Apparatus and method for manipulating stomach tissue and treating gastroesophageal reflux disease

Abstract

Stomach tissue is manipulated to form, for example, a restored flap of a gastroesophageal flap valve. The manipulation includes gripping stomach tissue from within the stomach while the stomach is inflated to promote visualization and stabilization of the gripped stomach tissue. Once the stomach tissue is gripped, the stomach is deflated and pulled into a mold. The molded tissue is then fastened with at least one fastener. The stomach is inflated to a first pressure during visualization and then to a second higher pressure during the stomach tissue gripping.

1 - 9 . (canceled) 
     
     
         10 . A method of restoring a flap of a gastroesophageal flap valve associated with a stomach, comprising:
 gripping stomach tissue from within the stomach at a point displaced from the esophageal opening of the stomach;   collapsing the stomach;   pulling the gripped stomach tissue into a mold to form folded flap of tissue; and   deploying at least one fastener through the folded flap of tissue.   
     
     
         11 . The method of  claim 10 , wherein the stomach is associated with an esophagus and wherein the method further comprises gripping a wall of the esophagus prior to gripping the stomach. 
     
     
         12 . The method of  claim 11 , wherein the step of gripping a wall of the esophagus includes gripping the wall of the esophagus with a vacuum. 
     
     
         13 . The method of  claim 10 , further comprising repeating the gripping, collapsing, pulling, and deploying steps for forming another folded flap of tissue and deploying at least one other fastener displaced from the at least one fastener. 
     
     
         14 . The method of  claim 10 , further comprising inflating the stomach before deploying the at least one fastener. 
     
     
         15 . The method of  claim 10 , further comprising releasing the grip on the stomach tissue after the at least one fastener is deployed. 
     
     
         16 . The method of  claim 10 , further comprising inflating the stomach before gripping the stomach tissue. 
     
     
         17 . The method of  claim 16 , comprising the further step of re-inflating the stomach prior to deploying the at least one fastener. 
     
     
         18 . The method of  claim 10 , further comprising, before the gripping step, inflating the stomach to a first pressure, visualizing the stomach from within the stomach, and inflating the stomach to a second pressure, the second pressure being greater than the first pressure. 
     
     
         19 . The method of  claim 18 , wherein the stomach is associated with an esophagus and wherein the method further comprises gripping a wall of the esophagus after inflating the stomach to the first pressure and prior to gripping the stomach. 
     
     
         20 . The method of  claim 18 , comprising the further step of re-inflating the stomach prior to deploying the at least one fastener. 
     
     
         21 . The method of  claim 18 , further comprising repeating the inflating, gripping, collapsing, pulling, and deploying steps for forming another folded flap of tissue and deploying at least one other fastener displaced from the at least one fastener. 
     
     
         22 . The method of  claim 21 , further comprising measuring from the folded flap of tissue prior to repeating the gripping step. 
     
     
         23 . The method of  claim 10 , further comprising, before the gripping step, inflating the stomach to a first pressure, visualizing the stomach from within the stomach, and increasing inflation pressure within the stomach to a second pressure after visualizing the stomach. 
     
     
         24 . The method of  claim 23 , wherein the stomach is associated with an esophagus and wherein the method further comprises gripping a wall of the esophagus after inflating the stomach to the first pressure and prior to gripping the stomach. 
     
     
         25 . The method of  claim 23 , comprising the further step of re-inflating the stomach prior to deploying the at least one fastener. 
     
     
         26 . The method of  claim 23 , further comprising repeating the inflating, increasing, gripping, collapsing, pulling, and deploying steps for forming another folded flap of tissue and deploying at least one other fastener displaced from the at least one fastener. 
     
     
         27 - 42 . (canceled)