Abstract: Embodiments of an access device system useful for single or limited port procedures includes a retractor and a gel cap removably coupled to the retractor. The gel cap includes a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

Abstract: An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop placed therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

Abstract: An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop placed therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

Abstract: A surgical valve includes a housing with a proximal housing portion and a distal housing portion cooperating to define a gel cavity. A seal material is disposed in the gel cavity and includes a gel having flow characteristics and incompressible characteristics. A distal guide tube is provided to facilitate retrograde insertion of a surgical instrument into the seal material. During assembly, pressure is applied by the housing portions to the seal material in order to form a circumferential seal and to close an instrument channel. Manufacture can be facilitated by use of a mandrel for maintaining the structural elements in axial alignment. Complimentary screw threads disposed between the first and second housing portions can be used to pressurize the gel and thereby create a locking force on an inserted instrument. Detented tabs can be provided to facilitate control of this locking force.

Abstract: Embodiments of a surgical access system useful for single or limited port procedures comprise a trocar comprising a fixation cannula, a retractor, and a gel cap removably coupled to the retractor. The gel cap comprises a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The fixation cannula comprises a retainer and a bolster, which together, capture the artificial body wall therebetween, thereby fixing the trocar thereto. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

Abstract: A surgical access device or trocar defines an access channel for instruments extending from a proximal end to the distal end thereof. The trocar comprises a cannula and a seal assembly disposed at the proximal end of the cannula. The seal assembly comprises a first or zero seal, a second or instrument seal, and a trocar shield disposed proximally of the first seal and the second seal. The first seal seals the access channel in the absence of an instrument extending therethrough. The second seal seals the access channel in the presence of an instrument extending therethrough. The trocar shield protects the first seal and second seal from damage as an instrument is advanced through the access channel. The trocar shield comprises an open proximal end and a tapered distal end comprising a plurality of longitudinal pleats, converging in an opening.

Abstract: Bipolar electrosurgical scissors for treating biological tissue include first and second scissor blades. A shearing surface and cutting edge of each blade is electrically neutral. The scissors include a pair of electrical connections for receiving electrical currents of opposing polarities. Each blade includes at least one first electrode and at least one second electrode positioned on a surface opposite the shearing surface. The at least one first electrode on the first blade and the at least one second electrode on the second blade are coupled to the first electrical connection. The at least one second electrode on the first blade and the at least one first electrode on the second blade are coupled to the second electrical connection. In a first energized state, the electrical connections deliver electrical current only to the first electrodes. In a second energized state, the electrical connections deliver electrical current to all of the electrodes.

Abstract: A surgical access device has a surgical retractor having a noncompliant outer ring with an annular axis, an inner ring, and a sleeve coupling the outer ring to the inner ring. The noncompliant outer ring is adapted to roll over itself around the annular axis to roll the sleeve around the outer ring to retract and seal an opening in a biological body wall. The access device may include a lid adapted for being coupled to the noncompliant outer ring of the surgical retractor. The outer ring of the surgical retractor has a cross-sectional shape that prohibits the lid from being partially or incorrectly coupled to the outer ring of the surgical retractor.

Abstract: A surgical access device includes a single valve that forms a seal with a body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal for an instrument having a diameter up to about 37 mm. The valve can include a gel material and the access channel can include a protective sleeve to provide for wound protection during insertion and withdrawal of a sharp surgical instrument. The valve further comprises a cap ring which may be inserted or molded with the gel material. The protective sleeve may be bonded or molded around an inner diameter of the cap ring. The protective sleeve may be a single tubular member, or may comprise a plurality of axially extending sleeve members having a plurality of axial slits. The protective sleeve and the cap ring may comprise of the same or different materials.

Abstract: A surgical access device includes a seal housing and a roller disposed in the housing and defining a working channel. The roller may be stationary or moveable within the seal housing to form both a zero seal in the absence of an instrument, and an instrument seal in the presence of an instrument. Rotation of the roller is contemplated and low-friction surfaces are discussed to reduce instrument insertion forces. Multiple rollers, wiper elements, low-friction braid, pivoting elements and idler rollers are contemplated. The rollers will typically be formed of a gel material in order to facilitate the desired compliance, stretchability and elongation desired.

Abstract: A surgical access port comprises a valve or instrument seal that separates the instrument contact function from the instrument conforming function. Embodiments of the instrument seal comprise in instrument contact element that extends through an opening in a compression element, thereby defining an instrument orifice that seals with an instrument extending therethrough. Embodiments of the instrument contact element comprise a non-distensible membrane or film, for example, as a tube or cylinder. Some embodiments of the instrument contact element have an hourglass configuration with a first end proximal of the opening of the compression element and a second end distal of the opening of the compression element. Other embodiments of the instrument contact element “wrap around” the opening in the compression element, with the first end and the second end secured to the same side of the opening, for example, proximal of the opening.

Abstract: A multi-seal trocar system includes a plurality of co-axial sealing elements adapted for forming a seal with either a large or small instrument. Small and large sealing elements are disposed in an in-line arrangement such that a-single port is provided for instrument insertion. A zero seal is disposed distally of the sealing elements to seal a working channel of the system and to prevent backflow when no instruments are inserted. The small sealing element is configured such that insertion of a large instrument automatically moves the small sealing element out of its path, thereby avoiding contact with the large instrument.

Abstract: A surgical access device including a valve housing and an instrument receiving element mounted in the valve housing having an aperture for flexibly receiving and directing instruments having a wide range of diameters. The instrument receiving element includes a braid or mesh tube generally shaped like an hourglass. The surgical access device may include an access septum seal molded from a gel material. The surgical access device can flexibly engage instruments having diameters ranging from about 3.5 mm to about 12.9 mm.

Abstract: A surgical access device has a surgical retractor having a noncompliant outer ring with an annular axis, an inner ring, and a sleeve coupling the outer ring to the inner ring. The noncompliant outer ring is adapted to roll over itself around the annular axis to roll the sleeve around the outer ring to retract and seal an opening in a biological body wall. The access device may include a lid adapted for being coupled to the noncompliant outer ring of the surgical retractor. The outer ring of the surgical retractor has a cross-sectional shape that prohibits the lid from being partially or incorrectly coupled to the outer ring of the surgical retractor.

Abstract: A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.

Abstract: A surgical access device including a valve housing and an instrument receiving element mounted in the valve housing having an aperture for flexibly receiving and directing instruments having a wide range of diameters. The instrument receiving element includes a braid or mesh tube generally shaped like an hourglass. The surgical access device may include an access septum seal molded from a gel material. The surgical access device can flexibly engage instruments having diameters ranging from about 3.5 mm to about 12.9 mm.

Abstract: A monopolar electrosurgical return electrode to prevent unwanted thermal effects in monopolar electrosurgery, accomplished in one aspect by volumetric incorporation of temperature-resistive material of positive nature into a flexible and adhesive return electrode pad is provided. The incorporation of positive temperature coefficient resistance with low resistance at room temperature will increase the local electrical resistance of the pad with an increase of the local return electrode temperature corresponding to a switching of the resistance from low to high value which in turn will lead to a reduction of the local current density. The switching temperature of the positive temperature coefficient return electrode is low enough to prevent significant thermal heating of the patient's tissue.

Abstract: A surgical access device or trocar defines an access channel for instruments extending from a proximal end to the distal end thereof. The trocar comprises a cannula and a seal assembly disposed at the proximal end of the cannula. The seal assembly comprises a first or zero seal, a second or instrument seal, and a trocar shield disposed proximally of the first seal and the second seal. The first seal seals the access channel in the absence of an instrument extending therethrough. The second seal seals the access channel in the presence of an instrument extending therethrough. The trocar shield protects the first seal and second seal from damage as an instrument is advanced through the access channel. The trocar shield comprises an open proximal end and a tapered distal end comprising a plurality of longitudinal pleats, converging in an opening.

Abstract: A surgical access device adapted for disposition relative to an incision in a patient comprising a valve including a plurality of overlapping sheets defining an access channel, and a ring having an inner diameter for holding the valve by fixing each of the overlapping sheets along a portion of the perimeter is described. The access channel extends into communication with the incision in the patient. Each of the overlapping sheets includes a portion of the perimeter that is not fixed to the inner diameter of the ring, which provide open edges defining the access channel. The open edges slightly overlap at the center of the ring.

Abstract: A monopolar electrosurgical return electrode to prevent unwanted thermal effects in monopolar electrosurgery, accomplished in one aspect by volumetric incorporation of temperature-resistive material of positive nature into a flexible and adhesive return electrode pad is provided. The incorporation of positive temperature coefficient resistance with low resistance at room temperature will increase the local electrical resistance of the pad with an increase of the local return electrode temperature corresponding to a switching of the resistance from low to high value which in turn will lead to a reduction of the local current density. The switching temperature of the positive temperature coefficient return electrode is low enough to prevent significant thermal heating of the patient's tissue.