Method for controlling flow in a bodily organ

• US 8,992,409 B2
• Filed: 04/12/2010
• Issued: 03/31/2015
• Est. Priority Date: 10/11/2007
• Status: Active Grant

• Current Assignee: Kirk Promotion Ltd.
• Original Assignee: Kirk Promotion Ltd.
• Inventors: Forsell, Peter
• Primary Examiner(s): Matthews, Christine
• Assistant Examiner(s): LANNU, JOSHUA DARYL DEANON
• Application Number:
  US12/758,694
• Publication Number:
  US 20110066254A1
• Time in Patent Office: 1,814 Days
• Field of Search: 600/30, 600/37, 128897-899, 607/151
• US Class Current: 600/30
• 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 2002/045 Stomach, intestines
• CPC Class Codes: A61M 2205/8243 by induction
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/161 mechanically acting upon the outside of the patient's blood vessel structure, e.g. compressive structures placed around a vessel
• CPC Class Codes: A61M 60/196 replacing the entire heart, e.g. total artificial hearts [TAH]
• CPC Class Codes: A61M 60/268 the displacement member being flexible, e.g. membranes, diaphragms or bladders
• CPC Class Codes: A61M 60/284 Linear peristaltic pumps
• CPC Class Codes: A61M 60/289 Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] devices
• CPC Class Codes: A61M 60/427 the force acting on the blood contacting member being hydraulic or pneumatic
• CPC Class Codes: A61M 60/468 the force acting on the actuation means being hydraulic or pneumatic
• CPC Class Codes: A61M 60/515 Regulation using real-time patient data
• CPC Class Codes: A61M 60/531 using blood pressure data, e.g. from blood pressure sensors
• CPC Class Codes: A61M 60/538 Regulation using real-time blood pump operational parameter data, e.g. motor current
• CPC Class Codes: A61M 60/859 Connections therefor
• CPC Class Codes: A61M 60/873 specially adapted for wireless or transcutaneous energy transfer [TET], e.g. inductive charging
• CPC Class Codes: A61N 1/0507 Electrodes for the digestive system
• CPC Class Codes: A61N 1/0509 Stomach and intestinal electrodes
• CPC Class Codes: A61N 1/0517 Esophageal electrodes
• CPC Class Codes: A61N 1/0521 Genital electrodes
• CPC Class Codes: A61N 1/056 : Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/3605 : Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36085 : Eating disorders or obesity
• CPC Class Codes: A61N 1/36107 : Sexual dysfunction stimulating genital organs A61N1/36007
• CPC Class Codes: A61N 1/36514 : controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 : controlled by blood pressure
• CPC Class Codes: A61N 1/36578 : controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia

Abstract

There is provided a method for controlling a flow of fluid and/or other bodily matter in a lumen formed by a tissue wall of a patient'"'"'s organ. The method comprises gently constricting (i.e., without substantially hampering the blood circulation in the tissue wall) at least one portion of the tissue wall to influence the flow in the lumen, and stimulating the constricted wall portion to cause contraction of the wall portion to further influence the flow in the lumen. The method can be used for restricting or stopping the flow in the lumen, or for actively moving the fluid in the lumen, with a low risk of injuring the organ. Such an organ may be the esophagus, stomach, intestines, urine bladder, urethra, ureter, renal pelvis, aorta, corpus cavernosum, exit veins of erectile tissue, uterine tube, vas deferens or bile duct, or a blood vessel.

Claims

1. A method for controlling a flow of fluid and/or other bodily matter in a lumen formed by a tissue wall of a patient'"'"'s organ, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the tissue wall of the patient'"'"'s organ,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s organ,

using the constriction device to gently constrict the at least one portion of the tissue wall portion of the patient'"'"'s organ to influence the flow in the lumen, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall portion of the patient'"'"'s organ to cause contraction of the wall portion to further influence the flow in the lumen.

2. The method according to claim 1, wherein the constriction is performed by constricting the at least one portion of the tissue wall portion of the patient'"'"'s organ, so that the flow in the lumen is restricted but not stopped, and the stimulation is performed by stimulating the constricted at least one portion of the tissue wall portion of the patient'"'"'s organ to cause contraction thereof, so that the flow in the lumen is further restricted but not stopped.

3. The method according to claim 1, wherein the constriction is performed by constricting the at least one portion of the tissue wall portion of the patient'"'"'s organ, so that the flow in the lumen is restricted but not stopped, and the stimulation is performed by stimulating the constricted wall portion to cause contraction thereof, so that the flow in the lumen is stopped.

4. The method according to claim 1, wherein the constriction is performed by constricting the at least one portion of the tissue wall portion of the patient'"'"'s organ, so that the flow in the lumen is stopped, and the stimulation is performed by stimulating the constricted wall portion of the patient'"'"'s organ to cause contraction thereof, so that the flow in the lumen remains stopped when a pressure increase occurs in the lumen.

5. The method according to claim 1, wherein the constriction and the stimulation are co-operated to move the fluid and/or other bodily matter in the lumen.

6. The method according to claim 5, wherein the constriction is performed by constricting the at least one portion of the tissue wall portion of the patient'"'"'s organ to restrict the flow in the lumen, and the stimulation is performed by progressively stimulating the constricted at least one portion of the tissue wall portion of the patient'"'"'s organ to cause progressive contraction of the wall portion to move the fluid and/or other bodily matter in the lumen.

7. A method for controlling a flow of fluid in a food passageway formed by a tissue wall of a patient'"'"'s stomach, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the tissue wall of the patient'"'"'s stomach,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s stomach,

using the constriction device to gently constrict the at least one portion of the tissue wall portion of the patient'"'"'s stomach to influence the flow in the food passageway, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall portion of the patient'"'"'s stomach to cause contraction of the wall portion to further influence the flow in the food passageway.

8. A method for controlling a flow of fluid in a food passageway formed by a tissue wall of the stomach of a patient treated with VBG, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the tissue wall of the patient'"'"'s stomach,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s stomach,

using the constriction device to gently constrict the at least one portion of the tissue wall portion of the patient'"'"'s stomach to influence the flow in the food passageway, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall portion of the patient'"'"'s stomach to cause contraction of the wall portion to further influence the flow in the food passageway.

9. A method for treating a male impotent patient having a penile portion, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of a tissue wall of the male impotent patient'"'"'s penile portion,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the male impotent patient'"'"'s penile portion,

using the constriction device to gently constrict the at least one portion of the tissue wall of the male impotent patient'"'"'s penile portion of the male impotent patient'"'"'s penile portion to restrict the venous blood flow in the penile portion, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall of the male impotent patient'"'"'s penile portion of the male impotent patient'"'"'s penile portion to cause contraction of the male impotent patient'"'"'s penile portion to further restrict the venous blood flow in the penile portion to achieve erection.

10. A method for treating sexual dysfunction of a female patient having an erectile portion, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of a tissue wall of the patient'"'"'s erectile portion,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s erectile portion,

using the constriction device to gently constrict the at least one portion of the erectile portion of the patient'"'"'s erectile portion to restrict the venous blood flow in the erectile portion, and

using the stimulation device to stimulate the constricted at least one portion of the patient'"'"'s erectile portion to cause contraction of the patient'"'"'s erectile portion to further restrict the venous blood flow in the erectile portion to obtain engorgement with blood of the female erectile tissue.

11. A method for controlling a flow of eggs in a uterine tube formed by a uterine tube wall of a patient'"'"'s uterine tube, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the uterine tube wall of the patient'"'"'s uterine tube,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s uterine tube,

using the constriction device to gently constrict the at least one portion of the uterine tube wall portion of the patient'"'"'s uterine tube to influence the flow of eggs in the uterine tube, and

using the stimulation device to stimulate the constricted at least one portion of the uterine tube wall portion of the patient'"'"'s uterine tube to cause contraction of the uterine tube wall portion to further influence the flow of eggs in the uterine tube.

12. A method for controlling a flow of sperms in a uterine tube formed by a uterine tube wall of a patient'"'"'s uterine tube, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopic trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of the uterine tube wall of the patient'"'"'s the uterine tube,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s uterine tube,

using the constriction device to gently constrict the at least one portion of the uterine tube wall portion of the patient'"'"'s uterine tube to influence the flow of sperms in the uterine tube, and

using the stimulation device to stimulate the constricted at least one portion of the uterine tube wall portion of the patient'"'"'s uterine tube to cause contraction of the uterine tube wall portion to further influence the flow of sperms in the uterine tube.

13. A method for controlling a flow of blood and/or other bodily matter in a patient'"'"'s blood vessel, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the wall of the patient'"'"'s blood vessel,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s blood vessel,

using the constriction device to gently constrict the at least one portion of the wall of the patient'"'"'s blood vessel to influence the flow in the blood vessel, and

using the stimulation device to stimulate the constricted at least one wall portion of the patient'"'"'s blood vessel to cause contraction of the at least one portion of the wall to further influence the flow in the blood vessel.

14. A method for treating a vascular aneurysm of a blood vessel in a human or mammal patient, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the abdominal cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the tissue wall of the patient'"'"'s blood vessel,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s blood vessel,

using the constriction device to gently constrict the at least one portion of the tissue wall portion of the patient'"'"'s blood vessel extending along the aneurysm to reduce the bulge of the blood vessel caused by the aneurysm, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall portion of the patient'"'"'s blood vessel to cause contraction of the wall portion to further reduce the bulge of the blood vessel and strengthen the blood vessel tissue wall.

15. A method for controlling a flow of fluid in the vas deferens of a male patient, the method comprising the steps of:

inserting a needle like tube into a cavity of the patient'"'"'s body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocars and dissecting an area of at least one portion of the tissue wall of the patient'"'"'s vas deferens,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s vas deferens,

using the constriction device to gently constrict the at least one portion of the tissue wall portion of the patient'"'"'s vas deferens to influence the flow in the vas deferens, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall portion of the patient'"'"'s vas deferens to cause contraction of the wall portion to further influence the flow in the vas deferens.

16. A method for enhancing the movement of gallstones in the biliary duct of a patient suffering from gallstone trouble, the method comprising the steps of:

inserting a needle like tube into the abdomen of the patient'"'"'s body,

using the needle like tube to fill the abdomen with gas thereby expanding the abdominal cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the abdomen,

a dissecting tool through any of the trocars and dissecting an area of at least one portion of the tissue wall of the patient'"'"'s biliary duct,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the patient'"'"'s biliary duct,

using the constriction device to gently constrict the at least one portion of the tissue wall portion of the patient'"'"'s biliary duct to influence the movement of bile and/or gallstones in the biliary duct, and

using the stimulation device to stimulate the constricted at least one portion of the tissue wall portion of the patient'"'"'s biliary duct to cause contraction of the wall portion to further influence the movement of bile and/or gallstones in the biliary duct.

17. A method for promoting pregnancy of a female patient, comprising the steps of:

restricting a lumen of an oviduct of the patient to accumulate at least one egg released from an ovary in the oviduct for a predetermined period of time, and

ceasing restricting the oviduct lumen to admit the at least one egg in the oviduct to be transported to the uterus, when convenient for the patient to increase the likelihood for getting pregnant,

providing a constriction device configured to constrict a wall portion of the oviduct to at least partly temporarily restrict or vary the flow in the oviduct and a stimulation device configured to stimulate the constricted wall portion of the oviduct to further affect the temporary restriction or further vary the flow in the oviduct, and

controlling the stimulation device to progressively stimulate the constricted wall portion, in the downstream or upstream direction of the oviduct, to cause progressive contraction of the wall portion to move the at least one egg downstream in the oviduct or to temporarily prevent further transportation of the at least one egg to the uterus, increasing the likelihood for sperm meeting the egg.

18. The method according to claim 17, further comprising only partly restricting the oviduct lumen so that a sperm is able to pass in the oviduct lumen, creating peristaltic wave like movements of a part of the oviduct wall to prevent the at least one egg released from the ovary from being transported in the oviduct lumen to the uterus, accumulating the at least one egg in the oviduct lumen for a predetermined period of time, whereby the sperm appearing in the oviduct lumen is able to reach the egg during the time the at least one egg is accumulated, and ceasing restricting the oviduct lumen to release the egg, so that the egg is allowed to be transported in the oviduct lumen to the uterus.

19. The method according to claim 17, wherein the restricting step is performed postoperatively, further comprising controlling the restricting and ceasing restricting steps from outside the patient'"'"'s body.

20. A method for promoting pregnancy of a female patient, comprising the steps of:

performing an operation comprising the steps of;

inserting a needle like tube into the abdomen of the patient'"'"'s body,

using the needle like tube to fill the abdomen with gas thereby expanding the abdominal cavity,

placing at least two laparoscopic trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the abdomen,

inserting at least one dissecting tool through a trocar and dissecting an area of at least one portion of the two oviducts of the patient, and

placing two restriction devices on two oviduct lumens, respectively, and

placing a stimulation device to the oviducts,

the restriction devices being, after the operation at a time convenient to get pregnant, adjustable from outside the patient'"'"'s body,

to restrict and release the two oviduct lumens to increase the likelihood of getting pregnant, and configured to

restrict temporarily each of the oviduct lumens at places in consecutive order starting at places on each oviduct closest to the ovary, then restricting each oviduct lumen at any new place on each oviduct closer to the uterus, and

the stimulation device being configured to stimulate the restricted places of the oviduct lumens to further affect the restriction or further vary the flow in the oviduct,

and

being controllable to progressively stimulate the constricted wall portion, in the downstream or upstream direction of the oviduct, to cause progressive contraction of the wall portion to promote further transportation of n egg to the uterus or at least temporarily prevent the egg being transported to increase the likelihood for the egg to meet a sperm.

21. The method of claim 20, wherein the restricting step comprises

restricting the oviduct lumen at a first place of the oviduct to accumulate at least one egg released from the ovary in the oviduct lumen for a predetermined period of time,

restricting the oviduct lumen at a second place of the oviduct,

ceasing restricting the oviduct lumen at the first place of the oviduct, and

allowing the oviduct shorter restriction periods at each restriction place.

22. The method of claim 21, further comprising the step of:

ceasing restricting the oviduct lumen at the second place of the oviduct, allowing transport of the egg down to the uterus.

23. The method of claim 21, further comprising the steps of:

restricting the oviduct lumen at a third place of the oviduct,

ceasing restricting the oviduct lumen at the second place of the oviduct,

allowing the oviduct shorter restriction periods at each restriction place.

24. The method of claim 23, further comprising the step of:

ceasing restricting the oviduct lumen at the third place of the oviduct,

allowing transport of the egg down to the uterus.

25. The method of claim 23, further comprising the steps of:

restricting the oviduct lumen at a fourth place of the oviduct,

ceasing restricting the oviduct lumen at the third place of the oviduct,

allowing the oviduct shorter restriction periods at each restriction place.

26. The method of claim 25, further comprising the step of:

ceasing restricting the oviduct lumen at the fourth place of the oviduct,

allowing transport of the egg down to the uterus.

27. The method of claim 20, further comprising:

restricting each oviduct lumen at places on each oviduct in consecutive order starting at a place on each oviduct closest to the ovary,

then restricting the oviduct lumen at any new place on each oviduct closer to the uterus, and

overlapping in time the restriction of the oviduct lumen at more than one place on the oviduct to restrict the oviduct lumen without interfering with any egg accumulated in the oviduct lumen.

28. The method of claim 27, further comprising only postoperatively varying the restriction places on the oviduct independently of order, to allow the oviduct to recover or to avoid any damage from the restriction of the oviduct while the oviduct lumen is kept restricted.

29. The method of claim 20, further comprising the following steps:

causing a peristaltic like restriction wave movement of a portion of the oviduct wall to prevent at least one egg appearing in the oviduct lumen from being transported in the oviduct lumen to the uterus while only partly restricting the oviduct lumen,

accumulating the egg in the oviduct lumen for a predetermined period of time,

allowing a sperm to reach the egg during the time the egg is accumulated, and

post-operatively controlling from the outside the human body the oviduct wall wave movement to cease, whereby the egg is released and is transported to the uterus.

30. A method for promoting pregnancy of a female patient, comprising the steps of:

performing an operation comprising the steps of;

inserting a tube like needle into the abdomen of the patient'"'"'s body,

using the tube like needle like to fill the abdomen with gas thereby expanding the abdominal cavity,

placing at least two laparoscopic trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the abdomen,

inserting at least one dissecting tool through one of the trocars and dissecting an area of at least one portion of two oviducts of the patient,

placing two restriction devices on the two oviducts, respectively,

finishing the operation and withdrawing the needle, trocars, camera, and dissecting tool after eventual suturing, and thereafter, the restriction devices being adapted to be post operatively controlled from outside the patient'"'"'s body

to restrict the oviduct lumens at a time relevant to achieve pregnancy,

to cause peristaltic like wave movements of portions of the two oviduct walls towards at least one of the patient'"'"'s two ovaries to prevent an egg appearing in one of the two oviduct lumens containing the egg from being transported to the uterus for a predetermined period of time without fully restricting the oviduct lumen,

whereby any egg released from either of the two ovaries is accumulated in at least one of the oviduct lumens,

and whereby any sperm appearing in the at least one oviduct lumen is allowed to reach the egg during the time the egg is accumulated in the at least one oviduct lumen, and

to cease the peristaltic like wave movements to release the egg in the at least one oviduct lumen to thereby allow the egg to be transported to the patient'"'"'s uterus.

31. A method for promoting pregnancy of a female patient, comprising:

restricting a lumen of an oviduct of the patient at places on the oviduct in consecutive order, wherein the restricting starts at a place on an oviduct closest to the ovary, and

then restricting the oviduct lumen at a new place on the oviduct closer to the uterus,

wherein a restriction of the oviduct lumen at one place partially overlaps in time another restriction of the oviduct lumen at a second place on the oviduct lumen to restrict the oviduct lumen without interfering with any egg accumulated in the oviduct lumen.

32. A method for promoting pregnancy of a female patient, comprising the following steps:

causing a peristaltic like restriction wave movement of a portion of an oviduct lumen wall to prevent an egg appearing in the oviduct lumen from being transported in the oviduct lumen to the uterus while only partly restricting the oviduct lumen,

accumulating an egg in the oviduct lumen for a predetermined period of time,

allowing a sperm to reach the egg during the time the egg is accumulated, and

post-operatively controlling from the outside the human body the oviduct wall wave movement to cease, whereby the egg is released and is transported to the uterus.

33. A method for promoting pregnancy of a female patient, comprising the following steps:

restricting a first part of an oviduct lumen of the patient to accumulate at least one an egg released from an ovary in the oviduct lumen for a predetermined period of time,

moving the accumulated egg by an implanted movement device away in the oviduct lumen towards the ovary from a restriction area,

allowing a second part of the oviduct lumen closer to the ovary to be restricted without interfering with any accumulated egg,

ceasing restricting the first part of the oviduct lumen,

repeating restricting the first part of the oviduct lumen,

ceasing restricting the second part of the oviduct lumen, and

allowing the oviduct to recover between restriction intervals.