Abstract: A device to accommodate multiple ports through a single incision for laparoscopic surgery for replacing the three to four incisions required by standard laparoscopic surgeries with a single incision. The device to accommodate multiple ports through a single incision for laparoscopic surgery includes an incision access member having a cylindrical body with bores for accommodating various surgical instruments inside a person's body through an incision in a body cavity wall of a person.

Abstract: A system for positioning an interchangeable tool in a body cavity includes a channel having a lumen in direct communication with the body cavity; a tool introducer having a longitudinal axis and a distal end, the tool introducer capable of traveling through the channel lumen; and a tool holder covering at least a portion of the interchangeable tool that is pivotally connected to the tool introducer allowing angular positioning of the interchangeable tool after the tool holder emerges from the channel into the body cavity. A method for engaging an interchangeable tool with a distal portion of a tool manipulator in a body cavity includes inserting a tool introducer into a channel, orienting the distal portion of the tool manipulator in the body cavity; emerging the interchangeable tool from the channel into the body cavity; and positioning the interchangeable tool eccentrically to the lumen of the channel.

Abstract: A system and method for passing an end portion of a needle system from a body cavity to an outer environment through a laparoscopic port is provided. The system comprises a seal bridge which comprises an elongated body. The seal bridge is telescopically introducible at a first proximal end, through a first lumen in the port and bypassing a seal mechanism of the laparoscopic port. The seal bridge is adapted to be inserted through the proximal opening port to be deployed in the lumen of the port and thereby bridging across and/or deactivating the seal of the port. The method comprises positioning a distal portion of a needle shaft from within the body cavity into the port lumen and across the seal opened by the seal bridge.

Abstract: A retraction device for retracting an incision in a body wall includes a sheath that traverses through the incision from outside the body to a body cavity inside the body. The retraction device may include a deployable, adjustable frame that supports the sheath and that, together with the sheath, retracts the incision. The retraction device may include an outer ring and an inner ring coupled to opposing ends of the sheath and further include means to place the sheath in tension between the inner and outer rings, thereby retracting the incision.

Abstract: Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

Abstract: A guide and remote traction system for mini-invasive surgery in a body cavity that is easily positioned and hooked and causes lower injury, comprising: at least one detachable surgical endoclamp (10) with hooking means (11, 12), assembled with an introduction guide (20) and at an initially open position; and at a naturally closed position when detached from said introduction guide (20) by a detachment mechanism; said endoclamp (10) comprising a portion of ferromagnetic material at the end opposed to said hooking means (11, 12); a cylindrically-shaped introduction guide (20) assembled with said detachable surgical endoclamp (10), said introduction guide (20) comprising a mechanism to detach said endoclamp (10); and at least one remote traction means (30) for said endoclamp (10), acting through the application of an electromagnetic field over the ferromagnetic portion of said endoclamp (10).

Abstract: Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient's tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

Abstract: The present invention relates to surgical access devices (or surgical access ports) and related methods. More particularly, the present invention relates to such devices that are advantageously adapted for use in single-incision laparoscopic surgical (“SILS”) procedures The present invention also relates to kits and methods involving such surgical access devices.

Abstract: A vaginal manipulator includes a shaft, a head, and a door. The head has an anterior side opposite a posterior side and includes a core fixed to the shaft and a sleeve coupled in a sliding relationship to the core. The door has a distal end that is hinged to the sleeve and a proximal end that is movable away from the core of the head. A proximal end of the core defines a proximal end of the head and a distal end of the sleeve defines a distal end of the head, and the proximal end of the core is fixed to the shaft. The core includes a ramp and a recess that is sized to receive a portion of the door, and the door includes an inclined surface that is formed such that the distal end of the door is thinner than the proximal end of the door.

Abstract: Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

Abstract: The present disclosure relates to a surgical apparatus for positioning within an incision in tissue. In one aspect of the present disclosure, the surgical access apparatus includes an elongated seal member configured to removably receive at least one surgical object, and a deployment member. In another of the present disclosure, the surgical access apparatus includes a housing configured to removably receive at least one surgical object, an elongated member, and at least one filament. A method of percutaneously accessing an underlying surgical work site using the surgical apparatus is also disclosed.

Abstract: The embodiments disclosed herein relate to various medical device components, including components that can be incorporated into robotic and/or in vivo medical devices. Certain embodiments include various modular medical devices for in vivo medical procedures.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity includes a seal anchor member including leading portion, a trailing portion, and an intermediate portion disposed between the leading and trailing portions. The leading portion of the seal anchor member is configured and adapted to ease insertion of the seal anchor member into the tissue tract. Subsequent to insertion of the seal anchor member, the leading portion of the seal anchor member is also configured and adapted to facilitate securing and/or anchoring of the seal anchor member within the tissue tract.

Abstract: A method for treating a wound or defect at a surgical target site using a minimally invasive surgical procedure is provided which includes utilizing a surgical access device such as a port or a catheter having a plurality of reactive members of a specific binding pair releasably contained on a surface of the access device, the reactive members having affinity for binding a cellular component of tissue cells located at the target site; contacting the surface of the access device with the tissue cells, wherein upon contact of the reactive members on the surface of the access device with the tissue cells, the reactive members are released from the surface of the access device and bind to the tissue; providing a tissue repair member having secured thereto a plurality of complementary reactive members of the specific binding pair; and applying the tissue repair member to the tissue, wherein upon contact of the complementary reactive members on the surface of the tissue repair member with the reactive members on th

Abstract: An intracorporeal surgical tissue retractor is provided having an anchor selectively deployable in a first tissue not to be retracted and a grasper selectively deployable on a second tissue to be retracted. A longitudinally selectively movable support is threadable through the anchor and attached at a substantially distal end of the movable support to the grasper. A deployment user interface is couplable to the movable support and has a proximal end manipulable by a user extracorporeally and a distal end releasably attachable to both the anchor and the grasper, adapted to intracorporeally deploy the anchor into the first tissue and the grasper onto the second tissue. The user interface includes a first actuator having an anchor positioning tool enabling selective deployment of the anchor in the first tissue, and a second actuator enabling selective opening and closing of the jaws of the grasper.

Abstract: A flexible cannula device and delivery system for use in arthroscopic surgery. The delivery system engages the flexible cannula from the inside near the distal tip and pushes it into the surgical portal, essentially pulling the proximal portion of the cannula from the distal tip while being pushed from the proximal end with the specialized driver. The delivery system provides for single point engagement at the distal tip as well as a multiplicity of engagement points along the length of the system.

Abstract: An access device for use in a minimally invasive surgical procedure is disclosed. The access device is configured and adapted to be placed within a body opening to provide access to an underlying body cavity. The access device provides protection to the opening and minimizes contamination and the risk of possible infection.

Abstract: A bone screw mounted retractor apparatus for use in minimally invasive surgery, preferably minimally invasive spine surgery, comprising a screw extension detachably attached to a bone screw, a mounting ring attached to the screw extension, a connection arm attached to the mounting dag, a retractor retaining ring attached to the connection arm, and a tubular retractor body retained by the retractor retaining ring, as well as methods of minimally invasive surgery using such an apparatus.

Abstract: A mechanical cap ring/gel pad assembly useful in surgical access devices and methods for making the same, wherein the cap ring and the gel pad are formed separately and then mechanically attached to form a strong seal without the need for heating, solvents or adhesives.

Abstract: A device for obtaining selective rigidity with respect to a patient is provided. The device includes a scaffold that is arranged to be flexible when in a first relaxed configuration, wherein the scaffold is configured to become substantially more rigid when a suction force is applied thereto. The scaffold comprises first and second opposing outer flexible layers that are sealed together to form a plurality of elongate pockets therein, and an expanded structure disposed within the plurality of elongate pockets and in communication with a vacuum port that receives the suction force.

Abstract: A medical mouthpiece may include a generally U-shaped member forming a lateral interocclusal passageway extending from an anterior aperture to a posterior aperture configured to provide a conduit for respiratory gas exchange. A medical mouthpiece may include a sampling port for fluid communication with an analyzing apparatus configured to analyze exhaled respiratory gases. A medical mouthpiece may include a supplemental gas conduit for fluid communication between a source of supplemental gas and a supply orifice. A method for delivering a gas to a patient may include delivering a gas to the patient through a mouthpiece having a lateral interocclusal passageway such that the gas is delivered through a posterior aperture to a space adjacent the patient's posterior oropharynx.

Abstract: A device that can be delivered into a body cavity to manipulate tissue intracorporeally while being controlled extracorporeally and a method of using the device to perform a single-port laparoscopic or natural orifice surgery. The device is being capable of being passed through an interior diameter of a single port into the body cavity. The device comprises an anchor or suspension element that is attachable or mountable to the tissue intracorporeally, a guide element attached to the anchor or suspension element that allows for manipulation of at least one structure in at least one direction, and at least one structure attached to a suture or thread that is passable through the interior diameter of the port and positionable by the guide element. The structure is controllable extracorporeally by manipulating the suture or thread so that the structure moves in at least one direction intracorporeally.

Abstract: A vaginal manipulator includes a shaft attached to a head and a door connected to the head. The head has an anterior side opposite a posterior side and includes a core fixed to the shaft and a sleeve coupled in a sliding relationship to the core. The door is coupled to the core and is movable relative to the posterior side of the head through an opening provided in the sleeve. A proximal end of the core defines a proximal end of the head and a distal end of the sleeve defines a distal end of the head. The proximal end of the core is fixed to the shaft. The sleeve moves relative to the core to provide the head with an adjustable length between the proximal end of the head and the distal end of the head.

Abstract: A surgical retention port particularly useful as an arthroscopic port for shoulder surgery is provided. The surgical retention port has a long pointed instrument such as a trocar or obturator, an inner cannula extending around the pointed instrument, a plurality of rotatable fingers coupled to the inner cannula, and an outer cannula extending around the inner cannula. In one embodiment of the invention, the inner cannula and long pointed instrument are keyed such that rotation of the long pointed instrument can effect rotational movement of the inner cannula. Rotation of the inner cannula in turn causes the rotation of the fingers from a first position where the fingers assume a collapsed configuration to a second position where the fingers assume an extended or open configuration.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

Abstract: A device, system and method for orthopedic spine surgery using a novel screw-based retractor, disclosed herein, that allows for access to the spine through a minimally or less invasive approach. The retractor device is designed as an integrally formed part of the tulip of a pedicle screw assembly with opposed arms of the retractor spread apart to open the wound proximally. The arms are removed by separating the arms from the tulip and pulling it out of the wound. The retractor device is intended to be made of a stiff material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

Abstract: A cannula assembly includes a cannula and an obturator. The cannula includes an elongated shaft dimensioned to access tissue. The elongated shaft has a lumen extending therethrough. The elongated shaft includes a first shaft segment having a first pre-determined configuration and a second shaft segment having a second pre-determined configuration different from the first pre-determined configuration. The obturator includes an elongated body adapted for insertion through the lumen of the elongated shaft. The elongated body includes a first body segment having a configuration in general accordance with the first pre-determined configuration of the first shaft segment and a second body segment selectively adaptable to conform to the second pre-determined configuration of the second shaft segment upon insertion through the lumen of the elongated shaft.

Abstract: Provided herein is a clip for organ retraction or organ exposure during minimal invasive surgery wherein the clip comprises a body made of a biocompatible material wherein the body comprises at least two generally opposing first and second segments that form a jaw defined by a separation between the two segments; wherein the two segments each comprise distal and proximal ends wherein the proximal ends may be directly connected or connected through one or more segments within the body of the clip and wherein the clip defines at least four configurations a resting configuration, an open configuration, a grabbing configuration, and a sliding configuration.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity. The apparatus may include a seal anchor member comprising a compressible material. The seal anchor member may be adapted to transition between a first condition for insertion of at least a portion of the seal anchor member within a tissue tract and a second condition to facilitate a securing of the seal anchor member within a tissue tract and in substantial sealed relation with tissue surfaces defining a tissue tract. The seal anchor member may have proximal and distal ends and may define at least one port extending between the proximal and distal ends, the at least one port being adapted for the reception of an object whereby compressible material defining the at least one port is adapted to deform to establish a substantial sealed relation with the object. The at least one port may include an undercut to reduce the likelihood of leaks therethrough.

Abstract: Methods and devices are provided to allow for easy customization of a surgical access device by an end user. In one exemplary embodiment a surgical access device is provided that includes a plurality of elongate seal elements that are configured to form a sealed configuration between a surgical site and an outside environment. The seal elements can be disposed in a surgical opening and can mate directly to each other with the outermost seal elements mating directly to tissue of the opening. The seal elements can include one or more mating elements to provide the desired mating. The seal elements can also include sealable openings that are configured to receive surgical instruments for use at the surgical site. The sealable openings maintain the desired seal throughout the course of a surgical procedure. Exemplary methods for providing custom configurations on location are also provided.

Abstract: The present invention relates to surgical access devices (or surgical access ports) and related methods. More particularly, the present invention relates to such devices that are advantageously adapted for use in single-incision laparoscopic surgical (“SILS”) procedures The present invention also relates to kits and methods involving such surgical access devices.

Abstract: A medical device for managing tissue in an organ, such as the stomach, for retracting or positioning tissue and related organs to allow certain regions of the stomach to be acquired for a gastroplasty procedure. The medical device includes an elongated body having a proximal end and a distal end, and a tissue treatment device attached to the distal end of the elongated body. The tissue treatment device includes a first jaw opposite a second jaw, and each jaw is adapted to acquire tissue. A retractor is disposed along the tissue treatment device and adapted to be moveable from a delivery position to a retraction position to move or manage the tissue of the stomach. The medical device also includes a collapsible barrier disposed between the first and second jaws of the tissue treatment device to direct tissue into the first and second jaws separately.

Abstract: A surgical retractor apparatus having one or more independent, removable extension members adapted to be mounted at the distal end of the retractor, or between the blades of a spreadable retractor, after the retractor has been positioned in the patient, such that a significant portion of the extension member extends beyond the distal end of the retractor to preclude or minimize intrusion of tissue into the access area created by the retractor. The extension members may vary in size and shape so that the most appropriate extension member can be chosen to address the intrusion problem, and the extension members may be mounted at various fixed locations, using clips, mechanical interlocking structures or the like.

Abstract: A surgical retention port particularly useful as an arthroscopic port for shoulder surgery is provided. The surgical retention port has an inner cannula defining a throughbore, a plurality of rotatable fingers coupled to the inner cannula, and an outer cannula extending around the inner cannula. Rotation of the inner cannula relative to the outer cannula causes the rotation of the fingers from a first position where the fingers assume a collapsed configuration to a second position where the fingers assume an extended or open configuration.

Abstract: A medical instrument insertable through a cannula, the instrument comprising an elongate shaft; and an operative tip having a first jaw and a second jaw movable with respect to the first jaw. The operative tip disposed at a distal end of said elongate shaft and being disposed on said shaft for rotation relative to at least a distal end portion of said shaft about a longitudinal axis of said distal end portion.

Abstract: An access device for use in a minimally invasive surgical procedure is disclosed. The access device is configured and adapted to be placed within a body opening to provide access to an underlying body cavity. The access device provides protection to the opening and minimizes contamination and the risk of possible infection.

Abstract: A cannula assembly for use in laproscopic surgery includes a cannula having a proximal end for use in orientating the assembly into an abdominal cavity, a distal end for insertion into a patient, and a passage through which surgical instruments can be inserted. An expandable feature in the form of an anchor is located toward the distal end of the cannula and is selectively expandable and collapsible. The feature in its expanded state prevents withdrawal of the cannula. A collar is pushed distally until it releasably cinches to the outside of the abdominal cavity thereby creating an airtight seal and stabilizing the assembly. The collar has a friction fit with the cannula designed to prevent excessive force against the cavity walls.

Abstract: An intracorporeal surgical tissue retractor is provided having an anchor selectively deployable in a first tissue not to be retracted and a grasper selectively deployable on a second tissue to be retracted. A longitudinally selectively movable support is threadable through the anchor and attached at a substantially distal end of the movable support to the grasper. A deployment user interface is couplable to the movable support and has a proximal end manipulable by a user extracorporeally and a distal end releasably attachable to both the anchor and the grasper, adapted to intracorporeally deploy the anchor into the first tissue and the grasper onto the second tissue. The user interface includes a first actuator having an anchor positioning tool enabling selective deployment of the anchor in the first tissue, and a second actuator enabling selective opening and closing of the jaws of the grasper.

Abstract: A surgical apparatus includes a housing member having leading and trailing ends that define a longitudinal axis. One or more ports longitudinally extend between the leading and trailing ends, and are configured and adapted to receive a surgical instrument therein in a substantially sealed relation. At least one cleaning port longitudinally extends between the leading and trailing ends, and is configured and adapted to receive a cleaning device therein. The cleaning device is configured and adapted to clean surgical instruments positioned within the one or more ports without necessitating removal of the surgical instruments from the one or more ports.

Abstract: A seal assembly for reception of an elongated surgical instrument is provided which includes a body having at least one opening configured and dimensioned to permit entry of an elongated surgical instrument and defining a central longitudinal axis; a seal member formed of a resilient material and defining an aperture therein, the aperture being configured and dimensioned such that insertion of the surgical instrument into the aperture causes the resilient material defining the aperture to resiliently contact the outer surface of the surgical instrument in a substantially fluid tight manner; and a fabric layer juxtaposed relative to the resilient material. A coating may be applied to the seal member to reduce friction between the seal member and surgical instrumentation inserted therein. The coating is preferably a hydrocyclosiloxane membrane prepared by plasma polymerization process.

Abstract: A surgical port includes a port body having a lumen extending therethrough and a plate having an opening. The port body may be made from foam. The port is configured such that rotation of the plate with respect to the port body aligns the opening and lumen defining a passage therethrough for the insertion of surgical instruments.

Abstract: A heart retractor links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the heart retractor of the present invention. The retractor includes a plurality of flexible arms and a plurality of rigid arms as well as a surgery target immobilizing element. One form of the retractor can be sued in minimally invasive surgery, while other forms of the retractor can accommodate variations in heart size and paracardial spacing.

Abstract: A seal anchor member has opposing ends that define a longitudinal axis. The seal anchor member is adapted to transition between an expanded condition and a compressed condition to facilitate securing of the seal anchor member within a tissue tract in a substantially sealed relationship. The seal anchor member includes a biasing member positioned along the longitudinal axis. The biasing member is configured and adapted to facilitate the transition between the expanded and compressed conditions. The seal anchor member further includes at least one lumen extending through the seal anchor member for slidably receiving a surgical instrument.

Abstract: A cannula for use in laparoscopic surgery has a central passage which may accept a trocar to create a laparoscopic incision in a body wall to an inner body cavity. A tubular section of the cannula is then pressed into the incision to form a port. After completion of the operation a needle having a blunt distal end with a suture-engaging notch surrounded by a sheath with a sharpened edge is pressed through inclined passages in the side walls of the cannula so as to extend into the body tissue on one side of the cannula and into the body cavity, carrying the suture which is then grasped by an instrument to remove the suture and join it to a needle projecting from the opposite side of the cannula. The needle is then withdrawn so the suture may be knotted on the outer side of the body wall.

Abstract: Laparoscopic instruments and cannulas are provided for performing laparoscopic procedures entirely through the umbilicus. Generally S-shaped laparoscopic instruments placed through the C-shaped trocar sleeves or through the cannula and instrument holder unit provide markedly improved degrees of instruments' freedom during trans-umbilical laparoscopic procedures.

Abstract: An endoscopic surgical tool guider port, installed in a surgical puncture site of a patient during an endoscopic surgery, wherein an extraction bag for containing and preserving extractions made during surgery protrudes from a tube body to the outside so that the surgery can be continued while the extractions made in the surgical process are directly contained and stored in the extraction bag, formed on the tube body, without requiring the opening or releasing of the guide port during the surgical process. A gas exhaust valve for a surgical tool guider port, and more particularly, a gas exhaust valve for a surgical tool guider port for promptly releasing toxic gases or smoke generated during the surgical process through a simple one-touch manipulation of pushing a button, thereby improving the convenience of use and enabling a smooth endoscopic surgery, compared to a conventional gas exhaust port used during surgery.

Abstract: A surgical access device is disclosed which includes a housing, a collar, and a plurality of deformable members. The housing defines a proximal end and a distal end and has a plurality of lumens extending therethrough. The collar is repositionable between a first position and a second position with the second position being closer to the proximal end of the housing than the first position. Each of the plurality of deformable members defines a distal portion, is coupled to the collar and is transitionable through one of the plurality of lumens. The plurality of deformable members is in a retracted state when the collar is in the first position and a deployed state when the collar is in the second position. One or more of the plurality of deformable members may also include a barb attached to the distal portion.

Abstract: A rigidizable endoluminal access device includes a handle assembly 110, a flexible neck, a tip, and at least one lumen extending therethrough. Lumens are in fluid communication with entry ports located at the handle assembly and exit ports positioned on the tip. In one embodiment, entry ports and exit ports are angled with respect to one another. Lumens are configured to receive any suitable surgical instrument. The handle assembly includes an over-center toggle mechanism adapted to stiffen the flexible neck.

Abstract: A trocar comprises a retention cannula comprising an inverted or incised retention pattern disposed thereon. Embodiments of the incised cannula exhibit reduced tissue trauma compared with screw-threaded cannula, improved fixation and/or retention compared with an unthreaded cannula, and good sealing between the cannula and the incision.

Abstract: A wire guide system is provided for use during a endoscopic surgical procedures. The wire guide system includes a cylindrical shaft having a hollow chamber along a longitudinal axis of the cylindrical shaft, a flange fit disposed around the cylindrical shaft and a seal disposed around the cylindrical shaft and abutting the flange. The system may also include an anchor affixed to the cylindrical shaft and having an aperture from which at least one of a sensor, a light, a camera, tissue and/or organs may be suspended therefrom and at least one cable extending from one end of the cylindrical shaft to another end of the cylindrical shaft through the hollow chamber.