Abstract: A surgical apparatus for the placement of an instrument within a body cavity which comprises a placement device including an elongate element with an exposable tissue piercing tip, a first coupling means adjacent to the tip, and means for selectively exposing the tip; and an elongate instrument for placement including a second coupling means adapted to be coupled to the first coupling means to effect an end to end coupling of said device and said instrument whereby said instrument is positioned within said body cavity. Preferably the instrument is a suprapubic instrument for placement within a bladder. A method for placement of a suprapubic instrument is also disclosed. Also shown is a method and apparatus for end-to-end instrument coupling in the context of guidewire instrument placement. End-to-end coupling is accomplished by loop and slot arrangements, a tail and collapsing loop arrangement, and a tail captured between two slidably disposed sleeves.

Abstract: A surgical apparatus for the placement of an instrument within a body cavity which comprises (i) a placement device including an elongate element with an exposable tissue piercing tip, a first coupler adjacent to the tip, and a structure for selectively exposing the tip; and (ii) an elongate instrument for placement including a second coupler adapted to be coupled to the first coupler to effect an end to end coupling of the device and the instrument whereby the instrument is positioned within the body cavity. Preferably the instrument is a suprapubic instrument for placement within a bladder. A method for placement of a suprapubic instrument is also disclosed.

Abstract: Elongate flexible elements are guided into place within a tortuous body passage by providing the elements with annular guides adjacent their distal ends and sliding the elements over a guide wire extended through the passage. Column strength to move the elements through the body passage may be provided by a tubular pusher slidably received on the guide wire. The annular guides are localized at the distal ends of the members so that a plurality of members may be sequentially or simultaneously guided into place over a single guide wire.

Abstract: An open ended tubular sheath is provided with an annular guide element to facilitate placement of the sheath within a body passage. In use a guide wire is directed into the passage and the guide element is then slid over the wire to direct the sheath into the passage. Once in place, the sheath may be used to direct instruments into the passage without significant abrasion or trauma. The guide element may take the form of a loop or tube. Column strength may be provided to the sheath either by the guide element or a stiffener engaged with the element or the sheath.