Tissue treatment systems for cardiac surgical procedures can include an ablation and monitoring assembly having a first ablation element, a second ablation element, and a monitoring mechanism. Treatment methods may involve placing an ablation and monitoring assembly of the tissue treatment system at a patient tissue treatment site, applying a first ablative energy to a first tissue location via the first ablation element and a second ablative energy to a second tissue location via the second ablation element, monitoring a condition of the first tissue location with the monitoring mechanism, and modulating application of the first ablative energy to the first tissue location in response to the condition of the first tissue location while maintaining application of the second ablative energy to the second tissue location. Embodiments also include techniques for assessing a conduction delay across a lesion that involve evaluating local activation rates on various sides of a lesion.

Systems, devices, and methods for electroporation ablation therapy are disclosed, with the device including a first jaw including a plurality of first electrodes and a second jaw including a plurality of second electrodes. The first jaw and the second jaw may be substantially rigid, elongate, and collectively define a longitudinal axis. The first jaw and the second jaw may be configured to engage tissue therebetween during use.

A treatment instrument includes a first treatment portion including a first member with a first contact surface and a second member with a second contact surface; a movement mechanism to switch between a closed position where the first and second contact surfaces are close to each other and an open position where the first and second contact surfaces are separated each other; and a second treatment portion juxtaposed to the first treatment portion. A distal end of the second treatment portion is located at a distal side in the longitudinal axis than a distal end of the first treatment portion on the closed position.

An electrosurgical device can be delivered to a tissue site to provide supplemental sealing of vessels and/or vascular tissue that include suturing, stapling, or the like. The electrosurgical device is generally in the form of forceps, and includes an end effector assembly including opposing movable jaws. Each jaw includes a deformable pad or cushion including an electrode array positioned thereon. Each deformable cushion is configured to deliver a fluid, such as saline, during activation of the electrode array, thereby creating a virtual electrode which couples radiofrequency (RF) energy emitted from the electrode array into tissue in which the RF energy is converted into thermal energy. The deformable cushion and electrode array provide a controlled degree of compression upon the target tissue or vessel to maintain integrity of a suture, staple, or clip, as well as controlled energy emission for sealing, cauterizing, coagulating, and/or desiccating the target tissue or vessel.

A forceps includes an end effector assembly having a stop and a plurality of overmold teeth within at least one jaw member. One (or both) of the jaw members is moveable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. One (or both) of the jaw members includes a stop molded within an insulative housing, and an insulator plate with the overmold teeth formed from plastic. The overmold teeth extend through openings within a sealing plate and protrude past the tissue sealing surface of the sealing plate. The stop primarily controls the gap distance between opposing jaw members by bearing most of an applied load and the overmold teeth assist in controlling the gap distance by bearing the remaining applied load.

A method and apparatus for ablating tissue are disclosed that comprise positioning two or more bidirectional ablation energy sources in spaced-apart relation in sufficient proximity to the tissue to be ablated so that, upon activation each energy source creates an energy field in the tissue to be ablated. The energy sources are spaced such that the energy fields created by at least one of the activated sources partially overlaps with the energy field created by one or more of the other energy sources. The energy sources are alternately activated and deactivated, so that a substantially constant energy field results where the energy fields created by at least two of the energy sources overlap. While the energy sources are preferably RF energy sources, other energy sources, such as microwave, may be used.

A treatment instrument includes: a first treatment section which includes a first body including a first contact surface and a second body including a second contact surface; a movement mechanism which is configured to switch between a closed position in which the first contact surface and the second contact surface are close to each other, and an opened position in which the first contact surface and the second contact surface are distant from each other; and a second treatment section which is disposed on a distal side along the longitudinal axis with respect to the first treatment section when the first contact surface and the second contact surface are located in the closed position, and which is configured to apply energy to the living tissue to incise or separate the living tissue.

Unitary endoscopic vessel harvesting devices are disclosed. In some embodiments, such devices may comprise an elongated body having a proximal end and a distal end. A conical tip may be disposed at the distal end of the elongated body. In addition, the surgical instrument may include one or more surgical instruments moveable in a longitudinal direction along an axis substantially parallel to a central longitudinal axis of the cannula from a retracted position proximally of a distal end of the tip to an advanced position toward the distal end of the tip to seal and cut a blood vessel.

Various methods of treating a heart of a patient having a cardiac arrhythmia are disclosed. The method can comprise dissecting tissue at an inferior aspect of a right inferior pulmonary vein of the patient to create an oblique sinus defect, dissecting tissue to open a space between a superior vena cava and a left atrium, and dissecting tissue to open a space across a transverse sinus between a pulmonary artery and a roof of the left atrium. The method can further comprise passing a catheter through an oblique sinus defect underneath the heart and beyond a left ventricle and passing a first flexible guiding device across the transverse sinus and under the superior vena cava and the pulmonary artery.

A surgical clip device is provided for closing vessels, for example in neurosurgery. The surgical clip device is provided with at least two electrically conductive clip parts that are electrically isolated from each other and are arranged at a predetermined distance opposite each other. Each of the two clip parts may be held with a first free end thereof on an electrically isolating holding part in one of a U-shaped or a V-shaped configuration.