Submucosal Endoscopy Mucosal Flap Closure Mechanism
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Solution Overview
Problem
Current minimally invasive access methods for internal body cavities, such as the posterior mediastinum, require thoracotomy and pleural incisions, causing trauma to surrounding organs and lacking efficient closure mechanisms.
Innovation Solution
The development of submucosal endoscopic kits and methods that create a mucosal flap by forming a gas-filled bleb within the muscularis propria using pressurized carbon dioxide, allowing for minimally invasive access and secure closure through the use of an endoscope, needle, and tissue attachment materials.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If thoracotomy and pleural incision are used to access the posterior mediastinum, then access to internal body cavities is achieved, but trauma to surrounding organs occurs
Solution Approach 1:
The patent uses the gastrointestinal tract (esophagus or stomach) as an intermediary structure to access the posterior mediastinum and peritoneal cavity. Instead of directly incising through the chest wall and pleura, the procedure creates a submucosal tunnel through the GI tract wall, using the GI tract as a safe conduit that avoids direct trauma to surrounding organs while still providing access to the target cavity
Solution Approach 2:
The procedure segments the access path into distinct layers: first creating a submucosal bleb within the GI tract wall, then forming a mucosal flap, and finally creating the opening through the muscularis propria. This segmentation allows each layer to be manipulated independently, with the mucosal flap serving as a protective barrier that can be opened for access and then closed to seal the entry point
2Ease of operation
If conventional access methods are used, then entry into body cavities is achieved, but closure mechanisms are insufficient
Solution Approach 1:
The procedure performs preliminary actions by first creating the submucosal bleb and then forming the mucosal flap before making the actual opening into the body cavity. The mucosal flap is prepared in advance as a closure mechanism, allowing the access point to be sealed after the procedure by simply repositioning or suturing the pre-formed flap
Solution Approach 2:
The patent utilizes parameter changes in tissue properties by injecting fluid or gas to create a submucosal bleb, which changes the physical state of the tissue from compact to distended. This parameter change creates space and facilitates the formation of the mucosal flap, which can then be easily manipulated for both opening and closing the access point
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 approach reduces trauma to surrounding organs by providing a safe and efficient means of accessing internal cavities, such as the peritoneal cavity and posterior mediastinum, with the mucosal flap ensuring secure closure of the access point, minimizing tissue damage and procedural risks.
Implementation Method 1
The apparatus generally includes a fluid source adapted for connection to the fluid delivery lumen, the fluid source comprising a fluid, e.g., a liquid or pressurized gas, to form a gas-filled submucosal space
Implementation Method 2
Potential advantages of carbon dioxide may potentially include, e.g., that carbon dioxide is readily absorbed by tissue and is unlikely to cause embolisms
Data Source
AI summary
Kits and methods for submucosal endoscopic access into body cavities such as the peritoneal cavity and the posterior mediastinum through a submucosal endoscopic procedure in which an opening is formed through the muscularis propria within a bleb. The procedure may result in a mucosal flap formed by separated mucosal tissue within the bleb and the mucosal flap may be advantageously used to assist in closure of the opening.