Endoscopic instrument system for implanting a device in the stomach

• US 20060069414A1
• Filed: 11/16/2005
• Published: 03/30/2006
• Est. Priority Date: 05/01/2001
• Status: Active Grant

• Current Assignee: IntraPace, Inc.
• Original Assignee: IntraPace, Inc.
• Inventors: Layman, Ted W., Lake, Sharon L., Colliou, Olivier K., Imran, Mir A., Gandhi, Deepak R.
• Granted Patent: US 7,483,754 B2
• Time in Patent Office: Days
• US Class Current: 607/40
• CPC Class Codes: A61B 17/3421 Cannulas
• 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 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 5/4238 stomach
• CPC Class Codes: A61B 5/6882 Anchoring means
• CPC Class Codes: A61F 5/0003 Apparatus for the treatment of obesity; Anti-eating devices surgical instruments or methods for treatment of obesity, devices specially adapted therefor A61B17/00; hollow or tubular parts of organs A61F2/04
• CPC Class Codes: A61M 2025/0233 specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
• CPC Class Codes: A61M 2025/028 having a mainly rigid support structure
• CPC Class Codes: A61M 25/02 Holding devices, e.g. on the body
• CPC Class Codes: A61N 1/0509 Stomach and intestinal electrodes
• CPC Class Codes: A61N 1/0517 Esophageal electrodes
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: G01N 27/126 comprising organic polymers

Abstract

An endoscopic delivery system is provided to deliver a functional device through the esophagus and into the stomach where it is attached the stomach wall. The endoscopic instruments attach or remove the attachment devices and functional devices from the stomach and may be used to assist in determining the optimal attachment location.

Claims

1-145. -145. (canceled)

146. An endoscopic instrument comprising:

an elongate tube comprising a proximal portion, a distal portion and a circumferential wall forming a first lumen sized to receive an endoscope therethrough; and

at least one instrument channel extending within the circumferential wall from the proximal portion to the distal portion and configured to receive an instrument therethrough.

147. An endoscopic instrument system for piercing a stomach wall comprising:

a piercing needle; and

an elongate member comprising a distal portion having a first axis;

a lumen extending along a second axis parallel to said first axis; and

a wall engaging portion located on said distal portion,

wherein said piercing needle is arranged to extend through said lumen so that at said distal portion it is substantially parallel to said second axis so as to pierce the stomach wall.

148. The endoscopic instrument system of claim 147 wherein said wall engaging member is arranged to engage and hold tissue of a stomach wall.

149. The endoscopic instrument system of claim 148 wherein said wall engaging portion comprises a suction element and a vacuum conduit in communication with the suction element operative to couple to a vacuum source to supply a vacuum pressure to said suction element.

150. The endoscopic instrument system of claim 147 further comprising an anchor engaging instrument comprising an elongate member having a distal portion and an anchor engaging portion.

151. The endoscopic instrument system of claim 147 wherein said piercing needle comprises a hollow needle with a guide wire lumen extending therethrough, said guide wire lumen for removably receiving a guide wire.

152. The endoscopic instrument system of claim 151 further comprising a guide wire and an anchor having a guide wire lumen extending therethrough, wherein when said hollow needle is removed from said guide wire, said anchor is arranged to advance over said guide wire.

153. The endoscopic instrument system of claim 151 further comprising a sheath having a lumen extending therethrough, said lumen having an inner diameter configured to removably receive said piercing needle.

154. The endoscopic instrument of claim 153 further comprising an anchor having an outer diameter smaller than said inner diameter of said lumen so that said anchor may be advanced through said lumen.

155. The endoscopic instrument system of claim 154 further comprising an anchor engaging instrument comprising an elongate member sized to fit within the lumen and including an anchor engaging portion.

156. The endoscopic instrument system of claim 147 further comprising a sheath having a lumen extending therethrough, said lumen having an inner diameter configured to removably receive said piercing needle wherein said sheath comprises a dilator arranged to dilate an opening in the stomach wall.

237. The endoscopic instrument system of claim 151 wherein said hollow needle comprises a guide wire lumen extending therethrough, said guide wire lumen for removably receiving a guide wire.

157. An endoscopic instrument comprising:

an elongate member having a proximal portion and a distal portion;

at least one electrode located on said distal portion coupled to a conductor extending from said distal portion to said proximal portion;

an electronic circuit comprising an input and an output, said input coupled to said conductor at said proximal portion, said electronic circuit configured to receive sensed electrical signals at said electrode and to output a signal representative of said sensed signal on said output.

158-218. -218. (canceled)

219. An endoscopic instrument system for piercing a stomach wall comprising:

a piercing means for piercing the stomach wall in an orientation substantially perpendicular to said stomach wall; and

a lumen means receiving said piercing means said lumen means having an axis substantially parallel to said piercing means for receiving said piercing means therethrough, and having a wall engaging means for engaging and holding a portion of a stomach wall to be pierced by said piercing means.

220. The endoscopic instrument system of claim 219 wherein said wall engaging means comprises a vacuum means for applying a vacuum to a region of the stomach wall to be pierced.

221. The endoscopic instrument of claim 219 wherein said piercing means comprises means for advancing over a guide wire, said instrument further comprising a guide wire means for removably receiving said piercing means and for removably receiving an anchor means for anchoring in a stomach wall.

222. The endoscopic instrument of claim 219 wherein said instrument further comprises a sheath means for removably receiving said piercing means, said sheath means for receiving an anchor means for anchoring in a stomach wall.

223-236. -236. (canceled)

238. An endoscopic instrument for delivering a device to a stomach wall comprising:

a first elongate member configured to extend into a stomach wall, the first elongate member having a first outer diameter; and

a second elongate comprising a lumen having an inner diameter configured to receive the first elongate member therein, and configured to receive a device to deliver the device to the stomach wall.

239. The endoscopic instrument of claim 238 further comprising an expansion member coupled to the first elongate member and configured to expand to an expanded diameter greater than the first out diameter.

240. The endoscopic instrument of claim 239 wherein the second elongate member is configured to fit over the expanding member.

241. The endoscopic instrument of claim 239 wherein the first elongate member is configured to form an opening through the stomach wall;

and

wherein the expanding member is configured to expand the opening in the stomach wall.

242. The endoscopic instrument of claim 241 wherein the second elongate member is configured to fit over the expandable member into the expanded opening wherein upon the expanded member is removable from the lumen of the second elongate member.

243. The endoscopic instrument of claim 238 wherein the first elongate member is configured to form a path from the inside of the stomach wall to the outside of the stomach wall.

244. The endoscopic instrument of claim 243 wherein the lumen of the second elongate member is configured to form an opening from the inside of the stomach wall to the outside of the stomach along the path.

245. The endoscopic instrument of claim 244 wherein the second elongate member is configured to receive a device through the second lumen;

wherein the device extends to the outside of the stomach wall; and

wherein the second elongate member is configured to be removed leaving the device in place in the stomach wall.

246. The endoscopic device of claim 238 wherein the first elongate member is configured, to extend into the stomach wall in a direction substantially perpendicular to the stomach wall.

247. A method for delivery a device to a stomach wall comprising the steps of:

forming an opening in the stomach wall;

expanding the opening in the stomach wall; and

inserting a device through the expanded opening.

248. The method of claim 247 wherein the step of inserting the device comprises inserting the device from a first side of the stomach wall to an opposite side of the stomach wall and expanding the device on the opposite side of the stomach wall so that the device is anchored to the stomach wall.

249. The method of claim 248 wherein the step of inserting the device from a first side of the stomach wall to an opposite side of the stomach wall comprises inserting the device from the inside of the stomach to the outside of the stomach wall.

250. The method of claim 247 further comprises the step of inserting a hollow tubular member through the expanded opening and inserting at least a portion of the device through the hollow tubular member.

251. The method of claim 247 wherein the step forming an opening comprises piercing the stomach wall with a piercing member.

252. The method of claim 247 wherein the step of expanding the opening comprises positioning an expansion member through the opening to expand the opening.

253. The method of claim 252 wherein the step of inserting the device through the expanded opening comprises inserting the device over the expandable member.