Medical systems and devices for lifting tissue

Abstract

A medical system includes an insertion device having a working channel, a first medical device configured to be disposed inside the working channel of the insertion device, and a second medical device configured to be disposed inside the working channel of the insertion device. The first medical device includes a handle, a control element extending from the handle, a removable portion, a helical coil coupled to the removable portion, and a ring. The removable portion is removably coupled to the distal portion of the control element. A first portion of the ring is coupled to the removable portion, and a second portion of the ring extends radially away from the removable portion. The second medical device is configured to receive a second portion of the loop. A second medical device is configured to couple a second portion of the loop to a portion of the treatment site.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of priority to U.S. Provisional Patent Application No. 63 / 490,259, filed on March 15, 2023, the entire contents of which are incorporated herein by reference. Technical Field

[0002] The present disclosure generally relates to medical systems, devices, and related methods that can be used to treat a subject. More specifically, at least some embodiments of the present disclosure relate to systems, devices, and related methods for lifting tissue. Background Art

[0003] Organ walls are typically composed of several layers: the mucosa (surface layer), the submucosa, the muscularis (muscle layer), and the serosa (connective tissue layer). In gastrointestinal cancer, colon cancer, and esophageal cancer, lesions or cancerous masses may form along the mucosa and often extend into the lumen of the organ. Traditionally, the condition has been treated by removing a portion of the affected organ wall. However, this surgery can cause discomfort to the patient and / or pose health risks.

[0004] Doctors have adopted minimally invasive techniques, such as endoscopic surgery, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). The EMR method is typically used to remove little cancerous or abnormal tissue (such as polyps), and the ESD method is typically used to integrally remove large cancerous or abnormal tissue (such as lesions). These operations are usually performed using endoscopes and other instruments. During these operations, an endoscope can pass through a percutaneous incision, downwardly through the throat or be guided through the rectum to reach the target tissue for excision or dissection, and the tissue has an abnormality in the affected organ, such as a lesion or a cancerous mass. Usually identify and mark abnormality.

[0005] The mucosal layer containing the abnormality is then separated from the tissue layer below using a medical instrument extending through the working channel or lumen of the endoscope. The abnormal part is subsequently removed using the same or different medical instruments. Traditionally, tissue is removed by adopting a cutting device (such as a wire loop or a knife) that can be suitable for electrocautery. Subsequently, the excised tissue can be extracted using a tissue removal device (such as a grasper or other devices for holding tissue) for inspection or disposal. During surgery, both the cutting device and the tissue removal device usually need to apply a large traction force or lifting force on the tissue, and this lifting force may be limited by traditional devices. The limited lifting force in traditional tissue cutting and grasping devices may cause the operation time to increase, the patient to be injured or other surgical complications.

[0006] The systems, devices, and methods of the present disclosure may remedy some of the deficiencies described above or address other aspects of the art. Summary of the Invention

[0007] Examples of the present disclosure relate, inter alia, to systems, devices, and methods for performing one or more medical procedures using medical devices. Specifically, the present disclosure includes medical systems and devices including end effectors and methods of using the same (e.g., methods of delivering the end effectors to a treatment site on a patient (e.g., to elevate tissue)). Each example disclosed herein may include one or more features described in conjunction with any other disclosed example.

[0008] According to one aspect, a medical system may include an insertion device having a working channel, a first medical device, and a second medical device. The first medical device may be configured to be positioned within the working channel of the insertion device. The first medical device may have a handle, a control element extending from the handle, a detachable portion, a helical coil coupled to the detachable portion, and a ring. The detachable portion may be removably coupled to a distal portion of the control element. The helical coil may be coupled to the detachable portion. The ring may include a first portion and a second portion. The first portion of the ring may be coupled to the detachable portion. The second portion of the ring may extend radially away from the detachable portion. The second medical device may be configured to be positioned within the working channel of the insertion device. The second medical device may be configured to receive the second portion of the ring. The second medical device may be configured to couple the second portion of the ring to a portion of a treatment site.

[0009] The medical system may include one or more of the following features. The first medical device may further include a coupler. The coupler may include a first portion coupled to a distal portion or a portion of a distal portion of a control element. The coupler may include a second portion coupled to a proximal portion or a portion of a proximal portion of a detachable portion. The first portion and the second portion may be configured to releasably couple the detachable portion to the control element. The first portion of the coupler may be configured to overlap at least a portion of the second portion of the coupler.

[0010] In some configurations, the first contact surface of the first portion can abut the second contact surface of the second portion. The first contact surface of the first portion can be complementarily shaped to the contact surface of the second portion. In some embodiments, a portion of the first portion of the coupling can be magnetic. A portion of the second portion of the coupling can be magnetic of opposite polarity to a portion of the first portion.

[0011] In some embodiments, a portion of the first portion of the coupling may include an electromagnet and a portion of the second portion of the coupling may be a magnetic material.

[0012] In some configurations, rotation of the helical coil in a first direction can be configured to couple the distal portion to the tissue wall. Rotation of the helical coil in a second direction can be configured to decouple the helical coil from the tissue wall. The helical coil can include a plurality of turns. Adjacent turns of a first portion of the plurality of turns can be spaced apart by a first distance. Adjacent turns of a second portion of the plurality of turns can be spaced apart by a second distance. Adjacent turns of a third portion of the plurality of turns can be spaced apart by a third distance. In some embodiments, the third distance can be greater than the second distance, and the second distance can be greater than the first distance.

[0013] In some embodiments, the handle may include a fixed body, a first movable body, and a second movable body. The first movable body may control axial movement of a distal portion of the control element. The second movable body may control rotational movement of the distal portion of the control element. The fixed body may include a first indicator for identifying axial movement of the helical coil. The second movable body may include a second indicator for identifying rotational movement of the helical coil.

[0014] In some configurations, the second medical device can include a clip. In some configurations, the second portion of the ring can be made of an elastic material. In some configurations, the medical system can further include a third medical device configured to be positioned within the working channel of the insertion device. The third medical device can be configured to cut tissue.

[0015] In some configurations, the first and second portions of the coupler can be coupled by an adhesive material. In a first configuration, the material can be disposed within a sheath extending from the handle. In a second configuration, the material can be uncovered by the sheath, in which case the material can degrade to decouple the first and second portions of the coupler.

[0016] According to an alternative embodiment, a medical device may include a handle, a control element, a detachable portion, a helical coil, and a ring. The control element may extend from the handle. The detachable portion may be removably coupled to a distal portion of the control element. The helical coil may be coupled to the detachable portion. The ring may have a first portion and a second portion. The first portion of the ring may be coupled to the detachable portion. The second portion of the ring may extend radially outward from the detachable portion.

[0017] The medical device may include one or more of the following features. In some configurations, the first medical device may further include a coupler. The coupler may include a first portion coupled to a distal portion or a portion of a distal portion of a control element. The coupler may include a second portion coupled to a proximal portion or a portion of a proximal portion of a detachable portion. The first portion and the second portion may be configured to releasably couple the detachable portion to the control element. In some embodiments, a portion of the first portion of the coupler may be a magnet, and a portion of the second portion of the coupler may be a magnetic material.

[0018] According to another aspect, a method may include delivering an insertion device and a first medical device into an inner cavity to a treatment site. The first medical device may be configured to be disposed within a working channel of the insertion device. The first medical device may include a handle, a control element, a detachable portion, a helical coil, and a ring. The control element may extend from the handle. The detachable portion may be removably coupled to a distal portion of the control element. The helical coil may be coupled to the detachable portion. A first portion of the ring may be coupled to the detachable portion, and a second medical device may be configured to receive a second portion of the ring.

[0019] The method may further include coupling the helical coil to a wall of the lumen, decoupling the detachable portion from the control element, and delivering a second medical device. The second medical device may be configured to be positioned within a working channel of the insertion device. The second medical device may include a detachable clip. The method may further include attaching the detachable clip to the ring, coupling the detachable clip to the treatment site, delivering a third medical device, and resecting at least a portion of the treatment site using the third medical device. The third medical device may be configured to be positioned within a working channel of the insertion device.

[0020] After delivering the third medical device and partially resecting the treatment site with the third medical device, the method may further include delivering the first medical device, coupling the first medical device to the detachable portion (including the helical coil), and repositioning the detachable portion. The method may further include delivering the third medical device and resecting at least a second portion of the treatment site with the third medical device.

[0021] Any of the examples described herein can have any of these features in any combination. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of the disclosure and, together with the description, serve to explain the principles of the disclosure.

[0023] Figure 1A depicts a perspective view of a medical device including a distal portion in a first or coupled configuration, and Figure 1BDepicted is a perspective view of a distal portion of a medical device in a second configuration, according to aspects of the present disclosure.

[0024] Figures 2A-2E Depicted are perspective views of a distal portion of an exemplary medical system in various states during operation, according to aspects of the present disclosure.

[0025] Figure 3 is a flow chart of an exemplary method according to aspects of the present disclosure. DETAILED DESCRIPTION

[0026] Reference will now be made in detail to various aspects of the present disclosure, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numerals will be used to refer to the same or similar parts throughout the drawings. The terms "distal" or "distal side" refer to the portion of the device farthest from the user when the device is introduced into a subject (e.g., a patient). In contrast, the terms "proximal" or "proximal side" refer to the portion closest to the user when the device is placed into the subject.

[0027] The foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the features claimed. As used herein, the terms "comprises," "comprising," "having," or variations thereof are intended to encompass a non-exclusive inclusion such that a process, method, article, or apparatus that includes a list of elements includes not only those elements but may also include other elements not expressly listed or inherent to such process, method, article, or apparatus. In this disclosure, relative terms such as "about," "substantially," "generally," and "approximately" are used to indicate that a stated value or characteristic may vary by ±10%.

[0028] Although the treatment site is discussed herein as being in the gastrointestinal tract of a subject, the present disclosure is not limited thereto, as the treatment site can be any internal lumen, organ, cavity, or other tissue within the subject. Additionally, although endoscopes are mentioned herein, it should be understood that the present disclosure encompasses any medical device having a working channel or lumen extending from a proximal end to a distal end, such as a ureteroscope, duodenoscope, gastroscope, endoscopic ultrasound ("EUS") scope, colonoscope, bronchoscope, laparoscope, arthroscope, cystoscope, aspiroscope, sheath, or catheter.

[0029] Implementations of the present disclosure may address one or more limitations in the art. However, the scope of the present disclosure is defined by the appended claims rather than the ability to solve a specific problem. The present disclosure relates particularly to systems, devices, and related methods for tissue lifting medical devices.

[0030] Figure 1AA perspective view of a medical device 100 having a handle 101 and a distal portion 102 is shown in a first (eg, coupled or attached) configuration. Figure 1B The distal portion 102 of the medical device 100 is depicted in a second (e.g., decoupled or detached) configuration. One or more portions of the handle 101 may be movable or manipulable to control various aspects of the distal portion 102. One or more portions of the distal portion 102 may be movable to facilitate, for example, coupling and / or decoupling the distal portion 102 to tissue and / or decoupling the distal portion 102 from the medical device 100. The distal portion 102 may be in a Figure 1A Detailed illustration is shown in circle A.

[0031] refer to Figure 1A , the handle 101 can include a fixed body 104 and a first movable body or first actuator 106. Movement of the first movable body 106 relative to the fixed body 104 can control movement (e.g., extension or retraction) of a portion of the distal portion 102. For example, one or more control elements 108 can be coupled to the first movable body 106 and coupled to a portion of the distal portion 102, and thus the first movable body 106 can control movement (e.g., axial movement, such as extension or retraction) of one or more portions of the distal portion 102. The control element 108 can be constructed of any rigid or semi-rigid material, such as a metal, a polymer, a metal-polymer composite, etc. The control element 108 can be formed of a coil, a braid, a tube, a sheath, etc. The control element 108 can be coupled (e.g., directly or indirectly) or otherwise connected to the first movable body 106, for example, via an adhesive, a mechanical fit, a snap fit, a press fit, welding (e.g., laser welding), or any other coupling technique known in the art. In some embodiments, a plurality of control elements 108 are used. In such embodiments, each of the plurality of control elements 108 is formed of the same or different materials and / or is coupled or otherwise connected to the distal portion 102 and the first movable body 106 via the same or different coupling techniques.

[0032] The outer sheath 110 can be coupled (e.g., directly or indirectly) or otherwise connected to the fixed distal handle portion 111 of the handle 101, such as by adhesive, mechanical fit, snap fit, press fit, welding (e.g., laser welding), or any other coupling technique known in the art. The control element 108 can be movable within the outer sheath 110 (e.g., within the lumen 113). The proximal portion of the fixed body 104 can include a finger ring 112, for example, to receive a user's thumb.

[0033] The first movable body 106 can at least partially surround a portion of the fixed body 104, and a portion of the first movable body 106 can at least partially extend into the handle slot 114. The handle slot 114 can extend longitudinally through at least a portion of the fixed body 104 of the handle 101. In some aspects, although not shown, the handle 101 can include one or more biasing elements (e.g., one or more springs), for example, to bias the first movable body 106 distally relative to proximal movement of the fixed body 104. In these aspects, when the user releases proximal pressure or force on the first movable body 106, the one or more biasing elements can bias the first movable body 106 distally. Alternatively, the one or more biasing elements (e.g., one or more springs) can bias the first movable body 106 proximally. In these aspects, when the user releases distal pressure or force on the first movable body 106, the one or more biasing elements can bias the first movable body 106 proximally.

[0034] The first movable body 106 can include one or more reduced diameter sections or grooves 106A, such as one or more reduced diameter sections or grooves 106A between the proximal ridge 106B and the distal ridge 106C, which can help facilitate a user's grip on the first movable body 106. For example, a user can place the first movable body 106 between two fingers such that the user's fingers are positioned within the grooves 106A. Thus, movement of the user's fingers (i.e., relative to a user's thumb in the finger ring 112) controls the position of the first movable body 106 relative to the fixed body 104, and thus controls movement of the control element 108 and / or one or more portions of the distal portion 102.

[0035] The fixed body 104 can include one or more visual or physical indicators 116. The indicator 116 can physically or visually indicate actuation or extension of one or more portions of the distal portion 102. For example, as the first movable body 106 is advanced distally within the handle slot 114 relative to the fixed body 104, thereby actuating one or more portions of the distal portion 102, the first movable body 106 may have to overcome, for example, the indicator 116. The indicator 116 can signal to the user (e.g., via a tactile signal or feedback, via a visual signal, etc.) that the distal portion 102 has been actuated or is in an extended position. The indicator 116 can be on one side of the handle 101 or on opposite sides of the handle 101 (e.g., opposite the indicator 116, such as Figure 1A104 and / or the first movable body 106). The indicator 116 can be any combination of a protrusion, a cantilevered protrusion, a notch, a ridge, or the like. For example, the indicator 116 on one side of the handle 101 can be a protrusion, and the indicator 116 on the opposite side of the handle 101 can be a cantilevered protrusion. Many other combinations are also contemplated. Additionally or alternatively, the user can utilize one or more markings on the handle 101 (e.g., on the fixed body 104 and / or the first movable body 106) or other visual indicators to determine the status, position, actuation state, etc., of one or more portions of the distal portion 102.

[0036] The handle 101 can also include a second movable body or second actuator 118. For example, movement of the second movable body 118 can control movement (e.g., rotation) of the control element 108 and, therefore, one or more portions of the distal portion 102. For example, the control element 108 can be directly or indirectly coupled to the second movable body 118, such as via an adhesive, a mechanical fit, a snap fit, a press fit, welding (e.g., laser welding), or any other coupling technique known in the art.

[0037] The second movable body 118 can be positioned on a distal portion of the handle 101. For example, the second movable body 118 can be positioned on the fixed body 104 distally relative to the first movable body 106. Additionally or alternatively, the second movable body 118 can be between the fixed body 104 and the distal handle portion 111 of the handle 101. The distal handle portion 111 and / or the second movable body 118 can include one or more ridges or notches, for example, to facilitate a user's grip on the corresponding portion of the handle 101.

[0038] The distal handle portion 111 and / or the second movable body 118 may additionally or alternatively include one or more visual or physical indicators, such as two visual or physical indicators 120A and 120B. For example, indicator 120A may be located on the second movable body 118, and indicator 120B may be on the distal handle portion 111. Indicator 120A and / or indicator 120B may include one or more of the characteristics of indicator 116 described above.

[0039] Indicator 120A and indicator 120B can identify or signal the amount and / or direction of rotational movement of a portion of distal portion 102 (e.g., helical coil 130). For example, the distance or spacing between indicator 120A on distal handle portion 111 and indicator 120B on second movable body 118 can indicate the rotational movement of helical coil 130. For example, when indicator 120A on distal handle portion 111 and indicator 120B on second movable body 118 are aligned, helical coil 130 is not rotated. Similarly, when indicator 120A on distal handle portion 111 and indicator 120B on second movable body 118 are misaligned or misaligned, helical coil 130 is rotated (e.g., clockwise or counterclockwise). For example, clockwise rotation causes helical coil 130 to be twisted into tissue, while counterclockwise rotation causes helical coil 130 to be twisted out of tissue, or vice versa.

[0040] Although not shown, the handle 101 may include one or more locks, for example, so that the first movable body 106 and / or the second movable body 118 can be locked in position. For example, the indicator 116 may include one or more notches and / or protrusions so that when the first movable body 106 is advanced distally over the indicator 116, the first movable body 106 is locked in position and / or cannot be retracted proximally without again overcoming the indicator 116. The second movable body 118 may additionally or alternatively include a locking or securing mechanism (not shown), for example, to prevent rotational movement of the second movable body 118. The locking or securing mechanism may include, for example, a ratchet mechanism having a ratchet and pawl, or any other locking or securing mechanism known in the art. The locking or securing mechanism may alternatively or additionally include one or more biasing features, for example, to help control the movement or rotation of the first movable body 106 and / or the second movable body 118.

[0041] Although not shown, in some aspects, the handle 101 may not include the first movable body 106 and / or the second movable body 118. In such an embodiment, the medical device 100 may not include the outer sheath 110. Therefore, the control element 108 can be fixedly coupled to the handle 101 (e.g., directly or indirectly). In this configuration, the distal portion 102 can be rotated by (e.g., integrally) rotating the handle 101. Rotation of the handle 101 then causes the control element 108 and the distal portion 102 (including the helical coil 130) to rotate. For example, clockwise rotation of the handle 101 causes the helical coil 130 to be screwed into the tissue, while counterclockwise rotation of the handle 101 causes the helical coil 130 to be screwed out of the tissue, or vice versa.

[0042] exist Figure 1A The distal portion 102, shown in more detail in circle A of FIG, includes a detachable portion 124 and a coupler 126. The detachable portion 124 is configured to couple or attach to and / or decouple or detach from the distal portion 108D of the control element 108 (e.g., via the coupler 126). The coupler 126 is configured such that the detachable portion 124 can be coupled and / or decoupled from the control element 108 one or more times (e.g., throughout a procedure). Thus, in some aspects, the detachable portion 124 can be used two or more times throughout a procedure.

[0043] In an alternative configuration, a procedure may require two or more detachable parts 124. In this configuration, two or more detachable parts 124 can be used with the same coupler 126. For example, a first detachable part 124 can be coupled to the coupler 126. Once the first detachable part 124 is coupled to the target tissue and decoupled from the coupler 126, the second detachable part 124 can then be coupled to the coupler 126. Thus, multiple detachable parts 124 can be used with the same coupler 126. In this manner, the medical device 100 can be reloadable.

[0044] The cross-sectional diameter of the removable portion 124 can be greater than, less than, or equal to the cross-sectional diameter of the control element 108. For example, the removable portion 124 can have a cross-sectional diameter between 0.05 inches and 0.25 inches, such as between 0.10 inches and 0.21 inches. Similarly, the control element 108 can have a cross-sectional diameter between 0.05 inches and 0.25 inches, such as between 0.10 inches and 0.21 inches. Thus, in some configurations, the control element 108 has a cross-sectional diameter of approximately 0.10 inches and the removable portion 124 has a cross-sectional diameter of approximately 0.05 inches, or vice versa. Alternatively, the control element 108 and the removable portion 124 can have the same cross-sectional diameter.

[0045] The cross-section of the control element 108 can be circular (as shown), oval, elliptical, square, rectangular, hexagonal, or any other shape commonly used in the art. Similarly, the cross-section of the coupling 126 can be circular, semicircular, oval, elliptical, square, rectangular, hexagonal, or any other shape commonly used in the art. The control element 108 and the coupling 126 can have the same cross-sectional shape or can have different cross-sectional shapes. For example, the control element 108 can have a circular cross-sectional shape, and the coupling 126 can have a rectangular or square cross-sectional shape. Many other combinations are also contemplated.

[0046] Furthermore, the cross-section of the removable portion 124 can be circular (as shown), oval, elliptical, square, rectangular, hexagonal, or any other shape commonly used in the art. The removable portion 124 can have the same or similar cross-sectional shape as the control element 108 and / or the coupler 126. For example, the removable portion 124, the coupler 126, and / or the control element 108 can each have a circular cross-sectional shape. Alternatively, the removable portion 124 can have a hexagonal cross-sectional shape, the coupler 126 can have a rectangular cross-sectional shape, and / or the control element 108 can have a circular cross-sectional shape. Many other combinations are also contemplated. For example, Figure 1A and Figure 1B As shown, first portion 126A of coupler 126 extends distally from distal portion 108D of control element 108. First portion 126A can be coupled (directly or indirectly) to distal portion 108D of control element 108. For example, first portion 126A can be coupled to distal portion 108D of control element 108, such as by adhesive, welding (e.g., laser welding), swaging, crimping, or any other coupling technique known in the art. In an alternative configuration, first portion 126A is integrally formed with distal portion 108D of control element 108. As described above, first portion 126A and second portion 126B can be detached or decoupled. Thus, detachable portion 124 can be coupled to and / or decoupled from control element 108.

[0047] Although not shown, in another alternative configuration, the first portion 126A of the coupler 126 can be coupled to one or more secondary control elements that are confined or otherwise positioned within the interior of the control element 108. In such a configuration, the control elements 108 can each be a sheath having an internal lumen. The secondary control elements (not shown) can be contained or otherwise positioned within the internal lumens of the control elements 108. Thus, the secondary control elements can be configured to be independently movable relative to the control element 108. In such a configuration, the first portion 126A and the second portion 126B can be detached or decoupled, as described above. In this manner, the detachable portion 124 can be coupled to and / or decoupled from the secondary control elements (not shown).

[0048] like Figure 1B As shown, the cross section of the first portion 126A and / or the second portion 126B (eg, perpendicular to the Figure 1AThe longitudinal axis of the medical device 100 shown can be rectangular, triangular, semicircular, semi-elliptical, circular, oval, or any other shape commonly used in the art. In some configurations, the cross-sections of the first portion 126A and the second portion 126B can have similar shapes or different shapes. For example, the cross-section of each of the first portion 126A and the second portion 126B can be semicircular or rectangular. Alternatively, the cross-section of the first portion 126A can be semicircular, and the cross-section of the second portion 126B can be rectangular.

[0049] The second portion 126B of the coupler 126 extends proximally from the proximal portion 124A of the removable portion 124. The second portion 126B can be coupled (directly or indirectly) to the proximal portion 124A of the removable portion 124. For example, the second portion 126B can be coupled to the proximal portion 124A of the removable portion 124, such as by an adhesive, welding (e.g., laser welding), swaging, crimping, or any other coupling technique known in the art. In an alternative configuration, the second portion 126B is integrally formed with the proximal portion 124A of the removable portion 124.

[0050] In these aspects, the first portion 126A and the second portion 126B can help maintain the connection between the control element 108 and the removable portion 124. The first portion 126A and the second portion 126B also allow a user to separate the first portion 126A and the second portion 126B, thereby separating the control element 108 from the removable portion 124. For example, the first portion 126A and the second portion 126B can be separated by pulling the first portion 126A and the second portion 126B apart with a force sufficient to overcome the coupling force between the first portion 126A and the second portion 126B.

[0051] The first portion 126A and the second portion 126B can be detachably connected. For example, the first portion 126A may include a magnet, one or more magnetic materials (e.g., steel, iron, cobalt, nickel, neodymium, etc.) or a magnetic alloy, and the second portion 126B may include one or more magnetic materials (e.g., steel, iron, cobalt, nickel, neodymium, etc.) or a magnetic alloy. In these respects, the first portion 126A and the second portion 126B have opposite polarities. In other embodiments, the magnet, magnetic material or magnetic alloy constituting the first portion 126A and / or the magnetic material or magnetic alloy constituting the second portion 126B may be surrounded by an insulating material (e.g., partially or completely encapsulated). The insulating material may help prevent the magnet or one or more magnetic materials or magnetic alloys from being coupled to undesirable components. For example, the insulating material may help prevent the magnet or one or more magnetic materials or magnetic alloys from being coupled to other medical devices or tools, external magnets, external magnetic materials, etc.

[0052] Insulating material that partially or completely surrounds the magnets, magnetic material, or magnetic alloy comprising first portion 126A and / or the magnetic material or magnetic alloy comprising second portion 126B can help facilitate a localized coupling joint between first portion 126A and second portion 126B. For example, partially or completely surrounding the magnets, magnetic material, or magnetic alloy comprising first portion 126A and / or the magnetic material or magnetic alloy comprising second portion 126B can help ensure that first portion 126A and second portion 126B are coupled in the same orientation each time first portion 126A and second portion 126B are coupled.

[0053] The first portion 126A and the second portion 126B can additionally or alternatively be removably coupled via other mechanisms. For example, the first portion 126A and the second portion 126B can be removably coupled via a latch, threads, a bayonet mount, a snap fit, a slip fit, a releasable adhesive, a friction fit, or any combination thereof. The first portion 126A and the second portion 126B can additionally or alternatively include one or more keying features, such as slots, indentations, or any combination thereof. Thus, the one or more keying features can allow the first portion 126A and the second portion 126B to be securely coupled and / or enable the first portion 126A and the second portion 126B to be repeatedly coupled and uncoupled in the same manner.

[0054] The first portion 126A and the second portion 126B can also be decoupled, for example, by breaking, tearing, or otherwise separating the first portion 126A from the second portion 126B. For example, although not shown, the detachable portion 124 can include one or more tabs and / or one or more perforations between the first portion 126A and the second portion 126B. Thus, the first portion 126A and the second portion 126B can be separated by breaking one or more tabs and / or tearing one or more perforations.

[0055] Additionally or alternatively, first portion 126A and second portion 126B may be coupled via an adhesive or material that degrades upon exposure to the patient's gastrointestinal tract. The adhesive material may be positioned on portion 127 of surface 126E of first portion 126A of coupler 126 that contacts or abuts surface 126F of second portion 126B. Portion 127 may include a portion or all of surface 126E of first portion 126A. Although not shown, additionally or alternatively, surface 126F of second portion 126B of coupler 126 may include a similar portion of surface 126F of second portion 126B that contacts or abuts surface 126E of first portion 126A. For example, the adhesive or material may degrade or degrade due to exposure to body moisture, humidity, temperature, etc. For example, the adhesive or material may begin to degrade when portion 127 is at least partially uncovered by outer sheath 110. The adhesive or material can, for example, degrade over a period of time to allow the distal portion 102 to be positioned at or near a treatment site. For example, the distal portion 102, including the first portion 126A and the second portion 126B, can be at least partially covered (e.g., at least partially covered by the outer sheath 110) during delivery of the distal portion 102 to the treatment site. Because the distal portion 102 is at least partially covered by the outer sheath 110, the first portion 126A and the second portion 126B can be isolated from parts of the body, thereby preventing or slowing degradation of the adhesive or material.

[0056] Once the desired position is reached, the distal portion 102 can be extended via the first movable body 106 of the handle 101. The distal portion 102 can be extended, exposing the first portion 126A and the second portion 126B to the body's moisture, temperature, etc., and causing the adhesive or material to begin to decompose or degrade. In this way, the first portion 126A and the second portion 126B can be decoupled.

[0057] Additionally or alternatively, the first portion 126A and the second portion 126B can be coupled via electromagnetic principles. For example, the first portion 126A can include an electromagnet, and the second portion 126B can be made of a magnetic material. Therefore, the first portion 126A can be magnetized and demagnetized to selectively couple to and / or decouple from the second portion 126B. In this configuration, the control element 108 can include one or more lumens (not shown) to accommodate the wires or cables required to power the electromagnet of the first portion 126A. Additionally, the handle 101 can include one or more ports or plugs (not shown) so that the medical device 100 can be coupled to a power source, for example, to provide energy to the electromagnet of the first portion 126A. In an alternative embodiment, the handle 101 includes an internal power source that is configured to magnetize and / or demagnetize the electromagnet of the first portion 126A.

[0058] In some configurations, the first portion 126A and the second portion 126B may at least partially overlap when coupled, such as Figure 1A For example, the distal side 126C of the first portion 126A can be distal to the proximal side 126D of the second portion 126B, and the proximal side 126D of the second portion 126B can be proximal to the distal side 126C of the first portion 126A. In an alternative configuration, the distal side of the first portion 126A and the proximal side of the second portion 126B can be removably coupled such that no portions of the first portion 126A and the second portion 126B overlap.

[0059] First portion 126A may be at least partially complementary in shape to second portion 126B, or vice versa. For example, surface 126F of second portion 126B may be concave. Accordingly, surface 126E of first portion 126A that contacts or abuts surface 126F of second portion 126B may be convex, e.g., such that surface 126E of first portion 126A partially or completely contacts surface 126F of second portion 126B. Similarly, surface 126F of second portion 126B may include one or more protrusions, projections, ridges, recesses, cavities, etc. Accordingly, surface 126E of first portion 126A may be complementary in shape, e.g., such that surface 126E of first portion 126A partially or completely contacts surface 126F of second portion 126B.

[0060] The ring 128 is coupled to the removable portion 124. For example, at least a portion of the ring 128 can be positioned proximal to the distal-most portion 124C of the removable portion 124 and distal to the proximal portion 124A of the removable portion 124. A first portion 128A of the ring 128 can extend at least partially around an exterior surface of the removable portion 124.

[0061] The first portion 126B of the ring 128 can be coupled to the exterior surface of the removable portion 124, such as via an adhesive, welding (e.g., laser welding), swaging, crimping, or any other coupling technique known in the art. Additionally or alternatively, the exterior surface of the removable portion 124 can include a groove (not shown) so that the first portion 128A of the ring 128 can be coupled to the exterior surface of the removable portion 124, such as by a mechanical fit, a snap fit, a press fit, or any other coupling technique known in the art. In some embodiments, the first portion 128A of the ring 128 can be constructed from one or more resilient materials, such as an elastomeric polymer or rubber material, or any other material commonly used in the art. The first portion 128A of the ring 128 can additionally or alternatively be constructed from The suture may be composed of either nylon filaments (eg, similar to dental floss) or one or more suture materials (eg, surgical steel, silk, cotton, and / or linen).

[0062] In alternative embodiments, the first portion 128A of the ring 128 is constructed from one or more rigid or semi-rigid materials, such as metals, polymers, metal-polymer composites, and the like. In some embodiments, the first portion 128A of the ring 128 forms a continuous ring. In alternative embodiments (not shown), the first portion 128A is C-shaped or forms a discontinuous ring. The cross-section of the first portion 128A of the ring 128 can be circular, oval, elliptical, square, rectangular, hexagonal, or any other shape commonly used in the art.

[0063] The second portion 128B of the ring 128 can extend radially outward from the removable portion 124. In some embodiments, the second portion 128B forms a continuous ring. The second portion 128B of the ring 128 can be constructed from one or more elastic materials, such as an elastic polymer or rubber material, or any other material commonly used in the art. The second portion 128B of the ring 128 can additionally or alternatively be constructed from The second portion 128B can be made of the same material as the first portion 128A or a different material. For example, the second portion 128B can be made of a first rubber material, and the first portion 128A can be made of a second rubber material that is different from the first rubber material. Various other combinations of materials are also contemplated. The cross-section of the second portion 128B can be circular, oval, elliptical, square, rectangular, hexagonal or any other shape commonly used in this area. In some configurations, the second portion 128B is larger than the first portion 128A. For example, the second portion 128B can have a circumference and / or diameter that is larger than the first portion 128A.

[0064] The distal portion 102 also includes a helical coil 130. The helical coil 130 is configured to couple to and decouple from tissue. The helical coil 130 can be at least partially disposed within a cavity or lumen 132 of the detachable portion 124. At least a portion of the helical coil 130 can be distal to a distal-most end 124D of the detachable portion 124. The helical coil 130 can be comprised of a plurality of turns that are coupled (directly or indirectly) to the detachable portion 124. The helical coil 130 can be coupled (directly or indirectly) to the detachable portion 124, for example, via welding (e.g., laser welding), adhesives, mechanical fit, snap fit, crimping, swaging, or other mechanisms known in the art. In alternative configurations, the helical coil 130 is integrally formed with the detachable portion 124. For example, the wire or coil forming the helical coil 130 can also include or form the detachable portion 124. In this configuration, the helical coil 130 forms at least the distal-most portion 124C of the detachable portion 124 .

[0065] The spiral coil 130 may include, for example, one to ten or three to five complete spiral turns or coils. In some configurations, the multiple coils forming the spiral coil 130 may be evenly spaced. In alternative configurations, the spacing between each of the multiple coils forming the spiral coil 130 may vary. For example, in the proximal region 130A of the spiral coil 130, one or more adjacent coils may be spaced a first distance apart. For example, in the proximal region 130A, the multiple coils forming the spiral coil 130 may be in contact with each other. In the distal region 130C of the spiral coil 130, adjacent coils may be spaced a second distance apart. In the intermediate region 130B (e.g., between the proximal region 130A and the distal region 130C), adjacent coils may be spaced a third distance apart. In some configurations, the second distance may be greater than the third distance, and the third distance may be greater than the first distance. Many other configurations are also contemplated. In another configuration, the second distance is equal to the third distance, so that the intermediate region 130B and the distal region 130C are similarly spaced apart.

[0066] In other configurations, the coils forming the intermediate region 130B can have a non-constant pitch, resulting in gradually increasing spacing. For example, the coils in the intermediate region 130B can transition from adjacent coils that touch each other in the proximal region 130A to coils that are spaced apart in the distal region 130C.

[0067] The distal tip 130D of the spiral coil 130 can be narrowed or pointed, for example, to more easily pierce or penetrate the subject's tissue. In some embodiments, the distal tip 130D of the spiral coil 130 is oriented in a curved or curvilinear configuration, such that, for example, the distal tip 130D of the spiral coil 130 is parallel or substantially parallel to the turns forming the spiral coil 130. In this configuration, the distal tip 130D may be less likely to pierce or penetrate tissue surrounding the target area. The spiral coil 130 can be formed from solid circular wire or multiple wires. In some configurations, the spiral coil 130 can be configured to have a diameter that is smaller than the inner diameter of the detachable portion 124. For example, the spiral coil 130 can have an outer cross-sectional diameter between 0.002 inches and 0.200 inches, for example, between 0.005 inches and 0.020 inches. The spiral coil 130 can have an inner cross-sectional diameter between 0.001 inches and 0.190 inches, for example, between 0.002 inches and 0.15 inches. In some configurations, the wire forming the helical coil 130 can have a cross-sectional diameter that is greater than or equal to the wire or wires forming the detachable portion 124. In alternative configurations, the wire forming the helical coil 130 can have a cross-sectional diameter that is less than the wire or wires forming the detachable portion 124. For example, the wire forming the helical coil 130 can have a cross-sectional diameter that is between 0.0005 inches and 0.100 inches, such as between 0.005 inches and 0.015 inches.

[0068] Although not shown, helical coil 130 may include one or more markings, such as, for example, radiopaque markings, ultrasonic markings, etc., to help a user determine the status, position, actuation state, etc. of helical coil 130. For example, the turns or partial turns in proximal region 130A and / or middle region 130B may include markings to signal to the user how deep helical coil 130 is within the tissue, how many turns of helical coil 130 are inserted into the tissue, etc.

[0069] Still refer to Figure 1A , the control element 108 can extend from one or more portions of the handle 101 of the medical device 100 (e.g., from a distal portion of the first movable body 106) to one or more portions of the distal portion 102. The control elements 108 can each be formed from a wire, a coil, a tube, or the like. Additionally, the outer sheath 110 can extend from one or more portions of the handle 101 (e.g., from a distal portion of the distal handle portion 111) to one or more portions of the distal portion 102. The outer sheath 110 can be formed from a coil, a braid, a tube, a sheath, or the like, and the lumen 113 can extend longitudinally within the outer sheath 110, for example, to accommodate a portion of the control element 108. In these aspects, the control element 108 can be radially located within the outer sheath 110. For example, the control element 108 can be longitudinally and / or rotationally movable relative to the outer sheath 110 and at least partially disposed within the lumen 113 of the outer sheath 110.

[0070] In some configurations, for example, when the medical device 100 is in the retracted or closed configuration, at least a portion of the distal portion 102 is also disposed within the lumen 113 of the outer sheath 110. For example, the helical coil 130 can be within or positioned proximal to the distal-most end 110A of the outer sheath 110. In such a configuration, the first movable body 106 can be in a proximal position, such as within the handle slot 114.

[0071] In an alternative configuration, the medical device 100 may not include the outer sheath 110, the first movable body 106, and / or the second movable body 118. In such a configuration, the medical device 100 may simply include a gripping portion for a user to grasp the medical device 100, such as a proximal portion of the medical device 100, and a distal portion 102 having a detachable portion 124. The distal portion 102 may be directly or indirectly coupled to the gripping portion 108D (e.g., via the control element 108). In such an aspect, the helical coil 130 of the detachable portion 124 may be driven into tissue by rotating the gripping portion, thereby rotating the control element 108 and the helical coil 130. The detachable portion 124 may be decoupled by pulling or pushing the gripping portion proximally, for example, to overcome any connection forces between the detachable portion 124 and the rest of the medical device 100. In such a configuration, the medical device 100 may include fewer components and, therefore, may be easier and / or less expensive to manufacture or produce.

[0072] Figure 1B The distal portion 102 is depicted in a second or detached configuration. For example, in the detached configuration, the first portion 126A of the coupler 126 is detached or decoupled from the second portion 126B of the coupler 126. As described above, the first portion 126A and the second portion 126B can be detached or decoupled. Thus, the detachable portion 124 can be decoupled or removed from the control element 10.

[0073] The cross section of the first portion 126A and / or the second portion 126B (eg, perpendicular to Figure 1A The longitudinal axis of the medical device 100 shown can be rectangular, triangular, semicircular, semi-elliptical, circular, oval, or any other shape commonly used in the art. In some configurations, the cross-sections of the first portion 126A and the second portion 126B can have similar shapes or different shapes. For example, the cross-section of each of the first portion 126A and the second portion 126B can be semicircular or rectangular. Alternatively, the cross-section of the first portion 126A can be semicircular, and the cross-section of the second portion 126B can be rectangular.

[0074] Now refer to Figure 2A , showing a medical system 200. The medical system 200 includes a medical device 100 (as described above and in Figure 1A and 1B) and an endoscope 252. The medical device 100 can be disposed within a working channel or lumen 254 of the endoscope 252. In an alternative configuration (not shown), the medical device 100 can extend outside of the endoscope 252 (along an outer surface of the endoscope 252), for example, without extending through the working channel 254. Alternatively, one or more portions of the medical system 200 can be inserted and / or surrounded, for example, around the endoscope 252, via an insertion sheath (not shown). Additionally, Figure 3 An exemplary method or process 300 is depicted that one or more users may perform using any of the medical systems, devices, or portions of systems discussed herein (eg, medical system 200 ).

[0075] Although not shown, one or more portions of the endoscope 252 (e.g., the distal portion 252A) can be deflectable, for example, via one or more knobs, levers, buttons, or other controls on a proximal handle (not shown) of the endoscope 252. In these aspects, the distal portion 252A of the endoscope 252 can be manipulated while being delivered through a body cavity to a treatment site and / or positioned relative to the treatment site, such as in a retroflex position (which can be used when the treatment site is in the esophagus, stomach, duodenum, colon, or other portion of the gastrointestinal tract of a subject). Thus, at least a portion of the medical device 100 can be flexible or semi-flexible, for example, to facilitate manipulation with the endoscope 252.

[0076] Additionally, the distal side 252D of the endoscope 252 can include one or more visualization devices 256 (e.g., one or more cameras, light emitting diodes (LEDs), one or more image sensors, an endoscopic viewing element, an optical assembly including one or more image sensors and one or more lenses, etc.). Additionally or alternatively, the distal side 252D of the endoscope 252 can include one or more openings 258 configured to supply liquids, gases, and / or suction to a body cavity or treatment site.

[0077] refer to Figure 2A and Figure 3 In step 302, the medical system 200 (e.g., the distal portion of the medical system 200) can be inserted into a body cavity 260 of a subject (e.g., through a natural orifice or incision) to a treatment site 262. Before or after the medical system 200 reaches the treatment site 262, the first movable body 106 (e.g., Figure 1A ) can be actuated, extended, advanced or pushed distally within the handle slot 114 of the handle 101, so that the control element 108 is actuated, extended, advanced or pushed distally, and thereby at least a portion of the distal portion 102 is distal to the distal-most end 110A of the outer sheath 110.

[0078] The endoscope 252 and / or the medical device 100 can then be manipulated to position the helical coil 130 of the medical device 100 in contact with the wall 261 of the lumen 260, e.g., opposite or across the lumen 260 from the treatment site 262. The endoscope 252 can be manipulated by, for example, deflecting the distal portion 252A, advancing the endoscope 252 distally, and / or retracting the endoscope 252 proximally. Additionally or alternatively, a visualization device 256 can be used to manipulate and / or reposition the endoscope 252. Similarly, the medical device 100 can be manipulated by, for example, advancing the medical device 100 distally and / or retracting the medical device 100 proximally.

[0079] Once the helical coil 130 contacts the wall 261 of the lumen 260, the control element 108, and therefore the distal portion 102 and the helical coil 130, can be rotated in a first direction (e.g., clockwise or counterclockwise). The control element 108 can be rotated by, for example, rotating the second movable body 118 in the first direction (e.g., clockwise or counterclockwise). Figure 1A Thus, as helical coil 130 is rotated in the first direction, distal tip 130D of helical coil 130 can penetrate wall 261 of lumen 260. Continued rotation of helical coil 130 in the first direction can cause distal tip 130D to be driven deeper into the tissue of wall 261 (e.g., in a corkscrew manner).

[0080] Therefore, if Figure 2A As shown in FIG and described in step 304, the helical coil 130 can be anchored or coupled to the wall 261 of the lumen 260, for example, opposite the treatment site 262 or across the lumen 260. One or more turns of the helical coil 130 can be embedded in the wall 261 of the lumen 260, for example, to ensure that the helical coil 130 is securely fastened, coupled, or attached to the wall 261 of the lumen 260. Figure 1A The markings described in can be used to determine, for example, how many turns or which portion of helical coil 130 is inside wall 261 of lumen 260.

[0081] like Figure 2B As shown, in step 306, the removable portion 124 is then connected to the control element 108 ( Figure 1B ) decoupling or detaching. The detachable portion 124 can be decoupled from the control element 108, for example, by pulling or retracting the control element 108 so that the pulling or retracting force overcomes the first portion 126A ( Figure 1A 、 1B 2A) and the connecting force between the second portion 126B. In this way, the detachable portion 124 remains attached or coupled to the wall 261 while the remainder of the medical device 100 is pulled proximally and / or retracted.

[0082] Still refer to Figure 2B , the medical system 200 may further include a device 264 having a clamp 266. In addition, the medical system 200 may include a cutting tool 268 (in Figure 2C and 2E ). The device 264 and the cutting tool 268 are described in further detail below. Each of the device 264 and the cutting tool 268 can be configured to be positioned within the working channel 254 of the endoscope 252. For example, the device 264 can be inserted into the working channel 254 of the endoscope 252. The cutting tool 268 can be inserted into the working channel 254 before, during, or after the device 264 is removed from the working channel 254. Figures 2B-2E As shown, the clip 266 can be any clip commonly used in the art, for example, the clip 266 can be a blood clip or an endogenous clip. The clip 266 can include a first leg 266A and a second leg 266B.

[0083] Still refer to Figure 2B After the removable portion 124 of the medical device 100 is anchored to the wall 261 of the lumen 260, the device 264 can be inserted through the working channel 254 of the endoscope 252 such that the distal portion of the device 264 is distal to the distal side 252D of the endoscope 252. A portion of the second portion 128B of the ring 128 can be positioned within the clip 266, for example, between the first leg 266A and the second leg 266B. To position the second portion 128B of the ring 128 between the first leg 266A and the second leg 266B, the endoscope 252 can be pushed distally, pulled proximally, rotated, or deflected within the lumen 260, and / or the device 264 can be pushed distally, pulled proximally, or rotated within the working channel 254 of the endoscope 252.

[0084] In some configurations, the endoscope 252 can be oriented so that the working channel 254 is positioned closer to the second portion 128B, for example, to help position the second portion 128B between the first leg 266A and the second leg 266B. For example, the endoscope 252 can be oriented so that the working channel 254 is at the 6 o'clock position relative to the visualization device 256 and / or the opening 258, as shown. In alternative configurations, the endoscope 252 can be oriented so that the working channel 254 is at the 3 o'clock, 9 o'clock, or 12 o'clock position relative to the visualization device 256 and / or the opening 258. In this manner, the endoscope 252 can be rotated so that the working channel 254 is appropriately positioned and / or oriented to couple the device 264 to the second portion 128B of the ring 128. Many other configurations are also contemplated, for example, to help position the second portion 128B between the first leg 266A and the second leg 266B of the clamp 266.

[0085] refer to Figure 2B and Figure 3 , in step 308, the clip 266 can be coupled or anchored to the treatment site 262. The clip 266 is then released from the rest of the device 264. Thus, the second portion 128B of the loop 128 can be anchored to the treatment site 262, e.g., between the clip 266 and the treatment site 262. In this manner, the second portion 128B can be anchored between the first leg 266A and the second leg 266B of the clip 266 and anchored to the treatment site 262. With the removable portion 124 anchored to the wall 261 of the lumen 260 and the second portion 128B of the loop 128 anchored to the treatment site 262, the second portion 128B of the loop 128 can be subjected to tension, and the tissue at the treatment site 262 can be at least partially lifted or similarly tensioned.

[0086] like Figure 2C As shown, once the device 264 is removed from the working channel 254, a cutting tool 268 (e.g., a knife, scissors, a blade, an electrocautery blade, or any other cutting or cutting device) can be introduced through the working channel 254 of the endoscope 252. In step 309, the cutting tool 268 can be used to at least partially cut or resect tissue from the treatment site 262. The tension in the second portion 128B can help cause the resected tissue of the treatment site 262 to be lifted (e.g., when cutting or resecting the treatment site 262). Thus, as the resected tissue of the treatment site 262 is lifted, the tension in the second portion 128B can be reduced, and the second portion 128B can return to its original position.

[0087] like Figure 2D As shown in FIG and described in optional step 310, detachable portion 124 can be re-coupled or attached to medical device 100, as described below. Subsequently, in optional step 312, helical coil 130 can be repositioned within lumen 260. Thus, second portion 128B of loop 128 can be re-tensioned, for example, by repositioning helical coil 130 (e.g., relative to treatment site 262).

[0088] To reposition the helical coil 130 and subsequently re-tension the second portion 128B, the medical device 100 (without the detachable portion 124) can be reinserted through the working channel 254 of the endoscope 252. The medical device 100 can be reinserted through the working channel 254 of the endoscope 252, for example, once the cutting tool 268 is removed from the working channel 254 of the endoscope 252. The endoscope 252 can be used to manipulate the medical device 100 so that the first portion 126A of the coupling 126 contacts the second portion 126B of the coupling 126. The first portion 126A and the second portion 126B can then be recoupled or reattached according to the attachment mechanism described above. In this manner, the detachable portion 124 can be attached or coupled to the control element 108.

[0089] Once detachable portion 124 is coupled to control element 108, control element 108 can then be rotated in a second direction (e.g., counterclockwise or clockwise) that is opposite to the first direction. Thus, when control element 108 is rotated in the second direction, helical coil 130 also rotates in the second direction, e.g., such that helical coil 130 can be decoupled or withdrawn from wall 261 of lumen 260.

[0090] Once decoupled or withdrawn from the wall 261 of the lumen 260, the detachable portion 124 and the helical coil 130 can be repositioned, for example, to a location distal to the treatment site 262, such that the second portion 128B of the loop 128 is again under tension. For example, the endoscope 252 and / or the medical device 100 can then be manipulated to reposition the helical coil 130 of the medical device 100 into contact with the wall 261 of the lumen 260, for example, opposite the treatment site 262 or across the lumen 260. The endoscope 252 can be manipulated by, for example, deflecting the distal portion 252A, advancing the endoscope 252 distally, and / or retracting the endoscope 252 proximally. The medical device 100, including the detachable portion 124 and the helical coil 130, can also be manipulated by, for example, advancing the medical device 100 distally and / or retracting the medical device 100 proximally.

[0091] Throughout optional step 310 and optional step 312 , second portion 128B of loop 128 may remain anchored to treatment site 262 , eg, between first leg 266A and second leg 266B of clip 266 .

[0092] like Figure 2EAs shown, the detachable portion 124 can be detached or decoupled from the control element 108 again, as described above. For example, once the medical device 100 is removed from the working channel 254 of the endoscope 252, the cutting tool 268 can be reintroduced, for example, through the working channel 254 of the endoscope 252. Then, in optional step 314, the cutting tool 268 can be used to continue cutting or resecting tissue from the treatment site 262. Optional step 310, optional step 312, and / or optional step 314 can be repeated so that the helical coil 130 can be repositioned and / or the second portion 128B of the loop 128 can be re-tensioned multiple times, for example, until the treatment site 262 is resected to a desired amount. Additionally or alternatively, optional step 310 and optional step 312 may be performed prior to resecting tissue from treatment site 262 in step 309, for example, if desired tension is not present in second portion 128B or if removable portion 124 is improperly positioned after helical coil 130 is coupled to wall 261 of lumen 260.

[0093] Once tissue from treatment site 262 has been appropriately removed in step 309 or optional step 314, detachable portion 124, and therefore helical coil 130, can be detached from wall 261 in step 316, as described above. For example, once cutting tool 268 has been removed from working channel 254 of endoscope 252, medical device 100 can be reintroduced through working channel 254 of endoscope 252. Medical device 100 can be manipulated (e.g., via manipulation of medical device 100 and / or endoscope 252) such that first portion 126A of coupling 126 again contacts second portion 126B of coupling 126. First portion 126A and second portion 126B can then be reconnected or reattached according to the attachment mechanism described above. In this manner, detachable portion 124 can be reattached or reconnected to control element 108 and can be proximally retracted or removed. One or more portions of medical system 200 can then be proximally retracted or removed. For example, the medical device 100, the cutting tool 268 and / or the endoscope 252 can be retracted or removed proximally. Thus, the medical device 100 and / or the tissue removed from the treatment site 262 coupled to the clip 266 can then be removed from the lumen 260.

[0094] In an alternative embodiment, the helical coil 130 can be biodegradable. For example, the wire forming the helical coil 130 can disintegrate or break down, allowing the detachable portion 124 to be removed from the wall 261. The detachable portion 124 can then be removed using a basket, grabber, net, cage, suction, or other grasping tool or method. Alternatively, the detachable portion 124 can be naturally passed through the subject. In this way, the detachable portion 124 can be removed from the wall 261 without having to reconnect or reattach the detachable portion 124 to the medical device 100.

[0095] In some embodiments, the cutting tool 268 is used to detach the second portion 128B of the ring 128 from the medical device 100 so that, for example, tissue resected from the treatment site 262 can be removed naturally by the subject or through the working channel 254 of the endoscope 252, such as by applying suction. Although not shown, in some aspects, the tissue resected from the treatment site 262 can be removed through the working channel 254 of the endoscope 252, for example, by using one or more graspers, nets, cages, suction, or any other device or method commonly used in the art to remove objects or materials from a subject.

[0096] Each embodiment discussed herein can enable a user to apply tension to tissue, for example, to lift the tissue so that it can be more easily cut, excised, removed, or otherwise treated. Each embodiment can help reduce surgical time, the possibility of patient injury, and / or the possibility of other surgical complications.

[0097] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed apparatus without departing from the scope of the present disclosure. Other embodiments of the present disclosure will be apparent to those skilled in the art from consideration of the practice and specification of the invention disclosed herein. The present description and examples are to be considered as exemplary only, with the true scope and spirit of the invention being indicated by the following claims.

Claims

1. A medical system comprising: an insertion device having a working channel; A first medical device is configured to be disposed within a working channel of the insertion device, the first medical device comprising: handle; a control element extending from the handle; a detachable portion, wherein the detachable portion is removably coupled to a distal portion of the control element; a helical coil coupled to the detachable portion; a ring, wherein a first portion of the ring is coupled to a detachable portion, and wherein the ring The second portion extends radially away from the removable portion, and A second medical device is configured to be disposed within the working channel of the insertion device, wherein the second medical device is configured to receive the second portion of the loop, and wherein the second medical device is configured to couple the second portion of the loop to a portion of a treatment site.

2. The medical system of claim 1 , wherein the first medical device further comprises a coupler, wherein the coupler comprises a first portion coupled to a distal portion or a portion of the distal portion of the control element, wherein the coupler comprises a second portion coupled to a proximal portion or a portion of the proximal portion of the detachable portion, and wherein the first portion and the second portion are configured to releasably couple the detachable portion to the control element. 3 . The medical system of claim 2 , wherein the first portion of the coupler is configured to overlap at least a portion of the second portion of the coupler.

4. The medical system of claim 2 or claim 3, wherein the first contact surface of the first portion abuts the second contact surface of the second portion, and wherein the first contact surface of the first portion and the second contact surface of the second portion are complementary in shape.

5. The medical system of any one of claims 2-4, wherein a portion of the first portion of the coupler is magnetic, and wherein a portion of the second portion of the coupler is magnetic of opposite polarity to the portion of the first portion.

6. The medical system of any one of claims 2-5, wherein a portion of the first portion of the coupling comprises an electromagnet, and wherein a portion of the second portion of the coupling is a magnetic material.

7. The medical system of any of the preceding claims, wherein rotation of the helical coil in a first direction is configured to couple the distal portion to a tissue wall, and wherein rotation of the helical coil in a second direction is configured to decouple the helical coil from the tissue wall.

8. The medical system of any of the preceding claims, wherein the helical coil comprises a plurality of turns, wherein adjacent turns of a first portion of the plurality of turns are spaced apart by a first distance, wherein adjacent turns of a second portion of the plurality of turns are spaced apart by a second distance, and wherein adjacent turns of a third portion of the plurality of turns are spaced apart by a third distance.

9. The medical system of claim 8, wherein the third distance is greater than the second distance, and wherein the second distance is greater than the first distance.

10. The medical system of any of the preceding claims, wherein the handle comprises a fixed body, a first movable body, and a second movable body, wherein the first movable body controls axial movement of the distal portion of the control element, and wherein the second movable body controls rotational movement of the distal portion of the control element.

11. The medical system of claim 10, wherein the fixed body includes a first indicator for identifying axial movement of the helical coil, and wherein the second movable body includes a second indicator for identifying rotational movement of the helical coil.

12. The medical system of any of the preceding claims, wherein the second medical device comprises a clip.

13. The medical system of any of the preceding claims, wherein the second portion of the ring is comprised of an elastic material.

14. The medical system of any of the preceding claims, wherein the medical system comprises a third medical device configured to be disposed within the working channel of the insertion device, wherein the third medical device is configured to cut tissue.

15. The medical system of any one of claims 2-6, wherein the first portion of the coupler and the second portion of the coupler are coupled by an adhesive material, in, In a first configuration, the adhesive material is disposed within a sheath extending from the handle; and wherein, in the second configuration, the adhesive material is not covered by the sheath, wherein, in the second configuration, the adhesive material degrades to decouple the first portion of the coupler and the second portion of the coupler.

Images