EUS guided access device
A system for endoscopic ultrasound guided drainage includes an access sheath extending longitudinally from a proximal end to a distal end and including an access lumen extending therethrough from the proximal end to the distal end; a stylet slidably received within the access lumen, the stylet extending longitudinally from a proximal end to distal end and including a channel extending therethrough, the channel configured to receive a fluid therethrough; and a dilating sheath extending longitudinally from a proximal end to a distal end and including a dilating lumen extending therethrough. The dilating lumen is sized and shaped to slidably receive the access sheath.
1. A system for endoscopic ultrasound guided drainage, comprising:
an access sheath extending longitudinally from a proximal end to a distal end and including an access lumen extending therethrough from the proximal end to the distal end;
a stylet slidably received within the access lumen, the stylet extending longitudinally from a proximal end to distal end and including a channel extending therethrough, the channel configured to receive a fluid therethrough; and
a dilating sheath extending longitudinally from a proximal end to a distal end and including a dilating lumen extending therethrough, the dilating lumen sized and shaped to slidably receive the access sheath, the dilating sheath including a stepped diameter increase at a discrete distance from the distal end.
2. The system of claim 1 , wherein the access sheath includes a distal portion biased toward a curved configuration.
3. The system of claim 2 , wherein the access sheath is formed of a flexible polymeric material which permits the curved distal portion to be moved to a straightened configuration when the stylet is received therein.
4. The system of claim 2 , wherein the curved configuration is one of a pigtail loop, a J-shape and a shepherd's crook.
5. The system of claim 1 , wherein the stylet includes a distal portion having a diameter larger than a remaining length of the stylet extending proximally from the distal portion.
6. The system of claim 1 , wherein a portion of the channel extending through the distal portion of the stylet is defined by an annular space extending about a longitudinal axis of the stylet.
7. The system of claim 1 , further comprising a handle assembly coupled to a proximal end of each of the stylet, access sheath and dilating sheath.
8. The system of claim 7 , wherein the handle assembly includes an actuator for moving the dilating sheath longitudinally relative to the access sheath.
9. The system of claim 1 , the dilating sheath including an electrode at a distal end thereof configured to cauterize tissue.
10. The system of claim 1 , wherein the dilating sheath includes a plurality of stepped diameter increases at discrete distances from the distal end.
11. A system for endoscopic drainage, comprising:
an access sheath extending longitudinally from a proximal end to a distal end and including an access lumen extending therethrough from the proximal end to the distal end;
a stylet slidably received within the access lumen, the stylet extending longitudinally from a proximal end to distal tip and including a channel extending therethrough, the channel configured to receive a fluid therethrough, a distal portion of the stylet having a larger diameter than a remaining portion of the stylet extending proximally therefrom, the diameter of the distal portion of the stylet corresponding to a diameter of the access lumen to facilitate puncturing of a target tissue; and
a dilating sheath extending longitudinally from a proximal end to a distal end and including a dilating lumen extending therethrough, the dilating lumen sized and shaped to slidably receive the access sheath, the dilating sheath including a stepped diameter increase at a discrete distance from the distal end.
12. The system of claim 11 , wherein the access sheath includes a distal portion biased toward a curved configuration.
13. The system of claim 11 , further comprising a handle assembly coupled to a proximal end of each of the stylet, access sheath and dilating sheath.
14. The system of claim 11 , wherein a portion of the channel extending through the distal portion of the stylet is defined by an annular space extending about a longitudinal axis of the stylet.
15. The system of claim 13 , wherein the access sheath is formed of a flexible polymeric material which permits the curved distal portion to be moved to a straightened configuration when the stylet is received therein.
16. The system of claim 13 , wherein the handle assembly includes an actuator for moving the dilating sheath longitudinally relative to the access sheath.
17. A method for endoscopic ultrasound guided drainage, comprising:
inserting an access sheath and a stylet through a working channel of an endoscope into a target duct within a body, the stylet extending through a lumen of the access sheath such that a distal tip of the stylet extends distally past a distal end of the access sheath so that the distal tip punctures the target duct;
injecting a contrast media through a channel of the stylet into the target duct to visually verify that the target duct is filled with fluids; and
advancing a dilating sheath distally over the access sheath and into the target duct to dilate the target duct.
18. The method of claim 17 , wherein the target duct is one of a bile duct, pancreatic duct, a cyst and a gallbladder.
19. The method of claim 17 , further comprising removing the stylet from the access sheath so that a distal portion of the access sheath reverts to a curved configuration.
20. The method of claim 17 , further comprising cauterizing a surface of the target duct via an electrode of the dilating sheath.
21. The method of claim 17 , further comprising inserting a stent into the target duct to maintain the target duct in an enlarged configuration to ensure continued drainage thereof.