Peroral Transgastric Endoscopic Techniques
Methods and apparatus for accessing the peritoneal cavity and for ligation of fallopian tubes. A representative method includes using an endoscope to orally access a gastric wall. The gastric wall is punctured to provide access to a peritoneal cavity. The endoscope is advanced into the peritoneal cavity through the puncture. A fallopian tube is located and ligated. The endoscope is removed.
1 . A method for ligation of a fallopian tube of a patient, comprising:
using an endoscope to orally access a gastric wall;
puncturing the gastric wall to provide access to a peritoneal cavity;
advancing the endoscope into the peritoneal cavity through the puncture;
locating the fallopian tube;
ligating the fallopian tube; and
removing the endoscope.
2 . The method of claim 1 , further comprising sealing the puncture.
3 . The method of claim 1 , where the patient is human.
4 . The method of claim 1 , where puncturing the gastric wall comprises puncturing with a cutter coupled to a dilating balloon, the balloon being inflated to provide access to the peritoneal cavity.
5 . The method of claim 1 , where puncturing the gastric wall comprises puncturing with a needle knife electrocautery followed by balloon dilatation with a dilating balloon.
6 . A method of preventing pregnancy comprising peroral transgastric endoscopic ligation of a fallopian tube of a patient.
7 . The method of claim 6 , where the patient is human.
8 . An apparatus for peroral transgastric endoscopic ligation of a fallopian tube of a patient, comprising:
an endoscope configured to orally access a gastric wall;
a cutter coupled to the endoscope and configured to puncture the gastric wall,
a dilating balloon coupled to the cutter and configured to provide access from the puncture into a peritoneal cavity upon inflation;
endoscopic forceps coupled to the endoscope and configured to grasp the fallopian tube; and
a first loop coupled to the endoscope and configured to block a patency of the fallopian tube.
9 . The apparatus of claim 8 , further comprising a second loop coupled to the endoscope and configured to block a patency of the fallopian tube.
10 . An apparatus for peroral transgastric endoscopic ligation of a fallopian tube, comprising:
an endoscope configured to orally access a gastric wall;
a needle knife electrocautery coupled to the endoscope and configured to puncture the gastric wall;
a dilating balloon coupled to the needle knife and configured to expand the puncture to provide access into a peritoneal cavity;
endoscopic forceps coupled to the endoscope and configured to grasp the fallopian tube; and
a first loop coupled to the endoscope and configured to block a patency of the fallopian tube.
11 . The apparatus of claim 10 , further comprising a second loop coupled to the endoscope and configured to block a patency of the fallopian tube.