery, the apparatus comprising:

an endoluminal support configured for endoluminal placement within a gastrointestinal lumen; and

a marking device disposed on the support, the marking device configured to submucosally mark the gastrointestinal lumen.

2. The apparatus of claim 1, further comprising an approximation element configured to approximate the support and a mucosal surface of the gastrointestinal lumen.

3. The apparatus of claim 2, wherein the approximation element is disposed on the endoluminal support.

4. The apparatus of claim 2, wherein the approximation element comprises an element chosen from the group consisting of suction ports, inflation elements and combinations thereof.

5. The apparatus of claim 1, wherein the submucosal marking device comprises needles configured to penetrate mucosal tissue.

6. The apparatus of claim 5, wherein the needles are configured to inject marking elements submucosally.

7. The apparatus of claim 5, wherein the marking elements are chosen from the group consisting of dyes, fluorescent dyes, colored dyes, saline, bulking agents, collagen, spheres, nanospheres, magnetic materials, ferromagnetic materials, Curie point materials, plastic materials, inert materials, radiopaque materials, bioresorbable materials and combinations thereof.

8. Apparatus for mapping out endoluminal gastrointestinal surgery, the apparatus comprising:

an endoluminal support configured for endoluminal placement within a gastrointestinal lumen; and

a radiofrequency element on the support for marking the gastrointestinal lumen.

9. The apparatus of claim 8 further comprising an approximation element configured to approximate an interior of the gastrointestinal lumen and the endoluminal support.

10. The apparatus of claim 9, wherein the approximation element is disposed on the endoluminal support.

11. The apparatus of claim 8, wherein the radiofrequency element comprises at least one electrode, the at least one electrode disposed on a surface of the endoluminal support and coupleable to a radiofrequency generator.

12. The apparatus of claim 9, wherein the approximation element comprises an element chosen from the group consisting of suction ports, inflation elements and combinations thereof.

13. Apparatus for mapping out endoluminal gastrointestinal surgery, the apparatus comprising:

an endoluminal support configured for endoluminal placement within a gastrointestinal lumen; and

a marking device disposed on the support for marking the gastrointestinal lumen with pegs.

14. The apparatus of claim 13 further comprising an approximation element configured to approximate an interior of the gastrointestinal lumen and the endoluminal support.

15. The apparatus of claim 14, wherein the approximating element is disposed on the endoluminal support.

16. The apparatus of claim 13, wherein the marking device further comprises surgical mesh.

19. The apparatus of claim 15, wherein the approximating element is disposed on the endoluminal support.

17. Apparatus for mapping out endoluminal gastrointestinal surgery, the apparatus comprising:

an endoluminal support configured for endoluminal placement within a gastrointestinal lumen; and

indicia on the endoluminal support which are visible to provide a map of the endoluminal gastric reduction when the endoluminal support is present in the gastrointestinal lumen.

18. The apparatus of claim 17 further comprising an approximation element configured to approximate an interior of the gastrointestinal lumen and the endoluminal support.

20. The apparatus of claim 17, wherein the indicia are chosen from the group consisting of dimensions, shapes, colors, textures, and combinations thereof.

24. The method of claim 18, wherein submucosally marking the interior further comprises submucosally marking the interior with at least one marking element chosen from the group consisting of dye, bulking agents, spheres and combinations thereof.

21. A method for mapping out endoluminal gastric reduction, the method comprising:

advancing an endoluminal support into a patient'"'"'s stomach; and

submucosally marking an interior of the stomach at at least one specified location.

22. The method of claim 21, wherein submucosally marking the interior further comprises approximating the interior and the endoluminal support.

23. The method of claim 21, wherein submucosally marking the interior further comprises submucosally injecting at least one marking element into a wall of the stomach.

25. A method for mapping out endoluminal gastric reduction, the method comprising:

advancing a radiofrequency endoluminal support into a patient'"'"'s stomach; and

exposing an interior of the stomach to radiofrequency energy from the support at at least one specified location, wherein said exposure creates a visible marking.

26. The method of claim 25 further comprising approximating the interior of the stomach and the endoluminal support.

27. The method of claim 25, wherein exposing the interior to radiofrequency energy comprises locally burning a mucosa layer of the interior of the stomach.

28. A method for mapping out endoluminal gastric reduction, the method comprising:

advancing an endoluminal support into a patient'"'"'s stomach; and

marking an interior of the stomach at specified locations with at least one peg delivered from the endoluminal support.

29. The method of claim 28 further comprising approximating the interior of the stomach and the endoluminal support.

30. The method of claim 28 further comprising marking the interior with surgical mesh.

31. A method for mapping out endoluminal gastric reduction, the method comprising:

advancing an endoluminal support into a patient'"'"'s stomach; and

detecting indicia of the endoluminal support to map out endoluminal gastric reduction.