Abstract: The invention is directed to a bladeless trocar obturator to separate or divaricate body tissue during insertion through a body wall. In one aspect, the obturator of the invention comprises a shaft extending along an axis between a proximal end and a distal end; and a bladeless tip disposed at the distal end of the shaft and having a generally tapered configuration with an outer surface, the outer surface extending distally to a blunt point with a pair of side sections having a common shape and being separated by at least one intermediate section, wherein each of the side sections extends from the blunt point radially outwardly with progressive positions proximally along the axis, and the shaft is sized and configured to receive an optical instrument having a distal end to receive an image of the body tissue. With this aspect, the tapered configuration facilitates separation of different layers of the body tissue and provides proper alignment of the tip between the layers.

Abstract: An incrementally adjustable wound retractor (500), having a first ring (504) with a diameter greater than the desired diameter of the wound incision, a flexible second ring (502), having a lumen and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve (506), disposed in a generally cylindrical form between the first and second rings (502, 504), where the second ring may be rolled over itself to provide a sleeve with a radical retraction force sufficient to stretch the incision to the desired diameter.

Abstract: A surgical access device has a surgical retractor having a noncompliant outer ring with an annular axis, an inner ring, and a sleeve coupling the outer ring to the inner ring. The noncompliant outer ring is adapted to roll over itself around the annular axis to roll the sleeve around the outer ring to retract and seal an opening in a biological body wall. The access device may include a lid adapted for being coupled to the noncompliant outer ring of the surgical retractor. The outer ring of the surgical retractor has a cross-sectional shape that prohibits the lid from being partially or incorrectly coupled to the outer ring of the surgical retractor.

Abstract: A trocar system for providing access across a body wall includes a trocar and an anchor provided in the form of a first helix. The anchor is adapted for placement in an operative position wherein the anchor extends at least partially through the body wall. A second helix formed on the trocar is size and configured to engage the first helix of the anchor so that rotation of the trocar relative to the anchor moves the second helix along the first helix. In this manner, the trocar is drawn into the anchor as it moves into the body wall. A proximal force applied to the anchor resists tenting of the abdominal wall. The anchor also holds the layers of the body wall together thereby resisting peritoneal separation.

Abstract: A tamponade trocar includes an elongate balloon having a closed distal end and is adapted to expand from a small diameter to a large diameter. A cannula is positioned at a proximal portion within the balloon lumen. A rigid stylet is removably positioned within the balloon and cannula lumens. A distal end of the stylet supported balloon is inserted into a perforation in a body wall and advanced into a body cavity while the balloon is unexpanded. The balloon is expanded and the cannula is advanced to a distal portion of the balloon lumen and across the body wall. At this stage, the perforation is dilated and in compressive tamponade. The proximal portion of the balloon may be removed and a seal housing may be coupled to the proximal end of the cannula. The distal end of the balloon may be punctured and opened, making the trocar ready for use.

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: The invention is directed to a bladeless trocar obturator to separate or divaricate body tissue during insertion through a body wall. In one aspect, the obturator of the invention comprises a shaft extending along an axis between a proximal end and a distal end; and a bladeless tip disposed at the distal end of the shaft and having a generally tapered configuration with an outer surface, the outer surface extending distally to a blunt point with a pair of side sections having a common shape and being separated by at least one intermediate section, wherein each of the side sections extends from the blunt point radially outwardly with progressive positions proximally along the axis, and the shaft is sized and configured to receive an optical instrument having a distal end to receive an image of the body tissue. With this aspect, the tapered configuration facilitates separation of different layers of the body tissue and provides proper alignment of the tip between the layers.

Abstract: A device includes an access port adapted to permit access of a surgical instrument into a patient. The access port includes a proximal portion, a distal portion, and an intermediate portion monolithically formed. The proximal portion includes a proximal flange. The distal portion includes a distal flange. The intermediate portion includes an outer surface and an inner surface. The access port is adapted to be positioned in the patient such that the proximal flange is disposed exteriorly and the distal flange is disposed interiorly in an operative position. The access port is adapted to form a seal with the surgical instrument positioned through the access port in an operative position.

Abstract: Phase end point determination is provided to automatically halt the application of energy to tissue. Prior to the application of energy, the phase end point determination is identified by measuring the product of permittivity and conductivity of the tissue to be treated. An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.

Abstract: A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.

Abstract: A tamponade trocar includes an elongate balloon having a closed distal end and is adapted to expand from a small diameter to a large diameter. A cannula is positioned at a proximal portion within the balloon lumen. A rigid stylet is removably positioned within the balloon and cannula lumens. A distal end of the stylet supported balloon is inserted into a perforation in a body wall and advanced into a body cavity while the balloon is unexpanded. The balloon is expanded and the cannula is advanced to a distal portion of the balloon lumen and across the body wall. At this stage, the perforation is dilated and in compressive tamponade. The proximal portion of the balloon may be removed and a seal housing may be coupled to the proximal end of the cannula. The distal end of the balloon may be punctured and opened, making the trocar ready for use.

Abstract: Embodiments of a surgical access system useful for single or limited port procedures comprise a trocar comprising a fixation cannula, a retractor, and a gel cap removably coupled to the retractor. The gel cap comprises a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The fixation cannula comprises a retainer and a bolster, which together, capture the artificial body wall therebetween, thereby fixing the trocar thereto. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

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.

Abstract: A trocar surgical seal or surgical access device is provided. The trocar surgical seal comprises first and second supports coupled together by a film passageway. The trocar surgical seal provides an instrument seal for instruments inserted therethrough. The trocar surgical seal occupies minimal surgical space.

Abstract: A tamponade trocar includes an elongate balloon having a closed distal end and is adapted to expand from a small diameter to a large diameter. A cannula is positioned at a proximal portion within the balloon lumen. A rigid stylet is removably positioned within the balloon and cannula lumens. A distal end of the stylet supported balloon is inserted into a perforation in a body wall and advanced into a body cavity while the balloon is unexpanded. The balloon is expanded and the cannula is advanced to a distal portion of the balloon lumen and across the body wall. At this stage, the perforation is dilated and in compressive tamponade. The proximal portion of the balloon may be removed and a seal housing may be coupled to the proximal end of the cannula. The distal end of the balloon may be punctured and opened, making the trocar ready for use.

Abstract: Embodiments of a surgical access system useful for single or limited port procedures comprise a trocar comprising a fixation cannula, a retractor, and a gel cap removably coupled to the retractor. The gel cap comprises a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The fixation cannula comprises a retainer and a bolster, which together, capture the artificial body wall therebetween, thereby fixing the trocar thereto. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

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 process of making a tack-free gel is disclosed comprising the steps of providing a mold defining a mold cavity, the mold cavity comprising a plastic material; pouring or injecting a molten gel having a high molding temperature into the mold cavity; and forming the tack-free gel as a thin layer of plastic of the mold cavity is melted over the gel. The forming step further comprises cooling the gel from the molten state to a solidified state. The melting temperature of the plastic material is lower than the molding temperature of the gel; and the higher the temperature differential, the greater the melting of the plastic material and the thicker the layer of the plastic material on the surface of the gel. The mold may be formed of low-density polyethylene (LDPE).

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 access port comprises a valve or instrument seal that separates the instrument contact function from the instrument conforming function. Embodiments of the instrument seal comprise in instrument contact element that extends through an opening in a compression element, thereby defining an instrument orifice that seals with an instrument extending therethrough. Embodiments of the instrument contact element comprise a non-distensible membrane or film, for example, as a tube or cylinder.