Abstract: A retractor instrument for minimally invasive surgery may include a housing with a longitudinal axis, an arm extending from a distal end of the housing, and an actuation mechanism, wherein actuation of the actuation mechanism causes radial expansion of the arm relative to the longitudinal axis. The device may be adapted for use with an endoscope or arthroscope or may be an integral part of one such scope. A method of performing surgery in constrained areas within the body is also included and may be applicable to the carpal tunnel of a wrist and palm or the cubital tunnel of an elbow.

Abstract: A surgical device for providing or enlarging an operative space is described. The surgical device can include a shell having inflatable ribs and generally planar non-inflatable segments spaced apart by the ribs. When inflated, the ribs support the planar segments of the shell to provide an expansion space above a tissue layer. Once the shell is in the inflated configuration, a vacuum can be provided through the shell to lift the tissue layer toward the shell.

Abstract: A surgical method for providing or enlarging an operative space is described. The surgical method can employ a shell having inflatable ribs and generally planar non-inflatable segments spaced apart by the ribs. When inflated, the ribs support the planar segments of the shell to provide an expansion space above a tissue layer. Once the shell is in the inflated configuration, a vacuum can be provided through the shell to lift the tissue layer toward the shell.

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 a fabric and to move the fabric to relocate the tissue to one or more convenient locations during the procedure. The flexible nature of the fabric can allow the fabric to be moveable between an open position, in which the fabric can support tissue, and a closed position, in which the fabric can be folded, rolled, or otherwise compressed in size and fit through a port, such as a trocar or an incision in a tissue wall. Furthermore, the position of the fabric and thus the tissue held in the fabric can be adjusted and readjusted by pushing or pulling one or more grasping elements coupled to the fabric.

Abstract: Balloon cannula systems may be used for accessing and visualizing the spine and related methods of treatment, including a forward-looking balloon system for creating a working space and the balloon system having atraumatic dissection capability to allow visualization in spine. The devices and methods described may be used, for example, to perform annulus repair, herniated disc excision, and denervation of neurological tissue; to dispense pharmacological agents and/or cell or tissue therapy agents; to diagnose disc degeneration and bony degeneration, spinal stenosis, and nucleus decompression, and to perform disc augmentation.

Abstract: A laparoscopic disk assembly for a Hand Assisted Laparoscopic Surgery (HALS) procedure includes an exteriorly visible laparoscopic disk (seal cap) attached to a retractor skirt. The laparoscopic disk provides an adjustable exterior opening. A downward annular surface is supported by an attached flexible or resilient (“soft) support member that in turn forms an annular contact upon a patient's abdomen wall surrounding an incision to form a sealing connection, to facilitate improved manipulation or degrees of freedom through the laparoscopic disk without loss of insufflation pressure, to minimize, if not eliminate, bruising, to prevent rotation movement of a retractor skirt in the incision, and to reduce fatigue. Versions include a resilient pad, a resilient skirt that adheres to the patient's skin, a skirt with horizontal pleats, and a toroidal bladder that comfortably depresses into the skin.

Abstract: The present invention is concerned with a device and method for use in surgery, in particular hand assisted laparascopic surgery, the device comprising a flexible sleeve about one end of which is located a plurality of inflatable balloons, such that the sleeve may be located about a surgeon's forearm, with the balloons thus circumscribing the surgeon's wrist, the balloons being inflated once the surgeon's hand and wrist have been inserted into a surgical cavity, in order to distend the surgical cavity, thereby creating a space within which the surgical procedure may be performed.

Abstract: The present invention provides an inflatable retractor for providing access to a surgical site, such as a patient's spine, during a surgical process. When used in spinal surgery, the inflatable retractor allows a surgeon to operate on one or more spinal levels. The inflatable retractor includes an inflatable body defining a central cavity, wherein the body is flaccid in a non-inflated state and increasingly rigid in an inflated state. The inflatable retractor is inserted into an incision in a deflated, or partially inflated, state and then inflated once the retractor is in position. The inflation of the retractor retracts skin and muscle from the surgical site, allowing adequate visualization of the surgical site and forms a passage providing access for implants and surgical instruments to pass through the retractor and into the surgical site.

Abstract: An active cannula which does more than merely maintain a passage is usable to create and/or enlarge a passage, to position a scope or instrument, to move or locate tissue, etc. The cannula can vary in size or shape as needed, intraoperatively. Because a cannula of the present invention is expandable, the surgeon can make a relatively small incision, stretch the tissue with the expandable cannula, contract the cannula and remove it, allowing the skin to come back to its unstretched condition. Thus, a smaller incision can be made to fit the same size instrument. The cannulas can assume such a non-circular shape, to fit into a natural skin opening and cause less trauma. The devices can be used to seal off a space, expand an existing space or a potential space for working or visualization, move tissue (for example, to stretch an incision), or protect tissue.

Abstract: A surgical tool or applier facilitates laparoscopic or endoscopic implantation through a single bodily tissue lumen of an anastomotic ring device for forming a hollow rivet type of attachment between tissue lumens. In addition to forming a puncture between apposite tissue walls at the anastomosis site, the applier assists or wholly actuates the anastomotic ring device and is retracted to deploy the actuated ring device. Illumination incorporated into a distal portion of a cannula enables confirmation of deployment.

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: There are disclosed various embodiments of a balloon dissector and balloon tip cannula assembly which are provided to facilitate forming an anatomical space within the body, such as, for example, an anatomical space in the abdominal cavity or extraperitoneal space for facilitating hernia repair surgeries. The balloon dissector and balloon tip cannula assembly generally includes a balloon tip cannula assembly for anchoring the device to the abdominal wall and a balloon dissector assembly having a dissection balloon at a distal end for separating apart tissue layers and forming an anatomical space. Various structures are provided to connect the balloon dissector assembly to the balloon tip cannula assembly. Obturators associated with the balloon dissector assembly and the balloon tip cannula assembly may also be provided.

Abstract: An apparatus for creating an anatomic space in tissue in a body comprises an introducer and a sheath. The tubular sheath may surround the introducer, and may have a weakened region along its longitudinal axis. A handle may be provided on the sheath. The handle may be adapted to be pulled proximally to separate the weakened region and allow the sheath to be removed from the introducer. The sheath may be secured to the introducer via detents or latches on the handle.

Abstract: A surgical retractor is configured to provide surgical access in thoracic surgery, for example through an intercostal incision. The surgical retractor includes at least one inflated or inflatable member to cushion the ribs and surrounding tissue from injury or trauma. In one embodiment, the inflatable member is configured as an inflatable ring with a concave outer surface for engaging and spreading apart two adjacent ribs when the ring is inflated. In another embodiment, the inflatable ring can be combined with a substantially rigid inner ring for supporting and rigidifying the retractor. In yet another embodiment, a plurality of substantially rigid retractor blades is mounted on a spreading track or the like. One or more inflatable members or an inflatable ring are used to cushion the tissue from the rigid retractor blades.

Abstract: A minimally-invasive anastomosis system includes a suspension that connects an anastomosis tool to a stabilizer. The stabilizer may be rigidly connected to a retractor or other structure that is fixed relative to the patient. The suspension facilitates anastomosis of a graft vessel to a target vessel in that tissue, by allowing the anastomosis tool to move relative to the stabilizer so that it can move along with the remaining motion of the heart tissue.

Abstract: A balloon device useful for dissecting tissue or retracting tissue for the purpose of providing access for laparoscopic surgery, the device including a balloon which inflates to a shape specially suitable for the surgical procedure and the anatomical region of deployment. The present device, when configured with a tapered dissection balloon, is particularly useful for subfascial endoscopic perforator surgical procedures.

Abstract: A fluid operated retractor for use in surgery. The retractor has a portion that is expandable upon the introduction of fluid under pressure. The expandable portion is made of a material strong enough, and is inflated to enough pressure, to spread adjoining tissues within the body. The retractor is especially useful in fiber optic surgery because it can be inserted percutaneously through a small opening then expanded to a much larger dimension when in the desired location, to retract tissue from within. The retractor may be used to spread a joint, such as a knee joint or shoulder joint, or may be used to separate tissue planes generally, to improve visualization and create a working space for the surgeon.

Abstract: Laparoscopic apparatus and method for insertion into a space or potential space in a body comprising an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon.

Abstract: A wound retractor comprises a retracting member for insertion into a wound opening and a proximal member for location member for location externally of a wound opening. The proximal member is movable relative to the retracing member to shorten the axial extent of the retracting member to laterally retract a wound opening. The retracted wound opening is retracted by a seal which is integral with the retractor.

Abstract: An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation.

Abstract: The present invention is directed to a positioning apparatus for use during a surgical procedure, which may involve the repair of a vessel. The positioning apparatus in accordance with an embodiment of the present invention may comprise a delivery assembly and a distensible member having at least one expansible member. The expansible member has a distal end and a proximal end, wherein the proximal end is interposed with the delivery assembly. The positioning apparatus, by way of the at least one expansible member, is used to position an object within a vessel that may or may not be aneurismal.

Abstract: The present invention relates to an illuminated airway product that will allow visualization of the airway of a patient during intubation. The illuminated airway product includes a light source such as an LED disposed at its distal end. The LED shines axially, radially, or in both directions from the airway intubation device. The airway product includes an on-board voltage source. Hence, no additional or external voltage sources or components are necessary to light the device. The airway device may further include one or more lumens or tubes for delivering air, suctioning debris or fluids, delivering medicine, radio-opaqueness, etc. An inflatable cuff may be associated with the endotracheal tube such that collateral flow of air is prevented. An inflation lumen or tube is fluidly coupled to the inflatable cuff. The shape of the endotracheal tube may be adjusted either by use of a stylet or suction trocar made out of a malleable material such as aluminum or by inclusion of a malleable wire within the tube.

Abstract: A device for retracting edges of an incision in a surface to form an opening including: a flexible, tubular skirt having an upper end, a lower end, and a channel therebetween; a ring connected to the lower end of the skirt for maintaining the lower end in an open configuration and defining an exit opening to the channel; and an inflatable collar connected to the skirt and surrounding the upper end. The ring is designed to fit through the incision and remain under the surface when it is oriented parallel to surface. The collar, when inflated, maintains the upper end in an open configuration and defines an entry opening to the channel. During use, the ring is inserted through the incision and the collar is inflated while remaining outside of the incision, thereby drawing the skirt against the edges of the incision and retracting the edges of the incision to form the opening.

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. After the anatomic space has been created, the device and laparoscope are withdrawn through the incision. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon, forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.

Abstract: The present invention provides balloon dissection apparatus and methods of use in which an elongate balloon is utilized to dissect along a region that follows a naturally existing path alongside a vessel or structure, such as an artery, a vein, a lymphatic, the trachea, the esophagus or even a nerve bundle.

Abstract: An apparatus for creating an anatomic space in tissue in a body includes an introducer and a sheath. The tubular sheath may surround the introducer, and may have a weakened region along its longitudinal axis. A handle may be provided on the sheath. The handle may be adapted to be pulled proximally to separate the weakened region and allow the sheath to be removed from the introducer. The sheath may be secured to the introducer via detents or latches on the handle.

Abstract: An access port device is provided which enables hand access to a patient's body cavity while retaining pneumoperitoneum by minimizing gas leakage through the access port device. In one embodiment, the access port device includes first and second sleeves forming an inflatable chamber and a third sleeve mounted within the second sleeve including an elastic band for sealingly engaging a hand or wrist. The access port device may also include an exit opening seal for positioning within the patient's body cavity and a second sleeve retraction prevention device for preventing inadvertent movement of the second sleeve outwardly from the patient's body cavity through the incision. In another embodiment, an access port device provided which includes an inner annular sealing device and a non-adhesive outer annular sealing device for creating a non-adhesive seal against the outer surface of a patient. An access component forming an inflatable chamber and including an integral sleeved glove may also be provided.

Abstract: Systems and methods treat fractured or diseased bone by deploying more than a single therapeutic tool into the bone. In one arrangement, the systems and methods deploy an expandable body in association with a bone cement nozzle into the bone, such that both occupy the bone interior at the same time. In another arrangement, the systems and methods deploy multiple expandable bodies, which occupy the bone interior volume simultaneously. Expansion of the bodies form cavity or cavities in cancellous bone in the interior bone volume.

Abstract: An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation.

Abstract: A balloon device useful for dissecting tissue or retracting tissue for the purpose of providing access for laparoscopic surgery, the device comprising a balloon which inflates to a shape specially suitable for the surgical procedure and the anatomical region of deployment. The present device, when configured with a tapered dissection balloon, is particularly useful for subfascial endoscopic perforator surgical procedures.

Abstract: Tissue is retracted from a bone during spinal and other procedures by inserting an elongate balloon into a cannula, and guiding the cannula into position along between the tissue and the bone surface. The cannula is then partially withdrawn, and the balloon is inflated to retract the tissues. The method can be performed percutaneously, with minimal tissue damage.

Abstract: A hand access device includes a housing defining a longitudinal axis and having a passageway therethrough dimensioned to permit passage of a surgeon's arm and a fabric seal mounted within the opening and being dimensioned to form a substantial sealing relation with the surgeon's arm. The fabric seal is elongated extending along the longitudinal axis and may define a general hour glass configuration. A pair of flexible bands may be mounted about the fabric seal. The flexible bands are adapted to engage an outer surface of the seal to bias the fabric seal to a closed position thereof.

Abstract: A minimally invasive device for performing direct cardiac massage including an inflatable bladder mounted on a rigid inflation tube. The rigid inflation tube is used to push the bladder into the sternocostal space through an incision in the upper abdomen just below the xiphoid process. A tear-away insertion sleeve is provided over the balloon, so that the device may easily be inserted in to the body. The insertion sleeve includes various features that assist in placement of the device and removal of the sleeve. After insertion into the sternocostal space and removal of the insertion sleeve, the bladder is repeatedly inflated and deflated to massage the heart and provide blood flow.

Abstract: A endoscopic device for use in a laparoscopic surgical procedure such as a cystectomy is disclosed. An intact organ such as an ovary is encapsulated partially or completely with the endoscopic device while the organ remains attached to the body. By inserting instruments into the endoscopic device, a surgical procedure is then performed within the endoscopic device, for example, a cyst may be removed from an ovary. After cyst removal, the endoscopic device is irrigated to remove leakage before withdrawal of the cyst within the endoscopic device.

Abstract: An apparatus and method for shielding non-target tissues and organs during thermotherapy, brachytherapy or other treatment of a diseased target tissue. The apparatus includes a catheter shaft having input and output lumens and at least one inflatable balloon. A plurality of input lumens within the catheter shaft allows the passage of liquid or gas through an input port and into the interior of the balloon thereby inflating the balloon. The gas or liquid can then be cycled through the inflated balloon through an output port and output lumen and out of the catheter shaft. Temperature sensors or other sensors may be attached to the balloon or catheter to monitor temperature or other conditions at the treatment site. The catheter is positioned between the target tissue or organ and sensitive non-target tissues in proximity to the target tissue and inflated causing a physical separation of tissues as well as a physical shield.

Abstract: The present invention provides balloon dissection apparatus and methods of use in which an elongate balloon is utilized to dissect along a region that follows a naturally existing path alongside a vessel or structure, such as au artery, a vein, a lymphatic vessel, the trachea, the esophagus, or even a nerve bundle.

Abstract: Laparoscopic apparatus and method for insertion into a space or potential space in a body including an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon.

Abstract: Laparoscopic apparatus and method for insertion into a space or potential space in a body comprising an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon.

Abstract: A fluid operated retractor for use in surgery. The retractor has a portion that is expandable upon the introduction of fluid under pressure. The expandable portion is made of a material strong enough, and is inflated to enough pressure, to spread adjoining tissues within the body. The retractor is especially useful in fiber optic surgery because it can be inserted percutaneously through a small opening then expanded to a much larger dimension when in the desired location, to retract tissue from within. The retractor may be used to spread a joint such as a knee joint or shoulder joint, or may be used to separate tissue planes generally, to improve visualization and create a working space for the surgeon.

Abstract: A wound retractor comprises a retracting member for insertion into a wound opening and a proximal member for location member for location externally of a wound opening. The proximal member is movable relative to the retracing member to shorten the axial extent of the retracting member to laterally retract a wound opening. The retracted wound opening is retracted by a seal which is integral with the retractor.

Abstract: A hand access device for use in hand assisted laproscopic surgery comprises a substantially tubular inflatable sleeve of pliable gas tight material having a twisted inner sleeve section and an outer sleeve section. The device has an inner O-ring for insertion through a wound opening in the abdominal wall and an outer O-ring for location outside of the wound opening. On insertion of a surgeon's arm the sleeve everts while monitoring a reduced lumen seal to the arm and a seal to the wound openings.

Abstract: A minimally invasive device for performing direct cardiac massage including an inflatable bladder mounted on a rigid inflation tube. The rigid inflation tube is used to push the bladder into the sternocostal space through an incision in the upper abdomen just below the xiphoid process. A tear-away insertion sleeve is provided over the balloon, so that the device may easily be inserted in to the body. The insertion sleeve includes various features that assist in placement of the device and removal of the sleeve. After insertion into the sternocostal space and removal of the insertion sleeve, the bladder is repeatedly inflated and deflated to massage the heart and provide blood flow.

Abstract: Laparoscopic apparatus and method for insertion into a space or potential space in a body including an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon. A hernia graft is attached to the balloon for repairing a hernia.

Abstract: Tissue is retracted from a bone during spinal and other procedures by inserting an elongate balloon into a cannula, and guiding the cannula into position along between the tissue and the bone surface. The cannula is then partially withdrawn, and the balloon is inflated to retract the tissues. The method can be performed percutaneously, with minimal tissue damage.

Abstract: An endoscopic balloon device and method of using in a laparoscopic surgical procedure such as a cystectomy is disclosed. An intact organ such as an ovary is encapsulated with the endoscopic balloon while the organ remains attached to the body. By inserting instruments into the bag, a surgical procedure is then performed within the bag, for example, a cyst may be removed from an ovary. After cyst removal, the bag is irrigated to remove leakage before withdrawal of the cyst within the bag.

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creature of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdrawn through the incision.

Abstract: Laparoscopic apparatus and method for insertion into a space or potential space in a body including an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is provided and is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A tunneling member is mounted on the distal extremity of the tunneling shaft. A balloon assembly is provided which is removably secured to the tunneling shaft. The balloon assembly includes a balloon wrapped about said tunneling shaft. A sheath is provided which encloses the balloon on the tunneling shaft. The sheath has a slit extending longitudinally thereof permitting the sheath to be removed whereby the balloon can be released and inflated. A tubular member is provided which has a balloon inflation lumen thereon and is coupled to the balloon for inflating said balloon.

Abstract: An inflatable speculum adapted to be positioned within an orifice includes an inflatable bladder. In an embodiment, when the inflatable bladder is inflated, the inflatable bladder includes a baffle member. The baffle member includes a plurality of baffles, and each of the plurality of baffles has a substantially trapezoidal cross-sectional shape. The inflatable bladder also includes an opening formed between a first end of the inflatable bladder and a second end of the inflatable bladder for viewing an inside of the orifice. In another embodiment, when the inflatable bladder is inflated, the inflatable bladder includes the opening formed between the first end of the inflatable bladder and the second end of the inflatable bladder, a pump and inflation line for inflating the inflatable bladder, and an applicator.

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creation of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdraw through the incision.

Abstract: A hand access device for use as a seal for sealing a surgeon's forearm on entry through a wound opening, for example, in an abdominal wall contains a substantially tubular sleeve of pliable gas tight material. The tube is turned axially back on itself to define an outer sleeve section and an inner sleeve section which define therebetween a sealed inflatable chamber. The inner sleeve section is engaged by the forearm which, on insertion, causes the sleeve to evert. The device has eversion limiting means in the form of inner and outer rings which are of elastomeric material.