SYSTEMS AND METHODS FOR GASTRIC VOLUME REGULATION

• US 20110295056A1
• Filed: 05/10/2011
• Published: 12/01/2011
• Est. Priority Date: 05/26/2010
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Stulen, Foster B., Ortiz, Mark S., Shelton, Frederick E. IV, Voegele, James W., Harris, Jason L., Dlugos, Daniel F. JR., Messerly, Jeffrey D., Weaner, Lauren S., Hunt, John V., Malaviya, Prasanna, Cropper, Michael S., Zeiner, Mark S., Yates, David C., Widenhouse, Christopher W., Robertson, Galen C., Herrera-Davis, Denzel Z., Aldridge, Jeffrey L., Overmyer, Mark D., Thompson, Suzanne, Widenhouse, Tamara S. Vetro
• Application Number:
  US13/104,223
• Publication Number:
  US 20110295056A1
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12159 Solid plugs; being solid before insertion
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 2017/00035 pH
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00898 expandable upon contact with fluid
• CPC Class Codes: A61B 2017/1142 Purse-string sutures
• CPC Class Codes: A61F 5/004 remotely adjustable
• CPC Class Codes: A61F 5/0056 using injection ports
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

Devices and methods for modifying stomach volume include the formation of intragastric slots for wrapping one or more portions of the fundus therethrough with minimal interference with nerves and vasculature flow. Intragastric space occupying devices expand with environmental changes brought about by natural conditions inherent to the digestive cycle such as with changes in pH. Extragastric volume occupying balloons are placed into folded stomach sections. The balloons are fluidly coupled to external gastric filling devices. In yet another set of embodiments, methods and devices provide adjustable gastric volume reduction fundal wraps. In one embodiment, a device is placed in the fundus for Nissen fundoplication and permits postoperative adjustment to reach desired weight loss. Intragastric and extragastric balloons are optionally incorporated.

Claims

1. A method for modifying the volume of a stomach, the method comprising:

a. creating a reduced gastric volume passageway through a portion of a stomach through which food can pass; and

b. preventing ghrelin cells within a greater curvature portion of said stomach from contacting said food.

2. The method of claim 1, wherein said reduced gastric volume passageway is formed by passing said greater curvature portion of said stomach through a slot formed in said stomach.

3. The method of claim 1, wherein said reduced gastric volume passageway is formed by passing a portion of a fundus of said stomach through a slot in said stomach.

4. The method of claim 1, wherein said reduced gastric volume passageway is formed by a portion of said stomach wrapped around said passageway.

5. The method of claim 1, wherein said reduced gastric volume passageway functions as a gastric banding mechanism.

6. The method of claim 1, wherein said gastric volume passageway slows the exit of ingested food from said stomach.

7. The method of claim 1, wherein the act of creating a reduced gastric volume passageway comprises:

i. creating more than one slot in said stomach, wherein said more than one slot is oriented horizontally through a fundus portion of said stomach to create multiple fundus portions,

ii. pulling each said fundus portion individually through said more than one slot in said stomach,

iii. wrapping each said fundus portion around said stomach, and

iv. affixing said fundus portions.

8. The method of claim 1, wherein the act of creating a reduced gastric volume passageway comprises:

i. creating a horizontal slot below a portion of said stomach near an entrance to the small intestine, wherein said horizontal slot extends about one half to about two thirds down the length of a fundus of said stomach,

ii. creating a vertical transection from the angle of His along part of a lesser curvature portion of said stomach, sufficient to free up said fundus,

iii. folding said fundus through said horizontal slot and around an antrum of said stomach, and

iv. affixing said fundus.

9. The method of claim 8, further comprising severing the vagus nerve.

10. The method of claim 1, wherein said reduced volume gastric passageway comprises a volume occupying device in a pocket area of a fundus area of said stomach, wherein said fundus area is created by a wrap internal to a wall of said stomach.

11. The method of claim 10, wherein said volume occupying device stretches the wall of said stomach.

12. The method of claim 10, wherein said volume occupying device is selected from at least one of a fundal balloon, an environmental sensitive hydrogel, a pH sensitive material, an auto-adjust band placed between said vertical transection and said angle of His, or a combination thereof.

13. The method of claim 10, wherein said volume occupying device is placed in a location selected from an upper portion of a slot in said stomach and the angle of His, a pocket area of a slot external to said stomach, pressure points within said stomach capable of facilitating feelings of satiation, an outer portion of a wall of said stomach, and combinations thereof.

14. The method of claim 10, wherein said volume occupying device is pH sensitive.

15. The method of claim 1, wherein said method is used to treat or cure a condition selected from at least one of metabolic disorders, obesity, anorexia, depression, insomnia, learning disorders, attention disorders, memory loss, or a combination thereof.

16. A method of regulating the activation of ghrelin hormone within a stomach of a patient, the method comprising modifying ghrelin octanoyl acyl transferase access to ghrelin within the stomach, wherein the act of modifying ghrelin octanoyl acyl transferase access to ghrelin within the stomach comprises creating a fundal wrap;

wherein said method results in an effect selected from treatment of weight disorders, promotion of learning and/or memory functions, treatment of stress-induced depression, promotion of healthy sleep, and combinations thereof.

17. The method of claim 16, wherein ghrelin octanoyl acyl transferase interaction with ghrelin is decreased.

18. The method of claim 16, wherein ghrelin octanoyl acyl transferase interaction with ghrelin is increased.

19. The method of claim 16, further comprising the step of implanting a volume occupying device in said stomach.

20. A method of regulating gastric volume, the method comprising the steps of

a. performing a full or partial fundoplication procedure in a patient, wherein the act of performing a full or partial fundoplication procedure comprises attaching one end of a fundus in said patient to an esophagus in said patient;

and

b. implanting a volume occupying device external to or within said fundus of said patient concurrent with said fundoplication procedure, such that said volume occupying device is capable of expanding or contracting based on environmental changes in said stomach.