A DEVICE FOR THE TREATMENT OF GERD

Abstract

An implantable device for the treatment of acid reflux disorder has a body that includes an outer surface adapted to rest against the patient's abdominal wall. When implanted, the device fills a volume in the patient's abdomen in the area of ​​the cardia and above the cardia when the patient is standing. The body prevents the cardia from moving through the diaphragmatic opening into the thorax, thereby preventing reflux by maintaining abdominal pressure and supporting the cardiac sphincter muscle. The device may be fixed to the stomach tissue. It may also be invaginated or otherwise indirectly secured in position.

Description

A DEVICE FOR THE TREATMENT OF GERD TECHNICAL FIELD The present invention relates to an apparatus for treating Gastroesophageal Reflux Disease (GERD). BACKGROUND Gastroesophageal Reflux Disease (GERD), or acid reflux disorder, is a chronic condition that results in mucosal damage to the esophagus caused by the recurrent occurrence of acid reflux into the esophagus. This is commonly due to transient or permanent changes in the barrier between the esophagus and stomach. This may be due to incompetence of the lower esophageal sphincter (LES), transient relaxation of the LES, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. Gastroesophageal Reflux Disease can be treated in a number of different ways. Treatments include, but are not limited to, both medical and surgical treatments. A standard surgical treatment, which is sometimes preferred over long-term medication use, is Nissen fundoplication surgery, in which the upper curve of the stomach (the fundus) is wrapped around the LES to strengthen the sphincter and prevent reflux. acid and repair a hiatal hernia. The procedure is often done laparoscopically. Another surgical treatment that has been used is the Anglechik prosthesis, in which a device shaped like a horseshoe is placed around the esophagus above the cardia. The intended effect is to prevent the cardia from sliding upward into the chest cavity. However, this device has a number of complications, including migration through and damage to the esophagus. From experience with medical device implantation, it is known that sutures between an implanted device and human tissue will not hold long term. For long-term implantation of a device, there are two possibilities to keep the device in place. A first solution has been to suture human tissue to human tissue, thus keeping the device in place. A second approach has been to provide sutures that hold a device in place in the short term and allow ingrowth of human tissue into the device to hold the device in place in the long term. One problem with providing an implantable device associated with the esophagus is that the outer surface of the esophagus is only comprised of esophageal muscle tissue, which is very easy to damage or migrate. This is probably one reason why the Anglechik prosthesis described above has resulted in many complications, such as migration. The stomach, on the other hand, has a serosa on the outside, thus providing a much stronger membrane for suturing. In this way, suturing a device directly to the stomach wall provides a better result than suturing a device implanted into the esophagus. To date, there is a need for a long-term GERD treatment that is more effective ηβ^ηίη / ίζηζ / Β / γι than previous treatments and that does not result in any severe complications. SUMMARY OF THE INVENTION It is an object of the present invention to overcome, or at least reduce, some of the problems associated with existing surgical treatment of Gastroesophageal Reflux Disease (GERD). It is another object of the present invention to provide an apparatus for treating gastroesophageal reflux disease. These objects and others are obtained by the apparatus described in the attached claims. Thus, by providing an apparatus for the treatment of acid reflux disorder including an implantable motion restriction device having an outer surface that includes a biocompatible material, wherein the motion restriction device is adapted to rest with at least one part of its outer surface against the bottom stomach wall of the patient, in a position between the diaphragm of the patient and the bottom wall, in such a way that the movement of the cardiac notch of the patient's stomach towards the diaphragm of the patient is restricted, A device is obtained to treat Gastroesophageal Reflux Disease. The motion restriction device has a size of at least 125 mm3 and a circumference of at least 15 mm and restricts the movement of the cardiac notch of the patient's stomach towards the patient's diaphragm thereby preventing the cardia from slipping through the opening. of the patient's diaphragm toward the patient's chest, maintaining supporting pressure against the patient's cardia sphincter muscle exerted from the patient's abdomen. The fixing device is adapted to secure the movement restriction device in said position. By adapting the outer surface of the implanted motion restriction device to rest against the fundal wall, there is minimal risk of complications, such as migration of tissue damage, because the fundus is less fragile than the esophagus. In a first embodiment of the invention, the fixation device comprises sutures or staples that join together the portions of the bottom stomach wall enclosing the motion restriction device to secure the motion restriction device in said position. That is, the motion restriction device is placed at least partially in an invaginated space. Thus, by securing the implanted motion restriction device indirectly in this manner, no suture is required between the motion restriction device and the tissue, which, in turn, further reduces the risk of complications. Thus keeping the motion restriction device in place has resulted in an elastic suspension with improved long-term properties. The fixation device, such as sutures or staples, may join the bottom stomach wall portions together to substantially or completely invaginate the motion restriction device from either inside or outside the patient's stomach wall. Where the motion restriction device is placed on the exterior of the patient's stomach wall, the motion restriction device invaginates through the back stomach wall so that the stomach cavity is substantially reduced, by a volume substantially exceeding the volume of the ι η / ι znz / E / YL movement restriction device. In a second embodiment of the invention, the fixation device comprises a first implantable fixation device that joins the movement restriction device in said position to the bottom wall, a second fixation device that secures, indirectly or directly, the device of movement restriction to the esophagus near the angle of His of the patient, and a third fixation device that secures, indirectly or directly, the movement restriction device to the associated muscle or muscles of the patient's diaphragm. Any of the first, second and third fixation devices may be comprised of a plurality of sutures or staples. The first fixation device may comprise a tissue growth promoting structure for long-term attachment of the motion restriction device to the stomach wall. The structure that promotes tissue growth can be sutured to the stomach wall with a relatively large contact surface toward the stomach. The relatively large surface area of ​​the structure, such as a net, will allow ingrowth of human tissue to keep the motion restriction device in place over the long term. The tissue growth-promoting structure may comprise sutures or staples that attach the net-like structure to the background stomach wall. In addition to invaginating the motion restriction device according to the first embodiment of the invention, the second fixation device can be used to indirectly or directly secure the motion restriction device to the esophagus near the angle of His of the patient, and The third fixation device may be used to secure, indirectly or directly, the motion restriction device to the associated diaphragm muscle or muscles of the patient. At least a portion of the motion restriction device may be made of a material that is destructible or non-destructible by stomach acid. The motion restriction device may be unreliable and adapted to be inflated with a gel or fluid. A fluid or gel receiving member may be provided to receive fluid to inflate the motion restriction device. The motion restriction device may include a homogeneous material and may be a solid body. The motion restriction device may include a closure wall defining a chamber. The motion restriction device may have a flexible, elastic or rigid outer wall. Where the outer wall is rigid, it is rigid enough to remain undeformed when subjected to forces created by movements of the stomach. Where the motion restriction device is invaginated, according to the first embodiment described above, the motion restriction device preferably comprises a body adapted to be at least partially invaginated by the bottom stomach wall of the patient and having an outer surface that includes a biocompatible material. A substantial portion of the outer surface of the body is adapted to abut against the stomach wall in said position between the patient's diaphragm and the lower portion of the invaginated fundal stomach wall. Suitably, the body is made of a softer material than 25 or 15 shure. According to a first general design of the body, the body has a maximum circumference as seen in a plane perpendicular to an axis through the body. The circumferences of the body as observed in other planes perpendicular to said axis are equal to the maximum circumference or decrease as observed along said axis in the direction of the maximum circumference. For example, the body may be substantially egg-shaped, sphere-shaped, or substantially egg-like in shape with an indented or folded egg-like midsection. According to a second general design of the body, the circumference of the body as observed in a plane perpendicular to an axis through the body increases and decreases at least twice as the plane moves along said axis, or decreases and increases at least once as the plane moves along said axis. For example, the body may be formed substantially like a kidney. Preferably, the body is sized larger than the intestinal outlet of the stomach. The body may have a smaller outer diameter of 30 or 40mm or larger and may have a smaller outer circumference of 150, 110, 90, 70, 50 or 30mm. Suitably, the body has round contours without sharp edges that would injure the patient's stomach wall, and has a generally smooth outer surface for abutment against the bottom wall. The body is implanted either inside or outside of the patient's stomach and is adapted to be attached to the patient's stomach wall by surgery. The body can be changed to assume a slim shape having a smaller diameter than that of a trocar for laparoscopic use, whereby the body when changed to such a slim shape can be pushed or pulled through the trocar. The body may include a flexible outer wall that defines a chamber filled with a fluid, such as a gel, allowing the body to pass through such a trocar. Alternatively, the body may include an elastic compressible material, which allows the body to pass through a trocar. The body may be hollow and include at least two separate pieces adapted to be inserted into the hollow body, and further adapted to be placed together as a unitary piece within the body, thus allowing the body to be passed through a trocar for laparoscopic use. Alternatively, the body may include an outer wall and a hollow compressed inner part, to be filled with a fluid or gel after insertion into the patient's body. The body may include a chamber with an injection port, wherein the body chamber is filled with a fluid through the injection port. The body may include at least one holding device adapted to be used to push or pull the body through a trocar for laparoscopic use. The holding device is adapted to hold an extension of the body that is adapted to be held by a surgical instrument. More specifically, the clamping device is adapted to hold a thread or band inserted through the clamping device. Where the body comprises an outer wall the fastening device is positioned at least partially within the outer wall of the body. In an advantageous embodiment, the body is adjustable in size and invaginates into the patient's bottom stomach wall. As a result, the body stretches the patient's bottom stomach wall as the size of the stomach increases, thus creating satiety in a patient who also suffers from obesity. At least two implantable adjustable stretching devices may be provided to stretch different parts of the patient's stomach wall, thereby treating obesity by efficiently affecting the patient's appetite. The two stretching devices are suitably adjusted from outside the patient's body, whereby a first of the stretching devices is adjusted a first time to stretch a first portion of the patient's stomach wall and a second of the stretching devices is adjusted. regulates a second time to stretch a second part of the patient's stomach wall. The stretching device can be adjusted hydraulically. In this case, a subcutaneously implanted hydraulic container may be provided connected to the hydraulic regulated stretching device, whereby the hydraulic regulated stretching device is regulated non-invasively by manually depressing the hydraulic container. Furthermore, the motion restraint device suitably includes a reliable body, and a pump and a chamber are provided in fluid contact with the body, wherein the pump regulates the hydraulic container by pumping fluid or air from the body to the chamber. The apparatus may include an implantable stimulation device that delivers stimulation pulses to the cardia muscle to stimulate the cardia muscle and thereby further close the cardia to further prevent reflux disorder. The stimulation device is comprised of at least one conductor and at least one electrode that receives the stimulation pulses and applies them to the cardia muscle to thus stimulate the cardia muscle. The at least one electrode may also be held in place by stomach-esophageal sutures or invagination in the stomach wall. The stimulation pulses may be sent as a pulse train, where the pulse train is repeated with a time interruption in between, the interruption extending the interruption between each pulse in the pulse train. The stimulation device may include an electronic circuit and a power source preferably adapted to incorporate the electronic circuit and power source. In one embodiment, stimulation of the cardia with the stimulation device is done with energy pulses to increase sphincter tone such that the cardia is completely closed and a control device for controlling the stimulation device is operable by the patient to set the stimulation device in operation, in such operational state, the stimulation device continuously alternates at the same time when the patient does not swallow between a mode of operation in which the sphincter of the cardia is stimulated with said energy pulses and a mode of rest in which the cardia is not stimulated. The stimulation device preferably comprises at least one sensor for detecting a physical parameter of the patient or a functional parameter of the movement restriction device and an internal control unit for controlling the stimulation device. Typically, the internal control unit controls the stimulation device in response to information from the sensor. ηβ^ηίη / ίζηζ / Β / γι A sensor that detects a contraction wave of the esophagus, or any other parameter correlated with food intake, sends the information to the internal control unit and the internal control unit then ceases stimulation in response to such sensor information. The stimulation device, at any time, can be controlled by the patient. The present invention further relates to abdominal surgical methods for treating a reflux disorder. According to a first method, a reflux disorder in a patient is treated by implanting a motion restriction device which, when implanted in a patient, restricts the movement of the stomach notch in relation to the diaphragm muscle preventing the cardia from slides up through the opening of the hiatus of the diaphragm. The method comprises the steps of inserting a needle or tube-like instrument into the abdomen of the patient's body; using the needle or tube-like instrument to fill the patient's abdomen with gas; placing at least two laparoscopic trocars in the patient's body; inserting a camera through one of the laparoscopic trocars into the abdomen of the patient, inserting at least one dissection tool through one of said at least two laparoscopic trocars; dissect an area of ​​the stomach; introduce the device into the abdominal cavity; placing the device on the outside of the fundal stomach wall; and creating a pocket in the fundal stomach wall for the device; and invaginating the device into the pouch by providing sutures or staples to the bottom stomach wall, thereby preventing the cardia from slipping through the patient's diaphragm opening into the patient's chest, to maintain pressure support of the patient's abdomen. patient supporting the patient's sphincter cardia muscle. A second abdominal method to treat a reflux disorder for the same purpose uses the initial steps as the first method, comprising creating a hole in the bottom stomach wall; inserting a motion restriction device into the abdominal cavity; insert the device through the hole and into the stomach; placing the device within the fundal stomach wall; create a pouch on the outside of the stomach cavity for the device placed inside the bottom stomach wall, and invaginate the device into the pouch by providing sutures or staples to the bottom stomach wall, preventing the cardia from slipping into the pouch. through the patient's diaphragm opening into the patient's thorax, to maintain pressure support of the patient's abdomen supporting the patient's cardia sphincter muscle. A third abdominal method of treating a reflux disorder in a patient includes implanting a motion restriction device for the same purpose as the previously described methods and comprises the steps of surgically cutting an opening in the patient's abdominal wall; dissect an area of ​​the patient's stomach; introduce the motion restriction device through the abdominal incision; and attaching the device to the bottom stomach wall, thereby preventing the cardia from slipping through the patient's diaphragm opening into the patient's chest, to maintain pressure support of the patient's abdomen supporting the sphincter muscle. patient's cardia. According to a first alternative, the method includes placing the device on the outside of the bottom stomach wall; create a pouch on the bottom stomach wall for the device; and invaginating the device into the pouch by providing sutures or staples to the bottom stomach wall, thereby preventing the cardia from slipping through the patient's diaphragm opening into the patient's chest, to maintain pressure support of the patient's abdomen. patient supporting the patient's cardia sphincter muscle. According to a second alternative, the method includes creating a hole in the bottom stomach wall; insert the motion restriction device through the hole and into the stomach; place the device inside the bottom stomach wall; create a pouch in the bottom stomach wall for the device, and invaginate the device into the pouch by providing sutures or staples to the bottom stomach wall, preventing the cardia from slipping through the patient's diaphragm opening into the chest of the patient, to maintain the supporting pressure of the patient's abdomen that supports the patient's cardia sphincter muscle. The methods further comprise securing the device to the bottom stomach wall by providing sutures or staples and / or securing the bottom stomach wall to the lower part of the patient's esophagus by providing sutures or staples; and / or attach the bottom stomach wall to the patient's associated diaphragm muscle or muscles. The methods may further comprise providing apparatus for regulating the reflux treatment device from outside the patient's body; and operating said apparatus to regulate the reflux treatment device. Regulation of the reflux treatment device may include changing the volume of the filling body when it is implanted. For this purpose, the methods may include providing an injection type syringe comprising a fluid for injection into an implanted filling body; and inject volume of fluid into the filling body. Preferably, the methods comprise enclosing the device in the bag. In one embodiment, the method supports the bag being at least partially open, whereby the bag may exhibit only one opening, or the bag may exhibit two openings and extend non-circumferentially around the stomach. It is generally preferred that the volume of the bag be more than 15 milliliters An additional laparoscopic abdominal method of treating a reflux disorder comprises inserting a needle or tube-like instrument into the abdomen of the patient's body; use the needle or tube-like instrument to fill the patient's abdomen with gas; place at least two laparoscopic trocars in the patient's body; inserting a camera through one of the laparoscopic trocars into the patient's abdomen; inserting at least one dissection tool through one of said at least two laparoscopic trocars; dissect an area of ​​the stomach; create a bottom stomach wall pouch for the device; close the pouch by providing sutures and staples; introducing an injection member comprising an injectable filling material; and injecting the filling material into the bag, thereby creating a filling body that fills a volume in the patient's abdomen that is close to and above the patient's cardia when the patient is in a standing position to prevent the cardia from slides through the patient's diaphragm opening into the patient's chest, to maintain pressure on the patient's abdomen supporting the patient's cardia sphincter muscle. An additional abdominal surgical method to treat a reflux disorder involves cutting an opening in the skin to enter the patient's abdomen by dissecting an area of ​​the stomach; create a bottom stomach wall pouch for the device; close the pouch by providing sutures and staples; introducing an injection member comprising an injectable filling material; and injecting the filling material into the bag, thereby creating a filling body that fills a volume in the patient's abdomen that is close to and above the patient's cardia when the patient is in a standing position to prevent the cardia from slides through the patient's diaphragm opening into the patient's chest, to maintain pressure on the patient's abdomen supporting the patient's cardia sphincter muscle. Additional methods cited may include creating the bag on the outside of the bottom stomach wall, with the filling body placed against the inside of the bottom stomach wall, or alternatively, the methods include creating a hole in the bottom stomach wall. and the pouch is created on the inside of the bottom stomach wall, with the filling body placed against the outside of the bottom stomach wall. Additional methods preferably cited also include securing the bottom stomach wall to the lower part of the patient's esophagus by providing sutures or staples and / or securing the bottom stomach wall to the associated diaphragm muscle(s) of the patient. It is also generally preferable that the volume of the bag be greater than 15 milliliters. The filling material is preferably capable of undergoing a curing process from fluid material to a semi-solid or solid material. Such a healing process is preferentially activated by an increase in temperature from room temperature to body temperature. A suitable material, well known to those skilled in the art, is a thermocurable polysiloxane which (in the presence of a degradant and a catalyst) can undergo a degradation reaction under the influence of heat. Still an additional laparoscopic abdominal method to treat a reflux disorder in a patient by implanting a motion restriction device that, when implanted in a patient, restricts the movement of the stomach notch in relation to the diaphragm muscle preventing the cardia from slides upward through the opening of the diaphragm hiatus, comprises the steps of inserting a needle or tube-like instrument into the abdomen of the patient's body; use the needle or tube-like instrument to fill the patient's abdomen with gas; place at least two laparoscopic trocars in the patient's body; inserting a camera through one of the laparoscopic trocars into the patient's abdomen; inserting at least one dissection tool through one of said at least two laparoscopic trocars; dissect an area of ​​the stomach; create a hole in the bottom stomach wall; insert a motion restriction device into the abdominal cavity; insert the device through the hole and into the stomach; place the device on the outside of the bottom stomach wall; fix the device placed on the outside of the fundus stomach wall, and prevent the cardia from sliding through the opening of the patient's diaphragm into the patient's chest, to maintain the supporting pressure of the patient's abdomen supporting the muscle of the patient's cardia sphincter. The method may further comprise the step of securing the device to the bottom stomach wall by providing sutures or staples. The present invention also relates to a laparoscopic instrument for providing a motion restriction device for invaginating into the bottom stomach wall of a human patient to treat reflux disorder, suitable for use with any of the aforementioned laparoscopic methods. The instrument generally comprises an elongated member having a proximal end and a distal end, the elongated member having a diameter smaller than that of a laparoscopic trocar for introduction into the abdomen of the patient during a laparoscopic operation; a device that pushes the stomach to push the bottom stomach wall to create a tube-like portion of the bottom stomach wall protruding into the normal stomach cavity, said pushing device comprising the movement restriction device for invaginating through the bottom stomach wall in the tube-like portion of it. The pushing device comprises a vacuum suction device for suctioning the bottom of the stomach to assist the instrument in forming the tube-like portion of the bottom stomach wall together with the pushing device. The vacuum suction device comprises a vacuum passage leading from the proximal to the distal end of the instrument and at the end portion of the instrument, which includes the pushing device. The vacuum passage is divided into multiple small openings adapted to suction the stomach wall portion to become adherent to the pushing device to further form the tube-like stomach wall portion. The instrument further comprises an insertion device adapted to introduce the motion restriction device into the tube-like portion of the stomach. The instrument may further comprise at least one holding device for holding the opening of the tube-like portion substantially closed by clamping stomach to stomach in said opening, wherein the instrument is adapted to place the at least one holding device in the opening in such a way that allows posterior suturing of the opening. The instrument may further comprise an inflation device for inflating the motion restriction device before or after suturing. The instrument may further comprise a suturing device adapted to suture the opening of the tube-like portion with stomach-to-stomach sutures to at least partially create an enclosed space enclosing the motion restriction device, wherein the instrument adapts to be removed leaving the motion restriction device at least partially invaginated into the background stomach wall. The suture device may comprise a first and second suture placement member provided on the elongate member for placement in the stomach at the distal end thereof. The instrument further comprises an operating device adapted to adjust the first and second suture members in a position in which the first and second suture placement members face each other with the stomach wall on both sides of the open end. of the cup-like portion, and adapted to suture the open end of the cup-like portion of the bottom wall with a row of stomach-to-stomach sutures. The suturing device preferably comprises an operable reloadable multi-suturing device, which is reloaded with sutures from outside the patient's body and which is adapted to suture the open end of the cup-like portion of the bottom wall with said row of sutures. stomach-to-stomach sutures, wherein the row of sutures comprises two or more sutures or staples to be sutured simultaneously. The suturing device may also comprise multiple sutures to suture two or more sutures simultaneously. The present invention also relates to an intraluminal method of treating a reflux disorder in a patient by implanting a device comprising an implantable motion restriction device that, when implanted in a patient, restricts the movement of the stomach notch in relation to to the diaphragm muscle preventing the cardia from sliding upward through the opening of the diaphragm hiatus. The method includes the steps of introducing a gastroscope into the patient's esophagus and stomach; introducing an instrument into the esophagus and into the stomach of the patient, said instrument being integrated into said gastroscope or separated therefrom; providing, by means of said instrument, a pouch of the bottom stomach wall to accommodate the device and invaginating the device into the pouch with sutures or staples to the bottom stomach wall, thus preventing the cardia from slipping through the opening of the patient's diaphragm towards the patient's thorax, to maintain supporting pressure against the patient's cardia sphincter muscle exerted from the patient's abdomen. In a first alternative, the method comprises the steps of introducing the device into the stomach by means of the instrument; placing the device inside the bottom stomach wall, using said instrument; creating, by means of said instrument, a pouch in a portion of the bottom stomach wall on the outside of the stomach cavity, the device placed abutting against the interior of the bottom stomach wall; and invaginate the device into the pouch with sutures or staples to the bottom stomach wall. In a second alternative, the method comprises the steps of creating, by means of said instrument, a pouch from a portion of the bottom stomach wall; insert the device through the instrument into the bag; and invaginate the device with sutures or staples to the bottom stomach wall. According to this alternative, the method comprises inflating the device to its filling volume, preferably by injecting a filling fluid into the device so that it obtains its filling volume. The filling fluid may thus be a curable fluid with the characteristics previously described, such as the thermocurable polysiloxanes described above. In a third alternative, the method comprises the steps of creating a hole in the bottom stomach wall; introducing the device into the stomach by means of the instrument; move the device through the hole and place it on the outside of the bottom stomach wall; creating, by means of said instrument, a pocket of a portion of the bottom stomach wall inside the stomach cavity, with the device placed against the outside of the bottom stomach wall; invaginate the device into the pouch with sutures or staples to the bottom stomach wall; and sealing the hole with sutures or staples. In a fourth alternative, the method comprises the steps of creating a hole in the bottom stomach wall; creating, by means of said instrument, a pocket of a portion of the bottom stomach wall inside the stomach cavity; introducing the device into the stomach by means of the instrument; move the device through the hole and place it on the outside of the bottom stomach wall; insert the device through the instrument into the bag; invaginate the device with sutures or staples to the bottom stomach wall; and seal the hole with sutures or staples. This method may also comprise inflating the device to its filling volume, preferably by injecting a filling fluid into the device so that it obtains its filling volume. The filling fluid may have all of the ηβ^ηίη / ίζηζ / Β / γι characteristics previously described. The method also comprises securing the device to the fundal stomach wall by providing sutures or staples; and / or securing the bottom stomach wall to the lower part of the patient's esophagus by providing sutures or staples; and / or attach the bottom stomach wall to the patient's associated diaphragm muscle or muscles. The method may also comprise providing an apparatus for regulating the reflux treatment device from outside the patient's body; and operating said apparatus to regulate the reflux treatment device.Regulation of the reflux treatment device preferably includes changing the volume of the filling body when it is implanted. For this purpose, the method may comprise providing an injection type syringe comprising a fluid for injection into an implanted filling body; and inject volume of fluid into the filling body. The filling fluid may be curable fluid of a nature as discussed in previous sections. The pouch created by the method may enclose the motion restriction device, or may be at least partially opened, in one example having only one opening, and according to another example showing two openings and extending non-circumferentially around the stomach. Preferably, the volume of the bag is greater than 15 milliliters. It is generally preferentially found in the method that the gastroscope and the instrument are integrated. The method may also include inflating the stomach with gas. In a special embodiment of the method, the instrument generates a vacuum when providing the background stomach wall pouch. The invention also relates to a method of restoring the location of the cardia and fundus in a patient suffering from a reflux disorder comprising introducing an elongated instrument having at least one flexible part into the esophagus of a patient; activating a clamping device by the instrument, said activated clamping device having a cross-sectional area larger than said instrument; clamping the distal esophagus or stomach with said clamping device; move and push the instrument in a distal direction so that the cardia and stomach wall, or part of the fundus, incorrectly located above the diaphragm, or its associated muscles, slide back into a position below the diaphragm, or its associated muscles. In a first alternative, the method comprises expanding the clamping device radially above the cardia in the esophagus and using the device to push the cardia and the stomach wall or part of the fundus below the diaphragm or its associated muscles. In a second alternative, the method comprises releasing a balloon member at the proximal end of the instrument in the lower part of the stomach, and using the member to push the instrument against a lower wall portion of the stomach so that the cardia and the fundus or part of the fundus slides under the diaphragm or its associated muscles. In a third alternative, the method comprises locating the distal end of the instrument at the level of the diaphragm or its associated muscles; expand the limb in a radial direction; attach the limb to the stomach wall; and pushing the instrument in a distal direction so that the cardia and stomach wall or, part of the fundus, slide under the diaphragm or its associated muscles. The method according to all the aforementioned alternatives may comprise employing a fixing member as part of the fastening device in the distal part of the instrument capable of providing sutures or staples or other invasive mechanical members to fix the esophagus and stomach wall to the instrument, preferably, The method comprises the use of a suturing member in the distal part of the instrument capable of providing sutures or staples to suture the bottom stomach wall to the lower part of the esophagus above said cardia. The invention is also directed to a surgical gastroscopic instrument for treating a patient suffering from a hiatal hernia, wherein a portion of the patient's stomach passes through the hiatus of the diaphragm muscle with the patient's cardia positioned above the diaphragm muscle in the chest. The instrument comprises: (i) an elongated member having a proximal end and a distal end, said elongated member having a diameter smaller than that of the patient's esophagus and being flexible, thus allowing the flexible elongated member to be introduced with its first distal end from the throat towards the esophagus; (ii) a restraint device secured to the elongated member and operable between an active state, in which it is adapted to engage and hold the patient's esophagus or stomach, and an inactive state, in which it is adapted to release from the esophagus or stomach ; (ii) an operating device for operating the restraint device to switch between said active and inactive states from outside the patient's body; and (iv) a handle connected to the elongated member at the proximal end thereof to be manually held to move the elongated member distally, wherein the holding device, when operated by the operating device in its active state, is adapted to engage and holding the esophagus or stomach tightly enough to allow the elongated limb, when manually moved, to move and reintroduce the cardia back in the distal direction to a position below the diaphragm muscle. The operable holding device of the instrument is preferably adapted to expand radially relative to the elongated member from said inactive state to said active state, such that said holding device, when expanded radially, engages and holds the stomach or esophagus by force and friction. Alternatively, the operable fastening device comprises at least one introduction member adapted to be introduced invasively into the stomach wall or esophagus to secure the fastening device in the esophagus or stomach, when the fastening device is in its active state. In both alternatives, the operable restraint device is adapted to engage and secure the esophagus proximal to the cardia or at the cardia, or engage and secure the stomach in a position at or distal to the hiatus, when the cardia is above the muscle of diaphragm. According to another alternative, the elongated member of the instrument comprises a first suture placing member, which is positioned in the esophagus when the holding device is in its active state holding the esophagus or stomach, and a second suture placing member in the esophagus. distal end of the elongated limb. The operating device of the instrument is adapted to curve the flexible elongated member around the stomach notch to a position in which the first suture placing member is above the cardia and the first and second suture placing members are opposite each other. of the other with the back wall and esophageal wall moved together by the first and second suture placement members. The instrument further comprises a rechargeable multi-suture device for suturing together the patient's esophagus proximal to the cardia with the bottom stomach wall by a row of sutures, where the bottom wall and esophageal wall are moved together by the positioning members. suture, first and second, said row of sutures comprising two or more sutures to be sutured simultaneously by the multi-suturing device. ηβΜηη / ίζηζ / Β / γι The invention further comprises another embodiment of a surgical gastroscopic instrument for treating a human patient suffering from hiatal hernia, this instrument comprising: (i) an elongated member having a proximal end and a distal end, said elongated member having a diameter smaller than that of the esophagus of the patient and being flexible, thus allowing the flexible elongated member to be introduced with its first distal end from the patient's throat into the esophagus; (i) a first suture placing member provided on the elongated member so as to be positioned in the esophagus proximal to the cardia when the elongated member has been introduced into the esophagus with the distal end of the elongated member located in the stomach; (iii) a second suture placing member provided on the elongated member at the distal end thereof; (iv) an operating device adapted to bend the flexible elongated member around the stomach notch towards a position in which the first and second suture placing members face each other with the bottom wall and esophageal wall moved together by the first and second suture placing members; and (v) a rechargeable multi-suture device for suturing together the patient's esophagus proximal to the cardia with the bottom stomach wall by a row of sutures, where the bottom wall and esophageal wall are moved together by the positioning members. suture, first and second, the multi-suture device being reloadable with sutures from outside the body to apply additional rows of sutures in front of or behind the first row of sutures, wherein said row of sutures comprises two or more sutures to be sutured simultaneously by the multi-suture device. The instrument further comprises a holding device secured to the elongated member and operable between an active state, in which it is adapted to engage and hold the esophagus or stomach of the patient, and an inactive state, in which it is adapted to be released from the esophagus or stomach. stomach. The holding device is operable by the operating device to switch between said states, active and inactive, from outside the body of the patient, and a handle connected to the elongated member at the proximal end thereof to be manually grasped to move the elongated member distally. , wherein the holding device, when operated by the operating device in said active state, is adapted to engage and hold the esophagus or stomach tightly enough to allow the elongated member, when manually moved, to move and reintroduce the cardia again in the distal direction to a position below the diaphragm muscle. In an alternative, the operable holding device is adapted to expand radially relative to the elongated member from said inactive state to said active state, such that the holding device, when expanded radially, engages and holds the stomach or esophagus by force and friction. In another alternative, the operable fastening device comprises at least one introduction member adapted to be introduced invasively into the stomach or esophagus wall to secure the fastening device in the esophagus or stomach, when the fastening device is in its state. asset. In both alternatives, the operable restraint device is adapted to engage and secure the esophagus proximal to the cardia or at the cardia, or to engage and secure the stomach in a position at or distal to the hiatus, when the cardia is above the muscle. of diaphragm. The invention further comprises yet another embodiment of a surgical gastroscopic instrument for providing a motion restriction device for invaginating into the bottom stomach wall of a human patient to treat reflux disorder. The instrument comprises (i) an elongated member having a proximal end and a distal end, the elongated member having a diameter less than that of the patient's esophagus and being flexible, thus allowing the introduction of the flexible elongated member with its first distal end through from the patient's throat, esophagus and towards the stomach to the back wall; (i) an operable stomach penetration device provided the elongated member at the distal end thereof to penetrate the bottom stomach wall to create a hole in the bottom stomach wall, to allow introduction of the elongated member through the hole ; (iii) a special clamping device operable provided on the elongated member proximal to the penetration device, when penetrating said stomach wall, to maintain the elongated member in a position in which the elongated member extends through the background stomach wall and is prevented from moving through the hole in the proximal direction, wherein the special fastening device includes an expandable member that expands at least radially substantially perpendicular to the elongated member to abut against the bottom wall on the exterior thereof; and (iv) an insertion device for inserting the motion restriction device through the hole in the bottom stomach wall to the outside thereof to invaginate into the bottom wall. The instrument may further comprise a forming device provided on the elongated member proximal to the special holding device for abutting against the bottom wall therein. The forming device together with the special clamping device is adapted to form the bottom stomach wall in a cup-like shape, whereby the special clamping device is retracted relative to the forming device to pull the stomach wall against the forming device to form said cup-shaped portion of the stomach. The instrument may further comprise a suturing device adapted to suture the open end of the cup-like portion of the bottom wall with stomach-to-stomach sutures to create a space that is at least partially closed by a portion of the bottom wall. background. The suturing device preferably comprises multiple sutures for suturing two or more sutures simultaneously. The suturing device is adapted to suture the open end of the cup-like portion of the bottom wall before the motion restriction device is inserted through the insertion device through the hole in the bottom wall. The instrument may further comprise an inflation device for inflating the motion restriction device after being inserted through the insertion device through the hole in the bottom wall, or for inflating the motion restriction device after being inserted through the device. movement restriction introduced through the hole in the back wall. The suturing device may comprise an operable reloadable multi-suturing device, which is reloaded with sutures from outside the patient's body and which is adapted to suture the open end of the cup-like portion of the bottom wall with a row of stomach-to-stomach sutures, wherein the row of sutures comprises two or more sutures or staples to be sutured simultaneously. In another alternative, the instrument comprises a reliable movement restriction device, the penetration device comprising a wire adapted to be introduced through the hole in the bottom stomach wall and advanced at least as far as or passed through the abdominal wall.The i n / ι zoz / e / yl wire serves as a guide for a hydraulic tube, which is connected to the inflatable motion restriction device and which is connected to an injection port to be placed subcutaneously to fill the inflatable motion restriction device. with a fluid and adjust the amount thereof, when the movement restriction device has been inserted by the insertion device through the hole in the bottom wall. The invention further comprises another embodiment of a surgical gastroscopic instrument for providing an inflatable motion restriction device for invaginating into the bottom stomach wall of a human patient to treat reflux disorder. The instrument comprises: (i) an elongated member having a proximal end and a distal end, the elongated member having a diameter smaller than that of the patient's esophagus and being flexible, thus allowing the introduction of the flexible elongated member with its first distal end to through the patient's throat, esophagus and into the stomach to the back wall; and (i¡) an operable stomach penetration device provided in the elongated member at the distal end thereof to penetrate the bottom stomach wall to create a hole in the bottom stomach wall, to allow introduction of the elongated member through of the hole, wherein the penetration device includes a wire to be introduced through the hole in the bottom stomach wall and advanced at least to or passed through the abdominal wall, said wire serving as a guide for a hydraulic tube, which is connected to the inflatable motion restriction device and which is connected to an injection port to be placed subcutaneously to fill the inflatable motion restriction device with a fluid and adjust the amount thereof, and wherein at least one of the wire and The tube can be pulled to move the fluid-inflated motion restriction device toward the bottom stomach wall to be placed inside the bottom stomach wall where the motion restriction device is to invaginate into the bottom wall. Preferably, at least one of the wire and tube when pulled to move the inflated motion restriction device toward the bottom stomach wall allows a portion of the bottom stomach wall to move to form a cup-like portion of the stomach protruding from the normal stomach cavity. The instrument may further comprise an operable forming device having a cup-like shape for forming the cup-like shaped portion of the stomach. The instrument may further comprise a suturing device adapted to suture the open end of the cup-like portion of the bottom wall with stomach-to-stomach sutures to create a space that is at least partly closed by a portion of the bottom wall. background. The suturing device may comprise multiple sutures to suture two or more sutures simultaneously. The suturing device may be adapted to suture the open end of the cup-like portion of the bottom wall before the motion restriction device is inserted through the hole in the bottom wall. The motion restriction device is preferably inflatable, further comprising an inflation device for inflating the motion restriction device after being introduced through the hole in the bottom wall. The instrument may further comprise a first and second suture placing member provided on the elongated member located in the stomach at the distal end thereof, and an operating device adapted to adjust the first and second suture member in a position in which The first and second suture placing members face each other with the stomach wall on both sides of the open end of the cup-like portion, and are adapted to suture the open end of the cup-like portion of the stomach wall. bottom with a row of sutures from stomach to stomach. The suturing device may comprise an operable reloadable multi-suturing device, which is reloaded with sutures from outside the patient's body and which is adapted to suture the open end of the cup-like portion of the bottom wall with said row of sutures. stomach-to-stomach sutures, wherein the row of sutures comprises two or more sutures or staples to be sutured simultaneously. The invention further comprises yet another embodiment of a surgical gastroscopic instrument providing a motion restriction device for invaginating into the bottom stomach wall of a human patient to treat reflux disorder.The instrument comprising: (i) an elongated member having a proximal end and a distal end, the elongated member having a diameter less than that of the patient's esophagus and being flexible so as to allow introduction of the flexible elongated member with its first end distal through the patient's throat, esophagus and into the stomach to the back wall; (i) a device that pushes the stomach operable to push the bottom stomach wall to create a cup-shaped portion of the bottom stomach wall protruding from the normal stomach cavity, said pushing device including the restriction device movement to invaginate along the fundal stomach wall in the cup-shaped portion thereof; and (iii) a suturing device adapted to suture the opening of the cup-shaped portion of the bottom stomach wall with stomach-to-stomach sutures to at least partially enclose the motion restriction device. The instrument may further comprise a forming device provided on the elongate member proximal to the pushing device for pulling the bottom wall therein. The forming device together with the pushing device is adapted to form the bottom stomach wall into an optimal cup-like shape, wherein the pushing device is pushed to form said cup-like shaped portion of the stomach. The instrument may further comprise first and second suture placing members provided on the elongated member located in the stomach at the distal end thereof; and an operating device adapted to adjust the first and second suture members in a position in which said first and second suture placing members face each other with the stomach wall on both sides of the open end of the like portion to cup, and are adapted to suture the open end of the cup-like portion of the back wall with a row of stomach-to-stomach sutures. The suturing device may comprise an operable reloadable multi-suturing device, which is reloaded with sutures from outside the patient's body and which is adapted to suture the open end of the cup-like portion of the bottom wall with said row of sutures. stomach-to-stomach sutures, wherein the row of sutures comprises two or more sutures or staples to be sutured simultaneously. The suturing device may also comprise multiple sutures to suture two or more sutures simultaneously. The instrument may further comprise an inflation device for inflating the motion restriction device after suturing. The forming device may preferably comprise a vacuum suction device ηβΜηη / ίζηζ / Β / γι for suctioning the bottom of the stomach to assist the instrument in forming the cup-like portion of the bottom stomach wall together with the forming device. push. Embedded gastroscopic instruments as described in the previous section may comprise an optical device for examining the interior of the esophagus or stomach. For this purpose, the instruments may further comprise electrical wires extending along the elongated member, and the optical device comprises a camera positioned distally on the elongated member and connected to the wires, which are wired outside the patient's body for external exposure of camera images. The instruments may further comprise a light source placed distally on the elongated member to illuminate the interior of the esophagus or stomach. The optical device may suitably comprise optical fibers placed along the elongated member and extending outside the patient's body for external examination of the interior of the esophagus or stomach. The present invention further relates to an apparatus for treating a reflux disorder and obesity. This apparatus comprises a motion restriction device and fixation devices, adjustment device, wireless remote control function, wireless power transmitter and additional features as described above with an apparatus for treating a reflux disorder.Furthermore the apparatus for combined treatment of a reflux disorder comprises at least one operable stretching device which, when implanted in the patient, stretches a part of the patient's stomach wall, to thereby treat obesity by affecting the patient's appetite; and an operating device for operating the stretching device when implanted to stretch the stomach wall portion so as to create satiety. The stretching device may be held in contact with the stomach wall by stomach-to-stomach sutures or staples, in a position in which the stretching device is capable of stretching the stomach wall. Specifically, the stretching device can be invaginated through the stomach wall by means of stomach-to-stomach sutures or staples. The stretching device can be adapted to be placed in the stomach cavity. To this end, the stretching device can be adapted to be inserted into the stomach cavity through a gastroscope or intraluminal instrument, and adapted to be attached to the stomach wall by surgery. Alternatively, the stretching device can be adapted to be placed on the outside of the stomach. In one embodiment, the stretching device comprises a first clutch member adapted to engage a first stomach wall part and a second clutch member adapted to engage a second stomach wall part close to but spaced from the first stomach part. . The operating device is adapted to operate the first and second clutch members away from each other to stretch the stomach wall portion between the first and second stomach parts in such a way that satiety is created. At least one of the first and second clutch members may be adapted to be at least in part invaginated through the stomach wall by stomach-to-stomach sutures or staples holding the clutch member in place. Furthermore, at least one of the first and second clutch members may be adapted to be held in place by sutures or staples between the clutch member and the stomach wall. Suitably, at least one of the first and second clutch members comprises a tissue growth promoting structure, preferably a net-like structure, adapted to contact the stomach wall to ensure long-term attachment of the delivery device. stretch to the stomach wall. In another embodiment, the stretching device comprises at least one expandable body adapted to invaginate through a portion of the patient's stomach wall, and the operating device comprises a fluid container, which is in fluid communication with a chamber of the body. The operating device is non-invasively operable to deliver fluid from the fluid container to the body chamber to expand the body such that the stomach wall portion is stretched, when the body is invaginated. The fluid container can be operated by manually depressing it. The operating device may comprise a reverse servo, wherein a small volume of fluid in the fluid container is compressed with a higher force and the body chamber creates movement of a larger total volume with less force per unit volume. . The fluid container may be placed subcutaneously or in the abdomen, and may be regulated by moving a wall of the container, for example by a motor. Alternatively, a pump may be provided to pump fluid or air from the container to the body chamber. The term reverse servo means the definition of a device that is controlled with a higher force and a small stroke i.e. movement of a small amount of fluid with a high force controls a larger amount of fluid that moves by means of very small force, but may alternatively or additionally comprise the definition of a mechanism that transfers a strong force acting on a moving element having a short stroke to a small force acting on another moving element having a long stroke. The reverse half servo is preferably used when manual control of the device through intact skin is possible.In another embodiment the apparatus for treating a reflux disorder and obesity comprises a large chamber in contact with one or more small chambers. The chambers are adapted to communicate with fluid or air that is distributed between the chambers. A reverse servo may be provided to distribute fluid between the chambers, where a small volume of fluid in the large chamber is compressed with a higher force and the smaller chamber creates movement of a larger total volume with less force per unit of volume. The large chamber can be adapted to invaginate into the patient's bottom stomach wall to also treat reflux disorder by restricting movement of the cardiac notch toward the patient's diaphragm muscle, while the small chambers function as stretching devices to treat obesity. The large chamber can distribute fluid or air to the small chambers to cause them to expand and stretch the bottom stomach wall. In another embodiment, the stretching device comprises a mechanical stretching device, wherein a motor may be provided to mechanically regulate the stretching device. The mechanically regulated stretching device may be adapted to engage a first part of the stomach wall and a second part of the stomach, wherein the mechanically regulated stretching device comprises a linkage mechanism adapted to be moved by the operating device. Alternatively, the stretching device may comprise a first clutch member adapted to engage a first part of the stomach wall and a second clutch member adapted to engage a second part of the stomach wall close to but spaced apart from the i n / ι zoz / e / l first part of the stomach, wherein the mechanical stretching device regulates the distance between the first and second parts of the stomach wall. As an alternative, the hydraulic means described above can be used to regulate such a mechanical stretching device by hydraulic distribution of fluid or air. The stretching device may be non-invasively adjustable postoperatively. The operating device for operating the stretching device may in its simplest form comprise a subcutaneous switch adapted to be non-invasively operated by manually depressing the switch for operating the stretching device. At least two operable stretching devices adapted to stretch at least two different portions of the stomach wall may be provided, wherein the apparatus is adapted to be adjusted postoperatively and non-invasively. Specifically, the apparatus can be adjusted from time to time so that in a first time one of the stretching devices stretches one of the stomach wall portions and in a second time the other of the stretching devices stretches the other portion of the stomach wall. stomach wall. In another embodiment, the stretching device comprises a body adapted to fill a volume defined by portions of the stomach wall. The body appropriately has round contours without very sharp edges that would damage the patient's stomach wall. Where the body is to be invaginated it may have variable circumference to better hold it in its invaginated place by portions of the patient's stomach wall. The body can be formed like an egg or like a kidney. Generally, any kind of mechanical construction can be used. Any mechanically or hydraulically driven mechanical construction or any pneumatic construction can be used. Any motor or any moving pump or material that changes shape when actuated can be used to achieve the simple goal of stretching a part of the stomach wall by moving at least two parts of the stomach wall away from each other. Any kind of hydraulic operation can be used. It will be appreciated that instead of hydraulic operation; Pneumatic operation can be used, where air instead of hydraulic fluid is moved between a container and a chamber formed by the stretching device. Preferably the container has a locking position to keep it in the desired position if handled by the patient. To compress the container preferably remains compressed and is released after pressing again.Any kind of hydraulic solution can be used for the stretching device. The hydraulic solution can be driven both mechanically and energized with any motor or pump as well as manually. Of course, just expanding an invaginated part of the stomach also stretches away the stomach wall, which can also be achieved mechanically, hydraulically, pneumatically, or by operating with a motor or pump or by manual force. The present invention also provides a system for a combined treatment of a reflux disorder and obesity treatment system comprising an apparatus for treating obesity as described above. The system may comprise a subcutaneous electrical switch adapted to manually and non-invasively control a function of the obesity treatment apparatus. The system may comprise a hydraulic device having a hydraulic container, wherein the obesity treatment apparatus is adapted to be regulated non-invasively by manually depressing ηβ^ηίη / ίζηζ / Β / γι the hydraulic container. The system may comprise a wireless remote control for controlling a function of the apparatus. The wireless remote control comprises at least one external signal transmitter and an internal signal receiver may be provided to be implanted in the patient. The wireless remote control is adapted to transmit at least one wireless control signal to control the apparatus. The wireless control signal may comprise a frequency, amplitude or phase modulated signal or a combination thereof, and a digital or analog signal, or a combination of a digital and analog signal. Alternatively, the wireless control signal comprises an electric or magnetic field, or a combined electric and magnetic field. The remote control can transmit a carrier signal to carry the wireless control signal. The carrier signal may comprise digital, analog or a combination of digital and analog signals. The remote control can transmit an electromagnetic carrier wave signal to carry the digital or analog control signal. The system may comprise a wireless power transmitter for non-invasively powering the appliance with wireless power. The power transmitter transmits power by at least one wireless power signal. The wireless power signal may comprise a wave signal selected from the following: a sound wave signal, an ultrasound wave signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, a ultraviolet light, a laser light signal, a microwave signal, a radio wave signal, an x-ray radiation signal and a gamma radiation signal. Alternatively, the wireless power signal comprises an electric or magnetic field, or a combined electric and magnetic field. The wireless power transmitter can transmit a carrier signal to carry the wireless power signal. The carrier signal may comprise digital, analog or a combination of digital and analog signals. The system may comprise an energy transforming device for transforming wireless energy from a first form to a second form of energy. The energy transforming device can directly operate during energy transfer the apparatus with the second form of energy. The second form of energy may comprise a direct current or pulsating direct current, or a combination of a direct current and pulsating direct current. The second form of energy may comprise alternating current or a combination of alternating and direct current. An accumulator may be provided, wherein the second form of energy is at least partially used to charge the accumulator. Energy of the first or second form may comprise magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, photoenergy, nuclear energy or thermal energy. One of the energy of the first form and the energy of the second form can be non-magnetic, non-kinetic, non-chemical, non-sonic, non-nuclear or non-thermal. The system may comprise a power source adapted to power the apparatus. The power source may comprise an indoor power source adapted to receive power from an outdoor power source by transmitting power in a wireless mode. The indoor power source is charged by power in wireless mode. The system may comprise a feedback device for sending information from inside the patient's body to outside the patient's body to provide feedback information related to a functional parameter. The system may comprise a sensor that detects a parameter, such as a functional parameter of the system, that correlates with the transfer of energy to charge an indoor energy source. An indoor control unit may be provided to control the operating device of the apparatus in response to the sensor detecting a functional parameter. Alternatively, the sensor detects a physical parameter of the patient. The physical parameter can be one of body temperature, blood pressure, blood flow, heart rate and respiration. The physical parameter sensor may be a motility or pressure sensor, or a sensor that detects measurement, bending, stretching, or food intake. The indoor control unit may control the operating device in response to the sensor detecting the physical parameter. An indoor control unit may be provided to receive information from the sensor. The operating device of the apparatus may comprise a motor or a pump. Specifically, the operating device may comprise an electric motor. The operating device may be electrically driven, may be a hydraulic operating device or may be a pneumatic operating device. The transmitted energy, directly in its wireless form, can affect the operating device to create kinetic energy to operate the stretching device of the apparatus during energy transfer. The system may comprise a feedback device for sending information from inside the patient's body to outside the patient's body to provide feedback information related to a functional parameter. The system may comprise an external data communicator and an implanted internal data communicator communicating with the external data communicator, wherein the internal data communicator is adapted to feed data related to the obesity treatment device or the patient back to the external data communicator. external data communicator or the external data communicator feeds data to the internal data communicator. The system may comprise implantable electrical components including at least one voltage level protector and / or at least one constant current protector. The present invention also provides methods for treating a patient suffering from both a reflux disorder and odesity. The methods may be performed alongside or in conjunction with intraluminal or addominal methods described above to treat a reflux disorder. The invention provides the methods listed below: a) A method for surgically treating an odesus patient, the method comprising the steps of: cut a hole in the patient's abdominal wall, dissect an area around the stomach, place a device to treat the hole as described above, embedding the patient's stomach wall, and suture the stomach wall. The method may further comprise the additional step of: postoperatively regulating the stretching device to stretch a portion of the stomach wall to affect the patient's appetite, wherein the step of regulating the stretching device is controlled from outside the patient's body. The method may further comprise the additional steps of: placing an additional apparatus for treating obesity as described above, engaging the stomach wall of the patient, stretching a first part of the stomach wall by means of the apparatus for treating obesity, and stretching a second part of the stomach wall by means of the apparatus additional to treat obesity. b) A method of surgically placing an apparatus to treat obesity in a patient through a laparoscopic abdominal approach, the method comprising the steps of: insert a needle or a tube-like instrument into the abdomen of the patient's body, using the needle or a tube-like instrument to fill the patient's abdomen with gas thereby expanding the patient's abdominal cavity, place at least two laparoscopic trocars into the patient's body, inserting a camera through one of the laparoscopic trocars into the patient's abdomen, inserting at least one dissection tool through one of the at least two laparoscopic trocars, and dissecting a proposed placement area of ​​the patient , and place an obesity treatment device as described above, engaging the stomach wall. c) A method of using the system to treat obesity as described above, comprising the step of regulating the stretching device postoperatively to stretch a portion of the stomach wall to affect the appetite of the patient, wherein the step of regulating the device Stretching is done non-invasively. The stretching device comprises a hydraulic or mechanical stretching device. The hydraulic stretching device may comprise a container, for moving gel or gas or fluid to or from the stretching device. The container can be placed subcutaneously to be reached by the patient's hand to manually move fluid to or from the stretching device. The stretching device may be actuated by an internal energy source to stretch or release the stretching device, by means of a control device that controls energy from an internal control unit or from outside the patient's body. A wireless energy transmitter for wireless energy transfer drives the operating device so that the stretching device directly causes during energy transfer the stretching device to stretch the stomach wall. A wireless power transmitter for wireless power transfer charges the indoor power source. A reverse servo may be provided, where by the movement, in a closed hydraulic system, of a small amount of fluid, a larger movement of fluid is achieved in a second, larger closed hydraulic system, where the small amount of fluid is moves by a higher force per unit area than the large volume. A stretching device invaginated into the patient's bottom stomach wall is adapted to be adjustable, wherein the stretching device placed invaginated into the bottom stomach wall is adapted to fit and stretch the bottom stomach wall thereby creating satiety. The method may further comprise sending feedback information from inside the body to outside the body to provide feedback related to the functional parameters of the device. Alternatively, the method may further comprise sending feedback information from inside the body to outside the body to provide feedback related to physical parameters of the patient. The functional parameter of the device can be correlated with the energy transfer to charge the internal power source. The device is programmed from outside the patient's body. The method may also comprise the steps of: detecting a physical parameter of the patient or a functional parameter of the device, and sending detection information to a control unit adapted to regulate the stretching device. The method may also comprise the steps of: detecting a physical parameter of the patient or a functional parameter of the device, and sending detection information to a control unit adapted to regulate the load of the internal power source. The method may further comprise subcutaneously placing a reverse servo having a small control container and moving a small volume of the control container with a higher force per unit area, creating a larger movement of the stretching device with less force per unit area. area. The method may further comprise performing non-invasive regulation by manually depressing a subcutaneous switch. The method may further comprise performing non-invasive regulation by a wireless remote control. The method may further comprise performing non-invasive regulation by a wireless energy transmitter. The method may further comprise powering the obesity treating apparatus by an internal energy source. The method may further comprise driving the obesity treating apparatus by an external energy source transmitting wireless energy, wherein the energy source comprises an external energy source transmitting wireless energy. The method may further comprise transmitting wireless power from an outdoor power source to charge a rechargeable indoor power source. d) A method of using an apparatus as described above, wherein the stretching device comprises a main body including a large chamber in contact with one or more small containers / chambers adapted to stretch the stomach wall, where the chambers are adapted to communicate with fluid or air moving between the chambers. e) A method of using an apparatus as described above, wherein the large chamber is adapted to, with its main volume to be the most important volume of the stretching device and wherein, the small chambers are like the stretching devices stretching the stomach wall to treat obesity, where the main chamber is communicating with fluid or gel so that the small chambers cause the stretching effect on the background stomach wall, thus treating obesity. f) A method of using an apparatus as described above, comprising treating the reflux disorder by invaginating the large chamber with its main volume in the background stomach wall thereby restricting the movement of the stomach notch towards the diaphragm muscle of the patient , and stretching the bottom stomach wall using the small chambers, communicating with fluid or air from the large chamber to the small chambers causing a stretching effect on the bottom stomach wall thus treating obesity. In another aspect, the invention relates to an apparatus for treating a reflux and / or obesity device for a patient having a stomach with a food cavity. The apparatus generally comprises at least one volume filling device adapted to at least substantially invaginate a portion of the patient's stomach wall, wherein the volume filling device is adapted to be placed on the exterior of the stomach wall, so that the volume of the food cavity is reduced in size by a volume substantially exceeding the volume of the volume filling device, wherein the surface of the volume filling device comprises a biocompatible material, wherein a substantial portion of the surface of the device The volume filling device is adapted to rest against the exterior of the stomach wall, and wherein the volume filling device has a maximum circumference of at least 30 millimeters. The apparatus preferably comprises a volume filling device comprising an inflatable device expandable to an expanded state. The reliable device preferably has an entry port for a fluid or gel and is adapted to connect to a gastroscopic instrument. The inlet port preferably comprises a fluid connection adapted to interconnect the volume filling device and the gastroscopic instrument. The volume filling device has an elongated shape. Alternatively, the volume filling device has a round shape, or a curved or folded shape. The volume filling device preferably comprises an elastic material. The volume filling device preferably comprises a bio-compatible material. Preferably, the volume filling device comprises silicone. The volume filling device may be provided with a single or multi-layer coating, such as a Parylene coating, a polytetrafluoroethylene coating, or a polyurethane coating. The volume filling device comprises a fluid that is adapted to transform into a solid state or fixed form. In one example the fluid is liquid polyurethane. In another example, the fluid is isotonic. In another example, the fluid comprises large molecules to prevent diffusion. In another example, the fluid comprises iodine molecules. The volume filling device comprises a homogeneous material. The volume filling device may be a solid body, may comprise a closure wall defining a chamber, may comprise a rigid outer surface, may comprise an elastic outer surface, and may comprise a flexible outer surface. The volume filling device preferably has a maximum circumference of at least 50 millimeters, more preferably a circumference of at least 80 millimeters. The volume filling device preferably has a volume of between 0.00001 and 0.001 m3, more preferably a volume of between 0.00001 and 0.0002 m3. Preferably, the volume filling device is deformed to a maximum diameter to be inserted into a laparoscopic trocar. The volume filling device is adapted to be held in place by stomach-to-stomach sutures or staples to invaginate the device into the stomach wall. The stomach-to-stomach sutures or staples are provided with fixation portions showing a structure adapted to be in contact with the stomach wall to promote ingrowth of human tissue to ensure long-term placement of the volume filling device attached to the stomach wall. The structure preferably comprises a network-like structure. The volume filling device is adapted to be non-invasively adjustable postoperatively. In one embodiment, the volume filling device has variable circumference to better adapt to remain in its invaginated place in the patient's stomach wall. The apparatus according to the above may further comprise a stretching device positioned outside the stomach wall and adapted to stretch a portion of the stomach wall, thereby affecting the patient's appetite, the apparatus further comprising a fluid connection interconnecting the stretching device. and the volume filling device.In one embodiment, the volume filler device is adapted to be placed outside the stomach wall through a gastroscopic instrument. In one embodiment, the bulking device comprises at least two interconnectable portions, and wherein the bulking device is adapted to be positioned outside the stomach wall as separate portions. In one embodiment, an outer surface layer of the volume fill device comprises polyurethane, Teflon®, or PTFE, or a combination thereof. In one embodiment, the volume filling device is adapted to be destroyed by acid, preferably hydrochloric acid. In one embodiment, the volume filler comprises gel, preferably the gel has a shore value of less than 15. In one embodiment, the volume filler comprises an attachment device adapted to cooperate with a holding instrument. In one embodiment, the volume filling device is adapted to completely invaginate through the patient's stomach wall. The apparatus may further comprise a fixation device adapted to fix the food intake reducing device to the stomach wall to hold the bulking device in place, when the bulking device is implanted. The volume filling device has a volume of less than 0.0002 m3, preferably a volume of between 0.0001 and 0.001 m3. In one embodiment, the volume filling device is adapted not to be destroyed by acid, preferably hydrochloric acid. Preferably, the volume filler has a circumference of at least 120mm, more preferably at least 150mm, even more preferably at least 180mm, and most preferably a circumference of at least 220mm. The volume filling device preferably comprises a flexible, non-elastic material. The apparatus preferably comprises a bulking device comprising a fixation device adapted to be included in fixing the device to the stomach wall. In one embodiment, the bulking device comprises two or more fixation devices adapted to be included in fixing the device to the stomach wall. In one embodiment, the volume filling device comprises a holding device adapted to be capable of being held by an instrument and simplify implantation of the device. In one embodiment, the volume filling device comprises two or more holding devices adapted to be capable of being held by an instrument and simplify implantation of the device. In one embodiment, the volume filling device comprises at least one tube connected to the device. In one embodiment, the volume filling device comprises an injection port for connecting to said tube. The apparatus thus described for treating a patient's reflux and / or obesity device comprising at least one volume filling device may be combined with any features described in the previous sections, such as, but not limited to, carium stimulation devices. of stretching. It is also envisioned that the apparatus thus described for treating a reflux and / or obesity device of a patient comprising at least one volume filling device can be implanted by generally employing intraluminal or abdominal methods as highlighted in the previous sections of this document. and that suitable features of the motion restriction device described above can be employed with the volume filling device. It should be noted that any modality or part of modality or feature or method or associated system or part of system described herein may be combined in any combination. BRIEF DESCRIPTION OF THE FIGURES The present invention will now be described in more detail by way of non-limiting examples, and with reference to the attached figures, in which: Figs. 1A, 1B, 1C are schematic views of various modalities of an apparatus for treating Gastroesophageal Reflux Disease implanted in a human patient. Figs. 2A and 2B are schematic views of various modalities of an apparatus for treating Gastroesophageal Reflux Disease implanted in a human patient. Figs. 3A and 3B are schematic views of various modalities of an apparatus for treating Gastroesophageal Reflux Disease implanted in a human patient. Fig. 4a, Fig. 4B, Fig. 4C and Fig. 4D are schematic views of modalities of an apparatus for treating Gastroesophageal Reflux Disease and obesity implanted in a human patient. Fig. 5A and Fig. 5B is a schematic view of one embodiment of an apparatus for treating Gastroesophageal Reflux Disease implanted in a human patient. Fig. 6A, Fig. 6B, Fig. 6C and Fig. 6D and Fig. 7, Fig. 8 and Fig. 9 show alternative forms of a motion restriction device for treating Gastroesophageal Reflux Disease adapted for implantation in a human patient. Fig. 10 is a general view of a patient with a motion restriction device implanted to treat Gastroesophageal Reflux Disease. Fig. 11 to Fig. 27 are schematic views of various ways of operating an apparatus for treating ηβ^ηίη / ίζηζ / Β / γι Gastroesophageal reflux disease. Fig. 28 to Fig. 34c are schematic views of various ways of ordering the hydraulic or pneumatic drive of an apparatus of the invention to treat Gastroesophageal Reflux Disease. Fig. 35 is a flow chart illustrating the steps performed when implanting a motion restriction device to treat Gastroesophageal Reflux Disease. Fig. 36 and Fig. 41 show methods to restore the location of the cardia and fundus in a patient suffering from reflux disorder. Fig. 42 to Fig. 46 show different shapes and characteristics of a reflux treatment device comprised in an apparatus according to the invention, Fig. 47a, Fig. 47b, Fig. 47c Fig. 47d show a deflated unreliable reflux treatment device comprised in an apparatus according to the invention and an instrument for placing the reflux treatment device on the outside of the stomach wall of the patient. Fig. 48a to Fig. 48i illustrate different steps to invaginate the unreliable device of Fig. 47a into the exterior of a patient's stomach wall, Fig. 49 shows an embodiment where the reflux treatment apparatus is also adapted to treat obesity. Figs. 50 and Fig. 51 show an embodiment where the reflux treatment apparatus is also adapted to treat obesity Fig. 52a to Fig. 52h illustrate different steps to invaginate the unreliable device of Fig. 47a inside a stomach wall of a patient, Figs. 53a to Fig. 53c show an instrument for creating an invagination of the stomach wall. Fig.54 and Fig. 55 show an abdominal method to treat reflux disorder. DETAILED DESCRIPTION Fig. 1A is a schematic view depicting an apparatus 11, including a motion restriction device 10 of a biocompatible material, for treating reflux disorder, according to the invention, implanted in a human patient. In Fig. 1 A, device 10 invaginates into the fundus. The device 10 comprises a body 13 having an outer surface 15 suitable for abutting against a portion of the outer wall 16a of the bottom stomach wall 16 at a position between the patient's diaphragm 18 and at least a portion of the bottom of the invaginated bottom stomach wall 16. In this way, with the device 10 invaginated in this manner, the movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted, thus preventing the cardia from slipping through the opening of the patient's diaphragm towards the patient's chest 20 and supporting pressure against the patient's cardia sphincter muscle is maintained exerted from the patient's abdomen. The body 13 is unreliable and is adapted to be inflated with a gel or fluid. A fluid or gel receiving member for receiving fluid for inflating said motion restriction device may be provided. Alternatively, the body 13 includes a homogeneous material and is a solid body. Alternatively, the body 13 includes an outer wall in the form of a closure wall defining a chamber. The outer wall can be rigid, elastic or flexible. Where the outer wall is rigid, it is rigid enough to remain undeformed when subjected to forces created by movements of the stomach. The body 13 of the movement restriction device 10 can be fixed to the wall 16a of the bottom 16 in a number of different ways. In the embodiment shown in Fig. 1A, device 10 invaginates into the bottom stomach wall from outside the stomach. After intussusception, a first fixation device consisting of a number of stomach-to-stomach sutures or staples 22a is applied to keep the intussusception intact in the short term. This allows the growth of human tissue to keep the invagination intact in the long term. There may optionally be a second fixation device consisting of a number of sutures or staples 22b that are provided between the wall 16a of the bottom 16 and the wall 24a of the esophagus 24 to maintain the device 10 in said position between the diaphragm of the patient 18 and the least a portion of the lower part of the invaginated bottom stomach wall 16a. In this way, the device 10 is fixed in this position by this second fixing apparatus. Direct or indirect fixation of the device 10 to the diaphragm muscle 18 or associated muscles may be provided. As an alternative, direct or indirect fixation of the device 10 to the esophageal His may be provided. Alternatively, or additionally, there may be a third fixation device in the form of sutures or staples 22c provided between the wall 16a of the bottom 16 and the diaphragm 18 to maintain the device 10 in said position. Fig. 1B shows an embodiment substantially similar to that shown in Fig. 1A. In Fig. 1B, the body 13 and invagination, in addition to the fixation 22, are fixed by means of sutures and / or staples 22c between the reflux body 13 and the diaphragm 18, to maintain the device in position above the cardia 14. Fig. 1C shows another embodiment substantially similar to that shown in Fig. 1A. In Fig. 1C the reflux treatment device is held in place by stomach-to-stomach sutures or staples 22a connecting the wall 16a of the bottom 16 to the wall 16a of the bottom 16. Additionally the reflux treatment device 10 is held in place by sutures 22b or staples from the fundus wall 16 16a to the esophageal wall 24a, and by sutures or staples from the fundus wall 16a to the diaphragm. An alternative embodiment of an apparatus 17 for the treatment of reflux disorder in accordance with the invention is depicted in Fig. 2A. This embodiment, in many respects, is similar to that described above with reference to Figs. 1A-C. Thus, a motion restriction device 10 is shown implanted in a human patient and is fundus invaginated. However, in the embodiment shown in Fig. 2A, the device 10 invaginates from inside the stomach, rather than from outside the stomach, as in Figs. 1A-C. The motion restriction device 10 comprises a body 13 adapted to abut against a portion of the inner wall of the bottom stomach wall 16 at a position between the patient's diaphragm 18 and at least a portion of the bottom of the stomach wall. invaginated fundus 16. In this embodiment, the body 13 is situated above the cardia area 14 of a standing animal or human mammal patient. The body 13 of the device 10 is formed to bear against the wall 16a of the bottom 16, and furthermore, it has an outer surface 15 suitable for bearing against this bottom wall. In this way, with the device 10 invaginated in this manner as described above in connection with Fig. 1A, the movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted, thus preventing the cardia from slipping. through the patient's diaphragm opening into the patient's chest 20 and supporting pressure against the patient's cardia sphincter muscle is maintained exerted from the patient's abdomen. After intussusception, a number of stomach-to-stomach sutures or staples 33a comprising a first fixation device are applied from within the stomach 16 to keep the intussusception intact in the short term. This allows the growth of human tissue, keeping the intussusception intact in the long term. Additional sutures or staples 22b comprising a second fixation device may be provided between a wall portion 16b of the bottom 16 forming part of the invagination of the device 10 and the wall 24a of the esophagus 24 to maintain the device 10 in said position. Similarly, a third fixation device in the form of sutures or staples 22c may be provided between another portion of wall 16c of bottom 16 forming part of the invagination of device 10 and diaphragm 18 to hold device 10 in said position. An alternative modality is shown in Fig. 2B. This modality is in many respects similar to that described with reference to Fig. 2A. Here, however, sutures and staples 22b and 33a are connected to reflux treatment device fixator 10. This embodiment lacks stomach sutures or staples to the diaphragm. An alternative apparatus 19 for the treatment of reflux disorder is depicted in Fig. 3A. This alternative is in many respects similar to those described above with reference to Figs. 1A-C and 2A-B. Thus, a motion restriction device 10 is shown implanted in a human patient. The device 10 comprises a body 13 adapted to bear against a portion of the fundal stomach wall 16 at a position between the patient's diaphragm 18 and fundal stomach wall 16. However, in this alternative, the device 10 does not invaginate in the stomach 16. Instead, the attachment of the device 10 comprises an attachment structure 10a, preferably a net-like structure that is adapted to be in contact with the fundal stomach wall 16a to promote the growth of human tissue to ensure placement long-term reflux disorder treatment device attached to the stomach wall. In the short term, a first fixation device in the form of sutures or staples 44a may be provided between the attachment structure 10a and the bottom wall 16a to hold the attachment structure 10a in place. Attachment structure 10a may be adapted for a second fixation device in the form of sutures or staples 44b that are provided between bottom wall 16a and esophageal wall 24a 24 to maintain device 10 in said position between the diaphragm of the esophagus 24. patient 18 and fundal stomach wall 16. Similarly, attachment structure 10a may also be adapted for a third fixation device in the form of sutures or staples 44c that are provided between fundal wall 16a 16 and diaphragm 18, again , to maintain the device 10 in said position. An alternative modality is shown in Fig. 3B. This embodiment is in many respects similar to that described with reference to Fig. 3A. In this embodiment, the reflux treatment device 10, as in Fig. 2A-B is invaginated from inside the stomach. Attachment structure 10a is placed on bottom wall 16a above and around the intussusception created by reflux treatment device 10. An alternative embodiment of a reflux disorder treatment apparatus 21 according to the invention is depicted in Fig. 4A. This embodiment is in many respects similar to that described above with reference to Figs. 1A-C. In Fig. 4A, a view of a reflux disorder treatment device 10 according to the invention implanted in a human patient is shown. In Fig. 4A, the motion restriction device 10 is again invaginated into the fundus 16. The device 10 comprises a body 13 having an outer surface 15 suitable for bearing against a portion of the outer wall 16a of the stomach wall of fundus 16 at a position between the patient's diaphragm 18 and at least a portion of the lower part of the invaginated fundus stomach wall 16. The body 13 is formed to bear against the outer wall 16a of the fundus 16. Thus, with device 10 invaginated in this way, movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted, thus preventing the cardia from slipping through the opening of the patient's diaphragm towards the patient's thorax 20 and Support pressure against the patient's cardia sphincter muscle is maintained exerted from the patient's abdomen. In the embodiment of Fig. 4A, as in the embodiment of Fig. 1A, after invagination of device 10 into fundus 16, a first fixation device consisting of a number of sutures or stomach clips is applied to stomach 22a to keep the invagination intact in the short term. A second fixation device consisting of a number of sutures or staples 22b is provided to maintain the device 10 in said position between the patient's diaphragm 18 and at least a portion of the lower part of the invaginated fundal stomach wall 16. Additionally, A third fixation device in the form of sutures or staples 22c may be provided between bottom wall 16a and diaphragm 18, again, to hold device 10 in that position. In the embodiment shown in Fig. 4A, the size of the motion restriction device 10 can be adjusted while it is implanted. The device 10 is associated with a hydraulic container 52 connected to the device 10 by a cable 52b, whereby non-invasive regulation can be performed by manually pressing the container 52. The device 10, in turn, is connected to one or more chambers small 10b. Furthermore, the above modality can alternatively be used to also treat obesity. The apparatus, in this embodiment, can be adapted to treat obesity by using the volume of the movement restriction body 13 to contain a fluid, and further using one or more small chambers 10b connected to the body 13 with a pump to be filled with fluid to Stretch the back wall to create satiety. The small chambers 10b are also adapted to invaginate into the fundal ηβ^ηίη / ίζηζ / Β / γι stomach wall, and when filled with fluid, expansion occurs resulting in human sensor feedback creating satiety. By placing the small hydraulic container / pump subcutaneously in the patient, the patient is able to pump hydraulic fluid to fill the small chambers to feel full on demand. An alternative modality is shown in Fig. 4B. This embodiment is substantially similar to that shown in Fig. 4A but differs in how the reflux treatment device 10 and chambers 10b are controlled. Here, the chambers 10b are not controlled by a subcutaneous pump but by a powered internal control unit 56. The internal control unit 56 comprises means for the patient to control the device 10 in how it should be used considering the treatment of reflux and / or obesity. It may also comprise means for supplying power to the device. The interior control unit 56 may comprise a battery 70, an electrical switch 72, a motor / pump 44, a container 52, an injection port 1001. A power transmission device 34 with a remote control is adapted to control and operate the device. These items are selected depending on the circumstances, for example whether the device is operated electrically, hydraulically, pneumatically or mechanically. The control unit may receive input from any sensor 76, especially a pressure sensor. Any type of sensor can be supplied. The internal control unit 56 preferably includes intelligence in the forms of an FPGA or MCU or ASIC or any other circuit, component or memory (For a more extensive description see below under system). Fig. 4C shows essentially the same as Fig. 4A with the difference that there is one small chamber 10b instead of two small chambers as in 4A. Fig. 4C shows the small chamber 10b in its empty state while Fig. 4D shows the small chambers 10b when they have been filled and elongated to create satiety. Yet an alternative embodiment of an apparatus 23 for treating reflux disorder according to the invention is depicted in Fig. 5A. This embodiment is, again, in many respects similar to that described above with reference to Figs. 1A-C. In this way, as in the embodiment of Fig. 1A, a movement restriction device 10, which invaginates at the bottom, is comprised of a body 13 having an outer surface 15 suitable for abutting against a portion of the outer wall 16a of the bottom stomach wall 16 in a position between the patient's diaphragm 18 and at least a portion of the bottom of the invaginated bottom stomach wall 16. The body 13 of the device 10 is formed to abut against the outer wall 16a of the bottom 16 and has a generally smooth outer surface 15 suitable for resting against this bottom wall. And, again, after invagination of the device 10 into the bottom 16, a first fixation device consisting of a number of stomach-to-stomach sutures or staples 22a is applied to keep the invagination intact in the short term. A second fixation device consisting of a number of sutures or staples 22b applied between the wall 16a of the bottom 16 and the wall 24a of the esophagus 24 is provided to maintain the device 10 in said position. In the alternative embodiment shown in Fig. 5A, the apparatus 23 further comprises a stimulation device 26 for sending stimulation pulses adapted to stimulate the ηβΜηη / ίζηζ / Β / γι cardia muscle to further close the cardia to further prevent the disorder of Reflux. The apparatus 23 comprises at least one conductor 26a and at least one electrode 26b adapted to receive the stimulation pulses. The stimulation device 26 preferably comprises an electronic circuit and a power source, which in the preferred embodiment is provided in the device 10. The stimulation device 26 preferably sends stimulation pulses as a train of pulses, wherein the train of pulses is adapted to repeat with a time interruption in between, the interruption extending the interruption between each pulse in the train of pulses. Fig. 5B shows essentially the same embodiment as in Fig. 5A, with the addition of an indoor control unit 56, a remote control 28 and an outdoor power transmission device 34. The indoor control unit 56 connects to the stimulation device with a power cable 56b. The interior control unit 57 may comprise a battery 70 and an electrical switch 72 and other components described below under system. The reflux disorder treatment device 10, according to one embodiment of the present invention, may be formed as a generally egg-shaped body, as shown in Fig. 6A. The reflux disorder treatment device 10, according to another embodiment of the present invention, can also be formed as a sphere- or egg-shaped body with an indentation in its middle, as shown in Fig. 6B. The reflux disorder treatment device 10, according to yet another embodiment of the present invention, can further be formed as a slightly bent egg-shaped body as shown in Fig. 6C. The reflux disorder treatment device 10, according to a further embodiment of the present invention, may be formed as a generally spherical-shaped body, as shown in Fig. 6D. As discussed above, the reflux treatment device 10 is fixed in a position that is above the esophagus in a standing patient. To enable this, one modality of the reflux treatment shown in Fig. 7 comprises a fixator 10d which, for example, can serve as an attachment point for sutures or staples. The fixator may be a loop or ridge with or without holes or have any other shape that makes it suitable for fixing the reflux treatment device 10. Fig. 8 shows an embodiment of the reflux treatment device 10 where it is adjustable by hydraulic means, and 10e is an injection port where hydraulic fluid can be present to expand the device. Alternatively, in one embodiment the reflux treatment device 10 can be inflated from a small size to a larger size during a surgical procedure where it is advantageous for the device to be initially small in size, for example during a laparoscopic procedure. In such an embodiment, any filler material, solid, liquid or gas can be injected through the injection port 10e for the reflux treatment device 10 to achieve its final form. Fig. 9 shows an embodiment where the reflux treatment device 10 has a recessed ridge 10f adapted to be held by a surgical tool. This should be used, for example, during a surgical procedure when the reflux treatment device is implanted. When the reflux disorder treatment device 10 is generally spherical, whereby it can be made to completely or partially comprise the esophagus, the inner diameter D of the reflux disorder treatment device 10 is preferably such that it can comprise the esophagus and at least a portion of the bottom so that the device does not rest directly against the wall of the esophagus when implanted. The motion restriction device 10 may take any shape that allows the device 10 to rest in a position in which the movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted, thus preventing the cardia from slipping. through the patient's diaphragm opening into the patient's chest and supporting pressure against the patient's cardia sphincter muscle is maintained exerted from the patient's abdomen. System A power and operating system, generally designated 28, for incorporation into the apparatus according to the invention, will now be described with reference to Figs. 10 to Fig. 27. The system 28 shown in Fig. 10 comprises an internal energy source in the form of an implanted energy transforming device 30 adapted to supply energy-consuming components of the reflux disorder treatment apparatus with energy through a supply line. of energy 32. An external energy transmission device 34 includes a wireless remote control transmitting a wireless signal, which is received by a signal receiver that may be incorporated into the implanted energy transformer device 30, or detached. The implanted energy transforming device 30 transforms signal energy into electrical energy that is supplied through the power supply line 32. The system 28 of Fig. 10 is shown in a more generalized block diagram form in Fig. 11, where the skin of the patient 36, generally shown by a vertical line, separates the interior of the patient 29 to the right of the outside line to the left of the line. Fig. 11 shows a simplified block diagram showing the motion restriction device 10, the power transforming device 30 driving the device 10 through the power supply line 32, and the external power transmission device 34 . Fig. 12 shows an embodiment of the invention identical to that of Fig. 11, except that a reversal device in the form of an electrical switch 38 operable by polarized energy is also implanted in the patient 29 to reverse the device 10. The wireless remote control of the outdoor power transmission device 34 transmits a wireless signal carrying polarized energy and the implanted power transforming device 30 transforms the polarized wireless energy into a polarized current to operate the electrical switch 38. When the polarity of the current is changed by the implanted energy transforming device 30, the electrical switch 38 reverses the function performed by the device 10. Fig. 13 shows an embodiment of the invention identical to that of Fig. 11, except that an operating device 40 implanted in the patient for regulating the reflux disorder treatment device 10 is provided between the implanted power transformer device 30 and the device 10. This operating device may be in the form of a motor 40, such as an electric servomotor. The motor 40 is driven by power from the implanted energy transforming device 30, as the remote control of the external energy transmission device 34 transmits a wireless signal to the receiver of the implanted energy transforming device 30. Fig. 14 shows an embodiment of the invention identical to that of Fig. 11, except that it also comprises an operating device in the form of an assembly 42 including a motor / pump unit 78 and a fluid container 46 is implemented. in the patient. In this case the device 10 is operated hydraulically, that is, hydraulic fluid is pumped by the motor / pump unit 44 from the fluid container 46 through a conduit 48 to the device 10 to operate the device, and hydraulic fluid is pumped by the motor / pump unit 44 back from the device 10 to the fluid container 46 to return the device 10 to an initial position. The implanted power transforming device 30 transforms wireless energy into a current, for example a polarized current, to drive the motor / pump unit 44 through an electrical power supply line 50. Instead of a hydraulically operated motion restriction device, it is also provided that the operating device has a pneumatically operated operating device. In this case, pressurized air can be used for regulation and the fluid container is replaced by an air chamber and the fluid is replaced by air. In all of these embodiments the power transformer device 30 may include a rechargeable accumulator such as a battery or a capacitor to be charged by wireless power and supplies power for any power consuming part of the appliance. The external power transmission device 34 is preferably wireless and may include a remote controlled control device to control the device 10 from outside the human body. Such a control device may include a wireless remote control as well as a manual control of any part implanted to make contact with the patient's hand most likely indirectly for example, a push button placed under the skin. Fig. 15 shows an embodiment of the invention comprising the external energy transmission device 34 with its wireless remote control, the device 10, in this case hydraulically operated, and the implanted energy transformer device 30, and further comprising a container of hydraulic fluid 52, a motor / pump unit 44 and a reversing device in the form of a hydraulic valve changing device 54, all implanted in the patient. Of course hydraulic operation could easily be carried out by simply changing the pumping direction and the hydraulic valve can therefore be omitted. The remote control may be a separate device from or included in the external power transmission. The motor of the motor / pump unit 44 is an electric motor. In response to a control signal from the wireless remote control of the external power transmission device 34, the implanted power transforming device 30 drives the motor / pump unit 44 with energy from the energy carried by the control signal, whereby The motor / pump unit 44 distributes hydraulic fluid between the hydraulic fluid container 52 and the device 10. The remote control of the external power transmission device 34 controls the hydraulic valve changing device 54 to change the direction of fluid flow hydraulic between one direction in which the fluid is pumped by the motor / pump unit 44 from the hydraulic fluid container 52 to the device 10 to operate the device 10, and another opposite direction in which the fluid is pumped by the motor unit / pump 44 back from device 10 to hydraulic fluid container 52 to return device 10 to an initial position. Fig. 16 shows an embodiment of the invention identical to that of Fig. 15, except that an indoor control unit 56 controlled by the wireless remote control of the outdoor power transmission device 34, an accumulator 58 and a capacitor 60 also are implanted in the patient. The indoor control unit 56 commands the storage of electrical energy received from the implanted energy transforming device 30 in the accumulator 58, which supplies energy to the device 10. In response to a control signal from the wireless remote control of the outdoor energy transmission device 34, the interior control unit 56 either releases electrical energy from the accumulator 58 and transforms the released energy through power lines 62 and 64, or directly transforms electrical energy from the implanted energy transforming device 30 through a power line. 66, the capacitor 60, which stabilizes the electric current, a power line 68 and the power line 64, for the operation of the device 10. The internal control unit is preferably programmable from outside the patient's body. In a preferred embodiment, the interior control unit is programmed to regulate the device 10 to stretch the stomach according to a schedule with pre-programmed time or for the input of any sensor that detects any possible physical parameter of the patient or any functional parameter. Of the device. According to an alternative, the capacitor 60 in the embodiment of Fig. 16 can be omitted. According to another alternative, the accumulator 58 in this embodiment can be omitted. Fig. 17 shows an embodiment of the invention identical to that of Fig. 10, except that a battery 70 for supplying power for the operation of the device 10 and an electrical switch 72 for changing the operation of the device 10 are also implemented in the patient. The electrical switch 72 is operated by power supplied by the implanted power transforming device 30 to switch from an off mode, in which the battery 70 is not in use, to an on mode, in which the battery 70 supplies power for device operation 10. Fig. 18 shows an embodiment of the invention identical to that of Fig. 16, except that an interior control unit 56 controllable by the wireless remote control of the exterior energy transmission device 34 is also implanted in the patient. In this case, the electrical switch 72 is operated by the power supplied by the implanted power transforming device 30 to switch from a power-off mode, in which the wireless remote control is prevented from controlling the indoor control unit 56 and the battery is not is in use, to a sleep mode, in which the remote control is allowed to control the indoor control unit 56 to release electrical energy from the battery 70 for the operation of the device 10. Fig. 19 shows an embodiment of the invention identical to that of Fig. 17, except that an accumulator 58 is replaced by the battery 70 and the implanted components are interconnected differently. In this case, the accumulator 58 stores energy from the implanted energy transforming device 30. In response to a control signal from the wireless remote control of the outdoor energy transmission device 34, the indoor control unit 56 controls the electrical switch 72 to switch from an off mode, in which the accumulator 58 is not in use, to an on mode, in which the accumulator 58 supplies power for the operation of the device 10. Fig. 20 shows an embodiment of the invention identical to that of Fig. 18, except that a battery 70 is also implanted in the patient and the implanted components are interconnected differently. In response to a control signal from the wireless remote control of the outdoor power transmission device 34, the indoor control unit 56 controls the accumulator 58 to supply power to operate the electrical switch 72 to switch from an off mode, in which the battery 70 is not in use, to an on mode, in which the battery 70 supplies electrical power for the operation of the device 10. Alternatively, the electrical switch 72 may be operated by power supplied by the accumulator 58 to switch from an off mode, in which the wireless remote control is prevented from controlling the battery 70 to supply electrical power and is not in use, to an on mode. sleep, in which the wireless remote control is allowed to control the battery 70 to supply electrical power for the operation of the device 10. It must be understood that the switch must be interpreted in its broadest form. This means an FPGA or DA converter or any other electronic circuit or component can activate or deactivate the power preferably by being controlled from outside the patient's body or by an internal control unit. Fig. 21 shows an embodiment of the invention identical to that of Fig. 17, except that a motor 40, a mechanical reversing device in the form of a gear box 74, and an internal control unit 56 for controlling the Gearbox 74 are also implanted in the patient. The interior control unit 56 controls the gearbox 74 to reverse the function performed by the device 10 (mechanically operated). Even simpler is to change the direction of the motor electronically. Fig. 22 shows an embodiment of the invention identical to that of Fig. 20 except that the implanted components are interconnected differently. Thus, in this case, the interior control unit 56 is powered by the battery 70 when the accumulator 58, suitably a capacitor, activates the electrical switch 72 to change to an on mode. When the electrical switch 72 is in its on mode, the indoor control unit 56 is allowed to control the battery 70 to supply, or not supply, power for the operation of the device 10. Fig. 23 schematically shows conceivable combinations of implanted components of the apparatus to achieve various communication options. Basically, there are the device 10, the indoor control unit 56, motor or pump unit 44, and the outdoor power transmission device 34 including the outdoor wireless remote controller. As already described above the wireless remote control transmits a control signal which is received by the internal control unit 56, which in turn controls the various implanted components of the apparatus. ηβΜηη / ίζηζ / Β / γι A feedback device, preferably in the form of a sensor 76, can be implanted in the patient to detect a physical parameter of the patient, such as a wave of contraction in the esophagus that informs that the patient is eating. The indoor control unit 56, or alternatively the outdoor wireless remote control of the outdoor power transmission device 34, may control the device 10 in response to signals from the sensor 76. A transceiver may be combined with the sensor 76 to send information on the parameter physical detected to the outdoor wireless remote control. The wireless remote control may comprise a signal transmitter or transceiver and the indoor control unit 56 may comprise a signal receiver or transceiver. Alternatively, the wireless remote control may comprise a signal transceiver or receiver and the indoor control unit 56 may comprise a signal transceiver or transmitter. The above transceivers, transmitters and receivers can be used to send information or data related to the device 10 from inside the patient's body to the outside of the patient. Alternatively, the sensor 76 may be installed to detect a functional parameter of the device 10. Where the motor / pump unit 44 and battery 70 for driving the motor / pump unit 44 are implanted, the battery 70 can be equipped with a transceiver to send information on the condition of the battery 70. To be more precise, when charging feedback information related to said charging process is sent to a powered battery or accumulator and the power supply is switched accordingly. Fig. 24 shows an alternative embodiment where the device 10 is regulated from outside the patient's body. The system 28 comprises a movement restriction device 10 connected to a battery 70 through a subcutaneous switch 80. In this way, the regulation of the device 10 is performed non-invasively by manually depressing the subcutaneous switch, whereby the operation of device 10 is activated or deactivated. It will be appreciated that the embodiment shown is a simplification and that additional components, such as an internal control unit or any other part described in the present application may be added to the system. Fig. 25 shows an alternative embodiment, where the system 28 comprises a movement restriction device 10 in fluid connection with a hydraulic fluid container 52. Non-invasive regulation is performed by manually depressing the hydraulic container connected to the device 10. A further embodiment of a system to be incorporated in the apparatus according to the invention comprises a feedback device for sending information from inside the patient's body to the outside thereof to give feedback information related to at least one functional parameter of the restriction device. of movement or apparatus or a physical parameter of the patient, thus optimizing the performance of the apparatus. A preferred functional parameter of the device correlates with the transfer of energy to charge the internal power source. In Fig. 26, an installation for supplying an exact amount of energy to a system 28 implanted in a patient, whose skin 36 is indicated by a vertical line, is schematically illustrated. A motion restriction device 10 is connected to an implanted energy transforming device 30, likewise located within the patient, preferably just under the skin of the patient 36. Generally speaking, the implanted energy transforming device 30 can be placed in the abdomen, thorax, muscle fascia (for example in the abdominal wall), subcutaneously, or in any other suitable location. The implanted energy transforming device 30 is adapted to receive wireless energy E transmitted from an external energy source 34a provided on the external energy transmission device 34 located outside the skin of the patient 36 in the vicinity of the implanted energy transforming device 30 . As is well known in the art, wireless energy E can generally be transferred by means of any Transcutaneous Energy Transfer (TET) device, such as a device including a primary coil installed on the external power source 34a and an adjacent secondary coil. installed in the implanted energy transforming device 30. When an electrical current is fed through the primary coil, energy in the form of a voltage is induced in the secondary coil which can be used to operate a motion restraint device, e.g. example after storing the incoming energy in an accumulator or energy storing device, such as a battery or capacitor. However, the present invention is generally not limited to any particular energy transfer technique, ETT devices or energy storage devices, and any kind of wireless energy can be used. The amount of energy received inside the body to the device can be compared to the energy used by the device. The term used by the device is then understood to also include energy stored by the device. The amount of energy transferred can be regulated by an external control unit 34b that controls the external energy source 34a based on the determined energy balance, as described above. To transfer the correct amount of energy, the energy balance and the required amount of energy can be determined by means of an interior control unit 56 connected to the reflux disorder treatment device 10. The interior control unit 56 can thus be installed to receive various measurements obtained by suitable sensors or the like, not shown, measuring certain characteristics of the r10, in some way reflecting the required amount of energy necessary for the proper operation of the device 10. In addition, the current condition of the patient can also be detected through appropriate sensors or measuring devices, to provide parameters that reflect the patient's condition. Therefore, such characteristics and / or parameters may be related to the current state of the device 10, such as power consumption, operational mode and temperature, as well as the patient's condition reflected, for example, by body temperature, blood pressure, heart rate. heart and breathing. Additionally, an accumulator or energy storing device 58 may optionally be connected to the implanted energy transforming device 30 to accumulate received energy for later use by the device 10. Alternatively or additionally, the characteristics of such an accumulator may also be measured, also reflecting the amount of energy required. The accumulator can be replaced by a battery, and the measured characteristics can be related to the current state of the battery, such as voltage, temperature, etc. To provide sufficient voltage and current to the device 10, and also to avoid excessive heating, it is clearly understood that the battery must be optimally charged by receiving a correct amount of energy from the implanted energy transforming device 30, that is, neither too little nor too much. . The accumulator can also be a capacitor with corresponding characteristics. For example, the characteristics of the battery can be measured on a regular basis to determine the current state of the battery, which can then be stored as status information in a suitable storage medium in the indoor control unit 56. In this way, Every time a new measurement is made, the stored battery status information can be updated accordingly. In this way, the battery status can be calibrated by transferring a correct amount of energy, to keep the battery in optimal condition. In this way, the internal control unit 56 is adapted to determine the energy balance and / or the amount of energy currently required, (either energy per unit of time or accumulated energy) based on the measurements made by the control devices. measurement or sensors mentioned above in the reflux disorder treatment device 10, or the patient, or an energy storing device if used, or any combination thereof. The indoor control unit 56 is further connected to an indoor signal transmitter 82, installed to transmit a control signal reflecting the determined required amount of energy, to an outdoor signal receiver 34c connected to the outdoor control unit 34b. The amount of power transmitted from the external power source 34a can then be regulated in response to the received control signal. Alternatively, the sensor measurements may be transmitted directly to the outdoor control unit 34b where the power balance and / or the amount of energy currently required may be determined by the outdoor control unit 34b, thereby integrating the above-described function of the indoor control unit 56 into the outdoor control unit 34b. In such a case, the indoor control unit 56 can be bypassed and the sensor measurements are supplied directly to the indoor signal transmitter 82 which sends the measurements to the outdoor signal receiver 34c and the outdoor control unit 34b. The power balance and the amount of power currently required can then be determined by the external control unit 34b based on those sensor measurements. Therefore, the present solution employs information feedback indicating the required energy, which is more efficient than previous solutions as it is based on the current energy usage which is compared to the energy received, for example with respect to the amount of energy, the difference in energy, or the rate of receiving energy as compared to the rate of energy used by the device 10. The device 10 can use the received energy either to consume or to store the energy in a storage device. energy storage or similar. The different parameters discussed above in this way should be used if relevant and necessary and then as a tool to determine the current energy balance. However, such parameters may also be needed per se for any actions taken internally to specifically operate the device. The indoor signal transmitter 82 and the outdoor signal receiver 34c may be implemented as separate units using suitable signal transfer media, such as radio, IR (infrared) or ultrasonic signals. Alternatively, the indoor signal transmitter 82 and the outdoor signal receiver 34c may be integrated into the implanted power transformer device 30 and the outdoor power source 34a, respectively, to transmit control signals in a reverse direction relative to the energy transfer. , basically using the same transmission technique. Control signals can be modulated with respect to frequency, phase or amplitude. To conclude, the power supply facility illustrated in Fig. 26 can be basically operated as follows. The power balance is first determined by the indoor control unit 56. A control signal reflecting the required amount of energy is also created by the indoor control unit 56, and the control signal is transmitted from the indoor signal transmitter 82. to the external signal receiver 34c. Alternatively, the power balance may be determined by the external control unit 34b instead of depending on the implementation, as mentioned above. In that case, the control signal can carry measurement results from various sensors. The amount of energy emitted from the external power source 34a can then be regulated by the external control unit 34b, based on the determined energy balance, for example in response to the received control signal. This process may be repeated intermittently at certain intervals during the energy transfer process, or may be executed on a more or less continuous basis during the energy transfer. The amount of energy transferred can generally be regulated by adjusting various transmission parameters in the external power source 34a, such as voltage, current, amplitude, wave frequency and pulse characteristics. Thus provided is a method for controlling the transmission of wireless energy delivered to an electrically operable reflux disorder treatment device implanted in a patient. Wireless energy E is transmitted from an exterior power source located outside the patient and received by an interior energy receiver located within the patient, the interior energy receiver connecting to device 10 to directly or indirectly supply received energy thereto. A power balance is determined between the power received by the indoor power receiver and the power used for the device 10. The wireless power transmission E from the outdoor power source is then controlled based on the determined power balance. Also provided is a system for controlling wireless power transmission delivered to an electrically operable motion restriction device 10 implanted in a patient. The system is adapted to transmit wireless energy E from an external energy source located outside the patient that is received by an implanted energy transforming device located within the patient, the implanted energy transforming device connecting to the device 10 to directly or indirectly supply energy received to it. The system is further adapted to determine an energy balance between the energy received by the implanted energy transforming device and the energy used for the device 10, and control the wireless energy transmission E of the external energy source, based on the balance of determined energy. The functional parameter of the device is correlated with the energy transfer to charge the internal energy source. In yet an alternative embodiment, the external power source is controlled from outside the patient's body to release wireless electromagnetic energy, and the released wireless electromagnetic energy is used to operate the device 10. In another embodiment, the external power source is controlled from outside the patient's body to release non-magnetic wireless energy, and the released non-magnetic wireless energy is used to operate the device 10. Those skilled in the art will appreciate that the various above embodiments according to Figs. 14 to Fig. 26 could be combined in many different ways. For example, the electrical switch 38 operated with polarized power could be incorporated in any of the embodiments of Fig. 12, Fig. 15 to Fig. 21, the hydraulic valve changing device 54 could be incorporated in the embodiment of Fig. 24, and the gearbox 74 could be incorporated in the embodiment of Fig. 33. It should be noted that the switch could simply mean any electronic component or circuit. Wireless transfer of energy to operate the motion restriction device 10 has been described to allow non-invasive operation. It will be appreciated that the device 10 can be operated with wire-bound power as well. Such an example is shown in Fig. 26, where an outdoor switch 84 is interconnected between the outdoor power source 34a and an operating device, such as an electric motor that regulates the device 10, by means of power lines 86 and 88. An exterior control unit 34b controls the operation of the exterior switch to effect proper operation of the device 10. Pneumatic or hydraulic drive Fig. 28 to Fig. 31 show in more detail block diagrams of four different ways to hydraulically or pneumatically actuate a motion restriction device according to the invention. Fig. 28 shows a system for treating reflux disorder as described above. The system comprises a device 10 and also a separate regulating vessel 46, a one-way pump 44 and a toggle valve 54. Fig. 29 shows the device 10 and a fluid container 46. By moving the wall of the regulation container or changing its size in any other way, the adjustment of the device can be carried out without any valve, only free passage of fluid at any time by moving the container wall. Fig. 30 shows the device 10, a two-way pump 44 and the regulating vessel 46. Fig. 31 shows a block diagram of a reverse servo system with a first closed system controlling a second closed system. The servo system comprises a regulating container 46 and a servo container 90. The servo container 90 mechanically controls a motion restriction device 10 through a mechanical interface 94. The device 10 has an expandable / contactable cavity. This cavity preferably expands or contracts by supplying hydraulic fluid from the larger adjustable container 92 in fluid connection with the device 10. Alternatively, the cavity contains compressible gas, which can be compressed and expanded under the control of the servo container 90. The servo container 90 may also be part of the device itself. In one embodiment, the regulating container is placed subcutaneously under the skin of the patient and is operated by pushing the outer surface thereof with a finger. This reflux disorder treatment system is illustrated in Fig. 32c. In Fig. 31, a flexible subcutaneous regulation container 46 is shown connected to a bulge-shaped servo container 90 by means of a conduit 48. This bellows-shaped servo container 90 is comprised of a flexible motion restriction device. 10. In the state shown in Fig. 32a, the servo container 90 contains a minimum of fluid and the majority of fluid is in the regulating container 46. Due to the mechanical interconnection between the servo container 90 and the device 10, the external shape of the device 10 contracts, that is, it occupies less than its maximum volume. This maximum volume is shown with hatched lines in the figure. Fig. 32b shows a state where a user, such as the patient in whom the device is implanted, presses the regulation container 46 so that the fluid contained therein flows through the conduit 48 and into the servo container 90. , which thanks to its bellows shape, expands longitudinally. This expansion in turn expands the device 10 so that it occupies its maximum volume, thus stretching the stomach wall (not shown), which it contacts. The regulating container 46 is preferably provided with a means 46a for maintaining its shape after compression. This means, shown schematically in the figure, will thus also maintain the device 10 in a stretched position when the user releases the regulating container. In this way, the regulation vessel essentially operates as an on / off switch for the reflux disorder treatment system. An alternative mode of pneumatic or hydraulic operation will now be described with reference to Figs. 33, 34a, 34b and 34c. The block diagram shown in Fig. 33 comprises a first closed system controlling a second closed system. The first system comprises a regulating container 46 and a servo container 90. The servo container 90 mechanically controls a larger adjustable container 92 through a mechanical interconnection 94. A motion restriction device 10 having an expandable / contactable cavity at its It is instead controlled by the larger adjustable container 92 by supplying hydraulic fluid from the larger adjustable container 92 in fluid connection with the device 10. An example of this embodiment will now be described with reference to Fig. 34a, Fig. 34b and Fig. 34c. As in the previous embodiment, the regulation container is placed subcutaneously under the patient's skin and is operated by pushing the outer surface thereof with a finger. The regulation container 46 is in fluid connection with a bellows-shaped servo container 90 by means of a conduit 48. In the first closed system 46, 48, 90 shown in Fig. 32a, the servo container 90 contains a minimum of fluid and most of the fluid is in the regulating vessel 46. The servo container 90 is mechanically connected to a larger adjustable container 92, in this example also having a bellows shape but with a larger diameter than the servo container 90. The larger adjustable container 92 is in fluid connection with the device 10. This means that when a user pushes the regulation container 46, thereby displacing fluid from the regulation container 46 to the servo container 90, the expansion of the servo container 90 will displace a larger volume of fluid from the larger adjustable container 92 to the device 10. In other words, in this reverse servo, a small volume in the regulating vessel is compressed with a higher force and this creates a movement of a larger total area with less force per unit area. As in the previous embodiment described above with reference to Figs. 32a, 32b and 32c, the buffer container 46 is preferably provided with a means 46a to maintain its shape after compression. This means, shown schematically in the figure, will thus maintain the device 10 in a stretched position also when the user releases the regulating container. In this way, the regulation vessel essentially operates as an on / off switch for the reflux disorder treatment system. In Fig. 35, a flow chart is shown illustrating the steps performed when implanting a device in accordance with the present invention. First in a step 102, an opening is cut in the abdominal wall. Next, in a step 104, an area around the stomach is dissected. Thereafter, in a step 106 at least one movement restriction device according to the invention is placed in contact with the stomach wall, in particular the bottom wall. The stomach wall is then sutured in step 108. Method for restoration of the location of the cardia v the fundus Fig. 36 shows how an instrument 200 having at least one flexible part 201 is introduced into the esophagus 24 of a patient suffering from a hiatal hernia 202 where a part of the esophagus 24 and bottom 16 that is supposed to be located below the diaphragm 18 has moved through the hiatal opening 18a to a position above the diaphragm 18. Fig. 37 shows how, in a subsequent step, a member 203 having a cross-sectional area larger than said instrument 200 is released from instrument 200. Member 203 is adapted to have a cross-sectional area that is larger than said instrument 200. the opening of the cardia 14. This can be achieved by radial expansion of the member 203. The instrument 200 is then pushed in a distal direction so that the cardia 14 and the fundus 16, or part of the fundus 16, incorrectly located above the diaphragm 18, slide through the hiatal opening 18a back to a correct position below the diaphragm 18. Figure 38 shows an alternative method to one shown in Fig. 37 which is an embodiment of the invention. In many respects, this Figure is similar to Fig. 37. In Figure 38, the instrument 200 is adapted to release a balloon member 204 at the end 205 of the instrument 200 at the bottom of the stomach 206, and using the balloon member balloon 204 to push the instrument 200 against the lower wall portion of the stomach 207 so that the cardia 14 and the fundus 16 or part of the fundus 16 slide through the hiatal opening 18a to a position below the diaphragm 18. Figure 39 still shows an alternative method that is a modality of the invention. Again, this figure is in many respects similar to Figure 37. However, in Figure 39 the method includes ηβ^ηίη / ίζηζ / Β / γι attaching the member 203 to the stomach wall 207 by a fixation 208. As shown described above the instrument is then pushed in a distal direction so that the cardia 14 and the fundus 16 or, part of the fundus 16, slide under the diaphragm 18. Figure 40 shows how the fundus 16 and cardia 14 are located in a position below the diaphragm 18 after being pushed through the hiatal opening 18a by the instrument 200. Figure 41 shows the subsequent step of the method. After the fundus 16 and cardia 14 have been pushed into their correct position below the diaphragm 18, the fundus wall 16a is fixed to the lower part of the esophagus 24. This is carried out by using a member 209 at the bottom proximal 205 of the instrument 200 that is capable of providing sutures or staples 210. The fixation hinders the movement of the cardia 14 and the fundus 16a to a position above the diaphragm 18. Other methods according to the invention are briefly described below. A method of treating reflux disorder of a patient comprises the step of implanting a reflux disorder treatment system according to the invention into the patient's body. A method of using the system to treat reflux disorder according to the invention comprises the step of regulating the device postoperatively to prevent reflux. A method of surgically placing a motion restriction device according to the invention in a patient comprises the steps of cutting an opening in the abdominal wall of the patient, dissecting the area around the stomach, placing a motion restriction device attached to the stomach wall, and suture the stomach wall. A method of using a reflux disorder treatment system, postoperatively controlled from outside the body, regulating the device, comprises the steps of filling a volume attached to a part of the stomach wall, and regulating the device from outside the body of the patient to affect the patient's reflux. A method of using a motion restraint device comprises the steps of filling a volume in a first portion of the stomach wall by placing a first portion of the device, filling a volume in a second portion of the stomach wall by placing a second portion of the device, and regulate the devices from outside the patient's body to affect the patient's reflux. A method of treating reflux disorder in a patient comprises the steps of inserting a needle or tube-like instrument into the abdomen of the patient's body, using the needle or tube-like instrument to fill the patient's abdomen with expanding gas. thus the abdominal cavity, place at least two laparoscopic trocars in the patient's body, insert a camera through one of the laparoscopic trocars in the patient's abdomen, insert at least one dissection tool through one of said at least two laparoscopic trocars and dissect a proposed placement area of ​​at least a portion of the patient's stomach, place a motion restriction device according to the invention on the fundus stomach wall, invaginate the device on the fundus stomach wall, suture the stomach wall to itself to hold the device in place, suture the bottom of the stomach toward the lower part of the esophagus, and prevent the cardia from sliding up through the diaphragm into the thorax. Use of the method and device as described herein will provide a treatment of Gastroesophageal Reflux Disease that is very effective and does not suffer from complications such as tissue damage and unwanted migration of non-tissue into tissue. The filling body of the device may be adapted to be pushed or pulled through a trocar for laparoscopic use, where the trocar has a diameter that is smaller than the relaxed diameter of the body. The filling body may include an outer wall and a hollow inner portion filled with gas that allows the body to pass through the trocar. Alternatively, the filling body may include an outer wall and a hollow inner portion filled with fluid that allows the body to pass through the trocar. In the latter case, the fluid can be a gel. The filling body may further include multiple parts that can be inserted into the trocar, and which can then be placed together in a unitary piece within the patient's body, allowing the filling body to pass through the trocar. The filling body may include an outer wall and a hollow compressed inner portion that is filled with a fluid or gel after insertion into the patient's body. It may further include an injection port that can be used to fill the filling body with a fluid after insertion into the patient's body through the injection port. The filling body of the device may be an elastic compressible material, allowing the filling body to pass through the trocar. The filler body can be made of a material that is softer than 25 shure, or even 15 shure. The filling body may also include an outer wall substantially taking the shape of a ball. The filling body may also include at least one holding device adapted to be used to push or pull the filling body through a trocar for laparoscopic use. The holding device may be adapted to hold an extension of the device that is adapted to be held by a surgical instrument. The clamping device may also hold a passage or band inserted through the clamping device. The holding device may also be at least partially placed within the outer wall of the filling body. The filling body of the device may preferably have a size that is larger than the intestinal outlet of the stomach, to avoid ileus if the ball, as a complication, must enter the stomach. Preferably, the body has a smaller outer diameter between 30 mm and 40 mm or larger. Preferably, the body has a smaller outer circumference between 30 mm and 150 mm. Preferred embodiments of a device for treating reflux disorder, a system comprising a device for treating reflux disorder, and a method according to the invention have been described. A person skilled in the art notes that this could be varied within the scope of the appended claims. Thus, although the different features have been described in specific embodiments, it will be appreciated that they can be combined in different configurations where applicable. For example, although hydraulic control has been described in association with the device configuration of Figures 4A to Figure 4B, it can also be applied to the device configurations of Figs. 2A, 2B, 3A AND 3B. It is important that the implanted reflux treatment device stay firmly in place on the stomach wall into which it invaginates. To this end, the reflux treatment device may be provided with one or more through holes adapted to receive sutures or staples used for fixation of the intussusception. Such an embodiment is shown in Fig. 42, where the reflux treatment device 10 is provided with a row of holes 10i provided in a projection-like protrusion on the reflux treatment device. In this embodiment, the row of holes extends along the longitudinal axis of the reflux treatment device. Fig. 43 illustrates how the sutures 314 are provided so that they pass through the stomach wall 12a and through the holes 10i. In this way, the reflux treatment device is fixed in place in the pocket created in the stomach wall and will thus be prevented from slipping out. Although a plurality of holes is illustrated in Fig. 42, it will be appreciated that a single hole is sufficient to obtain improved fixation of the reflux treatment device 10. Fig. 44 illustrates a reflux treatment device provided with an inlet port 10h. The reflux treatment device is invaginated into the stomach wall and the inlet port 10h is available for connection to a tube or the like in the patient's abdominal area. Fig. 45 illustrates an invaginated reflux treatment device where, instead of an entry port, a 10g fixed tube extends into the patient's abdominal area. Fig. 46 is a figure similar to Fig. 44 but also illustrating the placement of a connecting tube 10g in the stomach wall between the inlet port 10h and the reflux treatment device 10. It has been shown that the shape of the reflux treatment device can take many different forms. It will be appreciated that the material of the reflux treatment device may also vary. It is preferred that the reflux treatment device be provided with a coating, such as a Parylene, polytetrafluoroethylene (PTFE), or polyurethane coating, or a combination of such coatings, ie, a multilayer coating. This coating or multilayer coating improves the properties of the reflux treatment device, such as its resistance to wear. In one embodiment, the reflux treatment device comprises an unreliable device expandable to an expanded state. In this case, the reliable device is provided with an inlet port for a fluid and is adapted to connect to a gastroscopic instrument. This embodiment will now be described in detail with reference to Figs. 47a to Fig.47d. A reliable reflux treatment device in its unexpanded state is shown in Fig. 47a. It is essentially a deflated device, similar to a balloon 10 having an entry port 10h. In this state, the unreliable device has a diameter of a few millimeters at most, allowing it to be inserted into the stomach through the patient's esophagus by means of a gastroscopic tube-like instrument 600, shown in Fig. 47b. . The instrument comprises an outer sheath 600a and an inner sheath 600b that is longitudinally movable relative to the outer sheath. The inner sheath is provided with a cutter in the form of a cutting edge 615 at the distal end thereof. This cutting edge can be used to cut a hole in the stomach wall, as will be explained in detail below. When the instrument reaches a stomach wall, see Fig. 47c, the inner sheath is advanced from its position in the outer sheath and into contact with the stomach wall 12a. The cutting edge 615 of the inner sleeve then cuts a hole in the stomach wall to allow subsequent insertion of the reflux treatment device 10 into and through this hole, see Fig. 47d. To push the reflux treatment device through the hole, a piston 602 may be provided in the instrument. Thus, the instrument further comprises a piston 602 adapted to push a deflated reflux treatment device 10 out of a position in the inner sheath, this position being shown in Fig. 47b, to a position outside the inner sheath, this shown in Fig. 47d. To protect the deflated reflux treatment device 10 from the cutting edge 615 of the inner sleeve, an additional protective sleeve (not shown) may be provided around the reflux treatment device. An intraluminal method for invaginating a reflux treatment device 10 on the exterior of stomach wall 12a will now be described with reference to Figs. 48a-! Initially, an instrument 600, preferably a gastroscopic instrument, is inserted into the patient's mouth, see Fig. 48a. The instrument comprises an injection device 601, 602 for injecting either fluid or a device into the patient's stomach. The instrument 600 further comprises a control unit 606 adapted to control the operation of the instrument. For this purpose, the control unit 606 comprises one or more steering devices, in the embodiment shown in the figure in the form of two joysticks 603 and two control buttons 604. A screen 605 is provided to display the provided image. by a camera (not shown) installed at the outer end of the elongated member 607, see Fig. 48e to Fig. 48i. The camera can be assisted by a light source (not shown). The instrument is further inserted into the esophagus and into the patient's stomach, see Fig. 48b. By means of the instrument 600, a hole 12b is created in the stomach wall 12. For this purpose, the instrument is provided with one or more cutters 615 at the distal end thereof, for example in the manner described above with reference to Fig. 47a to Fig. 47d. These cutters can of course be designed in different ways, such as a toothed drum cutter rotating around the central axis of the tube-like instrument. The instrument 600 is hollow providing a space for the reflux treatment device 10 in its deflated state. After cutting a hole in the stomach wall, the distal end of the instrument 600 is inserted into and through the hole 12b so that it terminates outside the stomach wall 12a. This is shown in Fig. 48c, showing a side view of the stomach 12, and Fig. 48d, which is a sectional view through the stomach of Fig. 48c taken along the lines Vd-Vd. The deflated reflux treatment device 10 is then inserted into the abdominal area. The instrument 600 is adapted to create a pocket or pouch on the outside of the stomach 12 around the hole 12b in the stomach wall. Such an instrument and the method of providing the bag will now be described. Fig. 48e to 48¡ show a laparoscopic or gastroscopic instrument for invaginating a reflux treatment device 10 into the stomach wall 12a of the patient by creating a stomach wall pocket 12a material in which the reflux treatment device is placed. . The instrument, generally designated 600, and which may comprise the features described above with reference to Fig. 47a to Fig. 47d, comprises an elongated member 607 having a proximal end and a distal end, the elongated member 607 having a smaller diameter to that of the patient's esophagus and being flexible to allow the introduction of the flexible elongated member 607 with its first distal end through the patient's throat, esophagus and into the stomach 12 to the stomach wall 12a. The cutter or stomach penetration device 615 is provided in the elongated member 607 at the distal end thereof to penetrate the stomach wall 12a to create a hole in the stomach wall 12a, to allow introduction of the elongated member 607 through the hole . The stomach penetrating device 615 could be adapted to be operable to retract said stomach penetrating device 615 after the bottom stomach wall 12a has been penetrated, so as not to further damage tissue within the body. The instrument further comprises a special clamping device 609 provided on the elongated member 607 on the proximal side to the penetration device 615. The elongated member further comprises an expandable member 611 that is adapted to expand after the elongated member has penetrated the stomach wall 12a and thereby assist in creating a cavity or pouch adapted to hold the reflux treatment device 610. The member Expandable 611 may comprise an inflatable circular balloon provided circumferentially around the distal end portion of the flexible elongate member 607. The steps of the method when the reflux treatment device is invaginated will now be described in detail. After the instrument 600 has been inserted into the stomach 12, the stomach penetration device 615 is placed in contact with the stomach wall 12a, see Fig. 48e. The cutter or stomach penetration device 615 is then brought to create the hole 12b in the stomach wall, after which at least the expandable member 611 is passed through the hole 12b in the stomach wall. The special clamping device 609 in this step is brought to a clamping state where it expands radially to form an essentially circular abutting surface to the stomach wall 12a, see Fig. 48f. In this way, the insertion of the stomach penetration device 615 and the expandable member 611 through the hole 12a in the stomach wall is limited to the position shown in Fig. 48f. The expandable member 611 is then expanded. In the case where the expandable member comprises a balloon or the like, air or other fluid is injected therein. The portion of the elongated member 607 comprising the expandable member 611 is then retracted in the proximal direction, as indicated by the arrow in Fig. 48g, thereby pulling the stomach wall 612 toward a basket-like structure created by the clamping device. special 609. A stapling or suturing device 608 is further provided, either as a device connected to the elongate member 607 or as a separate instrument. The stapling or suturing member comprises a stapling or suturing end 613 that is adapted to close the cavity or pouch by means of sutures or staples 14 from stomach to stomach. In a further step, illustrated in Fig. 48h, a reliable reflux treatment device 10 is placed in its deflated state in the basket-like structure. The reflux treatment device 10 is then inflated to its inflated or expanded state, see Fig. 48i. This inflation of the reflux treatment device 10 can be accomplished by injecting a fluid or gel into the deflated reflux treatment device. It can also be performed by injecting a material that is allowed to cure, thus forming a solid device 10. In this way, the reflux treatment device 10 shown in Figs. 48h and 48i may illustrate either a balloon-like device that is subsequently filled with fluid or gel or alternatively a material that is simply injected into the basket-like structure formed by the stomach wall 12a. The fluid used to fill the reflux treatment device 10 could be any fluid suitable for filling the backflush device 10, such as a salt solution. In another embodiment, when this fluid is a fluid that is adapted to transform into a solid state, the fluid could be liquid polyurethane. To minimize or completely eliminate spillage, the fluid is isotonic, meaning it has the same osmolarity as human body fluids. Another way to prevent diffusion is to provide a fluid comprising large molecules, such as iodine molecules. Stomach-to-stomach sutures or staples are preferably provided with fixation portions exhibiting a structure, such as a net-like structure, adapted to contact the stomach wall to promote ingrowth of human tissue to ensure placement. long-term use of the reflux treatment device attached to the stomach wall. After the non-reliable device 10 has been inflated, partially or completely, the inlet port 10b (not shown in Figs. 48h and 48i) of the reflux treatment device 10 is sealed and the instrument 600 is retracted from the hole 12b , which is subsequently closed in some suitable manner, such as by means of the instrument 600. The instrument is then removed from the stomach 600 and the unreliable device 10 in its inflated or expanded state is invaginated by a portion of the patient's stomach wall on the outside of the stomach wall. During one or more of the steps described above, the stomach may be inflated with gas, preferably by means of the gastroscopic instrument. The reflux treatment device 10 described above with reference to Figs. 48a-i has been described as an inflatable reflux treatment device. It will be appreciated that it may also be an elastic reflux treatment device with an elasticity that allows compression for insertion into a gastroscopic instrument and that expands to an expanded state after leaving the instrument. The reflux treatment device may have the additional functionality of treating obesity. In such an embodiment, the reflux treatment device may be a volume filling device that fills a volume of the stomach and thereby creates satiety. An embodiment having this function is shown in Fig. 49, where a combined reflux treatment device and obesity treatment device 310 invaginate into the stomach wall close to and at least partially above the cardia of the patient 14 when the patient is in a standing position and is fixed to a position above the cardia area 14c by a fixation, such as sutures or staples 22. For example, direct or indirect fixation may be provided to the diaphragm muscle or associated muscles. As an alternative, direct or indirect fixation to the esophagus above and close to the angle of His can be provided. In this alternative embodiment, the combined device 310 rests in a position against the fundal stomach wall when implanted and also fills a volume above the cardia area 14c between the cardia and the diaphragm muscle so that the cardia slides upward into the chest cavity, thereby preventing reflux disorder. Such a combined device 310 may be used to conserve electronics and / or a source of power and / or hydraulic fluid. The hydraulic fluid from that device can be distributed to several smaller inflatable areas of the device to vary the stretching area from time to time avoiding any possible more permanent stretching effects of the stomach wall. Even mechanically several stretching areas can be used. Reflux Treatment Device-Stretching Device Combination In an alternative embodiment, shown in Fig. 50, the volume of a reliable reflux treatment device 310 may be in fluid connection with one or more preferably smaller inflatable chambers or devices 10b. These chambers are adapted to communicate with fluid or air moving between the chambers. In this way, the large chamber 310 is adapted, with its main volume to be a reflux treatment device to reduce the size of the food cavity and to treat reflux disorder and the one or more small chambers are adapted to function as inflatable devices to treat obesity, where the main chamber is adapted to communicate with fluid or air to the small chambers causing a stretching effect on the stomach wall, thus also treating obesity. Fig. 51 shows an embodiment with a combination of an invaginated volume filling device in the central or lower portion of the stomach and an invaginated stretching device in the upper or lower portion of the patient's stomach. These two devices are used to treat obesity. The 399 volume filling device fills a volume of the stomach creating satiety. The stretching device stretches the stomach wall. This stretches the tissue by triggering endogenous signaling that creates satiety. This mimics the stretching effect of filling the stomach with food. In this way, an adjustable volume filling device 399 is shown in Fig. 51, which invaginates into the stomach wall of a patient's stomach 312. Additionally, an adjustable stretching device 350 with the previously described function invaginates into the patient's bottom stomach wall. It is preferred that the volume filling device 399 be substantially larger than the stretching device 350. The volume filling device 399 and the stretching device 350 can be adapted ηβ^ηίη / ίζηζ / Β / γι to treat reflux. In one embodiment, the volume filling device and stretching device are positioned to prevent the cardia 14 from sliding upward through the hernia opening 18a to a position above the diaphragm 18. The volume filling device 399 and the stretching device 350 are in fluid communication with each other through a first fluid tube 352, in which a pump 354 is provided. The pump 354 is under the control of a flow transformer device. energy 330, which is adapted to supply the pump 350 with energy through a power supply line 356. The energy transforming device 330 also connects to a sensor 319 provided in the esophagus of the patient so that the intake can be detected food. The reflux treatment device 10 and the stretching device 350 are also in fluid communication with each other through a second fluid tube 358, which preferably has a smaller cross-sectional area than the first fluid tube 352. The operation of this installation is as follows. The volume filling device 399 functions as in the embodiments described above, that is, it reduces the size of the food cavity of the patient's stomach 12. Additionally, when the stretching device 350 is elongated by pumping fluid from the volume filling device volume 10 and to the stretching device 350 by means of the pump 354, the bottom stomach wall is stretched, creating a feeling of satiety for the patient. In this way, for example when food intake is detected by sensor 319, fluid is automatically pumped into the stretching device 350 to increase the feeling of satiety and thus limit food intake. When the fluid has been injected into the stretching device 350, the internal pressure therein is higher than the internal pressure in the reflux treatment device 399. This difference in pressure will create a flow of fluid in the second tube preferably greater conduit 358 from the stretching device 350 to the reflux treatment device 399. The flow rate will be determined among other things by the difference in pressure and the cross-sectional area of ​​the second tube 358. It is preferred that the second tube be sized, so so that the pressures in the volume filling device 399 and the stretching device 350 will return to equilibrium after 3 hours that the fluid has been injected into the stretching device 350 to create the feeling of satiety. In this embodiment, the function of the second tube 358 is to allow fluid to return from the stretching device 350 to the volume filling device 399. It will be appreciated that this function can also be performed by the pump 354 in the first tube 352 and that the second tube 358 can then be omitted. Method for placing a reflux treatment device inside the stomach wall: A method and instrument for placing a reflux treatment device inside the stomach wall will now be described. The invagination instrument described in Fig. 52a-52h, generally designated 630, comprises an elongated tube member 632 similar to the elongated member 607 described above with reference to Fig. 48a to Fig. 48!. In this way, it can be connected to a control unit 606, ηκ+η i n / ι zoz / e / yl see Fig. 48a. The invagination instrument 630 further comprises a perforated suction portion 634, which is preferably elongated. The suction portion 634 shows a plurality of small holes 636, into which air will be drawn by providing suction on the tube member 632. This suction effect will be used to create a pocket or pouch in a portion of a stomach wall, generally designated 12th. In other words, when the tip of the suction portion 634 is pressed against the stomach wall 12a, see Fig. 52a, a small gap will be formed therein. When the suction portion 634 is further pressed against the stomach wall 12a, see Fig. 52b, a larger space will be formed. The part of the stomach wall 12a that forms the space, due to the suction effect, will adhere to the suction portion 634 of the invagination instrument 630. As the suction portion 634 is further pressed on the stomach wall 12a, see Fig. 52c, a deeper gap will form until the entire suction portion 634 is embedded in the gap, see Fig. 18d. The rim of the space at this stage will be fixed by means of fixing elements 638 and the suction portion will be removed from the instrument, see Fig. 52e. A compressed elastic reflux treatment device 10 will subsequently be inserted into the space, see Fig. 52f, for example in the manner described above with reference to Fig. 47d. This compressed reflux treatment device is then expanded to its final shape, see Fig. 52g, where the bag is then sealed by suturing or stapling by means of the fixing elements, see Fig. 52h. All alternatives described above with reference to Figs. 1-51 are also applicable to the embodiment described with reference to Figs. 52a-1, that is, to the modality where the reflux treatment device invaginates inside the stomach wall. The Figs. 53a to Fig. 53c show an instrument for creating a stomach wall intussusception that can either be placed on the outside of the stomach wall or on the inside of the stomach wall depending on whether the reflux treatment device is placed inside. or the outside of the wall. The instrument uses vacuum to cut a portion of the stomach wall into the cup of the instrument. It has been described how the reflux treatment device 10 is invaginated into the stomach wall by means of a gastroscopic instrument. The gastroscopic instrument can be used to either place the reflux treatment device on the outside of the stomach wall as shown in Fig. 1A or on the inside of the stomach as shown in Fig. 2A. In the latter case, the instruments will be used to make an incision in the stomach wall from inside the stomach. It will be appreciated that abdominal operation methods may also be used. Such methods will now be described with reference to Fig. 54 and Fig. 55. In Fig. 54 it is shown how the stomach is accessed by creating an incision 380 in the patient's abdomen. Fig. 55 shows how an instrument 381 is inserted into the patient's abdomen. Any of the instruments and methods described can be selected and adapted for this purpose. Thus, for example, the reflux treatment device can be placed on the outside of the stomach as shown in Fig. 1A or on the inside as shown in Fig. 2A. In the latter case, an incision is made in the stomach wall. It is important that the implanted reflux treatment device be held firmly in place on the stomach wall into which it is invaginated. To this end, the reflux treatment device may be provided with one or more through holes adapted to receive sutures or staples used for fixation of the intussusception. Such an embodiment is shown in Fig. 42, where the reflux treatment device 10 is provided with a row of holes 10i provided in a projection-like protrusion on the reflux treatment device. In this embodiment, the row of holes extends along the longitudinal axis of the reflux treatment device. Fig. 43 illustrates how sutures 314 are provided to pass through stomach wall 12a and through holes 10i. In this way, the reflux treatment device is fixed in place in the pocket created in the stomach wall and will thus be prevented from slipping out. Although a plurality of holes are illustrated in Fig. 42, it will be appreciated that a single hole is sufficient to obtain improved fixation of the reflux treatment device 10. Fig. 44 illustrates a reflux treatment device provided with an inlet port 10h. The reflux treatment device is invaginated into the stomach wall and the inlet port 10h is available for connection to a tube or the like in the patient's abdominal area. Fig. 45 illustrates an invaginated reflux treatment device where, instead of an entry port, a 10g fixed tube extends into the patient's abdominal area. Fig. 46 is a figure similar to Fig. 44 but also illustrating the placement of a connecting tube 10g in the stomach wall between the inlet port 10h and the reflux treatment device 10. It has been shown that the shape of the reflux treatment device can take many different forms. It will be appreciated that the material of the reflux treatment device may also vary. It is preferred that the reflux treatment device be provided with a coating, such as a Parylene, polytetrafluoroethylene (PTFE), or polyurethane coating, or a combination of such coatings, ie, a multilayer coating. This coating or multilayer coating improves the properties of the reflux treatment device, such as its resistance to wear. In one embodiment, the reflux treatment device comprises a reliable device expanded to an expanded state. In this case, the reliable device is provided with an inlet port for a fluid and is adapted to connect to a gastroscopic instrument. This embodiment will now be described in detail with reference to Fig. 47a to Fig. 47d. A reliable reflux treatment device in its unexpanded state is shown in Fig. 47a. It is essentially a deflated balloon-like device 10 having an entry port 10h. In this state, the unreliable device has a diameter of a few millimeters at most, allowing it to be inserted into the stomach through the patient's esophagus by means of a gastroscopic tube-like instrument 600, shown in Fig. 47b. . The instrument comprises an outer sheath 600a and an inner sheath 600b that is longitudinally movable relative to the outer sheath. The inner sheath is provided with a cutter in the form of a cutting edge 615 at the distal end thereof. This cutting edge can be used to cut a hole in the stomach wall, as will be explained in detail below. As the instrument reaches a stomach wall, see Fig. 47c, the inner sheath moves forward from its position in the outer sheath and toward contact with the stomach wall 12a. The cutting edge 615 of the inner sleeve then cuts a hole in the stomach wall to allow subsequent insertion of the reflux treatment device 10 into and through this hole, see Fig. 47d. To push the reflux treatment device through the hole, a piston 602 may be provided in the instrument. Thus, the instrument further comprises a piston 602 adapted to push a deflated reflux treatment device 10 out of a position in the inner sheath, this position being shown in Fig. 47b, to a position outside the inner sheath, this shown in Fig. 47d. To protect the deflated reflux treatment device 10 from the cutting edge 615 of the inner sleeve, an additional protective sleeve (not shown) may be provided around the reflux treatment device. An intraluminal method for invaginating a reflux treatment device 10 on the exterior of stomach wall 12a will now be described with reference to Figs. 48a to Fig. 48!. Initially, an instrument 600, preferably a gastroscopic instrument, is inserted into the patient's mouth, see Fig. 48a. The instrument comprises an injection device 601, 602 for injecting either fluid or a device into the patient's stomach. The instrument 600 further comprises a control unit 606 adapted to control the operation of the instrument. For this purpose, the control unit 606 comprises one or more steering devices, in the embodiment shown in the figure in the form of two joysticks 603 and two control buttons 604. A screen 605 is provided to display the provided image. by a camera (not shown) installed at the outer end of the elongated member 607, see Fig. 48e to Fig. 48i. The camera can be aided by a light source (not shown). The instrument is further inserted into the esophagus and into the patient's stomach, see Fig. 48b. By means of the instrument 600, a hole 12b is created in the stomach wall 12. For this purpose, the instrument is provided with one or more cutters 615 at the distal end thereof, for example in the manner described above with reference to Fig. 47a to Fig. 47d. These cutters can of course be designed in different ways, such as a toothed drum cutter rotating around the central axis of the tube-like instrument. The instrument 600 is hollow providing a space for the reflux treatment device 10 in its deflated state. After cutting a hole in the stomach wall, the distal end of the instrument 600 is inserted into and through the hole 12b so that it ends outside the stomach wall 12a. This is shown in Fig. 48c, showing a side view of the stomach 12, and Fig. 48d, which is a sectional view through the stomach of Fig. 48c taken along lines Vd-Vd. The deflated reflux treatment device 10 is then inserted into the abdominal area. The instrument 600 is adapted to create a pocket or pouch on the outside of the stomach 12 around the hole 12b in the stomach wall. Such an instrument and the method of providing the bag will now be described. Fig. 48e to Fig. 48¡ show a laparoscopic or gastroscopic instrument for invaginating a reflux treatment device 10 into the patient's stomach wall 12a by creating a stomach wall pocket 12a material in which the treatment device is placed. of reflux. The instrument, generally designated 600, and which may comprise the features described above with reference to Fig. 47a to Fig. 47d, comprises an elongated member 607 having a proximal end and a distal end, the elongated member 607 having a smaller diameter to that of the patient's esophagus and being flexible to allow the introduction of the flexible elongated member 607 with its first distal end through the patient's throat, esophagus and into the stomach 12 to the stomach wall 12a. The cutter or stomach penetration device 615 is provided in the elongated member 607 at the distal end thereof to penetrate the stomach wall 12a to create a hole in the stomach wall 12a, to allow introduction of the elongated member 607 through the hole . The stomach penetrating device 615 could be adapted to be operable to retract said stomach penetrating device 615 after the bottom stomach wall 12a has been penetrated, so as not to further damage tissue within the body. The instrument further comprises a special clamping device 609 provided on the elongated member 607 on the proximal side to the penetration device 615. The elongated member further comprises an expandable member 611 that is adapted to expand after the elongated member has penetrated the stomach wall 12a and thus assist in creating a cavity or pouch adapted to hold the reflux treatment device 610. The member Expandable 611 may comprise an inflatable circular balloon provided circumferentially around the distal end portion of the flexible elongate member 607. The steps of the method when the reflux treatment device is invaginated will now be described in detail. After the instrument 600 has been inserted into the stomach 12, the stomach penetration device 615 is placed in contact with the stomach wall 12a, see Fig. 48e. The cutter or stomach penetration device 615 is then brought to create the hole 12b in the stomach wall, after which at least the expandable member 611 is brought through the hole 12b in the stomach wall. The special clamping device 609 in this step is then brought to a clamping state where it expands radially to form an essentially circular abutting surface to the stomach wall 12a, see Fig. 48f. In this way, the insertion of the stomach penetration device 615 and the expandable member 611 through the hole 12a in the stomach wall is limited to the position shown in Fig. 48f. The expandable member 611 is then expanded. In the case where the expandable member comprises a balloon or the like, air or other fluid is injected therein. The portion of the elongated member 607 comprising the expandable member 611 is then retracted in the proximal direction, as indicated by the arrow in Fig. 48g, thereby pulling the stomach wall 612 towards a basket-like structure created by the clamping device. special 609. A stapling or suturing device 608 is further provided, either as a device connected to the elongate member 607 or as a separate instrument. The suturing or stapling member comprises a stapling or suturing end 613 that is adapted to close the cavity or pouch by means of sutures or staples 14 from stomach to stomach. In a further step, illustrated in Fig. 48h, a reliable reflux treatment device 10 is placed in its deflated state in the basket-like structure. The reflux treatment device 10 is then inflated to its inflated or expanded state, see Fig. 48i. This inflation of the reflux treatment device 10 can be accomplished by injecting a fluid or gel into the deflated reflux treatment device. It can also be performed by injecting a material that is allowed to cure, thus forming a solid device 10. In this way, the reflux treatment device 10 shown in Figs. 48h and 48i may illustrate either a balloon-like device that is subsequently filled with fluid or gel or alternatively a material that is simply injected into the basket-like structure formed by the stomach wall 12a. The fluid used to fill the reflux treatment device 10 could be any fluid suitable for filling the reflux treatment device 10, such as a salt solution. In another embodiment, when this fluid is a fluid that is adapted to transform into a solid state, the fluid could be liquid polyurethane. To minimize or completely eliminate spillage, the fluid is isotonic, meaning it has the same osmolarity as human body fluids. Another way to prevent diffusion is to provide a fluid comprising large molecules, such as iodine molecules. Stomach-to-stomach sutures or staples are preferably provided with fixation portions exhibiting a structure, such as a net-like structure, adapted to contact the stomach wall to promote ingrowth of human tissue to ensure placement. long-term use of the reflux treatment device attached to the stomach wall. After the non-reliable device 10 has been inflated, partially or completely, the inlet port 10b (not shown in Figs. 48h and 48i) of the reflux treatment device 10 is sealed and the instrument 600 is retracted from the hole 12b , which is subsequently closed in some suitable manner, such as by means of the instrument 600. The instrument is then removed from the stomach 600 and the unreliable device 10 in its inflated or expanded state is invaginated by a portion of the patient's stomach wall on the outside of the stomach wall. During one or more of the steps described above, the stomach may be inflated with gas, preferably by means of the gastroscopic instrument. The reflux treatment device 10 described above with reference to Fig. 48a to Fig. 48i has been described as a reliable reflux treatment device. It will be appreciated that it may also be an elastic reflux treatment device with a compression that allows elasticity to be inserted into a gastroscopic instrument and that expands to an expanded state after leaving the instrument. The reflux treatment device may have the additional functionality of treating obesity. In such an embodiment, the reflux treatment device may be a volume filling device that fills a volume of the stomach and thereby creates satiety. An embodiment having this function is shown ηβΜηη / ίζηζ / Β / γι in Fig. 49, wherein a combined reflux treatment device and obesity treatment device 310 invaginate into the stomach wall close to and at least partially above the cardia. of the patient 14 when the patient is in a standing position and is fixed to a position above the cardia area 14c by a fixation, such as sutures or staples 22. For example, direct or indirect fixation may be provided to the diaphragm muscle or muscles. associates. As an alternative, direct or indirect fixation to the esophagus above and close to the angle of His can be provided. In this alternative embodiment, the combined device 310 remains in a position against the fundal stomach wall when implanted and also fills a volume above the cardia area 14c between the cardia and the diaphragm muscle so that the cardia is prevented from slides upward into the chest cavity, thereby preventing reflux disorder. Such a combined device 310 may be used to conserve electronics and / or a source of power and / or hydraulic fluid. The hydraulic fluid from that device can be distributed to several smaller areas of the reliable device to vary the stretching area from time to time avoiding any possible more permanent stretching effect of the stomach wall. Even mechanically several stretching areas can be used. Reflux Treatment Device-Stretching Device Combination In an alternative embodiment, shown in Fig. 50, the volume of a non-reliable reflux treatment device 310 may be in fluid connection with one or more preferably smaller non-reliable chambers or devices 10b. These chambers are adapted to communicate with fluid or air moving between the chambers. In this way, the large chamber 310 is adapted, with its main volume to be a reflux treatment device to reduce the size of the food cavity and to treat reflux disorder and the one or more small chambers are adapted to function as unreliable devices for treating obesity, where the main chamber is adapted to communicate with fluid or air to the small chambers causing a stretching effect on the stomach wall thus also treating obesity. Fig. 51 shows an embodiment with a combination of an invaginated volume filling device in the central or lower portion of the stomach and an invaginated stretching device in the upper or lower portion of the patient's stomach. These two devices are used to treat obesity. The 399 volume filling device fills a volume of the stomach creating satiety. The stretching device stretches the stomach wall. This stretches the tissue by releasing endogenous signaling that creates satiety. This mimics the stretching effect of filling the stomach with food. In this way, an adjustable volume filling device 399 is shown in Fig. 51, which invaginates into the stomach wall of a patient's stomach 312. Additionally, an adjustable stretching device 350 with the previously described function invaginates into the patient's bottom stomach wall. It is preferred that the volume filling device 399 be substantially larger than the stretching device 350. The volume filling device 399 and the stretching device 350 can be adapted to treat reflux. In one embodiment, the volume filling device and the stretching device are positioned to prevent the cardia 14 from sliding upward through the hernia opening 18a to a position above the diaphragm 18. The volume filling device 399 and the stretching device 350 are in fluid communication with each other through a first fluid tube 352, in which a pump 354 is provided. The pump 354 is under the control of an energy transforming device 330, which adapts to supply the pump 350 with power through a power supply line 356. The power transforming device 330 also connects to a sensor 319 provided in the patient's esophagus so that food intake can be detected. The reflux treatment device 10 and the stretching device 350 are also in fluid communication with each other through a second fluid tube 358, which preferably has a smaller cross-sectional area than the first fluid tube 352. The operation of this installation is as follows. The volume filling device 399 functions as in the embodiments described above, that is, it reduces the size of the food cavity of the patient's stomach 12. Additionally, when the stretching device 350 is elongated by pumping fluid from the volume filling device volume 10 and to the stretching device 350 by means of the pump 354, the bottom stomach wall is stretched, creating a feeling of satiety for the patient. In this way, for example when food intake is detected by sensor 319, fluid is automatically pumped into the stretching device 350 to increase the feeling of satiety and thus limit food intake. When the fluid has been injected into the stretching device 350, the internal pressure therein is higher than the internal pressure in the reflux treatment device 399. This difference in pressure will create a flow of fluid in the second tube preferably greater narrow 358 from the stretching device 350 to the reflux treatment device 399. The flow rate will be determined among other things by the difference in pressure and the cross-sectional area of ​​the second tube 358. It is preferred that the second tube be sized, in so that the pressures in the volume filling device 399 and the stretching device 350 will return to equilibrium after 3 hours that the fluid has been injected into the stretching device 350 to create the feeling of satiety. In this embodiment, the function of the second tube 358 is to allow fluid to return from the stretching device 350 to the volume filling device 399. It will be appreciated that this function can also be performed by the pump 354 in the first tube 352 and that the second tube 358 can then be omitted. Method for placing a reflux treatment device inside the stomach wall: A method and an instrument for placing a reflux treatment device inside the stomach wall will now be described. The invagination instrument described in Fig. 52a-52h generally designated 630, comprises an elongated tube member 632 similar to the elongated member 607 described above with reference to Figs. 48a-! In this way, it can be connected to a control unit 606, see Fig. 48a. The invagination instrument 630 further comprises a perforated suction portion 634, which is preferably elongated. The suction portion 634 shows a plurality of small holes 636, into which air will be drawn by providing suction on the tube member 632. This suction effect will be used to create a pocket or pouch in a portion of a stomach wall, generally designated 12th. In other words, when the tip of the suction portion 634 is pressed against the stomach wall 12a, see Fig. 52a, a small gap will be formed therein. When the suction portion 634 is further pressed against the stomach wall 12a, see Fig. 52b, a larger space will be formed. The part of the stomach wall 12a that forms the space, due to the suction effect, will adhere to the suction portion 634 of the invagination instrument 630. As the suction portion 634 is further pressed on the stomach wall 12a, see Fig. 52c, a deeper gap will form until the entire suction portion 634 is embedded in the gap, see Fig. 18. The rim of the space at this stage will be fixed by means of fixing elements 638 and the suction portion removed from the instrument, see Fig. 52e. A compressed elastic reflux treatment device 10 will subsequently be inserted into the space, see Fig. 52f, for example in the manner described above with reference to Fig. 47d. This compressed reflux treatment device is then expanded to its final shape, see Fig. 52g, where the bag is then sealed by suturing or stapling by means of the fixing elements, see Fig. 52h. All alternatives described above with reference to Fig. 1A to Fig. 51 are also applicable to the embodiment described with reference to Figs. 52a-1, that is, to the modality where the reflux treatment device invaginates inside the stomach wall. Fig. 53a to Fig. 53c show an instrument for creating an invagination of the stomach wall that can either be placed on the outside of the stomach wall or on the inside of the stomach wall depending on whether the reflux treatment device is placed on the inside or outside of the wall. The instrument uses vacuum to cut a portion of the stomach wall into the cup of the instrument. It has been described how the reflux treatment device 10 is invaginated into the stomach wall by means of a gastroscopic instrument. The gastroscopic instrument can be used to either place the reflux treatment device on the outside of the stomach wall as shown in Fig. 1A or inside the stomach as shown in Fig. 2A. In the latter case, the instruments will be used to make an incision in the stomach wall from inside the stomach. It will be appreciated that abdominal operation methods may also be used. Such methods will now be described with reference to Fig. 54 and Fig.55. Fig. 54 shows how the stomach is accessed by creating a 380 incision in the patient's abdomen. Fig. 55 shows how an instrument 381 is inserted into the patient's abdomen. Any of the instruments and methods described can be selected and adapted for this purpose. In this way, for example, the reflux treatment device can be placed on the outside of the stomach as shown in Fig. 1A or on the inside as shown in Fig. 2A. In the latter case, an incision is made in the stomach wall.

Claims

1. An apparatus for treating reflux disorder in a human or mammalian patient by restricting the movement of the cardia, the apparatus being characterized in that it comprises: an implantable motion restriction device adapted to treat reflux disorder in a human or mammalian patient by restricting the movement of the cardia, the implantable motion restriction device having an outer surface including a biocompatible material, the motion restriction device being adapted to bear with at least a portion of its outer surface against the fundus wall of the patient's stomach, and in a position between the patient's diaphragm and the fundus wall, such that the movement of the cardiac notch of the patient's stomach towards the patient's diaphragm is restricted when the motion restriction device is implanted in the patient,To prevent the cardia from sliding through the patient's diaphragmatic opening into the patient's thorax, the motion restraint device is adapted to directly or indirectly contact the diaphragm muscle to prevent such sliding of the cardia through the patient's diaphragm, to maintain supportive pressure against the patient's cardiac sphincter muscle exerted from the patient's abdomen, wherein the motion restraint device is adapted to secure to the patient's esophagus in said position, preventing such sliding of the cardia through the patient's diaphragm, wherein the motion restraint device is implanted, and wherein the motion restraint device is adapted to be fully invaginated into at least a portion of the fundus wall of the stomach, and wherein the motion restraint device has a maximum volume of less than 200cc.

2. The apparatus according to claim 1, further characterized in that it additionally comprises a bottom fixing device which, when implanted in the patient, is adapted to hold the motion restraint device against or attached to the bottom wall to maintain the motion restraint device in said position.

3. The apparatus according to claim 1, further characterized in that the movement restriction device is not adjustable from outside the patient's body when implanted in the patient.

4. The apparatus according to claim 2, further characterized in that the fundus fixation device comprises a plurality of sutures or staples which, when implanted in the patient with the motion restraint device, are adapted to join the fundus wall and a wall of the patient's esophagus to maintain the motion restraint device in said position.

5. The apparatus according to claim 2, further characterized in that it additionally comprises a fixation device which, when implanted in the patient with the motion restraint device, is adapted to secure, indirectly or directly, the motion restraint device to the patient's diaphragm muscle or muscles associated with the diaphragm.

6. The apparatus according to claim 1, further characterized in that the movement restraint device comprises a body adapted to be at least partially invaginated by the patient's fundus stomach wall, a substantial part of an outer surface of the body that is adapted to rest against the stomach wall in said position between the patient's diaphragm and a portion of a lower part of the invaginated fundus stomach wall.

7. The apparatus according to claim 6, further characterized in that the body is substantially spherical.

8. The apparatus according to claim 7, further characterized in that the body has round contours without pointed edges that would damage the patient's stomach wall.

9. The apparatus according to claim 1, further characterized in that the movement restriction device is adapted to be invaginated by the fundus stomach wall of the patient.

10. The apparatus according to claim 1, further characterized in that it additionally comprises a fluid or gel receiving member for receiving fluid to inflate the movement restraint device.

11. The apparatus according to claim 1, further characterized in that a wall of the motion restraint device is provided with at least one layer or coating comprising at least one of: chemically vapor-deposited poly(p-xylene) polymer, polytetrafluoroethylene, and polyurethane.

12. The apparatus according to claim 1, further characterized in that the movement restraint device comprises a body, and wherein the apparatus is adapted to regulate a body size after being implanted in the patient, the body comprising an inflatable chamber and at least one of: an injection port where the inflatable chamber of the body is filled with a fluid through the injection port, a subcutaneously placed container adapted to be connected to the inflatable chamber to be regulated non-invasively by manually pressing the subcutaneously placed container from outside the patient's body, and a pump connected with a hydraulic container adapted to move hydraulic fluid between the hydraulic container and the inflatable chamber to enable the patient to be able to pump fluid non-invasively from outside the patient's body,to adjust the amount of hydraulic fluid supplied to the body.

13. The apparatus according to claim 1, further characterized in that the motion restraint device is adapted to be filled with a filling fluid capable of undergoing a curing process for a semi-solid or solid deformable material, after being injected into the motion restraint device after being implanted.

14. The apparatus according to claim 1, further characterized in that the motion-restraint device comprises an invagination fixation device adapted to be in contact with an outer stomach wall and adapted to be placed on the outside of the stomach wall to join together portions of the fundus stomach wall to enclose and invaginate the motion-restraint device to secure the motion-restraint device in position when the motion-restraint device is implanted in the patient.

15. The apparatus according to claim 1, further characterized in that the movement restriction device is adapted to be invaginated on the outside of the patient's stomach wall, from outside the patient's stomach wall, by joining together portions of the stomach wall from outside the patient's stomach wall.

16. The apparatus according to claim 1, further characterized in that the apparatus comprises an esophageal fixation device which, when implanted in the patient with the motion-restriction device, is adapted to secure the motion-restriction device to the esophagus near the patient's angle of His.

17. The apparatus according to claim 16, further characterized in that the esophageal fixation device comprises a structure that promotes tissue growth for long-term attachment of the motion restriction device to the stomach wall.

18. The apparatus according to claim 17, further characterized in that the tissue growth-promoting structure comprises a network.

19. The apparatus according to claim 18, further characterized in that the tissue growth-promoting structure comprises sutures or staples which, when implanted in the patient, are adapted to attach the net to the fundus stomach wall.

20. The apparatus according to claim 1, further characterized in that the movement restriction device is adapted to remain in place by contacting the fundus stomach wall without reducing the passage of food into the patient's stomach when implanted and in operation.

Images