Obesity treatment tools and methods

• US 20070167963A1
• Filed: 03/12/2007
• Published: 07/19/2007
• Est. Priority Date: 05/30/2001
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Andreas, Bernard, Gifford, Hanson, French, Ronald, Sutton, Douglas, Deem, Mark
• Granted Patent: US 8,075,577 B2
• Time in Patent Office: Days
• US Class Current: 606/153
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• 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

Abstract

Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Claims

1. A system for forming a restriction from an interior of an organ and for dilating an opening defined by the organ, comprising:

a tissue adhering member having a proximal end and a distal end with a length therebetween, the member having at least two releasably adherable regions for releasably positioning a first area of the interior near a second area of the interior, whereby the restriction is formed upon fastening the first area to the second area; and

an elongate device having a proximal end and a distal end with a length therebetween, the elongate device having a modifying region for contacting tissue in or around the opening and for delivering a stimulus to the tissue to dilate the opening.

2. The system of claim 1, further comprising at least one fastener disposable within the tissue adhering member for fastening the first area to the second area.

3. The system of claim 1, wherein the tissue adhering member defines an opening along the length.

4. The system of claim 3, wherein the opening is adapted to receive a retractable septum.

5. The system of claim 3, wherein the retractable septum defines at least one surface adapted to abrade an adjacent portion of the interior.

6. The system of claim 5, wherein the adjacent portion of the interior is abraded by the retractable septum using a method selected from the group consisting of cutting, scoring, heating, freezing, and chemical ablation.

7. The system of claim 1, wherein the first area and the second area are adhered to the tissue adhering member via a vacuum created in each of the two releasably adherable regions.

8. The system of claim 7, wherein each of the two releasably adherable regions are in fluid communication with a common channel defined within the tissue adhering member.

9. The system of claim 1, wherein the opening defined by the organ comprises a pylorus located at a distal end of the organ.

10. The system of claim 1, wherein the modifying region comprises a cutting member adapted to cut the tissue in or around the opening.

11. The system of claim 1, wherein the stimulus comprises a form of energy selected from the group consisting of heat energy, electrical energy, chemical energy, RF energy, and pressure.

12. The system of claim 1, wherein the elongate device comprises a dilatation device disposed near the distal end.

13. The system of claim 12, wherein the dilatation device comprises an angioplasty balloon.

14. The system of claim 1, wherein the elongate device comprises an angioplasty balloon disposed near the distal end, the balloon having the modifying region disposed on an exterior surface of the balloon.

15. The system of claim 14, wherein the modifying region comprises at least one cutting member disposed on the exterior surface.

16. The system of claim 15, wherein the cutting member is selected from the group consisting of blades and wires.

17. The system of-claim 1, wherein the elongate device comprises a dilation wire basket disposed near the distal end, the dilation wire basket being adapted to deliver the stimulus to the tissue.

18. The system of claim 17, wherein the stimulus comprises a change in temperature.

19. The system of claim 1, wherein the modifying region comprises at least one probe extending from the distal end of the elongate device, the probe having a distal end adapted for piercing the tissue in or around the opening.

20. The system of claim 19, wherein the probe distal end is adapted to deliver a stimulus selected from the group consisting of heat energy, electrical energy, chemical energy, and RF energy.

21. The system of claim 1, wherein the modifying region includes a needle an the stimulus includes a chemical delivered through the needle.

22. The system of claim 21, wherein the chemical is ablative to the tissue in or around the opening.

23. The system of claim 22, wherein the chemical is selected from the group consisting of alcohol, sotrodecol, and botulinum toxin molecule.

24. The system of claim 1, wherein the modifying region comprises a cutting wire extending between the elongate device distal end and a region proximal of the elongate device distal end.

25. The system of claim 1, wherein the modifying region is disposed at the distal end of the elongate device, the region defining a slot for receiving the tissue in or around the opening, and a cutting edge disposed between a plurality of stables slidingly held within the slot.

26. A method for forming a restriction from an interior of an organ and for dilating an opening defined by the organ, comprising:

releasably adhering a first area of the interior to a tissue adhering member;

displacing the first area of the interior via the tissue adhering member;

releasably adhering a second area of the interior to the tissue adhering member such that the first area is positioned near the second area;

fastening the first area to the second area to form the restriction; and

dilating the opening defined at a distal end of the organ.

27. The method of claim 26, wherein the first area of the interior is releasably adhered to the tissue adhering member via a vacuum created in a first opening defined in the tissue adhering member.

28. The method of claim 26, wherein the second area of the interior is releasably adhered to the tissue adhering member via a vacuum created in a second opening defined in the tissue adhering member.

29. The method of claim 26, wherein releasably adhering a second area of the interior to the tissue adhering member such that the first area is positioned near the second area further comprises removing a septum disposed in the tissue adhering member such that the first area contacts the second area.

30. The method of claim 26, wherein the opening comprises a pyloral sphincter.

31. The method of claim 26, wherein dilating the opening comprises applying a stimulus to tissue in or around the opening via an elongated device having a proximal end and a distal end with a length therebetween.

32. The method of claim 31, wherein the stimulus comprises a form of energy selected from the group consisting of heat energy, electrical energy, chemical energy, RF energy, and pressure.

33. The method of claim 31, wherein the elongated device comprises a dilatation device disposed near the distal end.

34. The method of claim 33, wherein the dilatation device comprises an angioplasty balloon.

35. The method of claim 33, wherein the angioplasty balloon comprises an expandable surface having at least one cutting member disposed thereon.

36. The method of claim 26, wherein dilating the opening defined at the distal end of the organ comprises piercing tissue in or around the opening with at least one elongate probe and applying a stimulus via the elongate probe.

37. The method of claim 36, wherein the stimulus comprises a chemical delivered through an opening defined in a distal end of the probe.

38. The system of claim 37, wherein the chemical is ablative to the tissue in or around the opening.

39. The system of claim 38, wherein the chemical is selected from the group consisting of alcohol, sotrodecol, and botulinum toxin molecule.

40. The method of claim 31, wherein the elongated device comprises a combination cutting edge and stapler disposed near the distal end.

41. The method of claim 26, wherein dilating the opening defined at the distal end of the organ occurs after forming the restriction.

42. A device for dilating an opening defined by an organ, comprising:

an elongate member having a proximal end and a distal end;

a housing defining a notch disposed at the distal end of the elongate member, and a cutting member disposed within the notch;

wherein tissue of the organ defining the opening is accommodated within the notch of the housing and the cutting member is adapted to severe tissue of the organ.

43. The device of claim 42, wherein the elongated member is an endoscope.

44. The device of claim 42, wherein the notch being oriented perpendicular to the longitudinal axis of the elongated member.

45. The device of claim 42, wherein the housing is tapered to fit within the opening of the organ.

46. The device of claim 42, wherein the cutting member is a blade.

47. The device of claim 42, further comprising a fastener disposed adjacent the cutting member within the housing to affix the severed tissue.

48. The device of claim 42, further comprising a vacuum in fluid communication with the opening for acquiring tissue of the organ.

49. A device for dilating an opening defined by an organ, comprising:

an elongate shaft having a proximal end and a distal end;

an expandable member disposed at the distal end of the elongate shaft, and stimulating members disposed on the exterior surface of the expandable member;

wherein the expandable member expands when positioned within the opening of the organ and the stimulating members provide a stimulus to the tissue defining the opening of the organ.

50. The device of claim 49, wherein the elongate shaft is an endoscope.

51. The device of claim 49, wherein the elongate shaft is a catheter.

52. The device of claim 49, wherein the expandable member includes an expandable balloon.

53. The device of claim 49, wherein the expandable member includes a dilation wire basket.

54. The device of claim 49, wherein the stimulating member includes a cutting blade.

55. The device of claim 49, wherein the stimulating member includes an electrode.

56. The device of claim 49, wherein the stimulating member includes a probe.

57. The device of claim 56, wherein the probe dispenses a cryogenic or chemical substance.