The present disclosure generally relates to systems and methods for guiding surgical tools to a surgical site, and more particularly, to systems and methods for guiding a tool sheath of a delivery system to a surgical site such as a location in a subject's brain and associated surgical procedures.

A surgical instrument for removing biological tissue during a surgical procedure comprises an elongate shaft and an end effector connected to the elongate shaft, the end effector including an edge configured to remove tissue, wherein curvature of one or both of the elongate shaft and end effector is adjustable to position the edge along a tissue surface when the curvature of the one or both of the elongate shaft and end effector is adjusted. A method of incising target tissue from an anatomic wall comprises inserting a shaft of a surgical instrument into an anatomic chamber of a patient, positioning a tissue-removal device connected to the shaft proximate the target tissue, deflecting an axis of the tissue-removal device relative to a central axis of the shaft, and shaving a surface of the anatomic wall by moving the tissue-removal device in a deflected state along the target tissue.

Disclosed herein are various systems and methods for guiding, supporting, and/or housing instruments. One exemplary system includes a guide tube having a manipulation section and mated with rails carrying instrument control members. Moving the rails with respect to the guide tube, or another point of reference, can control movement of the manipulation section.

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

A single-patient-use disposable tool comprises a molded, single-piece body with a curved upper surface having a predetermined bend radius for bending a needle slidably disposed in a sheath. A distal end of the curved surface has a slot for insertion of a tip of a needle, while the proximal end of the curved surface has a guide member for slidably receiving the sheath. Two finger loops or similar ergonomic features allow the user to rotate the bending tool relative to the sheath to bend the needle about the predetermined bend radius. After completing the bend, the tool is removed from the needle and disposed of.

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.

Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device (e.g., an energy delivery device).

A system for accessing a body cavity, such as a paranasal sinus, may include a sinus access member and a handle. The sinus access member may include a rigid support tube, a curved shape memory member slidably disposed at least partially within the rigid support tube, a flexible tube slidably disposed over at least part of the curved shape memory member, and proximal coupling end. The handle may include an engagement mechanism at a distal end for releasably attaching to the proximal coupling end of the sinus access member, a housing for gripping with a hand, a curving slider for extending and retracting the curved shape memory member, and an extension slider for extending and retracting the flexible tube relative to the curved shape memory member and the rigid support tube. The handle may be reusable, and the sinus access member may be disposable.

Systems comprising a needle assembly configured to be inserted and steered within the brain, body tissue, or cavity, for the purpose of performing a surgical procedure. The needle assembly comprises robotically controlled and motorized concentric cannulas. For bending, there may be provided, for example, a tensioning wire configured to bend an inner cannula, or a cannula with an adjustable natural curve. A flexible inner element passing through the bend of the inner cannula is made self-straightening to minimize susceptibility to displacement from its intended path as it is advanced through the tissue. The self-straightening inner element comprises, for example, at least one of a super-elastic tube, a shape-memory alloy tube, a slotted tube, a tightly coiled memory alloy spring, circular links held together by pulling cables preloaded by springs, and a notched inner cannula with a cable connected via a loaded spring to tension the inner cannula.

A system (1070) for accessing a body cavity, such as a paranasal sinus, including a sinus access member (1028) and a handle (1000). The sinus access member (1028) includes a rigid member (1020), a curved member (1027) slidably disposed at least partially with the rigid member (1020), and a flexible member (1023) slidably disposed with at least part of the curved member (1027). The system includes a handle (1000) that receives a proximal end of the sinus access member (1028). A slider (1310) extends from the handle (1000) for advancing or angulating the sinus access member (1028). The handle (1000) further includes an engagement control (1110) for selecting the advancing or angulating. The handle (1000) further includes a rotator (1400) rotationally linking two or more of the rigid member (1020), the curved member (1027), and a flexible member (1023).