Apparatus and methods for performing mucosectomy

Abstract

Apparatus and methods are provided for performing mucosectomy, such as to map out gastrointestinal surgery, including endoluminal gastric reduction. In one variation, tie apparatus comprises a separating element and an integrated resection element. In one variation, the apparatus is configured to simultaneously separate mucosal tissue from underlying muscularis tissue and to resect the separated mucosal tissue. Methods of using the apparatus are provided.

1 . Apparatus for separating and resecting mucosal tissue from an interior of a patient's stomach, the apparatus comprising:
 an elongated shaft having a lumen extending therethrough and having a distal end, the distal end defining a channel;   a hollow needle extending from the distal end of the shaft, the needle being in fluid communication with the lumen of the elongated shaft; and   a resection element disposed on the distal end of the shaft and within the channel.   
   
   
       2 . The apparatus of  claim 1 , wherein the elongated shaft is sufficiently flexible for endoluminal advancement within a human patient. 
   
   
       3 . The apparatus of  claim 1 , wherein the elongated shaft is sufficiently rigid for laparascopic advancement within a human patient. 
   
   
       4 . The apparatus of  claim 1 , wherein the needle defines a portion of the channel. 
   
   
       5 . The apparatus of  claim 1 , wherein the channel has a width that substantially corresponds with the thickness of a layer of the mucosal tissue of the patient's stomach. 
   
   
       6 . The apparatus of  claim 1 , wherein the needle extends in a proximal direction from the distal end of the shaft. 
   
   
       7 . The apparatus of  claim 1 , wherein the needle extends in a distal direction from the distal end of the shaft. 
   
   
       8 . The apparatus of  claim 1 , wherein the needle is disposed at an angle relative to the shaft. 
   
   
       9 . The apparatus of  claim 8 , wherein the angle is an obtuse angle. 
   
   
       10 . The apparatus of  claim 1 , wherein the resection element is configured to automatically engage mucosal tissue that has been separated from underlying muscularis tissue via the hollow needle. 
   
   
       11 . The apparatus of  claim 1 , wherein the resection element is chosen from the group consisting of energizable elements, RF elements, wires, cutting elements, blades, dissectors, jaw members and combinations thereof. 
   
   
       12 . Apparatus for separating and resecting mucosal tissue from an interior of a patient's stomach, the apparatus comprising:
 an elongated shaft having a lumen extending therethrough and having a distal end, the distal end defining a channel;   a separating element extending from the distal end of the shaft; and   a resection element disposed on the distal end of the shaft and within the channel.   
   
   
       13 . The apparatus of  claim 12 , wherein the elongated shaft is sufficiently flexible for endoluminal advancement within a human patient. 
   
   
       14 . The apparatus of  claim 12 , wherein the elongated shaft is sufficiently rigid for laparascopic advancement within a human patient. 
   
   
       15 . The apparatus of  claim 12 , wherein the separating element defines a portion of the channel. 
   
   
       16 . The apparatus of  claim 12 , wherein the channel has a width that substantially corresponds with the thickness of a layer of the mucosal tissue of the patient's stomach. 
   
   
       17 . The apparatus of  claim 12 , wherein the separating element extends in a proximal direction from the distal end of the shaft. 
   
   
       18 . The apparatus of  claim 12 , wherein the separating element extends in a distal direction from the distal end of the shaft. 
   
   
       19 . The apparatus of  claim 12 , wherein the separating element is disposed at an angle relative to the shaft. 
   
   
       20 . The apparatus of  claim 19 , wherein the angle is an obtuse angle. 
   
   
       21 . The apparatus of  claim 12 , wherein the resection element is configured to automatically engage mucosal tissue that has been separated from underlying muscularis tissue via the separating element. 
   
   
       22 . The apparatus of  claim 12 , wherein the resection element is chosen from the group consisting of energizable elements, RF elements, wires, cutting elements, blades, dissectors, jaw members and combinations thereof. 
   
   
       23 . The apparatus of  claim 12 , wherein the separating element comprises an inclined surface configured for placement within a submucosal space between the mucosal tissue and underlying muscularis tissue. 
   
   
       24 . The apparatus of  claim 12 , wherein the separating element is chosen from the group consisting of wedges, inclined planes, inclined surfaces, shoe horns, fluid boluses, dissectors, jaw members and combinations thereof.