Abstract: In one form, a system for use in percutaneous surgical procedures includes a cannula having an elongate body extending along a longitudinal axis between a proximal end and a distal end and including a working channel dynamically expandable from a first, unexpanded configuration. The system also includes a device that is positionable in and engageable with the working channel to expand the working channel from the first configuration as the device is moved through the working channel. In response to disengagement of the device with the working channel, the working channel returns to the first, unexpanded configuration. In one aspect of this form, the device includes an interbody spinal implant that is deliverable to a surgical site through the working channel of the cannula. In another form, a method for performing a percutaneous surgical procedure is provided. However, different forms and applications are envisioned.

Abstract: A surgical access assembly includes an access port and a seal anchor. The access port includes first and second rings and a sleeve extending between the first and second rings. In particular, the sleeve includes an inner surface having an attaching member. The seal anchor is adapted to be at least partially disposed in the access port. The seal anchor includes a base portion configured to detachably engage the attaching member of the access port.

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 port is provided for insertion through an incision formed in a body wall of a patient. The surgical access port generally includes a sleeve assembly having a folding assembly provided at a proximal end of the sleeve assembly. The sleeve assembly includes a flexible sleeve and a flexible distal ring provided at a distal end of the flexible sleeve. A proximal end of the sleeve assembly includes a pocket formed in the sleeve material. The folding assembly is located in the pocket and generally includes a proximal ring and one or more ring knobs rotatably mounted on the proximal ring. Locking structure, in the form of a ratchet and pawl mechanism, may be provided to secure the ring knobs in position relative to the proximal ring.

Abstract: A surgical access apparatus includes a liner base and an access housing for positioning outside the body. The liner base includes an inner member adapted for insertion through an opening within body tissue for positioning within the body; a sleeve member connected to the inner member and dimensioned to extend from the inner member through the opening within the body tissue, and a plurality of tensioning elements connected to the inner member and associated with the sleeve member to impart a tensioning effect on the sleeve member. The access housing includes a first element and a second element. The second element is operatively connected to the tensioning elements and adapted for rotational movement relative to the first member to cause the tensioning elements to displace the inner member toward the access housing and to cause the sleeve member to engage and retract tissue defining the opening within the body.

Abstract: A surgical access device for insertion into an opening in tissue includes an adjustable member at a proximal end which is transitionable between an un-deployed configuration where the adjustable member is rolled up proximally and a deployed configuration where the adjustable member is unrolled distally to allow for the use of the surgical access device in an opening having a larger size than the surgical access device. The surgical access device includes an elongate member which is adapted for insertion into an opening in tissue and including a lumen extending therethrough for the reception of a surgical instrument. An adjustable member extends from a proximal portion of the elongate member and is variable between the un-deployed configuration and the deployed configuration where the adjustable member extends distally from the proximal portion of the elongate member when in the deployed configuration to at least partially surround the elongate member.

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: In one embodiment, the wound protector has an annularly collapsible proximal ring and a flexible sleeve extends between the proximal ring and distal ring. After positioning of the distal ring in a wound, the proximal ring is expanded to draw the sleeve taut between the rings 11, 12 and is drawn tight against the wound. In a second embodiment, the wound protector has a flexible sleeve secured between a distal ring and proximal ring of fixed diameters. In addition, an expansion member is disposed within a loop of the flexible sleeve about the proximal ring. After positioning of the distal ring in a wound, movement of the expansion member into an extended diametric state expands the loop in the sleeve diametrically while drawing the rings towards each other.

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

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

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

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

Abstract: An access assembly 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.

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

Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port in a body cavity includes a pair of steerable tool cannulas extending from a rigid tube that is supported by an operating room fixture. The rigid tube is extendable through an incision to position distal ends of the rigid tube and tool cannulas within a body cavity. Each tool cannula has a lumen for receiving a corresponding surgical instrument so that an end effector of the each instrument may be used within the body cavity. Control devices are operatively associated with each tool cannula and include ports for receiving the surgical instruments. User manipulation of the handles of the surgical instruments results in steering of the tool cannulas, and thus the surgical instruments, within the body cavity.

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

Abstract: The present invention relates to a surgical tool guide, which is easily installed and separated to reduce operating time, and furthermore surgical instruments are not separated from the abdominal walls or gas does not leak to stably perform the surgical operation. In addition, the present invention relates to a protection cap for a surgical instrument guide, which is interlocked together with surgical instruments to maintain a seal even though the surgical instruments for the operation are variously moved, thereby efficiently preventing the leakage of gas. Therefore, since it is unnecessary to inject gas again during the operation, the surgical operation can be smoothly performed.

Abstract: A cannula system provides a cannula formed of a soft conformable material such as silicone and having an exterior thread. The cannula lacks rigidity, especially axially, and an obturator therefor is provided with an external thread to interact with the cannula an maintain its shape as it is inserted into a patient's body.

Abstract: The present invention provides methods and devices for obtaining percutaneous access, maintaining hemostasis, and providing closure of openings in tissues of the body. In particular, the present invention provides methods and devices for maintaining hemostasis and providing closure surgical incisions of the left ventricular apex of the heart.

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

Abstract: A retractor (101) for retracting the margins of a wound opening (103) comprises an inner anchoring O-ring (105) attached to a cylindrical sleeve (106) at a distal end and a reinforcing O-ring (109) attached to a proximal end of the sleeve (106). The sleeve (106) is led between an inner ring part (110) and a corresponding recess (116) in an outer ring part (111). The outer ring part (111) has anchor formations (120) over which the proximal end of the sleeve (106) is attached to anchor the sleeve (106). To retract the wound opening (103) the sleeve (106) is pulled while the guide rings (110, 111) are moved against the tissue surrounding the wound opening (103). This pulls the inner O-ring (105) against the inside of the tissue adjacent the wound opening (103), and retracts the wound opening (103). The sleeve (106) is manipulated locally for maximum retraction efficiency.

Abstract: In a first aspect of the subject invention, an iris expander is provided which includes a non-metallic, unitary, multi-segmented body which is expandable from a first state to a second state. The second state defines a larger footprint than the first state with the body being defined by a plurality of segments connected by living hinges. In a further aspect, an iris expander is provided which includes a multi-segmented body that is expandable from a first state to a larger-footprint second state. At least one aperture is formed in the body with a channel extending therefrom embedded in the body such that no portion thereof is exposed externally of the body. The channel is formed to accommodate a portion of an instrument for causing adjustment of the body with avoidance of direct contact of the instrument with the tissue of the iris.

Abstract: Disclosed herein is a retraction device for laparoscopy in which a trocar needle including latching grooves formed at the side of the lower end thereof is inserted into a trocar tube, both ends of which are opened, to form a laparoscopic platform, the laparoscopic platform pierces an abdominal wall and the trocar needle is pushed into an abdominal cavity so that the latching grooves are exposed to the outside of the trocar tube, sutures connected to tissue retractors retracting tissues are hung on the latching grooves, and then the trocar needle of the laparoscopic platform is drawn upwards so that the latching grooves are inserted back into the trocar tube to fix the tissue retractors to the laparoscopic platform. The retraction device for laparoscopy prevents the tissues from being unnecessarily damaged due to retraction and facilitates convenient retraction of the tissues without the help of assistant's two hands.

Abstract: An arthroscopic sealing cannula having improved efficiency, access and reduced manufacturing costs is described herein. In particular, the present invention describes arthroscopic sealing cannulae in which the conventional thermal and chemical bonding means are eliminated and replaced with a mechanical joining system that utilizes mating fastener pairs integrally molded into the distal and proximal elements of a cannula so as to thereby provide a strong reliable joining of the elements. Such a mechanical system eliminates the need for costly capital equipment and specializing tooling as well as the material and environmental handling problems associated with conventional bonding techniques. Furthermore, in that the join may be readily confirmed through simple visual examination, the present invention also eliminates the need for complex, costly, and time-consuming validation procedures mandated by regulations in place to ensure proper integrity, strength, and reliability of the bond.

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

Abstract: A surgical port comprising a body and first and second cannula extending from the body and movable with respect to the body via an instrument inserted through the respective cannula. The cannulas can extend distally from the body and can include one or more seals. A port assembly and first and second instruments manipulatable in a crossed configuration are also disclosed.

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

Abstract: A surgical port includes a port body having a lumen extending therethrough and a plate having an opening. The port body may be made from foam. The port is configured such that rotation of the plate with respect to the port body aligns the opening and lumen defining a passage therethrough for the insertion of surgical instruments.

Abstract: A surgical access device that includes a foam structure defining a plurality of generally triangular wedges circumferentially arranged about a longitudinal axis so as to seal the surgical incision, the plurality of generally triangular wedges defining, adjacent their respective apices, a central opening for sealed reception of a surgical object, and a second opening defined between a pair of adjacent wedges, the second opening configured to receive and seal with a surgical instrument inserted into the second opening.

Abstract: A surgical access system for accessing a surgical target site within a spine includes a retractor and an elongated element. The refractor has a closed configuration defining a lumen with an internal circumference, and an open configuration in which the internal circumference, at least at the distal end of the retractor, is enlarged relative to said closed configuration. The open configuration creates and maintains an operative corridor to said target site. The elongated element is releasably coupled to an interior wall of the retractor and has an extension extending distal of the distal end of the retractor into the surgical target site. When coupled to the retractor, the elongated element covers a body structure at the target site without blocking access to the operative corridor.

Abstract: An eyelids opening device with a drape comprising a flexible upper ring (1) applied in contact with the face while surrounding eyelids, a lower ring (2) inserted into a conjunctiva sac and applied in contact with the eyelids conjunctiva side, and an elastic sheet (3) of soft tubular thin film located to extend from the face side to the eyelids conjunctiva side and used to fix one end to the upper ring and to fix the other end to the lower ring by expanding, wherein the outside diameter at the smallest portion of the elastic sheet is substantially equal to or longer than the interpalpebral length (between upper and lower eyelids). Difference in size of conjunctiva sac or interpalpebral length of individuals is absorbed even by an appliance of one size, the eyelids can be opened by fitting the eyelids opening device to the eyelids or the face while burden on the eyeball is reduced and high safety is ensured.

Abstract: A surgical access device includes a seal housing and a roller disposed in the housing and defining a working channel. The roller may be stationary or moveable within the seal housing to form both a zero seal in the absence of an instrument, and an instrument seal in the presence of an instrument. Rotation of the roller is contemplated and low-friction surfaces are discussed to reduce instrument insertion forces. Multiple rollers, wiper elements, low-friction braid, pivoting elements and idler rollers are contemplated. The rollers will typically be formed of a gel material in order to facilitate the desired compliance, stretchability and elongation desired.

Abstract: A surgical site retractor is configured to retract tissue, such as in an intercostal procedure. The retractor may be formed from non-radiopaque material for improved monitoring via x-ray imaging. The retractor may have a rigid retractor and a soft tissue retractor, where the rigid retractor has a plurality of legs and the soft tissue retractor extends between the legs to prevent soft tissue from extending between said legs. The retractor may have a bendable arm with an implement holder, such as distal cuff or clip adapted to resiliently hold an implement such as a tube of an elongated port-access device. A method involves partly installing the surgical site retractor, expanding the surgical site retractor, deploying the surgical implement from outside the body through the incision and into the patient, resiliently capturing the implement with the holder of the arm, and bending the arm to hold the implement in a desired position.

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

Abstract: 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 method and apparatus for introducing a first elongate medical device and short wire guide that are coupled together into a work site and remotely disconnecting them within the work site such that a secondary device comprising a catheter member can be introduced over the wire guide to the work site, and/or a second wire guide can be introduced to the work site via a passageway of the primary access device. A separating member may be provided to remotely separate the wire guide from the elongate medical device.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more movable sealing ports for receiving surgical instruments. Each movable sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each movable sealing port can be rotatable relative to the housing and each sealing element can be rotatable relative to the housing along a predetermined orbital path.

Abstract: An intraocular expansion and retention device (“IERD”) expands the iris, enlarging the pupil during intraocular surgery, and can be removed following the procedure without damaging the eye tissue. The intraocular expansion and retention device includes a number of stepped blades that form pockets to cup the iris margins and expand the pupil allowing increased visualization during intraocular surgery.

Abstract: A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.

Abstract: In a first aspect of the subject invention, an iris expander is provided which includes a non-metallic, unitary, multi-segmented body which is expandable from a first state to a second state. The second state defines a larger footprint than the first state with the body being defined by a plurality of segments connected by living hinges. In a further aspect, an iris expander is provided which includes a multi-segmented body that is expandable from a first state to a larger-footprint second state. At least one aperture is formed in the body with a channel extending therefrom embedded in the body such that no portion thereof is exposed externally of the body. The channel is formed to accommodate a portion of an instrument for causing adjustment of the body with avoidance of direct contact of the instrument with the tissue of the iris.

Abstract: A surgical apparatus includes an elongated cannula having an external sidewall surface and a lumen extending between a cannula proximal regional and a cannula distal region, the cannula is further configured to receive an endoscope, and has a handle located at the cannula proximal region, a first wire extending from the cannula distal region and adapted to slide longitudinally with respect to the cannula in both a distal and proximal direction via a control at the handle, and a ring connected to the first wire. The ring has a curved surface with concavity hollowed towards a region of the cannula configured to receive the endoscope.

Abstract: A new and useful apparatus and method are provided for removing a foreign object from a rectal cavity. An anoscope is configured for insertion through the anus into a rectal cavity. The anoscope has a base and introducer with guides that route flexible members and a flexible sheath that are carried by actions of the operator through the anoscope beyond the guide and further into a rectal cavity and to expand about a foreign object in the rectal cavity. The anoscope also carries a noose that is manipulatable from outside the patient's rectal cavity to tighten and stricture the flexible sheath above the foreign object and capture the foreign object within the flexible sheath, so that the foreign object can be manipulated by the noose and the flexible sheath to remove the foreign object from the rectal cavity once the anoscope and flexible ribs are removed from the anus.

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: Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient's tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

Abstract: A surgical port includes a port body having a lumen extending therethrough and a plate having an opening. The port body may be made from foam. The port is configured such that rotation of the plate with respect to the port body aligns the opening and lumen defining a passage therethrough for the insertion of surgical instruments.

Abstract: An instrument access device includes a wound protector and retractor, a proximal assembly coupled to the wound protector and retractor, and an instrument receiver which can be releasably coupled to the proximal assembly. The instrument receiver has a valve assembly through which an instrument is passed and a cannula portion which extends in use through an incision which has been retracted and protected by the retractor. The instrument receiver has an insufflation/desufflation port. The proximal assembly comprises an inner proximal ring member and an outer proximal ring member. The proximal end of the retractor sleeve is located between the proximal ring members. The inner proximal ring member has a slot for receiving and releasably engaging with an insufflation port section of the instrument receiver.

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: A surgical access device for facilitating access through an incision to a surgical site in a patient's body has a pliable membrane which is configured to engage and expand the incision. The pliable membrane includes a base layer, a permeable membrane attached to the base layer, and a fluid channel disposed between the layers. The fluid channel is fluidly coupled to a fluid source. The fluid is delivered to the surgical site via the permeable membrane. The surgical access device may also have a locking mechanism for holding the device in a desired configuration.