Percutaneous gastroplasty

• US 20050216042A1
• Filed: 05/10/2005
• Published: 09/29/2005
• Est. Priority Date: 03/23/2004
• Status: Active Grant

• Current Assignee: Michael Gertner
• Original Assignee: Michael Gertner
• Inventors: Gertner, Michael
• Granted Patent: US 7,670,279 B2
• Time in Patent Office: Days
• US Class Current: 606/151
• 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 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00871 polymeric
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Disclosed are methods and apparatus for implantation into the walls of an organ such as the stomach. Deformable or inflatable anchors with a connector between are used to pull the walls of the organ together, or to implant devices in the wall of the organ. Also disclosed are surgical instruments useful in practicing the disclosed methods.

Claims

1. A method for implanting an organ traversing device in a patient, comprising:

placing a first surgical instrument adjacent to a second exterior surface of the organ;

passing a first end of a second surgical instrument through a patient'"'"'s skin, through a first exterior surface of the organ, through the interior of the organ, and thence through a second exterior surface of the organ, so that the surgical instrument traverses the organ;

contacting the first surgical instrument with the second surgical instrument;

deploying a first anchor from the first surgical instrument wherein the first anchor is located adjacent to the second exterior surface of the organ;

deploying a second anchor within the patient;

providing at least one connector wherein the connector contacts the first anchor, and the second anchor;

stabilizing the first and second anchors and the at least one connector by engaging the at least one connector with the first and second anchors.

2. The method of claim 1 further comprising urging said first anchor and said second anchor toward each other such that a tensile stress exists in said at least one connector.

3. The method of claim 1 wherein said second anchor contacts said second exterior surface of said organ.

4. The method of claim 1, wherein said patient'"'"'s skin is overlying the patient'"'"'s stomach, said organ is the patient'"'"'s stomach, said first exterior surface is the anterior wall of the stomach, said second exterior surface is the posterior wall of the stomach.

5. The method of claim 1, further comprising adjusting the length of said connector between said anterior and said posterior walls of the stomach after implantation of said organ traversing anchors is finished.

6. The method of claim 1, wherein the first or second surgical instrument is inserted into the patient'"'"'s abdomen by directly penetrating the patient'"'"'s skin and abdominal wall, by passing the surgical instrument through a laparoscopic port, or by passing the surgical instrument through an incision in the patient'"'"'s skin and abdominal wall.

7. A method for treating a patient comprising,

passing a first anchor through the skin of a patient;

positioning the first anchor adjacent to the posterior wall of the stomach;

passing at least one connector through the patient'"'"'s skin and thence through the patient'"'"'s anterior and posterior stomach walls;

contacting the first anchor and the at least one connector;

passing a second anchor through the skin of a patient'"'"'s abdominal wall;

connecting the first and second anchors by means of the at least one connector;

urging the first and second anchors toward each other; and

fixing the anterior and posterior walls of the stomach in the urged position with said first and second anchors.

8. The method of claim 7, wherein said second anchor is deployed within the peritoneal cavity.

9. The method of claim 7, wherein said second anchor is deployed between the abdominal skin and the outermost peritoneum of the abdominal cavity.

10. The method of claim 7, wherein passing said first anchor through the patient'"'"'s abdominal skin is done while said first anchor is in a reduced profile configuration, further comprising said first anchor subsequently being in a deployed configuration.

11. The method of claim 10, wherein said reduced profile configuration of said first anchor is substantially folded, and/or compressed, and/or uninflated, and said deployed configuration is substantially unfolded and/or uncompressed and/or inflated.

12. The method of claim 7 further comprising, repeating the steps of claim 7 for additional anchors in the same organ.

13. The method of claim 7, wherein said urging does not completely prevent food from passing through the stomach.

14. The method of claim 7 wherein said urging completely prevents food from passing through the region of the anterior and posterior fasteners.

15. The method of claim 7, further comprising delivering an electrical signal to said anterior stomach wall through said second anchor.

16. The method of claim 7, further comprising delivering an electrical signal to said posterior stomach wall through said first anchor.

17. A method of treating a patient, comprising:

positioning a surgical device having a reversibly engaged first anchor near an organ or near an organ-organ connection of the patient;

positioning or forming an elongate member in the patient, comprising a proximal end, a distal end and a circumferential wall forming a lumen sized to receive at least one connector therethrough, wherein the connector has a proximal end and a distal end;

engaging the first anchor with the distal end of the connector, the distal end of the connector advanced through the lumen of the elongate member, through a first portion of the organ, and thence through a second portion of the organ;

releasing the first anchor from the surgical device such that the first anchor remains engaged with the distal end of the connector;

advancing a second anchor over the proximal end of the connector wherein the second anchor tracks along the connector toward the distal end;

urging the first and second anchors together;

releasing the second anchor such that the second anchor engages the connector; and

,

cutting the connector such that the connector has a length that spans the first and second anchors.

18. The method of claim 17, wherein said organ or said organ-organ connection is one of:

the lung,

the colon;

the stomach;

the small intestine;

the liver;

the spleen;

a vein;

an artery;

a gastrojejenustomy;

a jejunoenterostomy;

a gastroduodenostomy;

and a colocolostomy.

19. The method of claim 17 further comprising adjusting said length of said connector at a time subsequent to said cutting step.

20. The method of claim 19 wherein said organ is the stomach.