Gas-tight seal assemblies for us during minimally invasive surgery include various aspects. A wiper seal includes a sealing portion and a surrounding flex portion. Upper and lower faces of the sealing portions are angled with reference to an inserted instrument, the upper face's angle being more acute with reference to the instrument's shaft than the lower face's angle. The flex portion is corrugated, support ribs are in one or more corrugation grooves, and the support ribs allow the groove to easily collapse but resist the groove widening. The support ribs also prevent the sealing portion from inverting. An instrument insertion guide is positioned over the sealing portion and moves laterally with the sealing portion. A latch piece removably secures the seal assembly to a cannula. An anti-inversion piece prevents the wiper seal from inverting when an instrument is withdrawn. An assembly may include various combinations of the seal assembly, a cannula, a surgical instrument, an obturator, an endoscope, and a teleoperated medical device. The seal assembly may rotate within a cannula. The seal assembly may be used during manual or teleoperated surgery.

An introducer sheath is provided for inserting at least one medical instrument directly toward a target patient tissue site. A plurality of lumens extend longitudinally between sheath proximal and distal ends of the introducer sheath. A septum extends between the sheath proximal and distal ends and selectively laterally separates each of the sheath lumens from one another. The septum is at least partially formed from a deformable and elastomeric material. The septum has a biased condition in which the plurality of sheath lumens are at least partially isolated from one another. The septum is selectively deflectable from the biased condition to at least partially place at least one of the plurality of sheath lumens in fluid communication with at least one other of the plurality of sheath lumens.

Disclosed are medical devices for surgical procedures, especially procedures that involve the manipulation of surgical instrument end effectors close to the skin surface at an incision site. In accordance with some embodiments, an instrument access device is configured to couple to a wound retractor at a distal end of the device and to receive a multiple instrument entry guide in a port at the proximal end of the instrument access device, with an envelope between the distal and proximal ends defining a sealed cavity for maintaining insufflation pressure. Various embodiments provide means for rotating an assistant port in the envelope about a port that receives the instrument entry guide without twisting the envelope. Also disclosed are various envelope shapes. Also disclosed is an instrument entry guide that aligns surgical instrument shafts.

A surgical instrument guide assembly includes a main guide portion that includes a shaft portion extending along a longitudinal axis and a body portion extending along the longitudinal axis, and a proximal end of the shaft portion is disposed at a distal end of the body portion. The main guide portion further includes a first lumen and a second lumen that each extends along the longitudinal axis from a proximal end at a proximal end of the body portion to a distal end at a distal end of the shaft portion. A seal portion is coupled to the proximal end of the body portion of the main guide portion, and the seal portion includes a first port and a second port formed in a seal wall of the seal portion. The seal portion is selectively displaceable from a first position to a second position.

A seal assembly including a septum seal, a lower seal support, an upper seal support and a return spring is disclosed. The septum seal includes an orifice and a plurality of apertures. The lower seal support includes an engagement surface configured to engage a portion of the septum seal. The upper seal support includes a plurality of fingers, wherein each of the plurality of fingers is configured to extend through a corresponding aperture of the septum seal. The return spring includes a collar portion and a plurality of spokes extending radially outward from the collar portion. At least a portion of the return spring may be sandwiched between the lower seal support and the upper seal support. The plurality of spokes is configured to bias the seal assembly toward a radial center of a housing.

A powered surgical instrument comprising a housing, an elongate shaft, an articulation joint, a rotary drive member configured to rotate in response to rotary motion from an electric motor, a coupling portion, and a stapling attachment releasably attachable to the coupling portion is disclosed. The stapling attachment is secured to the coupling portion by rotating one of the stapling attachment and the coupling portion relative to the other of the stapling attachment and the coupling portion. The stapling attachment comprises an elongate channel configured to receive a staple cartridge. The stapling attachment further comprises an anvil, a drive screw, and a firing member operably engaged with the drive screw. The coupling portion operably couples the rotary drive member and the drive screw when the stapling attachment is attached to the elongate shaft. The firing member is advanced distally within the stapling attachment when the drive screw is rotated.

A cannula with a proximally mounted camera and proximally mounted light sources. The lighting sources have beam axes directed distally, toward a workspace at the distal end of the cannula. The light sources are coupled with focusing lenses, to reduce the beam angle of the lighting sources and reduce glare within the cannula tube.

A method for performing an efficient and thorough percutaneous discectomy includes making into the patient a percutaneous incision, which is a small stab wound, no more than approximately 10 mm in length. A stimulated combination neuro-monitoring dilating probe is passed through an approximately 10 mm or less skin incision and into a patient's disc space to establish a safe path and trajectory through Kambin's Triangle. Once a neuro-monitoring dilating probe is in the disc space, a second dilator is placed over the neuro-monitoring dilating probe and impacted into the disc space. Neuro-monitoring dilating probe may then be removed. An access portal optionally combined with a force dissipation device may then be placed over the second dilator and into the disc space. The second dilator is removed and then discectomy instruments may be placed through the access portal to perform the discectomy.

A surgical robotic system has a tool drive coupled to a distal end of a robotic arm that has a plurality of actuators. The tool drive has a docking interface to receive a trocar. The system also includes one or more sensors that are operable to visually sense a surface feature of the trocar. One or more processors determine a position and orientation of the trocar, based on the visually sensed surface feature. In response, the processor controls the actuators to orient the docking interface to the determined orientation of the trocar and to guide the robotic arm toward the determined position of the trocar. Other aspects are also described and claimed.

An expandable access port includes a port body transitionable between expanded and collapsed configurations. The expandable access port also includes a plug with a first portion secured to the port body and a second portion flexibly coupled to the first portion by an arm. The first portion has an orifice and the second portion has a post insertable into the orifice. A tube is attached to an inflation port on the first portion of the plug. The tube is attachable to a source of inflation fluid and in fluid communication with a chamber of the port body. A lumen extends through the port body and is configured to slidably receive the post or a surgical instrument therethrough. The lumen forms a fluid-tight boundary when the port body is in the expanded configuration.