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Abstract

Apparatus and method for performing surgical procedures within the mediastinum or within the pericardium include an endoscopic cannula that is introduced into the mediastinum and optionally into the pericardium via a subxiphoid incision. A cavity may be initially dilated for advancing the endoscopic cannula using a dilating tool having an inner cannula and an outer expansible sheath that is expansible to exert a laterally expansive force against the surrounding tissue. Surgical instruments such as a pericardial entry device are inserted into a lumen of the endoscopic cannula to grasp a flap of the pericardium, and a cutting tool is extended to cut the flap to create a small opening through which other surgical tools may be introduced. The endoscopic cannula can then be advanced inside the pericardium to access all regions of the heart by sweeping the endoscopic cannula around the heart. Other surgical instruments may be inserted through the opening to perform surgical procedures within the pericardium.

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First Claim