Patent Publication Number: US-2009240105-A1

Title: Endoscope &amp; tools for applying sealants and adhesives and intestinal lining for reducing food absorption

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