Abstract: A steerable kink resistant access device is provided having an elongated body and a steerable portion. 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 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 incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop placed therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

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: An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop positioned therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

Abstract: A surgical clip applier is provided having a cartridge carrying multiple surgical clips with a manual graspable actuator configured to sequentially deliver clips to the jaws of the clip applier. Both the cartridge and the jaws are connectable to a scissors-like actuator arranged to translate motion from finger loops to the jaws to open and close the jaws and thus close or crimp a delivered clip between the jaws.

Abstract: A surgical clip assembly is provided having two molded components and a tension spring. In one aspect of the invention, the spring clip includes a first molded portion having a first jaw and a first finger tab, a second molded portion coupled to the first molded portion and having a second jaw and a second finger tab, and a tension spring coupled to both the first and second molded portions. The first and second molded portions may be identical components and are moveable by operation of the first and second finger tabs between a generally closed position and a generally open position. The finger tabs may include cavities or grooves to facilitate engagement with a user or the jaws of a clip applier. The jaws may be shaped, curved or bent to provide access to specific areas of a procedure.

Abstract: The invention is directed to a surgical instrument including a handle assembly and a shaft assembly. The handle assembly further includes a fixed handle and a pivoting handle. The shaft assembly extends from the handle assembly and further includes an outer tube and an inner actuation rod that slides coaxially with the outer tube. The shaft assembly includes a rotatable knob to provide 360° rotation. The actuation rod has a proximal end and a distal end; the proximal end has a ball end that couples with the pivoting handle to form a rotatable ball-and-socket joint. The outer tube is formed of plastic and fits over the actuation rod to function as an electrical insulator.

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: The invention is directed to a sealing apparatus for sealing around a medical instrument, the sealing apparatus comprising a housing body; a two-piece cam body disposed inside the housing body; a sealing member disposed inside the cam body and having a channel extending axially of the cam body, the sealing member having at least two protrusions disposed around the channel; a plurality of pins operable to engage with the protrusions of the sealing member for movement relative to the cam body to radially compress the sealing member against and form a seal around the medical instrument; and biasing means for compressing the sealing member.

Abstract: A vascular steerable access device is provided having an elongate body and a steerable portion. The access sheath has an outside diameter sufficiently small so that it may be inserted into a vessel and a sufficient length to extend through a patient's circulatory system. The access sheath may have 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: An incrementally adjustable wound retractor (100), having a first ring (102) with a diameter greater than the desired diameter of the wound incision. A second ring (104), having an annular axis and a diameter greater than the desired diameter of the wound incision. A flexible sleeve (106), disposed in a generally cylindrical form between the first and second rings (102, 104), the second ring may be rolled over itself and around the annular axis to provide a sleeve with a radical retraction force sufficient to stretch the incision to the desired diameter.

Abstract: The invention is directed to a suture clip with stop ribs and method for making same. The clip includes a housing having an outer surface, and a pair of jaws extending longitudinally from the housing in an opposing relationship to each other. A resilient pad is carried by one of the jaws and defines with the outer surface of the housing a shutoff cavity. At least one rib extends longitudinally of the housing and across the cavity to inhibit any undesirable passage of the suture into the cavity. In another aspect, the surgical clip includes a housing with an inner member and an outer member having a telescoping relationship. A first jaw extends from the inner member outwardly of the housing and has a first inner surface. A second jaw extends from the outer member outwardly of the housing and has a second inner surface. At least one first rib extends from the first inner surface toward the second inner surface, and at least one second rib extends from the second inner surface toward the first inner surface.

Abstract: A surgical instrument (10) is adapted to contact tissue of a patient, and to provide traction with the tissue in order to inhibit migration of the instrument relative to the tissue. The instrument may include a pair of opposing jaws (16, 18) with at least one of the jaws (16, 18) comprising a substrate having a particular surface facing the tissue, and a plurality of discrete elements (26, 28) disposed on the particular surface for increasing the traction of the instrument relative to the tissue. These discrete elements (26, 28) may include a multiplicity of granules, bristles, or projections, and may be formed of materials having various properties such as hydrophilic characteristics. The discrete elements in the form of bristles can be oriented too so that the column strength of each bristle provides increased traction in a predetermined direction.

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 be formed of a thermoplastic or a thermoset material. The ring-shaped elements may include plastic rings, metallic rings, un-reinforced plastic rings and/or metal reinforced plastic rings assembled along the length of the tubular structure to provide variable flexibility and kink-resistance. The tubular structure may have a cross-section of any geometric shape and it may be bent, twisted or curved without kinking. The ring-shaped elements may have different flexural modulus.

Abstract: A modular clip applier includes a cartridge containing multiple surgical clips, and a handle assembly for operating the cartridge to crimp one of the clips onto body tissue of a patient. The handle assembly has a scissors configuration with a bayonet coupling, and flange pairs widely separated to provide a high degree of stability. The bayonet coupling enables the handles of the assembly to be fully separated for cleaning. Snap fittings between the cartridge and handle assembly are provided at the fulcrum and also at a spaced location where an operating pin of the cartridge engages intersecting slots in the flanges. Overdrive protection of three different types is contemplated along with a structure facilitating operation of the handle assembly by palming a pair of handle bars.