Active sphincter implant to re-route flow through gastrointestinal tract

Patent metadata

Field	Value
Publication number	US-11051931-B2
Application number	US-201816176163-A
Country	US
Kind code	B2
Filing date	Oct 31, 2018
Priority date	Oct 31, 2018
Publication date	Jul 6, 2021
Grant date	Jul 6, 2021

Abstract

A method is provided for rerouting flow through the small intestine of a patient with an implanted artificial sphincter that encircles a portion of the small intestine. The small intestine includes a duodenum, a jejunum extending from the duodenum, and an ileum extending from the jejunum. The method includes providing the artificial sphincter in an open state to thereby permit intestinal flow through the encircled portion of the small intestine such that the intestinal flow passes through the duodenum, the jejunum, and the ileum. The method further includes, in response to a user-activated electrical input, transitioning the artificial sphincter to a closed state to constrict the encircled portion of the small intestine and thereby redirect intestinal flow from a first portion of the small intestine to a second portion of the small intestine such that the intestinal flow bypasses at least a portion of the jejunum.

First claim

We claim:

1. A method of rerouting flow through the small intestine of a patient with an implanted artificial sphincter that encircles a portion of the small intestine, wherein the small intestine includes a duodenum, a jejunum extending from the duodenum, and an ileum extending from the jejunum, the method comprising:
(a) providing the artificial sphincter in an open state to thereby permit intestinal flow through the encircled portion of the small intestine such that the intestinal flow passes through the duodenum, the jejunum, and the ileum; and
(b) in response to a first user-activated electrical input, transitioning the artificial sphincter to a closed state to constrict the encircled portion of the small intestine and thereby redirect intestinal flow from a first portion of the small intestine to a second portion of the small intestine such that the intestinal flow bypasses at least a portion of the jejunum,
wherein the artificial sphincter comprises an actuator and a constricting member coupled with the actuator, wherein transitioning the artificial sphincter to the closed state comprises actuating the constricting member with the actuator to constrict the encircled portion of the small intestine.

2. The method of claim 1 , further comprising, in response to a subsequent user-activated electrical input, transitioning the artificial sphincter from the closed state to the open state.

3. The method of claim 1 , wherein the artificial sphincter is located downstream of an anastomosis formed between the first portion of the small intestine and the second portion of the small intestine, wherein in the closed state the artificial sphincter redirects intestinal flow from the first portion directly to the second portion via the anastomosis.

4. The method of claim 1 , wherein the artificial sphincter is located downstream of a location at which an ampulla of Vater connects with the small intestine.

5. The method of claim 1 , wherein transitioning the artificial sphincter to the closed state comprises reducing an effective circumference of the artificial sphincter by shortening an active length of the constricting member.

6. The method of claim 1 , wherein the actuator is positioned on a first side of the small intestine and the constricting member extends circumferentially around an opposed second side of the small intestine.

7. The method of claim 1 , wherein the constricting member comprises a flexible elongate member.

8. The method of claim 1 , wherein the constricting member comprises a plurality of bodies, wherein transitioning the artificial sphincter from the open state to the closed state comprises drawing the bodies toward the actuator.

9. The method of claim 1 , wherein the constricting member comprises a magnetic element.

10. The method of claim 9 , wherein the actuator comprises an electromagnet, wherein transitioning the artificial sphincter from the open state to the closed state comprises activating the electromagnet to attract the magnetic element.

11. The method of claim 10 , further comprising, in response to a subsequent user-activated electrical input, deactivating the electromagnet to permit the artificial sphincter to return to the open state.

12. The method of claim 1 , wherein the artificial sphincter is operatively coupled with a power source provided externally of the patient, wherein transitioning the artificial sphincter from the open state to the closed state comprises transmitting electrical power from the power source to the artificial sphincter wirelessly.

13. The method of claim 1 , wherein the artificial sphincter is coupled with an internal coil implanted within the patient, wherein the internal coil is inductively coupled with an external coil provided externally of the patient, wherein transitioning the artificial sphincter from the open state to the closed state comprises transmitting electrical power from the external coil to the internal coil via transcutaneous energy transfer (TET).

14. The method of claim 13 , wherein the TET is activated in response to actuation of an external user input feature that provides the first user-activated electrical input.

15. A method of rerouting flow through the small intestine of a patient, wherein the small intestine includes a duodenum, a jejunum extending from the duodenum, and an ileum extending from the jejunum, the method comprising:
(a) forming an anastomosis between a first portion of the small intestine and a second portion of the small intestine; and
(b) positioning an artificial sphincter about the small intestine at a location downstream of the anastomosis, wherein in response to a user-activated electrical input the artificial sphincter is configured to transition between:
(i) an open state in which the artificial sphincter permits intestinal flow to pass through the duodenum, the jejunum, and the ileum, and
(ii) a closed state in which the artificial sphincter redirects intestinal flow from the first portion of the small intestine directly to the second portion, via the anastomosis, such that the intestinal flow bypasses at least a portion of the jejunum.

16. The method of claim 15 , wherein forming the anastomosis in the small intestine comprises forming the anastomosis downstream of a location at which an ampulla of Vater connects with the small intestine.

17. A method of rerouting flow through an anatomical structure of a patient with an implanted artificial sphincter that encircles a portion of the anatomical structure, wherein the anatomical structure includes an upstream passage, an intermediate passage extending from the upstream passage, and a downstream passage extending from the intermediate passage, the method comprising:
(a) providing the artificial sphincter in an open state to thereby permit fluid flow through the encircled portion of the anatomical structure such that the fluid flow passes through the upstream passage, the intermediate passage, and the downstream passage; and
(b) in response to a first user-activated electrical input, transitioning the artificial sphincter to a closed state to constrict the encircled portion of the anatomical structure and thereby redirect fluid flow from the upstream passage to the downstream passage such that the fluid flow bypasses the intermediate passage,
wherein the artificial sphincter comprises an actuator and a constricting member coupled with the actuator, wherein transitioning the artificial sphincter to the closed state comprises actuating the constricting member with the actuator to constrict the encircled portion of the anatomical structure.

18. The method of claim 17 , further comprising, in response to a subsequent user-activated electrical input, transitioning the artificial sphincter from the closed state to the open state.

19. The method of claim 17 , wherein the artificial sphincter is located downstream of an anastomosis formed between the upstream passage and the downstream passage, wherein in the closed state the artificial sphincter redirects fluid flow from the upstream passage directly to the downstream passage via the anastomosis.

20. The method of claim 17 , wherein transitioning the artificial sphincter to the closed state comprises reducing an effective circumference of the artificial sphincter by shortening an active length of the constricting member.

Assignees

• Ethicon Llc
• Torax Medical Inc
• Cilag Gmbh Int

Inventors

• Swensgard Brett E
• Auld Michael D
• Huster Celeste L

Classifications

• A61B17/12013 Primary

  for use in minimally invasive surgery, e.g. endoscopic surgery · CPC title

• A61B2017/00818

  Treatment of the gastro-intestinal system · CPC title

• A61B2017/00876

  magnetic · CPC title

• A61B2017/1139

  Side-to-side connections, e.g. shunt or X-connections · CPC title

• A61B2017/00017

  Electrical control of surgical instruments · CPC title