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.

What is claimed is: 
     
         1 . A system, comprising:
 a flexible catheter having a first lumen therethrough and a second lumen therethrough;   a first flexible tube movable through the first lumen;   a retractor including first and second flexible elements joined by a bridge member and movable between a non-expanded position and an expanded position forming an asymmetric cage, the first flexible tube having a longitudinal axis and a tube distal portion, the tube distal portion having an angled position with respect to the longitudinal axis of the first flexible tube within the asymmetric cage.   
     
     
         2 . The system of  claim 1 , further comprising a first medical tool movable through the first flexible tube. 
     
     
         3 . The system of  claim 2 , wherein the tube distal portion of the first flexible tube orients a distal portion of the first medical tool to the angled position within the asymmetric cage. 
     
     
         4 . The system of  claim 1 , wherein the first flexible tube is configured to rotate within the first lumen. 
     
     
         5 . The system of  claim 1 , further comprising a second flexible tube movable through the second lumen, the second flexible tube having:
 a longitudinal axis; and   a tube distal portion having an angled position with respect to the longitudinal axis of the second flexible tube within the asymmetric cage.   
     
     
         6 . The system of  claim 5 , further comprising a second medical tool movable through the second flexible tube. 
     
     
         7 . The system of  claim 6 , wherein the tube distal portion of the second flexible tube orients a distal portion of the second medical tool to the angled position of the second flexible tube within the asymmetric cage. 
     
     
         8 . The system of  claim 5 , wherein the second flexible tube is configured to rotate within the second lumen. 
     
     
         9 . The system of  claim 1 , the flexible catheter further comprising a third lumen therethrough configured to receive an endoscope. 
     
     
         10 . The system of  claim 1 , further comprising a rigid portion extending longitudinally from the flexible catheter within the asymmetric cage. 
     
     
         11 . The system of  claim 1 , wherein the asymmetric cage includes a cover with an opening formed therein. 
     
     
         12 . The system of  claim 11 , wherein the cover expands as the first and second elements move from the non-expanded position to the expanded position. 
     
     
         13 . A system, comprising:
 a flexible catheter having a first lumen therethrough and a second lumen therethrough;   a first flexible tube movable through the first lumen;   a retractor including first and second flexible elements joined by a bridge member and movable between a non-expanded position and a plurality of asymmetric expanded positions, the first flexible tube having a longitudinal axis and a tube distal portion, the tube distal portion having an angled position with respect to the longitudinal axis of the first flexible tube when disposed beyond a distal end of the first lumen.   
     
     
         14 . The system of  claim 13 , wherein the plurality of asymmetric expanded positions form a plurality of asymmetric cage configurations. 
     
     
         15 . The system of  claim 14 , wherein the angled position of the tube distal portion is formed within the asymmetric cage configurations. 
     
     
         16 . The system of  claim 13 , wherein the first flexible tube is configured to rotate within the first lumen. 
     
     
         17 . A system, comprising:
 a flexible catheter having a first channel therethrough and a second channel therethrough;   a first flexible tube movable through the first channel;   a retractor including first and second flexible elements joined by a distal nexus and movable between a non-expanded position and an expanded position forming an asymmetric cage, the first flexible tube having a longitudinal axis and a tube distal portion, the tube distal portion having an angled position with respect to the longitudinal axis of the first flexible tube within the asymmetric cage.   
     
     
         18 . The system of  claim 17 , further comprising a second flexible tube movable through the second channel, the second flexible tube having:
 a longitudinal axis; and   a tube distal portion having an angled position with respect to the longitudinal axis of the second flexible tube within the asymmetric cage.   
     
     
         19 . The system of  claim 17 , further comprising a first medical tool movable through the first flexible tube. 
     
     
         20 . The system of  claim 18 , further comprising a second medical tool movable through the second flexible tube.