Disclosed herein are apparatuses, systems, kits, and methods for treating skin, such as skin tightening or for treating diseases, disorders, and conditions that would benefit from tissue area or volume reduction, skin restoration, skin tightening, skin lifting, and/or skin repositioning and/or for generally improving skin function or appearance (e.g., the removal of unwanted skin features or irregularities such as sebaceous glands, sweat glands, hair follicles, necrosis, and fibrosis). Such apparatuses, systems, kits, and methods comprise an apparatus having a handheld main body and a detachably attachable tip comprising one or more needles.

A cannula for providing a pathway for surgical instruments in a minimally invasive procedure including a flexible body portion having a lumen extending from the proximal region to the distal region, a proximal opening, a distal opening and a flange extending radially outwardly from the distal region and being flexible for insertion through an incision in a body of a patient. A rigid body portion extends proximally of the flexible body portion which is more flexible than the rigid body portion. A first seal is positioned within the rigid body portion and spaced proximally of a region of the flexible body portion distal of the rigid body portion, the seal preventing egress of fluids from the body of the patient.

A trocar assembly comprises an elongate shaft, a piercing tip at a distal end of the shaft, a handle at a proximal end of the shaft, and a retaining member. When a passer tube is positioned over the shaft, the retaining member engages with an inner surface or an outer surface of the passer tube to retain a position of the passer tube over the shaft.

An intervertebral disc surgical system has at least one optical cannula configured with a working channel and an optical channel, wherein the working channel and the optical channel are positioned parallel to one another. The working channel is configured to receive the elongated tubular member of an electrosurgical instrument and the optical channel is configured to receive an optical scope. The optical cannula has an optical cannula operative end for entering an operative field of a patient.

A posterior spinal fusion system may include a plurality of cannulas that mate with cages polyaxially coupled to pedicle screws. The cannulas maintain access to the pedicle screws to facilitate percutaneous insertion of a fusion rod into engagement with the cages. Each cannula has a pair of blades that may be held together by an abutment member that at least partially encircles the blades. Each abutment member abuts the skin to define a variable subcutaneous length of the corresponding cannula. Each abutment members is also lockably removable from the corresponding blades to enable the blades to pivot with respect to the connecting element to a position in which they can be withdrawn from the connecting element. The blades of each cannula are spaced apart to provide first and second slots of each cannula, through which the fusion rod can be percutaneously inserted.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

The shaft-type instrument (1) has a shaft part (2), fixedly connected at one end to a shaft grip (3), and a sliding part (4). The sliding part (4) is displaceably mounted relative to the shaft part (2) and is, at one end, in operative connection with a pretensioned handgrip (5) such that by actuating the handgrip (5), the sliding part (4) is displaceable counter to the pretension. A respective lever arm (7, 7′) is articulated at two spaced apart shaft articulation points (6, 6′) on the shaft part (2) or shaft grip (3). The handgrip (5) has a coupling section (8) which connects the lever arms (7, 7′) and coupling joints (9, 9′) to one another such that same can pivot in the same direction. The coupling joints are spaced apart and a grip section (10) extends transverse to the coupling section (8) and to the shaft part (2).

A medical instrument includes a handle, a trocar in communication with the handle, and a cannula in communication with the trocar and the handle. The cannula is engaged (locked) with the handle when linearly displaced proximally towards the handle and, the cannula is disengaged (unlocked) from the handle when linearly displaced distally away from the handle. The cannula is linearly reciprocated, between the locked position and the unlocked position, along a linear travel path defined parallel to a longitudinal axis of the trocar such that the cannula is prohibited and permitted to articulate about the longitudinal axis of the trocar, and relative to the handle, respectively. Advantageously, the cannula is locked and unlocked from the trocar by without requiring an external force exerted generally transverse to trocar and/or cannula—thereby permitting a user to lock/unlock the cannula, relative to the trocar, with one hand.

A cannula assembly for use in robotic surgery is disclosed that includes a robotic cannula having a housing with an open end and a tubular portion extending distally from the housing, the tubular portion being dimensioned to accommodate passage of a surgical instrument having a 12 mm diameter, an adapter assembly configured for engagement within the open end of the cannula housing and including a tubular body with a passage supporting a primary seal dimensioned to accommodate passage of a surgical instrument having a 12 mm diameter, and an insert tube dimensioned to extend through the passage of the body portion of the adapter assembly and the tubular portion of the robotic cannula, the insert tube including a head portion with a passage supporting a secondary seal dimensioned to accommodate a surgical instrument having an 8 mm diameter.

Devices and methods for cleaning a port reservoir are disclosed. The system includes a trocar, cannula and cleaning member. In one embodiment, the cleaning member has scraping members disposed at its distal end for mechanical breakup of thrombus formation. The cleaning member can also have a lumen for infusing anti-coagulant fluid and aspirating loose pieces of thrombus formation.