An instrument advancement device may include a housing and an extension tube extending through the housing. A wedge may be disposed within the housing. The wedge may include an arc-shaped channel. A pair of opposing pinch members configured to pinch the extension tube may be disposed within the housing and configured to move along the extension tube. An instrument may extend through the arc-shaped channel. A first end of the instrument may be fixed. In response to moving the housing distally along the extension tube, the pair of opposing pinch members may push the wedge distally. In response to movement of the wedge distally a first distance, a second end of the instrument may be configured to advance distally a second distance. A support element or compressible element may be disposed within a lumen of the extension tube to support the instrument.

A surgical port includes an end face comprising a channel extending through the end face, the channel having a cross section shaped to receive a surgical instrument cannula, and a lateral wall extending around a perimeter of the end face, the lateral wall and end face enclosing an open volume. An end portion of a wound retractor is received in the open volume of the surgical port and in engagement with an inner surface of the lateral wall, and the surgical port is configured to abut a body wall in an inserted position of the wound retractor through the body wall.