Method and devices for coagulation of tissue

1. A method of creating a treatment pattern in a target tissue, where the target tissue comprises a first tissue surface and a second tissue surface, where the second tissue surface is on an opposite side of the first tissue surface, the method comprising:

positioning a first medical treatment device adjacent to the first tissue surface;

forming a first portion of the treatment pattern along the first tissue surface using the first medical treatment device such that the first portion of the treatment pattern is incomplete;

positioning a second medical device having at least one energy source adjacent to the second tissue surface;

applying energy adjacent to the second tissue surface using the energy source;

identifying a location of the energy source through the target tissue from the first tissue surface to locate the second medical device; and

repositioning the second medical device on the second tissue surface in response to the location of the first portion of the treatment pattern and using the second medical device to form a second portion of the treatment pattern on the second tissue surface to complete the treatment pattern.

2. The method of claim 1 , where the first medical treatment device comprises a first coagulation device.

3. The method of claim 2 , where the second medical treatment device further includes at least one coagulation source.

4. The method of claim 2 , further comprising advancing a second coagulation device to the target location to create the second coagulation lesion.

5. The method of claim 2 , where the first coagulation device and the second medical device comprise opposite poles of an RF energy supply, and where energy flows between the first coagulation device and second medical device during application of the RF energy supply.

6. The method of claim 1 , where the first medical treatment device comprises a device selected from the group consisting of an RF energy device, a laser device, an infrared heating device, a chemical ablation device, a cryogenic device, a microwave energy device, and a resistive heating device.

7. The method of claim 1 , where the energy source comprises an energy selected from the group consisting of visible light, coherent light, ultraviolet light, magnetic energy, and electrical energy.

8. The method of claim 1 , where identifying the energy source through the target tissue from the first tissue surface comprises placing a sensor device adjacent to the first tissue surface where the sensor device measures the energy to determine a proximity between the second device and the sensor device.

9. The method of claim 1 , where the first tissue surface comprises an epicardial surface and the second tissue surface comprises an endocardial surface.

10. The method of claim 1 , where the first tissue surface comprises an endocardial surface and the second tissue surface comprises an epicardial surface.

11. The method of claim 2 , where the first, coagulation device is advanced through a port or trocar positioned in a body and where the second device is advanced through a vascular path in the body.

12. The method of claim 11 , where the port or trocar is located in an abdominal wall of the body and the first coagulation device is advanced through the diaphragm.

13. The method of claim 12 , where no ports or trocars are positioned in a chest wall of the body.

14. The method of claim 12 , where the first coagulation device is positioned adjacent to the first cardiac surface without requiring deflation of a lung.

15. The method of claim 11 , where the port or trocar is located in a chest wall of the body and the first coagulation device is advanced through the diaphragm.

16. The method of claim 1 , further comprising advancing a scope into a body where the scope comprises at least one visualization element and where identifying the location of the energy source through the target tissue from the first tissue surface to locate the second device comprises using the visualization element to identify the location of the electromagnetic energy.