Method and apparatus for endoscopic repair of the lower esophageal sphincter

• US 8,628,543 B2
• Filed: 02/28/2011
• Issued: 01/14/2014
• Est. Priority Date: 11/12/1999
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Pugsley, Charles H. Jr., Gellman, Barry N.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): OU, JING RUI
• Application Number:
  US13/037,334
• Publication Number:
  US 20110208219A1
• Time in Patent Office: 1,051 Days
• Field of Search: 606/129, 606/139, 606/151, 606/152, 606/153, 606/213, 606/215, 606/216, 606/217, 606/232, 128/898
• US Class Current: 606/139
• 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 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61F 5/0086 using clamps, folding means or the like

Abstract

The present invention includes a method and apparatus for adhering tissue to one another. In an embodiment of the present invention the two tissues to be joined, for example the lower esophagus and the fundus of the stomach, are first placed adjacent to one another. Next a first restraint is placed near the outside surface of one of the tissues and a second restraint is placed near the outside surface of the other tissue. An irritant is then placed between the two adjacent tissues. The restraints, and consequently the tissue surfaces, are then drawn together. As the touching irritated tissue surfaces heal they will become bonded to one another and their need for the mechanical fastening of the restraints, to secure them together, will be diminished.

Claims

1. A method of fastening two tissue portions, comprising:

bringing a first gastrointestinal tissue portion towards a second gastrointestinal tissue portion to create a fold of tissue;

inserting a fastener into a patient;

fastening the first gastrointestinal tissue portion to the second gastrointestinal tissue portion with the fastener, wherein the fastener includes a first anchor, a second anchor, a third anchor, and a connecting member for connecting the first, second, and third anchors together, wherein the second anchor is slidably connected to the connecting member before the fastener is inserted into the patient, wherein one of the first and second anchors includes an irritating agent before the fastener is inserted into the patient; and

positioning the second anchor between the first and second gastrointestinal tissue portions.

2. The method of claim 1, wherein at least one of the first and second gastrointestinal tissue portions includes fundus tissue of a stomach.

3. The method of claim 1, further comprising extending the fastener through an exterior surface of a stomach wall.

4. A method of fastening two tissue portions, comprising:

bringing at least one of the two tissue portions towards the other of the two tissue portions to create a fold of tissue;

fastening together the two tissue portions with a fastener, wherein the fastener includes a first anchor, a second anchor, a third anchor, and a connecting member for connecting the first, second, and third anchors together, wherein the second anchor is slidably connected to the connecting member before the fastener is inserted into the patient, wherein the first anchor includes a heat-activated material within a periphery of the first anchor, and wherein the second anchor is absent any heat-activated material within a periphery of the second anchor; and

positioning the second anchor between the two tissue portions.

5. The method of claim 4, further comprising bringing a first gastrointestinal tissue portion towards a second gastrointestinal tissue portion to create the fold of tissue.

6. The method of claim 4, wherein at least one of the two tissue portions includes fundus tissue of a stomach.

7. The method of claim 4, further comprising extending the fastener through an exterior surface of a stomach wall.

8. The method of claim 4, wherein the third anchor includes a heat-activated material within a periphery of the third anchor, and the second anchor includes an irritating agent.

9. The method of claim 4, further comprising reconfiguring the fundus of a stomach.

10. A method of fastening two tissue portions, comprising:

bringing a first tissue portion towards a second tissue portion to create a fold of tissue, wherein at least one of the first and second tissue portions includes gastrointestinal tissue; and

fastening together the first and second tissue portions with a fastener, wherein the fastener includes a first anchor, a second anchor, a third anchor, and a connecting member for connecting the first, second, and third anchors together, wherein at least one of the second anchor and the third anchor is slidably connected to the connecting member, wherein the second anchor is positioned between the first and second tissue portions.

11. The method of claim 10, further comprising bringing a first gastrointestinal tissue portion towards a second gastrointestinal tissue portion to create the fold of tissue.

12. The method of claim 10, further comprising extending the fastener through an exterior surface of a stomach wall.

13. The method of claim 10, wherein the second anchor includes an irritating agent.

14. The method of claim 13, further comprising contacting the second anchor with an exterior surface of the first tissue portion and an exterior surface of the second tissue portion.

15. The method of claim 10, further comprising reconfiguring the fundus of a stomach.

16. A method of fastening two tissue portions, comprising:

bringing a first gastrointestinal tissue portion towards a second gastrointestinal tissue portion to create a fold of tissue; and

fastening the first gastrointestinal tissue portion to the second gastrointestinal tissue portion with a fastener, wherein the fastener includes a first anchor, a second anchor, a third anchor, and a connecting member for connecting the first, second, and third anchors together, wherein at least one of the second anchor and the third anchor is slidably connected to the connecting member, wherein one of the first and second anchors includes an irritating agent, wherein the second anchor is positioned between the first and second gastrointestinal tissue portions, and wherein the first anchor includes a heat-activated material within a periphery of the first anchor, the third anchor includes a heat-activated material within a periphery of the third anchor, and the second anchor is absent any heat-activated material within a periphery of the second anchor.

17. The method of claim 16, wherein the second anchor includes the irritating agent.

18. A method of fastening two tissue portions, comprising:

bringing a first tissue portion towards a second tissue portion to create a fold of tissue, wherein at least one of the first and second tissue portions includes gastrointestinal tissue; and

fastening together the first and second tissue portions with a fastener, wherein the fastener includes a first anchor, a second anchor, a third anchor, and a connecting member for connecting the first, second, and third anchors together, wherein at least one of the second anchor and the third anchor is slidably connected to the connecting member, wherein the second anchor is positioned between the first and second tissue portions, and wherein the first anchor includes a heat-activated material within a periphery of the first anchor, the third anchor includes a heat-activated material within a periphery of the third anchor, and the second anchor is absent any heat-activated material within a periphery of the second anchor.