Endoluminal therapy systems, devices, and related methods

Abstract

A medical device can include a catheter and a porous body coupled to a distal end of the catheter. A first loop can extend proximally from a proximal end of the porous body. A second loop can extend distally from a distal end of the porous body.

Description

Cross-references to related applications

[0001] This application claims priority under section 119 of 35 U.S.C., U.S. Provisional Application No. 63 / 583,974, filed September 20, 2023, which is incorporated herein by reference in its entirety. Technical Field

[0002] Various aspects of this disclosure generally relate to minimally invasive medical systems, devices, and methods. Specifically, various aspects of this disclosure relate to medical systems, devices, and methods for endoscopic medical procedures, such as closing wounds or otherwise treating tissue. Background Technology

[0003] Endoscopic and open surgical procedures of the gastrointestinal (GI) tract include procedures such as colectomy, bariatric surgery, esophagectomy, gastric bypass, and sleeve gastrectomy. These procedures can result in perforation, postoperative leakage, or other wounds in the gastrointestinal tract. Patients with perforation, postoperative leakage, and / or other wounds in the Gastrointestinal tract have high mortality rates and limited treatment options. Options include endoscopic placement of clips or stents, endoscopic sutures or sealants, or surgical re-operation. Surgical procedures are relatively invasive and have high morbidity and mortality rates. Although endoscopic stent placement is a less invasive option, placement and / or removal of stents still present unique challenges. Furthermore, stents may migrate from their intended location and / or isolate infection at the treatment site, thus inhibiting drainage.

[0004] The medical systems, apparatus, and methods disclosed herein can correct some of the above-mentioned defects or solve other aspects of the art. Summary of the Invention

[0005] Examples of this disclosure particularly relate to systems, apparatus, and methods for performing one or more medical procedures using a medical device. Specifically, this disclosure includes medical systems, apparatus, and methods for delivering and / or removing devices, such as, for example, endocavitary vacuum therapy devices. Each example disclosed herein may include one or more features described in conjunction with any other disclosed examples.

[0006] According to one aspect, the medical device may include a catheter and a porous body coupled to the distal end of the catheter. A first ring may extend proximally from the proximal end of the porous body. A second ring may extend distally from the distal end of the porous body.

[0007] The medical device may include one or more of the following features. In a first configuration, the porous body may have a first length and a first width. In a second configuration, the porous body may have a second length and a second width. The second length may be greater than the first length. The second width may be less than the first width. In some examples, to change the porous body from the first configuration to the second configuration, the first ring may be pulled proximally.

[0008] In some aspects, the first ring may define the proximal end of the elongated body. The second ring may define the distal end of the elongated body. An intermediate portion may extend between each of the first and second rings. In some examples, each of the first and second rings may be integrally formed with the intermediate portion. The intermediate portion may extend through at least a portion of the porous body.

[0009] In some aspects, the intermediate portion may include multiple turns. The multiple turns may extend circumferentially around at least a portion of the porous body.

[0010] In some respects, the netting may extend between the first and second rings. The netting may extend circumferentially around at least a portion of the porous body.

[0011] In some respects, the longitudinal axis may extend through the conduit and the porous body. In some respects, the second ring may be offset relative to the longitudinal axis.

[0012] In some respects, at least one of the first loop or the second loop may be composed of at least one of thread, silk, or cable. At least one of the first loop or the second loop may be a suture thread.

[0013] In some aspects, the conduit may include a connector. The connector may be configured to removably connect the conduit and the porous body. The conduit may be configured to connect to a vacuum source. The vacuum source may be configured to provide negative pressure to the porous body.

[0014] According to another aspect, the medical system may include a delivery device, a first medical device, and a second medical device. The delivery device may include a working channel extending therethrough. The first medical device may be movably disposed within the working channel of the delivery device. The second medical device may include a catheter, a porous body coupled to the distal end of the catheter, and an elongated body. The proximal end of the elongated body may include a first ring. The distal end of the elongated body may include a second ring.

[0015] The medical device may include one or more of the following features. In some aspects, the intermediate portion of the elongated body may include a plurality of turns. The plurality of turns may extend circumferentially around at least a portion of the porous body. In a first configuration, the porous body may have a first length and a first width. In a second configuration, the porous body may have a second length and a second width. The second length may be greater than the first length. The second width may be less than the first width. To change the porous body from the first configuration to the second configuration, the first ring may be pulled proximally. In some aspects, the second medical device may be movably disposed adjacent to a delivery device.

[0016] This disclosure also includes methods for performing medical procedures. One method may include inserting a medical device into a patient's cavity. The medical device may include a porous body coupled to a distal end of a catheter, a proximal ring extending proximally from the porous body, and a distal ring extending distally from the porous body. The method may further include using the distal ring to move the medical device into the wound cavity. When moving the medical device into the wound cavity using the distal ring, the distal ring may be on a first side of a wall defining the cavity. The porous body may extend through at least a portion of the wall defining the cavity. The proximal ring may be on a second side of the wall defining the cavity. The method may further include: applying a vacuum pressure to the porous body via the catheter, and pulling the proximal ring in a proximal direction to remove the medical device from the wound cavity.

[0017] In some respects, when the proximal ring is pulled in the proximal direction, the length of the porous body can be increased and the width of the porous body can be decreased.

[0018] Any example described in this article can have any of these features in any combination. Attached Figure Description

[0019] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate exemplary aspects of this disclosure and, together with the specification, serve to explain the principles of this disclosure.

[0020] Figure 1 This is a perspective view of the distal portion of a medical device according to various aspects of this disclosure.

[0021] Figure 2 This is a flowchart of exemplary methods according to various aspects of this disclosure.

[0022] Figure 3A and Figure 3B The first construction is described according to various aspects of this disclosure. Figure 3A ) and second construction ( Figure 3B A side view of the distal portion of an exemplary intracavitary device.

[0023] Figure 4A side view of the distal portion of another alternative intracavitary device according to various aspects of this disclosure is depicted.

[0024] Figure 5 A side view of the distal portion of another alternative intracavitary device according to various aspects of this disclosure is depicted. Detailed Implementation

[0025] Reference will now be made in detail to various aspects of this disclosure, examples of which are shown in the accompanying drawings. Wherever possible, the same or similar reference numerals will be used throughout the drawings to refer to the same or similar parts. The term "distal" or "farthest" refers to the part furthest from the user when the device is introduced into the body of a subject (e.g., a patient). In contrast, the term "proximal" or "near" refers to the part closest to the user when the device is placed in the subject. In the various drawings, the proximal and distal directions are marked with arrows labeled "P" and "D," respectively. If any terminology and definitions provided herein conflict with those incorporated by reference, the terminology and definitions provided herein shall prevail.

[0026] The foregoing general description and the following detailed description are exemplary and illustrative only, and not intended to limit the claimed features. As used herein, the terms “comprising,” “including,” “having,” or other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements may include not only those elements but also 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 stated values ​​or characteristics may vary by ±10%. Additionally, terms indicating the geometry of a component / surface cover both precise and approximate shapes.

[0027] Although the target site is discussed herein as being in the gastrointestinal tract of the subject, this disclosure is not limited thereto, as the target site can be any internal lumen, organ, cavity, or other tissue within the subject. Furthermore, although endoscopes are mentioned herein, it should be understood that this disclosure covers a variety of devices that can be inserted into the body of a subject, such as ureteroscopes, duodenoscopes, gastroscopes, endoscopic ultrasound (“EUS”) endoscopes, colonoscopes, bronchoscopes, laparoscopes, arthroscopes, cystoscopes, aspiration endoscopes, sheaths, or catheters.

[0028] Endocavitary vacuum therapy (EVT or EVAC, referred to herein as EVAC) is a surgical procedure for treating wounds. For example, EVAC can be used to treat postoperative leaks or perforations in the gastrointestinal tract (GI) following surgical or endoscopic procedures such as colectomy, bariatric surgery, or esophagectomy. In EVAC, negative pressure is delivered to the wound site in the GI tract, for example, through a porous body, such as a sponge / porous body (e.g., a vacuum-sealed porous body) at the distal end of a nasogastric tube. The proximal end of the nasogastric tube may be connected to a collection container. The sponge is inserted into the perforation, leak, or other wound via an endoscope.

[0029] In some examples, EVAC involves placing a sponge or other similar material into a wound (e.g., target) site, including perforations, leaks, cysts, anastomoses, etc. The material can be placed via catheters, endoscopes (endoscopes, bronchoscopes, colonoscopes, duodenoscopes, gastroscopes, etc.), tubes, or sheaths inserted into the gastrointestinal tract through an incision or natural orifice. Natural orifices can be, for example, the nose, natural mouth, or anus, and placement can occur in any part of the gastrointestinal tract, including the esophagus, stomach, duodenum, large intestine, or small intestine. In some examples, placement can occur within or through the wall of the gastrointestinal tract. The material can also be placed in other organs accessible via the gastrointestinal tract (e.g., the colon). Negative pressure is then applied through the tube or porous body.

[0030] Applying negative pressure through a porous body in the wound can help accelerate healing, for example, by promoting local granulation tissue growth at the wound site. For example, as the wound heals and / or closes, the porous body can be replaced with increasingly smaller porous bodies. Apparatus and systems suitable for EVAC are limited. During EVAC, a porous body can be delivered to the target site using a speculum, rodent-tooth forceps, and a suture loop located at the distal end of the porous body. For example, rodent-tooth forceps can extend through the working channel of the speculum and be used to grasp the loop at the distal end of the porous body. The rodent-tooth forceps are used to move the porous body to the target site when the speculum is navigated, which can be challenging. For example, when a user uses rodent-tooth forceps to move a porous body through the gastrointestinal tract, the porous body may obstruct or affect the visualization and / or operability of the speculum.

[0031] Removing the porous body from the target site during EVAC also presents challenges. For example, if the porous body remains in place at the target site for an extended period, tissue may grow into the interior of the porous body. This tissue growth can make it difficult to remove the porous body from the target site, for example, during porous body replacement. Therefore, EVAC typically requires replacing the porous body every 3 to 5 days to prevent inward growth and maintain cleanliness of the target site.

[0032] Various aspects of this disclosure include systems, apparatus, and methods that help improve the delivery and / or removal of implants (e.g., porous bodies) to and / or from the target site during EVAC procedures. For example, aspects of this disclosure include systems, apparatus, and methods that help reduce the time required to deliver implants (e.g., porous bodies) to the target site and / or reduce the time required to remove implants from the target site. Various aspects of this disclosure can improve implant (e.g., porous body) exchange at the target site.

[0033] Components of the systems and / or devices described herein can be packaged as kits for EVAC. For example, the devices disclosed herein may include a vacuum tube and / or a vacuum source. Additionally, a connector coupled to a proximal portion of a porous body may be configured to connect a distal end or distal portion of the vacuum tube to the porous body for wound treatment. The vacuum tube may be coupled to a vacuum source, for example, to apply negative pressure to tissue at a target site (e.g., via the porous body).

[0034] Figure 1 A distal portion of a medical system 100 is depicted. The medical system 100 can be inserted into a lumen 101 of a subject. The medical system 100 can be configured to treat wounds and / or otherwise treat the subject. The medical system 100 may include a delivery device 102, a first medical device 104, and a second medical device 106. As will be discussed in further detail below, the first medical device 104 may be an exemplary EVAC device that can be inserted into the subject, for example, to treat wounds and / or otherwise assist in the treatment of the subject's tissues. The delivery device 102 and / or the second medical device 106 may be configured to assist in positioning and / or repositioning the first medical device 104 within the lumen 101 and / or within the subject's tissues. Although not shown, the medical system 100 may include one or more additional medical components (e.g., additional delivery devices and / or additional accessory instruments) for example, to assist in the treatment of the subject.

[0035] In some examples, the delivery device 102 may be an endoscope (e.g., an endoscope, gastroscope, duodenoscope, etc.). The delivery device 102 may include an insertion portion 108 (e.g., a shaft or catheter) terminating at a distal tip 110. The distal tip 110 of the delivery device 102 may include one or more imaging devices 112 (e.g., a camera, image sensor, lens, etc.) and / or illumination elements 114 (e.g., light-emitting diodes or LEDs, optical fibers, etc.). For example, the illumination element 114 may be used (e.g., in combination with the imaging device 112) to enable the user to visualize and navigate inside the lumen 101, e.g., without invasive surgery. In some examples, one or more imaging devices 112 and / or illumination elements 114 may be positioned on the distal side 110D of the distal tip 110 (i.e., for an "anterior-facing" device). In other examples, one or more imaging devices 112 and / or one or more illumination elements 114 may be disposed on the surface 110S of the distal tip 110 and / or the side surface 108S of the insertion portion 108 (i.e., for a “side-facing” device).

[0036] Alternatively or concurrently, the distal side 110D of the distal tip 110 may include one or more distal openings. For example, the distal side 110D may include an opening 116 of a working channel 118. The working channel 118 may extend (e.g., longitudinally) through the insertion portion 108. The working channel 118 of the delivery device 102 may be configured to receive a second medical device 106. Although not shown, the distal tip 110 may include additional openings, such as those configured to provide flushing, blowing, and / or suction at the distal tip 110.

[0037] The insertion portion 108 may also include a hinge portion (articular movement portion) 120. The hinge portion 120 may be configured to allow the distal tip 110 to bend in one or more directions (e.g., left, right, up, and / or down). Although not shown, the delivery device 102 may include a handle coupled to the proximal end of the insertion portion 108. The handle may include one or more ports connected to the working channel 118 (e.g., for receiving a second medical device 106). Additionally or alternatively, the handle may include one or more actuators (e.g., buttons, knobs, levers, locks, etc.). One or more actuators (not shown) may be configured to control one or more aspects of the hinge portion 120 and / or the distal tip 110. For example, one or more actuators may be configured to control movement of the hinge portion 120, for example, via one or more steering or articular movement lines (not shown) extending longitudinally through the insertion portion 108 and reaching the distal tip 110. Additionally or alternatively, one or more additional actuators (e.g., buttons, knobs, levers, etc.) may be configured to capture images and / or video, and / or provide other functions to the distal tip 110.

[0038] As previously described, the second medical device 106 may be movably disposed within the working channel 118 of the insertion portion 108. The distal end of the second medical device 106 may include a gripper, forceps, rat-tooth forceps, or any other medical device configured to grip the first medical device 104. For example, the second medical device 106 may include a pair of movable jaws 122 coupled to (e.g., directly or indirectly) the distal end of the sheath 124 of the second medical device 106. Although not shown, the second medical device 106 may include a handle coupled to the proximal end of the sheath 124. The handle (not shown) may be operatively connected to one or more control lines or other elements such that actuation of one or more aspects of the handle is configured to open / close the jaws 122 and / or otherwise articulate the distal portion of the second medical device 106.

[0039] The first medical device 104 may be external to the delivery device 102. For example, the first medical device 104 may extend alongside or adjacent to the delivery device 102. The distal end 104D of the first medical device 104 may include a porous body 126 (e.g., an implant), such as a corpus cavernosum or other porous body. The first medical device 104 may also include a tube or catheter 128, and the porous body 126 may be (e.g., directly or indirectly) coupled to the distal end of the catheter 128. In some examples, the first medical device 104 may also include a connector 130. The connector 130 may be configured, for example, to couple or connect the distal end of the catheter 128 to the proximal end of the porous body 126. The connector 130 may include a quick-connect fitting, a Luer connector fitting, or any other fitting configured to couple the porous body 126 to the catheter 128 and allow fluid (e.g., liquid or gas) to flow between the porous body 126 and the catheter 128. Although the connector 130 is depicted as being located near or adjacent to the distal end 104D of the first medical device 104, the connector 130 may be located anywhere along the catheter 128 (e.g., at or near the proximal portion of the catheter, at or near the central portion of the catheter, etc.).

[0040] The porous body 126 may have any characteristics of any porous body known in the art for EVAC procedures. For example, the porous body 126 may include an open porous body. The porous body 126 may include a plurality of openings 132 (hereinafter referred to as "openings") on its outer surface and / or interior. The openings 132 may be any pores, pores, or channels. The openings 132 may include interconnecting channels and / or pores through the porous body 126. For example, the openings 132 may be pores of the porous body 126. The openings 132 may have different sizes and / or shapes. The characteristics of the openings 132 (e.g., the size and shape of the pores of the porous body 126) may be selected based on the treatment location in the body, the nature of the wound to be treated, the stage of treatment, or one or more other factors. The porous body 126 is depicted as having a cylindrical shape with a tapered proximal end 126A and a tapered distal end 126B, but may be any shape, including spherical, cubic, irregular, etc. The porous body 126 can be compressed into a lower profile or smaller size during insertion into the target site, and the porous body 126 can expand during deployment at the target site.

[0041] The porous body 126 may include any suitable biocompatible material that absorbs liquids and / or allows liquids or other materials to pass through it, for example, via negative pressure applied to the porous body 126. The material of the porous body 126 may be flexible, compressible, porous, hydrophilic, sterile, and / or disposable. Suitable materials include polyurethanes, esters, ethers, composites, and / or other medical-grade materials. Alternatively or additionally, the porous body 126 may include (e.g., doped, treated, infused, etc.) one or more drugs, for example, to help promote tissue growth, prevent infection, aid in pain management, etc.

[0042] The distal end 104D of the first medical device 104 may further include a proximal ring 134A and a distal ring 134B. The proximal ring 134A and distal ring 134B may be formed of an elongated body 134. For example, the proximal ring 134A may extend proximally or radially outward from the proximal end 126A of the porous body 126. The distal ring 134B may extend distally from the distal end 126B of the porous body 126. In some examples, each of the proximal ring 134A and distal ring 134B may be a separate ring formed by two or more elongated bodies 134. For example, the proximal ring 134A may be formed of a first elongated body and / or the distal ring 134B may be formed of a second elongated body. Alternatively, a middle portion 134C of the elongated body 134 may extend between the proximal ring 134A and the distal ring 134B, thereby joining or connecting the proximal ring 134A and the distal ring 134B. The intermediate portion 134C may extend longitudinally (e.g., proximal or distal) through the central portion of the porous body 126, as... Figure 1 Depicted by the dashed line. Although not shown, in another alternative example, the proximal ring 134A and the distal ring 134B may be portions of a larger single ring. In such an example, the middle portion of the larger ring (e.g., the portion extending between the proximal ring 134A and the distal ring 134B) may extend through or within the porous body 136.

[0043] The elongated body 134 (e.g., each of the proximal ring 134A, distal ring 134B, and intermediate portion 134C) may include one or more threads, wires, and / or cables formed, for example, of any number of materials or combinations of materials. For example, one or more portions of the elongated body 134 (e.g., the proximal ring 134A, distal ring 134B, and / or intermediate portion 134C) may be composed of one or more threads (e.g., sutures). For example, one or more threads comprising the elongated body 134 may be surgical wire, silk thread, cotton thread, linen thread, nylon thread, polypropylene thread, and / or polybutylene thread. Additionally or alternatively, one or more portions of the elongated body 134 may consist of one or more wires or cables. Wires and / or cables may be made of stainless steel, platinum, titanium, cobalt-chromium alloy, nickel-titanium alloy, or other medical-grade metals. Additionally or alternatively, one or more portions of the elongated body 134 may be made of one or more elastic materials, such as one or more elastomers (e.g., silicone rubber, latex, rubber latex), elastic polymers (e.g., polyurethane, thermoplastic elastomers, or TPE), and / or other medical-grade materials with elastic properties.

[0044] In some examples, the entire elongated body 134 (e.g., each of the proximal ring 134A, distal ring 134B, and intermediate portion 134C) may be formed of the same material. For example, the elongated body 134 may be made of stainless steel wire, a single suture, or a nickel-titanium cable. Alternatively, one or more portions of the elongated body 134 may be made of different materials. For example, each of the proximal ring 134A and distal ring 134B may be formed of a first material having flexible, bendable, and / or elastic properties, and the intermediate portion 134C may be formed of a second material having more rigid, non-flexible, or non-elastic properties. For example, the proximal ring 134A may be made of suture, the distal ring 134B may be made of nickel-titanium wire, and the intermediate portion 134C may be made of stainless steel cable. In such an example, the proximal ring 134A and / or the distal ring 134B may be coupled or connected to the intermediate portion 134C via, for example, a crimp, a ferrule, a knot, an adhesive, an epoxy resin, or any other coupling mechanism commonly used in the art, to connect two or more filaments / cables / wires.

[0045] In some examples, each portion of the elongated body 134 may be made of the same material and have the same physical properties. For example, each portion of the elongated body 134 (e.g., proximal ring 134A, distal ring 134B, and intermediate portion 134C) may be made of the same material having the same physical properties. Alternatively, one or more portions of the elongated body 134 may be made of two or more different materials, but still have the same physical properties. For example, for each of the proximal ring 134A, distal ring 134B, and intermediate portion 134C, the cross-sectional dimensions and / or shapes of one or more filaments / cables / wires forming the elongated body 134 may be the same or similar.

[0046] In alternative examples, one or more portions of the elongated body 134 may be made of the same material but have different physical properties. In such examples, the elongated body 134 may be made of a single material, and the cross-sectional dimensions and / or cross-sectional shapes of one or more portions of the elongated body 134 may differ. For example, the cross-sectional dimensions and / or cross-sectional shapes of the proximal ring 134A and / or the distal ring 134B may differ from the cross-sectional dimensions and / or shape of the intermediate portion 134C.

[0047] Alternatively, one or more portions of the elongated body 134 may be made of different materials and have different physical properties. For example, the intermediate portion 134C may have a larger cross-sectional dimension compared to the proximal ring 134A and / or the distal ring 134B. In some examples, the larger cross-sectional dimension of the intermediate portion 134C may provide additional structural support to the porous body 126. For example, the intermediate portion 134C may be configured to restrict the ability of the porous body 126 to bend or flex (e.g., to add structural support to the porous body 126). In alternative examples, the cross-sectional dimension / shape of the proximal ring 134A and / or the distal ring 134B may be larger than that of the intermediate portion 134C, for example, to withstand proximal (e.g., tensile) forces and / or distal (e.g., pushing) forces applied by a user to the proximal ring 134A and / or the distal ring 134B.

[0048] Figure 2 An exemplary process or method 200 is described, which can be performed by one or more users using any part of a medical system, device, or system discussed herein (e.g., medical system 100). References Figure 1 and Figure 2In step 202, the medical system 100 can be inserted into the subject's lumen 101 and navigated to the target tissue. In some examples, all components of the medical system 100 (e.g., delivery device 102, first medical device 104, and second medical device 106) can be inserted into the lumen 101 together or at once. In other examples, each component of the medical system 100 can be inserted individually (e.g., one at a time). In such an example, the delivery device 102 can be inserted into the lumen 101 first. The first medical device 104 can then be inserted alongside the delivery device 102, and / or the second medical device 106 can be inserted through the working channel 118 of the delivery device 102. The first medical device 104 and the second medical device 106 can be inserted such that the distal end of each device is distal to the distal end face 110D of the delivery device 102.

[0049] Once the medical system 100 is in place, step 204 includes positioning the first auxiliary device. For example, in step 204, the first medical device 104 may be positioned using the second medical device 106 and / or the delivery device 102. For example, the second medical device 106 may (e.g., via jaws 122) grasp at least a portion of the distal ring 134B of the first medical device 104. The first medical device 104 and the second medical device 106 may then be manipulated (e.g., moved proximally or distally), for example, to position the first medical device 104 as needed. For example, the second medical device 106 may be moved proximally and / or distally within the working channel 118 of the delivery device 102, and / or the delivery device 102 may be manipulated together with the second medical device 106 to manipulate the first medical device 104. Additionally or alternatively, the articulated portion 120 of the delivery device 102 may be articulated (e.g., bent) to, for example, help manipulate the first medical device 104 and / or the second medical device 106 to a desired location within the lumen 101. Additionally or alternatively, the user may manipulate the catheter 128 (e.g., proximally and / or distally) to position the porous body 126 to a desired location within the lumen 101.

[0050] Although not shown, in some methods of use, the first medical device 104 and the second medical device 106 can be inserted into or through a wound. For example, the first medical device 104 can be positioned such that the distal ring 134B is on a first side (e.g., lateral) of the wall defining the lumen 101, and the proximal ring 134A is on a second side (e.g., medial) of the wall defining the lumen 101. Thus, once the first medical device 104 is in place, tissue can circumferentially surround the porous body 126 of the first medical device 104.

[0051] Next, step 206 includes retraction to remove the delivery device and / or the second accessory device. For example, once the first medical device 104 is in place, in step 206, the delivery device 102 and / or the second medical device 106 may be removed from or retracted proximally from the lumen 101. For example, the jaws 122 of the second medical device 106 may be opened (e.g., via the handle of the second medical device 106) to release the distal ring 134B. The second medical device 106 and / or the delivery device 102 may be removed proximally from the lumen 101 while the first medical device 104 remains in the body. The first medical device 104 may remain in the lumen 101 for an extended period of time (e.g., from minutes to days).

[0052] Step 208 includes applying a vacuum or negative pressure via a first auxiliary device. For example, in step 208, suction or vacuum pressure may be applied (e.g., via porous body 126). In some aspects, porous body 126 may be positioned adjacent to tissue such that suction is applied to the tissue. Vacuum may be used to help remove excess fluid and / or promote tissue growth, for example, into porous body 126.

[0053] After a period of time, the first accessory device (i.e., the first medical device 104) may need to be removed or repositioned. For example, step 210 includes reinserting the delivery device and the second accessory device. In these respects, step 210 may include reinserting the delivery device 102 and / or the second medical device 106 into the lumen 101 and manipulating it to the target site. In some examples, the delivery device 102 may be inserted into the lumen 101 first, and then the second medical device 106 may be inserted through the working channel 118 of the delivery device 102.

[0054] Additionally, step 212 includes grasping the first auxiliary device using a second auxiliary device. For example, in step 212, the second medical device 106 may be used to grasp the proximal ring 134A of the first medical device 104 (e.g., via jaws 122). For example, the jaws 122 of the first medical device 104 may be opened and closed (e.g., via a handle of the second medical device 106) to grasp the proximal ring 134A between the jaws 122 of the second medical device 106.

[0055] Next, step 214 includes retracting or removing the first auxiliary device. For example, in step 214, the second medical device 106 and / or delivery device 102 may be pulled proximally (e.g., retracted) to release or remove the first medical device 104 from tissue or target site. The first medical device 104 can then be removed from lumen 101 (e.g., pulled proximally), thereby removing the porous body 136 from lumen 101. In other examples, the porous body 136 may be detached from or disconnected from catheter 128 (e.g., via connector 130). Thus, catheter 128 may be retracted from lumen 101 independently. In the case of catheter 128 being separated from porous body 136, porous body 136 may be removed via the working channel 118 of delivery device 102. For example, the second medical device 106 can grasp the porous body 136, the proximal ring 134A and / or the distal ring 134B (e.g., using jaws 122), and can pull or retract the porous body 136 proximally through the working channel 118 of the delivery device 102.

[0056] Optional step 216 includes replacing the first auxiliary device (e.g., with another first auxiliary device). In these aspects, as the first medical device 104 is removed from the lumen 101, in optional step 216, a new first medical device 104 (e.g., a new porous body 126) can be inserted and positioned within the tissue, as described above. For example, as the wound or tissue heals, the porous body 136 of the first medical device 104 can be replaced periodically (e.g., gradually reduced in size). The first medical device 104 can be replaced multiple times as needed, e.g., until the tissue at the target site is sufficiently or desiredly healed.

[0057] Finally, step 218 includes retracting or removing the medical system. For example, once the first medical device 104 has been adequately removed (e.g., retracted) and / or replaced, the medical system 100 (e.g., delivery device 102, the first medical device 104, and the second medical device 106) can be retracted or removed from the subject in step 218. Various aspects of method 200 (e.g., one or more of steps 202-218) may be repeated as needed.

[0058] Figure 3A and Figure 3B Depicting the first construction ( Figure 3A ) and second construction ( Figure 3B This is an alternative implementation of the first medical device 304. For example, the first medical device 304 may be an EVAC device. The first medical device 304 may be used with one or more aspects of the medical system 100. Alternatively, the first medical device 304 (e.g., in conjunction with delivery device 102 and / or second medical device 106) may be used to perform method 200.

[0059] In addition to the features described below, the first medical device 304 may have any or all of the features of the first medical device 104, as described above. Figure 1 As described above. For example, the distal end 304D of the first medical device 304 may include a porous body 326 removably or permanently (e.g., directly or indirectly) coupled to the distal end of the catheter 328. The porous body 326 may have any or all of the characteristics of the porous body 126 described above. For example, the porous body 326 may include an opening 332. The opening 332 may be any hole, pore, or channel. The opening 332 may include interconnecting channels and / or holes through the porous body 326. The opening 332 may be a hole in the porous body 326. Additionally, the catheter 328 may have any or all of the characteristics of the catheter 128 described above. For example, the catheter 328 may include a connector 330. For example, the connector 330 may be configured to couple or connect the catheter 328 to the porous body 326.

[0060] The first medical device 304 may further include a proximal ring 334A and a distal ring 334B formed by an elongated body 334. For example, the proximal ring 334A may extend proximally or radially outward from the proximal end 326A of the porous body 326. In some examples, the proximal ring 334A may extend proximally from the side of the porous body 326. For example, the proximal ring 334A may be offset relative to axis A, which extends longitudinally through the center of the porous body 326 and the catheter 328. The distal ring 334B may extend distally from the distal end 326B of the porous body 326. In some examples, the distal ring 334B may be aligned with axis A. A middle portion 334C of the elongated body 134 may extend between the proximal ring 334A and the distal ring 334B. Each portion of the elongated body 334 (e.g., proximal ring 334A, distal ring 334B, and intermediate portion 334C) may have any or all of the features of the corresponding portion of the elongated body 134, unless described below.

[0061] In some examples, the distal end of the intermediate portion 334C may be secured to the porous body 326 (e.g., via a knot, joint, crimp, fastener, etc.). Additionally or alternatively, the distal end of the intermediate portion 334C may be coupled to the distal ring 334B (e.g., via a knot, joint, crimp, fastener, etc.). In some examples, the proximal end of the intermediate portion 334C may be coupled to the proximal ring 334A (e.g., via a knot, joint, crimp, fastener, etc.). In some examples, knots, joints, crimps, fasteners, etc., between the proximal ring 334A and the intermediate portion 334C and / or between the distal ring 334B and the intermediate portion 334C may be configured to anchor each corresponding portion of the elongated body 334 to or within the porous body 326. Therefore, joints, connectors, crimps, fasteners, etc., can help prevent each of the proximal ring 334A, distal ring 334B, and / or intermediate portion 334C from moving relative to each other and / or relative to the porous body 326.

[0062] The intermediate portion 334C may include a helical structure surrounding at least a portion of the porous body 326. For example, the intermediate portion 334C may include a plurality of turns 335 extending circumferentially around the porous body 326. In some examples, the intermediate portion 334C may extend circumferentially around the outer surface 326S of the porous body 326. In other examples, the intermediate portion 334C may be at least partially embedded within the porous body 326 (e.g., the plurality of turns 335 may extend at least partially into or through corresponding portions of the porous body 326).

[0063] In the first construction, such as Figure 3A As shown, the porous body 326 may have a first length L1 and a first width W1. Figure 3A A first configuration of the first medical device 304 may be described, for example, before, during, and / or after placing the first medical device 304 into a subject (e.g., within the subject's target tissue). During delivery or implantation (e.g., when the porous body 326 is in the target tissue), tissue may grow into the porous body 326, and thus, in some configurations, at least one or more portions of the porous body 326 are anchored to the subject's tissue.

[0064] In the second construction, such as Figure 3B As shown, the porous body 326 can be elongated and compressed (e.g., during removal of the first medical device 304 from the target tissue). For example, in a second configuration, the porous body 326 may have a second length L2 and a second width W2. The second length L2 may be greater than or longer than the first length L1. The second width W2 may be less than or shorter than the first width W1. The porous body 326 can be elongated, for example, by pulling the proximal ring 334A proximally. For example, although not shown, the second medical device (e.g., Figure 1The second medical device 106 can be used to grasp and pull the proximal ring 334A in the proximal direction to help the porous body 326 from the first structure ( Figure 3A Transition to the second construction ( Figure 3B ).

[0065] When the proximal ring 334A is pulled proximally, the intermediate portion 334C can help to shrink or compress the porous body 326, thereby helping to reduce the width of the porous body 326 and increase its overall length. The shrinking or compressing of the porous body 326 by the intermediate portion 334C is achieved, for example, due to the nature of the multiple turns 335 of the intermediate portion 334C. In some examples, the intermediate portion 334C can be configured to uniformly compress or shrink the porous body 326.

[0066] In other examples, the porous body 326 can be compressed (e.g., when the proximal ring 334A is pulled proximally). When the proximal ring 334A is pulled proximally, the diameter of each of the plurality of turns 335 in the intermediate portion 334C decreases. Therefore, when the proximal ring 334A is pulled proximally, the spacing between adjacent turns of the plurality of turns 335 increases. In some aspects, for example, as the spacing between adjacent turns of the plurality of turns 335 increases, the diameter or width of the porous body 326 decreases. Therefore, the porous body 326 is contracted or compressed.

[0067] In other aspects, the spacing between adjacent turns of the plurality of turns 335 may remain unchanged (e.g., increase or decrease). For example, knots, crimps, splices, fasteners, etc., that may be formed between the proximal ring 334A and the intermediate portion 334C and / or between the distal ring 334B and the intermediate portion 334C may also be secured to the porous body 326. Thus, knots, crimps, splices, fasteners, etc., may be configured to prevent the space between adjacent turns of the plurality of turns 335 from increasing or decreasing. Furthermore, in some examples, the intermediate portion 334C may include a plurality of anchors distributed along the length of the intermediate portion 334C. For example, the plurality of anchors (e.g., knots, crimps, fasteners, etc.) may be configured to further anchor the intermediate portion 334C to or within the intermediate portion 334C. In some aspects, the plurality of anchors may be configured to prevent changes in the amount of space between adjacent turns of the plurality of turns 335.

[0068] Compression or contraction of the porous body 326 can facilitate the removal of the porous body 126 from any tissue that has grown into or through the porous body 326. For example, compression of the porous body 326 can cause the porous body 326 to de-anchor to the tissue. Therefore, once the porous body 326 has been de-anchored or removed from the tissue, the entire first medical device 304 can be removed and / or replaced from the subject. Furthermore, in some examples, the porous body 326 can be moved over at least a portion of the catheter 328 (e.g., when the porous body 326 is compressed). Therefore, in the first configuration ( Figure 3A ) and second construction ( Figure 3B The distance between the connector 330 and the proximal end of the porous body 326 can be reduced.

[0069] When the proximal ring 334A is pulled proximally, the porous body 326 can be bent or flexed, for example, based on the relationship of the proximal ring 334A offset relative to axis A. The helical structure of the intermediate portion 334C can be configured (e.g., by means of the property of the uniform compressive / contractive force applied to the porous body by the intermediate portion 334C) to help reduce the degree to which the porous body 326 can be bent or flexed (e.g., when the proximal ring 334A is pulled proximally).

[0070] Alternatively or concurrently, one or more support structures (not shown) may be provided within the porous body 326. For example, one or more support structures may extend longitudinally (e.g., proximal and distally) within the porous body 326. The support structures may be constructed of a rigid (e.g., rigid or semi-rigid) material, for example, to help prevent the porous body 326 from bending / bending during use. For example, the support structure (not shown) may comprise one or more plastics and / or metals. Thus, the support structure may help prevent the porous body 326 from bending / bending, for example, during positioning the porous body 326 within and / or removing the porous body 326 from the subject.

[0071] Figure 4 An alternative embodiment of the first medical device 404 is described. In addition to what is described below, the first medical device 404 may have… Figure 1 The first medical device 104 and / or Figure 3A and 3B The first medical device 304 may possess any or all of the characteristics of the first medical device 304. For example, the distal end 404D of the first medical device 404 may include a porous body 426 that is removably or permanently (e.g., directly or indirectly) coupled to the distal end of the catheter 428. Additionally, the first medical device 404 may be used (e.g., in conjunction with...) Figure 1 The delivery device 102 and / or the second medical device 106) are used to perform method 200.

[0072] The porous body 426 of the first medical device 404 may have any or all of the characteristics of the porous body 126 and / or porous body 326 described above. For example, the porous body 426 may include an opening 432. The opening 432 may be any hole, pore, or channel. The opening 432 may include interconnecting channels and / or holes through the porous body 426. The opening 432 may be a hole in the porous body 426. Additionally, the catheter 428 may have any or all of the characteristics of the catheter 128 and / or catheter 328 described above. For example, the catheter 428 may include a connector 430.

[0073] The porous body 426 includes a proximal portion 426A and a distal portion 426B. An intermediate portion 426C may extend between the proximal portion 426A and the distal portion 426B. The proximal portion 426A of the porous body 426 may taper gradually (e.g., towards the proximal end 426P of the porous body 426). For example, the proximal end 426P of the porous body 426 may have a smaller diameter, for example, a smaller diameter compared to the distal portion 426B, the distal end 426D of the porous body 426, and / or the intermediate portion 426C of the porous body 426. Although not shown, the distal portion 426B of the porous body 426 may similarly be tapered. For example, the distal portion 426B may taper gradually towards the distal end 426D of the porous body 426, such that the distal end 426D of the porous body 426 has a smaller diameter (e.g., compared to the intermediate portion 426C).

[0074] The first medical device 404 may further include a mesh 436 that at least partially surrounds or encloses the porous body 426. For example, the mesh 436 may extend circumferentially around the outer surface of the porous body 426 (e.g., from the proximal end 426P of the porous body 426 to the distal end 426D of the porous body 426). In other examples, the mesh 436 may be at least partially embedded within the porous body 426 (e.g., the mesh 436 may extend at least partially into or through a corresponding portion of the porous body 426).

[0075] Net 436 may be composed of a perforated mesh, webbing, a grid structure, and / or a mesh formed from one or more threads, filaments, and / or cables. For example, net 436 may be composed of surgical wire, silk thread, cotton thread, linen thread, nylon thread, polypropylene thread, and / or polybutylene thread. Additionally or alternatively, net 436 may consist of one or more filaments or cables. Fibers and / or cables may be made of stainless steel, platinum, titanium, cobalt-chromium alloy, nickel-titanium alloy, or other medical-grade metals. Additionally or alternatively, net 436 may be composed of one or more elastic materials, such as elastomers (e.g., silicone rubber, latex, rubber latex), elastic polymers (e.g., polyurethane, thermoplastic elastomers, or TPE), and / or other medical-grade materials with elastic properties.

[0076] The mesh 436 may be configured to conform to the size and / or shape of the porous body 426, for example, without applying a compressive force to the porous body 426. In other examples, the mesh 436 may be configured to apply a compressive force or a radially inward force, for example, to shape the porous body 426 and / or otherwise form the porous body 426. For example, the mesh 436 may be configured to form tapered portions of the porous body 426 (e.g., proximal portion 426A and / or distal portion 426B of the porous body 426).

[0077] In some examples, the proximal end 436P of the mesh 436 may extend proximally through the proximal end 426P of the porous body 426. Additionally or alternatively, the distal end 436D of the mesh 436 may extend distally through the distal end 426D of the porous body 426. In some examples, the distal end 436D of the mesh 436 may be closed or tightened, for example via fastener 438. Fastener 438 may include crimping, looping, knotting, adhesive, or epoxy and / or any other mechanism for closing or tightening the distal end 436D of the mesh 436. Although not shown, the proximal ends 436P of the mesh 436 may similarly be closed or tightened together. In other examples, the proximal end 426P may include an opening 440. The opening 440 may extend perpendicularly to the longitudinal direction (e.g., from proximal to distal) through axis A of the first medical device 404.

[0078] Net 436 may include a proximal loop 436A extending proximally from a proximal end 436P of net 436. Net 436 may also include a distal loop 436B extending distally from a distal end 436D of net 436. Proximal loop 436A and / or distal loop 436B may be formed from one or more filaments, cables, and / or wires. In some examples, each of proximal loop 436A and / or distal loop 436B may be integrally formed with net 436. Alternatively, proximal loop 436A and / or distal loop 436B may be coupled (e.g., connected) to net 436 (via, for example, crimping, looping, knotting, adhesive, epoxy, and / or any other means or combination thereof commonly used in the art), for example, to join two or more filaments / cables / wires.

[0079] In some examples, the proximal ring 436A may extend proximally from the proximal end 426P of the porous body 426. For example, the proximal ring 436A may be offset relative to axis B. The distal ring 436B may extend distally beyond the distal end 426D of the porous body 426. In some examples, the distal ring 436B may extend from the distal end 404D of the first medical device 404. For example, the distal ring 436B may be aligned with axis B.

[0080] The first medical device 404 may be configured such that, for example, when the proximal ring 436A is pulled proximally, the mesh 436 may contract or compress at least a portion of the porous body 426. In some examples, the mesh 436 may contract or compress the porous body 426 uniformly. For example, the cross-sectional diameter of the porous body 426 may decrease when the proximal ring 436A is pulled proximally. In some examples, the length of the porous body 426 may increase (e.g., when the proximal ring 436A is pulled proximally). Contracting or compressing the porous body 426 may facilitate the removal of the porous body 426 from any tissue that has grown into or through the porous body 426. For example, compressing the porous body 426 may cause the porous body 426 to deanchor from the tissue. Therefore, once the porous body 426 has been deanchored or removed from the tissue, the entire first medical device 404 may be removed and / or replaced from the subject.

[0081] When the proximal ring 436A is pulled proximally, the porous body 426 can bend or bend, for example, based on the offset of the proximal ring 436A relative to axis B. The mesh 436 can be configured to help reduce the degree to which the porous body 426 can be bent or bend, for example, by the property of applying a uniform compressive / contractive force to the porous body. For example, when the proximal ring 436A is pulled proximally, the mesh 436 can help reduce the degree to which the porous body 426 bends or bends.

[0082] Alternatively or concurrently, one or more support structures (not shown) may be provided within the porous body 426. For example, one or more support structures may extend longitudinally (e.g., proximal and distally) within the porous body 426. The support structures may be constructed of a rigid (e.g., rigid or semi-rigid) material, for example, to help prevent the porous body 426 from bending / bending during use. For example, the support structure (not shown) may comprise one or more plastics and / or metals. Thus, the support structure may help prevent the porous body 426 from bending / bending, for example, during positioning the porous body 426 within and / or removing the porous body 426 from the subject.

[0083] Figure 5 Another alternative embodiment of the first medical device 504 is described. In addition to what is described below, the first medical device 504 may have… Figure 1 First medical device 104 Figure 3A and 3B First medical device 304 and / or Figure 4 The first medical device 504 may possess any or all of the characteristics of the first medical device 404. For example, the distal end 504D of the first medical device 504 may include a porous body 526 that is removably or permanently (e.g., directly or indirectly) coupled to the distal end of the catheter 528. Additionally, the first medical device 504 may be used (e.g., in conjunction with...) Figure 1 The delivery device 102 and / or the second medical device 106) are used to perform method 200.

[0084] The porous body 526 of the first medical device 504 may have any or all of the characteristics of porous bodies 126, 326, and / or 426 described above. For example, the porous body 526 may include an opening 532. The opening 532 may be any hole, pore, or channel. The opening 532 may include interconnecting channels and / or holes through the porous body 526. The opening 532 may be a hole in the porous body 526. Additionally, the catheter 528 may have any or all of the characteristics of catheters 128, 328, and / or 428 described above.

[0085] In some examples, the proximal portion of the porous body 526 may include a fastener 544, for example, to help connect the porous body 526 to the conduit 428. For example, the fastener 544 may include a crimp, collar, knot, etc., surrounding the outer surface of the porous body 526. In some examples, the fastener 544 may form a tightened portion of the porous body 526.

[0086] The first medical device 504 may also include a gripper 546. The gripper 546 may be positioned proximal to the proximal end of the porous body 526 (e.g., along the distal portion of the catheter 528). In some examples, the gripper 546 may be an O-ring, for example, to serve or provide a gripping point for the second medical device 106. For example, the gripper 546 may be configured such that the jaws 122 can grip onto the gripper 546. Therefore, the second medical device 106 may use the gripper 546, for example, to position / reposition the first medical device 504 within the subject and / or to remove the first medical device 504 from the subject. Furthermore, when the gripper 546 is detached from and proximal to the porous body 526, the porous body 526 may be cut or otherwise resized / shaped by the user. For example, the distal portion of the porous body 526 may be cut off or otherwise removed in order to resize the porous body 526, for example, based on the size of the wound in the lumen or at the target site.

[0087] In some examples, the gripper 546 may be integrally formed with the conduit 528. In other examples, the gripper 546 may be a separate component. In such examples, the gripper 546 may be movably disposed along the conduit 528. Alternatively, the gripper 546 may be a component secured to the conduit 528, for example, by means of adhesives, epoxy resin, crimping, ferrules, forging, or any other coupling mechanism known in the art for securing two or more components together.

[0088] The gripper 546 may be made of one or more biocompatible materials. For example, the gripper 546 may be made of an elastic material (e.g., rubber, rubber latex, etc.), a hard or soft plastic (e.g., polypropylene, polyethylene, polyvinyl chloride, etc.), a metal (e.g., stainless steel, titanium, etc.), and / or any other biocompatible material. Furthermore, although... Figure 5 A gripper 546 is depicted, but the first medical device 504 may include additional grippers. In some examples, the first gripper in gripper 546 may be secured to catheter 528, and the second gripper in gripper 546 may be movable along catheter 528.

[0089] The gripper 546 may have an annular or toroidal cross-section. For example, although not shown, the gripper 546 may have an opening configured to receive the catheter 528. The opening may extend through a central portion of the gripper 546. The outer surface 546S of the gripper 546 may be smooth. Alternatively, the outer surface 542S of the gripper 546 may include one or more features (convex-concave structures, e.g., extensions and / or notches) extending radially outward from the outer surface 546S of the gripper 546. The one or more features may be configured to provide, for example, additional portions for gripping or holding the second medical device 106 (e.g., during placement and / or removal of the first medical device 504 within a subject). In some examples, the cross-section of the gripper 546 may be star-shaped (e.g., having multiple pointed extensions / notches), flower-shaped (e.g., having multiple curved extensions / notches), or any other shape, for example, to help allow the second medical device 106 to grip onto the gripper 546. Additionally or alternatively, the gripper 546 may be shaped similarly to FIG. 8 (e.g., having at least two openings). In such an example, the first opening of the gripper 546 may be configured to receive the catheter 528, and the second opening of the gripper 546 may be configured to receive the second medical device 106. Alternatively, the second opening of the gripper 546 may be configured to resemble a handle, such that the second medical device 106 can grip the gripper 546 (e.g., using jaws 122).

[0090] In this way, the second medical device 106 (e.g., via jaws 122) can be used to grasp the gripper 546 and / or any features extending radially outward or proximally from the gripper 546. The second medical device 106 and / or the delivery device 102 can then be pulled proximally, thereby pulling the gripper 546 and the first medical device 104 together with the second medical device 106 proximally. Thus, the first medical device 504 can be removed from the subject via the gripper 546.

[0091] Although not shown, any or all of the first medical device 104, first medical device 304, and / or first medical device 404 may include a gripper 546. For example, the gripper 546 may be coupled to a catheter 128 of the first medical device 104. Similarly, the gripper 546 may be coupled to a catheter 328 of the first medical device 304. The gripper 546 may also be coupled to a catheter 428 of the first medical device 404.

[0092] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed systems, apparatus, and methods without departing from the scope of this disclosure. In some examples, the various components / components discussed herein may be used interchangeably with each embodiment. Other embodiments of this disclosure will be apparent to those skilled in the art in light of the practice and specification of the invention disclosed herein. This specification and embodiments are to be considered exemplary only, and the true scope and spirit of the invention are shown by the following claims.

Claims

1. A medical device comprising: catheter; A porous body connected to the distal end of the conduit; A first ring extending proximally from the proximal end of the porous body; as well as A second ring extending distally from the distal end of the porous body.

2. The medical device of claim 1, wherein in a first configuration, the porous body has a first length and a first width, and in a second configuration, the porous body has a second length and a second width, wherein the second length is greater than the first length, and wherein the second width is less than the first width.

3. The medical device as claimed in claim 2, wherein, In order to change the porous body from the first configuration to the second configuration, the first ring is pulled proximally.

4. The medical device as claimed in any of the preceding claims, wherein the first ring defines a proximal end of the elongated body, wherein the second ring defines a distal end of the elongated body, and wherein a middle portion extends between each of the first ring and the second ring.

5. The medical device of claim 4, wherein each of the first ring and the second ring is integrally formed with the intermediate portion.

6. The medical device of claim 4 or claim 5, wherein the intermediate portion extends through at least a portion of the porous body.

7. The medical device according to any one of claims 4-6, wherein the intermediate portion comprises a plurality of turns.

8. The medical device of claim 7, wherein the plurality of turns extend circumferentially around at least a portion of the porous body.

9. The medical device of claim 1, wherein the mesh extends between the first ring and the second ring, wherein the mesh extends circumferentially around at least a portion of the porous body.

10. The medical device as claimed in any of the preceding claims, wherein a longitudinal axis extends through the conduit and the porous body.

11. The medical device of claim 10, wherein the second ring is offset relative to the longitudinal axis.

12. The medical device as claimed in any of the preceding claims, wherein at least one of the first ring or the second ring is composed of at least one of a thread, filament or cable.

13. The medical device as claimed in any of the preceding claims, wherein at least one of the first ring or the second ring is a suture.

14. The medical device of any of the preceding claims, wherein the catheter includes a connector configured to removably connect the catheter and the porous body.

15. The medical device of claim 14, wherein the catheter is configured to be coupled to a vacuum source, wherein the vacuum source is configured to provide negative pressure to the porous body.

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