Systems and methods of steerable elongate device

Abstract

Systems and methods for minimally invasive treatment of target tissue among one or more passageways include a flexible elongate device, a tool including a first tubular member, and an instrument to perform treatment on target tissue around the target location. The flexible elongate device includes a proximal end, a distal end, and a lumen therebetween. The tool is configured for deployment within the lumen to a passageway exit site, puncturing a passageway wall at the passageway exit site, and deployment to a target location. The instrument is sized to be deployed within the tool. In some embodiments, the systems and methods further include an anchor configured to stabilize the tool. In some embodiments, the first tubular member is a first hollow sheath configured to be deployed past the distal end of the flexible elongate device to the passageway exit site.

What is claimed is: 
     
         1 . A system comprising:
 a flexible elongate device comprising a proximal end, a distal end, and a lumen therebetween;   a tool including a first tubular member, wherein the tool is configured for:
 deployment within the lumen to a passageway exit site; 
 puncturing a passageway wall at the passageway exit site; and 
 deployment to a target location; and 
   an instrument to perform treatment on target tissue around the target location, wherein the instrument is sized to be deployed within the tool.   
     
     
         2 . The system of  claim 1 , further comprising an anchor configured to stabilize the tool. 
     
     
         3 . The system of  claim 2 , wherein the first tubular member is a first hollow sheath configured to be deployed past the distal end of the flexible elongate device to the passageway exit site. 
     
     
         4 . The system of  claim 3 , wherein the tool further comprises a second tubular member including a needle configured to be extended within the first hollow sheath, through the passageway exit site, and to the target location. 
     
     
         5 . The system of  claim 4 , wherein the tool further comprises a third tubular member including a second hollow sheath, wherein:
 the first hollow sheath, after being deployed to the passageway exit site, is further configured to be retracted and removed from the lumen of the flexible elongate device; and   the second hollow sheath is configured to be deployed within the lumen of the flexible elongate device, and extended along the needle to the target location.   
     
     
         6 . The system of  claim 5 , wherein the needle, after the second hollow sheath is at the target location, is configured to be retracted from the second hollow sheath. 
     
     
         7 . The system of  claim 6 , wherein:
 the anchor is coupled to the instrument;   the instrument, after the needle is retracted from the second hollow sheath, is further configured to be extended through a second lumen of the second hollow sheath; and   the tool, is further to be anchored before performing treatment on the target tissue.   
     
     
         8 . The system of  claim 4 , wherein the first hollow sheath is further configured to be extended along the needle; and
 the needle is further configured to be retracted from the first hollow sheath.   
     
     
         9 . The system of  claim 8 , wherein the first hollow sheath is further configured, after being extended along the needle, to be retracted and removed from the target tissue, and positioned at the passageway exit site. 
     
     
         10 . The system of  claim 8 , wherein the tool further comprises a guidewire and the anchor is coupled to the guidewire. 
     
     
         11 . The system of  claim 10 , wherein the guidewire is configured for:
 deployment through the first hollow sheath after the needle is retracted from the first hollow sheath; and   anchoring proximate the target tissue.   
     
     
         12 . The system of  claim 11 , wherein the first hollow sheath is further configured to be retracted from the target tissue and positioned at the passageway exit site, after the guidewire is anchored proximate the target tissue. 
     
     
         13 . The system of  claim 12 , wherein the guidewire is further configured for deployment of the instrument along the guidewire when the guidewire is anchored proximate the target tissue. 
     
     
         14 . The system of  claim 4 , wherein a distal end of the needle comprises one or more of a beveled end, a conical end, a cross-cut end, a crown point, or a bent crown point. 
     
     
         15 . The system of any one of  claim 14 , wherein the anchor includes one or more balloons, one or more barbs, one or more teeth, one or more tines, or one or more cleats. 
     
     
         16 . A system comprising:
 a flexible elongate device comprising a shape sensor, a proximal end, a distal end, and a lumen therebetween;   a hollow sheath with a channel, wherein the hollow sheath is configured for deployment within the lumen to a passageway exit site;   a needle configured for:
 deployment through the hollow sheath to the passageway exit site; 
 puncturing a passageway wall at the passageway exit site; and 
 deployment to a target location; 
   an instrument for performing treatment on target tissue around the target location, wherein the instrument is configured for deployment within the channel; and   an anchor for stabilizing the instrument during treatment on target tissue.   
     
     
         17 . The system of  claim 16 , further comprising a control unit coupled to the instrument, wherein the control unit is configured to confirm, based on data from the shape sensor, a location of the distal end of the flexible elongate device before extending the hollow sheath to the passageway exit site. 
     
     
         18 . The system of  claim 17 , wherein the control unit is further configured to confirm a location of the distal end of the flexible elongate device before extending the instrument to the target location. 
     
     
         19 . The system of  claim 17 , wherein the control unit is further configured to confirm location of the instrument before performing the treatment on the target tissue. 
     
     
         20 . The system of  claim 16 , further comprising a sensor system configured to measure data for confirming treatment of the target tissue, wherein the sensor system measures at least one of temperature or impedance of the target tissue.