An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

A tibial suprapatellar entry portal system (1) comprising a sleeve (2), an anchor pin (200), and a trocar (40).

A drape includes a first drape portion configured to receive a manipulator arm of a surgical system and a pocket coupled to a distal portion of the first drape portion. The pocket is configured to receive a manipulator of the surgical system. The pocket includes a flexible membrane positionable between an output of the manipulator and an input of a surgical instrument mountable to the manipulator. In some embodiments, the flexible membrane is located at a distal end of the pocket. In some embodiments, the flexible membrane is configured to allow an actuating force to be transmitted from the output of the manipulator to the input of the surgical instrument. In some embodiments, the pocket provides a sterile barrier between the manipulator and the surgical instrument. In some embodiments, the drape further includes a rotatable seal configured to couple a proximal opening of the pocket to the first drape portion.

A cannula and instrument guide assembly includes a cannula with a proximal portion and a tube. An instrument guide is removably inserted into the proximal portion of the cannula and extends through the cannula to a distal end of the tube. The proximal portion of the cannula has an insufflation port. The instrument guide provides at least one interior passageway to support a shaft of a surgical instrument that passes through the instrument guide. One or more channels on an outer surface of the instrument guide provide a passage for insufflation gas received from the insufflation port to the distal end of the tube. The one or more channels have a first cross-sectional area at a proximal end and a second, larger cross-sectional area at a distal end. The one or more channels may have the first cross-sectional area along a majority of the length of the channels.

A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. An access cannula may be introduced over the first dilator tube. A drill may be inserted through the access cannula and used to perform a foraminoplasty. Surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

The instrument ports for introducing instruments into a surgical site that are disclosed herein include a port body having a channel running therethrough from a proximal end to a distal end, an instrument sleeve in slidable contact with the channel, creating a gap therebetween, and a fluid flow element for removing emboli efficiently from the instrument port, wherein the fluid flow element includes the gap. Disclosed fluid flow systems are for use in the disclosed instrument ports. Methods are also disclosed for removably securing an instrument sleeve to a port body by anchoring the instrument port to heart tissue, making at least one flood line in a channel, flushing out emboli, and performing surgery with the instrument port.

An apparatus for performing surgical procedures is disclosed including a flexible entry guide tube and a first steering device. The guide tube has one or more lumens extending along its length from a proximal end to substantially at or near a distal end. At least one of the one or more lumens is an instrument lumen with open ends to receive a flexible shaft of a surgical tool. The first steering device is insertable into the instrument lumen to shape the guide tube as it is inserted through an opening in a body and along a path towards a surgical site. The apparatus may further include a flexible locking device to couple to the flexible entry guide tube and selectively rigidize the guide tube to hold its shape. The guide tube may be steered by remote control with one or more actuators.

A cannula is provided that includes a head portion that defines a proximal opening sized to receive one or more surgical instruments; an elongated inner tube rigidly fastened to the head portion defines an elongated conduit; a surgical instrument can be inserted within the conduit; an elongated overtube rigidly fastened to the head portion is coaxially aligned with the inner tube and extends about a portion of the inner tube; an inner wall of the overtube is spaced apart from an outer wall of the inner tube; sensors are disposed on the overtube to provide an indication of forces applied to the outer wall of the overtube in a direction generally transverse to the longitudinal dimension of the overtube.

The present disclosure provides a cannula assembly having a tube with an internal lumen, a proximal end portion and a distal end portion configured for insertion into a patient. The cannula assembly further includes a housing rotatably coupled to the tube between a closed position and one or more open positions. The housing contains an electronic component comprising an image transmission device, such as a camera, for collecting and receiving images of the surgical site. The housing is adapted to provide the image transmission device with a longitudinal or forward view when the housing is in the closed position and a transverse view (i.e., offset from the longitudinal axis) when the housing is in one of the open positions. The housing is disposed distal to the proximal end portion and proximal to the distal end portion of the tube to protect the image transmission device as the distal end portion creates an incision and/or passes through an existing incision in the patient.

An endoscope and an illuminator are safely placed in a body cavity without generating a noticeable postoperative scar. A method of placing medical insertion instruments into a body cavity includes a first step of inserting, into the body cavity through a first opening formed on a body wall, an endoscope together with a first illuminator; and a second step of inserting, into the body cavity through a second opening formed at a position different from the first opening, a second illuminator. Preferably, the method further includes a third step of pulling out the first illuminator from the first opening and inserting the first illuminator into the body cavity through a third opening formed at a position different from the first and second openings.