Methods and apparatus for performing endoluminal gastroplasty

• US 20050251158A1
• Filed: 05/07/2004
• Published: 11/10/2005
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Chen, Eugene G., Birkett, Desmond H.
• Granted Patent: US 7,918,869 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery

Abstract

The present invention provides methods and apparatus for endoluminally performing gastroplasty. In one variation, the apparatus comprises a sizing tube, and a steerable guide that may be reversibly disposed within the sizing tube. In another variation, the sizing tube and steerable guide are integrated into a single device. In one method of utilizing the apparatus, a pouch is endoluminally formed within a patient'"'"'s stomach, thereby partitioning or reducing the stomach and restricting the flow of food therethrough. The pouch may form a Vertical Banded Gastroplasty or Magenstrasse and Mill in an endoluminal fashion. Advantageously, the sizing tube or steerable guide may be used to properly size the endoluminal pouch.

Claims

1. A system for endoluminally performing gastroplasty, the system comprising:

a sizing tube configured for endoluminal passage through a patient'"'"'s esophagus into the patient'"'"'s stomach, the sizing tube having a lumen extending at least partially therethrough and at least one side port in communication with the lumen; and

a steerable guide configured for insertion within the lumen and passage through the side port.

2. The system of claim 1, wherein the sizing tube further comprises at least one reversible adhering element disposed along a length thereof.

3. The system of claim 2, wherein the sizing tube is configured to engage a lesser curvature of the patient'"'"'s stomach with the at least one reversible adhering element.

4. The system of claim 1, wherein the sizing tube further comprises a mechanical anchor.

5. The system of claim 4, wherein the sizing tube is configured to engage the patient'"'"'s pylorus with the mechanical anchor.

6. The system of claim 1, wherein the at least one side port further comprises at least one side slot.

7. The system of claim 1, wherein the at least one side port further comprises a seal.

8. The system of claim 1, further comprising at least one endoluminal tool configured for advancement through or along the steerable guide.

9. The system of claim 8, wherein the at least one endoluminal tool comprises at least one tool configured to perform at least one task chosen from the group consisting of tissue visualization, tissue grasping, tissue plication, tissue manipulation, tissue approximation, tissue securing, tissue treatment and combinations thereof.

10. The system of claim 1, wherein the steerable guide defines at least one lumen.

11. The system of claim 1, wherein the steerable guide comprises multiple sections.

12. The system of claim 11, wherein the multiple sections comprise varying capacities for performing tasks chosen from the group consisting of steering, rigidizing, shape-locking, retroflexing and combinations thereof.

13. The system of claim 11, wherein a first section of the multiple sections is configured for steering the guide along a substantially superior and inferior plane of the patient'"'"'s stomach.

14. The system of claim 13, wherein a second section of the multiple sections is configured for steering the guide along a substantially anterior and posterior plane of the patient'"'"'s stomach.

15. The system of claim 1, wherein the steerable guide is configured to endoluminally form a partition within a patient'"'"'s stomach about the sizing tube, the sizing tube facilitating proper sizing of the partition.

16. The system of claim 2, wherein the sizing tube further comprises a plurality of additional reversible adhering elements disposed along the length.

17. The system of claim 16, wherein each of the adhering elements are collinearly aligned with respect to one another.

18. The system of claim 16, wherein each of the adhering elements are spaced in a staggered pattern along the length.

19. The system of claim 2, wherein the adhering element is positioned on an opposing side of the sizing tube with respect to the side port.

20. The system of claim 2, wherein the adhering element is positioned at an angle about the circumference of the sizing tube with respect to the side port.

21. A method for endoluminally performing gastroplasty, the method comprising:

advancing a sizing tube down a patient'"'"'s throat into the patient'"'"'s stomach;

reversibly adhering the sizing tube to a lesser curvature of the patient'"'"'s stomach;

endoluminally forming a pouch about the sizing tube via a steerable guide; and

removing the sizing tube from the patient.

22. The method of claim 21, wherein advancing a sizing tube further comprises advancing a steerable guide with an integrated sizing tube.

23. The method of claim 21, wherein advancing a sizing tube further comprises advancing the sizing tube while the steerable guide is disposed within a lumen of the sizing tube.

24. The method of claim 23, wherein endoluminally forming a pouch about the sizing tube further comprises:

passing the steerable guide from the lumen of the sizing tube through a side.

port of the sizing tube;

steering the guide within the patient'"'"'s stomach;

advancing tools through or along the guide; and

endoluminally forming the pouch with the tools.

25. The method of claim 21, wherein endoluminally forming a pouch about the sizing tube further comprises sizing the pouch with the sizing tube.

26. A system for endoluminally performing gastroplasty, the system comprising:

a steerable guide having at least one reversible adhering element disposed along a length thereof for engaging a lesser curvature of a patient'"'"'s stomach; and

at least one endoluminal tool advanceable through or along the steerable guide.

27. The system of claim 26, wherein the steerable guide further comprises multiple sections, the multiple sections comprising:

a first section having the at least one reversible adhering element for engaging the lesser curvature; and

at least one additional section that is steerable to facilitate formation of an endoluminal pouch about the first section within the patient'"'"'s stomach via the endoluminal tool.

28. A sizing tube for endoluminally performing gastroplasty, the sizing tube configured for endoluminal passage through a patient'"'"'s esophagus into the patient'"'"'s stomach, the sizing tube comprising:

a lumen extending at least partially therethrough;

at least one side port in communication with the lumen; and

at least one reversible adhering element disposed along a length of the sizing tube.

29. The sizing tube of claim 28, wherein the sizing tube is configured to engage a lesser curvature of the patient'"'"'s stomach with the at least one reversible adhering element.

30. The sizing tube of claim 28, wherein the lumen and the at least one side port are configured for passage of a steerable guide therethrough.

31. The sizing tube of claim 28, wherein the at least one reversible adhering element further comprises a plurality of reversible adhering elements disposed along the length.

32. The sizing tube of claim 31, wherein each of the adhering elements are collinearly aligned with respect to one another.

33. The sizing tube of claim 31, wherein each of the adhering elements are spaced in a staggered pattern along the length.

34. The sizing tube of claim 28, wherein the adhering element is positioned on an opposing side of the sizing tube with respect to the side port.

35. The sizing tube of claim 28, wherein the adhering element is positioned at an angle about the circumference of the sizing tube with respect to the side port.