METHOD AND SYSTEM FOR ACCESSING A PERICARDIAL SPACE

A device and method for accessing a pericardial space of the heart includes a shaft having a cavity at a distal end, a suction lumen terminating in a distal port within the cavity and a hollow needle having a distal tip extending into the cavity. The cavity may be a recess in the shaft into which the distal tip of the needle fixedly protrudes. In other embodiments, the cavity is formed by an inflatable member positioned at the distal end of the shaft and the needle is slidable relative to the shaft. Suction is applied at the cavity to draw a pericardial bleb. The needle pierces the pericardial bleb for accessing the pericardial space and also facilitates delivery of payloads into the pericardial space. 1. A device for accessing a pericardial space of a heart , the device comprising:a shaft extending from a proximal end to a distal end, the shaft defining a cavity disposed near the distal end, and a suction lumen terminating in at least one distal suction port located within the cavity; anda hollow needle extending through the shaft and fixed in position relative to a longitudinal axis of the shaft, the needle having a sharp distal end protruding into the cavity downwardly toward a heart surface at an angle with respect to a longitudinal axis of the shaft.2. The device of further comprising a guidewire adapted for advancing through a bore of the needle.3. The device of wherein the suction lumen terminates in a plurality of distal suction ports.4. The device of wherein the needle extends a distance of from about 0.5 to about 3 mm into the cavity.5. The device of wherein the angle is between about 15 and about 60 degrees.6. The device of wherein the angle is about 90 degrees.73. The device of wherein the cavity has a generally concave configuration with respect to the heart surface. Page8. The device of further comprising a flange structure formed on an inner wall of the shaft adapted to prevent longitudinal movement of the needle relative to the shaft and permit ...

ENDOSCOPIC VESSEL HARVESTING SYSTEM COMPONENTS

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy. 162-. (canceled)63. A vessel dissector that is used in conjunction with an endoscope , comprising:an elongated cannula including a lumen therein for receiving the endoscope;a transparent blunt dissecting tip provided on a distal end of the elongated cannula that permits an operator of the vessel dissector to dissect tissue while viewing internal body structures via an objective lens of the endoscope, wherein the blunt dissection tip has a conical exterior surface;a vessel holding tool extending through the elongated cannula and adapted for longitudinal movement therein; anda vessel severing tool extending through the elongated cannula and adapted for longitudinal movement therein,wherein the dissecting ...

Apparatus and methods for performing minimally-invasive surgical procedures

Devices, tools and methods for performing minimally invasive surgical procedures. Methods of performing minimally invasive ablation procedures. Methods of performing rapid exchange of tools in a device while the device remains in a reduced-access surgical space.

APPARATUS AND METHOD FOR REGULATING TISSUE WELDER JAWS

A surgical apparatus and methods for severing and welding tissue, in particular blood vessels. The apparatus includes an elongated shaft having a pair of relatively movable jaws at a distal end thereof. A first heating element on one of the jaws is adapted to heat up to a first temperature and form a welded region within the tissue, while a second heating element on one of the jaws is adapted to heat up to a second temperature and sever the tissue within the welded region. The first and second heating elements may be provided on the same or opposite jaws. A control handle provided on the proximal end of the elongated shaft includes controls for opening and closing the jaws, and may include an actuator for sending current through the first and second heating elements. The first and second heating elements may be electrically connected in series, and the first heating element may be bifurcated such that it conducts about one half of the current as the second heating element. A force-limiting mechanism provided either within the control handle, in the elongated shaft, or at the jaws limits the pressure applied to the tissue by the jaws to ensure that the tissue is severed and the ends effectively welded within a short amount of time. 128-. (canceled)29. A surgical method of severing a target tissue while welding the severed ends using a surgical apparatus , the surgical apparatus comprising a shaft and first and second jaws extending from a distal end of the shaft , wherein the first jaw is relatively movable with respect to the second jaw; the surgical apparatus further comprising a first electrode and a second electrode electrically connected in series , wherein the first electrode is operatively associated with one of the first and second jaws and is adapted to weld tissue , and wherein the second electrode is operatively associated with one of the first and second jaws and is adapted to sever tissue , the method comprising: closing the jaws upon the target tissue; ...

APPARATUS AND METHODS FOR PERFORMING MINIMALLY-INVASIVE SURGICAL PROCEDURES

Devices, tools and methods for performing minimally invasive surgical procedures. Methods of performing minimally invasive ablation procedures. Methods of performing rapid exchange of tools in a device while the device remains in a reduced-access surgical space. 182-. (canceled)8322. The system of claim , wherein said distal tip comprises a ball-ended tip.84225-. (canceled)226. A surgical system for performing minimally invasive surgical procedures , said surgical system comprising:an elongated body having a distal end portion, an external body surface, an interior region encompassed by said external body surface, and at least two lumens extending generally along a direction of a longitudinal axis of said elongated body, wherein one of the two lumens is configured for receiving an endoscope therein; anda lens forming an elongated distal tip having a convex configuration with respect to the distal end portion of the elongated body and an outer circumferential surface that is entirely smooth and continuous to allow for endoscopic visability of a surgical field, wherein the distal tip comprises a proximal end, a curved and blunt distal end for blunt dissection of tissue, and an exterior side surface extending therebetween, when attached to the distal portion of the elongated body, the distal tip is configured to allow for endoscopic visibility of a surgical field along a length of the distal tip through the exterior side surface so as to minimize visual distortion.227. The system of claim 226 , wherein the distal tip is configured to provide an endoscopic field of view allowing for visibility of tissue from the distal tip proximal end to a location distal thereto.228. The system of claim 227 , wherein the distal tip is configured to breakup reflected waves of light from the curved and blunt distal end claim 227 , minimizing formation of rings of reflected light.229. The system of claim 226 , wherein the elongated distal tip is transparent.230. The system of claim 226 , ...

APPARATUS AND METHOD FOR REGULATING TISSUE WELDER JAWS

A surgical apparatus and methods for severing and welding tissue, in particular blood vessels. The apparatus includes an elongated shaft having a pair of relatively movable jaws at a distal end thereof. A first heating element on one of the jaws is adapted to heat up to a first temperature and form a welded region within the tissue, while a second heating element on one of the jaws is adapted to heat up to a second temperature and sever the tissue within the welded region. The first and second heating elements may be provided on the same or opposite jaws. A control handle provided on the proximal end of the elongated shaft includes controls for opening and closing the jaws, and may include an actuator for sending current through the first and second heating elements. The first and second heating elements may be electrically connected in series, and the first heating element may be bifurcated such that it conducts about one half of the current as the second heating element. A force-limiting mechanism provided either within the control handle, in the elongated shaft, or at the jaws limits the pressure applied to the tissue by the jaws to ensure that the tissue is severed and the ends effectively welded within a short amount of time.

ENDOSCOPIC VESSEL HARVESTING SYSTEM COMPONENTS

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy. 116-. (canceled)17. A vessel dissector that is used in conjunction with an endoscope , comprising:an elongated cannula including a lumen therein for receiving the endoscope; anda transparent blunt tip provided on a distal end of the elongated cannula that permits an operator of the dissector to dissect tissue while viewing internal body structures via an objective lens of the endoscope; anda wiper for clearing tissue from the exterior of the transparent blunt tip.18. The vessel dissector of claim 17 , wherein the wiper is arranged on the elongated cannula to pivot about an axis to alternately contact and disengage from the transparent blunt tip claim 17 , and a mechanism for rotating the blunt tip.19. ...

ENDOSCOPIC VESSEL HARVESTING SYSTEM COMPONENTS

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy. 162-. (canceled)63. A vessel dissector that is used in conjunction with an endoscope , comprising:an elongated cannula including a lumen therein for receiving the endoscope;a transparent blunt dissecting tip provided on a distal end of the elongated cannula that permits an operator of the vessel dissector to dissect tissue while viewing internal body structures via an objective lens of the endoscope, wherein the blunt dissection tip has a conical exterior surface;a vessel holding tool extending through the elongated cannula and adapted for longitudinal movement therein; anda vessel severing tool extending through the elongated cannula and adapted for longitudinal movement therein,wherein the dissecting ...

ENDOSCOPIC VESSEL HARVESTING SYSTEM COMPONENTS

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy. 116-. (canceled)17. A vessel dissector that is used in conjunction with an endoscope , comprising:an elongated cannula including a lumen therein for receiving the endoscope; anda transparent blunt tip provided on a distal end of the elongated cannula that permits an operator of the dissector to dissect tissue while viewing internal body structures via an objective lens of the endoscope; anda wiper for clearing tissue from the exterior of the transparent blunt tip.18. The vessel dissector of claim 17 , wherein the wiper is arranged on the elongated cannula to pivot about an axis to alternately contact and disengage from the transparent blunt tip claim 17 , and a mechanism for rotating the blunt tip.19. ...

Endoscopic vessel harvesting system components

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy.

Tissue welding and cutting apparatus and method

A surgical apparatus and methods for severing and welding tissue, in particular blood vessels, include a pair of relatively movable jaws at a distal end of an elongated shaft. A first heating element on one of the jaws is adapted to heat up to a first temperature and form a welded region within the tissue, while a second heating element on one of the jaws is adapted to heat up to a second temperature and sever the tissue within the welded region. A force-limiting mechanism is provided to limit the pressure applied to the tissue by the jaws to ensure that the tissue is severed and the ends effectively welded within a short amount of time.

Methods for inhibiting reperfusion injury

A method that includes introducing a catheter assembly to an obstructed region of a blood vessel lumen and recanalizing the obstructed region with the catheter assembly is disclosed. Prior to or during recanalization, a treatment agent may be delivered through the catheter assembly to a vessel region downstream to the obstructed region. The treatment agent may have a property that will inhibit reperfusion injury. Alternatively, a medical device may be introduced to an obstructed region of a blood vessel lumen and the obstructed region recanalized with the medical device. The treatment agent may be delivered to a vessel region downstream to the obstructed region. The treatment agent may include at least one of an immunosuppresant and an antioxidant. In other methods, a delivery cannula may be introduced to an unperfused region of an occluded vessel without disrupting the occlusion and the treatment agent having a property that will inhibit reperfusion injury may be delivered to the unperfused region through the delivery cannula. After delivering the treatment agent, the occluded vessel may be recanalized by advancing an angioplasty device into the occluded vessel.

Endoscopic vessel harvesting system components

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy.

Methods for inhibiting reperfusion injury

A method that includes introducing a catheter assembly to an obstructed region of a blood vessel lumen and recanalizing the obstructed region with the catheter assembly is disclosed. Prior to or during recanalization, a treatment agent may be delivered through the catheter assembly to a vessel region downstream to the obstructed region. The treatment agent may have a property that will inhibit reperfusion injury. Alternatively, a medical device may be introduced to an obstructed region of a blood vessel lumen and the obstructed region recanalized with the medical device. The treatment agent may be delivered to a vessel region downstream to the obstructed region. The treatment agent may include at least one of an immunosuppresant and an antioxidant. In other methods, a delivery cannula may be introduced to an unperfused region of an occluded vessel without disrupting the occlusion and the treatment agent having a property that will inhibit reperfusion injury may be delivered to the unperfused region through the delivery cannula. After delivering the treatment agent, the occluded vessel may be recanalized by advancing an angioplasty device into the occluded vessel.

Vorrichtung zum schweissen und schneiden von gewebe

Apparatus and method for regulating tissue welder jaws

A surgical apparatus and methods for severing and welding tissue, in particular blood vessels. The apparatus includes an elongated shaft having a pair of relatively movable jaws at a distal end thereof. A first heating element on one of the jaws is adapted to heat up to a first temperature and form a welded region within the tissue, while a second heating element on one of the jaws is adapted to heat up to a second temperature and sever the tissue within the welded region. The first and second heating elements may be provided on the same or opposite jaws. A control handle provided on the proximal end of the elongated shaft includes controls for opening and closing the jaws, and may include an actuator for sending current through the first and second heating elements. The first and second heating elements may be electrically connected in series, and the first heating element may be bifurcated such that it conducts about one half of the current as the second heating element. A force-limiting mechanism provided either within the control handle, in the elongated shaft, or at the jaws limits the pressure applied to the tissue by the jaws to ensure that the tissue is severed and the ends effectively welded within a short amount of time.

Catheter having window and partial balloon covering for dissecting tissue planes and injecting treatment agent to coronary blood vessel

A method is provided including introducing a delivery device through a vessel wall to a treatment site within one of a peri-adventitial space or a pericardium adjacent a coronary blood vessel and delivering a treatment agent through the delivery device. The treatment agent is delivered through the delivery device according to conditions that hydraulically dissect tissue planes within the peri-adventitial space. A kit is provided including a delivery device having a needle to be advanced through one of an epicardium of a heart and a wall of a coronary blood vessel into a peri-adventitial space and a treatment agent comprising particles having an average diameter on the order of 15 microns or more to be delivered through the delivery device into the peri-adventitial space.