Devices and Methods for Treatment of Obesity

Abstract

Methods, devices, tools, instruments and systems for treating a patient to induce weight loss. In one method embodiment, a device, including an expandable member in a collapsed configuration, is passed through an opening in the skin of the patient, and into the abdominal cavity of the patient. At least a portion of the expandable member is anchored relative to at least one structure in the abdominal cavity, without piercing the stomach. The expandable member is expanded to an expanded configuration in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach.

1 - 184 . (canceled) 
     
     
         185 . A method of treating a patient, said method comprising:
 passing a device including an expandable member in a collapsed configuration through an opening in the skin of the patient, and into the abdominal cavity of the patient;   anchoring at least one attachment tab extending from the expandable member, relative to at least one structure in the abdominal cavity, without piercing the stomach; and   expanding the expandable member to an expanded configuration in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach.   
     
     
         186 . The method of  claim 185 , wherein said method is performed as a mini-laparoscopic procedure. 
     
     
         187 . The method of  claim 185 , wherein a guidewire is passed through the skin of the patient, and into the abdominal cavity, and wherein the device is passed over the guidewire to guide the device to an intended location in the abdominal cavity; said method further comprising inserting a flexible endoscope through the skin and into the abdominal cavity, to view placement of the guidewire prior to passing the device over the guidewire. 
     
     
         188 . The method of  claim 185 , wherein a guidewire is passed through the skin of the patient, and into the abdominal cavity, and wherein the device is passed over the guidewire to guide the device to an intended location in the abdominal cavity, said method further comprising visualizing placement of the guidewire using at least one of: fluoroscopy, three-dimensional RF visualization, and three-dimensional magnetic visualization. 
     
     
         189 . The method of  claim 185 , wherein the device is passed in a compact configuration, the compact configuration being achieved by folding the expandable member in a compact accordion-fold configuration, and maintaining the compact accordion-fold configuration during said passing a device. 
     
     
         190 . The method of  claim 185 , wherein the device is passed in a compact configuration, the compact configuration being achieved by providing a capsule formed of a water soluble skin; inserting the expandable member, while in a compact configuration into the capsule; and maintaining the compact configuration of the expandable member with the capsule during said passing a device. 
     
     
         191 . The method of  claim 190 , wherein the water soluble skin of the capsule at least partially dissolves in the space prior to said expanding the expandable member. 
     
     
         192 . A method of treating a patient, said method comprising:
 passing a device including an expandable member through the skin of the patient, through the abdominal wall of the patient and into the abdominal cavity of the patient;   expanding the expandable member in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach; and   anchoring the expanded expandable member against the abdominal wall of the patient, wherein said anchoring comprises fastening a fastener against an external surface of the abdominal wall and over a member extending out of the abdominal wall, said member extending out of the abdominal wall being connected to said expandable member.   
     
     
         193 . The method of  claim 192 , further comprising anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity, without piercing the stomach. 
     
     
         194 . The method of  claim 192 , further comprising providing a layer of material that enhances tissue ingrowth between at least one of: the fastener and the external surface of the abdominal wall; and the expandable member and the inner surface of the abdominal wall. 
     
     
         195 . The method of  claim 192 , wherein said anchoring comprises:
 drawing at least one ratcheted tooth through a small opening in the abdominal wall, wherein a plurality of said ratcheted teeth are attached to the member at locations internal of the abdominal wall, wherein said ratcheted teeth are configured to be retractable out of the abdominal cavity but are prevented from passing back into the abdominal cavity.   
     
     
         196 . A method of treating a patient, said method comprising:
 passing a flexible viewing member through an opening in the skin of the patient, and into the abdominal cavity of the patient;   passing a device including an expandable member in a collapsed configuration over the flexible viewing member and into the abdominal cavity of the patient;   anchoring at least a portion of the expandable member, relative to at least one structure in the abdominal cavity; and   removing the flexible viewing member from the patient.   
     
     
         197 . The method of  claim 196 , comprising steering a distal end portion of the viewing member to advance it to a desired location in the abdominal cavity. 
     
     
         198 . The method of  claim 196 , further comprising expanding the expandable member to an expanded configuration in a space in the abdominal cavity to perform at least one of: prevention of expansion of the stomach of the patient into the space; and compression of a portion of the stomach. 
     
     
         199 . The method of  claim 196 , wherein said anchoring is performed without piercing the stomach. 
     
     
         200 . The method of  claim 196 , further comprising intermittent provision of impulses of pressurized insufflation gas at a distal end location of the viewing member during said passing of the viewing member to facilitate movement of tissue. 
     
     
         201 . The method of  claim 196 , further comprising expanding a expandable distal tip of the viewing member during said passing of the viewing member to facilitate movement of tissue to provide better visualization through a viewing tip of the viewing member. 
     
     
         202 . The method of  claim 196 , wherein the device is backloaded on a proximal portion of the viewing member prior to passing the viewing member through the opening in the patient. 
     
     
         203 . The method of  claim 196 , wherein said flexible viewing member is a flexible endoscope. 
     
     
         204 . The method of  claim 196 , wherein said device is contained within a sheath, in a compressed configuration as it is passed over the viewing member, and wherein said sheath is withdrawn after said device has been placed in the abdominal cavity. 
     
     
         205 . The method of  claim 196 , wherein said anchoring comprises anchoring a tab extending from said expandable member to the at least one structure in the abdominal cavity. 
     
     
         206 . The method of  claim 196 , wherein said anchoring comprises engaging a portion of said device with an anchoring frame mounted on an internal structure in the abdominal cavity. 
     
     
         207 . The method of  claim 196 , wherein said flexible viewing member is a flexible wire.