An introducer may include a layered tubular member having an inner liner including at least one folded portion extending along a distal region of the inner liner in a delivery configuration; a reinforcing member disposed over at least a portion of the inner liner, the reinforcing member including a plurality of longitudinal spines defining a plurality of openings disposed between adjacent longitudinal spines, wherein each folded portion is circumferentially overlapped by one of the plurality of openings; and an outer sheath disposed over the reinforcing member, wherein the outer sheath includes at least one perforation circumferentially overlapping each folded portion; and a tip member fixedly attached to a tapered distal region of the layered tubular member. The inner liner may extend to a distal end of the layered tubular member. At least a portion of each folded portion may terminate proximal of the distal end of the layered tubular member.

An improved vascular access dilator apparatus consisting of a wire, a blade with a locking safety mechanism, and straight but malleable dilator with a smooth surface having a lumen just large enough for the wire to slide easily in and out. The safety sheath covers the blade once an incision in the dermis is made, thereby protecting both the patient and caregiver.

An improved vascular access dilator apparatus consisting of a wire, a blade with a locking safety mechanism, and straight but malleable dilator with a smooth surface having a lumen just large enough for the wire to slide easily in and out. The safety sheath covers the blade once an incision in the dermis is made, thereby protecting both the patient and caregiver.

A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes an expandable structure for enhancing engagement with median lobe prostate tissue.

A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes an expandable structure for enhancing engagement with median lobe prostate tissue.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

A method comprises the steps of: fixing a distal end of a first member of a surgical instrument with tissue, the surgical instrument including a second member having a longitudinal passageway configured for disposal of the first member and being connected with a navigation component such that the distal end is disposable with the passageway at a selected distance from the navigation component, the navigation component being positioned relative to a sensor to communicate a signal representative of an orientation of the first member; removing the second member from the first member; and connecting a third member with the first member along the orientation such that a distal end of the third member is fixed with the tissue. Systems, spinal implants, constructs and instruments are disclosed.

A method comprises the steps of: fixing a distal end of a first member of a surgical instrument with tissue, the surgical instrument including a second member having a longitudinal passageway configured for disposal of the first member and being connected with a navigation component such that the distal end is disposable with the passageway at a selected distance from the navigation component, the navigation component being positioned relative to a sensor to communicate a signal representative of an orientation of the first member; removing the second member from the first member; and connecting a third member with the first member along the orientation such that a distal end of the third member is fixed with the tissue. Systems, spinal implants, constructs and instruments are disclosed.

A balloon dilator device, comprising an annularly shaped, cylindrical type structure having walls that are expandable from a radially collapsed state to a radially expanded state by inflation of a balloon inserted within the annular structure. Once the walls have been expanded, they remain in the expanded state even if the balloon is deflated, because the radially expanded state is a state of minimum mechanical potential energy, and in order to return to the collapsed state, the structure would have to pass a state of higher potential energy. The device walls require sufficient stiffness in their longitudinal direction to enable the device to be pushed into a minimally invasive incision made in the subject. This device stiffness can be achieved either by its mechanical material properties, or by its substantially closed wall structure, or by use of a stiff protector sheath used to protect the walls during insertion.