Various devices, systems, and methods are provided for allowing surgical instruments to access a body cavity through an access device, such as a cannula. In one embodiment, a cap can be removably and replaceably coupled to a proximal end of cannula and can have an opening therethrough that communicates with an inner passageway of the cannula. Various surgical elements can be passed through the cap and cannula and into a patient when the cannula is positioned within the patient. The cap can have a side slot formed therein. The slot can be configured to allow surgical elements, such as sutures, to pass through the cap and into the cannula. At least one surgical seal can be in the cap and can be configured to receive surgical elements therethrough.

An apparatus (100) includes: a expandable structure (140) formable into three dimensional shapes including a range of diameters (D) and corresponding lengths (L); a movable component (106) moveable between a range of positions (124, 126) effecting the range of diameters; and a mechanical linkage (110) disposed between the movable component and the expandable structure. The expandable structure is configured to fit inside a working channel (204) of an endoscope (202) when the expandable structure is collapsed. The mechanical linkage is configured to move the collapsed expandable structure through the working channel to a selected location (400) past a distal end (404) of the endoscope and to increase and decrease a diameter of the expandable structure in response to changes in the position of the movable component when the expandable structure is at the selected location.

A tissue protector has a body structure having a longitudinal extending thin web. The body structure has an unconstrained first shape configured to form a nerve shield and is configured to shrink about a longitudinal axis to a smaller constrained second shape sized to fit into a lumen of a cannula. Preferably, the second constrained shape is oval or round having a maximum diameter equal or less than an inside diameter of the lumen. The body structure is configured to return to the first shape when the cannula is withdrawn or returned to this shape as the implant advances.

A surgical portal apparatus includes a sleeve having a proximal end and a distal end that extends along a longitudinal axis, and a surgical tape. The sleeve includes an inner wall defining an internal longitudinal passageway dimensioned for permitting passage of a surgical object therethrough and an outer wall configured for positioning against tissue. The inner and outer walls define at least a partial annular space therebetween, the annular space being in fluid communication with an opening in the outer wall. The surgical tape includes a body portion retained within the annular space of the sleeve and a leading tab extendable through the opening in the outer wall of the sleeve. The surgical tape has a first surface and a second surface, each of the first and second surfaces having at least one of tissue reactive functional groups and self-reactive functional groups.

A retraction assembly for use in retracting soft tissue during spine surgery having a reactor blade having a blade body and proximal and distal ends, a support member engagable with the blade body and having proximal and distal ends. The proximal end engages a passage in the blade body and the second end of the support member includes an anchorage capable of anchoring the assembly to an anatomical structure while allowing movement of the support member. The retractor blade is capable of detachable engagement with and movement relative to the support member. The retractor blade is capable of detachable engagement with and movement relative to the support member. The first end of the support member includes operating nuts to adjust the support member rotationally and vertically.

The present disclosure illustrates an introducer sheath with a partially annealed metal frame. The introducer sheaths described herein include a hub coupled to a shaft. The shaft comprises a braided wire frame with (i) an annealed distal portion that prevents the braided wire frame from unraveling at a distal end, and (ii) a second portion that is unannealed; a jacket encompassing the braided wire frame; and a liner forming an inner wall.

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.

Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; a funnel segment extending between and coupling the outer ring and the tubular body, wherein the funnel segment provides a diametric reduction between the relatively large diameter of the outer ring and the relatively smaller diameter of the tubular body, which is sized to fit within a natural orifice with minimal distention of the orifice; and an inflatable member disposed around the distal end of the tubular body, the inflatable member sized and configured to fit snugly around the tubular body in the deflated condition and to expand against the wall of the natural orifice in the inflated state to thereby stabilize and retain the retractor within the orifice.

An elongated tissue traction device adhered to target tissue and configured to lift the target tissue away from surrounding tissue. The tissue traction device may lift the target tissue as a surgical procedure is performed, such as resecting or cutting of the target tissue. The tissue traction device may be a bistable spring. The tissue traction device is in a first stable configuration when initially adhered to the target tissue. The tissue traction device may be shifted (e.g., actuated) into the second configuration, such as when the tissue is resected or cut around the target tissue to which the tissue traction device is adhered. In the second stable configuration, the tissue traction device curls and lifts the target tissue from the surrounding tissue.

The present disclosure relates to tissue traction devices and systems. In one example, a tissue tensioning system may include a filament having a first end comprising an attachment member, a second end, and a length therebetween extendable externally along a catheter. A first tissue fastener may be engageable with the attachment member and with a target tissue. The second end of the filament may be translatable to adjust a tensional force along the filament.