Devices and methods for treatment of obesity

• US 20080255602A1
• Filed: 06/18/2008
• Published: 10/16/2008
• Est. Priority Date: 04/19/2006
• Status: Abandoned Application

• Current Assignee: Vibrynt, Inc.
• Original Assignee: Vibrynt, Inc.
• Inventors: Bender, Theodore M., Makower, Joshua, Uemura, Shuji, Friedmann, Josef L., Acosta, Pablo G., Shiu, Brian K., Lee, Crystine
• Application Number:
  US12/214,441
• Publication Number:
  US 20080255602A1
• Time in Patent Office: Days
• US Class Current: 606/192
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, 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 17/07292 Reinforcements for staple line, e.g. pledgets
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61F 5/0003 Apparatus for the treatment of obesity; Anti-eating devices surgical instruments or methods for treatment of obesity, devices specially adapted therefor A61B17/00; hollow or tubular parts of organs A61F2/04
• CPC Class Codes: A61F 5/003 inflatable
• CPC Class Codes: A61F 5/0073 in the abdominal cavity, e.g. not attached to the stomach

Abstract

Methods, devices, tools, instruments and systems for treating a patient to induce weight loss. In one method embodiment, a device, including an expandable member in a collapsed configuration, is passed through an opening in the skin of the patient, and into the abdominal cavity of the patient. At least a portion of the expandable member is anchored relative to at least one structure in the abdominal cavity, without piercing the stomach. The expandable member is expanded to an expanded configuration in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach.

Claims

1. A method of treating a patient, said method comprising:

passing an elongate guide through an opening in the skin of the patient, and into the abdominal cavity and defining a path to a target location;

inserting an endoscope through the opening and viewing placement of the path;

passing a device including an expandable member in a collapsed configuration through the an opening in the skin of the patient, and into the abdominal cavity of the patient, along the path;

anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity, without piercing the stomach; and

expanding the expandable member to an expanded configuration in a space in the abdominal cavity to perform at least one of;

prevention of expansion of the stomach of the patient into the space; and

compression of a portion of the stomach.

2. The method of claim 1, wherein said method is performed as a percutaneous procedure.

3. The method of claim 1, wherein said method is performed as a laparoscopic procedure.

4. The method of claim 1, wherein said method is performed as a mini-laparoscopic procedure.

5. The method of claim 1, wherein the elongate guide is a guidewire and wherein and the device is passed over the guidewire to guide the device to an intended location in the abdominal cavity.

6. The method of claim 1, further comprising inserting a sheath through a minimally invasive opening made through the skin and the abdominal wall, wherein the elongate guide is inserted through the sheath to pass the elongate guide through the skin and abdominal wall and into the abdominal cavity.

7. The method of claim 1, wherein the endoscope comprises further a flexible endoscope.

8. The method of claim 5, further comprising visualizing placement of the guidewire using at least one of:

fluoroscopy, three-dimensional RF visualization, and three-dimensional magnetic visualization.

9. The method of claim 6, further comprising inserting a trocar through the sheath and advancing the trocar to establish a pathway into the abdominal cavity.

25. The method of claim 1, wherein said expandable member is inflatable, said method further comprising attaching an access member external of the abdominal wall, said access member in fluid communication with said expandable member.

26. The method of claim 1, wherein said device further comprises a second expandable member, said method further comprising at least partially expanding the second expandable member.

27. The method of claim 1, wherein the device is passed in a compact configuration, the device being provided with looped tabs, the compact configuration being achieved by rolling the device to align opposite sets of the looped tabs, and inserting a rod or wire through the aligned sets of looped tabs.

32. The method of claim 1, wherein the device is passed in a compact configuration, the compact configuration being achieved by providing an rigid exoskeleton;

and placing the expandable member in the rigid exoskeleton, wherein the rd exoskeleton maintains the expandable member in the compact configuration.

33. The method of claim 32, further comprising extracting the expandable member from the exoskeleton once the expandable member has been positioned in a desired location in the abdominal cavity.

34. The method of claim 33, wherein a distal portion of the expandable member, at least one attachment tab or flange extending from a distal portion of the expandable member, or a distal portion of the expandable member and at least one attachment tab or flange extending from the expandable member extends out of the exoskeleton prior to said extracting, and wherein said anchoring at least a portion of the expandable member is performed prior to said extracting and assists in said extracting by retracting the exoskeleton against the force provided by said anchoring.

35. The method of claim 33, wherein said extracting comprises rotating the exoskeleton.

36. The method of claim 33, wherein said extracting comprises moving the exoskeleton linearly away from an anchored portion of the expandable member.

38. The method of claim 33, wherein said extracting is performed incrementally, said method further comprising anchoring additional portions of the expandable member in steps between incremental extraction steps performed.

42. The method of claim 1, wherein the device is passed in a compact configuration, the compact configuration being achieved by inserting the expandable member in an expandable exoskeleton, wherein the expandable exoskeleton has a first configuration that maintains the expandable member in the compact configuration, and a second, expanded configuration, wherein the second, expanded configuration is achieved by said expanding the expandable member.

43. The method of claim 1, wherein the expandable member comprises an elongated tube, said anchoring at least a portion of the expandable member comprises anchoring a distal end portion of the tube, said method further comprising incrementally advancing an additional portion of the tube and placing the additional portion into a desired location;

anchoring the additional portion; and

repeating the incrementally advancing, placing and anchoring the additional portion steps until all of the elongated tube has been placed and anchored in the abdominal cavity.

44. The method of claim 1, wherein the device is passed in a compact configuration, the compact configuration being achieved and maintained by compacting the expandable member and inserting the expandable member within a sheath.

46. The method of claim 1, wherein the device is passed in a compact configuration via an introducer that maintains the device in the compact configuration during said passing.

50. The method of claim 46, wherein said opening is performed by manipulation of one or more tethers extending though the introducer.

51. The method of claim 50, wherein the device is reoriented relative to the introducer by action of said opening, facilitated by the at least one tether.

52. The method of claim 46, further comprising extracting the expandable member after said opening.

53. The method of claim 51, further comprising extracting the expandable member after the device is reoriented.

58. The method of claim 46, further comprising providing the expandable member in the compact configuration around a distal end portion of an inner sheath of the introducer, and sliding a distal end portion of an outer sheath of the introducer over at least a portion of the expandable member to maintain the expandable member in the compact configuration during said passing a device.

59. The method of claim 58, further comprising retracting the outer sheath relative to the inner sheath, once the device has been placed in the space in the abdominal cavity, so that the outer sheath no longer covers the expandable member.

185. The method of claim 1, wherein the elongate guide is a rod having one or more lumens therethrough.

186. The method of claim 1, wherein said passing the device is performed with a deployment tool loaded with the device.

187. The method of claim 186, further comprising viewing positioning of said device during or after said passing via an endoscope inserted in said device.

188. The method of claim 186, further comprising viewing positioning of said device during or after said passing via an endoscope inserted through the opening.

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