System with instrument port for epicardial ablation

An instrument port comprising:

• an elongated shaft having proximal and distal ends and extending along a shaft axis, the elongated shaft having a fluid port defined in an external surface at the distal end of the elongated shaft,
• wherein the elongated shaft comprises a metal tube having a pattern of slits to increase flexibility of the elongated shaft;
• a bendable shaft having a proximal end attached to the distal end of the elongated shaft along a shaft axis, the bendable shaft configured to bend only within a pivot plane that is defined by the shaft axis and a pivot axis that is orthogonal to the shaft axis;
• a steerable tip attached to a distal end of the bendable shaft, the steerable tip including:
• a camera disposed at a distal end of the steerable tip;
• and
• a light emitter disposed at the distal end of the steerable tip;
• an offset balloon offset proximally to the steerable tip along the shaft axis and attached to the external surface of the distal end of the elongated shaft, the offset balloon having an internal volume in fluid communication with the fluid port, the offset balloon having an inflated state and a deflated state, wherein the bending of the bendable shaft is independent of the inflated state and the deflated state of the offset balloon;
• a balloon restriction tube attached to the elongated shaft and positioned over a portion of the offset balloon, such that the balloon restriction tube restricts inflation of the portion of the offset balloon,
• wherein the balloon restriction tube is a horizontal cylindrical segment;
• a handle attached to the proximal end of the elongated shaft, the handle including at least one lever in mechanical communication with the bendable shaft to adjust a customizable angle of the steerable tip, the customizable angle measured between the shaft axis and a tip axis,
• wherein the customizable angle is within a range of −90° to 90°, and when the bendable shaft is in an unbent state:
• the bendable shaft extends along the shaft axis, and
• the customizable angle is 0°;
• and
• wherein, in the inflated state, the offset balloon has a height, measured with respect to a vertical axis that is orthogonal to the shaft axis, that is greater than a bend distance, measured from the distal end of the steerable tip to an external surface on the distal end of the elongated shaft, when the customizable angle is 90°;
• a fluid tube disposed in the elongated shaft, the fluid tube fluidly coupled to the fluid port;
• a working tube disposed in the elongated shaft, the working tube forming a working channel to receive a medical instrument;
• and
• an RF ablation catheter, wherein:
• an internal diameter of the working channel is greater than an external diameter of RF ablation catheter, and
• a fluid channel is defined between the internal diameter of the working channel and the external diameter of RF ablation catheter,
• wherein the fluid channel is fluidly coupled to a flush liquid source and to a vacuum source, and wherein the bendable shaft bends without affecting any of the position, shape, orientation, or behavior of the elongated shaft.