Devices and methods for endolumenal gastrointestinal bypass

• US 8,182,459 B2
• Filed: 10/11/2006
• Issued: 05/22/2012
• Est. Priority Date: 11/01/2002
• Status: Expired due to Fees

• Current Assignee: ValenTx, Inc.
• Original Assignee: ValenTx, Inc.
• Inventors: Dann, Mitchell, Butters, Joshua, Fluet, Greg, Guterman, Lee, Kagan, Jonathan, Swain, Paul, von Hoffmann, Gerard, Wright, James
• Primary Examiner(s): Mehta, Bhisma
• Assistant Examiner(s): Bosques, Edelmira
• Application Number:
  US11/548,605
• Publication Number:
  US 20070198074A1
• Time in Patent Office: 2,050 Days
• Field of Search: 604/516, 604525-526, 604/256, 604/238, 604/167.02, 604909-910, 604/175, 604/500, 604/264, 600/591, 600/593, 600/350, 606/198
• US Class Current: 604/500
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/0643 with separate closing member, e.g. for interlocking with staple
• 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 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• 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 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• 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 2017/0472 Multiple-needled, e.g. double-needled, instruments
• 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: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 : Coils or spirals
• 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
• CPC Class Codes: A61F 2002/044 : Oesophagi or esophagi or gullets
• CPC Class Codes: A61F 5/0036 : Intragastrical devices
• 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

The present invention provides devices and methods for attachment of an endolumenal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve or other therapeutic or diagnostic device, within a patient'"'"'s digestive tract. In one application of the invention, an endolumenal bypass sleeve is removably attached in the vicinity of the gastroesophageal junction to treat obesity and/or its comorbidities, such as diabetes. The bypass sleeve may be at least partially deployed by eversion.

Claims

1. A method of treating a patient, comprising the steps of:

advancing a bypass sleeve deployment device transesophageally at least as far as the stomach;

advancing a distal end of a bypass sleeve from the bypass sleeve deployment device distally into the intestine;

attaching an attachment cuff in the vicinity of the gastroesophageal junction; and

attaching a proximal end of the bypass sleeve to the attachment cuff.

2. A method as in claim 1, wherein the advancing a bypass sleeve step comprises everting the bypass sleeve under pressure.

3. A method as in claim 1, wherein the attaching an attachment cuff step comprises advancing at least one tissue anchor through tissue in the area of the gastroesophageal junction.

4. A method as in claim 3, wherein the attaching an attachment cuff step comprises advancing at least eight tissue anchors through tissue in the area of the gastroesophageal junction.

5. A method as in claim 1, wherein the attaching the bypass sleeve step comprises reversibly attaching the bypass sleeve to the attachment cuff.

6. A method as in claim 1, wherein advancing the bypass sleeve deployment device transesophageally step comprises advancing the bypass sleeve deployment device transesophageally to about the pylorus.

7. A method as in claim 1, wherein attaching the attachment cuff step comprises attaching the attachment cuff at the gastroesophageal junction.

8. A method as in claim 1, wherein attaching the attachment cuff step comprises attaching the attachment cuff no more than about 2 cm below the squamocolumnar junction.

9. A method as in claim 1, wherein attaching the attachment cuff step comprises attaching the attachment cuff no more than about 1 cm below the squamocolumnar junction.

10. A method as in claim 1, wherein attaching the attachment cuff step comprises attaching the attachment cuff transmurally in the vicinity of the gastroesophageal junction.

11. A method as in claim 1, wherein advancing a bypass sleeve from the bypass sleeve deployment device distally into the intestine step comprises advancing the distal end of the bypass sleeve from the bypass sleeve deployment device distally into the duodenum.

12. A method as in claim 1, wherein advancing a bypass sleeve from the bypass sleeve deployment device distally into the intestine step comprises advancing the distal end of the bypass sleeve from the bypass sleeve deployment device distally into the jejunum.

13. A method as in claim 1, wherein advancing a bypass sleeve from the bypass sleeve deployment device distally into the intestine step comprises advancing the distal end of the bypass sleeve from the bypass sleeve deployment device distally into the ileum.

14. A method as in claim 1, wherein the method is accomplished endoscopically.

15. A method as in claim 1, wherein the bypass sleeve deployment device comprises a filling catheter.