A surgical access device including a housing having a nozzle assembly, a gas supply plenum, a gas return plenum, and a pressure sensing plenum, as well as an elongated tubular body that extends from the housing portion and defines a central lumen communicating with the nozzle assembly and the gas return plenum, a telescopic cannula assembly associated with the tubular body and including a proximal section arranged coaxially within the tubular body and a distal section coaxially supported within the proximal section and mounted for movement relative to the proximal section between retracted and extended positions, and an elastomeric sheath associated with the telescopic cannula assembly and having a distal anchor portion for securing the surgical access device during a laparoscopic surgical procedure.

The invention relates to a trocar sleeve or trocar and a trocar tip for minimally invasive/endoscopic surgical procedures carried out on people or animals. The trocar sleeve here has holding means in order to prevent the device from slipping out during the operation.

An insertion device that allows gaining access to the left ventricle of the heart, via the tissue forming the wall of the right ventricle and via the ventricular septum, which includes a tubular shaft with a lumen extending there through, the shaft comprising distal, proximal and central sections, whereby the distal and proximal sections are disc-shaped extended thus forming each a double disc and whereby the central section links the distally placed double disc with the proximally placed double disc and whereby pressure valves are fixed inside the shaft preferably on its distal and proximal end.

A device and system are described that are capable of isolating at least one targeted tissue and forming an anastomosis between two internal body structures though a completely endoscopic procedure. Further, the device and system described generally comprise two tubular members that are capable of moving in a telescopic fashion relative to one another. Additionally, a method is described for using the device and/or system to bypass the duodenum from digestion.

A method of treating a patient's joint having opposing joint surfaces includes providing an elongate member having a proximal end, a distal end and an expandable member near the distal end. The expandable member is positioned in the joint between the joint surfaces and expanded so as to separate the joint surfaces away from one another into a distracted position. The joint is manipulated while in the distracted position so that the joint is distracted and in flexion. A diagnostic or therapeutic procedure is then performed on the joint while maintaining the joint in the flexed and distracted position.

The present teachings provide devices and methods for percutaneously removing internal tissue. Specifically, one aspect of the present teachings provides a tissue incising element with a sharp cutting edge and a longitudinal lumen and a tissue stabilizer slidably disposed within the longitudinal lumen of the tissue incising element. The tissue incising element has a deployed configuration during tissue cutting and a small collapsed configuration during the percutaneous delivery and removal. The tissue stabilizer includes a tissue supporting/gripping element configured to support tissue during incising and capture the removed tissue.

A dilation assembly comprises an expandable and contractible main body having a corrugated outer surface, a guide cannula configured to be disposed through the main body to guide a movement of the main body, and an anchor configured to fix the main body in a target position.

An elongated catheter includes a tissue-engaging device configured to be urged to move and contact a first surface of the first biological wall. The tissue-engaging device extends from the distal catheter section. The tissue-engaging device is configured to be urged to puncture through the first biological wall. The tissue-engaging device is also configured to be urged to contact the first biological wall without impinging the second biological wall, after the tissue-engaging device has punctured through the first biological wall.

An apparatus is provided for use in a medical procedure for stabilizing a target during approach of the apparatus towards the target. The apparatus comprises a body having a proximal end and a distal end, the distal end having a cavity formed therein, and a advanceable tip housed within the cavity. The advanceable tip is advanceable to engage a surface of the target.

Apparatus comprises: (A) a housing (248), percutaneously deliverable to a heart of a subject, slidable along a guidewire (242), and shaped to define at least one opening (249); (B) a guide member (250), percutaneously deliverable to the heart, percutaneously removable from the subject, couplable to the housing, and having: (i) a distal portion, comprising a chord-engaging element (252), configured to be percutaneously slidably coupled to and decouplable from at least one chordae tendineae (244), and (ii) a proximal portion, comprising a longitudinal element (251); and (C) a deployment tool, configured (i) to be reversibly coupled to a tissue anchor (50,280), (ii) to be slidably coupled to the longitudinal element of the guide member, and (iii) to anchor the tissue anchor to a papillary muscle (254) of the subject. Other embodiments are also described.