|Publication number||US3411507 A|
|Publication date||Nov 19, 1968|
|Filing date||Apr 1, 1964|
|Priority date||Apr 1, 1964|
|Publication number||US 3411507 A, US 3411507A, US-A-3411507, US3411507 A, US3411507A|
|Inventors||Wingrove Robert C|
|Original Assignee||Medtronic Inc|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (3), Referenced by (205), Classifications (10)|
|External Links: USPTO, USPTO Assignment, Espacenet|
, R. c. WINGROVE METHOD OF GASTROINTESTINAL STIMULATION Nov. 19, 1968 WITH ELECTRICAL PULSES 2 Sheets-Sheet 1 Filed April 1, 1964 JNVENTOR. 02227 6'. h/uvakavz United States Patent 3,411,507 METHOD OF GASTROINTESTINAL STIMULATIO WITH ELECTRICAL PULSES Robert C. Wingrove, New Brighton, Minn., assignor to Medtronic, Inc., Minneapolis, Minn., a corporation of Minnesota Filed Apr. 1, 1964, Ser. No. 356,590 4 Claims. (Cl. 128-422) This invention has relation to a method for electrical pacing of the intestines as an effective means in the management of so-called paralytic ileus. The method of the present invention involves introducing a specific electrode nasogastrically into the stomach in proximity to or past the pyloric valve. An indifferent plate electrode is applied to the body of the patient at a convenient location such as the abdominal wall, and electrical impulses of predetermined duration and magnitude are applied between the electrodes. This causes peristaltic waves to be induced in the antrum; and these waves cross the pylorus and are carried down to the duodenum. Here these waves necessarily activate the duodenum which in turn, having a pacemaker area of its own, is thus stimulated and may control the rest of the intestinal tract. The observed result is that peristaltic activity is rapidly restored; passage of feces or flatus generally occur-ring four to sixteen hours after the electrical stimulation has been initiated.
Before the development of the method of the invention, a catheter was introduced into the stomach in proximity to or past the pylorus in order to perform normal post-operative gastic suction. When the method of the invention is used, this suction will generally be unnecessary and quite often oral administrations of fluids may begin immediately, thereby eliminating or at least substantially reducing the need for intravenous replacement of fluids and electrolytes normally lost by such suction. As gastrointestinal mobility can be induced and maintained by use of the invention and the swallowed gas or gas formed in the intestines are thus carried away by peristalsis, the need for the suction or delivery aspects of the cathether are greatly lessened.
However, a combination of nasogastric suction and electrical stimulation in accordance with the invention is sometimes desirable at the start of therapy in cases with a full-blown picture of ileus. For this reason, the electrode for stimulation at or near the pylorus is situated at or near the tip of an ordinary plastic nasogastric tube, and the electrical lead to that electrode extends out through the tube to position where the electrical stimulation is applied to it.
The problem Paralytic ileus is a form of intestinal obstruction characterized by inadequate peristaltic activity affecting the gastrointestinal system in its entirety or segmantally. Loss of normal peristaltic activity frequently occurs following intra-abdominal surgery, and secondary to a variety of pathological conditions such as peritonitis of various etiologies, retroperitoneal sepsis and hemorrhage, and from trauma, infections, or surgery in areas remote from the abdominal cavity. Spinal injuries, diseases of the genitourinary tract, and thoracic surgery or trauma are frequently observed causes of paresis of the bowel occurring as a reflex inhibition. Loss of effective peristaltic activity of the gastrointestinal tract rapidly leads to distention of bowel loops with fluid and gas which, if left untreated, is
prone to perpetuate itself as a vicious cycle, the more distention occurring the more paralyzed the bowel becomes. Fluid and electrolytes are lost into this third space and distention of the intestine further impairs obsorption. In addition, distended inactive loops may twist or kink and a mechanical obstruction thus may be superimposed.
Management of this condition heretofore has been 3,411,507 Patented Nov. 19, 1968 largely passive in nature and has not changed significantly since introduction of nasogastric intubation and suction with administration of intravenous fluids and electrolytes continued until the paretic bowel resumes its tonus and peristaltic activity. Hypertonic saline, multiple enemas, spinal anesthesia, repeated use of hot stupes to the abdomen, and bowel stimulants such as prostigimine, nestigmine, pitressin, and pantothenic acid have all been used with variable and inconsistent success.
Use of the method of the invention has been found effective to induce and maintain gastrointestinal activity when such paralytic ileus occurs. This early return of bowel activity has reduced the time interval required for intravenous administration of fluid and electrolytes and the period during which a catheter must be used has been shortened or eliminated except as the catheter is used as a means for placing the specific electrode of the invention. Oral intake by the patient is resumed sooner.
In the drawings,
FIG. 1 is an elevational view of the apparatus of the invention and a diagrammatic representation of its location when in use on a patient suffering from so-called paralytic ileus;
FIG. 2 is a fragmentary elevational view of the terminal end of a nasogastric catheter with parts in section and parts broken away showing the installation of a specific electrode of the invention and its electrical lead wire on the catheter;
FIG. 3 is a block diagram of one form of electrical circuitry for energizing the electrodes of the apparatus of the invention; and
FIG. 4 is a circuit diagram of one form of circuit useful in supplying the electrical energy to perform the method of the invention.
Referring now to the drawing and the numerals of reference thereon, a nasogastric catheter 10 is provided with the usual openings 11 which are useful in its normal use as a catheter. An electrical lead wire 12 extends through the catheter for a substantial portion of its length, leaving the catheter as at 13 to extend to a first terminal 14 of an electrical stimulator circuit indicated generally in FIG. 4 as 15, said circuit being encased in stimulator case 20.
The terminal end of the electrical lead wire 12 is soldered or fastened in some other suitable way to a cylindrical shaped specific electrode 21 as at 22, said wire extending through one of the openings 11 in the catheter 10.
As is clearly seen in FIG. 1, a nosagastric tube or catheter 10 is passed into the stomach transnasally and advanced to lie in the antral region. An indifferent electrode 23 is secured to the abdominal wall by means of surgical tape 24. In order to secure good electrical contact, it is advisable to use a small amount of electrode paste between the electrode 23 and the abdominal wall. An electrical lead wire 26 extends from this electrode 23 to a second terminal 27 of the electrical stimulator circuit 15.
If operative incisions, or dressings, or other obstructions do not permit the positioning of the indifferent electrode 23 as shown and described, this electrode may be applied to the flanks or to the dorsal abdominal wall.
With the apparatus in position as shown and described, an On-Off switch 30 will be turned on thus connecting a battery 31 to the timer circuit 32 and oscillator circuit 33. The area immediately adjacent the specific electrode 21 will then be stimulated as the electrical current passes from this specific electrode to the indifferent electrode. A discharge device or bulb 35 provides a visual indication of current flow and duration.
Operation of FIG. 4 is as follows. Closing switch 30 causes current to flow in the first timing network including resistor 40 and capacitor 41. Accumulation of charge on capacitor 41 forward biases the emitter-base junction of emitter follower transistor 42. However, no current flows through the collector-emitter circuit of transistor 42, current limiting resistor 43, Zener diode 44, and resistor 45 until the voltage rating, normally about four volts, of Zener diode 44 has been overcome. The values of timing resistor 40 and capacitor 41 are chosen so that it takes about fifty seconds after closing switch 30 to reach a voltage sufficient to cause flow in the collector-emitter circuit of transistor 42.
As soon as current flows through Zener diode 4, firing voltage is applied to the gate of SCR 46. As soon as SCR 46 fires, capacitor 41 discharges through diode 47 and conducting SCR 46. Dumping of capacitor 41 turns off transistor 42 thereby removing gate voltage from SCR 46. SCR 46, however, remains conductive until the anode to cathode current is reduced below the holding level. The combination of capacitor 48, resistors 49, 50 and 51 and the emitter-base junction of transistor 52 provides a current path through a second timing network designed to keep SCR 46, and therefore transistor 52, in the conductive state for a chosen time period, usually between five and ten seconds. While SCR 46 is on, transistor 52 is also on and supplies power to a decoupling network, comprised of resistor 53, resistor 54 and capacitor 55, and to oscillator circuit 33. When SCR 46 is off transistor 52 is also off and no power is supplied to the decoupling network or oscillator circuit 33.
The decoupling network prevents the oscillatory signal developed in oscillator 33 from affecting the timing intervals developed in timer circuit 32. A substantially constant charge is developed across capacitor 55 during the on time of transistor 52 and in effect, provides the power supply for oscillator 33.
The repetition rate of oscillator 33 is determined by timing resistor 56 and capacitor 57. The pulse width is determined by feed back capacitor 57 and the inductance of the primary winding of transformer 59. Upon application of supply voltage to oscillator 33, transistor 58 turns on and due to charging of capacitor 57, supplies a rapidly increasing current through the primary of transformer 59 until it becomes saturated and capacitor 57 is fully charged. At that time, the field collapses causing a polarity reversal which drives transistor 58 rapidly into cutoff where it is held until capacitor 57 discharges through a portion of the primary winding of transformer 59 and resistor 56. Diode 60 protects transistor 58 during collapse of the field in transformer 59. Oscillations continue in the manner described until transistor 52 turns off removing supply voltage from oscillator circuit 33.
The changing field in the primary of transformer 59 induces a pulsing current in the two secondaries causing illumination of lamp 35 to indicate proper operation of the oscillator and supplying power to the output circuit. Resistors 61 and 62 provides I protection for transistor 63 and hold it in cutoff until a pulse appears on the secondary of transformer 59. An induced pulse in the circuit containing resistors 61 and 62 and transistor 63 causes turn-on of transistor 63 thereby providing needed power gain and supplying current through the primary of trnsformer 64. The current flowing through the primary of transistor 64 induces a current in the secondary of transformer 64 which is applied to the patient through electrodes connected to terminals 14 and 27. A constant current output is achieved from this circuit. Diode 65 protects transistor 63 during field collapse in transformer 64.
One pattern of electrical stimulation which has been effective to institute peristaltic activity without being noticable to the patient consists of passing ten volts into onethousand ohms to cause ten milliamperes of current to flow for a period of 0.100 millisecond once every twenty-five milliseconds. After five seconds, these pulses are terminated and no current flows for fifty-five seconds. Then the ten milliampere flow per 0.100 millisecond once every twenty-five milliseconds resume for another five seconds. The cycle is repeated every minute until positive results are obtained. The first such result may be observed by ausculatating the abdomen for bowel sounds. Positive results in the form of passage of feces or flatus will generally be observed from four to sixteen hours after stimulation has begun, and the stimulation may be dis continued following the first bowel movement.
Other patterns of electrical stimulation have proved effective where the rates of the application of stimulation approximated the normal periodicity of the inherent peristaltic pacemaker activity of the duodenum of the animal on which the apparatus was being used. In fact, stimulation in time cycles of the same general order of magnitude as the entire normal range of periodicity of the inherent peristaltic pacemaker action of the duodenum have been found effective.
Initially, experiments upon dogs gastrointestinal motility were conducted to find optimal current amplitudes, pulse length frequency, and to determine feasible sites in the gastrointestinal tract for effective stimulation. Extensive experiments followed with various types of current in regard to wave shapes, pulse length and frequency and with regard to their effectiveness in inducing peristaltic activity. These findings were then tested and modified for human use based on experiments carried out on the researchers under fiuoroscopy and later in the operating room by direct observation upon patients undergoing laparotomy.
It was found from these studies that a current of 7 to 10 milliamperes output and a frequency of 50 cycles per second given for 5l0 seconds duration and repeated in intervals of from 1 to 5 minutes would be sufiicient to induce effective peristaltic activity. Such stimulation was found not to be perceptible to the patient.
The foregoing experiments are published in a paper entitled, Gastrointestinal Pacing-a New Concept in the Treatment of Ileus, in the Annals of Surgery, volume 158, No. 3, of September 1963, publisher J. B. Lippincott Company, USA.
Since the foregoing studies were made, it has been found that up to 30 milliamperes of current can be used with a frequency of from 40 to 50 cycles per second and with this stimulation applied continuously for a first finite time period of from 5 to 10 seconds. The stimulation is then removed and repeated every minute.
With the use of the present invention, nasogastric suction may not be required following ordinary abdominal procedures. In these cases, fluid intake (drip feeding) may be administered through the catheter 10, while the bowel activity is being restored and maintained by gastrointestinal stimulation or pacemaking in accordance with the invention.
Should nasogastric suction be indicated, this can be employed using the catheter 10 while the stimulation of the gastrointestinal tract is taking place as described. This suction will relieve excessive abdominal extension and will thereby shorten the patients recovery time.
What is claimed is:
1. A method of treatment of paralytic ileus in the bodies of animals including humans including the steps of positioning a first electrode in the antral region in proximity to the pylorus in such a body, positioning a second electrode in spaced relation to the first electrode and in contact with said body, generating a series of electrical pulses and impressing said series of impulses be tween said electrodes for a first finite time period, allowing a second finite time period to elapse without any electrical impulses being impressed, and repeating the impulse and non-impulse steps until positive signs of restored peristaltic activity are observed; wherein said first time period is approximately five seconds and said first and second time periods together are approximately one minute.
2. A method of treatment of paralytic ileus in the bodies of animals including humans including the steps of positioning a first electrode in the antral region in proximity to the pylorus in such a body, positioning a second electrode in spaced relation to the first electrode and in contact with said body, providing a generator of electrical impulses, electrically associating said electrodes with said generator, impressing a series of electrical impulses upon said generator across said electrodes for a first portion of a finite time period, allowing a second remaining portion of said finite time period to elapse without any electrical impulses being impressed, and repeating said impulse and no impulse steps during successive similar finite time periods until positive signs of restored peristaltic activity are observed, wherein said finite time period is approximately one minute.
3. The method of claim 2 wherein the step of positioning the first eletcrode includes positioning said electrode outside of one open end portion of a hollow flexible insulating tube and introducing said electrode and tube into the stomach through the nose and at least in part through the alimintary tract; wherein the step of electrically associating said first electrode with said generator includes extending a flexible electrical conductor from said generator, through said hollow tube and into elec-- trical contact with said electrode; and the further steps of connecting said tube to a source of suction and performing nasogastric suction with said hollow open-ended tube during the repetition of said impulse and no impulse steps.
4. A method of treatment of paralytic ileus in the bodies of animals including humans including the steps of positioning a first electrode in the antral region in proximity to the pylorus in such a body, positioning a second electrode in spaced relation to the first electrode and in contact with said body, providing a generator of electrical impulses, electrically associating said electrodes and said generator, impressing a series of electrical impulses from said generator across said electrodes for a first portion of a finite time period, allowing no electrical impulses across said electrodes during a second remaining portion of said finite time period, and repeating said impulse and no impulse steps during successive similar finite time periods until positive signs of restored peristaltic activity are observed, said finite time period being approximately one minute and said first portion of said period being at least five seconds.
References Cited UNITED STATES PATENTS 2,055,540 9/1936 Karnofsky 128-409 623,022 4/1899 Johnson 128--348 X 3,046,988 7/1962 Moreau et al. 128349 X OTHER REFERENCES Stephenson, et al.: Journal of Thoracic and Cardiovascular Surgery, vol. 38, No. 5, pp. 604-609, November, 1959.
RICHARD A. GAUDET, Primary Examiner.
W. E. KAMM, Assistant Examiner.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US623022 *||Mar 30, 1898||Apr 11, 1899||johnson|
|US2055540 *||Dec 18, 1933||Sep 29, 1936||Gen Therapeutics Corp||Process and apparatus for treating pathological conditions|
|US3046988 *||Dec 1, 1958||Jul 31, 1962||Davol Rubber Co||Esophageal nasogastric tube|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US3499435 *||Jun 2, 1967||Mar 10, 1970||Paul E Rockwell||Esophageal probe for use in monitoring|
|US3800800 *||Jan 24, 1972||Apr 2, 1974||D Garbe||Apparatus and method for incontinence control|
|US3846644 *||Jul 2, 1973||Nov 5, 1974||Tokai Rika Co Ltd||Intermittently driving circuit for a load such as a buzzer or a bell|
|US3881494 *||May 22, 1973||May 6, 1975||Jr James M Paul||Electro pulse arthritic physiotherapy system|
|US3902494 *||Apr 30, 1974||Sep 2, 1975||Scheerer||Suction surgical instrument|
|US3911930 *||Mar 1, 1974||Oct 14, 1975||Stimulation Tech||Method and structure of preventing and treating ileus, and reducing acute pain by electrical pulse stimulation|
|US4055190 *||Dec 19, 1974||Oct 25, 1977||Michio Tany||Electrical therapeutic apparatus|
|US4572214 *||Apr 10, 1981||Feb 25, 1986||Ursus Konsult Ab||Electrode device|
|US4616640 *||Nov 14, 1983||Oct 14, 1986||Steven Kaali||Birth control method and device employing electric forces|
|US4681122 *||Sep 23, 1985||Jul 21, 1987||Victory Engineering Corp.||Stereotaxic catheter for microwave thermotherapy|
|US4683890 *||Oct 2, 1986||Aug 4, 1987||Brunswick Manufacturing Co., Inc.||Method and apparatus for controlled breathing employing internal and external electrodes|
|US4763671 *||Apr 25, 1986||Aug 16, 1988||Stanford University||Method of treating tumors using selective application of heat and radiation|
|US4770167 *||Jul 1, 1987||Sep 13, 1988||Steven Kaali||Electrical, generally rounded resilient, canopy-like contraceptive devices|
|US4921481 *||Mar 23, 1988||May 1, 1990||Abbott Laboratories||Enteral feeding system utilizing gastrointestinal myoelectrography|
|US5236413 *||May 7, 1990||Aug 17, 1993||Feiring Andrew J||Method and apparatus for inducing the permeation of medication into internal tissue|
|US5292344 *||Jul 10, 1992||Mar 8, 1994||Douglas Donald D||Percutaneously placed electrical gastrointestinal pacemaker stimulatory system, sensing system, and pH monitoring system, with optional delivery port|
|US5423872 *||May 26, 1993||Jun 13, 1995||Cigaina; Valerio||Process and device for treating obesity and syndromes related to motor disorders of the stomach of a patient|
|US5425703 *||Jan 14, 1994||Jun 20, 1995||Feiring; Andrew J.||Method and apparatus for inducing the permeation of medication into internal tissue|
|US5549603 *||Nov 28, 1994||Aug 27, 1996||Feiring; Andrew J.||Method and apparatus for inducing the permeation of medication into internal tissue|
|US5669874 *||Jul 3, 1996||Sep 23, 1997||Feiring; Andrew Jonathan||Method and apparatus for inducing the permeation of medication into internal tissue|
|US5690691 *||May 8, 1996||Nov 25, 1997||The Center For Innovative Technology||Gastro-intestinal pacemaker having phased multi-point stimulation|
|US5800495 *||Mar 27, 1997||Sep 1, 1998||Sulzer Intermedics Inc.||Endocardial lead assembly|
|US5810763 *||Jul 25, 1997||Sep 22, 1998||Feiring; Andrew Jonathan||Method and apparatus for inducing the permeation of medication into internal tissue|
|US5938692 *||Mar 26, 1996||Aug 17, 1999||Urologix, Inc.||Voltage controlled variable tuning antenna|
|US6032078 *||Oct 22, 1997||Feb 29, 2000||Urologix, Inc.||Voltage controlled variable tuning antenna|
|US6195583||Sep 14, 1998||Feb 27, 2001||Andrew Jonathan Feiring||Method and apparatus for inducing the permeation of medication into internal tissue|
|US6389314||Dec 26, 2000||May 14, 2002||Andrew Jonathan Feiring||Method and apparatus for inducing the permeation of medication into internal tissue|
|US6535764||May 1, 2001||Mar 18, 2003||Intrapace, Inc.||Gastric treatment and diagnosis device and method|
|US6600953||Dec 11, 2000||Jul 29, 2003||Impulse Dynamics N.V.||Acute and chronic electrical signal therapy for obesity|
|US6684105||Aug 31, 2001||Jan 27, 2004||Biocontrol Medical, Ltd.||Treatment of disorders by unidirectional nerve stimulation|
|US6709388||Aug 3, 2000||Mar 23, 2004||University College London Hospitals Nhs Trust||Passage-travelling device|
|US6754536||Jan 30, 2002||Jun 22, 2004||Medtronic, Inc||Implantable medical device affixed internally within the gastrointestinal tract|
|US6892098||Sep 24, 2002||May 10, 2005||Biocontrol Medical Ltd.||Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders|
|US6907295||Jul 24, 2002||Jun 14, 2005||Biocontrol Medical Ltd.||Electrode assembly for nerve control|
|US6993391||May 28, 2003||Jan 31, 2006||Metacure N.V.||Acute and chronic electrical signal therapy for obesity|
|US7016735||Nov 7, 2002||Mar 21, 2006||Intrapace, Inc.||Gastric anchor and method|
|US7020526||May 16, 2002||Mar 28, 2006||Ruan Jin Zhao||Electronic gastro-intestinal stimulation device|
|US7020531||Apr 2, 2002||Mar 28, 2006||Intrapace, Inc.||Gastric device and suction assisted method for implanting a device on a stomach wall|
|US7076305||Nov 14, 2002||Jul 11, 2006||Intrapace, Inc.||Gastric device and instrument system and method|
|US7107100||Nov 7, 2002||Sep 12, 2006||Intrapace, Inc.||Aendoscopic instrument system@|
|US7120498||Oct 23, 2003||Oct 10, 2006||Intrapace, Inc.||Method and device for securing a functional device to a stomach|
|US7127295||May 2, 2005||Oct 24, 2006||Evans John R||Device and method for placement of electrodes in the GI tract|
|US7200443||Oct 7, 2003||Apr 3, 2007||John Faul||Transcutaneous electrical nerve stimulator for appetite control|
|US7321793||Jun 13, 2003||Jan 22, 2008||Biocontrol Medical Ltd.||Vagal stimulation for atrial fibrillation therapy|
|US7324853||Nov 5, 2004||Jan 29, 2008||Biocontrol Medical Ltd.||Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders|
|US7330753||Apr 16, 2002||Feb 12, 2008||Metacure N.V.||Analysis of eating habits|
|US7346398||Sep 23, 2004||Mar 18, 2008||Bio Control Medical (B.C.M.) Ltd.||Electrode assembly for nerve control|
|US7371215||Jul 9, 2004||May 13, 2008||Intrapace, Inc.||Endoscopic instrument for engaging a device|
|US7437195||Jan 3, 2002||Oct 14, 2008||Metalure N.V.||Regulation of eating habits|
|US7444183 *||Jan 6, 2004||Oct 28, 2008||Enteromedics, Inc.||Intraluminal electrode apparatus and method|
|US7483754||Nov 16, 2005||Jan 27, 2009||Intrapace, Inc.||Endoscopic instrument system for implanting a device in the stomach|
|US7489969||Sep 29, 2003||Feb 10, 2009||Enteromedics Inc.||Vagal down-regulation obesity treatment|
|US7502649||Jun 20, 2004||Mar 10, 2009||Metacure Ltd.||Gastrointestinal methods and apparatus for use in treating disorders|
|US7509174||Nov 14, 2002||Mar 24, 2009||Intrapace, Inc.||Gastric treatment/diagnosis device and attachment device and method|
|US7509175||Jul 30, 2007||Mar 24, 2009||Intrapace, Inc.||Method and devices for stimulation of an organ with the use of a transectionally placed guide wire|
|US7545740||Apr 7, 2006||Jun 9, 2009||Corrigent Systems Ltd.||Two-way link aggregation|
|US7551599||Mar 29, 2004||Jun 23, 2009||Corrigent Systems Ltd.||Layer-3 network routing with RPR layer-2 visibility|
|US7561922||Dec 22, 2004||Jul 14, 2009||Biocontrol Medical Ltd.||Construction of electrode assembly for nerve control|
|US7590452||Jul 9, 2004||Sep 15, 2009||Intrapace, Inc.||Endoscopic system for attaching a device to a stomach|
|US7613515||Jan 21, 2005||Nov 3, 2009||Enteromedics Inc.||High frequency vagal blockage therapy|
|US7616996||Sep 1, 2005||Nov 10, 2009||Intrapace, Inc.||Randomized stimulation of a gastrointestinal organ|
|US7627384||Nov 15, 2005||Dec 1, 2009||Bio Control Medical (B.C.M.) Ltd.||Techniques for nerve stimulation|
|US7630769||Jan 22, 2007||Dec 8, 2009||Enteromedics Inc.||GI inflammatory disease treatment|
|US7634317||Feb 18, 2005||Dec 15, 2009||Bio Control Medical (B.C.M.) Ltd.||Techniques for applying, calibrating, and controlling nerve fiber stimulation|
|US7643887||Oct 12, 2005||Jan 5, 2010||Intrapace, Inc.||Abdominally implanted stimulator and method|
|US7672727||Aug 17, 2005||Mar 2, 2010||Enteromedics Inc.||Neural electrode treatment|
|US7689284||Oct 12, 2005||Mar 30, 2010||Intrapace, Inc.||Pseudounipolar lead for stimulating a digestive organ|
|US7693577||Jan 22, 2007||Apr 6, 2010||Enteromedics Inc.||Irritable bowel syndrome treatment|
|US7702394||Sep 23, 2004||Apr 20, 2010||Intrapace, Inc.||Responsive gastric stimulator|
|US7720540||Jan 22, 2007||May 18, 2010||Enteromedics, Inc.||Pancreatitis treatment|
|US7729771||Aug 13, 2007||Jun 1, 2010||Enteromedics Inc.||Nerve stimulation and blocking for treatment of gastrointestinal disorders|
|US7734355||Jan 23, 2002||Jun 8, 2010||Bio Control Medical (B.C.M.) Ltd.||Treatment of disorders by unidirectional nerve stimulation|
|US7747322||Oct 12, 2005||Jun 29, 2010||Intrapace, Inc.||Digestive organ retention device|
|US7756582||Oct 21, 2005||Jul 13, 2010||Intrapace, Inc.||Gastric stimulation anchor and method|
|US7765006||Dec 13, 2007||Jul 27, 2010||Leto Medical, Llc||Method and apparatus for providing continence to a gastrointestinal ostomy|
|US7765007||Nov 4, 2008||Jul 27, 2010||Leto Medical, Llc||Apparatus and method for providing continence to a gastrointestinal ostomy|
|US7778703||Jul 24, 2002||Aug 17, 2010||Bio Control Medical (B.C.M.) Ltd.||Selective nerve fiber stimulation for treating heart conditions|
|US7778711||Nov 20, 2003||Aug 17, 2010||Bio Control Medical (B.C.M.) Ltd.||Reduction of heart rate variability by parasympathetic stimulation|
|US7787948||Jan 23, 2006||Aug 31, 2010||Ross Robert A||Energy efficient therapeutic pulse generator system|
|US7822486||Aug 17, 2005||Oct 26, 2010||Enteromedics Inc.||Custom sized neural electrodes|
|US7844338||Jun 30, 2004||Nov 30, 2010||Enteromedics Inc.||High frequency obesity treatment|
|US7844346||Feb 2, 2006||Nov 30, 2010||Biocontrol Medical Ltd.||Electrode assembly for nerve control|
|US7885709||Sep 22, 2005||Feb 8, 2011||Bio Control Medical (B.C.M.) Ltd.||Nerve stimulation for treating disorders|
|US7885711||Jun 10, 2004||Feb 8, 2011||Bio Control Medical (B.C.M.) Ltd.||Vagal stimulation for anti-embolic therapy|
|US7890185||Nov 25, 2003||Feb 15, 2011||Bio Control Medical (B.C.M.) Ltd.||Treatment of disorders by unidirectional nerve stimulation|
|US7899541||Jun 18, 2007||Mar 1, 2011||Ebr Systems, Inc.||Systems and methods for implantable leadless gastrointestinal tissue stimulation|
|US7904176||Sep 7, 2006||Mar 8, 2011||Bio Control Medical (B.C.M.) Ltd.||Techniques for reducing pain associated with nerve stimulation|
|US7974693||Feb 22, 2005||Jul 5, 2011||Bio Control Medical (B.C.M.) Ltd.||Techniques for applying, configuring, and coordinating nerve fiber stimulation|
|US7979127||May 25, 2010||Jul 12, 2011||Intrapace, Inc.||Digestive organ retention device|
|US7986995||Jan 22, 2007||Jul 26, 2011||Enteromedics Inc.||Bulimia treatment|
|US8010204||Mar 11, 2010||Aug 30, 2011||Enteromedics Inc.||Nerve blocking for treatment of gastrointestinal disorders|
|US8019422||Nov 16, 2005||Sep 13, 2011||Intrapace, Inc.||Gastric device and endoscopic delivery system|
|US8032222||Jun 18, 2008||Oct 4, 2011||Loushin Michael K H||Device for electrically and mechanically stimulating a compartment in a body|
|US8032223||Oct 1, 2009||Oct 4, 2011||Intrapace, Inc.||Randomized stimulation of a gastrointestinal organ|
|US8046085||Oct 20, 2010||Oct 25, 2011||Enteromedics Inc.||Controlled vagal blockage therapy|
|US8060197||Mar 16, 2007||Nov 15, 2011||Bio Control Medical (B.C.M.) Ltd.||Parasympathetic stimulation for termination of non-sinus atrial tachycardia|
|US8103349||Dec 15, 2009||Jan 24, 2012||Enteromedics Inc.||Neural electrode treatment|
|US8190261||May 4, 2009||May 29, 2012||Intrapace, Inc.||Gastrointestinal anchor in optimal surface area|
|US8204591||Jan 24, 2007||Jun 19, 2012||Bio Control Medical (B.C.M.) Ltd.||Techniques for prevention of atrial fibrillation|
|US8239027||Mar 12, 2010||Aug 7, 2012||Intrapace, Inc.||Responsive gastric stimulator|
|US8265758||Mar 24, 2006||Sep 11, 2012||Metacure Limited||Wireless leads for gastrointestinal tract applications|
|US8275460||Aug 26, 2011||Sep 25, 2012||Loushin Michael K H||Device for electrically and mechanically stimulating a compartment in a body|
|US8295932||Dec 5, 2006||Oct 23, 2012||Metacure Limited||Ingestible capsule for appetite regulation|
|US8301256||Jun 4, 2006||Oct 30, 2012||Metacure Limited||GI lead implantation|
|US8301265||Sep 10, 2007||Oct 30, 2012||Medtronic, Inc.||Selective depth electrode deployment for electrical stimulation|
|US8326438||Oct 19, 2009||Dec 4, 2012||Bio Control Medical (B.C.M.) Ltd.||Techniques for nerve stimulation|
|US8364269||Oct 19, 2009||Jan 29, 2013||Intrapace, Inc.||Responsive gastric stimulator|
|US8369952||Jul 7, 2011||Feb 5, 2013||Enteromedics, Inc.||Bulimia treatment|
|US8386056||Feb 24, 2005||Feb 26, 2013||Bio Control Medical (B.C.M.) Ltd.||Parasympathetic stimulation for treating atrial arrhythmia and heart failure|
|US8417329||May 11, 2008||Apr 9, 2013||Metacure Ltd.||Analysis and regulation of food intake|
|US8423130||Oct 23, 2008||Apr 16, 2013||Metacure Limited||Optimization of thresholds for eating detection|
|US8427953||May 31, 2011||Apr 23, 2013||Corrigent Systems Ltd.||Tunnel provisioning with link aggregation and hashing|
|US8442841||Oct 20, 2006||May 14, 2013||Matacure N.V.||Patient selection method for assisting weight loss|
|US8463404||Jan 14, 2007||Jun 11, 2013||Metacure Limited||Electrode assemblies, tools, and methods for gastric wall implantation|
|US8494637||Jan 18, 2011||Jul 23, 2013||Ebr Systems, Inc.||Systems and methods for implantable leadless gastrointestinal tissue stimulation|
|US8494655||Oct 12, 2011||Jul 23, 2013||Bio Control Medical (B.C.M.) Ltd.||Electrode devices with resistive elements|
|US8537682||May 26, 2011||Sep 17, 2013||Orckit-Corrigent Ltd.||Tunnel provisioning with link aggregation|
|US8538533||Oct 19, 2011||Sep 17, 2013||Enteromedics Inc.||Controlled vagal blockage therapy|
|US8538542||Jul 21, 2011||Sep 17, 2013||Enteromedics Inc.||Nerve stimulation and blocking for treatment of gastrointestinal disorders|
|US8541232||Mar 8, 2007||Sep 24, 2013||Kwalata Trading Limited||Composition comprising a progenitor/precursor cell population|
|US8571651||Feb 7, 2011||Oct 29, 2013||Bio Control Medical (B.C.M.) Ltd.||Techniques for reducing pain associated with nerve stimulation|
|US8571653||Feb 7, 2011||Oct 29, 2013||Bio Control Medical (B.C.M.) Ltd.||Nerve stimulation techniques|
|US8609082||Jan 25, 2006||Dec 17, 2013||Bio Control Medical Ltd.||Administering bone marrow progenitor cells or myoblasts followed by application of an electrical current for cardiac repair, increasing blood supply or enhancing angiogenesis|
|US8612016||Aug 18, 2005||Dec 17, 2013||Metacure Limited||Monitoring, analysis, and regulation of eating habits|
|US8666495||Mar 18, 2005||Mar 4, 2014||Metacure Limited||Gastrointestinal methods and apparatus for use in treating disorders and controlling blood sugar|
|US8685724||Jun 1, 2005||Apr 1, 2014||Kwalata Trading Limited||In vitro techniques for use with stem cells|
|US8715181||Apr 27, 2012||May 6, 2014||Intrapace, Inc.||Feedback systems and methods for communicating diagnostic and/or treatment signals to enhance obesity treatments|
|US8725271||Jul 11, 2013||May 13, 2014||Bio Control Medical (B.C.M.) Ltd.||Electrode device with elongated electrode|
|US8755893||Jun 20, 2012||Jun 17, 2014||Bluewind Medical Ltd.||Tibial nerve stimulation|
|US8792985||Jan 20, 2006||Jul 29, 2014||Metacure Limited||Gastrointestinal methods and apparatus for use in treating disorders and controlling blood sugar|
|US8825164||Jun 7, 2011||Sep 2, 2014||Enteromedics Inc.||Neural modulation devices and methods|
|US8855770||Jul 24, 2008||Oct 7, 2014||Betastim, Ltd.||Duodenal eating sensor|
|US8862233||Feb 4, 2013||Oct 14, 2014||Enteromedics Inc.||Electrode band system and methods of using the system to treat obesity|
|US8880192||Apr 2, 2012||Nov 4, 2014||Bio Control Medical (B.C.M.) Ltd.||Electrode cuffs|
|US8909355||Oct 26, 2012||Dec 9, 2014||Bio Control Medical (B.C.M.) Ltd.||Techniques for nerve stimulation|
|US8934975||Feb 1, 2011||Jan 13, 2015||Metacure Limited||Gastrointestinal electrical therapy|
|US8934976||Sep 30, 2011||Jan 13, 2015||Intrapace, Inc.||Feedback systems and methods to enhance obstructive and other obesity treatments, optionally using multiple sensors|
|US9011365||Mar 12, 2013||Apr 21, 2015||Medibotics Llc||Adjustable gastrointestinal bifurcation (AGB) for reduced absorption of unhealthy food|
|US9067070||Mar 12, 2013||Jun 30, 2015||Medibotics Llc||Dysgeusia-inducing neurostimulation for modifying consumption of a selected nutrient type|
|US9101765||Feb 16, 2006||Aug 11, 2015||Metacure Limited||Non-immediate effects of therapy|
|US9162062||Sep 16, 2013||Oct 20, 2015||Enteromedics Inc.||Controlled vagal blockage therapy|
|US9174040||Sep 5, 2013||Nov 3, 2015||Enteromedics Inc.||Nerve stimulation and blocking for treatment of gastrointestinal disorders|
|US9186504||Dec 3, 2014||Nov 17, 2015||Rainbow Medical Ltd||Sleep apnea treatment|
|US9234173||Aug 20, 2013||Jan 12, 2016||Kwalata Trading Ltd.||Regulating stem cells|
|US9259342||Dec 8, 2014||Feb 16, 2016||Intrapace, Inc.||Feedback systems and methods to enhance obstructive and other obesity treatments, optionally using multiple sensors|
|US9339190||Feb 15, 2006||May 17, 2016||Metacure Limited||Charger with data transfer capabilities|
|US9358395||Aug 6, 2014||Jun 7, 2016||Enteromedics Inc.||Neural modulation devices and methods|
|US9370660||Mar 26, 2014||Jun 21, 2016||Rainbow Medical Ltd.||Independently-controlled bidirectional nerve stimulation|
|US9456916||Mar 12, 2013||Oct 4, 2016||Medibotics Llc||Device for selectively reducing absorption of unhealthy food|
|US9457186||Jul 29, 2014||Oct 4, 2016||Bluewind Medical Ltd.||Bilateral feedback|
|US9517152||Jan 6, 2015||Dec 13, 2016||Intrapace, Inc.||Responsive gastric stimulator|
|US9586046||Sep 8, 2014||Mar 7, 2017||Enteromedics, Inc.||Electrode band system and methods of using the system to treat obesity|
|US9590899||Aug 25, 2015||Mar 7, 2017||Orckit Ip, Llc||Tunnel provisioning with link aggregation|
|US20020165589 *||May 1, 2001||Nov 7, 2002||Imran Mir A.||Gastric treatment and diagnosis device and method|
|US20030144708 *||May 17, 2002||Jul 31, 2003||Starkebaum Warren L.||Methods and apparatus for retarding stomach emptying for treatment of eating disorders|
|US20030164304 *||Nov 7, 2002||Sep 4, 2003||Imran Mir A.||Aendoscopic instrument system@|
|US20030167025 *||Nov 14, 2002||Sep 4, 2003||Imran Mir A.||Gastric treatment/diagnosis device and attachment device and method|
|US20040044376 *||May 28, 2003||Mar 4, 2004||Melina Flesler||Acute and chronic electrical signal therapy for obesity|
|US20040147816 *||Apr 16, 2002||Jul 29, 2004||Shai Policker||Analysis of eating habits|
|US20040172088 *||Jan 6, 2004||Sep 2, 2004||Enteromedics, Inc.||Intraluminal electrode apparatus and method|
|US20040172094 *||Nov 25, 2003||Sep 2, 2004||Biocontrol Medical Ltd.||Treatment of disorders by unidirectional nerve stimulation|
|US20040243195 *||Jul 9, 2004||Dec 2, 2004||Imran Mir A.||Endoscopic system for attaching a device to a stomach|
|US20050075678 *||Oct 7, 2003||Apr 7, 2005||John Faul||Transcutaneous electrical nerve stimulator for appetite control|
|US20050102007 *||Nov 5, 2004||May 12, 2005||Biocontrol Medical Ltd.||Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders|
|US20050209653 *||Mar 16, 2004||Sep 22, 2005||Medtronic, Inc.||Intra-luminal device for gastrointestinal electrical stimulation|
|US20050236277 *||Nov 7, 2002||Oct 27, 2005||Imran Mir A||Aendoscopic instrument system@|
|US20050251219 *||May 2, 2005||Nov 10, 2005||Evans John R||Device and method for placement of electrodes in the GI tract|
|US20060030889 *||Oct 11, 2005||Feb 9, 2006||Shlomo Ben-Haim||Local cardiac motion control using applied signals and mechanical force|
|US20060069414 *||Nov 16, 2005||Mar 30, 2006||Imran Mir A||Endoscopic instrument system for implanting a device in the stomach|
|US20060106441 *||Nov 15, 2005||May 18, 2006||Shai Ayal||Techniques for nerve stimulation|
|US20060110374 *||Nov 11, 2005||May 25, 2006||Dudy Czeiger||Method to accelerate stem cell recruitment and homing|
|US20060111753 *||Oct 21, 2005||May 25, 2006||Imran Mir A||Gastric stimulation anchor and method|
|US20060116735 *||Nov 16, 2005||Jun 1, 2006||Imran Mir A||Gastric device and endoscopic delivery system|
|US20060167512 *||Jan 23, 2006||Jul 27, 2006||Virginia Technologies, Inc.||Energy efficient therapeutic pulse generator system|
|US20060251074 *||May 6, 2005||Nov 9, 2006||Corrigent Systems Ltd.||Tunnel provisioning with link aggregation|
|US20070237172 *||Apr 7, 2006||Oct 11, 2007||Corrigent Systems Ltd.||Two-way link aggregation|
|US20070293905 *||Jun 18, 2007||Dec 20, 2007||Ebr Systems, Inc.||Systems and methods for implantable leadless gastrointestinal tissue stimulation|
|US20080004671 *||Jun 26, 2007||Jan 3, 2008||Alza Corporation||Vagus nerve stimulation via orally delivered apparatus|
|US20080065169 *||Nov 13, 2007||Mar 13, 2008||Intrapace, Inc.||Endoscopic Instrument for Engaging a Device|
|US20080151890 *||Dec 21, 2006||Jun 26, 2008||Corrigent Systems Ltd.||Forwarding multicast traffic over link aggregation ports|
|US20080318314 *||Jun 20, 2007||Dec 25, 2008||Valentin Fulga||Production from blood of cells of neural lineage|
|US20080319504 *||Jun 18, 2008||Dec 25, 2008||Loushin Michael K H||Device for Electrically and Mechanically Stimulating a Compartment in a Body|
|US20090018605 *||Sep 23, 2008||Jan 15, 2009||Intrapace, Inc.||Gastric Treatment/Diagnosis Device and Attachment Device and Method|
|US20090149910 *||Feb 12, 2009||Jun 11, 2009||Inrapace, Inc.||Gastric Treatment/Diagnosis Device and Attachment Device and Method|
|US20090157139 *||Dec 13, 2007||Jun 18, 2009||Nicholas Martino||Method and apparatus for providing continence to a gastrointestinal ostomy|
|US20090157140 *||Nov 4, 2008||Jun 18, 2009||Nicholas Martino||Apparatus and method for providing continence to a gastrointestinal ostomy|
|US20090299434 *||Aug 7, 2009||Dec 3, 2009||Intrapace, Inc.||Endoscopic System For Attaching a Device to a Stomach|
|US20100087706 *||Sep 29, 2009||Apr 8, 2010||Intrapace, Inc.||Lead Access|
|US20100228105 *||Mar 24, 2006||Sep 9, 2010||Metacure N.V.||Wireless Leads For Gastrointestinal Tract Applications|
|US20100291610 *||Mar 8, 2007||Nov 18, 2010||Yael Porat||Regulating Stem Cells|
|US20100298741 *||Jul 24, 2008||Nov 25, 2010||Betastim, Ltd.||Duodenal eating sensor|
|US20100305468 *||May 11, 2008||Dec 2, 2010||Metacurt Ltd.||Analysis and regulation of food intake|
|US20110046660 *||Feb 12, 2010||Feb 24, 2011||Intrapace, Inc.||Endoscopic Forceps With Removable Handle|
|US20110112600 *||Jan 18, 2011||May 12, 2011||Ebr Systems, Inc.||Systems and methods for implantable leadless gastrointestinal tissue stimulation|
|USRE35755 *||Sep 10, 1993||Mar 24, 1998||Scimed Life Systems, Inc.||Method for inducing thrombosis in blood vessels|
|USRE39200||Jan 17, 1997||Jul 18, 2006||Boston Scientific Scimed, Inc.||Apparatus for treating a blood vessel|
|EP0101595A1 *||Aug 8, 1983||Feb 29, 1984||Vital Signs, Inc.||Biological probes and methods of making same|
|EP2298166A1||Apr 16, 2002||Mar 23, 2011||Metacure Limited||Analysis of eating habits|
|WO1985002779A1 *||Dec 24, 1984||Jul 4, 1985||Board Of Trustees Of Leland Stanford Junior Univer||Catheter for treatment of tumors and method for using same|
|WO1994001172A1 *||Jul 9, 1993||Jan 20, 1994||Douglas Donald D||A percutaneously placed electrical intestinal pacemaker|
|WO1997031679A2 *||Feb 21, 1997||Sep 4, 1997||Vladimir Nikolaevich Dirin||Biological electrostimulator of viscera|
|WO1997031679A3 *||Feb 21, 1997||Oct 9, 1997||Vladimir Nikolaevich Dirin||Biological electrostimulator of viscera|
|WO1998048890A1 *||Apr 6, 1998||Nov 5, 1998||Medtronic, Inc.||Method and apparatus for electrical stimulation of the gastrointestinal tract|
|WO1999003532A3 *||Mar 30, 1998||Apr 8, 1999||Medtronic Inc||Apparatus for treatment of gastric arrhythmias|
|WO2015153427A1 *||Mar 30, 2015||Oct 8, 2015||Regents Of The University Of Minnesota||Systems and methods for electrical stimulation of the gastrointestinal tract for treatment of post-operative ileus|
|U.S. Classification||607/40, 604/21, 331/46, 331/111, 331/52, 607/71|
|International Classification||A61M25/00, A61N1/36|