Abstract: A surgical stabilizer arm includes a reusable base portion and a disposable arm portion. The articulating links that enable the arm to be positioned into arbitrary trajectories are included the disposable portion, thus eliminating the need to clean between the links after a surgical procedure. The disposable portion also includes a tool attachment mechanism and a cable. The reusable portion includes a retractor clamping mechanism, a top plate, a T-shaped base post, a main body, a nosepiece, a threaded drawbar, a thrust bearing assembly, and a threaded handle that can extend or retract the drawbar when rotated. The threaded drawbar may include a slot into which an end of the cable can be inserted, which allows tension to be applied to the cable when the handle is rotated to pull the drawbar into the body of the reusable portion and lock the articulating links in place.

Abstract: A valve component 1 of the invention comprises a main valve 2 which is located on a centre line and at least one auxiliary valve 3 which is located radially outwardly of the main valve 2. The main valve may be used for sealing engagement with a cannula. In some cases the cannula may be used for introduction of a number of robotically controlled surgical instruments generally, including a camera. The auxiliary valves 3 may be utilised to introduce another instrument through the valve component. The valve component is mounted in a manner which ensures that the valve component 1 is rotatable about a centre line through the axis of the valve component 1. This ensures that the valve component 1 can be rotated relative to a cannula inserted through the main valve 2 and consequently that the auxiliary valves 3 are rotatable relative to the cannula allowing the auxiliary valves 3 to be positioned to facilitate optimum access and manipulation for an auxiliary instrument(s) inserted through the auxiliary valve(s) 2.

Abstract: An evacuation adapter for use with a surgical access device includes a distal section selectively engageable with a proximal section. The distal section and the proximal section each include a base, an outer ring, and an inner ring. Each base defines a central opening. Each outer ring defines at least one opening. Each inner ring defines at least one opening. The outer ring of the proximal section includes a port. The proximal section is rotatable relative to the distal section between a first position where fluid is able to flow from the central opening of the distal section through the port, and a second position where fluid is blocked from flowing from the central opening of the distal section through the port.

Abstract: A tissue guard for use with a surgical access device includes a body having a proximal end, a distal end and lumen defined therebetween. A proximal lip extends radially from the proximal end and is configured to mount atop a rim of an access device. The proximal lip includes an annular channel defined therein disposed in fluid communication with the lumen, the annular channel configured to direct surgical gases from the lumen to a smoke evacuation system. The annular channel includes a neck defined therein disposed between the lumen and the annular channel, the neck having geometry configured to induce the evacuation of surgical gases or smoke therethrough. One or more fingers extend from the proximal lip and are configured to engage an access device to secure the tissue guard thereon.

Abstract: Disclosed are instruments, implants and methods of accessing the spine from an Anterior to the Psoas (ATP) approach, performing a discectomy through an ATP approach and then placing an intervertebral implant via an ATP approach for spinal fusion.

Abstract: An anchoring system for cannulas or tools to be inserted into a surgical workspace in the body, particularly the brain, of a patient. The system comprises a grommet which may be fixed to the skull to both secure the system to the skull and protect the skull opening from passage of cannulas and tools, a resilient clip with grasping jaws adapted to firmly grasp a cannula or tool, and a flexible membrane secured to the outer rim of the grommet and the clip.

Abstract: A multi-stage dilator and cannula assembly for use in surgical procedures, including minimally invasive surgical procedures, to provide tissue dilation and opening of a portal to enable the surgeon to access and provide treatment to anatomical feature of interest.

Abstract: Some devices for atraumatic retraction of tissue include a transcatheter deployable mesh hammock that is well-suited for laparoscopic, endoscopic, and robotic surgeries. Methods for atraumatic retraction of tissue include wrapping a mesh material around the tissue in a cradle-like fashion. In some embodiments, magnetic coupling of the proximal and distal ends of the mesh material can provide tissue containment and retractor securement to facilitate tissue retraction.

Abstract: A surgical access device including a cannula, a seal, and a seal guard is disclosed. The cannula includes a housing and an elongated portion extending distally from the housing. The seal is disposed at least partially within the housing of the cannula and includes an aperture for sealed reception of a surgical instrument therethrough. The seal guard is disposed at least partially within the housing of the cannula and proximally of the seal. The seal guard is formed from a flat sheet of material and folded into a funnel-like shape.

Abstract: A tissue guard includes a body defining an open proximal end, an open distal end, and a lumen extending through the body between the open proximal end and the open distal end. The tissue guard further includes a lip extending radially outwardly from the open proximal end of the body. The lip includes a plurality of spaced-apart cut-outs defined about the outer circumference of the lip to define a plurality of tabs of the lip. Each tab includes an outer edge segment. The body and the lip are monolithically formed as a single piece of material.

Abstract: An access assembly includes an instrument valve housing and a valve assembly disposed within the instrument valve housing. The instrument valve housing includes upper and lower housing sections. The valve assembly includes a centering mechanism, a seal assembly, and a guard assembly. The centering mechanism is configured to bias the valve assembly towards a generally centered position within the instrument valve housing. The centering mechanism includes a base seal member having an annular base and a flange portion. The flange portion includes an arcuate portion configured to adjustably engage first and second surfaces of the instrument valve housing in a sealing relation. The seal assembly is attachable to the centering mechanism. The seal assembly is configured to engage a surgical instrument inserted into the access assembly in a sealing relation. The guard assembly is attachable to the centering mechanism.

Abstract: Systems, methods, and devices allow intravascular or percutaneous mapping, orientation and/or ablation, in bodily cavities or lumens. A device includes elongate members, moveable between an unexpanded configuration and an expanded or fanned configuration. The elongate members form a stack in the unexpanded configuration to fit through a catheter sheath. The elongate members follow respective arcuate or curvilinear paths as advanced from the sheath into the bent or coiled stack configuration, adopting volute, scroll or rho shapes, and may be nested. The elongated members are fanned or radially spaced circumferentially with respect to one another into the expanded or fanned configuration. Transducer elements carried by elongate members sense various physiological characteristics of or proximate tissue, and/or may apply energy to or proximate tissue. The elongate members are rotatable in groups or as a group in the expanded configuration. The device is retractable.

Abstract: A surgical tool coupler (10) includes a housing (12) with a door (14). The door (14) and housing (12) include mating structures (18, 20) that mate with each other when the door (14) is closed. The housing (12) includes a robotic interface (26) which is connectable to a portion of a robotic surgery system (28).

Abstract: Methods and devices described herein facilitate diaphragm entry for posterior access of body organs.

Abstract: Systems, methods, and devices allow intravascular or percutaneous mapping, orientation and/or ablation, in bodily cavities or lumens. A device includes elongate members, moveable between an unexpanded configuration and an expanded or fanned configuration. The elongate members form a stack in the unexpanded configuration to fit through a catheter sheath. The elongate members follow respective arcuate or curvilinear paths as advanced from the sheath into the bent or coiled stack configuration, adopting volute, scroll or rho shapes, and may be nested. The elongated members are fanned or radially spaced circumferentially with respect to one another into the expanded or fanned configuration. Transducer elements carried by elongate members sense various physiological characteristics of or proximate tissue, and/or may apply energy to or proximate tissue. The elongate members are rotatable in groups or as a group in the expanded configuration. The device is retractable.

Abstract: A kyphoplasty cannula includes a shaft extending between opposite first and second end surfaces. The shaft has an inner surface defining a lumen. The shaft has a first opening that extends through the first end surface and a second opening that extends through the second end surface. A scoop extends from the second end surface. The scoop has an arcuate inner surface that is continuous with the inner surface of the shaft an opposite outer surface. The scoop has a rib. Kits and methods of use are disclosed.

Abstract: A shaft assembly is disclosed comprising a shaft including a proximal end, a distal end, a longitudinal axis extending between the proximal end and the distal end, and an outer housing comprising a shaft radius defined with respect to the longitudinal axis. The shaft assembly further comprises an end effector comprising an end effector frame rotatably coupled to the shaft about a fixed articulation axis positioned laterally offset with respect to the longitudinal axis. The shaft assembly further comprises an articulation driver coupled to the end effector frame at an attachment location, wherein a lateral moment arm is defined between the attachment location and the fixed articulation axis, wherein the lateral moment arm is orthogonal to the longitudinal axis, and wherein the shaft assembly is configured such that a ratio of the shaft radius to the lateral moment arm is minimized.

Abstract: An example introducer is disclosed. An example introducer sheath includes a tubular member including an inner surface, an outer surface and a wall extending therebetween. The introducer further includes a plurality of spine members. The plurality of spine members are positioned radially inward of the outer surface of the tubular member. Further, each of the plurality of the spine members are positioned radially outward of the inner surface of the tubular member. Additionally, the tubular member is designed to shift from a first configuration to a second configuration and the wall has a first thickness in the first position and a second thickness in the second position, the second thickness smaller than the first thickness.

Abstract: A specimen retrieval device is provided. The specimen retrieval device includes a housing including an outer shaft extending distally therefrom. An inner shaft is disposed within the outer shaft and includes at least one tissue engaging device configured to engage tissue and at least one spring. A pouch is coupled to the inner shaft and the at least one spring. The pouch includes an open proximal end and a closed distal end and is movable from a first configuration for deployment from the outer shaft to a second configuration for receiving tissue therein. The at least one tissue engaging device is positionable within the pouch and movable along the inner shaft for engaging tissue and pulling the tissue within the pouch.

Abstract: Described here are methods, systems, and devices, useful for minimally invasive surgical procedures. The methods may include introducing a grasper through an opening into an abdominal cavity, grasping a portion of a left lobe of a liver with the grasper, rotating the grasper towards a control element located outside the abdominal cavity by applying a magnetic field to the grasper across a body wall, and moving the control element over a set of ribs such that the liver bends into a folded configuration.

Abstract: Methods for protecting a peritoneum or other tissue during a surgical procedure are disclosed. In some embodiments, a protective lining is applied to the peritoneum or other tissue before an active surgical intervention, such as before tissue dissection, tissue approximation, and/or other surgical act. In some embodiments, the protective lining includes a protective film applied to the peritoneum or other tissue via a delivery balloon or via a spray instrument.

Abstract: A kyphoplasty cannula includes a shaft extending between opposite first and second end surfaces. The shaft includes an inner surface defining a lumen. The shaft includes a first opening that extends through the first end surface and a second opening that extends through the second end surface. A scoop extends from the second end surface. The scoop includes an arcuate surface that is continuous with the inner surface. Kits and methods of use are disclosed.

Abstract: A flexible cannula device and delivery system for use in arthroscopic surgery. The delivery system engages the flexible cannula from the inside near the distal tip and pushes it into the surgical portal, essentially pulling the proximal portion of the cannula from the distal tip while being pushed from the proximal end with the specialized driver. The delivery system provides for single point engagement at the distal tip as well as a multiplicity of engagement points along the length of the system.

Abstract: A tissue specimen retrieval device includes a housing having an outer shaft that extends distally therefrom. An end effector assembly is included that extends distally from the outer shaft in a deployed position. A first actuator is operably associated with the housing and actuatable to deploy and retract the end effector assembly. A drive shaft operably couples to the first actuator and includes a link disposed at a distal end thereof that operably couples to the end effector assembly. The drive shaft is movable via actuation of the first actuator from a first position wherein the end effector assembly and link are retracted within the outer shaft to a second position wherein the end effector assembly and link are fully exposed from the outer shaft. The link includes a biasing member that, once the link is fully exposed, articulates the end effector assembly to a position to engage tissue.

Abstract: The present disclosure is directed to a surgical device and method of using the same. The surgical device includes a proximal ring, a distal ring, wherein the distal ring is operably connected to the proximal ring with a sleeve, the sleeve extending about a circumference of the proximal ring and a circumference of the distal ring, a film, a distal end of the film attached to a portion of the distal ring, wherein the film is configured to extend past the sleeve and past the distal ring, and wherein a proximal portion of the film comprises an opening and a channel and a draw string extending through the channel and exposed to an exterior of the device through the opening.

Abstract: A system for percutaneous or open facet joint fusion includes an imaging system configured to identify a docking location on a facet joint between a first vertebra and a second vertebra of a patient. The system also includes a cannula configured to be positioned at the docking location on the facet joint. The system further includes a rotary tool that is configured to mount within the cannula. The rotary tool is configured to create a void in the facet joint by way of the cannula, where the void is configured to receive a bone graft or bone growth promoting material.

Abstract: A method of accessing a target site within the brain of a patient, through the skull of the patient, with an expandable cannula.

Abstract: An annulus ring or a constricting cord may be delivered to the vicinity of a cardiac annulus using a set of anchor launchers, with each of the anchor launchers being supported by a respective support arm. An inflatable balloon is disposed between the support arms, and the balloon is configured so that when the balloon is inflated, the balloon will push the support arms away from each other. At least one retainer cord is connected to the support arms and is arranged with respect to the support arms to encompass the balloon and prevent the balloon from slipping out between the support arms.

Abstract: A multi-stage dilator and cannula assembly for use in surgical procedures, including minimally invasive surgical procedures, to provide tissue dilation and opening of a portal to enable the surgeon to access and provide treatment to anatomical feature of interest.

Abstract: Self-rolling mechanical atherectomy aka thrombectomy apparatuses for removing a clot from a vessel include a tractor tube portion that rolls and inverts over itself in a continuous motion, tractor-like, to draw material into the tractor tube, wherein the tractor tube rolls over itself without requiring any additional internal support at the distal-facing region of the tractor tube.

Abstract: An access device for surgical procedures includes a multiport end cap having a rigid body with a flexible support sealingly mounted to the rigid body with a plurality of separate access ports for accommodating introduction of individual surgical instruments into a body of a patient. At least one of the access ports is sealingly attached to the flexible support and extends in a proximal direction therefrom. The flexible support is of a material more flexible than those of the rigid body and access ports to provide for relative angular movement of at least one of the access ports to provide flexibility for positioning surgical instruments introduced through the access ports. The flexible support can include at least one flexible bellow.

Abstract: A percuscopic access device is disclosed. The percuscopic access device has a hollow shaft with a proximal opening and a distal opening. The percuscopic access device also has one or more barrier ridges on the outside of the hollow shaft. The percuscopic access device also has one or more recesses on the inside of the hollow shaft and in communication with the distal opening. A cleaning obturator for use with the percuscopic access device is also disclosed. The cleaning obturator and percuscopic access device may be combined as a surgical apparatus. The cleaning obturator has a guide rod having a proximal end and a distal end. The cleaning obturator also has a plugging tip on the distal end. The cleaning obturator further has one or more swab guides proximal to the plugging tip.

Abstract: A retractor having an elongated body that provides access to a surgical location within a patient. The elongate body includes a plurality of segments that are connected to one another through a plurality of ratcheting mechanisms. The ratcheting mechanisms permit relative movement of the segments with respect to one another when expander dilators are inserted within the retractor. The segments are surrounded and retained by a resilient elastomeric sleeve or bands. The distal end surfaces of the segments include thin edges that are configured to mobilize, dissect, split and retract the terminal tissues in the surgical area. The retractor may be used in conjunction with a shim.

Abstract: The present disclosure relates to a trocar assembly with an integrated scope-cleaning structure. The trocar assembly may include a housing defining boundaries of a chamber with (a) a proximal opening configured to receive a distal end of a scope, and (b) a distal opening in fluid and mechanical communication with a trocar cannula. The trocar assembly may further include a cleaning element located at least partially between the proximal opening and the distal opening, where the cleaning element is movable with respect to the housing from at least a first setting where a first portion of the cleaning element may be in a first location and may form a first cleaning surface within the chamber, the first cleaning surface configured to remove debris from a distal end of the scope when the distal end of the scope contacts the first portion of the cleaning element.

Abstract: Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; and a funnel segment extending between and coupling the outer ring and the tubular body, wherein the funnel segment provides a diametric reduction between the relatively large diameter of the outer ring and the relatively smaller diameter of the tubular body, which is sized to fit within a natural orifice with minimal distention of the orifice.

Abstract: Embodiments hereof relate methods of delivering a valve prosthesis to an annulus of a native valve of a heart. A valve delivery system is introduced into a ventricle of the heart via a ventricular wall of the heart. The valve delivery system has a displacement component at the distal portion thereof. The valve prosthesis is in a delivery configuration and the displacement component is in a delivery state in which the displacement component has a first outer diameter. While the valve prosthesis is in the delivery configuration, the displacement component of the valve delivery system is radially expanded into an expanded state in which the displacement component has a second outer diameter greater than the first outer diameter. The valve delivery system is advanced towards the annulus of the native valve of the heart with the displacement component in the expanded state to displace chordae tendineae.

Abstract: Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described.

Abstract: A surgical instrument including a housing, an elongated body, an end effector, and a dissection element. The housing has a handle assembly and the elongated body extends from the housing. The end effector is supported at a distal end of the elongated body and is operatively associated with the handle assembly. The dissection element is disposed about the elongated body proximal to the distal end of the elongated body. The dissection element is configured to bluntly dissect tissue surrounding the elongated body.

Abstract: Methods and devices are provided for performing minimally invasive surgical procedures. In one embodiment, a surgical device is provided that include an elongate shaft having a distal portion configured to be movable between a first configuration in which the distal portion of the shaft is substantially straight or linear and a second configuration in which the distal portion of the shaft is articulated at a compound angle. The shaft's distal portion can include two articulation joints to facilitate formation of the compound angle.

Abstract: A retractor system is provided having a plurality of blade portions that collectively present a low profile tapered configuration for insertion through tissue along a natural tissue plane. Once inserted through tissue the blade portions may be independently moved apart to form an access path to a surgical site, such as by first moving the blade portions apart along the natural tissue plane followed by moving the blade portions apart transverse to the natural tissue plane. The blade portions may be attached to retractor frame members, and rack and pinion frame components may be used to control movement of the blade portions relative to one another. Pins may be used to secure the blade portions to bone.

Abstract: A surgical site retractor is configured to retract tissue, such as in an intercostal procedure. The retractor may be formed from non-radiopaque material for improved monitoring via X-ray imaging. The retractor may have a rigid retractor and a soft tissue retractor, where the rigid retractor has a plurality of legs and the soft tissue retractor extends between the legs to prevent soft tissue from extending between said legs. The retractor may have a bendable arm with an implement holder, such as distal cuff or clip adapted to resiliently hold an implement such as a tube of an elongated port-access device. A method involves partly installing the surgical site retractor, expanding the surgical site retractor, deploying the surgical implement from outside the body through the incision and into the patient, resiliently capturing the implement with the holder of the arm, and bending the arm to hold the implement in a desired position.

Abstract: Exemplary embodiments describe soft robotic actuators for medical use, such as during surgeries and other medical procedures. According to one embodiment, a soft robotic incision retractor is provided. According to another embodiment, a soft robotic body tissue retractor is provided. The incision retractor and body tissue retractor may be used together, for example by using the incision retractor to hold open an incision while the body tissue retractor manipulates biological matter or an object accessible through the incision. Described embodiments offer the ability to conform to a given space, reduced risk of damage to surrounding structures as compared to traditional retractors, the ability to deliver varying amounts of force, the ability to be made from medically safe materials, and the potential for re-use or disposability.

Abstract: A thin resilient strand, such as medical suture material, extends from a stiffer shank. The strand can form a resilient hook and/or it can have an arcuate free end to engage tissue such as the interior of a capsular bag at approximately its equator during ophthalmic surgery.

Abstract: A surgical instrument, such as a capsular retractor, and methods of use are disclosed.

Abstract: A stent delivery system is disclosed in which a stent is contained in a sheath in an initial state and the stent is released inside a living body lumen in accordance with a movement of the sheath in a proximal direction with respect to an inner member. A movement mechanism of the stent delivery system has a rack member which is connected to a proximal end of the sheath, and a plurality of pinions which move the rack member in accordance with rotations thereof.

Abstract: Described is a barrier application device comprising a handle, an introducer assembly slidably and rotatably coupled to the handle, a beam assembly coupled to a distal end of the handle, and a flag coupled to the beam assembly. A method of using a barrier application device comprises providing a device comprising a handle, an introducer assembly slidably and rotatably coupled to the handle, a beam assembly coupled to a distal end of the handle, and a flag coupled to the beam assembly, and placing a barrier on the flag, sliding the introducer assembly along the handle from a retracted position to an extended position at least partially covering the beam assembly, and rotating the handle relative to the introducer assembly until the flag and the barrier are wound around the beam assembly.

Abstract: Exemplary embodiments describe soft robotic actuators for medical use, such as during surgeries and other medical procedures. According to one embodiment, a soft robotic incision retractor is provided. According to another embodiment, a soft robotic body tissue retractor is provided. The incision retractor and body tissue refractor may be used together, for example by using the incision retractor to hold open an incision while the body tissue retractor manipulates biological matter or an object accessible through the incision. Described embodiments offer the ability to conform to a given space, reduced risk of damage to surrounding structures as compared to traditional retractors, the ability to deliver varying amounts of force, the ability to be made from medically safe materials, and the potential for re-use or disposability.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A kit of parts for inserting a deformable implant into a cavity in a bone of a patient is described. An inserter instrument (1) comprises a body (100) having a cavity extending along a longitudinal axis from a distal end to a proximal end. An attachment mechanism (108) is provided at the distal end and to which a deformable implant can be releasably attached. A drive mechanism (132) is provided at the proximal end of the body. A push rod (150) is freely and slidably arranged within the cavity and has a distal end engageable with a part of the deformable implant and a proximal end abutable by the drive mechanism. The drive mechanism is operable to drive the push rod toward the distal end of the body. The kit also includes an impactor (210) dimensioned for slidable engagement within the cavity.

Abstract: A portal for accessing a desired lamina portion of a desired cervical vertebra to perform a laminoplasty. In one aspect, a laminoplasty portal is presented that defines an interior conduit and has a first sidewall section and a second sidewall section.