Methods of replacing a gastrointestinal bypass sleeve for therapy adjustment

• US 8,968,270 B2
• Filed: 12/05/2011
• Issued: 03/03/2015
• Est. Priority Date: 11/01/2002
• Status: Active Grant

• Current Assignee: ValenTx, Inc.
• Original Assignee: ValenTx, Inc.
• Inventors: Kagan, Jonathan, Dann, Mitchell, Guterman, Lee, Butters, Joshua, Swain, Paul, Fallin, T. Wade, Baldwin, Thomas
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): GRAY, PHILLIP A
• Application Number:
  US13/373,999
• Publication Number:
  US 20120209164A1
• Time in Patent Office: 1,184 Days
• Field of Search: 604500-522, 604/264, 604275-279, 604/96.01, 604/164.01, 604/523, 623/23, 623/6, 606/153
• US Class Current: 604/516
• 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
• 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
• 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

Methods are disclosed for replaceable attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device or an attachment cuff, within a patient'"'"'s digestive tract for treatment of obesity.

Claims

1. A method of adjusting therapy in a patient, comprising the steps of:

identifying a patient with an implanted first gastrointestinal bypass tube, the first bypass tube releasably connected to a support which is attached to tissue in the vicinity of the gastroesophageal junction;

separating the first bypass tube from the support and removing the first bypass tube from the patient after separating the first bypass tube from the support;

providing a second bypass tube, wherein the second bypass tube is different from the first bypass tube; and

attaching the second bypass tube to the support.

2. The method of claim 1, wherein the second bypass tube is less permeable than the first bypass tube.

3. The method of claim 1, wherein the second bypass tube is more permeable than the first bypass tube.

4. The method of claim 1, wherein the second bypass tube comprises a coating.

5. The method of claim 4, wherein the coating is on the exterior of the second bypass tube.

6. The method of claim 4, wherein the coating is on the interior of the second bypass tube.

7. The method of claim 1, wherein the coating comprises a low friction material.

8. The method of claim 7, wherein the low friction material is a lubricious material.

9. The method of claim 1, wherein the second bypass tube comprises a drug coating.

10. The method of claim 1, wherein the second bypass tube comprises a constant diameter.

11. The method of claim 1, wherein the second bypass tube comprises a variable diameter.

12. The method of claim 1, wherein the second bypass sleeve comprises a biodegradable material.

13. The method of claim 1, wherein the second bypass sleeve comprises a series of segments that biodegrade sequentially.

14. The method of claim 1, wherein a distal portion of the second bypass sleeve degrades more rapidly than a proximal portion of the second bypass sleeve.