Methods and devices for creating an opening through an anatomic wall

Abstract

Disclosed herein are various systems and methods for traversing an anatomic wall. A system can include a port that mates with an anatomic wall and provides a lumen for the passage of a guide tube of a transluminal device. The port can inhibit the passage of biological materials through the anatomic wall. Further described herein are methods for implanting the port and/or for inserting the transluminal device into a body cavity.

1 - 36 . (canceled) 
     
     
         37 . A method of creating an opening, the method comprising:
 positioning a guidewire adjacent to a first side of a stomach wall;   sliding a device having an electrosurgical instrument and a tapered tip along the guidewire so that a distal end of the tapered tip is adjacent to the first side of the stomach wall, wherein the tapered tip tapers radially inward toward the distal end;   cutting the opening in the stomach wall with the electrosurgical instrument;   extending the tapered tip through the stomach wall, wherein the distal end of the tapered tip is extended through the opening before a proximal end of the tapered tip;   positioning a first portion of a cylindrical wire mesh through the opening to a second side of the stomach wall, at least a portion of the cylindrical wire mesh having a polymeric coating;   radially expanding the first portion of the cylindrical wire mesh on the second side of the stomach wall to create a first mating element;   securing the first mating element against tissue adjacent the second side of the stomach wall;   positioning a second portion of the cylindrical wire mesh on the first side of the stomach wall;   radially expanding the second portion of the cylindrical wire mesh on the first side of the stomach wall to create a second mating element; and   securing the second mating element against tissue adjacent the first side of the stomach wall, wherein materials are able to move from the second side of the stomach wall to the first side of the stomach wall through the cylindrical wire mesh.   
     
     
         38 . The method of  claim 37 , further including delivering the device to the stomach through an endoscope. 
     
     
         39 . A method of creating an opening, the method comprising:
 creating the opening through a gastrointestinal wall;   positioning a first portion of an implant through the opening to a second side of the gastrointestinal wall;   radially expanding the first portion of the implant on the second side of the gastrointestinal wall to create a first mating element;   securing the first mating element against tissue adjacent the second side of the stomach wall;   positioning a second portion of the implant on the first side of the gastrointestinal wall;   radially expanding the second portion of the implant on the first side of the gastrointestinal wall to create a second mating element; and   securing the second mating element against tissue adjacent the first side of the gastrointestinal wall.   
     
     
         40 . The method of  claim 39 , further including positioning a guidewire adjacent the first side of the gastrointestinal wall, and sliding a device having an electrosurgical instrument along the guidewire so that the electrosurgical instrument is adjacent to the first side of the gastrointestinal wall. 
     
     
         41 . The method of  claim 40 , wherein the device includes a tapered tip, and the method further includes sliding the tapered tip along the guidewire so that a distal end of the tapered tip is adjacent the first side of the gastrointestinal wall. 
     
     
         42 . The method of  claim 41 , wherein the tapered tip tapers radially inward from a proximal portion of the tapered tip toward the distal end, and has a distalmost portion including a flat surface. 
     
     
         43 . The method of  claim 42 , further including, after creating the opening in the gastrointestinal wall, extending the tapered tip through the gastrointestinal wall. 
     
     
         44 . The method of  claim 40 , wherein creating the opening in the gastrointestinal wall includes cutting the gastrointestinal wall with the electrosurgical instrument. 
     
     
         45 . The method of  claim 39 , further including delivering the device to the stomach through an endoscope. 
     
     
         46 . The method of  claim 39 , wherein the implant is a cylindrical mesh. 
     
     
         47 . The method of  claim 39 , wherein the implant is a wire mesh. 
     
     
         48 . The method of  claim 39 , wherein at least a portion of the implant has a polymeric coating. 
     
     
         49 . The method of  claim 39 , wherein materials are able to move from the second side of the gastrointestinal wall to the first side of the gastrointestinal wall through the implant. 
     
     
         50 . The method of  claim 39 , wherein the gastrointestinal wall includes a stomach wall. 
     
     
         51 . The method of  claim 39 , wherein the gastrointestinal wall includes an intestinal wall. 
     
     
         52 . A method of creating an opening, the method comprising:
 creating the opening through a stomach wall;   positioning an implant through the opening so that material from outside of the stomach can enter the stomach through the opening; and   radially expanding portions of the implant on opposite sides of the stomach wall to create mating elements that secure the implant to the stomach wall.   
     
     
         53 . The method of  claim 52 , wherein creating the opening through the stomach wall includes making an electrosurgical cut through the stomach wall. 
     
     
         54 . The method of  claim 53 , further including, after making the electrosurgical cut through the stomach wall, extending a tapered tip through the opening. 
     
     
         55 . The method of  claim 54 , wherein extending the tapered tip through the opening enlarges the opening. 
     
     
         56 . The method of  claim 55 , wherein a distalmost portion of the tapered tip includes a flat surface.