Abstract: Systems and methods are provided to improve respiratory function. Systems include an external electrical stimulator coupled to electrodes that stimulates diaphragm contraction and may optionally include a positive pressure mechanical ventilator. The system further includes an electrode suitable for temporary implantation. Electrical stimulation is provided to specific portions of the diaphragm, such as one hemidiaphragm preferentially over another. By preferentially contracting one hemidiaphragm, a specific portion of a lung may be expanded, such as a posterior portion. By the provision of the negative intrathoracic pressure from diaphragm contraction, greater expansion of specific portion of lung is achieved in relationship to air pressure within the lung, thereby improving compliance. Supplementation of stimulated diaphragm contraction with positive pressure driven air flow from a PPMV directs the air flow to specific portions of the lung.

Abstract: The invention provides a method and device for providing electrical stimulation to a patient's diaphragm (or other organ or tissue) including the steps of: introducing an endoscope transviscerally (e.g., transgastrically) into the patient's body cavity; delivering an electrode into the patient's body cavity through a lumen of the endoscope; applying suction to attach the electrode to a stimulation site on the diaphragm (or other organ or tissue); and delivering a stimulation pulse to the stimulation site. The stimulation may be repeated at multiple stimulation sites.

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 apparatus for use with a cannula includes a rigid rod which is receivable and movable in the cannula throughout a range of operative positions in which inner and outer end portions of the rod extend longitudinally outward from the inner and outer ends of the cannula. The apparatus further includes a contact electrode which is configured to be supported on the inner end portion of the rigid rod for movement with the rigid rod through the cannula.

Abstract: A method of conditioning a diaphragm of a patient is provided. The method can include the steps of implanting an electrode adjacent a target site in the diaphragm of the patient and operating the electrode to deliver a sufficient amount of electrical stimulation to the target site in the diaphragm of the patient to cause the diaphragm to contract.