Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when a surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to a surgical tool.

Abstract: An apparatus and method for separating a first layer of tissue from a second layer of tissue. An inflatable balloon is mounted to a delivery device. The inflatable balloon has a first, inwardly-displaced portion which everts when the balloon is inflated. The balloon is inserted into a patient between the first and second tissue layers when the balloon is in the deflated state. The balloon is then inflated so that the first portion is everted thereby minimizing trauma to the tissue layers.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when a surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to a surgical tool.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool.

Abstract: A disposable seal assembly for use with a reusable cannula preferably includes a flapper valve fluid seal and at least one instrument seal. The instrument seal has a sacrificial flange and a sealing flange that protrude from an inner baffle connected to the assembly's main body by a flexible outer baffle, and at least one elastomeric rib extending between the inner baffle and the body to prevent inversion of the inner baffle. Preferably, a surface of the sacrificial flange is configured to prevent the flanges from sticking together during use. An adaptor, tethered to the assembly's main body, has a central channel with an hourglass profile, a concave distal flange, distal bumpers for preventing the adaptor from translating too far into the main body, and a grip portion shaped to allow a user conveniently to separate the adaptor from the main body. Other aspects include systems with a reusable cannula, and methods for using such systems.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis at an angle to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axis of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vein and side branch of interest, the surgeon extends the retractor to cradle the vein in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vein away from the axis of the cannula isolate the side branch for exposure to the surgical tool.

Abstract: An apparatus for tissue dissection and instrument anchoring, including a dissection balloon having a viewing window (preferably a rigid, transparent window) at its distal end, or including an anchoring or dissection balloon having nonuniform elasticity selected to achieve desired inflated shape and pressure characteristics, and methods for using such apparatus. The window, which can be a lens (such as a wide angle lens), is transparent and either rigid or non-rigid but sufficiently strong to retain a desired optical shape while (and after) being pushed against tissue layers by a rigid instrument deployed within the balloon. In preferred embodiments, the balloon is a long-necked dissection balloon deployed through a cannula.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis at an angle to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axis of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vein and side branch of interest, the surgeon extends the retractor to cradle the vein in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vein away from the axis of the cannula isolate the side branch for exposure to the surgical tool.

Abstract: A lifting apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall. The apparatus provides a broad lifting surface that is capable of applying a lifting force of at least 40 pounds (180 Newtons) to an area of a body wall sufficiently extensive to reduce the lifting pressure exerted on the body wall to well below that which could cause pressure trauma to the body wall, yet delivers this broad lifting surface through the body wall via an incision about 14 mm long. The apparatus comprises a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state. In the inflated state, the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole. The body wall engaging element includes an equatorial portion facing into the central hole.

Abstract: An apparatus for tissue dissection and instrument anchoring, including a dissection balloon having a viewing window (preferably a rigid, transparent window) at its distal end, or including an anchoring or dissection balloon having nonuniform elasticity selected to achieve desired inflated shape and pressure characteristics, and methods for using such apparatus. The window, which can be a lens (such as a wide angle lens), is transparent and either rigid or non-rigid but sufficiently strong to retain a desired optical shape while (and after) being pushed against tissue layers by a rigid instrument deployed within the balloon. In preferred embodiments, the balloon is a long-necked dissection balloon deployed through a cannula.

Abstract: An apparatus for tissue dissection and instrument anchoring, including a dissection balloon having a viewing window (preferably a rigid, transparent window) at its distal end, or including an anchoring or dissection balloon having nonuniform elasticity selected to achieve desired inflated shape and pressure characteristics, and methods for using such apparatus. The window, which can be a lens, is transparent and either rigid or non-rigid but sufficiently strong to retain a desired optical shape while being pushed against tissue layers by a rigid instrument deployed within the balloon. In preferred embodiments, the balloon is a long-necked dissection balloon deployed through a cannula. In other embodiments, the invention is a dissection balloon assembly including a long-necked dissection balloon having a viewing window at its distal end, and a housing to which the dissection balloon's mouth is attached.

Abstract: An apparatus for separating a first layer of tissue, such as the peritoneum, from a second layer of tissue, such as the properitoneal fascia. The apparatus includes a main envelope that defines a main inflatable chamber. The apparatus also includes an introducing device that introduces the main envelope in a collapsed state between the first layer of tissue and the second layer of tissue. The introducing device also inflates the main envelope into an expanded state to separate the first layer of tissue from the second layer of tissue, and to create a working space between the two layers of tissue. Finally, the apparatus includes an insufflating device that introduces insufflation gas into the working space between the two layers of tissue.A method for separating a first layer of tissue from a second layer of tissue provides a main envelope and insufflation gas. The main envelope defines a main inflatable chamber.

Abstract: A lifting apparatus for deployment through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall. The apparatus provides a broad lifting surface that is capable of applying a lifting force of at least 40 pounds (180 Newtons) to an area of a body wall sufficiently extensive to reduce the lifting pressure exerted on the body wall to well below that which could cause pressure trauma to the body wall, yet delivers this broad lifting surface through the body wall via an incision about 14 mm long. The apparatus comprises a body wall engaging element capable of passing in a packaged state through the laparoscopic incision, and being inflatable to an inflated state. In the inflated state, the body wall engaging element is substantially toroidal, provides a broad lifting face, and bounds a central hole. The body wall engaging element includes an equatorial portion facing into the central hole.

Abstract: A system for separating a first layer of tissue from a second layer of tissue and for maintaining separation of the first layer of tissue from the second layer of tissue while providing access to at least one of the layers of tissue. The system comprises a main envelope which defines a main inflatable chamber, an introducing means and an insufflating means. The introducing means includes a main cannula portion to which the main envelope is attached. The introducing means is for introducing the main envelope in a collapsed state between the first layer of tissue and the second layer of tissue, and for inflating the main envelope into an expanded state to separate the first layer of tissue from the second layer of tissue, and to create a working space between the first layer of tissue and the second layer of tissue. The insufflating means includes an auxiliary cannula portion to which an auxiliary envelope defining an auxiliary inflatable chamber is attached.

Abstract: A seal for use in a surgical instrument to provide a gas-tight seal with an instrument passed through the seal. The seal can form a gas-tight seal with an instrument having a diameter within a wide range of diameters. The seal comprises a seal body, an instrument seal, and a laterally-compliant seal mounting. The seal body includes a bore through which the instrument is passed. The instrument seal is made of an elastic material. The instrument seal extends radially outwards from an instrument port formed in the instrument seal through which the instrument is passed. The instrument port is substantially perpendicular to the axis. The instrument seal also extends axially from the instrument port in the direction opposite to that in which the instrument is passed through the instrument port.