Methods, instruments and devices for extragastric reduction of stomach volume

• US 9,314,362 B2
• Filed: 09/28/2012
• Issued: 04/19/2016
• Est. Priority Date: 01/08/2012
• Status: Active Grant

• Current Assignee: Vibrynt, Inc.
• Original Assignee: Vibrynt, Inc.
• Inventors: Bender, Theodore M., Makower, Joshua, Shiu, Brian K., Acosta, Pablo G., George, Robert M., Serventi, Lisa, Orbeta, Ed, Early, Scott, Bright, Earl A. II, Limon, Timothy A.
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US13/631,559
• Publication Number:
  US 20130178877A1
• Time in Patent Office: 1,299 Days
• Field of Search: 606/139, 606/144, 606/148, 606/153, 600/37, 600/201, 600/205, 227/175.1, 604/22, 271/90
• US Class Current: 1/1
• 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 17/0466 Suture bridges
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/062 Needle manipulators
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• 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 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/2944 Translation of jaw members
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

Methods, instruments and systems are provided for separating opposite walls of the stomach by extragastric application of suction. Plication of the stomach can be performed between the separated walls after which the separate walls are brought back toward one another. In another aspect, methods, instruments, devices and systems are provided for reducing the effective volume of a stomach by performing one or more extragastric plications of the stomach.

Claims

1. An instrument for use in modifying a patient'"'"'s stomach by operating on the stomach extragastrically to decrease the effective volume of the patient'"'"'s stomach, said instrument comprising:

a first elongate end effector formed at a distal end portion of said instrument, said first elongate end effector having a first operational surface configured to contact an external surface of the patient'"'"'s stomach;

a first plurality of suction ports extending along a length of said first elongate end effector and configured to deliver suction to the external surface of the stomach to engage said first elongate end effector therewith, at least one suction port comprising a means for providing a physical barrier to the escape of a portion of the stomach from the suction port

a second elongate end effector; and

a connector in fluid communication with the first elongate end effector and the second elongate end effector;

wherein the connector comprises telescoping segments.

2. The instrument of claim 1 wherein the means for providing a physical barrier to the escape of the stomach from the suction port comprises at least one suction hole configured to hold the stomach against an interior surface of a lip of the suction port.

3. The instrument of claim 2 wherein the at least one suction hole is configured within a cavity of the suction port to create a concave curve in a portion of the stomach near the interior surface of a lip of the suction port.

4. The instrument of claim 2 wherein the suction port comprises at least one vacuum channel.

5. The instrument of claim 2 wherein the suction port comprises a tissue excluder configured to exclude the stomach from the at least one vacuum channel.

6. The instrument of claim 1 wherein the means for providing a physical barrier to the escape of the stomach from the suction port comprises a resilient member configured to deflect as suction is delivered to the external surface of the stomach.

7. The instrument of claim 6 wherein the resilient member is configured to extend from the first operational surface toward the external surface of the stomach.

8. The instrument of claim 6 wherein the resilient member comprises at least one slot.

9. The instrument of claim 6 wherein the resilient member is configured to extend parallel to an opening of the suction port.

10. The instrument of claim 6 wherein the resilient member is configured to extend from an interior surface of the suction port.

11. The instrument of claim 1 further comprising:

the second elongate end effector formed at a distal end portion of said instrument, said second elongate end effector having a second operational surface configured to contact an external surface of the patient'"'"'s stomach;

a second plurality of suction ports extending along a length of said second elongate end effector and configured to deliver suction to the external surface of the stomach to engage said second elongate end effector therewith, at least one suction port comprising a means for providing a physical barrier to the escape of the stomach from the suction port.

12. The instrument of claim 1 wherein the connector is biased to hold the first elongate end effector and the second elongate end effector apart from each other.

13. The instrument of claim 1 wherein the connector is biased to hold the first elongate end effector and the second elongate end effector together.

14. An instrument for use in modifying a patient'"'"'s stomach by operating on the stomach extragastrically to decrease the effective volume of the patient'"'"'s stomach, said instrument comprising:

at least two elongate end effectors formed at a distal end portion of said instrument;

a plurality of suction ports extending along a length of each elongate end effector;

a resilient and flexible member proximate at least one suction port'"'"' wherein the member is configured to provide a physical barrier to the escape of a portion of the stomach from the suction port; and

a connector in fluid communication with the each of the at least two elongate end effectors;

wherein the connector comprises telescoping segments.

15. The instrument of claim 14 wherein at least a portion of the member is within the suction port.

16. The instrument of claim 14 wherein the member is entirely within the suction port.

17. The instrument of claim 14 wherein the member is outside the suction port.

18. An instrument for use in modifying a patient'"'"'s stomach by operating on the stomach extragastrically to decrease the effective volume of the patient'"'"'s stomach, said instrument comprising:

at least two elongate end effectors formed at a distal end portion of said instrument;

a plurality of suction ports extending along a length of each elongate end effector and configured to deliver suction to the external surface of the stomach to engage each end effector therewith, wherein at least one port comprises an interior lip configured to maintain contact with the stomach when a portion of the stomach is within the suction port; and

a connector in fluid communication with each of the at least two elongate end effectors;

wherein the connector comprises telescoping segments.

19. The instrument of claim 18 wherein the suction port comprises channels.

20. The instrument of claim 18 wherein the suction port comprises a tissue excluder.

21. The instrument of claim 18 wherein the suction port comprises a suction hole proximate the interior lip.