Device for treating gastroesophageal reflux disease

Abstract

A device for treating a tissue region at or near a lower esophageal sphincter to treat gastroesophageal reflux disease including a flexible tube having a plurality of arrays of first and second lumens, a proximal base, a distal hub, a plurality of radially spaced slits formed between the proximal base and distal hub, and a plurality of electrode ports and fluid ports, the electrode and fluid ports and the lumens are positioned between the slits. The tube is flexible outwardly between the slits to form an array of spines forming a three dimensional basket. A first electrode is movable within the first lumen of one array and a second electrode is movable within the first lumen of another array to exit through the electrode ports to penetrate tissue for application of energy to the tissue region to tighten the lower esophageal sphincter to treat gastroesophageal reflux disease.

1 . (canceled) 
     
     
         2 . A device for treating a tissue region at or near a lower esophageal sphincter to treat gastroesophageal reflux disease comprising a flexible tube having a plurality of arrays of first and second lumens, a proximal base, a distal hub, a plurality of radially spaced slits formed between the proximal base and distal hub, and a plurality of electrode ports and fluid ports, the electrode and fluid ports and the first and second lumens positioned between the slits, the tube flexible outwardly between the slits to form an array of spines forming a three dimensional basket, and a first electrode movable within the first lumen of one array and a second electrode movable within the first lumen of another array to exit through the electrode ports to penetrate tissue for application of energy to the tissue region to tighten the lower esophageal sphincter to treat gastroesophageal reflux disease. 
     
     
         3 . The device of  claim 2 , wherein movement of the proximal base or distal hub to a position closer to each other flexes the spines outwardly. 
     
     
         4 . The device of  claim 2 , wherein the tube has a central lumen sized to receive an endoscope or a guidewire. 
     
     
         5 . The device of  claim 2 , wherein the tube has a proximal end and a distal end, the proximal and distal ends being without spine forming slits. 
     
     
         6 . The device of  claim 2 , wherein the slits extend axially and are axially spaced from a proximal end and a distal end of the tube. 
     
     
         7 . The device of  claim 2 , wherein the first and second electrodes are biased with a bend. 
     
     
         8 . The device of  claim 2 , wherein the first and second electrodes have a penetrating tip to penetrate smooth muscle of the lower sphincter to transmit radio frequency energy, and a material on the electrodes insulates a mucosal surface of an esophagus to direct exposure of radio frequency energy. 
     
     
         9 . The device of  claim 2 , wherein the tube is dimensioned for transoral insertion. 
     
     
         10 . The device of  claim 2 , further comprising a limit collar on the first and second electrodes to contact tissue when a set maximum desired depth of electrode penetration has been reached to resist further advancement of the electrode. 
     
     
         11 . The device of  claim 2 , wherein the first and second electrodes have a lumen for conveying fluid. 
     
     
         12 . The device of  claim 2 , wherein the arrays of lumens are circumferentially spaced. 
     
     
         13 . The device of  claim 13 , wherein the second lumen of the arrays accommodates passage of fluids. 
     
     
         14 . The device of  claim 2 , further comprising a pull wire to change a distance between the distal hub and proximal base to flex the tube between the slits. 
     
     
         15 . The device of  claim 2 , wherein the distance between the distal hub and proximal base is increased to collapse the basket and the distance between the distal hub and proximal base is decreased to move the basket to an expanded configuration. 
     
     
         16 . The device of  claim 6 , further comprising a pull wire to change a distance between the distal hub and proximal base to flex the tube between the slits. 
     
     
         17 . The device of  claim 5 , wherein the slits extend axially and are axially spaced from a proximal end and a distal end of the tube.