US20030019498A1 - Non-injection port food intake restriction device - Google Patents
Non-injection port food intake restriction device Download PDFInfo
- Publication number
- US20030019498A1 US20030019498A1 US10/252,044 US25204402A US2003019498A1 US 20030019498 A1 US20030019498 A1 US 20030019498A1 US 25204402 A US25204402 A US 25204402A US 2003019498 A1 US2003019498 A1 US 2003019498A1
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- reservoir
- fluid
- cavity
- patient
- servo
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- Abandoned
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- 230000037406 food intake Effects 0.000 title claims abstract description 14
- 235000012631 food intake Nutrition 0.000 title claims abstract description 14
- 238000002347 injection Methods 0.000 title description 13
- 239000007924 injection Substances 0.000 title description 13
- 239000012530 fluid Substances 0.000 claims abstract description 104
- 210000002784 stomach Anatomy 0.000 claims abstract description 22
- 210000003238 esophagus Anatomy 0.000 claims abstract description 14
- 208000008589 Obesity Diseases 0.000 claims abstract description 8
- 208000012696 congenital leptin deficiency Diseases 0.000 claims abstract description 8
- 208000001022 morbid obesity Diseases 0.000 claims abstract description 8
- 230000008602 contraction Effects 0.000 claims abstract description 3
- 239000003990 capacitor Substances 0.000 claims description 18
- 230000004044 response Effects 0.000 claims description 18
- 230000008859 change Effects 0.000 claims description 15
- 210000001015 abdomen Anatomy 0.000 claims description 12
- 230000004913 activation Effects 0.000 claims description 12
- 238000000034 method Methods 0.000 claims description 11
- 230000003213 activating effect Effects 0.000 claims description 10
- 238000006073 displacement reaction Methods 0.000 claims description 10
- 230000000149 penetrating effect Effects 0.000 claims description 6
- 238000005086 pumping Methods 0.000 claims description 5
- 230000036541 health Effects 0.000 claims description 2
- 230000001939 inductive effect Effects 0.000 claims description 2
- 230000035515 penetration Effects 0.000 claims description 2
- 230000002496 gastric effect Effects 0.000 description 8
- 239000007788 liquid Substances 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 235000013305 food Nutrition 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 208000015181 infectious disease Diseases 0.000 description 3
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- 230000009471 action Effects 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 239000000560 biocompatible material Substances 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
- 208000031481 Pathologic Constriction Diseases 0.000 description 1
- 235000014676 Phragmites communis Nutrition 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
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- 230000009467 reduction Effects 0.000 description 1
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- 238000007789 sealing Methods 0.000 description 1
- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000004945 silicone rubber Substances 0.000 description 1
- 208000037804 stenosis Diseases 0.000 description 1
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Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
- A61F5/0013—Implantable devices or invasive measures
- A61F5/005—Gastric bands
- A61F5/0053—Gastric bands remotely adjustable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
Definitions
- the present invention relates to a food intake restriction device for the treatment of morbid obesity. More specifically, the invention relates to a food intake restriction device for surgical application in the abdomen of a patient for forming a stoma opening in the stomach or esophagus of the patient.
- 0611561 and International Patent Application WO 94/27504 comprise an inflatable cavity in the band and an injection port in fluid connection with the inflatable cavity for adding fluid to or withdrawing fluid from the latter.
- the band is made of silicone rubber which is a material approved for implantation and the fluid is a liquid such as an isotonic salt solution.
- the prior bands later might dislocate downwardly on the stomach and there is an increased risk of stoma stenosis due to too limited control of the band.
- the volume of the gastric pouch above the band increases in size up to ten times after the operation. Therefore the pouch volume during surgery needs to be very small, approximately 7 ml.
- the stoma initially needs to be relatively large and later needs to be substantially reduced, as the pouch volume increases.
- the cavity in the band has to be relatively large and be defined by a thin flexible wall, normally made of silicone material.
- the size of the stoma opening has to be gradually reduced during the first year after surgery as the gastric pouch increases in size.
- the reduction of the stoma opening by using the prior art gastric banding devices is achieved by adding liquid to the cavity of the band via the injection port to expand the band radially inwardly.
- a great disadvantage of repeatedly injecting liquid via the injection port is the increased risk of the patient getting an infection in the area surrounding the injection port. If such an infection occurs the injection port has to be surgically removed from the patient. Moreover, such an infection might be spread along the tube interconnecting the injection port and the band to the stomach causing even more serious complications. Thus, the stomach might be infected where it is in contact with the band, which might result in the band migrating through the wall of the stomach. Also it is uncomfortable for the patient when the necessary, often many, post-operation controls of the stoma opening are carried out by using an injection needle penetrating the skin of the patient into the injection port.
- the patient may swallow pieces of food that are too large and therefore cannot pass the restricted stoma opening.
- the patient has to visit a doctor who can remove the food pieces, if the band design so permits, by withdrawing some liquid from the band to enlarge the stoma opening to allow the food pieces to pass the stoma. Then, the doctor has to add liquid to the band in order to regain the restricted stoma opening.
- these measures require the use of an injection needle penetrating the skin of the patient, which is uncomfortable for the patient.
- the invention provides an adjustable food intake restriction device which does not require the use of an injection needle for accomplishing post-operation adjustments of the stoma opening. Rather, the invention provides an adjustable food intake restriction device which permits post-operation adjustments that are comfortable for the patient, and which reduces the risk of liquid leaking from the device.
- a food intake restriction device for surgical application in the abdomen of a patient for forming a stoma opening in the stomach or esophagus of the patient, the device comprising: an elongated non-inflatable restriction member formed into at least a substantially closed loop around the stomach or the esophagus, the loop defining a restriction opening, an adjustment device which mechanically adjusts the restriction member in the loop to change the size of the restriction opening, hydraulic operation means for operating the adjustment device, and a reservoir containing a predetermined amount of hydraulic fluid for supplying the hydraulic operation means with hydraulic fluid.
- a food intake restriction device for forming a stoma opening in the stomach or esophagus of a patient, comprising: an elongated restriction member forming an expandable and contractible cavity formed into an at least substantially closed loop around the stomach or esophagus of the patient and defining a restriction opening, the size of which is reduced upon expansion of the cavity and increased upon contraction of the cavity, a reservoir containing a predetermined amount of hydraulic fluid and connected to the cavity of the restriction member, and a hydraulic operation means for distributing fluid from the reservoir to the cavity to expand the cavity and for distributing fluid from the cavity to the reservoir to contract the cavity.
- an injection port for accomplishing necessary post-operation adjustments of the restriction opening to change the size of the stoma opening.
- an injection port connected to the reservoir may be provided for enabling, normally a single once-and-for-all, calibration of the predetermined amount of fluid in the reservoir.
- the reservoir defines a chamber for the predetermined amount of fluid and the hydraulic operation means changes the size of the chamber.
- the hydraulic operation means comprises first and second wall portions of the reservoir, which are displaceable relative to each other to change the size of the chamber of the reservoir.
- the hydraulic operation means may distribute fluid from the reservoir to the cavity of the restriction member in response to a predetermined first displacement of the first wall portion of the reservoir relative to the second wall portion of the reservoir and to distribute fluid from the cavity to the reservoir in response to a predetermined second displacement of the first wall portion relative to the second wall portion.
- the first and second wall portions of the reservoir may be displaceable relative to each other by manual manipulation thereof, such as by manually pushing, pulling or rotating any of the wall portions in one direction, or alternatively, may be displaceable relative to each other by a device powered magnetically, hydraulically, or electrically (e.g. by an electric motor).
- a device powered magnetically, hydraulically, or electrically e.g. by an electric motor.
- no pump is used, only the volume of the reservoir is varied. This is of great advantage compared to the solution described below when a pump is used to pump fluid between the reservoir and the adjustment device because there is no need for a non-return valve and it is still possible to have fluid going both to and from the reservoir.
- the hydraulic operation means comprises an activatable pump for pumping fluid between the reservoir and the cavity of the restriction member.
- the pump preferably comprises a first activation member for activating the pump to pump fluid from the reservoir to the cavity of the restriction member, and a second activation member for activating the pump to pump fluid from the cavity to the reservoir.
- the first and second activation members may be operable by manual manipulation thereof, such as by manually pushing, pulling or rotating any of the activation members in one direction. At least one of the activation members is constructed to operate when subjected to an external pressure exceeding a predetermined magnitude.
- At least one of the first and second activating members may be operable by a device powered magnetically, hydraulically, or electrically (e.g. by an electric motor).
- the pump may pump fluid both to and away from the adjustment device or hydraulic means controlling the adjustment device.
- a mechanical manual solution is proposed in which it is possible to pump in both directions just by pushing an activating member in one direction.
- Another alternative is a pump pumping in only one direction and an adjustable valve to change the direction of fluid to either increase or decrease the amount of fluid in the reservoir. This valve may be manipulated either manually, mechanically, electrically, magnetically, or hydraulically. Any kind of motor could be used for the different operations s well as wireless remote solutions.
- a magnetic means may comprise a permanent magnet and a magnetic material reed switch, or other suitable known or conventional magnetic devices.
- the hydraulic operation means comprises a servo means, suitably including a hydraulic device.
- the servo means may include magnetic or electric means.
- the servo means comprises a servo reservoir defining a chamber containing servo fluid and the hydraulic operation means comprises first and second wall portions of the servo reservoir, which are displaceable relative to each other to change the size of the chamber of the servo reservoir.
- the servo reservoir as for the earlier described reservoir wherein the volume in the servo reservoir may be increased or decreased by a first or second displacement of the first wall portion relative to the second wall portion of the servo reservoir and thereby control the earlier described reservoir and thereby indirectly control the restriction opening.
- the first and second wall portions of the servo reservoir may be displaceable relative to each other by manual manipulation thereof, such as by manually pushing, pulling or rotating any of the wall portions of the servo reservoir in one direction.
- the first and second wall portions may be displaceable by magnetically, hydraulically or electrically powered devices. These powered devices may all be activated by manual manipulating means preferably located subcutaneously. This activation may be indirect, for example via a switch.
- a servo means system could be used. With servo means less force is needed for controlling the adjustment device. Hydraulic operation is preferably used with servo means.
- One example is a closed system that controls another closed system in which the hydraulic means of the adjustment device is incorporated. Minor changes in the amount of fluid in a reservoir of the first system could then lead to major changes in the amount of fluid in a reservoir in the second system. Consequently, the change in volume in the reservoir of the second system affects the hydraulic operation of the adjustment device which is incorporated in the second closed system.
- the great advantage of this servo system is that the larger volume system could be placed inside the abdomen where there is more space and still it would be possible to use manual manipulation means of the smaller system subcutaneously.
- the servo reservoir could control the reservoir of the larger volume.
- the servo reservoir could be controlled directly or indirectly by a fluid supply means.
- the fluid supply means may be a small reservoir, which may be placed subcutaneously and may be activated by manual manipulation means controlling the servo reservoir, or other suitable device.
- the fluid supply means comprises hydraulic means and a fluid supply reservoir defining a chamber containing fluid
- the hydraulic operation means comprises first and second wall portions of the reservoir, which are displaceable relative to each other to change the size of the chamber of the fluid supply reservoir.
- the hydraulic operation means may distribute fluid from the fluid supply reservoir to the servo reservoir in response to a predetermined first displacement of the first wall portion of the fluid supply reservoir relative to the second wall portion of the fluid supply reservoir and to distribute fluid from the servo reservoir to the fluid supply reservoir in response to a predetermined second displacement of the first wall portion relative to the second wall portion.
- the wall portions of the fluid supply reservoir may be displaceable relative to each other by manual manipulation means or be displaceable relative to each other by manual manipulating means for pushing, pulling or rotating any of the wall portions of the fluid supply reservoir in one direction.
- the wall portions of the fluid supply reservoir may be displaceable relative to each other by magnetic means, hydraulic means, manually manipulated means, or electrical control means including an electric motor.
- the magnetic means, hydraulic means, or electrical control means may all be activated by manually manipulated means preferably located subcutaneously. This control may be indirect, for example via a switch.
- the adjustment device may comprise a servo means.
- the servo means may comprise a hydraulic operation means, an electric control means, a magnetic means, mechanical means, or a manual manipulating means.
- the hydraulic operation means, electric control means, mechanical means or magnetic means may be activated by manual manipulating means. Using a servo system will save the use of force when adjusting the adjustment device which may be of importance in many applications.
- All systems according to the invention may be controlled by a wireless remote control means.
- a wireless remote control means for controlling the hydraulic operation means and comprising a separate signal transmitting means and a signal receiving means for controlling the hydraulic operation means in response to signals received from the signal transmitting means.
- the remote control means comprises a motor for operating the hydraulic operation means and an energizer unit for providing energy
- the signal receiving means comprises a control unit powering the motor with energy provided by the energizer unit in response to signals received from the signal transmitting means.
- the energizer unit may be a battery.
- the wireless remote control may control the adjustment device and any type of hydraulic operation means including servo means and fluid supply means.
- the remote control also could control any of the other described embodiments including any kind of servo means.
- the signal transmitting means also transmits electromagnetic wave signals and the energizer unit draws radiant energy from the electromagnetic wave signals as they are transmitted to the signal receiving means and transfers the radiant energy into electric energy for powering the electric motor.
- the energizer unit may comprise a rechargeable electric power supply, such as a capacitor, for storing the electric energy and the control unit may power the electric motor, for instance a stepping motor, with energy from the rechargeable electric power supply in response to signals received from the signal transmitting means.
- the rechargeable power supply can be charged over a relatively long time (e.g. a few seconds up to a half hour) without powering the electric motor.
- the control unit powers the electric motor with energy from the charged power supply to operate the adjustment device, so that a desired change of the patient's stoma opening is achieved. If the capacity of the power supply is significant to achieve the necessary adjustment in one single operating step, the above steps may conveniently be repeated until the desired adjustment is achieved.
- the energizer unit may comprise a battery, an electrically operable switch connecting the battery to the signal receiving means in an “on” mode when the switch is powered and to keep the battery disconnected from the signal receiving means in a “standby” mode when the switch is unpowered, and a rechargeable electric power supply for powering the switch.
- the control unit may power the electric motor with energy from the battery in response to signals received from the signal transmitting means, when the switch is in its “on” mode.
- the energizer unit may transfer the radiant energy into a current for charging the rechargeable electric power supply, such as a capacitor.
- the energizer unit may comprise a coil connected to the signal receiving means for inducing an alternating current as electromagnetic wave signals are transmitted through the coil to the signal receiving means and a rectifier for rectifying the alternating current.
- the invention also relates to a method of treating morbid obesity, comprising: (a) Surgically implanting in the abdomen of a patient with morbid obesity a food intake restriction device which forms a stoma opening in the stomach or esophagus, by forming an elongated restriction member (e.g. of bio-compatible material, or covered with bio-compatible material) into at least a substantially closed loop around the stomach or the esophagus of the patient, the loop defining a restriction opening; and then (b) when necessary for the patient's health or desired progress, in a non-invasive procedure, hydraulically acting on the restriction member to change the size of the restriction opening.
- a food intake restriction device which forms a stoma opening in the stomach or esophagus
- the restriction member comprises a cavity which can be expanded and contracted by the supply of hydraulic fluid thereto
- (a) may be practiced in part by implanting in the patient a reservoir containing a predetermined amount of hydraulic fluid and connecting the reservoir to the cavity and a hydraulic operation means for distributing fluid from the reservoir to the cavity; and (b) may be practiced by controlling the hydraulic operation means from a point outside the patient's body without physically penetrating the patient's body.
- the restriction member is acted upon by an adjustment device which mechanically adjusts the loop
- (a) may be practiced in part by implanting in the patient the adjustment device, implanting a reservoir containing a predetermined amount of hydraulic fluid and connecting the reservoir to the cavity, and implanting a hydraulic operation means for distributing fluid from the reservoir to the cavity; and (b) may be practiced by controlling the hydraulic operation means from a point outside the patient's body without physically penetrating the patient's body to control the adjustment device so that the size of the restriction opening is changed. This may be done manually, remotely, by remote control, or in the other described manners.
- the method (a) may be practiced by laparoscopic techniques, e.g. by (i) inflating the patient's abdomen with gas by penetration of the patient's skin, (ii) introducing at least two laparoscopic trocars into the abdomen to introduce the elongated restriction member and one or more medical instruments, and then (iii) forming the elongated restriction member into the at least substantially closed loop.
- laparoscopic techniques e.g. by (i) inflating the patient's abdomen with gas by penetration of the patient's skin, (ii) introducing at least two laparoscopic trocars into the abdomen to introduce the elongated restriction member and one or more medical instruments, and then (iii) forming the elongated restriction member into the at least substantially closed loop.
- FIGS. 1 A-D are block diagrams of four different principal embodiments of the invention.
- FIGS. 2 A-D are cross-sectional views of a pump mechanism according to FIG. 1C, which is designed to pump fluid in opposite directions by mechanically pushing a wall portion in only one direction.
- FIG. 3 is a cross-sectional view of a reservoir having a variable volume controlled by a remote control motor, in accordance with a particular embodiment of the principal embodiment shown in FIGS. 1B or 2 B.
- FIG. 4 is a cross-sectional view of a reservoir having a variable volume adjustable by manual manipulation, in accordance with a particular embodiment of the principal embodiment shown in FIGS. 1B or 1 D.
- FIG. 5A is a perspective view of a hydraulic, pneumatic or mechanical servo system in accordance with a particular embodiment of the principal embodiment shown in FIG. 1D.
- FIG. 5B is a cross-sectional view taken along line VB-VB of FIG. 5A.
- FIG. 6 is a block diagram illustrating remote control components of the device of the invention.
- FIG. 7 is a schematic view of exemplary circuitry used for the block diagram of FIG. 6.
- FIG. 8 is a schematic view of a band with a cavity defining a restriction opening for use in accordance with the invention.
- FIGS. 1 A-D is a block diagram of four different embodiments.
- FIG. 1A shows a restriction member in the form of a typically conventional inflatable band 2 (SAGB), a separate reservoir 4 , a one way pump 6 and an alternate valve 8 .
- FIG. 1B shows the band 2 and a fluid supply reservoir 10 .
- FIG. 1C shows the band 2 , a two way pump 12 and the reservoir 4 .
- FIG. 1D shows a servo system with a first closed system controlling a second system. The servo system comprises the fluid supply reservoir 10 and a servo reservoir 14 .
- the servo reservoir 14 controls a larger adjustable reservoir 16 which in connection with the band 2 varies the volume of a cavity in the band, which in turn varies a restriction opening 3 in the band 2 .
- a band 2 and opening 3 are illustrated schematically in FIG. 8.
- the conventional band 2 has an expandable/contractable cavity 5 which is expanded or contracted by supplying hydraulic fluid (e.g. from 4 , 6 , 10 , 16 ), and the band 2 may be sutured in place, illustrated schematically at 7 in FIG. 8.
- FIGS. 2 A-D are cross-sectional views of a pump mechanism for pumping fluid in both directions only by mechanically pushing a separate sealing wall portion 18 in one direction.
- FIG. 2A shows a piston 20 pushed forwards against a spring 22 towards the wall portion 18 and located in a pump housing 24 conducting fluid from a right upper fluid passage 26 of the housing 24 to a left fluid passage 28 of the housing 24 .
- a main valve 30 is open and a nonreturn valve 32 is closed.
- FIG. 2B illustrates the first pump movement in which the piston 20 has moved forwards and reaches the wall portion 18 .
- FIG. 2C illustrates how the piston 20 moves backwards by the action of the spring 22 .
- FIG. 1D illustrates how the piston 20 is moved further downwardly from its position according to FIG. 2B while pushing the wall portion 18 downwardly against a second spring 34 that is stronger than spring 22 , so that fluid escapes from a right lower fluid passage 36 .
- FIG. 3 is a cross-sectional view of a reservoir 40 defining a chamber 42 , the size of which is variable and is controlled by a remote controlled electric motor 44 , in accordance with FIGS. 1B or 1 D.
- the reservoir 40 and the motor 44 are placed in a housing 46 .
- the chamber 42 is varied by moving a large wall 48 .
- the wall 48 is secured to a nut 50 , which is threaded on a rotatable spindle 52 .
- the spindle 52 is rotated by the motor 44 via an angular gearing, which comprises two conical gear wheels 54 and 56 in mesh with each other.
- the motor 44 is powered by a battery 58 placed in the housing 46 .
- a signal receiving means 60 for controlling the motor 44 is also placed in the housing 46 .
- the battery 58 and the signal receiving means 60 may be mounted in a separate place.
- the motor 44 may also be powered by transmitted electromagnetic wave signals.
- FIG. 4 is a cross-sectional view of a reservoir 62 defining a chamber 64 , the size of which is variable and is controlled by manual manipulation.
- a gable wall portion 66 of an open ended inner cylindrical housing 68 is adapted to be pushed downwards to fit in a desired locking groove 70 of a plurality of locking grooves 70 on the mantle wall of the cylindrical housing 68 , to reduce the size of the chamber 64 .
- the inner cylindrical housing 68 is suspended by springs 72 and is telescopically applied on an outer cylindrical housing 74 . When pushing the inner cylindrical housing 68 it moves downwards relative to the outer cylindrical housing 74 causing the gable wall portion 66 to release from the locking groove 70 and move upwards relative to the inner cylindrical housing 68 .
- the inner housing 68 is moved upwardly by the action of the springs 72 the size of the chamber 64 is increased.
- FIGS. 5A and 5B show a servo means comprising a main ring-shaped fluid reservoir 76 defining a chamber 78 , the size of which is variable.
- a servo fluid reservoir 80 Centrally positioned in the main ring-shaped reservoir 76 there is a servo fluid reservoir 80 defining a chamber 82 , the size of which is variable.
- the chamber 82 of the servo reservoir 80 is substantially smaller than the chamber 78 of the main reservoir 76 .
- the two reservoirs 76 and 80 are situated between two opposite separate walls 84 and 86 , and are secured thereto. When changing the amount of fluid in the servo reservoir 80 , the two opposite walls 84 , 86 are moved towards or away from each other, whereby the size of the chamber 78 of the main reservoir 76 is changed.
- FIG. 6 shows the basic parts of a remote control system of the device of the invention including the electric motor 44 of the embodiment shown in FIG. 3.
- the described remote control system is also based on the transmission of electromagnetic wave signals, often of high frequencies in the order of 100 kHz-1 gHz, through the skin 130 of the patient.
- all parts placed to the left of the skin 130 are located outside the patient's body and all parts placed to the right of the skin 130 are implanted. Any suitable remote control system may be used.
- An external signal transmitting antenna 132 is to be positioned close to a signal receiving antenna 134 implanted close to the skin 130 .
- the receiving antenna 134 may be placed for example inside the abdomen of the patient.
- the receiving antenna 134 comprises a coil, approximately 1-100 mm, preferably 25 mm in diameter, wound with a very thin wire and tuned with a capacitor to a specific high frequency.
- a small coil is chosen if it is to be implanted under the skin of the patient and a large coil is chosen if it is to be implanted in the abdomen of the patient.
- the transmitting antenna 132 comprises a coil having about the same size as the coil of the receiving antenna 134 but wound with a thick wire that can handle the larger currents that is necessary.
- the coil of the transmitting antenna 132 is tuned to the same specific high frequency as the coil of the receiving antenna 134 .
- An external control unit 136 comprises a microprocessor, a high frequency electromagnetic wave signal generator and a power amplifier.
- the microprocessor of the control unit 136 switches the generator on/off and modulates signals generated by the generator to send digital information via the power amplifier and the antennas 132 , 134 to an implanted control unit 138 .
- digital signal codes are used.
- a conventional keypad placed on the external control unit 136 is connected to the microprocessor thereof. The keypad is used to order the microprocessor to send digital signals to either increase or decrease the size of the restriction opening defined by the loop of the restriction member 2 .
- the microprocessor starts a command by applying a high frequency signal on the antenna 132 .
- commands are sent to increase or decrease the size of the restriction opening of the restriction member 2 in predefined steps.
- the commands are sent as digital packets in the form illustrated below. Start pattern, 8 bits Command, 8 bits Count, 8 bits Checksum, 8 bits
- the commands are sent continuously over a relatively long time period (e.g. about 30 seconds or more).
- a relatively long time period e.g. about 30 seconds or more.
- an implanted energizer unit 126 draws energy from the high frequency electromagnetic wave signals received by the receiving antenna 134 .
- the energizer unit 126 stores the energy in a power supply, such as a large capacitor, powers the control unit 138 and powers the electric motor 44 via a line 142 .
- the control unit 138 comprises a demodulator and a microprocessor.
- the demodulator demodulates digital signals sent from the external control unit 136 .
- the microprocessor of the control unit 138 receives the digital packet, decodes it and, provided that the power supply of the energizer unit 126 has sufficient energy stored, sends a signal via a signal line 144 to the motor 44 to either increase or decrease the size of the restriction opening of the restriction member 2 depending on the received command code.
- the energy stored in the power supply of the energizer unit may only be used for powering a switch, and the energy for powering the motor 44 may be obtained from another implanted power source of relatively high capacity, for example a battery.
- the switch is adapted to connect the battery to the control unit 138 in an “on” mode when the switch is powered by the power supply and to keep the battery disconnected from the control unit in a standby mode when the switch is unpowered.
- the external control unit 136 comprises a microprocessor 146 , a signal generator 148 and a power amplifier 150 connected thereto.
- the microprocessor 146 switches the signal generator 148 on/off and modulates signals generated by the signal generator 148 with digital commands that are sent to implanted components of the food intake restriction device.
- the power amplifier 150 amplifies the signals and sends them to the external signal transmitting antenna 132 .
- the antenna 132 is connected in parallel with a capacitor 152 to form a resonant circuit tuned to the frequency generated by the signal generator 148 .
- the implanted signal receiving antenna coil 134 forms together with a capacitor 154 a resonant circuit that is tuned to the same frequency as the transmitting antenna 132 .
- the signal receiving antenna coil 134 induces a current from the received high frequency electromagnetic waves and a rectifying diode 160 rectifies the induced current, which charges a storage capacitor 158 .
- a coil 156 connected between the antenna coil 134 and the diode 160 prevents the capacitor 158 and the diode 160 from loading the circuit of the signal receiving antenna 134 at higher frequencies.
- the coil 156 makes it possible to charge the capacitor 158 and to transmit digital information using amplitude modulation.
- a capacitor 162 and a resistor 164 connected in parallel and a diode 166 forms a detector used to detect amplitude modulated digital information.
- a filter circuit is formed by a resistor 168 connected in series with a resistor 170 connected in series with a capacitor 172 connected in series with the resistor 168 via ground, and a capacitor 174 , one terminal of which is connected between the resistors 168 , 170 and the other terminal of which is connected between the diode 166 and the circuit formed by the capacitor 162 and resistor 164 .
- the filter circuit is used to filter out undesired low and high frequencies.
- the detected and filtered signals are fed to an implanted microprocessor 176 that decodes the digital information and controls the motor 44 via an H-bridge 178 comprising transistors 180 , 182 , 184 and 186 .
- the motor 44 can be driven in two opposite directions by the H-bridge 178 .
- the microprocessor 176 also monitors the amount of stored energy in the storage capacitor 158 . Before sending signals to activate the motor 44 , the microprocessor 176 checks whether the energy stored in the storage capacitor 158 is enough. If the stored energy is not enough to perform the requested operation, the microprocessor 176 waits for the received signals to charge the storage capacitor 158 before activating the motor 44 .
- control units may be replaced by discrete components.
- the power amplifier of the external control unit may be omitted if the signals generated by the signal generator are strong enough. Therefore the invention is to be accorded the broadest interpretation of the appended claims to encompass all equivalent structures, assemblies, and methods.
Abstract
A food intake restriction device for forming a stoma opening in the stomach or esophagus of a patient, comprises an elongated restriction member forming an expandable and contractible cavity formed into an at least substantially closed loop defining a restriction opening, the size of which is reduced upon expansion of the cavity and increased upon contraction of said cavity. A reservoir containing a predetermined amount of hydraulic fluid and connected to the cavity of the restriction member, and a hydraulic operation device for distributing fluid from the reservoir to the cavity to expand the cavity and for distributing fluid from the cavity to the reservoir to contract the cavity, are also implanted in a patient with morbid obesity and operated from outside the patient's body in a non-invasive manner. A non-inflatable restriction member may alternatively be use, and hydraulically adjusted.
Description
- The present invention relates to a food intake restriction device for the treatment of morbid obesity. More specifically, the invention relates to a food intake restriction device for surgical application in the abdomen of a patient for forming a stoma opening in the stomach or esophagus of the patient.
- Food intake restriction devices in the form of gastric banding devices, in which an elongated restriction member in the form of a band encircles a portion of the stomach, have been used in surgery for morbid obesity to form a small gastric pouch above the band and a reduced stoma opening in the stomach. Although such a band is applied around the stomach to obtain an optimal stoma opening during surgery, some prior gastric banding devices are provided with a control means enabling minor post-operation control of the size of the stoma opening. The control means in such prior art devices as disclosed, for example, in U.S. Pat. No. 4,592,339, European Patent No. 0611561 and International Patent Application WO 94/27504, comprise an inflatable cavity in the band and an injection port in fluid connection with the inflatable cavity for adding fluid to or withdrawing fluid from the latter. In practice, the band is made of silicone rubber which is a material approved for implantation and the fluid is a liquid such as an isotonic salt solution.
- It has been found, however, that the prior bands later might dislocate downwardly on the stomach and there is an increased risk of stoma stenosis due to too limited control of the band. It has also been found that the volume of the gastric pouch above the band increases in size up to ten times after the operation. Therefore the pouch volume during surgery needs to be very small, approximately 7 ml. To enable the patient to feed the stomach with sufficient nutrition immediately after the operation considering such a small gastric pouch, the stoma initially needs to be relatively large and later needs to be substantially reduced, as the pouch volume increases. To be able to achieve acceptable control of the band, the cavity in the band has to be relatively large and be defined by a thin flexible wall, normally made of silicone material. Furthermore, the size of the stoma opening has to be gradually reduced during the first year after surgery as the gastric pouch increases in size. As indicated above, the reduction of the stoma opening by using the prior art gastric banding devices is achieved by adding liquid to the cavity of the band via the injection port to expand the band radially inwardly.
- A great disadvantage of repeatedly injecting liquid via the injection port is the increased risk of the patient getting an infection in the area surrounding the injection port. If such an infection occurs the injection port has to be surgically removed from the patient. Moreover, such an infection might be spread along the tube interconnecting the injection port and the band to the stomach causing even more serious complications. Thus, the stomach might be infected where it is in contact with the band, which might result in the band migrating through the wall of the stomach. Also it is uncomfortable for the patient when the necessary, often many, post-operation controls of the stoma opening are carried out by using an injection needle penetrating the skin of the patient into the injection port.
- Also the patient may swallow pieces of food that are too large and therefore cannot pass the restricted stoma opening. In this case the patient has to visit a doctor who can remove the food pieces, if the band design so permits, by withdrawing some liquid from the band to enlarge the stoma opening to allow the food pieces to pass the stoma. Then, the doctor has to add liquid to the band in order to regain the restricted stoma opening. Again, these measures require the use of an injection needle penetrating the skin of the patient, which is uncomfortable for the patient.
- Another problem with the known adjustable gastric banding devices is that there is a risk of leakage from the band balloon occurring some time after the operation.
- The invention provides an adjustable food intake restriction device which does not require the use of an injection needle for accomplishing post-operation adjustments of the stoma opening. Rather, the invention provides an adjustable food intake restriction device which permits post-operation adjustments that are comfortable for the patient, and which reduces the risk of liquid leaking from the device.
- In accordance with a broad aspect of the present invention, a food intake restriction device is provided for surgical application in the abdomen of a patient for forming a stoma opening in the stomach or esophagus of the patient, the device comprising: an elongated non-inflatable restriction member formed into at least a substantially closed loop around the stomach or the esophagus, the loop defining a restriction opening, an adjustment device which mechanically adjusts the restriction member in the loop to change the size of the restriction opening, hydraulic operation means for operating the adjustment device, and a reservoir containing a predetermined amount of hydraulic fluid for supplying the hydraulic operation means with hydraulic fluid.
- In accordance with a specific aspect of the present invention, a food intake restriction device is provided for forming a stoma opening in the stomach or esophagus of a patient, comprising: an elongated restriction member forming an expandable and contractible cavity formed into an at least substantially closed loop around the stomach or esophagus of the patient and defining a restriction opening, the size of which is reduced upon expansion of the cavity and increased upon contraction of the cavity, a reservoir containing a predetermined amount of hydraulic fluid and connected to the cavity of the restriction member, and a hydraulic operation means for distributing fluid from the reservoir to the cavity to expand the cavity and for distributing fluid from the cavity to the reservoir to contract the cavity.
- Thus, there is no need for an injection port for accomplishing necessary post-operation adjustments of the restriction opening to change the size of the stoma opening. (In certain applications, however, an injection port connected to the reservoir may be provided for enabling, normally a single once-and-for-all, calibration of the predetermined amount of fluid in the reservoir.)
- In accordance with a general embodiment of the invention, the reservoir defines a chamber for the predetermined amount of fluid and the hydraulic operation means changes the size of the chamber. Preferably, the hydraulic operation means comprises first and second wall portions of the reservoir, which are displaceable relative to each other to change the size of the chamber of the reservoir. The hydraulic operation means may distribute fluid from the reservoir to the cavity of the restriction member in response to a predetermined first displacement of the first wall portion of the reservoir relative to the second wall portion of the reservoir and to distribute fluid from the cavity to the reservoir in response to a predetermined second displacement of the first wall portion relative to the second wall portion.
- The first and second wall portions of the reservoir may be displaceable relative to each other by manual manipulation thereof, such as by manually pushing, pulling or rotating any of the wall portions in one direction, or alternatively, may be displaceable relative to each other by a device powered magnetically, hydraulically, or electrically (e.g. by an electric motor). In this embodiment no pump is used, only the volume of the reservoir is varied. This is of great advantage compared to the solution described below when a pump is used to pump fluid between the reservoir and the adjustment device because there is no need for a non-return valve and it is still possible to have fluid going both to and from the reservoir.
- In accordance with a particular embodiment of the invention, the hydraulic operation means comprises an activatable pump for pumping fluid between the reservoir and the cavity of the restriction member. The pump preferably comprises a first activation member for activating the pump to pump fluid from the reservoir to the cavity of the restriction member, and a second activation member for activating the pump to pump fluid from the cavity to the reservoir. The first and second activation members may be operable by manual manipulation thereof, such as by manually pushing, pulling or rotating any of the activation members in one direction. At least one of the activation members is constructed to operate when subjected to an external pressure exceeding a predetermined magnitude.
- As an alternative to the manual manipulation, at least one of the first and second activating members may be operable by a device powered magnetically, hydraulically, or electrically (e.g. by an electric motor). The pump may pump fluid both to and away from the adjustment device or hydraulic means controlling the adjustment device. A mechanical manual solution is proposed in which it is possible to pump in both directions just by pushing an activating member in one direction. Another alternative is a pump pumping in only one direction and an adjustable valve to change the direction of fluid to either increase or decrease the amount of fluid in the reservoir. This valve may be manipulated either manually, mechanically, electrically, magnetically, or hydraulically. Any kind of motor could be used for the different operations s well as wireless remote solutions.
- Wherever a magnetic means is utilized according to the invention it may comprise a permanent magnet and a magnetic material reed switch, or other suitable known or conventional magnetic devices.
- In accordance with another particular embodiment of the invention, the hydraulic operation means comprises a servo means, suitably including a hydraulic device. Alternatively, the servo means may include magnetic or electric means. Preferably, the servo means comprises a servo reservoir defining a chamber containing servo fluid and the hydraulic operation means comprises first and second wall portions of the servo reservoir, which are displaceable relative to each other to change the size of the chamber of the servo reservoir. The same principle will apply for the servo reservoir as for the earlier described reservoir wherein the volume in the servo reservoir may be increased or decreased by a first or second displacement of the first wall portion relative to the second wall portion of the servo reservoir and thereby control the earlier described reservoir and thereby indirectly control the restriction opening. The first and second wall portions of the servo reservoir may be displaceable relative to each other by manual manipulation thereof, such as by manually pushing, pulling or rotating any of the wall portions of the servo reservoir in one direction. Alternatively, the first and second wall portions may be displaceable by magnetically, hydraulically or electrically powered devices. These powered devices may all be activated by manual manipulating means preferably located subcutaneously. This activation may be indirect, for example via a switch.
- Advantageously, especially when manual manipulation means are used, a servo means system could be used. With servo means less force is needed for controlling the adjustment device. Hydraulic operation is preferably used with servo means. One example is a closed system that controls another closed system in which the hydraulic means of the adjustment device is incorporated. Minor changes in the amount of fluid in a reservoir of the first system could then lead to major changes in the amount of fluid in a reservoir in the second system. Consequently, the change in volume in the reservoir of the second system affects the hydraulic operation of the adjustment device which is incorporated in the second closed system. The great advantage of this servo system is that the larger volume system could be placed inside the abdomen where there is more space and still it would be possible to use manual manipulation means of the smaller system subcutaneously. The servo reservoir could control the reservoir of the larger volume. The servo reservoir could be controlled directly or indirectly by a fluid supply means. The fluid supply means may be a small reservoir, which may be placed subcutaneously and may be activated by manual manipulation means controlling the servo reservoir, or other suitable device.
- Preferably, the fluid supply means comprises hydraulic means and a fluid supply reservoir defining a chamber containing fluid, and the hydraulic operation means comprises first and second wall portions of the reservoir, which are displaceable relative to each other to change the size of the chamber of the fluid supply reservoir. The hydraulic operation means may distribute fluid from the fluid supply reservoir to the servo reservoir in response to a predetermined first displacement of the first wall portion of the fluid supply reservoir relative to the second wall portion of the fluid supply reservoir and to distribute fluid from the servo reservoir to the fluid supply reservoir in response to a predetermined second displacement of the first wall portion relative to the second wall portion. The wall portions of the fluid supply reservoir may be displaceable relative to each other by manual manipulation means or be displaceable relative to each other by manual manipulating means for pushing, pulling or rotating any of the wall portions of the fluid supply reservoir in one direction. Alternatively, the wall portions of the fluid supply reservoir may be displaceable relative to each other by magnetic means, hydraulic means, manually manipulated means, or electrical control means including an electric motor. The magnetic means, hydraulic means, or electrical control means may all be activated by manually manipulated means preferably located subcutaneously. This control may be indirect, for example via a switch.
- Even in the broadest embodiment of the invention the adjustment device may comprise a servo means. The servo means may comprise a hydraulic operation means, an electric control means, a magnetic means, mechanical means, or a manual manipulating means. The hydraulic operation means, electric control means, mechanical means or magnetic means may be activated by manual manipulating means. Using a servo system will save the use of force when adjusting the adjustment device which may be of importance in many applications.
- All systems according to the invention may be controlled by a wireless remote control means.
- In accordance with an advantageous embodiment of the invention, there is provided a wireless remote control means for controlling the hydraulic operation means and comprising a separate signal transmitting means and a signal receiving means for controlling the hydraulic operation means in response to signals received from the signal transmitting means. Preferably, the remote control means comprises a motor for operating the hydraulic operation means and an energizer unit for providing energy, and the signal receiving means comprises a control unit powering the motor with energy provided by the energizer unit in response to signals received from the signal transmitting means. In this case the energizer unit may be a battery. The wireless remote control may control the adjustment device and any type of hydraulic operation means including servo means and fluid supply means. The remote control also could control any of the other described embodiments including any kind of servo means. Advantageously, the signal transmitting means also transmits electromagnetic wave signals and the energizer unit draws radiant energy from the electromagnetic wave signals as they are transmitted to the signal receiving means and transfers the radiant energy into electric energy for powering the electric motor.
- To expand the field of application, the energizer unit may comprise a rechargeable electric power supply, such as a capacitor, for storing the electric energy and the control unit may power the electric motor, for instance a stepping motor, with energy from the rechargeable electric power supply in response to signals received from the signal transmitting means. In an initial charging step the rechargeable power supply can be charged over a relatively long time (e.g. a few seconds up to a half hour) without powering the electric motor. In a following operating step, when the power supply has been charged with sufficient energy, the control unit powers the electric motor with energy from the charged power supply to operate the adjustment device, so that a desired change of the patient's stoma opening is achieved. If the capacity of the power supply is significant to achieve the necessary adjustment in one single operating step, the above steps may conveniently be repeated until the desired adjustment is achieved.
- As an alternative, the energizer unit may comprise a battery, an electrically operable switch connecting the battery to the signal receiving means in an “on” mode when the switch is powered and to keep the battery disconnected from the signal receiving means in a “standby” mode when the switch is unpowered, and a rechargeable electric power supply for powering the switch. The control unit may power the electric motor with energy from the battery in response to signals received from the signal transmitting means, when the switch is in its “on” mode. Suitably, the energizer unit may transfer the radiant energy into a current for charging the rechargeable electric power supply, such as a capacitor.
- The energizer unit may comprise a coil connected to the signal receiving means for inducing an alternating current as electromagnetic wave signals are transmitted through the coil to the signal receiving means and a rectifier for rectifying the alternating current.
- The non-inflatable embodiment of the restriction member and the adjustment device utilized according to the invention may be as shown in a copending application entitled “Mechanical Food In-take Restriction Device” filed the same date as this application (attorney docket 2333-11), the disclosure of which is hereby incorporated by reference herein.
- The invention also relates to a method of treating morbid obesity, comprising: (a) Surgically implanting in the abdomen of a patient with morbid obesity a food intake restriction device which forms a stoma opening in the stomach or esophagus, by forming an elongated restriction member (e.g. of bio-compatible material, or covered with bio-compatible material) into at least a substantially closed loop around the stomach or the esophagus of the patient, the loop defining a restriction opening; and then (b) when necessary for the patient's health or desired progress, in a non-invasive procedure, hydraulically acting on the restriction member to change the size of the restriction opening. Where the restriction member comprises a cavity which can be expanded and contracted by the supply of hydraulic fluid thereto, then (a) may be practiced in part by implanting in the patient a reservoir containing a predetermined amount of hydraulic fluid and connecting the reservoir to the cavity and a hydraulic operation means for distributing fluid from the reservoir to the cavity; and (b) may be practiced by controlling the hydraulic operation means from a point outside the patient's body without physically penetrating the patient's body. Where the restriction member is acted upon by an adjustment device which mechanically adjusts the loop, then (a) may be practiced in part by implanting in the patient the adjustment device, implanting a reservoir containing a predetermined amount of hydraulic fluid and connecting the reservoir to the cavity, and implanting a hydraulic operation means for distributing fluid from the reservoir to the cavity; and (b) may be practiced by controlling the hydraulic operation means from a point outside the patient's body without physically penetrating the patient's body to control the adjustment device so that the size of the restriction opening is changed. This may be done manually, remotely, by remote control, or in the other described manners.
- In the method (a) may be practiced by laparoscopic techniques, e.g. by (i) inflating the patient's abdomen with gas by penetration of the patient's skin, (ii) introducing at least two laparoscopic trocars into the abdomen to introduce the elongated restriction member and one or more medical instruments, and then (iii) forming the elongated restriction member into the at least substantially closed loop.
- It is the primary object of the present invention to provide an advantageous yet relatively simple assembly and method for treating morbid obesity in a substantially non-invasive manner after initial surgical implantation of a restriction member. This and other objects will become clear from the detailed description and from the appended claims.
- FIGS.1A-D are block diagrams of four different principal embodiments of the invention.
- FIGS.2A-D are cross-sectional views of a pump mechanism according to FIG. 1C, which is designed to pump fluid in opposite directions by mechanically pushing a wall portion in only one direction.
- FIG. 3 is a cross-sectional view of a reservoir having a variable volume controlled by a remote control motor, in accordance with a particular embodiment of the principal embodiment shown in FIGS. 1B or2B.
- FIG. 4 is a cross-sectional view of a reservoir having a variable volume adjustable by manual manipulation, in accordance with a particular embodiment of the principal embodiment shown in FIGS. 1B or1D.
- FIG. 5A is a perspective view of a hydraulic, pneumatic or mechanical servo system in accordance with a particular embodiment of the principal embodiment shown in FIG. 1D.
- FIG. 5B is a cross-sectional view taken along line VB-VB of FIG. 5A.
- FIG. 6 is a block diagram illustrating remote control components of the device of the invention;
- FIG. 7 is a schematic view of exemplary circuitry used for the block diagram of FIG. 6; and
- FIG. 8 is a schematic view of a band with a cavity defining a restriction opening for use in accordance with the invention.
- FIGS.1A-D is a block diagram of four different embodiments. FIG. 1A shows a restriction member in the form of a typically conventional inflatable band 2 (SAGB), a
separate reservoir 4, a one way pump 6 and analternate valve 8. FIG. 1B shows theband 2 and afluid supply reservoir 10. FIG. 1C shows theband 2, a twoway pump 12 and thereservoir 4. FIG. 1D shows a servo system with a first closed system controlling a second system. The servo system comprises thefluid supply reservoir 10 and aservo reservoir 14. Theservo reservoir 14 controls a largeradjustable reservoir 16 which in connection with theband 2 varies the volume of a cavity in the band, which in turn varies arestriction opening 3 in theband 2. Such aband 2 andopening 3 are illustrated schematically in FIG. 8. Theconventional band 2 has an expandable/contractable cavity 5 which is expanded or contracted by supplying hydraulic fluid (e.g. from 4, 6, 10, 16), and theband 2 may be sutured in place, illustrated schematically at 7 in FIG. 8. - FIGS.2A-D are cross-sectional views of a pump mechanism for pumping fluid in both directions only by mechanically pushing a separate
sealing wall portion 18 in one direction. FIG. 2A shows apiston 20 pushed forwards against aspring 22 towards thewall portion 18 and located in apump housing 24 conducting fluid from a rightupper fluid passage 26 of thehousing 24 to aleft fluid passage 28 of thehousing 24. Amain valve 30 is open and anonreturn valve 32 is closed. FIG. 2B illustrates the first pump movement in which thepiston 20 has moved forwards and reaches thewall portion 18. FIG. 2C illustrates how thepiston 20 moves backwards by the action of thespring 22. Themain valve 30 is now closed and thenonreturn valve 32 is open for fluid from the rightupper passage 26. FIG. 1D illustrates how thepiston 20 is moved further downwardly from its position according to FIG. 2B while pushing thewall portion 18 downwardly against asecond spring 34 that is stronger thanspring 22, so that fluid escapes from a rightlower fluid passage 36. When moving thepiston 20 backwardly from the position according to FIG. 2D, fluid enters theleft fluid passage 28 and avalve 38 in the lowerright fluid passage 36 closes. - FIG. 3 is a cross-sectional view of a
reservoir 40 defining achamber 42, the size of which is variable and is controlled by a remote controlledelectric motor 44, in accordance with FIGS. 1B or 1D. Thereservoir 40 and themotor 44 are placed in a housing 46. Thechamber 42 is varied by moving alarge wall 48. Thewall 48 is secured to anut 50, which is threaded on arotatable spindle 52. Thespindle 52 is rotated by themotor 44 via an angular gearing, which comprises twoconical gear wheels 54 and 56 in mesh with each other. Themotor 44 is powered by abattery 58 placed in the housing 46. A signal receiving means 60 for controlling themotor 44 is also placed in the housing 46. Alternatively, thebattery 58 and the signal receiving means 60 may be mounted in a separate place. Themotor 44 may also be powered by transmitted electromagnetic wave signals. - FIG. 4 is a cross-sectional view of a
reservoir 62 defining achamber 64, the size of which is variable and is controlled by manual manipulation. A gable wall portion 66 of an open ended innercylindrical housing 68 is adapted to be pushed downwards to fit in a desiredlocking groove 70 of a plurality of lockinggrooves 70 on the mantle wall of thecylindrical housing 68, to reduce the size of thechamber 64. The innercylindrical housing 68 is suspended bysprings 72 and is telescopically applied on an outercylindrical housing 74. When pushing the innercylindrical housing 68 it moves downwards relative to the outercylindrical housing 74 causing the gable wall portion 66 to release from the lockinggroove 70 and move upwards relative to the innercylindrical housing 68. When theinner housing 68 is moved upwardly by the action of thesprings 72 the size of thechamber 64 is increased. - FIGS. 5A and 5B show a servo means comprising a main ring-shaped
fluid reservoir 76 defining achamber 78, the size of which is variable. Centrally positioned in the main ring-shapedreservoir 76 there is aservo fluid reservoir 80 defining achamber 82, the size of which is variable. Thechamber 82 of theservo reservoir 80 is substantially smaller than thechamber 78 of themain reservoir 76. The tworeservoirs separate walls servo reservoir 80, the twoopposite walls chamber 78 of themain reservoir 76 is changed. - FIG. 6 shows the basic parts of a remote control system of the device of the invention including the
electric motor 44 of the embodiment shown in FIG. 3. The described remote control system is also based on the transmission of electromagnetic wave signals, often of high frequencies in the order of 100 kHz-1 gHz, through theskin 130 of the patient. In FIG. 6, all parts placed to the left of theskin 130 are located outside the patient's body and all parts placed to the right of theskin 130 are implanted. Any suitable remote control system may be used. - An external
signal transmitting antenna 132 is to be positioned close to asignal receiving antenna 134 implanted close to theskin 130. As an alternative, the receivingantenna 134 may be placed for example inside the abdomen of the patient. The receivingantenna 134 comprises a coil, approximately 1-100 mm, preferably 25 mm in diameter, wound with a very thin wire and tuned with a capacitor to a specific high frequency. A small coil is chosen if it is to be implanted under the skin of the patient and a large coil is chosen if it is to be implanted in the abdomen of the patient. The transmittingantenna 132 comprises a coil having about the same size as the coil of the receivingantenna 134 but wound with a thick wire that can handle the larger currents that is necessary. The coil of the transmittingantenna 132 is tuned to the same specific high frequency as the coil of the receivingantenna 134. - An
external control unit 136 comprises a microprocessor, a high frequency electromagnetic wave signal generator and a power amplifier. The microprocessor of thecontrol unit 136 switches the generator on/off and modulates signals generated by the generator to send digital information via the power amplifier and theantennas control unit 138. To avoid that accidental random high frequency fields trigger control commands, digital signal codes are used. A conventional keypad placed on theexternal control unit 136 is connected to the microprocessor thereof. The keypad is used to order the microprocessor to send digital signals to either increase or decrease the size of the restriction opening defined by the loop of therestriction member 2. The microprocessor starts a command by applying a high frequency signal on theantenna 132. After a short time, when the signal has energized the implanted parts of the control system, commands are sent to increase or decrease the size of the restriction opening of therestriction member 2 in predefined steps. The commands are sent as digital packets in the form illustrated below.Start pattern, 8 bits Command, 8 bits Count, 8 bits Checksum, 8 bits - The commands are sent continuously over a relatively long time period (e.g. about 30 seconds or more). When a new increase or decrease step is desired the Count byte is increased by one to allow the implanted
control unit 138 to decode and understand that another step is demanded by theexternal control unit 136. If any part of the digital packet is erroneous, its content is simply ignored. - Through a line140, an implanted energizer unit 126 draws energy from the high frequency electromagnetic wave signals received by the receiving
antenna 134. The energizer unit 126 stores the energy in a power supply, such as a large capacitor, powers thecontrol unit 138 and powers theelectric motor 44 via a line 142. - The
control unit 138 comprises a demodulator and a microprocessor. The demodulator demodulates digital signals sent from theexternal control unit 136. The microprocessor of thecontrol unit 138 receives the digital packet, decodes it and, provided that the power supply of the energizer unit 126 has sufficient energy stored, sends a signal via asignal line 144 to themotor 44 to either increase or decrease the size of the restriction opening of therestriction member 2 depending on the received command code. - Alternatively, the energy stored in the power supply of the energizer unit may only be used for powering a switch, and the energy for powering the
motor 44 may be obtained from another implanted power source of relatively high capacity, for example a battery. In this case the switch is adapted to connect the battery to thecontrol unit 138 in an “on” mode when the switch is powered by the power supply and to keep the battery disconnected from the control unit in a standby mode when the switch is unpowered. - With reference to FIG. 7, the remote control system schematically described above will now be described in accordance with a more detailed embodiment. The
external control unit 136 comprises amicroprocessor 146, asignal generator 148 and apower amplifier 150 connected thereto. Themicroprocessor 146 switches thesignal generator 148 on/off and modulates signals generated by thesignal generator 148 with digital commands that are sent to implanted components of the food intake restriction device. Thepower amplifier 150 amplifies the signals and sends them to the externalsignal transmitting antenna 132. Theantenna 132 is connected in parallel with acapacitor 152 to form a resonant circuit tuned to the frequency generated by thesignal generator 148. - The implanted signal receiving
antenna coil 134 forms together with a capacitor 154 a resonant circuit that is tuned to the same frequency as the transmittingantenna 132. The signal receivingantenna coil 134 induces a current from the received high frequency electromagnetic waves and a rectifyingdiode 160 rectifies the induced current, which charges astorage capacitor 158. Acoil 156 connected between theantenna coil 134 and thediode 160 prevents thecapacitor 158 and thediode 160 from loading the circuit of thesignal receiving antenna 134 at higher frequencies. Thus, thecoil 156 makes it possible to charge thecapacitor 158 and to transmit digital information using amplitude modulation. - A
capacitor 162 and aresistor 164 connected in parallel and adiode 166 forms a detector used to detect amplitude modulated digital information. A filter circuit is formed by aresistor 168 connected in series with aresistor 170 connected in series with acapacitor 172 connected in series with theresistor 168 via ground, and acapacitor 174, one terminal of which is connected between theresistors diode 166 and the circuit formed by thecapacitor 162 andresistor 164. The filter circuit is used to filter out undesired low and high frequencies. The detected and filtered signals are fed to an implantedmicroprocessor 176 that decodes the digital information and controls themotor 44 via an H-bridge 178 comprisingtransistors motor 44 can be driven in two opposite directions by the H-bridge 178. - The
microprocessor 176 also monitors the amount of stored energy in thestorage capacitor 158. Before sending signals to activate themotor 44, themicroprocessor 176 checks whether the energy stored in thestorage capacitor 158 is enough. If the stored energy is not enough to perform the requested operation, themicroprocessor 176 waits for the received signals to charge thestorage capacitor 158 before activating themotor 44. - There are a number of other conceivable alternative embodiments of the invention that give the same result as the above-described embodiments. For example, the microprocessor of the external and implanted, respectively, control units may be replaced by discrete components. The power amplifier of the external control unit may be omitted if the signals generated by the signal generator are strong enough. Therefore the invention is to be accorded the broadest interpretation of the appended claims to encompass all equivalent structures, assemblies, and methods.
Claims (26)
1. A food intake restriction device for forming a stoma opening in the stomach or esophagus of a patient, comprising:
an elongated restriction member implanted in the patient forming an expandable and contractible cavity, said elongated restriction member formed into an at least substantially closed loop surrounding the patient's stomach or esophagus, and defining a restriction opening, the size of which is reduced upon expansion of said cavity and increased upon contraction of said cavity;
a reservoir implanted in the patient containing a predetermined amount of hydraulic fluid and connected to said cavity of said restriction member, and
hydraulic operation means implanted in the patient for distributing fluid from said reservoir to said cavity to expand said cavity, and for distributing fluid from said cavity to said reservoir to contract said cavity, to thereby control the size of the restriction opening.
2. The device according to claim 1 , wherein said reservoir defines a chamber for said predetermined amount of fluid and said hydraulic operation means changes the size of said chamber.
3. The device according to claim 2 , wherein said hydraulic operation means comprises first and second wall portions of said reservoir, which are displaceable relative to each other to change the size of said chamber of said reservoir.
4. The device according to claim 3 , wherein said first and second wall portions of said reservoir are displaceable relative to each other by manual manipulation thereof; and wherein said first and second wall portions of said reservoir are designed to be displaceable relative to each other by manually pushing, pulling or rotating any of said wall portions in one direction; and wherein said first and second wall portions of said reservoir are displaceable relative to each other by magnetic means, by hydraulic means, or by electric control means such as an electric motor; and wherein said hydraulic operation means distributes fluid from said reservoir to said cavity of said restriction member in response to a predetermined first displacement of said first wall portion of said reservoir relative to said second wall portion of said reservoir and distributes fluid from said cavity to said reservoir in response to a predetermined second displacement of said first wall portion relative to said second wall portion.
5. The device according to claim 1 , wherein said hydraulic operation means comprises an activatable pump for pumping fluid between said reservoir and said cavity of said restriction member; and wherein said pump comprises a first activation member for activating said pump to pump fluid from said reservoir to said cavity of said restriction member and a second activation member for activating said pump to pump fluid from said cavity to said reservoir; and wherein said first and second activation members are operable by manual manipulation thereof, by manually pushing, pulling or rotating thereof in one direction; and wherein at least one of said activation members operates when subjected to an external pressure exceeding a predetermined magnitude.
6. The device according to claim 1 , wherein said hydraulic operation means comprises an activatable pump for pumping fluid between said reservoir and said cavity of said restriction member; and wherein said pump comprises a first activation member for activating said pump to pump fluid from said reservoir to said cavity of said restriction member and a second activation member for activating said pump to pump fluid from said cavity to said reservoir; and wherein at least one of said first and second activating members are operable by magnetic means, or by hydraulic means, or by electric control means such as an electric motor.
7. The device according to claim 1 , wherein said hydraulic operation means comprises a servo means.
8. The device according to claim 7 , wherein said hydraulic operation means comprises first and second wall portions of said reservoir, and said servo means provides relative displacement between said first and second wall portions of reservoir; and wherein said servo means comprises magnetic means, electric means, or hydraulic means in which said servo means comprises a servo reservoir defining a chamber containing servo fluid and said hydraulic operation means comprises first and second wall portions of said servo reservoir, which are displaceable relative to each other to change the size of said chamber of said servo reservoir; and wherein said first and second wall portions of said servo reservoir are designed to be displaceable relative to each other by manual manipulation thereof; and wherein said first and second wall portions of said servo reservoir are displaceable relative to each other by manually pushing, pulling or rotating any of said wall portions of said servo reservoir in one direction; and wherein said first and second wall portions of said servo reservoir are displaceable relative to each other by magnetic means, or by hydraulic means, or by electric control means such as an electric motor.
9. The device according to claim 1 , further comprising a wireless remote control means for controlling said hydraulic operation means.
10. The device according to claim 9 , wherein said remote control means comprises a separate signal transmitting means and a signal receiving means adapted to control said hydraulic operation means in response to signals received from said signal transmitting means; wherein said remote control means comprises a motor for operating said hydraulic operation means and an energizer unit for providing energy, and said signal receiving means comprises a control unit adapted to power said motor with energy provided by said energizer unit in response to signals received from said signal transmitting means; and wherein said energizer unit comprises a power supply; and wherein said control unit is adapted to power said motor with energy from said power supply; and wherein said power supply is an electric power supply and said motor is an electric motor; wherein said electric power supply is a battery; wherein said motor is an electric motor.
11. The device according to claim 10 wherein said signal transmitting means is adapted to transmit electromagnetic wave signals and said energizer unit draws radiant energy from said electromagnetic wave signals as they are transmitted to said signal receiving means and transfer said radiant energy into electric energy for powering said electric motor; wherein said energizer unit comprises a rechargeable electric power supply for storing said electric energy and said control unit powers said electric motor with energy from said rechargeable electric power supply in response to signals received from said signal transmitting means.
12. The device according to claim 9 , wherein said remote control means comprises separate signal transmitting means and signal receiving means, said signal receiving means controlling said hydraulic operation means in response to signals received from said signal transmitting means; wherein said remote control means comprises a motor for operating said hydraulic operation means and an energizer unit for providing energy, and said signal receiving means comprises a control unit adapted to power said motor with energy provided by said energizer unit in response to signals received from said signal transmitting means; and wherein said motor is an electric motor powered by a rechargeable electric power supply; and wherein said signal transmitting means transmits electromagnetic wave signals and said energizer unit draws radiant energy from said electromagnetic wave signals as they are transmitted to said signal receiving means and transfers said radiant energy into a current for charging said rechargeable electric power supply.
13. The device according to claim 12 , wherein said rechargeable electric power supply is a capacitor.
14. The device according to claim 12 , wherein said energizer unit comprises a coil connected to said signal receiving means for inducing an alternating current as electromagnetic wave signals are transmitted through said coil to said signal receiving means and a rectifier for rectifying said alternating current.
15. The device according to claim 10 wherein said electric power supply comprises a capacitor, and said electric motor is a stepping motor.
16. The device according to claim 10 wherein said energizer unit comprises a battery, an electrically operable switch connects said battery to said signal receiving means in an “on” mode when said switch is powered and to keep said battery disconnected from said signal receiving means in a “standby” mode when said switch is unpowered, and a rechargeable electric power supply for powering said switch; and wherein said control unit powers said electric motor with energy from said battery in response to signals received from said signal transmitting means, when said switch is in its “on” mode.
17. A food intake restriction device for surgical application in the abdomen of a patient for forming a stoma opening in the stomach or esophagus of said patient, said device comprising:
an elongated non-inflatable restriction member formed into at least a substantially closed loop around the patient's stomach or the esophagus, and defining a restriction opening,
an adjustment device which mechanically adjusts said restriction member in said loop to change the size of said restriction opening,
hydraulic operation means implanted in the patient for operating said adjustment device, and
a reservoir implanted in the patient containing a predetermined amount of fluid for supplying said hydraulic operation means with hydraulic fluid.
18. The device according to claim 17 , wherein the adjustment device comprises a servo means.
19. The device according to claim 18 , wherein the servo means comprise a hydraulic operation means, or an electric control means, or a magnetic means; and wherein the servo means and said hydraulic operation means are activated by manual manipulation or wherein said electric control means is activated by manual manipulation means, or wherein said magnetic means is activated by manual manipulation.
20. The device according to claim 18 , wherein said servo means comprises a hydraulic operation means including a servo reservoir and a fluid supply reservoir connected in a closed system and containing a predetermined amount of fluid; and wherein said fluid supply reservoir defines a chamber for said predetermined amount of fluid and the hydraulic operation means is adapted to change the size of said chamber and thereby control the servo reservoir; and wherein said fluid supply reservoir comprises first wall portion and second wall portions of the fluid supply reservoir, which are displaceable relative to each other to change the size of said chamber.
21. The device according to claim 20 , wherein said first and second wall portions of said fluid supply reservoir are designed to be displaceable relative to each other by manual manipulation for pushing, pulling or rotating any of the wall portions in one direction, or wherein said first and second wall portions of the fluid supply reservoir are designed to be displaceable relative to each other by magnetic means for pushing, pulling or rotating any of the wall portions in one direction; or wherein said first and second wall portions of the fluid supply reservoir are displaceable relative to each other by electrical control means for pushing, pulling or rotating any of the all portions in one direction; or wherein said first and second wall portions of said fluid supply reservoir are displaceable relate to each other by hydraulic operation means for pushing, pulling or rotating any of the wall portions in one direction.
22. The device according to claim 20 , wherein the fluid supply reservoir operates the servo reservoir with fluid from the fluid supply reservoir in response to predetermined first displacement of the first wall portion of the fluid supply reservoir relative to the second wall portions of the fluid supply reservoir to increase the amount of fluid in the servo reservoir and to operate the servo reservoir in response to a predetermined second displacement of the first wall portion of the fluid supply reservoir relative to the second wall portion of the fluid supply reservoir to decrease the amount of fluid in the servo reservoir.
23. A method of treating morbid obesity, comprising:
(a) surgically implanting in the abdomen of a patient with morbid obesity a food intake restriction device which forms a stoma opening in the stomach or esophagus, by forming an elongated restriction member into at least a substantially closed loop around the stomach or the esophagus of the patient, the loop defining a restriction opening; and then
(b) when necessary for the patient's health or desired progress, in a non-invasive procedure, hydraulically acting on the restriction member to change the size of the restriction opening.
24. A method as recited in claim 23 wherein the restriction member comprises a cavity which can be expanded and contracted by the supply of hydraulic fluid thereto; and wherein (a) is practiced in part by implanting in the patient a reservoir containing a predetermined amount of hydraulic fluid and connecting the reservoir to the cavity and a hydraulic operation means for distributing fluid from the reservoir to the cavity; and wherein (b) is practiced by controlling the hydraulic operation means from a point outside the patient's body without physically penetrating the patient's body.
25. A method as recited in claim 23 wherein the restriction member is acted upon by an adjustment device which mechanically adjusts the loop; and wherein (a) is practiced in part by implanting in the patient the adjustment device, implanting a reservoir containing a predetermined amount of hydraulic fluid and connecting the reservoir to the cavity, and implanting a hydraulic operation means for distributing fluid from the reservoir to the cavity, and wherein (b) is practiced by controlling the hydraulic operation means from a point outside the patient's body without physically penetrating the patient's body to control the adjustment device so that the size of the restriction opening is changed.
26. A method as recited in claim 23 wherein (a) is practiced by: (i) inflating the patient's abdomen with gas by penetration of the patient's skin, (ii) introducing at least two laparoscopic trocars into the abdomen to introduce the elongated restriction member and one or more medical instruments, and then (iii) forming the elongated restriction member into the at least substantially closed loop.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US10/252,044 US20030019498A1 (en) | 1998-08-13 | 2002-09-23 | Non-injection port food intake restriction device |
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Application Number | Priority Date | Filing Date | Title |
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US09/133,322 US6460543B1 (en) | 1998-08-13 | 1998-08-13 | Non-injection port food intake restriction device |
US10/252,044 US20030019498A1 (en) | 1998-08-13 | 2002-09-23 | Non-injection port food intake restriction device |
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US09/133,322 Continuation US6460543B1 (en) | 1998-08-13 | 1998-08-13 | Non-injection port food intake restriction device |
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US20030019498A1 true US20030019498A1 (en) | 2003-01-30 |
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US10/252,044 Abandoned US20030019498A1 (en) | 1998-08-13 | 2002-09-23 | Non-injection port food intake restriction device |
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US09/133,322 Expired - Lifetime US6460543B1 (en) | 1998-08-13 | 1998-08-13 | Non-injection port food intake restriction device |
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Cited By (63)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060235448A1 (en) * | 2005-04-13 | 2006-10-19 | Roslin Mitchell S | Artificial gastric valve |
US20060244291A1 (en) * | 2005-04-29 | 2006-11-02 | Buell Motorcycle Company | Movable tailrack for a motorcycle |
US20070015954A1 (en) * | 2005-07-15 | 2007-01-18 | Dlugos Daniel F | Gastric band with mating end profiles |
US20070015955A1 (en) * | 2005-07-15 | 2007-01-18 | Mark Tsonton | Accordion-like gastric band |
US20070016230A1 (en) * | 2005-07-15 | 2007-01-18 | Jambor Kristin L | Gastric band |
US20070016231A1 (en) * | 2005-07-15 | 2007-01-18 | Jambor Kristin L | Precurved gastric band |
US20070016229A1 (en) * | 2005-07-15 | 2007-01-18 | Jambor Kristin L | Gastric band suture tab extender |
US20070173881A1 (en) * | 2004-03-18 | 2007-07-26 | Allergan, Inc. | Apparatus and method for volume adjustment of intragastric balloons |
US20070173685A1 (en) * | 2005-07-15 | 2007-07-26 | Jambor Kristin L | Method of implating a medical device using a suture tab extender |
US20070250086A1 (en) * | 2005-07-15 | 2007-10-25 | Wiley Jeffrey P | Gastric band composed of different hardness materials |
US20070255335A1 (en) * | 2006-04-28 | 2007-11-01 | Medtronic, Inc. | Controller for gastric constriction device with selectable electrode configurations |
US20070255336A1 (en) * | 2006-04-28 | 2007-11-01 | Medtronic, Inc. | Gastric constriction device with selectable electrode combinations |
US7416528B2 (en) | 2005-07-15 | 2008-08-26 | Ethicon Endo-Surgery, Inc. | Latching device for gastric band |
US20090312785A1 (en) * | 2008-06-11 | 2009-12-17 | Allergan, Inc. | Implantable Pump System |
US20100087843A1 (en) * | 2008-10-06 | 2010-04-08 | Allergan, Inc. | Mechanical Gastric Band With Cushions |
US20100185049A1 (en) * | 2008-10-22 | 2010-07-22 | Allergan, Inc. | Dome and screw valves for remotely adjustable gastric banding systems |
US20100280310A1 (en) * | 2009-05-01 | 2010-11-04 | Allergan, Inc. | Laparoscopic Gastric Band With Active Agents |
US20100324361A1 (en) * | 2008-01-29 | 2010-12-23 | Peter Forsell | Apparatus for treating obesity |
US20100324359A1 (en) * | 2002-08-28 | 2010-12-23 | Janel Birk | Fatigue-resistant gastric banding device |
US20110040141A1 (en) * | 2004-03-08 | 2011-02-17 | Allergan, Inc. | Closure system for tubular organs |
US20110054248A1 (en) * | 2009-08-28 | 2011-03-03 | Allergan, Inc. | Gastric band with electric stimulation |
US20110137112A1 (en) * | 2009-08-28 | 2011-06-09 | Allergan, Inc. | Gastric band with electric stimulation |
US20110152608A1 (en) * | 2002-09-04 | 2011-06-23 | Allergan, Inc. | Flow control method and device |
US20110184229A1 (en) * | 2009-05-01 | 2011-07-28 | Allergan, Inc. | Laparoscopic gastric band with active agents |
US20110201875A1 (en) * | 2010-02-12 | 2011-08-18 | Allergan, Inc. | Remotely adjustable gastric banding system |
US20110208229A1 (en) * | 2010-02-24 | 2011-08-25 | Allergan, Inc. | Source reservoir with potential energy for remotely adjustable gastric banding system |
US8308630B2 (en) | 2006-01-04 | 2012-11-13 | Allergan, Inc. | Hydraulic gastric band with collapsible reservoir |
US8372093B2 (en) * | 2008-11-04 | 2013-02-12 | Koletry Processing L.L.C. | Systems and processes for controlling gastric bands based on geographic location |
US8517915B2 (en) | 2010-06-10 | 2013-08-27 | Allergan, Inc. | Remotely adjustable gastric banding system |
US8698373B2 (en) | 2010-08-18 | 2014-04-15 | Apollo Endosurgery, Inc. | Pare piezo power with energy recovery |
US8764624B2 (en) | 2010-02-25 | 2014-07-01 | Apollo Endosurgery, Inc. | Inductively powered remotely adjustable gastric banding system |
US8840541B2 (en) | 2010-02-25 | 2014-09-23 | Apollo Endosurgery, Inc. | Pressure sensing gastric banding system |
US8845513B2 (en) | 2002-08-13 | 2014-09-30 | Apollo Endosurgery, Inc. | Remotely adjustable gastric banding device |
US8876694B2 (en) | 2011-12-07 | 2014-11-04 | Apollo Endosurgery, Inc. | Tube connector with a guiding tip |
US8900117B2 (en) | 2004-01-23 | 2014-12-02 | Apollo Endosurgery, Inc. | Releasably-securable one-piece adjustable gastric band |
US8905915B2 (en) | 2006-01-04 | 2014-12-09 | Apollo Endosurgery, Inc. | Self-regulating gastric band with pressure data processing |
US8961393B2 (en) | 2010-11-15 | 2015-02-24 | Apollo Endosurgery, Inc. | Gastric band devices and drive systems |
US8961394B2 (en) | 2011-12-20 | 2015-02-24 | Apollo Endosurgery, Inc. | Self-sealing fluid joint for use with a gastric band |
US9028394B2 (en) | 2010-04-29 | 2015-05-12 | Apollo Endosurgery, Inc. | Self-adjusting mechanical gastric band |
US9044298B2 (en) | 2010-04-29 | 2015-06-02 | Apollo Endosurgery, Inc. | Self-adjusting gastric band |
US9050165B2 (en) | 2010-09-07 | 2015-06-09 | Apollo Endosurgery, Inc. | Remotely adjustable gastric banding system |
US9192501B2 (en) | 2010-04-30 | 2015-11-24 | Apollo Endosurgery, Inc. | Remotely powered remotely adjustable gastric band system |
US9211207B2 (en) | 2010-08-18 | 2015-12-15 | Apollo Endosurgery, Inc. | Power regulated implant |
US9226840B2 (en) | 2010-06-03 | 2016-01-05 | Apollo Endosurgery, Inc. | Magnetically coupled implantable pump system and method |
US9283309B2 (en) | 2010-03-18 | 2016-03-15 | Deutsches Zentrum Fuer Luft-Und Raumfahrt E.V. | Device for supplying energy to hydraulically or pneumatically actuated active implants |
US9295573B2 (en) | 2010-04-29 | 2016-03-29 | Apollo Endosurgery, Inc. | Self-adjusting gastric band having various compliant components and/or a satiety booster |
US10349982B2 (en) | 2011-11-01 | 2019-07-16 | Nuvasive Specialized Orthopedics, Inc. | Adjustable magnetic devices and methods of using same |
US10478232B2 (en) | 2009-04-29 | 2019-11-19 | Nuvasive Specialized Orthopedics, Inc. | Interspinous process device and method |
US10617453B2 (en) | 2015-10-16 | 2020-04-14 | Nuvasive Specialized Orthopedics, Inc. | Adjustable devices for treating arthritis of the knee |
US10646262B2 (en) | 2011-02-14 | 2020-05-12 | Nuvasive Specialized Orthopedics, Inc. | System and method for altering rotational alignment of bone sections |
US10660675B2 (en) | 2010-06-30 | 2020-05-26 | Nuvasive Specialized Orthopedics, Inc. | External adjustment device for distraction device |
US10729470B2 (en) | 2008-11-10 | 2020-08-04 | Nuvasive Specialized Orthopedics, Inc. | External adjustment device for distraction device |
US10743794B2 (en) | 2011-10-04 | 2020-08-18 | Nuvasive Specialized Orthopedics, Inc. | Devices and methods for non-invasive implant length sensing |
US10751094B2 (en) | 2013-10-10 | 2020-08-25 | Nuvasive Specialized Orthopedics, Inc. | Adjustable spinal implant |
US10835290B2 (en) | 2015-12-10 | 2020-11-17 | Nuvasive Specialized Orthopedics, Inc. | External adjustment device for distraction device |
US10918425B2 (en) | 2016-01-28 | 2021-02-16 | Nuvasive Specialized Orthopedics, Inc. | System and methods for bone transport |
US11191579B2 (en) | 2012-10-29 | 2021-12-07 | Nuvasive Specialized Orthopedics, Inc. | Adjustable devices for treating arthritis of the knee |
US11202707B2 (en) | 2008-03-25 | 2021-12-21 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant system |
US11234849B2 (en) | 2006-10-20 | 2022-02-01 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant and method of use |
US11246694B2 (en) | 2014-04-28 | 2022-02-15 | Nuvasive Specialized Orthopedics, Inc. | System for informational magnetic feedback in adjustable implants |
US11357549B2 (en) | 2004-07-02 | 2022-06-14 | Nuvasive Specialized Orthopedics, Inc. | Expandable rod system to treat scoliosis and method of using the same |
US11439449B2 (en) | 2014-12-26 | 2022-09-13 | Nuvasive Specialized Orthopedics, Inc. | Systems and methods for distraction |
US11612416B2 (en) | 2015-02-19 | 2023-03-28 | Nuvasive Specialized Orthopedics, Inc. | Systems and methods for vertebral adjustment |
Families Citing this family (122)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050192629A1 (en) * | 1999-06-25 | 2005-09-01 | Usgi Medical Inc. | Methods and apparatus for creating and regulating a gastric stoma |
US6464628B1 (en) * | 1999-08-12 | 2002-10-15 | Obtech Medical Ag | Mechanical anal incontinence |
US6471635B1 (en) | 2000-02-10 | 2002-10-29 | Obtech Medical Ag | Anal incontinence disease treatment with controlled wireless energy supply |
US6482145B1 (en) | 2000-02-14 | 2002-11-19 | Obtech Medical Ag | Hydraulic anal incontinence treatment |
US6503189B1 (en) | 1999-08-12 | 2003-01-07 | Obtech Medical Ag | Controlled anal incontinence disease treatment |
CN1202784C (en) | 2000-02-10 | 2005-05-25 | 波滕西亚医疗公司 | Controlled urinary incontinence treatment |
DE60135257D1 (en) * | 2000-02-10 | 2008-09-18 | Potencia Medical Ag | Mechanical device for impotence treatment |
CA2398496C (en) | 2000-02-10 | 2009-05-19 | Surgical Development Ag | Urinary incontinence treatment with wireless energy supply |
CN1400888A (en) | 2000-02-11 | 2003-03-05 | 波滕西亚医疗公司 | Impotence treatment apparatus with energy transforming means |
AU778406B2 (en) | 2000-02-11 | 2004-12-02 | Potentica Ag | Controlled impotence treatment |
ATE296071T1 (en) | 2000-02-14 | 2005-06-15 | Potencia Medical Ag | PENIS PROSTHESIS |
US20030100929A1 (en) | 2000-02-14 | 2003-05-29 | Peter Forsell | Controlled penile prosthesis |
US6475136B1 (en) * | 2000-02-14 | 2002-11-05 | Obtech Medical Ag | Hydraulic heartburn and reflux treatment |
WO2001047440A2 (en) | 2000-02-14 | 2001-07-05 | Potencia Medical Ag | Male impotence prosthesis apparatus with wireless energy supply |
FR2813786B1 (en) * | 2000-09-11 | 2003-03-14 | Medical Innovation Dev | METHOD AND DEVICE FOR CONTROLLING THE INFLATION OF AN INFLATABLE PROSTHETIC BODY AND PROSTHESIS USING THE SAME |
US7033373B2 (en) | 2000-11-03 | 2006-04-25 | Satiety, Inc. | Method and device for use in minimally invasive placement of space-occupying intragastric devices |
US6558400B2 (en) | 2001-05-30 | 2003-05-06 | Satiety, Inc. | Obesity treatment tools and methods |
US6845776B2 (en) | 2001-08-27 | 2005-01-25 | Richard S. Stack | Satiation devices and methods |
CN101810521B (en) | 2001-08-27 | 2015-05-13 | 辛尼科有限责任公司 | Satiation devices and methods |
US7097665B2 (en) | 2003-01-16 | 2006-08-29 | Synecor, Llc | Positioning tools and methods for implanting medical devices |
US6675809B2 (en) | 2001-08-27 | 2004-01-13 | Richard S. Stack | Satiation devices and methods |
US7146984B2 (en) | 2002-04-08 | 2006-12-12 | Synecor, Llc | Method and apparatus for modifying the exit orifice of a satiation pouch |
US7294120B1 (en) * | 2002-04-18 | 2007-11-13 | Haleys Pump Company | Automated instillation apparatus and method |
EP1539262A1 (en) | 2002-07-29 | 2005-06-15 | Potencia Medical AG | Durable implant |
US20040034275A1 (en) | 2002-07-29 | 2004-02-19 | Peter Forsell | Multi-material incontinence treatment constriction device |
US6746460B2 (en) | 2002-08-07 | 2004-06-08 | Satiety, Inc. | Intra-gastric fastening devices |
US7033384B2 (en) | 2002-08-30 | 2006-04-25 | Satiety, Inc. | Stented anchoring of gastric space-occupying devices |
US7214233B2 (en) | 2002-08-30 | 2007-05-08 | Satiety, Inc. | Methods and devices for maintaining a space occupying device in a relatively fixed location within a stomach |
US7220237B2 (en) | 2002-10-23 | 2007-05-22 | Satiety, Inc. | Method and device for use in endoscopic organ procedures |
US20040143342A1 (en) | 2003-01-16 | 2004-07-22 | Stack Richard S. | Satiation pouches and methods of use |
US7175638B2 (en) | 2003-04-16 | 2007-02-13 | Satiety, Inc. | Method and devices for modifying the function of a body organ |
AT412525B (en) * | 2003-07-25 | 2005-04-25 | Wolfgang Dr Lechner | TAXABLE MAGNETIC BAND |
KR101059764B1 (en) * | 2003-07-25 | 2011-08-26 | 볼프강 레히너 | Adjustable camouflage band |
US20050247320A1 (en) | 2003-10-10 | 2005-11-10 | Stack Richard S | Devices and methods for retaining a gastro-esophageal implant |
US8206456B2 (en) | 2003-10-10 | 2012-06-26 | Barosense, Inc. | Restrictive and/or obstructive implant system for inducing weight loss |
US7914543B2 (en) | 2003-10-14 | 2011-03-29 | Satiety, Inc. | Single fold device for tissue fixation |
US7097650B2 (en) | 2003-10-14 | 2006-08-29 | Satiety, Inc. | System for tissue approximation and fixation |
AU2004235622A1 (en) * | 2003-12-17 | 2005-07-07 | Ethicon Endo-Surgery, Inc. | Mechanically adjustable gastric band |
US20050177176A1 (en) | 2004-02-05 | 2005-08-11 | Craig Gerbi | Single-fold system for tissue approximation and fixation |
EP1713402B1 (en) | 2004-02-13 | 2018-07-04 | Ethicon Endo-Surgery, Inc. | Device for reducing stomach volume |
EP1725194B1 (en) | 2004-02-27 | 2018-01-17 | Ethicon Endo-Surgery, Inc. | Methods and devices for reducing stomach volume |
US8449560B2 (en) | 2004-03-09 | 2013-05-28 | Satiety, Inc. | Devices and methods for placement of partitions within a hollow body organ |
US8252009B2 (en) | 2004-03-09 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Devices and methods for placement of partitions within a hollow body organ |
US8628547B2 (en) | 2004-03-09 | 2014-01-14 | Ethicon Endo-Surgery, Inc. | Devices and methods for placement of partitions within a hollow body organ |
US9028511B2 (en) | 2004-03-09 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Devices and methods for placement of partitions within a hollow body organ |
CA2561193A1 (en) | 2004-03-26 | 2005-10-20 | Satiety, Inc. | Systems and methods for treating obesity |
FR2869218B1 (en) * | 2004-04-21 | 2006-06-09 | Europlak Sa | GASTRIC CERCLING DEVICE OR MOTORIZED "GASTRIC RING" HAVING AT LEAST ONE RECEIVED ANTENNA FOR DELIVERY, REMOTE CONTROL AND DATA SENDING BY INDUCTION |
EP1740132B1 (en) * | 2004-04-26 | 2014-12-31 | Synecor, LLC | Restrictive and/or obstructive implant for inducing weight loss |
US7803195B2 (en) * | 2004-06-03 | 2010-09-28 | Mayo Foundation For Medical Education And Research | Obesity treatment and device |
WO2006047882A1 (en) * | 2004-11-05 | 2006-05-11 | Electronic Dietary Foods Inc. | Controlled degradation of expandable polymers in gastric volume reduction treatment |
US20060106288A1 (en) | 2004-11-17 | 2006-05-18 | Roth Alex T | Remote tissue retraction device |
US7775966B2 (en) * | 2005-02-24 | 2010-08-17 | Ethicon Endo-Surgery, Inc. | Non-invasive pressure measurement in a fluid adjustable restrictive device |
US20080051822A1 (en) * | 2005-01-18 | 2008-02-28 | Widgerow Alan D | Methods and apparatus for use in medical treatment |
WO2006086627A2 (en) * | 2005-02-11 | 2006-08-17 | Micardia Corporation | Dynamically adjustable gastric implants and methods of treating obesity using dynamically adjustable gastric implants |
US8066629B2 (en) | 2005-02-24 | 2011-11-29 | Ethicon Endo-Surgery, Inc. | Apparatus for adjustment and sensing of gastric band pressure |
US7927270B2 (en) | 2005-02-24 | 2011-04-19 | Ethicon Endo-Surgery, Inc. | External mechanical pressure sensor for gastric band pressure measurements |
US7909754B2 (en) * | 2005-02-24 | 2011-03-22 | Ethicon Endo-Surgery, Inc. | Non-invasive measurement of fluid pressure in an adjustable gastric band |
US7658196B2 (en) | 2005-02-24 | 2010-02-09 | Ethicon Endo-Surgery, Inc. | System and method for determining implanted device orientation |
US8016744B2 (en) | 2005-02-24 | 2011-09-13 | Ethicon Endo-Surgery, Inc. | External pressure-based gastric band adjustment system and method |
US7775215B2 (en) * | 2005-02-24 | 2010-08-17 | Ethicon Endo-Surgery, Inc. | System and method for determining implanted device positioning and obtaining pressure data |
US7699770B2 (en) * | 2005-02-24 | 2010-04-20 | Ethicon Endo-Surgery, Inc. | Device for non-invasive measurement of fluid pressure in an adjustable restriction device |
US20060276812A1 (en) * | 2005-04-04 | 2006-12-07 | Hill James W | Dynamic reinforcement of the lower esophageal sphincter |
US7691053B2 (en) | 2005-05-20 | 2010-04-06 | Tyco Healthcare Group Lp | Gastric restrictor assembly and method of use |
US7666180B2 (en) | 2005-05-20 | 2010-02-23 | Tyco Healthcare Group Lp | Gastric restrictor assembly and method of use |
US7967818B2 (en) | 2005-06-10 | 2011-06-28 | Cook Medical Technologies Llc | Cautery catheter |
US9055942B2 (en) | 2005-10-03 | 2015-06-16 | Boston Scienctific Scimed, Inc. | Endoscopic plication devices and methods |
US8216268B2 (en) | 2005-12-22 | 2012-07-10 | Cook Medical Technologies Llc | Intragastric bag for treating obesity |
US20070198039A1 (en) * | 2006-01-27 | 2007-08-23 | Wilson-Cook Medical, Inc. | Intragastric device for treating obesity |
US7908700B2 (en) * | 2006-02-28 | 2011-03-22 | Dipippo Joe J | Self-cleaning hair brush |
WO2007104356A1 (en) * | 2006-03-13 | 2007-09-20 | Rudolf Steffen | Adaptive device and adaptive method for adapting the stomach opening of a patient |
WO2007109904A1 (en) * | 2006-03-29 | 2007-10-04 | Electronic Dietary Foods Inc. | Ingestible implement for weight control |
US9579227B2 (en) | 2006-03-29 | 2017-02-28 | Eat Little Inc. | Ingestible implement for weight control |
US8152710B2 (en) | 2006-04-06 | 2012-04-10 | Ethicon Endo-Surgery, Inc. | Physiological parameter analysis for an implantable restriction device and a data logger |
US8342183B2 (en) * | 2006-04-19 | 2013-01-01 | Vibrynt, Inc. | Devices and methods for treatment of obesity |
US7763039B2 (en) * | 2006-06-09 | 2010-07-27 | Ethicon Endo-Surgery, Inc. | Articulating blunt dissector/gastric band application device |
US8109895B2 (en) | 2006-09-02 | 2012-02-07 | Barosense, Inc. | Intestinal sleeves and associated deployment systems and methods |
EP2068719B1 (en) | 2006-09-15 | 2017-10-25 | Boston Scientific Scimed, Inc. | System for anchoring stomach implant |
US20080319435A1 (en) * | 2006-10-12 | 2008-12-25 | Boston Scientific Scimed, Inc. | Shape-changing tissue constrictor and methods of use |
US8246533B2 (en) | 2006-10-20 | 2012-08-21 | Ellipse Technologies, Inc. | Implant system with resonant-driven actuator |
US8417329B2 (en) * | 2007-05-09 | 2013-04-09 | Metacure Ltd. | Analysis and regulation of food intake |
US8007507B2 (en) | 2007-05-10 | 2011-08-30 | Cook Medical Technologies Llc | Intragastric bag apparatus and method of delivery for treating obesity |
US8435203B2 (en) | 2007-06-20 | 2013-05-07 | Covidien Lp | Gastric restrictor assembly and method of use |
US20090012542A1 (en) * | 2007-07-03 | 2009-01-08 | Synecor, Llc | Satiation devices and methods for controlling obesity |
CA2696993C (en) | 2007-07-18 | 2017-01-03 | Samuel T. Crews | Endoscopic implant system and method |
US20090030284A1 (en) | 2007-07-18 | 2009-01-29 | David Cole | Overtube introducer for use in endoscopic bariatric surgery |
US8992409B2 (en) | 2007-10-11 | 2015-03-31 | Peter Forsell | Method for controlling flow in a bodily organ |
EP2211768B1 (en) | 2007-10-11 | 2021-03-24 | Implantica Patent Ltd. | Apparatus for controlling flow in a bodily organ |
US8795153B2 (en) | 2007-10-11 | 2014-08-05 | Peter Forsell | Method for treating female sexual dysfunction |
US8696543B2 (en) | 2007-10-11 | 2014-04-15 | Kirk Promotion Ltd. | Method for controlling flow of intestinal contents in a patient's intestines |
US20090112263A1 (en) | 2007-10-30 | 2009-04-30 | Scott Pool | Skeletal manipulation system |
US7883524B2 (en) | 2007-12-21 | 2011-02-08 | Wilson-Cook Medical Inc. | Method of delivering an intragastric device for treating obesity |
US8016851B2 (en) | 2007-12-27 | 2011-09-13 | Cook Medical Technologies Llc | Delivery system and method of delivery for treating obesity |
US20090171383A1 (en) | 2007-12-31 | 2009-07-02 | David Cole | Gastric space occupier systems and methods of use |
EP3964243A1 (en) * | 2008-01-28 | 2022-03-09 | Implantica Patent Ltd | Blood clot removal device, system, and method |
US20090209995A1 (en) * | 2008-02-14 | 2009-08-20 | Byrum Randal T | Implantable adjustable sphincter system |
US8034065B2 (en) * | 2008-02-26 | 2011-10-11 | Ethicon Endo-Surgery, Inc. | Controlling pressure in adjustable restriction devices |
US8020741B2 (en) | 2008-03-18 | 2011-09-20 | Barosense, Inc. | Endoscopic stapling devices and methods |
WO2009120764A2 (en) | 2008-03-25 | 2009-10-01 | Ellipse Technologies, Inc. | Systems and methods for adjusting an annuloplasty ring with an integrated magnetic drive |
EP2280670A4 (en) * | 2008-04-28 | 2012-08-01 | Eatlittle Inc | Bezoar-forming units for weight control |
US8423130B2 (en) | 2008-05-09 | 2013-04-16 | Metacure Limited | Optimization of thresholds for eating detection |
EP2349170B1 (en) | 2008-10-10 | 2023-09-27 | Implantica Patent Ltd. | Apparatus for the treatment of female sexual dysfunction |
US8874215B2 (en) | 2008-10-10 | 2014-10-28 | Peter Forsell | System, an apparatus, and a method for treating a sexual dysfunctional female patient |
ES2950024T3 (en) | 2008-10-10 | 2023-10-04 | Medicaltree Patent Ltd | Heart support device, system and procedure |
US11123171B2 (en) | 2008-10-10 | 2021-09-21 | Peter Forsell | Fastening means for implantable medical control assembly |
EP2349096B1 (en) | 2008-10-10 | 2021-01-27 | MedicalTree Patent Ltd. | An improved artificial valve |
US9072907B2 (en) | 2008-10-10 | 2015-07-07 | Peter Forsell | Heart help device, system, and method |
US7934631B2 (en) | 2008-11-10 | 2011-05-03 | Barosense, Inc. | Multi-fire stapling systems and methods for delivering arrays of staples |
US8197490B2 (en) | 2009-02-23 | 2012-06-12 | Ellipse Technologies, Inc. | Non-invasive adjustable distraction system |
US8961539B2 (en) | 2009-05-04 | 2015-02-24 | Boston Scientific Scimed, Inc. | Endoscopic implant system and method |
US10952836B2 (en) | 2009-07-17 | 2021-03-23 | Peter Forsell | Vaginal operation method for the treatment of urinary incontinence in women |
US9949812B2 (en) | 2009-07-17 | 2018-04-24 | Peter Forsell | Vaginal operation method for the treatment of anal incontinence in women |
US8594806B2 (en) | 2010-04-30 | 2013-11-26 | Cyberonics, Inc. | Recharging and communication lead for an implantable device |
EP2575700B1 (en) | 2010-05-27 | 2015-08-05 | The Regents of the University of Michigan | Device system for gastric volume reduction to facilitate weight loss |
WO2012021378A2 (en) | 2010-08-09 | 2012-02-16 | Ellipse Technologies, Inc. | Maintenance feature in magnetic implant |
US8382775B1 (en) | 2012-01-08 | 2013-02-26 | Vibrynt, Inc. | Methods, instruments and devices for extragastric reduction of stomach volume |
US9314362B2 (en) | 2012-01-08 | 2016-04-19 | Vibrynt, Inc. | Methods, instruments and devices for extragastric reduction of stomach volume |
US9343923B2 (en) | 2012-08-23 | 2016-05-17 | Cyberonics, Inc. | Implantable medical device with backscatter signal based communication |
US9935498B2 (en) | 2012-09-25 | 2018-04-03 | Cyberonics, Inc. | Communication efficiency with an implantable medical device using a circulator and a backscatter signal |
CN105228563B (en) * | 2013-03-15 | 2019-08-30 | 伊姆普兰蒂卡专利有限公司 | Restraint device |
US10123896B2 (en) | 2014-03-06 | 2018-11-13 | Mayo Foundation For Medical Education And Research | Apparatus and methods of inducing weight loss using blood flow control |
MX2017001193A (en) * | 2016-01-29 | 2019-04-29 | Eduardo Alvarez Ponce Carlos | Sphincter-type intestinal valve. |
EP3375416B1 (en) | 2016-01-29 | 2020-05-13 | Álvarez Ponce, Carlos Eduardo | Sphincter-type intestinal valve |
Family Cites Families (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3750194A (en) * | 1971-03-16 | 1973-08-07 | Fairchild Industries | Apparatus and method for reversibly closing a natural or implanted body passage |
IL67773A (en) | 1983-01-28 | 1985-02-28 | Antebi E | Tie for tying live tissue and an instrument for performing said tying operation |
US4592339A (en) | 1985-06-12 | 1986-06-03 | Mentor Corporation | Gastric banding device |
US4696288A (en) | 1985-08-14 | 1987-09-29 | Kuzmak Lubomyr I | Calibrating apparatus and method of using same for gastric banding surgery |
SE464558B (en) * | 1990-03-22 | 1991-05-13 | Hepar Ab | IMPLANTABLE DEVICE FOR SUSPENSION OF A CHANNEL IN THE BODY OF A LIVE BEING |
US5074868A (en) | 1990-08-03 | 1991-12-24 | Inamed Development Company | Reversible stoma-adjustable gastric band |
US5226429A (en) | 1991-06-20 | 1993-07-13 | Inamed Development Co. | Laparoscopic gastric band and method |
DK0611561T3 (en) | 1993-02-18 | 1999-08-16 | Lubomyr Ihor Kuzmak | Laparoscopically adjustable gastric band |
US5601604A (en) | 1993-05-27 | 1997-02-11 | Inamed Development Co. | Universal gastric band |
US5771903A (en) | 1995-09-22 | 1998-06-30 | Kirk Promotions Limited | Surgical method for reducing the food intake of a patient |
US5938669A (en) * | 1997-05-07 | 1999-08-17 | Klasamed S.A. | Adjustable gastric banding device for contracting a patient's stomach |
-
1998
- 1998-08-13 US US09/133,322 patent/US6460543B1/en not_active Expired - Lifetime
-
1999
- 1999-08-12 EP EP05075918A patent/EP1554997B1/en not_active Expired - Lifetime
- 1999-08-12 DE DE69942986T patent/DE69942986D1/en not_active Expired - Lifetime
- 1999-08-12 EP EP10179739.7A patent/EP2295010B1/en not_active Expired - Lifetime
- 1999-08-12 AT AT05075918T patent/ATE489061T1/en not_active IP Right Cessation
- 1999-08-12 AT AT99943572T patent/ATE293415T1/en active
- 1999-08-12 ES ES99943572T patent/ES2239458T3/en not_active Expired - Lifetime
- 1999-08-12 CA CA002338359A patent/CA2338359C/en not_active Expired - Lifetime
- 1999-08-12 BR BR9912794-6A patent/BR9912794A/en not_active IP Right Cessation
- 1999-08-12 WO PCT/SE1999/001367 patent/WO2000009049A1/en active IP Right Grant
- 1999-08-12 AU AU56641/99A patent/AU746371B2/en not_active Expired
- 1999-08-12 DE DE69924851T patent/DE69924851T2/en not_active Expired - Lifetime
- 1999-08-12 DK DK99943572T patent/DK1105075T3/en active
- 1999-08-12 MX MXPA01000598A patent/MXPA01000598A/en unknown
- 1999-08-12 EP EP99943572A patent/EP1105075B1/en not_active Expired - Lifetime
-
2002
- 2002-09-23 US US10/252,044 patent/US20030019498A1/en not_active Abandoned
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US8382780B2 (en) | 2002-08-28 | 2013-02-26 | Allergan, Inc. | Fatigue-resistant gastric banding device |
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US20110152608A1 (en) * | 2002-09-04 | 2011-06-23 | Allergan, Inc. | Flow control method and device |
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US20110040141A1 (en) * | 2004-03-08 | 2011-02-17 | Allergan, Inc. | Closure system for tubular organs |
US8377081B2 (en) | 2004-03-08 | 2013-02-19 | Allergan, Inc. | Closure system for tubular organs |
US8236023B2 (en) | 2004-03-18 | 2012-08-07 | Allergan, Inc. | Apparatus and method for volume adjustment of intragastric balloons |
US20070173881A1 (en) * | 2004-03-18 | 2007-07-26 | Allergan, Inc. | Apparatus and method for volume adjustment of intragastric balloons |
US11357549B2 (en) | 2004-07-02 | 2022-06-14 | Nuvasive Specialized Orthopedics, Inc. | Expandable rod system to treat scoliosis and method of using the same |
US8251888B2 (en) | 2005-04-13 | 2012-08-28 | Mitchell Steven Roslin | Artificial gastric valve |
US8623042B2 (en) | 2005-04-13 | 2014-01-07 | Mitchell Roslin | Artificial gastric valve |
US20060235448A1 (en) * | 2005-04-13 | 2006-10-19 | Roslin Mitchell S | Artificial gastric valve |
US20100274274A1 (en) * | 2005-04-13 | 2010-10-28 | Allergan, Inc. | Artificial gastric valve |
US20060244291A1 (en) * | 2005-04-29 | 2006-11-02 | Buell Motorcycle Company | Movable tailrack for a motorcycle |
US7618365B2 (en) | 2005-07-15 | 2009-11-17 | Ethicon Endo-Surgery, Inc. | Method of implating a medical device using a suture tab extender |
US20070016230A1 (en) * | 2005-07-15 | 2007-01-18 | Jambor Kristin L | Gastric band |
US7615001B2 (en) | 2005-07-15 | 2009-11-10 | Ethicon Endo-Surgery, Inc. | Precurved gastric band |
US20070015954A1 (en) * | 2005-07-15 | 2007-01-18 | Dlugos Daniel F | Gastric band with mating end profiles |
US7416528B2 (en) | 2005-07-15 | 2008-08-26 | Ethicon Endo-Surgery, Inc. | Latching device for gastric band |
US7367937B2 (en) | 2005-07-15 | 2008-05-06 | Ethicon Endo-Surgey, Inc. | Gastric band |
US7364542B2 (en) | 2005-07-15 | 2008-04-29 | Ethicon Endo-Surgery, Inc. | Gastric band suture tab extender |
US20070250086A1 (en) * | 2005-07-15 | 2007-10-25 | Wiley Jeffrey P | Gastric band composed of different hardness materials |
US20070173685A1 (en) * | 2005-07-15 | 2007-07-26 | Jambor Kristin L | Method of implating a medical device using a suture tab extender |
US20070015955A1 (en) * | 2005-07-15 | 2007-01-18 | Mark Tsonton | Accordion-like gastric band |
US20070016229A1 (en) * | 2005-07-15 | 2007-01-18 | Jambor Kristin L | Gastric band suture tab extender |
US20070016231A1 (en) * | 2005-07-15 | 2007-01-18 | Jambor Kristin L | Precurved gastric band |
US8298133B2 (en) | 2005-07-15 | 2012-10-30 | Ethicon Endo-Surgery, Inc. | Gastric band composed of different hardness materials |
US8182411B2 (en) | 2005-07-15 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Gastric band with mating end profiles |
US8308630B2 (en) | 2006-01-04 | 2012-11-13 | Allergan, Inc. | Hydraulic gastric band with collapsible reservoir |
US8323180B2 (en) | 2006-01-04 | 2012-12-04 | Allergan, Inc. | Hydraulic gastric band with collapsible reservoir |
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US20070255336A1 (en) * | 2006-04-28 | 2007-11-01 | Medtronic, Inc. | Gastric constriction device with selectable electrode combinations |
US20070255335A1 (en) * | 2006-04-28 | 2007-11-01 | Medtronic, Inc. | Controller for gastric constriction device with selectable electrode configurations |
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US8292800B2 (en) | 2008-06-11 | 2012-10-23 | Allergan, Inc. | Implantable pump system |
US20090312785A1 (en) * | 2008-06-11 | 2009-12-17 | Allergan, Inc. | Implantable Pump System |
US8317677B2 (en) | 2008-10-06 | 2012-11-27 | Allergan, Inc. | Mechanical gastric band with cushions |
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US20100185049A1 (en) * | 2008-10-22 | 2010-07-22 | Allergan, Inc. | Dome and screw valves for remotely adjustable gastric banding systems |
US8900118B2 (en) | 2008-10-22 | 2014-12-02 | Apollo Endosurgery, Inc. | Dome and screw valves for remotely adjustable gastric banding systems |
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Also Published As
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AU746371B2 (en) | 2002-04-18 |
CA2338359A1 (en) | 2000-02-24 |
CA2338359C (en) | 2009-12-15 |
BR9912794A (en) | 2001-05-02 |
DE69924851T2 (en) | 2006-01-26 |
MXPA01000598A (en) | 2002-04-08 |
ATE489061T1 (en) | 2010-12-15 |
EP1105075A1 (en) | 2001-06-13 |
AU5664199A (en) | 2000-03-06 |
EP2295010B1 (en) | 2017-01-11 |
EP1105075B1 (en) | 2005-04-20 |
EP2295010A1 (en) | 2011-03-16 |
DE69924851D1 (en) | 2005-05-25 |
WO2000009049A1 (en) | 2000-02-24 |
DE69942986D1 (en) | 2011-01-05 |
EP1554997B1 (en) | 2010-11-24 |
ATE293415T1 (en) | 2005-05-15 |
ES2239458T3 (en) | 2005-09-16 |
DK1105075T3 (en) | 2005-07-18 |
US6460543B1 (en) | 2002-10-08 |
EP1554997A1 (en) | 2005-07-20 |
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