An access system includes a proximal handle, an overtube coupled to the handle, and an endoscope port extending through handle and overtube sized for receiving an endoscope therethrough. The overtube includes anatomic wall securing system that secures a distal portion of the overtube within a hole in the anatomic wall. The overtube is provided with a shaped distal portion or a controllably shapeable distal portion that aids in directing an endoscope inserted through the port to a particular location within the peritoneal cavity. The access system includes a system for insufflating/deflating the peritoneal space separately from the body cavity accessible via a natural orifice. The access system includes a closure system to cinch closed the hole made in the anatomical wall after the access system has been removed from the hole. Methods are provided for inserting the access system through the anatomical wall to perform intra-abdominal surgery.

The present invention is directed at minimally invasive systems in which the proximal end portion of the working channel has either zero or a limited range of movement in the lateral direction. A first embodiment has a slidable collar attached to a pair of flanges, wherein movement of the collar is bounded by an annular frame. A second embodiment has a substantially spherical element attached to the tube. A third embodiment has a plurality of caps. A fourth embodiment is adapted for a larger working channel.

The instrument ports for introducing instruments into a surgical site that are disclosed herein include a port body having a channel running therethrough from a proximal end to a distal end, an instrument sleeve in slidable contact with the channel, creating a gap therebetween, and a fluid flow element for removing emboli efficiently from the instrument port, wherein the fluid flow element includes the gap. Disclosed fluid flow systems are for use in the disclosed instrument ports. Methods are also disclosed for removably securing an instrument sleeve to a port body by anchoring the instrument port to heart tissue, making at least one flood line in a channel, flushing out emboli, and performing surgery with the instrument port.

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 flange, a fixation sleeve, and a proximal sleeve. The flange is rotatable about the longitudinal axis. The fixation sleeve extends distally from the flange and radially surrounds a portion of the elongated portion of the cannula body. The proximal sleeve extends distally from the flange and radially surrounds a proximal portion of the fixation sleeve. Rotation of the flange causes a radially-expandable portion of the fixation sleeve to move between a first position defining a first gap between the radially-expandable portion and the elongated portion, and a second position defining a second, greater, gap between the radially-expandable portion and the elongated portion.

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 wireless pedicle screw system and method of use for fixation and/or stabilization of vertebral bodies using pedicle screws and rods or plates is described. The wireless pedicle screw system includes a dilator tube having a generally elongated body defined by a continuous wall. The elongated body has a proximal end, a distal end, and an inner lumen running the length of the elongated body sized to receive and enclose various pedicle screw implant instruments. Positioned at the distal end are alignment/positioning members constructed to properly aid a surgeon in aligning the dilator tube to portions of the vertebra. Proper placement about the vertebra using the engagement members results in the ability to insert pedicle screws, resulting in minimizing tissue trauma, reducing operating room time, reducing X-Ray radiation exposure, and eliminating the need for k-wire guidance.

A retractor having an elongated body that provides access to a surgical location within a patient. The elongate body includes a plurality of segments that are connected to one another through a plurality of ratcheting mechanisms. The ratcheting mechanisms permit relative movement of the segments with respect to one another when expander dilators are inserted within the retractor. The segments are surrounded and retained by a resilient elastomeric sleeve or bands. The distal end surfaces of the segments include thin edges that are configured to mobilize, dissect, split and retract the terminal tissues in the surgical area. The retractor may be used in conjunction with a shim.

The present disclosure is directed to devices, kits, and methods for treating lumbar spinal stenosis by at least partially decompressing a compressed nerve root. The method can include identifying the compressed nerve root and percutaneously accessing a region of a lamina located adjacent to the compressed nerve root. The method can also include forming a channel through the region of the lamina, wherein the channel can be formed medial to a lateral border of the lamina. Further, the method can include expanding the channel in a lateral direction.

An example assembly for use with a vacuum system and an esophageal positioning device esophageal positioning device includes an introducer, in which the esophageal positioning device includes a first segment and a second segment. The second segment is pivotally connected to the first segment. A gap portion of an outer tube of the introducer is defined along a longitudinal axis between a tube tip of the introducer and the distal end of the second segment of the esophageal positioning device when the esophageal positioning device is disposed within the introducer. The gap portion defines one or more radial vacuum holes.

A device for creating an intercostal transcutaneous access to an, in particular endoscopic, operating field including a base body, which closely surrounds an incision all-side frame-shaped and with at least two webs mounted on the base body, which can be introduced into an intercostal space, by which two ribs arranged next to each other can be moved apart. To create a device for creating an intercostal transcutaneous access to an, in particular endoscopic, operating field which allows individual pressing apart of the ribs, it is proposed according to the invention that the at least two webs are mounted adjustable relative to each other on the base body.