Gastric therapy system and method for suturing gastric wall

Abstract

This gastric therapy system includes a loop-forming member that forms a loop along a lesser-curvature-line and a greater-curvature-line in a stomach; a guide member that introduces the loop-forming member into the stomach; and a therapy section that cerclages a part of the gastric wall after looping the loop-forming member.

1 . A gastric therapy system, comprising:
 a loop-forming member, perorally inserted in a stomach, for forming a loop along a lesser-curvature-line and a greater-curvature-line in the stomach;   a guide member for introducing the loop-forming member into the stomach; and   a therapy section for cerclaging a part of a gastric wall after looping the loop-forming member.   
   
   
       2 . The gastric therapy system according to  claim 1 , wherein
 the loop-forming member is an insertion section of an endoscope,   the guide member is included in an overtube, and   the therapy section is attached to the insertion section.   
   
   
       3 . The gastric therapy system according to  claim 1 , wherein
 the loop-forming member and the guide member are included in the overtube and   the therapy section is attached to the distal end of the overtube.   
   
   
       4 . The gastric therapy system according to  claim 1 , wherein
 the loop-forming member is included in an overtube, and   the loop-forming member having elasticity is an elongated rod capable of being inserted through the overtube.   
   
   
       5 . The gastric therapy system according to  claim 1 , wherein
 the loop-forming member has elasticity and is elongate, and   the therapy section is attached to the distal end of the loop-forming member.   
   
   
       6 . The gastric therapy system according to  claim 1 , wherein the therapy section is a cerclage instrument that comprises:
 a cylindrical main unit;   a pair of holes, formed on the main unit, that are capable of retracting the gastric wall;   a tissue-dissecting instrument for dissecting a mucosa of the gastric wall that is retracted into the main unit from the pair of holes; and   a tissue-cerclage instrument for cerclaging two-dissected gastric walls in which the mucosa have been dissected.   
   
   
       7 . The gastric therapy system according to  claim 6 , wherein the therapy section further comprises:
 a pair of first gastric-wall-fixing sections for fixing the two gastric walls that are retracted into the main unit from the pair of holes; and   a pair of second gastric-wall-fixing sections for fixing the two gastric walls that underwent the dissection of the mucosa by the tissue-dissecting instrument, and wherein   the tissue-dissecting instrument dissects the mucosa of the gastric walls each fixed to the pair of first gastric-wall-fixing sections, and   the tissue-cerclage instrument cerelages the gastric wall fixed to one of the second gastric-wall-fixing sections to the gastric wall fixed to the other one of the second gastric-wall-fixing section.   
   
   
       8 . The gastric therapy system according to  claim 1 , further comprising a link apparatus for connecting the therapy section to the loop-forming member or the guide member when the loop-forming member forms a loop in the stomach. 
   
   
       9 . A gastric therapy system comprising an arc member, wherein
 the arc member is inserted into a stomach perorally,   the arc member is disposed along a lesser-curvature-line and a greater-curvature-line in the stomach, and   the arc member imparts a substantially uniform tension to an anterior wall and a posterior wall of the stomach.   
   
   
       10 . A cerclage instrument being inserted into a stomach perorally for cerclaging a gastric wall in the stomach, the cerclage instrument comprising:
 a cylindrical main unit;   a pair of holes formed on the main unit that are capable of retracting the gastric wall;   a tissue-dissecting instrument for dissecting a mucosa of the gastric wall retracted into the main unit from the pair of holes; and   a tissue-cerclage instrument for cerclaging the two gastric walls in which the mucosa have been dissected.   
   
   
       11 . The cerclage instrument according to  claim 10 , further comprising:
 a pair of first gastric-wall-fixing sections for fixing the two gastric walls that are retracted into the main unit from the pair of holes; and   a pair of second gastric-wall-fixing sections for fixing the two gastric walls that underwent the dissection of the mucosa by the tissue-dissecting instrument, wherein   the tissue-dissecting instrument dissects the mucosa of the gastric walls each fixed to the pair of first gastric-wall-fixing sections, and   the tissue-cerclage instrument cerclages the gastric wall fixed to one of the second gastric-wall-fixing sections to the gastric wall fixed to the other one of the second gastric-wall-fixing section.   
   
   
       12 . The cerelage instrument according to  claim 11 , wherein the first gastric-wall-fixing section is disposed inwardly in the main unit relative to the position of the tissue-dissecting instrument by the thickness of the mucosa of the gastric wall retracted into the main unit. 
   
   
       13 . The cerclage instrument according to  claim 10 , wherein the tissue-dissecting instrument is a wire for dissecting the mucosa of the gastric wall by supplying high frequency electricity. 
   
   
       14 . The cerclage instrument according to  claim 10 , wherein the tissue-cerclage instrument is one of the group consisting of a fastener, a stapler, a clip, a tag, a T-bar, and a clamp. 
   
   
       15 . The cerclage instrument according to  claim 10 , wherein the tissue-cerclage instrument further comprises:
 a needle that alternately punctures a muscle coat of the gastric wall retracted into the main unit from one of the holes and a muscle coat of the gastric wall retracted into the main unit from the other one of the holes, and passes a suture thread through the muscle coats; and   a thread-releasing member for removing the needle while disposing the suture thread in the muscle coat.   
   
   
       16 . The cerclage instrument according to  claim 15 , wherein an interval between a puncture position of the needle and the position of the second gastric-wall-fixing section is smaller than the thickness of the muscle coat of the gastric wall so that the needle can puncture the muscle coat of the gastric wall retracted into the main unit. 
   
   
       17 . The cerclage instrument according to  claim 15 , wherein the needle has a spiral shape so that the needle can alternately puncture the muscle coat of the gastric wall retracted into the main unit from one of the holes and the muscle coat of the gastric wall retracted into the main unit from the other one of the holes. 
   
   
       18 . The cerclage instrument according to  claim 15 , wherein the needle is bent so that the needle can alternately puncture the muscle coat of the gastric wall retracted into the main unit from one of the holes and the muscle coat of the gastric wall retracted into the main unit from the other one of the holes. 
   
   
       19 . The cerclage instrument according to  claim 10 , wherein the main unit comprises:
 an outer cylinder section having the holes formed thereon; and   an inner cylinder section having the first gastric-wall-fixing section and the second gastric-wall-fixing section, the inner cylinder section being capable of housing the mucosa dissected from the gastric wall, and the inner cylinder section being capable of rotating, or advancing and retracting.   
   
   
       20 . A method for cerclaging a gastric wall; comprising:
 inserting an elastic long length of the loop-forming member perorally into the stomach and advancing the loop-forming member along a lesser-curvature-line;   returning the loop-forming member at the vicinity of a pyloric antrum of the stomach; advancing the loop-forming member along a greater-curvature-line; and forming a loop in the stomach;   suctioning air from the stomach after looping the loop-forming member in the stomach; and shrinking the stomach so that the anterior gastric wall is in proximity with a posterior gastric wall within the looped loop-forming member; and   cerclaging the anterior gastric wall and the posterior gastric wall that are in proximity by shrinking the stomach.   
   
   
       21 . The method for cerclaging the gastric wall according to  claim 20 , wherein a suture thread is punctured alternately through the anterior wall and the posterior wall while rotating a bent needle when the anterior gastric wall and the posterior gastric wall are cerclaged. 
   
   
       22 . The for cerclaging the gastric wall according to  claim 20 , including dissecting the mucosa of tissues that should be adheded after the cerclage before cerclaging the anterior gastric wall and the posterior gastric wall. 
   
   
       23 . The method for cerclaging the gastric wall according to  claim 20 , including embedding an implant into the gastric wall after cercalging the anterior gastric wall and the posterior gastric wall. 
   
   
       24 . The method for cerlaging the gastric wall according to  claim 21 , wherein a position for embedding the endoscope is an entrance in the vicinity of a cardia of the stomach of a section that is cerclaged; an exit in the vicinity of the pylorus of the stomach; or the whole length or a part of the section that is cerclaged. 
   
   
       25 . The method for cerclaging the gastric wall according to  claim 21 , wherein the implant is a metal or resin coil, or a suture thread. 
   
   
       26 . The method for cerclaging the gastric wall according to  claim 21 , further comprising:
 measuring the thicknesses of a mucosa and a muscle coat of the gastric wall that should be cerclaged before or after inserting a cerclage instrument that cerclages the anterior gastric wall and the posterior gastric wall;   selecting the cerclage instrument suitable for the measured thicknesses of the mucosa and the muscle coat; and   cerclaging the mucosa of the gastric wall by using the cerclage instrument.   
   
   
       27 . The method for cerclaging the gastric wall according to  claim 26 , wherein the thicknesses of the mucosa and the muscle coat of the gastric wall are measured by using an ultrasonic endoscope or an ultrasonic searcher attached to the cerclage instrument. 
   
   
       28 . The method for cerclaging the gastric wall according to  claim 21 , further comprising:
 measuring the thicknesses of a mucosa and a muscle coat of the gastric wall that should be cerclaged before or after inserting a cerclage instrument that cerclages the anterior gastric wall and the posterior gastric wall; and   adjusting the cerclage instrument based on the measured thicknesses of the mucosa and the muscle coat; and cerclaging the mucosa of the stomach by using the cerclage instrument.   
   
   
       29 . The method for cerclaging the gastric wall according to  claim 28 , wherein the thicknesses of the mucosa and the muscle coat of the gastric wall are measured by using an ultrasonic endoscope or an ultrasonic searcher attached to the cerclage instrument.