Disclosed herein is a cannula and/or medical instrument accessory configured for providing localized insufflation or venting of gases with respect to a surgical cavity of a patient (such as the pneumoperitoneum) and allowing insertion of medical instruments into the surgical cavity through the cannula. A medical instrument accessory such as a cannula and/or medical instrument accessory can be used for localizing insufflation or venting of gas or fluid near operating end of a medical instrument. The medical instrument accessory can comprise a body mountable over at least a portion of a medical instrument shaft, the body having an inner lumen, proximal end and distal end, the distal end comprising an opening, wherein the distal end is arranged in use at or adjacent an operating end of the medical instrument. An outer wall of the medical instrument shaft and lumen can define a gas flow path, wherein as or fluid is released or introduced into the gas flow path at the distal end and adjacent the end of the medical instrument shaft.

A Veress needle is modified to receive a forward-looking miniature videoscope through the lumen of an insufflation tube of the Veress needle. The modified instrument enables direct viewing of progress of the instrument through tissue to the peritoneal cavity of a patient, for proper location of the needle and insufflation of the cavity via the needle. The videoscope has an elongated shaft of smaller diameter than the lumen of the insufflation tube for passage of insufflation gas with the scope in place. In another embodiment a needle is fitted with a miniature videoscope to provide the same function, with the needle's lumen serving as an insufflation tube.

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 instalment 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 (822) between the distal (804) and proximal (812) 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.

An instrument manipulator may comprise a frame comprising an outer shell and an inner frame, the inner frame being movably coupled to the outer shell. The instrument manipulator may also include a plurality of actuator outputs protruding in a distal direction from the frame and an instrument support feature coupled to the outer shell. The instrument manipulator may further comprise a latching mechanism, the latching mechanism being configured to move the inner frame, the outer shell, or both relative to one another, so as to operably engage the plurality of actuator outputs with a plurality of actuator inputs of an instrument supported by the instrument support feature.

A needle assembly for pleural space insufflation is disclosed. The needle assembly has an outer shaft defining one or more pliable tissue receivers. The needle assembly also has a needle moveable within the outer shaft from a retracted position to an engaged position that does not extend past a distal end of the outer shaft. A method of pleural space insufflation is also disclosed. A parietal pleura is contacted with a distal end of an outer shaft that defines one or more pliable tissue receivers. The distal end of the outer shaft is pushed against the parietal pleura so that a portion of the parietal pleura enters the one or more pliable tissue receivers. A needle is advanced within the outer shaft so that the needle pierces the parietal pleura.

Access assemblies includes an instrument valve housing and a valve assembly disposed within the cavity of the instrument valve housing. The valve assembly includes a guard assembly, a seal assembly disposed adjacent to the guard assembly, and a centering mechanism for maintaining the seal assembly and guard assembly centered within a cavity of the instrument valve. In embodiments, the seal assembly includes a plurality of seal sections that are movable from an unfolded configuration to folded configuration in which the seal assembly forms a hexagonal member defining an opening to facilitate sealed passage of a surgical instrument. The seal sections may include a tapered inner edge for engaging a surgical instrument inserted through the instrument valve housing.

Disclosed herein are sealing devices configured for improving sealing functionality with an engaged extension member of an apparatus. More specifically, disclosed herein are trocar sealing devices configured for improving insufflation gas containment in relation to trocars (and/or other related type of devices) that are used for enabling a surgical instrument such, for example, a laparoscope, to gain access to an abdominal cavity (or other body cavity). By providing for such improved insufflation gas containment, sealing devices as disclosed herein are particularly advantageous, desirable and useful in view of long-standing reasons for limiting insufflation gas leakage and in view of newly recognized reasons stemming from outbreak of COVID-19 disease for limiting insufflation gas leakage.

An obesity treatment apparatus comprises at least one operable stretching device implantable in an obese patient and adapted to stretch a portion of the patient's stomach wall, and an operation device for operating the stretching device when implanted to stretch the stomach wall portion such that satiety is created.

A medical puncture device system includes a puncture device, a sensor, and an indicator system. The puncture device is configured to create a puncture through patient tissue and into an internal patient cavity to enable a medical tool to be inserted through the puncture into the cavity. The sensor is configured to generate a signal indicative of motion of the puncture device through the tissue into the cavity. The indicator system is operable by a controller to produce human-perceptible feedback in response to the signal generated by the sensor.

A face mask (90) comprises an instrument shielding apparatus (91) which comprises an instrument shielding device (92) which is connected to the face mask (90) by an adapter (89). The adapter (89) comprises an instrument accommodating housing (15) through which an instrument bore (25) extends therethrough. The instrument accommodating housing (15) terminates at one end in a first main port (20) engageable with an instrument port (7) of the face mask (90), and in the other end in a second main port (23). The instrument shielding device (92) comprises a shielding sleeve (95) a first end (96) of which is secured by a coupling ring (98) to the second main port (23) of the adapter (89), and a second end (97) of which is secured in a storage chamber (94) of a sleeve storing housing (93) of the instrument shielding device (92). The sleeve storing housing (93) is sealably engageable with a proximal end (58) of an endoscope (10), and the shielding sleeve extends from a collapsed stored state in the storage chamber (94) to the adapter (89) for shielding the endoscope (10).