Obesity treatment tools and methods

• US 6,558,400 B2
• Filed: 05/30/2001
• Issued: 05/06/2003
• Est. Priority Date: 05/30/2001
• Status: Expired due to Term

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Satiety, Inc.
• Inventors: French, Ronald G., Sutton, Douglas S., Gifford, Hanson S. III, Andreas, Bernard H., Deem, Mark E.
• Primary Examiner(s): Izaguirre, Ismael
• Application Number:
  US09/871,297
• Publication Number:
  US 20020183768A1
• Time in Patent Office: 706 Days
• Field of Search: 606/151, 606/153, 606/154, 606/139, 606/142, 606/144, 606/148, 606/155, 606/157, 600/37
• US Class Current: 606/151
• 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 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• 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

Abstract

Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Claims

1. A device for reducing an interior volume of an organ comprising:

a tissue adhering member having a proximal end and a distal end with a length therebetween, the member having at least two releasably adherable regions for releasably positioning via a vacuum a first area of the interior near a second area of the interior,

wherein the interior volume of the organ is reduced upon fastening the first area to the second area such that communication with the interior volume is maintained.

2. The device of claim 1 wherein the first area is positioned adjacent to the second area.

3. The device of claim 1 wherein the first area is in apposition to the second area.

4. The device of claim 1 wherein the tissue adhering member defines a slot along the length, the slot being adapted to receive a retractable septum.

5. The device of claim 4 wherein the retractable septum defines at least one surface adapted to abrade an adjacent portion of the interior.

6. The device of claim 5 wherein the adjacent portion of the interior surface is abraded by the retractable septum using a method selected from the group consisting of cutting, scoring, heating, freezing, and chemical ablation.

7. The device of claim 1 wherein each of the two releasably adherable regions are separated by an angle between about 20°

to 180°

about a longitudinal axis defined by the length.

8. The device of claim 7 wherein the two releasably adherable regions are separated by an angle between about 90°

to 180°

.

9. The device of claim 1 wherein the first area and the second area are adhered to the tissue adhering member via the vacuum created in each of the two releasably adherable regions.

10. The device of claim 9 wherein each of the two releasably adherable regions are in fluid communication with a common channel defined within the tissue adhering member.

11. The device of claim 1 further comprising a delivery member having a proximal end and a distal end with a length therebetween, the tissue adhering member being attached to the distal end of the delivery member.

12. The device of claim 11 wherein the tissue adhering member is in fluid communication with the proximal end of the delivery member.

13. The device of claim 1 wherein the length of the tissue adhering member is straight.

14. The device of claim 1 wherein the length of the tissue adhering member defines an arc.

15. The device of claim 1 wherein a geometry of the tissue adhering member is adjustable.

16. The device of claim 1 wherein the distal end of the tissue adhering member flares away from a curvature of the organ.

17. The device of claim 1 wherein the organ comprises a stomach.

18. The device of claim 17 wherein the tissue adhering member is adapted to be inserted into the stomach endoscopically via an esophageal passageway.

19. The device of claim 1 further comprising at least one fastener disposable within the tissue adhering member for fastening the first area to the second area.

20. The device of claim 19 further comprising a wedge slidingly disposed within an interior channel defined by the tissue adhering member, the wedge being adapted to urge the fastener from an open first configuration to a closed second configuration.

21. The device of claim 20 further comprising a wire attached to the wedge.

22. The device of claim 19 wherein the fastener comprises a mechanical fastener selected from the group consisting of C staples, U staples, clips, and tags.

23. The device of claim 19 wherein the fastener comprises a screw having a helical shape.

24. The device of claim 23 wherein a diameter of a distal end of the screw is larger than a diameter of a proximal end of the screw.

25. The device of claim 24 wherein a length between the distal end of the screw and the proximal end of the screw is tapered.

26. The device of claim 23 wherein at least two coils at a distal end of the screw each comprise a diameter which is equal.

27. The device of claim 23 wherein a distal end of the screw is configured to pierce tissue.

28. The device of claim 23 wherein the screw is at least partially covered with securing members.

29. The device of claim 28 wherein the securing members are selected from the group consisting of barbs and whisker-like filaments.

30. The device of claim 23 wherein the screw comprises a bioabsorbable or biocompatible material.

31. The device of claim 30 wherein the bioabsorbable or biocompatible material is selected from the group consisting of polymers and superelastic alloys.

32. The device of claim 23 wherein the screw is configured to alternatingly pierce a first area of tissue and a second area of tissue while approximating the first area of tissue and the second area of tissue together.

33. The device of claim 19 further comprising a plurality of additional fasteners, each of the fasteners being configured to fasten the first area to the second area while juxtaposed linearly to form a continuous fixation line.

34. A method for reducing an interior volume of an organ comprising:

releasably adhering a first area of the interior to a tissue adhering member via a vacuum;

releasably adhering a second area of the interior to the tissue adhering member via the vacuum such that the first area is positioned near the second area; and

,

fastening the first area to the second area such that communication with the interior volume is maintained, thereby reducing the interior volume of the organ.

35. The method of claim 34 wherein the first area and the second area are releasably adhered to the tissue adhering member via the vacuum created in at least two releasably adherable regions defined in the tissue adhering member.

36. The method of claim 34 wherein the first area is positioned adjacent to the second area.

37. The method of claim 34 wherein the first area is in apposition to the second area.

38. The method of claim 34 wherein releasably adhering a second area of the interior surface to the tissue adhering member such that the first area is positioned near the second area further comprises removing a septum disposed in the tissue adhering member such that the first area contacts the second area.

39. The method of claim 34 further comprising inducing a healing response in the first area or the second area.

40. The method of claim 38 further comprising abrading the first area or the second area while removing the septum.

41. The method of claim 39 wherein inducing a healing response in the first area or the second area comprises a method selected from the group consisting of cutting, scoring, heating, freezing, and chemical ablation.

42. The method of claim 34 wherein fastening the first area to the second area further comprises sliding a wedge disposed within an interior channel defined by the tissue adhering member such that the wedge urges a mechanical fastener to cinch the first area to the second area.

43. The method of claim 34 wherein the fastener is selected from the group consisting of C staples, U staples, clips, and tags.

44. The method of claim 34 further comprising disengaging the first area and the second area from the tissue adhering member.

45. The method of claim 34 wherein the organ comprises a stomach.

46. The method of claim 45 wherein the tissue adhering member is endoscopically inserted into the stomach via an esophageal passageway prior to releasably adhering a first area of the interior to a tissue adhering member.

47. The method of claim 34 wherein fastening the first area to the second area creates a boundary between a lumen, formed by the fastened first area and second area, and a remaining portion of the organ.

48. The method of claim 47 wherein the boundary is straight.

49. The method of claim 47 wherein the boundary approximates a curvature of the organ.

50. The method of claim 47 wherein the boundary is adjustable.

51. The method of claim 47 wherein the boundary flares towards the remaining portion of the organ.

52. The method of claim 34 wherein fastening the first area to the second area to reduce the volume of an interior organ further comprises urging a fastener through an interior channel defined in the tissue adhering member to fasten the first area and the second area together.

53. The method of claim 52 wherein the fastener has a tapering helical shape with a piercing end.

54. The method of claim 52 wherein urging the fastener through the interior channel comprises rotating the fastener about a longitudinal axis defined by the fastener such that the first area and the second area cinches together.