Methods and instruments for treating GERD and haital hernia

• US 10,639,183 B2
• Filed: 05/08/2017
• Issued: 05/05/2020
• Est. Priority Date: 10/10/2008
• Status: Active Grant

• Current Assignee: Peter Forsell
• Original Assignee: Peter Forsell
• Inventors: Forsell, Peter
• Primary Examiner(s): Sharma, Yashita
• Application Number:
  US15/588,765
• Publication Number:
  US 20180085241A1
• Time in Patent Office: 1,093 Days
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/06 with illuminating arrangements
• CPC Class Codes: A61B 1/2736 Gastroscopes
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• 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 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00561 creating a vacuum
• 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 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/308 : with suction cups
• 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 2002/045 : Stomach, intestines
• CPC Class Codes: A61F 2005/0016 : comprising measuring means
• CPC Class Codes: A61F 2005/002 : for sensing mechanical parameters
• CPC Class Codes: A61F 2005/0023 : for sensing chemical parameters
• CPC Class Codes: A61F 2250/0001 : Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2250/0004 : adjustable
• CPC Class Codes: A61F 5/0003 : Apparatus for the treatment of obesity; Anti-eating devices surgical instruments or methods for treatment of obesity, devices specially adapted therefor A61B17/00; hollow or tubular parts of organs A61F2/04
• CPC Class Codes: A61F 5/0013 : Implantable devices or invasive measures
• CPC Class Codes: A61F 5/0026 : Anti-eating devices using electrical stimulation
• CPC Class Codes: A61F 5/003 : inflatable
• CPC Class Codes: A61F 5/0033 : with more than one chamber
• CPC Class Codes: A61F 5/0036 : Intragastrical devices
• CPC Class Codes: A61F 5/004 : remotely adjustable
• CPC Class Codes: A61F 5/0043 : using injection ports
• CPC Class Codes: A61F 5/0046 : with wireless means
• CPC Class Codes: A61F 5/005 : Gastric bands
• CPC Class Codes: A61F 5/0063 : wrapping the stomach
• CPC Class Codes: A61F 5/0069 : in the wall of the stomach
• CPC Class Codes: A61F 5/0073 : in the abdominal cavity, e.g. not attached to the stomach
• CPC Class Codes: A61F 5/0076 : preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0079 : Pyloric or esophageal obstructions
• CPC Class Codes: A61F 5/0083 : Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like
• CPC Class Codes: A61F 5/0089 : Instruments for placement or removal
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

An intraluminar method of treating a reflux disease in a patient by implanting a device comprising a non-encircling implantable movement restriction device that, when implanted in a patient, restricts the movement of the cardiac notch in relation to the diaphragm muscle, preventing the cardia from sliding through the esophageal hiatus. The intraluminar method comprises introducing an instrument through the esophagus and into the stomach of the patient, introducing the non-encircling implantable movement restriction device through the esophagus using said instrument, affixing the non-encircling movement restriction device to the fundus wall, such that it does not encircle the esophagus or stomach, thereby preventing the cardia from sliding through the esophageal hiatus and thus reducing reflux disease without encircling the esophagus or stomach.

Claims

1. An intraluminar method of treating a reflux disease in a patient by implanting a device comprising a non-encircling implantable movement restriction device that, when implanted in a patient, restricts the movement of the cardiac notch in relation to the diaphragm muscle, preventing the cardia from sliding through the esophageal hiatus, the intraluminar method comprising:

introducing an instrument through the esophagus and into the stomach of the patient,

introducing the non-encircling implantable movement restriction device through the esophagus using said instrument;

completely invaginating the non-encircling implantable movement restriction device by a portion of the fundus wall, such that an outer surface of the movement restriction device rests against an inner surface of the fundus wall; and

affixing the completely invaginated, non-encircling movement restriction device to the fundus wall, such that it does not encircle the esophagus or stomach, thereby preventing the cardia from sliding through the esophageal hiatus and thus reducing reflux disease without encircling the esophagus or stomach.

2. The method according to claim 1, further comprising;

creating, using a surgical instrument, a pouch in a portion of the stomach fundus wall on the outside of the stomach cavity, and

invaginating the implantable movement restriction device in the pouch.

3. The method according to claim 1, further comprising;

creating, using a surgical instrument, a pouch in a portion of the stomach fundus wall on the inside of the stomach cavity, and

invaginating the implantable movement restriction device in the pouch.

4. The method according to claim 1, further comprising inflating the implantable movement restriction device to its filling volume.

5. The method according to claim 1, wherein the step of affixing the implantable movement restriction device to the fundus wall comprises affixing the movement restriction device using sutures or staples.

6. The method according to claim 1, further comprising affixing the fundus wall to the lower part of the patient'"'"'s esophagus.

7. The method according to claim 1, wherein the step of affixing the fundus wall to the lower part of the patient'"'"'s esophagus comprises affixing the fundus wall to the lower part of the patient'"'"'s esophagus by providing sutures or staples.

8. The method according to claim 1, further comprising affixing the fundus wall to the patient'"'"'s diaphragm muscle or associated muscles.

9. The method according to claim 8, wherein the step of affixing the fundus wall to the patient'"'"'s diaphragm muscle or associated muscles comprises affixing the stomach fundus wall to the patient'"'"'s diaphragm muscle or associated muscles by providing sutures or staples.

10. The method according to claim 1, further comprising providing an apparatus for regulating the movement restriction device from the outside of the patient'"'"'s body.

11. The method according to claim 10, wherein the step of providing an apparatus for regulating the movement restriction device from the outside of the patient'"'"'s body comprises providing an injection port configured to allow the volume of the movement restriction device to be regulated by percutaneous injections.

12. The method according to claim 11, wherein the step of providing an injection port further comprises fixating said injection subcutaneously in the patient'"'"'s body.

13. The method according to claim 1, further comprising the step of pushing the fundus and cardia into its correct position below the diaphragm, using an instrument placed in the patient'"'"'s esophagus.

14. The method according to claim 3, wherein creating a pouch in a portion of the stomach fundus wall comprises creating a pouch having a volume of more than 15 millilitres.

15. The method according to claim 3, further comprising affixing the pouch to the lower part of the patient'"'"'s esophagus.

16. The method according to claim 3, further comprising affixing the pouch to the lower part of the patient'"'"'s esophagus.

17. The method according to claim 3, further comprising affixing the pouch to the patient'"'"'s diaphragm muscle or associated muscles.

18. The method according to claim 3, further comprising affixing the pouch to the patient'"'"'s diaphragm muscle or associated muscles.

19. The method according to claim 1, wherein the implantable movement restriction device comprises a fixation member, and wherein the step of affixing the movement restriction device to the fundus wall comprises affixing the fixation member to the fundus wall.

20. The method according to claim 1, wherein the implantable movement restriction device comprises a fluid conduit, and wherein the method further comprising tunneling the fluid conduit in the stomach wall.