Method and apparatus for augmentation of a sphincter
First Claim
1. A medical apparatus for adding bulk to the lower esophageal sphincter of a patient, comprising:
- an elongate introducer member including a distal end configured for penetrating tissue and a first passageway extending therethrough;
one or more resilient implantable members, each said implantable member being constrainable by the introducer member into an elongate first configuration from an expanded second configuration, the medical apparatus comprising a mechanism configured to urge the one or more implantable members from the introducer member into the tissue of the lower esophageal sphincter, the one or more implantable members being adapted to resiliently expand toward the expanded second configuration upon deployment from the introducer member, said one or more implantable members being configured to expand into static contact with surrounding tissue of the lower esophageal sphincter on implantation to push against the surrounding tissue of the lower esophageal sphincter, so that expansive force by said one or more implantable member on the tissue is in equilibrium with containing force exerted by the tissue on said one or more implantable member, the second configuration being substantially more curvilinear in shape than the first configuration,wherein said apparatus includes a means for separating tissue and creating a pocket within the submucosal layers sufficient for implantation of at least one of the one or more implantable members.
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0 Petitions
Accused Products
Abstract
A system and method for delivering one or more implantable members, such as metal coils, via an introducer member, such as an endoscopic needle, into a space created within the submucosal layers of the LES to augment and bulk the sphincter to improve compliance in patients with gastroesophageal reflux disease. The implantable member comprises a first substantially straightened configuration when carried by the introducer member, whereby it assumes a more curvilinear or coiled configuration following deployment such that it expands against adjacent submucosal tissue, creating a bulge at the implantation site. In another embodiment, the implantable member can serve as an anchoring port for sutures or other elements introduced for gastroplication of the LES to create tissue folds that increase sphincter compliance. The implantable members may be configured to include an external portion that interconnects with an adjacent implantable member, thereby creating tension that also increases compliance of the LES.
29 Citations
34 Claims
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1. A medical apparatus for adding bulk to the lower esophageal sphincter of a patient, comprising:
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an elongate introducer member including a distal end configured for penetrating tissue and a first passageway extending therethrough; one or more resilient implantable members, each said implantable member being constrainable by the introducer member into an elongate first configuration from an expanded second configuration, the medical apparatus comprising a mechanism configured to urge the one or more implantable members from the introducer member into the tissue of the lower esophageal sphincter, the one or more implantable members being adapted to resiliently expand toward the expanded second configuration upon deployment from the introducer member, said one or more implantable members being configured to expand into static contact with surrounding tissue of the lower esophageal sphincter on implantation to push against the surrounding tissue of the lower esophageal sphincter, so that expansive force by said one or more implantable member on the tissue is in equilibrium with containing force exerted by the tissue on said one or more implantable member, the second configuration being substantially more curvilinear in shape than the first configuration, wherein said apparatus includes a means for separating tissue and creating a pocket within the submucosal layers sufficient for implantation of at least one of the one or more implantable members. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 19, 20, 21, 22, 24, 25)
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17. A medical apparatus for introduction into the submucosal space of the lower esophageal sphincter of a patient, comprising:
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an elongate needle member and a coaxial outer sheath sized and configured for introduction through a flexible endoscope, the needle member including a distal end and a first passageway extending therethrough; at least one implantable member; wherein the at least one implantable member is constrainable into a first substantially linear configuration for introduction through the first passageway of the needle member, and in said first configuration said implantable member is substantially straight and has a substantially constant external diameter; and wherein the at least one implantable member includes a shape memory such that it is adapted to assume a second configuration upon deployment from the needle member, the at least one implantable member comprising a plurality of bends such that it is adapted to create a volumetric expansion of the submucosal space when implanted therein, and wherein the assumption of said second configuration includes maintaining said external diameter as substantially constant while said implantable member curls into a plurality of loops, said loops in contact along at least a portion of their respective exteriors. - View Dependent Claims (18, 23, 26, 34)
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27. A medical apparatus for adding bulk to the lower esophageal sphincter of a patient, comprising:
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an elongate introducer member including a distal end configured for penetrating tissue and a first passageway extending therethrough; one or more resilient implantable members, each said implantable member being constrainable by the introducer member into an elongate first configuration from an expanded second configuration, the medical apparatus comprising a mechanism configured to urge the one or more implantable members from the introducer member into the tissue of the lower esophageal sphincter, the one or more implantable members being adapted to resiliently expand toward the expanded second configuration upon deployment from the introducer member, said one or more implantable members being configured to expand into contact with tissue of the lower esophageal sphincter on implantation, so that force by said one or more implantable member on the tissue is in equilibrium with force exerted by the tissue on said one or more implantable member, the second configuration being substantially more curvilinear in shape than the first configuration, wherein at least one of said implantable members is configured to be anchored in the lower esophageal sphincter by piercing the lower esophageal sphincter with said at least one implantable member or a suture connected to said at least one implantable member. - View Dependent Claims (28, 29, 30, 31, 32, 33)
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Specification