Abstract: A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Abstract: A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Abstract: An applier for ligation clip is provided. The applier includes: an outer tube having mounting bosses; a pair of jaws pivotally connected to the mounting bosses, the jaws having actuating projections; a feed tube located in the outer tube and configured to move axially within the outer tube, the feed tube having actuating slots in which the actuating projections are located; a clip lock arm located in the outer tube and configured to move axially within the outer tube; and a clip advance arm located in the outer tube and configured to move axially within the outer tube, the clip advance arm having flexible pinchers at one end of the clip advance arm. A method of applying a ligation clip is also disclosed.

Abstract: Described is a tool positioning system comprising an introduction device, a first tool support and a second tool support. The introduction device is constructed and arranged to slidingly receive an articulating probe. The first tool support comprises at least one guide element constructed and arranged to slidingly receive a first tool. The first tool support is oriented toward a first operator location. The second tool support comprises at least one guide element constructed and arranged to slidingly receive a second tool. The second tool support is oriented toward a second operator location.

Abstract: A surgical tool comprises an elongated first assembly and an elongated second assembly. The second assembly comprises an elongated support element, an elongated activation element moveable relative to the support element, and a functional mechanism coupled to the activation element. A movement of the functional mechanism is in response to a movement of the activation element. A force imparted by the movement of the activation element is isolated from the first assembly by the support element.

Abstract: A seal system may include: an annular shaped resilient seal, the resilient seal having an outer portion, an inner portion, a distal end, and a proximal end; a conical portion located in the inner portion of the resilient seal, the conical portion converging toward the distal end, the conical portion defining a hole at the distal end; an anti-friction ring; flexible fingers defining at least part of the anti-friction ring; and an end feature located at a distal part of the flexible fingers, the end feature having at least a partial spherical cross-sectional shape, wherein the anti-friction ring is dimensioned to fit, at least partially, in the conical portion of the inner portion of the resilient seal. A method of making a seal system may also be provided.

Abstract: A suture placement device is inserted into an endoscopic trocar port site. A pivot bar with a pair of receptor ports is moved from a folded to an extended position below the fascia. The trocar port is removed over the device as the pivot bar is pulled upward against the fascia. A pair of stylet guides are deployed from two sides of the device housing, and intercept the receptor ports, thereby creating a suture path through the first guide, through a channel in the pivot bar between the receptor ports, and through the second guide. A stylet is directed through the suture path to pull a suture through the path. The guides are refracted, the pivot bar is folded, the device is removed, and the suture is tied. A stylet guide may have a partially deployed position to accurately inject an anesthetic at a desired intra-muscular layer.

Abstract: A dilating cannula includes a radially expandable flange and an expandable shaft. The radially expandable flange is disposed at a proximal end portion of the dilating cannula and includes two or more sectors that are each independently movable. The expandable shaft extends from the proximal end portion to a distal end portion of the dilating cannula and defines an inner passageway of the dilating cannula and includes two or more arms. A first branch of the two or more arms extends from one end of the base section and a second branch of the two or more arms extends from another end of the base section. The first branch is connected to a first sector of the two or more sectors of the radially expandable flange and the second branch is connected to a second, different sector of the two or more sectors of the radially expandable flange.

Abstract: An end effector actuation system includes a shaft assembly having an outer shaft with an internal lumen and an actuation rod slidably received in the lumen, the outer shaft having a distal end portion that is compressible only when the actuation rod is absent from the lumen in the distal end portion, a locking boss provided on the distal end portion; and an end effector assembly having a receiving opening and a retention pocket, wherein the receiving opening is sized to receive the compressed distal end portion of the outer shaft and the retention pocket is sized to receive the locking boss when the distal end portion is uncompressed due to the presence of the actuation rod in the lumen of the distal end portion.

Abstract: A medical instrument comprising a flexible, filamentous shaft slideably disposed in a sheath, the instrument including an electronic imaging system comprising an image sensor carried on a distal end portion of the instrument. The shaft may be used as a guidewire for a complementary guided device, or it may be used to carry a functional element for performing a procedure at a target site in a patient's body. In other embodiments, the present invention contemplates a flexible sheath, preferably having a simple tubular construction, with an electronic imaging system at its distal end. The sheath is adapted to slideably receive a shaft, preferably a filamentous shaft, that closely fits the sheath. The shaft carries functional element at its distal end. The instruments according to the present invention may include one or more filaments along their length for deflecting an insertable portion of the instrument.

Abstract: A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Abstract: A ligation clip applier is provided. The clip applier includes: a pair of jaws; a distal clevis tube to which the jaws are pivotally mounted; a proximal clevis tube located behind the distal clevis tube, wherein the distal clevis tube and the proximal clevis tubes move axially with respect to each other; a clip lock actuator fixed to one of the proximal and distal clevis tubes; and a distal pushrod extending through the distal and proximal clevis tubes and forming a camming connection with the jaws configured to close and move the jaws toward a proximal direction toward the clip lock actuator when the distal pushrod is moved in the proximal direction. A method for applying a clip on a vessel is disclosed.

Abstract: An applier for ligation clip is provided. The applier includes: an outer tube having mounting bosses; a pair of jaws pivotally connected to the mounting bosses, the jaws having actuating projections; a feed tube located in the outer tube and configured to move axially within the outer tube, the feed tube having actuating slots in which the actuating projections are located; a clip lock arm located in the outer tube and configured to move axially within the outer tube; and a clip advance arm located in the outer tube and configured to move axially within the outer tube, the clip advance arm having flexible pinchers at one end of the clip advance arm. A method of applying a ligation clip is also disclosed.

Abstract: A narrow profile surgical ligation clip has two legs with clamping surfaces joined by a hinge near the proximal ends, allowing the clip to reversibly open and close. A locking mechanism is proximal to the hinge to bias or lock the clip closed, including first and second jaw structures spaced on opposite sides of a longitudinal axis of the clip thereby defining a locking space therebetween. In one embodiment, a wedge or buttress body moves by application of an external force applied to a proximal end of the clip towards the hinge to move into the locking space such that one or more outer surfaces or projections of portions of the body fit into or abut against complementary surfaces or other parts of the locking mechanism or clip assembly to bias or lock the clip in a closed position and provide additional closing force to the inner clamping surfaces.

Abstract: A medical instrument comprising a flexible, filamentous shaft slideably disposed in a sheath, the instrument including an electronic imaging system comprising an image sensor carried on a distal end portion of the instrument. The shaft may be used as a guidewire for a complementary guided device, or it may be used to carry a functional element for performing a procedure at a target site in a patient's body. In other embodiments, the present invention contemplates a flexible sheath, preferably having a simple tubular construction, with an electronic imaging system at its distal end. The sheath is adapted to slideably receive a shaft, preferably a filamentous shaft, that closely fits the sheath. The shaft carries functional element at its distal end. The instruments according to the present invention may include one or more filaments along their length for deflecting an insertable portion of the instrument.

Abstract: An access system for surgical procedures includes an insertion tube having a distal end and a lumen, a pair of instrument delivery tubes extending through the lumen of the insertion tube, each instrument delivery tube having a fixed longitudinal position relative to the insertion tube and a steerable distal portion positioned distal to the distal end of the insertion tube. Proximal actuators are moveable to steer the distal portions of the instrument delivery tubes through manipulation of the handles of instruments extending through those tubes. First and second rigid tubes are mounted within the lumen, at least one of which has a distal end disposed within the lumen.

Abstract: A flexible medical instrument includes an elongate shaft, a jaw tip on the distal end of the elongate shaft and a handle on the proximal end. The elongate shaft includes a coil tube having a distal end fixedly attached to a portion of the jaw tip and a proximal end fixedly attached to a rigid structure at the proximal end of the instrument. The coil tube is disposed within an outer sheath that includes a tubular braid. The elongate shaft and jaw tip are axially rotatable relative to the handle for rotational positioning of the jaws. An actuation element is longitudinally moveable within the shaft to open and close the jaws. The sheath prevents or restricts expansion of the coil tube during pushing of the actuation element.

Abstract: An instrument port for a single instrument comprises an elongate tube having a lumen. The elongate tube has a rigid section of fixed shape, and a more distal deflectable section. An actuator is coupled to the rigid section of the elongate tube. The actuator has an instrument pathway in communication with the lumen of the tube. The instrument pathway is positioned such that a distal end of a medical instrument may be inserted through the instrument pathway and the lumen and out the distal end of the lumen into a body cavity. Manipulation of the instrument handle engages actuation elements that extend between the actuator and the deflectable section, causing movement of deflectable section and thus moving the instrument tip within the body. The port includes a mount that can be coupled to a stabilization arm within the operating room, allowing the port to be supported and maintained in a chosen position and orientation.

Abstract: An instrument port for a medical instrument includes an elongate access tube having a deflectable distal portion and a lumen for receiving a medical instrument. An actuator for deflecting the distal portion includes a distal actuator portion coupled to the access tube, a proximal actuator portion, and a coil spring extending between the distal and proximal actuator portions. An elongate actuation element such as a pull cable has a first end attached to the distal portion of the access tube and a second end coupled to the proximal actuator portion. When a medical instrument is disposed through the instrument port, with its distal end extending from the lumen and its proximal end disposed outside the body cavity, movement of the proximal end of the instrument moves the proximal actuator portion relative to the distal actuator portion to bend the spring and retract the pull cable, causing deflection of the deflectable distal portion of the elongate access tube, steering the distal end of medical instrument.

Abstract: A surgical access system for use in minimally invasive procedures such as single port or laparoscopic surgery. The system has a sealed base positionable in an incision formed in a body wall and at least two access tubes extending through the base. Each access tube includes a rigid tube having a fixed pre-formed shape including a bend in its distal section. The rigid tubes are restrained against pivotable movement relative to the base, but can be axially rotated and longitudinally repositioned relative to the base. A deflectable tubes extends from the distal end of each rigid tube. Each deflectable tube has a lumen for passage of a medical instrument, as well as a proximal actuator which engages a pullwire to deflect the tube when the user manipulates the instrument's handle.