Extracellular matrix based gastroesophageal junction reinforcement device
Provided are medical devices for implantation in patients having suffered the loss of or damage to at least part of their esophagus. The medical device connects the esophagus or remaining part thereof with the stomach to form a gastro-esophageal junction that promotes healing and encourages new host tissue growth while distributing the load and decreasing tension at the anastomotic site. The medical device comprises extracellular matrix shaped into a conformation that more closely approximates the geometry of the native gastro-esophageal junction than does direct attachment of the stomach to the shortened esophagus. Molds useful in manufacturing the medical device and methods of use of the device are also described herein.
1. A method of reinforcing an esophageal anastomotic site in a patient comprising implanting a tubular device comprising one or more layers of extracellular matrix either:
in the lumen of the patient's esophagus; or
overlaying the abluminal surface of the patient's esophagus at the anastomotic site.
2. The method of claim 1 , wherein the esophageal anastomotic site is a cervical esophageal anastomotic site.
3. The method of claim 1 , wherein the device has a length of between 1 to 30 cm.
4. The method of claim 1 , wherein the device has a diameter of between 0.5 to 5 cm.
5. The method of claim 1 , wherein the device is decellularized.
6. The method of claim 1 , wherein the extracellular matrix tissue is isolated from urinary bladder tissue.
7. The method of claim 1 , wherein the extracellular matrix tissue is isolated from small intestinal submucosa.
8. The method of claim 1 , wherein the extracellular matrix tissue is isolated from dermis of skin.
9. The method of claim 1 , wherein the extracellular matrix tissue is isolated from the esophagus.
10. The method of claim 1 , wherein the device comprises 1-10 layers of extracellular matrix tissue.
11. The method of claim 1 , wherein the device is seeded with cells.
12. The method of claim 1 , wherein the cells are autologous.
13. The method of claim 1 , wherein prior to implanting the tubular device endomucosa is removed from the lumen of the patient's esophagus, and the tubular device is implanted in the lumen and overlays at least a portion of the luminal surface from which endomucosa was removed.
14. A method of joining a resected esophagus in a patient comprising attaching a tubular device comprising one or more layers of extracellular matrix to the patient's esophagus in the lumen thereof and at the site of the resection such that the tubular device bridges the resection site.
15. The method of claim 14 , wherein the resection is a cervical esophageal resection.
16. The method of claim 14 , wherein the device has a diameter of between 0.5 to 5 cm.
17. The method of claim 14 , wherein the device is decellularized.
18. The method of claim 14 , wherein the extracellular matrix tissue is isolated from the esophagus.
19. The method of claim 14 , wherein the device comprises 1-10 layers of extracellular matrix tissue.
20. The method of claim 14 , wherein the device is seeded with cells.
21. The method of claim 20 , wherein the cells are autologous.