Abstract:
A dual-purpose surgical bougie is disclosed for vertical sleeve gastrectomy (VSG) procedures, and other related operations, that can serve the purpose of both operating as a guide or dilator for stapling and resecting a stomach and also securing, containing, and trans-orally extracting the resected stomach, thereby promoting faster patient recovery, minimizing and reducing the size and number of incisions, and further minimizing VSG procedure related complications, among other advantages. In one aspect of the disclosure described herein, the dual-purpose medical device can include a surgical bougie having a distal end and a proximal end, wherein the bougie can be made of at least one of rubber, silicone, plastic, and metal. In addition, the bougie can include a channel or passage disposed within its central axis extending from its distal end to the proximal end, and a securement member coupled to the bougie. Here, the securement member can extend from the distal end of the flexible member, such that the securement member securely couples to a resected body tissue thereby allowing the bougie to trans-orally extract the resected body tissue.

Description:
BACKGROUND 
     This section is intended to introduce the reader to aspects of art that may be related to various aspects of the present disclosure described herein, which are described and/or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present disclosure described herein. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art. 
     Laparoscopic gastric sleeve surgery or vertical sleeve gastrectomy (VSG) involves removing or resecting approximately 70%-90% of a patient&#39;s stomach and leaving a tube or gastric sleeve. During VSG and other operations involving the esophagus and stomach, there is a need for placement of a bougie, which can be a slender, flexible, and cylindrical instrument for introduction into a tubular organ. The bougie can be placed down via the mouth and across the esophagus and/or stomach or small bowel. The purpose of this device is to act to dilate strictures and/or help delineate or function as a guide for the borders of the stomach and esophagus for resection of the stomach. 
     Conventional VSG procedures are generally highly invasive and can involve up to five (5) various incisions to successfully perform, which further can require up to six (6) weeks of recovery time, “inpatient” hospital stays, potential complications, and undesirable cosmetic scarring. Therefore, it is desirable for VSG patients to have a minimally invasive procedure that results in less pain, lower risk of complications, faster recovery, and few scars. One recent method of performing a minimally invasive procedure is known as Natural Orifice Transluminal Endoscopic Surgery (NOTES). The NOTES procedure for VSG, or a variation thereof, can include using various natural entrances to the abdominal cavity (i.e. rectum, vagina, etc.) to remove the resected stomach, thereby minimizing incisions. For example, in one study, Mintz et al. (Mintz Y, Horgan S, Savu M K, et al. Hybrid natural orifice translumenal surgery (NOTES) sleeve gastrectomy: a feasibility study using an animal model. Surg Endosc. 2008; 22:1798-802) performed a hybrid NOTES sleeve gastrectomy in a porcine model. In the study, they report their experience utilizing abdominal and rectal entry sites to perform the gastric sleeve procedure. In general, a 5 mm trocar and laparoscope was placed for pneumoperitoneum and visualization, and a 12 mm or 15 mm laparoscope placed transanally through the rectal wall of the model. Further, sutures via the anterior abdominal wall were placed into the stomach to aid retraction and exposure and a stapler was placed through the transrectal trocar to resect the stomach and the resected stomach extracted through transanally through the proctomy. 
     While advances have been made in achieving minimally invasive VSG procedures, there is still a need to further improve VSG procedures that involve minimal incisions, faster recovery, and less complication. Hence, what is needed is an apparatus and method of performing minimally invasive VSG procedures that reduce the number and size of the incisions, reduce operating costs, reduce the need for expensive surgical equipment, promote faster patient recovery, and further reduce complications associated with VSG surgery. 
     BRIEF SUMMARY 
     In one aspect of the present disclosure described herein, a dual-purpose surgical bougie is disclosed for VSG procedures, and other related operations, that can serve the purpose of both operating as a guide or dilator for stapling and resecting a stomach and also extracting securing, containing, and trans-orally extracting the resected stomach, thereby minimizing operating costs, promote faster patient recovery, minimize and reduce the size and number of incisions, and further reduce VSG procedure related complications. 
     Specifically, in one aspect of the disclosure described herein, a medical device for sleeve gastrectomy surgery is disclosed. Here, the device can include a flexible member or surgical bougie having a distal end and a proximal end, wherein the surgical bougie is further comprised of at least one of rubber, silicone, plastic, and metal. In addition, a securement member can be coupled to the surgical bougie, wherein the securement member extends from the distal end of the flexible member, such that the securement member securely couples to a detached body tissue. Further, the bougie can also include a central channel passage or opening extending from the proximal end to the distal end. Here, the securement member can be a snare loop or forceps. In addition, the securement member can further include an actuator coupled to the proximal end of the surgical bougie. The surgical bougie can be made of uniform silicone and having a diameter ranging from approximately 10.6 mm to approximately 16 mm. Here, the bougie body can be partially or entirely made of silicone, plastic, rubber, metal, or a polymer. Further, a container, bag, or receptacle may also be connected to the surgical bougie. 
     In another aspect of the disclosure described herein, a medical device for sleeve gastrectomy surgery is disclosed. The device includes a flexible surgical bougie having a body with a distal end and a proximal end, wherein the bougie is further comprised of a uniform rubber, polymer, or silicone material, and the bougie having a diameter ranging from 32 French up to and including 48 French. In addition, the bougie further includes a channel extending from the distal end to the proximal end of the bougie. A securement member comprised of a surgical snare coupled to the bougie, the snare or securement member can further include a flexible cable assembly disposed within a sheath, wherein the sheath is further disposed within the channel of the bougie, a snare loop formed by the flexible cable assembly extending out the distal end of the bougie, an actuator coupled to the proximal end of the surgical bougie and further coupled to the cable assembly, and a fastener for securing the proximal end of the bougie to the actuator. In addition, the actuator can be configured for controlling the cable assembly and the snare loop, such that the snare loop of the bougie couples to and secure a resected stomach, thus retrieving the resected stomach through an opening in a gastric cavity and extracting the resected stomach through an esophagus and oral cavity. 
     In addition, the surgical bougie can further include a receptacle coupled to the bougie, and wherein the receptacle is for containing the resected stomach, and wherein the receptacle can be comprised of a flexible or elastic bag. The receptacle can be configured inside-out over the exterior body of the bougie. Alternatively, the receptacle may rolled over the bougie or rolled into a bundle. The receptacle may also be deployable or expandable and further include a closure member. The receptacle can be connected or fixed to the distal end of the bougie. Further, the distal end of the bougie can also include a flanged lip, wherein the receptacle can connect to. 
     In another aspect of the disclosure described herein, a method of using a medical device for sleeve gastrectomy surgery is disclosed. Here, the method can include inserting a flexible member through an oral cavity and an esophagus, wherein the flexible member further includes a securement member at its distal end. The method can further include positioning the flexible member adjacent to a stomach, fastening one side of the stomach adjacent to the flexible member, resecting the stomach near the fastened side, operating the securement member of the flexible member, thereby coupling the flexible member to the resected stomach, and removing the flexible member and the resected stomach through the esophagus wall and oral cavity. Here, the flexible member can be surgical bougie and the securement member can be a snare or a clamp. 
     The above summary is not intended to describe each and every disclosed embodiment or every implementation of the disclosure. The Description that follows more particularly exemplifies the various illustrative embodiments. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The following description should be read with reference to the drawings, in which like elements in different drawings are numbered in like fashion. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the disclosure. The disclosure may be more completely understood in consideration of the following detailed description of various embodiments in connection with the accompanying drawings, in which: 
         FIG. 1A  illustrates a top view for one non-limiting embodiment of a dual-purpose bougie of the disclosure described herein having a snare assembly. 
         FIG. 1B  illustrates a top view for another non-limiting embodiment of the dual-purpose bougie of the disclosure described herein having a forcep or clamp assembly. 
         FIG. 2A  illustrates a cross-sectional front view for the non-limiting embodiment of the dual-purpose bougie of the disclosure described herein. 
         FIG. 2B  illustrates a cross-sectional side view for the non-limiting embodiment of the dual-purpose bougie of the disclosure described herein having a blunt end. 
         FIG. 2C  illustrates a cross-sectional side view for a non-limiting embodiment of the dual-purpose bougie of the disclosure described herein having a tapered end. 
         FIG. 3A  illustrates a side view of a snare assembly and a cross-sectional side view for one non-limiting embodiment of the dual-purpose bougie of the disclosure described herein and a fastening mechanism for a snare actuator to the bougie body. 
         FIG. 3B  illustrates a side view of a snare assembly and a cross-sectional side view for the embodiment of  FIG. 3A  of the dual-purpose bougie of the disclosure described herein and the fastening mechanism of the snare actuator to the bougie body in an assembled configuration. 
         FIG. 4A  illustrates a side view of a snare assembly and a cross-sectional side view for the non-limiting embodiment of the dual-purpose bougie of the disclosure described herein and an embodiment for a fastening mechanism of a snare actuator to the bougie body. 
         FIG. 4B  illustrates a side view of the snare assembly and a cross-sectional side view for the embodiment of  FIG. 4A  of the dual-purpose bougie of the disclosure described herein and the fastening mechanism of the snare actuator to the bougie body in an assembled configuration. 
         FIG. 5A-5B  illustrate a cross-sectional side views for one non-limiting embodiment of the dual-purpose bougie of the disclosure described herein having a deployable receptacle for containing a resected stomach or body tissue. 
         FIG. 5C  illustrates an elevated side view of for the embodiment of  FIG. 5A-5B , wherein in one non-limiting embodiment the resected stomach contained and secured within the receptacle. 
         FIG. 6A  illustrates a cross-sectional side view for the non-limiting embodiment of the dual-purpose bougie of the disclosure described herein having a receptacle attached at one end of the bougie. 
         FIG. 6B  illustrates a front view for the embodiment of  FIG. 6A . 
         FIG. 6C  illustrates an elevated side view for the embodiment of  FIG. 6A , wherein the receptacle is placed over the bougie. 
         FIG. 6D  illustrates an elevated side view for the embodiment of  FIG. 6C , wherein the receptacle is deployed and inverted to contain and secure a resected stomach or body tissue. 
         FIG. 6E  illustrates a cross-sectional side view for the non-limiting embodiment of the dual-purpose bougie of the disclosure described herein having the receptacle secured at one end of the bougie and having a flanged end. 
         FIG. 6F  illustrates a front view for the embodiment of  FIG. 6E . 
         FIG. 6G  illustrates a side view for the embodiment of  FIG. 6E , wherein the receptacle is placed over the bougie. 
         FIG. 6H  illustrates a side view for the embodiment of  FIG. 6G , wherein the receptacle is deployed and inverted to contain and secure the resected stomach or body tissue. 
         FIG. 6I  illustrates a side view for the non-limiting embodiment of the dual-purpose bougie of the disclosure described herein wherein the receptacle is shown in a rolled up configuration and attached at the distal end of the bougie. 
         FIG. 6J  illustrates a side view for the embodiment of  FIG. 6I , wherein the receptacle is deployed and shown in a rolled out configuration to contain and cover a resected stomach or body tissue. 
         FIG. 7A  illustrates a partial cross-sectional environmental view for one non-limiting embodiment method of a VSG procedure with a top view of the dual-purpose bougie of the disclosure described herein being used to secure a resected stomach. 
         FIG. 7B  illustrates a partial cross-sectional environmental view for one non-limiting embodiment method of a VSG procedure with a top view of the dual-purpose bougie of the disclosure described herein being used to extract the resected stomach trans orally. 
     
    
    
     DETAILED DESCRIPTION 
     In the Brief Summary of the present disclosure above and in the Detailed Description of the Disclosure described herein, and the claims below, and in the accompanying drawings, reference is made to particular features (including method steps) of the disclosure described herein. It is to be understood that the disclosure of the disclosure described herein in this specification includes all possible combinations of such particular features. For example, where a particular feature is disclosed in the context of a particular aspect or embodiment of the disclosure described herein, or a particular claim, that feature can also be used, to the extent possible, in combination with and/or in the context of other particular aspects and embodiments of the disclosure described herein, and in the disclosure described herein generally. 
     The embodiments set forth below represent the necessary information to enable those skilled in the art to practice the disclosure described herein and illustrate the best mode of practicing the disclosure described herein. In addition, the disclosure described herein does not require that all the advantageous features and all the advantages need to be incorporated into every embodiment of the disclosure described herein. 
       FIG. 1A  illustrates one non-limiting embodiment for a dual-purpose surgical bougie  100  of the disclosure described herein. In particular, the bougie  100  having a slender, flexible or semi-rigid, and tubular cylindrical body  102 . Bougie  100  can further include a snare assembly  130  having a sliding or rotational snare actuator handle secured at a proximal end of body  102  for operating and controlling a deployable snare loop  150  extending from the distal end of body  102 .  FIG. 1B  illustrates another non-limiting embodiment for a surgical bougie  200  of the disclosure described herein. Here, bougie  200  can also have a slender, flexible or semi-rigid, and tubular cylindrical body  202 , and clamp, jaw, scissor, stapler, and/or forceps assembly  230  having an actuator secured at a proximal end of body  202  for operating and controlling a deployable clamp, jaw, scissor, stapler, and/or forceps  250  extending from the distal end of the body  202 . However, it is contemplated within the scope of the disclosure described herein that other securement members may also be used for the bougie. 
       FIG. 2A  illustrates the bougie  100  of the disclosure described herein. Here, bougie  100  can include the cylindrical body made of uniform flexible rubber, silicone, plastic, or metal material. The diameter A 1  of body  102  can range from 32 French (approximately 10.6 mm) up to and including 48 French (approximately 16 mm). Alternatively, the bougie can be sized from 10 French up to and including 100 French and having any length such as from 6 inches up to and including 60 inches. Also, the bougie may telescoping, foldable, or retractable in order to alter its size, form, configuration, or dimensions, whether within or outside of the body. In addition, body  102  can include a channel or passageway  106  extending the entire length of the bougie, wherein the channel can have a diameter A 2  ranging from 0.1 mm up to and including 16 mm. In addition, there may be a lumen, shaft, or sheath  104  disposed within channel  106 , wherein the sheath can have a diameter A 3  ranging from 0.1 mm up to and including 16 mm. Here, sheath  104  can serve the purpose of enclosing the snare cable assembly  150  disposed within the sheath  104  and channel  106  and allowing fluid and non-restricted operation of the cable assembly  150  within body  102 . However, it is contemplated within the scope of the disclosure described here that the body  102  may also include two or more sheaths, or two or more snare cable assemblies disposed within independent offset channels, such as one snare per channel. Alternatively, the two or more snare cable assemblies may all be disposed within one channel.  FIG. 2B  illustrates the bougie  100  of the disclosure described herein shown having the body  102  with a blunt distal end, and  FIG. 2C  illustrating a bougie  100 C having a body  102 C with a tapered or pointed distal end. However, it is contemplated within the scope of the disclosure described herein that the bougie body may have any type of configuration, dimension, or shape, either at its proximal, middle, or distal ends, including but not limited to blunt, tapered, rounded corners, triangular, oval, spear, cone or funnel, inverted cone or funnel, or the like. 
       FIGS. 3A-3B  illustrate one embodiment for a bougie  100 D and securing and coupling a snare assembly  130 A and its actuator  134  to a proximal end of bougie body  102 D. Here, snare assembly  130 A can include any type of manual or automatic/powered actuator  134  having dual-loop dual-finger operated component  132 A slidably or rotationally coupled to a second single-loop single finger held component  134 A, wherein component  132 A slides back and forth within an opening or track  136 A to deploy the snare cable and corresponding snare loop  150  and control the deployablility, expandability, rotation, position, size, grip, force, pressure, self-orienting, manipulation, and maneuverability of snare loop  150 , among other operational features. For example, the snare assembly  130 A may also include one or more swivel components for deploying the snare loop cable  150 . However, it is contemplated within the scope of the disclosure herein, that any other re-usable or disposable surgical snare assembly known in the art may also be assembled to, retro-fitted to, attached to, integrated with, and used with the bougie of the disclosure described herein. 
     Still referring to  FIG. 3A-3B , the snare actuator handle  134  may have a threaded male distal end  138 A configured to engage and securely couple within a female threaded opening  110 A. In addition, channel  106 A can further receive the sheath  104  (for housing the cable snare  150 ) therein. For example, in one embodiment for a method of manufacture or assembly, an existing snare assembly  130 A may be retro-fitted to an existing bougie  100 D of the disclosure described herein. In such an embodiment, a threaded tubular part, such as  138 A, can be slided over sheath  104  (such as from the sheath&#39;s distal end) and fastened to the lower end body of actuator  134 , such as via adhesives, screws, bolts, or related fasteners. In such an embodiment, area  110 A and channel  106 A may be cut, shaved, stamped, molded, or drilled out. Once part  138 A is secured to the actuator  134 , then part  138 A, along with actuator  134 , can then be securely coupled to the proximal end of the bougie body, such as via threaded engagement (as shown), screws, bolts, adhesives, or related fasteners. Alternatively, the bougie body may be a custom size and configuration so that the snare assembly  130 A may be secured to the bougie body  102 D at the time of manufacture, or wherein assembly  130 A and body  102 E are one unitary piece. 
       FIGS. 4A-4B  illustrates the bougie  100  and securing and coupling the snare assembly  130  and its actuator to a proximal end of bougie body  102 . Here, snare assembly  130  can include any type of manual or automatic/powered actuator having a dual-loop dual-finger operated component slidably coupled to a second single-loop single finger held component, wherein the two finger component slides back and forth within an opening or track to deploy the snare cable and corresponding snare loop  150  and control the size, grip, pressure, and maneuverability of snare loop, among other operational features. However, it is contemplated within the scope of the disclosure herein, that any other surgical snare assembly known in the art may also be assembled to, attached to, and within the bougie of the disclosure described herein. For example, the snare assembly  130  may also include one or more swivel components for deploying the snare loop cable  150 . However, it is contemplated within the scope of the disclosure herein, that any other re-usable or disposable surgical snare assembly known in the art may also be assembled to, retro-fitted to, attached to, integrated with, and used with the bougie of the disclosure described herein. 
     Still referring to  FIG. 4A-4B , the snare actuator may have a threaded female distal end or cap  138  configured to engage and securely couple to a threaded male end  110  of the bougie body. In addition, channel  106  can further receive the sheath  104  (for housing the cable snare  150 ) therein. For example, in one embodiment for a method of manufacture or assembly, an existing snare assembly  130  may be retro-fitted to the existing bougie  100  of the disclosure described herein. In such an embodiment, cap  138  (have a central opening) can be slid over sheath  104  (such as from its distal end) and fastened to the lower end body of the actuator, such as via adhesives, screws, bolts, or related fasteners. In such an embodiment, end  110  may be pre-threaded, molded, and cut, and channel  106  may be cut, shaved, stamped, molded, or drilled out. Once cap  138  is secured to the actuator, then part  138 , along with the actuator, can then be securely coupled to the proximal end of the bougie body, such as via threaded engagement (as shown), screws, bolts, adhesives, or related fasteners. Alternatively, the bougie body may be a custom size and configuration that the snare assembly  130  may be secured to the bougie body  102  at the time of manufacture, or wherein assembly  130  and body  102  are one unitary piece. 
       FIG. 5A-5C  illustrate one embodiment for a bougie and receptacle assembly for the disclosure described herein. Here, bougie  100 F having bougie body  102 F is shown having dual channels or passages, one for housing deployable cable snare loop  150  and another for housing deployable receptacle  500 . Here, receptacle  500  may be any elongated flexible, elastic, foldable, and expandable vessel, cover, bag, or container for containing or covering body tissue, such as a resected stomach  400 . In particular,  FIG. 5A  illustrates receptacle  500  in its un-expanded, folded, un-deployed, and collapsed configuration within a first channel of body  102 F, and also cable snare loop  150  in its un-deployed, folded, and collapsed configuration within a second channel.  FIG. 5B  illustrates receptacle  500  being deployed and expanded and having an opening  520  for receiving resected stomach  400  secured with and placed within receptacle  500  via deployed snare loop  150 , or in combination with one or more surgical tools.  FIG. 5C  illustrates resected stomach  400  contained within receptacle  500 . In addition, receptacle  500  may also include a securement member, such as an elastic band or drawstring  510  around opening  520  for closing the opening and further securing the contents therein. 
       FIG. 6A-6D  illustrate the embodiment for the bougie and receptacle assembly of the disclosure described herein having a receptacle. Here, bougie  100  having body  102  is shown having receptacle  600  securely fixed or attached to the distal end of body  102  and snare cable assembly  150  disposed within a central channel. Here, receptacle  600  may be any elongated flexible, elastic, foldable, and expandable vessel, cover, bag, shrink wrap, or container for containing, covering, and retrieving body tissue, such as a resected stomach  400 . In this embodiment, retrieval receptacle  600  can be fixed or attached to a circular opening, wedge, cut-out  120 G, wherein one end of the receptacle  600  is secured within cut-out  120 G or at distal end area  120 G, such as via adhesives, ring, bolt, clamp, or snap-fit. In particular,  FIG. 6A-6C  illustrate receptacle  600  in its un-deployed configuration, wherein receptacle  600  is initially pulled over the exterior of body  102 . In addition, receptacle  600  may also be secured to the body via elastic band  610  or drawstring  620 , which may or mat not include a tab. Alternatively, one end of receptacle  600  may be detached, floating, or hovering over the exterior bougie body  102 . In other embodiments, receptacle  600  may be rolled up in its un-deployed configuration.  FIG. 6D  illustrates receptacle  600  in its deployed configuration. In particular, referring back  FIG. 6C , the free end of receptacle  600  may be rolled or pulled back via the direction of arrows  650  using one or more surgical tools or forceps. More specifically, receptacle  600  is pulled back from its open end  630  wherein open end  630  of receptacle encloses or wraps over stomach  400  until receptacle  600  is at least partially, entirely, or substantially inverted or inside-out, thereby partially, entirely, or substantially containing resected stomach  400  and the snare loop  150  therein, wherein loop  150  secures stomach  400  ( FIG. 6D ). In addition, band, tab, or drawstring  610  and  620  may be used to close or secure opening end  630 . One advantage of the receptacle is that it allows containment of the resected stomach or body tissue and a non-restrictive smooth extraction of the resected through the esophagus and oral cavity and further preventing any potential inflammation, infection, wound, or damage to surrounding organs, tissue, esophagus, or oral cavity. For example, in some embodiments, the receptacle may be of any thickness and elasticity, and may also be coated with any coating or lubricating substance for a smooth and non-stick surface. 
       FIG. 6E-6H  illustrate the embodiment for the bougie and receptacle assembly of the disclosure described herein having a flanged end. Here, bougie  100  having body  102  is shown having receptacle  600  securely fixed or attached to the distal end of body  102  and snare cable assembly  150  disposed within a central channel. Here, receptacle  600  may be any elongated flexible, elastic, foldable, and expandable vessel, cover, bag, shrink wrap, or container for retrieving, containing, covering body tissue, such as a resected stomach  400 . In this embodiment, retrieval receptacle  600  can be fixed or attached to a circular flanged or lip groove opening  120 H of body  102 , wherein one end of the receptacle  600  may include an elastic or tapered band end  612  for being placed around and within the circular opening groove of flange  120 H, and secured or fixed to flange  120 H and body  102  via adhesives, clamp, elastic fit, or snap-fit. In particular,  FIG. 6E-6G  illustrate receptacle  600  in its un-deployed configuration, wherein receptacle  600  is initially pulled over the exterior of body  102 . In addition, receptacle  600  may also be secured to the body via elastic band  610  or drawstring  620 , which may or mat not include a tab. Alternatively, one end of receptacle  600  may be detached, floating, or hovering over the exterior bougie body  102 , as shown in  FIG. 6E . In other embodiments, receptacle  600  may be rolled up its un-deployed configuration.  FIG. 6H  illustrates receptacle  600  in its deployed configuration. In particular, referring back  FIG. 6G , the free end of receptacle  600  may be rolled or pulled back via the direction of arrows  650  using one or more surgical tools or forceps, or via tab  620 . More specifically, receptacle  600  is pulled back wherein open end  630  of receptacle encloses or wraps over stomach  400  until receptacle  600  is at least partially, entirely, or substantially inverted or inside-out, thereby partially, entirely, or substantially containing resected stomach  400  and the snare loop  150  therein, wherein loop  150  secures stomach  400  ( FIG. 6H ). In addition, band, tab, or drawstring  610  and  620  may be used to close or secure opening end  630 . One advantage of the receptacle is that it allows containment of the resected stomach or body tissue and a non-restrictive smooth extraction of the resected through the esophagus and oral cavity further preventing any potential inflammation, infection, wound, or damage to surrounding organs, tissue, esophagus, or oral cavity. For example, in some embodiments, the receptacle may be of any thickness and elasticity, and may also be coated with any coating or lubricant material for a smooth and non-stick surface. 
       FIG. 6I-6J  illustrate the embodiment for the bougie and receptacle assembly of the disclosure described herein. Here, bougie  100  having body  102  is shown having receptacle  600  securely fixed or attached to the distal end of body  102  and snare cable assembly  150  disposed within a central channel. Here, receptacle  600  may be any elongated flexible, elastic, foldable, and expandable vessel, cover, bag, shrink wrap, or container for retrieving, containing, covering body tissue, such as a resected stomach  400 . In this embodiment, retrieval receptacle  800  can be fixed or attached to a circular flanged or lip groove opening body  102  or coupled, attached, or fixed at near the distal end of body  102 , wherein one end of the receptacle  600  may be secured to body  102  via adhesives. Alternatively, receptacle  600  may be secured to the body via elastic or expandable fitment. Here, receptacle  600  is shown either rolled up in a bundle, collapsed, or folded configuration prior to deployment.  FIG. 6J  illustrate receptacle  600  in its un-deployed configuration, wherein receptacle  600  is initially pulled and unrolled. In particular, the free end of receptacle  600  may be un-rolled, rolled back, expanded, or pulled back via the direction of arrows  850  using one or more surgical tools or forceps, or via tab  620 . More specifically, open end  830  of receptacle  800  is rolled over the stomach  400  until receptacle  600  partially, entirely, or substantially contains resected stomach  400  and the snare loop  150  therein, wherein loop  150  secures stomach  400  ( FIG. 6H ). In addition, band, tab, or drawstring  620  may be used to close or secure open end  830 . One advantage of the receptacle is that it allows containment of the resected stomach or body tissue and a non-restrictive smooth extraction of the resected through the esophagus and oral cavity further preventing any potential inflammation, infection, wound, or damage to surrounding organs, tissue, esophagus, or oral cavity. For example, in some embodiments, the receptacle may be of any thickness and elasticity, and may also be coated with any coating or lubricant material for a smooth and non-stick surface. 
       FIG. 7A-7B  illustrate one embodiment for a method of at performing, at least in part, a VSG procedure using the bougie of the disclosure described herein for the aforementioned embodiments. Further, the VSG procedure and use of the bougie of the disclosure described herein may also be considered as a variation of a Natural Orifice Trans-endoluminal Esophageal Surgery (NOTES) procedure, or a partial NOTES procedure on a human. In particular, during a VSG procedure, the bougie  100  can be inserted via a patient&#39;s oral cavity and esophagus  450  into a stomach and gastric cavity. Here, a first use or first purpose of the bougie is positioning the bougie within the stomach/gastric cavity and using it for sizing and calibrating the stomach and/or used as a guide for stapling and cutting the stomach along staple line  430 , thereby leaving a gastric sleeve stomach  410 , wherein stomach  400  is entirely detached or resected via the staple line  430 . The second use of the bougie is for deploying the securement member or snare loop  150  and coupling the snare loop and bougie to a lower end region of resected stomach  400  and retrieving or extracting the stomach via the bougie and snare loop through an opening  420  within the gastric cavity. More specifically, an incision opening  420  may be made either prior to stapling or after stapling at the bottom floor or lower region of the gastric stomach cavity, thereby allowing snare loop  150 , and bougie  100 , to slide there through and to secure resected stomach  400  and to retrieve and extract stomach  400  through incision opening  420 . In addition, at anytime the aforementioned receptacle of the disclosure described herein may also be deployed to contain the extracted stomach  400 . As shown in the direction of arrows in  FIG. 7B , the resected stomach  400  is pulled, retrieved, and extracted via the bougie of the disclosure described herein through the esophagus  450  and out of the oral cavity of a patient. After extraction of the stomach  400  through the oral cavity, incision opening  420  can then be sutured and closed. 
     It is contemplated within the scope of the disclosure herein that the bougie, including its receptacle, securement members, or actuator and snare cable assembly, may also be disposable or re-usable. In other embodiments, the bougie may also be mechanically or automatically controlled via a locally and electrically powered connection or controlled remotely via one or more networked or wireless computing devices. In other embodiments, the bougie may also be a dilator, include a dilating member, or include endoscopic, camera, and lighting components. In addition, the size of the bougie used may also depend on the weight, size, diet, age, exercise habits, condition of the patient or the size of the resected stomach to be extracted, or gastric sleeve size. It is further contemplated within the scope of the disclosure herein that other surgical procedures for VSG, or the like, may also be performed using the bougie of the disclosure described herein, including but not limited to human or animal bariatric surgery, orthopedic, spine, bypass surgery, gastric bypass, gastric band or Lap-Band®, cosmetic, laparoscopy, open body, resection, reconnection, ligation, arthrodesis, excision surgery (-ectomy), cutting procedure (-otomy), minimally invasive (-oscopy), endoscopic, stoma (-ostomy), or any ectomy based, reconstructive (-oplasty), and congenital defects surgery (-rraphy), among others. 
     It is further contemplated within the scope of the disclosure described herein that the bougie, bougie body, receptacle, sheath, securement members, snare cable, and snare assembly may also be made of polymers, plastics, silicones, rubbers, metals, metal alloys, metal-polymer composites, anti-bacterial, anti-microbial, bio-compatible, latex-free, non-sterile, sterile materials, and the like. Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM), polybutylene terephthalate (PBT), polyether block ester, polyurethane, polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, a polyether-ester elastomer such as ARNITEL® available from DSM Engineering Plastics), polyester (for example, a polyester elastomer such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example, available under the trade name PEBAX®), silicones, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low density polyethylene (for example, REXELL®), polyethylene terephthalate (PET), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysulfone, nylon, perfluoro(propyl vinyl ether) (PFA), other suitable materials, or mixtures, combinations, copolymers thereof, polymer/metal composites, and some examples of suitable metals and metal alloys including stainless steel, such as 304V, 304 L, and 316 L stainless steel; nickel-titanium alloy such as linear-elastic or super-elastic nitinol, nickel-chromium alloy, nickel-chromium-iron alloy, cobalt alloy, tungsten or tungsten alloys, MP35-N (having a composition of about 35% Ni, 35% Co, 20% Cr, 9.75% Mo, a maximum 1% Fe, a maximum 1% Ti, a maximum 0.25% C, a maximum 0.15% Mn, and a maximum 0.15% Si), hastelloy, monel 400, inconel 825, or the like; or other suitable material. In addition, the bougie, bougie body, receptacle, sheath, and securement members can also be blended with a liquid crystal polymer (LCP). For example, the mixture can contain up to about 5% LCP. By employing selection of materials and processing techniques, thermoplastic, solvent soluble, and thermosetting variants of these and other materials can be employed to achieve the desired results. 
     Having thus described the several embodiments of the present disclosure described herein, those of skill in the art will readily appreciate that other embodiments may be made and used which fall within the scope of the claims attached hereto. Numerous advantages of the invention covered by this document have been set forth in the foregoing description. It will be understood that this disclosure is, in many respects, only illustrative. Changes can be made with respect to various elements described herein without exceeding the scope of the invention. Although the present disclosure described herein has been described in considerable detail with reference to certain preferred versions or embodiments thereof, other versions and embodiments are possible. Therefore, the spirit and scope of the appended claims should not be limited to the description of the embodiments contained herein.