Methods and apparatus for treating disorders of the ear, nose, throat or paranasal sinuses, including methods and apparatus for dilating ostia, passageways and other anatomical structures, endoscopic methods and apparatus for endoscopic visualization of structures within the ear, nose, throat or paranasal sinuses, navigation devices for use in conjunction with image guidance or navigation system and hand held devices having pistol type grips and other handpieces.

In one embodiment of the invention, an apparatus for performing surgical procedures is disclosed including a flexible entry guide tube, and a first steering device. The flexible entry guide tube has one or more lumens extending along its length from a proximal end to substantially at or near a distal end. At least one of the one or more lumens is an instrument lumen with open ends to receive a flexible shaft of a surgical tool to perform surgery near the distal end of the flexible entry guide tube. The first steering device is insertable into the instrument lumen to shape the flexible entry guide tube as it is inserted through an opening in a body and along a path towards a surgical site. The apparatus may further include a flexible locking device to couple to the flexible entry guide tube and selectively rigidize the flexible entry guide tube to hold its shape. The flexible entry guide tube may be steered by remote control with one or more actuators.

A seal comprises a first sealing member and a second sealing member. The sealing members each have an accessway to facilitate access from one side of the sealing member to the other side of the sealing member. The accessways are offset to facilitate sealed access of an object through the sealing members.

Disclosed is a method for manufacturing a steerable instrument for endoscopic and/or invasive type applications, the instrument including an elongated tubular body having a proximal end part, a distal end part and an intermediate part between proximal and distal end parts, the proximal end part having at least one actuation proximal zone. The distal end part has at least one flexible distal zone, and the elongated tubular body is configured such that a movement of an actuation proximal zone is transferred to a corresponding flexible distal zone for a corresponding movement thereof. The elongated tubular body includes an inner, outer, and intermediate cylindrical elements having longitudinal elements between the inner and outer cylindrical elements. Inner, outer and intermediate cylindrical elements are coupled so movement of an actuation proximal zone is transferred by the longitudinal elements of one of the intermediate cylindrical elements to a corresponding flexible distal zone.

This endoscopic surgical device includes: an endoscope; a treatment tool; and a mantle tube. The inside of the mantle tube is partitioned by a partition wall member provided with an endoscope guide groove and a treatment-tool guide groove, to form an endoscope insertion passage and a treatment-tool insertion passage. An endoscope fixation tool and a treatment-tool fixation tool are respectively disposed inside the endoscope guide groove and the treatment-tool guide groove. The endoscope fixation tool advances and retracts in conjunction with the endoscope insertion part inserted through the endoscope insertion passage. The treatment-tool fixation tool moves in conjunction with the treatment-tool insertion part inserted through the treatment-tool insertion passage. When a coupling ring externally fitted to the partition wall member interlocks the endoscope fixation tool with the treatment-tool fixation tool, the endoscope insertion part also moves in conjunction with the advancement and retraction of the treatment-tool insertion part.

The disclosed technology is directed to a medical instrument for endoscopic use. The medical instrument comprises an elongated open ended over tube configured to receive an endoscope in a direction along a longitudinal central axis of the over tube. The endoscope travels retractably from a distal end of the over tube. A tube is disposed concentrically outwardly of the over tube so that a treatment tool is inserted through the tube and is projected forwardly with respect to the over tube from a distal end of the tube. A balloon is disposed on an external surface of the over tube and is expandable outwardly in a radial direction of the over tube.

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.

Orthopedic implants, systems, instruments, and methods. A bi-portal lumbar interbody fusion system may include an expandable interbody implant and minimally invasive pedicle-based intradiscal fixation implants. The interbody and intradiscal implants may be installed with intelligent instrumentation capable of repeatably providing precision placement of the implants. The bi-portal system may be robotically-enabled to guide the instruments and implants along desired access trajectories to the surgical area.

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.

The present application discloses a device and methods for performing a vascular closure procedure that comprises inserting a sheath into a tissue tract defined in a body part and injecting a procoagulant material into the tissue tract adjacent a vascular access site via the sheath.