Apparatus including multiple invaginators for restoring a gastroesophageal flap valve and method

• US 20070112363A1
• Filed: 11/15/2005
• Published: 05/17/2007
• Est. Priority Date: 11/15/2005
• Status: Abandoned Application

• Current Assignee: Endogastric Solutions
• Original Assignee: Endogastric Solutions
• Inventors: Adams, John
• Application Number:
  US11/274,045
• Publication Number:
  US 20070112363A1
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61F 2/02 Prostheses implantable into the body closure means for urethra or rectum or for artificial body openings therefor A61F2/0004

Abstract

A transoral gastroesophageal flap valve restoration assembly comprises a pair of tissue grippers. The device comprises an elongated member having a distal end arranged for being fed down an esophagus in communication with a stomach and a tissue shaper carried on the distal end of the longitudinal member. The tissue shaper comprises a first member adjacent the distal end of the elongated member and a second member. The first and second members are hingedly coupled to receive the stomach tissue to be shaped there between. The distal end of the elongated member has one of the tissue grippers that grips esophageal tissue oral of a Z line and the first member of the tissue shaper has the other tissue gripper that grips stomach tissue aboral of the Z line. A tissue fastener maintains the Shaped stomach tissue.

Claims

1. A transoral gastroesophageal flap valve restoration assembly comprising:

an elongated member having a distal end arranged for being fed down an esophagus in communication with a stomach;

a tissue shaper carried on the distal end of the longitudinal member, the tissue shaper comprising a first member adjacent the distal end of the elongated member and a second member, the first and second members being hingedly coupled to receive the stomach tissue to be shaped there between, the distal end of the elongated member having a tissue gripper that grips esophageal tissue oral of a Z line and the first member of the tissue shaper having a tissue gripper that grips stomach tissue aboral of the Z line; and

a tissue fastener that maintains the shaped stomach tissue.

2. The assembly of claim 1, further comprising a window between the tissue gripper of the elongated member and the tissue gripper of the first member of the tissue shaper to permit visualization of the Z line.

3. The assembly of claim 2 wherein the tissue fastener is aboral of the window.

4. The assembly of claim 1, wherein at least one of the tissue gripper of the elongated member and the tissue gripper of the first member of the tissue shaper is a noninvasive gripper.

5. The assembly of claim 4, wherein both the tissue gripper of the elongated member and the tissue gripper of the first member of the tissue shaper are noninvasive grippers.

6. The assembly of claim 1, wherein at least one of the tissue gripper of the elongated member and the tissue gripper of the first member of the tissue shaper is a vacuum gripper.

7. The assembly of claim 6, wherein both the tissue gripper of the elongated member and the tissue gripper of the first member of the tissue shaper are vacuum grippers.

8. The assembly of claim 1, wherein the elongated member is arranged to axially translate after the gripper of the elongated member grips esophageal tissue and the gripper of the first member grips stomach tissue to cause the Z line to be aboral of an associated diaphragm.

10. The assembly of claim 1, further comprising a window between the first tissue gripper of the elongated member and the second tissue gripper of the elongated member to permit visualization of the Z line.

11. The assembly of claim 10 wherein the tissue fastener is aboral of the window.

9. A transoral gastroesophageal flap valve restoration assembly comprising:

an elongated member having a distal end arranged for being fed down an esophagus in communication with a stomach, the distal end of the elongated member having a first tissue gripper that grips esophageal tissue oral of a Z line and a second tissue gripper that grips stomach tissue aboral of the Z line;

a tissue shaper carried on the distal end of and hingedly coupled to the elongated member to cause stomach tissue to be shaped to be received between the elongated member and the tissue shaper when the tissue shaper hingedly pivots into engagement with the elongated member; and

a tissue fastener that maintains the shaped stomach tissue.

12. The assembly of claim 9, wherein at least one of the tissue grippers of the elongated member is a noninvasive gripper.

13. The assembly of claim 12, wherein both of the tissue grippers of the elongated member are noninvasive grippers.

14. The assembly of claim 9, wherein at least one of the tissue grippers of the elongated member is a vacuum gripper.

15. The assembly of claim 14, wherein both the tissue grippers of the elongated member are vacuum grippers.

16. The assembly of claim 9, wherein the elongated member is arranged to axially translate after the first gripper of the elongated member grips esophageal tissue and the second gripper of the elongated member grips stomach tissue to cause the Z line to be aboral of an associated diaphragm.

17. A transoral gastroesophageal flap valve restoration assembly comprising:

an elongated member having a distal end arranged for being fed down an esophagus in communication with a stomach, the distal end of the elongated member having a plurality of tissue grippers that together grip both esophageal tissue oral of a Z line and stomach tissue aboral of the Z line;

a tissue shaper carried on the distal end of and hingedly coupled to the elongated member to cause stomach tissue to be shaped to be received between the elongated member and the tissue shaper when the tissue shaper hingedly pivots into engagement with the elongated member; and

a tissue fastener that maintains the shaped stomach tissue.

18. The assembly of claim 17, further comprising a window between an adjacent pair of the tissue grippers of the elongated member to permit visualization of the Z line.

19. The assembly of claim 18 wherein the tissue fastener is aboral of the window.

20. The assembly of claim 17, wherein at least one of the tissue grippers of the elongated member is a noninvasive gripper.

21. The assembly of claim 20, wherein all of the tissue grippers of the elongated member are noninvasive grippers.

22. The assembly of claim 17, wherein at least one of the tissue grippers of the elongated member is a vacuum gripper.

23. The assembly of claim 22, wherein all of the tissue grippers of the elongated member are vacuum grippers.

24. The assembly of claim 17, wherein the elongated member is arranged to axially translate after the tissue grippers grip esophageal and stomach tissue to cause the Z line to be aboral of an associated diaphragm.

25. A method of restoring a gastroesophageal flap valve associated with an esophagus, a stomach and a Z line that transitions esophageal tissue and stomach tissue, the method comprising the steps of:

concurrently gripping esophageal tissue oral of the Z line and stomach tissue aboral of the Z line;

axially translating the gripped tissue until the Z line is within an associated diaphragm; and

manipulating stomach tissue from within the stomach to restore the gastroesophageal flap valve.

26. The method of claim 25, wherein the concurrently gripping step includes substantially simultaneously gripping the esophageal tissue oral of the Z line and stomach tissue aboral of the Z line.

27. The method of claim 25, wherein the concurrently gripping step includes non-invasively gripping the esophageal tissue oral of the Z line and stomach tissue aboral of the Z line.

28. The method of claim 25, wherein the concurrently gripping step includes vacuum gripping the esophageal tissue oral of the Z line and stomach tissue aboral of the Z line.

29. The method of claim 25, wherein the manipulating step includes folding stomach tissue into a gastroesophageal flap valve shape.

30. The method of claim 25, further comprising the step of fastening the manipulated tissue to maintain the restored gastroesophageal flap valve.

31. The method of claim 25, further comprising first gripping the esophagus oral of the Z line, translating the esophagus in an oral direction, and while maintaining a grip on the esophagus oral of the Z line, gripping the stomach tissue aboral of the Z line to concurrently grip esophageal tissue oral of the Z line and stomach tissue aboral of the Z line.

32. The method of claim 31, wherein the gripping steps include non-invasively gripping the esophageal tissue oral of the Z line and stomach tissue aboral of the Z line.

33. The method of claim 31, wherein the gripping steps include vacuum gripping the esophageal tissue oral of the Z line and stomach tissue aboral of the Z line.

34. The method of claim 31, wherein the manipulating step includes folding stomach tissue into a gastroesophageal flap valve shape.

35. The method of claim 31, further comprising the step of fastening the manipulated tissue to maintain the restored gastroesophageal flap valve.