Patent Description:
The present disclosure relates generally to endoscopic medical devices and related methods of use. More particularly, in some embodiments, the disclosure relates to endoscopic medical tools and methods related to accessing target sites and dispensing fluids and/or agents to the target sites.

Medical tools for dispensing fluids and/or therapeutic agents to target tissue, for example to create a protective layer to minimize bleeds using adhesives, may include a catheter with a dispensing tip. Drawbacks of endoscopic systems using such tools include, for example, clogging of the dispensing tip by the adhesives, which generally cure quickly once mixed. Such clogging can prevent further dispensing of adhesive materials. The dispensing tip or the entire endoscope device may need to be replaced, which requires removable of the device from the patient. This increases procedure time and may result in the user losing track of the treatment site when the endoscopic device is reinserted into the patient. The present disclosure may solve one or more of these problems or other problems in the art.

The scope of the disclosure, however, is defined by the attached claims and not the ability to solve a specific problem.

<CIT> discloses devices and methods for delivering sealing compound to a wound in animals, including humans. Such wound sealing is important after deep skin penetrating lacerations or subsequent to internal wounds. The apparatus utilize an aerosol dispensing system that both mixes and applies a multi-part sealant compound. The aerosol system includes a plurality of sealant component chambers, a source of pressurized gas, an aerosol mixing head, a pressure regulator, a pneumatic switch, and a component pumping mechanism. The aerosol system, either a reusable or a disposable device, is further provided with a system that keeps dry components from liquid components and then automatically mixes the liquid and dry components prior to application. The system provides for easy control over the application, inexpensive manufacture, and simplified preparation, thus minimizing the time needed for application and enhancing the potential outcomes of the patient.

<CIT> discloses an injection catheter including a drive mechanism, an elongate, flexible tubular body, and a first inner member. The tubular body has a distal end portion, a proximal end portion, and defines a first lumen extending therebetween. The first inner member includes a proximal end coupled to the drive mechanism and is rotatably disposed within the first lumen. The first inner member and the first lumen define an annular gap therebetween configured to deliver a therapeutic agent contained therein from the proximal end portion to the distal end portion of the tubular body when the first inner member is rotated within the lumen such that shear stresses exerted on the therapeutic agent are less than <NUM> pascals.

The invention is defined by appended claim <NUM>.

A medical system including a propellant source configured to contain a propellant fluid, a plurality of containers each configured to contain a material, and a shaft having a plurality of lumens, each of the plurality of lumens having a first opening at a proximal end of the shaft and a second opening at a distal end of the shaft. The plurality of lumens are fluidly coupled to one or more of the propellant source and at least one of the plurality of containers, and a first lumen of the plurality of lumens surrounds, is coaxial with, or is side-by-side with, at least one other lumen from the plurality of lumens.

The propellant source may be fluidly coupled to each of the plurality of containers and to the first lumen.

The shaft may include a tip at the distalmost end of the shaft, the tip including structure for mixing contents within the shaft.

The tip may include a distal opening, a passage connecting at least one of the plurality of lumens of the shaft to the distal opening, and an auger rotatably disposed in the passage and may be configured to move material with the passage toward the distal opening.

The material in a first container of the plurality of containers may be a first agent, and the material in a second container of the plurality of containers may be a second agent, different from the first agent.

The propellant fluid may be a gas configured to mix with the first agent in the first container and mix with the second agent in the second container, and the gas may transmit each of the first agent and the second agent through a respective lumen of the plurality of lumens.

The first agent and the second agent may be configured to contact each other to form a mixture at or adjacent to a distal opening of the shaft, and at least one of an adhesive property, a viscosity, and a therapeutic property of the mixture may be greater than the adhesive property, the viscosity, and the therapeutic property, respectively, of each of the first agent and second agent.

The gas from the first lumen may be configured to atomize the mixture.

At least one of the plurality of containers may be a syringe. The syringe may include a barrel with an inlet at a proximal end of the barrel, an outlet at a distal end of the barrel, and a chamber between the inlet and the outlet, and a piston may be configured to be inserted into the inlet and to move relative to the barrel, wherein material within the chamber may be configured to be expelled from the outlet by moving the piston toward the outlet.

Each lumen of the plurality of lumens may be fluidly isolated from the other lumens of the plurality of lumens from the first opening of each lumen to the second opening of each lumen.

The propellant source may be fluidly coupled directly to the first lumen, wherein an inlet of each of the plurality of containers may be fluidly coupled to the propellant source and an outlet of each of the plurality of containers may be fluidly coupled to a respective lumen of the plurality of lumens at the proximal end of the shaft.

The plurality of lumens fluidly coupled to the plurality of containers may share a common wall, and wherein the first lumen surrounds the plurality of lumens may be fluidly coupled to the plurality of containers.

An actuator may be coupled to an outlet of the propellant source, the first lumen, and each of the plurality of containers, wherein the actuator may be configured to control a release of the propellant fluid from the propellant source.

The actuator may be configured to individually control the release of propellant fluid to each of the first lumen and a first container and a second container of the plurality of containers, and wherein the propellant fluid may be configured to aerosolize a mixture of a first material and a second material at the distal end of the shaft.

The propellant source may be fluidly coupled directly to an inlet of a first container of the plurality of containers, and the first container may be configured to contain a liquid. The propellant source may be fluidly coupled directly to an inlet of a second container of the plurality of containers, the second container may be configured to contain a powder, the propellant fluid may be configured to transmit the liquid through the first lumen and transmit the powder through a second lumen, the second lumen may be fluidly decoupled from the first lumen, the fluid and the powder may be configured to contact each other to form a mixture at or adjacent to a distal opening of the shaft, and wherein at least one of an adhesive property, a viscosity, and a therapeutic property may be greater than the adhesive property, the viscosity, and the therapeutic property, respectively, of each of the fluid and the powder.

A medical system including a propellant source containing a propellant gas, a first container fluidly coupled to the propellant source and containing a powdered agent, a second container fluidly coupled to the propellant source and containing a fluid, and a shaft having a first lumen fluidly coupled to the first container, a second lumen fluidly coupled to the second container, and a third lumen fluidly coupled to the propellant source, wherein the propellant gas propels the powdered agent through the first lumen, and propels the fluid through the second lumen, so that the fluid mixes with the powdered agent distal to distal openings of the first and second lumens.

A first material may be flowed through a first lumen of a shaft, via a propellant fluid, a second material, different from the first material, may be flowed through a second lumen of the shaft, via the propellant fluid, wherein the first lumen may be coaxial with, side-by-side with, or surrounds the second lumen, and a mixture of the first material and the second material may be applied to tissue adjacent to a distalmost end of the shaft.

The shaft may be inserted in a natural orifice of a body, the shaft may be advanced to a target site of a gastrointestinal (GI) of the body, and the mixture may be applied to tissue at the target site.

The mixture may be configured to adhere to the tissue of the GI tract, and the material may include a therapeutic agent.

The propellant gas may be flowed through a third lumen of the shaft, surrounding the first and second lumens, wherein applying the mixture may include aerosolizing the mixture with the propellant gas at or adjacent to the distalmost end of the shaft.

The present disclosure is described with reference to exemplary medical systems and medical tools for accessing a target site and dispensing one or more agents, for example, a plurality of fluids that, once mixed, form an adhesive gel or liquid and/or regenerative agent. Such agents or fluids may minimize delayed bleeds in a patient. However, it should be noted that reference to any particular procedure and/or any particular agent is provided only for convenience and not intended to limit the disclosure. A person of ordinary skill in the art would recognize that the concepts underlying the disclosed devices and application methods may be utilized in any suitable procedure, medical or otherwise. The present disclosure may be understood with reference to the following description and the appended drawings, wherein like elements are referred to with the same reference numerals.

For ease of description, portions of the disclosed devices and/or their components are referred to as proximal and distal portions. It should be noted that the term "proximal" is intended to refer to portions closer to a user of the devices, and the term "distal" is used herein to refer to portions further away from the user. Similarly, extends "distally" indicates that a component extends in a distal direction, and extends "proximally" indicates that a component extends in a proximal direction. Further, as used herein, the terms "about," "approximately" and "substantially" indicate a range of values within +/- <NUM>% of a stated or implied value. Additionally, terms that indicate the geometric shape of a component/surface refer to exact and approximate shapes.

Referring to <FIG>, a medical system <NUM> according to an embodiment is shown. Medical system <NUM> includes a propellant fluid containment device <NUM>, a first container <NUM> and a second container <NUM> for containing first and second agents, respectively, and a catheter <NUM> (e.g., a shaft). These elements may be directly connected, or may be connected by tubes, hoses, valves, or the like, as will be described herein.

Containment device <NUM> is configured to contain a propellant fluid, such as a gas, e.g., carbon dioxide or any other gas or fluid known in the art for dispensing material, such as a medical powder or reagent, into a patient at a target location. While shown as a polygonal container, containment device <NUM> may be any shape, such as a sphere, or any other shape known in the art for containing gas. For example, containment device <NUM> may be a carbon dioxide tank or cylinder typically found in medical settings, such as a hospital, and may be connected to various components of medical system <NUM> by one or more conduits, as will be described herein. Containment device <NUM> may include one or more outer walls defining one or more inner chambers (not shown), the inner chamber(s) configured to contain the propellant fluid. The walls of containment device <NUM> may be formed of any material suitable for containing the propellant fluid, such as but not limited to a metal alloy, a ceramic, or other material known in the art. The propellant fluid contained in the inner chamber of containment device <NUM> may be under pressure. Accordingly, the walls are formed of a material and/or a thickness suitable to contain the propellant fluid at a pressure of, for example, approximately <NUM> pounds per square inch (PSI) (approx. <NUM> kPa) to approximately <NUM> PSI (approx. <NUM> kPa), but is not limited thereto. For example, gases which may be contained in containment device <NUM> include CO<NUM> or other like gases for propelling material from a medical device and into a body. It will be understood that these gases are examples and are not limiting to the types of gases contained in containment device <NUM>.

With continued reference to <FIG>, containment device <NUM> is fluidly connected to catheter <NUM> via a first conduit <NUM>, fluidly connected to first container <NUM> via a second conduit <NUM>, and fluidly connected to second container <NUM> via a third conduit <NUM>. While not shown, containment device <NUM> may include one or more actuators and valves for controlling the release of the propellant fluid to each of first conduit <NUM>, second conduit <NUM>, and third conduit <NUM>. Alternatively, or additionally, an actuation device (such as the actuation device described in <FIG>) may be used to control the release of propellant fluid from containment device <NUM>. As will be understood by one of ordinary skill in the art, modifying the amount of propellant fluid released from containment device <NUM> to each of first and second containers <NUM>, <NUM> may change the mixture ratio of the fluids, solids, or agents contained in first container <NUM> and second container <NUM>, and/or may change the discharge rate of the final mixture from catheter <NUM>, as will be explained in greater detail herein. Additionally, or alternatively, one or more pressure regulators may be associated with one or more of containment device <NUM>, first, second, and third conduits <NUM>, <NUM>, <NUM>, or first and second containers <NUM>, <NUM>. The pressure regulators may maintain an appropriate pressure of propellant gas through medical system <NUM>. It will be understood that first, second, and third conduits <NUM>, <NUM>, <NUM>, and other conduits described herein, may be any material known for transmitting materials used in a medical setting. These conduits may be rigid or flexible, according to a desired application.

As further shown in <FIG>, first container <NUM> and second container <NUM> are downstream of containment device <NUM>. First container <NUM> and second container <NUM> may have similar or different characteristics, e.g., shapes, sizes, or the like. First container <NUM> and second container <NUM> may each contain one or more agents, in the form of a fluid or a solid (including particles), which, once mixed together, are activated to have additional properties, e.g., an adhesive, to treat a target site. First container <NUM> and second container <NUM> may be formed of any material known in the art for containing therapeutic agents or other fluids or solids for delivery to the human body. For example, the materials used to form first and second containers <NUM>, <NUM> may be chemically inert to the one or more agents contained therein. In addition, first container <NUM> and second container <NUM> may be designed to withstand a pressure of propellant gas transmitted from containment device <NUM> to each of first container <NUM> and second container <NUM>. Additionally, one or more of first container and second container <NUM>, <NUM> may have fins or other protrusions within the container to aid in mixing of the propellant gas and the one or more agents to produce a uniform mixture at a downstream outlet of each of first container <NUM> and second container <NUM>. While only two containers are shown in <FIG>, it will be understood that any number of containers may be included in medical system <NUM> as appropriate, based on the number of agents, solvents, or other fluids or solids, being transmitted by catheter <NUM>.

As further shown in <FIG>, the downstream outlets of first container <NUM> and second container <NUM> are connected to catheter <NUM> by fourth conduit <NUM> and fifth conduit <NUM>, respectively. Fourth conduit <NUM> and fifth conduit <NUM> each transport a mixture of the contents of the respective container and the propellant fluid from containment device <NUM>. Each mixture enters a separate lumen at a proximalmost end 50a of catheter <NUM>, as will be described herein. As explained herein, regulators may be used to modify the pressure of the propellant fluid and/or a mixture of the propellant fluid with any of the agents described herein. For example, one or more regulators may be operably associated with the downstream outlets of one or more of the first container <NUM> or the second container <NUM> and/or one or more of the fourth conduit <NUM> and the fifth conduit <NUM>.

As will be understood, each of containment device <NUM>, first container <NUM>, and second container <NUM> may be stand-alone elements, e.g., containment tanks found in a hospital or other medical setting. Alternatively, one or more of the containers may be attached to or contained within a housing and associated with, e.g., an actuation device, such as the actuation device described in <FIG>. In this manner, medical system <NUM> may be handheld or portable.

Referring to <FIG>, a cross-section of catheter <NUM> is shown, taken along the line <NUM>-<NUM> of <FIG>. Catheter <NUM> may be a shaft (e.g., a flexible sheath, catheter, tube, or the like) and includes a second lumen <NUM> and a third lumen <NUM>, each fluidly separated from each other. A first lumen <NUM>, fluidly separated from second and third lumens <NUM>, <NUM>, is defined by an outermost wall 50b of second and third lumens <NUM>, <NUM> and an outermost wall 50a of catheter <NUM>, and surrounds second and third lumen <NUM>, <NUM>. As shown in <FIG>, second and third lumen <NUM>, <NUM> share a common wall 50c, resulting in a semicircular shaped cross-section for each of lumen <NUM> and <NUM>, but it will be understood that the invention is not limited to this example. For example, second and third lumen <NUM>, <NUM> may be independent tubes disposed within catheter <NUM>, with a space separating these independent tubes, and that space may be fluidly coupled with first lumen <NUM>. For example, second and third lumens <NUM>, <NUM> may be discrete tubes having circular or other cross-sectional shapes. While not shown, second lumen <NUM> and/or third lumen <NUM> may be attached to an outer wall of catheter <NUM> by one or more protrusions, adhesives, or other means, to maintain a proper spacing between and position of the second and third lumens <NUM>, <NUM> relative to the outer wall of catheter <NUM>. Further, any of first, second, and third lumens <NUM>, <NUM>, <NUM> may extend to distalmost end 50b of catheter <NUM>. Alternatively, one or more of first, second, or third lumen <NUM>, <NUM>, <NUM> may terminate proximal to distalmost end 50b of catheter <NUM>.

As will be explained in greater detail herein, propellant fluid from first lumen <NUM> may mix with or otherwise come into contact with the reagent and propellant fluid mixtures from second and third lumens <NUM>, <NUM>, respectively, at a distalmost end 50b of catheter <NUM> (see <FIG>). Once this occurs, the chemical properties of the mixtures may change to produce, e.g., an adhesive mixture. Additionally, or alternatively, the combined mixtures, after the fluids, reagents, etc., exit at distalmost end 50b, may activate a reagent, such as an antibacterial or other reagent, or the reagent may already be activated in one or both of the mixtures emanating from first and second containers <NUM>, <NUM>. Additional physical properties of the mixture resulting from contact/mixing after exiting from distalmost end 50b may be different from physical properties of the reagents or other fluids or mixtures exiting from first and second containers <NUM>, <NUM>. For example, the resulting mixture may be more viscous, may be an adhesive, may be a gel, and/or may activate a therapeutic agent.

A method of operation of medical system <NUM> will now be explained. Catheter <NUM> is inserted into a patient and advanced to a target site. Catheter <NUM> may be inserted directly into the patient without use of a guiding device, or catheter <NUM> may be advanced along an endoscope, guidewire, or other like device that has been previously advanced to the target site. Catheter <NUM> may be inserted through a natural orifice, like the mouth, anus, or the like, or through a surgical incision in the body. Once a distalmost tip of catheter, e.g., distalmost end 50b, is positioned at the target site, a user may actuate one or more actuators associated with containment device <NUM> and/or medical system <NUM> generally to release propellant gas from container <NUM> into one or more of first conduit <NUM>, second conduit <NUM>, and third conduit <NUM>. The one or more actuators allow the user to control the amount of propellant fluid flowing in each of first, second, and third lumen <NUM>, <NUM>, and <NUM>, and thereby control the dispersal rate of the reagents or other fluids or solids in first and second containers <NUM>, <NUM>. The propellant gas enters first and second containers <NUM>, <NUM> and mixes with the reagents, fluids, or solids therein. According to an example, a first mixture of a first reagent and the propellant gas travels from first container <NUM> to second lumen <NUM> via fourth conduit <NUM>. Similarly, a second mixture of a second reagent and the propellant gas may travel from second container <NUM> to third lumen <NUM> via fifth conduit <NUM>.

The first mixture and the second mixture subsequently exit second lumen <NUM> and third lumen <NUM>, respectively, at distal end 50b of catheter <NUM>. The first mixture and the second mixture mix with and, in some embodiments, may be atomized by propellant fluid from first lumen <NUM>. According to an example, mixing the first and the second mixtures after exiting distalmost end 50b may cause this resulting mixture to be activated or crosslinked, e.g., to create a gel or liquid adhesive, which may adhere to the target site, and/or may activate one or more therapeutic in the resulting mixture. As the mixture is dispersed from distal end 50b of catheter <NUM>, catheter <NUM> may be moved relative the target site to deposit the resulting mixture to the target site. In this manner, the first mixture and the second mixture have no contact within catheter <NUM>, thereby preventing the mixture from becoming an adhesive within catheter <NUM> and preventing the adhesive from curing within and full or partially blocking the outlet of catheter <NUM> at distal end 50b.

It will be understood that first container <NUM> and second container <NUM> may be eliminated from system <NUM> if catheter <NUM> is preloaded with the agent, fluid, or solid that is otherwise in first and second containers <NUM>, <NUM>. For example, second lumen <NUM> and third lumen <NUM> may be preloaded with different agents. According to an example, containment device <NUM> may be directly connected to catheter <NUM> without any intervening containers. In this example, containment device <NUM> may provide propellant gas directly to first, second, and third lumens <NUM>, <NUM>, <NUM>, forcing the first and second agents down respective second and third lumens <NUM>, <NUM> and, for example, atomizing the mixture of the first and second agents at distalmost end 50b of catheter <NUM> with propellant gas from first lumen <NUM>. This may reduce the size of medical system <NUM> and allow for greater portability, and may provide a more even and/or complete distribution of the agent at the target site. Alternatively, or additionally, first and second containers <NUM>, <NUM> may be attached to respective second and third lumens <NUM>, <NUM> if a user determines that additional first and second agents are necessary to be dispersed to the target site. According to an example, each element of system <NUM> may be screw fit, snap fit, or the like to other elements to enable quick, efficient, and safe addition or removal of elements. In this way, containment device <NUM> may be disconnected from second and third lumens <NUM>, <NUM>, and first and second containers <NUM>, <NUM> may be interposed between containment device <NUM> and respective second and third lumens <NUM>, <NUM>.

A catheter tip <NUM> according to an embodiment is shown in <FIG>. Catheter tip <NUM> may include an auger <NUM> for moving and/or mixing one or more of the first mixture and the second mixture toward an outlet <NUM> (or a plurality of outlets) at distalmost end <NUM>. Catheter tip <NUM> may include a tapered portion <NUM> which tapers toward distalmost end <NUM>. Catheter tip <NUM> may be integrally formed with catheter <NUM> or may be attached to distalmost end 50b of catheter <NUM> by, e.g., an adhesive, a snap-fit connection, or the like. Catheter tip <NUM> may be permanently fixed to, or may be removably attached to, catheter <NUM>. Catheter tip <NUM> may dispense the mixture of agents with or without atomization of the agents. For example, auger <NUM> may move the combined first mixture and second mixture from each of second lumen <NUM> and third lumen <NUM> at the distalmost end 50b of catheter <NUM> toward distalmost end <NUM>, and the combined mixture may be dispensed to the target site without atomizing the combined mixture. Alternatively, the combined mixture may be moved toward distalmost end <NUM> of catheter tip <NUM>, and propellant gas from first lumen <NUM> may atomize and propel the combined mixture from catheter <NUM> (via catheter tip <NUM>) toward the target site.

As shown in <FIG>, auger <NUM> may include a single helical thread, where the diameter and/or pitch of the thread decreases at tapered portion <NUM> of catheter tip <NUM>, which may increase the precision of the distribution of the agent from catheter tip <NUM> to the target site. Auger <NUM> is not limited to a single thread, nor is auger <NUM> limited to a thread size and/or pitch. Additionally, auger <NUM> may include protrusions or thread surfaces that cause agents therein to be mixed during dispersal. Auger <NUM> may be driven by any way known, including but not limited to electrical or pneumatic driving.

Referring to <FIG>, a medical system <NUM> according to another example is illustrated. Containment device <NUM>, first conduit <NUM>, and catheter <NUM> have similar features as those devices in medical system <NUM> of <FIG>. According to an example, a first syringe <NUM> contains a first fluid, agent, or other material in a first chamber 130a, and a second syringe <NUM> contains a second fluid, agent, or other material in a second chamber 140a. First and second syringes <NUM>, <NUM> may be any known syringes used in medical systems, including a piston for forcing material from respective first and second chambers 130a, 140a out of a distalmost end of a body, or barrel, of the syringe. First and second chambers 130a, 140a of respective first and second syringes <NUM>, <NUM> may be filed with materials, e.g., agents, therapeutic agents, or the like, by removing the pistons, adding the material, and reinserting the pistons. Alternatively, or additionally, first and second syringes <NUM>, <NUM> may be filled through a distalmost end thereof by creating a vacuum in first and second chambers 130a, 140a by pulling the pistons proximally.

Actuation of syringe <NUM> by, for example, forcing the plunger into the body/barrel, causes the first agent in first chamber 130a to flow through a second conduit <NUM> to second lumen <NUM>. Similarly, actuation of syringe <NUM> causes the second agent in second chamber 140a to flow through a third conduit <NUM> to third lumen <NUM>. First syringe <NUM> and second syringe <NUM> may be individually or simultaneously activated. Further, first and second syringes <NUM>, <NUM> may be actuated by a user, e.g., pushing with a hand or finger, on a proximalmost end of the plunger of first and second syringes <NUM>, <NUM>. Alternatively, or additionally, first and second syringes <NUM>, <NUM> may be actuated pneumatically or using a mechanical or electrical device for depressing the pistons of each of first and second syringes <NUM>, <NUM>. For example, the pistons of each of first and second syringes <NUM>, <NUM> may be connected to a device having a motor, e.g., an electrically driven motor, that may separately or simultaneously actuate the pistons of each of the first and second syringes <NUM>, <NUM>. The device may further include a processor and a memory having a program stored thereon that may control the motor to actuate the first and second syringes <NUM>, <NUM>.

First and second agents of medical system <NUM> may be dispersed from distal end 50b of catheter <NUM> by, e.g., atomizing a mixture of first and second agents using propellant gas. For example, as discussed above, first lumen <NUM> may be arranged about second and third lumens <NUM>, <NUM> and may receive propellant gas from containment device <NUM> via first conduit <NUM>. The propellant gas may force a combined mixture of first and second agents from distalmost end 50b of catheter <NUM>. Alternatively, the mixing catheter tip <NUM> of <FIG> may be used to dispense a combined mixture of first and second agents, as described herein.

Referring to <FIG>, another example of a medical system <NUM> is shown. Medical system <NUM> includes similar features of medical system <NUM> of <FIG>. As shown in <FIG>, containment device <NUM> is attached to an actuation mechanism <NUM> via first conduit <NUM>. Actuation mechanism <NUM> may be a console, trigger mechanism, or the like, having one or more actuation elements for fluidly coupling containment device <NUM> to elements downstream of actuation mechanism <NUM>, such as first and second containers <NUM>, <NUM>. Actuation mechanism <NUM> is connected to first lumen <NUM> via a second conduit <NUM>, connected to first container <NUM> via third conduit <NUM>, and connected to second container <NUM> via fourth conduit <NUM>. Actuation mechanism <NUM> may include a valve, discrete fluid passages, and/or other actuation devices for controlling the release of fluid to each of conduits <NUM>, <NUM>, and <NUM>. Actuation mechanism <NUM> allows a user to control the amount of propellant fluid released to each of first lumen <NUM>, first container <NUM>, and second container <NUM>. Controlling the propellant fluid allows the user to control the amount of first and second agents released from distalmost end 50b of catheter <NUM> and the rate at which the propellant gas is released from first lumen <NUM> at distalmost end 50b. Actuation mechanism <NUM> may additionally include a processor and a memory having one or more programs stored thereon that may automatically actuate actuation mechanism <NUM> to disperse propellant fluid from containment device <NUM>.

A medical system <NUM> according to another embodiment is shown in <FIG>. Medical system <NUM> includes containment device <NUM> fluidly coupled to a first container <NUM> and a second container <NUM> via first and second conduits <NUM>, <NUM> respectively. First container <NUM> may include a fluid, such as saline, but is not limited thereto. Second container <NUM> may include one or more agents, e.g., a powdered agent or mixture of powdered agents, which may be activated once contacted by a fluid, such as saline, or any other medically suitable fluid, which is stored in first container <NUM>.

First container <NUM> is fluidly coupled to a proximalmost end 350a of catheter <NUM> via a third conduit <NUM>. Second container <NUM> is similarly fluidly coupled to proximalmost end 350a of catheter <NUM> via a fourth conduit <NUM>. Both first lumen and second lumen <NUM>, <NUM> extend from proximalmost end 350a of catheter <NUM> to a distalmost end 350b, but one or both of first and second lumen <NUM>, <NUM> may terminate proximally of distalmost end 350b. It will be understood that the arrangement is not limited, and first container <NUM> may be fluidly coupled to second lumen <NUM>, while second lumen may be fluidly coupled to first lumen <NUM>.

With reference to <FIG>, a cross-section of catheter <NUM> taken along the line <NUM>-<NUM> in <FIG> is shown. First lumen <NUM> is coaxially arranged with second lumen <NUM>, and first lumen <NUM> is defined by an outermost wall 350b of second lumen <NUM> and an outermost wall <NUM> a of catheter <NUM>. As discussed herein, a mixture of fluid and propellant gas from first container <NUM> may be transmitted along first lumen <NUM>, and one or more agents from second container <NUM> may be transmitted along second lumen <NUM> by the propellant gas. Alternatively, the one or more agents from second container <NUM> may be transmitted along first lumen <NUM> and the propellant gas and fluid mixture may be transmitted along second lumen <NUM>. In both configurations, the propellant gas and fluid mixture may atomize the one or more agents at distalmost end 350b of catheter <NUM>. This interaction may support mixing of the powdered agent(s), causing the one or more agents to be crosslinked or activated and to be propelled toward a treatment site. This also minimizes cloud formation during the application of the powdered agent(s) during application to the target site. While only one lumen, second lumen <NUM>, is shown for transferring the powdered agent(s), the invention is not limited, and multiple containers and/or lumens may be used. Additionally, the powdered agent(s) may be urged down a lumen of the catheter in any manner described herein.

While different medical systems have been described, it will be understood that the particular arrangements of elements in these medical systems are not limited. Moreover, a size and a shape of the catheter or shaft of the medical system, or the dispersal method of the medical system, are not limited. As described in examples herein, agents, such as fluids or powders, are dispersed from a distal end of a catheter, where the agent(s) interact with each other or an additional substance to change one or more physical properties thereof. In this manner, a therapeutic agent, such as an adhesive to limit bleeds, may be applied endoscopically without clogging lumens, passages, inlets, or outlets of the medical system.

Claim 1:
A medical system, comprising:
a propellant source (<NUM>) configured to contain a propellant fluid;
a plurality of containers (<NUM>, <NUM>) each configured to contain a material; and
a shaft (<NUM>) having a plurality of is lumens (<NUM>, <NUM>, <NUM>), each of the plurality of lumens having a first opening at a proximal end (50a) of the shaft and a second opening at a distal end (50b) of the shaft,
wherein the plurality of lumens are fluidly coupled to one or more of the propellant source and at least one of the plurality of containers, and
wherein a first lumen of the plurality of lumens surrounds, is coaxial with, or is side-by-side with, at least one other lumen from the plurality of lumens;
wherein the shaft includes a tip (<NUM>) at a distalmost end of the shaft
wherein the tip includes a distal opening (<NUM>), and a passage connecting at least one of the plurality of lumens of the shaft to the distal opening, characterised in that the tip comprises an auger (<NUM>) rotatably disposed in the passage, the auger being configured to move material within the passage toward the distal opening.