Steerable endoluminal punch

An apparatus adapted for punching a hole in a body lumen or hollow organ of a mammal comprising:

• an outer tube having a proximal end, a distal end, a longitudinal axis, and a lumen extending therethrough;
• an inner tube having proximal end, a distal end, a longitudinal axis, and a lumen extending therethrough, said inner tube disposed within the distal end of the outer tube, with a portion of said inner tube projecting distally from the distal end of the outer tube;
• a first control rod and a second control rod disposed within the lumen of the outer tube,
• a plurality of laterally oriented slits extending partway into the outer tube within a bendable region but not completely transecting the outer tube;
• a connection point between the first control rod and the outer tube such that the first control rod is affixed to the outer tube on a side of the outer tube comprising the laterally oriented slits and distally to the bendable region,
• a connection point between the second control rod and the outer tube such that a distal end of the second control rod is affixed to the outer tube on a side of the outer tube opposite the laterally oriented slits and distally to the bendable region,
• a needle hub affixed to the proximal end of the inner tube, wherein said needle hub comprises an internal lumen capable of receiving a control mechanism, wherein the outer tube is longitudinally constrained relative to the needle hub;
• and
• the control mechanism is longitudinally fixed to the first control rod and the second control rod, and operable to tension the first control and the second control rod relative to the outer tube.