Methods and systems for performing submucosal medical procedures
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 resecting a target area of mucosal tissue, comprising:
identifying the target area of mucosal tissue for resection;
elevating a submucosal layer adjacent the target area by injecting a fluid into the submucosal layer;
inserting a submucosal tunneling instrument into the elevated submucosal layer;
operating said submucosal tunneling instrument to create an elongate tunnel in the submucosal layer;
positioning a submucosal dissecting instrument within the elongate tunnel formed by said tunneling instrument;
operating said submucosal dissecting instrument within the elongate tunnel to thereby dissect an area having a diameter larger than a diameter of said elongate tunnel and encompassing said target area;
positioning a tissue resection tool within the dissected area adjacent a boundary between the dissected submucosal layer and an undissected submucosal layer; and
operating said tissue resection tool to resect said target area of mucosal tissue.
2. The method of resecting a target area of mucosal tissue according to claim 1 , wherein said submucosal tunneling instrument and said submucosal dissecting instrument are integrally formed.
3. The method of resecting a target area of mucosal tissue according to claim 1 , wherein said submucosal tunneling instrument comprises an elongate tubular member having proximal and distal ends and a lumen extending therethrough and an expandable member having proximal and distal ends wherein the proximal end of said expandable member is attached to the distal end of said tubular member and the distal end of said expandable member is everted and positioned within the lumen of said tubular member.
4. The method of resecting a target area of mucosal tissue according to claim 1 , wherein said tissue resection tool comprises a sheath, an elongate member having proximal and distal sections and being slidably disposed within a lumen of said sheath, said elongate member having a first state in which a distal section configuration is generally linear and a second state in which the distal section configuration is generally curved wherein said elongate member is operable between said first and second states, and a resection member having proximal and distal ends wherein the distal end is movably engaged to the distal section of said elongate member such that when said elongate member is in said first or second states said resection member may traverse a path defined by said distal section to thereby resect the mucosal tissue along said path.
5. The method of resecting a target area of mucosal tissue according to claim 4 , wherein said distal end is slidably engaged to the distal section such that when said elongate member is in said first or second states said resection member may slide along said path defined by said distal section to thereby resect the mucosal tissue along said path.