Methods and systems for performing submucosal medical procedures
View Patent ↗Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.
1. A method of performing a submucosal medical procedure in a mammal, comprising:
defining a submucosal space by forming at least a submucosal tunnel extending longitudinally beneath a mucosal layer and above a muscular layer of an esophagus, the submucosal tunnel formed by expanding an expandable member substantially greater in length than in diameter, the mucosal layer encompassing a lower esophageal sphincter;
identifying a circular muscle of the lower esophageal sphincter;
delivering an endoscopic cutting instrument into the submucosal space;
incising completely across said circular muscle with said cutting instrument; and
removing the cutting instrument from the patient.
2. A method according to claim 1 , wherein:
the endoscopic cutting instrument is delivered through the esophagus.
3. A method according to claim 1 , wherein:
the endoscopic cutting instrument is flexible.
4. A method according to claim 3 , wherein:
the endoscopic cutting instrument is delivered through an instrument channel of a flexible endoscope.
5. A method according to claim 1 , wherein:
the submucosal space is defined from the interior of the esophagus.
6. A method according to claim 1 , wherein:
the submucosal tunnel first extends through the mucosal layer and then extends longitudinally beneath the mucosal layer.
7. A method according to claim 1 , wherein the submucosal space is further defined by dissecting the mucosal layer from the muscular layer of the esophagus.
8. A method of performing a submucosal medical procedure in a mammal, comprising:
defining a submucosal space by forming at least a submucosal tunnel beneath a mucosal layer of an esophagus, the submucosal tunnel formed by expanding an expandable member substantially greater in length than in diameter, the mucosal layer encompassing a lower esophageal sphincter;
identifying a circular muscle of the lower esophageal sphincter;
delivering an endoscopic cutting instrument through the esophagus and into the submucosal space;
incising completely across said circular muscle with said cutting instrument; and
removing the cutting instrument from the patient.
9. A method according to claim 8 , wherein:
the endoscopic cutting instrument is flexible.
10. A method according to claim 9 , wherein:
the endoscopic cutting instrument is delivered through an instrument channel of a flexible endoscope.
11. A method according to claim 8 , wherein the submucosal space is formed by further dissecting beneath the mucosal layer.