APPARATUS AND METHODS FOR PERFORMING MUCOSECTOMY

• US 20090270856A1
• Filed: 07/07/2009
• Published: 10/29/2009
• Est. Priority Date: 03/09/2004
• Status: Abandoned Application

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Swanstrom, Lee L.
• Application Number:
  US12/499,023
• Publication Number:
  US 20090270856A1
• Time in Patent Office: Days
• US Class Current: 606/33
• 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 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00269 endoscopic mucosal resection EMR
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/0411 Instruments for removing suture anchors for removing suture clamps, clips or locks A61B2017/049
• CPC Class Codes: A61B 2017/0419 H-fasteners
• 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: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2018/00029 : open
• CPC Class Codes: A61B 2018/00244 : adapted to separate target tissue from other tissue
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00494 : Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00595 : Cauterization
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1415 : multiple blades
• CPC Class Codes: A61B 2018/144 : Wire
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2090/036 : abutting on tissue or skin
• CPC Class Codes: A61B 2090/3908 : Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/3912 : Body cavities
• CPC Class Codes: A61B 2090/3937 : Visible markers
• CPC Class Codes: A61B 2090/395 : with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3987 : Applicators for implanting markers
• CPC Class Codes: A61B 2090/3991 : having specific anchoring means to fixate the marker to the tissue, e.g. hooks
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 5/0013 : Implantable devices or invasive measures

Abstract

Apparatus and methods are provided for performing mucosectomy, such as to map out gastrointestinal surgery, including endoluminal gastric reduction. In one variation, tie apparatus comprises a separating element and an integrated resection element. In one variation, the apparatus is configured to simultaneously separate mucosal tissue from underlying muscularis tissue and to resect the separated mucosal tissue. Methods of using the apparatus are provided.

Claims

1. Apparatus for separating and resecting mucosal tissue from an interior of a patient'"'"'s stomach, the apparatus comprising:

an elongated shaft having a lumen extending therethrough and having a distal end, the distal end defining a channel;

a hollow needle extending from the distal end of the shaft, the needle being in fluid communication with the lumen of the elongated shaft; and

a resection element disposed on the distal end of the shaft and within the channel.

2. The apparatus of claim 1, wherein the elongated shaft is sufficiently flexible for endoluminal advancement within a human patient.

3. The apparatus of claim 1, wherein the elongated shaft is sufficiently rigid for laparascopic advancement within a human patient.

4. The apparatus of claim 1, wherein the needle defines a portion of the channel.

5. The apparatus of claim 1, wherein the channel has a width that substantially corresponds with the thickness of a layer of the mucosal tissue of the patient'"'"'s stomach.

6. The apparatus of claim 1, wherein the needle extends in a proximal direction from the distal end of the shaft.

7. The apparatus of claim 1, wherein the needle extends in a distal direction from the distal end of the shaft.

8. The apparatus of claim 1, wherein the needle is disposed at an angle relative to the shaft.

9. The apparatus of claim 8, wherein the angle is an obtuse angle.

10. The apparatus of claim 1, wherein the resection element is configured to automatically engage mucosal tissue that has been separated from underlying muscularis tissue via the hollow needle.

11. The apparatus of claim 1, wherein the resection element is chosen from the group consisting of energizable elements, RF elements, wires, cutting elements, blades, dissectors, jaw members and combinations thereof.

12. Apparatus for separating and resecting mucosal tissue from an interior of a patient'"'"'s stomach, the apparatus comprising:

an elongated shaft having a lumen extending therethrough and having a distal end, the distal end defining a channel;

a separating element extending from the distal end of the shaft; and

a resection element disposed on the distal end of the shaft and within the channel.

13. The apparatus of claim 12, wherein the elongated shaft is sufficiently flexible for endoluminal advancement within a human patient.

14. The apparatus of claim 12, wherein the elongated shaft is sufficiently rigid for laparascopic advancement within a human patient.

15. The apparatus of claim 12, wherein the separating element defines a portion of the channel.

16. The apparatus of claim 12, wherein the channel has a width that substantially corresponds with the thickness of a layer of the mucosal tissue of the patient'"'"'s stomach.

17. The apparatus of claim 12, wherein the separating element extends in a proximal direction from the distal end of the shaft.

18. The apparatus of claim 12, wherein the separating element extends in a distal direction from the distal end of the shaft.

19. The apparatus of claim 12, wherein the separating element is disposed at an angle relative to the shaft.

20. The apparatus of claim 19, wherein the angle is an obtuse angle.

21. The apparatus of claim 12, wherein the resection element is configured to automatically engage mucosal tissue that has been separated from underlying muscularis tissue via the separating element.

22. The apparatus of claim 12, wherein the resection element is chosen from the group consisting of energizable elements, RF elements, wires, cutting elements, blades, dissectors, jaw members and combinations thereof.

23. The apparatus of claim 12, wherein the separating element comprises an inclined surface configured for placement within a submucosal space between the mucosal tissue and underlying muscularis tissue.

24. The apparatus of claim 12, wherein the separating element is chosen from the group consisting of wedges, inclined planes, inclined surfaces, shoe horns, fluid boluses, dissectors, jaw members and combinations thereof.