Ablation instruments and methods for performing abalation
First Claim
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1. A method of performing ablation transmurally across the wall of an organ, said method comprising the steps of:
- preparing an opening in a patient to provide direct access to the wall of the organ;
preparing an opening through the organ;
inserting an ablation device through the opening in the patient and the opening through the organ;
approximating a target area of an inner wall of the organ with an ablation element of the ablation device; and
ablating the target area to create a lesion.
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Accused Products
Abstract
Methods, devices and instruments provided for performing ablation transmurally across the wall of an organ. Devices may directly access tissue to be ablated through direct access openings formed in the patient and, optionally, an organ where the ablation is to be performed. Instruments facilitating making openings, dissecting, and delivery of ablation instruments are also described.
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Citations
119 Claims
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1. A method of performing ablation transmurally across the wall of an organ, said method comprising the steps of:
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preparing an opening in a patient to provide direct access to the wall of the organ;
preparing an opening through the organ;
inserting an ablation device through the opening in the patient and the opening through the organ;
approximating a target area of an inner wall of the organ with an ablation element of the ablation device; and
ablating the target area to create a lesion. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method of performing atrial ablation, said method comprising the steps of:
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making an opening in a patient to provide direct access to the heart of the patient;
making an opening in the pericardium;
inserting an ablation device through the opening in the patient and the opening in the pericardium;
approximating a target area of a wall of the organ with an ablation element of the ablation device; and
ablating the target area to create a lesion. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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19. A method of performing atrial ablation, said method comprising the steps of:
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inserting an ablation device comprising a rigid or malleable tube and at least one ablation element at a distal end portion thereof through an opening in the chest of a patient and through the atrium;
viewing the location and placement of the distal end of the ablation device through an endoscope passing axially therethrough; and
ablating tissue at a target location on the endocardium in the atrium. - View Dependent Claims (20, 21, 22, 23, 24)
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25. An ablation device for directly accessing a surgical site to perform ablation on a targeted tissue, said device comprising:
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an elongated rigid or malleable tube having a distal end portion and a proximal end portion, said elongated tube having sufficient length so that at least a proximal end of the proximal end portion extends out of a patient when a distal end of the distal end portion contacts the targeted tissue;
an endoscope axially received within said elongated rigid or malleable tube;
a transparent tip closing the distal end of said distal end portion, wherein said transparent tip enables direct viewing through the distal end of the device using said endoscope; and
at least one ablation element mounted on said device at said distal end portion. - View Dependent Claims (26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 77, 78, 79, 80, 81)
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82. An ablation device for directly accessing a surgical site to perform ablation on a targeted tissue, said device comprising:
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an elongated rigid or malleable tube having a distal end portion and a proximal end portion, said elongated tube having sufficient length so that at least a proximal end of the proximal end portion extends out of a patient when a distal end of the distal end portion contacts the targeted tissue;
an endoscope axially received within said elongated rigid or malleable tube;
a transparent tip axially aligned with said elongated tube, distally of said elongated tube, wherein said transparent tip enables direct viewing through the distal end of the device using said endoscope, and wherein said transparent tip is expandable to vary an outside diameter thereof; and
at least one ablation element mounted on said device for application of ablation energy to tissue when approximated by said device.
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83. An ablation device for directly accessing a surgical site to perform ablation on a targeted tissue, said device comprising:
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an elongated rigid or malleable tube having a distal end portion and a proximal end portion, said elongated tube having sufficient length so that at least a proximal end of the proximal end portion extends out of a patient when a distal end of the distal end portion contacts the targeted tissue; and
a variable diameter tip mounted to said distal end portion of said tube, said variable diameter tip adapted to contact tissue and apply at least one of an energy or chemical to the tissue to perform ablation of the tissue. - View Dependent Claims (84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99)
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100. An ablation device for directly accessing a surgical site to perform ablation on a targeted tissue, said device comprising:
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an elongated rigid or malleable tube;
a transparent distal tip mounted at a distal end of said tube;
a balloon member axially mounted over a distal end portion of said tube, proximal of said distal tip and fluidly connected to an opening through said tube for inflation of said balloon member by delivering pressurized fluid through said tube; and
an ablation element located within said balloon member - View Dependent Claims (101, 102)
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100-1. A dissection instrument comprising:
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an elongated rigid or malleable tube having a distal end portion and a proximal end portion, said elongated tube having sufficient length so that at least a proximal end of the proximal end portion extends out of a patient when a distal end of the distal end portion contacts tissue as it is dissected;
an endoscope axially received within said elongated rigid or malleable tube;
a transparent blunt tip closing the distal end of said distal end portion, wherein said transparent blunt tip enables direct viewing through the distal end of the device using said endoscope; and
a transparent member having a sharp configuration mounted between said blunt tip and a distal end of said endoscope.
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103. A device for facilitating the formation of an opening through an organ and for facilitating the delivery of at least one instrument through the opening, said device comprising:
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an elongated main tube having proximal and distal ends;
a sewing ring located about said distal end; and
a one-way valve located within a proximal end portion of said main tube. - View Dependent Claims (104, 105)
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107. The dissection instrument of claim 106, further comprising a protrusion extending distally from a distal end surface of said transparent blunt tip, said protrusion configured to facilitate dissection.
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108. The dissection instrument of claim 106, wherein said transparent member having a sharp configuration comprises a conical lens.
- 109. The dissection instrument of claim 106, further comprising a channel extending through at least a portion of a length of said elongated tube and extending through said transparent blunt tip.
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112. An ablation device for directly accessing a surgical site to perform ablation on a targeted tissue, said device comprising:
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an elongated rigid or malleable tube having a distal end portion and a proximal end portion, said elongated tube having sufficient length so that at least a proximal end of the proximal end portion extends out of a patient when a distal end of the distal end portion contacts the targeted tissue;
an endoscope axially received within said elongated rigid or malleable tube;
a transparent tip closing the distal end of said distal end portion, wherein said transparent tip enables direct viewing through the distal end of the device using said endoscope; and
at least one ablation element mounted on a distal end portion of said device. - View Dependent Claims (113, 114, 115, 116, 117, 118, 119)
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Specification