Multi-lumen-catheter system for a minimally-invasive treatment

Abstract

A system for performing minimally invasive procedures in a body lumen of a patient including a flexible catheter having a first lumen configured and dimensioned to receive an endoscope therethrough and a second lumen configured and dimensioned to receive a first flexible tube therethrough. The first flexible tube is movable through the second lumen and has a distal portion including a first curve extending in a first direction with respect to the longitudinal axis and a second curve extending in a second different direction with respect to the longitudinal axis. A retractor system is positioned at a distal portion of the catheter and is movable from a non-expanded insertion position to an expanded position forming an expanded cage to form a larger working space. The distal portion of the first flexible tube is movable within the expanded cage.

1 - 15 . (canceled) 
     
     
         16 . A method for performing a minimally invasive procedure in a body lumen of a patient, the method comprising:
 inserting a flexible endoscope in the body lumen to visualize target tissue;   advancing a flexible catheter over the endoscope, the flexible catheter including a retractor system;   expanding the retractor system from a non-expanded insertion position to an expanded position to expand the body lumen to create a larger working space;   maneuvering a first flexible tube within the catheter, the first flexible tube having a double curved tip with a first curve extending in a first direction and a second curve extending in a second different direction, the first flexible tube being axially movable and rotatable within the catheter to locate and orient the curved tip; and   maneuvering a first endoscopic tool within the first flexible tube, wherein the first flexible tube is located at a selected position to define a fixed second curve and the first endoscopic tool is movable axially to adjust a distance between a distal tip of the first endoscopic tool and target tissue without changing the selected position or curvature of the fixed second curve.   
     
     
         17 . The method of  claim 16 , further comprising the steps of:
 maneuvering a second flexible tube within the catheter, the second flexible tube having a double curved tip with a first curve extending in a first direction and a second curve extending in a second different direction, the second flexible tube being axially movable and rotatable within the catheter to locate and orient its curved tip; and   maneuvering a second endoscopic tool within the second flexible tube, wherein the second flexible tube is located at a selected position to define a fixed second curve and the second endoscopic tool is movable axially to adjust a distance between a distal tip of the second endoscopic tool and the target tissue without changing the selected position or curvature of the fixed second curve.   
     
     
         18 . The method of  claim 17 , wherein the distal curved tip of the first and second flexible tubes are normally curved and are in a substantially straightened position when in a lumen of the catheter during insertion and automatically assume a curved position when exposed from the catheter. 
     
     
         19 . The method of  claim 17 , wherein the first and second endoscopic tools are angled toward the target tissue to achieve triangulation with the target tissue. 
     
     
         20 . The method of  claim 17 , wherein the first and second flexible tubes are independently axially movable and independently rotatable and are removably insertable through the catheter and remain unattached to the catheter. 
     
     
         21 . The method of  claim 17 , wherein the retractor system has a distalmost end, and the curved tip of the first flexible tube and the curved tip of the second flexible tube are maneuverable in a region proximal of the distalmost end of the retractor system. 
     
     
         22 . The method of  claim 17 , wherein the first and second flexible tubes are composed of shape memory material. 
     
     
         23 . The method of  claim 17 , wherein the catheter has a separate lumen to removably receive the endoscope therein. 
     
     
         24 . A method for performing a minimally invasive procedure in a body lumen of a patient, the method comprising:
 a) providing a flexible elongated member having a proximal region, a distal region, a first lumen terminating in a distal opening, and an expandable structure in the distal region, the expandable structure movable from a non-expanded insertion position to an expanded position;   b) inserting the elongated member into the body lumen;   c) visualizing the body lumen;   d) expanding the expandable structure from the non-expanded insertion position to the expanded position;   e) either before or after step (d) inserting a first flexible tube into the proximal region of the elongated member, the first flexible tube having a pre-curved distal tip;   f) advancing the first flexible tube through the first lumen of the elongated member so the pre-curved distal tip extends out the distal opening of the first lumen of the elongated member, the distal tip maintained in a straighter configuration during passage through the elongated member and returning to its pre-curved configuration when exposed from the elongated member, the first flexible tube being axially movable and rotatable within the elongated member to locate and orient the distal tip; and   g) maneuvering a first endoscopic tool within the first flexible tube, wherein when the first flexible tube is positioned at a selected position it defines a fixed curve and the first endoscopic tool is movable axially to adjust a distance between a distal tip of the first endoscopic tool and target tissue without changing the selected position or curvature of the fixed curve.   
     
     
         25 . The method of  claim 24 , wherein the first flexible tube has a valve to prevent backflow of insufflation gas and the step of inserting the endoscopic tool advances the tool through the valve while maintaining insufflation. 
     
     
         26 . The method of  claim 24 , wherein the distal opening of the first lumen terminates proximal of a distalmost end of the expandable structure, and the step of advancing the first flexible tube advances the distal tip of the first flexible tube out of the distal opening into a region proximal of the distalmost end of the expandable structure. 
     
     
         27 . The method of  claim 24 , further comprising the steps of inserting a second flexible tube into the proximal region of the elongated member and advancing the second flexible tube through the elongated member, the second flexible tube having a pre-curved distal tip, the pre-curved distal tip maintained in a straighter configuration during passage through the elongated member and returning to its pre-curved configuration when exposed from the elongated member, the second flexible tube being axially movable and rotatable within the elongated member to locate and orient the distal tip, and the first and second flexible tubes being independently movable and rotatable. 
     
     
         28 . A method for performing a minimally invasive procedure in a body lumen of a patient, the method comprising:
 a) inserting a flexible elongated member into the body lumen, the elongated member having a proximal region, a distal region, and a first lumen terminating in a distal opening;   b) visualizing the body lumen;   c) inserting into the first lumen a first flexible tube, the first flexible tube being a separate component from the elongated member and removably insertable through the proximal region of the elongated member and maneuverable to extend out the distal opening of the first lumen; and   d) inserting a first endoscopic tool through a lumen of the first flexible tube.   
     
     
         29 . The method of  claim 28 , wherein the first flexible tube has a distal tip having a preset curved position. 
     
     
         30 . The method of  claim 28 , further comprising the step of inserting into the elongated member a second flexible tube, the second flexible tube being a separate component from the elongated member and removably insertable through the proximal region of the elongated member, the second flexible tube having a distal tip having a preset curved position. 
     
     
         31 . The method of  claim 30 , wherein the first endoscopic tool is inserted through a valve in the first flexible tube, the valve preventing backflow of insufflation gas. 
     
     
         32 . The system of  claim 30 , wherein the first and second flexible tubes are composed of shape memory material with the preset curved position being a shape memorized position. 
     
     
         33 . The system of  claim 30 , wherein the distal portions of the first and second flexible tubes are in a straighter condition positioned within confines of the elongated member and automatically return to the preset curved position when exposed from the elongated member. 
     
     
         34 . The system of  claim 30 , wherein the first and second flexible tubes are unattached to the elongated member during manipulation.