Method and apparatus for transgastric neurostimulation

摘要

A method of placing an electrode in a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; and using the endoscope to place the electrode in contact with tissue within the peritoneal cavity other than stomach tissue. Another aspect of the invention provides a method of electrically mapping tissue accessed from a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; passing an electrode through the endoscope; placing the electrode in contact with tissue within the peritoneal cavity other than stomach tissue; and applying a mapping stimulation signal to the electrode from a mapping stimulator.

主权项

1. A method of transcutaneously implanting a stimulation electrode in a peritoneal cavity of a patient using transgastric mapping and guidance, the method comprising:
inserting an endoscope having a proximal end and a distal end through a mouth into a stomach; passing the distal end of the endoscope through an opening in the stomach into the peritoneal cavity; retroflexing the distal end of the endoscope to orient the distal end of the endoscope towards a diaphragm, the retroflexed distal end of the endoscope configured to bend at least 90 degrees; inserting a mapping instrument having a mapping electrode through the endoscope and into the peritoneal cavity, the mapping instrument adapted to pass through the retroflexed endoscope; using the endoscope to place the mapping electrode in contact with the diaphragm of the patient within the peritoneal cavity; using the mapping electrode, coupled to a mapping stimulator, to map electrical activity in the diaphragm; and transcutaneously positioning a stimulation electrode using a percutaneous needle into the peritoneal cavity under visualization from the endoscope based on the mapped electrical activity in the diaphragm.