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 instalment 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 (822) between the distal (804) and proximal (812) 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.

An instrument manipulator may comprise a frame comprising an outer shell and an inner frame, the inner frame being movably coupled to the outer shell. The instrument manipulator may also include a plurality of actuator outputs protruding in a distal direction from the frame and an instrument support feature coupled to the outer shell. The instrument manipulator may further comprise a latching mechanism, the latching mechanism being configured to move the inner frame, the outer shell, or both relative to one another, so as to operably engage the plurality of actuator outputs with a plurality of actuator inputs of an instrument supported by the instrument support feature.

An invention for transfixing a plurality of cannulas 14 through a tissue 25 for providing a plurality of entry-ports 33 to a surgical site 26, comprising: a base 10; and a plurality of cannulas 14 connected to said base 10; wherein each said cannula 14 includes an access-port 3, is provided. Also, the invention for transfixing a plurality of cannulas 14 through a tissue 25 for providing a plurality of entry-ports 33 to a surgical site 26, comprising: a sleeve 9 including a base 10; said sleeve 9 including a plurality of cannulas 14 connected to said base 10; a mandrel 1 including a handle 7; and said mandrel 1 including a plurality of piercing tips 2 connected to said handle 7; wherein said mandrel 1 detachably engage said sleeve 9 forming a single punch assembly; wherein said cannula 14 includes an access-port 3 to a surgical site 26, is provided.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

The present invention relates to a hysteresis compensation control apparatus of a flexible tube and a method thereof for compensation control of hysteresis of a surgical instrument disposed in a channel of an overtube. The hysteresis compensation control apparatus includes: an input unit receiving image information and tension information of a flexible surgical instrument required for mode switching; a mode switching determining unit for determining a current state of the surgical instrument on the basis of the image information of the surgical instrument, and generating a control mode switching signal according to the current state of the surgical instrument; a mode switching unit for switching a control mode from a flexible tube control based on the image information to a flexible tube control based on the tension information according to the control mode switching signal; and a compensation control unit for compensatingly controlling a flexible surgical instrument having hysteresis characteristics on the basis of a tension error value calculated by a learning model.

Surgical devices having a plurality of outwardly-biased flexible fins capable of both inward convergence and outward flexion, provide for fluid retention and soft tissue retraction during surgical procedures. The outwardly-biased flexible fins also provide for soft tissue compression, decreasing the length of the lumen or passageway through which instruments pass, allowing for a wider range of movement of instruments and better access to the surgical site, especially in patients with greater amounts of fat tissue that would otherwise require longer lumen lengths in prior art endoscopic cannulas. An obturator assembly including a cannulated handle member with a cannulated shaft attached to said handle member, said shaft extending distally and terminating at a cannulated obturator tip. A hood structure found on such obturator tip may be used to secure one or more flexible fins prior to deployment.

An insertable robot for minimally invasive surgery includes a tube array having a guide tube housed within a straightening tube. The guide tube includes a curved working end. The guide tube may be axially translated and rotated relative to the straightening tube such that the curved working end is constrained inside the straightening tube, causing the curved working end to achieve a smaller dimension. The tube array is inserted into a working channel on an endoscope, resectoscope or trocar. Once the tube array is inserted, the curved working end of the guide tube is translated forward beyond the distal end of the working channel, allowing the curved working end to return to its pre-formed shape. A surgical tool is inserted through the guide tube for an operation. The straightening tube allows the guide tube curved working end to be temporarily straightened during insertion and removal of the tube array.

Surgical sealing ports for use with surgical instruments for access of a natural body orifice are provided. In one exemplary embodiment, a surgical sealing port includes a seal housing and at least one retention element. The seal housing is configured to be at least partially disposed within a natural body orifice and defining a plurality of ports. The plurality of ports includes at least one first port configured to control the ingress and egress of fluid between an interior volume of the natural body orifice and an ambient environment, and at least one second port that is configured to form a seal around an instrument inserted therethrough. The at least one retention element is arranged on an exterior surface of the housing and configured to affix the housing to the natural body orifice. Methods for using the same are also provided.

A steerable instrument has an actuator at a proximal side and a bendable zone at a distal side. The actuator controls bending of the flexible zone by means of one or more longitudinal elements. The instrument has a first cylindrical element, a second cylindrical element and a third cylindrical element. The second cylindrical element has a zone with a longitudinal element portion with a first height in a radial direction of the instrument. Radial spacers are located at mutual sides of the longitudinal element portion, which have, at least locally, a second height in the radial direction larger than the first height.

A system for use in surgery includes a central body, a visualization system operably connected to the central body, a video rendering system, a head-mounted display for displaying images from the video rendering system, a sensor system, and a robotic device operably connected to the central body. The visualization system includes at least one camera and a pan system and/or a tilt system. The sensor system tracks the position and/or orientation in space of the head-mounted display relative to a reference point. The pan system and/or the tilt system are configured to adjust the field of view of the camera in response to information from the sensor system about changes in at least one of position and orientation in space of the head-mounted display relative to the reference point.