Abstract: Systems and methods for implanting an electrode under ultrasound guidance in muscle, such as the diaphragm, or near nerve tissue can include inserting under ultrasound guidance a catheter or cannula into a body cavity of the patient proximate the target muscle or near the target nerve tissue; inserting under ultrasound guidance an insertion needle, with the electrode loaded into a lumen of the insertion needle, into the body cavity and into the target muscle or near the target nerve tissue; and withdrawing the insertion needle to expulse the electrode and lead from the central lumen of the insertion needle.

Abstract: An implantable medical electrode system for intramuscular use that is readily removable is provided, as well as methods for its use. The system includes an electrode, an electrical lead mechanically and electrically connected to the electrode and extending proximally, and a tether bonded to the electrode and extending proximally. A conductor with an insulated portion enwraps the electrical lead; an uninsulated portion enwraps the electrode. Some embodiments may include a tissue-piercing guide such as a needle. In some embodiments, the electrode includes a barb, although in some of these embodiments the tether does not extend through the barb. The method of using the system includes inserting the through a target tissue, pulling the electrode with the needle into the target tissue, and extending the electrical lead and tether proximally to an electrical connection. Methods are further provided for removing the electrode which take advantage of structural features of the system.

Abstract: A method of placing an electrode in a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; and using the endoscope to place the electrode in contact with tissue within the peritoneal cavity other than stomach tissue. Another aspect of the invention provides a method of electrically mapping tissue accessed from a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; passing an electrode through the endoscope; placing the electrode in contact with tissue within the peritoneal cavity other than stomach tissue; and applying a mapping stimulation signal to the electrode from a mapping stimulator.

Abstract: An implantable medical electrode system for intramuscular use that is readily removable is provided, as well as methods for its use. The system includes an electrode, an electrical lead mechanically and electrically connected to the electrode and extending proximally, and a tether bonded to the electrode and extending proximally. A conductor with an insulated portion enwraps the electrical lead; an uninsulated portion enwraps the electrode. Some embodiments may include a tissue-piercing guide such as a needle. In some embodiments, the electrode includes a barb, although in some of these embodiments the tether does not extend through the barb. The method of using the system includes inserting the through a target tissue, pulling the electrode with the needle into the target tissue, and extending the electrical lead and tether proximally to an electrical connection. Methods are further provided for removing the electrode which take advantage of structural features of the system.

Abstract: A method of delivering a tool to a peritoneal cavity including the following steps: inserting a guidewire percutaneously through an abdominal wall into a stomach; pulling the abdominal wall away from the stomach; and guiding a distal end of an endoscope with the guidewire through a wall of the stomach into the peritoneal cavity. Another aspect of the invention provides an abdominal wall grasping device having an abdominal wall attachment portion adapted to attach to an abdominal wall and a grasping element adapted to be grasped by a user to pull the abdominal wall away from a stomach.