Enhanced techniques for insertion and extraction of a bougie during gastroplasty
An assembly including a bougie and a sheath for use in performing a gastroplasty for dividing a stomach of a patient into a sleeve receiving food and a bypass portion. The bougie includes an elongated body having a segment being shaped to follow a lesser curve of the stomach, and an extension member being movable within the stomach for positioning a distal portion thereof away from a gastroesophageal junction of the stomach and to define a fluid passage between the sleeve and the bypass portion. The sheath has an elongated main lumen in which the bougie is inserted and the sheath is translatable along the bougie to selectively expose the extension member of the bougie to perform its guiding action, or hide the extension member to ensure secure displacement of the bougie within the stomach and along the oesophagus.
1. A sheathing device for guiding insertion and extraction of a bougie into and from a stomach during a sleeve gastroplasty, the sheathing device comprising a tubular body having a main elongated lumen for slidably receiving the bougie therein, and the tubular body being translatable with respect to the bougie between:
a first position in which the tubular body at least covers a guiding segment of the bougie during insertion and extraction of the guiding segment into and from the stomach, and
a second position in which the tubular body is staggered with respect to the guiding segment for allowing the guiding segment to serve as guide to form a sleeve within the stomach.
2. The sheathing device of claim 1 , comprising an actuator which is configured to displace the tubular body between the first position and the second position along the bougie.
3. The sheathing device of claim 2 , wherein the actuator is a wire system comprising at least one wire which is pullable to actuate translation of the sheathing device with respect to the bougie.
4. The sheathing device of claim 3 , wherein the at least one wire is at least partially integrated within a wall of the tubular body.
5. The sheathing device of claim 1 , wherein the tubular body is made of a polymeric material.
6. The sheathing device of claim 1 , wherein the tubular body has a proximal portion made of a first material and a distal portion made of a second material, the second material having an enhanced rigidity in comparison to the first material, said distal portion enclosing the guiding segment of the bougie when the tubular body is in the first position.
7. The sheathing device of claim 1 , wherein the tubular body is made of a material which is flexible enough to bend according to the movements of the bougie.
8. The sheathing device of claim 1 , wherein the tubular body comprises distal and proximal tube segments, the proximal tube segment being translatable with respect to the bougie in a backward direction to expose the guiding segment, and the distal tube segment being translatable with respect to the bougie in a forward direction to hide the guiding segment.
9. The sheathing device of claim 1 , wherein the tubular body extends along the bougie from the stomach and further along the oesophagus so as to be actuated from an oral cavity of a patient.
10. The sheathing device of claim 1 , wherein the tubular body extends along an entire length of the bougie.
11. The sheathing device of claim 1 , wherein the guiding segment of the bougie is movable from a retracted position to an extended position by an activation mechanism, and the sheathing device has a diameter selected to accommodate both the bougie and the activation mechanism.
12. The sheathing device of claim 1 , wherein the tubular body is curved to facilitate insertion and positioning of the bougie within the stomach.