LOCALIZED TISSUE TREATMENT DEVICE
The localized treatment device addresses the challenge of treating locally advanced pancreatic tumors by using an endoscopic injection needle and stimulation element to create an electroporation phenomenon, enhancing the delivery and effectiveness of therapeutic molecules.
Patent Information
- Application Number
- FR2023011609
- Authority / Receiving Office
- FR · FR
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2023-10-25
- Publication Date
- 2025-05-02
- Estimated Expiration
- 2043-10-25
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Abstract
Description
Title of the invention: DEVICE FOR LOCALIZED TREATMENT OF A TISSUE Technical field of the invention
[0001] The present invention relates to a device for localized treatment of tumor tissue. This device makes it possible to treat a solid tumor in a targeted and local manner, in particular in the case of chemoresistant cancers, including in regions that are difficult to access, for example pancreatic cancers. Technical background
[0002] Some cancers are particularly chemoresistant and this chemoresistance is largely responsible for a poor prognosis. This is particularly the case for pancreatic cancer, characterized by a particular microenvironment, where the cells and the extracellular matrix support, protect and nourish the tumor in its development, and which chemotherapy only partially and with difficulty reaches, with significant systemic toxicity. The majority of these tumors are revealed at a stage where radical surgical excision is not feasible, even in the absence of distant metastases ("locally advanced" tumors).
[0003] Recently, devices have been proposed to destroy tumors located in the pancreas by applying radiofrequency using an echoendoscopic approach. These devices perform immediate thermal ablation in a limited target volume. A priori adapted to the destruction of tumors of small volume and low malignant potential, these devices only have a limited scope for reducing tumor size (in English "debulking") in pancreatic cancer.
[0004] Thus, no device to date makes it possible to treat a localized or locally advanced pancreatic tumor in a simple and effective manner.
[0005] The object of the invention is to propose a new localized treatment device making it possible to improve the effectiveness of a treatment applied to a tissue, for example a tumor.
[0006] The device according to the invention makes it possible, among other things, to generate an electroporation phenomenon in the tissue, which may be reversible or irreversible, thus improving the penetration and migration of the molecules of interest in the tissue. Summary of the invention
[0007] The invention provides a device for localized treatment of a tissue comprising:
[0008] - an endoscopic injection needle comprising a flow channel of a fluid and / or at least one side injection port;
[0009] - at least one stimulation element arranged around the injection needle and comprising a base from which at least two electrodes in the form of shape memory rods extend;
[0010] the injection needle and the stimulation element each being electrically connected to a separate electrical conductor intended to be supplied with electric current,
[0011] - a tube intended to house the injection needle and the stimulation element in a state retracted from the device, the electrodes of the stimulation element extending along the injection needle within the tube in the retracted state of the device;
[0012] the injection needle and the stimulation element being movable in the tube such that, in a deployed state of the device, the injection needle extends at least partly outside the tube and the electrodes extend outside the tube at the periphery and at least partly at a non-zero distance from the injection needle, according to a predetermined shape.
[0013] According to other characteristics of the invention: - the electrodes of the stimulation element are electrically independent of each other; - the injection needle and the stimulation element move relative to the tube such that the device passes from its retracted state to its deployed state at least by a rectilinear translational movement of the stimulation element and the needle relative to the tube; - the injection needle and the stimulation element are movable relative to the tube independently of each other; - in the deployed state of the device, the electrodes of the stimulation element are included in a cylinder of revolution having a diameter less than or equal to 35 mm; - in the deployed state of the device, the electrodes extend from the base outside the tube in a helical shape; - in the deployed state of the device, the electrodes extend from the base outside the tube in a curved shape; - a free end of each of the electrodes is secured to one end injection needle injection; - the electrodes of the stimulation element are made of the same material as the base ; - the device comprises two stimulation elements which extend around the injection needle while being contained at least in part in an intermediate sheath, the intermediate sheath being mounted in the tube in the retracted state of the device and being movable in translation relative to the tube.
[0014] The invention also relates to an endoscope comprising a device for localized treatment of a tissue according to any one of the preceding characteristics, the device being configured so that it is capable of being in its deployed state within a solid volume. Brief description of the figures
[0015] Other characteristics and advantages of the invention will appear during the reading of the detailed description which follows for the understanding of which reference will be made to the appended drawings in which:
[0016] [Fig-1] is a general perspective view of a localized treatment device installed in an endoscope, the device being in a retracted state;
[0017] [Fig.2] is a general perspective view of the device of [Fig.l] in a state deployed;
[0018] [Fig.3] is an axial sectional view of a portion of the device of [Fig.l];
[0019] [Fig.4] is a general perspective view of a step in a method of using the device ;
[0020] [Fig.5] is a general perspective view of another step of the method of use of the device;
[0021] [Fig.6] is a general perspective view of another example of embodiment of the device according to the invention;
[0022] [Fig.7] is a general perspective view of another example of embodiment of the device according to the invention;
[0023] [Fig.8] is a general perspective view of another example of embodiment of the device according to the invention;
[0024] [Fig.9] is a general perspective view of another example of embodiment of the device according to the invention;
[0025] [Fig. 10] is a general perspective view of another exemplary embodiment of the device according to the invention. Detailed description of the invention
[0026] In the following description, identical, similar or analogous elements will be designated by the same reference numbers.
[0027] [Fig.l] illustrates an endoscope 12 comprising a device 10 for localized treatment of a tissue according to an example of the invention.
[0028] The device 10 can also be mounted for example on an echo-endoscope.
[0029] Such a device 10 installed in an endoscope 12 or an echo-endoscope, can be used for example for the purpose of applying treatment to a tumor whose location, for example in the pancreas, makes it difficult to access.
[0030] Thus, the endoscopic or echoendoscopic approach makes it possible to approach the pancreas by crossing the wall of the stomach or the duodenum, depending on the location of the tumor.
[0031] The device 10 coupled to the endoscope 12 then makes it possible to apply a treatment directly to a tissue of interest, for example a pancreatic tumor.
[0032] To this end, the device 10 according to the example of the invention illustrated in [Fig.2] comprises an injection needle 14 which extends in a main longitudinal direction L and which comprises a flow channel 16 for a fluid, opening onto an outlet orifice 17.
[0033] It is then understood that the injection needle 14 takes the form of a hollow cylinder.
[0034] According to an example of the invention not illustrated, the injection needle may comprise at least one lateral injection orifice, which extends radially at the periphery of the injection needle in the longitudinal direction, the lateral injection orifice being fluidically connected to the flow channel.
[0035] An injection end 20 of the injection needle is defined, comprising the outlet orifice 17, and a fluid connection end 18, opposite one another in the longitudinal direction L.
[0036] The fluid connection end 18 is for example fluidically connected to a channel, not visible, which extends into the endoscope and which is configured to allow the routing of a fluid of interest to the fluid flow channel 16 of the injection needle 14.
[0037] According to the example of the invention illustrated, the injection end 20 has a beveled profile, so as to facilitate implantation in the tissue.
[0038] The device 10 according to the invention comprises at least one stimulation element 22, arranged around the injection needle 14.
[0039] The stimulation element 22 comprises, among other things, a base 24 from which at least two electrodes 26 extend in the form of shape memory rods.
[0040] The base 24 and the electrodes 26 of the stimulation element 22 are also electrically conductive.
[0041] In the example of the invention illustrated in Figures 1 to 3, the device 10 comprises a single stimulation element 22.
[0042] According to this example, the stimulation element 22 comprises the base 24 from which extend six electrodes 26 in the form of shape memory rods.
[0043] The base 24 of the stimulation element 22 here has a hollow cylindrical shape from which the electrodes 26 extend in the form of shape memory rods.
[0044] According to this example of the invention, the electrodes 26 in the form of shape memory rods extend from the base 24 in a helical shape.
[0045] According to a non-limiting example of the invention, the electrodes 26 each comprise a free end 30 whose profile is beveled so as to facilitate insertion into the tissue.
[0046] According to an example of the invention, the electrodes 26 of the stimulation element 22 are integral with the base 24. In other words, the electrodes 26 and the base 24 of the stimulation element 22 are monobloc and are made of the same material.
[0047] The device 10 further comprises a tube 28 which extends around the periphery of the injection needle 14 and the stimulation element 22.
[0048] More precisely, a retracted state of the device 10 is defined, visible in [Fig.l], in which the tube 28 houses the injection needle 14 and the electrodes 26 of the stimulation element 22.
[0049] It is understood that in the retracted state of the device 10, the electrodes 26 in the form of shape memory rods are contained in the tube 28 in a deformed stressed shape.
[0050] A deployed state of the device 10 is also defined, visible in [Fig. 2], in which the injection needle 14 extends at least partly outside the tube 28 and in which the electrodes 26 extend outside the tube 28 at the periphery of the injection needle 14 in a predetermined shape.
[0051] It is then understood that in the deployed state of the device 10, the electrodes 26 in the form of shape memory rods extend in an initial, non-deformed shape corresponding to their predetermined shape.
[0052] According to the example of the invention illustrated in Figures 1 to 3, in the retracted state of the device 10, the deformed stressed shape of the electrodes 26 corresponds to a circular helix and in the deployed state of the device 10, the initial undeformed shape of the electrodes 26 corresponds to a conical helix.
[0053] According to the invention, in the deployed state of the device 10, the electrodes 26 of the stimulation element 22 are included in a longitudinal cylinder of revolution having a diameter of less than 35 mm.
[0054] According to a preferred embodiment of the invention, the electrodes 26 of the stimulation element 22 are included in a longitudinal cylinder of revolution having a diameter of 30 mm.
[0055] In order to move the device 10 from its retracted state to its deployed state and vice versa, the injection needle 14 and the stimulation element 22 are movable in the tube 28.
[0056] Furthermore, it should be considered that the injection needle 14 and the stimulation element 22 are movable relative to the tube 28 independently of each other.
[0057] Thus, it is understood that when using the device 10, the injection needle 22 can be inserted into the tissue before or simultaneously with the introduction of the electrodes 26 into the latter.
[0058] According to the invention, the injection needle 14 is movable in longitudinal translation in the tube 28.
[0059] According to the example of the invention illustrated in Figures 1 to 3, the stimulation element 22 is mobile in the tube following a helical movement.
[0060] Alternatively, the stimulation element 22 of FIGS. 1 to 3 can be movable in the tube 28 according to a longitudinal translational movement.
[0061] The device 10 according to the invention comprises electrical connectors 32, visible in [Fig. 3], intended to be supplied with electric current via an electric generator, not visible, arranged outside the device 10.
[0062] According to the example of the invention illustrated in Figures 2 and 3, the device 10 comprises two electrical connectors 32, one connected to the injection needle 14 and the other connected to the stimulation element 22.
[0063] It is then understood that the stimulation element 22 and the injection needle 14 are electrically independent of each other.
[0064] It is further understood that, in this configuration of figures 1 to 3, one of the connectors corresponds to a positive pole and the other connector corresponds to a negative pole.
[0065] In this way, the application of an electric current to the electrodes 26 of the stimulation device 22 and to the injection needle 14 via the electrical connectors 32, makes it possible to create an electric field between the electrodes 26 and the injection needle 14.
[0066] According to a non-limiting example of the invention, the electrical connectors 32 are connected to an electrical generator, not visible, outside the endoscope, the generator being capable of emitting a pulsed type electrical current, such that the electrodes 26 and the injection needle 14 subject the tissues to a pulsed electrical field.
[0067] According to a non-limiting example of the invention, the established pulsed type voltage has a voltage value between 2000V and 3000V, measured between two electrodes.
[0068] Also, the electrical generator may be capable of imposing a direct voltage on the electrical connectors 32, such that the electrodes 26 and the injection needle 14 subject the tissues to a constant electric field.
[0069] According to a non-limiting example of the invention, the established DC voltage has a voltage between 5V and 30V, measured between two electrodes.
[0070] As seen in [Fig. 3], the electrical connectors 32 are arranged in the tube 28 such that they extend between the injection needle 14 and the stimulation element 22.
[0071] More specifically, the electrical connectors 32 extend between the base 24 of the stimulation element 22 and the injection needle 14, at its fluid connection end 18.
[0072] Thus, one of the electrical connectors 32 is electrically connected to the base 24 of the stimulation element 22 and the other electrical connector 32 is electrically connected at the fluid connection end 18 of the injection needle 14.
[0073] Thus, it is understood that the electrical connectors 32 are arranged in the device 10 such that they extend into the tube 28, in the retracted state and in the deployed state of the device 10.
[0074] According to an example of the invention, it should be considered that the electrodes of the stimulation element can be electrically independent of each other.
[0075] In such a configuration, several electrical connectors are electrically connected to the stimulation element.
[0076] A method of using the device 10 will now be described in relation to the exemplary embodiment of the device 10 of FIGS. 1 to 3.
[0077] In a first step of the method of use, visible in [Fig.l], the device 10 is in its retracted state and is arranged in the volume of the endoscope 12.
[0078] This first step corresponds for example to the introduction of the endoscope 12 equipped with the device 10 into the body of a patient up to the area of interest, for example the pancreas.
[0079] Once the endoscope 12 comprising the device 10 is positioned in the area of interest, for example opposite a pancreatic tumor, a second step visible in [Fig.4] is implemented, during which the device 10 is removed at least partly outside the volume of the endoscope 12.
[0080] During this second step, the injection needle 14 is also moved in longitudinal translation in the tube 28 so that its injection end 20 penetrates the tissue.
[0081] During this second step, the device 10 is in an intermediate state between its retracted state and its deployed state mentioned previously.
[0082] Once the injection end 20 of the injection needle 14 is inserted into the tissue, a third step is implemented during which the fluid of interest is injected into the tumor via the outlet orifice 17 and possibly the lateral injection orifice(s).
[0083] The third injection step can, for example, last five minutes.
[0084] Following the third step, a fourth step is implemented during which the stimulation element 22 is moved into the tube 28 so as to deploy the electrodes 26 outside the tube 28 in their predetermined shape, as seen in [Fig.2].
[0085] To do this, the stimulation element 22 is moved in longitudinal translation in the tube 28, towards the tissue of interest, here the tumor.
[0086] Alternatively and in relation to the embodiment of Figures 1 to 3, the stimulation element 22 is moved outside the tube 28 by a helical movement, so as to facilitate the deployment of the electrodes 26 having a shape helical, outside the tube 28.
[0087] Also, according to another example visible in [Fig.5], the deployment of the electrodes 26 outside the tube 28 according to their predetermined conical helix shape can be facilitated by the exit of the free ends 30 of the electrodes 26 outside the tube 28, prior to the implantation of said electrodes 26 in the tissue.
[0088] Once the free ends 30 of the electrodes 26 are outside the tube 28, the latter are inserted into the tissue by a rectilinear translational movement allowing their deployment.
[0089] The prior exit of the free ends 30 of the electrodes 26 outside the tube 28 makes it possible, among other things, to facilitate the passage of the electrodes 26 from their circular helix shape in the tube 28 to their conical helix shape outside the tube 28.
[0090] It is understood that at the end of the fourth step the device 10 is in its deployed state, in the tissue.
[0091] It should be considered that the fourth step can be implemented simultaneously with the second step of the method of use.
[0092] Once the device 10 is in its deployed state in the tissue, a fifth step is implemented during which an electric current is applied to the electrodes 26 and to the injection needle 14, via their respective electrical connector 32.
[0093] More precisely, a pulsed electric current is applied to the electrodes 26 and to the injection needle 14 such that the latter generate a pulsed electric field in the tissue, as mentioned previously.
[0094] In particular, the application of the pulsed electric field between the electrodes 26 of the stimulation element 22 and the injection needle 14 allows the molecules of interest contained in the fluid injected in the third step to migrate from the injection end 20 and possibly from the lateral injection orifice(s) of the injection needle 14, towards the electrodes 26.
[0095] Among other things, the application of the pulsed electric field in the tissue, here the tumor, makes it possible to create a phenomenon called reversible electroporation.
[0096] In other words, the application of the pulsed electric field makes it possible to sensitize the tissue and thus improve the diffusion of the molecules of interest throughout said tissue. This improves the effectiveness of the treatment comprising the molecules of interest on the tumor.
[0097] It is then understood that the particular shape of the electrodes 26 of the device 10 of figures 2 and 3, deployed in the form of a conical helix on the periphery of the injection needle 14, makes it possible to optimize the migration of the molecules of interest in a larger volume of the tissue.
[0098] Optionally, the method of use may comprise an intermediate step between the third step and the fifth step during which a current DC is applied through the electrical connectors 32 to the electrodes 26 and to the injection needle 14.
[0099] The application of such a direct electric current between the electrodes 26 and the injection needle 14 makes it possible to generate an iontophoresis effect in the tissue, improving the migration and diffusion of the molecules of interest in the tissue to be treated.
[0100] It is then understood that the application of the intermediate step and then of the fifth step makes it possible to optimize the impregnation of the molecules of interest contained in the injected fluid, in the tumor, thus improving the effectiveness of the action of said molecules on the tumor.
[0101] In connection with Figures 6 to 9, other predetermined shapes of electrodes 26 will be described.
[0102] It should however be considered that only the distinct characteristics of the embodiment previously described in Figures 1 to 3 will be detailed in the remainder of the description. For the common elements, it will be appropriate to refer to the description of Figures 1 to 3.
[0103] According to the embodiment of [Fig.6], the free ends 30 of the electrodes 26 are integral with the injection end 20 of the injection needle 14.
[0104] More precisely, in the retracted state of the device 10, the electrodes 26 extend longitudinally in the tube 28, along the injection needle 14 and in the deployed state of the device 10 the electrodes 26 extend outside the tube 28 while having a curved shape relative to the injection needle 14.
[0105] It is then understood that according to this exemplary embodiment of the device 10, the second step and the fourth step of the method of use are carried out simultaneously.
[0106] Furthermore, the deployment of the electrodes 26 from their deformed stressed state to their initial undeformed state is carried out by a rectilinear translational movement of the base 24 along the injection needle 14.
[0107] In order to allow the deployment of the electrodes 26 in the tissue, a harmonic electric current, advantageously at high frequency, can be applied to the electrodes 26, via the electrical connector 32, so as to cut the tissue between two electrodes 26 or facilitate the penetration of the injection needle 14.
[0108] According to another exemplary embodiment of the invention visible in [Fig.7], in the deployed state of the device 10, the electrodes 26 extend from the base 24 in a curved shape.
[0109] More precisely, the curved shape of each of the electrodes 26 is directed away from the injection needle 14 so that the radial distance separating the electrode 26 from the injection needle 14 increases as the base 24 moves away from the stimulation element 22, towards the free end 30 of the electrode 26.
[0110] Furthermore, the rods forming the electrodes 26 have a distinct extension dimension.
[0111] For example and in a non-limiting manner, a first group 26a of electrodes 26 has a first extension dimension taken between the base 24 and the free ends 30 of the electrodes 26, and a second group of electrodes 26b has a second extension dimension, strictly greater than the first extension dimension.
[0112] Furthermore, it is understood that during the method of using the device 10 according to this embodiment, during the fifth step, a longitudinal rectilinear translational movement is applied to the stimulation element 22 to extract the electrodes 26 from the tube 28.
[0113] According to an alternative of the embodiment of [Fig.7], each of the electrodes 26 is electrically independent of the other electrodes 26.
[0114] The stimulation element 22 then comprises several distinct bases 24 from which each of the electrodes 26 extends.
[0115] Each base 24 is then connected to a separate electrical connector 32.
[0116] Thus, during the fifth step of the use method, the electric current can be transmitted only to certain electrodes 26 depending on the area to be treated.
[0117] According to the embodiment of [Fig.8], the tube 28 comprises peripheral openings 36.
[0118] More precisely, a main opening 38 formed at a longitudinal end of the tube 28 and the peripheral openings 36 which extend radially around the tube 28, in the longitudinal direction L, are defined.
[0119] Thus, in the deployed state of the device 10, the injection needle 14 passes through the main opening 38 of the tube 28, while the shape memory rods forming the electrodes 26 of the stimulation element 22 pass through the peripheral openings 36 of the tube 28.
[0120] Furthermore, in this embodiment, the shape memory rods forming the electrodes 26 have a helical shape.
[0121] According to the embodiment of [Fig.9], the device comprises two stimulation elements 22.
[0122] More specifically, a first stimulation element 22b extends around the injection needle 14 and a second stimulation element 22a extends around the first stimulation element 22b.
[0123] According to this embodiment, the shape memory rods forming the electrodes 26 of each of the stimulation elements 22a, 22b have a curved shape from their base 24, directed opposite the injection needle 14.
[0124] Thus, during the fourth step of the method of using the device 10, each of the stimulation elements 22a, 22b is moved in longitudinal translation in the tube 28 so that the electrodes 26 of each of the stimulation elements 22a, 22b are offset longitudinally relative to each other.
[0125] The injection needle 14 moves in longitudinal translation through the stimulation elements 22a, 22b.
[0126] According to another example of the invention visible in [Fig.10], the device 10 comprises the two stimulation elements 22, aligned axially with respect to each other around the injection needle.
[0127] Here, each of the two stimulation elements 22 is arranged around the injection needle 14 and in such a way that the electrodes of each of the stimulation elements 22 extend opposite each other.
[0128] According to this embodiment of the invention of [Fig. 10], the device 10 comprises an intermediate sheath 40 mounted in the tube 28 in the retracted state of the device 10.
[0129] The intermediate sheath 40 is notably arranged around the two stimulation elements 22a, 22b and the injection needle 14 in the retracted state and in the deployed state of the device 10.
[0130] In particular, the stimulation elements 22 are integral with the intermediate sheath 40 such that the longitudinal translational movement of the intermediate sheath 40 in the tube 28 moves the stimulation elements 22a, 22b.
[0131] The intermediate sheath 40 comprises an axial end opening 42 from which emerges the injection end 20 of the injection needle 14 and two series of radial openings 44 from which extend the rods forming the electrodes 26 of the two stimulation elements 22a, 22b.
[0132] It is then understood that the injection needle 14 is movable in longitudinal translation through the stimulation elements 22 and the intermediate sheath 40.
[0133] Furthermore, in the retracted state of the device 10, the electrodes 22 of the stimulation elements 22a, 22b extend through the radial openings 44, in the tube 28, against an external face of the intermediate sheath 40.
[0134] In the deployed state of the device 10, the electrodes 26 extend through the radial openings 44 such that they have a curved shape from their respective base 24.
Claims
1.
2.
3.
4. Claims Device (10) for localized treatment of a tissue comprising: - an endoscopic injection needle (14) comprising a fluid flow channel and / or at least one lateral injection orifice; - at least one stimulation element (22) arranged around the injection needle (14) and comprising a base (24) from which at least two electrodes (26) extend in the form of shape memory rods; the injection needle (14) and the stimulation element (22) each being electrically connected to a separate electrical conductor (32) intended to be supplied with electric current, - a tube (28) for housing the injection needle (14) and the stimulation element (22) in a retracted state of the device (10), the electrodes (26) of the stimulation element (22) extending along the injection needle (14) within the tube (28) in the retracted state of the device (10); the injection needle (14) and the stimulation element (22) being movable in the tube (28) such that, in a deployed state of the device (10), the injection needle (14) extends at least partly outside the tube (28) and the electrodes (26) extend outside the tube (28) at the periphery and at least partly at a non-zero distance from the injection needle (14), according to a predetermined shape. Device (10) according to the preceding claim, wherein the electrodes (26) of the stimulation element (22) are electrically independent of each other. A device (10) according to any preceding claim, wherein the injection needle (14) and the stimulation element (22) move relative to the tube (28) such that the device (10) transitions from its retracted state to its deployed state at least by a rectilinear translational movement of the stimulation element (22) and the needle (14) relative to the tube (28). A device (10) according to any preceding claim, wherein the injection needle (14) and the stimulation element (22) are movable relative to the tube (28) independently of each other.
5. Device (10) according to any one of the preceding claims, wherein in the deployed state of the device (10), the electrodes (26) of the stimulation element (22) are comprised in a cylinder of revolution having a diameter less than or equal to 35mm.
6. A device (10) according to any preceding claim, wherein in the deployed state of the device (10), the electrodes (26) extend from the base (24) out of the tube (28) in a helical shape.
7. A device (10) according to any one of claims 1 to 5, wherein in the deployed state of the device (10), the electrodes (26) extend from the base (24) out of the tube (28) in a curved shape.
8. Device (10) according to any one of the preceding claims, in which a free end (30) of each of the electrodes (26) is integral with an injection end (20) of the injection needle (14).
9. A device (10) according to any preceding claim, wherein the electrodes (26) of the stimulation element (22) are integral with the base (24).
10. Device (10) according to any one of the preceding claims, comprising two stimulation elements (22) which extend around the injection needle (14) while being contained at least in part in an intermediate sheath (40), the intermediate sheath (40) being mounted in the tube (28) in the retracted state of the device (10) and being movable in translation relative to the tube (28).
11. An endoscope (12) comprising a device (10) for localized treatment of tissue according to any one of the preceding claims, the device (10) being configured such that it is capable of being in its deployed state within a solid volume.
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