Endoscopic Anastomosis System with Nested Instruments
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Solution Overview
Problem
Current surgical methods for intestinal bypass anastomosis, such as gastrojejunostomy, are invasive and carry high risks and complication rates, making them unsuitable for many patients, especially those with morbid obesity or other conditions like diabetes and cancer.
Innovation Solution
A minimally invasive method and system using an endoscope with elongated cutting, grasping, and needle instruments to create openings in the stomach and small intestine, allowing for the formation of anastomosis by moving and attaching portions of the intestine to bypass a section, utilizing tacks, sutures, clips, or tissue anchors to secure the anastomosis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional surgical methods are used for intestinal bypass anastomosis, then the anastomosis can be formed, but the procedure carries high risks and complication rates
Solution Approach 1:
The patent replaces traditional mechanical surgical instruments with an endoscopic system that uses elongated flexible instruments delivered through the endoscope's working channel. This substitution allows the complex surgical procedure to be performed through a minimally invasive endoscopic approach, reducing surgical risks and complications while maintaining the ability to form the anastomosis.
Solution Approach 2:
The patent employs nested instrumentation where elongated cutting devices, grasping devices, and needle devices are delivered through the working channel of an endoscope. Each instrument is contained within the endoscope structure, allowing multiple functions to be performed through a single minimally invasive access point, thereby reducing procedural complexity and patient risk.
2Reliability
If minimally invasive endoscopic methods are used, then complications are reduced, but the difficulty of forming and controlling the anastomosis increases
Solution Approach 1:
The patent employs self-grasping and self-aligning mechanisms where the elongated grasping device captures the proximal and distal portions of the intestine, and the tissue anchors automatically position themselves to maintain the loops. The system uses the body's own anatomical structures and forces to facilitate the anastomosis formation, reducing the operational difficulty despite the minimally invasive approach.
Solution Approach 2:
The patent introduces intermediary devices including elongate members (such as sutures, wires, or catheters) that are passed through the loops of intestine to maintain their position. These intermediaries act as mediators between the endoscopic instruments and the intestinal tissue, facilitating control and positioning of the anastomosis loops while maintaining the minimally invasive benefit.
3Manufacturing precision
If tissue anchors and elongate members are used to maintain loop position, then control over anastomosis placement is improved, but the device complexity increases
Solution Approach 1:
The patent employs tissue anchors and elongate members that serve multiple functions: they maintain the position of intestinal loops, provide control for anastomosis formation, and can be deployed through the same endoscopic working channel. This multi-functionality reduces the need for separate specialized devices, thereby limiting the increase in overall device complexity while achieving precise placement control.
Data Source
AI summary
Medical system and methods are provided for forming an Anastomosis, such as an intestinal bypass anastomosis for treatment of obesity or diabetes. The medical devices and methods are minimally invasive and reduce complications. One embodiment of the method includes forming a first opening in the first section and forming a second opening in the first section. A proximal portion of the second section is moved to a position adjacent the first opening, and a distal portion of the second section is moved to a position adjacent the second opening. In this manner, an intermediate portion of the second section extends along the first section and an anastomosis can then be formed between the first section and the second section.