DEVICES FOR DELIVERING SUBSTANCES THROUGH AN EXTRA-ANATOMIC OPENING CREATED IN AN AIRWAY

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

an inspecting device configured to be advanced through the bronchoscope into the airway;

a piercing member configured to extend through the bronchoscope to create an opening through the airway wall;

a tubular member located about the piercing member, the tubular member configured to extend through the opening of the airway wall;

a second device comprising an elongate flexible proximal shaft to access a treatment site in the lung beyond the airway wall, the second device configured to extend through the passageway of the tubular member when the piercing member is removed from the tubular member; and

wherein the second device is further configured to perform the procedure at the treatment site.

2 . The system of claim 1 , wherein the second device comprises a needle.

3 . The system of claim 1 , wherein the second device is a biopsy tool for performing a biopsy.

4 . The system of claim 1 , wherein the tubular member comprises a polymer.

5 . The system of claim 1 , further comprising the bronchoscope.

6 . The system 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.

7 . The system of claim 1 , wherein the inspecting device is an imaging or ultrasound based device.