Minimally invasive access channels into bodily regions
The present invention discloses access devices and methods to create an access channel for introduction of one or more working devices into an anatomical region. The access channel is created using a visualization modality that is later removed before inserting one or more working devices through the access channel. This allows the methods and devices of the present invention to be used even in small sized natural or surgically created insertion tracts leading to the anatomical region. The access channel can be made of a device such as a sheath, a guidewire, and an elongate device comprising a lumen. Examples of visualization modalities are endoscopes and body insertable ultrasound imaging devices. The working devices can be used to perform a variety of diagnostic, therapeutic, or preventive procedures. Endometrial ablation devices and procedures have been used as an example to describe various aspects of the present invention.
1. A method of performing a medical procedure within an anatomical region, the method comprising:
advancing an endoscope to the anatomical region through a cannula;
visualizing the anatomical region using the endoscope to determine at least one treatment parameter;
positioning a distal region of the cannula in a target location;
removing the endoscope while maintaining the distal region of the cannula at the target location
advancing a medical device comprising an antenna through the cannula to the target location within the anatomical region; and
performing an ablation procedure in the anatomical region with the medical device using the at least one treatment parameter.
2. The method of claim 1 , wherein the at least one treatment parameter is based on a size of the anatomical region.
3. The method of claim 1 , further comprising performing a visual analysis using the endoscope, where the visual analysis affects the medical procedure.
4. The method of claim 3 , where the visual analysis is selected from a group consisting of
screening a patient for eligibility of the medical procedure;
checking an anatomical or a pathological landmark; and
measuring at least one parameter of the anatomical region.
5. The method of claim 3 , wherein the endoscope is used to visualize the anatomical region before and after performing the medical procedure, and the method further comprises estimating a change in the anatomical region due to the medical procedure.
6. The method of claim 5 , wherein the change in the anatomical region due to the medical procedure is used for one or more of: to determine a necessity of a second medical procedure using the medical device, to confirm an effect of the medical procedure, to estimate an outcome of the medical procedure.
7. The method of claim 1 , further comprising introducing the endoscope to the anatomical region using the cannula after performing the medical procedure.
8. The method of claim 7 , further comprising confirming an effect of the medical procedure using the endoscope.
9. The method of claim 7 , further comprising performing a second medical procedure using the medical device.
10. The method of claim 1 , further comprising distending the anatomical region using one of: fluid based distension and mechanical distension without a distension fluid.
11. The method of claim 10 , wherein distending the anatomical region is used for one or more of: visualizing an interior surface of the anatomical region, visualizing anatomical landmarks of the anatomical region, and flushing the anatomical region.
12. The method of claim 1 , further comprising removing one or more materials from the anatomical region through the cannula.
13. The method of claim 1 , further comprising confirming one or both of: position and deployment of the medical device.
14. The method of claim 13 , wherein confirming the deployment of the medical device comprises the step of confirming that an antenna of the medical device is deployed to one of: a greatest transverse dimension, a greatest volume, and a greatest longitudinal dimension that is mechanically possible in the anatomical region.
15. The method of claim 13 , wherein confirming the position and/or deployment of the medical device comprises one of: comparing a measured insertion depth of the medical device with an expected insertion depth, measuring a returned power level of microwave energy delivered to the medical device, measuring an inflation volume of a balloon, measuring pressure at a point over or inside the medical device, measuring temperature, measuring a dimension of the medical device, using an imaging modality, checking for perforation, noting pain or discomfort felt by a patient, feeling a resistance to insertion of the medical device.
16. The method of claim 13 , further comprising confirming that a distal end of the medical device is touching a distal end of the anatomical region.
17. The method of claim 13 , further comprising preventing a start of a medical procedure if one or both of: position and deployment of the medical device are improper.
18. The method of claim 1 , further comprising sealing a region between the cannula and the anatomical region.
19. The method of claim 1 , further comprising inserting a tube into the cannula to stiffen the cannula.
20. The method of claim 1 , further comprising converting the medical device between an undeployed configuration when introduced using the cannula and a deployed configuration inside the anatomical region.