In at least one embodiment, a medical device can comprise an elongate outer sheath that extends along a sheath longitudinal axis and defines a central lumen extending therethrough, the elongate outer sheath can comprise a proximal sheath portion and a distal sheath portion. A first guidewire can comprise a first guidewire end and a second guidewire end, the first guidewire can extend from the first and second guidewire ends through the central lumen and can form a distal looped portion. An occlusion device can be disposed at a distal end of an elongate flexible shaft. The elongate flexible shaft can extend from the proximal sheath portion through the central lumen. The occlusion device can include a guide lumen through which the first guide wire passes.

A surgical access device includes a cannula body and a fixation mechanism. The cannula body includes a housing, and an elongated portion extending distally from the housing and defining a longitudinal axis. The fixation mechanism includes a sleeve and a spring. The sleeve radially surrounds a portion of the elongated portion of the cannula body. The sleeve is rotatable about the longitudinal axis relative to the elongated portion of the cannula body, and the sleeve is longitudinally translatable relative to the elongated portion of the cannula body. A first portion of the spring is engaged with the sleeve, and a second portion of the spring engaged with a distal portion of the elongated portion of the cannula body. Rotation of the sleeve about the longitudinal axis relative to the elongated portion of the cannula body causes a portion of the spring to move away from the longitudinal axis.

Tool assemblies and methods are disclosed, such as for robotic-assisted surgery with a robot. The tool assembly includes a working tool (44) sized to be coaxially movable within the dilator (60). A locking mechanism (70) releasably couples the working tool (44) and the dilator (60) to one another such that, in a locked configuration, the robot supports the tool assembly. An actuator (86) is configured to receive an input to move the locking mechanism to an unlocked configuration and permit axial movement of the working tool within the dilator. The dilator (60) may include at least one spike (104) disposed within the grooves (128) to penetrate bone. The dilator (60) may include an inner sleeve and outer sleeve coaxially movable relative to one another to move the tool assembly from an initial configuration to a deployed configuration in which the spikes are exposed beyond the sleeve(s). Methods of preparing a pedicle of the spine with the tool assembly with robotic assistance are also disclosed.

A surgical access system is disclosed. The surgical access system having a cannula may include a distal tip having one or more longitudinal channels distributed around a circumference of the distal tip, and one or more circumferential channels around the distal tip. The surgical access system also includes an obturator coaxially insertable within the cannula which may include a distal tip and a retractable cutting element having an actuator. The surgical access system also includes an articulation interface. The surgical access system may also include a distal tip of the cannula that may further include one or more bridges distributed circumferentially along the one or more circumferential channels of the distal tip. The obturator further may include an elongated tube and a slidable plunger element configured to control fluid flow inside the elongated tube of the obturator.

A soft tissue and bone repair system and corresponding method are provided which are particularly useful for labral repairs in the human shoulder. The system comprises at least two guide cannulae capable of being introduced into an anatomical structure of a human body at different entry points for repair of a tear in soft tissue. A pulling line can be passed within the anatomical structure between the guide cannulae. A guide device may be attached to the pulling line and inserted into one of the guide cannula. The guide device is capable of delivering a drilling device into the anatomical structure. The pulling line is capable of being pulled to move an end of the guide device from a one location to another within the anatomical structure to position the drilling device on a desired drilling path to access the tear in soft tissue.

Devices, systems and methods for cardiac and vascular access configured to allow for intracardiac access to conduct medical procedures. The devices, systems and methods are particularly useful in trans-cardiac extra-corporeal membrane oxygenation (ECMO) procedures, ventricular assist procedures, cardiopulmonary bypass, or other medical procedures where intracardiac access may be required.

A system for performing minimally invasive procedures in a working space within a body lumen of a patient including a flexible catheter configured to receive a working instrument therethrough. The flexible catheter has a working space expanding system positioned at the distal portion, the working space expanding system including first and second flexible elements movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body. The first and second flexible elements are connected at a distal region by a coupling structure. A stabilizing member stabilizes the distal portion of the flexible catheter.

In some embodiments a PEG feeding device includes a tube sized to bridge a channel between a stomach and an outer abdominal surface; an internal bolster, and an external bolster. Optionally the bolsters are connected to the tube. The internal bolster may be sized to resist movement out of the stomach through the stoma. The external bolster may be sized to resist movement into the stoma from the outer abdominal surface. The external bolster may include an underside which extends from the tube in a radial direction between the external bolster and the outer abdominal surface. The underside of the outer bolster may contact the outer abdominal surface at a distance from an external opening of the stoma. Optionally the distance between the internal bolster and the external bolster is adjustable. Optionally an angle between one or both of the bolsters and the tube is adjustable.

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).