Apparatus and methods for performing transluminal gastrointestinal procedures
View Patent ↗Methods and apparatus are provided for diagnosing and treating digestive or other organs (as well as other parts of the body) endoluminally and transluminally, via instruments passed into the GI tract per-orally and/or per-anally. The instruments may, for example, pass transluminally out of the stomach and/or the colon through a breach formed therein in order to conduct diagnostic or therapeutic procedures, such as gastroenterostomy.
1. A method for performing a surgical procedure, the method comprising:
endoluminally advancing a conduit per-orally into a patient's stomach;
breaching a wall of the stomach;
securing the conduit to the wall in a vicinity of the breach;
rigidizing the conduit;
advancing an instrument along or through the conduit such that the instrument passes transluminally from the interior to the exterior of the stomach;
performing the surgical procedure with the instrument;
retrieving the instrument back into the stomach;
grasping a first portion of tissue on the wall of the stomach at or near the location of the breach;
advancing a needle through the first portion of tissue;
deploying a first anchor from the needle;
retracting the needle from the first portion of tissue, whereby a suture extends from the first anchor and through the first portion of tissue;
releasing the first portion of tissue;
grasping a second portion of tissue on the wall of the stomach at or near the location of the breach;
advancing the needle through the second portion of tissue;
deploying a second anchor from the needle, the second anchor being disposed on the suture;
retracting the needle from the second portion of tissue, whereby the suture extends from the second anchor and through the second portion of tissue; and
releasing the second portion of tissue.
2. The method of claim 1 , wherein endoluminally advancing a conduit further comprises advancing an overtube conduit having a lumen, the instrument advanced through the lumen.
3. The method of claim 1 , wherein breaching a wall of the stomach further comprises breaching the wall with a distal region of the conduit.
4. The method of claim 1 , wherein breaching a wall of the stomach further comprises breaching the wall with the instrument.
5. The method of claim 1 , wherein breaching a wall of the stomach further comprises breaching the wall with a piercing element.
6. The method of claim 1 , wherein securing the conduit to the wall further comprises securing the conduit with first and second members, the first member disposed on an interior surface of the wall, the second member disposed on an exterior surface of the wall.
7. The method of claim 6 , wherein securing the conduit with first and second members further comprises securing the conduit with first and second balloon members.
8. The method of claim 1 , wherein rigidizing the conduit further comprises shape-locking the conduit.
9. The method of claim 1 , wherein advancing an instrument further comprises advancing a guide along or through the conduit such that the guide transluminally passes from the interior to the exterior of the stomach, then advancing the instrument along or through the guide.
10. The method of claim 9 further comprising steering the guide.
11. The method of claim 9 further comprising shape-locking the guide.
12. The method of claim 1 , wherein performing the procedure comprises performing a diagnostic procedure.
13. The method of claim 1 , wherein performing the procedure comprises performing a therapeutic procedure.
14. The method of claim 1 , wherein performing the procedure further comprises performing a gastroenterostomy procedure.
15. The method of claim 1 , wherein endoluminally advancing a conduit into a patient's stomach further comprises advancing the conduit transluminally out of the stomach.
16. The method of claim 1 , wherein the first anchor is coupled to the second anchor via the suture when the first anchor is deployed from the needle.
17. The method of claim 1 , wherein the step of grasping a first portion of tissue comprises grasping the first portion of tissue using a grasping member that is movable independently of the needle.
18. The method of claim 17 , wherein the step of grasping a second portion of tissue comprises grasping the second portion of tissue using the grasping member.
19. A method for performing a diagnostic or therapeutic medical procedure on a patient, the method comprising:
endoluminally advancing a conduit per-orally into a stomach of the patient;
breaching a wall of the stomach;
rigidizing the conduit;
advancing an instrument along or through the conduit such that the instrument passes transluminally from the interior to the exterior of the stomach;
performing the medical procedure with the instrument;
retrieving the instrument back into the stomach;
grasping a first portion of tissue on the wall of the stomach at or near the location of the breach with a grasping member;
advancing a needle through the first portion of tissue;
deploying a first anchor from the needle;
retracting the needle from the first portion of tissue, whereby a suture extends from the first anchor and through the first portion of tissue; and
releasing the first portion of tissue.
20. The method of claim 19 , wherein breaching a wall of the stomach further comprises breaching the wall with the instrument.
21. The method of claim 19 , wherein breaching a wall of the stomach further comprises breaching the wall with a piercing element.
22. The method of claim 19 , wherein advancing an instrument further comprises advancing a guide along or through the conduit such that the guide transluminally passes from the interior to the exterior of the stomach, then advancing the instrument along or through the guide.
23. The method of claim 19 , wherein the grasping member is movable independently of the needle.
24. A method for performing a diagnostic or therapeutic medical procedure on a patient, the method comprising:
endoluminally advancing a conduit into a stomach of the patient;
piercing a wall of the stomach to create a breach in the wall;
rigidizing the conduit;
advancing an instrument along or through the conduit such that the instrument passes transluminally through the breach in the wall of the stomach;
performing the medical procedure with the instrument;
retrieving the instrument back into the stomach;
grasping a first portion of tissue on the wall of the stomach at or near the location of the breach with a grasping member;
advancing a needle through the first portion of tissue;
deploying a first anchor from the needle;
retracting the needle from the first portion of tissue, whereby a suture extends from the first anchor and through the first portion of tissue; and
releasing the first portion of tissue.
25. The method of claim 24 , further comprising:
grasping a second portion of tissue on the wall of the stomach at or near the location of the breach and opposed from the first portion of tissue with the grasping member;
advancing the needle through the second portion of tissue;
deploying a second anchor from the needle, the second anchor being attached to the first anchor by the suture;
retracting the needle from the second portion of tissue, whereby the suture extends from the second anchor and through the second portion of tissue; and
releasing the second portion of tissue.
26. The method of claim 25 , further comprising:
shortening a length of the suture disposed between the first and second anchors.
27. The method of claim 26 , further comprising:
deploying a third anchor and fourth anchor joined by a suture through tissue on the wall of the stomach at or near the location of the breach.
28. The method of claim 25 , wherein the first anchor is attached to the second anchor via the suture when the first anchor is deployed from the needle.
29. The method of claim 25 , wherein the step of grasping a first portion of tissue comprises grasping the first portion of tissue using the grasping member that is movable independently of the needle, and wherein the step of grasping a second portion of tissue comprises grasping the second portion of tissue using the grasping member.
30. The method of claim 24 , wherein the grasping member is movable independently of the needle.