# US 2021/0330482 A1 · Apparatus for treating gerd

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- Number: US 2021/0330482 A1
- Document ID: US20210330482A1
- Status: Published application
- Kind: A1
- Application number: 17/371,170
- Filed: 2021-07-09
- Published: 2021-10-28
- Earliest claimed: 2008-10-10
- Inventors: Peter Forsell
- Web page: https://patentgrep.com/patent/US20210330482A1

## CPC

- A61F 5/0083: {Reducing the size of the stomach, e.g. gastroplasty (surgical interventions A61B17/00)}
- A61B 1/32: Devices for opening or enlarging the visual field, e.g. of a tube of the body
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61F 2/04: Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts (A61F2/18, A61F2/20 take precedence; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95)
- A61B 1/04: combined with photographic or television appliances
- A61B 1/06: with illuminating arrangements
- A61B 1/2736: {Gastroscopes}
- A61B 1/3132: {for laparoscopy}
- A61B 17/00: Surgical instruments, devices or methods (A61B18/00 takes precedence; dental tools A61C3/00; eye surgery A61F9/007; ear surgery A61F11/20)
- A61B 17/064: Surgical staples, {i.e. penetrating the tissue}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/0682: {for applying U-shaped staples or clamps, e.g. without a forming anvil}
- A61B 17/08: Wound clamps {or clips, i.e. not or only partly penetrating the tissue (suture bridges A61B17/0466); Devices for bringing together the edges of a wound}
- A61B 17/30: Surgical pincettes, i.e. surgical tweezers {without pivotal connections (for holding suture needles or materials A61B17/0483)}
- A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)}
- A61B 17/3423: {Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247)}
- A61B 17/3474: {Insufflating needles, e.g. Veress needles}
- A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)}
- A61B 2017/00278: {Transorgan operations, e.g. transgastric}
- A61B 2017/00561: {creating a vacuum}
- A61B 2017/00818: {Treatment of the gastro-intestinal system}
- A61B 2017/00827: {Treatment of gastro-esophageal reflux}
- A61B 2017/081: {Tissue approximator (A61B2017/1103, A61B17/8866 take precedence)}
- A61B 2017/306: {holding by means of suction}
- A61B 2017/308: {with suction cups}
- A61F 5/0003: {Apparatus for the treatment of obesity; Anti-eating devices (surgical instruments or methods for treatment of obesity, devices specially adapted therefor A61B17/00; hollow or tubular parts of organs A61F2/04)}
- A61F 5/0013: {Implantable devices or invasive measures}
- A61F 5/0026: {Anti-eating devices using electrical stimulation}
- A61F 5/003: {inflatable}
- A61F 5/0033: {with more than one chamber}
- A61F 5/0036: {Intragastrical devices}
- A61F 5/004: {remotely adjustable}
- A61F 5/0043: {using injection ports}
- A61F 5/0046: {with wireless means}
- A61F 5/005: {Gastric bands}
- A61F 5/0063: {wrapping the stomach}
- A61F 5/0069: {in the wall of the stomach}
- A61F 5/0073: {in the abdominal cavity, e.g. not attached to the stomach}
- A61F 5/0076: {preventing normal digestion, e.g. Bariatric or gastric sleeves}
- A61F 5/0079: {Pyloric or esophageal obstructions}
- A61F 5/0086: {using clamps, folding means or the like}
- A61F 5/0089: {Instruments for placement or removal}
- A61F 2002/044: {Oesophagi or esophagi or gullets}
- A61F 2002/045: {Stomach, intestines}
- A61F 2005/0016: {comprising measuring means}
- A61F 2005/002: {for sensing mechanical parameters}
- A61F 2005/0023: {for sensing chemical parameters}
- A61F 2250/0001: Means for transferring electromagnetic energy to implants
- A61F 2250/0004: adjustable
- A61N 1/36007: {of urogenital or gastrointestinal organs, e.g. for incontinence control}
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

The present invention relates to a reflux disease treatment apparatus, comprising an implantable movement restriction device with an elongated shape that maintains cardia in the correct position and an implantable stimulation device adapted to engage with the cardia sphincter of a patient. The movement restriction device has a proximal and a distal end, wherein the distal end is adapted to stabilize and hold the distal end. The invention further comprises a control device for controlling the stimulation device to stimulate the cardia sphincter. The distal end can be further adapted to treat obesity, for example by stretching the wall of the stomach or filling out a volume of the stomach.

## Claims

### Claim at position 1

1-322. (canceled)

### Claim 323

An apparatus for treating reflux disease in a patient, comprising at least a first and a second segment adapted to be assembled into an implantable movement restriction device having a size and shape allowing it to be invaginated by, or fixated to, a wall portion of the fundus of the stomach of the patient, such that movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted when the movement restriction device is implanted in the patient, to thereby prevent the cardia from sliding through the patient's diaphragm opening into the patient's thorax, wherein the first and second segments are configured to be directly connected to each other to form the implantable movement restriction device,
wherein the assembled implantable movement restriction device has an outer surface for resting against the wall portion of the fundus of the stomach of the patient, wherein the outer surface has an elliptical point.

### Claim 324 (depends on 323)

The apparatus according to claim 323, wherein the implantable movement restriction device is an elongated movement restriction device having a distal invaginated part and a proximal part, and wherein the distal invaginated part of the elongated movement restriction device has sufficient length to stabilize the proximal part of the elongated movement restriction device to prevent the cardia from sliding through the patient's diaphragm opening into the patient's thorax.

### Claim 325 (depends on 324)

The apparatus according to claim 324, wherein a circumference of the distal invaginated part of the elongated movement restriction device is sufficient to stabilize the proximal part of the elongated movement restriction device to prevent the cardia from sliding through the patient's diaphragm opening into the patient's thorax.

### Claim 326 (depends on 324)

The apparatus according to claim 324, wherein the proximal part of the movement restriction device has a size of at least 125 mm3 and a circumference of at least 15 mm.

### Claim 327 (depends on 323)

The apparatus according to claim 323, wherein the apparatus further comprises a tissue growth promoting structure for long term attachment of the implantable movement restriction device to the stomach wall.

### Claim 328 (depends on 327)

The apparatus according to claim 327, wherein the tissue growth promoting structure comprises a net like structure.

### Claim 329 (depends on 328)

The apparatus according to claim 328, wherein the tissue growth promoting structure further comprises sutures or staples that, when implanted in the patient, attach the net like structure to the fundus stomach wall.

### Claim 330 (depends on 323)

The apparatus according to claim 323, wherein the apparatus further comprises a fixation device further comprising sutures or staples that, when implanted in the patient, attach together portions of the fundus stomach wall that enclose the movement restriction device to secure the movement restriction device in place.

### Claim 331 (depends on 330)

The apparatus according to claim 330, wherein the sutures or staples, when implanted in the patient to attach together portions of the fundus stomach wall, invaginate the movement restriction device in the fundus stomach wall to thereby keep the movement restriction device in place.

### Claim 332 (depends on 331)

The apparatus according to claim 331, wherein the sutures or staples, when implanted in a patient with the movement restriction device, attach together portions of the fundus stomach wall so as to invaginate the movement restriction device from inside of the patient's stomach wall.

### Claim 333 (depends on 331)

The apparatus according to claim 331, wherein the sutures or staples attach together portions of the fundus stomach wall so as to invaginate the movement restriction device from outside of the patient's stomach wall.

### Claim 334 (depends on 324)

The apparatus according to claim 324, wherein the apparatus further comprises a second fixation device that, when implanted in the patient with the proximal part of the movement restriction device, secures, indirectly or directly, the movement restriction device to the oesophagus close to the patient's angle of His.

### Claim 335 (depends on 334)

The apparatus according to claim 334, wherein the second fixation device is comprised of a plurality of sutures or staples that, when implanted in the patient with the movement restriction device, attach the fundus wall and a wall of the patient's oesophagus to hold the movement restriction device in place.

### Claim 336 (depends on 334)

The apparatus according to claim 334, wherein the apparatus further comprises a third fixation device that, when implanted in the patient with the proximal part of the movement restriction device, secures, indirectly or directly, the movement restriction device to the patient's diaphragm muscle or other muscle tissue.

### Claim 337 (depends on 336)

The apparatus according to claim 336, wherein the third fixation device is comprised of a plurality of sutures or staples that, when implanted in the patient with the movement restriction device, attach the fundus wall and the diaphragm muscle or other muscle tissue to hold the movement restriction device in place.

### Claim 338 (depends on 324)

The apparatus according to claim 324, wherein the proximal part of the movement restriction device comprises a body adapted to be invaginated by the patient's stomach fundus wall and having an outer surface that includes a biocompatible material, a part of the outer surface of the body being adapted to rest against the stomach wall between the patient's diaphragm and a portion of a lower part of the invaginated stomach fundus wall.

### Claim 339 (depends on 338)

The apparatus according to claim 338, wherein the body has a substantially curved shape.

### Claim 340 (depends on 324)

The apparatus according to claim 324, wherein the proximal and distal invaginated part together form a curved elongated device adapted to be implanted substantially parallel to a food passageway and further adapted to be invaginated in the stomach wall substantially perpendicular to an elongated extension.

### Claim 341 (depends on 324)

The apparatus according to claim 324, comprising electronics, or an energy source, or electronics and an energy source, said electronics, or energy source, or electronics and energy source being enclosed within the proximal part, distal invaginated part, or both proximal and distal invaginated parts.