A method for gripping the pericardium uses a device with an outer part and an inner part. The device is pushed through an incision towards the pericardium until an end of the device touches the pericardium or the heart or a layer arranged on the heart. Subsequently, the inner part is moved until at least one outer part end and/or an inner part end is arranged on the pericardium. The device for gripping the pericardium has an inner tube and an outer tube. The inner tube and the outer tube have end surfaces with different surface structures.

Various exemplary angled surgical trocars and methods of using angled surgical trocars are provided. In general, a trocar configured to be advanced into a body of a patient can have an angled distal portion. The trocar can have a cut-out at its distal end in the angled distal portion of the trocar. The trocar can be advanced into the patient's body alone or with an obturator located therein. The obturator located in the trocar can have a flexible portion configured to bend within the trocar's angled distal portion. The trocar and obturator can be used in a variety of medical procedures, for example thoracic procedures in which the trocar is used to provide access to a thoracic cavity of a patient.

A surgical access assembly may include an outer sheath defined by an open distal end and an open proximal end and including a hollow body portion therebetween, and a flexible tool delivery device having a hub and a guide tube, the hub configured to selectively secure to a rim at the proximal end of the outer sheath, and the guide tube configured to extend at least partially into the outer sheath and provide a flexible tool proximate to a tissue.

A valve component 1 of the invention comprises a main valve 2 which is located on a centre line and at least one auxiliary valve 3 which is located radially outwardly of the main valve 2. The main valve may be used for sealing engagement with a cannula. In some cases the cannula may be used for introduction of a number of robotically controlled surgical instruments generally, including a camera. The auxiliary valves 3 may be utilised to introduce another instrument through the valve component. The valve component is mounted in a manner which ensures that the valve component 1 is rotatable about a centre line through the axis of the valve component 1. This ensures that the valve component 1 can be rotated relative to a cannula inserted through the main valve 2 and consequently that the auxiliary valves 3 are rotatable relative to the cannula allowing the auxiliary valves 3 to be positioned to facilitate optimum access and manipulation for an auxiliary instrument(s) inserted through the auxiliary valve(s) 2.

A surgical apparatus includes an instrument portal including a first proximal end, a first distal end, and a first elongated member, the first elongated member defining a first bore having a first dimension, wherein the first bore extends from the first distal end to the first proximal end, wherein the maximum clearance of the instrument portal is the first dimension and a drill guide reducer configured to be inserted into the instrument portal, the drill guide reducer including an elongated cylindrical member defining an enclosed body surrounding an opening, the enclosed body having an outside dimension that is smaller than the first dimension, such that the drill guide reducer is sized to fit within the instrument portal and defining an inner dimension configured to receive a drill guide, wherein the inner dimension of the drill guide reducer is smaller than the first dimension of the instrument portal.

An insertion part of an endoscope and an insertion part of a treatment tool, which are inserted in an outer tube, can be synchronously moved in the axial direction, and, even when the insertion part of the treatment tool is slightly moved in the axial direction, an excellent endoscopic image without shake is obtained. When a treatment tool of an endoscopic surgery device moves by a displacement amount over an allowance amount, an endoscope moves in interlock with the movement of the treatment tool. Moreover, the treatment tool 50 moves in the axial direction with the allowance amount t with respect to the endoscope 10. Therefore, when the treatment tool is moved by a displacement amount of allowance amount or less, the endoscope does not move. By providing such allowance amount, slight movement of the treatment tool is not transmitted to the endoscope.

Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.

In some embodiments, disclosed herein are systems and methods of treating a patient that can include the steps of accessing the sphenopalatine fossa, and cannulating the inferior orbital fissure from the sphenopalatine fossa to access the retro-orbital space. The sphenopalatine fossa can be accessed via various routes, including percutaneously. Accessing the sphenopalatine fossa can include the step of inserting a needle-catheter system into the sphenopalatine fossa. Integrated needle-catheter systems as described herein can also be configured to access the trigeminal ganglion, epidural space, intrathecal space, and other desired anatomical locations.

A method for performing a surgical procedure includes generating, by a computing device, an anatomical map of a patient from a plurality of images; positioning a trocar obturator adjacent to the patient; calculating, by the computing device, a projected path of the trocar obturator; overlaying, by the computing device, the projected path of the trocar obturator with the anatomical map of the patient; and displaying the projected path of the trocar obturator and the anatomical map of the patient on a display device to define an augmented image.

A surgical access assembly includes a cannula and a retention anchor including an annular body and a washer secured to the annular body. The annular body includes an inner side surface defining an opening therethrough, and the washer includes an inner terminal edge defining an opening therethrough that is aligned with the opening of the annular body. The elongated shaft of the cannula extends through the openings. The washer is transitionable between a first configuration in which the inner terminal edge of the washer is coincident with or disposed radially outwardly of the inner side surface of the annular body so that the retention anchor is slidable along the elongated shaft, and a second configuration in which the inner terminal edge of the washer extends radially inwardly of the inner side surface of the annular body and engages the elongated shaft to fix the retention anchor to the elongated shaft.