Apparatus and method for concurrently forming a gastroesophageal valve and tightening the lower esophageal sphincter
An apparatus enables concurrent restoration of a gastroesophageal valve and tightening of the lower esophageal sphincter. The apparatus comprises a longitudinal member having a distal end arranged to be received within a stomach, a tissue shaper at the distal end of the longitudinal member that forms a gastroesophageal valve from stomach tissue, and a tissue gatherer that gathers fundus tissue at or aboral to the gastroesophageal junction to reduce an esophageal opening into the stomach and tighten the lower esophageal sphincter. A fastener deployer then deploys at least one fastener pair to maintain both the restored gastroesophageal valve and the tightened lower esophageal sphincter.
1. An assembly for forming a fold of stomach tissue, comprising:
a longitudinal member having a distal end arranged to be received within a stomach;
a chassis hingedly coupled to a bail at the distal end of the longitudinal member to form a mold to shape stomach tissue into a flap of a restored gastroesophageal valve;
a helical coil at a distal end of a cable configured for gathering the stomach tissue at or aboral to the gastroesophageal junction to reduce an esophageal opening into the stomach;
the cable extends from a circuitous-shaped slit in a guide tube on the bail so that the helical coil can be inserted into stomach tissue, the circuitous-shaped slit permitting the cable to disassociate from the bail after the stomach tissue is gripped, and the cable can be retracted into the guide tube and pull the stomach tissue into the mold;
the chassis having a longitudinal channel for receiving the stomach tissue and a first stylet and a second stylet being movable toward each other to form the fold of stomach tissue;
a fastener deployer having fastener deployment guide tubes for receiving deployment wires, the deployment wires configured to advance through the fastener deployment guide tubes and extend through one layer of the fold of stomach tissue;
a fastener configured to advance over each deployment wire and extend through the fold of stomach tissue thereby reducing the esophageal opening.
2. The assembly of claim 1 , wherein the fastener deployment guide tubes include a first fastener deployment guide tube and a second fastener deployment guide tube.
3. The assembly of claim 2 , wherein each of the first and second fastener deployment guide tubes has a guide lumen through which the deployment wires can advance.
4. The assembly of claim 3 , wherein each guide lumen terminates in a delivery point where the fastener is driven into the fold of stomach tissue.
5. The assembly of claim 4 , wherein the guide tube on the bail has a conical surface to guide the cable back into the circuitous-shaped slit.