DEVICES AND METHODS FOR PLACEMENT OF PARTITIONS WITHIN A HOLLOW BODY ORGAN

• US 20070233161A1
• Filed: 06/08/2007
• Published: 10/04/2007
• Est. Priority Date: 03/09/2004
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Satiety, Inc.
• Inventors: Julian, Christopher, Gerbi, Craig, Gannoe, James, Weller, Gary, Lee, Crystine, Hancock, Andrew, Roth, Alex
• Application Number:
  US11/760,687
• Publication Number:
  US 20070233161A1
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07221 curved
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 90/92 coded with colour
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

Devices and methods for tissue acquisition and fixation, or gastroplasty, are described. Generally, the devices of the system may be advanced in a minimally invasive manner within a patient'"'"'s body to create one or more plications within the hollow body organ. A tissue treatment device attached to a distal end of a flexible elongated member and has a cartridge member opposite an anvil member. The cartridge member and the anvil member are movable between a closed position and an open position relative to one another, and the cartridge member is re-loadable with a removable staple cartridge to form multiple plications within the organ with the same tissue treatment device.

Claims

1-26. -26. (canceled)

27. A method for delivering and implanting a staple line in the stomach of a patient, comprising:

providing an elongated tubular member having a proximal end and a distal end and having a first lumen extending at least through a portion thereof;

advancing the distal end of the tubular member transorally into the patient'"'"'s stomach;

advancing an endoscope through the first lumen for real time visualization of the patient'"'"'s stomach;

positioning the endoscope to visualize a treatment site in the stomach;

position the distal end of the tubular member at the treatment site and visualize the position of the distal end of the tubular member with the endoscope;

implant a staple line at the treatment site while visualizing with the endoscope;

visualize the staple line with the endoscope; and

withdraw the tubular member and endoscope from the patient.

28. The method of claim 27, wherein the endoscope is retroflexed to visualize the distal end of the tubular member.

29. The method of claim 28, wherein the endoscope, when in the retroflexed position, visualizes a proximal end of a fastening member aligned with the gastroesophogeal junction (GEJ).

30. The method of claim 27, wherein the endoscope retracts stomach tissue.

31. The method of claim 27, wherein dual folds of tissue are fastened together by the staple line.

32. The method of claim 27, wherein the staple line is placed along the lesser curve of the stomach.

33. A delivery system for transoral treatment of the stomach of a patient, comprising:

a flexible elongated body having a proximal end extending outside the patient, a central section extending transorally into the patient, and a distal end extending into the stomach;

a fixation member attached to the distal end of the flexible elongated body;

an endoscope associated with the flexible elongated body for real time visualization; and

the flexible elongated body, fixation member, and endoscope having an overall diameter equal to or less than 18.136 mm (0.714 inch).

34. The delivery system of claim 33, wherein the flexible elongated body being compatible with side-by-side insertion of the endoscope.

35. The delivery system of claim 33, further comprising an acquisition member attached to the distal end of the flexible elongated body.

36. The delivery system of claim 35, wherein the acquisition member is a vacuum pod.

37. The delivery system of claim 36, further comprising a vacuum tube extending from the vacuum pod at the distal end of the flexible elongated body to the proximal end of the flexible elongated body.

38. The delivery system of claim 37, wherein the vacuum tube is attached to a vacuum source at a proximal end of the flexible elongated body.

39. The delivery system of claim 33, wherein one or more cables or wires extend along the flexible elongated body for operative engagement with the fixation member.

40. The delivery system of claim 33, wherein the fixation member has a maximum diameter of 15.1 mm (0.595 inch) in a closed configuration and a maximum diameter of 17.0 mm (0.668 inch) in an open configuration.

41. The delivery system of claim 33, wherein the flexible elongated body can be bent to achieve a 10.16 cm (4.00 inch) bend radius to flexibly navigate the esophagus.

42. The delivery system of claim 33, wherein the fixation member is configured to place a line of fasteners through stomach tissue having a length in the range from about 12.5 mm (0.492 inch) to about 50.0 mm (1.97 inch).

43. A delivery system for transoral treatment of the stomach, comprising:

a flexible elongated member having a proximal end extending outside of a patient, a central section extending transorally into the patient, and a distal end extending into the stomach;

a tissue treatment device attached to the distal end of the elongated member;

a first lumen extending within the elongated member and being in fluid communication with a vacuum source at a proximal end of the first lumen and the tissue treatment device at a distal end of the first lumen;

the tissue treatment device forming a first tissue fold and a second tissue fold via a vacuum;

a fastener for fastening the first tissue fold to the second tissue fold; and

an endoscope for real time visualization of the stomach and tissue treatment device.

44. The delivery system of claim 43, wherein at least a portion of the elongated member having a plurality of sliding links to increase flexibility of the elongate member.

45. The delivery system of claim 44, wherein each link has a substantially cylindrical configuration.

46. The delivery system of claim 45, wherein each link slidingly engages an adjacent link.

47. The delivery system of claim 44, wherein the plurality of sliding links are covered with a material to limit trauma to the esophagus.

48. The delivery system of claim 47, wherein the cover material includes ployethylene tape, silicone and urethanes.

49. The delivery system of claim 44, wherein the first lumen extends through the sliding links.

50. The delivery system of claim 43, wherein cables and/or wires extend through the first lumen.

51. The delivery system of claim 43, wherein the endoscope extends through the first lumen.

52. The delivery system of claim 43, wherein the elongated member includes a second lumen extending for at least a portion therethrough.

53. The delivery system of claim 52, wherein the first lumen and the second lumen extend side by side.

54. The delivery system of claim 43, wherein the elongated member is formed from a braided material.

55. The delivery system of claim 43, wherein the elongated member is formed from a molded material.

56. The delivery system of claim 43, wherein the elongated member is formed from a slotted material.

57. The delivery system of claim 43, wherein the elongated member is formed from a polymer material.

53-1. The delivery system of claim 52, wherein the second lumen slidingly receives the endoscope.