Abstract: A positionable internal retraction device is provided comprising a malleable ring member and a web-like structure. The retraction device operates to temporarily reposition tissues and organs from an operative site to provide a clear access and visual path for the surgeon. The ring member may be elongated, twisted, folded, bent or deformed to provide an appropriate insertion profile and subsequent functional shape. The retraction device may be shaped for both open and minimally invasive surgeries. The retraction device is atraumatic and may be used for retraction of delicate tissues and organs. The ring member may have different bending biases. The web-like structure may be constructed of any elastic material that can stretch and recover from the shaping and reshaping of the ring member.

Abstract: The present invention relates to a surgical access device comprising an elongate tubular member having a working channel and a proximal end and a distal end, a septum seal integrally formed at the distal end of the tubular member, and a zero seal disposed at the distal end of the tubular member and distal to the septum seal, the zero seal being sized and configured to seal when no instrument is in place within the working channel of the tubular member, and the zero seal being coupled to the septum seal The zero seal may be a duckbill seal having opposing lip portions separated by a slit portion. The opposing lip portions are coated with or attached to a soft or occlusive material.

Abstract: A balloon trocar includes a cannula assembly including a cannula and an outer sleeve fitting over the cannula. The distal end of the outer sleeve is proximal to the distal end of the cannula. A balloon is coupled to a distal portion of the sleeve and a distal portion of the cannula. The outer surface of the cannula includes a plurality of longitudinal channels for transmitting gas or fluid to the balloon. A bolster having a gel pad at its distal portion is slidably mounted to the cannula assembly and may be locked in a desired position. In use, the trocar is inserted into an incision through a body wall and into a body cavity. The balloon is inflated and the cannula assembly pulled proximally against the incision while the bolster is slid distally to the body wall and locked in place to seal the incision with the compressed balloon.

Abstract: A surgical stapler is provided that maintains the jaws of the stapler in an open position and prevents firing of staples when a cartridge is not loaded in one of the jaws. Distinct positioning and sequencing of the jaws, capture pin and firing of the staples are provided by a latch mechanism. Such locking and latching mechanisms ensure proper operation of the stapler.

Abstract: A laparoscopic scissor instrument can include a scissor assembly pivotally coupled to an elongate shaft. The scissor assembly can be formed of scissor blades having pivot posts thereon. The pivot posts can engage apertures on the elongate shaft, thus eliminating the need for a through-pinned pivot connection of the scissor blades. The scissor blades can also include actuation posts thereon. An actuation mechanism can include a slot to engage the actuation posts and open or close the blades of the scissor assembly. The scissor assemblies described herein can have a relatively low operational height such that they do not extend beyond a diameter of the elongate shaft during opening and closing of the scissor assembly.

Abstract: A surgical instrument includes a shaft having a proximal end and a distal end with an operating device disposed at the distal end. A cable assembly is carried by the shaft and extends proximally to a terminus. A handle assembly coupled to the cable assembly concludes a first handle and a second handle. The first handle includes portions configured to receive the terminus and the proximal end of the shaft while portions of the second handle are configured to receive the terminus of the cable assembly. The proximal end of the shaft and the terminus are simultaneously rotatable to cover the proximal end of the shaft to the portions of the first handle and to couple the terminus to the portions of the second handle. The handle assembly can be made sterilizable with a minimum of non-bearing surfaces, while the shaft assembly can be made disposable and interchangeable with various operating devices. An associated method includes the step of releasably locking the shaft assembly to the handle assembly.

Abstract: A trocar comprises a retention cannula comprising an inverted or incised retention pattern disposed thereon. Embodiments of the incised cannula exhibit reduced tissue trauma compared with screw-threaded cannula, improved fixation and/or retention compared with an unthreaded cannula, and good sealing between the cannula and the incision.

Abstract: A stability assembly for a trocar cannula includes a conical stability member, a base, and a cannula retention member. The base has a passage defining an inner surface, and a constriction in the passage. The cannula retention member is rotatable within the passage, and advancement of the cannula retention member over the constriction reduces the inner diameter of the passage to restrain a cannula in the passage. Various latch mechanisms including interface surfaces on the base and the cannula retention member can be used in the stability assembly to secure the stability assembly around a cannula. Various conical stability members can be used in the stability assembly.

Abstract: A trocar fixation device includes a cannula and an elongate tube mounted onto and coupled to the exterior surface of the cannula with the distal end of the cannula extending distally beyond the distal end of the elongate tube. The elongate tube includes a plurality of slits cut at an angle to a longitudinal axis of the elongate tube. The trocar fixation device is activated by rotating the proximal-end region of the elongate tube in a first direction and is deactivated by rotating the proximal-end region of the elongate tube in a second direction, opposite to the first direction. Activation of the trocar fixation device compresses the material positioned between adjacent slits and forces the material radially outwardly, away from the exterior surface of the cannula, thereby forming ridges. Deactivation of the trocar fixation device returns the exterior surface of the elongate tube to a substantially smooth condition.

Abstract: A balloon trocar includes a cannula assembly including a cannula and an outer sleeve fitting over the cannula. The distal end of the outer sleeve is proximal to the distal end of the cannula. A balloon is coupled to a distal portion of the sleeve and a distal portion of the cannula. The outer surface of the cannula includes a plurality of longitudinal channels for transmitting gas or fluid to the balloon. A bolster having a gel pad at its distal portion is slidably mounted to the cannula assembly and may be locked in a desired position. In use, the trocar is inserted into an incision through a body wall and into a body cavity. The balloon is inflated and the cannula assembly pulled proximally against the incision while the bolster is slid distally to the body wall and locked in place to seal the incision with the compressed balloon.

Abstract: An insufflation gas warmer and humidifier apparatus and methods are provided. Insufflation gas is received from a bulky insufflation tubing. Insufflation gas received travels through, in one aspect, a channel or winding flow path, in a passage. The configuration of the passage ensures that the insufflation gas, which travels through the passage, receives sufficient heat and moisture. A humidifying reservoir humidifies the insufflation gas as the insufflation gas is passed to the passage. In one aspect, an oxygenator introduces slight amounts of oxygen into the insufflation gas. A warmer connected to the passage warms the gas in the passage. The warmer, in one aspect, contains a reactive agent that when exposed to air produces heat that is transferred to the passage to warm the insufflation gas within the passage.

Abstract: A surgical access device, such as a trocar, includes a pendent valve having an elongate structure extending from a proximal end to a septum valve disposed at a distal end. In operation, the elongate structure follows the angle of the instrument to pre-position the septum valve into the path of the instrument where it is not significantly challenged during instrument insertion or manipulation. The pendant valve can be made to float at both the proximal end and the distal end of the elongate structure, to further reduce the vulnerability of the septum valve. Since the valve is less vulnerable to instrument insertion, it can be formed to minimize friction and maximize the functional range of the access device.

Abstract: A surgical instrument can include tips and an actuation rod having a pin and slot design where the driving slots are moved from the tips to the actuation rod in one aspect of the invention. As a result, the back end of each blade or tip can be dramatically reduced in area so that during full deflection, very little or no part of the blade or tip extends beyond the outside diameter of the shaft. In addition, the depth of each slot can be varied such that during actuation, increased tension can be put on the blades or tips throughout the cut.

Abstract: A laparoscopic scissor with a shaft for use through an access port, such as a trocar cannula, with one or more parabolic, cubic, quadratic or higher order cutting blades extending from the shaft is provided.

Abstract: A laparoscopic insufflation device is provided in the configuration of a coil with a blunt tip. The device is capable of passing through the abdominal wall without cutting tissue, and exiting the abdominal wall substantially parallel to the inner surface. While rotation of the coiled device results in forward movement through the abdominal wall, a counter force can be applied to the device to create a safety space between the wall and the interior organs. With the blunt distal tip, parallel exit angle, and safety space, there is substantially no threat to the interior organs during placement of the device. Further space can be generated with the use of pressured gas to produce an abdominal cavity for the subsequent placement of trocars. By rotatably attaching the coiled insufflation device to a trocar, the advantage of a counter force can be used not only to establish the safety space but also to pull the trocar into the abdominal wall with a counterforce which resists tenting.

Abstract: A surgical clamp includes opposing jaws and a covering enhancing traction between the jaws and a body conduit. A multiplicity of fibers oriented to extend longitudinally between the clamp and conduit may be composed of filaments and either woven or non-woven to form a fabric. A variety of weaves are contemplated to provide different textures, each having its own traction characteristics. The nature of the weave can control characteristics such as smoothness, absorption, and texture. The fibers or filaments may be formed from any solid or semi-solid material, adding its own characteristics to the resulting fabric insert or clamp.

Abstract: A stabilization seal is used with existing cannulas for forming a gas-tight seal with tissue in a body wall. The stabilization seal includes a cylindrical inflatable elongate tube having a graduated wall-thickness that is thicker in a central region and thinner in a distal-end region. The tube includes a sealing cuff, having an inflation port, for sealing around a cannula. Application of inflation pressure greatly expands the distal-end region while the central region expands slightly. Another embodiment of a stabilization seal includes an inflatable thread that is used with a cannula having a helical channel on its outer surface. An inflatable tube is wound into the channel. A distal end of the tube includes a gas-tight seal and a proximal end of the tube includes an inflation port. In the uninflated condition the nested tube is flush with the channel. Inflating the tube enlarges the cannula assembly.

Abstract: A surgical access port for insertion into a body cavity can have an elongate tubular body extending along an axis between a proximal end and a distal end, and a tip at the distal end of the tubular body for penetrating through a body wall and into the body cavity. The distal tip moves from a first, penetrating position to a second, retaining position when the body wall has been traversed. The surgical access port may further comprise a seal housing connected to the proximal end of the tubular body, the seal housing having an access port providing an opening into the tubular body to allow passage of surgical instruments. The distal tip may be sharp, pointed or bladed. The distal tip may also be substantially blunt or have a conical surface. The access port may further comprise a retention member for connecting the tubular body and the distal tip.

Abstract: A trocar system for providing access across a body wall includes a trocar and an anchor provided in the form of a first helix. The anchor is adapted for placement in an operative position wherein the anchor extends at least partially through the body wall. A second helix formed on the trocar is size and configured to engage the first helix of the anchor so that rotation of the trocar relative to the anchor moves the second helix along the first helix. In this manner, the trocar is drawn into the anchor as it moves into the body wall. A proximal force applied to the anchor resists tenting of the abdominal wall. The anchor also holds the layers of the body wall together thereby resisting peritoneal separation.

Abstract: A surgical stapler is provided that maintains the jaws of the stapler in an open position and prevents firing of staples when a cartridge is not loaded in one of the jaws. Distinct positioning and sequencing of the jaws, capture pin and firing of the staples are provided by a latch mechanism. Such locking and latching mechanisms ensure proper operation of the stapler.