Endoscope and endoscopic suturing instrument for treatment of gastroesophageal reflux disease

Abstract

The holding device of the endoscope allows suspension of the tissue while it is held and fixed securely. Use of the holding device with large distal ends will not damage tissue and allows holding and suspension of a large area. A needle pierces at least the proper muscularis, thereby forming a large protrusion including the proper muscularis of the stomach and the esophagus as artificial valve to prevent reflux effectively. The holding device, formed extending out of the distal end of the endoscope, can touch the tissue easily under observation of the endoscope. Treatment is simple, and takes a shorter time.

1 . An apparatus for forming an artificial valve to treat gastroesophageal reflux disease, comprising: 
 a sheath which is adapted to be orally inserted into a body cavity, and which has having proximal and distal sections and a lumen extending therethrough;    an endoscope which has an observation system, and which is adapted to be orally inserted into a body cavity and is slidably positioned within said sheath;    a holding device extending from said sheath, the holding device comprising a distal end portion adapted to hold a point of a digestive wall of the body cavity where the artificial valve is to be formed;    a first needle which is provided outside of the endoscope and is not mechanically connected to said holding device, and which is moveable outside of the endoscope along a lengthwise direction of the first needle relative to the endoscope for penetrating the digestive wall; and    a binding member adapted to pass through the digestive wall following said first needle.    
     
     
         2 . The apparatus according to  claim 1 , wherein the first needle has a hollow space disposed therein for engaging said binding member.  
     
     
         3 . The apparatus according to  claim 1 , wherein said holding device is adapted to hold a junction of a stomach and an esophagus, and the first needle is adapted to be positioned at an oral side of the junction.  
     
     
         4 . The apparatus according to  claim 1 , further comprising a second needle assembly which is provided outside of the endoscope and is not mechanically connected to said holding device, wherein said second needle is spaced apart from said first needle by a fixed distance and is arranged substantially in parallel with the first needle.  
     
     
         5 . The apparatus according to  claim 4 , wherein the second needle has a hollow space disposed therein for engaging said binding member.  
     
     
         6 . The apparatus according to  claim 4 , wherein said holding device is adapted to hold a junction of a stomach and an esophagus, and the second needle is adapted to be positioned at an oral side of the junction.  
     
     
         7 . An apparatus for forming an artificial valve to treat gastroesophageal reflux disease, comprising: 
 a sheath which is adapted to be orally inserted into a body cavity, and which has proximal and distal sections and a lumen extending therethrough:    an endoscope which has an observation system, and which is adapted to be orally inserted into a body cavity and to be slidably positioned within said sheath:    a holding device extending from said sheath, the holding device comprising a distal end portion adapted to hold a point of a digestive wall of the body cavity where the artificial valve is to be formed;    a first needle which is provided outside of the endoscope and is not mechanically connected to said holding device, and which is moveable outside of the endoscope along a lengthwise direction of the first needle relative to the endoscope for penetrating the digestive wall; and    a tissue fastener adapted to pass through the digestive wall following said first needle.    
     
     
         8 . The apparatus according to  claim 7 , wherein the first needle has a hollow space disposed therein for engaging said binding member.  
     
     
         9 . The apparatus according to  claim 7 , wherein said holding device is adapted to hold a junction of a stomach and an esophagus, and the first needle is adapted to be positioned at an oral side of the junction.  
     
     
         10 . The apparatus according to  claim 7 , further comprising a second needle assembly which is provided outside of the endoscope and is not mechanically connected to said holding device, wherein said second needle is spaced apart from said first needle by a fixed distance and is arranged substantially in parallel with the first needle.  
     
     
         11 . The apparatus according to  claim 10 , wherein the second needle has a hollow space disposed therein for engaging said binding member.  
     
     
         12 . The apparatus according to  claim 10 , wherein said holding device is adapted to hold a junction of a stomach and an esophagus, and the second needle is adapted to be positioned at an oral side of the junction.