Method of using endoscopic truncal vagoscopy with gastric bypass, gastric banding and other procedures

• US 20060015151A1
• Filed: 07/05/2005
• Published: 01/19/2006
• Est. Priority Date: 03/14/2003
• Status: Abandoned Application

• Current Assignee: EndoVx, Inc.
• Original Assignee: EndoVx, Inc.
• Inventors: Aldrich, William N.
• Application Number:
  US11/175,553
• Publication Number:
  US 20060015151A1
• Time in Patent Office: Days
• US Class Current: 607/40
• CPC Class Codes: A61F 5/0026 Anti-eating devices using electrical stimulation
• CPC Class Codes: A61F 5/005 Gastric bands
• CPC Class Codes: A61N 1/40 Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 for thermotherapy, e.g. hyperthermia

Abstract

Methods and devices for treating obesity by combining known bariatric surgeries with a method for disrupting the vagal nerve. The method for disrupting the vagal nerve comprises use of a high energy delivery device which is positioned within the esophagus to deliver transesophageal energy to interrupt the function of one or both branches of the vagal nerves. Combination of this method with known methods, such as gastric bypass and gastric banding, may increase weight loss by the patient in comparison to a single treatment on its own. In addition, methods and devices for disposing a restrictive structure such as a mesh around a selected segment of the gastrointestinal tract prevents enlargement of the segment.

Claims

2. The method of claim 1, further comprising attaching a restrictive structure to a portion of the stomach to maintain a desired size of the portion.

7. A method for reducing obesity comprising:

positioning an energy delivery device within the esophagus;

energizing the delivery device to deliver energy to the site of at least one vagal nerve branch on the outer wall of the esophagus; and

performing a gastric banding surgery, wherein the stomach is divided into at least a small upper pouch and a larger lower pouch.

8. The method of claim 7, further comprising attaching a restrictive structure to the upper pouch configured to prevent enlargement of the pouch.

9. The method of claim 7, further comprising attaching a restrictive structure to the lower pouch configured to prevent enlargement of the pouch.

10. The method of claim 7, wherein said energy is highly focused ultrasound.

11. The method of claim 8, wherein the restrictive structure comprises a mesh.

12. The method of claim 8, wherein the restrictive structure includes cloth.

13. The method of claim 8, wherein the restrictive structure includes nitinol.

14. The method of claim 9, wherein the restrictive structure comprises a mesh.

15. The method of claim 9, wherein the restrictive structure includes cloth.

16. The method of claim 9, wherein the restrictive structure includes nitinol.

17. The method of claim 7, further comprising adjusting the position of the energy delivery device along a first axis and a second axis, the first axis being a longitudinal axis of the esophagus and the second axis being transversely along a radius of the esophagus.

18. A method for reducing obesity comprising:

positioning an energy delivery device within the esophagus;

energizing the delivery device to deliver energy to the site of at least one vagal nerve branch on the outer wall of the esophagus; and

electrically stimulating the vagal nerve with another device.

19. The method of claim 18, further comprising adjusting the position of the energy delivery device along a first axis and a second axis, the first axis being a longitudinal axis of the esophagus and the second axis being transversely along a radius of the esophagus.

20. A method for reducing obesity comprising:

positioning an energy delivery device within the esophagus;

energizing the delivery device to deliver energy to the site of at least one vagal nerve branch on the outer wall of the esophagus; and

performing surgical reduction of the size of the stomach.

21. The method of claim 20, further comprising adjusting the position of the energy delivery device along a first axis and a second axis, the first axis being a longitudinal axis of the esophagus and the second axis being transversely along a radius of the esophagus.

22. The method of claim 20, further comprising attaching a restrictive structure to the stomach configured to prevent enlargement of the stomach.

23. The method of claim 22, wherein the restrictive structure comprises a mesh.

24. The method of claim 22, wherein the restrictive structure includes cloth.

25. The method of claim 22, wherein the restrictive structure includes nitinol.

26. A method for reducing obesity comprising:

positioning an energy delivery device within the esophagus;

adjusting the position of the energy delivery device along a first axis and a second axis, the first axis being a longitudinal axis of the esophagus and the second axis being tranversely along a radius of the esophagus; and

causing the energy delivery device to deliver energy to the site of at least one vagal nerve branch on the outer wall of the esophagus.

1. A method for reducing obesity comprising:

positioning an energy delivery device within the esophagus;

energizing the delivery device to deliver energy to the site of at least one vagal nerve branch on the outer wall of the esophagus; and

performing a gastric bypass surgery.

3. The method of claim 1, wherein the restrictive structure comprises a mesh.

4. The method of claim 1, wherein the restrictive structure includes cloth.

5. The method of claim 1, wherein the restrictive structure includes nitinol.

6. The method of claim 1, further comprising adjusting the position of the energy delivery device along a first axis and a second axis, the first axis being a longitudinal axis of the esophagus and the second axis being transversely along a radius of the esophagus.

27. The method of claim 26, further comprising creating gastrointestinal folds within the gastrointestinal tract to reduce adsorption.

27-1. The method of claim 26, further comprising inserting one or more intestinal sleeves within the small bowel.

28. The method of claim 26, further comprising inserting one or more gastric sleeves within the stomach.

29. The method of claim 28, wherein the restrictive structure comprises a mesh.

30. The method of claim 28, wherein the restrictive structure includes cloth.

31. The method of claim 28, wherein the restrictive structure includes nitinol.

28-2. A method for reducing obesity comprising:

bypassing a first region of the stomach and a first portion of the small intestine;

attaching a second portion of the small intestine directly to a second region of the stomach;

attaching a restrictive structure around the second region configured to maintain the size of the second region.

32. A method for reducing obesity comprising:

performing a gastric bypass surgery; and

attaching a restrictive structure around the stomach configured to prevent enlargement of the stomach.

33. The method of claim 32, wherein the restrictive structure comprises a mesh.

34. The method of claim 32, wherein the restrictive structure includes cloth.

35. The method of claim 33, wherein the restrictive structure includes nitinol.

36. A method of reducing obesity comprising:

attaching a gastric band around an upper portion of the stomach thereby creating at least a small upper pouch and a larger lower pouch; and

disposing a restrictive structure around the upper pouch configured to prevent enlargement of the upper pouch.

37. The method of claim 36, wherein the restrictive structure comprises a mesh.

38. The method of claim 36, wherein the restrictive structure includes cloth.

39. The method of claim 36, wherein the restrictive structure includes nitinol.

40. A method of reducing obesity comprising:

positioning an elongate body within the esophagus, the elongate body comprising an ablation device;

adjusting the position of the ablation device to a position near the site of a first vagal nerve branch disposed on the outer wall of the esophagus;

ablating the first vagal nerve with the with the ablation device.

41. The method of claim 40, further comprising performing biliopancreatic diversion surgery.

42. The method of claim 40, further comprising performing a vertical banded gastroplasty surgery.

43. The method of claim 40, further comprising performing a silicone ring gastroplasty surgery.

44. The method of claim 40, further comprising performing a jejuno-ileal bypass surgery.

45. The method of claim 40, further comprising performing a procedure to create a jejuno-colic shunt.

46. A method for reducing obesity comprising:

positioning a highly focused ultrasound delivery device within the esophagus;

energizing the device to focus on energy at the site of at least one vagal nerve on the outer wall of the esophagus to disrupt the function of said nerve; and

performing an additional interventional obesity treatment therapy.

47. The method of claim 46, wherein said additional treatment is gastric bypass surgery.

48. The method of claim 46, wherein said additional treatment is gastric banding surgery.

49. The method of claim 46, wherein said additional treatment is gastrointestinal pacing.

50. The method of claim 46, wherein said additional treatment is electrical stimulation of the vagal nerve.