Abstract: Described here are devices, systems, and methods for closing the left atrial appendage. The methods described here utilize a closure device for closing the left atrial appendage and guides or expandable elements with ablation or abrading elements to ablate or abrade the left atrial appendage. In general, these methods include positioning a balloon at least partially within the atrial appendage, positioning a closure assembly of a closure device around an exterior of the atrial appendage, inflating the balloon, partially closing the closure assembly, ablating the interior tissue of the atrial appendage with the inflated balloon, removing the balloon from the atrial appendage, and closing the atrial appendage with the closure assembly.

Abstract: Systems and methods for forming a lesion on an endocardial tissue of a patient's heart involve placing an ablation assembly inside of the heart and adjacent to the endocardial tissue, and placing a guiding assembly outside of the heart. An ablation assembly includes an ablation element and a first attraction element, and a guiding assembly includes a second attraction element. First and second attraction elements can be attracted via magnetism. Techniques involve forming an ablation on the cardiac tissue of a patient's heart with an ablation element of the ablation assembly. Optionally, techniques may include moving the second attraction element of the guiding assembly relative to the patient's heart, so as to effect a corresponding movement of the ablation element of the ablation assembly.

Abstract: Methods for using a surgical device integrating a suction mechanism with a coagulation mechanism for improving lesion creation capabilities. The device comprises an elongate member having an insulative covering attached about means for coagulating soft tissue with at least one diagnostic element coupled to an energy transfer element of the device. Openings through the covering expose regions of the coagulation-causing elements and are coupled to lumens in the elongate member which are routed to a vacuum source and a fluid source to passively transport fluid along the contacted soft tissue surface in order to push the maximum temperature deeper into tissue.

Abstract: Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.

Abstract: Disclosed are devices for pericardial access to the heart, including direct access to the left atrium. In certain embodiments, the device may comprise a device and/or an atrial appendage (AA) portal having a configuration such that the distal end of the device and/or the portal can access an atrial appendage while the proximal end of the device and/or portal can extend to outside of the subject. The devices and methods may also include a pericardial portal for emplacement of the device and/or the AA portal. Also, methods for using such devices and/or AA portals and pericardial portals to perform surgery on the heart, and systems (e.g., kits) comprising these devices and/or portals in combination with other therapeutic devices are disclosed.

Abstract: A method and apparatus for ablating tissue are disclosed that comprise positioning two or more bi-directional ablation energy sources in spaced-apart relation in sufficient proximity to the tissue to be ablated so that, upon activation each energy source creates an energy field in the tissue to be ablated. The energy sources are spaced such that the energy fields created by at least one of the activated sources partially overlaps with the energy field created by one or more of the other energy sources. The energy sources are alternately activated and deactivated, so that a substantially constant energy field results where the energy fields created by at least two of the energy sources overlap. While the energy sources are preferably RF energy sources, other energy sources, such as microwave, may be used.

Abstract: Surgical devices and related methods are disclosed. An example surgical device may include an end effector disposed at a distal end of the shaft, the end effector comprising a head, the head comprising an articulating mechanism, the articulating mechanism being operable to move a first jaw between an open position in which the first jaw and a second jaw are separated and substantially non-parallel and a closed position in which the first jaw and the second jaw are substantially adjacent and substantially parallel, where each of the first jaw and the second jaw comprises a first substantially straight portion proximate the head, a second substantially straight portion, a third substantially straight portion distant from the head, a first curved portion between the first substantially straight portion and the second substantially straight portion, and a second curved portion between the second substantially straight portion and the third substantially straight portion.

Abstract: Bipolar belt ablation systems and methods for treating patient tissue involve the use of an ablation an ablation apparatus with a plurality of ablation elements carried by a flexible tube structure, a radiofrequency generator capable of delivering a plurality of differing radio frequency power signals to the ablation elements of the ablation device, wires transmitting the radiofrequency power signals from the radiofrequency generator to the ablation elements, and a control mechanism to enable temperature-based power control to each of the powered ablation elements.

Abstract: A tissue treatment system configured to ablate a tissue, the system comprising: (a) a clamp assembly comprising a first jaw mechanism and a second jaw mechanism configured to receive and compress a tissue therebetween; (b) a first electrode disposed on the first jaw mechanism and configured to contact the tissue; and (c) a second electrode disposed on the second jaw mechanism and configured to contact the tissue, where the first electrode and the second electrode are configured so that at least one of an ablation energy output of the first electrode and an ablation energy output of the second electrode is automatically adjusted to accommodate variable tissue thicknesses between the first electrode and the second electrode.

Abstract: A surgical system for ablating a tissue, the system comprising: (a) an ablation mechanism comprising a first electrode and an opposed second electrode, wherein the ablation mechanism is configured to receive a tissue between the first electrode and the second electrode, and wherein at least one of the first electrode and the second electrode is movable to allow the first electrode and the second electrode to accommodate variable tissue thicknesses therebetween; and (b) a clamping mechanism configured to release and apply clamping pressure to the tissue between the first electrode and the second electrode, where the ablation mechanism is configured to automatically individually adjust at least one of an ablation energy output of the first electrode and an ablation energy output of the second electrode to accommodate variable tissue thicknesses between the first electrode and the second electrode.

Abstract: Methods of performing surgical operations and associated devices are disclosed. An example method may include locating a first position on a first surface of a biological tissue; locating a second position on a second opposing surface of the biological tissue, the second position corresponding to the first position; and marking the second position on the second surface. The second surface may be generally opposite the first surface. An example method may include, after marking the second position, performing a therapeutic procedure on the biological tissue in the vicinity of the second position.

Abstract: Methods for using a surgical device integrating a suction mechanism with a coagulation mechanism for improving lesion creation capabilities. The device comprises an elongate member having an insulative covering attached about means for coagulating soft tissue with at least one diagnostic element coupled to an energy transfer element of the device. Openings through the covering expose regions of the coagulation-causing elements and are coupled to lumens in the elongate member which are routed to a vacuum source and a fluid source to passively transport fluid along the contacted soft tissue surface in order to push the maximum temperature deeper into tissue.

Abstract: Systems and methods for forming a lesion on an endocardial tissue of a patient's heart involve placing an ablation assembly inside of the heart and adjacent to the endocardial tissue, and placing a guiding assembly outside of the heart. An ablation assembly includes an ablation element and a first attraction element, and a guiding assembly includes a second attraction element. First and second attraction elements can be attracted via magnetism. Techniques involve forming an ablation on the cardiac tissue of a patient's heart with an ablation element of the ablation assembly. Optionally, techniques may include moving the second attraction element of the guiding assembly relative to the patient's heart, so as to effect a corresponding movement of the ablation element of the ablation assembly.

Abstract: A medical instrument comprising: (A) a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in an X-Y plane; (B) a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a Y-Z plane perpendicular to the X-Y plane; and, (C) a controller operatively coupled to the first joint and the second joint, the controller including a first control configured to direct repositioning of at least one of the first member and the second member, and a second control configured to direct repositioning of at least one of the third member and the fourth member.

Abstract: Disclosed are devices for pericardial access to the heart, including direct access to the left atrium. In certain embodiments, the device may comprise a device and/or an atrial appendage (AA) portal having a configuration such that the distal end of the device and/or the portal can access an atrial appendage while the proximal end of the device and/or portal can extend to outside of the subject. The devices and methods may also include a pericardial portal for emplacement of the device and/or the AA portal. Also, methods for using such devices and/or AA portals and pericardial portals to perform surgery on the heart, and systems (e.g., kits) comprising these devices and/or portals in combination with other therapeutic devices are disclosed.

Abstract: Cryosurgical devices, such as cryosurgical probes (cryoprobes) are disclosed. Some example embodiments may include a cryogenic probe comprising an elongated tube at least partially housing or delineating a fluid supply conduit and a fluid exhaust conduit, the elongated tube including a distal ablation section terminating at a closed distal end, the elongated tube including at least one stagnant fluid pocket interposing an exterior of the conduit and at least one of the fluid supply conduit and the fluid exhaust conduit, and a housing at least partially circumscribing at least a portion of a proximal end of the elongated tube and receiving or delineating at least a portion of the fluid supply conduit and a portion of the fluid exhaust conduit.

Abstract: A medical instrument comprising an end effector comprising a first jaw configured to be repositionable with respect to a second jaw, the first and second jaws removably mounted to an open-ended occlusion clip, the end effector configured to configured to be removably coupled to an open-ended occlusion clip with a pair of terminal ends and first and second robotic arms, and wherein the end effector includes at least one of a cavity and a projection configured to be engaged by at least one of the first and second robotic arms.

Abstract: Methods and devices described herein facilitate improved treatment of body organs.

Abstract: Electrosurgical pericardiotomy devices are disclosed. An example electrosurgical pericardiotomy device configured to create an opening through a pericardium may include an end effector comprising a tip portion and at least one electrosurgical electrode. The tip portion may include an opening configured to engage a target portion of a pericardium, and the tip portion may be configured, upon application of vacuum to the tip portion, to separate the target portion of the pericardium from an external surface of a heart. The electrosurgical electrode may be disposed proximate the tip portion so that, with vacuum applied to the tip portion, the target portion of the pericardium contacts the electrosurgical electrode. The electrosurgical electrode may be configured to create an opening through the target portion of the pericardium using electrosurgical energy.

Abstract: Pericardiotomy devices are disclosed. An example pericardiotomy device includes an elongated shaft and an end effector disposed distally on the shaft. The end effector includes a tip portion and a penetrating element. The tip portion includes an opening configured to engage a target portion of a pericardium and is configured, upon application of vacuum to the tip portion, to separate the target portion of the pericardium from an external surface of a heart. The penetrating element is disposed within the tip portion so that, with vacuum applied to the tip portion, the penetrating element is operative to create an opening in the target portion of the pericardium.