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1. (WO2018126158) SYSTÈME POUR UN TRAITEMENT MINI-INVASIF À L'INTÉRIEUR D'UNE LUMIÈRE CORPORELLE
Note: Texte fondé sur des processus automatiques de reconnaissance optique de caractères. Seule la version PDF a une valeur juridique

CLAIMS:

1. A system for endoscopic surgery within a body lumen of a patient comprising a flexible catheter having a proximal portion, a distal portion, an expandable region at the distal portion, and an access opening, the expandable region expandable from a collapsed insertion configuration to an expanded configuration, the expandable region expanding asymmetrically and having an increased transverse dimension to provide an expanded chamber on a first side of the catheter, the access opening positioned on a second side of the catheter opposite the first side to provide a window to access target tissue, the catheter including a lumen dimensioned to receive an endoscopic instrument therethrough such that a distal end of the endoscopic instrument is positionable within the expanded chamber and angled laterally within the expanded chamber to access the target tissue through the window, the lumen of the catheter having an opening at a distal end communicating with the chamber, the catheter further dimensioned to receive a visualization device to visualize the target tissue, the endoscopic instrument received in the lumen of the catheter is movable independently of the visualization device.

2. The system of claim 1, wherein the catheter includes an elongated actuation member for expanding the expandable region and an actuator at the proximal portion of the catheter to move the elongated actuation member.

3. The system of any of claims 1-2, wherein the window is axially aligned with the expanded chamber.

4. The system of any of claims 1-3, wherein the expandable region includes a wall of the catheter expandable by an elongated member.

5. The system of any of claims 1-4, further comprising an articulation member for angling the distal portion of the catheter with respect to a longitudinal axis of the catheter.

6. The system of any of claims 1-5, wherein the expandable region is formed by an expandable balloon.

7. The system of claim 6, wherein the expandable balloon has a U-shape forming a space within the U.

8. The system of any of claims 1-7, wherein the endoscopic instrument has a first curve extending in a first direction and a second curve extending in an opposite direction, the first curve angling away from the window and the second curve angling toward the window.

9. The system of any of claims 1-8, wherein the catheter has a seal at a distal end and the visualization device is movable through the seal to visualize distally of the catheter.

10. The system of any of claims 1-9, further comprising a flexible guide positionable within the lumen of the catheter, the flexible guide having a distal portion extendable into the expandable chamber and the endoscopic instrument is insertable through the flexible guide.

11. The system of claim 10, wherein at least a portion of the flexible guide is embedded in a wall of the catheter.

12. A flexible catheter for endoscopic surgery within a body lumen of a patient comprising a proximal portion and a distal portion having an expandable region expandable from a collapsed insertion configuration to an expanded configuration, the expandable region expanding asymmetrically and having an increased transverse dimension to provide an expanded chamber on a first side of the catheter, the catheter having an opening on a second side opposite the first side to provide access to target tissue, the opening being aligned with the expandable chamber, the catheter including a lumen having a distal opening communicating with the expanded chamber.

13. The catheter of claim 12, wherein the expandable region is formed by an inflatable balloon.

14. The catheter of claim 13, wherein the balloon has a U-shaped cross-sectional configuration.

15. The catheter of any of claims 12-14, wherein the catheter includes a seal at its distalmost end.

16. The catheter of any of claims 12-15, further comprising an elongated member axially movable to move the expandable region to the expanded configuration.

17. A method of minimally invasively treating tissue comprising:

a) inserting into a body lumen of a patient an endoscopic device having a window and an expandable portion in a collapsed configuration, the expandable portion having an inner wall;

b) after insertion of the endoscopic device into the body lumen, expanding the expandable portion from the collapsed configuration to an expanded configuration to create a chamber of increased transverse dimension to increase a distance between the inner wall of the expandable portion and the window;

c) inserting a distal portion of a working instrument into the chamber, the working instrument extending through a first channel in the endoscopic device, and the distal portion of the working instrument extending laterally with respect to a longitudinal axis of the endoscopic device; and

d) visualizing the distal portion of the working instrument by a visualization device; and e) inserting a tip of the working instrument through the window to access target tissue.

18. The method of claim 17, wherein the step of expanding the expandable portion expands the chamber to only one side of the longitudinal axis of the endoscopic device and retracts tissue opposite the target tissue.

19. The method of any of claims 17-18, wherein the step of expanding the expandable portion includes a step of expanding a balloon.

20. The method of any of claims 17-19, wherein the step of expanding the expandable portion includes a step of axially moving an elongated member positioned in the endoscopic device.