Multi-method and multi-apparatus for treating obesity

Abstract

A multi-method and multi-apparatus for treating obesity. The multi-method includes a method for estimating a volume of an intragastric balloon appropriate for an individual patient, a method for using an enterocutaneous fistula to inspect an intragastric balloon without sedation and endoscopic complications associated with an upper endoscopy, and a method for decreasing ability of the stomach of an individual patient to distend or expand after a meal increasing satiety and helping the individual patient to comply with a weight loss diet. The multi-apparatus includes an intragastric balloon for inflating without installation of a pressurized gas or liquid, an intragastric balloon for minimizing trauma of the intragastric balloon on the gastric mucosa, and an intragastric balloon for administering therapeutic medications.

What is claimed is: 
     
         1 . A method for estimating volume of an intragastric balloon appropriate for an individual patient, the method comprising:
 drinking by the individual patient, who is a candidate for the intragastric balloon, as much of a fluid as possible over a given period of time;   monitoring volume of the fluid ingested;   advising, by the individual patient, to a physician or person administering the method when the individual patient feels uncomfortably bloated or if the individual patient vomits so that the volume of the fluid ingested is determined;   selecting for the individual patient the intragastric balloon that is a fraction of the volume leading to uncomfortable symptoms; and   monitoring the individual patient with specialized equipment during ingestion.   
     
     
         2 . The method of  claim 1 , wherein the drinking step includes drinking by the individual patient, who is a candidate for the intragastric balloon, as much fluid as possible over a 10 minute period of time. 
     
     
         3 . The method of  claim 1 , wherein the selecting step includes selecting for the individual patient the intragastric balloon that is 75% of the ingested volume of fluid. 
     
     
         4 . The method of  claim 1 , wherein the monitoring step includes monitoring the individual patient with one of an electrogastrograph, an upper endoscope, and a barostat balloon. 
     
     
         5 . The method of  claim 1 , further comprising the step of challenging over time the individual patient with the intragastric balloon with another load of the fluid to see if the individual patient can tolerate a larger intragastric balloon because a larger intragastric balloon has greater therapeutic effect in management of obesity and satiety symptoms. 
     
     
         6 . The method of  claim 1 , wherein the drinking step includes drinking by the individual patient, who is a candidate for the intragastric balloon, as much of a fluid that is selected from the group consisting of water, a water solution suspension and a non-aqueous based material as possible over a given period of time. 
     
     
         7 . The method of  claim 1 , wherein the selecting step includes selecting for the individual patient the intragastric balloon that will be a fraction of the volume leading to uncomfortable symptoms at room temperature. 
     
     
         8 . A method for using an enterocutaneous fistula to inspect an intragastric balloon without sedation and endoscopic complications associated with an upper endoscopy, comprising:
 placing a percutaneous gastrostomy in a usual manner;   allowing the percutaneous gastrostomy to heal;   dilating the tract to allow passage of an upper endoscope directly into the stomach; and   evaluating the balloon and the gastric mucosa.   
     
     
         9 . A method for decreasing ability of the stomach of an individual patient to distend or expand after a meal to increase satiety and help the individual patient to comply with a weight loss diet, comprising:
 locating the stomach of the individual patient to facilitate proper placement of a band;   wrapping the band around the stomach of the individual patient; and   closing/attaching the band to apply pressure to the stomach of the individual patient, thereby decreasing the ability of the stomach of the individual patient to distend or expand after the meal, thereby increasing the satiety and helping the individual patient to comply with the weight loss diet.   
     
     
         10 . The method of  claim 9 , wherein the locating step includes locating the stomach of the individual patient to facilitate proper placement of a band by utilizing one of roentgenography and fluoroscopy. 
     
     
         11 . The method of  claim 9 , wherein the wrapping step includes wrapping the band around the stomach of the individual patient in one of an area caudal to the xiphoid process of the sternum and cranial to the lower edge of the rib cage of the individual patient and along the circumference of the portion of the stomach of the individual patient. 
     
     
         12 . The method of  claim 9 , wherein the closing/attaching step includes closing/attaching the band with one of buttons and hook and loop fasteners. 
     
     
         13 . The method of  claim 9 , further comprising the step of attaching a pulley device to one end of the band to tighten the band. 
     
     
         14 . The method of  claim 9 , wherein the closing/attaching step includes closing/attaching the band to apply pressure to the stomach of the individual patient at the left upper quadrant portion of the stomach of the individual patient by use of one of the balloon, other space-occupying device, and the pillow. 
     
     
         15 . The method of  claim 9 , further comprising the step of utilizing one of pulse oximetry, blood gas measurement, and capnography to determine if the band significantly decreases respiratory status of the individual patient. 
     
     
         16 . The method of  claim 9 , further comprising the step of measuring tension of the band and tension applied to skin of the individual patient to ascertain likelihood of causing damage or ulceration to the skin of the individual patient. 
     
     
         17 . The method of  claim 9 , further comprising the step of attaching one of a balloon, another space occupying device, and a pillow to the band. 
     
     
         18 . The method of  claim 17 , wherein the locating step includes locating the stomach of the individual patient to facilitate proper placement of a band that is of cloth, is 3 inches wide, is one of resistant to stretching and elastic, has a width that is dependent upon weight of the individual patient and anatomy of the individual patient, and has a portion thereof widened compared to the rest of the band to accommodate one of the balloon, the another space occupying device, and the pillow. 
     
     
         19 . The method of  claim 9 , further comprising the step of utilizing an adhesive on at least one of the skin of the individual patient and the band to prevent the band from migrating while being worn by the individual patient. 
     
     
         20 . The method of  claim 9 , further comprising the step of attaching a device with an appearance of standard suspenders to an adjustable belt around the waist of the individual patient to hold the band in a proper position by one of hook and loop fasteners, buttons, and snap devices.