Access and tissue modification systems and methods

A method for guiding at least a portion of a surgical device to a desired position in a patient's body, the method comprising:

• advancing a sharp distal end of a guidewire into the patient's body, and out of the body, while maintaining a proximal end of the guidewire outside the body, wherein the sharp distal end cuts through tissues of the patient's body;
• coupling the proximal end of the guidewire with at least one coupling member on or near a distal end of a first surgical device outside of the body by inserting the guidewire into a channel at or near the distal end of the first surgical device;
• pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position adjacent to the target tissue;
• withdrawing the surgical device and distal end of the guidewire proximally from the patient while maintaining the guidewire within the body and de-coupling the proximal end of the guidewire from the surgical device;
• coupling the proximal end of the guidewire with at least one coupling member on or near a distal end of a second surgical device outside of the body;
• pulling the distal end of the guidewire to guide at least a portion of an abrasive surface of the second surgical device to a desired position adjacent to the target tissue.

A method for performing a procedure on a target tissue in a patient's body, the method comprising:

• coupling a proximal end of a guidewire with a coupling member on or near a distal end of a first surgical device outside of the body by inserting the proximal end of the guidewire into or near the distal end of the first surgical device;
• pulling a distal end of the guidewire to guide at least a portion of the first surgical device to a desired position in the patient's body;
• performing a procedure on the target tissue by reciprocating the surgical device by applying tension to both a portion of the guidewire outside of the body and a proximal portion of the surgical device;
• withdrawing the surgical device and proximal end of the guidewire from the patient leaving the guidewire within the patient;
• de-coupling the proximal end of the guidewire from the surgical device, and coupling the proximal end of the guidewire on or near a distal end of a second surgical device outside of the body;
• and
• pulling a distal end of the guidewire to guide at least a portion of the second surgical device to a desired position in the patient's body, such that an abrasive portion of the second surgical device faces the target tissue.