Bulking of upper esophageal sphincter for treatment of obesity

Abstract

A method for treatment of obesity involves implantation of bulking devices within the upper esophageal sphincter (UES) to inhibit swallowing, thereby limiting food intake and treating obesity. One or more bulking devices are implanted within or near the UES to create a partial obstruction, partially impair UES muscle function, or both. The bulking devices make swallowing difficult, limiting the rate of food intake by a patient, and discouraging the patient from quickly consuming an excessive amount of food at one time.

1 . A method for causing weight loss, the method comprising implanting in a patient one or more bulking devices having one or more characteristics selected to limit food intake into an esophagus of the patient, wherein the one or more bulking devices are implanted in at least one of an inferior constrictor muscle or a crycopharyngeus muscle of an upper esophageal sphincter (UES) of the patient. 
   
   
       2 . The method of  claim 1 , further comprising implanting the bulking devices within at least one of horizontal or oblique fibers of the crycopharyngeus muscle of the UES. 
   
   
       3 . The method of  claim 1 , further comprising implanting the bulking devices within at least one of horizontal or oblique fibers of the inferior constrictor muscle of the UES. 
   
   
       4 . The method of  claim 1 , wherein the bulking devices are implanted and sized to at least partially obstruct the UES. 
   
   
       5 . The method of  claim 1 , wherein the bulking devices are implanted and sized to at least partially impair function of a muscle associated with the UES. 
   
   
       6 . The method of  claim 1 , further comprising endoscopically implanting the bulking devices within the UES of the patient. 
   
   
       7 . The method of  claim 1 , further comprising repositioning an endoscopic device among a plurality of implantation sites to endoscopically implant a plurality of the bulking devices. 
   
   
       8 . The method of  claim 1 , wherein each of the bulking devices includes a solid, hydrogel material. 
   
   
       9 . The method of  claim 8 , further comprising implanting the bulking devices with the hydrogel material in an at least partially dehydrated state, the bulking devices rehydrating upon implantation and thereby expanding in size to at least partially obstruct the UES. 
   
   
       10 . The method of  claim 1 , wherein the bulking devices are expandable following implantation. 
   
   
       11 . The method of  claim 10 , wherein the bulking devices are expandable from a pre-implantation volume of less than approximately 100 mm 3  to a post-implantation size of greater than or equal to approximately 200 mm 3 . 
   
   
       12 . The method of  claim 11 , wherein the bulking devices are expandable from a pre-implantation size to a post-implantation size of greater than or equal to approximately two times the pre-implantation size. 
   
   
       13 . The method of  claim 1 , wherein each of the bulking devices is substantially capsule-like in shape, substantially spherical in shape, substantially disc-like in shape, or substantially rod-like in shape. 
   
   
       14 . The method of  claim 1 , further comprising implanting a plurality of the bulking devices at different angular positions about the inner lumen of the esophagus. 
   
   
       15 . The method of  claim 14 , wherein the bulking devices include four bulking devices spaced at approximately 90 degree intervals from one another. 
   
   
       16 . The method of  claim 1 , further comprising injecting a fluid into a mucosal wall to create an implantation pocket, and implanting one of the bulking devices in the implantation pocket. 
   
   
       17 . The method of  claim 1 , further comprising explanting the bulking devices from the patient after the patient has achieved a desired amount of weight loss. 
   
   
       18 . A method for causing weight loss, the method comprising:
 implanting one or more bulking devices in an upper esophageal sphincter (UES) of a patient such that the implanted bulking devices limit food intake by the patient and thereby treat obesity; and   explanting one or more of the bulking devices from the patient after the patient has achieved a desired amount of weight loss.   
   
   
       19 . The method of  claim 18 , further comprising implanting the bulking devices at least one of in a sub-mucosal region of the UES, within a muscle layer of the UES, between muscle layers of the UES, within at least one of oblique or horizontal fibers of a crycopharyngeus muscle of the UES, or within at least one of oblique or horizontal fibers of an inferior constrictor muscle of the UES. 
   
   
       20 . The method of  claim 18 , wherein the bulking devices are implanted and sized to at least one of partially obstruct the UES or partially impair function of a muscle associated with the UES. 
   
   
       21 . The method of  claim 18 , wherein each of the bulking devices includes a solid, hydrogel material, the method further comprising implanting the bulking devices with the hydrogel material in an at least partially dehydrated state, the bulking devices rehydrating upon implantation and thereby expanding in size to expand the UES. 
   
   
       22 . The method of  claim 18 , wherein the bulking devices are expandable from a pre-implantation size to a post-implantation size of greater than or equal to approximately two times the pre-implantation size. 
   
   
       23 . The method of  claim 18 , wherein each of the bulking devices is substantially capsule-like in shape, substantially spherical in shape, substantially disc-like in shape, or substantially rod-like in shape. 
   
   
       24 . The method of  claim 18 , further comprising implanting a plurality of the bulking devices at different angular positions about the inner lumen of the esophagus, wherein the bulking devices include four bulking devices spaced at approximately 90 degree intervals from one another. 
   
   
       25 . The method of  claim 18 , further comprising injecting a fluid into a mucosal wall to create an implantation pocket, and implanting one of the bulking devices in the implantation pocket. 
   
   
       26 . The method of  claim 18 , further comprising explanting the bulking devices from the patient after the patient has achieved a desired amount of weight loss. 
   
   
       27 . The method of  claim 18 , further comprising endoscopically implanting the bulking devices within the UES of the patient. 
   
   
       28 . A method for simulating symptoms of oropharyngeal dysphagia to cause weight loss, the method comprising implanting in a patient one or more bulking devices in one or more regions of an upper esophageal sphincter (UES) of the patient, wherein the regions of the UES and one or more characteristics of the bulking devices are selected to simulate symptoms of oropharyngeal dysphagia and thereby limit food intake into an esophagus of the patient to cause weight loss by the patient. 
   
   
       29 . The method of  claim 28 , further comprising identifying the patient for obesity treatment. 
   
   
       30 . The method of  claim 28 , further comprising explanting the bulking devices from the patient after the patient has achieved a desired amount of weight loss. 
   
   
       31 . The method of  claim 28 , further comprising implanting the bulking devices at least one of in a sub-mucosal region of the UES, within a muscle layer of the UES, between muscle layers of the UES, within at least one of oblique or horizontal fibers of a crycopharyngeus muscle of the UES, or within at least one of oblique or horizontal fibers of an inferior constrictor muscle of the UES. 
   
   
       32 . The method of  claim 28 , wherein each of the bulking devices includes a solid, hydrogel material, the method further comprising implanting the bulking devices with the hydrogel material in an at least partially dehydrated state, the bulking devices rehydrating upon implantation and thereby expanding in size to expand the UES. 
   
   
       33 . The method of  claim 28 , wherein the bulking devices are expandable from a pre-implantation size to a post-implantation size of greater than or equal to approximately two times the pre-implantation size. 
   
   
       34 . The method of  claim 28 , wherein each of the bulking devices is substantially capsule-like in shape, substantially spherical in shape, substantially disc-like in shape, or substantially rod-like in shape. 
   
   
       35 . The method of  claim 28 , further comprising implanting a plurality of the bulking devices at different angular positions about the inner lumen of the esophagus, wherein the bulking devices include four bulking devices spaced at approximately 90 degree intervals from one another.