Endoluminal system for gastrointestinal treatment

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 system for removing a lesion from a colon of a patient comprising:
 an endoscopic device having a longitudinal axis and a chamber movable with respect to the longitudinal axis, the chamber movable from a first collapsed insertion position to an expanded position to apply a force to a wall of the colon having the lesion to move the wall radially to increase a working space adjacent the lesion; 
 a first instrument insertable through the endoscopic device, the first instrument having a first tip, the first tip manipulable at a bent angle from the longitudinal axis of the endoscopic device to extend radially toward the lesion; and 
 a second instrument insertable through the endoscopic device and having a second tip, the second tip manipulable at an a bent angle from the longitudinal axis of the endoscopic device to extend radially toward the lesion, the first and second tips achieving triangulation with respect to the lesion within the increased working space to facilitate maneuverability and access and removal of the lesion; 
 wherein the chamber is formed by a plurality of flexible elements, the flexible elements positioned distal of an opening in the endoscopic device through which the first and second instruments extend; and 
 wherein the chamber includes a substantially rigid beam movable longitudinally in a direction toward the chamber to rigidify one of the flexible elements forming the chamber. 
 
     
     
       2. The system of  claim 1 , further comprising a first tube and a second tube, the first and second tubes being independently manipulable, the first tube having a first distal tip and movable within the endoscopic device to orient the first instrument positioned in the first tube, wherein bending of a first distal tip of the first tube angles the first tip of the first instrument within the chamber toward the lesion, the second tube having a second distal tip and movable within the second a lumen to orient the second instrument positioned in the second tube, wherein bending of the second distal tip of the second tube bends the second tip of the second instrument within the chamber toward the lesion. 
     
     
       3. The system of  claim 1 , wherein the chamber has a partially rigid portion. 
     
     
       4. The system of  claim 1 , wherein the chamber includes a substantially rigid beam movable longitudinally in a direction toward the chamber to rigidify one of the flexible elements forming the chamber. 
     
     
       5. The system of  claim 1 , wherein the plurality of flexible elements are connected at a proximal end and a distal end and expanded at a region between the proximal and distal ends. 
     
     
       6. The system of  claim 1 , wherein the chamber is expanded to an asymmetric configuration to create an asymmetric working space. 
     
     
       7. The system of  claim 1 , wherein the endoscopic device is dimensioned to removably receive an endoscope. 
     
     
       8. An endoluminal system for removing a lesion from a colon of a patient comprising:
 an endoscopic device having a longitudinal axis and a chamber movable with respect to the longitudinal axis, the chamber movable from a first collapsed insertion position to an expanded position to apply a force to a wall of the colon having the lesion to move the wall radially to increase a working space adjacent the lesion; 
 a first instrument insertable through the endoscopic device, the first instrument having a first tip, the first tip manipulable at a bent angle from the longitudinal axis of the endoscopic device to extend radially toward the lesion; and 
 a second instrument insertable through the endoscopic device and having a second tip, the second tip manipulable at an a bent angle from the longitudinal axis of the endoscopic device to extend radially toward the lesion, the first and second tips achieving triangulation with respect to the lesion within the increased working space to facilitate maneuverability and access and removal of the lesion; 
 wherein the chamber includes a cover to form an enclosed chamber to capture a lesion therein for withdrawal from the colon, the cover having an access opening for access to an interior of the chamber; and 
 wherein the chamber includes a substantially rigid beam movable longitudinally in a direction toward the chamber to rigidify one of the flexible elements forming the chamber. 
 
     
     
       9. The system of  claim 8 , wherein the chamber is formed by a plurality of flexible elements, the flexible elements positioned distal of an opening in the endoscopic device through which the first and second instruments extend. 
     
     
       10. The system of  claim 8 , wherein the chamber is formed of a plurality of flexible elements and the cover is in a closed configuration and opened by the plurality of flexible elements. 
     
     
       11. The system of  claim 10 , further comprising a drawstring to re-close the cover. 
     
     
       12. An endoluminal device for removing a lesion from a colon of a patient comprising:
 an endoscopic device having a longitudinal axis and a chamber movable with respect to the longitudinal axis, the chamber having a cover positioned at least partially thereover to create an entrapment for capture of the lesion and containment of the lesion for withdrawal from the colon, the chamber movable from a first collapsed position for insertion to an expanded position to apply a force to a wall of the colon having the lesion to move the wall radially to increase a working space adjacent the lesion, the chamber expandable asymmetrically to create an asymmetric chamber so a distance configured to extend from the longitudinal axis of the endoscopic device to a wall of the colon having the lesion is greater than a distance configured to extend from the longitudinal axis to a wall of the colon opposite the lesion, 
 the endoscopic device configured to receive a first and second instrument and the chamber configured to create a working space for the first and second instruments so tips of the first and second instruments can be bent to be angled radially toward the lesion to achieve triangulation of the instruments with respect to the lesion to facilitate access to the lesion and maneuverability; 
 wherein the chamber includes a substantially rigid beam movable longitudinally in a direction toward the chamber to rigidify one of the flexible elements forming the chamber. 
 
     
     
       13. The endoluminal device of  claim 12 , in combination with a first instrument and second instrument insertable through the endoscopic device, the tip of the first instrument manipulable at a bent angle from the longitudinal axis toward the lesion and the tip of the second instrument manipulable at a bent angle from the longitudinal axis toward the lesion, the first and second tips being independently movable to achieve triangulation with respect to the lesion within the increased working space to facilitate and access to the lesion and maneuverability. 
     
     
       14. The endoluminal device of  claim 12 , further comprising a first tool channel and a second tool channel extending through the endoscopic device, the first tool channel dimensioned to receive the first instrument and the second tool channel dimensioned to receive the second instrument, the first and second tool channels bendable to bend the tips of the first and second instruments inserted therethrough. 
     
     
       15. The system of  claim 12 , wherein the chamber is formed of a plurality of flexible elements and the cover has an access opening for access to an interior of the chamber through which the first and second instruments can extend. 
     
     
       16. The system of  claim 12 , wherein the chamber is formed by a plurality of flexible elements, the flexible elements positioned distal of an opening in the endoscopic device through which the first and second instruments extend and the cover is positioned at least partially over the flexible elements. 
     
     
       17. The system of  claim 16 , wherein the cover is opened by the plurality of flexible elements.