Abstract: The present invention provides a surgical training device for training laparoscopic first entry surgical techniques. The training device includes a simulated abdominal wall that is penetrable with an optical trocar. A receptacle containing a tissue simulation is located inside the receptacle. The tissue simulation is observable via scope placed inside the optical trocar. Upon penetration of the one or more of the simulated abdominal wall and receptacle, the tissue simulation appears to translate distally relative to the simulated abdominal wall. The distal translation is effected by a variety of ways including the release of negative pressure inside the receptacle upon penetration and the expansion of an elastic wall of the receptacle with the introduction of fluid under pressure into the receptacle.

Abstract: An inexpensive and practical surgical training system to train practitioners in the use of surgical stapling and energy-based ligation instruments and procedures is provided. The system comprises a modified or simulated surgical instrument such as linear surgical stapling device having a fixed anvil and an opposed, movable jaw sized and configured to be closed upon a simulated tissue structure. A marking or inking element is associated with the jaw and anvil of the stapling device and configured to impose a visible pattern on the surfaces of simulated tissue placed between the anvil and jaw. A pressure sensitive adhesive or other adhesive is associated with the inner surfaces of the simulated tissue that is activated upon compression between the anvil and jaw to simulate surgical occlusion.

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 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: The invention primarily is directed to a medical tubing adapted for insertion into a body tissue or cavity and method of manufacturing different variations of the tubing along a length of the tubing. The tubing comprises a plurality of individual, discrete, generally ring-shaped elements arranged in series and fused or bonded together forming a continuous tubular structure. The ring-shaped elements may include a combination of flexible and rigid ring-shaped elements assembled along different portions or sections of the tubular structure. In another aspect of the invention, the medical tubing may further comprise a secondary lumen and a pull wire to control the tubular structure. In another aspect of the invention, the ring-shaped elements may vary in diameter and/or composition in different portions or sections of the tubular structure.

Abstract: A surgical simulation system is provided. The system includes at least one simulated body organ placed upon the base of an organ tray and at least one covering layer placed over the simulated body organ. At least one of the simulated body organ and covering layer includes electro-conductive gel that is operably severable under application of electrical current to simulate electrosurgery in a training environment. The training environment comprises a top cover connected to and spaced apart from a base to define an internal cavity that is partially obstructed from direct observation by a practitioner. The tray, simulated body organs and covering layer are placed inside the internal cavity for the practice of laparoscopic surgical procedures.

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: An anatomical model for surgical training is provided. The model includes a first layer simulating a liver and a second layer including a simulated gallbladder. A third layer having an inner surface and an outer surface is provided between the first and second layer. The outer surface of the third layer is adhered to the first layer at location around the simulated gallbladder and the simulated gallbladder is adhered to the inner surface of the third layer. A fourth layer is provided that overlays both the second layer and the simulated gallbladder. A frame is embedded within the first layer and is connectable to a support. The model provides a substantially upright projection of a simulated gallbladder and liver in a retracted orientation ideally suited for practicing laparoscopic cholecystectomy when inserted inside a simulated insufflated cavity of laparoscopic trainer.

Abstract: The invention primarily is directed to a medical tubing adapted for insertion into a body tissue or cavity and method of manufacturing different variations of the tubing along a length of the tubing. The tubing comprises a plurality of individual, discrete, generally ring-shaped elements arranged in series and fused or bonded together forming a continuous tubular structure. The ring-shaped elements may include a combination of flexible and rigid ring-shaped elements assembled along different portions or sections of the tubular structure. In another aspect of the invention, the medical tubing may further comprise a secondary lumen and a pull wire to control the tubular structure. In another aspect of the invention, the ring-shaped elements may vary in diameter and/or composition in different portions or sections of the tubular structure.

Abstract: The invention relates to a tissue morcellator for minimally invasive surgery. The morcellator has a metallic cutting ring mounted on a visually transparent hollow cylinder, which in combination with a visually transparent outer morcellator tube enables a surgeon to visualize the inside of the morcellator shaft for detection of loose tissue fragments in the device. A tenaculum used with the morcellation device has a spacer for preventing contact with the blade. The cutting tube can oscillate, rather than rotate, along the longitudinal axis of the cutting tube. The morcellator utilizes an extendable tissue guide on the outer tube of the morcellator shaft for preventing the tissue from rotating along the longitudinal axis of the morcellator tube. This allows the tissue to be continuously rotated into the morcellator device for continuous peel. The tissue guide can also be fully retracted to allow for coring of the bulk tissue.

Abstract: Embodiments of a circumferential retractor having an attached supporting, manipulating or positioning tool are described. The retractor optionally includes a sealing member associated with an external member of the retractor and an external support structure that may be used with the retractor and positioning tool as needed.

Abstract: Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.

Abstract: A surgical simulation system is provided. The system includes at least one simulated body organ placed upon the base of an organ tray and at least one covering layer placed over the simulated body organ. At least one of the simulated body organ and covering layer includes electro-conductive gel that is operably severable under application of electrical current to simulate electrosurgery in a training environment. The training environment comprises a top cover connected to and spaced apart from a base to define an internal cavity that is partially obstructed from direct observation by a practitioner. The tray, simulated body organs and covering layer are placed inside the internal cavity for the practice of laparoscopic surgical procedures.

Abstract: An anatomical model for surgical training is provided. The model includes a first layer simulating a liver and a second layer including a simulated gallbladder. A third layer having an inner surface and an outer surface is provided between the first and second layer. The outer surface of the third layer is adhered to the first layer at location around the simulated gallbladder and the simulated gallbladder is adhered to the inner surface of the third layer. A fourth layer is provided that overlays both the second layer and the simulated gallbladder. A frame is embedded within the first layer and is connectable to a support. The model provides a substantially upright projection of a simulated gallbladder and liver in a retracted orientation ideally suited for practicing laparoscopic cholecystectomy when inserted inside a simulated insufflated cavity of laparoscopic trainer.

Abstract: Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.

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: 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 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 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.