US20150238342A1 - Gastric space filler delivery system and related methods - Google Patents

Abstract

According to features of the present disclosure, a gastric space filler device and methods effective for reducing stomach volume are disclosed. A gastric space filler comprising at least one inflatable space filler and a sleeve to prevent leakage out of the gastric space filler device is disclosed. The gastric space filler device may be inflated with an insufflation fluid and with mineral oil, which further has the effect of reducing leakage. Delivery systems and methods for inserting a gastric space filler device into a patient are also disclosed. Sheaths and methods for covering a gastric space filler device during delivery into a patient are also disclosed.

Description

RELATED APPLICATION
• This application claims full Paris Convention benefit of and priority to U.S. patent application (a) Ser. No. 11/694,536, filed Mar. 30, 2007 and PCT applications (b) Serial No. PCT/US06/142,336, filed Oct. 31, 2006, (c) Serial No. PCT/US06/42711, filed Oct. 31, 2006, and (d) Serial No. PCT/US06/42710, filed Oct. 31, 2006, and (e) Serial No. PCT/US06/48647, filed Dec. 20, 2006, the contents of which are hereby incorporated by reference in their entirety, as if fully set forth herein.
BACKGROUND
• 1. Field
• This disclosure relates to implantable weight control devices. More particularly, this disclosure relates to a gastric space filler device which is retrievably implantable in a patient, an improved device and method for delivery of a gastric space filler device, and a method and device for retaining fluid in a gastric space filler device, among other things.
• 2. General Background
• Gastric space fillers used for achieving loss of weight in extremely obese persons have been known in the art. Some gastric space fillers utilized for this purpose function on the principle that an empty bag or space filler is placed into the stomach through the esophagus. Thereafter, the bag or space filler is fully or partially filled with a suitable insufflation fluid, such as saline solution, through a filler tube or catheter which is inserted into the stomach through the mouth or the nose. The space filler occupies space in the stomach thereby leaving less room available for food and creating a feeling of satiety for the obese person. Clinical experience has shown that, for many obese patients, reducing the size of the gastric compartment with gastric space fillers significantly helps to control appetite and accomplish weight loss. The present disclosure is directed to a device which non-operatively reduces the size of the gastric compartment and which is easily removed. Artisans shall readily appreciate that emergency operative morbidity rates and co-morbidity statistics relating to such devices which have migrated beyond the stomach underscore the need for an effective medical device that can be removed.
SUMMARY
• According to features of the present disclosure, a gastric space filler device and methods effective for reducing stomach volume are disclosed. A gastric space filler comprising at least one inflatable space filler and a sleeve to prevent leakage out of the gastric space filler device is disclosed. The gastric space filler device may be inflated with an insufflation fluid and with mineral oil, which further has the effect of reducing leakage. Delivery systems and methods for inserting a gastric space filler device into a patient are also disclosed. Sheaths and methods for covering a gastric space filler device during delivery into a patient are also disclosed.
• According to embodiments of the instant teachings, there is disclosed a gastric space filler device comprising a space filler, an opening to inflate the space filler, and a sleeve that is configured to receive mineral oil between the sleeve and the opening. According to at least one embodiment, the sleeve is disposed between the opening and the outer periphery of the space filler. According to at least one embodiment, the sleeve allows fluid to enter the space filler during inflation, but does not allow fluid to exit the space filler when mineral oil is received between the sleeve and the opening.
• According to embodiments of the instant teachings, there is disclosed a gastric space filler device comprising a space filler and a sheath, wherein the sheath at least partially covers the space filler. According to at least one embodiment, the sheath is secured around the space filler with a stitch that can be released by pulling on the stitch. According to at least one embodiment, the sheath automatically uncovers the space filler as the space filler is inflated.
• According to embodiments of the instant teachings, there is disclosed a delivery system comprising a delivery lumen, a barb configured for coupling with an infusing lumen of a gastric space filler device, and a docking clip configured for securely attaching the delivery system to the gastric space filler device. According to at least one embodiment, the delivery system contains a handle that, when removed from the infusing lumen, pulls a stitch to release a space filler and simultaneously uncovers a luer for infusing a fluid into the gastric space filler device.
• According to embodiments of the instant teachings, there is disclosed a method for treating obesity challenged patients comprising providing a gastric space filler device comprising a space filler, an opening to inflate the space filler with a fluid, and a sleeve disposed between the opening and an outer periphery of the space filler; allowing the fluid to enter the space filler through the opening; and preventing the fluid from exiting the space filler through the opening.
• According to embodiments of the instant teachings, there is disclosed a method for emplacing a gastric space filler device in a patient comprising providing a delivery system attached to a gastric space filler device comprising a space filler; covering at least part of the space filler with a sheath; and delivering the delivery system and the gastric space filler device through an esophagus into a stomach of a patient.
DRAWINGS
• The above-mentioned features and objects of the present disclosure will become more apparent with reference to the following description taken in conjunction with the accompanying drawings wherein like reference numerals denote like elements and in which:
• FIG. 1 shows an embodiment of a gastric space filler device and delivery system;
• FIG. 2A shows an embodiment of an infusing member without proximal sleeve or distal sleeve;
• FIG. 2B shows an embodiment of an infusing member with a proximal sleeve and a distal sleeve;
• FIG. 3 shows a cross-sectional view of an embodiment of an infusing member, a proximal sleeve, and a proximal opening;
• FIG. 4 shows a cross-sectional view of an embodiment of an infusing member, a distal sleeve, and a distal opening;
• FIG. 5 shows a rear view of an embodiment of a gastric space filler device containing a distal space filler;
• FIG. 6 shows a front view of an embodiment of a gastric space filler device containing a proximal space filler;
• FIG. 7 shows a cross-sectional view of an embodiment of a gastric space filler device and a delivery system containing a proximal delivery lumen and a distal delivery lumen;
• FIG. 8 shows a cross-sectional view of an embodiment of a gastric space filler device and a delivery system containing a stitch channel and a delivery guide wire channel;
• FIG. 9 shows an embodiment of a gastric space filler device and a delivery system containing a sheath, a stitch, and a sheath release cap;
• FIG. 10A shows an embodiment of a delivery system containing a handle;
• FIG. 10B shows a cross-sectional view of an embodiment of a delivery system containing a handle;
• FIG. 10C shows an embodiment of a delivery system and a handle detached from delivery system;
• FIG. 11A shows an embodiment of a gastric space filler device and sheaths wherein a proximal space filler and a distal space filler are deflated;
• FIG. 11B shows an embodiment of a gastric space filler device, wherein a distal space filler is inflated;
• FIG. 11C shows an embodiment of a gastric space filler device, wherein a proximal space filler is inflated.
DETAILED DESCRIPTION
• According to an embodiment as schematically depicted inFIG. 1, gastricspace filler device19 comprisesproximal space filler91A, distal space filler91B, and infusingmember93.Proximal space filler91A is filled with an insufflation fluid throughproximal opening96A of infusingmember93, and distal space filler91B is filled with fluid from distal opening96B of infusingmember93.Delivery system200 infuses and expands gastricspace filler device19.
• According to an illustrative embodiment,proximal space filler91A and distal space filler91B are spaced apart and secured to each other by infusingmember93. According to an illustrative embodiment, the distance between the two space fillers is between at least about 10 to approximately 40 mm. The overall axial length of gastricspace filler device19 is between about 100 and about 300 mm. According to an illustrative embodiment, infusingmember93 may be made of semi-flexible or flexible material. The semi-flexible material may be selected from space filler-compatible polymer, such as, polyethylene, polystyrene, polyurethane, silicone, fluoro-polymer, and co-polymers thereof.
• According to an illustrative embodiment, the longitudinal length ofproximal space filler91A is between about 70 and about 80 mm, preferably about 75 mm.Proximal space filler91A may be expanded to a space volume of between about 100 and about 600 cc. In an embodiment, the longitudinal length of distal space filler91B is between about 60 and about 70 mm, preferably about 65 mm.
• Distal space filler91B may be expanded to a space volume of between about 100 and about 400 cc. According to a further embodiment, a radial diameter ofproximal space filler91A may be expanded to a diameter between about 40 and about 60 mm, and a radial diameter of distal space filler91B may be expanded to a diameter between about 20 and about 40 mm. According to an illustrative embodiment,proximal space filler91A is substantially larger than distal space filler91B in gastricspace filler device19 to take the advantage of the restricted space at the entrance region of the stomach and to create a better feeling of satiety for the patient. According to an illustrative embodiment, the thickness ofproximal space filler91A and distal space filler91B is between about 0.2 and about 1.0 mm, effectively between about 0.3 to about 0.5 mm.
• According to an embodiment as depicted inFIG. 2B, infusingmember93 containsproximal sleeve110A that wraps around infusingmember93 and coversproximal opening96A, which connectsproximal space filler91A to proximal infusinglumen94A. Infusingmember93 also contains distal sleeve110B that wraps around infusingmember93 and covers distal opening96B, which connects distal space filler91B to distal infusing lumen94B.
• According to an embodiment as depicted inFIG. 3, proximal infusinglumen94A of infusingmember93 hasproximal opening96A that provides fluid communication between infusinglumen94A andproximal space filler91A. According to an embodiment as depicted inFIG. 4, distal infusing lumen94B of infusingmember93 has distal opening96B that provides fluid communication between distal infusing lumen94B and distal space filler91B.Proximal space filler91A and proximal infusinglumen94A are not in fluid communication with either distal space filler91B or distal infusing lumen94B. According to an illustrative embodiment, infusingmember93 has an inner diameter of between about 1 and about 6 mm. According to an illustrative embodiment, proximal infusinglumen94A is substantially larger than distal infusing lumen94B.
• According to an illustrative embodiment,proximal opening96A connectsproximal space filler91A to proximal infusinglumen94A. According to an illustrative embodiment,proximal sleeve110A wraps around infusingmember93 and coversproximal opening96A.Proximal sleeve110A may be disposed betweenproximal opening96A and outer periphery ofproximal space filler91A.
• Asproximal space filler91A is being inflated,proximal sleeve110A allows an insufflation fluid to enterproximal space filler91A from proximal infusinglumen94A throughproximal opening96A. According to an illustrative embodiment,proximal sleeve110A allows an insufflation fluid to enterproximal space filler91A by moving at least part ofproximal sleeve110A away fromproximal opening96A. According to an illustrative embodiment, at least part ofproximal sleeve110A is moved away fromproximal opening96A as a result of higher pressure outsideproximal space filler91A in relation to pressure insideproximal space filler91A.
• According to an illustrative embodiment, afterproximal space filler91A is inflated,proximal sleeve110A is pressed againstproximal opening96A; thusproximal sleeve110A does not allow fluid to exitproximal space filler91A throughproximal opening96A. According to an illustrative embodiment, higher pressure insideproximal space filler91A, relative to pressure outsideproximal space filler91A, pressesproximal sleeve110A againstproximal opening96A.
• According to another embodiment,proximal sleeve110A is not wrapped around infusingmember93, but is attached to infusingmember93 and is configured to move at least partially away fromproximal opening96A whileproximal space filler91A is being inflated and is also configured to blockproximal opening96A afterproximal space filler91A has been inflated.
• According to an embodiment as depicted inFIG. 4, distal sleeve1103 covers distal opening96B. Distal sleeve110B allows inflation of distal space filler91B through distal opening96B and prevents deflation of distal space filler91B through distal opening96B while distal space filler91B is inflated. Appropriate materials forproximal sleeve110A or distal sleeve110B include any elastomeric material, such as silicone.
• According to an illustrative embodiment, an insufflation fluid, such as a saline solution, is used to inflateproximal space filler91A or distal space filler91B to a desired volume effective to fill the desired portion of a stomach of a patient and create the desired feeling of satiety. Whenproximal space filler91A is inflated to this point, mineral oil is infused throughproximal opening96A and received betweenproximal sleeve110A andproximal opening96A. The mineral oil displaces the insufflation fluid in the area betweenproximal sleeve110A andproximal opening96A. Mineral oil betweenproximal sleeve110A andproximal opening96A has the effect of decreasing leakage of the insufflation fluid out ofproximal space filler91A throughproximal opening96A. According to an illustrative embodiment, an effective amount of mineral oil is the amount of mineral oil with volume equal to the volume of the insufflation fluid to be displaced by the mineral oil. According to an illustrative embodiment, mineral oil is received between distal sleeve110B and distal opening96B. Unexpectedly, this teaching substantially improves leakage and has yet to have been disclosed.
• According to an embodiment as depicted inFIG. 6, proximal infusinglumen94A containsproximal gate112A, and distal infusing lumen94B contains distal gate112B, disposed at proximal end of infusingmember93.Proximal gate112A prevents at least some of any fluid from traveling into or out of proximal infusinglumen94A untilproximal barb206A is inserted throughproximal gate112A and into proximal infusinglumen94A. Similarly, distal gate112B prevents at least some of any fluid from traveling into or out of distal infusing lumen94B until distal barb206B is inserted through distal gate112B and into distal infusing lumen94B.Proximal gate112A or distal gate112B may be made of a flexible material that substantially covers proximal infusinglumen94A or distal infusing lumen94B and can be manipulated to allow insertion ofproximal barb206A or distal barb206B.
• According to an embodiment as depicted inFIG. 7, after gastricspace filler device19 is delivered to the stomach of a patient,delivery system200 is inserted through the mouth to securely couple with proximal end of gastricspace filler device19. According to another embodiment,delivery system200 is securely coupled to gastricspace filler device19 before gastricspace filler device19 anddelivery system200 are delivered to the stomach of a patient. According to an illustrative embodiment,delivery system200 may be coupled to gastricspace filler device19 by dockingclip222 ofdelivery system200, which is configured to securely attach todocking notch208 of gastricspace filler device19.
• According to an illustrative embodiment,delivery system200 containsproximal barb206A and distal barb206B.Proximal barb206A is in fluid communication withproximal delivery lumen210A, and distal barb206B is in fluid communication with distal delivery lumen210B. Whendelivery system200 is securely coupled with proximal end of gastricspace filler device19,proximal barb206A and distal barb206B are at least partially inserted into proximal infusinglumen94A and distal infusing lumen94B, respectively.
• Proximal space filler91A may be inflated by delivering an insufflation fluid intoproximal delivery lumen210A, thereby delivering insufflation fluid throughproximal barb206A and into proximal infusinglumen94A. Similarly, distal space filler91B may be inflated by delivering an insufflation fluid into distal delivery lumen210B, thereby delivering insufflation fluid through distal barb206B and into the distal infusing lumen94B.
• According to an embodiment as depicted inFIG. 8, gastricspace filler device19 contains fillerguide wire channel108, anddelivery system200 contains deliveryguide wire channel224. According to an illustrative embodiment,guide wire218 is laid along a path to be traveled by gastricspace filler device19 ordelivery system200.Guide wire218 is then threaded through at least one ofguide wire channel108 of gastricspace filler device19 and deliveryguide wire channel224 ofdelivery system200. Once threaded, gastricspace filler device19 ordelivery system200 may travel alongguide wire218.
• According to an embodiment as depicted inFIG. 9,sheath202 at least partially coversproximal space filler91A and distal space filler91B before or during insertion through an esophagus of a patient.Sheath202 may be made from flexible or semi-flexible materials, including mesh fabric and silicone. According to an illustrative embodiment,sheath202 is secured to gastricspace filler device19 bystitch204. Various stitching patterns are known in the art.Stitch204 may comprise an easily releasable stitching pattern, such as one that may be released by pulling on one end ofstitch204. Whenproximal space filer91A or distal space filer91B is ready to inflate, stitch204 is removed.
• According to an illustrative embodiment, at least part ofstitch204 is secured bysheath release clip212 until gastricspace filler device19 is ready to be inserted into patient.Sheath release clip212, while engaged, secures at least part ofstitch204, such thatstitch204 may not be released. Whensheath release clip212 is removed,stitch204 is capable of being released.
• According to an illustrative embodiment, at least part ofstitch204 is located insidestitch channel214 ofdelivery system200. This allowsstitch204 to be pulled away from gastricspace filler device19 without additional instruments. Wherestitch204 is released fromsheath202 by pulling on an end ofstitch204,stitch204 may be released by pullingstitch204 throughstitch channel214.
• According to an embodiment as depicted inFIG. 10A,delivery system200 may contain handle216, which may be removably attached todelivery system200. According to an embodiment as depicted inFIG. 10B, handle216 containsinner compartment226.Proximal luer220A and distal luer220B may be contained withininner compartment226 while handle is attached todelivery system200. Whilehandle216 is attached todelivery system200,proximal luer220A and distal luer220B may not be accessed to infuse fluid intoproximal space filler91A or distal space filler91B.
• According to an embodiment as depicted inFIG. 100,stitch204 may be attached to handle216, such that whenhandle216 is removed fromdelivery system200,stitch204 is pulled away fromsheath202, thereby releasingsheath202 from coveringproximal space filler91A or distal space filler91B. Likewise, removal ofhandle216 exposesproximal luer220A and distal luer220B, such thatproximal space filler91A and distal space filler91B can be infused only whenhandle216 is removed. In this embodiment,proximal space filler91A and distal space filler91B cannot be inflated untilsheath202 is released.
• According to an embodiment as depicted inFIG. 11A,FIG. 11B, andFIG. 110, gastricspace filler device19 is at least partially covered by three sheaths: proximal sheath202A,central sheath202C, and distal sheath202B. Distal sheath202B at least partially covers distal portion of distal space filler91B,central sheath202C at least partially covers proximal portion of distal space filler91B and distal portion ofproximal space filler91A, and proximal sheath202A at least partially covers proximal portion ofproximal space filler91A.
• As distal space filler91B is inflated, distal sheath202B is rolled onto itself toward distal end of gastricspace filler device19 and distal portion ofcentral sheath2020 is rolled onto itself toward center of gastricspace filler device19. Asproximal space filler91A is inflated, proximal sheath202A is rolled onto itself toward proximal end of gastricspace filler device19, and proximal portion ofcentral sheath2020 is rolled onto itself toward center of gastricspace filler device19. In an illustrative embodiment, asproximal space filler91A is inflated, proximal sheath202A is rolled onto itself towarddelivery system200 attached to proximal end of gastricspace filler device19, such that whenproximal space filler91A is inflated, proximal sheath202A is rolled ontodelivery system200 and whendelivery system200 is detached and removed, proximal sheath202A is removed withdelivery system200.
• In an illustrative embodiment, gastricspacer filler device19 is at least partially covered by two sheaths: proximal sheath202A and distal sheath202B. Distal sheath202B at least partially covers distal space filler91B until distal space filler91B is inflated, which causes distal sheath202B to be rolled onto itself, either toward distal end of gastricspace filler device19 or toward center of gastricspace filler device19. Similarly, proximal sheath202A at least partially coversproximal space filler91A untilproximal space filler91A is inflated, which causes proximal sheath202A to be rolled onto itself, either toward proximal end of gastricspace filler device19 or toward the center of gastricspace filler device19.
• In an illustrative embodiment, gastricspace filler device19 is at least partially covered by a single sheath:central sheath202C.Central sheath202C at least partially covers each ofproximal space filler91A and distal space filler91B. As distal space filler91B is inflated,central sheath2020 is rolled onto itself from proximal end of gastricspace filler device19 toward center of gastricspace filler device19 untilcentral sheath202C no longer covers distal space filler91B. Asproximal space filler91A is inflated,central sheath202C is rolled onto itself from proximal end of gastricspace filler device19 toward center of gastricspace filler device19 untilcentral sheath2020 no longer coversproximal space filler91A. Alternatively, asproximal space filler91A is inflated,central sheath202C may be rolled from center of gastricspace filler device19 toward proximal end of gastricspace filler device19.
• While the apparatus and method have been described in terms of what are presently considered to be the most practical embodiments, it is to be understood that the disclosure need not be limited to the disclosed embodiments. It is intended to cover various modifications and similar arrangements included within the spirit and scope of the claims, the scope of which should be accorded the broadest interpretation so as to encompass all such modifications and similar structures. The present disclosure includes any and all embodiments of the following claims.

Claims (11)

1-20. (canceled)

21. A gastric space filler device, comprising:

a flexible, elongate infusing member having a proximal end, a distal end, and a guide wire channel extending completely through the infusing member from the proximal end to the distal end; and

a plurality of inflatable gastric space fillers secured to the infusing member, wherein the infusing member extends completely through the gastric space fillers, and wherein the inflatable gastric space fillers are configured to be implanted and inflated in a stomach of a human patient.

22. The gastric space filler device ofclaim 21, further comprising a delivery system configured to be releasably attached to the gastric space filler device, wherein the delivery system comprises:

a proximal barb positioned to engage a proximal delivery lumen of the infusing member and provide fluid communication between the delivery system and a proximal inflatable space filler coupled to the infusing member; and

a distal barb positioned to engage a distal lumen of the infusing member and provide fluid communication between the delivery system and a distal inflatable space filler coupled to the infusing member.

23. The gastric space filler device ofclaim 22 wherein the delivery system is configured to be attached to the gastric space filler device with the proximal barb and/or the distal barb of the delivery system inserted into a gate at the proximal end of the infusing member.

24. The gastric space filler device ofclaim 22 wherein the delivery system further comprises a delivery guide wire channel aligned with the guide wire channel when the delivery system is releasably attached to the gastric space filler device.

25. The gastric space filler device ofclaim 24, further comprising a guidewire threaded through the filler guide wire channel and the delivery guide wire channel.

26. The gastric space filler device ofclaim 21 wherein at least one of the gastric space fillers has an outer diameter of at least about 40 mm when inflated with a fluid.

27. The gastric space filler device ofclaim 21 wherein the gastric space fillers are configured to at least partially fill a portion of the stomach of the human patient to create a feeling of satiety.

28. The gastric space filler device ofclaim 22 wherein the infusing member comprises a gate at the proximal end, and wherein the gate is configured to close when the proximal barb and/or the distal barb is removed from the proximal end of the infusing member.

29. The gastric space filler device ofclaim 21 wherein the gastric space filler device is configured to be at least partially covered with a sheath before guiding the gastric space filler device along a guide wire.

30. The gastric space filler device ofclaim 21 wherein:

the infusing member includes a docking notch; and

wherein the gastric space filler device further comprises a delivery system having a docking clip configured to be releasably attached over the docking notch of the infusing member.

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