Method and apparatus for endoscopically treating rectal prolapse

Abstract

A method for treating rectal prolapse, the method comprising: inserting a rectum-gripping and advancement apparatus into a prolapsed rectum via the anus; maneuvering the rectum-gripping and advancement apparatus so that the rectum-gripping and advancement apparatus securely engages the rectum; advancing the rectum-gripping and advancement apparatus distally so as to return the prolapsed rectum to its normal, non-prolapsed state; and securing the rectum to supporting tissue whereby to retain the rectum in its normal, non-prolapsed state.

What is claimed is: 
     
         1 . A method for treating rectal prolapse, the method comprising:
 inserting a rectum-gripping and advancement apparatus into a prolapsed rectum via the anus;   maneuvering the rectum-gripping and advancement apparatus so that the rectum-gripping and advancement apparatus securely engages the rectum;   advancing the rectum-gripping and advancement apparatus distally so as to return the prolapsed rectum to its normal, non-prolapsed state; and   securing the rectum to supporting tissue whereby to retain the rectum in its normal, non-prolapsed state.   
     
     
         2 . A method according to  claim 1  wherein the method comprises the additional step of withdrawing the rectum-gripping and advancement apparatus from the rectum via the anus. 
     
     
         3 . A method according to  claim 1  wherein the rectum-gripping and advancement apparatus comprises a shaft having a distal end comprising a tissue support for engaging the interior wall of the rectum. 
     
     
         4 . A method according to  claim 3  wherein the tissue support comprises an opening. 
     
     
         5 . A method according to  claim 4  wherein the tissue support is in the form of a generally circular shape, with the opening located in the middle of the tissue support. 
     
     
         6 . A method according to  claim 3  wherein the exterior of the tissue support includes texturing. 
     
     
         7 . A method according to  claim 6  wherein the texturing comprises a layer of at least one selected from the group consisting of suture, foam and fabric secured to the tissue support. 
     
     
         8 . A method according to  claim 3  wherein the shaft comprises a proximal end having a handle. 
     
     
         9 . A method according to  claim 4  wherein the step of securing the rectum to supporting tissue is performed through the opening in the tissue support. 
     
     
         10 . A method according to  claim 3  wherein the step of securing the rectum to supporting tissue is performed around the periphery of the tissue support. 
     
     
         11 . A method according to  claim 1  wherein the method is performed under visualization provided by an endoscope. 
     
     
         12 . A method according to  claim 1  wherein the rectum-gripping and advancement apparatus is slidably mounted to an endoscope. 
     
     
         13 . A method according to  claim 1  wherein the rectum is secured to supporting tissue with a fastener deployment device. 
     
     
         14 . A method according to  claim 13  wherein the fastener deployment device is slidably mounted to an endoscope. 
     
     
         15 . A method according to  claim 1  wherein the rectum is secured to supporting tissue with at least one selected from the group consisting of a fastener and suture. 
     
     
         16 . A method according to  claim 15  wherein the fastener is selected from the group consisting of shaft-type tacks, legged staples, multi-part fasteners, and tacks comprising a body having suture extending therefrom. 
     
     
         17 . A method according to  claim 15  wherein the fastener consists of at least one substantially rigid element having a suture attached thereto. 
     
     
         18 . A method according to  claim 15  wherein the fastener further comprises a securement band for securing the suture. 
     
     
         19 . A method according to  claim 1  wherein the rectum is secured to supporting tissue by suturing. 
     
     
         20 . A method according to  claim 1  wherein the rectum is secured to the presacral fascia. 
     
     
         21 . A method according to  claim 1  wherein the securement location is determined by identifying an anatomical landmark. 
     
     
         22 . A method according to  claim 21  wherein the anatomical landmark is determined from a location within the rectum. 
     
     
         23 . A method according to  claim 21  wherein the anatomical landmark is identified by an ultrasound probe disposed within the rectum. 
     
     
         24 . A method according to  claim 21  wherein the anatomical landmark is identified by an endoscope disposed within the rectum. 
     
     
         25 . A method according to  claim 21  wherein the anatomical landmark is the sacral promontory. 
     
     
         26 . A method according to  claim 1  wherein the rectum is secured to supporting tissue with a plurality of fasteners. 
     
     
         27 . A rectum-gripping and advancement apparatus for treating rectal prolapse comprising:
 a shaft having a distal end and a proximal end; and   a tissue support for engaging the interior wall of a rectum and repositioning the interior wall of the rectum.   
     
     
         28 . Apparatus according to  claim 27  wherein the tissue support comprises an opening. 
     
     
         29 . Apparatus according to  claim 28  wherein the tissue support is in the form of a generally circular shape, with the opening located in the middle of the tissue support. 
     
     
         30 . Apparatus according to  claim 27  wherein the exterior of the tissue support includes texturing. 
     
     
         31 . Apparatus according to  claim 30  wherein the texturing comprises a layer of at least one selected from the group consisting of suture, foam and fabric secured to the tissue support. 
     
     
         32 . Apparatus according to  claim 23  wherein the proximal end of the shaft comprises a handle. 
     
     
         33 . Apparatus according to  claim 28  wherein a fastener deployment device can be inserted through the opening so as to access the interior wall of the rectum engaged by the tissue support and secure the tissue to supporting tissue. 
     
     
         34 . Apparatus according to  claim 27  wherein the rectum-gripping and advancement apparatus may be slidably mounted to an endoscope. 
     
     
         35 . An assembly for treating rectal prolapse, the assembly comprising:
 an endoscope;   a rectum-gripping and advancement apparatus for treating rectal prolapse comprising:
 a shaft having a distal end and a proximal end; and 
 a tissue support for engaging the interior wall of a rectum and repositioning the interior wall of the rectum; and 
   a fastener deployment device.   
     
     
         36 . An assembly according to  claim 35  wherein at least one of the rectum-gripping and advancement apparatus and fastener deployment device are slidably mounted to the endoscope. 
     
     
         37 . An assembly according to  claim 35 , wherein the assembly further comprises an ultrasound probe. 
     
     
         38 . An assembly according to  claim 37  wherein the endoscope comprises at least one working channel, and further wherein the ultrasound probe is delivered via the at least one working channel. 
     
     
         39 . An assembly according to  claim 35  wherein the fastener deployment device is adapted to deploy a fastener selected from the group consisting of shaft-type tacks, legged staples, multi-part fasteners, and tacks comprising a body having suture extending therefrom. 
     
     
         40 . An assembly according to  claim 35  wherein the tissue support comprises an opening. 
     
     
         41 . An assembly according to  claim 40  wherein the tissue support is in the form of a generally circular shape, with the opening located in the middle of the tissue support. 
     
     
         42 . An assembly according to  claim 35  wherein the exterior of the tissue support includes texturing. 
     
     
         43 . An assembly according to  claim 42  wherein the texturing comprises a layer of at least one selected from the group consisting of suture, foam and fabric secured to the tissue support. 
     
     
         44 . An assembly according to  claim 35  wherein the proximal end of the shaft comprises a handle. 
     
     
         45 . An assembly according to  claim 35  wherein a fastener deployment device can be inserted through the opening so as to access the rectum engaged by the tissue support and secure the tissue to supporting tissue.