Obesity treatment tools and methods

• US 8,075,577 B2
• Filed: 03/12/2007
• Issued: 12/13/2011
• Est. Priority Date: 05/30/2001
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Deem, Mark E., Sutton, Douglas S., Gifford, Hanson S. III, Andreas, Bernard H., French, Ronald G.
• Primary Examiner(s): Nguyen, Victor
• Application Number:
  US11/716,902
• Publication Number:
  US 20070167963A1
• Time in Patent Office: 1,737 Days
• Field of Search: 606/139, 606/142, 606/151, 606/153, 623/23.64, 623/23.68, 128/898, 227/175.1
• US Class Current: 606/153
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61F 5/0083 Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Claims

1. A method for forming a restriction from an interior of an organ and for dilating an opening defined by the organ, comprising:

releasably adhering a first area of the interior to a tissue adhering member;

displacing the first area of the interior via the tissue adhering member;

releasably adhering a second area of the interior to the tissue adhering member such that the first area is positioned near the second area;

fastening the first area to the second area to form the restriction; and

dilating the opening defined at a distal end of the organ, wherein dilating the opening defined at the distal end of the organ occurs after forming the restriction.

2. The method of claim 1, wherein fastening the first area to the second area comprises applying at least one fastener disposed within the tissue adhering member to the first area and the second area.

3. The method of claim 1, wherein the tissue adhering member defines an opening along a length extending between proximal and distal ends of the tissue adhering member.

4. The method of claim 3, wherein the opening defined by the tissue adhering member is adapted to receive a retractable septum.

5. The method of claim 4, wherein the retractable septum defines at least one surface adapted to abrade an adjacent portion of the interior.

6. The method of claim 5, wherein the adjacent portion of the interior is abraded by the retractable septum using a method selected from the group consisting of cutting, scoring, heating, freezing, and chemical ablation.

7. The method of claim 1, wherein the first area of the interior is releasably adhered to the tissue adhering member via a vacuum created in a first opening defined in the tissue adhering member.

8. The method of claim 7, wherein the second area is releasably adhered to the tissue adhering member via a vacuum created in a second opening defined in the tissue adhering member.

9. The method of claim 1, wherein the second area of the interior is releasably adhered to the tissue adhering member via a vacuum created in a second opening defined in the tissue adhering member.

10. The method of claim 1, wherein releasably adhering a second area of the interior to the tissue adhering member such that the first area is positioned near the second area further comprises removing a septum disposed in the tissue adhering member such that the first area contacts the second area.

11. The method of claim 1, wherein the opening comprises a pyloral sphincter.

12. The method of claim 1, wherein dilating the opening comprises applying a stimulus to tissue in or around the opening via an elongated device having a proximal end and a distal end with a length therebetween.

13. The method of claim 12, wherein the stimulus comprises a form of energy selected from the group consisting of heat energy, electrical energy, chemical energy, RF energy, and pressure.

14. The method of claim 12, wherein the elongated device comprises a dilatation device disposed near the distal end.

15. The method of claim 14, wherein the dilation device comprises a dilation wire basket disposed near the distal end, the dilation wire basket applying the stimulus to the tissue.

16. The method of claim 15, wherein the stimulus comprises a change in temperature.

17. The method of claim 14, wherein the dilatation device comprises an angioplasty balloon.

18. The method of claim 14, wherein the angioplasty balloon comprises an expandable surface having at least one cutting member disposed thereon.

19. The method of claim 18, wherein the cutting member is selected from the group consisting of blades and wires.

20. The method of claim 12, wherein the elongated device comprises a combination cutting edge and stapler disposed near the distal end.

21. The method of claim 12, wherein the elongated device comprises:

an elongate shaft having a proximal end and a distal end;

an expandable member disposed at the distal end of the elongate shaft, and stimulating members disposed on the exterior surface of the expandable member;

wherein the expandable member expands when positioned within the opening defined by the organ, and the stimulating members apply the stimulus.

22. The method of claim 21, wherein the elongate shaft is an endoscope.

23. The method of claim 21, wherein the elongate shaft is a catheter.

24. The method of claim 21, wherein the expandable member includes an expandable balloon.

25. The method of claim 21, wherein the expandable member includes a dilation wire basket.

26. The method of claim 21, wherein the stimulating member includes a cutting blade.

27. The method of claim 21, wherein the stimulating member includes an electrode.

28. The method of claim 21, wherein the stimulating member includes a probe.

29. The device method of claim 28, wherein the probe dispenses a cryogenic or chemical substance.

30. The method of claim 1, wherein dilating the opening defined at the distal end of the organ comprises piercing tissue in or around the opening with at least one elongate probe and applying a stimulus via the elongate probe.

31. The method of claim 30, wherein the stimulus comprises a form of energy selected from the group consisting of heat energy, electrical energy, chemical energy, RF energy, and pressure.

32. The method of claim 30, wherein the stimulus is selected from the group consisting of heat energy, electrical energy, chemical energy, and RF energy.

33. The method of claim 30, wherein the stimulus comprises a chemical delivered through an opening defined in a distal end of the probe.

34. The method of claim 33, wherein the chemical is ablative to the tissue in or around the opening.

35. The method of claim 34, wherein the chemical is selected from the group consisting of alcohol, sotrodecol, and botulinum toxin molecule.

36. A surgical method, comprising:

releasably adhering a first area of an interior surface of a stomach to a tissue adhering member, the first area being near a pylorus;

releasably adhering a second area of the interior surface to the tissue adhering member such that the first area is positioned near the second area, the second area being near the pylorus;

with the first and second areas adhered to the tissue adhering member, applying at least one fastener to the first and second areas, thereby fastening the first and second areas together to form a restriction; and

delivering a stimulus to the pylorus to dilate the pylorus and render it incompetent.

37. The method of claim 36, wherein delivering the stimulus comprises applying a form of energy to the pylorus selected from the group consisting of heat energy, electrical energy, chemical energy, RF energy, and pressure.

38. The method of claim 36, wherein delivering the stimulus comprises delivering a poison to the pylorus.

39. The method of claim 36, wherein delivering the stimulus comprises expanding an expandable balloon to dilate the pylorus.

40. The method of claim 39, wherein expanding an expandable balloon causes at least one stimulating member formed on the expandable balloon to pierce the interior surface and deliver the stimulus to the pylorus.

41. The method of claim 36, wherein the stimulus is delivered after the at least one fastener is applied.

42. The method of claim 36, wherein releasably adhering the first area comprises applying a vacuum to adhere the first area to the tissue adhering member, and releasably adhering the second area comprises applying a vacuum to adhere the second area to the tissue adhering member.