Abstract: A working cannula is advanced through the urethra into the bladder. Gas is infused through the cannula into the bladder, pressurizing the bladder. A fenestrating shunt catheter is then advanced through the urethra into the bladder and against the wall of the bladder, fenestrating it. A distal segment of the shunt catheter is then advanced through the wall into the peritoneal space, while a more proximal segment of the shunt catheter remains in the bladder. Shunt holes are formed in both the distal segment and more proximal segment so that gas from the pressurized bladder flows through the shunt holes into the peritoneal space, insufflating the peritoneal space.

Abstract: The invention relates to a device and related method for sealing and/or dissecting body tissue using a reverse action instrument. The devices and methods described permit laparoscopic or natural body orifice access to an anatomical space and facilitate sealing portions of tissue together, dissecting tissue or combinations thereof. A surgical instrument for sealing and dissecting body tissue is described having distal and proximal ends with an elongated body. The body includes a jaw member positioned at the distal end that is defined by a stationary arm and a pivotable arm. A moveable closure sleeve is disposed at least partially about the body and the closure sleeve is configured such that coaxial movement of the sleeve along the longitudinal axis of the body causes the jaw member to open or close.

Abstract: An outer tube for natural orifice surgery. The outer tube can have interchangeable inserts to establish a desired size and number of lumens. A distal tapered soft plastic plug may be provided to cover the distal end of the tube. Different segments of the tube may have different stiffness characteristics.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

Abstract: A transuterine cannula through which an endoscope can be advanced into the peritoneal space to provide visualization of tissue cutting in the peritoneal space pursuant to a vaginal hysterectomy.