Pericardium management method for intra-pericardial surgical procedures

Abstract

A method for managing the pericardium during intra-pericardial procedures such as the delivery of cardiac support devices. One embodiment of the method includes making an incision through the pericardium to provide access to the pericardial space, and inserting a plurality of strips of lubricious material into and through the incision. The strips of material are spaced around the edges of the incision to form a tubular barrier against the pericardium. End portions of the strips of material in the pericardial space are expanded away from the body to form a lip that lines the inside of the pericardium around the incision.

1 . A method for managing a patient's pericardium during an intra-pericardial procedure, including:
 making an incision though the pericardium to provide access to the pericardial space;   inserting one or more flexible members into and through the incision;   forming portions of the one or more flexible members into a tubular barrier against exposed edges of the pericardium; and   extending portions of one or both ends of the one or more flexible members away from the tubular barrier and around the exposed edges of the pericardium to line at least portions of the pericardium around incision.   
   
   
       2 . The method of  claim 1  wherein inserting one or more flexible members includes inserting a tubular structure formed of flexible material. 
   
   
       3 . The method of  claim 2  wherein extending end portions of the one or more flexible members includes forming a lip on an end of the tubular structure. 
   
   
       4 . The method of  claim 3  wherein forming the lip includes actuating an actuating member to form the lip. 
   
   
       5 . The method of  claim 4  wherein actuating an actuating member includes forming a hoop on the end portion of the tubular structure. 
   
   
       6 . The method of  claim 3  wherein inserting one or more flexible members into the incision includes inserting flexible sheet material into the incision. 
   
   
       7 . The method of  claim 2  wherein extending end portions of the one or more flexible members includes forming a lip on an end of the tubular structure within the pericardial space and under the pericardium. 
   
   
       8 . The method of  claim 1  wherein inserting one or more flexible members includes inserting a plurality of flexible members. 
   
   
       9 . The method of  claim 8  wherein inserting a plurality of flexible members includes inserting a plurality of strips of flexible material. 
   
   
       10 . The method of  claim 9  wherein forming the tubular barrier includes circumferentially spacing the strips of material around the edges of the incision. 
   
   
       11 . The method of  claim 9  wherein extending end portions of the flexible members includes fanning the end portions of the flexible material away from the tubular barrier. 
   
   
       12 . The method of  claim 9  wherein inserting flexible material includes inserting ends of strips of material extending from circumferentially spaced locations around a hoop into the incision. 
   
   
       13 . The method of  claim 9  wherein inserting the strips of flexible material includes inserting the strips within the pericardial space and extending ends of the strips under the pericardium. 
   
   
       14 . The method of  claim 9  wherein inserting flexible material includes inserting material having a relatively low friction surface. 
   
   
       15 . The method of  claim 9  wherein forming a portion of the one or more flexible members into a tubular barrier includes attaching at least portions of the strips of flexible material to one another. 
   
   
       16 . The method of  claim 1  wherein inserting one or more flexible members includes inserting relatively low friction members. 
   
   
       17 . The method of  claim 1  wherein extending portions of one or both ends of the one or more flexible members includes increasing a diameter of the portions of the members extending away from the tubular barrier with respect to a diameter of the tubular barrier. 
   
   
       18 . The method of  claim 1  wherein:
 inserting one or more flexible members includes inserting a plurality of flexible members; and   forming portions of the flexible members into a tubular barrier includes positioning edges of the flexible members adjacent to one another.   
   
   
       19 . The method of  claim 18  wherein positioning edges of the flexible members adjacent to one another includes overlapping the edges of the flexible members. 
   
   
       20 . The method of  claim 18  and further including attaching portions of the edges of adjacent flexible members.