CLOSED LOOP GASTRIC RESTRICTION DEVICES AND METHODS

• US 20100234682A1
• Filed: 05/26/2010
• Published: 09/16/2010
• Est. Priority Date: 03/23/2004
• Status: Active Grant

• Current Assignee: Michael Gertner
• Original Assignee: Michael Gertner
• Inventors: Gertner, Michael
• Granted Patent: US 7,963,907 B2
• Time in Patent Office: Days
• US Class Current: 600/37
• 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 17/0218 for minimally invasive surgery A61B17/0281, 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 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• 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 2017/0419 H-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 2017/0462 One way system, i.e. also tensioning the suture
• 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: A61B 2017/1135 : End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61F 2002/044 : Oesophagi or esophagi or gullets
• CPC Class Codes: A61F 5/0083 : Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

In some embodiments, methods to sense parameters associated with restriction procedures and/or devices are disclosed. In some embodiments, the parameters are sensed directly from the region of the procedure and/or device and in other embodiments, associated neural pathways are sensed. Methods for further optimization of the obesity treatment regimens are also disclosed.

Claims

1. A system to treat an obese patient comprising:

a) an adjustable implantable band having a volume of fluid therein and adapted to encircle the stomach;

b) an implantable pressure sensor adapted to measure changes in fluid pressure within the band, the fluid pressure changes related to patient ingestion of food which passes through the lumen of the stomach of the patient;

c) memory adapted to store information related to ingestion of food by the patient;

d) a gain control which modifies the relationship between an input signal from the pressure sensor and an output signal, wherein the input signal is related to food passing through the stomach and the output signal is related to adjusting the volume of fluid of the band; and

e) a subcutaneous access port, wherein the pressure sensor is located within the port.

2. A system to treat an obese patient comprising:

a) an adjustable implantable band having a volume of fluid therein and adapted to encircle the stomach;

b) an implantable pressure sensor system adapted to measure changes in pressure applied to the band from an organ external to the band and to generate an input signal related to said changes;

c) memory adapted to store information related to the input signal from the pressure sensor; and

d) a gain control which generates an output signal based on the input signal from the pressure sensor system, wherein the output signal adjusts the volume of fluid of the band.

3. The system of claim 2 further comprising an automated system which fills or empties the band in response to the output signal.

4. The system of claim 2 further comprising a subcutaneous access port connected to the band and wherein said pressure sensor system is located within said port.

5. The system of claim 4 wherein said subcutaneous access port is configured to allow for calibration of the pressure sensor or charging of a power supply.

6. The system of claim 2 further comprising telemetry hardware which enables communication with the system through the skin of a patient.

7. The system of claim 2 further comprising an inductive circuit connected to the gain control configured to receive power through the skin of the patient.

8. The system of claim 2 further comprising an electrical stimulator connected to the system and adapted to provide stimulation to the gastrointestinal system of a patient.

9. The system of claim 8 wherein said electrical stimulator is activated when a food bolus passes through the lumen of the stomach.

10. A system to treat an obese patient comprising:

a) an adjustable implantable band having a volume of fluid therein and adapted to encircle the stomach;

b) an implantable sensor for generating an input signal in response to a physiological change in the patient, the implantable sensor selected from the group consisting of a strain gauge sensor, a circumferential tension sensor, a volume sensor;

a temperature sensor, a peristaltic wave sensor, and a pH sensor;

c) memory adapted to store information related to the input signal from the sensor; and

d) a control system which generates an output signal based on the input signal, wherein the output signal is adapted to adjust the volume of fluid within the band.

11. The system of claim 10, further comprising a gain control associated with the control system, wherein the gain control is adapted to increase or decrease the magnitude of the adjustment of the fluid volume responsive to said output signal.

12. The system of claim 10, wherein the sensor is located on the band.

13. The system of claim 10, wherein the sensor is located on a structure attached to the band.

14. The system of claim 13, wherein the structure attached to the band is a balloon.

15. The system of claim 10, wherein the sensor is located on the stomach.

16. The system of claim 10, wherein the sensor is a circumferential tension sensor adapted to measure tension within the band, the tension related to passage of food through the digestive system.

17. The system of claim 10, wherein the sensor is a volume sensor adapted to measure volume changes in the digestive system.

18. The system of claim 17, wherein the volume changes in the digestive system are in the stomach.

19. The system of claim 17, wherein the volume changes in the digestive system are in the distal esophagus.

20. The system of claim 10, wherein the sensor is a peristaltic wave sensor adapted to measure contraction of a digestive system structure.

21. The system of claim 20, wherein the digestive system structure is the stomach or esophagus.

22. A system to treat an obese patient comprising:

a) an adjustable implantable band having a volume of fluid therein and adapted to encircle the stomach;

b) an implantable pressure sensor adapted to measure changes in fluid pressure within the band, the fluid pressure changes related to patient ingestion of food which passes through the lumen of the stomach of the patient; and

c) a controller adapted to change the volume of the fluid in the band in response to the changes in fluid pressure within the band.

23. The system of claim 22 further comprising a gain control associated with the controller, wherein the gain control is adapted to increase or decrease the magnitude of the change in volume.

24. The system of claim 22 further comprising an automated system which fills or empties the band based on measurements from the pressure sensor.

25. The system of claim 22 further comprising a subcutaneous access port and wherein said pressure sensor is located within said port.

26. The system of claim 25 wherein said subcutaneous access port is configured to allow for calibration of the pressure sensor or charging of a power supply.

27. The system of claim 22 further comprising telemetry hardware which enables communication through the skin of a patient.

28. The system of claim 22 further comprising an inductive circuit configured to receive power through the skin of the patient.

29. The system of claim 22 further comprising an electrical stimulator adapted to provide stimulation to the gastrointestinal system of a patient.

30. The system of claim 29 wherein said electrical stimulator is activated when a food bolus passes through the lumen of the stomach.