Apparatus for treating obesity

Abstract

An apparatus for treating obesity of a patient having a stomach with a food cavity. The apparatus comprising a volume filling device adapted to be at least substantially invaginated by a stomach wall portion of the patient with the outer surface of the volume filling device resting against the stomach wall, such that the volume of the food cavity is reduced in size by a volume substantially exceeding the volume of the volume filling device. The apparatus further comprises at least one adjustable stretching device adapted to be at least substantially invaginated by a stomach wall portion of the patient with the outer surface of the stretching device resting against the stomach wall and adapted to stretch a portion of stomach wall, and a fluid connection device interconnecting the volume filling device and the stretching device.

1 - 52 . (canceled) 
     
     
         53 . An apparatus for treating obesity of an obese patient having a stomach with a food cavity, the apparatus comprising:
 at least one volume filling device adapted to be at least substantially invaginated by a stomach wall portion of the patient and having an outer surface adapted to rest against the stomach wall, such that the volume of the food cavity is reduced in size, characterized in that the apparatus further comprises   at least one implantable operable stretching device adapted to stretch a portion of the patient's stomach wall, and   an operation device for non-invasively operating the stretching device when implanted, to stretch the stomach wall portion such that satiety is created wherein the operable stretching device is adapted to be placed against the outside of the stomach wall.   
     
     
         54 . The apparatus according to  claim 53 , wherein the stretching device comprises a first engaging member adapted to engage a first part of the stomach wall and a second engaging member adapted to engage a second part of the stomach wall close to but spaced from the first stomach part, wherein the operation device is adapted to operate the first and second engaging member to move away from each other, when the engaging members engage the first and second stomach parts, to stretch the stomach wall portion between the first and second parts of the stomach such that satiety is created. 
     
     
         55 . The apparatus according to  claim 54 , wherein at least one of the first and second engaging members is adapted to:
 a. at least in part be invaginated by the stomach wall by stomach-to-stomach sutures or staplers holding the engaging member in place, or   b. be kept in place by sutures or staplers between the engaging member and the stomach wall.   
     
     
         56 . The apparatus according to  claim 53 , further comprising at least two operable stretching devices adapted to stretch at least two different portions of the stomach wall. 
     
     
         57 . The apparatus according to  claim 56 , wherein the device is adapted to be postoperatively and non-invasively regulated, and adapted to be regulated from time to time such that at a first time one of the stretching devices stretches one of the portions of the stomach wall and at a second time the other of the stretching devices stretches the other portion of the stomach wall. 
     
     
         58 . The apparatus according to  claim 53 , wherein the operation device comprises at least one of:
 a. a subcutaneous switch adapted to be non-invasively operated by manually pressing the switch for the operation of the stretching device, and   b. a wireless remote control for controlling a function of the stretching device.   
     
     
         59 . The apparatus according to  claim 53 , wherein the stretching device comprises at least one expandable body adapted to be invaginated by a portion of the patient's stomach wall, and the operation device comprises a fluid reservoir, which is in fluid communication with a chamber of the body, the operation device being non-invasively operable to distribute fluid from the fluid reservoir to the chamber of the body to expand the body such that the stomach wall portion is stretched, when the body is invaginated. 
     
     
         60 . The apparatus according to  claim 59 , wherein the fluid reservoir is operated by:
 a. manually pressing the fluid reservoir, or   b. by a pump pumping fluid or air from the reservoir to the chamber of the body.   
     
     
         61 . The apparatus according to  claim 53 , wherein the apparatus comprises at least one of:
 a. a hydraulically regulated device comprising a mechanical stretching device adapted to be regulated by the hydraulic distribution of fluid or air, and   b. a mechanically regulated stretching device, or   c. a mechanically regulated stretching device comprising a motor for mechanically regulating the stretching device.   
     
     
         62 . The apparatus according to  claim 55 , wherein the stomach-to-stomach sutures or staples are provided with fixation portions exhibiting a structure adapted to be in contact with the stomach wall to promote growth in of human tissue to secure long term placement of the volume filling device attached to the stomach wall. 
     
     
         63 . The apparatus according to  claim 53 , wherein the stretching device is integrated in the volume filling device. 
     
     
         64 . The apparatus according to  claim 53 , wherein the apparatus further comprises at least one of: a wireless energy transmitter for non-invasively energizing the apparatus with wireless energy, and an implantable internal energy source. 
     
     
         65 . The apparatus according to  claim 53 , wherein the apparatus further comprises at least one of:
 a. a sensor adapted to be implanted in the patient's body and adapted to sense at least one of: the food intake of the patient, a physical parameter of the patient, and a functional parameter of the apparatus, and   b. an internal control unit adapted to control the apparatus in response to an implantable sensor sensing at least one of: the food intake of the patient, a physical parameter of the patient, and a functional parameter of the apparatus.   
     
     
         66 . The apparatus according to  claim 53 , wherein the apparatus further comprises a sensor adapted to sense a parameter selected from a group consisting of: contraction and relaxation of the Cardia or esophagus, esophagus movement, esophagus bending, esophagus motility, esophagus stretching, esophagus pressure, food passing esophagus, food in the stomach, neural activity, vagus activity, muscle activity, hormonal activity, stomach motility, stomach stretching, stomach pressure, stomach bending, stomach filling, and acidity in the stomach, capacitance, resistance, volt, ampere, light absorption or visualization, ultrasound reflection or absorption, bending metal, bimetal and PH. 
     
     
         67 . The apparatus according to  claim 53 , wherein the apparatus comprises at least one of:
 a. at least one layer comprising a material selected from a group consisting of: metal, silicon, PTFE, Polyurethane, Teflon®, or a combination of any of metal, silicon, PTFE, Polyurethane and Teflon; and   b. at least one coating, comprising a coating selected from a group consisting of: Parylene coating, Polytetrafluoroethylene coating, Polyurethane coating, and Multi-layer coating.   
     
     
         68 . The apparatus according to  claim 53 , wherein the stretching device is adapted to have the ability to change shape and/or size substantially without the presence of fibrotic tissue substantially hindering or impeding the function of the stretching device. 
     
     
         69 . The apparatus according to  claim 53 , wherein the volume filling device is adapted to be at least substantially invaginated by a stomach wall portion of the patient and having an outer surface adapted to rest against the stomach wall, such that the volume of the food cavity is reduced in size by a volume substantially exceeding the volume of the volume filling device.