Devices, systems and methods for tissue resection

Abstract

Exemplary embodiments of the present disclosure relate to devices, systems, and methods for tissue resection in a body lumen of a patient, and may include an elongate body having a cavity at a distal end and a tissue retractor extendable distally from the distal end of the elongate body. The tissue retractor may include an expansion mechanism. The expansion mechanism may include a plurality of arms each having a first end coupled around a distal cap and expandable radially outward from the distal cap such that an anchoring mechanism on a second end of the arms is engageable with selected tissue for resection of the body lumen. The tissue resection device may further include a tissue resecting device.

What is claimed is: 
     
         1 . A device for tissue resection from within a body, the device comprising:
 an elongate body defining a cavity therein;   a sheath extendable from or retractable into the cavity of said elongate body; and   a tissue retractor coupled to said sheath;   wherein:   said tissue retractor includes an expansion mechanism expandable radially outwardly from said sheath, and then retractable toward said sheath to capture tissue between said expansion member and said sheath.   
     
     
         2 . The tissue resection device of  claim 1 , wherein said expansion mechanism comprises a plurality of arms extending around said sheath, each arm having a first end and a second end, the first end being pivotably coupled with respect to said sheath so that each arm is independently extendable from a position extending along said sheath to an expanded position in which said second end is radially extended away from said sheath 
     
     
         3 . The tissue resection device of  claim 2 , wherein said second ends of said plurality of arms have a tip comprising an anchoring mechanism engageable with selected tissue for resection. 
     
     
         4 . The tissue resection device of  claim 1 , wherein said expansion mechanism expands symmetrically or asymmetrically around said sheath. 
     
     
         5 . The tissue resection device of  claim 1 , wherein said sheath is retractable toward the cavity to draw the tissue captured between said expansion mechanism and said sheath into the cavity. 
     
     
         6 . The tissue resection device of  claim 1 , further comprising a tissue resecting device. 
     
     
         7 . The tissue resection device of  claim 6 , wherein said tissue resecting device comprises a shear edge around the cavity, a shear proximal edge of a distal cap from which said expansion mechanism extends proximally, or a shear edge of a distal end of said elongate body, or combinations thereof. 
     
     
         8 . A system for tissue resection from within a body, said system comprising:
 a lumen extendable into a patient, said lumen including one or more working channels for delivering accessories to selected tissue for resection; and   a tissue resection device deliverable over said lumen, said tissue resection device
 an elongate body defining a cavity therein; 
 a sheath extendable from or retractable into the cavity of said elongate body; and 
 a tissue retractor coupled to said sheath and having an expansion mechanism expandable radially outwardly from said sheath, and then retractable toward said sheath to capture tissue between said expansion member and said sheath. 
   
     
     
         9 . The tissue resection system of  claim 8 , wherein said expansion mechanism comprises a plurality of arms extending around said sheath, each arm having a first end and a second end, the first end being pivotably coupled with respect to said sheath so that each arm is independently extendable from a position extending along said sheath to an expanded position in which said second end is radially extended away from said sheath 
     
     
         10 . The tissue resection system of  claim 9 , wherein said second ends of said plurality of arms have a tip comprising an anchoring mechanism engageable with selected tissue for resection. 
     
     
         11 . The tissue resection system of  claim 9 , said expansion mechanism further comprising a distal cap, the first ends of said plurality of arms being pivotably coupled to a hub disposed within said distal cap, said arms being radially outwardly expandable with respect to said distal cap. 
     
     
         12 . The tissue resection system of  claim 8 , wherein said expansion mechanism expands symmetrically or asymmetrically around said sheath. 
     
     
         13 . The tissue resection system of  claim 8 , wherein said sheath is retractable toward the cavity to draw the tissue captured between said expansion mechanism and said sheath into the cavity. 
     
     
         14 . The tissue resection device of  claim 8 , further comprising a tissue resecting device. 
     
     
         15 . The tissue resection device of  claim 14 , wherein said tissue resecting device comprises a shear edge around the cavity, a shear proximal edge of a distal cap from which said expansion mechanism extends proximally, or a shear edge of a distal end of said elongate body, or combinations thereof. 
     
     
         16 . The tissue resection device of  claim 8 , further comprising a tissue penetrating device extendable through said lumen to pierce through the selected tissue for resection before extending said tissue resection device through the selected tissue for resection. 
     
     
         17 . A method for resection of selected tissue in a patient, said method comprising:
 positioning a distal end of a lumen with respect to the selected tissue for resection;   extending a tissue resection device to the selected tissue for resection, the tissue resection device including an elongate body having a cavity at a distal end and a tissue retractor extendable distally from the distal end of the elongate body;   distally advancing a sheath of the tissue resection device to advance an expansion mechanism of the tissue retractor from a first surface of the selected tissue to a second surface of the selected tissue;   radially expanding a plurality of arms of the expansion mechanism of the tissue retractor away from the sheath;   retracting the plurality of arms radially inward toward the sheath to capture the selected tissue between the arms and the sheath;   retracting the tissue retractor proximally toward the elongate body such that the captured tissue is received within the cavity of the elongate body; and   resecting the selected tissue from the body lumen   
     
     
         18 . The method of  claim 17 , further comprising penetrating the tissue for resection with a tissue penetrating device to create an opening through the tissue for resection and then extending the tissue resection device through such opening. 
     
     
         19 . The method of  claim 17 , further comprising dilating an opening in the tissue for resection with a distal cap of the tissue resection device to facilitate advancement of the tissue resection device therethrough. 
     
     
         20 . The method of  claim 17 , wherein the expansion member comprises a plurality of arms extending around the sheath and each having a first end pivotably coupled with respect to the sheath, said method comprising pivoting the plurality of arms with respect to the sheath to extend second ends of the plurality of arms away from the sheath, engaging the second ends of the plurality of arms with tissue to be resected, and pivoting the plurality of arms toward the sheath to capture the tissue for resection between the plurality of arms and the sheath.