Methods for performing gastroplasty

Abstract

Methods for performing gastroplasty include reducing the effective volume or cross-sectional area of the stomach via approximation of gastric tissue. Such reduction preferably is achieved endoluminally, either with or without laparoscopic ports. In one variation, a sleeve, pouch, Magenstrasse and Mill, Vertical Banded Gastroplasty (“VBG”), etc., is formed within the stomach by approximating opposing anterior and posterior segments or ridges of the stomach wall at locations inferior to the gastroesophageal junction. In another variation, opposing walls of the stomach are approximated at a plurality of substantially random locations to reduce an effective volume of the stomach. In yet another variation, both a sleeve and random approximations are formed, the random approximations preferably disposed in a portion of the stomach excluded by the sleeve. In still another variation, opposing walls of the stomach are approximated over significant lengths at random or specified locations.

1 . A method for performing gastroplasty, the method comprising:
 inserting a securing element down the throat of a patient to a position within the stomach of the patient;   forming tissue folds on opposing walls of a patient's stomach;   approximating the tissue folds to thereby form a sleeve or pouch within the patient's stomach; and   securing the approximated tissue folds forming a sleeve or pouch with the securing element.   
   
   
       2 . The method of  claim 1 , further comprising reinforcing the approximated and secured tissue folds. 
   
   
       3 . The method of  claim 1 , further comprising endoluminally approximating tissue folds at substantially random locations confined to regions of the stomach disposed outside of the sleeve or pouch. 
   
   
       4 . The method of  claim 3 , further comprising securing the approximated tissue folds at substantially random locations. 
   
   
       5 . The method of  claim 4 , further comprising reinforcing the approximated and secured tissue folds at substantially random locations. 
   
   
       6 . The method of  claim 1 , wherein approximating the tissue folds to thereby form a sleeve or pouch further comprises endoluminally forming a sleeve or pouch that extends from a location just inferior to the patient's gastroesophageal junction to a location opening to the patient's antral mill. 
   
   
       7 . The method of  claim 6 , further comprising reinforcing the approximated and secured tissue folds. 
   
   
       8 . The method of  claim 1 , wherein approximating the tissue folds further comprises approximating the tissue folds over a significant length greater than or equal to about 1 cm. 
   
   
       9 . The method of  claim 8 , further comprising reinforcing the approximated and secured tissue folds. 
   
   
       10 . A method for performing gastroplasty, the method comprising:
 advancing instruments down the throat of a patient to a position within a the patient's stomach;   forming a plurality of tissue folds secured by tissue anchors on opposing walls of the patient's stomach; and   endoluminally forming a pouch or sleeve within the stomach by approximating the tissue folds on the opposing walls of the stomach with the instruments, wherein the pouch or sleeve extends from a location just inferior to the patient's gastroesophageal junction to a location opening to the patient's antral mill, and wherein the pouch or sleeve is partially defined by a portion of the lesser curvature of the patient's stomach.   
   
   
       11 . The method of  claim 10 , further comprising securing the approximated tissue folds forming a sleeve or pouch with a first plurality of tissue anchors. 
   
   
       12 . The method of  claim 11 , further comprising reinforcing the approximated and secured tissue folds. 
   
   
       13 . The method of  claim 1  further comprising reinforcing the approximated and secured tissue folds with a second plurality of tissue anchors.