Endoscopic submucosal dissection hood
The present disclosure relates to the field of endoscopy. In particular, the present disclosure relates to systems and methods suitable for resecting or dissecting large areas of mucosal or submucosal tissue. The system may apply tension to and continuously manipulate mucosal tissue such that large lesions may be resected or dissected by a cutting element disposed at the distal end of an endoscope.
1. An endoscopic hood configured to be disposed at a distal end of an endoscope comprising an endoscope body and a working channel disposed within the endoscope body, the endoscopic hood comprising:
a first portion comprising a proximal end, a distal end and first and second lumens extending therebetween;
a second portion extending from the distal end of the first portion, said second portion comprising a curved wall with an open distal end and defining a working area adjacent a concave surface of the curved wall and the first lumen; and
a support member extending into the first lumen adjacent to the curved wall;
wherein the first lumen is configured to receive a portion of a shaft of a first device disposed in the working channel of the endoscope, and wherein the second lumen is configured to slidably and rotationally receive a portion of a shaft of a second device disposed along an outer surface of the endoscope.
2. The endoscopic hood of claim 1 , wherein the curved wall comprises one or more of a partial hollow conic section, a partial hollow cylinder or a partial hollow sphere.
3. The endoscopic hood of claim 1 , wherein the curved wall comprises a cross-section in the form of an arc.
4. The endoscopic hood of claim 3 , wherein the arc ranges from approximately 90 degrees to approximately 180 degrees.
5. The endoscopic hood of claim 1 , wherein the curved wall is formed from a transparent material.
6. The endoscopic hood of claim 1 , wherein the support member defines an aperture having a non-circular cross-section.
7. An endoscopic system comprising:
an endoscope comprising an elongate body having a proximal end, a distal end and a working channel disposed within the elongate body;
an endoscopic hood coupled to the distal end of the endoscope, the endoscopic hood comprising:
a first portion comprising a proximal end, a distal end and first and second lumens extending therebetween, wherein the first lumen is in communication with the working channel of the endoscope,
a second portion extending from the distal end of the first portion, said second portion comprising a curved wall with an open distal end and defining a working area adjacent a concave surface of the curved wall and the first lumen, and
a support member extending into the first lumen adjacent to the curved wall;
a first shaft having a proximal end and a distal end, wherein a portion of the first shaft is disposed within the working channel and the first lumen; and
a second shaft having a proximal end and a distal end, wherein a portion of the second shaft is slidably and rotationally disposed along an outer surface of the elongate body and extends through the second lumen.
8. The endoscopic system of claim 7 , wherein the curved wall comprises one or more of a partial hollow conic section, a partial hollow cylinder or a partial hollow sphere.
9. The endoscopic system of claim 7 , wherein the curved wall comprises a cross-section in the form of an arc.
10. The endoscopic system of claim 7 , wherein the support member defines an aperture having a non-circular cross-section.
11. The endoscopic system of claim 10 , wherein the aperture of the support member is configured to slidably receive the first shaft.
12. The endoscopic system of claim 7 , wherein the first shaft is slidably, but not rotationally, disposed within the working channel and first lumen.
13. The endoscopic system of claim 7 , wherein the distal end of the first shaft includes a shape memory material that is configured to assume a bent configuration when unconstrained by an over-sheath or core wire.
14. The endoscopic system of claim 7 , wherein the distal end of the first shaft includes a tissue cutting element, and wherein the distal end of the second shaft includes a tissue engaging element.
15. The endoscopic system of claim 14 , wherein rotating a proximal end of the second shaft in a first direction moves the tissue engaging element towards the working area, and rotating a proximal end of the second shaft in a second direction moves the tissue engaging element away from the working area.
16. The endoscopic system of claim 14 , wherein the tissue cutting element is configured to bend upon actuation by an operation.
17. The endoscopic system of claim 7 , wherein the curved wall comprises a cross-section in the form of an arc.
18. The endoscopic system of claim 17 , wherein the arc ranges from approximately 90 degrees to approximately 180 degrees.
19. The endoscopic system of claim 7 , wherein the curved wall is formed from a transparent material.
20. A method of resecting or dissecting tissue, comprising:
a) inserting, into a body lumen of a patient, an endoscopic system comprising:
an endoscope comprising an elongate body having a proximal end and a distal end and a working channel disposed within the elongate body;
an endoscopic hood coupled to the distal end of the endoscope, the endoscopic hood comprising:
a first portion comprising a proximal end, a distal end and first and second lumens extending therebetween, wherein the first lumen is in communication with the working channel of the endoscope; and
a second portion extending from the distal end of the first portion, said second portion comprising a curved wall with an open distal end and defining a working area adjacent a concave surface of the curved wall and the first lumen;
a first shaft having a proximal end and a distal end, wherein a portion of the first shaft is disposed within the working channel and the first lumen; and
a second shaft having a proximal end and a distal end, wherein a portion of the second shaft is slidably and rotationally disposed along an outer surface of the elongate body and extends through the second lumen, wherein the distal end of the first shaft includes a tissue cutting element, and wherein the distal end of the second shaft includes a tissue engaging element;
b) positioning the endoscopic hood over the surface of a target tissue; and
c) resecting or dissecting the target tissue with said tissue cutting element while engaging the tissue with said tissue engaging element.