# US 7,608,093 B2 · Treatment method > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 7,608,093 B2 - Document ID: US7608093B2 - Status: Granted - Kind: B2 - Application number: 11/089,735 - Filed: 2005-03-25 - Published: 2005-09-29 - Granted: 2009-10-27 - Earliest claimed: 2004-03-26 - Assignees: Olympus Corporation - Inventors: Yuta Okada; Keita Suzuki - Web page: https://patentgrep.com/patent/US7608093B2 ## CPC - 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 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)} - A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery} - A61B 17/10: for applying or removing wound clamps {, e.g. containing only one clamp or staple (A61B17/076 takes precedence; containing multiple wound clamps A61B17/068)}; Wound clamp magazines - A61B 17/29: Forceps for use in minimally invasive surgery - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 2017/00296: {mounted on an endoscope} - A61B 2017/0419: {H-fasteners} - A61B 2017/06052: {Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle} - A61B 2017/3445: {used as instrument channel for multiple instruments} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract In the treatment method of the present invention, the operation is performed in the following steps: an apparatus is perorally inserted in the stomach, a distal end portion of the apparatus inserted in the stomach is introduced from the stomach into the peritoneal cavity, a membrane of part of the outer wall of the abdominal esophagus is removed by the distal end portion of the apparatus which is introduced in the peritoneal cavity, the distal end portion of the apparatus which is introduced in the peritoneal cavity is returned therefrom into the stomach, the stomach fundus is perorally pulled to the part of the outer wall of the abdominal esophagus, and the pulled stomach fundus is fixed to the part of the outer wall of the abdominal esophagus. ## Claims ### Claim 1 A treatment method comprising: perorally inserting an apparatus into a stomach; introducing a distal end portion of the apparatus inserted in the stomach from the stomach into a peritoneal cavity; removing a membrane of part of an outer wall of an abdominal esophagus; returning the distal end portion of the apparatus introduced in the peritoneal cavity into the stomach; perorally pulling a stomach fundus to the part of the outer wall of the abdominal esophagus; and perorally fixing the pulled stomach fundus to the part of the outer wall of the abdominal esophagus. ### Claim 2 (depends on 1) The treatment method according to claim 1, wherein the introducing the distal end portion of the apparatus includes: incising part of the stomach; and moving the apparatus from the stomach into the peritoneal cavity through the incised part. ### Claim 3 (depends on 2) The treatment method according to claim 2, wherein the incising the part of the stomach includes incising the part of the stomach by using an instrument projected from an instrument channel of an endoscope provided in the apparatus. ### Claim 4 (depends on 3) The treatment method according to claim 3, wherein the moving the apparatus into the peritoneal cavity includes: moving the endoscope provided in the apparatus from the stomach into the peritoneal cavity through the incised part; and moving a tubular member, in which the endoscope is inserted, from the stomach into the peritoneal cavity along the endoscope through the incised part. ### Claim 5 (depends on 2) The treatment method according to claim 2, wherein the returning the distal end portion of the apparatus introduced in the peritoneal cavity into the stomach includes: returning the distal end portion of the apparatus from the peritoneal cavity into the stomach through the incised part; and closing the incised part. ### Claim 6 (depends on 1) The treatment method according to claim 1, wherein the removing the membrane of the part of the outer wall of the abdominal esophagus includes: bringing the distal end portion of the apparatus which is introduced in the peritoneal cavity, close to the outer wall of the abdominal esophagus; and stripping off the membrane of the part of the outer wall of the abdominal esophagus. ### Claim 7 (depends on 6) The treatment method according to claim 6, wherein the bringing the distal end portion of the apparatus close to the outer wall of the abdominal esophagus includes: introducing a tubular member provided in the apparatus into the peritoneal cavity; bending the tubular member introduced in the peritoneal cavity to make a distal end opening portion of the tubular member face the abdominal esophagus; and projecting an endoscope inserted in the tubular member, from the distal end opening portion of the tubular member, and moving the endoscope forwards. ### Claim 8 (depends on 6) The treatment method according to claim 6, wherein the stripping off the membrane of the part of the outer wall of the abdominal esophagus includes incising and ablating the membrane of the part of the outer wall of the abdominal esophagus by using an instrument projected from an instrument channel of an endoscope provided in the apparatus. ### Claim 9 (depends on 8) The treatment method according to claim 8, wherein the incising and ablating the membrane of the part of the outer wall of the abdominal esophagus includes: grasping the membrane of the part of the outer wall of the abdominal esophagus by using a first instrument projected from a first channel of the endoscope; pulling the gasped membrane by using the first instrument; and incising and ablating the pulled membrane by using a second instrument projected from a second instrument channel of the endoscope. ### Claim 10 (depends on 1) The treatment method according to claim 1, wherein the pulling the stomach fundus to the part of the outer wall of the abdominal esophagus includes: abutting the distal end portion of the apparatus inserted in the stomach against an inner surface of the stomach fundus; and moving the distal end portion of the apparatus which is abutted against the inner surface of the stomach fundus, towards the part of the outer wall of the abdominal esophagus. ### Claim 11 (depends on 10) The treatment method according to claim 10, wherein the abutting the distal end portion of the apparatus inserted in the stomach against the inner surface of the stomach fundus includes abutting an abut member provided at a distal end portion of an endoscope provided in the apparatus against the inner surface of the stomach fundus. ### Claim 12 (depends on 10) The treatment method according to claim 10, wherein the moving the distal end portion of the apparatus towards the part of the outer wall of the abdominal esophagus includes bending a bending portion of an endoscope provided in the apparatus. ### Claim 13 (depends on 1) The treatment method according to claim 1, wherein the fixing the pulled stomach fundus to the part of the outer wall of the abdominal esophagus includes: pulling tissues of the stomach fundus and tissues of the abdominal esophagus into a tube member provided at a distal end portion of an endoscope provided in the apparatus through a communication portion formed in the tube member; and fixing the tissues of the stomach fundus and the tissues of the abdominal esophagus which are pulled into the tube member to each other. ### Claim 14 (depends on 13) The treatment method according to claim 13, wherein the fixing the tissues of the stomach fundus and the tissues of the abdominal esophagus to each other includes: making a hollow puncture in both the tissues of the stomach fundus and the tissues of the abdominal esophagus using a hollow puncture needle; ejecting a first engagement portion of a placement member contained in the hollow puncture needle, and engaging the first engagement portion with the tissue of the stomach fundus; pulling out the hollow puncture needle from both the tissues of the stomach fundus and the tissues of the abdominal esophagus; and ejecting a second engagement portion of the placement member from the hollow puncture needle, and engaging the second engagement portion with the tissue of the stomach fundus.