Abstract: Surgical access ports useful in minimally invasive surgical procedures are provided. The access ports comprise a cannula that defines a passageway for one or more surgical instruments through a tissue tract and a dome extending from the cannula to provide an expanded diameter for receiving one or more surgical instruments.

Abstract: An assembly for accessing a body cavity through an opening in tissue is provided. The access assembly includes a flexible outer sleeve configured to be received through an opening in tissue. The outer sleeve defines a passageway therethrough. The access assembly further includes an inner core configured for selective reception within the passageway of the outer sleeve. The inner core defines at least a first lumen configured to receive a surgical instrument therethrough.

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: The invention relates to a retraction system for exposing accesses in human medicine, dentistry or veterinary medicine, wherein said retraction system is arranged on the respective body region and has at least one hook-shaped retractor element 1 and retaining means for fixing the latter. The retraction system is characterized in that it is made of a radioparent material and in that it has a self-retaining action and/or is flexible at least in some areas such that, during retraction, a flexible element or a flexible section nestles against a tissue that is to be retracted.

Abstract: An instrument access device comprises first, second and third instrument seals for sealing around instruments extended through the device. The seals have respective connector sleeves. Each sleeve connects a base to one of the instrument seals. The device also comprises two insufflation/desufflation ports. Each of the ports comprises a connector extending from the base, a tube extending from the connector, a luer connector and a removable cap. The luer connector is used for connection to any suitable supply line for insufflation gas or for discharge if insufflation gas. In use, the insufflation/desufflation ports facilitate independent control of insufflation and desufflation as may be required during a surgical procedure. Access sleeve at the proximal end is cut-off, folded over the inner proximal ring and is held in place between the base and the inner proximal ring when the base is fitted.

Abstract: A retractor has an oximeter sensor at its tip, which allows measuring of oxygen saturation of a tissue being retracted by the retractor. The tip includes one or more openings for at least one source and detector. A specific implementation is a spinal nerve root retractor with an oximeter sensor.

Abstract: Sealing assemblies and methods are disclosed for sealing a surgical instrument having an internal drive shaft subject to lateral displacement. A sealing assembly includes a rigid portion shaped to interface with an instrument shaft of the surgical instrument. A laterally oriented slot is open at a radially perimeter location and configured to receive an o-ring seal via the perimeter location. Apertures are disposed on opposing sides of the slot and open to the slot. The apertures are configured to receive the drive shaft there through and are larger than the drive shaft to accommodate lateral displacement of the drive shaft. The slot includes opposing internal sides spaced to interface with opposed axial surfaces of the o-ring seal. The seal inhibits axial transmission of an insufflated gas and/or bodily fluids while accommodating lateral displacement of the drive shaft.

Abstract: A handleless surgical stay includes an elastomeric band with a longitudinal body having a first end. The surgical stay further includes a tissue retention member including a tissue engaging portion and an anchor portion. The anchor portion is coupled to the first end of the elastomeric band such that the tissue engaging portion extends outwardly relative to the first end. Substantially all of the elastomeric band can be configured for engagement with a surgical retractor frame such that the stay does not include a handle.

Abstract: A surgical access assembly for positioning within an opening in tissue including an outer frame positionable outside a patient and defining an opening therein dimensioned to receive a surgical instrument therethrough. The outer frame includes first and second portions. The first portion is biased into locking engagement with the second portion such that a first engagement structure is in locking engagement with a second engagement structure. An inner member is positionable within a patient and a flexible member extends between the inner member and outer member and is operatively associated with the outer member. The first portion is movable to overcome the bias to move the first and second engagement structures to a disengaged position, wherein in the disengaged position at least one of the first and second portions is movable with respect to the other portion to adjust the tension on the flexible member to retract tissue.

Abstract: An integrated passive wireless chip diagnostic sensor system is described that can be interrogated remotely with a wireless device such as a modified cell phone incorporating multi-protocol RFID reader capabilities (such as the emerging Gen-2 standard) or Bluetooth, providing universal easy to use, low cost and immediate quantitative analyses, geolocation and sensor networking capabilities to users of the technology. The present invention can be integrated into various diagnostic platforms and is applicable for use with low power sensors such as thin films, MEMS, electrochemical, thermal, resistive, nano or microfluidic sensor technologies.

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: A surgical access assembly includes a sleeve and a port. The sleeve is adapted for insertion within tissue to access an underlying tissue site. The sleeve defines a first passage therethrough. The first passage has a first diameter. The port defines one or more second passages extending therethrough. The port is adapted for insertion within the first passage of the sleeve in a substantially sealed relationship therewith. The one or more second passages are adapted for a substantially sealed reception of a surgical object therethrough. The one or more second passages have one or more second diameters. The port is selectively removably positionable within the first passage of the sleeve. The first diameter is greater than the one or more second diameters.

Abstract: A reinforced access assembly is provided. The access assembly includes a compressible body having proximal and distal ends and a substantially hourglass-shaped central portion extending therebetween. The compressible body defining at least a first lumen configured to receive an instrument in a sealing manner. The access assembly further includes a reinforcing mechanism extending between the proximal and distal ends of the compressible body. The reinforcing mechanism includes a plurality of rib members configured to permit compression of the compressible body during insertion into an incision and return the compressible body to an uncompressed condition following insertion.

Abstract: A surgical access device is disclosed herein. The surgical access device includes a housing adapted for insertion into an incision in tissue and at least one inflatable portion disposed on the housing. The housing defines a proximal end and a distal end and has a lumen extending therethrough for the reception of a surgical access portal. The at least one inflatable portion has a deflated state and an inflated state and the housing is insertable into the incision in tissue when the at least one inflatable portion is in the deflated state. The housing is adapted to form a substantially fluid tight seal with the incision in tissue and with a surgical access portal inserted therethrough when the at least one inflatable portion is in the inflated state.

Abstract: The application relates to a hand access laparoscopy device having a gelcap, a retainer, a sleeve and a retention ring. The gelcap includes gel that is bonded to a cap. The cap includes an inner cylindrical wall to which the gel in bonded, thereby providing a sealing area between the device and the wound in a body wall. By securing the gel to the inner cylindrical wall, the thickness of the gel and corresponding cap is minimized along with the overall footprint of the device. With the gel thickness reduced and able to be substantially flush, the “doming” phenomenon produced by insufflation of a patient's abdomen is reduced.

Abstract: A device including a hollow pipe with a variable diameter is used for medical procedures. Means are provided for reducing the diameter either internally or externally so that the pipe can be inserted into a patient's body through an incision or an opening until the distal end of the pipe reaches a desired position. Thereafter, the diameter of the pipe is increased to allow various surgical devices to be introduced through the pipe.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: An access assembly is provided including a tubular member having a proximal end and a distal end, the proximal end in mechanical cooperation with a foldable cap member having a first set of lumens extending the length of the tubular member. The access assembly also includes a first ring secured at the proximal end of the tubular member and a second ring secured at the distal end of the tubular member. The foldable cap member is configured to fold in at least one direction to expose a second set of lumens extending the length of the tubular member.

Abstract: Devices and methods for temporarily retaining spinal rootlets within a dural sac are provided. In this regard, a representative device includes: a handle operative to be grasped by a user; an arm extending outwardly from the handle; and moveable fins supported at a distal end of the arm, the fins being moveable between an unbiased position and a biased position; in the biased position, free ends of the fins having been moved toward each other such that an extent of the fins along a major axis is decreased relative to an extent of the fins along the major axis in the unbiased position.

Abstract: A surgical retractor device for retaining and/or moving internal organs during minimally invasive or laparoscopic surgery is provided. The surgical retractor can be a single continuous structure that includes a shaft. The shaft can branch into a first elongate finger with a first distal end opposite the shaft and a second elongate finger with a second distal end opposite the shaft. The retractor can further include a resilient lattice structure disposed between the first elongate finger and the second elongate finger. The retractor can have an expanded configuration and a collapsed configuration based on relative distance between the first distal end and the second distal end. When the retractor is in the collapsed configuration, spring force energy can be stored in the resilient lattice structure.

Abstract: A surgical apparatus includes a housing member and an inner member. The housing member includes an expandable material that is adapted to transition between a compressed condition and an expanded condition. In the expanded condition, an outer surface of the housing member is adapted for a substantial sealing relationship with tissue upon insertion of the housing member within the tissue for accessing an underlying tissue site. The housing member has leading and trailing ends that define a longitudinal axis. The inner member is operably associated with the housing member and includes one or more longitudinal portals extending therethrough adapted for substantially sealed reception of a surgical object. The inner member may be less compliant than the housing member. The inner member may rotate about the longitudinal axis of the housing member.

Abstract: An access assembly configured to receive one or more surgical instruments is provided. The access assembly includes a flexible housing having a proximal end and a distal end, the housing defining a longitudinal passageway extending from the proximal end to the distal end and a seal assembly received within the longitudinal passageway of the housing. The seal assembly defining a plurality of ports each configured to receive an instrument inserted therethrough in a sealing manner.

Abstract: A vaginal speculum comprises upper and lower blades arranged to pivot relative to each other about coupling elements each associated with a respective blade. The upper blade is detachable from the lower blade, when the speculum is in situ in the vaginal cavity, upon pulling the upper blade generally proximally. This decouples the coupling elements from each other or detaches at least one of the coupling elements from the associated blade. The speculum has optional side blades.

Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: A surgical access assembly for accessing a cavity of a patient includes a proximal frame member, a distal frame member, and a membrane between the proximal and distal frame members. The proximal frame member is positionable adjacent an external surface of tissue and has first and second frame portions movable between a contracted condition and an expanded condition to expand an opening defined therethrough. The membrane defines a loop disposed about at least a portion of the proximal frame member at a proximal end thereof and is engaged to the distal frame member at a distal end thereof. The membrane is transitionable between a crumpled condition and an extended condition upon transitioning of the proximal frame member between the contracted condition and the expanded condition.

Abstract: A surgical access assembly for positioning within an opening in tissue including an outer frame positionable outside a patient and defining an opening therein dimensioned to receive a surgical instrument therethrough. The outer frame includes a first portion, a second portion and a locking portion. An inner member is positionable within a patient and a flexible member extends between the inner member and outer frame and is spreadable by actuation of the outer frame.

Abstract: A minimally invasive retractor assembly includes a posted screw and one or more retractor blades. Each retractor blade is releasably coupled to the posted screw. The retractor blade or blades are manipulated or flexed relative to the posted screw allowing retraction of tissue surrounding the incision. The retractor is made of a biocompatible 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: An eyelids opening device with a drape comprising a flexible upper ring (1) applied in contact with the face while surrounding eyelids, a lower ring (2) inserted into a conjunctiva sac and applied in contact with the eyelids conjunctiva side, and an elastic sheet (3) of soft tubular thin film located to extend from the face side to the eyelids conjunctiva side and used to fix one end to the upper ring and to fix the other end to the lower ring by expanding, wherein the outside diameter at the smallest portion of the elastic sheet is substantially equal to or longer than the interpalpebral length (between upper and lower eyelids). Difference in size of conjunctiva sac or interpalpebral length of individuals is absorbed even by an appliance of one size, the eyelids can be opened by fitting the eyelids opening device to the eyelids or the face while burden on the eyeball is reduced and high safety is ensured.

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 method for retracting tissue in a surgical procedure includes inserting a first blade of a retractor system into an incision in a body of a patient. The retractor system includes a first articulating arm and a second articulating arm. The first articulating arm is coupled to a retractor assembly blade. The retractor assembly blade has a handle portion and the first blade. The second articulating arm is coupled to a bracket securing a second blade. The method includes retracting tissue using the first blade, inserting the second blade into the incision in the body of the patient and retracting tissue using the second blade.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: The invention is directed to a surgical access system that provides access to a surgical area while maintaining pneumoperitoneum during laparoscopic surgery. The access system comprises a sheath retractor adapted to dilate a wound stretchable to a desired diameter and a detachable seal adapted to be removable from the sheath retractor. In another aspect, the detachable seal comprising a valve including a plurality of overlapping sheets defining an access channel that extends into communication with the incision in the patient. Each of the overlapping sheets includes a portion of the perimeter that is not fixed to the inner diameter of the ring, which provide open edges defining the access channel.

Abstract: A method of accessing an internal portion of a patient including the steps of providing an access assembly including an outer frame, an inner member and a flexible member, inserting the inner member through an opening in tissue into a body of a patient with the flexible member extending proximally through the opening in tissue, moving at least a first portion or second portion of the outer member to a select unlocked spread position to enlarge the opening in tissue and the passageway through the flexible member, and subsequently moving the locking member to move the first and second engagement structures into a locking position to lock the first portion in the select spread position.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity is adapted to tissues having different thicknesses. The surgical apparatus is configured to have different lengths. In one embodiment, the surgical includes a seal anchor member having two ends, and one of which is adapted to fold resulting in a plurality of folded states. Each folded state corresponds to a different length of the seal anchor member. The seal anchor member includes a slot to facilitate transition within the plurality of folded states. The seal anchor member further includes an aperture and a pin configured to further facilitate transition within the plurality of folded states.

Abstract: A tissue retention system to assist in maintaining adipose tissue on a patient in a displaced position during a medical procedure to provide access to a body region of the patient includes a flexible anchor pad having a pad length and a pad width. The anchor pad may include a pad body with an adhesive surface thereon, the adhesive being configured to selectively adhere to a patient's skin. The anchor pad also may include an opposing first attachment surface facing away from the adhesive surface. The tissue retention system also may include a flexible tension member having a second attachment surface.

Abstract: Embodiments of a surgical access system useful for single or limited port procedures comprise a trocar comprising a fixation cannula, a retractor, and a gel cap removably coupled to the retractor. The gel cap comprises a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The fixation cannula comprises a retainer and a bolster, which together, capture the artificial body wall therebetween, thereby fixing the trocar thereto. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

Abstract: A surgical portal apparatus includes a housing and a portal member extending from the housing. The portal member is dimensioned for insertion within tissue to access an underlying tissue site and defines a longitudinal axis. The portal member includes an outer wall having a longitudinal opening for reception of a surgical object. The outer wall includes first and second peripheral segments extending along the longitudinal axis. The first peripheral segment includes a substantially rigid material and the second peripheral segment includes a substantially elastomeric material. The first peripheral segment and the second peripheral segment cooperate to permit the outer wall to radially expand from a first condition where the outer wall defines a first internal dimension to a second condition where the outer wall defines a second internal dimension greater than the first internal dimension upon insertion of the surgical object.

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: Expandable dilators, dilation assemblies, and kits are disclosed, along with methods for using same.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity, includes a seal anchor member comprising a compressible material and being adapted to transition between a first expanded condition to facilitate securing of the seal anchor member within the tissue tract and in substantial sealed relation with tissue surfaces defining the tissue tract and a second compressed condition to facilitate at least partial insertion of the seal anchor member within the tissue tract. The seal anchor member defines a central longitudinal axis and has leading and trailing ends. At least one longitudinal object port extends between the leading and trailing ends and is adapted for reception of a surgical object whereby compressible material defining the at least one longitudinal object port is adapted to deform to establish a substantial sealed relation with the object.

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: An apparatus and method for an anchoring cannula including a first cannula having a proximal end, a distal end, a longitudinal axis and a lumen extending from the proximal end to the oppositely disposed distal end along the longitudinal axis. A second cannula is concentrically arranged within the lumen of the first cannula, the second cannula having a proximal end, a distal end and a lumen extending from the proximal end to the oppositely disposed distal end along the longitudinal axis. The second cannula includes an expandable portion connected to the distal end that is configured to expand when the second cannula is advanced out of the distal end of the first cannula and to change to an unexpanded configuration when retracted back into the distal end of the first cannula.

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 scaled 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 scaled relation with the object. The seal anchor member may have a non-circular cross-section.

Abstract: A wire-operated selective compliance mobile platform (100), in particular for endoscopic surgery devices, obtains a perfect and precise mobility and thus it allows to handle, in the most effective way, the supported instruments, and comprises a mobile surface (1), a connecting base (2) apt to be connected to a flexible tubular duct (4) for endoscopic uses, a plurality of supporting elements (3), apt to permit the motion of said mobile surface (1) relative to said base (2), characterized in that said supporting elements (3) have at least a selective compliance turning pair (31) and a number of joints (32, 34) so as to provide a predetermined number of degrees of freedom to said platform (100), neither determining any over-constraining, nor forcing the system to be deformed in unselected directions, each supporting element (3) being operated by moving means (51, 52) so as to move said mobile surface (1).

Abstract: A retractor for manipulating an object, the retractor includes a retractor body with proximal and distal ends, a retraction device with a head connected at the distal end of the retractor body and flexible needles of a shape memory material having a memory shape, the memory shape of the needles including a portion with an arcuate shape housed, at least partially, within the head. The retractor further includes an actuation device connected to the proximal end of the retractor body and operatively connected to the needles, the actuation device, upon actuation thereof, moving the needles out of the head and withdrawing the needles into the head and a rotation joint allowing the distal end of the retractor body and the retraction device to rotate independent of the proximal end of the retractor body.

Abstract: A flexible arm for use in a medical procedure includes a plurality of bushings and a plurality of double-ball members engaged with one another to thereby provide flexibility to the flexible arm. The double-ball members include a concave bore having a convex interior surface. The flexible arm further includes a wire extending through the concave bore of the double-ball members. An exterior diameter of the wire closely approximates or matches an interior diameter of the concave bore at its smallest point such that the curved members are operable to guide the wire as the flexible arm is flexed. The wire may be adjusted to thereby manipulate the amount of engagement between the bushings and the double-ball members to thereby manipulate the flexibility of the flexible arm.

Abstract: Medical systems, devices and methods are provided for accessing a bodily opening that, among other things, are safe and reliable, and facilitate manipulation of a medical instrument. The medical access device generally includes an elongated flexible sheath and an expandable frame connected to the distal end of the flexible sheath. The sheath and expandable frame are operable between expanded and collapsed configurations to provide a pathway from a natural orifice to the bodily opening.

Abstract: Embodiments of a surgical access system useful for single or limited port procedures comprise a trocar comprising a fixation cannula, a retractor, and a gel cap removably coupled to the retractor. The gel cap comprises a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The fixation cannula comprises a retainer and a bolster, which together, capture the artificial body wall therebetween, thereby fixing the trocar thereto. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

Abstract: An apparatus for perineal retraction during a prostatectomy includes a handle portion with a first end, a second end and a curvilinear segment between the first and second end. The second end faces in a direction toward the first end. The apparatus also includes a head portion including a first surface on one side of the head portion and a second surface on an opposite side of the head portion, the second surface being connected to or engageable with the second end of the handle. Use of the apparatus for perineal retraction during prostatectomy is also described.

Abstract: A surgical access assembly includes a sleeve and a port. The sleeve is adapted for insertion within tissue to access an underlying tissue site. The sleeve defines a first passage therethrough. The first passage has a first diameter. The port defines one or more second passages extending therethrough. The port is adapted for insertion within the first passage of the sleeve in a substantially sealed relationship therewith. The one or more second passages are adapted for a substantially sealed reception of a surgical object therethrough. The one or more second passages have one or more second diameters. The port is selectively removably positionable within the first passage of the sleeve. The first diameter is greater than the one or more second diameters.