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EP-4736735-A2 - TETHER TRACTION SYSTEMS AND METHODS OF USE THEREOF

EP4736735A2EP 4736735 A2EP4736735 A2EP 4736735A2EP-4736735-A2

Abstract

A system for use with a flexible elongate tubular member, the system comprises a first guide mounted on an outer surface of the flexible elongate tubular member. The flexible elongate tubular member has a working channel extending therethrough. The system further comprises a first filament extendable through the first guide and along the outer surface of the flexible elongate tubular member, and wherein a distal end of the first filament is configured to be attached to a distal end of a first endoscopic instrument disposable within the working channel.

Inventors

  • WEITZNER, BARRY

Assignees

  • Boston Scientific Scimed, Inc.

Dates

Publication Date
20260506
Application Date
20200513

Claims (15)

  1. A system (200) for use with a flexible elongate tubular member, the system comprising: a first guide (226) mounted on an outer surface of the flexible elongate tubular member (210), the flexible elongate tubular member having a working channel (214) extending therethrough; a first filament (230) extendable through the first guide (226) and along the outer surface of the flexible elongate tubular member (210); and wherein a distal end (232) of the first filament (230) is configured to be attached to a distal end of a first endoscopic instrument (140) disposable within the working channel (214).
  2. The system of claim 1, wherein the flexible elongate tubular member (210) is an endoscope.
  3. The system of claim 1 or 2, wherein the first endoscopic instrument (140) includes a sheath (142) and a first medical device (146) releasably attached to a distal end of the sheath (142).
  4. The system of claim 3, wherein the first medical device (146) includes a tissue clamp and wherein the distal end (232) of the first filament (230) is attached to an arm (146a) of the tissue clamp.
  5. The system of any of claims 3-4, wherein the first filament (230) is attachable either directly or indirectly to the first medical device (146) by adhesives, soldering, welding, brazing, or mechanical attachments such as bands, clamps, or ratchet, or combination thereof; and/or wherein the first medical device (146) is configured to be moved from an open position to a closed position.
  6. The system of any of claims 1-5, wherein the first endoscopic instrument (140) is configured to be retracted such that the first medical device (146) is disposed within the working channel (214).
  7. The system of any of claims 1-6, further comprising a second guide (227) extending along a portion of the outer surface of the flexible elongate tubular member and a second filament (231) extending through the second guide (227) and along the outer surface of the flexible elongate tubular member, wherein a distal end (233) of the second filament (231) is attached to an arm (147a) of a second medical device (147).
  8. The system of any of claims 1-7, further comprising a flexible elongate shaft (234) extendable along the outer surface of the flexible elongate tubular member and through the first guide (226), wherein the first filament (230) extends through the flexible elongate shaft (234).
  9. The system of any of claims 1-8, comprising the features of claim 7, further comprising a flexible elongate shaft extendable along the outer surface of the flexible elongate tubular member and through the second guide (227), wherein the second filament (231) extends through the flexible elongate shaft.
  10. The system of any of claims 1-9, wherein the first filament (230) comprises a suture, a wire, or a string.
  11. The system of any of claims 1-10, further comprising a cap (220) attachable to a distal end (212) of the flexible elongate tubular member and having a lumen (224) coextensive with the working channel (214) of the flexible elongate tubular member, wherein the first guide (226) is attached to an outer surface of the cap (220).
  12. The system of claim 11, wherein the cap (220) is attachable to the distal end (212) of the flexible elongate tubular member by a friction or interference fit, a threaded fit, or a snap-lock fit.
  13. The system of any of claims 1-12, wherein a proximal end of the filament (230) is configured to be proximally retracted to apply tension to a target tissue,
  14. The system of any of claims 1-13, wherein a proximal end (236) of the first filament (230) is configured to be extended beyond a proximal end of the elongate tubular member, and preferably to be external to the patient such that a medical professional may proximally retract the first filament (230) to apply tension/traction to the target tissue engaged with the first endoscopic instrument (146).
  15. The system of any of claims 1-14, wherein the first medical device (146) is configured to be advanced distally beyond a distal end (212) of the flexible elongate tubular member.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS The present application claims the benefit of priority under 35 U.S.C. §119 to U.S. Provisional Patent Application 62/861,555, filed June 14, 2019, which application is incorporated herein by reference in its entirety for all purposes. FIELD The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to traction systems, and methods of use thereof, for endoscopic procedures such as tissue dissection. BACKGROUND Performing an endoscopic tissue resection/dissection procedure may include maintaining traction as the boundaries of the target tissue are dissected for accuracy and efficiency of the procedure. Physicians may use a tethered system in which an endoscopic clip is attached to a length of filament extending external to the patient to retract/immobilize a target tissue for dissection along the tissue margins and/or to retrieve the dissected target tissue for biopsy. It is with the above considerations in mind that the improvements of the present disclosure may be useful. SUMMARY In one aspect, the present disclosure relates to a system for use with an endoscope comprising a cap attachable to (or a portion of) a distal end of an endoscope having a working channel extending therethrough. The cap may include a lumen coextensive with the working channel. A first guide may be attached to / mounted on an outer surface of the cap. A first filament may be extendable through the first guide and along an outer surface of the endoscope and the cap. A first endoscopic instrument may be disposable within the working channel. A distal end of the first filament may be attached to a distal end of the first endoscopic instrument. In the described and other embodiments, the first endoscopic instrument may include a sheath and a first medical device may be releasably attached to a distal end of the sheath. The first medical device may include a tissue clamp. The distal end of the first filament may be attached to an arm of the tissue clamp. A handle may be operatively attached to a proximal end of the first endoscopic instrument. The handle may be configured to move the first medical device between a first and second position. The handle may be configured to release the first medical device from the distal end of the sheath. A flexible elongate shaft may be extendable along the outer surface of the endoscope and the cap and through the first guide. The first filament may extend through the flexible elongate shaft. A handle assembly may be attachable to a proximal end of the flexible elongate shaft. The handle assembly may include first, second, and third gripping elements. The first gripping element may be configured to advance and retract the flexible elongate shaft through the first guide. The second and third gripping elements may be attached to each other by a connector. A proximal end of the first filament may be attached to the connector. In another aspect, the present disclosure relates to a system for use with an endoscope comprising a cap attachable to (or a portion of) a distal end of an endoscope having a working channel extending therethrough. The cap may include a lumen coextensive with the working channel. A first guide and a second guide may be attached to / mounted on an outer surface of the cap. A first filament may be extendable through the first guide and along an outer surface of the endoscope and the cap. A first endoscopic instrument may be disposable within the working channel. A distal end of the first filament may be attached to a distal end of the first endoscopic instrument. In the described and other embodiments, the first endoscopic instrument may include a sheath and a first medical device may be releasably attached to a distal end of the sheath. The first medical device may include a tissue clamp. The distal end of the first filament may be attached to an arm of the tissue clamp. A second filament may extend through the second guide and along an outer surface of the endoscope and the cap. A distal end of the second filament may be attached to an arm of a second medical device. A flexible elongate shaft may extend along the outer surface of the endoscope and the cap and through the first guide. The first filament may extend through the flexible elongate shaft. A flexible elongate shaft may be extendable along the outer surface of the endoscope and the cap and through the second guide. The second filament may extend through the flexible elongate shaft. In another aspect, the present disclosure relates to a system for performing an endoscopic procedure. The system may comprise a first guide extendable along an outer surface of the endoscope. The guide may be configured for mounting on an endoscope or a portion of an endoscope (part of the endoscope or separately formed and attached to / mounted on the endoscope). A first filament may be extendable through the first guide and along an outer surface