A needle assembly (10) for relieving a pneumothorax and/or a hemothorax, the needle assembly (10) comprising a canula (12), the canula (12) comprising: a distal end portion (20) comprising a cutting end (22) for puncturing a thoracic cavity wall (24), a proximal end portion (14) for removing a fluid or gas from a thoracic cavity (28), a first curved portion (18) between the distal end portion (20) and the proximal end portion (14), an intermediate portion (16) between the first curved portion (18) and the proximal end portion (14), and a first fixing bulge (42) arranged between the first curved portion (18) and the intermediate portion (16), wherein an outer diameter of the canula (12) at the first fixing bulge (42) is increased with respect to the diameter (D1) of the intermediate portion (16), said first fixing bulge (42) being arranged such as to be placed at or close to the inner surface (24) of the thoracic cavity wall (24i), when the canula (12) is inserted for relieving the pneumothorax, such as to prevent or to reduce the risk that the canula (12) inadvertently slides out of its inserted position.

A surgical access system comprises a trocar, an insufflating optical obturator slidably insertable into the trocar, and a laparoscope slidably insertable into the obturator. A distal end of the obturator comprises a tip, at least a portion of which comprises a wall with a generally uniform thickness comprising a transparent material. At least one vent hole disposed at the obturator tip is fluidly connected to a gas flow channel defined by an interior surface of the obturator and the laparoscope, which is fluidly connected to an insufflation gas inlet disposed at a proximal end of the trocar. Improved optical characteristics of the trocar system permit precise and accurate visual placement thereof into a body cavity. Accordingly the access system is suitable as a first entry surgical access system. Embodiments of the trocar access are also useful for drug delivery, and/or for fluid and/or tissue aspiration.

A method of operating a surgical anchoring system can include inserting an outer sleeve of a surgical instrument at least partially into a first natural body lumen, the outer sleeve having a working channel. The method can include inserting a channel arm of the surgical instrument through the working channel of the outer sleeve and into a second natural body lumen. The channel arm has at least one first anchor member coupled thereto and a control actuator operatively coupled to the at least one first anchor member. The method can include expanding the at least one first anchor member from an unexpanded state to an expanded state to form an anchor point at a portion of the second natural body lumen. The method can include controlling, by the control actuator, a motion of the channel arm to selectively manipulate an organ associated with the first and second natural body lumens.

In some embodiments an apparatus for providing access for a medical procedure in a patient's body cavity includes a stem configured for insertion through an opening in a body cavity wall. The stem has a bore and a cap is disposed at a proximal end thereof and includes an entry port in communication with the bore which receives an instrument to be inserted into the body cavity. An inflatable annular seal is disposed on the stem proximate the cap and a conduit extends through the cap providing pressurized gas at a first outlet in fluid communication with the body cavity providing insufflation pressure. A second outlet of the conduit is in fluid communication the seal, which when disposed inside the body cavity proximate the wall and inflated by pressurized gas, bears on an inner surface of the wall urging the cap into contact with an outer surface of the wall while sealing the opening.

Systems for insufflation and recirculation of insufflation fluid in a surgical procedure include a control unit having a fluid pump, a supply conduit, a return fluid conduit and a pressure-controlled valve. The pressure-controlled valve is in fluid communication with an insufflation gas supply, the supply conduit and the return conduit and is adapted and configured to respond to pressure control signals to adjust position and thereby system flow parameters, to reduce entrainment of air from the surrounding environment, and to increase the concentration of insufflation gas in an operative space, and/or to reduce an overpressure condition in the operative space.

An volume filling device for treatment of obesity is placed outside the stomach wall of the patient to reduce the inner volume of the stomach, thereby affecting the patient's appetite. By providing the volume filling device outside the stomach wall, contact with stomach acids is avoided, thereby increasing the life of the device.

A surgical access device includes a cannula, an instrument housing coupled to the cannula, a port coupled to the instrument housing, and a valve disposed within the port. The cannula includes an elongated shaft defining an access lumen and an inflation lumen therethrough. The port includes an inflation channel and an insufflation channel defined therethrough. The inflation channel is in fluid communication with the inflation lumen of the cannula and the insufflation channel is in fluid communication with the access lumen of the cannula. The valve is movable within the port between an inflation position in which a passageway defined through the valve is aligned with the inflation channel of the port, and an insufflation position in which the passageway of the valve is aligned with the insufflation channel of the port.

An instrument guide is removably inserted into a proximal portion of a cannula and extends to a distal end of the cannula to guide and support multiple surgical instruments within the cannula. The instrument guide is designed to be manufactured by injection molding of plastic material. The instrument guide includes a tube and several radial walls connected to the tube to form passageways within the tube. The radial walls are joined to a core where they intersect. The tube and radial walls have substantially the same wall thickness and the core has a minimum diameter that is substantially larger than the wall thickness to facilitate delivery of plastic material. Portions of the tube and radial walls are thinner than the general wall and rib thickness to form guideways that support surgical instruments within the passageways. Channels may be formed on an outside of the tube to deliver insufflation gas.

A method of performing a gas arthroscopy by injecting a joint capsule with sealant prior to insufflation with gas. This sealant can be any biocompatible gel or liquid with sufficient viscosity or sealing capability to prevent air embolisms while performing gas arthroscopy.

The present invention is directed to systems, devices and methods for trans-septally delivering carbon dioxide through a minimally invasive catheter to create a gaseous pocket or emphysema between the posterior wall of the left atrium and the esophagus during cardiac ablation of the left atrium. This pocket of gas expanded tissue serves to thermally insulate and separate the esophagus from the left atrium during ablation to prevent the formation of an atrial-esophageal fistula. The system comprises a control system to precisely deliver the gas to a desired location through a needle-based catheter assembly.