Method and apparatus for performing biopsy

A method of obtaining a tissue specimen from a patient during endoscopic surgery, comprising:

• providing an access device having a proximal end, distal end and an elongate body extending therebetween, the access device comprising a first channel providing a first lumen for the insertion of an instrument, endoscope or other visualization device, the first lumen having a substantially fixed cross-sectional area;
• at least one secondary channel providing a secondary lumen for the insertion of an instrument, endoscope or other visualization device, said secondary channel being mounted on the access device so as to be positioned along an outer surface thereof, said secondary channel being constructed at least in part by a flexible wall, the secondary lumen having an internal cross-sectional area that is movable from a first, reduced area to a second, enlarged area;
• and a transverse aperture formed through a wall beyond the distal end of the first channel;
• percutaneously advancing the access device into the patient while the secondary lumen is in the first, reduced cross-sectional area configuration in order to minimize patient discomfort;
• enlarging the diameter of the secondary lumen from the first, reduced cross-sectional area to the second, enlarged cross-sectional area to provide percutaneous access to said tissue specimen by way of the secondary lumen;
• and
• removing said tissue specimen from the patient.

A surgical access device for obtaining tissue during endoscopic surgery, said surgical access device having a proximal end, a distal end and an elongate body extending therebetween, said surgical access device also having an outer surface defining at any particular location along its longitudinal axis, a cross-sectional profile, said surgical access device comprising:

• a first channel providing a first lumen for the insertion of an instrument, endoscope or other visualization device;
• an open-loop member at a distal end of said first channel, said open-loop member having an aperture formed therethrough;
• and
• at least one secondary channel providing a secondary lumen for the insertion of an instrument, endoscope or other visualization device, said secondary channel being mounted on said surgical access device so as to be positioned along said outer surface thereof, said secondary channel being constructed from a thin pleated membrane which, prior to dilation of said secondary channel, so closely conforms to said outer surface so as to only negligibly increase the size of said profile of said surgical access device;
• wherein said distal end of said surgical access device is curved and said secondary channel extends along a generally convex side of said first channel, and said secondary channel is in fluid communication with said aperture formed through said open-loop member.

A method of obtaining a tissue specimen from a patient during endoscopic surgery, comprising:

• providing an access device having a proximal end, distal end and an elongate body extending therebetween, the access device comprising a first channel providing a first lumen for the insertion of an instrument, endoscope or other visualization device, the first lumen having a substantially fixed cross-sectional area, the access device also comprising at least one secondary channel providing a secondary lumen for the insertion of an instrument, endoscope or other visualization device, said secondary channel being mounted on the access device so as to be positioned along an outer surface thereof, said secondary channel being constructed at least in part by a substantially inelastic flexible wall, the secondary lumen having an internal cross-sectional area that is movable from a first, reduced area to a second, enlarged area;
• percutaneously advancing the access device into the patient while the secondary lumen is in the first, reduced cross-sectional area configuration in order to minimize patient discomfort;
• enlarging the diameter of the secondary lumen from the first, reduced cross-sectional area to the second, enlarged cross-sectional area to provide percutaneous access to said tissue specimen by way of the secondary lumen;
• and
• removing said tissue specimen from the patient;
• wherein the access device further comprises an open-loop member at a distal end of said first channel, said open-loop member having an aperture formed therethrough, wherein the removing said tissue step comprises manipulating the open-loop member to excise said tissue specimen.

A surgical access device for obtaining tissue during endoscopic surgery, said surgical access device having an outer surface defining at any particular location along its longitudinal axis, a cross-sectional profile, said device comprising:

• a tubular wall providing a first lumen for the insertion of an instrument, endoscope or other visualization device, said tubular wall having a proximal end, a distal end and a distal extension on the distal end;
• at least one collapsible secondary wall providing a secondary lumen for the insertion of an instrument, endoscope or other visualization device, said secondary wall mounted on an outer surface of the tubular wall;
• and
• a traverse aperture formed through the distal extension on the tubular wall .