Abstract: Described herein is a system for inducing weight loss in a patient, which comprises an extragastric space occupier positionable in contact with an exterior surface of a stomach wall to form an inward protrusion of wall into the stomach, and a retention device positionable in contact with the wall to retain the inward protrusion and to thereby capture the extragastric space occupier within the protrusion.

Abstract: Described herein is a system for inducing weight loss in a patient, which comprises an extragastric space occupier positionable in contact with an exterior surface of a stomach wall to form an inward protrusion of wall into the stomach, and a retention device positionable in contact with the wall to retain the inward protrusion and to thereby capture the extragastric space occupier within the protrusion.

Abstract: A staple housing includes an array of staples each in a staple delivery position or “ready position” ready to be fired into target tissue. A staple driver is advanceable to drive the ready-position staples from the staple head into the tissue using staple pushers. During use, the staples in the ready positions are simultaneously fired into the target tissue using the staple pushers, forming an array of staples in the target tissue. After the array has been fired, one or more feed mechanisms within the staple housing advance a second group of staples from one or more staple storage locations into the ready positions in preparation for firing of the second group of staples.

Abstract: Described herein are endoscopic staplers used to apply one or more fasteners to body tissue. In one embodiment, a fastener-applying device, which is preferably a stapler, is passed transorally into the stomach and used to plicate stomach tissue by engaging tissue from inside of the stomach and drawing it inwardly. In the disclosed embodiments, the tissue is drawn inwardly into a vacuum chamber, causing sections of serosal tissue on the exterior of the stomach to be positioned facing one another. The disclosed staplers allow the opposed sections of tissue to be moved into contact with one another, and preferably deliver staples for maintaining contact between the tissue sections at least until serosal bonds form between them. Each of these steps may be performed wholly from the inside of the stomach and thus can eliminate the need for any surgical or laparoscopic intervention.

Abstract: A tissue surface treatment apparatus includes a housing having a proximal end, a distal end including a tissue contacting surface, an interior defined by the housing and a handpiece coupled to the housing. The contactinc surface has a plurality of apertures. An energy delivery device including an electrode is positionable in the housing interior. The electrode includes a tissue penetrating distal end in substantial alignment with an aperture. The electrode is configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface. An advancement device is coupled to the energy delivery device and is at least partly positionable within at least one of the housing or the handpiece. The advancement device is configured to advance the electrode from the housing interior into the target tissue site and withdrawal the electrode into the housing interior.

Abstract: Systems for controlling obesity utilize a number of space occupiers positioned in the stomach to reduce the effective volume of the stomach. Such arrangements provides sufficient stomach volume consumption to induce weight loss, but enable use of space occupiers that are proportioned to minimize the threat of obstruction even if they should migrate into the intestine. In general, numerous small volume space occupiers are placed in the stomach such that the total volume equals or exceeds the single volume of prior art single unit space occupiers. However, each individual space occupier is proportioned so that it will pass without obstruction if it moves into the intestine.

Abstract: A device and method for acquiring tissue in preparation for tissue fastening includes an acquisition head having a pair of vacuum chambers. A vacuum source is used to draw a tissue into a first one of the chambers, and a grasper is extended into the chamber to engage the tissue, allowing vacuum pressure to be released without loss of the tissue from the chamber. Tissue is subsequently drawn into an adjacent chamber and then similarly engaged in the chamber using a second grasper. The two or more sections of acquired tissue may be held in complete or partial alignment with one another as staples or other fasteners are driven through the pinches, thus forming a four-layer tissue plication.

Abstract: A method of controlling ablation volume depth includes providing a treatment apparatus. The apparatus comprises a housing having a proximal and distal end including a tissue contacting surface. The housing defines an interior with an energy delivery device positionable in the interior. The energy delivery device includes at least one electrode with a tissue penetrating distal end and is configured to be advanced from the interior into a target tissue site to define an ablation volume. An advancement device is coupled to the energy delivery device and is configured to advance the at least one electrode. The at least one electrode is advanced to a selected deployment depth beneath a tissue surface while avoiding a critical structure. Energy is delivered from the energy delivery device. An ablation volume is created at a controlled depth below the tissue surface responsive to the deployment depth while minimizing injury to the critical structure.

Abstract: This application describes an overtube device that gives diagnostic and/or therapeutic access to body cavities using natural orifices of the body. The overtube includes an elongate flexible body having a distal portion deflectable in response to activation of a control cable. Proximal features of the overtube include an insufflations port and seals for minimizing loss of insufflations pressure around the shafts of instruments passed through the tube. In some embodiments, retractor elements are including on the distal portion of the overtube.

Abstract: A device and method for remodeling or partitioning a body cavity, hollow organ or tissue tract includes graspers operable to engage two or more sections of tissue within a body cavity and to draw the engaged tissue between a first and second members of a tissue remodeling tool. The two or more pinches of tissue are held in complete or partial alignment with one another as staples or other fasteners are driven through the pinches, thus forming a four-layer tissue plication. Over time, adhesions formed between the opposed serosal layers create strong bonds that can facilitate retention of the plication over extended durations, despite the forces imparted on them by stomach movement. A cut or cut-out may be formed in the plication during or separate from the stapling step to promote edge-to-edge healing effects that will enhance tissue knitting/adhesion.

Abstract: A method and apparatus for carrying our thermal ablation of target tissue is disclosed. The apparatus includes an RF ablation device having a multi-electrode electrode assembly designed to be deployed in target tissue, defining a selected-volume tissue region to be ablated, and having infusion channels for infusing a liquid into the target tissue during the ablation process. A control unit in the apparatus is operably connected to an RF energy source, for controlling the RF power level supplied to the electrodes, and to an infusion device, for controlling the rate of infusion of a liquid through the device into the tissue. During both electrode deployment and tissue ablation, impedance and or temperature measurements made within the tissue are used to control the RF source and infusion device, for optimizing the time and extent of tissue ablation.

Abstract: Disclosed in the present application are devices for localized delivery of energy and methods of using such devices, particularly for therapeutic treatment of biological tissues. The disclosed devices may contain one or more energy delivery members. The disclosed methods may involve positioning and deploying the energy delivery members in a target site, and delivering energy through the energy delivery members.

Abstract: A tissue surface reatment apparatus includes a housing having a proximal end, a distal end including a tissue contacting surface, an interior defined by the housing and a handpiece coupled to the housing. The contactine surface has a plurality of apertures. An energy delivery device including an electrode is positionable in the housing interior. The electrode includes a tissue penetrating distal end in substantial alignment with an aperture. The electrode is configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface. An advancement device is coupled to the energy deliveru device and is at least partly positionable within at least one of the housing or the handpiece. The advancement device is configured to advance the electrode fdro the housing interior into the target tissuesite and withdrawal the electrode into the housing interior.

Abstract: An apparatus for treating tumors comprises an elongated delivery device that includes a lumen and is maneuverable in tissue. An impedance sensor array is deployable from the elongated device and configured to be coupled to at least one of an energy source or a switching device. The impedance array includes a plurality of resilient members, at least one of the plurality being positionable in the elongated device in a compacted state and deployable with curvature into tissue from the elongated device in a deployed state. In the deployed state, the plurality of resilient members defines a sample volume. At least one of the resilient members includes an impedance sensor and at least a portion of the array is configured to sample tissue impedance through a plurality of conductive pathways. An energy delivery device is coupled to one of the array, the at least one resilient member or the elongated device.

Abstract: A method and apparatus for carrying our thermal ablation of target tissue is disclosed. The apparatus includes an RF ablation device having a multi-electrode electrode assembly designed to be deployed in target tissue, defining a selected-volume tissue region to be ablated, and having infusion channels for infusing a liquid into the target tissue during the ablation process. A control unit in the apparatus is operably connected to an RF energy source, for controlling the RF power level supplied to the electrodes, and to an infusion device, for controlling the rate of infusion of a liquid through the device into the tissue. During both electrode deployment and tissue ablation, impedance and or temperature measurements made within the tissue are used to control the RF source and infusion device, for optimizing the time and extent of tissue ablation.

Abstract: The present application describes an implant system useable for positioning an implant device such as a device useful for restricting passage of ingested food into the stomach. In one embodiment, the disclosed system includes a plurality of anchors that may be coupled to tissue within the stomach, or to a tissue tunnel formed by plicating stomach wall tissue. The anchor includes a loop. During use, the implant device is inserted through the loop and expanded such that it retains its position within the loop until removed. Instruments for implanting and explanting the implant device are also described.

Abstract: A method of controlling ablation volume depth includes providing a treatment apparatus. The apparatus comprises a housing having a proximal and distal end including a tissue contacting surface. The housing defines an interior with an energy delivery device positionable in the interior. The energy delivery device includes at least one electrode with a tissue penetrating distal end and is configured to be advanced from the interior into a target tissue site to define an ablation volume. An advancement device is coupled to the energy delivery device and is configured to advance the at least one electrode. The at least one electrode is advanced to a selected deployment depth beneath a tissue surface while avoiding a critical structure. Energy is delivered from the energy delivery device. An ablation volume is created at a controlled depth below the tissue surface responsive to the deployment depth while minimizing injury to the critical structure.

Abstract: A tissue-ablation method and apparatus are disclosed. The apparatus includes a plurality of RF ablation electrodes, and a plurality of sensor elements, each movable from retracted to deployed positions in a tissue to be ablated. A control device in the apparatus is operatively connected to the electrodes for supplying an RF power to the electrodes, to produce tissue ablation that advances from individual-electrode ablation regions to fill a combined-electrode ablation volume. The control device is operatively connected to the sensor elements for determining the extent of ablation in the regions of the sensor elements. The supply of RF power to the electrodes can thus be regulated to control the level and extent of tissue ablation throughout the combined-electrode volume. The electrodes are preferably hollow-needle electrodes through which liquid can be infused into the tissue, also under the control of the control unit, to modulate and optimize tissue ablation.

Abstract: Ablation devices and associated methods are provided for use in palliative treatment of a bone tumor on or in a compact bone region. The bone treatment devices include an elongate probe having a distal end. A proximal end of the probe supports placement in a location at or adjacent to the bone tumor. Electrodes are carried within the probe for deployment from the distal end into the bone tumor. The electrodes may be shapable to create, upon deployment, an array of electrodes that defines a geometric area within the bone tumor. Application of energy, for example energy from a radio frequency (RF) source, to the area of the bone tumor via the electrodes destroys at least a portion of the nerve receptors located in or adjacent to the tumor and produces a reduction in pain associated with the bone tumor.

Abstract: A method of treating a tumor includes providing a tissue biopsy and treatment apparatus that includes an elongated delivery device that has a lumen and is maneuverable in tissue. A sensor array having a plurality of resilient members is deployable from the elongated delivery device. At least one of the plurality of resilient members is positionable in the elongated delivery device in a compacted state and deployable with curvature into tissue from the elongated delivery device in a deployed state. At least one of the plurality of resilient members includes at least one of a sensor, a tissue piercing distal end or a lumen. The sensor array has a geometric configuration adapted to volumetrically sample tissue at a tissue site to differentiate or identify tissue at the tissue site. At least one energy delivery device is coupled to one of the sensor array, at least one of the plurality of resilient members or the elongated delivery device. The apparatus is then introduced into a target tissue site.