Methods and Devices for Stimulation of an Organ with the Use of a Transectionally Placed Guide Wire
Devices, systems and methods are provided for electrical stimulation of a body organ, particularly within the gastrointestinal tract. In preferred embodiments, the stomach is the organ within the gastrointestinal tract which is targeted for such stimulation. A guide wire or other delivery device is positioned within the body so as to transect the stomach wall. Devices and systems are then advanced over the guide wire for attachment to the stomach wall. The guide wire may be placed by endoscopic, open, laparoscopic or a modified percutaneous approach. In a modified percutaneous approach, the stomach is accessed without the use of general anesthesia by advancing a needle through the abdomen, transecting the stomach wall with the needle and advancing the guide wire through the needle. In some embodiments, particularly for use in obese patients, the modified percutaneous approach includes advancing a trocar through the tissue of the patient toward the outer surface of the organ and advancing the needle through the trocar prior to transecting the wall with the needle.
1 . A method of attaching a device to a wall of a hollow organ within a patient, the wall having an inner surface facing within the organ and an outer surface facing away from the organ, the method comprising:
positioning a guide wire wherein the guide wire transects the wall of the organ and extends through tissue to an exterior of the patient;
advancing the device over the guide wire from the exterior of the patient toward the organ, wherein the device comprises at least one lead having at least one electrode; and
attaching the device to the wall of the organ so that the at least one electrode is positioned so as to stimulate the wall.
2 . A method as in claim 1 , wherein positioning the guide wire comprises accessing the organ by a modified percutaneous approach without the use of general anesthesia, wherein the modified percutaneous approach comprises advancing a needle through the tissue of the patient toward the outer surface of the organ, transecting the wall with the needle and advancing the guide wire through the needle.
3 . The method of claim 2 , wherein the modified percutaneous approach includes advancing a trocar through the tissue of the patient toward the outer surface of the organ and advancing the needle through the trocar prior to transecting the wall with the needle.
4 . The method of claim 2 , wherein attaching the device to the wall comprises positioning the at least one electrode within the wall.
5 . The method of claim 4 , wherein positioning the at least one electrode within the wall comprises positioning the at least one electrode within or against a muscle layer within the wall.
6 . The method of claim 4 , further comprising implanting a stimulator externally of the hollow organ within the patient, wherein the stimulator is in electrical communication with the at least one lead.
7 . The method of claim 1 , wherein attaching the device comprises attaching a stimulator to the wall of the organ so that the stimulator is implanted within the hollow organ.
8 . The method of claim 7 , wherein positioning the guide wire comprises extending the guide wire through a mouth of the patient, the method further comprising advancing the stimulator through the mouth and over the guide wire toward the inner surface of the wall of the hollow organ.
9 . The method of claim 1 , wherein attaching the device comprises implanting a stimulator within the tissue external to the hollow organ.
10 . The method of claim 1 , wherein the device includes a retention feature and wherein attaching the device to the wall of the organ comprises positioning the retention feature within the wall of the organ.
11 . The method of claim 10 , wherein the organ comprises a stomach and the wall includes at least a muscle layer and a submucosal layer, and wherein positioning the retention feature within the wall of the organ comprises positioning the retention feature between the muscle layer and the submucosal layer.
12 . The method of claim 1 , wherein the device includes a fixation feature and a conical segment near the fixation feature, and wherein attaching the device to the wall of the organ comprises positioning the fixation feature against the outer surface of the organ while the conical segment transects the wall.