METHODS AND INSTRUMENTS FOR TREATING GERD AND HAITAL HERNIA

• US 20100312356A1
• Filed: 01/29/2009
• Published: 12/09/2010
• Est. Priority Date: 01/29/2008
• Status: Active Grant

• Current Assignee: Kirk Promotion Ltd.
• Original Assignee: Kirk Promotion Ltd.
• Inventors: Forsell, Peter
• Granted Patent: US 8,992,629 B2
• Time in Patent Office: Days
• US Class Current: 623/23.65
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/06 with illuminating arrangements
• CPC Class Codes: A61B 1/2736 Gastroscopes
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• 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 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• 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 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00561 creating a vacuum
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00827 : Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/308 : with suction cups
• CPC Class Codes: A61F 2/04 : Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts A61F2/18, A61F2/20 take precedence; devices, other than stent-grafts, providing patency to, or preventing collapsing of, tubular structures of the body other than stent-grafts, e.g. stents A61F2/82; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95
• CPC Class Codes: A61F 2002/044 : Oesophagi or esophagi or gullets
• CPC Class Codes: A61F 2002/045 : Stomach, intestines
• CPC Class Codes: A61F 2005/0016 : comprising measuring means
• CPC Class Codes: A61F 2005/002 : for sensing mechanical parameters
• CPC Class Codes: A61F 2005/0023 : for sensing chemical parameters
• CPC Class Codes: A61F 2250/0001 : Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2250/0004 : adjustable
• 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 5/0013 : Implantable devices or invasive measures
• CPC Class Codes: A61F 5/0026 : Anti-eating devices using electrical stimulation
• CPC Class Codes: A61F 5/003 : inflatable
• CPC Class Codes: A61F 5/0033 : with more than one chamber
• CPC Class Codes: A61F 5/0036 : Intragastrical devices
• CPC Class Codes: A61F 5/004 : remotely adjustable
• CPC Class Codes: A61F 5/0043 : using injection ports
• CPC Class Codes: A61F 5/0046 : with wireless means
• CPC Class Codes: A61F 5/005 : Gastric bands
• CPC Class Codes: A61F 5/0063 : wrapping the stomach
• CPC Class Codes: A61F 5/0069 : in the wall of the stomach
• CPC Class Codes: A61F 5/0073 : in the abdominal cavity, e.g. not attached to the stomach
• CPC Class Codes: A61F 5/0076 : preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0079 : Pyloric or esophageal obstructions
• CPC Class Codes: A61F 5/0083 : Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like
• CPC Class Codes: A61F 5/0089 : Instruments for placement or removal
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

The invention relates to an intraluminar method of treating a reflux disease in a patient by implanting a device comprising an movement restriction device that, when implanted in a patient, fills a volume in the patient'"'"'s abdomen that is close to and at least partially above the patient'"'"'s cardia when the patient is in a standing position. The invention further relates to a method of restoring the location of the cardia in a patient suffering from a reflux disease and to an instrument suitable to use with intraluminar method and/or restoration method. Also disclosed are instruments treating a patient suffering hiatal hernia and providing a movement restriction device to be invaginated in the stomach fundus wall.

Claims

1. An intraluminar method of treating a reflux disease in a patient by implanting a device comprising an implantable movement restriction device that, when implanted in a patient, restricts the movement of the stomach notch in relation to the diaphragm muscle preventing the cardia to slide up through the diaphragm hiatus opening, comprising the steps of:

introducing a gastroscope in the oesophagus and into the stomach of the patient;

introducing an instrument in the oesophagus and into the stomach of the patient,

said instrument being integrated in said gastroscope or separate from the same;

providing, by means of said of instrument, a pouch from the stomach fundus wall for accommodating the device and invaginating the device in the pouch with sutures or stables to the stomach fundus wall, thereby preventing the cardia from sliding through the patient'"'"'s diaphragm opening into the patient'"'"'s thorax, so as to maintain the supporting pressure against the patient'"'"'s cardia sphincter muscle exerted from the patient'"'"'s abdomen.

2. A method according to claim 1 comprising the steps of:

introducing the device into the stomach by means of the instrument;

placing the device on the inside of the stomach fundus wall, using said instrument;

creating, by means of said instrument, a pouch in a portion of the stomach fundus wall on the outside of the stomach cavity, the device placed resting against the inside of the stomach fundus wall; and

invaginating the device in the pouch by with sutures or stables to the stomach fundus wall.

3. A method according to claim 1 comprising the steps of:

creating, by means of said instrument, a pouch of a portion of the stomach fundus wall;

introducing the device by means of the instrument into the pouch; and

invaginating the device with sutures or stables to the stomach fundus wall.

4. A method according to claim 3, comprising inflating the device to its filling volume.

5. A method according claim 3, comprising injecting a filling fluid into the device so it obtains its filling volume.

6. A method according to claim 1 comprising the steps of:

creating a hole in the stomach fundus wall;

introducing the device into the stomach by means of the instrument;

moving the device through the hole and placing it on the outside of the stomach fundus wall;

creating, by means of said instrument, a pouch of a portion of the stomach fundus wall on the inside of the stomach cavity, with the device placed against the outside of the stomach fundus wall;

invaginating the device in the pouch with sutures or stables to the stomach fundus wall; and

sealing the hole with sutures or staples.

7. A method according to claim 1 comprising the steps of:

creating a hole in the stomach fundus wall;

creating, by means of said instrument, a pouch of a portion of the stomach fundus wall on the inside of the stomach cavity;

introducing the device into the stomach by means of the instrument;

moving the device through the hole and placing it on the outside of the stomach fundus wall;

introducing the device by means of the instrument into the pouch;

invaginating the device with sutures or stables to the stomach fundus wall; and

sealing the hole with sutures or staples

8. A method according to claim 7, comprising inflating the device to its filling volume.

9. A method according claim 8, comprising injecting a filling fluid into the device so it obtains its filling volume.

10. A method according to claim 1, further comprising affixing the device to the stomach fundus wall by providing sutures or staples.

11. A method according to claim 1 further comprising affixing the stomach fundus wall to the lower part of the patient'"'"'s oesophagus by providing sutures or staples.

12. A method according to claim 1, further comprising affixing the stomach fundus wall to the patient'"'"'s diaphragm muscle or associated muscles.

13. A method according to claim 1, further comprising providing an apparatus for regulating the reflux treatment device from the outside of the patient'"'"'s body;

and operating said apparatus to regulate the reflux treatment device.

14. A method according to claim 13, wherein regulation of the reflux treatment device includes changing the volume of the filling body when implanted.

15. A method according to claim 14, comprising providing an injection type syringe comprising a fluid for injection into an implanted filling body;

and injecting volume of fluid into filling body.

16. A method according to claim 1, comprising enclosing the device in the pouch.

17. A method according to claim 1 comprising admitting the pouch being at least partly open.

18. A method according to claim 17, admitting that the pouch exhibits only one opening.

19. A method according to claim 17, admitting the pouch to exhibit two openings and to extend non-circumferentially around the stomach.

20. A method according to claim 1, wherein the volume of the pouch is more than 15 millilitres.

21-84. -84. (canceled)