Multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment
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.
1. A method, comprising:
inserting a flexible catheter into a body lumen, wherein the flexible catheter includes a body lumen reshaping system and is configured to receive an endoscope;
expanding the body lumen reshaping system from a non-expanded insertion position to an expanded position to create an asymmetric working space within the body lumen;
rigidifying the body lumen reshaping system by distally advancing a rigidifying structure;
maneuvering a first flexible tube within the catheter, the first flexible tube being axially movable and rotatable within the catheter, wherein a portion of the first flexible tube when extending distally beyond a distal end of the catheter defines a fixed curve; and
maneuvering a first endoscopic tool within the first flexible tube to adjust a distance between a distal tip of the first endoscopic tool and a target tissue within the body lumen without changing the fixed curve of the first flexible tube.
2. The method of claim 1 , wherein the portion of the first flexible tube includes a substantially straightened configuration when disposed in a lumen of the catheter and moves to the fixed curve when extended distally beyond the distal end of the catheter.
3. The method of claim 1 , further comprising maneuvering a second flexible tube within the catheter, the second flexible tube being axially movable and rotatable within the catheter, wherein a portion of the second flexible tube when extended distally beyond a distal end of the catheter defines a fixed curve; and
maneuvering a second endoscopic tool within the second flexible tube to adjust a distance between a distal tip of the second endoscopic tool and the target tissue without changing the fixed curve of the second flexible tube.
4. The method of claim 3 , wherein the portion of the second flexible tube includes a substantially straightened configuration when disposed in a lumen of the catheter and moves to the fixed curve when extended distally beyond the distal end of the catheter.
5. The method of claim 4 , wherein the fixed curves of the first and second flexible tubes angle the respective first and second endoscopic tools toward the target tissue.
6. The method of claim 3 , wherein the first and second flexible tubes are removably insertable through the catheter.
7. The method of claim 1 , wherein the catheter includes the endoscope received therethrough and the method further comprises inserting a working instrument through a working channel of the endoscope and into the asymmetric working space.
8. The method of claim 1 , further comprising the step of capturing an excised portion of the target tissue within the body lumen reshaping system.
9. A method, comprising:
advancing a flexible catheter and a flexible endoscope within a body lumen adjacent to a target tissue, the flexible catheter including a working space expanding system;
visualizing the target tissue with the flexible endoscope;
expanding the working space expanding system from a non-expanded insertion position to an expanded position to provide increased working space within the body lumen;
rigidifying the working space expanding system by advancing a rigidifying structure with respect to the working space expanding system;
maneuvering a first flexible tube within the catheter, the first flexible tube being axially movable and rotatable within the catheter, wherein a distal portion of the first flexible tube defines a fixed curve when extended beyond a distal end of the flexible catheter; and
maneuvering a first endoscopic tool within the first flexible tube to adjust a distance between a distal tip of the first endoscopic tool and the target tissue without changing the fixed curve of the first flexible tube.
10. The method of claim 9 , further comprising maneuvering a second flexible tube within the catheter, the second flexible tube being axially movable and rotatable within the catheter, wherein a distal portion of the second flexible tube defines a fixed curve when extended beyond a distal end of the flexible catheter; and
maneuvering a second endoscopic tool within the second flexible tube to adjust a distance between a distal tip of the second endoscopic tool and the target tissue without changing the fixed curve of the second flexible tube.
11. The method of claim 10 , wherein the distal portion of the second flexible tube includes a substantially straightened configuration when disposed in a lumen of the catheter and moves to the fixed curve when extended distally beyond the distal end of the catheter.
12. The method of claim 10 , wherein the fixed curves of the first and second flexible tubes angle the respective first and second endoscopic tools toward the target tissue.
13. The method of claim 9 , wherein the distal portion of the first flexible tube includes a substantially straightened configuration when disposed in a lumen of the catheter and moves to the fixed curve when extended distally beyond the distal end of the catheter.
14. The method of claim 9 , wherein the working space expanding system includes a covering.
15. The method of claim 9 , wherein the rigidifying structure is distally advanced by actuating a control.
16. A method, comprising:
inserting a flexible catheter into a body lumen, wherein the flexible catheter includes a body lumen reshaping system and is configured to receive an endoscope;
expanding the body lumen reshaping system from a non-expanded insertion position to an expanded position to create an asymmetric working space within the body lumen;
maneuvering a first flexible tube within the catheter, the first flexible tube being axially movable and rotatable within the catheter, wherein a portion of the first flexible tube when extending distally beyond a distal end of the catheter defines a fixed curve;
maneuvering a first endoscopic tool within the first flexible tube to adjust a distance between a distal tip of the first endoscopic tool and a target tissue within the body lumen without changing the fixed curve of the first flexible tube; and
capturing an excised portion of the target tissue within the body lumen reshaping system.
17. The method of claim 16 , wherein the portion of the first flexible tube includes a substantially straightened configuration when disposed in a lumen of the catheter and moves to the fixed curve when extended distally beyond the distal end of the catheter.
18. The method of claim 16 , further comprising maneuvering a second flexible tube within the catheter, the second flexible tube being axially movable and rotatable within the catheter, wherein a portion of the second flexible tube when extended distally beyond a distal end of the catheter defines a fixed curve; and
maneuvering a second endoscopic tool within the second flexible tube to adjust a distance between a distal tip of the second endoscopic tool and the target tissue without changing the fixed curve of the second flexible tube.
19. The method of claim 18 , wherein the portion of the second flexible tube includes a substantially straightened configuration when disposed in a lumen of the catheter and moves to the fixed curve when extended distally beyond the distal end of the catheter.
20. The method of claim 19 , wherein the fixed curves of the first and second flexible tubes angle the respective first and second endoscopic tools toward the target tissue.
21. The method of claim 16 , wherein the catheter includes the endoscope received therethrough and the method further comprises inserting a working instrument through a working channel of the endoscope and into the asymmetric working space, further comprising inserting a working instrument through a working channel of the endoscope and into the asymmetric working space.