Endoscopic subxiphoid surgical procedures
First Claim
1. A surgical procedure comprising:
- forming an incision;
advancing an endoscopic cannula through the incision toward a target location on a patient'"'"'s pericardium;
introducing a pericardium-penetrating instrument through the endoscopic cannula into contact with the pericardium at the target location;
forming an aperture through the pericardium at the target site to expose epicardial tissue;
introducing a tacking instrument through the endoscopic cannula through the aperture in the pericardium for installing a plural number of tacks at selected locations in the epicardial tissue including one epicardial tack at a region of the mitral annulus below the circumflex coronary artery, and another epicardial tack at a region of the mitral annulus below the coronary sinus; and
installing an element in contact with at least a pair of the plural number of tacks to exert tension therebetween.
2 Assignments
0 Petitions
Accused Products
Abstract
Endoscopic subxiphoid surgical procedures and instruments facilitate translumination of tissue through the pericardium, and promote encircling an intrapericardial region with one or more tissue-ablating probes for ablating cardiac tissue substantially encircling the left and right pulmonary veins as a treatment for chronic atrial fibrillation. Such endoscopic subxiphoid surgical procedures and instruments also facilitate placement of epicardial tacks about the annulus of the mitral valve for supporting a tensioned suture or band that decreases the size of the mitral annulus to repair a regurgitant valve. Suction-oriented instruments facilitate temporary attachment to an organ to establish precise positioning on the organ during a surgical procedure.
265 Citations
3 Claims
-
1. A surgical procedure comprising:
-
forming an incision; advancing an endoscopic cannula through the incision toward a target location on a patient'"'"'s pericardium; introducing a pericardium-penetrating instrument through the endoscopic cannula into contact with the pericardium at the target location; forming an aperture through the pericardium at the target site to expose epicardial tissue; introducing a tacking instrument through the endoscopic cannula through the aperture in the pericardium for installing a plural number of tacks at selected locations in the epicardial tissue including one epicardial tack at a region of the mitral annulus below the circumflex coronary artery, and another epicardial tack at a region of the mitral annulus below the coronary sinus; and installing an element in contact with at least a pair of the plural number of tacks to exert tension therebetween. - View Dependent Claims (3)
-
-
2. A surgical procedure comprising:
-
forming an incision; advancing an endoscopic cannula through the incision toward a target location on a patient'"'"'s pericardium; introducing a pericardium-penetrating instrument through the endoscopic cannula into contact with the pericardium at the target location; forming an aperture through the pericardium at the target site to expose epicardial tissue; introducing a tacking instrument through the endoscopic cannula through the aperture in the pericardium for installing a plural number of tacks at selected locations in the epicardial tissue; installing an element in contact with at least a pair of the plural number of tacks to exert tension therebetween including; assembling a suture with a pair of loops formed with slip knots having trailing suture ends at spaced locations along the length of the suture; positioning one of the pair of loops of the suture about one of the plural number of installed epicardial tacks; positioning another of the pair of loops of the suture about another of the plural number of installed epicardial tacks; advancing an elongated hollow tube along a trailing suture end from a slip knot for engagement thereof with a distal end of the tube; and pulling on the trailing suture end relative to the tube to selectively decrease a suture loop about an installed epicardial tack for tensioning the trailing suture ends to tension the suture between the pair of loops disposed about the installed epicardial tacks.
-
Specification