Systems and techniques for minimally invasive gastrointestinal procedures

• US 8,641,729 B2
• Filed: 07/13/2006
• Issued: 02/04/2014
• Est. Priority Date: 07/13/2005
• Status: Expired due to Fees

• Current Assignee: Creighton University
• Original Assignee: Creighton University
• Inventors: Filipi, Charles J., Klopfenstein, Scott D., Addink, Jason L.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): MASHACK, MARK F
• Application Number:
  US11/457,442
• Publication Number:
  US 20070129735A1
• Time in Patent Office: 2,763 Days
• Field of Search: 606/139, 606/1, 606/142, 606144-148, 606/151, 606/153, 606/158, 128/898
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12099 characterised by the location of the occluder
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/12136 Balloons
• 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 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• 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 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/22068 Centering
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22071 Steering
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/144 : Wire

Abstract

A surgical system for performing gastroplasty is disclosed. The system includes an elongated body adapted to be inserted into the esophagus with a proximal end extending from a body orifice. A working member includes a pair of elongated suction cavities that capture and excise portions of the anterior and posterior stomach walls and apply sutures to the captured tissue, which, when drawn tight, serve to create a modified lumen in the stomach.

Claims

1. A method for joining gastric tissue, comprising:

(a) capturing a first portion of gastric tissue with a first elongated suction cavity of an elongated member introduced via the esophagus, wherein the gastric tissue is in the stomach or at the esophageal junction;

(b) excising at least the mucosal layer of the captured first portion so as to create a first elongated exposed tissue section;

(c) capturing a second portion of the gastric tissue with a second elongated suction cavity introduced via the esophagus;

(d) excising at least the mucosal layer of the captured second portion so as to create a second elongated exposed tissue section; and

(e) suturing the first and second portions together at multiple locations with sutures applied to the tissue in a direction transverse to the elongation direction of the elongated member, wherein the applied sutures are drawn together to bring the tissue portions into position with the first elongated exposed tissue section facing the second elongated exposed tissue section wherein prior to excising in (b) and (d), the captured tissue is injected with an infusate with at least one needles extending in a direction transverse to a longitudinal axis of the elongated member, the at least one needle disposed in a bottom surface of the first elongated suction cavity.

2. The method of claim 1 wherein the excising in (b) and (d) involves advancing a cutting device along guiding slots provided in opposed sidewalls of the elongated suction cavities.

3. The method of claim 2 wherein the cutting device is a wire or a blade.

4. The method of claim 3 wherein the cutting device is a blade.

5. The method of claim 1 wherein the sutures are applied with a curved needle.

6. The method of claim 5 wherein the sutures are applied with a generally helical needle.

7. The method of claim 5 wherein the elongated member comprises an endoscope lumen which terminates in an endoscope exit hole, the method further comprising providing endoscopic visualization via an endoscope extending from the endoscope exit hole in the device.

8. The method of claim 7 wherein the endoscope exit hole is distal to the first elongated suction cavity.

9. The method of claim 7 wherein the endoscope exit hole is proximal to the first elongated suction cavity.

10. The method of claim 1 wherein the tissue is stomach tissue and the anterior and posterior walls of the stomach are joined to create a modified lumen in the stomach.

11. The method of claim 1 wherein the first elongated suction cavity is provided on a device having an endoscope lumen which terminates in an endoscope exit hole, the method further comprising providing endoscopic visualization via an endoscope extending from the endoscope exit hole in the device.

12. The method of claim 11 wherein the endoscope exit hole is distal to the first elongated suction cavity.

13. The method of claim 11 wherein the endoscope exit hole is proximal to the first elongated suction cavity.

14. The method of claim 13 wherein the excising in (b) and (d) involves advancing a cutting device along guiding slots provided in opposed sidewalls of the elongated suction cavities.

15. The method of claim 1 wherein the at least one of the first elongated suction cavity and the second elongated suction cavity is provided on an elongated body which is aligned along the lesser curvature of the stomach during the capturing.

16. The method of claim 1 wherein plications are formed at the esophageal junction.