Abstract: An insertion device for safely creating an incision through tissue is provided. The device includes a tubular member and a cutting assembly. The tubular member includes proximal and distal ends and defines a passageway therethrough. The tubular member includes at least one longitudinal slot extending proximally from a distal end thereof. The cutting assembly includes a blade assembly mounted on a distal end thereof. The distal end of the cutting assembly is configured for sliding reception within the passageway of the tubular member. The blade assembly includes at least one blade movable between a retracted position and an extended position. The blade assembly is configured such that the at least one blade is received through the at least one longitudinal slot of the tubular member when the at least one blade is in an extended position.

Abstract: Devices and methods are disclosed herein for accessing the hip joint. A first device can be securely attached to the capsule of a joint. The first device can tent the capsule to increase the volume of the peripheral compartment. A second device can be biased against the first device to pierce the tented capsule and create a portal. Devices and methods are also disclosed herein for distending the capsule of a joint. A distention device may access a portal established within the capsule. The distention device can expand the capsule by applying an expansive force within the peripheral compartment. The distention device can maintain distention of the peripheral compartment while other devices access the joint.

Abstract: An access port for use in single port surgery includes a cannula to provide minimally invasive access to a surgical site and an instrument guide that fits closely within the cannula. The instrument guide includes guide channels that are open to the outside surface of the instrument guide. Each of the guide channels is configured to support a single surgical instrument at a defined position within the cannula. The guide channels may be smoothly enlarged at the end that receives surgical instruments. The access port may further include a seal that couples the instrument guide to the cannula such that the seal retains a pressurized insufflation fluid within the surgical site. The instrument guide may include one or more insufflation channels for introducing an insufflation fluid to the surgical site. The access port may include a flexible section. The surgical instruments may be controlled robotically by servo actuators.

Abstract: A surgical portal apparatus includes a portal having an elongated portal member and defining a portal passage for reception of a surgical object, and a locking base. The locking base includes a flange segment defining a longitudinal axis and having a longitudinal opening for permitting reciprocal longitudinal passage of the portal member and a locking segment mounted to the flange segment. The flange segment is dimensioned and configured for positioning against body tissue. The locking segment is dimensioned to selectively engage the portal member and establish a secured relation therewith to selectively secure the portal at a predetermined longitudinal position with respect to the longitudinal axis of the locking base. The flange segment of the locking base may include an adhesive coating for adhesive engagement with the body tissue.

Abstract: An apparatus for shielding a body structure during surgical procedures which is configured for insertion into the internal passage of a support structure, and includes an elongated body portion with a distal tip portion configured to cover the body structure without substantially displacing the body structure. The apparatus also includes a mounting portion at a proximal end portion thereof for mounting the apparatus within the internal passage of the support structure, and a member connected to the mounting portion to release the mounting portion with respect to the internal passage of the wall portion.

Abstract: A surgical access apparatus includes a housing member, a portal member extending from the housing member and defining a central longitudinal axis, and defining a longitudinal passage therethrough dimensioned to permit passage of an surgical object and a constraining mechanism associated with at least one of the housing member and the portal member. The constraining mechanism includes a constraining member dimensioned and positioned to intersect the longitudinal passage. The constraining member is adapted to engage the surgical object and bias the surgical object toward a position radially displaced relative to the central longitudinal axis. The constraining member is adapted to transition from an initial condition in the absence of the surgical object to a stressed condition in the presence of the surgical object. The constraining member may be normally biased toward the initial condition.

Abstract: The invention provides a surgical apparatus and method for performing less-invasive, closed chest cardiac surgery through a transabdominal approach, without cardiopulmonary bypass. In a preferred embodiment, the invention provides a heart manipulator and a coronary stabilizer which are deployed through an access cannula and secured relative to a stationary support through a surgical arm. Heart manipulator and coronary stabilizer cooperate together to enable access to all the coronary artery territories of the heart through a single access cannula. Also provided is a diaphragm tissue retractor.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. A surgical access port is provided that has an adjustable longitudinal length, such as by being formed from multiple segments configured to move relative to one another. An anchor can be coupled to a distal end of the surgical access port to help secure the surgical access port within a tissue opening by engaging a distal side of the tissue. Optionally, the anchor can be removably coupled to the distal end of the surgical access port, thereby allowing any one of a plurality of anchors to be selectively coupled thereto.

Abstract: To avoid traditional muscle dissection required in the placement of a surgical implant during arthrodesis, a pedicle seeker and retractor are provided. The pedicle seeker includes a distal end that approximates the size, shape and length of a surgical implant and is of sufficient length to extend beyond the face of the retractor, allowing the pedicle seeker to be removed from the surgical site once the retractor has been placed. The pedicle seeker is used to palpate the bony surface of the patient's spine in order to locate the proper place to place an implant. After the desired location has been located, the retractor is placed into the surgical site and held in place in order to maintain the desired location for placement of the surgical implant, and the seeker is removed. The retractor includes surficial features that approximate the size of the pedicle seeker and the surgical implant, to allow the implant to be moved down the length of the face of the retractor to the desired location.

Abstract: A method and instruments for performing breast augmentation mammaplasty in a patient are provided. The method includes making an incision to gain access to an area underneath the breast of the patient, and providing a retractor including a shaft and a tubular member connected to the shaft. The tubular member includes a hollow endoscope guide portion and a generally flattened blade portion, where the endoscope guide portion transitions into the blade portion such that an end of the blade extends beyond an end of the endoscope guide. The method further includes inserting the retractor at least partially through the incision to aid in placing a breast implant within the patient.

Abstract: A collateral soft tissue protection surgical device protects collateral soft tissue from damage during a surgical procedure within a surgical space of a body. The device comprises an elongated flexible sheath having a proximal end and a distal end. The proximal end has a first opening and the distal end has a second opening. The sheath further comprises a side wall between the proximal and distal ends that defines the first and second openings. The side wall is conformal to the surgical space and arranged to resist perforation by surgical instruments in use during the surgical procedure, and also to define and maintain the access pathway to the surgical site.

Abstract: The various embodiments of the present inventions provide stabilization devices and methods for use of the stabilization devices with minimally invasive gynecological procedures such as methods of preventing pregnancy by inserting intrafallopian contraceptive devices into the fallopian tubes

Abstract: A multi-instrument access device includes a base positionable within a percutaneous opening formed in a body. Ports are positioned on the base for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having steerable distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site. Some embodiments of the surgical access system may be particularly suited for establishing an operative corridor to a surgical target site in the spine. Such an operative corridor may be established through the retroperitoneal space and the psoas muscle during a direct lateral, retroperitoneal approach to the spine.

Abstract: Apparatus and methods for stabilizing and/or positioning tissues or organs during surgical procedures. One feature of the positioners of the invention includes the use of one or more suction elements used to grip the organ or tissue. The main body of the suction element comprises body defining a polyhedral shaped chamber, an elliptical ring structure and a vacuum port. The invention further includes structures to support the suction element and hold the suction element and attached tissue in a fixed position including catheters, lockable flexible arms, and retractors.

Abstract: A surgical portal device comprising a body portion and at least one thread is disclosed. The body portion defines a longitudinal axis and has a proximal end, a distal end, an exterior surface, and a lumen configured to allow a surgical instrument to pass therethrough. The at least one thread extends at least partially along the exterior surface of the body portion. The at least one thread defines a thread pitch between adjacent portions of the thread. A distal portion of the thread pitch is different from a proximal portion of the thread pitch.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: A lordotic guard and method for guiding a bone removal device to form an implantation space in the human spine and, if desired, for inserting a spinal implant into the implantation space.

Abstract: A method for laterally accessing a lumbosacral intervertebral disc space of a patient includes positioning the patient laterally and making an incision to provide lateral access to the patient's iliac crest. A bracket (24) may be placed on the iliac crest and a retractor (28) may be attached to the bracket such that a distal end of the retractor is positioned over the lumbosacral intervertebral disc space while a proximal end of the retractor provides an entry space for a surgeon to insert at least one tool (90). The surgeon may perform a surgical procedure on the lumbosacral intervertebral disc space through a channel (49) defined by the retractor.

Abstract: A surgical instrument for insertion of an interbody fusion implant between adjacent vertebral bodies. The surgical instrument comprises a frame member, and a first and a second arm coupled to the frame member. Each arm includes a distal end region and a proximal end region, whereby the proximal end region of at least one arm is pivotably coupled to the frame member, and the distal end region of each arm defines a distractor plate. The distractor plate of each arm is configured to be positioned in direct contact with a vertebral body. A wedge is positioned between the first and second arms, and is configured to translate the interbody fusion implant along an axis between the proximal end region and the distal end region of the arms while adjusting a distance between the distractor plates of the arms via a rack and pinion.

Abstract: An apparatus includes a tubular structure having a proximal end, a distal end, and a body extending between the proximal and distal ends, wherein the body includes a lumen for housing at least a part of an imaging device, and a fluid delivery channel that is fixed in position relative to the body, and an opening that is in fluid communication with the fluid delivery channel, wherein the fluid delivery channel has a first portion, and a second portion that forms an angle with an axis of the first portion.

Abstract: A tissue retracting apparatus for use in cardiac surgery having a first tissue retracting member configured and sized to retract a cardiac tissue of the patient's heart in a manner to obtain surgical access to a target heart valve located within an internal heart cavity, and a second tissue retracting member configured and sized to retract, depress or displace a valve cusp tissue of the target heart valve in a manner to obtain surgical access beyond the target heart valve. In use, the second tissue retracting member is operatively couplable to the first retracting member, so that the first and second retracting members cooperate together to collectively allow the simultaneous retraction of both (i) a cardiac tissue of the patient's heart, and (ii) a valve cusp of the target valve while a surgical intervention can be carried out on either the target heart valve or a subvalvular structure of said target heart valve.

Abstract: A mountable, top-loading retractor device that is quickly and easily mountable to a surgical tool support frame. The device has two main sections a mount assembly for attaching to the support frame, and a top-loading retractor assembly pivotably linked to the mount assembly. The mount assembly has opposed upper and lower clamping jaws to a grip a section of the frame when the assembly is operated to set the clamping jaws. The retractor assembly includes a retractor mechanism having a separate arm receivable into the top surface of the retractor assembly and engageable by the retractor mechanism. The arm extends beyond the retractor assembly and is positionable along its length. The distal end of the arm is adapted to attach to a surgical retractor tool, and to apply a force to operate the tool.

Abstract: The present disclosure relates to a surgical access member for establishing percutaneous access to a surgical worksite within tissue. The surgical access member includes a constricting mechanism that is adapted to removably receive a surgical instrument and resiliently transition between an open state and a constricted state. In the open state, insertion of the surgical instrument through the constricting mechanism is substantially uninhibited. In the constricted state, the constricting mechanism substantially limits transverse movement of the surgical instrument, and may facilitate the creation of a substantially fluid-tight seal therewith.

Abstract: A method and apparatus for dissecting a first layer of tissue from a second layer of tissue and thereafter holding open an anatomic space for the performance of a surgical procedure. The method includes steps of making an incision in a body, introducing a deflated balloon dissector into the incision, inflating the balloon dissector to effect dissection of the first layer of tissue from the second layer of tissue, deploying a retractor within the anatomic space in order to hold open the anatomic space, and optionally deflating or evacuating the balloon dissector to open a cavity for surgical manipulations. The apparatus includes a combined dissector-retractor having a balloon retractor disposed upon the surface of the balloon dissector and integrated therewith.

Abstract: A surgical tool holder that includes a holding member with a clamping jaw, which is movable between open and clamping positions. A gripping member is configured to supportingly grip a surgical tool and is selectively placed in a rotatable or fixed association with the holding member. Engagement portions of the holding member and gripping member are engagable to block rotation therebetween to obtain the fixed association.

Abstract: A steerable multi-linked device. The device includes a first multi-linked mechanism and a second multi-linked mechanism. At least one of the first and second multi-linked mechanisms is steerable and includes a modular link assembly at an end thereof. The modular link assembly includes a base, and a tip removably connected to the base.

Abstract: A minimal incision maximal access system allows for maximum desirable work space exposure within the incision along with maximum access to the operative field utilizing a minimum incision as small as the width of the working tube. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing retractors depending from a bi-hinged frame having internal or external controls to control the angle and separation of the retractors. Interchangeable retractor blades can be attached to the frame. At least one retractor blade is independently controlled.

Abstract: Methods and devices are provided to allow for easy customization of a surgical access device by an end user. In one exemplary embodiment a surgical access device is provided that includes a plurality of elongate seal elements that are configured to form a sealed configuration between a surgical site and an outside environment. The seal elements can be disposed in a surgical opening and can mate directly to each other with the outermost seal elements mating directly to tissue of the opening. The seal elements can include one or more mating elements to provide the desired mating. The seal elements can also include sealable openings that are configured to receive surgical instruments for use at the surgical site. The sealable openings maintain the desired seal throughout the course of a surgical procedure. Exemplary methods for providing custom configurations on location are also provided.

Abstract: Methods and devices are provided for providing access through tissue to a surgical site. A surgical access device can be configured to be positioned in tissue to provide access through a working channel of the access device to a body cavity underlying the tissue. The access device can include a sealing element positioned at least partially within the working channel. The sealing element can be formed of a puncturable self-sealing material such as a gel and/or a foam configured to provide a channel seal that seals the working channel when no instrument is inserted through the sealing element and configured to provide an instrument seal that provides a seal around one or more surgical instruments inserted through the sealing element.

Abstract: A surgical retractor comprising a retractor body having a site portion and a handle portion, and an impactor body on the retractor body. The impactor body is positioned and configured for use in impacting the site portion in the surgical site. An impaction axis of the impaction body is preferably substantially aligned with an axis of the site portion of the impactor body. The impactor body is preferably attached to the retractor body at a junction between the site portion and the handle portion of the retractor body. In one embodiment, the impactor portion is configured to selectively mate with an impactor extension member to thereby optionally receive direct impaction on the impactor portion or indirect impaction through the impactor extension member.

Abstract: A system and method for performing surgical procedures within a body cavity, e.g. abdomen, uses a magnetized device is utilized to allow a surgeon to control intra-abdominal organs and objects. The system and method allows a surgeon to perform an intra-abdominal procedure without the need to position surgical tools inside of the body cavity. Additional surgical ports are not necessary as the magnetized device allows the surgeon to retract or position various objects within the abdomen.

Abstract: A catheter (2) is used in medical applications, for example for the retrieval of a sample from a patient or the insertion or retrieval of medical devices such as filters, stents (3) to and from the patient. The catheter (2) includes an expandable tip (6) at a leading portion of a catheter tube portion (5). This expandable tip (6) can retrieve or deliver samples, medical devices, etc. (3), which are slightly larger than the dimensions of a main catheter tube (5) inserted into the patient. The expandable tip (6) can also include extension members (10) which provide axial support to the expandable tip (6) but which still allow expansion in the radial direction.

Abstract: A tissue suspension device has an elongated spanning element with a first and a second end. A suspending element is attachable to the spanning element. A first supporting element is attached to the first end of the spanning element, and a second supporting element is attached to the second end of the spanning element. The tissue suspension device substantially spans the transverse width of the body cavity and suspends tissue within the body cavity. The first and second supporting elements are attachable to the body wall, which supports the weight of the suspended tissue.

Abstract: Septic barriers interposed between a target tissue such as an oral or vaginal cavity, exposed epidermis, or wound or surgical site, and a user and his/her optical interrogation instruments to reduce cross-infection and/or contamination. In certain embodiments, the septic barrier is substantially transparent for viewing purposes and is typically effectively non-fluorescent, particularly when used for investigating autofluorescence or other fluorescence emanating from a target, so as to have little or no effect on the measurements and observations being made. The sepsis barrier can comprises a window through which the user sees the tissue, a frame holding the window, and an attachment structure, such as threads or bayonet attachment, configured to connect the barrier to the instrument. If desired, the system can also have an optional attachment mechanism for permanent or temporary connection of a further instrument to the frame, such as a tissue retractor configured to aid manipulation of the target tissue.

Abstract: A tissue retractor is disclosed.

Abstract: A surgical apparatus. The apparatus includes a handle structure, a shaft structure coupled to the handle structure, and a spreading structure coupled to the shaft structure and movable between a compact and an expanded configuration. The apparatus includes a protective sheath of shape-recovery material. The protective sheath covers the entire spreading structure in a substantially form fitting manner in any configuration of the spreading structure including the compact configuration, the expanded configuration and any configurations therebetween.

Abstract: An organ manipulator including at least one suction member or adhesive disk mounted to a joint providing freedom of movement of the at least one suction member or adhesive disk relative to its support. A method for retracting and maintaining an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) is provided.

Abstract: A surgical support for a femur utilizing a shaft having a proximal portion and a distal portion. The shaft lies along an axis which is coincident with a first plane. A hook connects to the shaft through an intermediate portion and lies in a second plane which intersects the first plane. The hook includes a flattened portion for support of the femur.

Abstract: Methods and devices are provided for identifying surgical port size. In one embodiment, a surgical access device can include a proximal housing and a distal retractor with a plurality of sealing ports seated in the housing. The surgical access device can also include at least one identifier configured to indicate sizes of the sealing ports. The one or more identifiers can be visual and/or tactile for each of the sealing ports.

Abstract: A positioning device for providing access to a ventricle of a heart. In one embodiment, the device includes a cup positionable over an apex of the heart and at least a first access valve in the cup for accessing an entry point to the ventricle of the heart.

Abstract: A laparoscopic device assembly provides a tubular diaphragm twist seal that responds to a slight rotation of an actuating ring in a first direction by coupling a motor spring power assisted rotation of a bottom circumference of the twist seal achieves a pneumatic seal in an adjustable access channel defined by the state of the twist seal for maintaining an insufflated body cavity for a hand assisted laparoscopic surgical procedure. A slight rotation of the actuating ring in an opposite second direction releases compression spring energy and energy in the twisted state of the twist seal so that an upper circumference of the twist seal is allowed to open the adjustable access channel.

Abstract: A surgical access apparatus for use during a surgical procedure for passing through tissue to an underlying surgical area is provided. The surgical access apparatus includes a vibration source connected to a seal member located in an internal passage of an access member. The seal is configured to form a substantial sealing relation with an inserted surgical instrument and substantially close in the absence of the surgical instrument. The vibration source causes the seal to vibrate, in order to decrease the force needed to insert the surgical instrument. The source of vibration may be one of the following: a rotating eccentric mass, mass moving in a linear path, exciting a piezoelectric, a crystal, or an electro active polymer capable of expanding or contracting.

Abstract: Methods and devices are provided to improve access to a surgical site during surgical procedures. In one exemplary embodiment a surgical access device is provided having a cannula, a cannula base, and a retractor. The cannula base is configured to couple both to the retractor and the cannula to provide access to a surgical site. The cannula can be removably and replaceably coupled to the cannula base. Optionally, the cannula base can be removably and replaceably coupled to the retractor. As desired, the cannula can be decoupled from the cannula base, which can allow for an object to be removed from the surgical site and/or for the cannula, or another cannula to be attached to the cannula base that remains in place to maintain access to the surgical site. Exemplary methods for accessing a surgical site are also provided.

Abstract: A specimen retrieval apparatus includes an elongated tubular member defining a lumen therethrough and having an end effector disposed at a distal end thereof. The end effector includes a shaft defining a longitudinal axis, the shaft including a lumen extending therethrough. The lumen of the shaft communicates with the lumen of the elongated tubular member. A suction member is disposed at a distal end of the shaft in communication with the lumen of the shaft. The suction member is configured to retain a tissue specimen thereon. A sleeve is disposed about the shaft and is movable with respect to the shaft from a proximal to a distal position. A specimen retrieval bag is coupled to the sleeve. The bag is deployable from an undeployed position wherein the bag is disposed about the sleeve to an extended position wherein the bag is deployed over the tissue specimen.

Abstract: A surgical access portal includes a seal housing, a sleeve mountable to the seal housing, and a seal disposed within the seal housing. The seal includes a first layer having an opening for the reception and passage of a surgical instrument, a second continuous layer for providing a fluid tight seal in the seal housing in the presence and/or in the absence of a surgical instrument, and a third layer having an opening for the passage of a surgical instrument therethrough. The first and third layers have a higher density than the second layer for maintaining the second layer in an axially compressed state therebetween.

Abstract: An access port includes a housing defining a longitudinal axis and having proximal and distal ends, and an interior wall defining a longitudinal opening adapted for passage of a surgical object, an object seal disposed in mechanical cooperation with the housing and being configured to create a substantially fluid-tight seal around a surgical object inserted through the object seal and a centering mechanism mounted to the housing. The centering mechanism includes at least one centering element extending at least in a general longitudinal direction within the longitudinal opening and a substantially annular ring mounted to the at least one centering element.

Abstract: A surgical portal apparatus includes a housing and a cannula member. The housing includes a seal mount and a flexible housing wall. The cannula member is connected to the housing and defines a longitudinal axis and passageway. The seal mount has an internal seal. The flexible housing wall is dimensioned to permit both axial and radial movement of the seal mount with respect to the longitudinal axis between a first position of the seal mount and a plurality of second positions of the seal mount. The seal mount may be biased by a biasing member toward the first position. In an embodiment, the biasing member is a spring that is engageable with the cannula member and the seal mount.

Abstract: A surgical instrument adapted and configured for use in minimally invasive surgical procedures includes a shaft, an end effector and a proximal handle. The longitudinal shaft has proximal and distal end portions, and defines a longitudinal axis of the surgical instrument. The distal end effector is connected to the distal end portion of the shaft, and is adapted and configured for performing a surgical task. The proximal handle portion is operably connected to the proximal end portion of the longitudinal shaft and has an actuatable portion operably connected to the end effector to result in movement of the end effector. The distal end portion of the shaft can be laterally offset from the longitudinal axis of the shaft and/or have one or more bends or curves formed therein. The proximal portion of the shaft can include at least one bend to allow for comfortable positioning of a surgeon's hands.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more sealing ports for receiving surgical instruments. Each sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each sealing port can be in a fixed position relative to the housing and can be rotatable with the housing relative to the retractor. A plurality of safety shields can extend from the housing into the retractor to protect the retractor from instruments inserted through the sealing ports and into the retractor.