Abstract: A bariatric device 10 for use in inducing weight loss, comprising a cardiac element 12, a pyloric element 26, and a connecting element 25 between the two other elements, wherein the connecting element 25 provides structure between the cardiac 12 and pyloric 26 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. Alternatively, the cardiac 12 and pyloric 26 elements may be symmetrical, so that the device can orient itself either way in the stomach and still achieve the weight loss function. Alternatively, the cardiac 12 and/or pyloric 26 elements may have a restriction element to slow gastric filling or emptying, to produce a satiety signal.

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 system includes a first tube, a sharp coil at a distal end of the first tube, a second tube displaceable within the first tube, and a sharp housing at a distal of the second tube for storing fasteners. The housing can be positioned at a first tissue, and the coil rotated to advance the coil into engagement with the first tissue. The first tube is retracted to retract the first tissue, and then a first fastener is deployed at the first tissue location. Then, without removing the system from the patient, the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second fastener at the second tissue location. A suture extends between the first and second fasteners, and tension is applied to the suture to draw the first and second tissues toward each other to reconfigure the tissue.

Abstract: A gastric implant includes a distal sleeve portion configured to be disposed in a duodenum of a patient, and a pyloric restriction portion connected to a proximal end of the distal sleeve portion. The pyloric restriction portion is configured to be disposed in a pylorus of a patient. Also, the implant includes a proximal anchor portion connected to a proximal end of the pyloric restriction portion. The proximal anchor portion is configured to be disposed in a lower stomach of the patient. The proximal anchor portion has at least one eyelet for fastening to the stomach to secure the implant to the gastrointestinal tract.

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: A system includes a slit valve for use with an inflatable intragastric balloon having a flange surface with an opening therein. The slit valve has a valve body connected to the flange surface and a chamber formed in the valve body. The system also includes a filler tube, that is accepted into the chamber when it is inserted through the opening in the flange surface.

Abstract: A variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive devices do 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: A variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive devices do not autonomously change shape, but instead react within the stomach to induce satiety. The devices may take up volume within 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. Also, certain devices slow gastric emptying by blocking or otherwise impeding flow through the pyloric sphincter. A number of 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.

Abstract: Transoral implantable devices includes an inflatable body made of a material that permits it to be compressed into a substantially linear transoral delivery configuration and that when implanted in the stomach is adapted to reduce obesity or weight by stimulating the stomach walls of the patient. The body has a plurality of popout features on its surface that reside generally flush with the inflatable body in relaxed, refracted states, and which respond to an increase in pressure within the inflatable body by projecting outward from the body in a stressed, deployed state. The popout features may convert between their retracted and deployed states by movement of rolling diaphragms formed in the inflatable body.

Abstract: A distal cap apparatus for use with an endoscope, having a proximal end and a distal end and a longitudinal axis extending therebetween, includes a mount configured for mounting to the distal end of the endoscope, and a strap connected to the mount and configured for banding about the distal end of the endoscope when the distal end of the endoscope is received in the mount. The mount defines a strap slot configured to receive an end of the strap to configure the strap in the banded configuration. The strap may be elastic. The strap may be a continuous band. In one embodiment, a distal cap apparatus includes a mount having a strap and a buckle for adjusting a size of a loop formed at least partially by the strap about the distal end of the endoscope.

Abstract: A bariatric device for use in inducing weight loss, comprising a cardiac element and a fixation element wherein the fixation element attaches the cardiac element to the upper stomach to allow the cardiac element to apply at least intermittent pressure to the upper stomach which produces a satiety signal to the user, giving the recipient a feeling of fullness and reducing his or her hunger feelings. The device may also contain an esophageal element which is connected to the cardiac element by a connecting element.

Abstract: A treatment device for use with an endoscope having a instrument channel for passage of an endoscopic instrument and a distal end is provided. The treatment device includes an end effector assembly with a base for placement at the distal end of the endoscope, an end effector rotatable relative to the base, and a mounting portion for attaching the base to the endoscope. The mounting portion is resiliently compressible and can be radially compressed for insertion into the instrument channel, whereby an expansion force of the resiliently compressed mounting portion retains the base relative to the distal end of the endoscope. The mounting portion also includes an opening longitudinally extending therethrough and communicable with the instrument channel and sized for receiving an endoscopic instrument therethrough.

Abstract: An access system includes a proximal handle, an overtube coupled to the handle, and an endoscope port extending through handle and overtube sized for receiving an endoscope therethrough. The overtube includes anatomic wall securing system that secures a distal portion of the overtube within a hole in the anatomic wall. The overtube is provided with a shaped distal portion or a controllably shapeable distal portion that aids in directing an endoscope inserted through the port to a particular location within the peritoneal cavity. The access system includes a system for insufflating/deflating the peritoneal space separately from the body cavity accessible via a natural orifice. The access system includes a closure system to cinch closed the hole made in the anatomical wall after the access system has been removed from the hole. Methods are provided for inserting the access system through the anatomical wall to perform intra-abdominal surgery.

Abstract: A variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive devices do not autonomously change shape, but instead react within the stomach to induce satiety. The devices may take up volume within the stomach, thus reducing the intake capacity. Additionally, the devices may contact areas within the stomach, such as the cardia surrounding the esophageal sphincter, or the greater and lesser curvatures in the middle of the stomach, to stimulate satiety-inducing nerves. Some devices may 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.

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: 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 variety of passive intragastric implant devices for obesity treatment are disclosed. Such passive devices do not autonomously change shape, but instead react within the stomach to induce satiety. The devices may take up volume within the stomach, thus reducing the intake capacity. Additionally, the devices may contact areas within the stomach, such as the cardia surrounding the esophageal sphincter, or the greater and lesser curvatures in the middle of the stomach, to stimulate satiety-inducing nerves. Some devices may 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.

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: Intragastric fluid transfer devices and related methods for operation thereof are disclosed. The intragastric fluid transfer devices and related methods are intended to assist a patient in maintaining a healthy body weight by stimulating the inner stomach walls and/or the inner duodenum walls. Features of the intragastric fluid transfer device include insertion of the devices transorally and without invasive surgery, without associated patient risks of invasive surgery, and without substantial patient discomfort. The life span of these intragastric fluid transfer devices may be material-dependent upon long-term survivability within an acidic stomach, but is intended to last one year or longer.

Abstract: Generally described herein are apparatus, systems and methods related to a novel esophageal device implantable in the patient's body and designed to replicate the restrictive and satiety mechanism associated with gastric banding systems known in the art. The device can be a compliant and tubular-shaped and fixated within the gastro-esophageal lumen using tissue anchors.