Endoluminal device with retractor system

Abstract

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

We claim: 
     
       1. An endoluminal device for insertion into a body lumen of a patient, the endoluminal device comprising:
 a tubular member having at least one lumen formed therein to receive an endoscopic instrument and an opening communicating with the lumen; and 
 a chamber at a distal portion of the device, the chamber including first, second and third connected flexible retractor elements and a covering over a portion of the flexible retractor elements to form with the flexible retractor elements an at least partially enclosed chamber with an access opening in the chamber to access target tissue, the second and third flexible retractor elements connected at a distal portion of the second and third flexible retractor elements and movable from a first non-expanded position for insertion into the body lumen of the patient to a second expanded position to create an increased working space and increased viewing space within the body lumen for performance of a procedure on the target tissue, the first flexible retractor element providing a stiffened structure along the chamber to stabilize the chamber, wherein the first flexible retractor element includes a flexible tube, and the device further includes a rigid rod slidable into the flexible tube, the rigid rod being a straight component of rigid material to maintain the first flexible retractor element in a rigid and straight condition. 
 
     
     
       2. The endoluminal device of  claim 1 , wherein the first flexible retractor element includes a lumen formed therein and is transitioned from a first flexible condition to a second more stiffened condition by movement of the rigid rod into the lumen of the first flexible retractor element. 
     
     
       3. The endoluminal device of  claim 2 , further comprising an actuator to move the rigid rod from a retracted position to an extended position into the lumen of the first flexible retractor element. 
     
     
       4. The endoluminal device of  claim 3 , further comprising an actuator to move the second and third flexible retractor elements between non-expanded and expanded positions, wherein the actuator has multiple fixed positions for achieving multiple fixed expanded positions of the flexible retractor elements. 
     
     
       5. The endoluminal device of  claim 1 , wherein the first flexible retractor element forms a substantially rigid beam to provide structural support for the chamber. 
     
     
       6. The endoluminal device of  claim 1 , further comprising a bridge member attached to the second and third flexible retractor elements for maintaining a desired orientation of the flexible retractor elements during expansion, the bridge member stabilizing the second and third flexible retractor elements. 
     
     
       7. The endoluminal device of  claim 1 , wherein the tubular member is flexible and includes at least two lumens, wherein one of the lumens is dimensioned to receive an imaging device. 
     
     
       8. The endoluminal device of  claim 1 , wherein the chamber is positioned distal of the opening in the tubular member. 
     
     
       9. The endoluminal device of  claim 1 , wherein the chamber in the expanded position is asymmetrical to form an asymmetric working space such that the first flexible retractor element is closer to a wall of the body lumen opposing the target tissue than it is to the target tissue. 
     
     
       10. The endoluminal device of  claim 1 , wherein the tubular member comprises a multi-lumen tube with at least two working channels to receive an endoscopic instrument through each working channel. 
     
     
       11. The endoluminal device of  claim 1 , wherein the tubular member comprises a multi-lumen tube to receive at least two tool channels to guide insertion of endoscopic tools, the tool channels being bendable to angle a distal end of the endoscopic tool inserted therethrough. 
     
     
       12. An endoluminal device for insertion into a body lumen of a patient, the endoluminal device comprising:
 a tubular member having at least one lumen formed therein to receive an endoscopic instrument and an opening communicating with the lumen; and 
 a chamber at a distal portion of the device, the chamber including first, second and third flexible retractor elements, the flexible retractor elements connected at a distal portion to form a distal region of the chamber, a bridge member and a covering material to form with the flexible retractor elements an at least partially enclosed chamber with an access opening in the chamber to access target tissue, the flexible retractor elements movable from a first non-expanded position for insertion into the body lumen of the patient to an expanded position to create an increased working space in the body lumen and increased viewing space for performance of an operative procedure on the target tissue, the bridge member connected to the second and third flexible retractor elements to maintain the orientation of the second and third flexible retractor elements and stabilize the chamber, the bridge member positioned proximal of the distal portion where the flexible retractor elements are connected; 
 wherein the bridge member is configured to flex to prevent the flexible retractor elements from bending away from each other; and 
 wherein the bridge member includes a distal component having a first incline and a proximal component having a second incline. 
 
     
     
       13. The endoluminal device of  claim 12 , wherein the bridge member includes a distal component having a first incline and a proximal component having a second incline. 
     
     
       14. The endoluminal device of  claim 12 , wherein the bridge member is configured to flex to prevent the flexible retractor elements from bending away from each other.