Method and apparatus for endoscopically treating rectal prolapse

Patent metadata

Field	Value
Publication number	US-9320587-B2
Application number	US-201113641422-A
Country	US
Kind code	B2
Filing date	Apr 14, 2011
Priority date	Nov 2, 2007
Publication date	Apr 26, 2016
Grant date	Apr 26, 2016

Abstract

A method for treating rectal prolapse, the method comprising: inserting a rectum-gripping and advancement apparatus into a prolapsed rectum via the anus; maneuvering the rectum-gripping and advancement apparatus so that the rectum-gripping and advancement apparatus securely engages the rectum; advancing the rectum-gripping and advancement apparatus distally so as to return the prolapsed rectum to its normal, non-prolapsed state; and securing the rectum to supporting tissue whereby to retain the rectum in its normal, non-prolapsed state.

First claim

What is claimed is:

1. A method for treating rectal prolapse, the method comprising:
inserting a rectum-gripping and advancement apparatus and a fastener deployment device into a prolapsed rectum via an anus;
securely engaging the prolapsed rectum by maneuvering the rectum-gripping and advancement apparatus;
advancing the rectum-gripping and advancement apparatus distally to return the prolapsed rectum to its normal, non-prolapsed state;
while maintaining the rectum-gripping and advancement apparatus in position within the prolapsed rectum, using the fastener deployment device to advance a fastening device distally to a fastening site, and passing a portion of the fastening device through the wall of the prolapsed rectum at the fastening site, through a mesorectum and through a presacral fascia to fasten the prolapsed rectum to the presacral fascia, whereby to retain the prolapsed rectum in its normal, non-prolapsed state;
wherein the rectum-gripping and advancement apparatus and the fastener deployment device are simultaneously slidably mounted directly to an endoscope via a distal mount.

2. A method according to claim 1 wherein the rectum-gripping and advancement apparatus comprises a shaft having a distal end comprising a tissue support for engaging an interior wall of the prolapsed rectum.

3. A method according to claim 2 wherein the tissue support comprises an opening.

4. A method according to claim 3 wherein the tissue support is generally circular in shape, with the opening located in a middle of the tissue support.

5. A method according to claim 3 wherein the step of securing the prolapsed rectum to the presacral fascia is performed through the opening in the tissue support.

6. A method according to claim 2 wherein an exterior of the tissue support includes texturing.

7. A method according to claim 6 wherein the texturing comprises a layer of at least one selected from the group consisting of suture, foam and fabric secured to the tissue support.

8. A method according to claim 2 wherein the shaft comprises a proximal end having a handle.

9. A method according to claim 2 wherein the step of securing the prolapsed rectum to the presacral fascia is performed around a periphery of the tissue support.

10. A method according to claim 1 wherein the method is performed under visualization provided by an endoscope.

11. A method according to claim 1 wherein the fastening device comprises at least one selected from the group consisting of a fastener and suture.

12. A method according to claim 11 wherein the fastener is selected from the group consisting of shaft-type tacks, legged staples, multi-part fasteners, and tacks comprising a body having a suture extending therefrom.

13. A method according to claim 11 wherein the fastener consists of at least one substantially rigid element having a suture attached thereto.

14. A method according to claim 11 wherein the fastener further comprises a securement band for securing the suture.

15. A method according to claim 1 wherein the prolapsed rectum is secured to the presacral fascia by suturing.

16. A method according to claim 1 wherein a securement location for securing the prolapsed rectum to the presacral fascia is determined by identifying an anatomical landmark.

17. A method according to claim 16 wherein the anatomical landmark is determined from a location within the prolapsed rectum.

18. A method according to claim 16 wherein the anatomical landmark is identified by an ultrasound probe disposed within the prolapsed rectum.

19. A method according to claim 16 wherein the anatomical landmark is identified by an endoscope disposed within the prolapsed rectum.

20. A method according to claim 16 wherein the anatomical landmark is the sacral promontory.

21. A method according to claim 1 wherein the prolapsed rectum is secured to the presacral fascia a plurality of fasteners.

Assignees

• Milsom Jeffrey
• Riina Howard
• Cornhill J Frederick
• Univ Cornell

Inventors

• Milsom Jeffrey
• Riina Howard
• Cornhill J Frederick

Classifications

• A61B1/31

  for the rectum, e.g. proctoscopes, sigmoidoscopes {, colonoscopes} · CPC title

• A61B17/0487

  Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122) · CPC title

• A61B2017/00818

  Treatment of the gastro-intestinal system · CPC title

• A61B17/0401

  Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811) · CPC title

• A61B2017/0488

  Instruments for applying suture clamps, clips or locks · CPC title