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 device for human organ packing in a laproscopic surgical procedure, including an expandable barrier configured to be laproscopically implanted into a human abdominal cavity such that a side of the expandable barrier interfaces with organs in the abdominal cavity, thereby forming a barrier between the organs and a region of the abdominal cavity on an opposing side of the barrier relative to the organs, wherein at least a portion of the barrier is configured to be controllably transformed from a first state to a second state, wherein when in the second state the barrier is in a more rigid state relative to the first state.

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: Methods and devices are disclosed to reduce tissue trauma when a physician retracts a patient's tissues for surgery. In one part, methods and devices are disclosed for controlling retraction force and pace. In another part, methods and devices are disclosed for oscillating force when opening. In another part, methods and devices are disclosed for detecting trauma during retraction. In another part, methods and devices are disclosed for balancing forces on multiple retraction elements. In another part, methods and devices are disclosed for reducing forces in multiple dimensions. In another part, methods and devices are disclosed for engaging ribs. In another part, methods and devices are disclosed to compensate for deformation of a retractor under load. In another part, methods and devices are disclosed that combine these methods and devices. In another part, methods and devices are disclosed for controlling pressure inside inflatable devices used for deforming biological tissues.

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 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 motor driven seal assembly for permitting hand assisted laparoscopic procedures. The seal assembly includes a seal cap having a seal positioned within a housing, the housing includes a lower seal ring having a track which supports an upper seal ring for rotational motion relative thereto. The seal is supported between the upper seal ring and the lower seal ring for rotation between an open orientation and a closed orientation. A motor-driven drive assembly is associated with the lower seal ring and the upper seal ring for controlling relative to movement thereof.

Abstract: There is a method and surgical retractor provided which includes a member having a first end and a second end. The member defines a concave inner side between the two ends. The member also defines a convex outer side between the two ends. The member includes a first side and a second side wherein the edge of the first side extends, between the two ends, beyond an edge of the second side. The surgical retractor may further comprise a V-shaped channel defined in the convex inner side. The member may be composed of a surgical foam, wherein the surgical foam includes a characteristic of restorative shape memory.

Abstract: An apparatus is disclosed for the reception of a surgical instrument inserted through a cannula assembly. An orifice in a seal member defines a central longitudinal axis in general alignment with the cannula assembly. The seal member includes an elastic member for engaging the surgical object about the orifice and forming a fluid-tight interface. A fiber loop is at least partially embedded in the elastic member and serves to compress central portions of the elastic member around the instrument. The fiber loop may form a loop around the orifice and may cooperate with other fiber loops similarly embedded in the seal.

Abstract: Methods and devices are provided for performing surgical procedures using tissue retractors. In general, the methods and devices allow a surgeon to use a retractor to capture a large or small amount of tissue in the retractor and to move the retractor to relocate tissue to one or more convenient locations during a surgical procedure. The retractor can be configured from a pliable state to a substantially rigid state to hold the retractor and the tissue in a substantially fixed position during the procedure.

Abstract: A retractor device for cervical spinal fusion surgery. The retractor device includes a first post assembly having a first pin for mounting the first post assembly to a first vertebral body and a first rod coupled thereto in a multi-axial manner so that the first rod can be pivoted relative to the first pin. The retractor device also includes a second post assembly having a second pin for mounting the second post assembly to a second vertebral body and a second rod coupled thereto in a multi-axial manner so that the second rod can be pivoted relative to the second pin. The retractor device also includes a first retractor blade having a first retractor blade arm slideably engageable to the first rod, and a second retractor blade having a second retractor blade arm slideably engageable to the second rod. The first retractor blade is slid down the first rod and the second retractor blade is slid down the second rod to be positioned and separate the anatomical structures.

Abstract: A surgical access port for accessing a cavity of a patient having an outer frame including first and second frame portions, wherein at least one of the frame portions is movable with respect to the other frame portion. The outer frame has a first length greater than the first width, wherein movement of at least one of the frame portions away from the other frame portion increases the outer frame to a third length greater than the first length. An inner member has a second length and a second width, the second length being substantially transverse to the first length of the outer frame and the second width being substantially transverse to the first width of the outer frame. A flexible member extends between the outer frame and inner member and is movable by movement of at least one of the frame portions.

Abstract: A surgical access assembly for positioning within an opening in tissue including an outer member positionable outside a patient and defining an opening therein to receive a surgical instrument. The outer member has a first portion and a second portion wherein at least one of the first and second portions is movable with respect to the other portion. The assembly also includes an inner member positionable within a patient and a flexible member extending between the inner member and outer member, wherein movement of one of the first and second portions of the outer member adjusts tension on the flexible member to retract tissue. A locking mechanism locks the outer member in a plurality of select expanded positions. The locking mechanism includes first engagement structure on the first portion engageable with the second portion and a slidable member movable to a locking position to retain the first and second portions in the select expanded position.

Abstract: Devices for use during surgical or non-surgical procedures can move items from the field of view or work space. Retraction of items during any surgical or non-surgical procedure moves the items from the field of view or work space. The flexibility and compactness of a retraction device can make it suitable for surgery, especially minimally invasive surgery (MIS).

Abstract: Embodiments of the invention include instruments and methods for providing surgical access to a surgical site. Some embodiments include a flexible arm that adjustably holds a retractor blade to enable access to the surgical site.

Abstract: A surgical access device has a surgical retractor having a noncompliant outer ring with an annular axis, an inner ring, and a sleeve coupling the outer ring to the inner ring. The noncompliant outer ring is adapted to roll over itself around the annular axis to roll the sleeve around the outer ring to retract and seal an opening in a biological body wall. The access device may include a lid adapted for being coupled to the noncompliant outer ring of the surgical retractor. The outer ring of the surgical retractor has a cross-sectional shape that prohibits the lid from being partially or incorrectly coupled to the outer ring of the surgical retractor.

Abstract: A pannus support member is configured to support and contain a pannus during a surgical procedure to provide unobstructed access to the surgical site and provide, post surgery, a clean site that is exposed to air to promote proper healing.

Abstract: A surgical access device can include a plurality of retractor members that together define a lumen having a first cross-sectional dimension. Each of the plurality of retractor members can be moved radially outward to at least a second cross-sectional dimension to create a surgical access passage. The surgical access device, systems and kits comprising the surgical access device, and methods of using the surgical access device can include a mechanism for inserting an elongate member from exterior the body to the surgical site, a mechanism for moving the retractor members radially outward, a mechanism for guiding the radially outward movement of the retractor members, a mechanism for securing each of the retractor members in a range of positions, and a mechanism for illuminating the surgical site. Variations of the devices, systems, kits, and methods are useful for creating and maintaining a surgical access passage for performing minimally invasive surgery.

Abstract: A steerable multi-linked device. The device includes a first multi-linked mechanism and a second multi-linked mechanism. At least one of the first and second multi-linked mechanisms is steerable and includes a modular link assembly at an end thereof. The modular link assembly includes a base, and a tip removably connected to the base.

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 access assembly having a body including a leading end, a trailing end, and first and second body members extending between the leading and trailing ends. The leading end, trailing end and first and second body members define a passageway therethrough for receipt of surgical instrumentation. First and second flexible wing members extend proximally from the body. A flexible member is attached to the body and extends proximally therefrom.

Abstract: A laparoscopic seal assembly includes a seal cap having a seal with an access opening. The seal cap also includes a manifold connection for attachment of a functional apparatus. The seal assembly further includes a retractor.

Abstract: A handless 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 distractor for distracting tissue of a patient to access structure underlying the tissue of the patient. The distractor includes a tube having a distal end adapted for insertion in tissue, a proximal end opposite the distal end, an exterior surface adapted for contacting the tissue, and an interior surface opposite the exterior surface defining a hollow interior extending between the distal end and the proximal end for accessing structure underlying the tissue when the distal end is inserted in the tissue. The distractor is adjustable from a reduced configuration, in which the tube has a reduced width sized for inserting the distal end in the tissue, and an expanded configuration, in which the tube has an expanded width greater than the reduced width sized to provide the hollow interior with a size sufficient for accessing the structure underlying the tissue.

Abstract: An instrument for field isolation during surgery. The instrument includes a flexible member, and a retractor configured to retract the flexible member for field isolation during a surgical procedure. A method of providing field isolation during a surgical procedure is also provided.

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 surgical device is disclosed which can be utilized to access a surgical site within a patient. The surgical device can comprise a member insertable into a patient, a base member configured to be positioned against the patient, and a flexible sleeve extending therebetween. The surgical device can further comprise an upper member which can be assembled to the base member such that it can be rotated about an axis. The upper member and the base member can comprise corresponding retention features and slots which can permit the upper member to be rotated relative to the base member yet prevent the upper member from being disassembled from the base member unless the upper member and the base member have been aligned in a unique orientation.

Abstract: The present invention provides a non-rigid retractor for providing access to a surgical site, such as a patient's spine, during a surgical process. When used in spinal surgery, the non-rigid retractor allows a surgeon to operate on one or more spinal levels. The non-rigid retractor includes at least one flexible strap anchored at a first end to the spine or other internal body part at the surgical site.

Abstract: An access port for use in single port surgery includes a cannula to provide minimally invasive access to a surgical site and an instrument guide that fits closely within the cannula. The instrument guide includes guide channels that are open to the outside surface of the instrument guide. Each of the guide channels is configured to support a single surgical instrument at a defined position within the cannula. The guide channels may be smoothly enlarged at the end that receives surgical instruments. The access port may further include a seal that couples the instrument guide to the cannula such that the seal retains a pressurized insufflation fluid within the surgical site. The instrument guide may include one or more insufflation channels for introducing an insufflation fluid to the surgical site. The access port may include a flexible section. The surgical instruments may be controlled robotically by servo actuators.

Abstract: A surgical access assembly includes a body having first and second side panels opposing one another and first and second end panels interconnecting the side panels. The first and second end panels are moveable between a folded position and an expanded position to correspondingly move the first and second side panels with respect to one another between an approximated position and a spaced apart position. In the spaced apart position, the first and second side panels are flexed outwardly and apart from one another to define a passageway therebetween. A flexible membrane is coupled to the first and second side panels and extends proximally therefrom.

Abstract: A surgical access assembly includes a body having first and second body members. Each body member has an opposed side and an outer side. The body members are coupled to one another by a connector and are moveable with respect to one another between an approximated position and a spread position wherein the opposed sides are flexed outwardly and apart from one another to define a passageway therebetween. A flexible membrane is coupled to the first and second body members and extends therefrom such that translating the flexible membrane radially outwardly moves the body members from the approximated position to the spread position.

Abstract: A retractor and a surgical tool are positioned at the distal end of the cannula. A dissection cradle is located at the distal end of a distal portion of the retractor that is resiliently skewed relative to the cannula axis, and includes two substantially parallel, spaced legs with the retractor shaped in a loop therebetween. The procedure includes locating a vessel and side branch of interest and extending the retractor to retain the vessel in the dissection cradle to urge the vessel away from the axis of the cannula in order to isolate a side branch for exposure to the surgical tool.

Abstract: A percutaneous tube assembly is provided for performing minimally invasive surgery, the system comprising a percutaneous tube comprising a translucent main body; an external attachment fixture attached to the main body; an access channel longitudinally bored through the main body; an internal attachment channel longitudinally bored through the main body, wherein the internal attachment channel comprises a partially smooth inner surface adjacent to a partially rough inner surface; and an internal attachment, mating with the internal attachment channel.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. A surgical access port is provided that has an adjustable longitudinal length, such as by being formed from multiple segments configured to move relative to one another. An anchor can be coupled to a distal end of the surgical access port to help secure the surgical access port within a tissue opening by engaging a distal side of the tissue. Optionally, the anchor can be removably coupled to the distal end of the surgical access port, thereby allowing any one of a plurality of anchors to be selectively coupled thereto.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In general, the methods and devices allow a surgical access device to be securely positioned within an opening in tissue to provide access to a body cavity underlying the tissue. An actuator can be rotatably disposed on or in a housing of a surgical access device such that rotation of the actuator relative to the housing is effective to move a cannula of the surgical access device between an insertion configuration in which the cannula has a reduced profile enabling it to easily be inserted into a tissue opening, and an expanded profile enabling it to form an anchor against and/or within the tissue opening.

Abstract: Access devices and related methods are disclosed that generally involve flexible or adjustable cannulas that have a substantially cylindrical insertion configuration and a substantially conical expanded configuration. Various methods and features are provided for transitioning the cannula from the insertion configuration to the expanded configuration while the access device is inserted through tissue to form a conical opening through the tissue. Examples include cables, biasing elements, retaining elements, bimodal rings, and coil springs. The devices and methods disclosed herein can allow for improved retention of the access device, improved angulation of instruments passed through the access device, and can increase the integrity of a seal formed between the access device and surrounding tissue.

Abstract: A retractor includes a retractor support and an elongated retractor blade. The retractor blade has a first, closed position in which ends of the blade are positioned proximal to the support and a second, open position in which ends of the blade are positioned distal to the support. The retractor support has structure for engaging the retractor blade. A handle extends from the retractor support. A method of retracting tissue is also disclosed.

Abstract: A scaffold assembly includes an instrument pod and a plurality of actuable movers. The instrument pod may include one or more instruments operably coupled thereto. The instrument pod is inserted through a tissue tract into the body cavity. Each actuatable mover includes an insertion member extending therefrom therefrom for insertion within tissue. Each mover has one or more lines removably attachable to the instrument pod that are configured to move the instrument pod between different positions relative to each mover upon the actuation of one or more of the movers to move the instrument pod within the body cavity.

Abstract: The present invention provides a non-rigid retractor for providing access to a surgical site, such as a patient's spine, during a surgical process. When used in spinal surgery, the non-rigid retractor allows a surgeon to operate on one or more spinal levels. The non-rigid retractor includes at least one flexible strap anchored at a first end to the spine or other internal body part at the surgical site. The body of the at least one flexible strap extends from a skin incision and is anchored at a second location external to the body to retract skin and muscle from the surgical site, allowing adequate visualization of the surgical site and providing access for implants and surgical instruments to pass through the retractor and into the surgical site.

Abstract: A surgical access device adapted for disposition relative to an incision in a patient comprising a valve including a plurality of overlapping sheets defining an access channel, and a ring having an inner diameter for holding the valve by fixing each of the overlapping sheets along a portion of the perimeter is described. The access channel 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. The open edges slightly overlap at the center of the ring.

Abstract: A surgical portal and introducer assembly includes an introducer and a portal. The introducer has a surface member and a portal member extending from the surface member. The surface member limits the positioning of the portal member within a tissue tract relative to an outer tissue surface. The portal member and the surface member define a longitudinal channel therethrough. The portal is positionable within the longitudinal channel of the introducer. The portal has one or more longitudinal ports dimensioned to permit passage of a surgical object therethrough. The portal includes a compressible material that permits the portal to transition between a first expanded condition and a second compressed condition. The portal is biased toward the first expanded condition. The portal maintains a substantially sealed relationship with the longitudinal channel when positioned in the longitudinal channel and disposed in the expanded condition.

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 port fixation device is disclosed. The port fixation device comprises a body portion and a longitudinal slit. The body portion has an elongated tubular shaped and has an interior lumen defining a longitudinal axis therethrough. The interior lumen is configured for reception of a surgical access port. The longitudinal slit is disposed in the body portion between a first longitudinal edge thereof and a second longitudinal edge thereof, and extends between a proximal portion and a distal portion of the body portion. The body portion is configured to expand radially outwardly to accommodate a surgical access port therein.

Abstract: The present invention provides minimally invasive devices and methods for accessing the sinuses and their surrounding structures for surgery and other treatments. The anterior ethmoid and maxillary sinuses are accessed and treated under minimal anesthesia with little or no postoperative limitation of activity or adverse symptoms. Direct visual verification of the sinuses and their natural ostia is utilized. Other paranasal sinuses may be treated by this method as well. The sinuses, in particular the maxillary and anterior ethmoid, are accessed via a direct anterior to posterior axis and the natural ostia of those sinuses is directly visualized for placement of a guide-free dilator, in the desired location within the natural ostia. That access to the maxillary ostium is accomplished by the anterior transuncinate “keyhole” approach in which a hole is punched in the uncinate process with the described devices according to the described methods.

Abstract: A surgical spatula has a blade with a tip formed with a portion with a first bendable portion beginning at the tip and a second, non-bendable portion extending from the terminus of the first blade portion toward the handle of the spatula. The blade is constructed in such a way as to allow the bending of the bendable portion by exerting very light pressure thereon making it possible for the surgeon to effect such bends during surgery without removing the instrument from the operating field.

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 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 orifice introducer device for introducing, e.g., a surgical device, into, e.g., an orifice of a body, includes a tubular member having a distal end and a proximal end. The distal end is adjustable between a first position for insertion into an orifice and a second position once inserted into the orifice. Alternatively, the orifice introducer device includes a distal portion having a proximal end configured to be detachably secured to the distal end of the tubular member. The distal portion is selectively detachable when the orifice introducer device is positioned in the orifice.

Abstract: A retractor for manipulating an object includes a body having proximal and distal ends and a retraction device with a head connected to the distal end of the body, a connector movably disposed in the body, and flexible needles of a shape memory material having a memory shape. The needles are connected to the connector and each have a distal tip. The memory shape of the needles include a portion with an arcuate shape biasing the needles in a memory direction out and away from the head and toward the body to position the distal tip of each of the needles closer to the body when the needles are fully extended out of the head than when the needles are only partially extended out of the head. An actuation device is connected to the proximal end of the body and operatively connected to the connector through the body, the actuation device, upon actuation thereof, moves the connector to selectively extend the needles out of the head in different directions and withdraw the needles into the head.

Abstract: An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop placed therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.