Described here are devices, systems, and methods for closing the left atrial appendage. The methods described here utilize a closure device for closing the left atrial appendage and guides or expandable elements with ablation or abrading elements to ablate or abrade the left atrial appendage. In general, these methods include positioning a balloon at least partially within the atrial appendage, positioning a closure assembly of a closure device around an exterior of the atrial appendage, inflating the balloon, partially closing the closure assembly, ablating the interior tissue of the atrial appendage with the inflated balloon, removing the balloon from the atrial appendage, and closing the atrial appendage with the closure assembly.

A treatment device includes a flexible sheath; a control wire that can move axially within the flexible sheath; a first treatment member connected to a distal end of the control wire; a second treatment member connected to a distal end of the first treatment member; and a protection member that covers the second treatment member depending on the mode of operation. When the treatment device is in a first treatment mode, the second treatment member projects from a distal end of the protection member. When the treatment device is in a second treatment mode, the first treatment member projects from the distal end of the flexible sheath, and the protection member covers the second treatment member.

An endarterectomy device configured to remove plaque from an occluded artery is disclosed. The endarterectomy device uses an adjustable wire loop end effector to establish and advance a dissection plane in the subadventitial space of the artery. The endarterectomy device is passed down the length of an artery in the subadventitial plane, adjusting the size of the wire loop end effector as needed to navigate the artery and dissect a plaque column, until the end of the plaque is reached. The wire loop end effector is then used as a plaque cutter to transect the distal end of the plaque column. The endarterectomy device is further configured along its length with support arms that facilitate removal of the plaque column as the device is removed from the artery.

Methods, devices, and systems are described herein that allow for improved sampling of tissue from remote sites in the body. A tissue sampling device comprises a handle allowing single hand operation. In one variation the tissue sampling device includes a blood vessel scanning means and tissue coring means to excise a histology sample from a target site free of blood vessels. The sampling device also includes an adjustable stop to control the depth of needle penetration. The sampling device may be used through a working channel of a bronchoscope.

A device, system, and method for ligating the left atrial appendage without creating pro-arrhythmic tissue. The device may generally include a snare including a thermally transmissive distal portion and a suture including a distal portion, both distal portions having a lasso-shaped configuration that may be positioned proximate the base of the left atrial appendage. Once the distal portions of the snare and the suture are tightened around the base of the left atrial appendage, the thermally transmissive distal portion of the snare may be activated to create an ablation lesion in adjacent left atrial appendage tissue. The lesion may be created with radiofrequency energy or through cryoablation by the circulation of refrigerant within the thermally transmissive distal portion of the snare.

An endoscopic forceps includes an elongate shaft defining an instrument axis. An end effector includes first and second jaw members each supporting an opposed sealing surface for clamping tissue. At least one of the jaw members is movable relative to the instrument axis such that the jaw members are movable between a first spaced-apart configuration and a second closed configuration for grasping tissue. A cutting instrument includes a reciprocating blade translatable relative to the sealing surfaces to sever tissue clamped between the jaw members. The reciprocating blade contacts an undersurface of at least one of the jaw members when the jaw members are in the second configuration to define a gap distance between the sealing surfaces. A handle adjacent the proximal end of the elongate shaft is operable to induce motion in the jaw members, and an actuator is operable to selectively translate the reciprocating blade.

This disclosure is directed to a method for providing electrical communication with a heart using a catheter having a lasso electrode assembly with a moveable spine. The lasso electrode assembly may have an array of sensing electrodes and may be configured to engage the ostium of the vessel of a patient. The moveable spine may have an ablation electrode and may travel along track around the circumference of the lasso electrode assembly. By adjusting the position of the moveable spine, tissue may be ablated to form lesions around a circumference of the vessel.

The present invention relates to methods of removing a lesion from a patient. A method of removing a lesion from a patient includes positioning wire loops of a probe device relative to the lesion. The wire loops are simultaneously rotated and expanded to cut material from the lesion. Irrigation fluid is supplied, via the probe device, to irrigate the material cut from the lesion. The supplied irrigation fluid is aspirated, via the probe device, to facilitate removal of the material cut from the lesion.

An endoscopic instrument includes an outer cannula and an inner cannula disposed within the outer cannula, a tool channel, a retractable tool, and a retractable tool actuator. The tool channel is defined within a radial wall of the outer cannula or positioned adjacent to the radial wall of the outer cannula. The retractable tool includes a distal tip and sized to fit within the tool channel The retractable tool actuator is configured to move, responsive to actuation of the retractable tool actuator, the retractable tool along the tool channel from a first position in which the distal tip of the retractable tool is within the tool channel to a second position in which the distal tip of the retractable tool extends beyond a distal end of the outer cannula

An electrode assembly (3) is provided for use in a resectoscope, the electrode assembly (3) comprising a pair of arms (4), and a tissue treatment element (9) depending from the arms. The arms (4) are pivotably mounted one to the other such that they are movable between a retracted position in which they lie alongside one another and a deployed position in which they diverge one from another. The electrode assembly (3) includes actuation means for moving the arms between their retracted and deployed positions. The tissue treatment element (9) is disposed at the distal end of each arm such that it is movable between at least two different operating positions.