Various devices and methods are provided with respect to inserting multiple surgical instruments through a single surgical access device. A medical device including a flexible tissue retractor a releasable insert having multiple instrument openings, and a member such as a sleeve is disclosed. The insert can be in the form of an insert assembly including multiple components. The sleeve can support the insert with respect to the retractor such that the insert and sleeve can be removed together with the retractor remaining in the incision. A method of using the insert is also described.

An access device for surgical procedures includes an end cap having a rigid body with a flexible support sealingly mounted to the rigid body with at least one separate access port for accommodating introduction of individual surgical instruments into a body of a patient. The at least one access port is sealingly attached to the flexible support and extend in a proximal direction therefrom. The flexible support is of a material more flexible than those of the rigid body and the at least one access port to provide for relative angular movement of the at least one access port to provide flexibility for positioning surgical instruments introduced through the at least one access port.

A method for performing a laparoscopic procedure may include inserting a bag through an opening. The method may also include delivering tissue into the bag, sealing the bag, and inflating the bag to create an artificial pneumoperitoneum that extends the abdomen and provides additional working and viewing space. Further, the method may include carrying out a procedure on the tissue located in the inflated bag.

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.

Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.

A flexible cannula and radially extending conformable flanges used to provide an adjustable effective length of flexible cannula, adjustable for varying tissue depths. At least some of the example embodiments include a flexible tubular body having a length, a flexible distal flange, a flexible proximal flange, and one or more flexible intermediate flanges positioned on the length of the tubular body between the distal and the proximal flanges. All of the flanges may be have the equivalent outer diameters. Each flange may be spaced axially spaced apart from the adjacent flexible flange with varying spacing. Some flanges may also have a circumferential row of perforations, allowing for selective removal of some flanges. The tubular body may also have a ring of perforations, allowing for selective removal of a portion of the tubular body. The flexible cannula may also have at least one suture docking stations on a proximal end of the cannula, to selectively retain a length of suture therein.

A surgical access device includes a cannula body and an anchor. The cannula body includes a housing, and an elongated portion extending distally from the housing. The elongated portion defines a longitudinal axis and defines a channel extending therethrough. The anchor is disposed in mechanical cooperation with the elongated portion of the cannula body and is longitudinally translatable relative to the elongated portion. The anchor defines an aperture and includes a ratchet mechanism configured to selectively lock a size of the aperture.

In some examples, a medical device includes a substrate defining a central port configured to provide surgical access to a surgical site opposite the substrate during a surgical procedure; and a plurality of reinforcement features disposed around the central port, wherein each reinforcement feature of the plurality of reinforcement features is configured to receive a suture, and wherein the plurality of reinforcement features are positioned to cause the substrate to tighten around the central port in response to tension being applied to ends of at least one suture connecting two or more reinforcement features.

A guard for providing a cut-resistant pathway through a body orifice or incision to circumferentially protect tissue at the margin is provided. The guard is made of flexible, cut-resistant mesh material having a plurality of interwoven thermosoftening filaments. The guard has a central lumen and at least one flared end. The flared end, which serves to anchor the guard in the body opening, is deformable into a reduced configuration to facilitate its insertion and removal. The layer of mesh stretches laterally to increase the diameter of the central lumen. The flexibility and expandability of the guard allows the guard to conform to body openings of different sizes. The guard may include a drawstring to cinch the flared distal end from the proximal end. The guard is thermoset with the flared distal end that is biased to spring back to its normal, undeformed configuration when released from a deformed configuration.

Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.