264 results about "Peritoneum" patented technology

Instrument assisted abdominal access methods and apparatus are described herein. A shape-lockable elongate body can be advanced endoluminally in a flexible state into the stomach, where an opening is created through the stomach wall. The opening can be created endoluminally or by incising instruments placed through the abdominal wall. The elongate body can be transitioned to a rigid state prior to, during, or after advancement into the patient and is passed through the opening into the peritoneal cavity. To assist in the passage of the elongate body, a helical tissue engager can be advanced into the peritoneal cavity and temporarily anchored into a tissue wall. By pulling the helical tissue engager proximally and pushing the elongate body over a flexible length of the engager, the elongate body can be brought into the peritoneal cavity

The present invention provides systems and methods for applying RF energy to injured tissue, particularly the peritoneum, in order to prevent harmful post-surgical adhesions. One aspect of the invention is RF energy delivery systems employing trocars, which are designed for use in laparotomies and laparoscopies. Another aspect of the invention is an RF delivery system comprising a surgical sheet with one or more electrodes for delivering the RF energy to the injured tissue resulting from conventional surgical incisions into the abdominal wall. Additionally, another aspect of the invention provides methods for controlling the treatment dosage of RF heat to the injured tissue using parameters such as treatment time, change in tissue temperature, and change in tissue impedance.

A device and methods for treating renal failure are disclosed. One embodiment of the device is an implantable peritoneal dialysis device. When in use, the device can have a semi-permeable reservoir implanted in the peritoneal cavity. The reservoir can receive blood waste and drain through one or more conduits, via a pump, to the biological bladder. Solids and/or a solution benefiting dialysis can be pumped to the reservoir and/or implanted in the peritoneal cavity.

The present invention provides systems and methods for applying RF energy to injured tissue, particularly the peritoneum, in order to prevent harmful post-surgical adhesions. One aspect of the invention is RF energy delivery systems employing trocars, which are designed for use in laparotomies and laparoscopies. Another aspect of the invention is an RF delivery system comprising a surgical sheet with one or more electrodes for delivering the RF energy to the injured tissue resulting from conventional surgical incisions into the abdominal wall. Additionally, another aspect of the invention provides methods for controlling the treatment dosage of RF heat to the injured tissue using parameters such as treatment time, change in tissue temperature, and change in tissue impedance.

A minimally invasive method of placing a delivery device substantially adjacent to vascular tissue and a device for use with such a method are disclosed. The delivery device may be a flexible biological construct with a flexible tethering means. The delivery device may be percutaneously inserted near vascular tissue such as, for example, peritoneal tissue. When the delivery device has been inserted, the tether may be used to pull the delivery device toward the vascular tissue and secure the device thereto. Contact between the front surface of the delivery device and the vascular tissue may be maintained by making and keeping the tether substantially taut. The delivery device may serve accomplish sustained delivery of active agents.

The present invention provides a pharmaceutical composition, comprising a non-infectious, non-integrating polynucleotide construct comprising a polynucleotide encoding an interferon ω and one or more cationic compounds. The present invention also provides methods of treating cancer in a mammal, comprising administering into a muscle of the mammal a non-infectious, non-integrating DNA polynucleotide construct comprising a polynucleotide encoding a cytokine. In addition, the present invention also relates to the methodology for selective transfection of malignant cells with polynucleotides expressing therapeutic or prophylactic molecules in intra-cavity tumor bearing mammals. More specifically, the present invention provides a methodology for the suppression of an intra-cavity dissemination of malignant cells, such as intraperitoneal dissemination. Furthermore, the invention relates to compositions and methods to deliver polynucleotides encoding polypeptides to vertebrate cells in vivo, where the composition comprises an aqueous solution of sodium phosphate.

A surgical instrument, guide, and method capable of being used for closure of peritoneum fascia, occlusion of bleeding vessels such as inferior epigastric, and for all uses related to accurately passing suture material through a guide into tissue. A tip of a surgical instrument in a standard suture-/needle-driving position with a sharp tip that opens and closes with the surgeon grasping suture material with the sharp tip is provided. Insertion of the tip/suture through tissue until the tip is seen through the peritoneum by direct vision begins the wound-closing procedure. The suture is released by opening and withdrawing the tip from the guide. The suture is recovered by using the guide to redirect the tip and puncturing the tissue opposite the first point of insertion. The tip grasps the suture and pulls the suture through the guide. The suture is pulled outside the wound, providing for rapid closure of the surgical incision. The guide is insertable within the wound to be closed and guides the surgical instrument at a predetermined angle from the longitudinal axis of the guide for optimum wound closure. Alternative embodiments of the guide include providing a slot through which non-linear surgical instruments may pass through an open or enclosed passageway.

Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alterative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.

Methods, devices and systems facilitate retention of a variety of therapeutic devices. Devices generally include an anchoring element, which has been designed to promote fibrotic ingrowth, and an anchored device, which has been designed to firmly engage the complementary region of the anchoring element. The anchoring element may be placed in a minimally invasive procedure temporally separated from the deployment of the anchored device. Once enough time has passed to ensure appropriate fixation of the anchoring element by tissue and cellular ingrowth at the site of placement, the anchored device may then be deployed during which it firmly engages the complementary region of the anchoring element. In this manner, a firm attachment to the implantation site may be made with a minimum of required hardware. Some embodiments are delivered through a delivery tube or catheter and while some embodiments may require laparoscopy or open surgery for one or more of the placement procedures. Some embodiments anchor devices within the cardiovascular tree while others may anchor devices within the gastrointestinal, peritoneal, pleural, pulmonary, urogynecologic, nasopharyngeal or dermatologic regions of the body.

A cardiac stimulation system and method delivers a left ventricle stimulator from a right ventricle lead system in the right ventricle chamber, into a right side of an interventricular septum at a first location, and transmuscularly from the first location to a second location along the left side of the septum. The left ventricle stimulator is affixed at the second location for transmuscular stimulation of the left ventricle conduction system. A biventricular stimulation system further includes a right ventricle stimulator also delivered by the right ventricle lead system to the first location along the right side of the septum for right ventricular stimulation. An energy source is coupled to the transmuscular stimulation system, i.e., a pacemaker, and/or defibrillator, or to enhance contractility, and may be coupled directly or via “leadless” system(s). Various highly beneficial particular arrangements of stimulators and leads are further described.

Methods and apparatus for accessing and treating regions of the body are disclosed herein. Using an endoscopic device having an automatically controllable proximal portion and a selectively steerable distal portion, the device generally may be advanced into the body through an opening. The distal portion is selectively steered to assume a selected curve along a desired path within the body which avoids contact with tissue while the proximal portion is automatically controlled to assume the selected curve of the distal portion. The endoscopic device can then be used for accessing various regions of the body which are typically difficult to access and treat through conventional surgical techniques because the device is unconstrained by “straight-line” requirements. Various applications can include accessing regions of the brain, thoracic cavity, including regions within the heart, peritoneal cavity, etc., which are difficult to reach using conventional surgical procedures.

A model for practicing transabdominal pre-peritoneal (TAPP) and total extraperitoneal (TEP) approaches for laparoscopic hernia repairs is provided. The model simulates an insufflated space between the abdominal muscles and peritoneum. A spring layer may be incorporated to provide a realistic resiliency to the model while in the simulated insufflated configuration. At least one hole is provided in the model from which synthetic tissue protrudes to simulate a hernia. The model is used to selectively simulate direct, indirect and femoral inguinal hernias as well as incisional hernias by removably placing the protruding simulated tissue into any one of several openings. The model contains all important anatomical structures and sits on a base frame or is connected to a rigid simulated pelvis. When located inside a laparoscopic trainer with an angled top cover, the model provides an ideal simulation for teaching and practicing laparoscopic hernia repair.

The invention provides, inter alia, automated medical methods and apparatus that test PD effluent in a flow path (e.g., with an APD system or CAPD setup) to detect, for example, the onset of peritonitis, based on optical characteristics of the effluent resolved at cellular scales of distance. For example, according to one aspect of the invention, an APD machine includes, in an effluent flow path, apparatus for early stage peritonitis detection comprising an illumination source and a detector. The source is arranged to illuminate peritoneal effluent in a chamber that forms part of the flow path, and the detector is arranged to detect illuminant scattered by the effluent. The detector detects that reflected or scattered illuminant at a cellular scale of resolution, e.g., on a scale such that separate cellular-sized biological (or other) components in the effluent can be distinguished from one another based on scattering events detected by the detector. Other aspects of the invention provide automated medical testing methods and apparatus that detect the onset of peritonitis and other bodily conditions by testing fluids in the body in vivo, e.g., the patient's peritoneum. Such apparatus and methods utilize a first fiber optic bundle to carry illuminant from a source of the type described above into a bodily organ or cavity, and a second fiber optic bundle to carry illuminant scattered by fluid in that organ or cavity to a detector as described above.

A method is disclosed for introducing a spinal disc implant into an intervertebral space of a subject. The subject is placed in a lateral position, and the anterior face of the spinal disc intervertebral space is accessed, between the L5 and S1 vertebrae, from an anterior and lateral retroperitoneal approach. An operative corridor to the anterior face of the spinal disc space is established by introducing a retractor instrument anterolaterally to the spinal disc space between the anterior superior iliac spine and the anterior inferior iliac spine. The damaged spinal disc contents are removed from the intervertebral space through the operative corridor, and the implant is advanced into the intervertebral space at an oblique angle and pivoted to position the implant substantially laterally within the intervertebral space. Elongated retractor and insertion instruments, as well as a modified disc implant, are also disclosed for carrying out the method.

A method of placing an electrode in a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; and using the endoscope to place the electrode in contact with tissue within the peritoneal cavity other than stomach tissue. Another aspect of the invention provides a method of electrically mapping tissue accessed from a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; passing an electrode through the endoscope; placing the electrode in contact with tissue within the peritoneal cavity other than stomach tissue; and applying a mapping stimulation signal to the electrode from a mapping stimulator.

The invention features methods of treating visceral pain in humans by administering an effective amount of a 5HT_1B or 5HT_1D receptor agonist, (e.g., a triptan). These methods can be used, for example, to treat a human suffering from visceral pain secondary to an underlying disease of a visceral organ, such as pancreatitis. Visceral pain treatable by the methods of the invention may also be secondary to a disease of the liver, kidney, ovary, uterus, bladder, bowel, stomach, esophagus, duodenum, intestine, colon, spleen, pancreas, appendix, heart, or peritoneum.

Peritoneal Dialysis systems, methods, and catheters are provided for performing peritoneal dialysis therapies. Multiple fluid pathways are provided to a patient's peritoneal cavity for conveying dialysis fluid to and from the patient.

The invention discloses high levels of receptors for Clostridium perfringens enterotoxin (CPE) have been found in ovarian cancer and uterine cancer tissue samples. In addition, successful in vivo treatment of a mouse model of ovarian cancer with intraperitoneal injection of CPE is disclosed. High levels of Ep-CAM protein is also disclosed in ovarian cancer tissue samples. Thus, the invention provides a method of treating ovarian cancer and uterine cancer by administering CPE. The invention also provides a method of treating cancer in a mammal involving intraperitoneal administration of CPE, where at least some cancerous cells are located in or adjacent to the peritoneal cavity of the mammal. The invention also provides a method of treating ovarian cancer involving administering an anti-Ep-CAM antibody. The invention also provides a method of treating cancers expressing claudin-3 or claudin-4 by administering an antibody against claudin-3 and/or an antibody against claudin-4. The invention also provides a method of protecting a mammal from CPE toxicity involving administering a protective agent that binds to claudin-3 and/or claudin-4 and inhibits CPE binding to claudin-3 and/or claudin-4.