Toposcopic methods and devices for delivering a sleeve having axially compressed and elongate configurations

Abstract

Disclosed herein are elongate flexible medical devices which are capable of axial elongation through the mechanism of eversion or toposcopic expansion. In general, this may be accomplished by providing a flexible tubular device having a proximal end and a distal end. Retraction of the distal end in a proximal direction through the tubular body inverts the tube upon itself, causing an axial shortening of the overall length of the device. The original length of the device can be restored by coupling a pressurized media to the proximal end of the sleeve. If the distal end of the sleeve is temporarily restricted or closed, the pressurized media causes the distal end of the sleeve to travel distally until the full length of the sleeve has been restored.

Description

[0001]This application claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Application No. 60 / 826,862 filed Sep. 25, 2006, which is hereby incorporated by reference in its entirety.[0002]U.S. patent application Ser. No. 10 / 698,148, filed Oct. 31, 2003, published May 13, 2004 as U.S. Patent Pub. No. 2004-0092892 A1 and entitled “APPARATUS AND METHODS FOR TREATMENT OF MORBID OBESITY” (and may be referred to herein as the “Kagan '148 application”); U.S. patent application Ser. No. 11 / 025,364, filed Dec. 29, 2004, published Aug. 11, 2005 as U.S. Patent Pub. No. 2005-0177181 A1 and entitled “DEVICES AND METHODS FOR TREATING MORBID OBESITY” (and may be referred to herein as the “Kagan '181 application”); U.S. patent application Ser. No. 11 / 124,634, filed May 5, 2005, published Jan. 26, 2006 as U.S. Patent Pub. No. 2006-0020247 A1 and entitled “DEVICES AND METHODS FOR ATTACHMENT OF AN ENDOLUMENAL GASTROINTESTINAL IMPLANT” (and may be referred to herein as the “Kagan '634 applicati...

AI Technical Summary

Benefits of technology

[0009]In another embodiment, also disclosed herein is a method of toposcopically delivering a sleeve to a body lumen, according to some embodiments of the invention. The method includes the steps of providing the sleeve at least partially inverted within a filling catheter, the sleeve comprising a proximal end, a distal end, and an elongate body, the proximal end of the sleeve attached to a distal end of the filling catheter; advancing the sleeve and the filling catheter to position the distal end of the filling catheter at a first point in the body lumen; and flowing inflation media within the sleeve to promote eversion of the sleeve to a second point in the body lumen. The body lumen can be the gastrointestinal tract. The method can also include the step of at least partially inverting the sleeve w

Problems solved by technology

Conventional distal axial advance (i.e., pushing) of a device is sometimes unable to reach a desired treatment or diagnostic site, and may in any event cause discomfort to the patient or trauma to delicate or sensitive tissues as the device is being advanced.

Lubricants and lubricious polymers or other coatings can reduce these effects, but not always to a sufficient degree.

In the biliary system, as one example, passing a biliary catheter through the ampulla of Vater and into the common bile duct often results in swelling and subsequent closure of the opening, compromising normal drainage and making subsequent access difficult.

Similar problems with discomfort or edema or failure to achieve proper device placement can be experienced by the patients when other anatomical sites are being accessed, for example, in the nasal passages, urethra, small intestine, colon, rectum, etc.

While patient comfort may not be an issue when navigating internally such as within the biliary tree, the introduced device may be difficult or even impossible to advance as a result of frictional forces acting against it, especially since these obstructions and narrowed passages often cannot be adequately visualized.

Accessing the small intestines is a significant challenge with current endoscopic technologies.

The intestines are substantially unconstrained, mobile and follow a tortuous path so it is difficult to advance a pushable device through the intestinal lumen.

However, both methods rely on applying a pushing force on the device or using the device to apply force against the walls of the intestine to advance the devices.

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