An end effector including an elongate shaft with a lumen has an adapter at one end for coupling with a handle assembly of a surgical instrument. A support member has opposed openings defining a passage. The support member is positionable within the lumen. A trocar assembly has a sleeve and a trocar member. The trocar assembly is insertable into the passage. The sleeve includes an orifice extending through a wall of the sleeve. A pin is disposed in the elongate shaft and is slidable in a direction that is transverse to a longitudinal axis of the elongate shaft. The pin is insertable into the orifice for retaining the trocar assembly longitudinally stationary relative to the elongate shaft that defines an inserted position of the pin. The support member includes a proximal ramp that is engageable with a head of the pin to maintain the pin in the orifice of the sleeve.

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 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.

Trocar retractor apparatus and methods for use are described where an apparatus for positioning an instrument may generally include a substrate having a first surface and a second surface opposite to the first surface, an instrument positioning guide projecting from the first surface of the substrate, and one or more suction assemblies positioned along the second surface and in fluid communication with an interior of the substrate. The one or more suction assemblies may be attachable to a tissue region via a vacuum force applied through the one or more suction assemblies. The apparatus may also have the substrate configured to maintain a predetermined configuration when the vacuum force is applied.

In an aspect, a device includes a body structure including a core and a sleeve disposed around at least a portion of the core, the core defining a channel through the core extending from a first end of the core to a second end of the core, the sleeve including a flange adjacent the second end of the core; and a deployable portion coupled to the body structure adjacent the first end of the core, the deployable portion having a wired structure transitionable between a retained configuration and a deployed configuration, wherein a top portion of the wired structure extends beyond the first end of the core in a longitudinal direction when the wired structure is in the retained configuration, and wherein first end of the core extends beyond the top portion of the wired structure when the wired structure is in the deployed configuration.

An end effector including an elongate shaft with a lumen has an adapter at one end for coupling with a handle assembly of a surgical instrument. A support member has opposed openings defining a passage. The support member is positionable within the lumen. A trocar assembly has a sleeve and a trocar member. The trocar assembly is insertable into the passage. The sleeve includes an orifice extending through a wall of the sleeve. A pin is disposed in the elongate shaft and is slidable in a direction that is transverse to a longitudinal axis of the elongate shaft. The pin is insertable into the orifice for retaining the trocar assembly longitudinally stationary relative to the elongate shaft that defines an inserted position of the pin. The support member includes a proximal ramp that is engageable with a head of the pin to maintain the pin in the orifice of the sleeve.

An electrical lead for implantation in a patient is disclosed. The electrical lead can include a distal portion configured to split apart into sub-portions that travel in multiple directions during implantation into the patient and an electrode extension that increases a distance between an electrode and one or more other electrodes on the distal portion of the lead and/or facilitates contact of the electrode with patient tissue.

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.

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.