Abstract: The present invention relates to a surgical access device comprising an elongate tubular member having a working channel and a proximal end and a distal end, a septum seal integrally formed at the distal end of the tubular member, and a zero seal disposed at the distal end of the tubular member and distal to the septum seal, the zero seal being sized and configured to seal when no instrument is in place within the working channel of the tubular member, and the zero seal being coupled to the septum seal The zero seal may be a duckbill seal having opposing lip portions separated by a slit portion. The opposing lip portions are coated with or attached to a soft or occlusive material.

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 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: The invention is directed to a bladeless trocar and obturator combination configured to separate body tissue. In one aspect, the obturator of the invention includes a rigid shaft extending along an axis between a proximal end and a closed, tapered distal end. The bladeless, closed and tapered tip is adapted to penetrate tissue. The shaft is sized and configured to receive an optical instrument having a distal end to receive an image of the body tissue. The shaft includes an ledge on the inner surface to provide proper positioning of the distal end of the optical instrument. The tapered configuration facilitates separation of different layers of the body tissue and provides proper alignment of the tip between the layers.

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 device is adapted for performing laparoscopic surgical procedures with at least one instrument passing through the surgical access device and through an incision in the abdominal wall of a patient with the abdominal cavity pressurized with an insufflation gas. The surgical access device comprises an access seal. The material of the access seal is adapted to form a seal to generally maintain insufflation pressure within the abdominal cavity. At least one opening is formed through the material of the access seal between a proximal portion and a distal portion of the access seal. The at least one opening when operatively disposed is in communication with the incision and forms a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The material of the access seal conforms to a surface of an instrument inserted through the working channel.

Abstract: A trocar fixation device includes a cannula and an elongate tube mounted onto and coupled to the exterior surface of the cannula with the distal end of the cannula extending distally beyond the distal end of the elongate tube. The elongate tube includes a plurality of slits cut at an angle to a longitudinal axis of the elongate tube. The trocar fixation device is activated by rotating the proximal-end region of the elongate tube in a first direction and is deactivated by rotating the proximal-end region of the elongate tube in a second direction, opposite to the first direction. Activation of the trocar fixation device compresses the material positioned between adjacent slits and forces the material radially outwardly, away from the exterior surface of the cannula, thereby forming ridges. Deactivation of the trocar fixation device returns the exterior surface of the elongate tube to a substantially smooth condition.

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: 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: 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: 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 device comprises an access port adapted to permit access of at least one surgical instrument into a patient. The access port comprises 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 comprises a proximal flange. The distal portion comprises a distal flange. The intermediate portion comprises 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: An insufflation gas warmer and humidifier apparatus and methods are provided. Insufflation gas is received from a bulky insufflation tubing. Insufflation gas received travels through, in one aspect, a channel or winding flow path, in a passage. The configuration of the passage ensures that the insufflation gas, which travels through the passage, receives sufficient heat and moisture. A humidifying reservoir humidifies the insufflation gas as the insufflation gas is passed to the passage. In one aspect, an oxygenator introduces slight amounts of oxygen into the insufflation gas. A warmer connected to the passage warms the gas in the passage. The warmer, in one aspect, contains a reactive agent that when exposed to air produces heat that is transferred to the passage to warm the insufflation gas within the passage.

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.

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 surgical access device, such as a trocar, includes a pendent valve having an elongate structure extending from a proximal end to a septum valve disposed at a distal end. In operation, the elongate structure follows the angle of the instrument to pre-position the septum valve into the path of the instrument where it is not significantly challenged during instrument insertion or manipulation. The pendant valve can be made to float at both the proximal end and the distal end of the elongate structure, to further reduce the vulnerability of 100 the septum valve. Since the valve is less vulnerable to instrument insertion, it can be formed to minimize friction and maximize the functional range of the access device.

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: An electrosurgical instrument includes jaws having an electrode configuration utilized to electrically modify tissue in contact with one or more electrodes. The instrument is removably connectable to an electrosurgical unit via an electrosurgical connector extending from the instrument and a receptacle on the electrosurgical unit. The electrosurgical instrument is rotatable without disrupting electrical connection to the electrodes of the jaws. One or more of the electrodes is retractable. The electrosurgical unit and instrument optimally seals and/or cuts tissue based on identifying the tissue and monitoring the modification of the tissue by the application of radio frequency energy.

Abstract: An insufflating surgical instrument adapted for movement across an abdominal wall to insufflate an abdominal region of a patient is disclosed. The instrument comprises a shaft having an insufflation channel extending between a proximal end and a distal end, the insufflation channel being adapted for connection to a source of fluid under pressure at the proximal end. A tip is at the distal end and a vent hole is formed in the tip being in connection with the insufflation channel and adapted to expel fluid under pressure to insufflate the abdominal region. The tip is formed of a transparent material to facilitate visualization of the abdominal wall and region. The shaft includes a lumen extending along the axis between the proximal end and the distal end to enable insertion of a laparoscope. The lumen and insufflation channel may be formed as separate channels or as one shared channel.

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.