Transmural ablation device

Abstract

A method and apparatus for transmural ablation using an instrument containing two electrodes or cryogenic probes. A clamping force is exerted on the two electrodes or probes such that the tissue of the hollow organ is clamped therebetween. Bipolar RF energy is then applied between the two electrodes, or the probes are cryogenically cooled, thus ablating the tissue therebetween. The method provides for ablating cardiac tissue of a patient utilizing a sub-xyphoid approach and identifying cardiac tissue prior to ablation.

1 . A bipolar clamp for bringing the opposing walls of a hollow organ or vessel into contact with each other along a line of contact, the clamp including at least two conductors adapted to be disposed on opposed sides of the organ or vessel along the line of contact, and the conductors being adapted to pass sufficient electrical current through both walls along the line of contact to form a corresponding line of ablated tissue through both walls of the tissue without bonding the walls together.  
   
   
       2 . The bipolar clamp of  claim 1  in which the clamp has a pair of opposed jaws suitable to clamp together opposing walls of the vessel or organ, each jaw carrying at least one of said conductors, the conductors of the opposed jaws being connectable to opposite terminals of an RF generator.  
   
   
       3 . The bipolar clamp of  claim 2  in which each conductor comprises a continuous elongated electrode.  
   
   
       4 . A system for forming transmural lesions in opposing walls of a hollow organ or vessel comprising: 
 a bipolar clamp for bringing the opposing walls of the hollow organ or vessel into contact with each other along a line of contact, the clamp including at least two conductors adapted to be disposed on opposed sides of the organ or vessel along the line of contact, and the conductors being adapted to pass sufficient electrical current through both walls along the line of contact to form a corresponding line of ablated tissue through both walls of the tissue without bonding the walls together; and    a monitoring device cooperatively associated with the bipolar clamp for gauging the completeness of tissue ablation through the opposed walls of the hollow organ or vessel.    
   
   
       5 . The system of  claim 4  wherein the monitoring device is adapted to monitor the current between the conductors.  
   
   
       6 . The system of  claim 4  wherein the monitoring device is adapted to monitor the voltage between the conductors.  
   
   
       7 . The system of  claim 4  wherein the monitoring device is adapted to monitor the impedence of the ablated tissue along the line of contact.  
   
   
       8 . The system of  claim 4  wherein the monitoring device is adapted to monitor the temperature of the ablated tissue along the line of contact.  
   
   
       9 . The system of  claim 4  wherein the monitoring device is adapted to generate an audible or visible signal when it is gauged that the ablation is transmural.  
   
   
       10 . A system for forming transmural lesions in opposing walls of a hollow organ or vessel comprising: 
 a bipolar clamp for bringing the opposing walls of the hollow organ or vessel into contact with each other along a line of contact, the clamp including at least two conductors adapted to be disposed on opposed sides of the organ or vessel along the line of contact, and the conductors being adapted to pass sufficient electrical current through both walls along the line of contact to form a corresponding line of ablated tissue through both walls of the tissue without bonding the walls together; and    a monitoring device in electrical communication with a conductor for gauging the completeness of tissue ablation through the opposed walls of the hollow organ or vessel by one or more of monitoring the current between the conductors, monitoring the voltage between the conductors, or monitoring the impedence of the ablated tissue along the line of contact.    
   
   
       11 . The system of  claim 10  wherein the monitoring device is adapted to generate an audible or visible signal when it is gauged that the ablation is transmural.  
   
   
       12 . The system of  claim 10  wherein the monitoring device includes a bipolar energy generator for generating biopolar energy through the opposed walls of the hollow organ or vessel along the line of contact between the conductors.