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Publication numberCN101980674 A
Publication typeApplication
Application numberCN 200980111664
PCT numberPCT/SE2009/000059
Publication date23 Feb 2011
Filing date29 Jan 2009
Priority date29 Jan 2008
Also published asCA2749778A1, CA2749782A1, CA2749792A1, CA2776479A1, CN101980673A, CN101980673B, CN102245133A, CN102245133B, CN104323877A, CN105361986A, CN105997315A, EP2240127A1, EP2240127A4, EP2240128A1, EP2240128A4, EP2240129A1, EP2240129A4, EP2240130A1, EP2240130A4, EP2240131A1, EP2240131A4, EP2240132A1, EP2240132A4, EP2240133A1, EP2240133A4, EP2240134A1, EP2240134A4, EP2240135A1, EP2240135A4, EP2240136A1, EP2240136A4, EP2240137A1, EP2240137A4, EP2240138A1, EP2240138A4, EP2240139A1, EP2240139A4, EP2240139B1, EP2240140A1, EP2240140A4, EP2249752A1, EP2249752A4, EP2249753A1, EP2249753A4, EP2349132A1, EP2349132A4, EP2349133A1, EP2349133A4, EP2349134A1, EP2349134A4, EP3072480A1, US8567409, US8636809, US8992629, US9060771, US9259223, US9277920, US9375213, US9445815, US9526649, US9561033, US9642733, US9681874, US9687335, US20100312047, US20100312048, US20100312049, US20100312050, US20100312356, US20100324360, US20100324361, US20100324362, US20100331614, US20100331615, US20100331616, US20100331617, US20100331945, US20100332000, US20110009894, US20110009896, US20110009897, US20110172693, US20110196197, US20110196391, US20110218394, US20120022561, US20120029550, US20120029551, US20140148645, US20140236212, US20140330075, US20150305851, US20160022462, US20160166418, US20160324673, US20160374843, US20170165092, US20170209292, WO2009096857A1, WO2009096858A1, WO2009096859A1, WO2009096860A1, WO2009096861A1, WO2009096862A1, WO2009096862A8, WO2009096863A1, WO2009096864A1, WO2009096865A1, WO2009096865A8, WO2009096866A1, WO2009096867A1, WO2009096868A1, WO2009096869A1, WO2009096870A1, WO2009096871A1, WO2009096872A1, WO2009096872A9, WO2009096873A1, WO2009096873A9, WO2009096874A1, WO2010042061A1, WO2010042062A1, WO2010042063A1
Publication number200980111664.2, CN 101980674 A, CN 101980674A, CN 200980111664, CN-A-101980674, CN101980674 A, CN101980674A, CN200980111664, CN200980111664.2, PCT/2009/59, PCT/SE/2009/000059, PCT/SE/2009/00059, PCT/SE/9/000059, PCT/SE/9/00059, PCT/SE2009/000059, PCT/SE2009/00059, PCT/SE2009000059, PCT/SE200900059, PCT/SE9/000059, PCT/SE9/00059, PCT/SE9000059, PCT/SE900059
Inventors彼得福塞尔
Applicant米卢克斯控股股份有限公司
Export CitationBiBTeX, EndNote, RefMan
External Links: SIPO, Espacenet
An apparatus for treating gerd
CN 101980674 A
Abstract
An implantable device for the treatment of acid reflux disease has a body including an outer surface adapted to rest against a patient's fundus wall. The device, when implanted in a patient, fills a volume in the patient's abdomen in the cardia area and above the cardia of the patient, when standing. The body prevents the cardia from moving through the diaphragm opening into the thorax, thereby preventing reflux by keeping the abdominal pressure supporting the cardia sphincter muscle. The device may be affixed to stomach tissue. The device may also be invaginated or otherwise indirectly secured in position.
Claims(194)  translated from Chinese
  1. 一种用于治疗人类或哺乳动物患者的反流病的设备,所述设备包括可植入的运动限制器件,所述可植入的运动限制器件适于至少部分地被患者胃底壁套叠,并且具有包括生物相容材料的外表面,其中所述运动限制器件的外表面的大部分适于在不伤害胃壁的前提下在患者横膈膜与被套叠的胃底壁下部的至少一部分之间的位置靠在胃壁上,从而当所述运动限制器件被套叠时,限制患者的胃的贲门切迹向患者的横膈膜移动,进而防止贲门穿过患者的横膈膜开口滑入患者的胸部,以维持从患者的腹部施加的抵住患者的贲门括约肌的支撑压力,所述运动限制器件具有至少125mm3的尺寸以及至少15mm的周长。 A method of treating a human or mammalian subject reflux disease apparatus, the apparatus comprising an implantable movement restriction device, the implantable movement restriction device is adapted to be at least partially gastric wall in patients with intussusception and having an outer surface including a biocompatible material, most of which do not harm the stomach wall adapted to precondition the outer surface of the movement restriction device is invaginated in the lower portion of the diaphragm and the fundus wall of at least a portion of the patient against the stomach wall between the positions, so that when the motion limiting device invaginated, the limit of the cardiac notch patient's stomach to the diaphragm to move the patient, thereby preventing cardiac patients through the patient's diaphragm opening slide chest in order to maintain the patient against the patient's abdomen from cardiac sphincter of support applied pressure, the movement restriction device has at least 125mm3 in size and at least 15mm circumference.
  2. 2.根据权利要求1所述的设备,进一步包括可植入的第一固定器,所述第一固定器在植入患者时,将所述运动限制器件保持在限制胃的贲门切迹向患者的横膈膜移动的位置, 并且所述运动限制器件的外表面基本上与患者的胃底壁相接触。 2. The apparatus according to claim 1, further comprising an implantable first holder of the first holder when implanted in a patient, said motion restriction device is held in the gastric cardia notch limiting to the patient moving the position of the diaphragm, and the movement restriction device is substantially in contact with the outer surface of the patient's gastric wall.
  3. 3.根据权利要求1所述的设备,其中所述运动限制器件在植入患者时不能从患者身体外部进行调整。 3. The apparatus according to claim 1, wherein when the movement restriction device implanted in a patient can not be adjusted from outside the patient's body.
  4. 4.根据权利要求2所述的设备,其中所述第一固定器包括组织生长促进结构,以在没有套叠的情况下使所述运动限制器件长期附着于胃壁。 4. The apparatus according to claim 2, wherein the first holder comprises a tissue growth promoting structure to nested in the absence of said long-term motion limiting device attached to the stomach wall.
  5. 5.根据权利要求4所述的设备,其中所述组织生长促进结构包括网状结构。 5. The apparatus according to claim 4, wherein the tissue growth promoting structure includes a mesh structure.
  6. 6.根据权利要求5所述的设备,其中所述组织生长促进结构进一步包括缝线或U形钉, 所述缝线或U形钉在植入患者时将所述网状结构附着到所述胃底壁。 6. The apparatus according to claim 5, wherein the tissue growth promoting structure further comprises a U-shaped staples or sutures, the suture or U-shaped staples when implanted in a patient to the mesh structure is attached to the gastric wall.
  7. 7.根据权利要求2所述的设备,其中所述第一固定器包括缝线或U形钉,所述缝线或U形钉在植入患者时,将包围所述运动限制器件的胃底壁的部分附在一起,以将所述运动限制器件保持于所述位置。 7. The apparatus according to claim 2, wherein the first holder comprises a U-shaped staples or sutures, the sutures or staples in the U-shaped when implanted in a patient, the movement restriction device surrounds the fundus together part of the wall is attached to the movement restriction device is held in the position.
  8. 8.根据权利要求7所述的设备,其中所述缝线或U形钉在植入患者时将所述胃底壁的部分附在一起,将所述运动限制器件套叠在所述胃底壁中,从而将所述运动限制器件保持在适当的位置。 8. The apparatus according to claim 7, wherein said U-shaped staples or sutures implanted in a patient when the fundus wall portion attached together, the movement restriction device is invaginated in the stomach fundus wall, thereby limiting the movement of the device is held in place.
  9. 9.根据权利要求8所述的设备,其中所述缝线或U形钉在与所述运动限制器件一起植入患者时,将所述胃底壁的部分附在一起,以从患者的胃壁内侧套叠所述运动限制器件。 9. The apparatus according to claim 8, wherein said U-shaped staples or sutures in conjunction with the movement restriction device implanted in a patient, the attachment portion of the gastric wall together to from a patient's stomach the medial telescoping movement restriction devices.
  10. 10.根据权利要求8所述的设备,其中所述缝线或U形钉在与所述运动限制器件一起植入患者时,将所述胃底壁的部分附在一起,以从患者的胃壁外侧套叠所述运动限制器件。 10. The apparatus according to claim 8, wherein said U-shaped staples or sutures in conjunction with the movement restriction device implanted in a patient, the attachment portion of the gastric wall together to from a patient's stomach the outer telescoping movement restriction devices.
  11. 11.根据权利要求2所述的设备,进一步包括第二固定器,所述第二固定器在与所述运动限制器件一起植入患者时,将所述运动限制器件间接或直接地固定到食管接近于患者的His角的位置。 11. The apparatus according to claim 2, further comprising a second retainer, the second fixed in conjunction with the movement restriction device implanted in a patient, the movement restriction device is directly or indirectly secured to the esophagus His position is close to the angle of the patient.
  12. 12.根据权利要求11所述的设备,其中所述第二固定器由多个缝线或U形钉组成,所述缝线或U形钉在与所述运动限制器件一起植入患者时,将胃底壁与患者的食管壁附在一起,以将所述运动限制器件保持在所述位置。 12. The apparatus according to claim 11, wherein said second suture holder by a plurality of U-shaped staples or composition, said U-shaped staples or sutures when the device is implanted in a patient in conjunction with the movement limit, The gastric wall with the patient's esophagus attached together to restrict the movement of the device is held at the position.
  13. 13.根据权利要求11所述的设备,进一步包括第三固定器,所述第三固定器在与所述运动限制器件一起植入患者时,将所述运动限制器件间接或直接地固定到患者的横膈膜肌肉或相关联的肌肉。 13. The apparatus according to claim 11, further comprising a third anchor, the third fixed in conjunction with the movement restriction device implanted in a patient, the movement restriction device is directly or indirectly secured to the patient The diaphragm muscle or muscle associated.
  14. 14.根据权利要求13所述的设备,其中所述第三固定器由多个缝线或U形钉组成,所述缝线或U形钉在与所述运动限制器件一起植入患者时,将胃底壁与横膈膜肌肉或相关联的肌肉附在一起,以将所述运动限制器件保持在所述位置。 14. The apparatus according to claim 13, wherein the third holder by a plurality of U-shaped staples or sutures composition, said U-shaped staples or sutures when the device is implanted in a patient in conjunction with the movement limit, The gastric wall and diaphragm muscle or muscle associated attached together to limit the movement of the device is held in position.
  15. 15.根据权利要求1所述的设备,其中所述运动限制器件包括主体,所述主体适于至少部分地由患者的胃底壁套叠,并且具有包括生物相容材料的外表面,所述主体的外表面的大部分适于在患者的横膈膜与被套叠的胃底壁的下部的部分之间的所述位置靠在胃壁上。 15. The apparatus according to claim 1, wherein said motion limiting device comprising a main body adapted to at least partly invaginated by the patient's gastric wall and having an outer surface including a biocompatible material, the most suitable for the location of the outer surface of the body portion of the patient's diaphragm between the stack and the quilt gastric wall against the lower part of the stomach wall.
  16. 16.根据权利要求15所述的设备,其中所述主体基本上是卵形。 16. The apparatus according to claim 15, wherein said body is substantially oval.
  17. 17.根据权利要求15所述的设备,其中所述主体基本上是类似具有缩进的中间部分的卵的形状。 17. The apparatus according to claim 15, wherein said body is substantially similar to the intermediate portion having indented egg shape.
  18. 18.根据权利要求15所述的设备,其中所述主体基本上是类似于弯曲的卵的形状。 18. The apparatus according to claim 15, wherein said body is substantially shaped like a curved eggs.
  19. 19.根据权利要求15所述的设备,其中所述主体基本上是球形。 19. The apparatus according to claim 15, wherein said body is substantially spherical.
  20. 20.根据权利要求15所述的设备,其中所述主体具有滚圆的轮廓,而没有会损伤患者胃壁的过于尖锐的边缘。 20. The apparatus according to claim 15, wherein the body has rounded contours without too sharp edges can damage the stomach wall of the patient.
  21. 21.根据权利要求15所述的设备,进一步包括在被植入患者之后适于调节所述主体的尺寸的装置。 21. The apparatus of claim 15, further comprising, after being implanted in a patient's body is adapted to adjust the size of the apparatus.
  22. 22.根据权利要求15所述的设备,其中所述主体形成包含流体的腔室,当所述主体被植入患者时所述流体的量可控制以调节所述主体的尺寸。 22. The apparatus according to claim 15, wherein said body comprises a fluid chamber is formed, when the amount of the body is implanted in a patient the fluid may be controlled to adjust the size of the body.
  23. 23.根据权利要求15所述的设备,其中在被植入患者之后所述主体的尺寸可无创地进行调节。 23. The apparatus of claim 15, wherein the size of the patient after being implanted in the body can be adjusted non-invasively.
  24. 24.根据权利要求15所述的设备,其中所述主体适于借助于胃镜或管腔仪器被放置在患者胃壁的内侧。 24. The apparatus according to claim 15, wherein said body is adapted by means of a gastroscope or the instrument is placed on the inside of the lumen of the stomach wall of the patient.
  25. 25.根据权利要求1所述的设备,进一步包括可植入的刺激器,所述刺激器在被植入患者时,向贲门肌肉发出刺激脉冲以刺激贲门肌肉,从而进一步闭合贲门以进一步防止反流病。 25. The apparatus according to claim 1, further comprising an implantable stimulator, the stimulator is implanted in the patient at the time, to emit stimulation pulses to stimulate the cardiac muscle cardiac muscle, thereby further closing the cardia to further prevent anti- reflux disease.
  26. 26.根据权利要求25所述的设备,其中所述刺激器由至少一个导体和至少一个电极构成,所述至少一个电极在被植入患者时接收刺激脉冲并将这些脉冲施加到贲门肌肉,从而刺激贲门肌肉。 26. The apparatus according to claim 25, wherein the stimulator by at least one conductor and at least one electrode, the at least one electrode is implanted in a patient receiving stimulation pulses and these pulses applied to the cardiac muscle, thereby stimulate cardiac muscle.
  27. 27.根据权利要求26所述的设备,其中所述刺激器发射脉冲串形式的刺激脉冲,并且其中所述脉冲串被重复,脉冲串之间具有一时间间隔,所述间隔延长在所述脉冲串中的各个脉冲之间的间隔。 27. The apparatus according to claim 26, wherein said stimulator emitting bursts of stimulation pulses, and wherein said burst is repeated with a time interval between bursts, the time between the pulses string spacing between each pulse.
  28. 28.根据权利要求25所述的设备,其中所述刺激器由电子电路和能源构成。 28. The apparatus according to claim 25, wherein said stimulus is constituted by an electronic circuit, and energy.
  29. 29.根据权利要求15所述的设备在,其中可植入主体具有大致光滑的外表面,以靠在胃底壁上。 29. The apparatus according to claim 15 in which the implantable body having a generally smooth outer surface, to against the gastric wall.
  30. 30.根据权利要求15所述的设备,其中所述主体可植入患者的胃的内侧。 30. The apparatus according to claim 15, wherein the inner body implantable in the patient's stomach.
  31. 31.根据权利要求15所述的设备,其中所述主体适于通过外科手术附着到患者的胃壁上。 31. The apparatus according to claim 15, wherein said body is adapted to be surgically attached to the patient's stomach.
  32. 32.根据权利要求15所述的设备,其中所述主体适于被放置在患者的胃的外侧。 32. The apparatus according to claim 15, wherein said body is adapted to be placed outside the patient's stomach.
  33. 33.根据权利要求15所述的设备,其中所述主体可变为具有比腹腔镜使用的套管针更小的直径的细长形式,由此所述主体在变为所述细长形式时可以通过所述套管针推入或拉出o 33. The apparatus of claim 15, wherein the form of an elongate body may become smaller than the diameter of the trocar laparoscopic use, whereby said elongated body in the form of changes o You can push or pull through the trocar
  34. 34.根据权利要求15所述的设备,其中所述主体包括形成一由流体填充的腔室的柔性外壁,从而允许所述主体穿过腹腔镜使用的套管针。 34. The apparatus according to claim 15, wherein said body includes forming a flexible outer wall by a fluid-filled chamber, thereby allowing the body through the laparoscopic trocar used. 3 3
  35. 35.根据权利要求34所述的设备,其中所述流体包括凝胶。 35. The apparatus according to claim 34, wherein the fluid comprises a gel.
  36. 36.根据权利要求15所述的设备,其中所述主体是中空的,并且包括适于插入所述中空主体中并进一步适于被放置在一起成为主体内部的一个单片的至少两个独立片,从而允许所述主体穿过腹腔镜使用的套管针。 36. The apparatus of at least two separate sheets according to claim 15, wherein said body is hollow and includes a body adapted to be inserted in the hollow and further adapted to be placed together into an interior of the monolithic body , thereby allowing the body through the trocar laparoscopic use.
  37. 37.根据权利要求15所述的设备,其中所述主体包括外壁以及中空的压缩内部,用于在插入患者身体中之后由流体或凝胶填充。 37. The apparatus according to claim 15, wherein said body comprises an outer wall and a hollow interior of the compression, the fluid or gel used to fill the body of a patient after insertion.
  38. 38.根据权利要求15所述的设备,其中所述主体包括具有注入口的腔室,所述主体的腔室通过所述注入口被填充流体。 38. The apparatus according to claim 15, wherein the body comprises an inlet chamber, the chamber of the body through the injection port is filled with a fluid.
  39. 39.根据权利要求15所述的设备,其中所述主体包括弹性的可压缩材料,从而允许所述主体穿过腹腔镜使用的套管针。 39. The apparatus according to claim 15, wherein said body comprises a resilient compressible material, thereby allowing the body through the laparoscopic trocar used.
  40. 40.根据权利要求15所述的设备,其中所述主体由比25肖氏硬度更软的材料制成。 40. The apparatus according to claim 15, wherein said body is formed softer than 25 Shore hardness material.
  41. 41.根据权利要求15所述的设备,其中所述主体由比15肖氏硬度更软的材料制成。 41. The apparatus according to claim 15, wherein said body is formed softer than 15 Shore hardness material.
  42. 42.根据权利要求15所述的设备,其中所述主体包括基本上为球形的外壁。 42. The apparatus according to claim 15, wherein said body comprises a substantially spherical outer wall.
  43. 43.根据权利要求15所述的设备,其中所述主体包括适用于推动或拉动所述主体通过腹腔镜使用的套管针的至少一个夹持器。 43. The apparatus according to claim 15, wherein said body comprises a push or pull applied to the body through the laparoscopic trocar used in at least one holder.
  44. 44.根据权利要求43所述的设备,其中所述夹持器适于夹持所述器件的延长部分,所述延长部分适于由外科手术仪器夹持。 44. The apparatus according to claim 43, wherein said holder is adapted to clamp the extension device, said extension portion is adapted by a surgical instrument holder.
  45. 45.根据权利要求43所述的设备,其中所述夹持器适于夹持通过所述夹持器插入的线或带。 45. The apparatus according to claim 43, wherein said holder is adapted to be inserted through the holding wire or belt holder.
  46. 46.根据权利要求43所述的设备,其中所述主体包括外壁,并且所述夹持器至少部分地被置于所述主体的外壁内部。 46. The apparatus according to claim 43, wherein said body includes an outer wall, and the holder is at least partially disposed within the body outer wall.
  47. 47.根据权利要求15所述的设备,其中所述主体具有大于从胃到肠的出口的尺寸。 47. The apparatus according to claim 15, wherein the body has a greater than the outlet from the stomach to the intestine size.
  48. 48.根据权利要求15所述的设备,其中所述主体具有30mm或更大的最小外径。 48. The apparatus according to claim 15, wherein the body has a minimum outer diameter of 30mm or larger.
  49. 49.根据权利要求15所述的设备,其中所述主体具有40mm或更大的最小外径。 49. The apparatus according to claim 15, wherein the body has a minimum outer diameter of 40mm or larger.
  50. 50.根据权利要求15所述的设备,其中所述主体具有90mm的最小外周长。 50. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 90mm.
  51. 51.根据权利要求15所述的设备,其中所述主体具有70mm的最小外周长。 51. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 70mm.
  52. 52.根据权利要求15所述的设备,其中所述主体具有50mm的最小外周长。 52. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 50mm.
  53. 53.根据权利要求15所述的设备,其中所述主体具有30mm的最小外周长。 53. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 30mm.
  54. 54.根据权利要求15所述的设备,其中所述主体具有110mm的最小外周长。 54. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 110mm.
  55. 55.根据权利要求15所述的设备,其中所述主体具有130mm的最小外周长。 55. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 130mm.
  56. 56.根据权利要求15所述的设备,其中所述主体具有150mm的最小外周长。 56. The apparatus according to claim 15, wherein the body has a minimum outer circumference of 150mm.
  57. 57.根据权利要求1所述的设备,进一步包括用于调整所述运动限制器件的调整器。 57. The apparatus according to claim 1, further comprising means for adjusting the motion limiting regulator device.
  58. 58.根据权利要求57所述的设备,其中所述运动限制器件包括主体,所述主体的尺寸以液压方式可调整,并且所述调整器包括液压流体储存器,所述液压流体储存器在被植入患者时连接至所述主体,并且其中所述主体的尺寸通过手动按压所述液压流体储存器以无创的方式调节,以调整供给所述主体的液压流体量,从而调整所述主体的尺寸。 58. The apparatus according to claim 57, wherein said motion limiting device comprises a body, the body size of hydraulically adjustable, and the adjustment device comprises a hydraulic fluid reservoir, the hydraulic fluid in the reservoir is When implanted in a patient is connected to the body, and wherein the size of the body by manually pressing the hydraulic fluid reservoir to regulate non-invasive manner, to adjust the amount of hydraulic fluid supplied to said main body, to adjust the size of the body .
  59. 59.根据权利要求58所述的设备,进一步包括液压调节器,所述液压调节器包括至少一个腔室,所述至少一个腔室在被植入患者时与所述主体一起套叠到患者的胃壁中并连接至所述主体,并且其中所述主体中容纳的液压流体的量通过在所述液压储存器与所述至少一个腔室之间分配流体来无创地进行调节。 59. The apparatus according to claim according to claim 58, further comprising a hydraulic actuator, the hydraulic actuator comprises at least one chamber, said at least one chamber, when implanted in a patient and the patient body nested together the amount of the stomach wall and connected to the body, and wherein said main body accommodating the hydraulic fluid by dispensing the fluid between said hydraulic reservoir and said at least one chamber to be adjusted non-invasively.
  60. 60.根据权利要求59所述的设备,其中所述至少一个腔室在被植入患者时使用所述储存器中的泵来填充所述液压流体,以拉伸胃底,从而在患者体内产生饱胀感。 60. The apparatus according to claim 59, wherein said at least one chamber of the reservoir using a pump, when implanted in a patient to fill the hydraulic fluid, in order to stretch the fundus, resulting in a patient a sense of fullness.
  61. 61.根据权利要求60所述的设备,其中所述调整器进一步包括反向伺服,并且其中所述储存器中的小体积的流体用较大的力进行压缩,并且所述腔室使用较小的每单位容积的力产生了较大的总体积的移动。 61. The apparatus according to claim 60, wherein said adjuster further comprises a reverse servo, and wherein the small volume of the reservoir fluid is compressed with great force, and the use of smaller chambers per unit volume of the moving force generating larger total volume.
  62. 62.根据权利要求1所述的设备,进一步包括用于无创地控制所述设备的无线遥控。 62. The apparatus of claim 1, wherein, further comprising a wireless remote control for non-invasively controlling the device.
  63. 63.根据权利要求62所述的设备,其中所述无线遥控包括至少一个外部信号发射器, 进一步包括可植入患者的内部信号接收器,以接收所述外部信号发射器发射的信号。 63. The apparatus according to claim 62, wherein the wireless remote control comprises at least one external signal transmitter, further comprising an internal signal receiver implantable in the patient, for receiving said external signal transmitter transmits the signal.
  64. 64.根据权利要求62所述的设备,其中所述无线遥控发射至少一个无线控制信号用于控制所述反流病治疗器件。 64. The apparatus according to claim 62, wherein the wireless remote control transmitting at least one wireless control signal for controlling the reflux disease treatment device.
  65. 65.根据权利要求64所述的设备,其中所述无线控制信号包括频率、幅度或相位调制信号或它们的组合。 65. The apparatus according to claim 64, wherein the wireless control signal comprises a frequency, amplitude or phase modulated signal or a combination thereof.
  66. 66.根据权利要求64所述的设备,其中所述无线控制信号包括模拟信号或数字信号, 或者模拟信号与数字信号的组合。 66. The apparatus according to claim 64, wherein the wireless control signal comprises a combination of analog or digital signals, or analog and digital signals.
  67. 67.根据权利要求64所述的设备,其中所述无线控制信号包括电场或磁场,或者组合的电磁场。 67. The apparatus according to claim 64, wherein the wireless control signal comprises an electric or magnetic field, or a combination of an electromagnetic field.
  68. 68.根据权利要求62所述的设备,其中所述无线遥控发射用于承载所述无线控制信号的载波信号。 68. The apparatus according to claim 62, wherein the wireless remote control transmitting a carrier signal for carrying the control signal of the radio.
  69. 69.根据权利要求68所述的设备,其中所述载波信号包括数字信号、模拟信号或数字信号和模拟信号的组合。 69. The apparatus according to claim 68, wherein the carrier signal comprises a combination of digital signals, analog signals or digital signals and analog signals.
  70. 70.根据权利要求62所述的设备,其中所述无线遥控发射用于承载所述数字控制信号或模拟控制信号的电磁载波信号。 70. The apparatus according to claim 62, wherein the wireless remote control transmitting a control signal for carrying the digital or analog control signal, an electromagnetic carrier signal.
  71. 71.根据权利要求1所述的设备,进一步包括用于无创地为所述设备供能的无线能量发射器。 71. The apparatus according to claim 1, further comprising means for non-invasive device for the energy supply of wireless energy transmitters.
  72. 72.根据权利要求71所述的设备,其中所述能量发射器通过至少一个无线能量信号发射能量。 72. The apparatus according to claim 71, wherein the energy emitter via at least one wireless energy signal emitted energy.
  73. 73.根据权利要求72所述的设备,其中所述无线能量信号包括波信号。 73. The apparatus according to claim 72, wherein the wireless energy signal comprises a wave signal.
  74. 74.根据权利要求70所述的设备,其中所述波信号选自由声波信号、超声波信号、电磁波信号、红外线信号、可见光信号、紫外线信号、激光信号、微波信号、无线电波信号、x射线辐射信号和伽马辐射信号组成的组。 74. The apparatus according to claim 70, wherein said acoustic wave signal selected signal, an ultrasonic signal, an electromagnetic wave signal, an infrared signal, a visible light signal, an ultraviolet signal, a laser signal, a microwave signal, a radio wave signals, x-ray radiation signal group and gamma radiation signal component.
  75. 75.根据权利要求72所述的设备,其中所述无线能量信号包括电场或磁场,或者组合的电磁场。 75. The apparatus according to claim 72, wherein the wireless energy signal comprises an electric or magnetic field, or a combination of an electromagnetic field.
  76. 76.根据权利要求72所述的设备,其中所述无线能量发射器发射用于承载所述无线能量信号的载波信号。 76. The apparatus according to claim 72, wherein the wireless energy transmitter for transmitting wireless energy signal carrying the carrier signal.
  77. 77.根据权利要求76所述的设备,其中所述载波信号包括数字信号、模拟信号或数字信号和模拟信号的组合。 77. The apparatus according to claim 76, wherein the carrier signal comprises a combination of digital signals, analog signals or digital signals and analog signals.
  78. 78.根据权利要求72所述的设备,其中所述无线能量信号包括模拟信号或数字信号, 或者模拟信号与数字信号的组合。 78. The apparatus according to claim 72, wherein the wireless energy signal comprises a combination of analog or digital signals, or analog and digital signals.
  79. 79.根据权利要求72所述的设备,进一步包括适于发射用于承载所述能量信号的电磁载波信号的无线遥控。 79. The apparatus according to claim 72, further comprising a wireless remote control adapted to transmit an electromagnetic carrier wave signal for carrying said energy signal.
  80. 80.根据权利要求1所述的设备,进一步包括用于给所述设备供能的能源。 80. The apparatus according to claim 1, further comprising the energy supply to the device for energy.
  81. 81.根据权利要求80所述的设备,其中所述能源包括可植入的内部能源。 81. The apparatus according to claim 80, wherein said energy comprises an implantable internal energy.
  82. 82.根据权利要求81所述的设备,进一步包括用于以无线模式传送能量的外部能源, 其中所述内部能源可由以无线模式传送的能量充能。 82. The apparatus according to claim 81, further comprising means for transmitting energy in a wireless mode of external energy, internal energy wherein the energy may be transmitted in wireless mode energized.
  83. 83.根据权利要求82所述的设备,进一步包括传感器,用于检测与用于对所述内部能源充能的能量传送相关的功能性参数;和反馈器件,用于从患者身体内部向其外部发送反馈信息,所述反馈信息与所述由传感器检测的功能性参数有关。 83. The apparatus according to claim 82, further comprising a sensor for detecting transmission related functions for parameters on the energy of the internal energy empowerment; and a feedback device from inside the patient's body for its external transmitting feedback information, the feedback information detected by the sensor of the functional parameters.
  84. 84.根据权利要求1所述的设备,进一步包括检测参数的传感器。 84. The apparatus according to claim 1, further comprising a sensor detecting parameters.
  85. 85.根据权利要求84所述的设备,其中所述参数是功能性参数。 85. The apparatus according to claim 84, wherein said parameter is a functional parameter.
  86. 86.根据权利要求85所述的设备,其中所述功能性参数与用于对可植入患者体内的内部能源进行充能的能量传送相关。 86. The apparatus according to claim 85, wherein the functional parameter for an implantable patient can charge the internal energy correlation energy transfer.
  87. 87.根据权利要求86所述的设备,进一步包括反馈器件,所述反馈器件在植入患者时从患者身体内部向其外部发送反馈信息,所述反馈信号与所述功能性参数有关。 87. The apparatus according to claim 86, further comprising a feedback device, the feedback device when implanted inside a patient from outside the patient's body to which to send the feedback information, the feedback signal and the functional parameters.
  88. 88.根据权利要求85所述的设备,进一步包括可植入内部控制单元,用于响应于检测所述功能性参数的传感器来控制所述反流病治疗器件。 88. The apparatus according to claim 85, further comprising an implantable internal control unit, in response to detecting said functional parameter sensor for controlling the reflux disease treatment device.
  89. 89.根据权利要求84所述的设备,其中所述参数是患者的生理参数。 89. The apparatus according to claim 84, wherein said physiological parameter is a parameter of a patient.
  90. 90.根据权利要求89所述的设备,其中所述生理参数选自由体温、血压、血流、心跳和呼吸组成的组。 90. The apparatus set forth in claim 89, wherein the physiological parameter is selected from temperature, blood pressure, blood flow, heart rate, and respiration thereof.
  91. 91.根据权利要求89所述的设备,其中用于检测生理参数的传感器是压力传感器。 91. The apparatus according to claim 89, wherein the sensor for detecting a physiological parameter is a pressure sensor.
  92. 92.根据权利要求89所述的设备,其中用于检测生理参数的传感器是活动性传感器。 92. The apparatus according to claim 89, wherein the sensor for detecting a physiological parameter sensor is active.
  93. 93.根据权利要求89所述的设备,进一步包括可植入的内部控制单元,用于响应于检测所述生理参数的传感器来控制所述反流病治疗器件。 93. The apparatus according to claim 89, further comprising an implantable internal control unit, in response to detecting said physiological parameter sensor for controlling the reflux disease treatment device.
  94. 94.根据权利要求1所述的设备,进一步包括用于操作所述运动限制器件的操作器。 94. The apparatus according to claim 1, further comprising means for limiting movement of the operator operating the device.
  95. 95.根据权利要求94所述的设备,其中所述操作器包括马达或泵。 95. The apparatus according to claim 94, wherein said operator includes a motor or a pump.
  96. 96.根据权利要求95所述的设备,其中所述操作器包括电动机。 96. The apparatus according to claim 95, wherein said operator includes an electric motor.
  97. 97.根据权利要求94所述的设备,其中所述操作器由电力驱动。 97. The apparatus according to claim 94, wherein said electric drive by the operator.
  98. 98.根据权利要求94所述的设备,其中所述操作器包括液压操作器。 98. The apparatus according to claim 94, wherein the operator comprises a hydraulic operation device.
  99. 99.根据权利要求94所述的设备,其中所述操作器包括气动操作器。 99. The apparatus according to claim 94, wherein the operator comprises a pneumatic operator.
  100. 100.根据权利要求94所述的设备,进一步包括用于传输无线能量的能量传输器,其中在所述能量传输器发射所述无线能量时,所述无线能量被用于直接驱动所述操作器,以产生用于操作所述反流病治疗器件的动能。 100. When the apparatus according to claim 94, further comprising means for transmitting wireless energy transmitter power, wherein the transmitting wireless energy in the energy transmission device, the wireless energy is directly used to drive the manipulator to produce for the operation of the reflux disease treatment device kinetic energy.
  101. 101.根据权利要求15所述的设备,其中所述主体形成第一腔室,进一步包括形成比所述第一腔室小的第二腔室的至少一个附加体,所述第一腔室和所述第二腔室彼此相接触。 101. The apparatus according to claim 15, wherein said body forms a first chamber, further comprising forming said first chamber is smaller than at least one of the additional volume of the second chamber, the first chamber and said second chamber in contact with one another.
  102. 102.根据权利要求101所述的设备,其中所述第一腔室和所述第二腔室彼此流体连iM o 102. The apparatus according to claim 101, wherein said first chamber and said second chamber in fluid communication with each other iM o
  103. 103.根据权利要求58所述的设备,其中所述液压储存器适于放置在患者的皮下。 103. The apparatus according to claim 58, wherein said hydraulic reservoir adapted to be placed in the patient's skin.
  104. 104.根据权利要求58所述的设备,其中所述液压储存器适于放置在患者的腹内。 104. The apparatus according to claim 58, wherein said hydraulic reservoir adapted to be placed in the patient's abdominal.
  105. 105.根据权利要求58所述的设备,其中所述液压储存器具有限定其容积的壁,并且所述液压储存器的容积通过移动所述液压储存器的壁的壁部分来调节。 Volume 105. Device according to claim 58, wherein said hydraulic reservoir having a wall defining the volume, and the hydraulic reservoir by moving the wall portion of the wall of the hydraulic reservoir is adjusted.
  106. 106.根据权利要求105所述的设备,进一步包括用于移动所述壁部分的马达。 106. The apparatus according to claim 105, further comprising means for moving said wall portion of the motor.
  107. 107.根据权利要求59所述的设备,其中所述液压调节器包括泵,并且所述液压储存器通过所述泵在所述液压储存器与所述至少一个腔室之间泵送流体来调节。 107. adjusting apparatus according to claim according to claim 59, wherein said actuator comprises a hydraulic pump and said hydraulic reservoir through said pump in the pumping of hydraulic fluid between the reservoir and the at least one chamber .
  108. 108.根据权利要求59所述的设备,进一步包括机械器件,所述机械器件可操作地连接至所述液压调节器,以在操作所述液压调节器时移动所述机械器件。 108. The apparatus of claim 59, further comprising a mechanical device, said mechanical device is operatively connected to the hydraulic actuator, a mechanical device to move the operation of the hydraulic actuator.
  109. 109.根据权利要求1所述的设备,其中所述运动限制器件以机械方式被调节。 109. The apparatus according to claim 1, wherein the movement restriction device is adjusted mechanically.
  110. 110.根据权利要求109所述的设备,进一步包括用于以机械方式调节所述运动限制器件的马达。 110. The apparatus according to claim 109, further comprising means for mechanically limiting movement of the adjusting device of the motor.
  111. 111.根据权利要求15所述的设备,进一步包括第二主体,所述第二主体在与所述主体一起植入患者时分别填充位于患者的胃的两个不同部分处的两个容积,从而影响患者的反流。 111. The apparatus according to claim 15, further comprising a second body, the second body when implanted in a patient together with the filling body is located at two different portions of the two volumes of the patient's stomach, respectively, thereby Patients reflux.
  112. 112.根据权利要求111所述的设备,其中所述反流病治疗器件适于在手术后无创地进行调节,并且适于不时地进行调节,以在第一时间,所述填充体之一填充胃的所述部分之一处的容积,并且在第二时间,所述填充体中的另一个填充胃的另一部分处的容积。 112. The apparatus according to claim 111, wherein the device is adapted to treat reflux disease after surgery noninvasively adjusted and adapted to be adjusted from time to time to the first time, one of the filling body filling the portion of the volume of the stomach, and a second time, another portion of the volume of the other filling body filling the stomach.
  113. 113.根据权利要求1所述的设备,进一步包括刺激器,用于使用刺激脉冲刺激贲门肌肉以引起贲门的收缩,从而抵抗反流。 113. The apparatus according to claim 1, further comprising a stimulator for stimulation of cardiac stimulation pulses used to induce cardiac muscle contraction, and thus resist reflux.
  114. 114.根据权利要求113所述的设备,其中所述刺激器包括至少一个导体和适于接收所述刺激脉冲的至少一个电极。 114. The apparatus according to claim 113, wherein said stimulator comprises at least one conductor and at least one electrode adapted to receive said stimulation pulses.
  115. 115.根据权利要求114所述的设备,其中所述刺激器包括电子电路和能源。 115. The apparatus according to claim 114, wherein said stimulator comprises an electronic circuit and energy.
  116. 116.根据权利要求115所述的设备,其中所述运动限制器件适于合并所述电子电路和能源。 116. The apparatus according to claim 115, wherein the movement restriction device is adapted to combine the electronic circuitry and energy.
  117. 117.根据权利要求113所述的设备,其中所述刺激器产生脉冲串形式的刺激脉冲,并且连续脉冲串之间的时间间隔长于每个脉冲串中连续脉冲之间的时间间隔。 117. The apparatus according to claim 113, wherein said stimulator produces bursts of stimulation pulses, and continuous pulse train time is longer than the time interval between each burst interval between successive pulses.
  118. 118.根据权利要求113所述的设备,进一步包括至少一个传感器,用于检测患者的生理参数或所述反流病治疗器件的功能性参数。 118. The apparatus according to claim 113, further comprising at least one sensor for detecting a physiological parameter of a patient or a functional parameter of the reflux disease treatment device.
  119. 119.根据权利要求113所述的设备,进一步包括可植入的内部控制单元,用于控制所述刺激器。 119. The apparatus according to claim 113, further comprising an implantable internal control unit for controlling the stimulator.
  120. 120.根据权利要求119所述的设备,进一步包括传感器,其中所述内部控制单元响应于来自所述传感器的信号来控制所述刺激器。 120. The apparatus according to claim 119, further comprising a sensor, wherein the internal control unit in response to a signal from said sensor to control the stimulator.
  121. 121.根据权利要求120所述的设备,其中所述传感器检测食管的收缩波或与食物摄入相关的参数,并且所述内部控制单元控制所述刺激器,以响应于检测所述收缩波或所述参数的传感器而停止刺激所述贲门肌肉。 121. The apparatus according to claim 120, wherein the sensor detects the esophagus contraction wave or food intake related parameter, and the internal control unit controls the stimulation device in response to detecting the waves or contractions The sensor parameters and stops stimulation of the cardiac muscle.
  122. 122.根据权利要求113所述的设备,其中所述刺激器由患者控制。 122. The apparatus according to claim 113, wherein the stimulator is controlled by the patient.
  123. 123.根据权利要求57所述的设备,进一步包括外部数据通信器和与所述外部数据通信器通信的可植入的内部数据通信器,其中所述内部通信器适于向所述外部数据通信器反馈与用于治疗反流病的器件或患者有关的数据,或者所述外部数据通信器向所述内部数据通信器发送数据。 123. The apparatus according to claim 57, further comprising an external data communicator and the data communication with the external communication implantable internal data communicator, wherein the internal communicator is adapted to communicate to the external data Device data feedback and for the treatment of reflux disease or patient-related or external data communication transmits the data to the internal data communicator.
  124. 124.根据权利要求1所述的设备,进一步包括用于发射能量的能量传输器和用于将无线能量从第一形式转换为第二形式的能量的能量转换器。 124. The apparatus according to claim 1, further comprising an energy transmitter for transmitting wireless energy, and means for converting energy from a first form to a second form of energy of the energy converter.
  125. 125.根据权利要求124所述的设备,其中所述能量转换器在将所述能量传输器发射的第一形式的能量转换为第二形式的能量时,使用所述第二形式的能量直接给所述设备供能。 125. The apparatus according to claim 124, wherein the energy converter when the energy transmission device transmitting energy of a first form into a second form of energy, using the second form of energy directly to the The equipment for energy.
  126. 126.根据权利要求124所述的设备,其中所述第二形式的能量包括直流或脉动直流, 或者直流和脉动直流的组合。 126. The apparatus according to claim 124, wherein the second form energy comprises a direct current or pulsating direct current, or a combination of DC and pulse DC.
  127. 127.根据权利要求124所述的设备,其中所述第二形式的能量包括交流或交流与直流的组合。 127. The apparatus according to claim 124, wherein the second form of energy including exchange or a combination of AC and DC.
  128. 128.根据权利要求124所述的设备,进一步包括可植入的储能器,其中所述第二形式的能量至少部分地用于给所述储能器充能。 128. The apparatus according to claim 124, further comprising an implantable energy storage device, wherein the second form of energy is used to at least partially recharge the accumulator.
  129. 129.根据权利要求124所述的设备,其中所述第一形式的能量或所述第二形式的能量包括磁能、动能、声能、化学能、辐射能、电磁能、光能、核能或热能。 129. The apparatus according to claim 124, wherein the first form of energy or the energy of the second form comprises magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, solar energy, nuclear energy or thermal energy .
  130. 130.根据权利要求124所述的设备,其中所述第一形式的能量和所述第二形式的能量之一是非磁能、非动能、非化学能、非声能、非核能或非热能。 130. The apparatus according to claim 124, wherein one of the energy of the first form and the energy of the second form is non-magnetic, non-kinetic, non-chemical, non-sonic energy, non-nuclear or non-thermal energy.
  131. 131.根据权利要求1所述的设备,进一步包括可植入的电子组件,所述可植入的电子组件包括至少一个电压电平保护器。 131. The apparatus according to claim 1, further comprising implantable electrical components, implantable electrical components including at least one of said voltage level protection.
  132. 132.根据权利要求1所述的设备,进一步包括可植入的电子组件,所述可植入的电子组件包括至少一个恒流保护器。 132. The apparatus according to claim 1, further comprising implantable electrical components, implantable electrical components including at least one of said constant-current protector.
  133. 133.根据权利要求1所述的设备,进一步包括至少一个可调整的拉伸器,所述拉伸器在被植入患者时拉伸患者的胃壁的一部分,从而通过影响患者的食欲来治疗肥胖症。 133. The apparatus according to claim 1, further comprising at least one adjustable stretcher, stretching the stomach wall portion is stretched when the patient is implanted in a patient, so that by affecting the patient's appetite to treat obesity disease.
  134. 134.根据权利要求1所述的设备,其中所述运动限制器件包括拉伸器,所述拉伸器在被植入患者时拉伸患者的胃壁的一部分,从而通过影响患者的食欲来治疗肥胖症。 134. The apparatus according to claim 1, wherein said motion limiting device comprises a stretcher, stretching the stomach wall portion is stretched when a patient is implanted in a patient, so that by affecting the patient's appetite to treat obesity disease.
  135. 135.根据权利要求134所述的设备,其中所述运动限制器件包括具有腔室的主体,并且进一步包括与所述主体腔室流体接触的第二腔室。 135. The apparatus according to claim 134, wherein said motion limiting device comprises a body having a chamber, and further comprising a second chamber of the body in contact with the fluid chamber.
  136. 136.根据权利要求135所述的设备,其中所述第二腔室比所述主体小。 136. The apparatus according to claim 135, wherein said second chamber is smaller than the body.
  137. 137.根据权利要求135所述的设备,其中所述主体和所述第二腔室在被植入患者时彼此连通,因此流体或空气在所述主体与所述第二腔室之间移动。 137. The apparatus according to claim 135, wherein said body and said second chamber in communication with each other when it is implanted in a patient, thus the fluid or air movement between the body and the second chamber.
  138. 138.根据权利要求135所述的设备,其中所述主体的腔室是主腔室,并且所述第二腔室在被植入患者时充当拉伸器的功能以治疗肥胖症,所述主腔室和所述第二腔室在被植入患者时彼此连通,因此流体或空气在所述主腔室与所述第二腔室之间移动,从而引起患者的胃底壁的拉伸效果以治疗肥胖症。 138. The apparatus according to claim 135, wherein the chamber is a main body of said chamber and said second chamber acts as the function of stretching, when implanted in a patient to treat obesity, the main chamber and said second chamber in communication with each other when it is implanted in a patient, therefore move the fluid or air between the main chamber and the second chamber, causing the stretching effect of the patient's gastric wall for the treatment of obesity.
  139. 139.根据权利要求134所述的设备,其中所述运动限制器件包括主体,所述主体在被植入患者时尺寸可调节并且套叠到患者的胃底壁中,因此所述主体在尺寸增加时拉伸患者的胃底壁,从而在患者体内产生饱胀感。 139. The apparatus according to claim 134, wherein said motion limiting device comprises a body, the body size can be adjusted telescopically and into the patient's gastric wall, when implanted in a patient, thus increasing the size of the body stretching the patient's gastric wall, resulting in a sense of fullness in the patient.
  140. 140.根据权利要求1所述的设备,进一步包括至少两个可植入且可调整的拉伸器,所述拉伸器在被植入患者时拉伸患者的胃壁的不同部分,从而通过影响患者的食欲来治疗肥胖症。 140. The apparatus according to claim 1, further comprising at least two implantable and adjustable stretcher, the stretcher stretching of different parts of the stomach wall of the patient when implanted in the patient, so that by the impact the patient's appetite to treat obesity.
  141. 141.根据权利要求140所述的设备,其中所述两个拉伸器在被植入患者时从患者身体外部进行调节,因此所述拉伸器中的第一拉伸器在第一时间被调节为拉伸患者胃壁的第一部分,所述拉伸器中的第二拉伸器在第二时间被调节为拉伸患者胃壁的第二部分。 141. The apparatus according to claim 140, wherein the two stretcher when it is implanted in a patient to adjust a patient from outside the body, thus stretching the first reactor at the first time is stretched stretching the stomach wall of the patient is adjusted to a first portion of the stretcher in the second device is adjusted to stretch the stomach wall of the patient stretched a second time at the second portion.
  142. 142.根据权利要求133所述的设备,其中所述拉伸器以液压方式调节,进一步包括连接至以液压方式调节的拉伸器的液压储存器,因此所述以液压方式调节的拉伸器在被植入患者时通过手动按压所述液压储存器无创地进行调节。 142. The apparatus according to claim 133, wherein the stretching is adjusted hydraulically, further comprising hydraulically connected to the hydraulic regulator stretched reservoir, whereby said hydraulically adjustable stretcher when implanted in a patient in pressing the hydraulic reservoir noninvasively adjusted manually.
  143. 143.根据权利要求142所述的设备,其中所述液压储存器在被植入患者时被植入皮下。 143. The apparatus according to claim 142, wherein said hydraulic reservoir when it is implanted in a patient to be implanted subcutaneously.
  144. 144.根据权利要求142所述的设备,其中所述运动限制器件包括可充盈的主体,进一步包括泵和与所述主体流体接触的腔室,并且其中所述泵在被植入患者时通过从所述主体向所述腔室泵送流体或空气来调节所述液压储存器。 144. The apparatus according to claim 142, wherein said motion limiting device comprises a filling body, and further comprising a pump body in contact with the fluid chamber, and wherein, when the pump is implanted in a patient by the pumping said body fluid or air into the chamber to adjust the hydraulic reservoir.
  145. 145.根据权利要求133所述的设备,进一步包括无线遥控,其中所述拉伸器在被植入患者时通过所述无线遥控无创地进行调节。 145. The apparatus according to claim 133, further comprising a wireless remote control, wherein the stretcher, when implanted in a patient noninvasively adjusted by the wireless remote control.
  146. 146.根据权利要求133所述的设备,进一步包括能源,所述能源在被植入患者时给所述可调整的拉伸器供能。 146. The apparatus according to claim 133, further including energy, the energy when it is implanted in a patient to the adjustable stretcher for energy.
  147. 147.根据权利要求146所述的设备,其中所述能源包括可植入患者体内的内部能源。 147. The apparatus according to claim 146, wherein the energy comprises an implantable internal energy of the patient.
  148. 148.根据权利要求146所述的设备,其中所述能源包括发射无线能量的外部能源。 148. The apparatus according to claim 146, wherein the energy source comprises an external energy source transmitting wireless energy.
  149. 149.根据权利要求148所述的设备,进一步包括可植入患者体内的内部能源,所述内部能源在被植入患者时可用所述外部能源发射的无线能量充能。 149. The apparatus according to claim 148, further comprising an implantable patient's internal energy, the internal energy is implanted in a patient when the available wireless energy emitted by an external energy source energized.
  150. 150.根据权利要求1所述的设备,进一步包括第一可植入固定器、第二可植入固定器和第三可植入固定器,所述第一可植入固定器在被植入患者时将所述运动限制器件固定在所述位置,并且所述运动限制器件的外表面基本上与患者的胃底壁接触,所述第二可植入固定器在被植入患者时将所述运动限制器件固定到食管,所述第三可植入固定器在被植入患者时将所述运动限制器件固定到患者的横膈膜肌肉或相关联的肌肉。 150. The apparatus according to claim 1, further comprising a first implantable anchor, second anchor, and third implantable implantable retainer, the implantable retainer first being implanted The outer surface of the patient motion restriction device fixed at the position, and the movement restriction device is substantially in contact with the patient's gastric wall fixed to said second implantable device is implanted in the patient to the time said movement limiting device is fixed to the esophagus, the implantable fixture third, when implanted in a patient to the movement restriction device is secured to the patient's diaphragm muscle or muscle associated.
  151. 151.根据权利要求150所述的设备,其中所述固定器中的每一个由多个缝线或U形钉构成。 151. The apparatus according to claim 150, wherein said holder in each of a plurality of U-shaped staples or sutures constituted.
  152. 152.根据权利要求1所述的设备,进一步包括用于手动且无创地控制所述设备的开关。 152. The apparatus according to claim 1, further comprising means for manually and non-invasively controlling the switching device.
  153. 153.根据权利要求152所述的设备,其中所述开关可植入患者皮下。 153. The apparatus according to claim 152, wherein the switch may be subcutaneously implanted in the patient.
  154. 154.根据权利要求152所述的设备,其中所述开关是电开关。 154. The apparatus according to claim 152, wherein the switch is an electrical switch.
  155. 155.根据权利要求15所述的设备,其中随着与贯穿所述主体的轴垂直的平面沿所述轴移动,所述主体在一个所述平面上具有最大周长,并且当比较沿所述轴移动的两个连续相接的平面时,当从所述最大周长开始向远离所述最大周长的一个或两个方向上移动时, 所述周长随所述平面沿所述轴的移动减小或者保持不变。 155. The apparatus according to claim 15, wherein with the plane perpendicular to the axis extending through the body along the axis, the body having a maximum perimeter on the plane, and when compared along the When two axes move continuously in contact with the plane, from the maximum circumference when away from the start to one or both directions of movement when the maximum circumference, the circumference reduction with the plane moving along the axis small or remains unchanged.
  156. 156.根据权利要求15所述的设备,其中所述主体在垂直于贯穿所述主体的至少一个轴的平面上具有周长,并且当比较沿具有两个端点的所述轴移动的这样两个连续相接的平面时,随着所述平面沿所述轴移动,与两个端点之间的最小周长相比,所述周长增加至少两倍或减小至少两倍,或者在端点处具有更大的周长。 156. Thus two devices according to claim 15, wherein said body has a circumference at least one plane perpendicular to the axis extending through the body, and when comparing the shaft along with the movement of the two endpoints When the continuous phase of the plane, as the plane along the axis, as compared with the minimum circumference between the two endpoints, at least twice the circumference increase or decrease at least twice, or have at the endpoints larger circumference.
  157. 157.根据权利要求1所述的设备,其中所述运动限制器件适于基本上被患者的胃底壁套叠。 157. The apparatus according to claim 1, wherein the movement restriction device is adapted to the patient's gastric wall substantially nested.
  158. 158.根据权利要求1所述的设备,进一步包括固定器,所述固定器在所述运动限制器件被植入时适于将所述运动限制器件连到胃底壁上,以将所述运动限制器件保持在所述位置。 158. The apparatus according to claim 1, further comprising a holder, the holder when the movement restriction device is implanted in the movement restriction device is adapted to be connected to the wall of the fundus, to the motion limiting device remains in the position.
  159. 159.根据权利要求1所述的设备,其中所述运动限制器件是可充盈的,并且适于充入凝胶或流体。 159. The apparatus according to claim 1, wherein the movement restriction device is filling, and adapted to the gel or fluid filled.
  160. 160.根据权利要求159所述的设备,进一步包括用于接纳流体以充盈所述运动限制器件的流体或凝胶接纳构件。 160. The apparatus according to claim 159, further comprising means for receiving a fluid to limit the movement of the filling device in fluid or gel receiving member.
  161. 161.根据权利要求1所述的设备,其中所述运动限制器件包括均质材料。 161. The apparatus according to claim 1, wherein said motion limiting device comprises a homogeneous material.
  162. 162.根据权利要求161所述的设备,其中所述运动限制器件包括实心体。 162. The apparatus according to claim 161, wherein said motion limiting device comprises a solid body.
  163. 163.根据权利要求1所述的设备,其中所述运动限制器件包括形成腔室的包围壁。 163. The apparatus according to claim 1, wherein said motion limiting device comprising a chamber surrounded by a wall formation.
  164. 164.根据权利要求159至163中任一项所述的设备,其中所述运动限制器件具有刚性的外壁。 159 to 164. The apparatus 163 according to any one of claims, wherein the movement restriction device having a rigid outer wall.
  165. 165.根据权利要求159至163中任一项所述的设备,其中所述运动限制器件具有弹性外壁。 159 to 165. The apparatus 163 according to any one of claims, wherein the movement restriction device having a resilient outer wall.
  166. 166.根据权利要求159至163中任一项所述的设备,其中所述运动限制器件具有柔性外壁。 159 to 166. The apparatus 163 according to any one of claims, wherein the movement restriction device having a flexible outer wall.
  167. 167.根据权利要求164所述的设备,其中所述刚性外壁硬到足以在承受胃的运动所产生的力时保持不变形。 167. The apparatus according to claim 164, wherein said rigid outer wall is not hard enough to maintain the deformation when subjected to the force generated by the movement of the stomach.
  168. 168.根据权利要求1所述的设备,其中所述运动限制器件适于穿过腹腔镜套管针或胃镜套管针或仪器。 168. The apparatus according to claim 1, wherein the movement restriction device is adapted to pass through the laparoscopic trocar or trocar or endoscopic instrument.
  169. 169.根据权利要求1所述的设备,其中所述运动限制器件能够改变形状以便穿过腹腔镜套管针或胃镜套管针或仪器。 169. The apparatus according to claim 1, wherein the movement restriction device is capable of changing shape to pass through the laparoscopic trocar or trocar or endoscopic instrument.
  170. 170.根据权利要求1所述的设备,其中所述运动限制器件具有滚圆的形状而没有过于尖锐的边缘,使得所述运动限制器件被植入时不会损伤胃壁。 Edge 170. apparatus according to claim 1, wherein the movement restriction device having a rounded shape and not too sharp, so that when the movement restriction device is implanted will not damage the stomach wall.
  171. 171.根据权利要求1所述的设备,其中所述运动限制器件适于被放置在患者胃壁的外侧,使得胃腔被显著减小一个显著超出所述运动限制器件的体积的容积。 171. The apparatus according to claim 1, wherein the movement restriction device is adapted to be placed on the outside of the stomach wall of the patient, so that the stomach cavity is substantially reduced a significant volume exceeds the volume of the movement restriction device.
  172. 172.根据权利要求1所述的设备,其中所述运动限制器件的体积可无创地调整。 172. The apparatus according to claim 1, wherein said movement limiting device may be non-invasively adjust the volume.
  173. 173.根据权利要求1所述的设备,其中所述运动限制器件适于被患者的胃底壁完全套叠。 173. The apparatus of claim 1, wherein, wherein the device is adapted to restrict the movement of patients with gastric wall is completely nested.
  174. 174.根据权利要求1或157或173所述的设备,其中所述运动限制器件适于被套叠,所述运动限制器件被放置在胃底壁的内侧。 1 or 157 or 174. Device according to claim 173, wherein the movement restriction device is adapted invaginated, the movement restriction device is placed on the inside wall of the fundus.
  175. 175.根据权利要求1或157或173所述的设备,其中所述运动限制器件适于被套叠,所述运动限制器件被放置在胃底壁的外侧。 1 or 157 or 175. Device according to claim 173, wherein the movement restriction device is adapted invaginated, the movement restriction device is placed on the outside wall of the fundus.
  176. 176.根据权利要求1所述的设备,进一步包括注入口,所述注入口适于连接至所述运动限制器件的可充盈腔室,以调整所述可充盈腔室的体积。 176. The apparatus according to claim 1, further comprising an injection port, said injection port adapted to be connected to the movement restriction device can filling chamber to adjust the volume of the chamber can be filling.
  177. 177.根据权利要求1所述的设备,进一步包括用于在植入所述运动限制器件的过程中夹持所述运动限制器件的夹持器。 177. The apparatus according to claim 1, further comprising means for holding the movement in the movement restriction device is implanted during limiting device holder.
  178. 178.根据权利要求2所述的设备,进一步包括用于在植入所述运动限制器件的过程中固定所述运动限制器件的第二固定器。 178. The apparatus according to claim 2, further comprising means for limiting movement of the implanted device is fixed during the second movement restriction device holder.
  179. 179.根据权利要求1所述的设备,其中所述运动限制器件的至少一部分由可被胃酸破坏的材料制成。 179. The apparatus according to claim 1, wherein said movement limiting device is formed at least in part by a material that can be destroyed acid.
  180. 180.根据权利要求1所述的设备,其中所述运动限制器件的至少一部分由不会被胃酸破坏的材料制成。 180. The apparatus according to claim 1, wherein at least a portion of the movement limiting device is made of a material not damaged stomach acid.
  181. 181.根据权利要求1所述的设备,其中所述主体在垂直于贯穿所述主体的轴的平面上具有周长,并且其中当沿所述轴从所述轴的第一端点向具有最大值的中间点移动时,所述周长稳定地增大或保持恒定,并且当从所述中间点向所述轴的第二端点移动时,所述周长稳定地减小或保持恒定。 181. The apparatus according to claim 1, wherein said body has a circumference in perpendicular to the axis through the plane of the body, and wherein when said shaft along said axis from a first end to have a maximum value moves intermediate point, the circumference is stably increased or kept constant, and when moving from the intermediate point to the second end of the shaft, the circumference is stably reduced or kept constant.
  182. 182.根据权利要求1所述的设备,其中所述主体在垂直于贯穿所述主体的轴的平面上具有周长,其中当在沿所述轴从所述轴的第一端点向具有第一最大值的第一中间点移动时,所述周长稳定地增大或保持恒定,当从所述第一中间点向具有第一最小值的第二中间点移动时,所述周长稳定地减小或保持恒定,当沿所述轴从所述轴的第二中间点向具有第二最大值的第三中间点移动时,所述周长稳定地增大或保持恒定,并且在从所述第三中间点向所述轴的第二端点移动时,所述周长稳定地减小或保持恒定。 182. The apparatus according to claim 1, wherein said body has a circumference in perpendicular to the axis through the plane of the body, wherein when said shaft along said axis from a first end to a first a first intermediate point of a maximum value when the movement of the perimeter is stably increased or kept constant, when the point is moved from the first intermediate point to a second intermediate having a first minimum value, stabilizing the circumference decreases or remains constant along the axial direction when the third intermediate having the second maximum point moves, the circumference remains constant or increases stably from the second intermediate point of said shaft, and from said third intermediate point to a second end of said shaft is moved, the circumference is stably reduced or kept constant.
  183. 183.根据权利要求57所述的设备,其中所述调整器是注射器类型的器件,包括用于注入所述运动限制器件的可注入的填充流体。 183. The apparatus according to claim 57, wherein said adjusting device is a syringe type device comprising a motion limiting device for injecting the fill fluid may be injected.
  184. 184.根据权利要求183所述的设备,其中所述填充流体能够经历固化过程从而形成半固态或固态的可变形材料。 184. The apparatus according to claim 183, wherein said filling fluid can undergo a curing process to form a semi-solid or solid deformable material.
  185. 185.根据权利要求184所述的设备,其中所述固化过程由从环境温度到身体温度的温度升高而触发。 185. The apparatus according to claim 184, wherein said curing process the temperature increased from ambient to body temperature and triggers.
  186. 186.根据权利要求185所述的设备,其中所述填充流体是可热固化的聚硅氧烷。 186. The apparatus according to claim 185, wherein said filling fluid is a heat-curable silicone.
  187. 187. —种外科手术套件,包括根据权利要求1至182中任一项所述的用于治疗反流病的设备以及注射器型的注入器件,所述注入器件包括用于注入被植入的填充体中的可注入的填充流体。 187. - Species surgery kit, comprising filling device comprises means for injecting any of 1 to 182 reflux disease treatment apparatus and a syringe-type injection device according to one of the injection is implanted claim the body can be injected into the fluid-filled.
  188. 188.根据权利要求187所述的外科手术套件,其中所述填充流体能够经历固化过程从而形成半固态或固态的可变形材料。 188. The surgical kit according to claim 187, wherein said filling fluid can undergo a curing process to form a semi-solid or solid deformable material.
  189. 189.根据权利要求188所述的外科手术套件,其中所述固化过程由从环境温度到身体温度的温度升高而触发。 189. The surgical kit according to claim 188, wherein said curing process the temperature increased from ambient to body temperature and triggers.
  190. 190.根据权利要求189所述的外科手术套件,其中所述填充流体是可热固化的聚硅氧焼。 190. The surgical kit of claim 189, wherein the fill fluid is a heat-curable silicone ware.
  191. 191.根据权利要求1所述的设备,其中随着与贯穿所述主体的轴垂直的平面沿所述轴移动,所述容积填充器件在一个所述平面上具有最大周长,并且当比较沿所述轴移动的两个连续相接的平面时,当从所述最大周长开始向远离所述最大周长的一个或两个方向移动时,所述周长随所述平面沿所述轴的移动而减小或保持不变。 191. The apparatus according to claim 1, wherein with the plane perpendicular to the axis extending through the body along the axis, the volume filling device has a maximum circumference on the plane, and when compared along When the two-axis plane moving continuously in contact when start moving from the maximum circumference to one or both directions away from said maximum circumference when moving over the circumference of the shaft along the plane decrease or remain the same.
  192. 192.根据权利要求1所述的设备,其中所述容积填充器件在垂直于贯穿所述主体的轴的平面上具有周长,并且其中当沿所述轴从所述轴的第一端点向具有最大值的中间点移动时,所述周长稳定地增大或保持不变,并且当从所述中间点向所述轴的第二端点移动时,所述周长稳定地减小或保持恒定。 192. The apparatus according to claim 1, wherein the volume filling device has a circumference perpendicular to the plane through the axis of said body, and wherein when said shaft along said axis from a first end to the It has a maximum value of the intermediate point moves, the perimeter steady increase or remain the same, and when moving from the intermediate point to a second end of the shaft, the circumference decreases or remains stable constant.
  193. 193.根据权利要求1所述的用于治疗反流病的设备,其中随着与贯穿所述主体的至少一个轴垂直的平面沿所述轴运动,所述容积填充器件在所述平面上具有周长,并且当比较沿具有两个端点的所述轴移动的这样两个连续相接的平面时,与两个端点之间的最小周长相比,所述周长增加至少两倍或减小至少两倍,或者在端点处具有更大的周长。 193. The device for treating reflux disease according to claim 1, wherein the body and the through with at least one shaft along a plane perpendicular to the axis of movement, the volume filling device has on the plane perimeter, and when this phase two successive planes along the axis with two endpoints relatively movable, compared with the minimum circumference between the two endpoints, at least twice the circumference increase or decrease at least twice, or have a greater circumference at the endpoints.
  194. 194.根据权利要求1所述的设备,其中所述容积填充器件在垂直于贯穿所述主体的轴的平面上具有周长,并且其中当沿所述轴从所述轴的第一端点向具有第一最大值的第一中间点移动时,所述周长稳定地增大或保持恒定;当从所述第一中间点向具有第一最小值的第二中间点移动时,所述周长稳定地减小或保持恒定;当沿所述轴从所述轴的第二中间点向具有第二最大值的第三中间点移动时,所述周长稳定地增大或保持恒定;并且当从所述第三中间点向所述轴的第二端点移动时,所述周长稳定地减小或保持恒定。 194. The apparatus according to claim 1, wherein the volume filling device has a circumference perpendicular to the plane through the axis of said body, and wherein when said shaft along said axis from a first end to the a first intermediate point having a first maximum value when moving, increasing or stabilizing the circumference remains constant; when moving from the first to the second intermediate point with a first intermediate point of a minimum value of the peripheral Long stably reduced or kept constant; when the direction of the axis to a third intermediate point of the second maximum moves, the perimeter steady increases or remains constant from the second intermediate point of said shaft; and When moving from the third point to the second end of the intermediate shaft, the circumference is stably reduced or kept constant.
Description  translated from Chinese

用于治疗胃食管反流病的设备 Apparatus for the treatment of gastroesophageal reflux disease

技术领域 Technical Field

[0001] 本发明涉及用于治疗胃食管反流病(GERD)的设备。 [0001] The present invention relates to a device for the treatment of gastroesophageal reflux disease (GERD) in. 背景技术 Background

[0002] 胃食管反流病(GERD)或胃酸反流病是一种由食管中反复发作的胃酸反流所引起的导致食管黏膜损伤的慢性疾病。 [0002] gastroesophageal reflux disease (GERD) or acid reflux disease is a recurrent from the esophagus caused by acid reflux esophageal mucosal injury leads to chronic disease. 这通常是由于食管与胃之间屏障发生了暂时性或永久性的改变。 This is usually due to the barrier between the esophagus and the stomach occurred in temporary or permanent change. 这可能是由于发生了下食管括约肌(LES)的功能异常、暂时性的LES松弛、胃反流从食管的廓清功能受损、或者食管裂孔疝。 This may be due to a lower esophageal sphincter (LES) dysfunction, transient LES relaxation, gastric reflux from the esophagus clearance function is impaired, or hiatal hernia.

[0003] 胃食管反流病可以以多种不同的方式治疗。 [0003] Gastroesophageal reflux disease may be therapeutic in many different ways. 治疗方法包括但不限于药物治疗和外科手术治疗两种。 Treatment methods include, but are not limited to two drugs and surgery. 在较长时间的药物治疗之后有时优选标准外科手术治疗——尼森(Nissen)胃底(fundus)折叠术,其中胃的上部曲面(底部)包围着LES卷绕以加强括约肌且防止胃酸反流,并修复食管裂孔疝。 After a long period of drug therapy is sometimes preferred standard surgical treatment - Nissen (Nissen) and gastric (fundus) plication, where the upper surface of the stomach (bottom) surrounded by winding LES to strengthen the sphincter and prevent acid reflux, and repair a hiatal hernia. 该过程经常通过腹腔镜进行。 This process is often carried out by laparoscopy.

[0004] 另外一种已经使用的外科手术治疗是Anglechik修复术,其中形成为类似马蹄铁形状的器件围绕食管置于贲门之上。 [0004] An additional surgery has been used is Anglechik prosthetics, which is formed like a horseshoe-shaped device placed around the esophagus above the cardia. 计划的效果是防止贲门向上滑到胸腔中。 The effect of the plan is to prevent the cardia slid up the chest. 然而,该器件有一些并发症,包括沿食管迁移并损伤食管。 However, this device has a number of complications, including migration along the esophagus and damage the esophagus.

[0005] 根据植入医疗器件的经验,已知被植入器件与人体组织之间的缝合不会维持很长时间。 [0005] According to the implantable medical device experience suture device known to be implanted with human organizations will not last very long. 对于器件的长期植入,有两种固定住器件的可能性。 For long-term implantation of the device, there are two possibilities for fixed devices. 第一方案是将人体组织与人体组织缝合在一起,从而固定住器件。 The first option is to human tissue and human tissue sutured together to hold the device. 第二种方法是提供短期将器件固定在适当位置的缝合, 并允许人体组织向内生长进入该器件中,用于将器件长期固定在适当位置。 The second method is to provide a short-term device is secured in place suture, and to allow this tissue ingrowth into the device, the device for long-term fixed in place.

[0006] 提供与食管相结合的可植入器件的问题是,食管的外表面仅由极易损伤并沿其迁移的食管肌肉组织构成。 [0006] The implantable device issues with a combination of the esophagus, the outer surface of the esophagus and only by easily damage along its migration esophageal muscle tissue composition. 这或许就是以上所述的Anglechik修复术导致诸如迁移的很多并发症的原因之一。 Perhaps this is above Anglechik repair one of the reasons such as the migration of many complications.

[0007] 另一方面,在胃的外侧上具有浆膜,从而提供了用于缝合的更结实的膜。 [0007] On the other hand, on the outside of the stomach with a serous membrane, thus providing a more robust films for stitching. 因此,将器件直接缝合到胃壁提供了比将植入器件缝合到食管更好的效果。 Thus, the device is sutured to the stomach than the implant device provides sutured to the esophagus better results.

[0008] 如今,需要比现有治疗方法更有效并且不会导致任何严重并发症的GERD长期治疗方法。 [0008] Today, the need is more effective than existing therapies and will not result in long-term treatment of GERD any serious complications.

发明内容 DISCLOSURE

[0009] 本发明的一个目的在于克服或至少减轻现有的胃食管反流病(GERD)的外科手术治疗带来的一些问题。 [0009] An object of the present invention to overcome or at least alleviate some of the problems existing in gastroesophageal reflux disease (GERD) in the surgical treatment brings.

[0010] 本发明的另一目的在于提供一种用于治疗胃食管反流病的设备。 [0010] Another object of the present invention is to provide a device for the treatment of gastroesophageal reflux disease.

[0011] 这些和其它目的可以通过所附权利要求中描述的设备来实现。 [0011] These devices and other objects can be described by the appended claims to achieve. 因此,提供了一种用于治疗胃酸反流病的设备,所述设备包括可植入运动限制器件,所述可植入运动限制器件具有包括生物相容材料的外表面,其中所述运动限制器件适于使其外表面的至少一部分靠在患者胃底壁上从而使所述器件停留在患者横膈膜与胃底壁之间的位置上,从而限制患者胃的贲门切迹向患者横膈膜移动,由此得到了一种用于治疗胃食管反流病的设备。 Accordingly, there is provided an apparatus for the treatment of acid reflux disease, the apparatus comprising an implantable movement restriction device, the implantable movement restriction device having an outer surface including a biocompatible material, wherein said movement restriction the device is adapted so that at least a portion of the outer surface of the gastric wall against the patient so that the patient device stays in position between the diaphragm and the gastric wall, thereby limiting patient to patient gastric cardia notch diaphragmatic film movement, whereby a device for the treatment of gastroesophageal reflux disease. [0012] 所述运动限制器件具有至少125mm3的尺寸和至少15mm的周长,并且限制患者胃的贲门切迹向患者横膈膜运动,从而防止贲门通过患者横膈膜开口而滑到患者胸腔中,并且维持了对患者贲门括约肌从患者腹部施加的支撑压力。 [0012] The motion limiting device has at least 125mm3 in size and at least 15mm in circumference, and limit the patient's cardiac notch stomach the diaphragm motion to the patient, thereby preventing cardiac patients by opening the diaphragm slide in patients with chest and to maintain the support of patients with cardiac sphincter pressure from the patient's abdomen applied. 固定器适于将所述运动限制器件保持在所述位置。 The holder is adapted to limit the movement of the device is held in position.

[0013] 由于胃底与食管相比不易损伤,因此通过使植入的运动限制器件的外表面适于靠在胃底壁上,使诸如对组织的移动损伤之类的并发症的风险最小。 [0013] Since the gastric and esophageal damage than not, so by limiting the movement of the implant device against the gastric wall outer surface adapted so that the risk of complications such as mobile tissue injury like minimum.

[0014] 在本发明第一实施方案中,所述固定器包括缝线或U形钉,所述缝线或U形钉将胃底壁中包围所述运动限制器件的部分连接在一起,以将所述运动限制器件保持在所述位置。 [0014] In a first embodiment of the present invention, the holder comprises a U-shaped staples or sutures, the sutures or staples surrounds the U-shaped movement restriction device fundic wall portions connected together, to the motion restriction device is held in the position. 即,所述运动限制器件被至少部分地放置在套叠的空间中。 That is, the movement restriction device is at least partially placed in the nesting space. 因此,通过以上方式间接地附着可植入运动限制器件,不需要在运动限制器件与组织之间缝合,反过来进一步减小了并发症的风险。 Thus, by way of indirectly attached above the implantable movement restriction device need not be limited suture between the device and tissue in motion, which in turn further reduces the risk of complications. 以此方式将所述运动限制器件维持在合适的位置得到了具有改善的长期性质的弹性悬浮。 In this way the movement restriction device is maintained in the right position to get a long-term nature of the elastic suspension has improved.

[0015] 诸如缝线或U形钉之类的固定器可以将胃底壁的部分连接在一起,从而从患者胃壁内部或外部基本上或完全套叠所述运动限制器件。 [0015] sutures or staples like U-shaped holder can be part of the connection, such as gastric wall together, from the patient's stomach and thus substantially or completely inside or outside the telescopic movement restriction devices. 在运动限制器件被放置在胃底壁外部的情况下,运动限制器件被胃底壁套叠,使得胃腔显著减小了显著超出所述运动限制器件的体积的容积。 In the motion limiting device is placed in the gastric wall outside, the motion limiting device is gastric wall nesting, so the stomach cavity significantly reduces the volume significantly beyond the movement restriction device volume.

[0016] 在本发明的第二实施方案中,所述固定器包括可植入的第一固定器、第二固定器和第三固定器,所述第一固定器将在所述位置上的所述运动限制器件连到胃底壁上,所述第二固定器将所述运动限制器件直接或间接固定到食管接近于患者的His角的位置,所述第三固定器直接或间接将所述运动限制器件固定于患者的横膈膜肌肉或相关联的肌肉。 [0016] In the second embodiment of the present invention, the implantable retainer comprising a first holder, the second and the third fixed retainer, said retainer in said first position The motion restriction device is connected to the gastric wall, the second holder will restrict the movement of the device is fixed directly or indirectly to the esophagus close to the position angle of His patient, said third fixed directly or indirectly to the said movement limiting device is fixed to the diaphragm muscle or muscle associated with the patient. 所述第一固定器、第二固定器和第三固定器中的任意一个可以由多个缝线或U形钉构成。 The first holder of the second and the third holder fixed in any one may be composed of a plurality of U-shaped sutures or staples. 所述第一固定器可以包括组织生长促进结构,用于将所述运动限制器件长期连到胃壁上。 The first anchor may include tissue growth promoting structure for the long-term movement restriction device is connected to the stomach. 所述组织生长促进结构可以被缝合到胃壁,具有面向胃的相对较大的接触表面。 The tissue growth promoting structure can be sutured to the stomach wall, having a relatively large contact surface facing the stomach. 所述结构的相对较大的接触表面,例如网状,允许人体组织的向内生长,以长期将所述运动限制器件维持在适当位置。 Relatively large contact surface of the structure, such as a mesh, allowing ingrowth of body tissue, the long-term motion restriction device maintained at an appropriate position. 所述组织生长促进结构可以包括将网状结构连在胃底壁上的缝线或U形钉。 The tissue growth promoting structure may comprise a mesh structure even in gastric wall U-shaped sutures or staples.

[0017] 除根据本发明第一实施方案套叠所述运动限制器件之外,所述第二固定器可以用于将所述运动限制器件直接或间接固定到食管接近于患者的Hi s角的位置,并且所述第三固定器可以用于将所述运动限制器件直接或间接固定于患者的横膈膜肌肉或相关联的肌肉。 [0017] In addition according to the first embodiment of the present invention nested outside the movement restriction device, the second holder can be used to restrict the movement of the device is fixed directly or indirectly to the esophagus close to the Hi s angle patient position, and the third holder may be used to restrict the movement of the device is fixed directly or indirectly to the patient's diaphragm muscle or muscle associated.

[0018] 所述运动限制器件的至少一部分可以由易受胃酸腐蚀或不易受胃酸腐蚀的材料制成。 [0018] The motion limiting device may be made of at least part of the acid susceptible or less susceptible to acid corrosion resistant materials.

[0019] 所述运动限制器件可以是可充盈的,并且适于充入凝胶或流体。 [0019] The movement limiting device may be a filling, and is adapted to gel or fluid filled. 可以提供用于收纳流体以充满所述运动限制器件的流体或凝胶收纳构件。 May be provided for receiving a fluid to fill the movement restriction device is fluid or gel accommodating member.

[0020] 所述运动限制器件可以包括均质材料,并且可以是实心(solid)主体。 [0020] The movement limiting device may comprise a homogeneous material, and may be solid (solid) body. [0021 ] 所述运动限制器件可以包括形成腔室的包围壁。 [0021] The motion limiting device may include forming chamber surrounded by a wall.

[0022] 所述运动限制器件可以具有刚性、弹性或柔性外壁。 [0022] The movement limiting device may have a rigid, elastic or flexible outer wall. 在外壁是刚性的情况下,它的刚性足以在承受胃运动所产生的力量时维持不变形。 In the case of the outer wall is rigid, it is rigid enough to withstand the forces generated by the movement of the stomach while maintaining deformation. 在所述运动限制器件被套叠的情况下,根据以上所述的第一实施方案,所述运动限制器件优选包括的主体适于至少部分被患者的胃底壁套叠,并且具有包括生物相容材料的外表面。 In the case of the movement restriction device is invaginated, according to the above described first embodiment, the motion restriction device preferably comprises a body adapted to at least partially nested in patients with gastric wall, and having a biocompatible comprising the outer surface of the material. 所述主体的大部分外表面适于靠在胃壁上保持在患者横膈膜与被套叠的胃底壁的下部的部分之间的所述位置上。 The majority of the outer surface of the body portion adapted to maintain the position of the diaphragm in patients with gastric wall quilt stack between the lower against the upper stomach. 适当地, 所述主体由比25或15肖氏硬度(shure)更软的材料制成。 Suitably, the body is made softer than the 25 or 15 Shore hardness (shure) material.

[0023] 根据所述主体的第一个大致的设计,所述主体在与贯穿所述主体的轴垂直的一个平面上具有最大周长。 [0023] According to a first general design of the body, the body in a plane perpendicular to the axis extending through the body having the largest circumference. 在垂直于所述轴的其它平面上,所述主体的周长等于所述最大周长, 或者从所述最大周长开始沿所述轴的方向减小。 On the other plane perpendicular to the axis, the perimeter of the body is equal to said maximum circumference, or start from the maximum circumference decreases along the axis direction. 例如,所述主体可以基本上具有卵形、球形或基本上形如具有缩进的中间部分的卵或弯曲的卵。 For example, the body may have a substantially oval, substantially spherical or egg-shaped as having a curved or indented intermediate portion of the egg.

[0024] 根据所述主体的第二个大致的设计,在与贯穿所述主体的轴垂直的平面上,所述主体的周长随着所述平面沿所述轴的移动增大或减小至少两倍,或者随着所述平面沿所述轴的移动减小或增大至少一倍。 [0024] According to a second design of the body substantially in a plane perpendicular to the axis extending through the body, the circumference of the body along with the plane of movement of the shaft is increased or decreased at least two times, or with the plane of movement along the axis decreases or increases at least doubled. 例如,所述主体可以基本上具有肾脏的形状。 For example, the body may have a shape substantially the kidneys.

[0025] 优选地,所述主体具有大于从胃到肠的出口的尺寸。 [0025] Preferably, the body has more than exports from the stomach to the intestine size. 所述主体可以具有30或40mm 或更大的最小外径,并且可以具有150、110、90、70、50或30mm的最小外周长。 The main body 30 or may have a minimum outside diameter of 40mm or larger, and may have 150,110,90,70,50 or 30mm minimum circumference.

[0026] 适当地,所述主体具有圆滑的轮廓,而没有会损伤患者胃壁的过于尖锐的边缘,并且具有大致平滑的外表面以靠在胃底壁上。 [0026] Suitably, the body has a sleek profile, but no patient can damage the stomach too sharp edges, and has a generally smooth outer surface against the gastric wall.

[0027] 所述主体可植入患者胃的内部或外部,并且适于通过外科手术被连到患者的胃壁上。 [0027] The body implantable internal or external to the patient's stomach, and is adapted to be attached to the patient's stomach wall by surgery. 所述主体可改变为具有比腹腔镜使用的套管针更小的直径的细长形式,由此所述主体在被改变为所述细长形式时可以通过所述套管针推入或拉出。 The elongate body may be changed to the form of a laparoscopic trocar used than the smaller diameter, whereby the body may be pushed or pulled when the form is changed to the elongated needle through the cannula out. 所述主体可以包括形成了被诸如凝胶的流体填充的腔室的柔性外壁,从而允许所述主体穿过这种套管针。 The body may be formed as a gel comprising a fluid-filled flexible outer wall of the chamber, thereby allowing the body through this trocar. 可替代地,所述主体可以包括弹性可压缩材料,以允许所述主体穿过套管针。 Alternatively, the body may comprise a resiliently compressible material to allow the body through the trocar.

[0028] 所述主体可以是中空的,并且包括至少两个独立片,所述至少两个独立片适于插入中空主体中并进一步适于在所述主体内被放在一起成为一个单片,从而允许所述主体穿过用于腹腔镜的套管针。 [0028] The body may be hollow, and includes at least two separate sheets, at least two separate pieces of the hollow body and adapted to be inserted within the body is further adapted to be placed together to become a single piece, thereby allowing the body through the laparoscopic trocar. 可替代地,所述主体可以包括外壁和中空的压缩的内部,以在插入患者身体中之后由流体或凝胶填充。 Alternatively, the body may include an outer wall and a hollow internal compression, in order to insert a fluid or gel filled after the patient's body.

[0029] 所述主体可以包括具有注入口的腔室,其中通过所述注入口向所述主体的腔室填充流体。 [0029] The body may include a chamber having an injection port, wherein the fluid filling the chamber of the body through the injection port.

[0030] 所述主体还可以包括适用于推动或拉动所述主体通过用于腹腔镜的套管针的至少一个夹持器。 [0030] The body may also include suitable for pushing or pulling the body by at least one holder for laparoscopic trocar. 所述夹持器适于夹持所述主体的延长部分,所述延长部分适于由外科手术仪器夹持。 The holder is adapted to clamp the body portion of the extension, the extension is adapted by a surgical instrument holder. 更具体地,所述夹持器适于夹持穿过所述夹持器插入的线或带。 More particularly, the holder is adapted to clamp the retainer insertion through wire or tape. 在所述主体包括外壁的情况下,所述夹持器至少部分置于所述主体的外壁内部。 In the case includes an outer wall of said body, said holder body at least partially disposed in the interior of the outer wall.

[0031] 在一个有利的实施方案中,所述主体的尺寸可调整,并且可以被套叠到患者的胃底壁中。 [0031] In one advantageous embodiment, the body size adjustable, and can be invaginated into the patient's gastric wall. 结果,所述主体在其尺寸增大时拉伸患者的胃底壁,从而使还患有肥胖症的患者产生饱胀感。 As a result, the body of patients with gastric wall stretching its size increases, so that obese patients also produce a sense of fullness. 可以提供至少两个可植入可调整的拉伸器,以拉伸患者胃壁的不同部分,从而通过有效地影响患者的食欲来治疗肥胖症。 It may provide at least two implantable adjustable stretcher to stretch the stomach wall different in some patients, so that by effectively influence the appetite of the patient to the treatment of obesity. 所述两个拉伸器从患者身体外部进行适当调节, 由此,所述拉伸器中的第一拉伸器在第一时间被调节为拉伸患者胃壁的第一部分,所述拉伸器中的第二拉伸器在第二时间被调节为拉伸患者胃壁的第二部分。 The two drawn from outside the patient's body be appropriately adjusted, whereby the first stretch of the stretcher in the first time is adjusted to stretch the stomach wall of the patient first portion, said stretcher The second device is adjusted to stretch the stomach wall of the patient stretched a second time at the second portion.

[0032] 所述拉伸器可以以液压方式调节。 [0032] The stretch can be hydraulically adjusted. 在这种情况下,可以提供连接至以液压方式调节的拉伸器的可皮下植入的液压储存库,由此所述以液压方式调节的拉伸器通过手动按压所述液压储存库进行无创调节。 In this case, the connection may be provided to a hydraulically adjustable hydraulic tensioner repository can be subcutaneously implanted, whereby the hydraulically adjustable stretcher by manually pressing the hydraulic reservoir noninvasive library regulation. 进一步地,所述运动限制器件适当地包括可充盈的主体,并且提供与所述主体流体接触的泵和腔室,其中所述泵通过将流体或空气从所述主体泵送到所述腔室来调节所述液压储存库。 Furthermore, the movement restriction device suitably comprises a filling body, and providing fluid contact with said pump body and the chamber, wherein the pump through the fluid or air to the chamber from the pump body adjusting the hydraulic repository.

[0033] 所述设备可以包括可植入刺激器,所述刺激器向贲门肌肉发出刺激脉冲以刺激贲门肌肉,从而进一步闭合贲门以进一步防止反流病。 [0033] The apparatus may comprise an implantable stimulator, the stimulator emit stimulation pulses to cardiac muscle to stimulate cardiac muscle, thereby further closing the cardia to further prevent reflux disease. 所述刺激器由至少一个导体和至少一个电极构成,所述至少一个电极接收刺激脉冲并将这些脉冲施加到贲门肌肉,从而刺激贲门肌肉。 The stimulator by at least one conductor and at least one electrode, the at least one receiving electrode stimulation pulses and applies these pulses to the cardiac muscle, thereby stimulating the cardiac muscle. 所述至少一个电极也可以通过胃-食管缝合或套叠在胃壁中而被维持在适当的位置。 The at least one electrode may pass through the stomach - stitching or invaginated esophagus in the stomach wall is maintained in place. 刺激脉冲可以作为脉冲串发送,其中所述脉冲串适于被重复,脉冲串之间具有一时间间隔,所述间隔延长在所述脉冲串中的各个脉冲之间的间隔。 Stimulation pulses can be transmitted as a burst, wherein said burst being adapted to be repeated, with a time interval between bursts, the time between the intervals between each burst pulses. 所述刺激器可以包括电子电路和能源,并且优选适于合并所述电子电路和能源。 The stimulator may include electronic circuitry and energy, and is preferably adapted to combine the electronic circuitry and energy. 在一个实施方案中,使用刺激器对贲门的刺激使用能量脉冲来进行,以增强括约肌的紧张性,从而使贲门完全闭合;并且用于控制刺激器的控制器可由患者操作以启动刺激器,在这样的工作状态下,刺激器在患者不吞咽时在使用所述能量脉冲刺激贲门括约肌的操作模式与不刺激贲门的停止模式之间连续切换。 In one embodiment of the cardiac stimulator using the stimulation energy pulses for use to enhance the sphincter tension, so that the cardia completely closed; and a controller for controlling the stimulator may be operated to start the stimulator patient, in Under such working conditions, stimulation while the patient is not swallowing the use of the energy pulse stimulation mode of operation between cardiac sphincter does not stimulate the cardia stop mode and continuous switching.

[0034] 所述刺激器优选包括用于检测患者的生理参数或所述运动限制器件的功能性参数的至少一个传感器以及用于控制所述刺激器的内部控制单元。 [0034] The stimulator preferably includes means for detecting the motion or physiological parameter limits patient functional parameters of the device, and at least one sensor for controlling the internal control unit of the stimulator.

[0035] 通常,内部控制单元对来自传感器的信息进行相应从而对刺激器进行控制。 [0035] In general, the internal control unit of the information from the sensors accordingly so as to control the stimulator.

[0036] 检测食管收缩波或与食物摄入相关的任意其它参数的传感器向内部控制单元发送所述信息,然后内部控制单元对来自传感器的该信息进行相应而停止刺激。 [0036] detection of esophageal contraction wave or intake of any other food-related parameters of the sensor to the internal control unit transmits the information, then the internal control unit and stop stimulation on the information from the sensors accordingly.

[0037] 刺激器在任意时间都可以由患者控制。 [0037] stimulator can be controlled by the patient at any time.

[0038] 本发明进一步涉及治疗反流病的腹部外科手术方法。 [0038] The present invention further relates to a method for the treatment of abdominal surgery reflux disease.

[0039] 根据第一方法,通过植入运动限制器件来治疗患者的反流病,所述运动限制器件在被植入患者时限制胃切迹相对于横膈膜肌肉的运动,从而防止贲门穿过横膈膜缺口向上滑动。 [0039] According to the first method, the motion restriction device implanted in a patient for treating reflux disease, gastric limit the movement restriction device is implanted in the patient at the time of notch relative to the diaphragm muscles, thereby preventing wear cardia slide up over the diaphragm gap. 所述方法包括以下步骤:在患者身体的腹部插入针状或管状仪器;使用所述针状或管状仪器给患者的腹部充气;在患者身体中放置至少两个腹腔镜套管针;通过腹腔镜套管针之一将摄像机插入患者腹部,通过所述至少两个腹腔镜套管针之一插入至少一个剖开工具;剖开胃区域;将所述器件引入腹腔;将所述器件放置在胃底壁的外侧;在胃底壁中为所述器件创建一个袋囊;并且通过在胃底壁上设置缝线或U形钉将所述器件套叠到所述袋囊中,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以便维持支撑着患者贲门括约肌的来自患者腹部的压力支撑。 Said method comprising the steps of: inserting a needle body of a patient's abdomen or tubular instrument; using the needle or tubular instrument to the patient's abdomen inflated; placing at least two laparoscopic trocars in the patient's body; laparoscopic One trocar insertion camcorder patient's abdomen, at least one of the two laparoscopic trocar is inserted through the at least one cut tool; cut stomach area; the device is introduced intraperitoneally; the device is placed in the fundus the outer wall; in the fundus wall to create a pouch of the device; and by sutures or U-shaped staples disposed in the wall of the gastric device to said invaginated pouch, thereby preventing the patient through the cardia Slide the diaphragm opening the patient's chest in order to maintain the support of patients with cardiac sphincter pressure from the abdomen of a patient support.

[0040] 用于相同目的的治疗反流病的第二腹部方法使用第一方法的初始步骤,并且包括:在胃底壁中创建一个孔洞;在腹腔中引入运动限制器件;通过所述孔洞将器件引入胃; 将所述器件放置在胃底壁的内侧;在胃腔外侧上为放置在胃底壁内侧的所述器件创建一个袋囊;并且通过在胃底壁上设置缝线或U形钉将所述器件套叠在所述袋囊中,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以维持用于支撑着患者贲门括约肌的来自患者腹部的支撑压力。 [0040] for the treatment of reflux disease abdominal second method uses the same initial purpose of the first step of the method, and comprising: creating a hole in the gastric wall; motion restriction device is introduced in the abdominal cavity; said holes by the Devices introduced stomach; the device is placed on the inside wall of the fundus; create a pocket for the device is placed in the inside of the gastric wall on the outside of the stomach cavity; and by providing sutures or U-shaped in the gastric wall Nail the telescoping device in the pouch, thereby preventing the cardia opening slide through the patient's diaphragm patient's chest in order to maintain cardiac sphincter for supporting a patient support pressure from the patient's abdomen.

[0041] 治疗患者反流病的第三腹部方法包括如以上所述的方法那样植入用于相同目的的运动限制器件,并且还包括以下步骤:在患者的腹壁上切开开口;剖开患者的胃的区域; 通过腹部的切口引入所述运动限制器件;并将所述器件连到胃底壁上,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以维持用于支撑患者贲门括约肌的来自患者腹部的支撑压力。 [0041] The treatment of patients with reflux disease, abdominal method comprising the third method as described above movement restrictions implantable devices for the same purpose, and further comprising the steps of: opening the patient's abdominal incision; cut patient stomach area; introduced through the abdominal incision movement restriction device; and the device is connected to the gastric wall to prevent cardia slide through the patient's diaphragm opening the patient's chest in order to maintain support for cardiac patients sphincter pressure support from the patient's abdomen. 根据第一替代方案,所述方法包括将所述器件放置在胃底壁的外侧;在胃底壁为所述器件创建一个袋囊;并且通过在胃底壁上设置缝线或U形钉将所述器件套叠在所述袋囊中,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以便维持用于支撑患者贲门括约肌的来自患者腹部的支撑压力。 According to a first alternative, the method comprising placing the device on the outside wall of the fundus; in the gastric wall to create a pocket for said device; and by providing U-shaped staples or sutures to the walls of the fundus The device is nested in the bag, thereby preventing the cardia through the patient's diaphragm slide opening the patient's chest in order to maintain cardiac sphincter of the patient for supporting the support pressure from the patient's abdomen. 根据第二替代方案,所述方法包括在胃底壁中创建一个孔洞;通过所述孔洞将所述运动限制器件引入胃中;将所述器件放置在胃底壁内侧;在胃底壁上为所述器件创建一个袋囊;并且通过在胃底壁上设置缝线或U形钉将所述器件套叠在所述袋囊中,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以维持用于支撑患者贲门括约肌的来自患者腹部的支撑压力。 According to a second alternative, the method comprising creating a hole in the gastric wall; said through holes of said motion limiting device incorporated in the stomach; the device is placed on the inside of the gastric wall; the wall of the fundus The device creates a pouch; and by setting the sutures or staples in the U-shaped wall of the fundus of the device in the invaginated pouch, thereby preventing the cardia through the patient's diaphragm slide opening the patient's chest, for supporting a patient in order to maintain the support of the cardiac sphincter pressure from the patient's abdomen.

[0042] 所述方法进一步包括:通过使用缝线或U形钉将所述器件附到胃底壁上,和/或通过使用缝线或U形钉将胃底壁附到患者食管的下部;和/或将胃底壁附到患者的横膈膜肌肉或相关联的肌肉。 [0042] The method further includes: U-shaped by using sutures or staples to attach the device to the gastric wall and / or by the use of sutures or staples U gastric wall will be attached to the lower portion of the patient's esophagus; and / or gastric wall attached to the diaphragm muscle or muscle associated with the patient. 所述方法可以进一步包括:提供用于从患者身体外部调节反流病治疗器件的设备;并且操作所述设备以调节反流病治疗器件。 The method may further comprise: providing for adjusting the reflux disease treatment device from outside the body of the patient device; and operation of the device to adjust the reflux disease treatment device. 反流病治疗器件的调节可以包括在被植入时改变填充体的容积。 Reflux disease treatment device to fill the volume adjustment may include changing body when implanted. 为此,所述方法可以包括提供包含用于注入被植入的填充体的流体的注入型注射器;并且向填充体中注入一定体积的流体。 To this end, the method may comprise providing a fluid comprising implanted for injection of the filler injection syringe; and injecting a volume of fluid to fill the body. 优选地,所述方法包括将所述器件包在所述袋囊中。 Preferably, the method comprises the device package in the pouch. 在一个实施方案中,所述方法允许所述袋囊至少部分打开,由此所述袋囊仅呈现一个开口,或者所述袋囊可以呈现两个开口,并且允许所述袋囊以非环周的方式围绕着胃延伸。 In one embodiment, the method allows the at least partially open said bag, whereby said bag showing only one opening, or the bag may present two openings, and allows the pouch to the non-circumferential The way around the stomach extends. 通常优选所述袋囊的容积超过15毫升。 Preferably the pouch is generally more than 15 ml volume.

[0043] 治疗反流病的另一腹腔镜腹部方法包括:在患者身体的腹部插入针状或管状仪器;使用所述针状或管状仪器给患者的腹部充气;在患者身体中放置至少两个腹腔镜套管针;通过腹腔镜套管针之一将摄像机插入患者腹部;通过所述至少两个腹腔镜套管针之一插入至少一个剖开工具;剖开胃的区域;从胃底壁为所述器件创建一个袋囊;通过使用缝线和U形钉使所述袋囊闭合;引入包含可注入的填充材料的注入构件;并将所述填充材料注入所述袋囊中,以创建一个填充体,当患者处于站立位时,所述填充体在患者腹部中在接近患者贲门并在患者贲门之上的位置填充一定的容积,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以维持支撑着患者贲门括约肌的患者腹内的压力。 [0043] Another method of abdominal laparoscopic treatment of reflux disease include: In the body of the patient's abdomen to insert needles or tubular instrument; the instrument using the needle or tube to the patient's abdomen inflatable; placing at least two of the patient's body laparoscopic trocar; through one of the laparoscopic trocar camcorder into the patient's abdomen; at least one of the two laparoscopic trocar insertion of at least one cut by the tool; cut open the stomach area; from the gastric wall to The device creates a pouch; through the use of U-shaped staples and sutures so that the bag is closed; injection member comprises introducing the injected filler material; and injected into the bag in the filler material, to create a filler, when the patient is in the standing position, the filler in the patient's abdomen close to the patient in position above the cardia and cardiac patients fill a certain volume, so as to prevent the patient's diaphragm opening cardia slide through the patient's chest, to maintain the support of patients with cardiac sphincter of patients with intra-abdominal pressure.

[0044] 治疗反流病的再一外科腹部方法包括:在皮肤上切开一开口以进入患者腹部;剖开胃的区域;从胃底壁为所述器件创建一个袋囊;通过使用缝线和U形钉使所述袋闭合;引入包含可注入的填充材料的注入构件;并将所述填充材料注入所述袋囊中,以创建一个填充体,当患者处于站立位时,所述填充体在患者腹内接近患者贲门并在患者贲门之上的位置填充一定的容积,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以维持支撑着患者贲门括约肌的患者腹内的压力。 [0044] treatment of reflux disease surgical abdominal method further comprising: an opening in the skin incision into the patient's abdomen; cut open the stomach area; from the gastric wall to create a pocket for said device; and through the use of sutures U-shaped staples to make the bag closure; introducing member comprising implanted injectable filler material; and the filling material is injected into the bag in order to create a packing body, when the patient is in a standing position, the filling body In patients with intra-abdominal position in near-patient cardiac and cardiac patients above a certain volume of filling to prevent cardia slide through the patient's diaphragm opening the patient's chest in order to maintain the support of patients with intra-abdominal pressure in patients with cardiac sphincter.

[0045] 列举的再一方法可以包括:在胃底壁的外侧创建一个袋囊,使所述填充体抵在胃底壁的内侧,或者可替代地,所述方法包括在胃底壁中创建一个孔洞,并且在胃底壁的内侧创建所述袋囊,使所述填充体抵在胃底壁的外侧上。 [0045] Yet another exemplified method may include: creating a wall of the outer gastric pouch, so that the filling body against the inside wall of the fundus, or alternatively, the method comprising creating in the gastric wall a hole, and the pouch is created on the inside of the gastric wall, so that the filling body against the wall on the outside of the fundus. 列举的再一方法优选还包括:通过使用缝线或U形钉将胃底壁附到患者食管的下部和/或将胃底壁附到患者横膈膜肌肉或相关联的肌肉上。 Yet another method as recited preferably further includes: U-shaped by using sutures or staples gastric wall is attached to the lower esophageal and / or gastric wall will be attached to the patient's diaphragm muscle on muscle or associated. 通常还优选所述袋囊的容积超过15毫升。 Also generally preferred that the pouch volume of over 15 ml. 填充材料优选能够经历从流体材料到半固体或固体材料的固化过程。 Preferably the filler material can undergo a curing process from a fluid material to a semi-solid or solid material. 这种固化过程优选由从环境温度到身体温度的温度升高所触发。 This curing process is preferably triggered by elevated from ambient temperature to a temperature of the body temperature. 本领域技术人员已知的合适的这类材料是(在交联剂和催化剂的存在下)在热的影响下能够经历交联反应的热可固化的聚硅氧烷。 Known to those skilled in such materials are suitable (in the presence of a crosslinking agent and catalyst) under the influence of heat can undergo thermal crosslinking reaction curable silicone.

[0046] 在另一腹腔镜腹部方法中通过植入运动限制器件治疗患者的反流病,其中所述运动限制器件在被植入患者时限制胃切迹相对于横膈膜肌肉的移动从而防止贲门穿过横膈膜缺口向上滑动,该方法包括以下步骤:在患者身体的腹部插入针状或管状仪器;使用所述针状或管状仪器给患者的腹部充气;在患者身体中放置至少两个腹腔镜套管针;通过腹腔镜套管针之一将摄像机插入患者腹部;通过所述至少两个腹腔镜套管针之一插入至少一个剖开工具;剖开胃区域;在胃底壁中创建一个孔洞;将运动限制器件引入腹腔中;通过所述孔洞将所述器件引入胃;将所述器件放置在胃底壁的外侧;将放置在胃底壁外侧的所述器件固定,并且防止贲门通过患者的横膈膜开口滑入患者胸部,以维持支撑着患者贲门括约肌的来自患者腹部的支撑压力。 [0046] In another laparoscopic abdominal approach movement limiting device by implanting reflux disease treating a patient, wherein said movement limiting notch gastric restriction device is implanted in the patient at the time with respect to movement of the diaphragm muscles to prevent cardiac gap upwardly through the slide diaphragm, the method comprising the steps of: inserting a needle body of a patient's abdomen or tubular instrument; using the needle or tubular instrument to the patient's abdomen inflated; placed in a patient's body, at least two laparoscopic trocar; through one of the laparoscopic trocar camcorder into the patient's abdomen; at least one of the two laparoscopic trocar insertion of at least one cut by the tool; cut open the stomach area; created in the gastric wall A hole; motion limiting device incorporated in the abdominal cavity; the device by the introducing holes stomach; the device is placed on the outside of the gastric wall; the device will be placed in the gastric wall fixed to the outside, and to prevent the cardia Slide through the patient's diaphragm opening the patient's chest in order to maintain the support of patients with cardiac sphincter of support pressure from the patient's abdomen. 所述方法可以进一步包括通过使用缝线或U形钉将所述器件附到胃底壁的步骤。 The method may further comprise the step by the use of U-shaped staples or sutures to attach the device to the gastric wall.

[0047] 本发明还涉及腹腔镜仪器,用于将运动限制器件套叠在患者的胃底壁中以治疗反流病,适于与以上所述的任意腹腔镜方法一起使用。 [0047] The present invention also relates to a laparoscopic instrument for telescopic movement restriction device in the patient's gastric wall to treat reflux disease, suitable for use with any laparoscopic procedures described above together. 所述仪器通常包括:具有近端和远端的细长构件,所述细长构件具有比腹腔镜套管针小的直径以在腹腔镜操作过程中引入患者腹部;胃推进器,用于推动胃底壁以创建一个突出到正常胃腔中的胃底壁的管形部分,所述推进器包括即将被胃底壁套叠在管形部分中的运动限制器件。 The apparatus generally comprises: an elongate member having proximal and distal ends, said elongate member having a smaller diameter than the laparoscopic trocar to introduce the patient's abdomen during laparoscopic operation; stomach pusher for pushing gastric wall to create a highlight to normal gastric cavity wall of the tubular portion of the fundus, the pusher includes gastric wall about to be nested within the tubular portion of the motion limiting device. 所述推进器包括真空抽吸器, 用于抽吸胃底以与推进器一起帮助所述仪器形成胃底壁的管形部分。 The pusher includes a vacuum suction device for sucking gastric pusher together with the help of the instrument is formed tubular portion gastric wall. 所述真空抽吸器包括从所述仪器的近端引至末端并且位于所述仪器末端部分的真空通道,其包括推进器。 The device comprises a vacuum suction from the proximal end of the instrument and lead to the end of the vacuum passage of said end portion of the instrument, which comprises a pusher. 真空通道被划分出多个小的开口,所述开口适于抽吸胃壁部分以使其贴附到推进器上,从而进一步形成所述管形胃壁部分。 Vacuum channels are divided into a plurality of small openings, the suction opening is adapted to make the stomach wall portion is attached to the pusher, thereby further forming the tubular portions of the stomach wall. 所述仪器进一步包括适于将所述运动限制器件弓I入所述管形胃部分的插入器。 The apparatus further comprises a device adapted to limit the movement of the bow I said tubular portion of the stomach into the inserter. 所述仪器可以进一步包括至少一个夹具,所述夹具用于通过将所述管形部分的开口中的胃夹在一起来维持所述开口基本闭合,其中所述仪器适于以允许之后缝合所述开口的方式在所述开口处放置所述至少一个夹具。 The apparatus may further comprise at least one clamp, said clamp for through the opening of the tubular portion of the stomach are clamped together to maintain the substantially closed opening, wherein the apparatus is adapted to allow the suture after opening the way to an opening disposed in said at least one clamp. 所述仪器进一步包括充盈器,用于在缝合之前或之后充盈所述运动限制器件。 The apparatus further comprises a filling device for the movement before or after filling limit suturing device. 所述仪器可以进一步包括缝合器,所述缝合器适于使用胃-胃缝线来缝合所述管形部分的开口以至少部分地创建包围所述运动限制器件的闭合空间,其中所述仪器适于被取出,并保持所述运动限制器件至少部分套叠在胃底壁中。 The apparatus may further comprise a suturing device, the suture is adapted to use the stomach - at least partially surrounds the movement restriction device to create a closed space gastric suture to suture opening of the tubular portion, wherein said apparatus adapted to be taken out, and kept the movement restriction device at least partially nested in the gastric wall. 所述缝合器可以包括设置在所述细长构件上的第一和第二缝合定位构件,所述细长构件的末端即将被置于胃中。 Positioning the first and second stitching member may comprise the suture disposed on said elongated member, the end of the elongated member is about to be placed in the stomach. 所述仪器进一步包括操作器,所述操作器适于调整第一和第二缝合构件的位置使使所述第一和第二缝合定位构件位于彼此的前面并且使胃壁位于杯形部分开口端的两侧,并且适于使用一排胃-胃缝线来缝合胃底壁的杯形部分的开口端。 The apparatus further comprises a manipulator, the manipulator is adapted to adjust the position of the first and second stitching member so that said first and second suture retention member in front of each other and make the stomach wall portion located on an open end of the cup-shaped two- side, and is suitable for use in a row stomach - stomach stitches to sew up the open end of the cup-shaped portion of the gastric wall. 所述缝合器优选包括可操作且可重新装载的多缝合器,其可以从患者身体外部重新装载缝线,并且适于使用所述的一排胃-胃缝线缝合胃底壁的杯形部分的开口端,其中所述的一排缝线包括即将被同时缝合的两个或更多个缝线或υ形钉。 The stapler is operable and preferably comprises a multi-reloadable suturing device that can be reloaded from the external suture patient body, and adapted to use a row of the stomach - stomach fundus wall of the suture cup-shaped portion open end, wherein a row of stitches sewn simultaneously including the upcoming two or more υ sutures or staples. 所述缝合器还可以包括多个缝合以同时缝合两条或更多条缝线。 The stapler may also include a plurality of suture simultaneously to two or more seam stitching line.

[0048] 本发明还涉及通过植入包括可植入的运动限制器件的器件来治疗患者的反流病的管腔内方法,其中所述可植入的运动限制器件在被植入患者时限制胃切迹相对于横膈膜肌肉的运动,从而防止贲门穿过横膈膜缺口向上滑动。 [0048] The present invention also relates to a method for intraluminal by implantation include movement restriction device implantable devices to treat patients with reflux disease, which restrict the movement of the implantable device is implanted in the patient at the time limit stomach notch relative to the diaphragm muscles to prevent cardiac notch slide upward through the diaphragm. 所述方法包括以下步骤:将胃镜引入食管并使其进入患者的胃中;将仪器引入食管并使其进入患者的胃中,所述仪器被整合在所述胃镜中或者独立于所述胃镜;借助于所述仪器从胃底壁设置用于容纳所述器件的袋囊;并且使用连到胃底壁的缝线或U形钉将所述器件套叠在所述袋囊中,从而防止贲门通过患者的横膈膜开口滑入患者胸部,以维持抵住患者贲门括约肌的从患者腹部施加的支撑压力。 Said method comprising the steps of: introducing the gastroscope the esophagus and into the stomach of the patient; the instrument is introduced into the patient's esophagus and stomach it, the instrument is integrated in the endoscopic or independent of the gastroscope; by means of the instrument from the gastric pouch wall arranged for receiving said device; and connected to the gastric wall using sutures or staples to the U-shaped components nested in the bag, thereby preventing the cardia Slide through the patient's diaphragm opening the patient's chest in order to maintain the support against the patient cardiac sphincter pressure exerted from the patient's abdomen. 在第一替代方案中,所述方法包括以下步骤:借助于所述仪器将所述器件引入胃中;使用所述仪器将所述器件放置在胃底壁的内侧;借助于所述仪器在胃腔外侧的胃底壁的一部分中创建一个袋囊,所述器件被放置为靠在胃底壁的内侧;并且通过使用连到胃底壁的缝线或U形钉将所述器件套叠在所述袋囊中。 In the first alternative, the method comprising the steps of: by means of the introduction of the instrument to the device in the stomach; the apparatus using the device is placed on the inside of the gastric wall; by means of the apparatus in the stomach the outer portion of the cavity walls to create a gastric pouch, the device is placed against the inside of the gastric wall; and connected to the gastric wall by using sutures or staples U nesting in the device The pouches. 在第二替代方案中,所述方法包括以下步骤: 借助于所述仪器创建胃底壁的一部分的袋囊;借助于所述仪器将所述器件引入所述袋囊中;并使用连到胃底壁上的缝合或U形钉套叠所述器件。 In a second alternative, the method comprising the steps of: by means of the instrument to create a gastric pouch wall part; said apparatus by means of said device into said pouch; and attached to the stomach using the bottom wall of the U-shaped sutures or staples intussuscepting the device. 根据这一替代方案,所述方法包括将所述器件充盈到其填充体积,优选通过向所述器件注入填充流体使其得到填充体积。 Under this alternative, the method comprising the filling device to fill the volume thereof, preferably by the injection device to fill the resulting fill volume fluid it. 因此,所述填充流体可以是具有先前所描述特征的可固化流体,例如之前所述的可热固化的聚硅氧烷。 Thus, the filler fluid may be characterized by having the previously described curable fluid, e.g., heat-curable polysiloxane previously described. 在第三替代方案中,所述方法包括以下步骤:在胃底壁中创建一个孔洞;借助于所述仪器将所述器件引入胃中;移动所述器件通过所述孔洞,并将其放置在胃底壁的外侧; 借助于所述仪器在胃腔的内侧创建胃底壁的一部分的袋囊,所述器件被放置为靠在胃底壁的外侧上;使用连到胃底壁的缝线或U形钉将所述器件套叠在所述袋囊中;并使用缝线或U形钉密封所述孔洞。 In a third alternative, the method comprises the following steps: Create a hole in the gastric wall; the device by means of the instrument is introduced in the stomach; moving the device through the hole, and place it in outside of the gastric wall; by means of the instrument to create a gastric wall of the inside of the stomach pouch part of the device is placed on the outside against the gastric wall; using sutures attached to the gastric wall or U-shaped staples of the device nesting in the pouch; and the use of U-shaped sutures or staples to seal the holes. 在第四替代方案中,所述方法包括以下步骤:在胃底壁中创建一个孔洞;借助于所述仪器在胃腔的内侧创建胃底壁的一部分的袋囊;借助于所述仪器将所述器件引入胃中;移动所述器件通过所述孔洞,并将其放置在胃底壁的外侧;借助于所述仪器将所述器件引入所述袋囊中;使用连到胃底壁的缝线或U形钉来套叠所述器件;并使用缝合或U形钉来密封所述孔洞。 In a fourth alternative, the method comprising the steps of: creating a hole in the gastric wall; means the portion of the instrument creating gastric pouch on the inside wall of the gastric cavity; means that the instrument will said device is introduced in the stomach; moving the device through the hole, and place it on the outside wall of the fundus; the device by means of the instrument is introduced into the pouch; use a hyphen to the gastric wall seam line or U-shaped staples to telescoping the device; and the use of U-shaped sutures or staples to seal the holes. 而且,所述方法可以包括将所述器件充盈到其填充体积,优选通过向所述器件注入填充流体使其得到填充体积。 Further, the method may include filling the device to its fill volume, preferably by injecting the fill fluid to the device to get it fill volume. 所述填充流体可以具有所有先前所述的特征。 The fill fluid may have all the previously described characteristics. 所述方法还包括:通过使用缝线或U形钉将所述器件附到胃底壁上;和/或通过使用缝线或U形钉将胃底壁附到患者食管的下部;和/或将胃底壁附到患者的横膈膜肌肉或相关联的肌肉。 The method further comprising: using a U-shaped sutures or staples attached to the gastric wall of the device; and / or through the use of sutures or staples U gastric wall will be attached to the lower esophagus of a patient; and / or The gastric wall is attached to the patient's diaphragm muscle or muscle associated. 所述方法还可以包括:提供用于从患者身体外部调节反流病治疗器件的设备; 并且操作所述设备以调节所述反流病治疗器件。 The method may further comprise: providing for adjusting the reflux disease treatment device from outside the body of the patient device; and operating the device to regulate the reflux disease treatment device. 反流病治疗器件的调节优选包括在被植入时改变填充体的体积。 Reflux disease treatment device for adjusting preferably comprises altering the volume of the packing body when implanted. 为此,所述方法可以包括提供包含用于注入被植入的填充体的流体的注入型注射器;并且向填充体中注入一定体积的流体。 To this end, the method may comprise providing a fluid comprising implanted for injection of the filler injection syringe; and injecting a volume of fluid to fill the body. 该填充流体可以是具有如先前部分所述的性质的可固化流体。 The fill fluid may be a part of such nature previously described curable fluid. 通过所述方法创建的袋囊可以包围着所述运动限制器件,或者可以至少部分地打开,在一个示例中,所述袋囊仅具有一个开口,并且根据另一示例其呈现出两个开口,并且以非环周的方式围绕着胃延伸。 By the method of creating the pouch may be surrounded by the movement restriction device, or may be at least partially opened, in one example, the pouch having only one opening, and according to another example which exhibits two openings, and a non-circumferential manner extending around the stomach. 优选地,所述袋囊的容积超过15毫升。 Preferably, the pouch volume more than 15 ml. 在所述方法中通常优选的是整合所述胃镜和所述仪器。 In the method is generally preferred that the integration of the endoscopy and the instrument. 所述方法可以进一步包括给胃充气。 The method may further comprise the inflator to the stomach. 在所述方法的特定实施方案中,所述仪器在由胃底壁提供所述袋囊时产生真空。 In a particular embodiment of the method, the instrument is provided by generating a vacuum in the gastric wall when said bag. [0049] 本发明还涉及一种恢复患反流病的患者的贲门和胃底位置的方法,包括:向患者的食管中引入具有至少一个柔性部件的细长仪器;通过所述仪器启动夹持器,所述启动的夹持器具有比所述仪器大的截面积;使用所述夹持器夹持远处的食管或胃;向远处移动并推动所述仪器,使得不正确地位于横膈膜或相关联的肌肉之上的贲门和胃壁或者部分胃底滑回横膈膜或相关联的肌肉之下的位置。 [0049] The present invention also relates to a method for recovering patients suffering from reflux disease and gastric cardia location, comprising: introducing at least one flexible elongate member to the patient's esophagus instrument; the instrument start by holding , said boot retainer having a large cross-sectional area than that of the instrument; using the distance holder holding the esophagus or stomach; moved distally and pushing the instrument, so that incorrectly positioned transverse diaphragm or above the cardia and stomach muscles associated with gastric or part of the diaphragm or slide back under the muscle associated with the position. 在第一替代方案中,所述方法包括在食管中贲门之上径向扩张所述夹持器,并且使用该夹持器将贲门和胃壁或部分胃底推到横膈膜或相关联的肌肉之下。 In the first alternative, the method comprises the esophagus above the cardia radial expansion of the holder, and use of the holder or part of the stomach and gastric cardia and pushed to the diaphragm or the associated muscles below. 在第二替代方式中,所述方法包括在胃的下部释放仪器近端处的气球构件, 并且使用所述构件使仪器推挤胃的下壁部,从而使贲门和胃底或部分胃底滑到横膈膜或相关联的肌肉之下。 In a second alternative embodiment, the method comprises the lower portion of the stomach balloon member to release the instrument at the proximal end, and using the instrument to push the member lower wall of the stomach, allowing gastric cardia and fundus or partially slip beneath the diaphragm muscle or associated. 在第三替代方式中,所述方法包括将仪器的远端定位在横膈膜或与其关联肌肉的水平;在径向扩张所述构件;将所述构件连到胃壁;并向远处推动所述仪器,使得贲门和胃壁或部分胃底滑到横膈膜或其相关联的肌肉之下。 In a third alternative embodiment, the method includes positioning the distal end of the instrument or the associated diaphragm muscle level; radially expanding said member; member attached to the stomach wall; to promote the distance said instrument makes the stomach or part of gastric cardia and slide under the muscle of the diaphragm or associated. 根据所有列举的替代方案的方法可以包括:在所述仪器远端采用附着构件作为夹持器的一部分,所述附着构件能够提供缝线或U形钉或其它侵入性机械构件,用于将食管和胃壁附着到所述仪器,优选地,所述方法包括在所述仪器的远端采用缝合构件,所述缝合构件能够提供缝线或U形钉,用于将胃底壁缝合到贲门之上的食管下部。 The method according to all the enumerated alternatives may include: at the distal end of the instrument as part of using the attachment member of the holder, the attachment member can be provided a U-shaped staples or sutures or other mechanical means invasive, for esophagus stomach wall attached to the instrument and, preferably, the method comprises the use of a distal end of the suturing instrument member, said member capable of providing a suture or suture U-shaped staples for suturing the fundus wall onto the cardia The lower part of the esophagus.

[0050] 本发明还致力于用于治疗患裂孔疝的患者的外科手术胃镜仪器,其中患者胃的一部分穿过了横膈膜肌肉的缺口,并且患者的贲门位于横膈膜之上的胸部中。 [0050] The present invention is also committed to surgical endoscopy instruments for the treatment of patients suffering from hernia, a portion of the diaphragm muscle through the gap where the patient's stomach, and the patient's cardiac located in the chest above the diaphragm . 所述仪器包括: (i)具有近端和远端的细长构件,所述细长构件具有比患者的食管小的直径,并且是柔性的,从而允许引入所述柔性细长构件,使其远端首先从咽喉进入食管;(ii)固定至所述细长构件的夹持器,可在适于接合并夹持患者的食管或胃的启动状态与适于释放食管或胃的未启动状态之间操作;(iii)操作器,用于从患者身体外部操作所述夹持器使其在所述启动和未启动状态之间切换;(iv)手柄,连接至所述细长构件的近端以被手动握持,用于移动所述细长构件的远端,其中所述夹持器在由所述操作器操作在其启动状态下时,适于足够紧地接合并夹持食管或胃以允许所述细长构件在被手动移动时将贲门朝远端方向移动并重新牵引回横膈膜肌肉之下的位置。 The apparatus comprises: (i) an elongate member having proximal and distal ends, said elongate member having a smaller diameter than the patient's esophagus, and is flexible, so as to allow the introduction of the flexible elongate member, so that First, from the throat into the esophagus distal end; (ii) the holder is fixed to the elongate member, may be adapted to engage and clamp the esophagus or stomach of a patient and adapted to release start state of the esophagus or stomach is not activated state between operations; (iii) operator, so that it is used to switch between the operation starting from outside the patient's body and the holder is not activated state; (iv) a handle connected to the elongated member near end so as to be manually grip for moving the distal end of the elongated member, wherein the holder by the operator when operating at its startup state, is adapted to engage sufficiently tightly clamped the esophagus or stomach to allow the elongated member is moved manually cardia distal direction and re-position the diaphragm muscle pull back under. 所述仪器的可操作的夹持器优选适于相对于所述细长构件径向扩张从而从所述未启动状态到所述启动状态,使得所述夹持器在径向扩张时通过力和摩擦接合并夹持胃或食管。 The operational instrument holder is preferably adapted with respect to the elongated member radially expanded so that state to the state does not start from the start, so that the holder during radial expansion by force and The combined frictional clamping the stomach or esophagus. 可替代地,所述可操作夹持器包括至少一个牵引构件,所述牵引构件在所述夹持器处于启动状态时以侵入性方式引入到胃壁或食管壁以将所述夹持器固定在食管或胃上。 Alternatively, the operable holder comprises at least one traction member, said traction member when the holder is active in invasive incorporated into the stomach or esophageal wall fixed to said holder On the esophagus or stomach. 在两个替代方案中,可操作的夹持器均适于接合并夹持接近贲门或贲门处的食管,或者当贲门位于横膈膜肌肉之上时接合并夹持在缺口中或其远端的位置处的胃。 In both the alternative, operable gripper are adapted to engage and clamp close esophageal or cardia, or when cardia is located above the diaphragm muscles engaged and held in the notch in the distal end thereof stomach position. 根据另一替代方案,所述仪器的细长构件包括第一缝合定位构件和处于所述细长构件远端处的第二缝合定位构件,其中当所述夹持器处于其启动状态夹持着食管或胃时, 所述第一缝合定位构件位于食管中。 According to another alternative, the elongated member of the suturing instrument comprises a first member and in said elongated positioning member positioned at the distal end of the second stitching member, wherein when said retainer is in its activated state sandwiched When the esophagus or stomach, the first suture positioning member is located in the esophagus. 所述仪器的操作器适于围绕胃切迹将柔性的细长构件弯曲到一定的位置使第一缝合定位构件在贲门之上,并且所述第一和第二缝合定位构件在彼此前面,而胃底壁和食管壁由所述第一和第二缝合定位构件移动到一起。 The operation of the instrument is adapted to notch the stomach around the flexible elongate member is bent to a certain position of the first positioning member in the cardia stitched on the front and positioning said first and second stitching member each, and esophagus gastric wall and moved by the first and second positioning member to the stitched together. 所述仪器进一步包括可重新装载的多缝合器,用于通过一排缝线将患者贲门附近的食管与胃底壁缝合在一起,其中胃底壁和食管壁由第一和第二缝合定位构件移动到一起,所述一排缝线包括由所述多缝合器同时缝合的两条或多条缝线。 The apparatus further comprises a reloadable multi staplers, by a row of stitches for the patient's esophagus and gastric cardia nearby wall stitched together, wherein the gastric wall and the esophagus by the first and second suture positioning member moved together, the suture comprises a row of the multi-stapling suturing of two or more simultaneously slit lines.

[0051] 本发明进一步包括用于治疗患裂孔疝的人类患者的外科手术胃镜仪器的另一实施方案,所述仪器包括:(i)具有近端和远端的细长构件,所述细长构件具有比患者的食管小的直径,并且是柔性的,从而允许引入所述柔性的细长构件,使其远端首先从患者的咽喉进入食管;(ii)设于所述细长构件上的第一缝合定位构件,使得当所述细长构件被引入食管中并使其远端位于胃中时,所述第一缝合定位构件位于接近贲门的食管中;(iii)设于所述细长构件的远端处的第二缝合定位构件;(iv)操作器,适于围绕胃切迹将柔性细长构件弯曲到一定的位置使所述第一和第二缝合定位构件在彼此前面,而胃底壁和食管壁由所述第一和第二缝合定位构件移动到一起;以及(ν)可重新装载的多缝合器,用于通过一排缝线将患者接近贲门的食管与胃底壁缝合在一起,其中胃底壁和食管壁由第一和第二缝合定位构件移动到一起,所述多缝合器从身体外部重新装载缝线以在第一排缝线前面或后面提供更多排缝线,其中所述一排缝线包括由所述多缝合器同时缝合的两条或多条缝线。 [0051] The present invention further comprises another embodiment for treating a human patient suffering from hernia endoscopic surgical instrument, said instrument comprising: (i) an elongate member having proximal and distal ends, said elongate member having a smaller diameter than the patient's esophagus, and is flexible, so as to allow the introduction of the flexible elongate member to the distal end of the first throat into the esophagus from the patient; (ii) disposed on said elongated member first suture positioning member, such that when the elongate member is introduced into the esophagus and the stomach so that the distal end is located, said first positioning member is located close to the cardia suturing the esophagus; (iii) provided on the elongate a second positioning member at the distal end of the suture member; (iv) operator, is adapted to the notch of the stomach around the flexible elongate member bent to a certain position so that said first and second stitching member positioned in front of each other, and esophagus gastric wall and moved by the first and second positioning members sewn together; and (ν) can be reloaded more staplers, used by a row of stitches will be close to the patient's esophagus and gastric cardia wall stitched together, wherein the esophageal wall and gastric wall and moved by the first and second positioning members sewn together, the multi-suture from outside the body to reload the suture in front of or behind the first row of the suture to provide more rows suture, wherein the suture comprises a row of the multi-stapling suturing of the two or more simultaneously slit lines. 所述仪器进一步包括固定至所述细长构件的夹持器,所述夹持器可在适于接合并夹持患者的食管或胃的启动状态与适于释放食管或胃的未启动状态之间操作。 The apparatus further comprises a holder secured to the elongate member, the holder may be adapted to engage and clamp the esophagus or stomach of a patient and adapted to release start state of the esophagus or stomach of a state does not start the operating room. 所述夹持器可从患者身体外部由所述操作器操作以在所述启动状态与未启动状态之间切换;手柄连接至细长构件的近端以被手动握持,用于移动所述细长构件的远端,其中所述夹持器在由所述操作器操作在启动状态下时,适于足够紧地接合并夹持食管或胃以允许所述细长构件在被手动移动时将贲门朝远端方向移动并重新牵引回横膈膜肌肉之下的位置。 The holder may be a patient from outside the body by the operator to operate between the activated state and non-activated state switch; a handle connected to the proximal end of the elongate member to be manually grip for moving the the distal end of the elongated member, wherein the holder by the operator when operating in a start-up state, is adapted to engage sufficiently tightly clamped the esophagus or stomach to allow the elongated member is moved manually when The cardia distal direction and re pulling back below the diaphragm muscle location. 在一种替代方案中,所述可操作的夹持器适于相对于所述细长构件径向扩张从而从所述未启动状态到所述启动状态,使得所述夹持器在径向扩张时通过力和摩擦接合并夹持胃或食管。 In an alternative embodiment, the retainer operable with respect to the elongate member is adapted to expand radially so that the state does not start from the state to the start, so that the radial expansion of the holder When the merger by force and frictional clamping the stomach or esophagus. 在另一替代方案中, 所述可操作的夹持器包括至少一个牵引构件,所述牵引构件在所述夹持器处于其启动状态时以侵入性方式引入到胃壁或食管壁中以将所述夹持器固定在食管或胃上。 In yet another alternative, the retainer operable member comprises at least one traction, the traction member when the holder is in its activated state in an invasive manner is introduced into the stomach or esophagus to the The holder is fixed in the esophagus or the stomach. 在两个替代方案中,所述可操作的夹持器均适于接合并夹持接近贲门或贲门处的食管,或者在贲门位于横膈膜肌肉之上时接合并夹持在缺口中或其远端的位置处的胃。 In both alternatives, the holder are adapted to operably engage and clamp close esophageal or cardia, or in cardiac muscle located above the diaphragm engages in a notch or clamping stomach position at the distal end.

[0052] 本发明进一步包括用于将运动限制器件套叠在人类患者的胃底壁中以治疗反流病的外科手术胃镜仪器的再一个实施方案。 [0052] The present invention further includes means for telescopic movement restriction device in human patients to treat gastric wall reflux disease surgical endoscopy instruments of yet another embodiment. 所述仪器包括:(i)具有近端和远端的细长构件,所述细长构件具有比患者的食管小的直径,并且是柔性的,从而允许引入所述柔性的细长构件,使其远端首先通过患者的咽喉、食管进入胃直到胃底壁;(ii)设于所述细长构件的远端的可操作的胃穿刺器,用于刺穿胃底壁以在胃底壁中创建一个孔洞,以允许通过所述孔洞引入所述细长构件;(iii)设于所述细长构件上接近所述穿刺器的位置的可操作的专用夹持器,用于当刺穿所述胃壁时将所述细长构件保持在一定位置上使所述细长构件穿过所述胃底胃壁延伸但防止所述细长构件穿过所述孔洞朝近端方向移动,其中所述专用夹持器包括可扩张构件,其至少可以径向地基本垂直于所述细长构件进行扩张以使其抵住胃底壁的外侧;以及(iv)插入器,用于将所述运动限制器件插入通过胃底壁上的所述孔洞中直到胃底壁外以将其套叠在胃底壁中。 The apparatus comprises: (i) an elongate member having proximal and distal ends, said elongate member having a smaller diameter than the patient's esophagus, and is flexible, so as to allow the introduction of the flexible elongate member, so that its distal end first through the patient's throat, esophagus into the stomach until gastric wall; (ii) provided at the distal end of the elongate member operable stomach piercer for piercing the wall of the gastric fundus wall create a hole, through the holes to allow the introduction of said elongate member; (iii) provided in the proximity of the puncture location dedicated operable on the elongated holder member, for, when piercing the stomach wall when said elongate member is maintained at a predetermined position so that the elongate member extending through the fundus stomach wall but prevents the elongate member passes through the holes move toward the proximal direction, wherein said special holder includes an expandable member, which at least substantially radially perpendicular to the elongate member so as to expand outward against the gastric wall; and (iv) is inserted, for limiting the movement the device is inserted through the gastric wall of the bore until the outer gastric wall to be nested within the gastric wall. 所述仪器可以进一步包括设于所述细长构件上接近所述专用夹持器位置的成形器,以抵住胃底壁的内侧。 The apparatus may further comprise disposed proximate said upper elongate member dedicated shaper holder position to against the inside wall of the fundus. 所述成形器与所述专用夹持器一起适于使胃底壁形成杯形,由此所述专用夹持器可相对于所述成形器缩回,以拉动胃壁抵住所述成形器,从而形成胃的所述杯形部分。 The shaper together with the dedicated holder adapted to gastric wall forming a cup-shaped, whereby the special holder with respect to the former retracts to pull the stomach wall against the former, thereby forming a cup-shaped portion of the stomach. 所述仪器可以进一步包括缝合器,所述缝合器适于用胃-胃缝线缝合胃底壁的杯形部分的开口端,以创建至少部分地被胃底壁的一部分包围的空间。 The apparatus may further comprise a suturing device, the suturing device adapted for use stomach - gastric suture an open end of the cup-shaped portion of the gastric wall to create the space portion at least partially surrounded gastric wall. 所述缝合器优选包括用于同时缝合两条或更多条缝线的多个缝合。 The stapler preferably includes means for simultaneously stitching two or more of a plurality of sewn seam line. 所述缝合器适于在用所述插入器将所述运动限制器件插入胃底壁的孔洞之前缝合胃底壁的杯形部分的开口端。 The suture is adapted to use the inserter before the gastric wall motion limiting device into the open end of the suture holes cup-shaped portion of the gastric wall. 所述仪器可以进一步包括充盈器,用于在用所述插入器引导所述充盈器穿过胃底壁的孔洞之后充盈所述运动限制器件,或者用于在由所述运动限制器件弓I导所述充盈器穿过胃底壁的孔洞之后充盈所述运动限制器件。 The apparatus may further comprise a filling device for use after the boot is inserted through the gastric wall is filling the hole filling movement restriction device or for the device by limiting the movement of the guide bow I After the filling is through the gastric wall hole filling limit the movement of the device. 所述缝合器可以包括可操作且可重新装载的多缝合器,其可以从患者身体外部重新装载缝线,并且适于使用一排胃_胃缝线缝合胃底壁的杯形部分的开口端,其中所述一排缝线包括即将被同时缝合的两个或更多个缝线或U形钉。 The suture may include re-loaded and operable multi stapler, which can reload the suture from outside the patient's body and adapted for use in a row _ gastric fundic stomach stapling suture opening end wall of the cup-shaped portion wherein a row of stitches sewn simultaneously including the upcoming two or more U-shaped sutures or staples. 在另一替代方案中,所述仪器包括可充盈的运动限制器件,所述穿刺器包括金属线, 所述金属线适于被引导着穿过所述胃底壁上的孔洞并且至少前进到腹壁或穿过腹壁。 In yet another alternative, the apparatus including a motion limiting device filling, the puncture wire comprises a metal, the metal wire is adapted to be guided through the gastric wall to the abdominal wall hole and proceeds at least or through the abdominal wall. 所述金属线充当液压管的向导,所述液压管连接至所述可充盈的运动限制器件,并且可连接至置于皮下的注入口,所述注入口用于在已用插入器将所述运动限制器件插进所述胃底壁的孔洞时使用流体填充可充盈的运动限制器件并调节流体的量。 The wire acts as a hydraulic tube guide, the hydraulic pipe connected to said motion limiting device filling, and can be connected to an injection port placed under the skin, the injection port for the use inserter has Use motion limiting device is inserted into the hole of the gastric wall when the fluid-filled motion limiting device can be filling and adjusting the amount of fluid.

[0053] 本发明进一步包括用于将可充盈的运动限制器件套叠在人类患者的胃底壁中以治疗反流病的外科手术胃镜仪器的又一实施例。 [0053] The present invention further includes means for limiting the movement of the device can be filling nesting in human patients to treat gastric wall in surgical endoscopy instruments of another embodiment of reflux disease. 所述仪器包括:(i)具有近端和远端的细长构件,所述细长构件具有比患者的食管小的直径,并且是柔性的,从而允许引入所述柔性的细长构件,使其远端首先通过患者的咽喉、食管进入胃直到胃底壁;和(ii)设于所述细长构件的远端的可操作的胃穿刺器,用于刺穿胃底壁以在胃底壁中创建一个孔洞,以允许引导所述细长构件穿过所述孔洞,其中所述穿刺器包括金属线,所述金属线被引导着穿过所述胃底壁中的孔洞并且至少前进到腹壁或穿过腹壁,所述金属线充当液压管的向导,所述液压管连接至可充盈的运动限制器件,并且可连接至置于皮下的注入口,所述注入口用于用流体填充所述可充盈的运动限制器件并调节流体的量,并且其中所述金属线和管中的至少一个可以被拉动,以将充盈有流体的运动限制器件移向胃底壁,以将其放置在胃底壁内侧,在这一位置所述运动限制器件将被套叠在胃底壁中。 The apparatus comprises: (i) an elongate member having proximal and distal ends, said elongate member having a smaller diameter than the patient's esophagus, and is flexible, so as to allow the introduction of the flexible elongate member, so that its distal end first through the patient's throat, esophagus into the stomach through gastric wall; and (ii) provided at the distal end of the elongate member operably stomach piercer for piercing the wall of the gastric fundus Create a hole in the wall to allow guide the elongated member through the hole, wherein the puncture device comprises a metal wire, the wire is guided through the gastric wall in the hole and advance to at least the abdominal wall or through the abdominal wall, the metal wire acts as a hydraulic hose guides, the hydraulic tube can be connected to the filling of the movement restriction devices, and can be connected to an injection port placed under the skin, which is filled with a fluid inlet for the filling said motion limiting device can be adjusted and the amount of fluid, and wherein at least one of the wires may be pulled and the tube, to limit the motion of the fluid filling device has moved gastric wall, to be placed in the stomach the inside of the bottom wall, in the position of the movement restriction device will invaginated in the gastric wall. 优选地,所述金属线和管中的至少一个在被拉动以将充盈的运动限制器件移向胃底壁时,允许胃底壁的一部分移动以形成从正常胃腔突出的胃的杯形部分。 Preferably, the metal wire and tube is pulled at least one time in order to limit the movement of the filling device toward the gastric wall, allowing the gastric wall to form part of moving from the cup-shaped part of the normal stomach protruding stomach . 所述仪器可以进一步包括具有杯形的可操作的成形器, 用于形成胃的杯形部分。 The apparatus may further comprise a cup-shaped molding is operable for forming the cup-shaped portion of the stomach. 所述仪器可以进一步包括缝合器,所述缝合器适于使用胃-胃缝线缝合胃底壁的杯形部分的开口端,以创建至少部分地被胃底壁的一部分包围的空间。 The apparatus may further comprise a suturing device, the suture is adapted to use the stomach - gastric suture an open end of the cup-shaped portion of the gastric wall to create the space at least partially surrounded by a portion of the gastric wall. 所述缝合器可以包括用于同时缝合两条或更多条缝线的多个缝合。 The suturing device may comprise two or more simultaneous stapling plurality suture seam line. 所述缝合器可以适于在将所述运动限制器件插入所述胃底壁的孔洞之前缝合胃底壁的杯形部分的开口端。 The suture may be adapted to the open end of the cup-shaped portion prior to the movement restriction device into the wall of the gastric fundus suture holes in the wall. 优选为可充盈的运动限制器件进一步包括充盈器,用于在引导所述运动限制器件穿过胃底壁的孔洞之后充盈所述运动限制器件。 The filling is preferably a motion limiting device further comprises a filling device for guiding the movement of the hole after passing through the gastric wall limiting device filling the movement restriction device. 所述仪器可以进一步包括第一和第二缝合定位构件,设于位于胃中的细长构件的远端;以及操作器,适于将第一和第二缝合构件调整到一定的位置使所述第一和第二缝合定位构件位于彼此的前面并且使胃壁位于杯形部分开口端的两侧,所述操作器还适于使用一排胃_胃缝线来缝合胃底壁的杯形部分的开口端。 The apparatus may further comprise a first and a second suture positioning member, provided on the distal end of the elongate member is positioned in the stomach; and a manipulator, adapted to adjust the first and second stitching member to a certain position so that the opening of the first and second suture retention member in front of each other on opposite sides of the stomach and make the cup portion open end, said operator further adapted to use a row of stitches to sew the stomach _ stomach fundus wall of the cup-shaped portion end. 所述缝合器可以包括可操作且可重新装载的多缝合器,其可以从患者身体外部重新装载缝线,并且适于使用所述一排胃_胃缝线缝合胃底壁的杯形部分的开口端,其中所述一排缝线包括即将被同时缝合的两个或更多个缝线或U形钉。 The suture may include re-loaded and operable multi stapler, which can reload the suture from outside the patient's body, and adapted to use the row _ stomach fundus wall of the stomach suture cup-shaped portion open end, wherein said suture comprises a row is about to be sewn simultaneously two or more U-shaped sutures or staples. 本发明进一步包括用于将运动限制器件套叠在人类患者的胃底壁中以治疗反流病的外科手术胃镜仪器的再一实施方案。 The present invention further includes means for telescopic movement restriction device in human patients to treat gastric wall reflux disease surgical endoscopy instruments of yet another embodiment. 所述仪器包括:(i) 具有近端和远端的细长构件,所述细长构件具有比患者的食管小的直径,并且是柔性的,从而允许引入所述柔性的细长构件,使其远端首先通过患者的咽喉、食管进入胃直到胃底壁; (ii)可操作的胃推进器,用于推动胃底壁以创建从正常胃腔突出的胃底壁的杯形部分,所述推进器包括即将由胃底壁中的杯形部分套叠的运动限制器件;以及(iii)缝合器,适于使用胃_胃缝线缝合胃底壁的杯形部分的开口以至少部分地包围所述运动限制器件。 The apparatus comprises: (i) an elongate member having proximal and distal ends, said elongate member having a smaller diameter than the patient's esophagus, and is flexible, so as to allow the introduction of the flexible elongate member, so that its distal end first through the patient's throat, esophagus into the stomach through gastric wall; (ii) operable stomach pusher for urging the gastric wall to create a normal gastric cavity projecting from the wall of the cup-shaped portion of the fundus, the said pusher including the upcoming gastric wall by a cup-shaped part telescopic motion limiting device; and (iii) suturing device adapted to use open cup-shaped part of the gastric fundus suture _ stomach wall to at least partially surrounds the movement restriction device. 所述仪器可以进一步包括设于所述细长构件上接近所述推进器的位置上的成形器,以在内侧拉动胃底壁。 The apparatus may further comprise an elongate member provided on the proximity of the pusher former position, so as to pull the inner gastric wall. 所述成形器与所述推进器一起适于使胃底壁形成最佳的杯形,其中推动所述推进器以形成胃的所述杯形部分。 Said forming together with said pusher adapted to gastric wall forming the best cup-shaped, which pushes the pusher to form the cup-shaped part of the stomach. 所述仪器可以进一步包括第一和第二缝合定位构件,设置在位于胃中的细长构件的远端处;以及操作器,适于将第一和第二缝合构件调整到一定的位置使所述第一和第二缝合定位构件位于彼此的前面并且使胃壁位于杯形部分开口端的两侧,所述操作器还适于用一排胃_胃缝线来缝合胃底壁的杯形部分的开口端。 The apparatus may further comprise a first and a second suture positioning member, the elongate member is provided at the distal end of the stomach; and an operation unit, adapted to adjust the first and second stitching member to a certain position so that the said first and in front of each other on opposite sides of the stomach and make the open end of the cup-shaped portion, the operation is further adapted to use a row of stitches to sew the stomach _ stomach fundus wall of the cup-shaped portion of the second stitching member positioned open end. 所述缝合器可以包括可操作且可重新装载的多缝合器,其可以从患者身体外部重新装载缝线,并且适于使用所述一排胃_胃缝线缝合胃底壁的杯形部分的开口端,其中所述一排缝线包括即将被同时缝合的两个或更多个缝线或U形钉。 The suture may include re-loaded and operable multi stapler, which can reload the suture from outside the patient's body, and adapted to use the row _ stomach fundus wall of the stomach suture cup-shaped portion open end, wherein said suture comprises a row is about to be sewn simultaneously two or more U-shaped sutures or staples. 所述缝合器还可以包括用于同时缝合两条或更多条缝线的多个缝合。 The stapler may further include a suture simultaneously two or more of a plurality of sewn seam line. 所述仪器可进一步包括充盈器,用于在缝合之后充盈所述运动限制器件。 The apparatus may further include a filling device for filling the suture after motion limiting device. 所述成形器可以优选包括真空抽吸器,以抽吸胃底以与所述推进器一起帮助所述仪器形成胃底壁的杯形部分。 The former may preferably include a vacuum aspirator to suction the fundus of the propeller together with the help of the instrument forming part of the cup-shaped gastric wall. 之前部分中描述的实施的胃镜仪器可以包括用于检测食管或胃内部的光学器件。 Endoscopic instrument of embodiment described in the previous section may include detecting the esophagus or the stomach for optics. 为此,所述仪器可以进一步包括沿所述细长构件延伸的电线,所述光学器件包括置于所述细长构件远端并连接至所述电线的摄像机,所述电线从患者身体引出以向外公开来自摄像机的图像。 To this end, the apparatus may further include a wire extending along said elongated member, said optical device comprising an elongate member disposed in the distal end and connected to the wire camera, the wire drawn from the body of the patient in order to outward public image from the camera. 所述仪器可以进一步包括置于所述细长构件的远端用于照亮食管或胃内部的光源。 The apparatus may further comprise a distal end of the elongate member disposed for illuminating the esophagus or stomach of a light source. 所述光学器件可以适当地包括沿所述细长构件放置并从患者身体引出以在外面检查食管或胃内部的光纤。 The optical device may suitably comprise an elongated member disposed along the lead and to check the inside of the esophagus or the stomach from the patient's body outside the fiber. 本发明进一步涉及用于治疗反流病和肥胖症的设备。 The present invention further relates to a device for the treatment of reflux disease and obesity. 该设备包括运动限制器件、固定器、调整器、无线遥控功能、无线能量发射器以及先前描述的用于治疗反流病的设备所具有的其它特征。 The apparatus includes a motion limiting device, other features of the holder, the regulator, wireless remote control, wireless power transmitter and a device for the treatment of reflux disease previously described have. 另外,用于联合治疗反流病的设备包括至少一个可操作的拉伸器,所述拉伸器在被植入患者时拉伸患者胃壁的一部分,从而通过影响患者的食欲来治疗肥胖症;以及操作器,用于在植入所述拉伸器时操作所述拉伸器,使其拉伸胃壁部分,从而产生饱胀感。 In addition, combination therapy for reflux disease apparatus includes at least one operable stretcher, the stretching portion of the stomach wall is stretched when the patient is implanted in a patient, so that by affecting the patient's appetite to treat obesity; and an operation device for operating the stretching in the stretching device when implanted to stretch the stomach wall portion, thereby creating a sense of fullness. 所述拉伸器可以通过胃_胃缝线或U形钉在所述拉伸器能够拉伸胃壁的位置保持与胃壁的接触。 The stretcher can pass through the stomach _ stomach sutures or staples in the U-shaped stretcher can stretch the stomach position to maintain contact with the stomach wall. 具体地,所述拉伸器可以借助于胃_胃缝线或U 形钉被胃壁套叠。 Specifically, the stretching can aid the stomach _ stomach sutures or staples are U-shaped stomach intussusception. 所述拉伸器可以适于被放置在胃腔中。 The tension may be adapted to be placed in the stomach cavity. 为此,所述拉伸器可以适于通过胃镜或管腔内仪器被插入胃腔中,并且适于通过外科手术连到胃壁上。 To this end, the stretching may be adapted to be inserted into the stomach cavity, or lumen through the gastroscope equipment, and adapted to be connected to the stomach by surgery. 可替代地,所述拉伸器可以适于被放置在胃的外部。 Alternatively, the stretching may be adapted to be placed on the outside of the stomach. 在一个实施例中,所述拉伸器包括适于接合胃壁的第一部分的第一接合构件和适于接合与第一胃壁部分接近但与之隔开的胃壁的第二部分的第二接合构件。 In one embodiment, the stretcher comprises a first engaging member adapted to engage the first portion of the stomach wall and adapted to engage the first portion of the stomach wall of the stomach wall close to but spaced from a second portion of the second engagement member . 所述操作器适于操作所述第一和第二接合构件使它们远离彼此移动,以拉伸胃的第一部分与第二部分之间的胃壁部分,从而产生饱胀感。 The manipulator is adapted to operate said first and second engagement members so that they move away from each other to the stomach wall portion between the first portion and the second portion of the stomach stretched, resulting in a sense of fullness. 所述第一和第二接合构件中的至少一个可以适于通过胃_胃缝线或U形钉至少部分地被胃壁套叠,以将所述接合构件保持在适当的位置。 Said first and second engagement members at least one of the stomach wall can be adapted to be invaginated by the stomach _ U stomach sutures or staples at least partially, to maintaining the engagement member in place. 另外,所述第一和第二接合构件中的至少一个可以适于由所述接合构件与胃壁之间的缝线或U形钉保持在适当的位置。 Further, the first and second engaging members may be adapted by the at least one of the U-shaped staples or sutures engaging member and the stomach wall is maintained in place. 适当地,所述第一和第二接合构件中的至少一个包括组织生长促进结构,优选是网状结构,适于与胃壁相接触,从而保证所述拉伸器能够长期附着于胃壁。 Suitably, the first and second engagement member comprises at least one tissue growth promoting structure, preferably a reticulated structure, adapted to contact with the stomach wall, thereby ensuring the long-term stretcher attached to the stomach wall. 在另一实施方案中,所述拉伸器包括适于被患者胃壁的一部分套叠的至少一个可扩张的主体,并且所述操作器包括与所述主体的腔室流体连通的流体储存器。 In another embodiment, the stretcher comprising a portion adapted to be at least one expandable sleeve body overlapping the patient's stomach wall, and the manipulator comprises a chamber in fluid communication with said body fluid reservoir. 当所述主体被套叠后,所述操作器可无创地操作,以将流体从流体储存器分配到所述主体的腔室中以扩张所述主体,从而使胃壁部分被拉伸。 When the body invaginated, the operator can operate non-invasive to the fluid dispensed from the fluid reservoir into the body cavity to expand the body, so that the stomach wall portion is stretched. 所述流体储存器可以通过手动按压来操作。 The fluid reservoir may be operated by manually pressing. 所述操作器可包括反向伺服,其中所述流体储存器中的小体积的流体由较大的力进行压缩,所述主体的腔室使用较小的每单位体积的力产生了较大的总体积的移动。 The manipulator may comprise a reverse servo, wherein the fluid in the fluid reservoir by a small volume of a large force compression chamber of the body using a smaller force generated per unit volume greater The total volume of the mobile. 所述流体储存器可以置于皮下或腹内,并且可以例如由马达通过移动所述储存器的壁来进行调节。 The fluid reservoir may be placed subcutaneously or intra-abdominal, e.g., by a motor and may be adjusted by moving the reservoir wall. 可替代地,可以设置用于从所述储存器向所述主体的腔室泵送流体或空气的泵。 Alternatively, you can set for pumping fluid or air from the reservoir to the chamber of the body pump. 术语“反向伺服装置”的定义涵盖了使用较大力和小冲程来控制(即例如,通过使用大的力移动小量的流体来控制以极小的力移动较大量的流体的器件)的器件,但可替代地或附加地, 也可以涵盖以下定义的机械装置:所述机械装置将作用在移动构件上的具有短冲程的的强力转换为作用在另一移动构件上的具有长冲程的的小力。 Definitions The term "reverse servo means" encompasses the use of a large force and a small stroke to control (i.e., for example, by using a large force to move a small amount of fluid is controlled with a minimum force larger amount of fluid moving device) device , but may alternatively or additionally be defined by mechanical means to cover the following: the mechanical means acting on the moving force conversion member having a short stroke for acting on another moving element having a long stroke a small force. 当可以通过无创的皮肤手动控制所述器件时,优选使用所述反向伺服装置。 When manually through the skin noninvasive control of the device, it is preferable to use the reverse servo. 在另一实施例中,用于治疗反流病和肥胖症的设备包括与一个或多个较小腔室相接触的大腔室。 In another embodiment, for the treatment of reflux disease and obesity equipment including large chamber with one or more smaller chambers contact. 这些腔室适于连通在这些腔室之间分布的流体或空气。 Adapted for fluid communication with the chambers or air chambers between these distributions. 可以设置用于在腔室之间分配流体的反向伺服,其中所述大腔室中的小体积的流体由较大的力进行压缩,所述较小腔室使用较小的每单位体积的力产生了较大的总容积的移动。 May be provided for dispensing a fluid between a reverse servo chamber, wherein the large chamber of small volume of fluid is compressed by a large force, said smaller chamber using a smaller volume per unit force generation mobile larger total volume. 所述大腔室可以适于被套叠在患者的胃底壁中,以通过限制贲门切迹向患者横膈膜肌肉的移动同样也来治疗反流病,而所述小腔室产生拉伸器的功能以治疗肥胖症。 The large chamber can be adapted to the patient's fundus invaginated wall in order also to treat reflux disease by moving the restriction cardiac notch diaphragm muscle to the patient, and the small chamber to generate stretcher It functions to treat obesity. 所述大腔室可以将流体或空气分配到小腔室中,以使小腔室扩张并拉伸胃底壁。 The large chamber can assign a fluid or air to a small chamber, so that the small chamber to expand and stretch gastric wall. 在另一实施方案中,所述拉伸器包括机械拉伸器,其中可以设置用于机械调节所述拉伸器的马达。 In another embodiment, the stretcher comprises a mechanical tensioner, which may be provided for the mechanical adjustment of the stretcher motors. 所述机械调节的拉伸器可以适于接合胃壁的第一部分和胃的第二部分,其中所述机械调节的拉伸器包括适于由操作器移动的联合机构。 The stretching may be mechanical adjustment adapted to engage a first portion and a second portion of the stomach wall of the stomach, wherein the mechanically regulated stretching device comprises a joint mechanism adapted to move by the operator. 可替代地,所述拉伸器可以包括适于接合胃壁的第一部分的第一接合构件和适于接合与所述的第一胃部分接近但与之隔开的胃壁的第二部分的第二接合构件,其中所述机械拉伸器调节胃壁的所述第一部分与第二部分之间的距离。 Alternatively, the stretcher may comprise a first engaging member adapted to engage the first portion of the stomach wall and adapted to engage a second portion of the first stomach of the stomach wall close to but spaced from the second portion engaging member, wherein the mechanical stretching is adjusting the distance of the first portion of the stomach wall and the second portion. 作为替代方案,以上所述的液压装置可以用于通过流体或空气的液压分布来调节这种机械拉伸器。 As an alternative, the hydraulic device described above may be used to adjust the distribution of such mechanical stretching through the hydraulic fluid or air. 所述拉伸器可以是在术后可无创地进行调节的。 The stretching can be in non-invasive surgery can be performed regulation. 用于操作所述拉伸器的操作器可以为最简单的形式,所述最简单的形式包括皮下开关,所述皮下开关适于通过手动按压进行无创操作,以操作所述拉伸器件。 Operating device for operating the stretching device may be the most simple form, the simplest forms include subcutaneous switch, pressing the subcutaneous switch adapted to be non-invasive operation manual to operate the stretching device. 可以设置至少两个适于拉伸胃壁的至少两个不同部分的可操作的拉伸器,其中所述设备适于在术后无创地进行调节。 It can be adapted to stretch at least two of the at least two different parts of the stomach wall operable stretch, wherein the device is adapted to be adjusted after the non-invasively. 具体地,所述设备可以不时地进行调节,使得在第一时间所述拉伸器之一拉伸胃壁的一个部分,而在第二时间所述拉伸器中的另一个拉伸胃壁的另一部分。 In particular, the device may be adjusted from time to time, such that one of the tensioners at a first time stretch a stomach wall portion, and said second time is stretched in the other drawing the other of the stomach wall part. 在另一个实施方案中,所述拉伸器包括主体,所述主体适于填充扩张由胃壁部分所形成的容积。 In another embodiment, the stretching device comprises a body, the body is adapted to expand to fill the volume formed by a portion of the stomach. 所述主体适当地具有滚圆的轮廓而没有会对患者的胃壁造成损伤的过于尖锐的边缘。 The body has a rounded profile properly without the patient's stomach would damage too sharp edges. 在所述主体被套叠的情况下,所述主体可以具有变化的周长,以更好地保持在被患者的胃壁部分套叠的合适的位置。 In the case of the main quilt stack, the body may have varying circumference, in order to better maintain the proper position partially overlapping sets of patients stomach. 所述主体可以具有卵形或肾形。 The body may have an oval or kidney-shaped. 一般而言,可以使用任意种类的机械架构。 Generally, you can use any type of mechanical structure. 可以使用机械或液压驱动的任意的机械架构或者任意的气动架构。 You can use mechanical or hydraulic drive of any mechanical architecture or any aerodynamic architecture. 可以使用任意马达或任意泵或在提供动力时改变形式的移动物质以实现通过使胃的至少两个部分远离彼此移动来拉伸胃壁的一部分这一简单的目的马达。 You can use any motor or any pump or moving material changing form when powered by the stomach in order to achieve at least two portions away from each other to stretch the stomach wall as part of the simple purpose motor. 可以使用任意种类的液压操作。 You can use any type of hydraulic operation. 可以理解,可以使用气动操作代替液压操作,其中是空气而不是液压流体在储存器与由所述拉伸器形成的腔室之间移动。 Will be appreciated, it may be used instead of pneumatically operated hydraulic operation, wherein air instead of hydraulic fluid is moved between the reservoir and the chamber formed by the stretching device. 优选地,所述储存器在由患者操控时具有使其保持在期望位置的锁定位置。 Preferably, the reservoir when manipulated by the patient having to keep it in a desired position a locking position. 为了压缩所述储存器,所述储存器优选停留在被压缩状态,并且在再次按压之后释放。 To compress the reservoir, the reservoir is preferably remain in the compressed state, and released again after the pressing. 可以将任意种类的液压液用于所述拉伸器。 Any kind of hydraulic fluid may be used for the stretcher. 所述液压液可以由机械方式和由任意的马达或泵提供动力来驱动,也可以手动驱动。 The hydraulic fluid may be driven by mechanical means and by any motor or pump power, you can manually driven. 当然,仅扩张胃的套叠部分也可以拉开胃壁,这一操作也可以由机械方式、液压方式、 气动方式和由任意马达或泵提供动力或用手施力来驱动。 Of course, only the expansion of the stomach telescoping portion may also pull the stomach, this operation may be made mechanically, hydraulically, pneumatically or by hand and powered by a motor or pump any urging to drive.

[0054] 本发明还提供一种用于联合治疗反流病的系统和包括以上所述的用于治疗肥胖症的设备的肥胖症治疗系统。 [0054] The present invention also provides a combination therapy for reflux disease include obesity treatment systems and systems described above apparatus for the treatment of obesity. 所述系统可以包括皮下电子开关,适于手动并且无创地控制用于治疗肥胖症的设备的功能。 The system may include subcutaneous electronic switch, suitable for manual and non-invasively control device for the treatment of obesity. 所述系统可以包括具有液压储存器的液压器件,其中用于治疗肥胖症的设备适于通过手动按压所述液压储存器无创地进行调节。 The system may comprise a hydraulic device having a hydraulic reservoir, wherein the device is adapted for treating obesity by manually pressing the hydraulic reservoir noninvasively adjusted. 所述系统可以包括用于控制所述设备的功能的无线遥控。 The system may include a wireless remote control for controlling functions of the apparatus. 所述无线遥控包括至少一个外部信号发射器和可以被设置为植入患者的内部信号接收器。 The wireless remote control comprises at least one external signal transmitter and can be implanted in a patient to set an internal signal receiver. 所述无线遥控适于发射用于控制所述设备的至少一个无线控制信号。 The wireless remote control adapted to transmit at least one wireless control signal for controlling the device. 所述无线控制信号可以包括频率、幅度或相位调制信号或它们的组合,以及模拟或数字信号或模拟信号和数字信号的组合。 The wireless control signal may include a combination of frequency, amplitude or phase modulation signal or a combination thereof, as well as analog or digital signals or analog signals and digital signals. 可替代地,所述无线控制信号包括电场或磁场或者结合的电磁场的组合。 Alternatively, the wireless control signal comprises a combination of electric or magnetic field or a combination of electromagnetic fields. 所述遥控可以发射用于承载所述无线控制信号的载波信号。 The remote control may transmit a carrier signal carrying the wireless control signal is provided. 所述载波信号可以包括数字信号、模拟信号或者数字信号和模拟信号的组合。 The carrier signal may comprise a combination of digital signals, analog signals or digital signals and analog signals. 所述遥控可以发射用于承载数字控制信号或模拟控制信号的电磁载波信号。 The remote control can transmit control signals for carrying the digital or analog control signal, an electromagnetic carrier signal. 所述系统可以包括用于无创地对所述设备提供无线能量的无线能量发射器。 The system may include a non-invasive way to provide wireless energy to the device for wireless energy transmitter. 所述能量发射器通过至少一个无线能量信号来发射能量。 The energy transmitter via the at least one wireless energy signal to transmit energy. 所述无线能量信号可以包括选自以下的波信号:声波信号、超声波信号、电磁波信号、红外线信号、可见光信号、紫外线信号、激光信号、微波信号、无线电波信号、X射线辐射信号和伽马辐射信号。 The wireless energy signal may comprise a wave signal selected from the following: an acoustic signal, an ultrasonic signal, an electromagnetic wave signal, an infrared signal, a visible light signal, an ultraviolet signal, a laser signal, a microwave signal, a radio wave signal, X-ray radiation and gamma radiation signal signal. 可替代地,所述无线能量信号包括电场或磁场或者结合的电磁场的组合。 Alternatively, the wireless energy signal comprises an electric or magnetic field or a combination of a combination of electromagnetic fields. 所述无线能量发射器可以发射用于承载所述无线能量信号的载波信号。 The wireless power transmitter may transmit a carrier signal for carrying the wireless energy signal. 所述载波信号可以包括数字信号、模拟信号或者数字信号和模拟信号的组合。 The carrier signal may comprise a combination of digital signals, analog signals or digital signals and analog signals. 所述系统可以包括用于将所述无线能量从第一形式转换为第二形式的能量的能量转换器。 The system may comprise means for the wireless energy into a second form of energy from a first form of energy converters. 所述能量转换器可以在能量传送的过程中使用所述第二形式的能量直接操作所述设备。 The energy converter may be used in the energy of the second form of the process of energy transfer in the direct operation of the device. 所述第二形式的能量可以包括直流或脉动直流,或者直流和脉动直流的组合。 The second form of energy may include a DC or pulsed DC, or a combination of DC and pulse DC. 所述第二形式的能量可包括交流或交流与直流的组合。 The second form of energy may include AC or a combination of AC and DC. 可以提供储能器,其中所述第二形式的能量至少部分地用于给所述储能器充能。 Accumulator may be provided, wherein the second form of energy used to at least partially recharge the accumulator. 所述第一或第二形式的能量可包括磁能、动能、声能、化学能、辐射能、电磁能、光能、核能或热能。 The first or second form may include magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, solar energy, nuclear energy or thermal energy. 所述第一形式的能量和所述第二形式的能量之一可以是非磁能、非动能、非化学能、非声能、非核能或非热能。 One of the first form of energy and the energy of the second form may be non-magnetic, non-kinetic, non-chemical, non-sonic energy, non-nuclear or non-thermal energy. 所述系统可以包括适于给所述设备供能的能源。 The system may include a device adapted to the energy supply of energy. 所述能源可以包括适于从以无线模式发射能量的外部能源接收能量的内部能源。 The energy may comprise adapted to receive energy from the external energy source transmitting energy in a wireless mode of internal energy. 所述内部能源以无线模式的能量充能。 The internal energy in the energy wireless mode of empowerment.

[0055] 所述系统可以包括反馈器件,所述反馈器件用于从患者身体内部向其外部发送信息,以给出与功能性参数有关的反馈信息。 [0055] The system may include a feedback device, said feedback device for sending information from inside the patient's body to its outside, in order to give feedback information related to the functional parameter. 所述系统可以包括用于检测参数的传感器,所述参数例如系统的功能性参数,与用于为所述内部能源充能的能量传送相关。 The system may include a sensor for detecting a parameter, said parameter e.g. functional parameters of the system, and the internal energy is used to recharge the energy transfer associated. 可以提供内部控制单元,用于对检测功能性参数的传感器进行响应来控制所述设备的操作器。 Internal control unit may be provided for the sensor to detect functional parameters in response to control the operation connected to the device. 可替代地, 传感器检测患者的生理参数。 Alternatively, the patient's physiological parameter sensor. 所述生理参数可以是体温、血压、血流、心跳和呼吸之一。 The physiological parameter may be body temperature, blood pressure, blood flow, heart rate and breathing one. 所述生理参数传感器可以是压力或活动力传感器,或检测尺寸、弯曲、拉伸或食物摄入的传感器。 The physiological parameter sensor can be a pressure sensor or motility, or the detection size, bending, stretching or food intake sensor. 所述内部控制单元可以对检测所述生理参数的传感器进行响应而控制所述操作器。 The internal control unit of the sensor can detect the physiological parameters in response to control of the operator. 可以提供内部控制单元,用于从所述传感器接收信息。 Internal control unit may be provided for receiving information from the sensor. 所述设备的操作器可以包括马达或泵。 Operator of the device may comprise a motor or a pump. 具体地,所述操作器可以包括电动机。 Specifically, the operator may comprise a motor. 所述操作器可以以由电供能,可以是液压操作器或者可以是气动操作器。 The operator may be an electrically energized device may be hydraulically operated or may be a pneumatically operated device. 直接以其无线形式发射的能量可以影响所述操作器以产生动能,从而在能量传送的过程中操作所述设备的拉伸器。 Its transmit wireless energy in the form of direct operator may affect the kinetic energy to produce, and thus the operation of the apparatus of the stretcher in the energy transfer process. 所述系统可以包括反馈器件,以从患者身体内部向其外部发送信息,以给出与功能性参数有关的反馈信息。 The system may comprise a feedback device for sending information from inside the patient's body to its outside, in order to give feedback information related to the functional parameter. 所述系统可以包括外部数据通信器和与所述外部数据通信器通信的可植入式内部数据通信器,其中所述内部通信器适于向所述外部数据通信器反馈与用于治疗反流病的设备或与患者有关的数据,或者所述外部数据通信器向所述内部数据通信器发送数据。 The system may include an external data communicator and the data communication with the external communication implantable internal data communicator, wherein the internal communicator is adapted to feedback to the external data communicator and for the treatment of reflux Disease device or data related to the patient, or the external data communicator transmits data to the internal data communicator. 所述系统可以包括可植入的电子组件, 所述可植入的电子组件包括至少一个电压电平保护器和/或至少一个恒流保护器。 The system may comprise implantable electrical components, the implantable electronic assembly including at least one voltage level protection and / or at least one constant-current protector.

[0056] 本发明还提供治疗同时患反流病和肥胖症的患者的方法。 [0056] The present invention also provides methods of treating patients also suffer from reflux disease and obesity approach. 所述方法可以与先前所描述的治疗反流病的腹部或管腔内方法一起进行或结合进行。 The method may be carried out in conjunction with or in combination treatment of reflux disease stomach or lumen previously described method. 本发明提供以下所列的方法: The present invention provides methods listed below:

[0057] a) 一种用于以外科手术方式治疗肥胖患者的方法,所述方法包括以下步骤: Method [0057] a) A method for surgically treating obese patients, the method comprising the steps of:

[0058] 在患者腹壁中切割开口; [0058] In the patient's abdominal wall cutting openings;

[0059] 剖开胃周围的区域, [0059] cut around the stomach area,

[0060] 放置如以上所述的用于治疗肥胖症的设备,接合患者的胃壁,和[0061] 缝合胃壁。 [0060] placement of a device for treating obesity above, engaging the patient's stomach, and [0061] suture the stomach.

[0062] 所述方法可以进一步包括以下附加步骤: [0062] The method may further comprise the following additional steps:

[0063] 在手术后调节所述拉伸器以拉伸胃壁的一部分,以影响患者的食欲,其中调节所述拉伸器的步骤从患者身体外部进行控制。 [0063] After adjusting the operative part of the stretcher to stretch the stomach wall to affect the appetite of the patient, wherein the step of adjusting the stretching device is controlled from outside the body of the patient.

[0064] 所述方法可以进一步包括以下附加步骤: [0064] The method may further comprise the following additional steps:

[0065] 放置如以上所述的用于治疗肥胖症的附加设备,接合患者的胃壁, [0065] place such as additional equipment for the treatment of obesity above, engaging the patient's stomach,

[0066] 借助于所述用于治疗肥胖症的设备拉伸胃壁的第一部分,和 [0066] by means of a first portion of the device for treating obesity stretching of the stomach wall, and

[0067] 借助于所述用于治疗肥胖症的附加设备拉伸胃壁的第二部分。 [0067] by means of additional equipment to treat obesity stretch for the second portion of the stomach wall.

[0068] b) 一种用于通过腹腔镜腹部方法以外科手术方式将用于治疗患者的肥胖症的设备置入病人体内的方法,所述方法包括以下步骤: [0068] b) A method in laparoscopic abdominal surgery manner for the treatment of obesity in a patient device into a patient, said method comprising the steps of:

[0069] 在患者身体的腹部插入与针状或管状仪器, [0069] and the needle is inserted in the patient's body or tubular instrument abdomen,

[0070] 使用所述针状或管状仪器给患者的腹部充气从而扩张患者的腹腔, [0070] Using the needle-like or tubular instrument to the patient's abdomen in order to expand the inflatable patient's abdominal cavity,

[0071] 在患者身体中放置至少两个腹腔镜套管针, [0071] placing at least two laparoscopic trocars in the patient's body,

[0072] 将摄像机穿过所述腹腔镜套管针之一插入患者腹部, [0072] One of the camera through the laparoscopic trocar inserted into the patient's abdomen,

[0073] 穿过所述至少两个腹腔镜套管针之一插入至少一个剖开工具并剖开患者的计划放置的区域,和 [0073] through the one of the at least two laparoscopic trocar insertion of at least one tool and cut open the patient's taken place in the regional plan, and

[0074] 放置如以上所述的用于治疗肥胖症的设备,接合胃壁。 [0074] placement of a device for treating obesity above, engaging the stomach wall.

[0075] c) —种使用如上所述的用于治疗肥胖症的系统的方法,包括在手术后调节所述拉伸器以拉伸胃壁的一部分从而影响患者的食欲的步骤,其中调节所述拉伸器的步骤无创地进行。 [0075] c) - the kind of use of the system for treating obesity as described above, including the post-operative adjustment of the stretcher to stretch the stomach wall portion thus affecting the patient's appetite step, wherein said adjusting stretcher steps noninvasive manner. 所述拉伸器包括机械或液压拉伸器。 The stretch includes a mechanical or hydraulic tensioners. 所述液压拉伸器可以包括储存器,用于向、或从所述拉伸器中移动凝胶或气体或流体。 The hydraulic tensioner may include a reservoir for supplying, or mobile gel or gas or fluid from the stretcher in. 所述储存器可以置于皮下,从而使患者的手可触及, 以向、或从所述拉伸器中手动移动流体。 The reservoir may be placed subcutaneously, so that the patient's hand can reach to, or can manually move the fluid from the stretcher. 所述拉伸器可以由内部能源供能以拉伸或松开所述拉伸器,其中借助于控制器来控制来自内部控制单元或来自患者身体外部的能量。 The stretcher can be used for the internal energy can be stretched or loosen the tensioner, which by means of a controller to control the energy from the internal control unit or from outside the patient's body. 用于无线传送能量的无线能量发射器驱动所述操作器控制所述拉伸器,以使在能量传送的过程中直接使所述拉伸器拉伸胃壁。 Wireless energy transmitter for wireless transfer of energy to drive the operator to control the stretcher, so in the process of energy transfer directly causing the stretcher stretching the stomach wall. 用于无线传送能量的无线能量发射器给所述内部能源供能。 Wireless energy transmitter for wireless transfer of energy to the internal energy supply energy. 可以提供反向伺服,其中当在封闭的液压系统中移动小量流体时,在第二个较大的封闭的液压系统中实现流体的较大移动,其中所述小量流体使用比大体积更大的每单位面积的力来移动。 Can provide reverse servo, which when moving a small amount of fluid, achieve greater movement of fluid in the hydraulic system second, larger enclosed in a closed hydraulic system in which a small amount of fluid is larger than the bulky The force per unit area to move. 在患者胃底胃壁中套叠的拉伸器适于是可调整的,其中被放置为套叠在胃底壁中的拉伸器适于被调节,并拉伸胃底壁从而产生饱胀感。 In patients with gastric stomach wall adapted telescopic stretch is adjustable, which is positioned to nesting in gastric wall tension is adapted to be adjusted, and stretched gastric wall to produce a sense of fullness.

[0076] 所述方法可以进一步包括从身体内部向其外部发送反馈信息,以给出与器件的功能性参数有关的反馈。 [0076] The method may further comprise sending feedback information from inside the body to its outside, to give the functional parameters relating to the feedback device. 可替代地,所述方法可以进一步包括从身体内部向其外部发送反馈信息,以给出与患者的生理参数有关的反馈。 Alternatively, the method may further comprise from inside the body to its external transmitter feedback information to give the patient's physiological parameters related feedback. 所述器件的功能性参数可以与用于对内部能源进行充能的能量的传送有关。 Functional parameters of the device can be used to recharge the internal energy of the energy transfer related. 可以从患者身体外部对所述器件发送指令。 It can send commands from outside the patient's body to the device.

[0077] 所述方法可以进一步包括以下步骤: [0077] The method may further comprise the steps of:

[0078] 检测患者的生理参数或所述器件的功能性参数,和 [0078] or physiological parameters of the device to detect the patient's functional parameters, and

[0079] 向适于调节所述拉伸器的控制单元发送检测信息。 [0079] to send a test message to be adapted to adjust the control unit of the stretch.

[0080] 所述方法可以进一步包括以下步骤: [0080] The method may further comprise the steps of:

[0081] 检测患者的生理参数或所述器件的功能性参数,和 [0081] or physiological parameters of the device to detect the patient's functional parameters, and

[0082] 向适于调节所述内部能源的充能的控制单元发送检测信息。 [0082] to send a test message to be adapted to regulate the internal energy of the charge energy control unit. [0083] 所述方法可以进一步包括皮下放置反向伺服,所述反向伺服具有小的控制储存器,并且使用较大的每单位面积的力从控制储存器移动小的体积,从而使用较小的每单位面积的力使所述拉伸器发生较大的移动。 [0083] The method may further comprise subcutaneously placing a reverse servo, the reverse servo having a small control reservoir and use the force per unit area of a larger movement of a small volume from the control reservoir, so that the use of smaller The force per unit area of a larger movement occurs the stretcher.

[0084] 所述方法可以进一步包括通过手动按压皮下开关进行所述的无创调节。 [0084] The method may further comprise performing the noninvasive regulation by manually pressing the subcutaneous switch.

[0085] 所述方法可以进一步包括通过无线遥控进行所述的无创调节。 [0085] The method may further comprise performing the noninvasive regulation by a wireless remote control.

[0086] 所述方法可以进一步包括通过无线能量发射器进行所述的无创调节。 [0086] The method may further comprise performing the noninvasive regulation by a wireless energy transmitter.

[0087] 所述方法可以进一步包括通过内部能源驱动所述用于治疗肥胖症的设备。 [0087] The method may further comprise an internal energy of the driving apparatus for the treatment of obesity.

[0088] 所述方法可以进一步包括通过外部能源发射无线能量来驱动所述用于治疗肥胖症的设备,其中所述能源包括发射无线能量的外部能源。 [0088] The method may further comprise transmitting wireless energy from an external energy source to drive the device for the treatment of obesity, wherein said energy source comprises an external energy source transmitting wireless energy.

[0089] 所述方法可以进一步包括从外部能源发射无线能量,以给可重复充能的内部能源岁δ會邑。 [0089] The method may further comprise transmitting wireless energy from the external energy source, in order to be able to be repeated charge of internal energy δ-year-old would Yap.

[0090] d) 一种使用如上所述的设备的方法,其中所述拉伸器包括主体,所述主体包括与一个或多个适于拉伸胃壁的较小储存器/腔室相接触的大腔室,其中所述腔室适于连通在所述腔室之间移动的流体或空气。 [0090] d) A method of using the apparatus as described above, wherein the stretching device comprises a body, said body comprising one or more adapted to stretch the stomach wall small reservoir / chamber in contact large chamber, wherein the chamber is adapted to communication between the chamber fluid or air movement.

[0091] e) 一种使用如上所述的设备的方法,其中所述大腔室适于使用其主容积作为所述拉伸器的最重要的容积,并且其中所述小腔室作为拉伸胃壁以治疗肥胖症的拉伸器,其中所述主腔室将流体或凝胶连通到小腔室,从而在胃底壁中产生拉伸效果,从而治疗肥胖症。 [0091] e) A method of using the apparatus described above, wherein the chamber is adapted to use a large volume of the main volume as the most important of the stretcher, and wherein the small chambers as stretching stretch the stomach to treat obesity, wherein the main chamber of the fluid or gel communication to a small chamber, resulting in the stretching effect in gastric wall, thereby treating obesity.

[0092] f) 一种使用如上所述的设备的方法,包括通过套叠将大腔室的主容积套叠在胃底壁中,从而限制胃切迹向患者横膈膜肌肉的移动来治疗反流病,并且使用所述小腔室拉伸胃底壁,从所述大腔室向所述小腔室连通流体或空气,以在胃底壁中产生拉伸效果,从而治疗肥胖症。 [0092] f) A method of using the device as described above, including by telescoping the main large chamber volume nesting in the gastric wall, thereby limiting notch stomach muscles to move the diaphragm to the patient to treat reflux disease, and the use of the small chamber stretched gastric wall, connecting fluid or air from the large to the small chamber of the chamber to produce the stretching effect in the gastric wall, thereby treating obesity.

[0093] 在另一方面,本发明涉及一种治疗具有带食物腔的胃的患者的反流病和/或肥胖症的设备。 [0093] In another aspect, the present invention relates to a method of treating a patient with a stomach cavity with food of reflux disease and / or obesity equipment. 所述设备通常包括至少一个适于至少基本上被患者的胃壁部分套叠的容积填充器件,其中所述容积填充器件适于被放置在胃壁的外侧,使得食物腔容积的尺寸减小了一个显著超出所述容积填充器件的体积的容积,其中所述容积填充器件的表面包括生物相容材料,其中所述容积填充器件的表面的大部分适于靠在胃壁的外侧,并且其中所述容积填充器件具有至少30毫米的最大周长。 The apparatus generally comprises at least one at least substantially adapted to the patient's stomach wall invaginated portion of the volume filling device, wherein the volume filling device adapted to be placed on the outside of the stomach wall, so that the volume of the food cavity of a significant size reduction volume exceeds the volume of the volume filling device, wherein the surface of the volume filling device comprises a biocompatible material, wherein most of the volume filling device is adapted against the outer surface of the stomach wall, and wherein the volume filling the device has a maximum circumference of at least 30 mm. 所述设备优选包括容积填充器件,所述容积填充器件包括可扩张成扩张状态的可充盈器件。 The apparatus preferably includes a volume filling device, the volume filling device comprises an expandable into an expanded state can filling devices. 所述可充盈器件优选具有流体或凝胶的入口,并且适于连接至胃镜仪器。 The filling device may be a fluid or gel preferably has an inlet and adapted to be connected to the endoscopic instrument. 所述入口优选包括适于将所述容积填充器件和胃镜仪器互连的流体连接。 The inlet preferably comprises adapted to fill the volume of interconnected devices and endoscopic instruments fluidly connected. 所述容积填充器件具有细长的形状。 The volume filling device has an elongated shape. 可替代地,所述容积填充器件具有滚圆的形状, 或者弯曲的形状或曲线的形状。 Alternatively, the volume filling device has a rounded shape, or the shape of the curve or curved shape. 所述容积填充器件优选包括弹性材料。 The volume filling device preferably comprises a resilient material. 所述容积填充器件优选包括生物相容材料。 The volume filling device preferably comprises a biocompatible material. 优选地,所述容积填充器件包括硅树脂。 Preferably, the volume filling device comprises a silicone resin. 所述容积填充器件可以具有一层或多层的涂层,例如聚对二甲苯(Parylene)涂层、聚四氟乙烯涂层或聚氨酯涂层。 The volume filling device may have one or more layers of the coating, e.g., parylene (Parylene) coating, Teflon coating or a polyurethane coating. 所述容积填充器件包括适于被转化为固态或固定形式的流体。 The volume filling device comprises or is adapted to be fixed into a solid form of the fluid. 在一个示例中,所述流体是液态聚氨酯。 In one example, the fluid is a liquid polyurethane. 在另一示例中,所述流体是等压的。 In another example, the fluid is isobaric. 在另一示例中,所述流体包括大分子以防止扩散。 In another example, the fluid comprises molecules to prevent proliferation. 在另一示例中,所述流体包括碘分子。 In another example, the fluid comprises an iodine molecule. 所述容积填充器件包括均质材料。 The volume filling device comprises a homogeneous material. 所述容积填充器件可以是实心体,它可以包括形成一腔室的包围壁,它可以包括刚性外表面,其可以包括弹性外表面,并且它可以包括柔性外表面。 The volume filling device may be a solid body, which may include forming a chamber surrounded by walls, which may include a rigid outer surface, which may include an outer surface of the elastic, and it may include a flexible outer surface. 所述容积填充器件优选具有至少50mm的最大周长,更优选地具有至少80mm的周长。 Preferably the volume filling device has a maximum circumference of at least 50mm, more preferably at least 80mm in circumference. 所述容积填充器件优选具有0. 00001至0. OOlm3之间的容积(体积),更优选地具有0. 00001与0. 0002m3之间的容积(体积)。 The volume filling device preferably has a volume (v) between 0.00001 to 0. OOlm3, more preferably has a volume (v) 0.00001 and between 0. 0002m3. 优选地,所述容积填充器件可变形到最大直径,以便插入腹腔镜套管针。 Preferably, the volume filling device can be deformed to the maximum diameter, in order to insert the laparoscopic trocar. 所述容积填充器件适于通过胃_胃缝线或U形钉被保持在适当的位置,以将所述器件套叠在胃壁中。 The volume filling device is adapted to be retained in place through the stomach _ stomach sutures or U-shaped staples to the device invaginated in the stomach wall. 所述胃_胃缝线或U形钉具有呈现出适于与胃壁接触的结构的固定部分,以促进人体组织的生长,从而保证接触胃壁的容积填充器件的长期放置。 _ The gastric stomach sutures or staples having a U-shaped structure and is adapted to exhibit a fixed contact part of the stomach wall, in order to promote the growth of human tissue, thus ensuring the long-term contact with the stomach wall to place the volume filling device. 所述结构优选包括网状结构。 The structure preferably comprises a mesh structure. 所述容积填充器件适于在手术后可无创地进行调整。 The volume filling device is adapted to be adjusted after surgery can be non-invasively. 在一个实施方案中,所述容积填充器件具有变化的周长,以更好地适于保持在套叠到患者胃壁中的适当位置。 In one embodiment, the volume filling device has varying circumference to be better adapted to maintain the invaginated stomach wall of the patient to the proper position. 根据本发明的设备可以进一步包括放置在胃壁外侧并且适于拉伸部分胃壁从而影响患者的食欲的拉伸器,所述设备进一步包括将所述拉伸器与所述容积填充器件互连的流体连接。 The apparatus according to the present invention may further comprise the stomach wall and is adapted to be placed on the outside of the stomach wall portion stretching which affects the patient's appetite stretching, said apparatus further comprising stretching said volume filled with said fluid interconnection device connection. 在一个实施方案中,所述容积填充器件适于通过胃镜仪器放置在胃壁外侧。 In one embodiment, the volume filling device is adapted to the instrument through the gastroscope placed outside the stomach wall. 在一个实施方案中,所述容积填充器件包括至少两个可互连部分,并且其中所述容积填充器件适于作为独立部分被放置在胃壁外侧。 In one embodiment, the volume filling device comprises at least two interconnectable portions, and wherein the volume filling device adapted to be placed as a separate part on the outside of the stomach wall. 在一个实施方案中,所述容积填充器件的外表面层包括聚氨酯、聚四氟乙烯(Teflon) 或PTFE或它们的组合。 In one embodiment, the outer surface of the volume filling device comprises a layer of polyurethane, polytetrafluoroethylene (Teflon) or PTFE or combinations thereof. 在一个实施方案中,所述容积填充器件适于被酸破坏,优选适于被氢氯酸破坏。 In one embodiment, the volume filling device is adapted to be destroyed acid, hydrochloric acid is preferably adapted to be destroyed. 在一个实施方案中,所述容积填充器件包括凝胶,优选所述凝胶具有小于15的肖氏硬度值。 In one embodiment, the volume filling device comprises a gel, the gel preferably has a durometer hardness less than 15. 在一个实施方案中,所述容积填充器件包括适于与抓取仪协作的附着器。 In one embodiment, the volume filling device comprises a meter adapted to cooperate with grab attachment device. 在一个实施方案中,所述容积填充器件适于被患者的胃壁完全套叠。 In one embodiment, the device is adapted to be patient to fill the volume of the stomach is completely nested. 所述设备可以进一步包括固定器,适于将食物摄入减少器固定到胃壁,以在所述容积填充器件被植入时将所述容积填充器件保持在适当位置。 The apparatus may further comprise a holder adapted to reduce food intake to the stomach wall is secured to the volume filling device is implanted when the volume filling device is held in place. 所述容积填充器件具有小于0. 0002m3的容积(体积),优选具有0. 0001与0.001m3之间的容积(体积)。 The volume filling device has a volume of less than 0. 0002m3 (by volume), preferably has a volume (v) between 0.0001 and 0.001m3. 在一个实施方案中,所述容积填充器件适于不受酸的破坏, 优选是不受氢氯酸的破坏。 In one embodiment, the volume filling device is adapted from acid destruction, preferably hydrochloric acid is not destroyed. 优选地,所述容积填充器件具有至少120mm的周长,优选地具有至少150mm的周长,更优选地具有至少180mm的周长,再优选地具有至少220mm的周长。 Preferably, the volume filling device has a circumference of at least 120mm, preferably at least 150mm in circumference, more preferably at least 180mm in circumference, and then preferably has a circumference of at least 220mm. 所述容积填充器件优选包括柔性非弹性材料。 The volume filling device preferably comprises a flexible non-elastic material. 所述设备优选包括容积填充器件,所述容积填充器件包括适于与将所述器件固定到胃壁有关的固定器。 The apparatus preferably comprises a volume filling device, the device comprises a volume filling device adapted to be secured to the holder about the stomach wall. 在一个实施方案中,所述容积填充器件包括两个或更多个与将所述器件固定到胃壁有关的固定器。 In one embodiment, the volume filling device comprises two or more of the fixing device related to the stomach wall holder. 在一个实施方案中,所述容积填充器件包括能够由仪器夹持并且简化所述器件的植入的夹持器。 In one embodiment, the device comprises a filling volume can be held by the instrument holder and to simplify the implantation of the device. 在一个实施方案中,所述容积填充器件包括两个或更多个能够由仪器夹持并且简化所述器件的植入的夹持器。 In one embodiment, the volume filling device comprises two or more can be held by the instrument holder and to simplify the implanted device. 在一个实施方案中,所述容积填充器件包括至少一个连接至所述器件的管。 In one embodiment, the volume filling device comprises at least one tube connected to the device. 在一个实施方案中,所述容积填充器件包括用于连接至所述管的注入口。 In one embodiment, the volume filling device comprises means for connecting the tube to the injection port.

[0094] 如上所述的包括至少一个容积填充器件的用于治疗患者的反流病和/或肥胖症的设备可以结合先前部分中公开的任意特征,例如但不限于拉伸贲门刺激器。 [0094] As described above comprises at least one volume filling device for the treatment of patients with reflux disease and / or obesity may be bonded to any of the features of the device disclosed in the previous section, such as but not limited to cardiac stimulator stretching. 还可以设想, 上述包括至少一个容积填充器件的用于治疗患者的反流病和/或肥胖症的设备可以通过一般采用在本文件先前部分中概述的腹部或管腔内方法来植入,并且也可以想到先前描述的运动限制器件的合适的特征可以与所述容积填充器件一起使用。 It is also envisaged, including at least one said volume filling device for the treatment of patients with reflux disease, and / or obesity device can be commonly used in this document was previously part of the abdomen or inner lumen method outlined to implant, and It is also conceivable to limit the movement of the device suitable features previously described may be used with the volume filling device.

[0095] 应当注意,这里所描述的任意实施方案、实施方案的部分、特征、方法、相关联的系统或者系统的部分可以以任意合并方式合并。 [0095] It should be noted that part of any of the embodiments described herein, some embodiments, features, methods, associated systems or systems can merge in any merger.

附图说明 Brief Description

[0096] 现在将参考附图通过非限制性的实施例更详细地描述本发明,附图中: [0096] will now be described with reference to the accompanying drawings by way of non-limiting embodiments of the present invention in more detail, in the drawings:

[0097] 图IA-C是植入人类患者体内的用于治疗胃食管反流病的设备的各种实施方案的 [0097] FIG. IA-C is implanted in a human patient of various embodiments of the apparatus for the treatment of gastroesophageal reflux disease

28示意图。 28 Fig.

[0098] 图2A-B是植入人类患者体内的用于治疗胃食管反流病的设备的各种实施方案的示意图。 [0098] FIG. 2A-B is a schematic view of the device for treatment of gastroesophageal reflux disease, various embodiments of implantable human patients.

[0099] 图3A-B是植入人类患者体内的用于治疗胃食管反流病的设备的各种实施方案的示意图。 [0099] FIG. 3A-B is a schematic view of the device for the treatment of gastroesophageal reflux disease, various embodiments of implantable human patients.

[0100] 图4A-D是植入人类患者体内的用于治疗胃食管反流病和肥胖症的设备的实施方案的示意图。 [0100] FIG. 4A-D are schematic treatment of gastroesophageal reflux disease and obesity apparatus for the embodiment implanted in human patients.

[0101] 图5是植入人类患者体内的用于治疗胃食管反流病的设备的一个实施方案的示意图。 [0101] FIG. 5 is a schematic diagram of apparatus for treatment of gastroesophageal reflux disease, an embodiment of the implanted human patients.

[0102] 图6A-D和7-9示出了适于植入人类患者体内的用于治疗胃食管反流病的运动限制器件的可替换的形状。 [0102] FIG. 6A-D and 7-9 shows a body suitable for implantation in a human patient for the treatment of gastroesophageal reflux disease alternative motion limiting device shape.

[0103] 图10是植入了用于治疗胃食管反流病的运动限制器件的患者的整体图。 [0103] FIG. 10 is an overall view of the implant for the treatment of gastroesophageal reflux disease in patients with movement limiting device.

[0104] 图11-27是给用于治疗胃食管反流病的设备供能的各种方式的示意图。 [0104] FIG. 11-27 is for equipment for the treatment of gastroesophageal reflux disease, a schematic can supply a variety of ways.

[0105] 图28-34是给本发明的用于治疗胃食管反流病的设备进行液压或气动供能的各种方式的示意图。 [0105] FIG. 28-34 to the present invention is used to treat gastroesophageal reflux disease equipment for hydraulic or pneumatic schematic diagram of the energy in various ways.

[0106] 图35是示出了在植入用于治疗胃食管反流病的运动限制器件时仅行的步骤的流程图。 [0106] FIG. 35 is a flowchart illustrating a motion at the time of implantation for the treatment of gastroesophageal reflux disease restricted devices only rows of steps.

[0107] 图36-41示出了恢复患反流病的患者的贲门和胃底位置的方法。 [0107] Figure 36-41 shows the location reflux disease and gastric cardia patient way of restoring suffering.

[0108] 图42-46示出根据本发明的设备中包括的反流治疗器件的不同形状和特征。 [0108] FIG. 42-46 show different shapes and features reflux treatment device according to the apparatus of the present invention comprises a.

[0109] 图47a_d示出了根据本发明的设备中包括的排空后的可充盈反流治疗器件和用于将所述反流治疗器件放置在患者胃壁外侧的仪器。 [0109] FIG 47a_d shows reflux treatment device and for the reflux treatment device is placed on the outside of the patient's stomach filling device instrument according to the present invention may be included after emptying.

[0110] 图48a_i示出了将图47a的可充盈器件套叠到患者胃壁外侧的不同步骤。 [0110] FIG 48a_i shows the map can filling device 47a is nested to the outside of the stomach in patients with different steps.

[0111] 图49示出了反流治疗设备还适于治疗肥胖症的一个实施方案。 [0111] FIG. 49 illustrates the reflux treatment device is further adapted to one embodiment of the treatment of obesity.

[0112] 图50-51示出了反流治疗设备还适于治疗肥胖症的一个实施方案。 [0112] Figure 50-51 shows the reflux treatment device is further adapted to one embodiment of the treatment of obesity.

[0113] 图52a_h示出了将图47a的可充盈器件套叠到患者胃壁内侧的不同步骤。 [0113] FIG 52a_h shows the map can filling device 47a is nested inside of the patient to the different steps of the stomach wall.

[0114] 图53a_c示出了用于创建胃壁的套叠的仪器。 [0114] FIG 53a_c shows an instrument for creating the stomach of intussusception.

[0115] 图54-55示出了用于治疗反流病的腹部方法。 [0115] Figure 54-55 shows a method for the treatment of abdominal reflux disease.

具体实施方式 DETAILED DESCRIPTION

[0116] 图IA是描绘植入人类患者体内的根据本发明的用于治疗反流病的设备11的示意图,该设备11包括生物相容材料制成的运动限制器件10。 [0116] FIG IA is a schematic diagram depicting implanted in a human patient according to the invention for reflux disease treatment apparatus 11, 11 made of biocompatible material including motion restriction device 10 of the apparatus. 在图IA中,器件10套叠在胃底中。 In Fig. IA, the device 10 nested in the fundus. 器件10包括具有外表面15的主体13,外表面15适于在患者横膈膜18与被套叠的胃底壁16下部的至少一部分之间的位置上靠在胃底壁16的外壁16a的一部分上。 Device 10 includes a body having an outer surface 15 of the 13, the outer surface 15 against the gastric wall at a position suitable for at least part of the diaphragm 18 between the patient and the quilt stack of gastric wall 16 on the lower portion of the outer wall portion 16a 16 on. 因此,使用以此方式套叠的器件10,限制了患者胃的贲门切迹向患者横膈膜的运动,从而防止贲门穿过患者的横膈膜开口滑入病人的胸部20,并且维持了从患者腹部施加的顶住患者贲门括约肌的支撑压力。 Therefore, in this way telescopic device 10, limiting the patient's cardiac notch stomach the diaphragm motion to the patient, thereby preventing the cardia through the patient's diaphragm opening the patient's chest slide 20, and maintained from applied against the patient's abdomen in patients with cardiac sphincter pressure support.

[0117] 主体13是可充盈的,并且适于充入凝胶或流体。 [0117] Body 13 is filling, and adapted to the gel or fluid filled. 可以设置用于收纳流体以充盈所述运动限制器件的流体或凝胶收纳构件。 It may be provided for storing fluid filling the fluid motion limiting device or gel accommodating member. 可替换地,主体13包括均质材料并且为实心体。 Alternatively, the body 13 comprises a homogeneous material and a solid body. 可替换地,主体13包括形成一腔室的包围壁形式的外壁。 Alternatively, the body 13 includes an outer wall formed in the form of a wall surrounding the chamber. 外壁可以是刚性的、弹性的或者柔性的。 The outer wall may be rigid, elastic or flexible. 在外壁是刚性的情况下,其刚性的程度足以在承受胃运动所产生的力量时保持不变形。 In the case of the outer wall is rigid, which remain rigid enough to deform when subjected to forces generated by the movement of the stomach.

[0118] 运动限制器件10的主体13可以以多种不同的方式附到胃底16的壁16a上。 [0118] The motion restriction device 10 in the body 13 may be attached to a variety of different ways on the gastric wall 16a 16. 在图IA示出的实施方案中,器件10从胃的外侧套叠到胃底壁中。 In Fig. IA shows an embodiment, the device 10 from the outside of the stomach to the gastric wall intussusception. 在套叠之后,使用由多个胃_胃缝线或U形钉22a组成的第一固定器,以在短期内保持套叠的完整无损。 After nesting, is used by more than one stomach _ U stomach sutures or staples 22a consisting of a first holder to keep nested within a short period intact. 这使得人体组织能够生长以长期保持套叠完整无损。 This makes it possible to grow human tissue in order to maintain long-term nesting intact.

[0119] 可选地还可以存在由多个缝线或U形钉22b组成的第二固定器,这些缝线或U形钉被用在胃底16的壁16a与食管24的壁24a之间,以将器件10保持在患者横膈膜18与被套叠的胃底壁16a下部的至少一部分之间的所述位置处。 [0119] optionally also be present a plurality of U-shaped staples or sutures comprising a second holder 22b, the U-shaped staples or sutures are used between the walls 16 and 16a fundus wall 24a of the esophagus 24 to the device 10 in the diaphragm 18 patients with gastric wall quilt stack 16a at the lower portion of the position of at least a portion between. 因此,由该第二固定设备在该位置附着器件10。 Therefore, by the second fixing device attachment device 10 at that location. 可以设置器件10到横膈膜肌肉18或相关联的肌肉上的直接或间接的附着结构。 You can set the device 10 to the diaphragm muscle 18 is attached directly or indirectly associated with the structure of muscle on. 作为替换,可以设置器件10到食管的His角上的直接或间接的附着结构。 Alternatively, you can set 10 directly or indirectly attached to the structure of the esophagus His corner of the device. 可替换地或附加地,可以在胃底16的壁16a与横膈膜18之间设有缝线或U形钉22c形式的第三固定器,以将器件10保持在所述位置。 Alternatively or additionally, it is provided with a U-shaped staples or sutures 22c forms a third anchor fundus wall 16a between the diaphragm 18 and 16, to the device 10 held in the position.

[0120] 图IB示出了与图IA中所示基本类似的一个实施方案。 [0120] FIG. IB illustrates that shown in Figure IA substantially similar to one embodiment. 在图IB中,除附着结构22 之外,主体13和套叠结构通过在反流主体13与横膈膜18之间的缝线和/或U形钉22c固定,以将所述器件保持在贲门14之上的位置。 In Figure IB, in addition to attachment structure 22, 13 and telescopic structure by suture body 13 and the diaphragm 18 between the reflux body and / or U-shaped staples 22c fixed to the device is held in cardia position 14 above.

[0121] 图IC示出了与图IA中所示基本类似的另一个实施方案。 [0121] FIG IC shown in FIG. IA and FIG substantially similar to another embodiment. 在图IC中,反流治疗器件由连接胃底16的壁16a与胃底16的壁16a的胃-胃缝线或U形钉22a保持在适当的位置。 In FIG IC, a reflux treatment device 16 by a connecting wall 16a and gastric fundus wall 16a of the stomach 16 - U-shaped stomach sutures or staples 22a remain in place. 另外,所述反流治疗器件10由从胃底16a的壁16到食管壁24a上的缝线22b或U形钉以及由从胃底壁16a到横膈膜的缝线或U形钉保持在适当的位置。 In addition, the reflux treatment device 10 by a U-shaped staples or sutures 22b 16a from gastric wall 16 to 24a on the esophageal wall and held by the fundus to the diaphragm wall 16a of U-shaped sutures or staples in place.

[0122] 图2A中描绘了根据本发明的用于治疗反流病的设备17的一个替换性的实施方案。 [0122] FIG. 2A depicts a device for treatment of reflux disease according to the invention an alternative embodiment 17. 该实施方案在诸多方面类似于以上参考图IA-C所述的实施方案。 This embodiment is similar to the above embodiments described with reference to FIG. IA-C in many aspects. 因此,运动限制器件10被示为已植入人类患者体内并且套叠在胃底中。 Therefore, the motion restriction device 10 is shown as implanted in a human patient and nesting in gastric. 然而,在图2A所示的实施方案中,器件10从胃的内侧套叠,而不是像图IA-C那样从胃的外侧套叠。 However, in the embodiment shown in FIG. 2A, the device 10 telescopically from the inside of the stomach, rather than from the outside of the stomach as nesting image Figure IA-C. 运动限制器件10包括主体13, 主体13适于在患者横膈膜18与被套叠的胃底壁16下部的至少一部分之间的位置靠在胃底壁16的部分内壁上。 At least a part of the movement between the position limit device 10 includes a body 13, the body 13 is adapted to the diaphragm 18 in patients with gastric wall quilt stack 16 against the lower part of the upper part of the inner wall of the gastric wall 16. 在该实施方案中,主体13位于站立的人或哺乳动物患者的贲门区域14的上方。 In this embodiment, the top 13 or cardia region of the subject in the standing mammalian patient 14. 器件10的主体13被成形为靠在胃底16的壁16a上,并且进一步具有适于靠在该胃底壁上的外表面15。 The body 13 of the device 10 is shaped against the gastric wall 16a 16, and further having adapted to the gastric wall against the outer surface 15. 因此,使用以如上结合图IA所述的方式套叠的器件10,限制了患者胃的贲门切迹向患者横膈膜的运动,从而防止贲门穿过患者横膈膜开口而滑入患者胸部20,并且维持了从患者腹部施加的顶住患者贲门括约肌的支撑压力。 Therefore, as described above in conjunction with FIG. IA said device 10 nested manner, limiting the movement of the cardiac notch of the patient's stomach to the diaphragm of the patient, through the patient to prevent the cardia diaphragm slide opening the patient's chest 20 and maintain the patient from the patient's abdomen against the cardiac sphincter of support applied pressure.

[0123] 在套叠之后,从胃16的内侧应用包括第一固定器的多个胃-胃缝线或U形钉33a, 以在短期内保持套叠完整无缺。 [0123] After the overlay, the stomach from the inside applied 16 includes a plurality of first fixed the stomach - stomach sutures or U-shaped staples 33a, in order to maintain intussusception in the short term intact. 这使得人体组织能够生长以长期保持套叠完整无缺。 This makes it possible to grow human tissue in order to maintain long-term nesting intact. 包括第二固定器的附加的缝线或U形钉22b可以设置在形成器件10的一部分套叠的胃底16的壁部分16b与食管24的壁24a之间,以将器件10保持在所述位置。 Comprises a second holder attached sutures or U-shaped staples 22b may be provided between a part forming device 10 nested gastric wall portion 16b and the wall of the esophagus 24 24a 16 of the device 10 to remain in the Location. 类似地,缝线或U形钉22c形式的第三固定器可以设置在形成器件10的部分套叠的胃底16的另一壁部分16c与横膈膜18之间,以将器件10保持在所述位置。 Similarly, U-shaped staples or sutures 22c forms a third anchor portion may be provided between the nested portion of the other wall 16 of the gastric fundus 10 of the diaphragm 18 and 16c forming device, the device 10 to remain in the location.

[0124] 图2B示出了一个替换性的实施例。 [0124] FIG. 2B illustrates an alternative embodiment. 该实施例在诸多方面类似于参考图2A所描述的实施方案。 This embodiment is similar to the embodiment described with reference to FIG. 2A in many aspects. 然而,这里,缝线和U形钉22b和33a都连接至反流治疗器件10的固定器。 Here, however, U-shaped sutures and staples 22b and 33a are connected to the reflux treatment device 10 is fixed. 该实施方案中不存在胃-横膈膜的缝线或U形钉。 This embodiment does not exist in the stomach - diaphragm U sutures or staples.

30[0125] 图3A示出了用于治疗反流病的一个替换性的设备19。 30 [0125] FIG. 3A shows an alternative device 19 for the treatment of reflux disease. 该替换方案在诸多方面类似于以上参考图IA-C和图2A-B所描述的实施方案。 This alternative is similar to the above with reference to FIG. IA-C and Figures 2A-B embodiments described in many ways. 因此,运动限制器件10被示为已植入人类患者体内。 Therefore, the movement restriction device 10 is shown as implanted in a human patient. 器件10包括主体13,主体13适于在患者横膈膜18与胃底壁16之间的位置靠在胃底壁16的一部分上。 Device 10 includes a body 13, the body 13 is adapted to the position of the diaphragm 18 between the patient and the gastric wall 16 against the gastric wall portion 16. 然而,在该替换方案中,器件10没有套叠到胃16中。 However, in this alternative, the device 10 is not nested into the stomach 16. 作为代替,器件10的附着结构包括接触结构10a,优选是适于与胃底壁16a相接触的网状结构以促进人体组织的生长,从而保证所述反流病治疗器件能够长期接触胃壁放置。 Instead, the device attachment structure 10 comprises a contact structure 10a, the network structure is preferably adapted to contact with the gastric wall 16a to facilitate the growth of human tissue, thus ensuring the reflux disease treatment device to the stomach wall to place the long-term exposure. 在短期内,缝线或U形钉44a形式的第一固定器可以设置在接触结构IOa与胃底壁16a之间以将接触结构IOa保持在适当的位置。 In the short term, sutures or staples 44a in the form of U-shaped first holder may be disposed between the contact structure IOa and gastric wall 16a to the contact structure IOa to keep in place.

[0126] 接触结构IOa可以适用于缝线或U形钉44b形式的第二固定器,这些缝线或U形钉44b设置在胃底16的壁16a与食管24的壁24a之间,以将器件10保持在患者横膈膜18 与胃底壁16之间的所述位置。 [0126] IOa contact structure can be applied to sutures or staples 44b in the form of U-shaped second holder, these sutures or staples U 44b is provided between the wall 16a and esophageal and gastric wall 24a 24 16, to the device 10 is held at the position of the diaphragm 18 patients with gastric wall 16 between. 类似地,接触结构IOa还可以适用于缝线或U形钉44c形式的第三固定器,这些缝线或U形钉44c设置在胃底16的壁16a与横膈膜之间,以将器件10 保持在所述位置。 Similarly, the contact structure IOa also be applied to sutures or staples 44c in the form of U-shaped third holder, the U-shaped staples or sutures 44c disposed between the fundus wall 16a and the diaphragm 16 to the device 10 held in the position.

[0127] 图3B示出了一个替换性的实施方案。 [0127] FIG. 3B illustrates an alternative embodiment. 该实施方案在诸多方面类似于参考图3A描述的实施方案。 This embodiment is similar to embodiments described with reference to FIG. 3A in many aspects. 在该实施方案中,反流治疗器件10如图2A-B那样从胃的内侧被套叠。 In this embodiment, the reflux treatment device 10 as shown in Figure 2A-B invaginated from the inside of the stomach. 接触结构IOa位于胃底16的壁16a上在反流治疗器件10所产生的套叠之上并围绕着所述套叠。 IOa contact structure located on the telescopic reflux treatment device 10 generates and around the nesting on the gastric wall 16a 16.

[0128] 图4A中描绘了根据本发明的用于治疗反流病的设备21的一个替换性的实施方案。 [0128] FIG. 4A depicts a device for treatment of reflux disease according to the invention an alternative embodiment 21. 该实施例在诸多方面类似于以上参考图IA-C描述的实施方案。 This embodiment is similar to the above with reference to FIG. IA-C the embodiments described in many ways. 在图4A中示出了已植入人类患者体内的根据本发明的用于治疗反流病的器件10的视图。 In Figure 4A shows have been implanted in human patients view treatment of reflux disease, according to the present invention, the device 10. 在图4A中,运动限制器件10同样套叠在胃底16中。 In Figure 4A, the motion restriction device 10 is also nested in the fundus 16. 器件10包括具有外表面15的主体13,外表面15适于在患者横膈膜18与被套叠的胃底壁16下部的至少一部分之间的位置靠在胃底壁16的外壁16a 的一部分上。 Device 10 includes a body having an outer surface 15 of the 13, the outer surface 15 adapted to position at least a portion of the diaphragm 18 patients between the gastric wall and invaginated against the gastric wall 16 on the lower portion of the outer wall portion 16a 16 . 主体13被成形为靠在胃底16的外壁16a上。 Body 13 is shaped against the outer wall 16a 16 of the fundus. 因此,使用以此方式套叠的器件10,限制了患者胃的贲门切迹向患者横膈膜的运动,从而防止贲门穿过患者的横膈膜开口滑入患者的胸部20,并且维持了从患者腹部施加的顶住患者贲门括约肌的支撑压力。 Therefore, in this way telescopic device 10, limiting the patient's cardiac notch stomach the diaphragm motion to the patient, thereby preventing the cardia through the patient's diaphragm opening the patient's chest slide 20, and maintained from applied against the patient's abdomen in patients with cardiac sphincter pressure support.

[0129] 在图4A的实施方案中,如图IA的实施方案中一样,在器件10套叠到胃底16中之后,应用由多个胃-胃缝线或U形钉22a组成的第一固定器,以在短期内保持套叠的完整无损。 [0129] In the embodiment of FIG. 4A, in the embodiment, as shown in Figure IA, after the device 10 nested into the fundus 16, the application by a number of stomach - stomach sutures or staples 22a consisting of U-shaped first holder, in order to maintain the integrity nested in the short term destructive. 设置由多个缝线或U形钉22b组成的第二固定器,以将器件10保持在患者横膈膜18 与被套叠的胃底壁16下部的至少一部分之间的所述位置中。 Set by a plurality of U-shaped sutures or staples consisting of second holder 22b to the position between at least a portion of the device 10 in the diaphragm 18 patients with gastric wall quilt stack 16 in the lower part. 另外,缝线或U形钉22c形式的第三固定器同样可以设在胃底16的壁16a与横膈膜18之间,以将器件10保持在所述位置。 Additionally, sutures or staples 22c in the form of a U-shaped third holder can also be provided between the diaphragm and the fundus wall 16a 18 16, to the device 10 held in the position.

[0130] 在图4A描绘的实施方案中,运动限制器件10的尺寸可以在植入时进行调节。 [0130] In the embodiment depicted in Fig. 4A, motion limiting the size of the device 10 may be adjusted at the time of implantation. 器件10伴有一个通过引线52b与器件10相连的液压储存器52,因而可以通过手动按压液压储存器52进行无创的调节。 Device 10 with a lead 52b by the device 10 is connected to a hydraulic reservoir 52, which can be adjusted noninvasive hydraulic reservoir 52 is pressed by hand. 器件10另一方面连接至一个或多个较小的腔室10b。 On the other hand the device 10 is connected to one or more smaller chambers 10b.

[0131] 此外,以上实施方案可替换地还用于治疗肥胖症。 [0131] In addition, the above embodiments may alternatively be also used for the treatment of obesity. 在该实施方案中,该设备可以适于使用运动限制主体13的容积容纳流体,并进一步使用通过泵与主体13相连的、待填充流体的一个或多个较小腔室IOb来拉伸胃底壁以产生饱胀感,从而治疗肥胖症。 In this embodiment, the apparatus may be adapted to use the motion limiting body 13 accommodating a volume of fluid, and further use by the pump 13 is connected to the main body, to be filled with fluid to one or more smaller chambers IOb stretched fundus wall to create a sense of fullness, thereby treating obesity. 小腔室IOb还适于被套叠到胃底壁中,并且在填充流体时会发生膨胀,导致人体传感器反馈产生饱胀感。 Also suitable for small chamber IOb invaginated into gastric wall, and when the fluid-filled expansion occur, causes the body to produce a sense of fullness sensor feedback. 通过在患者皮下放置小型液压储存器/泵,患者能够在需要时泵送液压流体填充小腔室以产生饱胀感。 By placing small hydraulic reservoir in the skin of patients / pump, capable of pumping hydraulic fluid in patients with small chamber filled when you need to generate a sense of fullness.

[0132] 图4B示出了一个替换性的实施方案。 [0132] Figure 4B shows an alternative embodiment. 该实施方案基本上类似于图4A所示的实施方案,不同之处在于如何控制反流治疗器件10和腔室10b。 This embodiment is substantially similar to the embodiment shown in Fig. 4A, the difference lies in how to control the reflux treatment device 10 and the chamber 10b. 这里,腔室IOb不由皮下的泵控制,而是由启动的内部控制单元56控制。 Here, the chamber IOb help subcutaneous pump control, the control unit 56 but is controlled by the internal start. 内部控制单元56包括供患者控制器件10如何被使用以治疗反流和/或肥胖症的装置。 Internal control unit 56 includes a control device for a patient 10 how it is used in a device for treatment of reflux and / or obesity. 其还可以包括给所述器件供能的装置。 It may also include means for energy supply of the device.

[0133] 内部控制单元56可以包括电池70、电子开关72、马达/泵44、储存器52、注入口1001。 [0133] The internal control unit 56 may include a battery 70, an electronic switch 72, the motor / pump 44, reservoir 52, injection port 1001. 具有遥控的能量传输器34适用于对器件进行控制和供能。 Energy transmission device 34 having a remote control device suitable for controlling and energizing. 这些东西依赖于实际情形选择,例如所述器件是电操作、液压操作、气动操作或机械操作的。 These things depend on the actual situation selection, e.g., the device is electrically operated, hydraulically operated, pneumatically operated, or mechanically operated.

[0134] 控制单元可以接受来自任意传感器76、尤其是压力传感器的输入。 [0134] The control unit can accept 76, especially the input pressure sensor from any sensor. 可以提供任意类型的传感器。 We can provide any type of sensor. 内部控制单元56优选包括FPGA或MCU或ASIC或任意其它电路、组件或存储器形式的智能(对于更广义的描述,参见以下的“系统”项下)。 Internal control unit 56 preferably includes a FPGA or ASIC or MCU or any other circuit, or a memory in the form of intelligent components (for more general description, see below "system" under).

[0135] 图4C示出了与图4A本质上相同的实施方案,不同之处在于,用一个小腔室IOb代替了图4A的两个小腔室。 [0135] Figure 4C shows the same embodiment of FIGS. 4A essentially, except that, with a small chamber IOb instead of two small chambers Fig. 4A. 图4C示出了排空状态的小腔室10b,而图4D示出了已被填充并扩大到产生饱胀感时的小腔室10b。 Small chamber 4C shows a state of emptying 10b, and Figure 4D shows have been filled and expanded to a small chamber 10b generate a sense of fullness when.

[0136] 图5A中描绘了根据本发明的用于治疗反流病的设备23的又一替换性的实施方案。 [0136] Figure 5A depicts a device for treatment of reflux disease of the present invention, according to yet another alternative embodiment 23. 该实施方案同样在诸多方面类似于以上参考图IA-C描述的实施方案。 This embodiment is also similar to the embodiment of the above described with reference to FIG. IA-C in many aspects. 因此,如图IA 的实施方案所示,套叠在胃底中的运动限制器件10由具有外表面15的主体13组成,外表面15适于在患者横膈膜18与被套叠的胃底壁16下部的至少一部分之间的位置靠在胃底壁16的外壁16a的一部分上。 Thus, the embodiment shown in FIG. IA, nested in the fundus of the motion restriction device 10 by the main body having an outer surface 15 of the composition 13, the outer surface 15 of the diaphragm 18 is adapted to the patient's gastric wall and invaginated position at least a portion 16 between the upper part of the lower portion of the gastric wall against the outer wall 16a 16's. 器件10的主体13被成形为靠在胃底16的外壁16a上,并且具有适于靠在该胃底壁上的大致光滑的外表面15。 The body 13 of the device 10 is shaped against the outer wall 16a 16 gastric and adapted against the gastric wall having a substantially smooth outer surface 15. 同样,在将器件10套叠在胃底16中之后,应用由多个胃-胃缝线或U形钉22a的第一固定器,以在短期内保持套叠完整无损。 Similarly, after the device 10 nested in the fundus 16, the application by a number of stomach - stomach sutures or U-shaped staple 22a of the first holder to keep intussusception in the short term intact. 用设于胃底16的壁16a与食管24的壁24a之间并由多个缝线或U形钉22b构成的第一固定器将器件10保持在所述位置。 The first fixture between the walls 16a and 24a of esophageal wall 24 by a plurality of U-shaped sutures or staples 22b constituted with 16 located in the fundus the device 10 is held at the position.

[0137] 在图5A的一个替换性的实施方案中,设备23进一步包括刺激器26,用于发出适于刺激贲门肌肉的刺激脉冲以进一步闭合贲门从而进一步防止反流病。 [0137] In view of an alternative embodiment. 5A, the device 23 further comprises a stimulator 26, adapted for emitting stimulation pulses to stimulate the cardiac muscle of the cardia further closed thereby further preventing reflux disease. 设备23包括至少一个导体26a和适于接收所述刺激脉冲的至少一个电极26b。 Device 23 comprises at least one conductor 26a and is adapted to receive the at least one electrode stimulation pulses 26b.

[0138] 刺激器26优选包括电子电路和能源,在优选实施方案中设于器件10中。 [0138] stimulator 26 preferably includes an electronic circuit and energy, in a preferred embodiment is provided in the device 10.

[0139] 刺激器26优选发送脉冲串形式的刺激脉冲,其中所述脉冲串适于被重复,脉冲串之间具有一时间间隔,所述间隔延长在脉冲串中的各个脉冲之间的间隔。 [0139] stimulator 26 preferably transmits bursts of stimulation pulses, the interval of the pulse train is adapted to be repeated, with a time interval between bursts, the burst interval to extend in between respective pulses therein.

[0140] 图5B示出了与图5A本质上相同的实施方案,增加了内部控制单元56、遥控28和外部能量传输器34。 [0140] FIG. 5B shows the same embodiment of Figure 5A in essence, an increase of the internal control unit 56, remote control 28 and the external energy transmission device 34. 内部控制单元56使用供能引线56b连接至所述刺激器。 Internal control unit 56 can use for lead 56b is connected to the stimulator. 内部控制单元57可以包括电池70和电子开关72以及以下在“系统”项下描述的其它组件。 Internal control unit 57 may include a battery 70 and an electronic switch 72 and the following other components in the "System" item description.

[0141] 根据本发明的一个实施方案,反流病治疗器件10可以形成大致为卵形的主体,如图6A所示。 [0141] In accordance with one embodiment of the invention, the reflux disease treatment device 10 may be formed substantially oval body, shown in Figure 6A. 根据本发明的另一个实施方案,反流病治疗器件10也可以形成为中间缩进的卵形或球形体,如图6B所示。 According to another embodiment of the present invention, the reflux disease treatment device 10 may be formed as an intermediate indented oval or spherical bodies, shown in Figure 6B. 根据本发明的再一个实施方案,反流病治疗器件10可以进一步形成为稍微弯曲的卵形体,如图6C所示。 According to a further embodiment of the present invention, reflux disease treatment device 10 may further be formed as a slightly curved ovoid, shown in Figure 6C.

[0142] 根据本发明的另一个的实施方案,反流病治疗器件10可以形成大致为球形的主体,如图6D所示。 [0142] In accordance with another embodiment of the present invention, reflux disease treatment device 10 may be formed of a substantially spherical body, shown in Figure 6D.

[0143] 如上所述,反流治疗器件10被固定在站立的患者的食管之上的位置。 [0143] As noted above, 10 is fixed on the standing position of the patient's esophagus reflux treatment device. 为此,图7中所示的反流治疗的一个实施方案包括可以例如用作缝线或U形钉的连接点的固定器10d。 To this end, an embodiment of the reflux treatment shown in FIG. 7 includes a fixator 10d may for example be used as sutures or staples U-shaped connection point. 该固定器可以是有孔洞或没有孔洞的环形或脊形,或者具有使其适于固定反流治疗器件10 的任意其它形状。 The holder may have holes or no holes or annular ridge, or have other shapes to make it suitable for any fixed reflux treatment device 10.

[0144] 图8示出了反流治疗器件10的一个实施例,其中反流治疗器件10通过液压装置可调整,并且IOe是可以注入液压流体以使器件膨胀的注入口。 [0144] FIG. 8 shows a reflux treatment device 10 of embodiment in which the reflux treatment device 10 can be adjusted by a hydraulic device, and IOe hydraulic fluid is injected into the inlet device to enable expansion. 可替换地,在一个实施方案中,反流治疗器件10可以在手术过程中从小尺寸膨胀到较大的尺寸,其优点在于,例如在腹腔镜过程中该器件最初是小尺寸。 Alternatively, in one embodiment, the reflux treatment device 10 may be expanded in size from small surgical procedure to a larger size, it has the advantage that, for example, in the device during laparoscopic initially small size. 在这样的实施方案中,任意填充材料、固体、液体或气体都可以通过注入口IOe注入,以反流治疗器件10达到其最终形状。 In such an embodiment, any filler material, a solid, liquid or gas can be injected through the injection port IOe to reflux treatment device 10 has reached its final shape.

[0145] 图9示出了一个实施方案,其中反流治疗器件具有适于使用外科手术工具夹持的凹陷脊10f。 [0145] Figure 9 illustrates an embodiment in which reflux treatment device adapted for use with a surgical tool holder recess ridges 10f. 凹陷脊IOf例如在植入所述反流治疗器件时用于外科手术过程中。 Depression ridge IOf example, when the reflux treatment device implanted for the surgical procedure.

[0146] 当反流病治疗器件10大致为球形时,由此其可以被制作为完全或部分包围食管, 反流病治疗器件10的内径D优选可以包围食管和至少一部分胃底,从而使该器件在植入时不会直接靠在食管壁上。 [0146] When the reflux disease treatment device 10 is roughly spherical shape, whereby it can be made fully or partially surrounded esophagus, reflux disease treatment device 10 is preferably an inner diameter D may enclose at least a portion of the esophagus and gastric fundus, so that the When the device is not implanted directly against the wall of the esophagus.

[0147] 运动限制器件10可以为任意的形式,只要其能够使器件10位于限制患者胃的贲门切迹向患者横膈膜的运动的位置,从而防止贲门穿过患者横膈膜开口滑入患者胸部20, 并且维持了从患者腹部施加的顶住患者贲门括约肌的支撑压力。 [0147] motion limiting device 10 may be any form as long as it enables the device 10 is located in the stomach in patients with cardiac notch restrictions to the movement of the diaphragm position of the patient, thereby preventing cardiac patients through the patient diaphragm opening slide chest 20, and maintain the patient from the patient's abdomen against the cardiac sphincter of support applied pressure.

[0148] [0148]

[0149] 现在将参照图10-27描述合并到根据本发明的设备中的能量和操作系统,其一般表示为28。 [0149] will now be described with reference to FIG. 10-27 incorporated into the device according to the present invention, energy and operating system, which is generally indicated as 28.

[0150] 图10中所示的系统28包括植入的能量转换器30形式的内部能源,其适于通过供能线32给反流病治疗设备的耗能组件供应能量。 The system shown in [0150] 10 28 including 30 in the form of an implanted energy converter internal energy, which is adapted to 32 to reflux disease treatment equipment energy component supply energy through energy supply lines. 外部能量传输器34包括发射无线信号的无线遥控,所述无线信号由可以合并到所述植入的能量转换器30中的或独立的信号接收器接收。 The external energy transmission device 34 includes a wireless remote control transmitting a wireless signal, the wireless signal may be incorporated into the implant by a power converter 30 or a separate receiver for receiving a signal. 植入的能量转换器30将来自信号的能量转换为通过供能线32供应的电能。 Implanted energy converter 30 converts the energy from the power signal to line 32 by energizing supply.

[0151] 图10的系统28在图11中被示为更一般化的框图,其中一般用竖线示出的患者皮肤36将该线右侧的患者内部29与该线左侧的外部隔开。 [0151] The system 28 of FIG. 10 is shown in FIG. 11 is a block diagram of a more generalized, wherein the inner skin of the patient generally use the patient shows a vertical line on the right side of the 36 and 29 spaced from the outside of the left side of the line .

[0152] 图11示出简化的框图,其示出了运动限制器件10、通过供能线32给器件10供能的能量转换器30以及外部能量传输器34。 [0152] Figure 11 shows a simplified block diagram illustrating a motion restriction device 10 through supply line 32 to the device 10 can be energized power converter 30, and the external energy transmission device 34.

[0153] 图12示出了与图11相同的本发明的一个实施方案,不同之处在于,电子开关38 形式的反转器也植入患者29体内以使器件10反转,所述电子开关38可由极化能操作。 [0153] FIG. 12 and FIG. 11 shows an embodiment of the same invention, except that, the electronic switch 38 in the form of inverter 29 is also implanted in the body of a patient so that the reversing device 10, the electronic switch 38 can be operated by polarization. 外部能量传输器34的无线遥控发射承载了极化能的无线信号,并且植入的能量转换器30将无线极化能转换为用于操作电子开关38的极化电流。 The external energy transmission device 34 of the wireless remote control transmitting a wireless signal carries polarized energy and the implanted energy transforming device 30 to the wireless polarized energy into a current for operating the electronic switch 38 is polarized. 当电流的极性由植入的能量转换器30切换时,电子开关38反转器件10所执行的功能。 When the polarity of the current 30 is switched from the implanted energy converter, the function performed by an electronic switch 38 reverse device 10.

[0154] 图13示出了与图11相同的本发明的一个实施方案,不同之处在于,在植入的能量转换器30与器件10之间设置植入患者体内的用于调节反流病治疗器件10的操作器40。 [0154] FIG. 13 and FIG. 11 illustrates an embodiment of the same invention, except that between the implanted energy converter 30 and the device implanted in a patient 10 is provided for adjusting reflux disease treatment device operation 10 40. 该操作器可以采用马达40的形式,例如伺服马达的形式。 The operator motor 40 may take the form, for example in the form of a servo motor. 当外部能量传输器34的遥控向植入的能量转换器30的接收器发射无线信号时,马达40由来自植入的能量转换器30的能 When the external energy transmission device 34 implanted remote to the energy converter of the receiver 30 transmit a radio signal, the motor 40 by the energy from the implanted energy converter 30

量供能。 The amount for energy.

[0155] 图14示出了与图11相同的本发明的一个实施方案,不同之处在于,它还包括组合件42形式的马达操作器,所述组合件包括马达/泵氮源78和流体储存器46,并被植入患者体内。 [0155] FIG. 14 and FIG. 11 shows an embodiment of the same invention, except that it further comprises a motor assembly 42 in the form of operator, the assembly comprises a motor / pump 78 and fluid nitrogen the reservoir 46, and is implanted in the patient. 在这种情况下,器件10以液压方式操作,即液压流体由马达/泵单元44从流体储存器46通过管道48泵送到器件10以操作器件10,并且液压流体由马达/泵单元44从器件10泵送回流体储存器46以将器件10返回到启动位置。 In this case, the device 10 is a hydraulic manner, i.e., the hydraulic fluid from the motor / pump unit 44 from the fluid reservoir 46 through a conduit 48 to a pump device 10 to operate the device 10, and the hydraulic fluid by the motor / pump unit 44 from device 10 pumped back into the fluid reservoir 46 to the device 10 returns to the starting position. 植入的能量转换器30将无线能量转换为电流,例如极化电流,以通过输电线50给马达/泵单元44供能。 30 implanted energy transforming wireless energy into a current, such as polarization current, through power lines 50 to the motor / pump unit 44 energized.

[0156] 代替以液压方式操作的运动限制器件10,还可以设想所述操作器包括气动操作器。 [0156] instead of motion limiting device 10 is hydraulically operated, it is contemplated that the operation also includes a pneumatic operator. 在这种情况下,加压的空气可以用于进行调节,流体储存器由空气腔替换,并且流体由空气替换。 In this case, the pressurized air can be used to adjust the fluid reservoir is replaced by an air chamber, and the fluid is replaced by air.

[0157] 在所有这些实施方案中,能量转换器30可以包括由无线能量充能的可重复充能式储能器,如电池或电容器,并且为设备中的任意耗能部件提供能量。 [0157] In all of these embodiments, the energy converter 30 by the wireless energy may comprise a reusable Charge Charge accumulators, such as a battery or capacitor, and provide energy for any energy consuming device member.

[0158] 外部能量传输器34优选是无线的,并且可以包括用于从人体外部控制器件10的受遥控的控制器。 [0158] the external energy transmission device 34 preferably is wireless, and may include a body from an external control device 10 by a remote controller.

[0159] 这种控制器可以包括无线遥控,以及任意植入部件的手动控制,在大部分情况下患者的手可能是非直接地与所述手动控制接触,这样的手动控制例如置于皮肤之下用于按压的按钮。 [0159] The controller may include a wireless remote control, and manual control any part of the implant, in most cases the patient's hand may be non-directly under the skin and the manual control of exposure, such as manual controls such as place pressing the button.

[0160] 图15示出了本发明的一个实施方案,包括具有其无线遥控的外部能量传输器34、 在该例子中以液压方式操作的器件10和植入的能量转换器30,并且进一步包括液压流体储存器52、马达/泵单元44和液压阀转换器54形式的反转器,所有这些器件都植入患者体内。 [0160] FIG. 15 illustrates an embodiment of the present invention, which comprises a wireless remote control of the external energy transmission device 34, in this case hydraulically operated device 10 and the implanted energy converter 30, and further comprising the hydraulic fluid reservoir 52, the motor / pump unit 44 and the hydraulic valve form converter 54 is inverted, all of these devices are implanted in the patient. 当然,液压操作可以仅通过改变泵送方向而容易地进行,因此液压阀可以省略。 Of course, hydraulically operated only by changing the pumping direction can be easily performed, the hydraulic valve may therefore be omitted. 遥控可以是独立于所述外部能量传输器或包括在所述外部能量传输器中的器件。 Remote control can be independent of the external energy transmission device or included in the external energy transmission device is in. 马达/泵单元44 的马达是电动机。 The motor / pump unit 44 of the motor is an electric motor. 响应于来自外部能量传输器34的无线遥控的控制信号,植入的能量转换器30使用来自控制信号所承载的能量的能量给马达/泵单元44供能,由此马达/泵单元44在液压流体储存器52与器件10之间分配液压流体。 In response to a control signal from the external energy transmission device 34 of the wireless remote control, the implanted energy converter 30 using energy from the energy carried by the control signal to the motor / pump unit 44 for energy, thus the motor / pump unit 44 in the hydraulic distribution of hydraulic fluid between the fluid reservoir 52 and 10 devices. 外部能量传输器34的遥控控制液压阀转换器54在以下两个方向之间转换液压流体的流动方向,在一个方向上所述流体由马达/泵单元44从液压流体储存器52泵送到器件10以操作器件10,在另一个反方向上所述流体由马达/泵单元44从器件10泵送回液压流体储存器以使器件10返回到启动位置。 Remote external energy transmission device 34 of the hydraulic control valve between the converter 54 to convert the flow direction of the two directions of the hydraulic fluid, the fluid in one direction by the motor / pump unit 44 from the hydraulic pump 52 to the fluid reservoir device 10 to operate the device 10, in the opposite direction of the other fluid by the motor / pump unit 44 from the device 10 is pumped back to the hydraulic fluid reservoir to the device 10 returns to the starting position.

[0161] 图16示出了与图15相同的本发明的一个实施方案,不同之处在于,还将受外部能量传输器34的无线遥控控制的内部控制单元56、储能器58和电容器60植入患者体内。 [0161] FIG. 16 and FIG. 15 illustrates an embodiment of the same invention, except that, will be subject to internal wireless remote control unit 34 of the external energy transmission control 56, the accumulator 58 and a capacitor 60 implanted in the patient. 内部控制单元56将从植入的能量转换器30接收的电能存储在向器件10供能的储能器58 中。 In the device 10 to the energizing of the accumulator 58 from the internal control unit 56 the implanted energy converter 30 receives electrical energy storage. 响应于来自外部能量传输器34的无线遥控的控制信号,内部控制单元56或从储能器58释放电能并通过供能线62和64转换所释放的电能,或通过供能线66、使电流稳定的电容器60、供能线68和供能线64直接转换来自植入的能量转换器30的电能,用于器件10的操作。 In response to the energy transfer from an external wireless remote control of the control signal 34, the internal control unit 56 or the release of energy from the accumulator 58 through lines 62 and 64 supply energy to release electric energy conversion or energy supply through line 66, a current stable capacitor 60, the energizing power line 68 and line power supply converter 64 can be directly converted from the implant 30, for operating the device 10.

[0162] 内部控制单元优选是从患者身体外部可编程的。 [0162] Preferably the internal control unit is programmable from outside the patient's body. 在一个优选的实施方案中,内部控制单元被编程为对器件10进行调节以根据预编程的时间表或者根据来自用于检测患者的任意可能的生理参数或器件的任意功能性参数的任意传感器的输入来拉伸胃。 In a preferred embodiment, the internal control unit is programmed for the device 10 to be adjusted according to a preprogrammed schedule or according to any function from any parameter for detecting a physiological parameter of a patient may be any device or sensor Enter to stretch the stomach.

[0163] 根据一个替换方案,图16的实施方案中的电容器60可以省略。 [0163] According to one alternative, the embodiment of FIG. 16 of the capacitor 60 can be omitted. 根据另一个替换方案,该实施方案中的储能器可以省略。 According to another alternative, the embodiment of energy storage may be omitted.

[0164] 图17示出了与图10相同的本发明的一个实施方案,不同之处在于,还将用于为器件10的操作供能的电池70和用于切换器件10的操作的电子开关72植入患者体内。 [0164] FIG. 17 and FIG. 10 shows an embodiment of the same invention, except that, the operation will be used for the operation of electronic switches 10 energizing device 70 and a battery 10 for switching devices 72 implanted in the patient. 电子开关72用植入的能量转换器30所供应的能量来操作,以从不使用电池70的关闭模式切换到电池70提供能量用于操作器件10的开启模式。 Energy of an implanted electronic switch 72 with the energy converter 30 are supplied to the operation, in order to never use the shutdown mode battery 70 is switched to the battery 70 to provide power for the operation of the device 10 on mode.

[0165] 图18示出了与图16相同的本发明的一个实施方案,不同之处在于,还将可由外部能量传输器34的无线遥控进行控制的内部控制单元56植入患者体内。 [0165] FIG. 18 and FIG. 16 illustrates an embodiment of the same invention, except that, also by an external energy transmission device 34 of the wireless remote control unit controls the internal 56 implanted in the patient. 在这种情况下,电子开关72用植入的能量转换器30所供应的能量来操作,以从阻止所述无线遥控对内部控制单元56进行控制并且不使用电池的关闭模式,切换到允许所述遥控对内部控制单元56 进行控制以从电池70释放电能用于操作器件10的待机模式。 In this case, the energy of the electron switch 72 with the implanted energy supply converter 30 to operate, in order to prevent the wireless remote control from the control unit 56 of the internal control and do not use the battery off mode, switch to allow the said remote control unit 56 of the internal controls to release energy from the battery 70 for the operation of the device in standby mode 10.

[0166] 图19示出了与图17相同的本发明的一个实施方案,不同之处在于,用储能器58 代替电池70并且植入的组件以不同方式互连。 [0166] FIG. 19 and FIG. 17 illustrates an embodiment of the same invention, except that, in different ways for the interconnection of the accumulator 58 instead of the battery 70 and the implanted components. 在这种情况下,储能器58存储来自植入的能量转换器30的能量。 In this case, the accumulator 58 stores energy from the implanted energy converter 30. 响应于来自外部能量传输器34的无线遥控的控制信号,内部控制单元56控制电子开关72从不使用储能器58的关闭模式切换到储能器58提供用于操作器件10的能量的开启模式。 In response to the energy transfer from an external wireless remote control of the control signal 34, the control unit 56 controls an internal electronic switch 72 is never closed using the accumulator 58 the accumulator 58 to the mode switch to provide energy for the operation of the device 10 of the opening pattern .

[0167] 图20示出了与图18相同的本发明的一个实施方案,不同之处在于,储能器70也植入患者体内并且植入的组件以不同方式互连。 [0167] FIG. 20 and FIG. 18 shows an embodiment of the same invention, except that, the accumulator 70 is also implanted in the patient and the implanted components interconnected in different ways. 响应于来自外部能量传输器34的无线遥控的控制信号,内部控制单元56控制储能器58传递用于操作电子开关72的能量,以从不使用电池70的关闭模式切换到电池70供应用于操作器件10的电能的开启模式。 In response to the energy transfer from an external wireless remote control of the control signal 34, the internal control unit 56 controls the accumulator 58 to transfer energy for operating the electronic switches 72, 70 to never use the battery off mode switches to battery supply 70 for Operation of the device 10 is turned on power mode.

[0168] 可替换地,电子开关72可以用储能器58所供应的能量操作,以从阻止所述无线遥控对电池70进行控制以供应电能并且所述遥控并未使用的关闭模式,切换到允许所述无线遥控对电池70进行控制以提供用于操作器件10的电能的待机模式。 [0168] Alternatively, the electronic switch 72 can be operated by the energy supplied by the accumulator 58 to prevent from the wireless remote control of the battery 70 to supply electric power and does not use off the remote control mode is switched to allowing the wireless remote control of the battery 70 is controlled to provide a standby mode for power operation of the device 10 is.

[0169] 应当理解,所述开关应当以其最广义的实施方案来解释。 [0169] It should be understood that the switch should be in its broadest embodiment explained. 这意味着,FPGA或DA转换器或任意其它电子组件或电路都可以通电和断电,优选地从患者身体外部或者由内部控制单元进行控制。 This means, FPGA or DA converter, or any other electronic components or circuits can be on and off, preferably from outside the patient's body or is controlled by the internal control unit.

[0170] 图21示出了与图17相同的本发明的一个实施方案,不同之处在于,还将马达40、 齿轮箱74形式的机械反转器以及用于控制齿轮箱74的内部控制单元56植入患者体内。 [0170] FIG. 21 and FIG. 17 illustrates an embodiment of the same invention, except that, it will be the motor 40, the gear box 74 in the form of a mechanical inverter, and a control unit for controlling the internal gear box 74 56 implanted in the patient. 内部控制单元56控制齿轮箱74,以反转器件10所执行的功能(以机械方式操作)。 Internal control unit 56 controls the gearbox 74 to reverse the function performed by the device 10 (mechanically operated). 甚至更简单的是以电的方式切换马达的方向。 Even easier way is to switch the direction of electric motor.

[0171] 图22示出了与图20相同的本发明的一个实施方案,其特征在于,植入的组件以不同方式互连。 [0171] FIG. 22 and FIG. 20 shows an embodiment of the same invention, it is characterized in that the implant components interconnected in different ways. 因此,在这种情况下,当储能器58 (合适的是电容器)启动电子开关72切换到开启模式时,内部控制单元56由电池70供电。 Therefore, in this case, when the accumulator 58 (suitable capacitors) start electronic switch 72 is switched to the open mode, the internal control unit 56 is powered by a battery 70. 当电子开关72处于其开启模式时,允许内部控制单元56控制电池70,以提供或不提供用于操作器件10的能量。 When the electronic switch 72 is in its open mode, allowing the internal control unit 56 controls the battery 70 to provide or energy for the operation of the device 10 is not provided.

[0172] 图23示意性地示出了用于实现各种通信选择的设备中植入组件的可以想出的组合。 [0172] FIG. 23 schematically shows a combination can come up with a device implanted components for achieving various communication choices. 基本地有器件10、内部控制单元56、马达或泵单元44和包括外部无线遥控的外部能量传输器34。 Basically there are devices 10, the internal control unit 56, the motor or pump unit 44 and includes an external wireless remote control of the external energy transmission device 34. 如以上所述,所述无线遥控发射控制信号,由内部控制单元56接收该控制信号并接下来控制所述设备的各种植入组件。 As described above, the wireless remote control transmitting a control signal, receives the control signal generated by the control unit 56 controls the apparatus and the following various implant components.

[0173] 反馈器件优选是传感器76的形式,可以植入患者,用于检测患者的生理参数,例如用于表示患者正在进食的食管收缩波。 [0173] The feedback device is preferably in the form of sensor 76 can be implanted in a patient for detecting a physiological parameter of a patient, e.g., for indicating that the patient is eating esophageal contraction wave. 内部控制单元56,或者可替换地,外部能量传输器34的外部无线遥控,可以响应于来自传感器76的信号来控制器件10。 Internal control unit 56, or alternatively, the external energy transmission device 34 of the external wireless remote control, in response to a signal from the sensor 76 to the control device 10. 收发器可以与传感器76合并,用于向外部无线遥控发送关于所检测的生理参数的信息。 Transceivers may be combined with the sensor 76 for sending information on the sensed physiological parameter to the external wireless remote control. 无线遥控可以包括信号发射器或收发器,并且内部控制单元56可以包括信号接收器或收发器。 Wireless remote control may comprise a signal transmitter or transceiver and the internal control unit 56 may comprise a signal receiver or transceiver. 可替换地,无线遥控可以包括信号接收器或收发器,并且内部控制单元56可以包括信号发射器或收发器。 Alternatively, the wireless remote control may comprise a signal receiver or transceiver and the internal control unit 56 may comprise a signal transmitter or transceiver. 上述收发器、发射器和接收器可以用于从患者身体内部向其外部发送与器件10相关的信息或数据。 Said transceiver, transmitter and receiver can be used from inside the patient's body to its external transmitter 10 associated with the device information or data.

[0174] 可替换地,传感器76可以被设置为检测器件10的功能性参数。 [0174] Alternatively, the sensor 76 can be set to detect the device functional parameter 10.

[0175] 当植入马达/泵单元44和用于给马达/泵单元44供电的电池70时,电池70可以装配有收发器,用于发送关于电池70的状态的信息。 [0175] When implanted motor / pump unit 44 and to 70 for the motor / pump unit 44 of the battery-powered, the battery 70 may be equipped with a transceiver for sending information about the status of the battery 70. 更准确地说,当用能量对电池或储能器充电时,发送与所述充电过程相关的反馈信息,并且相应地,能量提供发生改变。 More specifically, when using the energy of the battery or accumulator charge, sending feedback information associated with the charging process, and accordingly, energy supply changes.

[0176] 图24示出了一个替换性的实施方案,其中器件10从患者身体外部进行调节。 [0176] FIG. 24 shows an alternative embodiment in which the device 10 is adjusted from outside the patient's body. 系统28包括通过皮下的开关80与电池70相连的运动限制器件10。 System 28 includes a switch 80 via subcutaneous battery 70 is connected with the movement restriction device 10. 因此,器件10的调节通过手动按下皮下开关无创地进行,由此将器件10的操作切换为通电或断电。 Thus, regulating device 10 by manually pressing the subcutaneous switch non-invasive manner, whereby the operation of the device 10 is switched to the power on or off. 可以理解,所示的实施方案是简化方案,并且附加的组件,诸如内部控制单元或本申请中所公开的任意其它部件,均可以增加到该系统中。 Will be appreciated, the illustrated embodiment is a simplified scheme, and additional components, such as internal control unit or any other means as disclosed in the present application, it can be added to the system.

[0177] 图25示出了一个替换性的实施方案,其中系统28包括与液压流体储存器52流体连接的运动限制器件10。 [0177] FIG. 25 illustrates an alternative embodiment wherein system 28 includes a hydraulic fluid reservoir 52 fluidly connected to the motion restriction device 10. 无创的调节可以通过手动按压连接至器件10的液压储存器来进行。 Non-invasive adjustment can be connected to the device by manually pressing the hydraulic reservoir 10 to carry out.

[0178] 可合并到根据本发明的设备中的系统的另一个实施方案包括用于从患者身体内部向其外部发送信息的反馈器件,以给出与所述运动限制器件或设备的至少一项功能性参数或者患者的生理参数相关的反馈信息,从而优化设备的性能。 [0178] can be incorporated into the device in accordance with another embodiment of the present invention, the system includes a feedback device for sending information from inside the patient's body to its external, to give the movement restriction device or the device is at least one physiological functional parameter or parameters related to patient feedback to optimize device performance.

[0179] 该器件的一个优选的功能性参数与用于对内部能源进行充能的能量传送有关。 [0179] A preferred feature of the device parameters and the energy used to charge the internal energy can transfer related.

[0180] 在图26中,示意性地示出了一个用于给植入患者的系统28供应准确量的能量的配置方案,患者的皮肤36由竖线示出。 [0180] In Figure 26 schematically illustrates a system for implantation into a patient 28 to supply the exact amount of energy configuration, the patient's skin 36 is shown by the vertical bar. 运动限制器件10连接至同样位于患者内部并且优选恰在患者皮肤36之下的植入的能量转换器30。 Motion restriction device 10 is connected to the patient and preferably also located just inside the skin of the patient 36 beneath the implanted energy transforming device 30. 一般而言,植入的能量转换器30可以位于腹内、胸内、(例如在腹壁上的)肌肉筋膜、皮下或任意其它合适的位置。 In general, the implanted energy converter 30 may be located in abdominal, thoracic, (for example in the abdominal wall) muscle fascia, subcutaneous, or any other suitable location. 植入的能量转换器30适于接收从外部能源34a发射的无线能量E,其中外部能源34a设在位于患者皮肤36外并靠近植入的能量转换器30的外部能量传输器34中。 Implanted energy converter 30 from an external source 34a is adapted to receive transmitted wireless energy E, wherein the external energy source 34a provided in the skin of the patient 36 located near the outer and the implanted energy transforming device 30 of the external energy transmission device 34.

[0181] 在本领域中已知的是,所述无线能量E通常可以借助于任意合适的经皮能量传送(TET)器来传送,所述经皮能量传送器例如包括设置在外部能源34a中的初级线圈和相邻的设置在植入的能量转换器30中的次级线圈的器件。 [0181] In the art it is known that the wireless energy E is generally by means of any suitable transcutaneous energy transfer (TET) is transmitted, for example, the transcutaneous energy transmitter comprises an external energy source 34a provided in The primary coil and the implanted energy converter in the secondary coil 30 is provided adjacent to the device. 在通过所述初级线圈输送电流时,在次级线圈中感应产生电压形式的能量,该能量可以例如在将输入的能量存储在诸如电池或电容器之类的能量存储器或储能器中之后,用于操作运动限制器件。 When carrying current through the primary winding, the voltage induced in the secondary coil in the form of energy, for example, the energy may be the energy stored in the battery input or like energy storage capacitor or accumulator, such as the following, by operating motion restriction devices. 然而,本发明通常不限于任何特定的能量传送技术、TET器件或能量存储器,并且可以使用任意种类的无线能量。 However, the present invention is generally not limited to any particular energy transfer technique, TET devices or energy storage, and may use any type of wireless energy.

[0182] 器件在身体内部接收的能量的量可与所述器件所使用的能量相当。 [0182] the amount of devices within the body receives energy comparable to the energy of the device can be used. 那么,术语该器件所使用的被理解为还包括该器件所存储的能量。 Then, the device used term is understood to also include the energy stored in the device. 所传送的能量的量可以借助于外部控制单元34b进行调节,外部控制单元34b基于所确定的能量平衡控制外部能源34a,如以上所述。 Amount of energy transferred by means of the external control unit 34b can be adjusted, the external control unit 34b based on the determined energy balance control an external energy source 34a, as described above. 为了传送正确量的能量,可以借助于连接至反流病治疗器件10的内部控制单元56 来确定所述能量平衡和所需的能量的量。 In order to transfer the correct amount of energy, by means connected to the reflux disease treatment device internal volume 10 of the control unit 56 to determine the energy balance and energy required. 因此,内部控制单元56可以被设置为接收由用于测量rlO的某些特性的合适的传感器等(未示出)获得的各种测量值,所述rlO的某些特性在某种程度上反映器件10的适当操作所需的能量的量。 Therefore, the internal control unit 56 can be set to receive a variety of measurements from suitable sensors for measuring certain characteristics rlO the like (not shown) is obtained, certain characteristics are reflected to some extent the rlO the amount required for the proper operation of the device 10 of the energy. 此外,也可以借助于合适的测量器件或传感器来探测患者的当前状况,以提供反映患者状况的参数。 It is also possible by means of suitable measuring devices or sensors to detect the current condition of the patient to provide parameters reflecting the patient's condition. 因此,这种特性和/或 Thus, the characteristics and / or

36参数可以与器件10的当前状态诸如功耗、操作模式和温度以及由例如体温、血压、心跳和呼吸反映的患者状况相关。 36 parameters with the current state of the device 10, such as power consumption, operating mode and temperature as well as the patient's condition such as temperature, blood pressure, heart rate and breathing reflect relevant.

[0183] 另外,能量存储器或储能器58可以选择性地连接至植入的能量转换器30,以累积接收到的能量以供器件10之后使用。 [0183] In addition, the energy storage or accumulator 58 can be selectively connected to the implanted energy transforming device 30 to accumulate the received energy for use after the device 10. 可替换地或附加地,也可以测量诸如储能器的特性, 该特性也反映所需的能量的量。 Alternatively or additionally, it is also possible to measure characteristics such as the accumulator, which also reflects the characteristics of the amount of energy required. 所述储能器可以由电池来代替,并且所测量的特性可以与电池的当前状态诸如电压、温度等相关。 The accumulator may be replaced by a battery, and the measured characteristics may voltage, temperature, etc. associated with the current state of the battery, such as. 为了给器件10提供足够的电压和电流,并且为了避免过量发热,显而易见,应当最优选通过从植入的能量转换器30接收正确量的能量,就是说不要太少也不要太多,来给电池充电。 In order to give the device 10 to provide sufficient voltage and current, and in order to avoid excessive heat, obviously, it should most preferably implanted energy converter 30 receives the correct amount of energy through, that is too little nor too much, to give the battery charge. 所述储能器也可以是具有相应特性的电容器。 The accumulator may be a capacitor with corresponding characteristics.

[0184] 例如,可以定期测量所述电池的特性以确定电池的当前状态,然后电池的当前状态可以作为状态信息存储在内部控制单元56中的合适的存储装置中。 [0184] For example, periodic measurement of the battery characteristics in order to determine the current state of the battery, then the current state of the battery can be used as status information stored in the internal control unit 56 in the appropriate storage device. 这样,无论何时进行新的测量,所存储的电池状态信息都可以相应地得到更新。 Thus, whenever a new measurement, battery status stored information can be updated accordingly. 以此方式,可以通过传送正确的能量的量对电池的状态进行“校准”,以使电池维持在最优状态。 In this way, you can transfer the right amount of energy to the state of the battery will be "calibrated" so that the battery is maintained at optimum condition.

[0185] 因此,内部控制单元56适于基于以上提及的传感器或测量器件对反流病治疗器件10、患者、能量存储器(在使用的情况下)或它们任意的组合进行的测量,来确定能量平衡和/或当前所需能量的量(或者是每单位时间的能量或者是累积的能量)。 [0185] Thus, the control unit 56 adapted to measure the internal sensor or measurement device based on the above-mentioned reflux disease treatment device 10, the patient, the energy storage (in the case), or any combination of them, to determine energy balance and / or the amount (or energy per unit time or the cumulative energy) energy is needed today. 内部控制单元56进一步连接至内部信号发射器82,内部信号发射器82被设置为向连接至外部控制单元34b的外部信号接收器34c发射反映所确定的所需能量的量的控制信号。 Internal control unit 56 is further connected to the internal signal transmitter 82, the internal signal transmitter 82 is set to amount to an external control unit connected to the external signal receiver 34b, 34c reflects the energy required for transmitting the determined control signal. 然后,可以响应于所接收的控制信号来调节从外部能源34a发射的能量的量。 Then, in response to a control signal received from an external source to adjust the energy amount emitted 34a.

[0186] 可替换地,传感器测量值可以被直接发射给外部控制单元34b,其中由外部控制单元34b来确定所述能量平衡和/或当前所需能量的量,因此将以上所述的内部控制单元56 的功能整合在外部控制单元34b中。 [0186] Alternatively, sensor measurements can be transmitted directly to the external control unit 34b, wherein the external control unit 34b to determine the energy balance and / or the currently required amount of energy, and therefore the above-described internal control integrated functional unit 56 in the external control unit 34b. 在这种情况下,内部控制单元56可以省略,并且所述传感器测量值被直接提供给内部信号发射器82,内部信号发射器82将测量值发送给外部信号接收器34c和外部控制单元34b。 In this case, the internal control unit 56 may be omitted and the sensor measurements are supplied directly to the internal signal transmitter 82, the internal signal transmitter 82 transmits the measured values to an external signal receiver 34c and the external control unit 34b. 然后可以由外部控制单元34b基于那些传感器测量值来确定所述能量平衡和当前所需能量的量。 34b may then be based on an external control unit that sensor measurements to determine the energy balance and the amount of energy needed today.

[0187] 因此,本方案采用了表示所需能量的信息的反馈,该方案比先前的方案更有效,原因在于该方案基于例如在能量的量、能量差或与器件10所使用的能率相比较的能量接收率的方面与所接收的能量相当的实际使用的能量。 [0187] Thus, the program uses feedback information indicating the energy required, the program is more effective than the previous program, because the program for example, based on the amount of energy, or the energy difference compared to the rate of energy used by the device 10 The aspect ratio of the energy received by the energy and energy received considerable practical use. 器件10可以将所接收的能量用于消耗或用于在能量存储器等中存储能量。 Device 10 may be used for the energy of the received energy consumption or memory or the like for storing energy. 因此,在相关且需要的情况下会使用以上所讨论的不同的参数,然后作为用于确定实际的能量平衡的工具。 Thus, in the case of relevant and we will need to use different parameters discussed above, and as a tool for determining the actual energy balance.

[0188] 然而,对于内部所采取的任意的对器件进行特定操作的行为来说,本身也可能需要这种参数。 [0188] However, for any particular operation of the device is taken for internal behavior itself may need such parameters.

[0189] 内部信号发射器82和外部信号接收器34c可以为使用合适的信号传送装置诸如无线电、IR(红外线)或超声波信号的独立单元。 [0189] 82 and the external signal receiver 34c internal signal transmitter can transmit a signal using a suitable means such as a stand-alone unit radio, IR (Infrared) or ultrasonic signals. 可替换地,内部信号发射器82和外部信号接收器34c可以分别整合在植入的能量转换器30和外部能源34a中,以基本上使用相同的传输技术以与能量传送相反的方向传递控制信号。 Alternatively, an external signal receiver 82 and the internal signal transmitter 34c may respectively integrated in the implanted energy converter 30 and the external energy source 34a, the substantially same transmission technology and energy transfer in the direction opposite to the transfer control signal . 可以在频率、相位或幅度方面调制所述控制信号。 The control signal may be frequency, phase, or amplitude modulation aspect.

[0190] 最后,图26所示的能量供应配置方案可以基本上以以下方式来操作。 [0190] Finally, the power supply configuration shown in Figure 26 may operate substantially in the following manner. 首先由内部控制单元56来确定能量平衡。 First, the internal control unit 56 to determine the energy balance. 还由内部控制单元56来建立反映所需能量的量的控制信号,并且从内部信号发射器82向外部信号接收器34c发射所述控制信号。 Also by the internal control unit 56 to establish a control signal reflecting the amount of energy needed, and the control signal from the internal signal transmitter receiver 82 to transmit an external signal 34c. 可替换地,所述能量平衡可以依赖于具体实施方案而由外部控制单元34b来确定,如以上所述。 Alternatively, the energy balance may depend on the specific embodiments but is determined by the external control unit 34b, as described above. 在那种情况下,控制信号可以从承载来自各种传感器的测量结果。 In that case, the control signal from the carrier measurements from various sensors. 然后,由外部控制单元34b基于所确定的能量平衡(例如响应于所接收的控制信号)来对外部能源34a发射的能量的量进行调节。 Then, (e.g., in response to the control signal received) from the external control unit 34b based on the determined amount of the energy balance of external energy emitted energy 34a can be adjusted. 该过程可以在持续进行能量传送的过程中以特定的间隔间歇性地重复,或者可以在能量传送期间更连续地或更不连续地执行。 The specific procedure can be repeated intermittently at intervals during ongoing energy transfer to, or may be more or less continuously performed continuously during the energy transfer.

[0191] 所传送能量的量通常可以通过调整外部能源34a中的各种传输参数,例如电压、 电流、幅度、波频率和脉冲特性来调节。 [0191] The amount of transferred energy can generally be adjusted by an external energy source 34a various transmission parameters, such as voltage, current, amplitude, wave frequency and pulse characteristics adjustment.

[0192] 因此,提供了一种用于对供应给植入患者的可电操作的反流病治疗器件的无线能量的传输进行控制的方法。 [0192] Thus, there is provided a method for transmitting wireless energy of reflux disease treatment device for the supply to the implant patients can be controlled electrically operated. 无线能量E从位于患者体外的外部能源发射,并且由位于患者体内的内部能量接收器接收,所述内部能量接收器连接至器件10,用于直接或间接地将所接收的能量供应给器件10。 Wireless energy E from the external energy source located outside the patient's transmitter, and received by the patient is located in the internal energy receptor, the internal energy receiver is connected to a device 10 for supplying energy directly or indirectly, to the receiving device 10 . 确定在由所述内部能量接收器接收的能量与用于器件10的能量之间的能量平衡。 Determining the energy received by the internal energy receiver and the energy used for the energy balance between the device 10. 然后,基于所确定的能量平衡对来自所述外部能源的无线能量E的传输进行控制。 Then, based on the determined energy balance of wireless energy E from the external energy transmission is controlled.

[0193] 因此,还提供一种用于对供应给植入患者的可电操作的运动限制器件10的无线能量的传输进行控制的系统。 [0193] Thus, also provided an implant for the patient can be supplied to the electrically operated motion restriction device 10 of the wireless energy transmission controlling system. 该系统适于从位于患者体外的外部能源发射无线能量E,所述无线能量E由位于患者体内的植入的能量转换器接收,所述植入的能量变换器连接至器件10,用于直接或间接地将所接收的能量供应给器件10。 The system is adapted to emit from the external energy source located outside the patient's wireless energy E, the wireless energy E received by the patient is located in the implanted energy converter, said energy converter is connected to the implant device 10, for direct or to supply energy to the device 10 indirectly received. 该系统进一步适于确定在植入的能量转换器所接收的能量与用于器件10的能量之间的能量平衡,并且基于所确定的能量平衡对来自外部能源的无线能量E的传输进行控制。 The system is further adapted to determine the energy of the implanted energy converter with the received energy to the energy balance between the device 10, and based on the determined energy balance of wireless energy E from an external energy transmission is controlled.

[0194] 该器件的功能性参数与用于对内部能源充能的能量的传送有关。 [0194] functional parameters of the device and the transmission can be used to charge the internal energy energy related.

[0195] 在另一可替换的实施方案中,从患者身体的外部对所述外部能源进行控制以释放电磁无线能量,所释放的电磁无线能量被用于操作器件10。 [0195] In another alternative embodiment, from the outside of the patient's body for controlling the external energy to release electromagnetic wireless energy, and released electromagnetic wireless energy is used for operation of the device 10.

[0196] 在另一个实施方案中,从患者身体的外部对外部能源进行控制以释放非磁无线能量,所释放的非磁无线能量被用于操作器件10。 [0196] In yet another embodiment, from outside the patient's body for controlling the external energy to release non-magnetic wireless energy, non-magnetic wireless energy released is used to operate the device 10.

[0197] 本领域技术人员会认识到,以上根据图14-26的各种实施方案可以以多种不同的方式合并。 [0197] Those skilled in the art will recognize that the above can be combined in many different ways according to various embodiments 14-26 of FIG. 例如,由电子开关38操作的极化能量可以合并到图12、15-21中的任意一个实施方案中,液压阀转换器54可以合并到图24的实施方案中,齿轮箱74可以合并到图33的实施方案中。 For example, the polarization energy generated by the operation of the electronic switch 38 may be incorporated into any of the FIG. 12,15-21 one embodiment, a hydraulic converter valve 54 may be incorporated into the embodiment of FIG. 24, the gear box 74 may be incorporated into the FIG. 33 of embodiment. 应当注意,所述开关可简单地表示任意电子电路或组件。 It should be noted that the switch may simply represent any electronic circuits or components.

[0198] 以上已经描述了实现了无创操作的用于操作运动限制器件10的能量的无线传送。 [0198] have been described above to achieve a non-invasive procedure for operating a motion limiting device 10 of the wireless energy transmission. 可以理解,器件10也可以使用有线能量来操作。 It will be appreciated, the device 10 may be used to operate the power cable. 这样的一个示例示于图26中,其中外部开关84借助于供能线86和88连在外部能源34a与操作器例如调节器件10的电动机之间。 An example of this is shown in Figure 26, wherein by means of the external switch 84 between the energizing lines 86 and 88 connected to the external energy source 34a with the operator adjusting device 10 such as a motor. 外部控制单元34b对外部开关的操作进行控制,以实施器件10的恰当操作。 External control unit 34b for controlling the operation of external switch, to implement proper operation of the device 10.

[0199] 液压或气动供能 [0199] hydraulic or pneumatic energy supply

[0200] 图28-31示出了给根据本发明的运动限制器件进行液压或气动供能的四种不同方式的更为详细的框图。 [0200] Figure 28-31 shows a more detailed block diagram of four different ways to supply energy in accordance with the present invention is to limit the movement hydraulic or pneumatic devices.

[0201] 图28示出了如以上所述用于治疗反流病的系统。 [0201] FIG. 28 shows a system as described above for the treatment of reflux disease. 该系统包括器件10,并且进一步包括独立的调节储存器46、单向泵44和转换阀54。 The system includes a device 10, and further comprising independently adjusting reservoir 46, pump 44 and check valve 54 conversion.

[0202] 图29示出器件10和流体储存器46。 [0202] FIG. 29 shows a device 10 and a fluid reservoir 46. 通过移动调节储存器的壁或者以任意其它不同的方式改变调节储存器的大小,可以在没有任何阀的情况下仅通过在任意时刻移动储存器壁使流体自由通过来调整所述器件。 Adjusted by moving the walls of the reservoir or in any other different ways to change the size of the reservoir regulator, the valve can be without any case at any time simply by moving the fluid reservoir wall freely adjusted by the device.

[0203] 图30示出器件10、双向泵44和调节储存器46。 [0203] FIG. 30 shows a device 10, two-way pump 44 and the reservoir 46 regulator.

[0204] 图31示出了具有控制第二闭合系统的第一闭合系统的反向伺服系统的框图。 [0204] FIG. 31 illustrates a block diagram of a second closed control system having a first closed system of reverse servo system. 所述伺服系统包括调节储存器46和伺服储存器90。 The servo system comprises adjusting reservoir 46 and a servo reservoir 90. 伺服储存器90通过机械互连94对运动限制器件10进行机械控制。 Servo reservoir 90 through a mechanical device to restrict movement of the interconnect 94 10 machine control. 器件10具有可膨胀/可收缩的腔室。 Device 10 having an expandable / contractible chamber. 优选通过从与器件10 流体连接的较大的可调整储存器92供应液压流体来使该腔室膨胀或收缩。 Preferably by 10 fluidly connected to the device from a larger adjustable reservoir 92 so that the supply of hydraulic fluid to the expansion or contraction of the chamber. 可替换地,该腔室容纳有可压缩气体,所述可压缩气体可以在伺服储存器90的控制下被压缩和膨胀。 Alternatively, the chamber accommodating a compressible gas, the compressible gas may be compressed and expanded under the control of the servo reservoir 90.

[0205] 伺服储存器90还可以是所述器件本身的一部分。 [0205] The servo reservoir 90 can also be part of the device itself.

[0206] 在一个实施方案中,调节储存器被置于患者的皮肤下面,并且通过用手指推动其外表面来操作。 [0206] In one embodiment, the regulator is placed in the reservoir below the skin of the patient, and by pushing the outer surface thereof with a finger to operate. 这种反流病治疗系统示于图32-c中。 This reflux disease treatment system is shown in Fig. 32-c in. 在图31中显示了柔性的皮下调节储存器46通过导管48连接至凸形的伺服储存器90。 It shows a flexible subcutaneous regulation reservoir 46 is connected through a conduit 48 to a convex servo reservoir 90 in FIG. 31. 该褶箱形的伺服储存器90包括在柔性的运动限制器件10中。 The box pleat servo reservoir 90 comprises a flexible motion restriction device 10. 在图32所示的状态下,伺服储存器90包含最小量的流体,并且大部分流体处于调节储存器46中。 In the state shown in FIG. 32, the servo reservoir 90 contains a minimal amount of fluid, and most of the fluid reservoir 46 is in regulation. 由于在伺服储存器90与器件10之间的机械互连,器件10 的外形收缩,即它占据了比其最大容积小的体积。 Since the servo reservoir 90 and the device 10 mechanical interconnection between the shape of the device 10 of the contraction that it occupies a smaller volume than the maximum volume. 该最大容积在图中使用虚线示出。 The maximum volume using the dotted line shown in FIG.

[0207] 图32示出一种状态,在该状态下,使用者如植入了所述器件的患者按压调节储存器46从而带动调节储存器46中容纳的流体流过导管48并进入伺服储存器90中,伺服储存库90由于它的褶箱形状而纵向扩张。 Patient [0207] FIG. 32 illustrates a state, in this state, as the user presses the device implanted regulator reservoir 46 so as to drive the conditioning fluid reservoir contained 46 flows through conduit 48 and into the servo store 90, the servo repository 90 fold due to its shape and vertical expansion tank. 这种扩张接着会扩张器件10,使其占据其最大容积,从而拉伸与其接触的胃壁(未示出)。 This expansion device 10 will then expand to occupy a maximum volume, thereby stretching the stomach wall in contact therewith (not shown).

[0208] 调节储存器46优选设有用于在压缩之后维持其形状的装置46a。 [0208] regulator reservoir 46 is preferably provided with means for maintaining its shape after compression 46a. 在图中示意性地示出的该装置因此在用户释放所述调节储存器时还是可以将器件10维持在拉伸的位置。 The apparatus schematically illustrated in the device 10 so it can be maintained in the stretched position when the user releases the regulation reservoir in the figure. 以此方式,调节储存器基本上可以作为用于所述反流病治疗系统的通/断开关来工作。 In this way, the regulator can act as a reservoir for substantially the reflux disease treatment system on / off switch to work.

[0209] 现在参考图33和图34描述液压或气动操作的一个替代性的实施方案。 [0209] Now embodiments with reference to FIGS. 33 and 34 describe a hydraulically or pneumatically operated alternative. 图33中示出的框图包括控制第二闭合系统的第一闭合系统。 33 shows a block diagram of the closure system comprises a first control of the second closure system. 所述第一系统包括调节储存器46和伺服储存器90。 The system comprises a first reservoir 46 and a servo regulator reservoir 90. 伺服储存器90通过机械互连94以机械方式控制较大的可调整的储存器92。 Servo reservoir 90 via a mechanical interconnection 94 mechanically controls a larger adjustable reservoir 92. 反过来,具有可膨胀/可收缩的腔室的运动限制器件10由较大的可调整的储存器92通过从与器件10流体连接的较大的可调整的储存器92供应液压流体来控制。 Motion of the chamber, in turn, has an expandable / contractible by limiting device 10 from the device 10 is fluidly connected with a larger adjustable reservoir 92 by the supply of hydraulic fluid to control a larger adjustable reservoir 92.

[0210] 现在将参考图34来描述该实施方案的一个示例。 [0210] 34 now will be an example of this embodiment is described with reference to FIG. 与先前的实施方案相同,所述调节储存器以皮下方式置于患者皮肤之下,并且通过用手指推动其外表面来操作。 The same as the previous embodiments, the regulator reservoir subcutaneously placed under the patient's skin, and by pushing the outer surface thereof with a finger to operate. 调节储存器46通过导管48与褶箱形的伺服储存器90流体连接。 Adjust the reservoir 46 through a conduit 90 in fluid connection with the pleats 48 box-shaped servo reservoir. 在图32a中所示的第一闭合系统46,48和90中,伺服储存器90容纳最小量的流体,可见大部分流体处于调节储存器46中。 In the first closed system shown in FIG. 32a 46,48 and 90 in the servo reservoir 90 receiving the smallest amount of fluid, the fluid can be seen in most of the regulator 46 in the reservoir.

[0211] 伺服储存器90以机械方式连接至较大的可调整的储存器92,在该示例中,较大的可调整的储存器92也具有褶箱形状,但直径比伺服储存器90大。 [0211] The servo reservoir 90 is mechanically connected to a larger adjustable reservoir 92, in this example, the larger adjustable reservoir 92 also has a box pleat shape, but larger than the diameter of the servo reservoir 90 . 较大的可调整的储存器92与器件10流体连接。 Larger adjustable reservoir 92 in fluid connection with the device 10. 这意味着,当用户推动调节储存器46从而将流体从调节储存器46 移动到伺服储存器90时,伺服储存器90的扩张会使较大量的流体从较大的可调整的储存器92移动到器件10。 This means that, when the user pushes the regulation reservoir 46 so that fluid from the reservoir 46 is moved to adjust the servo reservoir 90, the expansion of the servo reservoir 90 will make a relatively large amount of fluid 92 is moved from the larger adjustable reservoir to the device 10. 换句话说,在该反向伺服中,调节储存器中的小体积由较大力进行压缩,这产生了使用较小的每单位面积的力的较大总面积的移动。 In other words, the reverse servo regulating reservoir of small volume is compressed by the larger force, which results in a smaller mobile use of force per unit area of a larger total area.

[0212] 与以上参考图32a_c所描述的先前的实施方案相同,调节储存器46优选设有用于在压缩之后维持其形状的装置46a。 [0212] with the previous embodiment described above with reference to FIG 32a_c same regulation reservoir 46 is preferably provided with means for maintaining its shape after compression 46a. 在图中示意性地示出的该装置因此在用户释放调节储存器时还是可以将器件10维持在拉伸的位置。 The device is schematically illustrated device 10 so it can be maintained in the stretched position when the user releases the regulation of the reservoir in the figure. 以此方式,调节储存器基本上可以作为用于所述反流病治疗系统的通/断开关来工作。 In this way, the regulator can act as a reservoir for substantially the reflux disease treatment system on / off switch to work.

[0213] 在图35中,流程图示出了在植入根据本发明的器件时所进行的步骤。 [0213] In Figure 35, a flow chart showing the steps in implanting the device according to the present invention is carried out. 首先,在步骤102中,在腹壁上切开开口。 First, in step 102, incision in the abdominal wall opening. 接着,在步骤104中,剖开胃周围的区域。 Next, at step 104, the area around the stomach cut open. 之后,在步骤106 中,将至少一个根据本发明的运动限制器件与胃壁接触、尤其是与胃底壁接触放置。 Thereafter, in step 106, at least one device in contact with the stomach to limit the invention according to the motion, especially in contact with the gastric wall placement. 然后, 在步骤108中缝合胃壁。 Then, in step 108 the gastric wall sutured.

[0214] 恢复啬门和胃底的位置的方法 [0214] recovery stingy door and gastric location method

[0215] 图36示出了如何将具有至少一个柔性部件201的仪器200引入患食管裂孔疝的患者的食管24中,其中应该位于横膈膜18之下的食管24和胃底16的一部分已经通过缺口18a移动到横膈膜18之上的位置。 [0215] FIG. 36 illustrates how a flexible member having at least 201 200 instrument introduced into a patient suffering from a hiatal hernia in the esophagus 24, which should be located in a part of the esophagus and gastric 16 24 18 under the diaphragm has 18a through the notch 18 is moved to a position above the diaphragm.

[0216] 在图37中示出了,在接下来的步骤中,如何从仪器200中释放横截面积比所述仪器200大的构件203。 [0216] In FIG. 37 illustrates, in the next step, how to release the instrument from the instrument 200 200 cross-sectional area larger than 203 members. 构件203适于具有比贲门14的开口大的横截面。 Member 203 is adapted to have an opening larger than the cross section of the cardia 14. 这可以通过构件203的径向扩张来实现。 This may be achieved by radial expansion member 203. 然后,向远端方向推动仪器200,以使不正确地位于横膈膜18之上的贲门14和胃底16或部分胃底16通过缺口18a滑回横膈膜18之下的正确位置。 Then, push the instrument 200 in the distal direction, so that the diaphragm 18 is not properly located above the gastric cardia 14 and 16 or section 16 through the notch 18a gastric slip back into the correct position of the diaphragm 18 under.

[0217] 图38示出了图37中所示的本发明的一个实施方案的一个替代方法。 [0217] FIG. 38 illustrates an alternative embodiment of FIG. 37 an embodiment of the present invention shown in FIG. 该图在诸多方面类似于图37。 The figure is similar in many respects 37. 在图38中,仪器200适于将仪器200的末端205处的气球构件204释放在胃206的下部,并且使用气球构件204使仪器200推挤胃207的下壁部,从而使贲门14 和胃底16或部分胃底16通过缺口18a滑到横膈膜18之下的位置。 In Figure 38, the instrument 200 is adapted to the end of the balloon member 205 of the apparatus 200 of 204 in the lower part of the stomach to release 206, and 204 using a balloon member 200 pushes the instrument 207 of the lower wall portion of the stomach, allowing gastric cardia 14 and the bottom 16 or section 16 gastric slide position below the diaphragm 18 through the notch 18a.

[0218] 图39示出了作为本发明的实施方案的再一替代方法。 [0218] FIG. 39 illustrates an embodiment of the present invention as a further alternative. 同样,该图在诸多方面与图37类似。 Again, this figure is similar in many respects 37. 然而,在图39中,该方法涉及通过固定器208将构件203连到胃207的壁上。 However, in FIG. 39, the method relates to the fixing member 208 attached to the stomach wall 203 207. 如以上所述,然后向远端方向推动所述仪器,使得贲门14和胃底16或者部分胃底16滑到横膈膜18之下。 As described above, then push the instrument in the distal direction, making 14 and gastric cardia gastric section 16 or 16 slide under the diaphragm 18.

[0219] 图40示出了如何使胃底16和贲门14在由仪器200推过缺口18a之后定位于横膈膜18之下的位置。 [0219] FIG. 40 illustrates how gastric cardia 16 and 14 after a push by the instrument 200 through the notch 18a positioned below the position of the diaphragm 18.

[0220] 图41示出该方法的后续步骤。 [0220] FIG. 41 illustrates a subsequent step of the process. 在胃底16和贲门14被推入其在横膈膜18之下的正确位置时,胃底壁16a被附到食管24的下部。 When gastric cardia 16 and 14 pushed into its correct position below the diaphragm 18, the gastric wall 16a is attached to the lower part of the esophagus (24). 这是通过使用在仪器200的近端部分205 中能够提供缝线或U形钉210的构件209来实施的。 This is done by using the instrument in the proximal portion 200 of member 205 can be provided in the U-shaped staples or sutures 210 209 to be implemented. 这一固定防止贲门14和胃底16向横膈膜18之上的位置移动。 The fixed prevent gastric cardia 14 and 16 to move to position 18 above the diaphragm.

[0221] 以下简要描述根据本发明的其它方法。 [0221] The following brief description of the method according to the present invention further.

[0222] 一种治疗患者的反流病的方法包括将根据本发明的反流病治疗系统植入患者体内的步骤。 [0222] A method of treating reflux disease patients includes the step of patient implanted reflux disease treatment system according to the invention.

[0223] 一种使用根据本发明的用于治疗反流病的系统的方法包括在手术后调节该器件以防止反流的步骤。 [0223] A use of the method according to the present invention, the system comprises treating reflux disease in post-operative adjustment of the device to prevent the reflux step.

[0224] 一种以外科手术方法将根据本发明的运动限制器件置入患者体内的方法包括以下步骤:在患者的腹壁中切开开口,剖开胃周围的区域,放置运动限制器件并将其连到胃壁上,并缝合胃壁。 [0224] In a surgical procedure to limit the movement of the device according to the present invention is placed in a patient comprising the steps of: cutting an opening in the patient's abdominal wall, the stomach around the cut zone, the movement restriction device placement and even to the stomach wall and suturing the stomach wall.

[0225] 一种使用在手术后从身体外部控制的、调节所述器件的反流病治疗系统的方法包括以下步骤:填充连到部分胃壁上的容积并从患者身体外部调节所述器件以影响患者的反流。 [0225] A reflux disease treatment system used in the body after surgery from externally controlled, the regulating device comprising the steps of: filling volume is connected to the upper portion of the stomach wall and the adjusting device from outside the patient's body to effect patients with reflux.

[0226] 一种使用运动限制器件的方法包括以下步骤:通过放置所述器件的第一部分填充胃壁的第一部分中的容积,通过放置所述器件的第二部分来填充胃壁的第二部分中的容积,并从患者身体外部调节该器件以影响患者的反流。 [0226] A method of using a motion limiting device comprising the steps of: placing a first portion of the device through a first portion of the volume of the stomach is filled, the second portion of the device by placing the second portion of the stomach wall to fill volume, and adjust the device from outside the patient's body to affect reflux patients.

[0227] —种治疗患者的反流病的方法包括以下步骤:在患者身体的腹部插入针状或管状仪器,使用所述针状或管状仪器给患者的腹部充气从而扩张腹腔,在患者身体中放置至少两个腹腔镜套管针,通过所述腹腔镜套管针中之一将摄像机插入患者腹部,通过所述至少两个腹腔镜套管针之一插入至少一个剖开工具并剖开患者胃的至少一部分的计划放置的区域,将根据本发明的运动限制器件放置在胃底壁上,将该器件套叠到胃底壁中,缝合胃壁本身以将该器件保持在合适的位置,将胃的胃底缝合到食管的下部,并防止贲门通过横膈膜向上滑入胸部。 [0227] - therapeutic reflux disease patient comprising the steps of: inserting a needle body of a patient's abdomen or tubular instrument, using a needle or tubular instrument to the patient's abdomen inflated thereby expanding the abdominal cavity, the patient's body placing at least two laparoscopic trocar, through the laparoscopic trocar is inserted in the patient's abdomen, one of the camera, at least one of the two laparoscopic trocar insertion of at least one cut tool and cut through the patient Regional plan at least a portion of the stomach is placed, according to the motion to limit the invention to the device in the gastric wall, the telescopic device to the gastric wall, the suture the stomach itself to the device is held in the right position, gastric fundus sutured to the lower part of the esophagus and cardia slide into the chest to prevent upward through the diaphragm. 使用这里所述的方法和器件将提供对胃食管反流病的治疗,该治疗极其有效,并且不会出现诸如组织损伤及不利的非组织向组织的转移等并发症。 The use of methods and devices described herein will provide the treatment of gastroesophageal reflux disease, the treatment is extremely effective, and does not appear such as tissue damage and adverse tissue non-tissue transfer to other complications.

[0228] 该器件的填充体可以适于通过腹腔镜使用的套管针被推动或拉动,其中所述套管针具有比该填充体松弛的直径小的直径。 [0228] filling the body of the device can be adapted by laparoscopy using a trocar is pushed or pulled, wherein said trocar body relaxation than the filling of a diameter smaller. 填充体可以包括外壁和中空的由气体填充的内部,这使得所述填充体能够穿过所述套管针。 Filler may include an outer wall and a hollow interior of a gas-filled, which makes the filler capable of passing through the trocar. 可替换地,所述填充体可以包括外壁和中空的由流体填充的内部,这使得该填充体能够穿过套管针。 Alternatively, the filler may include an outer wall and a hollow interior of the fluid-filled, which makes the filling member capable of passing through a trocar. 在后面的情况下,所述流体可以是凝胶。 In the latter case, the fluid may be a gel. 填充体可以进一步包括可以被插入套管针的多个部分,所述多个部分然后可以在患者身体内部被放在一起形成一个单片,从而使所述填充体能够穿过套管针。 Packing body may further comprise a plurality of portions of the trocar can be inserted, and the plurality of portions can be put together to form a monolithic body of the patient inside, so that the filling member capable of passing through a trocar. 所述填充体可以包括外壁以及在插入患者身体中之后由流体或凝胶填充的中空的压缩内部。 The filling may include an outer wall and a hollow inside compressed after the insertion by the patient's body fluid or gel-filled. 所述填充体可以进一步包括注入口,所述注入口可以用于在插入患者身体之后通过注入口用流体来填充所述填充体。 The filler may further comprise an injection port, the injection port may be used to fill the body of a patient's body after insertion by injection to fill the fluid inlet.

[0229] 该器件的填充体可以是弹性的可压缩材料,以允许所述填充体穿过套管针。 [0229] The filling device body may be resilient compressible material, to allow the packing body through a trocar. 所述填充体可以由比25肖氏硬度或甚至是比15肖氏硬度更软的材料制成。 The filler may be composed of or even made more than 25 to 15 durometer Shore hardness of softer material.

[0230] 所述填充体还可以包括基本上呈球形的外壁。 [0230] The filler may also include a substantially spherical outer wall. 所述填充体还可以包括至少一个适于推动或拉动所述填充体使其穿过腹腔镜使用的套管针的夹持器。 The filler may also include at least one adapted for pushing or pulling it through the filler used in laparoscopic trocar holder. 所述夹持器可以适于夹持该器件的延长部分,该延长部分适于由外科手术仪器夹持。 The holder may be adapted to extend the holding portion of the device, the extended portion is adapted by a surgical instrument holder. 所述夹持器还可以夹持通过该夹持器插入的线或带。 The holder may also be inserted into the holding by the holder of wire or ribbon. 所述夹持器还可以至少部分地被置于所述填充体的外壁内部。 The holder may also be at least partially disposed inside the outer wall of the filling body. 该器件的填充体可优选具有大于从胃到肠的出口的尺寸,以避免当所述球形物进入胃的情况下发生并发症肠梗阻。 Filling the body of the device may preferably have more than exports from the stomach to the intestines of the size to avoid the occurrence of the case when the bulb into the stomach complications ileus. 优选地,所述填充体具有在30mm至40mm之间或更大的最小外径。 Preferably, the filler has a 30mm to 40mm or more between the minimum outer diameter. 优选地,所述填充体具有在30mm至150mm之间的最小外周长。 Preferably, the filler has a minimum between 30mm to 150mm circumference.

[0231] 已经描述了根据本发明的用于治疗反流病的器件、包括用于治疗反流病的器件的系统以及方法的优选实施方案。 [0231] have been described for the treatment of reflux disease device according to the invention, including a preferred embodiment for treatment of reflux disease of device systems, and methods. 本领域技术人员会认识到这些实施方案可以在所附权利要求的范围内有所变化。 Those skilled in the art will recognize that these embodiments may vary within the scope of the appended claims. 因此,尽管在具体实施例中描述了不同的特征,但是可以理解,在可以应用时这些不同特征可以组合在不同的构造方案中。 Thus, despite the various features described in the specific embodiment, it will be appreciated, in the application of these different features can be combined in a different configuration scenarios. 例如,尽管结合图4A-B的器件的构造方案配置描述了液压控制,但是所述液压控制也可以应用于图2A-B和图3A-B的器件的构造方案。 For example, although the structure of the program of the device in conjunction with Figure 4A-B configuration described hydraulic control, but also the structure of the hydraulic control device Scheme 2A-B and 3A-B may be applied to FIG.

[0232] 重要的是,植入的反流病治疗器件牢固地保持在胃壁中被套叠的位置。 [0232] Importantly, implanted reflux disease treatment device securely retained in the stomach wall quilt stack position. 为此,所述反流病治疗器件可以具有一个或多个适于接纳用于固定所述套叠的缝线或U形钉的通孔。 To this end, the reflux disease treatment device may have one or more adapted to receive through holes for fixing the telescopic U-shaped sutures or staples. 这种实施方案示于图42中,其中反流病治疗器件10具有一排孔10i,这些孔被设在反流病治疗器件上突出的凸缘状的突起上。 This embodiment is illustrated in FIG. 42, where the reflux disease treatment device 10 having a row of holes 10i, these holes are provided in the flange-shaped protrusion protruding upper reflux disease therapy device. 在该实施方案中,这排孔沿着所述反流病治疗器件的纵轴延伸。 In this embodiment, the row of holes extending along the longitudinal axis of the reflux disease treatment device.

41[0233] 图43示出了如何使用缝线314以使它们通过胃壁12a并通过孔10i。 41 [0233] Figure 43 shows how the suture through the stomach wall 314 to make them through the holes 12a and 10i. 以此方式, 所述反流病治疗器件被固定在由胃壁形成的袋囊中,因此防止其滑动。 In this way, the reflux disease treatment device is fixed to the pouch formed by the stomach, thus preventing sliding.

[0234] 尽管在图42中示出多个孔,但是可以理解单独一个孔也足以能够改善反流病治疗器件10的固定。 [0234] Although a plurality of apertures is shown in FIG. 42, but it will be appreciated that a single hole sufficient to improve the fixing reflux disease treatment device 10.

[0235] 图44示出了设有入口IOh的反流病治疗器件。 [0235] FIG. 44 illustrates an inlet IOh reflux disease therapy device. 所述反流病治疗器件被套叠到胃壁中,并且入口IOh可以用于连接至从患者的腹部区域引出的管等。 The reflux disease treatment device to the stomach wall quilt stack, and the entrance IOh be used to connect to leads from the abdominal area of the patient's tube.

[0236] 图45示出了被套叠的反流病治疗器件,其中代替入口的固定管IOg延伸到患者的腹部区域。 [0236] FIG. 45 shows the invaginated reflux disease treatment device, in which instead of the inlet pipe is fixed to the abdominal region extends IOg patient.

[0237] 图46是类似于图44的图,但是还示出了胃壁中的连接管IOg在入口IOh与反流病治疗器件10之间的隧道作用(tunneling)。 [0237] FIG. 46 is similar to Figure 44, but also shows the connection pipe IOg stomach tunnel effect (tunneling) between the inlet IOh and reflux disease treatment device 10.

[0238] 已经示出所述反流病治疗器件的形状可以采取很多不同的形式。 [0238] It has been shown the reflux disease treatment device shape can take many different forms. 可以理解,反流病治疗器件的材料也可以改变。 It will be appreciated reflux disease treatment device material may also vary. 优选所述反流病治疗器件具有涂层,诸如聚对二甲苯、聚四氟乙烯(PTEE)或聚氨酯涂层或者这些涂层的组合,即多层涂层。 Preferably, the reflux disease treatment device with a coating, such as parylene, polytetrafluoroethylene (PTEE) or a combination of these coatings or polyurethane coatings, namely multi-layer coating. 该涂层或多层涂层改善了所述反流病治疗器件的性质,例如其耐磨性。 This coating or multi-layer coating improves the reflux disease treatment device properties, such as its abrasion resistance.

[0239] 在一个实施方案中,反流病治疗器件包括可扩张成扩张状态的可充盈器件。 [0239] In one embodiment, the reflux disease treatment device comprises an expandable into an expanded state can filling devices. 在这种情况下,所述可充盈器件设有用于流体的入口,并且适于与胃镜仪器相连。 In this case, the filling device may be provided with an inlet for the fluid, and connected to the endoscopic instrument adapted. 现将参考图47a-47d对此实施方案进行详细的描述。 Now with reference to FIG. 47a-47d of this embodiment is described in detail.

[0240] 处于非扩张状态的可充盈的反流病治疗器件示于图47a中。 [0240] in a non-expanded state may be filling reflux disease treatment device is shown in Figure 47a in. 它基本上成气球样, 排空器件10具有入口10h。 It's basically a balloon-like emptying device 10 has an inlet 10h. 在这种状态下,所述可充盈的器件最多具有几毫米的直径,从而能够通过图47b所示的管状胃镜仪器600将其通过患者的食管插入胃中。 In this state, the filling device may have a maximum diameter of a few millimeters, so that the tubular endoscopic instrument shown by FIG. 47b can be inserted into the stomach 600 through the patient's esophagus. 该仪器包括外套管600a和可以在长度方向上相对于所述外套管移动的内套管600b。 The apparatus comprises an outer tube 600a and the tube can be moved in the longitudinal direction with respect to the housing inner sleeve 600b. 所述内套管在其远端具有刀刃615形式的切割工具。 Said inner sleeve having a cutting edge at its distal end 615 in the form of a cutting tool. 该刀刃可以用于在胃壁中切割孔洞,以下将作出详细解释。 The blade can be used to cut the hole in the stomach wall, the following will give a detailed explanation.

[0241] 当所述仪器到达胃壁时,参见图47c,将内套管从其在外套管中的位置向前移动, 并与胃壁12a相接触。 [0241] When the instrument reaches the stomach wall, see Fig. 47c, the inner sleeve is moved forward from the position of the outer sleeve, and in contact with the stomach wall 12a. 然后,内套管的刀刃615在胃壁上切割一个孔洞,以允许接下来将反流病治疗器件10插入并通过该孔洞,见图47d。 Then, the inner sleeve of the blade 615 to cut a hole in the stomach wall, in order to allow the next will reflux disease treatment device 10 is inserted through the hole as shown in Figure 47d. 为了推动所述反流病治疗器件通过该孔洞, 可以在该仪器中设置活塞602。 In order to promote the reflux disease treatment device through the hole, the piston 602 may be provided in the instrument. 因此,该仪器进一步包括活塞602,该活塞适于将排空的反流病治疗器件10从在内套管中的位置推出到内套管外部的位置,所述排空的反流病治疗器件10在内套管中的位置在图47b中示出,其被推出到内套管外的位置示于图47d中。 Thus, the apparatus further includes a piston 602, the piston adapted to emptying reflux disease treatment device 10 from the position of the inner cannula introduced into a position outside the casing, the emptying of the reflux disease treatment device the inner sleeve 10 in the position shown in FIG. 47b, which is pushed into the outer sleeve in the position shown in Figure 47d.

[0242] 为了保护排空的反流病治疗器件10不被内套管的刀刃615损伤,可以在反流病治疗器件周围设置另外的保护套管(未示出)。 [0242] In order to protect the evacuated reflux disease treatment device 10 will not damage the inner sleeve of the blade 615, you can set additional protective sleeve (not shown) around the reflux disease treatment device.

[0243] 现在参考图48a_i描述一种在胃壁12a的外侧套叠所述反流病治疗器件10的管腔内方法。 [0243] Referring now to FIG 48a_i describes a stomach wall 12a of the outer telescoping the reflux disease treatment device 10 within the lumen of the method. 开始时,将仪器600、优选是胃镜仪器插入到患者的嘴中,参见图48a。 Initially, the instrument 600, preferably endoscopic instrument inserted into the patient's mouth, see Figure 48a. 该仪器包括用于向患者的胃中注入流体或器械的注入器601、602。 The instrument includes an injection to a patient's stomach fluid injector 601, 602, or instrument. 仪器600进一步包括适于控制该仪器的工作的控制单元606。 Apparatus 600 further includes a control unit 606 is adapted to control the instrument work. 为此,控制单元606包括一个或多个操纵器,在该图所示的实施方案中是两个操纵杆603和两个控制按钮604的形式。 To this end, the control unit 606 comprises one or more manipulators, in the embodiment shown in the figure is in the form of two joysticks 603 and two control buttons 604. 设置显示器605用于显示由设在细长构件607的外端处的摄像机(未示出)提供的图像,参见图48e-i。 Setting up the monitor for display provided by 605 located at the outer end of the elongated member 607 of the camera (not shown) of the image, see Fig. 48e-i. 所述摄像机可以由光源(未示出)辅助。 The camera can (not shown) by the auxiliary light source.

[0244] 该仪器进一步被插入患者的食管,并进入患者的胃中,参见图48b。 [0244] The instrument is further inserted into the patient's esophagus and into the stomach of the patient, see Figure 48b. 借助于仪器600,在胃12的壁上创建孔洞12b。 By means of the instrument 600, creating holes 12b in the wall 12 of the stomach. 为此,该仪器在其远端设有一个或多个切割工具615,例如以以上参考图47a_d所述的方式设置。 To do this, the instrument has one or more cutting tool 615 at its distal end, for example in the manner described above with reference to FIG. 47a_d settings. 这些切割工具当然可以以不同的方式设计,例如绕所述管状仪器的中心轴旋转的齿状鼓切割工具。 The cutting tool of course be designed in different ways, e.g., toothed drum about said central axis of rotation of the tubular instrument cutting tool. 仪器600是中空的,从而为处于放气状态的反流病治疗器件10提供空间。 Instrument 600 is hollow, so as to put gas in the state of reflux disease treatment device is provided space 10.

[0245] 在胃壁上切割孔洞之后,仪器600的远端被插入并通过孔洞12b,使其最后处于胃壁12a的外部。 [0245] After the cutting holes in the stomach, the distal end of the instrument 600 is inserted through the hole 12b, so that finally in external stomach wall 12a. 这在图48c和图48d中示出,其中图48c示出胃12的侧视图,图48d是沿图48c中的线Vd-Vd截取的通过图48c的胃的截面图。 This is shown in FIG. 48c and FIG. 48d, in which FIG. 48c shows a side view of the stomach 12, and FIG. 48d is taken along the line Vd-Vd in Figure 48c taken through the stomach of a sectional view of FIG. 48c. 然后,排空的反流病治疗器件10被插入腹部区域。 Then, emptying reflux disease treatment device 10 is inserted into the abdominal area.

[0246] 仪器600适于在胃12的外侧围绕胃壁中的孔洞12b创建一个“ 口袋”或“袋囊”。 [0246] instrument 600 adapted to fit around the hole in the stomach wall 12b to create a "pocket" or "pouch" on the outside of the stomach 12. 现在将描述提供这种袋囊的仪器和方法。 We will now be described to provide apparatus and methods of this pouch.

[0247] 图48e_i示出了用于通过创建其中放置反流病治疗器件的胃壁12a材料的袋囊在患者的胃壁12a中套叠反流病治疗器件10的一个胃镜或腹腔镜仪器。 [0247] FIG 48e_i shows a stomach by creating a place where the bag reflux disease treatment device 12a of the material in the patient's stomach pouch 12a of the telescopic reflux disease treatment device is an endoscopic or laparoscopic instrument 10. 通常由600表示并且可以包括以上参考图47a-d所述的特征的仪器,包括具有近端和和远端的细长构件607, 细长构件607具有小于患者食管的直径,并且是柔性的,从而使得能够引入柔性的细长构件607,其远端首先通过患者咽喉、食管,并进入胃12到达胃壁12a。 Usually represented by the 600 and may include features described above with reference to FIG. 47a-d said instrument comprising an elongated member having a proximal end and a distal end 607 and elongate member 607 having a diameter less than the patient's esophagus, and is flexible, thereby enabling the introduction of the flexible elongate member 607, its distal end first through the patient throat, esophagus and into the stomach 12 reaches the stomach wall 12a.

[0248] 胃穿刺器件或切割工具615设置在细长构件607的远端用于刺穿胃壁12a,从而在胃壁12a上创建一孔洞,以使得能够通过该孔洞引入细长构件607。 [0248] stomach puncturing devices or cutting tool 615 disposed at the distal end of the elongate member 607 to pierce the stomach wall 12a, thereby creating a hole in the stomach wall 12a, to enable the introduction of the elongate member 607 through the hole. 为了不进一步损伤身体内的组织,胃穿刺器件615可以适于是可操作的,以在刺穿胃底壁12a之后撤回所述胃穿刺器件615。 In order not to further damage the body's tissues, stomach puncture device 615 may be adapted to be operable to pierce the gastric wall 12a after withdrawing the stomach puncture device 615. 该仪器进一步包括设在细长构件607上靠近穿刺器件615 —侧的专用夹持器609。 The apparatus further comprises an elongate member 607 provided on the puncture device near 615-- special holder 609 side.

[0249] 所述细长构件进一步包括可扩张的构件611,可扩张的构件611适于在所述细长构件刺穿胃壁12a之后扩张,从而帮助创建适于容纳反流病器件610的腔或袋囊。 [0249] The elongated member further comprises an expandable member 611, the expandable member 611 is adapted to pierce the stomach wall 12a of the elongate member after the expansion, thereby helping to create the device is adapted to accommodate 610 reflux disease or cavities bag. 可扩张的构件611可以包括环周地围绕柔性细长构件607的远端部分设置的可充盈的圆形气球。 Expandable member 611 may include a ring around the periphery of the distal end portion of the flexible elongate member 607 may be provided round balloon filling.

[0250] 现在将详细描述套叠所述反流病治疗器件时的方法步骤。 [0250] Now will be described in detail the nesting reflux disease treatment method steps when the device is. 在器件600插入胃12之后,胃穿刺器件615接触胃壁12a放置,参见图48e。 After the device 600 is inserted stomach 12, the stomach puncture device 615 is placed in contact stomach wall 12a, see Figure 48e. 接着,引导胃穿刺器件或切割装置615 在胃壁中创建孔洞12b,之后至少引导所述可扩张的构件611通过胃壁中的孔洞12b。 Then, guided stomach puncture device or cutting device 615 creating holes 12b in the stomach, after which at least guide the expandable member 611 through the stomach wall holes 12b. 在该步骤中,使专用夹持器609处于夹持状态,在该状态下它在径向扩张,以形成基本圆形的抵住胃壁12a的表面,参见48f。 In this step, the holder 609 is in dedicated clamped state, in which state it expand radially to form a substantially circular surface 12a against the stomach wall, see 48f. 以此方式,胃穿刺器件615和可扩张的构件611通过胃壁中的孔12a的插入局限在图48f所示的位置。 In this manner, the gastric biopsy device and the expandable member 615 through the stomach wall 611 is inserted in the hole 12a in the position shown in FIG limited to 48f.

[0251] 然后,可扩张的构件611被扩张。 [0251] Then, the expandable member 611 is expanded. 在所述可扩张的构件包括气球等的情况下,空气或其它流体被注入其中。 In the case of balloon expandable member such as lower include, air or other fluid is injected therein.

[0252] 然后,将细长构件607中包括可扩张的构件611的部分向近端方向撤回,如图48g 中的箭头所示,从而将胃壁612拉进由专用夹持器609形成的篮状结构中。 [0252] Then, the portion of the elongate member 607 comprises an expandable member 611 in the proximal direction to withdraw the arrows in Figure 48g, which will pull into the basket 612 stomach by a dedicated holder 609 is formed structure.

[0253] 进一步使用缝合或钉合器件608,或作为连接至细长构件607的器件或作为独立的器件。 [0253] Further use of stitching or stapling device 608, or as an elongated member 607 is connected to a device or as a stand-alone device. 所述缝合或钉合构件包括缝合或钉合端613,其适于用胃-胃缝线或U形钉14闭 The stitching or stapling member comprises a suture or stapling end 613, which is adapted with a stomach - gastric sutures or U-shaped staples 14 closed

合腔室或袋囊。 Co-chamber or pouch.

[0254] 在图48h所示的进一步的步骤中,可充盈的反流病治疗器件10以其排空状态被置于篮状结构中。 [0254] In a further step 48h as shown in the figure, can filling reflux disease treatment device 10 in its empty state are placed in a basket-like structure. 然后,反流病治疗器件10被充盈到其充盈或扩张状态,参见图48i。 Then, the reflux disease treatment device 10 is filling its filling or expanded state, see Figure 48i. 反流病治疗器件10的充盈可以通过将流体或凝胶注入排空的反流病治疗器件中来完成。 Filling reflux disease treatment device 10 may be a fluid or gel injected by emptying reflux disease treatment device to complete. 还可以通过注入能够固化的材料来完成,从而形成实心器件10。 It can also can be cured by injecting material to complete, thereby forming a solid device 10. 因此,图48h和图48i所示的反流 Thus, Figure 48h and 48i reflux shown

43病治疗器件10可以表现为接下来填充流体或凝胶的气球状器件,或者可替换地,表现为简单地注入到胃壁12a所形成的篮状结构中的材料。 43 disease treatment device 10 can be expressed as the following fluid-filled balloon-like device or a gel, or alternatively, the performance is simply injected into the stomach wall 12a of the basket-like structures formed in the material.

[0255] 用于填充反流病治疗器件10的流体可以是适于填充可充盈器件10的任意合适的流体,例如盐溶液。 [0255] is used to fill fluid reflux disease treatment device 10 may be adapted to be filled with any suitable fluid filling device 10, such as saline solution. 在另一个实施方案中,在该流体为适于转化为固态的流体时,所述流体可以是液态的聚氨酯。 In another embodiment, the fluid is adapted to flow into a solid, the fluid may be a liquid polyurethane.

[0256] 为了将泄漏最小化或完全消除,流体是等渗压的,即其与人体的体液具有相等的渗透压。 [0256] In order to minimize or completely eliminate the leak, the fluid is isotonic, that it has an equal osmotic pressure and the body's fluids. 防止扩散的另一种方式是提供包含大分子的流体,例如碘分子。 Another way to prevent the spread is to provide a fluid containing macromolecules, such as iodine molecules.

[0257] 所述胃-胃缝线或U形钉优选具有呈现出诸如网状结构的结构的固定部分,所述结构适于与胃壁相接触,以促进人体组织的生长,从而保证所述反流病治疗器件长期附着 [0257] The Stomach - gastric sutures or staples preferably have a U-shaped portion exhibits a fixed structure such as a net-like structure, the structure is adapted to contact with the stomach wall, in order to promote the growth of human tissue, thus ensuring the anti- Long-term treatment of reflux disease attached devices

胃壁放置。 Place the stomach.

[0258] 当可充盈器件10被部分或完全充盈之后,反流病治疗器件10的入口IOb (在图48h和48i中未示出)被密封,并且将器件600从孔洞12b中撤回,接下来以某种合适的方式例如借助于器件600闭合孔洞12b。 [0258] After filling the device 10 may be partially or completely filling, reflux disease treatment device inlet IOb 10 (in FIG. 48h and 48i not shown) is sealed, and the device 600 to withdraw from the hole 12b, and the next in some suitable manner, for example by means of a device 600 closes the hole 12b. 然后,将所述仪器从胃600中取出,并且处于充盈状态或扩张状态的可充盈器件10在患者的胃壁的外侧被胃壁部分套叠。 Then, the instrument is removed from the stomach 600, and in filling state or the expanded state may be filling device 10 on the outside of the patient's stomach is gastric part nesting. 在以上所述的一个或多个步骤的过程中,胃可以充气,优选借助于胃镜仪器充气。 In the process according to one or more of the above steps, the stomach may be inflated, preferably by means of a pneumatic endoscopy instruments.

[0259] 以上参考图48a_i描述的反流病治疗器件10被描述为可充盈的反流病治疗器件。 [0259] above with reference to FIG 48a_i reflux disease treatment device 10 described is described as filling reflux disease therapy device. 可以理解,该反流病治疗器件也可以是具有允许压缩的弹性的弹性反流病治疗器件,以便将其插入胃镜仪器,并在离开所述仪器之后扩张到扩张状态。 It will be appreciated that reflux disease treatment device may also be having an elastic compression elastic permit reflux disease treatment device to be inserted into the endoscopic instrument, and the instrument after leaving expansion to the expanded state.

[0260] 用于治疗反流病的设备可以具有治疗肥胖症的附加功能。 [0260] for the treatment of reflux disease treatment of obesity devices may have additional features. 在这种实施方案中,所述反流病治疗器件可以是填充胃的容积从而产生饱胀感的容积填充器件。 In this embodiment, the reflux disease treatment device can be filled with the volume of the stomach to produce a sense of fullness in the volume filling device. 一个具有这种功能的实施方案示于图49中,其中合并的反流病治疗器件和肥胖症治疗器件310被套叠到胃壁中,当患者处于站立位置时,该器件310接近于患者贲门14并且至少部分位于贲门14之上,并且由诸如缝线或U形钉22之类的固定器固定在贲门区域14c之上的位置。 Embodiments having this feature is shown in FIG. 49, in which the combined treatment of reflux disease and obesity treatment device 310 invaginated device to the stomach wall, and when the patient is in a standing position, the device 310 is close to 14 patients with cardiac and located at least partially above the cardia 14, and the U-shaped staples such as sutures or 22 like fixation on the location of the cardia region 14c. 例如,可以设置到横膈膜肌肉或相关联肌肉的直接或间接的固定器。 For example, you may be provided to the diaphragm muscle or muscles associated directly or indirectly holder. 作为一个替代方案,可以提供到食管的在His角之上并接近于His角的直接或间接的固定器。 As an alternative, you can offer to the esophagus above the angle of His and His angle close to a direct or indirect holder. 在该替代的实施方案中, 合并的器件310在被植入时位于紧靠胃底壁的位置处,并且该器件还填充了贲门区域14c 之上在所述贲门与横膈膜肌肉之间的容积,从而防止贲门向上滑入胸腔,从而防止反流病。 In this alternative embodiment, the combined device 310 is positioned immediately alongside the gastric wall when implanted, and the device is also packed with over cardia region 14c between the cardia and the diaphragm muscle volume, thereby preventing cardiac chest slide upward, thereby preventing reflux disease.

[0261] 这种合并的器件310可以用于容纳电子设备和/或能源和/或液压流体。 [0261] This combined device 310 may be used to accommodate electronic equipment and / or energy and / or hydraulic fluid. 来自该器件的液压流体可以被分配到若干个较小的可充盈的器件区域中,以不时地改变拉伸区域,从而避免对胃壁造成任何可能的更持久的拉伸效果。 The hydraulic fluid from the device can be assigned to several smaller filling device region may, from time to time to change the stretch zones, thereby avoiding any possible cause stomach more permanent stretching effect. 甚至可以使用若干个以机械方式拉伸的区域。 You can even use several mechanically stretched region.

[0262] 反流病治疗器件_拉伸器的合并 [0262] reflux disease treatment device _ stretcher merger

[0263] 在图50所示的一个替代的实施方案中,可充盈的反流病治疗器件310的容积可以与一个或多个优选较小的可充盈器件或腔室IOb流体连接。 [0263] In FIG. 50 an alternative embodiment, the volume can be filling reflux disease treatment device 310 may communicate with one or more preferred filling device can be smaller or chamber in fluid connection IOb. 这些腔室适于连通在这些腔室之间移动的流体或空气。 The chamber is adapted to communication between the chambers in fluid or air movement.

[0264] 因此,大腔室310因其具有的主容积适于作为用于减小食物腔尺寸并用于治疗反流病的反流病治疗器件,并且所述一个或多个小腔室适于充当治疗肥胖症的可充盈器件的功能,其中所述主腔室适于将流体或空气连通至小腔室,从而产生胃壁的拉伸效果,进而进一步治疗肥胖症。 [0264] Therefore, the large chamber 310 has adapted its main volume as the chamber for reducing the size of the food and for the treatment of reflux disease, reflux disease treatment device, and the one or more small chamber adapted Treatment of obesity may act as filling device functions, wherein the main chamber is adapted to be in fluid communication with air or a small chamber, resulting in stretching effect of the stomach wall, thereby further treatment of obesity. [0265] 图51示出了将套叠在胃的中部或下部的容积填充器件与套叠到患者的胃的上部或胃底中的拉伸器合并的一个实施方案。 [0265] FIG. 51 illustrates the nesting in the middle or lower part of the stomach volume filling device and nested into the patient's stomach or upper part of one embodiment of the fundus of the stretcher merger. 这两个器件用于治疗肥胖症。 These two devices for the treatment of obesity.

[0266] 容积填充器件399填充胃的容积从而产生饱胀感。 [0266] 399 to fill the volume of the stomach volume filling device to produce a sense of fullness. 所述拉伸器拉伸胃壁。 The stretching is stretching the stomach wall. 这拉伸了发出产生饱胀感的内源性信号的组织。 This stretch of the organization is making endogenous signal a feeling of satiety. 这模拟了用食物填充胃的拉伸效果。 This simulates the filling of the stomach with food stretch effect. 因此,在图51中示出可调整的容积填充器件399,其套叠到患者的胃312的胃壁中。 Thus, in Figure 51 shows adjustable volume filling device 399, which nested into a patient's stomach in the stomach 312. 另外,具有先前所描述的功能的可调整的拉伸器350套叠在患者的胃底壁中。 In addition, with the previously described function of adjustable stretcher 350 nested in the patient's gastric wall. 优选容积填充器件399明显大于拉伸器350。 Preferably the volume filling device 399 is significantly greater than the tensile 350.

[0267] 容积填充器件399和拉伸器350可以适于治疗反流病。 [0267] volume filling devices 399 and 350 may be adapted to stretch treatment of reflux disease. 在一个实施方案中,所述容积填充器件和拉伸器被放置为防止贲门14通过疝的缺口18a向上滑到横膈膜18之上的位置。 In one embodiment, the volume filling device is placed and stretched to prevent the cardia 14 through hernia gap 18a slide upwardly on the position of the diaphragm 18.

[0268] 容积填充器件399和拉伸器350通过其中设有泵354的第一流体管352彼此流体连通。 [0268] volume filling devices 399 and 350 through which the stretch with a first fluid pump 354 of the tube 352 in fluid communication with each other. 泵354受能量转换器330的控制,能量转换器330适于通过供能线356给泵350供应能量。 Pump 354 by the energy converter control 330, 356 energy converter 330 is adapted to supply energy to pump 350 by energizing the line. 能量转换器330还连接至设在患者食管中的传感器319,从而可以探测到食物摄入。 Power converter 330 is also connected to the esophagus in a patient is provided a sensor 319, so that food intake can be detected.

[0269] 反流病治疗器件10和拉伸器350还通过第二流体管358流体连通,第二流体管358优选具有比第一流体管352小的横截面积。 [0269] reflux disease treatment device 10 and stretch 350 through pipe 358 in fluid communication with the second fluid, the second fluid tube 358 preferably has a fluid tube 352 smaller than the first cross-sectional area.

[0270] 这种配置方案的操作如下。 Operation [0270] This configuration is as follows. 容积填充器件399起到如在上述的实施方案中一样的功能,即其减小患者胃12的食物腔的尺寸。 Volume filling device 399 in the same function as the above-described embodiment functions, i.e., the size of which is reduced in patients with gastric cavity 12 of the food. 另外,当通过用泵354从容积填充器件10向拉伸器350泵送流体来扩张拉伸器350时,胃底壁被拉伸,从而使患者产生饱胀感。 In addition, when a pump 354 by volume filling device 10 from stretching 350 pumping a fluid to expand stretcher 350, the gastric wall is stretched, so that patients have a sense of fullness. 因此,例如当用传感器319探测到食物摄入时,流体自动被泵送到拉伸器350中,以增加饱胀感,从而限制食物摄入。 Thus, for example, when the sensor 319 is detected by the intake of food, fluid is automatically pumped into the stretching device 350, in order to increase a sense of fullness, thus limiting food intake.

[0271 ] 当流体被注入拉伸器350时,其中的内部压高于反流病治疗器件399中的内部压。 [0271] When the fluid is injected into the tensioners 350, which is higher than the internal pressure of reflux disease treatment device 399 internal pressure. 该压力差在优选较窄的第二管358中产生从拉伸器350到反流病治疗器件399的流体流。 The pressure difference generated from 350 to stretch reflux disease treatment device 399 of the fluid flow in the preferred narrower second tube 358. 流速可以通过例如压力差和第二管358的截面积来确定。 The flow rate can be determined by, for example a pressure difference and a second cross-sectional area of the tube 358. 优选所述第二管的尺寸被设置为使得在流体注入拉伸器350以产生饱胀感之后的3个小时后,容积填充器件399和拉伸器350中的压力回复平衡。 Preferably, the second tube is dimensioned such that the fluid injection stretch 350 to 3 hours to produce a sense of fullness after, the volume filling device 399 and 350 of the pressure stretching back into balance.

[0272] 在该实施方案中,第二管358的功能是使流体能够从拉伸器350返回到容积填充器件399。 [0272] In this embodiment, the second pipe 358 functions enable fluid 350 returned from the stretcher to the volume filling device 399. 可以理解,该功能还可以由第一管352中的泵354来执行,此时第二管358可以省略。 Will be appreciated, this function can also be performed by the first pump 354 in the tube 352, while the second tube 358 may be omitted.

[0273] 在胃壁内侧放置反流病治病器件的方法 [0273] placing reflux disease treatment device method on the inside of the stomach

[0274] 在下文中,将描述在胃壁内侧放置反流病治疗器件的方法和仪器。 [0274] In the following, description will be placed reflux disease treatment device Method and apparatus for the inside of the stomach.

[0275] 图52a_l中描述了一般由630表示的套叠仪器,该套叠仪器包括与以上参考图48a-i所描述的细长构件607类似的细长管构件632。 [0275] FIG 52a_l described telescopic instrument generally indicated by the 630, the apparatus includes an elongate member telescopically above with reference to FIG. 48a-i 607 described a similar elongated tube member 632. 因此,它可以连接至控制单元606,参见图48a。 Thus, it can be connected to the control unit 606, see FIG. 48a. 套叠仪器630进一步包括有孔的抽吸部分634,其优选是细长的。 Instrument 630 further includes a telescoping portion 634 has a suction hole, which is preferably elongated. 抽吸部634呈现出多个小孔636,通过在管构件632中抽吸将空气抽吸进多个小孔636中。 Suction unit 634 showing a plurality of apertures 636, 632 by the suction tube member in the air is sucked into the plurality of apertures 636. 这种抽吸效果可用于在一般用12a表示的部分胃壁中产生“ 口袋”或“袋囊”。 This suction effect can be used to generate a "pocket" or "pouch" in the section of the stomach wall 12a represented by general.

[0276] 换句话说,当抽吸部分634的头部被压到胃壁12a上时,会在其中形成小的凹陷, 参见图52a。 [0276] In other words, when the suction head portion 634 is pressed onto the stomach wall 12a, in the small recess formed therein, see Figure 52a. 当抽吸部634被进一步压到胃壁12a上时,会形成更大的凹陷,参见图52b。 When the suction unit 634 is further pressed to the stomach wall 12a, it will form a larger depression, see Figure 52b. 胃壁12a中形成凹陷的部分会由于抽吸效果而贴附到套叠仪器630的抽吸部634上。 Part of the stomach wall 12a formed in depressions due to the suction effect of the suction unit 634 is attached to the telescopic instrument 630. 当抽吸部634被进一步按压到胃壁12a上时,会形成较深的凹陷,参见图52c,直到整个抽吸部634 嵌入所述凹陷中,参见图18d。 When the suction unit 634 is further pressed to the stomach wall 12a, the formation of deep depression, see Fig. 52c, until the entire suction portion 634 is embedded in the recess 18d see Fig.

[0277] 在该阶段,所述凹陷的边缘用固定件638固定,并且所述抽吸部分从仪器中移出, 参见图52e。 [0277] In this stage, the edge of the recess 638 for fixing the fixing member, and the suction portion is removed from the apparatus, see Figure 52e. 接下来,将压缩的弹性反流病治疗器件10以例如以上参考图47d所述的方式插入所述凹陷中,参见图52f。 Next, the compressed resilient reflux disease treatment device 10, for example, with reference to FIG manner described above is inserted into the recesses 47d, see Fig. 52f. 然后,使压缩的反流病治疗器件扩张成其最终形状,参见图52g,然后通过用固定件缝合或钉合将所述袋囊密封,参见图52h。 Then, the compressed reflux disease treatment device is expanded into its final shape, see Figure 52g, then by stitching or stapling fixture the pouch seal, see Fig. 52h.

[0278] 以上参考图1-51所描述的所有的替代方案也可以应用于参考图52a_l所描述的实施方案中,即应用于所述反流病治疗器件在胃壁内侧套叠的实施方案。 [0278] All of the alternatives described above with reference to Figure 1-51 may also be applied with reference to FIG 52a_l the described embodiments, i.e. reflux disease treatment device on the inside of the stomach wall invaginated applied to the embodiment.

[0279] 图53a_c示出了一种用于创建胃壁的套叠的仪器;取决于所述反流病治疗器件是被放置在胃壁内侧还是外侧,所述胃壁的套叠可以置于胃壁外侧也可以置于胃壁内侧。 [0279] FIG 53a_c shows instrument for creating a nested stomach wall; depends on the reflux disease treatment device is placed in the inside or the outside of the stomach, the stomach wall can be placed on the outside of the stomach wall nesting also It can be placed on the inside of the stomach wall. 该仪器对进入该仪器的杯体中的胃壁部分应用真空。 The instrument for entering the body of the stomach wall cup part of the application of vacuum.

[0280] 已经描述了如何用胃镜仪器将反流病治疗器件10套叠到胃壁中。 [0280] have described how to use endoscopic instrument reflux disease treatment device 10 nested into the stomach wall. 所述胃镜仪器可以用于将所述反流病治疗器件置于胃壁外侧(如图IA所示),或置于胃的内侧(如图2A 中所示)。 The endoscopic instrument may be used to the reflux disease treatment device disposed outside of the stomach wall (as shown in FIG. IA), or placed on the inside of the stomach (as shown in Figure 2A). 在后一情况下,该仪器被用于在胃壁上从胃的内侧制造切口。 In the latter case, the instrument is used in the manufacture of the stomach from the inside of the stomach incision.

[0281] 可以理解,也可以使用腹部手术方法。 [0281] It will be appreciated abdominal surgical methods may also be used. 现在将参考图54-55描述这种方法。 54-55 will now be described with reference to FIG this method. 在图54中示出了如何通过在患者腹部制造切口380来到达胃。 In FIG. 54 illustrates how the incision in the patient's abdomen manufacture 380 to reach the stomach. 在图55中示出了如何将仪器381 插入患者的腹部。 In FIG. 55 illustrates how the instrument 381 inserted into the patient's abdomen. 只要适于实现此目的,可以选择所述的任何仪器和方法。 As long as suitable for this purpose, you can select any instrument and method described. 因此,例如,所述反流病器件可以如图IA所示被放置在胃的外侧,或者图2A所示被放置在胃的内侧。 Thus, for example, the device can reflux disease as shown in FIG. IA is placed on the outside of the stomach, or as shown in FIG. 2A is placed on the inside of the stomach. 在后一情况下,在胃壁上制造切口。 In the latter case, the manufacturer incision in the stomach wall.

[0282] 重要的是,植入的反流病治疗器件被牢固地保持在胃壁中被套叠的位置。 [0282] Importantly, implanted reflux disease treatment device is securely retained in the stomach wall quilt stack position. 为此,所述反流病治疗器件可以设有一个或多个适于接纳用于固定所述套叠的缝线或U形钉的通孔。 To this end, the reflux disease treatment device may be provided with one or more nested adapted to receive sutures or staples for fixing the U-shaped through-hole. 这种实施方案示于图42中,其中反流病治疗器件10具有一排孔10i,这些孔被设在所述反流病治疗器件上突出的凸缘状的突起上。 This embodiment is illustrated in FIG. 42, where the reflux disease treatment device 10 having a row of holes 10i, these holes are provided on the reflux disease treatment device projecting flange-like projections. 在该实施方案中,这排孔沿着所述反流病治疗器件的长轴延伸。 In this embodiment, the row of holes extending along the reflux disease treatment device of the major axis.

[0283] 图43示出了如何使用缝线314以使它们穿过胃壁12a并穿过孔IOi。 [0283] FIG. 43 shows how the suture 314 such that they pass through the stomach and through the holes 12a IOi. 以此方式, 所述反流病治疗器件被固定在由胃壁创建的袋囊中,因此可以防止滑动。 In this way, the reflux disease treatment device is fixed by the stomach pouch is created, so you can prevent sliding.

[0284] 尽管在图42中示出多个孔,但是可以理解,单独一个孔也足以能够改进对反流病治疗器件10的固定。 [0284] Although a plurality of apertures is shown in FIG. 42, it will be appreciated, a single hole may be sufficient to improve the fixing of the reflux disease treatment device 10.

[0285] 图44示出了设有入口IOh的反流病治疗器件。 [0285] FIG. 44 illustrates an inlet IOh reflux disease therapy device. 该反流病治疗器件被套叠到胃壁中,并且入口IOh可以用于连接来自患者的腹部区域的管等。 The reflux disease treatment device is invaginated into the stomach wall and entrance IOh be used to connect the abdominal region of the tube from the patient.

[0286] 图45示出了一个被套叠的反流病治疗器件,其中代替入口的固定管IOg延伸到患者的腹部区域。 [0286] FIG. 45 shows a quilt stack of reflux disease treatment device, which, instead of fixing the inlet tube IOg extends to the abdominal area of the patient.

[0287] 图46是类似于图44的图,但是还示出在胃壁中的连接管IOg在入口IOh与反流病治疗器件10之间的隧道作用。 [0287] FIG. 46 is similar to Figure 44, but also shows in the stomach in the tunnel connecting pipe between the inlet IOh IOg and reflux disease treatment device 10.

[0288] 已经示出所述反流病治疗器件的形状可以采取很多不同的形式。 [0288] It has been shown the reflux disease treatment device shape can take many different forms. 可以理解,反流病治疗器件的材料也可以改变。 It will be appreciated reflux disease treatment device material may also vary. 优选所述反流病治疗器件具有涂层,诸如聚对二甲苯、聚四氟乙烯(PTEE)或聚氨酯涂层或者这些涂层的组合,即多层涂层。 Preferably, the reflux disease treatment device with a coating, such as parylene, polytetrafluoroethylene (PTEE) or a combination of these coatings or polyurethane coatings, namely multi-layer coating. 该涂层或多层涂层改善了所述反流病治疗器件的性质,例如其耐磨性。 This coating or multi-layer coating improves the reflux disease treatment device properties, such as its abrasion resistance.

[0289] 在一个实施方案中,反流病治疗器件包括可扩张成扩张状态的可充盈器件。 [0289] In one embodiment, the reflux disease treatment device comprises an expandable into an expanded state can filling devices. 在这 In this

46种情况下,所述可充盈器件设有用于流体的入口,并且适于与胃镜仪器相连。 At 46 cases, the device may be provided with an inlet for fluid filling, and the endoscopic instrument adapted for connection. 现将参考图47a-47d对此实施方案进行详细的描述。 Now with reference to FIG. 47a-47d of this embodiment is described in detail.

[0290] 处于非扩张状态的可充盈的反流病治疗器件示于图47a中。 [0290] in a non-expanded state may be filling reflux disease treatment device is shown in Figure 47a in. 它基本上成气球样, 排空器件10具有入口10h。 It's basically a balloon-like emptying device 10 has an inlet 10h. 在这种状态下,所述可充盈的器件最多具有几毫米的直径,从而能够通过图47b所示的管状胃镜仪器600将其通过患者的食管插入胃中。 In this state, the filling device may have a maximum diameter of a few millimeters, so that the tubular endoscopic instrument shown by FIG. 47b can be inserted into the stomach 600 through the patient's esophagus. 该仪器包括外套管600a和可以在长度方向上相对于所述外套管移动的内套管600b。 The apparatus comprises an outer tube 600a and the tube can be moved in the longitudinal direction with respect to the housing inner sleeve 600b. 所述内套管在其远端具有刀刃615形式的切割工具。 Said inner sleeve having a cutting edge at its distal end 615 in the form of a cutting tool. 该刀刃可以用于在胃壁中切割孔洞,以下将作出详细解释。 The blade can be used to cut the hole in the stomach wall, the following will give a detailed explanation.

[0291] 当所述仪器到达胃壁时,参见图47c,将内套管从其在外套管中的位置向前移动, 并与胃壁12a相接触。 [0291] When the instrument reaches the stomach wall, see Fig. 47c, the inner sleeve is moved forward from the position of the outer sleeve, and in contact with the stomach wall 12a. 然后,内套管的刀刃615在胃壁上切割一个孔洞,以允许接下来将反流病治疗器件10插入并通过该孔洞,见图47d。 Then, the inner sleeve of the blade 615 to cut a hole in the stomach wall, in order to allow the next will reflux disease treatment device 10 is inserted through the hole as shown in Figure 47d. 为了推动所述反流病治疗器件通过该孔洞, 可以在该仪器中设置活塞602。 In order to promote the reflux disease treatment device through the hole, the piston 602 may be provided in the instrument. 因此,该仪器进一步包括活塞602,该活塞适于将排空的反流病治疗器件10从在内套管中的位置推出到内套管外部的位置,所述排空的反流病治疗器件10在内套管中的位置在图47b中示出,其被推出到内套管外的位置示于图47d中。 Thus, the apparatus further includes a piston 602, the piston adapted to emptying reflux disease treatment device 10 from the position of the inner cannula introduced into a position outside the casing, the emptying of the reflux disease treatment device the inner sleeve 10 in the position shown in FIG. 47b, which is pushed into the outer sleeve in the position shown in Figure 47d.

[0292] 为了保护排空的反流病治疗器件10不被内套管的刀刃615损伤,可以在反流病治疗器件周围设置另外的保护套管(未示出)。 [0292] In order to protect the evacuated reflux disease treatment device 10 will not damage the inner sleeve of the blade 615, you can set additional protective sleeve (not shown) around the reflux disease treatment device.

[0293] 现在参考图48a_i描述一种在胃壁12a的外侧套叠所述反流病治疗器件10的管腔内方法。 [0293] Referring now to FIG 48a_i describes a stomach wall 12a of the outer telescoping the reflux disease treatment device 10 within the lumen of the method. 开始时,将仪器600、优选是胃镜仪器插入到患者的嘴中,参见图48a。 Initially, the instrument 600, preferably endoscopic instrument inserted into the patient's mouth, see Figure 48a. 该仪器包括用于向患者的胃中注入流体或器械的注入器601、602。 The instrument includes an injection to a patient's stomach fluid injector 601, 602, or instrument. 仪器600进一步包括适于控制该仪器的工作的控制单元606。 Apparatus 600 further includes a control unit 606 is adapted to control the instrument work. 为此,控制单元606包括一个或多个操纵器,在该图所示的实施方案中是两个操纵杆603和两个控制按钮604的形式。 To this end, the control unit 606 comprises one or more manipulators, in the embodiment shown in the figure is in the form of two joysticks 603 and two control buttons 604. 设置显示器605用于显示由设在细长构件607的外端处的摄像机(未示出)提供的图像,参见图48e-i。 Setting up the monitor for display provided by 605 located at the outer end of the elongated member 607 of the camera (not shown) of the image, see Fig. 48e-i. 所述摄像机可以由光源(未示出)辅助。 The camera can (not shown) by the auxiliary light source.

[0294] 该仪器进一步被插入患者的食管,并进入患者的胃中,参见图48b。 [0294] The instrument is further inserted into the patient's esophagus and into the stomach of the patient, see Figure 48b. 借助于仪器600,在胃12的壁上创建孔洞12b。 By means of the instrument 600, creating holes 12b in the wall 12 of the stomach. 为此,该仪器在其远端设有一个或多个切割工具615,例如以以上参考图47a-d所述的方式设置。 To this end, the apparatus is provided with one or more cutting tool 615 at its distal end, e.g., in the manner above described with reference to FIG. 47a-d is provided. 这些切割工具当然可以以不同的方式设计,例如绕所述管状仪器的中心轴旋转的齿状鼓切割工具。 The cutting tool of course be designed in different ways, e.g., toothed drum about said central axis of rotation of the tubular instrument cutting tool. 仪器600是中空的,从而为处于放气状态的反流病治疗器件10提供空间。 Instrument 600 is hollow, so as to put gas in the state of reflux disease treatment device is provided space 10.

[0295] 在胃壁上切割孔洞之后,仪器600的远端被插入并通过孔洞12b,使其最后处于胃壁12a的外部。 [0295] After the cutting holes in the stomach, the distal end of the instrument 600 is inserted through the hole 12b, so that finally in external stomach wall 12a. 这在图48c和图48d中示出,其中图48c示出胃12的侧视图,图48d是沿图48c中的线Vd-Vd截取的通过图48c的胃的截面图。 This is shown in FIG. 48c and FIG. 48d, in which FIG. 48c shows a side view of the stomach 12, and FIG. 48d is taken along the line Vd-Vd in Figure 48c taken through the stomach of a sectional view of FIG. 48c. 然后,排空的反流病治疗器件10被插入腹部区域。 Then, emptying reflux disease treatment device 10 is inserted into the abdominal area.

[0296] 仪器600适于在胃12的外侧围绕胃壁中的孔洞12b创建一个“ 口袋”或“袋囊”。 [0296] instrument 600 adapted to fit around the hole in the stomach wall 12b to create a "pocket" or "pouch" on the outside of the stomach 12. 现在将描述提供这种袋囊的仪器和方法。 We will now be described to provide apparatus and methods of this pouch.

[0297] 图48e_i示出了用于通过创建其中放置反流病治疗器件的胃壁12a材料的袋囊在患者的胃壁12a中套叠反流病治疗器件10的一个胃镜或腹腔镜仪器。 [0297] FIG 48e_i shows a stomach by creating a place where the bag reflux disease treatment device 12a of the material in the patient's stomach pouch 12a of the telescopic reflux disease treatment device is an endoscopic or laparoscopic instrument 10. 通常由600表示并且可以包括以上参考图47a-d所述的特征的仪器,包括具有近端和和远端的细长构件607, 细长构件607具有小于患者食管的直径,并且是柔性的,从而使得能够引入柔性的细长构件607,其远端首先通过患者咽喉、食管,并进入胃12到达胃壁12a。 Usually represented by the 600 and may include features described above with reference to FIG. 47a-d said instrument comprising an elongated member having a proximal end and a distal end 607 and elongate member 607 having a diameter less than the patient's esophagus, and is flexible, thereby enabling the introduction of the flexible elongate member 607, its distal end first through the patient throat, esophagus and into the stomach 12 reaches the stomach wall 12a.

[0298] 胃穿刺器件或切割工具615设置在细长构件607的远端用于刺穿胃壁12a,从而在胃壁12a上创建一孔洞,以使得能够通过该孔洞引入细长构件607。 [0298] stomach puncturing devices or cutting tool 615 disposed at the distal end of the elongate member 607 to pierce the stomach wall 12a, thereby creating a hole in the stomach wall 12a, to enable the introduction of the elongate member 607 through the hole. 为了不进一步损伤身体内的组织,胃穿刺器件615可以适于是可操作的,以在刺穿胃底壁12a之后撤回所述胃穿刺器件615。 In order not to further damage the body's tissues, stomach puncture device 615 may be adapted to be operable to pierce the gastric wall 12a after withdrawing the stomach puncture device 615. 该仪器进一步包括设在细长构件607上靠近穿刺器件615 —侧的专用夹持器609。 The apparatus further comprises an elongate member 607 provided on the puncture device near 615-- special holder 609 side.

[0299] 所述细长构件进一步包括可扩张的构件611,可扩张的构件611适于在所述细长构件刺穿胃壁12a之后扩张,从而帮助创建适于容纳反流病器件610的腔或袋囊。 [0299] The elongated member further comprises an expandable member 611, the expandable member 611 is adapted to pierce the stomach wall 12a of the elongate member after the expansion, thereby helping to create the device is adapted to accommodate 610 reflux disease or cavities bag. 可扩张的构件611可以包括环周地围绕柔性细长构件607的远端部分设置的可充盈的圆形气球。 Expandable member 611 may include a ring around the periphery of the distal end portion of the flexible elongate member 607 may be provided round balloon filling.

[0300] 现在将详细描述套叠所述反流病治疗器件时的方法步骤。 [0300] Now will be described in detail the nesting reflux disease treatment method steps when the device is. 在器件600插入胃12之后,胃穿刺器件615接触胃壁12a放置,参见图48e。 After the device 600 is inserted stomach 12, the stomach puncture device 615 is placed in contact stomach wall 12a, see Figure 48e. 接着,引导胃穿刺器件或切割装置615 在胃壁中创建孔洞12b,之后至少引导所述可扩张的构件611通过胃壁中的孔洞12b。 Then, guided stomach puncture device or cutting device 615 creating holes 12b in the stomach, after which at least guide the expandable member 611 through the stomach wall holes 12b. 在该步骤中,使专用夹持器609处于夹持状态,在该状态下它在径向扩张,以形成基本圆形的抵住胃壁12a的表面,参见48f。 In this step, the holder 609 is in dedicated clamped state, in which state it expand radially to form a substantially circular surface 12a against the stomach wall, see 48f. 以此方式,胃穿刺器件615和可扩张的构件611通过胃壁中的孔12a的插入局限在图48f所示的位置。 In this manner, the gastric biopsy device and the expandable member 615 through the stomach wall 611 is inserted in the hole 12a in the position shown in FIG limited to 48f.

[0301] 然后,可扩张的构件611被扩张。 [0301] Then, the expandable member 611 is expanded. 在所述可扩张的构件包括气球等的情况下,空气或其它流体被注入其中。 In the case of balloon expandable member such as lower include, air or other fluid is injected therein.

[0302] 然后,将细长构件607中包括可扩张的构件611的部分向近端方向撤回,如图48g 中的箭头所示,从而将胃壁612拉进由专用夹持器609形成的篮状结构中。 [0302] Then, the portion of the elongate member 607 comprises an expandable member 611 in the proximal direction to withdraw the arrows in Figure 48g, which will pull into the basket 612 stomach by a dedicated holder 609 is formed structure.

[0303] 进一步使用缝合或钉合器件608,或作为连接至细长构件607的器件或作为独立的器件。 [0303] Further use of stitching or stapling device 608, or as an elongated member 607 is connected to a device or as a stand-alone device. 所述缝合或钉合构件包括缝合或钉合端613,其适于用胃-胃缝线或U形钉14闭 The stitching or stapling member comprises a suture or stapling end 613, which is adapted with a stomach - gastric sutures or U-shaped staples 14 closed

合腔室或袋囊。 Co-chamber or pouch.

[0304] 在图48h所示的进一步的步骤中,可充盈的反流病治疗器件10以其排空状态被置于篮状结构中。 [0304] In a further step 48h as shown in the figure, can filling reflux disease treatment device 10 in its empty state are placed in a basket-like structure. 然后,反流病治疗器件10被充盈到其充盈或扩张状态,参见图48i。 Then, the reflux disease treatment device 10 is filling its filling or expanded state, see Figure 48i. 反流病治疗器件10的充盈可以通过将流体或凝胶注入排空的反流病治疗器件中来完成。 Filling reflux disease treatment device 10 may be a fluid or gel injected by emptying reflux disease treatment device to complete. 还可以通过注入能够固化的材料来完成,从而形成实心器件10。 It can also can be cured by injecting material to complete, thereby forming a solid device 10. 因此,图48h和图48i所示的反流病治疗器件10可以表现为接下来填充流体或凝胶的气球状器件,或者可替换地,表现为简单地注入到胃壁12a所形成的篮状结构中的材料。 Thus, FIG. 48h and 48i reflux disease treatment device shown in Fig. 10 can be expressed as the following fluid-filled balloon-like device or a gel, or alternatively, the performance is simply injected into the stomach wall 12a of the basket-like structures formed the material.

[0305] 用于填充反流病治疗器件10的流体可以是适于填充可充盈器件10的任意合适的流体,例如盐溶液。 [0305] is used to fill fluid reflux disease treatment device 10 may be adapted to be filled with any suitable fluid filling device 10, such as saline solution. 在另一个实施方案中,在该流体为适于转化为固态的流体时,所述流体可以是液态的聚氨酯。 In another embodiment, the fluid is adapted to flow into a solid, the fluid may be a liquid polyurethane.

[0306] 为了将泄漏最小化或完全消除,流体是等渗压的,即其与人体的体液具有相等的渗透压。 [0306] In order to minimize or completely eliminate the leak, the fluid is isotonic, that it has an equal osmotic pressure and the body's fluids. 防止扩散的另一种方式是提供包含大分子的流体,例如碘分子。 Another way to prevent the spread is to provide a fluid containing macromolecules, such as iodine molecules.

[0307] 所述胃-胃缝线或U形钉优选具有呈现出诸如网状结构的结构的固定部分,所述结构适于与胃壁相接触,以促进人体组织的生长,从而保证所述反流病治疗器件长期附着 [0307] The Stomach - gastric sutures or staples preferably have a U-shaped portion exhibits a fixed structure such as a net-like structure, the structure is adapted to contact with the stomach wall, in order to promote the growth of human tissue, thus ensuring the anti- Long-term treatment of reflux disease attached devices

胃壁放置。 Place the stomach.

[0308] 当可充盈器件10被部分或完全充盈之后,反流病治疗器件10的入口IOb (在图48h和48i中未示出)被密封,并且将器件600从孔洞12b中撤回,接下来以某种合适的方式例如借助于器件600闭合孔洞12b。 [0308] After filling the device 10 may be partially or completely filling, reflux disease treatment device inlet IOb 10 (in FIG. 48h and 48i not shown) is sealed, and the device 600 to withdraw from the hole 12b, and the next in some suitable manner, for example by means of a device 600 closes the hole 12b. 然后,将所述仪器从胃600中取出,并且处于充盈状态或扩张状态的可充盈器件10在患者的胃壁的外侧被胃壁部分套叠。 Then, the instrument is removed from the stomach 600, and in filling state or the expanded state may be filling device 10 on the outside of the patient's stomach is gastric part nesting. 在以上所述的一个或多个步骤的过程中,胃可以充气,优选借助于胃镜仪器充气。 In the process according to one or more of the above steps, the stomach may be inflated, preferably by means of a pneumatic endoscopy instruments. [0309] 以上参考图48a_i描述的反流病治疗器件10被描述为可充盈的反流病治疗器件。 [0309] above with reference to FIG 48a_i reflux disease treatment device 10 described is described as filling reflux disease therapy device. 可以理解,该反流病治疗器件也可以是具有允许压缩的弹性的弹性反流病治疗器件,以便将其插入胃镜仪器,并在离开所述仪器之后扩张到扩张状态。 It will be appreciated that reflux disease treatment device may also be having an elastic compression elastic permit reflux disease treatment device to be inserted into the endoscopic instrument, and the instrument after leaving expansion to the expanded state.

[0310] 用于治疗反流病的设备可以具有治疗肥胖症的附加功能。 [0310] for the treatment of reflux disease treatment of obesity devices may have additional features. 在这种实施方案中,所述反流病治疗器件可以是填充胃的容积从而产生饱胀感的容积填充器件。 In this embodiment, the reflux disease treatment device can be filled with the volume of the stomach to produce a sense of fullness in the volume filling device. 一个具有这种功能的实施方案示于图49中,其中合并的反流病治疗器件和肥胖症治疗器件310被套叠到胃壁中,当患者处于站立位置时,该器件310接近于患者贲门14并且至少部分位于贲门14之上,并且由诸如缝线或U形钉22之类的固定器固定在贲门区域14c之上的位置。 Embodiments having this feature is shown in FIG. 49, in which the combined treatment of reflux disease and obesity treatment device 310 invaginated device to the stomach wall, and when the patient is in a standing position, the device 310 is close to 14 patients with cardiac and located at least partially above the cardia 14, and the U-shaped staples such as sutures or 22 like fixation on the location of the cardia region 14c. 例如,可以设置到横膈膜肌肉或相关联肌肉的直接或间接的固定器。 For example, you may be provided to the diaphragm muscle or muscles associated directly or indirectly holder. 作为一个替代方案,可以提供到食管的在His角之上并接近于His角的直接或间接的固定器。 As an alternative, you can offer to the esophagus above the angle of His and His angle close to a direct or indirect holder. 在该替代的实施方案中, 合并的器件310在被植入时位于紧靠胃底壁的位置处,并且该器件还填充了贲门区域14c 之上在所述贲门与横膈膜肌肉之间的容积,从而防止贲门向上滑入胸腔,从而防止反流病。 In this alternative embodiment, the combined device 310 is positioned immediately alongside the gastric wall when implanted, and the device is also packed with over cardia region 14c between the cardia and the diaphragm muscle volume, thereby preventing cardiac chest slide upward, thereby preventing reflux disease.

[0311] 这种合并的器件310可以用于容纳电子设备和/或能源和/或液压流体。 [0311] This combined device 310 may be used to accommodate electronic equipment and / or energy and / or hydraulic fluid. 来自该器件的液压流体可以被分配到若干个较小的可充盈的器件区域中,以不时地改变拉伸区域,从而避免对胃壁造成任何可能的更持久的拉伸效果。 The hydraulic fluid from the device can be assigned to several smaller filling device region may, from time to time to change the stretch zones, thereby avoiding any possible cause stomach more permanent stretching effect. 甚至可以使用若干个以机械方式拉伸的区域。 You can even use several mechanically stretched region.

[0312] 反流病治疗器件_拉伸器的合并 [0312] reflux disease treatment device _ stretcher merger

[0313] 在图50所示的一个替代的实施方案中,可充盈的反流病治疗器件310的容积可以与一个或多个优选较小的可充盈器件或腔室IOb流体连接。 [0313] In FIG. 50 an alternative embodiment, the volume can be filling reflux disease treatment device 310 may communicate with one or more preferred filling device can be smaller or chamber in fluid connection IOb. 这些腔室适于连通在这些腔室之间移动的流体或空气。 The chamber is adapted to communication between the chambers in fluid or air movement.

[0314] 因此,大腔室310因其具有的主容积适于作为用于减小食物腔尺寸并用于治疗反流病的反流病治疗器件,并且所述一个或多个小腔室适于充当治疗肥胖症的可充盈器件的功能,其中所述主腔室适于将流体或空气连通至小腔室,从而产生胃壁的拉伸效果,进而进一步治疗肥胖症。 [0314] Therefore, the large chamber 310 has adapted its main volume as the chamber for reducing the size of the food and for the treatment of reflux disease, reflux disease treatment device, and the one or more small chamber adapted Treatment of obesity may act as filling device functions, wherein the main chamber is adapted to be in fluid communication with air or a small chamber, resulting in stretching effect of the stomach wall, thereby further treatment of obesity.

[0315] 图51示出了将套叠在胃的中部或下部的容积填充器件与套叠到患者的胃的上部或胃底中的拉伸器合并的一个实施方案。 [0315] FIG. 51 illustrates the nesting in the middle or lower part of the stomach volume filling device and nested into the patient's stomach or upper part of one embodiment of the fundus of the stretcher merger. 这两个器件用于治疗肥胖症。 These two devices for the treatment of obesity.

[0316] 容积填充器件399填充胃的容积从而产生饱胀感。 [0316] 399 to fill the volume of the stomach volume filling device to produce a sense of fullness. 所述拉伸器拉伸胃壁。 The stretching is stretching the stomach wall. 这拉伸了发出产生饱胀感的内源性信号的组织。 This stretch of the organization is making endogenous signal a feeling of satiety. 这模拟了用食物填充胃的拉伸效果。 This simulates the filling of the stomach with food stretch effect. 因此,在图51中示出可调整的容积填充器件399,其套叠到患者的胃312的胃壁中。 Thus, in Figure 51 shows adjustable volume filling device 399, which nested into a patient's stomach in the stomach 312. 另外,具有先前所描述的功能的可调整的拉伸器350套叠在患者的胃底壁中。 In addition, with the previously described function of adjustable stretcher 350 nested in the patient's gastric wall. 优选容积填充器件399明显大于拉伸器350。 Preferably the volume filling device 399 is significantly greater than the tensile 350.

[0317] 容积填充器件399和拉伸器350可以适于治疗反流病。 [0317] volume filling devices 399 and 350 may be adapted to stretch treatment of reflux disease. 在一个实施方案中,所述容积填充器件和拉伸器被放置为防止贲门14通过疝的缺口18a向上滑到横膈膜18之上的位置。 In one embodiment, the volume filling device is placed and stretched to prevent the cardia 14 through hernia gap 18a slide upwardly on the position of the diaphragm 18.

[0318] 容积填充器件399和拉伸器350通过其中设有泵354的第一流体管352彼此流体连通。 [0318] volume filling devices 399 and 350 through which the stretch with a first fluid pump 354 of the tube 352 in fluid communication with each other. 泵354受能量转换器330的控制,能量转换器330适于通过供能线356给泵350供应能量。 Pump 354 by the energy converter control 330, 356 energy converter 330 is adapted to supply energy to pump 350 by energizing the line. 能量转换器330还连接至设在患者食管中的传感器319,从而可以探测到食物摄入。 Power converter 330 is also connected to the esophagus in a patient is provided a sensor 319, so that food intake can be detected.

[0319] 反流病治疗器件10和拉伸器350还通过第二流体管358流体连通,第二流体管 [0319] reflux disease treatment device 10 and stretch 350 through pipe 358 in fluid communication with the second fluid, the second fluid tube

49358优选具有比第一流体管352小的横截面积。 49358 preferable than the first fluid tube 352 small cross-sectional area.

[0320] 这种配置方案的操作如下。 Operation [0320] This configuration is as follows. 容积填充器件399起到如在上述的实施方案中一样的功能,即其减小患者胃12的食物腔的尺寸。 Volume filling device 399 in the same function as the above-described embodiment functions, i.e., the size of which is reduced in patients with gastric cavity 12 of the food. 另外,当通过用泵354从容积填充器件10向拉伸器350泵送流体来扩张拉伸器350时,胃底壁被拉伸,从而使患者产生饱胀感。 In addition, when a pump 354 by volume filling device 10 from stretching 350 pumping a fluid to expand stretcher 350, the gastric wall is stretched, so that patients have a sense of fullness. 因此,例如当用传感器319探测到食物摄入时,流体自动被泵送到拉伸器350中,以增加饱胀感,从而限制食物摄入。 Thus, for example, when the sensor 319 is detected by the intake of food, fluid is automatically pumped into the stretching device 350, in order to increase a sense of fullness, thus limiting food intake.

[0321 ] 当流体被注入拉伸器350时,其中的内部压高于反流病治疗器件399中的内部压。 [0321] When the fluid is injected into the tensioners 350, which is higher than the internal pressure of reflux disease treatment device 399 internal pressure. 该压力差在优选较窄的第二管358中产生从拉伸器350到反流病治疗器件399的流体流。 The pressure difference generated from 350 to stretch reflux disease treatment device 399 of the fluid flow in the preferred narrower second tube 358. 流速可以通过例如压力差和第二管358的截面积来确定。 The flow rate can be determined by, for example a pressure difference and a second cross-sectional area of the tube 358. 优选所述第二管的尺寸被设置为使得在流体注入拉伸器350以产生饱胀感之后的3个小时后,容积填充器件399和拉伸器350中的压力回复平衡。 Preferably, the second tube is dimensioned such that the fluid injection stretch 350 to 3 hours to produce a sense of fullness after, the volume filling device 399 and 350 of the pressure stretching back into balance.

[0322] 在该实施方案中,第二管358的功能是使流体能够从拉伸器350返回到容积填充器件399。 [0322] In this embodiment, the second pipe 358 functions enable fluid 350 returned from the stretcher to the volume filling device 399. 可以理解,该功能还可以由第一管352中的泵354来执行,此时第二管358可以省略。 Will be appreciated, this function can also be performed by the first pump 354 in the tube 352, while the second tube 358 may be omitted.

[0323] 在胃壁内侧放置反流病治病器件的方法 [0323] placing reflux disease treatment device method on the inside of the stomach

[0324] 在下文中,将描述在胃壁内侧放置反流病治疗器件的方法和仪器。 [0324] In the following, description will be placed reflux disease treatment device Method and apparatus for the inside of the stomach.

[0325] 图52a_l中描述了一般由630表示的套叠仪器,该套叠仪器包括与以上参考图48a-i所描述的细长构件607类似的细长管构件632。 [0325] FIG 52a_l described telescopic instrument generally indicated by the 630, the apparatus includes an elongate member telescopically above with reference to FIG. 48a-i 607 described a similar elongated tube member 632. 因此,它可以连接至控制单元606,参见图48a。 Thus, it can be connected to the control unit 606, see FIG. 48a. 套叠仪器630进一步包括有孔的抽吸部分634,其优选是细长的。 Instrument 630 further includes a telescoping portion 634 has a suction hole, which is preferably elongated. 抽吸部634呈现出多个小孔636,通过在管构件632中抽吸将空气抽吸进多个小孔636中。 Suction unit 634 showing a plurality of apertures 636, 632 by the suction tube member in the air is sucked into the plurality of apertures 636. 这种抽吸效果可用于在一般用12a表示的部分胃壁中产生“ 口袋”或“袋囊”。 This suction effect can be used to generate a "pocket" or "pouch" in the section of the stomach wall 12a represented by general.

[0326] 换句话说,当抽吸部分634的头部被压到胃壁12a上时,会在其中形成小的凹陷, 参见图52a。 [0326] In other words, when the suction head portion 634 is pressed onto the stomach wall 12a, in the small recess formed therein, see Figure 52a. 当抽吸部634被进一步压到胃壁12a上时,会形成更大的凹陷,参见图52b。 When the suction unit 634 is further pressed to the stomach wall 12a, it will form a larger depression, see Figure 52b. 胃壁12a中形成凹陷的部分会由于抽吸效果而贴附到套叠仪器630的抽吸部634上。 Part of the stomach wall 12a formed in depressions due to the suction effect of the suction unit 634 is attached to the telescopic instrument 630. 当抽吸部634被进一步按压到胃壁12a上时,会形成较深的凹陷,参见图52c,直到整个抽吸部634 嵌入所述凹陷中,参见图18d。 When the suction unit 634 is further pressed to the stomach wall 12a, the formation of deep depression, see Fig. 52c, until the entire suction portion 634 is embedded in the recess 18d see Fig.

[0327] 在该阶段,所述凹陷的边缘用固定件638固定,并且所述抽吸部分从仪器中移出, 参见图52e。 [0327] In this stage, the edge of the recess 638 for fixing the fixing member, and the suction portion is removed from the apparatus, see Figure 52e. 接下来,将压缩的弹性反流病治疗器件10以例如以上参考图47d所述的方式插入所述凹陷中,参见图52f。 Next, the compressed resilient reflux disease treatment device 10, for example, with reference to FIG manner described above is inserted into the recesses 47d, see Fig. 52f. 然后,使压缩的反流病治疗器件扩张成其最终形状,参见图52h,然后通过用固定件缝合或钉合将所述袋囊密封,参见图52i。 Then, the compressed reflux disease treatment device is expanded into its final shape, see Fig. 52h, then by stitching or stapling fixture the pouch seal, see Figure 52i.

[0328] 以上参考图1-51所描述的所有的替代方案也可以应用于参考图52a_l所描述的实施方案中,即应用于所述反流病治疗器件在胃壁内侧套叠的实施方案。 [0328] All of the alternatives described above with reference to Figure 1-51 may also be applied with reference to FIG 52a_l the described embodiments, i.e. reflux disease treatment device on the inside of the stomach wall invaginated applied to the embodiment.

[0329] 图53a_c示出了一种用于创建胃壁的套叠的仪器;取决于所述反流病治疗器件是被放置在胃壁内侧还是外侧,所述胃壁的套叠可以置于胃壁外侧也可以置于胃壁内侧。 [0329] FIG 53a_c shows instrument for creating a nested stomach wall; depends on the reflux disease treatment device is placed in the inside or the outside of the stomach, the stomach wall can be placed on the outside of the stomach wall nesting also It can be placed on the inside of the stomach wall. 该仪器对进入该仪器的杯体中的胃壁部分应用真空。 The instrument for entering the body of the stomach wall cup part of the application of vacuum.

[0330] 已经描述了如何用胃镜仪器将反流病治疗器件10套叠到胃壁中。 [0330] have described how to use endoscopic instrument reflux disease treatment device 10 nested into the stomach wall. 所述胃镜仪器可以用于将所述反流病治疗器件置于胃壁外侧(如图IA所示),或置于胃的内侧(如图2A 中所示)。 The endoscopic instrument may be used to the reflux disease treatment device disposed outside of the stomach wall (as shown in FIG. IA), or placed on the inside of the stomach (as shown in Figure 2A). 在后一情况下,该仪器被用于在胃壁上从胃的内侧制造切口。 In the latter case, the instrument is used in the manufacture of the stomach from the inside of the stomach incision.

[0331] 可以理解,也可以使用腹部手术方法。 [0331] It will be appreciated abdominal surgical methods may also be used. 现在将参考图54-55描述这种方法。 54-55 will now be described with reference to FIG this method. 在图54中示出了如何通过在患者腹部制造切口380来到达胃。 In FIG. 54 illustrates how the incision in the patient's abdomen manufacture 380 to reach the stomach. 在图55中示出了如何将仪器381 插入患者的腹部。 In FIG. 55 illustrates how the instrument 381 inserted into the patient's abdomen. 只要适于实现此目的,可以选择所述的任何仪器和方法。 As long as suitable for this purpose, you can select any instrument and method described. 因此,例如,所述反流病器件可以如图IA所示被放置在胃的外侧,或者图2A所示被放置在胃的内侧。 Thus, for example, the device can reflux disease as shown in FIG. IA is placed on the outside of the stomach, or as shown in FIG. 2A is placed on the inside of the stomach. 在后一情况下,在胃壁上制造切口。 In the latter case, the manufacturer incision in the stomach wall.

Referenced by
Citing PatentFiling datePublication dateApplicantTitle
CN104684614A *21 Jun 20133 Jun 2015西蒙弗雷泽大学Transvascular diaphragm pacing systems and methods of use
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