Method and devices for use in surgical gastroplastic procedure

Claim 1

A method for performing laparoscopic gastroplasty on a patient, said method comprising: percutaneously introducing a plurality of trocars through the patient's abdominal wall; visualizing the patient's stomach using a laparoscope disposed in one of the trocars; manipulating the stomach to expose the lesser curvature, anterior, and posterior walls of the stomach to the laparoscope; dissecting the stomach from the peritoneum along a line dividing the stomach into a proximal pouch adjacent the esophagus and a distal region; introducing a stapling device having a fastening head including a pair of opposed jaws with stapling surfaces through another of the trocars, said fastening head defining an aperture at the junction of the opposed jaws; positioning the stapling device so that the jaws lie along the dissected line with the aperture aligned beneath the esophagus; introducing a nasogastric tube into the stomach so that it passes through the aperture; inflating a first balloon on the nasogastric tube distally of the aperture and a second balloon on the nasogastric tube in the esophagus, to seal the proximal pouch in the stomach; introducing a measured volume of fluid into the proximal pouch through the nasogastric tube until the pouch is filled; repositioning the fastening head and reintroducing fluid until the position of the fastening head provides a preselected fluid volume upon filling; and stapling the stomach along a line defined by the fastening head at its final position, with a passage between the proximal pouch and distal region of the stomach being defined by the aperture.

Claim 2

A method for performing laparoscopic gastroplasty on a patient, said method comprising: percutaneously introducing a plurality of trocars through the patient's abdominal wall; visualizing the patient's stomach using a laparoscope disposed in one of the trocars; manipulating the stomach to expose the lesser curvature, anterior, and posterior walls of the stomach to the laparoscope; dissecting the stomach from the peritoneum along a line dividing the stomach into a proximal pouch adjacent the esophagus and a distal region; introducing a stapling device having a fastening head including a pair of opposed jaws with stapling surfaces through another of the trocars, said fastening head defining an aperture at the junction of the opposed jaws; positioning the stapling device so that the jaws lie along the dissected line with the aperture aligned beneath the esophagus; introducing a nasogastric tube into the stomach so that it passes through the aperture; inflating a first balloon on the nasogastric tube distally of the aperture and a second balloon on the nasogastric tube in the esophagus, to seal the proximal pouch in the stomach; introducing a measured volume of fluid into the proximal pouch through the nasogastric tube until the pouch is filled; repositioning the fastening head and reintroducing fluid until the position of the fastening head provides a preselected fluid volume upon filling; and stapling the stomach along a line defined by the fastening head at its final position, with a passage between the proximal pouch and distal region of the stomach being defined by the aperture.

Claim 6

A method for performing laparoscopic gastroplasty on a patient, said method comprising: laparoscopically dissecting the stomach from the peritoneum along a line dividing the stomach into a proximal pouch adjacent the esophagus and a distal region; providing a staple support strip having anterior and posterior ends for being stapled over the stomach; and, laparoscopically inserting said staple supporting strip and stapling the anterior and posterior walls of the stomach together along said dividing line by passing staples through anterior and posterior ends of said strip and through anterior and posterior walls of the stomach located between said strip ends to define a fixed diameter passage between said proximal pouch and said distal region.

Claim 7

A method for performing laparoscopic gastroplasty on a patient, said method comprising: laparoscopically dissecting the stomach from the peritoneum along a line dividing the stomach into a proximal pouch adjacent the esophagus and a distal region; providing a staple support strip having anterior and posterior ends for being stapled over the stomach; and, laparoscopically inserting said staple supporting strip and stapling the anterior and posterior walls of the stomach together along said dividing line by passing staples through anterior and posterior ends of said strip and through anterior and posterior walls of the stomach located between said strip ends to define a fixed diameter passage between said proximal pouch and said distal region.

Claim 11

A method for performing laparoscopic gastroplasty on a patient, said method comprising: percutaneously introducing a plurality of trocars through the patient's abdominal wall; visualizing the patient's stomach using a laparoscope disposed in one of the trocars; manipulating the stomach to expose the lesser curvature, anterior, and posterior walls of the stomach to the laparoscope; dissecting the stomach from the peritoneum along a line dividing the stomach into a proximal pouch adjacent the esophagus and a distal region; introducing a banding device for encircling the stomach along a dissecting line for defining a proximal pouch, a distal portion and an aperture defined therebetween; introducing a nasogastric tube into the stomach so that it passes through the aperture; inflating a first balloon on the nasogastric tube distally of the aperture and a second balloon on the nasogastric tube in the esophagus, to seal the proximal pouch in the stomach; introducing a measured volume of fluid into the proximal pouch through the nasogastric tube until the pouch is filled; repositioning the banding device and reintroducing fluid until the position of the fastening head provides a preselected fluid volume upon filling; closing the banding device over the stomach along a line defined by the aperture in the band at its final position, with a passage between the proximal pouch and distal portion of the stomach being defined by the aperture; and maintaining the banding device relative to the stomach by stapling the banding device to the stomach wall.

Claim 12

A method for performing laparoscopic gastroplasty on a patient, said method comprising: percutaneously introducing a plurality of trocars through the patient's abdominal wall; visualizing the patient's stomach using a laparoscope disposed in one of the trocars; manipulating the stomach to expose the lesser curvature, anterior, and posterior walls of the stomach to the laparoscope; dissecting the stomach from the peritoneum along a line dividing the stomach into a proximal pouch adjacent the esophagus and a distal region; introducing a banding device for encircling the stomach along a dissecting line for defining a proximal pouch, a distal portion and an aperture defined therebetween; introducing a nasogastric tube into the stomach so that it passes through the aperture; inflating a first balloon on the nasogastric tube distally of the aperture and a second balloon on the nasogastric tube in the esophagus, to seal the proximal pouch in the stomach; introducing a measured volume of fluid into the proximal pouch through the nasogastric tube until the pouch is filled; repositioning the banding device and reintroducing fluid until the position of the fastening head provides a preselected fluid volume upon filling; closing the banding device over the stomach along a line defined by the aperture in the band at its final position, with a passage between the proximal pouch and distal portion of the stomach being defined by the aperture; and maintaining the banding device relative to the stomach by stapling the banding device to the stomach wall.