Patent Description:
Dissection and removal of tissues, for example tumors, tissues suspected to be tumors, like polyps, and the like, from a patient's organs, is a procedure known in the art. Dissection and removal of large, complex and distinct tissues is relatively easy and straightforward. However, dissection and removal of tissues that are slightly elevated from a surface of a tissue is more challenging, particularly when the elevated tissue to be removed resides in a cavity in the body. Manipulation of soft elevated tissues, as well as soft surface tissues, is more challenging, particularly when there is a desire to dissect and separate the elevated tissue by less invasive procedures, like endoscopic procedures, polypectomy, and the like. The dissection and separation of the elevated tissue is even more challenging when the elevated tissue to be removed is non-symmetric.

In addition, other types of manipulation of the elevated tissue are challenging, particularly when the elevated tissue is slightly elevated from the surface tissue. Some exemplary challenged manipulations include: close imaging of all the sides of the elevated tissue, injection of substances into all the sides of the elevated tissue, dissecting and ablation of all sides of the elevated tissue, for example by polypectomy and/or ablation and/or tissue disconnecting, a combination thereof and the like.

A system comprising the features of the preamble portion of claim <NUM> is known from <CIT>, which discloses an endoscopic guide wire track. In one variant, a simple ring is arranged around a wire track to guide a tool having a blade. In another variant, a U-shaped portion of the tool engages with the track.

<CIT> discloses a tubular track member having a lateral slot, through which a cutting tip is exposed laterally. By pulling a wire member that is connected to the cutting tip, the cutting tip may move along the slot for cutting tissue.

The object of the present invention is to enhancing operation of the tool along the track.

This technical problem is solved by a system comprising the features of claim <NUM>.

Embodiments are herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of the preferred embodiments, and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the embodiments. In this regard, no attempt is made to show structural details in more detail than is necessary for a fundamental understanding, the description taken with the drawings making apparent to those skilled in the art how several forms may be embodied in practice.

Before explaining at least one embodiment in detail, it is to be understood that the subject matter is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The subject matter is capable of other embodiments or of being practiced or carried out in various ways. In discussion of the various figures described herein below, like numbers refer to like parts. The drawings are generally not to scale.

For clarity, non-essential elements were omitted from some of the drawings.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a surface tissue, and an elevated tissue. <FIG> illustrates an elevated tissue <NUM> extending from a surface tissue <NUM>. The surface tissue <NUM> is any type of tissue present in a body of a patient, for example a surface tissue <NUM> of an organ, or a cavity, in the body, like the colon, also known as the large intestine, as illustrated in <FIG>, or any other type of tissue that can be accessed by any tool, for either surgical activity or any other manipulation.

The elevated tissue <NUM> is any type of tissue that is elevated from a surface tissue <NUM> and there is a desire to manipulate it, for example dissect and separate the elevated tissue <NUM> from the surface tissue <NUM>, and in some embodiments, remove the dissected and separated elevated tissue <NUM> from the body of the patient; close imaging of all the sides of the elevated tissue <NUM> from appropriate angles; injection of substances into all the sides of the elevated tissue; burning all sides of the elevated tissue <NUM>, a combination thereof, and the like. The use of the term "sides" is intended also to all the curves that form the shape of the elevated tissue <NUM>.

Some exemplary elevated tissues <NUM> include: tumors, tissues suspected to be tumors, like polyps, lesions, a combination thereof, and the like. The elevated tissue <NUM> can be either symmetric, or non-symmetric. The elevated tissue <NUM> can be hard or soft. The elevated tissue <NUM> can be a large and distinct tissue that can be easily manipulated, for example dissected and separated from the surface tissue <NUM>. Alternatively, the elevated tissue <NUM> can be slightly elevated from the surface tissue <NUM>, rendering its manipulation more challenging.

The present subject matter provides a system and method for allowing access of a tool to all sides of an elevated tissue <NUM>. Some exemplary tools that the system and method allow their access to all sides of the elevated tissue <NUM>, include: a dissecting tool, a grabbing tool, an imaging tool, an injecting tool, a burning tool, and the like.

In some embodiments, the system and method of the present subject matter allow dissection and separation of an elevated tissue <NUM> from a surface tissue <NUM> in a body of a patient. In some other embodiments, the system and method of the present subject matter further allow removal of the dissected and separated elevated tissue <NUM> from the body of the patient. In some additional embodiments, the system and method of the present subject matter allow performance of additional manipulations on the elevated tissue <NUM> and its surroundings, as described in detail hereinafter.

According to one embodiment, the patient is an animal, particularly a vertebrate. According to another embodiment, the animal is a human.

The term "tool" as disclosed herein refers to any type of tool that is configured to be used during manipulation of tissues in a body of a patient. Some exemplary types of tools include; a dissecting tool configured to dissect a tissue; a grabbing tool configured to grab a piece of tissue; a storing tool configured to store an object, for example a piece of tissue, for example during removal of the object from the body of the patient; an imaging tool configured to acquire images inside a body of a patient; an illuminating tool configured to illuminate inside a body of a patient; an injecting tool configured to inject substances into a tissue; a burning tool configured to burn parts of a tissue, a combination thereof, and the like.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a system for allowing controlled access of a tool to all sides of an elevated tissue in a body of a patient. <FIG> illustrates components of a system <NUM> for allowing controlled access of a tool to all sides of an elevated tissue <NUM> in a body of a patient, the system <NUM> comprising:.

According to one embodiment, at least one connector <NUM> is attached to the vehicle <NUM>, and configured to connect the at least one tool to the vehicle <NUM>.

According to one embodiment, the tool is an integral part of the vehicle <NUM>. According to another embodiment, the tool is separated from the vehicle and configured to connect to the vehicle <NUM>.

As can be seen in <FIG>, the surface tissue <NUM> is a part of a cavity in a body of a patient, and the elevated tissue <NUM> extends from the surface tissue <NUM>. The rail <NUM> surrounds the elevated tissue <NUM>, and the vehicle <NUM> is stilled attached to, or moves along, the rail <NUM>. Since the rail <NUM> surrounds the elevated target tissue <NUM>, and the vehicle <NUM> is configured to move along the rail <NUM>, the vehicle <NUM> can surround the elevated tissue <NUM>. Thus, the system <NUM> allows access of the vehicle <NUM> to at least part of the elevated tissue <NUM>, up to all sides of the elevated tissue <NUM>, thereby allowing manipulation of the elevated tissue <NUM>, depending on the tool connected to the vehicle <NUM>.

Also illustrated in the circled zoom-in image in <FIG>, at least one connector <NUM> attached to the vehicle <NUM>. Thus, the system <NUM> allows access of any tool connected to the connector <NUM> to at least part of the elevated tissue <NUM>, up to all sides of the elevated tissue <NUM> up to the edges of the elevated tissue.

According to one embodiment, the rail <NUM> and the vehicle <NUM> are configured to be inserted into a body of a patient. According to another embodiment, the rail <NUM> and the vehicle <NUM> are configured to be inserted into a cavity in the body of the patient. According to yet another embodiment, the rail <NUM> and the vehicle <NUM> are configured to be manually inserted into the body of the patient, or into a cavity in the body of the patient. According to a further embodiment, the rail <NUM> is configured to be inserted into the body of the patient, or into the cavity in the body of the patient, through an endoscope. According to yet a further embodiment, the vehicle <NUM> is configured to be inserted into the body of the patient, or into the cavity in the body of the patient, through an endoscope. According to still a further embodiment, the rail <NUM> and the vehicle <NUM> are both configured to be inserted into the body of the patient, or into the cavity in the body of the patient, through an endoscope. According to a further embodiment, the insertion of the rail <NUM>, or the vehicle <NUM>, or the rail <NUM> and the vehicle <NUM> can be either manual, or autonomous, namely by a robotic mechanism. According to an additional embodiment, the rail <NUM>, or the vehicle <NUM>, or both the rail <NUM> and the vehicle <NUM>, are configured to be inserted in the body of the patient, or into the cavity in the body of the patient, through a multi-lumen that is transferred through an endoscope.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail surrounding an elevated tissue, the rail protrudes from an endoscope inserted into a cavity of a body of a patient. <FIG> illustrates an endoscope <NUM> that was inserted into a cavity of a body of a patient. Thus, the surface tissue <NUM> is the tissue of the cavity. As can be seen in <FIG>, endoscope <NUM> has a tube-like structure. The endoscope <NUM> comprises at least one, but preferably a plurality of channels <NUM>, <NUM>, <NUM>, through which objects, illumination, imaging, multi-lumen through which working tools such as a rail <NUM>, a combination thereof and the like, can be transferred or positioned. Further seen in <FIG> is a rail <NUM> exiting a channel <NUM> of the endoscope <NUM> and surrounding an elevated tissue <NUM> extending above the surface tissue <NUM>. In other words, <FIG> illustrates the exemplary embodiment of a rail <NUM> configured to be inserted into a body of a patient, or into a cavity in the body of the patient, through an endoscope, for example via a multi-lumen <NUM>. In this embodiment, during insertion of the endoscope <NUM> into the body of the patient the rail <NUM> resides inside a channel <NUM> of the multi-lumen <NUM> that is inserted in an endoscope <NUM>. When the endoscope <NUM> approaches a vicinity of the elevated tissue <NUM>, the multi-lumen <NUM> can depart the endoscope, as seen in <FIG>, and the rail <NUM> can exit the channel <NUM> in which the rail <NUM> resides, and surround the elevated tissue <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail exiting a multi-lumen approaching an elevated tissue. <FIG> illustrates an internal cavity having a surface tissue <NUM>, and an elevated tissue <NUM> extending above the surface tissue <NUM>. Also shown is a multi-lumen <NUM> that protrudes from the endoscope <NUM> and approaching to the vicinity of the elevated tissue <NUM>. multi-lumen <NUM>, during insertion of the endoscope into the cavity, the multi-lumen <NUM> resides inside the working channel <NUM> of the endoscope <NUM>, and the rail <NUM> resides in the working channel <NUM> of the endoscope <NUM>. When the endoscope approaches the vicinity of the elevated tissue <NUM>, the multi-lumen <NUM> can extend out of the endoscope, and the rail <NUM> can exit from the channel <NUM> of the multi-lumen 70towards the elevated tissue. <FIG> illustrates an edge of the rail <NUM> exiting the channel <NUM> of the endoscope <NUM>. After the rail <NUM> exits the channel <NUM>, the rail <NUM> is configured to surround the elevated tissue <NUM>.

It should be noted again that the insertion of the rail <NUM> into the body to the vicinity of the elevated tissue <NUM>, by using an endoscope, with or without a multi-lumen <NUM> in the endoscope, is only exemplary and should not be considered as limiting the scope of the present matter. The rail <NUM> can be brought to the vicinity of the elevated tissue <NUM> by any other mechanism as well, for example manually during an open surgery, or by any other means, for example a robotic arm, forceps, a combination thereof, and the like.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail exiting a multi-lumen and surrounding an elevated tissue. <FIG> illustrates an exemplary embodiment of a mechanism by which a rail <NUM> exiting a multi-lumen <NUM> surrounds an elevated tissue <NUM>. According to one embodiment, the rail <NUM> comprises a distal edge <NUM>-<NUM>. According to another embodiment, the system <NUM> further comprises a pulling element <NUM> is configured to be attached to the distal edge <NUM>-<NUM> of the rail <NUM>. The pulling element <NUM> is also configured to reside inside a channel <NUM> of the multi-lumen <NUM>. When the multi-lumen <NUM> reaches a vicinity of an elevated tissue <NUM>, as shown in <FIG>, the pushing element <NUM> that is attached to the distal edge <NUM>-<NUM> of the rail <NUM> is configured to exit the multi-lumen <NUM> alongside the rail <NUM>. Then, rail <NUM> is configured to extend away from the multi-lumen <NUM>, in a direction marked by arrow <NUM>. According to one embodiment, as can be seen in <FIG>, the rail <NUM> extends in a straight direction <NUM> from the multi-lumen <NUM>. At this stage, the rail <NUM> itself is straight. Simultaneously, the pulling element <NUM> that is attached to the distal edge <NUM>-<NUM> of the rail <NUM>, also exits the multi-lumen <NUM>, and surrounds the elevated tissue <NUM> in an opposite side of the elevated tissue <NUM> compared to the rail <NUM>. In order to allow the surrounding of the elevated tissue <NUM> by the rail <NUM>, the pulling element <NUM> is pulled back into the multi-lumen <NUM> in direction <NUM>, thus pulling the distal edge <NUM>-<NUM> of the rail <NUM> around the elevated tissue <NUM>, and allowing the rail <NUM> to surround the elevated tissue <NUM>. Eventually, the pulling element <NUM> is pulled back into the multi-lumen <NUM>, and the rail <NUM> entirely surrounds the elevated tissue <NUM>, as illustrated in <FIG>. It should be noted that the rail <NUM> is configured to surround an elevated tissue <NUM> having any size, height and shape, including non-symmetrical elevated tissues <NUM>. It should be noted also that the aforementioned mechanism and method of surrounding an elevated tissue <NUM> with the rail <NUM> is only exemplary, and should not be considered as limiting the scope of the present subject matter. Other mechanisms and methods of surrounding an elevated tissue <NUM> with the rail <NUM> are also under the scope of the present subject matter.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail in a surrounding position extending from a multi-lumen, and a vehicle standing or moving on the rail. <FIG> illustrates the aforementioned embodiment, according to which, the vehicle <NUM> is configured to be inserted into the body of the patient, or into the cavity in the body of the patient, through a multi-lumen <NUM> that is transferred through an endoscope. As can be seen in <FIG>, a tool <NUM> is attached to the vehicle <NUM>. The tool <NUM> can also be connected to a cable <NUM>. The cable <NUM> runs through a channel <NUM> of the multi-lumen <NUM> and the endoscope, to a control panel operated by an operator, as will be shown in other drawings hereinafter.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail surrounding an elevated tissue, a vehicle standing or moving along the rail, and a tool attached to the vehicle. <FIG> is similar to <FIG>, except that <FIG> shows the elevated tissue <NUM> that is surrounded by the rail <NUM>. As mentioned above, the rail <NUM> that surrounds the elevated tissue <NUM> allows movement of the vehicle <NUM> around the elevated tissue <NUM>. <FIG> shows the vehicle <NUM> standing or moving along the rail <NUM>, and a tool <NUM> attached to the vehicle <NUM>, and a cable <NUM> attached to the tool <NUM> and passing though the multi-lumen <NUM>. The tool <NUM> shown in <FIG> is a cutting tool <NUM> that is configured to cut the elevated tissue <NUM>. The cutting tool <NUM> comprises a blade <NUM> configured to cut the elevated tissue <NUM>. Any mechanism by which the blade <NUM> is configured to cut the elevated tissue <NUM> is under the scope of the present subject matter, for example by heating the elevated tissue. According to one embodiment, the blade <NUM> cuts the elevated tissue <NUM> during movement of the vehicle <NUM> on the rail <NUM>. A cut line <NUM> over the elevated tissue <NUM> designates a line on which the elevated tissue <NUM> is cut during movement of the blade <NUM> along the elevated tissue <NUM> as a result of the movement of the vehicle <NUM> along the rail <NUM>. Three-dimensionally, the cut line <NUM> defines a plane of cut of the elevated tissue <NUM>. In some embodiments, the plane of cut of the elevated tissue is parallel to a base of the elevated tissue <NUM>. The cut line <NUM> can be planned before the procedure of cutting the elevated tissue <NUM> with the system <NUM> so that the procedure can be controlled.

Additionally, seen in <FIG> is a manifold head <NUM> configured to store the vehicle <NUM> during transfer through from the multi-lumen <NUM>. After the rail <NUM> is positioned in place around the elevated tissue <NUM>, the vehicle <NUM> exists the manifold head <NUM> to the rail <NUM> and can start its working mode.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, another view of a rail surrounding an elevated tissue, a vehicle standing or moving along the rail, and a tool attached to the vehicle. The features illustrated in <FIG> are similar to the feature illustrated in <FIG>. However, <FIG> provides another view of the manifold head <NUM>. Using this view, it is clearer that the manifold head <NUM> can have a corner-like shape and provides a shelter to the vehicle <NUM> during transfer through the endoscope and the multi-lumen <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, an overall view of the system. <FIG> illustrates some additional embodiments of the system. The endoscope <NUM> is seen, comprising an endoscope camera <NUM>. The multi-lumen <NUM> resides in the endoscope <NUM>, while in the vicinity of the elevated tissue <NUM>, the multi-lumen <NUM> extends out of the endoscope <NUM>. The rail <NUM> protrudes from the multi-lumen <NUM>, surrounds the elevated tissue <NUM> and returns to the multi-lumen <NUM>. The rail <NUM> has a distal edge <NUM>-<NUM>, also shown in <FIG>. The distal edge <NUM>-<NUM> is movable. Namely, the distal edge <NUM>-<NUM> of the rail exits the multi-lumen <NUM>, surrounds the elevated tissue <NUM>, and returns to the multi-lumen <NUM>. An opposite edge of the rail <NUM> is referred to as a proximal edge <NUM>-<NUM> of the rail <NUM>. The proximal edge <NUM>-<NUM> remains inside the multi-lumen <NUM> during deployment of the rail <NUM> around the elevated tissue <NUM>. Therefore, the proximal edge <NUM>-<NUM> of the rail is also referred to as the fixed edge <NUM>-<NUM> of the rail <NUM>.

Also seen in <FIG> is the pulling element <NUM> attached to the distal edge <NUM>-<NUM> of the rail <NUM>. An operator of the system <NUM> can pull the pulling element <NUM> in order to tighten the embrace of the elevated tissue <NUM> by the rail <NUM>. Alternatively, the pulling element can be pushed in a direction outside the multi-lumen <NUM> in order to release the embrace of the elevated tissue <NUM> by the rail <NUM>.

The system <NUM> further comprises at least one control panel <NUM>. <FIG> illustrates an embodiment of the system <NUM> comprising two control panels <NUM> - a first control panel <NUM>-<NUM> and a second control panel <NUM>-<NUM>. The at least one control panel <NUM> is configured to allow an at least one, preferably two, operators of the system <NUM> to operate the system <NUM> and control the action of the various components of the system <NUM>, for example, the rail <NUM>, the vehicle <NUM>, the tool <NUM>, the endoscope <NUM>, the multi-lumen <NUM>, the endoscope camera <NUM>, and additional components described herein. For example, the pulling element <NUM> is attached to a control panel <NUM>, and the operator can push or pull the pulling element <NUM> as desired mechanically, electronically, magnetically, a combination thereof and the like.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail surrounding an elevated tissue and a cutting tool attached to a vehicle moving along the rail, while the cutting tool cuts the elevated tissue. <FIG> shows a rail <NUM> exiting a multi-lumen <NUM>, surrounding an elevated tissue <NUM>, and returning to the multi-lumen <NUM>. A vehicle <NUM> moves along the rail <NUM> in a circular direction <NUM> according to the route of the rail <NUM>. The circular arrow <NUM> that designates the direction of movement of the vehicle <NUM> is bi-directional, indicating that the vehicle <NUM> can move along the rail in both possible directions, for example forward and backward. A cutting tool <NUM> is attached to the vehicle <NUM>, and a cable <NUM> is attached to the cutting tool <NUM>. The cable <NUM> is connected to a control panel <NUM>, and passes through the endoscope <NUM>, or the multi-lumen <NUM> as well, thus allowing control of the operation of the cutting tool <NUM> by the operator. During the movement of the vehicle <NUM> on the rail <NUM>, the blade <NUM> cuts the elevated tissue <NUM> along a cut line <NUM> that can be pre-determined prior to this procedure. According to some embodiments, the cutting of the elevated tissue <NUM> is gradual. In other words, during a travel of the vehicle <NUM> around the elevated tissue <NUM>, the blade <NUM> cuts the elevated tissue <NUM> in a certain depth in the elevated tissue <NUM>. Then, during a following travel of the vehicle <NUM> along the rail <NUM>, the blade further extends from the cutting tool <NUM> and cuts further inside the elevated tissue. Thus, during the cutting process, the blade <NUM> can extend out of the cutting tool <NUM> and back into the cutting tool, in a straight direction designated with a bidirectional arrow straight arrow <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a cutting tool comprising a laser blade, attached to a vehicle. <FIG> illustrates an additional embodiment of a blade of a cutting tool <NUM> - a laser blade. The laser blade comprises an optical fiber <NUM> running from the control panel <NUM>, seen in <FIG>, through the endoscope <NUM>, and optionally through the multi-lumen <NUM>, toward the cutting tool <NUM>. A distal fiber edge <NUM> of the optical fiber <NUM> is attached to a lens <NUM>, and a spherical transparent medium <NUM> is held in contact with the lens <NUM>. The optical fiber <NUM> is configured to allow passage of a laser beam through the optical fiber <NUM>. The lens <NUM> is configured to focus the laser beam and direct the focused laser beam toward the spherical transparent medium <NUM>. The spherical transparent medium <NUM> is configured to allow passage of the focused laser beam toward a tissue <NUM> to be cut by the focused laser beam, for example an elevated tissue <NUM>. Line <NUM> shows the direction of the focused laser beam passing through the spherical transparent medium <NUM>. The spherical transparent medium <NUM> is also configured to prevent passage of the focused laser beam through the air. Therefore, the spherical transparent medium is always in contact with the lens <NUM> and the tissue <NUM> to be cut by the focused laser beam. Therefore, the spherical transparent medium <NUM> is spherical, in order to allow turning and sliding of the spherical transparent medium <NUM> over the tissue <NUM> to be cut during movement of the vehicle <NUM>. This embodiment is achieved by a holder <NUM> configured to hold the spherical transparent medium <NUM> and maintain continuous contact of the spherical transparent medium <NUM> with the lens <NUM> and the tissue <NUM> to be cut. Any shape of the holder <NUM> is under the scope of the present subject matter, for example a holder <NUM> having a spiral line shape, as shown in <FIG>.

<FIG> further shows the vehicle <NUM> to which the laser blade is attached, and the rail <NUM> on which the vehicle <NUM> moves. Also shown is the multi-lumen <NUM> through which the components are transferred.

Additionally, shown in <FIG> is an imaging device <NUM>, for example a camera <NUM>, attached to the vehicle <NUM>. The imaging device <NUM> comprises an imaging device lens <NUM>, that can comprise at least one light source <NUM>, for example a light emitting diode, also known as LED, configured to illuminate an area that is imaged, or photographed, by the imaging device <NUM>. Preferably, the number of light sources <NUM> is even, for example four as can be seen in <FIG>, in order to achieve symmetric illumination of the area that is imaged or photographed.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle comprising at least one bearing and at least one drive wheel. According to one embodiment, the vehicle <NUM> can move along the rail <NUM> by pushing and pulling the vehicle <NUM> with a cable that is attached to the vehicle <NUM>, optionally passes through the multi-lumen <NUM> and the endoscope <NUM>. The cable can continue till a control panel <NUM>, similarly to the cable <NUM> illustrated in <FIG>. According to another embodiment, the vehicle <NUM> can comprise at least one bearing <NUM> configured to roll over the rail <NUM> and reduce friction forces exerted on the vehicle <NUM> during the movement of the vehicle <NUM> along the rail. This at least one bearing <NUM> is illustrated in <FIG>.

According to another embodiment, illustrated in <FIG>, the vehicle <NUM> comprises a drive wheel <NUM> configured to roll over the rail <NUM> and drive the movement of the vehicle <NUM>. This embodiment renders the vehicle <NUM> the autonomous ability to drive the vehicle <NUM> along the rail <NUM>. The vehicle <NUM> illustrated in <FIG> further comprises an internal motor (not seen) that is configured to provide kinetic energy to the drive wheel <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle further comprising an external motor. In another embodiment, the aforementioned motor <NUM> is external, and can be seen in <FIG>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, another view of a vehicle comprising a drive wheel. <FIG> shows a different view of the same embodiments illustrated in <FIG> and <FIG>. It is clearly seen in <FIG> that the drive wheel <NUM> is configured to attach the rail <NUM> while rotating, in order to drive the movement of the vehicle <NUM> along the rail <NUM>.

An additional embodiment seen in <FIG> relates to the imaging device <NUM>. According to one embodiment, the imaging device <NUM> is configured to change its orientation upwards and downwards relative to the vehicle <NUM>, as illustrated with the bidirectional curved arrow <NUM>. This can be achieved, for example, by using at least one arm <NUM>, for example two arms <NUM> as shown in <FIG>, that is connected to the imaging device <NUM> and the vehicle <NUM>, and configured to change the orientation of the imaging device <NUM> upwards and downwards relative to the vehicle <NUM>.

Returning now to <FIG>. As can be seen in <FIG>, the rail <NUM> is configured to bend and form a loop-like structure when deployed outside the endoscope <NUM>, or the multi-lumen <NUM>. In other words, the rail <NUM> is configured to exit the endoscope <NUM>, or the multi-lumen <NUM>, turn and return to the endoscope <NUM>, or multi-lumen <NUM>, while assuming a loop-like structure, as shown in <FIG>.

Returning now to <FIG>. The rail <NUM> shown in <FIG> surround an elevated tissue <NUM> and assumes the structure of the contour of the elevated tissue <NUM> in the place where the rail <NUM> surrounds the elevated tissue <NUM>. As can be seen in <FIG>, the contour of the elevated tissue is amorphic, but nevertheless the rail <NUM> is configured to assume even an amorphic structure that relates to the structure of the contour of the elevated tissue <NUM>. In other words, the rail <NUM> is configured to assume any two-dimensional structure over a planar surface.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a side view of a rail extended from a multi-lumen. <FIG> shows a side view of a rail <NUM> extending from a multi-lumen <NUM> and a vehicle <NUM> standing still on the rail <NUM>. Line <NUM> is a horizontal line exiting the multi-lumen. As can be seen in <FIG>, the rail <NUM> is bent downwards relative to the horizontal line <NUM>, and forming an angle <NUM> between the rail <NUM> and the horizontal line <NUM>. This shows that the rail <NUM> is configured to bend up and down relative to a horizontal plane. It should be noted that similarly to the bending downwards relative to the horizontal line <NUM>, the rail <NUM> is configured to bend upwards relative to the horizontal line <NUM>. This embodiment allows the rail <NUM> to assume any contour structure of the surface tissue <NUM> on which the rail <NUM> resides, up and down relative to a horizontal line <NUM>.

To summarize, the rail <NUM> is configured to assume any structure in any dimension, and adapt the structure of the rail <NUM> to the contour and surface features of the elevated tissue <NUM> that the rail surrounds, and the surface tissue <NUM> on which the rail resides. This embodiment can be achieved due to an elasticity, and flexibility of the rail <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail comprising inflatable elements surrounding an elevated tissue. <FIG> shows a rail <NUM> surrounding an elevated tissue <NUM>. In order to achieve that structure of the contour of the elevated tissue <NUM>, parts of the rail <NUM> have to move toward the elevated tissue as shown for example by arrows <NUM> for some parts of the rail <NUM>. This can be achieved due to the elasticity, and flexibility of the rail <NUM>.

After the rail <NUM> has assumed a desired structure, in order to allow movement of the vehicle <NUM> along the rail <NUM>, in some occasions there is a need for the rail <NUM> to become rigid, because in some embodiments of the rail <NUM> and the vehicle <NUM> the vehicle cannot move along an elastic, or flexible rail <NUM>. One of the mechanisms to make the rail <NUM> or parts of it rigid, for example after the rail has assumed a desired structure, is shown in <FIG>. According to this embodiment, the rail <NUM> comprises multiple inflating elements <NUM> that are attached along the rail <NUM> and configured to be inflated. Therefore, the inflatable elements <NUM> are connected to at least one pipe <NUM> that transfers a fluid to the inflating elements <NUM>, and is also configured to transfer the fluid from the inflatable elements <NUM>, for example in order to empty the fluid from the inflatable elements <NUM> and let the rail <NUM> to regain its elasticity and flexibility. For this purpose, the at least one pipe <NUM> passes through the rail <NUM> to the inflatable elements <NUM>, and from the rail <NUM>, through the endoscope <NUM>, and occasionally through the multi-lumen <NUM>, to a control panel <NUM>. Any type of fluid is suitable for inflating the inflatable elements <NUM>, for example a gas like air, nitrogen, carbon dioxide, and the like; or a liquid like water, saline, oil, and the like.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle surface and a tissue surface of a rail. According to one embodiment, the rail <NUM> comprises a vehicle surface <NUM> along the rail <NUM>, and a tissue surface <NUM> along the rail <NUM>. The vehicle surface <NUM> is configured to face a vehicle <NUM> that stands on or moves along the rail <NUM>, and in some embodiments, the vehicle surface <NUM> is also configured to be in contact with the vehicle <NUM> that stands on or moves along the rail <NUM>. The tissue surface <NUM> is configured to be in contact with the elevated tissue <NUM> that is surrounded by the rail <NUM>.

<FIG> further illustrates an exemplary embodiment of the structure of the vehicle surface <NUM>, and a mechanism for moving the vehicle along the rail <NUM>. In this embodiment, the rail <NUM> comprises a flat tissue surface <NUM> and a plurality of extensions <NUM>, having gaps <NUM> in between the extensions <NUM>, protruding substantially vertically to the tissue surface <NUM> and away from the tissue surface <NUM>, from an upper side and a lower side of the tissue surface <NUM>, thus forming a groove-like structure of the vehicle surface <NUM> having slotted walls comprised of the extensions <NUM> and the gaps <NUM> in between them. This structure of the slotted walls confers flexibility to the rail <NUM> and facilitates bending of the rail <NUM> when assuming a desired structure or contour. The groove-like structure of the vehicle surface <NUM> is configured to accommodate vehicle cable <NUM> that is attached to the vehicle <NUM>, passes along the rail <NUM> through the endoscope <NUM>, and optionally though the multi-lumen <NUM>, until a control panel <NUM>. The vehicle <NUM> is moved by pushing and pulling the vehicle cable <NUM>. In order to facilitate smooth movement of the vehicle cable <NUM>, the rail <NUM> can further comprise a plurality of balls <NUM> trapped in the groove-like structure of the vehicle surface <NUM> along the rail <NUM>, the balls <NUM> are configured to be in contact with the vehicle cable <NUM> and rotate when the vehicle cable <NUM> is pushed or pulled.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, an elevated tissue surrounded by a rail comprising a vehicle cable and a plurality of balls. <FIG> illustrates a rail <NUM> that similarly to the rail <NUM> shown in <FIG> comprises a vehicle cable <NUM> and a plurality of balls <NUM> for facilitating smooth movement of the vehicle cable <NUM>. The rail <NUM> illustrated in <FIG> also comprises a vehicle surface <NUM> having a groove-like structure that is configured to trap the balls <NUM> along the rail <NUM>. However, in contrast to the rail <NUM> illustrated in <FIG>, in which the walls of the groove-like structure are slotted and made of extensions <NUM> and gaps <NUM> in between the extension, the walls of the groove-like structure of the vehicle surface <NUM> shown in <FIG> are complete or full, not slotted. Therefore, the walls of the vehicle surface <NUM> of the rail <NUM> shown in <FIG> are made of an elastic or flexible material in order to allow the rail <NUM> to assume any desired structure according to the contour of the elevated tissue <NUM> that has to be surrounded by the rail <NUM>, as can be seen in <FIG>. It can be seen that the elevated tissue <NUM> is elevated above the surface tissue <NUM>, and that the tissue surface <NUM> is in contact with the elevated tissue <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, an elevated tissue surrounded by a rail comprising a vehicle cable and a plurality of balls, and a vehicle with a cutting tool moving along the rail. It should be noted that the elevated tissue <NUM> shown in <FIG> is illustrated as transparent. Therefore, the tissue surface <NUM> of the rail <NUM> that is attached to a rear surface of the elevated tissue <NUM> can be seen through the so-called transparent elevated tissue <NUM>. The rail <NUM> shown in <FIG> is similar to the rail <NUM> shown in <FIG> shows, in addition, a vehicle <NUM> on the vehicle surface <NUM> of the rail <NUM>. As described above, the vehicle cable <NUM> that passes along the groove-like structure of the vehicle surface <NUM> is attached to the vehicle <NUM>, for allowing driving the movement of the vehicle <NUM> along the rail <NUM> by pushing and pulling the vehicle cable <NUM> from control panel <NUM>. Also shown in <FIG> is a cutting tool <NUM> attached to the vehicle <NUM> that cuts the elevated tissue <NUM> during the movement of the vehicle <NUM>.

In addition to the aforementioned embodiments, <FIG> also shows a direction of movement of the cutting tool <NUM>, and additionally and more specifically of the blade <NUM> of the cutting tool <NUM>. According to one embodiment, the cutting tool <NUM> is configured to move in the direction of the elevated tissue <NUM> and away from the elevated tissue <NUM>, as designated with arrow <NUM> in <FIG>. This embodiment is important for the cutting process of the elevated tissue <NUM> during movement of the vehicle <NUM>, and the cutting tool <NUM> that is attached to the vehicle <NUM>, along the rail <NUM>. This embodiment can allow control of the depth of cutting in the elevated tissue <NUM>. When the cutting tool <NUM>, the blade <NUM>, or both the cutting tool <NUM> and the blade <NUM>, move toward the elevated tissue <NUM> - this increases the depth of cutting of the elevated tissue <NUM>, and vice versa.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a segment of rail having a toothed vehicle surface and a folded tissue surface; and to <FIG>, schematically illustrating, according to an exemplary embodiment, the rail shown in <FIG> surrounding an elevated tissue and a vehicle with a cutting tool moving along the rail. <FIG> shows an embodiment of a toothed vehicle surface <NUM> of the rail <NUM>, and an embodiment of a folded tissue surface <NUM> of the rail <NUM>, and <FIG> additionally shows an embodiment of the vehicle <NUM> that is configured to move along, as indicated with arrow <NUM>, and be in contact with the toothed vehicle surface <NUM> of the rail <NUM>.

According to one embodiment, shown in <FIG>, the vehicle surface <NUM> is toothed. In other words, the vehicle surface <NUM> comprises a plurality of teeth <NUM> along the vehicle surface <NUM>, and gaps <NUM> between the teeth <NUM>. According to one embodiment, the teeth can be vertical relative to a base <NUM> of the vehicle surface <NUM>, as shown in <FIG>. According to another embodiment, the teeth can be tilted relative to the base <NUM> of the vehicle surface <NUM>, as shown in <FIG>.

According to one embodiment, the vehicle <NUM> comprises at least one toothed wheel <NUM> that is configured to be in contact with and roll along the toothed vehicle surface <NUM> of the rail <NUM>. Thus, an orientation of wheel teeth <NUM> of the toothed wheel <NUM> correspond to the orientation of the teeth <NUM> of the vehicle surface <NUM> of the rail <NUM>. For example, wheel teeth <NUM> of a toothed wheel <NUM> are tilted similarly to the teeth <NUM> of the vehicle surface <NUM> with which the toothed wheel <NUM> is configured to be in contact and move along, as shown in <FIG>. Similarly, a toothed wheel <NUM> that is configured to be in contact and move along the toothed vehicle surface <NUM> having vertical teeth <NUM>, shown in <FIG>, has vertical wheel teeth <NUM> as well.

The vehicle <NUM> that comprises at least one toothed wheel <NUM> can move along the rail <NUM> in any mechanism, for example, by using a vehicle cable <NUM> as shown for example in <NUM>, and the like. Preferably, the vehicle <NUM> that comprises at least one toothed wheel <NUM> can move along the rail <NUM> by using a motor <NUM> as shown for example in <FIG>.

Returning now to <FIG>. According to one embodiment, the tissue surface <NUM> of the rail <NUM> is folded. In other words, according to this embodiment, the tissue surface <NUM> comprises multiple folds <NUM> along the length of the tissue surface <NUM>. The folds <NUM> increase the surface area of the tissue surface <NUM> and tighten the attachment of the tissue surface <NUM> of the rail <NUM> with the elevated tissue <NUM>. The rail <NUM> shown in <FIG> is tightly attached to the elevated tissue <NUM> because of the folded tissue surface <NUM> of the rail <NUM>.

Referring now to <FIG>, schematically illustrating, according to some exemplary embodiments, cross-sectional views of rails comprising a folded tissue surface having various structures of folds. The folds <NUM> of the folded tissue surface <NUM> of the rail <NUM> can have any type of structure and relative sizes, examples of which are shown in <FIG> also show the interaction of the elevated tissue <NUM> with the folded tissue surface. The folds <NUM> increase the surface area of tissue surface <NUM>, thus tightening the attachment of the elevated tissue with the folded tissue surface <NUM> of the rail <NUM>. This embodiment decreases the chance of separation between the rail <NUM> and the elevated tissue <NUM>, or sliding of the rail <NUM> off the elevated tissue <NUM>, during manipulation, for example cutting, of the elevated tissue <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, perspective views of rails comprising a folded tissue surface having various structures of folds. <FIG> show a three dimensional structure of two exemplary folded tissue surface <NUM> of a rail <NUM>, and how the folds <NUM> increase the surface area of the tissue surface <NUM>.

<FIG> show another embodiment of the rail <NUM>, according to which the rail <NUM> comprises at least one hardening pipe <NUM> passing internally inside the rail <NUM>. The hardening pipe <NUM> passes until a control panel <NUM> and is configured to allow passage of fluid through the hardening pipe <NUM> in order to harden and make the rail <NUM> more rigid, for example after the rail <NUM> has surrounded an elevated tissue <NUM>, for purposes described above in relation to the inflatable elements <NUM>. Any type of fluid is under the scope of the present subject matter, for example a gas like air, nitrogen, carbon dioxide, and the like; or a liquid like water, saline, oil, and the like.

<FIG> show a further embodiment of the rail <NUM>, according to which the rail <NUM> comprises at least one suction pipe <NUM> passing internally inside the rail <NUM>, and at least one suction orifice <NUM> on the tissue surface <NUM> that is fluidically connected to the suction pipe <NUM>. In <FIG> a cross-section of the rail <NUM> passes through a specific suction pipe <NUM>-<NUM> and a specific suction orifice <NUM>-<NUM> fluidically connected to the specific suction pipe <NUM>, in order to illustrate the fluid connection between the suction pipe <NUM> and the suction orifice <NUM>. The suction pipe <NUM> passes until a control panel <NUM>. The suction pipe <NUM> is configured to allow formation of negative gas pressure at the suction orifice <NUM><NUM> in order to suck the elevated tissue <NUM> that is in contact with the tissue surface <NUM> and the at least one suction orifice <NUM> on the tissue surface <NUM>. The suction of the elevated tissue <NUM> through the at least one suction orifice <NUM> tightens the contact of the rail <NUM> with the elevated tissue <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail having a tube-like structure and a longitudinal slot along the rail. <FIG> shows a multi-lumen <NUM> from which a rail <NUM> extends. The rail <NUM> is cross-sectioned in order to show the structure of a profile of the rail <NUM>. According to the embodiment shown in <FIG>, the rail <NUM> has a tube like structure, and a longitudinal slot <NUM> along the rail <NUM>. Due to the tube-like structure of the rail <NUM>, the rail also comprises an internal space <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle comprising at least one vehicle bearing configured to be accommodated in a rail having a tube-like structure and a longitudinal slot along the rail. <FIG> shows a vehicle <NUM>, a cutting tool <NUM>, comprising a blade <NUM>, attached to the vehicle <NUM>, and an imaging device <NUM>, comprising an imaging device lens <NUM> and at least one, for example two, light sources <NUM>, the imaging device <NUM> also attached to the vehicle <NUM>. The vehicle <NUM> in <FIG> is configured to attach to and move along a rail <NUM> having a tube-like structure and a longitudinal slot <NUM> along the rail <NUM>, described in detail in <FIG>. For this purpose, the vehicle comprises a bearing base <NUM> attached to a lower side of the vehicle <NUM>, at least one bearing axis <NUM> attached to an edge of the bearing base <NUM>, and a vehicle bearing <NUM> attached to each bearing base <NUM>. The vehicle bearing <NUM> is configured to be accommodated in the internal space <NUM> of the rail <NUM>, and the bearing axis <NUM> is configured to pass through longitudinal slot <NUM> of the rail <NUM>, thus connecting the vehicle bearing <NUM> that is inside the internal space <NUM> of the rail <NUM>, with the bearing base <NUM> that is out of the rail <NUM>. During movement of the vehicle <NUM> along the rail <NUM>, the at least one vehicle bearing <NUM> facilitates attachment of the vehicle <NUM> to the rail <NUM>, and reduces friction forces with the rail <NUM> in order to allow smooth movement of the vehicle <NUM> along the rail <NUM>. As can be seen in <FIG>, the vehicle bearings <NUM> are attached to a bottom side of the vehicle <NUM>, and the vehicle <NUM> is positioned above the rail <NUM>. However, this relative position of the vehicle <NUM> above the rail <NUM> is only exemplary, and should not be considered as limiting the scope of the present subject matter. The vehicle <NUM> can be positioned in any position relative to rail <NUM>, for example above the rail <NUM>, as described above, aside the rail <NUM>, or below the rail <NUM>, as described hereinafter, and the like.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle comprising at least one vehicle bearing configured to be positioned below a rail. <FIG> illustrates a vehicle <NUM> comprising at least one vehicle bearing <NUM>, for example four vehicle bearings <NUM>, as seen in <FIG>. The at least one vehicle bearing <NUM> is configured to be accommodated in an internal space <NUM> of the rail <NUM>. Three of the four vehicle bearings <NUM> are seen inside the rail <NUM> in <FIG>. The vehicle is moved along the rail by using a vehicle cable <NUM> attached to the vehicle <NUM>, as described above. As can be further seen in <FIG>, the vehicle <NUM> is positioned under the rail <NUM>.

Additional embodiments of the cutting tool <NUM> that is attached to the vehicle <NUM> are shown in <FIG>. The blade <NUM> of the cutting tool <NUM> is shown. The cable <NUM> that is attached to the cutting tool <NUM> is slotted, namely comprising multiple cable slots <NUM>, preferably vertically to the length of the cable <NUM>. Some of the cable slots <NUM> can be longer than other cable slots <NUM>. The cable slots <NUM> confer flexibility to the cable <NUM>, which is important for smooth movement and passage of the cable <NUM> through the endoscope <NUM>, and occasionally through the multi-lumen <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, integrated vehicle bearings of a vehicle. <FIG> shows a vehicle <NUM> similar to the vehicle <NUM> shown in <FIG>. A cutting tool <NUM>, with a blade <NUM> and a cable <NUM>, is attached to the vehicle <NUM>. In this embodiment, a vehicle cable <NUM> is attached to one side of the vehicle <NUM>, and another vehicle cable <NUM> is attached to another side of the vehicle <NUM>. Further seen in <FIG> is that the four vehicle bearings <NUM> of the vehicle <NUM> are divided to two pairs <NUM>-P of integrated vehicle bearings <NUM>. The integration of each two vehicle bearings <NUM> can be achieved, for example, by a graduated structure of a circumference of the vehicle bearings <NUM>. The circumference of the vehicle bearing <NUM> comprises a lower stair <NUM> and an upper stair <NUM>. In the pair <NUM>-P of the integrate vehicle bearings <NUM>, a lower stair <NUM> of one vehicle bearing <NUM> is positioned aside an upper stair <NUM> of the second vehicle bearing <NUM>, and vice versa. This enables integration of the vehicle bearings <NUM> each in pair <NUM>-P. An advantage of the integrated vehicle bearings <NUM> is that this feature stabilizes the movement of the vehicle <NUM> along the rail <NUM>, and renders the movement more smooth, because the contact of the two vehicle bearings <NUM> in each pair <NUM>-P prevents unnecessary friction of the vehicle bearings <NUM> that can be present in the path of the vehicle <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, another perspective view of integrated vehicle bearings of a vehicle. <FIG> show another perspective view of the vehicle <NUM> shown in <FIG>. The cutting tool <NUM> is attached to the bottom of the vehicle <NUM>, and the cable <NUM> of the cutting tool <NUM> is seen cross-sectioned in <FIG>. The two pairs <NUM>-<NUM> of integrated vehicle bearings <NUM> and the mechanism of integration of the vehicle bearings <NUM>, as described in <FIG> are clearly seen. A clear view of an exemplary embodiment of the vehicle <NUM> is shown in <FIG>. According to this embodiment, the vehicle <NUM> is elongated, and the vehicle bearings <NUM> are connected to the vehicle <NUM>. In addition, a connector <NUM> is attached to the vehicle <NUM>, in this embodiment, to a bottom side of the vehicle <NUM>. The cutting tool <NUM> is connected to the connector <NUM>, thereby the cutting tool <NUM> is connected to the vehicle <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail comprising multiple elongated windows, a vehicle and a cutting tool configured to operate with the rail comprising multiple elongated windows. <FIG> shows an embodiment of a rail <NUM> that has a strip-like structure with multiple elongated windows <NUM> along the rail <NUM>. In addition, the rail <NUM> comprises extended rims <NUM> along the two sides of the strip-like structure. The rims <NUM> are configured to trap the vehicle <NUM> in between them, and the vehicle <NUM> is configured to be trapped by the rims <NUM> close to the strip-like structure of the rail <NUM>, and move along the rail <NUM>. <FIG> further shows a cutting tool <NUM> attached to the vehicle <NUM>, and a cable <NUM> extending from the cutting tool <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, different projections of a close-up view of a rail comprising multiple elongated windows, a vehicle and a cutting tool configured to operate with the rail comprising multiple elongated windows. <FIG> clearly show the vehicle <NUM> trapped by the rims <NUM> of the strip-like structure of the rail <NUM>, and the cutting device <NUM> attached to the vehicle <NUM>. In this embodiment, the vehicle <NUM> comprises two vehicle parts <NUM>-P that are configured to be trapped between the rims <NUM> of the rail <NUM>. The parts <NUM>-P of the vehicle <NUM> can have any structure that is suitable to be trapped by the rims <NUM> of the rail <NUM>, for example a rod-like structure, as seen in <FIG>. The two parts <NUM>-P of the vehicle are connected to both sides of the cutting tool <NUM>. Thus, the cutting tool <NUM> moves together with the two parts <NUM>-P of the vehicle <NUM> along the rail <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail comprising multiple elongated windows, and a blade, a cutting probe, or an electrode of a cutting tool extending through a window. The cutting tool will be referred to as a blade. <FIG> shows the rail <NUM><NUM> comprising multiple elongated windows <NUM> illustrated in <FIG>, from a side of the elevated tissue. The windows height should be smaller than the height of the rail. When there is a desire to cut the elevated tissue, the blade <NUM> is extended out of the cutting tool <NUM> through the window <NUM>, and cuts the elevated tissue during movement of the vehicle <NUM>. The blade is protected within an isolation ring <NUM>-<NUM>. When the blade <NUM> reaches an edge of the window <NUM>, the blade <NUM> is returned back into the cutting tool <NUM>, the vehicle <NUM> moves further until the blade <NUM> is positioned in front of a next window, and the blade <NUM> is extended out again from the cutting tool <NUM> and through the window <NUM> in order to cut the elevated tissue. As a result of this procedure, the cutting of the elevated tissue is broken, or fragmented. In order to complete the cutting, the rail <NUM> can be moved a little and brought to a position where the un-cut areas are in front of windows, and the cutting procedure described above is performed again in order to cut the un-cut areas. Another solution for this non-continuous cutting of the elevated tissue due to the presence of windows <NUM> in the rail <NUM> is described hereinafter.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle with a cutting tool that are configured to be held and moved manually. <FIG> is similar to <FIG>, except that a handle <NUM> is attached to the cutting tool <NUM>. The handle <NUM> is configured to be held by fingers of an operator, thus allowing the operator to manually move the cutting tool <NUM> with the vehicle <NUM> along the rail <NUM>. It should be noted that this embodiment of a handle <NUM> attached to the cutting tool <NUM> should be considered as limiting the scope of the present subject matter. The handle <NUM> can be attached directly to any type of vehicle <NUM> that is configured to move along any type of rail <NUM>, or to any type of tool that is attached to the vehicle <NUM>. This embodiment of a handle <NUM> attached to the vehicle <NUM>, or to the tool that is attached to the vehicle <NUM>, is suitable, for example, to open surgeries where the elevated tissue that is to be manipulated, for example removed, with the system <NUM> of the present subject matter, can be accessed by hands of an operator of the system <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment in accordance with the present claimed invention, a tissue remover attached to cutting tool. <FIG> is similar to <FIG> except that view is further away from the rail <NUM>. During the cutting of the elevated tissue, particularly when the cutting is in an advanced stage inside the elevated tissue, part of the elevated tissue can cover the rail <NUM>, the vehicle <NUM> and the cutting tool <NUM>, thereby interfering with the movement of the vehicle <NUM> along the rail <NUM>, and the cutting process. In order to prevent such an interference, a tissue remover <NUM> is attached to an upper part of the cutting tool <NUM>. Alternatively, the tissue remover <NUM> can be attached to an upper part of the vehicle <NUM>. The tissue remover <NUM> has a substantially flat structure, and can be attached substantially diagonally above the cutting tool <NUM>, or the vehicle <NUM>. Thus, the elevated tissue <NUM> is removed away from the cutting tool <NUM>, or the vehicle <NUM>.

Referring now to <FIG> and <FIG>, schematically illustrating, according to an exemplary embodiment, different views of a rail comprising a continuous window, a vehicle and a cutting tool configured to operate with the rail comprising a continuous window. The rail <NUM> illustrated in <FIG> solves the problem of non-continuous cutting of the elevated tissue caused by the rail <NUM> comprising multiple elongated windows <NUM> described above. The rail <NUM> shown in <FIG> is similar to the aforementioned rail <NUM> comprising multiple elongated windows <NUM>, except that instead of comprising multiple elongated windows <NUM>, the rail <NUM> comprises a continuous window <NUM>. This enables continuous cutting of the elevated tissue with the blade <NUM> that extends through the continuous window <NUM>, as can be seen in <FIG>.

As a result of the continuous window <NUM>, the strip-like structure of the <NUM> is divided to two strips <NUM>, when the gap between the two strips <NUM> is the continuous window <NUM>. <FIG> also illustrates a vehicle <NUM> that is configured to attach and move along the rail <NUM> that comprises two strips <NUM>. In this embodiment, the vehicle <NUM> is configured to enclose from the outside the two strips 1f, while allowing to the blade <NUM> of the cutting tool <NUM> that is attached to the vehicle <NUM> to extend through the continuous window <NUM> that is between the two strips <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail comprising two strips and a continuous window, a vehicle configured to attached and move along the rail, and a cutting tool, and a handle and a tissue remover attached to the cutting tool. The rail <NUM>, the vehicle <NUM> and the cutting tool <NUM> illustrated in <FIG> are similar to the rail <NUM>, the vehicle <NUM> and the cutting tool <NUM> that are shown in <FIG>. The embodiments of the handle <NUM> shown in <FIG> are similar to the embodiments of the handle <NUM> shown in <FIG>, and the embodiments of the tissue remover <NUM> shown in <FIG> are similar to the embodiments of the tissue remover <NUM> shown in <FIG>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, an articulated vehicle. The vehicle <NUM> shown in <FIG> has the same embodiments as the vehicle <NUM> shown in <FIG>. An additional embodiment is shown here, according to which the vehicle is articulated. Thus, the vehicle <NUM> comprises multiple sections <NUM> linked by pivoting joints <NUM>. For example, the vehicle <NUM> shown in <FIG> comprises two sections <NUM> linked by a pivoting joint <NUM>. This embodiment confers flexibility to the vehicle <NUM>, and improved ability for the vehicle <NUM> to turn, particularly in sharp curves, of the rail <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a vehicle comprising sliding wheels. The vehicle shown in <FIG> has the same embodiments as the vehicle <NUM> shown in <FIG>. An additional embodiment is shown here, according to which the vehicle <NUM> comprises at least one sliding wheel <NUM>. For example, the vehicle <NUM> shown in <FIG> comprises two sliding wheels <NUM>. The at least one sliding wheel <NUM> is attached to a side of the vehicle <NUM> that faces the elevated tissue, and is configured to slide over the elevated tissue.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a holder of tool in a form of a clamp. <FIG> illustrate an open state and a closed state, respectively, of a holder of a tool in a form of a clamp. The holder comprises two clamp arms <NUM> that are configured to be in an open state, as shown in <FIG>, and in a closed state, as shown in <FIG>. When the clamp arms <NUM> are in the open state, shown with arrows <NUM> and <NUM>, a tool, for example a cutting tool <NUM>, can be inserted between the clamp arms <NUM>, or removed from the clamp arms <NUM>. When the clamp arms <NUM> are in the closed state, shown with arrows <NUM> and <NUM>, the clamp arms <NUM> hold the tool. According to one embodiment, the clamp arms <NUM> can be housed in a clamp housing <NUM>, for example in order to protect the clamp arms <NUM>. The clamp arms <NUM>, or the clamp housing <NUM>, are pivotally connected, with a clamp pivot <NUM>, to a clamp holder <NUM>, and the clamp holder is attached to the vehicle. The clamp pivot <NUM> allows swiveling of the clamp arms <NUM>, or the clamp housing <NUM>, about the clamp pivot <NUM>, in directions indicated with arrow <NUM>, thus allowing the tool, for example the cutting tool <NUM>, and the blade <NUM> of the cutting tool <NUM>, to swivel to the left and right in relation to the clamp pivot <NUM>. This embodiment allows, in one hand, holding the tool, for example the cutting tool <NUM>, by the vehicle, and on the other hand, this embodiment allows an increased degree of freedom of movement of the tool.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a lock of a tool. <FIG> show a lock <NUM> for locking a tool, for example a cutting tool <NUM>, to a connector <NUM> of a vehicle <NUM>. According to a state of the lock <NUM>, the tool can be either free, as shown in <FIG>, or locked in the connector <NUM>, as shown in <FIG> shows a vehicle <NUM> comprising a connector <NUM> configured to connect a tool to the vehicle <NUM>. Aside the vehicle <NUM> there is a cutting tool <NUM> comprising a cable <NUM> and a blade <NUM>. Broken line <NUM> indicates a blade line <NUM> that runs along the blade <NUM>. Broken line <NUM> indicates a locked blade line <NUM> that runs along the blade <NUM> when the cutting tool <NUM> is locked to the connector <NUM>. In <FIG>, which shows the cutting tool <NUM> in a free state, the blade line <NUM> is substantially vertical to the locked blade line <NUM>. In order to lock the cutting tool <NUM> in the connector <NUM>, the cutting tool <NUM> has to swivel until the blade line <NUM> overlaps with the locked blade line <NUM>, is shown in <FIG>. This is achieved with the lock <NUM>.

The lock <NUM> comprises a lock frame <NUM> pivotally connected, with a lock pivot <NUM>, to a side of the connector <NUM>. At least one, for example two, lock presses <NUM> are framed by the lock frame <NUM>. The lock press <NUM> can have a cylindrical shape, or preferably a curved cylindrical shape having a concavity, as shown in <FIG>. The lock press <NUM> can turn around its longitudinal axis. In the free state, shown in <FIG>, the lock frame <NUM> is in a first position that allows the cutting tool <NUM> and the cable <NUM> of the cutting tool <NUM>, to rest aside the connector <NUM>, when the blade line <NUM> is substantially vertical to the locked blade line <NUM>. In order to lock the cutting tool <NUM> in the connector <NUM>, the lock frame <NUM> is configured to turn about the lock pivot <NUM> in a direction of the cutting tool <NUM> and the cable <NUM>, until the lock frame <NUM> reaches a second state, shown in <FIG>. This causes the cutting tool <NUM> to turn toward the holder <NUM> and get locked in the holder <NUM>, when the blade line <NUM> overlaps with the locked blade line <NUM>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, capabilities of movement of a tool relative to a vehicle. <FIG> show a cutting tool <NUM> locked in a connector <NUM>, similarly to the embodiments shown in <FIG>. In order to improve cutting of the elevated tissue with the cutting tool <NUM>, the cutting tool <NUM> and the connector <NUM> have several degrees of freedom of movement, giving the blade <NUM> increased maneuvering capabilities for cutting the elevated tissue. According to one embodiment, the blade <NUM> is configured to move in and out from the cutting tool <NUM>, as indicated with arrow <NUM> in <FIG>. According to another embodiment, the connector <NUM>, and as a result also the cutting tool <NUM> locked in the connector <NUM>, is configured to turn left and right, as indicated with arrow <NUM> in <FIG>. According to yet another embodiment, the connector <NUM>, and as a result also the cutting tool <NUM> locked in the connector <NUM>, is configured to turn upward and downward, a indicated with arrow <NUM> in <FIG>. According to still another embodiment, the blade <NUM> is configured to turn about its length, as indicated with arrow <NUM> in <FIG>. All these embodiments allow movement of the blade <NUM> essentially in any desired direction and toward any desired location on the elevated tissue.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a rail surrounding an elevated tissue, a vehicle moving along the rail, and a cutting tool attached to the vehicle, and cutting the elevated tissue in various directions. <FIG> shows an example of cutting capabilities of a cutting tool <NUM> that has freedom to move and turn according to embodiments shown in <FIG>. The cutting line <NUM> in front of the cutting tool <NUM> is curved upwards and then downwards. This can be achieved due to the turning capabilities of the connector <NUM>, and the cutting tool <NUM> locked in the connector <NUM>, that are shown in <FIG>.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a marker in a form of a collapsible marker rod attached to a rail. <FIG> illustrates another component of the system <NUM> - a marker <NUM> configured to allow an operator to determine whether a hidden part of the rail <NUM> is positioned in a right place at a hidden side of the elevated tissue. As shown in <FIG>, the endoscope <NUM> is placed at a right side of the elevated tissue <NUM>. An operator of the endoscope <NUM> observes the elevated tissue <NUM> and the area of the elevated tissue <NUM> with an endoscope camera <NUM> that has a limited camera field of view <NUM>, designated with dashed lines <NUM>. An opposite side of the elevated tissue <NUM>, relative to the endoscope <NUM> is hidden by the elevated tissue520, and therefore an operator cannot see the opposite side of the elevated tissue <NUM>. Therefore, the operator cannot see whether the rail <NUM> that is deployed around the elevated tissue <NUM> is placed in a desired position at the hidden side of the elevated tissue <NUM>. The marker <NUM> is designed to provide a solution for this problem.

According to one embodiment, the marker <NUM> is a collapsible marker rod <NUM> having multiple marks <NUM> along the rod <NUM>, that is attached to the rail <NUM>, for example at an area of the rail <NUM> that is to be positioned at a hidden side of the elevated tissue <NUM>. When the rail <NUM> is transferred toward the elevated tissue <NUM> through the endoscope <NUM>, or also through the multi-lumen <NUM>, the collapsible marker rod <NUM> is collapsed. After the rail <NUM> is positioned in place around the elevated tissue <NUM>, the collapsible marker rod <NUM> is erected, and its edge that is distant from the rail <NUM> moves along dashed line <NUM> in <FIG>, from a collapsed state to an erected state, of which the erected state is shown in <FIG>. Any mechanism for erecting the collapsible marker rod <NUM> is under the scope of the present subject matter. For example, the collapsible marker rod <NUM> is inflatable. When in the collapsed state, the collapsible marker rod <NUM> is deflated. In order to erect the collapsible marker rod <NUM>, the collapsible marker rod <NUM> is inflated, for example with a fluid as defined above. When erected, for example in a hollow organ, like an intestine, the collapsible marker rod <NUM> presses an upper wall of the hollow organ, and as a result the edge of the collapsible marker rod <NUM> that is attached to the rail <NUM> fixes the rail <NUM> in place. An operator that observes the collapsible marker rod with the endoscope camera <NUM>, for example along sight line <NUM>, can determine, according to observation and analysis of the marks <NUM>, where the collapsible marker rod <NUM> is placed and whether the collapsible marker rod <NUM> is placed in a desired position. If not, the operator can adjust the position of the rail <NUM> accordingly.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a marker in a form of a collapsible mirror attached to a rail. <FIG> shows another embodiment of the marker described in <FIG> - a collapsible mirror <NUM> that is attached to the part of the rail <NUM> that is to be placed in a hidden area with a collapsible holder <NUM>. Similarly to the collapsible marker rod <NUM>, the collapsible mirror <NUM> is collapsed during transfer through the endoscope <NUM>, and occasionally through the multi-lumen <NUM>, and when the rail <NUM> is deployed in place the collapsible mirror <NUM> is erected. The collapsible mirror <NUM> is positioned in an orientation that allows the operator to observe with the collapsible mirror <NUM>, through sight line <NUM> the hidden area behind the elevated tissue <NUM>, and determine whether the rail <NUM> is positioned in the right place, or not.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a net for collecting a dissected elevated tissue. After cutting the elevated tissue <NUM> there is a need to remove the dissected elevated tissue <NUM> from the body of the patient. When the dissected elevated tissue <NUM> comprises malignant cells, like cancer cells, there is a need to remove the dissected elevated tissue <NUM> without spreading malignant cells during the removal of the dissected elevated tissue <NUM>, in order to prevent formation of metastases. <FIG> show a net <NUM> that is configured to wrap the elevated tissue <NUM> during the cutting of the elevated tissue <NUM>, and during the removal of the dissected elevated tissue <NUM>. According to one embodiment, the net <NUM> prevents passage of individual cells, or cell clusters, through the net <NUM>. The net <NUM> is towed by the vehicle <NUM> during the movement of the vehicle <NUM> around the elevated tissue <NUM>, in direction <NUM>, designated with arrow <NUM>. A net cable <NUM> is attached to a rear side of the net <NUM>, relative to the direction <NUM> of movement of the vehicle <NUM>. When transferred through the endoscope <NUM>, and occasionally through the multi-lumen <NUM>, the net is folded. When there is a need to wrap the elevated tissue <NUM> with the net <NUM>, the net <NUM> can attach the vehicle <NUM> and be towed by the vehicle <NUM> out of the endoscope <NUM>, or out of the multi-lumen <NUM>. When the net <NUM> is in a desired place aside the elevated tissue <NUM>, as shown in <FIG>, the vehicle <NUM> continues to move along the rail <NUM> in direction <NUM>, while movements of the net <NUM> is prevented by pulling the net cable <NUM> toward the endoscope <NUM>, or multi-lumen <NUM>. This causes deployment of the net <NUM> over the elevated tissue <NUM>, as shown in <FIG>.

According to one embodiment, strings <NUM> are placed between the net <NUM> and the vehicle <NUM>. The strings <NUM> facilitate deployment of the net <NUM> over the elevated tissue.

After the entire dissected elevated tissue <NUM> is wrapped by the net <NUM>, the rail <NUM> is pulled back into the endoscope <NUM>, or into the multi-lumen <NUM>, thereby enclosing the wrapped dissected elevated tissue <NUM> with the net <NUM>. Thus, the dissected elevated tissue <NUM> is removed from the body without spreading cells from the elevated tissue.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, a closing mechanism for bringing ends of a rail closer one to the other. When surrounding an elevated tissue <NUM> with the rail <NUM>, the two ends of the rail <NUM> that converge to the endoscope <NUM>, or to the multi-lumen <NUM>, can be distant one from the other. As a result, a cutting tool <NUM> that is attached to the vehicle <NUM> cannot reach the area of the elevated tissue <NUM> that is aside the place of convergence of the ends of the rail <NUM>, and the cutting of the elevated tissue <NUM> would not be complete. The present subject matter provides a closing mechanism <NUM> for bringing the converging ends of the rail <NUM> closer one to the other, in order to facilitate complete cutting of the elevated tissue <NUM>, also in the area that is aside the place of convergence of the ends of the rail <NUM>.

<FIG> shows the closing mechanism <NUM> bringing ends of a rail <NUM> closer one to the other, in an area where the ends of the rail <NUM> converge into an endoscope <NUM>. On the rail <NUM> shown in <FIG>, there is a vehicle <NUM>. <FIG> is similar to <FIG>, and it additionally shows a cutting tool <NUM> connected the vehicle <NUM>, and a cable <NUM> exiting the endoscope <NUM> and attached to the cutting tool <NUM>. <FIG> shows a detailed view of the closing mechanism <NUM>.

According to one embodiment, shown in <FIG>, the closing mechanism <NUM> comprises a closing element <NUM> configured to push an end of the rail <NUM> in direction <NUM> towards another end of the rail <NUM>, in a place of convergence of the two ends of the rail <NUM>. By pushing one end of the rail <NUM>, with the closing element <NUM>, toward the other end of the rail <NUM>, complete cutting of the elevated tissue <NUM> in this area is facilitated.

As shown in <FIG>, the closing mechanism <NUM> further comprises a closing shaft <NUM>. One end of the closing shaft <NUM> is pivotally connected to the closing element <NUM>, and another end of the closing shaft <NUM> is pivotally connected to an edge of the endoscope <NUM>, or multi-lumen <NUM>, to which the two ends of the rail <NUM> converge. The closing element <NUM> can have any structure, preferably a wheel-like structure, as seen in <FIG>. In addition, a closing cable <NUM> is attached to the closing element <NUM>, preferably to the point of pivotal connection of the closing element <NUM> with the closing shaft <NUM>. The closing cable <NUM> passes from the closing element <NUM>, through the endoscope <NUM>, and occasionally through the multi-lumen <NUM>, to a control panel <NUM>. In addition, the pushing element <NUM> is configured to be in contact with an end of the rail <NUM>. Pulling the closing cable <NUM> causes movement of the closing element <NUM> toward the end of the rail <NUM> and as a result pushing the end of the rail <NUM> toward the other end of the rail <NUM>, thereby bringing both ends of the rail <NUM> closer one to the other.

Referring now to <FIG>, schematically illustrating, according to an exemplary embodiment, an electromagnetic rail. As described above, any mechanism for moving the vehicle <NUM> along the rail <NUM> is under the scope of the present subject matter. <FIG> show another embodiment of a rail <NUM> and a mechanism of moving the vehicle <NUM> along the rail <NUM>. According to one embodiment, the rail <NUM> is an electromagnetic rail <NUM> in a form of an electromagnetic grid <NUM> that has a ring-like structure enclosing a space <NUM>. The electromagnetic grid <NUM> is configured to be deployed around an elevated tissue <NUM>, when the space <NUM> is configured to harbor the elevated tissue <NUM>. Accordingly, the vehicle <NUM> comprises elements that are configured to be attracted to a magnetic field, for example wheels made of a metal that is magnetically attractable. When the vehicle <NUM> stands on the electromagnetic grid <NUM>, actuation of an area of the electromagnetic grid <NUM> creates a magnetic field in that area that attracts the vehicle <NUM>. Actuation of an electric field in another area of the electromagnetic grid <NUM> attracts the vehicle <NUM> to that area and so on. This mechanism essentially allows movement of the vehicle <NUM> on the electromagnetic grid <NUM> in ant desired direction, as indicated with arrows <NUM>. Thus, in one hand the magnetic fields generated in the electromagnetic grid <NUM> drive movement of the vehicle <NUM>, and on the other hand, the magnetic fields facilitate attachment of the vehicle <NUM> to the electromagnetic rail <NUM>.

Any mechanism for deploying the electromagnetic grid <NUM> from the endoscope <NUM>, or the multi-lumen <NUM>, is under the scope of the present subject matter, for example a couple of deployment arms <NUM> that are attached to the electromagnetic grid <NUM> and are configured to exit the endoscope <NUM>, or the multi-lumen <NUM>, and deploy the electromagnetic grid <NUM> in a desired place.

<FIG> shows a side view of an exemplary design of the electromagnetic grid <NUM>. According to one embodiment, the electromagnetic grid comprises multiple electromagnetic elements <NUM>, arranged in two layers and having gaps in between them, while an electromagnetic element <NUM> of one layer overlaps with a gap in the other layer.

The present subject matter further provides a method for cutting an elevated tissue in a body of a patient, the method comprising:.

According to one embodiment, the inserting of the rail into the body of the patient is with an endoscope.

According to one embodiment, the cutting of the elevated tissue is controlled with a control panel operable through the endoscope.

It is appreciated that certain features of the subject matter, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the subject matter, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub combination.

Claim 1:
A system (<NUM>) for allowing controlled access of a tool (<NUM>) to all sides of an elevated tissue (<NUM>) in a body of a patient, the system comprising:
a rail (<NUM>) configured to surround the elevated tissue (<NUM>);
at least one vehicle (<NUM>) configured to move along the rail (<NUM>) and carry at least one tool (<NUM>) that is configured to manipulate the elevated tissue (<NUM>),
wherein the tool (<NUM>) is a cutting tool (<NUM>) comprising a blade (<NUM>) configured to cut the elevated tissue (<NUM>),
characterized in that
a tissue remover (<NUM>) is attached to an upper part of the at least one tool (<NUM>) or of the at least one vehicle (<NUM>), said tissue remover (<NUM>) having a substantially flat structure and being attached substantially diagonally above the cutting tool (<NUM>) or vehicle (<NUM>).