Patent Description:
This disclosure generally relates to medical systems, devices, and related methods that may be used to treat a subject. The methods do not form part of the invention as claimed. Aspects of the disclosure relate to medical systems, devices, and methods for endoscopic medical procedures, such as applying negative pressure to tissue for wound treatment.

Endoscopic and open surgical procedures of the gastrointestinal (Gl) tract include, for example, colonic resection, bariatric surgery, esophagectomy, gastric bypass, and sleeve gastrectomy, among others. These procedures may result in perforation, post-surgical leaks, or other wounds of the tract. Limited treatment options exist for managing such wounds, which have significant morbidity and mortality rates. Options include surgical re-operation and endoscopic placement of a stent or clips. Surgery is relatively invasive and also has high morbidity and mortality rates. Endoscopic stent placement is a less invasive option. The placed stent, however, can migrate from the intended location and/or wall off infection at the treatment site, inhibiting drainage.

The systems, devices, and methods of this disclosure may rectify some of the deficiencies described above or address other aspects of the art. Examples of prior art documents are disclosed in <CIT> and <CIT>.

Examples of the disclosure relate to, among other things, systems, devices, and methods for performing one or more medical procedures with the medical systems and devices. Each of the examples disclosed herein may include one or more of the features described in connection with any of the other disclosed examples.

According to the invention as claimed, a medical system comprises a delivery tube configured to couple to a vacuum source and provide negative pressure to a distal portion of the delivery tube; and a porous body at a distal portion of the delivery tube, the porous body including a first section and a second section removable from the first section.

In other aspects of the disclosure, the medical system may include one or more of the features below. The second section may extend circumferentially around a radially-outermost surface of the first section, and the radially-outermost surface may be radially-outermost from a central longitudinal axis of the porous body. According to the invention as claimed, the system further comprises a string coupled to the second section and extending from the porous body to a proximal portion of the delivery tube. The porous body may further comprise a third section extending circumferentially around a radially-outermost surface of the second section, and the radially-outermost surface of the second section may be radially-outermost from a central longitudinal axis of the porous body. The system may further comprise a first string coupled to the second section and extending from the porous body to a proximal portion of the delivery tube; and a second string coupled to the third section and extending from the porous body to the proximal portion of the delivery tube. The delivery tube may be coupled to a vacuum source, the porous body may be cylindrical, and a central longitudinal axis of the porous body may be longitudinally aligned with a central longitudinal axis of the delivery tube. The system may further comprise a flexible overtube coupled to the second section, and the delivery tube may extend through a lumen of the flexible overtube.

In other aspects of the disclosure, the medical system may include one or more of the features below. The first section may be cylindrical and the second section may wrap around the first section. The first section and the second section may be separated by perforations. The first section may be cylindrical and may include a central longitudinal axis; the second section may extend circumferentially around a radially-outermost surface of the first section, the radially-outermost surface may be radially-outermost from the central longitudinal axis of the first section; and the second section may be cylindrical and include a lumen extending through the central longitudinal axis configured to receive the first section. A layer of mesh, adhesive, or agent may be positioned between the first section and the second section. The system may further comprise a cylindrical overtube extending around the delivery tube and the porous body, and the overtube may be configured to cover the porous body and the delivery tube. The system may further comprise a string coupled to the second section and the third section, the string may extend from the sponge to a proximal portion of the delivery tube, and wherein the string includes: a first portion coupled to the second section and the third section, wherein the first portion has a length longer than a length of the delivery tube; and a second portion coupled to the third section and extending proximally to the proximal portion of delivery tube. The first section, the second section, and the third section may be concentric and may have different thicknesses measured orthogonal to a central longitudinal axis of the porous body. The first string may be a different color than the second string.

In another aspect, a medical device may comprise a porous body including at least one perforation; a negative pressure conduit having an opening formed therein that is in fluid communication with the porous body, wherein the negative pressure conduit is configured to apply a negative pressure to the porous body; and a string coupled to the porous body and extending from the porous body to a proximal portion of the conduit. The porous body may be configured to separate into separate sections when the string is pulled proximally.

In other aspects of the disclosure, the device may include one or more of the features below. The at least one perforation may extend longitudinally along the porous body. The conduit may be longitudinally aligned with a central cylindrical section of the porous body, and the at least one perforation may extend parallel to a longitudinal axis of the central section. The at least one perforation may include a first perforation and a second perforation; and the first perforation may be closer to a central longitudinal axis of the porous body than the second perforation.

In another aspect, a method (not claimed) of performing a medical procedure may comprise: positioning a porous body adjacent to tissue of a target site; applying a negative pressure to the porous body; and pulling a string coupled to the porous body proximally to remove a first section of the porous body while a second section of the porous body remains positioned at the target site.

It may be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of this disclosure, as claimed.

The terms "proximal" and "distal" are used herein to refer to the relative positions of the components of an exemplary medical system and exemplary medical devices. When used herein, "proximal" refers to a position relatively closer to the exterior of the body or closer to a medical professional using the medical system or medical device. In contrast, "distal" refers to a position relatively further away from the medical professional using the medical system or medical device, or closer to the interior of the body. Proximal and distal directions are labeled with arrows marked "P" and "D", respectively, throughout the figures. As used herein, the terms "comprises," "comprising," "having," "including," or other variations thereof, are intended to cover a non-exclusive inclusion, such that a system, device, or method that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent thereto. Unless stated otherwise, the term "exemplary" is used in the sense of "example" rather than "ideal. " As used herein, the terms "about," "substantially," and "approximately," indicate a range of values within +/- <NUM>% of a stated value.

Endoluminal vacuum therapy (EVAC) has been proposed. In EVAC, negative pressure is delivered to the wound site in the GI tract, for example through a nasogastric tube having a sponge at its terminal end. The sponge is placed endoscopically into the perforation, leak, or other wound. Negative pressure then is applied. Devices and systems suited for EVAC are limited, however.

Embodiments of this disclosure include devices, systems, and methods for endoluminal vacuum therapy (EVAC). In examples, EVAC includes endoluminal placement of a sponge or other like material into the wound site, including a perforation, cyst, a leak, an anastomosis, etc. Placement of the material may be via a catheter, scope (endoscope, bronchoscope, colonoscope, gastroscope, duodenoscope, etc.), tube, or sheath, inserted into the GI tract via a natural orifice. The orifice can be, for example, the nose, mouth, or anus, and the placement can be in any portion of the GI tract, including the esophagus, stomach, duodenum, large intestine, or small intestine. Placement also can be in other organs reachable via the GI tract.

Reference will now be made in detail to examples of this disclosure described above and illustrated in the accompanying drawings.

<FIG> illustrates a perspective view of an exemplary medical device <NUM> including a sponge <NUM>, that may be used to help the healing of an internal wound, anastomosis, or the like, in a subject. Sponge <NUM> may be substantially cylindrical and may be attachable, e.g., coupled, to a vacuum tube <NUM>. A central longitudinal axis A of sponge <NUM> may be aligned with a central longitudinal axis (also shown as axis A in <FIG>) of vacuum tube <NUM>. Sponge <NUM> may be sized in accordance with a patient's anatomy and may include a lumen or recess (not shown) to receive vacuum tube <NUM>. The recess may be in a proximal end of sponge <NUM>. In some examples, sponge <NUM> may include a curved, radially-outermost surface <NUM>. Sponge <NUM> may be flexible and configured to move through tortuous pathways of body lumens of a patient.

Sponge <NUM> may include a plurality of concentric sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>. Each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be separate from each other section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>. A central section <NUM> may be shaped as a cylinder and may be directly coupled to vacuum tube <NUM>. For example, section <NUM> may have a lesser length than sections <NUM>, <NUM>, <NUM>, and <NUM>, to accommodate a distal portion of tube <NUM> within sponge <NUM>. Each of the other sections <NUM>, <NUM>, <NUM>, <NUM> may extend circumferentially around the central section <NUM> forming concentric, ring-like cylindrical sections <NUM>, <NUM>, <NUM>, <NUM> that are nested within one another. In some examples, each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM> of sponge <NUM> may be a different distance from central longitudinal axis A, and each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may extend longitudinally in the direction of central longitudinal axis A. In some examples, sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may have the same thickness measured in a direction perpendicular to longitudinal axis A, and sections <NUM>, <NUM>, <NUM>, <NUM> may have the same length measured parallel to longitudinal axis A. In other examples, sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may have different thicknesses and/or may have different lengths. In some examples, sponge <NUM> may include five sections (shown in <FIG>), and in other examples, sponge <NUM> may include <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, or any other suitable number of sections. Each section <NUM>, <NUM>, <NUM>, <NUM> may contact the radially-outer surface from longitudinal axis A of the adjacent section <NUM>, <NUM>, <NUM>, <NUM>, respectively.

Sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be configured to move relative to each other such that a section <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be moved in the proximal-distal direction relative to the other sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM> with no or minimal movement of the other sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>. In some examples, a layer of mesh, adhesive, or agent may be positioned between each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM> and the adjacent section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, which may facilitate removal of each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>. In other examples, any other suitable material, capable of coupling adjacent sections together yet permitting them to release from one another upon a suitable force, may be used between adjacent sections. Such materials can include a suitable adhesive layer sandwiched between adjacent sections. In some examples, a medicament may be layered/sandwiched between adjacent sections and may be configured to release from sponge <NUM> when the radially-outer layer from the longitudinal axis of sponge <NUM> is removed and exposes the layer of medicament. In some examples, sponge <NUM> may be sized to fill a wound region <NUM> with a radius of between approximately <NUM> and <NUM>, and/or a wound region <NUM> with a depth of between approximately <NUM> and <NUM>.

In embodiments of this disclosure, sponge <NUM> may be any suitable biocompatible material that may absorb liquids and/or permit liquid to pass therethrough via negative pressure. The material may be flexible, compressible, porous, hydrophilic, sterile, biodegradable, and/or disposable. The sponge material may be an open-cell foam having pores and channels therein. Suitable materials include polyurethanes, esters, ethers, composite materials, and any medical-grade material.

A string or suture <NUM> may be coupled to sponge <NUM> and may extend from sponge <NUM> proximally to a proximal portion of medical device <NUM>. String <NUM> may be coupled to each section <NUM>, <NUM>, <NUM>, <NUM> except central section <NUM>. A length of string <NUM> longer than the length (measured longitudinally) of medical device <NUM> may be between each point at which string <NUM> is coupled to each section <NUM>, <NUM>, <NUM>, <NUM>, which may allow each section <NUM>, <NUM>, <NUM>, <NUM> to be pulled proximally the entire length of medical device <NUM> without pulling any other section <NUM>, <NUM>, <NUM>, <NUM>. The length of string <NUM> between each point of string <NUM> that is coupled to each section <NUM>, <NUM>, <NUM>, <NUM> may be sandwiched between adjacent sections <NUM>, <NUM>, <NUM>, <NUM>. For example, string <NUM> may be coupled to section <NUM>, then coupled to section <NUM>, then coupled to section <NUM>, and then coupled to section <NUM>; and the length of string between each point at which string <NUM> is coupled to each section may be positioned between sections (such as wound around a section, etc.). This additional length of string <NUM> between each section <NUM>, <NUM>, <NUM>, <NUM> is configured to allow the user to pull section <NUM> proximally out of a patient's body without removing the rest of sections <NUM>, <NUM>, <NUM>, <NUM>; and then proceed to pull the next radially-outermost section (in this case, section <NUM>) proximally out of a patient's body without moving the rest of sections <NUM>, <NUM>, <NUM>; and so forth.

In some examples, medical device <NUM> may include a single, separate string coupled to each section <NUM>, <NUM>, <NUM>, <NUM>; and thus four strings <NUM> would extend proximally from sponge <NUM>. In some examples, medical device <NUM> may include a single string <NUM> coupled to each section <NUM>, <NUM>, <NUM>, <NUM>, and each of the strings <NUM> may be a different color so the user removing the layers (sections <NUM>, <NUM>, <NUM>, <NUM>) of sponge <NUM> may identify which layer is being removed. In other examples, string <NUM> may be replaced with a wire, a tether, or an extrusion. In some examples, string <NUM> may be replaced with a series of concentric tubes extending from sponge <NUM> to a proximal portion of medical device <NUM>, with each tube coupled to a single section <NUM>, <NUM>, <NUM>, <NUM>. In this example, the tubes would be flexible and configured to move through a patient's body.

Vacuum tube <NUM> may be cylindrical with a central lumen (not shown) extending along central longitudinal axis A of vacuum tube <NUM>. Vacuum tube <NUM> may have a length and width configured to extend through a working channel of an endoscope or other medical delivery device, and may be flexible. In some examples, vacuum tube <NUM> may include one or more holes at a distal portion of vacuum tube <NUM>, including portions within sponge <NUM>. Vacuum tube <NUM> may be coupled to a vacuum source <NUM> at a proximal portion of vacuum tube <NUM>. Vacuum source <NUM> may supply negative air pressure to vacuum tube <NUM>. Vacuum tube <NUM> may be coupled to at least central section <NUM> of sponge <NUM>, and may supply negative air pressure to sponge <NUM>. In some examples, vacuum tube <NUM> may extend through central portion <NUM> of sponge <NUM>. Vacuum tube <NUM> may be received within a recess of a proximal portion of sponge <NUM>, and in some examples vacuum tube <NUM> may be coupled to sponge <NUM> via an adhesive, a suture, a thread, and/or other attachment means.

In some examples, medical device <NUM> may include an overtube (not shown) which may extend over vacuum tube <NUM> and sponge <NUM>. The overtube may compress sponge <NUM> such that the radially-outermost surface from longitudinal axis A of sponge <NUM> is smaller than when sponge <NUM> is positioned outside of the overtube. An overtube may facilitate movement of medical device <NUM> through a working channel of an endoscope or other medical device. In addition, an overtube may prevent unwanted contact of sponge <NUM> with tissue of the patient.

<FIG> shows a perspective view of a distal portion of an alternative embodiment of a medical device <NUM>. Medical device <NUM> may have any of the features described hereinabove with regard to medical device <NUM>. Medical device <NUM> may include a vacuum tube <NUM> and a sponge <NUM>, and may be coupled to a vacuum source <NUM> at a proximal portion of medical device <NUM>. In the same manner described hereinabove with regard to sponge <NUM>, sponge <NUM> includes concentric, cylindrical sections <NUM>, <NUM>, <NUM>. At least central section <NUM> is directly coupled to vacuum tube <NUM>, section <NUM> is coupled to a first string <NUM>, and section <NUM> is coupled to a second string <NUM>. Each of first string <NUM> and second string <NUM> may extend from sponge <NUM> to a proximal portion of medical device, and may be configured to be moved proximally to remove a section <NUM>, <NUM> of sponge <NUM> from a body of a patient. In some examples (shown in <FIG>), strings <NUM>, <NUM> may be coupled to each of sections <NUM>, <NUM>, respectively, at a proximal portion of each section <NUM>, <NUM>. Strings <NUM>, <NUM> may extend proximally outside of vacuum tube <NUM>.

<FIG> shows a perspective view of a distal portion of another embodiment of a medical device <NUM>. Medical device <NUM> may have any of the features described hereinabove with regard to medical devices <NUM>, <NUM>. Medical device <NUM> may include a vacuum tube <NUM>, a sponge <NUM>, and a string <NUM>. Vacuum tube <NUM> may be coupled to a vacuum source <NUM> at a proximal portion of vacuum tube <NUM>. Sponge <NUM> may include several sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, and the sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be coiled around central section <NUM>. Each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be wrapped around the section or sections adjacent to it and/or radially inward of it, and sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may form a spiral about a central longitudinal axis of sponge <NUM>. In some examples, a single, rectangular sponge may be perforated to divide the sponge into sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, and then the rectangular sponge may be rolled around a central section (such as section <NUM> in <FIG>) to form sponge <NUM>. String <NUM> may be coupled to each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, with portions of string that are the length of medical device <NUM> between each point of coupling string <NUM> to each respective section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>.

Adjacent sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be separated by perforations <NUM>, <NUM>, <NUM>, <NUM>, <NUM>. Perforations <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be configured to allow sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> to separate from each other when a user pulls string <NUM> proximally. For example, when a user first pulls string <NUM> proximally, section <NUM> may be pulled proximally and perforation <NUM> may allow section <NUM> to separate from section <NUM> without moving or minimally moving section <NUM> or any other section. The user may then continue to pull string <NUM> proximally to separate section <NUM> from section <NUM>, then separate section <NUM> from section <NUM>, etc. In other examples, individual strings <NUM> may be coupled to each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> such that a user needs to pull one string to remove section <NUM>, then a second string to remove section <NUM>, etc. In some examples (not shown), central section <NUM> may be a separate sponge from sponge <NUM>. Perforations <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may extend longitudinally, substantially parallel to axis A. In other examples, perforations <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be replaced by a thinner region or otherwise weakened region between each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, permitting release of adjacent sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> upon application of a suitable force. Each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may be any suitable size. In some examples, each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may extend <NUM>° circumferentially around a central longitudinal axis of vacuum tube <NUM>. In other examples, each section <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> may extend less than <NUM>° circumferentially around the axis, like section <NUM> shown in <FIG>. Perforations <NUM>, <NUM> may provide a means for a user to select the size of sponge <NUM> prior to insertion of sponge <NUM> into a body of a patient. Also, a layer of mesh, adhesive, agent, or other material can be used between adjacent sections <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, as described hereinabove.

Reference will now be made in detail to methods of operating medical devices <NUM>, <NUM>, <NUM>. Although <FIG> show the operation of medical device <NUM>, any of the medical devices <NUM>, <NUM>, <NUM> may operate by the same method described herein below with regard to medical device <NUM>.

<FIG> show side views of medical device <NUM> in use within a body lumen <NUM> of a patient (e.g. a portion of the gastrointestinal tract) to treat a wound region <NUM>. To position medical device <NUM> at a wound region <NUM> within a body of a patient, a user may insert an endoscope (or other medical device) into the patient and locate wound region <NUM> by visualizing the wound region <NUM> using an image sensor (not shown) at a distal end of the endoscope. Once the endoscope is positioned proximate to wound region <NUM>, the user may insert medical device <NUM> into a working channel of the endoscope and move medical device <NUM> distally through the working channel. In other examples, medical device <NUM> may be positioned within a working channel proximate to the distal end of the endoscope prior to inserting the endoscope into the body of the patient. In some examples, an overtube may be positioned between medical device <NUM> and a working channel, and the overtube may prevent excessive bending, twisting, or other shape distortion of medical device <NUM> within the working channel while the user moves medical device <NUM> distally through the working channel. In other examples, a user may not use an endoscope and may insert medical device <NUM> into the body of the patient directly and not within a working channel of a separate medical device.

With a distal portion of the endoscope positioned proximate to wound region <NUM>, the user may move medical device <NUM> distally out of the working channel and position sponge <NUM> within wound region <NUM>. The flexibility, compressibility, and shape of sponge <NUM>, and the flexibility of vacuum tube <NUM> may facilitate maneuvering medical device <NUM> within wound region <NUM>. In some examples, sponge <NUM> may bend, twist, and/or change shape to conform to the shape of wound region <NUM>. The user may then activate vacuum source <NUM> to supply negative pressure to sponge <NUM> through vacuum tube <NUM>, which may pull portions of wound region <NUM> towards sponge <NUM>. Once medical device <NUM> is positioned within wound region <NUM> and vacuum pressure is supplied to sponge <NUM>, the user may then leave sponge <NUM> and vacuum tube <NUM> positioned within the body of the patient for approximately <NUM>-<NUM> hours. The negative pressure applied to sponge <NUM> may also remove fluid and other material from the wound region <NUM>. In other examples, sponge <NUM> may be left within the patient's body for any other period of time. Vacuum tube <NUM> may remain within the body of the patient during treatment, and may extend out of the patient to vacuum source <NUM> through the patient's rectum, mouth, nose, other bodily orifice, or other opening in the patient's body such as an incision, etc. In some examples, an overtube may also remain within the patient's body during treatment and may cover a portion of sponge <NUM> outside of the wound region <NUM>.

As wound region <NUM> heals, wound region <NUM> may shrink and become smaller. When a user would like to remove a section of sponge <NUM> (such as after <NUM>-<NUM> hours has passed since the initial positioning of sponge <NUM> within wound region), the user may first disconnect vacuum tube <NUM> from vacuum source <NUM> and supply saline <NUM> to vacuum tube <NUM> in order to deliver saline <NUM> to wound region <NUM>. <FIG> illustrates saline <NUM> deployed within wound region <NUM>. Although saline <NUM> is shown in <FIG>, any suitable liquid known in the art may be used to fill wound region <NUM> to facilitate removal of portions of sponge <NUM>. Saline <NUM> may facilitate release of sponge <NUM> from the walls of wound region <NUM>. Once saline <NUM> is deployed, a user may position a rigid tool <NUM> within the patient such that a distal end of rigid tool <NUM> is contacting section <NUM> of sponge <NUM>. Rigid tool <NUM> may prevent proximal movement of section <NUM> when the user pulls section <NUM> proximally. Rigid tool <NUM> may be a metal wire, tube, rod, or any other suitable relatively rigid member.

After filling wound region <NUM> with saline <NUM> and positioning rigid tool <NUM> abutting section <NUM>, the user may then pull string <NUM> proximally to pull section <NUM> proximally and remove section <NUM> from wound region <NUM>. <FIG> shows section <NUM> being pulled proximally out of wound region <NUM>, and rigid tool <NUM> contacting section <NUM> to prevent proximal movement of section <NUM>. Although <FIG> shows the use of rigid tool <NUM>, a user may just pull string <NUM> proximally to remove section <NUM> without the aid of a rigid tool <NUM>. After section <NUM> has been removed from the patient's body, the user may then reconnect and activate vacuum source <NUM> to supply negative pressure to sponge <NUM>, and tissue of wound region <NUM> may be pulled towards section <NUM> (shown in <FIG>). This may allow sponge <NUM> to consume less space within wound region <NUM> and may also allow wound region <NUM> to continue to decrease in size as wound region <NUM> heals. The user may repeat these steps until central section <NUM> is fully exposed to wound region <NUM>, and then the user may fully remove medical device <NUM> from the patient once treatment is complete. Note central section <NUM> may be removed from the patient's body by pulling vacuum tube <NUM> proximally.

When treating tissue with any of the medical devices <NUM>, <NUM>, <NUM>, described herein, it may be beneficial to remove portions of sponge after a patient's tissue has developed scabbing or otherwise healed. By removing sections of a sponge <NUM>, <NUM>, <NUM>, from the area of tissue with scabbing and allowing a new section of sponge (or portion of sponge that has not yet contacted tissue for treatment) to engage tissue, the tissue may heal faster.

Although <FIG> illustrate sponge <NUM> being used to treat a wound region within a patient's body, this disclosure is not so limited. Sponges <NUM>, <NUM>, <NUM> and the procedures discussed herein may be used to treat wounds, leaks, perforations, etc. in a subject's upper gastrointestinal tract, a subject's lower gastrointestinal tract, other lumens or cavities within a subject, on an exterior of a subject, etc. Various aspects discussed herein may help to reduce recovery time, reduce physician interventions, reduce a need and/or reliance on imaging or visualization to position the sponge, reduce component costs, reduce the risks to the subject, etc..

Additionally, various aspects discussed herein may be packaged as a kit to be used to treat a subject.

Claim 1:
A medical system (<NUM>, <NUM>, <NUM>) comprising:
a delivery tube (<NUM>, <NUM>, <NUM>) configured to couple to a vacuum source (<NUM>, <NUM>, <NUM>) and provide negative pressure to a distal portion of the delivery tube (<NUM>, <NUM>, <NUM>);
a porous body (<NUM>, <NUM>, <NUM>) at a distal portion of the delivery tube, wherein the porous body includes a first section (<NUM>, <NUM>, <NUM>), a second section (<NUM>, <NUM>, <NUM>) removable from the first section (<NUM>, <NUM>, <NUM>); and
a string (<NUM>, <NUM>, <NUM>) coupled to the second section (<NUM>, <NUM>, <NUM>) and extending from the porous body (<NUM>, <NUM>, <NUM>) to a proximal portion of the delivery tube (<NUM>, <NUM>, <NUM>), the string (<NUM>, <NUM>, <NUM>) being pullable for removing the second section (<NUM>, <NUM>, <NUM>) from the first section (<NUM>, <NUM>, <NUM>).