Abstract: This invention discloses methods for reducing physiologic molecules in abnormal levels and/or exogenous toxins in blood from blood by way of an extracorporeal circuit comprising a hollow-fiber filter module and polymer sorbent in combination.

Abstract: A drug delivery device comprises a medicament reservoir attached to a housing, a drive mechanism comprising a plunger movable relative to the housing, a dose selecting element releasably coupled to the drive mechanism and rotatable relative to the housing, a trigger axially movable relative to the housing, and a limiter selectively permitting and preventing axial movement of the trigger depending on the amount of a selected dose. The limiter is constrained to the dose selecting element and to the trigger. One of the limiter or a component part is axially coupled to the housing comprises a track which is in engagement with a blocking feature of the other of the limiter or the component part axially coupled to the housing. The track comprises a narrow section limiting relative movement between the track and the blocking feature and a wide section permitting relative movement between the track and the blocking feature.

Abstract: Catheter-based devices and methods for endoluminally accessing and occluding hollow anatomical structures are disclosed. Occlusion clips are contained in one or more needles that pierce opposing walls of the anatomical structure to deploy the clips externally of the structure. The clips then are drawn together to press the opposing anatomical walls together.

Abstract: Systems and methods for treating a subject are provided. A first dataset comprising timestamped autonomous glucose measurements of the subject over a first time course is obtained. A second dataset, associated with a standing insulin regimen for the subject over the first time course and comprising insulin medicament records, is also obtained. Each record comprises a timestamped administration event including an amount and type of insulin medicament administered into the subject by an insulin delivery device. The first and second datasets serve to calculate a glycemic risk measure and an insulin sensitivity factor of the subject during the first time course, which are used to obtain a basal rate titration schedule and a fasting blood glucose profile model over a subsequent second time course for the subject. The model predicts the fasting blood glucose level of the subject based upon amounts of insulin medicament administered into the subject.

Abstract: A system can automatically adjust flow rates/feeding regimen of a feeding pump feeding fluids/enteral nutrition to a patient. The system can, based upon a prescribed volume of nutrition or nutritional targets (such as and not limited to energy (calories), protein etc.) to be delivered and a prescribed delivery duration, adjust the pump flow rate/feeding regimen following unexpected delivery interruptions to achieve at or near to the prescribed total volume/nutritional targets to be delivered, despite the interruptions.

Abstract: A method of controlling a robotic arm in a surgical system comprises manually applying a force to a body of the robotic arm. Force information is received from a gesture force sensor on the robotic arm and a controller determines, using the force information, whether the force is a gesture force input. If the force is determined to be a gesture force input, the controller initiates a predetermined system function. The predetermined system function may be a change in operational state, movement between operational modes, or a movement from a first configuration of the arm's joints to a second, predetermined, configuration of the arms joints.

Abstract: The present disclosure relates to the field of endoscopy. Specifically, the present disclosure relates to systems and methods which allow the distal portion of a catheter to be visualized within the body using a colored marker and one or more secondary markers. In particular, the present disclosure relates to systems and methods which indicate when a medical device is properly positioned for deployment within a body lumen.

Abstract: An infusion set (1) includes: a first flow path (10a) having a first connector (11a) and a downstream connector (19); a first open/close valve (12a), a first liquid surface sensor (13a), a second liquid surface sensor (13b), a drip chamber (14), and a variable valve (17) that are provided in this order on the first flow path from the first connector side toward the downstream connector side; a droplet sensor (15) with which the drip chamber is provided; a second flow path (10b) having a second connector (11b); and a second open/close valve (12b) provided on the second flow path. The second flow path is in communication with a portion of the first flow path between the first liquid surface sensor and the second liquid surface sensor. The controller is configured to control the first and second open/close valves and the variable valves based on signals from the first and second liquid surface sensors and the droplet sensor.

Abstract: A method includes providing microvalve device having inner and outer catheters, and a filter valve attached to the distal end of the inner and outer catheters. Longitudinal displacement of the inner catheter relative to the outer catheter moves the filter valve from a non-deployed configuration to a deployed configuration. With the inner catheter longitudinally advanced a first amount relative to the outer catheter, the filter valve is in a reduced first diameter for advancement of a guidewire to a target location. Once the filter valve reaches the target location, the inner catheter is moved relative to the outer catheter such that the filter valve assumes a larger second diameter. A therapeutic agent is infused through the inner catheter and beyond the filter valve.

Abstract: The invention relates to an immersion matrix (5), designed for adjusting optical properties at interfaces of optical arrangements, having a porosity with pores of at least one pore size selected from a range from >20 nm to 200 ?m and/or nanopores in the material of the immersion matrix (5), wherein the nanopores have at least one average pore size selected from a range of 0.5 nm to 20 nm, and an elasticity modulus E selected from a range of 0.1-100 MPa. The invention furthermore relates to the use of the immersion matrix (5), an arrangement with the immersion matrix and an immersion device.

Abstract: In some embodiments, an insertion device for a single port robotic surgery apparatus includes a plurality of instrument channels positioned in an interior of a housing and extending along substantially an entire length of the housing, the plurality of instrument channels configured to removably house a plurality of surgical instruments, a plurality of openings in a rear exterior surface of the housing, the plurality of openings providing access to the plurality of instrument channels and configured to facilitate insertion of the plurality of surgical instruments into the plurality of instrument channels, and an illumination device supported at least partially at the rear exterior surface of the housing and positioned proximal to the plurality of openings, the illumination device configured to illuminate the openings to facilitate insertion of the plurality of instruments through the plurality of openings.

Abstract: Described are implantable devices having expandable reservoirs for the sustained release of therapeutic agents. The device is configured to be at least partially implanted in an eye and includes a retention structure and a penetrable element coupled to and extending within at least a portion of the retention structure. A porous drug release mechanism is positioned in fluid communication with an outlet of the device; and a reservoir having a volume configured to contain one or more therapeutic agents is in fluid communication with the outlet through the porous drug release mechanism. The device is at least partially inserted along an axis of insertion. The reservoir enlarges from an insertion configuration having a first three-dimensional shape to an expanded configuration having a second three-dimensional shape, the second three-dimensional shape being eccentrically positioned relative to the axis of insertion.

Abstract: Applicators for a microprojection array and methods of using the applicators are described.

Abstract: There is disclosed a device and method for delivering constant target current to a muscle for electro-stimulation of that muscle. One device is a completely self-contained device with no external means for the adjustment and control of the electro-stimulation delivered to the muscle during treatment. The microprocessor based device monitors indirectly the actual current delivered to the muscle during electro-stimulation via measurement of the return path voltage through the muscle and optionally in addition monitors and adjusts for the internal battery voltage during use of the device in order to deliver a more consistent an accurate and effective target output current to the muscle being stimulated at each and every pulse delivered from the device. The device is pre-programmed with an electro-stimulation treatment cycle and the whole treatment cycle, including the monitoring and adjustment required to achieve this treatment cycle, is automatic within the device.

Abstract: An assembly for advancing a piston through a rotationally fixed cartridge includes a rotatable, axially fixed first member and an axially movable, rotatable second member connected thereto via a threaded connection and connectable to the piston. A friction pad is rotationally fixedly connected with the second member and includes first and second sets of fingers extending radially outwardly from a central disk. Both the first and second sets of fingers are configured to contact an interior side wall of the cartridge. The first set of fingers are angled toward a first rotational direction and are configured to wedge the friction pad between the side wall and the second member upon rotation of the first member in the first direction, thereby substantially preventing rotation in the first direction. The second set of fingers are angled toward a second rotational direction and are configured to substantially prevent rotation in the second direction.

Abstract: Systems, methods, and devices provide alarms and alerts in an on-body networked diabetes management system. Methods may include receiving glucose sensor data from a continuous glucose monitor and determining a dosage of insulin delivery based at least in part on the glucose sensor data. The method may include detecting an alarm or alert condition, and sending a wireless communication regarding the alarm or alert condition to a remote user-interface device. The method may include triggering an audible, visual, or haptic alarm or alert on the insulin delivery device unless an acknowledgement of the alarm or alert condition is received within a predetermined period of time.

Abstract: A combination hanger arm extension and pump cover device can be used with an instillation unit. The device includes a body portion that has a first end and a second end. A hook extends from the first end, and a tab extends from the body proximate the hook. A panel is disposed proximate the second end. A substantially rectangular sleeve extends at least partially through the body. The sleeve is disposed between the first and second end.

Abstract: A user-wearable patch pump system for delivery of insulin or other medicament can include a pump and an attachment portion that attaches the pump to a user's body. The pump can include a drive unit and a disposable cartridge containing a medicament with the drive unit configured to cause the pump to deliver the medicament in the cartridge to the user. The attachment portion can include a retention frame configured to selectively retain the pump therein and an adhesive patch configured to be attached to the user's body. The pump can be selectively attached to the retention frame and used to deliver medicament either through a cannula to an infusion site directly beneath the retention frame or through tubing to an infusion site displaced from the retention frame.

Abstract: An insertion device for the insertion of a medical implant into a human and/or animal body. The device has at least one outer shaft, which has a proximal end and a distal end opposite the proximal end. A receiving element is connected to the outer shaft, for the implant. The outer shaft and the receiving element are surrounded at a transition between the outer shaft and receiving element by a locally placed sleeve, which dampens mechanical tensile and/or compressive stresses.

Abstract: A clamping device that is always capable of clamping a flexible tube in a good manner and assuredly closing the flexible tube without a large clamping force. A clamping device includes a holding member that holds a flexible tube in which a fluid is allowed to flow, and a clamping member that clamps and closes a clamping portion of the flexible tube that is held by the holding member. The clamping device further includes a heating device that heats the clamping portion of the flexible tube.

Abstract: A medical connector includes: a body member that partitions a flow path between a proximal side opening and a distal side opening; and a male connector connection portion including: a valve body facing the flow path, and a male connector connection port openable and closable by the valve body. The body member comprises a male connector housing portion configured to house a distal end portion of a male connector connected to the male connector connection portion. The male connector housing portion is configured to cause the male connector to communicate with the distal side opening and to prevent inflow of a fluid from the proximal side opening to the male connector housing portion by connection of the male connector to the male connector connection portion.

Abstract: The disclosure presents methods and systems for applying a suction force to a surface of a left atrial appendage (LAA) with a tube attached to an exterior surface of an inflatable balloon. The disclosure also presents methods and systems for inflating a first inflatable balloon within a cavity of a left atrial appendage (LAA). A method may include applying a suction force with at least one tube coupled to the first inflatable balloon to attract the first inflatable balloon to an interior surface of the LAA or to a second inflatable balloon. A method may include puncturing, using a tissue-penetrating tip, a target surface of the LAA.

Abstract: Devices and methods for assisting cardiac function. In an exemplary embodiment of a device for assisting heart function of the present disclosure, the device includes a first plate and an opposing second plate, each plate having an inner surface, a cardiac processor coupled to at least one of the first plate and the second plate, a bladder having an inner chamber and disposed between the inner surfaces, and a first catheter having a proximal end in communication with the inner chamber of the bladder and a distal end having a first pericardial balloon coupled thereto, wherein a gas and/or a liquid within the inner chamber of the bladder can be injected into the first pericardial balloon upon compression of the first plate relative to the second plate, and wherein the gas and/or the liquid can be removed from the first pericardial balloon upon retraction of the first plate relative to the second plate.

Abstract: Various embodiments of bulking or cushioning agents or material and related medical devices and methods are disclosed. For example, a method of performing a medical procedure in a tract of a body may include injecting a material in a liquid phase proximate a target site between a first tissue layer and a second tissue layer, allowing the material to transition from the liquid phase to the gel phase in response to a raise in temperature of the material to approximately at or above the predetermined temperature, and performing a surgical procedure on the target site. The material may have the liquid phase at temperatures below a predetermined temperature and a gel phase at temperature approximately at or above the predetermined temperature.

Abstract: Electrode leads for providing neuromuscular stimulation of the spinal muscles, and methods of implantation of electrode leads, are provided that reduce injury to target muscles, and avoid extended recuperation period, by enabling a clinician to visualize and confirm the implantation site of the electrode leads during an implantation procedure.

Abstract: Catheter assembly includes a cable assembly. The cable assembly includes first and second cable segments that are interconnected by a plug connector and a receptacle connector. The plug connector includes an elongated plug substrate and a mating array of electrical contacts supported by the plug substrate. The receptacle connector includes a system array of electrical contacts. The receptacle housing is sized and shaped to receive the plug substrate during a mating operation.

Abstract: Provided is a system for calculating design specifications of an administration apparatus which administers an administration object substance to an object region using a high-energy substance as a driving source. An object administration apparatus to be an object of calculation of the design specifications is specified and substance information related to a prescribed administration object substance to be administered in the object administration apparatus is acquired. Region information related to a prescribed object region is acquired, and distribution information related to a distribution state of the prescribed administration object substance is acquired. In addition, based on the respective pieces of acquired information, design specification information related to a configuration of the object administration apparatus including energy information related to a high-energy substance to be used to administer the prescribed administration object substance is calculated.

Abstract: Among other things, one or more systems and/or techniques for harvesting thermal energy for utilization by a dispensing system are provided herein. The dispensing system may comprise one or more thermal scavenging devices configured to collect thermal energy from a user. For example, a first thermal scavenging device, coupled to a top housing portion of the dispensing system, may collect thermal energy from a palm of a user hand; a second thermal scavenging device, coupled to a bottom housing portion of the dispensing system, may collect thermal energy from a top portion of the user hand; and/or other thermal scavenging devices may be operatively coupled to the dispensing system. In this way, the collected thermal energy is transformed into electrical energy for powering the dispensing system (e.g., powering a current dispense event, stored for a subsequent dispense event, validation of a refill container, detection of a user, etc.).

Abstract: Methods of enhancing reproductive capacity in a female subject are provided. Aspects of the methods include inducing infertility in the subject in a manner effective to cause the subject to mount a compensatory response and thereby enhance reproductive capacity in the subject. Systems and kits useful in practicing the methods of the present disclosure are also provided.

Abstract: A rotational atherectomy device may include a flexible, elongated, rotatable drive shaft with a system of eccentric abrading heads attached thereto. At least part of the eccentric enlarged abrading heads have a tissue removing surface—typically an abrasive surface. The abrading heads may be at least partially hollow. Preferably the eccentric enlarged abrading heads have centers of mass spaced radially from the rotational axis of the drive shaft, enabling the eccentric abrading heads to work together to open a stenotic lesion to a diameter substantially larger than the outer resting diameter of the enlarged abrading heads when operated at high speeds. The system of eccentric abrading heads may have unbalanced centers of mass to stimulate greater rotational diameters and may be arranged in a manner providing a debris-removing augering effect. Alternatively, a rotational atherectomy device may include a system of eccentric abrading heads with balanced centers of mass.

Abstract: An Infusion device (1) for administering a medical fluid to a patient (P), comprises: a receptacle (12) for receiving a syringe (2) having a tube (20) containing a medical fluid and a piston (21) movable with respect to the tube (20); a pusher device (11) for acting onto the piston (21) for pumping the medical fluid from the tube (20) towards a patient (P) at a set flow rate; a sensor device (14) for measuring a force acting in between the pusher device (11) and the piston (21) of the syringe (2); and a processor device (15) for deriving, from the force measured by the sensor device (14), a pressure value indicative of the pressure in the delivery line (3), wherein the processor device (15) is constituted to compare the pressure value to a threshold value (Pthres) for determining whether an occlusion (O) in the delivery line (3) is present.

Abstract: An apparatus having an outer wall that encompasses an interior chamber that holds a predetermined volume of fluid and gas where the gas rises to one end of the interior chamber and the fluid flows to the other end of the interior chamber. The apparatus also has an inlet port that allows for fluid to ingress into the interior chamber and an outlet port that allows for fluid to egress out of the interior chamber.

Abstract: An apparatus having an outer wall that encompasses an interior chamber that holds a predetermined volume of fluid and gas where the gas rises to one end of the interior chamber and the fluid flows to the other end of the interior chamber. The apparatus also has an inlet port that allows for fluid to ingress into the interior chamber and an outlet port that allows for fluid to egress out of the interior chamber.

Abstract: A medical tube clamp for clamping a flexible medical tube comprising: a tube receiving area which is adapted to receive the medical tube, a first clamping portion including a first clamping jaw which is movable relative to a second clamping portion including a second clamping jaw, and a closure system for safely positioning the two clamping portions in more than one snap-fit position relative to each other so that, when the closure system is unlocked, the medical tube can be inserted in and removed from the tube clamp, in an open snap-fit position the inserted medical tube cannot be removed and is not clamped and in a clamping snap-fit position the medical tube is clamped between the first clamping jaw and the second clamping jaw, with the first clamping jaw being configured to be elastically movable relative to the first clamping portion via a connecting member and/or the second clamping jaw being configured to be elastically movable relative to the second clamping portion via a connecting member.

Abstract: Disclosed is a system which extends NFC near field communication over a user's skin by converting electromagnetic signals into modulated alternating electric fields and vice versa. A modified patch is attached to an NFC device, which gets energized from its electromagnetic resonance which may contain data. The patch uses the energy to create an alternating electric field which couples into and spreads over a user's skin. The user may approach or touch objects which then get energized by the alternating electric field. The objects have a tag which modulates the electric field with data back over the user's skin to the patch, which then demodulates the data to modulate the NFC communication of the NFC device for further processing.

Abstract: An intravascular balloon catheter device includes an outer member disposed about an inner member. A balloon has a proximal portion which is connected to the outer member and a distal portion which is connected to the inner member. A sheath is disposed about the outer member and adapted for movement relative to the balloon. A coating with a therapeutic agent is provided on at least the distal portion of the balloon. The distal portion fits snugly into the sheath so as to provide a substantially watertight engagement therebetween when inside the sheath. The sheath is configured to prevent the proximal portion of the balloon from inflating to a diameter larger than the sheath.

Abstract: A cleaning device, system and method for use with an ETT or tracheostomy ventilation tube 60, a ventilator machine 900, a source(s) 602 of fluid (for example, pressurized or unpressurized) and a source(s) of suctioning 603 is disclosed. In some embodiments, the cleaning device is useful for cleaning an inner surface of the ventilation tube 60 and/or for preventing or hindering the accumulation of biofilm thereon. In some embodiments, it is possible to clean biofilm or any other material on the inner surface 201 by delivering fluid into an interior of the ventilation tube, wiping the tube interior with a width-expanded wiping element (e.g. an inflated balloon) by longitudinal motion of the wiping element, and suctioning material out of the ventilation tube ventilation tube.

Abstract: The present disclosure is directed to an over-the-needle (OTN) catheter assembly having a sleeve configured thereon. The catheter includes a body having an outer diameter. The body also includes a proximal end and a distal end and defines a lumen extending from the proximal end to the distal end. A needle is configured within the lumen of the catheter and extends from the proximal end to the distal end. The sleeve is configured around a portion of the outer diameter of the catheter that passes through an insertion site of the catheter. Further, the sleeve includes a length extending from a first end to a second end and is configured to prevent the catheter from collapsing along the length of the sleeve. In addition, the sleeve is configured to prevent leakage from the insertion site of the catheter.

Abstract: A curved inflatable bone tamp includes an outer shaft defining a passageway. An inner shaft is positioned within the passageway. The inner shaft extends between opposite first and second end. The inner shaft defines a lumen. The inner shaft is curved between the first end and the second end. A first leg of a balloon is coupled to the outer shaft and a second leg of the balloon is coupled to the inner shaft such that a material can flow through the lumen and into the balloon to inflate the balloon. The balloon includes a wall having a variable thickness between the legs when the balloon is uninflated and a uniform thickness between the legs when the balloon is inflated. Kits, systems and methods are disclosed.

Abstract: Atrial appendage occlusion systems are provided, such systems including a first device and a second device. The first device has a first tube sized and shaped for insertion into the heart and a balloon coupled thereto. The second device has a second tube sized and shaped for insertion into a pericardial space surrounding the heart, and has a lumen extending at least partially from a second tube distal end to a second tube proximal end. The second device also includes a loop sized and shaped to fit at least partially within the lumen of the second tube, with the loop configured for protraction from the second tube distal end and for placement, and to be tightened and secured around, the atrial appendage.

Abstract: A method and system for infusing medical liquid with gasses, the system comprising a gas source, a vacuum pump, a temperature-controlled container including a fluid reservoir coupled to the gas source and the vacuum pump, a heating and cooling system, and a sonicator, and a controller configured to de-gas a liquid in the fluid reservoir by activating the vacuum pump, re-gas the liquid in the fluid reservoir by releasing gas from the gas source to the fluid reservoir via a first fluid line, and deliver the re-gassed liquid from the fluid reservoir to a catheter via a second fluid line.

Abstract: A method of obtaining information about the position and/or orientation of a magnetic component relatively to a magnetometric detector, the magnetic component and the magnetometric detector being moveable independently from each other relatively to a static secondary magnetic field, the method comprising the steps of: measuring in the presence of the combination of both the magnetic field of the magnetic component and the static secondary magnetic field essentially simultaneously the strength and/or orientation of a magnetic field at at least a first position and a second position spatially associated with the magnetometric detector, the second position being distanced from the first position; and combining the results of the measurements to computationally eliminate the effect of the secondary magnetic field and derive the information about the position and/or orientation of the magnetic component.

Abstract: Provided herein are implantable devices, such as vascular grafts and access port for hemodialysis, that include a microporous sheath layer having a corrugated outer surface, and use therefore for reducing the risk of infection or stenosis.

Abstract: A hub assembly for connection to a medical device having a built in strain relief. The hub assembly may comprise a hub body having a proximal end and a distal end. A lumen may extend from the proximal end to the distal end of the hub body. The distal end of the hub body may have a rounded surface. The rounded surface may have a radius of curvature of greater than 1 millimeter.

Abstract: Devices for removing clot material from a blood vessel lumen and associated systems and methods are disclosed herein. A clot retrieving device may include, for example, an elongated shaft, a capture structure having a proximal region coupled to the distal zone of the elongated shaft, a cover, and a connector coupling the cover to the distal zone of the elongated shaft. The device may further include a jacket at least partially over the proximal terminus of the connector and a portion of the filaments protruding from the connector.

Abstract: The present invention relates to a medicinal fluid flow rate control apparatus and a medicinal fluid injector including the medicinal fluid flow control apparatus. The medicinal fluid flow rate control apparatus includes: an operation knob being able to be turned; a plurality of medicinal fluid delivery lines each having an elastically deformable tube and arranged such that the tubes are arranged at different heights at a side from the operation knob; a tube support member supporting the tubes; a medicinal fluid converger converging medicinal fluids from the medicinal fluid delivery lines into one stream; and a pipe switch selectively pressing or releasing the tubes to open or block all of the medicinal fluid delivery lines or block some of the medicinal fluid delivery lines, depending on a rotational angle of the operation knob.

Abstract: An implantable system for delivering fluids, such as drugs, to one or more anatomical structures in a patient's (i.e., human or animal) body. A number of medical conditions require continual and/or periodic administration of fluids (e.g., drugs) to target regions (e.g., anatomic organs) of the body. Accessibility to those target regions might be limited technically for ex. and not limited to: frequent endoscopic, radiologically guided or surgical approaches. The system delivers the fluid needed in a continual or intermittent fashion to the target region. It controls the amount of fluid delivered to the target region and measures the intended physiologic effect of the fluid delivered.

Abstract: A hydraulic system having a hydraulic device and at least one external database is provided. The hydraulic device comprises at least one hydraulic component, a control electronics having a memory to control the hydraulic component, and an identification element assigned to the hydraulic component. Specific parameters for the hydraulic component are stored in the external database, and the hydraulic component can be clearly identified by a configuration means via the identification element. The configuration means can be connected to the control electronics and the external database to access the specific parameters so that these can be transferred to the memory of the control electronics by means of the configuration means. Further, the disclosure relates to a method for parameterizing control electronics of a hydraulic device of a hydraulic system as well as an arithmetic unit for compiling a program code for the operation of a hydraulic assembly with several components.

Abstract: The present teachings provide methods for resizing, reducing, and closing left atrial appendage. Specifically, a percutaneous trans-septal access is first established from outside the body to a patient's LAA. At least two tissue anchors are then implanted inside the LAA chamber and along the tissue wall. At least one anchor is implanted near the opening of the LAA camber. Both tissue anchors are pulled together so that the wall of the LAA chamber collapse. The LAA chamber is therefore resized, reduced, and/or closed off completely. This closure method and system could be used alone in closing LAA chamber. This closure method and system could also be used in addition to other treatment mechanisms, such as filling the LAA chamber with space-filling material, then closing off its opening.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.