Reversible Gastric Closure for Endoscopic Access
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Solution Overview
Problem
Conventional endoscopy systems face challenges in navigating and stabilizing endoscopes within anatomical regions, particularly in surgically altered gastric anatomy, leading to difficulties in accessing the pancreaticobiliary system, requiring advanced surgical skills and high variability in patient anatomy.
Innovation Solution
A method and system for creating a reversible alteration of gastric anatomy using an alterable gastric closure, allowing for endoscopic access to the pancreaticobiliary system by disengaging a portion of the closure to facilitate endoscope passage, which is more accessible and safer than permanent alterations.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If permanent surgical alteration of gastric anatomy is performed, then access to pancreaticobiliary system is enabled, but reversibility and safety are reduced
Solution Approach 1:
The gastric closure device transitions from a static permanent closure to a dynamic reversible closure. The alterable gastric closure allows the stomach to be disconnected during bariatric surgery and then reconnected later when endoscopic access is needed, providing adaptability between permanent alteration and reversibility based on clinical requirements.
Solution Approach 2:
The patent changes the parameter of closure permanence from fixed to variable. The alterable gastric closure can be in a closed state during bariatric surgery and switched to an open state when endoscopic access is required, allowing parameter modification based on procedural needs.
2Productivity
If conventional endoscopy is used in altered anatomy, then diagnostic and therapeutic procedures can be performed, but navigation difficulty increases
Solution Approach 1:
The alterable gastric closure is deployed in advance during bariatric surgery to create the necessary anatomical alteration. This preliminary action enables subsequent endoscopic procedures to be performed more easily by pre-establishing the altered anatomy, rather than attempting to navigate through unchanged surgery-altered structures.
3Reliability
If advanced surgical skills are required for endoscopy in altered anatomy, then procedure success rate improves, but accessibility and safety are reduced
Solution Approach 1:
The alterable gastric closure acts as an intermediary structure that simplifies the endoscopic navigation path. By creating a controlled alteration in gastric anatomy, it serves as a mediator between the endoscope and the pancreaticobiliary system, reducing the navigational complexity and skill requirements compared to conventional approaches in permanently altered anatomy.
Data Source
AI summary
Systems, devices, and methods for endoluminal transgastric access to the pancreaticobiliary anatomy are disclosed. An exemplary transgastric access technique comprises creating a reversible alteration of gastric anatomy using a closing device, including a reversible disconnection between a first gastric portion and a second gastric portion via an alterable gastric closure. The technique further includes, during an endoscopy procedure, passing a steerable elongate instrument into the first gastric portion, identifying the alterable gastric closure, and disengaging at least a portion of the alterable gastric closure using an endoluminal disengaging device to at least partially reconnect the first and second gastric portions. The steerable elongate instrument can then pass through the disengaged portion and extend into the pancreaticobiliary anatomy to perform the endoscopic procedure therein. The disengaged portion can be closed using the alterable gastric closure at the conclusion of the procedure.