Tissue modification devices are provided. Aspects of the devices include an elongated member having a proximal end and a distal end. The distal end of the elongated member is dimensioned to pass through a minimally invasive body opening and includes a distal end integrated visualization sensor and tissue modifier. In some instances, the devices further include an integrated articulation mechanism that imparts steerability to at least one of the visualization sensor, the tissue modifier and the distal end of the elongated member. Also provided are methods of modifying internal target tissue of a subject using the tissue modification devices.
