The present invention is directed generically to a means for altering the
ability of the mammalian body to absorb nutritive content from ingested
foodstuffs, and more specifically to an apparatus and method of use for
an endolumenal sleeve (referred to also as an "intragastrointestinal
device" or "gastrointestinal device") positioned in the mammalian
gastrointestinal (GI) tract. A suitable endolumenal sleeve is comprised
of an anchor element and an opening at a proximal end, an elongate lumen
or hollow open-ended tube having a transverse dimension, and a distal
orifice. Optionally, an exterior aspect of the elongate lumen may include
additional modes of attachment to the tissues walls of the GI tract
through the use of one or more means for promoting tissue in-growth. The
endolumenal sleeve is retained in the GI tract such that a substantial
fraction of the food and liquids passing through the GI tract is
channeled into the proximal opening and through an interlumenal space
defined within the interior space of the endolumenal sleeve. Within the
endolumenal sleeve there may be one or more restrictive means to
constrain, impede or otherwise control the operative flow of material
through the device. An individual restrictive means can either be of a
fixed geometry or such means may include one or more elements which are
adjustable in nature or function. The elongate lumen of the endolumenal
sleeve is formed of a polymer composition suitable for controlled ingress
of biological secretions, egress of certain selected nutritional
elements, and may comprise either a single tubular structure or a
multi-section (i.e. articulated and/or multiple lumen) assembly. When the
endolumenal sleeve is in situ within the mammalian gastro-intestinal
system, ingested foodstuffs are conveyed from the proximal end to said
distal orifice. In typical applications, the proximal end of the
endolumenal sleeve is positioned within the physiological region
extending from the lower esophagus to the duodenum and the distal orifice
is positioned within the physiological region extending from the upper
duodenum to the lower jejunum, though further extension into the lower
intestine is possible. Through proper selection of position for the
endolumenal sleeve proximal and distal ends, combined by selection of the
composition used in the fabrication of the elongate lumen, it is possible
to finitely control the degree of nutritive absorption performed by the
gastrointestinal tract.