|Publication number||US20050080431 A1|
|Application number||US 11/001,812|
|Publication date||Apr 14, 2005|
|Filing date||Nov 30, 2004|
|Priority date||Dec 2, 2002|
|Also published as||EP2382948A1, US7025791, US7267694, US7329285, US7347875, US7758535, US7935073, US8870806, US20040107004, US20050075622, US20050080395, US20050080491, US20080097466, US20080103604, US20110245752, US20150112241|
|Publication number||001812, 11001812, US 2005/0080431 A1, US 2005/080431 A1, US 20050080431 A1, US 20050080431A1, US 2005080431 A1, US 2005080431A1, US-A1-20050080431, US-A1-2005080431, US2005/0080431A1, US2005/080431A1, US20050080431 A1, US20050080431A1, US2005080431 A1, US2005080431A1|
|Inventors||Andy Levine, Dave Melanson, John Meade|
|Original Assignee||Gi Dynamics, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (99), Referenced by (63), Classifications (41)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application is a divisional of U.S. application Ser. No. 10/339,786, filed on Jan. 9, 2003 which claims the benefit of U.S. Provisional Application No. 60/430,321, filed Dec. 2, 2002. The entire teachings of the above applications are incorporated herein by reference.
According to the Center for Disease Control (CDC), over sixty percent of the United States population is overweight, and almost twenty percent are obese. This translates into 38.8 million adults in the United States with a Body Mass Index (BMI) of 30 or above. The BMI is defined as a person's weight (in kilograms) divided by height (in meters), squared. To be considered clinically, morbidly obese, one must meet one of three criteria: BMI over 35, 100 lbs. overweight or 100% above ideal body weight. There is also a category for the super-obese for those weighing over 350 lbs.
Obesity is an overwhelming health problem. Because of the enormous strain associated with carrying this excess weight, organs are affected, as are the nervous and circulatory systems. In 2000, the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) estimated that there were 280,000 deaths directly related to obesity. The NIDDK further estimated that the direct cost of healthcare in the US associated with obesity is $51 billion. In addition, Americans spend $33 billion per year on weight loss products. In spite of this economic cost and consumer commitment, the prevalence of obesity continues to rise at alarming rates. From 1991 to 2000, obesity in the US grew by 61%. Not exclusively a US problem, worldwide obesity ranges are also increasing dramatically.
One of the principle costs to the healthcare system stems from the co-morbidities associated with obesity. Type-2 diabetes has climbed to 7.3% of the population. Of those persons with Type-2 diabetes, almost half are clinically obese, and two thirds are approaching obese. Other co-morbidities include hypertension, coronary artery disease, hypercholesteremia, sleep apnea and pulmonary hypertension.
Although the physiology and psychology of obesity are complex, the medical consensus is that the cause is quite simple—an over intake of calories combined with a reduction in energy expenditures seen in modern society. While the treatment seems quite intuitive, the institution of a cure is a complex issue that has so far vexed the best efforts of medical science. Dieting is not an adequate long-term solution for most people. Once an individual has slipped past the BMI of 30, significant changes in lifestyle are the only solution.
There have been many attempts in the past to surgically modify patients' anatomies to attack the consumption problem by reducing the desire to eat. Stomach saplings, or gastroplasties, to reduce the volumetric size of the stomach, therein achieving faster satiety, were performed in the 1980's and early 1990's. Although able to achieve early weight loss, sustained reduction was not obtained. The reasons are not all known, but are believed related to several factors. One of which is that the stomach stretches over time increasing volume while psychological drivers motivate patients to find creative approaches to literally eat around the smaller pouch.
There are currently two surgical procedures that successfully produce long-term weight loss; the Roux-en-Y gastric bypass and the biliopancreatic diversion with duodenal switch (BPD). Both procedures reduce the size of the stomach plus shorten the effective-length of intestine available for nutrient absorption. Reduction of the stomach size reduces stomach capacity and the ability of the patient to take in food. Bypassing the duodenum makes it more difficult to digest fats, high sugar and carbohydrate rich foods. One objective of the surgery is to provide feedback to the patient by producing a dumping syndrome if they do eat these food products. Dumping occurs when carbohydrates directly enter the jejunum without being first conditioned in the duodenum. The result is that a large quantity of fluid is discharged into the food from the intestinal lining. The total effect makes the patient feel light-headed and results in severe diarrhea. For reasons that have not been determined the procedure also has an immediate therapeutic effect on diabetes.
Although the physiology seems simple, the exact mechanism of action in these procedures is not understood. Current theory is that negative feedback is provided from both regurgitation into the esophagus and dumping when large volumes of the wrong foods are eaten. Eventually, patients learn that to avoid both these issues they must be compliant with the dietary restrictions imposed by their modified anatomy. In the BPD procedure, large lengths of jejunum are bypassed resulting in malabsorption and therefore, reduced caloric uptake. In fact, the stomach is not reduced in size as much in the BPD procedure so that the patient is able to consume sufficient quantities of food to compensate for the reduced absorption. This procedure is reserved for the most morbidly obese as there are several serious side effects of prolonged malabsorption.
Unfortunately, these procedures carry a heavy toll. The morbidity rate for surgical procedures is alarmingly high with 11% requiring surgical intervention for correction. Early small bowel obstruction occurs at a rate of between 2-6% in these surgeries and mortality rates are reported to be approximately 0.5-1.5%. While surgery seems to be an effective answer, the current invasive procedures are not acceptable with these complication rates. Laparoscopic techniques applied to these surgeries provide fewer surgical complications but continue to expose these very ill patients to high operative risk in addition to requiring an enormous level of skill by the surgeon. Devices to reduce absorption in the small intestines have been proposed (See U.S. Pat. No. 5,820,584 (Crabb), U.S. Pat. No. 5,306,300 (Berry) and U.S. Pat. No. 4,315,509 (Smit)). However, these devices have not been successfully implemented.
A gastrointestinal implant device includes a flexible sleeve and a sleeve anchor, which may be a stent including a network of struts, coupled to a proximal portion of the sleeve. The flexible sleeve is open at both ends, and adapted to extend into the duodenum to limit absorption of nutrients in the duodenum. The sleeve anchor is adapted to be retained within the digestive system. For example, the device may be anchored distal to the pylorus, leaving the pylorus to function normally, or a stent may be retained within the pyloric orifice to hold the pylorus open.
A removal device is adapted for removing a gastrointestinal implant device from a patient's body. The removal device can include an outer sheath adapted to store a proximal portion of the gastrointestinal implant device, an inner sheath within the outer sheath, and a number of fingers extending from the distal end of the inner sheath.
The removal device is adapted to remove a gastrointestinal implant device anchored within the digestive system. For example, prior to removal, the gastrointestinal implant device may be anchored in the stomach, or distal to the pylorus leaving the pylorus to function normally. Alternatively or in addition prior to removal, the implant device may be anchored within the pyloric orifice to hold the pylorus open.
In operation, the fingers collapse the proximal end of the gastrointestinal implant device, allow the proximal end of the device to be drawn into the outer sheath. For example, the fingers can collapse the implant device by engaging the stent and pulling radially inward on the proximal end of the implant device. The fingers can pull radially inward by moving the inner sheath over the fingers.
The foregoing and other objects, features and advantages of the invention will be apparent from the following more particular description of preferred embodiments of the invention, as illustrated in the accompanying drawings in which like reference characters refer to the same parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention.
A description of preferred embodiments of the invention follows.
The duodenum has four sections: superior, descending, transverse and ascending which typically form a U-shape. The superior section is about two inches long and ends at the neck of the gall bladder. The descending section is about three to four inches long and includes a nipple shaped structure (papilla of vater) 114 through which pancreatic juice from the pancreas and bile produced by the liver and stored by the gall bladder enter the duodenum from the pancreatic duct. The pancreatic juice contains enzymes essential to protein digestion and bile dissolves the products of fat digestion. The ascending section is about two inches long and forms the duodenal-jejunal flexure 116 where it joins the jejunum 106, the next section of the small intestine. The duodenal-jejunal flexure 116 is fixed to the ligament of Treitz 118 (musculus supensionus duodeni). The juices secreted in the duodenum break the partially digested food down into particles small enough to be absorbed by the body. The digestive system is described in Gray's Anatomy (“Anatomy of the Human Body”, by Henry Gray) and “Human Physiology”, Vander, 3rd ed, McGraw Hill, 1980, the contents of which are incorporated herein by reference in their entirety.
Within the implant device 200 at the proximal end including the first proximal opening 204 is a collapsible self-expanding stent 208. The stent 208 includes a plurality of opposed barbs 210 for anchoring the implant device 200 to the muscular pylorus in the stomach 102. The diameter of the stent 208 is dependent on the diameter of the pyloric orifice 108 (
The sleeve material is thin and conformable so that it collapses in the intestine to a small volume to minimize bowel irritability. It has a low coefficient of friction (<0.20) so that chyme slides easily through it and the bowel slides easily around it. It is of low permeability to fluids so that the chyme does not touch the bowel wall and the digestive enzymes do not significantly breakdown the chyme. It is biologically inert and non-irritating to the tissues. One such material is expanded polytetrafluoroethylene (ePTFE), a fluoropolymer, with a wall thickness of about 0.006″ and an internodal distance of 20 microns. This material is hydrophobic but is slightly porous. However, these very small pores may plug over time. The porosity may be reduced by coating the material on the inside, outside or in the pores with dilute solutions of silicone or polyurethane. Another material is polyethylene with a wall thickness of less than 0.001″. Rubber-like materials typically have friction coefficients of 1-4, significantly stickier than these materials. However, in alternate embodiments other materials having similar characteristics can be used.
The sleeve 202 includes two layers of material at least at the proximal end. A first outer layer covers the exterior of the stent. The second inner layer covers the interior surface of the stent 208. The barbs 210 protrude from the exterior surface of the stent 208 through the first outer layer of the sleeve 208. The holes in the first outer layer through which the barbs 210 protrude are filled with an impervious material such as silicone or urethane to limit mixing of digestive juices with the chyme flowing through the passageway. The diameter of the sleeve 208 is selected such that the first outer layer of the sleeve 208 fits over the stent 208.
The sleeve length 212 ranges from about one foot to about five feet. The typical length of the sleeve 208 is about 1.5 feet from the anchor (barbs 210) in the pyloric region of the stomach to below the ligament of Treitz 118 (
The covered stent 208 can be collapsed into a sheath having a diameter less than ¼ inch to enable endoscopic delivery. Covering the exterior surface of the stent 208 with the first outer layer of the sleeve 202 permits endoscopic removal of the implant device 200 by preventing tissue in-growth on the exterior surface of the stent 208.
Markings can be added to the exterior surface of the sleeve 202 to detect the position and orientation of the sleeve on a fluoroscopic image and whether the sleeve is twisted. For example, a stripe can be painted down the length of the device 200 using tantalum impregnated ink, or tantalum bands can be bonded to the exterior surface of the device. If the sleeve 202 is twisted, the sleeve 202 can be untwisted by inserting a balloon into the proximal end of the device thereby sealing it, and then injecting water into the sleeve at low pressure.
The sleeve 202 extends over the ligament of Treitz 118 beyond the proximal jejunum. Extending the sleeve below the ligament of Treitz reduces the likelihood that the sleeve will move back through the duodenum 104 toward the stomach 102.
After the gastrointestinal implant device 200 has been placed in the body and anchored in either the pyloric portion of the stomach or distal to the pylorus 108, chyme leaving the stomach passes through passageway 304 (
The pyloric valve opens periodically to allow chyme to exit the stomach 102 to the duodenum 104. In one embodiment of the invention the length of the stent 208 is selected to keep the pyloric valve permanently open to induce “dumping syndrome.” By keeping the pylorus 108 open, the chyme empties rapidly into the sleeve 202 and passes down through the sleeve 202 and into the jejunum 106 with minimal digestion. This results in a “dumping syndrome” which is a reaction to excessive rapid dumping of chyme into the jejunum 106 causing the patient to feel ill, dizzy and nauseated. This syndrome is particularly enhanced when sugars and carbohydrates are eaten and passed directly into the jejunum 106.
To hold the pyloric valve open, the length of the stent 208 should be at least 1.5 inches so that the stent 208 extends from the anchoring position in the pyloric portion of the stomach through the pyloric orifice 108 (the opening from the stomach while the pyloric valve is open). The length of the stent is selected so that the distal end of the stent is above the papilla of vater 114 (
The sleeve 202 provides weight loss mechanisms by providing negative feedback, reduced fat digestion and reduced desire for food. The reduced fat digestion occurs because the sleeve 202 delays the mixing of bile and pancreatic juices with chyme from the stomach until after the chyme leaves the sleeve. The reduced desire for food may occur because the sleeve 202 blocks hormonal release from the duodenum.
After the chyme from the stomach has passed through the sleeve, the sleeve becomes extremely thin and floppy, permitting the sleeve to contour to the inner walls of the intestine. The sleeve is non-compliant and drapes away from the intestinal walls thereby permitting the pancreatic juice to flow unimpeded into the duodenum through the papilla of vater. The normal peristalsis of the bowel is used to propel the chyme through the intestines.
In the embodiment shown, the stent has a length L of about 1.5 inches and has a diameter D of about 1 inch. The struts 602 are flat, about 0.010 inches wide and about 0.004 to 0.010 inches thick. The stent can be formed from a tube of material by laser cutting followed by expansion and heat setting, or other methods well known to those skilled in the art.
In an alternate embodiment, the struts 602 can be formed separately and the strut intersections can be welded or attached by other means well known to those skilled in the art. Visually the struts form sections 604 around the circumference of the stent. Each section has a series of triangles with each triangle defined by one distal strut connection 606 and two proximal strut connections 608, 610. The ratio of the collapsed diameter to the expanded diameter of the stent is roughly 1:4.
When expanded, the angle a between divergent strut sections is about 45-50 degrees and the diameter of the stent is about one inch. When compressed, the angle β between divergent strut sections is about 5-6 degrees to reduce the diameter of the stent to about 0.21 inch for endoscopic delivery and removal. The elasticity of the struts permits this compression. When the radial compression is released, the elasticity of the struts causes the stent to expand to diameter D. The stent assumes its desired diameter as the elastic restoring forces seek their minimum stress.
The ends of the struts at the proximal end of the stent 600 are elongated and shaped to provide barbs 612 to anchor to the muscle in the pyloric portion of the stomach 102.
The length of the sleeve 202 can be sized to just pass over the ligament of Treitz thereby bypassing only the duodenum and proximal jejunum 106. By doing this, it may not be necessary to provide any anti-buckling mechanisms in the sleeve 202 since the duodenum 104 is not very mobile compared to the jejunum 106. Typically, an anti-buckling mechanism 1102 is added to the exterior surface of a sleeve 202 having a length exceeding the length of the duodenum 104 and proximal jejunum 106.
The gastrointestinal implant device 200 is designed for endoscopic placement.
The catheter system 1200 includes an outer sheath 1202 for storing the stent 208 in collapsed form, a flange 1216 to pull back the outer sheath 1202 and a sleeve retention wire mechanism 1214 for releasing a sleeve retention wire 1210 from the proximal end of the flexible sleeve 202 after the stent has been released from the outer sheath 1202.
As described in conjunction with
The sleeve 202 is secured temporarily outside the inner sheath 1226 allowing for proper positioning of the gastrointestinal implant device and then for release. As shown, the sleeve 202 is secured by the sleeve retention wire 1210 using a dead-bolt mechanism 1206. Non-stick coatings such as Teflon on the sleeve retention wire 1210 are preferred to make release easier to accommodate tortuous anatomical pathways. The sleeve retention wire 1210 extends through the second inner lumen from the release mechanism 1214 of the catheter system 1200 to the dead-bolt mechanism 1206. The dead-bolt mechanism 1206 is described later in conjunction with
As described in conjunction with
FIGS. 16A-C illustrate a method for delivery of the gastrointestinal implant device.
Once in place, the sleeve retention wire 1210 can be removed. As described previously in conjunction with
The anchoring ring 2204 does not hold the pylorus open. However, in an alternate embodiment, the anchoring ring 2204 can be bonded to a stent with sufficient length and diameter to hold the pylorus open as described in conjunction with
FIGS. 26A-E illustrate an alternative embodiment of a locking mechanism for holding the distal end of the sleeve 202 in position during delivery of the gastrointestinal implant device. A snare wire 2656 is passed through one of the lumens of a catheter 2650 to the distal end. At the distal end, the end of the snare wire 2650 is looped back and attached to or anchored inside the catheter 2650. The folds of the sleeve 202 are advanced through this snare loop. The snare handle 2664 pulls and releases the snare wire 2656 to lock and release the distal end of the sleeve 202. The delivery system includes a pull tap 2666 for releasing a drawstring holding the stent in a collapsed position.
The gastrointestinal implant device offers a new alternative where other means of weight loss and efforts at behavior modification have failed. Because the gastrointestinal implant device is endoscopically introduced, there is a reduced risk at insertion compared to surgery. The procedure is also completely reversible, making this approach the ideal solution for patients who are desperate to reverse behavioral patterns that have lead to weight gain.
When inserted in the body, the gastrointestinal implant device mimics the duodenal bypass of the Roux-en-Y procedure. The implanted device reduces caloric absorption by delaying enzyme mixing with food and provides the feedback produced by the Roux-en-Y procedure by producing dumping syndrome when high sugar meals are ingested. Rapid stomach emptying is encouraged by inserting a stent in the pylorus to hold the pylorus open and all food bypasses the duodenum and passes rapidly into the jejunum. The implant device is an improvement on the Roux-en-Y procedure because it is minimally invasive and reversible. In the treatment of the super-obese where aggressive weight loss is not achieved, the length of the implant device below the stent can be further increased to drive the patient close to the point of malabsorption.
The gastrointestinal implant device can be used to reduce Type 2 diabetes symptoms by bypassing the duodenum. Following gastric bypass surgery, patients commonly experience complete reversal of Type 2 diabetes. While the exact mechanism of this remarkable effect is not understood, the clinical result is reported in a high percentage of cases. Reversal of Type 2 diabetes after gastric bypass is described in “Potential of Surgery for Curing Type 2 Diabetes Mellitus” by Rubino et al. incorporated herein by reference in its entirety. Since the gastrointestinal implant device provides equivalent blockage of duodenal processes, a similar effect is elicited but without the trauma of surgery. In patients who are not obese but suffer Type 2 diabetes, a modified gastrointestinal implant device is inserted. This gastrointestinal implant device provides the necessary effect to hinder pancreatic processes and receptors without blocking absorption.
In the embodiment of the gastrointestinal implant device for treating diabetes, the length of the stent is selected to allow the pylorus to operate normally. The length of the sleeve is also reduced to mimic the duodenum bypass. The sleeve extends to just below the ligament of Treitz but does not extend further into the jejunum, thus allowing absorption to occur in the jejunum.
While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US1263708 *||Mar 2, 1917||Apr 23, 1918||Norton Co||PRODUCT CONTAINING β-ALUMINA AND PROCESS OF PREPARING THE SAME.|
|US1899781 *||Apr 27, 1932||Feb 28, 1933||Twiss John Russell||Stomach tube or the like|
|US2464933 *||Sep 28, 1946||Mar 22, 1949||Kaslow Arthur L||Gastrointestinal tube|
|US3708296 *||Aug 20, 1968||Jan 2, 1973||American Can Co||Photopolymerization of epoxy monomers|
|US3709866 *||Jun 1, 1970||Jan 9, 1973||Dentsply Int Inc||Photopolymerizable dental products|
|US3714059 *||Mar 10, 1971||Jan 30, 1973||American Optical Corp||Neodymium glass laser having room temperature output at wavelengths shorter than 1060 nm|
|US3717583 *||Mar 10, 1971||Feb 20, 1973||American Optical Corp||Neodymium glass laser having room temperature output at wavelengths shorter than 1060 nm.|
|US3860556 *||Nov 1, 1971||Jan 14, 1975||Minnesota Mining & Mfg||Low water absorption dental restorative|
|US4002669 *||Jan 27, 1975||Jan 11, 1977||Kulzer & Co. Gmbh||Hydroxy group containing diesters of acrylic acid|
|US4069055 *||Dec 9, 1975||Jan 17, 1978||General Electric Company||Photocurable epoxy compositions containing group Va onium salts|
|US4071424 *||Feb 11, 1975||Jan 31, 1978||Imperial Chemical Industries Limited||Photopolymerizable composition|
|US4133315 *||Dec 27, 1976||Jan 9, 1979||Berman Edward J||Method and apparatus for reducing obesity|
|US4134405 *||Jan 10, 1977||Jan 16, 1979||Smit Julie A||Catheter and intestine tube and method of using the same|
|US4182437 *||May 8, 1978||Jan 8, 1980||Ferro Corporation||Unstable devitrifiable glasses and friction materials containing them|
|US4250311 *||Apr 7, 1980||Feb 10, 1981||General Electric Company||P, As, and Sb hexafluoride onium salts as photoinitiators|
|US4259117 *||Aug 25, 1978||Mar 31, 1981||Kuraray Co., Ltd.||Dental filling material|
|US4315509 *||Oct 16, 1978||Feb 16, 1982||Smit Julie A||Insertion and removal catheters and intestinal tubes for restricting absorption|
|US4327014 *||Apr 9, 1980||Apr 27, 1982||Kanebo Ltd.||Resin-forming material, implant material and compositions for restorative material suitable for medical or dental use|
|US4379695 *||May 27, 1981||Apr 12, 1983||Scientific Pharmaceuticals, Inc.||Dental material comprising dimethyacrylate adducts of glycidyl methacrylate with diesters of bis(hydroxymethyl) tricyclo[5.2.1.02,6 ]decane and dicarboxylic acids|
|US4501264 *||Dec 16, 1980||Feb 26, 1985||Rockey Arthur G||Medical sleeve|
|US4503169 *||Apr 19, 1984||Mar 5, 1985||Minnesota Mining And Manufacturing Company||Radiopaque, low visual opacity dental composites containing non-vitreous microparticles|
|US4580568 *||Oct 1, 1984||Apr 8, 1986||Cook, Incorporated||Percutaneous endovascular stent and method for insertion thereof|
|US4641653 *||Feb 19, 1985||Feb 10, 1987||Rockey Arthur G||Medical sleeve|
|US4642126 *||Feb 11, 1985||Feb 10, 1987||Norton Company||Coated abrasives with rapidly curable adhesives and controllable curvature|
|US4648383 *||Jul 22, 1985||Mar 10, 1987||Angelchik Jean P||Peroral apparatus for morbid obesity treatment|
|US4652274 *||Aug 7, 1985||Mar 24, 1987||Minnesota Mining And Manufacturing Company||Coated abrasive product having radiation curable binder|
|US4737593 *||Nov 25, 1985||Apr 12, 1988||Fabrik Pharmazeutischer Praparate||Bisacylphosphine oxides, the preparation and use thereof|
|US4820666 *||Mar 21, 1986||Apr 11, 1989||Noritake Co., Limited||Zirconia base ceramics|
|US4823808 *||Jul 6, 1987||Apr 25, 1989||Clegg Charles T||Method for control of obesity, overweight and eating disorders|
|US4905693 *||Nov 16, 1988||Mar 6, 1990||Biagio Ravo||Surgical method for using an intraintestinal bypass graft|
|US4913141 *||Oct 25, 1988||Apr 3, 1990||Cordis Corporation||Apparatus and method for placement of a stent within a subject vessel|
|US4985340 *||Jun 1, 1988||Jan 15, 1991||Minnesota Mining And Manufacturing Company||Energy curable compositions: two component curing agents|
|US5084586 *||Feb 12, 1990||Jan 28, 1992||Minnesota Mining And Manufacturing Company||Novel initiators for cationic polymerization|
|US5089536 *||Nov 22, 1982||Feb 18, 1992||Minnesota Mining And Manufacturing Company||Energy polmerizable compositions containing organometallic initiators|
|US5104399 *||Mar 9, 1988||Apr 14, 1992||Endovascular Technologies, Inc.||Artificial graft and implantation method|
|US5185299 *||Jul 9, 1990||Feb 9, 1993||Minnesota Mining And Manufacturing Company||Microcrystalline alumina-based ceramic articles|
|US5279553 *||Apr 2, 1992||Jan 18, 1994||Martin J. Winkler||Transpyloric jejunostomy cannulating system|
|US5282824 *||Jun 15, 1992||Feb 1, 1994||Cook, Incorporated||Percutaneous stent assembly|
|US5290294 *||Feb 14, 1992||Mar 1, 1994||Brian Cox||Method and apparatus for removal of a foreign body cavity|
|US5306300 *||Sep 22, 1992||Apr 26, 1994||Berry H Lee||Tubular digestive screen|
|US5387235 *||Oct 21, 1992||Feb 7, 1995||Cook Incorporated||Expandable transluminal graft prosthesis for repair of aneurysm|
|US5401241 *||May 7, 1992||Mar 28, 1995||Inamed Development Co.||Duodenal intubation catheter|
|US5405378 *||May 20, 1992||Apr 11, 1995||Strecker; Ernst P.||Device with a prosthesis implantable in the body of a patient|
|US5480423 *||May 20, 1993||Jan 2, 1996||Boston Scientific Corporation||Prosthesis delivery|
|US5498269 *||May 26, 1995||Mar 12, 1996||Minnesota Mining And Manufacturing Company||Abrasive grain having rare earth oxide therein|
|US5507767 *||Jan 15, 1992||Apr 16, 1996||Cook Incorporated||Spiral stent|
|US5507771 *||Apr 24, 1995||Apr 16, 1996||Cook Incorporated||Stent assembly|
|US5605870 *||May 19, 1994||Feb 25, 1997||Martinex Science, Inc.||Ceramic fibers, and methods, machines and compositions of matter for making same|
|US5611787 *||Oct 13, 1994||Mar 18, 1997||Methodist Hospital Of Indiana, Inc.||Method and device for gastric line insertion|
|US5624430 *||Nov 28, 1994||Apr 29, 1997||Eton; Darwin||Magnetic device to assist transcorporeal guidewire placement|
|US5713948 *||Jul 19, 1995||Feb 3, 1998||Uflacker; Renan||Adjustable and retrievable graft and graft delivery system for stent-graft system|
|US5715832 *||Feb 28, 1995||Feb 10, 1998||Boston Scientific Corporation||Deflectable biopsy catheter|
|US5720776 *||Jun 7, 1995||Feb 24, 1998||Cook Incorporated||Barb and expandable transluminal graft prosthesis for repair of aneurysm|
|US5733325 *||May 6, 1996||Mar 31, 1998||C. R. Bard, Inc.||Non-migrating vascular prosthesis and minimally invasive placement system|
|US5855601 *||Jun 21, 1996||Jan 5, 1999||The Trustees Of Columbia University In The City Of New York||Artificial heart valve and method and device for implanting the same|
|US5856373 *||Oct 3, 1997||Jan 5, 1999||Minnesota Mining And Manufacturing Company||Dental visible light curable epoxy system with enhanced depth of cure|
|US5876445 *||Nov 26, 1996||Mar 2, 1999||Boston Scientific Corporation||Medical stents for body lumens exhibiting peristaltic motion|
|US5895391 *||Sep 27, 1996||Apr 20, 1999||Target Therapeutics, Inc.||Ball lock joint and introducer for vaso-occlusive member|
|US6020528 *||Feb 26, 1997||Feb 1, 2000||Ciba Specialty Chemicals Corporation||Alkylphenylbisacylphosphine oxides and photoinitiator mixtures|
|US6025406 *||Apr 11, 1997||Feb 15, 2000||3M Innovative Properties Company||Ternary photoinitiator system for curing of epoxy resins|
|US6027508 *||Oct 3, 1996||Feb 22, 2000||Scimed Life Systems, Inc.||Stent retrieval device|
|US6187016 *||Sep 14, 1999||Feb 13, 2001||Daniel G. Hedges||Stent retrieval device|
|US6200336 *||Jun 2, 1999||Mar 13, 2001||Cook Incorporated||Multiple-sided intraluminal medical device|
|US6342458 *||Aug 23, 1999||Jan 29, 2002||Ivoclar Ag||Lithium disilicate glass ceramics dental product|
|US6356782 *||Apr 2, 1999||Mar 12, 2002||Vivant Medical, Inc.||Subcutaneous cavity marking device and method|
|US6362119 *||May 31, 2000||Mar 26, 2002||Asahi Glass Company, Limited||Barium borosilicate glass and glass ceramic composition|
|US6508833 *||Mar 12, 2001||Jan 21, 2003||Cook Incorporated||Multiple-sided intraluminal medical device|
|US6524335 *||Dec 9, 1998||Feb 25, 2003||William A. Cook Australia Pty. Ltd.||Endoluminal aortic stents|
|US6524336 *||Apr 6, 1999||Feb 25, 2003||Cook Incorporated||Endovascular graft|
|US6530951 *||Oct 23, 1997||Mar 11, 2003||Cook Incorporated||Silver implantable medical device|
|US6537247 *||Jun 4, 2001||Mar 25, 2003||Donald T. Shannon||Shrouded strain relief medical balloon device and method of use|
|US6540789 *||Nov 10, 2000||Apr 1, 2003||Scimed Life Systems, Inc.||Method for treating morbid obesity|
|US6675809 *||Aug 27, 2001||Jan 13, 2004||Richard S. Stack||Satiation devices and methods|
|US6676692 *||Apr 27, 2001||Jan 13, 2004||Intek Technology L.L.C.||Apparatus for delivering, repositioning and/or retrieving self-expanding stents|
|US6695875 *||Mar 14, 2001||Feb 24, 2004||Cook Incorporated||Endovascular stent graft|
|US6699263 *||Apr 5, 2002||Mar 2, 2004||Cook Incorporated||Sliding suture anchor|
|US6706083 *||Nov 2, 2000||Mar 16, 2004||3M Innovative Properties Company||Fused—Al2O3-MgO-Y2O3 eutectic abrasive particles, abrasive articles, and methods of making and using the same|
|US6845776 *||Apr 8, 2002||Jan 25, 2005||Richard S. Stack||Satiation devices and methods|
|US7175660 *||Aug 29, 2003||Feb 13, 2007||Mitralsolutions, Inc.||Apparatus for implanting surgical devices for controlling the internal circumference of an anatomic orifice or lumen|
|US20020022853 *||Sep 17, 2001||Feb 21, 2002||St. Jude Medical Cardiovascular Group, Inc.||Medical anastomosis apparatus|
|US20020032487 *||Jun 7, 2001||Mar 14, 2002||Wilson-Cook Medical Incorporated||Prosthesis having a sleeve valve|
|US20030032941 *||Aug 13, 2001||Feb 13, 2003||Boyle William J.||Convertible delivery systems for medical devices|
|US20030040804 *||Aug 27, 2001||Feb 27, 2003||Stack Richard S.||Satiation devices and methods|
|US20030040808 *||Apr 8, 2002||Feb 27, 2003||Stack Richard S.||Satiation devices and methods|
|US20030050684 *||Sep 10, 2001||Mar 13, 2003||Abrams Robert M.||Internal restraint for delivery of self-expanding stents|
|US20040020245 *||Aug 2, 2002||Feb 5, 2004||Rosenflanz Anatoly Z.||Method of making amorphous and ceramics via melt spinning|
|US20040023078 *||Aug 2, 2002||Feb 5, 2004||Rosenflanz Anatoly Z.||Plasma spraying|
|US20040024386 *||Mar 27, 2003||Feb 5, 2004||Deem Mark E.||Obesity treatment tools and methods|
|US20040044357 *||Aug 30, 2002||Mar 4, 2004||James Gannoe||Stented anchoring of gastric space-occupying devices|
|US20040082963 *||Oct 23, 2002||Apr 29, 2004||Jamy Gannoe||Method and device for use in endoscopic organ procedures|
|US20050004681 *||Jul 16, 2004||Jan 6, 2005||Stack Richard S.||Satiation devices and methods|
|US20050043601 *||Oct 16, 2003||Feb 24, 2005||Endonetics, Inc.||Implantable monitoring probe|
|US20050043817 *||Aug 20, 2003||Feb 24, 2005||Mckenna Robert Hugh||Method and apparatus to facilitate nutritional malabsorption|
|US20050049718 *||Jul 30, 2004||Mar 3, 2005||Valentx, Inc.||Gastrointestinal sleeve device and methods for treatment of morbid obesity|
|US20050055039 *||Aug 9, 2004||Mar 10, 2005||Polymorfix, Inc.||Devices and methods for pyloric anchoring|
|US20050075622 *||Nov 30, 2004||Apr 7, 2005||Gi Dynamics, Inc.||Bariatric sleeve|
|US20050080395 *||Nov 30, 2004||Apr 14, 2005||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US20050080431 *||Nov 30, 2004||Apr 14, 2005||Gi Dynamics, Inc.||Bariatric sleeve removal devices|
|US20050080491 *||Nov 30, 2004||Apr 14, 2005||Gi Dynamics, Inc.||Bariatric sleeve delivery devices|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US7347875 *||Nov 30, 2004||Mar 25, 2008||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US7678068||Dec 13, 2005||Mar 16, 2010||Gi Dynamics, Inc.||Atraumatic delivery devices|
|US7682330||Mar 23, 2010||Gi Dynamics, Inc.||Intestinal sleeve|
|US7695446||Dec 13, 2005||Apr 13, 2010||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US7758535||Dec 11, 2007||Jul 20, 2010||Gi Dynamics, Inc.||Bariatric sleeve delivery devices|
|US7758589 *||May 3, 2005||Jul 20, 2010||Ethicon Endo-Surgery, Inc.||Surgical instrument for extracting an anastomotic ring device|
|US7766861||Oct 2, 2006||Aug 3, 2010||Gi Dynamics, Inc.||Anti-obesity devices|
|US7766973||Jun 8, 2005||Aug 3, 2010||Gi Dynamics, Inc.||Eversion resistant sleeves|
|US7771382||Jan 11, 2006||Aug 10, 2010||Gi Dynamics, Inc.||Resistive anti-obesity devices|
|US7794447||Jul 30, 2004||Sep 14, 2010||Valentx, Inc.||Gastrointestinal sleeve device and methods for treatment of morbid obesity|
|US7815589||Oct 19, 2010||Gi Dynamics, Inc.||Methods and apparatus for anchoring within the gastrointestinal tract|
|US7815591||Sep 16, 2005||Oct 19, 2010||Gi Dynamics, Inc.||Atraumatic gastrointestinal anchor|
|US7819836||Jul 12, 2007||Oct 26, 2010||Gi Dynamics, Inc.||Resistive anti-obesity devices|
|US7837643||Feb 14, 2005||Nov 23, 2010||Gi Dynamics, Inc.||Methods and devices for placing a gastrointestinal sleeve|
|US7846138||May 8, 2006||Dec 7, 2010||Valentx, Inc.||Cuff and sleeve system for gastrointestinal bypass|
|US7881797||Apr 25, 2007||Feb 1, 2011||Valentx, Inc.||Methods and devices for gastrointestinal stimulation|
|US7892214||May 9, 2006||Feb 22, 2011||Valentx, Inc.||Attachment system for transmural attachment at the gastroesophageal junction|
|US7931693||Nov 30, 2004||Apr 26, 2011||Endosphere, Inc.||Method and apparatus for reducing obesity|
|US7935073||Oct 29, 2007||May 3, 2011||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US8118774||Sep 25, 2007||Feb 21, 2012||Valentx, Inc.||Toposcopic access and delivery devices|
|US8137301||May 26, 2009||Mar 20, 2012||Gi Dynamics, Inc.||Bariatric sleeve|
|US8147561||Dec 15, 2005||Apr 3, 2012||Endosphere, Inc.||Methods and devices to curb appetite and/or reduce food intake|
|US8162871||Apr 24, 2012||Gi Dynamics, Inc.||Bariatric sleeve|
|US8303669||Nov 6, 2012||Gi Dynamics, Inc.||Methods and apparatus for anchoring within the gastrointestinal tract|
|US8454684 *||Aug 2, 2007||Jun 4, 2013||Medtronic, Inc.||Heart valve holder for use in valve implantation procedures|
|US8585771||May 25, 2007||Nov 19, 2013||Endosphere, Inc.||Methods and devices to curb appetite and/or to reduce food intake|
|US8597224||Mar 28, 2011||Dec 3, 2013||IBIS Medical, Inc.||Intragastric implant devices|
|US8603186||Mar 14, 2012||Dec 10, 2013||Endosphere, Inc.||Methods and devices to curb appetite and/or reduce food intake|
|US8623095||Apr 13, 2011||Jan 7, 2014||Endosphere, Inc.||Method and apparatus for reducing obesity|
|US8628583||Sep 14, 2012||Jan 14, 2014||Gi Dynamics, Inc.||Methods and apparatus for anchoring within the gastrointestinal tract|
|US8771219||Oct 4, 2011||Jul 8, 2014||Gi Dynamics, Inc.||Gastrointestinal implant with drawstring|
|US8808270||Sep 25, 2007||Aug 19, 2014||Valentx, Inc.||Methods for toposcopic sleeve delivery|
|US8821429||Sep 29, 2009||Sep 2, 2014||IBIS Medical, Inc.||Intragastric implant devices|
|US8828073 *||Jun 21, 2013||Sep 9, 2014||Paul Sherburne||Stent and other object removal from a body|
|US8828090||Aug 11, 2009||Sep 9, 2014||Binerix Medical Ltd.||Liner for tubular body portion and apparatus and methods for application thereof|
|US8834405||Jun 28, 2011||Sep 16, 2014||Gi Dynamics, Inc.||Intestinal sleeve|
|US8870806 *||May 2, 2011||Oct 28, 2014||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US8882798 *||Feb 13, 2012||Nov 11, 2014||Apollo Endosurgery, Inc.||Endoscopic tools for the removal of balloon-like intragastric devices|
|US9017358 *||Feb 26, 2014||Apr 28, 2015||Apollo Endosurgery, Inc.||Endoscopic tools for the removal of balloon-like intragastric devices|
|US9039649||May 31, 2012||May 26, 2015||Valentx, Inc.||Devices and methods for gastrointestinal bypass|
|US9044300||Apr 3, 2014||Jun 2, 2015||Metamodix, Inc.||Gastrointestinal prostheses|
|US9050168||May 31, 2012||Jun 9, 2015||Valentx, Inc.||Devices and methods for gastrointestinal bypass|
|US9060835||Jul 16, 2008||Jun 23, 2015||Endosphere, Inc.||Conformationally-stabilized intraluminal device for medical applications|
|US9060844||Oct 31, 2003||Jun 23, 2015||Valentx, Inc.||Apparatus and methods for treatment of morbid obesity|
|US9072861||Feb 15, 2013||Jul 7, 2015||Endosphere, Inc.||Methods and devices for delivering or delaying lipids within a duodenum|
|US9084669||Dec 10, 2013||Jul 21, 2015||Gi Dynamics, Inc.||Methods and apparatus for anchoring within the gastrointestinal tract|
|US9095416||Jun 3, 2014||Aug 4, 2015||Gi Dynamics, Inc.||Removal and repositioning devices|
|US20040220682 *||Mar 26, 2004||Nov 4, 2004||Gi Dynamics, Inc.||Anti-obesity devices|
|US20040249362 *||Mar 26, 2004||Dec 9, 2004||Gi Dynamics, Inc.||Enzyme sleeve|
|US20050075622 *||Nov 30, 2004||Apr 7, 2005||Gi Dynamics, Inc.||Bariatric sleeve|
|US20050080395 *||Nov 30, 2004||Apr 14, 2005||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US20050080431 *||Nov 30, 2004||Apr 14, 2005||Gi Dynamics, Inc.||Bariatric sleeve removal devices|
|US20050080491 *||Nov 30, 2004||Apr 14, 2005||Gi Dynamics, Inc.||Bariatric sleeve delivery devices|
|US20050125020 *||Jun 1, 2004||Jun 9, 2005||Gi Dynamics, Inc.||Methods and apparatus for anchoring within the gastrointestinal tract|
|US20060015125 *||May 6, 2005||Jan 19, 2006||Paul Swain||Devices and methods for gastric surgery|
|US20080071367 *||Aug 2, 2007||Mar 20, 2008||Bergin Cathleen A||Heart valve holder for use in valve implantation procedures|
|US20100305589 *||Aug 29, 2008||Dec 2, 2010||Cousin Biotech||textile implant, in particular for repairing hernias|
|US20100331949 *||Jan 11, 2008||Dec 30, 2010||Emcision Limited||Stents, devices for use with stents and methods relating thereto|
|US20110245752 *||Oct 6, 2011||Gi Dynamics, Inc.||Methods of treatment using a bariatric sleeve|
|US20130211440 *||Feb 13, 2012||Aug 15, 2013||Allergan, Inc.||Endoscopic tools for the removal of balloon-like intragastric devices|
|US20130289694 *||Jun 21, 2013||Oct 31, 2013||Paul Sherburne||Stent and other object removal from a body|
|US20140180327 *||Feb 26, 2014||Jun 26, 2014||Apollo Endosurgery, Inc.||Endoscopic Tools for the Removal of Balloon-Like Intragastric Devices|
|WO2013049167A1 *||Sep 26, 2012||Apr 4, 2013||IBIS Medical, Inc.||Intragastric implant devices|
|International Classification||A61B17/06, A61B17/04, A61F2/04, A61F2/00, A61F5/00|
|Cooperative Classification||A61F2220/0016, A61B2017/0084, A61B17/0482, A61F2/91, A61F2/95, A61F2002/8483, A61B2017/06052, A61F2002/075, A61F2/90, A61B2017/00867, A61F2002/9528, A61F2002/044, A61F2250/0039, A61F2/04, A61F5/0076, A61B17/1114, A61F5/0089, A61B2017/00238, A61B17/0469, A61F2002/8486, A61F2/848, A61B2017/0419, A61F2/07, A61F2002/045, A61B17/0401, A61B2017/061, A61F2210/0076|
|European Classification||A61F2/07, A61B17/11D, A61B17/04E, A61B17/04A, A61F5/00B8, A61B17/04G, A61F2/04, A61F5/00B6N|