Abstract:
A laparoscopic band or non-adjustable clamp is placed about the greater curvature of the stomach in a vertical orientation. The band or clamp completely compartmentalizes the stomach between a small pouch and the fundus. The fundic part of the stomach is excluded from nutrients and creates a long narrow channel where the food travels. A small passage at the level of the antrum allows gastric juices to empty from the fundic areas.

Description:
[0001]    This application claims benefit of provisional application 60/881,138 filed Jan. 19, 2007. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    For patients whose obesity presents an immediate serious health risk, surgical procedures are available to promote weight loss. One of the most common surgical procedures is gastric bypass. During gastric bypass, the stomach is made smaller and food bypasses part of the small intestine. The smaller size stomach causes the patient to eat less before the stomach is full and the bypass of the small intestines leads to less calories being absorbed by the body. 
         [0003]    In the most common type of gastric bypass surgery, roux-en-y, a small pouch is formed at the top of the stomach using staples or a plastic band. The smaller stomach is connected to the middle portion of the small intestines bypassing the upper portion of the small intestines. 
         [0004]    Devices have been developed to form the smaller stomach from the patient&#39;s original stomach. One such device is disclosed in U.S. 2002/0022851 (Kalloo et al). The Kalloo et al patent discloses a loop 80 reducing the volume of the gastric cavity. A feeder line is pulled to reduce the diameter of the loop and collapse the walls of the stomach to define a smaller pouch. 
         [0005]    Saadat et al (2006/0157067) discloses the use of tissue anchors to form a gastric pouch acting as a restriction to the passage of fluids and food. U.S. Pat. No. 5,345,949 (Shlain) discloses a clip placed across the fundus of the stomach to restrict the inlet chamber or proximal pouch. Likewise, U.S. Pat. No. 6,869,438 (Chao) discloses a gastric partitioning clip creating a stomach pouch from the stomach to restrict the amount of food intake. 
         [0006]    It is an object of the invention to provide a device for separating the stomach into two compartments but allowing communication between the compartments. 
         [0007]    It is another object of the invention to provide a device for forming a smaller stomach pouch, the size of the pouch being tailored to the patient&#39;s individual circumstances. 
         [0008]    It is another object of the invention to provide a procedure creating a small stomach pouch to limit intake of food separate from the stomach but allowing gastric juices from the stomach to flow into the pouch. 
         [0009]    It is still another object of the invention to provide a system for creating a small pouch from the main stomach that is reversible. 
         [0010]    It is still another object of the invention to alter the production of hormones, enzymes and chemicals that affect metabolism, energy levels, hunger, digestion, absorption of nutrients that may be affected by exclusion of the gastric fundus. 
         [0011]    These and other objects of the invention will become apparent after reading the disclosure of the invention. 
       SUMMARY OF THE INVENTION 
       [0012]    A laparoscopic adjustable band or an adjustable or non-adjustable clamp is placed about the greater curvature of the stomach in a vertical orientation. The band or clamp completely compartmentalizes the stomach between a small vertical pouch and the fundus. The fundic part of the stomach is excluded from nutrients and is separated from a long narrow channel where the food travels. A small passage at the level of the antrum allows gastric juices to empty from the fundic areas. The band may be applied during open surgery or through a trochar. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0013]      FIG. 1  is a view of the band applied to a stomach; 
           [0014]      FIG. 2  is a cross-sectional view of an inflatable band useable with the invention; 
           [0015]      FIG. 3  is a view of a non-adjustable clamp used with the invention; 
           [0016]      FIG. 4  is a detailed view of the strap attachment to the band; 
           [0017]      FIG. 5  is a perspective view of a second embodiment of the band; and 
           [0018]      FIG. 6  is a view of the band in  FIG. 5  applied to a stomach. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0019]    In  FIG. 1 , a stomach having the band  10  applied can be seen dividing the stomach into the pouch  12  and fundic area  16 . Food traveling down the esophagus enters the pouch  12  and exits into the antrum. The band  10  applies pressure against the sides of the stomach to separate the stomach into the two compartments  12 ,  14  but does not apply pressure to the stomach walls at the bottom part of the stomach. This creates a passage  16  allowing flow of gastric juices from the fundic area  14  into the antrum. Food will not enter the fundic area through this passage, however. At least one horizontal strap  18  may be used to secure the band in place. The straps do not apply pressure sufficient to impact the size and function of the compartment  12 . 
         [0020]      FIG. 2  shows an embodiment of the band having an inflatable chamber  20  and a connecting section  22 . The band is placed about the stomach in a vertical orientation to separate the stomach into the two compartments and inflated. The inflated chamber  20  applies pressure on the stomach to seal the two compartments from one another except for the passage  16 . The connecting section  22 , being not inflated, does not apply pressure to the bottom portion of the stomach, allowing for the formation of the passage  16 . 
         [0021]      FIG. 3  shows the rigid clamp embodiment having a U portion formed by two legs  32 ,  34  connected by a bight portion  36 . When the clamp is placed on the stomach, the bight portion  36  fits over the top of the stomach with the legs  32 ,  34  applying enough pressure to collapse the walls of the stomach against one another to create the two compartments. The legs  32 ,  34  do not extend the full vertical extent of the stomach to allow for the creation of the passage  16 . The legs are attached by a connector  38 . When applied to the stomach, the legs serves to push the sides of the stomach together to form a complete seal but the connector allows for the formation of a passage between the two compartments  12 ,  16 . The clamp may be adjustable. The legs of the clamp may be made of any length so that depending on the patient&#39;s condition and prior uses of the band, the legs can be made shorter or longer and the band moved to the right, forming a larger pouch  12  and a smaller fundic portion  14 . 
         [0022]    Besides a clip, the vertical band may be form as or with an inflatable balloon, as discussed with reference to  FIG. 2 . The orientation of the balloon is such that, upon inflation, the balloon bulges to the left to decrease the size of the compartment  12 . The bottom portion may or may not be inflatable. The balloon may be attached to a tube exiting the body so that the balloon may be adjusted without the need for invasive surgery. 
         [0023]    Straps  18  can be secured to the band in any number of conventional ways. One possible way in which to secure the straps to the band is depicted in  FIG. 4 . The band  18  engages and is secured by clips  19  which extend outwardly from the band. This arrangement allows the straps to be tightened by being pulled through the clip and, if desired, the straps can be released for the removal of the band. 
         [0024]    An alternative construction of the band is seen in  FIG. 5 . In this embodiment, the band has a first section  42  having two parallel arms and a second section with two space members so that, when applied to a stomach, the passageway  16  is formed. The arms may be straight, curved or undulating. The surface may be smooth or serrated. The arms of the first section  42  are resiliently biased against one another and are spaced from one another in order that, when applied, the first section maintains the walls of the stomach together to separate the stomach into the first and second compartments  12 ,  14 . The pressure applied must be enough that the two compartments are formed but not so much that the walls of the stomach are damaged or compromise the blood supply. The section  44  is connected together by a section  46  acting as a hinge. This allows the arms of the first section  42  to be separated from one another in order that the band may be applied. Conversely, it is possible to have the two arms of the first section  42  hinged to one another and the two arcuate portions forming the second section  44  not connected to one another. 
         [0025]    The band of  FIG. 5  applied to stomach is seen in  FIG. 6 . Seen here as the first section  42  extending along the stomach to separate the stomach to separate the stomach into two compartments  12 ,  14  whereas the second section has arcuate arms forming a passage  16 . At least one of the arms of the first section is provided with apertures  48 . The apertures, which may be large or small, allow part of the stomach wall to enter the aperture to help prevent movement of the band once it has been applied. 
         [0026]    While the invention has been described with reference to preferred embodiments, various modifications would be apparent to one of ordinary skill in the art. The invention encompasses such variations and modifications.