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 radially expandable trocar, port or cannula system is provided for use in minimally invasive surgeries. The cannula creates a port access with an initial small internal diameter. The passage of the cannula devices is defined by a plurality of elongate rigid members. A number of mechanisms are provided for expanding the passage of the cannula devices, by moving the plurality of elongate rigid members towards a larger radial location, thereby creating a larger internal diameter for the port. The elongate rigid members can be prevented from unintended movement when the system is at the un-expanded state, during expansion and when it is expanded to the desired larger diameter. Exemplary embodiments include methods of preventing gas loss from the tissue that would occur through the gaps created during expansion.

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.

Systems, devices, and methods for providing access to the heart. The system includes an intracardiac access device comprising an elongate member having a channel extending between a distal end and a proximal end thereof. The intracardiac access device is configured to be advanced through an extrapericardial penetration in the left atrial wall without penetrating the pericardium of the heart. An optional procedural device is configured to be advanced through the channel of the intracardiac access device into an internal chamber of the heart and configured to perform a surgical procedure in the internal chamber of the heart. A working channel of an optional suprasternal access device is configured to facilitate access of the intracardiac access device into the body of the patient by providing a path from a suprasternal opening to a position adjacent the roof of the left atrium.

A system may comprise a first catheter having a first steerable segment and a second catheter disposed within the first catheter. The second catheter may have a second steerable segment. The system may also comprise an imaging element supported at a distal end of the second catheter, a coil reference sensor supported at a distal portion of the second catheter, and a processor in electrical communication with the coil reference sensor. The processor may be configured to determine a position of a distal portion of the first catheter with reference to the coil reference sensor.

A cannula for passing surgical instruments through tissue. In some instances, the cannula may include a distal flange flexible between a radial configuration and a longitudinal configuration. In some instances, the cannula may also include an actuator configured to move the distal flange between the radial configuration and the longitudinal configuration. In some instances, the cannula may include a valve disposed within the lumen of the cannula, and a cap configured to secure the valve to the cannula. The valve may include a body member having a base and first and second opposing walls extending from the base. In some instances, the valve has an arcuate cutout in the lower surface configured to fit around an instrument shaft inserted therethrough. In some instance, the cannula includes a slit extending an entire length of the cannular to permit an instrument shaft to be inserted and/or removed laterally.

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.

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.