Devices and methods for placement of partitions within a hollow body organ

Abstract

Devices and methods for tissue acquisition and fixation, or gastroplasty, are described. Generally, the devices of the system may be advanced in a minimally invasive manner within a patient's body to create one or more plications within the hollow body organ. A tissue treatment device attached to a distal end of a flexible elongated member and has a cartridge member opposite an anvil member. The cartridge member and the anvil member are movable between a closed position and an open position relative to one another, and the cartridge member is re-loadable with a removable staple cartridge to form multiple plications within the organ with the same tissue treatment device.

1 - 26 . (canceled)  
     
     
         27 . A method for delivering and implanting a staple line in the stomach of a patient, comprising: 
 providing an elongated tubular member having a proximal end and a distal end and having a first lumen extending at least through a portion thereof;    advancing the distal end of the tubular member transorally into the patient's stomach;    advancing an endoscope through the first lumen for real time visualization of the patient's stomach;    positioning the endoscope to visualize a treatment site in the stomach;    position the distal end of the tubular member at the treatment site and visualize the position of the distal end of the tubular member with the endoscope;    implant a staple line at the treatment site while visualizing with the endoscope;    visualize the staple line with the endoscope; and    withdraw the tubular member and endoscope from the patient.    
     
     
         28 . The method of  claim 27 , wherein the endoscope is retroflexed to visualize the distal end of the tubular member.  
     
     
         29 . The method of  claim 28 , wherein the endoscope, when in the retroflexed position, visualizes a proximal end of a fastening member aligned with the gastroesophogeal junction (GEJ).  
     
     
         30 . The method of  claim 27 , wherein the endoscope retracts stomach tissue.  
     
     
         31 . The method of  claim 27 , wherein dual folds of tissue are fastened together by the staple line.  
     
     
         32 . The method of  claim 27 , wherein the staple line is placed along the lesser curve of the stomach.  
     
     
         33 . A delivery system for transoral treatment of the stomach of a patient, comprising: 
 a flexible elongated body having a proximal end extending outside the patient, a central section extending transorally into the patient, and a distal end extending into the stomach;    a fixation member attached to the distal end of the flexible elongated body;    an endoscope associated with the flexible elongated body for real time visualization; and    the flexible elongated body, fixation member, and endoscope having an overall diameter equal to or less than 18.136 mm (0.714 inch).    
     
     
         34 . The delivery system of  claim 33 , wherein the flexible elongated body being compatible with side-by-side insertion of the endoscope.  
     
     
         35 . The delivery system of  claim 33 , further comprising an acquisition member attached to the distal end of the flexible elongated body.  
     
     
         36 . The delivery system of  claim 35 , wherein the acquisition member is a vacuum pod.  
     
     
         37 . The delivery system of  claim 36 , further comprising a vacuum tube extending from the vacuum pod at the distal end of the flexible elongated body to the proximal end of the flexible elongated body.  
     
     
         38 . The delivery system of  claim 37 , wherein the vacuum tube is attached to a vacuum source at a proximal end of the flexible elongated body.  
     
     
         39 . The delivery system of  claim 33 , wherein one or more cables or wires extend along the flexible elongated body for operative engagement with the fixation member.  
     
     
         40 . The delivery system of  claim 33 , wherein the fixation member has a maximum diameter of 15.1 mm (0.595 inch) in a closed configuration and a maximum diameter of 17.0 mm (0.668 inch) in an open configuration.  
     
     
         41 . The delivery system of  claim 33 , wherein the flexible elongated body can be bent to achieve a 10.16 cm (4.00 inch) bend radius to flexibly navigate the esophagus.  
     
     
         42 . The delivery system of  claim 33 , wherein the fixation member is configured to place a line of fasteners through stomach tissue having a length in the range from about 12.5 mm (0.492 inch) to about 50.0 mm (1.97 inch).  
     
     
         43 . A delivery system for transoral treatment of the stomach, comprising: 
 a flexible elongated member having a proximal end extending outside of a patient, a central section extending transorally into the patient, and a distal end extending into the stomach;    a tissue treatment device attached to the distal end of the elongated member;    a first lumen extending within the elongated member and being in fluid communication with a vacuum source at a proximal end of the first lumen and the tissue treatment device at a distal end of the first lumen;    the tissue treatment device forming a first tissue fold and a second tissue fold via a vacuum;    a fastener for fastening the first tissue fold to the second tissue fold; and    an endoscope for real time visualization of the stomach and tissue treatment device.    
     
     
         44 . The delivery system of  claim 43 , wherein at least a portion of the elongated member having a plurality of sliding links to increase flexibility of the elongate member.  
     
     
         45 . The delivery system of  claim 44 , wherein each link has a substantially cylindrical configuration.  
     
     
         46 . The delivery system of  claim 45 , wherein each link slidingly engages an adjacent link.  
     
     
         47 . The delivery system of  claim 44 , wherein the plurality of sliding links are covered with a material to limit trauma to the esophagus.  
     
     
         48 . The delivery system of  claim 47 , wherein the cover material includes ployethylene tape, silicone and urethanes.  
     
     
         49 . The delivery system of  claim 44 , wherein the first lumen extends through the sliding links.  
     
     
         50 . The delivery system of  claim 43 , wherein cables and/or wires extend through the first lumen.  
     
     
         51 . The delivery system of  claim 43 , wherein the endoscope extends through the first lumen.  
     
     
         52 . The delivery system of  claim 43 , wherein the elongated member includes a second lumen extending for at least a portion therethrough.  
     
     
         53 . The delivery system of  claim 52 , wherein the first lumen and the second lumen extend side by side.  
     
     
         53 . The delivery system of  claim 52 , wherein the second lumen slidingly receives the endoscope.  
     
     
         54 . The delivery system of  claim 43 , wherein the elongated member is formed from a braided material.  
     
     
         55 . The delivery system of  claim 43 , wherein the elongated member is formed from a molded material.  
     
     
         56 . The delivery system of  claim 43 , wherein the elongated member is formed from a slotted material.  
     
     
         57 . The delivery system of  claim 43 , wherein the elongated member is formed from a polymer material.