Method and apparatus for adjusting body lumens
First Claim
1. A delivery system, for placing an implant at least partially outside a body lumen, comprising:
- an elongate member having a sidewall, distal and proximal ends, and a lumen extending through the elongate member;
a piercing guide axially slidable within said lumen of said elongate member, said piercing guide configured to extend radially outwardly from, or retract radially inwardly into, an aperture in the elongate member at or near the elongate member'"'"'s distal end, said piercing guide having (1) a sharp distal end, configured to penetrate tissue surrounding the body lumen, and (2) a lumen extending through the piercing guide;
a pusher configured to move axially an elongate implant within said piercing guide lumen, wherein said axial movement is controllable by a control mechanism at or near the proximal end of the delivery system;
a coupler at a distal end of the pusher, said coupler configured to couple releasably the implant to the pusher, wherein release of the implant is controlled by a release mechanism located at or near the proximal end of the delivery system.
1 Assignment
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Accused Products
Abstract
Disclosed is a device and method for accessing the lower esophageal sphincter through the esophagus. In one embodiment, a catheter is inserted through the mouth or nose of a patient and advanced to the region of the diaphragm. Under fluoroscopy or endoscopy, a hollow needle at the distal end of the catheter punctures the wall of the esophagus from the inside so that the distal end of the needle is positioned outside the esophagus. An implant is next advanced out through the hollow needle to the region outside the sphincter where it is deflected and coerced to bluntly dissect around the circumference of the esophagus, where the implant is left in place to heal. The hollow needle is removed and the esophageal wall is allowed to heal. Subsequent diametric adjustment of the implant allows for tightening or loosening of the sphincter to minimize gastric reflux. The device and method can also be used to treat the pyloric or other body sphincters, hollow organs, or ducts.
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Citations
45 Claims
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1. A delivery system, for placing an implant at least partially outside a body lumen, comprising:
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an elongate member having a sidewall, distal and proximal ends, and a lumen extending through the elongate member;
a piercing guide axially slidable within said lumen of said elongate member, said piercing guide configured to extend radially outwardly from, or retract radially inwardly into, an aperture in the elongate member at or near the elongate member'"'"'s distal end, said piercing guide having (1) a sharp distal end, configured to penetrate tissue surrounding the body lumen, and (2) a lumen extending through the piercing guide;
a pusher configured to move axially an elongate implant within said piercing guide lumen, wherein said axial movement is controllable by a control mechanism at or near the proximal end of the delivery system;
a coupler at a distal end of the pusher, said coupler configured to couple releasably the implant to the pusher, wherein release of the implant is controlled by a release mechanism located at or near the proximal end of the delivery system. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method, of placing of an implant within a portion of a mammalian gut, comprising:
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at least partially puncturing a mammalian gut wall, such that at an opening in at least part of the gut wall is created, said opening extending between a first layer and a second layer of tissue within the gut wall;
inserting an implant comprising a shape memory material into said opening in the gut wall, said implant having a first delivery configuration and a second configuration;
advancing said implant through said gut wall, between said first and second layers of tissue;
closing the opening in the gut wall such that the implant is wholly retained between said tissue layers. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A method of placing of an implant around a portion of a mammal'"'"'s gut comprising:
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puncturing a portion of the gut wall, such that an opening in the gut wall is created, said opening extending from within a lumen of the gut through the gut wall;
inserting an implant having a first delivery configuration and a second configuration through said opening in the gut wall, said implant;
placing said implant near an outer circumference of said gut; and
closing the opening in the gut wall such that the implant at least partially surrounds said gut and resides between the gut wall and the mammal'"'"'s visceral peritoneum. - View Dependent Claims (33, 34, 35)
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36. An implant for adjusting a diameter of a portion of a mammalian gut, comprising:
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an outer sheath having a proximal end and a distal end, wherein the outer sheath is configured to assume a first, elongate shape when constrained and to transform to a second, substantially circular shape when unconstrained;
a blunt dissecting tip located on the distal end of the outer sheath;
a coupler located at the proximal end of the outer sheath, wherein the coupler is configured to couple releasably to a delivery system pusher; and
an inner core comprising a shape memory material configured to adjust a diameter of the implant when the implant is in said second, unconstrained configuration and said shape memory material is activated. - View Dependent Claims (37, 38, 39, 40, 41, 42)
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43. An implant for adjusting a diameter of a portion of a mammalian gut, comprising:
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an outer sheath having a proximal end and a distal end, wherein the outer sheath is configured to assume a first, elongate shape when constrained and to transform to a second, substantially curvilinear shape when unconstrained;
a blunt dissecting tip located on the distal end of the outer sheath;
a coupler located at the proximal end of the outer sheath, wherein the coupler is configured to couple releasably to a delivery system pusher; and
an inner core comprising a diameter-changing member having distal and proximal ends, said distal end coupled to the distal end of said outer sheath, wherein movement of said diameter-changing member relative to said outer sheath causes a diameter of said implant to change. - View Dependent Claims (44, 45)
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Specification