Abstract: System and methods of delivering adhesive material are described for occluding target locations within a patient. The systems include a catheter configured to deliver adhesive to a target location and one or more of a light source to harden the adhesive, a retention structure to contain the adhesive prior to curing, a balloon to occupy a target location, and an open cell foam plug to occupy a target location.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to a tissue traction device, e.g., for an endoscopic procedure such as endoscopic tissue dissection. For example, a tissue traction device may include a traction band having a first end, a second end, a length therebetween and extending along a longitudinal axis. A first attachment member may extend from the first end of the traction band. A second attachment member may be associated with the body between the first end and the second end of the traction band. A third attachment member may extend from the second end of the traction band.

Abstract: An embodiment of a uterine hemorrhage controlling system comprises a suction module including a suction end coupleable to a pump by a connecting tube, and a sealing module coupled to the suction module. The system may further comprise the pump and a filter coupled to the suction module. A uterine hemorrhage controlling method comprises: shielding a suction module that has been delivered into a uterus; sealing an entrance into the uterus while the suction module is situated within the uterus; applying a negative pressure within the uterus upon activation of a pump; and maintaining the negative pressure within the uterus to induce uterine contraction. The method may further comprise delivering the suction module into the uterus; transmitting bodily fluids, out of the uterus through the suction module, and filtering the bodily fluids.

Abstract: Vaginal dilator assemblies, devices and kits. Assemblies can include a base, and an adapter. The base can have an inner portion and the adapter can have an outer portion that is complimentary to the inner portion of the base such that the adapter is non-rotatably fitted into the base. Vaginal dilator devices can include a base defining a recess aligned with the longitudinal axis of the base. The recess can have a plurality of step tapered sections. Vaginal dilator kits are also provided that include a plurality of vaginal dilators having different diameters. Each of the plurality of vaginal dilators is configured to be axially aligned and securely fitted into one of the step tapered sections of the recess of the base.

Abstract: A cap for a trocar assembly includes a housing configured to be removably attached to a proximal portion of a trocar. The housing defines an access port opening therethrough configured to be aligned for passage of a surgical instrument through the access port opening and into a main access port of the trocar. The housing defines at least one siphon opening for siphoning particles from the proximal portion of the trocar for filtration.

Abstract: A diffuser for use with a wound retractor and configured to deliver gases includes an interface tube for connecting to a gases supply and a diffuser interface positioned at a proximal end of the interface tube, the diffuser interface configured for delivering gases received from the gases supply through the interface tube, and the diffuser interface comprising a diffusion mechanism configured to deliver gases in a diffusion direction. A wound retractor with an integrated diffuser is also disclosed. The wound retractor includes an upper ring, a lower ring, a sleeve extending between and connecting the upper ring to the lower ring, and an integrated diffuser interface having a gases inlet and a diffusion mechanism.

Abstract: Methods of joint repair employing sutures and attached fixation devices are discussed. For example, a bone block graft procedure (e.g., Latarjet) is discussed which employs fixation devices to secure contact between graft surfaces of two bones. A suture construct, including a continuous suture loop routed through a first fastener, is secured to a first bone. Looped ends of the suture loop are passed through passageways formed in the two bones. The looped suture ends are further routed through a second fastener. The second fastener is mounted to the second bone and a sliding knot, formed in the looped suture ends, is advanced into contact with the second fastener. The suture is further tensioned using a tensioner device to secure the two bones together.

Abstract: One or more sensors are incorporated onto one or more of an implantable device and a surgical tool used for placement and/or adjustment of the implantable device. The implantable device includes an adjustable membrane element for controllable coaptation of a body lumen, such as coaptation of a urethra as treatment for urinary incontinence. In various embodiments, the one or more sensors can be configured to detect information indicative of at least one of a shape of the adjustable membrane element, a position of the adjustable membrane element relative to the body lumen, or a shape of the body lumen.

Abstract: In some embodiments an apparatus for providing access for a medical procedure in a patient's body cavity includes a stem configured for insertion through an opening in a body cavity wall. The stem has a bore and a cap is disposed at a proximal end thereof and includes an entry port in communication with the bore which receives an instrument to be inserted into the body cavity. An inflatable annular seal is disposed on the stem proximate the cap and a conduit extends through the cap providing pressurized gas at a first outlet in fluid communication with the body cavity providing insufflation pressure. A second outlet of the conduit is in fluid communication the seal, which when disposed inside the body cavity proximate the wall and inflated by pressurized gas, bears on an inner surface of the wall urging the cap into contact with an outer surface of the wall while sealing the opening.

Abstract: Retraction of one or more three-dimensional or planar amorphous objects is provided to gain access for a procedure where the retracted elements are easily damaged by application of normal forces. For example, a surgical instrument to provide access to an organ or tissue plane. Microtextured surfaces are provided that provide immobilization of amorphous objects, the immobilization of which is characterized by low normal forces and high shear or in plane forces. The retraction device is comprised of microstructured surfaces on one or more arms. Preferably these arms are soft and flexible to minimize damage to retracted objects. In some instances, these arms resemble and are used as a nonslip tape. Alternatively, parts or whole arms of the retraction device are rigid to provide a supportive aspect. These arms may be configured around a handle.

Abstract: Expandable specula devices and methods are disclosed. In one aspect, a speculum includes inner and outer balloon layers configured to expand circumferentially. The inner and outer balloon layers form a sealed cavity configured to hold a liquid. The speculum further includes an access tube for injecting the liquid into the cavity. The speculum further includes a shape memory alloy layer within the outer balloon layer. The shape memory alloy layer is configured to transition to a first shape when heated above a transition temperature.

Abstract: A surgical access system includes an access device and a distal smoke evacuator. The access device includes a proximal rim configured for positioning on an external side of an opening in tissue, a distal rim configured for positioning on an internal side of an opening in tissue, and a body interconnecting the proximal and distal rims. The body is configured to extend through an opening in tissue and defines a passageway extending therethrough for insertion of a surgical instrument through the opening in tissue into an internal surgical site. The distal smoke evacuator is integrated into or coupled to the distal rim. The distal smoke evacuator includes a tube ring adapted to connect to a source of suction to evacuate smoke circumferentially about an internal side of an opening in tissue.

Abstract: Embodiments of a rotating assistant port device are presented. The assistant port device can be utilized to provide for additional assistant instruments in single port robotic surgery. In some embodiments, the assistant port device can be utilized for skin retraction during single port teleoperated robotic surgery.

Abstract: A method for performing a laparoscopic procedure may include inserting a bag through an opening. The method may also include delivering tissue into the bag, sealing the bag, and inflating the bag to create an artificial pneumoperitoneum that extends the abdomen and provides additional working and viewing space. Further, the method may include carrying out a procedure on the tissue located in the inflated bag.

Abstract: A tissue guard for insertion within an access device disposed within an operating cavity includes a base section defining open proximal and distal ends and a lumen extending therethrough between the open proximal end and the open distal end. The base section includes one or more openings in a side thereof in fluid communication with the lumen. The proximal end of the base section includes an evacuation ring in fluid communication with the lumen. A tissue cuff is configured to encapsulate the base section and is selectively moveable between a distal position for facilitating insertion of the tissue guard within an access device disposed within a tissue opening in an operating cavity and a proximal position wherein the tissue cuff encloses the one or more openings to form an evacuation channel between the one or more openings and the evacuation ring to facilitate fluid evacuation from the operating cavity.

Abstract: A surgical access system facilitates access to a surgical site within a patient's body through an incision in the body. Surgical access systems can have at least one retention member and a fluid transportation member configured to deliver fluid to a surgical site or to remove fluid from a surgical site. In some embodiments, a surgical access device irrigates a surgical site to reduce surgical site infections and removes fluid from the surgical site to increase a physician's visibility into the surgical site.

Abstract: An occlusion device includes a body having a plurality of layers and defining a first diameter. Each layer of the plurality of layers is releasably coupled to a respective inwardly-adjacent layer. An outermost layer of the plurality of layers is removable from the respective inwardly-adjacent layer. Removal of the outermost layer reduces an outer diameter of the body from the first diameter to a second diameter that is less than the first diameter.

Abstract: A diffuser for use with a wound retractor and configured to deliver gases includes an interface tube for connecting to a gases supply and a diffuser interface positioned at a proximal end of the interface tube, the diffuser interface configured for delivering gases received from the gases supply through the interface tube, and the diffuser interface comprising a diffusion mechanism configured to deliver gases in a diffusion direction. A wound retractor with an integrated diffuser is also disclosed. The wound retractor includes an upper ring, a lower ring, a sleeve extending between and connecting the upper ring to the lower ring, and an integrated diffuser interface having a gases inlet and a diffusion mechanism.

Abstract: A vein harvesting device is disclosed. The vein harvesting device includes a handle assembly, an elongated portion extending distally from the handle assembly and defining a longitudinal axis, an end effector, and a retractor. The end effector is disposed adjacent a distal portion of the elongated portion, and includes a first jaw member and a second jaw member. At least one jaw member is movable toward the other jaw member. The retractor is disposed in mechanical cooperation with the elongated portion, and includes a shaft and a pair of legs. The retractor is movable from a non-deployed position where the shaft is aligned with the longitudinal axis, to a deployed position where the shaft is disposed at an angle with respect to the longitudinal axis.

Abstract: An intrauterine device includes an articulating array. The intrauterine device can be operated by articulating the articulating array into an installed position or geometry within the uterus of a patient. Further, the articulating array can be constructed to include an insertion geometry have a smaller cross section than an installation geometry. The articulating array can also be constructed to be housed within a sheath in the intrauterine device. Once the sheath has been inserted into a patient, for example through the patient's cervix, the articulating array can be deployed in its insertion geometry and then articulated into an installed position. The articulating array can include a plurality of expansion chambers. The expansion chambers can be constructed and arranged to take on the installed geometry when expanded. In one embodiment, the purpose of the articulating array is to position a conductive array within the patient's uterus enabling ablation of the uterine lining.

Abstract: A surgical port assembly for use with surgical instruments includes a body including an exterior surface and an interior space defined by an interior surface of the body. The surgical port assembly includes a control interface including a plurality of drive members coupled to the body and controllable to apply a force to a different portion of a shaft of an surgical instrument, when the shaft is disposed within the interior space, to move a distal portion of the surgical instrument to a desired position within a body cavity.

Abstract: A cannula assembly having a retention member and a method of manufacture of the cannula assembly is provided. The cannula assembly includes a cannula and a sleeve disposed around the cannula from a proximal end to a distal end. The sleeve can include a balloon formed by a stretch blow molding process following local heating once advanced over the cannula. Once formed, the balloon can be conditioned to constrict against the cannula. A conditioning aid can be advanced over the balloon when it is still formable to constrict the balloon against the cannula.

Abstract: A soft material retractor includes at least two soft actuators, each actuator having at least one pressurizable interior space, wherein the actuator has a first flexible resting state and a second stiffer pressurized state; and a flexible sheet spanning the actuators such that the actuators can be spaced apart from each other by a distance selected to displace a volume of material of a body cavity. The retractor can be uses for holding open wounds or incisions, with trochars, or to displace anatomical features such as organs within a body cavity.

Abstract: A tissue protector has a body structure having a longitudinal extending thin web. The body structure has an unconstrained first shape configured to form a nerve shield and is configured to shrink about a longitudinal axis to a smaller constrained second shape sized to fit into a lumen of a cannula. Preferably, the second constrained shape is oval or round having a maximum diameter equal or less than an inside diameter of the lumen. The body structure is configured to return to the first shape when the cannula is withdrawn or returned to this shape as the implant advances.

Abstract: Systems and methods for stabilization of a bone structure. A distal curved portion of a delivery tube is directed through an access cannula to a target site within the bone structure. The distal curved portion forms a curved path with respect to the access cannula. A cavity-forming device including an expandable member is adapted to be curved by a support structure in the expandable member. The curve may be provided by tracking the curved path formed by the delivery tube. The support structure may provide trackability and pushability to the expandable member of the cavity-forming device as it is directed into the curved path. Curable material is delivered through the delivery tube into a cavity formed by expanding the expandable member within the bone structure. The cavity is offset relative to the access cannula and/or the distal curved portion of the delivery tube.

Abstract: An intrauterine device includes an articulating array. The intrauterine device can be operated by articulating the articulating array into an installed position or geometry within the uterus of a patient. Further, the articulating array can be constructed to include an insertion geometry have a smaller cross section than an installation geometry. The articulating array can also be constructed to be housed within a sheath in the intrauterine device. Once the sheath has been inserted into a patient, for example through the patient's cervix, the articulating array can be deployed in its insertion geometry and then articulated into an installed position. The articulating array can include a plurality of expansion chambers. The expansion chambers can be constructed and arranged to take on the installed geometry when expanded. In one embodiment, the purpose of the articulating array is to position a conductive array within the patient's uterus enabling ablation of the uterine lining.

Abstract: An access system includes a proximal handle, an overtube coupled to the handle, and an endoscope port extending through handle and overtube sized for receiving an endoscope therethrough. The overtube includes anatomic wall securing system that secures a distal portion of the overtube within a hole in the anatomic wall. The overtube is provided with a shaped distal portion or a controllably shapeable distal portion that aids in directing an endoscope inserted through the port to a particular location within the peritoneal cavity. The access system includes a system for insufflating/deflating the peritoneal space separately from the body cavity accessible via a natural orifice. The access system includes a closure system to cinch closed the hole made in the anatomical wall after the access system has been removed from the hole. Methods are provided for inserting the access system through the anatomical wall to perform intra-abdominal surgery.

Abstract: An instrument access device (500) comprises a distal O-ring (11) for insertion into a wound interior, a proximal member for location externally of a wound opening and a sleeve (12) extending in two layers between the distal O-ring (11) and the proximal member. The proximal member comprises an inner proximal ring member (25) and an outer proximal ring member (24) between which the sleeve (12) is led. A seal housing (300) is mounted to the inner proximal ring member (25). A gelatinous elastomeric seal (302) with a pinhole opening (303) therethrough is received in the housing (300). An instrument may be extended through the seal (302) to access the wound interior through the retracted wound opening in a sealed manner.

Abstract: A cushion member (12, 12?, 12?) for a patient interface device (4) that includes a main body portion (34) including a plurality of chambers (48) and a self-sealing cap portion (36) coupled to the main body portion. The cap portion covers each of the chambers and forms a plurality of membrane members (52), with each membrane member being positioned over and sealing a respective one of the chambers. The cap portion is made of a self-sealing material such that that each of the membrane members is structured to self-seal responsive to having a needle inserted through and pulled out of the membrane member. Also, an apparatus and a method for selectively adjusting the internal pressure of the chambers of such a cushion.

Abstract: The present invention relates to a laparoscopic port unit module in which one end thereof and the other end are placed inside and outside the human body, respectively, through the vaginal inlet, and provides a vaginal endoscopic port unit module comprising: an outer unit of which the end is exposed to the outside of the vaginal inlet and which comprises one or more outer ports allowing the entry of a surgical instrument including an endoscope; an inner unit formed at the inner wall of the vaginal canal so as to be placed at an incision region connected to the abdominal cavity and allowing the surgical instrument entering through the outer port to come in and out of the abdominal cavity; and a runner unit for connecting the outer unit and the inner unit.

Abstract: Apparatus for straightening and flattening a side wall of a body lumen or body cavity so as to provide three dimensional exposure of an abnormality within the body lumen, and simultaneously providing for the stabilization of the working end of an endoscope or surgical tool, the apparatus comprising a deployable hoop expander comprising a structure defining a volume and being configured so as to be transitionable between a reduced cross-sectional configuration for easy insertion into a body lumen and an expanded cross-sectional configuration for engaging, straightening and flattening the side wall of the body lumen, whereby to provide three dimensional exposure of the abnormality within the body lumen, the deployable hoop expander being configured for simultaneously providing for the docking of the end of the endoscope or other instrument so as to stabilize the same for endoscopic viewing and/or therapy.

Abstract: The present application is directed to a colonoscope closure device. The colonoscope closure device includes an inner tubular member that defines an entry way sized to accommodate a colonoscope, an intermediate tubular member surrounding the inner tubular member, and an expandable sealing member at least partially surrounding the intermediate tubular member. The colonoscope closure device serves to prevent the escape of air during a colonoscopy procedure.

Abstract: The present invention relates to a device for creating a working space within a human or animal body. The device comprises an outer wall which is configurable to adopt a non-expanded condition and an expanded condition. When the outer wall is in said expanded condition it defines a hollow body having an inner cavity in communication with an orifice for location adjacent a working site within the body such that, in use, said working site can be visualized and/or accessed via said inner cavity and said orifice.

Abstract: Medical dressings and medical dressing kits that can be used to proved positive pressure wound therapy. The medical dressings include one or more normally-closed valves. The medical dressing kits may further include fittings.

Abstract: An inflatable retractor for use in laparoscopic surgery of a patient's body includes an inflatable element disposed at a distal end of a retractor shaft. The retractor shaft includes a port for receiving insufflating fluid. The inflatable element is designed so that different parts of the inflatable element may be filled to different pressure levels. The inflatable element may include separately inflatable chambers. In this way, the rigidity and shape of the inflatable element is controlled by the surgeon, allowing for flexibility and ease of use.

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 spreader for the atrium of the heart is disclosed, particularly for the exposure of the mitral valve, having a thin-walled axially continuous hollow retractor body, the diameter of which expands from a distal edge to a proximal edge. The wall of the retractor body is made of an elastically deformable flat material, preferably of a shape memory metal. At the proximal edge of the retractor body, a receptacle is arranged, into which a fixing rod for positioning and fixing the retractor body can be inserted.

Abstract: The present invention provides a device and method for use in laparoscopic surgery, in particular hand assisted laparoscopic surgery, the device comprising a flexible body having a sidewall of double wall construction which defines an inflatable cavity enabling the body to be inflated from a collapsed state into an expanded state, in order to distend a surgical cavity to provide an enclosure within which a surgical procedure may be performed, the body having an opened to allow communication between the enclosure defined by the body when in the expanded state and tissue/organs surrounding the body, in particular directly adjacent, in use, the open end of body.

Abstract: A device for creating endoscopic operating space includes an external cannula, an internal cannula disposed in the external cannula, and an expandable retractor disposed at a distal end of the device and cooperable with the external cannula and the internal cannula. The expandable retractor is displaceable between an unexpanded position and an expanded position. An actuator is cooperable with the expandable retractor to displace the expandable retractor between the unexpanded position and the expanded position.

Abstract: An access assembly for insertion through an opening in tissue is provided. The access assembly includes a flexible outer sleeve having an upper rim formed on a proximal end, a lower rim formed on a distal end and defining a longitudinal opening extending therebetween. The lower rim may define an inflatable space that in a deflated state facilitates insertion of the lower rim through tissue and in an inflated state assists in retaining the access assembly in place relative to the tissue. The access assembly further includes an inflatable member secured within the longitudinal opening of the outer sleeve. The inflatable member includes a plurality of inflatable lobes configured to selectively receive at least one surgical device therebetween in a sealing manner.

Abstract: Off-axis visualization systems are described herein which facilitate the deployment, visualization, and retraction of an imaging element from a catheter. Such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration as well as an imaging element, such as a CCD or CMOS imager, which may be deployed from a low profile configuration into a position which is off-axis relative to a longitudinal axis of the deployment catheter and/or imaging hood.

Abstract: A medical device includes an elongate member and an expandable member. The elongate member has an inner surface and an outer surface. The inner surface defines a lumen. The elongate member has a collapsed configuration and an expanded configuration and is biased to its collapsed configuration. The expandable member is coupled to the outer surface of the elongate member. The expandable member is configured to move the elongate member from its collapsed configuration to its expanded configuration.

Abstract: Tissue visualization devices and variations thereof are described herein where such devices may utilize a variety of methods for facilitating clearing of the device of opaque bodily fluids and sealing between the device and the underlying tissue surface. Additionally, methods and devices for enhancing navigation of the device through a patient body are also described.

Abstract: Exemplary embodiments of devices and method for affecting at least one anatomical tissue can be provided. A configuration can be provided that includes a structure which is expandable (i) having and/or (ii) forming at least one opening or a working space through which the anatomical tissue(s) is placed in the structure. For example, the structure, prior to being expanding, can have at least one partially rigid portion. In addition, or as an alternative, upon a partial or complete expansion thereof, the structure can be controllable to have a plurality of shapes. Further, the structure can be controllable to provide the working space with multiple shapes and/or multiple sizes.

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: Everting balloon systems and methods for using the same are disclosed herein. The systems can be configured to access and dilate body lumen and cavities. For example, the systems can be used to dilate the cervix and access the uterine cavity. The systems can also be used to occlude the cervix. The systems can also be used to occlude the urethra.

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: An improved access assembly is provided. The access assembly includes an inflatable port and an inflation cannula operably connected to the inflatable port to provide inflation fluid to the inflatable port. The inflatable port may be tapered in a first configuration to facilitate insertion through tissue. The inflation port defines a substantially hour-glass shape when in a second configuration to create a seal within an opening in the tissue.

Abstract: A surgical device for displacement of organs within a body cavity for providing at least visual access to a selected site includes an expandable bladder, wherein the elasticity of the bladder varies across the surface of the bladder, said variation in elasticity selected to provide a predetermined, non-spherical shape when expanded; and a valve on the proximal end on the inflatable bladder for introduction of a pressurizing gas into the soft bladder.

Abstract: An access assembly includes a body portion defining a longitudinal axis and having at least one lumen defined therethrough. The at least one lumen is configured for passage of a surgical instrument therethrough. An outer sleeve is disposed about the body portion to define a chamber therebetween. The chamber is selectively inflatable from a deflated condition, for positioning the access assembly within an opening in tissue, and an inflated condition, for retaining the access assembly within the opening in tissue in sealing relation therewith.