Abstract: A modular system for therapy within a gastrointestinal system. The system includes anchoring or attachment functionality embodied in a low-profile implant technology and removable therapy components, which can be reversibly attached to these low-profile implants to accomplish various therapies. This modular design allows the physician to tailor the therapy to the patient's needs. The modular system has the potential to create conduits for diversion and/or restriction of food and organ secretions and to facilitate the treatment of metabolic disorders such as obesity and T2DM.

Abstract: A retrieval device comprising a hook assembly and a capsule assembly. The hook assembly has an attachment feature at a first end. The capsule assembly includes a capsule, a capsule shaft, and a handle connected in series and defining an inner bore. The capsule has a first end defining an opening. The inner bore of the capsule assembly is configured to slidably receive the hook assembly. The handle has a central portion, a first extension portion attached to the capsule shaft, and a second extension portion with a hook assembly lock at a second end. The hook assembly lock is configured to lock the hook assembly to the second extension portion. The second extension portion is configured to pull the hook assembly relative to the capsule shaft, and the first extension portion is configured to push the capsule shaft relative to the hook assembly along the central longitudinal axis.

Abstract: A gastrointestinal device for implanting within a patient's gastrointestinal tract, the device having a central axis and a first expandable portion comprising a hollow tubular braided structure of wire and having a first cylinder extending parallel to the central axis, the first cylinder having a length and a first face; a neck portion extending from the first face of the first expandable portion parallel to the central axis, the neck portion having a first end, a second end, a wall extending between the first end and second end, and a diameter sized to fit within a pylorus; and a second expandable portion comprising a hollow tubular braided structure of wire and having a second cylinder extending parallel to the central axis, the second cylinder having a second face located at the proximal end of the second cylinder and oriented transverse to the central axis.

Abstract: An internal tissue puncture closure method and apparatus. The method and apparatus provide a folded sealing plug that provides more surface area than conventional plugs to more fully cover and seal an external situs of an internal tissue puncture. The folded sealing plug may have a weave pattern that tends to cause the sealing plug to corkscrew into the internal tissue puncture as it is compressed toward an anchor placed inside of the tissue puncture.

Abstract: A gastrointestinal device for implanting within a patient's gastrointestinal tract, the device having a central axis and a first expandable portion comprising a hollow tubular braided structure of wire and having a first cylinder extending parallel to the central axis, the first cylinder having a length and a first face; a neck portion extending from the first face of the first expandable portion parallel to the central axis, the neck portion having a first end, a second end, a wall extending between the first end and second end, and a diameter sized to fit within a pylorus; and a second expandable portion comprising a hollow tubular braided structure of wire and having a second cylinder extending parallel to the central axis, the second cylinder having a second face located at the proximal end of the second cylinder and oriented transverse to the central axis.

Abstract: A gastrointestinal device for implanting within a pylorus, a duodenal bulb, and a duodenum of a patient's gastrointestinal tract includes an expandable structure includes a proximal portion having a plurality of spring arms and a distal portion having a plurality of spring arms, the proximal and distal portions coupled by a rigid central cylinder having a diameter capable of fitting within the pylorus and having a length greater than a width of the pylorus. A membrane is coupled to and covering at least a portion of one of the proximal portion and the distal portion of the expandable structure. An intestinal bypass sleeve is coupled to at least one of the proximal and distal portions of the expandable structure and having a length sufficient to extend at least partially into the duodenum.

Abstract: An electrode catheter and a method for assessing electrode-tissue contact and coupling are disclosed. An exemplary electrode catheter comprises an electrode adapted to apply electrical energy. A measurement circuit is adapted to measure impedance between the electrode and ground as the electrode approaches a target tissue. A processor determines a contact and coupling condition for the target tissue based at least in part on reactance of the impedance measured by the measurement circuit. In another exemplary embodiment, the electrode catheter determines the contact and coupling condition based at least in part on a phase angle of the impedance.

Abstract: Several gastrointestinal surgery procedures are effective as treatments for metabolic disorders such as obesity and diabetes. Minimally invasive procedures including intra-luminal gastrointestinal implants have been proposed to mimic the anatomical, physiological and metabolic changes achieved by these procedures. Many of these designs include long sleeve like elements that prevent contact of food with the walls of the small intestine. It is desirable to have simple delivery systems that can place these implants under endoscopic guidance. However, in order to anchor these sleeve elements safely and reliably, the inventors have previously disclosed anchoring means that anchor the sleeves at the junctions of the stomach and the intestine or the stomach and esophagus.

Abstract: A gastrointestinal device for implanting within a pylorus, a duodenal bulb, and a duodenum of a patient's gastrointestinal tract includes an expandable structure including a proximal portion having a plurality of spring arms and a distal portion having a plurality of spring arms, the proximal and distal portions coupled by a rigid central cylinder having a diameter capable of fitting within the pylorus and having a length greater than a width of the pylorus. An intestinal bypass sleeve is coupled to at least one of the proximal and distal portions of the expandable structure and having a length sufficient to extend at least partially into the duodenum. In the expanded configuration, the proximal portion has a diameter larger than a maximum opening diameter of the pylorus and further wherein, in the expanded configuration, the distal portion has a diameter larger than a maximum opening diameter of the pylorus.

Abstract: Several gastrointestinal surgery procedures are effective as treatments for metabolic disorders such as obesity and diabetes. Minimally invasive procedures including intra-luminal gastrointestinal implants have been proposed to mimic the anatomical, physiological and metabolic changes achieved by these procedures. Many of these designs include long sleeve like elements that prevent contact of food with the walls of the small intestine. It is desirable to have simple delivery systems that can place these implants under endoscopic guidance. However, in order to anchor these sleeve elements safely and reliably, the inventors have previously disclosed anchoring means that anchor the sleeves at the junctions of the stomach and the intestine or the stomach and esophagus.

Abstract: An internal tissue puncture closure method and apparatus. The method and apparatus provide a folded sealing plug that provides more surface area than conventional plugs to more fully cover and seal an external situs of an internal tissue puncture. The folded sealing plug may have a weave pattern that tends to cause the sealing plug to corkscrew into the internal tissue puncture as it is compressed toward an anchor placed inside of the tissue puncture.

Abstract: A system for therapy within a gastrointestinal system includes anchoring or attachment functionality embodied in a low-profile implant technology and removable therapy components, which can be reversibly attached to these low-profile implants to accomplish various therapies. This design allows the physician to tailor the therapy to the patient's needs. The system has the potential to create conduits for diversion and/or restriction of food and organ secretions and to facilitate the treatment of metabolic disorders such as obesity and T2DM.

Abstract: An internal tissue puncture closure method and apparatus. The method and apparatus provide a folded sealing plug that provides more surface area than conventional plugs to more fully cover and seal an external situs of an internal tissue puncture. The folded sealing plug may have a weave pattern that tends to cause the sealing plug to corkscrew into the internal tissue puncture as it is compressed toward an anchor placed inside of the tissue puncture.

Abstract: The present invention describes apparatus and methods for tying a filament across subcutaneous punctures. According to some embodiments, the apparatus and methods provide pre-tied knots that are inserted into a bodily lumen. Needles flanking the subcutaneous puncture are inserted into the lumen and grab the pre-tied knots. The pre-tied knots are pulled through tiny holes flanking the subcutaneous puncture by the needles, leaving an internal length of the filament across the subcutaneous puncture. The filament is then externally tied, closing the subcutaneous puncture.

Abstract: A system of components may be used separately or in combination to create partial bypass of food, stomach and intestinal secretions and digestive enzymes. The systems are designed to be modular so as to allow the physicians to quickly replace certain elements to tailor the amount of material bypassed, the restriction applied to food passage, and the origin and destination of bypass according to the patient's individualized clinical needs.

Abstract: A vascular closure delivery system is provided comprising a needle and suture delivery unit and a suture knot system. The delivery unit may comprise a tube, a leg, a tensioning device, a pusher, a needle, and an actuator, the tube being configured to house the needle. In an open position, the tensioning device exerts tension on the leg, and the pusher and suturing apparatus are in a delivery configuration for delivering the needle to the internal tissue wall. Further, actuation of the actuator moves the pusher towards an expulsion end of the tube such that the pusher engages the needle and expels the needle from the tube. The suture knot system comprises a shaft, an inner tubular member, and an inner rod. The inner tubular member is radially translatable with respect to the shaft. The inner rod is slidably coupled to and is axially translatable within the inner tubular member.

Abstract: A system for therapy within a gastrointestinal system includes anchoring or attachment functionality embodied in a low-profile implant technology and removable therapy components, which can be reversibly attached to these low-profile implants to accomplish various therapies. This design allows the physician to tailor the therapy to the patient's needs. The system has the potential to create conduits for diversion and/or restriction of food and organ secretions and to facilitate the treatment of metabolic disorders such as obesity and T2DM.

Abstract: Described is a system for affecting intestinal microbial flora. The system includes an intestinal sleeve that is implanted in a patient and bypasses a section of the intestine; and probiotics, prebiotics or pharmacologic therapy used in combination with the intestinal sleeve. Also described are related methods.

Abstract: Components may be used separately or in combination to create anchoring systems for intra-luminal implants for the treatment of metabolic disorders such as obesity and diabetes. Various systems include an external component adapted for deployment around a portion of the gastrointestinal tract (e.g., the duodenum) and an internal component adapted for implantation within the gastrointestinal tract. Various systems use anchoring means that are based on mechanical interference, elasticity, spring force, shape memory transformation, magnetic attraction, repulsion and/or levitation. Various embodiments rely on longitudinal anchoring of the implants with minimal force against tissue.

Abstract: An ablation catheter is provided for ablating internal tissue of a patient. The catheter includes a distal end that is adapted to be inserted into a body cavity relative to a desired location therein (e.g., within the heart). An ablation electrode is connected relative to the distal end of the catheter for providing ablation energy to patient tissue. A heat sink is provided that is in thermal contact with the ablation electrode. The heat sink, in addition to being in thermal contact with the ablation electrode, is electrically isolated from the ablation electrode. This allows the heat sink to conduct heat away from the ablation electrode without dissipating electrical energy from the electrode. In this regard, the heat sink may prevent build-up of excess heat within the electrode that may result in blood coagulation and/or tissue charring.