A variable flow stent is described for use with AV fistulas, TIPS procedures or dialysis grafts. The flow may be varied by adjusting the diameter of the stent. Embodiments include: a covered stent having a secondary chamber that functions as an air or fluid bladder; an expandable chamber within an interior stent covering; a retractable jack device with hooks that engage (snag) opposing walls of the stent; and, a stent with a hollow chamber or pocket in the interior stent covering into which an expandable balloon can be inserted. A self-healing valve is described for inflating or deflating expandable elements within the stent and may be implemented using a self-healing membrane. A radiopaque collar may be used to provide a marker surrounding the self-healing valve. If under-shunting or over-shunting occurs over time, the variable diameter stent may be adjusted using a second procedure.

The present invention generally provides methods and devices for removing fluid from a surgical instrument. Surgical access devices and seal systems are generally provided having one or more valves or seal assemblies to create a closed system between the outside environment and the environment in which the surgical access device is being inserted. The devices of systems can also include a fluid remover in the form of a sorbent element, a scraper element, a wicking element, or any combination thereof that is configured to remove fluid from a working channel of the device or system and/or from a surgical instrument inserted therethrough.

A valve mechanism (3) for attaching to a proximal end (4) of a trocar cannula (2) for minimising leakage of insufflating and other gases proximally from the trocar cannula (2), comprises a housing (7) adapted for securing to the trocar cannula (2) adjacent the proximal end (4) thereof. The housing (7) defines an instrument bore (22) extending from a proximal end (23) to a distal end (21). A distal valve (28) is located adjacent the distal end (21) of the instrument bore (22) and is pivotal from an open state to a closed state. A proximal valve (40) is located towards the proximal end (23) of the instrument bore (22), and comprises first and second valve members (41) and (42) which are urgeable from a withdrawn state clear of the instrument bore (22) to an engagement state sealably engaging an instrument in the instrument bore (22) for sealing the instrument bore (22). A detecting probe (34) pivotal about a primary pivot axis (35) is urgeable distally from a first state to a second state by the distal end of an instrument passing distally through the instrument bore (22). A drive transmission (74,108) transmits drive from the detecting probe (34) to the proximal and distal valves (40,28), so that as the detecting probe (34) is urged from a first state to a second state the distal valve (28) is urged into the open state and the proximal valve (40) is simultaneously urged from the withdrawn state to the engagement state to minimise leakage of gas proximally through the instrument bore (22) and to minimise contact of an instrument with the proximal and distal valves (40,28).

A containment vessel for storing and rinsing a medical implant coupled to a delivery system having an outer sheath may include a hollow element having a wall, a proximal end, a distal end, and a lumen extending between the proximal end and the distal end, the lumen of the hollow element being configured and adapted to contain a medical implant in a partially-deployed configuration during storage and rinsing of the medical implant and a proximal end cap including a secondary proximal end cap removably secured to the proximal end cap and configured to reversibly seal the proximal end cap to the outer sheath, thereby establishing a closed fluid connection between the lumen of the hollow element and a lumen of the outer sheath. The proximal end cap may include a sheathing guide configured and adapted to direct the medical implant into the lumen of the outer sheath.

Access assemblies includes an instrument valve housing and a valve assembly disposed within the cavity of the instrument valve housing. The valve assembly includes a guard assembly, and a seal assembly disposed distal of the guard assembly. In embodiments, the seal assembly includes a plurality of seal segments in an overlapping configuration. Each seal segment of the plurality of seal segments includes a seal portion having a smooth surface and a ribbed surface. The ribbed surfaces include a plurality of ribs extending in a radial direction.

Access assemblies include an instrument valve housing and a valve assembly. The valve assembly includes a guard assembly, a seal assembly disposed adjacent to the guard assembly, and a gimbal mount assembly supporting the guard assembly and the seal assembly. The gimbal mount assembly is configured to permit angulation of the valve assembly relative to the instrument valve housing.

The surgical robotic access system provides access for robotic instruments and/or actuators including the introduction, operation and withdrawal of such robotic manipulators into a body cavity without permitting the escape of pressurized fluid or gas. The surgical robotic access system also provides a multi-faceted range of movement without touching or effecting pressure on the opening in the patient's body cavity.

Access assemblies include an instrument valve housing and a valve assembly disposed within the cavity of the instrument valve housing. The valve assembly includes a guard assembly, a seal assembly disposed adjacent to the guard assembly, and a centering mechanism for maintaining the seal assembly and guard assembly centered within a cavity of the instrument valve. The guard assembly includes a support ring and a plurality of guard sections disposed distally of the support ring. The seal assembly includes a proximal seal member, an intermediate seal assembly, and a distal seal member, the intermediate seal assembly including a plurality of seal sections in a stacked configuration

A surgical system comprising a cannula assembly and an obturator assembly for penetrating tissue is disclosed. A cover of the cannula assembly is mounted to a cannula housing and has a cover aperture therethrough. The cover has a trailing end face defining a predetermined geometrical configuration, at least a portion of the trailing end face is obliquely arranged relative to a longitudinal axis and terminates in, and leads toward the cover aperture to facilitate guiding of the surgical object through the cover aperture. The obturator assembly includes an obturator housing and an obturator member. The obturator housing has a housing base defining a leading end face, which defines a predetermined geometrical configuration corresponding to the predetermined geometrical configuration of the trailing end face of the cover to mate therewith upon assembly of the obturator assembly with the cannula assembly.

Surgical access devices having wound closure features incorporated as part of the device are provided. The devices allow suture to be inserted directly into the device and operated to close an opening through which the device is disposed as or shortly after the device is removed from the surgical site. Further, the wound closure features allow for various orientations of wound closure to be achieved by adjusting an angle at which the suture enters tissue surrounding the opening to be closed. Some of the wound closure features provided for include openings formed in both the housing and cannula of the surgical access device, multiple openings formed in one or both the housing and cannula, locations of the openings being adjustable or otherwise movable, and various flexible seals. Other features, as well as methods of closing an opening through which the surgical access device was disposed, are also provided.