Abstract: A surgical access port or trocar is provided. The trocar has a trocar seal housing and a trocar cannula with an optical obturator insertable through the trocar seal housing and the trocar cannula. The trocar is configured to access a body cavity, to maintain positive pressure and to prevent loss of surgical insufflation gas used in laparoscopic procedures. The trocar seal housing can be releasably attached to the trocar cannula. The trocar seal housing may also have a shield and/or alignment channel that provide protection or assist in operation of instrument and zero seals housed in the trocar seal housing.

Abstract: Jaw assemblies for a surgical stapler are provided. The jaw assemblies comprise a first jaw having a first clamping surface and a plurality of staples disposed therein and second jaw assembly having a second clamping surface. The jaw assemblies can be actuated from a closed configuration in which the first clamping surface contacts or is adjacent to the second clamping surface to an open configuration in which the second jaw is pivoted away from the first jaw to a stapling position in which the second clamping surface is parallel to the first clamping surface and spaced apart from the first clamping surface. A pivoting link or sliding pivot joint can couple the second jaw to the first jaw to facilitate motion between the closed position, the open position, and the stapling position.

Abstract: A tissue retractor comprising an outer ring, an inner ring, and a flexible, metal sheath extending therebetween is described. Embodiments of the outer ring comprise an outer ring rotatable around an annular axis thereof, thereby rolling the sheath therearound when retracting an incision or opening in a body wall. Embodiments of the sheath comprise a plurality of linked loops, a plurality of loops joined by a wire extending through adjacent loops, a braided wire, and a plurality of chains. Also described are kits comprising outer rings, inner rings, and sheaths, some or all of varying dimensions, which may be selected and assembled by the user for their intended use. Some or all of the kit components may be resterilized for reuse.

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 access port for passage through body tissue to provide access to an underlying tissue site is provided. The access port has a working channel dimensioned for receiving a surgical instrument and a seal assembly for providing a substantial seal before, during and after insertion of a surgical instrument. The seal assembly includes an instrument seal and a zero seal. The instrument seal includes a proximal base that is interconnected to a distal instrument engaging portion by an elongate supporting portion. The engaging portion has a lateral dimension larger than the lateral dimension of the supporting portion forming a bulbous, mushroom-like head. The lateral dimension of the engaging portion decreases toward a distal opening of the instrument seal such that the distal end of the engaging portion is substantially perpendicular to the seal axis. The supporting portion closely conforms to an inserted instrument and serves to align the distal end of the seal.

Abstract: A surgical access system comprises a wound retractor comprising an outer anchor, an inner anchor, and a flexible, tubular sheath extending therebetween. Embodiments of the outer anchor comprise an outer ring rotatable around an annular axis thereof, thereby rolling the sheath therearound when retracting an incision or opening in a body wall. The sheath comprises a plurality of fibers or strands that improve the abrasion and puncture resistance thereof. Consequently, the surgical access system is useful in procedures in which damage to the sheath is likely, for example, orthopedic hip replacement, and spinal procedures. In some embodiments, the sheath tapers from the outer ring to the inner ring.

Abstract: A trocar fixation device can comprise a cannula, at least one flap coupled to an exterior surface of the cannula within a central region of the cannula, and an elongate tube rotatably mounted onto the cannula and over the at least one flap. The elongate tube has at least one opening extending between an interior surface and an exterior surface of the elongate tube. In a free, activated state, the flap biases radially outwardly from the cannula. In a constrained, deactivated state, the at least one flap is positioned between the cannula and the elongate tube and maintained substantially parallel to the exterior surface of the cannula. The at least one opening in the elongate tube is sized and positioned such that rotation of the elongate tube in a first direction about the cannula exposes the flap in its entirety through the opening and allows the flap to activate.

Abstract: A steerable kink resistant access device is provided having an elongated body and a steerable portion; methods for manufacturing the kink resistant device are also provided. The access sheath has an outside diameter sufficiently small so that it may be inserted into a body cavity or conduit. The access sheath typically has two internal lumen, a first lumen sized and configured as an access to a surgical site and a second lumen sized and configured to contain a tensioning device that, when acted upon, will deflect the steerable portion. The tensioning device may be directly or remotely attached to an actuation device that operates to control the tensioning and loosening of the tensioning device.

Abstract: A process of making a tack-free gel is disclosed comprising the steps of providing a mold defining a mold cavity, the mold cavity comprising a plastic material; pouring or injecting a molten gel having a high molding temperature into the mold cavity; and forming the tack-free gel as a thin layer of plastic of the mold cavity is melted over the gel. The forming step further comprises cooling the gel from the molten state to a solidified state. The melting temperature of the plastic material is lower than the molding temperature of the gel; and the higher the temperature differential, the greater the melting of the plastic material and the thicker the layer of the plastic material on the surface of the gel. The mold may be formed of low-density polyethylene (LDPE).

Abstract: A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include a rotational mechanism arranged to discretely position the rotatable actuation shaft in one of the rotational orientations. The rotational mechanism can be arranged for single handed operation such as by including a slidable switch or selector to rotate the actuation shaft.

Abstract: A cannula assembly having a retention member and a method of manufacture of the cannula assembly is provided. The cannula assembly includes a cannula and a sleeve disposed around the cannula from a proximal end to a distal end. The sleeve can be pre-formed by a stretch blow molding process then advanced over the cannula. The sleeve includes an inflatable balloon and an annular ring distal the inflatable balloon. The cannula includes an annular recess. The annular ring is sized to have an interference fit with the annular recess.

Abstract: The invention is directed to a bladeless trocar obturator to separate or divaricate body tissue during insertion through a body wall. In one aspect, the obturator of the invention includes a shaft extending along an axis between a proximal end and a distal end; and a bladeless tip disposed at the distal end of the shaft and having a generally tapered configuration with an outer surface, the outer surface extending distally to a blunt point with a pair of side sections having a common shape and being separated by at least one intermediate section, wherein each of the side sections extends from the blunt point radially outwardly with progressive positions proximally along the axis, and the shaft is sized and configured to receive an optical instrument having a distal end to receive an image of the body tissue. With this aspect, the tapered configuration facilitates separation of different layers of the body tissue and provides proper alignment of the tip between the layers.

Abstract: An incrementally adjustable wound retractor, which provides access to a body cavity, includes a flexible retraction sheath, an inner ring having a diameter greater than the desired diameter of the wound incision attached to the distal end of the retraction sheath, and at least two rows of a plurality of loops disposed around the proximal end of the retraction sheath, each row of loops sized and configured to receive a noncompliant split hoop. The two split hoops may be rolled over each other and around the annular axis to retract the sheath with sufficient force to stretch the incision to the desired diameter.

Abstract: The present invention is directed to tack-free gels and to methods for manufacturing a tack-free gel pad, in which a discontinuous layer of fluorinated ultrahigh molecular weight polyethylene is permanently bonded to the gel pad to provide a tack-free coating. The gel pad may be incorporated into a gel cap to provide a surgical access device having a tack-free surface.

Abstract: The tissue retrieval system deploys a tissue bag at the surgical site. The bag is supported by the system as tissue is placed within the bag and is closed to isolate the collected tissue and allow the bag and collected tissue to be removed from the body. The bag can be reopened and re-closed as desired through use of a guide bead and cord. The bead also facilitates removal of the collected tissue.

Abstract: An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.

Abstract: An incrementally adjustable wound retractor (500), having a first ring (504) with a diameter greater than the desired diameter of the wound incision, a flexible second ring (502), having a lumen and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve (506), disposed in a generally cylindrical form between the first and second rings (502, 504), where the second ring may be rolled over itself to provide a sleeve with a radical retraction force sufficient to stretch the incision to the desired diameter.

Abstract: A simulated abdominal wall model that is ideal for practicing laparoscopic first entry surgical techniques is provided. The model includes a simulated abdominal wall portion captured between two frame elements of a support. The support is connectable to a surgical trainer. When connected to the trainer, the model provides a penetrable abdominal tissue portion for accessing an internal cavity of the trainer. The simulated abdominal wall includes a plurality of layers including a skin layer, a fabric posterior rectus sheath layer, a simulated fat layer of low-resilience polyurethane foam and at least two layers that provide distinctive haptic feedback upon penetration of the simulated transversalis fascia and muscle layers. The simulated abdominal wall includes a simulated umbilicus across several layers of simulated tissue.

Abstract: A surgical obturator comprising an elongate shaft extending along an axis between a proximal end and a distal end includes a bladeless tip disposed at the distal end of the shaft. The tip has a blunt point and a pair of shorter side surfaces separated by a relatively longer pair of opposing surfaces to form in radial cross-section a geometric shape that has a longer length and relatively narrower width. The side surfaces and opposing surfaces terminate in end surfaces located proximally from the blunt point. The end surfaces extend radially outwardly from opposite locations of the outer surface. A conical surface facilitates initial insertion of the obturator and the geometric shape facilitates separation of consecutive layers of muscle tissue having fibers oriented in different directions and provides proper alignment of the tip between the layers of muscle.

Abstract: A cannula assembly having a retention member and a method of manufacture of the cannula assembly is provided. The cannula assembly includes a cannula and a sleeve disposed around the cannula from a proximal end to a distal end. The sleeve can include a balloon formed by a stretch blow molding process following local heating once advanced over the cannula. Once formed, the balloon can be conditioned to constrict against the cannula. A conditioning aid can be advanced over the balloon when it is still formable to constrict the balloon against the cannula.