Apparatus and methods for achieving endoluminal access

Abstract

The present invention provides methods and apparatus for pleating at least a portion of a patient's body lumen, such as the colon. Pleating is achieved via relative motion between an endoscope and a flexible conduit having an engagement element configured to reversibly engage the body lumen.

What is claimed is:  
     
         1 . Apparatus for pleating at least a portion of a patient's body lumen, the apparatus comprising: 
 a first flexible conduit; and    a second flexible conduit comprising an engagement element,    wherein the second flexible conduit is configured for sliding axial movement relative to the first flexible conduit, and    wherein the engagement element is configured to reversibly engage the patient's body lumen.    
     
     
         2 . The apparatus of  claim 1 , wherein the body lumen comprises a lumen chosen from the group consisting of the patient's colon, gastrointestinal lumen, small bowel, vascular lumens, and combinations thereof.  
     
     
         3 . The apparatus of  claim 1 , wherein the first flexible conduit comprises an endoscope.  
     
     
         4 . The apparatus of  claim 1 , wherein the second flexible conduit comprises a sheath coaxially disposed about the first flexible conduit.  
     
     
         5 . The apparatus of  claim 1 , wherein the first flexible conduit comprises a lumen, and wherein the second flexible conduit is configured for sliding axial movement within the lumen.  
     
     
         6 . The apparatus of  claim 1 , wherein the first flexible conduit comprises a deflection tip.  
     
     
         7 . The apparatus of  claim 1 , wherein the engagement element is chosen from the group consisting of expandable spines, balloons, distensible balloons, non-distensible balloons, expandable meshes, expandable braids, cut tubing, expandable anchors, expandable helices, suction elements, extendable elements, malcots, corrugated tubes, spiral ribs, continuous engagement elements, pleat capture elements, and combinations thereof.  
     
     
         8 . The apparatus of  claim 1 , wherein the second flexible conduit is configured to pleat the body lumen.  
     
     
         9 . The apparatus of  claim 1 , wherein the first flexible conduit is configured to pleat the body lumen and the second flexible conduit is configured to maintain pleats formed by the first flexible conduit.  
     
     
         10 . The apparatus of  claim 1 , wherein the second flexible conduit is adapted to transition between a flexible configuration and a substantially rigid configuration in a desired arrangement.  
     
     
         11 . A method for pleating a least a portion of a patient's body lumen, the method comprising: 
 advancing a first flexible conduit into the body lumen;    advancing a second flexible conduit having an engagement element along the first flexible conduit;    actuating the engagement element to reversibly engage the body lumen; and    retracting the second flexible conduit relative to the first flexible conduit, thereby pleating at least a portion of the body lumen.    
     
     
         12 . The method of  claim 11 , wherein advancing a first flexible conduit further comprises advancing an endoscope.  
     
     
         13 . The method of  claim 11 , wherein advancing the second flexible conduit along the first flexible conduit further comprises advancing the second flexible conduit over the first flexible conduit.  
     
     
         14 . The method of  claim 11 , wherein advancing the second flexible conduit along the first flexible conduit further comprises advancing the second flexible conduit through the first flexible conduit.  
     
     
         15 . The method of  claim 11  further comprising advancing the first flexible conduit further into the body lumen.  
     
     
         16 . The method of  claim 11  further comprising disengaging the engagement element from the body lumen.  
     
     
         17 . The method of  claim 16  further comprising advancing a third conduit over the first and second conduits, and maintaining body lumen pleats with the third conduit.  
     
     
         18 . A method for pleating a least a portion of a patient's body lumen, the method comprising: 
 advancing a first flexible conduit into the body lumen;    advancing a second flexible conduit having an capture element along the first flexible conduit;    engaging the body lumen with the first flexible conduit;    retracting the first flexible conduit relative to the second flexible conduit, thereby pleating at least a portion of the body lumen; and    actuating the capture element of the second flexible conduit to maintain body lumen pleats.    
     
     
         19 . The method of  claim 18  further comprising advancing the first flexible conduit further within the body lumen.  
     
     
         20 . The method of  claim 18  wherein advancing the first flexible conduit further comprises advancing an endoscope into the body lumen.