Extragastric minimally invasive methods and devices to treat obesity

• US 7,988,617 B2
• Filed: 03/31/2006
• Issued: 08/02/2011
• 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:
  US11/396,160
• Publication Number:
  US 20060212053A1
• Time in Patent Office: 1,950 Days
• Field of Search: 600/37, 606191-198, 604/96.01
• 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
• 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
• 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
• 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 placing a device to restrict flow of food into the stomach of a patient comprising:

a. penetrating the abdominal wall of a patient;

b. contacting the stomach of the patient with a connector;

c. pushing an extragastric balloon through the abdominal wall while the extragastric balloon is in contact with the connector and while the extragastric balloon is undeployed and thence contacting the stomach of the patient with the balloon;

d. fixing the extragastric balloon to an outer portion of the stomach;

e. placing an endoscope through the mouth of a patient and into the stomach of the patient;

f. penetrating the wall of the stomach with the endoscope;

g. delivering a fastener through the endoscope and fastening the extragastric balloon to the outer portion of the stomach.

2. A method of placing a device to restrict flow of food into the stomach of a patient comprising:

a. penetrating the abdominal wall of a patient;

b. contacting the stomach of the patient with a connector;

c. pushing an extragastric balloon comprising a material which promotes ingrowth and tissue adhesion through the abdominal wall while the extragastric balloon is in contact with the connector and while the extragastric balloon is undeployed;

d. contacting the stomach of the patient with the extragastric balloon;

e. fixing the extragastric balloon to an outer portion of the stomach.

3. The method of claim 2 further comprising:

a. Cutting the connector so that the residual of the connector remains in the abdominal cavity.

4. The method of claim 2 further comprising:

a. Cutting the connector so that the residual of the connector traverses at least a part of the abdominal wall.

5. The method of claim 4 further comprising:

a. Attaching an access port to the connector operable to inflate or deflate the extragastric balloon.

6. The method of claim 4 wherein said outer portion of the stomach is about 1-5 centimeters from the GE junction.

7. The method of claim 2 wherein the extragastric balloon comprises a structure which enables gripping by a gripping tool, said gripping tool being slideable over the connector.

8. The method of claim 2 further comprising visualizing the connector under fluoroscopy.

9. The method of claim 2 further comprising visualizing the connector with a laparoscope.

10. The method of claim 2 further comprising:

locking a fastener on the connector.

11. The method of claim 2 further comprising fixing the extragastric balloon to the abdominal wall.

12. The method of claim 2 wherein the connector is a suture and the extragastric balloon comprises an attachment anchor, said method further comprising applying a knot with the suture, to the attachment anchor.

13. A method of treating a patient comprising:

a. Passing an extragastric balloon through the skin over a connector;

b. anchoring the extragastric balloon to the outer wall of the stomach;

c. leaving the connector at least partially within the abdominal wall;

d. inflating or deflating the extragastric balloon through the connector.

14. The method of claim 13 further comprising passing an electrical current through the connector.

15. The method of claim 13 wherein the connector extends through the gastric wall.

16. A medical device comprising:

a device body portion expandable from an undeployed configuration to a deployed configuration;

a device body surface constructed to be directly fixtured to the outer surface of the stomach when the device body is maintained between the abdominal wall and the stomach;

a support structure attached directly adjacent to the device body and constructed to slide over a connector.

17. The medical device of claim 16 wherein said support structure is operable to lock onto the connector.

18. The medical device of claim 16 wherein the device body surface further comprises a second anchor is constructed to be fixtured to the inner surface of the abdominal wall.

19. The medical device of claim 16 wherein the connector is operable to inflate or deflate the body.

20. The device of claim 16 wherein the elongate connector is a surgical suture.

21. The device of claim 16 wherein the device body portion comprises a portion which is inflatable with a fluid.

22. The device of claim 21 wherein the device body portion circumscribes the stomach.

23. A medical device comprising:

a device body portion, expandable from an undeployed configuration to a deployed configuration;

a device body surface constructed to be fixtured to the outer surface of the stomach;

an elongate connector comprising a current conducting material and operable to attach the medical device to the stomach;

a support structure constructed to slide over the elongate connector.

24. A medical device comprising:

a device body portion, expandable from an undeployed configuration to a deployed configuration;

an elongate connector configured to attach the medical device to a stomach;

a device body surface, comprising a material which conducts an electrical current and constructed to be fixtured to the outer surface of the stomach using the connector; and

, a support structure constructed to slide over the connector.