Interspinous process implants are disclosed. Also disclosed are systems and kits including such implants, methods of inserting such implants, and methods of alleviating pain or discomfort associated with the spinal column.

Certain aspects of the present disclosure generally relate to ophthalmic surgery, and more particularly, to methods and apparatuses for controlling intraocular pressure (IOP) and administering ocular tamponades during or after ophthalmic surgery. An exemplary apparatus generally includes a proximal segment having a first inner diameter (ID), a first proximal end, and a first distal end. The apparatus further includes a distal segment having a second ID smaller than the first ID, a second proximal end, and a second distal end configured to be disposed inside a hub or a cannula transition of a valved cannula comprising the hub, a shaft, and the cannula transition between the hub and the shaft.

A surgical access device assembly includes a cannula hub and a cannula tube. The cannula tube extends distally from the cannula hub along a longitudinal axis. The cannula tube defines a working channel. The cannula tube includes a tissue engagement feature and a balancing feature. The balancing feature is configured to promote lateral stability of the cannula tube and the cannula hub relative to the body cavity wall of the patient. The balancing feature includes a proximal portion of the cannula tube having a first wall thickness. The balancing feature also includes a distal portion of the cannula tube having a second wall thickness that is greater than the first wall thickness. At least a portion of the proximal portion is proximal relative to the tissue engagement feature. At least a portion of the distal portion is distal relative to the tissue engagement feature.

A surgical access device assembly includes a cannula hub and a cannula tube. The cannula tube extends distally from the cannula hub along a longitudinal axis. The cannula tube defines a working channel. The cannula tube includes a tissue engagement feature and a balancing feature. The balancing feature is configured to promote lateral stability of the cannula tube and the cannula hub relative to the body cavity wall of the patient. The balancing feature includes a proximal portion of the cannula tube having a first wall thickness. The balancing feature also includes a distal portion of the cannula tube having a second wall thickness that is greater than the first wall thickness. At least a portion of the proximal portion is proximal relative to the tissue engagement feature. At least a portion of the distal portion is distal relative to the tissue engagement feature.

A serial dilation system includes a plurality of serial dilators that can be advanced over each other so as to dilate anatomical soft tissue along a trajectory toward a target anatomical site. An access cannula can then be introduced over the serial dilators. The serial dilators can be coupled to each other, such that once the access cannula is in place, removal of one of the serial dilators from the access cannula causes all of the serial dilators to be removed from the access cannula.

A modular retractor may include a first body portion that houses a distraction mechanism for opening and closing a first arm and a second arm. A first pivoting member may be coupled to a distal end of the first arm and a second pivoting member may be coupled to a distal end of the second arm, for example. A first blade attachment mechanism may be coupled to the first pivoting member and a second blade attachment mechanism may be coupled to the second pivoting member. The first and second blade attachment mechanisms may be configured to couple to first and second blades and be independently inclinable. Various embodiments may include at least one connection point for connecting to at least one additional retractor module. Various embodiments may include at least one quick connect coupler for connecting to a snap on table mount.

The use of stepped cannulas, wherein a step structure creates a backstop to reduce backflow along the cannula body, is known for convection enhanced delivery of agents to the brain and other structures within an animal. Described herein are novel and improved stepped cannula designs wherein the length of the cannula segment between the step and the dispensing outlet is variable and can be controllably adjusted inside the patient during delivery. This advantageously allows the operator to place the cannula step at the optimal position and deliver agents at one or more positions within the target structure.

An arthroscopic port introduction system includes an elongate hollow introducing needle and an elongate stylet sized and adapted to be disposed within the elongate hollow introducing needle together forming a single tissue-penetrating tip. The system also includes an elongate hollow enlarging shaft adapted to be disposed over the elongate hollow introducing needle. An operative tissue-penetrating length of the elongate hollow introducing needle is exposed beyond a distal end of the elongate hollow enlarging shaft. The elongate hollow introducing needle can be removed in a proximal direction from the elongate hollow enlarging shaft. An arthroscopic port sheath is disposed over the elongate hollow enlarging shaft and an operative tissue-penetrating length of the elongate hollow enlarging shaft is exposed beyond a distal end of the arthroscopic port sheath. The elongate hollow enlarging shaft can be removed in a proximal direction from the arthroscopic port sheath.

A self-contained, battery powered transseptal crossing system is disclosed. An elongate, flexible electrically conductive needle body has a proximal end and a distal end. An insulation layer surrounds the sidewall and leaves exposed a distal electrode tip. A generator is configured to deliver RF energy to the electrode tip, and includes a processor configured to take impedance measurements at the tip to confirm contact with the intra atrial septum and/or confirm entry into the left atrium.

To be able to prevent a situation in which, in percutaneous dilational tracheostomy, the guide catheter already inserted into the trachea can kink, a device for percutaneous dilational tracheostomy is disclosed which has a puncture needle, a guide catheter and a guidewire. The puncture needle has a ground tip at its distal end. The maximum external diameter of the puncture needle is smaller than the minimum internal diameter of the guide catheter, and the puncture needle is insertable so far into the guide catheter that the ground tip of the puncture needle protrudes beyond the distal end of the guide catheter. The maximum diameter of the guidewire is smaller than the minimum internal diameter of the puncture needle, with the result that the guidewire can be guided through the puncture needle such that its end protrudes beyond the ground tip of the puncture needle.