Per Os Placement of Extragastric Devices

• US 20080275484A1
• Filed: 07/06/2008
• Published: 11/06/2008
• Est. Priority Date: 03/23/2004
• Status: Abandoned Application

• Current Assignee: Michael Gertner
• Original Assignee: Michael Gertner
• Inventors: Gertner, Michael
• Application Number:
  US12/168,134
• Publication Number:
  US 20080275484A1
• 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 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00871 polymeric
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Methods and devices to externally create a restriction on the stomach are described. In some embodiments, the devices are contoured to fit the stomach and can be further anchored to the stomach. In further embodiments, the degree of deployment of the extragastric restriction device is controllable after implantation. In other embodiments, specialized wires, catheters, ports, and trocars specific for placement of extragastric restriction devices are presented. In still further embodiments, systems are described in which adjustability of the devices is provided along with sensing and actuating ability.

Claims

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

passing an elongated implement into the esophagus of the patient, and into the cavity of the stomach of the patient, wherein a proximal end portion of the implement extends outside of the patient when a distal end of the implement is located in the stomach cavity;

forming an opening through the wall of the stomach;

passing a device, in a contracted configuration, into the esophagus, into the stomach and through the opening through the wall of the stomach, thereby delivering the device to an extra-gastric location in the abdominal cavity;

expanding the device;

urging the device against the external wall of the stomach.

2. The method of claim 1, further comprising attaching the device at least one location to at least one internal abdominal structure other than the stomach.

3. The method of claim 1, wherein said expanding comprises inflating the device via a conduit in fluid communication with the device and extending into the stomach, through the esophagus and out of the mouth of the patient.

4. The method of claim 1, further comprising extending a connector through the implement, and into the stomach, so that a distal end of the connector extends out through the stomach wall and into the abdominal cavity and a proximal end of the connector extends proximally out of the implement, outside of the patient.

5. The method of claim 4, wherein the device is delivered in combination with the connector during said passing a device.

6. The method of claim 1, further comprising passing an anchor pad or strip into the esophagus and stomach of the patient, through the opening of the stomach, and attaching the anchor pad or strip to an internal abdominal structure, and wherein the device includes a region configured to connect with the anchor pad or strip, said method further comprising, after said passing the device, attaching the anchoring pad or strip to the anchor pad or strip.

7. A method of treating obesity in a patient, said method comprising:

making an opening through a wall of the stomach of the patient;

passing an expandable device, while in a contracted configuration, through the opening from a location within the cavity in the stomach to a location external of the stomach wall, without substantially deforming the stomach wall;

expanding the expandable device; and

anchoring the expandable device against an inner surface of the stomach wall, opposite a location of the expandable device adjacent an outer surface of the stomach wall.

8. The method of claim 7, further comprising anchoring the expandable device, relative to at least one additional structure in the abdominal cavity.

9. The method of claim 7, wherein the step of expanding the expandable device causes the device to occupy a space into which the stomach would expand if the device were not expanded there, and wherein the step of expanding the expandable device does not substantially deform the wall of the stomach during said expanding the expandable device.

10. The method of claim 7, wherein said anchoring the expandable device against an inner surface of the stomach wall comprises attaching an adjustment member to a conduit passing through the opening.

11. A flexible conduit for trans-oral delivery of a device into an abdominal cavity of a patient, said conduit comprising:

an elongated, flexible tube having a length sufficient to be inserted into the esophagus of the patient, into the stomach of the patient and through an opening formed through the wall of the stomach such that a distal end portion of the tube extends out of the stomach an into the abdominal cavity, and a proximal end portion at the same time extends proximally outside of the patient; and

at least one radially expandable anchor on a distal end portion of said tube.

12. The flexible conduit of claim 11 wherein said flexible tube further comprises:

a pair of radially extensible anchors, a more distal of said pair of anchors configured to abut against an intra-abdominal structure other than the stomach, and a more proximal of the pair of anchors configured to abut against the inner wall of the stomach, such that said anchors fix a distal end portion of said sheath relative to the stomach wall.

13. The flexible conduit of claim 12 wherein said pair of radially extensible anchors are independently moveable with respect to one another and tension between them can be controlled by applying tension to said flexible tube.

14. The flexible conduit of claim 12 wherein at least one of said pair of radially extensible anchors are attached to a connector.

15. The flexible conduit of claim 11 wherein said radially extensible anchor is attachable such that is exerts a compressive force on the stomach during stomach distention.

16. The flexible conduit of claim 11 wherein said extensible anchor is fillable with a fluid.