Minimally invasive methods and apparatus

1. A lung biopsy device for use in extracting target tissue from the lung by passing through the intercostal region of a patient's chest wall and passing through the plural space of the patient's chest, the device comprising:

a biopsy tool and a bladed pull-type cutting device having a first reduced diameter with blades retracted and a second inflated enlarged diameter with blades deployed; the biopsy tool comprising:

a set of sequentially applied hollow needles each needle having a needle distal end; and

a deployable and retractable snare, the needle distal end sharpened so as to pass through tissue, the needle defining a needle bore, the snare including a snare shaft and a snare head at a distal end of the snare shaft, the snare head adapted to collapse to a low-profile state when housed within the needle bore and deploy to a higher profile when extended from the needle bore, the snare adapted to be advanced beyond the needle distal end after the needle distal end is advanced beyond the target tissue, and extends through said tissue, hereby defining a tissue track, and thereby anchoring the snare proximate said target tissue, thereby permitting over the snare shaft exchange of sequential hollow needles to enlarge and dilate said tissue track by passage through said intercostal region

the snare having a snare coupling element;

the pull-type cutting device comprising:

a shaft having a shaft distal end and a shaft proximal end and a lumen extending there through;

a cutting head disposed about the shaft distal end, the cutting head including an expandable portion having a bladed cutting portion proximal from the shaft distal end, the expandable portion in fluid communication with a fluid lumen which is adapted to supply fluid to the expandable portion so as to inflate the expandable portion to a second enlarged diameter from a collapsed uninflated diameter, the lumen adapted to pass over a guide wire or snare shaft, at the shaft distal end the expandable portion defining a cavity, extending from the cutting portion are a plurality of cutting elements, the expandable portion distal end including a cutting device coupling element adapted to couple with the snare coupling element, the expandable portion adapted to couple with the snare head and remove tissue along said tissue track defined by said snare location, by the retrograde retraction of the pull-type cutting device without moving said snare head.

2. The device of claim 1 , the snare head further comprising a sealing element adapted to permanently seal the tissue as it is drawn past and through the intercostal region and the plural space tissue.

3. The device of claim 2 , wherein the sealing element is an energy imparting element adapted to cauterize tissue coupled directly to said hollow needle.

4. The device of claim 2 , wherein the sealing element is an energy imparting element adapted to produce radiofrequency energy suitable to cauterize tissue coupled directly to said hollow needle.

5. The device of claim 2 , wherein the sealing element is an energy imparting element adapted to produce laser energy suitable to cauterize tissue coupled directly to said hollow needle.

6. The device of claim 2 , wherein the sealing element is adapted to extrude polymer sealing material.

7. The device of claim 2 , wherein the sealing element is adapted to expel a sealing fluid suitable to seal tissue.

8. The device of claim 7 , wherein the sealing fluid is a biodegradable material suitable to form a plug.

9. The device of claim 2 , wherein the sealing element is adapted to extrude a biodegradable material suitable to form a plug.

10. The device of claim 1 , wherein the cutting elements are blades extending from the cutting portion.

11. The device of claim 1 , wherein the snare comprises a snare head having a proximal end comprising a snare head coupling element, the expandable portion comprising an expandable portion coupling element, the snare head coupling element adapted to couple with the expandable portion coupling element.