A method of preventing contraction and peristaltic wave action of an esophagus in which a GARD is placed, preventing displacement of the GARD towards or into a stomach, the method comprising injecting botulinum toxin very precisely in the muscular layer of the esophageal wall at the level where the GARD is or will be placed. A system comprising a catheter having one or two expandable balloon(s) which carries guide needle catheters that can pierce the esophageal wall and reach precisely the muscular layer of the wall of the esophagus, the needles used to inject the toxin at precisely the exact location in the esophageal wall in relationship with the GARD device to block esophageal peristalsis locally.

The invention relates surgical abdominal methods of treating obesity in a patient by implanting a volume filling device that, when implanted in a patient, reduces the food cavity in size by a volume substantially exceeding the volume of the volume filling device. Also disclosed is a laparoscopic instrument for providing a volume filling device to be invaginated in the stomach wall of a human patient to treat obesity.

An apparatus for treating obesity comprises a volume filling device formed by at least two segments and is provided and following implantation, the device is placed resting against the stomach wall of the patient to reduce the inner volume of the stomach, thereby affecting the patients appetite.

An implantable flow-restricting device, extending along a longitudinal extent which need not be linear, and having a first portion and a second portion with a saddle region therebetween. At least one of the first or second portions may be angled with respect to the saddle region to resist migration of the device. At least one of the first or second portions may be configured to maintain a distance from a region of the anatomical structure in which such portion is positioned. An occluder, such as an expandable occluder, may be associated with the flow-restricting device, such as with one of the first or second portions thereof. The occluder may serve to block passage of material through the anatomical passage in which the saddle region is positioned, prevent migration of the device (e.g., through such passage), and/or increase volume occupied by the device.

An implantable device capable of regulating flow of material through a body passage. The implantable device may include at least one retention member having a surface curved to resist migration of the implantable device with respect to the body passage. The implantable device may be provided with features providing a cushioning effect with respect to tissue at which the implantable device is implanted. The length of the implantable device and/or the configuration of at least one retention member on the implantable device may be adjustable. A removal element may be provided to facilitate removal of the implantable device.

A mesh element having a mesh gauge selected to control flow of materials therethrough. The mesh element is implantable into an anatomical structure upstream of a body passage or within a body passage to control flow of materials through the body passage. The mesh element may be coupled to a support structure to facilitate anchoring of the mesh element in place relative to the body passage. The support structure may have a lumen defined therethrough to allow flow of materials through the body passage, with the mesh element regulating the flow of materials into the lumen. The mesh element alternatively may be directly coupled to an anatomical structure upstream of a body passage to regulate or determine flow of materials through the body passage.

A gastrointestinal device for treating obesity includes a three-dimensional porous structure configurable between a compressed pre-deployment configuration to facilitate delivery and an expanded post-deployment configuration. The porous structure includes a first opening at its proximal end and a larger second opening at its distal end. The porous structure also includes a sleeve coupled to its distal end. Optionally, the device further includes a suture at the proximal end of the wire mesh structure to facilitate retrieval and an anti-migration component positioned at the junction of the porous structure with the sleeve. The porous structure is deployed in a patient's stomach such that the anti-migration component sits proximal to the patient's pylorus and prevents migration of the entirety of the device into and through the pylorus. The sleeve extends through the pylorus, into the duodenum and ends in the duodenum or jejunum. Food enters the device from the first opening at the proximal end of the porous structure, passes through the porous structure and sleeve, and exits at the distal end of the sleeve. The device treats obesity by providing a relatively immovable volume occupying structure in the stomach and a bypass for food past the pylorus and proximal portion of the small intestine. Optionally, the device further acts to slow the passage of food through the digestive tract. Patients with the device experience satiety more quickly and have a prolonged sensation of satiety.

A stomach lining patch includes a collapsible frame, a membrane covering the collapsible frame, collapsible frame and the membrane providing a collapsed configuration suitable for endoluminal delivery to a stomach of a patient and an expanded configuration suitable for lining an internal surface of a gastric wall of the stomach, and a set of anchoring arms extending from the collapsible frame and being configured to pass through a puncture in the gastric wall and lay flat against an outer surface of the gastric wall when the collapsible frame and the membrane are in an expanded configuration lining the internal surface of the gastric wall.

A gastrointestinal device for treating obesity includes a three-dimensional porous structure configurable between a compressed pre-deployment configuration to facilitate delivery and an expanded post-deployment configuration. The porous structure includes a first opening at its proximal end and a larger second opening at its distal end. The porous structure also includes a sleeve coupled to its distal end. Optionally, the device further includes a suture at the proximal end of the wire mesh structure to facilitate retrieval and an anti-migration component positioned at the junction of the porous structure with the sleeve. The porous structure is deployed in a patient's stomach such that the anti-migration component sits proximal to the patient's pylorus and prevents migration of the entirety of the device into and through the pylorus. The sleeve extends through the pylorus, into the duodenum and ends in the duodenum or jejunum. Food enters the device from the first opening at the proximal end of the porous structure, passes through the porous structure and sleeve, and exits at the distal end of the sleeve. The device treats obesity by providing a relatively immovable volume occupying structure in the stomach and a bypass for food past the pylorus and proximal portion of the small intestine. Optionally, the device further acts to slow the passage of food through the digestive tract. Patients with the device experience satiety more quickly and have a prolonged sensation of satiety.

A surgical instrument (100) for placement of a movement restriction device (10) for use in a surgical procedure for treating reflux disease in a patient. The instrument comprises a sleeve (113) and a holding device (111) configured to engage the movement restriction device, wherein the holding device is configured to be placed within the sleeve and be displaceable in relation to the sleeve. The instrument further comprises a first handling portion (101) connected to the sleeve, and a second handling portion (102) connected to the holding device. The handling of at least one of the first and second handling portion creates relative displacement of the holding device in relation to the sleeve, which disengages the holding device from the movement restriction device for performing the placement of the movement restriction device.