A surgical access device includes a seal assembly having a seal housing and a gimbal mount disposed within the seal housing, the seal housing defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis. The surgical access device also includes a bellows configured to engage at least a portion of the gimbal mount, the bellows dimensioned and adapted to establish a biasing relationship with the gimbal mount, such that the bellows overcomes a frictional relationship between the gimbal mount and the seal housing, thereby moving the gimbal mount towards a position in which the passage of the gimbal mount is aligned with the central longitudinal axis. The bellows is configured to be attached to a side wall of the seal housing.

An assembly comprising a drive gear coupled to a shaft and a dial. The drive gear is configured to rotate along a first axis based on movement of the dial. The assembly includes a first linking member located along a second axis and configured to rotate about the second axis based on contact with the drive gear as the drive gear is rotated. The assembly includes a second linking member located along the second axis and configured to rotate about the second axis based on rotation of the drive gear and a coupling between the first linking member and the second linking member. The assembly includes a linking member selector configured to rotate about the first axis and for selecting at least a position corresponding to the first linking member that causes the coupling between the first linking member and the second linking member.

A hydrodissector for hydrodissecting a vascular target, the hydrodissector comprising: a handle; a shaft extending from the handle at an angle and including a tip at a distal end thereof; at least one port provided at the tip and configured to be coupled to a fluid supply and to eject fluid from the at least one port into the space between the vascular target and surrounding tissues to dissect the vascular target from the surrounding tissues, the at least one port being sized to provide sufficient pressure and velocity to dissect the vascular target from the surrounding tissues, wherein the length of the shaft is configured for insertion into an incision to atraumatically hydrodissect the vascular target from the surrounding tissues, and wherein the shaft is configured to releasably couple with one or more hook-shaped attachments configured to lift the vascular target after the vascular target is dissected from the surrounding tissues.

A clip unit includes: an arm portion including arms extending from a proximal end portion to a distal end portion so as to be openable and closeable; a holder than can hold the arms in a closed state by accommodating the proximal end portion of the arm portion; and a thread grip attached to at least one of the arms and positioned between the arms. In a state where the arms are spread open, a dimension of the thread grip in the opening/closing direction of the arms is equal to or larger than a distance between the arms in the closed state. The thread can be elastically deformed in the closed state.

Gas-tight seal assemblies for us during minimally invasive surgery include various aspects. A wiper seal includes a sealing portion and a surrounding flex portion. Upper and lower faces of the sealing portions are angled with reference to an inserted instrument, the upper face's angle being more acute with reference to the instrument's shaft than the lower face's angle. The flex portion is corrugated, support ribs are in one or more corrugation grooves, and the support ribs allow the groove to easily collapse but resist the groove widening. The support ribs also prevent the sealing portion from inverting. An instrument insertion guide is positioned over the sealing portion and moves laterally with the sealing portion. A latch piece removably secures the seal assembly to a cannula. An anti-inversion piece prevents the wiper seal from inverting when an instrument is withdrawn. An assembly may include various combinations of the seal assembly, a cannula, a surgical instrument, an obturator, an endoscope, and a teleoperated medical device. The seal assembly may rotate within a cannula. The seal assembly may be used during manual or teleoperated surgery.

A multi-stage dilator and cannula assembly for use in surgical procedures, including minimally invasive surgical procedures, to provide tissue dilation and opening of a portal to enable the surgeon to access and provide treatment to anatomical feature of interest.

In an example, a surgical retractor includes an elongated shaft extending from a first end to a second end, and a retractor blade extending from the second end of the elongated shaft. The elongated shaft defines an internal chamber. The elongated shaft includes a handle portion at the first end of the elongated shaft, a suction conduit in a first lateral portion of the internal chamber, and a light conduit in a second lateral portion of the internal chamber. The suction conduit extends from a suction port at the first end to a suction aperture at the second end. The light conduit extends from a light-input port at the first end to a light aperture at the second end. The suction conduit and the light conduit are substantially coplanar. The surgical retractor also includes an optical waveguide in the light conduit of the elongated shaft.

Disclosed are medical devices for surgical procedures, especially procedures that involve the manipulation of surgical instrument end effectors close to the skin surface at an incision site. In accordance with some embodiments, an instrument access device is configured to couple to a wound retractor at a distal end of the device and to receive a multiple instrument entry guide in a port at the proximal end of the instrument access device, with an envelope between the distal and proximal ends defining a sealed cavity for maintaining insufflation pressure. Various embodiments provide means for rotating an assistant port in the envelope about a port that receives the instrument entry guide without twisting the envelope. Also disclosed are various envelope shapes. Also disclosed is an instrument entry guide that aligns surgical instrument shafts.

A retractor having a pair of blades is disclosed. A ring having an opening is attached to one end of the blades. The blades define a channel therebetween. The blades may be pivotally coupled to the ring. The retractor may have at least two conditions. In a first condition, the retractor is insertable through an incision in a patient's skin to an operative site. In a second condition, the retractor may be manipulated for retracting tissue surrounding the operative site. Instruments, prostheses, or tissue may be inserted or removed through the channel of the retractor.

A seal assembly including a septum seal, a lower seal support, an upper seal support and a return spring is disclosed. The septum seal includes an orifice and a plurality of apertures. The lower seal support includes an engagement surface configured to engage a portion of the septum seal. The upper seal support includes a plurality of fingers, wherein each of the plurality of fingers is configured to extend through a corresponding aperture of the septum seal. The return spring includes a collar portion and a plurality of spokes extending radially outward from the collar portion. At least a portion of the return spring may be sandwiched between the lower seal support and the upper seal support. The plurality of spokes is configured to bias the seal assembly toward a radial center of a housing.