Abstract: A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The needle body has first and second ends, tip tabs, retainers for removably retaining the needle body relative to the needle holder arm, and a suture opening. The needle tip is fixed relative to the needle body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the needle body and is fixed therein.

Abstract: An intragastric implant for obesity treatment is disclosed. The device delays digestion by providing a duodenal sleeve, and may also slows gastric emptying by limiting flow through the pyloric sphincter. The implant includes an elongated axially-compressible duodenal sleeve having a non-tissue-piercing anchor on a proximal end sized to lodge within the duodenal bulb. The anchor may have oppositely-directed anchoring flanges to resists migration in both directions. The sleeve may also have barbed ribs to resist proximal movement back up into the stomach. A method of implant includes collapsing/compressing the device and transorally advancing it through the esophagus to be deployed within the duodenum. A dissolvable jacket may constrain the implant for delivery and naturally dissolve upon implant. Removal of the implant may occur in the reverse.

Abstract: A method includes providing an inflatable implant formed of a flexible polymer material suitable for residence in the body. The implant includes a slit valve provided in its wall. The slit valve includes an elastomeric valve body with an open internal chamber being in fluid communication with a proximal opening of the valve, a concave section at its distal end, and a normally closed slit in a solid portion of the valve body connecting the concave section and the distal end of the valve body. An inflation tube having an injection tip with a distal end and an insertion stop is provided. The injection tip is inserted into the internal chamber of the slit valve until the insertion stop positively engages the proximal opening. Then, the implant with the inflation tube is delivered to a body cavity. Once delivered, fluid is introduced through the inflation tube and into the implant.

Abstract: An endoscopic suturing system includes an endoscope, a suturing device, a needle assembly movable through tissue by the suturing device, and first and second devices used in association with the suturing device. The cap assembly includes a rotatable needle arm supporting the needle assembly and actuatable by a proximal handle via a transmission assembly. First and second separate lumen extends outside the endoscope from the cap assembly to a proximal handle to advance instruments therethrough to engage the needle assembly and target the tissue. The cap assembly is retained at an end of the endoscope by a securing arm. The securing arm may be resilient or rotatable. Ancillary clips are also provided about the first and second lumen and transmission assembly to couple them to the endoscope.

Abstract: A variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive implants do not autonomously change shape, but instead react within the stomach to induce satiety. The implants may take up volume within the stomach, thus reducing the digestive capacity. Additionally, the implants may contact areas within the stomach, such as the cardia surrounding the esophageal sphincter, to stimulate satiety-inducing nerves. Also, a number of implants slow gastric emptying by blocking or otherwise impeding flow through the pyloric sphincter. Other implants delay digestion by providing a duodenal sleeve. A number of implants combine two or more of these satiety-inducing features. Methods of implant are disclosed including compressing the implants within a delivery tube and transorally advancing the implants through the esophagus to be deployed within the stomach. Removal of the implants occurs in the reverse.

Abstract: A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

Abstract: A bariatric device for use in inducing weight loss, comprising a cardiac element, a pyloric element, and a connecting element between the two other elements, wherein the connecting element provides structure between the cardiac and pyloric elements, keeping them largely in place and at least intermittently touching and applying pressure to the stomach's cardiac, adjacent fundic and pyloric regions, respectively, which produces a satiety signal to the user, giving the recipient a feeling of fullness and reducing his or her hunger feelings. In an alternative embodiment, the pyloric and connecting elements may be replaced with a positioning element, which keeps the cardiac element in its relative position by pushing against various structures in the stomach. In any of the embodiments, the bariatric device may be made from multiple sizes or adjustable, either manually, automatically or remotely, to optimally size and/or position the device to produce the desired satiety signals and weight loss.

Abstract: A mechanism for removing a fluid-filled object such as an intragastric balloon from a patient. The apparatus includes a delivery tube having a lumen and a retrieval tool able to slide within the lumen that can both puncture and grasp the intragastric balloon. The retrieval tool may have sharpened graspers with either a sharp tip and/or knife-like edges. Alternatively, the delivery tube itself may have sharpened cutting blades that deploy outward to puncture the intragastric balloon. One embodiment utilizes a suction cup tip on the delivery sheath and a sharpened puncture rod that extends past the distal tip of the lumen, for rapid deflation of a balloon. Various embodiments hasten the deflation process and simplify the manipulation required by the surgeon.

Abstract: A mechanism for removing a fluid-filled object such as an intragastric balloon from a patient. The apparatus includes a delivery tube having a lumen and a retrieval tool able to slide within the lumen that can both puncture and grasp the intragastric balloon. The retrieval tool may have sharpened graspers with either a sharp tip and/or knife-like edges. Alternatively, the delivery tube itself may have sharpened cutting blades that deploy outward to puncture the intragastric balloon. One embodiment utilizes a suction cup tip on the delivery sheath and a sharpened puncture rod that extends past the distal tip of the lumen, for rapid deflation of a balloon. Various embodiments hasten the deflation process and simplify the manipulation required by the surgeon.

Abstract: A suture cinch, cinch applicator, and cinch loader for loading the cinch into the cinch applicator are provided and permit re-use of the applicator with multiple cinches during an endoscopic procedure. The applicator can be loaded with a first cinch, apply the first cinch onto a portion of suture to fix the portion of suture relative to anatomical tissue, reloaded with a second cinch optionally using the loader, and subsequently used to apply the second cinch to fix another portion of suture to fix the other portion of suture relative to anatomical tissue. The cinch is a tubular member through which the suture can be advanced when the cinch is loaded within the applicator. The cinch defines multiple ribs and cutter defined in a wall thereof. Operation of the applicator deforms the ribs inward to retain the cinch on the suture, and displaces the cutter to sever the suture.

Abstract: A suture cinch, cinch applicator, and cinch loader for loading the cinch into the applicator are provided and permit re-use of the applicator with multiple cinches during an endoscopic procedure. The applicator can be loaded with a first cinch, apply the first cinch onto a portion of suture to fix the portion of suture relative to anatomical tissue, reloaded with a second cinch optionally using the loader, and subsequently used to apply the second cinch to fix another portion of suture to fix the other portion of suture relative to anatomical tissue. The cinch is a unitary tubular member through which the suture can be advanced when the cinch is loaded within the applicator. The cinch defines multiple ribs and a cutter in a wall thereof. Operation of the applicator deforms the ribs inward to retain the cinch on the suture and displaces the cutter to sever the suture.

Abstract: Transoral obesity treatment devices and related methods for operation thereof are described which occupy space within a stomach and/or stimulate the stomach wall. The transoral obesity treatment devices and related methods are intended to assist a patient in maintaining a healthy body weight. Features of the devices include insertion transorally and without invasive surgery, without associated patient risks of invasive surgery, and without substantial patient discomfort. The life span of these devices may be material-dependent upon long-term survivability within an acidic stomach, but is intended to last one year or longer. The devices have the capacity to vary in size and are desirably self-actuating in that they change shape and/or volume using internal motors or actuators. The changing character of the devices helps prevent the person's stomach from compensating for the implant, such as sometimes happens with static intragastric devices.

Abstract: A variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive implants do not autonomously change shape, but instead react within the stomach to induce satiety. The implants may take up volume within the stomach, thus reducing the digestive capacity. Additionally, the implants may contact areas within the stomach, such as the cardia surrounding the esophageal sphincter, to stimulate satiety-inducing nerves. Also, a number of implants slow gastric emptying by blocking or otherwise impeding flow through the pyloric sphincter. Other implants delay digestion by providing a duodenal sleeve. A number of implants combine two or more of these satiety-inducing features. Methods of implant are disclosed including compressing the implants within a delivery tube and transorally advancing the implants through the esophagus to be deployed within the stomach. Removal of the implants occurs in the reverse.

Abstract: A bariatric device for use in inducing weight loss, comprising a cardiac element, a pyloric element, and a connecting element between the two other elements, wherein the connecting element provides structure between the cardiac and pyloric elements, keeping them largely in place and at least intermittently touching and applying pressure to the stomach's cardiac, adjacent fundic and pyloric regions, respectively, which produces a satiety signal to the user, giving the recipient a feeling of fullness and reducing his or her hunger feelings.

Abstract: An intragastric obesity treatment implant promotes a feeling of satiety in the patient by contacting the insides of the stomach wall, reducing the space in the stomach, or otherwise reducing the amount of food consumed. One intragastric obesity treatment implant two inflatable balloons coupled via a flow restrictor through which fluid may flow in response to peristaltic motions of a patient's stomach. Additionally, one implant comprises a pumping chamber coupled to a reservoir, where the pumping chamber moves stomach fluids into the reservoir in response to peristaltic motions of the patient's stomach.

Abstract: A transorally implanted intragastric balloon or treating obesity and for weight control including a variable size balloon with one or interconnected regions acting to exert a pressure on the stomach, to provide a stomach volume occupying effect, and/or to anchor the balloon within the stomach.

Abstract: An endoscopic tissue grasper device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, and a distal helical coil having a sharpened end for engaging tissue. The helical coil has a proximal close wound portion, a distal open wound portion, and an intermediate transition portion between the proximal and distal portions. The flexible shaft extends into the proximal and intermediate portions and is secured thereto, which prevents tissue engaged by the helical coil from becoming wedged in the transition portion and thereby facilitates release of the coil from engaged tissue. In addition, a bearing sheath is provided between the shaft and tubular member to prevent the shaft from binding during operation.

Abstract: Transoral obesity treatment devices and related methods for operation thereof are described which occupy space within a stomach and/or stimulate the stomach wall. The transoral obesity treatment devices and related methods are intended to assist a patient in maintaining a healthy body weight. Features of the devices include insertion transorally and without invasive surgery, without associated patient risks of invasive surgery, and without substantial patient discomfort. The life span of these devices may be material-dependent upon long-term survivability within an acidic stomach, but is intended to last one year or longer. The devices have the capacity to vary in size and are desirably self-actuating in that they change shape and/or volume using internal motors or actuators. The changing character of the devices helps prevent the person's stomach from compensating for the implant, such as sometimes happens with static intragastric devices.

Abstract: A variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive devices may not autonomously change shape, but instead react within the stomach to induce satiety. The devices may provide slowed entry into the stomach, thus reducing the intake capacity. Additionally, the devices may contact areas within the stomach, such as the cardia surrounding the esophageal sphincter, to stimulate satiety-inducing nerves. Some devices combine two or more of these satiety-inducing features. Methods of implant are disclosed including compressing the devices within a delivery tube and transorally advancing the devices through the esophagus to be deployed within the stomach. Removal of the devices occurs in the reverse. The implants are formed of materials that permit the implant to be compressed into a substantially linear transoral delivery configuration and that will resist degradation over a period of at least six months within the stomach.

Abstract: An endoscope overtube includes a flexible tubular member and a hub assembly provided at the proximal end of the tubular member. The hub assembly includes an elastic sleeve seal cuff extending about the inner surface of a body member of the hub. The ends of seal cuff are coupled to the body member. An inflation line extends into the body member in communication with the outer surface of the seal cuff. When fluid is pressurized through the inflation line, the cuff is distended inward to reduce the size of the opening through the port such that the cuff forms a seal about an endoscope received through the hub. The body member is preferably coupled to each of the flexible tubular member and to the elastic seal cuff using a snap-fit engagement of parts such that no fasteners, welds, glues, etc. are necessary for securing the hub assembly together.