Methods and devices for endosonography-guided fundoplexy
First Claim
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1. A method for treating gastroesophageal reflux disease comprising:
- inserting a tissue securement apparatus through an esophageal wall, a diaphragmatic crura and a fundal wall of a stomach;
advancing a connecting element into the stomach;
joining the proximal end of the connecting element to a ligating element;
pulling the connecting element to position the ligating element across the esophageal wall, the diaphragmatic crura and the fundal wall of the stomach; and
fastening the esophageal wall to the fundal wall with the ligating element to capture the diaphragmatic crura between the walls.
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Abstract
The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a ligation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a ligation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This ligation element placed from the esophagus and around the Angle of His to create a barrier to gastroesophageal reflux.
268 Citations
13 Claims
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1. A method for treating gastroesophageal reflux disease comprising:
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inserting a tissue securement apparatus through an esophageal wall, a diaphragmatic crura and a fundal wall of a stomach; advancing a connecting element into the stomach; joining the proximal end of the connecting element to a ligating element; pulling the connecting element to position the ligating element across the esophageal wall, the diaphragmatic crura and the fundal wall of the stomach; and fastening the esophageal wall to the fundal wall with the ligating element to capture the diaphragmatic crura between the walls.
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2. A method for connecting a first body cavity having an esophageal wall to a stomach having a fundal wall comprising:
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inserting a tissue securement apparatus containing a needle with proximal and distal end portions, through the esophageal and fundal walls, wherein the needle comprises a hollow needle body, a detachable sharpened needle tip, a stylet positioned coaxially inside the needle body, and a connecting element coupled to the needle tip, wherein the tip directly penetrates the walls and a diaphragmatic crura to position the needle tip in the stomach; removing the needle body while engaging the stylet against the needle tip to disengage the needle tip from the needle body to leave the needle tip and a portion of the connecting element remaining in the stomach; joining a proximal end of the connecting element to a ligating element, positioning a grasping forceps inside the stomach and grasping and pulling a distal end of the connecting element to position the ligating element across the esophageal and fundal walls; and bringing the ends of the ligating element together to form a loop that draws the esophageal and fundal walls together. - View Dependent Claims (3, 4, 5, 6)
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7. A method for repairing a gastroesophageal flap valve comprising:
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positioning a tissue securement apparatus containing a needle with proximal and distal end portions along the esophageal wall wherein the needle comprises a hollow body, a detachable sharpened tip, a stylet positioned coaxially inside the needle body and a connecting element coupled to the needle tip, inserting the tissue securement apparatus through the esophageal wall, the diaphragmatic crura and a fundal wall of the stomach, wherein the sharpened needle tip directly penetrates the walls to position the needle tip in the stomach, advancing the sylet to push the sharpened needle tip from the needle body so that the needle tip is left in the stomach, advancing the connecting element into the stomach, withdrawing the needle body, joining a proximal end of said connecting element to a ligating element, positioning grasping forceps inside the stomach, grasping and pulling the connecting element to position the ligating element across the esophageal wall, the diaphragmatic crura and a fundal wall of the stomach, and bringing the ends of the ligating element together to form a loop that encircles the gastro-esophageal flap valve and draws the esophageal and fundal walls together. - View Dependent Claims (8, 9, 10, 11, 12, 13)
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Specification