Abstract: An articulating surgical instrument includes a case having a trigger handle, a sheath coupled to the case, a flexible bending section coupled to the sheath, an end effector removably attachable to the bending section, a set of cables that control position of the bending section, at least two motors coupled to the cables, and a user control module configured to control position of the bending section and the end effector. The instrument further includes a pushrod disposed within the sheath and within the bending section that is configured for axial motion relative to the sheath and the bending section and rotational motion within the sheath and the bending section. The pushrod is coupled to the trigger handle and removably coupled to the end effector, so that rotational motion of the pushrod effectuates rotation of the end effector and axial motion of the pushrod is controllable by the trigger handle.

Abstract: A multi-utility surgical instrument may include a nosecone, a handle, a housing sleeve, an actuation facilitating sleeve, a piston tube, a hypodermic tube, and an end plug. The hypodermic tube may be disposed within the piston tube; the piston tube may be disposed within the actuation facilitating sleeve; the actuation facilitating sleeve may be disposed within the housing sleeve; the end plug may be disposed within a portion of the housing sleeve; the housing sleeve and the end plug may be disposed within the handle; the nose cone may be fixed to a distal end of the handle; and the hypodermic tube may be fixed to the nosecone.

Abstract: A delicate tissue retraction system having a hollow tubular retractor, a hollow tubular introducer that is removably installed within the retractor, and a navigation module that is removably installed within the introducer. The navigation module has a shaft with a proximal shaft end and a distal shaft end, and a navigation unit mounted to the proximal shaft end. When assembled, the distal shaft end is contained generally within the introducer and the navigation module outside the introducer. The navigation module indicates the location of one or more points on at least one of the retractor and the introducer to a navigation system.

Abstract: The invention relates to a surgical retractor, particularly for the retraction of a separated sternum, with a holding device and two spreader arms, wherein the spreader arms are mounted with one end on the holding device, at a distance from each other that is adjustable in a spreading plane, and at least two retaining elements for retention of bone material, for example of the separated sternum, are arranged on each of the spreader arms. To develop this retractor for sternotomy in such a way as to permit gentler opening of the separated sternum, it is proposed that at least one of the retaining elements is mounted such that its position can be modified in the retraction direction with respect to that end of the spreader arm mounted on the holding device.

Abstract: A surgical instrument includes a first member defining a passageway defining a first axis. A second member is positioned in the passageway and includes a lip extending at an angle relative to a second axis defined by the second member that engages a flange of the first member. A third member engages an outer surface of the first member. The third member includes an end surface. A fourth member defines a pathway having the first and second members disposed therein. The fourth member includes a first locking element. A fifth member includes a body including an inner surface that engages the third member. The fifth member includes a plurality of straps extending outwardly from the body. At least one of the straps includes a second locking element that engages the first locking element to fix the fourth member relative to the fifth member. Systems and methods are disclosed.

Abstract: A retractor having an elongate body that provides access to a surgical location within a patient. The elongate body includes a plurality of segments that are connected to one another through a plurality of ratcheting mechanisms. The ratcheting mechanisms permit relative movement of the segments with respect to one another when expander dilators are inserted within the retractor. The segments are surrounded and retained by a resilient elastomeric sleeve or bands. The distal end surfaces of the segments include thin edges that are configured to mobilize, dissect, split and retract the terminal tissues in the surgical area. The retractor is used in conjunction with a resilient elastomeric pad that is affixed to the patient and firmly engages the outer surface of the elongate body to thereby anchor the retractor to the patient. A separate anchoring device can be used to connect the retractor to the pad.

Abstract: A speculum drape for use in ophthalmic procedures. The speculum drape has at least a first sleeve made of surgical drape material that envelops at least a first retaining portion of a speculum or retractor. The sleeve is an elongate hollow structure with first and second open ends through which at least the first retaining portion is insertable. The sleeve is adapted and arranged such that, with the first retaining portion of the speculum or retractor inserted into the sleeve and with the speculum or retractor in an operating position with the respective retaining portions of the speculum or retractor engaged with opposite edges of an eyelid of a patient, the sleeve (i) envelops the inserted first retaining, (ii) is maintained in a disposition between the inserted retaining portion and the eyelid of the patient solely by compressive force and (iii) covers an eyelash of the patient.

Abstract: Devices and methods are disclosed herein for accessing the hip joint. A first device can be securely attached to the capsule of a joint. The first device can tent the capsule to increase the volume of the peripheral compartment. A second device can be biased against the first device to pierce the tented capsule and create a portal. Devices and methods are also disclosed herein for distending the capsule of a joint. A distention device may access a portal established within the capsule. The distention device can expand the capsule by applying an expansive force within the peripheral compartment. The distention device can maintain distention of the peripheral compartment while other devices access the joint.

Abstract: Devices, systems and methods for minimally open orthopedic spine surgery are disclosed. A first flexible screw-based retractor is designed to be coupled to each pedicle screw inserted into adjacent vertebral bodies. A retractor system is provided in which a first retractor blade is mounted to one of the screws and a second movable retractor blade is moved away from the first blade, in a medial direction, to create a working channel through which the disc space may be accessed for passing instruments and implants. Light may be incorporated into the device to illuminate the surgical field. One or all of the retractor blades may be made of a sterilizable plastic or metal and be disposable or reusable.

Abstract: One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising a delivery member having proximal and distal ends; a first helical member having proximal and distal ends and a helical shape, the proximal end coupled to the delivery member distal end, the distal end extending distally of the delivery member distal end; an anchor member removably coupled to the helical member distal end; and a suture member coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein upon rotation of the delivery member in a first direction, the first helical member and coupled anchor member are advanced across at least a portion of the wall of the tissue structure, pulling along the distal portion of the suture member in a deployed suture pattern which remains coupled to the anchor member, the deployed suture pattern being characterized in that it is substantially

Abstract: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: A needle for use with an endoscopic stitching device includes a first end portion that is movable relative to a second end portion to allow the needle to convert from a first, mis-aligned orientation to a second, aligned orientation, thereby allowing the length of the needle in the aligned orientation to exceed the height of an end effector.

Abstract: A removable self-retaining suture system and methods for use thereof in emergency situations. The system comprises one or more self-retaining suture segments and a grasp engagement element. The system may be used for temporary wound closure in a trauma victim, and may be easily removed upon the availability of proper medical care to the victim.

Abstract: A wound closure device includes a shaft, a sleeve, a suture, and a cartridge. The sleeve is disposed about the shaft and defines first and second sleeve arms movable between a retracted position, wherein the sleeve arms extend along the shaft, and a deployed position, wherein the sleeve arms extend outwardly from the shaft. The cartridge includes a base and first and second cartridge arms. The base is configured for releasable coupling with the shaft and defining a pocket configured to retain an intermediate portion of the suture. The first and second cartridge arms are configured for positioning adjacent the respective first and second sleeve arms and are configured to move in conjunction with the respective first and second sleeve arms between the retracted and deployed positions. The first and second cartridge arms are configured to retain first and second ends of the suture, respectively.

Abstract: In one embodiment, a medical device includes an elongate member, a fixation device and a driving member. The elongate member defines a lumen and includes a proximal end and a distal end. The distal end of the elongate member has an opening. The fixation device is at least partially disposed within the elongate member and includes a tissue piercing portion at a distal end of the fixation device. The driving member is at least partially disposed within the elongate member and is configured to move the fixation device from a position within the lumen to a location outside of the lumen through the opening. The opening at the distal end of the elongate member is angled to insert the fixation device in a tissue of a patient at an angle to a plane of the tissue of the patient to fasten a bodily implant to the tissue.

Abstract: A surgical instrument includes an implant, a grip, and a pre-set breaking point connecting the implant and the grip. The implant has a joining profile.

Abstract: The present invention relates to devices and methods for creating and securing a tissue fold during an endoluminal medical procedure. The devices and methods may be used for folding and securing, for example, a fundus wall onto an esophagus wall. An aspect of the invention includes a two-piece tissue clip configured to be installed through an endoluminal device to secure a tissue fold. The clip includes a female member and a male member configured to engage one another to secure the tissue fold. Another aspect of the invention includes a clipping device comprising a tissue clip magazine. The magazine is configured to hold a plurality of tissue clips and install the plurality of tissue clips in a single actuation of the magazine. A method for using the clipping device together with the tissue clips of the present invention to create and secure a fold of tissue during an endoluminal procedure also is disclosed.

Abstract: A staple for attaching a sheet-like implant to tissue or bone may include first and second arms, and first and second flukes. In some embodiments, the first arm has a proximal end and a distal end, and the second arm has a proximal end and a distal end. A bridge extends from the proximal end of the first arm to the proximal end of the second arm. The first fluke has a proximal end abutting the distal end of the first arm, and the first fluke extends distally from the first arm. The first fluke has a lateral extent larger than a lateral extent of the first arm and is mounted eccentrically thereto. The first fluke includes a proximal surface projecting at an outward angle in a proximal direction away from the distal end of the first arm to engage the tissue or bone when inserted therein. The second fluke has similar features. This arrangement causes the first and second flukes to rotate in response to a pullout force on the bridge.

Abstract: A system for treatment of tissue includes a fixation apparatus and a delivery tool releasably carrying the fixation apparatus. The fixation apparatus includes first and second anchors and an adjustable band connecting the anchors. The band includes a cinch line and a tether connected to one of the anchors. The delivery apparatus includes a body, a tubular shaft, a displacement rod within the tubular shaft, and an actuator.

Abstract: Electrically operated surgical instrument, comprising a handle having a power supply; a drive assembly having an electrical motor, a controller electrically connected to the power supply and motor, and a drive part selectively moved by the motor between a fully extended position and a fully retracted position; and a control assembly operably connected to the motor to control a rotation of the motor; an end effector having a tissue-cutting assembly comprising: a blade connected to the drive part to move between opposing compression surfaces over the course of a blade stroke to cut tissue compressed between the compression surfaces, the blade stroke being comprised of the drive part advancing the blade towards the tissue to an extended position and retreating proximally to a retracted position, the control assembly being operable to selectively cause the motor to automatically retreat the drive part to place the blade in the retracted position.

Abstract: A surgical stapling apparatus includes a staple cartridge and an anvil member. The staple cartridge includes a plurality of surgical fasteners disposed in rows of retention slots. The staple cartridge may have an annular or linear configuration of retention slots. The tissue contacting surface of the staple cartridge may be tapered or stepped. The anvil member has a tissue contacting surface that includes a number of pockets arranged for substantially aligning with the retention slots. In addition, the tissue contacting surface of the anvil member may complement the tissue contacting surface of the staple cartridge.

Abstract: A surgical stapling apparatus includes a staple cartridge and an anvil member. The staple cartridge includes a plurality of surgical fasteners disposed in rows of retention slots. The staple cartridge may have an annular or linear configuration of retention slots. The tissue contacting surface of the staple cartridge may be tapered or stepped. The anvil member has a tissue contacting surface that includes a number of pockets arranged for substantially aligning with the retention slots. In addition, the tissue contacting surface of the anvil member may complement the tissue contacting surface of the staple cartridge.

Abstract: A surgical stapling apparatus including a releasable buttress material includes a cartridge assembly, an anvil assembly, a knife, and a buttress material. The cartridge assembly includes a plurality of staples and a tissue contacting surface defining staple retaining slots. The anvil assembly includes a tissue contacting surface defining staple pockets for forming staples expelled from the staple retaining slots of the cartridge assembly. The knife is disposed within a knife slot formed in the tissue contacting surface of the cartridge assembly. The buttress material includes at least one weld joining the buttress material to the tissue contacting surface of the cartridge assembly. The at least one weld is positioned across the knife slot.

Abstract: Endoscopic devices and methods used for fastening multiple tissue layers, such as, for example, an endoscopic fundoplication procedure, are disclosed. The device may include, for example, an elongated tubular member having a proximal end for extending outside of the body and a distal end for positioning proximate the multiple tissue layers, a grasper configured for positioning proximate the distal end of the tubular member and for grasping at least one of the multiple tissue layers, a device coupled to the distal end of the tubular member for folding the multiple tissue layers together, a tissue fastener configured to be inserted into the tissue layers to hold the tissue layers together, and a fastener head for inserting the tissue fastener into the tissue layers.

Abstract: A surgical fastener and a related deployment device as well as their methods of use are disclosed. In one embodiment, the deployment device includes one or more surgical fasteners including a head and a distally extending coil body attached to the head. The head includes a through hole with an internal thread. The deployment device also includes a mandrel including a threaded portion located at a distal end of the mandrel. The threaded portion is engaged with the internal thread of the one or more surgical fasteners. A rotator is associated with the one or more surgical fasteners such that the rotator can selectively rotate the one or more surgical fasteners relative to the mandrel to displace the one or more surgical fasteners in a distal direction.

Abstract: Embodiments of a clamping system are disclosed. In some embodiments, a system used with a motor assembly and a clamping device is presented, the system adjusting torque limits in the motor assembly according to conditions, for example operating temperature of the motor assembly and aging of the clamping device and the motor assembly. The clamping device can be, for example, a stapler or a vessel sealer.

Abstract: An end effector for use with a surgical instrument is disclosed. The end effector comprises a first jaw, a second jaw, a curved slot, and a cutting element. The cutting element comprises a laterally-offset cutting edge, a first camming surface, and a second camming surface. One of the first jaw and the second jaw comprises a plurality of staple cavities arranged in a plurality of curved staple cavity rows.

Abstract: A surgical instrument comprising a handle portion, an elongated portion defining a longitudinal axis and extending distally from the handle portion, and first and second jaw members dimensioned to clamp tissue therebetween. The first jaw member has at least one row of fasteners arranged in a row substantially transverse to the longitudinal axis. A pin is disposed in mechanical cooperation with the first jaw member and is movable between a first position where the engagement section is spaced from the second jaw member and a second position where the engagement section engages the second jaw member. The pin has a non-circular cross-section.

Abstract: A method for performing a coronary artery bypass graft procedure on a patient to connect a bypass vessel to a target vessel includes the steps of creating an opening in the patient that communicates with the thoracic cavity of the patient; providing a bypass vessel having a lumen and at least one free end; passing the free end of the bypass vessel from the thoracic cavity through the opening to a position outside the body of the patient; attaching a connector to the free end of bypass vessel while the free end of the bypass vessel is outside the body of the patient; passing the free end of the bypass vessel from the position outside the body of the patient through the opening and into the thoracic cavity; and connecting the free end of the bypass vessel to a target vessel with the connector.

Abstract: A biphasic material and devices comprising the same are provided for the development of conductive conduits that may be used for the treatment of peripheral nerve injury. These devices or conduits are designed such that repeated electric field gradients can be initiated to promote neurite and axonal outgrowth. Conducting conduits using doped synthetic and/or natural polymers create specifically patterned high and low conducting segmented materials, which are mechanically used to produce the electrical properties needed for nerve conduits. These electrical properties stimulate neurite outgrowth and axonal repair following a peripheral nerve transection.

Abstract: A surgical instrument comprising a handle assembly, an elongated body portion extending distally from the handle assembly, a head portion and a preload assembly is disclosed. The head portion is disposed adjacent a distal end of the elongated body portion and includes an anvil assembly and a shell assembly. The anvil assembly is movable in relation to the shell assembly between spaced and approximated positions. The preload assembly is disposed in mechanical cooperation with the shell assembly and enables longitudinal movement of the shell assembly with respect to the elongated body portion.

Abstract: An assembly for restoring a gastroesophageal flap valve includes a restoration device substantially free for rotation. The assembly comprises an elongated member configured to be fed through a throat, down an adjoining esophagus and into an associated stomach. The elongated member has a distal end. The assembly further comprises a gastroesophageal flap valve restoration device carried on the distal end of the elongated member for placement in the stomach, and an invaginator carried by the elongated member. The invaginator is configured to grip the esophagus and the elongated member and invaginator are coupled for restricted relative axial movement and substantially free relative rotational movement.

Abstract: An occlusion device comprising a plurality of inner coils and a plurality of outer coils is described. When the device is deployed to a body vessel or a body cavity, it expands radially due to the material from which the outer coils are made. The inner coils function to occlude the vessel while the outer coils provide support. The device can be capped at both ends or may have a free distal end. A method of deploying the device is also provided.

Abstract: Device for haemostatic control of a blood flow, comprising a suction cup which provides leaktight coverage and is able to surround and be applied tightly to a tissue area (2) that is to be treated, said tissue area (2) being the site of a haemorrhage or of a blood flow that is to be controlled, this suction cup (3) coming into contact with the periphery of the tissue area and delimiting an internal volume (8) which is connected in a leaktight manner, by a catheter or a similar connecting tube (7), to an external aspiration element that establishes a vacuum, so as to create an underpressure of defined value within this volume between the suction cup and the tissue area, the suction cup (3) having the general shape of a dome (4), of which the base (5) supports an inner bearing element (11) that can be arranged opposite the tissue area (2) under the suction cup (3). The invention lies in the inner bearing element being formed by a solid obturator (11) or an open grill (13).

Abstract: A cannula tool in combination with other tools is used to provide multiple instruments necessary for surgical procedures. The cannula tool is used in combination with a piercing tool to form a dilator instrument to access a treatment site and in combination with a plunger tool to deliver biological or grafting material to a treatment site. Each of the plunger and piercing tools includes a guide lumen to track the tools over a K-wire or other guide device for placement at the treatment site. The application discloses asymmetrical piercing and plunger tools for placement proximate to a facet joint for treatment.

Abstract: An instrument for preparing an acetabulum. The instrument includes a handle having a reamer coupling feature and a trial coupling feature. The instrument further includes an acetabular reamer having an outer cutting surface and an inner concave surface having an apex. The acetabular reamer has a first handle coupling feature located at the apex adapted to couple to the reamer coupling feature of the handle. A trial having an outer convex surface having an apex is also included. The outer convex surface adapted to fit inside the inner concave surface of the acetabular reamer. The trial has a second handle coupling feature located at the apex of the outer convex surface adapted to couple to the trial coupling feature of the handle.

Abstract: A method includes inserting a guide mount into a space between a talus and a tibia until a mating portion having a conformal bone engaging surface is disposed against the tibia. An instrument guide is into a cavity defined by the guide mount such that an opening defined by a superior wall of the instrument guide aligns with an opening defined by a superior wall of the guide mount. A reamer head disposed within the opening defined by the instrument guide is connected to a flexible reamer shaft that is received within a passageway defined by the instrument guide. The talus is reamed with the reamer head driven by the flexible reamer shaft.

Abstract: The present disclosure relates to a guide assembly. The guide assembly includes a guide having a body having a first set of marks and a joint including at least one through hole, the joint configured for sliding along the length of the body; and a first surgical device having a second set of marks, wherein the guide is coupled to the first surgical device and a longitudinal axis of the through hole is co-radial with a mark of the second set of marks when the joint is located at a mark of the first set of marks. Other guides are also disclosed.

Abstract: A guide tool (100) for guiding resection of a bone piece, comprising a body (102), a burr guide opening (130) extending through the body (102) and defining a burr resection surface, and a saw guide opening (120) extending through the body (102) and defining a saw resection surface, the burr guide opening (130) and the saw guide opening (120) being aligned such that the burr resection surface and the saw resection surface intersect, defining a bone piece resection surface.

Abstract: A touch panel includes a plurality of drive lines, a plurality of orthogonal sense lines, and a plurality of sensors. A method of controlling the touch panel to detect touches includes simultaneously applying a drive signal to each of a group of drive lines of the touch panel. Each of the drive signals is applied to a corresponding drive line in the group during a time slot and all the applied drive signals having the same electrical characteristics over the time slot. The method includes sensing sense signals generated on the sense lines in response to the applied drive signals and processing the sense signals to detect touches of the touch panel.

Abstract: An embodiment of a medical device includes a proximal handle, a distal end effector, an elongate member connecting the end effector to the handle, and a sheath enclosing at least a portion of the elongate member. The handle may include a first mechanism coupled to one of the sheath and the elongate member to move the sheath relative to the elongate member, a second mechanism coupled to the elongate member to rotate the elongate member relative to the handle, and a locking mechanism coupled to the first mechanism to hold the first mechanism in a default position. Embodiments also include methods of positioning the medical device to perform a medical procedure.

Abstract: A minimal access tool includes a frame arranged to be attached to an arm of a user, a tool shaft having a proximal end and a distal end, where the tool shaft proximal end is connected to the frame. The tool further includes an input joint having a first end connected to the frame and a second end arranged to receive user input, the input joint including a virtual center-of-rotation (VC) mechanism which provides a center of rotation that generally coincides with a wrist joint of the user. An output joint is connected to the tool shaft distal end, where the output joint is coupled to the input joint via a mechanical transmission connected therebetween to correlate motion of the input joint to motion of the output joint.

Abstract: This disclosure discusses various methods and devices for providing multiple types of indicators to be used with a sheath set. One type of indicator indicates the linear position and alignment of each of the sheaths within the sheath set, and another type of indicator indicates the rotational position and alignment of the sheaths. Both types of indicators may be included on the ends of the sheath set proximal to the user outside the patient's vasculature, thereby informing the user of the sheath set of the linear and rotational position and alignment of the ends of the inner and outer sheaths within the vasculature.

Abstract: A motor-driven surgical instrument that may comprise (i) a moveable drive member that is driven in a first direction when the electric motor operates in a first direction and that is driven in a second direction when the electric motor operates in a second direction. Movement of the drive member causes movement of the moveable component of the end effector, and (ii) a motor control circuit connected to the motor for controlling the motor. The motor control circuit may comprise a switching circuit that, upon actuation, reverses the direction of the motor from the first direction to the second direction. The switching circuit may be actuatable separately through each of: (i) actuation of a moveable actuator of the switching circuit through movement of the drive member at least in the first direction; and (ii) manual actuation by a user of the surgical instrument.

Abstract: The invention comprises a system to alleviate conditions such as prostate cancer, benign prostatic hyperplasia (BPH), and the like. The system includes a probe for mechanically cutting tissue and a device for simultaneously tamponading, inducing hemostasis, and dilating a plurality of lumens while minimizing inflammation. The tamponading device has a plurality of balloons configured for inflation with a coolant fluid. Other components of the system include a luminally protective sheath, a microscopic end cauterizing probe, a surgical console, an identification-sensitive self-sealed cassette, and a plurality of flexible tubing lines with pinch valves thereon.

Abstract: An ultrasonic forceps comprises a housing, an acoustic assembly, and a tine. The housing joins the acoustic assembly and the tine to the forceps and permits the tine to pivot relative to the acoustic assembly. The acoustic assembly comprises a transducer, a waveguide, and ultrasonic blade, and a waveguide sheath. The transducer is configured to generate ultrasonic vibrations directing the ultrasonic vibrations to the waveguide. The waveguide communicates the ultrasonic vibrations distally to the ultrasonic blade. The ultrasonic blade is configured to vibrate in response to the ultrasonic vibrations generated by the transducer. When the tine is pivoted relative to the transducer, the tine is configured to move toward the ultrasonic blade. Tissue may be grasped between the tine and the ultrasonic blade. The tissue may be denatured when the ultrasonic vibrations generated by the transducer vibrate the ultrasonic blade, thus resulting in the tissue being cut and/or sealed.

Abstract: An ultrasonic surgical system has an ultrasonic unit including an instrument operatively connected to an ultrasonic generator, wherein the instrument has an ultrasonic end effector on the distal end of a shaft. The system further includes a positioning unit including a movable arm adapted for releasably holding the instrument, whereby an operator may direct the positioning unit to position the end effector at a surgical site inside a body cavity of a patient for performing a plurality of surgical tasks. The system further includes a control unit operatively connected to the ultrasonic and positioning units, wherein the control unit is programmable with a surgical subroutine for performing the surgical tasks. The system further includes a user interface operatively connected to the control unit for initiating an operative cycle of the surgical subroutine such that the surgical tasks are automatically performed during the operative cycle.

Abstract: The devices and methods generally relate to treatment of occluded body lumens. In particular, the present devices and method relate to removal of the occluding material from the blood vessels as well as other body lumens.

Abstract: A method for making a non-linear incision includes forming a non-linear incision in tissue to improve post-operative adhesion of the incised tissue. In one aspect, a method for making a non-linear incision in tissue includes providing a surgical device including a housing and an end effector. The end effector is secured to the housing and includes a pair of jaws operable coupled to the housing. The jaws are disposed in substantial registration. The jaws may be oriented in substantially vertical registration or oriented in substantially horizontal registration. The method may include forming a non-linear incision in tissue with movement of tone or both of the jaws between approximated and unapproximated configurations. The movement may be horizontal or vertical.

Abstract: A steerable kink resistant access device is provided having an elongated body and a steerable portion; methods for manufacturing the kink resistant device are also provided. The access sheath has an outside diameter sufficiently small so that it may be inserted into a body cavity or conduit. The access sheath typically has two internal lumen, a first lumen sized and configured as an access to a surgical site and a second lumen sized and configured to contain a tensioning device that, when acted upon, will deflect the steerable portion. The tensioning device may be directly or remotely attached to an actuation device that operates to control the tensioning and loosening of the tensioning device.