JP2005013749A - Implantable band with attachment mechanism having dissimilar material characteristic - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an improved attachment mechanism having a dissimilar material characteristic for an adjustable stomach band. <P>SOLUTION: This implantable band 10 is arranged around an anatomical passage, and has a strap 30 made of a material having at least one first material characteristic, and has an attachment mechanism including a material having at least one second material characteristic different from the first material characteristic. The band 10 has a first end part 40 and a second end part 42 arranged in a place of respective end parts of the strap. The attachment mechanism is constituted, so as to adjacently fix the strap to the anatomical passage, for example, a stomach, by attaching the first end part 40 to the second end part 42. The attachment mechanism preferably includes a plastically deformable or elastically deformable material. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates generally to a surgically implantable band or band annulus surrounding an anatomical passage, and more particularly to an adjustable gastric band surrounding the stomach for obesity management. The present invention is disclosed in connection with an improved attachment mechanism, particularly for an adjustable gastric band.

  In addition, the present application is the following US provisional patent application, that is, US provisional patent application No. 60 / 483,353 filed on June 27, 2003 (name of invention: adjustable gastric band hubbing).・ Adjustable Gastric Band Having An Improved Attachment Mechanism) and US Provisional Patent Application No. 60 / 507,612 filed on Sep. 30, 2003 (Title of Invention: Implantable)・ A priority claim application for Implantable Band With Deformable Attachment Mechanism, and the disclosure of these US provisional patent application specifications is considered to form part of this specification. Quote. In addition, in this application, the following co-pending US patent application filed on September 30, 2003, US Provisional Patent Application No. 60 / 507,625 (name of invention: Implantable Band Haven Improved) Implantable Band Having Improved Attachment Mechanism), US Patent Application No. 10 / 677,088 (Title of Invention: Implantable Band with Transverse Attachment Mechanism) Mechanism)), US Patent Application No. 10 / 676,368 (Title of Invention: Implantable Band with Non-Mechanical Attachment Mechanism) and US Provisional Patent Application 60 / 507,916 (Title of Invention: Imp The description of the Implantable Band with Attachment Mechanism is cited as forming part of this specification. In addition, in this application, the following co-pending US patent application filed on December 19, 2003, namely US Patent Application No. 10 / 742,483 (name of invention: implantable band hubbing improve) Implantable Band With Improved Attachment Mechanism) and US Patent Application No. 10 / 741,869 (Title of Invention: Implantable Band with Attachment Mechanism) ) Is hereby incorporated by reference as forming part of this specification.

  Since the early 1980s, adjustable gastric bands have been an effective alternative to gastric bypass and other irreversible surgical weight loss treatments for morbid obesity. The gastric band is wrapped around the upper part of the patient's stomach and forms a stoma that is smaller than the normal inner diameter of the stomach and restricts food from the upper part of the stomach to the lower digestive part. When the stoma is of an appropriate size, food held in the upper part of the stomach creates a feeling of fullness that discourages overeating.

  In addition to the latching position that sets the diameter of the gastric band, gastric band accommodation is generally achieved with an inwardly inflatable balloon resembling a blood pressure cuff, in which fluid, such as saline, is fluid. Injected through the injection port, thereby achieving the desired diameter. The balloon is only deflated or partially inflated when initially placed in the body to allow adjustment to the body and healing around the new band site. Since the adjustable gastric band remains in the patient's body for an extended period of time, the fluid injection port is typically provided subcutaneously to avoid infection, for example, in front of the sternum. Following the initial implantation, the surgeon can adjust the band by loosening or tightening as desired by the patient. Adjustment of the amount of fluid in the adjustable gastric band is accomplished by inserting a Huber tip needle into the skin and into the silicone septum of the injection port. Once the needle is removed, the diaphragm will adhere to the hole due to the compressive load generated by the diaphragm. A flexible conduit provides communication between the injection port and the adjustable gastric band.

The attachment mechanism for the adjustable gastric band needs to allow the initial sizing of the gastric stoma. One commonly known attachment method is to stitch the ends of the adjustable gastric band together. Another commonly known method of attachment is to have one end of the gastric band terminating in a flexible conduit having a divergent portion that passes into an opening in the second end of the gastric band. Withdrawing and then sewing to the surrounding band part, thereby securing the band to the stomach. After the suture is in place, the injection port is anchored at an advantageous location.
US Provisional Patent Application No. 60 / 483,353 US Provisional Patent Application No. 60 / 507,612 US Provisional Patent Application No. 60 / 507,625 US patent application Ser. No. 10 / 677,088 US patent application Ser. No. 10 / 676,368 US Provisional Patent Application No. 60 / 507,916 US patent application Ser. No. 10 / 742,483 US patent application Ser. No. 10 / 741,869

  While the above known methods are effective for gastric band fixation, further improvements are desired that simplify clinical implantation procedures, provide long-term reliability, and facilitate readjustment or removal.

  Although the suture has been trusted as the most reliable connection means in the past, it is desirable to provide a fixed attachment that does not require a suture and does not require a large force to form the fixed attachment. If this is not the case, it may be difficult to achieve this by properly holding the attachment with a laparoscopic instrument. Accordingly, there is a great need for an adjustable gastric band with an improved attachment mechanism.

  The present invention is based on the prior art by providing an adjustable gastrostomy device that can be used with low force, thereby facilitating handling when using a laparoscopic instrument and yet the attachment remains firm for extended use. Solve the above and other problems.

  A general object of the present invention is to provide a material having a strap made of a material having at least one first material property and having at least one second material property different from the first material property. It is to provide an implantable gastric band having an attachment mechanism including. The attachment mechanism may comprise a plastically deformable or elastically deformable material.

  Another object of the present invention is to provide an easily turnable adjustable gastric band that can be attached and removed without reducing the holding strength of the attachment mechanism.

  Yet another object of the present invention is to provide an attachment mechanism that requires a small force to latch and requires a large force to disengage the end.

  Thus, the present invention is an implantable band for treating a medical condition comprising (a) a strap configured to surround an anatomical passage, said strap being circumferentially around the strap Wherein the strap has an inner surface and an outer surface, the strap is made of a material having at least one first material property, and (b) a first provided at each end of the strap. An end portion and a second end portion, wherein the first and second end portions respectively have respective inner and outer surfaces corresponding to the inner and outer surfaces of the strap; and (c) the first An integral attachment mechanism configured to attach an end portion to the second end portion and secure the strap adjacent to the anatomical passage, the attachment mechanism comprising at least one second material property The It consists example was the material, the at least one second material property, provides a band, characterized in that is different from said at least one first material property.

  According to the band configuration of the present invention, the band can be effectively fixed around an anatomical passage, for example, the stomach, by using different straps of different material properties and an integral mechanical attachment mechanism. For example, effective treatment of obesity can be performed. Further, the mechanical attachment mechanism of the present invention can easily perform readjustment or removal of the belt, and exhibits long-term reliability in attachment. The mechanical attachment mechanism of the present invention can be used not only for a gastric band for obesity management but also for an arbitrary gastric band.

  The accompanying drawings, which are included in and constitute a part of this application, illustrate various embodiments of the invention, and together with the general description of the invention described above and the detailed description of embodiments given below, It serves to explain the principle of the invention.

  Reference will now be made in detail to the presently preferred embodiments of the invention, examples of which are illustrated in the accompanying drawings.

  In the following description, the same reference numerals denote the same or corresponding parts throughout the several views. Moreover, in the following description, terms such as front, back, inside, outside, etc. are terms for convenience and should not be construed as limiting terms. The terminology used herein is not intended to limit the invention as the devices described herein or portions thereof may be mounted or utilized in other orientations. The present invention will now be described with reference to the drawings in detail.

  Referring to FIG. 1, an adjustable gastric band 10 is wrapped around the top of the stomach 12, held in place by attaching the two ends together, and a portion 14 of the stomach 12 is sutured to the stomach 12. Is shown with a portion 14 of the stomach 12 over the adjustable gastric band 10. Referring also to FIG. 2, the adjustable gastric band 10 has a non-extensible strap 16 and an inflatable balloon 18 made of medical silicone polymer or any other suitable material has an inner surface of the strap 16. 20 is supported. Balloon 18 may be secured to inner surface 20 by any known method, or the balloon may be integral with strap 16. However, the strap 16 is typically made of a different material.

  One end of the flexible conduit 22 is in fluid communication with the internal cavity 24 of the balloon 18 and the other end is in fluid communication with the internal cavity (not shown) of the remote injection port 26. The remote injection port 26 has a silicone diaphragm 28. When the adjustable gastric band 10 is applied around a portion of the stomach, the remote injection port 26 is also usually at a suitable location within the rectus sheath so that it can be percutaneously accessed via a Hoover needle. Provided.

  As is well known, the internal cavity 24, the flexible conduit 22, and the internal cavity of the remote infusion port 26 are preferably at least partially filled with a physiologically compatible fluid, such as saline. The post-surgical adjustment surrounding the balloon 18 and thus the size of the stomach can be adjusted by adding fluid to the internal cavity 24 of the balloon 18 by percutaneously inserting a Hoover needle into the silicone septum 28 of the injection port 26. This is achieved by removal from this.

  As is well known in the art, adjustable gastric band 10 is made of any suitable medically compatible material with sufficient strength necessary for a particular laparoscopic surgery or a particular patient. It is good to be.

  As mentioned above, the two ends of the adjustable gastric band 10 are attached to each other (the structure of the particular attachment mechanism is not shown in FIG. 1).

  The present invention relates to various embodiments of attachment mechanisms that connect two ends together, wherein the attachment mechanism comprises a material having at least one material property that is different from the material property of the main constituent material of the strip. The overall configuration of the adjustable gastric band 10 shown in FIGS. 1 and 2 and described above is common to the embodiments shown in FIGS. 3-7, and these embodiments differ in specific attachment mechanisms. It should be noted that the present invention can be used with any gastric band and is not limited to use with an adjustable gastric band having the features described above or below.

  Referring now to FIG. 3, the adjustable gastric band 30 has an arcuate configuration when implanted, but has an elongated strap 32 extending in a direction referred to herein as the “longitudinal direction”. The strap 32 has an inner surface 34 and an outer surface 36, and the balloon 38 extends inwardly from a location adjacent to the inner surface 34. The adjustable gastric band 30 has a first end 40 that overlaps a second end 42. The first end portion 40 and the second end portion 42 are secured to each other by a deformable attachment mechanism.

  Referring also to FIG. 4, in the illustrated embodiment, the first end portion 40 of the strap 32 has a first portion of an attachment mechanism, shown as an elongated cylindrical shaft portion 44, associated therewith. The shaft portion 44 is axially spaced along it and a plurality of engagement members 46 shown as frustoconical annular flanges 46 that are inclined away from the distal end 44a. have. The second end portion 42 of the strap 32 has a second portion of the attachment mechanism associated therewith, shown as a laterally extending member 48, and the laterally extending member 48 extends from the outer surface 36. It extends vertically as a whole.

  Member 48 is shaped to receive first end portion 40. Referring also to FIGS. 6 and 7, the laterally extending member 48 forms a cavity 50, at least partially referred to as a passage, that is shaped to receive the first end portion 40. The member 48 has two spaced apart legs 52, 54 extending from the outer surface 36 with a gap 56 formed between the legs. The gap 56 communicates with the passage 50.

  As can be seen in FIG. 7, the surface 50 a of the passage 50 is shaped to cooperate with the engagement member 46 to resist axial withdrawal of the first end portion 40 from the passage 50. Specifically, the passage 50 has a plurality of axially spaced holding members 58, also called rings 58, whose annular shape is interrupted by a gap 56. In the illustrated embodiment, each retaining member 58 has a generally frustoconical surface 58a and a generally transverse (relative to the longitudinal) retaining surface 58b.

  The passage 50 and a portion of the gap 56 are surrounded by a holding actuator 60 shown as a “U” shaped (although any suitable shape can be used) member that is completely provided within the member 48. The actuator 60 can be easily plastically deformed or folded into a desired shape without breaking so as to increase the resistance to axial or lateral withdrawal of the first end portion 40 by pressing the retaining member 58 against the shaft 44. Made of material. Thus, at least one material property of the actuator 60, i.e., plastic deformation without significant elastic deformation prior, or a relatively low yield point, is a material property that corresponds to the constituent material of the remainder of the strap 16. Is different. When energy is applied to the actuator 60, the actuator plastically deforms so that the first end portion 40 is securely attached to the second end portion 42.

  Specifically, bending causes the actuator 60 to deform, thereby tightening the actuator to the shaft 44, so that the retaining member 58 provides great resistance to the axial movement of the engagement member 46 in the direction of arrow 62. . Further, the gap 56 may be closed by bending.

  The shaft 44 is pushed into the passage 50 to attach the first end portion 40 to the second end portion 42. In the illustrated embodiment, the shaft 44 is advanced through the passage 50 to the desired position with the engagement member 46 receiving minimal resistance to such axial movement from the frustoconical surface 58a. Thus, the band 30 can be set to a size of two or more diameters. Once the actuator member 60 is in the desired position, it can be folded with a gripper or other suitable instrument to activate the attachment mechanism. To remove the two ends, the closed gap 56 may be opened, for example, by spreading and separating the opposing surfaces of the gap 56 with a gripper.

  Actuator 60 may be made of any biologically suitable material that yields the desired deformation and force when folded, such as a plastically deformable metal. Although the actuator 60 is shown fully retracted within the second end portion 42, eg, insert molded, the actuator 60 remains held in the second end portion 42 in some manner. And as long as the second end portion 42 remains integral, it may extend beyond the outer surface. The width of the gap 56 is selected to provide sufficient clearance so that it lies through the shaft 44 and is closed by folding so that deformation of the actuator 60 is not severely limited.

  Referring now to FIGS. 8 and 9, another embodiment having a deformable attachment mechanism that is elastically deformable is shown. The adjustable gastric band 70 has a first end portion 72 and a second end portion 74 that are shown attached to each other, with an inner surface 76 abutting each other at each end 72, 74. . The first end portion 72 has a first portion of the attachment mechanism associated therewith, shown as a laterally extending member 78, and the laterally extending member 78 is an inner surface 76 of the end 72. As a whole, it extends vertically. Member 78 is shaped to engage a second portion of the attachment mechanism associated with second end portion 74. Specifically, the laterally extending member 78 defines a passage 80 in association with the inner surface 76 at the first end portion 72, which passage 80 is adapted to receive the second end portion 74. It is formed. Member 78 has two spaced apart legs 82, 84 that are inner surfaces 76 at opposite edges of strap 70 with transverse member 86 extending therebetween. Extends from.

  The second portion of the attachment mechanism associated with the second end portion 74 is shown as having a retaining member 88 extending laterally from its outer surface 90. The holding member 88 has an inclined surface 92 that may be arcuate or flat as shown. The retaining member 88 further includes a retaining surface 96 that extends generally perpendicularly from the outer surface 90 and perpendicular to the direction of relative motion of the first end portion 72 and the second end portion 74. The retaining surface 96 extends above the upper edge of the passage 80 a distance sufficient to provide the desired force to resist detachment. In the illustrated embodiment, the retaining surface 96 extends slightly beyond the top of the transverse member 86.

  The retaining member 88 preferably comprises a member 98 made of a material different from the rest of the strap 100 or having at least different elastic properties. In particular, in this embodiment, the elasticity of the constituent material of the member 98 is different from the elasticity of the constituent material of the strap 100, and has high elasticity to elastically bias the holding member toward the shape shown in the figure. Yes. In the illustrated form, due to the high elasticity, when the holding member 88 is inserted into the passage 80, the holding member 88 can be easily compressed.

  In the disclosed embodiment, the member 98 is shown schematically as a coil spring housed in a cavity 102 formed in the retaining member 88. The cavity 102 of the member 98 can be formed by any suitable method, for example, using a two-step molding method, insert molding, or other known methods. By providing the cavity 102, the retaining member 88 can bend more easily to the side than if the cavity was made of the same material as the rest of the band 100, typically silicone. . The member 98 is laterally elastic and presses the holding member 88 outward to maintain the holding surface 96 in a position that requires a large longitudinal force to separate the two ends. Since the direction of lateral elasticity of the member 98 is perpendicular to the removal direction, the retaining surface 96 is below or substantially below the transverse member 86 and does not prevent or against the second end portion 74 from exiting the passage 80. Only a relatively small lateral force is required to move the exerted resistance to a small position.

  The elastically deformable element of dissimilar material and the cavity in which it is housed may be of any suitable shape. Referring to FIG. 10, another embodiment of the elastic member 104 is schematically illustrated as being housed within the cavity 106. The member 104 has a “V” shape and the wide end is open toward the holding surface 108.

  Referring to FIG. 11, another embodiment of an attachment mechanism, indicated generally at 110, is shown, which includes a receiver 112 and a second end portion 118 supported by a first end portion 114. And has a resilient member shown as a dual cantilever spring 116. The receiver 112 and spring 116 may be made of any suitable medically compatible material with sufficient strength. In the illustrated embodiment, the receiver 112 and the spring 116 are provided with a first end portion 114 and a second end of an adjustable gastric band (not numbered in FIG. 11) made of silicon injection molded polymer. It is made by insert molding into part 118. The material properties of the constituent material of the receiver 112 and the spring 116 are different from the material properties of the constituent material of the strap. In particular, in the illustrated embodiment, this material has a higher bending and torsional stiffness and is harder than the strap material (eg, silicone).

  Referring also to FIG. 11A, receiver 112 has two pairs of spaced apart side walls 120, 122, 124, 126 that are two spaced apart legs 130 of spring 116. , 132 is formed into a cavity 120, also referred to as a pocket shaped to receive. The side walls 122, 124 have two openings 134, 136 that are shaped to receive the ends 138, 140 of the legs 122, 124. Ends 138 and 140 have stepped portions 142 and 144, respectively, which are on the side portions 146 and 148 of the respective openings 134 and 136 to resist withdrawal from the pocket 128 as described below. Each is dimensioned to engage.

  The spring 116 has step portions 150 and 152 extending outward from the leg portions 138 and 140, respectively. The second end portion 118 is molded around a portion of the spring 116 and the second end portion is held by the spring with the legs 138, 140 extending from the end 154. Recessed surfaces 156, 158 are provided, which are generally aligned with the steps 150, 152 and provide a place to grip the second end portion 118 to clamp the ends 138, 140 toward each other as shown. It is good to have a rough surface pattern or satin or protrusion.

  Referring also to FIG. 12, the legs 130, 132 are inserted into the pockets 128 to connect the attachment mechanism 110 to each other. The ends 138, 140 have ramps 160, 162 that engage the corners 164, 166 when inserted so that when the legs 130, 132 are advanced into the pocket 128, the legs 130, 132 face each other. Compressed. The material and structure of the spring 116 provides elasticity to the two legs 138 and 140. The end portions 138 and 140 move outwardly and snap into the openings 134 and 136 so that the two end portions 114 and 118 are in contact with the end portion 168 as a whole. Advance into pocket 128 until they can be held together.

  As shown, the openings 134, 136 extend completely through the spaced apart side walls 122, 124 of the receiver 112, and the steps 142, 144 do not extend outside the openings. . Openings 134 and 136 are shown covered by silicon material at end portion 114. Once installed as shown, the receiver 112 and spring 116 are not exposed and are contained within the band shroud and do not erode the surrounding tissue.

  In order to remove the first end portion 114 from the second end portion 118, the recessed surfaces 156, 158 are tightened inward so that the legs 130, 132 move inward and finally the ends 138, 140. Can be removed from the openings 134, 136 so that the spring 116 can be removed from the receiver 112. The recessed surfaces 156 and 158 may be tightened using a gripper.

  Referring to FIGS. 13-15, there is shown yet another embodiment of an attachment mechanism, generally designated 170, which includes a first material made of the same material as the remainder of the band, such as silicon. One end portion 172 and a second end portion 174. The first end portion 172 has a retaining member 176 shown as a conical shape, more specifically a truncated conical shape, provided adjacent to the annular groove 178, and the annular groove 178 has a first shape. The cylindrical portion 180 and the base 182 of the holding member 176 are separated. A second cylindrical portion 184 extends between the first cylindrical portion and the retaining member 176. Another cylindrical portion 186 extends from the opposite end of the retaining member 176.

  The second end portion 174 has a generally cylindrical interior cavity 188, also referred to as an opening, that is configured to be complementary to and receive the first end portion 172. The first end portion 172 is shown as having an inner diameter that is slightly larger than the outer diameter of the first cylindrical portion 180 enough to be inserted into the cavity 188 as described below. . The second end portion 174 has two spaced apart lateral slot openings 190, 192 in communication with an internal cavity 188 provided on opposite sides of the second end portion 174. is doing.

  An elastic member 196, shown generally as a U-shaped spring clip, has two legs 198, 200 that extend from the base 202 and are generally parallel to each other in the free state. The spring clip 196 may be made of any suitable medically compatible material that provides the necessary elasticity and strength. It differs from one or more material properties that make up the correspondence of the constituent materials of the spring clip 196. In the illustrated embodiment, the spring clip 196 has higher hardness, torsional stiffness, bending stiffness, resilience and elasticity than the strap.

  Spring clip 196 is supported by second end portion 174 with legs 198 and 200 partially located within openings 190 and 192, respectively. The end portions of the leg portions 198a and 200a extend beyond the openings 190 and 192 and terminate at curved portions. The base 202 is molded into the second end portion 174 and the legs 198, 200 remain free to spread outward so that the retaining member 176 can be passed between the legs 198, 200. In the free state, the distance between the legs 198, 200 is sufficient to allow the leading end 176a of the retaining member 176 to pass between them. Preferably, the diameter of the end portion 176a is smaller than the distance forming the corresponding relationship between the leg portions 198 and 200. In order to connect the attachment mechanisms 170 together, the first end portion 172 is inserted into the cavity 188. Due to the slanted shape of the retaining member 176, the legs 198, 200 widen with each other as the first end portion 172 is advanced into the cavity 188, eventually opening 190, 192 aligned with the groove 178, at which point Legs 198, 200 move into groove 178 and are preferably resiliently pressed against cylindrical portion 184 as seen in FIG. 15, but are sufficient to hold at least first end portion 172 within cavity 188. The holding member 176 moves to a position adjacent to the base 182.

  To remove the first end portion 172 from the second end portion, the legs 198, 200 are pulled far enough so that the base 182 can pass between them. This can be achieved by using a gripper.

  Referring generally to FIGS. 16-23, and with particular reference to FIGS. 16 and 21-23, another embodiment of an attachment mechanism is shown, generally designated 204, with adjustable gastric band 254. The attachment mechanism has a first end portion 206 and a second end portion 174. FIG. 16 is an exploded perspective view of the attachment mechanism 204 with the band omitted. The first end portion 206 supports the insert assembly 210 and the second end portion 208 supports the housing assembly 212. Insert assembly 210 and housing assembly 212 may be attached to first end portion 206 and second end portion 208 in any suitable manner. In the illustrated embodiment, the insert assembly 210 and the housing assembly 212 are molded into end portions 206 and 208, respectively, in longitudinal alignment with the band 254. It is noted that as an alternative, the insert assembly 210 and the housing assembly 212 may be directed laterally or transversely to the band 254.

  In the illustrated embodiment, the insert assembly 210 includes an insert 214, a cap 216 and a retainer 218. The insert 214 is rotatably connected to the cap 216 by a retainer 218. As shown, the insert 214 has a hole 220 shaped to receive a portion of the retainer 218, shown as a threaded pin. However, any appropriate retainer or holding structure may be used. The cap 216 also has a hole 222 through which the threaded shaft portion 218 a of the retainer 218 passes through the hole 222 and meshes with the female thread of the hole 220. The cap 216 may have a counterbore or other recess (not shown) on its surface located adjacent to the upper end 214a of the insert 214. Such a recess may be complementary to an adjacent portion of the insert 214 to receive a portion of the insert 210 while allowing sufficient rotation of the insert 214. Any form can be utilized that allows the insert to be supported by the first end portion 206 in a suitably free rotating manner.

  The insert 214 has three legs 224, each having a radially extending portion 224a and an axially extending portion 224b. Although three spaced apart legs 224 are shown, one or more spaced apart legs may be present. In the illustrated embodiment, the legs 224 are equally spaced in the circumferential direction with an angle of 120 ° between them. Although the axially extending portion 224b is continuous and aligned with the radially extending portion 224a, the function of the legs 224 can be achieved without being continuous and aligned.

  In the illustrated embodiment, the housing assembly 212 includes a housing 222, a resistor 228, a biasing member 230, shown as an elastically deformable coil spring, and an end cap 232. Referring also to FIG. 17, the housing 226 defines an internal cavity 234, also referred to as a bore. The first portion 234a of the bore 234 that begins at the upper end 226a of the housing 226 (also referred to as the inlet portion) has a nominal diameter that is complementary to the nominal outer diameter of the insert 214 (not including the legs 224). ing. A plurality of longitudinal slots 236 are formed extending outwardly from the inner surface 234b of the inlet portion 234a. The slots 236 are shaped to receive the legs 224a, and the number and spacing of the slots 236 matches the number and spacing of the legs 224. The width (circumferential direction) and depth (beyond the inner surface 234b) of the slot 236 allows clearance for the leg 224 to slide axially through it with little or no axial force required. Sized to provide. As will be described, the insert 214 rotates within the housing 226 to connect and disengage (activate and deactivate) the attachment mechanism 204 so that the legs 224 and the slots 236 are equally spaced circumferentially / angularly. Are preferably arranged uniformly.

  The bore 234 has a second portion 234c. The second portion 234c has a diameter that provides a diametrical clearance for the leg 224 so that the insert 214 can freely rotate within the housing 226 once the leg 224 passes over the slot 236. This will be described below. In the illustrated embodiment, the diameter of the second portion 234c is substantially the same as the depth of the slot 236, and the inner surface 234d is continuous with the bottom 236a of the slot 236.

  The inlet portion 234 includes a plurality of arcuate slopes 238, 240 that extend outwardly a distance that provides a diametrical clearance for the leg 224 relative to the inner surface 234b. The slope 238 extends between the lower end portion of the side portion 236b extending in the longitudinal direction and the upper end portion of the stop surface 242 extending in the longitudinal direction. The slope 240 extends between the lower end portion of the stop surface 242 and the lower end portion of the side portion 236c extending in the longitudinal direction. In the illustrated embodiment, the inner surface 234d extends to the slopes 238,240.

  A plurality of longitudinal slots 244 are formed extending outward from the lower end of the second portion 234c as viewed from the inner surface 234d. The slot 244 is shaped to receive the leg 228a of the resistor 228 and along this slot requires little or no axial force until the leg 228a is stopped by the end 244a. Provides sufficient clearance to slide axially. The number and spacing of the slots 244 matches the number and spacing of the legs 228. In the illustrated embodiment, the grooves 224 and the legs 228 are uniformly provided at equal intervals in the circumferential direction / angle. However, any number and orientation that provides the desired function can be used.

  Referring also to FIG. 18, the inner surface 234 d is complementary to the outer surface 228 b of the resistor 228 provided in the bore 234. In the illustrated embodiment, the surface 228b is cylindrical and its diameter is such that the resistor 228 can slide axially within this surface with little or no axial force required. It is smaller than the diameter of the inner surface 234d by a sufficient size. In order to hold the resistor 228 in the housing 226, the end cap 232 has a biasing member 230 positioned between the lower end of the resistor 228 and the upper end of the cap 232, and the resistor 228 is inserted into the inlet end 234 a. It is being fixed to the lower end part 226b in the state pressed to the direction. The cap 232 and the lower end 226b may be connected to each other using any suitable method, such as a screw thread.

  The resistor 228 has a plurality of uphill roads 246 and downhill roads 248 (clockwise directions as viewed in a plan view) that intersect at a mountain part 250 and a valley part 252 facing in the radial direction. The ramps 246, 248 and the axially extending portion 224b are configured to cooperate with each other to rotationally bias the insert 214 when the insert 214 is pressed against the resistor 228 during actuation and deactivation of the mounting mechanism 204. ing. In the illustrated embodiment, each axially extending portion 224b has a lower surface 224c, which is a radially oriented edge shaped to engage the ramps 246, 248 of the resistor 228. It terminates at 224d. As will be appreciated, the configuration of the ramps 246, 248, the axially extending portion 224b, the surface 224c, and the edge 224d approach the center of the end of the insert 214 to avoid interference and gradually reduce the circumferential distance. Now it is necessary to complement each other. Other forms that exhibit the same function of these features can be used. For example, the axially extending portion 224 b may extend only in the axial direction in alignment with the remainder of the leg 224 without passing radially inward around the insert 214.

  18-20 illustrate various positions of the insert 214 during actuation and deactivation of the attachment mechanism 204. FIG. 18 to 20, it is noted that the curvature of the slope 238 'is opposite to the curvature shown in FIG. The shape of the slopes and legs may be any suitable shape that cooperates with each other to achieve indexing rotation of the insert 214 as described below.

  In FIG. 18, the insert 214 is shown at least partially housed within the bore 234 of the housing 216, with each leg 224 positioned in a corresponding slot 236. When the leg portions 224 are arranged in this way, the respective edge portions 224d of the portion 224b extending in the axial direction are positioned so as to engage with the corresponding downhill roads 248. When the insert 214 is advanced axially into the bore, the descending surface of the ramp 248 urges the edge 224d to rotate, while the upper edge 224e of the insert 214 is at the lower end 238a '/ slope 238' of the side 236b. Rotation is initially blocked by the stop 236b until it is advanced deep enough into the bore 234 to cross the lower end of the. The resistor 228 does not rotate if it moves axially within the bore 234 when the insert 214 is moving forward.

  Once the upper edge 224e has passed the lower end 238a ′ and the insert 214 is able to rotate, the descending surface of the ramp 248 causes the insert to rotate until the lower edge 224d reaches the valley 252 and the valley , The end of the down surface 248, that is, the portion of the down surface 248 where the rotation of the insert ends. At this location, the upper edge 224e rotates beyond the lower end 238a 'and is located below the slope 238'.

  Next, when the axial force applied to the insert 214 is removed, the resistor 228 biased upward presses the insert 214 upward by the contact between the edge 224d and the uphill 246, thereby pressing the upper edge 224e. This is engaged with the slope 238 '. The upper edge 224e is the only portion of the radially extending portion 224a that contacts the surface 238 'as shown in FIG. 18, or the surface 224f is engaged with the edge 224e as shown in FIGS. Note that in addition, it may be configured to engage slope 238 'without engaging slope 238' or engaging upper edge 224e.

  FIG. 19 shows the state of engagement of the upper edge 224e and the surface 224f with the slope 238 ', which exerts a rotational biasing force that advances (clockwise in the drawing) to the insert 214. The upward slope 246 resists forward rotation of the insert 214 as the resistor 228 is biased upward. However, the forward rotational bias provided by the ramp 238 'is sufficient to overcome the resistance rotational bias provided by the uphill 246, and the insert 214 advances in rotation, eventually turning into FIG. Stopped by stop surface 242 as shown, and the insert is retained in bore 234 and attachment mechanism 204 is activated to secure the ends of the band together.

  As can be seen in FIG. 20, the lower edge 224 d has advanced beyond the peak 250. To separate the end of the band, the attachment mechanism 204 is deactivated by pushing the insert 214, that is, by moving the insert forward into the bore 234 and pressing the lower edge 224 d against the downhill 248. As in the case of the actuation process, the downhill 248 urges the edge 224 to rotate, but in this case the insert 214 is sufficiently into the bore 234 so that the upper edge 224e passes the lower end 242a of the stop surface 242. Rotation is initially blocked by stop surface 242 until it is advanced sufficiently deep.

  Once the upper edge 224e passes through the lower end 242a and the insert 214 can rotate, the down surface of the slope 248 causes the insert to rotate until the lower edge 224d reaches the valley 252. At this location, the upper edge 224e rotates beyond the lower end 242a and is located below the slope 240 '.

  Next, when the axial force applied to the insert 214 is removed, the resistor 228 biased upward presses the insert 214 upward by the contact between the edge 224d and the uphill 246, thereby pressing the upper edge 224e. This is engaged with the slope 240 '. As described above with respect to surface 238 ', upper edge 224e is the only portion of radially extending portion 224a that contacts surface 240', or surface 224f is slope 238 'in addition to engagement with edge 224e. Note that it may be shaped to engage the ramp 238 'without engaging the upper edge 224e.

  Due to the engagement of the upper edge 224 e and the surface 224 f with the slope 240 ′, a forward rotation biasing force is exerted on the insert 214, and the uphill road 246 resists forward rotation of the insert 214. The forward rotational biasing force provided by the ramp 240 is sufficient to overcome the resistance rotational biasing force provided by the uphill road 246 and the insert 214 can be advanced into rotation into the slot 236 and the insert 214 can be removed. .

  Referring to FIGS. 21-23, the attachment mechanism 204 is shown in an activated state. FIG. 21 shows the first end portion 206 and the second end portion 208 in general alignment and proximity to each other prior to operation. In these figures, arrows 206a and 208a are shown on the cap 216 and housing 226 to show the rotational state of the insert 214 during operation, providing a visualization of the relative orientation and rotation of the insert 214 during operation. It may be provided in the actual device to allow it, but the arrow need not necessarily be provided. The legs 224 are aligned with the slots 236 so that the insert 214 can be inserted into the bore 234. FIG. 22 shows the insert 214 advanced into the bore 236 and the position where the resistor 228 has moved axially. The insert 214 is rotated when it is inserted far enough, and when the axial force is removed, the arrows 206a and 208a are held in the housing 226 as shown in FIG. Deactivation is accomplished by advancing the insert 214 in the axial direction so that it rotates and then withdrawing it from the bore 234.

  The components of the attachment mechanism 204 may be made of any medically compatible material, such as, but not limited to, metal, plastic, or combinations thereof. In the illustrated embodiment, the attachment mechanism 204 is made of a material different from the band. The material properties of the constituent materials of the insert assembly 210 and the housing assembly 212 are different from the material properties of the strap constituent materials. Generally speaking, a component has a high bending rigidity, a high torsional rigidity, and is hard. The biasing member 230 has great elasticity and resilience.

  With reference to FIGS. 24-26, another embodiment of an attachment mechanism is shown, generally designated 256, of adjustable gastric band 258, which attachment mechanism is associated with first end portion 260. And a second portion of the mounting mechanism associated with the first end portion 262 and the second end portion 262. The first end portion 260, also referred to as the tongue, may be made of the same type of material as the band 258 and is generally shown as having the same width and thickness as the band 258.

  In the illustrated embodiment, the second portion 262 has a proximal section 264, an intermediate section 266, and a distal section 268 located proximal to the band 258. The edge 270 of the proximal section 264 is roughened or textured to resist unintentional separation of the attachment mechanism 256 as described below. The edge 270 is shown as having a plurality of laterally raised ridges along the length of the proximal section 264. The edges 270 may be rough or textured along their entire length as shown, but this need not be the case. Although the inner surface 272 of the proximal section 264 is shown as having a surface pattern, it may not have a surface pattern as a variation.

  The intermediate section 266 resists, and preferably prevents, relative longitudinal movement of the first end portion 260 and the second end portion 262 when the attachment mechanism 256 is actuated, as described below. It has a patterned or satin surface 274 configured. A pair of outwardly open recesses 276, also called release slots, may be formed in the intermediate section 266 adjacent to the proximal section 264. The recess 276 is provided adjacent to the intermediate section 266 and adjacent to the proximal section 264 as provided between the intermediate section 266 and the proximal section 264 and as provided between the intermediate section and the proximal section. It may have features as provided, or as provided in both the proximal and intermediate sections. Suitable for operation of the attachment mechanism 256 is not such a feature, but the location of the recess 276 relative to the latch.

  Distal section 268 can pivot relative to intermediate section 266 via hinge 278. Depending on the material, hinge 278 may be an elastomeric hinge or a plastic integral hinge.

  The distal end 280 of the distal section 268 has two spaced apart latches 282 that extend laterally from the edge of the distal end 280. As shown, the latches 282 comprise respective upstanding members having inwardly facing surfaces 282a that are spaced from each other by a distance that is preferably less than the distance between the edges 270. positioned. The proximal end 280 may be tapered and the width of the distal end 280 decreases along its length, or the distal end is such that the inner surface 282a engages the edge 270. It may have a small width along its length compared to the width between the edges 270. The width of the first end portion 260 adjacent to the latch 282, the width between the edges 270, and the width between the surfaces 282a when the mounting mechanism 256 is mounted is set so that the surfaces 282a can engage the edges 270. Has been.

  The latch 282 includes an inwardly extending surface 282b located over the inner surface 284 of the distal end 280. Due to the longitudinal width of the latch 282 and the lateral distance between the inner surfaces 282c of the latch 282, the latch 282 can pass through the recess 276 without much resistance as will be described below.

  Referring to FIG. 25, the inner surface 260 a of the first end portion 260 is located adjacent to the proximal section 264 and the intermediate section 266 and the distal end 260 b is located adjacent to the hinge 278. Distal section 268 pivots about hinge 278 to capture first end portion 260 between distal section 268 and proximal section 264 and intermediate section 266. The distal section 268 exerts a clamping force on the first end portion to cause the proximal inner surface 260a of the distal end portion 260b to be a patterned surface between the first end portion 260 and the second end portion 262. 274, which may result in at least some degree due to the size and shape of the hinge 278. The inclined surface 282d of the latch 282 can push the latch 282 downward beyond the first end portion 260 and the proximal section 264 until the inner surface 282c passes the edge 270, so that the inwardly facing surface 282a An inwardly extending surface 282b that can engage the edge 270 can abut or at least face the outer lateral outer surface 264a in the latched position as shown in FIG.

  FIG. 26 shows the attachment mechanism in an intermediate stage where the connection is released. To deactivate or decouple attachment mechanism 256, the distal end is moved longitudinally relative to proximal segment 264 and intermediate segment 266 until the latch 282 is aligned with recess 276. Thereby allowing the distal end of the latch 282 to move laterally into the recess 276, allowing the proximal section 264 and the intermediate section 266 to pivot relative to the distal section 268, thereby providing a first The tightening force applied to the end portion 260 of the main body is reduced. Once the clamping force is reduced, the first end portion can be separated from the second end portion 262.

  The outer surface of the band 258 has pull tabs 286, 288 that can be grasped using a gripper or other suitable instrument to effect movement of the distal end 280.

  As described above, the first end portion 260 may be made of the same type of material as the band 258, which is typically silicon. The distal end 280 provides any necessary resiliency to the latch 282 and any desired stiffness and elasticity that is sufficient material properties to hold the first end portion 260 with the required clamping load. It may be made of a material, for example a hard plastic material, and thus made of a material different from the rest of the band 258. The entire second end portion 262 may be made from a rigid material, but this is not necessarily so. As an alternative, any section up to the distal end 280 or possibly up to the latch 282 is made of the same material as the rest of the band 258 or a material with similar properties. Good. For example, the distal section 268 may be made entirely of rigid material. The hinge 278 may be an elastomer hinge or a plastic integral hinge. As another possibility, the intermediate section 266 is made of a rigid material.

  It is noted that the components of the attachment mechanism described above may be made of any suitable material or materials with one or more material properties necessary to perform the function of the component. As long as the functional requirements of the component permit, the component may be made of the same material as the strap part of the band (or of course it may be made of a completely different material) Good). For example, it is possible to fabricate a silicone attachment mechanism component having a durometer higher than a strip made of silicone. In such an example, the Sure A scale indentation hardness of the silicone strap may be 50 ± 5 and the components of the attachment mechanism have a Sure A scale indentation hardness of at least about 10 higher than the strap.

  It will be apparent to those skilled in the art that the above-described invention can be applied directly to other types of implantable bands. For example, these bands are used to treat fecal incontinence. One such band is described in US Pat. No. 6,461,292, the contents of which are hereby incorporated by reference as if forming part of this specification. The band can also be used to treat urinary incontinence. One such band is described in U.S. Patent Application Publication No. 2003/0105385, the contents of which are hereby incorporated by reference as if forming part of this specification. . The band can also be used to treat heartburn and / or acid reflux. One such band is described in US Pat. No. 6,470,892, the contents of which are hereby incorporated by reference as if forming part of this specification. The band can also be used to treat impotence. One such band is described in U.S. Patent Application Publication No. 2003/0114729, the contents of which are hereby incorporated by reference as if forming part of this specification. .

  Thus, as used herein and in the appended claims, an “implantable band” is a band that can be implanted at a location that occludes flow through an anatomical passage, such as the stomach or lumen, such as food or fluid. is there.

  In short, the many advantages obtained as a result of adopting the technical idea of the present invention have been described. The foregoing description of one or more embodiments of the invention has been presented for purposes of illustration and description. The embodiment of the present invention is not limited to the disclosed one, and the present invention is not limited to the disclosed form itself. The one or more embodiments best illustrate the principles of the invention and its practical application so that those skilled in the art will appreciate the various design modifications that will make the invention fit to the various embodiments and to the particular application intended. It was selected and explained for the purpose of optimal use. The scope of the present invention is defined by the description of the scope of claims.

Specific embodiments of the present invention are as follows.
(1) The attachment mechanism has a first portion associated with the first end portion and a second portion associated with the second end portion, and the first portion has a cavity. The band according to claim 1, wherein
(2) The first portion includes a first member extending laterally from the first end portion, and at least a part of the cavity is constituted by the member. The belt according to the embodiment (1).
(3) The second portion includes a second member extending laterally from the second end portion, and the second member is inserted through the first end portion and the first member. A passage configured to cause the first member and the second member to cooperate with each other to resist withdrawal of the first member and the first end portion from the passage. The band according to the embodiment (1) or (2), which is configured.
(4) The belt according to the embodiment (1) or (2), wherein at least a part has an elastic member provided in the cavity.
(5) The belt according to the embodiment (4), wherein the elastic member is made of the second material.

(6) The second portion includes a second member extending laterally from the second end portion, and the second member is inserted through the first end portion and the first member. A passage configured to cause the first member and the second member to cooperate with each other to resist withdrawal of the first member and the first end portion from the passage. The belt according to the embodiment (4), which is configured.
(7) The cavity is configured to receive the second portion, the second portion has at least one groove, and the elastic member places the second portion in the first position. The band according to embodiment (4), wherein when provided at least partially within the cavity, the band is positioned relative to the cavity to engage the at least one groove.
(8) The first portion includes two spaced openings in communication with the cavity, and the elastic member as a whole includes two spaced legs extending from a base. A U-shaped spring, wherein the base is provided in the first portion, and the spaced apart leg portions are each provided at least partially in an opening corresponding to each other. The belt according to the embodiment (7), which is characterized.
(9) The second end portion has at least one inclined surface configured to separate the leg portions from each other when the second end portion is moved toward the first position. The belt according to the embodiment (8), wherein

(10) The band according to the embodiment (1) or (2), wherein the cavity is configured by a plurality of holding members spaced from each other.
(11) The belt according to the embodiment (10), wherein the holding member is formed of an annular ring.
(12) The belt according to the embodiment (10), wherein the second part has a cylindrical part.
(13) The cylindrical portion has at least one engagement member configured to cooperate with the cavity to resist axial withdrawal of the second portion from the cavity. The belt according to the embodiment (12).
(14) The belt according to the above embodiment (1) or (2), which has a plastically deformable member provided adjacent to the cavity.
(15) The band according to the embodiment (14), wherein the cavity includes a plurality of holding members spaced from each other.

(16) The belt according to the embodiment (15), wherein the holding member is formed of an annular ring.
(17) The belt according to the embodiment (14), wherein the first member has two legs spaced apart from each other.
(18) The first portion includes a first member extending in a longitudinal direction, and the first member includes at least two mutually spaced side walls forming at least a part of the cavity. The second portion is at least partially disposed within the cavity and is configured to engage at least one of the side walls to resist withdrawal of the first member from the cavity. The belt according to the embodiment (1), which has at least one elastic member.
(19) The belt according to the embodiment (18), wherein the at least one elastic member includes first and second leg portions spaced apart from each other.
(20) Each of the leg portions has an outwardly extending step portion, and each of the spaced apart side walls resists the first member from slipping out of the cavity. The band according to the embodiment (19), characterized in that it has respective openings configured to engage one of them.

(21) The embodiment (18), wherein the first member and the second member are insert-molded into the first end portion and the second end portion, respectively. The belt according to 19) or (20).
(22) The first portion includes a first member, and at least a part of the cavity is configured by the first member, and the cavity has an overall cylindrical inner surface that defines an axis. A plurality of spaced apart slots and a plurality of ramps, the second portion having a cylindrical member rotatable with respect to the second end portion, the cylindrical member having a plurality of outer sides The band according to the embodiment (1), characterized in that the belt is configured to be inserted into the cavity and rotated therein.
(23) The first portion includes an axially movable member provided in the cavity, and the axially movable member is axially urged in a direction of exiting the cylindrical member from the cavity. The belt according to the embodiment (22), which is elastically biased.
(24) The axially movable member has a plurality of uphill roads and downhill roads configured to engage with the cylindrical member and to urge the cylindrical member to rotate. The belt according to the embodiment (22).
(25) At least two of the plurality of slopes are provided in a circumferential direction between at least two adjacent slots of the plurality of slots, and the cavity is formed between the at least two of the plurality of slopes. The belt according to the embodiment (22), which has at least one slot provided therebetween.

(26) The belt according to any one of the embodiments (22) to (25), wherein at least one of the axis and the cylindrical member extends in a longitudinal direction.
(27) The attachment mechanism includes the first end having a distal section, a proximal section, and a patterned section located intermediate the distal section and the proximal section, the distal section comprising: Pivotable with respect to the patterned section, the distal section having a distal end made of the second material, the distal end extending at least one lateral side. Comprising a latch, wherein the at least one latch includes the second end portion between the distal section and the proximal and patterned sections, the distal section being the proximal and patterned sections. The band according to claim 1, wherein the band is configured to engage the proximal section when positioned in a first position overlying.
28. The at least one latch is sized to engage an outer surface of the proximal section so that the distal section presses the second end portion against the inner surface of the patterned section. The belt according to the embodiment (27).
(29) The inner surface of the patterned section has a patterned surface configured to engage the second end portion and resist withdrawal of the second end portion. The belt according to the embodiment (28).
(30) the proximal section has opposite lateral edges, the at least one latch comprises at least two spaced apart latches, each latch having an inner surface; Each latch is configured to engage one of the lateral edges on its inner surface, each of the lateral edges resisting relative movement of the latch along the lateral edge. The belt according to the embodiment (28), which is configured as described above.

(31) The belt according to the embodiment (30), wherein the lateral edge is provided with a surface pattern.
(32) The band according to the embodiment (31), wherein each of the lateral edges includes a plurality of laterally directed ridges.
(33) The embodiment described above, wherein the inner surface of the proximal section comprises a patterned surface configured to engage the second end portion and resist withdrawal of the second end portion. (28) The belt according to the description.
(34) The band according to claim 1, further comprising a hinge provided between the patterned section and the distal section.
(35) The belt according to the embodiment (34), wherein the hinge is an elastomer hinge.

(36) The belt according to the embodiment (34), wherein the hinge is an integral hinge.
(37) The hinge is configured such that a distal end section located adjacent to the hinge presses the second end portion against the inner surface of the patterned section located adjacent to the hinge. The belt according to the embodiment (34), characterized in that
(38) The first end portion has a respective release slot associated with the at least one latch, each of the release slots configured to allow the associated latch to be inserted without much resistance. The belt according to any one of the above embodiments (27) to (37), wherein
(39) The belt according to the embodiment (38), wherein each of the release slots is provided adjacent to the proximal section.
(40) The attachment mechanism has a first portion associated with the first end portion and a second portion associated with the second end portion, and the first portion comprises an elastic member. The band according to claim 1.

(41) The first portion has a first member extending laterally from the first end portion, and at least a part of the member is made of the second material. Item 1. The belt according to item 1.
(42) The second portion includes a second member extending laterally from the second end portion, and the second member is inserted through the first end portion and the first member. A passage configured to permit the first member and the second member to cooperate with each other to resist withdrawal of the first member and the first end portion from the passage. It is comprised, The belt | band | zone of the said embodiment (41) characterized by the above-mentioned.

1 is a schematic diagram showing an adjustable gastric band wrapped around the top of the stomach. FIG. 2 is a cross-sectional view of the adjustable gastric band of FIG. FIG. 6 is a plan view of an adjustable gastric band having an attachment mechanism made of a plastically deformable dissimilar material. FIG. 4 is an enlarged partial view of an end portion of the band shown in FIG. 3. FIG. 5 is a cross-sectional view taken along line 5-5 in FIG. 4. FIG. 6 is a cross-sectional view taken along line 6-6 in FIG. FIG. 7 is a cross-sectional view taken along line 7-7 in FIG. 6. FIG. 7 is a partial cross-sectional plan view of another embodiment of an adjustable gastric band having an attachment mechanism made of a different material that is elastically deformable. FIG. 9 is an enlarged partial view of the attachment mechanism of FIG. 8. FIG. 10 is an enlarged partial cross-sectional view similar to FIG. 9 of another embodiment of a mounting mechanism made of an elastically deformable dissimilar material. It is an expanded partial sectional top view of another embodiment of the attachment mechanism which consists of a dissimilar material which can be elastically deformed. FIG. 12 is an end view of the receiver shown in FIG. 11. FIG. 12 is an enlarged partial cross-sectional plan view of the embodiment shown in FIG. 11, showing attachment mechanisms connected to each other. FIG. 5 is an enlarged partial perspective view of another embodiment of an attachment mechanism made of a differently elastically deformable material. It is an expansion partial perspective view of embodiment shown in FIG. 13, and is a figure which shows the attachment mechanism connected mutually. FIG. 15 is an enlarged cross-sectional view taken along line 15-15 in FIG. 14. FIG. 6 is an enlarged exploded perspective view of another embodiment of a mounting mechanism made of a dissimilar material including an elastically deformable component. FIG. 17 is an enlarged cross-sectional perspective view of the housing shown in FIG. 16. FIG. 18 is a view similar to FIG. 17 with the insert provided in the housing, showing the various parts of the insert during operation. FIG. 18 is a view similar to FIG. 17 with the insert provided in the housing, showing the various parts of the insert during operation. FIG. 18 is a view similar to FIG. 17 with the insert provided in the housing, showing the various parts of the insert during operation. It is a top view of the attachment mechanism shown in FIGS. It is a top view of the attachment mechanism shown in FIGS. It is a top view of the attachment mechanism shown in FIGS. FIG. 5 is an enlarged partial perspective view of another embodiment of an attachment mechanism made of a differently elastically deformable material. FIG. 25 is an enlarged partial perspective view of the embodiment shown in FIG. 24, showing the attachment mechanisms coupled together. FIG. 25 is an enlarged partial perspective view of the embodiment shown in FIG. 24, showing the attachment mechanism at an intermediate stage of removing the end of the adjustable gastric band.

Explanation of symbols

10, 30, 70 Adjustable gastric band 12 Stomach 16 Strap 18, 38 Balloon 22 Flexible conduit 24 Internal cavity 32, 100 Strap 40, 72, 114, 172, 206, 260 First part 42, 74, 118, 174, 208, 262 Second part 46 Flange 50 Passage or cavity 52, 54 Leg 58 Holding member or ring 60 Actuating member 98 Coil spring 104 Elastic member 110, 170, 204, 256 Mounting mechanism 112 Receiver 128 Pocket 176 Holding member 196 Spring clip 210 Insert assembly 212 Housing assembly 214 Insert 216 Cap 218 Retainer 226 Housing 228 Resistor 230 Biasing member 232 End cap 238, 240, 246, 248 Slope 282 Latch

Claims (1)

An implantable band for treating a medical condition,
(A) having a strap configured to surround the anatomical passage, the strap defining a circumferential direction around the strap, the strap having an inner surface and an outer surface, the strap having at least one first A material having a material characteristic of 1,
(B) having a first end portion and a second end portion provided at each end of the strap, wherein the first and second end portions correspond to the inner and outer surfaces of the strap; Each has an inner surface and an outer surface,
(C) having an integral attachment mechanism configured to attach the first end portion to the second end portion and secure the strap adjacent to the anatomical passage, wherein the attachment mechanism comprises at least A band comprising a material with one second material property, wherein the at least one second material property is different from the at least one first material property.

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