Abstract: An incisionless fully endoscopic method of reducing the capacity of the stomach is provided to surgically treat obesity. The method is directed to endoluminal tissue approximation of a portion of the stomach, including at least a portion of the greater curvature thereof. The method includes a pattern of stitching in which a portion of the stomach is closed off. One stitching pattern causes the lateral portion of the stomach to be drawn to reduce the usable volume of the stomach while maintaining a pathway from the esophagus to the pylorus. As the stitching pattern advances, the fundus is automatically drawn downward so that it may be endoscopically approached for stitching in a facilitated manner. According to another aspect of the invention, another stitching pattern extends from the antrum to the fundus between the anterior and posterior portions of the stomach.

Abstract: A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity is described. More specifically, a technique for accessing the peritoneal cavity via the wall of the digestive tract is provided so that examination of and/or a surgical procedure in the peritoneal cavity can be conducted via the wall of the digestive tract with the use of a flexible endoscope. As presently proposed, the technique is particularly adapted to transgastric peritoneoscopy. However, access in addition or in the alternative through the intestinal wall is contemplated and described as well. Transgastric and/or transintestinal peritoneoscopy will have an excellent cosmetic result as there are no incisions in the abdominal wall and no potential for visible post-surgical scars or hernias.

Abstract: An implantable device controls the movement of fluid to an inflatable portion of a gastric band. The implantable device includes a body. The body has an inlet, an outlet and a valve seat positioned between the inlet and the outlet. The body defines a fluid passage from the inlet to the outlet. The implantable device also includes a diaphragm. The diaphragm has one or more edges coupled to the body. The diaphragm is made of an elastomeric material and capable of being moved between a closed position that blocks the valve seat and does not allow the fluid to move from the inlet to the outlet and an open position that does not block the valve seat and allows the fluid to move from the inlet to the outlet.

Abstract: A system for attaching an access port to bodily tissue includes an access port assembly and including an access port having a generally central axis. The access port assembly further includes an attachment mechanism structured to enable the access port to be attached, for example, to an abdominal muscle of a patient. The delivery tool includes a handle having a generally longitudinal axis and a delivery head structured to engage the access port assembly, and an activation mechanism for enabling deployment of the attachment mechanism when the delivery head is so engaged with the access port assembly. The delivery tool is configured such that the longitudinal axis of the handle is spaced apart from the generally central axis of the access port when the delivery head is so engaged with the access port assembly.

Abstract: A treatment device for endoscopic therapy of the present invention includes a suturing-ligating member having a distal end portion and a proximal end portion, that carries out at least one of suturing and ligation of biological tissue, a stopper provided to be movable forward or backward on an proximal end side of the suturing or ligating member, and stoppable by friction on the suturing-ligating member to maintain the biological tissue in a sutured or ligated state by the suturing-ligating member, and a suturing-ligation releasing member provided movable with relative to the suturing-ligating member to release the suturing-ligation state maintained by firctional stopping between the suturing-ligating member and the stopper by moving the releasing member to the proximal end portion side of the suturing-ligating member.

Abstract: A system for attaching an access port to bodily tissue includes an access port assembly and including an access port having a generally central axis. The access port assembly further includes an attachment mechanism structured to enable the access port to be attached, for example, to an abdominal muscle of a patient. The system includes a safety cap which lies substantially flush against the anchor base to provide no space for movement of the anchors. The safety cap prevents the anchors from deploying prematurely.

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: 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: An implantable device used in a gastric band system includes an access port, a tube coupled to the access port, and a shielding device covering a portion of the tube. The shielding device is positioned adjacent to the access port and covers the end of the tube coupled to the access port. The shielding device is made from a puncture resistant material, to protect the tube from puncture by a misplaced syringe needle inserted by a physician.

Abstract: An apparatus comprises a controller for remotely controlling an implantable device that is used to adjust a gastric band, and the controller transmits a telemetric signal to the implantable device. The apparatus further comprises a table that provides support for the controller. A rail is oriented in a first direction with respect to the table, and a tray is slidably coupled to the rail. The tray receives the controller, and the rail moves the tray and the controller in the first direction with respect to the table. The apparatus further comprises a roller coupled to the rail. The roller aids in moving the rail, the tray, and the controller in a second direction with respect to the table. The apparatus further comprises an attachment mechanism for securing the controller to the tray. The apparatus locates the controller in a desired location with respect to a patient.

Abstract: Generally described herein are apparatus, systems and methods related to a mechanical interlock joint geometry for various components and joining of components thereby creating a reliable seal against fluid leaks that is resistant at typical pressures experienced when the components are implanted into a human body. Furthermore, the seal may be enhanced when a fluid pressure exerted inside the components is increased (e.g., from 1 to 10 psi).

Abstract: Gastric banding devices, and drive systems designed to operate gastric banding devices, are disclosed. The gastric banding devices and drive systems intend to increase performance, durability, and simplicity over known gastric banding systems. Embodiments include transmission systems configured to output a variable force. Embodiments also include banding structures biased to apply a constrictive force to a patient's stomach. Supporting, or skeletal, structures are also disclosed. Various drive systems designed to improve power efficiency are also disclosed.

Abstract: Transoral three-dimensionally orthogonal intragastric spring systems, devices, methods of operation and manufacture are provided. A transoral three-dimensionally orthogonal intragastric spring system and/or device (and related methods of manufacture and operation) may reduce obesity or weight by stimulating the stomach walls of the patient. The three-dimensionally orthogonal intragastric spring device may be a purely mechanical device comprising a flexible body which in response to an input force in one direction, may deform and cause a resultant displacement in an orthogonal direction, thereby exerting a pressure on the inner stomach walls of the patient. Alternatively, a three-dimensionally orthogonal intragastric spring device may include a variable size balloon configured to occupy volume in the patient's stomach, thereby reducing the amount of space in the patient's stomach.

Abstract: A method and system for determining pressure in a syringe, and more specifically to a syringe pressure accessory which can be connected to a syringe to determine pressure in a syringe and a gastric band. The syringe pressure accessory can detect a pressure of a syringe and/or a gastric band and digitally display the pressure. The syringe pressure accessory can include a durable unit and a disposable unit. The disposable unit can be disposed of after a single use, while the durable unit can be reused with multiple disposable units. The syringe pressure accessory can also include a syringe attachment unit and one or more display units for a caretaker or a patient. The display unit can be wirelessly connected to the syringe attachment unit to display a pressure chart or the results of various analysis of the pressure data. Markers can be added to the pressure chart.

Abstract: An arterio-venous graft (16) is provided with a constriction device (20) near its arterial end. The constriction device (20) is used to reduce the flow through the AV graft under normal conditions and to relieve the constriction when high flow through the AV graft is required, such as for vascular access for hemodialysis.

Abstract: Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, and a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided. In accordance with one aspect there is provided a submucosal implant device for diagnosing and treating disorders of the body. The submucosal implant device may take the form of a gastric stimulator in which signals are supplied to the muscular wall of a mammal to treat motility disorders. In accordance with yet another aspect there is provided a method for performing a submucosal medical procedure to deploy a submucosal implant device in the digestive tract of a mammal.

Abstract: Intragastric implant devices for obesity treatment are disclosed. The device is passive and does not autonomously change shape, but instead reacts to movement of the stomach to induce satiety. The device includes a series of connected, articulated clips that plicate the stomach wall nondestructively (no puncturing through the gastric wall) such that the overall volume of the stomach is reduced. Cam-shaped clamping surfaces prevent slippage of the stomach tissue from within the clips. Methods of implant are disclosed including delivering the device through a transoral delivery tube and advancing the device through the esophagus to be deployed within the stomach. Removal of the device occurs in the reverse.

Abstract: A power management system provides wireless power to operate components of a remotely adjustable gastric banding system. The power management system comprises an external power component transmitting power, and an implantable power management component receiving power and converting the power for use in powering one or more components of the remotely adjustable gastric banding system, such as a pump. The internal power management component and the external power component may be tunable. By utilizing the power management system, implantable batteries may be eliminated.

Abstract: Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.

Abstract: An implantable injection port for use with a gastric band for treating obesity and for attaching to a tissue of a patient is disclosed. The implantable injection port includes a base having an anchor opening, a gear coupled to the base and rotatable about a central axis, the gear having a plurality of gear teeth, an anchor coupled to the gear, and a top portion spaced apart from the base and having a plurality of top teeth that engage with the plurality of gear teeth. The top portion is rotatable causing rotation of the gear such that the rotation of the gear causes movement of the anchor through the anchor opening of the base and into the tissue of the patient.