Access devices including access ports and retractors, which enhance the working area and access to a surgical site. The access port includes a tubular body with at least one sidewall defining an interior path along the length of the tubular body. The sidewall includes a rigid portion and a flexible portion. The flexible portion is able to stretch or deform, for example, to accommodate an angled trajectory of a surgical implement. A surgical access device for retracting tissue includes a plurality of retractor blades. The outer surface of the retractor blades form a substantially circular cross-sectional configuration with a plurality of spiral ridges projecting therefrom such that advancement of the retractor into the surgical site may be improved.

A medical device includes a tube comprising a proximal end, a distal end, a wall extending from the proximal end to the distal end of the tube and surrounding a hollow interior of the tube, and one or more engagement features on the lateral wall. An inflatable member is located at a distal end portion of the tube. The medical device also includes a repositionable anchor located on the tube proximal to the inflatable anchor and configured to engage the one or more features on the lateral wall. In a first configuration of the medical device, the repositionable anchor is translatable along the tube, and in a second configuration of the medical device the repositionable anchor is fixed in translation relative to the tube.

An anchoring system for cannulas or tools to be inserted into a surgical workspace in the body, particularly the brain, of a patient. The system comprises a grommet which may be fixed to the skull to both secure the system to the skull and protect the skull opening from passage of cannulas and tools, a resilient clip with grasping jaws adapted to firmly grasp a cannula or tool, and a flexible membrane secured to the outer rim of the grommet and the clip.

A pressure relief device for controlling the outflow of fluid from a surgical site. The pressure relief device includes a cannula body having a proximal end and a distal end with a thread extending along the entire cannula body from the distal end. The device also has a proximal end cap connected to the proximal end of the cannula body, a spacer connected between the cannula body and the proximal end cap, and a proximal seal enclosed between the proximal end cap and the spacer. One or more distal seals can be enclosed between the spacer and the proximal end of the cannula body. The device additionally includes a channel between the spacer and an inner wall of the proximal end cap. Fluid flows out of the device through the channel.

A surgical access device includes a proximal end portion configured to support a seal assembly having an insufflation port. The device includes a cannula tube extending distally from the proximal end portion and having an inner surface that defines a lumen extending longitudinally through the cannula tube. The cannula tube is configured to be inserted distally through a body cavity wall of a patient, and the lumen is configured to guide a surgical instrument shaft distally through the cannula tube for accessing a body cavity of the patient. The device includes a channel formed in the inner surface of the cannula tube. The channel extends longitudinally between a proximal end of the lumen and a distal end of the lumen, and the channel is configured to direct a gas therethrough to or from the insufflation port of the seal assembly while a surgical instrument shaft is disposed within the lumen.

Medical devices, systems, and methods reduce the distance between two locations in tissue in a minimally invasive manner, often for treatment of congestive heart failure. In one embodiment, an anchor of an implant system may, when the implant system is fully deployed, reside within the right ventricle in engagement with the ventricular septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along an epicardial surface of the heart. Deployment of the anchor within the right ventricle may be performed by inserting a guidewire through the septal wall into the right ventricle. The anchor may be inserted into the right ventricle over the guidewire and through a lumen of a delivery catheter. Delivering the anchor over the guidewire may provide improved control in the delivery and placement of the anchor within the right ventricle.

Embodiments described herein include devices, systems, and methods for reducing the distance between two locations in tissue. In one embodiment, an anchor may reside within the right ventricle in engagement with the septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along a surface of the heart. Perforating the exterior wall and the septum from an epicardial approach can provide control over the reshaping of the ventricular chamber. Guiding deployment of the implant from along the epicardial access path and another access path into and through the right ventricle provides control over the movement of the anchor within the ventricle. The joined epicardial pathway and right atrial pathway allows the tension member to be advanced into the heart through the right atrium and pulled into engagement along the epicardial access path.

A catheter device 10 with a cutting structure or means 16 on the distal portion 14 is disclosed, along with a medical procedure for using the device. The catheter 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

A catheter has a cannulated guiding rail extending therethrough, an advance segment of the rail extending at least about 10 cm beyond the distal end of the catheter. The catheter and rail are advanced over a guidewire until the distal end of the advance segment is at a target vascular site. The catheter is thereafter advanced along the rail to the target vascular site.

A catheter has a cannulated guiding rail extending therethrough, an advance segment of the rail extending at least about 10 cm beyond the distal end of the catheter. The catheter and rail are advanced over a guidewire until the distal end of the advance segment is at a target vascular site. The catheter is thereafter advanced along the rail to the target vascular site.