Abstract: A method of accessing an internal portion of a patient including the steps of providing an access assembly including an outer frame, an inner member and a flexible member, inserting the inner member through an opening in tissue into a body of a patient with the flexible member extending proximally through the opening in tissue, moving at least a first portion or second portion of the outer member to a select unlocked spread position to enlarge the opening in tissue and the passageway through the flexible member, and subsequently moving the locking member to move the first and second engagement structures into a locking position to lock the first portion in the select spread position.

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 pupil expander is disclosed. The pupil expander comprises a support member sized to expand a pupil and a plurality of engaging portions. The plurality of engaging portions are coupled to and spaced about the support member. The engaging portions have a recess and are shaped and sized to receive an inner margin of an iris.

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

Abstract: 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 cannula assembly having a plurality of outwardly-biased flexible fins capable of inward movement such that the fins converge upon insertion of a trocar device. The fin embodiment including a slot formed therein, with a corresponding raised feature on the trocar shaft capable of engaging the slots. Inward movement of the trocar within the cannula lumen causes the fins to converge. An additional embodiment utilizes outwardly-biased flexible fins that lock together in a closed position, with corrugated features in the fin inner surface that contact the trocar shaft such that, upon insertion of the trocar, the fins unlock and splay outward. One or more of the flexible fins also including one or more penetrations for accepting a biasing device for altering the biasing force of the fin.

Abstract: A surgical seal system is adapted for use with a cannula assembly having a cannula housing and a cannula sleeve extending from the cannula housing. The surgical seal assembly includes a seal assembly and an adapter assembly. The seal assembly is mountable to the cannula housing. The seal assembly includes a seal housing and a seal defining inner portions adapted to form a substantial seal about an instrument with a first cross-sectional dimension. The adapter assembly includes an adapter body adapted for releasably coupling to the seal housing of the seal assembly. The adapter body has an adapter seal and a tether. The adapter seal is adapted to form a substantial seal about an instrument with a second cross-sectional dimension less than the first cross-sectional dimension. The tether is mountable to the cannula sleeve thus securing the adapter assembly to the cannula.

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

Abstract: A laparoscopic surgical system configured for cooperation with a trocar is described. In one configuration, the system is configured to expand to accommodate trocars of varying dimensions. In another configuration, which is not necessarily exclusive of the first configuration, the system may function to provide an anchoring and closure system for use in laparoscopic surgery.

Abstract: An expandable cannula includes a proximal end portion having a substantially constant diameter therethrough, and a distal end portion, coupled to the proximal end portion and having a proximal end and a distal end. The distal end portion includes a plurality of panels hinged by “living hinges” to the proximal end portion, and a locking mechanism that stabilizes the distal end portion in one of a contracted position and an expanded position. The locking mechanism may be a strut pressed overcenter during expansion distal portion to expanded configuration, or may include a locking ring and a catch for stabilizing the ring in a configuration where it holds the panels in expanded configuration.

Abstract: A device allows access into a body has at least: A first cannula with an outer surface, an inner lumen surface, an inner lumen diameter and proximal and distal end portions; and An expandable covering over the outer surface, the expandable covering having an outer surface and an inner surface; and The inner surface of the expandable covering remaining in contact with the outer surface of the first cannula.

Abstract: Medical systems, devices and methods are provided for accessing a bodily opening that, among other things, are safe and reliable, and facilitate manipulation of a medical instrument. The medical access device generally includes an elongated flexible sheath and an expandable frame connected to the distal end of the flexible sheath. The sheath and expandable frame are operable between expanded and collapsed configurations to provide a pathway from a natural orifice to the bodily opening.

Abstract: A retraction device for retracting an incision in a body wall includes a sheath that traverses through the incision from outside the body to a body cavity inside the body. The retraction device may include a deployable, adjustable frame that supports the sheath and that, together with the sheath, retracts the incision. The retraction device may include an outer ring and an inner ring coupled to opposing ends of the sheath and further include means to place the sheath in tension between the inner and outer rings, thereby retracting the incision.

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: 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: Implementations of the present disclosure provide an access tube including a wall structure and an optional handle extending from the wall structure. Selectively weakened areas facilitate selective resection of the wall structure to reveal windows that accommodate lateral intrusions by surrounding anatomical structures and/or provide increased access to an intervertebral disc. For example, a first distal weakened portion is configured to form a first window to afford lateral intrusion of a spinous process. A second distal weakened portion is configured to form a second window to afford lateral intrusion of facet. A proximal weakened portion is configured to afford additional angular access on a proximal end of the tube.

Abstract: A device, system and method for orthopedic spine surgery using a novel screw-based retractor, disclosed herein, that allows for access to the spine through a minimally or less invasive approach. The retractor device is designed to be coupled to a pedicle screw and then to have opposed arms of the retractor spread apart to open the wound proximally. The retractor is removed by pulling it out of the wound whereby the retractor is deformed to pass over the pedicle screw head. The retractor is intended to be made of a stiff plastic material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

Abstract: An access port device is provided including a tubular member having a proximal end and a distal end with at least one lumen extending therethrough, 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 access port device further includes a flow regulator disposed on a top portion of the at least one lumen, the flow regulator having a head portion and a body portion, the body portion extending asymmetrically downward to form a substantially triangular opening for regulating an output rate of insufflation gasses from a surgical site.

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

Abstract: A surgical access assembly includes a sleeve and a port. The sleeve is adapted for insertion within tissue to access an underlying tissue site. The sleeve defines a first passage therethrough. The first passage has a first diameter. The port defines one or more second passages extending therethrough. The port is adapted for insertion within the first passage of the sleeve in a substantially sealed relationship therewith. The one or more second passages are adapted for a substantially sealed reception of a surgical object therethrough. The one or more second passages have one or more second diameters. The port is selectively removably positionable within the first passage of the sleeve. The first diameter is greater than the one or more second diameters.

Abstract: A 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 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 apparatus for positioning within a tissue tract accessing an underlying body cavity includes a seal anchor member including leading portion, a trailing portion, and an intermediate portion disposed between the leading and trailing portions. The leading portion of the seal anchor member is configured and adapted to ease insertion of the seal anchor member into the tissue tract. Subsequent to insertion of the seal anchor member, the leading portion of the seal anchor member is also configured and adapted to facilitate securing and/or anchoring of the seal anchor member within the tissue tract.

Abstract: In one aspect of the present disclosure, a surgical access apparatus is disclosed for positioning within an incision in tissue that includes an elongated seal member configured to removably receive at least one surgical object, and a deployment member. In another aspect of the present disclosure, a surgical access apparatus is disclosed for positioning within an incision in tissue that includes a housing configured to removably receive at least one surgical object, an elongated member, and at least one filament. A method of percutaneously accessing an underlying surgical work site using a surgical apparatus is also disclosed.

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 assembly including a base and an elongated member extending from the base. The base defines a central axis and has an opening for receipt of a surgical instrument. The elongated member defines a passageway for passage of at least a portion of the surgical instrument and is adapted to assume a substantially rolled configuration in a normal unstressed condition thereof. When in the rolled configuration, the elongated member is rolled transverse to the central axis.

Abstract: A hybrid cannula may comprise a rigid portion overmolded with a flexible portion. The rigid portion at its proximal end may comprise a rigid flange for preventing the proximal end of the hybrid cannula from being pushed through the portal. The flexible portion may comprise a dam within the passage of the hybrid cannula, the dam defining interior spaces thereof between the proximal and distal ends of the hybrid cannula. The flexible portion's distal end may comprise a variety of features extending therefrom, including a flange and/or a cannulated tip. The flexible portion's proximal end may further comprise a membrane to prevent liquid from projecting during insertion of a tool into the dam and/or removal of the tool from the dam. The hybrid cannula can be useful in minimally invasive surgical procedures, including arthroscopic and endoscopic surgeries.

Abstract: A clip is provided for managing access through tissue. The clip is placed around an opening in tissue, although the opening may alternatively be formed after the clip is deployed. The clip can expand when medical devices are introduced through the clip and through the opening. When the medical devices are removed, the clip closed automatically to substantially close the opening.

Abstract: An in-dwelling port for providing repeated entry to a body during and/or after an operation is described. The port may include an external portion secured to a body outside an incision and a collapsible insertion portion that is inserted through the incision. The collapsible portion collapses when no instrument or lumen is present to permits the body to return to substantially a normal profile around the incision.

Abstract: The present invention provides an access device for surgery. The access device includes a guide member and a head member. The guide member and head member define a channel configured to receive and guide a sterile flexible scope with a working channel. The guide member and head member cooperate to extend through a small opening of 2 cm or less to access tissue structures. The head member may include surfaces to separate a pericardium from a surface of the heart, stabilize a beating heart and, with the endoscope, provide visibility for the implantation of a therapeutic such as stem cells to the surface of the heart with improved safety and accuracy. Ranges of other diagnostic, application of therapeutics or biologics, and observational applications may be facilitated by the access device, such as TMR, ablation, echo-probe diagnostics, LAA isolation, observation of the same procedures, etc.

Abstract: A surgical retractor apparatus having one or more independent, removable extension members adapted to be mounted at the distal end of the retractor, or between the blades of a spreadable retractor, after the retractor has been positioned in the patient, such that a significant portion of the extension member extends beyond the distal end of the retractor to preclude or minimize intrusion of tissue into the access area created by the retractor. The extension members may vary in size and shape so that the most appropriate extension member can be chosen to address the intrusion problem, and the extension members may be mounted at various fixed locations, using clips, mechanical interlocking structures or the like.

Abstract: An access device for use in a minimally invasive surgical procedure is disclosed. The access device is configured and adapted to be placed within a body opening to provide access to an underlying body cavity. The access device provides protection to the opening and minimizes contamination and the risk of possible infection.

Abstract: A surgical apparatus includes a seal anchor member. The seal anchor member includes a leading end, a trailing end, and at least one longitudinal port extending between the two ends. The at least one longitudinal port is dimensioned for reception of a surgical object. One end of the at least one longitudinal port is closed by a membrane, which can be pierced through by a sharp-pointed device. The at least one longitudinal port further includes at least one lip therein. The at least one lip is configured to establish a substantially sealed relation with the surgical object entered therethrough, thereby inhibiting the loss of insufflation gas between the at least one longitudinal port and the surgical object.

Abstract: A trocar unit includes a flexible lateral wall defining a cavity and a longitudinal axis. A flexible first plate connects to the flexible lateral wall and is surrounded by the flexible lateral wall. The flexible first plate extends generally transversely to the longitudinal axis. Independent portals extend through at least the flexible first plate. The flexible first plate includes a rigid section attached around the periphery of the flexible first plate. The flexible first plate is spaced from the open distal end of the cavity and is positioned above an opening at a surgical site. A second plate is configured to fit securely within a portion of the flexible lateral wall and is disposed distally with respect to the flexible first plate. A second rigid section is attached around the periphery of the second plate.

Abstract: The invention provides a device for bowel packing having an essentially elliptical shape that is essentially symmetrical along a minor axis of the ellipse, and the device includes a notch located on the minor axis below the major axis. The device is composed of material comprising an elastomeric polymer and the device is appropriately sized for retaining the intestines of a mammal. The invention further provides methods of use of the devices of the invention for bowel packing. The invention further provides methods for increasing bowel packing speed, increasing effectiveness of bowel retention, decreasing the formation of post-operative intraperitoneal adhesions, and increasing temperature of the abdominal cavity during surgery by use of the device.

Abstract: A foldable retractor is provided. The retractor includes an arcuate deformable frame that is defined from a first arm extending through a first portion of an outer circumference of the frame, and a second arm that defines a remaining portion of the outer circumference. The first and second arms each include opposite first and second end portions, wherein the respective first end portions and the respective second end portions are hingedly connected together. The first and second arms of the frame are biased toward a first configuration wherein the combined first and second arms are aligned substantially continuously through the combined first and second end portions and the frame extends through substantially a single plane.

Abstract: A retraction device for retracting an incision in a body wall includes a sheath that traverses through the incision from outside the body to a body cavity inside the body. The retraction device may include a deployable, adjustable frame that supports the sheath and that, together with the sheath, retracts the incision. The retraction device may include an outer ring and an inner ring coupled to opposing ends of the sheath and further include means to place the sheath in tension between the inner and outer rings, thereby retracting the incision.

Abstract: Apparatus for use in surgery comprises a sleeve (1) having an entry opening (4) at an outer end and an exit opening (5) at an inner end to access a patient's body. Exit sealing means (10) are provided for sealing the exit opening (5) to a body. Entry sealing means (20) are provided for sealing the outer entry against an arm passing therethrough to create a controlled environment within the sleeve. A valve (101) comprises an outer ring (105,106) and a sealing sleeve (107) of flexible material mounted to the ring (105,106) and extending into the opening defined by the ring to terminate in a substantially centrally disposed inlet opening (108).

Abstract: An endoscopic access port and sheath assembly or laparoscopic port (10) comprises a sheath (12) and a haemostatic valve. The sheath has an elongate tubular body and a sheath lumen through it. The haemostatic valve comprising a housing (14), the housing comprises a tubular body with an internal lumen (18) and a first end and a second end. The first end is connected to the sheath and the sheath lumen and the internal lumen are in fluid communication. The second end of the housing has an access port. There is a substantially cylindrical valve assembly (27) within the housing at the second end of the housing. The substantially cylindrical valve assembly is formed from a plurality of valve segments (28). Each valve segment has an elongate body being in cross section a sector of a circle. Each valve segment is formed from a resilient material.

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: 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 wound retractor system comprises a retractor having a distal ring 91 and a retracting sleeve 4 extending from the ring. An insertion tool 120 has a distal groove 122 to hold the ring for insertion of the ring through a small incision 90 in the abdominal wall 97. The retractor may be used for retracting an incision to receive an instrument therethrough. A seal or valve may be mounted to the retractor through which an instrument can pass.

Abstract: A wound retractor device comprises a distal member for insertion into a wound opening, a proximal member for location externally of the wound opening, a connecting member extending at least between the distal member and the proximal member. At least part of the connecting member is movable relative to the proximal member to shorten the length of the connecting member located between the distal member and the proximal member and thereby retract laterally the sides of the wound opening. At least part of the connecting member is movable relative to the proximal member by a guide slot through which the connecting member changes its direction to substantially perpendicular to the longitudinal axis of the wound retractor device.

Abstract: A flexible surgical sheath and multi-part insertion cannula for inserting the flexible sheath in a cranial surgical tunnel for gaining access to a ventricle or other surgical target. An obturator or other elongated insertion member drives a sheath assembly into a surgical recess, typically a hole drilled through the skull and brain of the surgical patient. The inserted sheath assembly includes two or more rigid sheath portions disposed around the obturator. The obturator has a tapered or angled tip for guiding the sheath assembly through the surgical tunnel to a target region such as a ventricle or other brain structure for which surgical intervention is sought. Following insertion, the obturator is withdrawn and a flexible sheath inserted in an insertion tunnel defined by the rigid sheath portions.

Abstract: A surgical apparatus, for positioning within a tissue tract to access an underlying body cavity, is provided. The surgical apparatus includes a first and second member. The first member has a proximal ramp section, an accordion section, and a retaining portion. The first member defines a first longitudinal axis, a first proximal end, and a first distal end. The second member has a tubular proximal section, a portal portion, and a distal flange. The second member defines a second longitudinal axis, a second proximal end, and a second distal end. The second member includes a retaining structure to couple the first member to the second member. The first member is located at least partially in the tubular section of the second member.

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 at least one slit seal member configured to create a fluid-tight seal in a first configuration. 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 at least one slit seal member is configured to create an opening in a second configuration when forces are applied at opposing ends of the first ring.

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: This disclosure is directed to minimally-invasive devices, methods and systems used through small access portals to minimize trauma to structures adjacent the treatment site. The access device includes a guide frame and a cannula support washer movebly coupled to the guide frame. The washer has a cannula port aperture extending therethrough and a surface geometry complementary to the surface geometry of the guide frame. The complementary surface geometries limit movement of the cannula port aperture to arcuate movement along a surface segment of a sphere.

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