Abstract: Methods and devices are provided for activating brown adipose tissue (BAT) with cooling. Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss and/or improved metabolic function. In one embodiment, a medical device is provided that activates BAT by cooling tissue having a high density of cold sensitive thermoreceptors and/or by cooling BAT depots directly, thereby increasing thermogenesis in the BAT and inducing weight loss and/or improved metabolic function through energy expenditure.

Abstract: The present invention provides a linear stapler having a multi-functional retaining pin subassembly. The linear stapler comprises a handle stem connecting an anvil to a handle, and the retaining pin subassembly is movably supported on the handle stem and comprises a connecting cover having a retaining pin extending from the connecting cover. The present invention also provides a multi-functional retaining pin subassembly. The retaining pin subassembly can achieve cartridge alignment and tissue retention during the firing of the stapler and protect tissue from unintended damage.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: An endoluminal sleeve device for internally lining a section of the GI tract, comprises a sleeve configured for deployment inside a duodenum, the sleeve having walls of a flexible material defining a sleeve lumen, a proximal end defining a proximal lumen opening, and a distal end defining a distal lumen opening, an anchoring component having a slender transport configuration and a bulky deployed configuration, wherein the anchoring component is locatable at a distance from the proximal sleeve end and connected thereto by an elongated tether.

Abstract: A method for treating a patient includes creating at least one incision to gain access to an peritoneal cavity, performing a gastric volume reduction procedure and introducing a device to prevent gastric contents from interacting with at least a portion of the duodenum.

Abstract: An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.

Abstract: A surgical instrument, such as an electrical ablation device, includes an elongate member having therealong disposed a first electrode extending along an axis. A first expandable portion extends along the axis and defines a first perimeter of the first electrode and has an associated first diameter with respect to the axis. The first expandable portion includes a first framework selectively expandable to transition the first expandable portion from a contracted state to an expanded state. The first framework is selectively contractible to transition the first expandable portion from the expanded state to the contracted state. When the first framework is expanded, the first diameter is expanded and the first expandable portion is transitioned from the contracted state to the expanded state. When the first framework is contracted, the first diameter is contracted and the first expandable portion is transitioned from the expanded state to the contracted state.

Abstract: A duodenal sleeve assembly comprises a sleeve, an expandable sealing member, a tether, and an expandable anchor. The sleeve is secured to the sealing member. The tether couples the anchor with the sealing member. A deployment instrument comprises a shaft assembly, a first retention member, and a second retention member. The first retention member selectively secures the sealing member to the shaft assembly. The second retention member selectively secures the anchor to the shaft assembly. When the first retention member is released, the sealing member expands outwardly to seal the proximal end of the sleeve against the mucosa of the patient's duodenum. When the second retention member is released, the anchor expands outwardly within the stomach to anchor the sleeve assembly relative to the stomach. The tether traverses the pylorus. The sleeve isolates chyme from enzymes in the duodenum; and the mucosa of the duodenum from nutrients in the chyme.

Abstract: Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an interior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.

Abstract: A method of creating a switch, comprising disposing a switching element movably within an interior cavity of the switch to define switch-making and switch-breaking positions along a switching axis of the switching element, disposing a biasing element about the switching element to impart a biasing force to the switching element to place the switching element in one of the switch-making and switch-breaking positions until an external force imparted to the switching element exceeds the biasing force to cause the switching element to change to the other position, disposing a biasing force-adjusting element in cooperative engagement with the biasing element such that a magnitude of the biasing force is adjustable, and coupling a conductive contact to the switching element to define a switch-making state when the switching element is in the switch-making position and a switch-breaking state when the switching element is in the switch-breaking position.

Abstract: A system for stimulating the release of satiety hormone in a subject comprises a stimulus device which is implantable in the subject and adapted to apply an electrical stimulus to a tissue of a gastrointestinal system of said subject, and a detection device which is implantable in the subject and adapted to continuously monitoring at least one of a mechanical characteristic and an electrical characteristic of the subject to detect an ingestion of food by said subject, wherein the detection device cooperates with the stimulus device such that the stimulus device applies said electrical stimulus in response to a detected ingestion of food.

Abstract: Various systems and methods for predicting metabolic and bariatric surgery outcomes are provided. The systems and methods can also provide predictions for non-surgical metabolic and bariatric treatments. In general, a user can receive predictive outcomes of multiple bariatric procedures that could be performed on a patient. In one embodiment, a user can electronically access a metabolic and bariatric surgery outcome prediction system, e.g., using one or more web pages. The system can provide predictive outcomes of one or more different bariatric surgeries for the patient based on data gathered from the user and on historical data regarding outcomes of the different bariatric surgeries. The system can additionally provide predictive outcomes for not having any treatment and/or a comparison of the predictive outcomes of the one or more different bariatric surgeries to the predictive outcomes for not having any treatment.

Abstract: A method of creating a switch, comprising disposing a switching element movably within an interior cavity of the switch to define first and second positions along a switching axis of the switching element, disposing a biasing element about the switching element to impart a biasing force to the switching element to place the switching element in one of the first and second positions until an external force imparted to the switching element exceeds the biasing force to cause the switching element to move to the other position, disposing a biasing force-adjusting element in cooperative engagement with the biasing element such that a magnitude of the biasing force is adjustable, and coupling a conductive contact to the switching element to define a first switching state when the switching element is in the first position and a second switching state when the switching element is in the second position.

Abstract: Methods and devices are provided for activating brown adipose tissue (BAT). Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss. In one embodiment, a medical device is provided that activates BAT by electrically stimulating nerves that activate the BAT and/or electrically stimulating brown adipocytes directly, thereby increasing thermogenesis in the BAT and inducing weight loss through energy expenditure.

Abstract: Methods and devices are provided for performing various procedures using interchangeable end effectors. In general, the methods and devices allow a surgeon to remotely and selectively attach various interchangeable surgical end effectors to a shaft located within a patient's body, thus allowing the surgeon to perform various procedures without the need to remove the shaft from the patient's body. In an exemplary embodiment, multiple end effectors can be introduced into a body cavity. The end effectors can be disassociated or separate from one another such that they float within the body cavity. A distal end of a shaft can be positioned within the body cavity and it can be used to selectively engage one of the end effectors. In particular, the device can be configured to allow each end effector to be remotely attached and detached from the distal end of the shaft.

Abstract: Adjunct materials for delivery to stomach tissue are provided. In general, the adjunct materials can be configured to be delivered to tissue by deployment of staples from a cartridge body of a surgical stapler. The adjunct material can have a structure effective to cause a desired reaction in the stomach tissue. The adjunct material can include an effective amount of one or more medicants disposed within and releasable from the adjunct material for delivery to the stomach tissue to encourage the desired reaction. The adjunct material can be in the form of at least one of a film and a foam that is releasably retained on the cartridge body. Methods of using a staple cartridge assembly or an end effector to apply such adjunct materials to stomach tissue are also provided.

Abstract: Methods and compositions are provided for treating weight related conditions and metabolic disorders by altering microbiota in a subject. One aspect provides methods and compositions to alter microbiota in a subject by administering to the subject a composition that includes a substantially purified microbiota from phyla such as Bacteroidetes, Proteobacteria, Firmicutes and Verrucomicrobia or orders such as Bacteroidales, Verrucomicrobiales, Clostridiales and Enterobacteriales or genera such as Alistipes, Clostridium, Escherichia, and Akkermansia. Another aspect includes a pharmaceutical composition for altering microbiota that includes a therapeutically effective amount of substantially purified microbiota and a pharmaceutically acceptable carrier. Yet another aspect includes methods for treating a disorder, such as obesity, in a subject in need of such treatment by changing relative abundance of microbiota in a gastrointestinal tract of the subject without or in addition to a surgical procedure.

Abstract: Various exemplary methods, systems, and devices for initializing a surgical tool are provided. In general, a surgical tool can include an end effector, an elongate shaft, and a wrist that couples the end effector to a distal end of the shaft. The wrist can be configured to facilitate movement of the end effector relative to the shaft. The surgical tool can include multiple flexible members configured to move, either individually or as a group including any plural number of the flexible members, to cause the movement of the end effector relative to the shaft by pivoting at the wrist. The movement of the end effector can include movement between an unarticulated position and an articulated position. The surgical tool can also include one or more homing members configured to be selectively actuated to force the end effector into the unarticulated position.

Abstract: Methods and compositions are provided for treating weight related conditions and metabolic disorders by altering microbiota in a subject. One aspect provides methods and compositions to alter microbiota in a subject by administering to the subject a composition that includes a substantially purified microbiota from phyla such as Bacteroidetes, Proteobacteria, Firmicutes and Verrucomicrobia or orders such as Bacteroidales, Verrucomicrobiales, Clostridiales and Enterobacteriales or genera such as Alistipes, Clostridium, Escherichia, and Akkermansia. Another aspect includes a pharmaceutical composition for altering microbiota that includes a therapeutically effective amount of substantially purified microbiota and a pharmaceutically acceptable carrier. Yet another aspect includes methods for treating a disorder, such as obesity, in a subject in need of such treatment by changing relative abundance of microbiota in a gastrointestinal tract of the subject without or in addition to a surgical procedure.

Abstract: Methods and devices are provided for activating brown adipose tissue with targeted substance delivery. Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss and/or improved metabolic function. In one embodiment, a chemical configured to stimulate nerves that activate the BAT and/or to stimulate brown adipocytes directly can be delivered to a patient, thereby increasing thermogenesis in the BAT and inducing weight loss and/or improved metabolic function through energy expenditure. The chemical can be delivered to the patient locally and/or systemically to stimulate the nerves and/or the brown adipocytes.