Devices and methods for treatment of obesity

• US 8,353,925 B2
• Filed: 06/23/2008
• Issued: 01/15/2013
• Est. Priority Date: 04/19/2006
• Status: Expired due to Fees

• Current Assignee: Vibrynt, Inc.
• Original Assignee: Vibrynt, Inc.
• Inventors: Makower, Joshua, Bender, Theodore M., Shiu, Brian K., Acosta, Pablo G., Uemura, Shuji, Friedmann, Josef L., Lee, Crystine
• Primary Examiner(s): Jackson, Gary
• Assistant Examiner(s): MENDOZA, MICHAEL G
• Application Number:
  US12/214,950
• Publication Number:
  US 20090012555A1
• Time in Patent Office: 1,667 Days
• Field of Search: 606/119, 606/151, 606/191, 606/192, 606/198, 606/200, 606/201, 606/203, 600/37
• US Class Current: 606/192
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00221 with wireless transmission of data, e.g. by infrared radiation or radiowaves
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 5/036 by means introduced into body tracts A61B5/032 and A61B5/035 take precedence
• CPC Class Codes: A61B 5/392 Detecting gastrointestinal contractions
• CPC Class Codes: A61B 5/416 the spleen
• CPC Class Codes: A61B 5/42 Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems A61B1/00, A61B5/4857, A61B5/486, A61B5/4866, A61B5/4869 take precedence
• CPC Class Codes: A61B 90/98 using electromagnetic means, e.g. transponders
• CPC Class Codes: A61F 5/003 : inflatable
• CPC Class Codes: A61F 5/0073 : in the abdominal cavity, e.g. not attached to the stomach
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

Methods, devices, tools and assemblies for treating a patient to effect weight loss. One method embodiment involves passing a device including an expandable member in a collapsed configuration and a buoyancy member through an opening in the skin of a patient and into the abdominal cavity of the patient, and anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity. Devices including at least one expandable member and at least one buoyancy member are provided.

Claims

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

passing a device including an expandable member in a collapsed configuration and a buoyancy member into the abdominal cavity outside of the stomach of the patient; and

anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity;

wherein said expandable member, in an expanded configuration, and said buoyancy member are configured to provide said device with a density that is greater than a density of the patient'"'"'s fat and less than a density of water.

2. The method of claim 1, further comprising 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 of the patient into the space; and

compression of a portion of the stomach.

3. The method of claim 1, wherein the buoyancy member and the expandable member are passed into the abdominal cavity together, in the same method step.

4. The method of claim 1, wherein the buoyancy member and the expandable member are passed into the abdominal cavity in separate passing steps.

5. The method of claim 1, wherein the steps are performed without direct visualization thereof.

6. The method of claim 1, wherein at least one of the steps is performed under direct visualization.

7. The method of claim 2, wherein the expandable member is expanded by inputting liquid therein, and wherein the buoyancy member has a degree of positive buoyancy, relative to the density of the surroundings of the device in the abdominal cavity, to offset a negative buoyancy of the expandable member containing the liquid, to provide a combined buoyancy of the device so that the device is substantially neutrally buoyant relative to the surroundings.

8. The method of claim 1, wherein the buoyancy member is expandable, said method further comprising inputting gas into the buoyancy member to expand the buoyancy member.

9. The method of claim 2, wherein the buoyancy member is free floating within the expandable member.

10. The method of claim 1, wherein the buoyancy member is fixed to an inner surface of the expandable member.

11. The method of claim 8, further comprising adjusting buoyancy of the device by adjusting a degree of expansion of the buoyancy member by performing at least one of:

inputting additional gas into the buoyancy member, or removing gas from the buoyancy member.

12. The method of claim 1, wherein the buoyancy member is provided in the shape of an elongated spine.

13. The method of claim 12, wherein the buoyancy member is fixed to an inner surface of the expandable member and rigidifies the expandable member against kinking.

14. The method of claim 1 comprising flattening or otherwise compressing the buoyancy member to a compressed configuration and maintaining the compressed configuration during said passing.

15. The method of claim 14, further comprising removing flattening or compression force from the buoyancy member once the buoyancy member has been placed in the abdominal cavity, wherein, upon removal of said flattening or compression force, the buoyancy member self-expands to a non-compressed configuration.

16. The method of claim 1, wherein said passing comprises passing the expandable member into the abdominal cavity prior to passing the buoyancy member into the abdominal cavity, and wherein the buoyancy member is passed into a chamber within the expandable member when passed into the abdominal cavity.

17. The method of claim 1, wherein the device is passed through an opening in the skin of the patient, the opening through the skin being formed by an incision no longer than about 7 cm.

18. The method of claim 1, wherein the device is passed through an opening in the skin of the patient, the opening through the skin being formed by an incision no longer than about 5 cm.

19. The method of claim 1, wherein said anchoring comprises anchoring at least one attachment tab, extending from the expandable member, to the at least one structure.

20. The method of claim 19, wherein said anchoring comprises anchoring at least one of said attachment tabs to an internal surface of the abdominal cavity.

21. The method of claim 20, wherein said anchoring comprises passing at least one suture through said at least one attachment tab and through the abdominal wall, and fixing said at least one suture externally of an external surface of the abdominal wall.

22. The method of claim 20, wherein said anchoring comprises passing at least one ribbon, attached to said at least one attachment tab, through the abdominal wall, and fixing said at least ribbon externally of an external surface of the abdominal wall.

23. The method of claim 1, further comprising repositioning the device in the abdominal cavity prior to said anchoring.

24. The method of claim 23, wherein said repositioning comprises manipulating a positioning loop from outside the patient, the positioning loop being attached to the device.

25. The method of claim 23, wherein said repositioning comprises puncturing through a location of the skin of the patient and inserting an instrument into the abdominal cavity;

capturing a positioning loop attached to the device;

pulling a portion of the positioning loop through the abdominal wall; and

applying tension to the positioning loop to move the device and draw a portion of the device up against an internal surface of the abdominal wall.

26. The method of claim 25, further comprising fixing a portion of the positioning loop externally of the abdominal wall to prevent it from passing back into the abdominal cavity.

27. The method of claim 23, wherein said repositioning comprises grasping at least one positioning tab mounted to said device, and performing at least one of pushing, pulling or twisting forces on the at least one positioning tab to reposition or reorient the device.

28. The method of claim 20, wherein said anchoring comprises passing at least one Q-ring through said at least one attachment tab and through the abdominal wall, thereby fixing said at least one attachment tab to the abdominal wall.

29. The method of claim 19, wherein said anchoring comprises passing at least one Q-ring through said at least one attachment tab and through the at least one structure, thereby fixing said at least one attachment tab to the at least one structure.

30. The method of claim 21, wherein said anchoring comprises puncturing through a location of the skin above a location of at least one said suture and inserting an instrument into the abdominal cavity;

capturing the suture; and

wherein said passing at least one suture through the abdominal wall comprises pulling a portion of the at least one suture through the abdominal wall;

applying tension to the at least one suture to draw the at least one attachment tab against an internal surface of the abdominal wall; and

fixing the at least one suture externally of the abdominal wall.