A method for implanting a replacement heart valve within a diseased valve includes accessing a patient's heart by piercing a myocardium, advancing a guidewire into the patient's heart, and installing an access device in a wall of the heart. The access device preferably has at least one valve mechanism. A valve delivery device is advanced over the guidewire and through the access device. The valve delivery device has a replacement heart valve disposed along a distal end portion thereof. The replacement heart valve preferably includes an outer support structure and a leaflet valve disposed within the outer support structure. The replacement heart valve is radially expanded within the diseased valve. During implantation, the outer support structure conforms to a diameter of the diseased valve and the leaflet valve expands to a fixed size having a diameter smaller than the diameter of the diseased valve.

Transluminal access system includes a stent delivery catheter having a handle control mechanism. The catheter comprises a number of components for establishing an initial penetration between adjacent body lumens and subsequently implanting a stent or other luminal anchor therebetween. Manipulation of the stent components is achieved using control mechanisms on the handle while the handle is attached to an endoscope which provides access to a first body lumen.

Devices for approximating multiple tissue edges internal to a body are disclosed.

A trans-atrial septal catheter system for delivery of a steerable sheath into the left atrium contains three components. The first component is a three-segmented needle-guide wire composed of a distal needle designed to flex sharply in relation to the conjoined looped guide wire segment after fossa ovalis puncture and needle advancement. The distal guide wire loops are advanced into the left atrium maintaining the angled needle in a central location relevant to the loops for preserving an atraumatic position while stabilizing the loops in the left atrium. The elongated proximal extra stiff guide wire segment is conjoined to the looped segment which crosses the fossa ovalis and extends proximally to become externalized to the femoral vein. This segment is extra stiff and significantly elongated to permit catheter and device exchanges. The guide wire serves as a support rail over which the dilator and sheath can be advanced into the left atrium. This transseptal system is uniquely forward looking and permits cautious and iterative delivery of the dilator into the fossa ovalis for “tenting” by way of a proximal sheath activator that interacts with the dilator. The proximal externalized GW is then advanced to permit puncture of the fossa ovalis. After puncturing a precise location of the fossa ovalis, the needle and coiled guide wire loops are further advanced into the left atrium. With the proximal activator, the dilator is advanced across the fossa ovalis into the left atrium using single-handed maneuvering for separate dilator advancement and steering of the sheath by way of turning or actuating the sheath handle.

Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

A medical system comprises an elongate instrument including a camera configured to capture at least one real-time image of anatomy within a patient anatomy. The medical system further comprises a processor configured to display, on one or more display screens: a three-dimensional patient computer model of the patient anatomy; a synthetic representation of the elongate instrument registered to the three-dimensional patient computer model; over the patient computer model, a representation of a view angle of the elongate instrument, the representation of the view angle being displayed so as to appear to project from a distal tip of the synthetic representation of the elongate instrument; and in a position based on the registration of the synthetic representation of the elongate instrument to the patient computer model, the at least one captured real-time image so as to appear to project from the distal tip of the synthetic representation of the elongate instrument.

Embodiments relate to surgical devices, systems, and methods. The system includes a port assembly and surgical arm assembly. The port assembly includes a main body having a main channel. The main channel includes a left channel portion, right channel portion, left anchor channel portion, and right anchor channel portion. The left channel portion is shaped in such a way that, when a surgical arm of the surgical arm assembly is inserted through the left channel portion, a movement of the surgical arm is restricted to be a movement within the left channel portion and along a first central axis. The right channel portion is shaped in such a way that, when the surgical arm is inserted through the right channel portion, a movement of the surgical arm is restricted to be a movement within the right channel portion and along a second central axis.

This document describes devices and methods for suturing an anastomosis. For example, this document describes transurethral probe devices that can be used to suture a vesicourethral anastomosis with one continuous stitch along a helical toroidal path.

A surgical tool for piercing tissue of a body comprises a hollow external component (1) having a peripheral wall (11), an internal component (2) movable disposed inside the external component (1) and having a piercing head (21); when the piercing head (21) and the internal component (2) retract relative to the external component (1), the movable component (3) deforms partially, expands outwardly in a radial direction, and fills the bladder (6). The movable component can be deformed to expand outward in the radial direction, so as to make the bladder to expand, so that the surgical tool can be positioned on the body of the patient.

Trocar components and methods of use are described, wherein the trocar components are configured to provide access to intraperitoneal space via the rectouterine pouch to surgical tools, which optionally include one or more surgical robot members. The surgical tools are optionally 5 mm or more in diameter. In some embodiments, a cannula part has a lumen sized to provide to a plurality of the surgical tools simultaneous transvaginal access to the intraperitoneal space via the rectouterine pouch. In some embodiments, an incision sized to receive a distal aperture of the cannula is created, optionally using one or two dilators. The dilators are sized to create (optionally starting from a puncture by a needle 2 mm in diameter or less) an oblong aperture. In some embodiments, the oblong aperture is at least twice as wide across a long diameter as across a short diameter.