Method for transesophageal retraction of the stomach

• US 5,382,231 A
• Filed: 02/02/1993
• Issued: 01/17/1995
• Est. Priority Date: 02/02/1993
• Status: Expired due to Fees

• Current Assignee: Leonard M. Shlain
• Original Assignee: Leonard M. Shlain
• Inventors: Shlain, Leonard M.
• Primary Examiner(s): KRUTER, JEROME
• Application Number:
  US08/012,219
• Time in Patent Office: 714 Days
• Field of Search: 604/26, 604/49, 604/50, 604/51, 128/898, 128/DIG. 12, 128/DIG. 13
• US Class Current: 128/898
• 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 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61M 2025/0161 wherein the distal tips have two or more deflection regions
• CPC Class Codes: A61M 25/0138 having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0155 with hydraulic or pneumatic means, e.g. balloons or inflatable compartments

Abstract

A device for transesophageal stomach retraction comprises an elongate shaft having a proximal handle in a distal length. The distal length is deformable so that it can assume a desired configuration, such as a J-shaped curvature, and is deflectable so that it may be repositioned within the stomach. The proximal length may further include vacuum ports which permit the stomach to be drained and collapsed on the distal length to enhance contact. [This way, the] The treating physician inserts the device through the mouth of the patient with the distal length penetrating the stomach. Thereafter, the device is moved from the proximal end to manipulate the distal ends to move the stomach. Preferably, the device is deformed prior to such moving into a desired curvature, preferably a J-shaped configuration. The vacuum ports are utilized to draw the stomach over the device. Thereafter by exerting torque through the esophagus, the physician can manipulate and retract a patient'"'"'s stomach from the inside permitting operation on the outside of the stomach and adjacent organs that require retraction of the stomach over extended periods of time, [during a variety of surgical procedures,] including both laparoscopic and open surgical procedures.

Claims

1. A method for performing a laparoscopic procedure in the region of a patient'"'"'s stomach, said method comprising:

insufflating the abdomen to raise the abdominal wall over the stomach;

introducing a laparoscope into the region between the abdominal wall and the stomach;

viewing the region of the stomach through the laparoscope;

providing a device having a distal and proximal end with means for forming a J-shaped curvature in the distal end of the device from the proximal end of the device;

inserting a device through the patient'"'"'s esophagus so that a distal end of the device lies within the stomach and a proximal end of the device extends outward from the patient'"'"'s mouth;

manipulating the proximal end of the device to form the J-shaped curvature in the distal end of the device through the patient'"'"'s esophagus to move the stomach and expose a region of or near the patient'"'"'s stomach to the laparoscope; and

,

performing a procedure in the exposed region through an incision in the abdominal wall while viewing the region through the laparoscope.

2. A method as in claim 1, further comprising positioning the device within the esophagus and stomach by observing an illuminated light on the device through the tissue of the esophagus and stomach.

3. A method as in claim 1, further comprising increasing the cross-sectional area of the distal end of the device after inserting.

4. A method as in claim 3, further comprising deflecting an articulated distal length of the device to increase exposure of the lesser curvature of the stomach.

5. A method as in claim 3, further comprising applying a vacuum to a plurality of ports along the distal end of the device and thereafter manipulating the proximal end to turn the stomach and expose the posterior vessels of the lesser curvature of the stomach in a non-traumatic manner from the inside of the stomach for extended periods of time.

6. A method as in claim 1, wherein said performing a procedure in the exposed region through an incision in the abdominal wall while viewing the region through the laparoscope includes a procedure on the exterior of the stomach without perforating the stomach.

7. A method as in claim 6, wherein the proximal end of the device has been manipulated to position the distal end of the device so that the J-shaped curvature will engage the greater curvature of the stomach to expose the lesser curvature of the stomach in a non-traumatic manner for extended periods of time.

8. A method as in claim 6, wherein the procedure comprises clearing the anterior vessels of the lesser curvature of the stomach.