Devices and methods for laparoscopic gastric tissue reconfiguration
Inventors
Ewers, Richard C. • Chen, Eugene G. • Maahs, Tracy D. • Moran, Stuart • LAM, Cang C.
Assignees
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Publication Number
US-8906038-B2
Publication Date
2014-12-09
Expiration Date
Abstract
Devices and methods for forming and securing tissue folds and elongated invaginations in gastric tissue are used as a treatment for obesity. In several embodiments, a plurality of tissue folds is formed along the greater curvature of the stomach using laparoscopic tissue anchor deployment devices. Additional embodiments include various combinations of tissue folds, elongated invaginations, and other reconfigurations of stomach tissue using laparoscopic devices or laparoscopic devices in combination with endoscopic devices.
Core Innovation
The invention provides a laparoscopic method for reconfiguring tissue of a hollow organ within a patient by forming external tissue folds and approximating the folds using deployed anchors connected by a connecting member. A launch tube containing a needle is positioned outside of an external surface of the hollow organ, and a jaw member is operated to form a first tissue fold having an inner side and an outer side. The needle is extended out of the launch tube and pierces through the first tissue fold from the inner side so that the needle projects out from the outer side.
A first anchor assembly is carried by the needle, where a first anchor is connected to a second anchor by a connecting member. The first anchor is deployed by pushing it out of the needle on the outer side of the first tissue fold, and the needle is withdrawn from the first tissue fold. A second external tissue fold is then formed by advancing the launch tube to operate the jaw member so that the inner side of the first tissue fold faces the inner side of the second tissue fold, followed by extending the needle to pierce the second tissue fold and deploying a second anchor on the outer side of the second tissue fold.
After deployment, at least one of the first anchor or second anchor is moved along the connecting member to approximate the first and second tissue folds. In related embodiments, the method includes using a cinch along the connecting member to hold the tissue folds together. The laparoscopic reconfiguration is described in the context of gastric tissue reconfiguration for obesity, including creating external tissue folds and elongated stomach invaginations along the greater curvature, with anchors deployed along the stomach length to reduce stomach volume and with additional reinforcement options described.
Claims Coverage
The relevant independent claims are directed to two laparoscopic methods: (i) reconfiguring tissue of a hollow organ by forming external tissue folds and approximating them using deployed anchors and a connecting member, and (ii) performing surgery on an organ by forming first and second external tissue folds, deploying anchors from a needle, and moving at least one anchor along a connecting member to approximate the folds. Across these independent claims, the inventive coverage centers on the sequence of positioning a launch tube/needle outside the organ, forming folds with a jaw member, piercing and deploying anchors, and then approximating the folds by anchor movement along the connecting member.
External tissue fold reconfiguration with anchor deployment and connecting-member approximation
Positioning a launch tube containing a needle outside of an external surface of a hollow organ; forming a first tissue fold by advancing the launch tube to operate a jaw member; extending the needle to pierce the first tissue fold and deploying a first anchor from the needle on the outer side; forming a second tissue fold by advancing the launch tube to operate the jaw member with the inner side of the first tissue fold facing the inner side of the second tissue fold; extending the needle to pierce the second tissue fold and deploying a second anchor from the needle on the outer side; moving at least one of the first anchor or second anchor along the connecting member to approximate the first and second tissue folds.
Surgery on an organ by forming external tissue folds and moving anchors along a connecting member
Forming a first external tissue fold by grasping and holding an external surface of an organ by advancing a launch tube outside of the organ to operate a jaw member; extending a needle out of the launch tube and piercing the first external tissue fold to deploy a first anchor; withdrawing the needle; forming a second external tissue fold at a position spaced apart from the first anchor by advancing the launch tube outside of the organ to operate the jaw member; extending the needle out of the launch tube and piercing the second external tissue fold to deploy a second anchor; withdrawing the needle; and moving at least one of the first anchor or second anchor along the connecting member to approximate the first and second tissue folds.
Overall, the claims coverage focuses on an anchor-and-connecting-member approach for laparoscopic approximation of external tissue folds, where anchors are deployed from a needle after fold formation and piercing, and the folds are brought together by moving at least one anchor along the connecting member. Dependent claims further narrow features such as additional anchor deployment, specific piercing orientations and paths relative to a jaw member, and use of a cinch and/or additional tool manipulation.
Stated Advantages
Documented Applications
Laparoscopic gastric tissue reconfiguration for obesity, including forming and securing external tissue folds and elongated stomach invaginations along the greater curvature to reduce stomach volume.
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