A method of forming an access opening through a psoas muscle to a patient's spine includes laterally inserting a stimulating dilator into the psoas muscle. The stimulating dilator has a stimulation channel formed in an outer surface thereof. An electrical pulse is transmitted into the stimulating dilator to locate a position of a nerve in the patient's psoas muscle. The stimulating dilator is laterally inserted through the psoas muscle and toward the patient's spine in a way that avoids the nerve. A stimulating probe is inserted into the stimulation channel along the outer surface of the stimulating dilator while transmitting an electrical pulse into the stimulating probe to verify the position of the nerve.

A method for delivering a graft or synthetic mesh for anatomical repair to the repair site, with the graft or synthetic mesh in position for attachment to repair the defect. A plurality of spaced apart, flexible fingers is connected to the graft or synthetic mesh. The flexible fingers are initially in a position that is generally parallel to a direction of travel of the actuator. The actuator moves the plurality of flexible fingers from the initial to form a radial array, which opens or extends the graft or synthetic mesh. The graft or synthetic mesh may then be attached. A novel trocar is disclosed that is useful with the device. A measuring device including a measuring scale that is useful for determining the required size of the graft is also disclosed.

Minimally invasive surgical techniques are used to obtain access to vertebrae while protecting soft tissues in the surrounding area. The dilators may be used to provide a working channel through which the operation is performed. Standard dilators may be used with a robotic surgical system to provide precise guidance of surgical tools. A dilator may be held by the robot and automatically repositioned when the surgeon adjusts a trajectory for performing the surgery. The dilator itself may be used as a surgical instrument guide along with dilator adaptors that adjust the diameter of a portion of the dilator to allow for different sized tools to be guided by the dilator. Alternatively, surgical instrument guides may also be held by the robotic arm such that tools are guided by a surgical instrument guide through the dilator to perform a medical procedure.

A medical treatment implement which has an excellent degree of freedom of a procedure and into which a trocar can be re-stuck includes a tubular retractor main body configured to be indwelled in an incision wound and a converter (20) configured to close an opening end portion of an upper end of the retractor main body and to be puncturable with a trocar. The converter (20) includes a ring-shaped frame portion (22) detachably mounted on the opening end portion and a sheet portion (21) which is mounted inside the frame portion (22) and airtightly covers the opening end portion. A compression force P is applied to the sheet portion (21) in an inner diameter direction.

A surgical system includes a surgical arm including at least a distal segment. The surgical system further includes a drape disposed over the surgical arm such that the surgical arm is at least partially covered by the drape. An instrument connector is coupled to the distal segment of the surgical arm through the drape and includes a stem and a shaft. The shaft is configured to receive a surgical instrument. When the instrument connector is coupled to the surgical arm, the instrument connector secures a portion of the drape against the distal segment of the surgical arm. Other example surgical systems and surgical arms are also disclosed.

A cannula system and method for accessing a blood mass in the brain. The system comprises a cannula with a camera mounted on the proximal end of the cannula with a view into the cannula lumen and the surgical field below the lumen. A prism, reflector or other suitable optical element is oriented between the camera and the lumen of the cannula to afford the camera a view into the cannula while minimizing obstruction of the lumen. The system may also include an obturator with a small diameter shaft and a large diameter tip which is optically transmissive, so that a surgeon inserting or manipulating the assembly can easily see that the obturator tip is near brain tissue (which is white) or blood (which is red).

The present invention relates generally to implants and tools for the fixation or fusion of joints or bone segments. These tools include tissue dilators and protectors. Other tools include broaches used to shape bores in bone. The tools can also include a system for removing an implant from bone. Implants can include assemblies of one or more implant structures that make possible the achievement of diverse interventions involving the fusion and/or stabilization of lumbar and sacral vertebra in a non-invasive manner, with minimal incision, and without the necessitating the removing the intervertebral disc. Implants for fusing both sacroiliac joints of a patient include a long implant that extends across both sacroiliac joints.

An introducer sheath includes a tubular body configured to be percutaneously inserted into a body lumen and a hub that is connected to a proximal portion of the tubular body, wherein the tubular body contains a polyamide resin having a structural unit derived from a cyclic aliphatic hydrocarbon, and a wall thickness/inner diameter ratio of the tubular body is 1/14 or less, and a kink radius/outer diameter ratio of the tubular body is less than 10.

A catheter assembly may include a cannula. The cannula may include a distal tip, an elongated tubular shaft, and an inner lumen formed by the elongated tubular shaft. A first portion of the elongated tubular shaft may have a first outer diameter. The first portion may be proximate the distal tip. A second portion of the elongated tubular shaft may have a second outer diameter. The second outer diameter may be greater than the first outer diameter. The catheter assembly may also include a catheter adapter, which may include a catheter and a catheter hub. The second portion of the elongated tubular shaft may be at least partially disposed in the catheter hub.

Interspinous process implants are disclosed. Also disclosed are systems and kits including such implants, methods of inserting such implants, and methods of alleviating pain or discomfort associated with the spinal column.