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US20040172084A1 - Method and apparatus for treatment of gastro-esophageal reflux disease (GERD) - Google Patents

Method and apparatus for treatment of gastro-esophageal reflux disease (GERD) Download PDF

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Publication number
US20040172084A1
US20040172084A1 US10/358,093 US35809303A US2004172084A1 US 20040172084 A1 US20040172084 A1 US 20040172084A1 US 35809303 A US35809303 A US 35809303A US 2004172084 A1 US2004172084 A1 US 2004172084A1
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US
United States
Prior art keywords
patient
small intestine
stimulation
pancreas
contents
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10/358,093
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English (en)
Inventor
Mark Knudson
Timothy Conrad
Luke Evnin
Katherine Tweden
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Reshape Lifesciences Inc
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Individual
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Filing date
Publication date
Priority to US10/358,093 priority Critical patent/US20040172084A1/en
Application filed by Individual filed Critical Individual
Assigned to BETA MEDICAL, INC. reassignment BETA MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: EVNIN, LUKE B., KNUDSON, MARK B., CONRAD, TIMOTHY R., TWEDEN, KATHERINE S.
Priority to US10/674,330 priority patent/US7489969B2/en
Priority to US10/675,818 priority patent/US20040176812A1/en
Priority to US10/674,324 priority patent/US20040172085A1/en
Priority to US10/752,940 priority patent/US7444183B2/en
Priority to US10/752,944 priority patent/US7167750B2/en
Assigned to ENTEROMEDICS INC. reassignment ENTEROMEDICS INC. CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: BETA MEDICAL, INC.
Priority to AT04707111T priority patent/ATE537871T1/de
Priority to PCT/US2004/002841 priority patent/WO2004069330A1/en
Priority to AU2004209978A priority patent/AU2004209978B2/en
Priority to DK04707122.0T priority patent/DK1601414T3/da
Priority to PCT/US2004/002847 priority patent/WO2004069331A2/en
Priority to EP04707111A priority patent/EP1603634B1/de
Priority to EP11165936A priority patent/EP2366425A1/de
Priority to AT04707122T priority patent/ATE547148T1/de
Priority to PCT/US2004/002849 priority patent/WO2004069332A1/en
Priority to EP04707122A priority patent/EP1601414B1/de
Priority to US10/881,045 priority patent/US7844338B2/en
Publication of US20040172084A1 publication Critical patent/US20040172084A1/en
Priority to US11/040,767 priority patent/US7613515B2/en
Priority to US11/450,202 priority patent/US20060229685A1/en
Priority to US11/656,113 priority patent/US7693577B2/en
Priority to US11/656,123 priority patent/US20070135846A1/en
Priority to US11/656,122 priority patent/US7630769B2/en
Priority to US11/656,121 priority patent/US7986995B2/en
Priority to US11/656,132 priority patent/US7720540B2/en
Priority to US11/891,770 priority patent/US7729771B2/en
Assigned to ENTEROMEDICS, INC., A DELAWARE CORPORATION reassignment ENTEROMEDICS, INC., A DELAWARE CORPORATION MERGER (SEE DOCUMENT FOR DETAILS). Assignors: ENTEROMEDICS INC., A MINNESOTA CORPORATION
Assigned to ENTEROMEDICS INC., A DELAWARE CORPORATION reassignment ENTEROMEDICS INC., A DELAWARE CORPORATION CORRECTIVE ASSIGNMENT TO CORRECT THE ASSGINEE NAME PREVIOUSLY RECORDED ON REEL 021998 FRAME 0785. ASSIGNOR(S) HEREBY CONFIRMS THE MERGER. Assignors: ENTEROMEDICS INC., A MINNESOTA CORPORATION
Priority to AU2009245845A priority patent/AU2009245845B2/en
Priority to US12/721,603 priority patent/US8010204B2/en
Priority to US12/908,375 priority patent/US8046085B2/en
Priority to US13/178,221 priority patent/US8369952B2/en
Priority to US13/188,293 priority patent/US8538542B2/en
Priority to US13/276,638 priority patent/US8538533B2/en
Priority to US13/758,223 priority patent/US8862233B2/en
Priority to US14/019,126 priority patent/US9174040B2/en
Priority to US14/028,030 priority patent/US9162062B2/en
Priority to US14/480,242 priority patent/US9586046B2/en
Priority to US14/930,233 priority patent/US9682233B2/en
Priority to US15/625,755 priority patent/US20170304615A1/en
Assigned to RESHAPE LIFESCIENCES INC. reassignment RESHAPE LIFESCIENCES INC. CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: ENTEROMEDICS INC.
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/321—Electromedical belts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36053—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for vagal stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36071—Pain

Definitions

  • This invention pertains to the field of treatment of gastro-esophageal reflux disease (GERD).
  • GFD gastro-esophageal reflux disease
  • Gastro-esophageal reflux is a physical condition in which stomach acids reflux, or flow back from the stomach into the esophagus. Frequent reflux episodes may result in a more severe problem known as gastro-esophageal reflux disease (GERD).
  • GERD gastro-esophageal reflux disease
  • GERD is the most common form of dyspepsia, being present in approximately 40% of adults in the United States on an intermittent basis and some 10% on a daily basis as described in U.S. Pat. No. 6,098,629 Johnson et al., dated Aug. 8, 2000.
  • dyspepsia As indicated in Johnson et al., dyspepsia, or heartburn is defined as a burning sensation or discomfort behind the breastbone or sternum and is the most common symptom of GERD. Other symptoms of GERD include dysphasia, odynophagia, hemorrhage, water brash and pulmonary manifestations such as asthma, coughing, or intermittent wheezing due to acid aspiration.
  • GERD is generally considered to be the result of a motility disorder which permits the abnormal and prolonged exposure of the esophageal lumen to acidic gastric contents.
  • Hunt “The Relationship between the Control of pH and Healing and Symptom Relief in Gastro-Oesophageal Reflux Disease”, Ailment Pharmacol Ther., 9 (Suppl. 1) pp. 3-7 (1995).
  • Many factors are believed to contribute to the onset of GERD. These include transient lower esophageal sphincter (LES) relaxations, decreased LES resting tone, delayed stomach emptying and an ineffective esophageal clearance.
  • LES transient lower esophageal sphincter
  • Treatments for GERD include lifestyle changes such as weight loss, avoidance of certain foods (e.g., coffee, caffeine, alcohol, chocolate) that exacerbate the symptoms of GERD and avoidance of excessive bending. Elevation of the head of a patient's bed helps prevent nocturnal reflux. While these avoidance strategies may be helpful there is relatively little data pointing to the efficacy of lifestyle modification for the treatment of GERD.
  • lifestyle changes such as weight loss, avoidance of certain foods (e.g., coffee, caffeine, alcohol, chocolate) that exacerbate the symptoms of GERD and avoidance of excessive bending. Elevation of the head of a patient's bed helps prevent nocturnal reflux. While these avoidance strategies may be helpful there is relatively little data pointing to the efficacy of lifestyle modification for the treatment of GERD.
  • H 2 -receptor antagonists which control gastric acid secretion in the basal state
  • proton pump inhibitors which control meal-stimulated acid secretion
  • Surgery treatments are also known for the treatment of GERD and include techniques for bulking the lower esophageal sphincter such as techniques described in U.S. Pat. No. 6,098,629 Johnson et al, Aug. 8, 2000.
  • Other surgical techniques include placement of pacemakers for stimulating muscle contractions in the esophageal sphincter, the stomach muscles or in the pyloric valve.
  • U.S. Pat. No. 6,104,955 to Bourgeois U.S. Pat. No. 5,861,014 to Familoni.
  • One inventive aspect of the present disclosure relates to methods and devices for treating GERD by stimulating the duodenum of a patient to accelerate gastric emptying.
  • a method and apparatus for treating gastro-esophageal reflux disease of a patient.
  • the method includes stimulating a body organ to accelerate a discharge of contents from a duodenum of a patient to thereby encourage discharge of contents from a stomach of the patient across a pyloric valve of the patient and into the duodenum.
  • the apparatus of the invention includes a signal generator for generating a stimulation signal.
  • a conductor electrically connects the signal generator to the body organ to accelerate a discharge of contents from the duodenum of the patient to encourage gastric emptying.
  • FIG. 1 is a schematic representation of a gastric-emptying feedback loop with a patient-controlled stimulator for stimulating an organ of the loop;
  • FIG. 2 is a view similar to FIG. 1 with an automatic controller replacing the patient-controller of FIG. 1 and with feedback circuits to the automatic controller schematically represented.
  • a gastric emptying feedback loop is shown schematically for ease of illustration.
  • the feedback loop illustrates a patient's stomach S which is provided with food from the esophagus E.
  • a lower esophageal sphincter LES is shown positioned between the esophagus E and the stomach S.
  • the lower esophageal sphincter normally provides control of reflux of stomach contents into the esophagus E.
  • the stomach discharges into the superior duodenum D which is an upper portion of the intestines.
  • the superior duodenum D and the stomach S are separated by a pyloric valve PV which opens to permit gastric emptying from the stomach into the duodenum D.
  • FIG. 1 Also schematically illustrated in FIG. 1 are nerve paths N providing signal flow paths from both the superior duodenum D and the stomach S to the brain B.
  • An efferent Vagal nerve VN connects the brain B to the pancreas P of the patient.
  • a conduit pancreatic duct PD extends from the pancreas P and discharges into the superior duodenum D.
  • the presence of food contents within the duodenum D may prevent passage of gastric content of the stomach S past the pyloric valve PV into the duodenum D.
  • contents can be forced retrograde past the lower esophageal sphincter LES and into the esophagus E creating the symptoms and discomfort of GERD.
  • the contents discharging from the stomach S into the duodenum D are acidic (and high osmolality) and reside in the duodenum D until pH is elevated (close to a neutral pH of 6-7) and osmolality is normalized.
  • gastro-esophageal reflux disease results from a derangement of the feedback loops involved in upper GI digestion and motility control.
  • This problem encompasses receptors and reflexes that regulate the propulsive contractions of the stomach, upper duodenum and biliary tree and the secretions of the exocrine pancreas.
  • the interaction of these receptors and reflexes control gastric emptying (by coordinating gastric propulsive contractions and sphincter [primarily pyloric] tone) and regulate the pH and osmolality of the chyme in the duodenum.
  • ingestate delivered to the stomach is mixed by low intensity gastric mixing contractions with the enzymatic, ionic, including hydrogen ion (H + ), and water secretions of the glands of the stomach.
  • H + hydrogen ion
  • the fluid now called chyme
  • This material is at a very low pH (about 2) and high osmolality, which activates receptors, including those for H + and osmotic pressure, which are abundant in the wall of the ampulla.
  • This receptor activation initiates the series of reflexes that cause pancreatic exocrine secretion to be delivered into the superior duodenum and ampulla.
  • This fluid contains digestive enzymes, water and buffering compounds to raise the pH, and reduce the osmolality, of the chyme.
  • control system If the control system is down regulated by, for example, by increased pH of gastric contents entering the ampulla, feedback may thereby be reduced from the H + receptors in the duodenum that stimulate pancreatic exocrine secretion and bile delivery to the duodenum, then movement of chyme from the superior duodenum is delayed, causing delay of gastric emptying.
  • the drugs used to treat this disease raise pH further dampening the hydrogen-receptor-pancreatic secretion loop, further delaying gastric emptying.
  • Benini “Gastric Emptying and Dyspeptic Symptoms in Patients with Gastroesophageal Reflux”, Amer. J. of Gastroenterology, pp. 1351-1354 (1996).
  • the present invention is directed towards reestablishing the link between gastric emptying and pancreatic secretion delivery, thereby addressing the main pathology of this disease by shortening chyme residence time in the superior duodenum so that intestinal contents move into the distal digestive tract in a more normal manner.
  • this is done by stimulating the H+ ion receptors or by stimulation of the pancreas directly or via its parasympathetic innervation (pre-ganglionic Vagal nerves). Stimulation of pancreatic exocrine secretion has been shown by direct stimulation of the thoracic vagus nerves in dogs.
  • Acidity can be assessed by measuring bicarbonate. It will be understood that references to ⁇ H includes such indirect measurements. Also, effects of the therapy described herein can be assessed and/or controlled by measuring an indication of pancreatic exocrine secretion or bile (e.g., HCO 3 ⁇ ).
  • An alternative embodiment uses gastrocopic delivery of a paralyzing agent (e.g. botulism toxin) to the pyloric valve along with use of H 2 antagonists or PPI's to manage the acidity of the chyme reaching the duodenum.
  • a paralyzing agent e.g. botulism toxin
  • the gall bladder can be stimulated to encourage bile movement into the duodenum.
  • the gall bladder GB resides below the liver L.
  • the gall bladder is connected to the small intestine (specifically the duodenum D) via a bile duct BD.
  • the bile duct BD can discharge directly into the duodenum D or via the pancreatic duct PD as shown.
  • the bile can normalize the chyme to accelerate duodenal emptying.
  • Bile consists of bile acids (detergents that emulsify lipids), cholesterol, phospholipids, electrolytes such as (Na + , K + , Ca +2 , Cl ⁇ , HCO 3 ' ) and H 2 O. Chapter 4, “The Liver and Biliary Tract”, Gastrointestinal System, 2 nd Ed., M. S. Long editor, Mosby Publisher, London (2002).
  • the gall bladder GB or bile duct can be stimulated indirectly via stimulation of the vagal nerve VN or directly stimulated by an electrode or other stimulator.
  • an electrical stimulator 10 , 20 which may be implanted is provided which alternatively may be directly connected to the Vagal nerve VN (e.g., via stimulation pathway 13 ) or the pancreas P (e.g., via stimulation pathway 111 shown in dashed line) to stimulate the pancreas directly or indirectly to excrete exocrine into the duodenum D (or more distally into the small intestine—e.g., into the jejunum) and increase the pH of chyme in the duodenum D as described.
  • VN Vagal nerve
  • the pancreas P e.g., via stimulation pathway 111 shown in dashed line
  • the same can be done to promote bile release by stimulating the bile duct BD or the gall bladder GB either directly (e.g., via stimulation pathway 11 ) or indirectly (e.g., by stimulating Vagal nerve VN via stimulation pathway 13 ).
  • the duodenum D can be stimulated directly (e.g., via one or more electrodes or other stimulators as indicated by pathway 11 ) to cause propulsive contractions that accelerate duodenum emptying.
  • the frequency may be varied to maximize the response and selectively stimulate exocrine instead of endocrine secretions.
  • the patient may activate the stimulator 10 by remote transmitter to stimulate an electrical charge either after eating (e.g., about 60 to 90 minutes after eating) or on onset of GERD symptoms.
  • the stimulator 10 may activate the stimulator 10 by remote transmitter to stimulate an electrical charge either after eating (e.g., about 60 to 90 minutes after eating) or on onset of GERD symptoms.
  • an electrical charge either after eating (e.g., about 60 to 90 minutes after eating) or on onset of GERD symptoms.
  • nerve stimulators and organ stimulators available for implantation and are commercially available and which include connectors for connecting directly to nerves.
  • FIG. 2 illustrates an additional embodiment where the patient activated loop is replaced with an automatic loop having a programmable stimulator 20 which receives as an input signals from sensors in the duodenum to measure pH, osmolality or strain (e.g., from baro-sensors) on the duodenum indicating filling or may measure acidity in the esophagus or strain on the lower esophageal sphincter LES or stomach S all of which may be provided to the implantable controller 20 which can be provided with desirable software to process the incoming signals and generate a stimulating signal to either the Vagal nerve, the pancreas P, the gall bladder GB, the bile duct BD or the duodenum D (or jejunum) directly in response to such received signals.
  • a programmable stimulator 20 which receives as an input signals from sensors in the duodenum to measure pH, osmolality or strain (e.g., from baro-sensors) on the duodenum indicating filling or may measure

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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Electrotherapy Devices (AREA)
US10/358,093 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD) Abandoned US20040172084A1 (en)

Priority Applications (37)

Application Number Priority Date Filing Date Title
US10/358,093 US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US10/674,330 US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US10/675,818 US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management
US10/674,324 US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy
US10/752,940 US7444183B2 (en) 2003-02-03 2004-01-06 Intraluminal electrode apparatus and method
US10/752,944 US7167750B2 (en) 2003-02-03 2004-01-06 Obesity treatment with electrically induced vagal down regulation
AT04707122T ATE547148T1 (de) 2003-02-03 2004-01-30 Nervenstimulationsgerät
PCT/US2004/002849 WO2004069332A1 (en) 2003-02-03 2004-01-30 Intraluminal electrode
EP04707122A EP1601414B1 (de) 2003-02-03 2004-01-30 Nervenstimulationsgerät
AT04707111T ATE537871T1 (de) 2003-02-03 2004-01-30 Elektrodenband
AU2004209978A AU2004209978B2 (en) 2003-02-03 2004-01-30 Electrode band
DK04707122.0T DK1601414T3 (da) 2003-02-03 2004-01-30 Neural stimulation
PCT/US2004/002847 WO2004069331A2 (en) 2003-02-03 2004-01-30 Neural stimulation
EP04707111A EP1603634B1 (de) 2003-02-03 2004-01-30 Elektrodenband
EP11165936A EP2366425A1 (de) 2003-02-03 2004-01-30 Elektrodenband
PCT/US2004/002841 WO2004069330A1 (en) 2003-02-03 2004-01-30 Electrode band
US10/881,045 US7844338B2 (en) 2003-02-03 2004-06-30 High frequency obesity treatment
US11/040,767 US7613515B2 (en) 2003-02-03 2005-01-21 High frequency vagal blockage therapy
US11/450,202 US20060229685A1 (en) 2003-02-03 2006-06-09 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US11/656,123 US20070135846A1 (en) 2003-02-03 2007-01-22 Vagal obesity treatment
US11/656,121 US7986995B2 (en) 2003-02-03 2007-01-22 Bulimia treatment
US11/656,113 US7693577B2 (en) 2003-02-03 2007-01-22 Irritable bowel syndrome treatment
US11/656,122 US7630769B2 (en) 2003-02-03 2007-01-22 GI inflammatory disease treatment
US11/656,132 US7720540B2 (en) 2003-02-03 2007-01-22 Pancreatitis treatment
US11/891,770 US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders
AU2009245845A AU2009245845B2 (en) 2003-02-03 2009-12-08 Electrode band
US12/721,603 US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders
US12/908,375 US8046085B2 (en) 2003-02-03 2010-10-20 Controlled vagal blockage therapy
US13/178,221 US8369952B2 (en) 2003-02-03 2011-07-07 Bulimia treatment
US13/188,293 US8538542B2 (en) 2003-02-03 2011-07-21 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US13/276,638 US8538533B2 (en) 2003-02-03 2011-10-19 Controlled vagal blockage therapy
US13/758,223 US8862233B2 (en) 2003-02-03 2013-02-04 Electrode band system and methods of using the system to treat obesity
US14/019,126 US9174040B2 (en) 2003-02-03 2013-09-05 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14/028,030 US9162062B2 (en) 2003-02-03 2013-09-16 Controlled vagal blockage therapy
US14/480,242 US9586046B2 (en) 2003-02-03 2014-09-08 Electrode band system and methods of using the system to treat obesity
US14/930,233 US9682233B2 (en) 2003-02-03 2015-11-02 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US15/625,755 US20170304615A1 (en) 2003-02-03 2017-06-16 Nerve stimulation and blocking for treatment of gastrointestinal disorders

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US10/358,093 US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)

Related Child Applications (7)

Application Number Title Priority Date Filing Date
US10/674,330 Continuation-In-Part US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US10/675,818 Continuation-In-Part US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management
US10/674,324 Continuation-In-Part US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy
US10/752,940 Continuation-In-Part US7444183B2 (en) 2003-02-03 2004-01-06 Intraluminal electrode apparatus and method
US10/752,944 Continuation-In-Part US7167750B2 (en) 2003-02-03 2004-01-06 Obesity treatment with electrically induced vagal down regulation
US11/450,202 Division US20060229685A1 (en) 2003-02-03 2006-06-09 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US12/721,603 Continuation-In-Part US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders

Publications (1)

Publication Number Publication Date
US20040172084A1 true US20040172084A1 (en) 2004-09-02

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Family Applications (11)

Application Number Title Priority Date Filing Date
US10/358,093 Abandoned US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US10/675,818 Abandoned US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management
US10/674,330 Expired - Fee Related US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US10/674,324 Abandoned US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy
US11/450,202 Abandoned US20060229685A1 (en) 2003-02-03 2006-06-09 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US11/891,770 Expired - Lifetime US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US12/721,603 Expired - Fee Related US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders
US13/188,293 Expired - Fee Related US8538542B2 (en) 2003-02-03 2011-07-21 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14/019,126 Expired - Fee Related US9174040B2 (en) 2003-02-03 2013-09-05 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14/930,233 Expired - Fee Related US9682233B2 (en) 2003-02-03 2015-11-02 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US15/625,755 Abandoned US20170304615A1 (en) 2003-02-03 2017-06-16 Nerve stimulation and blocking for treatment of gastrointestinal disorders

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US10/675,818 Abandoned US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management
US10/674,330 Expired - Fee Related US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US10/674,324 Abandoned US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy
US11/450,202 Abandoned US20060229685A1 (en) 2003-02-03 2006-06-09 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US11/891,770 Expired - Lifetime US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US12/721,603 Expired - Fee Related US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders
US13/188,293 Expired - Fee Related US8538542B2 (en) 2003-02-03 2011-07-21 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14/019,126 Expired - Fee Related US9174040B2 (en) 2003-02-03 2013-09-05 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14/930,233 Expired - Fee Related US9682233B2 (en) 2003-02-03 2015-11-02 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US15/625,755 Abandoned US20170304615A1 (en) 2003-02-03 2017-06-16 Nerve stimulation and blocking for treatment of gastrointestinal disorders

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DK1601414T3 (da) 2012-05-29
US8010204B2 (en) 2011-08-30
US20040172086A1 (en) 2004-09-02
US9682233B2 (en) 2017-06-20
US20060229685A1 (en) 2006-10-12
US20100168815A1 (en) 2010-07-01
US20170304615A1 (en) 2017-10-26
US9174040B2 (en) 2015-11-03
US8538542B2 (en) 2013-09-17
ATE547148T1 (de) 2012-03-15
AU2009245845B2 (en) 2011-09-29
US20040172085A1 (en) 2004-09-02
US7489969B2 (en) 2009-02-10
US20110282411A1 (en) 2011-11-17
AU2009245845A1 (en) 2010-01-07
US20140172052A1 (en) 2014-06-19
US20160193465A1 (en) 2016-07-07
US7729771B2 (en) 2010-06-01
US20040176812A1 (en) 2004-09-09
US20080021512A1 (en) 2008-01-24
EP2366425A1 (de) 2011-09-21

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