Systems and methods for dissection tool

Abstract

To provide systems and devices for a fluid powered endoscopic dissection tool.SOLUTION: A medical device 102 is provided, including a body 108 that has a proximal end 110 with a proximal opening to interface with a fluid delivery device. The body defines a channel from the proximal opening to a distal opening 109 configured to emit a fluid jet 118 along a longitudinal axis of the body. The body further includes a distal wall surface that has a surface extending in a direction transverse to the longitudinal axis and faces the distal opening to receive the fluid jet. The body also defines a space between the distal wall surface and the distal opening. The distal wall includes a protrusion configured to engage tissue.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present disclosure generally relates to medical devices including endoscopic devices for tissue resection. In particular, embodiments of the present disclosure relate to systems and devices for fluid-driven endoscopic dissection tools.

Background Art

[0002] Tumor resection and other tissue treatments are often performed by medical devices (e.g., endoscopic devices) by supplying radio frequency (RF) energy to destroy tissue. In the case of malignant tumor resection, it may be desirable to preserve tissue structure in order to confirm an accurate diagnosis and to confirm complete removal and treatment of the tissue. Since tissue structure can be destroyed during RF energy supply, the medical confirmation of successful tissue resection may be delayed or incomplete. For example, the destroyed tissue structure may delay or inhibit proper biopsy and classification of the treated tissue. Also, RF energy supply devices may cause postoperative complications and tissue artifacts, for example, as a result of delayed tissue effects. Accordingly, there is a need for a fast, accurate, and precise method with minimal associated tissue damage.

Summary of the Invention

[0003] According to an example, a medical device is provided. The medical device includes a body having a proximal end with a proximal opening. The body defines a channel from the proximal opening to a distal opening configured to emit a fluid jet along the longitudinal axis of the body. The body has a surface extending in a direction transverse to the longitudinal axis and further includes a distal wall surface facing the distal opening for receiving the fluid jet. The body defines a space between the distal wall surface and the distal opening. The distal wall includes a protrusion configured to engage tissue.

[0004] In another exemplary embodiment, the medical device comprises a tubular member having a proximal end and a distal end that can be coupled to a fluid source. The medical device has a fluid channel disposed within the tubular member and is configured to supply fluid from the proximal end of the tubular member, through the tubular member, to the distal end. The medical device has a nozzle located at the distal end of the tubular member. The nozzle is configured to emit a fluid jet along a longitudinal axis. The distal wall has a surface extending in a direction transverse to the longitudinal axis and faces the nozzle to receive the fluid jet. The wall includes protrusions configured to engage tissue. The medical device defines a space between the nozzle and the distal wall.

[0005] In another embodiment, a method of treating tissue is provided. The method includes positioning a medical device in proximity to tissue of interest, engaging the tissue of interest with a protrusion of the medical device to hold the medical device in a position proximate to the tissue of interest, and emitting fluid along a longitudinal axis from a distal opening of the medical device to a distal wall surface of the medical device. The fluid penetrates the tissue of interest.

[0006] In some exemplary embodiments, the distal opening emits a fluid jet at a pressure that penetrates tissue. The pressure of the fluid jet can be 1723.69 kilopascals (250 pounds per square inch) or less, and the distal opening can have a diameter of about 1 millimeter or less. The proximal opening has a diameter larger than the diameter of the distal opening. The channel is tapered from the distal opening to the proximal opening in cross-sectional size, and the protrusions include one or more sharp tips for engaging tissue.

[0007] In an additional embodiment, the body further comprises a valve and a spring, the valve is fixedly coupled to the spring, disposed proximate to the spring, and positioned between the proximal and distal openings of the tubular member. The body may be conductive to supply radio frequency (RF) energy to tissue. The RF energy supplied to the body conducts to the distal wall surface. The body comprises a bottom surface for defining a region that engages tissue, disposed along a longitudinal axis between the proximal opening and the distal wall surface. The medical device also comprises a flexible tube coupled to the proximal end of the body. The flexible tube has a channel for supplying fluid to the body. The flexible tube includes a conductive tube, wire, cable, or blade for supplying radio frequency (RF) energy to the body.

[0008] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention as claimed. As used herein, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. The term "exemplary" is used in the sense of "example" rather than "ideal." As used herein, the term "proximal" means in a direction closer to the operator and the term "distal" means in a direction farther from the operator. Although endoscopy is referenced herein, such reference should not be construed as limiting the possible applications of the disclosed tool. For example, the disclosed tool may be used in procedures such as bronchoscopy, ureteroscopy, colonoscopy, or other procedures within the body.

[0009] The accompanying drawings, which are incorporated herein and constitute a part of this specification, illustrate examples of the disclosure and, together with the description, serve to explain the principles of the disclosure.

Brief Description of the Drawings

[0010]

Figure 1

Figure 2A

Figure 2B

Figure 3

Figure 4A

Figure 4B

Figure 4C

Figure 5

Figure 6

Modes for Carrying Out the Invention

[0011] Tissue dissection, and in particular tissue / tumor resection and removal, can benefit from medical devices that implement fast, accurate, and precise methods with minimal associated tissue damage. Such medical devices can be more effective and advantageous than, for example, medical devices that supply only radio frequency (RF) energy to perform tissue resection, by preserving tissue structure for medical diagnosis confirmation and for effective tissue treatment. In some embodiments, fluid can be supplied to perform tissue dissection techniques (e.g., submucosal dissection). The fluid-driven system can be configured to effectively dissect or excise tissue with high precision and low heat generation. Also, the fluid-driven resection system may be combined with an RF energy supply technique or other energy supply technique to provide a coagulation and hemostasis function during the tissue resection period. In one example, the fluid-driven tissue resection technique can lead to a reduction in blood loss during a surgical procedure, and hypothermia helps to preserve tissue and vascular structures. The resection depth can also be controlled by applying variable fluid pressure. Accordingly, aspects of the present disclosure are directed to medical devices having a fluid-driven tissue resection system.

[0012] Reference is now made to FIG. 1. FIG. 1 shows an exemplary medical device 102. The medical device 102 can be an endoscopic medical device such as a catheter used, for example, to perform a tissue resection method (e.g., submucosal dissection). The medical device 102 has a tubular member 104 with a proximal end (not shown) and a distal end 106. The tubular member 104 can be any known or contemplated tubular member used for medical procedures such as endoscopy, for example, a flexible tube-like member having one or more channels or lumens disposed therein and extending between the proximal end and the distal end 106 of the tubular member 104 for medical operations. In one example, the tubular member 104 is a catheter, and the catheter can be of a solid type, a slot type, a blade type, an injection molding type, or a reflow type. As shown in FIGS. 1 and 2A, at least the distal portion of the tubular member 104 has slots, for example, to add flexibility to the tubular member 104. The portion having the slots can extend to a portion without slots at the distal end 106 that couples to a body 108 described below. In one example, the tubular member can be an extrusion device. The medical device 102 also has a handle (not shown) connected to the proximal end of the tubular member 104. The operator can use the handle to perform the operations of the medical device 102, including the operations described by the examples herein. The handle can be any known or contemplated handle used for medical procedures and can include appropriate ports and plugs for fluid and / or energy supply. Also, the medical device 102 has a fluid supply mechanism (not shown) located at the proximal end of the tubular member 104. The fluid supply mechanism can be part of the handle or not part of the handle and enables fluid to flow from the proximal end of the tubular member 104, through one or more internal channels or lumens, to the distal end 106 and ultimately to the body 108 to perform the fluid-driven tissue resection technique described herein. In one example, the fluid supply mechanism can include a fluid source disposed at the proximal end of the tubular member 104, for example, within the handle.In another example, the fluid supply mechanism may be a mechanism for driving fluid from a remote fluid source through a tubular member 104 (e.g., a pump).

[0013] The medical device 102 also includes a body 108 disposed at the distal end 106 of the tubular member 104. The body 108 has a proximal end 110 and a distal end 112. In one example, the proximal end 110 of the body 108 is configured to interface / engage with the distal end 106 of the tubular member 104 in a state having a boundary therewith. For example, the body 108 may be inserted into a fitting component at the distal end 106 of the tubular member 104. It should be recognized that any internal working channels and / or lumens can be aligned with the body 108 and the tubular member 104. In other examples, the body 108 may be integrally formed with the tubular member 104 (e.g., by being joined to the tubular member 104, or being attached or mounted in other ways) and permanently fixed to the tubular member 104. The body 108 has a proximal opening (not shown in FIG. 1) and a distal opening 109.

[0014] FIG. 1 also shows a tissue boundary 114. The tissue boundary 114 can be any tissue layer within the human body. FIG. 1 also shows a target tissue at reference numeral 116. In one example, the target tissue 116 can be a tumor located within the gastrointestinal (GI) endothelium, but it should be recognized that the target tissue 116 can be any tissue in the human body. The techniques described herein enable the treatment of the target tissue 116, for example, by providing a fluid-driven tissue resection method. FIG. 1 shows the distal end 112 of the body 108 embedded under the tissue boundary 114. The reference numeral 118 indicates the direction in which fluid can be supplied at a sufficiently high pressure to pierce the tissue boundary 114 and the tissue region 120 where treatment is being applied. Ultimately, the medical device 102 is used to excise the target tissue 116. These systems and methods are described in more detail herein.

[0015] Reference is now made to FIG. 2A, which shows the body 108 at the distal end 106 of the tubular member 104 according to one exemplary embodiment. As described above, the body 108 is configured to connect in a boundary - having state with the tubular member 104, for example, by being inserted into an opening (not shown in FIG. 1) at the distal end 106 of the tubular member 104. The body 108 has a proximal opening (not shown in FIG. 1) and a distal opening 109 as shown in FIG. 1. An intermediate fluid channel (not shown in FIG. 1) is formed in the body 108 between the proximal opening of the body 108 and the distal opening 109 of the body 108, as described herein. In one example, it should be recognized that the intermediate fluid channel is aligned with at least one channel or lumen of the tubular member 104 (e.g., a catheter). FIG. 2A shows a fluid jet 210 radiating along an axis (e.g., the longitudinal axis) from the distal opening 109 of the body 108. FIG. 2A also shows the direction of fluid flow along the axis at reference numeral 211. The proximal opening of the body 108 is configured to connect in a boundary - having state with a fluid supply device (e.g., the fluid supply mechanism described in connection with FIG. 1) inside and / or outside the medical device 102 and to receive fluid from the fluid supply device. The distal opening 109 of the body 108 is configured to radiate the fluid supplied from the fluid supply device. An intermediate fluid channel (not shown in FIG. 2A) is formed in the body 108 between the proximal opening of the body 108 and the distal opening 109 of the body 108, as described herein. In one example, the fluid supply device can be a fluid lumen or channel disposed within the tubular member 104 of the medical device 102 such that fluid (e.g., water or saline) is supplied from a source at the proximal end of the medical device 102 to the proximal opening of the body 108 for discharge through the distal opening 109 of the body 108. In this example, the body 108 is configured to supply the fluid jet 210 when the fluid is radiated from the fluid supply device.

[0016] The fluid jet 210 can be a fluid jet of water, saline, or other liquid supplied at a fluid pressure sufficient for tissue resection. For example, the fluid jet 210 can be emitted through the distal opening 109 of the body 108 at a fluid pressure of up to 60 bar (「bar」), or up to about 5998.44 kPa (870 pounds per square inch (psi)). In one embodiment, when the diameter of the distal opening 109 of the body 108 is 1 millimeter (mm), the fluid jet 210 is emitted at a fluid pressure of 1723.69 kPa (250 psi) or less. It should be recognized that the appropriate fluid pressure can vary depending on system parameters and device parameters including, but not limited to, the tissue type, the fluid used for the fluid jet 210, the diameter of the distal opening 109 of the body 108, etc. In one example, the diameter of the distal opening 109 varies based on the channel of the tubular member 104 and the desired size of the intended area of tissue impact of the fluid jet 210. For example, a fluid pressure between about 20 and 60 bar may be used for tissue resection. For example, a relatively low pressure provides a cleaner and more precise tissue perforation or tissue penetration, minimizing the risk. In one example, when the distal opening 109 has a diameter of about 0.1016 centimeters (0.04 inches), a fluid pressure of less than about 1723.69 kPa (about 250 psi) may be sufficient to perforate tissue (e.g., muscle tissue, diseased tissue, or other types of tissue to be treated by the medical device 102). When the distal opening 109 has a diameter of about 0.127 centimeters (about 0.05 inches), a fluid pressure of less than about 689.476 kPa (about 100 psi) may be sufficient to perforate tissue. Since the mucosal and submucosal layers of the GI tract can be tougher than muscle, a higher fluid pressure may be desirable for tissue resection of the mucosal and / or submucosal layers, as opposed to the fluid pressure for muscle tissue. In one example, a fluid pressure of about 4136.85 kPa (about 600 psi) can penetrate mucosal tissue and / or submucosal tissue. The fluid pressure can also vary based on the type of distal opening 109 (e.g., the internal shape and geometric shape of the distal opening 109).In one example, the distal opening 109 may be chamfered to disperse pressure or may be inwardly conical / tapered (tapered in the proximal-to-distal direction) to concentrate a fluid stream (e.g., fluid jet 210).

[0017] FIG. 2A also shows the outer surface of the distal wall 220. The distal wall 220 extends in a direction transverse to the longitudinal axis along which the fluid jet 210 is emitted. Referring to FIG. 2B, which shows a view of the body 108 according to an exemplary embodiment, the proximal-facing inner surface of the distal wall 220 is shown at reference numeral 220a. The inner surface 220a faces the distal opening 109 of the body 108. When fluid is supplied through the body 108, the fluid jet 210 is emitted from the distal opening 109 of the body 108 and the fluid jet 210 is received at the inner surface 220a of the distal wall 220. FIG. 2B also shows the distal wall 220 having a protrusion 230 at the upper end thereof and extending in a direction transverse to the longitudinal axis along which the fluid jet 210 is emitted. The protrusion 230 may be a relatively sharp tip of the distal wall 220 that points in a radially outward direction. The protrusion 230 is configured to engage tissue (e.g., pierce the tissue surface and / or be disposed on the tissue surface). For example, the protrusion 230 engages the tissue boundary 114 described in relation to FIG. 1 to guide or attach the body 108 to an area proximate to the tissue of interest (e.g., target tissue 116) for the final execution of the fluid-driven tissue resection method described herein. In one example, the protrusion 230 is a hook or hook-like feature configured to engage and attach to tissue. The protrusion 230 may include one or more tips or prongs.

[0018] There is a desire to minimize or reduce unintentional tissue penetration when the fluid jet 210 is emitted at a fluid pressure high enough to excise tissue. In one example, an unmitigated fluid flow without a barrier to block the fluid jet 210 can rapidly penetrate an organ / tissue where tissue treatment is not intended. The protrusion 230 can prevent or limit unintentional tissue penetration by blocking the tissue acquired by the protrusion 230 from being passed through by the fluid flow. The protrusion 230 provides a solid surface (e.g., the inner surface 220a of the distal wall 220) against which the fluid jet 210 impinges, and the solid surface can dissipate the force of the fluid jet 210. When the fluid jet 210 impinges on the solid surface, the fluid can "rebound". To reduce or prevent unintentional tissue penetration due to the rebounding of the fluid, the rebounding of the fluid can be at a sufficiently low energy so as not to cause damage to the surrounding healthy tissue (and, for example, to avoid obstructing the camera view of the operation). Thus, the protrusion 230 can be shaped to minimize the rebounding fluid energy when the fluid jet 210 impinges on the protrusion 230. For example, the solid surface (e.g., the inner surface 220(a) of the distal wall 220) may be flat, convex, or concave with respect to the flow of the fluid jet 210. In general, the contours of the distal wall 220 and the protrusion 230 can be optimized in terms of the distance, shape, material, and thickness from the distal opening 109 to safely direct the rebounding. Referring again to FIG. 2A, this dissipation is shown at reference numeral 240, and the fluid dissipates along the edges and sides of the body 108 and the distal wall 220, causing minimal or no unintentional tissue penetration.

[0019] FIG. 2B also shows the bed region (“bed”) 250 of the body 108. The bed 250 is, in one example, a surface disposed along the longitudinal axis between the distal opening 109 of the body 108 and the distal wall 220 of the body 108. The bed 250 may define a space in the body 108 for receiving tissue between the distal opening 109 and the distal wall 220. In one example, the bed 250 is a surface that connects the inner surface 220a of the distal wall 220 to the side surface of the body 108 having the distal opening 109 of the body 108. The bed 250 may be used during a medical procedure to remove excised tissue from the patient's body. For example, after the target tissue 116 has been treated by a fluid-driven excision method, the body 108 may be manipulated such that the target tissue 116 is disposed on the bed 250 and removed from the patient's body when the medical device 102 is removed. To assist in holding the excised tissue during the period of capturing the excised tissue and retracting the medical device 102 from the patient, the surface of the bed 250 may be treated with an adhesive coating or otherwise such that the excised tissue adheres to the surface of the bed 250.

[0020] Reference is now made to FIG. 3, which shows a cross-sectional view of the medical device 102. FIG. 3 shows a cross-sectional view of the body 108 and the distal end of the tubular member 104 of the medical device 102. FIG. 3 shows an intermediate fluid channel 330 within the body 108 and a primary fluid channel 340 within the tubular member 104. As described in connection with FIG. 2A, the intermediate fluid channel 330 is formed between a proximal opening in the body 108 and the distal opening 109 of the body 108. In FIG. 3, the fluid within the primary fluid channel 340 flows into the intermediate fluid channel 330 through a proximal opening of the body 108 (not shown in FIG. 3) as indicated by arrow 350. In other words, the proximal opening of the body 108 connects in a state having a boundary with the distal opening of the primary fluid channel 340, whereby the fluid can flow between the primary fluid channel 340 and the intermediate fluid channel 330. The intermediate fluid channel 330 is tapered from its proximal end to its distal end. In other words, the cross-sectional area and / or diameter of the intermediate fluid channel 330 decreases from its proximal end towards its distal end. As a result, as the fluid flows distally through the intermediate fluid channel 330 (shown at arrow 360), the fluid pressure increases. Thus, the fluid flows at a higher pressure towards the distal end of the intermediate fluid channel 330 when compared to the fluid flow at the proximal end of the intermediate fluid channel 330 and when compared to the fluid flow within the primary fluid channel 340. As a result, when the fluid jet 210 exits the intermediate fluid channel 330 at the distal opening 109 of the body 108, the fluid jet 210 is ejected at a higher fluid pressure compared to the fluid pressure of the primary fluid channel 340. In this example, the distal opening 109 of the body 108 operates as a nozzle for ejecting the fluid jet 210 at a high relative fluid pressure. As described herein, the fluid pressure of the fluid jet 210 is high enough to perform a tissue resection operation. As shown by the dissipation of water at reference 240, the recoil is limited.

[0021] Here, FIGS. 4A - 4C are referred to, and FIGS. 4A - 4C show cross - sectional views of another embodiment of the medical device 102’. FIG. 4A shows a tubular member 410, a distal end structure 420, and a body 425. The tubular member 410 may have the structure and function of the tubular member 104, and the body 425 may have the structure and function of the body 108. The distal end structure 420 may have the structure and function of the distal end 106. The distal end structure 420 further includes a valve 450 and a spring 460. In the example illustrated in FIG. 4A, fluid may be supplied to the distal end of the medical device 102’. At the distal end, after the fluid passes through the tubular member 410 and enters the intermediate fluid channel shown at 430, the intermediate fluid channel 430 holds the fluid as the intermediate fluid channel 430 narrows.

[0022] The valve 450 is located in the distal portion of the intermediate fluid channel 430, distal to the constriction 435 of the intermediate fluid channel 430. The constriction 435 has a smaller diameter and / or cross - sectional area compared to the portion of the channel 430 distal to the constriction 435 and the portion of the channel 430 proximal to the constriction 435. The valve 450 is not fixed to the intermediate fluid channel 430 and can thus translate longitudinally within the channel 430, for example, along the direction indicated by the arrow 405. The spring 460 is also located in the distal portion of the intermediate fluid channel 430, distal to the valve 450. The spring 460 is attached to the valve 450 at the proximal end of the spring 460.

[0023] The spring 460 and the valve 450 are disposed between the proximal opening of the intermediate fluid channel 430, shown at reference 462, and the proximal end of the body 425. In one example, the body 425 is joined to the distal end structure 420, whereby the spring 460 is attached to the surface of the body 425 at the distal end of the spring 460. In one example, the spring 460 is a coil spring that is compressible upon application of pressure (e.g., upon application of fluid pressure along the direction 405 to the valve 450). In one example, the valve 450 is a one - way valve that allows fluid to exit the intermediate fluid channel 430 in a single direction.

[0024] Reference is now made to FIGS. 4B and 4C. FIG. 4B shows the closed state configuration of valve 450. In FIG. 4B, arrows 470a - 470c represent the fluid flowing into intermediate fluid channel 430. The fluid pressure increases at arrow 470c as intermediate fluid channel 430 narrows towards valve 450. In FIG. 4B, the valve is closed, and thus, the fluid does not exit intermediate fluid channel 430. FIG. 4C shows the open state configuration of valve 450. In FIG. 4C, when the fluid reaches a sufficient pressure (e.g., a threshold pressure), the proximal force applied by spring 460 to valve 450 is overcome, and the pressure biases valve 450 in the distal direction (e.g., along direction 405) towards spring 460, thus compressing spring 460 in the distal direction. When the distal movement begins, the shape of valve 450 results in a larger area of valve 450 being exposed to the fluid flow, quickly opening valve 450. Thus, when spring 460 is in a compressed state (e.g., when valve 450 and spring 460 have moved distally beyond a threshold distance due to the threshold pressure), the fluid can flow around the valve as shown by arrows 472a - 472d and into the discharge channel shown at reference 480. Discharge channel 480 can extend from proximal opening 462 to distal end structure 420, whereby the fluid can flow towards body 425, for example, in the direction of arrows 472a - 472d. The fluid leaves discharge channel 480 and flows towards a protrusion (e.g., protrusion 230). As the fluid pressure in intermediate fluid channel 430 decreases (e.g., when the fluid supplied to device 102' decreases), the proximal pressure of spring 460 on valve 450 can become greater than the fluid pressure applied to valve 450, and valve 450 can retreat to the closed state shown in FIG. 4B (e.g., advance in the proximal direction).

[0025] In one example, the fluid is emitted from the intermediate fluid channel 430 at a constant pressure or a relatively constant pressure. Thus, the mechanism described in FIGS. 4A-4C enables the fluid to be emitted from the discharge channel 480 at a constant pressure or a substantially constant pressure, which avoids scenarios where the fluid pressure gradually increases during the fluid discharge period from the intermediate fluid channel 430 and the distal opening 462. In some examples, it is advantageous for the fluid to be emitted from the discharge channel 480 at a substantially constant pressure to avoid pressure increases or unintended tissue damage during the next best tissue resection period.

[0026] Reference is now made to FIG. 5. FIG. 5 shows a cross-sectional view of yet another embodiment of a medical device at 500. Generally, device 500 is configured for fluid-driven tissue dissection and for supplying RF energy to tissue. FIG. 5 shows a cross-sectional view of tubular member 520 and body 530. Tubular member 520 and body 530 can each have any of the structure and function of tubular members 104, 420, and bodies 108, 410. Medical device 500 is advantageous for endoscopic procedures for providing a coagulation function by RF supply in addition to a tissue resection function performed by a fluid-driven system. Body 530 can be joined or otherwise attached to tubular member 520. Body 530 is made of metal or other conductive material. Body 530 is configured to conduct RF energy. For example, RF energy may be supplied to body 530 via a conductive tube, wire, cable, or blade of medical device 500. The conductive tube is shown by reference numeral 540 in an enlarged view of the junction between body 530 and tubular member 520. Conductive tube 540 can be surrounded by insulating materials shown by reference numerals 550 (inner insulator) and 560 (outer insulator). Thus, conductive tube 540 forms a conductive path for transmitting RF energy to body 530 and ultimately to distal wall 535 for coagulating tissue during a medical operation. Thus, the RF active component of body 530 includes distal wall 535. Thus, in one example, distal wall 535 can operate as a contact point to tissue for supplying RF energy for coagulation.

[0027] Here, reference is made to FIG. 6, which shows an exemplary flowchart 600 illustrating operations for performing a fluid-driven tissue resection technique as described herein. In operation 610, a resection device is positioned proximate to the tissue of interest. The resection device may be any of the medical devices 102, 102', 500 described herein. In operation 620, the tissue of interest is engaged with a protrusion of the resection device to hold the resection device at a location within the tissue of interest. In operation 630, fluid is radiated along the longitudinal axis from a distal opening of the resection device toward a distal wall surface of the resection device. The fluid resected the tissue of interest.

[0028] Other embodiments of the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. The specification and examples are intended to be considered as exemplary only, with the true scope and spirit of the invention being indicated by the following claims.

[0029] It should be understood that one or more of any aspects of the medical devices described herein may be used in combination with any other medical devices known in the art, such as medical imaging systems or other scopes, such as colonoscopes, bronchoscopes, ureteroscopes, duodenoscopes, or other types of imaging devices.

[0030] It should also be understood that one or more aspects of any of the medical devices described herein may be used to excise, cut, or otherwise dissect tissue in any part of the human body. For example, any of the medical devices described herein may be used in a medical procedure where tissue removal and / or detection is required.

[0031] Although the principles of the present disclosure are described herein with reference to illustrative examples for particular applications, it should be understood that the present disclosure is not limited thereto. Those having ordinary skill in the art and access to the teachings provided herein will recognize that all additional modifications, applications, and substitutions of equivalents fall within the scope of the examples described herein. Accordingly, the invention should not be considered as limited by the foregoing description.

Claims

1. 1. A medical device comprising: a body having a proximal end with a proximal opening, the body defining a channel from the proximal opening to a distal opening, the channel configured to emit a fluid jet along a longitudinal axis of the body; Equipped with The medical device, wherein the body has a surface extending transverse to the longitudinal axis, and further includes a distal wall surface facing the distal opening to receive the fluid jet, the body defining a space between the distal wall surface and the distal opening, the distal wall including a protrusion configured to engage tissue.

2. The medical device of claim 1 , wherein the distal opening emits the fluid jet at a pressure that perforates the tissue.

3. 3. The medical device of claim 2, wherein the pressure is less than or equal to 250 pounds per square inch.

4. The medical device of claim 1 , wherein the distal opening has a diameter of about 1 millimeter or less.

5. The medical device of claim 1 , wherein the proximal opening has a diameter greater than a diameter of the distal opening.

6. The medical device of claim 1 or 5, wherein the channel tapers in cross-sectional size from the distal opening to the proximal opening.

7. The medical device of claim 1 , wherein the prongs include one or more sharp tips for engaging the tissue.

8. 8. The medical device of claim 1 , wherein the body further comprises a valve and a spring configured to receive fluid at the proximal opening and maintain the fluid within the body until a pressure of the fluid exceeds a predetermined threshold.

9. 9. The medical device of claim 1 or 8, wherein the valve is fixedly coupled to the spring, the valve and the spring being disposed between the proximal opening and the distal opening, the valve being adjacent to the spring.

10. 10. The medical device of claim 1, 8 or 9, wherein the valve is a one-way valve and the spring is a coil spring having a distal end fixed within the body.

11. The medical device of claim 1 , wherein the body is an electrical medical device for delivering radio frequency (RF) energy to the tissue.

12. The medical device of claim 1 or 11, wherein the RF energy supplied to the body is conducted to the distal wall surface.

13. 13. The medical device of claim 1, wherein the body further comprises a bottom surface disposed along the longitudinal axis between the proximal opening and the distal wall surface for defining a tissue engaging region.

14. 14. The medical device of claim 1, further comprising a flexible tube coupled to the proximal end of the body, the flexible tube including a channel for supplying a fluid to the body.

15. 15. The medical device of claim 1 or 14, wherein the flexible tube comprises an electrically conductive tube, wire, cable, or braid for delivery of radio frequency (RF) energy to the body.

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