In some embodiments, an apparatus includes a catheter having a catheter body, a light emitter disposed at a distal end of the catheter body, and a fluid conduit coupleable to a source of fluid. The fluid conduit configured to discharge fluid from the source via the conduit and out a distal end of the catheter body. A spacing member is disposed at the distal end of the catheter body and can be moved between a collapsed configuration and an expanded configuration. In the expanded configuration, the spacing member is disposed about the light emitter. The spacing member is at least partially transmissive and/or transflective of light emitted from the light emitter. The apparatus configured to be inserted at least partially into a body lumen, to discharge fluid into the body lumen, and to emit light from the light emitter to illuminate an interior wall of the body lumen.

Various devices and methods are provided with respect to inserting multiple surgical instruments through a single surgical access device. A medical device including a flexible tissue retractor a releasable insert having multiple instrument openings, and a member such as a sleeve is disclosed. The insert can be in the form of an insert assembly including multiple components. The sleeve can support the insert with respect to the retractor such that the insert and sleeve can be removed together with the retractor remaining in the incision. A method of using the insert is also described.

A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

According to an aspect, a medical device includes an elongate member and a sleeve. The elongate member defines a lumen and has a first end portion and a second end portion. The second end portion has a first configuration and a second configuration. The second end portion has a first size when the second end portion is in its first configuration and a second size when the second end portion is in its second configuration. The first size is smaller than the second size. The second end portion is biased to its second configuration. The sleeve defines a lumen extending from a first end portion of the sleeve to a second end portion of the sleeve.

An introducer sheath system including an outer layer, an inner layer, and a dilator is disclosed. The outer layer is circumferentially extending between a first longitudinal edge and a second longitudinal edge. An expandable gap is defined between the first and second longitudinal edges. The inner layer is disposed within the outer layer. The inner layer is configured to be continuously circumferentially expandable. The inner layer includes a non-extended state having a circumferential portion extending circumferentially inside the outer layer and a fold portion extending into an interior cavity of the inner layer. The inner layer includes an extended state wherein the fold portion extends at least partially circumferentially between the first and second longitudinal edges. The dilator is extendable longitudinally within the inner layer. The dilator includes a recess configured to accommodate the fold portion of the inner layer.

A soft tissue retractor for medical use, formed as a rectangular blade-like retractor element made from shape memory alloy.

An instrument access device (500) comprises a distal O-ring (11) for insertion into a wound interior, a proximal member for location externally of a wound opening and a sleeve (12) extending in two layers between the distal O-ring (11) and the proximal member. The proximal member comprises an inner proximal ring member (25) and an outer proximal ring member (24) between which the sleeve (12) is led. A seal housing (300) is mounted to the inner proximal ring member (25). A gelatinous elastomeric seal (302) with a pinhole opening (303) therethrough is received in the housing (300). An instrument may be extended through the seal (302) to access the wound interior through the retracted wound opening in a sealed manner.

A flexible tubular member for guiding insertion of instrumentation to a bone screw affixed within bone includes a tubular body that is flexible, constructed of textile material, and defines a longitudinal axis. The tubular body also defines a proximal end and a distal end opposite each other along the longitudinal axis. The tubular body further defines a guide channel that extends from a proximal opening at the proximal end to a distal opening at the distal end. An attachment member is located at the distal end of the tubular body and is configured to couple the distal end to a proximal portion of the bone screw. The attachment member has an annular shape around the guide channel and is configured to expand responsive to a predetermined tensile force applied to the tubular body for decoupling from the bone screw

The present disclosure relates to methods and devices for surgically manipulating tissue. In general, the methods and devices can include an elongate retractor shaft having a distal retractor tip that is configured to manipulate tissue, for example the tip can be configured to separate muscle and nerve fibers surrounding a vertebra. The elongate retractor shaft can include an illumination source such that at least a portion of the surgical field is illuminated by the device when the device is used in the body. A sensor can also or alternatively be included on the elongate retractor shaft, for example on the blunt retraction tip, such that the sensor can monitor physiological parameters of the tissue in or adjacent to the surgical field.

A system and method for closing a fascial opening is disclosed. The system may include a strap that may be locked into each of a pair of anchors placed anterior to a muscle and on opposite sides of a fascial opening, one or more delivery tubes for delivering the anchors, and a needle for pulling the strap into each anchor. The method may include the steps of placing a dilating port through a skin incision, inserting an anchor through the dilating port, placing a strap into the body cavity, whereupon the strap may be pulled through the anchor. A second anchor may be placed on the contralateral side of the defect so that the strap may be pulled through the second anchor and cinched tightly closing the defect. The anchors may have a locking aperture that engages with the strap.