n/a
n/a
The present invention relates to a device for treating obesity.
Obesity is a condition defined by having an excessive amount of body fat. As of 2006, there are an estimated 70 million obese people in the United States. By some estimates, there are 1 billion obese individuals worldwide. In addition, hospital costs associated with childhood obesity have risen from about $35 million in 1979 to $127 million in 1999. Obesity not only affects the quality of life and productivity of those effected, it has also been proven to lead to long-term health related complications, such as diabetes, heart disease, hypertension, cancer, and a myriad of gastrointestinal maladies. Some researchers estimate that if the obesity epidemic is not brought under control, the number of adults with type II diabetes could skyrocket in the next decade.
Surgical treatments, for example, stomach stapling and bypass operations, are methods for inducing substantial weight loss in obese people. The mechanism behind the success of these surgical treatments is unclear because obesity is such a complex condition. Some researchers propose that surgery does no more than provide biofeedback for appetite retraining. Other researchers maintain that surgery alters the physiology of the patient such that satiety is induced earlier or fewer nutrients are absorbed. Regardless, the consensus among most obesity researchers is that at the current time, long-term weight loss is achievable by surgical means and that the success of surgery is due to a myriad of biological changes.
However, despite the efficacy of surgical procedures, they remain highly invasive and carry significant morbidity, including ubiquitous surgical complications such as infection, high incidence of pulmonary morbidity such as pneumonia and pulmonary embolism, and risk of leakage at the surgical site, which can result in a spectrum of consequences ranging from an extended hospital stay to death. Furthermore, surgery is a poor option for adolescents in whom the long-term consequence of malabsorption of nutrients is not known. In addition, many patients resist such irreversible, life altering procedures.
Dietary supplements have also been used to impart of feeling of satiety, to slow gastric transit of nutrients within a patient, and to reduce the impulse to eat. For example, fiber supplements may be ingested orally and swell within a patient's stomach to promote a temporary feeling of fullness. However, fiber supplements only remain within the stomach for a short period of time, and therefore do not provided a sustained feeling of satiety that fully promotes weight loss. Also, the gastrointestinal side effects of ingesting fiber supplements can be severe. For example, the more the fiber consumed by a patient, the greater the chance that the fiber will cause bloating, abdominal pain, and diarrhea. As such, only a small volume of fiber may be consumed at any one time, limiting its efficacy. Moreover, in order to obtain any benefit from fiber supplements, they need to be taken at least once a day, typically prior to a meal, for many days, thus creating a risk that patients may forget to ingest them or ingest too many.
Alternatively, recent attempts have been made to use an intragastric balloon to displace volume within the stomach such that a smaller volume of food leads to an earlier feeling of satiety. Currently, intragastric balloons on the market can lead to complications such as obstruction and mucosal erosion. Additionally, the incidence of nausea, vomiting, and epigastric pain may be present owing to the balloon having a tendency to obstruct the passage of food out of the stomach. This obstructive tendency is due in part because current intragastric balloon devices are filled with saline, which acts as ballast, and causes the balloon to sink to the bottom of the stomach and obstruct the pylorus.
Accordingly, what is needed is a temporary gastric device that is minimally invasive, avoids obstructing the passage of food out of the stomach, and achieves effective results.
The present invention advantageously provides for a temporary gastric device comprising a biodegradable ingestible delivery structure. A first volume filling agent retained by the delivery structure transitionable from a first state to a second state and defining suitable properties to remain within a human stomach for at least 30-180 days is also included.
In another embodiment, the device includes a biodegradable ingestable capsule and first volume filling agent disposed within the capsule. A composition disposed within the first volume filling agent is included, the composition producing a gas operable to expand the first volume filling agent such that it does not pass through the pyloric valve in the normal digestive process.
In yet another embodiment, the device includes a biodegradable and impermeable ingestible delivery structure and a biodegradable balloon disposed within the capsule. A coiled shape memory biodegradable polymer disposed within the balloon being operable to expand the biodegradable balloon is also included, the biodegradable balloon and the coiled shape memory biodegradable polymer being expandable to a size larger than the diameter of the pyloric canal and the diameter of the esophagus.
A more complete understanding of the present invention, and the attendant advantages and features thereof, will be more readily understood by reference to the following detailed description when considered in conjunction with the accompanying drawings wherein:
Now referring to the drawings where like reference designators refer to like elements, there is shown in
Referring now to
The first volume filling agent 14 may be a flexible self-contained structure, such as a balloon, that is generally resistant to disintegration from stomach acid for a period of time. For example, the first volume filling agent 14 may be a thin-walled medical grade balloon composed of FEP/PI/FEP (Fluorinated ethylene propylene/polymide/fluorinated ethylene propylene) or other polymers, and may further be thermoplastic, such that it is pliable when heated, without any change to its inherent properties. In an embodiment where the first volume filling agent 14 is balloon, the balloon may define a rigid volume or a flexible volume depending on the desired size of the balloon. The first volume filling agent 14 may further be gas permeable or substantially impermeable. The permeability of the first volume filling agent 14 may be variable depending on the size of the molecules or polymers desired to be contained within the first volume filling agent 14. For example, the first volume filling agent 14 may be gas permeable such that gaseous particles may diffuse in, but larger particles, such as polymers and gels, may be trapped inside.
The first volume filling agent 14 may further be biodegradable and have a lubricious coating on its outer surface so as to not stick to the walls of the stomach. Alternatively, the surface of the second volume filling agent 14 may be coated with a pharmaceutical or antimicrobial agent, such that the pharmaceutical or antimicrobial agent may be eluded from the surface of the first volume filling agent 14 for a predetermined time period. The first volume filling agent 14 may be composed of a material that degrades after a predetermined amount of time, for example, 180 days. The first volume filling agent 14 may define properties as discussed above such that it remains within the human stomach for at least 30 days and such that it degrades naturally over time or in response to a solvent, acid, or other chemical that may be ingested following the predetermined amount of time. After the predetermined amount of time, the first volume filling agent 14 may degrade and pass through the digestive system, eliminating the need to remove the device 10 from the body by invasive means.
Continuing to refer to
In an exemplary operation, the second volume filling agent 16 expands or unfolds when disposed within the stomach of the patient, which in turn applies pressure to the first volume filling agent 14 causing its expansion. Further, the second volume filling agent 16 may expand or unfold to a particular size such that it does not become lodged within any section of the stomach or the esophagus, while providing a feeling of satiety to the patient. For example, the second volume filling agent 16 may expand to occupy a space within the stomach of about 200 cc to about 500 cc. Similar to the first volume filling agent 14, the second volume filling agent 16 may be biodegradable after a predetermined amount of time to allow passage of the device 10. For example, the second volume filling agent 16 may be composed of a biodegradable and biocompatible shape memory polymer, hydrogel, or a biodegradable balloon composed of copolymers, for example, polyketal or PLGA. Accordingly, the second volume filling agent 16 may degrade upon exposure to stomach acid soon after the first volume filling agent 14 degrades.
The shape of the second volume filling agent 16 may also be variable and may further be fabricated such that when expanded, it is biased in a particular configuration. For example, as shown in
Alternatively, the second volume filling agent 16 may be composed of an electroactive polymer such that it can be expanded and/or contracted remotely. For example, the second volume filling agent 16 may include sensors or actuators (not shown) that may respond to an applied electric field, magnetic or electromagnetic, to adjust the size of the second volume filling agent 16. As such, it is contemplated that the second volume filling agent 16 may be re-sized overtime for adjustment and for removal. Optionally, the second volume filling agent 16 may include or be composed of an electro-active polymer (EAP) that may be actuated to release a chemical that degrades the second volume filling agent 16, such that it may be passed through the digestive system. It is further contemplated that the second volume filling agent 16 may define any shape or size and that the first volume filling agent 14 may accommodate any expansion of the second volume filling agent 16. For example, the first volume filling agent 14 and the second volume filling agent 16 may be expandable to a size larger than the diameter of the pyloric valve and the diameter of the esophagus to prevent the device 10 from causing an undesirable occlusion.
Referring now to
The second volume filling agent 16 may also be fabricated such that it defines a first engagement element 18 (
Referring now to
The pouch 20 may further be gas-impermeable or semi-impermeable, allowing some gaseous particles to diffuse. The pouch 20 may be filled with a gas, such as CO2 or N2, which may be pressurized or unpressurized. The CO2 may be created within the pouch 20 by, for example, mixing one or more compositions 22 comprising: sodium bicarbonate with citric acid and water; sodium bicarbonate with water and heat; sodium bicarbonate with a citric acid solution; and/or a combination thereof. For example, prior to swallowing the device 10, the pouch 20 may be injected with a solution of any of the above compositions 22. The composition 22 may begin to react when disposed within the stomach, owing to the increased temperature in the stomach. As the compositions 22 react they produce gaseous particles, such as CO2 that expand to fill the pouch 20 and applies pressure to the pouch 20.
Continuing to refer to
The pouch 20 may further include a separation element 32 at least partially disposed within and partially surrounding the first portion 26 of the pouch 20. For example, as shown in
Referring now to
Referring now to
It is further contemplated that the piercing element 24 may only slightly puncture the separation element 32, such that gases are slowly released into the first volume filling agent 14. For example, after a predetermined time, for example, 180 days, all of the gases may leak out into the first volume filling agent 14, allowing the first volume filling agent 14 to remain expanded for this predetermined period of time. After this predetermined time, the first volume filling agent 14 may degrade, which then harmlessly releases the gases into the stomach. Further, the first volume filling agent 14 and/or pouch 20 may be composed of materials that are resistant to being pierced by the piercing element 24, such that gases are released into the first volume filling agent 14 and not into the stomach through the pouch 20 or first volume filling agent 14 as a result of being pierced. However, the pouch 20 and the first volume filling agent 14 may be fabricated such that the second engagement element 30 extends outward from their respective surfaces without causing a release of gas.
The device 10 may alternatively removed from or inserted into the stomach by an endoscope using an esophageal probe (not shown). For example, the device 10, with or without the delivery structure 10, may be compressed by endoscope or similar device and inserted into the stomach. Once inserted, and the device removed, the device 10 may be allowed to expand to its predetermined biased size. To remove the device 10, the esophageal probe may grasp the first engagement element 18 (
Referring now to
Referring now to
Referring now to
In an exemplary operation, one or more devices 10 may be swallowed and traverse the esophagus toward the stomach. The device 10 may include a gelatin delivery structure 12 that resists digestive acids and enzymes present in the esophagus and mouth to prevent inadvertent expansion of the device 10. When the device is disposed within the stomach, stomach acid digests the gelatin delivery structure 12 exposing the first volume filling agent 14. The first volume filling agent 14 and/or the second volume filling agent 16 may then transition from a first displacement to a second displacement larger than the first displacement and float atop the stomach contents. After a predetermined time, or through the use an esophageal device, the device 10 may shrink, as discussed above, and pass through the digestive system.
Referring now to
Referring now to
It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described herein above. In addition, unless mention was made above to the contrary, it should be noted that all of the accompanying drawings are not to scale. A variety of modifications and variations are possible in light of the above teachings without departing from the scope and spirit of the invention, which is limited only by the following claims.
Number | Name | Date | Kind |
---|---|---|---|
3551556 | Kliment et al. | May 1970 | A |
3944064 | Bashaw et al. | Mar 1976 | A |
4178361 | Cohen et al. | Dec 1979 | A |
4501264 | Rockey | Feb 1985 | A |
4641653 | Rockey | Feb 1987 | A |
4739758 | Lai et al. | Apr 1988 | A |
4763653 | Rockey | Aug 1988 | A |
4812315 | Tarabishi | Mar 1989 | A |
5049106 | Kim et al. | Sep 1991 | A |
5129915 | Cantenys | Jul 1992 | A |
5336486 | Acharya | Aug 1994 | A |
5750585 | Park et al. | May 1998 | A |
6160084 | Langer et al. | Dec 2000 | A |
6245103 | Stinson | Jun 2001 | B1 |
6271278 | Park et al. | Aug 2001 | B1 |
6375668 | Gifford et al. | Apr 2002 | B1 |
6388043 | Langer et al. | May 2002 | B1 |
6488962 | Berner et al. | Dec 2002 | B1 |
6579301 | Bales et al. | Jun 2003 | B1 |
6585748 | Jeffree | Jul 2003 | B1 |
6627206 | Lloyd | Sep 2003 | B2 |
6733512 | McGhan | May 2004 | B2 |
6746460 | Gannoe et al. | Jun 2004 | B2 |
6833488 | Bucevschi et al. | Dec 2004 | B2 |
6981980 | Sampson et al. | Jan 2006 | B2 |
6994095 | Burnett | Feb 2006 | B2 |
7033373 | de la Torre et al. | Apr 2006 | B2 |
7056305 | Garza Alvarez | Jun 2006 | B2 |
7112186 | Shah | Sep 2006 | B2 |
7172613 | Wazne | Feb 2007 | B2 |
7223277 | DeLegge | May 2007 | B2 |
20050228504 | Demarais | Oct 2005 | A1 |
20060058829 | Sampson et al. | Mar 2006 | A1 |
20060142794 | Lendlein et al. | Jun 2006 | A1 |
20070135831 | Burnett | Jun 2007 | A1 |
20070178160 | Burnett | Aug 2007 | A1 |
20070276428 | Haller | Nov 2007 | A1 |
20080109027 | Chen et al. | May 2008 | A1 |
20080241094 | Burnett et al. | Oct 2008 | A1 |
20080249635 | Weitzner | Oct 2008 | A1 |
20080300618 | Gertner | Dec 2008 | A1 |
20080306506 | Leatherman | Dec 2008 | A1 |
20090093838 | Paganon | Apr 2009 | A1 |
20090192535 | Kasic, II | Jul 2009 | A1 |
20090259246 | Eskaros et al. | Oct 2009 | A1 |
20100076481 | Stephens et al. | Mar 2010 | A1 |
20100100117 | Brister | Apr 2010 | A1 |
20100137897 | Brister et al. | Jun 2010 | A1 |
Number | Date | Country |
---|---|---|
2005084724 | Sep 2005 | WO |
2007115169 | Oct 2007 | WO |
2009049105 | Apr 2009 | WO |
Number | Date | Country | |
---|---|---|---|
20120089169 A1 | Apr 2012 | US |