Transgastric Endoscopic Fundoplication via Stapling
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Solution Overview
Problem
Current methods for treating gastroesophageal reflux disease (GERD) require invasive surgeries under general anesthesia, which are costly, painful, and carry significant complications, and existing minimally invasive devices are difficult to control and prone to tissue damage.
Innovation Solution
A transgastric endoscopic partial fundoplication method involving an endoscope that introduces staples to the esophagus to create a functional sphincter by cutting a hole in the stomach, grabbing tissue, positioning a staple cartridge, firing staples, and closing the hole, allowing for a safer and less invasive procedure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional surgical fundoplication is performed, then GERD treatment effectiveness is improved, but surgical complexity and recovery time increase
Solution Approach 1:
The procedure is divided into distinct endoscopic steps: introducing the endoscope through the mouth and esophagus into the stomach, cutting a hole in the stomach wall, pushing the endoscope through the hole, grabbing tissue, positioning the staple cartridge, firing staples, and closing the hole. This segmentation allows complex surgical tasks to be performed through minimally invasive endoscopic approaches rather than open surgery.
Solution Approach 2:
Traditional mechanical surgical instruments and open incisions are replaced with an endoscopic system that uses a stapler mechanism delivered through the endoscope. The stapler fires staples through the tissue to create the fundoplication, substituting complex mechanical surgical manipulation with a more controlled endoscopic stapling process.
2Loss of time
If laparoscopic fundoplication is performed, then hospital stay is reduced, but anesthesia risk and complication rate remain significant
Solution Approach 1:
The procedure extracts the need for general anesthesia by performing the fundoplication through the oral cavity using endoscopy, eliminating the requirement for thoracic or abdominal incisions and associated anesthesia risks. The stapler is delivered through the endoscope's working channel, avoiding the need for surgical incisions.
Solution Approach 2:
Instead of approaching the esophagus from the abdominal or thoracic cavity through incisions, the procedure approaches it from the oral cavity through the endoscope, inverting the traditional surgical access route. This reversal eliminates the need for general anesthesia and major incisions while achieving the same therapeutic goal.
3Object-affected harmful factors
If existing minimally invasive devices are used, then tissue damage is reduced, but device control difficulty increases
Solution Approach 1:
The endoscope provides real-time visual feedback during the procedure, allowing the operator to see the tissue being manipulated and the stapler positioning. This feedback mechanism enables precise control of the stapler delivery and firing, ensuring accurate placement while minimizing tissue damage through direct visualization.
Solution Approach 2:
The endoscope acts as an intermediary tool that delivers the stapler system to the target location. Rather than requiring direct manual manipulation of surgical instruments through incisions, the endoscope serves as a controlled mediator that guides the stapler to the precise location and provides visualization throughout the procedure.
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 provides a safer, quicker, and more effective treatment for GERD by avoiding major surgery and reducing complications, with the potential for faster recovery and reduced costs compared to traditional surgical approaches.
Implementation Method 1
firing the staples
Implementation Method 2
cutting a hole in the wall of the stomach
Data Source
AI summary
The invention is a transgastric method for the endoscopic partial fundoplication for the treatment of gastroesophageal reflux disease (GERD). The method makes use of an articulated endoscope, which is introduced through the mouth and esophagus into the stomach of the patient. A cutting tool is introduced through the working channel of the endoscope to cut a hole in the wall of the stomach. The endoscope is pushed through the hole and a grabbing tool is introduced through the working channel and used to grab the tissue at a location on the outer surface of the stomach and move the grabbed tissue close to the esophagus. The grabbed tissue is then stapled to the esophagus using a stapling device that is an integral part of the endoscope. If desired, after stapling the endoscope can be rotated one or more times and the procedure repeated. After the selected portions of the stomach wall have been attached to the esophagus, the endoscope is withdrawn from the body of the patient and the hole in the stomach wall is closed, preferably by means of a dedicated endoscopic stapling device especially designed for the task of closing holes in tissue.