Devices, systems, and methods for accessing the internal and external tissues of the heart are disclosed. At least some of the embodiments disclosed herein provide access to the external surface of the heart through the pericardial space for localized delivery of substances to the heart tissue. In addition, various disclosed embodiments provide access to the internal surface of the heart for aspiration and delivery of substances to a targeted region without disturbing or interfering with nearby structures or surfaces.

Devices, systems, and methods for accessing the internal and external tissues of the heart are disclosed. At least some of the embodiments disclosed herein provide access to the external surface of the heart through the pericardial space for localized delivery of substances to the heart tissue. In addition, various disclosed embodiments provide access to the internal surface of the heart for aspiration and delivery of substances to a targeted region without disturbing or interfering with nearby structures or surfaces.

The present modification describes a surgical instrument which introduces a metric scale from the distal area of the forceps up to 5 cm proximal, allowing numerous uses, among which can be highlighted the measurement of the depth of ulcerous lesions following a plane perpendicular to the skin.

The present modification describes a surgical instrument which introduces a metric scale from the distal area of the forceps up to 5 cm proximal, allowing numerous uses, among which can be highlighted the measurement of the depth of ulcerous lesions following a plane perpendicular to the skin.

Ergonomic support units for use with medical instruments, such as surgical forceps. In various implementations the support units may include wings, rings, winged rings, or other support structures. An ergonomic instrument including a first support unit shaped to support at least one finger of a user and a second support unit shaped to support a thumb of a user, wherein the first support unit and second support unit are configured to reduce effort required to manipulate the ergonomic instrument.

Ergonomic support units for use with medical instruments, such as surgical forceps. In various implementations the support units may include wings, rings, winged rings, or other support structures. An ergonomic instrument including a first support unit shaped to support at least one finger of a user and a second support unit shaped to support a thumb of a user, wherein the first support unit and second support unit are configured to reduce effort required to manipulate the ergonomic instrument.

A device for engaging tissue includes a body disposable around the distal end of a medical instrument, such as an endoscope, and a handpiece. The body includes a primary channel for receiving the medical instrument and at least one arm channel for receiving an arm therethrough. At least one arm extends through the arm channel of the body and proximally to the handpiece. The arm includes an engagement member distally of the body, and may further include a bend between the body and engagement member. The engagement member is movable between a first position not contacting tissue and a second position contacting tissue. With multiple engagement members, the engagement members are farther apart from one another in the first position and closer together in the second position. Movement of the engagement members is controlled by selective and independent movement of the corresponding arms by rotational and/or translational motion.

A device for engaging tissue includes a body disposable around the distal end of a medical instrument, such as an endoscope, and a handpiece. The body includes a primary channel for receiving the medical instrument and at least one arm channel for receiving an arm therethrough. At least one arm extends through the arm channel of the body and proximally to the handpiece. The arm includes an engagement member distally of the body, and may further include a bend between the body and engagement member. The engagement member is movable between a first position not contacting tissue and a second position contacting tissue. With multiple engagement members, the engagement members are farther apart from one another in the first position and closer together in the second position. Movement of the engagement members is controlled by selective and independent movement of the corresponding arms by rotational and/or translational motion.

A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.

A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.