Systems, apparatus, and methods are described for forming an incision in tissue for receiving a surgical instrument. A cutting device for forming the incision can be reversibly coupleable to an instrument, e.g., a dilator. The instrument may define a lumen configured to receive a wire that extends or is otherwise extendable through a puncture site. The cutting device can include a cutting element configured to be actuated to form the incision such that the incision extends form the puncture site and is sized to receive the instrument.

A catheter placement system including a catheter, a needle for creating an insertion site, and a skin nicking device for enlarging the insertion site. A catheter placement device includes the skin nicking device slidably coupled with the needle, where the skin nicking device has one or more blades attached to a frame thereof. Distally displacing the skin nicking device along the needle causes the blade to nick the skin to enlarge the insertion site. A shield of the skin nicking device transitions between a safe configuration encapsulating the blade and a use configuration exposing the blade and the shield may be biased toward the safe configuration. A latch secures the shield in the safe configuration and an actuator releases the latch. A sheath of the skin nicking device includes the needle slidably disposed within a lumen thereof and a sharp tip of the blade embedded within a wall thereof.

A catheter placement system having a catheter and a skin nicking device that includes a blade configured to nick the skin of a patient adjacent a catheter insertion site. The catheter includes a multi-luminal catheter tube coupled with multiple extension legs. The catheter tube includes a diameter transitioning section disposed between two sections of the catheter tube having different diameters. The skin nicking device is disposed within a lumen such that a blade at the distal of the skin nicking device protrudes from an aperture of the lumen. The skin nicking device is positionable and rotatable within lumen and removable from the lumen. The skin nicking device includes an elongate body that may include rigid portions and/or flexible portions.

A method for removing a tissue lesion where an anchor is established with the lesion. A channel is created in the tissue leading to the anchored lesion. A tissue core is created which includes the lesion. The tissue core is ligated, amputated and removed from the channel.

Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.

A fixed depth skin flap elevator device is provided. The device includes an elongated handle having a proximal end and a distal end. The device further includes an upper arm and lower arm mounted to, so as to extend longitudinally from, the distal end of the handle. The upper arm overlays the lower arm. At least free ends of the upper and lower arms are spaced apart by a distance which is equal to a pre-determined cutting depth. A blade is supported on the lower arm at about its free end. Translation of at least the lower arm within a tissue interior results in separation of a deeper tissue from a surface tissue at a pre-determined cutting depth to form an undermined skin and subcutaneous surface tissue flap of uniform thickness. A method of using the device is also provided.

A robotic surgical system according to at least one embodiment of the present disclosure includes a robot arm including a proximal end and a distal end and a surgical tool that attaches to the distal end of the robot arm via a robot mount flange on the surgical tool. The surgical tool includes a blade support tip that extends from a first end and a rod that extends from a second end opposite the first end. The rod may include a blunt tip end and an actuation end, where the blunt tip end extends from the second end. Accordingly, the surgical tool may be rotatable about a tool rotation axis between a cutting position disposing the blade support tip in proximity to a target site and a tissue pathway creation position disposing the blunt tip end in proximity to the target site.

A robotic surgical system according to at least one embodiment of the present disclosure includes a first robot arm coupled to a second robot arm, where a surgical tool is attached to the first robot arm and an ultrasonic sensor is attached to the second robot arm. Accordingly, when the first robot arm is moved to position the surgical tool adjacent a target site of a patient, the second robot arm is also moved to position the ultrasonic sensor adjacent the surgical tool and the target site. In some examples, images generated by the ultrasonic sensor may be used to determine layers of fascia of the patient at the target site. Subsequently, the surgical tool may move through the layers of fascia while continuing to receive real-time images of the tissue displacement instrument relative to the target site from the ultrasonic sensor.

A catheter placement system including a catheter having a catheter tube distally coupled to a catheter hub having one or more extension legs proximally coupled to the catheter hub. The catheter tube defines one or more lumens where each of the one or more lumens is in fluid communication with one of the extension legs. The catheter placement system further includes a skin nicking device configured to transition between a sheathed configuration and a deployed configuration. The skin nicking device includes a needle defining a needle lumen, having a needle wall including one or more slots in fluid communication with an outside surface of the needle, and one or more blades configured to be aligned with the one or more slots, the one or more blades coupled to a distal end of one or more connecting members within the needle lumen.

A catheter placement assembly includes a catheter and a skin nicking device having a blade configured to transition between a sheathed configuration and a deployed configuration. The skin nicking device includes a needle defining having a slot extending through the needle wall, where the blade is disposed within the slot. The is hingedly coupled to the needle wall defining a fulcrum. The skin nicking device includes a push rod within the needle lumen, having a distal end operatively engaged with the blade such displacement of the push rod between a proximal position and a distal position transitions the blade between the sheathed configuration and the deployed configuration, respectively.