A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

A valve component 1 of the invention comprises a main valve 2 which is located on a centre line and at least one auxiliary valve 3 which is located radially outwardly of the main valve 2. The main valve may be used for sealing engagement with a cannula. In some cases the cannula may be used for introduction of a number of robotically controlled surgical instruments generally, including a camera. The auxiliary valves 3 may be utilised to introduce another instrument through the valve component. The valve component is mounted in a manner which ensures that the valve component 1 is rotatable about a centre line through the axis of the valve component 1. This ensures that the valve component 1 can be rotated relative to a cannula inserted through the main valve 2 and consequently that the auxiliary valves 3 are rotatable relative to the cannula allowing the auxiliary valves 3 to be positioned to facilitate optimum access and manipulation for an auxiliary instrument(s) inserted through the auxiliary valve(s) 2.

A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; a flexible outer ring; an inner ring; a flexible sheath extending between the outer ring and the inner ring; and at least one rigid segment adapted to attach to the flexible outer ring to thereby increase the rigidity of the outer ring. Embodiments of the retractor/protector are described that have interlocking and non-interlocking rigid segments. Embodiments are also described that have bases that insert into or under the flexible outer ring in addition to or in lieu of rigid segments to increase rigidity and/or provide support for a detachable cap.

A surgical instrument for placement of a movement restriction device for use in a surgical procedure for treating reflux disease in a patient. The instrument comprises a sleeve and a holding device configured to engage the movement restriction device, wherein the holding device is configured to be placed within the sleeve and be displaceable in relation to the sleeve. The instrument further comprises a first handling portion connected to the sleeve, and a second handling portion connected to the holding device. The handling of at least one of the first and second handling portion creates relative displacement of the holding device in relation to the sleeve, which disengages the holding device from the movement restriction device for performing the placement of the movement restriction device.

A system for harvesting a tendon graft is disclosed, including a retractor, a guide and a harvesting tool. The retractor is collapsible and upon release, becomes self-supporting to hold open an anatomic space developed in a patient above the tendon. A guide assembles with the retractor to orient a guide shaft along the retractor and thereby the anatomic space. The harvesting tool includes a working end with a blade edge for cutting into the tendon. The harvesting tool defines a contoured surface for engaging and translating along the guide shaft while assembled to the retractor. The guide shaft and contoured surface limit the trajectory and translation extent of the harvesting tool along and into the tendon.

A fixation system (900) for the fixation of a first bone fragment (932) relative to a second bone fragment (934); the fixation system (900) comprising at least one first bone engagement element engagable with the first bone fragment (932), wherein the first bone engagement element has an elongate body portion, a proximal end, a distal end, and a passageway extending through the body portion from the proximal end to the distal end, at least one further bone engagement element engageable with the second bone fragment (934) and having a tensile element (920) securement portion for affixing a tensile element (920) to the further bone engagement element; wherein the tensile element (920) passing the first bone engagement element when engaged with the first bone fragment (932) is fixed relative to the further bone engagement element when engaged with the second bone fragment (934) by the tensile element (920) securement portion; such that the first bone fragment (932) is affixed relative to the second bone fragment (934) from tensile stress in the tensile element (920).

A complete removal and reinsertion of instruments is avoided when the instruments are initially not correctly positioned during a minimally invasive operation on a bone, in particular a vertebra of the spine. This aim is achieved by an instrument set for spinal operations, including a guide rod, which has a cavity extending along the axis of the guide rod, and a guide tube, which can be received in the cavity of the guide rod, wherein the guide rod has a distal lip, which is arranged eccentrically to the cavity and/or to a center axis of the guide rod.

A tissue retraction system comprising a drive gear coupled to a shaft. The tissue retraction system includes a first plurality of linking members located along a second axis and configured to rotate along the second axis based on contact with the drive gear as the drive gear is rotated. The tissue retraction system includes a linking member selector configured to rotate along the first axis, wherein the linking member selector comprises a cylindrical body integrally formed with a handle. The tissue retraction system includes a right arm assembly configured to move along a first trajectory. The tissue retraction system includes a first retractor blade coupled to the right arm assembly. The tissue retraction system includes a left arm assembly configured to move along a second trajectory. The tissue retraction system includes a second retractor blade coupled to the left arm assembly.

Methods and devices described herein facilitate improved treatment of body organs.