Gastric band

Abstract

A gastric band of a belt type is presented for attaching around a circumference of a patient's stomach, so as to define the diameter of the stomach opening. The band comprises outer and inner surfaces, wherein the inner surface engages the stomach, and at least the outer surface is formed by an elongated member substantially non-extendable along a longitudinal axis thereof. A through-going opening is made in the elongated member and is located so as to define an end portion of the band having a predetermined length. An opposite end portion of the band is shaped so as to be insertable into the through-going opening for adjusting a desired inner diameter of the band in its closed operating position and fastening the opposite end portion to the outer surface of the band.

1 . A non-inflatable gastric band sized and shaped to be mounted on the outside of a patient's stomach during a laparoscopic procedure, comprising: 
       (a) an elongated non-inflatable band formed of non-rigid PTFE and flexible enough for us in a laparoscopic procedure; 
       (b) a through-going opening in said material of said band at a location spaced from a butt-end of the band to define an extended end portion of said material past said opening including a section of about 3 cm in length enabling gripping the band material, said extended end portion freely extending from the band when the band is in a closed operating position; and 
       (c) an opposite end portion of the band shaped so as to be insertable into said through-going opening for adjusting a desired inner diameter of the band in said closed operating position and for fastening the opposite end portion to the band upon establishing the desired diameter, 
       wherein said extended end portion and the opposite portion are sized for gripping the band while mounting it onto the outside of a stomach and adjusting the diameter of the band to bring it into its operating closed position during a laparoscopic procedure, and wherein said extended end portion extends sufficiently so as to facilitate detection of the band while in a laparoscopic operative position and mounted on the stomach and enables gripping the band at said extended end portion for readjusting the diameter of the inner stomach opening after the band is brought into its laparoscopic operating position, 
       wherein said gastric band is formed of a single material. 
     
     
         2 . The gastric band according to  claim 1 , further including a fastener comprising at least one projection located on the outer surface of the band, and at least one through-going hole for receiving said at least one projection, when the band is in the operating position around the stomach. 
     
     
         3 . The gastric band according to  claim 1 , wherein the two ends of the band are fastened together by two or more stitches when the band is in the operating position around the stomach. 
     
     
         4 . The gastric band according to  claim 1 , wherein an inner surface of said band engaging the stomach has substantially circular shape when in the operating position of the band. 
     
     
         5 . The gastric band according to  claim 1 , wherein said predetermined length of the end portion is such as to enable the detection of the gastric band by a laparoscopic inspection tool. 
     
     
         6 . A system for laparoscopically attaching the gastric band of  claim 1  around a patient's stomach so as to define a certain diameter of the stomach opening, the system comprising: 
       a calibration device which is insertable into the stomach at a predetermined depth and three articulated gripping devices, 
       wherein the calibration device comprises: 
       an upper portion having variable volume, and a lower projection-like portion having a diameter substantially equal to said certain diameter of the stomach opening to be defined by the band, and 
       further comprising a pipe providing access to the interior of the stomach and stomach contents if any, 
       wherein the location of said projection-like portion when in the inserted position of the calibration device defines the location of the band with respect to the stomach. 
     
     
         7 . A system according to  claim 6  wherein the lower projection-like portion is a rigid tube of fixed diameter. 
     
     
         8 . A system according to  claim 6  wherein the pipe extends through the lower projection-like portion for aspiration of the contents of the stomach. 
     
     
         9 . A method for attaching the gastric band of  claim 1  around a circumference of a patient's stomach so as to define a desired diameter of the stomach opening and a desired volume of the stomach above the opening, the method comprising:
 performing a calibration with a calibration device having a balloon-like inflatable upper portion and a lower substantially rigid projection-like portion having a fixed diameter substantially equal to said desired diameter of the stomach opening and to define a plane of location where the gastric band is to be attached, thereby defining the volume of the stomach above the opening, the calibration comprising: 
 inserting the calibration device inside the stomach though a stomach inlet, 
 inflating the upper inflatable portion up to a volume corresponding to a certain maximal diameter thereof so as to substantially engage the inner circumference of the stomach; 
 partially deflating said portion to a volume corresponding to the diameter of the upper portion; and 
 pulling the calibration device towards the stomach inlet to thereby locate the lower portion and define the location for mounting the gastric band; and 
 laparoscopically attaching the gastric band around the circumference of the patient's stomach at said location. 
 
     
     
         10 . The method of  claim 9  wherein attaching the gastric band comprises:
 inserting a gripping device through cuttings made in the stomach connecting tissue on opposite sides of the back of the stomach in the plane of location of the gastric band; 
 clamping the opposite end portion of the band; and 
 pulling the gripping device to thereby thread the band through the cuttings to engage the back side of the stomach; 
 
       supporting the end portion of the band while passing the gripping device though said though-going opening of the band towards said opposite end portion of the band; 
       manipulating arms of the gripping device to thread said opposite end portion of the band through the through-going opening and close the band tight around the lower projection-like portion of the calibration device inside the stomach;
 holding together the end portions of the band by two arms of the gripping device and fastening the opposite end portion to the outer surface of the band; and 
 cutting off a free part of the opposite end portion of the band. 
 
     
     
         11 . A method of using a gastric band, comprising:
 encircling an uninflatable band having first and second ends and a through-going opening in a material of the band spaced from the first end of the band a predetermined distance to define an extended end portion of the material of the band of a predetermined length enabling gripping the band material, at a position intermediate upper and lower ends of a stomach with an inner surface of said band in contact with the stomach, whereby said extended end portion freely protrudes from the band sufficiently so as to facilitate detection of the band when the band is in a closed operating position;   engaging both ends of said band simultaneously, using laparoscopic instruments;   pulling the second end of the band via the through-going opening, using said laparoscopic instruments, until an opposite end portion of the band which has been pulled via the through-going opening corresponds to a desired inner diameter of the stomach opening and a desired volume of the stomach above the opening; and   fastening the opposite end portion to fixate said desired diameter.   
     
     
         12 . The method of  claim 11 , further including cutting off a free part of the opposite end portion of the band. 
     
     
         13 . The method of  claim 11 , wherein encircling the gastric band around the stomach comprises:
 making cuttings in the stomach connecting tissue on opposite sides of the back of the stomach in a desired location of the gastric band;   threading the band through the cuttings to engage the back side of the stomach; and   
       positioning the two ends of the band at the front of the stomach for insertion of the second end portion in the through-going opening. 
     
     
         14 . The method of  claim 11 , wherein the distance of insertion is determined by pulling the second end of the band until the band is tight around a fixed-diameter portion of a calibration device inserted inside the stomach. 
     
     
         15 . The method of  claim 11 , comprising detecting said extended end portion when it protrudes from said band after closing of said band, by its protrusion. 
     
     
         16 . The gastric band of  claim 1 , wherein said gastric band is formed of a single layer of material. 
     
     
         17 . The gastric band of  claim 1 , wherein said opposite end portion and said through-going opening are configured so that said opposite end portion is prevent from retracting through said opening once inserted through the opening. 
     
     
         18 . A method of treatment, comprising: 
       inserting a laparoscopic instrument into a body, the laparoscopic instrument including a non-inflatable band made from of a non-extendable and flexible material, the band comprising a first and second end; 
       inserting the first end of the band through a through-going opening near the second end of the band using a laparoscopic instrument, the opening at a location spaced from the second end of the band defining an extended end portion of said material past said opening; and 
       gripping the extended portion using a laparoscopic instrument; including a section of about 3 cm in length enabling gripping the band material, said extended end portion freely extending from the band when the band is in a closed operating position. 
     
     
         19 . A method according to  claim 18 , further comprising:
 detecting the extended portion by a laparoscopic inspection tool after the band is brought into its laparoscopic operating position.