CA2099354A1 - Flexible endoscopic surgical port - Google Patents

Flexible endoscopic surgical port

Info

Publication number
CA2099354A1
CA2099354A1 CA002099354A CA2099354A CA2099354A1 CA 2099354 A1 CA2099354 A1 CA 2099354A1 CA 002099354 A CA002099354 A CA 002099354A CA 2099354 A CA2099354 A CA 2099354A CA 2099354 A1 CA2099354 A1 CA 2099354A1
Authority
CA
Canada
Prior art keywords
tubular body
body wall
obturator
flange
surgical port
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002099354A
Other languages
French (fr)
Inventor
Roger L. Hildwein
Robert C. Uschold
J.D. Staley, Jr.
Paul Riestenberg
Laura Gallagher
Rex Nagao
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Inc
Original Assignee
Roger L. Hildwein
Robert C. Uschold
J.D. Staley, Jr.
Paul Riestenberg
Laura Gallagher
Rex Nagao
Ethicon, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Roger L. Hildwein, Robert C. Uschold, J.D. Staley, Jr., Paul Riestenberg, Laura Gallagher, Rex Nagao, Ethicon, Inc. filed Critical Roger L. Hildwein
Publication of CA2099354A1 publication Critical patent/CA2099354A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3423Access ports, e.g. toroid shape introducers for instruments or hands
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320016Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3431Cannulas being collapsible, e.g. made of thin flexible material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3439Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3419Sealing means between cannula and body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3423Access ports, e.g. toroid shape introducers for instruments or hands
    • A61B2017/3427Access ports, e.g. toroid shape introducers for instruments or hands for intercostal space
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B2017/348Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484Anchoring means, e.g. spreading-out umbrella-like structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B2017/348Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3492Means for supporting the trocar against the body or retaining the trocar inside the body against the outside of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006Properties of materials and coating materials
    • A61F2002/30092Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0019Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Abstract

ABSTRACT OF THE DISCLOSURE

A flexible endoscopic surgical port comprises a trocar tube or cannula made partially or entirely of flexible material which can be inserted into a body wall at an intercostal location to allow the insertion and manipulation of endoscopic surgical instruments within the thoracic cavity. The surgical port includes a hollow tubular body which is inserted through an intercostal opening in the body wall extending into the thoracic cavity with an annular flange at one end of the tubular body projecting radially outward and engaging the body wall adjacent to the opening. The flange is able to flex relative to the tubular body whereby the surgical instrument inserted in the tubular body can be manipulated over a wide range of motion inside the thoracic cavity. A retainer ring can be installed at the end of the tubular body opposite to the flange to secure the surgical port in the body wall. Improved obturators are provided for installation of the flexible surgical port.

Description

20~93~

FLEXIBLE ENDOSCOPIC SURGICAL PORT

DESCRIPTION

: FIELD OF THE INVENTION

The present invention generally relates to a flexible endoscopic surgical port and, more particularly, to a trocar tube or cannula made partially or entirely of flexible material which can be inserted into a body wall at an intercostal location to provide a flexible surgical port for the insertion and manipulation of endoscopic surgical instruments within the thoracic cavity.
The invention also relates an improved technique of performing surgery through a flexible surgical port extending into the thoracic cavity and to an improved obturator for installing a flexible trocar tube or cannula which provides the surgical port.

BACKGROUND OF THE INVENTION

In the past, endoscopic surqery has been facilitated by the use of trocars as operative surgical ports to gain entrance into the body for insertion and manipulation of surgical instruments.
Typically, these trocars or ports have employed a thin, rigid cannula as the passageway for various endoscopic instruments. Often, internal pressures in the body cavity are generated by an external positive pressure source and pressure is introduced internally into the body cavity through the trocar tube or cannula, which often employs valves or gaskets to maintain the internal pressure. An :

209~3~4 exception to this procedure is thoracoscopy, where internal pressures do not need to be maintained.
since the maintenance of internal pressures is not required for thoracoscopy, the associated valves and gaskets may be omitted from the trocars used in thoracic procedures. While it is possible for the thoracic surgery to be performed through small incisions, using existing, non-endoscopic instruments, skin sterility is difficult to maintain and damage to the instruments and to the tissue may occur due to abrasion and friction.
Thus, it appears that for thoracic surgery, a need exists for using a trocar tube or port to protect the surgical instruments and the body tissue lS against damage when the instru~ents are inserted and manipulated inside the body cavity.
Also, since the trocar tube or cannula must be inserted between the ribs for thoracic surgery, a concern about pain arises. A large, rigid trocar tube placed snugly within a relatively small intercostal space may have a tendency to exert pressure upon the intercostal nerve. Also, there is a tendency to disrupt the intercostal nerve by leaning on the instruments. The rigid trocar tube may, as well, limit the motion of the instruments being used to perform the surgery. Thus, it is desirable to provide a trocar tube or cannula for use as a surgical port in thoracoscopy which avoids the concentration of forces at the intercostal location and instead spreads out the forces when the instruments are inserted and manipulated in the body cavity. Also, it is desirable to provide a surgical port which allows a wide range of motion and use of curved instruments or instruments with non-round cross sections.

- ~ -- .~ ,, .
... .. .. ~ .

2Q993~

SUMMARY OF THE INVENTION

The present invention recognizes that a soft or malleable trocar tube can be used to avoid pain and to protect the tissue and surgical instruments in performing thoracic surgery. While flexible trocars are known in the prior art, none has been provided with a variable cross section which is conformable to the available intercostal spacing of individual patients. The present invention achieves this objective and provides a trocar tube which permits a wide range of motion for the manipulation of endoscopic surgical instruments in the thoracic cavity. The invention also provides an obturator to facilitate the insertion of the trocar tube or cannula into an intercostal space.
The present invention provides an improved surgical port which comprises a totally flexible grommet-like structure. The surgical port generally comprises a hollow, thin-walled flexible tubular body provided with a thin-walled flexible annular flange at one end of the tubular body.
Both the tubular body and the flange consist of flexible, resilient material, e.g., elastomeric material. Preferably, the tubular body and the flange of the flexible port have a circular cross section, although other alternative configurations, such as ovoid, can be employed if desired. For example, the internal diameter of the tubular body or cannula is normally in the range of 5 to 20 mm., or more, although other sizes such as larger oval shapes may be employed, if desired.
When the surgi~al port is inserted into an intercostal opening in the body wall for thoracic surgery, the flange may be placed either internally : ,': ., 209935~

or externally relative to the body wall. When placed externally, the flange can be attached to the body wall by staples, sutures, adhesives, or any other suitable means to the body wall. With the flange placed internally, the outer unflanged end of the surgical port is divided longitudinally into a plurality of flaps which are bent downward and secured to the external surface of the body wall by staples, sutures, adhesives or other suitable fasteners. Alternatively, with the flange placed internally, the flaps at the outer end of the port can be secured to a retainer ring.
An obturator is commonly used to insert the trocar tube into an intercostal space through an opening cut in the body wall. If the diameter of the trocar tube is too large to fit within the intercostal space, the trocar tube may be stretched into an oval shaped cross section by using either an oval shaped obturator or an obturator of variable geometry, or the outside diameter may be compressed for insertion of the trocar tube. When the obturator is removed, the trocar tube is pinched between the ribs so that the cross section of the trocar tube varies from its proximal end to its distal end. Alternatively, if the diameter of the trocar tube is small enough to fit between the ribs without being stretched into an oval shape, a circular shaped obturator can be used to insert the trocar tube in the intercostal space.
The trocar tube or cannula can he installed at an intercostal space in the body wall with its flange external to the thoracic cavity. The end of the trocar tube distal to the flange may be inserted into an opening in the body wall by use of the obturator until the flange is positioned in ~ ~ .
'.

209935~
':`

contact with the external surface of the body wall.
Then the obturator is pulled out of the trocar tube while retaining the trocar tube in place within the body wall. When an obturator of variable geometry ~ 5 is used, the obturator shape or cross section is ; contracted prior to pulling the obturator out of the trocar tube. After the flange is secured in place on the body wall, surgical instruments may be inserted through the trocar tube and manipulated inside the body cavity to perform the desired surgical procedures.
Alternatively, the trocar tube or cannula can be installed at an intercostal space on the body wall with its flange internal to the thoracic cavity. The trocar tube is inserted through the opening in the body wall with the flange positioned at the distal end of the trocar tube inside the body c~vity. After the trocar tube is inserted in this fashion, the flange is æpread out into contact with the internal surface of the body wall. With the flange contacting the internal surface of the body wall, the trocar tube presents an extremely clean internal profile which allows the maximum visualization and range of motion of the surgical instruments. Additionally, the proximal end of the trocar tube at the external surface of the body wall may be cut longitudinally into a plurality of flaps which are bent downward and secured to the external body surface by staples, sutures or other suitable fasteners. The trocar tube is adjustable to variable thicknesses of the body wall by varying - the length of the cuts made at the external end of the trocar tube. Also, the cut sections or flaps of the trocar tube can be tensioned as desired.

. . . .
. :.. .. ,, : ~ . :
. ...... :.:
.: ;
'' ~- : . , :

~099354 In a preferred embodiment of the surgical port, a retainer ring is placed on the external surface of the body wall surrounding the external or proximal portion of the trocar tube. Suitable fastener means is provided for attaching the ring to the cut sections or flaps of the trocar tube which are bent downward into engagement with the ring. The fastener means may be embodied as hook-like protrusions on the ring which are received in partially formed holes or weakened areas provided on the cut sections or flaps of the trocar tube. A
plurality of longitudinally spaced partially formed holes or weakened areas can be formed in the trocar tube to provide an adjustable retention feature.
In another embodiment, the surgical port comprises a pair of spaced parallel stay rods with a flexible band connecting the mid-sections of the stay rods together. The stay rods are adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity with the flexible band located within the opening. Each of the stay rods is adapted to bend outwardly at its proximal and distal ends into engagement with the body wall to protect the body wall from trauma when a surgical instrument is inserted and manipulated in the surgical port. The stay rods may consist of malleable material which can be bent manually after insertion of the surgical port into the intercostal opening. Alternatively, the stay rods may consist of memory alloy which is temperature activated, e.g., by body heat, after insertion of the surgical port into the intercostal opening to bend the stay rods into the desired configuration.

.

- ., ~ , , ~ . :

:
: 209935 ,.
Another aspect of the invention relates to an obturator of variable geometry for inserting a flexible trocar tube into an opening at an intercostal location in a body wall. The obturator comprises a pair of elongated jaw members mounted for movement laterally toward and away from each other. The obturator includes means for moving the jaw members laterally relative to each other from a closed position to an open position to vary the separation between the jaw members. The jaw members when closed are adapted to be inserted into the flexible trocar tube and the jaw members when opened are adapted to stretch the flexible trocar tube into an ovoid shape which is sufficiently narrow in width to fit between the ribs in the body wall at the intercostal location. The obturator is provided with knife means located between the jaw members for cutting the tissue at the intercostal location as the jaw members are inserted in the body wall. Also, the obturator includes means for maintaining the jaw members in parallel alignment as the jaw members are moved laterally relative to each other. Further, the obturator is provided with means for limiting the maximum separation of the jaw members.
The invention is also embodied in a trocar assembly comprising an elongated trocar obturator with a collar spaced proximally from the distal end of the obturator and an elongated trocar tube of flexible material comprising a hollow tubular body with an annular flange projecting radially outward ; from one end of the tubular body. The trocar obturator is insertable into the hollow tubular body of the trocar tube with the collar on the obturator engaging the flange on the trocar tube ~.

. , :: . :
.-.: . : ; .; . -.. . . . . .

and the distal end of the obturator extendinq fromthe hollow tubular body for inserting the trocar tube into an opening at an intercostal location in a body wall. The collar may be slidably mounted on the trocar obturator and adapted to remain in engagement with the flange as the trocar obturator is withdrawn from the trocar tube. Also, the obturator may have an oval-shaped cross section adapted to stretch the flexible trocar tube into an ovoid shape sufficiently narrow in width to fit between the ribs at the intercostal location in the body wall.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, aspects and advantages will be better understood from the following detailed description of the preferred embodiments of the invention with reference to the drawings, in which:
Figure 1 is a perspective view of a trocar for installing a trocar tube or cannula constructed in accordance with the invention;
Figure 2 is a longitudinal section of the trocar tube or cannula of Figure 1;
Figure 3 is a distal end view of the trocar tube or cannula;
Figures 4-7 illustrate the installation of the trocar tube or cannula of Figure 1;
Figure 8 illustrates the insertion of an endoscopic surgical instrument into the trocar tube or cannula of Figure l;
Fiqure 9 illustrates the flexing of the trocar tube or cannula of Figure 1 when the instrument is manipulated from side to side:

;,.
:
. .
~.

: 2~9935~

Figure 10 is a perspective view of another trocar for installing a trocar tube or cannula of a relatively large diameter constructed in accordance with the invention;
Figure 11 is a longitudinal section of the trocar tube or cannula of Figure 10:
Figure 12 is a distal end view of the trocar tube or cannula with the trocar inserted therein prior to installation;
Figures 13-16 illustrate the installation of the trocar tube or cannula of Figure 10;
Figure 16A illustrates the insertion of an endoscopic surgical instrument into the trocar tube or cannula of Figure 10;
Figure 16B illustrates the flexing of the trocar tube or cannula of Figure 10 when the instrument is manipulated from side to side;
Figures 17-19 show another embodiment of the trocar tube or cannula having its outer ends divided into a plurality of flaps to be fastened to the body wall;
Figures 20-22 show another embodiment of the trocar tube or cannula having its outer end divided into a plurality of flaps for attachment to a retainer ring;
Figureæ 23-31 illustrate the procedure for installing the trocar tube or cannula of Figures 20-22 in a bod~ wall;
Figure 32 shows the insertion of an endoscopic surgical tool into the trocar tube or cannula;
Figures 33 and 34 show the flexing of the trocar tube or cannula when the surgical tool is manipulated from side to side;

. _ ,, .. ;, , -. . . ~
. . . . : .
, . . : .:
~, :
: :. . :
~- ~
2~993~

Figure 35 is an interior perspective view of the trocar tube or cannula with the surgical tool inserted therein;
Figure 36 is a perspective view of another embodiment of the trocar tube or cannula including longitudinal reinforcing ribs;
Figure 37 is a perspective view of another embodiment of the trocar tube or cannula including criss-crossed reinforcing fibers;
Figure 38 is a perspective view of another embodiment of the trocar tube or cannula including an intermediate flexible tubular section;
Figure 39 shows the trocar tube or cannula of Figure 38 installed in a body wall;
Figure 40 is a perspective view of another embodiment of a trocar tube or cannula comprising a pair of stay rods of memory alloy connected by a flexible band;
Figure 41 shows the trocar tube or cannula of Figure 4~ installed in a body wall;
Figure 42 is a perspective view of an obturator with jaws of variable geometry for installing a trocar tube or cannula of relatively large diameter;
Figure 43 is a side elevation view of the obturator of Figure 42;
Figure 44 is a top view of the obturator of Figure 42;
Figure 45 is an enlarged, partially cutaway side view showing the obturator jaws closed and inserted in the trocar tube or cannula;
Figure 46 is an enlarged, partially cutaway side view showing the obturator jaws open to flex the trocar tube or cannula into an ovoid shape;

~,, ' ' ~, 209~3~

Figure 47 is an enlarged, horizontal section of one of the obturator jaws taken along iine 47-47 of Figure ~5;
Figure 48 is a front or distal end view of the obturator jaws in the closed position;
Figure 49 is a front or distal end view of the obturator jaws in the closed position;
Figure 50 is a vertical section of the closed obturator jaws and the trocar tube or cannula taken along line 50-50 of Figure 45; and Figure 51 is a vertical section of the open obturator jaws and the trocar tube or cannula taken along line 51-51 of Figure 46.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Referring to Figure 1, a trocar, generally 50, is shown which is adapted to install a trocar tube or cannula, generally 60, through a body wall to provide a surgical port which allows surgical instruments to be inserted and manipulated inside a body cavity. The trocar 50 includes a trocar handle 52 which supports an elongated, cylindrical obturator 54 provided with a conically tapered, pointed distal end 56. A circular flange or collar 58 is mounted at a fixed proximal position on the obturator 54 adjacent to the trocar handle 52.
The trocar tube or cannula 60 comprises an elongated hollow tubular body 62 having an open distal end 64 and an open proximal end 66 provided with a flat, annular flange 68 extending radially outward from the tubular body 62. A plurality of circumferentially spaced holes 70 is provided in the annular flange 68, if desired, to facilitate the attachment of the flange 68 to the surface of . .

., 2~993~

the body wall. The trocar tube or cannula 60 consists of a thin-walled construction made of elastomeric material which is flexible and resilient. The material and wall thickness of the trocar tube or cannula 60 are selected such that the flange 68 is sufficiently flexible to bend or flex in any direction relative to the tubular body 62 without appreciable distortion of the tubular body 62. Also, the wall thickness and material of the trocar tube or cannula 60 are selected such that the tubular body 62 can be readily flexed into an oval-shaped cross section, if necessary, to fit between the adjacent ribs at an intercostal space in the body wall.
The trocar tube or cannula 60, shown in Figures 1-3, has a relatively small inner diameter, e.g., 10 mm., which is small enough to fit between the adjacent ribs in an intercostal space of the body wall without any appreciable distortion from its circular shape. The trocar tube or cannula 60 is made of an elastomeric material, e.g., polyeurathane. The wall thickness of the tubular body 62 and the flange 68 is approximately 1.0 mm.
Four holes 70 are circumferentially spaced about the periphery of the flange 68 at equal angular intervals, e.g., approximately 90 degrees apart, ; for receiving staples, sutures or other fasteners to secure the flange 68 to the external surface of the body wall.
Referring to Figures 4-7, the procedure is shown for installing the trocar tube or cannula 60 into a body wall 80 at an intercostal space between a pair of adjacent ribs 82. The trocar 50 is inserted into the trocar tube or cannula 60 with the trocar flange 58 engaging the annular flange 68 -,;, ~ , ;
-20g93~4 of the trocar tube 60. The obturator 54 extends through the tubular body 62 with the pointed end 56 extending beyond the distal end 64 of the tubular body 62. A slit or opening 84 tFigure 4) is cut into the body wall 80 at the desired intercostal location. The trocar So is manually moved to align the pointed end 56 of the obturator 54 with the intercostal opening 84. Then the trocar 50 is pushed downward to insert the obturator 54 and the trocar tube or cannula 60 into the body wall 80.
The trocar flange 58 engages the annular flange 68 on the trocar tube or cannula 60 and advances the tubular body 62 into the body wall 80 as the trocar 50 is pushed downward (Figure 5).
The trocar tube or cannula 60 is pushed downward by the trocar 50 until the annular flange 68 engages the external surface of the body wall 80 (Figure 6). Then the trocar 50 is pulled upwardly to remove the obturator 54 from the trocar tube or cannula 60. Thereafter, if desired, the annular flange 68 is secured to the external surface of the body wall 80 by one or more surgical staples 72 (Figure 7) which extend through the holes 70 in the flange 68. Alternatively, the flange 68 can be secured to the body wall 80 by sutures, adhesives, or other suitable fasteners.
As shown in Figures 8 and 9, the trocar tube or cannula 60 provides a flexible surgical port which enables surgical instruments, e.g. a grasping forceps 180, to be inserted and manipulated within the thoracic cavity. The annular flange 68 is sufficiently flexible to allow the tubular body 62 to be flexed from side to side to provide a relatively wide range of angular displacement. For example, when the trocar tube 60 is flexed from :
.

20993~

side to side transversely relative to the ribs ~2, a total anqular range of approximately so to 110 degrees is available for manipulation of the surgical instruments inside the body cavityO Also, when the trocar tube or cannula 60 is flexed from side to side longitudinally between the adjacent ribs 82, a total angular range of approximately 120 to 150 degrees is available for manipulation of the surgical instruments inside the body cavity.
In the embodiment of Figure 10, a trocar, generally 100, includes a push head or handle 102 which supports an elongated, oval-shaped obturator 104 having a tapered, pointed tip 106. The trocar 100 includes a slidable flange or collar 108 having an oval-shaped slot 110 extending therethrough for slidably receiving the oval-shaped obturator 104.
The slidable flange or collar 108 has rounded edges 112 at the top and bottom and flat edges 114 at its opposite sides.
The oval-shaped obturator 100 is provided for installing a trocar tube or cannula 120 including a tubular body 122 with a relatively large diameter, e.g., 20 mm., compared with the intercostal spacing of the adjacent ribs in the body wall. The tubular body 122 has an open distal end 124 and an open proximal end 126 provided with an annular flange 128 projecting outward radially from the tubular body 122. Four holes 130 are circumferentially spaced about the flange 128 at equal angular intervals for receiving staples, sutures or other suitable fasteners to secure the flange 128 to the external surface of the body wall.
Referring to Figures 13-16, the procedure is shown for installing the trocar tube or cannula 120 in the body wall 80 at an intercostal location 20993~4 between the adjacent ribs 82. The trocar 100 with the trocar flange 108 slidably mounted on the obturator 104 is inserted into the trocar tube or cannula 120 with the trocar flange 108 engaging the handle 102 and the annular flange 128 of the trocar tube 120. The obturator 104 extends through the tubular body 122 with the pointed end 106 extending beyond the distal end 124 of the tubular body 122.
As shown in Figure 12, the tubular body 122 of the trocar tube or cannula 120 is flexed into a ovoid shape by the obturator 104. A slit or opening 84 (Figure 13) is cut into the body wall 80 at the desired intercostal location. The trocar loo is manually moved to align the pointed end 106 of the obturator 104 with the intercostal opening 84.
Then the trocar 100 is pushed downward to insert the obturator 104 and the trocar tube or cannula 120 into the body wall 80. The txocar flange 108 engages the annular flange 128 on the trocar tube or cannula 120 and advances the tubular body 122 ` into the body wall 80 as the trocar 100 is pushed downward.
The trocar tube or cannula 120 is pushed downward by the trocar 100 until the annular flange 128 engages the external surface of the body wall 80 (Figure 14). Then the trocar handle 102 is pulled upwardly to remove the obturator 104 from the trocar tube or cannula 120 which is held in place by pressing downward on the trocar flange 108 to hold the annular flange 128 of the trocar tube 120 against the external surface of the body wall 80 (Figure 15). As the oval-shaped obturator 104 is withdrawn, the distal end 124 and proximal end 126 of the tubular body 122 tend to return to the natural circular cross section. Thereafter, if 20993~

desired, the annular flange 128 is secured to the external surface of the body wall 80 by a set of surgical staples 132 (Figure 16) extending through the holes 130 in the flange 128. Alternatively, the flange 128 can be secured to the body wall 80 by sutures, adhesives or other suitable fasteners.
As shown in Figures 16A and 16B, the trocar tube or cannula 120 provides a flexible surgical port which enables surgical instruments to be inserted and manipulated within the thoracic cavity. The annular flange 128 is sufficiently flexible to allow the tubular body 122 to be flexed from side to side to provide a relatively wide range of angular displacement. For example, when the trocar tube 120 is flexed from side to side transversely relative to the ribs 82, a total angular range of approximately 90 to 110 degrees is available for manipulation of the surgical instruments inside the body cavity. Also, when the trocar tube or cannula 120 is flexed from side to side longitudinally between the adjacent ribs 82, a total angular range of approximately 120 to 150 degrees is available for manipulation of the surgical instruments inside the body cavity.
Referring to Figures 17-19, a trocar tube or cannula 140 includes a tubular body 142 having an open proximal end 144 and an open distal end 146 provided with an annular flange 148 projecting radially outward from the tubular body 142. The trocar tube or cannula 140 is installed as a surgical port with the annular flange 148 located inside the thoracic cavity in engagement with the internal surface of the body wall 80. The tubular body 142 is longitudinally scored at its outer or proximal end 144 to provide a plurality of thinned . .
. .
:

. .

20993~

strips or score lines 150 which facilitate the separation of the proximal end 144 into a plurality of flaps 152 capable of bending downward into engagement with the external surface of the body wall 80. The trocar tube or cannula 140 is adjustable to variable thicknesses of the body wall 80 by the length of the cuts made along the score lines 150 at the outer or proximal end 144 of the tubular body 142. Each flap 152 is provided with a a partially formed hole 154 comprising a thinned or weakened area, if desired, for receiving a surgical staple 156 to secure the flap 152 to the body wall 80. Alternatively, sutures, adhesives, or other suitable fasteners can be used to secure the flaps 152 to the body wall 80.
Referring to Figures 20-22, in a preferred embodiment of the trocar tube or cannula 140, a flat, annular retainer ring 160 is provided with a central opening 162 which allows the ring 160 to be slipped over the outer or proximal end 144 of the tubular body 142 into engagement with the external surface of the body wall 80. The ring 160 is provided with a plurality of attachment devices, e.g., a series of circumferentially spaced hook-like protrusions 164, for attaching the flaps 152 of the tubular body 142 to the ring 160. The hook-like protrusions 164 are uniformly spaced apart about the circumference of the ring 160 for alignment with the partially formed holes 154 when the flaps 152 are bent downward toward the ring 160. Each flap 152 has one or more partially formed holes or weakened areas 154 arranged in a longitudinal row to permit adjustment of the trocar tube or cannula 140 to accommodate various thicknesses of the body wall 80. The rows of . ~ .
. . . ~
: , : . : :

209935~

partially formed holes or weakened areas 154 also permit the tension in the flaps 152 to be adjusted.
When the flaps 152 are bent downward into engagement with the retainer ring 160, each hook-like protrusion 164 is punched into one of thepartially formed holes or weakened areas 154 to secure the flaps 152 to the retainer ring 160.
Alternatively, other attachment devices, such as Velcro~, can be used to secure the flaps 152 to the ring 160. Preferably, the partially formed holes or weakened areas 154 are recessed indentations or thinned areas which are not punched through until the flaps 152 are pressed into engagement with the retainer ring 160.
In the preferred embodiment, the trocar tube or cannula 140 consists of elastomeric material, e.g., polyeurathane, which is flexible and resilient. The ring 160 can be comprised of a stiff rigid material, a soft flexible material, or a combination of both materials in which the soft flexible material is used for an inner portion of the ring 160 adjacent to the tubular body 142 and the stiff rigid material is used for an outer portion of the ring 160. This construction of the ring 160 may be achieved by co-molding techniques.
Referring to Figures 23 and 24 the trocar tube or cannula 140 is installed by using a trocar, generally 170, comprising a handle 172 which supports an elon~ated obturator 174 provided with a pointed distal tip 176 and an annular flange 168 adjacent to the handle 172. The obturator 174 is oval in cross section or has a variable geometry to allow the trocar tube 140 to be received in the intercostal spacing of the adjacent ribs 82 in the body wall 80.

: ., , , ; , . ...
. . .
, " ::, .
:, " , : ,, 2~ 5~

The obturator 170 is inserted into the unflanged end of the trocar tube or cannula 140 so that ~he flange 148 is located adjacent to the pointed distal end 176 of the obturator 174. An incision 84 is made at intercostal location in the body wall 80 where it is desired to insert the trocar tube or cannula 140. The trocar 170 is manually moved into proximity with the incision 84 and the pointed distal end 176 of the obturator 174 is aligned with the incision 84.
As shown in Figures 25 and 26, the trocar 170 is pushed into the incision 84 to insert the obturator 174 and the trocar tube or cannula 140 into the body wall. AS the trocar 170 is advanced, the flange 148 is flexed upwardly by the body wall 80 to allow the tubular body 142 to pass through the body wall 80 between the adjacent ribs 82.
As shown in Figures 27 and 28, when the trocar tube or cannula 140 is fully inserted into the body wall 80, the flexible flange 148 returns to its natural position projecting radially outward from the tubular body 142 and the flange 148 engages the internal surface of the body wall 80.
Referring to Figures 29 and 30, after the trocar tube or cannula 140 is fully inserted into the body wall 80, the trocar 170 is removed. The ring 160 is slipped over the outer or proxi~al end 144 of the tubular body 142 and the ring 160 is secured by staples 166 to the external surface of the body wall 80. The longitudinal score lines 150 are cut down to the vicinity of the ring 160 to divide the outer or proximal end 144 of the tubular body 142 into the flaps 152.
Referring to Figures 31 and 32, the flaps 152 are bent radially outward and downward into contact i 2~9935~

with the ring 160. The hook-like protrusions 164 on the ring 160 are punched through the partially formed holes or wea~ened areas 154 in the flaps 152 to secure the flaps 152 to the ring 160. Each flap 152 is stretched to the desired tension and pressed against the ring 152 to punch the hook-like protrusion 164 through the corresponding partially formed hole or weakened area 154 to secure the trocar tube or cannula 140 in the opening in the body wall 80. The annular flange 148 is firmly held against the internal surface of the body wall 80. The trocar tube or cannula 140 and the retainer ring 160 provide a surgical port in the body wall 80 through which endoscopic surgical instruments, e.g., a grasping forceps 180, can be inserted and manipulated inside the thoracic cavity.
Referring to Figures 33 and 34, the flexibility of the trocar tube or cannula 140 allows a relatively severe angle of entry for the endoscopic instruments into the thoracic cavity.
For example, the grasping forceps 180 can be inserted through the surgical port at a severe angle between the adjacent ribs 82 to allow the forceps to manipulate a collapsed lung 90. As shown in Figure 34, the tubular body 142, the annular flange 148 and the flaps 152 are all capable of being flexed to permit the forceps 180 to be manipulated at different angles within the thoracic cavity. Also, the retainer ring 160 can be partially or completely made of flexible material to allow the forceps 180 to be moved from side to side at different angles with minimal interference from the surgical port. The flexibility of the trocar tube or cannula 140 2~

permits severe angles of entry for the endoscopic instruments while maintaining an external surface flush with the body wall to avoid clutter in the exterior work space. Also, the flexible material of the trocar tube or cannula 140 acts as a cushion to protect the intercostal nerves and vessels, particularly at severe angles of entry by the endoscopic instruments.
As shown in Figure 35, the annular flange 148 is held against the internal surface of the body wall and presents a clean, smooth internal profile to allow maximum visualization and motion of the surgical instruments. Because the annular flange 148 and the retainer ring 160 are firmly held against the internal and external surfaces of the body wall 80, the surgical port provides enhanced tissue protection over the open incision in the body wall 80.
In the embodiment of Figure 36, a trocar tube or cannula 190 including a tubular body 192 and an annular flange 194 of flexible material is provided with a plurality of longitudinal reinforcing ribs 196 on the tubular body 192. The reinforcing ribs 196 enhance the axial stiffness of the tubular body 192 and per~it bending of the tubular body 192 when endoscopic instruments are inserted into the trocar tube or cannula 190 and manipulated inside the body cavity. Alternatively, as shown in Figure 37, the tubular body 192 may be provided with a plurality of criss-crossed reinforcing fibers 198 which enhance the axial stiffness and permit bending of the trocar tube or cannula 190.
In the embodiment of Figures 38 and 39, a trocar tube or cannula 200 comprises a tubular body 202 of rigid material connected by a flexible . .

209935~

tubular section 204 to an annular flange 206 of rigid material. When the trocar tube or cannula 200 is installed at an intercostal space in the body wall 80, the flexible tubular section 204 permits the rigid tubular body 202 to be deflected from side to side by an endoscopic instrument ; inserted through the trocar tube or cannula 200.
In the embodiment of Figures 40 and 41, a flexible thoracic port 210 comprises a pair of spaced, parallel stay rods 212 which are connected at the mid-sections by a flexible band 214. Each stay rod 212 consists of an elongated strip which has a curved or rounded cross section with its convex side oriented outward. Each stay rod 212 has outer or proximal end 216 extending above the ; flexible band 214 and an inner or distal end 218 extending below the flexible band 214. To facilitate installation, the proximal end 216 is slightly longer than the distal end 218 of each stay rod 212.
As shown in Figure 40, the flexible band 214 consists of two thin strips of resilient material, e.g., polyurethane, connected to the mid-sections of the stay rods 212. Alternatively, the flexible band 214 consists of a single flexible strip which surrounds both stay rods 212. At the distal end of each stay rod 212 is a pair of flat, laterally extending flanges 220 which project outwardly from opposite edges of the stay rod 212.
The stay rods 212 consist of a material which allows the outer ends 214 and the inner ends 216 to bend in opposed radial directions extending outward ; from the flexible band 214. For example, the stay rods 212 can be made of a malleable metal which can be manually formed by digital manipulation into the , . ~ ;

209~3~L

configuration shown in Figure 41 after the surgical port 210 is inserted into the opening in the body wall 80. Alternatively, each stay rod 212 can be made of a resilient material, e.g., stainless steel, with the legs 216 and 218 of the stay rods 212 preformed at right angles. To install the surgical port 2~0, the legs 214 and 216 are temporarily straightened as the surgical port 210 is inserted through a rigid trocar sleeve extending into the opening in the body wall 80. Thereafter, when the rigid trocar sleeve is removed, the stay rods 212 are released and the legs 216 and 218 spring back into the bent configuration shown in Figure 41 curved around the ribs 82 in the body wall 80.
In an alternative embodiment, each stay rod 212 is made of a memory alloy, e.g., nitanol, which enables the stay rods 212 to assume the bent configuration shown in Figure 41 when activated by a temperature change. Prior to installation, the stay rods 212 are straight, as shown in Figure 40, to facilitate the insertion of the surgical port 210 into the opening in the body wall 80.
After the insertion of the flexible thoracic port 210 into the opening in the body wall 80, the memory alloy of the stay rods 212 is temperature activated, e.g., by the application of body heat, and the stay rods 212 assume the bent configuration shown in Figure 41. The proximal or outer ends 216 of the stay rods 212 are bent laterally outward at right angles in opposite directions into contact with the external surface of the body wall 80. The distal or inner ends 218 of the stay rods 212 are bent laterally outward at right angles in opposite directions into contact with the internal surface .-:
... .
~,:

2~993 of the body wall 80. The stay rods 212 curve over the ribs 82 and protect the nerves and vessels during the introduction, removal and manipulation of surgical instruments. The flexible band 214 permits the bent stay rods 212 to shift relative to each other as the surgical instruments are manipulated at different angles in the thoracic cavity. The flanges 220 tend to assume a flat configuration inside the thoracic cavity to protect the body wall 80 from trauma when a surgical instrument is inserted and manipulated within the surgical port 210.
The flexible surgical port 210 with nitanol stay rods 212 can be introduced into an opening at an intercostal space in the body wall 80 by using a conventional rigid trocar as follows. A rigid trocar tube and obturator are inserted through an incision into the intercostal space in the body wall 80. The obturator is removed leaving the rigid trocar tube inserted in the intercostal space. Then the flexible surgical port 210 is inserted through the rigid trocar tube with the flanges 220 extending into the thoracic cavity.
The memory alloy of the stay rods 212 is activated by applying heat while sliding the flexible surgical port 210 along the rigid trocar tube into the intercostal space. The rigid trocar tube is removed to allow the memory alloy of the stay rods 212 to assume the bent configuration shown in ~igure 41 curved around the ribs 82 in the body wall 80.
Alternatively, the flexible surgical port 210 can be inserted into the intercostal space in the body wall 80 by using a double lumen trocar including an inner trocar sleeve of smaller ::

, s:~

diameter housed-within an outer trocar sleeve of larger diameter. The flexible surgical port 210 is inserted into the space between the t~o sleeves of the trocar. After insertion of the trocar into the intercostal space, the obturator is removed and heat is applied to the trocar sleeves to actuate the memory alloy of the stay rods 212. Then the trocar sleeves are removed from the intercostal space to allow the memory alloy of the stay rods 212 to assume the bent configuration shown in Figure 41 curved around the ribs 82 in the body wall 80. Similarly, the double lumen trocar can be used to install the flexible surgical port 210 with preformed stay rods 212.
Referring to Figure 42, a surgical instrument or obturator, generally 250, is provided to facilitate the installation of a flexible trocar tube or cannula of relatively large diameter at an intercostal space in the body wall. The obturator 250 comprises a pair of elongated handles 252 and 254 pivotally connected by a pivot pin 256 in a reverse pliers arrangement. A pair of sleeve-like finger grips 258 and 2~0 cover the rear portions of handles 252 and 254, respectively, to facilitate the handling and operation of the obturator 250 by a surgeon. The handles 252 and 254 have front arms 262 and 264, respectively, which are connected by pivot pins 266 and 268 (Figure 43) to a pair of obturator jaws 270 and 272, respectively. A coil spring 274 is provided with spring arms 276 and 278 connected to the handles 252 and 254 rearwardly of the pivot pin 256 to normally bias the handles 252 and 254 apart and urge the front arms 262 and 264 together to maintain the obturator jaws 270 and 272 in the closed position (Figure 43).

209935~

The obturator jaw 270 consists of an elongated metal bar, preferably made of stainless steel, which is generally rectangular in configuration and includes an enlarged rectangular support block 274 at its proximal end connected by the pivot pin 266 to the front arm 262 of the handle 252. Similarly, the obturator jaw 272 comprises an elongated metal bar, preferably made of stainless steel, which is generally rectangular in configuration and includes an enlarged rectangular support block 276 at its proximal end connected by the pivot pin 268 to the front arm 264 of the handle 254. The support blocks 274 and 276 have front vertical edges 275 and 277 offset from the obturator jaws 272 and 274, respectively, for engaging the proximal end of the trocar tube or cannula 120 (Figure 45).
A guide pin 278 is fixed, e.g~, by welding, in a vertical bore 280 in the lower obturator jaw 272 and is slidably received in a vertical bore 282 formed in the upper obturator jaw 270. The guide pin 278 maintains the obturator jaws 270 and 272 in parallel alignment when the front arms 262 and 264 are moved apart by squeezing the handles 252 and 254 together. A stop pin 284 with enlarged heads 286 and 288 at its opposite ends is slidably received in vertical bores 290 and 292 formed in the obturator jaws 270 and 272, respectively. The stop pin 284 limits the amount of separation of the obturator jaws 270 and 272 when the handles 252 and 254 are squeezed together.
As shown in Figure 46, the obturator jaws 270 and 272 have flat elongated opposing surfaces 294 and 296 which are moved into engagement when the obturator jaws 270 and 272 are closed. Also, as shown in Figure 50, the obturator jaws 270 and 272 - s ~ :
. .

2~993~

have elongated semi-cylindrical exterior surfaces 298 and 300, respectively, for engaging the tubular body 122 of the trocar tube or cannula 120 when the obturator jaws 270 and 272 are inserted therein.
Referring to Figure 42, a pair of conically tapered pointed tips 302 and 304 is mounted at the distal ends of the obturator jaws 270 and 272, respectively. The upper conical tip 302 supports a knife blade 306 which is exposed when the obturator jaws 270 and 272 are separated to cut the tissue at an intercostal location as the obturator jaws 270 and 272 are inserted into the body wall.
As shown in Figures 45-47, the upper conical tip 302 has a narrow vertical slot 308 extending therethrough for receiving the knife blade 306 which is secured to the conical tip 302 by a cross pin 310. The lower conical tip 304 has a narrow vertical slot 312 for slidably receiving the knife blade 306. A pair of mounting posts 314 and 316 at the proximal ends of the conical tips 302 and 304 is received in a pair of axial openings at the distal ends of the obturator jaws 270 and 272, respectively. The mountinq posts 314 and 316 are secured to the obturator jaws 270 and 272 by set screws 318 and 320, respectively. The conical tips 302 and 304 have rear vertical edges 322 and 324 which are offset from the obturator jaws 272 and 274, respectively, for engaging the distal end of the trocar tube or cannula 120 (Figure 45).
The following procedure is performed by using the obturator 250 (Figure 42) to install the trocar tube or cannula 120 (Figure 10) at an intercostal location in the body wall. The obturator jaws 270 and 272 in the closed position (Figure 45) are inserted into the flanged end of the tubular trocar 2099~

body 122. The trocar tube or cannula 120 is positioned on the obturator jaws 270 and 272 with the flange 128 engaging the front edges 275 and 277 of the support blocks 274 and 276, respectively.
The distal end of the trocar tube or cannula is located adjacent to the rear edges 322 and 324 on the pointed tips 302 and 304. With the obturator jaws 270 and 272 closed, the tubular trocar body 122 remains in its natural circular cross section (Figure 50).
By squeezing the handles 252 and 254 together, the obturator jaws 270 and 272 are opened (Figure 46) to stretch the tubular trocar body 122 into an ovoid shape (Figure 51). Then the obturator jaws 270 and 272 are aligned with and pushed into an incision at an intercostal location to insert the trocar tube or cannula into the body wall. The ovoid shape of the trocar body 122 facilitates the insertion of the trocar tube or cannula 120 between the adjacent ribs at the intercostal location. The knife blade 306 cuts through the tissue of the body wall as the obturator jaws 270 and 272 are pushed into the incision. The trocar tube or cannula 120 ; is advanced into the body wall by the obturator jaws 270 and 272 until the flange 128 engages the external surface of the body wall. Then the obturator jaws 270 and 272 are closed by relaxing the squeezing forces applied to the handles 252 and 254. The obturator jaws 270 and 272 are returned ,~ 30 to the closed position by the coil spring 274 which biases the handles 252 and 254 apart. Then, by pulling on the handles 252 and 254, the closed obturator jaws 270 and 272 are removed from the trocar tube or cannula 120. Thereafter, the flange 128 is secured to the external surface of the body -", . . :
~ .
- .
.;

209~35~

wall by staples, sutures, adhesives or other suitable fasteners.
The invention in its broader aspects is not limited to the specific details of the preferred embodiments shown and described, and those skilled in the art will recognize that the invention can be practiced with modification within the spirit and scope of the appended claims.

' . ~ '''' ' . ' ,

Claims (58)

1. A surgical port for insertion through a body wall at an intercostal location to allow a surgical instrument to be inserted therein and manipulated inside a thoracic cavity, comprising:
a hollow tubular body adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity;
said tubular body being adapted to receive a surgical instrument extending therethrough into the thoracic cavity;
an annular flange at one end of said tubular body projecting radially outward therefrom and adapted to engage the body wall adjacent to the opening therein;
said flange being adapted to flex relative to said tubular body whereby the surgical instrument inserted in said tubular body can be manipulated inside the thoracic cavity.
2. The surgical port of Claim 1, wherein:
said flange and said tubular body consist of flexible material.
3. The surgical port of Claim 2, wherein:
said flange is located at the proximal end of said tubular body for engaging the exterior of the body wall.
4. The surgical port of Claim 2, wherein:
said flange is located at the distal end of said tubular body for engaging the interior of the body wall.
5. The surgical port of Claim 2, wherein:
said tubular body is adapted to flex into an oval shaped cross section for insertion at the intercostal location in the body wall.
6. The surgical port of Claim 3, wherein:
said flange is adapted to be fastened to the body wall adjacent to the opening therein.
7. The surgical port of Claim 3, wherein:
said flange includes one or more holes formed therein for receiving staples or the like to fasten said flange to the body wall adjacent to the intercostal opening.
8. The surgical port of Claim 4, wherein:
said tubular body is divided at its proximal end into a plurality of flaps which can be bent outward and secured to the body wall.
9. The surgical port of Claim 8, wherein:
said tubular body includes a series of score lines extending longitudinally from its proximal end along which said tubular body is cut to provide said flaps.
10. The surgical port of Claim 8, wherein:
each flap includes a hole for receiving a staple or the like to fasten said flap to the body wall adjacent to the intercostal opening.
11. A surgical port for insertion through a body wall at an intercostal location to allow a surgical instrument to be inserted therein and manipulated inside a thoracic cavity, comprising:

a hollow tubular body adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity;
said tubular body being adapted to receive a surgical instrument extending therethrough into the thoracic cavity;
an annular flange at one end of said tubular body projecting radially outward therefrom and adapted to engage the body wall adjacent to the opening therein;
said flange and said tubular body consisting of flexible material and adapted to allow said tubular body to bend from side to side whereby the surgical instrument inserted in said tubular body can be oriented at different angles inside the thoracic cavity.
12. The surgical port of Claim 11, wherein:
said flange is adapted to flex relative to said tubular body into a contorted shape to conform to the surface of the body wall as the surgical instrument is manipulated at different angles.
13. The surgical port of Claim 12, wherein:
said flange is located at the proximal end of said tubular body for engaging the exterior of the body wall.
14. The surgical port of Claim 12, wherein:
said flange is located at the distal end of said tubular body for engaging the interior of the body wall.
15. The surgical port of Claim 11, wherein:
said tubular body is adapted to flex into an oval shaped cross section for insertion at the intercostal location in the body wall.
16. The surgical port of Claim 13, wherein:
said flange is adapted to be fastened to the body wall adjacent to the opening therein.
17. The surgical port of Claim 13, wherein:
said flange includes one or more holes formed therein for receiving staples or the like to fasten said flange to the body wall adjacent to the intercostal opening.
18. The surgical port of Claim 14, wherein:
said tubular body is divided by a series of longitudinal circumferentially spaced slits at its proximal end into a plurality of flaps which can be bent outward and secured to the body wall.
19. A surgical port for insertion through a body wall at an intercostal location to allow a surgical instrument to be inserted therein and manipulated inside a thoracic cavity, comprising:
a hollow tubular body adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity;
said tubular body being adapted to receive a surgical instrument extending therethrough into the thoracic cavity;
an annular flange at one end of said tubular body projecting radially outward therefrom and adapted to engage the body wall adjacent to the opening therein;

said tubular body includes a flexible tubular section connected to said flange which allows said tubular body to bend relative to said flange whereby the surgical instrument inserted in said tubular body can be manipulated inside the thoracic cavity.
20. The surgical port of Claim 19, wherein:
said flange and said tubular body, except for said flexible tubular section, consist of rigid material.
21. A surgical port for insertion through a body wall at an intercostal location to allow a surgical instrument to be inserted therein and manipulated inside a thoracic cavity, comprising:
a hollow tubular body adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity;
said tubular body being adapted to receive a surgical instrument extending therethrough into the thoracic cavity;
an annular flange at the distal end of said tubular body projecting radially outward therefrom and adapted to engage the interior of the body wall adjacent to the opening therein;
said tubular body being divided at its proximal end by longitudinal slits into a plurality of flaps which are bendable radially outward from said tubular body and are adapted to be secured to the exterior of the body wall;
said flange and said flaps being adapted to flex relative to said tubular body whereby the surgical instrument inserted in said tubular body can be manipulated inside the thoracic cavity.
22. The surgical port of Claim 21, wherein:
said tubular body and said flange consist of flexible material.
23. The surgical port of Claim 22, wherein:
said tubular body is adapted to flex into an oval shaped cross section for insertion at the intercostal location in the body wall.
24. The surgical port of Claim 22, wherein:
said tubular body includes a series of score lines extending longitudinally from its proximal end along which said tubular body is cut to provide said flaps.
25. The surgical port of Claim 22, wherein:
each flap includes a hole for receiving a staple or the like to fasten said flap to the body wall adjacent to the intercostal opening.
26. A surgical port for insertion through a body wall at an intercostal location to allow a surgical instrument to be inserted therein and manipulated inside a thoracic cavity, comprising:
a hollow tubular body adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity;
said tubular body being adapted to receive a surgical instrument extending therethrough into the thoracic cavity;
an annular flange at the distal end of said tubular body projecting radially outward therefrom and adapted to engage the interior of the body wall adjacent to the opening therein;

a retainer ring including a central opening which allows said ring to be slipped over the proximal end of said tubular body to engage the body wall;
said tubular body being divided at its proximal end by longitudinal slits into a plurality of flaps which are bendable radially outward from said tubular body and are adapted to be secured to said retainer ring;
said flange and said flaps being adapted to flex relative to said tubular body whereby the surgical instrument inserted in said tubular body can be manipulated inside the thoracic cavity.
27. The surgical port of Claim 26, wherein:
said tubular body and said flange consist of flexible material.
28. The surgical port of Claim 27, wherein:
said retainer ring comprises a flat annular disk of rigid material.
29. The surgical port of Claim 27, wherein:
said retainer ring comprises a flat annular disk of flexible material.
30. The surgical port of Claim 27, wherein:
said retainer ring comprises a flat annular disk consisting of an outer annular section of rigid material connected to an inner annular section of flexible material.
31. The-surgical port of Claim 27, wherein:
said tubular body is adapted to flex into an oval shaped cross section for insertion at the intercostal location in the body wall.
32. The surgical port of Claim 27, wherein:
said tubular body includes a series of score lines extending longitudinally from its proximal end along which said tubular body is cut to provide said flaps.
33. The surgical port of Claim 27, which includes:
fastener means on said retainer ring for securing said flaps to said ring when said flaps are bent into engagement with said ring.
34. The surgical port of Claim 27, wherein;
said retainer ring includes a plurality of circumferentially spaced hook-like protrusions; and each flap includes a hole for receiving one of said hook-like protrusions when said flap is bent into engagement with said ring.
35. A surgical port for insertion through a body wall at an intercostal location to allow a surgical instrument to be inserted therein and manipulated inside a thoracic cavity, comprising:
a pair of spaced parallel stay rods;
a flexible band connecting said stay rods together at the mid-sections thereof;
said stay rods being adapted for insertion through an intercostal opening in the body wall extending into the thoracic cavity with said flexible band located within the opening; and each of said stay rods being adapted to bend outwardly at its proximal and distal ends into engagement with the body wall to protect the body wall from trauma when a surgical instrument is inserted and manipulated in said surgical port.
36. The surgical port of Claim 35, wherein said stay rods consist of malleable metal.
37. The surgical port of Claim 35, wherein said stay rods consist of memory alloy.
38. The surgical port of Claim 37, wherein said stay rods are temperature activated.
39. The surgical port of Claim 35, wherein each stay rod has its proximal end extending above said flexible band and its distal end extending below said flexible band.
40. The surgical port of Claim 39, wherein each of said stay rods includes an enlarged flange at its distal end for protecting the inner surface of the body wall from trauma.
41. An obturator for inserting a flexible trocar tube into an opening at an intercostal location in a body wall, comprising:
a pair of elongated jaw members mounted for movement laterally toward and away from each other;
means for moving said jaw members laterally relative to each other from a closed position to an open position to vary the separation between said jaw members; and said jaw members when closed being adapted to be inserted into the flexible trocar tube and said jaw members when open being adapted to stretch the flexible trocar tube into an ovoid shape which is sufficiently narrow in width to fit between the ribs in the body wall at the intercostal location.
42. The obturator of Claim 41, which includes:
knife means located between said jaw members for cutting the tissue at the intercostal location as said jaw members are inserted in the body wall.
43. The obturator of Claim 41, which includes:
means for maintaining said jaw members in parallel alignment as said jaw members are moved laterally relative to each other.
44. The obturator of Claim 43, which includes:
means for limiting the maximum separation of said jaw members.
45. An obturator for inserting a flexible trocar tube into an opening at an intercostal location in a body wall, comprising:
a pair of handles pivotally connected together in a reverse pliers arrangement;
a pair of obturator jaws connected to said handles, said jaws being closed together when said handles are moved apart and said jaws being open when said handles are moved toward each other; and said jaws when closed being adapted to be inserted into the flexible trocar tube and said jaws when open being adapted to stretch the flexible trocar tube into an ovoid shape which is sufficiently narrow in width to fit between the ribs in the body wall at the intercostal location.
46. The obturator of Claim 45, wherein:
said obturator jaws comprise a pair of elongated parallel jaw members mounted for movement laterally toward and away from each other.
47. The obturator of Claim 46, which includes:
knife means located between said jaw members for cutting the tissue at the intercostal location as said jaw members are inserted in the body wall.
48. The obturator of Claim 46, wherein:
one of said jaw members includes a knife blade extending laterally therefrom toward the other jaw member, said knife blade being exposed when said jaw members are separated to cut the tissue at the intercostal location as said jaws members are inserted in the body wall.
49. The obturator of Claim 46, wherein:
each of said jaw members has an elongated semi-cylindrical exterior surface for engaging the interior of the flexible trocar tube.
50. The obturator of Claim 49, wherein:
each of said jaw members includes a pair of offsets at opposite ends of said semi-cylindrical surface for engaging the opposite ends of the flexible trocar tube.
51. The obturator of Claim 46, which includes:
means for maintaining said jaw members in parallel alignment as said jaw members are moved laterally relative to each other.
52. The obturator of Claim 51, which includes:
means for limiting the maximum separation of said jaw members.
53. The obturator of Claim 46, wherein:
each of said jaw members has a pointed tip at its distal end.
54. The obturator of Claim 53, which includes:
a knife blade extending laterally from one of said tips and slidably received in a laterally extending slot in the other tip; and said knife blade being exposed when the obturator jaws are separated to cut the tissue at the intercostal location as said obturator jaws are inserted into the body wall.
55. An obturator for inserting a flexible trocar tube into an opening at an intercostal location in a body wall, comprising:
a handle; and an elongated obturator mounted on said handle and having a piercing tip at its distal end; and said obturator having an oval-shaped cross section adapted to stretch the flexible trocar tube into an ovoid shape sufficiently narrow in width to fit between the ribs at the intercostal location in the body wall.
56. A trocar assembly for inserting a flexible trocar tube into an opening at an intercostal location in a body wall, comprising:
an elongated trocar obturator having a collar spaced proximally from the distal end of said obturator;
an elongated trocar tube of flexible material comprising a hollow tubular body with an annular flange projecting radially outward from one end of said tubular body; and said trocar obturator being insertable into said hollow tubular body of said trocar tube with said collar engaging said flange and said distal end extending from said hollow tubular body for inserting said trocar tube into the opening at the intercostal location in the body wall.
57. The trocar assembly of Claim 56, wherein:
said collar is slidably mounted on said trocar obturator and adapted to remain in engagement with said flange as said trocar obturator is withdrawn from said trocar tube.
58. The trocar assembly of Claim 57, wherein:
said obturator has an oval-shaped cross section adapted to stretch the flexible trocar tube into an ovoid shape sufficiently narrow in width to fit between the ribs at the intercostal location in the body wall.
CA002099354A 1992-06-30 1993-06-28 Flexible endoscopic surgical port Abandoned CA2099354A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US90677492A 1992-06-30 1992-06-30
US906,774 1992-06-30

Publications (1)

Publication Number Publication Date
CA2099354A1 true CA2099354A1 (en) 1993-12-31

Family

ID=25422955

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002099354A Abandoned CA2099354A1 (en) 1992-06-30 1993-06-28 Flexible endoscopic surgical port

Country Status (9)

Country Link
US (4) US5490843A (en)
EP (1) EP0577400B1 (en)
JP (1) JPH07275252A (en)
AT (1) ATE185958T1 (en)
AU (1) AU664755B2 (en)
CA (1) CA2099354A1 (en)
DE (1) DE69326860T2 (en)
ES (1) ES2139628T3 (en)
GR (1) GR930100244A (en)

Families Citing this family (510)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5766249A (en) * 1990-11-20 1998-06-16 Griffith; Donald P. Tissue bondable cystostomy tube and method of cystostomy tube implantation
US5911757A (en) * 1991-05-16 1999-06-15 Seare, Jr.; William J. Methods and apparatus for transcutaneous access
US5571215A (en) * 1993-02-22 1996-11-05 Heartport, Inc. Devices and methods for intracardiac procedures
US5540648A (en) * 1992-08-17 1996-07-30 Yoon; Inbae Medical instrument stabilizer with anchoring system and methods
US5718725A (en) * 1992-12-03 1998-02-17 Heartport, Inc. Devices and methods for intracardiac procedures
US6283127B1 (en) 1992-12-03 2001-09-04 Wesley D. Sterman Devices and methods for intracardiac procedures
US5814097A (en) * 1992-12-03 1998-09-29 Heartport, Inc. Devices and methods for intracardiac procedures
US6338730B1 (en) * 1993-02-04 2002-01-15 Peter M. Bonutti Method of using expandable cannula
US5972030A (en) 1993-02-22 1999-10-26 Heartport, Inc. Less-invasive devices and methods for treatment of cardiac valves
US5797960A (en) * 1993-02-22 1998-08-25 Stevens; John H. Method and apparatus for thoracoscopic intracardiac procedures
US6010531A (en) * 1993-02-22 2000-01-04 Heartport, Inc. Less-invasive devices and methods for cardiac valve surgery
US5799661A (en) * 1993-02-22 1998-09-01 Heartport, Inc. Devices and methods for port-access multivessel coronary artery bypass surgery
US6125852A (en) * 1993-02-22 2000-10-03 Heartport, Inc. Minimally-invasive devices and methods for treatment of congestive heart failure
US7213601B2 (en) * 1993-02-22 2007-05-08 Heartport, Inc Minimally-invasive devices and methods for treatment of congestive heart failure
US6346074B1 (en) * 1993-02-22 2002-02-12 Heartport, Inc. Devices for less invasive intracardiac interventions
US5980455A (en) * 1993-02-22 1999-11-09 Heartport, Inc. Method for manipulating a tissue structure within a thoracic cavity
US5728151A (en) * 1993-02-22 1998-03-17 Heartport, Inc. Intercostal access devices for less-invasive cardiovascular surgery
WO1995002376A1 (en) * 1993-07-12 1995-01-26 The Regents Of The University Of California Soft tissue augmentation apparatus
CA2126150C (en) 1993-07-14 2005-02-22 David T. Green Seal assembly for accommodating introduction of surgical instruments
WO1995007056A2 (en) * 1993-09-06 1995-03-16 Encoret Limited Apparatus for use in surgery and a valve
EP0807416B1 (en) * 1994-02-18 2004-04-07 Gaya Limited An access port for use in surgery
US6162236A (en) * 1994-07-11 2000-12-19 Terumo Kabushiki Kaisha Trocar needle and expandable trocar tube
US5807243A (en) 1994-08-31 1998-09-15 Heartport, Inc. Method for isolating a surgical site
US7053752B2 (en) * 1996-08-06 2006-05-30 Intuitive Surgical General purpose distributed operating room control system
US6646541B1 (en) * 1996-06-24 2003-11-11 Computer Motion, Inc. General purpose distributed operating room control system
US6463361B1 (en) 1994-09-22 2002-10-08 Computer Motion, Inc. Speech interface for an automated endoscopic system
US5653705A (en) * 1994-10-07 1997-08-05 General Surgical Innovations, Inc. Laparoscopic access port for surgical instruments or the hand
US5672168A (en) * 1994-10-07 1997-09-30 De La Torre; Roger A. Laparoscopic access port for surgical instruments or the hand
US5849005A (en) 1995-06-07 1998-12-15 Heartport, Inc. Method and apparatus for minimizing the risk of air embolism when performing a procedure in a patient's thoracic cavity
DE19515280C2 (en) * 1995-04-26 1997-06-12 Siegfried Riek Device for removing tissue or the like from the abdominal cavity
US5741298A (en) * 1995-04-28 1998-04-21 Macleod; Cathel Method and devices for video-assisted surgical techniques
US5899208A (en) * 1995-05-08 1999-05-04 Gaya Limited Hand access port
US5997515A (en) 1995-05-19 1999-12-07 General Surgical Innovations, Inc. Screw-type skin seal with inflatable membrane
US5964781A (en) * 1995-05-19 1999-10-12 General Surgical Innovations, Inc. Skin seal with inflatable membrane
US5634937A (en) * 1995-05-19 1997-06-03 General Surgical Innovations, Inc. Skin seal with inflatable membrane
US5634911A (en) * 1995-05-19 1997-06-03 General Surgical Innovations, Inc. Screw-type skin seal with inflatable membrane
US5628753A (en) * 1995-06-01 1997-05-13 Sandoz Nutrition Ltd. Gastrostomy tube removal tool
IL118551A (en) * 1995-06-07 2004-05-12 Johnson & Johnson Medical Protective needle cover containment
DE29509370U1 (en) * 1995-06-08 1995-09-21 Angiomed Ag Stoma holder and device for placing a stoma
US5803922A (en) * 1995-06-27 1998-09-08 Christy; William J. Endoscopic wound access, anchoring, and insufflation device and method
US5683378A (en) * 1995-06-27 1997-11-04 Christy; William J. Endoscopic wound access and anchoring device method
USD381423S (en) * 1995-09-14 1997-07-22 Fuji Systems Corporation Support tool for insertion of a thoracoscope
US6714841B1 (en) 1995-09-15 2004-03-30 Computer Motion, Inc. Head cursor control interface for an automated endoscope system for optimal positioning
US5674196A (en) * 1996-01-05 1997-10-07 Donaldson; John Device for introducing medical fluid into the human ear
US5651773A (en) * 1996-01-19 1997-07-29 Perry; Larry C. Skin protector for ultrasonic-assisted liposuction and accessories
US5776110A (en) * 1996-01-26 1998-07-07 United States Surgical Corporation Thoracic port
US5860992A (en) * 1996-01-31 1999-01-19 Heartport, Inc. Endoscopic suturing devices and methods
WO1997027898A1 (en) * 1996-02-02 1997-08-07 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US5766220A (en) * 1996-02-29 1998-06-16 Moenning; Stephen P. Apparatus and method for protecting a port site opening in the wall of a body cavity
US5951588A (en) * 1996-02-29 1999-09-14 Moenning; Stephen P. Apparatus and method for protecting a port site opening in the wall of a body cavity
US6451041B1 (en) 1996-02-29 2002-09-17 Stephen P. Moenning Apparatus for protecting a port site opening in the wall of a body cavity and reducing electrosurgical injuries
US5941898A (en) * 1996-02-29 1999-08-24 Stephen P. Moenning Apparatus and method for moving sealing members of a medical apparatus between a first orientation and a second orientation
US6814700B1 (en) * 1996-03-04 2004-11-09 Heartport, Inc. Soft tissue retractor and method for providing surgical access
AU2064797A (en) * 1996-03-04 1997-09-22 Heartport, Inc. Retractor for providing surgical access and suture organizer
US5810721A (en) * 1996-03-04 1998-09-22 Heartport, Inc. Soft tissue retractor and method for providing surgical access
US6048309A (en) * 1996-03-04 2000-04-11 Heartport, Inc. Soft tissue retractor and delivery device therefor
US5817062A (en) * 1996-03-12 1998-10-06 Heartport, Inc. Trocar
ATE299687T1 (en) * 1996-03-19 2005-08-15 Sherwood Serv Ag GASTROINTESTINAL TUBE INSERTION OR REMOVAL DEVICE
US5685857A (en) * 1996-03-22 1997-11-11 Plc Medical Systems, Inc. Thoracoscopic cannula system
USD381424S (en) * 1996-03-26 1997-07-22 Fuji Systems Corporation Support tool for insertion of a thoracoscope
US5817099A (en) * 1996-06-06 1998-10-06 Skolik; Stephanie A. Universal port/seal device for ocular surgery
US6007544A (en) * 1996-06-14 1999-12-28 Beth Israel Deaconess Medical Center Catheter apparatus having an improved shape-memory alloy cuff and inflatable on-demand balloon for creating a bypass graft in-vivo
US6496099B2 (en) * 1996-06-24 2002-12-17 Computer Motion, Inc. General purpose distributed operating room control system
US6911916B1 (en) * 1996-06-24 2005-06-28 The Cleveland Clinic Foundation Method and apparatus for accessing medical data over a network
US5741234A (en) 1996-07-16 1998-04-21 Aboul-Hosn; Walid Nagib Anatomical cavity access sealing condit
DE19629537A1 (en) * 1996-07-22 1998-01-29 Storz Karl Gmbh & Co Trocar sleeve
US5728103A (en) * 1996-08-23 1998-03-17 Applied Medical Technology, Inc. Implantable subcutaneous access device and method of using same
US6293955B1 (en) 1996-09-20 2001-09-25 Converge Medical, Inc. Percutaneous bypass graft and securing system
AU721415B2 (en) 1996-11-08 2000-07-06 Converge Medical, Inc. Percutaneous bypass graft and securing system
US6132441A (en) 1996-11-22 2000-10-17 Computer Motion, Inc. Rigidly-linked articulating wrist with decoupled motion transmission
JP4709801B2 (en) * 1996-12-17 2011-06-29 オリンパス株式会社 Surgical cavity securing device and surgical cavity securing system
WO1998027878A1 (en) * 1996-12-20 1998-07-02 Fundação E.J. Zerbini A prosthesis for thoracostomy and method for its implantation
US6447484B1 (en) * 1997-01-09 2002-09-10 Medtronic, Inc. Flexible disc obturator for a cannula assembly
US6059801A (en) * 1997-03-24 2000-05-09 Samimi; Darius Bladder saver retropubic ligature carrier device
US6440063B1 (en) * 1997-04-30 2002-08-27 University Of Massachusetts Surgical access port and laparoscopic surgical method
IT1292016B1 (en) * 1997-05-28 1999-01-25 Valerio Cigaina IMPLANT DEVICE PARTICULARLY FOR ELECTROSTIMULATION AND / OR ELECTRO-REGISTRATION OF ENDOABDOMINAL VISCERS
US5779697A (en) * 1997-05-28 1998-07-14 Linvatec Corporation Arthroscopic cannula with fluid seals
JPH1176247A (en) * 1997-07-11 1999-03-23 Olympus Optical Co Ltd Surgical operation system
US6175758B1 (en) * 1997-07-15 2001-01-16 Parviz Kambin Method for percutaneous arthroscopic disc removal, bone biopsy and fixation of the vertebrae
US6390976B1 (en) * 1997-09-17 2002-05-21 Origin Medsystems, Inc. System to permit offpump beating heart coronary bypass surgery
US20040236352A1 (en) * 1997-09-22 2004-11-25 Yulun Wang Method and apparatus for performing minimally invasive cardiac procedures
US6099506A (en) * 1997-09-26 2000-08-08 Macoviak; John A. Introducer and perfusion cannula
ATE320229T1 (en) * 1998-01-30 2006-04-15 St Jude Medical Atg Inc MEDICAL TRANSPLANT CONNECTOR OR PLUG AND METHOD FOR PRODUCING THE SAME
US6994713B2 (en) * 1998-01-30 2006-02-07 St. Jude Medical Atg, Inc. Medical graft connector or plug structures, and methods of making and installing same
US6330882B1 (en) * 1998-03-06 2001-12-18 Ronald French Emergency apparatus for evacuating air from the body cavity
US6241729B1 (en) * 1998-04-09 2001-06-05 Sdgi Holdings, Inc. Method and instrumentation for posterior interbody fusion
US5951466A (en) 1998-04-13 1999-09-14 Viamedics, Llc Self-seating surgical access device and method of gaining surgical access to a body cavity
US6945955B1 (en) * 1998-05-20 2005-09-20 Disetronic Licensing Ag Sensor system including a port body
DE19822711B4 (en) * 1998-05-20 2006-11-23 Disetronic Licensing Ag Sensor system with port body
WO2000015144A1 (en) 1998-06-10 2000-03-23 Advanced Bypass Technologies, Inc. Aortic aneurysm treatment systems
US6033420A (en) * 1998-09-02 2000-03-07 Embol-X, Inc. Trocar introducer system and methods of use
US7344547B2 (en) 1998-09-15 2008-03-18 Phavel Systems, Inc. Laparoscopic instruments and trocar systems and related surgical method
US6086570A (en) * 1998-09-29 2000-07-11 A-Med Systems, Inc. Hemostasis valve with membranes having offset apertures
US6659939B2 (en) 1998-11-20 2003-12-09 Intuitive Surgical, Inc. Cooperative minimally invasive telesurgical system
US6398726B1 (en) 1998-11-20 2002-06-04 Intuitive Surgical, Inc. Stabilizer for robotic beating-heart surgery
US6852107B2 (en) 2002-01-16 2005-02-08 Computer Motion, Inc. Minimally invasive surgical training using robotics and tele-collaboration
US8527094B2 (en) 1998-11-20 2013-09-03 Intuitive Surgical Operations, Inc. Multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures
US6951535B2 (en) * 2002-01-16 2005-10-04 Intuitive Surgical, Inc. Tele-medicine system that transmits an entire state of a subsystem
US7195590B2 (en) * 1998-12-01 2007-03-27 Atropos Limited Surgical device
US7998068B2 (en) * 1998-12-01 2011-08-16 Atropos Limited Instrument access device
DE69937466T2 (en) 1998-12-01 2008-11-13 Atropos Ltd., Bray Laparoscopic sealed access device
CA2351643C (en) * 1998-12-01 2010-02-02 Atropos Limited A surgical device for retracting and/or sealing an incision
US7559893B2 (en) 1998-12-01 2009-07-14 Atropos Limited Wound retractor device
US20050192483A1 (en) * 1998-12-01 2005-09-01 Frank Bonadio Device
US20070004968A1 (en) * 1998-12-01 2007-01-04 Frank Bonadio Seal for a cannula
US7537564B2 (en) * 1998-12-01 2009-05-26 Atropos Limited Wound retractor device
US6254601B1 (en) * 1998-12-08 2001-07-03 Hysterx, Inc. Methods for occlusion of the uterine arteries
US6024755A (en) * 1998-12-11 2000-02-15 Embol-X, Inc. Suture-free clamp and sealing port and methods of use
US6086603A (en) * 1998-12-14 2000-07-11 Syntheon, Llc Luminal port device having internal and external sealing mechanisms
DE19858824C2 (en) * 1998-12-19 2002-11-28 Aesculap Ag & Co Kg Trocar with a trocar sleeve and an obturator
US6210397B1 (en) 1999-01-13 2001-04-03 A-Med Systems, Inc. Sealing cannula device
SE9900454D0 (en) 1999-02-10 1999-02-10 Safe Conduct Ab trocar
US6159179A (en) 1999-03-12 2000-12-12 Simonson; Robert E. Cannula and sizing and insertion method
FR2790950B1 (en) * 1999-03-15 2001-06-29 Thierry Scheye DEVICE FOR DELIVERING A HOLLOW VISCER ON THE SKIN
IES990219A2 (en) 1999-03-18 2000-11-15 Gaya Ltd A surgical device
DE19916088A1 (en) * 1999-04-09 2000-10-26 Storz Karl Gmbh & Co Kg Device for creating a transcutaneous access to an internal hollow organ
US6746396B1 (en) 1999-04-13 2004-06-08 Viamedics, Llc Self-seating surgical access device and method of use
DK199900539A (en) * 1999-04-21 2000-10-22 Bisgaard Therkel Expandable Trocar
US6716233B1 (en) 1999-06-02 2004-04-06 Power Medical Interventions, Inc. Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US7695485B2 (en) 2001-11-30 2010-04-13 Power Medical Interventions, Llc Surgical device
US7951071B2 (en) * 1999-06-02 2011-05-31 Tyco Healthcare Group Lp Moisture-detecting shaft for use with an electro-mechanical surgical device
US8025199B2 (en) 2004-02-23 2011-09-27 Tyco Healthcare Group Lp Surgical cutting and stapling device
US6793652B1 (en) 1999-06-02 2004-09-21 Power Medical Interventions, Inc. Electro-mechanical surgical device
US6264087B1 (en) 1999-07-12 2001-07-24 Powermed, Inc. Expanding parallel jaw device for use with an electromechanical driver device
US6171282B1 (en) * 1999-07-23 2001-01-09 Edgar K. Ragsdale Soft cannula and methods for use
IE990795A1 (en) * 1999-07-30 2001-03-07 Gaya Ltd Hand Access Port Device
IES990659A2 (en) * 1999-07-30 2001-02-21 Gaya Ltd A surgical device
US7815590B2 (en) 1999-08-05 2010-10-19 Broncus Technologies, Inc. Devices for maintaining patency of surgically created channels in tissue
US7175644B2 (en) * 2001-02-14 2007-02-13 Broncus Technologies, Inc. Devices and methods for maintaining collateral channels in tissue
US7597698B2 (en) * 1999-08-10 2009-10-06 Maquet Cardiovascular Llc Apparatus and method for endoscopic encirclement of pulmonary veins for epicardial ablation
US7398781B1 (en) * 1999-08-10 2008-07-15 Maquet Cardiovascular, Llc Method for subxiphoid endoscopic access
US20030187461A1 (en) * 1999-08-10 2003-10-02 Chin Albert K. Releasable guide and method for endoscopic cardiac lead placement
US7288096B2 (en) * 2003-01-17 2007-10-30 Origin Medsystems, Inc. Apparatus for placement of cardiac defibrillator and pacer
US6706052B1 (en) 1999-08-10 2004-03-16 Origin Medsystems, Inc. Longitudinal dilator and method
US20030187460A1 (en) * 1999-08-10 2003-10-02 Chin Albert K. Methods and apparatus for endoscopic cardiac surgery
US20040102804A1 (en) * 1999-08-10 2004-05-27 Chin Albert K. Apparatus and methods for endoscopic surgical procedures
US7526342B2 (en) * 1999-08-10 2009-04-28 Maquet Cardiovascular Llc Apparatus for endoscopic cardiac mapping and lead placement
US20060287574A1 (en) * 1999-08-25 2006-12-21 Chin Albert K Longitudinal dilator
US6494889B1 (en) 1999-09-01 2002-12-17 Converge Medical, Inc. Additional sutureless anastomosis embodiments
US6702828B2 (en) * 1999-09-01 2004-03-09 Converge Medical, Inc. Anastomosis system
US20020173809A1 (en) * 1999-09-01 2002-11-21 Fleischman Sidney D. Sutureless anastomosis system deployment concepts
US7361158B1 (en) * 1999-09-24 2008-04-22 Medicinvent, Llc Catheter including textured interface
US7217240B2 (en) * 1999-10-01 2007-05-15 Intuitive Surgical, Inc. Heart stabilizer
EP1392177B1 (en) 1999-10-14 2008-12-03 Atropos Limited A wound retractor
US20050203346A1 (en) * 1999-10-14 2005-09-15 Frank Bonadio Wound retractor device
US7540839B2 (en) * 1999-10-14 2009-06-02 Atropos Limited Wound retractor
US20040068278A1 (en) * 1999-12-06 2004-04-08 Converge Medical Inc. Anastomosis systems
US6669708B1 (en) * 1999-12-09 2003-12-30 Michael Nissenbaum Devices, systems and methods for creating sutureless on-demand vascular anastomoses and hollow organ communication channels
US8016855B2 (en) 2002-01-08 2011-09-13 Tyco Healthcare Group Lp Surgical device
US6514260B1 (en) * 2000-03-15 2003-02-04 Sdgi Holdings, Inc. Methods and instruments for laparoscopic spinal surgery
US6383191B1 (en) * 2000-03-15 2002-05-07 Sdgi Holdings, Inc. Laparoscopic instrument sleeve
US6312377B1 (en) 2000-04-06 2001-11-06 Viamedics, Llc Soft tissue compression shield and method of retracting tissue
US8398666B2 (en) * 2000-05-16 2013-03-19 Teleflex Medical Incorporated Penetrating tip for trocar assembly
US6884253B1 (en) 2000-05-16 2005-04-26 Taut, Inc. Penetrating tip for trocar assembly
DE10037421C2 (en) * 2000-07-21 2003-06-26 Leonid Sverdlov Device for minimally invasive access to the organs of the abdominal cavity
WO2002007618A1 (en) * 2000-07-21 2002-01-31 Atropos Limited A cannula
US6726699B1 (en) * 2000-08-15 2004-04-27 Computer Motion, Inc. Instrument guide
US6355028B2 (en) 2000-10-11 2002-03-12 Popcab,Llc Stable port device for port off-pump beating heart coronary artery bypass surgery system
US6582420B2 (en) 2000-10-11 2003-06-24 Popcab, Llc Intercostal lockable directable port device
US6464690B1 (en) 2000-10-11 2002-10-15 Popcab, Llc Port off-pump beating heart coronary artery bypass heart stabilization system
US6579281B2 (en) 2000-10-11 2003-06-17 Popcab, Llc Instrument stabilizer for through-a-port surgery
US6500170B2 (en) 2000-10-11 2002-12-31 Popcab, Llc Instrument stabilizer for through-the-port surgery
US6464691B1 (en) 2000-10-11 2002-10-15 Popcab, Llc Port device for port off-pump beating heart coronary artery bypass surgery system
US6592573B2 (en) 2000-10-11 2003-07-15 Popcab, Llc Through-port heart stabilization system
US6503245B2 (en) * 2000-10-11 2003-01-07 Medcanica, Inc. Method of performing port off-pump beating heart coronary artery bypass surgery
JP5190169B2 (en) 2000-10-19 2013-04-24 アプライド メディカル リソーシーズ コーポレイション Surgical access instruments and methods
EP2932884B1 (en) 2000-11-28 2020-09-09 Intuitive Surgical Operations, Inc. Endoscopic beating-heart stabilizer and vessel occlusion fastener
US20020133187A1 (en) * 2001-01-22 2002-09-19 Buckman Robert F. Methods and apparatus for intercostal access
US7905897B2 (en) 2001-03-14 2011-03-15 Tyco Healthcare Group Lp Trocar device
US9186177B2 (en) 2001-03-14 2015-11-17 Covidien Lp Trocar device
US20020165524A1 (en) * 2001-05-01 2002-11-07 Dan Sanchez Pivot point arm for a robotic system used to perform a surgical procedure
JP2002338688A (en) * 2001-05-15 2002-11-27 Sumitomo Chem Co Ltd Method for producing purified polyethersulfone
US7338514B2 (en) * 2001-06-01 2008-03-04 St. Jude Medical, Cardiology Division, Inc. Closure devices, related delivery methods and tools, and related methods of use
JP2003007916A (en) * 2001-06-19 2003-01-10 Sanyo Electric Co Ltd Method of manufacturing circuit device
US20060064119A9 (en) * 2001-07-05 2006-03-23 Converge Medical, Inc. Vascular anastomosis systems
US6858035B2 (en) 2001-07-05 2005-02-22 Converge Medical, Inc. Distal anastomosis system
US6626920B2 (en) * 2001-07-05 2003-09-30 Converge Medical, Inc. Distal anastomosis system
US20030229365A1 (en) * 2002-06-10 2003-12-11 Whayne James G. Angled vascular anastomosis system
US6972023B2 (en) * 2001-07-05 2005-12-06 Converge Medical, Inc. Distal anastomosis system
WO2003015848A1 (en) 2001-08-14 2003-02-27 Applied Medical Resources Corporation Access sealing apparatus and method
DE10142637B4 (en) * 2001-08-31 2009-07-09 Disetronic Licensing Ag Transcutaneous implant with surface structure and method for producing such an implant
US6989003B2 (en) * 2001-08-31 2006-01-24 Conmed Corporation Obturator and cannula for a trocar adapted for ease of insertion and removal
US7708712B2 (en) * 2001-09-04 2010-05-04 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US6728599B2 (en) 2001-09-07 2004-04-27 Computer Motion, Inc. Modularity system for computer assisted surgery
US6958037B2 (en) 2001-10-20 2005-10-25 Applied Medical Resources Corporation Wound retraction apparatus and method
US7008431B2 (en) 2001-10-30 2006-03-07 Depuy Spine, Inc. Configured and sized cannula
US7824410B2 (en) 2001-10-30 2010-11-02 Depuy Spine, Inc. Instruments and methods for minimally invasive spine surgery
EP1453432B1 (en) 2001-12-04 2012-08-01 Tyco Healthcare Group LP System and method for calibrating a surgical instrument
US6793653B2 (en) * 2001-12-08 2004-09-21 Computer Motion, Inc. Multifunctional handle for a medical robotic system
US6723088B2 (en) * 2001-12-20 2004-04-20 Board Of Regents, The University Of Texas Laparoscopic porting
JP2003199755A (en) 2001-12-28 2003-07-15 Olympus Optical Co Ltd Trocar for operation under endoscope
US9113878B2 (en) 2002-01-08 2015-08-25 Covidien Lp Pinion clip for right angle linear cutter
WO2003075256A1 (en) * 2002-03-05 2003-09-12 Nec Corporation Image display and its control method
DE10214414B4 (en) * 2002-03-30 2004-06-03 Delia Schinkel-Fleitmann Device for fixing a trocar, tube or catheter
US7976564B2 (en) * 2002-05-06 2011-07-12 St. Jude Medical, Cardiology Division, Inc. PFO closure devices and related methods of use
EP2343032B1 (en) 2002-06-05 2012-05-09 Applied Medical Resources Corporation Wound retractor
JP2004016239A (en) * 2002-06-12 2004-01-22 Fujitsu Ltd Crossword puzzle device and crossword puzzle program
WO2003105702A2 (en) 2002-06-14 2003-12-24 Power Medical Interventions, Inc. Surgical device
WO2004014234A2 (en) 2002-07-31 2004-02-19 Power Medical Interventions, Inc. Orifice introducer device
US9271753B2 (en) 2002-08-08 2016-03-01 Atropos Limited Surgical device
US7338433B2 (en) * 2002-08-13 2008-03-04 Allergan, Inc. Remotely adjustable gastric banding method
DE60331457D1 (en) * 2002-08-28 2010-04-08 Allergan Inc TEMPTING MAGNETIC BANDING DEVICE
US7901419B2 (en) * 2002-09-04 2011-03-08 Allergan, Inc. Telemetrically controlled band for regulating functioning of a body organ or duct, and methods of making, implantation and use
EP1610696B1 (en) * 2002-09-19 2007-06-13 Atropos Limited A wound retractor system
US7931658B2 (en) 2002-09-20 2011-04-26 Interrad Medical, Inc. Temporary retention device
AU2003288483A1 (en) * 2002-12-16 2004-07-09 Atropos Limited A surgical device
US20050020884A1 (en) 2003-02-25 2005-01-27 Hart Charles C. Surgical access system
US20050049675A1 (en) * 2003-03-28 2005-03-03 Board Of Regents, The University Of Texas System Medical devices and related methods
US7854724B2 (en) 2003-04-08 2010-12-21 Surgiquest, Inc. Trocar assembly with pneumatic sealing
US20040267306A1 (en) * 2003-04-11 2004-12-30 Velocimed, L.L.C. Closure devices, related delivery methods, and related methods of use
US8372112B2 (en) * 2003-04-11 2013-02-12 St. Jude Medical, Cardiology Division, Inc. Closure devices, related delivery methods, and related methods of use
US7426929B2 (en) * 2003-05-20 2008-09-23 Portaero, Inc. Intra/extra-thoracic collateral ventilation bypass system and method
US6916310B2 (en) * 2003-05-30 2005-07-12 Codman & Shurtleff, Inc. Percutaneous access device
US7252086B2 (en) * 2003-06-03 2007-08-07 Cordis Corporation Lung reduction system
US7264001B2 (en) * 2003-06-20 2007-09-04 Scimed Life Systems, Inc. Guidewire exit tool
US8021387B2 (en) 2003-07-11 2011-09-20 Biosense Webster, Inc. Trans-septal sheath with splitting dilating needle and method for its use
US8308682B2 (en) 2003-07-18 2012-11-13 Broncus Medical Inc. Devices for maintaining patency of surgically created channels in tissue
US8002740B2 (en) 2003-07-18 2011-08-23 Broncus Technologies, Inc. Devices for maintaining patency of surgically created channels in tissue
US7473220B2 (en) * 2003-08-04 2009-01-06 Medcanica, Inc. Surgical port device
EP1651094A4 (en) 2003-08-06 2008-07-30 Applied Med Resources Surgical device with tack-free gel and method of manufacture
ES2529617T3 (en) * 2003-09-15 2015-02-23 Apollo Endosurgery, Inc. Implantable device fixation system
US7163510B2 (en) 2003-09-17 2007-01-16 Applied Medical Resources Corporation Surgical instrument access device
US8764765B2 (en) 2003-09-23 2014-07-01 Covidien Lp Laparoscopic instrument and related surgical method
US7753901B2 (en) * 2004-07-21 2010-07-13 Tyco Healthcare Group Lp Laparoscopic instrument and cannula assembly and related surgical method
US7850600B1 (en) 2003-09-23 2010-12-14 Tyco Healthcare Group Lp Laparoscopic instrument and trocar system and related surgical method
US20050262673A1 (en) * 2003-10-09 2005-12-01 Strahm Textile Systems Ag Device for removing needles from a fabric web
US20060161050A1 (en) * 2003-10-15 2006-07-20 John Butler A surgical sealing device
WO2005034766A2 (en) * 2003-10-15 2005-04-21 Atropos Limited A surgical sealing device
JP2005121947A (en) * 2003-10-17 2005-05-12 Olympus Corp Object lens insertion fixture, microscope and microscope system
CA2542362C (en) * 2003-10-17 2012-12-04 Tyco Healthcare Group Lp Expandible surgical access device
WO2005044111A2 (en) * 2003-11-05 2005-05-19 Atropos Limited A surgical sealing device
US7160245B2 (en) * 2003-11-17 2007-01-09 Virginijus Burneikis Method and device for umbilicus protection during abdominal surgery
US7585290B2 (en) * 2004-01-20 2009-09-08 Ethicon Endo-Surgery, Inc. Medical device for providing access
US8900117B2 (en) 2004-01-23 2014-12-02 Apollo Endosurgery, Inc. Releasably-securable one-piece adjustable gastric band
PL1670362T3 (en) * 2004-01-23 2011-05-31 Apollo Endosurgery Inc Implantable device fastening system and methods of use
BRPI0508527A (en) * 2004-03-08 2007-08-14 Endoart Sa tubular system closure system
ES2368149T3 (en) * 2004-03-18 2011-11-14 Allergan, Inc. APPARATUS FOR ADJUSTMENT OF THE VOLUME OF INTRAGASTRIC BALLOONS.
US20050240155A1 (en) * 2004-04-27 2005-10-27 Conlon Sean P Surgically implantable injection port having a centered catheter connection tube
US7846171B2 (en) 2004-05-27 2010-12-07 C.R. Bard, Inc. Method and apparatus for delivering a prosthetic fabric into a patient
US8409167B2 (en) 2004-07-19 2013-04-02 Broncus Medical Inc Devices for delivering substances through an extra-anatomic opening created in an airway
US8961407B2 (en) * 2004-07-21 2015-02-24 Covidien Lp Surgical port assembly
US8888695B2 (en) 2007-03-30 2014-11-18 Covidien Lp Laparoscopic port assembly
US9161820B2 (en) * 2004-10-28 2015-10-20 Nico Corporation Surgical access assembly and method of using same
US9186175B2 (en) 2004-10-28 2015-11-17 Nico Corporation Surgical access assembly and method of using same
US9387010B2 (en) 2004-10-28 2016-07-12 Nico Corporation Surgical access assembly and method of using same
US8220460B2 (en) * 2004-11-19 2012-07-17 Portaero, Inc. Evacuation device and method for creating a localized pleurodesis
EP1848350B1 (en) 2005-02-04 2017-03-01 Atropos Limited An apparatus for inserting a surgical device at least partially through a wound opening
US7722558B2 (en) 2005-02-15 2010-05-25 Ott Douglas E Trocar sleeve for jet stream condition
US8251888B2 (en) 2005-04-13 2012-08-28 Mitchell Steven Roslin Artificial gastric valve
US20060241570A1 (en) * 2005-04-22 2006-10-26 Wilk Patent, Llc Intra-abdominal medical method
GB2425483A (en) * 2005-04-29 2006-11-01 Hans-Ulrich Laasch A single step trocar based insertion device
WO2007010511A1 (en) 2005-07-15 2007-01-25 Atropos Limited A wound retractor
US20070156165A1 (en) * 2005-07-21 2007-07-05 Chang Kenneth J Percutaneous transgastric gastroplication and transgastric minimally invasive surgery
US20070038224A1 (en) * 2005-07-28 2007-02-15 Ethicon Endo-Surgery, Inc. Electroactive polymer-based flexing access port
WO2007018520A1 (en) * 2005-07-28 2007-02-15 Samimi M D Darius Bladder saver retropubic ligature carrier device
WO2007044850A1 (en) * 2005-10-14 2007-04-19 Applied Medical Resources Corporation Wound retractor with gel cap
JP4896504B2 (en) * 2005-11-25 2012-03-14 株式会社八光 System device consisting of a retractor and a retractor assisting device
US7798954B2 (en) 2006-01-04 2010-09-21 Allergan, Inc. Hydraulic gastric band with collapsible reservoir
US8043206B2 (en) 2006-01-04 2011-10-25 Allergan, Inc. Self-regulating gastric band with pressure data processing
US8016794B2 (en) 2006-03-09 2011-09-13 Interrad Medical, Inc. Anchor device and method
US8066673B2 (en) * 2006-03-21 2011-11-29 Applied Medical Resources Corporation Cannula stabilization seal
US8357085B2 (en) 2009-03-31 2013-01-22 Ethicon Endo-Surgery, Inc. Devices and methods for providing access into a body cavity
US8114085B2 (en) * 2006-04-13 2012-02-14 General Electric Company Percutaneous registration-and-access tool for minimally invasive spinal surgery
US8518024B2 (en) * 2006-04-24 2013-08-27 Transenterix, Inc. System and method for multi-instrument surgical access using a single access port
AU2007243484B2 (en) 2006-04-24 2013-08-15 Transenterix Inc. Natural orifice surgical system
US7963912B2 (en) * 2006-05-08 2011-06-21 Ethicon Endo-Surgery, Inc. Endoscopic translumenal surgical methods using a sheath
US20070260273A1 (en) * 2006-05-08 2007-11-08 Ethicon Endo-Surgery, Inc. Endoscopic Translumenal Surgical Systems
US20070260121A1 (en) * 2006-05-08 2007-11-08 Ethicon Endo-Surgery, Inc. Endoscopic Translumenal Surgical Systems
US7806870B2 (en) * 2006-10-06 2010-10-05 Surgiquest, Incorporated Elastically deformable surgical access device having telescoping guide tube
US7798998B2 (en) * 2006-10-06 2010-09-21 Surgiquest, Inc. Elastically deformable surgical access device
US8795235B2 (en) * 2006-10-06 2014-08-05 Surgiquest, Inc. Devices for and methods of performing minimally-invasive surgical procedures through a single incision
EP2537477B1 (en) * 2006-10-06 2014-12-03 SurgiQuest, Incorporated Visualization trocar
US20080132931A1 (en) * 2006-12-04 2008-06-05 Gregory Paul Mueller Skin puncturing device
US20080132946A1 (en) * 2006-12-04 2008-06-05 Gregory Paul Mueller Skin port
US8951271B2 (en) 2006-12-04 2015-02-10 Implicitcare, Llc Surgical threading device and method for using same
US9033999B2 (en) 2006-12-04 2015-05-19 Implicitcare, Llc Surgical threading device with removable suture
US8025671B2 (en) * 2006-12-04 2011-09-27 Implicitcare, Llc Surgical threading device and method for using same
US20080132917A1 (en) * 2006-12-04 2008-06-05 Gregory Paul Mueller Surgical instrument docking device
US20080132920A1 (en) * 2006-12-04 2008-06-05 Gregory Paul Mueller Surgical instruments for positioning suture knots
JP5400621B2 (en) * 2007-02-21 2014-01-29 コヴィディエン リミテッド パートナーシップ Obturator tip
US8430852B2 (en) * 2007-04-17 2013-04-30 Medtronic, Inc. Therapeutic sleeve for implantable medical device
US20080275401A1 (en) * 2007-05-01 2008-11-06 Sage Shahn S Catheter anchor and system/method regarding same
US20080275481A1 (en) * 2007-05-04 2008-11-06 Scarpone Michael A Ultrasound guided percutaneous cutting tool with gradations and adjustable stop ring
WO2008140989A2 (en) * 2007-05-11 2008-11-20 Portaero, Inc. Medical devices and procedures for assessing a lung and treating chronic obstructive pulmonary disease
ES2623049T3 (en) * 2007-05-11 2017-07-10 Applied Medical Resources Corporation Surgical retractor
AU2008251303B2 (en) 2007-05-11 2013-09-19 Applied Medical Resources Corporation Surgical access device
ES2557882T3 (en) 2007-06-05 2016-01-29 Atropos Limited Instrument Access Device
US8657740B2 (en) 2007-06-05 2014-02-25 Atropos Limited Instrument access device
ITMI20071230A1 (en) * 2007-06-20 2008-12-21 Lucini Surgical Concept S R L CANNULA DEVICE FOR SURGICAL OPERATIONS IN ENDOSCOPY
US20090043314A1 (en) * 2007-07-16 2009-02-12 The Cleveland Clinic Foundation Access device for body tissue and method of using same
US8469987B2 (en) 2007-08-09 2013-06-25 Senorx, Inc. Split sheath for trocar assembly
US20110060183A1 (en) * 2007-09-12 2011-03-10 Salvatore Castro Multi-instrument access devices and systems
US20090227843A1 (en) * 2007-09-12 2009-09-10 Smith Jeffrey A Multi-instrument access devices and systems
EP3097869B1 (en) 2007-09-21 2020-03-11 Covidien LP Surgical device
AU2008302039B2 (en) 2007-09-21 2013-07-18 Covidien Lp Surgical device
USD667954S1 (en) 2007-10-05 2012-09-25 Surgiquest, Inc. Visualization trocar
BRPI0817421A2 (en) 2007-10-05 2015-06-16 Tyco Healthcare Sealing fastener for use in surgical procedures
USD663838S1 (en) 2007-10-05 2012-07-17 Surgiquest, Inc. Visualization trocar
CA2702201C (en) * 2007-10-09 2015-07-07 Wilson-Cook Medical, Inc. Systems, devices and methods having an overtube for accessing a bodily opening
WO2009048949A1 (en) * 2007-10-09 2009-04-16 Wilson-Cook Medical, Inc. Anastomosis plug for bariatric surgery
EP2237815B1 (en) 2008-01-22 2020-08-19 Applied Medical Resources Corporation Surgical instrument access device
US20090192473A1 (en) * 2008-01-24 2009-07-30 Arterioport, Inc. Systems for controlled closure of body lumens
WO2009105432A2 (en) * 2008-02-19 2009-08-27 Portaero, Inc. Devices and methods for delivery of a therapeutic agent through a pneumostoma
US8262624B2 (en) 2008-03-27 2012-09-11 Medtronic, Inc. Anchor and anchor deployment apparatus
US8632502B2 (en) 2008-03-27 2014-01-21 Medtronic, Inc. Anchor deployment apparatus
US20110144685A1 (en) * 2008-06-11 2011-06-16 Governors Of The University Of Alberta Cricothyrotomy device
US8025640B2 (en) 2008-06-27 2011-09-27 Tyco Healthcare Group Lp Pressurized surgical valve
US7850667B2 (en) * 2008-06-27 2010-12-14 Tyco Healthcare Group Lp Low profile instrument access device
US8038653B2 (en) 2008-07-16 2011-10-18 Interrad Medical, Inc. Anchor systems and methods
US8628539B2 (en) * 2008-09-05 2014-01-14 Innovia, Llc Flexible disposable surgical port
US20100081994A1 (en) * 2008-10-01 2010-04-01 David Leslie Zisow Self Retaining Laparoscopic Trocar System-Zisow Trocar Sleeve System
US8628468B2 (en) 2008-10-01 2014-01-14 David L. Zisow Device for anchoring a trocar
USD738500S1 (en) 2008-10-02 2015-09-08 Covidien Lp Seal anchor for use in surgical procedures
EP2362762A1 (en) 2008-10-06 2011-09-07 Allergan Medical Sàrl Mechanical gastric band with cushions
EP2341849B1 (en) 2008-10-10 2019-12-18 SurgiQuest, Incorporated System for improved gas recirculation in surgical trocars with pneumatic sealing
AU2009303470B2 (en) 2008-10-13 2015-04-23 Applied Medical Resources Corporation Single port access system
US20100185049A1 (en) * 2008-10-22 2010-07-22 Allergan, Inc. Dome and screw valves for remotely adjustable gastric banding systems
US20100168522A1 (en) * 2008-10-23 2010-07-01 Thomas Wenchell Surgical access assembly
US9610131B2 (en) * 2008-11-05 2017-04-04 The Johns Hopkins University Rotating needle driver and apparatuses and methods related thereto
US8992558B2 (en) 2008-12-18 2015-03-31 Osteomed, Llc Lateral access system for the lumbar spine
WO2010071810A1 (en) 2008-12-19 2010-06-24 Andy Christopher Kiser Methods and devices for endoscopic access to the heart
US20110230723A1 (en) * 2008-12-29 2011-09-22 Salvatore Castro Active Instrument Port System for Minimally-Invasive Surgical Procedures
US8375955B2 (en) 2009-02-06 2013-02-19 Atropos Limited Surgical procedure
US8328764B2 (en) * 2009-02-06 2012-12-11 Interrad Medical, Inc. System for anchoring medical devices
US8574153B2 (en) * 2009-03-20 2013-11-05 Covidien Lp Flexible port seal
US8328717B2 (en) * 2009-03-27 2012-12-11 Covidien Lp Seal device with adjustable aperture
US8206291B2 (en) * 2009-03-27 2012-06-26 Tyco Healthcare Group Lp Portal device
US20100249521A1 (en) 2009-03-31 2010-09-30 Shelton Iv Frederick E Access Device Including Retractor And Insert
US8317690B2 (en) 2009-03-31 2012-11-27 Covidien Lp Foam port and introducer assembly
US8323184B2 (en) * 2009-03-31 2012-12-04 Covidien Lp Surgical access port and associated introducer mechanism
WO2010117869A1 (en) * 2009-04-06 2010-10-14 Tufts Medical Center Cannula
US8257251B2 (en) 2009-04-08 2012-09-04 Ethicon Endo-Surgery, Inc. Methods and devices for providing access into a body cavity
US8419635B2 (en) 2009-04-08 2013-04-16 Ethicon Endo-Surgery, Inc. Surgical access device having removable and replaceable components
US8137267B2 (en) 2009-04-08 2012-03-20 Ethicon Endo-Surgery, Inc. Retractor with flexible sleeve
US20100280310A1 (en) * 2009-05-01 2010-11-04 Allergan, Inc. Laparoscopic Gastric Band With Active Agents
US20110184229A1 (en) * 2009-05-01 2011-07-28 Allergan, Inc. Laparoscopic gastric band with active agents
US20100298646A1 (en) * 2009-05-19 2010-11-25 Tyco Healthcare Group Lp Flexible access assembly with reinforced lumen
EP2434968A1 (en) * 2009-05-29 2012-04-04 Asalus Medical Instruments Limited Laparoscopic access port and port sleeve arrangement
US8361109B2 (en) 2009-06-05 2013-01-29 Ethicon Endo-Surgery, Inc. Multi-planar obturator with foldable retractor
US20100312189A1 (en) * 2009-06-05 2010-12-09 Ethicon Endo-Surgery, Inc. Flexible cannula devices and methods
US8475490B2 (en) 2009-06-05 2013-07-02 Ethicon Endo-Surgery, Inc. Methods and devices for providing access through tissue to a surgical site
US8241209B2 (en) 2009-06-05 2012-08-14 Ethicon Endo-Surgery, Inc. Active seal components
US8795163B2 (en) 2009-06-05 2014-08-05 Ethicon Endo-Surgery, Inc. Interlocking seal components
US9078695B2 (en) 2009-06-05 2015-07-14 Ethicon Endo-Surgery, Inc. Methods and devices for accessing a body cavity using a surgical access device with modular seal components
US8033995B2 (en) 2009-06-05 2011-10-11 Ethicon Endo-Surgery, Inc. Inflatable retractor with insufflation and method
US8465422B2 (en) 2009-06-05 2013-06-18 Ethicon Endo-Surgery, Inc. Retractor with integrated wound closure
EP2445418B1 (en) * 2009-06-26 2015-03-18 Cook Medical Technologies LLC Linear clamps for anastomosis
US20110021877A1 (en) * 2009-07-24 2011-01-27 Tyco Healthcare Group Lp Surgical port and frangible introducer assembly
WO2011014563A1 (en) 2009-07-29 2011-02-03 Vatrix Medical, Inc. Tissue stabilization for heart failure
KR20120085739A (en) * 2009-07-29 2012-08-01 트랜센테릭스 인크. Deflectable instrument ports
US8968190B2 (en) * 2009-08-25 2015-03-03 Covidien Lp Single incision surgical portal apparatus including inner member
US20110137112A1 (en) * 2009-08-28 2011-06-09 Allergan, Inc. Gastric band with electric stimulation
WO2011031400A2 (en) * 2009-08-28 2011-03-17 Allergan, Inc. Gastric band with electric stimulation
EP3636183B1 (en) 2009-08-31 2023-06-28 Applied Medical Resources Corporation Multifunctional surgical access system
WO2011033495A1 (en) 2009-09-17 2011-03-24 Atropos Limited An instrument access device
US8465476B2 (en) 2009-09-23 2013-06-18 Intuitive Surgical Operations, Inc. Cannula mounting fixture
US20110071541A1 (en) 2009-09-23 2011-03-24 Intuitive Surgical, Inc. Curved cannula
US8623028B2 (en) * 2009-09-23 2014-01-07 Intuitive Surgical Operations, Inc. Surgical port feature
US8888789B2 (en) 2009-09-23 2014-11-18 Intuitive Surgical Operations, Inc. Curved cannula surgical system control
US8932212B2 (en) 2009-10-01 2015-01-13 Covidien Lp Seal anchor with non-parallel lumens
US8920314B2 (en) * 2009-10-07 2014-12-30 Covidien Lp Universal height foam port
EP2496148B1 (en) 2009-11-03 2013-11-20 Cook Medical Technologies LLC Planar clamps for anastomosis
US20110118553A1 (en) * 2009-11-19 2011-05-19 Tyco Healthcare Group Lp Access device including an integrated light source
US8376938B2 (en) 2009-11-20 2013-02-19 Ethicon Endo-Surgery, Inc. Discrete flexion head for single port device
US8480683B2 (en) 2009-11-24 2013-07-09 Covidien Lp Foam introduction system including modified port geometry
US8740904B2 (en) * 2009-11-24 2014-06-03 Covidien Lp Seal anchor introducer including biasing member
US20110124968A1 (en) * 2009-11-24 2011-05-26 Tyco Healthcare Group Lp Surgical portal and introducer assembly
CA2689765A1 (en) * 2010-01-04 2011-07-04 Manoj Bhargava Two-piece cannula, a kit comprising a two-piece cannula and an inserter and a method for use thereof
US20110166423A1 (en) * 2010-01-07 2011-07-07 Tyco Healthcare Group Lp Foam port introduction system including dilator
US8574155B2 (en) * 2010-02-12 2013-11-05 Covidien Lp Expandable surgical access port
US8777849B2 (en) 2010-02-12 2014-07-15 Covidien Lp Expandable thoracic access port
US8579810B2 (en) * 2010-02-12 2013-11-12 Covidien Lp Expandable thoracic access port
US8540628B2 (en) 2010-02-12 2013-09-24 Covidien Lp Expandable thoracic access port
US8758221B2 (en) * 2010-02-24 2014-06-24 Apollo Endosurgery, Inc. Source reservoir with potential energy for remotely adjustable gastric banding system
US8840541B2 (en) 2010-02-25 2014-09-23 Apollo Endosurgery, Inc. Pressure sensing gastric banding system
US9017252B2 (en) 2010-04-12 2015-04-28 Covidien Lp Access assembly with flexible cannulas
US20110251463A1 (en) * 2010-04-12 2011-10-13 Tyco Healthcare Group Lp Bariatric foam port
WO2011130388A1 (en) 2010-04-14 2011-10-20 Surti Vihar C System for creating anastomoses
US8728162B2 (en) 2010-04-15 2014-05-20 Osteomed, Llc Direct lateral spine system instruments, implants and associated methods
US9028394B2 (en) 2010-04-29 2015-05-12 Apollo Endosurgery, Inc. Self-adjusting mechanical gastric band
US20110270024A1 (en) 2010-04-29 2011-11-03 Allergan, Inc. Self-adjusting gastric band having various compliant components
US9044298B2 (en) 2010-04-29 2015-06-02 Apollo Endosurgery, Inc. Self-adjusting gastric band
US20110270025A1 (en) 2010-04-30 2011-11-03 Allergan, Inc. Remotely powered remotely adjustable gastric band system
US8517915B2 (en) 2010-06-10 2013-08-27 Allergan, Inc. Remotely adjustable gastric banding system
US8961408B2 (en) 2010-08-12 2015-02-24 Covidien Lp Expandable surgical access port
US8864658B2 (en) 2010-08-12 2014-10-21 Covidien Lp Expandable surgical access port
US9247955B2 (en) 2010-08-12 2016-02-02 Covidien Lp Thoracic access port
US8597180B2 (en) 2010-08-12 2013-12-03 Covidien Lp Expandable thoracic access port
US20120059216A1 (en) 2010-09-07 2012-03-08 Allergan, Inc. Remotely adjustable gastric banding system
US10258368B2 (en) 2010-09-14 2019-04-16 Suremka, Llc Retractable cannula for surgical procedures
US8298185B2 (en) * 2010-09-14 2012-10-30 Suremka Medical, Llc Retractable cannula for surgical procedures
US9289115B2 (en) 2010-10-01 2016-03-22 Applied Medical Resources Corporation Natural orifice surgery system
EP2621348B1 (en) 2010-10-01 2019-06-12 Applied Medical Resources Corporation Natural orifice surgery system
US8961393B2 (en) 2010-11-15 2015-02-24 Apollo Endosurgery, Inc. Gastric band devices and drive systems
US9022926B2 (en) 2010-11-23 2015-05-05 Covidien Lp Reinforced flexible access assembly
US8641610B2 (en) 2010-12-20 2014-02-04 Covidien Lp Access assembly with translating lumens
US8550992B2 (en) 2010-12-20 2013-10-08 Covidien Lp Two-part access assembly
US20120157782A1 (en) 2010-12-20 2012-06-21 Francesco Alfieri Hand access device
US8602983B2 (en) 2010-12-20 2013-12-10 Covidien Lp Access assembly having undercut structure
US8696557B2 (en) 2010-12-21 2014-04-15 Covidien Lp Access assembly including inflatable seal member
FR2970412B1 (en) * 2011-01-18 2013-12-20 France Chirurgie Instr SELF-LOCKING CANNULA
GB201100902D0 (en) * 2011-01-19 2011-03-02 Univ Dundee A surgical guide and tissue anchor
US8753267B2 (en) 2011-01-24 2014-06-17 Covidien Lp Access assembly insertion device
US20120209078A1 (en) * 2011-02-15 2012-08-16 Tyco Healthcare Group Lp Compliance access device including proximal adhesive patch
WO2012122263A2 (en) 2011-03-08 2012-09-13 Surgiquest, Inc. Trocar assembly with pneumatic sealing
US9119665B2 (en) 2011-03-21 2015-09-01 Covidien Lp Thoracic access port including foldable anchor
US9259240B2 (en) 2011-03-29 2016-02-16 Covidien Lp Articulating surgical access system for laparoscopic surgery
KR102423785B1 (en) 2011-05-10 2022-07-21 어플라이드 메디컬 리소시스 코포레이션 Wound retractor
US9345532B2 (en) 2011-05-13 2016-05-24 Broncus Medical Inc. Methods and devices for ablation of tissue
US8709034B2 (en) 2011-05-13 2014-04-29 Broncus Medical Inc. Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US9039610B2 (en) 2011-05-19 2015-05-26 Covidien Lp Thoracic access port
US9161807B2 (en) 2011-05-23 2015-10-20 Covidien Lp Apparatus for performing an electrosurgical procedure
US10314594B2 (en) 2012-12-14 2019-06-11 Corquest Medical, Inc. Assembly and method for left atrial appendage occlusion
US10813630B2 (en) 2011-08-09 2020-10-27 Corquest Medical, Inc. Closure system for atrial wall
US20130041395A1 (en) * 2011-08-09 2013-02-14 Didier De Canniere Introductory assembly and method for inserting intracardiac instruments
US10307167B2 (en) 2012-12-14 2019-06-04 Corquest Medical, Inc. Assembly and method for left atrial appendage occlusion
US8821527B2 (en) * 2011-09-07 2014-09-02 Circulite, Inc. Cannula tips, tissue attachment rings, and methods of delivering and using the same
ES2536951T3 (en) 2011-11-02 2015-06-01 Ami Agency For Medical Innovations Gmbh Medical device for the introduction of endoscopic instruments into a body cavity
DE102011055129A1 (en) * 2011-11-08 2013-05-08 Aesculap Ag Surgical Access Device and Surgical Access System
WO2013078235A1 (en) 2011-11-23 2013-05-30 Broncus Medical Inc Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
CA2797624A1 (en) 2011-12-07 2013-06-07 Covidien Lp Thoracic access assembly
US8876694B2 (en) 2011-12-07 2014-11-04 Apollo Endosurgery, Inc. Tube connector with a guiding tip
US8961394B2 (en) 2011-12-20 2015-02-24 Apollo Endosurgery, Inc. Self-sealing fluid joint for use with a gastric band
US20130178708A1 (en) * 2012-01-09 2013-07-11 Covidien Lp Articulating Method Including A Pre-Bent Tube
US9463007B2 (en) * 2012-02-23 2016-10-11 Covidien Lp Adjustable height port including retention elements
US9271639B2 (en) 2012-02-29 2016-03-01 Covidien Lp Surgical introducer and access port assembly
US20150150593A1 (en) * 2012-06-14 2015-06-04 KONINKLIJKE PHILIPS N.V. a corporation Nested cannula device for lung collapse
EP2695581B1 (en) 2012-08-07 2019-03-13 Critical Innovations, LLC Device for simultaneously documenting and treating tension pneumothorax and/or hemothorax
US10646690B2 (en) * 2012-11-20 2020-05-12 University Of Massachusetts Flexible surgical sheath and multi-part insertion cannula
US20140142689A1 (en) 2012-11-21 2014-05-22 Didier De Canniere Device and method of treating heart valve malfunction
US9968348B2 (en) 2013-02-25 2018-05-15 DePuy Synthes Products, Inc. Surgical access tube
US9675379B2 (en) 2013-03-08 2017-06-13 Cannuflow, Inc. Arthroscopic flexible portal cannula device and delivery system
AU2014228334B2 (en) 2013-03-15 2018-11-29 Applied Medical Resources Corporation Mechanical gel surgical access device
US9694164B2 (en) * 2013-04-25 2017-07-04 David A. Hill Medical instrument for inserting a chest drainage tube
EP2999419B1 (en) 2013-05-22 2020-12-23 Covidien LP Apparatus for controlling surgical instruments using a port assembly
US9414830B2 (en) * 2013-06-14 2016-08-16 Covidien Lp Surgical access assembly including adhesive members for secure attachment to skin surfaces
US9808231B2 (en) 2013-07-09 2017-11-07 Edwards Lifesciences Corporation Tissue retractor
AU2014306232B2 (en) * 2013-08-05 2018-12-06 Cook Medical Technologies Llc Medical devices having a releasable tubular member and methods of using the same
US9408631B2 (en) * 2013-09-27 2016-08-09 Depuy Mitek, Llc Flexible cannula and obturator
US9566443B2 (en) 2013-11-26 2017-02-14 Corquest Medical, Inc. System for treating heart valve malfunction including mitral regurgitation
US10046147B2 (en) 2013-12-26 2018-08-14 Critical Innovations, LLC Percutaneous access pathway system and method
CN104906682A (en) 2014-01-24 2015-09-16 史蒂文·沙勒布瓦 Articulating balloon catheter and method for using the same
US9974563B2 (en) 2014-05-28 2018-05-22 Cook Medical Technologies Llc Medical devices having a releasable member and methods of using the same
EP3154459B1 (en) * 2014-06-10 2020-10-14 Suremka, Llc Retractable cannula device
US10064649B2 (en) 2014-07-07 2018-09-04 Covidien Lp Pleated seal for surgical hand or instrument access
US9642608B2 (en) 2014-07-18 2017-05-09 Applied Medical Resources Corporation Gels having permanent tack free coatings and method of manufacture
EP3177219B1 (en) 2014-08-04 2018-09-26 Cook Medical Technologies LLC Medical devices having a releasable tubular member
KR102509415B1 (en) 2014-08-15 2023-03-10 어플라이드 메디컬 리소시스 코포레이션 Natural orifice surgery system
US9636505B2 (en) 2014-11-24 2017-05-02 AtaCor Medical, Inc. Cardiac pacing sensing and control
CA2959177C (en) 2014-09-04 2023-10-10 AtaCor Medical, Inc. Cardiac pacing lead delivery system
US10743960B2 (en) 2014-09-04 2020-08-18 AtaCor Medical, Inc. Cardiac arrhythmia treatment devices and delivery
US10328268B2 (en) 2014-09-04 2019-06-25 AtaCor Medical, Inc. Cardiac pacing
US10226254B2 (en) * 2014-10-21 2019-03-12 Covidien Lp Adapter, extension, and connector assemblies for surgical devices
US9707011B2 (en) 2014-11-12 2017-07-18 Covidien Lp Attachments for use with a surgical access device
US11097109B2 (en) 2014-11-24 2021-08-24 AtaCor Medical, Inc. Cardiac pacing sensing and control
US9949730B2 (en) 2014-11-25 2018-04-24 Applied Medical Resources Corporation Circumferential wound retraction with support and guidance structures
US10842626B2 (en) 2014-12-09 2020-11-24 Didier De Canniere Intracardiac device to correct mitral regurgitation
US9808282B2 (en) * 2015-06-04 2017-11-07 Medos International Sarl Surgical cannula system and method of use
EP3310279A4 (en) * 2015-06-21 2019-02-27 Thoraxs Israel 17 Ltd. Pneumothorax device
US10117675B2 (en) * 2015-07-28 2018-11-06 Covidien Lp Trocar tip protector
EP4151165A1 (en) 2015-09-15 2023-03-22 Applied Medical Resources Corporation Surgical robotic access system
ES2951168T3 (en) 2015-10-07 2023-10-18 Applied Med Resources Multi-segment outer ring wound retractor
DE102016101462B4 (en) * 2016-01-27 2019-01-17 Karl Storz Se & Co. Kg Trocar sleeve, trocar system and method for producing a trocar sleeve
EP3471594A4 (en) * 2016-06-18 2019-11-13 Arthroscopic Innovations, LLC Surgical devices and methods
DE102016009848A1 (en) 2016-08-16 2018-02-22 Mecus GmbH Medical device for circumscribed fixation, cleaning and / or germ reduction of a tissue structure
EP3503814A1 (en) 2016-08-23 2019-07-03 Stryker European Holdings I, LLC Instrumentation for the implantation of spinal implants
JP7021200B2 (en) 2016-09-12 2022-02-16 アプライド メディカル リソーシーズ コーポレイション Surgical robot access system
US10987128B2 (en) 2017-03-22 2021-04-27 Covidien Lp Cannula assembly
USD863836S1 (en) * 2017-04-17 2019-10-22 Okamura Corporation Storage furniture
US11160682B2 (en) 2017-06-19 2021-11-02 Covidien Lp Method and apparatus for accessing matter disposed within an internal body vessel
US10828065B2 (en) 2017-08-28 2020-11-10 Covidien Lp Surgical access system
US10675056B2 (en) 2017-09-07 2020-06-09 Covidien Lp Access apparatus with integrated fluid connector and control valve
US10814119B2 (en) 2017-09-22 2020-10-27 Critical Innovations, LLC Percutaneous access pathway system
JP7237953B2 (en) * 2017-10-12 2023-03-13 クリストフ ミートケ ゲゼルシャフト ミット ベシュレンクテル ハフツング ウント コンパニー コマンディトゲゼルシャフト pericardial grasper
EP3723638B1 (en) * 2017-12-13 2021-11-17 CONMED Corporation Hip access portal saver
WO2019147756A1 (en) 2018-01-26 2019-08-01 Maine Medical Center Angled surgical trocars
US11172957B2 (en) * 2018-02-07 2021-11-16 Stryker Corporation Surgical cannula and methods of use
EP3545857B1 (en) 2018-03-30 2024-01-03 Stryker European Operations Holdings LLC Lateral access retractor and core insertion
US11039856B2 (en) 2018-05-10 2021-06-22 Verily Life Sciences Llc Surgical laparoscopic ports for implanting medical systems
US11389193B2 (en) 2018-10-02 2022-07-19 Covidien Lp Surgical access device with fascial closure system
US11457949B2 (en) 2018-10-12 2022-10-04 Covidien Lp Surgical access device and seal guard for use therewith
US11166748B2 (en) 2019-02-11 2021-11-09 Covidien Lp Seal assemblies for surgical access assemblies
US10792071B2 (en) 2019-02-11 2020-10-06 Covidien Lp Seals for surgical access assemblies
US11000313B2 (en) 2019-04-25 2021-05-11 Covidien Lp Seals for surgical access devices
US11413068B2 (en) 2019-05-09 2022-08-16 Covidien Lp Seal assemblies for surgical access assemblies
WO2020243534A1 (en) 2019-05-29 2020-12-03 AtaCor Medical, Inc. Implantable electrical leads and associated delivery systems
US11357542B2 (en) 2019-06-21 2022-06-14 Covidien Lp Valve assembly and retainer for surgical access assembly
US11259840B2 (en) 2019-06-21 2022-03-01 Covidien Lp Valve assemblies for surgical access assemblies
US11259841B2 (en) 2019-06-21 2022-03-01 Covidien Lp Seal assemblies for surgical access assemblies
US11413065B2 (en) 2019-06-28 2022-08-16 Covidien Lp Seal assemblies for surgical access assemblies
US11730468B2 (en) 2019-07-08 2023-08-22 Cannuflow, Inc. Arthroscopic cannula and suture management system
US11399865B2 (en) 2019-08-02 2022-08-02 Covidien Lp Seal assemblies for surgical access assemblies
US11432843B2 (en) 2019-09-09 2022-09-06 Covidien Lp Centering mechanisms for a surgical access assembly
US11523842B2 (en) 2019-09-09 2022-12-13 Covidien Lp Reusable surgical port with disposable seal assembly
EP4031030A1 (en) * 2019-09-16 2022-07-27 Bard Peripheral Vascular, Inc. Implant and system to facilitate access across pleura layers
USD945203S1 (en) * 2019-09-16 2022-03-08 Beijing Xiaomi Mobile Software Co., Ltd. Water collection box for water dispenser
US11812991B2 (en) 2019-10-18 2023-11-14 Covidien Lp Seal assemblies for surgical access assemblies
US11564674B2 (en) 2019-11-27 2023-01-31 K2M, Inc. Lateral access system and method of use
US11141191B2 (en) 2020-01-15 2021-10-12 Covidien Lp Surgical access assembly
US11464540B2 (en) 2020-01-17 2022-10-11 Covidien Lp Surgical access device with fixation mechanism
US11576701B2 (en) 2020-03-05 2023-02-14 Covidien Lp Surgical access assembly having a pump
US11642153B2 (en) 2020-03-19 2023-05-09 Covidien Lp Instrument seal for surgical access assembly
US11541218B2 (en) 2020-03-20 2023-01-03 Covidien Lp Seal assembly for a surgical access assembly and method of manufacturing the same
US11446058B2 (en) 2020-03-27 2022-09-20 Covidien Lp Fixture device for folding a seal member
US11717321B2 (en) 2020-04-24 2023-08-08 Covidien Lp Access assembly with retention mechanism
US11529170B2 (en) 2020-04-29 2022-12-20 Covidien Lp Expandable surgical access port
US11622790B2 (en) 2020-05-21 2023-04-11 Covidien Lp Obturators for surgical access assemblies and methods of assembly thereof
US11666771B2 (en) 2020-05-29 2023-06-06 AtaCor Medical, Inc. Implantable electrical leads and associated delivery systems
US11751908B2 (en) 2020-06-19 2023-09-12 Covidien Lp Seal assembly for surgical access assemblies
WO2023018558A1 (en) * 2021-08-11 2023-02-16 Maruho Medical Cannula and obturator system for minimally invasive surgery

Family Cites Families (43)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE214727C (en) *
FR743519A (en) * 1933-04-01
US1074077A (en) * 1910-01-14 1913-09-23 Michael W Wismer Reinforcement for collar-buttonholes.
CH70697A (en) * 1915-02-10 1916-03-01 Finck & Co H Surgical extraction forceps
US1274669A (en) * 1918-01-14 1918-08-06 Frank Bohn Surgical instrument.
US3667474A (en) * 1970-01-05 1972-06-06 Konstantin Vasilievich Lapkin Dilator for performing mitral and tricuspidal commissurotomy per atrium cordis
US3856021A (en) * 1973-10-01 1974-12-24 A Mcintosh Device for treatment of bloat of ruminants
US4452244A (en) * 1980-01-24 1984-06-05 Thomas J. Fogarty Endarterectomy roller
DE3017065A1 (en) * 1980-05-03 1981-11-26 Walter Dr. 4000 Düsseldorf Messingschlager Drainage tube for opening from nasal cavity to sinus - has flexible flap or disc to hold it in place
US4423740A (en) * 1981-03-30 1984-01-03 Howmedica, Inc. Slit catheter method for measuring interstitial pressure
US4535773A (en) * 1982-03-26 1985-08-20 Inbae Yoon Safety puncturing instrument and method
US4545374A (en) * 1982-09-03 1985-10-08 Jacobson Robert E Method and instruments for performing a percutaneous lumbar diskectomy
US4601710B1 (en) * 1983-08-24 1998-05-05 United States Surgical Corp Trocar assembly
US4645492A (en) * 1983-10-11 1987-02-24 Medical Engineering Corporation Catheter anchoring device
US4655752A (en) * 1983-10-24 1987-04-07 Acufex Microsurgical, Inc. Surgical cannula
NZ207341A (en) * 1984-03-01 1988-02-29 Harvey Alex Ind Ltd Device containing chemical impregnants for insertion into a body cavity of an animal
CA1245931A (en) * 1984-09-21 1988-12-06 Sophia Pesotchinsky Positionable tissue interfacing device for the management of percutaneous conduits
US4631051A (en) * 1984-09-24 1986-12-23 Cordis Corporation Ventricular amniotic shunt and introducer system
GB8424436D0 (en) * 1984-09-27 1984-10-31 Pratt Int Ltd Burnerd Surgical appliance
US4669470A (en) * 1985-11-20 1987-06-02 Brandfield Robert T Surgical forceps/scissors
US4955890A (en) * 1986-01-16 1990-09-11 Vitaphore Corporation Surgical skin incision device, percutaneous infection control kit and methods of use
US4654030A (en) * 1986-02-24 1987-03-31 Endotherapeutics Trocar
US5030206A (en) * 1986-10-17 1991-07-09 United States Surgical Corporation Trocar
US4889112A (en) * 1987-01-23 1989-12-26 Waltap Ltd. Apparatus for performing a tracheostomy operation
US4931042A (en) * 1987-10-26 1990-06-05 Endotherapeutics Trocar assembly with improved latch
US4874378A (en) * 1988-06-01 1989-10-17 Cordis Corporation Catheter sheath introducer
GB8816033D0 (en) * 1988-07-06 1988-08-10 Ethicon Inc Improved safety trocar
SU1618397A1 (en) * 1988-07-18 1991-01-07 Киевский государственный институт усовершенствования врачей Trochar
US4978334A (en) * 1988-09-08 1990-12-18 Toye Frederic J Apparatus and method for providing passage into body viscus
US4950257A (en) * 1988-09-15 1990-08-21 Mallinckrodt, Inc. Catheter introducer with flexible tip
US5009643A (en) * 1989-08-09 1991-04-23 Richard Wolf Medical Instruments Corp. Self-retaining electrically insulative trocar sleeve and trocar
US5014407A (en) * 1989-09-28 1991-05-14 Boughten Larry R Tube expanding device
US5281204A (en) * 1989-12-26 1994-01-25 Nissho Corporation Device for forming an inserting hole and method of using and making the same
US5078689A (en) * 1990-05-14 1992-01-07 Keller Alan M Device for removing body fluids
US5234447A (en) * 1990-08-28 1993-08-10 Robert L. Kaster Side-to-end vascular anastomotic staple apparatus
US5073169A (en) * 1990-10-02 1991-12-17 Steve Raiken Trocar support
CA2052310A1 (en) * 1990-10-09 1992-04-10 Thomas L. Foster Surgical access sheath
US5226426A (en) * 1990-12-18 1993-07-13 Inbae Yoon Safety penetrating instrument
US5176649A (en) * 1991-01-28 1993-01-05 Akio Wakabayashi Insertion device for use with curved, rigid endoscopic instruments and the like
US5169387A (en) * 1991-04-03 1992-12-08 Kronner Richard F Method and apparatus for catheterization of a body cavity
US5217007A (en) * 1991-04-26 1993-06-08 Cook Incorporated Speculum for forming an ostomy in a trachea
US5235966A (en) * 1991-10-17 1993-08-17 Jay Jamner Endoscopic retractor
US5176648A (en) * 1991-12-13 1993-01-05 Unisurge, Inc. Introducer assembly and instrument for use therewith

Also Published As

Publication number Publication date
US5830191A (en) 1998-11-03
US5490843A (en) 1996-02-13
AU664755B2 (en) 1995-11-30
GR930100244A (en) 1994-02-28
AU4136193A (en) 1994-01-06
US5391156A (en) 1995-02-21
ATE185958T1 (en) 1999-11-15
EP0577400B1 (en) 1999-10-27
JPH07275252A (en) 1995-10-24
EP0577400A1 (en) 1994-01-05
ES2139628T3 (en) 2000-02-16
DE69326860D1 (en) 1999-12-02
DE69326860T2 (en) 2000-04-20
US5562677A (en) 1996-10-08

Similar Documents

Publication Publication Date Title
US5391156A (en) Flexible encoscopic surgical port
US6056766A (en) Stabilized trocar, and method of using same
US7674273B2 (en) Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US7985218B2 (en) Structure for receiving surgical instruments
JP4276536B2 (en) Trocar with minimal insertion force
US5176128A (en) Organ retractor
US5741286A (en) Laparoscopic instrument kit including a plurality of rigid tubes
EP1175179B1 (en) A surgical forceps
JP4960346B2 (en) Surgical retractor
US5626597A (en) Percutaneous introducer
US5716369A (en) Apparatus facilitating suturing in laparoscopic surgery
US5397335A (en) Trocar assembly with improved adapter seals
EP0786234B1 (en) Thoracic port
US20010049498A1 (en) Sugical tool for use in expanding a cannula
US6358198B1 (en) Laparoscopic/thorascopic support device
US20070016223A1 (en) Apparatus and methods for shielding body structures during surgery
EP2535010B1 (en) Thoracic access port

Legal Events

Date Code Title Description
FZDE Discontinued