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 stimulation electrode assembly configured to be positioned relative to a patient for an operative procedure is disclosed. The stimulation electrode may be a connection or self-contained component to contact a portion of a nerve. The stimulation electrode may provide or receive a signal to and/or from the nerve to assist in testing integrity of the nerve.

A modified nerve cuff electrode is designed to enhance the stability of neural recording and/or nerve stimulation. Any nerve cuff electrode includes a nerve cuff and a plurality of electrodes within the nerve cuff. While traditional nerve cuff electrodes have every one of the plurality of electrode contacts on the inner surface of the nerve cuff, in the modified nerve cuff electrode each of an inner surface and an outer surface of the nerve cuff has at least one electrode contact. The at least one electrode contact on the outer surface can be electrically isolated from the peripheral nerve to provide a stable reference or ground during recording or a stable pathway for a return current during stimulation to enhance the stability of the recording or the stimulation.

Stimulation and recording electrode assemblies that are particularly useful for Automatic Period Stimulation (APS). Such embodiments are compatible with nerve monitoring systems to provide continuous stimulation of a nerve during surgery. Certain embodiments include an electrode assembly having cuff including a body and two ears extending from the body. Within the body, at least one electrode is supported and connected to a lead wire assembly. The ears can be brought together to enlarge a gap in the body so that the electrode assembly can be fixated around a nerve. Other embodiments include an electrode assembly including first and second needle electrodes that each have a tip. A body is provided to interconnect the needle electrodes and can be manipulated to move the tips either toward or away from one another. Disclosed embodiments provide nerve monitoring and stimulation in cases where the nerve is only partially dissected.

Stimulation and recording electrode assemblies that are particularly useful for Automatic Period Stimulation (APS). Such embodiments are compatible with nerve monitoring systems to provide continuous stimulation of a nerve during surgery. Certain embodiments include an electrode assembly having cuff including a body and two ears extending from the body. Within the body, at least one electrode is supported and connected to a lead wire assembly. The ears can be brought together to enlarge a gap in the body so that the electrode assembly can be fixated around a nerve. Other embodiments include an electrode assembly including first and second needle electrodes that each have a tip. A body is provided to interconnect the needle electrodes and can be manipulated to move the tips either toward or away from one another. Disclosed embodiments provide nerve monitoring and stimulation in cases where the nerve is only partially dissected.

Systems and methods provide stimulation of peripheral targets such as targets in the lower limbs. Electrode arrays realized in circumferential or longitudinal embodiments have pads with horizontal and/or vertical offsets. Electrode array geometries are customizable and adaptable to individual users and treatment of different disorders. Novel systems of customization include software and hardware implemented solutions. A single device can provide treatment of two or more disorders or unwanted states using selected electrode geometries and stimulation protocols. Systems and methods for assessment of candidate stimulation sites and protocols use subjective or objective measures or both to determine which meet stimulation success criteria. Simulation is provided using transcutaneous, percutaneous, or implantable stimulators. A main advantage is the improved treatment of pelvic floor disorders, and especially overactive bladder (OAB).

Methods and systems for conditioning a signal indicative of electrosurgical unit activity are described. A hardware circuit acquires AC current from an electrosurgical unit on patient isolated circuitry and conditions the signal in either of two alternate processing methods. The processed signal is routed as input to an analog to digital converter circuit. A method for determining saturation on referential inputs and recovering inputs to an unsaturated state is also described.

A stimulation electrode assembly configured to be positioned relative to a patient for an operative procedure is disclosed. An evoked stimulation response may be sensed by a sensor near a portion of a subject. The evoked response may be sensed by an electrode and determined with a monitoring system. The evoked response may additionally and/or alternatively be sensed with a motion sensor. A position sensor may be provided to measure or determine whether the sensor has moved during a procedure.

An intraoperative nerve evaluation device includes a flexible substrate, and a plurality of detection units disposed on the substrate and spaced apart from one another. Each of the detection units includes an electrode and a conductive wire electrically connected to the electrode. When the electrodes are attached to a nerve, a selected one of the electrodes is configured to receive an input signal via the corresponding conductive wire and to transmit the input signal to the nerve, and each of the electrodes other than the selected one is configured to receive from the nerve a response signal associated with the input signal and to transmit the response signal via the corresponding conductive wire.

Described herein are microelectrode array devices, and methods of fabrication, assembly and use of the same, to provide highly localized neural recording and/or neural stimulation to a neurological target. The device includes multiple microelectrode elements arranged protruding shafts. The protruding shafts are enclosed within an elongated probe shaft, and can be expanded from their enclosure. The microelectrode elements, and elongated probe shafts, are dimensioned in order to target small volumes of neurons located within the nervous system, such as in the deep brain region. Beneficially, the probe can be used to quickly identify the location of a neurological target, and remain implanted for long-term monitoring and/or stimulation.