DEVICES AND METHODS FOR PLACEMENT OF PARTITIONS WITHIN A HOLLOW BODY ORGAN
Devices and methods for tissue acquisition and fixation, or gastroplasty, are described. Generally, the devices of the system may be advanced in a minimally invasive manner within a patient's body to create one or more plications within the hollow body organ. A tissue treatment device attached to a distal end of a flexible elongated member and has a cartridge member opposite an anvil member. The cartridge member and the anvil member are movable between a closed position and an open position relative to one another, and the cartridge member is re-loadable with a removable staple cartridge to form multiple plications within the organ with the same tissue treatment device.
1 - 26 . (canceled)
27 . A method for delivering and implanting a staple line in the stomach of a patient, comprising:
providing an elongated tubular member having a proximal end and a distal end and having a first lumen extending at least through a portion thereof;
advancing the distal end of the tubular member transorally into the patient's stomach;
advancing an endoscope through the first lumen for real time visualization of the patient's stomach;
positioning the endoscope to visualize a treatment site in the stomach;
position the distal end of the tubular member at the treatment site and visualize the position of the distal end of the tubular member with the endoscope;
implant a staple line at the treatment site while visualizing with the endoscope;
visualize the staple line with the endoscope; and
withdraw the tubular member and endoscope from the patient.
28 . The method of claim 27 , wherein the endoscope is retroflexed to visualize the distal end of the tubular member.
29 . The method of claim 28 , wherein the endoscope, when in the retroflexed position, visualizes a proximal end of a fastening member aligned with the gastroesophogeal junction (GEJ).
30 . The method of claim 27 , wherein the endoscope retracts stomach tissue.
31 . The method of claim 27 , wherein dual folds of tissue are fastened together by the staple line.
32 . The method of claim 27 , wherein the staple line is placed along the lesser curve of the stomach.
33 . A delivery system for transoral treatment of the stomach of a patient, comprising:
a flexible elongated body having a proximal end extending outside the patient, a central section extending transorally into the patient, and a distal end extending into the stomach;
a fixation member attached to the distal end of the flexible elongated body;
an endoscope associated with the flexible elongated body for real time visualization; and
the flexible elongated body, fixation member, and endoscope having an overall diameter equal to or less than 18.136 mm (0.714 inch).
34 . The delivery system of claim 33 , wherein the flexible elongated body being compatible with side-by-side insertion of the endoscope.
35 . The delivery system of claim 33 , further comprising an acquisition member attached to the distal end of the flexible elongated body.
36 . The delivery system of claim 35 , wherein the acquisition member is a vacuum pod.
37 . The delivery system of claim 36 , further comprising a vacuum tube extending from the vacuum pod at the distal end of the flexible elongated body to the proximal end of the flexible elongated body.
38 . The delivery system of claim 37 , wherein the vacuum tube is attached to a vacuum source at a proximal end of the flexible elongated body.
39 . The delivery system of claim 33 , wherein one or more cables or wires extend along the flexible elongated body for operative engagement with the fixation member.
40 . The delivery system of claim 33 , wherein the fixation member has a maximum diameter of 15.1 mm (0.595 inch) in a closed configuration and a maximum diameter of 17.0 mm (0.668 inch) in an open configuration.
41 . The delivery system of claim 33 , wherein the flexible elongated body can be bent to achieve a 10.16 cm (4.00 inch) bend radius to flexibly navigate the esophagus.
42 . The delivery system of claim 33 , wherein the fixation member is configured to place a line of fasteners through stomach tissue having a length in the range from about 12.5 mm (0.492 inch) to about 50.0 mm (1.97 inch).
43 . A delivery system for transoral treatment of the stomach, comprising:
a flexible elongated member having a proximal end extending outside of a patient, a central section extending transorally into the patient, and a distal end extending into the stomach;
a tissue treatment device attached to the distal end of the elongated member;
a first lumen extending within the elongated member and being in fluid communication with a vacuum source at a proximal end of the first lumen and the tissue treatment device at a distal end of the first lumen;
the tissue treatment device forming a first tissue fold and a second tissue fold via a vacuum;
a fastener for fastening the first tissue fold to the second tissue fold; and
an endoscope for real time visualization of the stomach and tissue treatment device.
44 . The delivery system of claim 43 , wherein at least a portion of the elongated member having a plurality of sliding links to increase flexibility of the elongate member.
45 . The delivery system of claim 44 , wherein each link has a substantially cylindrical configuration.
46 . The delivery system of claim 45 , wherein each link slidingly engages an adjacent link.
47 . The delivery system of claim 44 , wherein the plurality of sliding links are covered with a material to limit trauma to the esophagus.
48 . The delivery system of claim 47 , wherein the cover material includes ployethylene tape, silicone and urethanes.
49 . The delivery system of claim 44 , wherein the first lumen extends through the sliding links.
50 . The delivery system of claim 43 , wherein cables and/or wires extend through the first lumen.
51 . The delivery system of claim 43 , wherein the endoscope extends through the first lumen.
52 . The delivery system of claim 43 , wherein the elongated member includes a second lumen extending for at least a portion therethrough.
53 . The delivery system of claim 52 , wherein the first lumen and the second lumen extend side by side.
53 . The delivery system of claim 52 , wherein the second lumen slidingly receives the endoscope.
54 . The delivery system of claim 43 , wherein the elongated member is formed from a braided material.
55 . The delivery system of claim 43 , wherein the elongated member is formed from a molded material.
56 . The delivery system of claim 43 , wherein the elongated member is formed from a slotted material.
57 . The delivery system of claim 43 , wherein the elongated member is formed from a polymer material.