Abstract: Described herein is a positioning tool having an elongate portion for carrying a medical implant. Also described is a method of positioning a medical implant using an elongate positioning tool. One form of the method includes positioning a medical implant on a distal portion of an elongate positioning tool, inserting the positioning tool with the implant thereon into a body cavity manipulating the positioning tool to position the implant into contact with tissue at an attachment location, attaching the implant to surrounding tissue at the attachment location, separating the implant from the positioning tool, and withdrawing the positioning tool from the body. In a preferred embodiment, the position of the implant is visually confirmed using an endoscope before the implant is attached to surrounding tissue. In one embodiment, the implant is a satiation device and the body cavity is the esophagus and/or stomach.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: A device for inducing weight loss in a patient includes a tubular prosthesis self-expandable from a collapsed position in which the prosthesis has a first diameter to an expanded position in which the prosthesis has a second, larger, diameter. In a method for inducing weight loss, the prosthesis is placed in the collapsed position and inserted into a stomach of a patient. The prosthesis is allowed to self-expand from the collapsed position to the expanded position and into contact with the walls of the stomach, where it induces feelings of satiety and/or inhibits modulation of satiety-controlling factors such as Ghrelin.

Abstract: Various methods and devices are described for retaining a medical implant within a body cavity. According to one aspect, one or more plications are formed and the medical device is coupled to or seated against the plication(s).

Abstract: Described herein is a positioning tool having an elongate portion for carrying a medical implant. Also described is a method of positioning a medical implant using an elongate positioning tool. One form of the method includes positioning a medical implant on a distal portion of an elongate positioning tool, inserting the positioning tool with the implant thereon into a body cavity manipulating the positioning tool to position the implant into contact with tissue at an attachment location, attaching the implant to surrounding tissue at the attachment location, separating the implant from the positioning tool, and withdrawing the positioning tool from the body. In a preferred embodiment, the position of the implant is visually confirmed using an endoscope before the implant is attached to surrounding tissue. In one embodiment, the implant is a satiation device and the body cavity is the esophagus and/or stomach.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: A neuromodulation system for treating acute heart failure syndromes includes a first catheter having a parasympathetic therapy element adapted for positioning within a first blood vessel such as a superior vena cava, and a second catheter sympathetic therapy element adapted for positioning with a second, different, blood vessel such as the pulmonary artery. The catheters comprise a system in which one of catheters is slidably disposed over the other of the catheters. The system may further be slidably disposed over a third elongate element such as a Swan-Ganz catheter positionable within a pulmonary artery, such that the Swan-Ganz may be used for monitoring parameters such as blood pressure and cardiac output during neuromodulation therapy.

Abstract: A device for inducing weight loss in a patient includes a tubular prosthesis positionable at the gastro-esophageal junction region, preferably below the z-line. In a method for inducing weight loss, the prosthesis is placed such that an opening at its proximal end receives masticated food from the esophagus, and such that the masticated food passes through the pouch and into the stomach via an opening in its distal end.

Abstract: A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed in a superior vena cava of the patient to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element disposed within the superior vena cava to deliver therapy to a sympathetic cardiac nerve fiber. A neuromodulation system includes a parasympathetic therapy element adapted for positioning within a blood vessel, a sympathetic therapy element adapted for positioning within the blood vessel; and a stimulator to energize the parasympathetic therapy element to deliver parasympathetic therapy to a parasympathetic nerve fiber disposed external to the blood vessel and energize the sympathetic therapy element within the blood vessel to deliver sympathetic therapy to a sympathetic nerve fiber disposed external to the blood vessel. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient.

Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port in a body cavity includes a pair of steerable tool cannulas extending from a rigid tube that is supported by an operating room fixture. The rigid tube is extendable through an incision to position distal ends of the rigid tube and tool cannulas within a body cavity. Each tool cannula has a lumen for receiving a corresponding surgical instrument so that an end effector of the each instrument may be used within the body cavity. Control devices are operatively associated with each tool cannula and include ports for receiving the surgical instruments. User manipulation of the handles of the surgical instruments results in steering of the tool cannulas, and thus the surgical instruments, within the body cavity.

Abstract: A device for inducing weight loss in a patient includes a tubular prosthesis positionable at the gastro-esophageal junction region, preferably below the z-line. In a method for inducing weight loss, the prosthesis is placed such that an opening at its proximal end receives masticated food from the esophagus, and such that the masticated food passes through the pouch and into the stomach via an opening in its distal end.

Abstract: An intravascular electrode system includes an expandable anchor and a flexible substrate which carries at least one electrode. The anchor is positioned in a blood vessel and expanded to an expanded position to bias the electrode in contact with the vessel wall. The flexible substrate may be longitudinally withdrawn from its position between the anchor and the vessel wall without removing the anchor from the blood vessel. A second flexible substrate may be longitudinally inserted into position between the anchor and vessel wall as replacement for the first substrate.

Abstract: A method for controlling appetite by means of a satiation device is disclosed. The device, which includes a flexible webbing defining proximal and distal openings and a biasing structure, is attached to the patient's stomach with the proximal opening positioned adjacent and below the patient's gastro-esophageal junction. The biasing structure imparts pressure against the wall of the patient's stomach adjacent the gastro-esophageal junction.

Abstract: A device for accessing the intra-thoracic space without the need for a thoracotomy or sternotomy includes a cannula having a shaft positionable through a supra-sternal incision into a retrosternal space and a stabilization system for supporting the cannula in a fixed position. The cannula includes illumination features used to illuminate the retrosternal space, giving clear, direct visualization of the retrosternal space during dissection to, and performance of procedures at, the surgical site.

Abstract: A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element to deliver therapy to a sympathetic cardiac nerve fiber. At least one of the therapeutic elements is disposed in the vasculature superior to the heart. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient.

Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port into a body cavity includes a rigid tube carried by a mount. Cannulas having instrument channels and steerable distal ends extend distally from the rigid tube. During a procedure using the system, the mount is supported by an operating room fixture, and instruments are advanced through the steerable instrument channels. Manipulation of the instrument handles engages actuators positioned on the mount, which steer the distal ends of the cannulas through the action of pull cables. The distal ends of the instruments may thus be steered within the body by the distal ends of the steerable cannulas.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: Described herein is a positioning tool having an elongate portion for carrying a medical implant. Also described is a method of positioning a medical implant using an elongate positioning tool. One form of the method includes positioning a medical implant on a distal portion of an elongate positioning tool, inserting the positioning tool with the implant thereon into a body cavity manipulating the positioning tool to position the implant into contact with tissue at an attachment location, attaching the implant to surrounding tissue at the attachment location, separating the implant from the positioning tool, and withdrawing the positioning tool from the body. In a preferred embodiment, the position of the implant is visually confirmed using an endoscope before the implant is attached to surrounding tissue. In one embodiment, the implant is a satiation device and the body cavity is the esophagus and/or stomach.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: Various methods and devices are described for retaining a medical implant within a body cavity. According to one aspect, at least a portion of a medical implant is positioned within a body cavity, and a wall of the body cavity is re-shaped such that the re-shaped wall prevents migration of the medical implant out of the body cavity. The re-shaped body wall may form a tissue pocket, tunnel, or other barrier against migration of the implant.