Transesophageal gastric reduction device, system and method

Abstract

A gastric reduction system and method provides for transesophageal formation of a gastric reduction pouch of the stomach. The system includes an expandable structure which may be placed in a stomach and expanded to occupy a fractional volume of the stomach. An evacuator is then fed through the expandable structure and utilized to deflate the stomach and draw the stomach to and around the expandable structure to form the gastric reduction pouch. A self-deploying fastener is then deployed to maintain the gastric reduction pouch.

1 . A gastric reduction device comprising: 
 an expandable structure, placeable in a stomach, the expandable structure, when expanded, occupying a portion of the stomach; and    an evacuator that deflates the stomach around the expandable structure to form a gastric reduction pouch.    
     
     
         2 . The device of  claim 1  wherein the expandable structure is placeable in the stomach immediately adjacent and distal to an esophageal orifice associated with the stomach.  
     
     
         3 . The device of  claim 1  wherein the expandable structure comprises a balloon.  
     
     
         4 . The device of  claim 1  wherein the expandable structure is an inflatable structure.  
     
     
         5 . The device of  claim 4  wherein the inflatable structure is a compliant balloon.  
     
     
         6 . The device of  claim 4  wherein the inflatable structure is a non-compliant balloon.  
     
     
         7 . The device of  claim 1  wherein the evacuator extends distally from the expandable member and terminates within the stomach.  
     
     
         8 . The device of  claim 1  further comprising a fastener that maintains the gastric reduction pouch.  
     
     
         9 . The device of  claim 8  wherein the fastener inwardly folds stomach tissue to fasten serosa tissue to serosa tissue of the stomach.  
     
     
         10 . The device of  claim 8  wherein the fastener comprises a cylindrically shaped member having opposed ends and tissue engaging arms radially extending from each of the opposed ends.  
     
     
         11 . The device of  claim 1  further comprising an endoscope that extends through the expandable member.  
     
     
         12 . The device of  claim 1  wherein the expandable member forms a spherically shaped ring when expanded.  
     
     
         13 . The device of  claim 12  wherein the spherically shaped ring includes an axial passageway and wherein the evacuator extends through the passageway.  
     
     
         14 . A gastric reduction system, comprising: 
 an expandable structure, placeable in a stomach and, when expanded, occupying a fractional volume of the stomach;    an evacuator that deflates the stomach and draws the stomach to and around the expandable structure to form a gastric reduction pouch with stomach tissue; and    a fastener that is operable to maintain the gastric reduction pouch.    
     
     
         15 . The system of  claim 14  wherein the expandable structure is placeable in the stomach immediately adjacent and distal to an esophageal orifice associated with the stomach.  
     
     
         16 . The system of  claim 14  wherein the expandable structure comprises a balloon.  
     
     
         17 . The device of  claim 14  wherein the expandable structure is an inflatable structure.  
     
     
         18 . The device of  claim 17  wherein the inflatable structure is a compliant balloon.  
     
     
         19 . The device of  claim 17  wherein the inflatable structure is a non-compliant balloon.  
     
     
         20 . The system of  claim 14  wherein the evacuator extends distally from the expandable member and terminates within the stomach.  
     
     
         21 . The system of  claim 14  wherein the fastener inwardly folds stomach tissue to fasten serosa tissue to serosa tissue of the stomach.  
     
     
         22 . The system of  claim 21  wherein the fastener comprises a cylindrically shaped member having opposed ends and tissue engaging arms radially extending from each of the opposed ends.  
     
     
         23 . The system of  claim 21  wherein the fastener is carried by the evacuator.  
     
     
         24 . The system of  claim 14  further comprising an endoscope that extends through the expandable member.  
     
     
         25 . The system of  claim 14  wherein the expandable member forms a spherically shaped ring when expanded.  
     
     
         26 . The system of  claim 25  wherein the spherically shaped ring includes an axial passageway and wherein the evacuator extends through the passageway.  
     
     
         27 . A method comprising: 
 positioning an expandable structure in a stomach of a patient;    expanding the expandable structure to occupy a portion of the stomach; and    drawing the stomach around the expanded expandable structure to form a gastric reduction pouch.    
     
     
         28 . The method of  claim 27  wherein the positioning step includes placing the expandable structure immediately distal to an esophageal orifice associated with the stomach.  
     
     
         29 . The method of  claim 27  wherein the expandable structure comprises a balloon and wherein the expanding step includes inflating the balloon.  
     
     
         30 . The method of  claim 27  wherein the deflating step includes evacuating the stomach.  
     
     
         31 . The method of  claim 27  wherein the deflating step includes feeding an evacuator into the stomach and evacuating the stomach.  
     
     
         32 . The method of  claim 27  including the further step of maintaining the gastric reduction pouch.  
     
     
         33 . The method of  claim 32  wherein the maintaining step includes inwardly folding stomach tissue to contact serosa tissue to serosa tissue to form a stomach.  
     
     
         34 . The method of  claim 33  wherein the maintaining step further includes fastening the inwardly folded stomach tissue together.