1. Field of the Invention
The present invention relates to an implantable restriction device. More particularly, the invention relates to the protection of both the implantable restriction device and internal tissue or lumen, such as, stomach tissue, during the application and operation of the implantable restriction device.
2. Description of the Prior Art
Morbid obesity is a serious medical condition. In fact, morbid obesity has become highly pervasive in the United States, as well as other countries, and the trend appears to be heading in a negative direction. Complications associated with morbid obesity include hypertension, diabetes, coronary artery disease, stroke, congestive heart failure, multiple orthopedic problems and pulmonary insufficiency with markedly decreased life expectancy. With this in mind, and as those skilled in the art will certainly appreciate, the monetary and physical costs associated with morbid obesity are substantial. In fact, it is estimated the costs relating to obesity are in excess of one hundred billion dollars in the United States alone.
A variety of surgical procedures have been developed to treat obesity. The most common currently performed procedure is Roux-en-Y gastric bypass (RYGB). This procedure is highly complex and is commonly utilized to treat people exhibiting morbid obesity. Other forms of bariatric surgery include Fobi pouch, bilio-pancreatic diversion, and gastroplastic or “stomach stapling”. In addition, implantable devices are known which limit the passage of food through the stomach and affect satiety.
In view of the highly invasive nature of many of these procedures, efforts have been made to develop less traumatic and less invasive procedures. Gastric-banding is one of these methods. Gastric-banding is a type of gastric reduction surgery attempting to limit food intake by reducing the size of the stomach. In contrast to RYGB and other stomach reduction procedures, gastric-banding does not require the alteration of the anatomy of the digestive tract in the duodenum or jejunum.
Since the early 1980's, gastric bands have provided an effective alternative to gastric bypass and other irreversible surgical weight loss treatments for the morbidly obese. Several alternate procedures are performed under the heading of gastric-banding. Some banding techniques employ a gastric ring, others use a band, some use stomach staples and still other procedures use a combination of rings, bands and staples. Among the procedures most commonly performed are vertical banded gastroplasty (VBG), silastic ring gastroplasty (SRG) and adjustable silastic gastric banding (AGB).
In general, the gastric band is wrapped around an upper portion of the patient's stomach, forming a stoma that is less than the normal interior diameter of the stomach. This restricts food passing from an upper portion to a lower digestive portion of the stomach. When the stoma is of an appropriate size, food held in the upper portion of the stomach provides a feeling of fullness that discourages over eating.
As those skilled in the art will certainly appreciate, hybrid procedures involving gastric bypass and the utilization of a gastric band are becoming more and more common. These hybrid procedures involve placing a gastric band about the stomach in conjunction with the performance of the surgical procedure for gastric bypass surgery. However, significant challenges are associated with this procedure and, more specifically, some of these challenges relate to the placement of the gastric band directly over a staple line created as a result of the gastric bypass surgery. When a balloon type gastric band is positioned over a staple line, potential complications are encountered. These complications include damage to the gastric band resulting from the interaction of the gastric band with the staples in a manner potentially causing puncture of the gastric band by the staples. In addition to the potential puncture of the gastric band, the interaction of the gastric band with the staples may cause damage to the staple line due to rubbing of the staple line by positioning of the gastric band thereover and infection at the site of the gastric band placement.
It is, therefore, an object of the present invention to provide an implantable restriction device including a belt and a balloon secured to the belt for engagement with tissue when the implantable restriction device is positioned about an organ. A protective member is associated with the balloon for positioning between the balloon and a tissue surface defining a band tissue interface.
It is a further object of the present invention to provide an implantable restriction device wherein the protective member includes a protective plate which is flexible and positioned along the inner surface of the balloon of the restrictive device.
It is also an object of the present invention to provide an implantable restriction device wherein the protective member includes a protective plate which is pleated and positioned along the inner surface of the balloon of the restrictive device.
It is another object of the present invention to provide an implantable restriction device wherein the protective plate is in the form of a directional flexible plate.
It is a further object of the present invention to provide an implantable restriction device wherein the protective plate is made of expandable PTFE.
It is also an object of the present invention to provide an implantable restriction device wherein the protective member is an overlapping plate system and the overlapping plate system utilizes an intralocking and overlapping construction that can accordion open or close to protect the balloon.
It is another object of the present invention to provide an implantable restriction device wherein the protective member is a sponge that conforms to the band tissue interface so as to prevent undesirable interaction which might ultimately cause damage to either the staple line or the balloon.
It is a further object of the present invention to provide an implantable restriction device wherein the protective member is an expandable PTFE applied to the inner surface of the balloon of the implantable restriction device.
It is also an object of the present invention to provide an implantable restriction device wherein the protective member is composed of stand-offs formed along the inner surface of the balloon.
It is another object of the present invention to provide an implantable restriction device wherein the stand-offs are of a different durometer than the balloon.
It is a further object of the present invention to provide an implantable restriction device wherein the stand-offs are shaped and dimensioned to straddle the staple line and protect the balloon.
It is also an object of the present invention to provide an implantable restriction device wherein the protective member is a protective layer added to the balloon that interfaces with the staple line and wherein a section of the balloon in contact with the staple line is formed from a material having a different durometer than the remainder of the balloon.
It is another object of the present invention to provide an implantable restriction device wherein the protective member is a fibrous mesh within an inner wall of the balloon.
It is a further object of the present invention to provide an implantable restriction device wherein the protective member is a self sealing material.
It is also an object of the present invention to provide an implantable restriction device wherein the self sealing material is an inner wall of the balloon.
It is another object of the present invention to provide an implantable restriction device wherein the protective member is integrally associated with the balloon.
It is a further object of the present invention to provide an implantable restriction device wherein the protective member includes a plurality of individual lumens in a layered configuration.
Other objects and advantages of the present invention will become apparent from the following detailed description when viewed in conjunction with the accompanying drawings, which set forth certain embodiments of the invention.
The detailed embodiments of the present invention are disclosed herein. It should be understood, however, that the disclosed embodiments are merely exemplary of the invention, which may be embodied in various forms. Therefore, the details disclosed herein are not to be interpreted as limiting, but merely as the basis for the claims and for teaching one skilled in the art how to make and/or use the invention.
As discussed above, the present invention relates to an implantable restriction device. A preferred embodiment of the implantable restriction device is disclosed herein within reference to a gastric band used in restricting the effective size of the stomach for application in bariatric procedures. As such, the implantable restriction device of the present invention is referred to as a gastric band throughout the present disclosure, although those skilled in the art will appreciate the concepts underlying the present invention may be applied in a variety of implantable restriction devices.
The present invention provides for various gastric band constructions addressing the problems associated with hybrid gastric procedures combining surgical gastric reduction with gastric banding. The present invention, therefore allows for the placement of a gastric band 10 directly over a staple line 11 created in the formation of a sleeve portion during the gastric bypass surgery of the hybrid procedure. The gastric band 10 constructions employed in accordance with the present invention protect the gastric band 10 from undesirable interaction with the staples, both during the implantation process and after the gastric band is fully applied about the stomach, in a manner minimizing the potential for puncture of the gastric band 10 by the staples and similar interactions which may cause damage to the staple line 11 due to rubbing of the staple line 11 by positioning of the gastric band 10 thereover. Infections at the placement site of the gastric band 10 are also minimized through utilization of the present gastric band 10.
Although it is contemplated various gastric band constructions may be employed in accordance with the present invention, a preferred gastric band 10 construction is disclosed. More details regarding gastric band construction appropriate for use in conjunction with the present invention may be found in commonly owned U.S. patent application Ser. No. 11/798,634, entitled “Gastric band composed of different hardness materials”, which is incorporated herein by reference.
In general, and with reference to
With regard to the balloon 20, it also includes a first end 34, a second end 36, an inner surface 38 and an outer surface 40. The inner surface 38 is substantially smooth and is shaped and dimensioned for engaging the patient's stomach when the gastric band 10 is secured thereto. The outer surface 40 of the balloon 20 is shaped and dimensioned for coupling with the inner surface 30 of the belt 18.
The gastric band 10 is shaped and dimensioned to circumscribe the stomach at a predetermined location providing for a controlled reduction in the size of the stomach. The gastric band 10 employs a flexible latching mechanism, composed of latching members 26, 28, capable of locking and unlocking without destruction of the latching mechanism or significant reduction in retention capabilities after re-locking. The first and second ends 22, 24 of the belt 18 respectively act as both male and female members depending on the direction of motion and intent to lock or unlock the latching mechanism of the present gastric band 10.
The first end 22 includes a shell member which is generally M-shaped as best shown in
More particularly, the shell member at the first end of the gastric band 10 is generally a half-moon shaped shell with an open, wide end tapering toward a narrow end adjacent the tip of the first end. The shell member is substantially hollow and is formed from a material, for example, silicone, which permits compression and expansion thereof.
Further details of the operation of the latching mechanism can be found in commonly owned U.S. patent application Ser. No. 11/182,072, entitled “LATCHING DEVICE FOR GASTRIC BAND”, which is incorporated herein by reference.
As discussed above, gastric bands are utilized in conjunction with surgical procedures formed along the stomach. As such, interaction between the interior surface 41 of the gastric band 10 and the staple line created as a result of a surgical procedure are at times encountered. As such, concerns are created regarding this interation and the present gastric band 10 includes mechanisms developed to minimize potential damage to gastric bands when applied over a staple line. These mechanisms relate specifically to the interior surface 38 of the balloon 20 for improving the interaction between the balloon 20 and the staple line.
With reference to
Referring now to the embodiment shown with reference to
Referring to the embodiment shown in
Similarly, and with reference to 5, an overlapping plate system 242 may be employed to protect the band 210. The overlapping plate system 242 utilizes an intralock and overlapping construction that can accordion open or close to protect the balloon 220 of the band 210. As with the prior embodiments, the plate system 242 is oriented to space the balloon 220 from the staple line 11 so as to prevent undesirable interaction which might ultimately cause damage to either the staple line or the balloon 220 or both.
Another embodiment is disclosed with reference to
In accordance with yet a further embodiment, and with reference to
In accordance with yet a further embodiment and with reference to
In accordance with yet a further embodiment and referring to
More specifically, the inner surface 638 of the balloon 620 is provided with an integrally formed protective layer 642. In
In accordance with an alternate embodiment and as shown with reference to
In accordance with yet a further embodiment and with reference to
In accordance with this embodiment, the balloon portion 820, that is, the expandable portion of the gastric band 810 that contacts the stomach during application, of the gastric band 810 includes an inner wall 838 that is constructed to self-seal upon puncture thereof. In accordance with such self-sealing properties, the material being punctured is resilient and maintained under compression such that any punctures are immediately closed as a result of the compression (see arrows in
In accordance with such an embodiment as disclosed with reference to
In accordance with an alternate embodiment, the balloon 920 of the gastric band 910 is constructed as a self-healing balloon 920 capable of maintaining positive pressure on the gastric restriction even after puncturing of the balloon 920 from a foreign body. Referring to
In accordance with a preferred embodiment, the various lumens 930a-k of the balloon 920 are oriented in a layered configuration extending from the inner surface 922 of the balloon 920 toward the outer surface 924 of the balloon 920. Each of the lumens 930a-k is in fluid communication with a fluid source maintaining the lumens 930a-k under pressure sufficient to maintain the balloon 920 in an expanded configuration. Referring to
While a preferred layering construction is disclosed in accordance with a preferred embodiment of the present invention, it is contemplated a variety of lumen configurations may be employed without departing from the spirit of the present invention. For example, it is contemplated each layer of the balloon may be broken up into various segments. This would allow for even greater control of the internal pressure applied by the balloon in the event one of the lumens is lacerated.
With respect to the filling of the various lumens 930a-k, it is contemplated filling may be controlled by an inlet valve (for example, a duckbill valve) 940 allowing controlled fluid flow from the fluid source 942 to the various lumens 930a-k in only one direction. In the event too much pressure is applied to an individual lumen 930a-k, fluid outflow is permitted via a pair of overflow valves (for example, umbrella valves) 944 integrally formed with the inlet valve 940. The overflow valves 944 have a cracking pressure greater than the maximum inflation pressure of the band 910. Referring to
As briefly discussed above,
Referring now to
The various cells 1030a making up the microcell wall 1030 are composed of independent linked inflatable cells 1030a which minimize damage to the overall gastric band 1010 if one of the cells 1030a happens to be punctured. In accordance with various cell structures and with reference to
In accordance with another embodiment and with reference to
Although the present invention is described for use in conjunction with gastric bands, those skilled in the art will appreciate the above invention has equal applicability to other types of implantable bands, for example, bands that are used for the treatment of fecal incontinence. One such band is described in U.S. Pat. No. 6,461,292. Bands can also be used to treat urinary incontinence. One such band is described in U.S. Patent Application Publication No. 2003/0105385. Bands can also be used to treat heartburn and/or acid reflux. One such band is described in U.S. Pat. No. 6,470,892. Bands can also be used to treat impotence. One such band is described in U.S. Patent Application Publication No. 2003/0114729.
While the preferred embodiments have been shown and described, it will be understood that there is no intent to limit the invention by such disclosure, but rather, is intended to cover all modifications and alternate constructions falling within the spirit and scope of the invention.