Apparatus for treating gerd comprising a stimulation device

Abstract

The present invention relates to a reflux disease treatment apparatus, apparatus, comprising an implantable movement restriction device that maintains cardia in the correct position and an implantable stimulation device adapted to engage with the cardia sphincter of a patient. The invention further comprises a control device for controlling the stimulation device to stimulate the cardia sphincter. The invention can be combined with various methods for treating obesity, in particular methods that creates satiety by stretching the wall of the stomach or fills out a volume of the stomach.

1 - 281 . (canceled) 
     
     
         282 . An apparatus for treating reflux disease of a human or animal mammal patient, comprising:
 an implantable stimulation device adapted to engage with the cardia sphincter of the patient; and   a control device for controlling the stimulation device to stimulate the cardia sphincter by providing electrical energy pulses for increasing a sphincter tonus so that the cardia closes; wherein:   the control device is adapted to, in an operational state, cause the stimulation device to stimulate the cardia sphincter with at least two pulse trains;   at least some of the pulses within at least one of the pulse trains are separated from each other by a first time break;   the at least two pulse trains are separated from each other by a second time break; and   the second time break is longer than the first time break.   
     
     
         283 . The apparatus according to claim  1 , wherein:
 the control device is adapted to, in the operational state, cause the stimulation device to stimulate the cardia sphincter with at least two pulse train segments;   each pulse train segment comprises at least two pulse trains that are separated from each other by the second time break;   the at least two pulse train segments are separated from each other by a third time break; and   the third time break is longer than the second time break.   
     
     
         284 . The apparatus according to claim  1  or  2 , further comprising an implantable movement restriction device adapted to be implanted in connection with the fundus wall of the patient's stomach fundus wall, in a non-encircling manner with respect to the patient's stomach. 
     
     
         285 . The apparatus according to claim  3 , wherein the movement restriction device adapted to be arranged such that a substantial pan of the outer surface of the movement restriction device rests against the stomach wall in a position between the patient's diaphragm and at least a portion of the lower part of the invaginated stomach fundus wall, such that movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted when the movement restriction device is invaginated, to thereby prevent the cardia from sliding through the patient's diaphragm opening into the patient's thorax, so as to maintain a supporting pressure against the patient's cardia sphincter muscle exerted from the patient's abdomen. 
     
     
         286 . The apparatus according to claim  4 , wherein the movement restriction device has a size of at least 125 mm3. 
     
     
         287 . The apparatus according to claim  4  or  5 , wherein the movement restriction device has a circumference of at least 15 mm. 
     
     
         288 . The apparatus according to any one of claims  4  to  6 , wherein the outer surface of the movement restriction device comprises a biocompatible material. 
     
     
         289 . The apparatus according to any one of claims  4  to  7 , further comprising an implantable fixation device that is adapted to, when implanted in the patient, attach the movement restriction device to the fundus wall to keep the movement restriction device in said position. 
     
     
         290 . The apparatus according to any one of the preceding claims, wherein the control device is adapted to set the stimulation device in a state wherein it is out of operation such that the cardia sphincter is not stimulated when the patient swallows. 
     
     
         291 . The apparatus according to any one of the preceding claims, wherein the control device is operable by the patient such that the patient is allowed to set the stimulation device in the operational state and in the state wherein it is out of operation. 
     
     
         292 . The apparatus according to any one of the preceding claims, wherein the control device is adapted to be implanted in the body of the patient. 
     
     
         293 . The apparatus according to claim  4 , wherein the stimulation device is adapted to be arranged within the movement restriction device, and further comprises an electrode adapted to engage with the cardia sphincter so as transmit the electrical energy pulses to the cardia sphincter. 
     
     
         294 . The apparatus according to any one of claims  1  to  11 , wherein the stimulation device is adapted to be placed on the outside of the patient's stomach. 
     
     
         295 . The apparatus according to any one of the preceding claims, further comprising a wireless remote control for non-invasively controlling the apparatus. 
     
     
         296 . The apparatus according to any one of the preceding claims, further comprising a wireless energy transmitter non-invasively energizing the apparatus.