A surgical access system is disclosed including a first robotic arm, a second robotic arm, and a surgical access device. The surgical access device includes an atraumatic outer housing defining an outer perimeter, a first access port including a first seal, a second access port including a second seal, a first docking portion, and a second docking portion. The first access port is configured to receive a first surgical tool and the second access port is configured to receive a second surgical tool. The first robotic arm is configured to be releasably coupled to the first docking portion to define a first remote center for the first surgical tool at the first access port and the second robotic arm is configured to be releasably coupled to the second docking portion to define a second remote center for the second surgical tool at the second access port.

A syringe is coupled to a biopsy needle through a coupling structure that includes a motor-driven element such as a gear to rotate the needle. The motor can oscillate back and forth to cause the needle to oscillate. Structures are described to permit one-handed operation of the device and automatic motor activation based on attaining a desired plunger position. Non-electric motors are described along with a mechanism for axial oscillation of the needle.

A syringe is coupled to a biopsy needle through a coupling structure that includes a motor-driven element such as a gear to rotate the needle. The motor can oscillate back and forth to cause the needle to oscillate. Structures are described to permit one-handed operation of the device and automatic motor activation based on attaining a desired plunger position.

The present disclosure relates to adapter assemblies for use with and to electrically and mechanically interconnect electromechanical surgical devices and surgical reloads, and to surgical systems including handheld electromechanical surgical devices and adapter assemblies for connecting surgical reloads to the handheld electromechanical surgical devices.

Methods and apparatus are disclosed for a needle comprising a distal shaft and a proximal shaft joined at a junction, the needle having a distal tip which includes an electrode for delivering energy to puncture a tissue, wherein the distal shaft is comprised of a superelastic material. In typical embodiments, the needle includes a lumen for delivering and withdrawing fluids from a treatment site. In some embodiments the junction is comprised of a superelastic material.

A cutting guard for use with a wound retractor includes a body having a lumen including a flexible inner surface with a ground contact extending therethrough. A ground guard is included having proximal and distal openings that define a guard lumen therethrough, the ground guard encapsulating the flexible inner surface of the body lumen. A biasing element is disposed within the guard lumen and encircles the flexible inner surface and biases the flexible inner surface inwardly. A cutting electrode is disposed proximate the distal opening of the ground guard and connects to a first electrical potential and the ground guard connects to a second electrical potential. Upon externalizing of tissue through the distal opening, oversized tissue forces the flexible inner surface of the body lumen and the ground contact outwardly to engage the ground guard to complete an electrical circuit and energize the cutting electrode to excise oversized tissue.

Adjacent tissue layers can be accessed using a catheter device with a distal tip having a conductive portion including a first cutting feature and one or more projections extending from the first cutting feature towards an outer diameter of the distal tip. Electrical energy can be supplied to the conductive portion of the device to cut tissue. A stent can be delivered to form a fluid communication between the adjacent tissue layers.

Trocar placement locations may be identified, before forming incisions in a patient, by visualizing reach of a surgical instrument relative to a surgical site within the patient. The reach of the surgical instrument is calculated from the position of a robotic manipulator associated therewith. An image of the reach of the surgical instrument may be generated, which a clinician may utilize to ascertain whether the surgical instrument has adequate access to the surgical site. The clinician may move the robotic manipulator to a new position relative to the surgical site and, as the robotic manipulator is repositioned, the image of the reach of the surgical instrument generated is continuously updated to correspond with the new position into which the robotic manipulator associated therewith has been moved.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A handle for an applicator of coloured liquid to skin is provided. The applicator comprises a needle and a needle actuator. The handle comprises a handle body having top and bottom portions. The top portion is engagable with the needle actuator and having a top opening for receiving a drive shaft of the needle actuator. The bottom portion is engagable with a needle module comprising the needle and having a bottom opening for receiving a needle shaft of the needle. The handle also comprises a reciprocally movable interface sealingly affixed to an internal surface of the handle body. The interface separates the bottom opening from the top opening so as to prevent fluid communication from the bottom opening to the top opening, and is configured to abut the drive shaft and the needle shaft during use to allow the drive shaft to indirectly drive the needle shaft.