Apparatus for single pass gastric restriction

• US 20070032800A1
• Filed: 08/05/2005
• Published: 02/08/2007
• Est. Priority Date: 08/05/2005
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Griffith, David, Ortiz, Mark, Stokes, Michael
• Granted Patent: US 7,896,894 B2
• Time in Patent Office: Days
• US Class Current: 606/148
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 2017/1142 Purse-string sutures
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

A gastric reduction apparatus that facilitates the creation of a transoral linear passageway through the stomach includes an elongated body including a proximal end and a distal end. The elongated body is generally sinusoidal shaped with at least one tissue engaging surface oriented such that a needle will pass therethrough. The elongated body also includes at least one needle passing channel respectively formed adjacent the at least one tissue engaging surface. The at least one needle passing channel generally passes through the center of the sinusoidal waveforms defined by the at least one tissue engaging surface such that a needle will pass entirely through stomach tissue contacting the tissue engaging surface of the elongated body. The elongated body further includes a suture passing channel.

Claims

1. A gastric reduction apparatus which facilitates the creation of a transoral linear passageway through the stomach, comprising

an elongated body including a proximal end and a distal end, the elongated body is generally sinusoidal shaped with at least one tissue engaging surface oriented such that a needle will pass therethrough;

the elongated body also includes at least one needle passing channel respectively formed adjacent the at least one tissue engaging surface, the at least one needle passing channel generally passes through the center of the sinusoidal waveforms defined by the at least one tissue engaging surface such that a needle will pass entirely through stomach tissue contacting the tissue engaging surface of the elongated body;

the elongated body further includes a suture passing channel.

2. The gastric reduction apparatus according to claim 1, wherein the elongated body is shaped and dimensioned for selective attachment to a distal end of an endoscopic flexible gastroscope.

3. The gastric reduction apparatus according to claim 1, wherein the elongated body includes opposed anterior and posterior tissue engaging surfaces positioned along the top and bottom of the elongated body.

4. The gastric reduction apparatus according to claim 3, wherein the elongated body includes first and second needle passing channels respectively formed adjacent the anterior and posterior tissue engaging surfaces.

5. The gastric reduction apparatus according to claim 4, wherein the respective first and second needle passing channels generally pass through the center of the sinusoidal waveforms defined by the anterior and posterior tissue engaging surfaces such that a needle will pass entirely through stomach tissue contacting the anterior and posterior tissue engaging surfaces of the stomach wall.

6. The gastric reduction apparatus according to claim 3, wherein the elongated body includes a suction inlet and at least one suction holes along the respective anterior and posterior tissue engaging surfaces.

7. The gastric reduction apparatus according to claim 3, wherein the extent of the sinusoidal wave defining the anterior and posterior tissue engaging surfaces is to draw opposed anterior and posterior walls of the stomach into an overlapping configuration such that a needle may be respectively passed through the posterior or anterior walls for placement of purse string sutures.

8. The gastric reduction apparatus according to claim 1, wherein the elongated body is shaped and dimensioned for the creation of a purse string suture.

9. The gastric reduction apparatus according to claim 8, wherein the elongated body is shaped and dimensioned for the creation of a double purse string suture.

10. The gastric reduction apparatus according to claim 1, wherein the elongated body includes a suction inlet and a series of suction holes along the at least one tissue engaging surface.

11. The gastric reduction apparatus according to claim 1, wherein the elongated body includes sinusoidal undulations such that the anterior and posterior walls of the stomach are simultaneously drawn onto the gastric reduction apparatus in an overlapping configuration allowing a single needle to simultaneously pierce both the anterior and posterior walls of the stomach.

12. The gastric reduction apparatus according to claim 11, wherein the elongated body includes only a single needle passing channel.

13. The gastric reduction apparatus according to claim 1, wherein the needle includes a means of reducing trauma positioned at both ends thereof.

14. The gastric reduction apparatus according to claim 1, further including a pre-woven suture positioned about the elongated body.

15. A method for performing gastric reduction surgery, comprising the following steps:

positioning a gastric reduction apparatus in the stomach, the gastric reduction apparatus including;

an elongated body including a proximal end and a distal end, the elongated body is generally sinusoidal shaped with at least one tissue engaging surface oriented such that a needle will pass therethrough;

the elongated body also includes at least one needle passing channel respectively formed adjacent the at least one tissue engaging surface, the at least one needle passing channel generally passes through the center of the sinusoidal waveforms defined by the at least one tissue engaging surface such that a needle will pass entirely through stomach tissue contacting the tissue engaging surface;

the elongated body further includes a suture passing channel;

creating a vacuum holding tissue of the stomach wall along the at least one tissue engaging surface of the gastric reduction apparatus;

passing at least one needle along the axis of the gastric reduction apparatus through the needle passing channel located adjacent the tissue engaging surface;

retracting the needle leaving a purse string suture behind;

releasing a pre-woven suture from the gastric reduction apparatus;

drawing upon the pre-woven suture causing the pre-woven suture to draw the stomach walls together.

16. The method according to claim 15, wherein a suture is secured at a head of the needle such that as the needle passes through the needle passing channel of the gastric reduction apparatus, the needle pierces the undulations in the stomach wall, passing alternately through mucosa, muscular layer, and serosa, and then back through the stomach wall in a reverse direction resulting in a full thickness penetration during the steps of passing and retracting in the creation of a purse string suture.

17. The method according to claim 15, wherein the gastric reduction apparatus includes anterior and posterior tissue engaging surfaces, and the step of creating a vacuum includes creating a vacuum holding tissue of the anterior and posterior stomach walls within the undulating anterior and posterior tissue engaging surfaces of the gastric reduction apparatus.

18. The method according to claim 15, wherein the gastric reduction apparatus includes anterior and posterior tissue engaging surfaces, and the step of passing includes passing first and second needles along the axis of the gastric reduction apparatus through needle passing channels located adjacent opposed suction holes of the anterior and posterior tissue engaging surfaces.

19. The method according to claim 18, wherein a suture is secured at the head of each of the needles such that as each of the needles passes through the needle passing channels of the gastric reduction apparatus, the straight needles pierce the undulations in the stomach wall, passing alternately through mucosa, muscular layer, and serosa, and then back through the stomach wall in a reverse direction resulting in a full thickness penetration during the steps of passing and retracting in the creation of a purse string suture.

20. The method according to claim 15, wherein the step of drawing includes drawing the anterior and posterior stomach walls together.