Method for esophageal invagination and devices useful therein.

摘要

A technique for invaginating the esophagus (20) at the gastroesophageal junction (10) is disclosed, as well as an invagination device (70) useful in the described technique. The invagination device includes an introducer guide (75) which has an outside diameter approximating that of the esophagus and a plurality of needle-receiving lumens (78) extending to its outer diametric surface. The invagination device also has an engagement assembly which includes 10 needles (88), each having a retracted position in which they lie within the needle-receiving lumens of the introducer guide, and an extended position in which they extend out of the lumens and project radially from the guide for engagement with the esophagus at the gastroesophageal junction. The invagination device is introduced transorally into the esophagus, its engagement assembly is activated to place the needles in their extended position in engagement with the esophagus, and the engaged invagination device is advanced the toward the stomach to fold the attached esophagus beyond the gastroesophageal junction. A remotely operable fastening assembly (50), which has been introduced into the stomach through an operating channel/insufflation port, is then operated to fasten the invaginated gastroesophageal junction to the surrounding involuted fundic wall. Finally, the needles are retracted back into their needle-receiving lumens and the invagination device and the fastening assembly are removed from the body of the patient. This minimally-invasive technique accomplishes the formation of a new valve between the esophagus and stomach, thus preventing acid reflux.