Abstract: A clip applier and method provide for surgically minimizing or eliminating a tissue appendage of the patient using an occlusion clip. An end effector of the clip applier has first and second channels that respectively receive/engage first and second elongate beams of the clip. The clip includes strand(s) that forms a loop through the first and the second elongate beams. Terminal segments of the strand(s) extend proximally through a clip setting mechanism of the occlusion clip. An opening between first and second elongate beams of the occlusion clip are positioned around a tissue appendage. A closure mechanism of the clip applier is actuated to proximally draw the terminal segments of the strand(s) to close the occlusion clip and to close the end effector. A release mechanism of the occlusion clip is actuated, allowing the end effector to open away from the occlusion clip in a clamped state.

Abstract: Delivery devices configured to deliver therapeutic and visualization devices to a surgical site are disclosed. An example delivery device may include a proximally disposed handle; a shaft extending distally from the handle, the shaft including a therapeutic device lumen configured to deliver a working end of a therapeutic device therethrough, a first portion of the shaft being steerable; and a space-making element disposed proximate a distal end portion of the shaft and configured to separate biological tissues to create or expand a working space. At least a portion of the space-making element may be reconfigurable between a retracted configuration and an expanded configuration.

Abstract: A surgical space maker device has a flexible member comprising an expandable space-making frame where at least a first frame member and a second frame member of the space-making frame are axially advanceable relative to each other.

Abstract: Disclosed herein are devices and methods for a reusable clip sizing tool to select a clip for use with a left atrial appendage. The clip can comprise a handle portion having a proximal end and a distal end, a base portion distal to the handle portion, a plurality of indicator markers on the base portion, wherein the plurality of indicator markers comprise numbers corresponding to a size of a left atrial appendage when a distal end of the base portion is aligned with the left atrial appendage. The plurality of indicator markers can comprise alternating contrast levels. The handle portion and the base portion can comprise a malleable material.

Abstract: Described here are devices for closing one or more tissues, and handles for controlling these devices. Generally, the devices described here comprise a snare loop assembly, wherein the snare loop assembly comprises a snare and a suture loop, and a handle for controlling the snare loop assembly. In some variations the snare loop assembly may comprise a retention member that may releasably connect the suture loop to the snare. In other variations the devices comprise one or more force-reducing suture locks to help prevent the suture loop from inadvertently disengaging from the snare loop assembly. In still other variations, the excess-suture management features. The handles described here may be configured to remove excess suture from a suture loop, and may also be configured to release the suture loop from the snare loop assembly.

Abstract: Devices, systems, and methods for therapeutically treating tissue. The devices and methods are suitable for minimally invasive surgery or open surgical procedures. More particularly, methods and devices described herein permit accessing and/or treating areas of tissue with a therapeutic device having a hood member with a plurality of channels located therein for applying a vacuum and cooling the areas of tissue as energy is delivered through electrodes located adjacent to or in the hood member.

Abstract: High-voltage pulses ablation systems and methods are used to ablate tissue and form lesions. A variety of different electrophysiology devices, such as catheters, surgical probes, and clamps, may be used to position one or more electrodes at a target location. Electrodes can be connected to power supply lines and, in some instances, the power to the electrodes can be controlled on an electrode-by-electrode basis. High-voltage pulse sequences provide a total amount of heating that is typically less than that which is observed with thermally-based radiofrequency energy ablation protocols.

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: An occlusion clip comprising: (a) a spring; (b) a first runner including a first open top and a first open end adjacent the first open top, the first runner including a first interior camming surface partially delineating a first interior cavity that is open by way of the first open top and the first open end; (c) a second runner including a second open top and a second open end adjacent the second open top, the second runner including a second interior camming surface partially delineating a second interior cavity that is open by way of the second open top and the second open end, where the spring is configured to be coupled to the first runner and the second runner, where the first interior cavity is configured to receive a first portion of the spring, where the second interior cavity is configured to receive a second portion of the spring, where the first camming surface is configured to engage a first cam of the spring, and where the second camming surface is configured to engage a second cam of the sprin

Abstract: High-voltage pulses ablation systems and methods are used to ablate tissue and form lesions. A variety of different electrophysiology devices, such as catheters, surgical probes, and clamps, may be used to position one or more electrodes at a target location. Electrodes can be connected to power supply lines and, in some instances, the power to the electrodes can be controlled on an electrode-by-electrode basis. High-voltage pulse sequences provide a total amount of heating that is typically less than that which is observed with thermally-based radiofrequency energy ablation protocols.

Abstract: A method of using an occlusion clamp, the method comprising: (a) repositioning a tongs so that tissue interposes the tongs, the tongs comprising a first longitudinal segment operatively coupled proximally to a second longitudinal segment, the tongs including a first spring exerting a proximal bias tending to direct a proximal portion of each of the first and second longitudinal segments toward one another, where each of the first and second longitudinal segments includes a distal free end; (b) repositioning a second spring distally along each of the first and second longitudinal segments to exert a bias tending to direct a distal portion of each of the first and second longitudinal segments toward one another, where repositioning of the tongs so that tissue interposes the tongs precedes repositioning the second spring distally along each of the first and second longitudinal segments.

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: Ablation systems, components thereof, and related methods are disclosed. An example ablation system may include a first ablation component including a first ablation component end effector configured to be positioned on a first side of a target tissue and a second ablation component including a second ablation component end effector configured to be positioned on a second side of the target tissue. The first ablation component may include a first ablation component permanent magnet that is translationally repositionable between an engaged configuration and a disengaged configuration. The second ablation component may include a second ablation component permanent magnet that is freely rotatable and is configured to rotatably self-orient into a magnetically attractive orientation with the first ablation component permanent magnet.

Abstract: The instant disclosure is directed to devices and methods for deploying a biased occlusion clamp. In addition, the present disclosure includes devices and methods for deploying a biased occlusion clamp using robotics. Moreover, the present disclosure includes devices and methods for reducing the force necessary to open an occlusion clamp without permanently compromising the clamping force of the clamp itself.

Abstract: A laparoscopic device comprising: (a) a housing operatively coupled to a first control and a second control; (b) an end effector operatively coupled to the first control, the end effector comprising a first component and a second component selectively repositionable with respect to one another within an X-Y plane, the end effector also including a third component selectively repositionable with respect to the second component within an Y-Z plane; (c) a laparoscopic conduit extending between the housing and the end effector; and, (d) an occlusion clip deployment device operatively coupled to the end effector and the second control.

Abstract: Devices, systems, and methods for therapeutically treating tissue. The devices and methods are suitable for minimally invasive surgery or open surgical procedures. More particularly, methods and devices described herein permit accessing and/or treating areas of tissue with a therapeutic device having a hood member with a plurality of channels located therein for applying a vacuum and cooling the areas of tissue as energy is delivered through electrodes located adjacent to or in the hood member.

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: Tissue stabilizing devices and methods for stabilizing, and optionally closing, a target tissue, such as the left atrial appendage, generally include an elongate body with a first lumen and a second lumen, a suction tip coupled to the elongate body, and an injection tip coupled to the elongate body proximal of the suction tip. The suction tip may define a suction aperture and the suction aperture may be in fluid communication with the first lumen to apply suction to the target tissue. The injection tip may be in fluid communication with the second lumen to dispense a contrast fluid.

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.