Compressive device for percutaneous treatment of obesity

• US 7,938,769 B2
• Filed: 01/15/2008
• Issued: 05/10/2011
• Est. Priority Date: 03/23/2004
• Status: Expired due to Fees

• Current Assignee: Michael Gertner
• Original Assignee: Michael Gertner
• Inventors: Gertner, Michael
• Primary Examiner(s): Gilbert; Samuel G
• Application Number:
  US12/014,107
• Publication Number:
  US 20080167648A1
• Time in Patent Office: 1,211 Days
• Field of Search: 606/153, 606/191, 606/192, 606/195, 606/232, 607/40, 600/37, 128/897, 128/898
• US Class Current: 600/37
• 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 17/0401 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00871 polymeric
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Disclosed are methods and apparatus for implantation into the walls of an organ such as the stomach. Deformable or inflatable anchors with a connector between are used to pull the walls of the organ together, or to implant devices in the wall of the organ. Also disclosed are surgical instruments useful in practicing the disclosed methods.

Claims

1. A method of treating a patient, said method comprising:

a. Passing a device including an expandable member in a collapsed configuration through an opening in the skin of the patient, and into the abdominal cavity of the patient;

b. passing a connector through the skin of the patient, and into the abdominal cavity; and

wherein the device is passed over the connector to guide the device to an intended location in the abdominal cavity;

c. anchoring at least a portion of the expandable member relative to the stomach of the patient; and

,

d. expanding the expandable member to an expanded configuration in a space in the abdominal cavity to perform at least one of;

prevention of expansion of the stomach into the space and compression of a portion of the stomach.

2. A method of treating obesity in a patient, said method comprising:

a. making a percutaneous opening through the abdominal wall of the patient;

passing a device having at least two portions contained within introducer tubes passed through an access sheath, said access sheath inserted through said opening;

b. positioning the at least two portions adjacent the stomach of the patient with a connector in between the at least two portions; and

c. expanding at least one of the portions to form a barrier that inhibits expansion of the stomach.

3. A method of treating obesity in a patient, said method comprising:

making a percutaneous opening through the abdominal wall of the patient;

passing a device having at least two portions through said opening;

positioning the at least two portions adjacent the stomach of the patient with a connector in between the at least two portions; and

, expanding at least one of the portions to form a barrier that inhibits expansion of the stomach;

anchoring the device to the abdominal wall of the patient wherein said anchoring comprises expanding an expandable anchor that circumscribes at least one filling tube connected to said expandable portions and protrudes out of the abdominal wall.

4. A method of treating a patient, said method comprising:

a. Passing a device including an expandable member in a collapsed configuration through an opening in the skin of the patient, and into the abdominal cavity of the patient;

b. inserting a sheath through a minimally invasive opening made through the skin and abdominal wall and passing a connector through the sheath to pass the connector through the skin and abdominal wall and into the abdominal cavity wherein the device is passed over the connector to guide the device to an intended location in the abdominal cavity;

c. anchoring at least a portion of the expandable member relative to the stomach of the patient; and

,

d. expanding the expandable member to an expanded configuration in a space in the abdominal cavity to perform at least one of;

prevention of expansion of the stomach into the space and compression of a portion of the stomach.

5. A method of treating a patient, said method comprising:

a. Passing a device including a first expandable member and a second expandable member in a collapsed configuration through an opening in the skin of the patient, and into the abdominal cavity of the patient;

b. anchoring at least a portion of the first or second expandable member relative to the stomach of the patient; and

,

c. expanding the first and second expandable members to an expanded configuration in a space in the abdominal cavity to perform at least one of;

prevention of expansion of the stomach into the space and compression of a portion of the stomach.

6. The method of claim 5 further comprising:

anchoring at least one said expandable member to the stomach.

7. The method of claim 5 wherein at least one of said expandable members is anchored to the abdominal wall.

8. The method of claim 5 further comprising:

attaching the first expandable member to the abdominal wall and configuring the second expandable member to press against the exterior of the stomach.

9. The method of claim 8 wherein the first expandable member further comprises a mesh and said method further comprises attaching said mesh to the abdominal wall.

10. The method of claim 5, further comprising a connector;

and, tensioning said connector to at least one said expandable member to attach the expandable member to the abdominal wall.

11. The method of claim 10 wherein said connector is a suture and said tensioning is performed with a surgical instrument with a lumen through which the suture travels.

12. A method of treating a patient, said method comprising:

a. Passing a device including an expandable member in a collapsed, compact configuration, the device being provided with an opening on one side of the device and an opening on a second side of the device, the compact configuration being achieved by compressing the device to align the openings on opposite ends of the device, and inserting a connector through the aligned set of openings;

b. anchoring at least a portion of the expandable member relative to the stomach of the patient; and

,

c. expanding the expandable member to a expanded configuration in a space in the abdominal cavity to perform at least one of;

prevention of expansion of the stomach into the space and compression of a portion of the stomach.