Abstract: A balloon anchor provides for the anchoring of a surgical instrument, such as conventional trocar sheath, within a puncture opening formed by a trocar. When used on a trocar sheath, the anchor is secured to the smooth outer surface of the sheath for extension through the puncture opening as the trocar within the sheath forms the opening. Adhesive or mechanical means are provided to secure the balloon the instrument. No modification to the structure of the instrument is required. Once in place within the opening, the balloon is inflated to the interior of the tissue to anchor the instrument in place. Certain embodiments also provide for inflation of the balloon within and/or to the exterior of the opening.

Abstract: An endoscopic surgical instrument suitable for use with a needle-grasper having a rotational translation device for creating rotational motion at the distal end of the surgical instrument in a non 1:1 ratio to rotational energy imparted at the handle of the surgical instrument. The shaft of the surgical instrument has an articulated segment capable of remote adjustment to articulate the effector unit at the end of the surgical instrument. The effector unit may be a needle-gripper having an upwardly pointed V-shaped notch in a channeled upper jaw, a convex gripping surface on the lower jaw, such that grasping a curved suture needle between the upper and lower jaw serves to automatically orient the needle perpendicular to the needle-gripper with the curvature pointed down. Conically tapered edges on the upper jaw further facilitate this orientation.

Abstract: A balloon anchor provides for the anchoring of a surgical instrument, such as conventional trocar sheath, within a puncture opening formed by a trocar. When used on a trocar sheath, the anchor is secured to the smooth outer surface of the sheath for extension through the puncture opening as the trocar within the sheath forms the opening. Adhesive or mechanical means are provided to secure the balloon the instrument. No modification to the structure of the instrument is required. Once in place within the opening, the balloon is inflated to the interior of the tissue to anchor the instrument in place. Certain embodiments also provide for inflation of the is balloon within and/or to the exterior of the opening.

Abstract: A balloon anchor provides for the anchoring of a surgical instrument, such as conventional trocar sheath, within a puncture opening formed by a trocar. When used on a trocar sheath, the anchor is secured to the smooth outer surface of the sheath for extension through the puncture opening as the trocar within the sheath forms the opening. Adhesive or mechanical means are provided to secure the balloon the instrument. No modification to the structure of the instrument is required. Once in place within the opening, the balloon is inflated to the interior of the tissue to anchor the instrument in place. Certain embodiments also provide for inflation of the balloon within and/or to the exterior of the opening.

Abstract: A system for locally stabilizing an anastomotic site of a vessel of a beating heart during a surgical procedure is disclosed. The system includes bonding a pad to the myocardium and attaching a control arm to the pad, all by use of a bioabsorbable adhesive. The control arm is grasped and manipulated by a retractor thereby stabilizing the anastomotic area during the surgical procedure. The pad is optional and can be ommitted in one embodiment where the control arm has feet that are directly bonded to tissue. The pad may also have barbs or can include suction cups. The pad can include a helix-shaped fastener or a mechanical fastener that can be easily linked or hooked to a surgical instrument for manipulation.

Abstract: An endoscopic surgical instrument suitable for use with a needle-grasper having a rotational translation device for creating rotational motion at the distal end of the surgical instrument in a non 1:1 ratio to rotational energy imparted at the handle of the surgical instrument. The shaft of the surgical instrument has an articulated segment capable of remote adjustment to articulate the effector unit at the end of the surgical instrument. The effector unit may be a needle-gripper having an upwardly pointed V-shaped notch in a channeled upper jaw, a convex gripping surface on the lower jaw, such that grasping a curved suture needle between the upper and lower jaw serves to automatically orient the needle perpendicular to the needle-gripper with the curvature pointed down. Conically tapered edges on the upper jaw further facilitate this orientation.

Abstract: A disposable seal assembly for use with a reusable cannula, where the seal assembly is designed for use with the cannula during a single medical procedure and the cannula is designed for multiple uses (each time with a different seal assembly) during a number of medical procedures. The seal assembly includes both a flapper valve fluid seal (for sealing the cannula when no medical instrument is inserted through the seal assembly) and at least one instrument seal (for sealing the cannula when a medical instrument is inserted through the seal assembly). Preferably, the seal assembly has a body with a flange which can be snapped onto the cannula before use, and readily removed after use. Also preferably, the flapper valve has an over-centered hinge. In other embodiments, the invention is a seal assembly which includes at least one double instrument seal including a sacrificial flange and a sealing flange, and optionally also a flapper valve.

Abstract: A disposable seal assembly for use with a reusable cannula preferably includes a flapper valve fluid seal and at least one instrument seal. The instrument seal has a sacrificial flange and a sealing flange that protrude from an inner baffle connected to the assembly's main body by a flexible outer baffle, and at least one elastomeric rib extending between the inner baffle and the body to prevent inversion of the inner baffle. Preferably, a surface of the sacrificial flange is configured to prevent the flanges from sticking together during use. An adaptor, tethered to the assembly's main body, has a central channel with an hourglass profile, a concave distal flange, distal bumpers for preventing the adaptor from translating too far into the main body, and a grip portion shaped to allow a user conveniently to separate the adaptor from the main body. Other aspects include systems with a reusable cannula, and methods for using such systems.

Abstract: A system for locally stabilizing an anastomotic site of a vessel of a beating heart during a surgical procedure is disclosed. The system includes bonding a pad to the myocardium and attaching a control arm to the pad, all by use of a bioabsorbable adhesive. The control arm is grasped and manipulated by a retractor thereby stabilizing the anastomotic area during the surgical procedure. The pad is optional and can be ommitted in one embodiment where the control arm has feet that are directly bonded to tissue. The pad may also have barbs or can include suction cups. The pad can include a helix-shaped fastener or a mechanical fastener that can be easily linked or hooked to a surgical instrument for manipulation.

Abstract: A lifting device for laparoscopic procedures is provided with joints to enable an instrument carried by the device to be rotated to selectively adjust its pitch, roll and yaw. The adjustment provides a mechanism whereby the instrument may be connected to the arm in a variety of rotational orientations and accommodate different conditions to provide operating space within the body of a patient. Various mechanisms are provided to selectively lock the joints.

Abstract: A disposable seal assembly for use with a reusable cannula, where the seal assembly is designed for use with the cannula during a single medical procedure and the cannula is designed for multiple uses (each time with a different seal assembly) during a number of medical procedures. The seal assembly includes both a flapper valve fluid seal (for sealing the cannula when no medical instrument is inserted through the seal assembly) and at least one instrument seal (for sealing the cannula when a medical instrument is inserted through the seal assembly). Preferably, the seal assembly has a body with a flange which can be snapped onto the cannula before use, and readily removed after use. Also preferably, the flapper valve has an over-centered hinge. In other embodiments, the invention is a seal assembly which includes at least one double instrument seal including a sacrificial flange and a sealing flange, and optionally also a flapper valve.

Abstract: A female urinary incontinence device (2) and method comprises an elongate body (4) and a pair of anterior support members (6, 8) extending from the proximal end of the elongate body. The anterior support members are spaced from each other and configured for elevating and/or supporting the superior vaginal tissue (122) on each side of the bladder neck (106) to normalize urodynamic parameters without completely occluding the urethra (108) so that the patient may urinate or not urinate, if desired. A pair of posterior support members (10, 12) extend from the distal end of the elongate body for engaging the posterior vaginal wall (120) to provide longitudinal support to the anterior support members. The device may be folded axially between a collapsed position for insertion into the vagina (100) and an expanded position for supporting the bladder neck to offer counterpressure to intra-bladder pressure so that continence is preserved.

Abstract: A method and apparatus for creating a surgical work space by lifting the abdominal wall and retracting abdominal organs during surgery utilizes a lifting body having two or more retraction rods supported by the lifting body. The rods are designed to be introduced into the abdominal cavity through a laparoscopic puncture opening and to be extended within the abdominal cavity to provide a lifting area. In the preferred embodiment, a pair of retraction rods disposed with the bores and substantially parallel to each other are inserted into the abdominal cavity through an incision in the abdominal wall. The retraction rods are spread apart from each other while their parallel orientation is maintained. The lifting body is connected to a lifting arm and lifted, causing the retraction rods to lift and support the abdominal wall.

Abstract: A balloon anchor provides for the anchoring of a surgical instrument, such as conventional trocar sheath, within a puncture opening formed by a trocar. When used on a trocar sheath, the anchor is secured to the smooth outer surface of the sheath for extension through the puncture opening as the trocar within the sheath forms the opening. Adhesive or mechanical means are provided to secure the balloon the instrument. No modification to the structure of the instrument is required. Once in place within the opening, the balloon is inflated to the interior of the tissue to anchor the instrument in place. Certain embodiments also provide for inflation of the balloon within and/or to the exterior of the opening.

Abstract: An apparatus for suturing deep puncture wounds utilizes a capturing member which is pivotally mounted to the distal end of an elongate rod. During use, the capturing member is inserted into a body cavity through a trocar sheath positioned in a wound and pivoted into a position in which it extends beneath the tissue surrounding the wound. A membrane or other suture-capturing surface is formed on the surface of the capturing member. A suture to be applied to the wound has anchors on each of its ends, and suture-carrying needles carry each of the suture ends and their corresponding anchors. The suture-carrying needles are individually passed through the tissue layers surrounding the wound and subsequently passed through the membrane of the capturing member. The suture ends and corresponding anchor means are released from the needles.