Extragastric minimally invasive methods and devices to treat obesity

• US 20060264699A1
• Filed: 03/31/2006
• Published: 11/23/2006
• Est. Priority Date: 10/27/2004
• Status: Abandoned Application

• Current Assignee: Michael Gertner
• Original Assignee: Michael Gertner
• Inventors: Gertner, Michael
• Application Number:
  US11/395,302
• Publication Number:
  US 20060264699A1
• Time in Patent Office: Days
• US Class Current: 600/37
• 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 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61F 2005/002 for sensing mechanical parameters
• CPC Class Codes: A61F 5/0026 Anti-eating devices using electrical stimulation
• CPC Class Codes: A61F 5/0036 Intragastrical devices
• CPC Class Codes: A61F 5/0063 wrapping the stomach
• CPC Class Codes: A61F 5/0079 Pyloric or esophageal obstructions
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like
• CPC Class Codes: A61N 1/0509 Stomach and intestinal electrodes
• CPC Class Codes: A61N 1/36057 adapted for stimulating afferent nerves
• CPC Class Codes: A61N 1/36085 Eating disorders or obesity
• CPC Class Codes: G06F 16/36 : Creation of semantic tools, e.g. ontology or thesauri
• CPC Class Codes: G06F 40/284 : Lexical analysis, e.g. tokenisation or collocates

Abstract

Methods and devices to externally create a restriction on the stomach are described. In some embodiments, the devices are contoured to fit the stomach and can be further anchored to the stomach. In further embodiments, the degree of deployment of the extragastric restriction device is controllable after implantation. In other embodiments, specialized wires, catheters, ports, and trocars specific for placement of extragastric restriction devices are presented. In still further embodiments, systems are described in which adjustability of the devices is provided along with sensing and actuating ability.

Claims

1. A Method for treating a patient comprising:

a. Penetrating the skin of the abdominal wall and entering the abdominal cavity;

b. Contacting an intra-abdominal structure with a first guiding device comprising a contact portion and a connecting portion;

c. Guiding a first surgical device over the first guiding device;

d. Contacting the external surface of the first intra-abdominal structure with the first surgical device.

2. The method of claim 1 wherein the first surgical device comprises an electrocautery device.

3. The method of claim 1 wherein the first surgical device comprises a device to visualize the first intra-abdominal structure.

4. The method of claim 1 wherein the first surgical device comprises a device with an undeployed configuration and a deployed configuration.

5. The method of claim 4 wherein the first surgical device is a balloon.

6. The method of claim 5 wherein said balloon is constructed so that its shape in the deployed configuration conforms to the region of the stomach close to the the gastroesophageal junction.

7. The method of claim 6 wherein the shape of the balloon surrounds at least half the circumference of an external cross-section of the stomach when the balloon is in its deployed configuration.

8. The method of claim 6 wherein the shape of the balloon surrounds at least three quarters of the circumference of an external cross-section of the stomach when the balloon is in its deployed configuration.

9. The method of claim 1 wherein the connecting portion further comprises a fastener.

10. The method of claim 9 further comprising:

fastening the fastener to the first abdominal structure.

11. The method of claim 1 wherein the first surgical device is an expandable device.

12. The method of claim 11 wherein the expandable device is placed between the liver and stomach to create a working space between the liver and the stomach.

13. The method of claim 12 further comprising:

a. Penetrating the skin and placing a second guiding device comprising a second contacting portion and a second connecting portion into the abdomen;

b. Contacting the external surface of a second intra-abdominal structure;

c. Guiding a second surgical device over the second connecting portion;

d. Contacting the external surface of the second intra-abdominal structure with the second surgical device.

14. The method of claim 1 further comprising:

guiding a second surgical device over the first guiding device.

15. The method of claim 3 further comprising:

guiding a second surgical device over the first guiding device.

16. The method of claim 15 further comprising:

injecting a tissue bulking agent into the external surface of the first abdominal structure.

17. The method of claim 1 wherein the first surgical device is device which applies electrical stimulation to the stomach.

18. The method of claim 1 wherein the first connecting device is constructed from a material which conducts electrical current and the first surgical device comprises a material which is both conducting and promotes tissue ingrowth.

19. A method of treating an obese patient comprising:

penetrating through the abdominal wall of a patient with a balloon adapted to track over a connector, wherein the balloon is expandable from a first undeployed configuration to a second deployed configuration, and wherein the balloon is fixed to a least two points inside the abdomen and wherein the balloon is further contoured to maintain contact with the gastrointestinal organ.

20. A method of treating an obese patient comprising:

advancing a guiding device through the skin of a patient and through the abdominal wall to contact an external surface of an intra-abdominal structure;

applying a surgical device over the guiding device to contact the external surface of the intra-abdominal structure;

applying a second device over the guiding device to lock the surgical device in place along the guiding device;

activating the surgical device via the guiding device.