Endoluminal device with retractor system

Patent metadata

Field	Value
Publication number	US-9554690-B2
Application number	US-201514696421-A
Country	US
Kind code	B2
Filing date	Apr 25, 2015
Priority date	Dec 16, 2009
Publication date	Jan 31, 2017
Grant date	Jan 31, 2017

Abstract

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

First claim

We claim:

1. An endoluminal device for insertion into a body lumen of a patient, the endoluminal device comprising:
a tubular member having at least one lumen extending therethrough to receive an endoscopic instrument and a distal opening communicating with the lumen and positioned at a distal end of the lumen; and
a chamber at a distal portion of the device, the chamber extending distal of the distal opening and lumen and including first, second and third connected flexible retractor elements extending distal of the distal opening and lumen and a covering over a portion of the flexible retractor elements to form with the flexible retractor elements an at least partially enclosed chamber distal of the distal opening and lumen with a side access opening in the chamber to access target tissue, the chamber formed within a space between the flexible retractor elements and within the covering, the second and third flexible retractor elements connected at a distal portion of the retractor elements and movable from a first non-expanded position for insertion into the body lumen of the patient to a second radially expanded position to create an increased working space and increased viewing space within the body lumen for performance of a procedure on the target tissue, the first flexible retractor element providing a stiffened structure along the chamber to stabilize the chamber.

2. The endoluminal device of claim 1 , wherein the first flexible retractor element transitions from a first flexible condition to a second more stiffened condition by slidable movement of a stiffening member further in a distal direction distally of the distal opening, the stiffening member axially slidable in a proximal direction to return the first flexible retractor element to the first flexible condition.

3. The endoluminal device of claim 2 , further comprising a first actuator operatively connected to the stiffening member to move the stiffening member in the distal direction from a retracted position to an extended position.

4. The endoluminal device of claim 3 , further comprising a second actuator operatively connected to the second and third flexible retractor elements to move the second and third flexible retractor elements between the non-expanded and expanded positions, wherein the second actuator has multiple fixed positions for achieving multiple fixed expanded positions of the second and third flexible retractor elements.

5. The endoluminal device of claim 1 , wherein the first flexible retractor element forms a substantially rigid beam to provide structural support for the chamber.

6. The endoluminal device of claim 1 , further comprising a transversely extending bridge member attached to and spanning to extend between the second and third flexible retractor elements for maintaining a desired orientation of the second and third flexible retractor elements during expansion, the bridge member stabilizing the second and third flexible retractor elements.

7. The endoluminal device of claim 1 , wherein the tubular member is flexible and includes a second lumen dimensioned to receive an imaging device and a distal opening communicating with the second lumen, both the distal opening communicating with the lumen to receive the endoscopic instrument and the distal opening communicating with the second lumen to receive the imaging device communicate with the chamber.

8. The endoluminal device of claim 1 , wherein the chamber in the expanded position is asymmetrical to form an asymmetric working space such that the first flexible retractor element is closer to a wall of the body lumen opposing the target tissue than it is to a wall having the target tissue.

9. The endoluminal device of claim 1 , wherein the second and third flexible retractor elements converge at a proximal portion and at a distal portion.

10. The endoluminal device of claim 1 , wherein the tubular member comprises a multi-lumen tube with at least two working channels to receive an endoscopic instrument through each working channel.

11. The endoluminal device of claim 1 , wherein the tubular member comprises a multi-lumen tube to receive at least two tool channels to guide insertion of endoscopic tools, the tool channels being bendable to angle a distal end of the endoscopic tool inserted therethrough.

12. An endoluminal device for insertion into a gastrointestinal tract of a patient for performing a surgical procedure on target tissue in the gastrointestinal tract, the endoluminal device comprising:
a tubular member having at least one lumen formed therein to receive an endoscopic instrument and a distal opening communicating with the lumen, the distal opening positioned at a distal end of the lumen; and
a chamber positioned distal of the distal opening and lumen and having a covering to form an at least partially enclosed chamber, the covering having a side access opening communicating with the chamber, the distal opening providing an opening into the chamber, the chamber having a collapsed insertion position and at least one expanded position to form a scaffolding to create an increased working space in the gastrointestinal tract, and further having a flexible condition and a more stiffened condition to stabilize the working space to resist moving forces within the gastrointestinal tract, and an elongated longitudinally extending substantially rigid beam extending distally of the distal opening and lumen forming part of the chamber causing the chamber to be in the more stiffened condition.

13. The endoluminal device of claim 12 , wherein the working space is an asymmetric working space, and the chamber includes a plurality of retractor elements movable to form an asymmetric chamber to increase a distance between a center longitudinal axis of the endoluminal device and the target tissue.

14. The endoluminal device of claim 12 , wherein the chamber includes a plurality of flexible elements and the substantially rigid beam is slidable in an axial direction with respect to one of the flexible elements to stiffen the flexible element to create the more stiffened condition of the chamber, the substantially rigid beam returnable through an opening in the tubular member to a first position to return the flexible element to the flexible condition, and an actuator is operatively connected to the substantially rigid beam to slide the beam in the axial direction.

15. The endoluminal device of claim 14 , wherein expansion of the flexible elements is disproportionately greater on a side between the stiffened flexible element and target tissue than on a side between the stiffening member and an opposing wall of the tract.

16. The endoluminal device of claim 14 , wherein the second and third flexible retractor elements converge at a proximal portion and at a distal portion, wherein the distal portion is distal of the distal opening and lumen.

17. The endoluminal device of claim 12 , further comprising a first actuator for reversibly moving the chamber between the collapsed and expanded position and a second actuator operatively connected to the substantially rigid beam for reversibly transitioning the chamber between the flexible condition and more stiffened condition.

18. The endoluminal device of claim 12 , wherein the substantially rigid beam is elongated such that a lengthwise dimension exceeds a transverse dimension.

Assignees

• Macroplata Inc
• Boston Scient Scimed Inc

Inventors

• Piskun Gregory
• To John
• Fabro Mariel
• Tang Brian
• Kantsevoy Sergey

Classifications

• A61B2017/0225

  flexible, e.g. fabrics, meshes, or membranes · CPC title

• A61B2017/3452

  for the rectum, e.g. for hemorrhoid surgery · CPC title

• A61B1/0125

  Endoscope within endoscope · CPC title

• A61B2017/003

  Steerable · CPC title

• A61B1/00098

  Deflecting means for inserted tools · CPC title