Endoscopic Gastric Sleeve Suture Mounds Avoid Vessel Puncture
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Solution Overview
Problem
Minimally invasive surgical procedures, such as endoscopic suturing, face a high risk of puncturing adjacent vessels due to the need to insert a cannula through the vessel wall to deploy anchor elements, which can be fatal if an artery is nearby, especially during procedures like sleeve gastroplasty.
Innovation Solution
The method involves forming mounds on the vessel wall by injecting an injectable fluid into the submucosal layer, allowing sutures to be inserted into these mounds without needing to pierce the wall, thereby avoiding the risk of puncturing adjacent vessels by using anchor elements located within the formed pockets.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a cannula is inserted through the vessel wall to deposit anchor elements, then the suture can be tightened to draw the vessel parts together, but the risk of puncturing adjacent vessels increases
Solution Approach 1:
Instead of inserting the cannula from the inner surface of the vessel wall to the outer surface (conventional approach), the invention inverts the sequence by first forming mounds on the outer surface, then inserting the cannula from the outer surface through the mounds back to the inner surface. This inversion allows the cannula tip to be contained within the mounds during insertion, preventing puncture of adjacent vessels while still enabling effective suture tightening.
Solution Approach 2:
The invention applies preliminary action by forming mounds on the outer surface of the vessel wall before inserting the cannula. These pre-formed mounds serve as safe zones that guide and contain the cannula insertion, eliminating the hazard of uncontrolled cannula tip movement that could puncture adjacent vessels. The mounds are created using an injectable substance that raises the outer surface, providing a predetermined safe path for subsequent cannula insertion.
2Ease of manufacture
If the cannula is inserted through the vessel wall for each suture, then anchor elements can be deposited, but the procedure time increases due to repeated instrument re-entry
Solution Approach 1:
The invention applies preliminary action by forming all necessary mounds on the outer surface of the vessel wall before inserting any cannula. This pre-preparation allows multiple sutures to be inserted through the already-formed mounds without needing to repeatedly puncture the vessel wall, thereby reducing procedure time while still enabling proper anchor element deployment for each suture.
Solution Approach 2:
The invention segments the procedure into distinct phases: first forming multiple mounds on the outer surface, then inserting multiple sutures through these pre-formed mounds. This segmentation allows the hazardous wall-puncturing action to be performed only once for mound formation, while subsequent suture insertions use the pre-prepared pathways, reducing repeated instrument re-entry and procedure time.
3Reliability
If mounds are formed on the vessel wall by injecting fluid, then suture insertion becomes safer, but additional steps and materials are required
Solution Approach 1:
The invention introduces an intermediary substance (injectable material) that is injected to form mounds on the outer surface of the vessel wall. This intermediary serves as a mediator between the surgeon's intent to create safe insertion pathways and the actual cannula insertion process. The mounds act as a protective intermediary structure that guides the cannula tip and prevents direct contact with adjacent vessels, thereby enhancing safety despite adding a procedural step.
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 the risk of vessel puncture and minimizes instrument re-entry, significantly shortening procedure time by allowing pre-formed mounds to guide suture insertion and tightening, promoting vessel wall knitting without the need for cannula penetration through the wall.
Implementation Method 1
each one of the first and second mounds being formed by forming a pocket in a submucosal layer of the vessel wall or between the submucosal layer and a muscular layer of the vessel wall adjacent the site at which the corresponding one of the first and second mounds is to be formed
Data Source
AI summary
An endoscopic sleeve gastroplasty procedure comprises forming a gastric sleeve (5) through a stomach (1) by suturing a first portion (9) of a wall (3) of the stomach (1) to a second portion (11) of the wall (3). First and second rows (20, 22) of first and second mounds (18, 19) are formed in the first and second portions (9,11) by injecting a viscus bulking solution (25) into a submucosal layer (28) at sites (17) of the wall (3) to form pockets (27) therein to form the first and second mounds (18, 19). Sutures (15) are inserted into respective pairs (16) of the first and second mounds (18, 19) with anchor bars (38) of the sutures (15) located in the corresponding pockets (27). The sutures (15) are tightened for drawing the first and second mounds (18, 19) together to in turn draw the first and second portions (9, 11) of the wall (3) of the stomach (1) together to form the gastric sleeve (5).