Method and apparatus for endoscopic repair of the lower esophageal sphincter

• US 6,837,894 B2
• Filed: 03/26/2002
• Issued: 01/04/2005
• Est. Priority Date: 11/12/1999
• Status: Expired due to Term

• Current Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Gellman, Barry N., Pugsley, Charles H. Jr.
• Primary Examiner(s): Woo, Julian W.
• Assistant Examiner(s): Ho, (Jackie) Tan-Uyen T.
• Application Number:
  US10/105,235
• Publication Number:
  US 20020161381A1
• Time in Patent Office: 1,015 Days
• Field of Search: 606151-153, 606/139, 606/232, 606/129, 606/213
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• 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 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

The present invention includes a method and apparatus for adhering tissue to one another. In an embodiment of the present invention the two tissues to be joined, for example the lower esophagus and the fundus of the stomach, are first placed adjacent to one another. Next a first restraint is placed near the outside surface of one of the tissues and a second restraint is placed near the outside surface of the other tissue. An irritant is then placed between the two adjacent tissues. The restraints, and consequently the tissue surfaces, are then drawn together. As the touching irritated tissue surfaces heal they will become bonded to one another and their need for the mechanical fastening of the restraints, to secure them together, will be diminished.

Claims

1. A method for connecting a first bodily organ and a second bodily organ comprising:

providing a first surgical anchor, a second surgical anchor, and a third surgical anchor;

placing a wall of the first organ between said first surgical anchor and said second surgical anchor,

said second surgical anchor containing an irritating agent;

placing a wall of the second organ between said second surgical anchor and said third surgical anchor, and,

drawing said first surgical anchor, the wall of the first organ, said second surgical anchor, the wall of the second organ, and said third surgical anchor together.

2. The method of claim 1 wherein said irritating agent is a sclerosing agent.

3. The method of claim 1 wherein a guy wire passes through said first surgical anchor, said second surgical anchor, and said third surgical anchor.

4. The method of claim 1 further comprising:

inserting an endoscope having a proximal end and a distal end into the second organ; and

inserting a pointed carrier containing said first surgical anchor, said second surgical anchor, and said third surgical anchor into said proximal end of said endoscope.

5. The method of claim 1 wherein the wall of the first organ is the fundal wall of the stomach and wherein the wall of the second organ is the esophageal wall.

6. The method of claim 5 further comprising:

placing a pointed carrier containing said first surgical anchor, said second surgical anchor, and said third surgical anchor in contact with the esophageal wall.

7. The method of claim 6 further comprising:

punching said pointed carrier through the esophageal wall and through the fundal wall of the stomach.

8. The method of claim 7 further comprising:

anchoring said first surgical anchor, the esophageal wall, said second surgical anchor, the fundal wall of the stomach, and said third surgical anchor together.

9. The method of claim 8 wherein said first surgical anchor, the esophageal wall, said second surgical anchor, the fundal wall of the stomach, and said third surgical anchor are anchored together for a predetermined period of time.

10. A method for connecting a first bodily organ and a second bodily organ comprising:

providing a first surgical anchor, a second surgical anchor, and a third surgical anchor;

placing a wall of the first organ between said first surgical anchor and said second surgical anchor;

placing a wall of the second organ between said second surgical anchor and said third surgical anchor; and

,

drawing said first surgical anchor, the wall of the first organ, said second surgical anchor, the wall of the second organ, and said third surgical anchor together,

wherein one of said anchors contain collagen.

11. The method of claim 10 wherein one of said surgical anchors is made with genetically engineered tissue.

12. The method of claim 10 wherein said first surgical anchor and said third surgical anchor each contain nitinol.

13. A method for repairing the lower esophageal sphincter of the esophagus having an upper end, a lower end, and an outside surface, by securing it to the stomach having a fundal wall, the fundal wall having an interior surface and an exterior surface, comprising:

inserting a pointed carrier containing a first anchor, a second anchor, and a third anchor into the esophagus;

punching said pointed carrier through the lower end of the esophagus into the stomach;

deploying said first anchor through the lower end of the esophagus, through the fundal wall, into the stomach;

deploying said second anchor between the outside surface of the lower end of the esophagus and the exterior surface of the fundal wall;

deploying said third anchor inside the lower end of the esophagus;

drawing said first anchor, the esophageal wall, said second anchor, the fundal wall, and said third anchor toward each other; and

securing said first anchor, the esophageal wall, said second anchor, the fundal wall, and said third anchor together,

wherein one of said anchors is made with genetically engineered tissue.

14. The method of claim 13 further comprising:

inserting an endoscope having a proximal end and a distal end into the esophagus; and

, inserting said pointed carrier into said proximal end of said endoscope.

15. The method of claim 13 further comprising:

mounting said first anchor, said second anchor, and said third anchor onto a guy wire.

16. The method of claim 13 wherein said pointed carrier is a hypotube.

17. A method for repairing the lower esophageal sphincter of the esophagus having an upper end, a lower end, and an outside surface, by securing it to the stomach having a fundal wall, the fundal wall having an interior surface and an exterior surface, comprising:

inserting a pointed carrier containing a first surgical anchor, a second surgical anchor, and a third surgical anchor into the esophagus;

punching said pointed carrier through the lower end of the esophagus into the stomach;

deploying said first anchor through the lower end of the esophagus, through the fundal wall, into the stomach;

deploying said second anchor between the outside surface of the lower end of the esophagus and the exterior surface of the fundal wall;

deploying said third anchor inside the lower end of the esophagus;

drawing said first anchor, the esophageal wall, said second anchor, the fundal wall, and said third anchor toward each other; and

securing said first anchor, the esophageal wall, said second anchor, the fundal wall, and said third anchor together,

wherein said second anchor is pre-treated with an irritating agent.

18. The method of claim 17 wherein said irritating agent is a sclerosing agent.

19. A method for repairing the lower esophageal sphincter of the esophagus having an upper end, a lower end, and an outside surface, by securing it to the stomach having a fundal wall, the fundal wall having an interior surface and an exterior surface, comprising:

inserting a pointed carrier containing a first anchor, a second anchor, and a third anchor into the esophagus;

punching said pointed carrier through the lower end of the esophagus into the stomach;

deploying said first anchor through the lower end of the esophagus, through the fundal wall, into the stomach;

deploying said second anchor between the outside surface of the lower end of the esophagus and the exterior surface of the fundal wall;

deploying said third anchor inside the lower end of the esophagus;

drawing said first anchor, the esophageal wall, said second anchor, the fundal wall, and said third anchor toward each other; and

securing said first anchor, the esophageal wall, said second anchor, the fundal wall, and said third anchor together,

wherein at least one of said first anchor, said second anchor, or said third anchor contains collagen or nitinol.

20. The method of claim 19 wherein said guy wire, said first anchor, and said third anchor each contain nitinol.