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 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 multi-instrument access device includes a base positionable within a percutaneous opening formed in a body. Ports are positioned on the base for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having steerable distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

Abstract: A medical device includes a tissue dissector and a snare loop on a common shaft. At least the distal tip of the snare loop is energizable to function as an electrosurgical element for tissue dissection. In use the snare loop is partially extended from the shaft to expose the electrosurgical element for electrosurgical dissection, and the snare loop is fully extended from the shaft to deploy the snare loop for retrieval and positioning of an implant such as a gastric banding device. The snare loop may be deployed through a pair of jaws also mounted on the shaft for use in tissue dissection.

Abstract: A system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

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 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 system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable using pivotable frame members to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

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 system for inducing weight loss in a patient, which comprises an extragastric space occupier positionable in contact with an exterior surface of a stomach wall to form an inward protrusion of wall into the stomach, and a retention device positionable in contact with the wall to retain the inward protrusion and to thereby capture the extragastric space occupier within the protrusion.

Abstract: Described herein is a system for inducing weight loss in a patient, which comprises an extragastric space occupier positionable in contact with an exterior surface of a stomach wall to form an inward protrusion of wall into the stomach, and a retention device positionable in contact with the wall to retain the inward protrusion and to thereby capture the extragastric space occupier within the protrusion.

Abstract: A prosthetic device is described that is positionable within the gastro-esophageal junction region of a patient. The prosthetic device includes a proximal opening and a distal orifice that is adjustable in size prior to and/or following implantation. During use, the prosthetic device is attached to tissue of the gastro-esophageal junction region of the patient, with the device positioned such that food ingested by the patient passes from the esophagus through the proximal opening into the interior of the prosthetic device, and eventually exits the prosthetic device via the distal opening.

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 prosthetic device is described that is positionable within the gastro-esophageal junction region of a patient. The prosthetic device includes a proximal opening and a distal orifice that is adjustable in size prior to and/or following implantation. During use, the prosthetic device is attached to tissue of the gastro-esophageal junction region of the patient, with the device positioned such that food ingested by the patient passes from the esophagus through the proximal opening into the interior of the prosthetic device, and eventually exits the prosthetic device via the distal opening.

Abstract: A multi-instrument access device includes a base positionable within an opening (e.g. an incision or puncture) formed in a body wall and a dome-shaped seal on the base and positioned such that it is disposed outside the body wall during use. A plurality of instrument ports extend proximally from the seal for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having pre-curved distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

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 system for minimally invasive medical procedures includes an elongate tubular access cannula comprising an elongate tubular member having a rigid proximal portion and an articulating portion. The tubular member has a first branch and a tubular bifurcation extending from the first branch, allowing simultaneous use of multiple instruments. A dissector suitable for use with the access cannula, or other access devices, for implantation of gastric bands or for other procedures includes a pre-curved distal portion having a dissection element such as a monopolar RF conductor and/or a dissection balloon, as well as a snare. In one method, the dissector is advanced around the posterior side of the stomach to form a tunnel in the connective tissue, and the snare is then extended from the dissector to engage a portion of the band and withdraw it through the tunnel.

Abstract: A device for treating GERD includes a pair of sections. Each section includes a proximal end portion with an arcuate interior opening, a distal end portion with an arcuate interior opening, an exterior plate portion, and a tapered body portion extending from the proximal end portion to the distal end portion. The pair of sections surround the esophagus at the gastro-esophageal junction thereof and to be secured together to form a tubular housing with a proximal orifice, a distal orifice smaller than the proximal orifice, and a plate adjacent the distal orifice. A portion of the housing adjacent the distal orifice is configured to elastically deform to constrict the esophagus and serve the function of the LES when a force is applied to the plate by the fundus. The proximal end portion of each mating section includes a flange portion configured to be attached to a body cavity wall.

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). A patch may be positioned between tissue layers forming the plication so as to reinforce the tissue adhesion forming between the tissue layers.

Abstract: A gastric implant system includes a gastric implant such as a restrictive pouch or a gastric balloon, an anchor passable through the mouth and stomach and further through the stomach wall into engageable with abdominal wall tissue. When the anchor is engaged to abdominal wall tissue, the stomach wall and abdominal wall are brought into contact with one another such that a proximal portion of the anchor extends into the stomach interior while a distal portion of the anchor remains engaged to the abdominal wall. A locking element coupled to the proximal section of the anchor is used to maintain contact between the stomach wall and abdominal wall. The gastric implant is advanced through the oral cavity into the stomach and is coupled to the anchor.