Abstract: A trocar system includes an obturator handle defining a handle axis and having an axial bore and an obturator cartridge adapted for releasable mounting to the obturator handle. The obturator cartridge includes a cartridge frame and an elongate obturator extending from the cartridge frame and at least partially positionable within the axial bore of the obturator handle. The elongate obturator includes an image transmitting member and having an obturator blade mounted adjacent the image transmitting member. The obturator blade is adapted for movement relative to the image transmitting member between an initial condition and a deployed position. A trigger is mounted to the obturator handle and adapted for releasable operative coupling to the obturator blade. The trigger is movable to cause movement of the obturator blade from at least the initial condition to the deployed position thereof. The obturator cartridge includes a longitudinal opening extending through the cartridge frame and the elongate obturator.

Abstract: A surgical access apparatus adaptable to permit the sealed insertion of either the surgeon's hand and/or surgical instruments during laparoscopic and endoscopic surgical procedures includes an access housing defining a central longitudinal axis and having a longitudinal opening extending therethrough for passage of a surgeon's hand, a retractor base mounted to the access housing and having a flexible liner for positioning within the incision to engage tissue portions defining the incision, and a trocar adapter which is releasably mounted to the access housing. The trocar adapter includes a trocar sleeve positioned for reception within the longitudinal opening and a trocar valve adapted to receive a surgical instrument in fluid tight relation therewith. The access housing may include a seal adapted to form a seal about each of the surgeon's arm and the trocar sleeve. The seal is adapted to close in absence of the surgeon's arm or the trocar sleeve.

Abstract: A surgical seal system is adapted for use with a cannula assembly having a cannula housing and a cannula sleeve extending from the cannula housing. The surgical seal assembly includes a seal assembly and an adapter assembly. The seal assembly is mountable to the cannula housing. The seal assembly includes a seal housing and a seal defining inner portions adapted to form a substantial seal about an instrument with a first cross-sectional dimension. The adapter assembly includes an adapter body adapted for releasably coupling to the seal housing of the seal assembly. The adapter body has an adapter seal and a tether. The adapter seal is adapted to form a substantial seal about an instrument with a second cross-sectional dimension less than the first cross-sectional dimension. The tether is mountable to the cannula sleeve thus securing the adapter assembly to the cannula.

Abstract: A surgical system comprising a cannula assembly and an obturator assembly for penetrating tissue is disclosed. A cover of the cannula assembly is mounted to a cannula housing and has a cover aperture therethrough. The cover has a trailing end face defining a predetermined geometrical configuration, at least a portion of the trailing end face is obliquely arranged relative to a longitudinal axis and terminates in, and leads toward the cover aperture to facilitate guiding of the surgical object through the cover aperture. The obturator assembly includes an obturator housing and an obturator member. The obturator housing has a housing base defining a leading end face, which defines a predetermined geometrical configuration corresponding to the predetermined geometrical configuration of the trailing end face of the cover to mate therewith upon assembly of the obturator assembly with the cannula assembly.

Abstract: An obturator for use in penetrating tissue includes an elongate member defining a longitudinal axis, and having a proximal end and a distal end, and a penetrating member adjacent the distal end of the elongate member. The penetrating member has a distal penetrating tip dimensioned to pass through tissue. The penetrating member defines an external wall leading toward the penetrating tip. The external wall includes a plurality of raised elements extending at least radially outwardly relative to the longitudinal axis and being in general longitudinal alignment. Adjacent raised elements are spaced along the longitudinal axis to thereby accommodate tissue displaced during passage of the penetrating member through tissue. The raised elements are dimensioned to be generally atraumatic to tissue. The raised elements may define an arcuate profile.

Abstract: A surgical system for penetrating tissue includes an obturator including an obturator housing and an obturator member extending from the obturator housing. The obturator member defines a longitudinal axis along which the obturator extends from trailing to leading ends thereof, and has a leading penetrating member adapted to penetrate tissue. The penetrating member defines, from leading to trailing, a cylindrical element having a generally arcuate leading surface and a generally planar dissecting element extending from the cylindrical portion. The obturator member and the leading penetrating member may be monolithically formed. The obturator member may include an obturator rod connected to the obturator housing, and defining a generally “t”-shaped cross-section. The generally planar dissecting element defines side surfaces obliquely arranged with respect to the longitudinal axis. The side surfaces may be arcuate or may define cutting edges.

Abstract: A system for accessing underlying tissue includes an elongated access sheath defining a longitudinal axis and a penetrating tip releasably mounted to the access sheath and dimensioned for facilitating passage through tissue. The penetrating tip is removable through the access sheath. The penetrating tip may include a transparent region adapted to permit passage of light.

Abstract: Pneumoperitoneum needles for providing and/or insufflating a corporal and/or abdominal cavity are provided. The pneumoperitoneum needle can include a housing, an elongate tubular body extending from a distal surface of the housing, and an elongate hollow tubular rod slidably received within the tubular body. The tubular body preferably includes a passage formed therethrough for connection to a gas administration system. The tubular rod preferably includes a blunt distal end defining an opening, and a proximal end portion defining an opening formed therethrough.

Abstract: A seal assembly for use with an access device includes a seal housing defining a central longitudinal axis, an inner wall and an outer wall. The inner wall defines a longitudinal opening to permit passage of instrumentation through the seal housing. A gimbal mount is at least partially accommodated within a space defined between the inner wall and the outer wall of the seal housing. The gimbal mount includes a seal member defining an aperture for substantial sealed reception of a surgical instrument. The gimbal mount is adapted for angular movement relative to the central longitudinal axis upon angulation of the surgical instrument while substantially maintaining the sealed reception of the surgical instrument.

Abstract: A flexible cannula assembly includes a tubular member having a proximal end portion and a distal end portion and a seal positioned adjacent the distal end portion of the tubular member. The tubular member is formed of a flexible material. The seal defines a hole in a central portion thereof for receiving surgical instruments therethrough. The flexible cannula assembly further includes a housing connected to the proximal end portion of the tubular member.

Abstract: A surgical system for penetrating tissue includes a cannula having a cannula housing and a cannula sleeve extending from the cannula housing and an obturator at least partially positionable within the cannula. The obturator includes an obturator housing, an obturator member extending from the obturator housing and having a penetrating member adapted to penetrate tissue and a stylet at least partially disposed within the obturator member. The stylet and the obturator member are adapted for relative longitudinal movement between a first relative position corresponding to an unarmed condition of the penetrating member and a second relative position corresponding to an armed condition of the penetrating member.

Abstract: Systems, kits, and methods for establishing percutaneous access are described. A system typically includes a deformable variable diameter cannula sleeve (DVDCS) and a guidewire. The DVDCS will generally have two states, an initial, un-activated condition and a second, activated condition, brought about and controlled under the discretion of the operator. The methods comprise creating an initial access point and tissue tract with a needle, positioning a guidewire through the initial tissue tract, passing the deformable variable diameter cannula sleeve over the guidewire through the tissue tract to a target blood vessel or cavity, and activating the DVDCS to effect radial deformation of the surrounding tissue. Use of the DVDCS reduces the risk of injuring tissue surrounding the tissue tract by lessening the axial forces imparted to the tissue. Kits comprise at least one deformable variable diameter cannula sleeve together with instructions for use.

Abstract: A seal assembly for use with an access device includes a seal housing defining a central longitudinal axis, an inner wall and an outer wall. The inner wall defines a longitudinal opening to permit passage of instrumentation through the seal housing. A gimbal mount is at least partially accommodated within a space defined between the inner wall and the outer wall of the seal housing. The gimbal mount includes a seal member defining an aperture for substantial sealed reception of a surgical instrument. The gimbal mount is adapted for angular movement relative to the central longitudinal axis upon angulation of the surgical instrument while substantially maintaining the sealed reception of the surgical instrument.

Abstract: A method of forming and enlarging a percutaneous penetration is provided. The method includes the step of providing a radially expandable dilation assembly having a needle assembly removably inserted in a axial lumen thereof. The radially expandable dilation assembly includes a radially expandable sleeve body defining a lumen and an introducer seal disposed across the lumen and defining an opening formed therein. The method further includes the steps of penetrating the radially expandable dilation assembly and needle assembly through tissue to a target surgical site, withdrawing the needle assembly from the radially expandable dilation assembly, and inserting an expansion assembly through the opening formed in the introducer seal and into the axial lumen of the radially expandable dilation assembly.

Abstract: Expandable casing has an expandable slip used for completion of a mono-diameter wellbore. The expandable casing is run through the upper casing and has an upper end that overlaps a lower end of the upper casing to form a fluid flow path between the expandable casing and the upper casing. The operator expands the overlapping portion of the expandable casing to an intermediate position, causing the expandable slip to anchor the expandable casing to the upper causing without blocking the flow path. Cement is then pumped up around the outside of the expandable casing and wellbore fluid displaced by the cement and excess cement are permitted to flow through the fluid flow path and up the upper casing. After sufficient cement is in place, the expandable casing is further expanded, compressing the expandable slip into to the inner wall of the upper casing and sealing off the fluid flow path.

Abstract: Pneumoperitoneum needles for providing and/or insufflating a corporal and/or abdominal cavity are provided. The pneumoperitoneum needle can include a housing, an elongate tubular body extending from a distal surface of the housing, and an elongate hollow tubular rod slidably received within the tubular body. The tubular body preferably includes a passage formed therethrough for connection to a gas administration system. The tubular rod preferably includes a blunt distal end defining an opening, and a proximal end portion defining an opening formed therethrough.

Abstract: A one trip top to bottom expansion to form a lower end recess on a tubular is described using two swages of different dimensions. The smaller swage is run down hole with the larger swage behind it in a locked collapsed position. When the proper depth is reached the leading swage hits a no go. A pickup force with dogs engaged in a groove releases the lock on the larger swage at which point applied pressure sets an anchor, extends the larger swage to take over the expansion for the recess at the lower end of the tubular. An emergency release is provided to pull out of the hole if the swage cannot complete the task.

Abstract: An apparatus for the reception of an instrument inserted through a surgical portal apparatus includes a valve mount, a major opening through the valve mount, a primary valve for selectively sealing the major opening, a minor opening through the primary valve, and a secondary valve for selectively sealing the minor opening. Components of both the major valve and the minor valve may be displaced to permit passage of a broad instrument, while components of only the secondary valve may be displaced to permit passage of a narrow instrument.

Abstract: A surgical portal apparatus includes a portal member dimensioned to access tissue and having a longitudinal passageway therethrough to permit access to underlying tissue, and defining leading and trailing ends, a seal housing associated with the portal member and a seal mount at least partially disposed within the seal housing. The seal mount is adapted for rotational movement within the seal housing. The seal mount includes an instrument seal adapted to establish a substantial sealed relation with a surgical object introduced within the longitudinal passageway and a closure valve adapted to substantially close the longitudinal passageway in the absence of the object.

Abstract: An obturator assembly for use in dissection of tissue includes an obturator housing, an obturator member mounted to the obturator housing and an obturator sleeve coaxially mounted about the obturator member and adapted for reciprocal longitudinal movement between a retracted position and an extended position. The obturator member includes an obturator rod and a penetrating end. The penetrating end defines a substantially planar dissecting segment and a central rod segment extending from the planar dissecting element. The planar segment of the penetrating end of the obturator member defines atraumatic outer edges which may be arcuate in character. The central rod segment defines a distal entry surface which is also atraumatic, and may be arcuate as well. In one embodiment, the distal entry surface of the central rod segment and the atraumatic edges of the planar dissecting segment are at least partially exposed from the nose shield when in the extended position of the obturator sleeve.