A tubular access sleeve and suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner are disclosed. A suction tool trunk extending through a suction tool lumen of the sleeve is coupled to suction pads at the ends elongated support arms. The suction pads can be retracted into a sleeve working lumen during advancement of the access sleeve through a passage and deployed from the tubular access sleeve lumen and disposed against the an outer tissue layer. Suction can be applied through suction tool lumens to suction ports of the suction pads that fix to the outer tissue layer so as to tension the outer tissue layer and/or pull the outer tissue layer away from an inner tissue layer so that the anatomic space can be accessed by instruments introduced through the working lumen to penetrate the outer tissue layer.