Extragastric devices and methods for gastroplasty

• US 20060195139A1
• Filed: 03/27/2006
• Published: 08/31/2006
• Est. Priority Date: 03/23/2004
• Status: Abandoned Application

• Current Assignee: Michael Gertner
• Original Assignee: Michael Gertner
• Inventors: Gertner, Michael
• Application Number:
  US11/391,126
• Publication Number:
  US 20060195139A1
• Time in Patent Office: Days
• US Class Current: 606/201
• 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 17/0218 for minimally invasive surgery A61B17/0281, 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 17/0469 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 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• 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 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• 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 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• 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 hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/1135 : End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61F 2002/044 : Oesophagi or esophagi or gullets
• CPC Class Codes: A61F 5/0083 : Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control

Abstract

Methods and devices to externally create a restriction on the stomach are described. In some embodiments, the devices are contoured to fit the stomach and can be further anchored to the stomach. In further embodiments, the degree of deployment of the extragastric restriction device is controllable after implantation. In other embodiments, specialized wires, catheters, ports, and trocars specific for placement of extragastric restriction devices are presented. In still further embodiments, systems are described in which adjustability of the devices is provided along with sensing and actuating ability.

Claims

1. A device for application to the external stomach surface of a patient comprising:

a. A first portion expandable from a collapsed state to an expanded state.

b. A second portion coupled to the first portion contoured to fit an external portion of the stomach without encircling the stomach

c. A third portion coupled to the device which is slideable over a flexible connector comprising a proximal end and a distal end.

2. The device of claim 1 wherein said first portion is a balloon.

3. The device of claim 2 further comprising a fluid communication line in contact with said balloon.

4. The device of claim 3 wherein said communication line and said connector are the same structure.

6. The device of claim 1 wherein said second portion has a radius of between 0.25 and 5 centimeters and is curved to fit the cardia of the stomach when the first portion is in its expanded state.

7. The device of claim 1 wherein said second portion is between 5 and 30 centimeters.

8. The device of claim 1 wherein the connector further comprises an anchor at its distal end.

9. The device of claim 1 wherein said device further comprises a sensor

10. The device of claim 3 wherein said communication line further comprises a sensor.

11. The device of claim 1 further comprising an implantable port which communicates with the expandable second portion.

12. The device of claim 1 wherein said first or said second portion further comprises a

5. The device of claim one wherein said first portion and said second portion are the same portion of the device.

13. A system comprising:

a. A device expandable from a first configuration to a second configuration wherein said device is contoured to partially surround a portion of the stomach without fully circumscribing the portion of the stomach;

b. A connector coupled to said device and operable to adjust the degree of expansion between the first configuration and the second configuration.

c. A port in communication with the connector said port operable to be accessed intermittently through the skin of a patient.

d. At least one sensor which senses a force applied to the device.

14. The system of claim 13 wherein said device comprises a balloon.

15. The system of claim 13 wherein said device comprises an electroactive polymer.

16. The system of claim 13 further comprising an actuator.

17. The system of claim 13 further comprising a fastening element attached between the device and outer layer of the stomach.

18. A device to apply external compression to the stomach comprising:

a. A first structure with a first width and a second smaller width wherein the structure is constructed to bias toward the second smaller width unless a force is applied to maintain the first width.

b. A second structure attached to the first structure and constructed from a material which enables force to be applied to the adjust the width of the first structure.

19. The device of claim 18 wherein said second structure comprises a fluid fillable structure.

20. The device of claim 18 wherein said first structure or said second structure comprises nitinol.

21. The device of claim 18 wherein said first structure or said second structure comprises an electroactive polymer.

22. The device of claim 18 further comprising a communicating line.

23. The device of claim 22 wherein said communicating line is a fluidic communicating line.