Tensioning endoscopic devices and methods of use thereof

An endoscope for tissue dissection, the endoscope comprising:

• a distal cap attachable to a distal end of an endoscope having a working channel extending therethrough, the cap including lumens coextensive with the working channel, wherein the lumens include a first lumen and a second lumen that is spaced apart radially from the first lumen;
• a tensioning member disposable within the working channel and a first lumen of the lumens, and wherein the tensioning member includes:
• a distal tip including a distal end;
• and
• a rotatable actuation mechanism that is non-movably coupled to a proximal end of the distal tip and is configured to rotate relative to a longitudinal axis of the endoscope to cause the distal tip to translate longitudinally relative to at least the distal cap;
• and
• a cutting knife including a cutting tip, wherein the cutting knife is disposable within the working channel and a second lumen of the lumens.

A method of endoscopic tissue dissection, the method comprising:

• inserting an endoscope in vivo to access a target lesion in a patient, wherein the endoscope includes a working channel and a distal cap coupled to a distal end of the endoscope, and wherein the distal cap includes a plurality of a lumens that are coextensive with a working channel of the endoscope;
• distally advancing a tensioning member through the working channel and a first lumen of the plurality of lumens of the distal cap to from a first position where a distal tip of the tensioning member is not in contact with the target lesion to a second position where the distal tip of the tensioning member is in contact with the target lesion;
• distally advancing a cutting knife through the working channel and a second lumen of the plurality of lumens to from a first position where a cutting tip of the cutting knife is not in contact with the target lesion to a second position wherein the cutting tip of the cutting knife is in contact with the target lesion;
• and
• actuating the cutting tip to dissect at least a portion of target lesion while the cutting tip is in the second position and the distal tip of the tensioning member is in the second position.