ENDOSCOPIC FULL THICKNESS GASTRIC REDUCTION APPARATUS AND METHOD

• US 20120239061A1
• Filed: 03/15/2011
• Published: 09/20/2012
• Est. Priority Date: 03/15/2011
• Status: Abandoned Application

• Current Assignee: Sandip V. Mathur
• Original Assignee: Sandip V. Mathur
• Inventors: Mathur, Sandip V.
• Application Number:
  US13/048,229
• Publication Number:
  US 20120239061A1
• Time in Patent Office: Days
• US Class Current: 606/140
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00738 part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
• 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 2017/00858 high friction or non-slip
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/12018 Elastic band ligators
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/345 for introduction into a natural body opening
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

A device, adapted to receive one or more gastric bands and adapted to be coupled to a surgical instrument such as an endoscope, comprises a tubular main body and a cap comprising an opening through which a guidewire may be threaded. A triggering wire may be detachably coupled to one or more bands to permit remote removal of said bands. The bands may be improved bands comprising gripping points, an inner reinforcement ring, or an expanded surface area portion.

A method for performing band ligation comprises the steps of: providing a device comprising a main body portion, a removably coupled cap, one or more gastric bands, and a band triggering wire; introducing the device through the mouth into the stomach; dislodging the cap; targeting and drying specific locations of the gastric wall; withdrawing a portion of the gastric wall into the device; and displacing one or more of the bands such that the band circumscribes said wall portion; and the administration of medication to prevent gastric contractions.

Claims

1. An apparatus for introducing a medical instrument into a patient, the apparatus comprising:

a main body portion and a distal tapered portion, said apparatus having a cavity adapted to receive said instrument, said apparatus being further adapted to receive a guidewire.

2. The apparatus of claim 1 wherein said distal tapered portion is removably coupled to said main body.

3. The apparatus of claim 1 wherein said medical instrument is an endoscope.

4. The apparatus of claim 2 wherein said distal tapered portion comprises a through opening adapted to allow said guidewire to be threaded.

5. The apparatus of claim 2 wherein said distal tapered portion is retrievable.

6. The apparatus of claim 2 wherein said distal tapered portion is at least partially formed from biodegradable material.

7. The apparatus of claim 2 wherein said distal tapered portion is at least partially formed from inert material.

8. The apparatus of claim 1 further comprising a guidewire channel through which the guidewire may be threaded.

9. The apparatus of claim 8 wherein said guidewire channel is positioned on an external surface of said main body.

10. The apparatus of claim 1 wherein said apparatus further comprises one or more elastic bands elastically coupled to and disposed around a perimeter of said main body portion.

11. The apparatus of claim 10 further comprising a triggering wire adapted to displace said one or more elastic bands from said main body portion.

12. The apparatus of claim 11 wherein said cap further comprises one or more triggering wire channels through which said band triggering wire may be threaded.

13. The apparatus of claim 11 wherein said main body further comprises one or more triggering wire channels through which said band triggering wire may be threaded.

14. The apparatus of claims 11 wherein said cap further comprises one or more triggering wire channels through which said band triggering wire may be threaded, wherein said main body further comprises one or more triggering wire channels through which said band triggering wire may be threaded, and wherein at least one of said cap triggering wire channels and at least one of said main body triggering wire channels may be arranged to form a combined triggering wire channel.

15. The apparatus of claim 1 wherein said main body portion comprises a tapered proximal portion.

16. The apparatus of claim 1 wherein said distal tapered portion is inflatable.

17. The apparatus of claim 1 wherein said main body portion comprises an angled distal portion.

18. The apparatus of claim 2 wherein said distal tapered portion is at least partially transparent.

19. The apparatus of claim 2 wherein said tapered portion is tethered to said main body.

20. The apparatus of claim 5 further comprising a flush tube.

21. The apparatus of claim 20 wherein said flush tube is adapted for use in retrieving said distal tapered portion.

22. The apparatus of claim 1 further comprising a distal main body opening in a side wall.

23. A method for performing band ligation comprising the steps of:

providing a device comprising a main body portion, a tapered distal portion, one or more gastric bands, and a band triggering wire, said tapered distal portion being removably coupled to said main body portion;

introducing the device through the mouth and esophageal opening and into the stomach, the stomach having a gastric wall;

dislodging the distal tapered portion from said main body portion;

withdrawing a portion of the gastric wall into the device to form a gathered portion; and

displacing one or more of said bands such that said band circumscribes said gathered portion.

24. The method for performing band ligation of claim 23 further comprising the step of drying a portion of the gastric wall.

25. The method for performing band ligation of claim 23 further comprising administering intravenous medication to prevent contractions of the stomach.

26. The method for performing band ligation of claim 23 further comprising the step of retrieving said distal tapered portion.

27. The method for performing band ligation of claim 23 further comprising the step of injecting said gathered portion with a destruction agent.

28. The method for performing band ligation of claim 23 further comprising the step of thermally destroying said gathered portion.

29. The method for performing band ligation of claim 23 wherein said method is used to treat a hiatal hernia.

30. The method for performing band ligation of claim 23 wherein said method is used to treat hyperacidity.

31. The method for performing band ligation of claim 23 wherein said method is used to treat acid reflux.

32. The method for performing band ligation of claim 23 wherein said method is used to treat Barrett'"'"'s Esophagitis.

33. The method for performing band ligation of claim 23 wherein a first plurality of gathered portions are gathered from a fundus area of the stomach and a second plurality of gathered portions are gathered from stomach areas more distal from said mouth than said fundus area, wherein the number of said gathered portions comprising said first plurality is greater than the number of said gathered portions comprising said second plurality.

34. The method for performing band ligation of claim 23 wherein a plurality of said gathered portions is arranged substantially in a ring pattern.

35. The method for performing band ligation of claim 23 wherein a plurality of said gathered portions is arranged substantially in a linear pattern.

36. A method for performing band ligation comprising the steps of:

providing a device comprising a main body portion, a tapered distal portion, one or more gastric bands, and a band triggering wire, said tapered distal portion being removably coupled to said main body portion;

providing a guidewire having first and second ends;

inserting the guidewire first end through a patient'"'"'s mouth, through an esophageal opening, and into a patient'"'"'s stomach, the stomach having a gastric wall;

introducing the device over the guidewire second end through the mouth and esophageal opening and into the stomach;

dislodging the distal tapered portion from said main body portion;

withdrawing a full thickness of the gastric wall into the device; and

displacing one or more of said bands such that said band circumscribes a portion of said wall.

37. The method for performing band ligation of claim 36 further comprising the step of drying a portion of the gastric wall.

38. The method for performing band ligation of claim 36 further comprising the step of administering medication to prevent contractions of the stomach.

39. The method for performing band ligation of claim 36 further comprising the step of threading said guidewire though a distal tapered portion through opening.

40. The method for performing band ligation of claim 36 further comprising the step of retrieving said distal tapered portion.

41. The method for performing band ligation of claim 36 further comprising the step of injecting said gathered portion with a destruction agent.

42. The method for performing band ligation of claim 36 further comprising the step of thermally destroying said gathered portion.

43. The method for performing band ligation of claim 36 wherein said method is used to treat a hiatal hernia.

44. The method for performing band ligation of claim 36 wherein said method is used to treat hyperacidity.

45. The method for performing band ligation of claim 36 wherein said method is used to treat acid reflux.

46. The method for performing band ligation of claim 36 wherein said method is used to treat Barrett'"'"'s Esophagitis.

47. The method for performing band ligation of claim 36 wherein a first plurality of gathered portions are gathered from a fundus area of the stomach and a second plurality of gathered portions are gathered from stomach areas more distal from said mouth than said fundus area, wherein the number of said gathered portions comprising said first plurality is greater than the number of said gathered portions comprising said second plurality.

48. The method for performing band ligation of claim 36 wherein a plurality of said gathered portions is arranged substantially in a ring pattern.

49. The method for performing band ligation of claim 36 wherein a plurality of said gathered portions is arranged substantially in a linear pattern.

50. An improved gastric band comprising:

a circular elastic outer band and a concentric inner band.

51. An improved gastric band comprising:

a circular main body comprising outer, inner, and side walls, wherein said inner wall comprises a plurality of gripping points.

52. An improved gastric band comprising:

a circular body comprising outer, inner, and side walls, said band having a width defined by said side walls, and a thickness defined by said outer and inner walls;

wherein said width is approximately equal to that of said thickness.

53. An improved gastric band comprising:

a circular body comprising outer, inner, and side walls, said band having a width defined by said side walls and a thickness defined by said outer and inner walls, wherein said width is different than said thickness.

54. An improved gastric band comprising an elastic mesh network.

55. An improved gastric band comprising a plurality of openings positioned around an inside perimeter of said band.