Endovascular drug delivery systems and methods are disclosed herein for delivering a therapeutic agent to the intracranial subarachnoid space of a patient, and/or deploying an endovascular drug delivery device distal portion in the intracranial subarachnoid space and a portion of the drug delivery device body in a dural venous sinus such that a therapeutic agent is delivered from the deployed drug delivery device into the intracranial subarachnoid space.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, ultra-MIS techniques.

Connectors for connecting or linking one instrument or object to one or more other instruments or objects are disclosed herein. In some embodiments, a connector can include a first arm with a first attachment feature for attaching to a first object, such as a surgical access device, and a second arm with a second attachment feature for attaching to a second object, such as a support. The connector can have an unlocked state, in which the position and orientation of the access device can be adjusted relative to the support, and a locked state in which movement of the access device relative to the support is prevented or limited. Locking the connector can also be effective to clamp or otherwise attach the connector to the access device and the support, or said attachment can be independent of the locking of the connector.

Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.

A smoke evacuating tissue guard includes a tubular body defining a longitudinally-extending passageway, a collar coupled to a proximal end portion of the tubular body, and an outlet coupled to the collar and in fluid communication with an annular channel defined through the collar. Upon application of suction through the smoke evacuating tissue guard, the smoke evacuating tissue guard establishes a fluid path extending from the passageway of the tubular body and into the annular channel of the collar via an annular gap defined between the tubular body and the collar.

Surgical access stabilization devices, systems, and methods are disclosed herein. For example, the devices, systems, and methods disclosed herein can be used during a surgical procedure to selectively establish, stabilize, and maintain a desired trajectory and/or positioning of a surgical access device. An exemplary surgical access stabilization device can include a pad with an adhesive distal facing surface to adhere to an anchor surface, a surgical access device coupled to the pad, and a locking mechanism to selectively lock a position of the surgical access device relative to the pad. In one embodiment, the anchor surface can be the skin of a patient. An exemplary surgical access device stabilization method can include making an incision in a patient at a surgical site, inserting a surgical access device through the incision, adhering a pad to an anchor surface, e.g., the skin of the patient, coupling the surgical access device to the pad, and selectively locking a position of the surgical access device relative to the pad. Other exemplary devices, systems, and methods are also provided.

Devices and methods for surgical retraction are described herein, e.g., for retracting nerve tissue, blood vessels, or other obstacles to create an unobstructed, safe surgical area. In some embodiments, a surgical access device can include an outer tube that defines a working channel through which a surgical procedure can be performed. A shield, blade, arm, or other structure can be manipulated with respect to the outer tube to retract an obstacle. For example, an inner blade can protrude from a distal end of the outer tube to retract obstacles disposed distal to the outer tube. The inner blade can be movable between a radially-inward position and a radially-outward position. The radially-inward position can allow insertion of the blade to the depth of the obstacle to position the obstacle adjacent to and radially-outward from the blade. Subsequent movement of the blade to the radially-outward position can retract the obstacle in a radially-outward direction. The blade can be manipulated remotely, e.g., from a proximal end of the access device or a location disposed outside of the patient. The blade can be manipulated in various ways, such as by rotating the blade relative to the outer tube, translating the blade longitudinally relative to the outer tube, sliding an expander along the blade, driving a wedge between the blade and the outer tube, actuating a cam mechanism of the access device, and/or pivoting the blade relative to the outer tube.

Surface features for device retention are disclosed herein, e.g., for retaining an access port within a patient during a surgical procedure. The surface features can prevent ejection of the access port from a body of a patient. The surface features can be positioned along the access port and configured to glide along body tissues with minimal friction so as not to hinder travel of the access port in an insertion direction. After insertion of the access port, the surface features can engage with surrounding tissue to increase friction therebetween and to prevent ejection of the access port from the patient. Deployment of the surface features can occur due to friction with the surrounding tissue and/or via activation of the surface features to protrude from the access port. The surface features can include teeth, hooks, scales, fins, bristles, braids, and/or threads for engaging tissue. The surface features can be disengaged from the tissue to enable withdrawal of the access port without damaging the surrounding tissue.

A retractor holds a surgical incision in a body in an opened state to ensure a surgical field in small-incision endoscopic surgery, and includes a base body that is a thin plate made of tin having a purity of not less than 99.9% and has an elongated rectangular shape in an extended state of the base body. The retractor, in an extended form in a rectangular shape or in a rounded form in a small shape, can be inserted from a small incision wound into the body, and can easily be delivered to the surgical incision in the body by a surgical instrument. The base body is bent and deformed into a desired shape by the surgical instrument and is applied to the surgical incision in the body, so that the surgical incision can be held in an opened state so as to ensure the surgical field.

Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.