Activable Bougie Y-Extension for Gastroplasty Stoma Formation
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Solution Overview
Problem
Current sleeve gastrectomy procedures require the removal of a stomach portion, increasing procedural complexity, recovery time, and morbidity rates, as they involve suturing along the entire stomach length and necessitate the resection of unused stomach tissue.
Innovation Solution
A bougie with a Y-shaped extension is used to create a funnel-shaped stoma, allowing the bypassed stomach portion to remain in place by ending the suture line short of the gastroesophageal junction, preventing food from passing through and reducing the need for stomach resection, with the bougie's extension directing food into the stoma and providing a method to angle the suture line away from the gastroesophageal junction.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If suturing is performed along the entire stomach length to create a sleeve gastrectomy, then a functional stoma is formed, but the procedure requires removal of the bypassed stomach portion, increasing procedural complexity and recovery time
Solution Approach 1:
The suture line is segmented into two parts: one that creates the functional stoma and another that stops short of the gastroesophageal junction. This segmentation allows the bypassed stomach portion to remain in place without requiring complete circumferential suturing, thereby reducing procedural complexity while maintaining stoma functionality.
Solution Approach 2:
Instead of suturing the entire length of the stomach, the procedure uses partial action by ending the suture line short of the gastroesophageal junction. This partial suturing is sufficient to create the desired stoma function while avoiding the need to remove the bypassed stomach portion, thus reducing procedural complexity and recovery time.
2Device complexity
If the suture line ends short of the gastroesophageal junction, then the bypassed stomach portion can remain in place, but food may pass through the bypassed portion
Solution Approach 1:
The bougie with its Y-shaped extension acts as an intermediary structure that directs food flow. The extension creates a funnel-shaped stoma that guides food into the functional stoma pathway, preventing food from passing through the bypassed stomach portion even though the suture line ends short of the gastroesophageal junction.
Solution Approach 2:
The Y-shaped extension creates a funnel-shaped (curved) stoma that directs food flow away from the bypassed stomach portion. This curvature geometry naturally channels food into the functional stoma, preventing harmful food passage through the bypassed portion while maintaining procedural simplicity.
3Productivity
If the entire stomach is removed and replaced with a sleeve, then weight loss is achieved, but patient recovery time and morbidity increase
Solution Approach 1:
The procedure extracts only the unnecessary portion of the suture line (ending short of the gastroesophageal junction) rather than removing the entire bypassed stomach. This selective extraction maintains weight loss effectiveness by preserving the sleeve structure while avoiding the time-consuming and morbid procedure of complete stomach resection.
Solution Approach 2:
The bougie with Y-shaped extension is inserted beforehand to pre-establish the funnel-shaped stoma geometry. This preliminary action ensures proper food direction is in place before completing the suture line, allowing the bypassed stomach to remain in place without requiring subsequent corrective procedures, thereby reducing recovery time.
Data Source
AI summary
A gastroplasty method involves a staple line that terminates prior to reaching the gastroesophageal junction such that the bypassed portion of the stomach does not require resection. Additionally, bougies are taught that assist a physician in following the improved staple line of the present invention.