Abstract: Systems and methods of cannulating a body orifice such as a bladder are disclosed. A cystoscopy catheter can include a proximal end, a distal end having at least one exit port, and a flexible elongate tubular body therebetween; an inflatable balloon near the distal end of the catheter, the balloon transformable from an unexpanded and an expanded configuration; a first proximal port for fluid inflow; a second proximal port for fluid outflow; a third proximal port for balloon inflation, in fluid connection with the balloon; and a fourth proximal port for insertion of a diagnostic and/or therapeutic instrument such as a cystoscope therethrough, wherein the first, second, and fourth proximal ports are fluidly connected to a common central lumen extending through the elongate tubular body to the exit port on the distal end.

Abstract: An access assembly is provided. The access assembly includes a tubular member having a proximal end and a distal end, the tubular member including a threading extending at least a portion of an internal length of the tubular member. The access assembly further 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 first ring and the second ring are expandable rings.

Abstract: An improved access assembly is provided. The access assembly includes a tubular member having a proximal end and a distal end, the tubular member including at least one section extending at least a portion of a length therein. The access assembly further includes a first ring including a plurality of first segments and secured at the proximal end of the tubular member and a second ring including a plurality of second segments and secured at the distal end of the tubular member. At least two segments of the first plurality of segments are independently expandable. At least two sections of the plurality of sections are independently expandable.

Abstract: A tissue retractor device is provided. The tissue retractor device includes a handle attached to an inflatable rake-shaped tissue retractor head.

Abstract: The present invention provides various systems, a kit, and a method for accessing, sampling within, and visualization of areas within the mediastinal cavity for assisting a surgeon in performing a mediastinoscopy procedure. The access system includes one or more preferably toroidal balloons that can be expanded to dilate and protect the inner walls of a bodily conduit. Instruments pass through hollow spaces within the expanded toroidal balloons. The proximally positioned balloons are expanded first and the unexpanded balloons to be positioned distally are passed through them and subsequently expanded. The sampling system includes an instrument with a rounded head having two or more jaws and a slit therein at the distal end of an elongated tubular body. The visualization system includes a 360° camera that can be positioned from proximal to distal a target site and can also do a U-turn about its axis of extension.

Abstract: A cannula assembly includes a cannula adapted for insertion within tissue and having a longitudinal passage extending along a longitudinal axis of the cannula for passage of a surgical instrument. An expandable member is mounted to the cannula and longitudinally spaced from a distal end of the cannula. The expandable member is adapted to expand, upon introduction of fluids therein, in a radially outward direction relative to the longitudinal axis whereby the expandable member engages the tissue to facilitate anchoring of the cannula relative to the tissue, and also to expand in a radially inward direction relative to the longitudinal axis and within the longitudinal passage to engage the surgical instrument positioned within the longitudinal passage to facilitate formation of a seal about the surgical instrument.

Abstract: A surgical access port that includes a cylindrical member having a proximal end and a distal end and defining a longitudinal axis; at least two lumen extending through the cylindrical member along the longitudinal axis; at least one cavity defined in the cylindrical member and positioned radially within the at least two lumen; and a source of inflation fluid coupled to the at least one cavity, the source of inflation configured to permit selectable inflation of the at least one cavity, whereby inflation of the at least one cavity increases the radial distance between the at least two lumen.

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 be pre-formed by a stretch blow molding process then advanced over the cannula. The sleeve includes an inflatable balloon and an annular ring distal the inflatable balloon. The cannula includes an annular recess. The annular ring is sized to have an interference fit with the annular recess.

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: The invention is a simple surgical drape system for female urology procedures that provides sealed isolation of top versus bottom sides of the drape and only exposes the female urethral meatus area for the procedure. It is achieved by a combination of a drape with a fenestration, a labia spreader where the drape fenestration is attached to provide a seal, and local illumination of the meatus area integrated in the drape system for safer and easier instrument insertion. The labia spreader also frees up one of the operator's hands and provides protection for false catherization. The labia spreader can have a vaginal inserted portion for precise position fixation of the drape fenestration to the female. The drape system also provides improved liquid management made possible by the unique combination of drape and labia spreader acting as seal between the two sides of the drape.

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 surgical access assembly includes an access port, a seal anchor and a sealing adapter. The access port includes proximal and distal rings and a sleeve defining a passage therethrough. The sleeve extends between the proximal and distal rings. The seal anchor is adapted to be at least partially disposed in the access port. The sealing adapter includes proximal and distal end portions. The distal end portion is configured and dimensioned to engage the seal anchor in a sealing relation therewith. The proximal end portion is configured and dimensioned to engage a least a portion of the distal ring of the access port in a sealing relation therewith, wherein the sealing adapter is transitionable between a first state in which the sealing adapter has a first diameter and a second state in which the sealing adapter has a second diameter. The second diameter is larger than the first diameter.

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: Disclosed is an expandable transluminal sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion of at least a part of the distal end of the sheath to a second, enlarged cross-sectional configuration. The distal end of the sheath is maintained in the first, low cross-sectional configuration and expanded using a radial dilatation device. In an exemplary application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as ureteroscopy or stone removal.

Abstract: An assembly for accessing a body cavity during a surgical procedure. The access assembly includes a compressible body having proximal and distal ends and a substantially hourglass-shaped central portion extending therebetween and includes first and second lumen extending therethrough. The access assembly further includes a translating mechanism operably positioned within the compressible body between the first and second lumen for selectively translating the first and second lumen relative to each other.

Abstract: A device for creating an operative space within a body lumen for the performance of a medical procedure, including a pressurizable, expandable balloon element insertable into the body lumen. The balloon element includes an interior space for receiving an inflation fluid. The device further includes an ingress valve coupled with the balloon element and insertable therewith into the body lumen. The ingress valve is capable of being opened to allow the interior space to be filled with the inflation fluid and closed to retain the inflation fluid in the interior space. The device may also include an egress valve coupled with the balloon element and insertable therewith into the body lumen. The egress valve is closed when the interior space is filled with the inflation fluid and is capable of being opened to allow the inflation fluid to vent from the interior space.

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: 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: A single port entry surgical instrument has an elongated structure with lumens through which surgical tools and an image capturing device may be inserted and controllably extended out of its distal end for performing a medical procedure, a tubular-shaped balloon disposed around the elongated structure, and an expandable retractor disposed around the balloon so that when the balloon is inflated, the retractor expands and locks in an expanded configuration to retract extraneous tissue. The port entry may be secured using the expandable retractor or sealed using another inflatable balloon disposed around the proximal end of the elongated structure and centered in the port entry.

Abstract: A surgical device for application in a treatment performed on the human or animal body with the aim of providing access to a surgical site in the body by exerting a force, upon expansion of the device at the location of the surgical site, on the organs and/or tissues at the surgical site, e.g. for mobilizing and/or supporting organs and/or tissues, the surgical device including an expansion structure, at least one fluid reservoir, and a conduit for conveying fluid from the reservoir to the expansion structure.

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 interconnectable port is provided. The interconnectable port is adapted to be at least partially placed in an incision in a patient's body. The interconnectable port comprises a first and second port adapted be interconnected to form the interconnectable port, wherein the second port is disconnectable from the first port, wherein the first port is connected to a first portion of a flexible wall, and the second port is connected to a second portion of the flexible wall, and wherein the flexible wall is adapted to form a chamber.

Abstract: A medical device for providing direct port-like endoscopic access to the urinary bladder, or other orifice, of a patient and a method of utilizing and inserting the medical device. The medical device can include a hollow tube with a main channel and a separate channel, a cap with an inflation port and a hollow flexible stem fluidly connecting the inflation port and the separate channel. A method can include inserting a needle above the pubic symphysis of a mammal, threading a guide wire through the needle, removing the needle and inserting the medical device. The method can optionally include determining measuring the depth between the skin surface of the patient's suprapubic region and urinary bladder.

Abstract: The disclosure provides a dilator with a tip that has a bump, an assembly comprising the dilator and a sheath, and methods of use, where the bump on the tip is configured to reduce or minimize damage to the sheath, and to prevent trauma to a patient during insertion or removal.

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: The invention provides an applicator for forming a hole in a wall of a hollow organ and for connecting a hemostatic connection assembly to the hollow organ, wherein, when the hole is formed in the wall of the hollow organ, a first fluid seal exists between the hemostatic connection assembly and the wall of the hollow organ and a second fluid seal exists between the hemostatic connection assembly and the applicator, thereby minimizing fluid loss from the hollow organ.

Abstract: An adjustable length sheath and a method for adjusting the length of a sheath is disclosed. The adjustable length sheath is primarily designed for uretral access, and for the insertion of a dilator or other medical equipment. The adjustable length sheath has and end cap that is removably attachable, and a proximal end with circumferential grooves cut lateral to the axis of said sheath such that it is possible to snap off a portion of the proximal end to adjust the length of the sheath. The proximal end may be made of a different material that has a lower degree of flexibility than the main body of the sheath to allow the end to be more easily broken. The end cap has a lip to prevent the sheath from sliding through said end cap.

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 surgical instrument stabilizer includes a body having a first material and a second material. The first material includes a wall defining an inner surface and an outer surface. The inner surface defines a first cavity configured for disposal of the second material. The outer surface defines an outer portion, a lateral portion and an inner portion. At least a portion of the lateral portion is configured to flexibly conform to a patient body surface. The inner portion defines a second cavity for disposal of an instrument and is configured to engage an outer surface of the instrument. Methods of use are disclosed.

Abstract: An assembly for accessing a body cavity during a surgical procedure. The access assembly includes a compressible body having proximal and distal ends and a substantially hourglass-shaped central portion extending therebetween and includes first and second lumen extending therethrough. The access assembly further includes a translating mechanism operably positioned within the compressible body between the first and second lumen for selectively translating the first and second lumen relative to each other.

Abstract: An introducer and method provides a surgical tool with a pathway through tissue to a surgical site, wherein the surgical tool includes at least one surgical instrument. The introducer comprises a flexible sheath having a distal portion including a distal end and is arranged for receiving the surgical tool. A tissue separation tip at the distal portion of the sheath advances the sheath into the tissue towards the surgical site. The tissue separation tip is arranged to form a tissue gap and provide the at least one surgical instrument access to the tissue gap for performing a medical procedure consonant with the formation of the tissue gap or the performance of work at the surgical site.

Abstract: A surgical method, system, kit, and various devices are provided for use in, among other things, vaginal entry during a natural orifice translumenal endoscopic surgical procedure. A system and/or method provide for the rapid creation of a conduit and/or multiple ports in a natural orifice, such as a patient's vagina, while accommodating anatomical variation to reduce the need to excise additional tissue from the patient.

Abstract: The robotic mechanism may be used to position a tissue retractor assembly relative to body tissue. Once the tissue retractor assembly has been positioned relative to the body tissue by the robotic mechanism, the robotic mechanism effects operation of the tissue retractor assembly from a contracted condition to an expanded condition to move body tissue. This movement of body tissue may advantageously create a space for the performance of a surgical procedure by the robotic mechanism. Embodiments may facilitate the insertion of one or more surgical instruments through a cannula to a working space created by expansion of a balloon or bladder from the contracted condition to the expanded condition. As the bladder or balloon expands, portions of body tissue are deflected under the influence of force applied to the body tissue by the bladder or balloon.

Abstract: A single port entry surgical instrument has an elongated structure with lumens through which surgical tools and an image capturing device may be inserted and controllably extended out of its distal end for performing a medical procedure, a tubular-shaped balloon disposed around the elongated structure, and an expandable retractor disposed around the balloon so that when the balloon is inflated, the retractor expands and locks in an expanded configuration to retract extraneous tissue. The port entry may be secured using the expandable retractor or sealed using another inflatable balloon disposed around the proximal end of the elongated structure and centered in the port entry.

Abstract: A flexible port seal is provided for use in single incision surgery and includes an outer seal defining a bore extending from a proximal end of the outer seal to a distal end of the outer seal. A support plate is located within the bore of the outer seal and one or more throughports are attached to the support plate for receipt of a surgical instrument. The throughports form a fluid tight seal with cannulas and/or surgical instruments inserted through the throughports. The flexible port seal is formed of a compressible or flexible material to facilitate insertion through the single incision in the patient and allow for movement of the surgical instruments relative to the seal to independently orient each of the surgical instruments.

Abstract: A surgical access apparatus adaptable to permit the sealed insertion of either the surgeon's hand and/or surgical instruments during laparoscopic and endoscopic surgical procedures includes an access housing defining a longitudinal axis and having a first internal passageway configured and dimensioned to permit passage of at least one of a hand and an arm of a surgeon, and a base mountable to the access housing. The base may include a liner member positionable within an incision of a patient to at least partially line the incision. The liner member may have a first end for positioning within the body and a second end for positioning external of the body. A displacement member may be operatively connected to the access housing and to the second end of the liner member.

Abstract: Laparoscopic instruments and trocars are provided for performing laparoscopic procedures entirely through the umbilicus. A generally C-shaped trocar provides increased work space between the hands of the surgeon as well as S-shaped laparoscopic instruments placed through the trocar when laparoscopic instrument-trocar units are placed through the umbilicus. In order to facilitate retraction of intra-abdominal structures during a laparoscopic procedure, an angulated needle and thread with either one-or two sharp ends is provided. Alternatively, an inflatable unit having at least one generally C-shaped trocar incorporated within the unit's walls can be placed through the umbilicus following a single incision. Generally S-shaped laparoscopic instruments may be placed through the generally C-shaped trocars to facilitate access to intra-abdominal structures.

Abstract: A single port entry surgical instrument has an elongated structure with lumens through which surgical tools and an image capturing device may be inserted and controllably extended out of its distal end for performing a medical procedure, a tubular-shaped balloon disposed around the elongated structure, and an expandable retractor disposed around the balloon so that when the balloon is inflated, the retractor expands and locks in an expanded configuration to retract extraneous tissue. The port entry may be secured using the expandable retractor or sealed using another inflatable balloon disposed around the proximal end of the elongated structure and centered in the port entry.

Abstract: A method for providing an endoscopic port includes inserting a distal portion of an expandable member into soft tissue in a patient's body. The distal portion of the expandable member is inflated to form a passageway in the soft tissue. A rigid tube member is delivered into the passageway formed by the expandable member through the inside of the inflatable member. A port is established between a proximal opening in the rigid tube member and a distal opening in the rigid tube member.

Abstract: A wound protection system is disclosed. The wound protection system includes a wound protector and a seal anchor member that are engageable with one another and insertable into a bodily opening. The wound protection system protects the bodily opening from contamination while facilitating access to underlying bodily structures within the surgical site.

Abstract: For minimally invasive surgical applications, an expandable surgical retractor is inserted in a surgical corridor and expanded to a desired size and shape. Cooling allows the retractor to maintain the expanded characteristic. Following surgery, the retractor can be removed in a manner that minimizes bleeding and tissue damage.

Abstract: Instruments, systems, implants, and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, and a mucosal resection device. A submucosal implant device for diagnosing and treating disorders of the body may be implanted. A passive submucosal implant device may take the form of a drug delivery depot in which a therapeutic agent within the depot elutes from the depot according to a predetermined elution profile. An active submucosal implant device may take the form of a drug delivery device that incorporates a self-contained diagnostic system to determine the appropriate delivery time and dosage of a therapeutic agent to be administered.

Abstract: A device for creating an operative space within a body lumen for the performance of a medical procedure, including a pressurizable, expandable balloon element insertable into the body lumen. The balloon element includes an interior space for receiving an inflation fluid. The device further includes an ingress valve coupled with the balloon element and insertable therewith into the body lumen. The ingress valve is capable of being opened to allow the interior space to be filled with the inflation fluid and closed to retain the inflation fluid in the interior space. The device may also include an egress valve coupled with the balloon element and insertable therewith into the body lumen. The egress valve is closed when the interior space is filled with the inflation fluid and is capable of being opened to allow the inflation fluid to vent from the interior space.

Abstract: Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.

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 apparatus includes an access member defining a longitudinal axis and having a longitudinal passageway for reception and passage of a surgical object and an access housing mountable to the access member. The access housing includes a diaphragm mounted thereto. The diaphragm is adapted for rotational movement about the longitudinal axis relative to the access housing. The diaphragm defines at least one internal pocket and has a seal assembly disposed within the internal pocket. The seal assembly has an interface seal member adapted for establishing a fluid tight seal about the surgical object. The seal assembly is adapted for selective movement within the pocket about multiple axes in response to manipulation of the surgical object.

Abstract: Disclosed is a retractor system for laparoscopic surgery. According to one aspect of the present invention, provided is a retractor system for laparoscopic surgery comprising: a sleeve portion for forming a passage at a retractor; an upper guide portion in which an upper circular elastic ring is built, formed at the upper portion of the sleeve portion; a lower guide portion comprising a circular tube in which a lower circular elastic ring is built, formed at the lower portion of the sleeve portion; a tube pressure controller for injecting air or water into the circular tube or discharging the air or water of the circular tube to contract or extend the circular tube, connected to the circular tube through a pipe; and an air injector or a CO2 injector in which one end is mounted to the adjacent area of the sleeve portion, the extended pipe passes through the inside of the lower guide portion along the outer wall of the sleeve portion, and the other end is mounted to the lower portion of the lower guide portion.

Abstract: Described are various embodiments of surgical procedure systems, devices, tools, and methods, useful for treating pelvic conditions such as vaginal prolapse and other conditions caused by muscle and ligament weakness, the devices and tools being useful for accessing a posterior region of pelvic anatomy, and related methods. Such devices can include retractors, introducers, and other devices for accessing desired areas of a patient's anatomy.

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 visualised and/or accessed via said inner cavity and said orifice.

Abstract: A surgical portal and introducer assembly includes an introducer and a portal member positionable within a longitudinal passageway of the introducer. The portal member is adapted for positioning within a tissue tract and has at least one longitudinal port for passage of a surgical object. The portal member comprises a compressible material and is adapted to transition between a first expanded condition and a second compressed condition. The assembly may include an expandable restraining member that may be disposed within the longitudinal passageway. The restraining member is adapted to expand and compress the portal member to cause the portal member to transition to the compressed condition.