Abstract: 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: 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.

Abstract: A tissue welding apparatus is adapted to fuse a first piece of tissue to a second piece of tissue which are disposed in a surface proximate relationship. An elongate shaft carries a first jaw, and a second opposing jaw moveable relative to the first jaw. At least one penetrating member is carried by the first jaw and moveable relative to the second jaw to create a channel through the first piece of material and the second piece of material. A source of heat is coupled to the penetrating member for denaturing the tissue defining the channel. This denatured tissue forms a column binding the first piece of tissue to the second piece of tissue. A chemical agent can be carried to the tissue with the penetrating member.

Abstract: A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter through body cavities of varying thicknesses. The retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound, a second ring having a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound, and a sheath disposed between the two rings. Optionally, the second ring may be detachably attached to the sheath to adapt the retractor to body cavities of varying thickness. Additional rings may be disposed along the sheath to provide for adjustment of the distance between the first and second rings. The retractor may also include an expandable foam annulus that can adjust the distance between the first and second rings.

Abstract: A trocar is provided with a cannula and a housing and valve assembly disposed in the housing which forms a housing seal, and instrument seal, and in some cases a zero seal. A gel material is included in the valve and provides the valve with superior flotation properties for maintaining the instrument seal even when the instrument is moved off-axis. In order to accommodate movement of the gel material, voids can be formed within the valve housing and even within the gel material.

Abstract: A device includes an access port adapted to permit access of at least one surgical instrument into a patient. The access port includes a proximal portion, a distal portion, and an intermediate portion monolithically formed of a flexible material. At least one opening extends through the access port. The proximal portion includes a proximal flange. The distal portion includes a distal flange. The intermediate portion includes an outer surface and at least one inner surface. The access port is adapted to form a perimeter seal when the proximal flange is disposed exteriorly and the distal flange is disposed interiorly. The access port is adapted to form a seal with the at least one surgical instrument positioned through the access port. The intermediate portion conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal between the inner surface and the surgical instrument.

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: 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 wound retractor for retracting a surgical incision includes an inner ring, an outer ring and a distensible sleeve coupled to the inner and outer rings. The outer ring includes at least a pair of circular tubes coupled to each other. At least one of the circular tubes includes a lumen and a split that forms open ends. A noncompliant tubular hoop having a split therein is positioned in the lumen. The tubular hoop is oriented with its open ends positioned away from the split of the circular tubes. A core is positioned in the lumen of the tubular hoop. The core has a first end and a second end and is oriented with the ends positioned away from the split in the tubular hoop. The circular tubes may be parallel or may form a helical pattern similar to a Mobius strip.

Abstract: A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter, the retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound. A second ring has a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound. A plurality of retraction elements are disposed in a generally cylindrical relationship to each other, between the first ring and the second ring. These elements extend through the wound to exert a radial retraction force on the wound which is dependent on the distance separating the first ring and the second ring. Retraction elements, both distensible and non-distensible are contemplated with appropriate attachment means at the rings to provide for variations in the retraction force. With a suitable retraction sleeve, a third ring can be provided to form a circumferential retainer to vary the retraction force.

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: Embodiments of an access device system useful for single or limited port procedures includes a retractor and a gel cap removably coupled to the retractor. The gel cap includes 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 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: 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 access device comprising a tissue separating obturator suitable for connection with a cannula is disclosed. The obturator includes an elongate shaft having a transparent distal tip. The elongate shaft extends along a longitudinal axis and defines a lumen. The transparent distal tip has a tapered configuration and includes an inner surface and an outer surface adapted for penetrating tissue. The lumen is sized and configured to receive an optical instrument such as a laparoscope. The surgical access device further includes a scope lock at the proximal end of the shaft portion. The lock includes a multi-fingered collet coaxial with the lumen. The inner diameter of the collet is smaller than an outer diameter of the optical instrument and the fingers of the collet provide frictional engagement with the outer diameter of the optical instrument that is inserted into the lumen of the obturator.

Abstract: An instrument seal of a surgical access device is provided and includes a plurality of nested coaxial seals arranged to cooperate and form a complete, circumferential seal around an inserted instrument.

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: Bipolar electrosurgical scissors for treating biological tissue include first and second scissor blades. A shearing surface and cutting edge of each blade is electrically neutral. The scissors include a pair of electrical connections for receiving electrical currents of opposing polarities. Each blade includes at least one first electrode and at least one second electrode positioned on a surface opposite the shearing surface. The at least one first electrode on the first blade and the at least one second electrode on the second blade are coupled to the first electrical connection. The at least one second electrode on the first blade and the at least one first electrode on the second blade are coupled to the second electrical connection. In a first energized state, the electrical connections deliver electrical current only to the first electrodes. In a second energized state, the electrical connections deliver electrical current to all of the electrodes.

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: 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: 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.