An instrument access device (500) comprises a distal O-ring (11) for insertion into a wound interior, a proximal member for location externally of a wound opening and a sleeve (12) extending in two layers between the distal O-ring (11) and the proximal member. The proximal member comprises an inner proximal ring member (25) and an outer proximal ring member (24) between which the sleeve (12) is led. A seal housing (300) is mounted to the inner proximal ring member (25). A gelatinous elastomeric seal (302) with a pinhole opening (303) therethrough is received in the housing (300). An instrument may be extended through the seal (302) to access the wound interior through the retracted wound opening in a sealed manner.

Access port cutters and related systems and methods can be used to cut an access port to a desired length based on particular patient and/or surgical procedure needs at a point of use. More particularly, an access port cutter can include a base with an opening that can receive an access port therein such that a desired length of the access port can extend from the opening. An actuation mechanism can translate a blade linearly along at least a portion of the base such that the blade can traverse the opening and cut across the access port. In some embodiments, the actuation mechanism can include a handle that can pivot relative to the base to drive the blade. One or more safety features can reduce the risk of inadvertent actuation of the blade and/or prevent debris from contaminating a surgical site or falling onto a patient.

Systems and methods for reducing insufflation loss due to gas leakage during a laparoscopic surgical procedure are provided. The surgical procedure includes the use of a surgical instrument having an end effector and a trocar through which the surgical instrument is inserted for access to the abdominal cavity of a patient receiving laparoscopic surgery. The trocar includes a lip, a lip seal disposed within the lip, and a cannula located beneath the lip. The systems and methods reduce or prevent a loss of insufflation when using conventional systems and methods to insert the surgical instrument through a conventional trocar.

Disclosed herein are multiple cannulas defining a lumen sized and dimensioned to receive one or more medical instruments, an inflatable outer membrane attached to an outer surface of the cannula, and at least one activator that reversibly pressurizes a fluid contained in the outer membrane to fill or pressurize the outer membrane.

A cannula assembly includes an elongate shaft assembly that is adjustable by a clinician to vary the length of the cannula assembly. In particular, the elongate shaft assembly may be transitioned to provide various lengths of the cannula assembly by selectively positioning a plurality of segments of the elongate shaft assembly. In this manner, a single cannula assembly may be tailored to each patient or a surgical procedure being performed.

An adjustable trocar assembly includes a housing configured to facilitate insertion of one or more surgical tools into a patient's body, and an elongated tubular member extending distally from the housing and defining a longitudinal axis. The elongated tubular member includes a channel configured to facilitate passage of surgical instruments through the elongated tubular member, an adjustable portion configured to facilitate axial movement of the elongated tubular member, a collar of fixed diameter; and a rim of fixed diameter equal to the diameter of the collar.

Systems and methods for augmenting a vertebral body may include an optional access cannula, introducer device, and a stylet having a stylet shaft. The access cannula includes a hub portion and a cannula shaft extending from the cannula hub. The cannula shaft includes a distal end positionable within the vertebral body that defines a lumen along a longitudinal axis. The introducer device may be a telescoping or pivoting introducer device that is removably coupled to the hub portion of the access cannula. The introducer device controls the movement of the flexible distal portion of the stylet shaft and the flexible sheath from within the introducer device through the access cannula to within a target site in the vertebral body, wherein the flexible distal portion is moved from the constrained to the unconstrained state to displace cancellous bone within the target site.

Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; a funnel segment extending between and coupling the outer ring and the tubular body, wherein the funnel segment provides a diametric reduction between the relatively large diameter of the outer ring and the relatively smaller diameter of the tubular body, which is sized to fit within a natural orifice with minimal distention of the orifice; and an inflatable member disposed around the distal end of the tubular body, the inflatable member sized and configured to fit snugly around the tubular body in the deflated condition and to expand against the wall of the natural orifice in the inflated state to thereby stabilize and retain the retractor within the orifice.

A portal saver assembly with a dermal fixation device that is removably attached to a length-adjustable portal saver. The portal saver assembly includes a tubular body having a rigid proximal end with threads and a proximal adjustment body having an outer ridge and an inner bore with threads. The threads on the rigid proximal end of the tubular body are configured to mate with the threads on the inner bore of the proximal adjustment body. The portal saver assembly also includes a dermal fixation device with a central bore and a locking mechanism around the central bore. The outer ridge of the proximal adjustment body is removably attached to within the central bore by the locking mechanism.

A surgical tool with a stiffening sleeve that is dynamically retractable during surgery. The tool includes a needle or implement for performing minimally invasive surgery through a pre-placed cannula at a surgical site. A stiffening sleeve of the tool about the implement may provide an added degree of stiffness such as where the implement is particularly thin. However, an end of the sleeve is held in position at the cannula as the implement advances therebeyond for the surgery. Nevertheless, as determined by the surgeon, the implement may be further advanced with a corresponding and deliberate retraction of the sleeve into the tool body as desired.