U.S. patent application number 12/005993 was filed with the patent office on 2009-09-24 for endoscope & tools for applying sealants and adhesives and intestinal lining for reducing food absorption.
Invention is credited to Thomas J. McGuigan, Julie Ann Smit.
Application Number | 20090240105 12/005993 |
Document ID | / |
Family ID | 28673835 |
Filed Date | 2009-09-24 |
United States Patent
Application |
20090240105 |
Kind Code |
A1 |
Smit; Julie Ann ; et
al. |
September 24, 2009 |
Endoscope & tools for applying sealants and adhesives and
intestinal lining for reducing food absorption
Abstract
A first part of the inventive instrument comprises an insertion
and removal device in the form of an endoscope which may be
inserted through the mouth, pharynx, esophagus and stomach into the
small intestine. The inside lumen of the endoscope contains two
extendable tools. One extendable tool has a balloon on its end,
which may be inflated and deflated. The other extendable tool
contains optical fibers for photopolymerizing adhesives and
sealants. The second part of the inventive instrument comprises a
tubular lining for implantation in and lining of the small
intestine, to prevent food from being absorbed into the villi. The
lining is anchored in position by means of medical-grade adhesives
that are contained on or applied to a mesh sleeve on one end of the
lining. The adhesive-coated sleeve is then expanded and glued to
the intestine. In operation the lining expands outwardly as
digesting food chemicals enter the lining. This allows the normal
bodily peristalsis to squeeze the food chemicals through the
lining. An alternate tool for an endoscope may be used to apply a
coating of biodegradable sealant to the walls of the small
intestine to restrict food absorption. Implanting the lining into
the intestine or coating the intestine with sealant can be
accomplished with no or minimal surgery.
Inventors: |
Smit; Julie Ann; (Evanston,
IL) ; McGuigan; Thomas J.; (Chicago, IL) |
Correspondence
Address: |
Julie A. Smit
1045 Hinman Avenue
Evanston
IL
60202
US
|
Family ID: |
28673835 |
Appl. No.: |
12/005993 |
Filed: |
December 28, 2007 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
10115771 |
Apr 3, 2002 |
7335210 |
|
|
12005993 |
|
|
|
|
Current U.S.
Class: |
600/104 ; 604/20;
604/500; 604/96.01 |
Current CPC
Class: |
A61B 2017/00557
20130101; A61F 5/0089 20130101; A61B 17/00491 20130101; A61M 25/09
20130101; A61F 5/0076 20130101 |
Class at
Publication: |
600/104 ;
604/96.01; 604/500; 604/20 |
International
Class: |
A61B 17/94 20060101
A61B017/94; A61M 29/02 20060101 A61M029/02; A61N 5/00 20060101
A61N005/00; A61B 1/018 20060101 A61B001/018 |
Claims
24. An instrument for use in applying a coating to an interior
surface of an intestine for restricting food absorption, the
instrument comprising: a flexible endoscope member having a
proximal end, a distal end, wherein the distal end configured to be
inserted into the intestine, and a lumen therethrough; a second
elongate member to be inserted through the lumen of the flexible
endoscopic member, wherein the second elongate member having a
proximal portion, a distal portion, a passageway, and a plurality
of flexible bands disposed at least on the distal portion, said
flexible bands configured to expand outwardly to contact the
interior surface of the intestine and radially expand the intestine
when the distal portion of the second member is extended beyond the
distal end of the first member; a coating delivery tool configured
to be inserted into the passageway of the second member, said
coating delivery tool having a proximal portion, a distal portion
configured to extend beyond the distal portion of the flexible
endoscopic member for applying a coating to the interior surface of
the intestine, at least one internal passage, and an outer surface,
wherein a coating is applied to the interior surface of the
intestine.
25. The instrument of claim 24, wherein a component of said coating
is a biodegradable primer.
26. The instrument of claim 24, wherein a component is a
biodegradable adhesive or biodegradable sealant that is configured
to be slowly disintegrated over time and eliminated by the
body.
27. The instrument of claim 26, wherein a component is a
photopolymerizing biodegradable sealant or photopolymerizing
biodegradable adhesive.
28. The instrument of claim 27, wherein the coating delivery tool
further comprises plurality of side openings on the outer surface
wherein the plurality of side openings configured to receive
optical fibers, wherein the optical fibers operate coupled to a
laser, configured for curing the coating after the coating is
applied to the interior surface of the intestine.
29. The instrument of claim 26, wherein the coating delivery tool
further comprises a heating coil, wherein the heating coil operates
coupled to a heat source, configured for curing the coating after
the coating is applied to the interior surface of the
intestine.
30. The instrument of claim 24, wherein the second elongate member
further comprises a non-stick coating that prevents adhesive and
sealant bonding to the second member.
31. The instrument of claim 24, wherein the flexible endoscope
member further includes an ultrasound transducer, said the
ultrasound transducer configured to aid a surgeon to accurately
positionthe distal end of the endoscopic member inside the
intestine.
32. The instrument of claim 24, wherein the second elongate member
further includes markings on the outer surface, said the markings
configured to aid a surgeon in accurately positioning the distal
end of the second member inside the intestine.
33. A method for applying a coating to an interior surface of an
intestine for partially restricting food absorption from the inside
of the intestine to the body thereby treating obesity, the method
comprising: inserting the distal end of the flexible endoscopic
member into the intestine, inserting the second elongate member
into the lumen of the flexible endoscopic member, extending the
distal portion of the second elongate member beyond the distal end
of the endoscopic member thereby expanding the distal portion of
the second elongate member outwardly to contact the interior
surface of the intestine and radially expand the intestine,
inserting the coating delivery tool into the passageway of the
second member and positioning the distal portion of the coating
delivery tool proximate to the distal portion of the second member,
applying the first component of an adhesive or sealant to the
interior surface of the intestine, applying the second component of
an adhesive or sealant to the interior surface of the intestine,
and applying energy to cure the coating.
34. A method of claim 33, wherein the first component is a
biodegradable primer.
35. A method of claim 33 wherein the second component is a
biodegradable adhesive or biodegradable sealant that is configured
to be slowly disintegrated over time and eliminated by the
body.
36. A method of claim 33, wherein the energy being applied is
heat.
37. A method of claim 33, wherein the energy being applied is
laser.
38. A hydrogel lining for blocking the intestinal villi in order to
restrict food absorption, whereby a person may consume whole food
through the mouth, said whole food becoming partially digested in
the stomach before coming into contact with said hydrogel lining,
and means for controlling a transfer of food chemicals from said
digesting food solids through the walls of said hydrogel lining to
the alimentary canal by preventing or altering the transfer of said
food chemicals between said hydrogel lining and the walls of the
alimentary canal to be used to treat obesity.
39. The hydrogel lining of claim 38 wherein it is pressed into
position by a balloon catheter at least one foot or longer in
length.
Description
[0001] This is a Continuation of my pending U.S. patent application
Ser. No. 10/1125,771, filed Apr. 3, 2202, entitled: Endoscope &
Tools for Applying Sealants and Adhesives and Intestinal Lining for
Reducing Food Absorption.
[0002] This invention relates to medical appliances and more
particularly to membranes and coatings to prevent digesting food
chemicals from being absorbed through the intestinal vill in order
to restrict food absorption.
[0003] Reduction of food absorption for weight loss may be
accomplished in several ways. One way is by implanting a
membrane-type lining to cover the intestinal villi and, thereby,
reduce the amount of food chemicals absorbed. The lining is
anchored in position by means of medical-grade adhesives that are
contained on or applied to a mesh sleeve attached to one end of the
lining. When the partially digested food chemicals enter the
implant, they are squeezed through the lining by the normal
peristaltic movements and contractions, in the patient's body. The
lining retains a collapsed state when empty of food and expands
outwardly as food chemicals enter. Thus, when the intestinal walls
feel a change in diameter, they commence peristaltic movements and
contractions, which squeeze the liquefied chyme through the lining
and then out its open end.
[0004] The lining can be inserted and removed, without major
surgery, by an endoscope, which contains two extendable tools
running coaxially within its lumen. One extendable tool has a
balloon on its end that may be inflated and deflated. The other
extendable tool contains optical fibers to photopolymerize
adhesives and sealants once application is complete.
[0005] An alternate endoscopic tool may be used to apply a
biodegradable medical-grade sealant to coat and block the
intestinal villi in order to reduce food chemical absorption.
[0006] Implanting the intestinal lining or coating the small
intestine can be accomplished with minimal or no surgery.
[0007] Obesity has become a problem of epidemic proportion in this
country. A growing number of people are submitting to surgical
treatments wherein portions of the intestine are either cut out,
bypassed or stapled in order to reduce the number of villi in the
intestine or interfere with food chemical absorption. Nowadays, the
stomach is frequently stapled to reduce the amount of food it will
hold. If a person eats too much, the person vomits the excess food
from the stomach. The more dangerous operations involving cutting
or bypassing the intestine very risky and people have even died on
occasion.
[0008] Thus, there is a need for a less drastic method of reducing
caloric absorption, without resorting to major surgery.
[0009] My two previous U.S. Pat. No. 4,134,405 and U.S. Pat. No.
4,315,509 were the original prior art in the field of linings,
which restrict food absorption in the intestine. This Continuation
contains further improvements and novel alternatives in the field
of linings and coatings for the alimentary canal.
[0010] Accordingly, an object of this invention is to line a large
portion of the intestine with a tubular membrane in order to
restrict food absorption through the intestinal villi.
[0011] Another object is to coat and block a large portion of the
intestinal villi with a medical-grade sealant for the treatment of
obesity.
[0012] Still another object of the invention is to cover an
ulcerated portion of the intestine so that it may have time to heal
without being exposed to the digestive process, especially the
stomach's hydrochloric acid.
[0013] A further object is to accomplish these and other objects
without permanently altering the alimentary canal.
[0014] Yet another object is to accomplish these objects in a
manner that may be reversed if unwanted side effects should
interfere with normal body processes.
[0015] In keeping with an aspect of the invention, these and other
objects are accomplished by use of a two-part instrument. The first
part of the instrument is an insertion and removal device in the
form of an endoscope that may be inserted through the mouth,
pharynx, esophagus, and into the stomach or small intestine. The
inside of the endoscope contains two extendable tools that run
coaxially through its lumen. One extendable tool is equipped with
an expandable balloon on its end. The other extendable tool is
equipped with optical fibers to photopolymerize adhesives and
sealants.
[0016] The second part of the instrument is a membrane-type lining
for the intestine. Attached to one end of the lining is a mesh
sleeve, which is glued to the walls of the alimentary canal to
anchor the lining in position.
[0017] Normally, for weight reduction most or all of the lining
will be contained in the small intestine. However, the two-part
inventive instrument may be utilized anywhere in the alimentary
canal it is desired to control, restrict or block absorption.
[0018] To insert the lining, the mesh sleeve is coated with primer
and adhesives and encased in a gelatin capsule secured over the
deflated balloon on the end of the extendable, endoscopic tool.
Once the lining and mesh sleeve are correctly positioned, the
balloon is inflated, thereby, breaking the gelatin capsule and
bonding the mesh sleeve to the intestinal walls.
[0019] Thereafter, pulsed ultraviolet light is applied to
photopolymerize the adhesive and securely bond it to the intestinal
walls. Additional adhesive and light may be applied to the mesh
sleeve, if necessary, by an alternate endoscopic tool. After the
mesh sleeve is securely glued to the intestinal mucosa, the
endoscope is removed from the body leaving the lining anchored in
the small intestine.
[0020] The lining has a semi-flexible strip, running the length of
the lining, which stabilizes the lining and prevents it from
twisting shut or kinking.
[0021] An alternate endoscopic tool applies a biodegradable sealant
to the walls of the small intestine to coat and, thereby, block
food absorption through the intestinal villi.
[0022] For this procedure, the small intestine is expanded and held
open by a Teflon-coated frame, which is extended beyond the
endoscope. The Teflon-coated frame is compressed when it is inside
the endoscope. The frame expands outwardly, of its own resilience,
once it is no longer restricted within the endoscope. A
medical-grade sealant is then applied to the intestinal walls
through the frame. Thereafter, a pulsed ultraviolet light is
applied, with the frame still expanding the intestine, to
photopolymerize the sealant onto the intestinal walls.
[0023] The sealant is biodegradable so it is slowly absorbed by the
body.
[0024] All tools and instruments contained within the endoscope,
which come into contact with the adhesives and sealants, must be
coated with Teflon, silicone or other non-stick material so bonding
will not occur.
[0025] The nature of the preferred embodiments may be understood
best from a study of the attached drawings, wherein:
[0026] FIG. 1 is a schematic diagram showing the inventive lining
being implanted in the small intestine, and the endoscope in a
position where it is about to be used to glue the mesh sleeve in
position;
[0027] FIG. 2 schematically shows, somewhat in perspective, a
tubular lining, which may be implanted in the small intestine;
[0028] FIG. 3A is a perspective view of the three main parts of the
endoscope, which is used as a tool for implanting and removing the
lining of FIG. 2;
[0029] FIG. 3B is a perspective view of an alternate balloon
catheter to aid in implanting a hydrogel lining;
[0030] FIG. 4 is a perspective view of the main parts of an
alternate endoscope, which shows a frame being extended to expand
the intestine and an endoscopic tool for applying and
photopolymerizing adhesives and sealants;
[0031] FIG. 5 is a cross section taken along line IA-IA of FIG. 4
showing the Teflon-coated frame dilating the intestine;
[0032] FIG. 6 is a cross section taken along line IB-IB of FIG. 4
showing optical fibers directed outward to photopolymerize the
sealant and bond it to the intestinal walls;
[0033] FIG. 7 shows a heat coil which may be used to bond adhesives
and sealants;
[0034] FIG. 8 is a perspective view of an alternate endoscope,
which contains a brush that can be rotated, to apply and mix
two-component adhesives and sealants; and
[0035] FIG. 9 is a perspective view of alternate frame means and
alternate tube means for applying primer & sealant.
[0036] In the description that follows, any suitable medical grade
material may be used for the lining, mesh sleeve, endoscope and
endoscopic tools.
[0037] One embodiment for the lining is preferably, manufactured of
silicone rubber. The other embodiment for the lining is preferably
made of hydrogel which is slowly absorbed by the body.
[0038] The mesh sleeve may be manufactured of any material, which
the medical-grade adhesives will securely bond with. Preferably,
these include hydrogels, marine adhesive proteins, polymeric
sealants, fibrin glues, cyanoacrylates, laser solder adhesives,
elastromers, collagen-thrombin fleece, bone dust sealants, albumin
solutions, and tissue adhesives based on protein engineering.
[0039] Several of the above are presently being used instead of
sutures and staples for binding of skin and tissues during surgery.
The new adhesives and sealants can be engineered to be absorbed, by
the body, over a predetermined amount of time. At present, it is
thought that a hydrogel should be used such as "FocalSeal".
"FocalSeal" is a registered trademark for Focal, In and Genzyme
Surgical Products' hydrogel materials and related products.
Ethicon, Inc. A Johnson & Johnson Company is marketing the
product.
[0040] According to the product overview Focal is currently
developing two principle FocalSeal Surgical Sealant products for a
broadrange of applications inside the body.
[0041] The company's FocalSeal-L Sealant and FocalSeal-S Sealant
are designed to have absorption times that parallel long-term and
short-term synthetic, absorbable polymer sutures. Focal believes
that these two sealants will be widely applicable to lung surgery,
cardiovascular surgery, neurosurgery, gastrointestinal surgery and
other surgical applications.
[0042] The company's sealants adhere to tissue as a result of a
proprietary 2-step priming and sealing process. The physician first
applies a liquid primer that penetrates into the crevices of the
tissue, and then the sealant is applied. Both are exposed to a
standard wavelength of visible light and in 40 seconds polymerize,
or change from a liquid to a solid gel (a process known as
photopolymerization). The solid gel formed after the light has been
applied is highly flexible, elastic and transparent, and strongly
adheres to moist or dry tissue. Focal's products remain adherent
during the critical wound healing process, and are then absorbed
and eliminated from the body. Regardless of whether "FocalSeal"
material is used or not used, the material should have these
characteristics.
[0043] Additionally, an adhesive hydrogel tape is currently
available. Accordingly, the anchoring sleeve could be engineered
entirely from hydrogel tape, which would eliminate or reduce the
need for primer and adhesive.
[0044] A different form of glue utilizes a composition of
two-component solutions, which are mixed together at the point of
application. They solidify rapidly without a light source. Examples
include marine adhesive proteins, collagen-thrombin fleece, fibrin
glues, hydrophilic gels, and cyanoacrylates, to name a few.
[0045] For tissue welding with adhesives and sealants, the Yag, CO
Sub 2, THC: Yag and Argon lasers are all being used with success
and the laser light could be utilized in the inventive endoscopic
tools through the optical fiber.
[0046] Currently different adhesives and sealants are being
successfully utilized during surgery and many more are being
experimented with in the field of protein engineering.
[0047] These and other suitable materials, adhesives and sealants
are used to make the inventive two-part instrument. The first part
of the instrument is a maneuverable endoscope 10 (FIG. 1), which is
used as an insertion or removal device or tool, which may be
inserted through the mouth, pharynx, esophagus, and into the
stomach or small intestine. The term "endoscope" has been used
throughout this application, however, it should be understood that
any form of maneuverable tube or catheter can be employed to
contain the insertion and removal tools.
[0048] In greater detail, endoscope 10 includes an extendable tool
22, which runs coaxially through the lumen of endoscope 10. The
distal portion of extendable tool 22 contains a balloon 26 formed
around its outer circumference. Balloon 26 is made of silicone
rubber so the adhesive material will not bond to it. Optical fibers
30 are contained within light wand 32 in endoscope 10 for
photopolymerizing the adhesives.
[0049] The lining 40 (FIG. 2) includes a long and extremely
thin-walled tube 42. Thin-walled tube 42 contains a narrow,
stabilizing strip 46. Stabilizing strip 46 is semi-flexible to
prevent thin-walled tube 42 from twisting shut or kinking as
digesting food chemicals are squeezed through it.
[0050] Incorporated into one end of thin-walled tube 42 is a mesh
sleeve 50. A primer and adhesive coating 52 is applied to mesh
sleeve 50 prior to insertion into the body.
[0051] Alternately, an anchoring sleeve may be engineered entirely
of adhesive hydrogel tape eliminating the need for applying primer
and adhesive coating 52.
[0052] FIG. 3 A shows the endoscope 10 used to insert and remove
lining 40. Endoscope 10 is equipped with a camera 12 for viewing
inside the body. Optical chamber 9 connects camera 12 and eyepiece
14. The end portion 16 of endoscope 10 is coiled so that it may be
maneuvered in a desired direction by adjusting knob 17. Knob 17
controls the angle and direction of end portion 16 via cables 18,
which run through tiny passageways 19 within walls 20 of endoscope
10.
[0053] The lumen 21 of endoscope 10 contains two extendable tools,
which are telescopically fitted together. Extendable tool 22 slides
within lumen 21 of endoscope 10 and light wand 32 slides within
lumen 25 of extendable tool 22. Both extendable tool 22 and light
wand 32 can be extended beyond the distal end of endoscope 10.
[0054] Extendable tool 22 has a balloon 26 incorporated around the
outer circumference of its end portion 24. An air passageway 28
runs through walls 23 of extendable tool 22. Air passageway 28 is
used to inflate and deflate balloon 26.
[0055] Light wand 32 contains optical fibers 30 that are connected
to a xenon light source 36 located in the procedure room.
Photopolymerization occurs after a forty-second pulsed application
of light (480-520 mm wavelength), is applied from the xenon light
source 36. Ends 34 of optical fibers 30 are directed to point
outward to apply the pulsed ultraviolet light to the intestinal
walls. Since the ultra violet light is pulsed, the patient is
exposed to a minimal amount of ultraviolet light.
[0056] For insertion into the body, mesh sleeve 50 is given an
application of primer and adhesive coating 52 and then positioned
over the deflated balloon 26. The coated mesh sleeve 50, positioned
over deflated balloon 26, is encapsulated within a gelatin capsule
and pulled inside lumen 21 of endoscope 10.
[0057] An alternate method is to manufacture mesh sleeve 50 from
adhesive hydrogel tape. For this method, mesh sleeve 50 would be
secured over deflated balloon 26, sticky side out, and encased in a
gelatin capsule. Mesh sleeve 50 would then be pulled inside lumen
21 of endoscope 10.
[0058] Thin-walled tube 42 retains a compressed state from a series
of lengthwise folds 58 so further compression is not necessary.
However, a gelatin capsule 56 may be placed on the end of
thin-walled tube 42 to better streamline it into the body.
[0059] Once the physician has determined lining 40 has reached the
correct location for implantation, mesh sleeve 50 is released from
inside lumen 21. Balloon 26 is then inflated which breaks the
gelatin capsule and presses mesh sleeve 50 against the walls of the
intestine, thereby, gluing it in place. The physician then deflates
and retracts balloon 26 back inside endoscope 10. Light wand 32 is
then extended to position ends 34 of optical fibers 30 inside mesh
sleeve 50. Optical fibers 30 are energized for forty seconds, via
xenon light source 36. to photopolymerize the adhesive and bond
mesh sleeve 50 to the intestinal walls. The light wand 32 is then
retracted back inside lumen 25. Endoscope 10 is then removed from
the body leaving lining 40 anchored in the intestine.
[0060] To remove the lining from the body, a slender forceps may be
placed inside lumen 21 of endoscope 10 to grasp a loop 54 on mesh
sleeve 50. The loop 54 and mesh sleeve 50 are then pulled partially
inside endoscope 10 for compression prior to removal from the
body.
[0061] Balloon 26 and optical fibers 30 could be incorporated into
one endoscopic tool instead of two.
[0062] FIG. 3B shows an alternate insertion tube 36 containing an
elongated balloon 38, which may be inflated to glue a hydrogel
lining 41 to the intestinal mucosa. Preferably, balloon 38 is a
foot or more in length to accommodate hydrogel lining 41 which is a
foot or longer in length.
[0063] In operation, the hydrogel lining would be secured over the
length of the deflated elongated balloon 38. A long gelatin capsule
could be slid over the hydrogel lining 41 to secure it to insertion
tube 36. Once positioned in the intestine, elongated balloon 38
would be inflated to break the gelatin capsule and bond hydrogel
lining 41 to the intestine. Over time, hydrogel lining 41 would be
absorbed by the body, so removal of the lining would not be
necessary.
[0064] Holes 49 may be punched through silicone lining 40 or
hydrogel lining 41 to allow limited food absorption.
[0065] Additionally, silicone lining 40 or hydrogel lining 41 may
be implanted through an incision in the abdomen for surgeons who
prefer a more visual procedure.
[0066] FIG. 4 shows an alternate endoscope 60 which can be used to
apply adhesives and sealants to the walls of the alimentary canal
or additional adhesive to mesh sleeve 50.
[0067] In greater detail, endoscope 60 contains a frame 62 which
can be extended out from lumen 64 of endoscope 60. Frame 62 is
coated with Teflon or other non-stick material to prevent bonding
with the adhesives and sealants.
[0068] Frame 62 comprises a series of billowed bands 68, which
expand outwardly of their own resilience once frame 62 is extended
beyond the confines of endoscope 60. Sealant tool 70 slides within
the center of frame 62 through rings 69. Rings 69 reinforce and
join billowed bands 68 together at constrictions 73.
[0069] FIG. 5 is a cross sectional view of frame 62 dilating the
intestine. Frame 62 dilates the intestine while a biodegradable
sealant is applied to the intestinal villi. Frame 62 is left in
position during the photopolymerization process as it keeps the
wet, sealant-coated, intestinal walls away from the optical fiber
chamber.
[0070] In operation, roughly a two-foot section of the small
intestine will be coated with sealant. In a living person the small
intestine is approximately five feet in length. The twenty-foot
quotes often attributed to the intestinal length are measured in a
dead person whose intestine has lost its tonus and with the
intestine stretched out to the maximum. Applying sealant to a
two-foot portion of the small intestine will result in safe yet
reliable weight loss.
[0071] In greater detail, sealant-tool 70 (FIG. 4), contains a
primer chamber 72 in its distal portion 74. Primer chamber 72 is
preferably at least six inches in length to allow at least six
inches of the intestine to be primed at one time. A passageway 77,
for delivering primer, runs through sealant tool 70. The primer is
directed, under pressure, into primer chamber 72 and is sprayed
through openings 78.
[0072] Directly behind primer chamber 72 is adhesive chamber 80.
Adhesive chamber 80 is preferably at least six inches in length to
allow at least six inches of the intestine to be coated with
adhesive at one time. A passageway 82, for delivering the adhesive,
runs through sealant tool 70. The adhesive is directed, under
pressure, into adhesive chamber 80 and is sprayed out openings
84.
[0073] Behind adhesive chamber 80 is light chamber 90 containing
optical fibers 92. Ends 94 of optical fibers 92 are arranged to
shine outward so light is directed at the intestinal mucosa. Ends
94 of optical fibers 92 can be circularly arranged to
photopolymerize at least six inches of the intestine at one time.
Optical fibers 92 are attached to a xenon light source 96 located
in the procedure room.
[0074] FIG. 6 is a cross section of light chamber 90 with optical
fibers 92 directed outward to photopolymerize the sealant and bond
it to the intestinal walls.
[0075] Light chamber 90 may be separated several inches or more
from chambers 72 and 80 to prevent any primer/sealant from
splattering on light chamber 90 during the application process.
[0076] Alternately sealant tool 70 may be designed with primer
chamber 72 and adhesive chamber 80 constructed around an open
lumen. Containing light wand 32 within a lumen running through
sealant tool 70 would protect the light chamber even further during
the application process, if necessary or desired.
[0077] In operation, endoscope 60 is inserted through the mouth,
pharynx, esophagus, and stomach into the small intestine. Once
endoscope 60 is in the desired location, frame 62 is extended
approximately two feet beyond the distal end 65 of endoscope 60.
Billowed bands 68 in frame 62 expand outwardly which dilates a
two-foot portion of the small intestine.
[0078] The physician extends sealant tool 70 six inches beyond
distal end 65 of endoscope 60. The physician then energizes an
outside pump which forces the primer into chamber 72 causing it to
be expelled through openings 78. The doctor coats this section of
the intestine with the desired amount of primer.
[0079] The physician then advances sealant tool 70 another six
inches to position adhesive chamber 80 in the area just coated with
primer. The physician energizes an outside pump, which forces the
adhesive into adhesive chamber 80 and out openings 84. The doctor
applies the adhesive on top of the primer to thoroughly coat
it.
[0080] At this point the physician can activate the xenon light
source 96 and advance sealant tool 70 to bring light chamber 90
into the area just treated with primer and adhesive. Light chamber
90 photopolymerizes the sealant in 40 seconds. This turns the
sealant into an elastic gel-like substance, which bonds to and
coats the intestinal walls. Frame 62 holds the wet, sealant-coated,
intestinal mucosa away from light chamber 90 during the
photopolymerization process.
[0081] The doctor can alternately coat the remaining portion of the
expanded intestine with primer, adhesive and light by advancing
sealant tube 70.
[0082] Sealant tool 70 may be marked in inches 98 to aid the doctor
in how far to advance the tube.
[0083] Additionally, sealant tool 70 may be exchanged with
alternate endoscopic tools. For example, sealant tool 70 may be
inserted into endoscope 10 (FIG. 3), to apply more primer and
adhesive to and through mesh sleeve 50.
[0084] Also, laser light could be brought through optical fibers 92
when sealant bonding using laser light is desired. For this a
low-power laser must be used.
[0085] Additionally, brushes may be incorporated onto the exterior
surface of primer chamber 72 sealant chamber 80 to better "paint"
the primer and sealant into the crevices of the intestinal
mucosa.
[0086] Also, some surgeons may prefer a more visual procedure and
for this a small incision may be made in the abdomen.
[0087] FIG. 7 shows a chamber 100, which utilizes temperate heat to
bond adhesives and sealants to the intestinal walls. A heat coil
102 is properly insulated and incorporated into one of the
endoscopic tools in lieu of the light chamber.
[0088] FIG. 8 shows an applicator 110 for applying adhesives and
sealants. Applicator 110 is used in conjunction with two-compound
sealants that must remain separated until application, because they
solidify rapidly after contact with each other. Normally, a light
source is not necessary to solidify these two-component
sealants.
[0089] In greater detail, applicator 110 fits within lumen 112 of
endoscope 114. The applicator 110 contains a brush portion 116 and
a handle portion 118. The brush portion 116 has a series of billows
117 and constrictions 119 to better coat the uneven intestinal
mucosa.
[0090] Brush portion 116 is preferably at least six inches in
length to coat at least six inches of the alimentary canal at a
time. Applicator 110 is coated with Teflon, silicone or other
suitable non-stick material.
[0091] Brush portion 116 contains two bladders 120 and 122, which
are of a semi-crushable nature. When brush portion 116 is pulled
inside endoscope 114, the billows 117 compress. When brush portion
116 is released from the confines of endoscope 114, the billows 117
expand of their own resilience and dilate the intestinal walls.
This slight pressure on the intestine produces a tighter bond
between the sealant and the intestinal mucosa. The slight pressure,
also, allows bristles 134 to better mix and blend the two compound
sealant.
[0092] Sealant is delivered to bladder 120 through tube 124 and a
different sealant compound is delivered to bladder 122 through tube
126. A multiplicity of openings 130 are formed through bladder 120.
Bladder 122, also, contains a multiplicity of openings 132.
[0093] Bristles 134 of various lengths are formed over the surface
of brush portion 116. Bristles 134 are of a soft nature and of
different lengths to better mix the two-compound sealant into the
rough intestinal mucosa.
[0094] In operation, a physician extends brush section 116 six
inches beyond the end of endoscope 114. The physician then
energizes an outside pump, which forces the two separate sealants,
into bladders 120 and 122. The sealants then flow out openings 130
and 132. At this point the physician disconnects the sealant tubes
and rotates handle 118 for approximately one minute so the bristles
134 mix and blend the two sealants together. Endoscope 114 acts as
a sheath and protects the body from irritation while applicator 110
is being turned. Within five minutes the combined sealants form a
solidified, gel-type coating over the intestine.
[0095] Applicator 110 should not be extended to coat the next
section of intestine until the sealant has had a chance to
solidify. Brush section 116 being a non-stick material can dilate
the intestine, during the polymerization process, without adhesion
occurring.
[0096] A Teflon-coated frame can, also, be utilized in conjunction
with endoscope 114 to dilate the intestine during the sealant
application and polymerization process.
[0097] FIG. 9 shows an alternate stent-like, frame means to dilate
the intestinal walls during sealant application. Preferably, stent
frame means 140 is at least one foot in length so at least one foot
of intestine can be primed and coated. Additionally, it is made of
a non-stick material. In operation, stent frame means 140 is
inserted into the intestine in a collapsed state. Once at the
desired site, it is expanded by pushing wire 142 that runs the
length of stent frame means 140. Tool 144 is then inserted into
stent frame means 140. Stent frame means 140 then acts as a sheath
for protecting the bodily passageway while tool 144 is maneuvered
and turned.
[0098] Tool 144 contains a passageway 146 running the entire length
of tool 144 for delivering primer to the intestinal mucosa through
opening 148. Tool 144 contains a brush section 150 on the surface
of its distal end which can be turned and maneuvered to paint the
primer onto the intestinal walls. After the primer application is
complete, tool 144 can be removed from inside stent frame means 140
and a duplicate tool 144 inserted for delivering the sealant
coating. After the sealant application is complete, duplicate tool
144 is removed from inside stent frame means 140 and light wand 152
inserted to complete the photopolymerization process.
[0099] There are other applications for lining or coating portions
of the alimentary canal. For example, duodenal ulcers, which are
the most common, are aggravated by the stomach's hydrochloric acid
constantly emptying onto the ulcer, thereby, eroding it further. A
lining or coating over the ulcer would prevent hydrochloric acid
from coming into contact with the ulcer and allow it to heal.
[0100] To treat duodenal ulcers, the lining would commence in the
stomach and bypass the hydrochloric acid through the lining instead
of onto the ulcer.
[0101] Similarly, acid-reflux disease could be treated by coating
the esophagus so gastric juices cannot erode and burn the lower
esophagus.
[0102] Diverticular disease could, additionally, be treated with
the lining. Diverticulosis is the presence of small, sac-like
swellings in the walls of the alimentary canal. When the sacs
become infected with stagnant food, it is a medical emergency
usually requiring surgery. The lining could be glued over each
diverticula after the pouch is flushed with water. The lining would
prevent digesting food chemicals from becoming trapped in the
diverticula.
[0103] In operation, different components of the endoscopic tools
could be interchanged with each other.
[0104] Additionally, the lining and/or endoscope could be inserted
through the rectum, which would allow a physician to use an
endoscope with a wider inside lumen for containing the tools. For
this application the various chambers could be in the reverse
order.
[0105] Also, the tip of an endoscope, maneuverable catheter or
endoscopic tool could contain an ultrasound transducer to aid in
insertion and removal of the lining or aid in coating of the
intestine.
[0106] Also, a series of tiny mirrors could be utilized with the
optical fibers to aid in the photopolymerization process.
[0107] Those skilled in the art will readily perceive still other
changes and modifications which may be made in the inventive
structures and perceive new and different uses for the inventive
structures. Therefore, the appended claims are to be construed
broadly enough to cover all equivalent structures falling within
the scope and the spirit of this invention.
* * * * *