Steerable device for accessing a target site and methods

Abstract

A variety of steerable needles, lancets, trocars, stylets, cannulas and systems are provided for examining, diagnosing, treating, or removing tissue from a patient. The steerable needles, trocars, stylets, cannulas and systems also provide a platform for delivery of target materials, such as therapeutics, biologics, polymes, glues, etc., to a target site. An embodiment of the invention includes a steerable device for use in accessing target site in a patient comprising: a steerable member adapted to penetrate tissue; and a steering mechanism adapted to be operated by a user to apply a bending force to bend the steerable member to access the target site.

What is claimed is: 
     
         1 . A method of delivering a device to a target site in a patient comprising:
 introducing a steerable member through a scope; and   applying a bending force to bend the steerable member to deliver the device to the target site.   
     
     
         2 . A method of delivering a steerable-device to a target site in a patient comprising:
 removably coupling a steering mechanism axially within a lumen of a steerable member;   penetrating tissue with the steerable member, the member having a proximal end and a sharp distal end with a longitudinal length therebetween, the distal end having a closed sharpened tip to penetrate the tissue and form a path through the tissue; wherein the steerable member defines an axial trajectory along the direction of the longitudinal length and extending distally from the distal end;   applying a bending force to a bendable portion of the steering mechanism to form the path through the tissue after penetrating the tissue to bend the steerable member along the path through the tissue, wherein the bending force imposes a curvature in the steerable member between the proximal end and the distal end to reorient the path; and   advancing the longitudinal length of the steerable member and the steering mechanism distally into the tissue along the path such that subsequent distal tissue penetrating advancement of the axially coupled steerable member and steering mechanism together within the tissue angles the path away from the trajectory suitably to deliver the device to the target site.   
     
     
         3 . The method of  claim 2 , further comprising:
 positioning a port along the longitudinal length of the steerable member and extending between an outer surface of the steerable member and the lumen of the steerable member.   
     
     
         4 . The method of  claim 2 , further comprising:
 positioning an outer sheath to removably receive the steerable member therein, the sheath having a distal end disposed near the distal end of the steerable member; and   advancing the sheath through the tissue with the steerable member when the steerable member is received in a lumen of the sheath.   
     
     
         5 . The method of  claim 4 , further comprising:
 advancing the steerable member longitudinally past the distal end of the outer sheath, wherein a distal end of the sheath lumen curves away from the axial trajectory of the steerable member and the steerable member bends away from the axial trajectory during advancement.   
     
     
         6 . The method of  claim 4 , wherein the steerable member rotates 360 degrees about a longitudinal axis of the steerable device. 
     
     
         7 . The method of  claim 4 , further comprising:
 providing at least one position indicator on the proximal end of the steerable member or on a proximal end of the outer sheath.   
     
     
         8 . The method of  claim 4 , further comprising:
 providing at least one position indicator on the proximal end of the steerable member and on a proximal end of the outer sheath.   
     
     
         9 . The method of  claim 2 , wherein the steering mechanism comprises at least one pull wire. 
     
     
         10 . The method of  claim 2 , wherein applying the bending force to the steering mechanism alters a location and orientation of the distal end within the tissue and distally advancing the steerable member within the tissue angles way from the trajectory and toward the target site. 
     
     
         11 . The method of  claim 2 , wherein the distal tissue penetrating end of the steerable member comprises a curved shape which deviates away from a longitudinal axis of the steerable device. 
     
     
         12 . The method of  claim 2 , further comprising at least one of the following steps of:
 using the steerable member to advance another device to the target site;   removing tissue at the target site;   draining the target site;   infusing the target site with a therapeutic or diagnostic agent;   delivering energy to the target site;   extracting heat energy from the target site; and   killing tissue at the target site.   
     
     
         13 . The method of  claim 2 , further comprising:
 assessing a location of the longitudinal length of the steerable member and the steering mechanism relative to the target site after the tissue has been penetrated.   
     
     
         14 . The method of  claim 13 , further comprising:
 adjusting the advancement of the longitudinal length of the steerable member and the steering mechanism distally into the tissue along the path based on the location assessment.