Endoscopic transoral duodenal sleeve applier

An apparatus comprising:

• (a) a body;
• (b) a shaft assembly extending distally from the body, wherein the shaft assembly comprises an inner lumen and an exterior surface;
• (c) a duodenal sleeve assembly, comprising:
• (i) a sleeve, wherein at least a portion of the sleeve is disposed in the inner lumen of the shaft assembly,
• (ii) an expandable sealing member coupled with the sleeve, and
• (iii) an expandable anchor coupled with the sealing member;
• (d) a first retention member selectively securing the sealing member to the exterior surface of the shaft assembly;
• and
• (e) a second retention member selectively securing the anchor to the exterior surface of the shaft assembly.

A method of using an instrument to deploy a duodenal sleeve assembly, wherein the duodenal sleeve assembly comprises a sleeve, an expandable sealing member, a tether, and an expandable anchor, wherein the sleeve is secured to the sealing member, wherein the tether couples the anchor with the sealing member, wherein the instrument comprises a shaft assembly, a first retention member, and a second retention member, wherein the first retention member selectively secures the sealing member to the shaft assembly, wherein the second retention member selectively secures the anchor to the shaft assembly, the method comprising:

• (a) inserting the shaft assembly transorally through a patient's esophagus and stomach such that a distal end of the shaft assembly is positioned in the patient's duodenum, wherein a portion of the sleeve is disposed within the shaft assembly during the act of inserting;
• (b) unfurling the portion of the sleeve from the shaft assembly such that the sleeve lines the interior of the duodenum;
• (c) releasing the first retention member to release the sealing member from the shaft assembly, wherein the released sealing member seals a proximal end of the sleeve against the mucosa of the duodenum;
• and
• (d) releasing the second retention member to release the anchor from the shaft assembly, wherein the anchor is released within the stomach, wherein the tether traverses the pylorus.