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WO2025212945A1 - Appareil et méthode de refroidissement et/ou de réchauffement d'un organe - Google Patents

Appareil et méthode de refroidissement et/ou de réchauffement d'un organe

Info

Publication number
WO2025212945A1
WO2025212945A1 PCT/US2025/023034 US2025023034W WO2025212945A1 WO 2025212945 A1 WO2025212945 A1 WO 2025212945A1 US 2025023034 W US2025023034 W US 2025023034W WO 2025212945 A1 WO2025212945 A1 WO 2025212945A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
lumen
tube
loop
inflow
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.)
Pending
Application number
PCT/US2025/023034
Other languages
English (en)
Inventor
Donnell W. Gurskis
Robert B. PELIKS
Steven R. Bacich
Susan E. Swann
Uriel Chee
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Arctx Medical Inc
Original Assignee
Arctx Medical Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Arctx Medical Inc filed Critical Arctx Medical Inc
Publication of WO2025212945A1 publication Critical patent/WO2025212945A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/12—Devices for heating or cooling internal body cavities
    • A61F7/123—Devices for heating or cooling internal body cavities using a flexible balloon containing the thermal element
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/12—Devices for heating or cooling internal body cavities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F2007/0001—Body part
    • A61F2007/0018—Trunk or parts thereof
    • A61F2007/0022—Abdomen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F2007/0054—Heating or cooling appliances for medical or therapeutic treatment of the human body with a closed fluid circuit, e.g. hot water
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F2007/0059—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit
    • A61F2007/0069—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit with return means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F2007/0095—Heating or cooling appliances for medical or therapeutic treatment of the human body with a temperature indicator
    • A61F2007/0096—Heating or cooling appliances for medical or therapeutic treatment of the human body with a temperature indicator with a thermometer

Definitions

  • Systems that can control and/or regulate a patient’ s core body temperature and/or a local internal temperature of the patient’ s body are disclosed.
  • Systems that can provide localized hypothermia treatment and/or localized cooling therapy that does not cause systemic hypothermia for inflammation of the pancreas and/or pancreatitis and use of the systems for treatments for obesity, pancreatic cancer, hypothermia to other bodily structures and organs, and general regulation of body temperature are disclosed.
  • the methods and apparatus disclosed can be used for hypothermia, for hyperthermia, for temperatures between hypothermia and hyperthermia, or any combination of such thermal applications during a medical procedure.
  • Pancreatitis can be classified as acute and/or chronic. Pancreatitis has many etiologies including, but not limited to the following: alcohol induced, gallbladder and/or gallstone related, and/or other causes/idiopathic. In each case, the pancreas can experience inflammation that can impact endocrine and exocrine functions of the patient. Severe pancreatitis occurs in one and four patients with an associated mortality rate of 5%.
  • Localized hypothermia that can be provided with internal and external heat exchangers and warming and/or cooling devices to raise and/or lower body temperature are disclosed.
  • a system can have a catheter assembly and an extension line assembly.
  • the catheter assembly can have a catheter and a catheter connector.
  • the catheter can have a catheter lumen.
  • the catheter lumen can have a catheter lumen inflow port and a catheter lumen outflow port.
  • the extension line assembly can have a first inflow tube, a second inflow tube, a first return tube, a second return tube, and an extension line connector.
  • the second flow path can include the first inflow tube, the second inflow tube, and the catheter.
  • the second flow path can be defined by the first inflow tube, the second inflow tube, and the catheter.
  • the third flow path can include the second return tube and the catheter.
  • the third flow path can be defined by the second return tube and the catheter.
  • a system is disclosed.
  • the system can have a catheter assembly and/or an extension line assembly.
  • a method of changing a temperature of a gastrointestinal tract caudal of a gastroesophageal junction of the gastrointestinal tract is disclosed.
  • the method can include inserting a catheter assembly into a stomach of the gastrointestinal tract.
  • the method can include attaching the catheter assembly to an extension line assembly.
  • the method can include transferring heat to and/or from the gastrointestinal tract. Transferring the heat to and/or from the gastrointestinal tract can include recirculating a fluid through the catheter assembly and the extension line assembly.
  • a method of changing and/or maintaining a temperature can include inserting a catheter assembly into a body lumen.
  • the method can include attaching the catheter assembly to an extension line assembly.
  • the method can include transferring heat to and/or from the catheter assembly. Transferring the heat to and/or from the catheter assembly can include recirculating a fluid through the catheter assembly and the extension line assembly.
  • the pancreas can be warmed and/or cooled directly and/or indirectly.
  • the pancreas can be cooled directly by inserting a needle into the pancreas.
  • the needle and/or catheter can be inserted transabdominally and/or laparoscopically.
  • the needle can remove heat directly from the pancreas.
  • the pancreas can be cooled indirectly by cooling organs, fluids (liquid or gas) and/or tissue adjacent to the pancreas.
  • the stomach wall, dermis and/or duodenum adjacent to the pancreas can be cooled, thereby cooling the pancreas.
  • the heat exchange process can occur external to the patient and/or inside of the patient.
  • the method of heat exchange can include thermoelectric cooling, vapor-compression refrigeration, phase change, Carnot cycle refrigeration, reverse rankine refrigeration, evaporative cooling, thermotunnel cooling, magnetic refrigeration, cyclic refrigeration, non-cyclic refrigeration, sortpion cycle, elastocaloric refrigeration, fridget gate, vortex tube, pulse tube refrigeration and/or thermoacoustics.
  • a catheter can be introduced orally and/or nasally. The catheter can extend into the stomach, duodenum, intestine, jejunum, and/or the Ampulla of Vater.
  • the heat transfer fluid can be in direct contact with the patient’s organs, tissue and/or fluids; the heat transfer fluid can have indirect contact with the patient’s organs, tissue and/or fluids; for example, the heat transfer fluid can be in the catheter, a balloon and/or multiple balloons.
  • the catheter can have communication ports that can provide the operator a mechanism to administer analgesics to soothe or numb the bodily orifice, esophagus, and stomach.
  • the analgesics can be administered to reduce tissue irritation over the duration of the treatment.
  • the catheter system can be placed via nasal, oral, or transgastric routes.
  • the catheter system can be delivered in a low profile state in which the balloon can be sheathed, housed, and/or contained within the distal portions of the catheter system.
  • the balloon on the distal end of the catheter can be unrolled or unsheathed by separating, pulling, or rotating a portion of the catheter to unveil the balloon.
  • the deployment of the balloon can be facilitated by internal stents within the balloon to facilitate a predetermined shape for the balloon.
  • the protrusions can be inflatable nubs, cones, or balloons that can push the distal end of the catheter nearer to the inner wall of the stomach.
  • the distal end of the catheter system can have a ferromagnetic material that can engage external magnetic forces to allow the balloon nearer to the pancreas.
  • Distension of the Balloon Air, liquid, gas, and media, and combination of these can be used to fill the balloon on the distal end of the catheter. Distension of the balloon can be monitored and measured by pressure and the total volume of air, liquid, gas or media delivered. Distension media can be supplied into the balloon by openings or ports within the catheter that can fluidically communicate with an inner lumen or multiple lumens.
  • Cooling media can be supplied and monitored to the balloon in a manner to reduce overall pressure in the stomach to minimize patient discomfort.
  • Pressure sensors in the cooling balloon can record responsive contractions within the stomach acting on the balloon and catheter system.
  • distension media and pressure and or volume of distension media within the balloon can be reduced, or increased, in response to the monitored and recorded forces in the stomach.
  • thermocouples on the catheter system can provide feedback of temperatures in the distension media, in the catheter, at the external surface of the balloon, and multiple external surfaces of the balloon that are in contact with the stomach wall nearer to the pancreas and areas away from the pancreas area.
  • Hypothermia treatment can be monitored by time and checked by the body temperature of the patient. Ongoing real-time body temperature of the patient can be coupled to the cooling box by a wearable thermometer thereby providing a feedback to excessive hypothermia, or adding additional cooling media as appropriate.
  • the catheter system can allow for an endoscope to be inserted for internal visualization, or can be constructed with an integrated endoscope.
  • the catheter system can have ports that allow for the sampling of fluid or materials in the stomach for diagnostic purposes.
  • the catheter system can be configured with echogenic or radiopaque materials or members that facilitate ultrasound or fluoroscopic detection. Doppler ultrasound can be used to record the flow of distention media in the catheter system and the vasculature of the stomach and area near the pancreas.
  • the catheter system can be configured with ports that allow for the delivery of drugs to the patient.
  • Ports can be located in specific locations in the catheter system to apply medications or analgesics to the nasal, oral, and esophageal passageways, and the stomach. Ports can be located on the external portions of the balloon to deliver medications and analgesics directly to the inner stomach wall nearer to the pancreas.
  • the catheter system can have a lumen to supply nutrition, such as nutritional media, to the patient.
  • the nutrient delivery can be supplied with external pressure or mechanical force supplied by the medical professional or the cooling box directly.
  • the catheter system can have an expandable lumen that responds and expands to the mechanical force of the supplied nutrition that then allows the nutrition to reach the gastrointestinal tract of the patient.
  • the expandable lumen allows for a minimal insertion and wearing profile to the catheter system that can be expanded upon use in conjunction with patient nutrition.
  • Figure 1 illustrates a schematic of a thermal therapy system deployed in a patient’s digestive system.
  • Figures 2a-2d illustrate different cross-sections of a catheter.
  • Figure 3 illustrates a schematic of another embodiment of a thermal therapy system deployed in a patient’s digestive system.
  • Figures 4a and 4b illustrate a cross-section of the distal end of the cooling device with the balloon partially inflated.
  • Figures 5a and 5b illustrate a cross-section of the distal end of additional embodiments of the cooling device with the balloon partially inflated.
  • Figure 6 illustrates data from a simulated localized cooling system.
  • Figure 7 illustrates a schematic of another embodiment of a thermal therapy system deployed in a patient’s digestive system.
  • Figure 8 illustrates a cross-section of the distal end of additional embodiments of the cooling device with the balloon partially inflated.
  • Figure 9 illustrates a schematic of another embodiment of a thermal therapy system deployed transabdominally.
  • Figure 10 illustrates a mechanical structure that can position and/or fix the cooling balloon at the stomach wall adjacent to the pancreas
  • Figure 11 illustrates a pyloric plug in place to prevent cooling fluid from draining into duodenum and illustrates an impermeable and/or semi-permeable membrane and/or coating deposited on the stomach wall that can prevent and/or slow fluid absorption into the stomach wall.
  • Figure 12 illustrates that target temperatures of the pancreas can be achieved within a simulated pancreas (using bovine tissue) using a chilled fluid circulating in a cooling balloon placed inside of the simulated stomach (using bovine stomach tissue) in a body temperature (37C) water bath.
  • Figure 18 illustrates the stomach and pancreas in an isometric view with the anterior half removed.
  • Figure 18 illustrates a catheter residing in the stomach in a spiral configuration.
  • Figure 37b illustrates a variation of the catheter in the stomach.
  • Figure 38 illustrates a variation of the catheter with a remote sensor
  • Figure 41 illustrates a variation of the catheter inserted over a guidewire with an esophageal valve.
  • Figure 42 illustrates how the core body temperature can be impacted using a thermal therapy system.
  • Figure 43 illustrates a thermal insulation pad on the face of a patient.
  • Figure 44 illustrates a thermal insulation mechanism on the back of the throat.
  • Figure 45a and 45b illustrate a variation of the catheter in the stomach with an expandable catheter array.
  • Figures 46a, 46b, 46z2, and 46z3 illustrate the stomach, duodenum, and pancreas in an isometric view with the anterior half removed.
  • Figures 46b-46zl illustrate the stomach in an anterior view with the anterior half of the stomach shown transparent.
  • Figures 46a-46o illustrate the catheter being introduced to the stomach and
  • Figures 46o-46z3 illustrate the catheter being removed from the stomach.
  • Figures 47a-47i illustrate the stomach, duodenum, and pancreas in an isometric view with the anterior half removed.
  • Figures 47a-47e illustrate the catheter being introduced to the stomach and
  • Figures 47e-47i illustrate the catheter being removed from the stomach.
  • Figure s 52a-52d illustrate the stomach, duodenum, and pancreas in an isometric view with the anterior half removed. Figures 52a-52d illustrate the catheter in the body.
  • Figure 55c illustrates a variation of a cross-section view of the catheter of Figure 55a through the line 55c-55c.
  • Figure 56 is a schematic of a system that can provide thermal transfer therapy.
  • Figures 57a-57d are frontal x-rays of the catheter being introduced into the stomach.
  • Figures 60A-60E illustrate a variation of a catheter.
  • Figure 61 A illustrates a graph showing estimated cooling power over time, with Watts on the y-axis and time on the x-axis.
  • Figure 61B illustrates a magnified view of a section of figure 61 A showing a dip in thermal power.
  • Figure 62 illustrates a variation of a catheter.
  • Figure 63A illustrates an exploded view of a variation of a first assembly of a thermal therapy system.
  • Figure 63B illustrates the first assembly of figure 63A in a fully assembled configuration.
  • Figure 63C illustrates an exploded view of a variation of a second assembly of a thermal therapy system.
  • Figure 63D illustrates the second assembly of figure 63C in a fully assembled configuration.
  • Figure 63E illustrates the first assembly of figures 63A-63B and the second assembly of figures 63C-63D attached to each other.
  • Figure 63F illustrates the first assembly of figures 63A-63B and the second assembly of figures 63C-63D attached to each other, with an enteral system attached to the first assembly.
  • Figure 63G illustrates the first assembly of figures 63A-63B and the second assembly of figures 63C-63D attached to each other, with an adapter attached to the first assembly.
  • Figure 63H illustrates the first assembly of figures 63A-63B and the second assembly of figures 63C-63D attached to each other, with a suction system attached to the first assembly.
  • Figure63I illustrates an exploded view of a variation of a proximal end of the second assembly of figures 63C-63D.
  • Figure 63J illustrates a variation of a second assembly of a thermal therapy system.
  • Figure 63L illustrates a variation of a heat exchanger and a second assembly of a thermal therapy system.
  • Figure 63M illustrates a variation of a first assembly of a thermal therapy system.
  • Figure 63N illustrates a variation of a first assembly of a thermal therapy system.
  • Figure 65A illustrates a schematic of a variation of a thermal therapy system.
  • Figure 65C illustrates a schematic of a variation of a thermal therapy system.
  • Figures 67A-67F illustrate variations of a catheter.
  • Figures 68A-68B illustrate a variation of a catheter.
  • Figures 69A-69B illustrate a variation of a catheter.
  • Figures 70A-70B illustrate a variation of a catheter.
  • Figures 71A-71F illustrate a variation of a catheter.
  • Figures 72A-72F illustrate a variation of a catheter.
  • Figures 73A-73F illustrate a variation of a catheter.
  • Figures 74A-74C illustrate a variation of a catheter and a variation of a method of eliminating, ameliorating, or reducing a kink.
  • Figure 75 illustrates a variation of a catheter.
  • Figure 76 illustrates a variation of a catheter.
  • Figures 77A-77B illustrate a schematic of a variation of a thermal therapy system.
  • Figures 78 illustrates a variation of a thermal therapy system.
  • Figure s 79A-79JJ illustrate a 360-degree CT scan of a patient’s torso with a catheter in a deployed configuration in the patient’s gastrointestinal tract.
  • Figure 79KK illustrates a front X-Ray image of the patient’s torso of figures 79A-79JJ immediately after initial insertion into the gastrointestinal tract of the patient.
  • Figures 80A-80C illustrate front images of a CT scan of a patient’s torso with a catheter in a deployed configuration in the patient’s gastrointestinal tract.
  • Figures 81 A-81B illustrate an X-Ray image of a patient’s torso with a catheter in a deployed configuration in the patient’ s gastrointestinal tract.
  • FIG. 1 illustrates a variation of a thermal therapy system 33 (also referred to as the system 33).
  • the thermal therapy system 33 can be, for example, a localized thermal therapy system.
  • the thermal therapy system 33 can be, for example, a heat transfer therapy system.
  • the thermal therapy system 33 can be a warming therapy system and/or a cooling therapy system.
  • the thermal therapy system 33 can deliver thermal therapy (e.g., warming therapy and/or cooling therapy) to a heat transfer target 146 (also referred to as the thermal energy target 146).
  • the thermal therapy system 33 can, for example, transfer heat to and/or from the heat transfer target 146. Transferring heat to the heat transfer target 146 can include, for example, increasing a temperature of the heat transfer target 146 and/or warming the heat transfer target 146. Transferring heat from the heat transfer target 146 can include, for example, decreasing a temperature of the heat transfer target
  • Figure 1 illustrates that the thermal therapy system 33 can include a heat transferer 4 and/or a heat exchanger 13 (also referred to as a heat exchange system 13).
  • Figure 1 illustrates that the heat transferer 4 can be connected (e.g., removably connected) to the heat exchanger 13.
  • the heat exchanger 13 can be, for example, a recirculating heat exchanger.
  • the heat exchanger 13 can be, for example, an external heat exchanger (also referred to as an external heat exchange system).
  • the heat transferer 4 can transfer heat to and/or from the heat transfer target 146.
  • the heat transferer 4 can, for example, increase and/or decrease a temperature of the heat transfer target 146.
  • the heat transferer 4 can, for example, warm and/or cool the heat transfer target 146.
  • Figure 1 illustrates that the heat transferer 4 can have and/or can be, for example, a catheter 9, a balloon 3, or any combination thereof.
  • the heat transferer 4 include the catheter 9 but not the balloon 3.
  • the transferer 4 can include the balloon 3 but not the catheter 9.
  • the heat transferer 4 can include the catheter 9 and the balloon 3.
  • the heat transferer 4 can be the catheter 9.
  • the heat transferer 4 can be the balloon 3.
  • the heat transferer 4 can be the catheter 9 and the balloon 3.
  • Figure 1 illustrates that the catheter 9 and/or the balloon 3 can transfer heat to and/or from the heat transfer target 146.
  • Figure 1 illustrates that the catheter 9 and/or the balloon 3 can increase and/or decrease a temperature of the heat transfer target 146.
  • Figure 1 illustrates that the catheter 9 and/or the balloon 3 can warm and/or cool the heat transfer target 146.
  • the balloon 3 can be a warming and/or a cooling balloon and/or the catheter 9 can be a warming and/or a cooling catheter.
  • Figure 1 illustrates that the thermal therapy system 33 can be a heat exchange catheter system and/or a heat exchange balloon system.
  • the catheter 9 can be a heat exchange catheter and/or the balloon 3 can be a heat exchange balloon.
  • Figure 1 illustrates that the fluid 6 can be circulated and/or recirculated through the catheter 9 and/or the balloon 3 via the pump 148.
  • Figure 1 illustrates, for example, that the pump 148 can pump the fluid 6 from the fluid reservoir 150 into the catheter 9 and/or the balloon 3, and/or that the pump 148 can pump the fluid 6 from the catheter 9 and/or the balloon 3 into the fluid reservoir 150.
  • Figure 1 illustrates, for example, that the thermal therapy system 33 can be a closed loop heat exchange system.
  • the balloon 3 can be inflated, for example, by filling the balloon 3 with fluid 6.
  • Figure 1 illustrates the balloon 3 in an inflated configuration with a portion of the fluid 6 in the balloon 3.
  • the balloon 3 can be deflated, for example, by removing the fluid 6 from the balloon 3.
  • Nutrients, medications, sensors, devices and/or tools can be delivered through the heat transferer 4, the catheter 9, and/or the balloon 3.
  • nutrients, medications, sensors, devices and/or tools can exit from the catheter tip 7.
  • the catheter tip 7 can aspirate the stomach 2.
  • Nutrients, medications, sensors, devices, and/or tools can be delivered to the duodenum 37 and/or the jejunum 10.
  • Figure 1 illustrates that the catheter 9, the balloon 3, and/or the heat transferer 4 can pass through the nose 11.
  • the catheter 9, the balloon 3, and/or the heat transferer 4 can pass through the mouth 12.
  • the catheter 9, the balloon 3, and/or the heat transferer 4 can be connected to (e.g., removably connected to) the heat exchange system 13.
  • the fluid 6 can be, for example, an alcohol, nitrogen, carbon dioxide, a refrigerant (e.g., such as Freon, CFC, HFC, R22, R-290, R-600a, R-717, R-1234, R-744, R- 32, R-134a and/or R-410a).
  • the fluid 6 can be stored and/or transported in the catheter 9 at a pressure higher than ambient pressure.
  • the catheter 9 can transfer heat to and/or from the stomach 2, the gastric pancreas wall 8, the pancreas 1, the duodenum 37, and/or the jejunum 10 via a thermoelectric process.
  • the method of heat exchange can include thermoelectric cooling, vaporcompression refrigeration, phase change, carnot cycle refrigeration, reverse rankine refrigeration, evaporative cooling, thermotunnel cooling, magnetic refrigeration, cyclic refrigeration, non-cyclic refrigeration, sortpion cycle, elastocaloric refrigeration, fridget gate, vortex tube, pulse tube refrigeration, thermoacoustics, or any combination thereof.
  • Figure 3 illustrates that an intestinal plug 28 can be deployed in the target site 147.
  • the intestinal plug 28 can be secured at or near the distal terminal end of the catheter 9 and/or can be disengageable from the catheter 9.
  • the intestinal plug 28 can be delivered through the catheter 9.
  • the intestinal plug 28 can be delivered through the third lumen 17 and/or the fourth lumen 18.
  • the intestinal plug 28 can form an outflow blockage at the interface of stomach 2, the duodenum 37, the jejunum 10, a pyloric sphincter 66 and/or the intestine.
  • the intestinal plug 28 can block fluid from traveling exiting the stomach 2.
  • the intestinal plug 28 can be bioabsorbable.
  • a coating can be delivered to the stomach 2 to alter the rate of absorption and/or adsorption of fluid through the stomach wall 108 and/or the gastric pancreas wall 8. The coating can absorb and/or degrade at a predetermined rate.
  • one or multiple sensors 21 can monitor the temperature of the fluid 6 entering and exiting from the catheter 9, the heat transferer 4, the heat exchange system 13, and/or the balloon 3.
  • the sensors 21 can be connected to the heat exchange system 13.
  • a sensor 21 can be placed in the patient bladder, mouth, nose, skin, dermis, pancreas, jejunum, esophagus, stomach, and/or any other organ, tissue and/or patient fluid.
  • the sensor 21 can monitor the patient for localized and/or generalized hypothermia and/or normathermia.
  • the sensor 21 can monitor the stomach fluid contents, including, but not limited to the stomach fluid acidity.
  • the sensor 21 can provide an alert to the patient, physicians, nurses and/or other staff.
  • the sensor 21 can determine the orientation of the patient, the fluid 6, the balloon 3, the catheter 9, the heat transferer 4, and/or the catheter tip 7.
  • the sensor 21 can determine if the patient is in an ideal or non-ideal position for efficient localized hypothermia of the pancreas 1.
  • the sensor 21 can determine if the balloon 3, the fluid 6 and/or the catheter tip 7 are adjacent to the gastric pancreas wall 8.
  • the patient can move or be moved to improve patient comfort and/or to prevent sores (e.g., pressure ulcers).
  • the patient can move and/or be moved at regular intervals.
  • the heat exchange system 13 can provide manual and/or automatic feedback based on the sensors 21. For example, if the pressure is out of range and/or the patient is not in an ideal therapeutic position, then the balloon 3 can be automatically deflated.
  • the balloon 3 can be periodically adjusted, moved, inflated and/or deflated. For example, to help prevent pressure ulcers, the balloon 3 can be deflated every 5 minutes, 10 minutes, 15 minutes, 30 minutes, 60 minutes, 90 minutes and/or 120 minutes.
  • the frequency and duration of the inflation/deflation of the balloon 3 can be manually and/or automatically controlled by the heat exchange system 13.
  • Figure 4a illustrates that the balloon 3 can fluidically communicate with the first lumen 15 through a balloon port 22.
  • the heat transferer 4 and/or the catheter 9 can have multiple balloon ports 22.
  • the multiple balloon ports 22 can allow for improved flow of the fluid 6.
  • multiple balloon ports 22 can provide redundancy, in case one of the balloon ports 22 becomes occluded.
  • multiple balloon ports 22 can provide redundancy, in case one of the balloon ports 22 is occluded.
  • Figure 4b illustrates that the balloon 3 can fluidically communicate with the first lumen 15 and/or the second lumen 16 through the balloon ports 22.
  • the fluid 6 can travel distally from the heat exchange system 13 in a lumen flow direction 24a, the fluid 6 can exit the first lumen 15 through the balloon port 22a in a balloon port flow direction 23a, the fluid 6 can circulate in the balloon 3, the fluid 6 can enter the second lumen 16 through the balloon port 22b in the balloon port flow direction 23b, and the fluid 6 can travel proximally toward the heat exchange system 13 in the lumen flow direction 24b.
  • the fluid 6 can be warmed and/or cooled in the heat exchange system 13 and then travel distally toward the balloon 3.
  • the wire can be secured to the catheter tip 7 and then pulled, torqued, twisted and/or pushed relative to the catheter 9 to adjust the shape of the catheter 9. For example, if the wire is off-axis and pulled taught, it can curl the catheter 9 into a spiral shape.
  • the wire can be made from a shape memory alloy (e.g., nitinol) that can adjust its shape based on temperature.
  • a lumen of the catheter 9 can be placed under high or low pressure to force the catheter to form a spiral shape.
  • the catheter 9 can include one and/or multiple of the sensor 21.
  • the sensor 21a can be different than the sensor 21b.
  • the sensor 21 can measure temperature, pressure, flow, pH, sound, enzymes, proteins, biologic activity and/or motion.
  • the engager 48 can extend into the stomach 2.
  • the gastric coil 47 can provide additional surface area and/or flexibility.
  • the gastric coil 47 and/or a spiral shape can help prevent the catheter 9 from kinking and/or forming a knot.
  • the engager 48 can help to retain the catheter tip 7 in the duodenum 37.
  • the engager 48 and/or the gastric coil 47 can help increase thermal contact with the fluids and/or tissue.
  • the engager 48 can increase thermal contact with the duodenum 37.
  • the engager 48 and/or the gastric coil 47 can provide some strain relief to counteract and/or resist peristalsis, motility and/or other external forces.
  • the engager 48 can be, for example, a duodenal coil.
  • a tether 73 can be secured to an anchor point 74 on the catheter 9.
  • the tether 73 can run alongside the catheter 9 and/or can enter the catheter 9 at an anchor port 75.
  • the tether 73 can inhibit or prevent a portion of the catheter 9 from passing through the duodenum 37.
  • the tether 73 can ensure that a portion of the catheter 9 does not pass through the duodenum 37.
  • the tether 73 can restrict a section of the catheter 9 proximal to the anchor point 74 from traveling distally into the pylorus 65 and/or the duodenum 37.
  • the tether 73 can he pulled taught relative to the catheter 9 to adjust the maximum distance between the anchor point 74 and the anchor port 75.
  • the distance between the anchor point 74 and the anchor port 75 can be larger during insertion, use and/or removal.
  • the distance between the anchor point 74 and the anchor port 75 can be larger during insertion/removal than once it is in position in the stomach.
  • the tether 73 can pass inside of the first lumen 15, the second lumen 16, the third lumen 17 and/or the fourth lumen 18.
  • the tether 73 can be secured to the catheter 9, the nose 11 and/or the heat transferer 4. For example, once the tether 73 is pulled taught it can be secured to a proximal section of the catheter 9 external to the body.
  • the tether 73 can be released from the proximal section of the catheter 9 external to the body for easier removal of the catheter 9 from the patient.
  • the tether 73 can be made from a natural and/or synthetic polymer.
  • the tether 73 can be made from metal, plastic and/or ceramic.
  • the proximal section of the tether 73, the catheter 9 and/or the heat transferer 4 can be secured to the patient (e.g., the nose 11, the mouth 12 and/or other points on the patient.
  • the proximal end of the tether can be attached to an actuator.
  • the actuator can create translation of the tether and may have a locking portion that is automatic like a ratchet. Alternately the actuator may be locked into position manually.
  • the total length of the catheter 9 between the anchor point 74 and the anchor port 75 can be greater than the length of the tether 73 between the anchor point 74 and the anchor port 75.
  • the tether 73 can be, for example, a string.
  • the tether 73 can be, for example, an anchor string.
  • Figure 21 illustrates that an introducer 49 can be inserted into the esophagus 5 and/or the stomach 2.
  • the introducer 49 can allow easier and/or more controlled placement of the heat transferer 4.
  • the catheter 9 and/or an inner catheter 51 can be introduced through the introducer 49.
  • the introducer 49 can be stiffer than the catheter 9 and/or the inner catheter 51.
  • the introducer 49 can include various features including bend-and-stay, deformability, deflectable guide catheter, sensors, etc.
  • the inner catheter 51 can be a compliant single lumen tube.
  • the inner catheter 51 can provide a high surface area to volume ratio.
  • the fluid 6 can pass through the inner catheter 51.
  • the inner catheter 51 can be the catheter 9.
  • the introducer 49 can provide insulation between the catheter 9 and the tissue and/or organs.
  • the introducer 49 can provide thermal insulation between the catheter 9 and the esophagus 5, the nose 1 1 , the mouth 12 and/or the stomach 2.
  • the introducer 49 can provide thermal insulation between the heat transferer 4 and the esophagus 5, the nose 11, the mouth 12 and/or the stomach 2.
  • the inelastic balloons at low pressure can have a wall thickness thin enough so that it can expand and conform to the rugae or curvature of the stomach to allow more intimate contact and greater heat transfer.
  • the same catheter with inelastic balloons can have elastic regions or bellows that can expand for pressure relief within the there is internal or external pressure on the inelastic balloons to maintain integrity of the inelastic balloon material.
  • Any of the cooling balloons can be an extruded tube made from a polymer, elastomer and/or rubber.
  • the balloon 3 can be a thin-walled extruded silicone tube.
  • the balloon 3 can have approximately the same outer diameter as the catheter 9 in the deflated configuration illustrated in Figure 22.
  • the balloon 3 can be inflated with the fluid 6.
  • the balloon 3 can be inflated to a low pressure that can adapt and/or conform to the stomach 2.
  • the peristaltic motion and/or motility of the stomach 2 can manipulate and/or move the most distal balloon 3.
  • the stomach contractions can urge and/or force the balloon 3 toward the pylorus 65.
  • the catheter tip 7 can remain in the stomach 2, the esophagus 5, the pylorus 65 and/or the duodenum 37.
  • the catheter tip 7 can have a port for aspiration, decompression, feeding and/or inserting instruments.
  • the catheter tip 7 can be introduced and/or positioned over a guidewire.
  • the multiple cooling balloons 3 can be secured to the catheter 9 with adhesive, ultrasonic welding, heat shrink tubing, metal bands and/or reflow melting.
  • the multiple balloon 3 can be inserted into and/or removed from the esophagus 5 and/or the stomach 2 in the deflated configuration illustrated in Figure 22.
  • the cooling balloon materials 3 can be made from PET, LDPE, HDPE, mylar and/or nylon or elastic materials such as silicone or urethane.
  • the most distal balloon in series can be sized such that peristaltic movement or guided placement via imaging can place it into the duodenum.
  • Such a balloon in the duodenum can serve both to anchor position as well as provide cooling at the duodenum with the intention of cooling the head of the pancreas adjacent to the duodenum.
  • a duodenal device 40 can be an elastic and/or inelastic balloon secured to the catheter 9. The duodenal device 40 can act as a reservoir for the balloon 3.
  • Figure 23 illustrates that lumens of the catheter 9 can expand.
  • the expandable catheter wall can be the balloon 3.
  • the expandable catheter wall can allow for increased surface area of the catheter 9 during use.
  • the expandable catheter wall can be in the unexpanded configuration during insertion and/or removal.
  • the expandable catheter wall can include an expandable tube and/or balloon secured concentrically around the catheter 9.
  • the catheter 9 can include a catheter port 52 at the catheter tip 7 and/or along the circumference of the catheter 9.
  • the catheter 9 can include multiple catheter ports 52.
  • the catheter ports 52 can provide distributed access for decompression, feeding, tools and/or sensors.
  • the catheter ports 52 can be connected to the first lumen 15, the second lumen 16, the third lumen 17 and/or the fourth lumen 18.
  • the size and/or diameter of the catheter ports 52 can be the same and/or different.
  • Figure 24 illustrates an intestine valve 90 at the level of the intestine past the ampulla of vater 41.
  • the intestine valve 90 can be placed endoscopically and anchored by expanding radially or having barb-like retention features.
  • the intestine valve 90 can have barb-like retention features.
  • the intestine valve 90 can be anchored in place by radially expanding the intestine valve 90 and/or by bringing the barb-like retention features into engagement with tissue.
  • the intestine valve 90 can be remotely activated by a signal via an attached wire or wireless through remote control or magnet activation.
  • Cold or warm fluid can be introduced and circulated in the gastric and proximal plugged duodenal region to cool the sections of the stomach 2 and the duodenum 37 adjacent to the pancreas 1 when the valve is in the closed position.
  • Cold or warmed fluid can pass into the pancreatic duct via the ampulla of vater 41.
  • the intestine valve 90 can be programmed to open at a set interval or set temperatures via onboard sensors to allow drainage of fluid after the cooling fluid has warmed due to the surrounding structures.
  • the intestine valve 90 can be manually or automatically opened via remote control.
  • FIG. 25 illustrates a pylorus valve 91 at the level of the pylorus.
  • the pylorus valve 91 can be placed endoscopically and anchored by expanding radially or having barb-like retention features or having a geometry such that it lodges into the pylorus to seal the stomach 2.
  • the pylorus valve 91 can have barb-like retention features.
  • the pylorus valve 91 can be anchored in place by radially expanding the pylorus valve 91 and/or by bringing the barb-like retention features into engagement with tissue.
  • the pylorus valve 91 can be remotely activated by a signal via an attached wire or wireless through remote control or magnet activation.
  • Cold or warm fluid can be introduced and circulated in the gastric region to cool the sections of the stomach 2 adjacent to the pancreas 1 when the pylorus valve 91 is in the closed position. Closure of the pylorus valve 91 controls how much fluid can be absorbed into the by limiting or stopping fluids to pass into the intestine. Once the cool fluid has transferred from the stomach 2 and surrounding organs such that the fluid has warmed, fluid can be evacuated via aspiration and replaced with cold fluids in automatic cycles.
  • a lumen of the catheter 9 with the catheter tip 7 continues past the pylorus valve 91 so that feeding can occur directly into the intestine and bypassing any stimulation of the stomach 2.
  • the pylorus valve 91 can be programmed to open at a set interval or set temperatures via onboard sensors to allow drainage of fluid after the cooling fluid has warmed due to the surrounding structures.
  • the pylorus valve 91 can be manually or automatically opened via remote control. Opening of the pylorus valve 91 can allow resident fluids such as secretions or ingested food or liquid to pass.
  • Figure 26 illustrates a peritoneal cooling device 53 applied to the outer surface of the pancreas 1.
  • the peritoneal cooling device 53 can be a balloon and/or a catheter. Fluid can be circulated with the peritoneal cooling device 53 via a peritoneal cooling device catheter 54.
  • the peritoneal cooling device 53 can be placed laparoscopically or through direct transabdominal placement.
  • Figures 27a-27f illustrate that the catheter 9 can include various cross-sectional profiles.
  • the cross-section of the catheter 9 can be the same and/or different along its length.
  • Figure 27a illustrates that the catheter 9 can have circular and/or approximately circular lumens.
  • the diameter and/or area of the first lumen 15, the second lumen 16, the third lumen 17 and/or the fourth lumen 18 can be the same and/or different.
  • Figure 27b illustrates that the cross-section of the first lumen 15 and/or the second lumen 16 can be non-circular.
  • a circular cross-sectional profile for the third lumen 17 and/or fourth lumen 18 can be desirable for improved passage of tools, sensor, food, tissue and/or other matter.
  • a circular cross-sectional profile for the first lumen 15 and/or the second lumen 16 can allow for higher flow and/or a smaller pressure drop.
  • a non-circular cross-sectional profile for the first lumen 15 and/or the second lumen 16 can allow for a larger hydraulic diameter.
  • a non- circular cross- sectional profile for the first lumen 15 and/or the second lumen 16 can increase thermal transfer through the wall of the catheter 9 by providing a larger surface area in contact with the fluid 6.
  • Figure 27c illustrates that the cross-sectional profile of the catheter 9 can be non-circular.
  • Figure 27c illustrates that the wall thickness of the catheter 9 can vary at a given cross-section. A thinner catheter wall 20 can allow for increased thermal transfer through the catheter wall 20.
  • the lumens of the catheter 9 can expand and/or contract under different pressures.
  • the cross-section of the catheter 9 can transform from that illustrated in Figure 27b to that illustrated in Figure 27c.
  • the catheter 9 in Figure 23 can have the cross-section of Figure 27b and Figure 27c.
  • the catheter wall 20 can be elastic and/or inelastic.
  • Figure 27d and Figure 27e illustrates that the cross- sectional profile of the catheter 9 can maximize thermal transfer through the catheter outer diameter 19.
  • a non-circular profile for the first lumen 15 and/or the second lumen 16 can maximize contact with the external wall of the catheter 9 and thereby can increase thermal transfer through the catheter wall 20.
  • Figure 27f illustrates that the diameter and/or area of the third lumen 17 can be different than the diameter and/or area of the fourth lumen 18.
  • the third lumen 17 can benefit from a larger diameter if it is being used for aspiration, decompression, feeding and/or passage of tools.
  • the fourth lumen 18 can be beneficial for venting, feeding, sensing and/or for the passage/installation of small tools/sensors.
  • the first lumen 15, the second lumen 16, the third lumen 17 and/or the fourth lumen 18 can spiral around and/or through the catheter 9.
  • the first lumen 15, the second lumen 16, the third lumen 17 and/or the fourth lumen 18 can spiral and/or twist around each other.
  • the catheter outer diameter 19 can be smaller in the nose 11, the mouth 12, head and/or the esophagus 5.
  • a smaller catheter outer diameter 19 can reduce risk of knotting and/or kinking and/or allow for improved passage, insertion, removal and/or bending.
  • a larger catheter outer diameter 19 can improve heat transfer, increase the heat transfer surface area, reduce risk of knotting and/or kinking.
  • the distal section of the catheter 9 may not have the third lumen 17 and/or the fourth lumen 18.
  • the distal section of the catheter 9 can have a smaller catheter outer diameter 19 if the distal section of the catheter 9 does not have the third lumen 17 and/or the fourth lumen 18.
  • the distal section of the catheter 9 may only have the first lumen 15 and/or the second lumen 16.
  • the heat the distal section of the catheter 9 can have the first lumen 15 and/or the second lumen 16 but may not have the third lumen 17 and/or the fourth lumen 18).
  • FIG. 30 illustrates that a bypass lumen 63 can allow some of the fluid 6 to pass directly from the output port of the heat exchange system 13 to the return port of the heat exchange system 13 without passing through the heat transferer 4 and/or entering the stomach 2.
  • the heat exchange system 13 can have (e.g., can require) a minimum How rate which can be higher than can pass through the catheter 9.
  • the bypass lumen 63 can allow the heat exchange system 13 to maintain a sufficiently high flow rate by allowing a portion of the fluid 6 to pass through the catheter 9 and the remainder to pass through the bypass lumen 63.
  • the bypass lumen 63, the heat exchange system 13, the catheter 9 and/or other components can have sensors, pressure relief valves and/or switches to control the flow through the bypass lumen 63.
  • Figures 46a-46o illustrate that the catheter 9 can be formed into configurations 116a-116o before passing the fluid 6 through the first lumen 15 and/or the second lumen 16
  • Figures 46p-46z3 illustrate that the catheter 9 can be formed into configurations 116p- 116z3 after passing (e.g., pumping) the fluid 6 through the first lumen 15 and/or the second lumen 16.
  • Figures 46a-46z3 illustrate that the shapes 117p-117z3 can be the same as the shapes 117n-117a, respectively (e.g., the sixteenth shape 117p can be the same as the fourteenth shape 117n, the twenty-seventh shape 117zl can be the same as the third shape 117c).
  • the shapes 117 formed by the catheter 9 during withdrawal of the catheter 9 from the body can be different from the shapes 117 formed by the catheter 9 during insertion of the catheter 9 into the body.
  • the shape 117 of the catheter 9 in each configuration 116 can include, for example, one or more straight sections of the catheter 9 and/or one or more curved sections of the catheter 9.
  • a first loop (e.g., loop 118b) can include the same and/or different sections of the catheter as a second loop (e.g., loop 118a, 118c, or 118d).
  • the loop first end 118-1, the loop second end 118-2, and the loop head 118-3 can have relative positions to each other along the length of the catheter 9.
  • Each loop 118 can be, for example, a closed loop or an open loop (e.g., one or more of the loops 118 can be an open loop and one or more of the loops 118 can be a closed loop).
  • An open loop can be, for example, a loop 118 that has a loop first end 118-1 that is separated from a loop second end 118-2 by a gap.
  • a closed loop can be, for example, a loop 118 that has a loop first end 118-1 that crosses a loop second end 118-2 or vice versa. The loop first end 118-1 and the loop second end 118- 2 of a closed loop may or may not contact each other.
  • the catheter shape 117 in a deployed configuration can include, for example, one or more cells 122.
  • the catheter 9 can have, for example, 1 -30 or more cells 122 in a deployed configuration (e.g., the configurations 116), including every 1 cell increment within this range (e.g., 1 cell, 2 cells, 3 cells, 4 cells, 5 cells, 10 cells, 30 cells).
  • the one or more straight sections of the catheter 9 and/or one or more curved sections of the catheter 9 can define the one or more cells 122.
  • the loops 118 can define the cells 122.
  • the cells 122 can be defined by an external surface of the catheter 9.
  • the boundary of the cells 122 can be the catheter 9, for example, an exterior surface of the catheter 9.
  • the loops 118 can have a length, a width, and a height (also referred to as a loop length, a loop width, and a loop height).
  • each loop 118 can be the 1.0-7.0 or more times the diameter of the catheter 9.
  • the height of each loop 118 can be, for example, the height a flat plane that the loop extends through loop first end 118-1, the loop second end 118-2, and the loop head 118-3.
  • Figures 46a-46z3 illustrate that the loops 118 can have various sizes, shapes, and relative positions. Figures 46a-46z3 illustrate that some of the loops 118 can be smaller than another one of the loops 118. Figures 46a-46z3 illustrate that some of the loops 118 can be larger than another one of the loops 118.
  • the loops 118 can change from an open loop to a closed loop inside the target site 147 (e.g., inside the stomach 2, the pylorus 65, and/or the duodenum 37) and/or can change from a closed loop to an open loop inside the target site 147 (e.g., inside the stomach 2, the pylorus 65, and/or the duodenum 37), for example, as the catheter 9 is advanced into the target site 147 and/or as the catheter 9 is withdrawn from the target site 147.
  • a loop 118 can have a closed section and an open section.
  • Each loop 118 can have the same size as or a different size than another one of the loops 118.
  • a first loop e.g., one of the loops 118
  • a second loop e.g., another one of the loops 118).
  • Each loop 118 can have the same shape as or a different shape than another one of the loops 118.
  • a first loop e.g., one of the loops 118
  • a second loop e.g., another one of the loops 118.
  • the loops 118 can have, for example, a bulbous shape, an oblong shape, a teardrop shape, an irregular shape, or any combination thereof.
  • the catheter 9 can be moved relative to the loops 118 in the target site 147, for example, by inserting and/or withdrawing the catheter 9 from the target site 147.
  • Figures 46a-46z3 illustrate that catheter 9 inside the target site 147 can be moved (e.g., pushed and/or pulled) relative to the loops 118 which can cause, for example, one or more loops 118 to form and/or unwind.
  • the catheter 9 can be moved into and/or out of contact with the loops 118 in the target site 147.
  • the catheter 9 can be moved against (e.g., slid against) one or more of the loops 118 in the target site 147.
  • the loops 118 can be moved relative to each other in the target site 147, for example, by inserting and/or withdrawing the catheter 9 from the target site 147.
  • Figures 46a-46z3 illustrate that the loops 118a-l 18d can be moved relative to each other in in the target site 147.
  • the loops 118 can be moved into and/or out of contact with each other in the target site 147.
  • the loops 118 can be moved against (e.g., slid against) each other in the target site 147.
  • the loops 118 can be moved toward and/or away from each other in the target site 147.
  • the loops 118 can be moved over and/or under each other in the target site 147.
  • the cells 122 can change size and/or shape in the target site 147.
  • the size (e.g., the area, length, and/or height) of a cell 122 can increase and/or decrease as the catheter 9 is inserted into the target site 147 (e.g., the stomach 2 and/or the duodenum 37).
  • the cells 122 can have an area (also referred to as a cell area).
  • the cell area can be the space bounded (e.g., enclosed) by the loops 118.
  • the cell area of the cell 122a can be the area of the space enclosed by the loop 118a.
  • the loop area can be, for example, 7cm 2 -300cm 2 , including every 1cm 2 increment within this range (e.g., 7cm 2 , 50cm 2 , 100cm 2 , 300cm 2 ).
  • the loop area can be, for example, greater than 7cm 2 -300cm 2 , including ever 1cm 2 increment within this range (e.g., greater than 7cm 2 , 50cm 2 , 100cm 2 , 300cm 2 ).
  • Figures 46a-46z3 illustrate that the size of the cells 122 can increase and/or decrease in the target site 147, for example, as the loops 118 increase and/or decrease in size in the target site 147, respectively.
  • Figures 46a-46z3 illustrate that the shape of a cell 122 can change, for example, as the shape of the loops 118 change.
  • the cells 122 can have a length, a width, and a height (also referred to as a cell length, a cell width, and a cell height).
  • the cell length can be measured along the same axis that the loop length can be measured along.
  • the cell length can be measured along the straight axis from the base of the loop 118 to the loop head 118-3 of the loop 118.
  • the cell length can be the same as or different than the loop length.
  • the cell length can be, for example, the loop length minus the radius or the diameter of the catheter 9.
  • the cell width can be measured along the same axis that the loop width can be measured along.
  • the cell width can be measured along the straight axis from a point on the loop first end 118-1 of the loop 118 to a point on the loop second end 118-2 of the loop 118.
  • the cell width can be the same as or different than the loop width.
  • the cell width can be the same as the loop width.
  • the cell width can be, for example, the loop width minus the diameter of the catheter 9.
  • the cell height can be, for example, the same as the loop height.
  • the cells 122 can change from an open cell to a closed cell inside the target site 147 (e.g., inside the stomach 2, the pylorus 65, and/or the duodenum 37) and/or can change from a closed cell to an open cell inside the target site 147 (e.g., inside the stomach 2, the pylorus 65, and/or the duodenum 37), for example, as the catheter 9 is advanced into the target site 147 and/or as the catheter 9 is withdrawn from the target site 147.
  • the loops 118 can define open and/or closed cells 122.
  • open loops 118 can define open cells 122 and closed loops 122 can define open cells 122.
  • loops 118 in which the loop first end 118-1 and the loop second end 118-2 cross each other can define one or more open cells 122 and one or more closed cells 122 (e.g., the tip of the loop 118 can define a closed cell 122 and the base of the loop 118 can define an open cell 122).
  • Each cell 122 can have the same size as or a different size than another one of the cells 122.
  • a first cell e.g., one of the cells 122
  • Each cell 122 can have the same shape as or a different shape than another one of the cells 122.
  • a first cell e.g., one of the cells 122
  • a second cell e.g., another one of the cells 122).
  • the cells 122 can have, for example, a bulbous shape, an oblong shape, a teardrop shape, an irregular shape, or any combination thereof.
  • the cells 122 can be aligned with each other, can be offset with each other, can overlap each other, or any combination thereof.
  • Figures 46a-46z3 illustrate that the cells 122 can be offset with each other and/or can overlap each other.
  • Each of the cells 122 can have a cell central axis that extends through a center cell 122.
  • the central axis of the two cells 122 can be aligned with (e.g., coincident with) each other such that the catheter 9 can have a helical shape.
  • the central axis of the two cells 122 can be offset from each other.
  • the central axis of the two cells 122 can be separated by a gap (also referred to as the cell axis gap).
  • the central axes of the cells 122 can extend through the cells 122 at an angle perpendicular to the face of the of the cell.
  • the cell axis gap between the cell central axis of a first cell (e.g., one of the cells 122) and the cell central axis of a second cell (e.g., another one of the cells 122) can be, for example, lcm-40cm or more, including every 1cm increment within this range (e.g., 1cm, 5cm, 10cm, 20cm, 40cm).
  • the cell axis gap can be, for example, greater than lcm-40cm, including every 1cm increment within this range (e.g., greater than 1cm, 3cm, 4cm, 5cm, 40cm).
  • the cell axis gap can be greater than the lesser curvature of the stomach 2 and/or greater than the greater curvature of the stomach 2.
  • One or more of the cell central axes can be parallel with another cell central axis.
  • One or more of the cell central axes can be at an angle (e.g., less than 180 degrees) relative to another cell central axis.
  • the cells 122 can be separated from each other by gaps between loops and/or the cells 122 can overlap each other.
  • the cells 122 can be moved relative to each other (e.g., over and/or under each other) in the target site 147, for example, by inserting and/or withdrawing the catheter 9 from the target site 147.
  • the cells 122 can be moved into and/or out of alignment with each other in the target site 147.
  • the cells 122 can be moved from first offset positions to second offset positions.
  • the cells 122 may or may not be moved into and/or out of alignment with each other.
  • the catheter 9 (e.g., a portion of one of the loops 118) can be moved across one or more of the cells 122.
  • the portion of the catheter 9 that extends across the cell 122 can partially occlude (also referred to as partially obstruct) the cell 122.
  • the cells 122 can be obstructed and/or unobstructed by moving the catheter 9 over a cell 122 and/or by moving the catheter 9 away from the cell 122, respectively. Moving the catheter 9 across a cell 122 can, for example, split the cell 122 into two or more subcells.
  • Figures 46a-46z3 illustrate that the catheter 9 (e.g., the loops 118) and/or the cells 122 can have various arrangements and orientations in the target site 147, for example, relative to a flow path through the target site 147 and/or one or more walls of the target site 147.
  • the flow path through the stomach 2 can be along a path having a curved axis that does not contact the stomach wall 108 from a gastroesophageal junction 120 of the gastrointestinal tract 110, through the stomach 2, to the pylorus 65.
  • Figures 46a-46z3 illustrate that when the catheter 9 is in a deployed configuration (e.g., a configuration 116), the catheter 9 can obstruct a center of the flow path through the target site 147 (e.g., the flow path that extends through the stomach 2, the pylorus 65, and/or the duodenum 37).
  • Figures 46a-46z3 illustrate that when the catheter 9 is in a deployed configuration (e.g., a configuration 116), the catheter 9 can extend across a center of the flow path through the target site 147 (e.g., the flow path that extends through the stomach 2, the pylorus 65, and/or the duodenum 37).
  • the catheter 9 When the catheter 9 is in a deployed configuration, the catheter 9 (e.g., the loops 118) can contact an anterior wall of the stomach 2, a posterior wall of the stomach 2, a superior wall of the stomach 2, an inferior wall of the stomach 2, a lateral wall of the stomach 2, a proximal wall of the stomach 2, a distal wall of the stomach 2, or any combination thereof.
  • the cells 122 can face the anterior wall of the stomach 2, the posterior wall of the stomach 2, the superior wall of the stomach 2, the inferior wall of the stomach 2, the lateral wall of the stomach 2, the proximal wall of the stomach 2, the distal wall of the stomach 2, or any combination thereof.
  • Figures 46a-46z3 illustrate that the cells 122 can face the anterior wall of the stomach 2 and the posterior wall of the stomach 2.
  • the cell central axis of the cells 122 can be at an angle of 70 degrees- 110 degrees relative to a longitudinal axis of the flow path through the target site 147 (e.g., relative to a flow path along having a curved axis from a gastroesophageal junction 120 of the gastrointestinal tract 110 to the pylorus 65), including every 1 degree increment within this range (e.g., 70 degrees, 90 degrees, 110 degrees).
  • the cells 122 can be perpendicular to the flow path through the target site 147.
  • the loops 118 and/or the cells 122 can be formed and/or collapsed in the target site 147 in any order.
  • Figures 46a-46o illustrate that the loops 1 18 (e.g., 1 18a, 1 18b, 1 18c, and/or 118d) can be formed in the order shown
  • Figures 46o-46z3 illustrate that the loops 118 (e.g., 118a, 118b, 118c, and/or 118d) can be collapsed in the order shown.
  • a loop 118 can be considered to collapse, for example, when the size (e.g., the perimeter) of the loop 118 decreases, the loop length of the loop 118 decreases, the loop width of the loop 118 decreases, the loop height of the loop 118 decreases, or any combination thereof.
  • the loops 118 can be collapsed, for example, by withdrawing the catheter 9 from the target site 147.
  • the loops 118 and/or the cells 122 can be formed and/or collapsed in the target site 147 in any order, for example, sequentially and/or simultaneously.
  • Figures 46a-46c illustrate that during a first phase of loop formation, the loop 118a can be formed before the loop 118b
  • Figures 46d-46f illustrate that during a second phase of loop formation, the loop 118a and the loop 118b can be formed simultaneously.
  • Figures 46x-46z illustrate that during a first phase of loop collapse, the loop 118a and the loop 118b can simultaneously collapse
  • Figures 46d-46f illustrate that during a second phase of loop collapse, the loop 118a can be collapsed after the loop 118 is collapsed.
  • Figures 46a-46z3 illustrate that the catheter 9 can be packed into and/or unpacked from a target site 147 in the body such that the catheter 9 crisscrosses and/or extends across the target site 147 in multiple directions.
  • Figures 46a-46z3 illustrate that the target site 147 can be the stomach 2.
  • the catheter 9 can be packed into a target site 147 by inserting the catheter 9 into the target site 147.
  • the catheter 9 can be unpacked from the target site 147 by withdrawing the catheter 9 from the target site 147.
  • FIGS 46a-46z3 illustrate that when the catheter 9 is in a deployed configuration (e.g., a configuration 116), the catheter 9 can define a mesh having cells (e.g., cells 122), a lattice structure having cells (e.g., cells 122), a matting having cells (e.g., cells 122), a path (e.g., a tortuous path) defining cells (e.g., cells 122) and nodes (e.g., the nodes can be where the catheter 9 crosses over itself — the catheter 9 may or may not contact itself at the nodes), a meandering path defining cells (e.g., cells 122), a serpentine path defining cells (e.g., cells 122), a scaffold having cells (e.g., cells 122), a 3D structure having cells (e.g., cells 122), an amorphous 3D structure having cells (e.g., cells 122), an arrangement having cells (e.g., cells (e.
  • Figures 46a-46z3 illustrate that the catheter 9 can form a coil 138 inside the target site 147 such that the catheter 9 winds back and forth in multiple directions across (e.g., longitudinally across and/or transversely across) the target site 147.
  • Figures 46a-46z3 illustrate, for example, that the catheter 9 can extend across the target site 147 in multiple directions and/or zigzag across the target site 147.
  • the catheter 9 can have a total length 124 (also referred to as the total catheter total length 124).
  • the catheter total length 124 can be, for example, 100cm-900cm or more, including every 1 cm increment within this range (e.g., 100cm, 200cm, 300cm, 500cm, 900cm).
  • the total length 124 can be, for example, the total length of the catheter 9 from a proximal end of the catheter 9 to a distal end of the catheter 9.
  • the total length 124 can be, for example, the total length of the catheter 9 from a proximal end of the catheter 9 to the catheter tip 7.
  • the total length 124 can be, for example, the total length of the catheter 9 from a proximal terminal end of the catheter 9 to a distal terminal end of the catheter 9 (e.g., to a distal terminal end of the catheter tip 7).
  • total length 124 can be, for example, the total length of the catheter 9 from the connector 14 to a distal terminal end of the catheter 9.
  • the total length 124 can be, for example, the total length of the catheter 9 from a handle of the catheter 9 to a distal terminal end of the catheter 9 (e.g., to a distal terminal end of the catheter tip 7).
  • a length 126 of the catheter 9 (also referred to as the catheter length 126) can be inserted into and/or removed from the target site 147.
  • the length 126 of the catheter 9 can be a portion of the total length 124 of the catheter.
  • the catheter length 126 can be, for example, 20cm-600cm, 20cm-300cm, 30cm-300cm, 50cm-300cm, 70cm-300cm, or 110cm-300cm, including every 1cm increment within these ranges (e.g., 20cm, 30cm, 40cm, 50cm, 60cm, 100cm, 110cm, 150cm, 300cm, 600cm).
  • the length 126 can be, for example, 5%-90% of the total length 124, including every 1 % increment within this range (e.g., 5%, 10%, 50%, 90%).
  • the length 126 can be, for example, 10% or more, 20% or more 30% or more, 40% or more, 50% or more, 60% or more, and/or 70% or more of the total length 124.
  • the length 126 of the catheter 9 in the target site 147 can include a distal portion of the catheter 9.
  • 50% or less of the total length 124 can be in the target site 147.
  • the length 126 of the catheter 9 in the target site 147 can include a proximal portion of the catheter 9 and a distal portion of the catheter 9.
  • the catheter 9 can have a midpoint between the proximal terminal end of the catheter 9 and the distal terminal end of the catheter 9.
  • the proximal portion of the catheter 9 can be the portion of the catheter 9 proximal the midpoint and the distal portion of the catheter 9 can be the portion of the catheter 9 distal the midpoint such that the proximal portion of the catheter 9 and the distal portion of the catheter 9 can have the same length (e.g., 50% of the total length 124).
  • Different lengths (e.g., any length 126) of the catheter 9 can be introduced into and/or removed from the target site 147.
  • the length 126 of the catheter 9 in the target site 147 can be increased and/or decreased.
  • more and/or less length of the catheter 9 can be introduced and/or removed depending on the size of the target site 147 (e.g., the stomach 2 and/or the duodenum 37) and/or other organs (e.g., the duodenum 37 and/or the pancreas 1).
  • the length 126 of the catheter 9 in the target site 147 can be adjusted, for example, before, during, and/or after transferring heat to and/or from the catheter 9 (e.g., before, after, and/or while passing the fluid 6 through the catheter 9).
  • the catheter length 126 in the target site 147 can be increased and/or decreased. Adjusting the length of the catheter 9 in the target site 147 can, for example, impact the surface area of the catheter 9 that contacts the stomach 2 and/or impact the total heat transfer to the stomach 2 and/or other organs.
  • Figures 46a-46o illustrate, for example, that increasing the length 126 of the catheter 9 in the target site 147 can increase the surface area of the catheter 9 inside the target site 147 and can increase the total heat transfer to and/or from the stomach 2 and/or other organs.
  • Figures 46o- 46z3 illustrate, for example, that decreasing the length 126 of the catheter 9 in the stomach 2 can decrease the surface area of the catheter 9 inside the stomach 2 and can decrease the total heat transfer to and/or from the stomach 2 and/or other organs.
  • the configuration 116 and the shape 117 of the catheter 9 can be changed, for example, by increasing and/or decreasing the length 126 of the catheter 9 in the target site 147.
  • the configuration 116 and the shape 117 of the catheter 9 can be changed from a first configuration and a first shape (e.g., any configuration 116 and shape 117) to a second configuration and a second shape (e.g., any configuration 116 and shape 117), for example, by increasing and/or decreasing the length 126 of the catheter 9 in the target site 147.
  • any of the configurations 116 and shapes 117 in Figures 46a-46z3 can be a first configuration and a first shape, respectively, and any of the configurations 116 and shapes 117 in Figures 46a-46z3 can be a second configuration and a second shape, respectively.
  • the catheter 9 can have one or multiple heat transfer regions 128, for example, 1-30 or more heat transfer regions 128, including every 1 heat transfer region increment within this range (e.g., 1 heat transfer region, 2 heat transfer regions, 30 heat transfer regions).
  • One or more portions of the catheter 9 can be a heat transfer region 128.
  • One or more portions of the catheter 9 can have a heat transfer region 128.
  • the heat transfer region 128 can be a length (e.g., a section) of the catheter 9.
  • the heat transfer region 128 can be a continuous length of the catheter 9.
  • the heat transfer region 128 can be a length of the catheter 9, for example, the length 126 and/or the total length 124.
  • Figures 46a-46z3 illustrate that the heat transfer region 128 can be the catheter 9, for example, a length of the catheter 9 (e.g., the length 126 of the catheter 9).
  • the heat transfer regions 128 can be, for example, one or more lengths (e.g., one or more sections) of the catheter 9.
  • the heat transfer regions 128 can be integrated with and/or attached to each other.
  • the heat transfer regions 128 can be, for example, the loops 118.
  • Each loop 118 in a configuration 116 can be a different heat transfer region 128 or a different portion of the same heat transfer region 128.
  • Figures 46a-46z3 illustrate that each loop 118 in a configuration 116 can be a different portion of the same heat transfer region 128.
  • the heat transfer zone 132 can extend, for example, a distance 132d (e.g., a radius) of 1 cm- 10cm or more away (e.g., radially away) from the catheter 9, for example, as measured from a center longitudinal axis Ac of the catheter 9 or from the exterior surface of the catheter 9, including every 1cm increment within this range (e.g., 1cm, 2cm 5cm, 10cm).
  • a distance 132d e.g., a radius
  • 1 cm- 10cm or more away e.g., radially away
  • the heat transfer zone 132 of different lengths (also referred to as sections) of the catheter 9 can overlap with each other.
  • a first heating zone of a first length of the heat transfer region 128 can overlap a second heating zone of a second length of the heat transfer region 128.
  • the first heating zone can be the heating zone 132 of any first length of the catheter 9 and the second heating zone can be the heating zone 132 of any second length of the catheter 9.
  • the first heating zone can be a heating zone 132 that can extend from the loop first end 118-1 to the loop second end 118-1 of one of the loops 118 (e.g., the loop 118a) and the second heating zone can be a heating zone 132 that can extend from the loop first end 118-1 to the loop second end 118-1 of another one of the loops 118 (e.g., the loop 118b, 118c, or 118d).
  • the first heating zone can be the heating zone 132 that can extend from one of the loops 118 (e.g., loop 118a) and the second heating zone can be the heating zone 132 that can extend from another one of the loops 118 (e.g., loop 118b, 118c, or 118d).
  • the first heating zone can be a heating zone 1 2 that can extend from the loop first end 1 18-1 to the loop second end 118-1 of one of the loops 118 (e.g., the loop 118a) and the second heating zone can be a heating zone 132 that can extend from the loop second end 118-2 of the same or a different loop 118 (e.g., the loop 118a, 118b, 118c, or 118d).
  • the catheter 9 can have various configurations 116 and/or shapes 117 in the target site 147.
  • the catheter 9 can have the configurations 116 and the shapes 117 shown in Figures 46a- 58b.
  • the catheter 9 can have various positions relative to itself, the target site 147, and the surrounding organs.
  • the catheter 9 can have the various positions relative to itself, the target site 147, and the surrounding organs shown in Figures 46a-58b.
  • the loops 118 can have various relative positions to each other.
  • the loops 118 can have the relative positions between each other shown in Figures 46a-58b.
  • the loops 118 can have various sizes and/or shapes.
  • the loops 118 can have the sizes and/or shapes shown in Figures 46a-58b.
  • the cells 122 can have various sizes, shapes, and/or relative positions.
  • the cells 122 can have the sizes, shapes, and/or relative positions shown in Figures 46a-58b.
  • reference points B1-B2, C1-C2, D1-D4, E1-E3, F1-F3, G1-G3, H1-H4, 11-15 J1-J5, K1-K5, L1-L5, M1-M5, N1-N5, O1-O5 are provided to assist in the identification of different sections of the catheter 9 and to assist in the description of the shapes 117 (e.g., shapes 117a- 117z3) and/or the loops 118 that the catheter 9 can have.
  • the reference points are used, for example, to refer to different sections of the catheter 9.
  • the different sections can be integral with each other and/or attached to each other.
  • the different sections of the catheter 9 can be sections of a single length of the catheter 9 (e.g., sections of the total length 124 of the catheter 9).
  • Reference points Bl, Cl, DI, El, DI, El, Fl, Gl, Hl, II, JI, KI, LI, Ml, Nl, and O1 can mark, for example, the distal terminal end of the catheter 9 and/or the distal terminal end of the heat transfer region 128.
  • Reference points B2, C2, D3, E3, F3, G3, H4, 15, J5, K5, L5, M5 N5, and 05 can mark, for example, the location that catheter 9 enters the target site 147.
  • Figures 46a-46o illustrate that when the catheter 9 is in the first through the fifteenth configuration 116a-l 16o, the catheter 9 can have the first through the fifteenth the shape 117a-l 17o, respectively.
  • Figures 46a-46o illustrate that the catheter 9 can change from the first to through the fifteenth configuration 116a-l 16o by inserting the catheter 9 into the target site 147.
  • Figures 46o- 46z3 illustrate that when the catheter 9 is in the fifteenth through the twenty-ninth configuration 116o- 116z3, the catheter 9 can have the fifteenth through the twenty-ninth shape 117o-l 17z3, respectively.
  • Figures 46a-46z3 illustrate that the catheter 9 can change from the fifteenth to the twenty-ninth configuration 116o-l 16z3 by withdrawing the catheter 9 from the target site 147.
  • Figure 46a illustrates that when the catheter tip 7 is in the esophagus 5, the catheter 9 may not have a loop 118. As another example, when the catheter tip 7 is in the esophagus 5, the catheter 9 can have loops that can expand upon entry into the target site 147 and/or when the loops are inflated.
  • Figure 46b illustrates that the first loop 118a can be formed by section B1-B2 of the of the catheter 9.
  • the length of section B1-B2 of the catheter 9 can be, for example, the length 126.
  • Figure 46c illustrates that the first loop 118a can be formed by section C1-C2 of the of the catheter 9.
  • the length of section C1-C2 of the catheter 9 can be, for example, the length 126.
  • Figure 46c illustrates that the size (e.g., the perimeter) of the first loop 118a can be larger when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figure 46c illustrates that the gap between the first loop first end 118a-l and the first loop second end 118a-2 can be smaller when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figure 46c illustrates that the catheter tip 7 can be in a different position in the target site 147 when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figure 46c illustrates that the catheter tip 7 can be closer to a superior portion of the stomach 2 and/or to the gastroesophageal junction 120 when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figure 46d illustrates that the first loop 118a can be formed by section D1-D3 of the of the catheter 9 and that the second loop 1 18b can be formed by section D2-D4 of the catheter 9.
  • the length of section D1-D3 of the catheter 9 can be, for example, the length 126.
  • the length of section D2-D4 can be, for example, less than the length of section D1-D3.
  • Figure 46d illustrates that section D3-D4 of the second loop 118b can be in the esophagus 5 and that section D2-D3 of the second loop 118b can be in the target site 147.
  • Figure 46d illustrates that the same section of the catheter 9 can define multiple loops 118.
  • Figure 46d illustrates that section D2-D3 of the catheter 9 can be a section of the first loop 118a and a section of the second loop 118b.
  • Figure 46d illustrates, for example, that the second loop 118b can be formed from a section (e.g., section D2-D3) of the first loop 118a.
  • Figure 46d illustrates that the size (e.g., the perimeter) of the first loop 118a can be larger when the catheter 9 is in the fourth configuration 116d than when the catheter 9 is in the third configuration 116c.
  • Figure 46d illustrates that the gap between the first loop first end 118a-l and the first loop second end 118a-2 can be smaller when the catheter 9 is in the fourth configuration 116d than when the catheter 9 is in the third configuration 116b.
  • Figure 46d illustrates that when the catheter 9 is in the fourth configuration 116d, the catheter tip 7 can be in the same position in the target site 147 as when the catheter 9 is in the third configuration 116c.
  • Figure 46e illustrates that the first loop 118a can be formed by section E1-E3 of the of the catheter 9 and that the second loop 118b can be formed by section E2-E3 of the catheter 9.
  • the length of section E1-E3 of the catheter 9 can be, for example, the length 126.
  • the length of section E2-E3 can be, for example, less than the length of section E1-E3.
  • Figure 46e illustrates that the size (e.g., the perimeter) of the first loop 118a and/or the second loop 118b can be larger when the catheter 9 is in the fifth configuration 116e than when the catheter 9 is in the fourth configuration 116d.
  • Figure 46e illustrates that the second loop 1 18b can be closer to the catheter tip 7 when the catheter 9 is in the fifth configuration 116e than when the catheter 9 is in the fourth configuration 116d.
  • Figure 46e illustrates that the second loop 118b (e.g., the second loop head 118b-3) can be closer to the first loop 118a (e.g., to the first loop first end 118a-l and/or to the first loop head 118a-3) when the catheter 9 is in the fifth configuration 116e than when the catheter 9 is in the fourth configuration 116d.
  • Figure 46d illustrates that when the catheter 9 is in the fifth configuration 116e, the catheter tip 7 can be in the same position in the target site 147 as when the catheter 9 is in the fourth configuration 116d.
  • Figure 46e illustrates that the gap between the first loop first end 118a-l and the first loop second end 118a-2 can be smaller when the catheter 9 is in the fifth configuration 116c (e.g., the gap between reference points El and E3) than when the catheter 9 is in the fourth configuration 116d (e.g., the gap between reference points DI and D3).
  • the fifth configuration 116c e.g., the gap between reference points El and E3
  • the fourth configuration 116d e.g., the gap between reference points DI and D3
  • Figure 46f illustrates that the first loop 118a can be formed by section F1-F3 of the of the catheter 9 and that the second loop 118b can be formed by section F2-F3 of the catheter 9.
  • the length of section F1-F3 of the catheter 9 can be, for example, the length 126.
  • the length of section F2-F3 can be, for example, less than the length of section F1-F3.
  • Figure 46f illustrates that the size (e.g., the perimeter) of the first loop 118a and/or the second loop 118b can be larger when the catheter 9 is in the sixth configuration 116f than when the catheter 9 is in the fifth configuration 116e.
  • Figure 46f illustrates that the second loop 118b (e.g., the second loop head 118b-3) can be closer to the first loop 118a (e.g., to the first loop first end 118a-l and/or to the first loop head 118a-3) when the catheter 9 is in the sixth configuration 116f than when the catheter 9 is in the fifth configuration 116e.
  • the second loop 118b e.g., the second loop head 118b-3
  • Figure 46f illustrates that the second loop 118b (e.g., the second loop head 118b-3) can be closer to the first loop 118a (e.g., to the first loop first end 118a-l and/or to the first loop head 118a-3) when the catheter 9 is in the sixth configuration 116f than when the catheter 9 is in the fifth configuration 116e.
  • Figure 46g illustrates that the first loop 1 18a can be formed by section G1 -G3 of the of the catheter 9 and that the second loop 118b can be formed by section G2-G3 of the catheter 9.
  • the length of section G1-G3 of the catheter 9 can be, for example, the length 126.
  • the length of section G2-G3 can be, for example, less than the length of section G1-G3.
  • Figure 46g illustrates that the size (e.g., the perimeter) of the first loop 118a and/or the second loop 118b can be larger when the catheter 9 is in the seventh configuration 116g than when the catheter 9 is in the sixth configuration 116f .
  • Figure 46g illustrates that the second loop 118b (e.g., the second loop head 118b-3) can be closer to the first loop 118a (e.g., to the first loop first end 118a- 1 and/or to the first loop head 118a-3) when the catheter 9 is in the seventh configuration 116g than when the catheter 9 is in the sixth configuration 116f.
  • Figures 46d-46g illustrate that increasing the length of the catheter 9 in the target site 147 (e.g., the stomach 2) can move the second loop 118b toward the first loop 118a.
  • Figures 46f- 46g illustrate that increasing the length of the catheter 9 in the target site 147 (e.g., the stomach 2) can move the second loop 118b across (e.g., over or under) the first ioop 118a.
  • Figures 46f-46g illustrate that increasing the length of the catheter 9 in the target site 147 can pinch the first loop 118a closed which can split the first cell 122a into subcells, for example, a first subcell 122al and a second subcell 122a2.
  • Figure 46g illustrates that the first subcell 122al can be an open cell and that the second subcell 122a2 can be a closed cell.
  • Figure 46g illustrates, for example, that the second cell 122b can be between the first subcell 122al and the second subcell 122a2.
  • Figures 46d-46f illustrate that increasing the length of the catheter 9 in the target site 147 (e.g., the stomach 2) can move the second loop 118b (e.g., the second loop first end 118b- 1 ) toward the catheter tip 7.
  • Figures 46f-46g illustrate that increasing the length of the catheter 9 in the target site 147 (e.g., the stomach 2) can move the second loop 118b (e.g., the second loop first end 118b- 1 ) away from the catheter tip 7.
  • Figure 46h illustrates that the first loop 118a can be formed by section H1-H4 of the of the catheter 9, that the second loop 118b can be formed by section H2-H4 of the catheter 9, and that the third loop 118c can be formed by section H3-H4 of the catheter 9.
  • the length of section H1-H4 of the catheter 9 can be, for example, the length 126.
  • the length of sections H2-H4 and H3-H4 can be, for example, less than the length of section H1-H4.
  • Figure 46h illustrates that the size (e.g., the perimeter) of the third loop 118c can be larger when the catheter 9 is in the eighth configuration 116h than when the catheter 9 is in the seventh configuration 116g.
  • Figure 46h illustrates that the third loop 118c can be farther from the gastroesophageal junction 120 when the catheter 9 is in the eighth configuration 116h than when the catheter 9 is in the seventh configuration 116g.
  • Figure 46h illustrates that the same section of the catheter 9 can define multiple loops 118.
  • Figure 46h illustrates that section H3-H4 of the catheter 9 can be a section of the second loop 118b and a section of the third loop 118c.
  • Figure 46h illustrates that the first loop 118 can extend back and forth across the target site 147.
  • Figure 46h illustrates that the first loop first end 118a-l can extend back and forth across the target site 147.
  • Figure 46h illustrates that a first section of the catheter 9 (e.g., the second loop head 118b-3) can extend across a second section of the catheter 9 (e.g., the first loop second end 118a-2 and/or the first loop head 118-3) at two locations, for example, at opposite ends of the cell 134.
  • Figure 46h illustrates that the cell 134 can be created, for example, between a radial outer surface of the first loop 118a and a radial inner surface of the second loop 118b.
  • Figure 46i illustrates that the first loop 118a can be formed by section 11-15 of the of the catheter 9, that the second loop 118b can be formed by section 12-14 of the catheter 9, and that the third loop 118c can be formed by section 13-15 of the catheter 9.
  • the length of section 11-15 of the catheter 9 can be, for example, the length 126.
  • the length of sections 12-14 and 13-15 can be, for example, less than the length of section 11-15.
  • Figure 46i illustrates that the size (e.g., the perimeter) of the third loop 118c can be larger when the catheter 9 is in the ninth configuration 116i than when the catheter 9 is in the eighth configuration 116h.
  • Figures 46h-46i illustrate that increasing the length of the catheter 9 in the target site 147 can pinch the second loop 118b closed which can split the second cell 122b into suhcells, for example, a first subcell 122b 1 and a second suhcell 122b2.
  • Figure 46i illustrates that the first subcell 122bl can be an open cell and that the second subcell 122b2 can be a closed cell.
  • Figure 46i illustrates, for example, that a first section of the catheter 9 (e.g., the second loop first end 118b- 1 and/or the third loop head 118c-3) can be adjacent to and/or in contact with a second section of the catheter 9 (e.g., second loop second end 118b-2) at a location Zl.
  • Figures 46h- 46i illustrate, for example, that increasing the length of the catheter 9 in the target site 147 can cause a first section of the catheter 9 (e.g., the second loop first end 118b- 1 and/or the third loop head 118c-3) to move adjacent to and/or in contact with a second section of the catheter 9 (e.g., second loop second end 118b-2) at the first location Zl.
  • a first section of the catheter 9 e.g., the second loop first end 118b- 1 and/or the third loop head 118c-3
  • a second section of the catheter 9 e.g., second loop second end 118b-2
  • Figure 46j illustrates that the first loop 118a can be formed by section J1-J5 of the of the catheter 9, that the second loop 118b can be formed by section J2-J4 of the catheter 9, and that the third loop 118c can be formed by section J3-J5 of the catheter 9.
  • the length of section J1-J5 of the catheter 9 can be, for example, the length 126.
  • the length of sections J2-J4 and J3-J5 can be, for example, less than the length of section JI -J5.
  • Figure 46j illustrates that the size (e.g., the perimeter) of the third loop 118c can be larger when the catheter 9 is in the tenth configuration 116j than when the catheter 9 is in the ninth configuration 116i.
  • Figures 46i-46j illustrate that increasing the length of the catheter 9 in the target site 147 can cause a first section of the catheter 9 (e.g., the second loop first end 118b- 1 and/or the third loop head 118c-3) to move (e.g., push) a second section of the catheter 9 (e.g., second loop second end 118b-2) from the first location Zl to a second location Z2.
  • Figure 46j illustrates that location Z2 can be farther from the esophagus 5 and/or closer to the pylorus 65 by a distance Z3.
  • Figures 46i-46j illustrate, for example, that the second section of the catheter 9 (e.g., second loop second end 118b-2) can resist movement of the first section of the catheter 9 (e.g., the second loop first end 118b- 1 and/or the third loop head 118c-3) into the target site 147 as the catheter 9 is packed into (e.g., inserted into) the target site 147.
  • the second section of the catheter 9 e.g., second loop second end 118b-2
  • first section of the catheter 9 e.g., the second loop first end 118b- 1 and/or the third loop head 118c-3
  • Figure 46k illustrates that the first loop 118a can be formed by section K1-K5 of the of the catheter 9, that the second loop 118b can be formed by section K2-K4 of the catheter 9, and that the third loop 118c can be formed by section K3-K5 of the catheter 9.
  • the length of section K1-K5 of the catheter 9 can be, for example, the length 126.
  • the length of sections K2-K4 and K3-K5 can be, for example, less than the length of section K1-K5.
  • Figure 46k illustrates that the size (e.g., the perimeter) of the third loop 118c can be larger when the catheter 9 is in the eleventh configuration 116k than when the catheter 9 is in the tenth configuration 116j.
  • Figure 461 illustrates that the first loop 118a can be formed by section L1-L5 of the of the catheter 9, that the second loop 118b can be formed by section L2-L4 of the catheter 9, and that the third loop 118c can be formed by section L3-L5 of the catheter 9.
  • the length of section L1-L5 of the catheter 9 can be, for example, the length 126.
  • the length of sections L2-L4 and L3-L5 can be, for example, less than the length of section L1-L5.
  • Figure 46n illustrates, for example, that a first section of the catheter 9 (e.g., the third loop first end 118c- 1 and/or the fourth loop head 118d-3) can be adjacent to and/or in contact with a second section of the catheter 9 (e.g., the third loop second end 118c-2).
  • Figures 46m-46n illustrate, for example, that increasing the length of the catheter 9 in the target site 147 can cause a first section of the catheter 9 (e.g., the third loop first end 118c- 1 and/or the fourth loop head 118d-3) to move adjacent to and/or in contact with a second section of the catheter 9 (e.g., the third loop second end 118c-2).
  • the loops 118 can be formed proximal and/or distal the catheter tip 7 in the target site 147.
  • Figures 46a-46z3 illustrate that the loops 118 can be formed distal the catheter tip 7 in the target site 147.
  • Figures 46a-46z3 illustrate that the loops 118 (e.g., the second loop 118b, the third loop 118c, and the fourth loop 118d) can be formed between the catheter tip 7 and the pylorus 65.
  • Figures 46o-46z3 illustrate that the catheter 9 can be withdrawn from the target site 147.
  • Figures 46o-46z3 illustrate that the loops 118 can be collapsed in and/or removed from the target site 147.
  • Figures 46o-46z3 illustrate that collapsing the loops 118 can include straightening the loop 118, decreasing the curve of a loop, decreasing the perimeter of the loop 118, decreasing the loop length of the loops 118, decreasing the width of the loops 118, decreasing the height of the loops 118, or any combination thereof.
  • Figures 46a-46z3 illustrate that the loops 118 can be collapsed in the target site 147 by withdrawing the catheter 9 from the target site 147.
  • Figures 46a-46o illustrate that the catheter 9 can form a coil (e.g., the coil 138) in the target site 147, for example, by inserting the catheter 9 into the target site 147.
  • Figures 46a-46o illustrate, for example, that the coil 138 (e.g., the length 126 of the catheter 9 in the target site 147) can become more tangled, can become larger, can extend across the target site 147 more times, and/or can become more dense (e.g., more of the catheter 9 per unit of volume of the target site 147 such as more of the catheter per 1cm 3 of the target site 147) as the catheter 9 is inserted into the target site 147.
  • 46a- 46z3 illustrate that the catheter 9 can form (e.g., progressively form) the coil 138.
  • Figures 46o-46z3 illustrate, for example, that the coil 138 can become less tangled, decrease in size, extend across the target site 147 less times, and/or become less dense in the target site 147 as the catheter 9 is withdrawn from the target site 147.
  • Figures 46o-46z3 illustrate that the catheter 9 can uncoil (e.g., progressively uncoil) as the catheter 9 is withdrawn from the target site 147.
  • Figures 46o-46z3 illustrate, for example, that the coil 138 can uncoil (e.g., progressively uncoil) in the target site 147 as the catheter 9 is withdrawn from the target site 147.
  • Figures 46a-46z3 illustrate that when the catheter 9 is in a deployed configuration (e.g., a configuration 116), the heat transfer region 128 can be in the stomach 2 and the esophagus 5.
  • Figures 47a-47i illustrate that the catheter 9 can be inserted into and/or removed from the stomach 2.
  • Figures 47a-47i illustrate that various lengths of the catheter 9 (e.g., the length 126 shown in Figures 47b-47h) can be introduced into and/or removed from the stomach 2.
  • Figures 47a-47i illustrate various configurations 116 and shapes 117 that the catheter 9 can have.
  • the configurations 116 and shapes 117 in Figures 47a-47i can be, for example, different than the configurations 116 and shapes 117 in Figures 46a-46z3.
  • Figures 47a-47i illustrate, for example, that when the catheter 9 is in a first through a ninth configuration 116a-l 16i, the catheter 9 can have the first through the ninth shape 117a-l 17i, respectively.
  • the catheter 9 in the target site 147 can have any combination of the loops 118 and/or cells 122 shown in Figures 46b-46z2 and 47b-47i.
  • Figure 47a illustrates that when the catheter tip 7 is in the esophagus 5, the catheter 9 may not have the loops 118.
  • Figure 47b illustrates that the first loop 118a can be an open loop.
  • Figure 47b illustrates that in the configuration 116 shown, the length 126 can be, for example, 15cm-40cm (e.g., 25cm).
  • Figure 47c illustrates that the first loop 118a can be a closed loop.
  • Figures 47b-47c illustrate that the first loop 118 can be changed from an open loop to a closed loop, for example, by inserting the catheter 9 into the target site 147.
  • Figures 47b-47c illustrate that the size (e.g., the perimeter) of the first loop 118a can be larger when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figure 47c illustrates that in the configuration 116 shown, the length 126 can be, for example, 20cm-90cm (e.g., 50cm).
  • Figure 47d illustrates that the first loop 118a and the second loop 118b can be closed loops and that the third loop 118c can be an open loop.
  • Figure 47d illustrates that the first loop 118a can overlap with the second loop 118b.
  • Figure 47d illustrates that the second loop 118b can overlap with the first loop 118a.
  • Figure 47d illustrates that a portion of the second loop 118b can be posterior to the first loop 118a.
  • Figure 47d illustrates that the first cell 122a and the second cell 122b can overlap and be offset from each other.
  • Figure 47d illustrates that an inferior portion of the first cell 122b can overlap with (e.g., be aligned with) a superior portion of the second cell 122b.
  • Figure 47d illustrates that in the configuration 116 shown, the length 126 can be, for example, 70cm-200cm (e.g., 80cm).
  • Figures 47d-47e illustrates that a distal loop (e.g., the second loop 118b and/or the third loop 118c) can be formed in the target site 147 after a proximal loop (e.g., the first loop 118a) loop is formed in the target site 147.
  • Figure 47e illustrates that a distal cell (e.g., the second cell 122b and/or the third cell 122c) can be formed in the target site 147 after a proximal cell (e.g., the first cell 122a) is formed in the target site 147.
  • Figures 47a-47e illustrate that the loops 118 and the cells 122 can be formed by inserting the catheter 9 into the target site 147.
  • the loops 118 can be formed in the target site 147 in any order, for example, sequentially and/or simultaneously.
  • Figures 47a-47e illustrate that the first loop 1 18a, the second loop 1 18b, and the third loop 1 18c can be sequentially formed.
  • Figures 47a-47e illustrate that the first loop 118a can be formed in the target site 147, then the second loop 118b can be formed in the target site 147, and then the third loop 118c can be formed in the target site 147.
  • Figures 47a-47e illustrate that the second loop 118b can be formed after the first loop 118a is formed and that the third loop 118c can be formed after the first loop 118a and/or the second loop 118b are formed.
  • Figures 47a-47e illustrate, for example, that during a first phase of loop formation, the loop 118a can be formed, that during a second phase of loop formation, the loop 118b can be formed, and that during a third phase of loop formation, the loop 118c can be formed.
  • the first phase of loop formation can be before the second phase of loop formation.
  • the second phase of loop formation can be after the first phase of loop formation.
  • the third phase of loop formation can be after the second phase of loop formation.
  • the first loop 118a can have a constant size and/or shape.
  • the size (e.g., perimeter) of the first loop 118a and/or the second loop 118b can increase and/or decrease, the shape of the first loop 118a and/or the second loop 118b can change, or any combination thereof.
  • Figures 47a-47e illustrate that different sections of the catheter 9 can form different loops 118 at different times and/or at different stages of loop formation.
  • Figures 47a-47e illustrate that when the catheter 9 is in the third configuration 116c, a first section of the catheter 9 can form the first loop 118a, and that when the catheter 9 is in the fourth configuration 116d, the first section of the catheter 9 can form the third loop 118c and a second section of the catheter 9 can form the first loop 118a.
  • Figures 47a-47e illustrate that when the catheter 9 is in the third configuration 116c, a first section of the catheter 9 can form the first loop 118a, and that when the catheter 9 is in the fifth configuration 116e, the first section of the catheter 9 can form the third loop 118c and a second section of the catheter 9 can form the first loop 118a.
  • the first section of the catheter 9 can have the same length when the catheter 9 is in the third configuration 116c, the fourth configuration 116d, and the fifth configuration 116e.
  • Figures 47a-47e illustrate that the first section of the catheter 9 can be distal the second section of the catheter along the length of the catheter 9.
  • Figures 47a-47e illustrate, for example, that the first section of the catheter 9 can be a distal end of the catheter 9.
  • Figures 47a-47e illustrate, for example, that the first section of the catheter 9 can have the catheter tip 7.
  • a first section of the catheter 9 can form the first loop 118a
  • the first section of the catheter 9 can form the second loop 118b and a second section of the catheter 9 can form the first loop 118a
  • the first section of the catheter 9 can form the third loop 118c
  • the second section of the catheter 9 can form the second loop 118b
  • a third section of the catheter 9 can form the first loop 118a.
  • Figures 47a-47e illustrate that the second loop 118b can be formed distal the first loop 118a and that the third loop 118c can be formed distal the first loop 118a and the second loop 118b.
  • Figures 47a-47e illustrate, for example, that when the catheter 9 is in the fourth configuration 116d and the fifth configuration 116e, the third loop 118c can be the distal most loop along the catheter 9 in the target site 147 and the first loop 118a can be the proximal most loop along the catheter 9 in the target site 147.
  • Figures 47e-47i illustrate that the catheter 9 can be withdrawn from the target site 147 as shown by arrow 114.
  • Figures 47e-47i illustrate that the loops 118 can be collapsed in and/or removed from the target site 147.
  • Figures 47e-47i illustrate that collapsing the loops 118 can include straightening the loop 118, decreasing the curve of a loop, decreasing the perimeter of the loop 118, decreasing the loop length of the loops 118, decreasing the width of the loops 118, decreasing the height of the loops 118, or any combination thereof.
  • Figures 47e-47i illustrate that the loops 118 can be collapsed in the target site 147 by withdrawing the catheter 9 from the target site 147 as shown by arrow 114.
  • Figures 47e-47i illustrate, for example, that the catheter 9 can straighten and/or become less curved in the target site 147 as the catheter 9 is withdrawn (e.g., pulled) from the target site 147 into the esophag
  • the loops 118 can be collapsed in and/or removed from the target site 147 in any order, for example, sequentially and/or simultaneously.
  • Figures 47e-47i illustrate that the first loop 118a, the second loop 118b, and the third loop 118c can be sequentially collapsed and/or sequentially removed from the target site 147.
  • Figures 47e-47i illustrate, for example, that the first loop 118a, the second loop 118b, and the third loop 118c can be removed from the target site 147 as they are collapsing (e.g., as they are decreasing in size).
  • Figures 47e-47i illustrate that the loops 118 can be collapsed independently from one another as the catheter 9 is withdrawn from the target site 147, starting with the proximal most loop (e.g., the loop 118a) and ending with the distal most loop (e.g., the loop 118c).
  • Figures 47e-47i illustrate that as the first loop 118a is being collapsed and removed from the target site 147, the second loop 118b and the third loop 118c can move (e.g., be pulled) toward the gastroesophageal junction 120.
  • Figures 47e-47i illustrate that as the second loop 118b is being collapsed and removed from the target site 147, the third loop 118c can move (e.g., be pulled) toward the gastroesophageal junction 120.
  • Figures 47e-47i illustrate, for example, that during a first phase of catheter removal, the section of the catheter 9 defining the first loop 118a can be removed from the target site 147, that during a second phase of catheter removal, the section of the catheter 9 defining the second loop 118b can be removed from the target site 147, and that during a third phase of catheter removal, the section of the catheter 9 defining the third loop 118c can be removed from the target site 147.
  • the first loop 118a can collapse in the target site 147.
  • the second loop 118b can collapse in the target site 147.
  • the third loop 118c can collapse in the target site 147.
  • the first loop 118a, the second loop 118b, and/or the third loop 118c can be removed from the target site 147 without collapsing, for example, if the size of the first loop 118a, the second loop 118b, and/or the third loop 118c is smaller than the passageway through the esophagus 5.
  • the first phase of catheter removal can be before the second phase of catheter removal.
  • the second phase of catheter removal can be after the first phase of catheter removal.
  • the third phase of catheter removal can be after the second phase of catheter removal. While the first loop 118a is being removed (e.g., during the first phase of catheter removal), the second loop 118b and/or the third loop 118c can have a constant size and/or shape.
  • the size (e.g., perimeter) of the second loop 118b and/or the third loop 118c can increase and/or decrease, the shape of the second loop 118b and/or the third loop 118c can change, or any combination thereof.
  • the third loop 118c can have a constant size and/or shape.
  • Figures 48a-48i illustrate the same configurations 116 and shapes 117 as Figures 47a-47i but illustrate that the loops 118 can be formed differently and/or can be collapsed and/or removed in a different order.
  • Figures 48a-48e illustrate that the coil 138 can have a preset shape.
  • Figures 48a-48i illustrate that the catheter 9 and/or the guidewire 99 can have a preset shape in the shape of the coil 138.
  • Figures 48a-48i illustrate that the coil 138 can be, for example, a loose coil (e.g., a coil with loops 118 and/or cells 122 offset from each other).
  • Figures 48a-48i illustrate various shapes 117 of the coil 138.
  • Figures 48a-48e illustrate that the first loop 118a can be formed by a section of the catheter 9 that is distal the sections of the catheter that form the second loop 1 18b and the third loop 1 18c, respectively.
  • Figures 48a-48e illustrate that the second loop 118b can be formed by a section of the catheter 9 that is distal the section of the catheter 9 that forms the third loop 118c.
  • Figures 48d and 48e illustrate, for example, that when the catheter 9 is in the fourth configuration 116d and the fifth configuration 116e, the first loop 118a can be distal the second loop 118b and the third loop 118c in the target site 147 and the second loop 118b can be distal the third loop 118c in the target site 147.
  • Figures 48a-48e illustrate that different sections of the catheter 9 can form the loops 118 at different times and/or at different stages of loop formation.
  • Figures 48a-48e illustrate that when the catheter 9 is in the third configuration 116c, a first section of the catheter 9 can form the first loop 118a, and that when the catheter 9 is in the fourth configuration 116d and the fifth configuration 116e, the first section of the catheter 9 can form the first loop 118a, a second section of the catheter 9 can form the second loop 118b, and a third section of the catheter 9 can form the third loop 118c.
  • the loops 118 can be collapsed in and/or removed from the target site 147 in any order, for example, sequentially and/or simultaneously.
  • Figures 48e-48i illustrate that the third loop 118c, the second loop 118b, and the first loop 118a can be sequentially collapsed and/or sequentially removed from the target site 147.
  • Figures 48e-48i illustrate, for example, that the third loop 118c, the second loop 118b, and the first loop 118a can be removed from the target site 147 as they are collapsing (e.g., as they are decreasing in size).
  • Figures 48e-48i illustrate that the third loop 118c can be collapsed and removed from the target site 147, then the second loop 118b can be collapsed and removed from the target site 147, and then the first loop 118a can be collapsed and removed from the target site 147.
  • Figures 48e-48i illustrate that the second loop 118b can be collapsed and removed from the target site 147 after the third loop 118c is collapsed and removed from the target site 147 and that the first loop 118a can be collapsed and removed from the target site 147 after the second loop 118b and the third loop 118c are collapsed and removed from the target site 147.
  • Figures 48e-48i illustrate that the loops 118 can be collapsed independently from one another as the catheter 9 is withdrawn from the target site 147, starting with the proximal most loop (e.g., the loop 1 18c) and ending with the distal most loop (e.g., the loop 1 18a).
  • Figures 48e-48i illustrate that as the third loop 118c is being collapsed and removed from the target site 147, the second loop 118b and the first loop 118a can move (e.g., be pulled) toward the gastroesophageal junction 120.
  • Figures 48e-48i illustrate that as the second loop 118b is being collapsed and removed from the target site 147, the first loop 118a can move (e.g., be pulled) toward the gastroesophageal junction 120.
  • the size (e.g., perimeter) of the first loop 118a can increase and/or decrease, the shape of the third loop 118c can change, or any combination thereof.
  • the catheter tip 7 and/or the proboscis 97 can be permanently and/or temporarily engaged with a wall of the stomach 2, the duodenum 37, and/or another other organ.
  • the stomach wall 108 can include a naturally occurring feature in the stomach 2, including, for example, a gastric ruga, gastric rugae, an ulcer, or any combination thereof.
  • Figures 49b-49h illustrate that the proboscis 97 can be permanently and/or temporarily engageable with the stomach wall 108, for example, with a gastric ruga, gastric rugae, an ulcer, or any combination thereof.
  • the catheter 9 can be unanchored and/or disengaged from the stomach wall 108, for example, by moving (e.g., pulling) the proboscis 97 away from the stomach wall 108 by withdrawing the catheter 9 from the stomach 2 as shown by arrow 114.
  • FIGs 49a-49b illustrate that as the catheter 9 is introduced into the stomach 2, the proboscis 97 can become engaged with (e.g., can be moved into contact with) the stomach wall 108.
  • the proboscis 97 can remain engaged with (e.g., can remain in contact with) the stomach wall 108, can disengage from (e.g., can move out of contact with) the stomach wall 108, can re-engage with the stomach wall 108, or any combination thereof while the catheter 9 is advanced into the stomach 2, while the catheter 9 is withdrawn from the stomach 2, and/or while the catheter 9 migrates in the stomach 2 and/or in the duodenum 37.
  • Figures 49b-49h illustrate that the proboscis 97 can remain in a fixed position relative to the stomach wall 108 while the catheter 9 is advanced into the stomach 2, while the catheter 9 migrates into the duodenum 37, while the catheter 9 is withdrawn from the stomach 2, and while the catheter 9 is withdrawn from the duodenum 37.
  • a 0.0cm movement of the proboscis 97 can correspond to the proboscis 97 remaining stationary relative to the stomach wall 108.
  • Figures 49b-49h illustrate that the proboscis 97 can remain stationary (e.g., 0.0cm movement) relative to the stomach wall 108 while the catheter 9 is advanced into the stomach 2, while the catheter 9 is forced into and/or migrates into the duodenum 37, while the catheter 9 is withdrawn from the stomach 2, while the catheter 9 is withdrawn from the duodenum 37, or any combination thereof.
  • Figures 49h-49i illustrate that the catheter 9 can become disengaged from (e.g., can be moved out of contact with) the stomach wall 108.
  • Figures 49h-49i illustrate, for example, that the proboscis 97 can be disengaged from the stomach wall 108 by withdrawing the catheter 9 from the stomach 2. Withdrawing the catheter 9 from the stomach 2 can, for example, include pulling the proboscis 97 away from the stomach wall 108 toward the gastroesophageal junction 120.
  • the proboscis 97 and/or the catheter tip 7 may or may not pivot on the stomach wall 108 once the proboscis 97 and/or the catheter tip 7 contacts the stomach wall 108.
  • Figures 49b- 49h illustrate that the proboscis 97 and the catheter tip 7 may not pivot on the stomach wall 108 when the proboscis 97 is in contact with the stomach wall 108.
  • the catheter tip 7 can pivot on the stomach wall 108 when the proboscis 97 is in contact with the stomach wall 108.
  • the proboscis 97 may or may not be forced into (e.g., pressed into) contact with the stomach wall 108 during insertion of the catheter 9 into the stomach 2.
  • Figures 49a-49b illustrate that the proboscis 97 can be forced into the stomach wall 108 during insertion of the catheter 9 into the stomach 2.
  • the proboscis 97 can inhibit and/or prevent the catheter tip 7 from tunneling into and/or through the stomach wall 108, for example, by deflecting.
  • Figures 49b-49c illustrate that the proboscis 97 can be flexible and/or can be a flexible tip that can deform (e.g., bend) when pushed into the stomach wall 108.
  • Figures 49d-49e illustrate that the catheter 9 can enter the duodenum 37.
  • the insertion of the catheter 9 into the stomach 2 can force the catheter 9 to enter the duodenum 37, the natural stomach motility and/or peristalsis can urge and/or force the catheter 9 to enter the duodenum 37 and/or the intestine caudal the duodenum 37, or any combination thereof.
  • the catheter 9 can, for example, migrate into the duodenum 37 from the stomach 2 through the pylorus 65 by the natural motility and/or peristalsis of the stomach 2.
  • Figures 49d-49e illustrate that the insertion of the catheter 9 into the stomach 2 can force the catheter 9 to enter the duodenum 37.
  • Figures 49d-49e illustrate that the natural stomach motility and/or peristalsis can urge and/or force the catheter 9 to enter the duodenum 37.
  • Figures 49d-49e illustrate that the insertion of the catheter 9 into the stomach 2 can force the catheter 9 to enter the duodenum 37 and the natural stomach motility and/or peristalsis can urge and/or force the catheter 9 to enter the duodenum 37.
  • the catheter 9 and/or the catheter tip 7 can enter the duodenum before, during, and/or after passing (e.g., pumping) a fluid (e.g., the fluid 6) through a lumen in the catheter 9.
  • a fluid e.g., the fluid 6
  • Figures 49d-49e illustrate that the catheter 7 can migrate into the duodenum 37 while the fluid 6 is being pumped (e.g., recirculated) through an inflow lumen and an outflow lumen in the catheter 9.
  • the catheter 9 can enter the duodenum 37 before, during, and/or after the catheter tip 7 enters the stomach 2.
  • Figures 49a-49e illustrate that the catheter 9 can enter the duodenum 37 after the catheter tip 7 enters the stomach 2.
  • the catheter 9 can enter the duodenum 37 when the catheter tip 7 is in the stomach 2, in the esophagus 5, in the pylorus 65, in the duodenum 37, and/or outside the body.
  • Figures 49a-49e illustrate that the catheter 9 can enter the duodenum 37 when the catheter tip 7 is in the stomach 2.
  • the catheter 9 can enter the duodenum 37 before, during, and/or after the proboscis 97 enters the stomach 2.
  • Figures 49a-49e illustrate that the catheter 9 can enter the duodenum 37 after the proboscis 97 enters the stomach 2.
  • the catheter 9 can enter the duodenum 37 when the proboscis 97 is in the stomach 2, in the esophagus 5, in the pylorus 65, in the duodenum 37, and/or outside the body.
  • Figures 49a-49e illustrate that the catheter 9 can enter the duodenum 37 when the proboscis 97 is in the stomach 2.
  • the catheter 9 can enter the duodenum 37 before, during, and/or after the catheter tip 7 and/or the proboscis 97 becomes engaged with the stomach wall 108.
  • Figures 49a-49e illustrate that the catheter 9 can enter the duodenum 37 after the proboscis 97 is pushed into engagement with (e.g., into contact with) the stomach wall 108.
  • the catheter 9 can enter the duodenum 37 when at least 10cm-150cm or more of the catheter 9 is in the stomach 2, including every 1cm increment within this range (e.g., at least 10cm, at least 30cm, at least 40cm, at least 70cm, at least 100cm).
  • Figures 49a-49e illustrate that the catheter 9 can enter the duodenum 37 when at least 30cm of the catheter 9 is in the stomach 2.
  • Figures 49e-49f illustrate that the catheter 9 can be removed from the duodenum 37, for example, by withdrawing (e.g., pulling) the catheter 9 out of the stomach 2 as shown by arrow 114.
  • the catheter 9 can be withdrawn from the duodenum 37 before, during, and/or after the catheter tip 7 is withdrawn from the stomach 2.
  • Figures 49e-49i illustrate that the catheter 9 can be withdrawn from the duodenum 37 before the catheter tip 7 is withdrawn from the stomach 2.
  • the catheter 9 can be withdrawn from the duodenum 37 when the catheter tip 7 is in the stomach 2, in the esophagus 5, in the pylorus 65, in the duodenum 37, and/or outside the body.
  • Figures 49e-49i illustrate that the catheter 9 can be withdrawn from the duodenum 37 when the proboscis 97 is in the stomach 2.
  • the catheter 9 can be withdrawn from the duodenum 37 before, during, and/or after the proboscis 97 becomes engaged with the stomach wall 108.
  • Figures 49e-49i illustrate that the catheter 9 can be withdrawn from the duodenum 37 after the proboscis 97 is pushed into engagement with (e.g., into contact with) the stomach wall 108.
  • the catheter 9 can be withdrawn from the duodenum 37 when at least 10cm- 150cm or more of the catheter 9 is in the stomach 2, including every 1cm increment within this range (e.g., at least 10cm, at least 30cm, at least 40cm, at least 70cm, at least 100cm).
  • Figures 49e-49i illustrate that the catheter 9 can be withdrawn from the duodenum 37 when at least 30cm of the catheter 9 is in the stomach 2.
  • the catheter tip 7 can be in the stomach 2 and/or the duodenum 37.
  • Figure 49e illustrates that when the catheter 9 is in the duodenum 37, the catheter tip 7 can be in the stomach 2.
  • the catheter 9 may or may not be in the stomach 2 and/or the duodenum 37 when the catheter 9 is in a deployed configuration.
  • Figures 49b-49d and 49f-49h illustrate that the catheter 9 can be in the stomach 2 in a deployed configuration (e.g., the configurations 116b-l 16d and 116f- 116h) and
  • Figure 49e illustrates that the catheter 9 can be in the stomach 2 and the duodenum 37 when the catheter is in a deployed configuration (e.g., the configuration 116e).
  • Figures 49b-49h illustrate that the catheter 9 can form a deployed configuration by inserting the catheter 9 into the stomach 2, by inserting the catheter 9 into the duodenum 37, by the catheter 9 migrating out of the stomach 2 through the pylorus 65 and into the duodenum 37 via the natural stomach motility and/or peristalsis, by withdrawing the catheter 9 from the stomach 2, by withdrawing the catheter 9 from the duodenum 37, or any combination thereof.
  • FIG. 49e illustrates that when the catheter 9 is in a deployed configuration (e.g., a configuration 116), zero, one, or more sections of the catheter 9 can be in the stomach 2 and zero, one, or more sections of the catheter 9 can be in the duodenum 37.
  • Figure 49e illustrates that when the catheter 9 is in a deployed configuration (e.g., configuration 1 16e), a first section of the catheter 9 (e.g., section el -e2) can be in the stomach 2, a second section of the catheter 9 (e.g., section e2-e3) can be in the duodenum 37, and a third section of the catheter 9 (e.g., section e3-e4) can be in the stomach 2.
  • a deployed configuration e.g., configuration 1 16e
  • a first section of the catheter 9 e.g., section el -e2
  • a second section of the catheter 9 e.g., section e2-e3
  • the second section of the catheter 9 can enter the duodenum 37 by forcing the second section of the catheter 9 to enter the duodenum 37 (e.g., by inserting the catheter 9 into the stomach 2), by the natural stomach motility and/or peristalsis urging and/or forcing the second section of the catheter 9 to enter the duodenum 37, or any combination thereof.
  • Figures 49d-49e illustrate that the second section of the catheter 9 can enter the duodenum 37 by the natural stomach motility and/or peristalsis urging and/or forcing the second section of the catheter 9 into the duodenum 37 through the pylorus 65.
  • Figure 49c illustrates that the second section of the catheter 9 can be between the first section and the second section of the catheter 9 along the length of the catheter 9.
  • Figure 49e illustrates, for example, that when the catheter 9 is in a straight configuration, the first section of the catheter 9 can be distal the second section and the third section of the catheter 9 and that the second section of the catheter 9 can be distal the first section of the catheter 9.
  • Figure 49e illustrates that when the catheter 9 is in the configuration 116e, the first section of the catheter 9 can be closer to the pancreas 1 than the third section of the catheter 9 and that the third section of the catheter 9 can be closer to the gastroesophageal junction 120 than the first section of the catheter 9 or vice versa.
  • Figure 49e illustrates that the loop 118 (e.g., the first loop 118a) can be formed by section el- 64 of the of the catheter 9.
  • Figure 49e illustrates, for example, that the first loop 118a can be in the stomach 2 and the duodenum 37.
  • Figure 49e illustrates that the loop head can be in the duodenum 37 and that the loop base can be in the stomach 2.
  • Figure 49e illustrates that the cell 122 (e.g., the first cell 122a) can be in the stomach 2 and the duodenum 37.
  • the length of section el-e4 of the catheter 9 can be, for example, the length 126.
  • Figure 49e illustrates that the length 126 can be, for example, 50cm-120cm (e.g., 80cm).
  • Figures 49d-49e illustrate that the size (e.g., the perimeter) of the first loop 118a can be larger when the catheter 9 is in the fifth configuration 116e than when the catheter 9 is in the fourth configuration 116d.
  • Figure 49e illustrates that a first gap can be between section el-e2 and section e3-e4 in the stomach 2, that a second gap can be between a first end of the second section e2-e3 (e.g., the end closer to point e2) and a second end of the second section e2-e3 (e.g., the end closer to point e3) in the duodenum 37, and that the second gap can be less than the first gap.
  • the second gap can be, for example, at least 1cm- 10cm less than the first gap, including every 1cm increment within this range (e.g., at least 1cm, at least 5cm, at least 10cm).
  • Figure 49e illustrates that the second gap can be at least 4cm less than the first gap.
  • Figures 49d-49e illustrate that a middle portion of the catheter 9 between points el and e4 can enter the duodenum 37 while the catheter tip 7 and/or the proboscis 97 are in the stomach 2.
  • reference points el-e4 are provided to assist in the identification of the first, second, and third sections of the catheter 9.
  • the first, second, and third sections of the catheter 9 e.g., sections el-e2, e2-e3, and e3-e4
  • Figure 49e illustrates that section el-e2 can be integral with section e2-e3, that section e2-e3 can be integral with section e3-e4, and that section e3-e4 can be integral with the portion of the catheter 9 in the esophagus 5.
  • Figure 49e illustrates that the first, second, and third sections of the catheter 9 can be sections of a single length of the catheter 9 (e.g., sections of the total length 124 of the catheter 9).
  • Reference point el can mark, for example, the distal terminal end of the catheter 9, the distal terminal end of the proboscis 97, the distal terminal end of the heat transfer region 128, or any combination thereof.
  • Reference point e2 can mark, for example, a first location that the catheter 9 passes through the pylorus 65.
  • Reference point e3 can mark, for example, a second location that the catheter 9 passes through the pylorus 65.
  • Reference point e4 can mark, for example, the location that catheter 9 enters the target site 147 (e.g., the stomach 2).
  • the length 126 of the catheter 9 in the stomach 2 can be, for example, at least 20cm-300cm, including every 1cm increment within this range (e.g., at least 30cm, at least 40cm, at least 50cm, at least 60cm, at least 70cm, at least 80cm, at least 90cm, at least 100cm).
  • Figure 49e illustrates that when the catheter 9 is in the duodenum 37, the length 126 of the catheter 9 in the stomach 2 can be at least 50cm.
  • the length 126 of the catheter 9 in the stomach 2 can be, for example, 20cm-300cm or more, including every 1cm increment within this range (e.g., 20cm, 50cm, 100cm, 150cm, 300cm).
  • Figure 49e illustrates that when the catheter 9 is in the duodenum 37, the length 126 of the catheter 9 in the stomach 2 can be 55cm.
  • Figure 49e illustrates that the length 126 of the catheter 9 in the stomach 2 can be, for example, the length of section el-e2 and section e3-e4.
  • the length 126 of the catheter 9 in the duodenum 37 can be, for example, lcm-80cm or more, including every 1cm increment within this range (e.g., 1cm, 10cm, 30cm, 50cm, 80cm).
  • Figure 49e illustrates that when the catheter 9 is in the duodenum 37, the length 126 of the catheter 9 in the duodenum 37 can be 25cm.
  • Figure 49e illustrates that the length 126 of the catheter 9 in the duodenum 37 can be, for example, the length of section e2-e3.
  • the length 126 of the catheter 9 in the stomach 2 can be, for example, 40cm-300cm greater than the length 126 of the catheter 9 in the duodenum 37, including every 1cm increment within this range (e.g., 40cm, 50cm, 60cm, 100cm, 200cm, 300cm).
  • Figures 49a-49i illustrate that the catheter 9 can extend across the target site 147 multiple times, for example, a first time proximally to distally from the stomach into the duodenum 37 and a second distally to proximally from the duodenum 37 into the stomach 2.
  • Figure 49e illustrates that the catheter 9 can have undulations along the length of the catheter 9 when the catheter 9 is in a deployed configuration.
  • Figure 49e illustrates that the undulations can be, for example, bends in the catheter 9.
  • the undulations can have, for example, a sinusoidal pattern, a serpentine pattern, a zig-zag pattern, or any combination thereof.
  • Figures 49e-49f illustrate that the undulations can straighten as the catheter 9 is withdrawn from the body.
  • Figures 50a-50i illustrate that the catheter 9 can be inserted into and/or removed from the stomach 2 and/or the duodenum 37.
  • Figures 50a-50i illustrate, for example, that the target site 147 can be the stomach 2 and the duodenum 37.
  • Figures 50a-50i illustrate that various lengths of the catheter 9 (e.g., the length 126 shown in Figures 50b-50h) can be introduced into and/or removed from the stomach 2 and/or the duodenum 37.
  • Figures 50a-50i illustrate various configurations 116 and shapes 117 that the catheter 9 can have.
  • Figures 50a-50i illustrate, for example, that when the catheter 9 is in a first through a ninth configuration 116a-l 16i, the catheter 9 can have the first through the ninth shape 117a-l 17i, respectively.
  • the catheter 9 can, for example, be releasably anchored and/or releasably engaged to the duodenum wall 136 via the catheter tip 7 via friction between the catheter tip 7 and the duodenum wall 136, via the catheter tip 7 being wedged between two duodenal folds (e.g., between two adjacent duodenal folds), or any combination thereof.
  • the catheter 9 can be unanchored and/or disengaged from the duodenum wall 136, for example, by moving (e.g., pulling) the catheter tip 7 away from the duodenum wall 136 by withdrawing the catheter 9 from the duodenum 37 as shown by arrow 114.
  • FIGs 50a-50b illustrate that as the catheter 9 is introduced into the duodenum 37, the catheter tip 7 can become engaged with (e.g., can be moved into contact with) the duodenum wall 136.
  • the catheter tip 7 can remain engaged with (e.g., can remain in contact with) the duodenum wall 136, can disengage from (e.g., can move out of contact with) the duodenum wall 136, can re-engage with the duodenum wall 136, or any combination thereof while the catheter 9 is advanced into the stomach 2, while the catheter 9 is withdrawn from the stomach 2, while the catheter 9 is inserted into the duodenum 37, while the catheter 9 is withdrawn from the duodenum, while the catheter 9 migrates in the stomach 2 and/or in the duodenum 37, or any combination thereof.
  • the catheter tip 7 can move and/or remain in a fixed position relative to the duodenum wall 136 as the catheter 9 moves in the stomach 2 and/or in the duodenum 37, for example, during insertion, withdrawal, and/or migration of the catheter 9.
  • the catheter tip 7 can, for example, move and/or remain in a fixed position relative to the duodenum wall 136 while the catheter 9 is advanced into the stomach 2, while the catheter 9 is forced into and/or migrates into the duodenum 37, while the catheter 9 is withdrawn from the stomach 2, while the catheter 9 is withdrawn from the duodenum 37, or any combination thereof.
  • Figures 50b-50h illustrate that the catheter tip 7 can remain in a fixed position relative to the duodenum wall 136 while the catheter 9 is advanced into the stomach 2, while the catheter 9 is inserted into the duodenum 37, while the catheter 9 is withdrawn from the stomach 2, and while the catheter 9 is withdrawn from the duodenum 37.
  • the catheter tip 7 can move 0.00-5.0cm or more away from the engaged position (e.g., the engaged position shown in Figure 50b) in any direction along the duodenum wall 136, in any direction away from the duodenum wall 136 (e.g., perpendicularly away), in any direction toward the duodenum wall 136 (e.g., perpendicularly toward), or any combination thereof while the catheter 9 is advanced into the stomach 2, while the catheter 9 is forced into and/or migrates into the duodenum 37, while the catheter 9 is withdrawn from the stomach 2, while the catheter 9 is withdrawn from the duodenum 37, or any combination thereof, including every 0.1cm increment within this range (e.g., 0.0cm, 0.1cm, 1.0cm, 2.0cm, 3.0cm, 5.0cm).
  • a 0.0cm movement of the catheter tip 7 can correspond to the catheter tip 7 remaining stationary relative to the duodenum wall 136.
  • Figures 50b-50h illustrate that the catheter tip 7 can remain in the same location (e.g., 0.0cm movement) relative to the duodenum wall 136 while the catheter 9 is advanced into the stomach 2, while the catheter 9 is forced into and/or migrates into the duodenum 37, while the catheter 9 is withdrawn from the stomach 2, while the catheter 9 is withdrawn from the duodenum 37, or any combination thereof.
  • Figures 50h-50i illustrate that the catheter 9 can become disengaged from (e.g., can be moved out of contact with) the duodenum wall 136.
  • Figures 50h-50i illustrate, for example, that the catheter tip 7 can be disengaged from the duodenum wall 136 by withdrawing the catheter 9 from the stomach 2. Withdrawing the catheter 9 from the stomach 2 can, for example, include pulling the catheter tip 7 away from the duodenum wall 136 toward the gastroesophageal junction 120.
  • the proboscis 97 and/or the catheter tip 7 may or may not pivot on the duodenum wall 136 once the proboscis 97 and/or the catheter tip 7 contacts the duodenum wall 136.
  • Figures 50b-50c illustrate that the catheter tip 7 can pivot on the duodenum wall 136 when the catheter tip 7 is in contact with the duodenum wall 136 during insertion
  • Figures 50g-50h illustrate that the catheter tip 7 can pivot on the duodenum wall 136 when the catheter tip 7 is in contact with the duodenum wall 136 during withdrawal.
  • the catheter tip 7 may or may not be forced into (e.g., pressed into) contact with the duodenum wall 1 6 during insertion of the catheter 9 into the stomach 2.
  • Figures 50a- 50b illustrate that the catheter tip 7 can be forced into the duodenum wall 136 during insertion of the catheter 9 into the stomach 2.
  • the catheter tip 7 can inhibit and/or prevent the catheter tip 7 from tunneling into and/or through the duodenum wall 136, for example, by the catheter 9 bending and/or the catheter tip 7 pivoting on the duodenum wall 136 as shown Figures 50b-50c.
  • Figures 50b-50c illustrate that the catheter tip 7 can be flexible and/or can be a flexible tip that can deform (e.g., bend) when pushed into the duodenum wall 136.
  • the catheter 9 can enter the duodenum 37 before, during, and/or after the catheter tip 7 and/or the proboscis 97 enters the duodenum 37.
  • Figures 50a-50b illustrate that the catheter tip 7 can enter the duodenum 37 before the body of the catheter 9 (e.g., the body of the catheter 9 can be, for example, the portion of the catheter 9 proximal the catheter tip 7).
  • Figures 50a-50e illustrate, for example, that the catheter 9 can enter the duodenum 37 after the catheter tip 7 enters the duodenum 37.
  • Figures 50a-50e illustrate, for example, that the catheter 9 can enter the duodenum 37 when the catheter tip 7 is in the duodenum 37.
  • the catheter 9 can enter the duodenum 37 while the catheter tip 7 and/or the proboscis 97 are engaged with the duodenum wall 136 (e.g., when the catheter tip 7 and/or the proboscis 97 is in contact with the stomach wall 108) and/or while the catheter tip 7 and/or proboscis 97 are disengaged from the stomach wall 108 (e.g., when the catheter tip 7 and/or the proboscis 97 is not in contact with the stomach wall 108).
  • Figures 50a-50e illustrate that the catheter 9 can enter the duodenum 37 while the catheter tip 7 is engaged with (e.g., in contact with) the duodenum wall 136.
  • the catheter tip 7 may or may not remain in the duodenum 37 during insertion and/or migration of the catheter 9.
  • Figures 50a-50e illustrate that the catheter tip 7 can remain in the duodenum 37 during insertion and/or migration of the catheter 9.
  • the catheter tip 7 and/or the proboscis 97 can enter the duodenum 37 when any length of the catheter 9 is in the stomach 2.
  • the catheter tip 7 and/or the proboscis 97 can enter the duodenum 37 when at least 10cm-150cm or more of the catheter 9 is in the stomach 2, including every 1cm increment within this range (e.g., at least 10cm, at least 30cm, at least 40cm, at least 70cm, at least 100cm).
  • the catheter 9 can be withdrawn from the duodenum 37 before, during, and/or after the catheter tip 7 and/or the proboscis 97 becomes engaged with the duodenum wall 136.
  • Figures 50e-50i illustrate that the catheter 9 can be withdrawn from the duodenum 37 after the catheter tip 7 is pushed into engagement with (e.g., into contact with) the duodenum wall 136.
  • Figures 50b-50h illustrate that when the catheter 9 is in the duodenum 37, the catheter tip 7 can be in the duodenum 37. [0399] Figures 50b-50h illustrate that the catheter 9 can be in the stomach 2 and the duodenum 37 when the catheter is in a deployed configuration (e.g., the configurations 116b-l 16h).
  • Figures 50b-50h illustrate that the catheter 9 can form a deployed configuration by inserting the catheter 9 into the stomach 2, by inserting the catheter 9 into the duodenum 37, by withdrawing the catheter 9 from the stomach 2, by withdrawing the catheter 9 from the duodenum 37, or any combination thereof.
  • Figures 50b-50h illustrate that when the catheter 9 is in a deployed configuration (e.g., configurations 116b-l 16h), a first section of the catheter 9 can be in the duodenum 37 (e.g., the portion of the catheter 9 distal the pylorus 65) and a second section of the catheter 9 can be in the stomach 2 (e.g., the portion of the catheter proximal the pylorus 65).
  • the portion of the catheter 9 distal the pylorus 65 can be forced into the duodenum 37 and/or can migrate into the duodenum 37.
  • Figures 50a-50e illustrate that the portion of the catheter 9 distal the pylorus 65 can be forced into the duodenum 37 by inserting the catheter 9 into the stomach 2.
  • Figures 50a-50i illustrate that the catheter 9 can form the loops 118 and cells 122 shown, for example, as the catheter 9 is inserted into and/or withdrawn from the target site 147.
  • Figures 50b-50h illustrate that the loops 118 can be open loops.
  • Figures 50a-50i illustrate that the target site 147 can be, for example, the stomach 2 and the duodenum 37.
  • Figure 50c illustrates that a loop 118 (e.g., the third loop 118c) can be in the duodenum 37.
  • Figures 50b-50c illustrate that the catheter 9 can form the third loop 118c as the catheter 9 is inserted into the stomach 2 and the duodenum 37.
  • Figures 50b-50c illustrate that the third loop 118c can be formed in the duodenum 37.
  • Figures 50b-50c illustrate that when the catheter tip 7 is in the duodenum 37, the third loop 118c can be formed in the duodenum 37, for example, by advancing the catheter 9 into the duodenum 37 as shown by arrow 112.
  • Figure 50c illustrates that the third loop first end, third loop second end, and the third loop head can be in the duodenum 37.
  • Figures 50b-50c illustrate that when the catheter tip 7 is engaged with the duodenum wall 136 (e.g., to a Kerckring rold) and the catheter 9 continues to be inserted into the stomach 2 as shown by arrow 112, a section of the catheter 9 proximal the catheter tip 7 can be advanced past (e.g., distal, caudal) the catheter tip 7, for example, as the catheter tip 7 pivots against the duodenum wall 136.
  • Figure 50c illustrates that the section of the catheter 9 advanced past the catheter tip 7 can be the third loop 118c.
  • the perimeters of the loops 118 can increase, decrease, and/or remain constant as the catheter 9 is inserted into the target site 147.
  • Figures 50h-50c illustrate that the size (e.g., the perimeter) of the first loop 118a can be smaller when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figures 50b-50c illustrate that the size (e.g., the perimeter) of the second loop 118b can be larger when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figures 50b-50c illustrate that less of the catheter 9 can be in the stomach 2 when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figures 50b-50c illustrate that as the catheter 9 is inserted into the duodenum 37, Icm-lOcm or more of the catheter 9, including every 1cm increment within this range (e.g., 1cm, 5cm, 10cm) can move out of the stomach 2 through the pylorus 65.
  • Figures 50b-50c illustrate that the size (e.g., the area) of the second cell 122b can be larger when the catheter 9 is in the third configuration 116c than when the catheter 9 is in the second configuration 116b.
  • Figures 50d-50e illustrate that the catheter 9 can form the fourth loop 118d as the catheter 9 is inserted into the stomach 2 and the duodenum 37.
  • Figures 50d-50e illustrate that the fourth loop 118d can be formed in the stomach 2.
  • Figures 50d-50e illustrate that when the catheter tip 7 is in the duodenum 37, the fourth loop 118d can be formed in the stomach 2, for example, by advancing the catheter 9 into the stomach 2 as shown by arrow 112.
  • Figure 50d illustrates that the fourth loop first end, fourth loop second end, and the fourth loop head can be in the stomach 2.
  • Figures 50d-50e illustrate that the size (e.g., the perimeter) of the first loop 118a can be smaller when the catheter 9 is in the fifth configuration 116e than when the catheter 9 is in the fourth configuration 116d.
  • Figures 50d-50e illustrate that the size (e.g., the perimeter) of the second loop 118b and the third loop 118c can be larger when the catheter 9 is in the fifth configuration 116e than when the catheter 9 is in the fourth configuration 116d.
  • the third loop 118c can wedge the catheter 9 into the duodenum 37, can inhibit and/or prevent the portion of the catheter 9 in the duodenum 37 from migrating further into the duodenum 37, can inhibit or prevent the portion of the catheter 9 in the stomach 2 from migrating into the duodenum 37, can inhibit or prevent more of the catheter 9 from being inserted into the duodenum 37, or any combination thereof.
  • Figures 50c-50e illustrate that the third loop 118c can inhibit (e.g., can start to inhibit) more of the catheter 9 from being inserted into the duodenum 37, which is shown, for example, by more of the catheter 9 being inserted into the stomach 2 than in the duodenum 37 in Figures 50c-50e.
  • Figures 50b and 50h illustrate that when the catheter 9 is in the second configuration 116b and the eighth configuration 118h, the portion of the length 126 of the catheter 9 in the stomach 2 can be, for example, 10cm-30cm (e.g., 20cm) and the portion of the length 126 of the catheter 9 in the duodenum 37 can be, for example, lcm-20cm (e.g., 10cm).
  • Figures 50e-50f illustrate that as the length of the catheter 9 in the stomach 2 is decreased, the length of the catheter 9 in the duodenum can simultaneously decrease.
  • the catheter 9 can transfer heat to and/or from surrounding tissue when the catheter 9 is in the stomach 2, in the duodenum 37, and/or in the intestine caudal the duodenum 37.
  • Figures 50b-50h illustrate that the catheter 9 can transfer heat to and/or from the stomach 2 and the duodenum 37.
  • Figures 50a-50i illustrate that the catheter 9 may not have the proboscis 97.
  • the catheter 9 in Figures 50a-50i can have the proboscis 97.
  • Figures 50a-50e illustrate that the second loop 118b can be formed after the first loop 118a is formed, that the third loop 118b can be formed after the first loop 118a and/or the second loop 118b are formed and that the fourth loop 118d can be formed after the first loop 118a, the second loop 118b, and/or the third loop 118c are formed.
  • the other loops 118 can change size and/or shape.
  • Figures 50a-50e illustrate, for example, that already formed loops 118 can change size and/or shape while one more other loops 118 are formed.
  • the second phase of loop formation can be after the first phase of loop formation.
  • the third phase of loop formation can be after the second phase of loop formation.
  • the fourth phase of loop formation can be after the second phase of loop formation. While the third loop 118c is being formed (e.g., during the third phase of loop formation), the first loop 118a and/or the second loop 118b can have a constant size and/or shape.
  • Figures 50b-50e illustrate that while the third loop 118c is being formed (e.g., during the third phase of loop formation), the size (e.g., perimeter) of the first loop 118a and/or the second loop 118b can increase and/or decrease, the shape of the first loop 118a and/or the second loop 118b can change, or any combination thereof. While the fourth loop 118d is being formed (e.g., during the fourth phase of loop formation), the first loop 118a, the second loop 118b, and/or the third loop 118c can have a constant size and/or shape.
  • Figures 50d-50e illustrate that while the fourth loop 118d is being formed (e.g., during the fourth phase of loop formation), the size (e.g., perimeter) of the first loop 118a, the second loop 118b, and/or the third loop 118c can increase and/or decrease, the shape of the first ioop 118a, the second loop 118b, and/or the third loop 118c can change, or any combination thereof.
  • the size e.g., perimeter
  • the shape of the first ioop 118a, the second loop 118b, and/or the third loop 118c can change, or any combination thereof.
  • Figures 50e-50i illustrate that the catheter 9 can be withdrawn from the target site 147.
  • Figures 50e-50i illustrate that the loops 118 can be collapsed in and/or removed from the target site 147.
  • Figures 50e-50i illustrate that collapsing the loops 1 18 can include straightening the loop 1 18, decreasing the curve of a loop, decreasing the perimeter of the loop 118, decreasing the loop length of the loops 118, decreasing the width of the loops 118, decreasing the height of the loops 118, or any combination thereof.
  • Figures 50e-50i illustrate that the loops 118 can be collapsed in the target site 147 by withdrawing the catheter 9 from the target site 147 as shown by arrow 114.
  • Figures 50e-50i illustrate, for example, that the catheter 9 can straighten and/or become less curved in the target site 147 as the catheter 9 is withdrawn (e.g., pulled) from the target site 147 into the esophagus 5 as shown by arrow 114.
  • the loops 118 can be collapsed in and/or removed from the target site 147 in any order, for example, sequentially and/or simultaneously.
  • Figures 50e-50i illustrate that the first loop 118a, the second loop 118b, the third loop 118c, and the fourth loop 118d can be collapsed from the target site 147 in the order shown.
  • Figures 50e-50i illustrate, for example, that the fourth loop 118d can be collapsed, then the first loop 118a can be collapsed a first time, then the third loop 118c can be collapsed, then the second loop 118b can be collapsed, and then the first loop 118a can be collapsed a second time.
  • Figures 50e-50f illustrate that as the fourth loop 118d is collapsing (e.g., decreasing in size) the first loop 118a can increase in size and/or the third loop 118c can decrease in size.
  • Figures 50f-50g illustrate that as the first loop 118a is collapsing (e.g., decreasing in size) the third loop 118c can have a constant size and/or shape.
  • Figures 50g-50i illustrate that the third loop 118c can be collapsed, then the second loop 118b can be collapsed, and then the first loop 118a can be collapsed by withdrawing the catheter 9 from the target site 147 as shown by arrow 114.
  • Figures 5 la-5 Id illustrate that the catheter 9 can be inserted into and/or removed from the stomach 2.
  • Figures 51a-51d illustrate that the catheter 9 can be inserted into the stomach 2 as shown by arrow 112 and Figures 51d-51a illustrate that the catheter 9 can be withdrawn from the stomach 2 as shown by arrow 114.
  • Figures 51a-51d illustrate that various lengths of the catheter 9 (e.g., the length 126 shown in Figures 51b-51d) can be introduced into and/or removed from the stomach 2.
  • Figures 51a-51d illustrate various configurations 116 and shapes 117 that the catheter 9 can have.
  • Figures 51 a-5 Id illustrate, for example, that when the catheter 9 is in a first through a fourth configuration 116a- 116d, the catheter 9 can have the first through the fourth shape 117a-l 17d, respectively.
  • Figures 5 la-51d illustrate that the catheter 9 can form the coil 138 in the target site 147 by forming bends, forming loops (e.g., loops 118), folding over itself, crossing over and/or under itself, contacting itself, extending longitudinally across the target site 147, extending transversely across the target site 147, extending vertically across the target site 147, extending anteriorly across the target site 147, extending posteriorly across the target site 147, extending superiorly across the target site 147, extending inferiorly across the target site 147, extending proximally across the target site 147, extending distally across the target site 147, winding back and forth in multiple directions through the target site 147, extending around the target site 147, undulating (e.g., zigzagging) across the target site 147, or any combination thereof as the catheter 9 is inserted into the target site 147.
  • loops e.g., loops 118
  • Figures 51a-51d illustrate, for example, that as the catheter 9 is inserted into the target site 147, the catheter 9 can engage with, can be pushed against, and/or can be constrained by a wall of the target site 147 (e.g., the stomach wall 108) which can, for example, cause the catheter 9 to assemble into the coil 138 in the target site 147.
  • Figures 51a-51d illustrate, for example, that the coil 138 can become progressively more complex and/or dense as the catheter 9 is inserted into the stomach 2.
  • Figures 5 la-5 Id illustrate that when the catheter 9 is in a straight configuration, the portion of the catheter 9 that forms the coil 138 can be straight.
  • Figures 51d-51a illustrate that the catheter 9 can be withdrawn (e.g., pulled) from the coil 138 inside the target site 147, for example, by withdrawing the catheter 9 from the target site 147 as shown by arrow 114.
  • Figures 51d-51a illustrate, for example, that the coil 138 can be uncoiled in the target site 147, for example, by withdrawing the catheter 9 from the target site 147 as shown by arrow 114.
  • the catheter 9 can be withdrawn from an exterior of the coil 138 and/or from an interior of the coil 138. For example, withdrawing a section of catheter on the exterior of the coil 138 and/or on the interior of the coil 138 can uncoil the coil 138.
  • Figures 51a -5 Id illustrate a first axis Al, a second axis A2, and a third axis A3 that can intersect each other, for example, in the center of the target site 147.
  • Figures 5 la-5 Id illustrate, for example, that the point at which the first axis Al, the second axis A2, and the third axis A3 intersect can be closer to the lesser curvature 21c of the stomach 2 than to the greater curvature 2gc of the stomach 2.
  • Figures 51a-51d illustrate that the first axis Al, the second axis A2, and the third axis A3 can be orthogonal to each other.
  • Figures 5 la-5 Id illustrate that the first axis Al, the second axis A2, and the third axis A3 can be straight axes. As another example, one or more of the first axis Al, the second axis A2, and the third axis A3 can be a curved axis. Figures 5 la-5 Id illustrate, for example, that the first axis Al, the second axis A2, and the third axis A3 can be a longitudinal axis, a transverse axis, and a vertical axis, respectively.
  • Figures 5 la-5 Id illustrate, for example, that the first axis Al can pass through the fundus 2f, the stomach body 2b, and the antrum 2a.
  • Figures 5 la-5 Id illustrate, for example, that the second axis A2 can pass through the greater curvature 2gc of the stomach 2, the stomach body 2b, and the lesser curvature 21c of the stomach 2.
  • Figures 51 a-51d illustrate that the greater curvature 2gc can be the length along the border of the stomach 2 and/or the pyloric region from point 2pl to point 2p2.
  • Figures 5 la-5 Id illustrate that the lesser curvature 21c can be the length along the border of the stomach 2 and/or the pyloric region from point 2p3 to point 2p4.
  • the greater curvature 2gc can be, for example, 19.0cm-36.0cm, including every 0.1cm increment within this range (e.g., 19.0cm, 22.2cm, 25.3cm, 26.0cm, 31.0cm, 34.0cm, 36.0cm).
  • the lesser curvature 21c can be, for example, 13.0cm-19.5cm, including every 0.1cm increment within this range (e.g., 13.0cm, 16.3cm, 19.3cm, 19.5cm).
  • Figures 51a-51d illustrate, for example, that the third axis A3 can pass through a posterior wall 2pw of the stomach 2, the stomach body 2b, and an anterior wall 2aw of the stomach 2 (shown transparent).
  • Figures 5 la-5 Id illustrate that the first axis Al can extend proximally to distally through the stomach 2, for example, from the fundus 2f toward the antrum 2a and vice versa, for example, distally to proximally through the stomach 2, for example, from the antrum 2a toward the fundus 2f.
  • a distal position in the stomach 2 can be, for example, closer to the pylorus 65 and/or the duodenum 37 than a proximal position in the stomach 2.
  • Figures 5 la-5 Id illustrate that the second axis A2 can extend laterally through the stomach 2, for example, from the side of the stomach 2 having the greater curvature 2gc toward the side of the stomach 2 having the lesser curvature 21c and vice versa, for example, from the side of the stomach 2 having the lesser curvature 21c to the side of the stomach 2 having the greater curvature 2gc.
  • Figures 5 la-5 Id illustrate that the third axis A3 can extend posteriorly to anteriorly through the stomach 2, for example, from the posterior wall 2pw toward the anterior wall 2aw and vice versa, for example, anteriorly to posteriorly through the stomach 2 from the anterior wall 2aw toward the posterior wall 2pw.
  • Figures 5 la-5 Id illustrate, for example, that the first axis Al can separate the stomach 2 into a first lateral side LSI and a second lateral side LS2 opposite the first lateral side LSI .
  • Figures 5 la-5 Id illustrate, for example, that the second axis A2 can separate the stomach 2 into a first longitudinal end LEI and a second longitudinal end LE2 opposite the first longitudinal end LEI.
  • Figures 5 la-5 Id illustrate, for example, the second axis A2 can separate the stomach 2 into a posterior side PS and an anterior side AS (shown transparent in Figures 5 la-5 Id).
  • Figures 5 la-5 Id illustrate that a flat plane that extends through the first axis Al and the second axis A2 can separate the stomach 2 into the posterior side PS and the anterior side AS (shown transparent in Figures 5 la-5 Id).
  • the portion of the catheter 9 that forms the coil 138 can extend back and forth across target site 147 in multiple directions, for example, longitudinally back and forth across the target site 147 along the first axis Al, transversely (e.g., laterally) back and forth across the target site 147 along the second axis A2, vertically back and forth across the target site 147 along the third axis A3, or any combination thereof.
  • Figures 5 la-5 Id illustrate that the catheter 9 that defines the coil 138 can extend back and forth across target site 147 in multiple directions, for example, longitudinally back and forth across the target site 147 from the first longitudinal end LEI to the second longitudinal end LE2 and from the longitudinal end LE2 to the first longitudinal end LEI, transversely (e.g., laterally) back and forth across the target site 147 from the first lateral side LSI to the second lateral side LS2 and from the second lateral side LS2 to the first lateral side LSI, and vertically back and forth across the target site 147 from the posterior side PS to the anterior side AS and from the anterior side AS to the posterior side PS.
  • Figures 51a-5 Id illustrate, for example, that the catheter 9 can extend superiorly, inferiorly, proximally, distally, laterally, anteriorly, and/or posteriorly across the target site 147, for example, along the first axis Al, the second axis A2, and/or the third axis A3.
  • Figures 5 la-5 Id illustrate, for example, that the catheter 9 can wind back and forth in multiple directions through the target site 147, can extend around the target site 147, can undulate (e.g., zigzag) across the target site 147, can extend through an interior of the coil 138, can define an exterior surface of the coil 138, or any combination thereof.
  • the coil 138 can have a coil first longitudinal end and a coil second longitudinal end.
  • Figures 5 la-5 Id illustrate that the coil first longitudinal end can be the portion of the coil 138 in the first longitudinal end LEI of the stomach 2 and that the coil second longitudinal end can be the portion of the coil 138 in the second longitudinal end LE2 of the stomach 2, in the pylorus 65, and/or in the duodenum 37.
  • the coil first longitudinal end can be opposite the coil second longitudinal end.
  • the coil first longitudinal end can be the coil proximal end and the coil second longitudinal end can be the coil distal end.
  • the coil proximal terminal end can be, for example, the portion of the catheter 9 that is farthest from the second axis A2 in the first longitudinal end LEI of the stomach 2
  • the coil distal terminal end can be, for example, the portion of the catheter 9 that is farthest from the second axis A2 in the second in the second longitudinal end LE2 of the stomach 2, in the pylorus 65, and/or in the duodenum 37.
  • the coil 138 can have a coil first lateral side and a coil second lateral side.
  • Figures 5 la-5 Id illustrate that the coil first lateral side can be the portion of the coil 138 in the first lateral side LSI of the stomach 2, in the pylorus 65, and/or in the duodenum 37 and that the coil second lateral side can be the portion of the coil 138 in the second lateral side LS2 of the stomach 2 and/or in the duodenum 37.
  • the coil first lateral side can be opposite the coil second lateral side.
  • the coil first lateral side terminal end can be, for example, the portion of the catheter 9 that is farthest from the first axis Al in the first lateral side LSI of the stomach 2, in the pylorus 65, and/or in the duodenum 37
  • the coil second lateral side terminal end can be, for example, the portion of the catheter 9 that is farthest from the first axis Al in the second in the second lateral side LS2 of the stomach 2 and/or in the duodenum 37.
  • the coil 138 can have a coil posterior side and a coil anterior side.
  • Figures 51 a-51 d illustrate that the coil posterior side can be the portion of the coil 138 in the posterior side PS of the stomach 2 and that the coil anterior side can be the portion of the coil 138 in the anterior side AS of the stomach 2 and/or in the duodenum 37.
  • the coil posterior side can be opposite the coil anterior side.
  • a coil posterior side terminal end can be, for example, the portion of the catheter 9 that is farthest from the first axis Al in the posterior side PS of the stomach 2, in the pylorus 65, and/or in the duodenum 37
  • the coil anterior side terminal end can be, for example, the portion of the catheter 9 that is farthest from the first axis Al in the second in the anterior side AS of the stomach 2 and/or in the duodenum 37.
  • Figures 51a-51d illustrate that the coil length 138L can be measured, for example, along the first axis Al between the point on the catheter 9 that is farthest from the second axis A2 in the first longitudinal end LEI of the stomach 2 and the point on the catheter 9 that is farthest from the second axis A2 in the second longitudinal end LE2 of the stomach 2.
  • Figures 5 la-5 Id illustrate that the coil length 138L can be measured along the first axis Al between the coil proximal terminal end and the coil distal terminal end.
  • Figures 51a-51d illustrate that the coil height 138H can be measured, for example, along the third axis A3 between the point on the catheter 9 that is farthest from the first axis Al and/or the second axis A2 in the posterior side PS of the stomach 2 and the point on the catheter 9 that is farthest from the first axis Al and/or the second axis A2 in the anterior side AS of the stomach 2.
  • Figures 51a-51d illustrate that the coil height 138W can be measured along the third axis A3 between the coil posterior side terminal end and the coil anterior side terminal end.
  • Figures 51a-51d illustrate that the coil length 138L can be, for example, 3cm-50cm or more, including every 1cm increment within this range (e.g., 3cm, 4cm, 10cm, 20cm, 30cm, 50cm).
  • the coil length 138L can be greater than the stomach length 2L, for example, when the coil 138 is in the stomach 2 and in the duodenum 37.
  • Figures 5 la-5 Id illustrate that the coil width 138W can be, for example, 3cm-20cm or more, including every 1cm increment within this range (e.g., 3cm, 4cm, 10cm, 20cm).
  • the cross-sectional area of the outflow lumen can be, for example, 1.50mm 2 -20.00mm 2 , including every 0.01mm 2 increment within this range (e.g., 1.50mm 2 , 2.00mm 2 , 2.54mm 2 , 3.00mm 2 , 4.00mm 2 , 20.00mm 2 ).
  • Figures 5 la-5 Id illustrate that a posterior side of the coil 138 can contact the posterior side PS of the of the stomach 2 and that an anterior side of the coil 138 can contact the anterior side AS of the stomach 2.
  • Figures 52c-52d illustrate, for example, that the coil length 138L can be greater (e.g., 1cm- 10cm greater) when the catheter 9 is in the fourth configuration 116d than when the catheter 9 is in the third configuration 116c.
  • Figures 52c-52d illustrate, for example, that the coil width 138W can be greater (e.g., Icm-lOcm greater) when the catheter 9 is in the fourth configuration 116d than when the catheter 9 is in the third configuration 116c.
  • Figures 52c-52d illustrate, for example, that the coil height 138H can be the same when the catheter 9 is in the fourth configuration 116d as when the catheter 9 is in the third configuration 116c.
  • the stomach 2 can have a stomach length 2L, a stomach width 2W, and a stomach height 2H.
  • Figures 5 la-5 Id illustrates that the stomach length 2L, the stomach width 2W, and the stomach height 2H can be measured, for example, along the first axis Al, the second axis A2, and the third axis A3, respectively.
  • Figure 5 la-5 Id illustrate that the stomach width 2W can be measured, for example, along the second axis A2 between two points on the stomach wall 108 that the second axis A2 crosses (e.g., the first point along the lesser curvature 21c and the second point along the greater curvature 2gc shown in Figures 5 la-5 Id).
  • Figure 51 a-5 Id illustrate that the stomach height 2H can be measured, for example, along the third axis A3 between two points on the stomach wall 108 that the third axis A3 crosses (e.g., the first point on the posterior wall 2pw of the stomach 2 and a second point on the anterior wall 2aw of the stomach 2 (the second point is shown transparent).
  • the stomach 2 can have any size.
  • the stomach 2 can be, for example, an adult’s stomach.
  • Figures 5 la-5 Id illustrate, for example, that the stomach length 2L, the stomach width 2W, and the stomach height 2H can be 20cm, 10cm, and 10cm, respectively.
  • Figures 5 la-5 Id illustrate that the length of the catheter 9 that defines the coil 138 can be the length 126.
  • the length 126 of the catheter 9 can be greater than the lesser curvature 21c of the stomach 2, the greater curvature 2gc of the stomach 2, the stomach length 2L, the stomach width 2W, the stomach height 2H, or any combination thereof.
  • Figures 5 la-5 Id illustrate that the length 126 of the catheter 9 can be greater than the lesser curvature 21c of the stomach 2, the greater curvature 2gc of the stomach 2, the stomach length 2L, the stomach width 2W, and the stomach height 2H.
  • Figures 5 la-5 Id illustrate that the coil 138 can be assembled in the stomach 2, for example, by inserting the catheter 9 into the stomach 2 as shown by arrow 112 and/or Figures 5 ld-51a illustrate that the coil 138 can be disassembled in the stomach 2, for example, by withdrawing the catheter 9 from the stomach 2 as shown by arrow 114.
  • Figures 5 la-5 Id illustrate that the coil 138 can be formed in the stomach 2 by accumulating the catheter 9 in the stomach 2 by inserting the catheter 9 into the stomach 2 as shown by arrow 112.
  • Figures 5 la-5 Id illustrate that the catheter 9 can be packed into the target site 147 to form the coil 138 and/or Figures 51 d-51 a illustrate that the catheter 9 can be unpacked from the target site 147 to uncoil the coil 138.
  • the catheter 9 can be packed into the target site 147, for example, by inserting the catheter 9 into the target site 147.
  • the catheter 9 can be unpacked from the target site 147, for example, by withdrawing the catheter 9 from the target site 147.
  • Figures 51b-51d illustrates that the coil 138 can inhibit and/or prevent the catheter 9 from migrating into the pylorus 65 and/or into the duodenum 37.
  • the size of the coil 138 e.g., the coil length 138L, the coil width 138W, and/or the coil height 138H
  • Figures 51b-52d illustrate that the coil 138 can be too large to fit through the pylorus 65.
  • the coil width 138W and/or the coil height 138H can be, for example, 0.5cm-5.0cm or greater than the maximum dimension (e.g., height, width, and/or diameter) passable through the pylorus 65, for example, when the pylorus is fully open.
  • the width and/or height of a portion of the coil distal end can be, for example, 0.5cm-5.0cm or greater than the maximum dimension (e.g., height, width, and/or diameter) across the opening of the pylorus 65 when the pylorus is fully open.
  • friction between the coil 138 and the stomach wall 108 can inhibit and/or prevent the catheter 9 and/or the coil 138 from entering the pylorus 65 and/or the duodenum 37.
  • the coil 138 can, for example, wedge the catheter in the stomach 2 and/or in the pylorus 65, for example, via contact between the coil 138 and the stomach wall 108.
  • the stomach 2 can expand, contact, and/or remain the same size while the catheter 9 is inserted into and/or withdrawn from the stomach 2. Inserting the catheter 9 into the stomach 2 can, for example, expand the stomach 2 and/or withdrawing the catheter 9 from the stomach 2 can, for example, contract the stomach 2.
  • One or more dimensions of the stomach 2 can increase, decrease, and/or remain constant as the catheter 9 is inserted into and/or withdrawn from the stomach 2.
  • the stomach length 2L, the stomach width 2W, and/or the stomach height 2H can increase, decrease, and/or remain constant, as the catheter 9 is inserted into and/or withdrawn from the stomach 2.
  • Figures 5 la-5 Id and 5 ld-5 la illustrate, for example, that the stomach length 2L, the stomach width 2W, and the stomach height 2H can remain constant as the catheter 9 is inserted into the stomach 2 as shown by arrow 112 and as the catheter 9 is withdrawn from the stomach 2 as shown by arrow 114.
  • Figures 52a-52d illustrate, for example, that the stomach 2 can expand as the catheter 9 is inserted into the stomach 2 as shown by arrow 112 and that the stomach 2 can contract as the catheter 9 is withdrawn from the stomach 2 as shown by arrow 114.
  • the configurations 1 16 formed by the catheter 9 during withdrawal of the catheter 9 from the body can be the same as or different than the configurations 116 formed by the catheter 9 during insertion of the catheter 9 into the body.
  • Figures 5 la-5 Id and 5 ld-5 la illustrate, for example, that the configurations 116 formed by the catheter 9 during withdrawal can be the same as the configurations 116 formed by the catheter 9 during insertion.
  • the configurations 116 formed by the catheter 9 during withdrawal of the catheter 9 from the body can be different from the configurations 116 formed by the catheter 9 during insertion of the catheter 9 into the body.
  • the catheter 9 can be formed into the coil 138, for example, before, during, and/or after passing (e.g., pumping) a fluid through a lumen in the catheter 9.
  • the catheter 9 can be formed into the coil 138, for example, before, during, and/or after passing (e.g., pumping) a fluid through the first lumen 15 and/or the second lumen 16 in the catheter 9.
  • Figures 5 ld-51e4 illustrate, for example, that the natural motility and/or peristalsis of the stomach can rearrange the catheter 9 in the stomach 2.
  • Figure 51e4 illustrates, for example, that the arrangement of the catheter 9 that defines the coil 138 in the configuration 116 in Figure 51 e4 can be different than the arrangement of the catheter 9 that defines the coil 138 in the configuration 1 16 shown in Figure 51d.
  • Figures 51e5 and 51e6 illustrate that the coil 138 can increase in size as more catheter 9 is inserted into the stomach 2.
  • Figures 51d-51e5 illustrate 50cm more of the catheter 9 inserted into the stomach 2
  • Figures 51d-51e6 illustrate 100cm more of the catheter 9 inserted into the stomach 2.
  • Figures 51d-51e5 and 51d-51e6 illustrate that the coil 138 can become denser and/or more packed with the catheter 9 as more of the catheter 9 is inserted into the stomach 2.
  • Figure 5 Id illustrates, for example, that the length 126 can be 150cm.
  • Figure 51e5 illustrates, for example, that the length 126 can be 200cm.
  • Figures 51el-51e6 illustrate that the catheter 9 can be withdrawn (e.g., pulled) from the coil 138 inside the target site 147, for example, by withdrawing the catheter 9 from the target site 147 as shown by arrow 114.
  • Figures 52a -52d illustrate that inserting the catheter 9 into the target site 147 can expand the target site 147.
  • Figures 52a-52d illustrate that inserting the catheter 9 into the stomach 2 as shown by arrow 112 can expand the stomach 2.
  • Inserting the catheter 9 into the stomach 2 can, for example, increase the stomach length 2L, the stomach width 2W, the stomach height 2H, or any combination thereof by the catheter 9 exerting a force against the stomach wall 108 as the catheter 9 is inserted into the stomach 2.
  • Figures 52a-52d illustrate, for example, that forming the coil 138 in the target site 147 can expand the stomach 2 as the coil 138 increases in size.
  • Figures 52a-52b illustrate, for example, that the stomach width 2W and/or the stomach height 2H can increase as the catheter 9 is inserted into the stomach 2 and/or as the coil 138 is assembled in the stomach 2.
  • Figures 52a-52b illustrate, for example, that inserting the catheter 9 into the stomach 2 and/or forming the coil 138 in the stomach 128 can increase the stomach width 2W by at least 2.0cm and/or can increase the stomach height 2H by at least 1cm.
  • Zero, one, or more dimensions of the stomach 2 e.g., the stomach length 2L, the stomach width 2W, and/or the stomach height 2H
  • Figures 52a-52b illustrate that the stomach length 2L can remain constant while the catheter 9 is inserted into the stomach 2.
  • Figures 52c-52d illustrate that the stomach length 2L, the stomach width 2W, and the stomach height 2H can remain constant while the catheter 9 is inserted into the stomach 2.
  • Figures 52a-52d illustrate that the stomach length 2L can increase more than the stomach height 2H, for example, by 0.1cm-5.0cm or more than the stomach height 2H, including every 0.1cm increment within this range (e.g., 0.1cm, 1.0cm, 3.0cm, 5.0cm, 5.0cm).
  • Figures 52a-52d illustrate that the stomach 2 can have a first, second, third, and fourth stomach lengths 2L, respectively, and that the first, second, third, and fourth stomach lengths 2L can be equal to each other.
  • FIGs 52a-52c illustrate that the stomach 2 can have a first, second, third stomach, and fourth stomach widths 2W, respectively, that the first stomach width 2W (e.g., the stomach width 2W in Figure 52a) can be less than the second stomach width 2W (e.g., the stomach width 2W in Figure 52b), that the stomach second width 2W can be less than the stomach third width 2W (e.g., the stomach width 2W in Figure 53c), and that the stomach third width can be the same as the stomach fourth width 2W (e.g., the stomach width 2W in Figure 52d).
  • the first stomach width 2W e.g., the stomach width 2W in Figure 52a
  • the stomach width 2W e.g., the stomach width 2W in Figure 52b
  • the stomach second width 2W can be less than the stomach third width 2W (e.g., the stomach width 2W in Figure 53c)
  • the stomach third width can be the same as the stomach fourth width 2W (e.g., the stomach width 2
  • Figures 52d-52a illustrate that withdrawing the catheter 9 from the target site 147 can contract the target site 147.
  • Figures 52d-52a illustrate that withdrawing the catheter 9 from the stomach 2 as shown by arrow 114 can contract the stomach 2.
  • Withdrawing the catheter 9 from the stomach 2 can, for example, decrease the stomach length 2L, the stomach width 2W, the stomach height 2H, or any combination thereof by reducing the force that the catheter 9 exerts against the stomach wall 108 and/or by reducing the size of the coil 138 in the stomach 2 as the catheter 9 is withdrawn from the stomach 2.
  • Figures 52d-52a illustrate, for example, that disassembling the coil 138 in the target site 147 can contract the stomach 2 as the coil 138 decreases in size.
  • the stomach length 2L can decrease as the coil length 138L decreases
  • the stomach width 2W can decrease as the coil width 138W decreases
  • the stomach height 2H can decrease as the coil height 138H decreases, or any combination thereof.
  • Withdrawing the catheter 9 from the stomach 2 can, for example, decrease the stomach length 2L by O.lcm-lO.Ocm, decrease the stomach width 2W by O.lcm-lO.Ocm, decrease the stomach height 2H by O.lcm-lO.Ocm, or any combination thereof, including every 0.1cm increment within these ranges (e.g., 0.1cm, 1.0cm, 3.0cm, 5.0cm, 10.0cm).
  • Withdrawing the catheter 9 from the stomach 2 can, for example, decrease the stomach length 2L by at least O.lcm-lO.Ocm, decrease the stomach width 2W by at least O.lcm-lO.Ocm, decrease the stomach height 2H by at least O.lcm-lO.Ocm, or any combination thereof, including every 0.1cm increment within these ranges (e.g., by at least 0.1cm, 1.0cm, 3.0cm, 5.0cm, 10.0cm).
  • Figures 52c-52b illustrate, for example, that the stomach width 2W and/or the stomach height 2H can decrease as the catheter 9 is withdrawn from the stomach 2 and/or as the coil 138 is disassembled in the stomach 2.
  • Figures 52c-52b illustrate, for example, that withdrawing the catheter 9 from the stomach 2 and/or disassembling the coil 138 in the stomach 2 can decrease the stomach width 2W by at least 1.0cm and/or can decrease the stomach height 2H by at least 0.5cm.
  • Figures 52c-52b illustrate that the stomach length 2L can remain constant while the catheter 9 is withdrawn from the stomach 2.
  • Figures 52a-52d illustrate, for example, that expanding the stomach 2 by inserting the catheter 9 into the stomach 2 and/or forming the coil 138 in the stomach can cause folds in the stomach wall 108 to unfold and/or flatten which can increase the heat transfer efficiency through the stomach wall 108 to and/or from surrounding organs (e.g., the pancreas).
  • Figures 53a-53b illustrate that the catheter 9 can have a first tube 9a connected end to end with a second tube 9b at location 9x.
  • Figures 53a-53b illustrate the first tube 9a can have the first lumen 15 and that the second tube 9b can have the second lumen 16.
  • the first tube 9a and the second tube 9b can be inserted and/or withdrawn into the target site 147 as shown by arrows 112 and 114.
  • Figures 53a-53b illustrate that the first tube 9a and the second tube 9b can be inserted and/or withdrawn together, for example, simultaneously.
  • the first tube 9a and the second tube 9b can be independently insertable and/or withdrawable.
  • Figures 46o, 47e, 48e, 49e, 5 Id, and 51e illustrate that the temperature of the stomach 2 can be measured with the first sensor 21a and/or the second sensor 21b.
  • Figure 51e2 illustrates that the temperature of the duodenum 37 can be measured with the first sensor 21a and that the temperature of the stomach 2 can be measured with the second sensor 21b.
  • Figures 55c-55d illustrates that the heat transfer zone 132 can extend radially to and/or from the catheter 9, for example, as represented by the unlabeled double-headed arrows in Figures 55c and 55d.
  • Figure 55d illustrates that a first heat zone can overlap a second heating zone.
  • Figure 56 illustrates that when the catheter 9 is in a deployed configuration, the length of the catheter 9 between the adherer 156 and a distal terminal end of the catheter 9 can be greater than 60-100cm from the adherer 156 as measured along the center longitudinal axis Ac of the catheter 9 (e.g., as represented by line 123 in Figure 56), including every 1cm increment within this range (e.g., greater than 60cm, greater than 70cm, greater than 80cm, greater than 90cm).
  • Figure 56 illustrates that the length of the catheter 9 between the adherer 156 and a distal terminal end of the catheter 9 can be greater than 90cm from the adherer 156 as measured along the center longitudinal axis Ac of the catheter 9.
  • Figure 56 illustrates that when the catheter 9 is in a deployed configuration, the distance 121 d as measured along a straight line 121 from the adherer 156 to the distal terminal end of the catheter 9 can be less than 50-70cm, including every 1cm increment with this range (e.g., less than 50cm, less than 60cm, less than 70cm).
  • Figure 56 illustrates that when the catheter 9 is in a deployed configuration, the distance 121d as measured along the straight line 121 from the adherer 156 to the distal terminal end of the catheter 9 can be less than 60cm.
  • Figures 46a-58b illustrate, for example, the widths of the loops 118 can be less than 31cm, or
  • Figures 46a-58b illustrate, for example, that the fluid 6 can be recirculated through the lumen
  • Figures 46a-58b illustrate, for example, that the fluid 6 can be recirculated through the lumen
  • Figures 46a-58b illustrate, for example, that the fluid 6 can be recirculated through the lumen
  • Figures 46a-58b illustrate, for example, that the fluid 6 can be recirculated through the lumen
  • Figures 46a-58b illustrate that a lumen (e.g., an inflow lumen and an outflow lumen) extend
  • the catheter tip 7 may reside in the pyloric canal, the pyloric antrum and/or the body of the
  • the catheter 9 can be, for example, 7.0mL-9.0mL, including every ImL increment within this range
  • the volume of the aspiration lumen (e.g., the third lumen 16) can be, for example, l.OmL- 2.0mL, including every O.lmL increment within this range (e.g., 1.5mL).
  • the volume of the catheter walls can be, for example, 8.0mL-12.0mL, including every O.lmL increment within this range (e.g., 9.7mL).
  • the volume of the first lumen 15, can be for example, 0.0150mL/cm to 0.0500mL/cm (e.g., 0.0253mL/cm).
  • the volume of the second lumen 15, can be for example, 0.0150mL/cm to 0.0500mL/cm (e.g., 0.0253mL/cm).
  • the stomach 2 can be warmed to 37-42 degrees Celsius (e.g., 37 degrees, 38 degrees, 42 degrees).
  • the temperature change of the fluid 6 between the heat exchange system 13 can be 2-10 deg Celsius.
  • the change in the fluid temperature can depend, for example, on the flow rate and input parameters. A higher flow rate can result in a smaller temperature change
  • the heat exchange system 13 e.g., a recirculating chiller
  • the heat exchange system 13 can, for example, have a fluid temperature range of 4-42 degrees Celsius for the fluid 6 (e.g., water).
  • the temperature of the water when it enters the body can be 9-12 degrees Celsius and the temperature of the water when it exits the body can be 15-20 degrees Celsius.
  • the temperature of the fluid when it enters the body can be, for example, 37-38 degrees Celsius, meaning that the temperature change of the fluid 6 for warming can be fairly small when the patient is 30-36 degrees Celsius.
  • the sensor 21 may expand and/or separate from the catheter 9.
  • the sensor 21 can be secured with a dissolvable and/or retractable sheath.
  • the sensor 21 can be a spring member and/or ni tinol.
  • the sensor 21 could expand away from the catheter with mechanical manipulation, temperature change, pressure and/or if a sheath is removed from the sensor 21.
  • the sensor 21 can sense if it is submersed in a gas or liquid (e.g., by measuring resistance and/or conductivity across two points).
  • the temperature difference between multiple sensors 21 and/or the remote sensor 93 can be used to determine the location and/or accuracy of the sensors 21.
  • the catheter 9 may be insulated outside of the patient to minimize heat transfer to the surrounding environment.
  • a fluid bypass may be located external to the patient to reduce the pressure of the fluid entering into the portion of the catheter 9 inside of the patient.
  • the flow rate of the fluid 6 fluid may be different before and/or after the bypass. For example, a high flow rate of the fluid 6 proximal to the fluid bypass may help to reduce and/or increase the temperature of the fluid 6 at the fluid bypass and/or entering the patient through the catheter 9.
  • the operator can confirm if the catheter tip 7 is in the duodenum 37, the stomach 2, the pancreas 1, the pylorus 65, the ampulla of vater 41, the pancreatic duct 42, the esophagus 5, the lung and/or a different organ.
  • the diameter and/or the hydraulic diameter of the first lumen 15, the catheter OD 19, the proboscis tip diameter 95, the second lumen 16, the third lumen 17 and/or the fourth lumen 18 can be less than approximately 3 mm (0.12 in), yet more narrowly less than approximately 2.5 mm (0.10 in), yet more narrowly less than approximately 2 mm (0.08 in), yet more narrowly less than approximately 1.5 mm (0.06 in), yet more narrowly less than approximately 1 mm (0.04 in), yet more narrowly less than approximately 0.5 mm (0.02 in) and/or yet more narrowly less than approximately 0.25 mm (0.01 in).
  • the weight of the duodenal device 40 and/or the catheter tip 7 can be greater than approximately 1 g, yet more narrowly greater than approximately 2 g, yet more narrowly greater than approximately 5 g, yet more narrowly greater than approximately 10 g and/or yet more narrowly greater than approximately 20 g.
  • the weight of the duodenal device 40 and/or the catheter tip 7 can be less than approximately 20 g, yet more narrowly less than approximately 10 g, yet more narrowly less than approximately 5 g, yet more narrowly less than approximately 2 g and/or yet more narrowly less than approximately 1 g.
  • the length of the catheter 9 and/or the length of the catheter 9 in the stomach 2 can be greater than approximately 10 cm (3.9 in), yet more narrowly greater than approximately 25 cm (9.8 in), yet more narrowly greater than approximately 50 cm (19.7 in), yet more narrowly greater than approximately 75 cm (29.5 in), yet more narrowly greater than approximately 100 cm (39.4 in), yet more narrowly greater than approximately 150 cm (59 in)and/or yet more narrowly greater than approximately 200 cm (78.7 in).
  • the length of the catheter 9 and/or the length of the catheter 9 in the stomach 2 can be less than approximately 200 cm (78.7 in), yet more narrowly less than approximately 150 cm (59 in), yet more narrowly less than approximately 100 cm (39.4 in), yet more narrowly less than approximately 75 cm (29.5 in), yet more narrowly less than approximately 50 cm (19.7 in), yet more narrowly less than approximately 25 cm (9.8 in) and/or yet more narrowly less than approximately 10 cm (3.9 in).
  • the surface area of the heat transferer 4, the catheter 9, the duodenal device 40 and/or the balloon 3 can be greater than approximately 10 cm2 (1.6in 2 ), yet more narrowly greater than approximately 50cm2 (7.8in 2 ), yet more narrowly greater than approximately 100cm2 (15.5in 2 ), yet more narrowly greater than approximately 200cm2 (31in 2 ), yet more narrowly greater than approximately 300cm2 (46.5in 2 ) and/or yet more narrowly greater than approximately 500cm2 (77.5in 2 ).
  • the length of the balloon 3 and/or the proboscis length 96 can be greater than approximately 1cm (0.4in), yet more narrowly greater than approximately 2cm (0.8in), yet more narrowly greater than approximately 4cm (1.6in), yet more narrowly greater than approximately 6cm (2.4in), yet more narrowly greater than approximately 8cm (3.1 in), yet more narrowly greater than approximately 10cm (3.9in), and/or yet more narrowly greater than approximately 20cm (7.9in).
  • the maximum heat transfer rate of the heat transferer 4, the catheter 9, the balloon, and/or the heat exchange system 13 can be fixed and/or controlled by the operator.
  • the maximum heat transfer rate of the heat transferer 4 and/or the heat exchange system 13 can be greater than 10 W, yet more narrowly greater than 30 W, yet more narrowly greater than 50 W, yet more narrowly greater than 100 W, yet more narrowly greater than 150 W, yet more narrowly greater than 250 W, yet more narrowly greater than 500 W and/or yet more narrowly greater than 1000 W.
  • the maximum heat transfer rate of the heat transferer 4 and/or the heat exchange system 13 can be less than 1000 W, yet more narrowly less than 500 W, yet more narrowly less than 250 W, yet more narrowly less than 150 W, yet more narrowly less than 100 W, yet more narrowly less than 50 W and/or yet more narrowly less than 30 W.
  • the heat transferer 4, the catheter 9 and/or the balloon 3 can be used to provide localized cooling and/or heating therapy to specific regions and/or organs.
  • the heat transferer 4, the catheter 9 and/or the balloon 3 can provide heat transfer to the stomach 2 and/or the pancreas 1.
  • the heat transferer 4, the catheter 9 and/or the balloon 3 can be used to provide general cooling.
  • the heat transferer 4, the catheter 9 and/or the balloon 3 can be used to reduce and/or increase the core body temperature.
  • Approximately 50W of cooling power can be adequate to lower the core body temperature of a human being. Reducing the heating and/or cooling power can localize the temperature therapy.
  • the balloon 3 can be filled to a volume less than 1000 mL, yet more narrowly less than 900 mL, yet more narrowly less than 800 mL, yet more narrowly less than 700 mL, yet more narrowly less than 600 mL, yet more narrowly less than 500 mL, yet more narrowly less than 400 mL, yet more narrowly less than 300 mL, yet more narrowly less than 200 mL, yet more narrowly less than 100 mL and/or yet more narrowly less than 50 mL.
  • the catheter 9 can be removed from the stomach 2 to reduce the total surface area of the catheter 9 in the stomach.
  • the user can set the target temperature of the thermal therapy system 33 to a temperature that is higher or lower than the normal body temperature, with the intention of providing additional heating and/or cooling to an organ of the patient.
  • the user can set the target temperature of the thermal therapy system 33 to 1 deg Celsius below normal body temperature, with the expectation that this will not cause general hypothermia, but should cool the stomach 2 and/or the pancreas 1 to a temperature greater than 1 deg Celsius below normal body temperature.
  • the temperature of the control thermocouple can be higher and/or lower than the temperature of the organ targeted for heating and/or cooling. One can expect a thermal gradient between the control thermocouple and the heat transferer 4 and/or the catheter 9.
  • the volume of the balloon 3 relative to the volume of the stomach 2 can be greater than 10%, yet more narrowly greater than 20%, yet more narrowly greater than 30%, yet more narrowly greater than 40%, yet more narrowly greater than 50%, yet more narrowly greater than 60%, yet more narrowly greater than 70%, yet more narrowly greater than 80% and/or yet more narrowly greater than 90%.
  • the volume of the balloon 3 relative to the volume of the stomach 2 can be less than 100%, yet more narrowly less than 90%, yet more narrowly less than 80%, yet more narrowly less than 70%, yet more narrowly less than 60%, yet more narrowly less than 50%, yet more narrowly less than 40%, yet more narrowly less than 30%, yet more narrowly less than 20% and/or yet more narrowly less than 10%.
  • the pressure in the balloon 3 when deflated, partially inflated and/or fully inflated can be greater than 0.05 PSI, yet more narrowly greater than 0.1 PSI, yet more narrowly greater than 0.3 PSI, yet more narrowly greater than 0.5 PSI, yet more narrowly greater than 1 PSI, yet more narrowly greater than 2 PSI, yet more narrowly greater than 5 PSI and/or yet more narrowly greater than 10 PSI.
  • the maximum diameter of the catheter 9 and/or the uninflated balloon 3 can be greater than approximately 5 Fr, yet more narrowly greater than 8 Fr, yet more narrowly greater than 11 Fr, yet more narrowly greater than 15 Fr, yet more narrowly greater than 18 Fr, yet more narrowly greater than 22 Fr, yet more narrowly greater than 30 Fr and/or yet more narrowly greater than 50 Fr.
  • the maximum diameter of the catheter 9 and/or the uninflated balloon 3 can be less than approximately 50 Fr, yet more narrowly less than 30 Fr, yet more narrowly less than 22 Fr, yet more narrowly less than 18 Fr, yet more narrowly less than 15 Fr, yet more narrowly less than 12 Fr, yet more narrowly less than 9 Fr and/or yet more narrowly less than 6 Fr.
  • the French size is three times the diameter in millimeters. Thus, the French size is roughly equivalent to the circumference of a circular catheter; the true circumference being slightly larger.
  • the pancreas 1, , the fluid 6, the stomach 2 and/or the gastric pancreas wall 8 can be 50° C, yet more narrowly less than 45° C, yet more narrowly less than 40° C, yet more narrowly less than 39° C, yet more narrowly less than 36° C, yet more narrowly less than 35° C, yet more narrowly less than 34° C, yet more narrowly less than 33° C, yet more narrowly less than 32° C, yet more narrowly less than 31° C, yet more narrowly less than 30° C, yet more narrowly less than 29° C, yet more narrowly less than 28° C, yet more narrowly less than 27° C, yet more narrowly less than 26° C, yet more narrowly less than 25° C, yet more narrowly less than 24° C, yet more narrowly less than 23° C, yet more narrowly less than 22° C, yet more narrowly less than 21° C, yet more narrowly less than 20° C, yet more narrowly less than 19° C, yet more narrowly less than 18° C, yet more
  • the flow rate of the fluid 6 and/or the insulating fluid 25 in the catheter 9 can be greater than 10 mL/min, yet more narrowly greater than 50 mL/min, yet more narrowly greater than 100 mL/min, yet more narrowly greater than 200 mL/min, yet more narrowly greater than 500 mL/min, yet more narrowly greater than 1,000 mL/min and/or yet more narrowly greater than 2,000 mL/min.
  • Any elements described herein as singular can be pluralized (i.e., anything described as “one” can be more than one). Any species element of a genus element can have the characteristics or elements of any other species element of that genus.
  • the media delivered herein can be any of the fluids (e.g., liquid and/or gas) described herein.
  • the patents and patent applications cited herein are all incorporated by reference herein in their entireties for all purposes. Some elements can be absent from individual figures for reasons of illustrative clarity.
  • the above-described configurations, elements or complete assemblies and methods and their elements for carrying out the disclosure, and variations of aspects of the disclosure can be combined and modified with each other in any combination. All devices, apparatuses, systems, and methods described herein can be used for medical (e.g., diagnostic, therapeutic or rehabilitative) or non-medical purposes.
  • the thermal therapy system 33 can be used to cool the esophagus (e.g., during cardiac ablation therapy). Medications can be used to increase and/or decrease the motility, peristalsis and/or gastric waves.
  • the catheter 9 and/or the catheter tip 7 can be coated with a medication and/or material that can increase and/or decrease the motility, peristalsis and/or gastric waves.
  • the thermal therapy system 33 or any or all elements of the tool and/or other tools or apparatuses described herein can be made from or coated with, for example, rubber, thermoplastic elastomer (TPE), polyisoprene rubber, latex-free elastomer, silicone, liquid silicone rubber (LSR), polypropylene, LDPE, HDPE, single or multiple stainless steel alloys, steel, spring steel, nickel titanium alloys (e.g., Nitinol), cobalt-chrome alloys (e.g., ELGILOY® from Elgin Specialty Metals, Elgin, IL; CONICHROME® from Carpenter Metals Corp., Wyomissing, PA), nickel-cobalt alloys (e.g., MP35N® from Magellan Industrial Trading Company, Inc., Westport, CT), molybdenum alloys (e.g., molybdenum TZM alloy), tungsten-rhenium alloys, polymers such as polyethylene teraphathalate
  • polypropylene polypropylene
  • aromatic polyesters such as liquid crystal polymers (e.g., Vectran, from Kuraray Co., Ltd., Tokyo, Japan), ultra high molecular weight polyethylene (i.e., extended chain, high-modulus or high-performance polyethylene) fiber and/or yarn (e.g., SPECTRA® Fiber and SPECTRA® Guard, from Honeywell International, Inc., Morris Township, NJ, or DYNEEMA® from Royal DSM N.V., Heerlen, the Netherlands), polytetrafluoroethylene (PTFE), Parylene poly(p- xylylene) polymers, Parylene N, Parylene C, Parylene D, expanded PTFE (ePTFE), polyether ketone (PEK), polyether ether ketone (PEEK), polycarbonate (PC), Acrylonitrile Butadiene Styrene (ABS), poly ether ketone ketone (PEKK) (also poly ether ketone ketone (also poly
  • the system 33 and/or the device 4 can have, for example, any combination of features described herein and/or shown in Figures l-58b.
  • the catheter 9 in any of the figures can have any of the features in any of the other figures, including, for example, the balloon 3, the sensors 21, the configurations 116, the shapes 117, the loops 118, the cells 122, the total length 124, the length 126, the heat transfer region 128, the length 130, the heat transfer zones 132, the coil 138, or any combination thereof.
  • the catheter 9 can have any combination of the features in Figures l-58b.
  • any portion of the catheter 9 can be a first section of the catheter 9 and any portion of the catheter 9 different than the first section can be a second section of the catheter 9. As another example, a portion of the first section of the catheter 9 can be a portion of and/or all of the second section of the catheter 9.
  • the catheter 9 in the target site 147 can have any combination of the loops 118 and/or cells 122, for example, shown in Figures l-58b.
  • the catheter 9 in the target site 147 can have any combination of the loops 118 and/or cells 122, for example, shown in Figures 46a-58b.
  • the catheter 9 in the target site 147 can have any combination of the loops 118 and/or cells 122, for example, shown in Figures l-58b.
  • the systems, methods, and/or devices can have any combination of features, for example, in Figures l-58b.
  • the figures illustrate, for example, a device (e.g., the device 4) for changing a temperature of an organ or a first organ.
  • the device can have a tube (e.g., the catheter 9).
  • the tube can have a lumen, a tube first portion, and a tube second portion.
  • a fluid e.g., the fluid 6
  • the device can have a tether (e.g., the tether 73).
  • a distance between the tube first portion and the tube second portion can be maintainable via the tether.
  • the tube can have a first configuration and a second configuration. The tether can be under more tension when the tube is in the second configuration than when the tube is in the first configuration.
  • a distance between the tube first portion and the tube second portion can be changeable via the tether. Movement of the tube second portion away from the tube first portion can be limitable via the tether. 50cm- 150cm of the tube can be positionable in a second organ adjacent the first organ. The tube can be formable into a lattice shape.
  • Figures l-58b illustrate, for example, a method of a method of changing a temperature of a first organ.
  • the method can include positioning a tube (e.g., the catheter 9) having a lumen, a tube first portion, and a tube second portion in a second organ.
  • the method can include positioning a tether (e.g., the tether 73) in the second organ.
  • the method can include maintaining a distance between the tube first portion and the tube second portion via the tether.
  • the method can include changing the tube from a first configuration to a second configuration or allowing the tube to change from the first configuration to the second configuration.
  • the tether can be under more tension when the tube is in the second configuration than when the tube is in the first configuration.
  • the method can include changing a distance between the tube first portion and the tube second portion via the tether.
  • the method can include limiting movement of the tube second portion away from the tube first portion via the tether.
  • the method can include positioning 50cm-150cm of the tube in the second organ adjacent the first organ.
  • the method can include forming the tube into a lattice shape in the second organ.
  • Figures 1-56 illustrate, for example, a method of a method of changing a temperature of a first organ.
  • the method can include positioning 50cm-150cm of a tube (e.g., the catheter 9) having a lumen, a tube first portion, and a tube second portion in a second organ adjacent the first organ.
  • the tube can formable into a lattice shape.
  • the distance between the tube first portion and the tube second portion can be maintainable via the tether.
  • the tube can have a tube distal terminal end.
  • the tether can have a tether distal terminal end.
  • the tube distal terminal end can be migratable away from the tether distal terminal end up to a threshold distance.
  • the tube distal terminal end can migrate away from the tether distal terminal end up to a threshold distance.
  • the tube distal terminal end can passively migrate away from the tether distal terminal end up to a threshold distance.
  • the tube distal terminal end can passively move away from the tether distal terminal end up to a threshold distance.
  • the tube distal terminal end can be movable away from the tether distal terminal end up to a threshold distance.
  • the tube second portion can have a tube second portion proximal end and a tube second portion distal end.
  • the distance between the tube first portion and the tube second portion can be a distance between the tube first portion and the tube second portion proximal end.
  • the distance between the tube first portion and the tube second portion proximal end can be maintainable via the tether.
  • the tube second portion distal end can be migratable away from the tube first portion up to a threshold distance.
  • the threshold distance can be 1cm to 50cm.
  • the threshold distance can be 1cm to 25cm.
  • the tube can have a first configuration and a second configuration.
  • the tether distal terminal end can be closer to the tube first portion when the tube is in the second configuration than when the tube is in the first configuration.
  • the tube second portion can be closer to the tube first portion when the tube is in the second configuration than when the tube is in the first configuration.
  • the tube can be movable from the first configuration to the second configuration via the tether. When the tube is in the first configuration, the tube second portion can be a first distance from the tube first portion.
  • the tube second portion can have the tube distal terminal end.
  • the tube second portion can be distal the tube first portion.
  • the tube second portion can be distal the tube first portion.
  • the tube first portion can have a first port.
  • the tube second portion can have a second port.
  • the second port can be closer to the first port when the tube is in the second configuration than when the tube is in the first configuration.
  • the second port can be farther from the first port when the tube is in the third configuration than when the tube is in the second configuration.
  • the tether can be attached to the tube between the first port and the second port.
  • the tether can be attached to the tube second portion between the first port and the second port.
  • the tether can be movable (e.g., translatable) through the first port. When the tube is in the first configuration, the tether can be in the first port. When the tube is in the second configuration, the tether can be in the first port.
  • the tether When the tube is in the third configuration, the tether can be in the first port.
  • the second port can be at a distal end of the tube or at a distal terminal end of the tube.
  • a tool can be deliverable through the second port. Fluid and/or nutrients can be deliverable through the second port.
  • the tether When the tube is in the first configuration, the tether can be loose. When the tube is in the second configuration, the tether can be taut. When the tube is in the first configuration, a section of tether can have a bend. When the tube is in the second configuration, the section of tether can be straight or have another bend with a radius of curvature that can be larger than a radius of curvature of the bend. The tether can be under zero tension when the tube is in the first configuration. When the tube is in the first configuration, the tether can have a first tension. When the tube is in the second configuration, the tether can have a second tension. The second tension can be greater than the first tension. The first tension can be zero tension.
  • the tether When the tube is in the first configuration, the tether can be in a non-tensioned state. When the tube is in the second configuration, the tether can be in a tensioned state. When the tether is in the tensioned state, movement of the tube second portion away from the tube first portion can be preventable by the tether. When the tether is in the tensioned state, the tube second portion can be movable toward the tube first portion via the tether. When the tether is in the tensioned state, the tube second portion can be pullable toward the tube first portion via the tether.
  • the tube can have a port.
  • the tether can have a tether distal terminal end.
  • the tether distal terminal end can be farther from the port when the tube is in the second configuration than when the tube is in the first configuration.
  • the port can be proximal the tether distal terminal end when the tube is in the first configuration and when the tube is in the second configuration.
  • the tether can be in the port when the tube is in the first configuration and when the tube is in the second configuration.
  • the tether can be movable from a non-actuated position to an actuated position.
  • the tether can be movable from the non-actuated position to the actuated position via a control on a handle of the device.
  • the non-actuated position can be a non-retracted position of the tether.
  • the actuated position can be a retracted position of the tether.
  • the tether can have a distal terminal end. The tether distal terminal end can be closer to the tube first portion when the tether is in the actuated position than when the tether is in the non-actuated position.
  • the tube second portion can be closer to the tube first portion when the tether is in the actuated position than when the tether is in the non-actuated position.
  • the tether can be under more tension when the tether is in the actuated position than when the tether is in the non-actuated position.
  • the distance between the tube first portion and the tube second portion can be maintainable via the tether.
  • the tube can have a heat transfer region.
  • a portion of the tube can have a heat transfer region.
  • the heat transfer region can have a heat transfer region length.
  • a ratio of the heat transfer length to a length of the organ, the first organ, or the second organ can be 1.5 to 20.0.
  • the heat transfer region length can be 80%-100% of a length of the tube positionable adjacent the organ or the first organ.
  • the heat transfer region length can be 20cm-200cm of the tube.
  • the heat transfer region length can be 20cm-150cm.
  • the heat transfer region length can be 75cm-150cm.
  • the heat transfer region length can be 50cm- 150cm.
  • the heat transfer region length can be 50cm- 100cm.
  • the heat transfer region can be a length of the tube.
  • the heat transfer region can be continuous length of the tube.
  • the heat transfer region can be the tube first portion and the tube second portion.
  • the heat transfer region can be the tube second portion.
  • the heat transfer region can be distal the tube first portion.
  • the tube can have a tube distal terminal end.
  • the heat transfer region can have the tube distal terminal end.
  • the heat transfer region can cross over itself 0- 15 times.
  • the heat transfer region can cross over itself 0-10 times.
  • the heat transfer region can cross over itself 0-5 times.
  • a first external portion of the heat transfer region can contact a second external portion of the heat transfer region.
  • the first external portion of the heat transfer region can be a first portion of an external surface of the tube.
  • the second external portion of the heat transfer region can be a second portion of an external surface of the tube.
  • the first external portion of the heat transfer region and the second external portion of the heat transfer region can be separated by a distance as measured along a length of the tube.
  • the heat transfer region can have 0-15 bends.
  • the heat transfer region can have 0-10 bends.
  • the heat transfer region can have 0-5 bends.
  • the heat transfer region can have more bends when the tube is in a deployed configuration than when the tube is in a non-deployed configuration.
  • the tube can be deployable (e.g., changeable, movable) from a deployed first configuration to a deployed second configuration.
  • the tube can have more bends when the tube is in the deployed second configuration than when the tube is in the deployed first configuration.
  • the tube can be deployable (e.g., changeable, movable) from the deployed second configuration to a deployed third configuration.
  • the tube can have more bends when the tube is in the deployed third configuration than when the tube is in the deployed second configuration.
  • the tube can have 1 bend.
  • the tube can have 2 bends.
  • the tube can have 3 bends.
  • the tube can have 1-2 bends.
  • the tube can have 3-4 bends.
  • the tube can have 5-10 bends.
  • the tube can be deployable (e.g., changeable, movable) from the deployed second configuration to a deployed third configuration such that the tube can have more loops when the tube is in the deployed third configuration than when the tube is in the deployed second configuration.
  • the tube When the tube is in the deployed first configuration, the tube can have 0 loops.
  • the tube When the tube is in the deployed second configuration, the tube can have 1 loop.
  • the tube When the tube is in the third deployed configuration, the tube can have 2 loops.
  • the tube When the tube is in the deployed first configuration, the tube can have 0-2 loops.
  • the tube When the tube is in the deployed second configuration, the tube can have 3- 4 loops.
  • the tube can have 5-10 loops.
  • the tube When the tube is in the deployed configuration, the tube can define a mesh having cells. A mesh having cells can be formable by the tube. When the tube is in the deployed configuration, the tube can define a lattice structure. A lattice structure can be formable by the tube. The lattice structure can have cells.
  • the deployed configuration can be the second configuration.
  • the heat transfer region can be straight or less curved than when the tube is in a deployed configuration.
  • the tether can be movable along the tube outside of the tube.
  • the tether can be movable into the tube.
  • the tether can be flexible or rigid.
  • the tube can be movable via the tether.
  • the tube first portion and the tube second portion can be a first distance apart when the tether is in a non-actuated state.
  • the tube first portion and the tube second portion can be a second distance part when the tether is in an actuated state.
  • the second distance can be less than the first distance.
  • the tube first portion can be movable closer to the tube second portion via the tether.
  • the tube first portion can be movable into contact with the tube second portion via the tether.
  • the tube can be changeable from a first shape to a second shape via the tether.
  • a bend can be formable in the tube via the tether.
  • the tether can be attached to the tube.
  • the tether can have a non-actuated state and an actuated state. More of a distal end of the tether can be outside the tube when the tether is in the non-actuated state than when the tether is in the actuated state.
  • the tether can have a non-actuated state and an actuated state. More of a distal end of the tether can be inside the tube when the tether is in the actuated state than when the tether is in the non-actuated state.
  • the tether can be retractable through the tube.
  • the tether can have a tether distal end.
  • the tether distal end can be attached to the tube.
  • the tether distal end can be closer to a port in the tube when the tether is in an actuated state than when the tether is in a nonactuated state.
  • the tether can be configured to prevent knotting of the tube.
  • the tether can be configured to limit or prevent migration of the tube.
  • the tether can be configured to limit or prevent migration of the tube distal the tether distal terminal end.
  • the tether can be configured to limit or prevent migration of a portion of the tube distal the tether distal terminal end away from a portion of the tube proximal tether distal terminal end.
  • the tether can be configured to inhibit or prevent movement of the tube from the first body space to a second body space.
  • the tether can be configured to limit movement of the tube from the first body space to a second body space.
  • the device can have an engager (e.g., the engager 48).
  • the tube can have the engager.
  • the engager can have the lumen.
  • the engager can include a distal end of the tube.
  • the engager can be a distal coil in the tube having 1 to 5 turns.
  • the distal coil can have a helical profile.
  • the distal coil can have a spiral profile.
  • the engager can be configured to retain a distal end of the catheter in a duodenum.
  • the tube can be insertable into a patient. When the engager is in the patient’ s duodenum, the tether can be in the patient’s stomach.
  • the engager can include the heat transfer region.
  • the engager can include a distal end of the heat transfer region.
  • the engager can have an engager length of 2cm- 10cm.
  • the engager can have an engager length of 2cm-20cm.
  • the engager can have an engager length of 2cm-40cm.
  • the lumen can be a first lumen.
  • the tube can have a second lumen.
  • the fluid can be flowable toward a distal end of the tube through the first lumen.
  • the fluid can be flowable toward a proximal end of the tube through the second lumen.
  • the tube can be a catheter.
  • the fluid can be a liquid and/or a gas.
  • the fluid can be flowable through the lumen at a temperature greater than 37 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 37-50 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 37-45 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 37-40 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 37.1-45.0 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature less than 37 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 2-20 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 4-20 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 5-15 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 5-8 degrees Celsius.
  • the fluid can be flowable through the lumen at a temperature of 10 degrees Celsius.
  • the fluid can be flowable through the first lumen at a temperature of 5-8 degrees Celsius.
  • the fluid can be flowable through the second lumen at a temperature of 11-13 degrees Celsius.
  • the tube can be configured to maintain flexibility under pressure.
  • the tube can be configured to constrain a maximum volume.
  • the tube can be configured to constrain a maximum volume.
  • the device can have a balloon.
  • the tube can have the balloon.
  • the balloon can be elastic, inelastic, or both.
  • the balloon can be inflatable with the fluid.
  • the balloon can have bubbles, ridges, ribs, or dots.
  • the balloon can have a first chamber and a second chamber.
  • 50cm- 150cm of the tube can be insertable in a stomach.
  • the lumen can be expandable.
  • the lumen can be non-expandable.
  • the device can have a temperature sensor, a pressure sensor, an enzyme sensor, and/or a motion sensor.
  • the tube can have the temperature sensor, the pressure sensor, the enzyme sensor, and/or the motion sensor.
  • the device can include a visualization aid.
  • the visualization aid can have magnets, a radiopaque marker, and/or an echogenic marker.
  • the tube can be configured to change the temperature of the organ from a stomach and/or a duodenum.
  • the organ can be a pancreas.
  • the first organ can be a pancreas.
  • the lumen can be a first lumen.
  • the tube can have a second lumen and a third lumen.
  • the first lumen can be an inflow lumen for the fluid.
  • the second lumen can be an outflow lumen for the fluid.
  • the third lumen can be a working channel.
  • the third lumen can be an aspiration lumen.
  • a tool can be deliverable through the third lumen.
  • a fluid and nutrients are deliverable through the third lumen.
  • the first lumen can have a smaller diameter than the second lumen.
  • the first lumen and the second lumen can have the same diameter.
  • the tube can have bars, a weighted tip, and/or a coiled tip.
  • 1cm- 30cm of the tube can be positionable in a third organ.
  • the third organ can be adjacent the first organ.
  • the lcm-30cm of the tube positionable in the third organ can be distal the 50cm- 150cm of the tube positionable in the second organ
  • the second organ can be a stomach.
  • the third organ can be a duodenum.
  • the first organ can be a pancreas.
  • the lattice shape can have a strut and a cell.
  • the cell can be a hole in the lattice shape.
  • the tube first portion or the tube second portion can have the strut.
  • a section of the tube can be the strut.
  • the lattice shape can have a first strut and a second strut.
  • the lattice shape can have a first cell and a second cell.
  • the first cell can be a first hole in the lattice shape.
  • the second cell can be a second hole in the lattice shape.
  • the tube first portion can have the first strut.
  • the tube second portion can have the second strut.
  • the tube first portion can have the first strut and the second strut.
  • the tube second portion can have the first strut and the second strut.
  • a first section of the tube can be the first strut.
  • a second section of the tube can be the second strut.
  • the lattice shape can have a joint.
  • the joint can be a portion of the lattice shape where the first strut and the second strut intersect each other.
  • the joint can be a portion of the lattice shape where the first strut crosses under or over the second strut.
  • the joint can be a portion of the lattice shape where the first strut contacts the second strut.
  • the joint can be a friction point configured to resist movement of the second strut away from the first strut.
  • the joint can be a friction point configured to resist migration of the tube.
  • the first strut and the second strut can be continuous with each other.
  • a third strut can be between the first strut and the second strut.
  • the strut can be a length of the tube between two joints.
  • the first strut can be a length of the tube between two joints.
  • the second strut can be a length of the tube between two joints.
  • the strut can be straight or can have a bend.
  • the first strut can be straight or can have a bend.
  • the second strut can be straight or can have a bend.
  • the cell can be an open cell or a closed cell.
  • the first cell can be an open cell or a closed cell.
  • the second cell can be an open cell or a closed cell.
  • the tube can have a non-lattice shape and the lattice shape.
  • the tube can be formable into the lattice shape from the non-lattice shape.
  • the tube can be changeable from the non-lattice shape to the lattice shape.
  • the tube can be changeable from the lattice shape to the non-lattice shape.
  • the tube can have a tube distal terminal end. When the tube has the non-lattice shape, the portion of the tube that defines the first strut when the tube has the lattice shape can be farther from the tube distal terminal than the portion of the tube that defines the second strut when the tube has the lattice shape.
  • the first strut can be farther from the tube distal terminal end than the second strut.
  • the first strut can be closer to the tube distal terminal end than the second strut.
  • a distance between the first strut and the second strut can be increasable or decreasable.
  • the first strut can be movable toward and away from the second strut.
  • the lattice shape can be formable with 20cm-200cm of the tube.
  • the lattice shape can be defined by 20cm-200cm of the tube.
  • the lattice shape can be formable in the second organ.
  • the lattice shape can be formable in the third organ.
  • the lattice shape can be formed in the second organ and a portion of the tube that defines the lattice shape (e.g., a portion of the tube that defines a distal portion of the lattice shape) can be move (e.g., migrate, advance) into the third organ.
  • Such movement of a portion of the tube that defines the lattice shape into the third organ can be limited, inhibited, and/or prevented by a tether (e.g., the tether 73), an engager (e.g., the engager 48), and/or by tension in the tube.
  • the non-lattice shape can include a straight configuration of the tube or a linear configuration of the tube.
  • the joint can be a portion of the lattice shape where the tube first portion and the tube second portion intersect each other.
  • the lattice shape can be formable by the tube in the second organ.
  • the lattice shape can be formable by the tube via the tube bending during advancement into the second organ.
  • the tube When the tube has the lattice shape, the tube can have 1-50 bends. When the tube has the lattice shape, the tube can have 1-30 bends. When the tube has the lattice shape, the tube can have 10- 50 bends.
  • a size of the cell, the first cell, or the second cell can be changeable via the tether.
  • a shape of the cell, the first cell, or the second cell can be changeable via the tether.
  • Another fluid can be flowable through the cell, the first cell, or the second cell.
  • Nutrients can be flowable through the cell, the first cell, or the second cell.
  • the cell, the first cell, or the second cell can be configured to provide space for nutrients to pass through.
  • the tube When the tube is in the first configuration, the tube can have the lattice shape.
  • the tube When the tube is in the second configuration, the tube can have the lattice shape.
  • the tube When the tube is in the third configuration, the tube can have the lattice shape.
  • the lattice shape can include 20cm-200cm of the tube.
  • the tube When the tube is in a deployed configuration, the tube can have the lattice shape.
  • the lattice shape can be defined by 20cm-200cm of the tube.
  • the lattice shape can have the heat transfer region.
  • the lattice shape can be the heat transfer region.
  • the fluid can be flowable through the lumen.
  • the tether When the tube is in a fully deployed configuration, the tether can be in the actuated position and the tube can have the lattice shape.
  • Forming the tube into the lattice shape in the second organ can include progressively advancing the tube into the second organ.
  • the method can include changing the tube from the lattice shape to a non-lattice shape by progressively retracting the tube from the second organ.
  • the method can include changing the tube from the lattice shape to a non-lattice shape by unbending the tube in the second organ.
  • the method can include changing the temperature of the first organ by passing the fluid through the lumen in the second organ.
  • the method can include changing the temperature of the first organ by passing the fluid through the heat transfer region in the second organ.
  • the method can include changing the temperature of the first organ by passing the fluid through the lumen in the third organ.
  • the method can include preventing knotting of the tube via the tether.
  • the method can include preventing kinking of the tube via the tether.
  • the method can include limiting or preventing migration of the tube from the second organ into the third organ via the tether.
  • Positioning the tube in the second organ can including positioning 50cm-150cm of the tube in the second organ.
  • the method can include positioning the tube in a third organ.
  • Positioning the tube in the third organ can include positioning 1cm -40cm of the tube in the third organ.
  • 50cm- 150cm of the heat transfer region can be positionable in the second organ.
  • lcm-40cm of the heat transfer region can be positionable in the third organ.
  • the tube can have a total length of 30cm-250cm.
  • the figures illustrate, for example, a method of changing a temperature of a gastrointestinal tract caudal of a gastroesophageal junction of the gastrointestinal tract via a catheter (e.g., the catheter 9).
  • the method can include inserting 50cm-300cm of the catheter into a stomach of the gastrointestinal tract.
  • the method can include adding or removing a fluid from the catheter through an inflow port and an outflow port with 10-100 Watts of cooling or warming power.
  • the method can include changing the temperature of the gastrointestinal tract caudal of the gastroesophageal junction of the gastrointestinal tract via the 50cm-300cm of the catheter inserted into the stomach.
  • the method can include circulating the fluid through an inflow lumen and an outflow lumen that extend through the 50cm-300cm of the catheter inserted into the stomach.
  • the fluid can have a temperature greater than 37 degrees Celsius and/or the fluid can have a temperature less than 37 degrees Celsius.
  • the method can include increasing and/or decreasing the temperature of the gastrointestinal tract caudal of the gastroesophageal junction of the gastrointestinal tract by 1 degree Celsius to 20 degrees Celsius.
  • the method can include increasing and/or decreasing a temperature of a wall of the gastrointestinal tract caudal of the gastroesophageal junction of the gastrointestinal tract by 1 degree Celsius to 20 degrees Celsius.
  • the wall of the gastrointestinal tract caudal of the gastroesophageal junction of the gastrointestinal tract can be adjacent to a pancreas.
  • the length of the inflow lumen can be the same as the length of the outflow lumen.
  • the method can include simultaneously positioning the inflow lumen and the outflow lumen in the gastrointestinal tract.
  • the inflow lumen and the outflow lumen can merge with each other at a merge point.
  • the merge point can be inside the catheter.
  • the merge point can be in a distal end of the catheter.
  • the merge point can be 0.10cm to 3.00cm proximal the distal terminal end of the catheter.
  • the figures illustrate, for example, a method of changing a temperature of a gastrointestinal tract caudal of a gastroesophageal junction of the gastrointestinal tract.
  • the method can include positioning a first section of a catheter in a stomach of the gastrointestinal tract.
  • the method can include transferring heat to or from the gastrointestinal tract comprising recirculating a fluid through an inflow lumen and an outflow lumen in the first section of the catheter.
  • the length of the first section of the catheter can be greater than a length of a greater curvature of the stomach.
  • Transferring the heat to and/or from the gastrointestinal tract can include transferring the heat to and/or from the gastrointestinal tract via the first section of the catheter in the stomach.
  • the figures illustrate, for example, a method of changing a temperature of a gastrointestinal tract caudal of a gastroesophageal junction of the gastrointestinal tract.
  • the method can include positioning a length of a lumen in a stomach of the gastrointestinal tract.
  • the method can include passing a fluid through the length of the lumen at a flow rate over a treatment period.
  • the flow rate can be at least 20mL/min and the treatment period can be at least 2 hours.
  • the length of the lumen in the stomach can be 30cm- 150cm.
  • a volume of the length of the lumen in the gastrointestinal tract can be 2.0mL-50.0mL.
  • the flow rate can be less than 200mL/min and/or the treatment period can be 2 hours to 31 days.
  • the method can include passing 4L-9,000L of the fluid through the length of the lumen.
  • the method can include flowing the fluid through the length of the lumen in the stomach at a flow rate comprising 20mL/min-200mL/min.
  • the lumen can be a first lumen.
  • the method can include positioning a length of a second lumen in the stomach.
  • the method can include passing the fluid through the length of the second lumen at the flow rate over the treatment period.
  • the length of the second lumen in the stomach can be 30cm-150cm.
  • the first lumen can be an inflow lumen and wherein the second lumen can be an outflow lumen.
  • the first lumen and the second lumen can merge with each other at a merge point. The merge point is inside the catheter.
  • the figures illustrate, for example, a device (e.g., the heat transferer 4).
  • the device can have a catheter having a heat transfer region.
  • a heating zone can extend radially from the heat transfer region.
  • the heat transfer region can have a length of 50cm-300cm.
  • a first heating zone of a first length of the heat transfer region can overlap a second heating zone of a second length of the heat transfer region.
  • the device can have a recirculating pump.
  • the device can have an inflow port and an outflow port at a proximal end of the catheter. When the catheter is in the deployed configuration, the heat transfer region can cross over itself.
  • the figures illustrate, for example, a device (e.g., the heat transferer 4).
  • the device can have a recirculating pump.
  • the device can have a catheter having a lumen.
  • a first end of the lumen can have an inflow port and a second end of the lumen can have an outflow port.
  • the recirculating pump is recirculating fluid
  • the inflow port and the outflow port can be in fluid communication with the recirculating pump.
  • an adherer can be attached to the catheter.
  • a volume of the lumen distal to the inflow port and the outflow port can be less than 50mL.
  • the figures illustrate, for example, a device (e.g., the heat transferer 4).
  • the device can have a recirculating pump.
  • the device can have a catheter having a having lumen.
  • a first end of the lumen can have an inflow port and a second end of the lumen can have an outflow port.
  • the inflow port and the outflow port can be at a first end of the catheter.
  • the recirculating pump is recirculating fluid
  • the inflow port and the outflow port can be in fluid communication with the recirculating pump.
  • an adherer can be attached to the catheter.
  • the distance as measured along the second straight line from the adherer to the distal terminal end of the catheter can be lcm-15cm greater than the distance as measured along the first straight line from the adherer to the distal terminal end of the catheter.
  • the adherer can be adhesive and/or a piece of tape.
  • the figures illustrate, for example, a method of changing a temperature of a gastrointestinal tract caudal of a gastroesophageal junction of the gastrointestinal tract.
  • the method can include forming a first length of a catheter into a first loop inside a stomach of the gastrointestinal tract.
  • the first loop can have a first loop first end that crosses a first loop second end.
  • a width of the first loop can be greater than 3cm.
  • the method can include transferring heat to and/or from the gastrointestinal tract which can include recirculating a fluid through an inflow lumen and an outflow lumen in the catheter.
  • the inflow lumen and the outflow lumen can extend through the first length of the catheter.
  • Forming the first length of the catheter into the first loop can include advancing the catheter into the stomach.
  • Forming the catheter into the first loop defining the first cell in the stomach of the gastrointestinal tract by advancing the catheter into the stomach can include pushing the catheter against a wall of the stomach.
  • the inflow lumen and the outflow lumen can be in the first section of the catheter.
  • the first section of the catheter can be straight.
  • the method can include forming a second section of the catheter into a second loop defining a second cell in the stomach by advancing the catheter into the stomach.
  • the method can include moving the first loop relative to the second loop and/or moving the second loop relative to the first loop.
  • the figures illustrate, for example, a method of changing a temperature of a gastrointestinal tract caudal of a gastroesophageal junction of the gastrointestinal tract.
  • the method can include forming a first section of a catheter into a first loop in a stomach of the gastrointestinal tract.
  • the method can include forming a second section of the catheter into a second loop in the stomach which can include forming or moving the second loop distal the first loop.
  • the first section of the catheter can be distal the second section of the catheter.
  • the method can include transferring heat to and/or from the gastrointestinal tract via the catheter.
  • the method can include forming the first section of the catheter into the first loop in the stomach by advancing the first section of the catheter into the stomach.
  • Forming the catheter into the first loop in the stomach by advancing the catheter into the stomach can include pushing the catheter against a wall of the stomach.
  • the method can include forming the second section of the catheter into the second loop in the stomach by advancing the second section of the catheter into the stomach.
  • Forming the catheter into the second loop in the stomach by advancing the catheter into the stomach can include pushing the catheter against a wall of the stomach.
  • Forming the second section of the catheter into the second loop can include moving the second section of the catheter against the first section of the catheter and/or moving the second section of the catheter over or under the first section of the catheter.
  • the figures illustrate, for example, a device (e.g., the heat transferer 4).
  • the device can have a catheter having a first section.
  • the first section can have a first section first configuration and a first section second configuration. When the first section is in first section first configuration, the first section can be straight.
  • the first section When the first section is in the first section second configuration, the first section can include a first loop having a first loop first end that crosses a first loop second end at a first location along the catheter.
  • a width of the first loop can be greater than 3cm as measured from an axis perpendicular to a center longitudinal axis of the catheter.
  • the device can have a recirculating pump.
  • the catheter can have an inflow lumen and an outflow lumen.
  • the figures illustrate, for example, a device (e.g., the heat transferer 4).
  • the device can have a catheter having a first section and a second section.
  • the catheter can have a first configuration and a second configuration.
  • the first section and the second section can be less curved than when the catheter is in the second configuration and the first section is distal the second section.
  • the first section can define a first loop
  • the second section can define a second loop
  • the second section can be distal the first section such that the second loop can be distal the first loop.
  • the first section and the second section can be straight.
  • the first loop can be an open loop or a closed loop and the second loop can be an open loop or a closed loop.
  • the device can have a recirculating pump.
  • the catheter can have an inflow lumen and an outflow lumen.
  • the recirculating pump is recirculating fluid, the inflow lumen and the outflow lumen can be in fluid communication with the recirculating pump.
  • a perimeter of the first loop as measured along a center longitudinal axis of the catheter can be smaller or larger when the catheter is in the second configuration than when the catheter is in the first configuration.
  • the first loop can define a first cell having a first cell central axis.
  • the second loop can define a second cell having a second cell central axis.
  • the first cell central axis can be offset from the second cell central axis.
  • the first loop can be closer to or farther from the second loop when the catheter is in the second configuration than when the catheter is in a third configuration.
  • a perimeter of the second loop as measured along a center longitudinal axis of the catheter can be smaller or larger when the catheter is in the second configuration than when the catheter is in a third configuration.
  • the first configuration, the second configuration, and the third configuration can be deployed configurations.
  • the first loop can be an open loop.
  • the first loop can be a closed loop.
  • the second loop can be a closed loop.
  • the first loop can be an open loop
  • the figures illustrate, for example, a method of changing a temperature of a stomach via a catheter (e.g., the catheter 9).
  • the catheter can have an inflow channel, an outflow channel, a first temperature sensor, a second temperature sensor, and a proboscis.
  • the proboscis can have the first temperature sensor.
  • the proboscis and the first temperature sensor can be distal the inflow channel, the outflow channel, and the second temperature sensor.
  • the method can include positioning the catheter in the stomach. Positioning the catheter in the stomach can include positioning the first temperature sensor and the proboscis closer to the pylorus than the second temperature sensor.
  • Positioning the catheter in the stomach can include positioning the second temperature sensor lcm-20cm from the lower esophageal sphincter.
  • the second temperature sensor can be 50cm-300cm proximal the first temperature sensor.
  • the method can include measuring a temperature of the stomach with the first temperature sensor and/or measuring a temperature of the stomach with the second temperature sensor.
  • the first temperature sensor can be embedded in the proboscis. Transferring heat to and/or from the stomach via the catheter positioned in the stomach can include flowing a fluid through the inflow channel and the outflow channel.
  • the first temperature sensor can be a first thermocouple.
  • the second temperature sensor can be a second thermocouple. Transferring heat to and/or from the stomach via the catheter positioned in the stomach can include flowing a fluid through the inflow channel and the outflow channel.
  • the figures illustrate, for example, a method of changing a temperature of a stomach via a catheter (e.g., the catheter 9).
  • the catheter can have an inflow channel, an outflow channel, a first temperature sensor, a second temperature sensor, and a proboscis.
  • the proboscis can have the first temperature sensor.
  • the method can include positioning the catheter in the stomach. Positioning the catheter in the stomach can include positioning the first temperature sensor and the proboscis farther from the pylorus than the second temperature sensor.
  • the method can include transferring heat to and/or from the stomach via the catheter positioned in the stomach.
  • the first temperature sensor and the second temperature sensor can be separated by a first distance.
  • the first temperature sensor and the second temperature sensor can be separated by a second distance.
  • the first distance can be greater than the second distance.
  • Positioning the catheter in the stomach can include positioning the second temperature sensor lcm-20cm from the pylorus.
  • Positioning the catheter in the stomach can include positioning the second temperature sensor farther from the lower esophageal sphincter than the first temperature sensor and the proboscis.
  • the catheter can moving from the first operational configuration to the second operational configuration can include a portion of the catheter migrating out of the stomach, through the pylorus, and into the duodenum.
  • the catheter moving from the first operational configuration to the second operational configuration can include a portion of the catheter passively moving out of the stomach, through the pylorus, and into the duodenum.
  • the method can include transferring heat to and/or from the stomach when the catheter is in the first operational configuration.
  • the method can include transferring heat to and/or from the stomach, the pylorus, and the duodenum when the catheter is in the second operational configuration.
  • Transferring heat to and/or from the stomach when the catheter is in the first operational configuration can include flowing a fluid through an inflow lumen and an outflow lumen in the catheter when the catheter is in the first operational configuration.
  • Transferring heat to and/or from the stomach, the pylorus, and the duodenum when the catheter is in the second operational configuration can include flowing the fluid through the inflow lumen and the outflow lumen in the catheter when the catheter is in the second operational configuration.
  • the method can include transferring heat to and/or from the stomach as the catheter moves from the first operational configuration to the second operational configuration.
  • Transferring heat to and/or from the stomach as the catheter moves from the first operational configuration to the second operational configuration can include flowing the fluid through the inflow lumen and the outflow lumen in the catheter as the catheter moves from the first operational configuration to the second operational configuration.
  • the figures illustrate, for example, a device (e.g., the heat transferer 4).
  • the device can have a catheter having an inflow channel, an outflow channel, a first temperature sensor, a second temperature sensor, and a proboscis.
  • the proboscis can include the first temperature sensor.
  • the proboscis and the first temperature sensor can be distal the inflow channel, the outflow channel, and the second temperature sensor.
  • the first temperature sensor and the second temperature sensor can be separated by a first distance.
  • the first temperature sensor and the second temperature sensor can be separated by a second distance. The first distance can be greater than the second distance.
  • the manual retraction of the pull wire can be performed automatically by the cooling and/or warming console at the onset of applying cooling and/or warming media into the insertion tube.
  • the balloon can be expelled automatically when the cooling and/or warming media is applied to the two-lumen tether.
  • the cooling and/or warming media can be directed through the inflow lumen of the tether and can begin to expand the proboscis portion of the balloon.
  • the cooling and/or warming media can distend the balloon out from the distal end of the insertion tube.
  • the mechanical action of the fluid can expel the balloon as it expands to allow the balloon to fall to the bottom portion of the stomach.
  • the balloon can continue to be filled through the inflow tube with return media traveling through the outflow lumen.
  • the instillation of the cooling and/or warming media can inflate the balloon and the hydraulic energy can evert the balloon from the distal end of the insertion tube as the balloon unfolds.
  • the balloon can be shaped like a straight or curved cylinder, round ball, donut with an open central hole, or a spiral coil.
  • the balloon shape can prevent the balloon from traveling through the pylorus and into the duodenum.
  • the balloon can have sensors.
  • the sensors can be applied to the balloon.
  • the sensors can measure stomach activity during the course of treatment.
  • Types of sensors include pH, temperature, and pressure sensors to measure the activity of the stomach on the balloon.
  • the sensors can inform the user on the degree of cooling and/or warming and its effect on the activity of the stomach during treatment.
  • the catheter or balloon system can include a dynamic actuator at the distal portion of the system that resides in the stomach during cooling and/or warming.
  • the distal portion can be configured to rotate or gyrate to provide constant movement of the applicator of cooling and/or warming energy in the stomach.
  • the dynamic movement can ensure that cooling and/or warming energy is applied to varying locations of the stomach during cooling and/or warming treatment without being applied in the same location.
  • Gyration of the distal portion can occur with an internal torque wire within the catheter system that can be mechanically connected to the cooling and/or warming console. Upon the onset of cooling and/or warming energy, the torque wire can be rotated that applies constant and dynamic movement to the distal portion of the catheter system.
  • the distal portion of the catheter system can curve and fold up upon retraction of an internal pull wire within the catheter system.
  • the proximal portion of the pull wire can be mechanically attached to the cooling and/or warming console. Upon the onset of cooling and/or warming energy, the pull wire can be retracted and released which can apply constant and dynamic movement to the distal portion of the catheter system.
  • the distal portion of the catheter system can be configured with drip holes that allow controlled amounts of cooling and/or warming fluid to be dripped into the stomach.
  • This action can apply a controlled volume of fluid to the interior portion of the stomach to facilitate cooling and/or warming action and coupling the cooling and/or warming energy to the stomach.
  • the cooling and/or warming fluid through the drip holes can be controlled by pore size and fluid pressure of the cooling and/or warming media within the catheter.
  • the dripping action can occur automatically as part of the cooling and/or warming treatment.
  • the volume of cooling and/or warming fluid in the stomach can be controlled by the user and cooling and/or warming console by adjusting the cooling and/or warming fluid pressure. A higher inflow pressure can match the rate of absorption of fluid in the stomach to keep the fluid coupling environment optimum for providing cooling and/or warming energy to the stomach.
  • the distal portion of the first lumen of a catheter system can be configured with drip holes that allow controlled amounts of cooling and/or warming fluid to be dripped into the stomach. This action can apply a controlled volume of fluid to the interior portion of the stomach to facilitate cooling and/or warming action and coupling the cooling and/or warming energy to the stomach.
  • the cooling and/or warming fluid through the drip holes can be controlled by pore size and fluid pressure of the cooling and/or warming media within the first lumen of the catheter.
  • the dripping action can occur automatically as part of the cooling and/or warming treatment.
  • a second lumen of the catheter can have holes for outflow of the fluid to return external to the cooling and/or warming source (temperature regulation device) or discarded.
  • Suction can be applied at the portion of the second lumen external to the body.
  • the volume of cooling and/or warming fluid in the stomach can be by the adjustment of the rate of inflow into the stomach and outflow out of the stomach.
  • a higher inflow pressure can match the outflow rate of fluid in the stomach to keep the fluid coupling optimum for transfer of cooling and/or warming energy to the stomach.
  • the catheter system can be configured for preferential thermal transfer on the inflow portion of the catheter over the remaining portions of the catheter including exterior portions of the catheter system that are adjacent to the outflow lumen or aspiration lumen.
  • the exterior wall of the inflow lumen can have less insulation or wall thickness than the remaining portions of the catheter.
  • the preferential thermal transfer region of the inflow lumen can be positioned at the distal portion of the catheter or the region of the body of cooling/warming.
  • the preferential thermal transfer region can be made by providing a thin-wall membrane on the exterior of the inflow lumen at the distal end portion of the catheter system.
  • a thin-wall membrane on the exterior of the inflow lumen at the distal end portion of the catheter system.
  • FIG. 28a and 28b depict a thin-wall membrane on two locations around the circumference of the catheter.
  • one thin-wall membrane e.g., only one thin-wall membrane
  • the outflow lumen can maintain the wall thickness catheter and less preferential thermal transfer to the body.
  • Preferential thermal transfer can be achieved by impregnating the wall of the inflow lumen with metallic particles for added thermal transfer to the body at that location of the catheter system. These metallic particles can also provide greater radiopacity on the inflow portion of the catheter to facilitate catheter placement by providing an indication of location.
  • Metallic particles can be constructed from titanium, stainless steel, tungsten, cobalt chromium, and other biocompatible metals that have greater thermal conductivity than the polymer used for the catheter system.
  • the external console, a DAQ, a data acquisition device, the heat exchange system 13, a computer and/or other systems may provide visual or audible feedback to the user regarding the status the target temperatures of the organ/ and our surrounding fluids.
  • this maybe an LED, LCD or LED screen, or audible tone.
  • Figure 59A illustrates a variation of a shape and/or arrangement of features that the catheter 9 can have.
  • Figure 59A illustrates that the catheter 9 can be, for example, a triangular extrusion.
  • Figure 59A illustrates a variation of a transverse cross-section that the catheter 9 can have.
  • figure 59A illustrates that the catheter 9 can have a triangular cross-section.
  • Figure 59A illustrates that the catheter can have catheter walls 9w (e.g., inner walls 9iw and outer walls 9ow) and any number and/or combination of features described herein.
  • figure 59A illustrates that the catheter 9 can have three lumens, including, for example, the lumen 15, the lumen 16, and the lumen 17.
  • the cross-section of the catheter 9 can have an impact on the heat transfer to and/or from the catheter 9.
  • Figures 59A-59C illustrate that the catheter 9 can have a triangular cross-section.
  • Figure 59C illustrates that the triangular cross-section can extend along a length of the catheter such that the portion of the catheter having the triangular cross-section can form a triangular extrusion (e.g., a triangular prism).
  • the corners of a catheter having a cross-section with a triangular shape can be angular (e.g., sharp) and/or rounded.
  • Figures 59A and 59B illustrate that the corners can be rounded.
  • Figure 59A illustrates that the triangular cross-section can have a vertical width, a horizontal width, and various wall thicknesses.
  • Figure 59A illustrates the wall thickness of the catheter can vary.
  • the vertical width can be, for example, 0.05 inches to 0.5 inches.
  • the horizontal width can be, for example, 0.05 inches to 0.5 inches.
  • the wall thickness of the catheter can be, for example, 0.005 inches to .08 inches thick.
  • Figure 59D illustrates dimensions that a catheter with a triangular cross-section can have.
  • figure 59D illustrates that the catheter 9 can have dimension DI (e.g., 0.015 inches +/- 0.002 inches, 0.018 inches +/- 0.002 inches), dimension D2 (e.g., 0.010 inches +/- 0.003 inches, 0.012 inches +/- 0.003 inches), dimension D3 (e.g., 0.015 inches +/- 0.002 inches, 0.018 inches +/- 0.002 inches), dimension D4 (e.g., 0.065 inches +/- 0.002 inches), dimension D5 (e.g., 0.044 inches +/- 0.002 inches, 0.046 inches +/- 0.002 inches), dimension D6 (e.g., 0.039 inches +/- 0.002 inches), dimension D7 (e.g., 0.034 inches +/- 0.002 inches), catheter horizontal width 9hw (e.g., 0.175 inches +/- 0.002 inches, 0.184 inches +/- 0.002 inches), catheter vertical width 9vw (e.g.,
  • the cross-sectional shape of the catheter 9, the dimensions of the features of the catheter 9 can be selected to improve the heat transfer to and/or from the catheter 9, including for example, providing preferential heat transfer (e.g., cooling and/or warming) on a side of the catheter 9 (e.g., the side having the inflow lumen).
  • the catheter 9 can comprise, for example, Pellethane® 80 AE with 20% BASO4, color: 3.5% compounding solutions #DEV-MCC 0441 (Pebax® 5533 Blue (PMS 2985C reference)
  • the hydraulic diameter of the circular lumens may be larger than the hydraulic diameter of the non-circular lumens.
  • a circular lumen can provide better flow throughout the entire length of the lumen, for example, relative to a non-circular lumen having the same lumenal area. For example, there may be lower flow rates in the corners of the non-circular lumens shown in Figure 27b.
  • Figures 59A and 59B illustrate that the triangular cross-section can have splines.
  • the splines can be heavier walled sections around the circular lumens that can help increase the stiffness of the extrusion (e.g., the portion of the catheter having the triangular cross-section).
  • Figures 59A and 59B illustrate that the catheter can have three splines.
  • the splines can extend along the length of the portion of the catheter having the triangular cross-section.
  • the splines can help improve the resistance of the catheter to kinking when bent and/or the splines can increase the torsional stiffness of the catheter.
  • a catheter with a triangular cross-section can help maximize the thermal transfer (also referred to as heat transfer) between the fluid inside of the heat transfer lumen(s) and the environment (e.g., an organ).
  • the round lumens can reduce kinking of the round lumens, can reduce collapse of the round lumens, or both.
  • the thinner walled section can bow outward with a thicker foundation (e.g., like an arched bridge).

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Abstract

L'invention divulgue des systèmes de thérapie thermique, des dispositifs et leurs méthodes d'utilisation. L'invention divulgue également une hypothermie localisée du pancréas avec un acte d'administration et de mise en place dans l'estomac d'un patient comprenant un système de ballonnet de refroidissement qui peut être utilisé pour le traitement de la pancréatite chez un patient. Le système de ballonnet de refroidissement peut comporter des mécanismes ayant un effet sur le pancréas sans impacter ou induire une hypothermie chez le patient d'une manière systémique. Le système d'hypothermie localisée peut comporter un système d'administration simplifié et peut être destiné à réduire l'inconfort du patient tout en réduisant l'activité métabolique du pancréas enflammé du patient.
PCT/US2025/023034 2024-04-03 2025-04-03 Appareil et méthode de refroidissement et/ou de réchauffement d'un organe Pending WO2025212945A1 (fr)

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US63/574,030 2024-04-03

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Citations (4)

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Publication number Priority date Publication date Assignee Title
US20140074081A1 (en) * 2011-02-01 2014-03-13 Channel Medsystems, Inc. Cyrogenic treatment systems
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