Methods and devices for diagnostic and therapeutic interventions in the peritoneal cavity

Abstract

A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity is described. More specifically, a technique for accessing the peritoneal cavity via the wall of the digestive tract is provided so that examination of and/or a surgical procedure in the peritoneal cavity can be conducted via the wall of the digestive tract with the use of a flexible endoscope. As presently proposed, the technique is particularly adapted to transgastric peritoneoscopy. However, access in addition or in the alternative through the intestinal wall is contemplated and described as well. Transgastric and/or transintestinal peritoneoscopy will have an excellent cosmetic result as there are no incisions in the abdominal wall and no potential for visible post-surgical scars or hernias.

1 - 29 . (canceled)  
     
     
         30 . A dilating needle knife device comprising: 
 an elongated conduit having a passage defined therethrough;    a needle-knife wire disposed in said conduit and terminating distally in a needle-knife tip;    an actuation device provided adjacent a proximal end of said conduit and secured to a proximal end of said needle-knife wire, said actuating device including an actuation mechanism for selectively shifting said needle-knife wire relative to said conduit for selectively extending said needle-knife tip to a deployed position, projecting from a distal end of said conduit, and retracting said needle-knife tip to a sheathed position, within said distal end of said conduit;    an inflatable balloon structure one of mounted to and defined on an exterior surface of said conduit, adjacent said distal end; and    an inflation lumen extending proximally from said balloon to an inflation port adjacent said proximal end of said conduit.    
     
     
         31 . A dilating needle-knife device as in  claim 30 , wherein said actuation device further comprises an electrical coupler, electrically coupled to said needle-knife wire, for selectively coupling said needle-knife wire to a current source.  
     
     
         32 . A dilating needle-knife device as in  claim 30 , wherein said actuation device is detachably coupled to said proximal end of said conduit whereby said needle-knife wire is removable from said conduit on detachment of said actuation device from said conduit.  
     
     
         33 . A dilating needle-knife device as in  claim 30 , wherein said inflatable balloon structure is elongated such that a length thereof is substantially greater than a diameter thereof following inflation.  
     
     
         34 . A dilating needle-knife device as in  claim 33 , wherein said length of said balloon is at least about twice the inflated diameter thereof.  
     
     
         35 . A dilating needle-knife device as in  claim 34 , wherein said length of said balloon is about three-five times the inflated diameter thereof.