# US 11,992,180 B2 · Endoluminal device with retractor system > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,992,180 B2 - Document ID: US11992180B2 - Status: Granted - Kind: B2 - Application number: 17/669,990 - Filed: 2022-02-11 - Published: 2022-05-26 - Granted: 2024-05-28 - Earliest claimed: 2009-12-18 - Assignees: Boston Scientific Scimed, Inc. - Applicants: Boston Scientific Scimed, Inc. - Inventors: Gregory Piskun; John To; Mariel Fabro; Brian Tang; Sergey Kantsevoy - Web page: https://patentgrep.com/patent/US11992180B2 ## CPC - A61B 1/00085: {Baskets} - A61B 1/00087: {Tools (A61B17/00234 takes precedence)} - A61B 1/00089: {Hoods} - A61B 1/00098: {Deflecting means for inserted tools} - A61B 1/00154: {using guiding arrangements for insertion} - A61B 1/00183: {for variable viewing angles} - A61B 1/0125: {Endoscope within endoscope} - A61B 1/018: for receiving instruments - A61B 1/04: combined with photographic or television appliances - A61B 1/31: for the rectum, e.g. proctoscopes or sigmoidoscopes - A61B 1/32: Devices for opening or enlarging the visual field, e.g. of a tube of the body - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/0057: {Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect (sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009)} - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/08: Wound clamps {or clips, i.e. not or only partly penetrating the tissue (suture bridges A61B17/0466); Devices for bringing together the edges of a wound} - A61B 17/10: for applying or removing wound clamps {, e.g. containing only one clamp or staple (A61B17/076 takes precedence; containing multiple wound clamps A61B17/068)}; Wound clamp magazines - A61B 17/12045: {double occlusion, e.g. during anastomosis} - A61B 17/22: Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for - A61B 17/221: Gripping devices in the form of loops or baskets {for gripping calculi or similar types of obstructions (surgical snare instruments A61B17/32056)} - A61B 17/3423: {Access ports, e.g. toroid shape introducers for instruments or hands (access sites for liquids A61M39/0247)} - A61M 25/1011: {Multiple balloon catheters} - A61M 29/02: Dilators made of swellable material {(balloon catheters for angioplasty A61M25/104)} - A61B 1/00082: {Balloons} - A61B 1/0051: {with controlled bending of insertion part} - A61B 2017/00269: {endoscopic mucosal resection EMR} - A61B 2017/00296: {mounted on an endoscope} - A61B 2017/003: {Steerable} - A61B 2017/0034: {adapted to be inserted through a working channel of an endoscope} - A61B 2017/00557: {inflatable (A61B2017/22051 takes precedence)} - A61B 2017/0225: {flexible, e.g. fabrics, meshes, or membranes} - A61B 2017/12127: {Double occlusion, e.g. for creating blood-free anastomosis site} - A61B 2017/2212: {having a closed distal end, e.g. a loop} - A61B 2017/345: {for introduction into a natural body opening} - A61B 2017/3452: {for the rectum, e.g. for hemorrhoid surgery} - A61B 2217/005: with suction drainage system - A61M 2025/1052: {for temporarily occluding a vessel for isolating a sector} - A61M 2029/025: {characterised by the guiding element} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner. ## Claims ### Claim 1 An endoluminal device, comprising: a tubular member; and a chamber extending beyond a distal end of the tubular member; wherein the chamber is formed by a plurality of flexible elements comprising first and second expanding retractor elements and first and second lower retractor elements, wherein the first and second expanding retractor elements are coupled to a retractor actuator disposed on a handle portion of the endoluminal device, the retractor actuator operable to move the first and second expanding retractor elements from a collapsed insertion position to an expanded position to contact target tissue in a body lumen to create a working space around the target tissue, and wherein the first and second lower retractor elements are not coupled to the retractor actuator. ### Claim 2 (depends on 1) The endoluminal device of claim 1, wherein the plurality of flexible elements are coupled at distal ends thereof to a distal nexus. ### Claim 3 (depends on 1) The endoluminal device of claim 1, wherein the first and second expanding retractor elements extend radially outward on one side of a longitudinal axis of the tubular member when the first and second expanding retractor elements are in the expanded position. ### Claim 4 (depends on 1) The endoluminal device of claim 1, further comprising a proximal coupler disposed at a distal end of the tubular member, the proximal coupler having a plurality of lumens for receiving the first and second expanding retractor elements and the first and second lower retractor elements. ### Claim 5 (depends on 4) The endoluminal device of claim 4, wherein first and second of the plurality of lumens are configured to slidingly receive at least the first and second expanding retractor elements. ### Claim 6 (depends on 1) The endoluminal device of claim 1, further comprising a proximal coupler disposed at a distal end of the tubular member, the proximal coupler including first and second slot guides for receiving the first and second expanding retractor elements, the first and second slot guides configured to control an orientation of the first and second expanding retractor elements as the first and second expanding retractor elements move from the collapsed insertion position to the expanded position. ### Claim 7 (depends on 6) The endoluminal device of claim 6, the proximal coupler further comprising first and second ports for receiving the first and second lower retractor elements. ### Claim 8 An endoluminal device, comprising: a tubular member; a chamber disposed at a distal end of the tubular member, the chamber formed by a plurality of flexible elements comprising first and second expanding retractor elements and a lower retractor element; and a proximal coupler disposed at the distal end of the tubular member and proximal to the chamber, the proximal coupler having a plurality of lumens for receiving the first and second expanding retractor elements and the lower retractor element, wherein the first and second expanding retractor elements are coupled to a retractor actuator disposed on a handle of the endoluminal device, the retractor actuator operable to move the first and second expanding retractor elements from a collapsed insertion position to an expanded position to contact target tissue in a body lumen to create a working space to enable access to the target tissue via the chamber. ### Claim 9 (depends on 8) The endoluminal device of claim 8, wherein the first and second expanding retractor elements extend radially outward on one side of a longitudinal axis of the tubular member when the first and second expanding retractor elements are in the expanded position. ### Claim 10 (depends on 8) The endoluminal device of claim 8, wherein one or more of the plurality of lumens are first and second slot guides for receiving the first and second expanding retractor elements, the first and second slot guides configured to control an orientation of the first and second expanding retractor elements as the first and second expanding retractor elements move from the collapsed insertion position to the expanded position. ### Claim 11 (depends on 8) The endoluminal device of claim 8, further comprising a stabilizer actuator coupled to a stabilizing member, the stabilizing member configured to span the chamber to provide structural support for the first and second expanding retractor elements when the first and second expanding retractor elements are in the expanded position. ### Claim 12 An endoluminal device, comprising: a tubular member; a chamber disposed at a distal end of the tubular member, the chamber formed by a plurality of flexible elements comprising first and second expanding retractor elements and a lower retractor element; and a proximal coupler disposed at the distal end of the tubular member and proximal to the chamber, the proximal coupler having a plurality of lumens for receiving the first and second expanding retractor elements and the lower retractor element, wherein the first and second expanding retractor elements are coupled to a retractor actuator operable to move the first and second expanding retractor elements from a collapsed insertion position to an expanded position to contact target tissue in a body lumen to create a working space to enable access to the target tissue via the chamber, and wherein the retractor actuator is disposed on a handle portion of the endoluminal device. ### Claim 13 (depends on 12) The endoluminal device of claim 12, the handle portion comprising a plurality of ports for introducing a tool and an endoscope into the tubular member, the handle portion further comprising inner channels in communication with the plurality of ports, the inner channels routed axially within a body of the handle. ### Claim 14 (depends on 13) The endoluminal device of claim 13, further comprising a proximal coupler disposed at a distal end of the tubular member, the proximal coupler including a plurality of openings in communication with the inner channels of the handle, the plurality of openings configured to receive the tool and the endoscope to enable the tool and the endoscope to be introduced into the chamber. ### Claim 15 (depends on 14) The endoluminal device of claim 14, the tubular member further comprising a plurality of openings coupled to the plurality of openings in the proximal coupler. ### Claim 16 (depends on 12) The endoluminal device of claim 12, further comprising a proximal coupler disposed at a distal end of the tubular member, the proximal coupler including first and second slot guides for receiving the first and second expanding retractor elements, the first and second slot guides configured to control an orientation of the first and second expanding retractor elements as the first and second expanding retractor elements move from the collapsed insertion position to the expanded position. ### Claim 17 (depends on 12) The endoluminal device of claim 12, further comprising a stabilizer actuator coupled to a stabilizing member, the stabilizing member configured to span the chamber to provide structural support for the first and second expanding retractor elements when the first and second expanding retractor elements are in the expanded position.