Endosonography-Guided Tissue Securement for Reflux
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Solution Overview
Problem
Endoscopic treatments for gastroesophageal reflux disease (GERD) are limited by the inability to visualize structures deep within or outside the gastrointestinal wall, affecting the proper placement of treatment apparatuses like sutures or ligating elements, which are crucial for creating a mechanical barrier to prevent reflux.
Innovation Solution
An endosonography-guided tissue securement system that uses a hollow needle with a detachable needle tip and a ligating element to create a loop around the gastro-esophageal flap valve, securing the esophageal and stomach tissues together to enhance the lower esophageal sphincter function, employing an echoendoscope for visualization and a grasper for precise placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If endoscopic methods are used to treat GERD, then surgical incisions are avoided and recovery time is reduced, but the ability to visualize deep structures within or outside the gastrointestinal wall is limited
Solution Approach 1:
The patent uses an echoendoscope as an intermediary device that combines endoscopic visualization with ultrasonic imaging capabilities. The ultrasonic transducer array integrated into the endoscope acts as a mediator to penetrate and visualize deep structures within the gastrointestinal wall that are not visible through standard endoscopy alone, thereby resolving the visualization limitation while maintaining the minimally invasive nature of the procedure
2Reliability
If surgical fundoplication is performed to correct GERD, then anatomic correction is achieved, but postoperative complications and recovery time increase
Solution Approach 1:
The patent replaces the complex mechanical surgical fundoplication procedure with an endosonography-guided tissue securing system that uses ultrasonic imaging and targeted tissue anchoring. This substitution maintains the anatomic correction benefit by precisely placing securing elements at the gastroesophageal junction while avoiding the extensive dissection and manipulation required in traditional surgery, thereby reducing recovery time and postoperative complications
3Reliability
If sutures or ligating elements are placed to create a mechanical barrier, then reflux prevention is improved, but proper placement becomes difficult without visualization of deep structures
Solution Approach 1:
The patent employs real-time ultrasonic imaging feedback from the echoendoscope to guide the placement of sutures and ligating elements. The ultrasonic images provide continuous feedback on the position of the needle and securing elements relative to deep structures within the gastrointestinal wall, enabling precise placement at the gastroesophageal junction and ensuring proper formation of the mechanical barrier for reflux prevention
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This method effectively reduces gastroesophageal reflux by creating a mechanical barrier that enhances the function of the lower esophageal sphincter, offering a minimally invasive alternative to surgery with reduced recovery times and fewer complications.
Implementation Method 1
The use of endosonography may address this limitation. In this procedure a combination endoscope and ultrasound instrument called an echoendoscope is utilized.
Data Source
AI summary
The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a ligation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a ligation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This ligation element placed from the esophagus and around the Angle of His to create a barrier to gastroesophageal reflux.