Tissue resection device
Instruments and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. The instruments include a mucosal resection device, a tissue grasper and a snare. Systems include a combination of one or more of such instruments. Embodiments of various methods for performing the procedures are also provided.
1. An apparatus for resecting a target area of mucosal tissue comprising:
an elongate member having proximal and distal sections wherein said distal section includes first and second guides, each a separate tube and each having a proximal end, a distal end, and a longitudinally extending slot along said guide and ending proximal of said distal end, at least one of said distal ends of said first and second guides having an outward bias relative to the other of said distal ends, and said slots defining a path; and
a resection member having first and second proximal ends and a distal end wherein said first and second proximal ends extend within interiors of said first and second guides, respectively, and said distal end extends between said first and second guides of said elongate member such that said distal end of said resection member may traverse said path defined by said slots of said first and second guides,
wherein distal advancement of said first and second proximal ends of said resection member within said first and second guides causes at least one of said first and second guides to be moved against said outward bias and be brought closer to the other of said first and second guides.
2. An apparatus according to claim 1 , wherein said resection member is electro-conductive.
3. An apparatus according to claim 2 , wherein said first and second guides are non-conductive and curved.
4. An apparatus according to claim 2 , further comprising a proximal handle coupled to said proximal end of said elongate member and which longitudinally displaces said resection member through said distal section.
5. An apparatus according to claim 4 , wherein said proximal handle includes an electrical connector adapted for coupling said resection member to an electrosurgical generator.
6. An apparatus according to claim 1 , wherein said first and second guides are non-conductive.
7. An apparatus according to claim 6 , wherein said first and second guides are curved.
8. An apparatus according to claim 7 , wherein said slots face one another.
9. An apparatus according to claim 1 , wherein said first and second guides are non-conductive, and said slots face one another.
10. An apparatus according to claim 1 , wherein said slots face one another.
11. An apparatus according to claim 1 , wherein when said resection member is retracted, said first and second guides are allowed to open apart from each other.
12. An apparatus according to claim 1 , wherein proximal retraction of said resection member relative to the path allows said first and second guides to move away from each other under the force of said outward bias.
13. An apparatus according to claim 1 , wherein said first and second proximal ends of said resection member each have an outer diameter that is larger than a width of the respective slot of said first and second guides.
14. An apparatus according to claim 1 , wherein said first guide is longer than said second guide.
15. An apparatus for resecting a target area of mucosal tissue, comprising:
an elongate member having proximal and distal sections;
first and second electrically-insulated tubular guides coupled to said distal section, each of said guides defining a longitudinal slot, said longitudinal slots facing each other, each of said first and second guides having an outer diameter larger than a width of said longitudinal slots;
an electro-conductive resection member having proximal and distal ends wherein the distal end forms a loop that extends through said first guide, through said longitudinal slots, and back through said second guide,
wherein when said resection member is distally advanced relative to said first and second guides, said first and second guides are brought closer together, and when said resection member is retracted, said first and second guides are allowed to open apart from each other; and
a proximal handle coupled to said elongate member for longitudinally displacing said resection member within said longitudinal slots such that said resection member may traverse mucosal tissue along a path defined between said first and second guides and resect such mucosal tissue, said handle including an electrical connector adapted for coupling said resection member to an electrosurgical generator.
16. An apparatus according to claim 15 , wherein said first and second guides have an arcuate shape.
17. An apparatus according to claim 15 , wherein:
said tubular guides are configured in a ‘Y’-configuration.
18. An apparatus for resecting a target area of mucosal tissue comprising:
an elongate member having proximal and distal sections wherein said distal section includes separate first and second tubular guides each having a proximal end, a distal end, and a longitudinally extending slot, and at least one of said distal ends of said first and second guides having an outward bias relative to the other of said distal ends, and said slots defining a path; and
a resection member having first and second proximal ends and a distal end wherein said first and second proximal ends extend within interiors of said first and second guides, respectively, and said distal end extends between said first and second guides of said elongate member such that said distal end of said resection member may traverse said path defined by said slots of said first and second guides, and said first and second proximal ends of said resection member each have an outer diameter that is larger than a width of the slot through the respective first and second guides,
wherein distal advancement of said first and second proximal ends of said resection member within said first and second guides causes at least one of said first and second guides to be moved against said outward bias and be brought closer to the other of said first and second guides.