Methods and apparatus for improving the function of biological passages

• US 6,960,233 B1
• Filed: 12/09/2003
• Issued: 11/01/2005
• Est. Priority Date: 12/10/2002
• Status: Active Grant

• Current Assignee: Torax Medical, Inc. (Johnson & Johnson)
• Original Assignee: Torax Medical, Inc. (Johnson & Johnson)
• Inventors: Torborg, Jeffrey G., Berg, Todd A.
• Primary Examiner(s): Stewart, Alvin
• Application Number:
  US10/732,696
• Time in Patent Office: 693 Days
• Field of Search: 623/23.7, 623/23.64, 623/23.65, 623/23.68, 623 124- 126, 606/153, 606/151, 606/139, 606/142, 606/196
• US Class Current: 623/23.7
• CPC Class Codes: A61F 2/04 Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts A61F2/18, A61F2/20 take precedence; devices, other than stent-grafts, providing patency to, or preventing collapsing of, tubular structures of the body other than stent-grafts, e.g. stents A61F2/82; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95

Abstract

Several methods and apparatus are available for treating patients that suffer from both gastro-esophageal reflux disorder and hiatal hernias. In order to treat these patients, an endoscopic probe may be used to push the herniated stomach below the diaphragm. In some embodiments, a two-part stent comprising a funnel stent and a reverse stent may be deployed to prevent a future re-herniation of the stomach and to reduce the annulus of the lower esophageal sphincter. In some embodiments, a reverse stent with perforating barbs may be deployed, in which the barbs penetrate the esophageal wall and attach to the diaphragm. In some embodiments, the crus muscles may be sutured together to reduce the hiatus size and a reverse stent may be deployed to reduce the annulus of the lower esophageal sphincter.

Claims

1. A method for treating a patient with a hiatal hernia and gastro-esophageal reflux disorder, the method comprising:

pushing the patient'"'"'s herniated stomach below the patient'"'"'s diaphragm using an endoscopic probe;

inserting a first catheter through the patient'"'"'s mouth to the patient'"'"'s stomach, wherein the first catheter contains a compressed funnel stent;

releasing the funnel stent, wherein the funnel stent expands and engages to the patient'"'"'s stomach and prevents the stomach from re-herniating through the patients diaphragm;

inserting a second catheter through the patient'"'"'s mouth to the patient'"'"'s lower esophageal sphincter, wherein the second catheter contains a reverse stent;

releasing the reverse stent from the second catheter;

expanding the reverse stent to engage the patient'"'"'s esophageal tissue; and

releasing the reverse stent, such that the reverse stent draws the patient'"'"'s esophageal tissue inwards to decrease the annulus of the lower esophageal sphincter.

2. The method of claim 1, wherein the funnel stent includes barbs arranged on its exterior.

3. The method of claim 1, wherein the reverse stent includes barbs arranged on its exterior.

4. The method of claim 1, wherein the reverse stent is expanded using a balloon.

5. A method for treating a patient with a hiatal hernia and gastro-esophageal reflux disorder, the method comprising:

pushing the patient'"'"'s herniated stomach below the patient'"'"'s diaphragm using an endoscopic probe;

inserting a catheter through the patient'"'"'s mouth to the patient'"'"'s stomach, wherein the catheter contains a reverse stent with perforating barbs;

releasing the reverse stent from the catheter;

expanding the reverse stent, wherein the barbs engage the patient'"'"'s esophageal tissue and diaphragm; and

releasing the reverse stent, such that the reverse stent draws the patient'"'"'s esophageal tissue and diaphragm inwards to strengthen the patient'"'"'s crus muscles and decrease the annulus of the patient'"'"'s lower esophageal sphincter.

6. The method of claim 5, wherein the reverse stent is expanded using a balloon.

7. A method for treating a patient with a hiatal hernia and gastro-esophageal reflux disorder, the method comprising:

pushing the patient'"'"'s herniated stomach below the patient'"'"'s diaphragm using an endoscopic probe;

suturing the patient'"'"'s left and right crus muscles laparoscopically to reduce the size of the hiatus;

inserting a catheter through the patient'"'"'s mouth to the patient'"'"'s lower esophageal sphincter, wherein the catheter contains a reverse stent;

releasing the reverse stent from the catheter;

expanding the reverse stent to engage the patient'"'"'s esophageal tissue; and

releasing the reverse stent, wherein the reverse stent draws the patient'"'"'s esophageal tissue inwards to decrease the annulus of the patient'"'"'s lower esophageal sphincter.

8. The method of claim 7, wherein the reverse stent contains barbs arranged on its exterior.

9. The method of claim 7, wherein the reverse stent is expanded using a balloon.