Devices for delivering substances through an extra-anatomic opening created in an airway

1. A method for performing a procedure on a target tissue in a lung of a patient located outside of an airway lumen, the method comprising:

advancing a tubular structure through the airway lumen of the patient, the airway lumen comprising a tissue lumen wall;

selecting a location along the airway lumen to create an opening through the tissue lumen wall;

creating an incision at the location with a wire member;

enlarging the incision with an inflatable member to form the opening;

advancing the tubular structure into the opening;

advancing a tool through the opening and through the passageway in the tubular structure towards the target tissue within the parenchyma; and

performing a procedure on the target tissue in the parenchyma with the tool.

2. The method of claim 1 , wherein the tool is selected from the group consisting of a substance delivery catheter, an ablation device, a biopsy device, and an imaging device.

3. The method of claim 1 , wherein the tool is a forceps.

4. The method of claim 1 , wherein the procedure is a biopsy.

5. The method of claim 1 , wherein the target tissue is a tumor.

6. The method of claim 1 , wherein the tubular structure is a flexible elongate tubular member.

7. The method of claim 1 , wherein the tubular structure is rigid.

8. The method of claim 1 , wherein advancing the tubular structure through the airway lumen comprises advancing the tubular structure through a branching structure of airways.

9. The method of claim 8 , further comprising mechanically maintaining the patency of the opening by inserting the tubular structure into the opening.

10. The method of claim 1 , further comprising mechanically maintaining the patency of the opening, thereby forming an open channel.

11. A method for performing a procedure on a target tissue of a lung of a patient located outside of an airway lumen within a parenchyma of the lung, the method comprising:

selecting a location along the airway lumen to create an access point through a tissue lumen wall;

delivering energy to the location to create an incision at the location;

enlarging the incision to form the access point;

inserting a tubular structure in the access point, the tubular structure comprising an open channel to establish the access point to the target tissue within the parenchyma; and

advancing a tool through the open channel, and towards the target tissue; and

performing a procedure on the target tissue within the parenchyma with the tool.

12. The method of claim 11 , wherein the procedure is a biopsy.