Orthopedic implants, systems, instruments, and methods. A bi-portal lumbar interbody fusion system may include an expandable interbody implant and minimally invasive pedicle-based intradiscal fixation implants. The interbody and intradiscal implants may be installed with intelligent instrumentation capable of repeatably providing precision placement of the implants. The bi-portal system may be robotically-enabled to guide the instruments and implants along desired access trajectories to the surgical area.

A surgical instrument guide assembly includes a main guide portion that includes a shaft portion extending along a longitudinal axis and a body portion extending along the longitudinal axis, and a proximal end of the shaft portion is disposed at a distal end of the body portion. The main guide portion further includes a first lumen and a second lumen that each extends along the longitudinal axis from a proximal end at a proximal end of the body portion to a distal end at a distal end of the shaft portion. A seal portion is coupled to the proximal end of the body portion of the main guide portion, and the seal portion includes a first port and a second port formed in a seal wall of the seal portion. The seal portion is selectively displaceable from a first position to a second position.

A medical device to protect a body opening, such as a vagina. The medical device may include a lumen and anchoring structure(s) for securing the device in the body opening. In some embodiments, the medical device includes a sleeve, a proximal ring attached to a proximal end of the sleeve, and a distal ring attached to a distal end of the sleeve.

A surgical system includes a surgical assist robot including a robot main body and a slave controller, and a console. The robot main body has an entry guide, an entry guide support device, and at least one manipulator having an end effector provided at a distal end. The entry guide includes an inner cylinder, an outer cylinder into which the inner cylinder is inserted in an insertion axial direction, and a guide advancing device that displaces the inner cylinder in the insertion axial direction with respect to the outer cylinder. While a position and a posture of the end effector that has advanced from the entry guide are maintained, the inner cylinder is caused to advance toward the end effector within a predetermined movable range along the insertion axial direction with respect to the outer cylinder.

A surgical port feature may include a funnel portion, a tongue, a waist portion, and surgical instrument channels. The waist portion may be located between the funnel portion and the tongue. The surgical instrument channels may extend from the funnel portion through the waist portion. The surgical port feature may further include a second tongue, with the wait portion being located between the funnel portion, the tongue, and the second tongue.

A surgical system includes a robot main body, a slave controller, a display device that displays an endoscopic image, and an manipulation input device. The robot main body includes an entry guide having a plurality of guide bores, an entry guide support device that supports the entry guide, an instrument manipulator that has a surgical instrument provided at a distal end and is inserted into the entry guide, and an endoscope manipulator that has an endoscopic camera provided at a distal end and is inserted into the entry guide. The slave controller operates the robot main body such that the surgical instrument advances from an exit of the entry guide after the endoscopic camera advances from the exit of the entry guide and starts capturing in response to input of a body cavity insertion manipulation received by the manipulation input device.

Improved methods and devices for performing an endoscopic surgery including a system for performing minimally invasive procedures including a flexible catheter having a working space expanding system positioned at a distal portion, the working space expanding system movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body lumen. A tissue retractor having an inner member positioned within an outer member has a plurality of closed loops at a distal portion forming a petal-like structure. The loops are positioned in a collapsed position within the outer member and are movable to an expanded position when exposed from the outer member.

A positioning system comprising a first working element having a first tubular shaft, a second working element having a second tubular shaft, an arcuate element having a holding element and an arcuate rail, wherein the arcuate rail is disposed on the holding element and the holding element is adapted to be fixed on the receiving section by means of a fastening element, and a guiding element having a holding section and a guiding section, wherein the holding section is guided on the rail and the guiding section receives the second shaft, the holding section having a locking element securing the guiding element to the rail, wherein the locking element in a locking position blocks displacement of the holding section in a transverse direction and in a release position allows displacement of the holding section in the transverse direction.

An articulating working channel system for use with a plurality of flexible tools which are adapted to be interleaved in a single surgical procedure, comprising: a working channel subassembly including a hollow flexible shaft; and a surgical tool subassembly including the flexible tool, wherein the flexible tool includes a flexible tube which is adapted to be inserted into the flexible shaft and wherein the flexible shaft is adapted to be articulated and the flexible tube is adapted to be passively articulated therewith.

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. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.