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

1. A method for performing a procedure on a patient in an area of a lung beyond and remote from an airway in the lung, the method comprising:

advancing a first device through a natural respiratory opening and into an airway in the lung;

creating an opening through the airway wall of the lung with a piercing member;

advancing a tubular member located about the piercing member into the opening such that a passageway through the tubular member extends through the airway wall;

removing the piercing member from the tubular member such that the tubular member remains in the airway wall and the passageway of the tubular member provides an access path to a treatment site;

advancing a second device through the passageway of the tubular member to access the treatment site in the lung beyond the airway wall, the second device comprising an elongate flexible proximal shaft; and

performing the procedure at the treatment site via the second device after advancing the second device through the passageway of the tubular member.

2. The method of claim 1 , wherein the piercing member has a lumen.

3. The method of claim 1 , wherein the step of performing the procedure comprises delivering a substance to the treatment site through the second device.

4. The method of claim 1 , wherein at least one of the steps is performed through a bronchoscope.

5. The method of claim 1 , wherein the piercing member includes an obturator.

6. The method of claim 1 , wherein the step of performing the procedure comprises treating a suspected diseased tissue.

7. The method of claim 6 , wherein the suspected diseased tissue is a lung tumor.

8. The method of claim 1 , further comprising enlarging the opening with a balloon.

9. The method of claim 1 , wherein the step of performing a procedure comprises a biopsy.

10. The method of claim 9 , wherein the tubular member is placed using a guide-wire.

11. The method of claim 1 , wherein the piercing member comprises a piercing device having a conical tip and a lumen extending therethrough, and an elongate wire extendable past the conical tip, and wherein after the elongate wire creates the opening the conical tip may be driven into the opening gradually expanding the opening to allow the tubular member to be subsequently placed therethrough.

12. The method of claim 1 , further comprising inspecting the treatment site with the first device.

13. The method of claim 1 , further comprising inspecting the treatment site for a blood vessel with the first device.

14. The method of claim 13 , wherein the inspecting step is performed prior to the creating step.

15. The method of claim 1 , wherein the first device comprises an ultrasound device, a thermal device, or an imaging device.

16. The method of claim 1 , wherein the piercing member is a needle.

17. The method of claim 1 , wherein the piercing member is used to deliver a substance to the lung.