A multi-portal method for treating a subject's spine includes distracting adjacent vertebrae using a distraction instrument positioned at a first entrance along the subject to enlarge an intervertebral space between the adjacent vertebrae. An interbody fusion implant can be delivered into the enlarged intervertebral space. The interbody fusion implant can be positioned directly between vertebral bodies of the adjacent vertebrae while endoscopically viewing the interbody fusion implant using an endoscopic instrument. The patient's spine can be visualized using endoscopic techniques to view, for example, the spine, tissue, instruments and implants before, during, and after implantation, or the like. The visualization can help a physician throughout the surgical procedure to improve patient outcome.

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.

The present disclosure relates to an openable/closable vertebral endoscopic device. The openable/closable vertebral endoscopic device includes an endoscope body including a working channel for providing an access route of a surgical instrument to a diseased area of a human body, the working channel having an open channel formed by opening a portion of the working channel such that a portion of the surgical instrument inserted into the working channel is exposed to the outside; and a cover member provided on the endoscope body to selectively open or close the open channel of the endoscope body.

The present disclosure includes devices and methods of treating a herniated disc comprising treating an opening in a vertebral disc by applying plasma to the vertebral disc, wherein the vertebral disc comprises a nucleus portion and an outer annulus fibrosus portion, and wherein the plasma seals the opening in the vertebral disc. The devices and method comprises a plasma delivery device configured to be handheld and used percutaneously or in minimally invasive surgery. The vertebral disc, which comprises a nucleus pulposus and an outer annulus fibrosus, can be herniated with a rupture caused by a tear or opening in the annulus fibrosus, that can be repaired when the annulus fibrosus is sealed by the use of the plasma.

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.

Connectors for connecting or linking one instrument or object to one or more other instruments or objects are disclosed herein. In some embodiments, a connector can include a first arm with a first attachment feature for attaching to a first object, such as a surgical access device, and a second arm with a second attachment feature for attaching to a second object, such as a support. The connector can have an unlocked state, in which the position and orientation of the access device can be adjusted relative to the support, and a locked state in which movement of the access device relative to the support is prevented or limited. Locking the connector can also be effective to clamp or otherwise attach the connector to the access device and the support, or said attachment can be independent of the locking of the connector.

Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.

A sheath at the end of an endoscope may be elastically expanded to clear an area within a body cavity during a medical procedure and retracted to within an envelope of the endoscope when not in use. In the expanded state, the sheath may provide sufficient mechanical strength to clear space for a camera or surgical tool, while also having sufficient pliability to mitigate impact on surrounding, sensitive tissue. In an example embodiment, the sheath may be an elastomeric sheath or the like coupled between portions of coaxial shafts of an endoscope, and the coaxial shafts can move relative to one another to deploy or retract the sheath by relatively tensioning and relaxing opposing ends of the sheath. In this manner, the sheath may be selectively expanded and retracted without exposed moving parts or sharp edges.

Devices and methods for surgical retraction are described herein, e.g., for retracting nerve tissue, blood vessels, or other obstacles to create an unobstructed, safe surgical area. In some embodiments, a surgical access device can include an outer tube that defines a working channel through which a surgical procedure can be performed. A shield, blade, arm, or other structure can be manipulated with respect to the outer tube to retract an obstacle. For example, an inner blade can protrude from a distal end of the outer tube to retract obstacles disposed distal to the outer tube. The inner blade can be movable between a radially-inward position and a radially-outward position. The radially-inward position can allow insertion of the blade to the depth of the obstacle to position the obstacle adjacent to and radially-outward from the blade. Subsequent movement of the blade to the radially-outward position can retract the obstacle in a radially-outward direction. The blade can be manipulated remotely, e.g., from a proximal end of the access device or a location disposed outside of the patient. The blade can be manipulated in various ways, such as by rotating the blade relative to the outer tube, translating the blade longitudinally relative to the outer tube, sliding an expander along the blade, driving a wedge between the blade and the outer tube, actuating a cam mechanism of the access device, and/or pivoting the blade relative to the outer tube.