Transluminal endoscopic surgery kit

Abstract

A transluminal surgery kit and method of using the same. In one embodiment, the kit may include an endoscope, a surgical instrument, and an overtube. The surgical instrument may be an injection needle. The overtube, whose primary function is to provide a substantially sterile pathway for the surgical instrument, may include a tubular member having a proximal end, a distal end and a plurality of longitudinal bores. A film may cover the distal end of the tubular member. One of the bores may be appropriately dimensioned to coaxially receive the distal end of the endoscope, with the proximal end of the endoscope preferably not being inserted into the bore but extending proximally therefrom. A fastener for securing the tubular member to a lumen wall within a patient, together with a tool for inserting the fastener through the lumen wall, may be disposed within another one of the bores.

1 . A transluminal surgery kit comprising:
 (a) an access tube, the access tube comprising a proximal end, a distal end, and a channel;   (b) a surgical instrument, the surgical instrument being adapted for removable insertion into the channel of the access tube; and   (c) an overtube, the overtube having a proximal end, a distal end and a longitudinally-extending bore, the longitudinally-extending bore being adapted to removably receive the distal end of the access tube, the distal end of the overtube being adapted to be secured to a lumen wall within a patient.   
     
     
         2 . The transluminal surgery kit as claimed in  claim 1  wherein the distal end of the overtube comprises a cover over a distal end of the longitudinally-extending bore. 
     
     
         3 . The transluminal surgery kit as claimed in  claim 1  wherein the distal end of the overtube comprises a flange through which a fastening element may be inserted to fix the overtube to a lumen wall within a patient. 
     
     
         4 . The transluminal surgery kit as claimed in  claim 3  wherein the flange extends radially outwardly. 
     
     
         5 . The transluminal surgery kit as claimed in  claim 3  wherein the flange extends radially inwardly. 
     
     
         6 . The transluminal surgery kit as claimed in  claim 1  wherein the overtube comprises a tubular member and a transparent film, the tubular member being shaped to include a proximal end, a distal end, a side wall, and a longitudinal bore, the transparent film covering the distal end. 
     
     
         7 . The trans luminal surgery kit as claimed in  claim 1  wherein the surgical instrument comprises an injection needle. 
     
     
         8 . The transluminal surgery kit as claimed in  claim 7  wherein the injection needle comprises a hollow needle, an inner catheter and an outer catheter, the hollow needle being fixedly mounted within a distal end of the inner catheter, the hollow needle and the inner catheter being slidably mounted within the outer catheter. 
     
     
         9 . The transluminal surgery kit as claimed in  claim 8  wherein the channel of the access tube has a diameter of about 4-8 mm and wherein the hollow needle is at least a 9 gauge needle. 
     
     
         10 . The transluminal surgery kit as claimed in  claim 7  wherein the injection needle is dimensioned to extend the length of the overtube. 
     
     
         11 . The transluminal surgery kit as claimed in  claim 1  further comprising a perforating tool. 
     
     
         12 . The transluminal surgery kit as claimed in  claim 1  wherein the overtube includes a tubular member and a fastener for securing the tubular member to a lumen wall within a patient. 
     
     
         13 . The transluminal surgery kit as claimed in  claim 12  wherein the tubular member is radially expandable. 
     
     
         14 . The transluminal surgery kit as claimed in  claim 12  wherein the fastener is a T-fastener. 
     
     
         15 . The transluminal surgery kit as claimed in  claim 12  wherein the overtube further includes means for inserting the fastener through the lumen wall within the patient. 
     
     
         16 . The transluminal surgery kit as claimed in  claim 15  wherein the inserting means comprises a pusher rod. 
     
     
         17 . The transluminal surgery kit as claimed in  claim 1  wherein the access tube is an endoscope. 
     
     
         18 . An injection needle comprising:
 (a) an inner catheter, the inner catheter having a proximal end, a distal end, and a longitudinal bore;   (b) a hollow needle, the hollow needle having a proximal end and a distal end, the proximal end of the hollow needle being coaxially mounted within the distal end of the inner catheter, the hollow needle having an outer diameter at least that of a 9 gauge needle; and   (c) an outer catheter, the outer catheter having a proximal end, a distal end, and a longitudinal bore, the inner catheter and the hollow needle being coaxially mounted within the outer catheter and being movable between an extended position in which the hollow needle extends distally beyond the distal end of the outer catheter and a retracted position in which the hollow needle does not extend distally beyond the distal end of the outer catheter.   
     
     
         19 . The injection needle as claimed in  claim 18  further comprising an inner hub and an outer hub, the inner hub being fixed to the proximal end of the inner catheter and being adapted to convey fluids, the outer hub being fixed to the outer catheter and being adapted to engage the inner hub to limit movement of the hollow needle and the inner catheter relative to the outer catheter. 
     
     
         20 - 29 . (canceled) 
     
     
         30 . A method of accessing a body organ with a needle, the method comprising the steps of:
 (a) providing an overtube, the overtube having a proximal end, a distal end and a longitudinally-extending bore, the longitudinally-extending bore being adapted to removably receive a distal end of an access tube, the distal end of the overtube being adapted to be secured to a lumen wall within a patient;   (b) inserting the distal end of the overtube into a lumen within a patient while keeping the proximal end of the overtube external to the patient;   (c) securing the distal end of the overtube to a wall of the lumen while keeping the proximal end of the overtube external to the patient;   (d) inserting a distal end of an access tube into the overtube;   (e) forming a perforation in the wall of the lumen using a perforating tool inserted into the access tube;   (f) inserting a distal end of a needle into the access tube; and   (g) passing the distal end of the needle through the perforation in the wall of the lumen.   
     
     
         31 - 37 . (canceled)