Methods for the Endoluminal Treatment of Gastroesophageal Reflux Disease (GERD)

Abstract

A medical method includes sliding two substantially straight unconnected arms over a fold of body tissue such that a first arm contacts a first portion of the fold and a second arm contacts a second portion. Then, each arm is bent completely through the fold such that both of the arms compress the portions of the fold into contact with each other. Another method includes releasably coupling first and second substantially linear arms to a bridge, each of the arms having a substantially straight sliding portion and a bendable piercing portion. The arms are slid over opposing sides of two body tissue layers, the first arm sliding over the first layer and the second over the second layer. While the sliding portions of the arms remain substantially straight, each piercing portion is bent completely through the adjacent layer and halfway through the other layer to compress the two layers together.

1 . A medical method, comprising:
 inserting an endoscope transorally through the esophagus to the stomach;   inserting a grasping device transorally through the esophagus to the stomach;   inserting a surgical clip applier having at least one clip transorally through the esophagus to the stomach;   invaginating the fundus of the stomach with the grasping device; and   using the clip applier to first slide the clip over the invaginated fundus and then to apply force to bend at least one end of the clip to pass through the invaginated fundus in order to plicate the fundus.   
     
     
         2 . The method according to  claim 1 , wherein:
 the step of inserting a grasping device comprises inserting the grasping device through a lumen of the endoscope.   
     
     
         3 . The method according to  claim 2 , which further comprises:
 attaching a sheath to an exterior of the endoscope; and   the step of inserting a surgical clip applier comprises inserting the clip applier through the sheath.   
     
     
         4 . The method according to  claim 1 , wherein:
 the step of inserting a surgical clip applier comprises attaching the clip applier to the exterior of the endoscope prior to said inserting the endoscope.   
     
     
         5 . The method according to  claim 2 , wherein:
 the step of inserting a surgical clip applier includes inserting the clip applier through a second lumen of the endoscope.   
     
     
         6 . The method according to  claim 2 , which further comprises:
 attaching a guide to an exterior of the endoscope; and   the step of inserting a surgical clip applier comprises attaching the clip applier to the guide.   
     
     
         7 . The method according to  claim 1 , wherein:
 the step of inserting a surgical clip applier comprises attaching the clip applier to the exterior of the endoscope after said inserting the endoscope.