Abstract: A method for obtaining access to a hollow organ of a patient comprises the steps of (i) providing a tubular member, (ii) pressing an end of the tubular member against a wall of the hollow organ, and (iii) removing a section of the organ wall surrounded by the tubular member, while maintaining the tubular member in engagement with the organ wall. The tubular member has a flange at the end which glued to the organ wall prior to the removal removal of the organ wall section. To remove the organ wall section an elongate instrument is inserted through the tubular member and operated to excise the organ wall section. An incision is made by cutting the organ wall with a laser or a blade. In either event, the excising instrument may be turned about an axis to form a closed circuit incision. The removal excised organ wall section is further implemented by securing the excised section of the organ wall to a distal end of the instrument, e.g., via suction or a hook element.