Systems and methods for anatomical tools

Abstract

According to one example, a medical device (102) is provided. The medical device includes a body (108) having a proximal end (110) with a proximal opening for interfacing with a fluid delivery device. The body defines a passageway from the proximal opening to a distal opening (109) configured to emit a jet of fluid (118) along a longitudinal axis of the body. The body further includes a distal wall surface (112) having a surface extending in a direction transverse to the longitudinal axis and facing the distal opening to receive the jet of fluid. The body further defines a space between the distal wall surface and the distal opening. The distal wall includes a protrusion configured to engage tissue.

Description

[0001] Cross-references to related applications

[0002] This application claims priority to U.S. Provisional Application No. 62 / 887,230, filed August 15, 2019, which is incorporated herein by reference in its entirety. Technical Field

[0003] This disclosure generally relates to medical devices, including endoscopic devices for tissue resection. In particular, embodiments of this disclosure relate to systems and devices for hydrodynamic endoscopic dissection tools. Background Technology

[0004] Tumor resection and other tissue treatments are typically performed using medical devices (e.g., endoscopic devices) by delivering radiofrequency (RF) energy to destroy tissue. For malignant tumor resection, it may be necessary to preserve tissue structure to confirm an accurate diagnosis and to confirm complete tissue removal and treatment. Because tissue structure can be damaged during RF energy delivery, medical confirmation of successful tissue resection may be delayed or incomplete. For example, damaged tissue structure may delay or inhibit proper biopsy and classification of the treated tissue. Furthermore, RF energy delivery devices may cause postoperative complications and tissue artifacts due to, for example, delayed tissue effects. Therefore, there is a need for a rapid, accurate, and precise resection method with minimal collateral tissue damage. Summary of the Invention

[0005] According to one example, a medical device is provided. The medical device includes a body having a proximal end with a proximal opening. The body defines a channel from the proximal opening to a distal opening configured to emit a fluid jet along the longitudinal axis of the body. The body also includes a distal wall surface having a surface extending in a direction transverse to the longitudinal axis and facing the distal opening to receive the fluid jet. The body defines a space between the distal wall surface and the distal opening. The distal wall includes protrusions configured to connect with tissue.

[0006] In another exemplary embodiment, the medical device includes a tubular member having a proximal end and a distal end, the proximal end being connectable to a fluid source. The medical device has a fluid channel disposed within the tubular member and is configured to deliver fluid from the proximal end of the tubular member through the tubular member to the distal end. The medical device has a nozzle located at the distal end of the tubular member. The nozzle is configured to emit a fluid jet along a longitudinal axis. A distal wall has a surface extending in a direction transverse to the longitudinal axis and facing the nozzle to receive the fluid jet. The wall includes protrusions configured to engage tissue. The medical device defines a space between the nozzle and the distal wall.

[0007] In another embodiment, a method for treating medical tissue is provided. The method includes placing a medical device close to a tissue of interest, engaging the tissue of interest with a protrusion of the medical device to hold the medical device in position close to the tissue of interest, and dispensing fluid along a longitudinal axis from a distal opening of the medical device toward a distal wall surface of the medical device. The fluid punctures the tissue of interest.

[0008] In some exemplary embodiments, the distal opening ejects a fluid jet at a certain pressure to pierce tissue. The pressure of the fluid jet may be 250 pounds per square inch or less, and the distal opening may have a diameter of approximately 1 millimeter or less. The diameter of the proximal opening is larger than that of the distal opening. The cross-sectional dimensions of the channel taper from the distal opening to the proximal opening, and the protrusion includes one or more tips to engage tissue.

[0009] In another embodiment, the body further includes a valve and a spring, the valve being fixedly coupled to the spring and disposed proximal to the spring and positioned between a proximal opening and a distal opening of the tubular member. The body may be conductive to deliver radio frequency (RF) energy to tissue. The RF energy delivered to the body is conducted to a distal wall surface. The body includes a bottom surface disposed along a longitudinal axis between the proximal opening and the distal wall surface to define an area of ​​contacting tissue. The medical device also includes a flexible tube coupled to a proximal end of the body. The flexible tube has a channel for delivering fluid to the body. The flexible tube includes a conductive tube, wire, cable, or braid for delivering radio frequency (RF) energy to the body.

[0010] It is understood that, as claimed, the foregoing general description and the following detailed description are exemplary and explanatory only, and not limiting of the invention. As used herein, the terms “comprising,” “including,” or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that includes a list of elements may include not only those elements but also other elements not expressly listed or elements inherent to such a process, method, article, or apparatus. The term “exemplary” is used in the sense of “example” rather than “ideal.” As used herein, the term “proximal” refers to a direction closer to the operator, while the term “distal” refers to a direction farther from the operator. Although endoscopy is referenced herein, such reference should not be construed as limiting the possible applications of the disclosed tools. For example, the disclosed tools may be used in procedures such as bronchoscopy, ureteroscopy, colonoscopy, or other intra-body surgeries. Attached Figure Description

[0011] The accompanying drawings, which are included in and form part of this specification, illustrate examples of this disclosure and, together with the specification, serve to explain the principles of this disclosure.

[0012] Figure 1This is a perspective view of a medical device for performing hydrodynamic tissue dissection according to an embodiment of the present disclosure;

[0013] Figure 2A and 2B It shows Figure 1 The remote end of a medical device;

[0014] Figure 3 It shows Figure 1 A cross-sectional view of a medical device;

[0015] Figures 4A-4C A cross-sectional view of another embodiment of the medical device is shown;

[0016] Figure 5 A cross-sectional view of another embodiment of a medical device according to the present disclosure is shown, the medical device being configured to perform dual-fluid dynamic tissue dissection and deliver RF energy to tissue;

[0017] Figure 6 An example flowchart is shown to describe the operations used to perform hydrodynamic tissue dissection. Detailed Implementation

[0018] Tissue anatomy, particularly tissue / tumor resection and removal, can benefit from medical devices that perform rapid, accurate, and precise resection methods with minimal associated tissue damage. For example, such medical devices may be more effective and advantageous than those that simply deliver radiofrequency (RF) energy to perform tissue resection, by preserving tissue structures to confirm medical diagnoses and conduct effective tissue treatments. In some embodiments, fluids may be delivered to perform tissue anatomy techniques (e.g., submucosal dissection). Hydrodynamic systems can be configured to efficiently dissect or remove tissue with high precision and low thermality. Furthermore, hydrodynamic resection systems can be combined with RF or other energy delivery technologies to provide coagulation and hemostasis during tissue resection. In one example, hydrodynamic tissue resection techniques can reduce blood loss during surgery, and the low temperature helps protect tissue and vascular structures. The depth of resection can also be controlled by applying different fluid pressures. Therefore, aspects of this disclosure relate to medical devices having a hydrodynamic tissue resection system.

[0019] Now for reference Figure 1 . Figure 1An example medical device 102 is depicted. Medical device 102 can be, for example, an endoscopic medical device, such as a catheter, for performing tissue resection methods (e.g., submucosal tissue dissection). Medical device 102 has a tubular member 104 having a proximal end (not shown) and a distal end 106. Tubular member 104 can be any known or anticipated tubular member 104 for medical procedures (e.g., endoscopy), and can be, for example, a flexible tubular member for medical manipulation having one or more channels or lumens disposed therein and extending between the proximal and distal ends 106 of tubular member 104. In one example, tubular member 104 is a catheter, which can be solid, slotted, braided, injection-molded, or reflux. Figure 1 and Figure 2A As shown, at least the distal portion of the tubular member 104 is grooved to, for example, increase the flexibility of the tubular member 104. The grooved portion may extend to an ungrooved portion at the distal end 106, which is coupled to the body 108 described herein. In one example, the tubular member may be a compression device. The medical device 102 also has a handle (not shown) connected to the proximal end of the tubular member 104. An operator may use the handle to perform operations on the medical device 102, including those described in the examples herein. The handle may be any known or contemplated handle for medical procedures and may include suitable ports and plugs for fluid and / or energy delivery. Furthermore, the medical device 102 has a fluid delivery mechanism (not shown) located at the proximal end of the tubular member 104. The fluid delivery mechanism may or may not be part of the handle and enables fluid to flow from the proximal end of the tubular member 104 via one or more internal channels or lumens to the distal end 106 and ultimately to the body 108 to perform the hydrodynamic tissue resection technique described herein. In one example, the fluid delivery mechanism may include a fluid source disposed at the proximal end of the tubular member 104, such as within a handle. In another example, the fluid delivery mechanism may be a mechanism (e.g., a pump) for driving fluid from a remote fluid source through the tubular member 104.

[0020] The medical device 102 also includes a body 108 disposed on the distal end 106 of the tubular member 104. The body 108 has a proximal end 110 and a distal end 112. In one example, the proximal end 110 of the body 108 is configured to abut / engage with the distal end 106 of the tubular member 104. For example, the body 108 may be inserted into a mating part at the distal end 106 of the tubular member 104. It should be understood that any internal working channels and / or lumens may be aligned in the body 108 and the tubular member 104. In other examples, the body 108 may be integrally formed with and permanently fixed to the tubular member 104 (e.g., by bonding or otherwise adhering or fixing to the tubular member 104). The body 108 has a proximal opening ( Figure 1(not shown in the middle) and distal opening 109.

[0021] Figure 1 Tissue boundary 114 is also shown. Tissue boundary 114 can be any tissue layer within the human body. Figure 1 The target tissue is also shown at reference numeral 116 in the accompanying drawings. In one example, target tissue 116 may be a tumor located within the gastrointestinal (GI) endothelium, although it should be understood that this can be any tissue in the human body. The techniques described herein are capable of treating target tissue 116, for example, by providing a hydrodynamic tissue resection method. Figure 1 The distal end 112 of the body 108, embedded below the tissue boundary 114, is shown. Reference numeral 118 indicates the direction in which fluid can be delivered at sufficiently high pressure to pierce the tissue boundary 114 and the tissue region 120 to which treatment is being applied. Ultimately, the medical device 102 is used to remove the target tissue 116. These systems and methods are described in more detail herein.

[0022] Now refer to Figure 2A This illustrates a body 108 at the distal end 106 of a tubular member 104 according to an exemplary embodiment. As described above, the body 108 is configured to abut against the tubular member 104, for example, by inserting into an opening at the distal end 106 of the tubular member 104. Figure 1 (Not shown in the image). The body 108 has a proximal opening ( Figure 1 (not shown in the image) and Figure 1 The distal opening 109 is shown. As described herein, an intermediate fluid channel is formed in the body 108 between the proximal opening and the distal opening 109 of the body 108. Figure 1 (Not shown in the image). It should be understood that, in one example, the intermediate fluid channel is aligned with at least one channel or lumen of the tubular member 104 (e.g., a conduit). Figure 2A A fluid jet 210 is shown emitted from the distal opening 109 of the body 108 along an axis (e.g., longitudinal axis). Figure 2A The direction of fluid flow along the axis is also shown at reference numeral 211 in the accompanying drawings. The proximal opening of the body 108 is configured to connect with fluid delivery devices (e.g., in conjunction with) inside and / or outside the medical device 102. Figure 1 The described fluid delivery mechanism engages with and receives fluid from the fluid delivery device. The distal opening 109 of the body 108 is configured to eject fluid delivered from the fluid delivery device. As described herein, the intermediate fluid channel ( Figure 2A(Not shown) is formed in the body 108 between the proximal opening and the distal opening 109 of the body 108. In one example, the fluid delivery device may be a fluid lumen or channel disposed within the tubular member 104 of the medical device 102, such that fluid (e.g., water or saline solution) is delivered from a source located proximal to the medical device 102 to the proximal opening of the body 108 for discharge through the distal opening 109 of the body 108. In this example, the body 108 is configured to deliver a fluid jet 210 when fluid is emitted from the fluid delivery device.

[0023] The fluid jet 210 can be a fluid jet of water, saline, or other liquid delivered at a fluid pressure sufficient for tissue resection. For example, the fluid jet 210 can be fired through the distal opening 109 of the body 108 at a fluid pressure of up to 60 atmospheres (“bars”) or approximately up to 870 pounds per square inch (psi). In one embodiment, the fluid jet 210 is fired at a fluid pressure of 250 psi or lower when the diameter of the distal opening 109 of the body 108 is 1 millimeter (mm). It should be understood that the appropriate fluid pressure can vary depending on system and device parameters, including but not limited to tissue type, fluid used for the fluid jet 210, diameter of the distal opening 109 of the body 108, etc. In one example, the diameter of the distal opening 109 varies based on the channel of the tubular member 104 and the desired size of the intended tissue impact area of ​​the fluid jet 210. For example, a fluid pressure between approximately 20 and 60 bars can be used for tissue resection; for example, relatively lower pressures provide cleaner and more precise tissue puncture or perforation to minimize risk. In one example, when the distal opening 109 has a diameter of approximately 0.04 inches, a fluid pressure of less than approximately 250 psi may be sufficient to puncture tissue (e.g., muscle tissue, diseased tissue, or other types of tissue to be treated by medical device 102), and when the distal opening 109 has a diameter of approximately 0.05 inches, a fluid pressure of less than approximately 100 psi may be sufficient to puncture tissue. In contrast to the fluid pressure required for muscle tissue, higher fluid pressures may be needed for tissue resection of the mucosa and / or submucosa, as the mucosa and submucosa of the gastrointestinal tract may be tougher than muscle. In one example, a fluid pressure of approximately 600 psi may be sufficient to puncture mucosal and / or submucosa tissue. The fluid pressure may also vary based on the type of distal opening 109 (e.g., the internal shape and geometry of distal opening 109). In one example, the distal opening 109 may be chamfered to distribute pressure, or tapered / inwardly tapered (from proximal to distal) to focus the fluid flow (e.g., fluid jet 210).

[0024] Figure 2AThe outer surface of the distal wall 220 is also shown. The distal wall 220 extends in a direction transverse to the longitudinal axis along which the fluid jet 210 is emitted. (Reference) Figure 2B The figure shows a view of the body 108 according to an exemplary embodiment, with the proximal-facing inner surface of the distal wall 220 shown at reference numeral 220a. The inner surface 220a faces the distal opening 109 of the body 108. When fluid is delivered through the body 108, a fluid jet 210 is emitted from the distal opening 109 of the body 108 and is received at the inner surface 220a of the distal wall 220. Figure 2B A distal wall 220 is also shown, which has a projection 230 at its apex and extends in a direction transverse to the longitudinal axis of the emissive fluid jet 210. The projection 230 may be a relatively sharp tip of the distal wall 220 pointing in a radially outward direction. The projection 230 is configured to engage tissue (e.g., puncture a tissue surface and / or be placed on a tissue surface). For example, the projection 230 engages with... Figure 1 The tissue boundary 114 is described to guide or anchor the body 108 to a region close to the tissue of interest (e.g., target tissue 116) to ultimately perform the hydrodynamic tissue resection method described herein. In one example, the protrusion 230 is a hook or hook-like feature configured to engage and anchor to the tissue. The protrusion 230 may include one or more tips or points.

[0025] Since the fluid jet 210 is fired at a sufficiently high fluid pressure to remove tissue, it is desirable to minimize or mitigate accidental tissue perforation. In one example, without a barrier to prevent the fluid jet 210, an undiminished fluid flow could rapidly penetrate an organ / tissue not intended for tissue treatment. The protrusion 230 can prevent or limit accidental tissue perforation by preventing fluid flow through the tissue acquired by the protrusion 230. The protrusion 230 provides a solid surface (e.g., the inner surface 220a of the distal wall 220) for the fluid jet 210 to impact, which can dissipate the force of the fluid jet 210. When the fluid jet 210 impacts a solid surface, the fluid may “splash back.” To mitigate or prevent accidental tissue perforation caused by fluid splash, the fluid splash can have sufficiently low energy to cause no damage to surrounding healthy tissue (and, for example, to avoid obstructing the camera’s operational view). Therefore, when the fluid jet 210 impacts the protrusion 230, the protrusion 230 can be shaped to minimize the fluid energy of the splash. For example, a solid surface (e.g., the inner surface 220(a) of the distal wall 220) can be flat, convex, or concave relative to the flow of the fluid jet 210. Generally, the profiles of the distal wall 220 and the protrusion 230 can be optimized in terms of shape, material, thickness, and distance from the distal opening 109 to safely guide backsplash. See again Figure 2AThis dissipation is shown at reference numeral 240, as the fluid dissipates along the edges and sides of the body 108 and the distal wall 220 and results in minimal or no accidental tissue perforation.

[0026] Figure 2B A bed region (“bed”) 250 of the body 108 is also shown. In one example, the bed 250 is a surface disposed along a longitudinal axis between the distal opening 109 of the body 108 and the distal wall 220 of the body 108. The bed 250 may define a space within the body 108 for receiving tissue between the distal opening 109 and the distal wall 220. In one example, the bed 250 is a surface that connects the inner surface 220a of the distal wall 220 to one side of the body 108 having the distal opening 109 of the body 108. The bed 250 may be used in medical procedures to remove excised tissue from a patient's body. For example, after treating target tissue 116 with a hydrodynamic excision method, the body 108 may be manipulated such that the target tissue 116 is placed on the bed 250 and removed from the patient's body as the medical device 102 is removed. To help capture the excised tissue and retain it during the retraction of the medical device 102 from the patient, the surface of the bed 250 may be treated with an adhesive coating or otherwise to allow the excised tissue to adhere to the surface of the bed 250.

[0027] Now refer to Figure 3 It shows a cross-sectional view of the medical device 102. Figure 3 A cross-sectional view of the distal end of the tubular member 104 of the body 108 and the medical device 102 is shown. Figure 3 The intermediate fluid channel 330 in the body 108 and the main fluid channel 340 in the tubular member 104 are shown. Figure 2A As shown, an intermediate fluid channel 330 is formed between the proximal opening and the distal opening 109 of the body 108. Figure 3 In the middle, the fluid in the main fluid channel 340 passes through the proximal opening of the body 108 ( Figure 3(Not shown) The fluid flows towards the intermediate fluid channel 330, as indicated by arrow 350. In other words, the proximal opening of the body 108 aligns with the distal opening of the main fluid channel 340, allowing fluid to flow between the main fluid channel 340 and the intermediate fluid channel 330. The intermediate fluid channel 330 tapers from its proximal end to its distal end. In other words, the cross-sectional area and / or diameter of the intermediate fluid channel 330 decreases from its proximal end to its distal end. As a result, the fluid pressure increases as the fluid flows through the intermediate fluid channel 330 in a distal direction (as indicated by arrow 360). Therefore, the fluid flows towards the distal end of the intermediate fluid channel 330 at a higher pressure compared to the fluid flow at the proximal end of the intermediate fluid channel 330 and compared to the fluid flow in the main fluid channel 340. As a result, when the fluid jet 210 exits from the intermediate fluid channel 330 at the distal opening 109 of the body 108, the fluid jet 210 is emitted at a higher fluid pressure relative to the fluid pressure in the main fluid channel 340. In this example, the distal opening 109 of the body 108 serves as a nozzle to eject a fluid jet 210 at a relatively high fluid pressure. As described herein, the fluid pressure of the fluid jet 210 is high enough to perform a tissue resection operation. Backsplash is limited, as indicated by water dissipation at marker 240.

[0028] Now for reference Figures 4A-4C This shows a cross-sectional view of another embodiment of the medical device 102'. Figure 4A A tubular member 410, a distal structure 420, and a body 425 are shown. The tubular member 410 may have the structure and function of the tubular member 104, and the body 425 may have the structure and function of the body 108. The distal structure 420 may have the structure and function of the distal end 106. The distal structure 420 also includes a valve 450 and a spring 460. Figure 4A As shown, fluid can be delivered to the distal end of the medical device 102'. At the distal end, after the fluid has traveled through the tubular member 410 to the intermediate fluid channel, as shown at 430, the intermediate fluid channel 430 retains the fluid as it narrows.

[0029] Valve 450 is located at the distal portion of the intermediate fluid channel 430, distal to the narrowing 435 of the intermediate fluid channel 430. The narrowing 435 has a smaller diameter and / or cross-sectional area relative to portions of the channel 430 that are farther from and closer to the narrowing 435. Valve 450 is not fixed to the intermediate fluid channel 430, and is therefore capable of longitudinal translation within the channel 430, for example, in the direction indicated by arrow 405. Spring 460 is also located at the distal portion of the intermediate fluid channel 430, distal to valve 450. Spring 460 is fixed to valve 450 at its proximal end.

[0030] Spring 460 and valve 450 are located between the proximal opening of the intermediate fluid passage 430 (shown as reference numeral 462) and the proximal end of body 425. In one example, body 425 is coupled to distal structure 420 such that spring 460 is secured to the surface of body 425 at the distal end of spring 460. In one example, spring 460 is a compressible helical spring that is compressible when pressure is applied (e.g., when fluid pressure is applied to valve 450 in direction 405). In one example, valve 450 is a one-way valve that allows fluid to exit from intermediate fluid passage 430 in a single direction.

[0031] Now for reference Figure 4B and 4C . Figure 4B The closed configuration of valve 450 is shown. Figure 4B In the diagram, arrows 470a-470c indicate the fluid flowing into the intermediate fluid passage 430. As the intermediate fluid passage 430 narrows towards valve 450, the fluid pressure increases at arrow 470c. Figure 4B In the middle, the valve is closed, so fluid will not be discharged from the intermediate fluid passage 430. Figure 4C The open configuration of valve 450 is shown. Figure 4C Once the fluid reaches sufficient pressure (e.g., threshold pressure), the proximal force exerted on valve 450 by spring 460 is overcome, and the pressure forces valve 450 toward spring 460 in the distal direction (e.g., along direction 405), thereby compressing spring 460 in the distal direction. Once distal movement begins, the shape of valve 450 allows a larger area of ​​valve 450 to be exposed to fluid flow, forcing it to open rapidly. Therefore, when spring 460 is compressed (e.g., when valve 450 and spring 460 have moved more than the threshold distance caused by the threshold pressure in the distal direction), fluid is able to flow around the valve, as indicated by arrows 472a-472d, into the discharge passage, as indicated by reference numeral 480. Discharge passage 480 can extend from proximal opening 462 to distal structure 420, allowing fluid to flow toward body 425, for example, in the direction of arrows 472a-472d. Fluid exits discharge passage 480 and flows toward a protrusion (e.g., protrusion 230). As the fluid pressure in the intermediate fluid passage 430 decreases (e.g., when the fluid supplied to device 102' decreases), the proximal pressure of the spring 460 on valve 450 can be greater than the fluid pressure applied to valve 450, and valve 450 can retract (e.g., travel in the proximal direction) to Figure 4B The state shown is closed.

[0032] In one example, fluid is emitted from the intermediate fluid channel 430 at a constant or relatively constant pressure. Therefore, Figures 4A-4CThe described mechanism allows fluid to be ejected from the discharge channel 480 at a constant or near-constant pressure, which avoids a gradual increase in fluid pressure during discharge from the intermediate fluid channel 430 and the distal opening 462. In some examples, it is advantageous for fluid to be ejected from the discharge channel 480 at a substantially constant pressure to avoid accidental tissue damage during pressure buildup or suboptimal tissue removal.

[0033] Now for reference Figure 5 . Figure 5 A cross-sectional view of another embodiment of the medical device is shown at 500. Typically, device 500 is configured for hydrodynamic tissue dissection and delivery of RF energy to tissue. Figure 5 A cross-sectional view of the tubular member 520 and the body 530 is shown. The tubular member 520 and the body 530 may have any structure and function of the tubular members 104, 420 and the bodies 108, 410, respectively. In addition to the tissue resection function performed by the hydrodynamic system, the medical device 500 provides a coagulation function with RF delivery, which is advantageous for endoscopic surgery. The body 530 may be coupled to or otherwise secured to the tubular member 520. The body 530 is made of metal or other conductive material. The body 530 is configured to conduct RF energy. For example, RF energy may be transmitted to the body 530 via a conductive tube, wire, cable, or braid of the medical device 500. In an enlarged view of the joint between the body 530 and the tubular member 520, the conductive tube is shown at reference numeral 540. The conductive tube 540 may be surrounded by an insulating material, as indicated by reference numerals 550 (inner insulation) and 560 (outer insulation). Therefore, the conductive tube 540 forms an electrical conduit to deliver RF energy to the body 530 and ultimately to the distal wall 535 to coagulate tissue during medical procedures. The RF active component of the body 530 thus includes the distal wall 535. Therefore, in one example, the distal wall 535 can function as a point of contact with tissue to deliver RF energy for coagulation.

[0034] Now for reference Figure 6 The diagram illustrates an example flowchart 600, depicting operations for performing the hydrodynamic tissue resection technique described herein. In operation 610, the resection device is positioned close to the tissue of interest. The resection device can be any of the medical devices 102, 102', and 500 described herein. In operation 620, the tissue of interest engages with a protrusion of the resection device to hold the device in position at the tissue of interest. In operation 630, fluid is ejected from a distal opening of the resection device along its longitudinal axis toward the distal wall surface of the resection device. The fluid resection removes the tissue of interest.

[0035] Other embodiments of this disclosure will be apparent to those skilled in the art upon consideration of the specification and the practice of the invention disclosed herein. The specification and embodiments are intended to be illustrative only, and the true scope and spirit of the invention are indicated by the appended claims.

[0036] It should be understood that one or more aspects of any medical device described herein may be used in conjunction with any other medical device known in the art, such as medical imaging systems or other ranges, such as colonoscopes, bronchoscopes, ureteroscopes, duodenoscopes, etc., or other types of imagers.

[0037] It should also be understood that one or more aspects of any medical device described herein can be used to remove, cut, or otherwise dissect tissue in any part of the human body. For example, any medical device described herein can be used in medical procedures requiring the removal and / or examination of tissue.

[0038] While the principles of this disclosure have been described herein with reference to illustrative examples of specific applications, it should be understood that this disclosure is not limited thereto. Those skilled in the art and those who have received the teachings provided herein will recognize that additional modifications, applications, and substitutions of equivalents fall within the scope of the examples described herein. Therefore, the invention should not be considered limited to the foregoing description.

Claims

1. A medical device comprising: A body having a proximal end with a proximal opening, the body defining a channel from the proximal opening to a distal opening, the distal opening being configured to emit a fluid jet along the longitudinal axis of the body; and The body also includes a distal sidewall having a surface extending in a direction transverse to the longitudinal axis and facing the distal opening to receive the fluid jet. The body defines a space between the distal sidewall and the distal opening. The distal sidewall includes protrusions configured to form an interlocking structure, wherein the protrusions provide a solid surface that is convex or concave relative to the flow of the fluid jet.

2. The medical device according to claim 1, wherein, The distal opening emits the fluid jet at a certain pressure to pierce the tissue, and wherein the solid surface is configured to receive the flow of the fluid jet.

3. The medical device according to claim 2, wherein, The pressure is 250 pounds per square inch or less.

4. The medical device according to any one of claims 1-3, wherein, The distal opening has a diameter of approximately 1 mm or less.

5. The medical device according to any one of claims 1-3, wherein, The diameter of the proximal opening is larger than the diameter of the distal opening.

6. The medical device according to claim 1, wherein, The cross-sectional dimensions of the channel gradually decrease from the proximal opening to the distal opening.

7. The medical device according to any one of claims 1-3 and 6, wherein, The protrusion includes one or more tips to engage the tissue.

8. The medical device according to any one of claims 1-3 and 6, wherein, The body receives fluid at the proximal opening and also includes a valve and a spring configured to retain the fluid within the body until the pressure of the fluid exceeds a predetermined threshold.

9. The medical device according to claim 8, wherein, The valve is fixedly connected to the spring, wherein the valve is a one-way valve, wherein the spring is a helical spring having a distal end fixed within the body, wherein the valve and the spring are located between the proximal opening and the distal opening, and wherein the valve is located proximal to the spring.

10. The medical device according to any one of claims 1-3 and 6, wherein, The body is electromedical to deliver radio frequency (RF) energy to the tissue.

11. The medical device according to claim 1, wherein, The RF energy delivered to the body is conductive to the distal sidewall.

12. The medical device according to any one of claims 1-3, 6, and 11, wherein, The body also includes a bottom surface disposed along the longitudinal axis between the distal opening and the distal wall to define an area for adhering tissue, wherein the bottom surface includes an adhesive coating configured to adhere the tissue.

13. The medical device according to any one of claims 1-3, 6, and 11, further comprising a flexible tube coupled to a proximal end of the body, the flexible tube including a channel for delivering fluid to the body, and wherein, The flexible tube includes a conductive tube, wire, cable, or braid for delivering radio frequency (RF) energy to the body.

14. The medical device according to any one of claims 1-3, 6, and 11, wherein, The protrusion is configured to engage with the tissue via a hook.

15. The medical device of claim 9, further comprising a discharge channel adjacent to the valve and the spring-positioned, wherein, The discharge channel is configured to guide the flow of the fluid jet from the proximal opening to the distal opening.

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